Conhecimentos, atitudes e comportamentos sobre o rastreio do cancro colorretal em beneficiários do SAMS

A proteção da saúde é um direito e uma responsabilidade individual e, simultaneamente, coletiva. É da responsabilidade dos sistemas de saúde promover e garantir o acesso dos seus utilizadores aos programas de saúde. Salvaguardada esta garantia, é responsabilidade individual estar informado para melhor participar em programas de prevenção e manutenção da saúde e tratamento da doença. O cancro colorretal (CCR) é a terceira causa de morte em todo o mundo. É responsável pela morte de cerca de 230 000 pessoas por ano na Europa e, em Portugal, é responsável pela morte de 10 a 12 pessoas por dia. A sua história natural, longa, bem conhecida e com uma fase precursora benigna, torna o CCR uma doença com enorme potencial para a prevenção e o diagnóstico precoce. A evidência indica que, na grande maioria dos casos, o rastreio do CCR é eficaz não só em relação à redução da mortalidade, mas também da incidência. O objetivo do estudo é caracterizar os níveis de conhecimentos, atitudes e práticas preventivas sobre o CCR numa amostra de 136 indivíduos, beneficiários do subsistema de saúde SAMS (Serviços de Assistência Médico Social). Os dados foram obtidos por questionário tendo sido tratados em programa de análise estatística SPSS®. A análise do estudo revelou que a amostra possui, de um modo geral, bons conhecimentos sobre os fatores de risco do CCR, conhece os exames de rastreio e tem uma atitude preventiva. Revelou ainda uma significativa adesão aos exames de rastreio recomendados, nomeadamente, aos dois mais frequentes métodos: a PSOF e a colonoscopia.Health protection is a right and simultaneously an individual and collective responsibility. It is the health system duty to promote and guarantee the access of their users to the health programs. By being this assured, it is the individual responsibility to be informed in order to better participate in prevention and health maintenance programs and disease treatment. Colorectal Cancer (CRC) is the third death cause worldwide. It is responsible for the death of about 230 000 people per year in Europe and in Portugal it is the cause of death of about 10 to 12 people per day. Its natural and long history is well known. By being initially harmless, CRC turns into a disease with an enormous potential for prevention and early diagnosis. Evidence indicates that in most cases, CRC screening is not only effective in terms of death rate reduction but also in terms of its incidence. This study aims to characterize the levels of knowledge, attitudes and a preventive practice in what the CRC is concerned in a sampling of 136 patients who benefit from the SAMS (assistence service medical social) health subsystem. Data were obtained through questionnaires and analyzed by using a statistics program called SPSS®. The study analysis revealed that the sampling has, in general, good knowledge about the CRC risk factors, is informed about the screening exams and has a preventive attitude towards it. In addition, results also showed a significant adhesion to the recommended screening exams, namely the two most frequent methods: the FOBT and colonoscopy

Cartography of contaminants around a plant for the production of zinc (Três Marias, Minas Gerais, Brazil)

Este trabalho enquadra-se num contrato assinado entre a Universidade de Évora e a empresa Votorantim-Metais, com o objectivo de identificar metais contaminantes e sua distribuição em solos, água e sedimentos na envolvente duma unidade fabril. Entre Agosto e Novembro realizaram-se as duas primeiras campanhas de recolha de amostras, respectiva georreferenciação e fizeram-se os primeiros testes de avaliação da espessura dos sedimentos depositados ao longo das ribeiras que delimitam a área fabril. Os dados preliminares parecem indicar dois tipos de contaminação: por escorrência superficial e deposição de partículas sólidas à superfície e por circulação subterrânea e deposição de sais em profundidade, em zonas aluvionares saturadas a pouca profundidade. Nas próximas campanhas a cartografia dos sedimentos contaminados será complementada com recurso a métodos de prospecção geoeléctrica em terra e a dragagens e levantamentos batimétricos no Rio São Francisco e afluentes que delimitam a fábrica

Uma perspectiva pós-moderna sobre a saúde bucal de idosos

This article aims to comprehend meaning assigned to oral health, by means of older adults discourses, supported by a Social Constructionist perspective. This is a qualitative study with a descriptive and comprehensive design based on the Social Constructionism theoretical support conducted by means of interviews with 19 older adults. Data were analysed by means of a Discourse Analysis with identification of Interpretative Repertoires, which structured the meanings proposed to oral health. It were created repertories to disclosure possible meanings assigned to the oral health by older people as: having a clean mouth; having good comprehensive/general health; having a beautiful smile and oral health well-being condition; and suffering in the past and accepting pain. The meaning assigned to oral health by older people, in a social constructionist perspective, allow us to comprehend the subjectivity behind oral health of older people, which can guide health professionals’ approaches to deal with itO objetivo deste artigo é compreender o significado da saúde bucal, por meio de discursos de idosos, com apoio da perspectiva teórica Construcionista Social. Trata-se de um estudo qualitativo com um desenho descritivo e compreensivista, baseado no referencial teórico do Construcionismo Social realizado por meio entrevistas com 19 idosos. Os dados foram analisados por meio de uma Análise de Discurso com identificação de Repertórios Interpretativos, que estruturou os significados atribuídos à saúde bucal. Foram criados repertórios para a compreensão de significados possíveis atribuídos à saúde bucal por pessoas idosas. Deste modo, saúde bucal é: ter uma boca limpa; ter boa saúde geral; ter um sorriso bonito e se sentir bem com a condição bucal; ter tido algum sofrimento no passado aceitando a dor. Os significados atribuídos à saúde bucal pelos idosos, numa perspectiva construcionista social, nos permite compreender a subjetividade por trás da saúde bucal das pessoas idosas na atualidade, o que pode orientar as abordagens dos profissionais de saúde para lidar com iss

HOSPITALIZATION FOR PERTUSSIS – A TEN YEARS CASUISTIC FROM A LEVEL III HOSPITAL

Introdução: A tosse convulsa continua a ser uma preocupação em idade pediátrica. Os adolescentes e adultos são reconhecidos como fonte de transmissão de doença, particularmente para lactentes sem primovacinação completa. Pretende-se caracterizar os casos de tosse convulsa sob o ponto de vista epidemiológico, clínico e terapêutico. Material e Métodos: Estudo observacional, descritivo, através da análise retrospetiva dos processos clínicos dos doentes internados por infeção por Bordetella pertussis (identificada por método de PCR) no Serviço de Pediatria de um hospital nível III entre Janeiro de 2005 e Dezembro de 2014. Resultados: Foram internados 43 doentes, com uma duração mediana de oito dias. Verificou-se maior número de internamentos nos anos de 2008 e 2012, com predomínio no Verão. Apresentavam uma mediana de idades de 2,5 meses (mínimo 12 dias, máximo 16 anos), 86,0% dos quais (n=37) eram lactentes sem primovacinação completa. Todos os doentes apresentavam tosse e 48,8% (n=21) tinham contexto sugestivo de coqueluche. Todos foram medicados com macrólido, com intervalo entre o início dos sintomas e da terapêutica, mediano de oito dias (mínimo 2; máximo 60 dias). Verificou-se coinfeção vírica em 21,6% (n=14). Dez doentes foram internados em cuidados intensivos e registaram-se dois óbitos. Discussão e Conclusões: À semelhança de outros estudos, verificou-se um pico de incidência no ano de 2012. Os lactentes foram o grupo mais vulnerável para infeção por Bordetella pertussis, com maior número de internamentos. Parecem ser necessárias novas estratégias de prevenção complementares às existentes para reduzir a ocorrência desta infeção neste grupo etário.Background: Whooping cough remains a concern in pediatric age. Adolescents and adults are recognized as a source of disease transmission, particularly for infants without complete primary immunization. The objectives of this study were to characterize clinically and epidemiologicaly hospitalized pediatric cases of pertussis. Material and methods: Retrospective, observational study of pediatric patients hospitalized at a level III Portuguese hospital with Bordetella pertussis infection confirmed by PCR DNA assay, between January 2005 and December 2014. Results: Forty-three patients were admitted with an median duration of eight days. We observed a higher number of admissions in 2008 and 2012, with majority of cases in the summer. The median age was 2,5 months old (minimum 12 days; maximum 16 years), of which 86.0% (n=37) infants without complete primary vaccination. All patients had cough and 48.8% (n=21) had an identified epidemiological contact of pertussis. All were treated with macrolides, with a mean interval between onset of symptoms and treatment of eight days (minimum 2; maximum 60 days). Viral coinfection occurred in 21.6% (n=14). Ten patients were admitted to intensive care unit and two deceased. Conclusions: Like other studies, there was a incidence peak in 2012. Infants were the most vulnerable age group to infection by Bordetella pertussis, with the highest number of hospitalizations. There is a need for additional prevention strategies to improve prevention in this age group.info:eu-repo/semantics/publishedVersio

Perceptions of a group of elderly on the fact of not seeing the dentist regularly

Ainda existe no imaginário coletivo a ideia de que idosos não necessitam de assistência odontológica, pois são em sua maioria desdentados e usuários de dentaduras. Assim, a pergunta desta pesquisa é: Qual o motivo que faz com que muitos idosos não consultem regularmente o cirurgião-dentista? O objetivo foi levantar e analisar os motivos que fazem com que idosos cadastrados em uma Unidade de Saúde da Família não consultem regularmente o dentista. Trata-se de uma pesquisa descritiva exploratória de abordagem metodológica quanti-qualitativa realizada por meio de entrevistas domiciliares semiestruturadas aplicadas em 149 idosos cadastrados em uma Unidade de Saúde da Família na cidade de Ribeirão Preto,SP. Os dados foram analisados e sistematizados por meio da técnica da Análise de Conteúdo, e para a análise quantitativa foram realizadas análises bivariadas com associações significantes baseadas em valor de p<0,05. Houve associação estatisticamente significante entre visita ao dentista e idade (p=0,025), e observou-se que idosos com idades mais avançadas relataram ir menos ao dentista. Alguns dos motivos alegados foram: medo, dificuldade financeira, falta de tempo, além de falta de sintomatologia dolorosa nos dentes devido ao uso de dentaduras. Concluiu-se que os motivos alegados estão associados a aspectos sociais e culturais que devem ser analisados frente ao cuidado na atenção primária à saúde

Envelhecimento activo e estilos de vida saudáveis : a actividade física

Uma das grandes preocupações sobre a população mundial para os próximos 50 anos é o processo de envelhecimento da população, a sua repercussão sobre os problemas de saúde, a vigência de uma transição epidemiológica em concomitância com novas doenças, a busca de avanços científicos e tecnológicos para responder à procura emergente e a adopção e consolidação de modelos de saúde centrados na prevenção. A ênfase em novos paradigmas constitui ponto convergente das abordagens dos órgãos oficiais (inter)nacionais, havendo incentivo para a realização de investigações nas áreas biomédicas e nas ciências sociais. As políticas públicas implantadas têm como preocupação maximizar a melhoria da qualidade dos anos vividos da população, numa perspectiva interdisciplinar, integrada, articulada e individualizada, que percorra todo o curso de vida e seja capaz de consolidar estratégias de estilos de vida saudáveis, enfatizando, entre outras, a prática regular da actividade física.One of the great concerns about global population for the next 50 years is the aging process, its repercussion on health, the validity of an epidemiologic transition in concurrence with new illnesses, the search of scientific and technological advances to answer the emergent demands and the adoption and consolidation of models on health prevention. The emphasis in new paradigms is a convergent point of the (inter)national official agencies agenda, namely the incentives to conduct research at biomedical and social sciences. Current public policies try to improve the quality of the lived years of the population, in an interdisciplinary, integrated, articulated and individualized perspective that covers the entire life course of the individual so that healthy life styles can be consolidated, with a special reference to the regular practice of physical activity

Alkali Iodide Deep Eutectic Solvents as Alternative Electrolytes for Dye Sensitized Solar Cells

PTDC/QEQ- QFI/1971/2014 POCI- 01-0145-FEDER-016387Different alkali deep eutectic solvents (DES), such as LiI:nEG, NaI:nEG, and KI:nEG, have been tested as electrolytes for dye sensitized solar cells (DSSCs). These DSSCs were prepared using pure DES or, alternatively, DES combined with different amounts of iodine (I2). The most important parameters, such as open circuit voltage (VOC), short circuit current density (JSC), fill factor (FF), and the overall conversion efficiency (η), were evaluated. Some DES seem to be promising candidates for DSSC applications, since they present higher VOC (up to 140 mV), similar FF values but less current density values, when compared with a reference electrolyte in the same experimental conditions. Additionally, electrochemical impedance spectroscopy (EIS) has been performed to elucidate the charge transfer and transport processes that occur in DSSCs. The values of different resistance (Ω·cm2) phenomena and recombination/relaxation time (s) for each process have been calculated. The best-performance was obtained for DES-based electrolyte, KI:EG (containing 0.5 mol% I2) showing an efficiency of 2.3%. The efficiency of this DES-based electrolyte is comparable to other literature systems, but the device stability is higher (only after seven months the performance of the device drop to 60%).publishersversionpublishe

Intraoral epithelioid hemangioendothelioma : a case report and review of the literature

The epithelioid hemangioendothelioma (EH) is an uncommon angiocentric neoplasm of borderline or intermediate malignant potential, between the hemangioma and conventional angiosarcoma. It is characterized by the proliferation of endothelial cells with epithelioid or histiocitóide morphology with vacuolated cytoplasm and occasional eosinophilic spindle cells. Shows potential for local recurrence as well as the ability to metastasize. Rarely affects the oral cavity, it have been described from 1975 until 2008 only 27 oral cases. Morphologically the EHs may be confused with other lesions, from a hemangioma to a squamous cell carcinoma, and thus immunohistochemical analysis is required. This paper reports the clinical and immunohistochemical characteristics of a case of EH in the gingiva of the tooth 35 of a 17 years-old-white-female. We present a review of the clinicopathological and immunohistochemical characteristics of the intraoral epithelioid hemangioendothelioma cases previously reported

Prevalence of shigatoxigenic Escherichia coli in bovine cattle: a survey in the north region of portugal

Shiga toxin-producing Escherichia coli (STEC) strains are food-borne pathogens that can be transmitted to humans through many different routes, but mainly through consumption of contaminated foods. STEC strains are characterized by the production of Shiga toxins (Stx) that are encoded by two genes stx1 and/or stx2. Each toxin can be subdivided into subtypes and, currently, there are three known subtypes for stx1 (stx1a, stx1c, and stx1d) and seven for stx2 (stx2a, stx2b, stx2c, stx2d, stx2e, stx2f, and stx2g). Others virulence factors, such the production of intimin protein, encoded by eae gene, are associated with severe outcomes of STEC-associated diseases. The most common STEC serotype implicated worldwide is E. coli O157:H7, but many other STEC strains are associated with severe human diseases. Ruminants, especially cattle, are a major reservoir for O157 and non-O157 STEC. Information on STEC prevalence in Portuguese dairy cattle is limited, so we analysed for the presence of STEC 329 faecal specimens collected from the rectum of healthy dairy cattle. The samples were collected from adults lactating cows (n=194) and from heifers (n=135) with ages among 6 to 18 months, between March and June 2019, at milk farms (n=17) in the North region of Portugal. After enrichment, in modified TSB with novobiocin, samples were analysed by real time PCR to detect the presence of stx1, stx2 and eae in accordance to ISO/TS 13136:2012(E). In addition, conventional PCR for the detection of sxt1 and stx2 gene subtypes was performed according to the guidelines of the VTEC European Union Reference Laboratory. A total of 139 isolates were recovered from 108 positive animals (dairy cows and heifers). The STEC prevalence was significantly higher in heifers (68/135; 50.4%) than in adult cows (40/194; 20.6%) (p < 0.05, Fisher exact test statistic value is <0.00001). STEC harbouring only stx2 (67/139; 48.2%) were the most common strains, followed by both genes stx1 and stx2 (40/139, 28.8%) and stx1 (32/139, 23%). Of the 139 STEC isolates, 35.3% have also the eae gene. Subtyping of stx1 (72) showed that stx1a was the most prevalent (100%), followed by stx1c (88.9%) and stx1d (6.9%). Stx1a and stx1c subtypes occurred alone or combination with other subtypes. However, subtype stx1d was only found in combination with subtype stx1a and or stx1c. Concerning strains with stx2 (107), the stx2a subtype was the most common and was found in 84.1% of the isolates, followed by stx2d (76.6%), stx2c (74.8%), stx2g (23.4%), stx2b (4.7%), stx2e (3.7%) and stx2f (0.9%). No strains carried stx2b or stx2f alone. For isolates carrying stx1 and stx2 simultaneously, combinations of subtypes stx1a, stx1c, stx2a, stx2c and stx2d were the most common. Furthermore, in 42 isolates (30.2%) 4 or more stx subtypes were detected simultaneously. These results show that STEC prevalence in dairy cattle is high, and that most isolates present a diverse combination of Shiga-toxin genes. Future strategies are needed to mitigate the presence of STEC in cattle and then reduce the possible contamination of food and, thus, humans.Project PhageSTEC (POCI-01-0145-FEDER-029628) funded by FEDER through COMPETE2020 (Programa Operacional Competitividade e Internacionalização) and by National Funds thought FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Introduction of robotic surgery for endometrial cancer into a Brazilian cancer service: a randomized trial evaluating perioperative clinical outcomes and costs

OBJECTIVE: The purpose of this study was to evaluate the clinical outcome and costs after the implementation of robotic surgery in the treatment of endometrial cancer, compared to the traditional laparoscopic approach. METHODS: In this prospective randomized study from 2015 to 2017, eighty-nine patients with endometrial carcinoma that was clinically restricted to the uterus were randomized in robotic surgery (44 cases) and traditional laparoscopic surgery (45 cases). We compared the number of retrieved lymph nodes, total time of surgery, time of each surgical step, blood loss, length of hospital stay, major and minor complications, conversion rates and costs. RESULTS: The ages of the patients ranged from 47 to 69 years. The median body mass index was 31.1 (21.4-54.2) in the robotic surgery arm and 31.6 (22.9-58.6) in the traditional laparoscopic arm. The median tumor sizes were 4.0 (1.5-10.0) cm and 4.0 (0.0-9.0) cm in the robotic and traditional laparoscopic surgery groups, respectively. The median total numbers of lymph nodes retrieved were 19 (3-61) and 20 (4-34) in the robotic and traditional laparoscopic surgery arms, respectively. The median total duration of the whole procedure was 319.5 (170-520) minutes in the robotic surgery arm and 248 (85-465) minutes in the traditional laparoscopic arm. Eight major complications were registered in each group. The total cost was 41% higher for robotic surgery than for traditional laparoscopic surgery. CONCLUSIONS: Robotic surgery for endometrial cancer presented equivalent perioperative morbidity to that of traditional laparoscopic surgery. The duration and total cost of robotic surgery were higher than those of traditional laparoscopic surgery