Background: Neurological manifestations of celiac disease (CD) have a prevalence of 10% to 22% among patients. Of this group, neuropathy is present in up to 23%, with small fiber neuropathy (SFN) being the most described, with a predominance of painful symptoms and appendicular paresthesia. Objectives: Review literature to describe the clinical management of SFN in CD. Design and setting: Narrative review. Methods: Non-systematic review on Pubmed and Scielo database. Results: CD is a chronic inflammatory autoimmune disease that can generate extraintestinal manifestations as SFN. Small fiber neuropathy is a painful focal sensory neuropathy of slow progression, with distal predominance, symmetrical or not, beginning in adulthood and, sometimes, followed by autonomic dysfunction. Electroneuromyography studies (ENMG) suggest greater involvement of myelinated Adelta and C myelinated thin fibers, which is a precursor of sensory ganglionopathy in the dorsal root and can progress to large fiber neuropathy. The ENMG of SFN is usually normal because it is generally not demyelinating. To confirm the diagnosis, a skin biopsy that evaluates the fiber’s intra-epidermal density is indicated. Another exam is the quantitative test of the sudomotor reflex, capable of evaluating autonomic function. Finally, treatment should be directed to the underlying cause, optimization of the treatment of CD, and the management of symptoms, such as pain. Conclusions: The SFN, despite being an uncommon manifestation of CD, is possibly underdiagnosed due to the lack of studies evaluating this manifestation in celiac patients. Therefore, further studies are needed in order to instigate early diagnosis and adequate clinical management.
Objetivo: Compreender os principais motivos que levam os homens a não buscarem auxílio profissional para suas queixas relativas à saúde mental. Método: Revisão de literatura narrativa, adaptada do PRISMA, com busca de artigos nos sítios PubMed, SciELO entre outros, no esquema booleano (man AND mental health) AND (adherence OR services OR risks). Resultado: Encontrou-se de 5.669 artigos, no qual 44 atendiam os critérios de seleção e 15 tinham relação direta com o problema. Via mapa mental, resultados foram agrupados em cinco sessões: aspectos da saúde mental nos homens, hipóteses para baixa procura, imposição de regras sociais, características dos homens que não buscam auxílio e consequências na saúde do homem do não cuidado da saúde mental. Principais causas relatadas para o absenteísmo foram comportamentais - visto que os homens buscam não aparentar fraqueza e vulnerabilidade. Conclusão: Questões sociais e um imperativo comportamental leva os homens a distanciar-se dos serviços de assistência
RESUMO INTRODUÇÃO: Os acadêmicos de medicina sofrem com muita ansiedade ao entrarem na faculdade, e isso se deve principalmente a mudança no ciclo de vida e à adaptação a uma realidade ainda desconhecida. O evento “Passei, e agora?” foi criado com o intuito de acolher e auxiliar esses novos estudantes a se ajustarem a uma nova rotina, por meio da apresentação de temas desde materiais usados na faculdade até saúde mental. O objetivo deste relato é descrever a organização e a importância do evento. RELATO: A reunião, realizada em agosto de 2021 de forma híbrida, contou com 24 inscrições por um formulário que continha um pré-teste. Foram apresentados, por meio de slides, temas particulares da faculdade, como materiais, ligas acadêmicas, estágios, projetos de extensão e pesquisa, e habilidades a serem desenvolvidas, como planejamento, gestão de tempo, produtividade, saúde mental e sono. Posteriormente, foi aplicado um formulário pós-teste, a fim de avaliar a apresentação e impacto da reunião. DISCUSSÃO: O estudante de medicina atinge seu maior nível de ansiedade no 1° semestre, quando tem de lidar com a adaptação a uma nova realidade e o encontro de novas preocupações. Nesse contexto, o “Passei, e agora?” auxilia os estudantes a lidar com o início do curso, afinal, nesse período salienta-se a relevância da saúde mental. Apesar dos elogios e iniciativa dos estudantes presentes, a forma híbrida limitou a participação daqueles que assistiam de forma online, por estarem no primeiro período, não foi possível mensurar o impacto a longo prazo. CONCLUSÃO: Evidenciou-se a importância do evento que, trazendo auxilio e conforto aos novos estudantes de medicina, contribui para o processo de adaptação à vida acadêmica universitária. Assim, pretende-se continuar com a realização deste, inserindo dinâmicas integrativas entre os presentes. ABSTRACT INTRODUCTION: Medical students suffer from a lot of anxiety when they get into college, this is mainly due to the change in the life cycle and the adaptation to a still unknown reality. The event "Passei, e agora?" intends to welcome and help these new students to adjust to a new routine, through the presentation of topics ranging from materials used in college to mental health. The purpose of this report is to describe the organization and importance of the event. EXPERIENCE REPORT: The meeting, held in August 2021 in a hybrid way, had 24 registrations through a form that contained a pre-test. Particular college topics were presented by slides, such as materials, academic leagues, internships, extension and research projects, and skills to be developed, such as planning, time management, productivity, mental health and sleep. Subsequently, a post-test form was applied in order to measure the presentation and impact of the meeting. DISCUSSION: Medical students reach their highest level of anxiety in the 1st semester, when they have to deal with adapting to a new reality and dealing with new concerns. In this context, "Passei, e agora?" helps students to deal with the beginning of the course, after all, in this period, the importance of mental health is highlighted. Despite the compliments and initiative of the students that were present, the hybrid form limited the participation of those who watched it online, in addition to the fact that they were still in their first year, making it hard to measure the long-term impact. CONCLUSION: The importance of the event, which brings help and comfort to the new medical students, is evident, as it contributes to the process of adaptation to the university academic life. Thus, it is intended to continue with its realization, inserting integrative dynamics among those present.
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