Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Background: The systemic immunoinflammatory index (SII) is a novel prognostic biomarker used in certain studies to analyze the prognosis of certain types of cancers and heart diseases. Its main characteristic is being a rapid, inexpensive, and simple biomarker to use. It is based on the counts of lymphocytes (L), neutrophils (N), and platelets (P). The value of SII in patients diagnosed with Acute Coronary Syndrome (ACS) - ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA) - is not well established and could contribute to the risk stratification of these individuals. Objectives: This study aimed to analyze the value of SII in patients diagnosed with STEMI and compare it with those of patients with NSTEMI and UA. Methods: Information was collected through electronic medical record analysis and laboratory tests of patients diagnosed with Acute Coronary Syndrome (ACS) between July 2022 and July 2023. Results: Our sample included 333 patients, of whom 163 (48.9%) were diagnosed with STEMI, 139 (41.7%) with NSTEMI, and 31 (9.3%) with U. The STEMI group exhibited higher SII values compared to the NSTEMI and UA groups (1735 × 10³ vs. 1167 × 10³ vs. 1069 × 10³, p < 0.001). Conclusions: Our study demonstrated that patients with STEMI exhibit higher SII values, suggesting greater inflammation and severity, compared to patients diagnosed with NSTEMI/UA. Keywords: Inflammation; Acute Coronary Syndrome; Coronary Artery Disease.   Introdução: O systemic immunoinflammatory index (SII), ou índice imunoinflamatório sistêmico, é um novo biomarcador utilizado para analisar o prognóstico de alguns tipos de cânceres e doenças cardíacas. Sua principal característica é ser um biomarcador rápido, barato e simples de ser utilizado. Baseia-se na contagem de linfócitos (L), neutrófilos (N) e plaquetas (P). O valor do SII nos pacientes com diagnóstico de Síndrome Coronária Aguda (SCA) - infarto agudo do miocárdio agudo do miocárdio com supra ST (IAMCSST), infarto agudo do miocárdio sem supra de ST (IAMSSST) e angina instável (AI) – não está bem estabelecido e poderia contribuir na estratificação de risco na SCA. Objetivos: Analisar e comparar o valor do SII em pacientes com diagnóstico de SCA (IAMCSST, IAMSSST e AI). Métodos: As informações foram colhidas através de análise de prontuário eletrônico e exames laboratoriais dos pacientes com diagnóstico de SCA entre julho de 2022 e julho de 2023. Resultados: Nossa amostra incluiu 333 pacientes, dos quais 163 (48,9%) foram diagnosticados com IAMCSST, 139 (41,7%) com IAMSSST e 31 (9,3%) com AI. Na amostra geral, a média do SII foi de 1436 x 10³ e mediana de 973 x 10³. A comparação entre os grupos de diagnósticos de SCA, revelou que os pacientes com IAMCSST apresentaram um SII significativamente maior (IAMCSST: 1735 x 10³, IAMSSST:1167 x 10³ e AI: 1069 x 10³, p<0,001). Conclusões: Nosso estudo demonstrou que pacientes com IAMCSST exibem maiores valores de SII, sugerindo maior inflamação e gravidade, em comparação aos pacientes diagnosticados com IAMSSST/AI. Palavras-chave: Inflamação; Síndrome Coronariana Aguda; Doença da Artéria Coronariana.

Introducción: Debido al creciente volumen y complejidad de la información en el ámbito de la salud, el desarrollo de herramientas metodológicas que puedan ayudar a los especialistas a hacer el mejor uso de la evidencia científica se ha vuelto cada vez más relevante. Una de estas herramientas es la revisión sistemática. Este tipo de estudio ha sido considerado una de las mejores herramientas en la Práctica Basada en la Evidencia (PBE), que, a su vez, se centra en la calidad de la información y la evidencia. Aunque es un instrumento fundamental de la PBE, existen muchas lagunas e incertidumbres respecto a la definición de una revisión sistemática, sus principales tipos y su relevancia para la práctica clínica. Objetivo: Presentar los principales conceptos y características de una revisión sistemática, así como clasificar sus diferentes tipos y discutir su aplicación en la práctica clínica. Metodología: Se trata de una revisión narrativa de carácter exploratorio-descriptivo y enfoque cualitativo, que buscó sintetizar la información principal relacionada con las revisiones sistemáticas, apoyándose en documentos guía como el Manual Cochrane y PRISMA, las directrices metodológicas del Ministerio de Salud de Brasil y artículos de SciELO, Medline/Pubmed, Lilacs y Redalyc. Resultados: La revisión sistemática demostró ser una herramienta metodológica esencial, ya que busca integrar el conocimiento de investigaciones similares sobre un tema específico y permite la aplicabilidad de sus resultados en la práctica clínica. Conclusión: La revisión sistemática contribuye significativamente a la práctica de profesionales e investigadores, además de ayudar en la formulación de políticas públicas de salud, al permitir un análisis profundo y de alta calidad de la evidencia disponible. Palabras clave: Revisión; Evidencia científica; Información en salud; Práctica clínica; Herramienta metodológica.

Objective: This study aimed to analyze the effects of microablative fractional radiofrequency (MFRF) on vaginal epithelial morphometry in postmenopausal women with genitourinary syndrome. Method: A prospective clinical study included postmenopausal women who attended five visits to the Climacteric  Clinic of Santa Casa de São Paulo from September 2019 to April 2023. During the visits, biopsies, and MFRF applications were conducted. Histological and morphometric variations between baseline (T0) and after three MFRF applications (T3) were analyzed using a light microscope and Wilcoxon’s test for statistical analysis. Results: Most patients showed a reduction in the menopausal index. Sexual problems and vaginal dryness were the symptoms that most participants showed improvement in. The average vaginal epithelial thickness increased significantly from 0.075 mm at T0 to 0.228 mm at T3 after 90 days of treatment (p < 0.05). Thirteen women showed an average increase of 304% in vaginal epithelial thickness, while three women exhibited a decrease of 32% from T0 to T3. Conclusion: MFRF applications in postmenopausal women resulted in a significant improvement in the clinical aspects of Genitourinary Syndrome and an increase in the thickness of the vaginal epithelium.

Introduction: Non-ketotic hyperglycemia is a rare cause of hemiballismus-hemichorea, with some cases noted in literature as the first manifestation of Type 2 Diabetes Mellitus (DM2). Case Report: A 77-year-old male with a history of hypertension and hypothyroidism was admitted to the hospital due to acute involuntary hyperkinetic movements in the neck and left upper limb, along with symptoms of polydipsia and urinary frequency. Upon admission, he was diagnosed with DM2, evidenced by high capillary blood glucose levels and a glycated hemoglobin of 14.7%. Initial examinations, including head tomography and arterial blood gas analysis, were normal. After eight days of hospitalization and effective glycemic control through insulin therapy, the hemiballismus-hemichorea condition completely regressed. Discussion: Neurological conditions and movement disorders are not typical initial indicators of DM2. Ballismus is defined as a rare hyperkinetic movement disorder involving involuntary, violent, and high-amplitude movements, primarily affecting proximal and axial appendicular muscles. Hemiballismus is linked to lesions or functional inactivation of the subthalamic nucleus, which reduces neuronal activity in the globus pallidus. In cases of non-ketotic hyperglycemia, a shift to anaerobic metabolism may lead to decreased GABA levels, thereby increasing dopaminergic activity. Conclusion: This report underscores the significance of early recognition of involuntary movement disorders as potential initial manifestations of DM2, which can enhance recovery through proper glycemic management.

Cecal volvulus is a rare cause of intestinal obstruction, resulting from torsion of the cecum, terminal ileum, and, occasionally, the ascending colon. Its nonspecific clinical presentation makes early diagnosis challenging, and in the absence of timely intervention, it may progress to ischemia, necrosis, and intestinal perforation. This report aims to describe a case of type III cecal volvulus in a patient without comorbidities or relevant medical history, discussing the clinical findings, diagnostic workup, therapeutic management, and outcome in light of current literature. A 31-year-old male patient with no known comorbidities presented with progressive abdominal pain, distension, nausea, and absence of bowel movements. Abdominal computed tomography revealed dilated bowel loops without a clearly defined obstructive cause, and laboratory tests showed elevated serum creatinine levels. Due to failure of conservative management, an exploratory laparotomy was performed, which revealed a type III cecal volvulus. A right hemicolectomy with ileotransverse anastomosis was carried out. The patient had a favorable postoperative course, with recovery of renal function and complete resolution of clinical symptoms. Although rare, cecal volvulus should be considered among the differential diagnoses in cases of acute obstructive abdomen. Early recognition and appropriate surgical intervention, such as right hemicolectomy, are essential to prevent severe complications and reduce the risk of recurrence.

Hormone therapy during climateric period remains the most effective treatment for peri- and postmenopausal symptoms, depending on the hypoestrogenism resulting from the gradual and progressive decrease in sex steroid production by the gonads. For women who are not candidates for hormone therapy due to contraindications or personal preference, it is important that healthcare professionals are well-informed about non-hormonal treatment options. In this analysis, we will focus on non-hormonal indications for the treatment of vasomotor symptoms or hot flashes, the most common complaint during this period.

En este artículo haremos un análisis de los paratextos legales y literarios que anteceden al Arte de Navegar (1673) de Lázaro de Flores Navarro, el primer libro científico escrito en Cuba. A través de nuestro estudio llevaremos a cabo un análisis atendiendo a las convenciones literarias de dichos textos y acudiremos a los archivos históricos de la época con la intención de sacar a la luz la identidad de los autores de los paratextos literarios que estuvieron relacionados con Lázaro de Flores, responder algunas de las interrogantes referentes a la vida de su autor y vislumbrar el entorno cultural de este médico radicado en la Cuba del siglo XVII. In this article we will do an analysis of the legal and literary paratexts that precede Lázaro de Flores Navarro’s Arte de Navegar (1673), the first scientific book written in Cuba. In our study we will perform an analysis paying attention to the literary conventions of said texts and review historical documents of the time in order to shed light on the identity of the authors behind these literary paratexts, their relationship to Lázaro de Flores, answer a few questions regarding the author’s life and understand the cultural milieu of this doctor who lived in  XVII century Cuba.

Introdução: O acompanhamento pré-natal com no mínimo 6 consultas é essencial para uma gravidez saudável com desfechos favoráveis e recomendado pelo Ministério da Saúde. No entanto, estudos mostram que a escolaridade materna influencia a qualidade do pré-natal e os desfechos maternos e perinatais, sugerindo que mulheres com maior nível de escolaridade tendem a aderir melhor ao cuidado pré-natal e podem ter melhores resultados de saúde. Objetivos: Investigar como o nível de escolaridade materna afeta o pré-natal e como isso se relaciona com os desfechos maternos e perinatais. Materiais e Métodos: O estudo é caracterizado como epidemiológico do tipo observacional, analítico, longitudinal do tipo caso-controle e retrospectivo. Foram analisados prontuários das puérperas de risco habitual do período de Janeiro a Março de 2022 que realizaram o parto na Maternidade do Complexo Hospital de Clínicas da UFPR (CHC-UFPR-EBSERH), categorizando escolaridade, quantidade de consultas do pré-natal e desfechos maternos e perinatais. Resultados: A maioria das puérperas possuía Ensino Médio completo ou superior e realizou ≥6 consultas do pré-natal. Houve uma associação significante entre escolaridade materna e realização de consultas. A escolaridade se relacionou positivamente com o uso de anestesia ou analgesia no parto, bem como com maior peso dos recém-nascidos ao nascimento. Quanto à quantidade de consultas do pré-natal, a proporção de recém-nascidos que nasceram com <37 semanas foi maior no grupo de puérperas que realizaram menos do que 6 consultas, bem como foi maior, para esse grupo, a admissão na Unidade de Terapia Intensiva Neonatal. Conclusão: Maiores níveis de escolaridade materna afetam diretamente a adesão ao pré-natal, o uso de analgesia ou anestesia no parto e o peso ao nascer. O baixo número de consultas está associado a desfechos perinatais desfavoráveis. Palavras chaves: Escolaridade Materna; Cuidado Pré-Natal; Analgesia Obstétrica; Prematuridade; Baixo Peso ao Nascer; Unidades de Terapia Intensiva Neonatal Abstract Introduction: Prenatal care with a minimum of 6 appointments is essential for a healthy pregnancy with favorable outcomes and is recommended by the Brazilian Department of Health. However, studies show that maternal education influences the quality of prenatal care and maternal and perinatal outcomes, suggesting that more educated women tend to adhere better to prenatal care and may have better health outcomes. Objectives: The aim of this study is to investigate how the level of maternal education affects prenatal care and how this relates to maternal and perinatal outcomes. Materials and Methods: The study is characterized as an observational, analytical, longitudinal case-control epidemiological and retrospective study. It entailed the examination of medical records of postpartum women of typical risk who delivered at the Maternity of the Federal University of Paraná's Hospital Complex (HC-UFPR-EBSERH) between January and March 2022. Variables such as education level, frequency of prenatal appointments, and maternal and perinatal outcomes were categorized for analysis. Results: The majority of postpartum women had completed high school or higher education and attended to ≥6 prenatal appointments. There was a significant association between maternal education and attendance to the appointments. Educational status was also positively correlated with the use of anesthesia or analgesia during childbirth, as well as with higher birth weight of newborns. Regarding the number of prenatal appointments, the proportion of newborns born with less than 37 weeks was higher in the group of postpartum women who attended less than 6 appointments, and admission to the Neonatal Intensive Care Unit was also higher for this group. Conclusion: Maternal educational status directly affects adhesion to prenatal care, use of analgesia or anesthesia during childbirth and birth weight. A low number of prenatal appointments is associated with unfavorable perinatal outcomes. Keywords: Maternal Educational Status; Prenatal Care; Obstetric Analgesia; Neonatal Prematurity; Low Birth Weight; Intensive Care Units, Neonatal    

Mais de 50% dos edifícios que compõem a área monumental de Arequipa, Peru, pertencem ao período republicano. Cerca de 500 edifícios, em sua maioria de arquitetura doméstica - razão pela qual recebem o nome genérico de “casonas” - possuem fachadas que podem ser catalogadas dentro dos estilos neoclássico, neorrenascentista, eclético, neogótico, art déco e art nouveau. Desses, 240 foram tombados como Patrimônio Cultural, o que deixa cerca de 50% dos edifícios desprotegidos e, portanto, expostos a maiores riscos de serem abandonados, deteriorados ou alterados com intervenções que afetem seu tecido original. Diante dessa realidade, a presente pesquisa busca interpretar os processos de evolução espacial, construtiva e estilística de edifícios significativos desse período, como uma contribuição para seu conhecimento e preservação. A pesquisa aplicou uma metodologia para classificar, selecionar, avaliar e analisar as principais características de três grandes casarões que atualmente abrigam as instituições Alianza Francesa de Arequipa, Centro de la Artes de la Universidad Católica San Pablo e Colegio de Arquitectos del Perú Regional Arequipa, todos eles exemplos significativos da arquitetura do período republicano que adaptaram seus espaços a novos usos. Estas mansões foram selecionadas com base na qualificação de uma amostra maior. A partir da análise realizada, foram obtidos resultados que mostram aspectos como o percentual de conservação do tecido original dos edifícios, que em todos os casos é superior a 50%, ou a proporção de espaço aberto, que em alguns casos foi reduzida até ocupar 20% do lote. Em termos de construção, a preservação das estruturas de cantaria de ignimbrito com paredes de caixa, telhados em abóbada de berço em dois dos casos estudados e coberturas planas com trilhos de ferro em um deles, sendo que os acréscimos estruturais com materiais contemporâneos representam até 30%. Com relação às qualidades estilísticas, foram identificadas as principais características compositivas que lhes atribuem valor estilístico, sendo a linguagem neoclássica a predominante.

Objective: To identify the incidence of cesarean sections on maternal request performed at a university hospital, the profile of these pregnant women, and the factors associated with their choice. Methods: This is a cross-sectional descriptive study based on the answers to a virtual questionnaire filled by 106 patients who underwent a cesarean section on maternal request between May 2020 and May 2021. The RStudio software (4.2.1) was used for the statistical analysis, calculating the mean and standard deviation for variables with a normal distribution and absolute numbers, as well as percentages for categorical variables. Results: The incidence of cesarean sections on request was 24.2% of all cesarean deliveries. 80.2% of these procedures were conducted on white women, with an average age of 30.6 years, 65% multiparous – that is, they have had two or more pregnancies -, 54.7% are married or in a civil union, 50% have completed high school, 81.1% are Christians, and 53.7% have a family income greater than two minimum wages. In addition, 77% of the participants were instructed about cesarean delivery, and 71% were instructed on vaginal delivery during prenatal care. Regarding the choice of delivery method, 46.2% of the women said they were afraid of vaginal delivery and 71.4% were aware of the law regarding cesarean sections on request in force in the state of Paraná, Brazil. Conclusion: In this study, the predominant patients’ profile was white, married and multiparous women, with an average age of 30 years. The fear of pain and vaginal delivery, along with negative experiences from people close to them, are associated with the maternal decision regarding the mode of delivery, highlighting the importance of prenatal care, multidisciplinary assessment, and the strengthening of public policies aimed at maternity and postpartum assistance.