Abbreviated Title: Act. Eli. Salt. e-ISSN: 2675-1208 Journal edited by the Health Sciences Center (Universidade Estadual do Oeste do Paraná - Unioeste) and linked to the Postgraduate Program in Applied Health Sciences at the Francisco Beltrão Campus. It is a project that aims to encourage scientific dissemination of research outputs from health sciences and related fields. Acta Elit Salutis (AES) is a semiannual, exclusively online journal that publishes original articles in all areas of health sciences, including medicine, nutrition, dentistry, nursing, pharmacy, physical therapy, physical education and others. Original articles (written in Portuguese, Spanish or English) addressing health sciences in general, public health and epidemiology are welcome. Articles may include new experimental methods, results obtained experimentally, new interpretation of existing results or data related to clinical problems, as well as epidemiological work that provides substantial scientific information related to the health sciences. If you are unsure if your paper fits the requirements of this journal, or wish to discuss the possibility of organizing a special issue, please, contact the Editors-in-Chief. Are you considering your papers to our journal? Please, read our policies for each section (About this journal) and our instructions for authors (Submission guidelines). Make sure to select the appropriated Language on your right side menu (Português, English or Spanish).
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Are You Still There, Reader? Peer Review, Unpaid Labor, and the Enshittification of Science
Copyright (c) 2026 Acta Elit Salutis http://creativecommons.org/licenses/by-nc-sa/4.0
Perceptions of paternal involvement in the pregnancy–puerperal cycle: a qualitative study with puerperal women
The pregnancy-puerperal cycle represents a period of intense physical, emotional, and social transformations that demand adaptations from women and their support networks. This study aimed to understand mothers’ perceptions of paternal involvement during pregnancy, childbirth, and the puerperium, analyzing the meanings attributed to this participation. It is a qualitative, exploratory, and descriptive research conducted with 30 women assisted at the Elpídio de Almeida Health Institute (ISEA), in Campina Grande, Brazil. Data were collected through a sociodemographic questionnaire and semi-structured interviews, analyzed using Thematic Categorical Analysis1. Results revealed five thematic classes and thirteen categories addressing paternal involvement during pregnancy, childbirth, and the postpartum period, as well as the difficulties and benefits related to this presence. The participants’ narratives indicated a transition from the traditional provider model to a more affective and participatory fatherhood, although still limited by cultural, social, and institutional barriers. It is concluded that active fatherhood is an ongoing process that requires public policies, interdisciplinary practices, and health actions aimed at gender equity and strengthening parental co-responsibility.
Realization of values and marital satisfaction: a case study in light of Logotherapy
This study aims to verify the relationship between the realization of values and marital satisfaction, through a case study, based on Logotherapy and Existential Analysis. To this end, a couple with a 23-year relationship was recruited, consisting of a 43-year-old woman and a 51-year-old man. Initially, the Avaliação de Valores instrument was applied to measure the self-assessment of current and potential values ​​of each participant. Then, the same instrument was applied to measure the assessment of the spouse's current and potential values. Subsequently, a semi-structured interview guide was used to obtain a description of the couple's history and current situation, as well as to verify the existence of mutual support in the realization of values. The results suggest that the couple experiences noological love, based on the perception of who the spouse is and can become, with mutual support in the realization of values. The findings discussed can contribute to the training of logotherapists and researchers interested in the subject, thus assisting in the development of future research with representative samples.
Impact of the SARS‑CoV‑2 Pandemic on Streptococcus pneumoniae Infections in a Tertiary Pediatric Hospital in Southern Brazil
Introduction/Objectives: Streptococcus pneumoniae remains a major etiological agent contributing to pediatric morbidity and mortality. The COVID-19 pandemic altered the behavior of infections in children, raising the need to assess possible changes in the profile of pneumococcal infections. This study evaluated the clinical, microbiological, and therapeutic characteristics of S. pneumoniae infections in children hospitalized in a tertiary center in Southern Brazil during the pre- and post-pandemic periods, aiming to identify the pandemic’s impact on these outcomes. Methods: This was a retrospective, observational, and analytical study including patients hospitalized for more than 24 hours with a positive culture for S. pneumoniae between January 2018 and December 2024. Clinical, epidemiological, microbiological, therapeutic, and outcome data were analyzed using descriptive statistics and the chi-square test (p<0.05). Results: Children under 2 years represented the largest group (45.8%), and most were previously healthy (>60%). Vaccination records were scarce (9.2% overall; 2.4% post-pandemic). Antimicrobial resistance was present in 66% of isolates, mainly to Sulfamethoxazole-Trimethoprim (57%) and Clindamycin (56%), with no significant difference between periods. Pneumonia was the most frequent diagnosis (60.8%), with no relevant variation in infection site or length of stay. A trend toward greater severity was observed post-pandemic, with higher ICU admission rates (66.3% vs. 48.6%) and a greater proportion of hospitalizations longer than 15 days (51.8% vs. 43.2%). Conclusion: The study showed increased severity in the post-pandemic period, with longer hospitalizations and greater ICU need, possibly due to an “immunity debt,” reinforcing the importance of surveillance, appropriate management, and vaccination.
Differences in Covid-19 response policies between developed and developing countries in relation to health system quality indicators
The COVID-19 pandemic highlighted structural inequalities and diverse response strategies between developed and developing countries. This scoping review analyzed eight nations from different continents (South Africa, Australia, Brazil, Canada, South Korea, the Netherlands, Japan, and Sweden), comparing containment policies, financing, and quality indicators of health systems. Findings show that countries with universal, well-funded, and technologically prepared systems, such as South Korea, Japan, Australia, and Canada, achieved lower mortality rates and broader vaccination coverage. In contrast, Brazil and South Africa faced greater challenges, associated with social inequalities, infrastructural limitations, and shortages of human resources. Heterogeneity was also observed among developed countries, such as the Netherlands and Sweden, which adopted distinct strategies with divergent outcomes. It is concluded that the resilience of health systems depends not only on financial resources, but also on efficient allocation, transparent governance, and rapid evidence-based responses.
Copyright (c) 2025 Acta Elit Salutis http://creativecommons.org/licenses/by-nc-sa/4.0
Dexamethasone, dexmedetomidine, clonidine, and morphine as adjuvants in regional anaesthesia: a narrative review of safety and efficacy
Introduction: The limited duration of local anesthetics and the occurrence of rebound pain have encouraged the use of pharmacological adjuvants to prolong analgesia and improve postoperative comfort. Several substances, including dexamethasone, dexmedetomidine, clonidine, and morphine, have been studied for this purpose, although evidence remains heterogeneous regarding the efficacy and safety of each agent. Objective: To analyze the available evidence on the use of pharmacological adjuvants in regional anesthetic blocks. Methods: This narrative review was conducted in the PubMed/MEDLINE and Embase databases, covering the period from 2000 to 2025, with no language restrictions. Results: The initial search identified 4,167 records, of which 21 were included in the final analysis. Dexamethasone was the most studied adjuvant, consistently demonstrating prolonged analgesia duration and reduced opioid consumption, with similar effects between perineural and intravenous administration. Dexmedetomidine showed comparable results but with a higher incidence of mild bradycardia and sedation. Clonidine exhibited moderate efficacy, limited by hypotension and somnolence, while perineural morphine prolonged analgesia at the expense of higher rates of pruritus and nausea. Recent studies suggest a synergistic effect between dexamethasone and dexmedetomidine, with potential additional benefits in prolonging block duration and reducing opioid use. Conclusion: Current evidence indicates that dexamethasone and dexmedetomidine are the most effective and safest adjuvants for prolonging analgesia in regional blocks, presenting a superior benefit–risk profile compared with clonidine and morphine. The combination of both appears promising but still requires validation through larger, methodologically robust clinical trials. Standardization of dosing regimens and long-term neurotoxicity assessment remain priorities for research.
Epidemiological profile of patients with primary bone tumors in a pediatric hospital in southern Brazil over a 10-year period
Introduction: Primary bone tumors are rare but clinically relevant pediatric neoplasms, with osteosarcoma and Ewing’s sarcoma being the most frequent and among the main causes of oncologic morbidity and mortality in adolescents. Objective: To describe and analyze the epidemiological, clinical, and therapeutic profile of pediatric and adolescent patients diagnosed with primary bone tumors in a reference hospital in southern Brazil. Methods: A retrospective, descriptive, cross-sectional study was conducted with 24 patients aged 0–19 years diagnosed between 2014 and 2024. Statistical analysis included Shapiro–Wilk, Pearson’s chi-square, Fisher’s exact, and Mann–Whitney U tests, with significance set at p<0.05. Results: Ewing’s sarcoma was the most frequent histological type (54.2%), followed by osteosarcoma (45.8%). The mean age at diagnosis was 11.67 ± 3.45 years, with male predominance (58.3%). Metastases were present in 37.5% of patients, and 37.5% died, mainly due to disease progression. No statistically significant differences were found between tumor types for any variable (p>0.05). Conclusion: The findings suggest a similar clinical pattern between osteosarcoma and Ewing’s sarcoma, likely influenced by sample size and regional factors. Early diagnosis and multidisciplinary management remain key to improving outcomes in pediatric oncology.
Manifestações neurológicas na neurofibromatose do tipo 1: o estado da arte
A neurofibromatose tipo 1 (NF1) é uma doença genética autossômica dominante, causada por mutações no gene NF1, que codifica a neurofibromina, proteína reguladora da via Ras. Trata-se de uma condição multissistêmica e neurocutânea, caracterizada por manifestações cutâneas, ósseas e, principalmente, neurológicas, que determinam grande parte da morbidade e do impacto sobre o desenvolvimento infantil. Esta revisão de escopo teve como objetivo mapear as evidências científicas disponíveis sobre as manifestações neurológicas em crianças e adolescentes com NF1, descrevendo sua frequência, características e implicações clínicas. O estudo foi conduzido conforme as diretrizes metodológicas do Joanna Briggs Institute (JBI) e as recomendações PRISMA-ScR, utilizando o arcabouço PCC (População, Conceito e Contexto). Foram pesquisadas as bases MEDLINE, Embase, Scopus, LILACS e SciELO, sem restrição temporal, incluindo publicações em português, inglês e espanhol. Após triagem e leitura crítica, 11 estudos preencheram os critérios de inclusão e foram analisados quanto aos achados clínicos e de imagem. Os resultados demonstraram que as manifestações neurológicas são altamente prevalentes na NF1 pediátrica, abrangendo desde déficits cognitivos e comportamentais até achados estruturais como lesões hiperintensas em T2, macrocefalia e gliomas ópticos. O fenótipo mostrou-se mais grave em portadores de microdeleções NF1 e mais brando nas formas mosaicas. Conclui-se que a NF1 na infância constitui uma condição neurológica e neurodesenvolvimental complexa, exigindo avaliação multidisciplinar precoce e acompanhamento longitudinal. Esta revisão fornece uma síntese abrangente do estado atual do conhecimento, destacando a necessidade de padronização diagnóstica e de estudos prospectivos que integrem aspectos clínicos, genéticos e cognitivos.
Situational Psychological Assessment in the Practice of Brazilian Hospital Psychologists
This study investigates the practice of situational psychological assessment among psychologists in Brazilian hospitals, exploring how individual variables of these professionals impact its implementation. The research involved 168 psychologists from public and private hospitals in Brazil, who answered a questionnaire based on technical-normative documents. The results indicate a discrepancy between current practices and the psychologists' desire to incorporate situational psychological assessment more consistently into their professional routine. Additionally, the psychologists' age, the type of employment contract, the hospital administration, and the theoretical model of psychological care impact the implementation of situational psychological assessment. Younger professionals, with more stable employment contracts, working in private hospitals, as well as those adopting a biopsychosocial theoretical model for practice, were more likely to consider this assessment as an integral part of their work. Implications for the clinical practice of hospital psychologists are discussed.
Burnout syndrome among physicians on duty in emergency care units: a cross-sectional study with a quantitative approach
Objectives: to assess burnout prevalence among UPA physicians and explore associations between its dimensions (emotional exhaustion, depersonalization, and personal accomplishment) and sociodemographic and organizational factors. Methods: a cross-sectional, quantitative study involving 29 full-time UPA physicians in the Campos Gerais region. Data were collected via electronic questionnaires, including the Maslach Burnout Inventory (MBI), and analyzed using R software. Results: high burnout levels were identified, with 82.76% reporting disorganized work environments and 79.31% citing excessive management demands. Significant associations included higher emotional exhaustion in physicians with longer UPA tenure (OR=5.99; 95% CI: 2.91-6.13) and turnover intentions linked to low personal accomplishment (OR=5.94; 95% CI: 1.15-7.35). Conclusion: organizational and emotional factors were pivotal in the development of burnout among UPA physicians. Interventions improving work conditions and providing psychological support are crucial. This study supports health policies aimed at professional well-being and enhanced patient care quality.
Microdeletions in the SHANK3 gene as a monogenic etiology of syndromic Autism Spectrum Disorder: case report with microarray confirmation
Neurodevelopmental disorders (NDDs) comprise a group of early-onset clinical conditions often associated with cognitive, linguistic, motor, and behavioral deficits. Among these, Phelan-McDermid syndrome, caused by deletions in the 22q13.3 chromosome region or pathogenic variants in the SHANK3 gene, stands out for its strong correlation with global developmental delay, language deficits, epilepsy, mild facial dysmorphisms, and traits consistent with autism spectrum disorder (ASD). This article presents the case of a 10-year-old female patient with an interstitial deletion at 22q13.31q13.33, with clinical findings consistent with the syndrome. Diagnostic confirmation by chromosomal microarray reinforces the importance of early genetic investigation in patients suspected of having NDD, allowing for more accurate genotype-phenotype correlation, appropriate multidisciplinary management, and appropriate genetic counseling. The report contributes to the recognition of phenotypic variability and to the consolidation of the central role of SHANK3 in the pathophysiology of the syndrome.
Genetic and cytogenetic markers in leukemia: unraveling the pathways of the disease
Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the clonal expansion of abnormal leukocytes, which compromises normal hematopoiesis. A key milestone in its understanding was the discovery of the Philadelphia chromosome (Ph), resulting from the reciprocal translocation t(9;22)(q34;q11), which generates the BCR-ABL1 fusion gene. This gene encodes a constitutively active tyrosine kinase protein, responsible for promoting excessive cell proliferation, inhibiting apoptosis, and inducing genomic instability. This study aimed to conduct a narrative review on the contribution of molecular biology and cytogenetic techniques in the diagnosis and monitoring of CML. The search was carried out in the SciELO, Google Scholar, PubMed, LILACS, and BIREME databases, using the descriptors “chronic myeloid leukemia,” “molecular biology,” “cytogenetics,” and “diagnosis.” Articles published between 2019 and 2024, in Portuguese, English, and Spanish, were included. The analysis of 10 articles showed that the diagnosis of CML combines hematological tests with specific molecular techniques, such as fluorescence in situ hybridization (FISH) and polymerase chain reaction (PCR), which allow the detection of the Ph chromosome and the BCR-ABL1 transcript. These methodologies not only confirm diagnosis and staging but also provide essential information for prognosis and therapeutic monitoring. It is concluded that the integration of cytogenetic and molecular approaches is indispensable for the clinical management of CML, making them a strategic tool of precision in patient follow-up and in guiding more effective therapies.
Occurrence, risk factors and maternal-fetal outcomes in gestational diabetes mellitus: an integrative review
Introduction: Gestational diabetes mellitus (GDM) is characterized by the onset of glycemic dysfunction during pregnancy and has a prevalence in Brazil of between 2.4% and 7.2%, with an increasing trend. It is a condition associated with significant risks to maternal and fetal health. Objective: To analyze the occurrence of GDM and its impact on maternal and fetal health. Methods: A bibliographic survey of articles published between 2019 and 2024 was conducted in PubMed, SciELO, and Scopus, using descriptors related to GDM and its maternal and fetal outcomes. Articles available in full in Portuguese and English were included. Results and discussion: A total of 2,496 studies were identified, of which 20 met the inclusion criteria after applying the eligibility criteria and reading them in full. High body mass index and advanced maternal age were the main risk factors identified. Among the fetal consequences, macrosomia, neonatal hypoglycemia, and, in the long term, a higher risk of type 2 diabetes and cardiovascular disease stood out. In pregnant women, a higher incidence of preeclampsia and premature birth was observed. Appropriate treatment, including lifestyle changes, insulin therapy, and/or oral hypoglycemic agents, proved essential to reduce complications. Final considerations: GDM is associated with significant adverse outcomes for both mother and fetus, and early diagnosis, continued monitoring, and effective therapeutic interventions are essential to minimize risks.
Evaluation of cases of Clostridioides difficile detected in a tertiary hospital in western Paraná state, Brazil.
Background: Clostridioides difficile is an obligate anaerobic, gram-positive bacillus, with subterminal spores. It is also a producer of enterotoxins. Prolonged use of broad-spectrum antimicrobials in immunocompromised patients is often related to the occurrence of diarrhea and pseudomembranous colitis. The study aimed to evaluate the cases of C. difficile detected at the Western Paraná University Hospital (HUOP). Methods: Data were collected from the hospital’s electronic medical record system (TASY®) from February 2018 to January 2023. We analyzed patient data, such as gender, age, pre-existing pathologies, clinical manifestation period, antimicrobial use, and whether there was COVID-19 co-infection, as well as the pre-pandemic and pandemic periods to determine if there were changes in the profile of patients affected by complications. Results: A total of 700 tests for C. difficile toxins A and B were evaluated. Patients were predominantly female over 60 years of age. Conclusion: In addition, it is possible to highlight that, despite the increasing number of tests in recent years, the pandemic has not been statistically related to cases.
Stillbirth in full-term pregnancy: a case report
Stillbirth is characterized by the death of the conceptus inside the uterus or during childbirth, being considered a stillbirth at term when the gestation is more than 37 weeks and is usually associated with obstetric, fetal and maternal conditions. A patient with gestational age of 38 weeks and 5 days had a change in the perception of fetal movements and uterine contractions, was referred to the reference hospital where fetal death was found due to the absence of heartbeat, being performed cesarean section. Patient evolved with mood alteration, underwent the mourning process, requiring drug and psychiatric management. The diagnosis of fetal death can be done through clinical examination and confirmed by image exams. Investigation of the cause of the stillbirth is mandatory and necessary by the Reference Hospital. The most obvious comorbidity that may have contributed was grade 3 of obesity.
An analysis of the most recent scientific evidence: is ketamine the solution for treating patients with depression?
Depression is one of the main causes of disability worldwide and a significant portion of patients do not respond adequately to available treatments, triggering the need for new pharmacological options. Originally developed as an anesthetic and known for abuse potential, ketamine has recently been reevaluated as a medication for depression, especially in resistant cases. The objective of this research is to analyze the use of ketamine as a therapeutic alternative for the treatment of resistant depression. The methodology used was an integrative literature review, with analysis of clinical studies published in the last 5 years, through the combination of the terms “ketamine” and “antidepressant” in PubMed, ScienceDirect, Google Scholar and LILACS databases. The search strategy resulted in 322 articles and, of these, 13 were used in the research. The data showed that ketamine provides a rapid reduction in depressive symptoms, including in severe cases with suicidal ideation. However, the potential for abuse and adverse effects justify the need for controlled use. Another obstacle to the use of ketamine is the price of the medication and the ideal conditions for its application, which makes it inaccessible to most patients. However, more studies need to be conducted to mitigate its adverse effects and clearly define its mechanism of action.
Efficacy, Adherence, and Constraints of Post-Exposure Prophylaxis of Risk to HIV: A Systematic Review
Objective: To evaluate the efficacy of HIV post-exposure prophylaxis, the percentage of adherence and its conditioning factors, and adverse effects. Method: This is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were performed in the Virtual Health Library portal and the Cumulative Index to Nursing and Allied Health, PubMed and Embase databases using the combined keywords: post-exposure prophylaxis, anti-HIV agents, medication adherence and medication compliance. Methodological rigour was analysed using tools developed by the Joanna Briggs Institute. Results: From 119 eligible studies, 24 were selected. The efficacy of post-exposure prophylaxis was almost 100% in individuals with good adherence and no exposure to new situations of potential HIV risk. Most of the trials reported mild and transient adverse effects. In half of the trials, adherence was less than 60%. Being male, older, abstinent from alcohol/drugs, having a higher level of education and having a relationship with the health care team were factors associated with good adherence. Conclusion: Post-exposure prophylaxis was found to be highly effective and tolerable, but adequate adherence to prophylaxis remains a public health challenge in HIV/AIDS prevention.
Cross-sectional study of the national school health survey in Paraná (2019): tobacco consumption and its correlates
Tobacco use among adolescents is a public health problem. The aim of this study was to address the prevalence of tobacco use indicators, health conditions, and risk factors associated with tobacco consumption among students aged 13 to 17 in Paraná, Brazil. In 2019, the Brazilian Institute of Geography and Statistics (IBGE) conducted the National School Health Survey (PeNSE), involving students from all regions of the country. For this quantitative, cross-sectional study, the criteria of chemical substance use, social and economic determinants, and risk behaviors in young people were analyzed. The PeNSE/IBGE database and specialized software were used for the state data analysis. Among the 1,591 survey participants, it was observed that 333 (38.7%) adolescents aged 13 to 15 reported cigarette use, while 528 (61.3%) did not. Regarding students in the 16 to 17 age group, 368 (50.4%) reported having used nicotine, while 362 (49.6%) had not. Other parameters, such as prevalence by school type, smoking among friends, smoking in the family, and e-cigarette use, stratified by age group and school type, were correlated in this study to identify patterns of use. The research emphasizes the importance of public policies aimed at preventing tobacco use among adolescents, highlighting the need for health education and restriction of media-influenced advertising of tobacco products.
Introduction to the last edition of Acta Elit Salutis
Clinical and epidemiological profile of heart failure in a hospital located south-west of Paraná
Objectives: It aims to analyze the clinical and epidemiological profile of patients with HF, identifying the main etiologies, risk factors, clinical progression, and current treatment. To this end, we proceed to a retrospective, descriptive, and observational analysis of the data collected In a hospital of the Southwest of Paraná in the year 2023. Methods: The sample was selected by the ICD codes I50, I50.0, I50.1, I50.9, and the data were analyzed using Microsoft Excel® software. Results: The analysis revealed that individuals aged 70 to 89 years represented the predominant age group (43.63%), a predominance of males (51%), and white race/color (71.82%). The most common risk factor was hypertension (58.18%), being more prevalent in males (64.29%). The most prevalent etiology was Hypertensive Cardiomyopathy (32.73%), in men, whites, and in the 70-89 age group. Valvular diseases (21.82%) were the most frequent etiology in women, whites, and in the 60-69 age group. In the clinical progression of patients, the average length of hospitalization was 6.83 days, and the outcome of death occurred in 16.36% of the sample. The most commonly used treatment consisted of Furosemide (60.91%), Spironolactone (38.18%), Carvedilol (31.82%), Enalapril and Losartan (24.55%, each). Conclusion: The Hypertensive Cardiomyopathy was the main cause of HF, associated with hypertension, male sex, and aging as the most frequent risk factors.
Patient autonomy and the Informed Consent Form
Objective: To gather the opinions of physicians from a small town in the interior of São Paulo regarding the informed consent form (TCLE). Method: This is a methodological study with a qualitative-quantitative, descriptive, and exploratory approach, conducted through semi-structured interviews with physicians who shared their views on the ethical aspects of the TCLE concerning Patient Autonomy. Data were analyzed using Bardin's Content Analysis, along with basic statistical analyses employing a percentage calculation model. Results: After analyzing the interviews, it was found that 69.3% of the professionals interviewed agreed that patients have full autonomy over their health decisions, 11.5% believed they do not, and 19.2% responded that it "depends" on other factors and circumstances for patients to exercise their autonomy freely. Conclusion: The study concludes that most professionals believe patients have the autonomy to make decisions regarding their health, provided they are well-informed, and all their questions are addressed, enabling them to sign the TCLE with informed consent.
Sociodemographic profile of blood donors with positive serology for HTLV-1 in the State of Santa Catarina from 2020 to 2023
Even though human T-cell lymphotropic virus (HTLV-1) is a global concern, epidemiological information is scarce. This makes it difficult to plan timely and effective health actions. Thus, this study aimed to evaluate the profile of HTLV-1 seropositive blood donors in the Hematology and Hemotherapy Centers of Santa Catarina (HEMOSC) to enlarge the information framework regarding the virus above and finally assist in providing resources for crucial prevention actions. On the data, sociodemographic aspects of candidates who showed serological reactivity for the virus from 2020 to 2023 were analyzed. The variables studied included: sex, age, ethnicity, education level, and city of residence. The number of positive cases in the analysis period totaled 507. Of these, 50.9% were male. The study population was composed mainly of individuals aged 16 to 39, of white ethnicity, mostly graduated from high school and lived in the capital. In short, characterizing the sociodemographic profile of individuals living with HTLV-1 gathered in this research constitutes an important tool for directing public strategies to combat infection by the virus.
Plant-based approach to combating Dengue Fever: Active compounds, Immunotargets and Mechanism of actions
Background: Dengue fever remains a global health threat, particularly in tropical regions, with no effective vaccines or antiviral treatments available. This review explores plant-based therapies as a promising approach to manage dengue by focusing on bioactive compounds, immunotargets, and mechanisms of action. Aim: The review aims to explore the therapeutic potential of phytomedicines in dengue management, highlighting their antiviral and immune-modulating effects, and addressing the challenges in clinical application. Methods: In this review, a comprehensive literature search was conducted, sourcing peer-reviewed articles on medicinal plants and their bioactive compounds in relation to dengue fever. The review analyzes the interaction of these compounds with key immunotargets and their mechanisms in alleviating dengue symptoms. Results: Plants such as Andrographis paniculata, Azadirachta indica, Carica papaya, Curcuma longa, Tinospora cordifolia, and Euphorbia hirta contain bioactive compounds like flavonoids, alkaloids, terpenoids, and saponins. These compounds inhibit viral replication, modulate immune responses, and target critical immunotargets, including viral proteins and cytokine production. For example, quercetin suppresses viral replication, while berberine reduces pro-inflammatory cytokines, potentially reducing dengue complications. Terpenoids, with their anti-inflammatory properties, can mitigate excessive immune activation. Saponins may enhance antiviral defenses, lowering viral load and disease severity. Conclusion: Phytomedicines offer significant potential as adjunct therapies for dengue, with antiviral and immune-modulating properties. However, challenges related to standardization, quality control, and variability in active compound concentrations must be addressed to ensure their clinical application. Integrating phytomedicines with conventional therapies may provide effective and sustainable strategies for managing dengue globally.
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Dengue Fever: Strategies for responding to the global health emergency
Saúde mental dos acadêmicos de medicina do ciclo básico da Universidade Regional de Blumenau
The Medicine course at the Regional University of Blumenau underwent changes to its curriculum in mid-2019, modifying some subjects and adding Basic-Clinical Integration. Therefore, the current curriculum uses a combination of Traditional and Active Methodology, something new for academics, who are often only accustomed to the classical teaching method. This fact, linked to the pandemic experienced globally, can be considered a stressor for medical students. Thus, the research aimed to seek knowledge of the rates of stress, depression and anxiety in students in the basic cycle, between the first and fourth phase. This is a cross-sectional study in which the Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was applied to analyze the effects on students due to the change in the curriculum. Data demonstrated that the search for psychological support was not prevalent during the period, while the practice of physical activity was present in the routine of more than 70% of students. Furthermore, the amount of extra daily hours allocated to studies was in the range of 2 to 4 hours. The combination of these factors may have been responsible for the variable indices being unchanged in the majority of the students covered, as demonstrated by the DASS-21 result. Therefore, it is inferred that the curricular change and the pandemic did not significantly affect the mental health of medical students in the basic cycle in the second semester of 2021.
Analysis of the quality of puericulture in children aged up to one year in Basic Health Unit in Cascavel - PR
This study aims to analyze the quality of childcare provided to children up to one year of age who attend a Basic Health Unit in the city of Cascavel-PR, with the goal of ensuring good physical and mental development of the child until puberty (ten to fourteen years old), with multidisciplinary monitoring, and to determine whether this procedure is performed appropriately in accordance with the recommendations of the Ministry of Health. Childcare continues and will continue for a long time to be the basis of medical practice in pediatrics, as it generates a sense of support and satisfaction for parents, in addition to monitoring and promoting the healthy development of the child and preventing or mitigating future complications that these babies may have. To this end, it is essential to have a childcare program that is effectively implemented in a network with all health professionals. In this way, childcare can be considered an excellent method of preventive care, being one of the pillars of primary care in childcare.
Microbial profile of cancer patients with febrile neutropenia in the southern Brazilian region
Febrile neutropenia (NF) is a frequent and unfavourable situation that occurs after chemotherapy treatment. Therefore, it is considered an oncological emergency. The risk of developing infections in patients is very high due to compromised immune systems. Given this situation, the objective of this work was to evaluate the aetiology of bacterial infections among cancer patients with febrile neutropenia, in addition to establishing the antimicrobial resistance profile of the isolated bacteria. The blood count and blood and/or urinary culture results of 73 patients treated at an oncology centre from October 2020 to October 2022 were analysed. Thus, 29 bacteria were identified. The most common were Escherichia coli (31.0%), coagulase-negative Staphylococcus (31.0%), Enterococcus spp. (13.8%) and Klebsiella pneumoniae (10.3%). Antimicrobial susceptibility testing revealed that Escherichia coli strains had the highest resistance profile. There was also the occurrence of a strain of extended spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL). The treatment of cancer patients with neutropenia is a challenge. This justifies the urgency of characterizing the microbial profile in care centres for such patients to guide preventive strategies and management.
Detection of Dengue virus infection among febrile patients presumptively diagnosed with malaria in Ogun State, Nigeria
Background: In Nigeria, where malaria is endemic, greater than 70% of febrile illnesses are treated presumptively as malaria, often without a laboratory evaluation for other possible causes of fever. Dengue virus infection presents a significant health challenge in tropical regions, often exhibiting clinical symptoms similar to malaria. In Ogun State, Nigeria, febrile patients are frequently presumed to have malaria, potentially overlooking concurrent or alternative infections like dengue. Accurate diagnosis is crucial for appropriate treatment and management. The aim of this study was to determine the prevalence of dengue virus antibodies and antigen among febrile patients attending a state hospital in Ogun State. Methodology: Blood samples from 120 consenting febrile patients suspected of malaria in Ogun state were evaluated for the presence of malaria parasites by microscopic examination of Giemsa-stained blood smears and also tested for the presence of anti-dengue immunoglobulin M (IgM) and immunoglobulin G (IgG), as well as anti-non-structural protein (NS1) using lateral flow chromatographic immunoassay in line with manufacturer’s instructions. The study lasted for three months (January- March, 2024). Data analysis was done using the Statistical Package for the Social Sciences (SPSS). A p value <0.05 was considered statistically significant. Results: The percentage occurrence of Dengue IgG Ab only, NS1 Ag, IgM Ab + NS1 Ag and IgM Ab + IgG Ab + NS1 Ag combined were: 4.2%, 0.8%, 3.3% and 6.7%, respectively. In all, 50% tested positive to malaria. A statistically significant association (p=0.026) was found between gender and preventive practice. Females exhibited higher proportions of good preventive practice 45.0% compared to males (20.8%). A significant association (p=0.014) was observed between age range and Dengue NS1 antigen status. Conclusion: These findings imply dengue fever should feature as a prominent differential diagnosis for febrile illnesses and screening for dengue virus should be part of routine tests amongst patients that presents with febrile illness. Given the prevalence of dengue virus infections, there is also a need for a dengue control programme and public education to prevent outbreaks and occurrence of severe dengue complications.
Epidemiological profile of Dengue fever between 2018 and 2024 in the State of Paraná, Brazil
Dengue is a viral infection transmitted to humans through mosquitoes infected with the Dengue Flavivirus, most of the Aedes aegypti species. This study aimed to describe the prevalence of Dengue in the State of Paraná, from 2018 to 2024. The results showed that the total number of suspected cases reported between 2018 and 2024 in the State of Paraná was 1,093,566. The highest number of suspected cases was in 2024 (n= 380,697), although only the first four months of this year were recorded. The cases were more predominant in female individuals (55.08%), aged between 20 and 39 years old (34.12%), and white (67.64%). Moreover, 80.44% had a confirmed diagnosis of the disease, 3.16% of cases required hospitalization, and 1,147 individuals died. The most prevalent serotype was DENV-1 (65.4%). Dengue control faces challenges: vector resistance to insecticides, the need for community engagement and climate change, influencing vector distribution and disease transmission. The development of vaccines and improvement of epidemiological surveillance systems are crucial to face the challenges of the disease. The control of the disease depends on new technologies, implementation of health and education strategies and community engagement to ensure the adoption and maintenance of Dengue control and prevention measures.
Dengue and Acute Acalculous Cholecystitis
Acute acalculous cholecystitis is an inflammatory condition of the gallbladder without evidence of gallstones, and usually appears about two weeks after a serious clinical condition, such as major surgery, severe trauma, large body burns, end-stage renal disease, leukemia, and infections. This clinical experience report discusses this pathology in the medical training, mainly as a sudden and atypical evolution of Dengue. The experience reports on an elderly patient, who only had diffuse myalgia as a previous symptom, quickly evolving into choluria, vomiting, paleness, and abdominal pain. In light with the literature, conservative treatment was chosen, which resulted in rapid clinical improvement. This experience report contributes to the bibliography of an atypical complication of Dengue, highlighting the effectiveness of conservative treatment in this case and enhances the literature regarding medical training.