9 research outputs found
Síndrome da unha amarela - relato de caso
-A síndrome da unha amarela é uma doença rara, caracterizada pela tríade de linfedema, derrame pleural e unhas Distróficas de crescimento lento e coloração amarelada. Várias associações já foram descritas, entre elas, afecções crônicas do aparelho respiratório, doenças autoimunes, malignidades e estados de imunodeficiência. Entre os casos citados na literatura, apenas cerca de um terço se apresenta com todos os achados e o caso relatado a seguir é um exemplo da tríade clássica
Strengths of primary healthcare regarding care provided for chronic kidney disease
Objective: to assess the structure and results obtained by the “Chronic Renal Patients Care Program” in a Brazilian city. Method: epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14
physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes. Results: most units lacked sufficient offices for physicians and nurses to provide consultations, had incomplete staffing, and most professionals had
not received proper qualification to provide care for chronic renal disease. Physicians from PHC units classified as capable more frequently referred patients to the secondary care service in the early stages of chronic renal disease (stage 3B) when compared to physicians of units considered not capable (58% vs. 36%) (p=0.049). Capable PHC units also more frequently presented stabilized glomerular filtration
rates (51%) when compared to partially capable units (36%) and not capable units (44%) (p=0.046). Conclusion: patients cared for by primary healthcare units that scored higher in structure and process criteria presented better clinical outcomes. Objective: to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to
the patient’s clinical variables. Method: this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. Results: the coping strategies
most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined. Conclusion: despite the suffering resulting from the illness of a dear one, family members make more use
of functional strategies, allowing them to cope with adversities in a more well-adjusted way.
Quality of Care of Patients with Diabetes in Primary Health Services in Southeast Brazil
Background. Diabetes management involves multiple aspects that go beyond drug therapy as a way of providing high quality care. The objective of this study was to describe quality of care indicators for individuals with diabetes in southeast Brazil and to explore associations among these indicators. Methods. In this cross-sectional, observational study, health care providers filled out a questionnaire addressing health care structure and processes at 14 primary health care units (PHCUs). Clinical and laboratory data of diabetic patients attending the PHCUs and from patients referred to a secondary health care (SHC) center were collected. Results. There was a shortage of professionals in 53.8% of the PHCUs besides a high proportion of problems regarding referrals to SHC. At the PHCU, glycated hemoglobin results were available only in half of the medical records. A low rate of adequate glycemic control was also observed. An association between structure and process indicators and the outcomes analyzed was not found. Conclusion. Major deficiencies were found in the structure and processes of the PHCUs, in addition to unsatisfactory diabetes care outcomes. However, no association between structure, process, and outcomes was found
Estudo da rede de atenção ao diabetes mellitus em Juiz de Fora, Minas Gerais: avaliação da atenção primária à saúde quanto às dimensões de estrutura, processo e resultado e caracterização da população admitida na atenção secundária à saúde
Introduction: Diabetes mellitus is a condition with high morbidity and mortality. The
complexity involved in managing patients with Diabetes mellitus requires changes in
the health system that must be aligned with the Model of Care for Chronic
Conditions. The objective of this study was to describe indicators of quality care for
individuals with Diabetes mellitus in a medium-sized municipality in Brazil and to
explore associations among these indicators. Methods: In this cross-sectional,
observational study, physicians, managers, and community health agents filled out a
questionnaire addressing issues related to health care structure and process at 14
primary health care units. We collected clinical and laboratory data from medical
records of patients with Diabetes mellitus attending the primary health care units and
from those referred to a multiprofessional secondary health care center. Categorical
and quantitative variables were analyzed descriptively. Using random-effects linear
regression, we explored the associations between structure and process elements at
the primary health care units and clinical parameters of the users upon their
admission to the secondary health care center. Results: Regarding the structure of
the primary health care units, we observed an insufficient number of both offices
available for multiprofessional care and amount of medications available to the
patients. There was a shortage of professionals, with 53.8% of incomplete teams in
the Family Health Strategy program, as well as a high proportion of problems
reported by physicians and nurses regarding referrals to the secondary health care
unit (70.0%). Also, there were a low percentage (51.2%) of glycosylated hemoglobin
(HbA1c) results (a process indicator) in the medical records. In the medical records
at the secondary health care unit, 18.7% of the patients presented HbA1c levels <
7% and 43.9% had blood pressure levels below 140x90 mmHg. There was no clear
association between structure and process indicators at the primary health care units
and the results of care recorded in the secondary health care units. Conclusion:
Although we detected important structure and process problems in the care of
patients with Diabetes mellitus at the primary health care units, these problems were
not associated with the clinical status of the patients upon their admission to the
secondary health care unit.Introdução: O diabetes mellitus é uma condição com elevada morbimortalidade. A
complexidade do manejo da doença requer mudanças no sistema de saúde, cuja
assistência deve estar em concordância com o Modelo de Atenção a Condições
Crônicas. O objetivo do presente estudo é descrever indicadores da qualidade da
assistência ao indivíduo com diabetes mellitus no município de Juiz de Fora, Minas
gerais, e explorar associações entre eles. Métodos: Em estudo observacional
transversal realizado em 14 Unidades de Atenção Primária à Saúde, foi aplicado um
questionário a médicos, gerentes e agentes comunitários de saúde, contemplando
perguntas sobre estrutura e processo da assistência. Além disso, foram colhidos
dados clínico-laboratoriais de prontuários dos pacientes com diabetes mellitus nas
Unidades de Atenção Primária à Saúde e de pacientes encaminhados a um centro
multiprofissional de Atenção Secundária à Saúde. As variáveis categóricas e
quantitativas foram analisadas de forma descritiva. A exploração de associações
entre elementos da Estrutura e Processo das Unidades de Atenção Primária à
Saúde e os parâmetros clínicos dos usuários em sua admissão na Atenção
Secundária à Saúde foi realizada através de Regressão Linear de Efeitos Aleatórios.
Resultados: Em relação à estrutura das Unidades de Atenção Primária à Saúde,
observou-se insuficiência de consultórios para atendimento multiprofissional e de
medicamentos para dispensação. Merece destaque a carência de profissionais, com
53,8% das equipes da Estratégia de Saúde da Família incompletas, além da elevada
proporção de médicos e enfermeiros que informam problemas com o
encaminhamento para a Atenção Secundária à Saúde (70,0%). Como indicador de
processo, destaca-se a baixa disponibilidade (51,2%) de resultado de hemoglobina
glicada (HbA1c) registrado nos prontuários. Na análise dos prontuários da Atenção
Secundária à Saúde, 18,7% dos pacientes apresentavam HbA1c < 7% e 43,9%
tinham níveis de pressão arterial inferiores a 140 x 90 mmHg em sua consulta inicial.
Não foi encontrada associação entre elementos da estrutura e processo das
Unidades de Atenção Primária à Saúde e os resultados da assistência apresentados
na consulta inicial na Atenção Secundária à Saúde. Conclusão: Embora tenham sido
detectados déficits importantes na estrutura e processo da assistência ao usuário
com diabetes mellitus nas Unidades de Atenção Primária à Saúde, estes não se
relacionaram ao estado clínico dos pacientes ao ingressarem na Atenção
Secundária à Saúde.FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerai
Strengths of primary healthcare regarding care provided for chronic kidney disease
ABSTRACT Objective: to assess the structure and results obtained by the "Chronic Renal Patients Care Program" in a Brazilian city. Method: epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14 physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes. Results: most units lacked sufficient offices for physicians and nurses to provide consultations, had incomplete staffing, and most professionals had not received proper qualification to provide care for chronic renal disease. Physicians from PHC units classified as capable more frequently referred patients to the secondary care service in the early stages of chronic renal disease (stage 3B) when compared to physicians of units considered not capable (58% vs. 36%) (p=0.049). Capable PHC units also more frequently presented stabilized glomerular filtration rates (51%) when compared to partially capable units (36%) and not capable units (44%) (p=0.046). Conclusion: patients cared for by primary healthcare units that scored higher in structure and process criteria presented better clinical outcomes. Objective: to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. Method: this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. Results: the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined. Conclusion: despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope with adversities in a more well-adjusted way
Strengths of primary healthcare regarding care provided for chronic kidney disease
OBJECTIVE: to assess the structure and results obtained by the "Chronic Renal Patients Care Program" in a Brazilian city. METHOD: epidemiological, cross-sectional study conducted in 14 PHC units and a secondary center from 2010 to 2013. The Donabedian Model was the methodological framework used. A total of 14 physicians, 13 supervisors, and 11 community health agents from primary healthcare were interviewed for the assessment of structure and process and 1,534 medical files from primary healthcare and 282 from secondary care were consulted to assess outcomes. RESULTS: most units lacked sufficient offices for physicians and nurses to provide consultations, had incomplete staffing, and most professionals had not received proper qualification to provide care for chronic renal disease. Physicians from PHC units classified as capable more frequently referred patients to the secondary care service in the early stages of chronic renal disease (stage 3B) when compared to physicians of units considered not capable (58% vs. 36%) (p=0.049). Capable PHC units also more frequently presented stabilized glomerular filtration rates (51%) when compared to partially capable units (36%) and not capable units (44%) (p=0.046). CONCLUSION: patients cared for by primary healthcare units that scored higher in structure and process criteria presented better clinical outcomes. OBJECTIVE: to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. METHOD: this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. RESULTS: the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined. CONCLUSION: despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope with adversities in a more well-adjusted way