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DOMESTIC VIOLENCE AGAINST WOMEN: EXPERIENCES OF PRIMARY HEALTH CARE PROFESSIONALS WOMEN
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Rodrigues, Paula Sales

; Araujo, Laissa Figueredo

; Vernasque, Juliana Ribeiro da Silva

; Souza, Aline Pereira de

; Alarcon, Miriam Fernanda Sanches

; Higa, Elza de Fátima Ribeiro

; Marin, Maria José Sanches

Texto & Contexto - Enfermagem

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2024, Volume 33 elocation e20230403

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: analisar como os profissionais da Atenção Primária à Saúde vivenciam a violência doméstica contra as mulheres. Método: pesquisa Qualitativa, desenvolvida no período de janeiro a junho de 2023, por meio de entrevistas com 20 profissionais da Atenção Primária à Saúde, em um Município de Médio Porte do Interior Paulista. Os dados obtidos foram interpretados pela Técnica de Análise de Conteúdo, modalidade temática. Resultados: os profissionais enfatizam a necessidade de abordagem sensível e identificação precoce, expressando sentimentos de perplexidade e impotência durante o atendimento. Os impactos da violência são percebidos pelas vítimas, famílias e sociedade, causando consequências físicas, psicológicas e sociais. Os desafios incluem falta de capacitação, medo de represálias e carência de apoio institucional. As limitações enfrentadas pelas mulheres no confronto com a violência estão ligadas à falta de informação, dependência financeira e emocional, gerando medo e insegurança. Conclusão: os profissionais vivenciam a complexidade que representa o cuidado em saúde às mulheres vítimas de violência doméstica e, depreende-se que são necessários investimentos na capacitação dos profissionais, proteção institucional e criação de espaços, que possam acolher as mulheres, evitando assim a revitimização. Objetivo Método Qualitativa 2023 2 Paulista Conteúdo temática Resultados precoce atendimento sociedade físicas sociais informação emocional insegurança Conclusão depreendese depreende se espaços revitimização 202

ABSTRACT Objective: to analyze how Primary Health Care professionals experience domestic violence against women. Method: qualitative research, conducted from January to June 2023, through interviews with 20 Primary Health Care professionals, in a medium-sized municipality in the state of São Paulo, Brazil. The data obtained were interpreted using the Content Analysis Technique, thematic modality. Results: professionals emphasize the need for a sensitive approach and early identification, expressing feelings of perplexity and powerlessness during care. The impacts of violence are perceived by the victims, families, and society, causing physical, psychological, and social consequences. Challenges include lack of training, fear of reprisals, and lack of institutional support. The limitations faced by women in confronting violence are linked to lack of information, financial and emotional dependence, generating fear and insecurity. Conclusion: professionals experience the complexity of providing health care to women who are victims of domestic violence, and it is inferred that investments in professional training, institutional protection, and the creation of spaces that can support women are necessary to prevent re-victimization. Objective Method research 2023 2 mediumsized medium sized Paulo Brazil Technique modality Results identification families society physical psychological consequences training reprisals information dependence insecurity Conclusion protection revictimization. revictimization re victimization. victimization re-victimization 202

RESUMEN Objetivo: analizar cómo los profesionales de Atención Primaria de Salud viven la violencia doméstica contra las mujeres. Método: investigación cualitativa, desarrollada de enero a junio de 2023, a través de entrevistas a 20 profesionales de la Atención Primaria de Salud, en un Municipio Mediano del interior de São Paulo. Los datos obtenidos fueron interpretados mediante la Técnica de Análisis de Contenido, modalidad temática. Resultados: los profesionales enfatizan la necesidad de abordaje sensible e identificación temprana, expresando sentimientos de perplejidad e impotencia durante la prestación de cuidados. Los impactos de la violencia son percibidos por las víctimas, los familiares y la sociedad y provocan consecuencias físicas, psicológicas y sociales. Los desafíos incluyen la falta de capacitación, el miedo a represalias y la falta de apoyo institucional. Las limitaciones que afrontan las mujeres quando se enfrentan con la violencia están vinculadas a la falta de información y a la dependencia financiera y emocional, lo que genera miedo e inseguridad. Conclusión: los profesionales experimentan la complejidad que representa la atención de la salud para las mujeres víctimas de violencia doméstica advirtiéndose la necesidad de inversiones en formación profesional, protección institucional y creación de espacios que puedan acoger a las mujeres y evitar la revictimización. Objetivo Método cualitativa 2023 2 Paulo Contenido temática Resultados temprana cuidados físicas sociales capacitación emocional inseguridad Conclusión profesional revictimización 202

https://doi.org/10.1590/1980-265x-tce-2023-0403en

Segurança medicamentosa de pessoas idosas no contexto hospitalar: revisão de escopo hospitalar
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Silva, Adrya Thayanne Henriques da

; Marinho, Joselane Izaquiel

; Souza, Ana Elza da Silva

; Barrêto, Denize Miquele dos Santos

; Rodrigues, Maria Eduarda da Silva

; Carvalho, Mariana Albernaz Pinheiro de

Revista Brasileira de Geriatria e Gerontologia

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2024, Volume 27 elocation e240016

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo Identificar as evidências científicas disponíveis na literatura sobre segurança medicamentosa de pessoas idosas no contexto hospitalar. Método Trata-se de uma Revisão de escopo. Foram feitas buscas nas seguintes bases de dados: LILACS, SCIELO, MEDLINE, e PUBMED, sobre a temática segurança medicamentosa de pacientes idosos no contexto hospitalar. Utilizaram-se os descritores em saúde de acordo com o DECS: Segurança do paciente, idoso, medicamentos, hospital. Foram incluídos na pesquisa: artigos completos disponíveis na íntegra, com os idiomas português, inglês e espanhol. Excluídos artigos duplicados, teses e dissertações. Resultados A busca resultou 172 publicações. Após leitura dos títulos e resumos, oito artigos foram selecionados por se adequarem aos critérios de inclusão. A amostra final desta revisão de escopo totalizou oito estudos selecionados e excluídos o restante por não contemplarem o tema da pesquisa. A revisão possibilitou mapear um quantitativo expressivo de publicações sobre segurança medicamentosa de pessoas idosas hospitalizadas. Conclusão Esta revisão encontrou propostas de estratégias de prevenção de erros de medicação no ambiente hospitalar. hospitalar Tratase Trata dados LILACS SCIELO MEDLINE PUBMED Utilizaramse Utilizaram DECS paciente idoso medicamentos hospital pesquisa íntegra português espanhol duplicados dissertações 17 resumos inclusão hospitalizadas 1

Abstract Objective To identify the scientific evidence available in the literature on medication safety for older adults in the hospital setting. Method A scoping review was conducted on medication safety among older patients in the hospital setting involving searches of the LILACS, SCIELO, MEDLINE, and PUBMED databases Health descriptors were used according to DECS: patient safety, elderly, medications, hospital. The study included complete articles available in full, in Portuguese, English or Spanish. Duplicate articles, theses and dissertations were excluded. Results The search retrieved 172 publications. After reading of titles and abstracts, 8 articles that met the inclusion criteria were selected. The final sample of this scoping review comprised 8 selected studies, while the rest were excluded for being off-topic. The review allowed mapping of a significant number of publications on medication safety for hospitalized older adults. Conclusion This review found proposed strategies for preventing medication errors in the hospital environment. LILACS SCIELO MEDLINE DECS elderly medications full Portuguese Spanish 17 abstracts studies offtopic. offtopic off topic. topic off-topic environment 1

https://doi.org/10.1590/1981-22562024027.240016.pt

Efficacy and safety of levetiracetam as adjunctive therapy for refractory focal epilepsy
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MANREZA, Maria Luiza Giraldes de

; PAN, Tatiane Amaral

; CARBONE, Eduardo Quinalha

; VATTIMO, Antonio Carlos Amedeo

; HERRERA, Renata

; MORAIS, Douglas Costa

; CARDOSO, Rita Antonelli

; LACERDA, Glenda Corrêa Borges de

; LIN, Katia

; NAKANO, Frederico Nakane

; KOWACS, Pedro André

; PALMINI, André Luis Fernandes

; SOUZA, Adélia Maria de Miranda Henriques

; ZUNG, Stevin

; YACUBIAN, Elza Márcia Targas

Arquivos de Neuro-Psiquiatria

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apr 2021, Volume 79 N. 4 Pages 290 - 298

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: A epilepsia afeta cerca de 50 milhões de pessoas em todo o mundo e aproximadamente 30% desses pacientes apresentam epilepsia refratária, com possíveis consequências na qualidade de vida, morbidade e mortalidade prematura. Objetivo: O objetivo do tratamento com fármacos antiepilépticos (FAEs) é permitir que os pacientes permaneçam sem crises epilépticas com boa tolerabilidade. O levetiracetam (LEV) é um FAE de amplo espectro, com mecanismo de ação único, diferente dos demais e que demonstra ser eficaz e seguro no tratamento de adultos e crianças. Métodos: Estudo de fase III, multicêntrico, randomizado, duplo-cego e controlado por placebo avalia a eficácia e a segurança do LEV em crianças e adultos (4-65 anos) como tratamento adjuvante para crises de início focal em 114 pacientes já tratados com até três FAEs. A análise de eficácia primária foi baseada na proporção de pacientes que apresentaram redução ≥50% no número médio de crises epilépticas focais semanais, durante 16 semanas. Os pacientes foram randomizados para receber placebo ou LEV, titulado a cada duas semanas de 20 mg/kg/dia ou 1.000 mg/dia até 60 mg/kg/dia ou 3.000 mg/dia. Resultados: LEV foi significativamente superior ao placebo (p=0,0031), com 38,7% dos participantes no grupo LEV e 14,3% no grupo controle que apresentaram redução das crises focais. LEV apresenta bom perfil de segurança com eventos adversos semelhantes ao placebo. Conclusão: Corroborando com os resultados da literatura, o levetiracetam mostra-se eficaz e seguro para crianças e adultos com epilepsia focal refratária.

ABSTRACT Background: Epilepsy affects about 50 million people worldwide and around 30% of these patients have refractory epilepsy, with potential consequences regarding quality of life, morbidity and premature mortality. Objective: The aim of treatment with antiseizure medications (ASMs) is to allow patients to remain without seizures, with good tolerability. Levetiracetam is a broad-spectrum ASM with a unique mechanism of action that differs it from other ASMs. It has been shown to be effective and safe for treating adults and children with epilepsy. Methods: This was a phase III, multicenter, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of levetiracetam in children and adults (4-65 years) as an adjuvant treatment for focal-onset seizures. It was conducted among 114 patients undergoing treatment with up to three ASMs. The primary efficacy analysis was based on the proportion of patients who achieved a reduction of ≥ 50% in the mean number of focal seizures per week, over a 16-week treatment period. The patients were randomized to receive placebo or levetiracetam, titrated every two weeks from 20 mg/kg/day or 1,000 mg/day up to 60 mg/kg/day or 3,000 mg/day. Results: Levetiracetam was significantly superior to placebo (p = 0.0031); 38.7% of the participants in the levetiracetam group and 14.3% in the control group shows reductions in focal seizures. Levetiracetam was seen to have a favorable safety profile and an adverse event rate similar to that of placebo. Conclusion: Corroborating the results in the literature, levetiracetam was shown to be effective and safe for children and adults with refractory focal-onset epilepsy.

https://doi.org/10.1590/0004-282x-anp-2020-0082 446 downloads

Educação popular, promoção da saúde e envelhecimento ativo: uma revisão bibliográfica integrativa
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Souza, Elza Maria de

; Silva, Daiane Pereira Pires

; Barros, Alexandre Soares de

Ciência & Saúde Coletiva

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apr 2021, Volume 26 N. 4 Pages 1355 - 1368

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O envelhecimento populacional é um fenômeno mundial e requer ações que propiciem bem-estar e previnam agravos e hospitalizações evitáveis. O propósito deste artigo foi identificar ações educativas e de promoção de saúde voltadas ao envelhecimento ativo. Trata-se de uma revisão bibliográfica integrativa de estudos publicados no ano de 2005 a agosto de 2018 nas bases de dados Lilacs e Medline, e nas bibliotecas virtuais SciELO e BVS em português, inglês e espanhol. Foram encontrados 2.069 estudos sobre os temas, sendo selecionados 33 depois de aplicados os critérios de inclusão. A observação mostrou que as ações identificadas promovem a adoção de hábitos saudáveis e a participação dos idosos, caracterizando-as como promotoras do envelhecimento ativo. No entanto, observam-se que estão limitadas ao segmento de idosos, o que pode favorecer a segregação etária, além de considerar o envelhecimento a partir da terceira idade e não um processo contínuo da vida. Das ações aqui evidenciadas, embora importantes, apenas onze delas foram avaliadas, o que sugere que a avaliação ainda não está sedimentada nos processos de intervenções de educação e promoção da saúde para mostrar efetividade e favorecer a replicação em outros locais ou serviços.

Abstract Population ageing is a global phenomenon and requires actions to promote well-being and prevent illnesses and unnecessary hospital admissions. The objective of this study was to identify education and health promotion actions aimed at promoting active aging. An integrative literature review was conducted of relevant articles written in Portuguese, English and Spanish published between 2005 and August 2018 using the following electronic databases and virtual libraries: Lilacs, MEDLINE, SciELO, and BVS. The initial search resulted in 2,069 articles, of which 33 met the inclusion criteria. The analysis showed that the actions identified by the review promoted the adoption of healthy habits and participation of older people, characterizing them as actions that promote active aging. However, the actions were limited almost exclusively to this age group, which may lead to age segregation, and focused on old age rather than adopting a life course perspective of active aging. Despite the importance of these actions, only 11 were evaluated, suggesting that the evaluation of education and health promotion actions to demonstrate effectiveness and promote replication in other locations or services is not very common practice.

https://doi.org/10.1590/1413-81232021264.09642019 1897 downloads

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

https://doi.org/10.11606/s1518-8787.2021055003970

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2021055003970 43 downloads

Inserção da acupuntura no ensino médico: revisão sistemática das experiências brasileiras
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Correia, Divanise Suruagy

; Cardoso, Geraldo Mario de Carvalho

; Taveira, Maria das Graças Monte Mello

; Duarte, Elza Marculino

; Souza, Carlos Dornels Freire de

Revista Brasileira de Educação Médica

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2021, Volume 45 N. 1 elocation e010

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: Introdução: A acupuntura objetiva o equilíbrio energético por meio de estímulos na pele com a inserção de agulhas em pontos específicos. Ela faz parte do conjunto de conhecimentos teórico práticos da medicina tradicional chinesa. Atualmente, a Organização Mundial da Saúde vem apoiando ações relacionadas ao ensino, à pesquisa e à troca de informações em todo o mundo. Este estudo busca responder à seguinte questão de pesquisa: “Quais são as evidências sobre a inserção da acupuntura no ensino médico no Brasil?”. Objetivo: Este estudo teve como objetivo revisar a literatura no que concerne à inserção da acupuntura nas escolas médias do Brasil. Método: Trata-se de uma revisão sistemática, realizada em fevereiro de 2020, com a busca da combinação das expressões e dos termos “medicinas alternativas e complementares”, “acupuntura”, “acupuntura médica”, “ensino médico” e “Brasil”, com as adaptações terminológicas para as línguas inglesa e espanhola, e de acordo com as bases de dados: PubMed/Medline, Medline/BVS, Lilacs, HomeoIndex, Scopus e SciELO. Os manuscritos incluídos foram avaliados na íntegra por dois pesquisadores com a finalidade de identificar núcleos temáticos de discussão, a saber: “Acupuntura no Brasil: desafios e perspectivas”; “Acupuntura na graduação médica: experiências, percepções e desafios”; “Especialização/residência em acupuntura médica”; “Divulgação científica: importância na educação médica”. Resultados: Os 16 artigos selecionados foram classificados segundo objetivos, método, resultados e conclusões, e discutidos com base nos núcleos temáticos identificados. Conclusão: Os dados do estudo mostram que a acupuntura vem crescendo no Brasil, com maior divulgação e ensino lato sensu, com resumida participação durante a graduação. Espera-se que as políticas públicas voltadas para o Sistema Único de Saúde possam incentivar maiores investimentos no ensino durante a graduação.

Abstract: Introduction: Acupuncture aims to ensure energetic balance by means of skin stimulation with the insertion of needles at specific points. It is part of the theoretical-practical knowledge set of Traditional Chinese Medicine. The World Health Organization has been supporting acupuncture educational, research, and knowledge exchange actions all over the world. This study seeks to answer the following research question: “What evidence is there of acupuncture being included in Brazilian medical training?” Objective: To present a systematic review to answer the research question. Method: Systematic review conducted in February 2020, involving a search in the databases PubMed/Medline, Medline/BVS, Lilacs, Homeoindex, Scopus e Scielo for combinations of the following terms in English, Portuguese and Spanish: “complementary and alternative medicine teaching”, “Acupuncture medicine teaching” and “Brazil”. The manuscripts returned by the search were fully evaluated by two researchers to identify relevant discussion themes: acupuncture in Brazil: challenges and perspectives; acupuncture in undergraduate medical training: experiences, perceptions, and challenges; acupuncture medical specialization/residency; scientific publication: importance in Medical Education. Results: The sixteen selected papers were classified according to their objectives, method, results, and conclusions, and discussed based on the identified themes. Conclusion: The study data show that acupuncture is growing in Brazil, with greater publicity and latu sense teaching, with summary participation during undergraduate medical training. It is hoped that public policies focused on the Unified Health System can encourage more investment in teaching for undergraduate training.

https://doi.org/10.1590/1981-5271v45.1-20200379 1142 downloads

Educação popular, promoção da saúde e envelhecimento ativo: uma revisão bibliográfica integrativa
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Souza, Elza Maria de

; Silva, Daiane Pereira Pires

; Barros, Alexandre Soares de

Ciência & Saúde Coletiva

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2021, Volume 26 N. 4 Pages 1355 - 1368

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232021264.09642019

Oferta pública e privada de leitos e acesso aos cuidados à saúde na pandemia de Covid-19 no Brasil
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Costa, Danielle Conte Alves Riani

; Bahia, Ligia

; Carvalho, Elza Maria Cristina Laurentino de

; Cardoso, Artur Monte

; Souza, Paulo Marcos Senra

Saúde em Debate

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2020, Volume 44 N. spe4 Pages 232 - 247

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A pandemia de Covid-19, uma crise sanitária global, pôs em xeque sistemas de saúde de diversos países. No Brasil, o atendimento aos pacientes trouxe à tona disparidades na oferta e no acesso a serviços públicos e privados, bem como iniciativas para preservar a segmentação assistencial. O trabalho sistematiza informações sobre: leitos para internação por Covid-19; pleitos de pacientes reivindicando acesso; e ações para ampliar a oferta de recursos assistenciais envolvendo proposições governamentais e setor privado (empresas de planos e hospitais). Houve expansão de leitos hospitalares, mas a distribuição desigual nas regiões do País não foi alterada; tampouco parece ter havido mudanças no padrão de controle de coberturas por parte das empresas de planos de saúde. Parcela significativa das ações judiciais analisadas refere-se à negação de acesso de clientes de planos privados por carência contratual, enquanto pacientes do Sistema Único de Saúde (SUS) pleitearam vaga em Unidade de Terapia Intensiva (UTI). Vidas foram perdidas em decorrência de omissões para proteção efetiva e qualificada. Unidades públicas de terapia intensiva tiveram ocupação máxima, enquanto o setor privado contabilizou leitos ociosos. A análise evidencia barreiras de acesso a leitos e resistência às tentativas de unificação de esforços públicos e privados para mitigar a letalidade pelo novo coronavírus.

ABSTRACT The Covid-19 pandemic, a global health crisis, has put health systems in several countries in check. In Brazil, patient care has brought about disparities in the offer and access to public and private services and initiatives to preserve healthcare segmentation. The work systematizes information about: beds for hospitalization by Covid-19; patients´ complaints claiming access; and actions to expand the supply of assistance resources involving government proposals and the private sector (health insurance companies and hospitals). There was an expansion of hospital beds, but the uneven distribution in the regions of the country has not changed, nor does it appear to be changes in the pattern of coverage control by health insurance companies. A significant portion of the analyzed law suits refers to the denial of access to private insurance clients due to contractual grace period, while Unified Health System (SUS) patients claimed a place in the Intensive Care Units (ICU). Lives were lost due to omissions for effective and qualified protection. Public Intensive Care Units had maximum occupancy, while the private sector accounted for empty beds. The analysis shows barriers to access to beds and resistance to attempts to unify public and private efforts to mitigate lethality by the new coronavirus.

https://doi.org/10.1590/0103-11042020e415

10.

Oferta pública e privada de leitos e acesso aos cuidados à saúde na pandemia de Covid-19 no Brasil
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Costa, Danielle Conte Alves Riani

; Bahia, Ligia

; Carvalho, Elza Maria Cristina Laurentino de

; Cardoso, Artur Monte

; Souza, Paulo Marcos Senra

Saúde em Debate

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2020, Volume 44 N. spe4 Pages 232 - 247

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/0103-11042020e415 130 downloads

11.

Identification of plasmid IncQ1 and NTEKPC-IId harboring bla KPC-2 in isolates from Klebsiella pneumoniae infections in patients from Recife-PE, Brazil
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Lima, Giselle Jucá de

; Scavuzzi, Alexsandra Maria Lima

; Beltrão, Elizabeth Maria Bispo

; Firmo, Elza Ferreira

; Oliveira, Érica Maria de

; Oliveira, Sibele Ribeiro de

; Rezende, Antônio Mauro

; Lopes, Ana Catarina de Souza

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20190526

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: This study investigated the genetic environment of bla KPC-2 in Klebsiella pnemoniae multi-drug resistant clinical isolates. METHODS: Four carbapenemase gene isolates resistant to carbapenems, collected from infected patients from two hospitals in Brazil, were investigated using polymerase chain reaction and plasmid DNA sequencing. RESULTS: The bla KPC-2 gene was located between ISKpn6 and a resolvase tnpR in the non-Tn4401 element (NTEKPC-IId). It was detected on a plasmid belonging to the IncQ1 group. CONCLUSIONS To our knowledge, this is the first report of the presence of the bla KPC-2 gene in the NTEKPC-IId element carried by plasmid IncQ1 from infections in Brazil.

https://doi.org/10.1590/0037-8682-0526-2019 504 downloads

12.

Prior exercise training and experimental myocardial infarction: A systematic review and meta-analysis
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Veiga, Eduardo Carvalho de Arruda

; Melo, Brunno Lemes de

; Vieira, Stella de Souza

; Simões, Ricardo S.

; Valenti, Vitor E.

; Campos, Marcelo Ferraz

; Vale, Joseane Elza Tonussi Mendez Rossetti do

; Rica, Roberta Lukesvicius

; Soares-Júnior, José Maria

; Baracat, Edmund Chada

; Serra, Andrey Jorge

; Baker, Julien S.

; Bocalini, Danilo Sales

Clinics

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2020, Volume 75 elocation e1293

Abstract: En | Text: En | PDF: En

Exercising prior to experimental infarction may have beneficial effects on the heart. The objective of this study was to analyze studies on animals that had exercised prior to myocardial infarction and to examine any benefits through a systematic review and meta-analysis. The databases MEDLINE, Google Scholar, and Cochrane were consulted. We analyzed articles published between January 1978 and November 2018. From a total of 858 articles, 13 manuscripts were selected in this review. When animals exercised before experimental infarction, there was a reduction in mortality, a reduction in infarct size, improvements in cardiac function, and a better molecular balance between genes and proteins that exhibit cardiac protective effects. Analyzing heart weight/body weight, we observed the following results - Mean difference 95% CI - -0.02 [-0.61,0.57]. Meta-analysis of the infarct size (% of the left ventricle) revealed a statistically significant decrease in the size of the infarction in animals that exercised before myocardial infarction, in comparison with the sedentary animals -5.05 [-7.68, -2.40]. Analysis of the ejection fraction, measured by echo (%), revealed that animals that exercised before myocardial infarction exhibited higher and statistically significant measures, compared with sedentary animals 8.77 [3.87,13.66]. We conclude that exercise performed prior to experimental myocardial infarction confers cardiac benefits to animals.

https://doi.org/10.6061/clinics/2020/e1293 522 downloads

13.

Emergence of bla NDM-1 associated with the aac(6’)-Ib-cr, acrB, cps, and mrkD genes in a clinical isolate of multi-drug resistant Klebsiella pneumoniae from Recife-PE, Brazil
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Scavuzzi, Alexsandra Maria Lima

; Firmo, Elza Ferreira

; Oliveira, Érica Maria de

; Lopes, Ana Catarina de Souza

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180352

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: The emergence of New Delhi metallo-β-lactamase (NDM) is concernig because it reduces the antibiotic therapy options for bacterial infections. METHODS: Resistant and virulent genes from an isolate of Klebsiella pneumoniae derived from a patient with sepsis in a hospital in Recife-PE, Brazil, were investigated using PCR and DNA sequencing. RESULTS: bla NDM-1, aac(6’)-Ib-cr and acrB resistance genes, and cps and mrkD virulence genes were detected. CONCLUSIONS To our knowledge, this is the first report on bla NDM-1 in Recife-PE. This detection alerts researchers to the need to control the spread of bla NDM-1 resistance gene by this bacterium in Brazil.

https://doi.org/10.1590/0037-8682-0352-2018 1678 downloads

14.

Emergence of aph(3’)-VI and accumulation of aminoglycoside modifying enzyme genes in KPC-2-possessing Enterobacter aerogenes isolates from infections and colonization in patients from Recife-PE, Brazil
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Firmo, Elza Ferreira

; Cabral, Adriane Borges

; Oliveira, Érica Maria de

; Lopes, Ana Catarina Souza

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180460

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: The objective of this study was to characterize genes of aminoglycoside modifying enzymes (AMEs) in colonizing and infecting isolates of E. aerogenes harboring bla KPC from patients at a public hospital in Recife-PE, Brazil. METHODS: We analyzed 29 E. aerogenes clinical isolates resistant to aminoglycosides. AMEs genes were investigated by PCR and sequencing. RESULTS: Colonizing and infecting isolates mainly presented the genetic profiles aac(3)-IIa/aph(3’)-VI or ant(2”)-IIa/aph(3’)-VI. This is the first report of aph(3’)-VI in E. aerogenes harboring bla KPC in Brazil. CONCLUSIONS: The results highlight the importance in establishing rigorous methods for the surveillance of resistance genes, especially in colonized patients.

https://doi.org/10.1590/0037-8682-0460-2018 802 downloads

15.

Effectiveness of Family Health Strategy on child's health indicators in São Paulo State
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Venancio, Sonia Isoyama

; Rosa, Tereza Etsuko da Costa

; Sanches, Maria Teresa Cera

; Shigeno, Elza Yoshie

; Souza, José Maria Pacheco

Revista Brasileira de Saúde Materno Infantil

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sep 2016, Volume 16 N. 3 Pages 271 - 281

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivos: avaliar a efetividade da Estratégia Saúde da Família (ESF) sobre indicadores de saúde da criança no Estado de São Paulo. Métodos: estudo ecológico longitudinal envolvendo todos os municípios do estado de São Paulo no período de 1998 a 2009. Os desfechos foram os coeficientes de mortalidade infantil e seus componentes e taxa de internações por pneumonia e diarreia. A variável independente principal foi "cobertura da ESF"; as covariáveis consideraram o contexto sociodemográfico e do sistema de saúde. Utilizaram-se modelos de regressão binomial negativa de efeitos fixos, utilizando o programa estatístico STATA 11.1. Resultados: coberturas da ESF superiores a 50% mostraram efeito de proteção em relação à mortalidade pós-neonatal (RR: 0,93; IC95%: 0,87-1,00) e coberturas de até 50% (RR: 0,88; IC95%: 0,82-0,99) ou superiores a 50% (RR: 0,87; IC95%: 0,82-0,92) foram fatores de proteção para internações por pneumonia. Conclusões: a efetividade da ESF sobre os desfechos relacionados à saúde da criança pode variar em função de contextos locais e regionais.

Abstract Objectives: to evaluate the effectiveness of Family Health Strategy (FHS) on child's health indicators in São Paulo State. Methods: longitudinal ecological study involving all the towns in São Paulo State from 1998 to 2009. The outcomes were the coefficients of infant mortality and its components and the rate for pneumonia and diarrhea hospitalizations. The main independent variable was "FHS coverage"; the covariates considered the context of sociodemographic and the health system. Negative binomial regression models of fixed effects and STRATA 11.1 statistical program were used. Results: FHS coverage above 50% showed a protective effect in relation to the postneonatal mortality (RR: 0.93; CI 95%: 0.87-1.00) and coverage up to 50% (RR 0.88 CI95% 0.82-0.99) or above 50% (RR: 0.87; CI95%: 0.82-0.92) were protective factors for pneumonia hospitalizations. Conclusions: the effectiveness of FHS on the outcomes related to child's health may vary according to local and regional contexts.

https://doi.org/10.1590/1806-93042016000300004 3102 downloads

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