Perfil epidemiológico do HIV nos idosos em Alagoas: análise de 10 anos

O perfil populacional no Brasil de indivíduos com idade maior ou igual a 60 anos está aumentando e, sincronamente, a infecção pelo HIV nessa população é uma realidade. Este estudo objetivou avaliar perfis epidemiológicos de infecção pelo HIV em idosos, observando diferenças étnicas, etárias, de escolaridade, gênero e orientação sexual dos infectados. Trata-se de um estudo quantitativo do tipo observacional, analítico, descritivo e retrospectivo com base nos dados obtidos pela Secretaria do Estado da Saúde de Alagoas(SESAU) e pelo Sistema de Informações de Agravos de Notificação (SINAN) entre os anos 2011 e 2020, com as diversas variáveis. Do total de 150 casos notificados, 62,66% dos casos eram do sexo masculino, com 60 até 69 anos representando 75,33%, heterossexuais e de raça parda. Por fim, é perceptível a necessidade de estratégias da saúde para atingir uma estabilização dos infectados  e desmistificar o HIV na população idosa.O perfil populacional no Brasil de indivíduos com idade maior ou igual a 60 anos está aumentando e, sincronamente, a infecção pelo HIV nessa população é uma realidade. Este estudo objetivou avaliar perfis epidemiológicos de infecção pelo HIV em idosos, observando diferenças étnicas, etárias, de escolaridade, gênero e orientação sexual dos infectados. Trata-se de um estudo quantitativo do tipo observacional, analítico, descritivo e retrospectivo com base nos dados obtidos pela Secretaria do Estado da Saúde de Alagoas(SESAU) e pelo Sistema de Informações de Agravos de Notificação (SINAN) entre os anos 2011 e 2020, com as diversas variáveis. Do total de 150 casos notificados, 62,66% dos casos eram do sexo masculino, com 60 até 69 anos representando 75,33%, heterossexuais e de raça parda. Por fim, é perceptível a necessidade de estratégias da saúde para atingir uma estabilização dos infectados  e desmistificar o HIV na população idosa

Knowledge of nursing students about the care provided to people with neoplastic wounds

Objective: To investigate the knowledge of nursing students about the care provided to patients with neoplastic wound. Method: This is an exploratory research of a qualitative nature, which was attended by 15 students of the Bachelor's Degree in Nursing from the Center of Education and Health of the Federal University of Campina Grande, campus Cuité - PB, in the period from October to November 2015. For data collection, we used a form for an interview. The data were analyzed through the Technique of Thematic Analysis of Minayo. Results: From the analysis of the empirical material emerged the following thematic categories: Category 1 - Defining neoplastic wounds; Category 2 - Knowledge incipient on ‘neoplastic wounds’ for academic and professional practice; Category 3 - Envisioning the theme "neoplastic wound" in the Academy; Category 4 - Knowledge about methods of evaluation of neoplastic wounds and Category 5 - Knowledge of therapeutic modalities of neoplastic wounds. Conclusions: The academics know the evaluative method of a patient with neoplastic wound as integralizadora unit of care process; recognize palliative care as the best therapeutic modality for these customers, especially when they are in completion and indicate the products contraindicated in the treatment of these lesions; however, do not mention the covers and recommended substances for the control of the signs and symptoms of these injuries. In this context, it is believed that the creation of academic projects of extension, with the aim of creating opportunities for integration between theory and practice, is one of the ways to improve the knowledge.   Keywords: Knowledge; Students of Nursing; Skin Neoplasms

Panorama atual da anorexia nervosa: complicações clínicas, implicações diagnósticas e manejo.

Introduction: Anorexia nervosa (AN) is an eating disorder characterized by a distorted perception of weight and body image, leading to significant dietary restriction and excessive concern about weight loss. Objective: To evaluate the clinical complications, diagnosis and management of anorexia nervosa. Methodology: This is a bibliographic review that included original articles and systematic reviews in English and Portuguese, which addressed the diagnostic, therapeutic components and complications of AN, published between 2013 and 2024, selected from the PubMed, Scopus and SciELO databases. After careful selection, 18 articles were chosen to compose this bibliographic review. Results: The diagnosis includes some criteria, including dietary restriction, intense fear of gaining weight and distortion of body image. The disorder can cause multiple changes, such as amenorrhea, compromised bone mineral density, fractures and changes in vital signs. Management of AN can utilize family treatment, such as the Maudsley method, and Cognitive-Behavioral Therapy for Eating Disorders (CBT-AT). Considerations: The physiological consequences of AN are serious, including compensatory behaviors. The diagnosis of AN is complex and treatment of AN requires a multidisciplinary and individualized approach and outpatient management is an affordable and safe option to avoid prolonged hospitalizations.Introdução: A anorexia nervosa (AN) é um transtorno alimentar caracterizado por uma percepção distorcida do peso e da imagem corporal, levando a uma restrição alimentar significativa e a uma preocupação excessiva com a perda de peso.  Objetivo: Avaliar as complicações clínicas, diagnóstico e manejo da anorexia nervosa. Metodologia: Trata-se de uma revisão bibliográfica que incluiu artigos originais e revisões sistemáticas em inglês e português, que abordaram os componentes diagnósticos, terapêuticos e complicações da AN, publicados entre 2013 e 2024, selecionados nas bases de dados PubMed, Scopus e SciELO. Após a seleção criteriosa, foram escolhidos 18 artigos para compor esta revisão bibliográfica. Resultados: O diagnóstico inclui alguns critérios, incluindo restrição alimentar, medo intenso de ganhar peso e distorção da imagem corporal. O distúrbio pode ocasionar múltiplas alterações, como amenorreia, comprometimento da densidade mineral óssea, fraturas e alterações dos sinais vitais. O manejo da AN pode utilizar o tratamento familiar, como o método Maudsley, e Terapia Cognitivo-Comportamental para Transtornos Alimentares (TCC-TA). Considerações: As consequências fisiológicas da AN são graves, incluindo comportamentos compensatórios. O diagnóstico de AN é complexo e tratamento requer uma abordagem multidisciplinar e individualizada e a gestão ambulatorial é uma opção acessível e segura para evitar internações prolongadas

Análise da eficácia da Tirzepatida como agente terapêutico para perda de peso em pacientes com Obesidade

A obesidade e o diabetes são doenças crônicas que afetam milhões de pessoas em todo o mundo, sendo consideradas epidemias crescentes. O tratamento da obesidade envolve uma abordagem multifacetada, incluindo mudanças no estilo de vida e intervenções farmacológicas. Nesse contexto, a tirzepatida, uma terapia combinada de dois medicamentos que atuam em diferentes vias metabólicas para reduzir o apetite e promover a perda de peso em pacientes com obesidade, tem se destacado como uma opção terapêutica promissora. O objetivo deste estudo foi avaliar a eficácia e segurança da tirzepatida como agente terapêutico para perda de peso em pacientes com obesidade. Para isso, foram selecionados quatro artigos que avaliaram o uso da tirzepatida em pacientes com obesidade, publicados entre 2018 e 2023, nas bases de dados PubMed (Medline), Scientific Electronic Library Online (SciELO) e Cochrane Library. Os resultados indicam que a tirzepatida é uma terapia promissora e segura para perda de peso em pacientes com obesidade. Todos os estudos relataram perda de peso significativa em pacientes tratados com essa terapia, variando de 8,6% a 16,0% do peso corporal inicial. Além disso, a tirzepatida também apresentou efeitos benéficos em outros parâmetros metabólicos, como redução da glicemia e melhora da função hepática. Efeitos adversos foram relatados em menor frequência e gravidade em comparação com outras terapias para perda de peso. Em resumo, a tirzepatida é uma terapia combinada de dois medicamentos que tem demonstrado eficácia e segurança para a perda de peso em pacientes com obesidade, de acordo com os resultados de quatro estudos avaliados nesta pesquisa. Essa terapia pode ser uma opção terapêutica válida para pacientes com obesidade. No entanto, é importante destacar a necessidade de mais pesquisas para avaliar sua eficácia e segurança a longo prazo e sua aplicabilidade em diferentes populações. Portanto, é fundamental que o tratamento seja realizado com acompanhamento médico e que cada caso seja avaliado individualmente

IL-8 is associated with non-viremic state and IFN-γ with biochemical activity in HCV-seropositive blood donors.

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-04-07T17:40:22Z No. of bitstreams: 1 Zarife MAS IL-8 Is....pdf: 276780 bytes, checksum: 0bd198d3622fa3b87ccc090449c5c117 (MD5)Made available in DSpace on 2014-04-07T17:40:22Z (GMT). No. of bitstreams: 1 Zarife MAS IL-8 Is....pdf: 276780 bytes, checksum: 0bd198d3622fa3b87ccc090449c5c117 (MD5) Previous issue date: 2011Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Laboratório Central de Saúde Pública, LACEN-BA. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa René Rachou. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilHEMOBA. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa René Rachou. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilThe aim of this study was to explore a possible association between the pattern of serum cytokines with the virological and biochemical status of hepatitis C virus (HCV)-seropositive blood donors. METHODS: 23 non-viremic and 33 viremic HCV-seropositive blood donors based on HCV-RNA tests, and 29 healthy individuals were included. Cytometric bead array assays were performed to detect cytokines. RESULTS: The subjects were classified as low, medium or high cytokine producers based on the tertile distribution. The absence of detectable viremia was associated with high IL-1ß and IL-8 producers. Conversely, elevated levels of IL-6, IL-10 and IL-12 were associated with detectable viremia. An increased frequency of high IL-1ß producers was observed frequently in the non-viremic recombinant immunoblot assay (RIBA)-indeterminate subjects, while the high IL-4, IL-6, IL-8, IL-10 and IL-12 producers were more frequent in the non-viremic RIBA-positive subjects. Furthermore, the levels of IL-1ß and IL-8 were higher in viremic subjects with a low level of alanine-aminotransferase (ALT), whereas the level of IFN-γ was increased among viremic subjects with a high ALT level. CONCLUSION: IL-1ß and IL-8 were more likely to be associated with a non-viremic or less severe HCV infection, whereas IL-2 and IFN-γ levels correlated with a high ALT level

Knowledge of nursing students about the care provided to people with neoplastic wounds

Objective: To investigate the knowledge of nursing students about the care provided to patients with neoplastic wound. Method: This is an exploratory research of a qualitative nature, which was attended by 15 students of the Bachelor's Degree in Nursing from the Center of Education and Health of the Federal University of Campina Grande, campus Cuité - PB, in the period from October to November 2015. For data collection, we used a form for an interview. The data were analyzed through the Technique of Thematic Analysis of Minayo. Results: From the analysis of the empirical material emerged the following thematic categories: Category 1 - Defining neoplastic wounds; Category 2 - Knowledge incipient on ‘neoplastic wounds’ for academic and professional practice; Category 3 - Envisioning the theme "neoplastic wound" in the Academy; Category 4 - Knowledge about methods of evaluation of neoplastic wounds and Category 5 - Knowledge of therapeutic modalities of neoplastic wounds. Conclusions: The academics know the evaluative method of a patient with neoplastic wound as integralizadora unit of care process; recognize palliative care as the best therapeutic modality for these customers, especially when they are in completion and indicate the products contraindicated in the treatment of these lesions; however, do not mention the covers and recommended substances for the control of the signs and symptoms of these injuries. In this context, it is believed that the creation of academic projects of extension, with the aim of creating opportunities for integration between theory and practice, is one of the ways to improve the knowledge.   Keywords: Knowledge; Students of Nursing; Skin Neoplasms

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline