Acompanhantes de idosos: reflexão sobre sua prática

OBJECTIVE To understand the job function of caregivers of older adults and contribute to the debate on the consolidation of this professional practice. METHODOLOGICAL PROCEDURES This is a descriptive, qualitative, and exploratory study. Four focal group sessions were performed in 2011 with 11 elderly companions, formal caregivers of older adults in the Programa Acompanhante de Idosos (Program for Caregivers of Older Adults), Sao Paulo, SP, Southeastern Brazil. These sessions, guided by a semi-structured script, were audio-recorded and fully transcribed. Data were analyzed using the Content Analysis technique, Thematic Modality. RESULTS In view of considering the caregivers of older adults as a new category of workers, it was difficult to define their duties. The elderly companions themselves as well as the care receivers, their families, and the professionals that comprised the team were unclear about their duties. The professional practice of these formal caregivers has been built on the basis of constant discussions and negotiations among them and other team members in Programa Acompanhante de Idosos during daily work. This was achieved via a recognition process of their job functions and by setting apart other workers’ exclusive responsibilities. CONCLUSIONS The delimitation of specific job functions for elderly companions is currently one of the greatest challenges faced by these workers to develop and consolidate their professional role as well as improve Programa Acompanhante de Idosos.OBJETIVO Compreender as funções dos acompanhantes de idosos e contribuir no debate acerca da consolidação dessa prática profissional. PROCEDIMENTOS METODOLÓGICOS Trata-se de estudo qualitativo, exploratório e descritivo. Foram realizadas quatro sessões de grupo focal com 11 acompanhantes de idosos das primeiras equipes do Programa Acompanhante de Idosos, em São Paulo, SP, em 2011. As sessões, orientadas por um roteiro semiestruturado, foram gravadas em áudio e transcritas integralmente. Os dados foram analisados por meio da técnica de Análise de Conteúdo, modalidade Temática. RESULTADOS Tendo em vista os acompanhantes de idosos como nova categoria de trabalhadores, havia dificuldade na compreensão de suas atribuições, tanto por eles mesmos como pelos idosos atendidos e seus familiares, incluindo os profissionais que compunham as equipes. A prática profissional dos acompanhantes tem sido construída a partir de discussões e negociações constantes entre eles e demais membros das equipes do Programa Acompanhante de Idosos no cotidiano de trabalho, por meio de um processo de reconhecimento de suas funções e diferenciação daquelas de responsabilidade exclusiva de outros trabalhadores. CONCLUSÕES A delimitação de funções específicas dos acompanhantes de idosos constitui-se atualmente como um dos grandes desafios enfrentados por esses trabalhadores para o desenvolvimento e consolidação de seu fazer profissional e do aprimoramento do próprio Programa Acompanhante de Idosos

Association of sleep quality and psychological aspects with reports of bruxism and TMD in Brazilian dentists during the COVID-19 pandemic

Dentists are exposed to contamination by SARS-CoV-2 due to dental interventions, leading to a state of alert and potential risk of negative impact in mental health and sleep quality, associated with Temporomandibular Disorder (TMD) and bruxism. Objective: to evaluate the psychosocial status, sleep quality, symptoms of TMD, and bruxism in Brazilian dentists (DSs) during the COVID-19 pandemic. Methodology: The sample (n=641 DSs) was divided into three groups (quarantined DSs; DSs in outpatient care; and frontline professionals), which answered an electronic form containing the TMD Pain Screening Questionnaire (Diagnostic Criteria for Temporomandibular Disorders – DC/TMD), the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety and Stress Scale (DASS-21), and the sleep and awake bruxism questionnaire. ANOVA test and Mann Whitney post-test were used, with Bonferroni adjustment (p<0.016) and a 95% confidence level. Results: Probable TMD was found in 24.3% (n=156) of the participants, while possible sleep and awake bruxism were diagnosed in 58% (n=372) and 53.8% (n=345) of them, respectively. Among all variables evaluated, only symptoms of depression were significantly greater in the quarantined DSs group when compared to those who were working at the clinical care (p=0.002). Working DSs were significantly less likely (OR=0.630, p=0.001) to have depressive symptoms. Those who were not worried or less worried about the pandemic were less likely to experience stress (OR=0.360), anxiety (OR=0.255), and poor sleep quality (OR=0.256). Sleep had a strong positive and moderate correlation with psychological factors on frontline workers and DSs in outpatient care, respectively. Conclusion: The results suggest confinement may have a more negative impact on the life of DSs than the act of being actively working. The concern about Covid-19 and poor sleep quality was significantly prevalent and may negatively affect the quality of life of DSs. Thus, further research on the topic is needed

Evaluation of the health status of elderly participants in different physical activity programs

O objetivo do presente estudo foi analisar o perfil de saúde de idosos participantes de Programas de Atividade Física. Foram avaliados 24 idosos de ambos os gêneros com idades entre 67,7 ± 6,1 anos participantes dos programas de atividades físicas Saúde em Movimento e Saúde na Ãgua. Para isto, foi aplicado o questionário de qualidade de vida WHOQOL-BREF, Teste de flexibilidade com o Banco de Wells, Teste de Força de Preensão Manual e o Teste de Caminhada de 6 Minutos. Foi aplicada a correlação de Pearson para verificar a associação entre a qualidade de vida e as aptidões físicas, assumido um nível de significância de 5%. Todos os idosos apresentaram níveis satisfatórios de qualidade de vida (regular/bom) e flexibilidade. Contudo, apenas metade dos participantes apresentaram níveis adequados de força de preensão manual e capacidade cardiorrespiratória. A qualidade de vida não foi correlacionada com as aptidões físicas. Em conclusão, os idosos praticantes de programas de atividade física apresentam resultados satisfatórios para Qualidade de Vida e Flexibilidade, no entanto, estes programas devem focar em exercícios que melhorem a força e aptidão cardiorrespiratória. ABSTRACTEvaluation of the health status of elderly participants in different physical activity programsThe objective of the present study was to analyze the health profile of elderly participants of Physical Activity Programs. Twenty-four elderly men and women of both sexes, aged 67.7 ± 6.1 years, participated in the physical activities programs Saúde em Movimento and Saúde na Ãgua. For this, the WHOQOL-BREF quality of life questionnaire, Flexibility Test with the Wells Bank, Manual Grip Test and the 6-Minute Walk Test were applied. Pearson's correlation was applied to verify the association between quality of life and physical fitness, assuming a level of significance of 5%. All the elderly presented satisfactory levels of quality of life (regular / good) and flexibility. However, only half of the participants had adequate levels of manual grip strength and cardiopulmonary capacity. Quality of life was not correlated with physical fitness. In conclusion, the elderly practicing physical activity programs present satisfactory results for Quality of Life and Flexibility, however, these programs should focus on exercises that improve cardiorespiratory fitness and fitness.The objective of the present study was to analyze the health profile of elderly participants of Physical Activity Programs. Twenty-four elderly men and women of both sexes, aged 67.7 ± 6.1 years, participated in the physical activities programs Saúde em Movimento and Saúde na Ãgua. For this, the WHOQOL-BREF quality of life questionnaire, Flexibility Test with the Wells Bank, Manual Grip Test and the 6-Minute Walk Test were applied. Pearson's correlation was applied to verify the association between quality of life and physical fitness, assuming a level of significance of 5%. All the elderly presented satisfactory levels of quality of life (regular / good) and flexibility. However, only half of the participants had adequate levels of manual grip strength and cardiopulmonary capacity. Quality of life was not correlated with physical fitness. In conclusion, the elderly practicing physical activity programs present satisfactory results for Quality of Life and Flexibility, however, these programs should focus on exercises that improve cardiorespiratory fitness and fitness

Blood groups in Native Americans : a look beyond ABO and Rh

The study presents comparisons between blood group frequencies beyond ABO and Rh blood systems in Native American populations and previously published data from Brazilian blood donors. The frequencies of Diego (c.2561C>T, rs2285644), Kell (c.578C>T, rs8176058), Duffy (c.125A>G, rs12075, c.1−67T>C, rs2814778) and Kidd (c.838A>G, rs1058396) variants in Kaingang (n=72) and Guarani (n=234) populations from Brazil (1990–2000) were obtained and compared with data from these populations sampled during the 1960s and with individuals of different Brazilian regions. Data showed high frequencies of DI*01 and FY*01 alleles: 11.8% and 57.6% in Kaingang and 6.8% and 75.7% in Guarani groups, respectively. The main results indicated: (1) reduction in genetic distance over time of Kaingang and Guarani in relation to other Brazilian populations is suggestive of ongoing admixture; (2) significant differences in some frequencies of blood group markers (especially Diego, Kidd and Duffy) in relation to Native Americans and individuals from different geographical regions of Brazil. Our study shows that the frequency of red blood cell polymorphisms in two Native American groups is very different from that of blood donors, when we evaluated blood groups different from ABO and Rh systems, suggesting that a better ethnic characterization of blood unit receptors is necessary

PREVALÊNCIA DA HIPERTENSÃO ARTERIAL SISTÊMICA EM UMA ESTRATÉGIA SAÚDE DA FAMÍLIA DE UM MUNICÍPIO NORTE MINEIRO

Este estudo objetiva investigar a prevalência da hipertensão arterial sistêmica em uma Estratégia Saúde da Família de um município norte mineiro. Trata-se de uma pesquisa documental, descritiva, com abordagem quantitativa e caráter exploratório. A pesquisa foi realizada em uma Estratégia Saúde da Família de Montes Claros, sendo os dados relacionados ao estudo obtidos mediante análise das fichas do HIPERDIA constando informações sobre os clientes hipertensos. Das 224 fichas analisadas, 29% apresentam peso corpóreo normal, porém 34% apresentam sobrepeso seguidos de 14% que apresentam obesidade grau I. Do total da amostra, 48% pacientes analisados apresentam pressão arterial normal, já 23% apresentam hipertensão arterial sistêmica leve (grau I). Quanto aos fatores de risco para aquisição de hipertensão arterial, 34,82% sofrem de sedentarismo seguido dos antecedentes familiares (32%). Quanto às complicações cardiovasculares, 80% dos hipertensos não têm e dos que apresentam 8% sofrem por outras cardiopatias. Em se tratando do tratamento medicamentoso, 26% utilizam diuréticos seguidos de 18% que utilizam diurético+beta bloqueador e outros 18% que utilizam diuréticos+IECA. Sendo assim, conclui-se que a hipertensão arterial encontra-se em níveis controlados, porém aumenta gradativamente em decorrência dos fatores de risco modificáveis e não-modificáveis dos pacientes, cabendo às Unidades Básicas trabalhar a promoção da saúde para prevenção das doenças

Autotransplante dentário: revisão da literature / Dental autotransplantation: literature review

O autotransplante dentário autógeno é a remoção e transferência de um dente com vitalidade do seu sítio de origem para outro local com a finalidade de repor um dente ausente ou perdido, sendo que este elemento dentário é doado pelo próprio indivíduo. Sendo assim, este estudo teve como objetivo realizar uma revisão de literatura sobre o autotransplante dentário, abordando as vantagens deste, as principais técnicas cirúrgicas e quais os fatores que influenciam no seu sucesso clínico. A metodologia da revisão de literatura contou com a busca de artigos científicos a respeito da temática nas plataforma on line SciELO e PubMed, publicados integralmente em língua portuguesa ou inglesa entre os anos de 2016 à 2021. Os principais achados revelam que o transplante dentário autógeno é uma opção adequada para reposições dentárias em pacientes jovens, pois devolve as características funcionais e estéticas de forma segura e conservadora. E por fim, para o sucesso clínico é muito importante um planejamento cirúrgico adequado, a idade do paciente, anatomia e condições do elemento dentário doador e do sítio receptor e habilidade do cirurgião-dentista

Comparative effectiveness of adalimumab and etanercept for rheumatoid arthritis in the Brazilian Public Health System

Aim: Biological disease-modifying antirheumatic drugs (bDMARDs) are used to treat rheumatoid arthritis (RA) with adalimumab and etanercept the most used bDMARDs in Brazil. This open prospective cohort study evaluated their effectiveness and safety among RA patients in the Brazilian Public Health System given their costs. Methods: The Clinical Disease Activity Index was primarily used to assess their effectiveness after 6 and 12 months of follow-up. The Health Assessment Questionnaire and EuroQol-5D were also used. Results: A total of 266 RA patients started treatment with adalimumab or etanercept. Adalimumab was the most widely used bDMARD (70%). In total, 46% achieved remission or low-disease activity at 12 months with no difference in effectiveness between them (p = 0.306). bDMARDs were more effective in patients who had better functionality at treatment onset and had spent longer in education. Conclusion: This real-world study demonstrated that adalimumab and etanercept are equal alternatives for RA treatment and both were well tolerated

Ten-year kidney transplant survival of cyclosporine- or tacrolimus-treated patients in Brazil

Background: Cyclosporine and tacrolimus are well established immunosuppressants; however little know about long term survival rates. Aim: Compare 10-year graft survival and associated factors among kidney transplant patients within the Brazilian Public Health system (SUS) prescribed either medicine. Methods: Analyze a national cohort of kidney transplant recipients within SUS. Graft loss defined by death or dialysis for more than three months. Kaplan-Meier method used to estimate cumulative probabilities of survival. Cox proportional hazards model used to evaluate factors associated with progression to graft loss. Results: 13,811 patients were included, 5,887 used cyclosporine and 7,924 tacrolimus. A higher risk of graft loss was associated with tacrolimus, a deceased donor, additional years of age, median period of dialysis greater than 47 months, diagnosis of diabetes as the primary cause of chronic kidney disease and transplantation between 2005 and 2009. Conclusions: Among other factors, tacrolimus-based regimens were associated with worse graft survival

Epidemiology and Clinical Forms of Primary Hyperparathyroidism: A Review

Primary hyperparathyroidism (PHPT) is a disease caused by overactive parathyroid glands with consequent hypercalcemia. However, its presentation is variable, with patients demonstrating a range from normocalcemia to severe hypercalcemic PHPT. The present study aims to perform a literature review on the epidemiology and the clinical forms of PHPT using information published in the PubMed and Cochrane databases. It describes data about prevalence, etiology, diagnosis, classic and non-classic manifestations, providing updated information on classical hypercalcemic hyperthyroidism, in addition to its normocalcemic variant