Hospital de Messejana

O Transtorno do Espectro Autista (TEA) é caracterizado por dificuldades nas interações sociais, comunicação, interesses restritos e comportamentos repetitivos, frequentemente acompanhados de déficits sensoriais e preferências por rotina. Além das limitações comportamentais, muitas crianças apresentam desafios motores, que nem sempre são diagnosticados ou tratados adequadamente. Nesse contexto, a psicomotricidade surge como abordagem integrativa, considerando a relação entre movimento, afetividade e comunicação, e o uso de atividades lúdicas como estratégia para estimular habilidades motoras, cognitivas, sensoriais e socioemocionais. O presente estudo teve como objetivo relatar as experiências e as atividades observadas durante o projeto de extensão realizado pelos alunos do curso de Fisioterapia e Psicologia. A metodologia consistiu em um relato de experiência das intervenções realizadas entre setembro de 2024 e maio de 2025, pelo Grupo de Extensão Crescendo em Movimento (GECMO), envolvendo crianças com TEA atendidas por acadêmicos dos cursos de Fisioterapia e Psicologia do Centro Universitário Católica de Quixadá (UniCatólica) incluindo circuitos psicomotores, jogos e brincadeiras, atividades motoras, contação de histórias, criação de recursos, jogos eletrônicos (Kinect) e exercícios em piscina terapêutica.

Heart transplantation remains the main treatment for end-stage heart failure. The opioid crisis has increased donor availability, including organs from intoxicated individuals, but the impact on outcomes is uncertain. Following PRISMA 2020, we searched MEDLINE, Embase, and Web of Science for studies on adult heart transplant recipients with donors exposed to substances like cocaine, heroin, marijuana, tobacco, or opioids. Eligible studies met PICOS criteria, and meta-analyses used a random-effects model. Twelve retrospective cohorts were included, totaling 189935 recipients, 33393 of whom received organs from intoxicated donors. The most reported substances were cocaine, alcohol, and tobacco. No significant differences were found in 5-year survival (HR=1.05; CI=0.94-1.17), 10-year survival (HR=0.94; CI=0.88-1.00), or survival with overdose-related donors (HR=0.96; CI=0.84-1.09). Rates of allograft rejection (HR=0.99; CI=0.21-0.88) and cardiac allograft vasculopathy (HR=1.02; CI=0.95-1.11) were also similar. Subgroup and sensitivity analyses confirmed result consistency. Organs from intoxicated donors do not compromise long-term outcomes and may help address donor shortages.

Tumor grading has been a traditional component of pathologic evaluation and offers guidance to therapy and patient management in many organs. However, there is no consensus on a grading system for invasive squamous cell carcinoma of the lung (SCC), while a few groups have proposed distinct grading systems using their own cohorts. Thus, we sought to establish a globally acceptable grading system for SCC by using international cohorts.

Brugada syndrome (BS) is a genetic channelopathy characterized by an increased risk of sudden cardiac death (SCD) in the absence of structural heart disease. Prognostic stratification is necessary to determine which patients are candidates for implantable cardioverter defibrillator (ICD). The present study aims to evaluate EKG changes during exercise stress tests in patients with BS and to identify any poor prognosis variables. This was an observational, case-control study. Three comparison groups were created: patients with Type 1 BS with or without prior arrhythmic events (BE and BNoE subgroups) and age- and sex-matched healthy individuals. Patients underwent EST and electrocardiographic variables were analyzed. The study recruited 36 patients with type 1 BS, 12 with prior Event (BE) and 24 without (BNoE). Patients in the BE group, in all postexercise recordings, had lower heart rates, notably in the first minute. A significant difference was also observed in the HR drop in the recovery phase, with a greater drop in relation to maximum HR in the first minute in the group of patients who had events. BS patients with prior events had a lower capacity to increase heart rate at peak effort and a greater proportional drop in the recovery phase. No relationship was observed between the occurrence of arrhythmic events and ST-segment elevation during the exercise test.

ResumoFundamento:O Brasil é um país com diferentes biomas e desigualdades sociais. Existem poucos dados disponíveis sobre as diferenças regionais e o prognóstico da insuficiência cardíaca (IC) no país.Objetivo:O estudo Rosa dos Ventos tem como objetivo investigar as diferenças regionais e o prognóstico atual de pacientes com IC com fração de ejeção reduzida ou moderadamente reduzida no Brasil.Métodos:Este é um estudo prospectivo, multicêntrico, observacional, do tipo coorte que incluirá pacientes ambulatoriais com idade superior a 18 anos com IC e fração de ejeção < 50% em 30 centros privados distribuídos nas regiões brasileiras. Um total de 2500 pacientes serão incluídos entre junho de 2021 e outubro de 2023, com um período de 12 meses de seguimento. Coletaremos dados sobre status clínico e socioeconômico, prescrição médica e resultados de exames cardiológicos. Serão realizados telefonemas para o seguimento dos pacientes seis e 12 meses após a inclusão para coleta de informações sobre visitas ao departamento de emergência, internações e mortalidade.Conclusão:O estudo Rosa dos Ventos permitirá uma caracterização mais precisa da IC crônica no Brasil. Essa iniciativa proverá informações relevantes para o desenvolvimento de estratégias de manejo efetivas para mitigar o impacto dessa condição sobre os pacientes e o sistema de saúde.

O transplante cardíaco é um tratamento contínuo que visa proporcionar uma melhor qualidade de vida ao usuário. Esta pesquisa tem como objetivo identificar estratégias de proteção social destinadas à criança e ao adolescente pacientes de transplante cardíaco. Trata-se de um estudo de caso, tendo como sujeito um adolescente de 15 anos, advindo de uma comunidade quilombola localizada no estado do Espírito Santo. Esta pesquisa adotou análise qualitativa como formato metodológico, por meio de um estudo exploratório, descritivo e de campo. A coleta de dados deu-se por meio de entrevista, além de ter um referencial teórico baseado nas análises de Melo et al. (2020), Azeka et al. (2014), Minayo (1994), Neto (1994), Pinto Jr. (2018), Setúbal (2013) e análise documental. O estudo proporcionou uma reflexão acerca do tema, apresentando relevância social para a comunidade científica, ampliando as possibilidades de pesquisas ulteriores sobre a temática em questão.

Stroke is a medical emergency characterized by the sudden onset of neurological deficits, classified as either ischemic, caused by obstruction of blood flow, or hemorrhagic, due to the rupture of a cerebral vessel. It remains one of the leading causes of death and disability worldwide, with early diagnosis being crucial for improving patient outcomes. This study presents an integrative review of advancements in stroke care, emphasizing the importance of prompt treatment to reduce complications and enhance functional independence. The review analyzed 14 relevant studies from the last five years, sourced from databases like PubMed and Google Scholar. Key findings highlight the significance of rapid hospital arrival, early use of MRI to predict cognitive impairments, and clear communication regarding prognosis. The study also identified barriers in patient care flow, indicating a need for Continuing Education and improved coordination within the Emergency Care Network. Effective integration among healthcare professionals is essential to optimize care quality and rehabilitation outcomes for stroke patients.

Abstract Background Orthotopic heart transplantation (OHT) has become the standard of care for children with end-stage heart failure refractory to medical or conventional surgical therapy. Despite the improvement in perioperative survival in the last decades, the long-term complications and mortality remain significant. This report examines the experience of a single center in Brazil with pediatric OHT, focusing on long-term results and mortality. Methods This is a retrospective study from January 2002 to December 2022. Data collection consisted of demographic data, indication, immunosuppression, main complications and mortality. Results There were 77 OHT in 74 patients. The median age at the time of OHT was 11.5 years (IQR 0.25–22 years). The indications for OHT were congenital heart disease in 36 (46.8%), cardiomyopathy in 35 (45.5%), and re-transplantation in 3 patients (primary diagnosis: 2 cardiomyopathy − 3.9%). There was an average of 2.2 rejection episodes/patient and 1.3 infection episodes/patient during the first year of follow-up. The most common complications were: acute kidney injury (51%), systemic hypertension (41.9%), anemia (24.3%) and type 2 diabetes (10.4%). Overall survival after 1 year of OHT was 89.6% while 5- and 10-year survival, were 80% and 59%, respectively. Despite late complications, such as infection and acute rejection, all survivors report a significant improvement in functional status. Conclusion Heart transplant is an acceptable therapeutic option for children and young adults in middle-upper resourced countries, with outcomes and long term follow up close to those higher resourced countries.