Journal of Social Issues and Health Sciences (JSIHS)
The Journal of Social Issues and Health Sciences (JSIHS) (ISSN 2966-0742) is a multidisciplinary academic journal that has a double-blind arbitration system and whose mission is to publish and disseminate research that brings reflections that present original contributions, of a theoretical or empirical nature, spreading knowledge in different areas. As a multidisciplinary journal, it is open to different theoretical and methodological approaches and receives contributions from authors from different academic levels.
Technical Visit to the Medium Security Penitentiary 2 and the Role of the Psychologist in the Prison System
The present study discusses the creation of the Medium-Security Penitentiary 2 (PSM2) in Viana, the first Brazilian prison unit exclusively designed for the LGBTQIAPN+ population, and analyzes its implications in light of the Technical Guidelines for the Work of Psychologists in the Prison System (CFP, 2021). Based on a technical visit to the facility and theoretical foundations, the study highlights the persistence of disciplinary practices and social control historically present in Brazilian prisons since the 19th century, marked by structural racism, LGBTQphobia, and hygienist logic. Drawing on authors such as Foucault, Koerner, Goulart, and Silva, the study argues that the penitentiary system continues to operate as a device of normalization and exclusion, even under discourses of resocialization. Overcrowding, the vulnerability of the LGBTQIAPN+ population, and the ambiguous role of psychology—often used as an instrument of classification, control, and maintenance of order—are central issues. The study concludes that a critical analysis of the Brazilian prison system requires considering its historical foundations, its subjective effects, and its ethical-political implications, particularly regarding the protection and human rights of minoritized groups.
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Nursing students' perceptions of patient safety in pediatric care: a multifaceted exploration
This article explores nursing students' perceptions of patient safety in the context of pediatric care, based on a comprehensive review of the most recent national literature. We investigate how these perceptions are formed, influenced by various factors, and how they shape the quality of care provided to children and their families. To achieve these objectives, the research employed a methodology that included a thorough review of articles and books in major databases, such as Capes Journals and Google Scholar, prioritizing recent national works. The collected data were organized through summaries and subsequently analyzed qualitatively, allowing the identification of recurring themes and emerging trends. The students' perceptions proved to be a complex tapestry, influenced by educational, practical, personal, and institutional factors. These perceptions go beyond the technical-operational scope, being driven by ethical principles, empathy towards pediatric patients, and a continuous commitment to excellence in care. We identified that the understanding of patient safety is not restricted to the theoretical realm but has significant practical implications. These implications include a focus on a safety-centered approach, the integration of evidence-based practices, the promotion of effective communication, the adoption of a holistic view, and contributing to the building of a strong safety culture. In response to the research question, we found that the perceptions of nursing students play a crucial role in training nursing professionals capable of providing safe, compassionate, and effective care to children and their families. This study offers a comprehensive and up-to-date view on a topic essential for the continuous improvement of pediatric care, prompting deep reflection on the perceptions of nursing students and their tangible impact on the quality of care.
Intestinal microbiota as a modulator of neuroinflammation in neurodegenerative diseases
The growing prevalence of neurodegenerative diseases, such as Alzheimer’s and Parkinson’s, has intensified research aimed at understanding biological factors associated with neuroinflammation, a central component of these conditions. Among these factors, the intestinal microbiota has gained increasing attention due to its ability to modulate immune responses and directly influence the gut–brain axis. This study aimed to analyze Brazilian evidence on the role of the intestinal microbiota as a modulator of neuroinflammation in neurodegenerative diseases. A narrative review was conducted based on six national articles published in scientific journals, addressing physiological mechanisms, intestinal dysbiosis, microglial activation, and emerging therapeutic strategies. The results indicate consistent alterations in the microbial composition of patients with Alzheimer’s and Parkinson’s, linked to elevated inflammatory markers and disruption of biological barriers. Moreover, interventions targeting microbiota modulation, such as prebiotics, probiotics, and fecal microbiota transplantation, appear to be promising. It is concluded that the intestinal microbiota plays a significant role in mediating neuroinflammation, contributing to a broader understanding of the pathophysiology of neurodegenerative diseases and suggesting relevant directions for future research and therapeutic approaches.
Judh Beatriz Trindade Gouveia dos Santos
(Re)inventing Academic Practice: organizing of an academic week in times of COVID-19
The COVID-19 pandemic imposed rapid adaptations on the academic environment, most notably the mandatory transition of in-person events to remote formats. This experience report aims to present the process of organizing and conducting the Academic Week of the Medicine program at a Brazilian public university, discussing the challenges faced, the strategies adopted, and the lessons learned from adapting activities to the virtual environment. The event, themed “The Future of Medicine,” was organized by members of the academic center and included symposiums, debates, and electronic sports competitions designed to foster student engagement. Through the use of digital platforms such as Even3®, YouTube®, and social media, the organizing committee successfully expanded participation and enhanced the integration of students and guest speakers from different regions of the country. Participant evaluations demonstrated high satisfaction, evidencing the feasibility and benefits of remote academic events, while also indicating the relevance of incorporating virtual and hybrid practices into medical extension activities in the post-pandemic period.
Trends and epidemiological profile of gestational and congenital syphilis in Brazil and Pará
Gestational and congenital syphilis represent a major public health problem due to their high vertical transmissibility and severe fetal impacts, such as stillbirth, prematurity, and neurological sequelae. This study analyzed data from the Notifiable Diseases Information System (Sinan-Net) between 2018 and 2023 in Brazil and in the state of Pará, totaling 439,723 cases of gestational syphilis and 154,525 cases of congenital syphilis nationwide, as well as 16,611 and 6,042 cases, respectively, in Pará. Variables such as sex, age group, ethnicity, education level, clinical classification, timing of diagnosis, prenatal care, and clinical outcome were evaluated, with data processed using Microsoft Excel. A progressive increase in gestational syphilis cases was observed, especially in 2022 and 2023. Most cases occurred among young women (20–29 years), of mixed race, and with low education levels, predominantly in the primary stage of the disease, suggesting recent infection. Recent congenital syphilis was the most prevalent form among newborns, with higher incidence in males. Although most maternal infections were diagnosed during prenatal care, a significant number were detected only at delivery. The persistence of severe outcomes, such as stillbirths and miscarriages, indicates failures in preventing vertical transmission despite advances in prenatal testing. The study highlights Sinan’s strategic role in epidemiological monitoring and public health policy formulation, emphasizing the need for integrated strategies of screening, health education, and qualified prenatal follow-up, particularly among socially vulnerable populations.
Pericarditis in adults: systematic review of epidemiology, etiologies, diagnosis and management – 2025 update
Pericarditis is the most common cause of pericardial inflammation in adults and presents a broad clinical spectrum, ranging from self-limited episodes to severe forms associated with cardiac tamponade or constrictive pericarditis. This systematic review synthesizes recent evidence on the epidemiology, etiologies, diagnosis and management of pericarditis in adults, focusing on publications from 2018 to 2025. Searches were conducted in PubMed/MEDLINE, Embase, Scopus and the Cochrane Library, including clinical trials, observational studies, meta-analyses and international guidelines. Of 3,106 initially identified studies, 156 met eligibility criteria. Findings indicate that most cases are idiopathic or viral with excellent prognosis, although high-risk features require hospitalization and expanded evaluation. Cardiac magnetic resonance has become central for detecting active inflammation, while biomarkers such as C-reactive protein and troponin aid in risk stratification. Treatment with non-steroidal anti-inflammatory drugs, colchicine and selected use of corticosteroids or immunosuppressants has reduced recurrence and complications. Advances in understanding inflammation have modernized therapeutic strategies and improved outcomes.
Fabry disease in adults: systematic review of epidemiology, pathophysiology, diagnosis and treatment – 2025 update
Fabry disease is an X-linked hereditary disorder caused by deficiency of the enzyme alpha-galactosidase A, leading to progressive accumulation of glycosphingolipids, especially globotriaosylceramide (Gb3), in multiple tissues. This systematic review aimed to synthesize recent evidence on epidemiology, pathophysiology, clinical manifestations, diagnosis and treatment of Fabry disease in adults, focusing on studies published between 2018 and 2025. Searches were conducted in PubMed/MEDLINE, Embase, Scopus and Cochrane Library, selecting observational studies, clinical trials, meta-analyses and international guidelines, while excluding case reports and very small series. From 2,962 initial articles, 148 were included for qualitative analysis. Findings show that prevalence is higher than previously estimated, largely due to expanded identification of late-onset variants through modern screening tools. Cardiac and renal variants predominate in adults and are frequently underdiagnosed. Advances such as cardiac magnetic resonance with T1 mapping, speckle-tracking echocardiography and biomarkers like lyso-Gb3 have improved diagnostic accuracy. Available treatments—including enzyme replacement and pharmacological chaperones—demonstrate enhanced benefit when started early, and innovative therapies such as gene therapy are promising. In conclusion, substantial progress has been made in understanding Fabry disease, enabling earlier diagnosis and more effective management, although challenges remain in personalized therapeutic approaches.
Aortic stenosis in adults: systematic review of epidemiology, pathophysiology, diagnosis and management – 2025 update
Aortic stenosis is the most common acquired valvular heart disease in adults and a major cause of cardiovascular morbidity and mortality, particularly in individuals over 65 years of age. It is characterized by progressive narrowing of the aortic valve orifice, usually secondary to degenerative calcification, leading to left ventricular pressure overload, concentric hypertrophy, and increased risk of heart failure, arrhythmias and sudden cardiac death. This systematic review aimed to synthesize recent evidence on the epidemiology, pathophysiology, diagnosis and management of aortic stenosis, focusing on studies published between 2018 and 2025. Searches were conducted in PubMed/MEDLINE, Embase, Cochrane Library and Scopus, including randomized clinical trials, cohort studies, meta-analyses and international guidelines. Of 3,418 studies initially identified, 162 met the inclusion criteria. Findings indicate that global prevalence continues to rise, driven by population aging, and that transcatheter aortic valve implantation (TAVI) has expanded significantly. Recent guidelines reinforce the central role of echocardiography in diagnosis, while emerging imaging markers and hemodynamic models provide improved risk stratification. We conclude that therapeutic advances have significantly modified the prognosis of aortic stenosis, especially in older adults and high-risk surgical patients, although challenges remain regarding optimal timing and management of low-flow aortic stenosis.
Myocarditis in adults: a systematic review of epidemiology, etiologies, diagnosis, and management – ​​updated 2025
Myocarditis is defined as inflammation of the heart muscle with non-ischemic myocyte injury and may present clinically from subclinical disease to cardiogenic shock and sudden death. Viral infection remains the predominant cause, but autoimmune, hypersensitivity and immune-mediated forms have been increasingly recognized, especially after the advent of cancer immunotherapy and the COVID-19 pandemic. The aim of this systematic review was to summarize recent evidence on the epidemiology, etiologies, pathophysiology, diagnosis and treatment of myocarditis in adults, focusing on studies published between 2019 and 2025. Searches were performed in PubMed/MEDLINE, Embase, Scopus and the Cochrane Library, including clinical trials, meta-analyses, cohort studies and international guidelines, and excluding case reports and very small series. Of the 4,312 records initially identified, 172 studies were deemed eligible. The results show an estimated annual incidence ranging from 10 to 105 cases per 100,000 adults, with higher prevalence in young men. Cardiac magnetic resonance imaging, particularly with the updated Lake Louise Criteria, has become the main noninvasive diagnostic modality, with high sensitivity and specificity. Treatment is based on hemodynamic support, etiology-directed therapies and careful use of immunosuppressive drugs in autoimmune and immune-mediated forms. We conclude that, although myocarditis remains a diagnostic challenge, advances in cardiovascular imaging and immunomodulatory therapies have enabled more accurate approaches and improved prognosis in selected subgroups.
Pericardial Effusion in Adults: a systematic review of epidemiology, etiologies, diagnosis, and management – ​​updated 2025
Introduction: Pericardial effusion (PE) is defined as an abnormal accumulation of fluid in the pericardial space and encompasses a wide spectrum of etiologies, ranging from benign conditions to life-threatening causes such as cardiac tamponade. Advances in imaging, image-guided interventions and understanding of the underlying pathophysiology justify an updated synthesis of the literature. Objective: To systematically review contemporary evidence on the epidemiology, etiologies, imaging-based diagnosis and therapeutic management of pericardial effusion in adults, focusing on studies published between 2000 and 2025. Methods: A systematic search was conducted in PubMed/MEDLINE, Embase, Cochrane Library and Google Scholar. Eligible studies included cohort and observational studies, clinical series with ≥20 patients, systematic reviews and guidelines. Pre-clinical, pediatric-only, very small series and purely narrative reviews were excluded. Two independent reviewers screened and selected the studies according to PRISMA principles. Extracted data included epidemiology, causes, diagnostic methods, echocardiographic parameters, management strategies (pericardiocentesis, surgery, adjuvant therapies), prognosis and recurrence. Results: A total of 3,274 records were identified, of which 82 met inclusion criteria. The most frequent etiologies were idiopathic/viral (20–30%), neoplastic (10–25%), post-operative (15–20%), uremic (5–15%), tuberculosis (in endemic regions: up to 70% of severe cases), autoimmune diseases (5–10%) and hypothyroidism (up to 5%). Transthoracic echocardiography remains the main diagnostic tool, while tomography and cardiac magnetic resonance are useful in complex or loculated effusions. Management is driven by effusion volume, rate of accumulation and hemodynamic impact. Image-guided pericardiocentesis shows a success rate of 92–98% with low procedure-related mortality (<1%), whereas malignant effusions present higher recurrence rates (up to 40%). Surgical pericardial window is associated with lower recurrence at the cost of greater invasiveness. Conclusion: Pericardial effusion is a multifactorial condition requiring rapid and structured evaluation. Echocardiography is the cornerstone of diagnosis, and image-guided pericardiocentesis remains the first-line intervention in symptomatic or hemodynamically unstable effusions. Ongoing advances in imaging, biomarkers and minimally invasive therapies continue to improve outcomes.
Transthyretin Amyloidosis (ATTR): a systematic review of diagnostic and therapeutic evidence – 2025
Introduction: Transthyretin amyloidosis (ATTR), in its hereditary (ATTRv) and wild-type (ATTRwt) forms, has emerged as a prevalent cause of cardiomyopathy and progressive neuropathy in adults, especially the elderly. Diagnostic advances and the development of disease-modifying therapies have transformed clinical management. Objective: To systematically evaluate contemporary evidence on the epidemiology, diagnosis, and treatment of ATTR, focusing on randomized studies and international guidelines. Methods: A systematic review of studies published in the PubMed/MEDLINE and ClinicalTrials.gov databases up to November 2025 was conducted using the descriptors transthyretin amyloidosis, ATTR cardiomyopathy, hereditary transthyretin amyloidosis, tafamidis, patisiran, vutrisiran, inotersen, eplontersen, acoramidis. Randomized clinical trials, cohorts with n≥20, and guidelines were included. Case reports and narrative studies were excluded. Results: 112 relevant studies were included. Diagnosis was based on an integrated algorithm involving exclusion of AL amyloidosis, bone scintigraphy with 99mTc-PYP/DPD/HMDP, and TTR gene genotyping. Tafamidis remains the TTR stabilizer with the strongest evidence for ATTR-CM. RNA silencers (patisiran, vutrisiran, inotersen, eplontersen) have demonstrated robust benefit in ATTRv-PN, and recent data on vutrisiran suggest a reduction in mortality and cardiovascular events in ATTR-CM. Acoramidis emerges as a new effective option. Emerging therapies include fibril-clearing antibodies and CRISPR gene editing. Conclusion: ATTR has become a treatable disease, with effective therapies and increasingly accessible diagnosis. Early management and evaluation in specialized centers remain essential to optimize survival and quality of life.
Semaglutide: clinical efficacy, mechanisms of action, and therapeutic implications in the integrated management of type 2 diabetes mellitus and obesity
Chronic metabolic diseases, such as Type 2 Diabetes Mellitus (T2DM) and obesity, represent a public health challenge due to their high prevalence and the complex impact on the cardiometabolic axis. Traditional management of these conditions presents limitations regarding glycemic control and modulation of body weight, justifying the search for therapies that act in a more integrated manner. This study aimed to critically analyze the role of GLP-1 receptor agonists, with emphasis on semaglutide, in the context of cardiometabolic diseases, considering pathophysiological foundations, clinical implications, and usage challenges. This is a narrative literature review conducted through searches in the PubMed, CAPES Journals, and Google Scholar databases, covering publications since 2016. Descriptors such as “semaglutide,” “type 2 diabetes mellitus,” and “weight loss” were used. Screening resulted in the selection of 15 studies, six (6) of which were Randomized Clinical Trials, considered the most relevant. The results confirmed the dual efficacy of semaglutide, evidenced by its potent reduction of HbA1c and clinically significant weight loss. The medication also demonstrated cardiovascular benefits and reductions in microvascular complications. It is concluded that semaglutide has solidified itself as a fundamental therapeutic tool in the integrated management of T2DM and obesity, but its use requires strict monitoring of adverse events, attention to dependence on continued therapy for weight maintenance, and ethical prescription that considers contemporary challenges related to off-label use and secondary aesthetic effects.
Silent burnout: when resilience becomes a trap for healthcare professionals
Introduction: Burnout Syndrome among healthcare professionals has intensified due to institutional cultures that glorify resilience as a moral imperative, leading to the silencing of emotional suffering. The concept of “silent burnout” reflects the normalization of exhaustion and the difficulty of early recognition. Methodology: This integrative review adopted an exploratory and qualitative approach, following the steps proposed by Mendes, Silveira, and Galvão. Searches were conducted through the Virtual Health Library across LILACS, SciELO, PubMed/MEDLINE, SCOPUS, and BDENF using DeCS/MeSH descriptors related to burnout. After screening, 14 articles published between 2019 and 2024 were included. Results and Discussion: Findings indicate that organizational issues, workload burden, long shifts, and resource shortages are predominant triggers of burnout. The demand for resilience functions as a mechanism of individual accountability, masking institutional failures and hindering recognition of symptoms. The “healthcare hero” narrative reinforces the belief that showing vulnerability represents weakness, increasing psychological distress. Continuous institutional interventions—such as emotional support programs, listening groups, and workload reduction policies—proved effective in reducing burnout rates. Conclusion: Burnout among healthcare workers is revealed as a systemic phenomenon exacerbated by misinterpreted resilience. Long-term institutional strategies are crucial to promoting emotional well-being, preventing mental exhaustion, and improving care quality.
Therapeutic Advances in Leishmaniasis: an integrative review of conventional strategies and pharmacological innovations
This integrative review summarizes the main therapeutic advances for leishmaniasis published between 2016 and 2023. The findings indicate that although antimonials, amphotericin B, and miltefosine remain the primary treatment options, their effectiveness is increasingly compromised by drug resistance, toxicity, and operational limitations in endemic regions. At the same time, significant progress has been achieved with emerging strategies such as nanocarriers, controlled-release systems, synthetic and marine-derived compounds, drug repurposing, and immunomodulatory approaches. These developments highlight substantial scientific progress; however, most innovations remain in preclinical stages, underscoring the need for translational research and robust clinical trials. Overall, the evidence points to a promising therapeutic landscape, with growing potential for incorporation of new technologies into clinical practice.
Teaching and neurological propedeutics in the context of academic tutoring in medical practice: a case report
Academic tutoring programs, grounded in the peer-assisted learning model, represent an effective strategy in medical education by fostering knowledge exchange among students at different levels of training. This study aims to describe and critically analyze the practices developed within a Neurology tutoring project conducted by medical students, highlighting its benefits, challenges, and contributions to the participants’ educational development. The activity was coordinated by senior student tutors and comprised in-person lectures, supervised hospital practices, online activities, clinical case discussions, and playful approaches to solving questions from national medical examinations. The results revealed the consolidation of theoretical and practical knowledge, improvement in clinical reasoning, enhancement of interpersonal skills, increased self-confidence, and integration of Evidence-Based Medicine principles. Tutees reported a deeper understanding of the subjects and appreciation for individualized feedback, while tutors reinforced their own learning through teaching. Despite challenges related to class heterogeneity and variability in tutors’ experience, the overall feedback was predominantly positive and reflected in course evaluations. It is concluded that academic tutoring is an effective pedagogical tool that promotes mutual learning, critical thinking, and preparation for clinical practice.
Analysis of health education practices by multidisciplinary team professionals in health promotion
The Family Health Strategy, the main tool of Primary Health Care, is composed of a multidisciplinary team—including physicians, nurses, dentists, community health agents, among others—that works in an integrated manner to promote health care. Health education plays a central role in this process, contributing to user empowerment, self-care, and the modification of risk behaviors. This study aims to identify the approaches, methodologies, and outcomes of educational practices carried out by multiprofessional teams within the FHS, evaluating their effectiveness in promoting health and individual autonomy. It also seeks to highlight gaps in the literature regarding the perceptions of these professionals about health education. A literature review was conducted covering publications from 2019 to 2025, using the LILACS and SciELO databases. The descriptors used were: “Educational Practices,” “Health Education,” and “Multiprofessional Team.” Educational practices have shown effectiveness in promoting healthy habits and strengthening bonds between health professionals and the community. However, they face challenges such as lack of resources, limited managerial support, and inadequate planning. The study emphasizes the importance of integrated team efforts, despite work overload and the invisibility of some professionals' contributions, such as nurses. Despite its challenges, health education is essential for transforming social realities and reducing inequalities. Collaborative work between the multiprofessional team and the community enhances the effectiveness of these actions, making it necessary to expand research and investment to continuously improve these practices.
Strategies for prevention and control of sarcopenia in obese patients undergoing treatment with GLP-1 agonists
Sarcopenia is a condition characterized by the progressive loss of muscle mass and strength, which can be exacerbated by rapid weight-loss treatments such as GLP-1 agonists, including semaglutide and tirzepatide, commonly used in obesity treatment. While these medications have proven effective in weight reduction, they may also result in muscle mass loss, leading to sarcopenia. This study aimed to analyze strategies for the prevention and management of sarcopenia in obese patients treated with GLP-1 agonists like semaglutide and tirzepatide. A qualitative narrative literature review was conducted using databases such as PubMed, Google Scholar, and SciELO, selecting studies published between 2021 and 2025 that specifically addressed sarcopenia in obese patients treated with GLP-1 agonists, focusing on nutritional interventions, physical exercise programs, and pharmacological approaches. Studies that did not directly address the topic or lacked relevant clinical data were excluded. Although GLP-1 agonists are effective in weight loss, they may lead to significant muscle mass loss. The most effective prevention strategies include adequate protein intake, especially leucine and HMB, and resistance training exercises. These interventions are crucial for preserving muscle mass and improving functionality during weight loss. The findings emphasize the importance of a multidisciplinary approach to treating obesity with GLP-1 agonists, which should include appropriate nutritional interventions, physical exercise, and medical monitoring to ensure muscle preservation and enhance patients’ quality of life during weight reduction.
Type 1 diabetes mellitus in adolescence: clinical management and quality of life
Introduction: Type 1 Diabetes Mellitus (T1DM) in adolescence represents a clinical and social challenge, as it occurs during a stage marked by intense physical, emotional, and psychosocial changes. The demands of continuous treatment, the need for self-care, and the impact on family and school routines directly influence adolescents’ quality of life, requiring a broader and more humanized approach by health professionals. Objective: To analyze how clinical management and health interventions influence the quality of life of adolescents with T1DM, identifying challenges, strategies, and impacts on the self-care process. Methodology: This is an integrative review, with an exploratory and explanatory design and a qualitative approach. Data collection occurred between September 2024 and July 2025 through the Virtual Health Library (VHL), which integrates the MEDLINE, LILACS, and BDENF databases. Free, full-text articles published in Portuguese and English between 2020 and 2025 were included. After screening 170 studies, only 10 met all inclusion criteria. Results and discussion: The studies indicated that family support, multidisciplinary follow-up, educational technologies, and health education are key determinants of treatment adherence and well-being among adolescents. Psychosocial and socioeconomic factors were also relevant, influencing autonomy and health perception. Conclusion: Managing T1DM during adolescence requires comprehensive and humanized care based on empathy, health education, and the strengthening of bonds among the healthcare team, patients, and families, promoting self-care and improving quality of life.
An analysis of brazilian legislation on special and inclusive education
The theme discussed throughout this article refers to an analysis of Brazilian legislation concerning Special and Inclusive Education, taking into account historical contexts and its development. The central question guiding this research is: what advances have emerged in relation to Inclusive Special Education based on the premises of existing legislation? The objectives are to identify the benefits brought by Brazilian laws regarding Special and Inclusive Education, to analyze the historical milestones that support it, and to verify whether the legislation is effectively implemented in practice. The research is justified by the need to assess whether the current laws in the country are truly reaching the target audience of this still underrepresented educational modality. Thus, the study is based on a bibliographic review supported by books, scientific articles, laws, and official government documents. It concludes that there have been significant advances concerning Special Education, both in school and family contexts. However, it was also found that having strong legislation is not enough if, in the praxis of social relations, rights are not respected in certain environments that continue to foster a culture of prejudice, discrimination, and educational hegemony.
Surgical Treatment versus Medical Treatment in Hidradenitis Suppurativa: an integrative review and comparative analysis of clinical outcomes and quality of life
Hidradenitis Suppurativa (HS) is a chronic, recurrent, and painful inflammatory disease of the hair follicles, whose medical and surgical management still represents a significant therapeutic challenge for modern dermatology. Characterized by deep nodules, abscesses, fistulas, and hypertrophic scars, HS affects areas of skin friction and exerts a devastating impact on quality of life, with major physical, psychological, and social repercussions. In recent decades, advances in the understanding of the immunoinflammatory pathophysiology of the disease have driven the development of targeted therapies, such as biologic agents, while more precise and conservative surgical techniques have been refined to reduce recurrence rates and promote functional rehabilitation. This study aims to conduct an integrative and comparative literature review of the clinical outcomes and quality of life of patients undergoing surgical versus medical treatment for Hidradenitis Suppurativa, analyzing evidence published between 2015 and 2025. Randomized trials, systematic reviews, and meta-analyses indexed in PubMed, Scielo, Embase, and ScienceDirect were included, addressing therapeutic efficacy, remission time, recurrence rates, complications, and psychosocial impact. The literature findings indicate that medical treatment—particularly the combined use of antibiotics and biologic agents such as adalimumab—provides significant inflammatory control and symptomatic improvement in mild to moderate stages, but with a high recurrence rate after discontinuation. In contrast, surgical treatment, including techniques such as deroofing and wide excision, shows better long-term remission rates and significant reductions in recurrence, although it involves longer recovery times and a higher risk of local complications. It is concluded that the ideal approach should be individualized and multimodal, integrating medical and surgical strategies combined with the management of metabolic comorbidities, smoking cessation, and psychological support. A deeper understanding of the interaction between chronic inflammation, skin microbiota, and psychosocial factors may, in the future, redefine therapeutic paradigms, enabling more personalized and effective treatments.
Educational Psychology: foundations for a transformative pedagogical practice
This article, developed within the scope of the Educational Psychology course in the Mathematics program at the University of Passo Fundo (UPF), integrates theories of human development with critical pedagogical practices. Drawing on foundational thinkers such as Piaget, Vygotsky, and Freud, as well as the analysis of documentaries and television series, it explores how the classroom can be transformed into a space of pedagogical resistance. The methodology comprised theoretical readings, audiovisual analysis, and practical reflection. The findings indicate that affective bonds, qualified mediation, active methodologies, and empathetic listening are essential components of an inclusive, meaningful, and transformative education.
The impact of spirituality on the acceptance of the dying process: perceptions of nursing professionals
This study analyzed the influence of spirituality on the acceptance of the dying process from the perspective of nursing professionals. Based on philosophical and existential references such as Heidegger and Seneca, the study highlights spirituality as an essential dimension of holistic care, distinct from religiosity but capable of providing meaning and comfort in the face of finitude. This is an integrative literature review, descriptive in nature, which used the PICo strategy to formulate the guiding question. Searches were conducted in the LILACS, SciELO, PubMed, and Scopus databases between August and October 2025, using the descriptors “Death,” “Life,” “Spirituality,” and “Nursing.” After applying inclusion and exclusion criteria, nine articles were selected for analysis. The results showed that spirituality significantly contributes to the acceptance of death, promoting spiritual well-being, resilience, and serenity in patients and professionals. However, a lack of technical and institutional preparation to address spiritual issues in hospital settings was identified, limiting comprehensive care. It was also observed that integrating spirituality into nursing practice strengthens humanization, encourages empathetic listening, and reduces spiritual suffering. It is concluded that recognizing this dimension is essential for person-centered care and that academic training should include content on spirituality, sensitive listening, and respect for beliefs. Thus, spiritual care constitutes an indispensable component for ethical, compassionate, and humanized nursing practice in end-of-life contexts.
Human Viral Infections: current overview and control prospects in Brazil
Human viral infections represent a significant public health challenge in Brazil, affecting various age groups and populations. This article addresses the current panorama of these infections in the country, highlighting the main viral diseases, their epidemiological trends, and the control strategies implemented. Recent epidemiological data, adopted public policies, and advances in prevention and treatment are analyzed. The methodology includes the analysis of epidemiological bulletins from the Ministry of Health and relevant scientific studies. The results indicate a reduction in mortality rates from viral hepatitis, although challenges persist in the control of HIV and syphilis. The discussion emphasizes the importance of integrating surveillance, prevention, and treatment actions, as well as the need for public policies that consider the social determinants of health. It concludes that, despite the advances, it is essential to strengthen control strategies and promote equity in access to health services to effectively address viral infections in Brazil.
Parkinson's Disease: current landscape, therapeutic challenges, and future perspectives
Parkinson's disease (PD) is the second most prevalent neurodegenerative disease worldwide, characterized by the progressive degeneration of dopaminergic neurons and the presence of motor and non-motor symptoms that significantly compromise patients' quality of life. Its prevalence increases with age, representing a growing challenge for global public health. This integrative review aimed to present a current overview of PD, highlighting therapeutic challenges and future perspectives in clinical management. To this end, a systematic search was conducted in the main databases between 2015 and 2024, selecting relevant articles in Portuguese, English, and Spanish. These were qualitatively analyzed using thematic categories related to diagnosis, treatment, and therapeutic advances. The findings highlight the etiological complexity of PD, involving genetic factors—such as mutations in the SNCA, LRRK2, and GBA genes—, environmental factors, and head trauma, as well as neuropathology associated with alpha-synuclein aggregation. Diagnosis still relies primarily on clinical evaluation, supplemented by imaging tests to rule out atypical syndromes. Current interventions combine pharmacological therapies, especially levodopa and dopamine agonists, with non-pharmacological and surgical approaches, including deep brain stimulation, which is effective for refractory motor symptoms. However, managing motor and non-motor complications remains a significant challenge, and disease-modifying therapies are still in their infancy. New therapeutic strategies, such as gene therapies, immunotherapies, and regenerative treatments, are under development, offering hope for the future. Therefore, this review highlights the importance of early diagnosis, multidisciplinary care, and scientific innovation to improve the prognosis and quality of life of patients with PD.
Factors associated with the high prevalence of off- label use of medicines in pediatric: an integrative review
The prevalence of off-label use of medications in pediatrics is a worrying and complex issue that involves different factors. The present study had the general objective: Investigate the factors associated with the high prevalence of off-label use of medications in pediatrics. It was developed through an integrative review, using the databases: Pubmed, Scielo and Lilacs, using some inclusion and exclusion criteria. Six studies were included in the final sample as a result of this review. The articles discuss the prevalence and factors associated with the off- label use of medications in pediatrics. They address different aspects, such as scientific evidence, reasons and risks of off-label use, choice of unlicensed drug therapy, safety and ethical issues, clinical studies, prevalence of prescriptions and potential risks and benefits. It was evident that the off-label use of medications is a frequent phenomenon in pediatric practice, with significant prevalence rates.
Impact of the Multiprofessional Team on the Clinical Management of Pregnant Women with Gestational Hypertension
Gestational hypertension is one of the most prevalent obstetric complications, representing a significant risk to maternal and fetal health. The clinical management of these pregnant women requires a coordinated and integrated approach, capable of ensuring safety, quality, and effectiveness in care. Objective: To analyze the impact of the multiprofessional team on the clinical management of pregnant women with gestational hypertension, highlighting its contribution to improving care and reducing maternal-fetal risks. Methodology: An integrative literature review was conducted, including quantitative and qualitative studies, systematic reviews, experience reports, and institutional guidelines, selected based on specific inclusion criteria and evaluated by independent reviewers. Results: The multiprofessional approach promotes adequate blood pressure control, prevention of maternal and fetal complications, adherence to prenatal care, and improvement of the pregnant woman's quality of life. Collaborative strategies enable continuous monitoring, psychological support, nutritional guidance, and efficient coordination of health resources, contributing to safer, comprehensive, and humanized care. Discussion: The integration of different professionals strengthens clinical care, optimizes care flows, and improves gestational outcomes. Conclusion: Multiprofessional care is essential for the effective management of gestational hypertension, promoting positive clinical outcomes and maternal-fetal well-being.
Care for stroke victims in the emergency room: analysis of challenges and strategies
Stroke (Cerebrovascular Accident) represents a highly complex acute neurological condition and is one of the leading causes of morbidity, disability, and mortality worldwide. Immediate emergency room care is essential to reduce sequelae and improve clinical outcomes, requiring adequate infrastructure, defined protocols, and multiprofessional integration. Objective: To analyze the challenges in the care of stroke victims in the emergency department and identify clinical and organizational strategies capable of optimizing management, reducing response time, and minimizing complications. Methodology: An integrative literature review was conducted, including quantitative and qualitative studies, systematic reviews, experience reports, and institutional guidelines, with searches in PubMed, Scopus, Web of Science, SciELO, and LILACS. Descriptors related to stroke, emergency care, clinical protocols, and hospital management were used, considering publications from 2018 to 2025 in Portuguese, English, or Spanish. Results: Efficient care depends on standardized clinical protocols, clear organizational flows, and staff training. Structured strategies reduce delays, increase the effectiveness of thrombolytic therapies, improve interdepartmental communication, and optimize the use of human and technological resources. Discussion: Structural limitations and staff overload compromise the agility of care, highlighting the need for multiprofessional integration and continuous education. Conclusion: The implementation of well-defined organizational and clinical strategies is essential to ensure rapid, safe, and efficient care for stroke patients, contributing to better clinical and organizational outcomes.
Population resistance against COVID vaccination in Brazil
Vaccination hesitation is defined as the act of refusing or delaying, despite their availability, the administration of recommended vaccines. The refusal, in turn, is the result of doubts or own convictions regarding the safety and efficacy of the vaccine. The present study is justified by the health professionals assisting patients who have doubts and/or fears about the safety and/or efficacy of vaccines. The present research aims to describe, through a literature review, the causes of hesitation in the vaccine against covid-19. The present study used the integrative literature review as a method, which aimed to gather and summarize the scientific knowledge already produced on the investigated topic, that is, it allows searching, evaluating and synthesizing the available evidence to contribute to the development of knowledge in the theme. As a result, vaccines against Covid-19 were prepared to provide extensive preservation against the virus and offer some level of protection against several variants. Over time, various vaccination practices may be indispensable as new variants appear. This could include modifying the vaccine dose, extra booster vaccinations, combination vaccines or tailoring the vaccines themselves to the target variants. It is concluded that above hygiene and social distance prevention, immunization is the only concrete way to prevent COVID-19. Vaccines are essential for preventing vaccine-preventable diseases that have a benefit confirmed through data and scientific studies.
Mathematics and Environmental Education: contributions to critical and sustainable education
This article investigates how the integration of Mathematics and Environmental Education can contribute to the critical development of students, raising their awareness of socio-environmental issues through contextualized activities. This article presents an empirical study conducted in elementary school classes, applying teaching sequences that connect mathematical concepts (statistics, proportionality, modeling) to local environmental issues (water use, waste, consumption). The qualitative and quantitative analysis reveals advances in students' understanding of environmental relationships, as well as challenges and limitations in teacher and institutional engagement. It concludes that the articulation between these two areas is promising for emancipatory educational processes, although it requires adequate teacher training and institutional support.
Importance of efficient triage in emergency and urgent care services for optimizing patient care
Emergency and urgent care services are essential within the healthcare system, serving as the entry point for patients at immediate risk or with acute conditions requiring rapid intervention. These services face high demand, a diversity of clinical severity, and unpredictability in patient arrivals, creating challenges in care prioritization, organization of care flow, and efficient resource use. Objective: To understand the importance of efficient triage in emergency and urgent care services and its impact on optimizing care, patient safety, and resource utilization. Methodology: An integrative literature review was conducted, gathering evidence from quantitative and qualitative research, systematic reviews, and experience reports. The search included PubMed, Scopus, Web of Science, SciELO, and LILACS databases, using the descriptors “Triage,” “Emergency Services,” “Patient Safety,” and “Waiting Time,” considering publications from 2018 to 2025 in Portuguese, English, or Spanish. Results: Efficient triage reduces waiting times for severe cases, improves patient flow predictability, supports time-sensitive interventions, and optimizes resource use.Discussion: Accuracy depends on continuous staff training, use of standardized protocols, and adequate structural resources, such as assessment equipment and computerized decision-support systems. Conclusion: Structured triage is essential to optimize care, ensure safety, reduce waiting times, and improve resource utilization, positively impacting clinical and organizational outcomes.
Patrícia Sarmento Cunha Cavalcanti Monteiro