RELAÇÃO ENTRE DOENÇAS CRÔNICAS NÃO TRANSMISSÍVEIS E O TEMPO DE INTERNAÇÃO DE IDOSOS EM UNIDADE DE TERAPIA INTENSIVA

Objective: To verify the relationship between Chronic Non-Communicable Diseases (CNCD) and the length of stay of elderly people in Intensive Care Units (ICU). Methodology: This is a broad literature review in which the research is based on the question "What is the relationship between chronic non-communicable diseases (NCDs) and the length of stay of the elderly in intensive care units (ICUs)?". The research was conducted in 2023, by consulting the databases Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Nursing Database (BDENF), accessed through the Virtual Health Library, as well as the Scientific Electronic Library Online (SciELO). Results: Five articles show that the relationship between chronic non-communicable diseases (NCDs) and length of stay in ICUs is complex, depending on various factors such as the severity of the conditions, age and quality of care. The majority of hospitalizations are linked to CNCDs, such as cardiovascular and respiratory diseases, affecting the elderly, who often already face fragile health conditions. The presence of multiple NCDs can increase the length of hospitalization, especially in private health systems. The complexity of the clinical condition also influences length of stay, with patients with more chronic diseases having longer stays. The studies showed variations in the average length of stay, but emphasize that hospitalization of the elderly can lead to reduced functionality, resulting in dependence on caregivers. Conclusion: This study provided insights into the profile of older people in ICUs, identifying the presence or absence of CNCDs and their impact on the average length of stay in intensive care for older people.Objetivo: Verificar la relación entre las enfermedades crónicas no transmisibles (ECNT) y la duración de la estancia de los ancianos en las unidades de cuidados intensivos (UCI). Metodología: Se trata de una amplia revisión bibliográfica en la que la investigación se basa en la pregunta "¿Cuál es la relación entre las enfermedades crónicas no transmisibles (ECNT) y la duración de la estancia de los ancianos en las unidades de cuidados intensivos (UCI)?". La investigación fue realizada en el año 2023, consultando las bases de datos Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), y Nursing Database (BDENF), accedidas a través de la Biblioteca Virtual en Salud, así como la Scientific Electronic Library Online (SciELO). Resultados: Cinco artículos presentan que la relación entre las enfermedades crónicas no transmisibles (ECNT) y la duración de la estancia en las UCI es compleja y depende de diversos factores, como la gravedad de las afecciones, la edad y la calidad de la asistencia. La mayoría de las hospitalizaciones están relacionadas con ENT, como las enfermedades cardiovasculares y respiratorias, que afectan a las personas mayores, que a menudo ya se enfrentan a condiciones de salud frágiles. La presencia de múltiples ENT puede aumentar la duración de la hospitalización, especialmente en los sistemas sanitarios privados. La complejidad del cuadro clínico también influye en la duración de la hospitalización, ya que los pacientes con más enfermedades crónicas tienen estancias más largas. Los estudios mostraron variaciones en la duración media de la estancia, pero destacan que la hospitalización de los ancianos puede conducir a una reducción de la funcionalidad, lo que se traduce en una dependencia de los cuidadores. Conclusión: Este estudio proporcionó información sobre el perfil de las personas mayores en las UCI, identificando la presencia o ausencia de ENT y su impacto en la duración media de la estancia en cuidados intensivos para personas mayores.Objetivo: Verificar a relação entre as Doenças Crônicas Não Transmissíveis (DCNT) e o tempo de internação de idosos em Unidades de Terapia Intensiva (UTI). Metodologia: Trata-se de uma ampla revisão da literatura em que a construção da pesquisa está amparada na questão "Qual a relação entre doenças crônicas não transmissíveis (DCNT) e o tempo de internação do idoso em unidade de terapia intensiva (UTI)?" A pesquisa foi conduzida em 2023, por meio da consulta às bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), e Base de Dados em Enfermagem (BDENF), acessadas através da Biblioteca Virtual em Saúde, bem como a Scientific Electronic Library Online (SciELO). Resultados: Cinco artigos apresentam que a relação entre doenças crônicas não transmissíveis (DCNT) e o tempo de internação em UTIs é complexa, dependendo de vários fatores, como gravidade das condições, idade e qualidade do cuidado. A maioria das internações está ligada a DCNT, como doenças cardiovasculares e respiratórias, afetando idosos, que muitas vezes já enfrentam fragilidades de saúde. A presença de múltiplas DCNT pode aumentar o tempo de internação, principalmente em sistemas de saúde privados. A complexidade do quadro clínico também influencia o tempo de internação, com pacientes com mais doenças crônicas tendo estadias mais longas. Os estudos apresentaram variações no tempo médio de internação, mas ressaltam que a hospitalização de idosos pode levar à redução da funcionalidade, resultando na dependência de cuidadores. Conclusão: Este estudo forneceu insights sobre o perfil dos idosos internados em UTIs, identificando a presença ou ausência de DCNTs e seu impacto no tempo médio de internação em tratamento intensivo para pessoas idosas

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Entrevista fenomenológica com egressos de Instituição Psiquiátrica: relatos de experiencias

Este artículo pretende describir la experiencia en la aplicación del método de investigación de Heidegger, en particular las entrevistas fenomenológicas con las personas con enfermedad mental dados de alta en las instituciones psiquiátricas en las que se encuentran actualmente los residentes de la terapéutica de Servicios Residenciales (SRTS). Se entrevistaron a nueve residentes de la SRT en Piauí. Se repitió esta fase varias veces y los resultados fueron sorprendentes dado que incidió en la estrategia de acercamiento a los sujetos, el escenario de las entrevistas y en el nivel de agitación de los sujetos. Esta experiencia me permitió identificar lo que es necesario e importante para establecer empatía con los sujetos, no existe una fórmula para la realización de la entrevista, pero es el investigador el que debe identificar la mejor estrategia para la selección de los informantes. En conclusión, la empatía experimentada por el entrevistador al obtener los informes de los sujetos residentes mediante la entrevista fenomenológica resultó crucial para descubrir el significado de las vivencias de la vida cotidiana de estos sujetos en estas instituciones.This article aims to describe my experience in applying the method of Heideggerian research, in particular the phenomenological interviews with people with mental illness discharged from psychiatric institutions that are currently residents of Therapeutic Residential Services (SRTS). We interviewed nine residents of SRTs in Piauí. In this step several times to walk were striking as the strategy of rapprochement with the interviewees, the location of interviews and even stirring account of the subjects. This experience enabled me to identify what is necessary and important to establish empathy with the subjects, there is no formula for conducting the interview, but it is the researcher to identify the best strategy for obtaining the reports. So is that the empathetic experienced by me in getting the reports of respondents in essence residents through phenomenological interview was crucial to uncovering the meaning of the subjects lived in the daily life of these devices.Este artigo tem por objetivo descrever minha experiência na aplicação do método Heideggeriano de investigação, em particular a entrevista fenomenológica, com portadores de transtorno mental egressos de instituições psiquiátricas que atualmente são moradores de Serviços Residenciais Terapêuticos (SRTs). Foram entrevistados nove moradores de SRTs no Piauí. No caminhar dessa etapa vários momentos foram marcantes como: a estratégia de aproximação com os depoentes, o local das entrevistas e o próprio relato emocionante dos sujeitos. Essa experiência possibilitou-me identificar que é necessário e importante o estabelecimento da empatia com os sujeitos da pesquisa, que não existe formula para a condução da entrevista, mas cabe ao pesquisador identificar a melhor estratégia para a obtenção dos relatos. Assim é que a relação empática vivenciada por mim na obtenção dos relatos dos moradores depoentes em sua essência por meio da entrevista fenomenológica foi fundamental para se desvelar o sentido do vivido dos sujeitos no cotidiano desses dispositivos

Violência contra adolescentes grávidas: uma revisão integrativa - doi: 10.5102/ucs.v10i1.1623

Objetivou-se apontar características do contexto que envolve a violência contra adolescentes grávidas, por meio de uma revisão bibliográfica. Para tanto, a partir da utilização dos descritores “violência” e “gravidez na adolescência”, selecionaram-se doze estudos pertencentes às bases de dados MEDLINE, LILACS e ADOLEC com abrangência temporal entre os anos 1998 e 2010. As adolescentes são mais prováveis de vivenciar agressões durante a gravidez que as mulheres adultas. O perfil das jovens evidenciou que a maioria é negra, solteira, possui baixa escolaridade e baixo nível socioeconômico. Os principais indivíduos perpetradores foram os parceiros ou ex-parceiros. As principais consequências das agressões foram o abuso de drogas, isolamento, falta de moradia, abortamento, doenças ginecobstétricas e resultados neonatais adversos. Evidenciou-se, portanto, um perfil de desvantagens entre as jovens grávidas agredidas. Faz-se necessário o empenho dos profissionais de saúde para identificar precocemente e tratar os casos de violência com vistas à redução dos índices deste agravo e seus possíveis efeitos