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Treatment of advanced melanoma - A changing landscape
Summary Following decades of relative ostracism, advances in the treatment of melanoma have brought a new reality for patients, physicians and researchers. While antibodies targeting molecules involved in the modulation of the interaction between melanoma and immune cells changed the meaning of the term “ cancer immunotherapy, ” a better characterization of the molecular aberrations involved in melanoma carcinogenesis prompted the development of inhibitors of the mitogen-activated protein kinase pathway (MAPK) that also led to significant improvements both in response rates and survival. As a result, new drugs ...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

CD20 role in pathophysiology of Hodgkin’s disease
The objective of our review is to discuss CD20 function in Hodgkin ’ s lymphoma development, its influence on disease evolution and outcomes, as well as its effects on therapeutics and patients ’ prognostic.Resumo O linfoma de Hodgkin (LH) é um tumor composto por células B não malignas e malignas. O LH clássico expressa antígenos CD15+ e CD30+, mas apenas cerca de 20 a 40% dos pacientes expressa também antígeno CD20. Este antígeno é uma proteína sem ligante presente nas células de linfócitos B cuja função nã...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Vitamin B12, bone mineral density and fracture risk in adults: A systematic review
Conclusion: A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.Resumo Objetivo: Consolidar as informa ções disponíveis acerca dos efeitos da vitamina B12 sobre a densidade mineral óssea e o risco de fraturas, com destaque para ensaios clínicos, dados observacionais e longitud...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Ischemic left ventricle systolic dysfunction: An evidence-based approach in diagnostic tools and therapeutics
Summary Coronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis. There is a lack of robust evidence in many aspects related to this condition, from definition to treatment. Ischemic cardiomyopathy is a spectrum ranging from stunned myocardium associated with myocardial fibrosis to hibernating myocardium and repetitive episodes of ischemia. In clinical practice, relevance lies in identifying the myocardium that has the ability to recover its contractile reserve after revascularization. Methods to evaluate cellular integrity tend to have higher sensitivity,...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Bariatric surgery in the elderly: A narrative review
Conclusion: Bariatric surgery is a safe and effective therapeutic option in the elderly population, but careful patient selection and specific preoperative assessment are mandatory.Resumo Introdu ção: Em virtude do envelhecimento populacional, a população obesa idosa também está aumentando. A cirurgia bariátrica é o tratamento padrão-ouro para obesidade mórbida atualmente, porém sua realização rotineira em idosos ainda é controversa. Objetivo: Revisar a literatura atual sobre a cirurgia bariátrica em idosos. Méto...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

The impact of anemia and body mass index (BMI) on neuromotor development of preschool children
Conclusion: According to the results obtained from the study, mild anemia may have a positive effect on the children ’ s neuromotor development, while malnutrition could have a negative impact. (Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Common mental disorders in medical students: A repeated cross-sectional study over six years
Conclusion: The factors potentially associated with the high prevalence of CMD were those related to medical training, showing that it is necessary to implement preventive measures and review the educational process in order to reduce the damages caused by the development of CMD.Resumo Introdu ção: Tornar-se médico é um processo bastante complexo. Fatores relacionados a personalidade do aluno, processo educacional e experiência diária com dor e morte contribuem para vivências psicoemocionais peculiares, nem sempre devidamente investigadas durante a formação m&eac...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

The importance of risk factors for the prediction of patients with invasive pulmonary aspergillosis
Conclusion: It may be possible to reduce the incidence of the disease by eliminating preventable risk factors. Predicting those risks would, per se, enable early diagnosis and treatment and, thus, the mortality rate of these patients would unquestionably decline. (Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Opioids and immunosupression in oncological postoperative patients
Conclusion: The baseline state of immunosuppression of cancer patients does not imply a higher incidence of HAI in relation to the interruption of remifentanil. It would be of interest to carry out a multicenter PACU study that included immunological patterns.Resumo Introdu ção: Recentes pesquisas utilizando animais demonstraram efeitos imunossupressores depois da suspensão de opiáceos, associados a um maior risco de infecção nosocomial. O objetivo desta investigação foi determinar o impacto da interrupção do opioide remifentanilo em uma Unidade de Reani...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?
Summary Introduction: A link of psoriasis with subclinical atherosclerosis has been postulated and cytokine network might intermediate this association. Few data are available in patients with mild psoriasis. We evaluated carotid intima-media thickness (cIMT) in drug-free psoriatic individuals and controls. In parallel, we searched for associations of cIMT with disease activity indexes and serum interleukins (IL) in psoriatic patients. Method: An experienced radiologist performed the cIMT analyses. Cytokine concentrations were assessed by flow cytometry. Disease activity was evaluated based on psoriasis area and severity i...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Pain-induced depression in the elderly: Validation of psychometric properties of the Brazilian version of the “Geriatric Emotional Assessment of Pain” - GEAP-b
Summary Objective: In order to introduce an instrument within our midst that allows a comprehensive clinical evaluation of pain-induced depression in the elderly, we proposed the translation, cross-cultural adaptation into Brazilian Portuguese, and study of the psychometric properties of the “ Geriatric Psychosocial Assessment of Pain-induced Depression ” (GEAP) scale. This instrument was especially developed for the screening of depression associated with chronic pain in the elderly. Method: We performed translation and cross-cultural adaptation of the GEAP scale, whose psychometric properties were analyzed in...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Nutritional knowledge and body mass index: A cross-sectional study
Summary Objective: To verify the knowledge about food and nutrition and its association with the nutritional status of obese patients with noncommunicable diseases (NCDs), and to identify the relationship between information sources and level of knowledge. Method: Cross-sectional study that included 263 outpatients of a cardiology referral hospital in Porto Alegre, Rio Grande do Sul, Brazil. The participants filled out a questionnaire on socioeconomic data and knowledge about food and nutrition and had their nutritional status evaluated by body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR). Results: ...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Rupture of the myocardium in autopsied MI hearts
We present the anatomopathological findings of three cases of myocardial rupture in autopsied hearts in the last 30 years, with a diagnosis of cardiac rupture in acute myocardial infarction. In these 30 years the percentage of AMI with myocardial rupture was 0.2%. Risk factors for post-AMI myocardial rupture include older age, atherosclerosis, diabetes mellitus and systemic arterial hypertension.Resumo Embora a ruptura do mioc árdio ocorra em apenas 2 a 4% dos casos de infarto agudo do miocárdio (IAM), está associada a alta mortalidade, principalmente em decorrência do estado de choque cardiog&ec...
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Guidelines for the treatment of lung cancer using radiotherapy
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

Isoflavones derived from Glycine max (L.) Merr. in the treatment of vaginal atrophy: A new frontier
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - December 12, 2017 Category: General Medicine Source Type: research

PSA screening for prostate cancer
Summary Screening of prostate cancer with prostate-specific antigen (PSA) is a highly controversial issue. One part of the controversy is due to the confusion between population screening and early diagnosis, another derives from problems related to the quality of existing screening studies, the results of radical curative treatment for low grade tumors and the complications resulting from treatments that affect the patient ’ s quality of life. Our review aimed to critically analyze the current recommendations for PSA testing, based on new data provided by the re-evaluation of the ongoing studies and the updated USPS...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Is a safety guidewire needed for retrograde ureteroscopy?
Conclusion: Our review showed a lack of relevant data supporting the use of SGW during retrograde URS. A well-designed prospective randomized trial is in order.Resumo Introdu ção: O uso de fio guia de segurança (FGS) costuma ser recomendado para a realização de ureteroscopia para prevenir e solucionar complicações durante o procedimento. Seu uso, porém, aumenta a força necessária para manipular o aparelho endoscópico dentro da luz ureteral e, atualmente, exist e uma carência de dados consistentes que indiquem o uso do FGS em todos os procedi...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Contemporary surgical treatment of benign prostatic hyperplasia
Summary Benign prostatic hyperplasia (BPH) is a common condition in adult men and its incidence increases progressively with aging. It has an important impact on the individual ’ s physical and mental health and its natural progression can lead to serious pathological situations. Although the initial treatment is pharmacological, except in specific situations, the tendency of disease progression causes a considerable portion of the patients to require surgical treatment. In this case, there are several options available today in the therapeutic armamentarium. Among the options, established techniques, such as open su...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Low serum testosterone is a predictor of high-grade disease in patients with prostate cancer
Conclusion: Hypogonadism is independently associated to higher GS in localized PCa. The effect of this association is significantly more pronounced among Black men and could partly explain aggressive characteristics of PCa found in this race.Resumo Objetivo: Avaliar a rela ção entre testosterona sérica total (TT) e grau do câncer de próstata (CP) e o efeito da raça e de características demográficas sobre essa associação. Método: Foram analisados 695 pacientes submetidos a prostatectomia radical (PR), dos quais 423 tinham medidas dos níveis s...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Overcoming male factor infertility with intracytoplasmic sperm injection
Conclusion: Our results showed that there is no difference in the outcomes of pregnancy between couples with male or tubal factor infertility, which indicates that ICSI surpasses the worse specific outcomes associated with male factor.Resumo Objetivo: Avaliar o efeito do fator masculino de infertilidade em resultados de inje ção intracitoplasmática de espermatozoides (ICSI) em comparação com um grupo controle que apresenta o fator tubário isolado. Método: Este estudo retrospectivo incluiu 743 casais submetidos a ICSI por fator masculino e 179 casais por fator tubário,...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Smoking and its association with cryptorchidism in Down syndrome
Conclusion: The prevalence of cryptorchidism is high in patients with Down syndrome. We can show a strong association between smoking parents and the occurrence of cryptorchidism, especially when it comes to maternal smoking.Resumo Introdu ção: A criptorquidia é uma condição comum e prevalente em pacientes com síndrome de Down. Fatores ambientais, como o tabagismo, estão associados a malformações fetais. A avaliação da prevalência do criptorquidismo e a associação com tabagismo dos pais na síndrome de Down podem contrib ...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Daily use of phosphodiesterase type 5 inhibitors as prevention for recurrent priapism
Conclusion: These findings suggest the hypothesis that PDE5 dysregulation exerts a pathogenic role for both sickle cell disease-associated priapism and for idiopathic priapism, and that it offers a molecular target for the therapeutic management of priapism. These preliminary observations suggest that continuous long-term oral PDE5 inhibitor therapy may treat and prevent recurrent priapism.Resumo Objetivo: Uma das teorias propostas para explicar a etiologia do priapismo recorrente est á baseada no mecanismo de regulação da fosfodiesterase tipo 5. Estudamos o uso diário dos inibidores de fosfodie...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?
Conclusion: Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.Resumo Objetivo: Analisar os resultados da ureterorrenolitotripsia flex ível (ULT-F) no tratamento de cálculos em rins com anomalia de posição e de fusão (rins em ferradura e rins com vício de rotação). Método: Realizamos a coleta prospectiva dos dados de 13 pacientes com anomalias de fusão e de posição submetidos a ULT-F entre abril de 2011 e abril de 2017 . Analisaram-se dados cl&iacu...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Association between renal cysts and abdominal aortic aneurysm: A case-control study
Conclusion: We found no significant differences in the prevalence of SRCs among patients with AAA and controls. Our findings suggest that the presence of SRCs is not a risk factor or a marker for AAA.Resumo Objetivo: Avaliar uma poss ível associação entre presença de cistos renais simples (CRS) e aneurisma aórtico abdominal (AAA). Método: Em um estudo de caso versus controle com sujeitos com idade> 50 anos, avaliamos a preval ência de CRS detectados por tomografia computadorizada (TC). Comparamos os achados de 91 pacientes consecutivos com AAA oriundos da Divisão de...
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Male urinary incontinence: Artificial sphincter
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

The new Brazilian Society of Urology
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - October 2, 2017 Category: General Medicine Source Type: research

Urinary EN-2 to predict prostate cancer: Systematic review and meta-analysis
Conclusion: The EN2 test showed high specificity (89%) and low sensitivity (66%).Resumo Introdu ção: O câncer de próstata é o segundo tipo de câncer diagnosticado e a quinta causa de morte em homens em todo o mundo. O diagnóstico precoce é fundamental para o prognóstico da doença. Atualmente, o antígeno específico da próstata (PSA) é o biomarcador mais utilizado; porém, biomarca dores mais específicos devem ser estudados. Objetivo: Avaliar a acurácia da proteína engrenada-2 (EN2) na urina como biomarc...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Mild cognitive impairment and progression to dementia of Alzheimer's disease
Summary The increase in life expectancy in the Brazilian population raises questions about the preparation of the public health system in identifying elderly patients with signs of cognitive impairment. Currently, as a consequence of the long duration of preclinical phase of Alzheimer's disease, efforts of early detection have been emphasized. Clinical dementia presents an important impact on the individual's caregivers, family, society and economy. Identifying individuals who already have some cognitive impairment, despite remaining functional, as well as analyzing associated comorbidities, constitutes an opportunity to a...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Pelvic floor muscle training protocol for stress urinary incontinence in women: A systematic review
Conclusion: The most effective training protocol consists of SEPFM by digital palpation combined with biofeedback monitoring and vaginal cones, including 12 week training parameters, and ten repetitions per series in different positions compared with SEPFM alone or a lack of treatment.Resumo Introdu ção: Os exercícios de fortalecimento dos músculos do pavimento pélvico (EFMPP) são considerados a primeira intervenção no tratamento da incontinência urinária de esforço (IUE); porém, não existe evidência sobre os parâmetros de...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus
Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.Resumo Introdu ção: O diabetes mellitus é uma das doenças crônicas mais frequentes no mundo, com altas taxas de morbimortalidade, resultando em um grande impacto negativo socioeconômico. Apesar de existirem diversas classes de antidiabéticos orais, a maioria dos pacientes acometidos está fora da meta terap êutica. Objetivo: Revisar o ...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Pregnancy recurrence in adolescents in Southern Brazil
Summary Objective: To determine the pregnancy recurrence among adolescents and young people in a city located in the extreme south of Brazil and to identify associated factors. Method: One hundred and twelve (112) women participated, having delivered their children in 2010, while adolescents. The sample was stratified in two stages, being the first a census of the whole population of the city and the second a convenience sample. For statistical analysis, Pearson Chi-square test was used, with a significance level of 5%. Results: The recurrence rate was 53.6%, with an average of 28.6 months. At the time of delivery, in 2010...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Risk factors and complications in type 2 diabetes outpatients
Conclusion: The associations identified reflect the condition of patients that were already treating diabetes and its complications, especially HBP. The characteristics of the study population indicate the need to improve clinical follow-up and increase motivation for healthy behaviors.Resumo Objetivo: O estudo investigou pacientes com diabetes tipo 2 (DM2) atendidos em um hospital universit ário de Montes Claros (MG) a fim de estimar a prevalência de fatores de risco e sua associação com complicações da diabetes. Método: Pesquisa quantitativa, documental, retrospectiva e ana...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Complications of central venous catheter insertion in a teaching hospital
Conclusion: These results show that the rate of mechanical complications of central venous puncture in our hospital is similar to the literature, but more attention should be given to infection prevention measures.Resumo Introdu ção: Cateteres venosos centrais são fundamentais na prática clínica diária. Em hospitais de ensino, esse procedimento é realizado por médicos residentes, frequentemente sem supervisão ou treinamento estruturado. Objetivo: Descrever as características das punções venosas centrais e a tax a de complicaçõ...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Antiretroviral changes during the first year of therapy
This study aimed to analyze the first year of HAART use in patients from a reference center on HIV/AIDS management in Fortaleza, Cear á. Method: This descriptive study reviewed all prescription forms of antiretroviral regimens initiation and changes from January to July 2014. All antiretroviral regimen changes that occurred during the first year of therapy were evaluated. Data were analyzed with SPSS version 20. Mean, standard d eviation and frequency, Student ’ s t and Mann-Whitney tests calculations were used, with significance at p
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Levels of uric acid and increased diastolic blood pressure: Risk factors for atrial fibrillation in patients older than 60 years
Conclusion: There is correla tion between diastolic BP and Pmax plus PWD in elderly patients with hyperuricemia.Resumen Objetivo: Caracterizar la m áxima duración de la onda P (Pmáx) y la dispersión de la onda P (DP) según las cifras de tensión arterial (TA) y los niveles de ácido úrico (AU) en pacientes geriátricos. Método: Se realizó un estudio analítico en 83 pacientes mayores de 60 años pertenecientes al Consultorio Médico de la Familia 5 del Policlínico Aracelio Rodríguez Castellón, Cienfuegos, Cuba e...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Functional decline in the elderly with MCI: Cultural adaptation of the ADCS-ADL scale
Summary Objective: Translate, transcultural adaptation and application to Brazilian Portuguese of the Alzheimer ’ s Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale as a cognitive screening instrument. Method: We applied the back translation added with pretest and bilingual methods. The sample was composed by 95 elderly individuals and their caregivers. Thirty-two (32) participants were diagnosed as mild cognitive impairment (MCI) patients, 33 as Alzheimer ’ s disease (AD) patients and 30 were considered as cognitively normal individuals. Results: There were only little changes on the sca...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Quality of life in breast cancer survivors
Summary Objective: To evaluate the influence of functional capacity (FC) and how it affects quality of life (QoL) in breast cancer survivors. Method: A total of 400 breast cancer survivors were studied - 118 without metastasis, 160 with locoregional metastasis and 122 with distant metastasis. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire--Core 30 (EORTC QLQ-C30), Breast Cancer-Specific (EORTC QLQ-BR23), and the Karnofsky Performance Scale (KPS) were used to evaluate FC and QoL. Results: Women with distant metastases presented lower KPS 75.3 (SD=12.5) (p
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Chronic joint symptoms in adults: A population-based study
Conclusion: Women an d individuals who were older, overweight and performing heavy work had a higher risk of CJS in this adult population residing in Viçosa, MG, Brazil.Resumo Objetivo: Analisar os fatores associados aos sintomas articulares cr ônicos (SAC) em adultos. Método: Trata-se de um estudo transversal, de base populacional, com 1.217 adultos, na faixa etária de 20 a 59 anos, na cidade de Viçosa, MG, 2014. A amostragem foi realizada por conglomerados em duplo estágio, sendo as unidades de primeiro estágio os setores censitá rios, e, em seguida, os domicí...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Assessment of HER-2 status in invasive breast cancer in Brazil
Conclusion: Our findings provide estimates for the frequency of HER-2 positivity in Brazil and raise the hypothesis that biological differences may underlie the different distribution of breast-cancer phenotypes among different Brazilian regions.Resumo Objetivo: Estimar a frequ ência de câncer de mama positivo para HER-2 no Brasil. Método: Neste estudo observacional e prospectivo, verificamos o escore de HER-2 de espécimes de câncer de mama invasivo por imuno-histoquímica automatizada (IHQ). Para amostras classificadas como 2+ por IHQ, fizemos hibridização in situ (HIS)....
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Foix-Alajouanine syndrome mimicking a spinal cord tumor
We report the case of a patient with SNM, who underwent biopsy on the assumption of it being a spinal cord tumor.Resumo Mielopatia necrotizante subaguda (MNS) ou s índrome de Foix-Alajouanine é uma doença rara que se caracteriza por disfunção neurológica progressiva causada por uma fístula arteriovenosa espinal dural. O diagnóstico radiológico é comumente suspeitado quando aparece captação não específica de contraste e de artefatos de fluxo (flow voids) perimedulares. Raramente, a captação de contraste exibe o as...
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Guidelines for the treatment of central nervous system metastases using radiosurgery
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Many reasons to talk about suicide
(Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - September 28, 2017 Category: General Medicine Source Type: research

Association between physical activity and vitamin D: A narrative literature review
Summary This narrative review of the medical literature assessed whether outdoor and indoor physical activity would increase the plasma levels of vitamin D. Synthesis of this liposoluble vitamin is mainly mediated by sunlight on the skin, where it is activated to perform its main action, which is to control the serum levels of calcium as soon as the element is absorbed in the intestines, assisting in the regulation of bone metabolism. Physical activity is any body movement that results in energy expenditure, while outdoor physical activity refers to physical activity carried out at public parks or other open spaces, as is ...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Hospitalization due to exacerbation of COPD: "Real-life" outcomes
Conclusion: Hospitalization for eCOPD is frequent. The number of readmissions was high and associated with death as an outcome. Patients hospitalized for eCOPD were a heterogeneous group separated in three clusters with different degrees of disease severity and no correlation with hospitalization outcomes.Resumo Introdu ção: As hospitalizações por exacerbação da doença pulmonar obstrutiva crônica (eDPOC) podem indicar um pior prognóstico. É importante conhecer o perfil dos pacientes internados e os desfechos das internações para personalizar...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Analysis of the availability of the resources necessary for urgent and emergency healthcare in São Paulo between 2009-2013
Conclusion: There is a lack of resources to meet urgent and emergency needs in the city of São Paulo.Resumo Introdu ção: O Complexo Regulador é a estrutura que operacionaliza as ações de acesso aos recursos para atendimento de urgência e emergência médicas no município de São Paulo. Nas urgências, as necessidades são imediatas e associadas a elevada morbidade e mortalidade. Objetivo: Identificar os r ecursos mais frequentemente solicitados, a capacidade de resolução e o índice de mortalidade associado à falta...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Thrombocytopenia as a marker of liver steatosis in a low-endemic area for schistosomiasis mansoni
Conclusion: Thrombocytopenia was not a good marker of hepatosplenic schistosomiasis mansoni in a low prevalence area in Brazil. Liver steatosis was associated with thrombocytopenia in our study.Resumo Introdu ção: Trombocitopenia é um achado comum em pacientes que residem em áreas com alta endemicidade de esquistossomose mansônica. Recentemente, diferentes graus de esteatose hepática também têm sido associados a níveis baixos de plaquetas em todo o mundo. Investigamos a associação de níveis s éricos de plaquetas com a forma grave da es...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Mueller-Hillis maneuver and angle of progression: Are they correlated?
Conclusion: An AOP o f 138º seems to be associated with a positive MHM in the second stage of labor.Resumo Objetivo: A manobra de Mueller-Hillis (MHM) e o ângulo de progressão da apresentação (AOP) medido através de ecografia transperineal têm sido utilizados para avaliar a descida do polo cefálico durante o segundo estágio do trabalho de parto. O objetivo do nosso trabalho foi avaliar se o AOP se correlaciona com a MHM no segundo estágio do trabalho de parto. Método: Conduzimos um estudo observacional e prospectivo. Incluímos mulheres com grav...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Diagnostic and prognostic performances of serum procalcitonin in patients with bloodstream infections: A parallel, case-control study comprising adults and elderly
Conclusion: Although admission serum PCT is a sensitive and specific biomarker for the diagnosis of BSIs in patients younger than 65 years old, its short-term prognostic value is comparable between adults and the elderly. (Source: Revista da Associacao Medica Brasileira)
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Geographical distribution of medical graduates from a public university
Conclusion: Most of the physicians included in this study pursue subspecialties training and were practicing medicine in large cities. Knowing the multiple factors that influenced the choice of practice location can assist in planning future strategies to reduce physician workforce misdistribution.Resumo Objetivo: Avaliar a distribui ção geográfica e a trajetória dos médicos e fatores associados à escolha para o local da prática médica. Método: Estudo transversal envolvendo graduados entre 2001 a 2010, utilizando-se questionário autoaplicado com dados so...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research

Factors associated with burnout syndrome in medical residents of a university hospital
Conclusion: The prevalence of burnout found in resident physicians is in accordance with previous Brazilian studies. Residents of surgical specialties and those who suffered some stressful event were identified as susceptible in this study. The early identification of risk factors is fundamental for the implementation of preventive measures against burno ut syndrome.Resumo Objetivo: Determinar a preval ência da síndrome de burnout entre médicos residentes de várias especialidades e avaliar os fatores associados. Método: Foram aplicados o questionário Maslach Burnout Inventory e um q...
Source: Revista da Associacao Medica Brasileira - September 4, 2017 Category: General Medicine Source Type: research