Journal of Research in Medicine and Health

Strategic approach to health disparities in Brazil towards the sustainable development goals (ODS)

Gisele Romagna Stocco — 2024-07-19

Introduction: The scale of the transformation required to achieve all the Sustainable Development Goals (SDGs) is considerable. The third SDG, explicitly, is related to health, aiming to ensure healthy lives and well-being for all, at all ages. Objective: This study proposes a prioritization index aimed at accelerating progress towards the health goals of the 2030 Agenda in Brazil. Methodology: We carried out an ecological study covering the country's 450 Health Regions. The developed index includes 25 indicators that show a significant demonstration with the official Agenda 2030 indicators, all based on publicly accessible data such as censuses and health surveys available on the government's open data portal, covering the period 2015 to 2019. Results : The index serves as a robust tool to guide decision-making in health management. Notably, the North region, which includes approximately 30% of the country's most vulnerable areas, requires prioritization in the allocation of health resources, reinforcing the need for municipalities in each established region. own priorities in the distribution of resources. Conclusion: By providing data on the most needed regions and areas requiring substantial investment, the study suggests strategies such as strengthening local health infrastructure and promoting context-specific health programs. Furthermore, it offers policymakers instruments to mitigate the effects of social disparities on health, focusing on regions with the most significant challenges.

Immunohistochemistry in Breast Cancer Diagnosis: Main Protein Markers

Victor Hugo Patuci da Silva — 2024-06-16

Introduction: Breast cancer (BC) is a malignant neoplasm that has a considerable impact on women's lives and is one of the main causes of mortality among women. Its prevalence and severity highlight the importance of ongoing research to deepen our understanding of this disease. Objective: To explore the role of immunohistochemistry as an essential tool in the diagnosis and prognostic evaluation of CM. Methods: This is a literature review using scientific articles from the US National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO) databases. To identify the relevant studies, descriptors from DeCS (Health Sciences Descriptors) were used with the Boolean operator “AND”, including the terms “Breast cancer”, “Immunohistochemistry” and “HER2+ protein”. Free full texts, published in peer-reviewed journals, available in English and Portuguese, and studies published between 2019 and 2023. Studies that were not directly related to the proposed topic were excluded from the analysis. Results: Immunohistochemistry demonstrates efficacy in accurately detecting the HER2+ protein in breast cancer, and is essential for assessing prognostic factors and differentiating lesions in breast tissue. Its ability to reliably identify the protein and discriminate between different types of BC contributes to a more precise and personalized therapeutic approach, improving patients' clinical outcomes. Conclusion: Immunohistochemistry is crucial in the diagnosis and understanding of breast cancer. In addition to confirming the diagnosis, it identifies the presence of HER2+ and other markers, influencing therapeutic and prognostic decisions. This personalized approach promotes more effective treatment, highlighting the importance of immunohistochemistry in the management of BC.

Public Health Administration in Brazil from the perspective of Bureaucracy Theory: deficiency of specialized doctors and regional disparities in accessibility

Gisele Romagna Stocco — 2024-07-15

Introdução: A administração pública burocrática veio substituir as formas patrimonialistas de gestão, ganhando importância em função da necessidade de maior previsibilidade e precisão no tratamento das questões organizacionais. Objetivo: Este estudo tem como objetivo destacar a relação entre a disparidade regional no acesso aos serviços de saúde especializados no Brasil e a estrutura burocrática do Sistema Único de Saúde (SUS), examinando a gestão de saúde pública brasileira à luz da teoria da burocracia. Metodologia: Com base em pesquisa empíricas e documentos governamentais, incluindo análises de fontes como Sistema Único de Saúde (SUS), foram abordadas algumas questões relacionadas ao tema, incluindo reflexões sobre a burocracia, administração pública no Brasil, escassez de profissionais de saúde especializados e alocação de recursos, bem como as consequências adversas para a população quando não consegue acessar os serviços públicos de saúde. Resultados: Identificamos evidências que apontam para duas trajetórias distintas: uma para os cidadãos que residem em áreas urbanas e outra para os residentes de áreas rurais e remotas. Essa disparidade regional é atribuída à gestão precária com distribuição concentrada dos recursos de saúde. Conclusão: A carência de médicos especializados é um problema significativo que afeta ambas as trajetórias, tanto para os cidadãos que residem em áreas urbanas quanto para os residentes de áreas rurais e remotas. Essa carência resulta dos processos burocráticos relacionados à formação e à fixação desses profissionais, incluindo a distribuição desigual de vagas de residência médica e a falta de incentivos para a fixação de profissionais em áreas menos desenvolvidas.

Palavras-chave: Disparidade Regional. Serviço de Saúde. SUS. Teoria da Burocracia.

Introduction: Bureaucratic public administration replaced patrimonial forms of management, gaining importance due to the need for greater predictability and precision in the treatment of organizational issues. Objective: This study aims to highlight the relationship between regional disparity in access to specialized health services in Brazil and the bureaucratic structure of the Unified Health System (SUS), examining Brazilian public health management in light of the theory of bureaucracy. Methodology: Based on empirical research and government documents, including analyzes of sources such as the Unified Health System (SUS), some issues related to the topic were addressed, including reflections on bureaucracy, public administration in Brazil, shortage of specialized health professionals and allocation of resources, as well as the adverse consequences for the population when they are unable to access public health services. Results: We identified evidence that points to two distinct trajectories: one for citizens residing in urban areas and another for residents of rural and remote areas. This regional disparity is attributed to poor management with concentrated distribution of health resources. Conclusion: The shortage of specialized doctors is a significant problem that affects both trajectories, both for citizens residing in urban areas and for residents of rural and remote areas. This shortage results from the bureaucratic processes related to the training and retention of these professionals, including the unequal distribution of medical residency places and the lack of incentives for the retention of professionals in less developed areas.

Keywords: Regional Disparity. Health Service. SUS. Bureaucracy Theory.

Transcranial Direct Current Stimulation in Cognition and Memory in the Elderly

Tereza Raquel Xavier Viana — 2024-06-24

Introduction: Transcranial direct current stimulation (tDCS) represents a promising approach to neuropsychological rehabilitation, especially among the elderly population. With accelerated global ageing, there is a need to address the challenges related to cognitive decline and memory loss, prevalent conditions that compromise the quality of life of older people. Objective: To analyze the effects of tDCS on cognition and memory in the elderly, consolidating current scientific findings to determine the effectiveness of this technique as a therapeutic intervention. Methods: This is a literature review, using scientific articles from the US National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO) databases and Latin American and Caribbean Health Sciences Literature (LILACS). Descriptors from DeCS (Health Sciences Descriptors) were used with the Boolean operator "AND", including the terms "Transcranial Direct Current Stimulation", "Cognition", "Elderly" and "Memory". Free full texts, published in peer-reviewed journals, available in English and Portuguese, and studies published between 2019 and 2024. Results: Initially, 28 articles were found. After applying inclusion and exclusion criteria, 5 articles were selected for the study. The studies showed a positive trend, indicating that tDCS can improve aspects of cognitive function and memory in the elderly. Overall, the results suggest potential benefits. Conclusion: Despite the promising results, caution is needed when interpreting the findings due to the heterogeneity of the studies. However, it seems that tDCS can be a viable tool for cognitive improvement in the elderly.

The Role of Cytogenetics and Immunophenotyping Techniques in the Differential Diagnosis of Acute Myeloid Leukemias

Camilly Isadora Pires — 2024-04-30

Introduction: Acute myeloid leukemia (AML) is a neoplasm characterized by the uncontrolled proliferation of precursor cells of the myeloid lineage in the bone marrow, resulting in visible morphological manifestations and immature cells in the peripheral circulation. The World Health Organization (WHO) currently classifies AML subtypes based on both morphological and genetic aspects. Objective: To evaluate the main diagnostic criteria for AML and identify the role played by cytogenetic analysis and immunophenotyping in the differential diagnosis of this pathology. Methods: This is a literature review using scientific articles available in the PubMed(US National Library of Medicine) and Scielo(Scientific Electronic Library Online) databases. DeCS descriptors with the Boolean operator "AND" were used, including "myeloid leukemia", "Immunophenotyping " and "cytogenetics". Free full texts, published in peer-reviewed journals, available in English and Portuguese, and studies published between 2019 and 2023. Studies that were not directly related to the proposed topic were excluded from the analysis. Results: The diagnosis of AML combines information from the blood count with cytogenetic analysis and immunophenotyping. Genetic analysis, through karyotyping, identifies AML subtypes by specific chromosomal translocations. Immunophenotyping uses antibodies to identify markers of immaturity, differentiating AML from lymphoblastic leukemias. These approaches are essential for an accurate and differential diagnosis of AML. Conclusion: Cytogenetic research and immunophenotyping play essential roles in the differential diagnosis of AML, providing essential information to guide treatment and patient care, based on their cytogenetic and immunophenotypic characteristics.

Socio-Demographic, Clinical and Obstetric Profile of Postpartum Women in Peri-Hospital Care

Isabela Soter Corrêa — 2024-08-17

Introduction: Care network that aims to ensure women receive humanized care during pregnancy, childbirth and the postpartum period, as well as the child's right to a safe birth. Objective: to characterize the socio-demographic, clinical and obstetric profile of postpartum women in a peri-hospital unit and to identify the clinical characteristics of their newborns admitted to the Neonatal ICU. Methods: descriptive, cross-sectional, retrospective research with a quantitative approach carried out in 2021. The participants were 180 puerperal women who were housed at Casa da Gestante, Baby Puerpera between February and August 2021 and their newborns.. Results: women aged 18 to 34 years, multi-gestations, with no previous diseases (63.3%), 1 to 2 gestational diseases (64.4%), number of prenatal consultations ≥ 6 (63, 9%), with high gestational risk (58.3%) and cesarean section as the delivery route (55.5%). As for newborns, it was identified: full-term newborns (38.1%), average of 15.2 days of hospitalization, with prevalence in diagnoses related to respiratory dysfunction, neonatal jaundice, needing phototherapy, prematurity and presumed early infection, hospital discharge on exclusive breastfeeding (72.5%). Conclusion: the characterization of puerperal women at Casa da Gestante, Baby Puerpera and their newborns can guarantee access to health services in a comprehensive and effective way, ensuring humanized care during pregnancy, childbirth and the puerperium.

Oxidative events related to angiotensin II and angiotensin 1-7 in hypertension

Matheus Vinicius Barbosa da Silva — 2024-09-12

Upregulation of the renin-angiotensin-aldosterone system and oxidative stress are among the main events related to the pathogenesis and pathophysiology of hypertension. In the renin-angiotensin system, specifically Angiotensin II and the recently discovered Angiotensin-(1-7), are important modulators of the redox state. In this sense, the objective of this study was to describe the effects promoted by Angiotensin II and Angiotensin 1-7 on oxidative parameters and the implications for blood pressure. This is a review study, developed in the PubMed, SciELO and ScienceDirect databases. The important relationship between the classical arm of the system, specifically related to the interaction between angiotensin-II and angiotensin receptor subtype I and the development of oxidative stress, is highlighted. Conversely, Angiotensin-(1-7) with opposite effects on this side of the system is highlighted. Thus, the importance of an approach aimed at this protective side of the system is observed, which appears to be a future therapeutic target for the treatment of hypertension.

Medicinal Cannabis: A Review of Current Perspectives and Future Challenges in Clinical Practice

Tereza Raquel Xavier Viana — 2024-04-15

Introduction: The growing attention paid to medicinal cannabis reflects interest in its therapeutic properties, which have been exploited since ancient times. Compounds such as tetrahydrocannabinol (THC) and cannabidiol (CBD) have aroused scientific interest due to their potential medicinal applications. Objective: To provide a comprehensive overview of the therapeutic potential of medicinal cannabis and its clinical applications. Methods: This is an integrative review of the scientific literature available in the PubMed (US National Library of Medicine), SciELO (Scientific Electronic Library Online) and Web of Science databases. Studies were selected that related to the therapeutic use of cannabis in different medical conditions, using the following inclusion criteria: registered Decs descriptors (((Medical Marijuana) AND (Therapy)) AND (Clinical)) AND (Diseases)), free full texts, published in peer-reviewed journals, articles available in English and Portuguese, and published in the last 5 years (2019 to 2024). Studies that were not directly related to the proposed topic were excluded from the analysis. Results: This review analyzed a total of 81 articles, of which only 8 were considered relevant to the topic under study. The study highlighted a variety of clinical applications for medicinal cannabis, including pain relief, anxiety reduction and seizure control in patients with epilepsy, among others. These results provide valuable information for health professionals and researchers interested in the therapeutic potential of Cannabis. Conclusion: Medical cannabis has significant therapeutic potential in various clinical applications, offering a promising alternative for patients seeking complementary or alternative treatments. However, more research is needed to elucidate the mechanisms of action and optimize its clinical use.

Influence of Genetic Variants of the TLR7 Gene on the Pathophysiology of Systemic Lupus Erythematosus

Luana Brilhante de Sousa — 2024-09-12

Introduction: The TLR7 gene encodes the TLR7 protein, which is essential for recognizing pathogens and activating pro-inflammatory factors. Its deregulation is associated with Systemic Lupus Erythematosus (SLE), an autoimmune disease characterized by the deposition of immune complexes in tissues. Objective: To analyze TLR7 genetic variants and their pathophysiological and therapeutic implications in SLE. Methods: This is an integrative literature review. The articles were collected from the PubMed, Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO) databases, using the descriptors “TLR7”, “TLR”, “Autoimmune Diseases”, “Lupus”, “Systemic Lupus Erythematosus”, “Treatments”, “Gain Of Function” and “Polymorphism”, consulted in the Health Sciences Descriptors (Decs). The inclusion criteria were articles dated from 2014 to 2024, in Portuguese or English, available free of charge. Exclusion criteria were articles not related to TLR7 and its expression in SLE. Results: The literature shows that gain-of-function variants in addition to activating the TLR7 protein are related to neurological damage. Searches for significant SNPs showed that rs3853839, its genotypes and alleles, not only correlated with the development of the disease, but also showed an association with TLR7-related components and clinical signs of SLE. Conclusion: The genetic variants detected in TLR7 were consistently linked to SLE susceptibility in different populations around the world. In particular, rs3853839 emerged as a crucial marker in this context. These findings highlight potential therapeutic targets and biomarkers for SLE.