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Postoperative Neutrophil to Lymphocyte and Platelet Ratio and Delayed Graft Function
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Oliveira, João

; Missa, João

; Gameiro, Joana

; Santana, Alice

; Lopes, José António

; Neves, Marta

Portuguese Journal of Nephrology & Hypertension

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dec 2023, Volume 37 N. 4 Pages 185 - 191

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Delayed graft function (DGF), an outcome for which inflammation is critical, has been associated with worse outcomes after kidney transplantation (KT). The neutrophil to lymphocyte and platelet (NLP) ratio is a biomarker of systemic inflammation. We assessed postoperative NLP ratio applicability as an early predictor of DGF in KT patients. Methods: Retrospective cohort of adult patients submitted to KT at our unit, between 1 January 2010 and 31 December 2020. NLP was calculated at 24 hours post-KT. Primary outcome was development of DGF. Logistic regression was calculated to determine significant factos which may have contributed to DGF. Results: We included 527 patients with a mean age of 49.9 ± 12.8 years. In 47.8% of patients expanded criteria donors were used, and in 3.6% non-heart-beating donors. DGF occurred in 17.8% of patients. Mean post-KT NLP was higher in patients submitted to induction therapy with lymphocyte depleting antibodies (50.2±40.3 vs 11.9±7.4 with basiliximab, p<0.001), but it was found to be higher even before KT (5.2±1.8 vs 1.9±1.2, p=0.001). Grafts from non-heart-beating donors (OR 13.989, 95% CI 4.741, 41.274, p=0.000), longer warm ischemia time (OR 1.035, 95% CI 1.007, 1.064, p=0.014) and higher NLP ratio 24 hours after transplantation (OR 1.009, 95% CI 1.002, 1.016, p=0.015) were independently associated with DGF. Conclusion: Higher NLP ratio at 24 hours after KT was independently associated with DGF. This reflects the impact of inflammation on KT outcomes and highlights the role of the NLP ratio as a sensitive marker of systemic inflammatory response after KT.

https://doi.org/10.32932/pjnh.2023.11.261

Perceção dos utentes sobre o papel dos médicos internos de medicina geral e familiar
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Antunes, Joana Palhota

; Gonçalves, Ana Margarida

; Custódio, Catarina S.

; Henriques, Daniela Monteiro

; Velho, Denise

; Cardoso, João Magalhães

; Carreira, Leonor Marques Caetano

; Sá, Margarida

; Santana, Marta Marques

Revista Portuguesa de Medicina Geral e Familiar

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jul 2023, Volume 39 N. 4 Pages 286 - 292

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

Abstract Introduction: Residency in general practice and family medicine (GP/FM) is essential for acquiring knowledge and skills. As patients play a fundamental role in residents’ training, it is important to understand their perception of GP/FM residents. Objectives: To evaluate patients’ perception of the role of GP/FM residents and their trust in the medical care provided by them at USF Santiago de Leiria, a family unit in Portugal. Methods: Cross-sectional study with a convenience sample of 450 patients of USF Santiago through a questionnaire consisting of a sociodemographic survey and questions designed to assess patients' perception of the role of GP/FM residents. Results: We obtained 405 valid questionnaires, where 87.7% of patients reported having already had an appointment with a resident and 57.0% reported that they had been previously explained what medical residency was. Of the patients who had already been consulted by a resident, the majority believed that residency was important for the training of family physicians (95.0%). When asked whether they accepted the consultation to be carried out by a resident, 94.2% responded affirmatively, however when asked whether they felt free to refuse to be seen by a resident, only 70.1% replied positively. Of the total sample, 93.3% reported feeling comfortable communicating their problems to residents and 96.0% felt confident in the care they received from them. Conclusions: Although there is still some lack of knowledge about what residency is, most patients believe that residency in general practice is important for the training of future family physicians and accept their consultations to be carried out by residents.

Resumo Introdução: A formação especializada em medicina geral e familiar (MGF) é essencial para a aquisição de conhecimentos e competências. Tendo os utentes um papel fundamental na formação dos médicos internos é importante compreender a perceção dos utentes sobre os médicos internos de MGF. Objetivos: Avaliação da perceção dos utentes da USF Santiago de Leiria sobre o papel dos médicos internos de MGF e a confiança nos cuidados médicos por estes prestados. Método: Estudo transversal com uma amostra de conveniência de 450 utentes da USF Santiago através de um questionário constituído por um inquérito sociodemográfico e questões desenhadas para avaliar a perceção dos utentes sobre o papel dos médicos internos de MGF. Resultados: Foram obtidos 405 questionários válidos: 87,7% dos utentes referiam já terem tido uma consulta com um médico interno e 57,0% referiam que já lhes tinha sido explicado previamente o que era o internato médico. Dos doentes que já tinham sido consultados por um médico interno, a maioria acreditava que o internato era importante para a formação dos médicos de família (95,0%). Quando questionados sobre se aceitavam que a consulta fosse realizada por um médico interno, 94,2% responderam afirmativamente; quando inquiridos sobre se sentiam que tinham liberdade para recusar serem vistos por um médico interno apenas 70,1% responderam positivamente. Do total da amostra 93,3% referiam sentir-se confortáveis para comunicar os seus problemas aos médicos internos e 96,0% sentiam confiança nos cuidados que destes recebiam. Conclusões: Apesar de haver ainda algum desconhecimento sobre o que é um médico interno, a maioria dos utentes acredita que o internato em MGF é importante para a formação dos futuros médicos de família e aceitam que as suas consultas sejam realizadas por médicos internos.

https://doi.org/10.32385/rpmgf.v39i4.13650

Triagem auditiva com o aplicativo para dispositivos móveis uHear™: reprodutibilidade dos resultados utilizando dois diferentes modos de resposta
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Cunha, Marta Luiza Santana da

; Lopes, Márcia da Silva

; Meira, Tatiane Costa

; Corona, Ana Paula

CoDAS

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2023, Volume 35 N. 2 elocation e20210143

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

ABSTRACT Purpose Estimate the reproducibility of hearing screening results using the uHear™ smartphone-based app in two response modes: self-test response and test-operator. Methods Reliability study conducted with 65 individuals aged ≥18 years assisted at the Speech-language and Hearing Therapy clinic of a public higher-education institution. Hearing screening was conducted by a single researcher using the uHear app and earbud headphones in a soundproof booth. Participants responded to sound stimuli in both self-test response mode and test-operator mode. The order in which these two uHear test modes were applied was altered according to the entrance of each participant in the study. The correspondence between the hearing thresholds obtained from each response mode was analyzed and their Intraclass Correlation Coefficient (ICC) was estimated. Results A correspondence of ±5 dBHL >75% was observed between these hearing thresholds. The ICC values showed excellent agreement between the two response modes at all frequencies >40 dBHL tested. Conclusion The two hearing screening response modes using the uHear app presented high reproducibility, suggesting that the test-operator mode is a viable alternative when the self-test response mode is not recommended.

RESUMO Objetivo Estimar a reprodutibilidade dos resultados da triagem auditiva com o aplicativo uHear, utilizando dois diferentes modos de resposta, o modo autoaplicado e o modo com intermediação do pesquisador. Método Estudo de confiabilidade realizado com 65 indivíduos, maiores de 18 anos, que compareceram à clínica escola de Fonoaudiologia de uma instituição pública de ensino superior. A triagem auditiva foi realizada com o aplicativo uHear, em cabina acústica, utilizando fone intra-auricular e conduzida sempre pelo mesmo pesquisador. Os participantes responderam ao estímulo sonoro de maneira autoaplicada e com intermediação do pesquisador. A ordem de realização dos dois modos de resposta ao aplicativo uHear foi alternada de acordo com a entrada do participante no estudo. Foi analisada a correspondência entre os limiares auditivos obtidos com os dois modos de resposta, bem como estimado o Coeficiente de Correlação Intraclasse (ICC). Resultados Verificou-se uma correspondência de ± 5 dBNA superior a 75% entre os limiares auditivos obtidos nos dois modos de resposta. O ICC revelou concordância excelente entre os dois modos de resposta, em todas as frequências testadas, para intensidades superiores a 40 dBNA. Conclusão Os dois modos de resposta à triagem auditiva com o aplicativo uHear apresentam elevada reprodutibilidade, o que permite indicar o modo de resposta com intermediação do pesquisador como uma alternativa viável quando o modo autoaplicado não for recomendado.

https://doi.org/10.1590/2317-1782/20232021143pt

Movimento multicultural dos direitos humanos: cinema brasileiro de retomada, pluralismo jurídico e os estereótipos da violência
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Santana, Samene Batista Pereira

; Fresquet, Adriana

; Rocha, Sheila Marta Carregosa

Revista Direito e Práxis

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jul 2022, Volume 13 N. 3 Pages 2024 - 2050

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

Resumo O presente artigo tem como escopo identificar as relações entre a concepção multicultural dos Direitos Humanos e a enunciação audiovisual no Cinema de retomada no Brasil. Por meio de uma análise metodológica descritiva e exploratória dos recursos fílmicos e bibliográficos percebemos, no trabalho, que o discurso jurídico se destaca nas diversas narrativas audiovisuais brasileiras, sobretudo no que diz respeito aos problemas de efetivação dos direitos humanos nas periferias. Para afirmar tal hipótese, o suporte teórico está ligado a dois eixos principais do trabalho: a análise crítica cinematográfica pautada, especialmente, nas reflexões de Ivana Bentes, Esther Hamburger e Fernão Pessoa Ramos; e a observação do movimento multicultural dos direitos humanos e o pluralismo jurídico nos espaços periféricos brasileiros, pelo olhar de Boaventura de Sousa Santos, Antônio Carlos Wolkmer e Joaquim Herrera Flores. A partir da análise dos regimes de visualidade - as condições históricas, técnicas e estéticas de existência de alguns filmes representativos dos anos 1990 - 2010 - e os processos de enunciação ou discursivização dos direitos humanos nas narrativas, observamos diferentes cenários de solidariedade, luta por cidadania e sociabilidade de um lado, e, de outro, exclusão social, estereótipos da violência e pluralismo jurídico nas periferias brasileiras enunciadas nas imagens em movimento, as quais irrompem a realidade.

Abstract The present article aims to identify the relations between the multicultural conception of Human Rights and the audiovisual enunciation in the Cinema of repossession in Brazil. Through a descriptive and exploratory methodological analysis of filmic and bibliographic resources we realize, in the work, that the legal discourse stands out in the various Brazilian audiovisual narratives, especially with regard to the problems of effectiveness of human rights in the peripheries. In order to affirm this hypothesis, the theoretical support is linked to two main axes of the work: the critical analysis of cinema, based especially on the reflections of Ivana Bentes, Esther Hamburger and Fernão Pessoa Ramos; and the observation of the multicultural movement of human rights and legal pluralism in the Brazilian peripheral spaces, through the eyes of Boaventura de Sousa Santos, Antônio Carlos Wolkmer and Joaquim Herrera Flores. From the analysis of the regimes of visuality - the historical, technical and aesthetic conditions of existence of some representative films of the years 1990 - 2010 - and the processes of enunciation or discursivization of human rights in the narratives, we observe different scenarios of solidarity, struggle for citizenship and sociability on the one hand, and, on the other, social exclusion, stereotypes of violence and legal pluralism in the Brazilian peripheries enunciated in the moving images, which erupt reality.

https://doi.org/10.1590/2179-8966/2022/68752

Lethal and sublethal effects of essential oils fromPiper capitarianumYunck andPiper krukoffiiYunck onPlutella xylostellaL
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SANTANA, MILENA L.G.

; MELO, JOÃO P.R. DE

; CAMARA, CLÁUDIO A.G. DA

; MORAES, MARCÍLIO M. DE

; ARAUJO, CAROLINA A. DE

; VASCONCELOS, GERALDO J.N. DE

; PEREIRA, MARTA R.S.

; ZARTMAN, CHARLES E.

Anais da Academia Brasileira de Ciências

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2022, Volume 94 N. 2 elocation e20200072

Abstract: En | Text: En | PDF: En

Abstract Plutella xylostella (L.) is responsible for considerable vegetable crop losses in the metropolitan region of Manaus, Brazil. In recent decades, essential oils have been investigated as an alternative to synthetic insecticides. The genusPiperis widely distributed in Amazonia and essential oils from these plants have insecticidal properties. This study describes the chemical composition of the essential oils fromPiper capiterianumandPiper krukoffiias well as the lethal and sublethal effects onP. xylostella. The phytotoxicity of the oils on the host plant was also evaluated. Globulol was the major constituent of theP. krukoffiioil ando-cymene was the major constituent of theP. capitarianumoil. The oil fromP. capiterianumexhibited greater toxicity to larvae and eggs. This oil also presented greater repellant action, feeding deterrence and mild phytotoxicity to the host plant (Brassicae oleraceae). The findings suggest that this oil can be used in the preparation of a formulated insecticide for the management ofP. xylostellain different development phases. However, further studies are needed to evaluate the effect of this oil on crops under field conditions as well as non-target organisms and determine the cost-benefit ratio of a product formulated withP. capitarianumoil.

https://doi.org/10.1590/0001-3765202220200072

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF CROHN’S DISEASE IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN’S DISEASE AND COLITIS (GEDIIB)
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IMBRIZI, Marcello

; BAIMA, Júlio Pinheiro

; AZEVEDO, Matheus Freitas Cardoso de

; ANDRADE, Adriana Ribas

; QUEIROZ, Natália Souza Freitas

; CHEBLI, Júlio Maria Fonseca

; CHEBLI, Liliane Andrade

; ARGOLLO, Marjorie Costa

; SASSAKI, Ligia Yukie

; PARRA, Rogerio Serafim

; QUARESMA, Abel Botelho

; VIEIRA, Andrea

; DAMIÃO, Adérson Omar Mourão Cintra

; MORAES, Antonio Carlos da Silva

; FLORES, Cristina

; ZALTMAN, Cyrla

; VILELA, Eduardo Garcia

; MORSOLETTO, Eloá Marussi

; GONÇALVES FILHO, Francisco de Assis

; PENNA, Francisco Guilherme Cancela e

; SANTANA, Genoile Oliveira

; ZABOT, Gilmara Pandolfo

; PARENTE, José Miguel Luz

; COSTA, Marcia Henriques de Magalhães

; ZERÔNCIO, Marco Antonio

; MACHADO, Marta Brenner

; CASSOL, Ornella Sari

; KOTZE, Paulo Gustavo

; FRÓES, Renata de Sá Brito

; MISZPUTEN, Sender Jankiel

; AMBROGINI JUNIOR, Orlando

; SAAD-HOSSNE, Rogério

; COY, Cláudio Saddy Rodrigues

Arquivos de Gastroenterologia

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2022, Volume 59 Suppl. 1 Pages 20 - 50

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

ABSTRACT Background: Inflammatory bowel disease (IBD) is an immune-mediated disorder that includes Crohn’s disease (CD) and ulcerative colitis. CD is characterized by a transmural intestinal involvement from the mouth to the anus with recurrent and remitting symptoms that can lead to progressive bowel damage and disability over time. Objective: To guide the safest and effective medical treatments of adults with CD. Methods: This consensus was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn's disease and Colitis (GEDIIB)). A systematic review of the most recent evidence was conducted to support the recommendations/statements. All included recommendations and statements were endorsed in a modified Delphi panel by the stakeholders and experts in IBD with an agreement of at least 80% or greater consensus rate. Results and conclusion: The medical recommendations (pharmacological and non-pharmacological interventions) were mapped according to the stage of treatment and severity of the disease in three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus is targeted towards general practitioners, gastroenterologists, and surgeons interested in treating and managing adults with CD and supports the decision-making of health insurance companies, regulatory agencies, and health institutional leaders or administrators.

RESUMO Contexto: A doença inflamatória intestinal (DII) é uma doença imunomediada que inclui a doença de Crohn (DC) e a retocolite ulcerativa. A DC é caracterizada por um envolvimento intestinal transmural da boca ao ânus com sintomas recorrentes e remitentes que podem levar a danos intestinais progressivos e incapacidade ao longo do tempo. Objetivo: Orientar os tratamentos médicos mais seguros e eficazes de adultos com DC. Métodos: Este consenso foi desenvolvido por autores que representam gastroenterologistas e cirurgiões brasileiros especialistas em doenças colorretais (GEDIIB, Organização Brasileira de Doença de Crohn e Colite). Uma revisão sistemática das evidências mais recentes foi realizada para apoiar as recomendações/declarações. Todas as recomendações e declarações incluídas foram endossadas em um painel Delphi modificado pelas partes interessadas e especialistas em DII com uma concordância de pelo menos 80% ou mais. Resultados e conclusão: As recomendações médicas (intervenções farmacológicas e não farmacológicas) foram mapeadas de acordo com o estágio de tratamento e gravidade da doença em três domínios: manejo e tratamento (intervenções medicamentosas e cirúrgicas), critérios para avaliar a eficácia do tratamento médico, e acompanhamento/monitoramento do paciente após o tratamento inicial. O consenso é direcionado a clínicos gerais, gastroenterologistas e cirurgiões interessados em tratar e gerenciar adultos com DC e apoia a tomada de decisões de companhias de seguro de saúde, agências reguladoras e líderes ou administradores de instituições de saúde.

https://doi.org/10.1590/s0004-2803.2022005s1-02

SECOND BRAZILIAN CONSENSUS ON THE MANAGEMENT OF ULCERATIVE COLITIS IN ADULTS: A CONSENSUS OF THE BRAZILIAN ORGANIZATION FOR CROHN’S DISEASE AND COLITIS (GEDIIB)
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BAIMA, Júlio Pinheiro

; IMBRIZI, Marcello

; ANDRADE, Adriana Ribas

; CHEBLI, Liliane Andrade

; ARGOLLO, Marjorie Costa

; QUEIROZ, Natália Sousa Freitas

; AZEVEDO, Matheus Freitas Cardoso de

; VIEIRA, Andrea

; COSTA, Marcia Henriques de Magalhães

; FRÓES, Renata de Sá Brito

; PENNA, Francisco Guilherme Cancela e

; QUARESMA, Abel Botelho

; DAMIÃO, Aderson Omar Mourão Cintra

; MORAES, Antonio Carlos da Silva

; SANTOS, Carlos Henrique Marques dos

; FLORES, Cristina

; ZALTMAN, Cyrla

; VILELA, Eduardo Garcia

; MORSOLETTO, Eloá

; GONÇALVES FILHO, Francisco de Assis

; SANTANA, Genoile Oliveira

; ZABOT, Gilmara Pandolfo

; PARENTE, José Miguel Luz

; SASSAKI, Ligia Yukie

; ZERÔNCIO, Marco Antonio

; MACHADO, Marta Brenner

; CASSOL, Ornella Sari

; KOTZE, Paulo Gustavo

; PARRA, Rogerio Serafim

; MISZPUTEN, Sender Jankiel

; COY, Cláudio Saddy Rodrigues

; AMBROGINI JUNIOR, Orlando

; CHEBLI, Júlio Maria Fonseca

; SAAD-HOSSNE, Rogério

Arquivos de Gastroenterologia

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2022, Volume 59 Suppl. 1 Pages 51 - 84

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

ABSTRACT Background: Inflammatory bowel diseases are immune-mediated disorders that include Crohn’s disease (CD) and ulcerative colitis (UC). UC is a progressive disease that affects the colorectal mucosa causing debilitating symptoms leading to high morbidity and work disability. As a consequence of chronic colonic inflammation, UC is also associated with an increased risk of colorectal cancer. Objective: This consensus aims to provide guidance on the most effective medical management of adult patients with UC. Methods: A consensus statement was developed by stakeholders representing Brazilian gastroenterologists and colorectal surgeons (Brazilian Organization for Crohn’s Disease and Colitis [GEDIIB]). A systematic review including the most recent evidence was conducted to support the recommendations and statements. All recommendations/statements were endorsed using a modified Delphi Panel by the stakeholders/experts in inflammatory bowel disease with at least 80% or greater consensus. Results and conclusion: The medical recommendations (pharmacological and non-pharmacological) were mapped according to the stage of treatment and severity of the disease onto three domains: management and treatment (drug and surgical interventions), criteria for evaluating the effectiveness of medical treatment, and follow-up/patient monitoring after initial treatment. The consensus targeted general practitioners, gastroenterologists and surgeons who manage patients with UC, and supports decision-making processes by health insurance companies, regulatory agencies, health institutional leaders, and administrators.

RESUMO Contexto: As doenças inflamatórias intestinais são doenças imunomediadas que incluem a doença de Crohn (DC) e a retocolite ulcerativa (RCU). A RCU é uma doença progressiva que acomete a mucosa colorretal causando sintomas debilitantes levando a alta morbidade e incapacidade laboral. Como consequência da inflamação crônica do cólon, a RCU também está associada a um risco aumentado de câncer colorretal. Objetivo: Este consenso visa fornecer orientações sobre o manejo médico mais eficaz de pacientes adultos com RCU. Métodos: As recomendações do consenso foram desenvolvidas por gastroenterologistas e cirurgiões colorretais referências no Brasil (membros da Organização Brasileira para Doença de Crohn e Colite [GEDIIB]). Uma revisão sistemática, incluindo as evidências mais recentes, foi conduzida para apoiar as recomendações. Todas as recomendações foram endossadas pelas partes interessadas/especialistas em doença inflamatória intestinal usando um Painel Delphi modificado. O nível de concordância para alcançar consenso foi de 80% ou mais. Resultados e conclus ão: As recomendações médicas (farmacológicas e não farmacológicas) foram mapeadas de acordo com o estágio de tratamento e gravidade da doença em três domínios: manejo e tratamento (intervenções medicamentosas e cirúrgicas), critérios para avaliar a eficácia do tratamento médico, e acompanhamento/monitoramento do paciente após o tratamento inicial. O consenso foi direcionado a clínicos gerais, gastroenterologistas e cirurgiões que tratam pacientes com RCU e apoia os processos de tomada de decisão por companhias de seguro de saúde, agências reguladoras, líderes institucionais de saúde e administradores.

https://doi.org/10.1590/s0004-2803.2022005s1-03

Ansiedade e depressão durante o estado de emergência nacional por COVID-19: realidade numa Unidade de Saúde Familiar
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Santana, Marta Marques

; Gonçalves, Ana Margarida

; Henriques, Daniela

; Velho, Denise

; Cardoso, João Magalhães

; Antunes, Joana

; Coimbra, Mariana

Revista Portuguesa de Medicina Geral e Familiar

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dec 2021, Volume 37 N. 6 Pages 498 - 505

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

Resumo Objetivos: Passaram alguns meses desde que foi confirmado o primeiro caso da doença COVID-19 em Portugal. A rápida progressão desta pandemia levou a diversas alterações no quotidiano dos utentes da Unidade de Saúde Familiar (USF) Santiago de Leiria, provavelmente com impacto na sua saúde mental. O objetivo deste trabalho é determinar os graus de ansiedade e depressão dos utentes da USF Santiago de Leiria durante o estado de emergência nacional. Tipo de estudo: Estudo transversal descritivo com componente analítica. Local: USF Santiago de Leiria. População: Utentes inscritos na USF Santiago de Leiria. Métodos: Estudo realizado através de um questionário online constituído por um inquérito sociodemográfico, a Escala Hospitalar de Ansiedade e Depressão e uma questão relativa ao apoio social, enviado a 1.000 utentes da USF em 9 de abril de 2020 e válido para submissão de respostas até 1 de maio de 2020. Resultados: Dos 285 indivíduos que participaram, 47% apresentavam sintomas de ansiedade e 32% sintomas depressivos. Indivíduos do género feminino apresentaram níveis mais elevados quer de sintomatologia ansiosa quer de sintomatologia depressiva. Indivíduos com níveis mais baixos de escolaridade, desempregados e trabalhadores em lay-off apresentaram uma maior prevalência de ansiedade. Entre os inquiridos, 89,1% referiu ter o apoio social necessário. Conclusão: Este trabalho demonstra uma elevada prevalência dos sintomas de ansiedade e depressão, com maior expressão no sexo feminino. Desta premissa, novas estratégias de melhoria da saúde mental dos utentes poderão surgir e evitar ainda mais danos provocados pela COVID-19.

Abstract Introduction: A few months have passed since the first case of COVID-19 disease in Portugal was confirmed. The rapid progression of this pandemic has led to several changes in the daily lives of the users of the Family Health Unit (FHU) Santiago de Leiria, probably with an impact on their mental health. The aim of our work is to determine the degrees of anxiety and depression of the users of the FHU Santiago de Leiria during a state of national emergency. Study design: Cross-sectional descriptive study, with an analytical component. Population: Users of the FHU Santiago de Leiria. Methods: The study was carried out through an online questionnaire consisting of a sociodemographic survey, the Hospital Anxiety and Depression Scale (HADS), and a question related to social support, sent to 1,000 users of the family health unit on April 9, 2020, and valid for submission of responses until May 1, 2020. Results: Of the 285 individuals who participated, 47% had symptoms of anxiety and 32% depressive symptoms. Individuals of the feminine gender, who had concluded high school or college, presented higher levels of both anxiety and depressive symptoms. Individuals with lower levels of education, unemployed, and lay-off workers presented with a higher prevalence of anxiety. Among respondents, 89.1% reported having the necessary social support. Conclusion: Our work demonstrates a high prevalence of symptoms of anxiety and depression, with greater expression in females. From this premise, new strategies to improve the mental health of users should arise to prevent further damage caused by COVID-19.

https://doi.org/10.32385/rpmgf.v37i6.13049 87 downloads

Understanding the provision of a clinical service in mental health and the role of the pharmacist: a qualitative analysis
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Fernandes, Sheilla Alessandra Ferreira

; Brito, Giselle de Carvalho

; Dosea, Aline Santana

; Lyra Junior, Divaldo Pereira de

; Garcia-Cardenas, Victoria

; Fonteles, Marta Maria de França

Interface - Comunicação, Saúde, Educação

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2021, Volume 25 elocation e200788

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

Farmacêuticos têm papéis importantes na área da saúde mental; entretanto, sua atuação nos Centros de Atenção Psicossociais (CAPS) brasileiros é desconhecida. Este estudo qualitativo foi realizado em um CAPS, Brasil; utilizando-se de entrevistas e análises sob a perspectiva de Bardin, no qual categorias em relação à prestação do serviço de acompanhamento farmacoterapêutico (AFT) e ao papel do farmacêutico na saúde mental emergiram através das percepções dos pacientes e equipe de saúde. Segundo os participantes, o serviço de AFT é essencial e importante porque permite o reconhecimento profissional, além da identificação dos atributos profissionais dos farmacêuticos. Além disso, houve uma dualidade no papel do farmacêutico em relação aos atributos logísticos e clínicos na saúde mental. Assim, essas percepções ajudam a elucidar o processo de trabalho do farmacêutico em saúde mental, subsidiando futuras estratégias de ação nesta área.

Pharmacists have important roles in mental health disease; however, their performance in Brazilian Psychosocial Care Centers (CAPS) is unknown. This qualitative study was conducted in a CAPS, Brazil; using interviews and analyzes from the perspective of Bardin, in which categories arising from the perceptions of patients and the health team emerged in relation to the provision of the medication review with follow up (MR) service and the role of the pharmacist in mental health. According to the participants, the MR service is essential and important because it allows professional recognition, beyond the identification of professional attributes of the pharmacists. Moreover, there was a duality in the pharmacist’s role between the logistic and clinical attributes of mental health. Thus, this perception helps to elucidate the pharmacist’s process of work in mental health and supports future strategies of action in this area.

Los farmacéuticos tienen un papel importante en el área de la salud mental; sin embargo, se desconoce su desempeño en los Centros de Atención Psicosocial de Brasil (CAPS). Este estudio cualitativo se llevó a cabo en un CAPS, Brasil; utilizando entrevistas y análisis desde la perspectiva de Bardin, en las que de las percepciones de los pacientes y del equipo de salud surgieron categorías en relación a la prestación del servicio de seguimento farmacoterapéutico (SFT) y el papel del farmacéutico en la salud mental. Según los participantes, el servicio de SFT es fundamental e importante. Además, existía una dualidad en el rol del farmacéutico en relación a los atributos logísticos y clínicos en salud mental. Así, estas percepciones ayudan a dilucidar el proceso de trabajo del farmacéutico en salud mental, apoyando futuras estrategias de actuación.

https://doi.org/10.1590/interface.200788

10.

Understanding the provision of a clinical service in mental health and the role of the pharmacist: a qualitative analysis
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Fernandes, Sheilla Alessandra Ferreira

; Brito, Giselle de Carvalho

; Dosea, Aline Santana

; Lyra Junior, Divaldo Pereira de

; Garcia-Cardenas, Victoria

; Fonteles, Marta Maria de França

Interface - Comunicação, Saúde, Educação

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2021, Volume 25 elocation e200788

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

https://doi.org/10.1590/interface.200788 29 downloads

11.

Identification and characterisation of SARS-CoV-2 and Human alphaherpesvirus 1 from a productive coinfection in a fatal COVID-19 case
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Herlinger, Alice Laschuk

; Monteiro, Fábio Luís Lima

; D’arc, Mirela

; Moreira, Filipe Romero Rebello

; Westgarth, Harrison James

; Galliez, Rafael Mello

; Mariani, Diana

; da Costa, Luciana Jesus

; de Almeida, Luiz Gonzaga Paula

; Voloch, Carolina Moreira

; Melo, Adriana Suely de Oliveira

; Aguiar, Renato Santana de

; dos Santos, André Felipe Andrade

; Castiñeiras, Terezinha Marta Pereira Pinto

; de Vasconcelos, Ana Tereza Ribeiro

; João Filho, Esaú Custódio

; Escosteguy, Claudia Caminha

; Ferreira Junior, Orlando da Costa

; Tanuri, Amilcar

; Higa, Luiza Mendonça

Memórias do Instituto Oswaldo Cruz

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2021, Volume 116 elocation e210176

Abstract: En | Text: En | PDF: En

BACKGROUND During routine Coronavirus disease 2019 (COVID-19) diagnosis, an unusually high viral load was detected by reverse transcription real-time polymerase chain reaction (RT-qPCR) in a nasopharyngeal swab sample collected from a patient with respiratory and neurological symptoms who rapidly succumbed to the disease. Therefore we sought to characterise the infection. OBJECTIVES We aimed to determine and characterise the etiological agent responsible for the poor outcome. METHODS Classical virological methods, such as plaque assay and plaque reduction neutralisation test combined with amplicon-based sequencing, as well as a viral metagenomic approach, were performed to characterise the etiological agents of the infection. FINDINGS Plaque assay revealed two distinct plaque phenotypes, suggesting either the presence of two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains or a productive coinfection of two different species of virus. Amplicon-based sequencing did not support the presence of any SARS-CoV-2 genetic variants that would explain the high viral load and suggested the presence of a single SARS-CoV-2 strain. Nonetheless, the viral metagenomic analysis revealed that Coronaviridae and Herpesviridae were the predominant virus families within the sample. This finding was confirmed by a plaque reduction neutralisation test and PCR. MAIN CONCLUSIONS We characterised a productive coinfection of SARS-CoV-2 and Herpes simplex virus 1 (HSV-1) in a patient with severe symptoms that succumbed to the disease. Although we cannot establish the causal relationship between the coinfection and the severity of the clinical case, this work serves as a warning for future studies focused on the interplay between SARS-CoV-2 and HSV-1 coinfection and COVID-19 severity.

https://doi.org/10.1590/0074-02760210176

12.

Ações para o fortalecimento da resiliência em adolescentes
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Santos, Laís Katharina da Paixão dos

; Santana, Cláudia de Carvalho

; Souza, Marta Vanessa Oliveira de

Ciência & Saúde Coletiva

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oct 2020, Volume 25 N. 10 Pages 3933 - 3943

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

Resumo A consolidação de práticas voltadas para o fortalecimento da resiliência corrobora com a atual mudança de paradigmas no âmbito da promoção da saúde de adolescentes, em que se considera a singularidade do sujeito, assim como sua relação com o meio. Identificar fatores protetivos envolvidos no processo de resiliência em adolescentes. Este trabalho revisa publicações indexadas que descrevem modelos e intervenções de atendimento ao adolescente. A análise dos textos consistiu em: 1) comparar as semelhanças e diferenças entre os conceitos utilizados; e 2) identificar, agrupar e compilar os fatores de proteção mais citados. Foram analisados 17 artigos que trabalham o fortalecimento da resiliência em seis contextos práticos distintos. A partir dos fatores de proteção encontrados foram geradas 17 ações norteadoras para desenvolvimento de trabalhos educativos em saúde. Fatores protetivos relacionado “Resolução de problemas”, “Valorização do sujeito” e “Habilidade de comunicação” foram identificados em diversos contextos de estudo sobre adolescência. Esses fatores constituem aspectos transversais necessários ao fortalecimento da resiliência e devem ser estimulados conjuntamente a fim de favorecer o desenvolvimento saudável do adolescente.

Abstract The consolidation of practices aimed at enhancing resilience corroborates the current paradigm shift within the scope of adolescent health promotion, in which the individual’s singularity is considered, as well as his/her relationship with the environment. The scope of the undertaking was to identify protective factors involved in the process of resilience among adolescents. This paper reviews indexed publications describing adolescent care models and interventions. The analysis of the texts consisted of: 1) comparing the similarities and differences between the concepts used; and 2) identifying, grouping and compiling the most cited protection factors. A total of 17 articles that strive to enhance resilience in six different practical contexts were analyzed. Based on the protection factors found, 17 actions were generated to guide the development of educational works in health. Protective factors related to “Problem solving”, “Valorization of the individual” and “Ability in communication” were identified in several contexts of study on adolescence. These factors represent transversal aspects necessary to enhance resilience and should be stimulated together in order to foster the healthy development of adolescents.

https://doi.org/10.1590/1413-812320202510.22312018

13.

Ações para o fortalecimento da resiliência em adolescentes
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Santos, Laís Katharina da Paixão dos

; Santana, Cláudia de Carvalho

; Souza, Marta Vanessa Oliveira de

Ciência & Saúde Coletiva

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oct 2020, Volume 25 N. 10 Pages 3933 - 3943

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

https://doi.org/10.1590/1413-812320202510.22312018 1745 downloads

14.

Cross-cultural adaptation and semantic validation of an instrument to identify palliative requirements in Portuguese
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Santana, Marcella Tardeli Esteves Angioleti

; Gómez-Batiste, Xavier

; Silva, Lucia Marta Giunta da

; Gutiérrez, Maria Gaby Rivero de

einstein (São Paulo)

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2020, Volume 18 elocation eAO5539

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

RESUMO Objetivo Realizar a tradução e a adaptação transcultural, e analisar a validade semântica do instrumento NECPAL CCOMS-ICO© para a língua portuguesa. Métodos Pesquisa metodológica, de adaptação transcultural da versão espanhola do instrumento para a língua portuguesa e mensuração da validade semântica. Conduziu-se a adaptação transcultural com base nas recomendações de Beaton, que inclui tradução, síntese da tradução, retrotradução, e análise da equivalência semântica, idiomática, conceitual e cultural das versões, resultando na versão pré-final, a qual foi submetida ao pré-teste (n=35). Para analisar a validade semântica, foi calculado o Índice de Validade de Conteúdo. Resultados O processo de adaptação transcultural possibilitou a elaboração da versão final, denominada NECPAL-BR. Os dados do pré-teste possibilitaram a análise da validade semântica. O Índice de Validade de Conteúdo obtido nessa etapa foi de 0,94. Conclusão O instrumento possui validade semântica em sua versão em língua portuguesa e, portanto, pode auxiliar na triagem de pacientes com doença crônica progressiva, com vistas a oferecer, de forma precoce, atenção paliativa. Pode, ainda, propiciar o desenvolvimento de indicadores clínicos, de desempenho de equipe e servir como ferramenta de gestão do cuidado, visando à otimização de recursos.

ABSTRACT Objective To translate and make cross-cultural adaptation of NECPAL CCOMS-ICO© tool to Portuguese, and to analyze its semantic validity. Methods A methodological research about NECPAL CCOMS-ICO© tool cross-cultural adaptation, translated from Spanish into Portuguese and measurement of semantic validity. The cross-cultural adaptation process was conducted according to Beaton recommendations, including translation, translation synthesis, back-translation, and analysis of semantic, idiomatic, conceptual, and cultural equivalence of translated and back-translated tool versions, resulting in a pre-final version, which was submitted to a pre-test (n=35). Contend Validity Index was calculated to analyze semantic validity. Results Cross-cultural adaptation process allowed us to prepare the final version of this tool, which was named NECPAL-BR. Collected data from pre-testing step enabled the analysis of semantic validity. The Content Validity Index observed at this step was 0.94. Conclusion The semantic validity of the tool in its Portuguese version was confirmed; therefore, it may assist in screening chronic progressive disease patients, aiming to provide early palliative care. It may also be used to develop clinical and team performance indicators, and be employed as a care management tool designed to optimize resources.

https://doi.org/10.31744/einstein_journal/2020ao5539 604 downloads

15.

Cultura de la salud en los familiares de niños sobre la vacunación. Policlínico “5 de Septiembre”, enero-junio 2015
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Galindo Santana, Belkys María

; Ávila Galindo, Yoane

; Castro Peraza, Ana Marta

; Pérez Chacón, Denis

; Carrión Chacón, Madeleine

; Amador Valdés, Carmen

Revista Cubana de Medicina Tropical

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dec 2019, Volume 71 N. 3 elocation e394

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

ABSTRACT Objective: to know, from the social perspective, the population´s knowledge and beliefs based on the meaning that people attribute to preventive vaccines and the vaccination process. Methods: An exploratory study was carried out with relatives of children from 0 to 24 months from “5 de Septiembre” community clinic in Playa municipality, Havana, from January to June 2015. A mixed convergent or triangulation design was used. Data collection was completed by questionnaire interview, expert interview and interview to key informants. A database was created in Excel, which was exported to the SPSS program version 19.0. Initially, a descriptive analysis was performed, in which absolute and relative frequencies were calculated for the study variables. Repeated readings were made of the transcripts of the interviews with experts and key informants and for the answers to the open questions of the questionnaire, to establish the analysis of the qualitative data, and for familiarization with their content. Results: It was shown the institutional pathway in health culture that family members have in relation to vaccines and the vaccination process. Most family members had poor knowledge about vaccines and the diseases they prevent. They did not show knowledge about serious or severe adverse events. The vaccination process showed great significance for family members, associated with positive experiences with it. Conclusions: This study initiates an approach to the health culture a group of family members had related to preventive vaccines and the vaccination process in Cuba. Mothers reinforce the responsibility of vaccinating the child as part of their child's health care. The health culture in family members of children does not include distorted information about preventive vaccines and their effectiveness. Their knowledge is fed exclusively by scientific culture, although it is entirety not reproduce. The vaccination process is highly valued by family members, given the importance they attach to it, the confidence they have in the National Immunization Program, the satisfaction they show with the organization of the service and the care of health personnel.

RESUMEN Objetivo: conocer desde la perspectiva social, los conocimientos y creencias de la población a partir del significado que las personas le atribuyen a las vacunas preventivas y al proceso de vacunación. Métodos: Se realizó un estudio exploratorio con familiares de niños de 0 a 24 meses pertenecientes al Policlínico “5 de Septiembre”, municipio Playa, La Habana, que abarcó de enero a junio de 2015. Se utilizó un diseño mixto convergente o por triangulación de datos. Para la recolección de datos se utilizó la entrevista-cuestionario, entrevista a expertos y entrevista a informantes claves. Se elaboró una base de datos en Excel, la que se exportó al programa SPSS versión 19.0. En un primer momento, se realizó un análisis descriptivo, en el que se calcularon frecuencias absolutas y relativas para las variables de estudio. Para establecer las relaciones entre el nivel de conocimiento y algunas variables sociodemográficas, para el análisis de los datos cualitativos, se realizaron lecturas reiteradas de las transcripciones de las entrevistas a expertos e informantes claves y de las respuestas a las preguntas abiertas del cuestionario para la familiarización con el contenido de estos. Resultados: Se puso de manifiesto la vía institucional en la cultura de la salud que poseen los familiares con relación a las vacunas y el proceso de vacunación. Los familiares presentaban en su mayoría conocimientos insuficientes acerca de las vacunas y las enfermedades que protegen estas. No presentaban conocimientos sobre los eventos adversos graves o severos. El proceso de vacunación mostró gran significado para los familiares, asociados a experiencias positivas con este. Conclusiones: Se inicia un acercamiento a la cultura de la salud, poseída por un grupo de familiares, relativos a las vacunas preventivas y el proceso de vacunación en Cuba. Las madres refuerzan la responsabilidad de vacunar al niño/a como parte del cuidado de la salud de este. La cultura de la salud en los familiares de niños/as no incluye información distorsionada sobre las vacunas preventivas y su efectividad. Se nutre exclusivamente de la cultura científica, aunque no la reproduce en su totalidad. El proceso de vacunación es altamente valorado por los familiares, dada la importancia que le atribuyen, la confianza que tienen en el Programa Nacional de Inmunización, la satisfacción que muestran con la organización del servicio y la atención del personal de salud.

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