FATORES QUE INFLUENCIAM A DEPRESSÃO NO PERÍODO DO CLIMATÉRIO

In the climacteric period, women present significant risk factors, increasing the predisposition for the occurrence of depressive symptoms and depression, thus, it is necessary to analyze the index of depression during the climacteric period. Thus, this study aimed to analyze, through an integrative review, the factors that influence depression in the climacteric period, aiming to observe the most frequent modifications that interfere in the quality of life of women. The study is an integrative review, with qualitative approaches, based on already published articles, in the databases (Lilacs, Scielo). To better understand the theme, the protocol of basic health care for women of the Ministry of Health Health (MS). The discussion of the results was organized into 5 subtopics: depression, climacteric, perimenopause, menopause and postmenopausal. It is concluded that it is extremely important to analyze the factors that influence depression during the climacteric period.No período do climatério as mulheres apresentam fatores de risco significativos, aumentando a predisposição para ocorrência de sintomas depressivos e depressão, desse modo, faz-se necessário analisar o índice de depressão no período do climatério. Sendo assim este estudo objetivou analisar, por meio de revisão integrativa os fatores que influenciam a depressão no período do climatério, visando observar as modificações mais frequentes que interferem na qualidade da vida da mulher. O estudo trata-se de uma revisão integrativa, com abordagens qualitativa, baseado em artigos já publicados, nas bases de dados (Lilacs, Scielo), para maior compreensão do tema ultilizou-se o protocolo da atenção básica da saúde da mulher do Ministério da Saúde (MS). A discussão dos resultados foi organizada em 5 subtemas: depressão, climatério, perimenopausa menopausa e pós menopausa. Conclui-se que é e de extrema importância analisar os fatores que influenciam a depressão no período de climatério

Núcleos de Ensino da Unesp: artigos 2012: volume 6: formação de professores e trabalho docente

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status