Estudio descriptivo de los efectos de las transfusiones de componentes sanguíneos en un grupo de pacientes con enfermedad terminal / A descriptive study of the effects of blood components transfusions in a group of terminally ill patients

Objetivo: Aproximadamente un 5-18 % de los/as pacientes con enfermedad avanzada reciben transfusiones, bajo criterios de sintomatología y cifras de hemoglobina y hematocrito. El objetivo fue conocer la relación entre las características sociodemográficas y clínicas de los/as pacientes y la mejoría subjetiva y objetiva tras haber realizado una transfusión de hemoderivados.Métodos: Estudio descriptivo transversal con pacientes ingresados/as en un hospital de tercer nivel que recibieron transfusiones de hemoderivados antes de fallecer por una enfermedad crónica terminal. Se recogieron datos de las historias clínicas.Resultados: Participaron 140 personas, un 54,3 % hombres, de 83 años de edad (mediana), a los que se transfundieron 474 concentrados de hematíes, 168 unidades de plaquetas y 5 unidades de plasma fresco, contabilizando una supervivencia media desde la última transfusión de 20,53 días. El hemograma (cifras de hemoglobina, hematocrito y recuento de leucocitos) mejoró en la analítica postransfusión, excepto el recuento plaquetario. Se encontró relación entre tener 81-90 años con el tipo de componente transfundido (p = 0,017) y entre la patología y el hemoderivado (p < 0,001), destacando la transfusión de hematíes a los/las pacientes con insuficiencia cardiaca (12,9 %). Se encontró relación entre la fiebre (p = 0,001), la debilidad y cansancio (p = 0,001) y la ortopnea (p = 0,002) para transfundir. La prueba T para muestras relacionadas mostró correlación entre los leucocitos medidos pre y postransfusión.Conclusiones: No se encontró un aumento destacable en la supervivencia, que fue 20,53 días de media tras las transfusiones, en la mejoría subjetiva de la sintomatología señalada por los/as pacientes. Esta situación podría abrir el debate de la legitimidad y relevancia de las transfusiones en pacientes terminales.(AU)

Objective: Approximately 5-18 % of patients with advanced disease receive transfusions according to criteria based on symptoms and on hemoglobin and hematocrit figures. The objective was to determine the relationship between the sociodemographic and clinical characteristics of patients and their subjective and objective improvement after transfusion of blood products.Material and methods: A cross-sectional descriptive study of patients admitted to a tertiary level hospital who received blood product transfusions before dying of chronic terminal disease. Data were collected from medical records.Results: A total of 140 patients participated, 54.3 % men, 83 years of age (median), who were transfused 474 red blood cell concentrates, 168 units of platelets, and 5 units of fresh plasma, with a mean survival of 20.53 days after their last transfusion. Their hemogram (hemoglobin, hematocrit, leukocyte count) improved in post-transfusion tests, except for platelet count. A relationship was found between being 81-90 years old and the type of component transfused (p = 0.017), as well as between the condition and the blood product (p < 0.001), with a highlight on transfusion of red blood cells to patients with heart failure (12.9 %). A relationship was found between fever (p = 0.001), weakness and tiredness (p = 0.001), and orthopnea (p = 0.002) with transfusion. A t-test for related samples showed correlation between leukocytes measured pre-and post-transfusion.Conclusions: We did not find any remarkable increase in survival, which was 20.53 days on average after transfusion, or in subjective symptom improvement as reported by patients. This situation might open a debate on the legitimacy and relevance of transfusions in terminally ill patients.(AU)

AELI® KINETEST, complemento para el diagnóstico clínico / AELI® KINETEST: A Complement for Clinical Diagnosis

Introducción: Con la meta permanente de mejorar la relación médico-paciente y favorecer que este último asuma una posición proactiva en la búsqueda de su salud, se implementa la metodología AELI® KINETEST, aceptada desde 2017 por la Oficina Cubana de la Propiedad Industrial, órgano estatal subordinado al Ministerio de Ciencia, Tecnología y Medio Ambiente. Esta emplea una forma diferente de realizar diagnóstico y tratamiento, con una marcada intención de lograr visión integral del paciente, que abarca contexto personal, familiar, laboral, y complementa así el método clínico. Objetivo: Describir los resultados de la atención a pacientes con AELI®KINETEST. Métodos: Estudio retrospectivo, descriptivo y de corte transversal. La población estuvo conformada por 582 pacientes del Hospital Universitario Clínico Quirúrgico Dr. Miguel Enríquez, entre marzo de 2016 y marzo de 2019. Se confeccionó una ficha personal que incluía los resultados de la aplicación del protocolo del test muscular de los miembros superiores para identificar las disarmonías energéticas. Resultados: Se halló una evolución positiva, predominante a partir de la segunda consulta, en la que se encontraba asintomático el 84,4 por ciento y en la tercera, el 91 por ciento. Conclusiones: AELI® KINETEST resulta una metodología que promueve salud desde una visión integral del ser humano; y permite crecimiento personal, control de los síntomas a corto plazo y rápida reincorporación laboral y familiar. Los resultados muestran la aceptación social y apuntan a una inmediata inclusión en el aprendizaje de las ciencias de la salud(AU)

Introduction: With the permanent goal of improving the doctor-patient relationship and encouraging the latter to assume a proactive position in the pursuit of her or his health, the AELI®KINETEST methodology is implemented. It has been accepted since 2017 by the Cuban Office of Industrial Property, a state body subordinated to the Ministry of Science, Technology and the Environment. This methodology uses a different way of making a diagnosis and carrying out treatment, with a marked intention to achieve an comprehensive vision of the patient, covering the individual, family, work, and other contexts. Objective: To describe the results of patient care with AELI®KINETEST. Methods: A retrospective, descriptive and cross-sectional study was conducted. The population consisted of 582 patients from Hospital Universitario Clínico Quirúrgico Dr. Miguel Enríquez, during March 2016 and March 2019. An individual file was prepared, including the results of the application of the upper limb muscle test protocol for identifying energetic disharmonies. Results: A positive evolution was observed, predominantly from the second consultation, at which moment 84.4 percent were asymptomatic; while at the moment of the third consultation, 91 percent were asymptomatic. Conclusions: AELI® KINETEST is a methodology that promotes health with an approach towards a comprehensive vision of the human being, as well as it allows individual growth, short-term symptom control and a rapid reincorporation to work and family. The results show social acceptance and point to an immediate inclusion in the learning of health sciences(AU)

Granos de polen anemófilos: sensibilización en pacientes alérgicos / Anemophilic pollen grains: sensitization in allergic patients

A nivel mundial, los aeroalérgenos más frecuentes causantes de enfermedades alérgicas son los granos de polen anemófilos. Estos han sido capaces de desencadenar crisis que han reflejado una elevada morbilidad. En Cuba los estudios de sensibilización a granos de polen han sido escasos. Con el objetivo de determinar la sensibilización a granos de polen en pacientes alérgicos y su relación con la presencia de enfermedades alérgicas, se realizó un estudio observacional descriptivo de corte transversal, no aleatorizado, de marzo a junio del 2019. La muestra se constituyó de 33 pacientes con asma, rinitis, rinoconjuntivitis alérgica, dermatitis atópica y conjuntivitis alérgica. A todos los pacientes se les realizó historia clínica alergológica y prueba cutánea por punción con extractos alergénicos de: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucaliptus sp. Se aplicaron las frecuencias absolutas, porcientos, desviación estándar, promedio, edad media y test de Spearman para su análisis. La edad media de la muestra fue de 36,9 años, con predominio de mujeres. Más del 50por ciento de los pacientes presentaron sensibilización a granos de polen; y de ellos, el 24,24por ciento resultaron polisensibilizados. El mayor porcentaje de sensibilización fue a Cynodon dactylon. La rinitis alérgica fue la enfermedad que prevaleció en la población estudiada(AU)

Nowadays, the most frequent aeroallergens causing allergy diseases have been anemophilous pollen grains. They have been able to triggers crises that have reflected a high morbidity. In Cuba, studies of sensitization to pollen grains have been scarce. The objective of our research was to determine the sensitization to pollen grains in allergic patients and its relationship with the presence of allergic diseases. A non-randomized, descriptive, cross-sectional, observational study was conducted from March to June 2019. The sample consisted of 33 patients with asthma, allergic rhinitis, rhinoconjunctivitis, atopic dermatitis and allergic conjunctivitis. All patients underwent allergic history and skin prick test testing with allergenic extracts of: Helianthus annus, Cosmos bipinnatus, Cynodon dactylon, Quercus sp, Eucalyptus sp. Absolute frequencies, percentages, standard deviation, mean, average age, and Spearman´s test were applied for analysis. The average age of the sample was 36.9 years, with a predominance of women. More than 50percent of the patients presented sensitization to pollen grains; of them, 24.24percent polysensitized. The highest percentage of sensitization was to Cynodon dactylon. Allergic rhinitis was the disease that prevailed in the population studied(AU)

Estrés y espiritualidad relacionado con la sobrecarga en cuidadores de adultos mayores con dependencia total / Stress and Spirituality Related to Overload in Caregivers of Totally Dependent Older Adults

Introducción: La población adulta mayor requiere atención por los cambios del envejecimiento, la atención que los cuidadores otorgan al adulto mayor dependiente suele generar estrés; los cuidadores recurren a la espiritualidad para afrontar la sobrecarga y estresores del cuidado. Objetivo: Relacionar el estrés y la espiritualidad con la sobrecarga en cuidadores de adultos mayores con dependencia total. Métodos: Se realizó un estudio descriptivo y correlacional en una población de cuidadores de adultos mayores de un centro comunitario de jurisdicción sanitaria en Heroica Matamoros, Tamaulipas, México, entre enero y julio del 2021. Muestra de 75 participantes para una población infinita, se aplicó muestreo por conveniencia. Se aplicó una cédula de datos personales, la Escala de Estrés Percibido, el Cuestionario de Espiritualidad y la Escala de Zarit. Los datos se analizaron en el paquete estadístico SPSS versión-21, se utilizó estadística descriptiva y se realizó correlación de Spearman. Resultados: El 56 por ciento de los cuidadores son hijos o hijas del adulto mayor dependiente, en promedio tuvieron 5,21 (DE= 3,68) horas al día dedicadas al cuidado y 7,67 (DE= 2,28) meses. Se encontró relación entre el estrés y la sobrecarga del cuidador (rs= 0,462; p= 0,000), no hubo relación entre la espiritualidad global y la sobrecarga del cuidador (rs= -0,169; p= 0,147). Conclusiones: A pesar de que la relación entre la espiritualidad global y la sobrecarga del cuidador no fue significativa, se observó relación entre el estrés y sobrecarga del cuidador(AU)

Introduction: The older adult population requires attention because of the changes as a result of aging. The caregivers' attention provided to dependent older adults often produces stress. Caregivers turn to spirituality to cope with the overload and stressors of caregiving. Objective: To relate stress and spirituality with overload in caregivers of totally dependent older adults. Methods: A descriptive and correlational study was conducted with a population of caregivers of older adults from a community health jurisdiction center in Heroica Matamoros, Tamaulipas, Mexico, between January and July 2021. Through convenience sampling, 75 participants made up a sample obtained as an infinite population. A personal data questionnaire, the Perceived Stress Scale, the Spirituality Questionnaire and the Zarit scale were applied. The data were analyzed using the statistical package SPSS (version 21), descriptive statistics were used and Spearman's correlation was performed. Results: 56 percent of the caregivers were children to dependent older adults, who were, on average, 5.21 (SD = 3.68) daily hours or 7.67 (SD = 2.28) months dedicated to caregiving. A relationship was found between stress and caregiver overload (rs= 0.462; p= 0.000). There was no relationship between overall spirituality and caregiver overload (rs= -0.169; p= 0.147). Conclusions: Although the relationship between overall spirituality and caregiver overload was not significant, there was a relationship between stress and caregiver overload(AU)

Caracterização dos usuários e das práticas integrativas e complementares em saúde na rede de atenção primária do município do Natal/RN / Characterization of users and integrative and complementary health practices in the primary care network in the city of Natal/RN

Introdução: A inserção das Práticas Integrativas e Complementares em Saúde (PICS) foi marcada por interesses, como resgate do conhecimento e identidade de grupos populares, alguns historicamente marginalizados e por interesse do Estado em uma nova cultura de cuidado pautado pela promoção da saúde. Objetivo: o presente estudo objetiva caracterizar os usuários e as PICS desenvolvidas no contexto do SUS no município do Natal, Rio Grande do Norte. Método: Trata-se de um estudo descritivo de abordagem quantitativa, do tipo exploratóriodescritivo, cujo formato é de campo com delineamento de levantamento na Rede de Atenção Primária à Saúde do município do Natal, mas especificamente na Unidade Básica de Saúde, na Estratégia Saúde da Família e na Unidade Mista. Para coleta dos dados, realizada no período de janeiro a julho de 2022, o instrumento utilizado foi Prontuário Eletrônico Cidadão (PEC) de pessoas maiores de 18 anos no sistema e-SUS. Os dados coletados foram constituídos em um banco de dados no Microsoft Office Excel versão 2019 e analisados por meio da estatística inferencial através de frequências absolutas e relativas, cujo bando de dados foi posteriormente inserido no software estatístico Statistical Package for the Social Science (SPSS) versão 20.0 para viabilizar o cruzamento comparativo entre adultos e idosos. O estudo foi aprovado pelo Comitê de Ética e Pesquisa (HUOL/UFRN) com o código nº 53201921.1.0000.5292. Resultados: Foram analisados 522 prontuários dos usuários adscritos, cuja maior frequência é de pessoas adultas do sexo feminino (83,0%); pessoas idosas de raça/cor não branca (82,6%) e com baixa escolaridade (67,8%); a hipertensão arterial (30,4%) e diabetes (17,4%) foi mais frequente em pessoas idosas, bem como a presença de dor corporal (71,3%) e doença dos dentes/gengivas (42,6%). A auriculoterapia (58,2%) foi a prática integrativa mais utilizada nas condutas de tratamento; 53.4% da população recebeu pelo menos um atendimento e 39.3% foram atendidos no distrito sanitário Norte I. Conclusão: Foi possível quantificar as os atendimentos, bem como caracterizar o perfil sociodemográfico, as principais demandas, condições de saúde dos usuários de acordo com a população que estão inseridos, adultos e idosos. Além disso, o estudo reafirma a posição das PICS no cuidado à saúde no SUS, bem como contribui com os estudos das PICS com informações importantes no contexto da saúde integrativa desse público para o planejamento e gestão em saúde a nível municipal, estadual e nacional (AU).

Introduction: The insertion of Integrative and Complementary Health Practices (PICS) was marked by interests, such as recovering the knowledge and identity of popular groups, some of which were historically marginalized, and by the State's interest in a new culture of care based on health promotion. Objective: This study aims to characterize the users and the PICS developed in the context of the SUS in the city of Natal, Rio Grande do Norte. Method: This is a descriptive study with a quantitative approach, of the exploratory-descriptive type, whose format is field with a survey design in the Primary Health Care Network in the municipality of Natal, but specifically in the Basic Health Unit, in the Strategy Family Health and Mixed Unit. For data collection, carried out from January to July 2022, the instrument used was the Electronic Citizen Record (PEC) of people over 18 years old in the e-SUS system. The collected data were constituted in a database in Microsoft Office Excel version 2019 and analyzed using inferential statistics through absolute and relative frequencies, whose database was later inserted in the statistical software Statistical Package for the Social Sciences (SPSS) version 20.0 to enable the comparative crossing between adults and seniors. The study was approved by the Ethics and Research Committee (HUOL/UFRN) under code nº 53201921.1.0000.5292. Results: 522 medical records of enrolled users were analyzed, the highest frequency being adult females (83.0%); elderly people of non-white race/color (82.6%) and with low education (67.8%); arterial hypertension (30.4%) and diabetes (17.4%) were more frequent in elderly people, as well as the presence of body pain (71.3%) and tooth/gum disease (42.6%). Auriculotherapy (58.2%) was the most used integrative practice in treatment procedures; 53.4% of the population received at least one service and 39.3% were attended in the North I health district. Conclusion: It was possible to quantify the visits, as well as to characterize the sociodemographic profile, the main demands, health conditions of the users according to the population who are inserted, adults and seniors. In addition, the study reaffirms the position of PICS in health care in the SUS, as well as contributing to PICS studies with important information in the context of the integrative health of this public for health planning and management at municipal, state and national levels (AU).

Sangramiento posextracción dentaria y medidas para su control en pacientes tratados con antiagregantes plaquetarios / Bleeding after tooth extraction and measures for its control in patients treated with antiplatelet agents

Introducción: El desarrollo de las ciencias médicas trae consigo un incremento en la expectativa de vida, junto a la detección temprana de un gran número de enfermedades crónicas como las cerebrovasculares y cardiovasculares, que son tratadas rutinariamente con medicamentos antiagregantes plaquetarios. El conocimiento del manejo de estos pacientes ante los procedimientos quirúrgicos estomatológicos constituye un reto en la práctica diaria profesional. Objetivo: Determinar el nivel de sangramiento posextracción dentaria en pacientes con enfermedad cardiovascular y cerebrovascular, según el tipo de antiagregantes plaquetarios y grupo dentario, así como la frecuencia de utilización de las medidas para su control. Métodos: Se efectuó un estudio observacional, descriptivo, longitudinal y prospectivo con un universo de 136 pacientes de más de 20 años, remitidos por su cardiólogo y que necesitaban realizarse extracciones dentarias sin modificar su tratamiento con antiagregantes plaquetarios. Las variables estudiadas fueron la enfermedad sistémica, el tipo de antiagregante plaquetario, el nivel de sangramiento, grupo dentario intervenido y método hemostático utilizado. Resultados: La mitad de los pacientes estudiados no presentó sangramiento posextracción dentaria. En los pacientes tratados con aspirina o clopidogrel predominaron los sujetos sin sangramiento para un 84,3 por ciento y 62,5 por ciento, respectivamente. En los de doble antiagregación prevaleció el sangramiento moderado con un 46,3 por ciento. Los grupos dentarios incisivo, canino y premolar no presentaron episodios de sangramiento para un 64,1 por ciento, 51,6 por ciento y 53,3por ciento, respectivamente. El método hemostático más utilizado fue la compresión de las corticales y termoterapia fría (47,8 por ciento). Conclusiones: La mitad de los pacientes con enfermedades cardiovasculares y cerebrovasculares no presentaron sangramiento posextracción dentaria(AU)

Introduction: The development of medical sciences brings with it an increase in life expectancy, together with the early detection of a large number of chronic diseases such as cerebrovascular and cardiovascular diseases, which are routinely treated with antiplatelet aggregation drugs. Knowledge on the treatment of these patients before stomatological surgical procedures constitutes a challenge in daily professional practice. Objective: To determine the level of bleeding after tooth extraction in patients with cardiovascular and cerebrovascular disease, according to the type of antiplatelet agents and dental group, as well as the frequency of use of measures for their control. Methods: An observational, descriptive, longitudinal and prospective study was carried out with a universe of 136 patients over 20 years of age, referred by their cardiologist, who needed dental extractions without modifying their treatment with antiplatelet agents. The variables studied were systemic disease, type of antiplatelet agent, level of bleeding, dental group treated and hemostatic method used. Results: Half of the patients studied did not present bleeding after tooth extraction. In patients treated with aspirin or clopidogrel, 84.3 percent and 62.5por ciento, respectively, had no bleeding. In those with double antiplatelet therapy, modera te bleeding prevailed with 46.3 The incisor, canine and premolar tooth groups did not present bleeding episodes (64.1 percent, 51.6and 53.3 percent respectively). The most commonly used hemostatic method was cortical compression and cold thermotherapy (47.8%). Conclusions: Half of the patients with cardiovascular and cerebrovascular diseases did not present bleeding after tooth extraction(AU)

Promoção da saúde mental dos trabalhadores da saúde: as práticas integrativas e complementares como estratégias de cuidado / Promoting the mental health of health workers: integrative andcomplementary practices as care strategies / Promoción de la salud mental del trabajadores de salud: prácticas integradoras y complementarias como estrategias de cuidado

Introdução:É indispensável entender a saúde mental por meio das relações históricas e socioculturais que o indivíduo mantém com o outro, com a comunidade e com o meio em que trabalha. Percebe-se que os aspectos referentes às conceituações de saúde não estão em consonância com a realidade dos profissionais de saúde no Brasil. Como forma de promover o autocuidado, as Práticas Integrativas e Complementares apresentam-se como uma estratégia de promoção da saúde mental dos trabalhadores da saúde. Objetivo:Descrever as experiências de realização de ações de promoção da saúde mental dos trabalhadores da saúde em um hospital geral do interior do Rio Grande do Norte. Metodologia:Trata-se de um estudo do tipo relato de experiência, desenvolvido a partir da realização de açõesde promoção à saúde mental dos trabalhadores no contexto do "Setembro Amarelo" e "Janeiro Branco", desenvolvidas pela equipe de Residência Multiprofissional em Saúde Materno-Infantil da Universidade Federal do Rio Grande do Norte. Resultados e Discussão:Os profissionais foram instigados a refletir sobre a temática e relacionar com as suas vivências, discutindo estratégias de autocuidado no ambiente de trabalho. Observou-se a predominância dos profissionais de enfermagem em relação às demais categorias profissionais. Estes relataram que os momentos foram prazerosos e o sentiram como uma oportunidade de relaxamento no ambiente de trabalho, desejando que estes pudessem ocorrer com mais frequência. Conclusões:As ações desenvolvidas e descritas se mostraram como estratégias importantes para a discussão e sensibilização sobre a temática, bem como a relevância de estratégias de promoção à saúde mental nos espaços ocupacionais do Sistema Único de Saúde (AU).

Introduction:It is essential to understand mental health through the historical and sociocultural relationships that the person maintains with each other, with the community and with the place on which he works. It is noticed that the aspects referring to health concepts are not into the reality of health professionals in Brazil. As a way of promoting self-care, the integrative and complementary practices are presented as a strategy to promote the mental health of health workers. Objective:To report the experiences ofaccomplishment of actions to promote the mental health of health workers in a general hospital in the countryside of Rio Grande do Norte. Methodology:This is an experience report study, developed from the implementation of actions to promote the mental health of workers in the context of "Yellow September" and "White January", performed by the Maternal Childlike Multiprofessional Residency team of the Federal University of Rio Grande do Norte. Results and Discussion:The professionals were encouraged to reflect on the theme and relate it with their experiences, discussing self-care strategies in the work environment. There was a prevalence of nursing professionals in relation to other professional categories. They reported that the moments were pleasant and felt it as an opportunity for relaxation in the work environment, wishing that these could happen more often.Conclusions:The actions developed and described proved to be important strategies for the discussion and awareness of the subject, as well as the relevance of strategies to promote mental health in the occupational spaces of the Unified Health System (AU).

Introducción: Es fundamental comprender la saludmental a través de las relaciones históricas y socioculturales que el individuo mantiene con el otro, con la comunidad y con el medio en el que se desenvuelve. Se nota que los aspectos referentes a los conceptos de salud no están en consonancia con la realidad de los profesionales de la salud en Brasil. Como una forma de promover el autocuidado, las Prácticas Integrativas y Complementarias se presentan como una estrategia para promover la salud mental de los trabajadores del área. Objetivo: Describir las experiencias de realización de acciones de promoción de la salud mental de los trabajadores de la salud en un hospital general en el interior del Rio Grande do Norte. Metodología: Se trata de un estudio de relato de experiencia, desarrollado a partir de la implementación de acciones de promoción de la salud mental de los trabajadores en el contexto de "Septiembre Amarillo" y "Enero Blanco", diseñado por el equipo de Residencia Multiprofesional en Salud Materno-Infantil de la Universidade Federal do Rio Grande do Norte. Resultados y Discusiones: Los profesionales fueron estimulados a reflexionar sobre el tema y relacionarlo con sus experiencias, discutiendo estrategias de autocuidado en el ambiente de trabajo. Hubo predominio de los profesionales de enfermeríaen relación a las demás categorías profesionales. Ellos dijeron que los momentos fueron agradables y lo sintieron como una oportunidad de relajación en el ambiente de trabajo, deseando que estos pudieran ocurrir con mayor frecuencia. Conclusiones: Las acciones desarrolladas y descritas demostraron ser estrategias importantes para la discusión y sensibilización sobre el tema, así como la pertinencia de las estrategias de promoción de la salud mental en los espacios ocupacionales del Sistema Único de Salud (AU).

Fitoterápicos e plantas medicinais na prática dos profissionais de saúde em Unidades de Estratégia Saúde da Família / Phytotherapies and medicinal plants in the practice of health professionals in Family Health Strategy units

Introdução: o uso da fitoterapia como alternativa terapêutica, tem aumentado, no entanto ainda existem lacunas no conhecimento sobre o tema, o que impede a completa adesão da prática por parte dos profissionais de saúde. Objetivos: este trabalho teve como objetivoverificar o conhecimento sobre a prática da fitoterapia por profissionais de saúde em unidades de Estratégia Saúde da Família (ESF). Metodologia: foi realizado umestudo quantitativo, transversal, com aplicação de questionário contendo perguntas sobre a fitoterapia. Além disso, foi também desenvolvida uma análise descritiva, com frequência relativa e absoluta e análise de correlação através do teste de qui-quadrado de Pearson, utilizando teste de regressão binomial e multinominal. Resultados: participaram da pesquisa, 156 profissionais de saúde, distribuídos em 20 ESF do município de Rondonópolis-MT, sendo 24 enfermeiros, 8 médicos, 7 odontólogos, 4 farmacêuticos, 6 psicólogos, 10 técnicos em enfermagem, 88 agentes comunitários de saúde, 7 técnicos em saúde bucal, 1 técnico de farmácia e 1 educador físico. Destaca-se que 58% não souberam explicar a diferença entre fitoterápicos e plantas medicinais, 52% não sabiam realizar orientações nem citar o nome de medicamentos proveniente das plantas (53%), 88% não fizeram curso ou disciplina na área. No entanto, 86% tem interesse em se qualificar no assunto. Dentre os profissionais prescritores, 72,1% afirmaram prescrever raramente ou não prescrever a fitoterapia em sua prática profissional. Conclusão: evidenciam-se falhas no conhecimento sobre a fitoterapia e a necessidade de capacitação aos profissionais que atuam nas ESF, de forma a se sentirem seguros para prescrever e orientar quanto aos riscos e benefícios do uso das plantas como alternativa terapêutica.

Introduction: the use of phytotherapy as a therapeutic alternativehas increased, however there are still gaps in knowledge on the subject, what stopping the full adherence to the practice by health professionals. Objectives: this work aimed to verify the knowledge about the practice of herbal medicine by health professionals in Family Health Strategy Units (FHS). Method: A quantitative study was carried out, cross-sectional study, with the application of a questionnaire containing questions about herbal medicine. In addition, a descriptive analysis was also carried out, using relative and absolute frequency and correlation analysis through Pearson's chi-square test, using binomial and multinomial regression test. Results: 156 health professionals participated in the research, distributed in 20 FHS in the city of Rondonópolis-MT, 24 nurses, 8 doctors, 7 dentists, 4 pharmacists, 6 psychologists, 10 nursing technicians, 88 community health agents, 7 technicians in oral health, 1 pharmacy technician and 1 physical educator. It is noteworthy that 58% could not explain the difference between herbal medicines and medicinal plants, 52% did not know how to provide guidance or mention the name of medicines derived from plants (53%), 88% did not take a course or discipline in the area. However, 86% are interested in qualifying in the subject. Among the prescribing professionals, 72.1% stated that they rarely or didn ́t prescribe phytotherapy in their professional practice. Conclusion: there is evidence of gaps in knowledge about herbal medicine and the need for training professionals working in the FHS, in order to feel safe to prescribe and guide about the risks and benefits of using plants as a therapeutic alternative.

Mejorando la elaboración de las hipótesis iniciales para el razonamiento clínico diagnóstico en estudiantes de kinesiología: una propuesta metodológica / Improving the development of initial hypotheses for clinical diagnostic reasoning in physical therapy students: a methodological proposal

El Razonamiento Clínico es un proceso fundamental para identificar los déficits en un paciente y formular un diagnóstico kinesiológico. El objetivo de este estudio es describir parte de la metodología y sus resultados, en el marco del curso de Razonamiento Clínico de la carrera de Kinesiología en la Universidad Finis Terrae, para mejorar el proceso de formulación de hipótesis iniciales para la evaluación kinesiológica. MUESTRA : MATERIALES Y MÉTODOS Los estudiantes fueron evaluados según la cantidad, coherencia y sintaxis de estas hipótesis iniciales, además de los dominios a los que pertenecían, al inicio y al final de la intervención que consistió en 3 actividades (2 clases presenciales y un informe de actividad de campo clínico). Las clases presenciales tenían como temas la Clasificación Internacional de la Funcionalidad, Salud y Enfermedad (CIF) de la OMS, y su rol en el razonamiento clínico diagnóstico; y la importancia de las hipótesis iniciales dentro del modelo hipotético deductivo de razonamiento y cómo escribirlas, junto con el uso de una herramienta (una "Tabla Hipocrática Modificada") para sistematizar la formulación de hipótesis iniciales con respecto a déficit en estructuras corporales. El informe de campo clínico integró todo lo anterior durante la evaluación de un paciente real. RESULTADOS La evaluación final mostró un aumento significativo en la cantidad (promedio ± DS inicial 10,1 ± 8,57, final 27 ± 9,23, p < 0,001) de hipótesis planteadas y en su coherencia con respecto a la información disponible. CONCLUSIÓN La sistematización descrita para la formulación de hipótesis diagnósticas en los estudiantes de kinesiología resulta en una mayor cantidad y calidad en sus hipótesis, validando esta metodología para la enseñanza inicial del razonamiento clínico diagnóstico en kinesiología

Clinical Reasoning is a fundamental process to identify deficits in a patient and state a diagnosis. The goal of this study is to describe part of the methodology and its results, within the framework of the Clinical Reasoning course of the Kinesiology career at Finis Terrae University, implemented to improve the process of formulating initial hypotheses for kinesiological evaluation. MATERIALS AND METHODS The students were evaluated according to the quantity, coherence and syntax of these initial hypotheses, in addition to the domains to which they belonged, at the beginning and at the end of the intervention that consisted of 3 activities (2 face-to-face classes and an activity report). The face-to-face classes had as topics the International Classification of Functioning, Health and Disease (ICF), WHO, and its role in diagnostic clinical reasoning; and the importance of initial hypotheses within the hypothetical deductive model of reasoning and how to write them, together with the use of a tool (a "Modified Hippocratic Table") to methodize the formulation of initial hypotheses regarding deficits in body structures. The report integrated all of the above during the evaluation of a real patient. RESULTS The final evaluation showed a significant increase in the quantity (mean ± initial SD 10.1±8.57, final 27±9.23, p < 0.001) of hypotheses raised and in their consistency to the available information. Conclusion: The Systematization described for formulating diagnostic hypotheses in kinesiology students results in a greater quantity and quality of their hypotheses, validating this methodology for the initial teaching of diagnostic clinical reasoning in kinesiology.

Utilización de medicinas tradicionales en la población que asiste a un hospital pediátrico de la Ciudad Autónoma de Buenos Aires / Use of traditional medicine in the population attending a children's hospital in the City of Buenos Aires

Introducción. Existen estudios que dan cuenta del uso extendido de la medicina tradicional (MT) en diversos países. La formación del pediatra es escasa en este campo. Objetivo. Describir las características de la MT utilizada por los pacientes de un hospital pediátrico de la Ciudad Autónoma de Buenos Aires. Población y métodos. Diseño cualitativo, basado en la teoría fundada. Entrevista a cuidadores de niños de 0 a 11 años. Resultados. Se entrevistaron 30 personas de diferentes colectividades, la gran mayoría mujeres amas de casa. Casi la totalidad refirió haber utilizado la MT. La fuente de recomendación más utilizada fue la familia. En general, el uso de la MT precede a la consulta a un médico del sistema de salud. Se acude a la MT por entidades definidas por la medicina convencional, pero también por otras propias, como pata de cabra, ojeo y empacho. Las prácticas terapéuticas incluyen la administración de preparados a base de plantas, infusiones, caldos, como también rituales conducidos por curanderos. Todos los usuarios refirieron una valoración positiva de la MT. Una gran parte de los entrevistados consideró importante que el médico conozca y pregunte sobre ella. Todos refirieron que su uso no fue abordado en consultas previas. Conclusiones. La MT se extiende como conocimiento y/o práctica en toda la población estudiada y forma parte de su vida cotidiana. Los métodos utilizados son muy diversos, así como las situaciones para las que se utiliza; las principales causas son de origen gastrointestinal y respiratoria. No es abordada en la consulta pediátrica, pero sus usuarios desearían que lo fuera.

Introduction. Several studies have reported on the widespread use of traditional medicine (TM) in different countries. Pediatricians receive scarce training in this field. Objective. To describe the characteristics of TM used by patients attending a children's hospital in the City of Buenos Aires. Population and methods. Qualitative design based on grounded theory. Interview with caregivers of children aged 0-11 years. Results. Thirty people from different communities were interviewed, mostly homemakers. Almost all referred having used TM. The most common source of recommendation was the family. In general, TM use precedes the visit to a physician in the health system. TM is used to manage conditions defined by conventional medicine, but also to treat folk illnesses such as Simeon's disease, evil eye, and indigestion. Therapeutic practices include plant-based preparations, infusions, broths, as well as other rituals performed by folk healers. All users had a positive opinion about TM. Most interviewees considered that physicians should know and ask about TM. All participants referred that its use had not been addressed in prior visits. Conclusions. TM spreads as knowledge and/ or practice across the studied population and is part of everyday life. TM methods vary greatly, as well as the conditions for which it is used; the main reasons for use included gastrointestinal and respiratory conditions. It is not addressed in pediatric visits, but users wish it was.

Lesiones bucales, factores de riesgo de cáncer bucal y autopercepción de irritación mecánica crónica en una campaña de prevención en la Ciudad de Buenos Aires / Oral lesions, oral cancer risk factors and self-perception of chronic mechanical irritation in a prevention campaign in Buenos Aires City

Objetivos: i) Describir las características poblaciona- les, la frecuencia de patologías de mucosa bucal y de factores de riesgo asociados al cáncer bucal en una Campaña de Pre- vención y Diagnóstico Precoz de Cáncer Bucal (CPDPCB) en la Ciudad de Buenos Aires; ii) establecer concordancia entre diagnóstico clínico profesional de irritación mecánica crónica (IMC) y autopercepción de trauma. Materiales y métodos: Se realizó un estudio descrip- tivo retrospectivo, en el que se utilizaron encuestas de 640 pa- cientes que participaron en las CPDPCB del Servicio de Odon- tología del Hospital Alemán entre los años 2016, 2017 y 2018. Se describen las variables demográficas, clínicas y cognitivas, y se analizan empleando chi cuadrado para variables cualitativas y ANOVA para variables cuantitativas comparando los años de campaña. Se realizó un estudio de concordancia entre el diag- nóstico clínico profesional de IMC y el trauma autopercibido mediante test Kappa, sensibilidad y especificidad. Resultados: Los sujetos participantes fueron predomi- nantemente mayores de edad, con bajo consumo de tabaco y alcohol. El porcentaje de pacientes con desórdenes potencial- mente malignos y cáncer bucal fue de 17,2%. La cartelería del hospital y la radio fueron las principales vías de información a los pacientes. El trauma autopercibido no presentó concor- dancia con el diagnóstico clínico profesional de IMC, y mos- tró sensibilidad de 0,41 y especificidad de 0,72. Conclusiones: El nivel de participación de los grupos de mayor riesgo de CBCE en la CPDPCB es bajo, y el perfil epidemiológico de los participantes no coincide generalmente con el perfil de los pacientes con CBCE. La autopercepción de trauma no sería una herramienta confiable para el diagnóstico de IMC (AU)

Aims: i) To describe population characteristics, frequency of oral mucosa pathologies, and risk factors for oral squamous cell carcinoma (OSCC) in a Campaign for the Prevention and Early Diagnosis of Oral Cancer (CPEDOC), and ii) to establish concordance between professional clinical diagnosis of chronic mechanical irritation (CMI) and self-perception of trauma. Materials and methods: A retrospective descriptive study was performed using surveys of 640 patients who had participated in the CPEDOC conducted by the Dentistry Ser- vice at the Hospital Alemán during 2016, 2017 and 2018. De- mographic, clinical and cognitive variables were described and analyzed, using chi-square for qualitative variables and ANOVA for quantitative variables, to compare campaign years. Concordance was studied between the professional clinical diagnosis of CMI and self-perceived trauma using the Kappa test, sensitivity and specificity. Results: Participants were predominantly older, with low consumption of tobacco and alcohol. The percentage of patients with potentially malignant disorders and oral cancer was 17.2%. Hospital posters and radio broadcasting were the main channels of information to patients. Self-perceived trauma did not agree with the professional clinical diagnosis of CMI. Self-perceived trauma sensitivity and specificity were 0.41 and 0.72, respectively. Conclusions: The level of participation in the CPEDOC by the groups at higher risk of OSCC was low, and the epide- miological profile of the participants did not generally coincide with the profile of patients with OSCC. Self-perception of trau- ma does not seem to be a reliable tool for the diagnosis of CMI (AU)

Impacto de la pandemia COVID-19 en pacientes con enfermedades desmielinizantes / IMPACT OF THE COVID-19 PANDEMIC ON PATIENTS WITH DEMYELINIZING DISEASES

Introducción: A más de un año del inicio de la pandemia, el seguimiento y la atención presencial de pacientes con enfermedades desmielinizantes se ha visto modificado. Según la evidencia, pacientes con diagnóstico de esclerosis múltiple (EM), síndrome desmielinizante aislado (SDA), Síndrome Radiológico Aislado (SRA) o enfermedades del espectro de neuromielitis óptica (NMO) no parecen ser un grupo de riesgo para COVID19 por el hecho de tener la enfermedad. La presencia de ciertas condiciones puede hacerlos susceptibles de cursar infección severa. Se ha descripto una asociación de curso grave con drogas anti CD20, faltan datos sobre la respuesta a vacunas COVID19 en esta población. Objetivos: Establecer características clínico-epidemiológicas de pacientes con enfermedades desmielinizantes que han padecido COVID-19 y describir su evolución. Caracterizar población vacunada, evaluar acceso al seguimiento médico/ terapéutico durante la pandemia. Materiales y métodos: Estudio observacional descriptivo. Se revisaron las historias clínicas de 168 pacientes con EM, SDA y SRA y 33 pacientes con NMO correspondientes al Hospital de Clínicas José de San Martin. Mediante encuesta telefónica se evaluó adherencia al tratamiento, evolución clínica, infección COVID-19, vacunación y acceso durante la pandemia. Resultados: Se encontraron 49 pacientes que desarrollaron COVID-19 en el grupo de pacientes con EM, y 7 en el grupo de NMO. Del primer grupo ninguno requirió internación, mientras que en el segundo, 2 fueron hospitalizados y uno de ellos falleció. La complicación post-COVID más frecuente fue: astenia prolongada y 3 pacientes presentaron un brote de la enfermedad de base en los 3 meses posteriores. Cerca del 90% de nuestra población ya contaba con al menos 1 dosis de vacuna para SARS-CoV2. Se interrogó sobre el acceso a la consulta neurológica y casi el 70% de los pacientes otorgó máximo puntaje al acceso a consultas virtuales. Conclusión: Los pacientes con enfermedades desmielinizantes que cursaron COVID-19 no tuvieron complicaciones severas por la infección, con solamente 2 pacientes cursando un brote en los 3 meses posteriores. No observamos reacciones adversas severas post vaccinales, ni infección posterior, sólo 2 pacientes presentaron un brote en el período post aplicación. Gran cantidad de pacientes percibieron acceso fluido a sus neurólogos de manera virtual, lo que podría relacionarse con alta tasa de adherencia a sus tratamientos a pesar de la limitación a la consulta presencial.

Introduction: More than a year after the start of the pandemic, the follow-up and face-to-face care of patients with demyelinating diseases has been modified. According to the evidence, patients with a diagnosis of multiple sclerosis (MS), isolated demyelinating syndrome (ADS), Isolated Radiological Syndrome (RAS) or neuromyelitis optica (NMO) spectrum diseases do not seem to be a risk group for COVID19 due to the fact that they have the disease. The presence of certain conditions can make them susceptible to severe infection. A severe course association with anti-CD20 drugs has been described, data on the response to COVID19 vaccines in this population are lacking. Objectives: To establish clinical-epidemiological characteristics of patients with demyelinating diseases who have suffered from COVID-19 and describe their evolution. Characterize the vaccinated population, evaluate access to medical/therapeutic follow-up during the pandemic. Materials and methods: Descriptive observational study. The medical records of 168 patients with MS, ADS and ARS and 33 patients with NMO corresponding to the Hospital de Clínicas José de San Martin were reviewed. Through a telephone survey, adherence to treatment, clinical evolution, COVID-19 infection, vaccination, and access during the pandemic were evaluated. Results: 49 patients who developed COVID-19 were found in the MS patient group, and 7 in the NMO group. Of the first group, none required hospitalization, unlike in the second, 2 were hospitalized and one of them died. The most frequent post-COVID complication was: prolonged asthenia and 3 patients presented an outbreak of the underlying disease in the following 3 months. Close to 90% of our population already had at least 1 dose of SARS-CoV2 vaccine. Access to the neurological consultation was questioned and almost 70% of the patients gave the highest score to access to virtual consultations. Conclusion: Patients with demyelinating diseases who had COVID-19 did not have severe complications from the infection, with only 2 patients having an outbreak in the subsequent 3 months. We did not observe severe post-vaccinal adverse reactions, nor subsequent infection, only 2 patients presented an outbreak in the post-application period. A large number of patients perceived fluid access to their neurologists virtually, which could be related to a high rate of adherence to their treatments despite the limitation to face-to-face consultation

Caracterización clínico-epidemiológica de la urolitiasis / Clinical-epidemiological description of urolithiasis

Introducción: Las urolitiasis ocasionan dolor, deterioro funcional renal y notorias erogaciones económicas. Objetivos: Identificar las características clínico-epidemiológicas de la nefrolitiasis. Métodos: Estudio descriptivo, transversal. Se estudiaron 2 923 personas pertenecientes a tres consultorios del Policlínico Plaza; municipio Plaza de la Revolución, provincia La Habana, Cuba., seleccionados por muestreo simple aleatorio de los 16 con que cuenta el área de salud. Los datos se obtuvieron mediante encuesta y entrevista estructurada. La información fue procesada de forma automatizada (IBMSPSS 22.0). Se utilizó análisis de distribución de frecuencias, se calcularon tasas de prevalencia, y fue empleado el test de homogeneidad. Resultados: La prevalencia de urolitiasis fue de 4,99 por cada 100 habitantes, de 6,3 entre los varones y de 5,7 en los de piel blanca. La edad promedio al diagnóstico fue de 39,3 años. Entre los factores de riesgo de litiasis predominó la alta ingestión de oxalatos (97,3 por ciento). La ecografía fue la forma de diagnóstico más usada (67,8 por ciento). La fitoterapia fue el tratamiento médico más utilizado (69,2 por ciento). Al 16,4 por ciento de los pacientes se les expidió certificado médico en los últimos dos años. Conclusiones: La prevalencia de litiasis urinaria en el Policlínico Docente Plaza de la Revolución es elevada, con predominio en el sexo masculino, en sujetos de piel blanca y en las edades medias de la vida. La alta ingestión de oxalato es el factor de riesgo de litiasis urinaria más frecuente encontrado. La forma de diagnóstico más utilizada es la ecografía y el tratamiento más empleado es la fitoterapia(AU)

Introduction: Urolithiasis causes pain, renal functional deterioration and notorious economic expenses. Objectives: To identify the clinical-epidemiological characteristics of nephrolithiasis. Methods: A descriptive, cross-sectional study was conducted in a total of 2,923 people from to three clinics of Plaza de la Revolution Teaching Community Clinic, Plaza de la Revolution municipality, Havana province, Cuba. They were selected by simple random sampling from the 16 clinics that the health area has. The data was obtained through a survey and structured interview. The information was processed automatically (IBMSPSS 22.0). Frequency distribution analysis was used, prevalence rates were calculated and the homogeneity test was used. Results: The prevalence of urolithiasis was 4.99 per 100 inhabitants, 6.3 among men and 5.7 among white-skinned men. The average age at diagnosis was 39.3 years. Among the risk factors for lithiasis, the high intake of oxalates prevailed (97.3 percent). Ultrasound was the most used form of diagnosis (67.8 percent). Phytotherapy was the most used medical treatment (69.2 percent). A medical permit was issued to 16.4 percent of the patients in the last two years. Conclusions: The prevalence of urinary lithiasis in Plaza de la Revolution Teaching Community Clinic is high, prevailing in males, in white-skinned and middle aged subjects. High oxalate intake is the most common risk factor for urinary lithiasis found. The most used form of diagnosis is ultrasound and the most used treatment is phytotherapy(AU)

Satisfacción de los servicios de medicina alópata vs la medicina tradicional en Oaxaca, México / Satisfaction with Allopathic Medicine Services versus Traditional Medicine in Oaxaca, Mexico

Introducción: Se ha reportado baja satisfacción con la atención recibida en el primer y el segundo nivel de atención de instituciones públicas. Existe incremento del uso de la medicina tradicional. Objetivo: Comparar el nivel de satisfacción percibida por los pacientes que acuden a los servicios de medicina alópata y medicina tradicional. Métodos: Estudio descriptivo, transversal y comparativo. La población estuvo constituida por pacientes que acudieron al Centro de Salud Urbano y curandero de medicina tradicional de la misma comunidad. El tamaño de la muestra fue de 344 personas, seleccionados por muestreo sistemático. Resultados: La media de edad fue de 40,6 años (DE=16,1), predominó el sexo femenino, los casados, con educación primaria y de religión católica. El padecimiento por el cual acudieron a los servicios de medicina alópata fue por consulta familiar y en la medicina tradicional por espanto. Se encontraron diferencias significativas entra la satisfacción medicina tradicional y alópata. Los pacientes reportan mayor satisfacción en los servicios de medicina tradicional. Conclusiones: Los pacientes perciben mayor satisfacción en la explicación, trato y tratamiento médico en la medicina tradicional(AU)

Introduction: Low satisfaction with the care received at the first and second levels in public institutions has been reported. There is an increase in the use of traditional medicine. Objective: To compare the level of satisfaction perceived by patients attending allopathic and traditional medicine services. Methods: Descriptive, cross-sectional and comparative study. The population consisted of patients attending the Urban Health Center and traditional medicine healer in the community of Oaxaca. The sample size was 344 people, selected by systematic sampling. Results: The mean age was 40.6 years (SD=16.1). There was a predominance of the female sex, married persons, with primary education and Catholic religion. The condition for which they sought allopathic medicine services was that they received family advice and, in traditional medicine, for fear. Significant differences were found between satisfaction with traditional and allopathic medicine. Patients report greater satisfaction in traditional medicine services. Conclusions: Patients perceive greater satisfaction in the explanation, treatment and medical treatment in traditional medicine(AU)

La sudoración compensatoria como efecto secundario en la cirugía de la hiperhidrosis palmar primaria / Compensatory Sweating as a Side Effect of Surgical Treatment of Primary Palmar Hyperhidrosis

Introducción: La sudoración compensatoria es un efecto secundario de la simpaticotomía videotoracoscópica, que tiene una alta incidencia y puede provocar insatisfacción en los pacientes operados. Objetivo: Determinar el comportamiento de la sudoración compensatoria en los pacientes en que se les realizó una simpaticotomía videotoracoscópica por hiperhidrosis palmar. Métodos: Se realizó un estudio retrospectivo, transversal y descriptivo de 42 pacientes que tras la cirugía por hiperhidrosis palmar presentaron sudor compensatorio. Se analizó la incidencia, localización, severidad, afectación de la calidad de vida y nivel de satisfacción. Resultados: Predominó la sudoración compensatoria ligera, la localización en la espalda y el abdomen. Hubo un alto nivel de tolerancia, con solo un paciente insatisfecho y un 100 por ciento de mejoría de la calidad de vida. Conclusiones: La sudoración compensatoria no influyó negativamente en la calidad de vida de los pacientes(AU)

Introduction: Compensatory sweating is a side effect of videothoracoscopic sympathectomy. It presents high incidence and may cause dissatisfaction to operated patients. Objective: To determine the characteristics of compensatory sweating in patients who underwent videothoracoscopic sympathectomy for palmar hyperhidrosis. Methods: A retrospective, cross-sectional and descriptive study was carried out with 42 patients who presented compensatory sweating after surgery for palmar hyperhidrosis. Incidence, location, severity, change in quality of life and level of satisfaction were analyzed. Results: Light compensatory sweating predominated, with location on back and abdomen. There was a high level of tolerance, with only one dissatisfied patient and 100 percent of improvement in quality of life. Conclusions: Compensatory sweating did not influence negatively the patients' quality of life(AU)

Implicações para homens do afastamento do(a) filho(a) devido medida protetiva de urgência / Impacto en los hombres del distanciamiento del(la) hijo(a) debido a medida protectora de urgencia / Implications for men of separation from their children due to emergency protective measure

Resumo Objetivo Desvelar as implicações para os homens do afastamento pai-filho(a) em decorrência de medida protetiva por violência conjugal. Métodos Estudo descritivo exploratório, abordagem qualitativa, desenvolvido com nove homens que respondiam a processo judicial por violência conjugal junto às 1ª e 2ª Varas de Justiça pela Paz em Casa de Salvador, Bahia, Brasil. A pesquisa ocorreu por meio da entrevista semiestruturada, tendo seu conteúdo gravado, transcrito e, em seguida, submetido à validação pelos homens. Os dados foram sistematizados com base nos passos preconizados pela análise de conteúdo temática categorial. Resultados O estudo revela que o afastamento pai-filho em decorrência da medida protetiva de urgência suscita no rompimento do vínculo paterno, fomentando o desenvolvimento de problemas psicoemocionais, como ansiedade, depressão e ideação suicida, muitas vezes somatizados e expressos desde cefaleia até condições que necessitam de cuidados hospitalares. Conclusão O comprometimento do exercício da paternidade viola também o direito de crianças e adolescentes ao convívio com a figura paterna. Deste modo, há grande necessidade de que a Política Nacional de Atenção Integral à Saúde dos Homens contemple uma gestão que priorize ações preventivas para a violência, assim como desempenhe acompanhamento psicossocial aos homens.

Resumen Objetivo Revelar el impacto en los hombres del distanciamiento padre-hijo(a) como consecuencia de medidas protectoras por violencia conyugal. Métodos Estudio descriptivo exploratorio, enfoque cualitativo, llevado a cabo con nueve hombres que respondían a juicio por violencia conyugal en el 1º y 2º Juzgado de Justicia por la Paz en Casa de Salvador, estado de Bahia, Brasil. La investigación se realizó a través de encuesta semiestructurada, con grabación y transcripción del contenido, y luego sometido a su validación por los hombres. Los datos fueron sistematizados con base en los pasos preconizados por el análisis de contenido temático de la categoría. Resultados El estudio revela que el distanciamiento padre-hijo como consecuencia de medidas protectoras de urgencia provoca la ruptura del vínculo paterno y fomenta el desarrollo de problemas psicoemocionales, como ansiedad, depresión e ideación suicida, muchas veces somatizados y expresados desde una cefalea hasta condiciones que necesitan cuidados hospitalarios. Conclusión El comprometimiento del ejercicio de la paternidad también viola el derecho de niños y adolescentes a convivir con la figura paterna. De este modo, hay una gran necesidad de que la Política Nacional de Atención Integral a la Salud de los Hombres contemple una gestión que establezca prioridades en acciones preventivas contra la violencia, así como también realice un seguimiento psicosocial de los hombres.

Abstract Objective To unveil the implications for men of father-son estrangement as a result of a protective measure for conjugal violence. Methods This is an exploratory descriptive study, with a qualitative approach, developed with nine men who were responding to a lawsuit for conjugal violence at the 1st and 2nd Courts of Justice of the Peace in Casa de Salvador, Bahia, Brazil. The research took place through a semi-structured interview, with its content recorded, transcribed and then submitted for validation by the men. Data were systematized based on the steps recommended by the categorical thematic content analysis. Results The study reveals that the father-son estrangement as a result of an emergency protective measure causes paternal bond rupture, promoting the development of psycho-emotional problems, such as anxiety, depression and suicidal ideation, often somatized and expressed from headache to conditions that require hospital care. Conclusion The commitment to the exercise of paternity also violates the right of children and adolescents to live with their father figure. Thus, there is a great need for the Brazilian National Policy for Comprehensive Care for Men's Health to include a management that prioritizes preventive actions against violence as well as providing psychosocial support to men.

Comportamentos promotores de saúde por cuidadores informais de idosos: revisão integrativa / Comportamientos de cuidadores informales de adultos mayores que promocionan la salud: revisión integradora / Health promoting behaviors by informal caregivers of older adults: an integrative review

Resumo Objetivo Analisar as evidências científicas sobre os comportamentos promotores de saúde adotados por cuidadores informais de pessoas idosas. Métodos Revisão integrativa realizada nas seguintes bases: Medical Literature Analysis and Retrieval System on-line, SCOPUS, Web of Science, Índice Bibliográfico de Ciências da Saúde, Banco de Dados de Enfermagem e Literatura Latino Americana e do Caribe em Ciências da Saúde. Foram levantados 12 estudos primários que constituíram a amostra, sem delimitação de tempo ou de idioma. Utilizou-se o método descritivo para análise e síntese dos resultados. Resultados Os comportamentos promotores de saúde desenvolvidos pelos cuidadores informais de pessoas idosas constituíram recursos favoráveis à manutenção das suas condições globais de saúde, ao seu bem-estar, à melhoria da qualidade de vida e à satisfação pessoal enquanto cuidador. Dentre as práticas evidenciadas, destacaram-se a busca por informações, aconselhamento familiar, apoio e suporte social, emocional e espiritual. Ainda, a adesão aos programas comunitários voltados para psicoeducação e às atividades físicas, bem como o uso de tecnologias de comunicação e a valorização do autocuidado se destacaram como estratégias associadas ao enfrentamento das repercussões negativas decorrentes do cuidar. Conclusão Foram evidenciados comportamentos promotores da saúde capazes de favorecer a qualidade de vida e o bem-estar físico, mental e social do cuidador informal de pessoas idosas. Estudos dessa natureza podem despertar a necessidade de políticas públicas e de linhas integrais de cuidados voltados para promoção da saúde do cuidador.

Resumen Objetivo Analizar las evidencias científicas sobre los comportamientos que promocionan la salud adoptados por cuidadores informales de adultos mayores. Métodos Revisión integradora realizada en las siguientes bases: Medical Literature Analysis and Retrieval System on-line, SCOPUS, Web of Science, Índice Bibliográfico de Ciencias de la Salud, Banco de Datos de Enfermería y Literatura Latinoamericana y del Caribe en Ciencias de la Salud. Se verificaron 12 estudios primarios que constituyeron la muestra, sin delimitación de tiempo o de idioma. Se utilizó el método descriptivo para el análisis y la síntesis de los resultados. Resultados Los comportamientos que promocionan la salud, desarrollados por los cuidadores informales de adultos mayores constituyeron recursos favorables para el mantenimiento de sus condiciones globales de salud, para su bienestar, para la mejora de la calidad de vida y para la satisfacción personal como cuidador. Entre las prácticas evidenciadas, se destacaron la búsqueda por informaciones, consejería familiar, apoyo y soporte social, emocional y espiritual. De igual forma, la adhesión a los programas comunitarios direccionados a la psicoeducación y a las actividades físicas, así como el uso de tecnologías de comunicación y la valoración del autocuidado se destacan como estrategias asociadas al enfrentamiento de las repercusiones negativas resultantes del cuidar. Conclusión Se evidenciaron comportamientos que promocionan la salud, capaces de favorecer la calidad de vida y el bienestar físico, mental y social del cuidador informal de adultos mayores. Estudios de esa naturaleza pueden despertar la necesidad de políticas públicas y de líneas integrales de cuidados direccionados a la promoción de la salud del cuidador.

Abstract Objective To analyze the scientific evidence on health promoting behaviors adopted by informal caregivers of older adults. Methods This is an integrative review carried out on the following bases: Online Medical Literature Analysis and Retrieval System, SCOPUS, Web of Science, Health Sciences Bibliographic Index, Nursing Database and Latin American and Caribbean Health Sciences Literature. Twelve primary studies were surveyed that constituted the sample, without time or language limitations. The descriptive method was used for analysis and synthesis of results. Results Health promoting behaviors developed by informal caregivers of older adults constituted resources favorable to the maintenance of their overall health conditions, their well-being, the improvement of quality of life and personal satisfaction as a caregiver. Among the practices evidenced, the search for information, family counseling, support and social, emotional and spiritual support stood out. Also, compliance with community programs aimed at psychoeducation and physical activities, as well as the use of communication technologies and the enhancement of self-care stood out as strategies associated with coping with the negative repercussions resulting from care. Conclusion Health promoting behaviors capable of favoring quality of life and physical, mental and social well-being of informal caregivers of older adults were evidenced. Studies of this nature may arouse the need for public policies and comprehensive lines of care aimed at promoting caregivers' health.

Perfil epidemiológico de usuários encaminhados para atendimento fonoaudiológico em um município do Rio Grande do Sul / Epidemiological profile of users referred to speech therapy in a municipality in Rio Grande do Sul

RESUMO Objetivo Caracterizar o perfil epidemiológico de usuários encaminhados para atendimento fonoaudiológico no município de Canoas (RS). Métodos Estudo epidemiológico, transversal e descritivo. A pesquisa foi feita a partir de dados do Sistema Integrado de Gestão de Serviços de Saúde de Canoas (RS), com coleta da lista de espera para atendimento fonoaudiológico, sob controle da Diretoria de Regulação Municipal. Resultados a lista de espera contemplou 850 encaminhamentos para Fonoaudiologia, datando de 18/01/2018 até 27/08/2021. O maior número de encaminhamentos foi de crianças de 4 a 7 anos de idade, com 244 (28%), sendo 484 usuários do gênero masculino (56,9%), 702 brancos (82,6%) e encaminhados pela atenção primária (totalizando 76,2%). O tempo de espera na lista da regulação teve média de um ano e seis meses e variou com 186 usuários aguardando entre 7-12 meses (21,8%), 168 usuários aguardando entre 0,6 meses (19,7%) e 167 usuários aguardando entre 25-30 meses (19,6%). As queixas principais foram de linguagem e fala (60,2%). Conclusão Observou-se um represamento da demanda para atendimento fonoaudiológico pelo Sistema Único de Saúde em Canoas (RS), com baixa rotatividade e tempo de espera longo para reabilitação dos usuários, em sua maioria crianças. A partir deste estudo, espera-se auxiliar na identificação dessa demanda e, assim, possibilitar a criação de políticas públicas de habilitação ou reabilitação no município e melhorar o acesso da população ao atendimento especializado

ABSTRACT Purpose This research aimed to characterize the epidemiological profile of users referred to speech therapy in the city of Canoas/RS. Methods This is an epidemiological, cross-sectional and descriptive study. The research was based on data from the Canoas/RS. Integrated Health Services Management System (SIGSS), with collection of the waiting list for speech therapy, under the control of the Municipal Regulation Board. Results The waiting list included 850 referrals to Speech Therapy, dating from 01/18/2018 to 08/27/2021. The highest number of referrals was from children aged 4 to 7 years, with 244 (28%), 484 male users (56.9%), 702 white (82.6%) and referred by primary care (totaling 76, two%). The waiting time on the regulation list averaged 17.89 months (one year and six months) and varied with 186 users waiting between 7-12 months (21.8%), 168 users waiting between 0.6 months (19.7%) and 167 users waiting between 25-30 months (19.6%). The main complaints were language and speech (60.2%). Conclusion According to the data found, there was a damming of the demand for speech therapy care by the SUS in Canoas/RS., with low turnover and long waiting time for the rehabilitation of users, mostly children. This study is expected to help in the identification of this demand, and thus, enable the creation of public policies of habilitation or rehabilitation in the municipality and improve the population's access to specialized care.

Descriptive epidemiology of external structural birth defects in Enugu State, Nigeria

Objectives: To determine the birth prevalence, trend, and characteristics of external structural birth defects occurrence in Enugu Metropolis, Nigeria. Design: Cross-sectional study involving review of delivery records. Setting: The study was conducted at three tertiary hospitals, one public and two missionary, in Enugu Metropolis. Participants: Mothers and their babies delivered between 1 January 2009 and 31 December 2016 in the study facilities. Main outcome measures: Birth prevalence of defects presented as frequency/10,000 births. Other descriptive variables are presented as frequencies and percentages. Results: There were 21530 births with 133 birth defects (birth prevalence: 61.8/10,000 births) and 1176 stillbirths (stillbirth rate: 54.6/1000 births). The frequencies and birth prevalence (/10,000 births) of recorded defects were: Limb deformities 60(27.9), Neural tube defects (NTDs): 36(16.7), Urogenital system defects: 12(5.6), Gastrointestinal system defects 10(4.6) and Orofacial clefts 4(1.9). Birth defects occurrence showed a rising trend from 2009 to 2016. The mean (SD) age of mothers whose babies had Birth defects was 29.1(4.7) years. Only 62(46.6%) of 133 antenatal clinic folders of these women were traceable for further review. Eighteen (29.0%) had febrile illness in early pregnancy, 9(14.5%) had Malaria, 17(27.4%) had <4 antenatal clinic attendance, 7(11.3%) did not take folic acid and 6(9.7%) took herbal medications during pregnancy. Conclusions: Birth defects occurrence showed a rising trend with limb deformities and NTDs having the highest prevalence. Record keeping was poor at the facilities. Birth defects preventive interventions like folic acid supplementation for women-of-childbearing age should be promoted in Enugu Metropolis.

Polifarmacia en Chile: una investigación descriptiva / Polipharmacy in Chile: a descriptive research

La polifarmacia es un término que, si bien no existe un consenso, se considerará como el uso concomitante de cinco o más medicamentos ya sean recetados o no por un profesional. Con respecto a ésta, se ha visto que se ha acrecentado en los últimos años tanto en Chile como en el mundo. En la presente investigación descriptiva se realizó un análisis de la Encuesta Nacional de Salud de Chile (ENS) 2016-17 y se comparó con los resultados obtenidos en la Encuesta Nacional de Salud 2009-10 y con la Encuesta sobre Salud, Envejecimiento y Jubilación Europea para de esta forma realizar un recuento objetivo sobre el aumento de esta condición en Chile. Al caracterizar a los grupos más afectados, se vio que en Chile la mayor prevalencia se daba en población adulta mayor sobre 65 años, mujeres y personas con escolaridad menor a 8 años cursados. Esto da cuenta del nivel del problema y la necesidad de una visión médica holística para el especial abordaje de la multimorbilidad, pues la polifarmacia trae consigo a su vez riesgos para la salud como lo son el aumento de las reacciones adversas e interacciones medicamentosas, riesgo de hospitalización, mayor deterioro del estado funcional, incremento de alteraciones cognitivas y mayores costos monetarios para el sistema de salud.

Polypharmacy is a term that, although there is no official definition, is understood as the concomitant use of five or more medications, regardless of whether they are prescribed by a professional. Regarding this phenomenon, an increase can be observed in recent years both in Chile and on a global level. This present descriptive research draws on an analysis of the National Health Survey (ENS) from 2016-17 and a comparison with the National Survey of Health from 2009-10 and with Survey of Health, Ageing and Retirement in Europe in order to carry out an objective count on the increase of this phenomenon. When characterizing the most affected groups, this paper shows that in Chile the highest prevalence can be found in the older adult population over 65 years of age, women and people with less than 8 years of schooling. These results reveal the dimension of the issue, and the need for a holistic medical vision to pay particular attention to multiple morbidities since polypharmacy brings with it health risks such as increased adverse reactions and drug interactions, risk of hospitalization, further deterioration of functional status, increase in cognitive alterations and higher monetary costs for the health system