REPRESENTAÇÕES SOCIAIS DO ENVELHECIMENTO EM PRIVAÇÃO DE LIBERDADE

O envelhecimento abordado neste estudo ocorre ao longo de toda a vida e não se restringe a uma fase do desenvolvimento humano. Objetivo: Identificar as representações sociais do envelhecimento para homens e mulheres em privação de liberdade. Método: Participaram 20 homens (média de idade 40,3 com DP de 11,3) e 20 mulheres (média de idade 32,3 com DP de 8,9). Instrumentos: Questionário Sociodemográfico, Teste de Associação Livre de Palavras (TALP) e Entrevista Semiestruturada. Resultados: Os dados evidenciaram que as palavras mais evocadas pelos participantes foram “Deus” e “tempo”. Os homens compreendem o envelhecimento pela ótica da religião e as mulheres atribuem valor cronológico de acordo com a análise prototípica. Quanto aos resultados do material textual, as subcategorias cronológico e perdas se destacaram relacionadosao aspecto psicossocial. Conclusões: A inquietação com os resultados do estudo reside no fato de que, para as pessoas, no sistema penitenciário, o processo de senescência acarreta danos ao desenvolvimento humano salutar, que compreende o envelhecimento ao longo da vida, pois enquanto estão no sistema penitenciário, prosseguem se desenvolvendo precariamente num ambiente que acumula insalubridades físicas e psicossociais

Proposta de diagnósticos, resultados e intervenções de enfermagem para pacientes em pós-operatório de cirurgia ortognática

Objective: To propose nursing diagnoses, outcomes and interventions for patients in the postoperative period of orthognathic surgery. Method: Secondary analysis of an information bank of a focal group with five patients submitted to orthognathic surgery. The classifications of the North American Nursing Diagnosis Association International, Nursing Outcomes Classification and Nursing Interventions Classification were used for elaborating nursing diagnoses, outcomes and interventions. Nursing diagnoses were identified based on the transcription of the focus group and the expected outcomes and interventions were proposed. In the second stage, the material was submitted to an analysis by judges for validating the previous stage. Results: After careful analysis of the retrieved information, nine nursing diagnoses that relate to both the difficulties already installed and to potential patient difficulties were identified. After this phase, the expected outcomes for nursing care and the appropriate interventions for the postoperative period at home were identified. Conclusion: Given the short hospital stay and the long postoperative period, the established actions have a strong educational focus.Objetivo: Propor diagnósticos, resultados e intervenções de enfermagem em pacientes em pós-operatório de cirurgia ortognática. Método: Análise secundária de um banco de informações de um grupo focal com cinco pacientes submetidos à cirurgia ortognática. Para elaboração dos diagnósticos, resultados e intervenções de enfermagem, utilizou-se das classificações da North American Nursing Diagnosis Association International, Nursing Outcomes Classification e Nursing Interventions Classification. A partir da transcrição do grupo focal, foram identificados os diagnósticos de enfermagem e propostos resultados esperados e intervenções. Em segunda etapa, o material foi submetido à análise por juízes para validação da etapa anterior. Resultados: Após análise cuidadosa das informações recuperadas, foram identificados nove diagnósticos de enfermagem que se relacionam tanto com as dificuldades já instaladas como com as dificuldades potenciais do paciente. Após esta fase, foram identificados os resultados esperados da assistência de enfermagem e as intervenções adequadas para um pós-operatório em domicílio. Conclusão: Dada a curta permanência hospitalar e um pós-operatório longo, as ações estabelecidas têm forte enfoque educacional.Objetivo: Proponer diagnósticos, resultados e intervenciones de enfermería para pacientes en posoperatorio de cirugía ortognática. Método: Análisis secundario de un banco de informaciones de un grupo focal con cinco pacientes sometidos a la cirugía ortognática. Para elaboración de los diagnósticos, resultados e intervenciones de enfermería, se utilizaron las clasificaciones de la North American Nursing Diagnosis Association International, Nursing Outcomes Classification y Nursing Interventions Classification. Desde la transcripción del grupo focal, fueron identificados los diagnósticos de enfermería y propuestos resultados esperados e intervenciones. En segunda etapa, el material fue sometido al análisis por jueces para validación de la etapa anterior. Resultados: Tras un análisis cuidadoso de las informaciones recuperadas, fueron identificados nueve diagnósticos de enfermería que se relacionan tanto con las dificultades ya instaladas como con las dificultades potenciales del paciente. Luego de esa fase, fueron identificados los resultados esperados de la asistencia de enfermería y las intervenciones adecuadas para un posoperatorio en domicilio. Conclusión: Dada la corta permanencia hospitalaria y un posoperatorio largo, las acciones establecidas tienen fuerte enfoque educativo

Antitumor activity of leaves of Himatanthus drasticus (Mart.) Plumel-Apocynaceae (janaguba) in the treatment of Sarcoma 180 tumor

Himatanthus drasticus, also known as janaguba, is used popularly in Brazil's Northeastern region in the treatment of cancer. However, no scientific reports are available. The present study is the first investigation on the antitumor activity of crude methanolic extract from Himatanthus drasticus leaves against Sarcoma 180 tumor and on its side effects including acute oral toxicity. The OECD 423 methodology was used to study acute oral toxicity, and the STOCK methodology to assess antitumor activity. The crude extract showed low toxicity at the tested doses (50, 300 and 2000 mg/kg) administered orally. The histopathological analyses demonstrated alterations in liver lung, spleen and kidney. It also showed activity against Sarcoma 180 tumor in male Swiss albino mice, evidencing tumor growth inhibition of 67.7% and 68% at 300 mg/kg and 400 mg/kg doses, respectively.Himatanthus drasticus, conhecida popularmente como janaguba, tem uma longa história de emprego na cura do câncer no nordeste brasileiro, porém quase sem registro na literatura. O objetivo desse trabalho foi investigar a atividade antitumoral do extrato bruto metanólico das folhas de Himatanthus drasticus frente ao modelo experimental Sarcoma 180 e avaliar sua toxicidade aguda. A determinação da toxicidade aguda foi realizada segundo a metodologia da OECD 423 e o transplante do tumor sólido de sarcoma 180 foi realizado seguindo a metodologia de Stock. O extrato apresentou baixa toxicidade nas doses testadas (50, 300 e 2000 mg/kg) por via oral. A análise histopatológica apresentou alterações em nível hepático, pulmonar, baço e renal. A atividade antineoplásica apresentou inibição tumoral significativa em relação ao grupo controle nas doses de 300 mg/kg e 400 mg/kg de peso do animal com um percentual de inibição de 67.7% e 68% respectivamente. Na menor dose analisada, 200 mg/kg, o percentual de inibição tumoral foi apenas de 32.8%

Aspectos clínicos-epidemiológicos da correlação da helicobacter pylori com a carcinogênese gástrica: uma revisão de literatura / Clinical-epidemiological aspects of the correlation of helicobacter pylori with gastric carcinogenesis: a literature review

Introdução: Helicobacter pylori é uma bactéria virulenta capaz de colonizar o estômago de forma crônica realçando a possibilidade de perigo no que se refere a evolução da carcinogênese gástrica.  Objetivo: estabelecer o efeito do Helicobacter pylori na apresentação e no curso clínico do câncer gástrico. Justificativa: O Brasil convive com cânceres associados a infecções, o que é característico de países em desenvolvimento. Portanto o entendimento de todos os âmbitos da infecção causada pela Helicobacter pylori se mostra de valoroso entendimento no âmbito social e médico. Metodologia: O presente estudo foi efetivado por meio de uma revisão bibliográfica de caráter qualitativo a partir de materiais já publicados com o objetivo de analisar diversas posições em relação aos aspectos clínicos-epidemiológicos da correlação da Helicobacter pylori com a carcinogênese gástrica. Conclusão: A relação entre o Helicobacter pylori e o aumento do risco de câncer gástrico, é significativa, uma vez que a incidência de lesões gástricas e vias inflamatórias que correlacionados aos genes virulentos da H. pylori podem gerar metaplasias ou lesões precursoras do câncer

Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon

Funding Information: We would like to thank the following institutions for all the support they accorded: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas Health Surveillance Foundation Dr. Rosimary Costa Pinto (FVS‐RCP/AM), the Municipal Health Departments of the affected by the outbreaks and Fundação de Amparo à Pesquisa do Estado do Amazonas for their financial support in acquiring materials for the molecular detection of the parasite. We would also like to thank the public health surveillance teams and the patients who agreed to participate in this study. Publisher Copyright: © 2023 Belgian Society of Tropical Medicine and the Prince Leopold Institute of Tropical Medicine.Objective: To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon. Methods: Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included. Results: There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas. Conclusion: The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.publishersversioninpres

Qualidade dos cuidados de enfermagem e satisfação do paciente atendido em um hospital de ensino

OBJECTIVES: assess the quality of nursing care, the patients' satisfaction and the correlation between both. METHOD: cross-sectional study, involving 275 patients hospitalized at a teaching hospital in the Central-West of Brazil. The data were collected through the simultaneous application of three instruments. Next, they were included in an electronic database and analyzed in function of the positivity, median value and Spearman's correlation coefficients. RESULTS: among the nursing care assessed, only two were considered safe - hygiene and physical comfort; nutrition and hydration - while the remainder were classified as poor. Nevertheless, the patients were satisfied with the care received in the domains assessed: technical-professional, confidence and educational. This can be justified by the weak to moderate correlation that was observed among these variables. CONCLUSION: Despite the quality deficit, the patients' satisfaction level with the nursing care received was high. These results indicate that the institution needs to center its objectives on a continuing evaluation system of the care quality, aiming to attend to the patients' expectations.OBJETIVOS: evaluar la calidad de los cuidados de enfermería, la satisfacción del paciente y la correlación entre ambos. MÉTODO: estudio trasversal con 275 pacientes internados en un hospital de enseñanza de la región Centro-Oeste de Brasil. Los datos fueron recolectados mediante la aplicación simultánea de tres instrumentos. A seguir, fueron digitalizados en un banco de datos electrónico y analizados en función de la positividad, valor de mediana y coeficientes de correlación de Spearman. RESULTADOS: entre los cuidados de enfermería evaluados, solamente dos fueron considerados seguros - higiene y conforto físico; nutrición e hidratación - y los demás clasificados como pobres. Sin embargo, los pacientes se mostraron satisfechos con los cuidados recibidos en los dominios evaluados: técnico-profesional, confianza y educacional. Eso puede ser justificado por la correlación débil a moderada observada entre esas variables. CONCLUSIÓN: A pesar del déficit de cualidad, fue encontrado alto nivel de satisfacción de los pacientes con los cuidados de enfermería recibidos. Tales resultados indican la necesidad de que la institución centre sus objetivos en un sistema de evaluación permanente de la cualidad del cuidado, visando atender a las expectativas de los pacientes.OBJETIVOS: avaliar a qualidade dos cuidados de enfermagem, a satisfação do paciente e a correlação entre ambos. MÉTODO: estudo transversal, realizado com 275 pacientes internados em um hospital de ensino da Região Centro-Oeste do Brasil. Os dados foram obtidos por meio da aplicação simultânea de três instrumentos. A seguir, foram digitados em banco de dados eletrônico e analisados em função da positividade, valor de mediana e coeficientes de correlação de Spearman. RESULTADOS: dentre os cuidados de enfermagem avaliados, apenas dois foram considerados seguros - higiene e conforto físico; nutrição e hidratação - e os demais foram classificados como pobres. Todavia, os pacientes mostraram-se satisfeitos com os cuidados recebidos nos domínios avaliados: técnico-profissional, confiança e educacional. Isso pode ser justificado pela correlação fraca a moderada observada entre essas variáveis. CONCLUSÃO: apesar do déficit de qualidade, houve alto nível de satisfação dos pacientes com os cuidados de enfermagem recebidos. Tais resultados apontam a necessidade de a instituição centrar seus objetivos num sistema de avaliação permanente da qualidade do cuidado, visando o atendimento das expectativas dos pacientes

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.Peer reviewe

ARIA 2016 : Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.Peer reviewe

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic