Evaluation of HNF1B, KLK3, ELAC2, TMPRSS2-ERG, and CTNNB1 polymorphisms associated with prostate cancer in samples of patients from HUPE-UERJ.

PURPOSE: Prostate cancer (PCa) is the leading cause of death among men in 48 countries. Genetic alterations play a significant role in PCa carcinogenesis. For the hypothesis of this research, five unique polymorphisms (SNP) were investigated in different genes that showed to be associated in different ways with PCa: rs4430796, rs2735839, rs4792311, rs12329760, and rs28931588, respectively for the genes HNF1B, KLK3, ELAC2, TMPRSS2-ERG, and CTNNB1. PATIENTS AND METHODS: Blood samples from 426 subjects were evaluated: 290 controls (161 females and 129 males) and 136 PCa patients. SNP were determined by real-time polymerase chain reaction. TaqMan SNP genotyping assay. In the control samples, the SNPs were defined in association with the self-reported ethnicity, and in 218 control samples with markers with ancestry indicators. The genes were in Hardy-Weinberg equilibrium. One hundred and seventy control samples were matched by ethnicity for comparison with the PCa samples. RESULTS: The G allele at rs28931588 was monomorphic in both patients and controls studied. Significant differences were observed in allelic and genotypic frequencies between the control and Pca samples in rs2735839 (KLK3; p = 0.002 and χ2 = 8.73 and p = 0.01, respectively), by the global frequency and in the dominant model rs2735839_GG (odds ratio [OR] = 0.51, p = 0.02). AA and GA genotypes at rs4792311 (ELAC2) were more frequent in patients with Gleason 7(4 + 3), 8, and 9 (n = 37%-59.7%) compared to patients with Gleason 6 and 7(3 + 4) (n = 26%-40.0%) conferring a protective effect on the GG genotype (OR = 0.45, p = 0.02). The same genotype showed an OR = 2.71 (p = 0.01) for patients with low severity. The HNF1B-KLK3-ELAC2-TMPRSS2-ERG haplotypes: GAAT, AAAT, GAGT, and AAGT were more frequent in patients with Pca with OR ranging from 4.65 to 2.48. CONCLUSIONS: Higher frequencies of risk alleles were confirmed in the SNPs, KLK3 rs2735839_A, ELAC2 rs4792311_A, and TMPRSS2 rs12329760_T in patients with Pca. Rs2735839_A was associated with risk of Pca and rs4792311_A with severity and Gleason score of 7(4 + 3) or greater. There is a need for careful observation of rs2735839 and rs4792311 in association with the prostatic biopsy due to the increased risk of Pca.

Estratégia Saúde da Família e a saúde da criança no Extremo Sul da Bahia, Brasil / Family Health Strategy and child health in the Extreme South of Bahia, Brazil / Estrategia Salud Familiar y salud infantil en el Extremo Sur de Bahia, Brasil

A Estratégia Saúde da Família é ordenadora do cuidado prestado às crianças em assistência, da prevenção de agravos e da promoção da saúde na maioria dos municípios de médio e pequeno porte. Este estudo descreve os cuidados prestados à saúde da criança no Extremo Sul da Bahia, no âmbito da Estratégia Saúde da Família, e discute a ausência do pediatra nesse contexto. Trata-se de estudo descritivo realizado nos 13 municípios da região. Coordenadores da atenção básica, médicos e enfermeiros responderam a distintos questionários online sobre a estrutura da Estratégia Saúde da Família e a forma de atendimento às crianças. Para os coordenadores, a cobertura para identificação precoce da gestação é baixa; 60% dos municípios realizam visita puerperal em até uma semana; na maior parte dos casos, a única triagem neonatal realizada é a biológica; a distribuição da caderneta da criança é regular para 56,2%; e a principal dificuldade encontrada na atenção à criança é a alta demanda da Estratégia Saúde da Família para outros grupos prioritários. As consultas de puericultura não têm agenda organizada, podendo ser periódicas ou por livre demanda, e cerca de 35% a 60% delas resultam no encaminhamento da criança para o parecer de pediatras, mas 90% dos médicos e 74% dos enfermeiros informam não receber contrarreferência do serviço especializado. Os profissionais destacam dificuldades para orientar famílias sobre comportamento, alimentação, higiene e sono. Os resultados possibilitam identificar falhas na assistência e no cuidado integral a esse público, contrariando o que preconizam suas políticas. Sobre a qualidade do cuidado, discute-se o papel do pediatra na composição dessa estratégia.

The Family Health Strategy is the organizer of the care provided to children in assistance, of prevention of diseases, and of health promotion in most Brazilian medium and small municipalities. This study describes the care provided to the health of children in the Extreme South of Bahia, in the context of the Family Health Strategy, and discusses the absence of the pediatrician in this context. This is a descriptive study carried out in the 13 municipalities of the region. Primary care coordinators, physicians, and nurses answered different online questionnaires about the structure of the Family Health Strategy and the way they care for children. For the coordinators, the coverage for the early identification of pregnancy is low; 60% of the municipalities perform puerperal visits within one week; and in most cases the only neonatal screening performed is the biological one; the distribution of the child's booklet is regular for 56.2%, and the main difficulty found in childcare is the high demand of the Family Health Strategy for other priority groups. The childcare consultations do not have an organized schedule, and may be periodical or by free demand, and about 35% to 60% of them result in referring children for a pediatricians' opinion, but 90% of the doctors and 74% of the nurses reported not receiving counter-reference from the specialized service. The professionals highlighted difficulties to guide families about the child's behavior, feeding, hygiene, and sleep. The results made it possible to identify failures in the assistance and comprehensive care to this public, contrary to what their policies advocate. About the quality of care, the role of the pediatrician in the composition of this strategy is discussed.

La Estrategia Salud Familiar coordina la atención prestada a los niños en la asistencia, la prevención de enfermedades y la promoción de la salud en la mayoría de los municipios brasileños de mediano y pequeño tamaños. Este estudio describe la atención prestada a la salud de los niños en el Extremo Sur de Bahía (Brasil), en el contexto de la Estrategia Salud Familiar, y discute la ausencia del pediatra en este contexto. Se trata de un estudio descriptivo realizado en los trece municipios de la región. Los coordinadores de la atención primaria, los médicos y los enfermeros respondieron diferentes cuestionarios en línea sobre la estructura de la Estrategia Salud Familiar y la forma de atención a los niños. Para los coordinadores, la cobertura para identificar precozmente el embarazo es baja; el 60% de los municipios realizan visitas puerperales en el plazo de una semana; y en casi todos ellos el único cribado neonatal que se realiza es el biológico; la distribución de la cartilla infantil es regular para el 56,2%, y la principal dificultad encontrada en la atención infantil es la alta demanda de la Estrategia Salud Familiar para otros colectivos prioritarios. Para los médicos y los enfermeros, las consultas de puericultura no tienen una agenda organizada que pueden ser por periodicidad o libre demanda; y cerca del 35% y 60% de estas remiten a los niños para los pediatras, pero el 90% de los médicos y el 74% de los enfermeros relataron no recibir contrarreferencia del servicio especializado. Los profesionales destacaron las dificultades para orientar a las familias sobre el comportamiento, la alimentación, la higiene y el sueño. Los resultados permiten identificar carencias en la asistencia y el cuidado integral a este público, contrariando lo que preconiza sus políticas. Con relación a la calidad del cuidado, se discutió el papel del pediatra en la composición de esta estrategia.

Quantitative G6PD Deficiency Screening in Routine Malaria Diagnostic Units in the Brazilian Amazon (SAFEPRIM): An Operational Mixed-Methods Study.

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency testing is not routinely performed before primaquine treatment in most Plasmodium vivax endemic areas, despite the risk of primaquine-associated hemolysis. This is due to the operational challenges associated with pragmatic G6PD testing and as such needs to be addressed. METHODS AND FINDINGS: This mixed-methods operational study was aimed at implementing the quantitative point-of-care StandardTM G6PD (SD Biosensor, Korea) screening test in malaria treatment units (MTUs) in the municipalities of Rio Preto da Eva and Mâncio Lima, in the Brazilian Amazon, between mid-January 2020 and December 2020. In total, 1286 P. vivax cases were treated based on the Standard G6PD test: 1230 had activity equal to or greater than 4.0 U/g Hb, and 56 less than 4.0 U/g Hb. No G6PD deficient (G6PDd) genotypes were found in 96 samples from the 1230, and only 21 of the 56 G6PDd cases had confirmed G6PDd genotypes. Evaluations were conducted on the proficiency of health care professionals (HCPs) training to perform the test, the reliability of testing performed in the field, and the perceptions of HCPs and patients about the implementation. Post-training proficiency was 73.4% after a 4-hour training session. This study revealed that locations with lower malaria caseloads will need regular refresher training. The test was well accepted by both HCPs and patients. Signs and symptoms of hemolysis were not always associated with malaria treatment drugs by HCPs and patients. INTERPRETATION: Point-of-care quantitative G6PD testing can be performed at MTUs in the Brazilian Amazon to inform treatment decisions with primaquine. Limitations related to technical and cultural aspects need to be addressed further when expanding screening to larger areas.

Effectiveness of mechanical treatment with customized insole and minimalist flexible footwear for women with calcaneal spur: randomized controlled trial.

BACKROUND: Calcaneal spurs are described as bony outgrowths arising on medial calcaneal, where inappropriate footwear can promote disease progression. OBJECTIVE: Investigate the effectiveness of mechanical treatment with customized insole and minimalist flexible footwear during gait training program in women with calcaneal spur. METHODS: Design: A single-blinded, randomized and controlled trial. SETTING: Biomechanics laboratory. PARTICIPANTS: Forty-three women, 29 with calcaneal spur and 14 control. INTERVENTION: Gait training program with use of the minimalist flexible footwear (MFG n = 15, age: 48.9 ± 9.4, height: 1.61 ± 0.1, BMI: 32.1 ± 7.0) and customized insole on footwear (COIG n = 14, age: 50.3 ± 5.8, height: 1.62 ± 0.1, BMI: 32.2 ± 4.3) and control (CG n = 14, age: 47.8 ± 8.6, height: 1.63 ± 0.1, BMI: 27.5 ± 4.5), followed of the evaluations: baseline (T0) and after three (T3) and six (T6) months. Duration of the intervention was of the six months consecutive for at least 42 h per week (six hours a day, seven days a week). Outcome primary were calcaneus pain (visual analogue scale), Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ-Br) and 6-min walk test (6MWT). Secondary was plantar pressure distribution by a pressure platform system during gait and static index foot posture (FPI). STATISTICAL ANALYSIS: analysis of variance for repeated measure and between groups were used to detect treatment-time interactions (α = 5%). Effect size with D Cohen's also was used between T0 and after six (T6) months of intervention. RESULTS: The MFG and COIG were effective at reducing pain after six months (MFG: 2.5-4.5 CI, p = 0.001; COIG: 1.5-3.5 CI, p = 0.011). The FFI and FHSQ-Br showed improvements with MFG and COIG after T6 (MFG: 13.7-15.4 CI, p = 0.010; COIG: 11.3-15.0 CI, p = 0.001). The 6MWT increased with MFG (589.3-622.7 CI) and COIG (401.3-644.7 CI) and foot pronation was decreased after T3 and T6 MFG (FPI Right: 4.2-5.4 CI; Left: 3.6-5.4 CI) COIG (FPI Right: 3.4-6.8 CI; Left: 3.3-5.7 CI). The contact area reduced on forefoot and rearfoot with MFG and GOIG and midfoot and rearfoot with MFG. Maximum force was reduced on foot with MFG after T3 and T6. The peak pressure was reduced on the forefoot with MFG and COIG and on midfoot and rearfoot with MFG. CONCLUSIONS: The mechanical treatment with customized insole and minimalist flexible footwear during gait training program during six months in women with calcaneal spur reduced the calcaneus pain, increased function and health feet and reduced plantar load on the rearfoot, midfoot and forefoot. However, the footwear alone was more effective than when combined customized insole, given the greater efficacy on clinical and biomechanical aspects. TRIAL REGISTRATION: ClinicalTrials.gov NCT03040557 (date of first registration: 02/02/2017).

Impact of Plasmodium vivax malaria on executive and cognitive functions in elderlies in the Brazilian Amazon.

The exact path leading to cognitive impairment that goes beyond malaria is unclear, but it appears to be the result of interactive factors. Time of exposure to disease and recurrences are potentially major determinant variables. Cognitive impairment is described mainly in children, rarely in adults. The disease in high endemic areas usually does not affect elderlies, because of acquired immunity over time. However, this population is relatively more frequently sick in lower endemic areas, such as in the Amazon. This study assessed the effect of Plasmodium vivax malaria on the executive and cognitive functions of elderlies, in the Brazilian Amazon. A cohort study was conducted to evaluate executive and cognitive functions one week (T0), two months (T2) and eight months (T8) after the malaria episode. Mini-Mental State Examination (MMSE), Beck Depression Inventory II (BDI-II), Clock Drawing Test (CDT), Wechsler adult intelligence scale (WAIS-III), and Wisconsin Card Sorting Test (WCST) were used to assess executive and cognitive functions. One hundred-forty elderlies were enrolled (70 with P. vivax malaria and 70 without malaria). P. vivax malaria was associated with impairment of the executive and cognitive functions in elderlies for up to 8 months after acute P. vivax malaria. Prior history of malaria, recurrences and higher parasitemia were independently associated with various surrogates of executive and cognitive impairment. With the increase in life expectancy, elderlies living in malaria endemic areas will deserve more attention from health authorities, to guarantee improvement of their quality of life in the tropics.

Effect of low back pain on clinical-functional factors and its associated potential risk of chronicity in adolescent dancers of classical ballet: cross-sectional study.

BACKGROUND: Low back pain (LBP) is a common symptom in classical ballet dancers, which can limit their daily activities and dance training routines. The purpose of the study was to verify the association and comparison of clinical-functional outcomes (spine flexibility and foot posture) between different levels of intensity low back pain in adolescents of classical ballet and the potential risk of chronicity using the STarT back tool. METHODS: Cross-sectional study. PARTICIPANTS: 78 adolescent girls who practice classical ballet were evaluated and divided into groups according to level of low back pain: mild (n = 21), moderate (n = 17), and high (n = 20), and a control group (n = 20). MAIN OUTCOME MEASURES: Pain, flexibility of the spine (thoracic and lumbosacral), risk of chronicity for low back pain, and foot posture were assessed using the visual analogue scale, clinical tests, STarT back screening tool (SBST) questionnaire, and foot posture index (FPI), respectively. RESULTS: Dancers with high-intensity low back pain showed a potential risk of chronicity by the SBST. The spine pain intensity was not different considering thoracic and lumbosacral flexibility in the sagittal plane, but was different with greater supine FPI when compared to control dancers. Mild low back pain was associated with greater supine FPI. The SBST score was associated with higher exposure time-frequency and time of dancing. CONCLUSION: Adolescents of classical ballet with high-intensity low back pain showed a potential risk of chronicity by the SBST. The level of intensity low back pain did not influence the clinical-functional aspects of spine flexibility in the sagittal plane, but the level of intensity moderate pain promoted changes in foot posture (more supinated). The potential risk of chronicity using the SBST was also associated with higher exposure time-frequency and time of dancing, in adolescents of classical ballet.

Real-life quantitative G6PD screening in Plasmodium vivax patients in the Brazilian Amazon: A cost-effectiveness analysis.

BACKGROUND: As quantitative glucose 6-phosphate dehydrogenase deficiency (G6PDd) screening tools are evaluated in operational studies, questions remain as to whether they are cost-effective. Here, a cost-effectiveness analysis (CEA) was performed to estimate the Incremental Cost-effectiveness Ratio (ICER) of the introduction of quantitative screening test to detect G6PDd among P. vivax carriers in two municipalities in the Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS: This cost-effectiveness analysis evaluated the use of the Standard G6PD quantitative screening test in vivax malaria treatment units in two municipalities of the Brazilian Amazon. Using the perspective of the Brazilian public health system, the analysis was performed for the outcome 'PQ-associated hospitalization avoided', based on a decision tree model. The results indicated that the G6PDd screening strategy compared with the routine strategy was highly cost-effective, with an ICER of US$495 per additional hospitalization avoided, which represented less than 8% of one Brazilian gross domestic product per capita (US$6,822). The uncertainties evaluated in the sensitivity analysis did not significantly affect the ICER identified in the base-case. CONCLUSIONS/SIGNIFICANCE: This cost-effectiveness analysis showed the quantitative G6PD testing was effective in avoiding PQ-associated hospitalizations. The incorporation of G6PD screening is of paramount importance towards P. vivax malaria elimination in the Amazon to promote the safe use of primaquine and tafenoquine.

The influence of beach geology and morphodynamics on chemical pollution assessments following a mining accident.

In the present study the distribution of chemical elements in beaches adjacent to the Doce River mouth hit by the tailings mud from a mining accident were assessed. Sedimentological and morphological coastal aspects were also considered. The results indicate that wave-exposed delta plain beaches exhibit high resiliency, despite their proximity to potential pollution sources. On the other hand, shore platform beaches tend to accumulate chemical elements, mainly due to limited cross-shore sediment exchanges. Arsenic concentrations in the evaluated shore platform beaches were significantly higher than the delta plain beach. Shore platform beaches are more susceptible to frequent flooding and to higher elemental concentrations at the berm and beach face. Thus, the morphological characteristics of the assessed shore platform beaches, and input from the mud plume must be considered in a joint assessment strategy in order to obtain a broad understanding of the actual scenario regarding beach contamination.

Aplicação de terapia por pressão negativa adaptada em lesão por queimadura no norte do Brasil: Relato de caso / Application of low cost negative pressure therapy in burn injury in northern Brazil: Case report

OBJETIVO: Relatar um caso clínico ocorrido em um Centro de Referência de Tratamento de Queimados, submetido a terapia por pressão negativa (TPN) adaptada com materiais hospitalares durante o período de internação, visando a cicatrização mais eficaz da lesão. RELATO DE CASO: Paciente de 47 anos de idade, sexo masculino, vítima de queimadura por descarga elétrica, apresentando lesão em pé direito, região submetida há 16 dias de tratamento por TPN adaptada, tendo como resultado a cicatrização da lesão sem necessidade de enxertia. CONSIDERAÇÕES FINAIS: A aplicação de TPN adaptada demonstrou ser um importante alicerce na cicatrização da lesão, permitindo como resultados a redução da planimetria da lesão, aumento do tecido de granulação, redução do esfacelo, além da aproximação das bordas.

OBJECTIVE: To report a clinical case that occurred in Reference Center for Burn Treatment, submitted to negative pressure therapy (NPT) adapted with hospital materials during the period of hospitalization, aiming at a more effective wound healing. CASE REPORT: 47-year-old male patient, victim of burns caused by electrical discharge, presenting a lesion in the right foot, region submitted to 16 days of treatment with adapted NPT, resulting in healing of the lesion without the need for grafting. FINAL CONSIDERATIONS: the application of adapted not proved to be an important foundation in the healing of the lesion, resulting in a reduction in the planimetry of the lesion, an increase in granulation tissue, a reduction in slough, in addition to approximation of the edges.

Real-life implementation of a G6PD deficiency screening qualitative test into routine vivax malaria diagnostic units in the Brazilian Amazon (SAFEPRIM study).

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency greatly hinders Plasmodium vivax malaria radical cure and further elimination due to 8-aminoquinolines-associated hemolysis. Although the deleterious health effects of primaquine in G6PD deficient individuals have been known for over 50 years, G6PD testing is not routinely performed before primaquine treatment in most P. vivax endemic areas. METHOD/PRINCIPAL FINDINGS: The qualitative CareStart G6PD screening test was implemented in 12 malaria treatment units (MTUs) in the municipality of Rio Preto da Eva, Western Brazilian Amazon, a malaria endemic area, between February 2019 and early January 2020. Training materials were developed and validated; evaluations were conducted on the effectiveness of training health care professionals (HCPs) to perform the test, the interpretation and reliability of routine testing performed by HCPs, and perceptions of HCPs and patients. Most HCPs were unaware of G6PD deficiency and primaquine-related adverse effects. Most of 110 HCPs trained (86/110, 78%) were able to correctly perform the G6PD test after a single 4-hour training session. The test performed by HCPs during implementation showed 100.0% (4/4) sensitivity and 68.1% (62/91) specificity in identifying G6PD deficient patients as compared to a point-of-care quantitative test (Standard G6PD). CONCLUSIONS/SIGNIFICANCE: G6PD screening using the qualitative CareStart G6PD test performed by HCPs in MTUs of an endemic area showed high sensitivity and concerning low specificity. The amount of false G6PD deficiency detected led to substantial loss of opportunities for radical cure.

Fluência verbal de adultos e idosos do Distrito Federal: proposta normativa piloto / Verbal fluency of younger and older adults from the Federal District: proposed normative values

RESUMO Objetivo Comparar o desempenho de adultos jovens e idosos do Distrito Federal com os dados normativos. Métodos Sessenta participantes hígidos responderam aos testes de fluência verbal semântica, livre e ortográfica da Bateria Montreal de Avaliação da Comunicação. Resultados Participantes do Distrito Federal obtiveram médias menores (<0,001), comparados à média normativa. Não houve diferença no desempenho entre os grupos etários, exceto ao compará-los com indivíduos com maior escolaridade. Conclusão Na amostra do Distrito Federal avaliada, o processo de envelhecimento típico não prejudicou a fluência verbal para indivíduos que concluíram o ensino fundamental. As médias menores, em relação aos dados normativos, evidenciaram a importância de padrões normativos regionais.

ABSTRACT Purpose To compare the performance of younger and older adults from the Federal District (FD) against normative data. Methods Sixty healthy participants completed the unconstrained, phonemic and semantic verbal fluency tests of the Montreal Communication Assessment Battery. Results The FD participants obtained lower mean scores (<0.001) compared to the normative average. There was no difference in performance between the age groups, except on the comparison with high-educated individuals. Conclusion In the FD, the typical aging process did not impact verbal fluency for individuals who were educated to primary level. The lower mean scores relative to normative data highlight the importance of regional normative standards.

IgA Nephropathy in Salvador, Brazil. Clinical and laboratory presentation at diagnosis / Nefropatia por IgA em Salvador, Brasil. Apresentação clínica e laboratorial no momento do diagnóstico

ABSTRACT Introduction: IgA nephropathy (IgAN) is the most prevalent primary glomerulopathy in the world, but great variation is reported in different countries. In Brazil, the reported prevalence is high in the Southeastern States and low in Salvador, Bahia State, Brazil. Objectives: This study investigated the clinical and histological patterns of patients with IgAN in Salvador, Brazil. Methods: This is a descriptive study that included all patients with a diagnosis of IgAN performed in native kidney biopsies collected from referral nephrology services of public hospitals in Salvador between 2010 and 2015. Results: Thirty-two cases of IgAN were identified, corresponding to 6% of primary glomerulopathies. There was a slight male predominance (56%) and the median age was 30 [22-40] years. Hematuria was present in 79%, non-nephrotic proteinuria was present in 61%, and hypertension was present in 69% of patients. Segmental sclerosis (S1 lesions) was present in 81% of cases, and chronic tubulo-interstitial lesions (T1 and T2 lesions) were present in 44% of cases. Patients with M1 and T2 MEST-C scores exhibited higher serum urea and creatinine than other patients. Conclusion: The prevalence of IgAN was lower in Salvador than other regions of Brazil. Chronic histological lesions and laboratory markers of severe disease were frequent. M1 and T2 MEST-C scores were correlated with markers of renal dysfunction.

RESUMO Introdução: A nefropatia por IgA (NIgA) é a glomerulopatia primária mais prevalente no mundo, mas grande variação é relatada em diferentes países. No Brasil, a prevalência relatada é alta nos estados do Sudeste e baixa em Salvador, Bahia, Brasil. Objetivos: Este estudo investigou os padrões clínicos e histológicos de pacientes com NIgA em Salvador, Brasil. Métodos: Trata-se de um estudo descritivo que incluiu todos os pacientes com diagnóstico de NIgA, realizados em biópsias de rins nativos, coletados nos serviços de referência em nefrologia dos hospitais públicos de Salvador, entre 2010 e 2015. Resultados: Foram identificados 32 casos de NIgA, correspondendo a 6% de glomerulopatias primárias. Houve uma ligeira predominância do sexo masculino (56%) e a mediana da idade foi de 30 [22-40] anos. Hematúria esteve presente em 79%, proteinúria não nefrótica esteve presente em 61% e hipertensão esteve presente em 69% dos pacientes. A esclerose segmentar (lesão S1) estava presente em 81% dos casos, e lesões túbulo-intersticiais crônicas (lesões T1 e T2) estavam presentes em 44% dos casos. Pacientes com escores M1 e T2 MEST-C exibiram maior ureia e creatinina séricas que outros pacientes. Conclusão: A prevalência de NIgA foi menor em Salvador do que em outras regiões do Brasil. Lesões histológicas crônicas e marcadores laboratoriais de doença grave foram frequentes. Os escores M1 e T2 MEST-C foram correlacionados com marcadores de disfunção renal.

IgA Nephropathy in Salvador, Brazil. Clinical and laboratory presentation at diagnosis.

INTRODUCTION: IgA nephropathy (IgAN) is the most prevalent primary glomerulopathy in the world, but great variation is reported in different countries. In Brazil, the reported prevalence is high in the Southeastern States and low in Salvador, Bahia State, Brazil. OBJECTIVES: This study investigated the clinical and histological patterns of patients with IgAN in Salvador, Brazil. METHODS: This is a descriptive study that included all patients with a diagnosis of IgAN performed in native kidney biopsies collected from referral nephrology services of public hospitals in Salvador between 2010 and 2015. Results: Thirty-two cases of IgAN were identified, corresponding to 6% of primary glomerulopathies. There was a slight male predominance (56%) and the median age was 30 [22-40] years. Hematuria was present in 79%, non-nephrotic proteinuria was present in 61%, and hypertension was present in 69% of patients. Segmental sclerosis (S1 lesions) was present in 81% of cases, and chronic tubulo-interstitial lesions (T1 and T2 lesions) were present in 44% of cases. Patients with M1 and T2 MEST-C scores exhibited higher serum urea and creatinine than other patients. CONCLUSION: The prevalence of IgAN was lower in Salvador than other regions of Brazil. Chronic histological lesions and laboratory markers of severe disease were frequent. M1 and T2 MEST-C scores were correlated with markers of renal dysfunction.

Participação em grupo como recurso para promoção da saúde e qualidade de vida entre idosos / Participación en grupo como recurso para la promoción de la salud y la calidad de vida en las personas mayores / Participation in group as a resource for health promotion and quality of life among older people

Objetivo analisar a participação em grupo de promoção da saúde como estratégia para melhorar a qualidade de vida de idosos. Método estudo transversal, analítico e prospectivo. Os dados foram coletados por meio de um instrumento com questões sociodemográficas e pelos WHOQOL-BREF e WHOQOL-OLD, e analisados no software Stata versão 11.0, por meio de regressão linear múltipla. O nível de significância adotado foi ≤ 5%. Resultados participar do grupo foi significativamente associado a melhores escores de qualidade de vida nos domínios "físico", "relações sociais" e "meio ambiente" (WHOQOL-BREF), e nas facetas "atividades passadas, presentes e futuras" e "participação social" (WHOQOL-OLD). Conclusão a participação em grupo de promoção da saúde favorece melhorias em diversos aspectos da vida dos idosos, especialmente os relacionados à inclusão social e ao estabelecimento/manutenção de relacionamento interpessoal.

Objetivo conocer la participación en las reuniones del grupos de promoción de la salud como estrategia para mejorar la calidad de vida de las personas mayores. Método se trata de un estudio transversal, analítico y prospectivo. Los datos se recolectaron utilizando un instrumento que incluía una pregunta sociodemográfica, WHOQOL-BREF y WHOQOL-OLD. Utilizamos la versión 11.0 del software Stata para conocer datos utilizando la regresión lineal múltiple. El nivel de significación fue ≤ 5%. Resultados participar en un grupo se asoció significativamente con mayor puntuación en calidad de vida en los siguientes ámbitos "físico", "relaciones sociales", "medio ambiente" (WHOQOL-BREF) y facetas "paso, actividades presentes y futuras" "Participación social" (WHOQOL-OLD). Conclusión las reuniones de grupos de promoción de la salud mejoraron muchos aspectos de la vida de las personas mayores, especialmente relacionadas con la inclusión social y el establecimiento / mantenimiento de una relación interpersonal.

Objective to analyze participation in health promotion group meetings as a strategy to improve quality of life among older people. Method this was a cross-sectional, analytical and prospective study. Data were collected using an instrument including sociodemographic question, WHOQOL-BREF, and WHOQOL-OLD. We used the Stata software version 11.0 to analyze data using the multiple linear regression. Level of significance adopted was ≤ 5%. Results to participate in a group was significantly associated with higher score in quality of life in the following domains "physical", "social relations", "enviroment" (WHOQOL-BREF), and facets "pass, present and future activities", "social participation" (WHOQOL-OLD). Conclusion the health promotion group meetings improved many aspects of life of older people, especially related to social inclusion and establishment/maintencare of an interpersonal relationship.

Qualidade de vida para avaliação de grupos de promoção da saúde / Calidad de vida para evaluación de grupos de promoción de la salud / Quality of life assessment for health promotion groups

RESUMO Objetivo: analisar o uso da avaliação da qualidade de vida (QV) como estratégia para avaliar o trabalho com grupos de promoção da saúde na comunidade. Método: estudo transversal, descritivo e analítico. Participantes de dois grupos de idosos (n=46) foram entrevistados individualmente para preenchimento dos instrumentos de caracterização sociodemográfica, WHOQOL-BREF e WHOQOL-OLD. Resultados: predominaram mulheres, com até 79 anos, que não moravam com companheiro, estudaram até quatro anos, aposentadas, com renda individual de até um salário mínimo. Os escores médios no WHOQOL-BREF foram mais elevados no domínio "Relações Sociais" e mais baixos em "Meio Ambiente". No WHOQOL-OLD, os maiores escores foram atingidos nas facetas "Participação Social" (G1) e "Atividades Passadas, Presentes e Futuras" (G2), enquanto a faceta "Morte e Morrer" obteve menores escores nos dois grupos. Conclusão: a avaliação da QV mostrou-se útil para ajudar a coordenação a identificar aspectos da vida dos idosos que precisam ser melhor trabalhados nos grupos.

RESUMEN Objetivo: analizar el uso de la evaluación de calidad de vida (CV) como estrategia para evaluar el trabajo realizado con grupos de promoción de la salud en la comunidad. Método: estudio transversal, descriptivo y analítico. Los participantes de dos grupos de personas mayores (n=46) fueron entrevistados de manera individual para completar los instrumentos de caracterización sociodemográfica WHOQOL-BREF y WHOQOL-OLD. Resultados: predominaron mujeres de hasta 79 años que no convivían con ningún compañero, con hasta cuatro años de estudios, jubiladas, con ingresos individuales equivalentes al salario mínimo. En WHOQOL-BREF la puntuación más alta se registró en "Relaciones Sociales" y la más baja en "Medio Ambiente". En WHOQOL-OLD, las puntuaciones más altas se registraron en los apartados de "Participación Social" (G1) y "Actividades Pasadas, Presentes y Futuras" (G2), mientras que el apartado "Muerte y Morir" obtuvo las puntuaciones más bajas en los dos grupos. Conclusión: la evaluación de CV resultó útil para coordinar e identificar los aspectos de la vida de personas mayores que necesitan de un desarrollo más profundo en los grupos.

ABSTRACT Objective: to analyze the use of quality of life assessment (QOL) as a strategy to evaluate the work with health promotion groups in the community. Method: cross-sectional, descriptive and analytical study. Participants of two elderly groups (n=46) were individually interviewed to fill the sociodemographic instruments, WHOQOL-BREF and WHOQOL-OLD. Results: the participants were women with up to 79 years, who did not live with a partner, with up to four years of study, retired, with individual income of up to a minimum salary. The mean scores on the WHOQOL-BREF were higher on "Social Relations" and lower in the "Environment". For the WHOQOL-OLD, the highest scores were achieved in facets "Social Participation" (G1) and "Past, Present and Future Activities" (G2), while "Death and Dying" facet obtained lower scores in both groups. Conclusion: the assessment of QOL appears to be useful in helping to identify the coordination aspects of life of elderly people that need to be better developed in groups.

A atuação da fisioterapia na inclusão de crianças deficientes físicas em escolas regulares: uma revisão da literatura / The Efficacy of Physical Therapy in the Inclusion of Physically Challenged Children in Regular Schools - A Review of Literature

Este estudo teve como objetivo mostrar os aspectos da inclusão escolar de crianças deficientes e como o fisioterapeuta fazendo parte de uma equipe multidisciplinar pode atuar de forma efetiva neste processo. Em 1994, em Salamanca, na Espanha, aconteceu a Conferência Mundial sobre as Necessidades Educativas Especiais (NEE), da qual se referiu a educação igualitária e sem distinções, classificando como obrigações dos governos a inserção dessas crianças no sistema regular de ensino. Fica claro que, por direito, o acesso de deficientes é livre nas escolas regulares e, desse modo, a escola tem de se apresentar como um contexto inclusivo, ou seja, deve estar preparada para receber todos os alunos. A atuação de uma equipe interdisciplinar composta por educadores, médicos, terapeutas ocupacionais, psicólogios e fisioterapeutas dentro da escola é de fundamental importância. O papel do fisioterapeuta é realçar as técnicas de recursos auxiliares existentes na fisioterapia que poderão ser utilizadas para minimizar as dificuldades do deficiente físico. Por meio de técnicas especiais e adequação de equipamentos e mobiliário podem-se criar condições para uma melhor adaptação, atuação e oportunidades para as crianças deficientes em termos de desenvolvimento de suas capacidades e trocas de experiência com o meio.