The Lipodystrophy Syndrome as a Risk Marker for Cardiovascular Disease in Patients with HIV/AIDS Treated with HAART

Introduction: The classic risk factors for cardiovascular disease in healthy individuals are well known, however, it lacks in the literature the mechanisms that predicts cardiovascular disease in the population living with HIV-AIDS treated with HAART and presenting syndrome lipodystrophy. We aimed to investigate the risk of cardiovascular disease in HIV-AIDS patients treated with HAART and lipodystrophy syndrome. Methods: A search was performed in Medline, SciELO, Lilacs and Cochrane using the intersection between the keywords: "cardiovascular disease", "HIV", "AIDS", "HAART" and "lipodystrophy syndrome". Results: The selected studies demonstrated that metabolic disorders such as hyperlipidemia, central adipose hypertrophy and peripheral lipoatrophy, besides the metabolic syndrome and lipodystrophy are maker clear risks of developing cardiovascular disease in these individuals. Conclusion: The metabolic alterations in HIV-AIDS treated with HAART and presenting lipodystrophy syndrome may potentiate the development of cardiovascular diseases

Prevalência da síndrome de burnout em enfermeiros da clínica médico-cirurgica de um hospital de excelência

A Síndrome de Burnout é considerada um estresse laboral de caráter duradouro vinculado à atividade de trabalho e embora a síndrome seja detectada em profissionais de áreas diversas, a prevalência desta condição é particularmente alta em profissionais da área da saúde, entre eles o enfermeiro que tem sido alvo de diversos estudos, já que vivencia situações de estresse laboral constante, atuando em contato direto com pacientes com expectativas e graus de sofrimento diversos. Objetivo: Identificar a prevalência, propensão e perfil sócio demográfico da síndrome de burnout, nos enfermeiros, além de fatores correlacionados a síndrome e suas dimensões: exaustão emocional, despersonalização e baixa realização profissional. Método: Foram analisados 188 enfermeiros de clínica médico cirurgia no período de agosto a outubro de 2012, utilizamos o questionário desenvolvido por Cristina Maslach em 1981, Maslach Burnout Invetory (MBI), questionário de perfil sócio demográfico criado para os devidos fins aplicados aos enfermeiros após assinarem o termo de Consentimento Livre e Esclarecido. Resultados: A prevalência da Síndrome de Burnout foi alta (10,1%) assim como a propensão (55,4%) à síndrome. Fatores como: trabalhar no período noturno, problemas de saúde associados ao trabalho e queixas emocionais apresentaram associação tanto na prevalência e propensão, podendo ser agravantes no desencadeamento da síndrome. Conclusão: Alta prevalência e propensão da Síndrome de Burnout prejudica x a saúde do trabalho e infere na qualidade da assistência prestada ao cliente gerando danos permanentes a instituição. Exaustão emocional e despersonalização estão diretamente relacionadas às queixas emocionais e a problemas de saúde associados ao trabalho, já a baixa realização profissional esta relacionada ao sexo feminino, sem filhos que apresentam queixas emocionais, no período noturno.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Cardiac autonomic modulation of children with down syndrome

The aim of this study is to analyze the autonomic modulation in children with Down syndrome (DS). The study was conducted with a convenience sample of children with DS and without heart disease, from the Genetics Clinic of the Hospital Infantil Darcy Vargas and APAE So Paulo, So Paulo, SP, Brazil. The control group was matched for sex and age. The analysis of autonomic modulation was performed using the indices of heart rate variability (HRV). The children remained in the supine position with spontaneous breathing for 20 min. Heart rate was recorded beat-to-beat. HRV analysis was performed in time and frequency domain. For data analysis, we used Student's t test: unpaired and Mann-Whitney. It was considered statistically significant at p < 0.05. From 75 children with DS, 50 were excluded, a total of 25 children [16 boys, 8.6 (1.4) years] participated in this study, and the control group also consisted of 25 children [16 boys, 9.0 (1.2) years] without the syndrome. The BMI of the volunteers with DS was higher than the controls [19.1 (2.9) vs. 15.8 (1.2), p < 0.0001]. There were differences between groups in the indices in frequency domain: LFms(2) [1242.1 (788.25) vs. 786.44 (481.90), p = 0.040], LFun [69.104 (11.247) vs. 57.348 (11.683), p = 0.0004], HFun [30.896 (11.247) vs. 42.520 (11.634), p = 0.0004] and LF/HF [2.594 (1.104) vs. 1.579 (0.9982), p = 0.0004]. No differences were observed in time domain indices. The results indicate increased indices representing the sympathetic branch of the autonomic nervous system and those that indicate the overall modulation in children with DS.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Stress, self-esteem and well-being among female health professionals: A randomized clinical trial on the impact of a self-care intervention mediated by the senses

<div><p>Background</p><p>Stress levels are evident among health professionals. However, there are few studies on sensory-based self-care aimed at stress management, self-esteem and subjective well-being in this group of professionals.</p><p>Objective</p><p>To assess the impact of a self-care intervention mediated by the senses on the stress levels, self-esteem and well-being of health professionals in a hospital environment.</p><p>Methods</p><p>A total of 93 health professionals participated in an unblinded clinical trial, randomized into four groups: 1) control (no intervention); 2) Monosensory—daily body moisturizing (DBM) with odorless cream; 3) Bisensory—DBM with scented cream; 4) Multisensory—DBM with scented cream associated with audiovisual material. Participants answered specific questionnaires to assess stress, self-esteem and well-being and cortisol samples were collected at baseline, 15 and 30 days following intervention, and at the 30-day follow-up.</p><p>Results</p><p>Self-care was characterized as neglected, with most participants reporting inadequate hours of sleep (74%), irregular physical activity (68%), and inadequate nutrition (45%). Compared to the other groups, the Bisensory group had lower stress on all three assessments (p = 0.017; 0.012; 0.036), a life satisfaction 8% higher at follow-up than at baseline (95% CI: 2% to 15%, p = 0.016), a 10% increase in positive affect (95% CI: 2% to 19%, p = 0.011) and a 12% reduction in negative affect (95% CI: 3% to 21% less, p = 0.014) after 30 days. The Multisensory group showed improvement in self-esteem (p = 0.012) and reduced cortisol (p = 0.036) after 30 days of intervention. The control group showed no changes in the variables studied, except for cortisol: an increase at the 15-day evaluation (denoting higher risk for stress, p = 0.009) and a reduction at follow-up (p = 0.028), which was nevertheless within normal levels.</p><p>Trial registration</p><p>Clinicaltrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02406755" target="_blank">NCT02406755</a></p></div

Sample description by groups.

<p>Sample description by groups.</p

Participation flowchart.

<p>Participation flowchart.</p

Study outcomes regarding stress (LIPP and cortisol) and self-esteem (Rosenberg Scale) for all groups over time.

<p>Study outcomes regarding stress (LIPP and cortisol) and self-esteem (Rosenberg Scale) for all groups over time.</p

Main symptoms included in the LIPP Stress Inventory.

<p>Main symptoms included in the LIPP Stress Inventory.</p

Comparison of variables across groups at baseline.

<p>Comparison of variables across groups at baseline.</p