American tegumentary leishmaniasis: epidemiological and molecular characterization of prevalent Leishmania species in the State of Tocantins, Brazil, 2011-2015

Determination of the epidemiological profile of the American tegumentary leishmaniasis (ATL) and identification of Leishmania species that are prevalent in the State of Tocantins were carried out through a retrospective and descriptive study based on data reported in SINAN, in the period from 2011 to 2015. Molecular techniques such as PCR-RFLP and PCR-G6PD to amplify Leishmania DNA were performed on stored on Giemsa-stained slides from lesion scarifications of ATL patients who were amastigote-positive by the direct microscopic examination. There were 1,434 ATL cases in Tocantins reported in this period. The highest incidence was reported in men aged over 60 years, rural residents, the most affected ethnic group was mixed ethnicity (mixed black and white) and the ones with lower education. The predominant clinical form was cutaneous, being diagnosed mainly by laboratory methods. Pentavalent antimonial was effective in resolving cases. The predominant species found in 271 analyzed samples from 32 municipalities located in 8 different health regions of Tocantins was Leishmania (Viannia) braziliensis. Identifying the epidemiological profile and characterizing the Leishmania spp species on regional level is essential to establish control and prevention behaviors, minimizing the number of cases and treatment resistance, recurrence and evolution to mucosal forms

Atuação do enfermeiro frente a uma gravidez fictícia/The nurse's action in the face of a fictitious pregnancy

A gravidez fictícia, também conhecida como gravidez psicológica ou pseudociese sucede devido a estímulos dos sistemas neuroendócrinos provocados por fatores psicológicos esse transtorno caracteriza-se por uma modificação psíquica do indivíduo, causando sintomas de uma gravidez normal. Dessa forma, esse estudo tem por objetivo descrever de que forma o enfermeiro dentro da atenção primária pode agir em um caso de pseudociese e como a assistência de enfermagem ligada a uma equipe multidisciplinar pode influenciar positivamente no acompanhamento a esse transtorno psicológico. O estudo foi desenvolvido por meio de uma pesquisa bibliográfica integrativa, os estudos selecionados foram tratados por meio de fichamentos, estabelecendo um instrumento útil para consulta posterior. Seguindo, os artigos foram relidos, com a finalidade de realizar uma análise interpretativa com base na questão norteadora e nos objetivos estabelecidos. Na gravidez fictícia ou psicológica, o fator determinante geralmente é derivado de um desvio da realidade ou de um desejo que não é real. Outros fatores podem impulsionar o desencadeamento de tal condição, como a pressão de familiares, principalmente do conjugue, ou até de seus filhos, pois mesmo a mulher alcançando sua liberdade de escolha, é marcada pelo discurso da maternidade. Diante deste cenário, conclui-se que se torna notório a importância da assistência da enfermagem, visto que o enfermeiro tem o papel de buscar novas soluções para os problemas, além de orientar a família e a paciente, sendo o profissional destaque ao atendimento à mulher.

Protocol Proposal For The Care Of The Person With Venous Ulcer

Objective: To propose a care protocol for the care of the person with a venous ulcer in highly complex services. Methods and results: This is a methodological study, in three stages: literature review, validation of content and validation in the clinical context. The literature review was carried out from June to August/2011, being the basis for the construction of the Protocol for Venous Ulcers. The content validation included 53 judges (44 nurses, 8 physicians and 1 physiotherapist) selected through the Lattes platform to evaluate the items of the protocol. Validation in the clinical context occurred at the University Hospital Onofre Lopes, in Natal/RN with four judges (nurses), who worked in pairs, evaluating 32 patients with venous ulcers. The protocol was validated with 15 categories: sociodemographic data; anamnesis; examinations; ulcer characteristics; care with the lesion and perilesional area; medicines used to treat the lesion; evaluation and treatment of pain; surgical treatment of chronic venous disease; recurrence prevention (clinical and educational strategies); reference; counter-reference; and quality of life. Conclusion: The validated protocol regarding content and clinical context was applicable. Its implementation is a viable measure that assists in the reorientation of the team in high complexity services, aiming at wound healing and restoration of the patient´s integral health. Keywords: Varicose ulcer; Tertiary Health Care; Protocols; Validation studies

Epidemiology of trauma victims served by prehospital service / Epidemiologia das vítimas de trauma atendidas por serviço pré-hospitalar

Objetivo: caracterizar os aspectos epidemiológicos das vítimas de trauma atendidas por um Serviço de Atendimento Móvel de Urgência 192. Método: estudo exploratório, descritivo e quantitativo, realizado no pronto socorro de um hospital de referência. A população alvo foram as vítimas de trauma atendidas pelo Serviço de Atendimento Móvel de Urgência, transportadas para o referido hospital. Resultados: observou-se que 5,9% deram entrada na urgência por Ferimentos por Arma de Fogo, 4,9% por Ferimento por Arma Branca, 23,8% por queda, e 60,4% por acidentes de trânsito. Conclusão: o perfil identificado foi de homens, vítimas de acidente de trânsito, nas idades de 18 a 35 anos, com segundo grau completo, sendo o tórax a região mais atingida. Esse estudo pode subsidiar a elaboração de estratégias para enfrentamento desses agravos, pois a grande quantidade de óbitos por causas externas são considerados um problema de saúde pública, causando sequelas irreparáveis

Quality Of Care Indicators Of A Pre-Hospital Mobile Emergency: A Review

Objective: To identify the quality of care indicators in pre-hospital mobile emergency services. Methods and results: This study is a systematic review conducted in December/2015 in eight databases using the keywords: quality indicators in health care; pre-hospital care; and quality, access, and evaluation of the health care. Seventeen studies were selected and the following indicators were identified: conservation of the ambulances; physical structure; comfort in the ambulance; material resources; safety for the patient/professional; continuing education; response time; professional remuneration; professional/patient satisfaction; access; host; humanization; performed service; safety demonstrated by the team; privacy to the patient; guidelines on care; relationship between the professional/patient; opportunity of the patient to complaint. Conclusion: The establishment the of the quality of care indicators the in mobile emergency services will allow the construction of instruments to evaluate this type of service to search for excellence results in mobile emergency services

Characterization of Publications on Burns in Brazil and Changes Resulting from Trauma in Brazil: Systematic Review of the Literature

Objective: Characterize the profile of scientific publications on burns in Brazil and systemic changes resulting from the trauma. Methods and results: This is a bibliographical, retrospective and descriptive research with a quantitative approach. It was held between April and May, 2016 in the databases Latin American and Caribbean Center on Health Sciences (LILACS); Nursing Database (BDENF); Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) and the Journal Portal of Higher Education Personnel Improvement Coordination (CAPES). After the analysis of the inclusion criteria (articles available in full, in Portuguese, published between 2011 and 2015), there were 49 productions, and 16 were selected. Analyzing the sample for the event characteristics, it was observed a higher incidence of accidents in males. The main causes of burns were heated by liquid, followed by direct flame. Regarding the classification, the most frequent injury was the 2nd degree, but also there were burns reports with mixed classification. Also, the upper limbs and trunk were the body parts most affected. In addition to these data, it was also highlighted the most frequent types of systemic changes caused by burns, which were respiratory complications, infection and/or sepsis and metabolic sequels.  Conclusion: The study showed the need to characterize of the publications in burns, since the crossing of this information provides a better understanding of the main causal factors, distribution and identification of risk groups. It also enables the planning of prevention strategies to help to reduce accidents, favoring the reduction of injuries and the number of hospitalizations. Moreover, it is extremely important that health professionals know about the epidemiological profile, to provide support in the evaluation and organization of care, and to prevention campaigns, aiming to decrease burn rates. Keywords: Profile; Burns; Burn Units

Evaluation Of The Quality Of Assistance In An Pre-Hospital Mobile Emergency Service

Background: to evaluate the quality of the assistance of a Mobile Emergency Care Service and to compare the evaluation of professionals according to training and level of education. Methods and Findings: this is a cross-sectional study, with a Donabedian theoretical reference. The sample was all the professionals of a Mobile Emergency Service and data collection performed by a previously validated quality assessment instrument. Some aspects of the service structure were evaluated negatively, and the process was evaluated in a positive way, in general. When comparing the evaluation of quality according to professional category and education, it was verified that the indicators of structure and process were considered appropriate by the professionals of average level and inadequate by the personnel of superior level. Conclusion: the professionals identified flaws in the service structure, which can impact the assistance provided. The level of education influenced the evaluation of the quality of the service. Keywords: Emergency medical services; Health Evaluation; Prehospital care; Evaluation studies; Health services &nbsp