Sintomas de estresse entre pessoas que procuram atendimento das práticas integrativas e complementares na Atenção Primária à Saúde

The aim was to identify the sociodemographic profile and the presence of stress in people who use PICS (Integrative and Complementary Practices in Health) in primary health care. This is a quantitative cross-sectional observational study, with a descriptive-analytic approach. As a result, the present study consisted of ninety-five participants, most of them female, and it was found that there is a prevalence of a high level of stress in people who seek PICS. In this regard, some signs of stress can be mentioned, including the presence of fatigue, headache, and decreased appetite. It is concluded that there is a high level of stress in people who seek PICS and the main public that seeks this form of care is the female public.Objetivou-se identificar o perfil sociodemográfico e a presença de estresse em pessoas que utilizam as (Práticas Integrativas e Complementares em Saúde) PICS na atenção primária à saúde. Trata-se de um estudo quantitativo do tipo observacional transversal, com abordagem descritiva analítica. Como resultado, o presente estudo foi composto por noventa e cinco participantes, a maioria do sexo feminino e constatado que há a prevalência de alto nível de estresse nas pessoas que procuram as PICS. Quanto a isso, pode-se citar alguns sinais do estresse, dentre eles a presença de fadiga, cefaleia e diminuição do apetite. Conclui-se que há presença de um alto nível de estresse nas pessoas que procuram as PICS e o principal público que procura essa forma de cuidado é o público do sexo feminino

Sintomas de estresse entre pessoas que procuram atendimento das práticas integrativas e complementares na Atenção Primária à Saúde

The aim was to identify the sociodemographic profile and the presence of stress in people who use PICS (Integrative and Complementary Practices in Health) in primary health care. This is a quantitative cross-sectional observational study, with a descriptive-analytic approach. As a result, the present study consisted of ninety-five participants, most of them female, and it was found that there is a prevalence of a high level of stress in people who seek PICS. In this regard, some signs of stress can be mentioned, including the presence of fatigue, headache, and decreased appetite. It is concluded that there is a high level of stress in people who seek PICS and the main public that seeks this form of care is the female public.Objetivou-se identificar o perfil sociodemográfico e a presença de estresse em pessoas que utilizam as (Práticas Integrativas e Complementares em Saúde) PICS na atenção primária à saúde. Trata-se de um estudo quantitativo do tipo observacional transversal, com abordagem descritiva analítica. Como resultado, o presente estudo foi composto por noventa e cinco participantes, a maioria do sexo feminino e constatado que há a prevalência de alto nível de estresse nas pessoas que procuram as PICS. Quanto a isso, pode-se citar alguns sinais do estresse, dentre eles a presença de fadiga, cefaleia e diminuição do apetite. Conclui-se que há presença de um alto nível de estresse nas pessoas que procuram as PICS e o principal público que procura essa forma de cuidado é o público do sexo feminino

Presença de sentimentos depressivos em usuários da atenção primária em saúde que buscam as práticas integrativas e complementares de saúde

The aim was to trace the sociodemographic, clinical, and psychological profile of people who seek PICS and identify the prevalence of depressive symptoms. Cross-sectional study with descriptive analysis. Carried out in three UBS that offer PICS in Lagarto/SE, Brazil, between September 2019 and March 2020. The instruments were the Characterization of Patients on the Use of Integrative Practices and Depression Scale (CES-D), applied in 95 volunteers. The research approved at the UFS CEP in August 2019, opinion No. 3,511,917. Following CNS Resolution No. 466/12. It was observed that 77.9% were female and the average age was 38.25 years, 83.2% in urban areas, 67.4% self-dwelling; receive up to 1 minimum wage (50.5%). 54.7% declare themselves brown. Prevalence of depression varies between 6 and 50, with a mean of 25.43 ± 12.4. It is necessary to carry out new scientific studies to search for people with depressive symptoms who use PICS in UBSs, for better management of professionals towards this population, developing promotion, prevention, and public policy actions.Objetivou-se traçar o perfil sociodemográfico, clínico e psíquico das pessoas que buscam as PICS e identificar a prevalência de sintomas depressivos. Com estudo transversal, com análise descritiva. Realizado em três UBS que ofertam as PICS em Lagarto/SE, Brasil, entre setembro de 2019 a março de 2020. Os instrumentos foram a Caracterização dos Pacientes Sobre o Uso das Práticas Integrativas e Escala de Depressão (CES-D), aplicados em 95 voluntários. A pesquisa aprovada no CEP da UFS em agosto de 2019 parecer n.º 3.511.917. Seguindo a Resolução n.º 466/12 do CNS. Observou-se que 77,9%eram do sexo feminino e a média de idade 38,25 anos, 83,2% zona urbana, 67,4%moradia própria; recebem até 1 salário-mínimo (50,5%).54,7% autodeclaram-se pardos. Prevalência de depressão varia entre 6 e 50, com média 25,43 ±12,4. É necessário a realização de novos estudos científicos para a busca de pessoas com sintomas depressivos que utilizam as PICS nas UBSs, para melhor manejo dos profissionais para com essa população, desenvolvendo ações de promoção, prevenção e políticas públicas

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Presença de sentimentos depressivos em usuários da atenção primária em saúde que buscam as práticas integrativas e complementares de saúde

The aim was to trace the sociodemographic, clinical, and psychological profile of people who seek PICS and identify the prevalence of depressive symptoms. Cross-sectional study with descriptive analysis. Carried out in three UBS that offer PICS in Lagarto/SE, Brazil, between September 2019 and March 2020. The instruments were the Characterization of Patients on the Use of Integrative Practices and Depression Scale (CES-D), applied in 95 volunteers. The research approved at the UFS CEP in August 2019, opinion No. 3,511,917. Following CNS Resolution No. 466/12. It was observed that 77.9% were female and the average age was 38.25 years, 83.2% in urban areas, 67.4% self-dwelling; receive up to 1 minimum wage (50.5%). 54.7% declare themselves brown. Prevalence of depression varies between 6 and 50, with a mean of 25.43 ± 12.4. It is necessary to carry out new scientific studies to search for people with depressive symptoms who use PICS in UBSs, for better management of professionals towards this population, developing promotion, prevention, and public policy actions.Objetivou-se traçar o perfil sociodemográfico, clínico e psíquico das pessoas que buscam as PICS e identificar a prevalência de sintomas depressivos. Com estudo transversal, com análise descritiva. Realizado em três UBS que ofertam as PICS em Lagarto/SE, Brasil, entre setembro de 2019 a março de 2020. Os instrumentos foram a Caracterização dos Pacientes Sobre o Uso das Práticas Integrativas e Escala de Depressão (CES-D), aplicados em 95 voluntários. A pesquisa aprovada no CEP da UFS em agosto de 2019 parecer n.º 3.511.917. Seguindo a Resolução n.º 466/12 do CNS. Observou-se que 77,9%eram do sexo feminino e a média de idade 38,25 anos, 83,2% zona urbana, 67,4%moradia própria; recebem até 1 salário-mínimo (50,5%).54,7% autodeclaram-se pardos. Prevalência de depressão varia entre 6 e 50, com média 25,43 ±12,4. É necessário a realização de novos estudos científicos para a busca de pessoas com sintomas depressivos que utilizam as PICS nas UBSs, para melhor manejo dos profissionais para com essa população, desenvolvendo ações de promoção, prevenção e políticas públicas