Thiago Dal Bosco

Our published study in the São Paulo Medical Journal (Associação Paulista de Medicina) evidences the profound disruptions caused by COVID-19 to Brazil's public health system. We analyzed data from 2019 to 2020 and uncovered stark declines in hospitalizations, primary care, and immunization coverage. Here’s what we found: - Hospitalizations fell by 13.7%, with elective procedures experiencing a steep decline of 34.3%. This reduction was most significant among indigenous people (16.1%) and in the Northeastern region (15.6%). - All-cause mortality increased by 30.6%, with even higher rates in the North (+44.6%) and among indigenous populations (+49.7%). Deaths from infectious and parasitic diseases alone increased by nearly 40%. - Healthcare funding saw a massive reduction in hospital support (-82%), despite overall spending on healthcare rising due to administrative costs. - Spending on critical services like hospital care, primary care, and epidemiological surveillance declined. - Immunization rates dropped from 73.4% to 66.6%, and the capacity for chronic disease management remained inadequate. Why does this matter?  These findings reveal the exacerbation of longstanding healthcare disparities during the pandemic, particularly affecting marginalized communities. The reduction in essential services and the surge in mortality highlight the need for urgent government action to address gaps in healthcare provision and social safety nets. It is crucial for Brazil's leadership to take decisive actions to rebuild and strengthen the healthcare system. Our findings underscore the need for strategic investments in essential healthcare services to address the alarming rise in mortality and the decline in access to care. Now is the time for government representatives to lead the charge in creating policies that ensure equitable healthcare for all. To support this cause, let’s bring this message to those who can make a difference: Marcelo Queiroga, Nísia Trindade Lima, and others. #PublicHealth #COVID19 #HealthcareInequality #BrazilHealth #GovernmentPolicy #HealthEquity #Immunization #PandemicResponse #IndigenousHealth #MortalityRates

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Read more (https://brnw.ch/21wJM1b) about how CAP Accreditation is demonstrable investment and supports ongoing educational, financial, and marketing objectives, including: - Preserving quality controls as Einstein laboratories scale-up - Educating laboratory managers and staff about new methodologies - Differentiating Einstein laboratories from the competition Integration of CAP accreditation supports growth, and by all measures, allowed Einstein to extend its benefits to thousands of more patients. While long recognized as the best hospital in Latin America, Forbes recently cited Einstein in their twenty “The Best Hospitals in the World” list and Newsweek ranked it 36th in its 2021“World Best Hospitals” survey.

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🎓 Proud to mentor Brazilian nursing and medicine students in their undergraduate dissertation projects! Today, one of these projects—an integrative literature review titled "Health Technologies for Tackling Client Absenteeism in Primary and Secondary Care Services"—was published in the Journal of Evaluation in Clinical Practice. https://lnkd.in/gCnxndsS 📌 Key Highlights from the paper: 🇧🇷 Brazil leads globally in studies on mobile applications addressing missed appointments in primary and secondary care settings, followed by the USA. 📱 Mobile applications have shown promising results in reducing client absenteeism in primary and secondary care settings. 🔧 Applications that boast managerial, educational, and assistive features help to not only reduce absenteeism but also promote client health literacy and engagement with healthcare. 🎓 By integrating mobile technology-related teaching into health education, healthcare services can ensure clients effectively navigate and utilize healthcare technologies. 🤝 Community-based participatory study approaches in creating mobile technologies can mitigate potential barriers to adoption, crucial for the successful implementation and efficacy of these applications. 🌍 This study has significant implications for Brazil's Universal Health System and other global health systems in designing policies to incorporate technological advancements to improve primary and secondary care services.

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Troca do Strain Relief ✅ #transdutores #transdutor #clinicaporimagem #clinicasultrasonografia #ultrassom #setordeimagem #engenhariaclínicaehospitalar

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Troca do Strain Relief ✅ #transdutores #transdutor #clinicaporimagem #clinicasultrasonografia #ultrassom #setordeimagem #engenhariaclínicaehospitalar

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Innovative Medication for Resistant Depression and Suicidal Ideation: HEOR Analysis From the Perspective of LMIC/Brazil/LATAM OBJECTIVES: In the context of real-world data on suicide numbers/ cases, we study the chance of a possible decrease in suicide ideation rates, based on scientific data and informations from a promising innovation (esketamine) clinical end point. METHODS: From database of the Notifiable Diseases Information System (SINAN) & Suicide data from the Mortality Information System (SIM) of the year 2022. A total of 496,583 cases of suicide from 2019 to 2022 in Brazilian scenario and a suicide attempt due to exogenous intoxication a subtotal of 4,259 cases, in one specific State (Pernambuco). Data from international literature showing esketamine intranasal and antidepressant treatment decreased: the risk of relapse by 51% (Hazard Ratio [HR], 0.49; 95% ci, 0.29-0.84) among patients who achieved stable remission, and 70% (HR, 0.30; 95% ci, 0.16-0.55) among those who achieved stable response compared to treatment with antidepressants and placebo. RESULTS: We speculate that 51% (Hazard Ratio [HR] of 496,583 CASES, means that esketamine and antidepressant treatment decreased the risk of relapse to avoidance risk of suicidal ideation in 253.257 cases. The 2,172 / 4,259 cases of attempted suicide reported in exogenous intoxication data, could contemplate the chances of rescue from “de novo" treatments and better clinical outcomes. CONCLUSIONS: For patients who have experienced remission or response after treatment with esketamine, there is a chance to resume a new treatment protocol in order to avoid loss of life or loss of productivity in cases of sequelae/suicide attempt. However, lengthy follow-up is needed in order to answer to this, with regard to economic impact and other outcomes.

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2Sport Science helps in performance pathophysiology to find your goals in a clear sport.

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🏥 do Nascimento IJ, Abdulazeem HM, Vasanthan LT, Martinez EZ, Zucoloto ML, Østengaard L, Azzopardi-Muscat N, Zapata T, Novillo-Ortiz D. The global effect of digital health technologies on health workers’ competencies and health workplace: an umbrella review of systematic reviews and lexical-based and sentence-based meta-analysis. The Lancet Digital Health. 2023 Aug 1;5(8):e534-44. URL: https://lnkd.in/gT2qFMgx This umbrella review has unveiled the significant impact of digital health technologies (DHTs) on healthcare workers and their environment. As a dental professional, here's what you need to know: Key Findings: 🚀 Enhanced clinical performance and decision-making 📈 Improved care delivery and management 🤝 Better interprofessional communication 😊 High satisfaction among healthcare workers Implications: 1. For Workforce 👨‍🔬👩‍🔬: DHTs are empowering healthcare professionals, boosting efficiency and job satisfaction. 2. For Institutions 🏥: Potential cost savings, but need for standardized performance metrics. 3. For Dental Councils 🏛: Time to integrate DHT competencies into curricula and develop ethical guidelines. Key Learning Points: 💡 DHTs positively influence daily practice across various medical specialities 🌐 Telemedicine and mobile health technologies show promising results 🧠 AI and clinical decision support systems are enhancing diagnostic capabilities ⚖️ Balancing benefits with potential challenges is crucial Moving Forward: 🌍 More research is needed, especially in low/middle-income countries 📊 Standardize performance metrics ⚠️ Address potential negative consequences 🕰️ Investigate long-term effects on healthcare worker performance As dental professionals, we must embrace these technologies while ensuring their responsible implementation. How are you incorporating DHTs in your practice? #DigitalHealth #DentalInnovation #HealthcareTransformation #ProfessionalDevelopment

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Analysis of Journal of Cancer Therapy and Research: The text provided appears to be a comprehensive study or paper on palliative care and pain management for cancer patients in Brazil. The focus is on the integration of palliative care in the treatment of terminally ill cancer patients, highlighting the importance of a multidisciplinary approach to manage symptoms, particularly pain, and improve the quality of life. ### Key Elements of the Content: 1. **Introduction**: - Highlights the significance of cancer as a leading cause of death in Brazil. - Discusses the importance of cancer control, including prevention, early detection, diagnosis, treatment, and palliative care. - Emphasizes the impact of an aging population on cancer incidence and the role of palliative care in managing advanced and terminal stages of the disease. 2. **Palliative Care Overview**: - Defines palliative care and its objectives, such as symptom control, emotional support, and enhancing the quality of life. - Describes the multidisciplinary nature of palliative care teams and the importance of early integration into cancer care. - Highlights studies and guidelines that support the integration of palliative care early in the treatment process. 3. **Pain Management in Palliative Care**: - Describes pain as a multifaceted experience influenced by biological, emotional, social, and cultural factors. - Discusses "total pain" in terminal cancer patients, encompassing physical, spiritual, social, and emotional dimensions. - Outlines the use of opioids and other medications for pain relief, emphasizing individualized treatment plans and the management of side effects. 4. **Terminal Illness and Ethical Considerations**: - Discusses the concept of terminal illness and the ethical considerations in providing care focused on comfort rather than cure. - Emphasizes the importance of respecting patient autonomy and providing a "good death." 5. **Conclusion**: - Reinforces the importance of maintaining patient dignity and comfort in the final stages of life. - Calls for a holistic approach that goes beyond technical medical care to include empathy and support for the patient's emotional and spiritual needs. ### Summary The paper underscores the complexity and necessity of palliative care in managing terminal cancer patients. It emphasizes the need for comprehensive care that addresses not only physical symptoms but also the emotional, social, and spiritual aspects of suffering. The importance of communication, family support, and ethical considerations in the care of terminally ill patients is highlighted, alongside the critical role of healthcare professionals in providing compassionate and effective care.

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The meaning in loss protocol: A clinical trial of online grief therapy Batista, J., Alves, D., Pires, N., Silva, J. R., Mendes, I., Magalhães, C., … Neimeyer, R. A. (2024). The meaning in loss protocol: A clinical trial of online grief therapy. Death Studies, 1–13. https://lnkd.in/eMRnugvP

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#CGM Diabetol Metab Syndr. 2023 Nov 25;15(1):242. doi: 10.1186/s13098-023-01208-5. Cost-effectiveness of continuous glucose monitoring with FreeStyle Libre® in Brazilian insulin-treated patients with types 1 and 2 diabetes mellitus Luciana Bahia 1, Karla F Mello 2, Lívia Lovato Pires Lemos 3, Naiane Lima Costa 3, Eduardo Mulinari 3, Domingos A Malerbi 2 Affiliations expand PMID: 38001509 PMCID: PMC10675900 DOI: 10.1186/s13098-023-01208-5 " a cost difference of R$ 7290, and an ICER of R$ 39,692.67 per QALY gained, in favour of CGM with FSL." #costeffectiveness for the win

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Aging population and Health Tech accessibility. Since we moved to Germany, I have been a frequent visitor to Brazil. The current trip has offered me a firsthand glance at Brazil's current state. The country, resilient as ever, is on a path to recovery, yet the journey ahead remains extensive. Amidst the visible progress, such as new infrastructural developments, concerns like public safety stand out, signaling areas demanding attention (not new, is it?). Conversations with clever business leaders (and friends) revealed parallel discussions on two fronts, both pivotal and converging for the future: (1) The accessibility of new health technologies stresses the importance of incorporating a holistic approach to patient care, paying attention to health tech and new business models (am I making people tired of me talking about it?). A diabetic patient is not a nutrition, endocrinologic, glucose monitoring, GLP1, or wound care patient only. They are all of those or, better, a cardiometabolic user, patient, consumer... etc. (2) Besides the always unmet need for new infrastructure, Brazil is experiencing rapid growth in demand for aging tech. This demand is authentic and challenging, as may be observed in other Latin American countries. Living between Frankfurt and Monaco this year has given me a dual perspective, especially regarding how societies engage with their elderly populations. Sundays in Germany were initially a culture shock with their closed businesses. Still, they gradually unveiled their charm by seeing elderly individuals actively participate in public life, whether cycling or utilizing city amenities (especially in the early years when our family lived in Rheiland-Pfalz). Although both regions are making strides toward accommodating the needs of their aging citizens, the journey toward total inclusivity and support is ongoing. However, in Santos, my hometown, I experienced a profound sense of delight today. The city's elderly demographic is rapidly approaching 20% of the population, showcasing an inspiring scene along the beachside. Active elders, grandpas, and grandmas intertwined with the energy of a KA'A competition (Polynesian canoeing)—including a category for individuals over 80. Isn't it amazing? Such moments remind us of our societies' potential to foster environments where everyone, regardless of age, can thrive. As I reflect on these observations, conversations about healthcare accessibility, the importance of holistic patient views, and the vital need for innovative approaches to support our elderly population resonate deeply, inspiring thoughts on what more we can achieve. #Brazil #longevity #PublicSafety #Infrastructure #HealthTech #ElderlyCare #ActiveAging #Santos #Innovation

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“Mari, I'm so discouraged with dentistry..." I receive at least three similar messages a week. At no time do I support quitting or encourage the weakening of the profession. I believe that dentistry in Brazil is going through a phase of growth and evolution, which can indeed bring different perspectives (including negative ones, obviously). On one hand, the field of dentistry generates around R$ 38 billion per year and is among the most profitable professions, with more than 400,000 professionals working. This makes Brazil the country with the highest number of dentists in the world, with an average of one dentist for every 503 inhabitants (Economia | O Dia; BuyCo). On the other hand, this high concentration of professionals can generate a sense of fatigue and perception of saturation, as my colleagues report daily. However, we cannot overlook the growth in the aesthetic sector, which is booming with a projected compound annual growth rate of 13% until 2030. Additionally, digital dentistry is bringing new opportunities and ways of working that do not necessarily involve "sitting in the dental chair" (If this is a problem for you, address it in therapy. For me, it never was, lol). While some areas may seem saturated, there are niches and regions with high demand for dental services. Honestly, I believe that the key is to seek specialization, invest in education, and innovate to stand out in the market. I am proud to say that I have never been a conventional dentist. Throughout my career, I have been exploring the opportunities that my profession can offer, from classic clinical care to surgical centers, corporate environments, scientific research, education, consulting, and the digital market. Believe me, dentistry surprises me more each day, whether in digital or in-person settings. In dental planning, I am always discovering new opportunities and possibilities. To stand out, it is essential to seek, innovate, specialize, constantly study, and above all, recognize that things do not happen overnight. I see careers consolidating over at least 7 to 10 years. I even feel privileged to be experiencing so many different aspects, which has greatly contributed to my professional growth. My advice is: BE CREATIVE, perseverant, read, sell, study, and do not get discouraged by the "no's." Do not give up. If today didn't work out, if today you didn't have patients, if today your work wasn't delivered, or if you didn't achieve the desired goal, do not get demotivated. Focus on your own growth and continue your process of evolution. If it is difficult, it means you are on the right path. Avoid the obvious! Dentists, I believe in the success and prosperity of our profession!

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🎉 Exciting news for Brazil! 🇧🇷 The unveiling of Brazil's first national dementia plan marks a significant step forward in addressing the needs of those affected by this condition. As a psychologist, I'm thrilled to see a comprehensive strategy in place to provide support, resources, and awareness. Let's work together to ensure a brighter future for individuals and families impacted by dementia. #Dementia #BrazilHealthcare #MentalHealthMatters 🧠💙

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Analyzing the reach of public health campaigns based on multidimensional aspects: the case of the syphilis epidemic in Brazil

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Exploring the Impact of Psychological Stress on Cardiovascular Risk in Women from Brazilian Communities Text: 🧠❤️ Psychological stress is an underestimated yet powerful factor in the development of cardiovascular diseases. In a recent cross-sectional study, we analysed how everyday pressures are affecting the heart health of women in Brazilian communities. 🌍 Our study reveals alarming data on the correlation between high levels of stress and increased cardiovascular risk, highlighting the urgent need for targeted interventions. 🔍 Read our article to discover: - The methodology employed to assess psychological stress and cardiovascular risk. - The key findings and their implications for public health. - Recommendations for policies and clinical practices aimed at mitigating these risks. Conclusion: Awareness and action are essential to protect the health of women in our society. Join us on this journey of knowledge and innovation in cardiovascular health. Henrique A. Fonseca @João Italo Dias França Alvaro Avezum Maria Cristina Izar Luciano Drager João Fernando M Ferreira José Francisco Kerr Saraiva SOCESP - SOCIEDADE DE CARDIOLOGIA DO ESTADO DE SÃO PAULO #CardiovascularHealth #PublicHealth #WomenHealth #PsychologicalStress #HealthResearch #InnovationInHealth https://lnkd.in/d9n7NgAe

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