Doenças Infectocontagiosas na Atenção Básica à Saúde [2016]

O Curso “Doenças Infectocontagiosas na Atenção Básica”(2016) tem o objetivo de proporcionar aos médicos e outros profissionais de saúde que atuam na ABS uma visão das principais medidas de vigilância e controle de agravos infectocontagiosos prevalentes no Brasil, bem como orientar o seu manejo clínico. O curso é dividido em 2 unidades educacionais: Unidade 1 - Vigilância das doenças infectocontagiosas na Atenção Básica; Unidade 2 - Abordagem clínica de agravos infecciosos na Atenção Básica2016Ministério da Saúde. Secretária de Gestão do Trabalho e da Educação na SaúdeUniversidade Aberta do SUSMinistério da Educação. Universidade Aberta do Brasi

Health related quality of life among patients with chronic hepatitis C: a cross-sectional study of sociodemographic, psychopathological and psychiatric determinants

AbstractIntroductionChronic hepatitis C virus infection patients have higher rates of psychiatric disorders than the general population. Chronic hepatitis C virus infection is known to be associated with impaired health related quality of life. To our knowledge, there is no previous research of health related quality of life in chronic hepatitis C patients that combined structured psychiatric interview and careful psychopathological evaluation, including depression, anxiety and fatigue instruments. The aim of this study was to evaluate health related quality of life of chronic hepatitis C patients and to investigate the association with sociodemographic, psychopathological and psychiatric factors.Materials and methodsEighty-one individuals with chronic hepatitis C virus infection receiving care at a Brazilian public university-based outpatient service for infectious diseases were enrolled in the study. The World Health Organization Quality of Life Scale Brief Version was used to assess health related quality of life. Standard psychiatric interview (Mini International Neuropsychiatric Interview-Plus) was conducted to establish Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I psychiatric diagnosis. Further instruments completed psychopathological investigation: Beck Depression Inventory, Hospital Anxiety and Depression Scale, Brief Fatigue Inventory, Hamilton Depression Scale and Hamilton Anxiety Scale. Pearson Chi-Square and Kruskal–Wallis were performed for categorical and continuous univariate analysis, respectively. Correlation between psychopathological and health related quality of life scores was performed according to Spearman's correlation. Multivariate analysis was performed according to stepwise forward ordinal logistic regression. The significance threshold was fixed at α=0.05.ResultsDepressive disorders were associated with worse scores in overall health related quality of life and in all domains. Fatigue was associated with lower scores in physical and psychological domains, and married status with higher scores in psychological health related quality of life. We found strong correlation among scores of depression, fatigue and health related quality of life.ConclusionDepression and fatigue must be properly investigated and managed in HCV patients in order to improve HRQL. WHOQOL-BREF proved to be a useful instrument to assess HRQL in HCV patients

Dengue: casos clínicos para atualização do manejo

Curso composto de oito casos de diagnóstico e manejo da dengue, que são: caso Ricardo, caso Maria do Socorro, caso Geraldo, caso Gisele, caso Laura, caso Pedro, caso Raimundo e caso Gabriela. O curso visa, no geral, capacitar e atualizar os profissionais de saúde no que concerne a doença, diagnóstico e manejo em populações distintas, criança, adulto, idoso, gestantes. Aborda o diagnóstico diferencial entre Dengue, Zika e Chikungunya e a correta realização da prova do laço. Cada caso possui atividades, objetivos e peculiaridades específicas

USING ENTRUSTABLE PROFESSIONAL ACTIVITIES IN THE DESIGN OF THREE NEW HEALTHCARE UNDERGRADUATE PROGRAMS: BIOMEDICINE, NURSING AND PSYCHOLOGY

Entrustable Professional Activities (EPAs) can be defined as a unit of professional practice that can be entrusted to a trainee after they have obtained adequate competency. EPAs integrate multiple competencies from several domains and are very useful in designing competency-based curricula. Using EPAs to design medical curricula has been widely described, but their application to curriculum design of other health-related undergraduate programs is scarce. This manuscript critically assesses an educational planning experience of using EPAs to simultaneously design three healthcare undergraduate programs (nursing, biomedicine and psychology) at Faculdade Santa Casa BH, Minas Gerais, Brazil. We present the EPAs for each program, curricula frameworks, educational strategies, and assessment methods. Expert groups of professors and educational specialists defined the core professional activities that would be directly assessed and entrusted to trainees from the three different programs. The expert group then defined the required knowledge, skills, and attitudes for each EPA and selected the appropriate assessment tools to be used in entrustment decisions. The expected entrustment level for each training phase guided the course’s distribution of core and elective courses. The experience of designing a curriculum using EPAs was successful and helped focus on the core activities of each profession. It also provided an opportunity to reflect upon formative and summative assessments throughout the course bringing the challenge of reorienting our teaching practices and assessment approaches. Designing undergraduate curricula of health-related professions using EPAs is feasible and might help operationalize competency-based curricula.  Article visualizations

Correlation between mass and volume of collected blood with positivity of blood cultures

Background The collection of blood cultures is an extremely important method in the management of patients with suspected infection. Microbiology laboratories should monitor blood culture collection. Methods Over an 8-month period we developed a prospective, observational study in an adult Intensive Care Unit (ICU). We correlated the mass contained in the blood vials with blood culture positivity and we also verified the relationship between the mass of blood and blood volume collected for the diagnosis of bloodstream infection (BSI), as well as we explored factors predicting positive blood cultures. Results We evaluated 345 patients with sepsis, severe sepsis or septic shock for whom blood culture bottles were collected for the diagnosis of BSI. Of the 55 patients with BSI, 40.0 % had peripheral blood culture collection only. BSIs were classified as nosocomial in 34.5 %. In the multivariate model, the blood culture mass (in grams) remained a significant predictor of positivity, with an odds ratio 1.01 (i.e., for each additional 1 mL of blood collected there was a 1 % increase in positivity; 95 % CI 1.01–1.02, p = 0.001; Nagelkerke R Square [R2] = 0.192). For blood volume collected, the adjusted odds ratio was estimated at 1.02 (95 % CI: 1.01–1.03, p \u3c 0.001; R2 = 0.199). For each set of collected blood cultures beyond one set, the adjusted odds ratio was estimated to be 1.27 (95 % CI: 1.14–1.41, p \u3c 0.001; R2 = 0.221). Conclusions Our study was a quality improvement project that showed that microbiology laboratories can use the weight of blood culture bottles to determine if appropriate volume has been collected to improve the diagnosis of BSI

Epidemiology of Meningococcal Disease, New York City, 1989–2000

Study of the epidemiologic trends in meningococcal disease is important in understanding infection dynamics and developing timely and appropriate public health interventions. We studied surveillance data from the New York City Department of Health and Mental Hygiene, which showed that during 1989–2000 a decrease occurred in both the proportion of patients with serogroup B infection (from 28% to 13% of reported cases; p<0.01) and the rate of serogroup B infection (from 0.25/100,000 to 0.08/100,000; p<0.01). We also noted an increased proportion (from 3% to 39%; p<0.01) and rate of serogroup Y infection (from 0.02/100,000 to 0.23/100,000; p<0.01). Median patient age increased (from 15 to 30 years; p<0.01). The case-fatality rate for the period was 17%. As more effective meningococcal vaccines become available, recommendations for their use in nonepidemic settings should consider current epidemiologic trends, particularly changes in age and serogroup distribution of meningococcal infections

Wild dogs at stake: deforestation threatens the only Amazon endemic canid, the short-eared dog (Atelocynus microtis)

The persistent high deforestation rate and fragmentation of the Amazon forests are the main threats to their biodiversity. To anticipate and mitigate these threats, it is important to understand and predict how species respond to the rapidly changing landscape. The short-eared dog Atelocynus microtis is the only Amazon-endemic canid and one of the most understudied wild dogs worldwide. We investigated short-eared dog habitat associations on two spatial scales. First, we used the largest record database ever compiled for short-eared dogs in combination with species distribution models to map species habitat suitability, estimate its distribution range and predict shifts in species distribution in response to predicted deforestation across the entire Amazon (regional scale). Second, we used systematic camera trap surveys and occupancy models to investigate how forest cover and forest fragmentation affect the space use of this species in the Southern Brazilian Amazon (local scale). Species distribution models suggested that the short-eared dog potentially occurs over an extensive and continuous area, through most of the Amazon region south of the Amazon River. However, approximately 30% of the short-eared dog's current distribution is expected to be lost or suffer sharp declines in habitat suitability by 2027 (within three generations) due to forest loss. This proportion might reach 40% of the species distribution in unprotected areas and exceed 60% in some interfluves (i.e. portions of land separated by large rivers) of the Amazon basin. Our local-scale analysis indicated that the presence of forest positively affected short-eared dog space use, while the density of forest edges had a negative effect. Beyond shedding light on the ecology of the short-eared dog and refining its distribution range, our results stress that forest loss poses a serious threat to the conservation of the species in a short time frame. Hence, we propose a re-assessment of the short-eared dog's current IUCN Red List status (Near Threatened) based on findings presented here. Our study exemplifies how data can be integrated across sources and modelling procedures to improve our knowledge of relatively understudied species

Heterogeneidade no tratamento do transtorno do espectro autista

O transtorno do espectro do autismo (TEA), anteriormente chamado de autismo, é uma condição de desenvolvimento que pode causar manifestações sociais, de comunicação e comportamentais significativos. O tratamento é multidisciplinar e individualizado, baseado na sintomatologia de cada paciente. O objetivo do estudo em questão é agregar conhecimento a respeito da heterogeneidade no tratamento do TEA por meio de uma revisão bibliográfica englobando informações atualizadas das revistas Scielo e PubMed utilizando as seguintes palavras chaves: autismo, terapêutica, transtorno autístico, farmacologia clínica, terapia assistida por cavalos. O período de publicação dos artigos incluídos foi de 2012 a 2022, que estiveram de acordo com o tema abordado no trabalho. Através do estudo, foi encontrada uma grande variedade de tratamentos auxiliares para o TEA, entre eles está a utilização de psicofármacos, psicoterapia, musicoterapia e equoterapia. Cada tratamento tem sua individualidade, auxiliando de maneira distinta, assim é possível concluir que não há uma superioridade de uma terapia em relação a outra, e cada tratamento deve ser realizado de acordo com as manifestações sintomáticas de cada paciente