Introdução: O termo ultrassonografia a beira do leito ou point of care (POCUS) tem sido utilizado para descrever o uso de ultrassons portáteis pelo médico quando do atendimento ao paciente. A POCUS está cada vez mais sendo integrada a prática médica como extensão do exame físico tradicional. Objetivo: Apresentar a experiência da implementação do ensino da POCUS no currículo de graduação da Faculdade de Medicina da UFJF. Relato de experiência: São descritos o processo e as condições de implementação da disciplina Ecografia Clínica (EC) I com os alunos do quarto período do curso de medicina da UFJF. Resultados: Avaliação cognitiva (AC) com opções de múltipla escolha, 88% dos estudantes obtiveram notas iguais ou superiores 80 pontos. Na AC de associação de imagens, o resultado foi ainda melhor, chegando 96% dos discentes com notas iguais ou superiores a 80 pontos (nenhum aluno obteve nota inferior a 60 pontos). No OSCE, o aproveitamento igual ou superior a 80 pontos foi alcançado por 92% dos alunos. Avaliação de satisfação com a disciplina EC I (escala do tipo Likert) pelos estudantes revelou que a maioria absoluta deles considera que a ultrassonografia melhorou a sua educação médica, melhorou a qualidade do seu exame físico e deveria ser mais inserida no currículo médico. Conclusão: a inserção da ultrassonografia no ensino de graduação em medicina é pedagogicamente adequada e aprovada pelos estudantes.

Journal of Human Growth and Development, 2015; 25(2): 151-155 -151 - 2015; 25(2): 151-155 ORIGINAL RESEARCH Journal of Human Growth and Development ABSTRACTIntroduction: A change in the atlanto-axial alignment in children with Down syndrome may be associated with pain, neurological disorders, high spinal cord compression and sudden death. Objective: To determine the prevalence of atlanto-axial instability in children with Down syndrome and its association with the presence of signs and symptoms of atlanto-axial instability. Methods: A cross-sectional study evaluated 21 children with Down syndrome aged between 3 and 5 years. Children who had undergone cervical spine surgery or who had diseases not associated with this syndrome were excluded. Sex, age, ethnicity of the child and the presence of signs suggestive of atlanto-axial instability, as reported by caregivers, such as neck pain, difficulty walking, weakness in the lower limbs, fatigue, difficulty with balance, urinary and fecal incontinence and projectile vomiting were studied. Children underwent a cervical spine X-ray in the lateral view in three positions: neutral, flexion and extension. When the atlasodontoid distance was equal to or greater than 4.5 mm, atlanto-axial instability was diagnosed. Results: The prevalence of atlanto-axial instability in the studied population was 9.5%. There was no significant association revealed in the chi-square test between the signs suggestive of atlanto-axial instability and the presence of atlanto-axial instability (p > 0.05). Conclusions: Atlanto-axial instability is possibly not associated with its suggestive signs.Key words: Down Syndrome, Joint Instability, Atlanto-axial Joint, X-rays, Prevalence.

Introduction: Obesity is a Chronic Non-Communicable Disease, which has been growing at alarming levels worldwide, being responsible for several chronic complications, among them, Non-Alcoholic Fatty Liver Disease (NAFLD). NAFLD is defined as a set of abnormalities that can affect the liver in the absence of excessive alcohol consumption, ranging from simple steatosis to hepatocellular carcinoma.Studies show that the excessive consumption of energy, simple sugars and fats can contribute to its triggering. Objective: To evaluate food consumption and its relationship with NAFLD in young adults with obesity treated at an obesity clinic in Juiz de Fora, MG. Methodology: Epidemiological study, of cross-sectional design, including young adults with obesity, of both sexes, aged 18 to 30 years. Sociodemographic (age, sex, education and race), behavioral (tobacco use and physical activity), anthropometric (weight, height, body mass index, waist circumference, hip and neck and waist-hip ratio) data were obtained , clinical (insulin resistance and blood pressure), biochemical (fasting blood glucose, glycated hemoglobin, insulin and HOMA-IR) and dietary, which were compiled through the application of a Food Frequency Questionnaire (FFQ). In addition to data on total energy and macronutrients, foods were grouped according to the NOVA classification by degree of processing. The frequency reported by the volunteer in the application of the questionnaire was transformed into a daily frequency and subsequently the reported quantities were converted into grams. For the estimation of the energy and macronutrient contribution, the Dietwin program was used. NAFLD was defined as a dependent variable and the independent ones were dichotomized for further analysis of multivariate logistic regression. The project was approved by the Human Research Ethics Committee of the Federal University of Juiz de Fora, opinion number: 2,475,428. Results: 95 individuals were evaluated, with an average age of 23.53 years (± 3.09 years), 71.6% of whom were female, 70% sedentary, 18% hypertensive and 41% with insulin resistance. In addition, 76.84% had some degree of NAFLD.The variables physical inactivity (p = 0.016), weight (p <0.001), body mass index (BMI) (p <0.001), waist circumference (WC) (p <0.001), neck circumference (p = 0.018) , hip circumference (p = 0.001), waist-to-hip ratio (p = 0.001), HOMA-IR (p <0.001), insulin (p <0.001), glycated hemoglobin (p = 0.006), insulin resistance (p = 0.013 ) and consumption of processed foods (p = 0.032) were statistically different among individuals, being higher in those with NAFLD. We also observed groups with high BMI, insulin and glycated hemoglobin (p = 0.03; p = 0.03; p = 0.01, respectively), associated with NAFLD, after adjustment for sex. The dietary variables analyzed were not associated with NAFLD. Conclusion: Only the processed foods group showed higher consumption in patients with NAFLD. In addition, an association of elevated glycated BMI, insulin and hemoglobin with NAFLD was observed. The impo...

ObjectiveThe aim of this study was to evaluate breast arterial calcification (BAC) detected on routine mammography, analyzing its association with chronic degenerative disease.Materials and MethodsThis was a cross-sectional study involving women treated at a specialized outpatient clinic for high-risk hypertension, diabetes, or chronic kidney disease, as well as volunteers who participated in a study to validate a method of screening for occult renal disease. A total of 312 patients between 40 and 69 years of age, with no history of breast cancer, all of whom had undergone routine mammography in the last two years, were included. The mammograms were analyzed by researchers who were unaware of the risk factors for BAC in each case.ResultsThe mean age was 55.9 ± 7.4 years, and 64.3% of the patients were white. The mean glomerular filtration rate was 41.87 ± 6.23 mL/min/1.73 m2. Seventy-one patients (22.8%) had BAC. We found that BAC was associated with advanced age, hypertension, diabetes, chronic kidney disease, and low glomerular filtration rate. In the multivariate analysis, advanced age and diabetes continued to be associated with BAC. The odds ratio for BAC was higher for all chronic diseases.ConclusionThe association of BAC with advanced age, hypertension, diabetes, chronic kidney disease, and low glomerular filtration rate should call the attention of radiologists. Therefore, the presence of BAC should be reported, and patients with BAC should be screened for those diseases.

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Tempo de acompanhamento no serviço (CAPS-ad) De 0 a 1m 32 29,6% De 2 m a ‹1 ano 30 27,8% De 1 a 2 anos 19 17,6% ›2 anos 27 25,0%

Agradeço a Deus, pela vida, pelas infinitas graças concedidas e por por sua presença marcante em todos os momentos da minha vida.Aos meus pais, Claudia e Ronaldo, fonte de sabedoria e amor, que sempre me incentivaram e apoiaram. Tudo que alcancei é resultado do carinho e dedicação de vocês. Vocês são TUDO pra mim! À minha grande família por serem meu porto seguro e minha maior riqueza. Ao meu namorado, Kahiã, pelo apoio e amor que foram fundamentais nessa caminhada. Seu incentivo e seus conselhos me ajudaram muito. Obrigado por compartilhar comigo todos os momentos desta minha formação e tornar os momentos mais amenos. Às minhas orientadoras, Ana Paula Cândido e Carla Lanna, por todo ensinamento, incentivo e paciência. Tenho muito orgulho de ser uma eterna aprendiz de vocês. À equipe do Ambulatório de Obesidade e Hipertensão do Núcleo Interdisciplinar de Estudo, Pesquisa e Tratamento em Nefrologia (NIEPEN/UFJF) pelo apoio para a realização deste projeto. Ao Dr Marcus Bastos e Dr Flávio Ronzani pela confiança em meu trabalho. E ao laboratório Neolab pela colaboração. Aos estagiários e amigos do grupo de pesquisa por toda dedicação ao projeto e aos pacientes. Em especial, à minha amiga Letícia, pela torcida, disponibilidade e fundamental contribuição neste trabalho. À cada paciente atendido e participante do projeto, pela colaboração e por me fazerem enxergar a vida de outra forma. Às amigas que fiz no mestrado, Iris, Fernanda e Marcela pela amizade nascida entre risadas, lagrimas e artigos. O incentivo constante foi um dos principais combustíveis que me impulsionaram a seguir sempre em frente. A todo o departamento de Nutrição, Fisiologia e Nates da UFJF, pelo aprendizado e por partilharem tanto conhecimento. Aos professores e doutores Joana, Arise, Ana Lívia e Jéssica que se dispuderam a participar da banca examinadora deste estudo. Aos meus amigos que se fizeram presentes nas conquistas e derrotas, que compreenderam os momentos de ausência, frustrações e insegurança, que tiveram paciência para ouvir meus monólogos intermináveis e que souberam me dar forças e conforto, o meu mais sincero muito obrigada!

Introduction: Some peculiar features of Down Syndrome (DS), such as ligament laxity, hypotonia, delay in gait acquisition, among others, may generate alterations in the distribution of plantar pressures, modifying the plantar support. Objective: To verify whether there are differences in the evaluation of plantar pressure distributions in standing posture between the measurement instruments (Baropodometer, SAPO, and Radiography). Method: This was a cross-sectional study, evaluating ten children with SD and ten children with normal development (ND), aged from two to five years old. Bio-photogrammetry, baropodometry, and foot radiography were used to assess the plantar pressure distribution. Kappa analysis was used to evaluate the agreement index between the different instruments. Results: Children with DS and ND had a higher prevalence of pronated feet in all three instruments, with poor to substantial agreement among the instruments. Conclusion: According to this study instruments, there was a greater prevalence of pronated feet in the two groups . Differences in the evaluation of the distribution of plantar pressures in the standing posture between the Baropodometer, SAPO, and radiography were observed. These instruments should be used in a complementary manner, as they propose to evaluate different aspects of the feet alignment.