Prevalence and follow-up analysis of evolution of severe and moderate neuropsychiatric manifestations in hospitalized systemic lupus erythematosus in the rheumatology service of the Hospital General de Fortaleza

OBJETIVO: Avaliar a prevalência e a resposta terapêutica das manifestações neuropsiquiátricas (MNP) moderadas ou graves em pacientes lúpicos internados no Hospital Geral de Fortaleza (HGF). MÉTODOS: Durante dois anos, 110 pacientes de internações consecutivas com lúpus eritematoso sistêmico, segundo os critérios do Colégio Americano de Reumatologia, foram avaliados para MNP moderadas ou graves. Nestes pacientes estudou-se: causa da internação, presença de auto-anticorpos, liquor, imagens radiológicas, análise retrospectiva dos prontuários e terapêutica utilizada. RESULTADOS: A prevalência de MNP foi de 16,4% (18/110), em 17 mulheres e um homem, com idade média de 29 anos; por ocasião do internamento, 33% (6/18) dos pacientes apresentavam apenas MNP. A ocorrência da primeira MNP foi de 11% (2/18) antes do diagnóstico, 33% (6/18) por ocasião do diagnóstico e 56% (10/18) pós-diagnóstico. A mortalidade foi de 11% (2/18). As principais MNP foram: convulsões e cefaléia (50%), psicose (22%), acidente vascular cerebral (17%) e síncope e depressão maior (11%). Resposta terapêutica: 28% (5/18) pacientes responderam à corticoterapia oral, 17% (3/18) realizaram pulso de metilprednisolona e 56% (10/18) pulso de ciclofosfamida. CONCLUSÃO: A prevalência de MNP na população estudada encontra-se no limite inferior da literatura. Na ausência de estudos clínicos controlados, a abordagem destes pacientes é fundamentada em séries de casos e na experiência profissional do serviço.OBJECTIVE: Evaluate the prevalence and therapy outcome of moderate and severe neuropsychiatric manifestations (NPM) in patients with systemic lupus erythematosus admitted at the Hospital Geral de Fortaleza. METHODS: During two years, 110 patients with consecutive hospitalizations suffering from systemic lupus erythematosus, according to the American College of Rheumatology criteria, were evaluated for moderate and severe NPM. The following parameters were studied in these patients: cause of admission, presence of auto-antibodies, cerebral spinal fluid, radiological imaging, retrospective study of medical records and treatment. RESULTS: The prevalence of NPM was 16.4% (18/110), being seventeen women and one man; the mean age was 29 years; during the hospitalization term, only 33% (6/18) of the patients had an NPM. The occurrence of the first NPM was in 11% (2/18) of the cases before diagnosis, in 33% (6/18) during diagnosis and in 56% (10/18) after diagnosis. The mortality rate was 11% (2/18). The most common NPM's were: seizures and headache (50%), psychosis (22%), cerebrovascular disease (17%), syncope and major depression (11%). Treatment outcome: 28% (5/18) of the patients responded to oral corticoids, 17% (3/18) had a pulse of methylprednisolone and 56% (10/18) were treated with cyclophosphamide. CONCLUSION: The prevalence of NPM in the patients of this study was on the lowest limit reported by the related literature. With no controlled clinical trials, the approach to these patients is based on case reports and the professional experience of the service

PROFESSIONAL ACTIVITY IN THE CONTEXT OF HEALTH EDUCATION: A SYSTEMATIC REVIEW

Describe educational practices performed by health professionals with reference to the paradigm of health promotion. It is systematic review the search for articles in databases: Medline, Lilacs and SciELO, published during the period from 2003 to 2013. The search was performed using the integrated method, using the terms: health promotion, health education and experiences. Given the results, was possible to demonstrate the importance of conducting health education experiences in different contexts: primary care, hospitals and schools with various themes and methodologies adopted. However, although these experiences implemented primarily with a view to promoting health, highlighting elements such as autonomy, empowerment and decision-making, it was found that even if educational actions on normative health are carried out they weaken the process of the empowerment of the individuals involved

Mensagem - Casa dos Estdantes do Império 1944-1994, Número Especial

A Casa dos Estudantes do Império (CEI) foi criada em 1944 pelo então Ministério das Coló- nias e pelo Comissariado Nacional da Mocidade Portuguesa sendo destinada ao enquadramento dos estudantes oriundos das Colónias portuguesas (de África, Índia, Macau e Timor). O eco das independências africanas ocorridas ao longo da década de 50 repercutiu-se no império colonial português, onde o regime do Estado Novo registava então grande contestação. Neste contexto histórico muitos jovens estudantes associados à CEI procuraram caminhos de descoberta / construção da identidade dos territó- rios de que eram originários com diversas iniciativas culturais, entre as quais a atividade editorial. A Associação Casa dos Estudantes do Império (ACEI), constituída por associados da CEI, em 1994 e com existência até 1997, reeditou, pela passagem do 50.o aniversário da Casa, dois volumes das Antologias de Poesia de Angola, Moçambique e São Tomé e Príncipe e elaborou um Nú- mero Especial da MENSAGEM, um Boletim publicado pela CEI, de forma irregular, de acordo com as vicissitudes vividas, entre 1948 e 1964. A União das Cidades Capitais de Língua Portuguesa (UCCLA) deliberou levar a efeito uma homenagem aos associados da CEI, iniciada numa cerimónia que teve lugar no Auditório da Reitoria da Universidade de Coimbra, em outubro de 2014, ano em que se perfizeram 70 anos da criação da CEI. Nessa homenagem iniciou-se a distribuição das reedições das referidas Antologias, com novo formato e ainda a distribuição de uma pen com os nomes de todos os associados da CEI, resultado de uma pesquisa levada a efeito na Torre do Tombo. Para 2015, ano em que se perfazem 50 anos sobre a extinção da CEI pela PIDE programaram-se vários eventos. De entre esses eventos constam debates, um Colóquio Internacional, a realizar na Fundação Calouste Gulbenkian, uma exposição na Câmara Municipal de Lisboa e, por fim, a sessão de encerramento no dia 25 de maio, Dia de África, em que intervirão como oradores todos os associados da CEI que vieram a ser Presidentes da República ou Primeiros Ministros dos territórios de onde eram originários. A reedição deste Número Especial da Revista MENSAGEM integra-se nesta justa homenagem.À Memória de Amílcar Cabral Mário de Andrade Carlos Ervedosa e daqueles que partiram cedo demais. Ao Dr. Arménio Ferreira, cuja generosidade e apoio nos anos difíceis prolongaram a existência da Casa. Aos ESTUDANTES AFRICANOS de hoje e do futuro.Ministério dos Negócios Estrangeiros, CPLP, Instituto Camões, Câmara Municipal de Lisboainfo:eu-repo/semantics/publishedVersio

Community health agent and the interface with the educational actions

IntroductionWithin the mandate of all the professionals who make up the Family Health Strategy , health education is common to all . The Nurse as part of the team has a key role in health levels of individuals, families and communities , because the primary purpose of these actions , are guided by the maintenance, promotion, restoration of health , prevention of diseases and disorders and psychological contribution to dealing with the consequences of an imbalance in health disease process can generate a family or community context.MethodsDescriptive qualitative study conducted in the city of Juazeiro do Norte, Ceará , Brazil , with the subject 17 nurses working in the Family Health Strategy . Was used to collect data, semi-structured interviews and content analysis organization.ResultsIt was evident that this is still a perception of limited health education in the prevention of diseases, which may affect the procedures adopted to implement these actions . On the other hand, although with this curative vision care, nurses consider these actions for planning, community health agents , which reveals a care focused on the real needs of the population . However, although they reveal how to easily build these shares access to community workers , point out problems such as lack of management support.ConclusionBecomes necessary reorientation of educational practices in health, which depends on the  qualification  through  graduation  and  support  managers  to  ensure  necessary resources to implement them , so that they are geared towards health  promotion, contributing a greater citizen participation to improve the quality of life .Key words: Health Education in Nursing. Agent Community Health, Family Health StrategyÂ

Health education for seniors: an analysis under Paulo Freire’s perspective

BackgroundPopulation aging is one of the hardest challenges for the current public health, however, for a proper attention to the elders, the development of reachable social and health policies which are consistent with the real needs of this population stratum it is essential. Thus, the aim of this research is to analyze the perceptions of nurses about health education for the elderly, according to the conceptions of Paulo Freire.MethodIt is a descriptive study with a qualitative approach, conducted in the city of Juazeiro do Norte, Ceará, Brazil taking as a background the Unidades de Saúde da Família – USF (Family Health Units). Eighteen nurses participated in this survey. The semi-structured interview was used for gathering data, and to organize those data to the analyses of contents. The analysis of the obtained data started since the conceptions of Paulo Freire and from some relevant articles related to the topic.ResultsConsidering the health concept as a tool to develop people, it was observed in this sense, that some professionals associate health education focused on knowledge exchange, behavior changes, and decision making in health, matching the Freireana ideology of questionable methodology. However, they also identified someprofessionals with a misperception in relation to the health education, since they associate the approach only focused on the concept of health, grounded in the absence of a disease, thus characterizing, a learning bank methodology, since they resort to vertical transmission of knowledge. It was evinced yet that the educational actions performed by those professionals envisioning healthy aging are directed from the identification of prevalent diseases within the community, and that the strict population that receives such assistance it is restricted only to the individuals who seek theUnits (USF), or those who are affected by diseases. ConclusionIt is thought that health education is the instrument that enables the change of behavior and decision making in health care for the users, but it should be planned on an ongoing manner, considering the reality of population, using methodologies that promote dialogue, essential element to establish the necessary link for conducting practical aspectson the perspective of health promotion.Â