Hansenapp: Development of a mobile application to assist primary healthcare providers to control leprosy.

OBJECTIVE: To describe the development and validation of a mobile application to assist health professionals in the management of patients with leprosy and surveillance of contacts in primary healthcare. METHOD: A methodological and developmental study was conducted in three phases: integrative literature review, mobile application development and application validation by health professionals. The construction of the application was supported by the literature review, Nielsen's heuristics and expert validation. Five experts individually analysed the prototype draft and performed two rounds of iterations to refine their recommendations. The validation step was performed by consulting health professionals working in primary healthcare, who evaluated the application for relevance, clarity and usability using a questionnaire based on task-technology fit theory. RESULTS: The mobile app's content, navigation methods and interaction were refined based on the discussions with experts. Their recommendations were applied, and the mobile app was revised until the final version was approved. Content validity indexes of 0.94 (p = 0.007), 0.99 (p > 0.0001) and 0.93 (p = 0.01) were obtained. CONCLUSION: The developed application is a technological tool that could assist primary healthcare providers in dealing with leprosy patients and their contacts in terms of management, planning, monitoring, evaluation, treatment and follow-up, in addition to leprosy control actions.

Principais comorbidades associadas à neoplasia mamária em tratamento quimioterápico / Main comorbidities associated with breast neoplasia in chemotherapeutic treatment

Objetivo: identificar as principais comorbidades relacionadas ao câncer de mama em mulheres em tratamento com quimioterapia. Método: trata-se de um estudo quantitativo, do tipo descritivo e transversal, em um hospital público, com a participação de 317 mulheres com câncer de mama submetidas a tratamento quimioterápico. Coletaram-se os dados por meio de questionário estruturado contendo questões fechadas e utilizaram-se, para a análise dos dados, frequências absolutas e relativas, apresentando-se os resultados em tabelas. Resultados: observou-se que 36,3% das participantes possuíam patologias associadas, onde as condições clínicas mais comuns foram a hipertensão arterial (65,2%) e a Diabetes Mellitus (36,5%). Conclusão: conclui-se que as mulheres com câncer de mama em tratamento quimioterápico possuem doenças e agravos associados, tanto físicos, como psicológicos, e os mais prevalentes foram a hipertensão arterial, o Diabetes Mellitus e a depressão.(AU)

Objective: to identify the main comorbidities related to breast cancer in women receiving chemotherapy. Method: this is a descriptive and cross-sectional quantitative study in a public hospital with the participation of 317 women with breast cancer undergoing chemotherapy. Data was collected using a structured questionnaire containing closed questions and absolute and relative frequencies were used for data analysis, and the results were presented in tables. Results: it was observed that 36.3% of the participants had associated pathologies, where the most common clinical conditions were hypertension (65.2%) and Diabetes Mellitus (36.5%). Conclusion: it is concluded that women with breast cancer undergoing chemotherapy have associated diseases, both physical and psychological, and the most prevalent were hypertension, diabetes mellitus and depression.(AU)

Objetivo: identificar las principales comorbilidades relacionadas con el cáncer de mama en mujeres en tratamiento con quimioterapia. Método: se trata de un estudio cuantitativo, del tipo descriptivo y transversal, en un hospital público, con la participación de 317 mujeres con cáncer de mama sometidas a tratamiento quimioterápico. Se recolectaron datos por medio de un cuestionario estructurado que contenía cuestiones cerradas y se utilizaron, para el análisis de los datos, frecuencias absolutas y relativas, presentándose los resultados en tablas. Resultados: se observó que el 36,3% de las participantes poseía patologías asociadas, donde las condiciones clínicas más comunes fueron la hipertensión arterial (65,2%) y la Diabetes Mellitus (36,5%). Conclusión: se concluye que las mujeres con cáncer de mama en tratamiento quimioterápico poseen enfermedades y agravios asociados, tanto físicos, como psicológicos, y los más prevalentes fueron la hipertensión arterial, la Diabetes Mellitus y la depresión.

Factors Associated with Multibacillary Leprosy in a Priority Region for Disease Control in Northeastern Brazil: A Retrospective Observational Study.

BACKGROUND: Leprosy is an infectious disease that can lead to physical disabilities and stigmatization. It remains an important public health problem, especially in Brazil. OBJECTIVE: To analyse sociodemographic and clinical factors associated with multibacillary leprosy in a hyperendemic region of the disease in northeastern Brazil. METHOD: This is a retrospective observational study with secondary data acquired from 2012 to 2015, from a group of leprosy cases reported in a reference outpatient clinic for the treatment and followup of leprosy in the city of Imperatriz, Maranhao, in northeastern Brazil. RESULTS: From 905 new cases of leprosy studied, 656 (72.5%) were classified as multibacillary leprosy and 249 (27.5%) as paucibacillary leprosy. We observed that men were more likely to present 5 to 15 skin lesions (OR: 1.32; 95% CI: 1.18-1.49; p <0.0001) and >15 skin lesions (OR: 1.26; 95% CI: 1.09 -1.45; p = 0.005) and a lower chance of having <5 skin lesions (OR: 0.67; 95% CI: 0.59-0.76; p <0.0001). Women were more likely to have no affected nerves compared to men (OR: 1.46; 95% CI: 1.20-1.77; p <0.0001). The age range of 16 to 60 years showed a greater chance of having <5 skin lesions (OR: 1.01; 95% CI: 1.007-1.20; p = 0.03) and a lower chance of having 5 to 15 skin lesions (OR: 1.12, 95% CI: 1.03-1.23; p= 0.008) and a lower chance of being a grade I disability ( CI= 0.73-0.94; p=0.83) and II (OR: 0.82; 95% CI: 0.77-0.98; p=000.1). CONCLUSION: Cases of multibacillary leprosy were associated with male gender, low educational level, and clinical variables such as number of skin lesions and grade I or II disability.

Análise de fatores associados à prática da episiotomia / Analysis of factors associated with the practice of episiotomy

Objetivo: identificar os fatores que levam enfermeiros obstetras a realizarem uma episiotomia. Método: trata-se de uma revisão integrativa, com vistas a responder à questão norteadora << O que leva o enfermeiro obstetra a realizar uma episiotomia? >>. Para isso, realizou-se uma busca por evidências, entre 2005 a 2017, nas bases de dados LILACS e BDENF e na BIREME e SciELO, com os descritores: episiotomia, humanização da assistência e trabalho de parto, considerando os critérios de inclusão e exclusão pré-estabelecidos. Foram selecionados 9 artigos posteriormente submetidos à leitura, análise e organizados em figuras para discussão através de um instrumento adaptado e validado por Ursi 2005. Resultado: foi possível verificar que a maioria dos estudos se referem à prática da episiotomia como intimamente ligada a primiparidade, rigidez perineal, macrossomia e prematuridade. Conclusão: a literatura evidenciou que os principais fatores que levam os enfermeiros obstetras a realizarem a episiotomia são: primiparidade, à rigidez perineal, macrossomia e prematuridade. Com isso, foi possível verificar que a episiotomia não previne lacerações de 3º e 4º grau e a mesma está relacionada diretamente com a dispareunia. Isso contribui para uma preocupação científica em instituir tecnologias que auxiliem na fisiologia do parto preservando a integridade corporal.(AU)