Neuromyelitis Optica and Multiple Sclerosis are idiopathic inflammatory demyelinating diseases of the central nervous system that currently are considered distinct autoimmune diseases, so differences in genetic susceptibility would be expected. This study aimed to investigate the HLA association with Neuromyelitis Optica by a systematic review with meta-analysis. The STROBE instrument guided research paper assessments. Thirteen papers published between 2009 and 2020 were eligible. 568 Neuromyelitis Optica patients, 41.4% Asians, 32.4% Latin Americans and 26.2% Europeans were analyzed. Only alleles of the DRB1 locus were genotyped in all studies. Neuromyelitis Optica patients have 2.46 more chances of having the DRB1*03 allelic group than controls. Ethnicity can influence genetic susceptibility. The main HLA association with Neuromyelitis Optica was the DRB1*03:01 allele in Western populations and with the DPB1*05:01 allele in Asia. Differences in the Multiple Sclerosis and Neuromyelitis Optica genetic susceptibility was confirmed in Afro descendants. The DRB1*03 allelic group associated with Neuromyelitis Optica has also been described in other systemic autoimmune diseases.
O processo de parturição é um evento fisiológico, que ocasiona contrações uterinas e dilatação cervical, o feto exerce pressão sobre as estruturas do assoalho pélvico materno aumentando a intensidade da dor. Este estudo buscou evidenciar o conhecimento e aplicabilidade dos métodos não farmacológicos utilizados pelos enfermeiros obstetras para alívio da dor na parturição. Trata-se de uma pesquisa de campo, com abordagem qualitativa, onde foram entrevistados 20 enfermeiros obstetras numa maternidade de referência Materno Infantil no Estado do Pará no período de outubro a novembro de 2016. Evidenciou-se o conhecimento dos enfermeiros obstetras sobre os métodos não farmacológicos, entretanto, somente uma pequena parcela dos profissionais utilizam os métodos em benefício da parturiente, devido a carga de trabalho ou falta de estrutura. Mesmo com as dificuldades encontradas nas práxis do cuidado os enfermeiros buscam vencer os obstáculos que aparecem no exercício profissional.
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