Neonatal isolated suppurative submandibular sialadenitis (NISSS) is rare, with only 21 cases described in the English literature. All cases, with the exception of one, were caused by Staphylococcus aureus. In this case report, we describe a preterm neonate with NISSS due to infection by S aureus and Klebsiella pneumonia presenting on day 11 of life with submandibular swelling and low-grade fever. Possible contributors for the development of the infection include prematurity, neutropenia, prolonged orogastric feed and bacterial virulence. Antibiotic treatment was effective. To the best of our knowledge, this is the first case report of NISSS caused by a mixed flora.

O ensino e a assistência são elementos centrais dos cursos de graduação da área da saúde. O desafio é articulá-los de forma a contribuir com o processo de formação do aluno enquanto futuro profissional, com o compromisso de desenvolver um trabalho de qualidade, resolutivo e humanizado, sobretudo nos serviços vinculados ao Sistema Único de Saúde (SUS). O estudo apresenta aspectos sobre a evolução do ensino em saúde no Brasil e, mais especificamente, da Terapia Ocupacional, e sua relação com uma unidade de reabilitação vinculada à Universidade do Estado do Pará (UEPA), denominada Unidade de Reabilitação de Fisioterapia e Terapia Ocupacional (UEAFTO). Para isso, realizou-se uma revisão narrativa, no período de fevereiro a maio de 2022, nas bases de dados Medical Literature Analysis and Retrieval System Online (MEDLINE), Biblioteca Virtual de Saúde (BVS), Scientific Electronic Library Online (SCIELO) e Google Acadêmico, bem como leitura e análise de referências bibliográficas da disciplina “O SUS como Escola” (componente curricular do Programa de Pós-graduação Ensino em Saúde na Amazônia - Mestrado Profissional, da UEPA). A UEAFTO tem enfrentado desafios no cotidiano de seu funcionamento quanto à articulação do ensino e assistência, em conformidade com as premissas do SUS e do perfil necessário para o futuro profissional desse sistema. A Unidade é um espaço de produção de conhecimento e de cuidado à saúde, em dinâmico processo de evolução, com potencial para contribuir ainda mais com a formação de profissionais capacitados para atuação no SUS.

Objective: To present a case of bilateral gynecomastia in a prepubertal boy with autism spectrum disorder, diagnosed with myotonic dystrophy type 1. Case description: A 12-year-old boy with autism spectrum disorder presented at a follow-up visit with bilateral breast growth. There was a family history of gynecomastia, cataracts at a young age, puberty delay, and myotonic dystrophy type 1. The physical examination showed that he had bilateral gynecomastia with external genitalia Tanner stage 1. Neurologic examination was regular, without demonstrable myotonia. The analytical study revealed increased estradiol levels and estradiol/testosterone ratio. After excluding endocrine diseases, the molecular study of the dystrophia myotonica protein kinase gene confirmed the diagnosis of myotonic dystrophy type 1. Comments: A diagnosis of prepubertal gynecomastia should include an investigation for possible underlying diseases. This case report highlights the importance of considering the diagnosis of myotonic dystrophy type 1 in the presence of endocrine and neurodevelopmental manifestations.

AIMS: The aims of this study were to characterize the etiological investigation of genetic cause in the autism spectrum disorder and to determine the factors related to its identification.METHODS: A retrospective descriptive study, with an analytical component, included children and adolescents with autism spectrum disorder followed in consultation at a level 2 hospital, between November 2017 and October 2019. The following variables were analyzed: age, sex, age at the first consultation, family history, objective examination, cognitive assessment, etiological investigation of genetic cause and etiological diagnosis of genetic cause. Statistical analysis was performed using the SPSS®v23 program (significance level 0.05).RESULTS: We identified 153 children with autism spectrum disorder, of which 48 underwent a genetic cause investigation: 45 performed microarray analysis (15.6% pathogenic); 42 carried out a molecular study of the Fragile X syndrome (one altered); two performed sequencing of the methyl CpG binding protein 2 (MECP2) gene (one altered). The diagnosis of genetic cause was made in 18.8% of the sample. The identification of the etiology of a genetic cause was related to global development delay/ intellectual disability (p = 0.04) and the presence of relevant family history (p = 0.005).CONCLUSIONS: The diagnostic yield of the genetic study was higher in patients with a global development delay /intellectual disability and in patients with relevant family history.

Durante a hospitalização, a criança é o principal alvo das repercussões desse processo; entretanto, além das reverberações e prejuízos que pode ocasionar à criança, a família e, principalmente, quem realiza o papel de acompanhante também são afetados diretamente. Trata-se de um relato de experiência profissional de caráter descritivo, qualitativo, com intuito de descrever as repercussões ocupacionais de acompanhantes de crianças em estado de hospitalização, além da atuação da Terapia Ocupacional. Realizou-se atendimento com as acompanhantes de crianças em situação de hospitalização com a finalidade de minimizar efeitos advindos do processo de hospitalização, estimular equilíbrio ocupacional, promover melhor desempenho ocupacional e (re)significar o processo de hospitalização. Em suma, foi possível compreender quais as repercussões ocupacionais que o processo de hospitalização pode ocasionar para o acompanhante e qual a importância da assistência para este público neste contexto, principalmente no que tange à atuação do Terapeuta Ocupacional.

This article aims to revisit the process of building the Unified Health System (Sistema Único de Saúde - SUS) and analyze how it has been constructed and established as a decolonial practice, from its implementation to the present day. In this sense, we highlight some concepts presented by Maldonado-Torres (2018) as the basis for the present work, such as colonialism, modern colonialism, coloniality, decolonization, and decoloniality. Thus, analyzing SUS as a decolonial action implies observing a change in attitude throughout its history, a fundamental condition of antagonistic engagement with coloniality and in favor of decoloniality as a project. In this sense, decolonial action is essential to the decolonial project, and vice versa. To this end, the historical antecedents of the creation of SUS were analyzed, as well as its principles as practices of decoloniality. We observe, therefore, that the implementation of SUS can be considered a significant advancement. Even though it may be progressing slowly, it represents a decolonial strategy and action, especially by raising the need for an attitudinal change and listening to the one who has always been considered a secondary element in healthcare: the patient themselves.