Occurrence of Gasterophilus spp. in Weanling Foals in Southern Brazil

Background: The occurrence of gastrointestinal myiasis caused by Gasterophilus spp. larvae (Diptera: Oestridae) in adult horses has been widely characterized, however data on natural infestation in young foals have been lacking. This observation may be related to the absence of conclusive diagnosis in these individuals, most likely due to logistical or financial constraints. Gastric ulceration is a problem and a significant cause of morbidity in foals, particularly during the weaning stage; therefore, gasterophilosis should be included in the differential diagnosis. The primary purpose of this study was to determine the prevalence of gasterophilosis in 4- to 6-month-old weanling foals.Material, Methods & Results: Seventy-one healthy weanling foals were enrolled in the study. Physical assessment blood sampling and was completed in all foals before the commencement of the experiment. Gastroscopy examinations were performed under sedation (Detomidine 0.01 - 0.02 mg/kg) with a flexible endoscope inserted through nasogastric via. The lumen of the stomach was examined in order to search for botflies’ larvae. Following gastroscopy, foals were classified into 2 groups based on the presence of Gasterophilus spp. larvae in their stomachs: 1) Infected and 2) Not Infected. Infected foals received a single dose of commercial trichlorfon and albendazole equine oral gel and were stalled for 24 h. The passed feces were thoroughly examined, searching for elimination of larvae. A Total of 64% of the foals (n=45/71) harbored Gasterophilus spp. larvae in the stomach. Mild hyperemia in the gastric mucosa was observed in the attachment sites of the parasites. Physical assessment and hematological parameters’ data were analyzed with Shapiro-Wilk normality test. Comparison between groups for clinical signs, hematological parameters and Gasterophilus spp. infection rates were evaluated using the Kruskal-Wallis test or Student's t-test. Statistical significance was set at P < 0.05. There were no statistically significant variations in physical and hematological parameters between foals that were affected and those that were not infected. The larvae found in the feces were subjected to morphological examination, which confirmed the diagnosis of Gasterophilus intestinalis.Discussion: No systemic clinical indications compatible with Gasterophilus infestation were seen, as described in previous studies of horses infected with the parasite. No botfly eggs were observed in the hair of evaluated foals. During gastroscopy, mild hyperemic lesions in the gastric mucosa were observed in the larvae fixation sites. Although no changes in clinical or hematological parameters were noted, the confirmation of parasite presence is a cause for concern due to horses' tolerance for low infestation levels and poor diagnosis. Additionally, the presence of this myiasis in foals may be a significant stressor during the weaning period and should be included in the differential diagnosis of recurring abdominal pain. Furthermore, infected foals might be a reservoir for the parasite and, contribute to the elimination and spread of the larvae in the environment. Thus, inclusion of young horses in deworming protocols targeted to botfly larvae is needed. This is the first report of Gasterophilus intestinalis myiasis in foals in Brazil. Further research is necessary to fully understand the epidemiology and prevalence of this condition in young horses in Brazil, based on the findings of this study. Keywords: Gasterophilus intestinalis, cavity myiasis, gastroscopy, Oestridae

Post-partum Utero-ovarian Artery Rupture in Mare

Background: Arterial rupture associated with pregnancy is an important cause of fatal hemorrhage in pregnant mares, regardless breeds and age. Such hemorrhagic events lead to blood loss into the abdomen, broad ligament and uterus and the broad ligament hematoma occurs as a consequence of arterial rupture. Although the rupture of the uterine artery is commonly caused by hemorrhage, there are few studies regarding this condition. Therefore, the aim of this study was to describe a case of rupture of the utero-ovarian artery, with broad ligament hematoma and intramural uterine hematoma in a Thoroughbred mare, emphasizing the predisposing factors and the diagnosis process.Case: A 13-year-old Thoroughbred mare, with nine parturition, was attended with abdominal pain after foaling. The mare had an eutocic delivery, however the foal was a big one to the race, with high of 1,02 m and weight of 68 kg. The animal arrived at the Veterinary Clinical Hospital 48 h after delivery, with abdominal pain, pale mucous membranes, heart rate slightly increased. The trans-rectal palpation revealed the presence of a solid mass in the left horn region, and it was painful to the touch. The ultrasonography evaluation of the mass showed a heterogeneous texture with a hypoechoic central area, which reinforced the clinical suspicion of a hematoma in the broad ligament and a uterine intramural hematoma. The animal did not respond to analgesic therapy, which resulted in shock and consequently death. Necropsy revealed free blood in the abdominal cavity and the uterine wall with swollen hematoma extended to the left broad ligament. It also showed the presence of a hematoma along the uterine wall, from the uterine body region to the ovarian insertion. Histological evaluation did not show significant changes in the arterial wall, and it revealed the formation of intramural hematoma thorough all extension of the left uterine horn, confirming the suspicion of rupture in the utero-ovarian artery and hematoma on the broad ligament and uterine intramural hematoma in the left horn.Discussion: Rupture of uterine arteries can occur at any age, although it is often observe in old mares, possibly because of the vascular degenerative features observed in these animals. In addition, multiparous mares are more prone to it because multiple births can favour damages in vascular system. The clinical assessment showed characteristics compatible with postpartum hemorrhage. A thorough trans-rectal evaluation revealed a mass in the left horn. The ultrasonography evaluation from the mass showed echogenic characteristics consistent with those described for broad ligament hematoma and uterineintramural hematoma in the left horn. The clinical suspicion, rupture of the uterine artery, with formation of a hematoma in the broad ligament and uterine intramural hematoma, was based upon the history, clinical signs and laboratory tests, especially the characteristics revealed by the ultrasound from the mass in left horn. Necropsy showed the rupture of the utero-ovarian artery. Lesions are usually observed on the right uterine artery due to the displacement of the uterus to the left abdominal wall by the cecum, which results in an increased tension on the right broad ligament. However, in this case the rupture was associated to the gravid horn. The rupture of the utero-ovarian artery is a major cause of hemorrhage in the postpartum and this can form a hematoma in the broad ligament and uterine intramural hematoma. In conclusion, the mare from this study showed as the predisposing factors the age and the number of parturition. Clinical sings are very similar to others abdominal pain conditions, being the exams essential to diagnosis, especially ultrasonography. Rupture of the utero-ovarian artery is an emergency with unfavorable prognosis.Keywords: artery, utero-ovarian, mare, hemorrhage

Effects of reading, exercise and exercise combined with reading on intraocular pressure for patients sustaining primary glaucoma (open angle) or ocular hypertension, both clinically controlled with topic medication

OBJETIVO: Verificar a pressão intra-ocular (Po) em indivíduos usuários de análogos de prostaglandina, prostamida ou beta-bloqueador em portadores de glaucoma primário de ângulo aberto ou hipertensão ocular após leitura, exercício e exercício sob leitura. MÉTODOS: Quarenta indivíduos (79 olhos), subdivididos em 5 grupos: G1 (portadores de hipertensão arterial e glaucoma ou hipertensão ocular usando análogos de prostaglandinas ou prostamidas); G2 (portadores de hipertensão arterial e glaucoma ou hipertensão ocular usando beta-bloqueador); G3 (indivíduos sem hipertensão arterial e portadores de glaucoma ou hipertensão ocular em uso de análogos de prostaglandinas ou prostamidas); G4 (indivíduos sem hipertensão arterial e portadores de glaucoma ou hipertensão ocular em uso de beta-bloqueador) e G5 (indivíduos sem hipertensão arterial e sem glaucoma ou hipertensão ocular), tiveram a pressão intra-ocular verificada antes e após realizarem leitura, exercício e exercício sob leitura. Cada teste foi realizado em dia distinto e sempre no período vespertino. RESULTADOS: Não houve diferença estatisticamente significante na média da pressão intra-ocular inicial e final nos diferentes grupos do estudo quando submetidos à leitura, exercício e exercício sob leitura. CONCLUSÃO: Ler e fazer exercícios individualmente ou concomitantemente, não representa fator de agravo da pressão intra-ocular em portadores de glaucoma primário de ângulo aberto ou hipertensão ocular em usuários de análogos de prostaglandinas ou prostamidas ou beta-bloqueador.PURPOSE: To check intraocular pressure (IOP) in individuals using prostaglandin, prostamide or beta-blocker analogues, who sustain either primary open angle glaucoma or ocular hypertension after reading, exercise or exercise combined with reading. METHODS: 40 individuals (79 eyes), subdivided in to five groups: G1 (with arterial hypertension and either glaucoma or ocular hypertension, all users of prostaglandin or prostamide analogues); G2 (with arterial hypertension and either glaucoma or ocular hypertension, all users of beta-blockers); G3 (not sustaining arterial hypertension but suffering from either glaucoma or ocular hypertension, all users of prostaglandin or prostamide analogues); G4 (not sustaining arterial hypertension but suffering from either glaucoma or ocular hypertension, all users of beta-blockers) and G5 (not sustaining arterial hypertension and also not suffering from either glaucoma or ocular hypertension) had their intraocular pressure checked before and after undergoing reading, exercise, and exercise combined with reading. Each type of test was conducted in a different day, always in the afternoon. RESULTS: No significant statistical difference has been noticed between the initial and final intraocular pressure mean in the different groups, when reading, performing exercises or exercises combined with reading. CONCLUSION: To read and to work out - either separately or jointly - does not pose an aggravating factor to the intraocular pressure of patients with primary open glaucoma or ocular hypertension, using prostaglandin, prostamide or beta-blocker analogues

Tuberculosis care: an evaluability study

OBJETIVO: verificar se o Programa de Controle da Tuberculose é avaliável e examinar a viabilidade de construção de modelo avaliativo, em município prioritário para o controle da tuberculose. MÉTODO: trata-se de Estudo de Avaliabilidade em município da Região Nordeste. Para a coleta, utilizaram-se as técnicas de análise documental e entrevista com informantes-chave. Na validação dos indicadores, utilizou-se a técnica de Grupo Nominal. RESULTADOS: descreveu-se o Programa e foram elaborados e pactuados o modelo lógico e a matriz de relevância dos indicadores, caracterizando os elementos estruturantes do programa, definição de indicadores de estrutura e processo, além das perguntas avaliativas. CONCLUSÃO: o Programa de Controle da Tuberculose é avaliável. A partir da análise lógica operacional, pode-se constatar a adequação dos objetivos do programa para enfrentamento da tuberculose. Recomenda-se proceder a uma avaliação somativa, com enfoque na análise dos efeitos da intervenção de controle da tuberculose, para redução da morbimortalidade.OBJETIVO: verificar si el Programa de Control de la Tuberculosis es evaluable y examinar la viabilidad de construcción de un modelo evaluativo en un municipio prioritario para el control de la tuberculosis. MÉTODO: se trata de un Estudio de Evaluabilidad en un municipio de la región noreste. Para la recolección de los datos se utilizaron las técnicas de análisis documental y la entrevista con informantes clave. En la validación de los indicadores, se utilizó la técnica de Grupo Nominal. RESULTADOS: se describió el programa y fueron elaborados y convenidos el modelo lógico y la matriz de relevancia de los indicadores, caracterizando los elementos estructurales del programa; se definieron indicadores de estructura y proceso, además se formularon las preguntas evaluativas. CONCLUSIÓN: el Programa de Control de la Tuberculosis es evaluable. A partir del análisis lógico operacional, se puede constatar la adecuación de los objetivos del programa para el enfrentamiento de la tuberculosis. Se recomienda proceder a realizar una evaluación sumativa, con enfoque en el análisis de los efectos de la intervención del control de la tuberculosis para reducción de la morbimortalidad.OBJECTIVE: to verify whether the tuberculosis control program (TCP) is evaluable and to examine the feasibility of building an evaluation model in apriority municipality for the control of tuberculosis. METHOD: this evaluability study was conducted in a municipality in northeastern Brazil. For data collection, documental analysis and interviews with key informants were performed. For indicator validation, the nominal group technique was adopted. RESULTS: the details of TCP were described, and both the logical model and the classification framework for indicators were developed and agreed up on, with the goal of characterizing the structural elements of the program, defining the structure and process indicators, and formulating the evaluation questions. CONCLUSION: TCP is evaluable. Based on logical operational analysis, it was possible to evaluate the adequacy of the program goals for the control of tuberculosis. Therefore, the performance of a summative evaluation is recommended, with a focus on the analysis of the effects of tuberculosis control interventions on decreasing morbidity and mortality

DIAGNÓSTICO SITUACIONAL DE UMA CLÍNICA DE TRATAMENTO ONCOLÓGICO DE BELO HORIZONTE

Introduction: Situational diagnosis is a tool for collecting, describing and analyzing data, which allows knowledge of points of improvement in a health institution. With the situational diagnosis it is possible to create interventions focused on the problems encountered during the study. Methodology: This is a descriptive field research carried out in an oncology clinic in Belo Horizonte. Results: During the study, the organizational structure, physical, human and material resources of the management instruments and the definition of nursing care indicators were evaluated. All data collected were described and compared to the current literature and standards. Conclusion: With the study, it was possible to identify positive and negative divergences between the clinic and the norms, but the positive ones stood out. In addition, the preparation of the Situational Diagnosis provides the academic with the ability to research, analyze data and develop a critical sense in relation to health institutions and the service offered by them.El diagnóstico situacional es una herramienta para la recopilación, descripción y análisis de datos, que permite el conocimiento de puntos de mejora en una institución de salud. Con el diagnóstico situacional es posible crear intervenciones centradas en los problemas encontrados durante el estudio. Metodología: Se trata de una investigación de campo descriptiva llevada a cabo en una clínica de oncología en Belo Horizonte. Resultados: Durante el estudio, se evaluó la estructura organizativa, los recursos físicos, humanos y materiales, los instrumentos de gestión y la definición de indicadores de cuidado de enfermería. Todos los datos recopilados fueron descritos y comparados con la literatura y los estándares actuales. Conclusión: Con el estudio, fue posible identificar divergencias positivas y negativas entre la clínica y las normas, pero las positivas estaban fuera. Además, la elaboración del diagnóstico situacional proporciona al académico la capacidad de investigar, analizar datos y desarrollar un sentido crítico en relación con las instituciones de salud y el servicio que ofrecen. O diagnóstico situacional é uma ferramenta de coleta, descrição e análise de dados, que permite o conhecimento de pontos de melhoria em uma instituição de saúde. Com o diagnóstico situacional é possível criar intervenções focadas nos problemas encontrados durante o estudo. Metodologia: Trata-se de uma pesquisa de campo descritiva realizada em uma clínica oncológica de Belo Horizonte. Resultados: Durante o estudo, foi avaliada a estrutura organizacional, recursos físicos, humanos e materiais, dos instrumentos gerenciais e a definição dos indicadores assistenciais de enfermagem. Todos os dados coletados foram descritos e comparados à literatura e normas vigentes. Conclusão: Com o estudo, foi possível identificar divergências positivas e negativas entre a clínica e as normas, porém as positivas se sobressaíram. Além disso, a elaboração do Diagnóstico Situacional proporciona ao acadêmico a capacidade de pesquisar, analisar dados e de desenvolver um senso crítico em relação às instituições de saúde e o serviço oferecido por elas

Construcción y Validación de un Instrumento Sobre el Uso de Anticonceptivos Hormonales Orales

Abstract  Introduction: Oral hormonal contraceptives are among the contraceptive methods most used by women, when used correctly, it is highly effective, but for proper use, it is essential that they have adequate knowledge and attitudes about them. Objective: To build and validate an inquiry to assess knowledge, attitudes and practice on or use of oral hormonal contraceptive. Methods: Methodological study, which took place in two stages: construction of the survey and validation by expert judges. The content validity analysis was performed using the Content Validity Index (CVI). The judges evaluated each item individually, with respect to language clarity, practical relevance and theoretical relevance. The Research Ethics Committee approved the research. Results: In the integrative literature review, 34 publications were selected and their analysis allowed the identification of the three categories: knowledge, attitudes and practice regarding the use of oral hormonal contraceptives, which led to the construction of the survey with 34 questions. As for the CVI, most of the questions had a value greater than 0.8 (80.0%), which was used as a parameter. Regarding the total CVI per judge, 10 (83.3%) of them also had a value higher than 0.8. The total CVI of the survey was 0.86. Conclusions: The constructed survey proved to be a valid instrument for obtaining a situational diagnosis of the levels of knowledge, attitudes and practice of a given population that uses oral contraceptives. How to cite this article: Santos, Francisco de Assis Viana dos; Ventura, Alice de Sousa; Castro, Amanda Bastos de; Furtado, Angelina Monteiro; Nogueira, Jéssica de Menezes; Penha, Jardeliny Corrêa da. Construção e Validação de Instrumento sobre o uso de Anticoncepcional Hormonal Oral. Revista Cuidarte. 2020;12(3):e1970. http://dx.doi.org/10.15649/cuidarte.1970Resumo  Introdução: Os anticoncepcionais hormonais orais estão entre os métodos contraceptivos mais utilizados pelas mulheres, quando usado corretamente apresenta grande eficácia, mas para o uso adequado é fundamental que elas tenham conhecimentos e atitudes adequadas sobre eles. Objetivo: Construir e validar um inquérito para avaliar os conhecimentos, atitudes e prática sobre o uso de anticoncepcional hormonal oral. Métodos: Estudo metodológico, que aconteceu em duas etapas: construção do inquérito e validação por juízes especialistas. A análise da validade de conteúdo foi realizada por meio do Índice de Validade de Conteúdo (IVC). Os juízes avaliaram cada item individualmente, com relação à clareza da linguagem, à pertinência prática e à relevância teórica. A pesquisa foi aprovada por Comitê de Ética em Pesquisa. Resultados: Na revisão integrativa da literatura, 34 publicações foram selecionadas e a análise delas permitiu a identificação das três categorias: conhecimentos, atitudes e prática quanto ao uso de anticoncepcionais hormonais orais, o que levou à construção do inquérito com 34 questões. Quanto ao IVC, grande parte das questões obteve valor superior a 0,8 (80,0%), o qual foi utilizado como parâmetro. Sobre o IVC total por juiz, em 10 (83,3%) deles se observou também valor superior a 0,8. Já o IVC total do inquérito foi de 0,86. Conclusões: O inquérito construído mostrou-se ser um instrumento válido para se obter um diagnóstico situacional dos níveis de conhecimentos, de atitudes e prática de uma dada população que faz uso de anticoncepcionais orais. Como citar este artigo: Santos, Francisco de Assis Viana dos; Ventura, Alice de Sousa; Castro, Amanda Bastos de; Furtado, Angelina Monteiro; Nogueira, Jéssica de Menezes; Penha, Jardeliny Corrêa da. Construção e Validação de Instrumento sobre o uso de Anticoncepcional Hormonal Oral. Revista Cuidarte. 2020;12(3):e1970. http://dx.doi.org/10.15649/cuidarte.1970  Resumen  Introducción: Anticonceptivos hormonales orales se encuentran entre los métodos anticonceptivos más utilizados por las mujeres, cuando se usan correctamente es altamente efectivo, pero para su uso adecuado es fundamental que tengan los conocimientos y actitudes adecuados. Objetivo: Construir y validar una encuesta para evaluar conocimientos, actitudes y prácticas con respecto al uso de anticonceptivos hormonales orales. Métodos: Estudio metodológico, que se desarrolló en dos etapas: construcción de la encuesta y validación por jueces expertos. Análisis de validez de contenido se realizó mediante el Índice de Validez de Contenido (IVC). Jueces evaluaron cada ítem individualmente, con respecto a la claridad del lenguaje, relevancia práctica y relevancia teórica. La investigación fue aprobada por el Comité de Ética en Investigación. Resultados: En la revisión integradora de la literatura se seleccionaron 34 publicaciones y su análisis permitió identificar las tres categorías: conocimientos, actitudes y práctica en relación al uso de anticonceptivos hormonales orales, lo que llevó a la construcción de la encuesta con 34 preguntas. La mayoría de las preguntas tuvo un IVC superior a 0,8 (80,0%), que se utilizó como parámetro. En cuanto al IVC total por juez, 10 (83,3%) de ellos también tenían un valor superior a 0,8. El CVI total de la encuesta fue de 0,86. Conclusiones: La encuesta construida resultó ser un instrumento válido para obtener un diagnóstico situacional de los niveles de conocimientos, actitudes y prácticas de una determinada población que usa anticonceptivos orales. Como citar este artículo: Santos, Francisco de Assis Viana dos; Ventura, Alice de Sousa; Castro, Amanda Bastos de; Furtado, Angelina Monteiro; Nogueira, Jéssica de Menezes; Penha, Jardeliny Corrêa da. Construção e Validação de Instrumento sobre o uso de Anticoncepcional Hormonal Oral. Revista Cuidarte. 2020;12(3):e1970. http://dx.doi.org/10.15649/cuidarte.197

Aneurysm in the Distal Portion of the Extern Jugular Vein in a Horse

Background: Aneurysm is a vascular disease that causes the partial rupture of arteries and veins and subsequent blood leakage due to the weakening of the vessels elastic middle layer. Venous aneurysms in horses are rare, but the arterial aneurysms are commonly reported. The aim of this paper is to report a rare occurrence of jugular external aneurysm in a horse and propose the inclusion this disease as a differential diagnosis, both because it is rare in this specie and invariably fatal. The medical examination showed a firm well-defined mass, painless, nonpulsatile on palpation and with no changed in the local temperature.Case: The horse was referred to the Veterinarian Hospital of the Federal University of Pelotas (UFPel, RS-Brazil. It was a male, Crioulo breed, 10 years old, used as stallion. The owner reported a swelling in the pectoral region that occurred after a trauma episode that had gradually grown for two years. The patient was clinically stable, and would undergo surgery extirpation for aesthetic matters. Clinical examination showed the swelling was circumscribed and centralized and it presented about 20 centimeters in diameter. The ultrasound of the pectoral area showed an anechoic structure with hyperechoic spots inside limited by an hyperechoic layer similar to a fibrous capsule. Presumptive diagnostics were of: hematoma, subcutaneous abscess, neoplasia, and possible vascular involvement. The use of conventional ultrasound was not enough to set the diagnosis, and the patient was referred to surgical exploration, where the procedures of isolation and anastomosis were performed, however rupture occurred and the patient died. Necropsy revealed sacculation of the ventral region of the neck next to the entrance of the thorax, and the involvement of the external right jugular vein, being the adjacent muscle tissue not involved. Histopathological evaluation showed intense proliferation of sub-endothelial fibrous tissue which infiltrated the tunica media and adventitia and a mild inflammatory infiltrate of lymphocytes and histiocytes, which was diagnosed as an aneurysm of the right external jugular vein.Discussion: The reported patient had a venous aneurysm located superficially, which may have contributed to the absence of symptoms. The ultrasound is a diagnostic method available to most veterinarians nowadays, mainly in the countryside. However, when it is used in the diagnosis of an aneurysm it displays a dilatation with anechoic content, which is com­mon to several other skin diseases. A similar ultrasound image was observed in the case reported, but the diagnosis was difficult because the aneurysm presented intense proliferation of fibrous tissue infiltrated in the media and adventitia of the vascular wall, similar to a capsule of fibrous tissue, which lead to the presumptive diagnostics of hematoma, abscess and neoplasia, with possible vascular involvement. The options for the treatment of the aneurysms consider the location, size and extent of them and it determines the choice between clinical observation and surgery. In veterinary medicine it is difficult to keep the animals still and in the case of a horse, any movement can lead to the spontaneous rupture of the aneurism. Considering the risk of spontaneous rupture and hemorrhage, the surgical resolution, even if risky, emerges as the most suitable treatment. Venous aneurysms although rare, need to be included as a differential diagnosis in skin diseases along with increased volume, as hematomas, abscesses and tumors. The prognosis, however, is poor because of the surgical limitations and risks of imminent rupture in the clinical treatment.Keywords: venous aneurysm, differential diagnosis, equine

INTERVENÇÃO DE ORIENTAÇÕES DE AUTOCUIDADO PARA PESSOAS EM SITUAÇÃO DE RUA: RELATO DE EXPERIÊNCIA

Introduction: nursing is responsible for providing assistance when there is a deficit in self-care, through actions of prevention, promotion, recovery and rehabilitation of health. Objective: to describe the experience of the operative group of self-care guidelines for the homeless population (PSR). Methodology: it is an experience report. Results: an operating group was created through the creation of posters and videos for guidance on self-care, using resources from the virtual environment. Final considerations: in view of the promotion of health education, the production of videos and posters were resources capable of making the operative group effective, developing the researchers' creativity, resoluteness and humanization.La enfermería es responsable de brindar atención cuando hay un déficit en el autocuidado, a través de acciones de prevención, promoción, recuperación y rehabilitación de la salud. Objetivo: describir la experiencia del grupo operativo de directrices de autocuciencia para la población sin hogar (PSR). Metodología: este es un informe de experiencia. Resultados: se llevó a cabo un grupo operativo a través de la elaboración de carteles y vídeos para orientación sobre el autocuidado, utilizando recursos del entorno virtual. Consideraciones finales: en vista de la promoción de la educación para la salud, la producción de vídeo y carteles fueron recursos capaces de realizar el grupo operativo, desarrollar la creatividad, la resolución de problemas y la humanización de los investigadores.A enfermagem é responsável pela prestação de assistência quando há um déficit no autocuidado, através de ações de prevenção, promoção, recuperação e reabilitação da saúde. Objetivo: descrever a experiência do grupo operativo de orientações de autocuidado para a população em situação de rua (PSR). Metodologia: trata-se de um relato de experiência. Resultados: foi realizado um grupo operativo por meio da elaboração de cartazes e vídeo para orientações sobre autocuidado, utilizando-se recursos de ambiente virtual. Considerações finais: diante da promoção de educação em saúde, a produção do vídeo e de cartazes foram recursos capazes de efetivar o grupo operativo, desenvolvendo a criatividade, resolutividade e humanização dos pesquisadores

Molecular epidemiological investigation of Mayaro virus in febrile patients from Goiania City, 2017-2018.

Mayaro virus (MAYV) has historically been associated with sylvatic transmission; however, urban outbreaks have been reported in Brazil, including cases of co-detection with dengue virus (DENV). Therefore, we performed a molecular survey to investigate MAYV circulation and cocirculation with DENV within Goiania, a major city in Central-West Brazil. Among 375 subjects with arbovirus-like symptoms, 259 were positive for DENV and 26 for MAYV. Of these, 17 were coinfected with DENV-2, suggesting co-transmission of the viruses. The most common complaints at the time of inclusion were myalgia, headache, fever, arthralgia, retro-orbital pain, and skin rash. No specific symptoms were associated with MAYV when either detected alone or co-detected with DENV, compared to that when DENV was detected alone. Most MAYV-infected subjects were women with no recent travel history to rural/sylvatic areas. Phylogenetic reconstruction indicated that the MAYV identified in this study is closely related with a lineage observed in Peru, belonging to genotype D. Our results corroborate the growing circulation of MAYV in urban environments in Brazil and reinforce the need to implement laboratory diagnosis in the Unified Health System, considering that the clinical manifestations of Mayaro fever are similar to those of other arboviruses, particularly dengue. Furthermore, most cases occurred in association with DENV-2. Further phylogenetic studies are needed to evaluate MAYV, which has not been widely examined

Tuberculosis care: an evaluability study

OBJECTIVE: to verify whether the tuberculosis control program (TCP) is evaluable and to examine the feasibility of building an evaluation model in apriority municipality for the control of tuberculosis.METHOD: this evaluability study was conducted in a municipality in northeastern Brazil. For data collection, documental analysis and interviews with key informants were performed. For indicator validation, the nominal group technique was adopted.RESULTS: the details of TCP were described, and both the logical model and the classification framework for indicators were developed and agreed up on, with the goal of characterizing the structural elements of the program, defining the structure and process indicators, and formulating the evaluation questions.CONCLUSION: TCP is evaluable. Based on logical operational analysis, it was possible to evaluate the adequacy of the program goals for the control of tuberculosis. Therefore, the performance of a summative evaluation is recommended, with a focus on the analysis of the effects of tuberculosis control interventions on decreasing morbidity and mortality