Validation of the Saint George's Respiratory Questionnaire in patients with chronic obstructive pulmonary disease in Brazil

Introduction: The term quality of life has gained increasing importance in the scientific context. This study describes the adaptation of a disease-specific questionnaire developed by Paul Jones et al. in 1991, the St. George's Respiratory Questionnaire (SGRQ), to the Brazilian language and culture. This questionnaire evaluates the quality of life in patients with chronic obstructive pulmonary disease (COPD) and contains three domains (symptoms, activity, and impacts) divided in 76 items. The questionnaire is self-administrated, but it may be read to illiterate persons. Goal: To verify if the St. George's Respiratory Questionnaire is a valid tool to measure quality of life in patients with chronic obstructive pulmonary disease in Brazil. Methods: In order to validate the questionnaire in Brazil, it was initially translated into Portuguese and afterwards a back-translation into English, that was compared to the original version. A final Portuguese version was then written. This final version was, then, answered by 30 clinically stable COPD patients, according to the spirometry and oximetry values. Patients answered the questionnaire twice, within a 15 day interval. The length of time the patients took to answer the questionnaire and their doubts were noted. Wilcoxon test was used for the calculation of r probability between every single question between the two days; interclass correlation ratio was calculated to test the trustworthiness and reliability of the questionnaire. Results: Among the 30 participant patients, 10 were female and 20 were male. Mean age was 65.9 years. Most of the patients were found to be in stage 2 (56.7 %) of COPD, according to the American Thoracic Society classification. The interclass correlation ratio for the total score of the questionnaire was a = 0.79 and Wilcoxon p = 0.2110 (not statistically significant). The mean answering time for the two days of interview was, respectively, 11 minutes and 50 seconds and 10 minutes and 31 seconds. As concerns the doubts about the questions, the patients reported difficulties in answering Sections 4 and 5, each one of these questions written in a negative form. Conclusion: It can be concluded that the Brazilian version of the St. George's Respiratory Questionnaire is a valid and reliable tool to measure quality of life in patients with COPD in Brazil.Introdução: O termo qualidade de vida tem adquirido cada vez mais importância no contexto científico. O presente estudo descreve a adaptação para as língua e cultura brasileiras de um questionário doença-específico desenvolvido por Paul Jones et al. em 1991(1): o Questionário do Hospital Saint George na Doença Respiratória (SGRQ), para a avaliação de qualidade de vida em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Esse questionário contém três componentes (sintomas, atividade e impactos) divididos em 76 itens. É auto-administrado e pode ser lido para pacientes analfabetos. Objetivo: Verificar se o SGRQ é um instrumento válido para medir qualidade de vida em pacientes portadores de DPOC no Brasil. Métodos: Para a validação deste questionário no Brasil, realizou-se, inicialmente, uma versão da língua inglesa para o português; em seguida, foi realizada a tradução retrógrada (back translation), do português para o inglês, e uma versão final foi aplicada em 30 pacientes com diagnóstico de DPOC, estáveis clinicamente e baseado em critérios de espirometria e oximetria. Os pacientes responderam ao questionário por duas vezes, num intervalo de 15 dias. O tempo de resposta foi cronometrado e as dúvidas apontadas pelos pacientes, anotadas. Foi utilizado o teste estatístico de Wilcoxon para cálculo de probabilidade de r e calculado o coeficiente de correlação intraclasse para testar a fidedignidade e a confiabilidade do questionário. Resultados: Dos 30 pacientes que participaram do estudo, 10 eram do sexo feminino e 20 do masculino. A média de idade foi de 65,9 anos. A maioria dos pacientes encontrava-se no estádio 2 (56,7%) da DPOC, segundo a classificação da American Thoracic Society. O coeficiente de correlação intraclasse para a pontuação total do questionário foi a = 0,79 e o resultado do teste de Wilcoxon p = 0,2110 (não significante estatisticamente). O tempo médio de resposta dos dois dias de entrevista foi, respectivamente, 11 minutos e 50 segundos e 10 minutos e 31 segundos. Em relação às dúvidas, as questões mais freqüentemente referidas foram as das seções 4 e 5, que contêm uma frase cada na forma negativa. Conclusão: Pode-se concluir que a versão brasileira do Questionário do Hospital Saint George na Doença Respiratória (SGRQ) é um instrumento válido e fidedigno para medir qualidade de vida em pacientes portadores de DPOC no Brasil.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaCentro Universitário de UberlândiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Centro de Reabilitação PulmonarUniversity of LondonUNIFESP, EPM, Centro de Reabilitação PulmonarSciEL

ENFERMAGEM E CONTROLE DE INFECÇÕES EM MEDICAÇÕES INJETÁVEIS: ELABORAÇÃO E VALIDAÇÃO DE INSTRUMENTO

Objective: to develop and validate an instrument for measuring the knowledge of nursing professionals about SafeInjecting practices for the prevention of infection in injectable medications. Method: methodological study, carried out in a city in the interior of São Paulo, between March 2018 and December 2019, according to stages: establishment of the conceptual structure, construction and validation of the instrument, by experts, through the agreement rate and content validity index. After the validation process, the instrument was applied with a target audience. The result: an instrument composed of 27 items was constructed, including: preparation of the environment, preparation and administration of injectable medications and disposal of sharp materials. There was a high rate of agreement among the ten specialists and semantic refinement after a response from 34 participants from the target audience. Conclusion: a tool capable of measuring knowledge on the subject in a standardized way was consolidated, allowing the development of specific educational interventions, according to the situational diagnosis performed.Objetivo: desarrollar y validar un instrumento para medir el conocimiento de los profesionales de enfermería sobre prácticas seguras para la prevención de la infección en medicamentos inyectables. Método: estudio metodológico, realizado en un municipio del interior de São Paulo, entre marzo de 2018 y diciembre de 2019, según etapas: establecimiento de la estructura conceptual, construcción y validación del instrumento, por expertos, a través del índice de tasa de acuerdo y validez de contenido. Después del proceso de validación, el instrumento se aplicó con un público objetivo. El resultado: se construyó un instrumento compuesto por 27 ítems, entre ellos: preparación del ambiente, preparación y administración de medicamentos inyectables y eliminación de materiales punzantes. Hubo una alta tasa de acuerdo entre los diez especialistas y refinamiento semántico después de una respuesta de 34 participantes del público objetivo. Conclusión: se consolidó una herramienta capaz de medir el conocimiento sobre el tema de manera estandarizada, permitiendo el desarrollo de intervenciones educativas específicas, de acuerdo al diagnóstico situacional realizado.Objetivo: elaborar e validar instrumento para mensuração de conhecimento de profissionais de enfermagem sobre práticas seguras para prevenção de infecção em medicações injetáveis. Método: estudo metodológico, realizado em município paulista, entre março de 2018 e dezembro de 2019, conforme etapas: estabelecimento da estrutura conceitual e construção do instrumento; validação por especialistas com experiência assistencial ou controle de infecção ou pesquisadores na área, com taxa de concordância >80% e índice de validade de conteúdo ≥0,78; e análise semântica junto ao público-alvo, recrutado por meio da técnica bola de neve. Resultados: construiu-se instrumento com 27 itens, contemplando: preparo do ambiente, preparo e administração de medicações injetáveis e descarte de materiais perfurocortantes. Houve alta taxa de concordância entre os 10 especialistas e refinamento semântico após resposta de 34 participantes do público-alvo. Conclusão: consolidada ferramenta para mensurar, de forma padronizada, o conhecimento de profissionais de enfermagem sobre o tema, permitindo intervenções educativas específicas, conforme diagnóstico situacional.Descritores: Controle de Infecções. Enfermagem. Estudo de Validação. Injeções. Gestão do Conhecimento para a Pesquisa em Saúde

O uso do jogo computacional para o ensino da tabela periódica no ensino de Química para alunos da EJA

Orientador : Roberto de Fino BentesArtigo (especialização) - Universidade Federal do Paraná, Setor de Educação Profissional e Tecnológica, Curso de Especialização em Mídias Integradas na Educação.Inclui referência

Pruning management of ‘Marselan’ grapevines in the Serra do Sudeste region, in Southern Brazil

The agronomical behavior of the ‘Marselan’ grapevine, indicated for the production of high-quality fine wines, is related to the management of the vineyard and the edaphoclimatic conditions of the cultivation region. This work aimed to evaluate the vegetative, productive, and qualitative behavior of ‘Marselan’ grapevines subjected to the Spur Pruning and Double Guyot pruning systems, cultivated in a municipality belonging to the Serra do Sudeste region, RS state, Brazil. The ‘Marselan’ grapevines were conducted in a vertical shoot positioning training system over a ‘Paulsen 1103’ rootstock, in a commercial vineyard located in Encruzilhada do Sul, RS, Brazil. During the 2016/2017 and 2017/2018 cropping seasons the vegetative vigor, the mass of pruned shoots, Ravaz Index, production, and chemical-physical composition of the must were evaluated. The double Guyot pruning system in the ‘Marselan’ grapevines induced a lower plant vigor, promoted an increase in the number of bunches per plant, bunch mass, production, and yield. The pruning type interferes with the vigor and yield of the ‘Marselan’ grapes without altering must quality. In the management of the cv. ‘Marselan’ in the Serra do Sudeste region, Brazil, the double Guyot pruning system is the most indicated.The agronomical behavior of the ‘Marselan’ grapevine, indicated for the production of high-quality fine wines, is related to the management of the vineyard and the edaphoclimatic conditions of the cultivation region. This work aimed to evaluate the vegetative, productive, and qualitative behavior of ‘Marselan’ grapevines subjected to the Spur Pruning and Double Guyot pruning systems, cultivated in a municipality belonging to the Serra do Sudeste region, RS state, Brazil. The ‘Marselan’ grapevines were conducted in a vertical shoot positioning training system over a ‘Paulsen 1103’ rootstock, in a commercial vineyard located in Encruzilhada do Sul, RS, Brazil. During the 2016/2017 and 2017/2018 cropping seasons the vegetative vigor, the mass of pruned shoots, Ravaz Index, production, and chemical-physical composition of the must were evaluated. The double Guyot pruning system in the ‘Marselan’ grapevines induced a lower plant vigor, promoted an increase in the number of bunches per plant, bunch mass, production, and yield. The pruning type interferes with the vigor and yield of the ‘Marselan’ grapes without altering must quality. In the management of the cv. ‘Marselan’ in the Serra do Sudeste region, Brazil, the double Guyot pruning system is the most indicated

Systematic review of temporal trends of congenital syphilis in Brazil

The present study was aimed to retrieve and analyse the temporal trends of congenital syphilis (CS) in Brazil, as well as to list its main associated factors. Methods: In August 2019 a systematic review was developed in four electronic databases (Lilacs, Pubmed, Scielo and Web of Science) and in manual searches on reference lists. It was established that the synthesis of this review would be composed by ecological studies with CS temporal trends in the Brazilian territory, regardless of the population characteristics and data representativeness. More specifically, it was also established that the prevalence of CS of the first and last year of the time series would be presented in the descriptive synthesis. Results: Of the 2,157 initial studies, 14 adequately met the inclusion criteria and composed the synthesis. Twelve (85.7%) of these studies showed increases in time trends, with particular emphasis on the two nationwide studies, which showed positive trends between 2003–2008 (0.4) and 2010–2015 (3.7). Associations were found between CS and socioeconomic and ethnic factors, especially in the groups of women with low income, low education, brown / black skin colour and who had untreated partners. Conclusion: most of the available research showed an increase in the temporal trends of CS, highlighting that these data were observed at the national, state and municipal levels. Since mothers' socioeconomic and ethnic factors are associated with higher CS frequencies, efforts are needed to increase the coverage of the Unified Health System to vulnerable women

USO DA RADIOTERAPIA NA NEOPLASIA TROFOBLÁSTICA GESTACIONAL

A neoplasia trofoblástica gestacional abrange um grupo de doenças que têm origem no tecido placentário, apresentando tendências distintas de invasão, podendo chegar até a metástase, que é a sua forma mais grave. É uma neoplasia curável e isto se dá devido à alta sensibilidade das dosagens seriadas de gonadotrofina coriônica humana aliada ao tratamento quimioterápico e em certos casos radioterápico. O objetivo deste estudo pautou-se em levantar, junto à literatura publicada, informações a respeito da neoplasia trofoblástica gestacional e a utilização da radioterapia em seu tratamento. A metodologia utilizada foi a revisão de literatura, usando como fonte de pesquisa base de dados como Google Acadêmico; Coleção Nacional das Fontes de Informação do SUS (Coleciona SUS); Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). A amostra deste estudo foi composta por nove artigos publicados. Os resultados obtidos na pesquisa demonstraram que quando o paciente evolui para neoplasia trofoblástica gestacional, é importante procurar por metástases, uma vez que elas podem trazer complicações, requerendo um tratamento quimioterápico, e no caso de metástase cerebral, requerem radioterapia. Ao final, concluiu-se que a neoplasia trofoblástica gestacional nada mais é do que um grupo de tumores raros que estão relacionados com a gravidez, e se caracterizam pela proliferação anormal de células que possuem características histológicas semelhantes a do trofoblasto.   Palavras-chave: Neoplasia Trofoblástica Gestacional.Radioterapia. Metástase. ABSTRACT Gestational trophoblastic neoplasm includes a group of diseases derived from the placental tissue, with distinct invasion tendencies, which might lead to metastasis, its most severe form. It is a curable neoplasm, due to the high sensitivity of serial dosages of human chorionic gonadotrophin, combined with chemotherapy treatment, and, in certain cases, radiotherapeutic treatment as well. The purpose of this study is to gather, along with the published literature, information regarding gestational trophoblastic neoplasm, and the usage of radiotherapy in its treatment. The methodology used was literature review. Also, data were collected from research databases such as Google Scholar; National Collection of Information Sources of SUS (Collects SUS); Latin American and Caribbean Literature in Health Sciences (LILACS). Samples of this study were composed by nine published articles. The results of this research have shown that when the patient advances to gestational trophoblastic neoplasm, it is important to search for metastases, since metastases may lead to complications, requiring a chemotherapeutic treatment, and, in case of cerebral metastasis, requiring radiotherapy as well. The final conclusion is that gestational trophoblastic neoplasm is nothing but a group of rare tumours that are related to pregnancy, and are characterized by the abnormal proliferation of cells that have histological characteristics in common with trophoblast. Keywords: Gestational trophoblastic neoplasia,radioterapy, metástase

The impact of different surface treatments on the shear bond strength of orthodontic metal brackets applied to different CAD/CAM composites

To investigate the shear bond strength (SBS) of orthodontic metal brackets applied to different CAD/CAM composites treated with different surface treatments. Specimens of two CAD/CAM composites were obtained of Lava Ultimate (LU; n=60) and Brilliant Cri

Tratamiento quirúrgico de enucleación completa y análisis histológico de un mucocele en el labio inferior en un niño: Reporte de Caso.

Objective: The aim of this case report is to describe the surgical removal of a mucocele and its histological analysis, in a child. Case Report: An 11-year-old female patient attended the Pediatric Dentistry clinic complaining of a lower lip lesion. During the anamnesis, the mother reported that the child had a habit of biting and sucking the spot frequently. Clinical examination showed the lesion was compatible with a mucocele. The proposed treatment was a complete enucleation of the lesion under local anesthesia. The incision and tissue divulsion were performed for maximum preservation of the mucosa, avoiding a possible recurrence. Total adjacent glands removal was also performed. The lesion was placed in 10% formaldehyde for histopathological analysis (H&E Staining), which showed dense connective tissue presenting chronic inflammatory infiltrate and extravasated mucin, presence of granulation tissue delimiting the area of extravasated mucin and presence of minor salivary glands. The patient was advised to quit the habit, and after seven days the sutures were removed. At the one-year follow-up there was no recurrence of the lesion. Conclusion: The proposed treatment proved to be effective without recurrence of the lesion.Objetivo: El objetivo de este reporte de caso es describir la extirpación quirúrgica de un mucocele y su análisis histológico en un niño. Informe del caso: una paciente de 11 años de edad asistió a la clínica de Odontopediatria quejándose de una lesión en el labio inferior. Durante la anamnesis, la madre informó que el niño tenía la costumbre de morder y chupar el lugar con frecuencia. En el examen clínico, la lesión fue compatible con un mucocele. El tratamiento propuesto fue una enucleación completa de la lesión bajo anestesia local. La incisión y la divulgación del tejido se realizaron para la máxima preservación de la mucosa, evitando una posible recurrencia. También se realizó la extracción total de las glándulas adyacentes. La lesión se colocó en formaldehído al 10% para el análisis histopatológico (tinción H&E), que mostró tejido conectivo denso que presenta infiltrado inflamatorio crónico y mucina extravasada, presencia de tejido de granulación que delimita el área de mucina extravasada y presencia de glándulas salivales menores. Se aconsejó al paciente que abandonara el hábito, y después de siete días se retiraron las suturas. En el seguimiento de un año no hubo recurrencia de la lesión. Conclusión: El tratamiento propuesto demostró ser efectivo sin recurrencia de la lesión