RMMG - Revista Médica de Minas Gerais

INTRODUCTION: Unfavorable neonatal outcomes in newborns have been associated with excessive medicalization in prenatal care, delivery and birth.
OBJECTIVE: to analyze unfavorable neonatal outcomes in live births in a Brazilian municipality.
METHODS: cohort study, carried out in public and private maternity hospitals. The sample consisted of live births. The occurrence of prematurity, low birth weight, neonatal resuscitation, use of oxygen, mechanical ventilation, use of antibiotics, admission to the Intensive Care Unit and death were included as unfavorable outcomes. Explanatory models were extracted using logistic regression.
RESULTS: 1088 newborns were evaluated, of which 32.7% had some unfavorable neonatal outcome, the most frequent being: resuscitation maneuvers, use of oxygen and prematurity. In the unfavorable neonatal outcome model, it was a risk factor, presenting clinical intercurrence during pregnancy, and protective factors, like having a health plan and prenatal card. In the model for neonatal death, the variables that expressed a significant association were gestational age, Apgar score below 7 at the 5th minute and location of prenatal care.
CONCLUSION: the high occurrence of unfavorable neonatal outcomes is a challenge to be overcome and its prevention involves actions in the process of pregnancy and childbirth.

Keywords Newborn; Prematurity; Low weight at birth; Morbidity; Cesarean.

OBJECTIVES: To analyze the main signs and symptoms, length of stay in the hospital, diagnoses found and clinical outcome of hospitalizations in pediatric patients with suspected COVID-19 in 2021.
METHODS: Retrospective descriptive observational study based on the medical records of patients with symptoms suggestive of COVID-19 between zero and 13 years incomplete, in 2021, who required hospitalization in an infirmary in a secondary care hospital, public/private, in the interior of Minas Gerais (MG).
RESULTS: In the 116 suspected pediatric patients evaluated, the clinical presentation was mostly with fever (70.7%), breathing difficulties (57.1%), cough (55.6%) and gastrointestinal symptoms (51.8%). Due to good clinical evolution, the median number of days the patients remained hospitalized was three days (2,0-4,0), and were discharged after clinical improvement with the recommendation of home isolation. Regarding the outcome of hospitalization, 92.5% of 116 patients evolved with improved discharge. Despite the suspicion of COVID-19, 93.2% of 116 patients tested negative and were diagnosed with other pathologies such as bronchiolitis (18%), asthma exacerbation crisis (18%), gastroenteritis (15%) and community pneumonia (12.8%).
CONCLUSION: Our data showed that although a similar clinic, there was a higher prevalence of other pathologies to the detriment of COVID-19 in pediatric patients hospitalized in the hospital of interior of MG in 2021.

Keywords Respiratory tract infections; Pediatrics; Length of stay; Patient isolation.

INTRODUCTION: Adolescence is the stage between childhood and adulthood, characterized by physical, and mainly, psychological changes, which make this period full of new experiences and uncertainties, increasing the vulnerability of this group. In this sense, the school becomes a privileged space to understand the individual demands of teenagers and promote early interventions focused on health education in an attempt to reduce exposure to potential risk situations.
OBJECTIVE: To describe the health profile of the teenagers enrolled in high school at the Escola Estadual Ouro Preto in 2022.
METHODS: This is a descriptive cross-sectional study that included the participation of 53 students enrolled in high school at the Escola Estadual Ouro Preto. The students answered the adapted Youth Risk Behaviour Survey (YRBS) questionnaire with questions related to mental health, sexual behavior, alcohol, tobacco and other drug use. The questionnaires were filled out anonymously and the answers were typed into Google Forms for later descriptive analysis. The study was approved by the Ethics Committee of the Federal University of Ouro Preto. RESULTS: The distribution of male and female participants was balanced; 30.8% of the teenagers have suffered some type of threat and 19.2% have been physically assaulted; 60.8% reported having depressive or anxious symptoms, and 34.6% have thought about committing suicide; 38.5% have had sexual intercourse, 75% have received guidance on sexually transmitted diseases, and 20% did not use a condom during the last sexual encounter; 70.6% of the young people have tried alcohol and 42.3% have tried cigarettes at least once in their life. Approximately 90% consider their health normal, good, or excellent, but 50% are dissatisfied with their body weight.
CONCLUSION: It can be seen that violence, depressive and anxious symptoms, unprotected sex, and early drug use are relevant issues among the studied teenagers, making interventions in health focused on these themes essential.

Keywords Adolescence; Health education; Early interventions; Health profile.

INTRODUCTION: One of the health indicators of the newborn children is low birth weight (LBW) - weight less than 2,500g - which can be determined by the influence of several reasons, such as, maternal, fetal, placental and environmental factors.
OBJECTIVE: To determine the prevalence and factors associated with LBW in the state of Minas Gerais (MG), Brazil.
METHOD: Cross-sectional study which analyzed data from 259,863 live births, in MG, from Brazilian Live Birth Information System (SINASC), in 2011. Of these, 242,487 records met the inclusion criteria: birth weight equal to or greater than 500g, no malformations, 22 weeks or more of gestational age. The prevalence of the LBW was determined. The crude and adjusted prevalence ratios were determined by Poisson regression.
RESULTS: The prevalence of LBW was 9.2%. The prevalence was higher in mothers with lower educational level, primiparity, dead children from previous pregnancies, prenatal care with less than 5 visits to doctor, gestational age less than 37 weeks, multiple pregnancy, and female newborn. The prevalence was lower in the North, Northeast, Northwest, Eastern of South, Southeast, Southern Triangle, East and Jequitinhonha health macro-regions.
CONCLUSION: The LBW prevalence was high, and the variables associated with higher LBW prevalence were gestational age, multiple pregnancy, educational level, number of prenatal visits to doctor, parity, gender, place of birth. The lower prevalence was observed in the health macro-regions in which the socioeconomic and sanitary conditions are worst, characterizing the LBW paradox.

Keywords Low birth weight, Maternal and child health, Health planning, Health Information System.

INTRODUCTION: Motherhood at an advanced age has shown significant growth in Brazil in recent decades. Socioeconomic transformations have modified the role of women, increasing their autonomy in relation to the parental project. The postponement of motherhood can be a recurrent phenomenon for future doctors, since training in Medicine has a long duration.
OBJECTIVE: To evaluate the knowledge of medical students about reproductive health, through questions about reproductive senescence, fertility preservation techniques and desires related to motherhood, highlighting the importance of the topic for satisfactory family planning associated with the pursuit for a medical career.
METHOD: Descriptive cross-sectional study, which analyzed the knowledge of 149 academics about reproductive health, through an online questionnaire. Data were analyzed using R software version 4.0.3.
RESULTS: Although aging determines a decline in female fertility, assisted reproduction technologies help those who opt for late motherhood. The training time was estimated at 11 years. Most students reported the desire to have biological children and were in favor of the possibility of postponing motherhood for professional reasons. Most erroneously reported that fecundity would be between 55-85%. 89.9% reported knowing what assisted reproduction is. Most students were not instructed about reproductive senescence and fertility preservation.
CONCLUSION: The students have a limited understanding of reproductive health, probably due to the lack of medical guidance, in addition to insufficient family planning, which does not always consider the professional factor.

Keywords Fertility preservation; Reproductive techniques; Family development planning; Medical students.

INTRODUCTION: Women living with HIV (MVHIV) have a lower mean age at menopause than the general population, in addition to more exuberant symptoms during this period. These factors can further reduce the quality of life of this population during perimenopause and negatively affect antiretroviral therapy (ART). Understanding this risk is important for medical advice at this stage, as well as for evaluating the initiation of hormonal therapy, when necessary.
OBJECTIVE: To evaluate the climacteric syndrome in women living with HIV/AIDS.
METHODS: During an endocrinological medical consultation, a clinical examination was performed, including an anthropometric physical examination, in addition to the application of a questionnaire to assess the symptoms of the climacteric syndrome and collection of hormonal values, viral load and serum CD4 cell values of 44 women, aged between 35 to 65 years old, living with HIV/AIDS.
RESULTS: The mean age at spontaneous menopause was 47.44 years, there was an association between FSH, LH and estradiol hormones and perimenopause phases. Anxiety and/or nervousness was present in 84.1% of patients and slowing of thinking in 72.7%. Skin dryness was also shown to be a significant symptom, with 75% of recurrence. Furthermore, women with skin dryness had higher FSH and LH compared to those without the symptom.
CONCLUSION: Women living with HIV in Belém-PA had menopause 3.76 years before the expected national average and presented a high prevalence of symptoms related to cognition and mood. Other similar studies, with a larger sample size, are needed in the region to establish more reliable results.

Keywords HIV; Early menopause; Climacteric symptoms; ART.

INTRODUCTION: The bariatric surgery, although very effective for obesity treatment, does not treat the psychological dysfunctions that contributed to the development of obesity. Therefore, a multidisciplinary treatment, aiming to treat not only the biological part, but the individual as a whole, can be decisive for the success of the procedure.
OBJECTIVE: To analyze the importance of psychiatric assessment before bariatric surgery.
METHODS: The study is an integrative review conducted in PubMed, LILACs, BVS and SciELO databases between September and November 2021. The descriptors used were: "Psychiatry" OR "Psychology" AND "Bariatric Surgery". 720 studies were found, of which only 22 matched the research theme according to the selection by the abstract and the full text.
RESULTS: Studies demonstrate that the prevalence of psychiatric disorders in bariatric candidates is higher than the general population. Furthermore, it is noted that the lack of standardization psychiatric evaluation before bariatric surgery, which can make detection difficult the diagnosis of psychopathologies for a later psychiatric intervention.
CONCLUSION: To improve the bariatric surgery prognosis, it is beneficial that the psychiatric care be made in standardized way, enabling the identification of psychopathology that can negatively influence success of the procedure.

Keywords Bariatric surgery; Psychiatry; Preoperative care.

INTRODUCTION: The indispensable application of the best evidence in the treatment of patients with respiratory diseases with increased tracheobronchial mucus production has led to the development of health technologies for the application of knowledge and skills organized in the form of devices, drugs, vaccines, procedures and systems to solve a health problem and improve the quality of life.
OBJECTIVE: The objective of this study was to update the knowledge about the real scenario of the use of international oscillatory positive expiratory pressure OPEP devices.
METHODS: Crossover randomized controlled trials were obtained from the PubMed, SciELO, Cochrane and UpToDate databases. Found 862 articles, 7 of which were included in the qualitative and quantitative analysis.
RESULTS: Predominantly the Flutter device was used in outpatient clinics of university hospitals with adults diagnosed with bronchiectasis with average age of 56.31 years. Treatment was ± 4.5 weeks lasting approximately 25 minutes.
CONCLUSION: The educational campaigns about the OPEP should be carried out, to make the target population aware of the importance of using the devices, as well as for health professionals, to rescue the use in clinical practice.

Keywords Airway clearance; Oscillatory Positive Expiratory Pressure (OPEP); Phisiotherapy; Physical therapy modalities.

INTRODUCTION: Infantile hemangioma (IH) is a benign tumor of the vascular endothelium, characterized by early appearance, rapid growth, and slow involution. It is the most common tumor in the pediatric age group, and several risk factors are associated with its development.
CASE REPORT: Monozygotic twins, female, 29 weeks premature and with low birth weight, presenting reddish spots that after 15 days evolved into erythematous tumors, with a diagnosis of IH.
CONCLUSION: This case report exemplifies simultaneously the main risk factors associated with the development of IH. Recognition of these factors by pediatricians is crucial for early diagnosis, appropriate follow-up, and management.

Keywords Infantile hemangioma; Hemangioma; Vascular tumor; Neonatal; Twins; Probability; Risk factors.

Giant cell tumors (GCT) are usually benign, typically found in the epiphyseal area of long bones, affect individuals in the third decade, and have a slight female predilection. GCT represent about 4% to 9.5% of all bone tumors and 20% of all benign ones. Approximately 2% of all GCT occur in the head and neck region. However, primary laryngeal GCT is an infrequent entity, with 43 cases reported to date. Therefore, the present study aimed to report an issue of laryngeal GCT in a young male patient. Given the uncertainty of clinical and radiological distinction between the wide variety of differential diagnoses, histopathological examination is indispensable for a definitive diagnosis and therapeutic management. The treatment of GCT is controversial. However, currently, the literature supports surgical management. The incidence of GCT is not a common situation in medical practice, and the diversity of differential diagnoses is quite broad, which may lead the physician to suspect other diseases that affect the larynx. GCT is rarely considered among the diagnostic hypotheses, its incidence is sporadic, and management data must be studied.

Keywords Giant cell tumors; Larynx; Dysphonia.