The role of brain perfusion SPECT in the diagnosis of frontotemporal dementia: A systematic review.

BACKGROUND AND PURPOSE: Frontotemporal dementia (FTD) is the second most common cause of presenile dementia. The clinical distinction between FTD, Alzheimer's disease (AD), and other dementias is a clinical challenge. Brain perfusion SPECT may contribute to the diagnosis of FTD, but its value is unclear. METHODS: We performed a systematic review to investigate the diagnostic accuracy of the brain SPECT in (1) distinguishing FTD from AD and other dementias and (2) differentiating FTD variants. RESULTS: Overall, 391 studies were retrieved on the initial search and 35 studies composed the final selection, comprising a total number of 3142 participants of which 1029 had FTD. The sensitivity and the specificity for the differential diagnosis of FTD versus AD ranged from 56% to 88% and from 51% to 93%, respectively. SPECT is not superior to the clinical method of diagnosis, but the combination of SPECT with clinical data seems to improve the diagnostic accuracy. CONCLUSION: Brain perfusion SPECT has a limited value in the diagnostic framework of FTD. SPECT can be performed when FDG-PET is not available. SPECT is recommended only for selected cases when the diagnosis is challenging using conventional methods.

Fatores que predispõem o uso inadequado de insulinas em diabéticos em uma unidade de saúde no município de Jaguaruana-Ceará / Factors that predispose to the inappropriate use of insulin in diabetics in a health unit in the city of Jaguaruana- Ceará / Factores que predisponen al uso inadecuado de insulina en diabéticos de una unidad de salud de la ciudad de Jaguaruana-Ceará

Introdução: O diabetes mellitus é um distúrbio metabólico crônico que afeta grande parcela da população mundial, no Brasil o número de diabéticos vem crescendo significativamente com o passar dos anos. A qualidade de vida destes pacientes está intimamente relacionada ao tratamento adequado que pode reduzir as complicações decorrentes da doença. O estudo teve como objetivo identificar dificuldades no uso de insulinas em pacientes da unidade de saúde do município de Jaguaruana-CE que possam estar relacionados a falhas no tratamento. Métodos: Tratou-se de uma análise do tipo descritivo, transversal e observacional com uma abordagem quantitativa, o questionário foi aplicado aos pacientes no momento da consulta na Unidade Básica de Saúde (UBS). A pesquisa ocorreu entre os meses de setembro a outubro de 2022 com mulheres e homens insulinodependentes acima de 18 anos. Resultados: Os dados mostraram maior prevalência de mulheres, 20 (67%), a maior faixa etária foi acima de 40 anos, 19 (63%) e a renda familiar prevaleceu de 1 à 2 salários mínimos, 14 (47%). O profissional de prestou maior orientação quanto ao uso da insulina foi o enfermeiro, citado por 12 (40%) pacientes, 20 (67%) relataram armazenar a insulina na porta da geladeira, 22 (74%) relataram desconhecer o motivo das aplicações dolorosas e 9 (30%) confirmam perder ou pular uma das aplicações diárias. Conclusão: Nota-se, portanto, a necessidade da atuação do farmacêutico na saúde da família, na avaliação e orientação quanto ao uso correto das insulinas, garantindo assim o uso racional e com maior eficácia.

Introduction: Diabetes mellitus is a chronic metabolic disorder that affects a large portion of the world population. In Brazil, the number of diabetics has been growing significantly over the years. The quality of life of these patients is closely related to adequate treatment that can reduce the complications arising from the disease. This study aimed to identify difficulties in the use of insulin in patients at the health care facility in the city of Jaguaruana-CE that may be related to treatment failure. Methods: This was a descriptive, cross-sectional and observational analysis with a quantitative approach, the questionnaire was applied to patients at the time of consultation in the Basic Health Unit (BHU). The research occurred between the months of September to October 2022 with insulin-dependent women and men over 18 years. Results: The data showed higher prevalence of women, 20 (67%), the highest age group was above 40 years, 19 (63%) and family income prevailed from 1 to 2 minimum wages, 14 (47%). The professional who provided the most orientation regarding insulin use was the nurse, mentioned by 12 (40%) patients, 20 (67%) reported storing insulin in the refrigerator door, 22 (74%) reported not knowing the reason for the painful applications, and 9 (30%) confirmed missing or skipping one of the daily applications. Conclusion: Therefore, it is noted the need for the role of the pharmacist in family health, in the evaluation and guidance on the correct use of insulin, thus ensuring the rational use and with greater efficacy.

Introducción: La diabetes mellitus es un trastorno metabólico crónico que afecta a gran parte de la población mundial, en Brasil el número de diabéticos viene creciendo significativamente a lo largo de los años. A qualidade de vida destes pacientes está estreitamente relacionada com um tratamento adequado que permita reduzir as complicações decorrentes da doença. O estudo teve como objetivo identificar dificuldades no uso de insulinas em pacientes da unidade de saúde do município de Jaguaruana-CE que possam estar relacionadas a falhas no tratamento. Método: Se trató de un análisis descriptivo, transversal y observacional con abordaje cuantitativo, el cuestionario fue aplicado a los pacientes en el momento de la consulta en la Unidad Básica de Salud (UBS). La investigación ocurrió entre los meses de septiembre a octubre de 2022 con mujeres y hombres insulinodependientes mayores de 18 años. Resultados: Los datos mostraron mayor prevalencia de mujeres, 20 (67%), el grupo de mayor edad fue superior a 40 años, 19 (63%) y la renta familiar prevaleció de 1 a 2 salarios mínimos, 14 (47%). El profesional que más orientó sobre el uso de la insulina fue la enfermera, mencionada por 12 (40%) pacientes, 20 (67%) relataron haber guardado la insulina en la puerta del refrigerador, 22 (74%) relataron no saber el motivo de las aplicaciones dolorosas y 9 (30%) confirmaron haber omitido o saltado una de las aplicaciones diarias. Conclusión: Se constata, por lo tanto, la necesidad del papel del farmacéutico en la salud familiar, en la evaluación y orientación en cuanto al uso correcto de las insulinas, garantizando así el uso racional y con mayor eficacia.

Marco Legal de Transparência na Política Estadual de Regulação do Sistema Único de Saúde ­ SUS, como Ferramenta de Otimização no Complexo Regulador do Escritório Regional de Peixoto de Azevedo / Legal Framework for Transparency in the State Regulatory Policy of the Unified Health System ­ SUS, as an Optimization Tool in the Regulatory Complex of the Peixoto de Azevedo Regional Office

Introdução: A transparência na Política Estadual de Regulação do Sistema Único de Saúde tem como marco legal o Decreto Estadual -MT, n° 670/2020, garantir acesso público de informações quanto à regulação do acesso e à taxa de ocupação hospitalar nas unidades hospitalares e UTIs credenciadas no Estado, bem como monitorar e organizar os pedidos de regulação ambulatorial e hospitalar solicitados pelos municípios, cujo serviços e atividades médicas são competências do Estado. Fragilidades recorrentes na regulação do acesso no atendimento do Hospital Regional de Peixoto de Azevedo, que é referência da região de Saúde do Vale do Peixoto, cuja missão é garantir a implantação/implementação das diretrizes do SUS.O projeto propõe minimizar possíveis fragilidades encontradas no processo regulação/agendamento de consultas/exames/procedimentos, utilizando-se como ferramenta principal o SISREG III. Objetivo:Estabelecer no âmbito do HRPAZ um mecanismo de melhorias na compreensão dos processos de transparência presentes na Política Estadual de Regulação do Sistema Único de Saúde.Metodologia: A metodologia utilizada na elaboração do projeto foi sistematizada em três principais eixos: 1. Identificação da oportunidade e relevância do tema; 2. Elaboração do diagnóstico utilizando a matriz 5W3H; 3. Análise e revisão de literatura com análise de artigos. Resultados:Na análise, torna-se necessário a adesão completa para garantir e melhorar a transparência nas atividades do setor de Regulação do ERS/PAZ, tendo a fragilidade e insegurança profissional como uma das principais causas a serem corrigidas. Conclusão. Os fatores limitantes da regulação demonstram que ferramentado projeto trouxe avanços quanto à integração da equipe, controle avaliação/regulação e divulgação da legislação, contudo, a problemática persiste e deverá ser um processo contínuo e sistemático na construção da resolutividade do acesso.

Marco legal de transparência na política estadual de regulação do sistema único de saúde - SUS, como ferramenta de otimização no complexo regulador do escritório regional de Peixoto de Azevedo / Legal framework for transparency in the state regulation policy of the single health system - SUS, as an optimization tool in the regulatory complex of the regional office of Peixoto de Azevedo

A transparência na Política Estadual de Regulação do Sistema Único de Saúde tem como marco legal o Decreto Estadual -MT, n° 670/2020, garantir acesso público de informações quanto à regulação do acesso e à taxa de ocupação hospitalar nas unidades hospitalares e UTIs credenciadas no Estado, bem como monitorar e organizar os pedidos de regulação ambulatorial e hospitalar solicitados pelos municípios, cujo serviços e atividades médicas são competências doEstado. Fragilidades recorrentes na regulação do acesso no atendimento do Hospital Regional de Peixoto de Azevedo, que é referência da região de Saúde do Vale do Peixoto, cuja missão é garantir a implantação/implementação das diretrizes do SUS.O projeto propõe minimizar possíveis fragilidades encontradas no processo regulação/agendamento de consultas/exames/procedimentos, utilizando-se como ferramenta principal o SISREG III. Objetivo:Estabelecer no âmbito do HRPAZ um mecanismo de melhorias na compreensão dos processos de transparência presentes na Política Estadual de Regulação do Sistema Único de Saúde.Metodologia: A metodologia utilizada na elaboração do projeto foi sistematizada em três principais eixos: 1. Identificação da oportunidade e relevância do tema; 2. Elaboração do diagnóstico utilizando a matriz 5W3H; 3. Análise e revisão de literatura com análise de artigos. Resultados:Na análise, torna-se necessário a adesão completa para garantir e melhorar a transparência nas atividades do setor de Regulação do ERS/PAZ, tendo a fragilidade e insegurança profissional como uma das principais causas a serem corrigidas. Conclusão. Os fatores limitantes da regulação demonstram que ferramentado projeto trouxe avanços quanto à integração da equipe, controle avaliação/regulação e divulgação da legislação, contudo, a problemática persiste e deverá ser um processo contínuo e sistemático na construção da resolutividade do acesso

Criopreservação do sêmen suíno: desafios a serem superados que auxiliam a identificação de espermatozoides mais férteis / Boar semen cryopreservation: challenges to be overcome that help the identification of more fertile spermatozoa

A criopreservação é o melhor método de armazenamento de sêmen por período indeterminado, conferindo alta flexibilidade de uso. Além disso, é o principal meio para formação de banco de germoplasma. No entanto, congelar sêmen suíno ainda é um desafio a ser enfrentado. Isso porquê, além das características de membrana espermática que ocasionam maiores efeitos deletérios às células durante os processos de congelação e descongelação, ainda é preciso lidar com a grande variabilidade de resultados, seja entre indivíduos, ejaculados de um mesmo indivíduo ou ainda, frações de um mesmo ejaculado. Frente a isso, diferentes estratégias têm sido investigadas a fim de obter melhores resultados e assim, aumentar a aplicabilidade do sêmen congelado suíno a nível comercial. Além disso, acreditamos que haja a possibilidade de se relacionar a capacidade de criotolerância de um determinado espermatozoide a sua maior ou menor capacidade de fertilizar o oócito.(AU)

Cryopreservation is the best method of storing semen indefinitely, providing high flexibility of use. In addition, it is the primary means for forming a germplasm bank. However, freezing boar semen is still a challenge to be faced because, in addition to the characteristics of the spermatic membrane that cause deleterious effects to the cells during the freezing and thawing processes, it is still necessary to deal with the significant variability of results, whether between individuals, ejaculates from the same individual or even fractions of an even ejaculated. Because of this, different strategies have been investigated to obtain better results and thus increase the applicability of frozen boar semen at a commercial level. Furthermore, we believe it is possible to relate the cryotolerance capacity of a given sperm to its greater or lesser capacity to fertilize the oocyte.(AU)

Importância do plasma seminal na qualidade e preservação do espermatozoide suíno / Importance of seminal plasma in the quality and preservation of boar sperm

Ao preservar o espermatozoide suíno no estado líquido ou criopreservado, os componentes do plasma seminal (PS) contidos nos ejaculados podem alterar a capacidade de fertilização desses gametas. O PS contém substâncias essenciais para a manutenção da viabilidade e fertilidade dos espermatozoides. No entanto, esses componentes podem ser deletérios dependendo da quantidade ou duração do tempo de contato entre a ejaculação e a remoção do PS durante o processamento do sêmen para a conservação na forma refrigerada ou congelada. Foram identificadas substâncias que prejudicam (principal proteína plasmática seminal PSPI) ou melhoram (espermadesina PSP-I) a capacidade de fertilização dos espermatozoides. Dependendo dos cachaços e dos procedimentos de colheita de sêmen, a remoção do PS pode ser benéfica antes da preservação no estado líquido ou criopreservado. Em alguns casos, o PS removido antes da congelação pode ser adicionado de volta ao diluente de descongelamento, com efeitos positivos no sêmen descongelado e na viabilidade do espermatozoide no trato reprodutivo da porca. Neste texto, há um foco nos diferentes efeitos de PS em amostras de sêmen refrigerado e criopreservado de suínos com ênfase em como PS modula a função e morfologia das células espermáticas antes, durante e após a preservação de forma refrigerada ou criopreservada.(AU)

When preserving sperm in the liquid or cryopreserved state, seminal plasma (SP) components within ejaculates can alter fertilizing capacity of these gametes. The SP contains substances essential for maintenance of sperm viability and fertility; however, these components can be deleterious depending on quantity, or duration of time before there is removal of SP from sperm in semen processing. Substances that impair (Major seminal plasma protein PSPI - boar) or improve (e.g., spermadhesin PSP-I - boar) sper- matozoa fertilizing capacity have been identified. Depending on individual males and semen collection procedures, SP removal may be beneficial before preservation in the liquid or cryopreserved state. In some cases, SP that is removed can be added back to thawing extender with there being positive effects in thawed sperm and for sperm viability in the female reproductive tract. In this review article, there is a focus on different effects of SP in samples of cooled and cryopreserved semen from boar with there being emphasis on how SP modulates the function and morphology of sperm cells before, during, and after preservation in the refrigerated or cryopreserved state.(AU)

Human endogenous retroviruses and the inflammatory response: A vicious circle associated with health and illness.

Human Endogenous Retroviruses (HERVs) are derived from ancient exogenous retroviral infections that have infected our ancestors' germline cells, underwent endogenization process, and were passed throughout the generations by retrotransposition and hereditary transmission. HERVs comprise 8% of the human genome and are critical for several physiological activities. Yet, HERVs reactivation is involved in pathological process as cancer and autoimmune diseases. In this review, we summarize the multiple aspects of HERVs' role within the human genome, as well as virological and molecular aspects, and their fusogenic property. We also discuss possibilities of how the HERVs are possibly transactivated and participate in modulating the inflammatory response in health conditions. An update on their role in several autoimmune, inflammatory, and aging-related diseases is also presented.

Transitional rehabilitation care and patient care continuity as an advanced nursing practice.

OBJECTIVE: To analyze the needs and facilitating and hindering elements related to transitional rehabilitation care. METHODS: Integrative literature review oriented toward answering the question "What nursing interventions guarantee transitional rehabilitation care to dependent adult or elderly people when they return home after hospitalization?". RESULTS: The patients did not participate much in the planning of hospital discharge and decision-making when they had to return home. Informal caretakers reported that professionals showed detachment during hospitalization and delayed guiding instructions. Health professionals mentioned lack of time to offer this care modality as a difficulty. FINAL CONSIDERATIONS: Ensuring training, follow-up, and coordination between care levels is essential. Care integration can reduce hospital stay and the impact of post-discharge complications. Transitional care contributes to a sustainable health system, higher care quality, and client satisfaction.

Vertical Jump Tests: A Safe Instrument to Improve the Accuracy of the Functional Capacity Assessment in Robust Older Women.

Age-related decreases in muscle function lead to disabilities and are associated with negative health outcomes in older people. Although several physical tests can be used to assess physical performance, muscle strength, and power, their interpretation can be hampered by the ceiling effect of some of them. The aim of this study was to assess whether vertical jump tests are safe in terms of physical integrity and whether they are useful in assessing physical performance in forty-one robust older women. The investigation entailed an assessment of anthropometric characteristics, physical functioning tests (Short Physical Performance Battery (SPPB), sit-to-up 5 times and sit-to-up 30 s, gait speed, time-up-to-go test (TUGT)), and tests evaluating muscle strength and power (handgrip, lower limb isokinetic tests, and vertical jumping tests). Significant negative correlations were found between vertical jumping tests and BMI, body fat percentage, sit-to-up 5 times and TUGT. In addition, significant positive correlations were observed between vertical jumping tests and SPPB, gait speed, handgrip, and concentric isokinetic tests of knee muscles. No adverse events in volunteers' physical integrity were reported during and after the performance of all physical tests. Thus, the study results showed that vertical jumping tests are safe and accurate for assessing physical performance and are useful for monitoring age-related loss of muscle performance in robust older women.

Transitional rehabilitation care and patient care continuity as an advanced nursing practice / Cuidado transicional de rehabilitación y continuidad de atención al paciente como práctica avanzada de enfermería / Cuidado transicional de reabilitação e continuidade da assistência ao paciente como prática avançada de enfermagem

ABSTRACT Objective: To analyze the needs and facilitating and hindering elements related to transitional rehabilitation care. Methods: Integrative literature review oriented toward answering the question "What nursing interventions guarantee transitional rehabilitation care to dependent adult or elderly people when they return home after hospitalization?". Results: The patients did not participate much in the planning of hospital discharge and decision-making when they had to return home. Informal caretakers reported that professionals showed detachment during hospitalization and delayed guiding instructions. Health professionals mentioned lack of time to offer this care modality as a difficulty. Final considerations: Ensuring training, follow-up, and coordination between care levels is essential. Care integration can reduce hospital stay and the impact of post-discharge complications. Transitional care contributes to a sustainable health system, higher care quality, and client satisfaction.

RESUMEN Objetivos: Analizar las necesidades, elementos facilitadores y dificultadores de cuidados transicionales de rehabilitación. Métodos: Revisión Integrativa de Literatura, respondiendo la pregunta: "¿Cuáles intervenciones de enfermería garantizan la continuidad de cuidados de rehabilitación al adulto/anciano dependiente en su regreso luego de una internación?". Resultados: Existe baja participación de la persona en la planificación de su alta y en la toma de decisiones al regresar a casa. Los cuidadores informales refieren distanciamiento de los profesionales durante la internación, y que la transmisión de enseñanzas es tardía. Los profesionales de salud alegan como dificultad la falta de tiempo del equipo para estos cuidados. Consideraciones Finales: Resulta esencial garantizar la formación, seguimiento y coordinación entre niveles de cuidados. La integración de cuidados puede reducir el tiempo de internación y las complicaciones postalta. El cuidado de transición favorece un sistema de salud sostenible, un aumento cualitativo del cuidado y la satisfacción de los pacientes.

RESUMO Objetivos: Analisar as necessidades, elementos facilitadores e dificultadores, de cuidados transicionais de reabilitação Métodos: Revisão integrativa da literatura para responder à questão "Quais as intervenções de enfermagem que garantem a continuidade dos cuidados de reabilitação à pessoa adulta/idosa dependente no regresso a casa, após hospitalização?". Resultados: Existe uma baixa participação da pessoa no seu planejamento da alta e na tomada de decisão no regresso a casa. Os cuidadores informais referem distanciamento dos profissionais durante a internação e que a realização de orientações é tardia. Os profissionais de saúde envolvidos apontam como dificuldade a falta de tempo da equipe para este cuidado. Considerações Finais: É fundamental garantir formação, acompanhamento e coordenação entre níveis de cuidados. A integração de cuidados pode reduzir o tempo de internação e as complicações pós-alta. O cuidado transicional contribui para um sistema de saúde sustentável, o incremento da qualidade dos cuidados e a satisfação dos clientes.

Hydroxy-selenomethionine as an organic source of selenium in the diet improves boar reproductive performance in artificial insemination programs.

This study aimed to compare different selenium (Se) sources in the diet on boar's semen quality and fertility. For this, 28 boars aged 8 to 28 mo were fed with the following dietary treatments for 95 d: 0.3 mg Se/kg as sodium selenite (SS; n = 14) and 0.3 mg Se/kg as hydroxy-selenomethionine (OH-SeMet; n = 14). During this period, two experiments were carried out. In experiment 1, the semen of all boars was evaluated every 2 wk. Raw semen was initially evaluated for the processing of seminal doses, which were stored at 17 °C for 72 h, followed by sperm quality assessments. Furthermore, Se concentration and glutathione peroxidase (GPx) activity were measured in the seminal plasma. In experiment 2, 728 females were inseminated weekly with seminal doses from boars of the different experimental groups to further assess in vivo fertility and litter characteristics. Results demonstrated that boars fed OH-SeMet had more Se in their seminal plasma (P < 0.05), showing the greater bioavailability of the organic source in the male reproductive system. Moreover, boars fed OH-SeMet tended (P < 0.10) toward a higher total sperm count in the ejaculate (66.60 vs. 56.57 × 109 sperm) and the number of seminal doses (22.11 vs. 18.86; 3 × 109 sperm/dose) when compared with those fed SS. No effect of the dietary treatments was observed on GPx activity in seminal plasma (P > 0.05) as well as on raw and stored semen quality (P > 0.05). Under in vivo conditions, seminal doses from boars fed OH-SeMet tended (P < 0.10) toward a higher pregnancy rate at weeks 3, 5, and 8, and also resulted in a higher (P < 0.05) percentage of pregnant females in the overall period (99.30 vs. 97.00). In conclusion, the replacement of SS with OH-SeMet in boars' diet can improve sperm production and results in better reproductive performance for them, bringing greater productivity and profitability to artificial insemination centers and commercial pig farms.

Spermatozoa and seminal plasma small extracellular vesicles miRNAs as biomarkers of boar semen cryotolerance.

Freeze boar semen is still the biggest challenge for the swine industry due to the high cold shock sensitivity of boar sperm cells and the variance of post-thaw results among individuals and ejaculates from the same boar. To solve this problem, we investigate if miRNAs present in sperm cells and small extracellular vesicles (EVs) from seminal plasma of raw boar ejaculates can predict high-quality ejaculates after underwent the freeze-thaw process. For this, we obtained miRNAs samples of sperm cells and EVs from raw seminal plasma from 27 ejaculates before the cryopreservation process. Two groups with different freezability considering the analysis post-thaw of structure and sperm functionality were formed: High freezability (HF; n = 04) and low freezability (LF; n = 04). That done, we investigated the miRNAs profile of sperm cells and EVs from seminal plasma in both groups. Three miRNAs were differently abundant in LF ejaculates, being the ssc-miR-503 found in higher levels in sperm cells (P < 0.10). The ssc-miR-130a and ssc-miR-9 most abundant in EVs from seminal plasma (P < 0.10), in LF ejaculates. Through enrichment analysis, it was possible to verify that these miRNAs could be performing modifications in the development of male germ cells and in the production of energy to spermatozoa to maintain their viability and functionality. Therefore, we can demonstrate that ssc-miR-503, ssc-miR-130a, and ssc-miR-9 are related to low sperm cryotolerance in boars semen. So those miRNAs can be used as a biomarker to predict their low ability to tolerate the cryopreservation process.

Renovascular hypertension in pediatric patients: update on diagnosis and management.

Renovascular hypertension (RVH) is defined as an elevated blood pressure caused by kidney hypoperfusion, generally as a result of anatomic stenosis of the renal artery with consequent activation of the Renin Angiotensin-Aldosterone System. The main causes include genetic and inflammatory disorders, extrinsic compression, and idiopathic alterations. RVH is often asymptomatic and should be suspected in any child with refractory hypertension, especially if other suggestive findings are present, including those with severe hypertension, abdominal bruit, and abrupt fall of glomerular filtration rate after administration of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers. There is a consensus that digital subtraction angiography is the gold standard method for the diagnosis of RVH. Nevertheless, the role of non-invasive imaging studies such as Doppler ultrasound, magnetic resonance angiography, or computed tomographic angiography remains controversial, especially due to limited pediatric evidence. The therapeutic approach should be individualized, and management options include non-surgical pharmacological therapy and revascularization with percutaneous transluminal renal angioplasty (PTRA) or surgery. The prognosis is related to the procedure performed, and PTRA has a higher restenosis rate compared to surgery, although a decreased risk of complications. This review summarizes the causes, physiopathology, diagnosis, treatment, and prognosis of RVH in pediatric patients. Further studies are required to define the best approach for RVH in children.

Young people in oncological treatment during COVID-19: indicators of the social representation of the coronavírus / Jovens em tratamento oncológico durante o COVID-19: indicadores da representação social do coronavírus

Abstract Objectives: to understand indicators of the social representation of the coronavirus in adolescents undergoing cancer treatment during the COVID -19pandemic. Methods: the theory of social representations was used as theoretical and methodological support in its procedural approach in an exploratory study of a qualitative nature. The free word association technique was used in the application of virtual forms using guidelines of the snowball method. The terms 'Coronavirus', 'Going to the hospital' and 'Cancer treatment' were applied. After that moment, the participants were asked for a hierarchy and justification of the evoked words. Data analysis was based on content analysis and frequency distribution of the content produced. Results: articulations were made on the impacts that the pandemic situation had on the treatment experience of that population. It was identified a character endowed with fear and tension about the elaboration of the reality of these subjects in the current period in face of the inevitability of a hospital scenario that facilitates contamination and facing the immunological vulnerability characteristic of their treatments. Conclusions: the participants constructed different contents of psychological suffering aimed at expressions of fear and insecurity experienced during the pandemic period in the face of assistance in the hospital setting. This study is understood as a contribution to more effective actions in order to adapt the care plan of this population, aiming at future professional interventions.

Resumo Objetivos: compreender indicadores da representação social do coronavírus em jovens em tratamento oncológico durante a pandemia do COVID-19. Métodos: utilizou-se como apoio teórico-metodológico a teoria das representações sociais na sua abordagem processual em estudo exploratório de natureza qualitativa. Empregou-se a técnica de associação livre de palavras na aplicação de formulários virtuais utilizando diretrizes do método bola de neve. Foram aplicados os termos indutores 'Coronavírus', 'Ir ao hospital' e 'Tratamento contra o câncer'. Após esse momento foi solicitado aos participantes uma hierarquização e justificativa das palavras evocadas. A análise dos dados foi pautada na análise de conteúdo e distribuição de frequência dos conteúdos produzidos. Resultados: realizou-se articulações sobre os impactos que a conjuntura pandêmica gerou na experiência de tratamento da referida população. Identificou-se um carácter dotado de receio e tensão sobre a elaboração da realidade desses sujeitos no período atual diante da inevitabilidade de um cenário hospitalar facilitador da contaminação e frente a vulnerabilidade imunológica característica de seus tratamentos. Conclusões: os participantes construíram diferentes conteúdos de sofrimento psicológico voltados para expressões de medo e insegurança vivenciadas no período da pandemia diante da assistência em cenário hospitalar. Entende-se este estudo como uma contribuição para ações mais efetivas no intuito de adequar o plano de cuidado dessa população, visando futuras intervenções profissionais.

Alport Syndrome: A Comprehensive Review on Genetics, Pathophysiology, Histology, Clinical and Therapeutic Perspectives.

BACKGROUND: Alport syndrome (AS) is a disease caused by mutations in COL4A3, COL4A4 or COL4A5, the genes that encode distinct chains of type IV collagen. The vast majority of cases present as an inherited disorder, although de novo mutations are present in around 10% of the cases. METHODS: This non-systematic review summarizes recent evidence on AS. We discuss the genetic and pathophysiology of AS, clinical manifestations, histopathology, diagnostic protocols, conventional treatment and prognostic markers of the disease. In addition, we summarize experimental findings with novel therapeutic perspectives for AS. RESULTS: The deficient synthesis of collagen heterotrimers throughout the organism leads to impaired basement membranes (BM) in several organs. As a result, the disease manifests in a wide range of conditions, particularly renal, ocular and auricular alterations. Moreover, leiomyomatosis and vascular abnormalities may also be present as atypical presentations. In this framework, diagnosis can be performed based on clinical evaluation, skin or renal biopsy and genetic screening, the latter being the gold standard. There are no formally approved treatments for AS, even though therapeutic options have been described to delay disease progression and increase life expectancy. Novel therapeutic targets under pre-clinical investigation included paricalcitol, sodium-glucose co-transporter- 2 inhibitors, bardoxolone methyl, anti-microRNA-21 oligonucleotides, recombinant human pentraxin-2, lysyl oxidase-like-2 blockers, hydroxypropyl-b-cyclodextrin, sodium 4-phenylbutyrate and stem cell therapy. CONCLUSION: AS is still a greatly under and misdiagnosed disorder. The pathophysiology is still not fully understood and genetics of the disease also have some gaps. Up to know, there is no specific and effective treatment for AS. Further studies are necessary to establish novel and effective therapeutic protocols.

COVID-19 and Renal Diseases: An Update.

BACKGROUND: It becomes increasingly evident that the SARS-CoV-2 infection is not limited to the respiratory system. In addition to being a target of the virus, the kidney also seems to have a substantial influence on the outcomes of the disease. METHODS: Data was obtained by a comprehensive and non-systematic search in the PubMed, Cochrane, Scopus and SciELO databases, using mainly the terms "SARS-CoV-2", "COVID-19", "chronic kidney disease", "renal transplantation", acute kidney injury" and "renal dysfunction" Discussion: The membrane-bound angiotensin-converting enzyme 2 is the receptor for SARS-CoV- -2, and this interaction may lead to an imbalance of the Renin-Angiotensin System (RAS), associated with worse clinical presentations of COVID-19, including acute pulmonary injury, hyperinflammatory state and hematological alterations. In the framework of renal diseases, the development of acute kidney injury is associated mostly with immune alterations and direct cytopathic lesions by the virus, leading to higher mortality. As for chronic kidney disease, the patients at a non-terminal stage have a worse prognosis, while the hemodialysis patients appear to have mild courses of COVID-19, probably due to lower chances of being affected by the cytokine storm. Furthermore, the current scenario is unfavorable to kidney donation and transplantation. The relationship between COVID-19 and immunosuppression in kidney transplantation recipients has been greatly discussed to determine whether it increases mortality and how it interacts with immunosuppressive medications. CONCLUSION: The kidney and the RAS exert fundamental roles in the SARS-CoV-2 infection, and more research is required to have a complete understanding of the repercussions caused by COVID-19 in renal diseases.

Emotional, Behavioral, and Psychological Impact of the COVID-19 Pandemic.

The emergence of SARS-CoV-2 in December 2019 prompted consternation in many parts of the world. Due to its fast dissemination, the World Health Organization declared a pandemic in March 2020. Aiming to contain the spread of the virus, leaders of many countries restrained social movement, targeting to flatten the curve of contamination with social distancing. This review aimed to analyze how human behavior has changed throughout this period. We also approached the key components of the emotional reaction to the pandemic, how internal and external factors, such as personality traits, gender, the media, the economy and the governmental response, influence the social perception of the pandemic and the psychological outcomes of the current scenario. Moreover, we explored in depth the groups at increased risk of suffering mental health burden secondary to these circumstances. These include the healthcare professionals, elderly individuals, children, college students, black subjects, latin and LGBTQ+ communities, economically disadvantaged groups, the homeless, prisoners, the rural population and psychiatric patients. We also discussed several measures that might minimize the emotional impact derived from this scenario. It is crucial that the health authorities, the government and the population articulate to assist the vulnerable groups and promote emotional and psychological support strategies. Moreover, it is fundamental that the population is provided with accurate information concerning the COVID-19 pandemic.