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VASCULAR TRAUMA IN THE AMAZON REGION: A TWO YEARS CASES REVIEW FROM A SINGLE INSTITUTION

Health 2014年第6期6卷 517-530页

作者： Adenauer Marinho de oliveira Góes Jr. Allan Dias Vasconcelos Rodrigues Fábio Brito braga Mariseth Carvalho de Andrade Simone de Campos Vieira Abib department of Surgery (CESUPA) Belém Brazil

Introduction: Vascular injuries are among the main mechanisms of death in trauma. In Brazil, the general surgeon is in charge of emergencies procedures in most hospitals, but many times these surgeons are not familiarized with more complex vascular surgical techniques that often require a vascular surgeon. Pará State is the most populated one in the Brazilian Amazon region and a single hospital with vascular surgeons permanently on call is available. Objectives: To evaluate demographic data on vascular trauma victims;to establish the mechanism, anatomic location, injury pattern and surgical techniques used to manage the vascular lesions treated at the Metropolitan Emergency Hospital;to ascertain associated non-vascular injuries and victim’s clinical outcome. Methods: Retrospective analysis of medical records of patients treated for vascular injuries from February 2011 to February 2013 at the institution in case. All arterial and venous injuries were analyzed. Patients who were not operated by the vascular surgery team, iatrogenic injuries and those who underwent primary or sustained traumatic amputation were excluded. Results: 173 cases;95.95% were male;54.90% were between 25 and 49 years;penetrating trauma mechanisms were found in 88.44%;lower limb was the most affected topography (41.50%);the most injured vessels were the superficial femoral and ulnar arteries (in 15.75% of cases each) and the superficial femoral vein (17.77 %);autologous vein graft was the most performed technique for arterial repair (36.57%) and ligature was performed in 85.00% of venous trauma;amputation rate was 15.60% and mortality rate was 6.35%. Conclusions: Vascular injuries occurred predominantly in men from 24 to 49 years old;penetrating mechanisms were most frequent;lower limb was the most affected topography;the most frequently injured vessels were the ulnar and superficial femoral arteries and the superficial femoral vein;complete vessel transection was the most common injury pattern;

关键词： External Causes Amazon. Blood vessels Wounds and Injuries Vascular System Injuries

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Estimating age of Brazilians using the methods of demirjian and Nicodemo,Moraes and Medici:A comparative analysis

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Forensic Medicine and Anatomy Research 2013年第3期1卷 57-62页

作者： Ricarda Duarte da Silva Marcos Andre Duarte da Silva Aline Yumi Uezono Simone Borges braga dos Santos Queiroz Rogerio Nogueira de oliveira department of Social dentistry University of Sao PauloSao PauloBrazil

This study proposed to evaluate the precision of Nicodemo, Moraes and Médici method and the method proposed by demirjian and compare both methodologies in relation to the efficiency and applicability in the Brazilian population. The sample consisted of 124 panoramic radiographs of subjects in the age group from 7 to 16 years old, 66 patients female and 58 male. For the comparison of the genders in relation to the average percentage difference, the t-Student test was considered. In average the method of Nicodemo, Moraes and Médici presented for the female gender an estimated result 14.7% lower than the real age. For the male gender the estimative obtained was that for each year of variation of the real age the method of Nicodemo estimates a variation of 0.48 years, with a confidence interval of 95% given by (0.43;0.54). For the method of demirjian the result was that for each year of variation of the real age the method of demirjian estimates a variation of 1.00 year, with a confidence interval of 95% given by (0.85;1.15) for the male gender and 0.96 years, with a confidence interval of 95% given by (0.84;1.08) for the female gender. It is concluded that the Method of Nicodemo, Moraes and Médici tends to underestimate the real age and that as the real age increases this underestimate becomes higher. Now, the method of demirjian tends to over- estimate the real age in 8.2 months for the male gender and in 7.1 for the female one in average.

关键词： dentistry Age Estimative Forensic dentistry Forensics

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Hakim-Adams syndrome secondary to syphilis

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Case Reports in Clinical Medicine 2013年第6期2卷 377-379页

作者： Ricardo Krause Martinez de Souza Alexandre Zatera Fernanda Leal Suzano Flavia de oliveira braga Samanta Fabrício Blattes da Rocha Ricardo Ramina Pedro Andre Kowacs Ambulatorio de desordens da Memoria e do Comportamento Instituto de Neurologia de CuritibaCuritibaBrazil Instituto de Psiquiatria do Parana CuritibaBrazil Servico de Neurologia e Neurocirurgia CuritibaBrazil

Normal pressure hydrocephalus (NPH) secondary to syphilis is an atypical form of neurosyphilis with an unusual clinical presentation and uncommon neuroimaging findings. A case of Syndrome de Hakim-Adams occurring in a 79-year-old male was admitted for investigation of a dementia syndrome. The patient presented with clinical features and neuroimaging compatible with NPH. Syphilis serology was reactive and compatible with active disease. The patient was treated with crystalline penicillin (4 million units every 4 hours for 21 days) and was assessed again after three months, when his cognition and gait had improved and the urinary incontinence had resolved. According to this information, we describe a case of syphilis mimicking normal pressure hydrocephalus, making clear the importance of the investigation of sexually transmitted diseases in the differential diagnosis of dementia, even in patients without established risk supposedly.

关键词： Neurosyphilis Hakim-Adams Syndrome Syphilis Normal Pressure Hydrocephalus

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Vegetation structure and edaphic factors in veredas reflect different conservation status in these threatened areas

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Forest Ecosystems 2022年第3期9卷 387-395页

作者： Yule Roberta Ferreira Nunes Camila Silveira Souza Islaine Francielly Pinheiro de Azevedo Odirlei Simôes de oliveira Leidivan Almeida Frazão Rúbia Santos Fonseca Rubens Manoel dos Santos Walter Viana Neves Programa de Pós-Graduaçao Em Botânica Aplicada Departamento de Biologia GeralUniversidade Estadual de Montes ClarosAvenida Dr.Ruy BragaS/N-Bairro Vila MauricéiaMontes ClarosMinas Gerais39401-089Brazil Laboratório de Ecologia Vegetal Universidade Estadual de Montes ClarosAvenida Dr.Ruy BragaS/N-Bairro Vila MauricéiaMontes ClarosMinas Gerais39401-089Brazil Instituto de Ciências Agrarias-Universidade Federal de Minas Gerais Avenida Universitária1.000-Bairro Universit�arioMontes ClarosMinas Gerais39404-547Brazil departamento de Ciências Florestais Universidade Federal de LavrasCP 3037LavrasMinas Gerais37200-000Brazil Instituto Mineiro de Gestao dasÁguas Secretaria de Estado de Meio Ambiente e Desenvolvimento SustentávelAvenida JoséCorreia Machado900-Bairro IbiturunaMontes ClarosMinas Gerais39401-832Brazil

Background:In Cerrado humid areas,veredas are considered as hygrophilous communities,marked by the presence of the Mauritia flexuosa palm tree emerging in the wetter *** in veredas ecosystems due to drought and changes in the water table,which represent important areas for biodiversity maintenance in the Brazilian cerrado,can lead to the emergence of new landscapes and *** that the veredas are changed in species composition due to anthropogenic factors,in this study,we evaluated the flora composition and described the current vegetation profile of two veredas under different disturbances levels that are located in the north of Minas Gerais State,***:Altogether,2,268 individuals of 91 species belonging to 36 families were *** results demonstrated that the studied veredas were floristically different in terms of the arboreous-shrubby species composition,richness,and *** the hygrophilous forest formations and open areas in the two veredas present typical species from these environments(same species with high importance values),the drought in the water table caused an expansion of Cerrado species in the open areas and in the hygrophilous ***,in the hygrophilous forest there was an increase in the abundance of species that occur in less saturated ***:Our results demonstrate that the studied veredas are changing in species composition due to anthropogenic factors which leads to the drought of these formations(water balance effect).These anthropogenic effects cause a modification with the expansion and increase in the abundance of typical species of other areas of Cerrado and resistant to less saturated soils,leading to the veredas ***,future studies should investigate other veredas on a broader scale to detect changes in the water table that lead to a consequent change in vegetation *** this way,we will have support for the conscientious management and conservatio

关键词： Cerrado Conservation Palm swamp Plant distribution Climate change Water balance effect Vereda drought Phytosociological analysis

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Maternal Predictors for Quality of Life during the Postpartum in Brazilian Mothers

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Health 2015年第3期7卷 371-380页

作者： Mirna Fontenele de oliveira Leslie Parker Hyochol Ahn Hellen Lívia oliveira Catunda Elizian braga Rodrigues Bernardo Mara Fontenele de oliveira Samila Gomes Ribeiro Cinthia Gondim Pereira Calou Franz Janco Antezana Paulo César Almeida Régia Christina Moura Barbosa Castro Priscila de Souza Aquino Ana Karina Bezerra Pinheiro College of Nursing University of Florida Gainesville USA department of Nursing Federal University of Ceará Fortaleza Brazil

Introduction: The postpartum period can have a significant physical, emotional, and social impact on the quality of a woman’s life. Most postpartum research has focused on physical complications and only a few studies have specifically investigated quality of life. The purpose of this study was to explore predictors affecting the quality of life of postpartum Brazilian mothers. Study design and Methods: A cross-sectional Quality of Life survey was performed in 210 Brazilian mothers during the early postpartum period. Data were collected using an interview technique and two instruments: 1) a maternal questionnaire and the 2) Maternal Postpartum Quality of Life tool/Brazilian version. The association between maternal characteristics and quality of life in the post-partum period was investigated with bivariate and multivariable analyses. Results: Mothers who had the best Quality of Life were white, registered students, 30 - 40 years of age, who were married or living with a partner, and without physical complaints;in addition, they had at least an 8th grade education, more than 4 children, and had attended more than 8 prenatal visits with a nurse. The stepwise model indicated that white race (p develop health interventions to enhance the quality of life of this population.

关键词： Mothers Postpartum Quality of Life Predictors

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Management of Gestational Trophoblast Disease: A Review Integrative National and International Guidelines

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Health 2022年第12期14卷 1321-1333页

作者： Marcela Curvêllo Beltrão Maira de Lima oliveira Mota Elizabeth Bacha Lusitania Maria de Barros Livia Helena Gomes de Barros Brandão Nelson Henriky Felix Mascarenhas Tallys Leandro Barbosa da Silva Maria Fernanda Telles Pires de Souza Séfora Maria Fragoso braga Victoria de oliveira Carmo Borges Centro Universitário Tiradentes (UNIT) Maceió Brasil Instituto de Medicina Integral Professor Fernando Figueira (IMIP) Pernambuco Brasil Estácio de Juazeiro do Norte (FMJ) Ceará Brasil Universidade Federal de Alagoas (UFAL) Maceió Brasil Sã o Leopoldo Mandic Campinas Brasil Hospital Regional de Arapiraca Arapiraca Brasil

GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdeveloped countries, colliding with the economic barrier. The frequent absence of clear protocols and guidelines for the correct diagnosis and treatment of the aforementioned pathology results in inadequate risk classification, imprecise treatment and failed post-therapeutic observation, increasing the risk of relapses, morbidity and mortality. The present study aims to compare the different national and international guidelines in the management of GTD, through an integrative review. Nine articles were selected and it was observed that the main international reference centers are agreed with the management suggested by the IFGO (International Federation of Gynecology and Obstetrics), being the conduct in the Hydatidiform Mole (HM): evacuation by suction and curettage under ultrasound guidance, followed by hCG monitoring every 1 - 2 weeks until normalized;in low-risk GTN (Gestational Trophoblastic Neoplasm): chemotherapy with methotrexate or actinomycin D, in high-risk: EMA/CO protocol, in ultra-high-risk EMA/PE, methotrexate with radiotherapy for brain metastases. All medical societies recommend the registration of these patients in GTD screening centers, endorse the use of the IFGO scoring system (2000) and recommend the surgical management of placental site trophoblastic or epithelioid tumors, as chemotherapy is less effective in these cases. The controversies are in the proper follow-up after the treatment of HM, use of ultrasound to evacuate the uterus, administration of anti-D immunoglobulin, time of oxytocin infusion and rescue regimens that can be used in cases of resistant or recurrent GTN. Establishing and complying with consistent guidelines can improve patient care, with early diagnosis of the pathology and its complications, reducing the rate of

关键词： Guidelines Gestational Trophoblastic Disease Treatment

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Updates in the Diagnosis of Gestational Trophoblast Disease

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Health 2023年第1期15卷 48-58页

作者： Maira de Lima oliveira Mota Marcela Curvêllo Beltrão Elizabeth Bacha Eduardo Fonseca Mascarenhas Filho Maísa Mendonça de Jesus Nelson Henriky Felix Mascarenhas Tallys Leandro Barbosa da Silva Maria Fernanda Telles Pires de Souza Victoria de oliveira Carmo Borges Séfora Maria Fragoso braga Centro Universitário Tiradentes (UNIT) Maceió Brasil Estácio de Juazeiro do Norte (FMJ) Ceará Brasil Universidade Federal de Alagoas (UFAL) Maceió Brasil Sã o Leopoldo Mandic Campinas Brasil Hospital Regional de Arapiraca Arapiraca Brasil

GTD (Gestational Trophoblastic Disease) is a pathology that encompasses benign and malignant clinical forms, affects women of childbearing age, has a variable incidence and is more frequent in developing or underdeveloped countries, colliding with the economic barrier. The frequent absence of clear protocols and guidelines for the correct diagnosis of the pathology results in inadequate classification, imprecise treatment and failed post-therapeutic observation, increasing the risk of relapses, morbidity and mortality. The present study aims to point out updated national and international practice protocols of diagnosis of GTD, through an integrative review. Seven articles were selected and it was observed that the main international reference centers are agreed with the management suggested by the IFGO (International Federation of Gynecology and Obstetrics), being the conduct in the Hydatidiform Mole (HM): evacuation by suction and curettage under ultrasound guidance, followed by hCG monitoring every 1 - 2 weeks until normalized (usually one month for Partial Hydatidiform Mole six months for Complete Hydatidiform Mole and one year for Gestational Trophoblastic Neoplasia). Unfortunately, regarding the diagnosis of MH, the guidelines of some countries show the absence or difficulty of access to the karyotype test and ploid p57 or pelvic ultrasound accompanying the uterine curettage, contrary to what is proposed by the IFGO guideline. Establishing and complying with consistent guidelines can improve patient care, with early diagnosis of the pathology and its complications, reducing the rate of recurrence, morbidity and mortality, especially in less developed countries.

关键词： Diagnosis Gestational Trophoblastic Disease Updates

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Atypical Hemolytic Uremic Syndrome in a Post-COVID-19 Child: Its Differential Diagnosis with COVID-19, Multisystemic Inflammatory Syndrome and Outcome

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Open Journal of Pediatrics 2022年第4期12卷 657-664页

作者： Fernanda Aparecida de oliveira Peixoto Célia Regina Malveste Ito André Luís Elias Moreira Paulo Alex N. Silva Mônica oliveira Santos Isabela Jubé Wastowski Liana de Medeiros Machado braga Vivian Da Cunha Rabelo Lilian Carla Carneiro Melissa Ameloti Gomes Avelino department of Pediatrics Neonatal ICU of Clinical Hospital of Federal University of Goiás/Ebserh Goiania Brazil Microorganism Biotechnology Laboratory of Institute of Tropical Pathology and Public Health Federal University of Goiás Goiania Brazil Molecular Immunology Laboratory of Goiás State University Anápolis Brazil Pediatrics ICU of State Emergency Hospital Governor Otávio Lage of Siqueira Goiania Brazil Surgical department of Pediatrics Medical School Federal University of Goiás Goiania Brazil

Pediatric Multisystemic Inflammatory Syndrome (MIS-C) is one of the most severe manifestations of SARS-CoV-2 in pediatrics [1]. This is a report of MIS-C with clinical presentation in infants with atypical Hemolytic U... 详细信息

关键词： MISC COVID-19 aHUS Children Critical Care

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Local Cutaneous Effects Associated with Chlorhexidine-Impregnated Gel Dressing in Hematopoietic Stem Cell Transplantation Patients

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Open Journal of Nursing 2018年第2期8卷 115-129页

作者： Bruna Nogueira dos Santos Maria Carolina de oliveira Fernanda T. M. M. braga Amanda Salles Margatho Laís C. C. Esparrachiari Renata C. de C. P. Silveira department of General and Specialized Nursing Ribeir&#227 o Preto College of Nursing University of S&#227 o Paulo Ribeir&#227 o Preto Brazil Division of Clinical Immunology Ribeir&#227 o Preto Medical School University of S&#227 o Paulo Ribeir&#227 o Preto Brazil department of Nursing State University of Londrina Londrina Brazil

Introduction: Hematopoietic stem cell transplantation (HSCT) often requires a central venous catheter (CVC) for quick and safe vascular access. Currently, new technologies are available to protect the catheter insertion site, such as chlorhexidine-impregnated gel dressings (CIGD). Objectives: To evaluate local cutaneous effects associated with CIGD in patients undergoing HSCT. Methods: In this cross-sectional, prospective study, we evaluated 25 HSCT patients who had a CVC inserted. Patients were visited daily to monitor the CIGD changing procedures and evaluate abnormalities of the underlying skin after dressing removal. Findings: Local erythema was the most frequently detected abnormality, although usually transient and considered secondary to the mechanical trauma of dressing removal. The most severe lesions, consisting of areas of skin loss, erythematous plaques and/or vesicles were classified as skin irritation and presented in 11 (44%) of the 25 patients. An association test showed that skin irritation was more frequent in patients who underwent allogeneic HSCT (p = 0.03). Skin irritation was most frequently observed in areas of contact with the non-woven polyester adhesive tape (n = 22;88%), which made up the adhesive margins of the dressing. The CIGD was discontinued in 6 (54%) of the 11 patients who presented severe skin injuries. Conclusion: In this study, we detected that skin irritation was more frequent in patients who underwent allogeneic HSCT. The most common skin manifestation was skin loss.

关键词： Bandages Catheterization Central Venous Catheters Hematopoietic Stem Cell Transplantation Skin Abnormalities

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Antimicrobial Action and Scaring of 10%Green Banana Shell in Chronic Wounds

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Open Journal of Medical Microbiology 2018年第3期8卷 47-55页

作者： Ana Beatriz Alkimim Teixeira Loyola Rafael Vieira Fernandes Joao Victor braga Mendes Nadir Alves de oliveira Neta Luiz Francisley de Paiva Adriana Rodrigues dos Anjos Mendonca Dênia Amélia Novato Castelli Von Atzingen department of Applied Health Sciences Faculty of Health SciencesThe Universidade do Vale do SapucaíPouso AlegreBrazil Faculty of Medicine Sapucai Valley University(UNIVáS)Pouso AlegreBrazil Laboratory of Microbiological Research Sapucai Valley University(UNIVáS)Pouso AlegreBrazil department of Applied Health Sciences Sapucai Valley University(UNIVAS)Pouso AlegreBrazil department of Bioethics Faculty of Health SciencesSapucai Valley University(UNIVáS)Pouso AlegreBrazil

The percentage of diabetic patients with contaminated lesions increases from 3% to 10%. Treatment with herbal products shows benefits in their use, as well as antioxidant and antifungal activities. Objective: to evaluate the antimicrobial action of 10% banana peel gel and the contraction of diabetic and venous wounds. Methods: individual, analytical, interventional, longitudinal, prospective, randomized study from February to december 2015. Five patients were included in the study;3 with venous ulcer and 2 with diabetic wound. Application of 10% green banana peel gel and weekly samples were performed. After six days, the second collection was performed. The samples were seeded in the Mannitol salt agar culture medium, MacConkey agar and Saboraund agar with chloramphenicol for isolation of cocci and Gram-positive and Gram-negative bacilli;and fungi. The total counts of bacteria were determined by PCA (Plate Count Agar) and measurement of the lesion margin. There was a reduction of microorganisms with the use of the gel in 53.57% of the patients, and reduction of wound areas in 48.1%.

关键词： Musa sapientum Phytotherapy Products with Antimicrobial Action Healing Wounds and Injuries

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