Infecção de Trato Urinário (ITU) pode ser definida pela colonização da uretra distal, bexiga, rim e próstata a partir de uropatógenos cuja origem principal é a flora fecal. Trata-se de uma doença frequente, além de ser apontada como um dos principais motivos de prescrição antimicrobiana na Atenção Primária à Saúde (APS). MÉTODOS: Revisão de literatura que objetivou reunir informações atualizadas sobre a ITU e sua abordagem na APS, cujo descritores utilizados foram "infecção de trato urinário" e "atenção primária à saúde", com recorte temporal entre os anos de 2016 a 2022. RESULTADOS E DISCUSSÃO: A busca literária resultou na seleção de 14 obras, das quais 12 tratavam-se de artigos científicos e 2 de protocolos de sociedades de especialidades médicas brasileiras. O quadro típico das ITUs baixas apresenta-se com disúria, aumento da frequência urinária, urgência miccional e, ocasionalmente, dor suprapúbica e hematúria. Já nas ITUs altas somado aos sinais e sintomas supracitados, podem ocorrer manifestações sistêmicas. As principais medidas para se evitar a ITU continuam sendo as mudanças comportamentais e de higiene pessoal. O tratamento antimicrobiano deve ser instituído o mais precoce possível para evitar complicações. Em relação às gestantes, faz-se necessário uma investigação durante o pré-natal e em caso de bacteriúria assintomática, é recomendado o seu tratamento. Em caso de ITUs recorrentes, podese utilizar a profilaxia antimicrobiana ou alternativas não antibióticas profiláticas. CONSIDERAÇÕES FINAIS: A ITU é uma doença de fácil diagnóstico e requer poucos exames complementares para sua avaliação, o que denota a plausibilidade de seu manejo a nível primário, sobretudo no contexto da cistite não complicada.Palavras-chaves: Infecção de trato urinário, ITU, atenção primária à saúde.

Background The assessment of clinical prognosis of pregnant COVID-19 patients at hospital presentation is challenging, due to physiological adaptations during pregnancy. Our aim was to assess the performance of the ABC2-SPH score to predict in-hospital mortality and mechanical ventilation support in pregnant patients with COVID-19, to assess the frequency of adverse pregnancy outcomes, and characteristics of pregnant women who died. Methods This multicenter cohort included consecutive pregnant patients with COVID-19 admitted to the participating hospitals, from April/2020 to March/2022. Primary outcomes were in-hospital mortality and the composite outcome of mechanical ventilation support and in-hospital mortality. Secondary endpoints were pregnancy outcomes. The overall discrimination of the model was presented as the area under the receiver operating characteristic curve (AUROC). Overall performance was assessed using the Brier score. Results From 350 pregnant patients (median age 30 [interquartile range (25.2, 35.0)] years-old]), 11.1% had hypertensive disorders, 19.7% required mechanical ventilation support and 6.0% died. The AUROC for in-hospital mortality and for the composite outcome were 0.809 (95% IC: 0.641–0.944) and 0.704 (95% IC: 0.617–0.792), respectively, with good overall performance (Brier = 0.0384 and 0.1610, respectively). Calibration was good for the prediction of in-hospital mortality, but poor for the composite outcome. Women who died had a median age 4 years-old higher, higher frequency of hypertensive disorders (38.1% vs. 9.4%, p < 0.001) and obesity (28.6% vs. 10.6%, p = 0.025) than those who were discharged alive, and their newborns had lower birth weight (2000 vs. 2813, p = 0.001) and five-minute Apgar score (3.0 vs. 8.0, p < 0.001). Conclusions The ABC2-SPH score had good overall performance for in-hospital mortality and the composite outcome mechanical ventilation and in-hospital mortality. Calibration was good for the prediction of in-hospital mortality, but it was poor for the composite outcome. Therefore, the score may be useful to predict in-hospital mortality in pregnant patients with COVID-19, in addition to clinical judgment. Newborns from women who died had lower birth weight and Apgar score than those who were discharged alive.

Introduction: Temporomandibular joint (TMJ) replacement is usually a last resort in the surgical treatment of end-stage joint disease. For all this gear to work efficiently, occlusion, articulation, musculature, ligaments, and psychological factors must be in complete harmony. As a treatment, implantation of a total alloplastic TMJ prosthesis. Objective: It was to demonstrate, through a systematic review, the main considerations and clinical outcomes of the treatment of temporomandibular disorders with different types of prostheses. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2013 to 2023. Results and Conclusion: A total of 127 articles were found, 60 articles were evaluated and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 33 studies that did not meet GRADE. Based on the results, temporomandibular disorders (TMD) treatment is diverse and depends on the type of disease, as well as the duration and subjective level of pain. Alloplastic reconstruction can be advantageous in obtaining a rapid improvement in symptoms and rapid rehabilitation of masticatory function. Treatment of functional TMD is commonly based on conservative therapy, including physical therapy, pain therapy, and splinting therapy. Depending on the severity of TMD, treatment varies according to the degree of surgical invasion. Thus, the TMJ prosthesis seems to be reserved for patients with persistent pain, bone or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of mandibular condyle fractures. Quality of life, mouth opening, and daily eating improved significantly after total TMJ prosthesis.

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