EsSEx: Revista Científica

7-14

Authors: Guilherme Fernandes Loures, Mariano Craveiro de Oliveira

Despite technical-scientific advances in rehabilitation therapy in dentistry, health education and preventive measures are still the most valuable tools in the control of periodontal disease and tooth decay. Recognition of the collective health of a given group, which is the target of some assistance plan or preventive measure, demonstrates the forecast of future expenditure on therapeutic treatments for this group and the effectiveness of that group, elucidating the importance of epidemiological surveys. This study aimed to analyze, through the collective epidemiological profile of students from the 2021 Army Health School Officers’ Training Course, therapeutic demands and preventive measures to avoid absences from the work environment of these new soldiers. For this, a descriptive structured qualitative applied research was carried out through an online questionnaire on the google forms platform. After the period established for answering the questionnaire, it was found that the largest number is physicians (80.2%) and the smallest number of veterinarians (2.5%). Most are at 31 (17.3%) and 30 years (16.0%). The states of Rio de Janeiro with 23.5% and Minas Gerais with 22.2% lead among the natives of students. Preventive dentistry is the greatest need reported by the military, with 55.6% of the answers in relation to self-perceived need for dental treatment, and the main prior guidance received by a professional in the area (42.0%). Given this analysis, it can be concluded that the various demands of the military will be met by the Army’s assistance plan, 75.3% of respondents are interested in FUSEX care and, probably in the next year, whether in the therapeutic modality or educational activity. Therefore, will bring costs and temporary removal of some specific military personnel.

24-31

Authors: Joyce Cristina Chevi da Rocha, Mariano Craveiro de Oliveira

Dental mobile units are dental offices structured in vehicles adapted and equipped for the development of oral care actions, offering dental services to populations in places that have greater difficulty in accessing health services. In order for the required complexity of some procedures to be met and for the number of appointments to be increased, the acquisition of a mobile dental unit by the Brazilian Army would be of great value, as in addition to increasing the number of dental appointments in campaign exercises and giving conditions to carry out complex procedures, the service would be less costly to the Union and with greater operational capacity. Therefore, the objective of this work is to identify and describe the procedures performed within the mobile dental unit, create a list of these procedures and point out the most common care. A literature review of articles, ordinances that regulate campaign exercises and statistical data provided by the Air Force Health Board was carried out. It was possible to conclude that mobile dental units are instruments of great value for care in remote areas, enabling treatment and prevention.

43-52

Authors: Ingrid Souza Reis Santos, Claudio Russio de Oliveira

Process auditing is currently a topic of growing relevance in the literature. In the Brazilian Army's health auditing services, auditing is an activity of the Military Health Organization (WHO) whose objective is, among others, to optimize financial resources, increase service performance, improve operational processes hospital and mainly to increase the level of customer satisfaction. Therefore,the possibility of improving services for greater efficiency is useful. Thus, in order to improve health services and practices, studies are needed that combine process auditing with health services. This work aims to present the application and benefits of auditing processes in organizations/com panies, and analyze its applicability and benefits in health audit services in Military Organizations (OM). This is a literature review study, having as source of reference books, articles and electronic publications on the subject analyzed, limited to publications in the period 2006-2021. Process auditing is a type of quality audit and is built on a systematic and independent analysis of the activities that make up the work processes. Divided into three stages, planning, execution and monitoring, it is a continuous contributor to the improvement of processes and consequently of quality, not only being a tool for detecting failures, but also, when executed in its perfect conformity, it is beyond a reactive methodology. With a view to the evolution and improvement of management, the Brazilian Army, in recent years, has been striving to modernize the health audit and inspection sector. The implementation of process auditing in the army’s health audit system can bring several benefits to the system. As an important improvement tool for something that already exists, process auditing adds value to what is already being audited by identifying the characteristics of the process, requiring strict compliance with what is foreseen and thus providing more quality to the final product. Avoiding the continuity of failures and inhibiting the emergence of other errors that affect the final product that reaches the user, it favors a higher quality of care, with less costs and greater productivity both in the audit sector and in the sectors audited from the process

64-77

Authors: Betania Amim Rubim, Claudia de Andrade Medeiros

Blood transfusion saves thousands of lives worldwide. However, to acquire a blood bag, the candidate for donation must undergo a questionnaire, clinical and hematological screening, for subsequent collection from the blood unit. In this collection, blood samples are taken in order to perform serological tests for HIV, HBV, HCV, HTLV, syphilis and Chagas disease. Objectives: To identify the epidemiological profile of IBEx blood donors. Methods: This is a retrospective study with a quantitative approach, using the HEMOVIDA system for data collection. A total of 14,732 blood bags collected at IBEx were evaluated in the period from 2015 to 2020. For data analysis, tables and graphs with absolute values and percentages were created. Results: There were 92.96% suitable donors in the serological screening and 7.03% unsuitable, with reactivity for syphilis representing 50.04% of serological unsuitability, 25.16% for Anti-HBc, 8% for Chagas disease, 7.13% for HIV, 4.33% for HTLV, 2.98% for HbsAg and 2.31% for Anti-HCV. The data found were compared with those obtained by the State Hemorrede of the state of Rio de Janeiro. Observing the epidemiological profile of IBEx blood donors, it is essential to implement continuous sexual education campaigns with the aim of improving the quality of blood offered to the military family, as well as minimizing the discard of blood. Conclusion: The present study demonstrated a high rate of serological incapacity, making it necessary to raise awareness for the act of blood donation based on campaigns that encourage individuals about the essential conditions, thus promoting the reduction of incapacity of donors.

91-103

Authors: Gabriel Ferreira Cid, Gabriel Lobo Ferreira

During the years 1914 and 1918, the global conflict known as the Great War or the First World War took place. Due to the naval blockade, the underwater campaign against neutral nations and the subsequent attack on Brazilian ships by the German government, Brazil made war on the Central Empires, being the only South American country to take part in the confrontation. The entry into the country took place in 1918, with an emphasis on the participation by sendind a medical mission to France. The Military Medical Mission was perhaps Brazil’s greatest contribution on the conflict, having as its main purposes the foundation and mobilization of a hospital in city of Paris. The Franco-Brasileiro Hospital was of fundamental importance, as it provided support to allied health services, acting with great proeminence in assisting the wounded in combat and patients affected by the Spanish flu epidemic.

7-14

Authors: Eliane Schaeffer, Liuhan Oliveira de Miranda, Diogo de Souza Leão da Rocha Pereira

Major Depressive Disorder (MDD) is a common mental health disorder in the Brazilian Army (BA), where most of its members are healthy, young and fit men. In order to enable a better diagnosis and treatment of MDD in the military, predictive models (PM) were created in other countries, which currently do not exist in BA. This article aims to propose, for the first time, a predictive model of this pathology aimed specifically at the population group of military personnel in the BA. A systematic review was carried out based on the databases: Pubmed, LILACS and BDEX, where the search words: 'depression', 'military' and 'mental health' were used. A total of 190 articles were selected, among which 12 were chosen for the review composition after applying the inclusion and exclusion criteria. The presence of two large international MPs (the STARRS-LS and Finnegan et al.) Was observed, which serve as a theoretical basis for the structuring of our MP, plus 3 articles belonging to the Brazilian army and allies on the Brazilian terrestrial border

25-34

Authors: Nivaldo Chirindza, Lucilia Mangona

Since the beginning of the outbreak of COVID-19, Mozambique, according to MISAU (2020), has registered 18 265 positive cases, 16 119 recovered and 161 dead, as well as some infection cases in the military. Officially, the first case was registered on March 22, 2020. The aim of this study was to evaluate the knowledge and practices of the military in relation to COVID-19. To this end, a questionnaire was conducted with questions about knowledge in relation to the good prevention practices of COVID-19, with a sample of 162 military personnel, at the Army Command-Mozambique. The display of a high level of knowledge about COVID-19. A little more than half tends to practices consistent with the prevention of contamination and / or the spread of infection by Covid-19. Such data obtained that health education interventions should be directed to this population segment, in particular, especially with regard to practices, since, an increased number of demonstrations have deviant practices in relation to the COVID-19 prevention measures recommended by health entities.

45-51

Authors: Gisele de Sá Mascarenhas, Otavio Augusto Brioschi Soares

Cholera is a serious public health problem in Haiti, introduced after the arrival of Nepalese soldiers on a peacekeeping mission by the United Nations (UN). This paper studies the cholera outbreak in Haiti in 2010 associated with the UN peacekeeping mission in Haiti; seeks to understand the origins and consequences of this outbreak, with emphasis on the socioeconomic and health determinants related to the spread of cholera; and describes, according to the UN protocols, how the preparation of a peace mission must take place so that situations of disease dispersal do not occur. The research was a historical bibliographic review, with its sources searched in reference bases of medical, military literature, newspapers and magazines of journalistic and historical content. The literature review identifies that the cholera outbreak was caused by the union of the country's poor sanitary infrastructure with the lack of care for human waste from the UN mission's Nepalese soldiers' camp, with catastrophic consequences for the local population; highlights the importance of preparing a peace mission to prevent the occurrence and spread of epidemics and the role of hygiene measures, antibiotic prophylaxis and the use of vaccines for the same purpose

61-74

Authors: Audrey Cristiane Alves Costa, Diego Huk Carlin, Suzelaine Taize Stadler

Hearing loss may be aggravated by exposure to occupational noise. Therefore, there is relevance for a reliable auditory evaluation in the incorporation of conscripts in the mandatory military service, since, during this training period, the activities are intense, with the purpose of training a trained military, being possible the optional stay of the soldiers. conscript for another seven years in the professional staff. That said, this research focuses on discussing the methods and parameters used in the auditory assessment of conscripts for compulsory military service, comparing with the civilian scope, governed by the Regulatory Norms of the Ministry of Labor Ordinance. As well as, identify the audiological evaluation criteria contained in the General Instructions for the Health Inspection of Conscripts in the Armed Forces (IGISC) and the Technical Norms for the Selection Commissions (EB30-N-30.004), these standards being used as parameters in the complementary selection. When faced with the norms used in the complementary selection, there was a significant distortion between the evaluation methods compared to the civil sphere, which is more precise and reliable. It is also noteworthy, the importance of auditory control both in the recruitment made in the complementary selection and in the annual (re) engagement of the temporary military. For the solution of the problem presented in this research, it is evident how favorable it is to increase the number of vacancies for the incorporation of professionals in the field of Speech Therapy, composing the health squads.

8-18

Authors: Otavio Augusto Brioschi Soares, Pedro Ivo da Silveira Santos

The Operational Medicine of the Brazilian Army, within the scope of the Parachute Infantry Brigade, has undergone a change in the protocols and modus operand in the activities developed by the Parachutist Health Detachment and by the Parachutist Logistics Health Company over the last three years. from the Paratrooper Logistic Battalion, which are the units responsible for this health support in the units of this Brigade. This growing update was necessary in the pre-Federal intervention period that took place in 2018, when the Paratrooper Infantry Brigade went to work with the federal, municipal and state bodies of Rio de Janeiro as a guarantee of law and order in the state of Rio de Janeiro and the operational health experienced in all missions in support of this brigade’s infantry battalions. In 2017, a new Logistics Manual was created, in which the Logistics Health Logistics Battalion Companies were extinguished, but in 2018, due to the particularities necessary for health support, the Parachutist units resumed their activities within the Logistics Battalion of the logistics company. only doctrinally with other characteristics. Along with these processes, the doctrine of Health Battalions is already in force, where each Military Area Command will have its Health Battalion and it will be responsible for the missions that may arise within the scope of this great command. meet the demands of the Brigade of Infantry Parachutists health elements must be able to this specialty then taking advantage of the proposal to terminate the Logistics Health Company Blog and the new proposal of the Health Battalion we studied this proposal, to extinguish the company Blog health logistics and the health elements of that company integrate the health detachment, following the methodology of FAMES and DOAMEPI, optimizing the management of personnel and health material with all its complexity and ultimately optimizing the performance of health operators within of the Parachute Infantry Brigade.

27-33

Authors: Bruno Ribeiro Guimarães, Raphael Teixeira Moreira, Miriam Kemper

Facial trauma in the warzone is an important factor of functional and aesthetic disability. Due to it’s position in the body and lack of proper protective equipment the face is a common area of this type of lesion. The pattern of these lesions have followed the change of it’s etiology during the last years. Therefore it’s important to identify the type of weapon employed and the prevention and optimal treatment of these types of lesions. The aim of this study is identify the incidence and etiology of these type of lesions trough an integrative literature review. Scientific database (PUBMED, Scieloe ScienceDirect) were used following the analysis of related papers. Based on the current data we may conclude that oral and maxillofacial lesions have a relevant incience and it’s major etiology are shrapnel/explosives. Therefore the oral and maxillofacial surgeon plays an important role in the context of operational health support.

46-60

Authors: Leandro Barbosa Torres dos Santos, Thiago Rabello Santos, Flávio Roberto Campos Maia

The aim of the present work was to unveil the impact of the training of military personnel in the pre-hospital care line, on the survival of the injured military. A systematic review of the topic was carried out in the literature, using the Virtual Health Library (VHL), Lilacs, Scielo, Medline (Pubmed), Cochrane Database of Systematic Reviews, Health Evidence and EBUSCA (Brazilian Army libraries) databases, in addition to the Google Scholar (gray literature). It was evidenced in the review that there are, even in Brazil, several medical entities specialized in tactical APH, some formed even by ex-combatants from other countries or military personnel who acted with the need for special first aid techniques, with specialization courses that they serve security companies, public agencies and the interested public in order to spread the TCCC mentality in the current scenario, showing that there is no lack of sources for the formation of such a doctrine in the Brazilian Army. The PHC is primary care for victims of trauma and clinical disorders, recommended in several countries and in Brazil. The clinical reasons for assistance during the actions carried out by the APH teams, in the military environment, are certainly not usual, due to the potential health of the military, which must be taken into account in the health of their personnel. It was also observed, the fact that the army consists of younger soldiers with unique physical strength to carry out the missions. Trauma, as well as clinical causes, is minimized by training the troops, and faithfully implementing safety regulations and standards in military activities, thereby preventing the occurrence of adverse events. Thus, the training of military personnel in the war line is of paramount importance for the effective implementation of the APH within the scope of the Brazilian Army. This aspect also allows for a more fluid system and relieves service in some more specialized sectors. From this perspective, another factor to be considered is the complexity of the training of the APH teams, requiring specialized technical knowledge for their execution, and also the provision of equipment (ambulances, supplies, etc.) for the execution of the missions, which must be of great importance for APH to be efficient in EB.

72-89

Authors: Mickaela Fischer Silva, Paula Sá, Otavio Augusto Brioschi Soares

Maintaining the health of the military personnel in the various scenarios is crucial to guarantee that troops will be in full condition for action. This force health protection encompasses several areas. However, in this study, they were listed on five main axes: disease and zoonosis control, waste management and management of synanthropic animals, immunization and chemoprophylaxis, water and food protection and health intelligence. The present study was based on the application of questionnaires among specialists, with the goal to contribute to the formulation of approaches for the training and development of force health protection skills in the scenarios of military campaign operations. For this, electronic questionnaires were produced, then answered by specialists in the relevant areas, on these five axes. Overall, it were discussed 46 tasks that would be fundamental to develop this aspect of health protection, 10 doctrinal points to follow, and some other activities that should be carried out at the operational and strategic levels for training and development of a preventive culture. The importance of such actions is evident in the high rate of losses and deaths due to preventable infectious diseases during military operations throughout history. It is essential that consistent policies and strategies are developed for the health protection of the military personnel.

5-23

Authors: Nádia Vaez Gonçalves da Cruz, Clarissa R. Damaso

The eradication of smallpox is considered one of the greatest achievements of mankind that was achieved in 1980 thanks to the use of one of the most potent vaccine ever developed. However, in the present global scenario, variola virus is considered a potential threat that can be used as a biological weapon for bioterrorism purposes. Advances in biotechnology, lack of immunity in much of the world population, restricted vaccine stocks, and the risk that hidden stocks of the virus still exist are the main reasons that would allow the disease to return. The present review covers several historical, epidemiological,and clinical aspects of smallpox and itseradication, but mainly it discusses measures for containment and prevention of smallpox used in the past and those currently available, as well as the worldwide efforts to prevent smallpox from returning and haunt the human race again.

35-40

Authors: Nastassja S. Mendes de Souza, Antonio Manne Filho

The present study aims to describe the functioning and importance of medical intelligence in support of military operations. A literature review on the subject was carried out from 1982 to the present day. The medical intelligence service is used to obtain knowledge and aims at formulating strategies for the prevention of diseases and health-related constraints. In 1941, during the period of the Second World War, it was initiated and applied through bulletins with health information. In the period leading up to its creation, large epidemics, poor sanitary conditions and adverse weather conditions lead to large casualties on the battlefields. In conclusion, technological improvements, vaccine discoveries and new preventive measures have been of great importance in the development of health intelligence and are determinant in maintaining the integrity of the troop and fulfillment of the mission.

57-73

Authors: João Gilberto de Sá de Jesus, Cláudia de Almeida Guaranha Guaranha

Introduction: Dysentery results from the evolution of a diarrheal syndrome, which has a multifactorial etiology. However, in many cases, dysentery may be due to a poor early diagnosis, which is usually quite simple, causing late treatment, providing the military with a clinical picture. much more exuberant and even serious, causing several casualties in the PRPO and even earlier, compromising the entire operation. Objectives: To stimulate the implementation of protocols that provide an effective, fast, simple and early diagnosis of military personnel with diarrhea complaints or already starting clinical presentation of dysenteric syndrome, promoting their screening, so that we can establish which ones can remain in the Line. Contact Zone (combat zone) and those to be removed / evacuated to the interior zone (Campaign Hospitals and General Hospitals), thus allowing a control of medical expenses by the combatant force employed. Development: Understand what are the initial changes in a military man with a complaint of diarrhea, who will seek care both pre, but mainly per operational, so that there is an early and efficient treatment for it, avoiding that the military gets sick in whatever way it takes. to be evacuated to higher levels as well as to prevent infection of other military personnel in the area of operation, leading to significant casualties, even before action on the target. Understanding what is a diarrhea and dysenteric syndrome, what are the main microorganisms involved bringing this information to the missions of EB. Conclusion: Promotion of pre-operative educational lectures on the symptoms for the staff to be employed, teaching the military in the Combat Zone symptomatic initial self-treatment measures, medical intelligence on local epidemiology and hygiene and operational ration to be adopted, determination of Symptom severity, with simple stool analysis as well as vital signs, can prevent major damage to the treasury for the health system of the force, maintaining the full operability of the troops

5-12

Authors: Marina Lannes Vieira

Cancer is a highly lethal disease whose incidence has been increasing in recent years.Radiation Therapy consists in the use of ionizing radiation produced by linear accelerators or emitted by natural or artificial isotopes for therapeutic purpose and is one of the three pillars of modern cancer treatment. Intensity modulated radiation therapy (IMRT) represent one of the greatest advances in Radiotherapy history. This technique modulates beam intensity and permit that prescription dose reach the target, sparring normal tissue, leading to fewer collateral effects and in some cases better local control. Central Army Hospital, seeking to fit in this context, acquires a new linac in 29 Th June of 2016, and in June of 2017 the first patient was treated with IMRT. The objective of this work is to describe all the cases treated with IMRT until April of 2018 and make a bibliography review about this technique.

29-35

Authors: Tainá Silva Vallim Moreira

Burnout Syndrome and occupational stress have a significant impact on workers when physical, cognitive and psychological demands exceed their abilities to cope with them, which is now a public health problem due to the negative impact that health and performance of the worker. Thus, this study is presented with the purpose of investigating the presence of these disorders specifically in the professional category of the military of the Brazilian Army, through a survey of the casuistry of occupational stress in this population in the current literature, dimensioning the physical, psychic and social impact of the disease. This study intends to bring to the discussion the aspects inherent to the military profession that can be considered as risk factors or worse ning of occupational stress and Burnout Syndrome, if it is feasible to minimize these triggering factors, how it is possible to perform the early diagnosis and then offer treatment. Bringing these aspects to the discussion it is possible to propose and encourage the inclusion of protocols for the investigation of occupational disorders in the regular health inspections to which the military of the Brazilian Army are submitted

52-68

Authors: Tatiane de Souza Pinto

The military carries out various physical and mental activities with potential health risks. Exercise related myopathies are very common in sports practice, and these are mainly caused by bruises and excessive muscle forces, making it necessary and essential to know about these injuries in order to improve the muscle regeneration process and preventive measures. Objectives: To evaluate clinical, laboratory, therapeutic and preventive aspects of exercise induced myopathy. A bibliographic review of articles indexed in the electronic databases of the National Library of Medicine and the National Institutes of Health (PubMed) and the Virtual Health Library (VHL), using references from Latin American and Caribbean Literature Health (LILACS). In addition, an evaluation of the bibliographic references of the selected articles was carried out to identify other potentially relevant studies. The descriptors were obtained from the DeCS and MeSH (Descriptors in Health Sciences and Medical Subject Headings, respectively),and the selection of studies was restricted to articles in humans. The enzymes creatine kinase (CK) and lactate dehydrogenase (LDH) are useful as muscle injury markers for the evaluation of exercise intensity. In the acute phase, immediate treatment for s keletal muscle injury is known as the PRICE (Protection, Rest, Ice, Compression and Elevation) principle. The postacute treatment consists of physiotherapy and specific muscle training. The optimal nutritional intake pre and post exercise is important to assist in the repair and reconditioning of muscle damage. The decision to return to specific training after injury should be based on the ability to stretch the injured muscle as much as the contralateral healthy side, and absence of pain in the injured muscle in basic movements.