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1.
Rev. cuid. (En línea) ; 15(2): 1-12, 20240501.
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1570341

ABSTRACT

Introduction: Multiple sclerosis significantly affects the quality of life of those suffering from this specific condition. Objective: To assess the quality of life of people with multiple sclerosis and analyse the correlation between the disease and its associated effects and different sociodemographic, clinical, and functional variables. Materials and Methods: An observational, cross-sectional, descriptive-correlational and quantitative study conducted using a non-probabilistic convenience sample composed of 70 patients suffering from multiple sclerosis registered with the Multiple Sclerosis Association of the Central Region of Portugal. The data collection protocol included sociodemographic and clinical questions, the Family Apgar Scale, and the Barthel Index. Descriptive and inferential statistics were used to process the data. Data collection took place between April and July 2021. Results: The majority of participants reported a moderate overall quality of life (M=51,78 ± 24,09). Higher scores were observed in the social relationships and environmental health domains, while lower scores were recorded for the physical domain. Better quality of life was found to be positively associated with being under 45 years old, having higher educational qualifications, living in functional families, and experiencing greater functional independence in activities of daily living. Discussion: The variables with the strongest association were those capable of influencing the physical and social domains. Those variables explained 59.00% and 53.00% of the variability. Conclusions: These results indicate that people with multiple sclerosis have a compromised quality of life, highlighting the need for new strategies focusing on early diagnosis and effective preventive interventions meant to improve quality of life across all its domains.


Subject(s)
Patients , Quality of Life , Demyelinating Diseases , Central Nervous System Stimulants , Multiple Sclerosis
2.
Rev. Pesqui. Fisioter ; 14(1)mar., 2024.
Article in English, Portuguese | LILACS | ID: biblio-1570171

ABSTRACT

INTRODUCTION: Inpatient rehabilitation is extremely important for patients recovering from cardiac surgery. Although a walking diary is routinely used in clinical practice, it has yet to be adequately tested and reported in the literature. OBJECTIVES: To establish whether the use of a walking diary affects the number of steps taken following cardiac surgery and whether this is related to the patient's level of cardiac anxiety. METHODS: An open, controlled, randomized clinical trial was conducted with adult patients submitted to elective valve and/or coronary surgery, who had no motor impairment. All the participants used a pedometer to register the number of steps taken over five consecutive days in the hospital. Twenty-nine individuals were randomized to create an intervention group that used the walking diary as treatment strategy, while twenty-three were allocated to a control group. The Mann-Whitney test was used to compare the number of steps between the two groups, while Spearman's correlation coeficiente was performed to evaluate the relationship between the number of steps and the level of cardiac anxiety. Statistical significance was defined as p<0.05. RESULTS: The groups were similar regarding their demographic, clinical and surgical characteristics. There was no difference between the groups regarding the total number of steps taken: control group=1,496 (477.5 - 2992.5) vs. Intervention group=1,468.5 (494.2 - 2,678) (p=0.902). CONCLUSION: The use of the walking diary had no effect on the number of steps taken and was unassociated with the level of cardiac anxiety in inpatients following cardiac surgery.


INTRODUÇÃO: A reabilitação hospitalar é extremamente importante para pacientes em recuperação de cirurgia cardíaca. Embora o diário de caminhada seja rotineiramente utilizado na prática clínica, ele ainda não foi adequadamente testado e relatado na literatura. OBJETIVOS: Estabelecer se o uso do diário de caminhada afeta o número de passos dados após cirurgia cardíaca e se isso está relacionado ao nível de ansiedade cardíaca do paciente. MÉTODOS: Foi realizado um ensaio clínico aberto, controlado e randomizado com pacientes adultos submetidos à cirurgia eletiva de valva e/ou coronária, sem comprometimento motor. Todos os participantes usaram um pedômetro para registrar o número de passos dados ao longo de cinco dias consecutivos de internação. Vinte e nove indivíduos foram randomizados para um grupo intervenção para usar o diário de caminhada como estratégia de tratamento, enquanto vinte e três foram alocados para um grupo controle. O teste de Mann-Whitney foi utilizado para comparar o número de passos entre os dois grupos, enquanto o coeficiente de correlação de Spearman foi realizado para avaliar a relação entre o número de passos e o nível de ansiedade cardíaca. A significância estatística foi definida como p < 0,05. RESULTADOS: Os grupos foram semelhantes quanto às características demográficas, clínicas e cirúrgicas. Não houve diferença entre os grupos quanto ao número total de passos dados: grupo controle=1.496 (477,5 - 2.992,5) vs. grupo intervenção=1.468,5 (494,2 - 2.678) (p=0,902). CONCLUSÃO: O uso do diário de caminhada não teve efeito no número de passos dados e não foi associado ao nível de ansiedade cardíaca em pacientes internados após cirurgia cardíaca.


Subject(s)
Cardiac Rehabilitation , Patients , Walking
3.
J. Health Biol. Sci. (Online) ; 12(1): 1-9, jan.-dez. 2024. tab
Article in Portuguese | LILACS | ID: biblio-1554635

ABSTRACT

Objetivo: analisar o perfil de micro-organismos presentes e resistência destes aos antimicrobianos em uroculturas de pacientes transplantados renais no período de 2021-2022. Métodos: trata-se de um estudo transversal com análise quantitativa dos dados de uroculturas positivas de pacientes transplantados renais, acompanhados no Hospital Geral de Fortaleza entre janeiro de 2021 a dezembro de 2022. Foi empregado um instrumento de pesquisa elaborado, contendo variáveis classificatórias, e os dados foram obtidos por meio de registros das uroculturas existentes no sistema de prontuário eletrônico utilizado pelo hospital. Resultados: das 534 uroculturas solicitadas, 36,7% apresentaram resultado positivo, sendo 60,4% de mulheres com idades entre 20 e 59 anos. A maioria dos casos foram desenvolvidos por pacientes que receberam acompanhamento ambulatorial (56,2%). Os micro-organismos isolados foram, predominantemente, enterobactérias (81,34%), com prevalência de E.coli (69,30%). Os perfis de sensibilidade antimicrobiana variaram, com a resistência da E.coli a antibióticos como ampicilina, ácido nalidíxico, norfloxacino e ciprofloxacino. Conclusões: essas descobertas fornecem informações importantes sobre métodos clínicos específicos, métodos preventivos e melhorias na qualidade de vida dos transplantados renais.


Objective: to analyze the profile of microorganisms present and their resistance to antimicrobials in urocultures of renal transplant patients in 2021-2022. Methods: it is a cross-sectional study with quantitative data analysis from positive urocultures of renal transplant patients accompanied at the General Hospital of Fortaleza between January 2021 and December 2022. An elaborate research instrument containing classification variables was employed, and the data were obtained through records of the urocultures existing in the electronic checkbook system used by the hospital. Results: of the 534 urocultures requested, 36.7% showed a positive result, of which 60.4% were women aged between 20 and 59. Most cases were developed by patients who received outpatient follow-up (56.2%). The isolated microorganisms were predominantly enterobacteria (81.34%), with the prevalence of E.coli (69.30%). Antimicrobial sensitivity profiles varied, with E.coli resistance to antibiotics such as ampicillin, nalidixic acid, norfloxacin, and ciprofloxacin. Conclusion: these findings provide important information about specific clinical methods, preventive methods, and improvements in the quality of life of renal transplant patients.


Subject(s)
Humans , Male , Female , Microbiota , Transplant Recipients , Anti-Infective Agents , Patients , Kidney
4.
Curitiba; s.n; 20240215. 82 p. ilus.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1562060

ABSTRACT

Resumo: O presente trabalho de desenvolvimento tecnológico aborda a criação de um e-book que reuniu evidências, informações e orientações para subsidiar o cuidado de Enfermagem ao paciente em período perioperatório. Trata-se de uma pesquisa metodológica desenvolvida em duas fases: (I) exploratória, que constituiu duas etapas: revisão de literatura e busca em manuais e diretrizes; (II) elaboração da tecnologia, com seis etapas: definição do conteúdo, avaliação do e-book, definição do editor de texto, editoração do e-book e seleção de imagens, produção de vídeos e edição final do e-book. Como resultado, obteve-se um e-book intitulado MELHORES PRÁTICAS DE ENFERMAGEM NO ATENDIMENTO A PACIENTES EM PERÍODO PERIOPERATÓRIO, que versa sobre a historicidade e evolução do ato anestésicocirúrgico, o processo de trabalho da Enfermagem e as práticas assistenciais disponibilizadas ao paciente em período perioperatório. Concebido para ser uma ferramenta de educação permanente, tem como característica a alta complexidade, uma vez que é fruto da associação de diferentes atores e interação de múltiplos conhecimentos como os de design, produção de vídeo e editoração de texto. A característica inovatória pauta-se no conteúdo, por ser um compilado de evidências científicas atuais sobre a temática, com a inclusão de vídeos educativos, instrumentos e escalas utilizados no período perioperatório, além de atividades para revisão, fixação e autoavaliação. De abrangência nacional, tem impacto científico, social e na educação por propiciar unidade nas informações para o atendimento ao paciente e excelência nas práticas, com contribuição de novos conhecimentos para a área de Enfermagem.


Abstract: This technological development work addresses the creation of an e-book that brought together evidence, information and guidance to support nursing care for patients in the perioperative period. This is a methodological research developed in two phases (I) exploratory that constituted two stages: literature review; search in manuals and guidelines; (II): elaboration of the technology, with six stages: definition of the content; e-book evaluation; definition of the text editor; e-book publishing and image selection; video production; and final e-book edition. As a result, an e-book entitled MELHORES PRÁTICAS DE ENFERMAGEM NO ATENDIMENTO A PACIENTES EM PERÍODO PERIOPERATÓRIO, was obtained, which deals with the historicity and evolution of the anesthetic-surgical act, the nursing work process and the care practices available to patients during the period. perioperative. Designed to be a permanent education tool, it is characterized by high complexity, as it is the result of the association of different actors and the interaction of multiple knowledge such as design, video production and text editing. The innovative characteristic is based on the content being a compilation of current scientific evidence on the topic, with the inclusion of educational videos, instruments and scales used in the perioperative period, in addition to activities for review, fixation and self-assessment. Of national scope, it has a scientific, social and educational impact, by providing unity in patient care and excellence in practices, with the contribution of new knowledge to the nursing area.


Subject(s)
Patients , Educational Technology , Education, Continuing , Perioperative Period , Patient Safety , Nursing Care
5.
Article in English | WPRIM | ID: wpr-1013422

ABSTRACT

Introduction@#Spirituality was defined as a way individual seek and express meaning and purpose and the way they experience their connectedness to the moment. Studies showed that spiritual beliefs provided comfort to cancer patients and that different dimensions were related with the different aspects of health.@*Objectives@#The aim of the study is to determine the correlation on effects of spirituality and the quality of life among patients enrolled in the outpatient chemotherapy clinic.@*Methodology@#An analytical cross-sectional study using a non-probability convenience sampling was done of which validated questionnaires on the Spirituality and Quality of Life were the research instruments of the study. The Pearson’s correlation coefficient/Spearman rho computed on the relationship between the dimensions of spirituality and subscales of the quality of life among cancer patients. Chi Square/Fisher’s test was used to determine the correlation among the types and stages of cancer with the quality of life and spirituality of the respondents.@*Results@#A total of 105 cancer patients participated in this study, with ages ranging from 21 to 76 years and a mean age of 51 +/- 11 years, 2/5 were married females and 4/5 were Roman Catholic. Fifty-six percent of the cancer patients have Invasive Ductal Carcinoma (Breast Cancer). Most of the respondents are at stages 2 and 3 with equal percentages of 41%. This study revealed that most of the cancer patients enrolled in the outpatient chemotherapy clinic had a mean score of 3.56 + 0.35 indicating moderate to high level of spirituality. It also showed a mean score of 5.41 +.53 indicating high QOLs. Dimensions of spirituality which were found to have significant association with QOL domains (p < 0.05) were Mindfulness and Feeling of Security which were both found to have positive correlation with Emotional Wellbeing and Social Status.@*Conclusion@#Spiritual care should be included as one of the non-pharmacological modalities in the comprehensive management and palliative care for the Filipino cancer patients in order to improve the over-all well-being, healthcare outcomes and quality of life of patients and their families.


Subject(s)
Neoplasms , Patients , Quality of Life
6.
Chinese Medical Journal ; (24): 172-180, 2024.
Article in English | WPRIM | ID: wpr-1007740

ABSTRACT

BACKGROUND@#Oral anti-coagulants (OAC) are the intervention for the prevention of stroke, which consistently improve clinical outcomes and survival among patients with atrial fibrillation (AF). The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.@*METHODS@#Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) registry, guideline-recommended OAC use in eligible patients was assessed.@*RESULTS@#A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019, of whom 38,203 were at a high risk of stroke, 9717 were at a moderate risk, and 4610 were at a low risk. On admission, only 20.0% (6075/30,420) of patients with a diagnosed AF and a high risk of stroke were taking OAC. The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population (adjusted odds ratio: 0.54, 95% confidence interval: 0.43-0.68; P  <0.001). At discharge, the prescription rate of OAC was 45.2% (16,757/37,087) in eligible patients with high stroke risk and 60.7% (2778/4578) in eligible patients with low stroke risk. OAC utilization in patients with high stroke risk on admission or at discharge both increased largely over time (all P  <0.001). Multivariate analysis showed that OAC utilization at discharge was positively associated with in-hospital rhythm control strategies, including catheter ablation (adjusted odds ratio [OR] 11.63, 95% confidence interval [CI] 10.04-13.47; P <0.001), electronic cardioversion (adjusted OR 2.41, 95% CI 1.65-3.51; P <0.001), and anti-arrhythmic drug use (adjusted OR 1.45, 95% CI 1.38-1.53; P <0.001).@*CONCLUSIONS@#In hospitals participated in the CCC-AF project, >70% of AF patients were at a high risk of stroke. Although poor performance on guideline-recommended OAC use was found in this study, over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov, NCT02309398.


Subject(s)
Humans , Administration, Oral , Anticoagulants/therapeutic use , Atrial Fibrillation/complications , Patient Discharge , Patients , Registries , Risk Factors , Stroke/drug therapy
7.
Health SA Gesondheid (Print) ; 29: 1-10, 2024. figures, tables
Article in English | AIM | ID: biblio-1553838

ABSTRACT

Background: Schizophrenia is a major psychiatric disorder affecting physical, psychosocial, and cognitive functioning. Treatment includes pharmacological and psychotherapeutic interventions. Adherence to prescribed medication is critical but reportedly low, because of side effects, failure to understand instructions, a lack of insight about the condition, cognitive deficits, and financial difficulties. Interventions to promote adherence to medication are required. This study introduced a treatment buddy to provide the patient with virtual support in adherence to medication. Aim: The aim of this study was to explore the participants' lived experiences of a treatment buddy support. Setting: A specialised psychiatric clinic in a resource-constrained district of KwaZulu-Natal, South Africa. Methods: A qualitative study design, using semi-structured one-on-one interviews, was used to collect in-depth data from 24 participants, suffering from schizophrenia and who had been offered virtual treatment buddy support for 6 months. Data were analysed using thematic analysis. Results: The intervention improved adherence to medication. Participants indicated that the text messages served as reminders to take their medication daily. An alleviation of associated problems such as sleeping difficulties was observed. Participants were willing to encourage other patients suffering from schizophrenia to join 'treatment buddy services'. Conclusion: The virtual treatment buddy support increased awareness of the importance to adhere to antipsychotic medications among patients suffering from schizophrenia and helped to resolve other schizophrenia-related problems experienced by the participants. Contribution: The study has provided a supportive intervention that can be utilised by mental health institutions to address poor adherence to medication by patients suffering from schizophrenia.


Subject(s)
Medication Adherence , Mental Disorders , Patients , COVID-19
8.
African journal of emergency medicine (Print) ; 14(3): 172-178, 2024. figures, tables
Article in English | AIM | ID: biblio-1567921

ABSTRACT

Introduction Emergency medical services (EMS) are minimally developed in many African countries. We sought to document the achievements and challenges faced by the National Ambulance Service (NAS) of Ghana during its 20-year nationwide expansion, and to understand how well it is providing access to previously unserved, remoter areas. Methods Data routinely collected by NAS from 2004 to 2023 were analyzed, including structure and capacity (number of stations, ambulances, employees) and utilization and process of care (number of patients served, demographics, medical conditions, response site). Per population indicators of capacity and utilization were compared across Ghana's 16 regions. Results From 64 emergency medical technicians (EMTs) and nine ambulances in 2004, NAS has grown to 3,473 EMTs and 356 ambulances. From covering three cities in 2004, NAS now has at least one station in each of Ghana's 261 districts. From transporting 205 patients in 2004, NAS transported 38,393 patients in 2022. There have been interruptions due to financial restrictions, with numbers of patients transported per year in 2017­2019 decreasing by over 50% from the prior peak (n = 20,236 in 2014). In 2022, there were 1.13 ambulances per 100,000 people and 0.33 transports/100,000/day. Most (81.3%) transports are inter-facility transfers. Among Ghana's 16 regions, there is moderate variation in utilization from 0.16 to 0.50 transports/100,000/day. However, the three lowest-income, remoter regions currently have utilizations of 0.16, 0.30, and 0.37 transports/100,000/day, mostly near the National average of 0.33. Conclusion Despite periodic limitations due to finances, the NAS has expanded to cover all of Ghana's 261 districts and has largely achieved geographic equity. Sustainability has been aided by having a training school directly under NAS's control, assuring a steady supply of EMTs. Challenges include assuring financial stability and increasing utilization for emergencies at the scene, in addition to the current high utilization for inter-facility transfer.


Subject(s)
Patients , Ambulances
9.
Rev. cuba. pediatr ; 962024. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1550960

ABSTRACT

Introducción: Los pacientes críticos pediátricos son susceptibles de presentar alteraciones del flujo sanguíneo cerebral que impliquen un deterioro de su estado de salud funcional. Objetivo: Identificar factores predictores de mayor riesgo de mala evolución funcional en pacientes pediátricos críticos con sepsis. Métodos: Se realizó un estudio de cohortes retrospectivo con menores de 18 años de edad con sepsis, ingresados en la unidad de cuidados intensivos pediátricos. Se recogieron variables epidemiológicas, clínicas y del estado de salud funcional previas al ingreso, al alta y a los 6 meses. El estado de salud funcional se evaluó mediante la escala de categorías de estado global y cerebral pediátrico. Se evaluó el cambio del estado funcional entre el ingreso y a los 6 meses del alta. Se realizó un análisis univariante para comparar grupos considerando el mal pronóstico y el cambio del estado funcional y su relación con las variables. Resultados: Se incluyeron 46 pacientes. A los 6 meses del alta, cuatro (8,7 por ciento) presentaron mal pronóstico funcional y ocho (17,4 por ciento) empeoramiento funcional respecto al ingreso. No se encontraron asociaciones entre las variables predictoras y la morbilidad, aunque se observó cierta tendencia en algunas como mayor soporte inotrópico (VIS > 20: 12,5 por ciento vs. 50 por ciento, p= 0,075), extracorpóreo y de reemplazo renal (25 por ciento vs. 2,6 por ciento, p= 0,074) y estancia hospitalaria más prolongada (50 por ciento vs. 15,8 por ciento , p= 0,055). Conclusiones: El soporte en la unidad de cuidados intensivos pediátricos no fue un predictor de morbilidad funcional en la muestra(AU)


Introduction: Critically ill pediatric patients are susceptible to cerebral blood flow alterations that imply a deterioration of their functional health status. Objective: To identify predictors of a higher risk of poor functional outcome in critically ill pediatric patients with sepsis. Methods: A retrospective cohort study was conducted with children under 18 years of age with sepsis, who were admitted to the pediatric intensive care unit. Epidemiological, clinical, and functional health status variables were collected prior to admission, discharge, and after 6 months. Functional health status was assessed using the Pediatric Global State and Brain Status Category Scale. The change in performance status between admission and 6 months after discharge was assessed. A univariate analysis was performed to compare groups considering poor prognosis and change in functional status and their relationship with the variables. Results: A total of 46 patients were included. At 6 months after discharge, four (8.7 percent) had a poor functional prognosis and eight (17.4 percent) had functional worsening at admission. No associations were found between the predictor variables and morbidity, although some trends were observed in some variables, such as greater inotropic support (SIV > 20: 12.5 percent vs. 50 percent, p = 0.075), extracorporeal and renal replacement (25 percent vs. 2.6 , percent p = 0.074), and longer hospital stay (50 percent vs. 15.8 percent , p = 0.055). Conclusions: Support in the pediatric intensive care unit was not a predictor of functional morbidity in the sample(AU)


Subject(s)
Humans , Child , Adolescent , Cerebrovascular Circulation , Health Status , Risk Factors , Sepsis/epidemiology , Patients , Intensive Care Units, Pediatric , Retrospective Studies , Cohort Studies , Critical Care/methods
10.
Cienc. Salud (St. Domingo) ; 8(1): [8], 2024. ilus, tab
Article in Spanish | LILACS | ID: biblio-1551343

ABSTRACT

Introducción: Las distrofias musculares son trastornos miogénicos hereditarios caracterizados por una atrofia muscular progresiva y una debilidad de distribución y gravedad variable. La población de Republica Dominicana es fruto de una mezcla de etnias, haciéndola portadora de una herencia cromosómica y ADN diverso, siendo susceptibles a poder presentar cualquier desorden de carácter hereditario. Material y métodos: Con una muestra de 17 pacientes obtenidos entre septiembre 2019- marzo 2020, se realizó un estudio retrospectivo, descriptivo y transversal, en el cual se hizo una revisión de los expedientes de la clínica de miopatías en la consulta de neurología pediátrica del Hospital Infantil Doctor Robert Reid Cabral, para describir el perfil clínico de los pacientes con distrofia muscular y los hallazgos de electromiografía en los casos que la misma. Resultados: se encontró que la distribución de la edad correspondió a 5-9 años en un 53%, siendo el sexo masculino, el más frecuente. En el 70.59% presentaron antecedentes familiares de distrofia muscular. Los principales motivos de consulta fueron cansancio y caídas frecuentes. Conclusión: En los hallazgos de electromiografía, el porcentaje de pacientes que presentó esta prueba con alteraciones fue de 88.24% y sin alteraciones el 11.76%. Esto nos demuestra, la gran utilidad de dicho estudio en el diagnóstico de las distrofias musculares en países donde no se cuenta con estudio molecular, siendo una de las pruebas esenciales en el abordaje diagnóstico de los pacientes con sospecha clínica de dichas patologías.


Introduction: Muscular dystrophies are hereditary myogenic disorders characterized by progressive muscular atrophy and weakness of variable distribution and severity. The population of the Dominican Republic is the result of a mixture of ethnic groups, making it the bearer of a diverse chromosomal inheritance and DNA, being susceptible to presenting any hereditary disorder. Methods: With a sample of 17 patients obtained between September 2019-March 2020, a retrospective, descriptive and cross-sectional study, in which a review of the files of the myopathies clinic was made in the pediatric neurology consultation of the Children's Hospital Doctor Robert Reid Cabral, to describe the clinical profile of patients with muscular dystrophy and the electromyography findings in the cases with the same. Results: The age distribution corresponded to 5-9 years; 53%, being the masculines, the most frequent sex. In 70.59%, there was a family history of muscular dystrophy. The main reasons for consultation were fatigue and frequent falls. Conclusion: In the electromyography findings, the percentage of patients who presented this test with alterations was 88.24% and 11.76% without alterations. This result shows us the great utility of said study in the workup of muscular dystrophies in countries with no availabilities for molecular studies, being one of the essential tests in the diagnostic approach of patients with clinical suspicion of said pathologies.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Prednisone , Muscular Dystrophies , Patients , Pediatrics , Cross-Sectional Studies , Retrospective Studies , Electromyography
11.
Audiol., Commun. res ; 29: e2850, 2024. tab
Article in Portuguese | LILACS | ID: biblio-1533843

ABSTRACT

RESUMO Objetivo Analisar a associação da independência funcional com aspectos clínicos de comprometimento neurológico, a localização e extensão do dano neuronal e os fatores sociodemográficos em pacientes na fase aguda do AVC. Método Estudo analítico de recorte transversal, realizado com 90 pacientes adultos e idosos acometidos por AVC isquêmico, que tiveram admissão no ambiente hospitalar nas primeiras 24 horas após o evento vascular. A coleta dos dados referentes aos aspectos clínicos e fatores sociodemográficos foi realizada pelo prontuário eletrônico e/ou entrevista para descrever o perfil dos pacientes, Oxfordshire Community Stroke Project, Alberta Stroke Programme Early CT Score, National Institute of Health Stroke Scale e a Medida de Independência Funcional. Resultados O comprometimento neurológico, de acordo com a National Institute of Health Stroke Scale, foi associado à funcionalidade nas primeiras 24 horas após o AVC. Além disso, a presença de hipertensão arterial, idade, trabalho inativo, tabagismo e extensão do dano neuronal estiveram associados à dependência funcional, mas não permaneceram no modelo final deste estudo. Conclusão A dependência funcional está associada à hipertensão arterial, idade, trabalho inativo, tabagismo, extensão do dano neuronal e grau de comprometimento neurológico nas primeiras 24 horas após o evento vascular. Além disso, um nível mais elevado de comprometimento neurológico foi independentemente associado a níveis aumentados de dependência funcional.


ABSTRACT Purpose To analyze the association of functional independence with clinical aspects of neurological impairment, the location and extent of neuronal damage and sociodemographic factors in patients in the acute phase of stroke. Methods Analytical cross-sectional study in 90 adult and older patients affected by ischemic stroke, admitted to the hospital within 24 hours of the vascular event. Sociodemographic factors and clinical aspects data were collected from electronic medical records and/or interviews in order to depict the patients'profile, Oxfordshire Community Stroke Project, Alberta Stroke Programme Early CT Score, National Institute of Health Stroke Scale, and Functional Independence Measure. Results Neurological impairment, according to the National Institute of Health Stroke Scale, was associated with functioning in the first 24 hours after the stroke. Furthermore, the presence of arterial hypertension, age, inactive work, smoking and extent of neuronal damage were associated with functional dependence, but did not remain in the final model of this study. Conclusion Functional dependence is associated with arterial hypertension, age, inactive work, smoking, extent of neuronal damage, and degree of neurological impairment in the first 24 hours after the vascular event. Furthermore, a higher level of neurological impairment was independently associated with increased levels of functional dependence.


Subject(s)
Humans , Adult , Middle Aged , Aged , Activities of Daily Living , Acute-Phase Reaction , Stroke/complications , Stroke/diagnosis , Functional Status , Sociodemographic Factors , Patients
12.
Rev. Headache Med. (Online) ; 15(1): 18-24, 2024. graf
Article in English | LILACS | ID: biblio-1538390

ABSTRACT

INTRODUCTION: Migraine is a disease that affects the overall performance of the patient, especially attention and executive functions (EF), with a direct impact on the person's functionality, highlighting the importance of studies in order to minimize its damage. OBJECTIVE: The objective of this study was to evaluate if there is a link between migraine and executive and attentional functions. METHODOLOGY: Observational study (44 subjects; 29 migraineurs and 15 non-migraineurs) on attentional and executive functioning changes in migraine. Subjects over 18 years of age were included in the study, regardless of gender, recruited for convenience at CAM FAME, FAME and Centro AMA, primary recruitment centers, following the criteria of the International Classification of Headache Disorders (ICHD-3). The participants underwent neuropsychological tests that estimated executive and attentional functioning. For attention, the Psychological Attention the Assessment Battery (AAB) was used, and for EF, the Five-Digit Test (FDT) was used. Student's t test, ANOVA, Mann-Whitney and/or Kruskal-Wallis U test were used, whose analyzes fixed the type I error at 0.05. RESULTS: All AAB subtests pointed to a reduction in the attentional potential in migraineurs when compared to the control group. The FDT showed lowering in the migraineurs group subjects, when compared with the non- migraineurs group. Multivariate analysis identified a relationship between EF, Attention and migraine (p<0.05). CONCLUSION: migraineurs present a decrease in executive functioning and attentional skills and an increase in execution time when compared to non-migraineurs individuals


INTRODUÇÃO: A enxaqueca é uma doença que afeta o desempenho global do paciente, principalmente a atenção e as funções executivas (FE), com impacto direto na funcionalidade da pessoa, destacando a importância de estudos a fim de minimizar seus danos. OBJETIVO: O objetivo deste estudo foi avaliar se existe ligação entre enxaqueca e funções executivas e atencionais. METODOLOGIA: Estudo observacional (44 indivíduos; 29 com enxaqueca e 15 sem enxaqueca) sobre alterações de atenção e funcionamento executivo na enxaqueca. Foram incluídos no estudo indivíduos maiores de 18 anos, independente do sexo, recrutados por conveniência no CAM FAME, FAME e Centro AMA, centros primários de recrutamento, seguindo os critérios da Classificação Internacional de Cefaleias (ICHD-3). Os participantes foram submetidos a testes neuropsicológicos que estimaram o funcionamento executivo e atencional. Para atenção foi utilizada a Bateria de Avaliação da Atenção Psicológica (AAB) e para FE foi utilizado o Teste de Cinco Dígitos (FDT). Foram utilizados teste t de Student, ANOVA, Mann-Whitney e/ou teste U de Kruskal-Wallis, cujas análises fixaram o erro tipo I em 0,05. RESULTADOS: Todos os subtestes da AAB apontaram redução do potencial atencional em enxaquecosos quando comparados ao grupo controle. O FDT apresentou redução nos indivíduos do grupo com enxaqueca, quando comparado com o grupo sem enxaqueca. A análise multivariada identificou relação entre FE, Atenção e enxaqueca (p<0,05). CONCLUSÃO: enxaquecosos apresentam diminuição do funcionamento executivo e das habilidades de atenção e aumento no tempo de execução quando comparados a indivíduos não enxaquecosos


Subject(s)
Humans , Male , Female , Patients/statistics & numerical data , Executive Function/classification , Migraine Disorders/complications
13.
Rev. Headache Med. (Online) ; 15(1): 7-12, 2024. tab
Article in English | LILACS | ID: biblio-1551344

ABSTRACT

BACKGROUND: In 2020, the first vaccines were approved, according to the WHO. However, speculations arose regarding their efficacy and post-vaccination adverse events (AEFV). OBJECTIVE: To evaluate the prevalence of headache as AEFI from the SARSCoV-2 vaccine in Piauí, Brazil. METHODS: This is a quantitative, observational, cross-sectional, and prevalence study. Data were provided by the Post-Vaccination Adverse Event Information System (SI-AEFV), from reported cases from January to September 2021. Data were analyzed, and the research was approved by the UFPI Research Ethics Committee. RESULTS: A total of 2,008 cases were analyzed. Headache was reported in 752 cases (27.99%) as an AEFV after vaccination against SARS-CoV-2. In most cases, patients were from Teresina (67.62%), of brown race/ethnicity (52.67%), female (79.00%), and the majority were not healthcare professionals (54.27%). The most common age of patients, with the original data, was 33 years. After data correction, the most common age was 28 years. The majority of these cases were not severe (96.44%), and the majority of cases were associated with the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine (43.18%).CONCLUSION: Thus, it is concluded from the partial analysis of the results that headache is the most common adverse event after vaccination against SARS-CoV-2. The profile of patients with the most notifications was brown women aged 30 to 40 years who received the first dose of the Covid-19-Covishield-Oxford/AstraZeneca vaccine. Regarding the severity of events, the vast majority were considered non-severe, and no deaths were mentioned, demonstrating the safety of immunobiologicals.


FUNDAMENTO: Em 2020, foram aprovadas as primeiras vacinas, segundo a OMS. No entanto, surgiram especulações quanto à sua eficácia e eventos adversos pós-vacinais (EAPV). OBJETIVO: Avaliar a prevalência de cefaleia como EAPV da vacina SARSCoV-2 no Piauí, Brasil. MÉTODOS: Trata-se de um estudo quantitativo, observacional, transversal e de prevalência. Os dados foram fornecidos pelo Sistema de Informação de Eventos Adversos Pós-Vacinação (SI-AEFV), dos casos notificados no período de janeiro a setembro de 2021. Os dados foram analisados ​​e a pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UFPI. RESULTADOS: Foram analisados ​​2.008 casos. Cefaleia foi relatada em 752 casos (27,99%) como EAPV após vacinação contra SARS-CoV-2. Na maioria dos casos, os pacientes eram procedentes de Teresina (67,62%), de raça/etnia parda (52,67%), do sexo feminino (79,00%) e a maioria não era profissional de saúde (54,27%). A idade mais comum dos pacientes, com os dados originais, era de 33 anos. Após correção dos dados, a idade mais comum foi 28 anos. A maioria desses casos não foi grave (96,44%), e a maioria dos casos esteve associada à primeira dose da vacina Covid-19-Covishield-Oxford/AstraZeneca (43,18%).CONCLUSÃO: Assim, conclui-se a partir da análise parcial dos resultados de que cefaleia é o evento adverso mais comum após vacinação contra SARS-CoV-2. O perfil dos pacientes com mais notificações foi de mulheres pardas com idade entre 30 e 40 anos que receberam a primeira dose da vacina Covid-19-Covishield-Oxford/AstraZeneca. Quanto à gravidade dos eventos, a grande maioria foi considerada não grave e não foram mencionados óbitos, demonstrando a segurança dos imunobiológicos.


Subject(s)
Humans , Male , Female , Vaccines/immunology , Vaccination/adverse effects , COVID-19/virology , Patients/classification , Safety/standards , Health Personnel/organization & administration
14.
São Paulo; s.n; s.n; 2024. 72 p tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1563356

ABSTRACT

A Dengue induz uma resposta exacerbada e transitória das células secretoras de anticorpos (ASCs) no sangue de pacientes cerca de sete dias após o início dos sintomas. A frequência dessas ASCs chega a representar mais de 50% de todas as células B circulantes neste período. No entanto, ainda é desconhecido se a magnitude dessa resposta tem relação com a gravidade da Dengue. Nosso grupo de pesquisa já mostrou que a cultura de células nucleares do sangue periférico (PBMCs) de indivíduos saudáveis com partículas do vírus da Dengue (DENV), por 7 dias, levava a diferenciação de células B em ASCs em magnitude similar àquelas estimuladas por mitógenos. Essas culturas apresentavam um consumo significativamente maior de triptofano (TRP), associado à maior expressão das enzimas IDO1 e IDO2, e, consequentemente, maior síntese de quinurenina (KYN) em relação ao estímulo por mitógenos. Considerando que as concentrações de TRP e KYN detectadas nos sobrenadantes dessas culturas eram diretamente proporcionais ao aumento de ASCs, decidimos investigar o papel desse metabolismo do TRP e de seus respectivos metabólitos na diferenciação das ASCs. Para isso, análises do transcriptoma público de células únicas do sangue periférico de pacientes com Dengue (estudo E-MTAB- 9467) foram realizadas para inferir a real participação do metabolismo do TRP na geração de ASCs. Com o programa R foram executadas análises de Downstream. Identificamos um aumento massivo das ASCs nas amostras dos pacientes infectados com Dengue. No entanto, os principais genes desencadeadores da ativação do metabolismo do TRP (IDO1 e IDO2) não foram expressos nas subpopulações de células B, mas sim em células dendríticas e monócitos CD14+ respectivamente. Isso sugeriria que esta via não seria ativada nos linfócitos B. Por outro lado, genes codificadores de outros participantes da via do TRP (HSD17B10, ECHS1 e SIRT3) foram detectados em células B e podem estar relacionados com a proliferação das ASCs. Além disso, a análise de enriquecimento mostrou uma aumentada expressão de genes associados com moléculas de MHC de classe II em plasmablastos e plasmócitos de pacientes com Dengue. Porém, com a expressão aumentada de ENTPD1 nessas células durante a fase sintomatológica, nossos dados sugerem também que um eventual papel de plasmablastos e plasmócitos como apresentadoras de antígenos na Dengue poderia induzir uma resposta supressora de células T


Dengue can cause an exacerbated and transient antibody-secreting cell (ASC) response in the blood of patients nearly 7 days of symptomatology. The ASC frequency reaches more than 50% of all circulating B cells during that period. However, it is still unknown whether the magnitude of this response may be directly related to the severity of Dengue. Our research group has already shown that the culture of peripheral blood mononuclear cells (PBMCs) from healthy individuals with Dengue virus (DENV) particles for 7 days led to a differentiation of B cells into ASCs to a magnitude similar to those stimulated by mitogens. These cultures showed significantly higher consumption of tryptophan (TRP), associated with higher expression of enzymes IDO1 and IDO2, and consequently, higher synthesis of quinurenine (KYN) compared to mitogen stimulation. The concentrations of TRP and KYN detected in the supernatants of these cultures were directly proportional to ASC frequency increase. Thus, we have decided to investigate the role of TRP metabolism and its respective metabolites in ASC differentiation. For this, we performed an analysis of single-cell transcriptome with peripheral blood from Dengue patients (dataset from E-MTAB-9467 study). Downstream analyses were performed with R software. Corroborating with literature, we identified a massive increase in ASC frequency of Dengue infected patients. However, the main genes triggering TRP metabolism activation (IDO1 and IDO2) were not expressed in B-cell subsets, but in dendritic cells and CD14+ monocytes, respectively. This would suggest that this pathway would not be activated in B lymphocytes. Nevertheless, genes encoding other participants in the TRP pathway (HSD17B10, ECHS1, and SIRT3) were detected in B cells and may be related to ASC proliferation. Futhermore, a Gene Ontology analysis showed an increased expression of genes associated with MHC class II molecules in plasmablasts and plasma cells of Dengue patients. As these cells also presented an increased expression of ENTPD1 during the symptomatic phase, our data suggest a potential role of plasmablasts and plasma cells as antigen-presenting cells associated with a suppressive T cell response in Dengue


Subject(s)
Patients/classification , Plasma Cells/classification , Histocompatibility Antigens Class II/pharmacology , Dengue/pathology , Single-Cell Gene Expression Analysis/instrumentation , Tryptophan/analogs & derivatives
15.
Rev. Nutr. (Online) ; 37: e220069, 2024. tab
Article in English | LILACS | ID: biblio-1559144

ABSTRACT

ABSTRACT Objective: Oxidative stress is triggered by malnutrition and antioxidant losses due to dialysis in hemodialysis patients and thus, oxidative stress increases the risk of mortality in patients with cardiovascular disease and obesity. The study aims to determine differences in cardiovascular risk scores and obesity indices between hemodialysis and control groups and to examine the relationship between the tertiles of dietary total antioxidant capacity with cardiovascular risk, and obesity in hemodialysis and control groups. Methods: This is a cross-sectional case-control study involving hemodialysis patients (n=46) and healthy individuals (n=46). Participants' general characteristics were obtained via a questionnaire, and the Framingham Risk Score was calculated. The dietary total antioxidant capacity was calculated using two methods based on a seven-day food record. Obesity indices, such as Basal Metabolism Index and Body Shape Index, were calculated using anthropometric measurements. Results: The mean age of the participants was 51.1±10.4 years. In the hemodialysis group, obesity indices including body weight, Basal Metabolism Index, waist circumference, fat mass index, and fat-free mass index were lower, while Framingham Risk Score values ​​were higher than the control group (p<0.05). Energy-adjusted dietary total antioksidant capacity values were lower ​​in hemodialysis group, and most patients were in the low tertiles of Trolox equivalent antioxidant capacity, total radical-trapping antioxidant parameter, ferric reducing-antioxidant power and vitamin C equivalent antioxidant capacity (p<0.05). Conclusion: Providing hemodialysis patients with a healthy diet can increase the dietary total antioxidant capacity, and potentially reduce cardiovascular risk, and obesity indices.


RESUMO Objetivo: O estresse oxidativo é desencadeado pela desnutrição e perdas de antioxidantes devido à diálise em pacientes em hemodiálise, portanto, o estresse oxidativo aumenta o risco de mortalidade em pacientes com doenças cardiovasculares e obesidade. O estudo visa determinar as diferenças nos escores de risco cardiovascular e índices de obesidade entre os grupos de hemodiálise e controle, bem como examinar a relação entre os tercis da capacidade antioxidante total da dieta e o risco cardiovascular e obesidade nos grupos de hemodiálise e controle. Métodos: Este é um estudo transversal de caso-controle envolvendo pacientes em hemodiálise (n=46) e indivíduos saudáveis (n=46). As características gerais dos participantes foram obtidas por meio de um questionário, e o Escore de Risco de Framingham foi calculado. A capacidade antioxidante total da dieta foi calculada utilizando dois métodos baseados em um registro alimentar de sete dias. Índices de obesidade como o Índice de Metabolismo Basal e o Índice de Forma Corporal, foram calculados por meio de medidas antropométricas. Resultados: A média de idade dos participantes foi de 51.1±10.4 anos. No grupo de hemodiálise, os índices de obesidade, incluindo peso corporal, Índice de Metabolismo Basal, circunferência da cintura, índice de massa gorda e índice de massa livre de gordura, foram menores, enquanto os valores do Escore de Risco de Framingham foram maiores do que no grupo controle (p<0.05). Os valores de dTAC ajustados pela energia foram menores no grupo de foram hemodiálise, e a maioria dos pacientes estava nos tercis mais baixos de Capacidade antioxidante equivalente ao Trolox, parâmetro antioxidante total de captura de radicais, poder antioxidante redutor férrico e capacidade antioxidante equivalente à vitamina C (p <0.05). Conclusão: Fornecer aos pacientes em hemodiálise uma dieta saudável pode aumentar a capacidade antioxidante total da dieta, reduzindo potencialmente o risco cardiovascular e os índices de obesidade.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Renal Dialysis/adverse effects , Oxidative Stress , Heart Disease Risk Factors , Antioxidants/therapeutic use , Patients/statistics & numerical data , Body Weight , Body Mass Index , Malnutrition , Waist Circumference , Obesity
16.
Audiol., Commun. res ; 29: e2847, 2024. tab, graf
Article in Portuguese | LILACS | ID: biblio-1557152

ABSTRACT

RESUMO Objetivo Descrever as contribuições da atuação fonoaudiológica em pacientes traqueostomizados no contexto da COVID-19. Métodos Estudo retrospectivo de natureza descritiva e análise quantitativa, com coleta em prontuários de variáveis clínicas e gerais dos pacientes e dos atendimentos fonoaudiológicos. Para análise estatística, foi adotado o coeficiente de correlação de Pearson ou Spearman e nível de significância de 5% (p< 0,05). Resultados Foram incluídos 28 prontuários de pacientes (57,1% gênero masculino) com média de idade de 52 anos e 1 mês, que permaneceram internados por, aproximadamente, 53,7 dias e evoluíram para traqueostomia após 22,1 dias de intubação orotraqueal. Foram registrados dez atendimentos fonoaudiológicos por paciente, que iniciaram, em média, 38,4 dias de internação e foram solicitados em 39,3% para progressão da traqueostomia e da dieta por via oral. O cuff da traqueostomia foi mantido desinsuflado no terceiro, sugerida a decanulação em sete dias após o início e liberada dieta por via oral com cinco atendimentos. Quando analisado o tempo de início dos atendimentos fonoaudiológicos, verificou-se correlação positiva com o tempo de internação hospitalar (p<0,0001), mas não com o processo de decanulação e com o tempo de traqueostomia. Já o número de atendimentos fonoaudiológicos teve correlação positiva com o tempo de uso da traqueostomia e até a liberação da dieta por via oral. Conclusão A atuação fonoaudiológica contribuiu para reabilitação da deglutição e retorno seguro à alimentação por via oral de pacientes internados por COVID-19 e submetidos à traqueostomia.


ABSTRACT Purpose To describe the contributions of speech therapy performance in tracheostomized patients in the context of COVID-19. Methods Retrospective descriptive and quantitative analysis research, using medical records to collect clinical and general variables from patients and speech therapy interventions. For statistical analysis, the Pearson or Spearman correlation coefficient was adopted and a significance level of 5% (p< 0.05). Results Twenty-eight medical records of patients were included (57.1% male) and an average age of 52 years and 1 month, who were hospitalized for approximately 53.7 days and progressed to tracheostomy after 22.1 days of orotracheal intubation. There were ten speech therapy sessions per patient, which started on average 38.4 days into hospitalization and were requested in 39.3% of cases for the progression of tracheostomy and oral feeding. The tracheostomy cuff was kept deflated on the third intervention, decannulation was suggested seven days after the start an d the patient was given an oral diet after five interventions. When we analyzed the time speech therapy interventions began, it showed a positive correlation with the length of hospital stay (p<0.0001), but not with the decannulation process and the length of time with the tracheostomy. On the other hand, the number of speech therapy interventions had a positive correlation with the length of time the tracheostomy was in use and the time until the oral diet was released. Conclusion Speech therapy performance contributes to swallowing rehabilitation and the safe return to oral feeding in patients submitted to tracheostomy in the context of COVID-19.


Subject(s)
Humans , Male , Female , Patients , Tracheostomy , Deglutition Disorders/rehabilitation , Hospital Care , Speech, Language and Hearing Sciences , COVID-19/epidemiology , Brazil/epidemiology
17.
Psicol. ciênc. prof ; 44: e258946, 2024.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1558745

ABSTRACT

Este trabalho tem o objetivo de analisar as concepções de maternidade para mulheres inférteis de diferentes níveis socioeconômicos que estão em tratamento de reprodução assistida. Trata-se de um estudo qualitativo, descritivo, que utilizou como instrumento uma entrevista semiestruturada e contemplou temas como o significado de família, desejo/expectativas sobre filho e gestação e expectativas sobre a maternidade. Participaram da pesquisa 48 mulheres inférteis acima de 35 anos que usam tecnologias de reprodução assistida de alta complexidade em instituições privada e pública. Os dados foram tratados pela análise de conteúdo em que emergiram os temas: representações sociais da família; representações sociais da maternidade; expectativas com a gestação e os modelos maternos; e o filho imaginado. As participantes representaram a família de forma positiva, como um sistema de suporte, de fundação e origem de amor, configurando-a como um laço social. Por outro lado, as concepções de família com base na consanguinidade também estiveram presentes, representando a família pela perpetuação da espécie e pela importância do laço biológico. A maternidade foi marcada por significativa idealização, sendo vista como um papel gratificante e de realização da feminilidade. O peso da cobrança social para procriar também foi sentido como um dever a cumprir e que, na impossibilidade de se realizar, gera sentimentos de inferioridade, menos-valia, impotência e inadequação perante a sociedade, o que reforça o estigma da infertilidade. Tais resultados apontam a importância de reflexões sobre o papel da mulher na nossa cultura, visto que a maternidade é ainda utilizada como medida para o sucesso ou fracasso feminino. Faz-se necessário também refletir sobre a possibilidade da maior inserção do trabalho psicológico na reprodução assistida, visto a carga emocional e social envolvidas nesse processo.(AU)


This study aimed to analyze the conceptions of motherhood for infertile women from different socioeconomic levels who are undergoing assisted reproduction treatment. This is a qualitative and descriptive study that used a semi-structured interview as an instrument and included topics such as the meaning of family and desires/expectations about the child, pregnancy, and motherhood. A total of 48 infertile women over 35 years of ages using high-complexity assisted reproductive technologies in private and public institutions participated in this research. The data were treated by content analysis in which the following themes emerged: family social representations; social representations of motherhood; expectations with pregnancy and maternal models; and the imagined son. Participants represented the family in a positive way as a support system and the foundation and origin of love, embracing the family as a social bond. On the other hand, the family concepts based on inbreeding were also present, representing the family by perpetuation of the species and the importance of biological bonds. Motherhood was marked by significant idealization, being seen as a gratifying role and the fulfillment of femininity. The weight of the social demand to procreate was also felt as a duty to be fulfilled that, in the impossibility of carrying it out, generates feelings of inferiority, worthlessness, impotence, and inadequacy toward society, which reinforce the stigma of infertility. Results point to the necessary reflections on the role of women and our culture since Motherhood is still used as a measure of female success or failure. They also point to a reflection on the possibility of greater inclusion of psychological work in assisted reproduction given the emotional and social burden involved in this process.(AU)


Este estudio tuvo como objetivo analizar las concepciones de maternidad de mujeres infértiles, de diferentes niveles socioeconómicos, que se encuentran en tratamiento de reproducción asistida. Se trata de un estudio cualitativo, descriptivo, que utilizó como instrumento una entrevista semiestructurada e incluyó temas como el sentido de la familia, deseos/expectativas sobre el hijo y el embarazo y expectativas sobre la maternidad. Participaron en la investigación un total de 48 mujeres infértiles, mayores de 35 años, usuarias de tecnologías de reproducción asistida de alta complejidad en instituciones públicas y privadas. Los datos se sometieron a análisis de contenido del cual surgieron los temas: representaciones sociales familiares; representaciones sociales de la maternidad; expectativas con el embarazo y modelos maternos; hijo imaginado. Las participantes representaron a la familia de manera positiva, como sistema de apoyo, fundamento y origen del amor, configurándola como vínculo social. Por otro lado, también estuvieron presentes las concepciones familiares basadas en la consanguinidad, representando a la familia para la perpetuación de la especie y la importancia del vínculo biológico. La maternidad estuvo marcada por una importante idealización, vista como un rol gratificante y de realización de la feminidad. También se sintió el peso de la demanda social de procrear como un deber que cumplir y que, ante la imposibilidad de realizarlo, genera sentimientos de inferioridad, desvalorización, impotencia e inadecuación en la sociedad, lo que refuerza el estigma de la infertilidad. Por tanto, son necesarias reflexiones sobre el papel de la mujer en nuestra cultura, ya que la maternidad se sigue utilizando como medida del éxito o fracaso femenino. También se reflexiona sobre la posibilidad de una mayor inclusión del trabajo psicológico en la reproducción asistida dada la carga emocional y social que implica este proceso.(AU)


Subject(s)
Humans , Female , Pregnancy , Reproduction , Family , Parenting , Social Representation , Infertility, Female , Anxiety , Ovulation Detection , Ovulation Induction , Ovum , Ovum Transport , Parent-Child Relations , Patient Care Team , Patients , Pregnancy Maintenance , Pregnancy, Multiple , Prejudice , Psychology , Quality of Life , Self Concept , Sex , Sexual Abstinence , Shame , Achievement , Social Identification , Sperm Transport , Spermatozoa , Taboo , Time , Tobacco Use Disorder , Urogenital System , Uterus , Population Characteristics , National Health Strategies , Labor, Obstetric , Pregnancy , Pregnancy Outcome , Pharmaceutical Preparations , Adoption , Divorce , Marriage , Fertilization in Vitro , Sexually Transmitted Diseases , Child Rearing , Family Characteristics , Risk Factors , Pelvic Inflammatory Disease , Reproductive Techniques , Gestational Age , Coitus , Pregnancy, High-Risk , Oocyte Donation , Consanguinity , Contraception , Sexuality , Couples Therapy , Affect , Abortion, Threatened , Pelvic Infection , Heredity , Inheritance Patterns , Ovulation Prediction , Depression , Reproductive Rights , Diagnosis , Dreams , Alcoholism , Embryo Transfer , Endometriosis , Conjugal Status , Job Market , Fallopian Tube Patency Tests , Family Conflict , Family Relations , Fantasy , Fear , Female Urogenital Diseases and Pregnancy Complications , Masculinity , Sedentary Behavior , Binge Drinking , Hope , Social Norms , Delay Discounting , Contraceptive Prevalence Surveys , Psychological Trauma , Donor Conception , Healthy Lifestyle , Contraceptive Effectiveness , Long-Acting Reversible Contraception , Social Construction of Gender , Gender Expression , Gender-Specific Needs , Frustration , Embarrassment , Sadness , Emotional Regulation , Psychological Distress , Empowerment , Varicocele , Belonging , Family Support , Emotional Exhaustion , Guilt , Happiness , Imagination , Infertility, Male , Insemination, Artificial, Homologous , Laboratories , Life Style , Loneliness , Maternal-Fetal Exchange , Medicine , Obesity
18.
Psicol. ciênc. prof ; 44: e261241, 2024. tab, graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1564974

ABSTRACT

Com a emergência da pandemia de Covid-19, as(os) psicólogas(os) passaram a oferecer atendimento online para pacientes que até então eram atendidos de forma presencial. Na maior parte dos casos, essa mudança se deu de forma improvisada e sem capacitação prévia. Nesse contexto, este estudo, de caráter descritivo-exploratório, quanti-qualitativo e com delineamento transversal, buscou compreender a experiência das(os) psicólogas(os) na transição das intervenções da modalidade presencial para o atendimento remoto durante a pandemia de Covid-19 no Brasil, identificando dificuldades e lacunas percebidas nas orientações disponibilizadas pelo Conselho Federal de Psicologia. Participaram da pesquisa 385 psicólogas(os). Utilizou-se um questionário online para a coleta dos dados, distribuído por meio de uma plataforma digital entre maio e novembro de 2020. O estudo também foi divulgado em grupos da categoria profissional da psicologia em diversas redes sociais. Os dados quantitativos foram analisados por meio de análise estatística descritiva, e as respostas para as questões abertas por meio de análise temática reflexiva. Os achados foram organizados em três categorias temáticas: (a) lacunas percebidas nas orientações quanto à escolha da plataforma digital; (b) lacunas quanto ao preenchimento do cadastro no site E-Psi ; e (c) falta de treinamento adequado para realizar a transição para o formato online. Entre os principais resultados, destacaram-se a insegurança gerada pela falta de preparo prévio das(os) profissionais e a resistência de alguns clientes a aceitar a transposição dos atendimentos do modelo presencial para o online. Espera-se que o mapeamento das principais dificuldades enfrentadas pela categoria contribua para qualificar o debate sobre a efetividade das orientações disponibilizadas para as(os) psicólogas(os).(AU)


With the emergence of the COVID-19 pandemic, psychologists began to offer online consultations to their patients, who were previously seen in person. In most cases, this change happened in an improvised way and with no prior training required. In this context, this study, of a descriptive-exploratory, quanti-qualitative character with cross-sectional design, aimed to understand the experience of psychologists in the transition from in-person to remote modality during the COVID-19 pandemic in Brazil, identifying difficulties and gaps regarding the guidelines provided by the Federal Council of Psychology. A total of 385 psychologists participated in the research. An online questionnaire was used for data collection, distributed via a digital platform between May and November 2020. The study was also shared in professional Psychology groups on several social networks. The quantitative data were analyzed by descriptive statistical analysis, and the answers to the open questions by reflective thematic analysis. The findings were organized into three thematic categories: (a) gaps perceived in the guidance regarding the choice of the digital platform; (b) gaps regarding the completion of the registration on the E-Psi website; and (c) lack of adequate training to make the transition to the online format. Among the main results were the insecurity generated by the lack of previous preparation of the professionals and the resistance of some clients to accept the transposition of the face-to-face services to the online model. It is expected that the mapping of the main difficulties faced by the category will contribute to qualify the debate about the effectiveness of the orientations made available to psychologists.(AU)


Con la emergencia de la pandemia de Covid-19, las(os) psicólogas(os) comenzaron a ofrecer atención psicológica en línea a pacientes que hasta entonces eran atendidos de forma presencial. Este cambio se producía a menudo de forma improvisada y sin la formación previa necesaria. Este estudio descriptivo, exploratorio, cuanticualitativo, con enfoque transversal, tuvo como objetivo comprender la experiencia de estos profesionales en la transición del trabajo presencial al remoto durante la pandemia de Covid-19 en Brasil, identificando dificultades y lagunas percibidas en las directrices del Consejo Federal de Psicología. Participaron en la investigación 385 psicólogos(as). Para la recogida de datos se utilizó un cuestionario en línea distribuido por plataforma digital entre mayo y noviembre de 2020. El estudio también se difundió en grupos de la categoría profesional de la Psicología en diversas redes sociales. Los datos cuantitativos se analizaron mediante análisis estadístico descriptivo, y las respuestas a las preguntas abiertas mediante análisis temático reflexivo. Los resultados se organizaron en tres categorías temáticas: (a) lagunas percibidas en la orientación sobre la elección de la plataforma digital; (b) lagunas relativas a la realización de la inscripción en el sitio web E-Psi ; y (c) falta de formación adecuada para realizar la transición al formato en línea. Entre los principales resultados, destacaron la inseguridad generada por la falta de preparación previa de los profesionales y la resistencia de algunos clientes a aceptar la transición de los servicios del modelo presencial al modelo en línea. Se espera que el estudio de las principales dificultades a las que se enfrenta la categoría contribuya a matizar el debate sobre la eficacia de las orientaciones puestas a disposición de los(as) psicólogos(as).(AU)


Subject(s)
Humans , Male , Female , Psychology , Information Technology , Internet-Based Intervention , Teleworking , COVID-19 , Organizational Innovation , Orientation , Patients , Policy Making , Psychotherapy , Referral and Consultation , Research , Social Adjustment , Social Control, Formal , Work , Computer Communication Networks , Mental Health , Efficacy , Data Collection , Surveys and Questionnaires , Guidelines as Topic , Congresses as Topic , Privacy , Censuses , Counseling , Internet , Credentialing , Crisis Intervention , Job Market , Ethics, Professional , Social Networking , Mentoring , Web Archives as Topic , e-Accessibility , Social Vulnerability , Persons
19.
Arq. ciências saúde UNIPAR ; 27(2): 813-828, Maio-Ago. 2023.
Article in Portuguese | LILACS | ID: biblio-1424962

ABSTRACT

OBJETIVO: Este trabalho aborda sobre características referente aos exames citopatológicos do colo do útero em Altamira, coletado no Sistema de Informação do Câncer, dentro do período de 2014 a 2020. Observou-se também a qualidade da interpretação dos principais resultados encontrados, sobre a técnica de coleta e qualidade de exames. O objetivo é analisar o perfil epidemiológico dos exames citopatológicos do colo do útero do município. MÉTODO: A metodologia realizada foi estudo quantitativo, de corte transversal, epidemiológico, descritiva e analítico. RESULTADOS: Verificou- se um crescimento anual na taxa de cobertura do exame do preventivo no período de 2014 a 2019, que está ligado à implementação do Plano de Desenvolvimento Regional Sustentável do Xingu, e que esse crescimento mostra uma diferença estatística significativa entre a taxa de cobertura de Altamira, Pará, Brasil. Observou-se presença de falhas no preenchimento da ficha de notificação é referente ao campo da escolaridade das pacientes que não apresentam registro. Quanto a faixa etária mais frequente que realizam o exame do preventivo está entre 25 a 34 anos e as lesões intraepiteliais do colo uterino mais frequentes são: a de baixo grau que corresponde à população jovem (<34 anos) e de alto grau entre 25 a 44 anos.


OBJECTIVE: This paper deals with characteristics related to cytopathological examinations of the cervix in Altamira, collected in the Cancer Information System, within the period from 2014 to 2020. It was also observed the quality of interpretation of the main results found, on the technique collection and quality of exams. The objective is to analyze the epidemiological profile of cytopathological tests of the cervix in the city. METHOD: The methodology used was a quantitative, cross- sectional, epidemiological study, descriptive and analytical approach. RESULTS: As a result, there was an annual growth in the coverage rate of the preventive exam in the period from 2014 to 2019, which is linked to the implementation of the Xingu Sustainable Regional Development Plan, and that this growth shows a significant statistical difference between the coverage rate of Altamira, Pará, Brazil. It was observed the presence of failures in completing the notification form referring to the field of education of patients who do not have a record. As for the most frequent age group that undergoes the preventive examination, it is between 25 and 34 years old and the most frequent intraepithelial lesions of the uterine cervix are: low-grade, which corresponds to the young population (<34 years) and high-grade, between 25 and 34 years old. 44 years.


OBJETIVO: En este trabajo se abordan las características relacionadas con los exámenes citopatológicos de cérvix en Altamira, recogidos en el Sistema de Información del Cáncer, en el periodo comprendido entre 2014 y 2020. También se observó la calidad de interpretación de los principales resultados encontrados, sobre la técnica de recolección y calidad de los exámenes. El objetivo es analizar el perfil epidemiológico de los exámenes citopatológicos de cuello uterino en la ciudad. MÉTODO: La metodología utilizada fue un estudio cuantitativo, transversal, epidemiológico, de abordaje descriptivo y analítico. RESULTADOS: Como resultado, se observó un crecimiento anual de la tasa de cobertura del examen preventivo en el período de 2014 a 2019, que está vinculado a la implementación del Plan de Desarrollo Regional Sostenible Xingu, y que este crecimiento muestra una diferencia estadística significativa entre la tasa de cobertura de Altamira, Pará, Brasil. Se observó la presencia de fallas en el llenado del formulario de notificación referente al campo de la educación de los pacientes que no tienen un registro. En cuanto al grupo de edad más frecuente que se somete al examen preventivo, es entre 25 y 34 años y las lesiones intraepiteliales del cuello uterino más frecuentes son: de bajo grado, que corresponde a la población joven (<34 años) y de alto grado, entre 25 y 44 años.


Subject(s)
Humans , Female , Adult , Health Profile , Epidemiologic Studies , Uterine Cervical Neoplasms/epidemiology , Patients/statistics & numerical data , Women , Information Systems/instrumentation , Papanicolaou Test , Clinical Studies as Topic/methods , Cell Biology
20.
Arq. ciências saúde UNIPAR ; 27(2): 1010-1026, Maio-Ago. 2023.
Article in Portuguese | LILACS | ID: biblio-1425168

ABSTRACT

A Doença Renal Crônica (DRC) é uma importante redução da função renal que causa alterações no metabolismo dos indivíduos. Para acompanhar a progressão da DRC e prevenir possíveis complicações, foi realizada uma pesquisa para avaliar o perfil sociodemográfico, bioquímico e hematológico de pacientes com Insuficiência Renal Crônica (IRC) submetidos a hemodiálise. Esta pesquisa foi quantitativa, descritiva e transversal de caráter retrospectivo, realizada por meio da análise de dados secundários contidos nos prontuários dos pacientes. A coleta de dados ocorreu no Centro de Hemodiálise da cidade de Russas, no Ceará. A amostra foi constituída por 161 pacientes com DRC, sendo 63,35% do sexo masculino e 85,71% pardos, com uma idade média de 54,39 anos. Desses, 63,97% tinham entre 2 e 10 anos de tratamento e 57,76% possuíam ensino fundamental incompleto. 19,25% residiam em Russas. Resultados: Após a hemodiálise, os resultados mostraram 44 mg/dL de Ureia, 48,44% dos pacientes com valores normais. A hemoglobina e hematócrito médios foram 11,8 g/dL e 33,7%, respectivamente, sendo que 63,35% tiveram valores reduzidos. 85,10% dos pacientes tiveram contagem de plaquetas normal, 72,04% níveis adequados de ferro e albumina, 52,79% tiveram níveis elevados de ferritina, 23,61% redução de transferrina e níveis lipídicos satisfatórios. 79,50% apresentaram níveis séricos de potássio dentro da normalidade, 12,42% de fósforo acima do normal, 85,09% de cálcio dentro dos valores normais, 39,13% de PTHi normais e 86,33% de glicose dentro dos valores considerados normais. Com base nos resultados, concluiu-se que todos os pacientes em tratamento hemodialítico apresentam diversas alterações em decorrência da DRC e do próprio processo de tratamento. Portanto, a realização de exames para avaliar ou monitorar possíveis complicações da IRC é essencial para criar estratégias e intervenções mais eficazes, que melhorem a assistência prestada a esses pacientes e, consequentemente, da qualidade e expectativa de vida dos mesmos.


Chronic Kidney Disease (CKD) is an important reduction in kidney function that causes changes in the metabolism of individuals. To monitor the progression of CKD and prevent possible complications, a survey was carried out to assess the sociodemographic, biochemical and hematological profile of patients with Chronic Renal Failure (CRF) undergoing hemodialysis. This research was quantitative, descriptive and cross-sectional with a retrospective character, carried out through the analysis of secondary data contained in the patients' medical records. Data collection took place at the Hemodialysis Center in the city of Russas, Ceará. The sample consisted of 161 patients with CKD, 63.35% male and 85.71% brown, with an average age of 54.39 years. Of these, 63.97% had between 2 and 10 years of treatment and 57.76% had incomplete primary education. 19.25% resided in Russas. Results: After hemodialysis, the results showed 44 mg/dL of Urea, 48.44% of patients with normal values. Average hemoglobin and hematocrit were 11.8 g/dL and 33.7%, respectively, with 63.35% having reduced values. 85.10% of the patients had normal platelet counts, 72.04% had adequate levels of iron and albumin, 52.79% had high levels of ferritin, 23.61% had reduced transferrin and satisfactory lipid levels. 79.50% had serum levels of potassium within the normal range, 12.42% of phosphorus above normal, 85.09% of calcium within normal values, 39.13% of PTHi normal and 86.33% of glucose within the values considered normal. Based on the results, it was concluded that all patients on hemodialysis have several changes due to CKD and the treatment process itself. Therefore, carrying out tests to assess or monitor possible complications of CRF is essential to create more effective strategies and interventions that improve the care provided to these patients and, consequently, their quality and life expectancy.


La Enfermedad Renal Crónica (ERC) es una reducción importante de la función renal que provoca cambios en el metabolismo de los individuos. Para monitorizar la evolución de la ERC y prevenir posibles complicaciones, se realizó una encuesta para evaluar el perfil sociodemográfico, bioquímico y hematológico de los pacientes con Insuficiencia Renal Crónica (IRC) en hemodiálisis. Esta investigación fue cuantitativa, descriptiva y transversal con carácter retrospectivo, realizada a través del análisis de datos secundarios contenidos en las historias clínicas de los pacientes. La recolección de datos ocurrió en el Centro de Hemodiálisis de la ciudad de Russas, Ceará. La muestra estuvo constituida por 161 pacientes con ERC, 63,35% del sexo masculino y 85,71% pardos, con una edad media de 54,39 años. De estos, 63,97% tenían entre 2 y 10 años de tratamiento y 57,76% tenían primaria incompleta. El 19,25% residía en Russas. Resultados: Posterior a la hemodiálisis los resultados arrojaron 44 mg/dL de Urea, 48,44% de los pacientes con valores normales. La hemoglobina y el hematocrito medios fueron 11,8 g/dl y 33,7 %, respectivamente, con un 63,35 % con valores reducidos. El 85,10% de los pacientes presentaba plaquetas normales, el 72,04% presentaba niveles adecuados de hierro y albúmina, el 52,79% presentaba niveles elevados de ferritina, el 23,61% presentaba transferrina reducida y niveles satisfactorios de lípidos. El 79,50% presentaba niveles séricos de potasio dentro de la normalidad, el 12,42% de fósforo por encima de lo normal, el 85,09% de calcio dentro de los valores normales, el 39,13% de PTHi normal y el 86,33% de glucosa dentro de los valores considerados normales. Con base en los resultados, se concluyó que todos los pacientes en hemodiálisis tienen varios cambios debido a la ERC y al propio proceso de tratamiento. Por tanto, la realización de pruebas para evaluar o monitorizar las posibles complicaciones de la IRC es fundamental para crear estrategias e intervenciones más eficaces que mejoren la atención a estos pacientes y, en consecuencia, su calidad y esperanza de vida.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Patients/statistics & numerical data , Health Profile , Renal Dialysis/statistics & numerical data , Renal Insufficiency, Chronic/epidemiology , Kidney Diseases/epidemiology , Serology , Biochemistry , Medical Records/statistics & numerical data , Cross-Sectional Studies/methods , Creatinine , Data Analysis , Hematology
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