Universidade São Francisco

Cystic fibrosis (CF) is an autosomal recessive disease that alters ionic transport in the body's secretions, including those of the lung mucosa, and is the most common hereditary respiratory disease in the Western world. One of the causes of morbidity and decreased quality of life in patients with CF is osteoporosis, which is currently assessed by bone densitometry. bi-centric, cross-sectional, retrospective study, reviewing data contained in the medical records of patients with cystic fibrosis participants who were treated at 2 CF reference centers, and reanalysis of chest tomography scans performed annually during checkup, in comparison with their bone densitometry measurements from the same period. A total of 73 CF patients were evaluated. Patients with DXA-defined osteoporosis showed significantly lower HU values. Using 215HU as the cutoff, we obtained 83% sensitivity and 68% specificity for osteoporosis. Area under the ROC curve was 0.86 using analyses of T10 to T12 vertebrae. Chest computed tomography may serve as an opportunistic screening for identifying patients with cystic fibrosis at increased risk of low bone mineral density, particularly when CT examinations are already being performed for other clinical reasons.

Uncertainties persist regarding the allocation of apical lymph nodes in colorectal cancer, the approaches to lymph node dissection and mesocolic excision, which may contribute to inconsistent surgical practices. The aim of this study is to assess surgeons' practices in lymph node dissection and mesocolic excision approaches and to identify areas lacking standardization. A multinational pilot survey of 22 colorectal surgeons from 6 countries was conducted during the FICARE colorectal meeting. The survey consisted of 21 Likert-scale questions on surgical practices and lymph node allocation in colorectal cancer surgery. Majority of the respondents (90.9%) recognized conceptual differences in apical lymph node stratification between right- and left-sided colon cancers, whereas D3 LND for left-sided cancer should include mesocolic tissue along the inferior mesenteric artery from its origin to the last sigmoid artery. Complete lymph node dissection requires excision of mesocolic tissue along inferior mesenteric artery for left colon cancer and superior mesenteric artery for right colon cancer according to 81.8% of respondents. At the same time, 95.5% agreed that intermediate and paracolic lymph nodes are located within a 10-cm resection margin proximally and distally from tumor, while 81.9% of respondents supported the concept of tumor-specific mesocolic excision to be sufficient enough for adequate paracolic and intermediate lymph node dissection. A multinational snapshot showed an existing contraindication in surgeons' perception of lymph node stratification and the variability in mesocolic excision and LND. Further Delphi consensus is needed to prove the suggested concepts.

O uso dependente de álcool na velhice constitui um fenômeno multifacetado e crescente no Brasil, com implicações relevantes para a saúde pública. Associado a fatores biológicos, sociais e emocionais, esse quadro frequentemente se apresenta de maneira silenciosa e negligenciada nos serviços de saúde. Diante desse contexto, o presente estudo de revisão tem como objetivo compreender, na literatura científica nacional, as características da experiência emocional vivida por pessoas idosas em uso dependente de álcool. Para isso, foi realizada uma busca no Portal de Periódicos da CAPES, utilizando os descritores: “Idosos” e (“Abuso de Álcool” OU “Alcoolismo” OU “Álcool” OU “Droga”), considerando produções publicadas entre 2013 e 2023. Após a aplicação dos critérios de inclusão e exclusão, cinco estudos compuseram o corpus final da revisão. As análises dos textos selecionados permitiram a construção de quatro eixos temáticos que descrevem aspectos centrais da experiência emocional de idosos com dependência alcoólica: “Vivendo com a Solidão”, “Desafios no Núcleo Familiar”, “Convivência Social” e “Doenças Físicas”. Os achados revelam que a solidão é uma vivência recorrente e estruturante na trajetória desses sujeitos, atuando como fator de risco para o consumo e como consequência do isolamento afetivo e social. Espera-se que este estudo contribua para o aprimoramento das políticas públicas e para a criação de estratégias psicossociais mais sensíveis às dimensões emocionais e relacionais da velhice marcada pela dependência do álcool.

This article presents reflections stemming from a master's research in Education, developed in dialogue with teachers and school administrators from the São Paulo state public education system who work in the Bragantina region of São Paulo. The aim of this study is to analyze the context of control over teaching work and the loss of teacher autonomy in light of the advancement of corporate management practices in public schools, within the broader scenario of the platformization of education—intensified during the administration of Governor Tarcísio de Freitas and his Secretary of Education, Renato Feder. The research adopts as its theoretical and methodological framework the principles of Popular Education, grounded in the legacy of Paulo Freire and in Latin American participatory research. The methodological procedures consisted of analyzing documents from the São Paulo state education network and conducting interviews with teachers and administrators from the São Paulo state public school system. The results obtained through the analysis of these interviews reaffirm the understanding that digital platforms are not neutral tools; on the contrary, they serve as strategies to legitimize the capitalist mode of production and to subordinate education to corporate and neoliberal interests. This process leads to the precarization of teaching work, the loss of professional autonomy, and also contributes to distress and illness among teachers. The study concludes that the platformization of education constitutes a fertile ground for the strengthening of surveillance capitalism, intensifying managerial control processes over both teaching staff and school leadership teams, while simultaneously hindering the realization of democratic management in public schools.

Background: The aim of this study was to investigate the direct and indirect predictive effects of metalinguistic skills (metatextual, morphological, and phonological awareness) for reading comprehension, adding intelligence to prediction models (verbal/numerical reasoning), school year and age. Method: Participants were 222 Brazilian students from public schools (Elementary School). The instruments were applied in person in pencil and paper format. Results: The results indicated that reading comprehension was predicted directly by the three metalinguistic skills and indirectly by the metatextual (mediated by verbal reasoning) and phonological (mediated by numerical reasoning) awareness. Findings also showed the direct predictive contribution of most metalinguistic skills and school year to only one of the reading comprehension measures (Cloze 1). Conclusions: Further studies are suggested to deepen the investigation of the predictive relationships existing between metalinguistic skills, reading comprehension, intelligence, and aspects inherent to formal instruction and maturation in basic education.

The magnitude of violence against women in Brazil National data consistently demonstrate the scale and severity of violence against women in Brazil. Reports from the Brazilian Public Security Forum indicate that sexual violence has reached historically high levels. According to the Brazilian Yearbook of Public Security 2024, 74,930 cases of rape were officially recorded in […]

IntroductionEnhanced recovery after surgery (ERAS) programs have transformed perioperative care. However, adherence to all ERAS components can be challenging, and the contribution of individual components remains uncertain. This study evaluates ERAS compliance and compares its predictive accuracy with four simplified protocols: a) remove, ambulate, postoperative analgesia, introduce diet (RAPID), b) Basse, c) Nygren, and d) Aarts in colorectal cancer surgery. MethodsA retrospective cohort study was conducted at Vila Santa Catarina Hospital (São Paulo, Brazil) and included patients undergoing elective colorectal resection for adenocarcinoma (2015-2022). ERAS compliance was measured by adherence to 22 components and compared with four simplified protocols (elements four to 12). Outcomes analyzed included stoma-free status, avoidance of readmission, absence of overall and severe complications, and mortality. Predictive accuracy was assessed via area under the curve (AUC) from receiver operating characteristic (ROC) curves (p<0.05). ResultsThe study included 410 patients (mean age: 62.3 ±11.5 years; 53.4% female). Laparoscopic surgery was predominant (90%), followed by robotic (6.3%) and open (3.7%) approaches. Mean ERAS compliance was 76.9% (±9%). Postoperative outcomes were 66.3% stoma-free, 92.7% avoided readmission, 68.5% had no complications, 85.9% had no severe complications, and 98.1% survived. ERAS had the highest predictive value for severe complications (AUC: 0.69), similar to Nygren (0.68). Nygren outperformed ERAS for stoma-free (0.7 vs. 0.66) and complications (0.63 vs. 0.62). ERAS had low accuracy for readmission avoidance (AUC: 0.51), with RAPID and Basse performing better. No protocol showed significant superiority in predicting mortality (p>0.05). ConclusionsSimplified protocols, especially Nygren and RAPID, showed competitive or superior predictive performance for certain outcomes. While ERAS remains a strong standard, simplified versions appear promising.

Frantz tumor, or solid pseudopapillary neoplasm (SPN), is a rare pancreatic tumor of low malignant potential that predominantly affects young women. Its clinical presentation is often nonspecific, and the differential diagnosis from other cystic pancreatic lesions, such as pseudocysts, represents a significant challenge. We report the case of a 31-year-old previously healthy woman who presented with abdominal pain, initially diagnosed and treated as an infected pancreatic pseudocyst. Following the initial surgical intervention and antibiotic therapy, the persistence of imaging findings and subsequent histopathological results led to the definitive diagnosis of a Frantz tumor. The patient subsequently underwent a curative-intent pancreatoduodenectomy. This case highlights the difficulty in distinguishing cystic pancreatic lesions. The patient’s initial presentation, with a large fluid collection, gas foci, and elevated inflammatory markers, strongly suggested an infectious process, such as a complicated pseudocyst. Only histopathological examination of the surgical specimen enabled the correct diagnosis of the underlying neoplasm. SPN may show cystic and hemorrhagic degeneration, mimicking other lesions. Frantz tumor should be considered in the differential diagnosis of cystic pancreatic lesions in young women, even when the initial presentation suggests an inflammatory or infectious process. Histopathological confirmation is essential for proper management, which consists of complete surgical resection and is associated with an excellent prognosis.