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Auriculotherapy in primary health care: A large-scale educational experience in brazil

Journal of Integrative Medicine 2019年第4期17卷 302-309页

作者： Charles Dalcanale Tesser Ari Ojeda Ocampo More Melissa Costa Santos Emiliana Domingues Cunha da Silva Fatima Terezinha Pelachini Farias Lucio Jose Botelho Department of public health Federal University of Santa Catarina Floriandpolis Santa Catarina 88036-800 Brazil Post-graduate Program in public health Federal University of Santa Catarina Florianopolis Santa Catarina 88036-800 Brazil Integrative Medicine and Acupuncture Service University Hospital Federal University of Santa Catarina Floriandpolis Santa Catarina 88036-800 Brazil Floriandpolis Municipality health Office Florianopolis Santa Catarina 88036-800 Brazil

Auriculotherapy consists of physical stimuli applied to the outer ear and is commonly associated with traditional Chinese medicine (TCM). The authors present and discuss the development of a course that offers a semi-on-site auriculotherapy course for brazilian primary health care (PHC) professionals. The course was funded by the brazilian Ministry of health and developed at the federal university of santa catarina in 2015 by a team of experts in auriculotherapy. It consisted of 75 h of distance learning (five sequential modules) and 5 h of on-site learning. The modules included the following items:(1) introduction to integrative practices;(2) ear reflexology;(3) introduction to TCM;(4) biomedical view of auriculotherapy;and (5) auriculotherapy in PHC. The teaching material in eluded a workbook for each module, 14 video lectures and an interactive ear(on line resource) to study location and application to the main auricular points. The on-site lectures follow a structured script of ear palpation techniques, auricular seed insertion practice and clinical case discussions, under the supervision of trained instructors. The course was offered in 2016 and 2017 and on-site lectures took place in 25 cities, covering all brazilian regions, in coordination with municipal or state boards of health. A total of 4273 health professionals concluded the training and their evaluation of the course was highly positive. The brazilian experience of large-scale training shows the potential to disseminate auriculotherapy in the context of PHC, given that its practice is fast, easy to learn, safe, effective for different health problems and well accepted by the patients.

关键词： Auriculotherapy Traditional Chinese medicine Primary health care health education Distance learning

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针灸临床实践的挑战:转化医学视角的解读(英文)

针灸临床实践的挑战:转化医学视角的解读(英文)

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第八届中医/中西医结合循证医学方法研讨会

作者： Ari Ojeda Ocampo Mora public health acupuncturist of the university hospital federal university of santa catarina-brazil

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Risk factors associated with inflammatory bowel disease: A multicenter case-control study in brazil

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World Journal of Gastroenterology 2020年第25期26卷 3611-3624页

作者： Valéria Cristina Loureiro Salgado Ronir Raggio Luiz Neio Lucio Fernandes Boéchat Isabella Sued Leao Bianca do Carmo Schorr JoséMiguel Luz Parente Daniela Calado Lima Eduardo Santos Silveira Júnior Genoile Oliveira santana Silva Neogélia Pereira Almeida Andrea Vieira Maria Luiza Queiroz de Bueno Júlio Maria Chebli érika Ruback Bertges Luísa Martins da Costa Brugnara Columbano Junqueira Neto Stefania Burjack Gabriel Campbell Luana Letiza Discacciati Joao Paulo Silva Cézar Tiago Nunes Gilaad G Kaplan Cyrla Zaltman Division of Gastroenterology Department of Internal MedicineClementino Fraga Filho HospitalFederal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Institute for Studies in public health Federal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Multidisciplinary Research Laboratory Clementino Fraga Filho HospitalInstitute of Thoracic DiseasesFaculty of MedicineFederal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Division of Gastroenterology Department of Internal MedicineHospital UniversityFaculty of MedicineFederal University of PiauíPiauí64049-550Brazil Almeida Division of GastroenterologyInflammatory Bowel Disease Outpatient ClinicRoberto Santos General Hospital(HGRS)of the Bahia State Department of HealthBahia 40110-060Brazil Division of Gastroenterology Inflammatory Bowel Disease Outpatient ClinicIrmandade Santa Casa da Misericórdia of São PauloSão Paulo 01221020Brazil Division of Gastroenterology Department of Internal MedicineHospital UniversityFaculty of MedicineFederal University of Juiz de ForaMinas Gerais 36036-247Brazil Division of Gastroenterology Inflammatory Bowel Disease Outpatient ClinicFederal District Base HospitalBrasília 70330-150Brazil Gastrointestinal Physiology Institute of Nutritional ScienceNestle Research CenterLausanne 1000Switzerland Departments of Medicine and Community health Sciences University of CalgaryCalgary T2N4Z6Canada

BACKGROUND The etiology of inflammatory bowel disease(IBD)is unknown,but it is believed to be *** hygiene hypothesis proposes that better hygiene conditions would lead to less infectious disease during childhood and favor the development of immune-mediated *** To test the hygiene hypothesis in IBD by assessing the environmental risk factors associated with IBD development in different regions of brazil with diverse socioeconomic development *** A multicenter case-control study was carried out with 548 Crohn’s disease(CD)and 492 ulcerative colitis(UC)outpatients and 416 healthy controls,from six IBD centers within different brazilian states at diverse socioeconomic development stages.A semi-structured questionnaire with 87 socioeconomic and environmental questions was *** regression model was created to assess the odds ratio(OR)with P value and 95%confidence intervals(CI).RESULTS Predictive variables for both diseases(CD and UC)were women[odd ratios(OR)=1.31;OR=1.69],low monthly family income(OR=1.78;OR=1.57),lower number of cohabitants(OR=1.70;OR=1.60),absence of vaccination(OR=3.11;OR=2.51),previous history of bowel infections(OR=1.78;OR=1.49),and family history of IBD(OR=5.26;OR=3.33).Associated risk factors for CD were age(18-39 years)(OR=1.73),higher educational level(OR=2.22),absence of infectious childhood diseases(OR=1.99).The UC predictive variables were living in an urban area(OR=1.62),inadequate living conditions(OR=1.48)and former smokers(OR=3.36).Appendectomy was a risk factor for CD(OR=1.58)with inverse association with UC(OR=4.79).Consumption of treated and untreated water was associated with risk of CD(OR=1.38)and UC(OR=1.53),*** This is the first examining environmental exposures as risk factors for inflammatory bowel disease in *** of the variables associated with disease risk support the role of the hygiene hypothesis in IBD development.

关键词： Crohn’s disease Ulcerative colitis Risk factors Environmental factors Hygiene hypothesis

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Renin Angiotensin System Components and Cancer: Reports of Association

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Journal of Biosciences and Medicines 2016年第5期4卷 65-75页

作者： Maria Del Carmen Garcia Molina Wolgien Silvana Aparecida Alves Correa Pedro Alexandre Federico Breuel Afonso Celso Pinto Nazário Gil Facina Division of Mastology Department of Gynecology Federal University of Sao Paulo Paulista School of Medicine (UNIFESP-EPM) Sao Paulo Brazil Division of Mastology Departament of Gynecology Municipal Hospital and Maternity School Vila Nova Cachoeirinha Sao Paulo Brazil Division of Plastic Surgery Department of Surgery Federal University of Sao Paulo Paulista School of Medicine (UNIFESP-EPM) Sao Paulo Brazil Facvest university Center (UNIFACVEST) Post-Graduation Public Health Division Lages Santa Catarina Brazil Department of Teaching and Research Municipal Hospital and Maternity School Vila Nova Cachoeirinha Sao Paulo Brazil

Renin-Angiotensin System (RAS) is involved with hypertension and other cardiovascular diseases. However, the association of RAS components to cancer still causes suspicion. To try to clarify this, here we aimed to show this association for three important components: Angiotensin Converting Enzyme 1 (ACE1), Angiotensin Type 1 Receptor (AGTR1) and Angiotensin Type 2 Receptor (AGTR2). The first articles show that association of RAS components with cancer dates back to the 70’s. ECA1 and AGTR1 have close association with cancer and ACE1 inhibitors or AGTR1 blockers are candidates to treatment of some tumors. Moreover, the action of AGTR2 is still controversial, but most studies show that the increased expression of AGTR2 can attack the cancer cells. In breast cancer, these components have also been widely studied and many works have shown that the correlation exists. Therefore specific target using these RAS components could be a beneficial, novel therapy to various tumors.

关键词： Renin-Angiotensin System Angiotensin Converting Enzyme Angiotensin Type 1 Receptor Angiotensin Type 2 Receptor Breast Cancer Cancer

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Delivery of essential pediatric congenital surgical care within brazil’s universal health coverage system:a national survey of pediatric surgeons

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World Journal of Pediatric Surgery 2023年第3期6卷 136-146页

作者： Paul R Truche Abbie E Naus Fabio Botelho Julia Ferreira Alexis Bowder Luke Caddell Kathrin Zimmerman Isabella Maria de Freitas Faria Bellisa Caldas Lopes Eduardo Corrêa Costa Fernanda Lage Lima Dantas Augusto J S A Cavalcante Carlos A L B Carvalho Simone Abib David P Mooney Nivaldo Alonso Program in Global Surgery and Social Change Harvard Medical SchoolBostonMassachusettsUSA Department of Surgery Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA Department of Pediatric Surgery McGill UniversityMontrealQuébecCanada Department of Surgery Medical College of WisconsinMilwaukeeWisconsinUSA Division of Otolaryngology-Head and Neck Surgery Department of SurgeryUniversity of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA School of Medicine UFMGBelo HorizonteMinas GeraisBrazil Department of Pediatric Surgery Instituto de Medicina Integral Professor Fernando FigueiraRecifeBrazil Department of Pediatric Surgery Hospital de Clinicas de Porto AlegrePorto AlegreBrazil Department of Pediatric Surgery Federal University of AcreRio BrancoBrazil Department of Pediatric Surgery Hospital Santa Casa de Belo HorizonteBelo HorizonteBrazil Department of Pediatric Surgery Federal University of Mato GrossoCuiabaBrazil Department of Pediatric Surgery UNIFESPSao PauloBrazil Department of Pediatric Surgery Boston Children's HospitalBostonMassachusettsUSA Department of Plastic Surgery University of São Paulo Institute of Biomedical SciencesSao PauloBrazil

Objective In this study,we assess the delivery of congenital pediatric surgical care under brazil’s system of universal health coverage and evaluate differences in delivery between public and private *** A cross-sectional national survey of pediatric surgeons in brazil was *** were asked which of 23 interventions identified through the Disease Control Priorities 3(Surgical Interventions for Congenital Anomalies)they perform and to report barriers faced while providing surgical *** were weighted by state and stratified by sector(public vs private).Results A sample of 352 responses was obtained and weighted to represent 1378 practicing pediatric surgeons registered in brazil during the survey time.73%spend the majority of their time working in the public sector(‘SistemaÚnico de Saúde’and Foundation hospitals),and most of them also work in the private ***,brazilian pediatric surgeons have the expertise to provide thoracic,abdominal,and urologic *** working mostly in the public sector were more likely to report a lack of access to essential medications(25%vs 9%,phospital beds for surgical patients(52%vs 32%,pbrazilian pediatric surgeons routinely perform thoracic,abdominal,and urologic *** working in government-financed hospitals face barriers related to infrastructure,which may impact brazilians who rely on brazil’s universal health coverage *** that support pediatric surgeons working in the public sector may promote the workforce available to provide congenital pediatric surgical care.

关键词： pediatric survey brazil

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Prevalence of risk factors for cardiovascular and kidney disease in brazilian healthy preschool children

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World Journal of Nephrology 2016年第6期5卷 507-516页

作者： Adriana Candida da Silva Marcelo de Sousa Tavares Maria Goretti Moreira Guimaraes Penido Post-graduation Program-Master in health Sciences Child and Adolescent HealthSchool of MedicineFederal University of Minas GeraisSanta EfigeniaBelo HorizonteCEP 30130-100Minas GeraisBrazil Pediatric Nephrology Unit School of MedicineFederal University of Minas GeraisBelo HorizonteCEP 30130-100Minas GeraisBrazil Pediatric Nephrology Unit Center of NephrologySanta Casa de Belo Horizonte HospitalBelo HorizonteCEP 30150-320Minas GeraisBrazil

AIM To investigate the prevalence of nutritional parameters of risk for cardiovascular disease(CVD) and kidney diseases in healthy preschool *** This is an observational cross-sectional study with 60 healthy children, of both genders, aged two to six years old and 56 mothers, in Belo Horizonte, Minas Gerais, brazil. Preschool children and their families with regular activities at public schools were invited to paticipate in the study. The following characteristics were assessed: Socio-demographic condictions, clinical health, anthropometric, biochemical, lifestyle and data on food consumption. The 56 healthy children were divided into two groups, overweight(C1) and non-overweight(C2), as well as their mothers, respectively, in overweight(M1) and non-overweight(M2). Nutritional status was defined according to results obtained through the Anthro? Software for nutritional analysis. RESULTS Thirty-five children were male, with mean age of 4.44 ± 1.0 years old. Eighty-nine percent of them were eutrophic, 86.7% were sedentary and they had five meals a day. Body mass index(BMI) for age and total cholesterol(TC) was higher on C1(P = 0.0001) and high density lipoprotein cholesterol(HDL-c) was higher on C2. Mothers were 32.5 ± 7.1 years old, mostly married and employed. Eighty-six percent of them were sedentary and 62.5% were overweight with BMI = 26.38 ± 5.07 kg/m2. Eighteen percent of the overweight mothers had isolated total hypercholesterolemia(TC levels elevated) and 12.5% had low HDL-c levels. The present study showed an association between overweight and obesity during the preschool years and the correspondent mothers' nutritional status of overweight and obesity(OR = 4.96; 95%CI: 0.558-44.17). There was a positive correlation between the food risk associated with CVD by children and mothers when their consumption was 4 times/wk(P = 0.049; r = 0.516) or daily(P = 0.000008; r = 0.892).CONCLUSION Analyzed children showed high rates of physical inactivity, hi

关键词： Cardiovascular disease Kidney disease Preschool children Food habits Lifestyle

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Prevalence of Family History of Cancer among Gastric Cancer Patients at brazilian National Cancer Institute

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health 2017年第1期9卷 25-37页

作者： Tamara Figueiredo Maria Teresa Santos Guedes Luis Paulo Souza e Souza Antonio Abílio santa Rosa Antonio Carlos Accetta Maria Aparecida de Luca Nascimento Lais Santiago Deivite Danilo Ferreira Alcantara Department of Postgraduate in Adult health Federal University of Minas GeraisBelo HorizonteBrazil Department of Radiotherapy Health Foundation Dilson de Quadros GodinhoMontes ClarosBrazil National Tumor/DNA Bank National Cancer Institute Rio de JaneiroBrazil Department of Postgraduate Course in Nursing and Biosciences Federal University of Rio de Janeiro StateRio de JaneiroBrazil Department of Postgraduation in public health Federal University of Minas GeraisBelo HorizonteBrazil Department of Medicine Federal University of Sao Joao del ReiSao Joao del ReiBrazil Research Department of the Bonsucesso General hospital Ethics Committee National Cancer InstituteRio de JaneiroBrazil Department of Abdominal-Pelvic Surgery National Cancer InstituteRio de JaneiroBrazil Department of Chemotherapy National Cancer InstituteRio de JaneiroBrazil

Background: Gastric cancer is the third most incident malignancy and the fifth leading cause of death in the world. In brazil, it is the fourth most common tumour in men and the fifth in women. Familial aggregation of this tumour is being studied and discussed by experts. Aim: Determine the frequency of family history of cancer in patients with gastric cancer, suggesting familial aggregation or increased risk for hereditary cancer syndromes. Methods: This is a retrospective cross-sectional study carried out from January 2011 to March 2015 at the Department of Abdominal and Pelvic Surgery of the brazilian National Cancer Institute (INCA). Data were collected from electronic medical records and analyzed using SPSS Statistics? version 20. Results: 873 patients with gastric adenocarcinoma were analyzed. A family history of cancer was reported by 451 patients (51.6%), which reported cancer in 878 relatives, of which 110 (12.6%), reported having more than three relatives with any type of cancer. The most prevalent malignancies among these relatives were gastric cancer (21.3%) and breast cancer (9.5%). Conclusion: Most of the patients had cancer family history, being gastric cancer the most common. The high percentage of cancer family history confirms the importance of collecting this information, whose lack reflects professional negligence, as family history study can serve as a low-cost tool, favoring prevention and early diagnosis, situations where morbidity and mortality are smaller, thus reducing health costs and assistance and preserving lives.

关键词： Stomach Neoplasms Family History Hereditary Aggregation hospital Records Cross-Sectional Studies

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Current impact of viral hepatitis on liver cancer development: The challenge remains

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World Journal of Gastroenterology 2021年第24期27卷 3556-3567页

作者： Ângelo Zambam de Mattos Jose D Debes Andre Boonstra Ju-Dong Yang Domingo C Balderramo Giovana D P Sartori Angelo Alves de Mattos Department of Gastroenterology and Hepatology Federal University of Health Sciences of Porto AlegrePorto Alegre 90020-090Brazil Gastroenterology and Hepatology Unit Irmandade Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90050-170Brazil Department of Medicine Division of Gastroenterology and Infectious DiseasesUniversity of MinnesotaMinneapolisMN 55455United States Department of Gastroenterology and Hepatology Erasmus Medical CenterRotterdam NL-3015Netherlands Division of Digestive and Liver Diseases Department of MedicineCedars-Sinai Medical CenterLos AngelesCA 90048United States Department of Gastroenterology Hospital Privado Universitario de CórdobaCórdoba 5016Argentina Department of Medicine Instituto Universitario de Ciencias Biomédicas de CórdobaCórdoba 5016Argentina Department of Internal Medicine Hospital Nossa Senhora da ConceiçãoPorto Alegre 91350-200Brazil

Chronic infections due to hepatitis B and hepatitis C viruses are responsible for most cases of hepatocellular carcinoma(HCC)worldwide,and this association is likely to remain during the next ***,viral hepatitis-related HCC imposes an important burden on public health in terms of disability-adjusted life *** order to reduce such a burden,some major challenges must be *** vaccination against hepatitis B virus,especially in the neonatal period,is probably the most relevant primary preventive measure against the development of ***,considering the large adult population already infected with hepatitis B and C viruses,it is also imperative to identify these individuals to ensure their access to *** hepatitis B and C currently have highly effective therapies,which are able to diminish the risk of development of liver ***,it is essential for individuals at high-risk of HCC to be included in surveillance programs,so that tumors are detected at an early *** with hepatitis B or C and advanced liver fibrosis or cirrhosis benefit from being followed in a surveillance *** hepatitis B virus is oncogenic and capable of leading to liver cancer even in individuals with early stages of liver fibrosis,other high-risk groups of patients with hepatitis B are also candidates for *** effort is required concerning these strategies in order to decrease the incidence and the mortality of viral hepatitis-related HCC.

关键词： Hepatitis B virus Hepatitis C virus Hepatocellular carcinoma Epidemiology Vaccination Surveillance

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