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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.
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Hanseníase , Aplicativos Móveis , Pessoal de Saúde , Humanos , Hanseníase/terapia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To evaluate the effectiveness of the nursing intervention Fall Prevention in reducing falls in older adults with arterial hypertension. METHODS: Pilot clinical trial, with 118 participants with arterial hypertension from a city in the Northeast of Brazil. Participants were allocated by simple randomization into two groups: intervention (n = 58) and control (n = 60). The intervention was carried out at the participants' homes and consisted of guidelines for modifying environmental and behavioral risk factors for falls. A protocol with nursing activities associated with the Fall Prevention intervention proposed in the Nursing Interventions Classification (NIC) taxonomy was used. The outcome was the self-reported occurrence of falls. RESULTS: There was a significant difference between the groups in the frequency of self-reported falls (p=0.38) with fewer falls occurring in the intervention group. Sixteen participants fell, of which 5.1% attributed the fall to difficulty walking, 6.8% fell in the living room, 3.4% had a sprain, and 6.8% reported to be afraid to fall again. CONCLUSION: The nursing intervention Fall Prevention was effective in reducing the occurrence of falls in older adults with arterial hypertension. These findings contribute to the advancement of clinical protocols for the prevention of falls in older adults, as the educational intervention investigated is applicable to different sociodemographic and cultural scenarios.
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Acidentes por Quedas , Hipertensão , Acidentes por Quedas/prevenção & controle , Idoso , Brasil , Enfermagem Geriátrica , Humanos , Hipertensão/prevenção & controle , Fatores de RiscoRESUMO
BACKGROUND:: People with diabetes have a high risk of developing micro and macrovascular complications that increase treatment costs and shorten life expectancy. Telecoaching programmes can improve short-term control of diabetes and reduce disease burden. AIMS:: To analyse the effect of a health telecoaching programme in the control of type 2 diabetes. METHODS:: A pragmatic clinical trial was carried out. Thirty-one patients with type 2 diabetes were divided into control and intervention groups. The control group received usual nursing care, and those in the intervention group received usual care and telecoaching for 24 weeks. FINDINGS:: The intervention group improved: measurements of abdominal circumference, systolic and diastolic blood pressure and body mass index; variables related to glycaemic control (fasting venous glucose and glycated haemoglobin/HbA1c); and high-density lipoprotein levels. CONCLUSION:: The data indicate that telecoaching is an effective tool for diabetes management. It is recommended that the study should be developed to include more people and run over the long term.
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Diabetes Mellitus Tipo 2/terapia , Autocuidado/métodos , Telemedicina , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos PilotoRESUMO
The aim of the present study was to characterize biofilms formed by Candida spp. clinical isolates (n = 19), isolated from the oral mucosa of HIV-positive patients. For characterizing the biofilms formed by several Candida sp. strains, isolated from HIV-positive patients, in terms of formed biomass, matrix composition and antifungal susceptibility profile, clinical isolates (n = 19) were collected from oral mucosa and identified. The biofilm of the samples was cultured with fluconazole (1250 mg/L), voriconazole (800 mg/L), anidulafungin (2 mg/L) or amphotericin B (2 mg/L). Afterwards, the quantification of the total biomass was performed using crystal violet assay, while the proteins and carbohydrates levels were quantified in the matrix. The results showed a predominance of C. albicans, followed by C. krusei. Around 58% of the Candida spp. biofilm had susceptibility to fluconazole and voriconazole (800 mg/L), 53% to anidulafungin and 74% to amphotericin B. C. krusei presented both the lowest and the highest biofilm matrix contents in polysaccharides and proteins. The low resistance to antifungal agents reported here was probably due to the fact that none of the participants had a prolonged exposure to these antifungals. A predominance of less virulent Candida spp. strains with low or no resistance to antifungals was observed. This can be attributed to a low fungal selective pressure. This most probably happened due to a low fungal selective pressure but also due to a good adherence to HAART therapy, which guarantees a stable and stronger immune patient response.
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The aim of this paper is to identify the prevalence of the most frequent drug interactions in patients using oral antidiabéticos and their association with capillary glucose and medication adherence. In total, 579 type 2 diabetes mellitus patients from 12 health institutions in Fortaleza, Brazil were interviewed in 2009. A form was applied, including questions on medication use, comorbidities, lifestyle, body mass index and random capillary glucose. Results revealed that 26.7% used five or more different drugs simultaneously and daily. Statistically significant drug interactions occurred between antidiabéticos and diuretics, angiotensin-converting enzyme inhibitors, anti-lipidaemics and corticoids. No significant association was found between polypharmacy, medication adherence and glucose. It is important for nurses, in consensus with other health professionals, to consider the possibility of other drugs that mean less risk for diabetes patients' glucose control or of increased antidiabetics doses.
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Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Interações Medicamentosas , Feminino , Humanos , Hipoglicemiantes/farmacologia , Masculino , Pessoa de Meia-Idade , Cooperação do PacienteRESUMO
The current study investigated the correlation between anthropometric indicators and sleep quality among Brazilian university students using the Pittsburgh Sleep Quality Index. A cross-sectional assessment with 702 university students was conducted between March 2010 and June 2011. Results showed that cases of obesity were more frequent among students who were good sleepers. On the other hand, overweight and high cervical and abdominal circumference was most prominent among poor sleepers. Thus, apart from the damage caused by sleep disorders alone, additional risks due to the association between poor sleep quality and being overweight, central obesity, and increased cervical perimeter are highlighted.
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Antropometria , Qualidade de Vida , Sono , Adolescente , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Estudantes , Universidades , Adulto JovemRESUMO
The aim of this study was to investigate the vulnerability of adolescent students related to sexually transmitted diseases (STD) and the human immunodeficiency virus (HIV), identifying the main risk behaviors and prevention. This quantitative, cross-sectional study was performed in three public schools in Imperatriz--Maranhão, with 295 adolescents, using a structured questionnaire. The results show that: most young people (86.3%) who used a condom the last time they had intercourse, usually keep this practice, 82.8% of adolescents who understand the concept of HIV protect themselves against these infections and believe the main form of contamination is through sex, infected blood or through the placental barrier. We conclude that most teenager participants showed coherent knowledge about sexual practices and risk behaviors that make them vulnerable to STD/HIK presenting a positive aspect for the prevention of these diseases.
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Comportamento do Adolescente , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Psicologia do Adolescente , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Adolescente , Patógenos Transmitidos pelo Sangue , Brasil , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Transmissão Vertical de Doenças Infecciosas , Masculino , Sexo Seguro , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/psicologia , Inquéritos e QuestionáriosRESUMO
Patients with comorbidities are more vulnerable to severe clinical cases of acute respiratory distress syndrome (ARDS) and COVID-19 require complex health care. To analyse the association between the individual and combined effects of diabetes, hypertension, and obesity on ARDS mortality rates among patients receiving clinical care. A multicentre study encompassing retrospective data analysis and conducted with 21,121 patients from 6,723 health services across Brazil, during the 2020-2022 time period. The sample group consisted of clinical patients of both sexes and different age groups who received clinical care and showed at least one comorbidity. The data collected were analysed using binary logistic regressions and the Chi-square test. The overall mortality rate was 38.7%, with a higher predominance among males (p < 0.001), mixed-race individuals (p < 0.001), and older adults (p < 0.001). The main comorbidity variables associated with and leading to death from ARDS were arterial hypertension (p < 0.001), diabetes mellitus (p < 0.001), diabetes mellitus and arterial hypertension (p < 0.001), cardiovascular diseases (p < 0.001) and obesity (p < 0.001). Both the patients who progressed to recovery (48.4%) and to death (20.5%) presented only one comorbidity (χ2 (1,749) = 8, p < 0.001), respectively. The isolated comorbidities with the greatest impact on death outcomes were diabetes (95% CI 2.48-3.05, p < 0.001), followed by obesity (95% CI 1.85-2.41, p < 0.001) and hypertension (95% CI 1.05-1.22, p < 0.001), even after adjusting for sex and number of simultaneous comorbidities. Diabetes and obesity, as isolated conditions, had a greater influence on the number of deaths of clinical patients with ARDS compared to those with mutual diagnosis of diabetes, hypertension and obesity.
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COVID-19 , Diabetes Mellitus , Hipertensão , Síndrome do Desconforto Respiratório , Masculino , Feminino , Humanos , Idoso , Estudos Retrospectivos , Fatores de Risco , Diabetes Mellitus/epidemiologia , Obesidade/epidemiologia , Hipertensão/epidemiologiaRESUMO
BACKGROUND: This study investigated the factors influencing the presentation, diagnosis and treatment of leprosy in primary healthcare. METHODS: Qualitative research was conducted on patients undergoing treatment in a priority hyperendemic region for leprosy control in northeastern Brazil. Interviews were conducted between September and December 2020 at primary healthcare centers. Data were analysed based on the basic interpretive qualitative structure according to Andersen and Newman's model of healthcare utilisation. RESULTS: Knowledge of leprosy symptoms influenced patients' search for a diagnosis. Unfavorable socioeconomic conditions experienced by patients made diagnosis and treatment difficult. Incorrect evaluations by health professionals caused difficulties and delays in obtaining a diagnosis of leprosy. Perceptions about the disease, such as non-acceptance of the disease and the adverse effects of the medications, affected treatment seeking and treatment continuity. CONCLUSIONS: Patients with leprosy faced delays and healthcare access barriers related to knowledge of the disease, socioeconomic conditions and the structure of healthcare services, which must be considered when creating care plans, surveillance and control actions against leprosy. Appropriate interventions are necessary to reduce delays and better control the disease.
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Hanseníase , Humanos , Hanseníase/diagnóstico , Hanseníase/terapia , Aceitação pelo Paciente de Cuidados de Saúde , Acessibilidade aos Serviços de Saúde , Pesquisa Qualitativa , Fatores SocioeconômicosRESUMO
The objective of this paper was to identify critically ill patients at risk for pressure ulcer (PU) using the Braden scale and digital photographs. A sample of 42 subjects was evaluated for 15 days, between March and June 2009, in Fortaleza, Brazil. A total of 47 lesions were identified, 23 (48.9%) as stage I and 24 (51.1%) as stage II. It is necessary for nurses to become familiar with and adopt the technologies used to assess and treat PU in order to lessen the negative effects of this public health problem.
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Avaliação em Enfermagem , Fotografação , Úlcera por Pressão , Medição de Risco/métodos , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Úlcera por Pressão/diagnóstico , Adulto JovemRESUMO
Despite advances in obstetrics, prematurity is still a major public health problem because of the neonatal morbidity and mortality it causes. The objective of this study was to investigate maternal risk factorsfor premature births in a public maternity in the city of Imperatriz-MA. A cross-sectional comparative study was conducted with 116 mothers, through structured interviews. The data were analyzed using Epi-Info version 3.5.1. The variables that showed statistically significant association with preterm delivery were monthly income below two minimum wages (p = 0.046), stress during pregnancy (p = 0.027), primiparity (p = 0.044), absent or inadequate prenatal care (p <0.001) and clinical complications in pregnancy (p<0.001). The results show that the maternal risk factors implicated in prematurity are related mainly with lifestyle, socioeconomic and clinical variables, and prenatal care.
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Nascimento Prematuro/epidemiologia , Adulto , Estudos Transversais , Feminino , Maternidades , Hospitais Públicos , Humanos , Gravidez , Fatores de Risco , Adulto JovemRESUMO
The major aim of this randomized, placebo-controlled, triple-blind clinical trial was to evaluate the efficacy of cinnamon as an adjuvant treatment in reducing glycemic levels in people with type 2 diabetes, compared to a placebo. The study was conducted between August and December 2019, with 160 people with type 2 diabetes, in five Primary Health Units, in Parnaíba, Brazil. Inclusion criteria were: persons of both genders using oral antidiabetic agents, with glycated hemoglobin ≥ 6.0%, and between 18 and 80 years of age. The primary outcome was change in glycated hemoglobin levels after 90 days of intervention. Other biomarkers evaluated were fasting blood glucose, insulin level, and HOMA-IR index. Participants were divided equally into two groups of 80 individuals each, and were given 3 g capsules of either cinnamon or placebo to be taken in combination with their usual oral antidiabetic agents. After 90 days, participants in the cinnamon group had statistically significant reductions of 0.2% of glycated hemoglobin and 0.55 mmol/L of fasting venous glucose, when compared with the placebo group. Cinnamon reduced the glycemic measures of persons with type 2 diabetes, albeit with modest reductions. TRIAL: RBR-2KKB6D.
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Glicemia , Diabetes Mellitus Tipo 2 , Adjuvantes Imunológicos/uso terapêutico , Adjuvantes Farmacêuticos/uso terapêutico , Biomarcadores , Cinnamomum zeylanicum , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Hemoglobinas Glicadas/uso terapêutico , Humanos , Hipoglicemiantes/uso terapêutico , MasculinoRESUMO
This study investigates risk factors for type 2 diabetes mellitus in a population of children in public schools, Fortaleza, CE, Brazil. A total of 727 children aged 6 to 11 years old from 12 schools were evaluated between March and June 2008. A form addressing socio-demographic data, body mass index, blood pressure, capillary blood glucose and waist circumference was applied. A total of 54.1% of the children were female, 21.7% were overweight, 6.6% were obese, 27% had central obesity, 6.2% showed altered capillary glucose, and 17% high blood pressure. In relation to risk factors, 53.4% presented no risk factors; 24.3% had at least one factor and 18.8% two risk factors. Nurses can intervene in schools through educational health programs encouraging the adoption of healthy habits and identifying children at risk of type 2 diabetes mellitus.
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Diabetes Mellitus Tipo 2/epidemiologia , Educação em Saúde , Saúde Pública , Fatores Etários , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Diabetes Mellitus Tipo 2/enfermagem , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Obesidade/epidemiologia , Sobrepeso , Fatores de Risco , Fatores SexuaisRESUMO
The objective of this study was to identify risk factors for type 2 diabetes (DM2) in a population of private schools adolescents of Fortaleza-Brazil. A total 794 students aged 12 to 17 years, from 12 schools, were evaluated in the months of May, June, August and September 2007. A form was applied approaching sociodemographics aspects, BMI, blood pressure, capillary glycemia and sedentary lifestyle. Approximately 24% of the participants had high BMI, 65% were sedentary and 51% had family history of DM2. In those with larger income, 73.5% had family history of DM2 (p = 0.04). About 39% of the adolescents had at least two risk factors for DM2. Most of the risk factors for DM2 identified in this study are changeable, therefore, susceptible to preventive interventions in the school setting.
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Diabetes Mellitus Tipo 2/epidemiologia , Adolescente , Criança , Estudos Transversais , Humanos , Fatores de RiscoRESUMO
It aimed to learn the daily habits related to the physical activity practice among private state schools adolescents in Fortaleza-Brazil. We investigated 307 students between 12 and 17 years old from six private schools, in the months March to June 2007. We applied a form which recorded sedentarism, BMI, blood pressure and blood glucose. The chi-squared test was used for to analysis the proportions. About 68% of young people were sedentary. The sedentarism was higher in females surveyed (p=0, 000) and those with over-weight (p=0,001). Among adolescents active exercise was the most practiced football (42%) and weights (19%). The health education in schools can assist in combating the sedentarism of the adolescents.
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Atividade Motora , Adolescente , Brasil , Criança , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Type 2 Diabetes Mellitus (T2DM) is a chronic disease that is increasing the number of cases worldwide. The treatments currently used have not worked as expected. Alternative and complementary medicines were inserted in health services, especially in primary care, as an attempt to minimize risks and help control diseases such as diabetes. Among the herbal medicines used stands out cinnamon, which can serve as an adjuvant in the control of diabetes. OBJECTIVE: To analyze the effectiveness of 3 grams of cinnamon (Cinnamomum verum) per day for 90 days in reducing glycemic and lipid levels in adults with T2DM compared with placebo METHODS:: A randomized, double-blind, placebo-controlled, phase II trial, which will be conducted at basic health units in the city of Parnaíba, state of Piauí, Brazil. In total, 130 people diagnosed with T2DM, followed at health units, with hemoglobin A1c >â6.5%, and using oral antidiabetic medicines, are expected to participate in the study. The intervention will last for 3 months, and each participant will receive a total of 3 bottles containing 120 capsules in each bottle of cinnamon or placebo. Each person should take 4 capsules daily, for 90 days. The patients will be distributed into the 2 groups by performing block randomization (nâ=â6) at a ratio of 1:1 according to a code generated by a software. Assessments of socioeconomic, clinical, lifestyle, anthropometric, and laboratory variables will be performed in 2 separate visits. DISCUSSION: This study will be the first to investigate cinnamon to reduce glycemic, lipid, and anthropometric levels in Brazil. In case of favorable results, this therapy may be used as an alternative or additional medicine in cases where only oral antidiabetic agents are used and can promote the use of the product to minimize future complications of patients with diabetes and people who do not have the disease. TRIAL REGISTRATION: RBR-2KKB6D, registered on December 11th, 2018.
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Glicemia/efeitos dos fármacos , Cinnamomum zeylanicum , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Lipídeos/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos Fase II como Assunto , Diabetes Mellitus Tipo 2/sangue , Método Duplo-Cego , Feminino , Hemoglobinas Glicadas/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto JovemRESUMO
The monitoring and combined use of dietary supplements to restore adequate growth are paramount and highly recommended in child malnutrition, an important public health problem. The objective of this study was to analyze the effects of cashew nut seed flour in children with moderate malnutrition, treated at primary healthcare services. This is a randomized clinical trial conducted from April to October 2017 in the city of Imperatriz, Brazil. The sample comprised 30 children born at term, aged between 2 and 5 years, and newly diagnosed with malnutrition (60 days or less), randomized into experimental and control groups. The intervention consisted of daily intake of cashew nut seed flour. There was intragroup statistically significant difference in the glucose levels of children who were assigned to the control group (p=0.02) and in the glycated hemoglobin in the experimental group (p < 0.01). Intergroup analysis of glycated hemoglobin levels showed statistically significant differences in favor of the experimental group (p=0.01). HDL and LDL had, respectively, increased and decreased in the experimental group. The use of cashew nut seed flour in a 24-week period had positive effects on glycated hemoglobin, HDL, and LDL parameters in moderately malnourished children.
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The research aimed at learning food habits of adolescents from public schools in Fortaleza, CE, Brazil. Seven hundred students age ranging from 4 to 19 years-old were interviewed from twelve education institutions by means of a structured form. From the usual food consumed the energetic rice and bread were highlighted, consumed by 95.8% and 85.2% of the adolescents, respectively (p=0.0001). Within constructor food, meat and beans are ingested by 60.6% and 75.0%, respectively (p=0.0001). Regulative food like fruit and vegetables do not have a usual consumption among adolescents, since just (34.3%) and (47.6%) respectively consume them (p=0.0001 and p=0.226). An unbalance in proper nutrient ingestion for the adolescence was stated, favoring overweight and, consequently, chronic diseases like mellitus diabetes.
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Comportamento Alimentar , Adolescente , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Setor Público , Instituições Acadêmicas , Adulto JovemRESUMO
OBJECTIVE: To evaluate effects of an educative intervention over the self-monitoring of blood glucose (SMBG) at home for metabolic control. METHOD: A total of 91 people with diabetes participated, recruited from the home capillary blood glycemia self-monitoring program. Two groups of participants were formed: one group participated in the SMBG program at home and with usual care (control group), while the other group participated in the SMBG at home and with educative intervention (intervention group). In total there were 12 meetings, three for each conversation map in the control of diabetes, during four months in 2011 and 2012. For all the analysis, a significance statistical level of 5% (p ≤ 0.05) was adopted. RESULTS: Most part of participants were females, married, with an average age of 62.1 years old and schooling from four to seven years of study. In the intervention group, an improvement was observed in the following measures: body mass index, abdominal circumference, diastolic blood pressure, fasting plasma glucose, HDL cholesterol, LDL cholesterol and triglycerides. The control group showed improvement in measures of systolic and diastolic blood pressure, fasting plasma glucose, HDL cholesterol and LDL cholesterol. Moreover, an increase on the values of glycated hemoglobin was observed in both groups. CONCLUSION: It was observed that there was not statistical significant improvement of the metabolic control. However, it was possible to confirm that an educative intervention for SMBG at home presented a clinical significance, which in turn, resonates in a special way on the health of participants.
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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.