Journal International Archives of Medicine-
International Archives of Medicine, Volume 11; doi:10.3823/2562
Abstract:Objective: This article seeks to present a pilot project of community intervention that aims to prevent the occurrence of falls in the elderly in a community setting. Method: It is a prospective study in the temporal relationship, based on Health Planning, it was developed for 9 weeks in a Community Care Unit in the Northern Region of Portugal. Data collection and interventions were performed in the home of 6 of the 12 elderly being followed up at home by the nursing team. Elderly institutionalized and totally dependent were excluded. For the collection of data, an evaluation protocol was filled out using the Morse scale, validated for the Portuguese population, to assess the risk of falls. Results: Of the elderly who underwent nursing interventions, 50% presented a high risk of falls. Epidemiological indicators show that the incidence rate of falls was 0% and the prevalence rate of falls, in the last year was, 37.5%. Conclusion: The data collected was used for the production of epidemiological indicators, structure, process, and results. It is suggested to continue the project for one year, covering a larger sample and subsequent evaluation, and the creation of indicators for informal care providers.
International Archives of Medicine, Volume 11; doi:10.3823/2558
Abstract:Objective: This study aims to compare maternal and fetal responses during two physical exercise types. Design: A randomized clinical trial compared 120 pregnant women, gestational age of 35-37 weeks, 56 exercising on a stationary bicycle (Group A) and 64 on a treadmill (Group B). Methods: Participants were monitored for three 20-minute phases: resting, exercise and recovery. Fetal heart rate (FHR) and maternal heart rate (MHR) were monitored. Glucose and lactate levels were evaluated at rest and during exercise. Results: After the beginning of exercise, maximum lactate (L) levels were reached at 20 minutes and never exceeded 4 mmol/l. FHR decreased by 22 bpm during exercise in relation to resting values, irrespective of the exercise type (p0.05), increasing at 20’ to 32% and 40.6%, respectively, (p>0.05). The FHR decrease during exercise was accompanied by a simultaneous increase in its variability (p
International Archives of Medicine, Volume 11; doi:10.3823/2559
Abstract:Background/Aim: Maternal hemodynamic responses (heart rate, systolic and diastolic blood pressure) were compared during two types of moderate-intensity physical exercise. Methods: A randomized clinical trial compared 120 pregnant women performing physical exercise on a treadmill (n=64) or stationary bicycle (n=56). In 44 of these women (n=23 treadmill; n=21 bicycle), blood pressure was monitored for 24 hours following exercise. Repeated-measures analysis compared maternal heart rate, systolic and diastolic blood pressure before, during and in the 24 hours following exercise in both groups. Results: Maternal heart rate increased significantly (p
International Archives of Medicine, Volume 11; doi:10.3823/2557
Abstract:Purpose: To analyze the retinal nerve fiber layer thickness (RNFL) in CKD patients by means of optical coherence tomography, ascertaining mean overall RNFL and mean RNFL in the nasal, temporal, superior, and inferior quadrants and comparing these measurements to those obtained from a control group. Methods: This was a prospective, analytical, cross-sectional case-control study. The study sample comprised 22 eyes from 11 patients and 33 eyes from 17 patients in the case and control groups respectively. RNFLT was measured with a model 3000 OCT unit (Stratus OCT-3â„¢, Carl Zeiss Meditec Inc., Dublin, CA). The fast RNFL protocol was used, which consists of three consecutive 3.4-mm-diameter circular scans centered on the optic nerve. Measured parameters included overall mean RNFL and mean RNFL at the temporal (316â€“45Â°), superior (46â€“135Â°), nasal (136â€“225Â°), and inferior (226â€“315Â°) quadrants. The Mann-Whitney U was employed to assess possible between-group differences in mean overall RNFL and RNFL at the superior, temporal, nasal, and inferior quadrants. The null hypothesis was rejected when p-values were smaller than the set significance level of
International Archives of Medicine, Volume 11; doi:10.3823/2555
Abstract:Introduction: Fibrocystic breast disease is the most widespread disorder in women during their phase of sexual maturity. Deep oscillation (DO) therapy has been used on patients who have undergone an operation for breast cancer as a special form of manual lymphatic drainage. Method: Experimental, prospective case-control studies were conducted in 401 women diagnosed with fibrocystic breast disease. The sample was selected at random and was divided into three groups, a study group and two control groups. Results: Pain was reduced in the three therapies applied. This was statistically significant in the study group. The sonography study presented a predominance of its fibrous form. Upon completion of the treatment a resolution of the fibrosis was observed in the study group. The women were using their bra in an incorrect manner. Conclusions: Pain was reduced in the three therapies applied. In the study group this reduction was statistically significant. It is possible to verify the magnitude of the resonant vibration in the connective tissue from surface to deep layers by viewing the effect of the deep oscillations through the use of diagnostic ultrasound. The most frequent sonographic finding was fibrosis. Deep oscillation therapy produces a tissue-relaxing, moderate vasoconstriction effect, favours local oedema reabsorption and fibrosis reduction. A factor that may affect breast pain is incorrect bra use. The majority of women studied were using their bra incorrectly.
International Archives of Medicine, Volume 11; doi:10.3823/2553
Abstract:Objective: analyze profile of users of primary health care services affected by leprosy, as well as the medical professionals and nurses responsible for the follow - up of these patients. Methods: This is a field study that surveyed the socioeconomic and clinical profile of 26 patients affected by leprosy, attended at the municipal health units of the urban area of Teresina-PI, as well as the professional profile and clinical practices of 15 physicians and 19 nurses responsible for the follow-up of these patients. Results: It was observed a profile of people affected by leprosy, characterized by: individuals aged 50 years or more; predominantly male; with low schooling and income. The clinical characteristics reveal a high prevalence of multibacillary cases of leprosy and with a significant diagnosis of some degree of physical disability. Regarding the profile of the professionals and their clinical behaviors, it was verified that the majority had post-graduation and a long time of experience in primary health care and leprosy control actions, however, it has been shown that they do not always put into practice all actions necessary for the diagnosis and treatment of the disease. Conclusions: The profile of patients with leprosy treated at the municipal health units in the urban area of Teresina was similar to that found in other Brazilian territories, thus evidencing the need to implement public social support policies and more effective diagnostic and therapeutic follow-up practices by reduce the high rates of endemicity of the disease.
International Archives of Medicine, Volume 11; doi:10.3823/2552
Abstract:Objective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved. Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM) database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM), of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224); doctors facing charges (191) and cases/penalties (146). Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile. Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown: the average age was 49.8 years, and all of these professionals were male. The mean length of time since graduation among the psychiatrists with appeals to the plenary body of the TSEM was 31.28 years at the time of judgment. The punishment handed down most frequently was to strike these professionals off the register, reaching the percentage of 42.9%. Among the five professionals with specialist titles, four complemented their studies with specializations, after the episode that originated the ethics charges. Conclusion: The data gathered showed that the professionals were punished for irregularities in the sphere of ethics, including issues going beyond technical and/or scientific competence. This makes it possible to highlight that punishments proportional to the seriousness of the infraction act were applied, along with the importance of bioethics in medical training and the need for specialization, from the results of the judgments on ethical-professional cases before the plenary body of the TSEM.
International Archives of Medicine, Volume 11; doi:10.3823/2554
Abstract:Aim: The aim of this investigation was characterize morphologically the cerebellar artery and its branches in a specimen of autopsy material. Methods: This descriptive cross-sectional study evaluated the anatomical characteristics of the cerebellar arteries and their branches in 93 brain stem and cerebellum blocks obtained from fresh cadavers. The specimens were perfused bilaterally channeling the proximal segments of the internal carotid and vertebral arteries with a semi-synthetic resin (Palatal GP40L 85%; styrene 15%) impregnated with mineral red dye. We evaluated the distribution patterns of the cerebellar artery and its branches. Results: The calibers of the superior cerebellar artery (SCA), anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) were 1.46 ± 0.2 mm, 1.02 ± 0.35 mm and 1.45 ± 0.37 mm, respectively. Agenesis of the SCA was observed in six specimens (3.2%), AICA in 30 (16.1%), and PICA in 14 (7.5%) specimens. Usual irrigation was observed in 44 (47.3%) cerebellar blocks, whereas 49 (52.7%) specimens showed irrigation variants, 23 (46.9%) of which appeared bilaterally. The dominant distribution of the cerebellar arteries corresponded to SCA in 9 (12.5%) cases, AICA in 46 (63.9%) and PICA in 7 (9.7%) specimens; shared dominance was found in 10 (13.9%) specimens. Conclusion: The high variability of the cerebellar arteries observed in the present study is consistent with previous reports. The diverse anatomic expressions of the cerebellar arteries were typified in relation to their dominance and territories irrigated, useful for the diagnosis and clinical-surgical management of the cerebellum blood supply.
International Archives of Medicine, Volume 11; doi:10.3823/2551
Abstract:Background: Tuberculosis is an infectious disease caused by a bacillus called Mycobacterium tuberculosis or Koch's Bacillus (BK). It is associated with various long-term lung complications, including: lung scarring (fibrosis), bronchiectasis, Chronic Pulmonary Aspergillosis, and more rarely, atelectasis. There is however very limited data in literature on the full spectrum of these complications, and relies mostly on case reports and small case series. Case: The authors report a case of atelectasis in a patient with previous diagnosis of Tuberculosis. Normal laboratory tests and imaging test presenting right lung atelectasis. Went under respiratory therapy, presented improve and is under clinical control. Conclusion: There is a huge importance of knowing the various methods to diagnose this disease and treat it well. Thus, it enables an improvement in the patient and a reduction in the spread of bacteria.
International Archives of Medicine, Volume 11; doi:10.3823/2550
Abstract:Background: The congenital malformation of the posterolateral portion of the diaphragm is called the Bochdalek hernia, and was first described in 1948 by anatomy professor Bochdalek. The diagnosis in adults is extremely rare, being in the majority, an occasional finding in a chest x-ray. Case: The authors report a Bochdalek Hernia case in an adult pacient, with complaints of dyspnea and epigastralgia refractory to pharmacological treatment. The diagnosis was confirmed after a chest CT scan. Conclusion: Bochdalek hernias are extremely rare in adults, commonly diagnosed in childhood. The importance of recognition of its diagnosis is crucial, so it should be always among differential diagnoses in radiology, due to the range of complications that may affect the patients.