Faculdade de Medicina - FM

URI Permanente desta comunidade

https://observatorio.fm.usp.br/handle/OPI/2
A Faculdade de Medicina da Universidade de São Paulo (FMUSP) foi fundada oficialmente em 24 de novembro de 1891, de acordo com a Lei nº 19, como 'Academia de Medicina, Cirurgia e Pharmácia'; a aula inaugural foi realizada anos mais tarde, em 1913, quando foi rebatizada como Faculdade de Medicina e Cirurgia de São Paulo, sendo designada como Faculdade de Medicina de São Paulo em 1925 e incorporada à Universidade de São Paulo em 1934.

A FMUSP está vincula ao Sistema FMUSP-HC, que é o maior do país e também o maior centro assistencial da América Latina, compreendendo, além da Faculdade de Medicina, institutos especializados no atendimento de alta complexidade (atenção terciária), hospital de média complexidade (atenção secundária), hospitais auxiliares, unidades especializadas no atendimento integral de pacientes portadores de HIV/AIDS, Centro de Saúde Escola (atenção primária), Unidades Básicas de Saúde (atenção primária), Laboratórios de Investigação Médica (LIMs) e Fundação de Apoio.

Atualmente a FMUSP atua na graduação e pós-graduação de médicos, fisioterapeutas, fonoaudiólogos e terapeutas ocupacionais com sólida formação geral e básica, além de promover o treinamento nos três níveis de atenção à saúde.

Entre as atividades realizadas na FMUSP estão pesquisa e desenvolvimento na área da saúde, além de pesquisa básica e clínica e o oferecimento de ensino, pesquisa e atividades de cultura e extensão, tendo como prioridade o investimento em pesquisa científica e sua reversão para projetos de assistência social.

Site oficial: http://www.fm.usp.br

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article
Autolesiones no suicidas en estudiantes de medicina: frecuencia y factores asociados
(2023) BARRIOS, Iván; MELGAREJO, Osvaldo; AMARILLA, Diego; ZÁRATE, Karen; CASTALDELLI-MAIA, João Mauricio; VENTRIGLIO, Antonio; GARCÍA, Deysi; CAYCHO-RODRÍGUEZ, Tomás; TORALES, Julio
ABSTRACT Introduction: the mental health of medical students has been extensively researched, showing that they are part of a group vulnerable to the development of mental disorders. Aim: the aim of this research was to determine the frequency of NSSI and its associated factors in medical students in Paraguay. Methodology: this was a descriptive and cross-sectional study. An online survey was launched to assess depression, anxiety, and self-harm, the PHQ-2, the GAD-7 and SHQ scales were used, respectively. Results: we received responses from 330 medical students. Of the participants, 71.2 % were female. 46.4% of the participants were identified as having depression (PHQ-2 ≥ 3) and 37.3 % as having anxiety (GAD-7 ≥10). The frequency of NSSI was 27 % (n = 89). The main factors associated with NSSI were a previous diagnosis of a mental disorder (which increased the likelihood of NSSI by 3.76 times) and/ or a history of physical or sexual abuse (with a 3.75-fold increase). Conclusion: this research found the presence of NSSI in almost 3 out of 10 of the medical students surveyed. The main factors associated with self-injurious behavior were a previous diagnosis of a mental disorder and/or a history of physical or sexual abuse.
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CORRELATION BETWEEN CYPHOSE AND LORDOSE WITH THE FOOT SUPPORT OF ADOLESCENTS WITH IDIOPATHIC SCOLIOSIS
(2023) MOURÃO, MAX MULLER BEZERRA; BARSOTTI, CARLOS EDUARDO GONÇALVES; TOSTES, GUSTAVO ALVES; TORINI, ALEXANDRE PENNA; ANDRADE, RODRIGO MANTELATTO; RIBEIRO, ANA PAULA
ABSTRACT Objective: To verify the correlation between the thoracic and lumbar Cobb angle and the type of foot, and the parameters of plantar support during gait in adolescents with idiopathic scoliosis. Material and Methods: Sixty adolescents with idiopathic scoliosis (AIS) were divided into three groups: normal foot (n=20), cavus foot (n=20), and flat foot (n=20). The Cobb angles of thoracic kyphosis and lumbar lordosis were evaluated by radiographic examination. The plantar arch was recorded the podoscope and calculated by the ratio between the midfoot and the total foot area. The adolescents performed the march on a 20-meter track, with their feet resting on the pressure platform, totaling an average of 12 steps of the foot (right and left). The variables evaluated were: contact area, peak pressure, and maximum force on the four regions of the feet: hindfoot (medial and lateral), midfoot, and forefoot. Results: There was a positive correlation between the Cobb angle of lumbar lordosis and the arch plantar cavus (r=0.40; p=0.048) and flat (0.25; p=0.004), with no significant correlations for the Cobb angle thoracic (p>0.005). The pressure peak strongly correlated with the cavus plantar arch (r=0.92, p=0.001) in the lateral hindfoot and forefoot region, while the flat foot with the midfoot region. Conclusion: The Cobb lumbar lordosis angle positively correlates with the plantar arch height and the plantar support pattern during gait in adolescents with idiopathic scoliosis. Level of Evidence II; Observational and Cross-Sectional Study.
article
Qualidade de vida e sobrecarga de mães de crianças com microcefalia
(2023) SANTOS, Daniel Batista Conceição dos; CARDOSO, Luana da Conceição Costa; TORALES, Andréia Poschi Barbosa; REIS II, Francisco Prado; OLIVEIRA, Cristiane Costa da Cunha; LIMA, Sonia Oliveira
Abstract Introduction: Due to congenital infection, children with microcephaly have great limitations due to this condition. These limitations make the child need more health and home care. Generally, the mother becomes the main caretaker for this child, this role can lead to overload feelings that affect their quality of life. Objective: To analyze the role overload and the quality of life of mothers or primary caregiver of children with microcephaly related to congenital infection. Method: Cross-sectional, correlational study carried out with 105 participants from the state of Sergipe, Brazil, during the period from October 2017 to April 2018, through the application of questionnaires: sociodemographic, WHOQOL-Bref, and caregiver burden. For statistical analysis, ANOVA, t-test, and Pearson (r) tests were used. Results: All of the participants were females, 39 % were classified with severe role overload and 30.5% with intense role overload. The total average of this caregiver burden (49.47) presents a moderate to severe classification. There was a strong correlation (p<0.0001) between the levels of their role overload and the domains of their quality of life, where the greatest damage was in the environmental (36.57) and physical (38.53) aspects. A significant and inversely proportional correlation (r=-0.547, p<0.0001) was observed between the quality of life and the caregiver burden. Conclusion: Mothers suffer severe and intense caregiver overload that has a negative influence on their quality of life. Nursing can contribute to the creation and implementation of specific lines of care for these women emphasizing the promotion of physical and mental health to improve their quality of life.
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Simulação in situ e suas diferentes aplicações na área da saúde: uma revisão integrativa
(2023) SANTOS, Marcos Maciel Candido Justino dos; LIMA, Sara Fiterman; VIEIRA, Carine Freitas Galvão; SLULLITEL, Alexandre; SANTOS, Elaine Cristina Negri; PEREIRA JÚNIOR, Gerson Alves
Abstract Introduction: The in situ simulation (ISS) consists of a training technique that takes place in the real workplace as a relevant method to promote environmental fidelity in the simulated scenario. Objective: To verify the use of the ISS in the world, to understand its applicability in healthcare. Method: This is an integrative review, which used the following guiding question: How has in situ simulation been used by health professionals? Searches were carried out in the PubMed, SciELO, LILACS and Web of Science databases, with different combinations of the following descriptors: in situ simulation, health and medicine (in Portuguese, English and Spanish) and the Boolean operators AND and OR using a temporal filter from 2012 to 2021. A total of 358 articles were found and the inclusion and exclusion criteria were applied, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and also with an independent peer review, using Rayyan, leaving 190 articles for this review. Results: The results showed that the United States has the absolute majority of productions (97/51%), followed by Canada, but with a large numerical difference (18/9.5%). Most of the works are written in English (184/96.8%), are quasi-experimental studies (97/51%), and have multidisciplinary teams as the target audience (155/81.6%). The articles have 11,315 participants and 2,268 simulation interventions. The main ISS scenarios were the urgent and emergency sectors (114/60%), followed by the ICU (17/9%), delivery room (16/8.42%) and surgical center (13/6.84%). The most frequently studied topics were CPR (27/14.21%), COVID-19 (21/11%), childbirth complications (13/6.8%) and trauma (11/5.8%). Discussion: The pointed-out advantages include the opportunity for professional updating with the acquisition of knowledge, skills and competencies, in an environment close to the real thing and at low cost, as it does not depend on expensive simulation centers. Conclusion: In situ simulation has been used by health professionals worldwide, as a health education strategy, with good results for learning and training at different moments of professional training, with improved care and low cost. There is still much to expand in relation to the use of ISS, especially in Brazil, in the publication of studies and experience reports on this approach.
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A visão de gerentes de atenção básica à saúde sobre suas atribuições
(2023) SILVA, Luciano Bairros da; SOUSA, Marcos Henrique Oliveira; ÍñIGUEZ-RUEDA, Lupicinio
Abstract The article aimed to understand the development of the attributions of the primary care manager from the perspective of these same professionals, in the capital Maceió, Alagoas, Brazil. It is a qualitative research, which interviewed eight managers of Basic Health Units and treated by means of content analysis. The results identified that the managers as routine manage the flow of care and the attendance record of the team members, but present limitations to manage the teamwork and the physical structure. At the institutional level, they mediate the relationship of the team's professionals with the administrative headquarters, but show little participation in the establishment of intersectoral actions. They value the relationship with the community, however, they report little social participation at the Unit level. They show little knowledge about health policies and information systems. It is considered that, for a positive impact on access and quality to the health of the population, it is necessary: to guarantee the governability of managers over material resources and personnel management; the monitoring of health goals with the collaborative participation of the community; the appropriation and promotion of health work networks; and an in-service training program that helps local management.
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Alimentação Saudável, Agricultura Urbana e Familiar
(2023) DOMENE, SEMÍRAMIS MARTINS ÁLVARES; SAWAYA, ANA LYDIA; MAUAD, THAIS; FRANCO, MARIA DO CARMO PINHO; ALBUQUERQUE, MARIA PAULA DE; WANDERLEY, MARIANGELA BELFIORE; PEREIRA, CRISTIANE MATOS; KAZZE, MARCELLA CABRAL; PELIANO, ANNA MARIA MEDEIROS
ABSTRACT As a result of the debates held during the XI Seminar on Service, Research and Public Policy, on the theme “Urban Agriculture and Food and Nutrition Security: organic food in school meals”, this article summarizes the speeches of researchers, agricultural producers, representatives of civil society institutions and government agencies on urban food production. From the perspective of the of urban agriculture contribution to the quality of food, issues related to the scope and limits of the distribution of these foods through public facilities and destination to public policies, such as the school meal program, are addressed in light of experiences in the cities of São Paulo and Castro, in Paraná. Considering the supply of urban centers and the importance of organizational and food environments, debate took national and international guidelines on the social determinants of contemporary health and nutrition as a theoretical reference. The difficulties that mark the production of urban agriculture were addressed, and the actions of local initiatives that made it possible to advance towards a viable economic activity that promotes healthy eating and equity were presented. The role of public food policies, still limited in the field of urban agriculture, is evident to strengthen the work of farmers and public managers engaged in initiatives that already point to the potential for growth in this form of food production.
article
INTRAHEPATIC BILIARY PROLIFERATIONS: HISTOPATHOLOGY AND POTENTIAL IMMUNOHISTOCHEMICAL MARKERS
(2023) HIRAYAMA, André Bubna; MELLO, Evandro Sobroza de; ALVES, Venâncio Avancini Ferreira
ABSTRACT Intrahepatic biliary proliferations represent a spectrum from reactive (ductular reaction, some with atypical architecture), hamartomatous (von Meyenburg complex), benign (bile duct adenoma) and precursor/borderline entities (biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct) to fully malignant (cholangiocarcinoma) neoplasms. Clinical pictures and even imaging patterns may be similar, requiring refined studies aiming at histopathological and immunohistochemistry for more precise diagnosis, essential for correct patient management. This article discusses updated concepts and definitions of most relevant entities aiming more specifically at the differential diagnosis in practice, focusing on morphology and immunohistochemistry, with a discussion of potential markers to help distinguishing between benign and malignant lesions.
article
GOVERNANÇA E COORDENAÇÃO NO SUS: Aprendendo com a pandemia de Covid-19
(2023) COELHO, VERA SCHATTAN P.; BLOOM, GERRY; PAES-SOUSA, RÔMULO; FIORE, DANILO CESAR; VIANA, ANA LUIZA; IBAÑEZ, NELSON; ARBIX, GLAUCO; MELLO, GUILHERME; CERON, MARIANE
ABSTRACT For plural health systems, promoting coordination between multiple sectors and governments levels is a permanent challenge. This study explores how the SUS dealt with this challenge during the Covid-19 pandemic, identifying proactive subnational actors, cross-sector cooperation and digital health as innovations that enhanced this coordination. Their emergence, the possibilities they represent for improving the SUS and how they can be sustained are discussed.
article
Risk and protective factors for the development of stress in the Federal Highway Police
(2023) OLIVEIRA, Léa Pintor de Arruda; OLIVEIRA, Lucio Garcia de; CARVALHO, Heráclito Barbosa de
Abstract Objective The present study aimed to identify the risk and protective factors for the development of stress in a random and stratified sample of Brazilian federal highway police officers in the state of São Paulo (N = 202). Method The instruments used were a General Questionnaire (sociodemographic and occupational variables) and Lipp’s Stress Symptom Inventory for Adults. The prevalence ratio was used as a measure of association and the independent variables were organized into 8 models and inserted into a logistic regression model. Results A stress prevalence of 43.1% (95% CI = 36.2–50.0) was found, with most of the sample in the resistance phase (82.7%). The factors related to stress were leisure, educational level, degree of job satisfaction, low remuneration, suicidal ideations, insomnia, lack of training, and work-family conflict. Conclusion The results can influence actions aimed at controlling stress.
article
“A Ballroom é um arquivo de pessoas negras que viveram a epidemia de aids”: narrativas sobre o arquivo negro da prevenção
(2023) LORENA, Allan Gomes de; COUTO, Flip; ÁKIRA, Luna; PIMENTA, Félix; TEIXEIRA, Ricardo Rodrigues
Abstract This article aims to present the narratives of the Ballroom Community in São Paulo to situate how combined HIV prevention practices are carried out in these people, identifying how the strategies conform, with what elements and influences, absences and restrictions. This is a qualitative research in the field of Collective Health that uses semi-structured interviews with Ballroom leaders to reconstruct narratives about HIV, opening a black archive on prevention. Such a perspective, in line with Saidiya Hartman's work from the perspective of radical black thought, focuses on the stories that have not been and will still be told: a way of radically imagining the future of blackness. As an analytical force, the black archive has the function of reparation, expanding narratives from a racial perspective, occluding a unique history of the HIV/Aids epidemic.