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Prevalência de hipertensão arterial sistêmica entre os docentes do curso de medicina do Centro Universitário do Estado do Pará
(Centro Universitário do Estado do Pará, 2019) Reis, Ana Catarina de Souza Carvalho; Azevedo, Silvia Karinny Brito Calandrini de; Rocha, Vanessa Campos Couto da; Mota, Diandro Marinho; http://lattes.cnpq.br/7979118007430529; http://lattes.cnpq.br/1897095774561517
Systemic arterial hypertension (SAH) is a multifactorial disease, in which the individual presents progressive and continuously elevated blood pressure values in relation to the criteria established by VII Diretriz Brasileira de Hipertensão Arterial from Brazilian Society of Cardiology (PA  140/90). Such syndrome is associated to innumerable modifiable and non-modifiable risk factors. This clinical condition, in turn, is an important risk factor for cardiac and cerebral complications. Objective: to identify the prevalence of arterial hypertension among professors of the school of medicine at Centro Universitário do Estado do Pará; during the year of 2018. Method: Cross-sectional descriptive epidemiological study based on data collected obtained by questionnaires, pressure and anthropometric values measurements taken from School Medical professors from June to September (third term of 2018). The populational sample encompasses 77 professors. A percentage of (45; 54.45%) out of a total of 77 was found to be women. Results: Data analysis revealed a hypertension prevalence of 29.9% over populational sample. The same prevalence hits 37.5 % among men and 24, 44% among women. As for hypertensive individuals, the average age of arterial hypertension is a range from 39 to 48. A percentage of 52.18 out of a total of 23 hypertensive individuals was found to be unaware of hypertension condition. Among the individuals who already knew to be hypertensive, 45.45% had controlled blood pressure values. Conclusion: The prevalence of SAH was 29.9%. From hypertensive patients, 52.2% were male. Among the hypertensive professors, 52. 18% of the condition had no previous knowledge of the disease. Regarding those who knew to be hypertensive, only 45.45% used antihypertensive medication regularly and 54. 55% did not present controlled blood pressure values. As for the analyzed risk factors among those 77 professors, the highest prevalence group associated to overweight hits (46.7%). Central obesity hits (50.6%). Alcoholic drink intake reached (61%).Stressed group hits (54.5%). Low physical activity levels or sedentary lifestyle hits (49.3%). And those with SAH (77.9%) and AIM (46.7%) familiar history.
Avaliação do manejo preventivo de pacientes com enxaqueca no ambulatório de neurologia do Centro de Especialidades do CESUPA no período de 2014-2018: um estudo retrospectivo
(Centro Universitário do Estado do Pará, 2019) Costa Neto, Antônio da Luz; Gomes, Fernando Bispo; Sefer, Celina Cláudia Israel; http://lattes.cnpq.br/0218316102057635
Introduction: Migraine is one of the most prevalent causes of pain in Brazil and globally, being incapacitating when severe. They are primary headaches and are classified for their etiology in migraine with aura and without aura. Treatment is performed according to the specificity of migraine. Thus, it is imperative that there be a knowledge of the medical conduct on this subject, so that it cannot only diagnose and treat, but also adequately guide patients with migraine in outpatient services. Objective: To evaluate the preventive management of patients with migraine at the CEMEC-CESUPA Outpatient Neurology in the period 2014-2018. Methodology: Retrospective study of 961 patient charts from the CEMEC-CESUPA Neurology Outpatient Clinic. 52 charts followed the exclusion and inclusion criteria established for this research. The sample characterization information was compiled in databases prepared in Microsoft Office Excel® 2016 software; adopting a significance level α < 0.05. Results: There was a predominance of females (88.46%), with a prevalence of patients with migraine without aura (55.8%) compared to aura (44.2%). The most evident age at onset of migraine was between 19 and 30 years (39.1%). Among the patients analyzed, 88.5% reported severe pain and only 5.8% moderate pain, and there were no subjects who reported poor pain or absence of pain. Migraine attacks usually occur in 50% of cases 3 to 14 times a month, followed by 15 to 30 times monthly (44.7%); its average duration is 4 to 72 hours in 64.1% of patients. The prodrome with the highest prevalence in the research were the scotomas (78.9%). Its most frequent triggering factors were stress (60.5%), food (32.6%) and sleep (32.6%); among the foods, coffee and chocolate (35.7% and 28.6%, respectively) were the most prevalent. In the morbid antecedents, systemic arterial hypertension and psychiatric diseases were the most mentioned in this study (41.9% and 38.7%, respectively). Among the most frequently mentioned life habits during non-pharmacological treatment, the therapeutic activity prevailed (55%). Of the patients evaluated, 40% of evasion was observed after the first return visit. There was little filling of the headache diary (34%). The prevalence of the main drugs used in prophylactic therapy were tricyclic derivatives (77%), topiramato (23%), flunarizine (9.5%) and propranolol (11.5%). It was noted that 66.6% of the patients were using abusive analgesics before treatment. Conclusion: The main benefits of this study for the CEMEC-CESUPA outpatient clinic of Neurology are the contribution of the scientific analysis to the elaboration of adherence strategies for the patients treated in this clinic and the elaboration of a proposal for a headache diary.
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.
Avaliação da função sexual e saúde reprodutiva em mulheres portadoras de Lúpus Eritematoso Sistêmico (LES)
(Centro Universitário do Estado do Pará, 2019) Moura, Ananda Mesquita; Gonzalez, Lorena Moura; Pacheco, Thayana Ribeiro Kajitani; http://lattes.cnpq.br/5792331557204177
Objective: The present study evaluated the presence of health reproductive and sexual function alterations in women with SLE treated at the Cesupa Medical Specialties Center (CEMEC). Method: A cross-sectional, analytical and descriptive study was carried out based on questionnaires, elaborated by the authors, in which the rheumatological, gynecological and obstetric antecedents of these patients were evaluated. The data were collected from November 2018 to February 2019. Results: Fifty patients with a diagnosis of SLE were analyzed, wich had between 6-9 years of diagnosis (38,5%), with the age between 41-51 years old (38.5%), single (59.6%), high school education (57.7% %) and family income equal to 1 minimum wage (46.1%). The diagnosis criterios most found was acute cutaneous lupus (66%), hemolytic anemia (66%), FAN positivity (98%) and the reduced complement (46%). The most used treatments were antimalarials (86%) and prednisone (70%). With regard to the sexual profile, they had a predominance of active sexual life (57.7%), with life partners between 1-2 (46.1%) and frequency of sexual intercourse between 3-8 times per month (50%). Regarding contraception, 82.7% of the patients did not use contraceptive methods. Among the contraceptive methods used by the patients, oral hormonal methods (55.6%) were the most prevalent. 69.2% of the patients were already pregnant, of which 52.8% had gestational complications. The majority of these pacients presents menarche age between 13-14 years (44.2%), and 22.9% had menstrual irregularities. Conclusion: There was a low frequency of health reproductive and sexual function alterations. However, an alarming finding observed was the low use of contraceptive methods. It suggests a better planning strategies about family counseling.
Tratamento de gastrite associada à infecção por Helicobacter Pylori no Centro de Especialidades Médicas do CESUPA
(Centro Universitário do Estado do Pará, 2019) Guerra, Andressa da Silva; Custódio, Sávio Sérgio Ferreira; Valente, Tárik Olívar de Nunes; http://lattes.cnpq.br/9516550105434600
Objective: To describe the epidemiological profile and treatment of patients with gastritis associated with Helicobacter pylori infection treated at CESUPA's Medical Specialties Center (CEMEC). Method: The cross-sectional descriptive study was carried out at the Center of Medical Specialties (CEMEC) of the University Center of Pará (CESUPA), from August 2018 to February 2019, where 352 medical records of patients regularly enrolled in the CEMEC’s Gastroenterology service during the first half of 2016 until the first half of 2018 were analyzed. Data collection was done according to the Data Collection Research Protocol. Results: In this series, the majority of the patients were female (80%). This study revealed that the majority of patients were concentrated in the age group between 51 and 70 years. Triple therapy with amoxicillin, clarithromycin, and pantoprazole was the most widely used regimen in this study, considering that all patients who tested positive for H. pylori infection were treated. It was observed that about 6% of patients started treatment with levofloxacin, clarithromycin and proton pump inhibitor (PPI). The vast majority of patients did not require retreatment (76.7%), but those who needed it were treated with levofloxacin, amoxicillin and proton pump inhibitor. Conclusion: There was a predominance of gastritis associated with Helicobacter pylori infection in women and in the population between 51 and 70 years. Regarding therapy of choice, the regimen with amoxicillin, clarithromycin and pantoprazole was the most used. The need for retreatment was identified in 23.3% of the patients, with levofloxacin, clarithromycin and PPI being the choice for these patients (66.7%).
Aspectos clínicos e histopatológicos do lúpus eritematoso cutâneo registrados em serviço de referência do estado do Pará no período de 2010 a 2017
(Centro Universitário do Estado do Pará, 2019) Lima, Luis Felipe Silva; Gouvêa, Rebecca Ribeiro; Bittencourt, Maraya de Jesus Semblano; Amin, Gabriela Athayde; http://lattes.cnpq.br/8604283847300465; http://lattes.cnpq.br/6566823528602319
INTRODUCTION: Systemic Lupus erythematosus (SLE) is an autoimmune and multifactorial disease characterized by a chronic inflammatory process resulting from changes in immune regulation due to the production of autoantibodies against various cellular constituents. The skin is one of the target organs most affected by the disease, and genetic, hormonal and environmental factors interact and interfere with the development of skin disease. The cutaneous manifestations can be divided into specific and nonspecific, according to their clinical and histological characteristics, and the specific ones can be found in the skin in three ways: chronic (CCLE) ; Subacute (SCLE) and Acute (ACLE). It presents genetic, autoimmune, hormonal and environmental factors as pathogenic substrates, and its clinical and laboratory characteristics help the diagnosis, which can be confirmed by histopathological study. OBJECTIVES: This study aims to elucidate the histopathological changes that occur in the LECC and its subtypes, correlating the disorders analyzed in the slides with the clinical manifestations presented by the patient. MATERIAL AND METHODS: This was a cross-sectional, retrospective and descriptive study conducted at the dermatology service of the Federal University of Pará through the analysis of medical records in which the disease was histologically confirmed. RESULTS: We analyzed epidemiological and clinical data from a group of 55 patients with Cutaneous lupus erythematosus (CLE) . The average age at disease onset was 42 years. There was a predominance of females (80% of cases). 64% of the cases affected the face, and 51% were disseminated or generalized in the skin (with lesions also below the neck). There was a predominance of erythema and peeling (87% and 47% of cases), followed by atrophy (42%). The most affected phototype was IV in 61.8% of cases. 33% of the cases were CCLE, followed by ACLE in 13 patients (24%) and SCLE in four patients (7%). The most frequent dermatological lesion was erythema (87%), followed by scaling, infiltration and atrophy. 29% of patients had positive antinuclear factor. In the epidermis it was observed that all cases presented vacuolar alteration, 64% of patients presented basal thickening and 58% atrophy. In the dermis, all patients presented lymphocytes in the infiltrate and 87% presented mucin in the connective interstices. CONCLUSION: Understanding the changes that appear at the microscopic level is of paramount importance for understanding the course of the disease and, thus, enabling the elaboration of an appropriate therapeutic approach. The medical professional plays a fundamental role in the management of patients with Cutaneous lupus erythematosus, and their duty is to understand all its universality for a satisfactory clinical follow-up and the prevention of possible injuries. Although not a common disease, its chronicity leads to the accumulation of cases in clinical outpatient clinics. In addition, although progress is good in most cases, delayed initiation of treatment can lead to disfiguring scars.
Relação de polimorfismos genéticos específicos como fatores de risco para o desenvolvimento de Malformações Arteriovenosas (MAVs) cerebrais: uma revisão sistemática
(Centro Universitário do Estado do Pará, 2019) Santos, Leonardo Magalhães; Farias, Valter Fernando Rodrigues; Paschoal Júnior, Fernando Mendes; Paschoal, Eric Homero Albuquerque; http://lattes.cnpq.br/1593548343125421; http://lattes.cnpq.br/0171195401629428
Arteriovenous Malformations (AVMs) of the brain are vascular lesions that shunt arterial blood directly into a low-resistance system of draining veins without an intervening normal capillary bed. Among the main clinical manifestations (which contribute greatly to the cases of death of this pathology), hemorrhage and seizures are prominent. The pathophysiology of this condition is still poorly understood, but the role of proinflammatory cytokines and genes responsible for these cytokines and cerebral angiogenesis in this process is recognized. The present work aimed to identify the relationship of specific genetic polymorphisms as risk factors for the development of Cerebral Arteriovenous Malformations (AVMs). A systematic review of the literature was performed, using the PRISMA Statement as the research protocol, in the MedLine databse. The terms / descriptors in Health Sciences, in the English language, included in the research of the title were: genetic polymorphism, arteriovenous malformation, single nucleotide polymorphism, genetic linkage, brain arteriovenous malformation, hemorrhage, seizures and headache. Case-control studies were included in this study, where, in the research methodology, the genetic tests used to identify the polymorphism and the presence of AVM in image examination were established. The extraction of articles was done by two authors independently. In all, 208 articles were found, of which only 11 fulfilled the inclusion criteria of this research. The most affected age group was in the range between 35 and 40 years. AVMs, in general, presented with a mean size of 3 to 6 cm. Of the analyzed polymorphisms, all had a direct relationship between having the polymorphism and being an MAV (each with its statistical frequency). And, of the more present clinical manifestations, the hemorrhage was highlighted. It is concluded that more studies should be listed to highlight the role of genetic polymorphisms in this process, in order to improve the therapeutic arsenal to lead this pathology and the prognosis of patients.
Aspectos epidemiológicos dos óbitos de crianças por afogamento nas regiões brasileiras
(Centro Universitário do Estado do Pará, 2019) Rezende, Maíra dos Santos da Mata; Gonçalves, Vívian Danielle Bastos da Silva; Neves, Dilma Costa de Oliveira; http://lattes.cnpq.br/7230812534416350
Introduction: Drowning is the leading cause of unintentional death in children, among external causes, and the one that has the greatest family, social and economic impact. It is a public health problem, in which prevention is the main tool. Objectives: Describing the epidemiological profile of children from 0 to 11 years old who were victims of drowning and accidental submersion that evolved to death in the Brazilian regions and capitals from 2010 to 2017. Methodology: Ecological study whose data were collected from the Mortality Information System (SIM) provided by the IT Department of the Unified Health System (Datasus). The study variables were: age, sex, race/color, year of death (2010 to 2017), place of death, region of occurrence and the primary cause of death classified in ICD-10, with alpha numeric code W65 to W74. The variables were grouped by Brazilian Regions. Results: Drowning as the primary cause of death in children in Brazil represented 19.3% (6,296) of all deaths from external causes, with the highest proportion (32.8%) observed in the Northern Region. The highest proportion of drowning deaths occurred in the state capitals was observed in the Midwest Region (25.1%), followed by the North Region (19.3%). It was observed that deaths from drowning children tend to increase in the Midwest and South regions and to decrease in the North, Northeast and Southeast regions. The predominant age group of deaths was between 0 and 2 years of age (2,405), mainly in the North, Midwest, South and Southeast. In the Northeast, there was superiority in the age group from 6 to 11 years (919), with the highest absolute number of drowning deaths in children. There was a predominance in males (4,337) in all Brazilian regions, with higher occurrence in the Northeast. Brown race/color was predominant in all regions except the Southern region. The mortality rate was higher in children aged from 0 to 2 years (163) in all regions. The main day of the week for all regions was Sunday, with a predominance of afternoon time. As for the place of occurrence, excluding the unspecified place of occurrence (615), the drowning of children in natural waters (422) stood out in all regions, followed by residence, for the North and Northeast regions and pool in the Center regions. West, South and Southeast. In the North and Northeast regions, the most frequent age range in natural waters is from 6 to 11 years and in residence from 0 to 2 years. While in the South, Southeast and Midwest, the occurrence of drowning in natural waters predominated, with the most frequent age range between 6 and 11 years, followed by swimming pool, aged between 0 and 2 years. Conclusion: We emphasize the importance of the results obtained for the creation of drowning prevention strategies in children, contributing to the improvement of the quality of life of families and society as a whole.
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.
Epidemiologia das internações por transtornos mentais e comportamentais no Brasil
(Centro Universitário do Estado do Pará, 2019) Melo, Maria Fernanda Marques; Camacho, Thais Feitosa; Del Nero, Luciana Brandão Carreira; http://lattes.cnpq.br/5056614008350803
Introduction: Mental disorders have high prevalence rates in the population and represent a significant demand for health services. Because chronic diseases are highly prevalent in the world, mental disorders contribute to early morbidity, disability, and mortality. It is estimated that 25% of the general population has one or more mental disorders throughout their lives. In Brazil, the National Mental Health Policy has been carried out through a model of mental health care advocated in the principles of Brazilian psychiatric reform. Objective: To analyze the epidemiological profile of hospitalizations due to mental and behavioral disorders in Brazil from 2008 to 2017. Method: The study is epidemiologic, ecological, quantitative and descriptive, based on secondary data related to hospital admissions due to Mental and Behavioral Disorders available at SIH / DATASUS. Results: In the analyzed period there were 2.583.073 million for mental and behavioral disorders, corresponding to 2.30% of total hospitalizations, there was a gradual decrease in the percentage of hospitalizations over the 10 years. Schizophrenia, schizotypal and delusional disorders presented the highest percentage (38.99%) among morbidities, there was a decrease in hospitalizations due to alcohol use (18.98% to 16.79%) and an increase in hospitalizations due to mood disorders (16.24% to 22.25%) and disorders due to the use of other psychoactive substances (14.53% to 18.54%). The largest number of hospitalizations is concentrated in the Southeast region (1,069,849) and the highest percentage in the South region (3.8%). The age group of 30 to 39 years (25.75%), male (64.03%), and white / race (41.4%) were the most prevalent. We observed a progressive increase in the mortality rate (0.55%) and a reduction in the average length of stay (45.4 days to 31.8 days). Conclusion: The present study demonstrated the gradual decrease in the percentage of hospitalizations due to mental and behavioral disorders in Brazil during the analyzed period and was an auxiliary tool in the formulation of strategies and public policies in the area of mental health.
Impacto clínico e prognóstico das modificações no sistema TNM do American Joint Committee For Cancer oitava edição em pacientes com câncer de mama
(Centro Universitário do Estado do Pará, 2019) Bohne, Mariana Rocha; Khayat, Yasmin de Farias; Pereira, Cynthia Mara Brito Lins; Khayat, André Salim; http://lattes.cnpq.br/6305099258051586; http://lattes.cnpq.br/3186657130674078
Introduction: Breast cancer is in fifth place as the cause of cancer death in the world population. In Brazil, this neoplasm is a first in the female public, without considering non-melanoma skin cancer. However, with the objective of conducting early research on the biological causes of breast cancer, there was a great reduction in mortality rates and greater survival in patients with metastatic disease. The American Joint Committee on Cancer (AJCC) is a state cancer system that enables disease progression. The AJCC instituted its history form based on anatomical information of the primary tumor ("T"), regional lymph nodes ("N") and metastases ("M"). Biological factors, tumor grade, estrogen receptor (ER) positivity, HER2 and progesterone receptor (PR), were included in the eighth edition of the manual, implemented in 2018. Aim: This work aimed to analyze the impact generated by the update of the TNM / AJCC staging system (eighth edition) and to elucidate the importance of including the biological factors and other modifications of the new system for a better medical approach. Method: A retrospective, analytical, cross-sectional, and documentary study of a qualitative approach in which patients with breast cancer were submitted to Ophir Loyola Hospital in 2018, having undergone the cancer staging of the TNM of the American Joint Committee on Cancer (AJCC) seventh edition, so that it could be reclassified according to the prognostic status of the eighth edition of this manual. Socio-demographic data, hormonal and reproductive histories, risk factors related to cancer, anatomopathological characteristics, biological factors and molecular subtype of the tumors were considered. Conclusion: Changes in the stage of the breast cancer patients evaluated after the reclassification with the eighth edition of the TNM / AJCC system were found, so that there was a positive impact of this system on the prognostic targeting, generating a better therapeutic selection.
Perfil clínico e epidemiológico na primeira consulta de pacientes matriculados em ambulatório de obesidade infantil
(Centro Universitário do Estado do Pará, 2019) Meira, Breno Figueiredo; Mergulhao, Thalita Martins; Silva, Silvana Cristina Rodrigues da; Rocha, Mônica Souza Filho Moura; http://lattes.cnpq.br/1302412321438738; http://lattes.cnpq.br/6484463061528812
INTRODUCTION: Obesity among children and adolescents is increasing, becoming a worldwide epidemic. Several factors are related in its genesis, including genetic, sedentary lifestyle, screen-based lifestyle, tablets and video games lifestyles, and unhealthy diet. In this context, the study that reveals the clinical and epidemiological profile of patients in the first consultation evaluation of the Childhood Obesity Outpatient Clinic of a Medical School of the city of Belém is enriching. OBJECTIVE: To evaluate the clinical and epidemiology of patients enrolled in the childhood obesity outpatient clinic. METHODOLOGY: A descriptive, transversal study with information extraction through an elaborated questionnaire applied in the first consultation file of the medical records. RESULTS: Sixty-one medical records registered at CEMEC's Childhood Obesity Outpatient Clinic were evaluated. It was identified 62.3% male and 37.7% female. The age groups found were schoolchildren and adolescents, with 47.5% and 52.5% respectively. Physical activity was not reported by 68.9% of patients. Most patients reported screen time greater than 2 hours daily. There is no significant difference in patients who underwent exclusive breastfeeding up to 6 months, and those who did not. A large proportion of patients had severe obesity (52.5%), especially boys, while 39.3% had obesity and 8.2% were overweight. The most declared monthly household income was 1 to 2 minimum wages. Among the parent's education there was a significant proportion for the complete high school of mothers (39.3%) and fathers (19.7). The presence of a family history of obesity was more frequently reported (72.1%). There was a significant proportion of patients with blood pressure below the 90th percentile (70.5%). CONCLUSION: it is necessary to know the epidemiological profile of childhood obesity, so that health professionals can update themselves with the current scenario, and take knowledge of childhood obesity, to better prevent, diagnosticate and treat, above all, doctors who work in childcare.
Avaliação da morfologia e função tireoidiana nos pacientes acromegálicos atendidos no Centro de Especialidades Médicas do CESUPA (CEMEC)
(Centro Universitário do Estado do Pará, 2019) Ribeiro, Bruna Dias da Costa; Rodrigues, Silvana da Silva; Bastos, Fabíola de Arruda; Caldato, Milena Coelho Fernandes; http://lattes.cnpq.br/9477878606835309; http://lattes.cnpq.br/9386935778704228
Introduction: Acromegaly is a chronic and multisystemic desease, has an insidious onset, and is debilitating. Results from hypersecretion of Growth Hormone and Insulin Growth Factor. The mortality rate is up to 3.5 times larger than the unaffected population due to mainly associated comorbidities and the late character of its diagnosis. Among the proved associations, it’s important to give attention to thyroid functional modifications and it’s morphology, due to evolution of these modifications until the appearance of thyroid neoplasms. Objective: Evaluate thyroid morphology and thyroid functional disorders in acromegalic patients attended at the “Centro de Especialidades Médicas (CEMEC) – CESUPA”, on the Pituitary and Adrenal abulatory. Methodology: Epidemiological, cross-sectional and retrospective study. Data were collected from the acromegalics patient’s medical records, enrolled at the Pituitary and Adrenal abulatory, at CEMEC until June 2019, with a total of 59 patients. Results: Most of the acromegalic patients treated at CEMEC presented pituitary macroadenoma (83.1%) in the initial evaluation. Among the altered laboratory results of TSH (first evaluation 17 and last evaluation 7), the majority presented values below normal in both the first (n = 15) and the last evaluation (n = 6). Thyroxine altered values were also analyzed (first evaluation n=10 and last evaluation n=8), and there was a higher occurrence of results below normality in the first evaluation (n = 7) and equality between values below and above normality in the final evaluation, however without statistically significant results (p = 0.9849). Evaluating the presence of thyroid nodules with gender and time of disease, there was no statistically significant difference (respectively p = 0.9426 and p = 0.4115), however, the relation was significant when related to age group, with a higher frequency between 70 and 79 years. years old (* p = 0.0435). Furthermore, it was evidenced that there was no statistically significant relation between the IGF-1 LSN values and the occurrence of thyroid nodules in the first and final evaluations (respectively p = 0.5834 and p = 0.9514). There was also no statistically significant relationship when analyzing mean GH values and nodule occurrence at the first and last assessment (p = 0.7197 and 0.6831).Conclusion: In the thyroid ultrasonography, most of the nodules found in the first and final evaluation had the following characteristics: localization in the right, single, hypoechoic sludge, with solid content and regular contours. The characteristics found weren’t suggestive of malignancy. Although acromegaly treatment control is unrelated to the occurrence of nodules, it is extremely important to follow up these possible modifications to improve the life expectancy of these patients and the early detection of potentially malignant lesions.
Desenvolvimento de modelo anatômico tridimensional de sistema ventricular encefálico pelo método de manufatura aditiva por impressão 3D
(Centro Universitário do Estado do Pará, 2019) Monteiro, Bruno Moraes; Sousa Junior, Jefferson Luiz Sacramento de; Oliveira, Wellington Pinheiro de; Teixeira, Cláudio Eduardo Corrêa; http://lattes.cnpq.br/7448998858430931; http://lattes.cnpq.br/4902455106917702
The study of human anatomy is common to practically every medical school. Currently, this discipline has undergone reformulations in order to make this content more profitable, raising students' interest better. The impression by means of additive manufacture of anatomical pieces in 3D has been shown a possibility for this reality. In addition to being a novelty in the medical academic environment, 3D printing modeling opens up a range of opportunities in the production of new models, including pathological ones, for a greater technical and didactic collection in human anatomy classes, guaranteeing a low cost. This research aimed to create anatomical parts by means of additive manufacture by 3D printing of the brain ventricle system. The pieces were selected and worked on public domain software, produced by the 3D printer by the authors themselves, translated into a format in which it is possible to use them in human anatomy classes. Four anatomical pieces were printed in 3D of the brain ventricle system, one of them being the anatomical encephalic ventricles, a second one simulating these structures affected by microcephaly, a third similar, but demonstrating the involvement by hydrocephalus and, finally, a fourth piece, all disassembled anatomical ventricles for better demonstration of the creation of the pieces. At the end of this research, it was possible to make pieces using a 3D printer with a high degree of resemblance to the real models, respecting the anatomical and pathological size scales and anatomical and pathological domains evidenced in computed tomography and magnetic resonance, for hydrocephalus and microcephaly pathologies and their configuration anatomical pattern.
Avaliação do conhecimento dos estudantes de medicina de uma instituição privada de ensino superior sobre a doença de Parkinson
(Centro Universitário do Estado do Pará, 2019) Machado, Bárbara Melina Rodrigues; Lima, Elaine Fernandes Melo Ribeiro; Sefer, Celina Cláudia Israel; http://lattes.cnpq.br/0218316102057635
Introduction: Parkinson's disease is among the main chronic and progressive neurodegenerative diseases affecting the nervous system and it is estimated that 1% of the population over 65 years of age is affected by this disease. In this way, it is essential to analyze the understanding that medical scholars have about the disease. Objective: To evaluate the knowledge of medical students from the 8th to the 11th semester of an institution of higher education on Parkinson's Disease. Methodology: Cross-sectional, analytical and descriptive study, using quantitative approach of questionnaire analysis applied to medical students distributed from the 8th to 11th period. After the data collection, the analysis was performed through the program Bioestat 5.0. Results: Most students (76.25%) had unsatisfactory levels of knowledge about the pathology. However, it was noted that the students have perception of the clinical picture, ease of diagnosis, as well as understanding about the pathophysiology of the disease and the initial treatment for the pathology. On the other hand, they have difficulty in monitoring, clinical segment of the patient and observation of side effects. Conclusion: The medical students participating in the study obtained a low level of knowledge about Parkinson's disease.
Avaliação do conhecimento dos graduandos de medicina de uma instituição de ensino particular acerca da conduta do paciente com AVE no serviço de urgência
(Centro Universitário do Estado do Pará, 2019) Sabóia, Cícero Alyson Dantas; Cunha, Karen Elita Marinho; Sefer, Celina Cláudia Israel; http://lattes.cnpq.br/0218316102057635
The stroke is the second leading cause of death worldwide and the leading cause of death in the adult population in Brazil. It usually affects people over 55 years of age and is one of the leading causes of disability in the world. Data from the Ministry of Health reveal that, in 2015, there were 100,520 deaths related to the AVE, constituting 7.95% of the total deaths in the country. Stroke is a clinical emergency and a short delay in your treatment may have important clinical implications. Therefore, it is necessary that the doctors have control over the matter and know how to conduct a patient with a stroke in the emergency department. Objective: To evaluate the knowledge of the medical students of a private higher education institution regarding the conduct of the patient with stroke in the emergency department. Methodology: A cross-sectional, descriptive study using a quantitative questionnaire analysis with 109 medical students from Centro Universitário do Estado do Pará (CESUPA), distributed in the fourth, eighth and eleventh semesters. The analytical statistic was used to evaluate the results through the G-tests and Chi-square Adherence for univariate tables and G-tests and Chi-square Independence for bivariate tables. Results: A total of 109 questionnaires were analyzed, being 36 of the fourth, 40 of the eighth and 33 of the 11th semester. There was a predominance of females (56%) and the age group of 22 to 23 years (32.1%). Students of the 11th semester (72.7%) were the ones who felt more secure to attend stroke victims in the emergency room. In addition, 99.1% of students consider it important to master the subject. The superiority of the 11th semester was noted in the following items: most common cause of stroke (87.9% of correct answers); signs and symptoms suggestive of stroke, except in the item "aphasia", in which eighth-semester students (95%) obtained more correct scores than the eleventh (78.8%); definition of onset of symptoms if patient wakes or is found with symptoms of stroke (69.7%); maximum time from onset of symptoms to thrombolysis (63.6%); blood pressure (BP), which indicates the use of anti-hypertensives in patients suffering from stroke (72.7%); and in all items of assertions of true or false. It is noteworthy that, in these assertions, a satisfactory result of the students of the 11th semester was observed in relation to the others. A relevant fact was the accuracy of 100% of these students about the information that the computed tomography (CT) of the skull can be normal up to 24 hours of the AVE. In addition, there is a partial evolution regarding the conduct in the case of suspected stroke, since there was evolution only in the items "CT of the skull or cerebral nuclear magnetic resonance (NMR)" and "Thrombolysis if ischemic stroke". There was no evolution in the items "acetylsalicylic acid (AAS)", "Measurement and control of blood glucose" and "electrocardiogram (ECG)". Conclusion: It is concluded that there is an evolution in the knowledge of medical graduates of CESUPA about the conduct of the patient victim of stroke in the urgency with the advancement of the semesters, but there are still gaps in theoretical and practical medical training on the subject proposed by the institution.
Perfil epidemiológico dos pacientes com síndrome vertiginosa atendidos no ambulatório de otorrinolaringologia do Centro de Especialidades Médicas do Cesupa (CEMEC) de 2015 a 2017
(Centro Universitário do Estado do Pará, 2019) Santos, Erik Matheus de Oliveira; Rocha, Iago Henriques Leite; Nunes, Leonardo Mendes Acatauassú; Penha, Nelson Elias Abrahão da; http://lattes.cnpq.br/5207645183090927; http://lattes.cnpq.br/3512764081076675
Introduction: Vertigo is a disabling symptom, with direct repercussions on the patient´s life, and has a significant prevalence. especially with the advancing age. Objective: To determine the epidemiological profile of patients with vertigo attended at the Otorhinolaryngology outpatient clinic of the CESUPA Medical Specialties Center (CEMEC). Method: This is a cross-sectional and descriptive study, based on the review of medical records of patients with vertigo attended at the Otorhinolaryngology outpatient clinic of the Center of Medical Specialties of CESUPA (CEMEC), between 2015 and 2017. The data analyzed included: age, gender, race, marital status, type of vertigo, previous treatment, presence of other clinical manifestations and etiological diagnosis of vertigo syndrome. Results: Females were the most prevalent with 91.4% of the individuals, and the age range between 61 and 70 years represented the highest prevalence with 41.4% of the total. As for comorbidities, 52.9% of the individuals did not present comorbidities and 47.1% had comorbidities, 46.1% had systemic arterial hypertension and 40.4% had dyslipidemia. When assessing the clinical manifestations, the most prevalent were imbalance, tinnitus and headache. No cases of paresis, diplopia and dysarthria were observed. Regarding the type of vertigo, 94% presented vertigo of peripheral origin and 6% of central origin. Of the individuals with central vertigo, 50% had vestibular migraine, 25% cerebrovascular accident or brainstem and 25% undetermined. In relation to the diagnosis of peripheral vertigo, 45.4% of the individuals presented benign paroxysmal positional vertigo (BPPV), 6.1% of the individuals presented Ménière's disease, 6.1% bacterial labyrinthitis and 42.4% undetermined. Regarding drug treatment for vertigo, 51.4% of patients used drugs as therapy once at time, 7% used dimenhydrate, 4.2% of the subjects used betahistine, 41.8% flunarizine and 7% other treatments. There was no significant difference between the factors evaluated about the treatment (p value> 0.05). Conclusion: Vertigo is a more common pathology in females and associated with advancing age, which requires careful clinical investigation. It may have an important impact on the quality of life and need pharmacological therapy. The most prevalent causes are those with peripheral etiology and benign paroxysmal positional vertigo (BPPV), which is the most common.
Principais aspectos clínicos e radiológicos pulmonares em pacientes portadores de artrite reumatóide em um Centro de Especialidades Médicas em Belém-PA
(Centro Universitário do Estado do Pará, 2019) Castro, Erick Garcia; Fernandes, Marina Assis da Escóssia; Monteiro, José Tadeu Colares; Ohashi, Claudia Barros; http://lattes.cnpq.br/0889116450004563; http://lattes.cnpq.br/7627103187307808
Objective: To analyze the main repercussions pulmonary, clinical and radiological, in patients diagnosed with rheumatoid arthritis who are being monitored by the Center for Medical Specialties of the Pará State University Center (CEMEC-CESUPA), and from there serve as a source for secondary studies. Methods: The study is cross-sectional, descriptive and observational with quantitative and qualitative descriptive and analytical approach, with data collection in the medical records of patients treated at the Center of Medical Specialties of the University Center of the State of Pará (CESUPA), in the period between january 2014 to december 2018. Results: 156 patients with rheumatoid arthritis were analyzed. The age group and the most affected sex were, respectively, patients older than 60 years and female. Regarding smoking, 53.8% non-smokers, 37.2% former smokers and 9% smokers. Regarding the performance or not of laboratory tests, it was found that 56.4% of the patients performed PPD, 83.3% of the DAS 28 was calculated and 99.4% of the rheumatoid factor. Among the pulmonary symptoms present in 40 patients (24.5%), the most common was dyspnea, followed by chest pain and cough. Regarding the imaging exams, it was concluded that 85.3% had documented in the medical records the description of chest radiography or computed tomography or magnetic resonance, among them, 30.8% presented alteration in the exam. The main documented radiological alteration was the acinar pattern present in 75.0% of patients with alteration, followed by interstitial pattern (66.7%), pulmonary nodule (27.1), pleural pattern (10.4%) and others. Conclusion: It is necessary to perform the analysis of all patients with rheumatoid arthritis, with special attention to pulmonary repercussions due to the significant appearance of clinical and / or radiological alterations in these patients.
Ocorrência da sarcopenia e suas principais complicações em idosos obesos
(Centro Universitário do Estado do Pará, 2019) Reis, Fernanda de Carvalho; Tadaiewsky, Zbyeth da Silva; Maués, Cristiane Ribeiro; Cavallero, Mônica Ribeiro Maués; http://lattes.cnpq.br/0584956998438639
Introduction: The world population is aging. It is estimated that in Brazil, in the last 60 years, there has been an increase of more than 15 million elderly individuals. The Ministry of Health accepts that in the elderly, defined as 60 years or older, there is an increase in the prevalence of chronic and disabling diseases, such as obesity and sarcopenia. The latter is defined by the gradual loss of skeletal muscle mass which results in a reduction in both muscle endurance and muscle strength.Objective: To identify the prevalence of sarcopenia among obese elderly who are followed up at the Obesity Outpatient Clinic of CESUPA Medical Center (CEMEC).Methodology: The study analyzed 14 patients who were enrolled at the CEMEC Obesity Outpatient Clinic. Data collection was performed in 2 steps. In the first, data on age, gender, previous diagnoses and occurrence of falls were collected in a specific research form. Then, the participants were submitted to anthropometric measurements, body composition evaluation and functional performance tests. Bioimpedance, Grip Hand Strength Test, Timed up and go and Gait Speed were used. The 2018 European Criteria (EWGSOP2) were used as a reference for the diagnosis of sarcopenia.Results: It was observed that none of the analyzed sample had a diagnosis for sarcopenia, however, two patients had lower palmar grip strength, which was classified as probable sarcopenia.Conclusion: This study concluded that although results were negative to confirm the diagnosis of sarcopenia in the sample, relevant changes in body composition and physical performance were perceived, thus contributing in the future to the establishment of a condition with sarcopenia and its complications.
Correlação entre o autodiagnóstico de alergia alimentar e a presença de IGE específica
(Centro Universitário do Estado do Pará, 2019) Eismann, Fernanda Carolina Pereira; Venturim, Vitória Destro; Barreto, Bruno Acatauassú Paes; http://lattes.cnpq.br/4741205865293040
OBJECTIVES: To evaluate the relationship between self-diagnosis of food al-lergy and the presence of specific IgE for said food; METHODS: A semi-struc-tured questionnaire was administered to 100 volunteers, followed by a Prick Test for ten pre-established foods. The study was conducted in individuals between the ages of 18 and 75, of both sexes, where all signed the Term of Free and Informed Consent prior to the beginning of the research. Statistical analysis of the data was done through the Biostat 5.0 program. RESULTS: Of the 100 inter-viewees, 63% reported having some type of allergy. Among the population of self-referenced allergic individuals, 55.5% answered that their allergies were of food etiology. Of the 35 pre-test food allergy self-diagnoses, only ten tested pos-itive for Prick Test. Four new diagnoses of food allergy were performed in the study population. CONCLUSION: We conclude that the wrong self-diagnoses are a reality in the world population. The diversity of food-related pathologies, the number of concomitant adverse reactions in various diseases and the mediatic appeal of fad diets can influence many of these cases. It is fundamental the role of the physician in establishing the diagnostic resolution to the patient to avoid unnecessary restrictive diets and the propagation of overdiagnosis.

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