Medicina

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    A importância da ultrassonografia no diagnóstico da doença hepática gordurosa não alcóolica
    (Centro Universitário do Estado do Pará, 2020) Mendes Netto, Ataíde José; Rocha, Everton Roberto de Castro; Silva, Flavio Tavares Freire da; http://lattes.cnpq.br/1386374444157946; Rodrigues, Ana Paula Guimaraes; http://lattes.cnpq.br/8714469084529838; Caldato, Cassio; http://lattes.cnpq.br/7526204330567369
    Introduction: Non-alcoholic fatty liver disease is considered the most common cause of liver disease in the world, being also a hepatic manifestation of the metabolic syndrome. In this context, the objective of this study was to determine the prevalence of non-alcoholic hepatic steatosis diagnosed by ultrasound in patients seen at an outpatient clinic of a Higher Education Institution in the city of Belém - PA. Methodology: Descriptive, documentary and cross-sectional study with a quantitative approach carried out with 115 patients who underwent abdominal ultrasound at the Centro de Especialidades Médicas of Centro Universitário do Pará in 2019. The association between metabolic syndrome and non-alcoholic liver steatosis was assessed by the test Fisher's exact, considering p≤0.05 statistically significant. Results: Most patients were female (71.3%), aged between 50 and 69 years old (53%), brown (90.4%) and married or in a stable relationship (41.7%). There was a high prevalence of obese patients (43.5%) with arterial hypertension (69.6%) and diabetics (32.2%). The prevalence of non-alcoholic hepatic steatosis was 72.2%, statistically associated with the presence of metabolic syndrome (p = 0.0001), where 89.1% of patients who had this syndrome had non-alcoholic hepatic steatosis. Conclusion: There was a high prevalence of non-alcoholic hepatic steatosis among patients, associated with metabolic syndrome. Therefore, it is emphasized that the early diagnosis of hepatic steatosis helps to monitor individuals with a chance of developing metabolic syndrome. In addition, ultrasonography proved to be a sensitive and effective test for the detection of hepatic steatosis, given the high prevalence of this disorder in the population studied.
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    A influência da metformina no declínio neurocognitivo: uma revisão sistemática com metanálise
    (Centro Universitário do Estado do Pará, 2021) Nakanishi, Deborah Ayumi Alves; Aragão, Diego Armando Barbosa; Teixeira, Cláudio Eduardo Corrêa; http://lattes.cnpq.br/7448998858430931
    Background: Blood glucose variations are generally associated with predisposition to the development of dementia in diabetes patients. And there is a controversy in the literature about whether the use of antihyperglycemic agents can(not) promote protective effects on cognition. Design and setting: we used a systematic review with meta-analysis to evaluate whether the evidence in the literature points to a protective or harmful effect of antihyperglycemic agents on cognition. Methods: PubMed, Science Direct and Scielo databases were used to collect articles in English, published between 2005 and 2020. Articles of reflection/opinion, monographs/theses/dissertations, and animal research were excluded. The blinding of authors during the searches contributed to search independence. Of 1,329 articles selected, 30 were adequate, but only 3 of these provided quantitative data from 53 cognitive tests, which were used for meta-analysis (random effect model), performed using R. Results: Funnel plot shows no publication bias. Forest plot, on the other hand, shows that literature points to the use of antihyperglycemic agents by patients as preventive of cognitive losses (standard mean difference equal to -0.18 [95% confidence interval between -0.29 and -0.06]). Conclusion: Evidence of the preventive effect of cognitive losses through the use of antihyperglycemic agents such as metformin should be further investigated, in order to better clarify this therapeutic potential.
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    A influência dos níveis séricos de IGF-1 no perfil lipídico e glicêmico de acromegálicos em um Centro de Especialidades Médicas no Pará
    (Centro Universitário do Estado do Pará, 2021) Pereira, Caroline de Oliveira; Ferraz, Louise Paiva; Bastos, Fabíola de Arruda; Caldato, Milena Coelho Fernandes; http://lattes.cnpq.br/9477878606835309; http://lattes.cnpq.br/9386935778704228
    Introduction: Acromegaly is an insidious and rare disease, associated with a high mortality rate, which results from the pathological autonomous overproduction of growth hormone (GH) and the subsequent increase in insulin-like growth factor-1 (IGF-1) levels. Chronic hypersecretion of these hormones causes several metabolic changes, among which we can highlight lipolysis, atherosclerotic processes, hyperinsulinemia, gluconeogenesis and peripheral insulin resistance. These changes in lipid and glycemic metabolism are related to an increased risk of cardiovascular events in acromegalic patients, being today the second most common cause of mortality in these patients. As a result, it is necessary to assess whether the control of the disease also corresponds to a better metabolic control of these patients, resulting in a lower cardiovascular risk and a lower mortality rate. Objectives: To evaluate the influence of IGF-1 levels on the lipid and glycemic profile of acromegalic patients treated at the Cesupa Medical Specialties Center. Methodology: This is an epidemiological, cross-sectional and descriptive study, based on an exploratory analysis of the medical records of the Endocrinology Service of the Cesupa Medical Specialties Center (CEMEC) from August 2019 to June 2020. Results: When comparing acromegaly activity in the first and last consultation, it was found that there was an increase in disease control, from 22.2% to 71.1%. As for the glycemic profile, the glycemia of diabetic acromegalic patients was statistically higher than that of non-diabetics, both in the first assessment (Mean ± SD: 135.8 ± 59.4 vs 95.1 ± 15.2; P <0.001), and in the latter (Mean ± SD: 98.6 ± 13.2 vs 84.0 ± 11.1; P <0.001). When observing diabetic acromegalic patients, there was a significant decrease in the levels of IGF-1 (mean ± SD: 480.9 ± 250.5 vs 189.5 ± 91.5, P <0.001) and IGF-1 by LSN ( mean ± SD: 1.8 ± 1.0 vs 1.0 ± 0.6, P <0.001), when comparing the two assessments. It was possible to observe, comparing the laboratory parameters between the first and last evaluation, that in the uncontrolled acromegaly at the end (n = 13), there was a decrease in the total cholesterol levels (Mean ± SD: 179.3 ± 30.0 vs 155, 9 ± 28.8; P = 0.018) and, significant increase in HDL (Mean ± SD: 46.8 ± 14.3 vs 53.3 ± 7.9; P = 0.048). For patients with controlled acromegaly at the end (n = 32), there was a significant increase in the HDL level (Mean ± SD: 46.3 ± 26.0 vs 58.0 ± 24.2; P = 0.003) and a decrease in levels of IGF-1, GH, total cholesterol, LDL and TG. Conclusion: These results suggest that most of the acromegalics under study had control of the disease by reducing the levels of IGF-1, evidencing success in their therapeutic conduct. Concomitantly, the majority also obtained improvement in the levels of glucose, glycated hemoglobin, total cholesterol and HDL. This suggests that controlling disease activity is one of the most important interventions for reducing cardiovascular risk in these patients.
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    A percepção de graduandos de medicina na utilização de imagens como recurso metodológico no processo de ensino-aprendizagem
    (Centro Universitário do Estado do Pará, 2022) Albuquerque, Lucas Eduardo Carneiro; Kawachi, Yuji Reis; Magno, Ismaelino Mauro Nunes; http://lattes.cnpq.br/3841081216551678
    Introduction: The teaching and learning process can happen in different ways, with education having a very important role in transforming society in a positive way. In addition, the objective of teaching is to achieve a good formation and qualification of the student, with the school being an aid in this development. The constant production of knowledge and the increasingly application of technology, makes there is an inherent need to search for methods and models that aim to ensure practical application, instigating the search for solutions. The use of material such as manuals, formulated in an objective, utilitarian way, with images and easy to understand, plays an important role in health education. In addition, the participatory approach used in the construction of the educational material allows identifying the needs of the target audience, as well as indicating the content of the materials corresponding to their own demands. Objectives: to evaluate the consolidation of knowledge built in different learning scenarios (tutoring, clinical and morphofunctional skills), using a picture book as a methodological resource. Methodology: the study carried out was of the descriptive type, in order to analyze the consolidation of knowledge through notebooks containing figures related to the contents worked in the tutorial sessions, in the Morphofunctional Laboratory and in Clinical Skills. Participating in the research were undergraduates of the Medicine course of the 8th semester of the University Center of the State of Pará (CESUPA). Results: the present study analyzed the consolidation of the knowledge built in the thematic modules (Tutoring, Morphofunctional Laboratory and Clinical Skills) from the answers given by 22 students. 21 questions were elaborated. In these questions the score varied between 47.2% (the lowest) and 95.2% (the highest), the academics had a mean of 80.5% and a standard deviation of 12.5%. The percentages of correct answers did not present a normal distribution, and the median is representative of the class = 85.7%. Conclusion: It was found that the use of images in the teaching-learning process can be an instrument for acquiring and fixing content. Its purpose is to strengthen, in an illustrative way and based on the current literature, the recommendations and possible innovations that will enable the ability to transform acquired knowledge into constructed knowledge.
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    A relação entre síndrome de burnout e lembranças de práticas parentais em estudantes de medicina
    (Centro Universitário do Estado do Pará, 2020) Diniz, Ana Beatriz de Sousa; Jamielniaski, Rafael Almeida Kapassi; Carvalho, Ana Emília Vita; Furlaneto, Ismari Perini; http://lattes.cnpq.br/9542085122721945; http://lattes.cnpq.br/1981562999898097
    Introduction: Medical students are continuously subjected to stressful factors, predisposing to psychological problems such as Burnout Syndrome. Socioeconomic factors influence the syndrome, but parental practice has not been taken into account in other studies with this population. Objectives: Describe the prevalence of Burnout Syndrome and the model of parenting practices in medical students. Methods: Cross-sectional, analytical and descriptive study with a quantitative approach to the data, in which 189 students from the 1st, 4th and 6th year of a medical course participated, with an average age of 22.9 years, with 60% of the sample being female, 40% male. The data were collected through socio-demographic and economic questionnaire, Maslach Burnout Inventory, and Scale on Memories of Parenting Practices. Results: The studied sample showed that in MBI the highest averages were in the domain 'personal achievement' (40.9). Comparing the MBI scores by academic year, it was found that the 6th grade students had lower 'emotional exhaustion' scores lower than those observed in 1st and 4th year students (p = 0.0117). As for the results in EMBU, the dimension 'emotional warmth' presented higher averages compared to the domain 'rejection' and that the 'overprotection' (p <0.0001).Conclusion: It is considered the importance of stimulating and promoting actions that encourage the performance of extra academic activities for students, as well as involving the family in the experiences of the medical course.
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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.
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    Achados campimetricos em pacientes com adenoma hipofisário atendidos no CEMEC no período de março de 2018 a dezembro de 2019
    (Centro Universitário do Estado do Pará, 2021) Silva, Aluyzio Miguel Ferreira Nunes e; Guerra, Jade Pinto de Queiroz; Silva, Carolina Trindade Pinto da; http://lattes.cnpq.br/1462166625345308
    Introduction: Adenomas are benign tumors that have their origin in glandular tissue, and are able to develop in breast tissue, in the glands of the colon, and in pituitary tissue. The presence of adenomas implies hyper or hyposecretion of hormones related to the affected tissue. The research focuses on the visual changes that pituitary adenomas cause in patients. Objective: To analyze the campimetric findings by Humphrey and Pclab methods in patients with pituitary adenoma who had visual impairment due to pituitary mass effect on the optic chiasm. Methods: The medical records of 14 patients were analyzed, counting nineteen eyes, to characterize and quantify the patient´s campimetry according to the methods used. Total deviation (MD) and Pattern Standard Deviation (PSD) results were compared in the nasal and temporal hemifields. The results found in each hemifield were compared by Bioestat version 5.3 application. Results: The epidemiological profile of the analyzed patients demonstrated no prevalence of gender, and a mean age of approximately 38 years. In the Humphrey group 10 eyes were evaluated, with mean MD and PSD values of -13.388±7.9294 and 10.637±6.0229, of which only the PSD values revealed a statistically significant value. Regarding the 9 eyes analyzed by the Pclab method, we obtained a MD and PSD value of -2.5422±1.1554 and 3.8555±1.4918, of which only the PSD showed statistically significant results. Conclusion: Finally, when the Humphrey campimeter was used, a prevalence of temporal hemianopsia by the gray scale graph was shown, which was not evidenced in the patients who underwent the exam by the Pclab methodology, showing a predominance of temporal field loss. The PSD was more useful in clearly showing the loss of temporal visual field fibers. Thus, the current study has shown that the simple analysis of the grayscale graph fails to identify discrete chiasmatic defects in a considerable number of patients. In view of this, comparison of the mean deviations calculated for the hemicamples appear to be useful criteria for identifying such defects.
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    Acionamento do serviço de atendimento móvel de urgência em Belém do Pará por motivos traumáticos nos meses de fevereiro e março de 2016
    (Centro Universitário do Estado do Pará, 2020) Siqueira, Ana Karolina Kalif; Pontes, Felipe Lobato; Neves, Dilma Costa de Oliveira; Siqueira, Claudia Regina Dias; http://lattes.cnpq.br/6013946222269824; http://lattes.cnpq.br/7230812534416350
    The trauma is caused by a physical agent of varied etiology, nature and extent, with the etiology of the traumatic event being the factor that guides patients or viewers to request specialized help, constituting the traumatic reasons for triggering an urgent and emergency service in a medical practice. Objective: To identify the main traumatic reasons for triggering the SAMU (acronym in portuguese for emergency mobile care service) in Belém-PA in the months of February and March 2016. Methodology: Quantitative, descriptive and exploratory document analysis, based on the records of care at SAMU in Belém do Pará. We included those with identification of the reasons for the trauma of patients treated by SAMU in the municipality of Belém, in the study period. For the present study, it was registered on the medical service's record and considered as traumatic reasons the following: collision between vehicles; fall; being run over; violence (physical, stab or firearm), burns and other accidents. The age and sex variables were used to describe the victim's profile. Because they have a small amount of records, data on occupation and education were removed from the data analysis. For the analysis of temporality, the information of the day of the week and time of the occurrence was used. The patient's evolution was limited to what was found in the victim's record at the time of care, such as death, transfer or hazing. Results: 1037 SAMU activation records were analyzed in the study period in the city of Belém-PA. 114 (11.0%) records were excluded because they did not contain the reasons for requesting the service. The age group and the gender most affected were, respectively, 20 to 59 years of age (70.6%) and males (67%). The main reasons identified were traffic accidents (52.8%), followed by falls (26.4%) and assaults (18.1%). Among traffic accidents, collisions between car and motorcycle stand out (29.2%), people falling of vehicles in motion (20.9%) and pedestrian accidents (14.8%). Regarding falls, the most common were motorcycle falls (74.5%), followed by bicycle falls (15%) and when getting on and off vehicles (11%). As for the assaults, the record with the highest occurrence was physical aggression (36.5%), followed by cold weapons (34.1%) and firearms (29.3%). The highest attendance frequency occurred in the maximum time of 10 minutes (48.1%) between the activation and the arrival of SAMU. The most frequent day of the week was on Saturday (16.3%) mainly during the night shift (29.5%). Conclusion: Proper completion of SAMU's service records is of the utmost importance, highlighting the reason for triggering the service, the profile of the victims affected and the trauma mechanism. This way more consistent financial assistance can be provided for the best initial care and arrangements for preventive measures and organization of SAMU's services.
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    Alterações auditivas no Diabetes Mellitus
    (Centro Universitário do Estado do Pará, 2019) Lima, Arthur Felipe Maciel de; Hamamura, Rubens Yuji; Rocha, Vanessa Campos Couto da; Nunes, Leonardo Mendes Acatauassú; http://lattes.cnpq.br/3512764081076675; http://lattes.cnpq.br/1897095774561517
    Diabetes Mellitus is a chronic condition with a potential to injure several organs, such as the eyes, kidneys, heart, blood vessels, nerves, and brain. Therefore, it is possible that these anatomopathological changes due to hyperglycemia may also alter the organs responsible for hearing. This work was carried out to investigate and establish a correlation between Diabetes Mellitus and reduction of auditory acuity, based on the investigation of the hearing threshold and cochlear function of the patients included in the study. This is an observational, analytical, case-control study in which the patients were selected through a chart analysis of the Endocrinology service of the CESUPA Medical Specialties Center. The sample consisted of (10) patients with diabetes mellitus and (10) patients in the control group, regardless of sex, between 18 and 70 years of age, and the study was performed from October 2018 to January 2019. In the present study it was verified that 100% of the hearing losses were of bilateral sensorineural character, with predominance in females aged between 60-70 years, in the case group. Diabetes mellitus type 2 was predominant, corresponding to 90% of the sample in the case group. 60% of the patients observed had DM for more than 10 years; The most prevalent hearing loss was observed in the frequencies of 6 and 8 kHz (70% in both frequencies). The results of the Distortion-Product Otoacoustic Emissions (DPOAEs) exam showed that 10% of the patients in the case group had absent emissions in the left ear and 20% had the same result in the right ear. Among the members of the control group, the percentage of patients with absence of emissions for both the left and right ears is 20%. These results suggest that hearing loss may be related to the metabolic, neurological and circulatory repercussions of Diabetes Mellitus. This fact underscores the importance of the development of researches both for the early diagnosis of Diabetes and for a more solid investigation of the impact on the hearing of patients with the disease.
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    Análise clínica-epidemiológica dos pacientes com acidente vascular encefálico isquêmico sob as diretrizes de atendimento no Hospital e Pronto Socorro Municipal Mário Pinotti
    (Centro Universitário do Estado do Pará, 2022-11-10) Soares, Gabriel dos Santos; Góes, Nicole Garcia dos Santos; Andrade, Selma Parente Sousa; Siqueira, Cláudia Regina Dias; http://lattes.cnpq.br/6013946222269824; http://lattes.cnpq.br/4429392453942556; Sefer, Celina Cláudia Israel; http://lattes.cnpq.br/0218316102057635; Souza, Aline Cristine Passos; http://lattes.cnpq.br/5404002728453981
    Cerebrovascular Accident (CVA), also popularly known as "stroke", can be classified as ischemic CVA (iCVA) or hemorrhagic CVA (hCVA). An ischemic stroke is the rapidly evolving neurological deficit caused by a focal brain injury resulting from reduced arterial blood flow (ischemia), followed by infarction, impairing the adequate supply of oxygen and nutrients to the brain tissue. On a global scale, stroke is the second leading cause of death, and, in Brazil, the fourth, with ischemic stroke being the most frequent subtype. Thus, the rapid recognition of symptoms and factors that influence prognosis are extremely important in preventing irreversible brain damage. This study aims to carry out a clinical-epidemiological analysis of patients with suspected or confirmed diagnosis of stroke at the Hospital Pronto Socorro Municipal Mário Pinotti, a reference in urgencies and emergencies in Belém-PA and compare with the goals established by the Brazilian Society of Cerebrovascular Diseases on Treatment of Ischemic Stroke. Data from medical records from the Rede Bem Estar program from July 2018 to December 2021 were used. The data were represented in Microsoft Excel tables and analyzed by the Biostat 5.5 program. Results: Men were more affected by stroke (54.3%), the age group with the highest prevalence was 61 to 80 years (52.7%). Most patients came from Belém and the metropolitan area (74.9%), followed by the interior of the state (24.6%) and from outside the state (0.5%). The time of medical care after admission was up to 2 hours in 77% of the cases and 15.9% were seen within 2 to 5 hours of time after arriving at the hospital. As for the imaging exam, about 16.2% of the sample took more than 30 minutes and 5.4% did not. The main risk factors seen were SAH (84.3%), DM (43.2%) and history of previous stroke (22.4%). Most patients had hemiparesis or hemiplegia (77.8%), language alterations (66.2%), alterations in the level of consciousness (52.4%) and labial rhyme deviation (27.3%). The therapeutic mainstay of stroke in HPSM was based on symptomatic, antiplatelet agents and statin. It was concluded that a series of factors are interconnected to achieve the best times of care, diagnosis and therapy, resulting in benefits for neurofunctionality in patients with ischemic stroke. Thus, meeting the goals recommended by national and international guidelines is essential to increasingly seek excellence in care.
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    Análise comparativa da termografia com a escala PSE/BORG aguda em um clube de futebol
    (Centro Universitário do Estado do Pará, 2022-11-16) Capeloni, Bruno Lisboa; Mouta, Caio Eduardo Puget; Silva, Flavio Tavares Freire da; Esteves, Tiago Costa; http://lattes.cnpq.br/1129943526806064; http://lattes.cnpq.br/1386374444157946; Fonseca, José Silvério Nunes da; http://lattes.cnpq.br/5799490272499275; Cecim, Paulo Eugênio Santos; http://lattes.cnpq.br/0424267310983270
    The use of the Borg CR10 scale adapted in sports is an important tool in the evaluation of effort intensity and optimization of training, preventing sports injuries. Thermography is a non-invasive and low-cost imaging test that requires little time for its use, being an adjuvant method in the evaluation of acute metabolic responses through heat variation. To evaluate the thermography and its alterations comparing with the subjective effort scale PSE/BORG in athletes of the basic categories of soccer in a club in the city of Belém - PA. 70 thermographic images and 73 modified PSE/BORG scores were captured, between 8 games of the Paraense Under-20 Championship and the Brazilian Under-23 Aspirants Championship, including 22 athletes registered in the BID (CBF Newsletter). For analysis of thermographic images, the present work used the FLIR TOOOLS software. Athletes were submitted to thermography capture and PSE/BORG scale after the end of the matches. Data organization was performed using Microsoft Word, Excel, Bioestat 5.5 and GraphPad Prism 8.4..2. For analysis of the data obtained, the Kruskal-Wallis tests were performed, adopting a (p < 0.05) being statistically significant. All practitioners signed the Free and Informed Consent Term. The number of thermographic images captured varied between 6-12 between collection days. The highest median of variation occurred on the eighth day (0.4C°) with a p=0.265 in the anterior thigh muscles. The highest median thermal variation of the anterior leg muscles occurred on the fifth and seventh days, respectively (0.4C°) with p=0.848. During the analysis, 73 PSE/BORG scores were performed, the seventh and eighth days with values greater than or equal to 7. The comparative analysis found a negative correlation between the temperature of the anterior thigh muscles and the PSE/BORG scale (p=0.206) without differ significantly from a value of zero. The correlation between anterior leg muscles temperature and PSE/BORG scores was positive (p=0.412) without significantly differing from a zero correlation. The use of thermography and the PSE/BORG scale are relevant in clinical practice for better health and better use of athletes. The present study demonstrated that there was no correlation between thermography and its numerical variations with the anterior thigh muscle segments using the PSE/BORG scale. However, there was a positive correlation between the anterior leg muscles and the scores. Therefore, it is important to emphasize the need for an analysis for a longer period in relation to this work. proved to be effective in preventing injuries in the evaluated athletes.
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    Análise comparativa de controles positivos no processo de cicatrização de feridas cutâneas em ratos
    (Centro Universitário do Estado do Pará, 2021) Medeiros, Isabela Parente e Silva de; Carmo, Tomaz José Aquino Vasconcelos do; Chaves, Rosa Helena de Figueiredo; http://lattes.cnpq.br/8319947015729094
    Introduction: Healing is a physiological process that involves several complex mechanisms, such as the interaction between cells and inflammatory factors that aim to restore the morphological and physiological characteristics of this injured tissue. Many factors interfere in this process, such as wound hydration and use of substances with healing potential. Furthermore, both in practice and in a situation in the experimental field, it is not yet well established which is the ideal substance to assist in the healing process. Therefore, the objective of this work will be to analyze the effect on the healing of skin wounds in rats with the following positive controls: PVPI, Chlorhexidine, Saline, Hydrogel and Sunflower Oil. Objectives: To compare the effect observed in the treatment with 0.9% saline solution, Sunflower Oil, Hydrogel, Chlorhexidine and aqueous PVPI on the healing of induced skin wounds in rats. Methodology: Experimental, prospective, longitudinal, statistical-comparative study. Thirty-five rats, 5 animals destined for the pilot group and the others were randomly distributed in 5 study groups, with 5 animals each. For this, a surgical wound in the dorsal region of the animals was performed and the substances mentioned were applied daily in each experimental group, every 12 hours. On the 3rd, 7th, 14th and 21st day, macroscopic analysis of the wound was performed and after the last analysis the animals were euthanized and histological tissue processing was performed for microscopic analysis. Negative Control Group (GCN): animals that receive an application of saline solution. Sunflower Oil Group (SOG): animals that receive treatment with Sunflower Oil. Hydrogel Group (HG): animals receiving wound treatment with hydrogel. Chlorhexidine Groupp (CG): animals that were treated with chlorhexidine. Aqueous PVPI group (APG): animals that were treated with aqueous PVPI. Results: In the macroscopic evaluation, there was a decrease in the areas of mean injury over the course of days, in all groups, more pronounced from the 7th to the 14th day. On the 7th day, the OG group presented significantly larger area (mean of 560.6 mm2) when compared alone to the SF group (mean of 302.8 mm2), but the other groups did not differ significantly from each other on this day. On the 14th day, significant variation was also found (p = 0.0093, Kruskal-Wallis test), so that the LC group was statistically superior to the SF group (area means 148.4 mm2 and 66.4 mm2, respectively). There was no significant difference between other groups. In histological analysis, it was observed that the proportions of vascular proliferation did not differ significantly between the groups, with p-value not significant (p = 0.07755). There was a significant association only between the groups and the intensity of mononuclear cells (p = 0.0169) and between the groups and the intensity of collagen fibers (p = 0.0486). As for mononuclear cells, more cases were observed with marked manifestation of mononuclear cells in the HG group and discrete in the SF. There was a significant association only between the groups and the intensity of mononuclear cells (p = 0.0169) and between the groups and the intensity of collagen fibers (p = 0.0486). As for mononuclear cells, more cases were observed with marked manifestation of mononuclear cells in the HG group and discrete in the SF. Conclusion: It was concluded that there was a significant reduction within each group, in relation to the wound diameter, macroscopically more accentuated in the SF group. However, it cannot be concluded that this would be the best group for control due to more discrete collagen proliferation.
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    Análise comparativa do padrão tomográfico pulmonar na infecção pelas variantes B.1.1.7 e P.1 do vírus SARS-COV-2
    (Centro Universitário do Estado do Pará, 2022) Savino, Beatriz Amaral Costa; Mafra, Eduarda Gabriel; Paes, Andréa Luzia Vaz; Bichara, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760; http://lattes.cnpq.br/4364540186589331
    Introduction: The SARS-CoV-2 virus quickly spread globally and acquired pandemic status in March 2020, posing a major threat to public health. Since then, it has suffered several genetic mutations, which culminated in multiple waves of disease transmission. Computed tomography (CT) of the chest may be a diagnostic alternative complementary to RT-PCR, to assess pulmonary involvement and assist in the therapeutic approach. Objective: To analyze lung tomographic patterns in the COVID-19 epidemic curves in 2020 and 2021 caused by the B.1.1.7 and P.1 variants of the SARS-CoV-2 virus. Methodology: A cross-sectional, descriptive, analytical and retrospective study was carried out through the evaluation of 360 CT scans of the chest, in a Reference Radiology Service, including patients with COVID-19 in two epidemic periods in an area of the Brazilian Amazon, characterized by lineages B.1.1.7 (Alpha) from April – September 2020 and P.1 (Gamma) from October 2020 – March 2021. Expert Consensus criteria of the Radiological Society of North America (RSNA) were used. In patients older than 18 years of age, of both sexes, the pattern and degree of pulmonary involvement, distribution of lesions, affected segments and other findings on tomography were evaluated. Results: The proportions of patients of different genders (p=0.289) or different age groups (p=0.314) did not vary significantly between periods. In the first period, 70.6% had pulmonary involvement between 10-25% and in the second period only 43.3%. All individuals had ground-glass lesions and the presence of thickening of the interlobular septa was significantly observed in the first epidemic curve (81.9%) (p=0.002). Conclusion: There was a prevalence of women and individuals aged between 45-60 years. 100% of the individuals presented ground-glass lesions and the typical pattern of involvement prevailed in both analyses. The Alpha variant, predominant in the first epidemic curve, presented a higher degree of pulmonary involvement in relation to the Gamma variant, predominant in the second epidemic curve.
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    Análise da dose de levotiroxina nos diversos tipos de hipotireoidismo atendidos no ambulatório de tireoide do Centro de Especialidades Médicas do CESUPA (CEMEC)
    (Centro Universitário do Estado do Pará, 2019) Silva, Lucas Ivanilson Guedes Henriques; Valente, Ana Augusta Motta Oliveira; Neves, Dilma Costa de Oliveira; http://lattes.cnpq.br/7230812534416350; http://lattes.cnpq.br/0439088319200326
    Introduction: Hypothyroidism is an endocrinopathy with a prevalence of 0.3% to 4.6% in the population, and its treatment is hormone replacement with levothyroxine (LT4) at an initial dose of 1.6 to 1.8 mcg / kg / day, however, it is known that the type of hypothyroidism may influence the amount of LT4 to be administered to the patient. Objectives: To analyze the dose of levothyroxine (LT4) used in the various types of hypothyroidism. Material and Method: It was a cross-sectional, descriptive and quantitative study based on the data collection of medical records of patients with hypothyroidism, attended, in the period from 2015 to 2018, in the Thyroid Ambulatory of the Center of Medical Specialties of CESUPA (CEMEC). The variables analyzed were age, sex, weight, type of hypothyroidism, levothyroxine dose, TSH and free T4 value recorded at the last visit, symptoms, comorbidities and use of other medications. Results: 187 medical records of patients with hypothyroidism were analyzed, with a predominance of women (97.9%) between 21-44 years of age. The most prevalent cause of hypothyroidism was total thyroidectomy and the highest mean levothyroxine dose was in this group. Among men, the postoperative period was predominant in adult patients (2). In most patients, there was no record of cardiovascular and gastrointestinal related comorbidities that could affect LT4 dose. There was also no significant statistical difference (p = 0.5428) between the use of other drugs and the absence of comorbidities and the age groups of the patients. Disabsortive disease was the comorbidity found that altered LT-4 replacement by age range. The highest mean doses of levothyroxine were recorded in patients with total thyroidectomy hypothyroidism. No significant statistical difference was observed between the averages and medians of the levothyroxine doses and the age ranges of the patients. The medications that may change the dose of LT4 most encountered were calcium, metformin and estrogens. The most controlled patients (within the TSH target) were those with an autoimmune cause. Conclusion: No type influence of hypothyroidism was observed on the dose of levothyroxine.
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    Análise da efetividade do fluxograma de encaminhamentos de pacientes ao ambulatório de reumatologia do Centro de Especialidades Médicas do Centro Universitário do Estado do Pará
    (Centro Universitário do Estado do Pará, 2020) Travassos, Bárbara Laíse Guimarães; Azevedo, Thaiana Pedrosa de; Rodrigues, Fabíola Brasil Barbosa; Neves, Dilma Costa de Oliveira; http://lattes.cnpq.br/7230812534416350; http://lattes.cnpq.br/2425897539868497
    Introduction. Pain is the main symptom of patients affected by rheumatological pathologies, and osteomyomaarticular pain is the most prevalent in the world. Although relatively simple, mistakes are common in referrals made by generalists and specialists, related to complaints and / or diagnostic hypotheses.Objectives: Evaluate the result of the implementation of the flowchart of referral of patients with joint complaints to the rheumatology service of CEMEC. Methodology. The present study was based on the preliminary study developed in 2017/2018, which was carried out in four stages, the fourth stage being the present study, whose research took place in three stages. In the first phase, the intervention was carried out, with a detailed explanation and explanation of the flowchart functioning for medical professionals of all CEMEC specialties and copies of the flowchart were attached on the premises of the establishment. The second phase consisted of a cross-sectional study, through the reapplication of a self-administered questionnaire, identical to that of the preliminary study, to the teaching and resident medical professionals working at CEMEC. The third phase consisted of a descriptive, qualitative, quantitative and comparative study and was based on a documentary analysis of referrals to CEMEC's rheumatology servisse, Results. Most referrals were classified as incorrect (cases with no real need for referral to a rheumatologist), even after the intervention. Among the correct referrals, more than half were classified as adequate (presence of appropriate technical terms in the reference guides), showing an improvement with regard to the number of correct and adequate referrals, compared to the preliminary study. The average waiting time to get an appointment at CEMEC Rheumatology in 2019 was 12 months, with a reduction of 6 months compared to the year 2017. The qualitative analysis of musculoskeletal complaints in the referral guides revealed that the osteomioarticular involvement with description, but without a diagnostic hypothesis was the criterion most frequently used by professionals to justify referrals. Among the specialties, nephrology was the one that referred the greatest number of patients to rheumatology. The highest percentage of correct referrals was observed in pneumology and infectious diseases. The professional profile of the interviewees was: young doctors; women; professionally experienced; and, most graduates from UFPA. The degree of complexity of musculoskeletal complaints was the reason most alleged by the participants to justify the referral. Regarding the degree of technical knowledge of the professionals, they present better clinical information about Gout disease (specific diagnosis and initial management). Conclusion. The increase in the number of correct referrals directly affects the quality of health care provided by the CEMEC Rheumatology service. The maintenance of the largest amount of incorrect and inadequate referrals points to the low adherence to the flowchart by the medical professionals working in the service. Thus, it is necessary to search for ways to encourage adherence to the tool, such as, for example, the periodic explanation of its operation not only to doctors, but also to CESUPA medical students, who are a fundamental part in the patient care.
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    Análise da prevalência da tríade atópica nos pacientes atendidos no ambulatório de pediatria no Centro de Especialidades Médicas do CESUPA
    (Centro Universitário do Estado do Pará, 2021) Mafra, Bárbara Gabriel; Costa, Victória Oliveira da; Neves, Eliza Lemos Barbosa; Neves, Dilma Costa de Oliveira; http://lattes.cnpq.br/7230812534416350
    Introduction: The Atopic Triad is formed by three very relevant and currently evidenced diseases: Atopic Dermatitis, Allergic Rhinitis and Allergic Asthma. Later, the concept of the “atopic march” emerged, which refers to a sequence of progression of atopic diseases. This concept is an attempt to highlight the relationship between them. In recent decades, there has been a substantial increase in the prevalence of atopic diseases, especially in children, which makes the subject currently relevant for discussion. Objective: To analyze the prevalence of the atopic triad in children aged 0-5 years seen at the Pediatrics clinic of CEMEC. Methods: observational, cross-sectional descriptive study, with data collection from the medical records of patients treated from March to August 2021, using a form. Results: the total sample consisted of 122 patients, with a prevalence of 19.7% (24) records in medical records of patients with any of the three atopic diseases. Among the 24 patients, the highest prevalence was of atopic dermatitis (62.5%), followed by allergic rhinitis (58.3%) and finally asthma (41.6%). Among those who have one of the atopic diseases, 11 (45.8%) have two or three associated diseases. Conclusion: Based on the analysis of the prevalence of atopic diseases in pediatric patients, it is extremely important to diagnose these diseases early and treat them early, avoiding the development of severe forms and the development of other atopies that may be associated; in addition to reducing health care costs that could be a consequence of the development of severe forms and the progression of atopic gait.
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    Análise da técnica e da compreensão do uso de dispositivos inalatórios em pacientes com doenças respiratórias em uma clínica de especialidades médicas em Belém do Pará
    (Centro Universitário do Estado do Pará, 2021) Pereira, Juliana de Ponte Souza; Silva, Renato Batista da; Monteiro, José Tadeu Colares; http://lattes.cnpq.br/7627103187307808
    Introduction: The inhalation route is currently the preferred method for administering drugs in the treatment of chronic respiratory diseases, contributing to improving the quality of life of patients. There are several inhalation systems available: dry powder inhalers, pressurized inhalers and nebulizers. The amount of drug deposited at the level of the airways depends, among other factors, on the device used and on the way the inhalation technique is performed. Objectives: This study aimed to analyze the technique and understanding of the use of inhalation devices in patients with chronic respiratory diseases, identifying the main errors and the different clinical profiles of patients. Methodology: This is a cross-sectional observational study, using a standardized questionnaire and checklist as a data collection instrument submitted to patients undergoing chronic lung diseases, seen at the pulmonology outpatient clinic of the CESUPA Medical Specialties Center (CEMEC). Data collection started with socioeconomic variables. Then, the clinical conditions of each patient were questioned and, finally, patients were asked to demonstrate objectively the way in which they used their respective devices. Results: Among the 50 participants, 98% performed the inhalation technique incorrectly and 28% stated that they had never received any guidance regarding the use of the devices. Among the 29 users of pressurized devices, a total of 85 errors were verified in the inhalation technique, while among the 26 who used powdered devices, a total of 55 errors were verified. Among patients who used dry powder devices, expiration and removal of the used capsule were the steps with the most errors, and among users of pressurized devices, the device's agitation and tilting the head back were the most compromised phases. Conclusion: Factors such as age, education and socioeconomic conditions can influence the patient's learning and, therefore, practical measures must be taken in order to reduce the amount of errors in the use of the devices, observing the learning capacity and the main difficulties of learning. each group of patients. Errors were more frequent among those who used pressurized devices compared to those who used dry powder devices.
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    Análise da violência contra a criança na pandemia da COVID-19 no Estado do Pará
    (Centro Universitário do Estado do Pará, 2023-05-29) Carneiro, Sâmya Maria Brito; Neves, Dilma Costa de Oliveira; Pereira, Ângela Regina Rosa Corrêa; http://lattes.cnpq.br/1342885069761211; http://lattes.cnpq.br/7230812534416350; Oliveira, Kátia Soares de; http://lattes.cnpq.br/7676881940781206; Miranda, Marisa Eiró; http://lattes.cnpq.br/9869549838157176
    The SARS-CoV-2 pandemic was characterized by several stressful events with potential to increase the chance of child abuse. The present work aims to analyze the tendency of interpersonal and self-provoked violence against children during the period of the COVID-19 pandemic in the state of Pará. Data was obtained from the Notifiable Diseases Information System (SINAN), under the management of the Department of Epidemiology of Pará Public Health Office (SESPA), in the period from 2018 to 2021, analyzing records referring to the victim (gender, age, color, education, physical disability/disorder), the occurrence (date, city, State, place, number of times the victimization occurred, type of violence and number of aggressors) and to the aggressor (relationship with the victim and use of alcohol by the aggressor). Cases with duplicity, occurrence in other states, failure to fill in more than 50% of the variables and occurrences in which it was impossible to identify the type of aggression were excluded. Statistical analysis was performed using the BioEstat 5.3 program, using descriptive statistics and, for differences between the proportions of subgroups of variables, the non-parametric Chi-square test of adherence for equal expected proportions. A p value < 0.05 (α=5.0%) was accepted as a significance level for the differences. There was a number of 4997 cases of interpersonal and self-provoked violence against children in the state of Pará between 2018 to 2021, with a higher occurrence in 2021 (33.24%) and the most affected age group was from 5 to 9 years old (44.20%), with most cases being sexual assault (65.46%). From 2019 to 2020 there was a decrease (16.54%) in occurrences, with an increase from 2020 to 2021 (49.63%). The victims were mostly girls (71.64%), brown (78.13%), with incomplete primary education (49.83%) and most of the violations were at home (92.34%), being caused mainly by acquaintances. In the records of disability/disorder, “Mental Disorder” was the most present. Most of the agressors had no suspicion of alcohol use (53.31%) and acted alone (81.55%). Revictimization between 2018 and 2021 was equivalent to 63.92%, psychological violence was the highest (146.66%). The 10 cities with the highest number of cases (68.14%) were Belém (34.30%), Ananindeua (7.46%), Altamira (5.40%), Santarém (4.96%), Parauapebas (3 .96%), Barcarena (3.30%), Tucuruí (3.00%), Thailand (2.08%), Abaetetuba (1.92%) and Moju (1.74%). Most of the violence corresponded to sexual violence, predominating in schoolchildren, girls, of brown race/color/ethnicity and with incomplete primary education. “Mental Disorder” was the most registered disability/disorder. Mostly of he aggressors were acquaintances who acted alone, at the victim's residence and with no suspicion of alcohol use. Most of the cases occurred in Belém. There was an increase of aggression reports during the COVID-19 pandemic. It is expected that this work will stimulate discussions and measures in the academic and professional environment for prevention and fight against child abuse in the health area, in order to promote protection and comprehensive care of this group.
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    Uma análise da violência contra a mulher na pandemia da COVID-19 no estado do Pará
    (Centro Universitário do Estado do Pará, 2022-11-07) Holanda, Júlia Borges Assad; Oliveira, Matheus Paulo Cavalcante de; Neves, Dilma Costa de Oliveira; Luz, Patrícia Bárbara Pinho da; http://lattes.cnpq.br/2182892468197821; http://lattes.cnpq.br/7230812534416350; Luz, Marília Gabriela Queiroz da; http://lattes.cnpq.br/7318301499873546
    Violence is a serious public health problem, because the pain, suffering, loss of life and mutilation of millions of people worldwide are some of the effects that violence inflicts on its victims, whether men or women of differentage groups. To analyze the incidence of violence against women during the COVID-19 pandemic period in the state of Pará. This was a study of the ecological type of exploratory time series. The study population will consist of the records of domestic violence cases that occurred in the state of Pará, existing in the database of the Notifiable Diseases Information System (SINAN), under the management of the Department of Epidemiology of SESPA, from 2018 to 2021. A total of 11,734 cases of violence against women in the state of Pará were recorded in the total study period. During the study period, 11,734 cases of violence against women were registered in the State of Pará. There was an almost for-fold increase in the number of cases, from 1,206 cases (2018) to 4,640 (2021). The majority of victims aged between 19 and 39 years, brown, single, with secondary education as schooling, mentally handicapped, living in urban areas. There was a predominance of cases in the victim's own residence with revictimization. Aggressor with record of alcohol use and mostly spouse. As for the type of violence, most were physical, followed by psychological. It is concluded that there was an increase in the number of occurrences of violence against women after the beginning of the COVID-19 pandemic in the state of Pará. This fact is rarely observed in practice, perhaps due to the lack of knowledge of the rights of the victim, that is, fear/dependence on the aggressor or even the difficulty in accessing the legal means necessary to achieve such measures. Therefore, the study addressed in this work shows the need to intensify efforts to combat violence against women in the state of Pará.
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    Análise da violência contra a pessoa idosa na pandemia da COVID-19 no estado do Pará
    (Centro Universitário do Estado do Pará, 2022) Goes, Larissa Mescouto; Sakairi, Sheila Aemy Takemura; Neves, Dilma Costa de Oliveira; Costa, Tanise Nazaré Maia; http://lattes.cnpq.br/4471975369870057; http://lattes.cnpq.br/7230812534416350
    The present study’s theme is the domestic violence against elderly people during the covid-19 pandemic in the state of Pará, in order to broaden the debate on the subject and offer theoretical elements that help to better understand the situation of vulnerability of the elderly in the face of the pandemic context in the state. Objective: Analyze the occurrence of this type of violence and the variables that involve it in general. Methodology: The type of research was ecological exploratory time series, with data obtained from the Notifiable Diseases Information System (SINAN) that were used under the management of the Department of Epidemiology of the State Department of Public Health of Pará (SESPA). The variables analyzed were gender, age, color, schooling, marital status, type of physical disability, mental disability, municipality of occurrence, place of occurrence, revictimization, type of violence, number of aggressors, relationship with the person victimized by aggression and alcohol use by the aggressor, and the exclusion criterion included duplication, occurrence in other states and cases with no filling of more than 50% of the variables mentioned above. Results: The data showed a significant increase in the number of records of violence in the period under analysis (2018 to 2021), with more cases related to females in the age group between 60-70 years, brown color, with elementary school education and married marital status. In addition, a predominance of psychological and hanging violence was identified, which occurred mostly from individuals unknown to the victim, in their residence itself and by one individual only. There was also an important recurrence of cases, which occurred more frequently in the urban area and with the aggressor being mostly male and often drunk during the episodes of aggression. Finally, it was found that there was no strong correlation between the Municipal Human Development Index and the occurrence of violence. Conclusion: Violence against the elderly is a public health, security, educational and economic problem that requires state actions to modify the current scenario, especially in the post-pandemic context, considering the increase in the fragility and vulnerability of this population in question.