Trabalho de Conclusão de Curso - TCC

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A utilização de etnofármacos pela comunidade ribeirinha de Belém-PA: uma avaliação sobre o conhecimento médico à medicina alternativa no início do século XXI
(Centro Universitário do Estado do Pará, 2021) Silva, Marcely Nascimento da; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982
This research aims to define the degree of knowledge and use of ethnopharmaceuticals by physicians at Basic Health Units in the Islands Region in Belém-Pa in 2021. This was a cross-sectional, observational and quantitative study for definition the clinical-epidemiological profile and knowledge about ethnopharmaceuticals of the participants. The collection of the research was carried out through interviews, with a multicentric, regional character. The questionnaire used was subdivided into part 1 (identification), part 2 (Who should know and use herbal medicines?), part 3 (professionals' knowledge of herbal products), part 4 (prescription and indications), part 5 (effectiveness) and part 6 (use and safety of herbal medicines and medicinal plants). The average age of the participants was 35.9 years, being equally distributed among 5 female professionals and 5 male professionals, totaling 10 physicians. 10% had graduated from college for 29 years, 60% graduated between 6-2 years and 30% graduated 6 months ago. 80% of physicians interviewed were graduates of public education and only 20% belonged to private education, the highest medical degree found among the participants was the title of specialist, represented by 60% of physicians. It was noted that 60% of physicians prescribed herbal medicines, however, only 30% received information about the subject during graduation, and no participant performed training on phytopharmaceuticals after starting their professional career. The most difficult factor for the prescription of herbal medicines was the lack of knowledge about the subject. 70% of respondents believed in the efficacy of the therapy, and among the most used biopharmaceuticals were Valeriana (Valeriana officinalis) and Espinheira santa (Maytenus ilicifolia). There was a lack of knowledge about contraindications for the use of herbal medicines and medicinal plants by 80% of respondents and 70% were unable to report risks generated by the use of herbal medicines. It was concluded that physicians in the riverside region of the islands of Belém/Pará believe in the efficacy of therapeutics with herbal medicines and medicinal plants, they usually prescribe for their primary health care users, but they have little knowledge about the resources and application of the therapy.
Autoaceitação e qualidade de vida pós mastectomia de transexualização
(Centro Universitário do Estado do Pará, 2023-05-30) Soares, Fernanda Piqueira de Andrade Lobo; Miranda, Letícia Colares; Rodrigues, Brenda Diniz; Loureiro, Camila Fernanda Antunes Castanho Cavaleiro de Macedo; http://lattes.cnpq.br/6746290429073526; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Amaral, Gabriela Borborema do; http://lattes.cnpq.br/9582500401192127
Introduction: The term “transgender person” refers to any person who does not identify with their birth gender. Allied to that, in the medical field many studies approach the concept of gender dysphoria, whih means a significant clinical discomfort associated with gender and biological characteristics, associated with impaired self-perception and impaired quality of life. Within this context, medical interventions and other areas of the health field come to help in the gender transition process, which includes the performance of mastectomy. In summary, the present study seeks to estimate the procedures impact on the sexual resignation process of transgender men. Objective: To measure the impact of mastectomy on transsexual men, and how this surgery influences aspects related to the quality of life of this population. Materials and methods: This is a cross- sectional, observational and descriptive study, based on data collected through the application of a virtual questionnaire for patients undergoing masculininzing mastectomy for in Brazil, between december 2022 and march 2023. Results: 50 individuals participated in the research. Among these, most of them were between 20 and 39 years old, identified themselves as trans men for more than 2 years and had health insurance. In the pre-operative period, the highest proportion of minimum grades was related to the level of satisfaction with physical appearance. In post-operative period, most evaluated their quality of life as very good. Comparatively, between the two periods, the highest difference between the averages found was related to the acceptance of physical appearance, the smallest difference occurred in terms of satisfaction with health services. Regarding gender violence, 66% reported having suffered violence when seeking health care, and most related what happened to embarrassment due to pronoun error. Conclusion: Thus, it is evident that the masculininzing mastectomy had a positive impact on the variables studied related to quality of life. In addition, it clarifies the need to develop new tools to measure the quality of life of the studied population.
Cartilha sobre cuidados paliativos: uma forma lúdica para inserir o assunto na graduação em medicina
(Centro Universitário do Estado do Pará, 2022-11-08) Azevedo, Giovanna Calderaro Coimbra Monteiro; Souza, Ravine Campos de; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Souza, Ivete Moura Seabra de; http://lattes.cnpq.br/5318491010793081; Maués, Cristiane Ribeiro; http://lattes.cnpq.br/0584956998438639
The increase in the prevalence of chronic non-communicable diseases has contributed to the training of technicists and biologist doctors. Consequently, the death was seen as a professional failure. On the other side, comprehensive patient care in line with humanized care promotes health care that reaffirms the importance of life and understands death as a natural process. This way, it is essential to develop, even in the undergraduate course, strategies the encourage the exercise and practice of palliative care, since the graduate must have a general, critical, reflective and ethical humanist training that defends human dignity and integral health. For this, approaching a delicate topic such as the end of life in a playful and recreational way is essential for the training of future professionals. The present work has the objective an elaboration and validation of a booklet to inset the theme of palliative care in the graduation in Medicine. This validation was carried out by expert judges on the subject, as well as by representatives of the target audience. This is a cross-sectional study, descriptive quantitative. The booklet was organized based on manuals and public health policies, in addition to scientific articles published in virtual libraries. The content was analyzed by health professionals through a questionnaire applied in person or via an electronic form. The evaluators were divided into two groups: the first one containing 10 doctor (geriatricians, oncologists, family doctor and clinicians) and a second group containing 12 medical students regularly enrolled at CESUPA. The method used was the Likert Scale. The technical jury and the target audience evaluated the topics “objective, contents, relevance, illustration, language, layout and design”. According to the Likert scale score, demonstrating that the higher the marking of the criterion “I totally agree” more approved will be the material, the booklet “Palliative Care: Shall we learn about it?” Had its validation confirmed, since the technical jury showed acceptance of 75% and the target audience 92%, creating an overall approval rating of 84%. The booklet obtained a good rate of approval by the experts, demonstrating the relevance of the theme and its insertion un the graduation. As for the target audience, it proved to be a useful tool, agile reading capable of providing relevant information about the topic and instigate the active search for new knowledge.
Comportamento sexual e reprodutivo de mulheres ribeirinhas habitantes de uma comunidade no Baixo Acará, Pará, Brasil
(Centro Universitário do Estado do Pará, 2022-11-10) Dias, Jéssica Maria Gouveia; Souza, José Lucas Dias de; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Santos, Eliane Regine Fonseca; http://lattes.cnpq.br/3837797857505891; Luz, Marília Gabriela Queiroz da; http://lattes.cnpq.br/7318301499873546
Riverside rural communities have geographic, social and economic barriers that refletc on the health of the riverdidade population, especiallu in women’s heatlh. Research on rivesidade women can show patterns that reacte profiles that help in the elaboration of pratical local actions. The objective of the study was to characterize the demographic and social, sexual and reproductive profile and knowledge about contraceptive methods, sexual transmited infections (STI) and family planning of riversidade women, from the Genipauba Community, in Baixo Acará, Pará, Brazil. The study typology was epidemiological and cross-sectional, quantitative and descriptive, through three semi-structured questionnaires with questions about social and demographic, sexual and reproductive health data, autored by the researchers and applied to women aged 18 yeas or older who lived in the community and who initiated the sexual life – the study had the participation of 33 womens. Social and demographic results revealed women aged between 18 and 60 years, broen and evangelical, with incomplete education, in steady and long-term relationships, autonomous, living in wooden houses with on stilts and more than a decade in the community. The sexual health results showed owmen with early coitarche, one or two sexual parners during their lifetime and knowledge about contraceptive methods, using surgical and non-surgical contraception. The sexual health results also showed knowledge about PCCU and STI, but uncertainties about their own serologies and with a case of syphilis during pregnancy, in addition to a family history of uterine câncer. The reproductive health results showed women with high fertility and birth rates, with early pregnancies, unplanned, but accepted, adequate prenatal care and term deliveries, vaginally and in hospitals, but with infectious and cardiovascular complications and abortions due to physical trauma. It was concluded that riverside women have social and health deficits that reflect geographic, social and economic barriers and that the internalization of clinical, gynecological and obstetric medicine is fundamental for the development of woemn and riversidade communities.
Conhecimento acerca dos cuidados paliativos em internos do curso de medicina de uma instituição privada de ensino em Belém/PA
(Centro Universitário do Estado do Pará, 2023-05-29) Anijar, Victória Haya; Azevedo, Yuri de Sousa; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Souza, Ivete Moura Seabra de; http://lattes.cnpq.br/5318491010793081; Vinagre, Nádia Carolina de Lima; http://lattes.cnpq.br/9449802655052094
Brazil is experiencing a demographic transition, with changes in dietary and behavioral patterns, increasing the incidence of non-communicable chronic diseases. In view of this, there is a breakdown of the family group as the disease progresses and even the patient's death. In this context, curative medicine emerges, with Palliative Care, which aims to alleviate the suffering of the patient and the family, through physical, psychological, social and spiritual health care, easing the death process. To analyze knowledge about palliative care in students of the 11th and 12th semester of the Medicine course at the Centro Universitário do Estado do Pará (CESUPA) in the year 2022. A cross-sectional, observational and descriptive study was carried out based on the application of a virtual evaluated to the academics in question. 89 students were analyzed, 70.78% female and 29.21% male, with most students being 20-25 years old (70.78%) and only 4.49% taking a course extracurricular on the subject. A large part of the students had knowledge about the subject, either in relation to the concepts that support palliative care (77.3%), or about the therapy used (85.69%), as well as who this care is intended for (79, 02%). Although most students have knowledge about the subject, it is noted that it is necessary to implement the subject in the course curriculum, as well as to offer extracurricular courses on the subject, due to the local and global importance in which it is inserted.
Conhecimento dos acadêmicos de medicina de uma faculdade privada de Belém do Pará acerca do reconhecimento de sinais e diagnóstico do transtorno do espectro autista (TEA)
(Centro Universitário do Estado do Pará, 2023-05-29) Braga, Eduarda Melo; Bahia, Lorena Barros; Albuquerque, Mário Roberto Tavares Cardoso de; Freitas, Juliana Pastana Ramos de; http://lattes.cnpq.br/8394880417480266; http://lattes.cnpq.br/3233617656287982; Carvalho, Ana Emília Vita; http://lattes.cnpq.br/1981562999898097; Miranda, Rayssa Pinheiro; http://lattes.cnpq.br/1849222504854523
Despite the existence of several clinical tests and analysis tools, the diagnosis of ASD is not always carried out effectively and early, given the existence of a wide variety of symptoms and signs manifested by patients, therefore it is essential to be in contact with this topic during the academic period, as a way to promote greater and more effective dissemination of knowledge about this disorder. Objective: To describe the level of knowledge of academics in the 11th and 12th semesters of the Medicine course at the University Center of the State of Pará (CESUPA) about the clinical diagnosis of autism spectrum disorder (ASD). Methodology: This is a descriptive, observational study with a quantitative approach, where classes were applied to students enrolled in the eleventh and twelfth semester of the Medicine course at the University Center of the State of Pará (CESUPA) . Results: Most respondents were able to identify ASD through a clinical case exposed to them during the research, in addition to being able to identify a case of ASD in terms of clinical presentation and DSM-5 criteria. was able to indicate a case of ASD through the signs and diagnostic aspects of ASD presented. Conclusion: It is concluded that there is an urgent need to develop research that assesses the level of knowledge about the early detection of warning signs for ASD even during academic training, because the majority of the participants did not present an advanced performance through the standard standards.
Desenvolvimento e validação de cartilha educativa “quebracuca” como estratégia de autocuidado em idosos hipertensos
(Centro Universitário do Estado do Pará, 2021) Pacheco, Mônica Vanessa de Moraes Lima; Fernandes, Ronicelli Cezario; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982
Introduction: The world population has been going through a demographic transition process, resulting in population aging. In addition, there was a change in the epidemiological profile, demonstrating a preponderance of chronic-degenerative diseases, such as systemic arterial hypertension (SAH). The high prevalence of SAH in the elderly makes it necessary to have greater knowledge about risk factors, drug and non-drug treatment, prevention of complications inherent to the pathology, in order to reduce morbidity and mortality and improve quality of life and functional independence. In this context, recreational activities are an instrument to facilitate learning, promote improvement in the individual's health, and change in behavior. Objectives: This study aimed to develop and validate a playful booklet with guidelines that enhance self-care in hypertensive elderly. This validation was carried out by expert judges on the subject, as well as representatives of the target audience. Methods: This is a cross-sectional, applied, quantitative descriptive study. The Booklet was organized based on manuals and public health policies, in addition to scientific articles published in virtual libraries. Its content was analyzed by health professionals through a questionnaire administered via e-mail. The evaluators were divided into two groups: the first containing 30 professionals (doctors, nurses, nutritionists and physical educators) who work with elderly hypertensive patients within their area of expertise, and a second group containing 15 elderly patients diagnosed with SAH registered in the CEMEC. The method used was the Likert Scale. Results and Discussion: The technical jury and the target audience evaluated the topics “objectives, content, relevance, illustrations, language and layout and design”. According to the Likert scale score, showing that the higher the “I totally agree” criterion, the more approved the material will be, the Quebra-Cuca Booklet had its validation confirmed, since the technical jury showed 81% acceptance and the public target 96%, generating an overall approval of 86%. Conclusion: The booklet obtained a good approval rate by the judges, demonstrating its importance for health education, in addition to being a useful tool to disseminate the minimum necessary knowledge, therefore considered validated.
Fatores dificultadores para o acesso e educação em saúde de pessoas surdas em Belém-Pará
(Centro Universitário do Estado do Pará, 2023-05-29) Barbosa, Luiza da Costa; Peres, Maria Clara Melo; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Macedo, Érika Maria Carmona Keuffer Cavalleiro de; http://lattes.cnpq.br/8498243104217470; Rodrigues, Cybelle Cristina Pereira; http://lattes.cnpq.br/9540610661271303
The reduction of the listening capacity promotes social, cultural, and linguistic barriers, mainly on the access of the deaf community to health, compromising humanized care and welfare. Research on that type of need can resolve those problems. The present study aims to identify the main challenges of deaf people on the access to health in Belém/Pará and the consequences on health education. The methodology of the study was descriptive observational and transversal study, with quantitative approach, using a questionary made by the authors, based on the Likert school, with questions about the accessibility rate, understanding, and independence of those disabled people in health services and the epidemic profile, applying the questionary online, in portuguese and translated in LIBRAS to the deaf community of Belém, over 18 years old, regardless of gender, that uses the health services in Belém, mapped with the help of the “Coordenadoria de Acessibilidade da Universidade Federal do Pará” and the “Captação e Profissionais da Educação e Atendimento à Pessoa Surda Center”, with 27 participants. The demographic results revealed that most participants were women, 20 to 39 years old, from Pará’s capital, with incomplete University education, with advanced or intermediary Portuguese knowledge, using mostly public service, and having for main communication oral speak, labial lectures,s, and LIBRAS. The results about the main difficulty factors on access to health services show the unprepared professionals and the lack of structural services, like translators and assistencial technologies. Regarding the medical appointments, the results show that all services are given none satisfy experiences. Therefore, mostly the participants consider mandatory LIBRAS knowledge. It was concluded that the difficult access of the deaf community to the health service is pertinent and it becomes the development of more studies aimed at this population to support the search for greater professionalization of health workers treated to the accessibility and integration of minorities, as well as technical assistance measures.
Manejo clínico pré-operatório de pacientes candidatos ao transplante facial: relato de caso
(Centro Universitário do Estado do Pará, 2021) Borges, Mateus de Sousa; Albuquerque, Mário Roberto Tavares Cardoso de; Morales, Martin Iglesias; http://lattes.cnpq.br/3233617656287982
Introduction: Face transplantation has gained recognition, changing the clinicalsurgical outlook for the restoration of complex facial defects, since it attributes functional and aesthetic recovery to patients who have suffered serious accidents. To date, in official publications, about 43 patients have undergone facial transplantation worldwide. The face transplant has numerous evidences that can provide improvements to the patient in an irrefutable way. For this, preoperative care for the patient must be carefully established, as in this stage the short and long term acquired comorbidities, lifestyle, food, among others, which are essential for the performance of a good surgery, are revealed. Objective: To report the routine of preoperative care and preparation of a patient who is a candidate for facial transplantation attended at a referral unit for reconstructive surgery in Mexico City. Methodology: This was a retrospective and cross-sectional study, which was carried out through the analysis of the medical record of the patient seen between January 2017 and January 2020, in the Ayuda para la Mano Artrítica AC Group, "Tlalpan Team". Report: a 46-year-old male patient reports that, at the age of 6, he had a burn from exposure to gasoline with 72% (TBSA), with sequelae from burns and surgical reconstructions on the face, scar from rotation of the frontal flap, amorphous frontal flap in a nasal site, redundant and ptotic skin flap on the left cheek, absence of upper and lower lip, ectropion on both lower eyelids, bilateral hyperemic conjunctiva, exposure of the lower teeth and loss of definition of the mandibular line. Conclusion: the importance of disseminating this innovative procedure in different medical specialties and preoperative care is emphasized through a thorough investigation, which attributes a better surgical efficacy and a good performance of the patient after the transplant and, thus, enabling the rescue of their facial identity once stigmatized.
Perfil clínico-epidemiológico da coinfecção HIV/tuberculose em um serviço de assistência especializado em Belém/PA no período de 2011 a 2018
(Centro Universitário do Estado do Pará, 2022-11-10) Silva, Lucas Solano Araújo da; Ribeiro, Samuel Soares; Santos, Eliane Regine Fonseca; http://lattes.cnpq.br/3837797857505891; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Santos, Bruno Souza dos; http://lattes.cnpq.br/6779627806652537
The human immunodeficiency virus (HIV) is a retrovirus whose pathogenesis consists of an asymptomatic or symptomatic acute phase. If the patient is not treated, the disease may progress to acquired immunodeficiency syndrome (AIDS), considered a chronic and lethal infectious disease, and consequently the individual be susceptible to opportunistic infections. Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is one of the main causes of morbidity and mortality among people living with HIV/AIDS (PLHA). In Brazil, a prevalence of 8.1% of HIV/TB coinfection was reported in 2019, an average similar to that found in the state of Pará, with 9.1 % PLHA had co-infection with TB. The present study aims to describe the epidemiological profile of PLWHA with Tuberculosis (TB) in a Health Care Center for Acquired Infectious Diseases (CASA DIA) in the municipality of Belém, state of Pará, Brazil. This is an observational cross-sectional study based on the epidemiological method, carried out after the appraisal and release of opinion, which consisted of a collection of data from medical records and the Tuberculosis Program Book of PLHA coinfected with TB, aged over 18 years, who were monitored at CASA DIA in the municipality of Belém-PA from 2011 to 2018. Around of 598 medical records were analyzed, but only 366 were selected to compose the study following the inclusion and exclusion criteria. Among the 366 medical records, the mean age was 35.3 years, with a prevalence of 68.9% male and 80.6% of schooling corresponding to incomplete elementary school. The main behavioural risk factors for HIV infection that obtained prevalence were sexual orientation - heterosexual, with 48.6%, followed by 34.4% and 42.6% who reported having more than 3 sexual partners and who reported not using condoms during sexual intercourse. It was observed that 55.5% of patients had a detectable viral load and 49.2% had CD4+ lymphocytes <350 cells/mm3. In the clinical profile of tuberculosis, a prevalence of 64.5% was recorded for new cases, 35.8% for non-reactive (NR - <5mm) in the tuberculin skin test, 38.5% for a diagnosis suggestive of TB by chest X-ray, and 57.4% of the patients were diagnosed with pulmonary tuberculosis. Noting that about 37.2% completed the treatment, but 24.3% abandoned it. The correlation between the immunovirological profile and the clinical profile of TB did not present a statistically significant difference, but it was possible to observe that the detectable viral load had a higher incidence in both the pulmonary and extrapulmonary clinical forms, with 84% and 82%, respectively. It was also found that CD4+ values <350 cells/mm3 were higher in the clinical forms of TB, with 75% (104/139) for the pulmonary form and 74% for the extrapulmonary form. Thus, it is necessary to intensify educational, preventive and infection control measures. The study warns about the importance of filling out the medical records properly, to correct this filling failure, it is essential to train health professionals until they are able to complete the medical records.
Sexualidade em idosos: características da abordagem por profissionais de saúde em serviço de referência em Belém/PA
(Centro Universitário do Estado do Pará, 2023-06-30) Chaves, Lígia Beatriz Pinho; Gomes, Sâmilly Campos; Albuquerque, Mário Roberto Tavares Cardoso de; http://lattes.cnpq.br/3233617656287982; Costa, Tanise Nazaré Maia; http://lattes.cnpq.br/4471975369870057; Maués, Cristiane Ribeiro; http://lattes.cnpq.br/0584956998438639
One of the keys to human behavior and personality is sexuality, considered to be one of the basic human needs. In this context, it is necessary to discuss the differences defined by the progress of age associated with sociocultural taboos and their relationship with the quality of medical care provided under this theme, since the idea of sexuality in older adults has been neglected and the possibility of an elderly person being infected with HIV, until recently, for example, was considered remote. However, national data indicate that the HIV rate in the elderly already exceeds that of adolescents and among the trends for these high rates is the increase in sexual practices in old age, which lack guidelines followed. To determine the frequency, scope and standard of addressing the sexuality of the elderly within the geriatrics service in the metropolitan region of Belém-Pará. Epidemiological and cross-sectional, descriptive, population-based study, in which data were collected from a clinical interview, using a model form with questions prepared by the investigator, in patients treated at health clinics of the Elderly, from the Medical Specialties Center of Cesupa (CEMEC), from November 2022 to February 2023. 101 patients participated in this study. Of these, the majority were women, over 75 years old, married, Catholic and heterosexual. About of 84% of patients did not have their sexuality addressed in a consultation, even though they felt comfortable talking about the topic. The justification for this suggests that they would feel more comfortable talking about the subject if the doctor addressed it and they were indifferent as to the gender of the doctor who could address the subject. This constitutes an obstacle in the face of resolving personalized dysfunctions, since 38% of those treated had some sexual complaint, while 39% of them have not yet informed a doctor, with the main justification being that in 63% of cases the doctor did not speak about the subject. In view of that, it is necessary to make the routine of questioning the sexual health of patients, providing safety for the practice and greater comfort, allowing for greater diagnoses and greater resolution of satisfied complaints, providing the well-being of the elderly assisted.

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