Scientia Medica

Factors associated to mammography exam according to two criteria

2021-02-04T15:26:53-03:00

Aims: we aimed to compare the prevalence and factors associated to mammography exam according to two Brazilian criteria.
Methods: a cross-sectional, population-based study, with women between 40 and 74 years old from Rio Grande, RS, Brazil. The coverage of mammography was evaluated: 1) annual screening for women aged 40 to 74 years old; 2) biennial screening for women aged 50 to 69 years old. Data analyses were performed by Poisson regression.
Results: it was included 413 (criterion 1) and 246 (criterion 2) women. The mammography coverage by criterion 1 was 49.4% (95%CI 43.8 to 55.0), ranging from a quarter for those who did not visit a doctor in the last year to two thirds for those with higher education level. Considering the criterion 2, the coverage was 65.5% (CI95% 59.2 to 71.7), ranging from one-third among those who did not visit a doctor in the last year to three-quarters among obese women.
Conclusions: the mammography coverage differed according to the criterion considered. Higher socioeconomic status and having visiting a doctor in the last year were the most associated factors, regardless of the criterion.

Epidemiology of COVID-19 cases diagnosed at quarantine facilities in Paraguay

2021-02-18T10:26:13-03:00

Aims: This study aimed to describe the epidemiological characteristics of COVID-19 cases diagnosed in quarantine facilities in Paraguay.
Methods: This was a descriptive, cross-sectional, temporarily retrospective study. The time scope was from April 1 to September 30 2020. The variables were sex, age and administrative departments. The open access data available on the website of the Ministry of Public Health and Social Welfare was used. Frequencies expressed in percentages and the Chi square value were calculated to observe the statistically significant differences between cases and age and sex.
Results: from April 4 to September 30 2020, 1.581 cases were diagnosed in COVID-19. The fewest number of positive cases were reported in April (50) and the highest number was reported in May (628). From the total, 69.6% (1.101) were male, (male / female ratio 2.3), 42.1% (666) were aged between 20-29 years, the average age was 30.23 years (range 0 to 87, standard deviation 14.66. 95% CI 1.5 - 58.95). The departments with the highest number of cases were Caaguazú 21.7 % (343), Alto Paraná 17.3 % (274), Central 13.3% (210) and Asunción 11.4% (180). The least number of cases of COVID-10 in women were registered in the Departments of Amambay, Pdte. Hayes, Ñeembucú and Boquerón, and in men the Departments of Ñeembucú and Boquerón. The largest number of male cases were registered in Caaguazú 70.8% (243), Alto Paraná 66.1% (181), Central 69.5% (146) and Asunción 68.9% (124). The number of Covid-19 infected people in quarantine facilities presented statistically significant differences between the variables sex and age.
Conclusion: the quarantine facilities are one of the measures that the Paraguayan government needed to avoid the rapid spread and dispersion of the virus. The epidemiology of the cases diagnosed in them corresponds to what was expected according to the characteristics of the country.

Benefits of Physical exercise in pulmonary arterial hypertension associated with uncorrected congenital heart disease

2021-02-22T10:47:51-03:00

Introduction: congenital heart disease is classified as one of the main groups to develop pulmonary arterial hypertension. The exercise program can help to improve daily living, capacity, clinical and functional improvement, minimizing the deleterious consequences of the disease.
Case report: we report a case of a 31-year-old male patient with a clinical diagnosis of severe pulmonary arterial hypertension due to the right ventricular double outflow tract with interventricular communication without surgical intervention. After being referred to the Cardiopulmonary and Metabolic Rehabilitation program at a cardiology reference center in Rio Grande do Sul, clinical evaluation was performed, as well as functional capacity by the 6-minute walk test, muscle strength and peripheral resistance by the sitting-rising test, and respiratory muscle strength by the manovacuometry exam. The values were below the predicted value. The proposed exercise program was performed during 30 sessions consisting of aerobic exercises lasting 33 minutes, added strength training of large muscle groups.
Conclusion: after the program there was an increase of 83 meters in the 6-minute walk test and an increase in respiratory muscle strength, as well as a reduction in Borg scale parameters.

Covid-19, the anti-vaccine movement and immunization challenges in Brazil

2021-02-18T15:19:18-03:00

AIMS: The COVID-19 pandemic suddenly and significantly increased hospitalizations for pneumonia with systemic inflammatory disease. Since its appearance, COVID-19 has affected more than 200 countries, with more than 90 million cases and almost 2 million deaths. So far, there is no quality evidence regarding the specific pharmacological therapy for COVID-19; most treatments usually involve off-label use of existing drugs and have unproven efficacy. The global effort converges on the development of a vaccine; however, the greatest challenge is to achieve collective immunization in the face of increasing vaccination hesitancy.
METHODS: This study investigated the impact of vaccine hesitancy movements on the goal of COVID-19 immunization in Brazil. An integrative bibliographic review was performed with an electronic search on PubMed and SciELO that yielded 13.535 articles. Inclusion and exclusion criteria were applied which included 29 interventional and descriptive studies.
RESULTS: The results of the 29 studies revealed that the most frequent reasons for hesitation is skepticism about the true interests of the industry and politicians, the lack of trust in research, and inaccurate information on social media.
CONCLUSION: The main factors that lead the population not to believe in vaccines were the real interests of industry and politicians, lack of confidence in research, and the amount of false information that circulates massively on social media and because of that it is possible that Brazil will face some challenges in achieving collective immunity due to the anti-vaccine movement.

Syndemics framework as an approach to explain the interaction between public health problems

2021-02-25T11:58:11-03:00

The syndemics theory provides an innovative framework that allows to understand why some public health problems are geographically and temporarily concentrated?, and how these problems interact biologically and socially?, generating harmful effects on vulnerable groups. However, the empirical evidence that supports this theory is still scarce and the existing has certain limitations in the approach and measurement of key concepts. For this reason, this article aims to generate a discussion about some conceptual and methodological implications of the use of syndemics theory. The correct approach to syndemics theory allows directing future research on this topic and promotes its importance for the study of health problems in the Latin American context.