[Primary health care in disaster situations: systematic reviewAtención primaria de salud en situaciones de desastre: revisión sistemática]. / Atenção primária à saúde em situações de desastres: revisão sistemática.

OBJECTIVE: To identify evidence from the literature regarding interventions related to preparedness and response of primary health care (PHC) teams in situations of natural disaster. METHOD: Systematic review of the following databases: PubMed, Scopus, Web of Science, Lilacs, Disasters, and Google Scholar. Quantitative case-control, cohort, or cross-sectional studies reporting interventions in the context of PHC on populations exposed to natural disaster were selected. RESULTS: Six studies were analyzed, performed in the Philippines, Vietnam, United States, Chile, and India. The preparedness interventions identified in the studies included the design of nursing preparedness and community education protocols; community vulnerability risk assessment; and identification of PHC services for implementation of disaster management plans. The response interventions described referred to trauma care, prevention of health problems, and participation in training. CONCLUSIONS: The evidence identified in the literature suggest that preparedness interventions are inadequate, and that the PHC response capacity is poor in situations of natural disaster.

OBJETIVO: Encontrar pruebas bibliográficas sobre intervenciones relacionadas con la preparación y la respuesta de los equipos de atención primaria de salud (APS) en situaciones de desastre relacionadas con amenazas naturales. MÉTODOS: Revisión sistemática de la bibliografía realizada en las bases PubMed, Scopus, Web of Science, Lilacs, Disasters y Google Scholar. Se seleccionaron estudios cuantitativos (de diseño transversal, de casos y testigos, o de cohortes) referentes a intervenciones en grupos poblacionales expuestos a desastres naturales en el contexto de la APS. RESULTADOS: Se analizaron seis estudios realizados en Chile, Estados Unidos, Filipinas, India y Vietnam. Las intervenciones de preparación encontradas incluyeron la elaboración de protocolos de preparación del personal de enfermería y de educación de la comunidad; la evaluación del riesgo de vulnerabilidad de la comunidad; y la identificación de los servicios de APS para realizar planes de gestión de desastres. Las intervenciones de respuesta descritas se centraron en el tratamiento de traumatismos, la prevención de afecciones de salud y la participación en cursos de capacitación. CONCLUSIONES: Las pruebas identificadas señalaron que las intervenciones de preparación son inadecuadas y que el desempeño en lo referente a la capacidad de respuesta de la APS es deficiente en situaciones de desastre.

[Discourses on the nursing and psychiatric nurse models, published in the Annals of Nursing (1933-1951)]. / Discursos sobre os modelos de enfermagem e de enfermeira psiquiátrica nos Annaes de Enfermagem (1933-1951).

Social-historical study aimed at discussing the nursing and psychiatric nurse models, from the discourses published in the Annals of Nursing.The historical sources were articles published in the Annals of Nursing journal, from 1933 to 1951. An analysis of the discourse was subsidized by the genealogy of power by Michel Foucault.The analysis showed that the discourse on nursing and the psychiatric nurse, in the first half of the 20th century, is set, on one side, by the propositions used by psychiatrists, who sought to reiterate stereotypes and vocations to practice nursing, and, on the other side, by the active participation of nurses seeking to legitimize expertise for psychiatric nursing. It was concluded that the discourses analyzed defined a psychiatric care focused on the nurse and not the rest of the nursing staff, at that time.

Efficacy and safety of implantable cardioverter-defibrillators in patients with Chagas disease.

AIMS: Implantable cardioverter-defibrillators (ICDs) are now a first-line option for prevention of sudden death in Chagas disease (ChD). However, efficacy and safety of ICD treatment in ChD remains controversial. The aim of our study was to compare clinical outcome after ICD implantation in ChD and non-ChD patients. METHODS AND RESULTS: The study population consists of patients who received ICD implantation in a tertiary Reference Center for ChD in Brazil. The primary endpoint of the study was appropriate therapy (appropriate shocks or anti-tachycardia pacing); the secondary endpoint was the event-free survival defined as absence of death or appropriate therapy. One hundred and thirty-five [corrected] patients were followed for the median time of 266 days. Sixty-five patients had ChD. Appropriate ICD therapy occurred in 32 (49.2%) ChD and in 19 (27.1%) non-ChD patients (P=0.005). Ventricular tachycardia occurred in 27 (42%) ChD and in 16 (23%) non-ChD (P = 0.01) patients. There was a statistically significant difference in event-free survival between the group of patients with and without ChD (P=0.004). The median event-free survival was 230 days (95% confidence interval, CI: 113-347) in patients with ChD and 549 days (95% CI: 412-687) in non-ChD patients. Chagas disease double the risk of the patient to have appropriate therapy (hazard ratio, HR = 2.2, 95% CI = 1.2-4.3, P = 0.02) and appropriate therapy or death (HR = 2.2, 95% CI = 1.2-4.2, P = 0.01) in multivariate analysis. There were 16 deaths (11.8%) with 8 deaths in each group and five inappropriate shocks (3.7%) with one in ChD patients (1.6%). CONCLUSION: The higher frequency of appropriate ICD therapy and the shorter event-free survival in ChD patients are consistent with the presence of an arrhythmogenic substrate that characterizes this cardiomyopathy.

[American participation in the creation of a nurse model in Brazilian society in the 1920's]. / Participação americana na formação de um modelo de enfermeira na sociedade brasileira na década de 1920.

The objectives of this historical-social study are: to describe the circumstances that determined the participation of North American nurses in the formation of the Brazilian nurse; and analyse the process of implementing institutional rituals as a strategy of symbolic fight, to confer visibility to the nurse profession and discuss the symbolic effects of institutional rituals for the consecration of a nurse model for Brazilian society at the time. The primary sources are constituted of pertaining written and photographic documents relative to the studied theme. By reading the documentary corpus an analysis was made of the symbols that had distinguished and established the hierarchies of the actions, as well as the strategies undertaken for the North American nurses, towards implementing a new model of nurses in Brazilian society, coherent with the model of the North American schools of nursing. Institutional rituals, conducted or testified by prestigious figures of the history of Brazil and nursing, were fundamental for the construction of professional identity.

PROFILE OF PATIENTS ON SICK LEAVE WITH CARPAL TUNNEL SYNDROME.

OBJECTIVE: To report clinical and epidemiological characteristics and risk factors of patients with Carpal Tunnel Syndrome (CTS) on sick leave admitted in a University Hospital. METHODS: This is a transversal study conducted with patients admitted sequentially over 18 years of age, without distinction of gender and race in the period between September and November 2014. Patients answered a questionnaire and underwent physical examination carried out by the authors. RESULTS: Twenty-five patients were admitted within three months, all females, the mean age was 50.24 years old (standard deviation 10,39) . Among the professions they performed, general and cleaning services were the most prevalent. Most patients featured obesity, followed by depression and systemic arterial hypertension. Approximately half of them were on sick leave. Sleep disorders were also a frequent complaint. CONCLUSION: CTS is a frequent cause of sick leave and it is related to obesity, dyslipidemia and depression. Level of Evidence IV, Series of Cases.