Effects of primary health care and socioeconomic aspects on the dispersion of COVID-19 in the Brazilian Northeast: Ecological study of the first pandemic wave.

BACKGROUND: The COVID-19 pandemic has had a negative impact on socioeconomic and public health conditions of the population. AIM: To measure the temporal evolution of COVID-19 cases in cities near the countryside outside metropolitan areas of northeastern Brazil and the impact of the primary care organization in its containment. METHODS: This is a time-series study, based on the first three months of COVID-19 incidence in northeastern Brazil. Secondary data were used, the outcome was number of COVID-19 cases. Independent variables were time, coverage and quality score of basic health services, and demographic, socioeconomic and social isolation variables. Generalizable Linear Models with first order autoregression were applied. RESULTS: COVID-19 spreads heterogeneously in cities near the countryside of Northeastern Brazilian cities, showing associations with the city size, socioeconomic and organizational indicators of services. The Family Health Strategy seems to mitigate the speed of progression and burden of the disease, in addition to measures such as social isolation and closure of commercial activities. CONCLUSION: The spread of COVID-19 reveals multiple related factors, which require coordinated intersectoral actions in order to mitigate its problems, especially in biologically and socially vulnerable populations.

Temporomandibular disorders: knowledge, competency, and attitudes of predoctoral dental students.

OBJECTIVE: To evaluate knowledge, competency, and attitudes related to temporomandibular disorders (TMD) among predoctoral dental students, and to investigate the curricular organization of contents related to TMD and occlusion. METHODS: Predoctoral dental students (n = 147) answered a questionnaire with topics related to TMD. Another questionnaire evaluated the organization of TMD and occlusion courses. RESULTS: Contents related to TMD and occlusion were taught in the same course in all dental schools. The students' responses showed low agreement with the current gold standards pertaining to TMD. Most students declared that they did not feel confident to treat patients with TMD (62.6%), were not satisfied with the content pertaining to TMD (55.8%), and considered a lack of clinical practice to be the primary limitation in their training (59.2%). DISCUSSION: Students' knowledge of basic concepts related to TMD was limited, highlighting the need for readjustment of the dental curriculum to increase clinical experience.

Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil.

This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0-50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23-1.68/PR = 1.38; CI95% 1.08-1.75), having informal social support (PR = 1.26; CI95% 1.10-1.44/PR = 1.19; CI95% 1.05-1.34), A social class (PR = 0.43; CI95% 0.25-0.73/PR = 0.46; CI95% 0.26-0.80), high schooling (PR = 0.34; CI95% 0.23-0.51/PR = 0.33; CI95% 0.24-0.46) as well as paid work (PR = 0.87; CI95% 0.78-0.96/PR = 0.89; CI95% 0.79-0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28-1.57), no having some disability (PR = 1.31; CI95% 1.03-1.66) and having private health insurance (PR = 1.26; CI95% 1.13-1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05-1.42), not be white (PR = 0.85; CI95% 0.77-0.95) and not having restful sleep (PR = 1.23; CI95% 1.08-1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.

COVID-19 in Brazilian cities: Impact of social determinants, coverage and quality of primary health care.

BACKGROUND: Brazil, as many other countries, have been heavily affected by COVID-19. This study aimed to analyze the impact of Primary health care and the family health strategy (FHS) coverage, the scores of the National Program for Improving Primary Care Access and Quality (PMAQ), and socioeconomic and social indicators in the number of COVID-19 cases in Brazilian largest cities. METHODS: This is an ecological study, carried out through the analysis of secondary data on the population of all Brazilian main cities, based on the analysis of a 26-week epidemiological epidemic week series by COVID-19. Statistical analysis was performed using Generalized Linear Models with an Autoregressive work correlation matrix. RESULTS: It was shown that greater PHC coverage and greater FHS coverage together with an above average PMAQ score are associated with slower dissemination and lower burden of COVID-19. CONCLUSION: It is evident that cities with less social inequality and restrictions of social protection combined with social development have a milder pandemic scenario. It is necessary to act quickly on these conditions for COVID-19 dissemination by timely actions with high capillarity. Expanding access to PHC and social support strategies for the vulnerable are essential.

Dissemination of COVID-19 in inland cities of Northeastern Brazil.

BACKGROUND: SARS-CoV-2 causes the new coronavirus disease (COVID-19) and it is weakening all health systems. Therefore, the most vulnerable populations are exposed to harmful consequences, such as illness and death. Thus, this study aims to estimate the temporal effect of COVID-19 dissemination on social indicators of the Northeastern region of Brazil. METHODS: An ecological time-series study was developed with the following: diagnosed cases of COVID-19 in the largest inland cities of Northeast Brazil, Human Development Index (HDI), poverty incidence, and Gini coefficient. Cities with high HDI, poverty rate, and Gini presented a larger number of patients. RESULTS: It was observed by evaluating case trends that COVID-19 spreads unevenly in inland cities of the Northeastern region of Brazil. CONCLUSIONS: In this sense, we emphasize that regional health managers should support small cities with vulnerable population and social assistance.

Primary health care and social isolation against COVID-19 in Northeastern Brazil: Ecological time-series study.

BACKGROUND: Brazil is witnessing a massive increase of corona virus disease (COVID-19). Its peculiar primary health care (PHC) system faces a burden due to the contagion occurring in the community environment. Then, the aim is to estimate the effect of the coverage of primary health care and social isolation on the evolution of confirmed cases and deaths by COVID-19, controlling sociodemographic, economic and health system aspects. METHODS: A time series design was designed with data on diagnosed cases of COVID-19 and their deaths as outcomes in the capital cities of the Northeast region of Brazil. Independent variables such as PHC coverage, hospital beds, social isolation, demographic density, Gini index and other indicators were analyzed. A Autoregressive Generalized Linear Model method was applied for model the relationship. RESULTS: We identified an exponential growth of cases (y = 0.00250.71x; p-value<0,001). However, there is a high variability in the occurrence of outcomes. PHC coverage≥75% (χ2 = 9.27; p-value = 0.01) and social isolation rate (χ2 = 365.99; p-value<0.001) proved to be mitigating factors for the spread of COVID-19 and its deaths. Capitals with hospital beds ≥ 3.2 per thousand inhabitants had fewer deaths (χ2 = 9.02; p-value = 0.003), but this was influenced by PHC coverage (χ2 = 30,87; p-value<0.001). CONCLUSIONS: PHC mitigates the occurrence of Covid-19 and its deaths in a region of social vulnerability in Brazil together with social isolation. However, it is not known until when the system will withstand the overload in view of the low adhesion to social isolation, the lack of support and appropriate direction from the government to its population.

Human anatomy education and management of anatomic specimens during and after COVID-19 pandemic: Ethical, legal and biosafety aspects.

COVID-19 is an infection caused by the SARS-CoV-2 virus, initially identified in the city of Wuhan, China, in December 2019. Since then, the virus has spread to the continents, causing a major pandemic. The impacts of this pandemic on the education of human anatomy interfere in at least two aspects: (1) receiving and managing anatomical specimens in anatomy laboratories and (2) adaptations for classes on remote virtual teaching. Therefore, this study reviewed and discussed the legal and bioethical aspects, considering the scenario of a South American Country, aiming to stimulate the debate on these two relevant themes in the international community. Because of the COVID-19 pandemic and the impossibility of mass testing, anatomists and other workers in the field must deal with the risk of receiving bodies infected with SARS-CoV-2. In this situation, additional care measures in biosafety practices are essential to protect the staff. Such measures are: the bodies must be preserved by the perfusion of formaldehyde or other fixative solutions; embalming must be performed in ventilated rooms with a good air exhaust system; to avoid excessive manipulation of bodies and procedures such as pulmonary insufflation or craniotomy; and proper use of personal protective equipment, including lab coat, gloves and masks. As for exposure of body images in online classes, this review showed that there are no legal impediments to this end. However, anatomists must adopt measures aimed at protecting the memory of the deceased, such as using secure digital platforms with restricted access; family authorization/consent and student awareness.

Sleep quality is associated with Disability and Quality of life in breast cancer survivors: a cross-sectional pilot study.

PURPOSE: To evaluate the sleep quality and its association with disability, fatigue and quality of life of breast cancer survivors. METHODS: This is a cross-sectional pilot study developed with breast cancer survivors. The data collection instruments consisted of general and clinical information on the disease and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0); Pittsburgh Sleep Quality Index (PSQI); Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F); and Disabilities of the arm and Shoulder (DASH). Descriptive statistical analysis, correlation tests, tests for means comparison and linear regression were performed. Cohen's d analysed the effect size. The significance was set at p < 0.05. RESULTS: 71,9% of women had poor sleep quality. Subjective poor sleep quality was a predictor of worse scores for fatigue (p = 0.007), quality of life by FACT-G (p = 0.010) and FACIT-F (p = 0.004), the functional performance of upper limbs (p = 0.001) and disability (p = 0.003). CONCLUSIONS: Breast cancer survivors with subjective poor sleep quality had more fatigue, less upper limb-related functional performance, more disability and worse quality of life.

ANATOMICAL VARIATIONS OF THE SUPERIOR MESENTERIC ARTERY AND ITS CLINICAL AND SURGICAL IMPLICATIONS IN HUMANS.

INTRODUCTION: Superior mesenteric artery (SMA) usually arises from the abdominal aorta, just below the celiac trunk and it supplies the midgut-derived embryonic structures. Anatomical variations in this vessel contribute to problems in the formation and/or absorption of this part of the intestine and its absence has been recognized as the cause of congenital duodenojejunal atresia. OBJECTIVE: To analyze SMA anatomical variations in humans and the possible associated clinical and surgical implications. METHODS: This is a systematic review of papers indexed in PubMed, SciELO, Springerlink, Science Direct, Lilacs, and Latindex databases. The search was performed by two independent reviewers between September and December 2018. Original studies involving SMA variations in humans were included. SMA presence/absence, level, place of origin and its terminal branches were considered. RESULTS: At the end of the search, 18 studies were selected, characterized as for the sample, method to evaluate the anatomical structure and main results. The most common type of variation was when SMA originated from the right hepatic artery (6.13%). Two studies (11.11%) evidenced the inferior mesenteric artery originating from the SMA, whereas other two (11.11%) found the SMA sharing the same origin of the celiac trunk. CONCLUSION: SMA variations are not uncommon findings and their reports evidenced through the scientific literature demonstrate a great role for the development of important clinical conditions, making knowledge about this subject relevant to surgeons and professionals working in this area.

Photobiostimulation activity of different low-level laser dosage on masticatory muscles and temporomandibular joint in an induced arthritis rat model.

This study aimed to investigate the anti-inflammatory effects of different dosage of low-level laser therapy (LLLT) in an experimental model of temporomandibular joint (TMJ) arthritis. One hundred male Wistar rats were used and divided into the following groups: CG, control group; AG, animals group with left TMJ arthritis induced by intra-articular injection of Complete Freund's adjuvant - CFA; LG5, LG10 and LG20 - animals with arthritis and treated with LLLT at doses 5, 10, and 20 J/cm2, respectively. Morphological analysis was performed by TMJ histological sections stained with hematoxylin-eosin (HE), picrosirius (PSR), and toluidine blue (TB), as well as histomorphometric evaluation of cartilage, articular disc, and masticatory muscles. The amount of feed consumed within 3 weeks was evaluated, and biochemical analysis of TMJ tissues included measurement of sulfated glycosaminoglycans (GAGs), matrix metalloproteinases (MMPs) 2 and 9 zymography, and ELISA for cytokines IL-6, TNF-α, and IL-1ß. Only the 20 J/cm2 dose promoted higher feed intake compared to AG. On the other hand, all LLLT doses promoted better organization of articular disc collagen fibers, greater number of proteoglycans in articular cartilage, increased area and diameter of left lateral pterygoid fibers, reduced latent and active MMP 9 and 2 activity, and lower IL-1ß concentration compared to AG. Considering the study limitations, it was observed that LLLT treatments were effective in protecting and tissue cleansing joint structures, accelerating tissue repair, especially at lower doses.

Prevalência da Deficiência e Associações Clínicas em Mulheres Sobreviventes ao Câncer de Mama: um Estudo-Piloto / Prevalence of Disability and Clinical Associations in Breast Cancer Women Survivors: a Pilot Study / Prevalencia de Discapacidad y Asociaciones Clínicas en Mujeres que Sobreviven al Cáncer de Mama: un Estudio Piloto

Introdução: O tratamento do câncer de mama proporciona aumento da sobrevida e reduz a mortalidade, mas traz limitações funcionais e efeitos colaterais que comprometem a sobrevida. Objetivo: Avaliar a prevalência da deficiência e sua associação com capacidade física, sono, fadiga e qualidade de vida em mulheres sobreviventes ao câncer de mama. Método: Trata-se de um estudo-piloto envolvendo 32 mulheres com, pelo menos, um ano após o tratamento clínico. Os dados da pesquisa foram obtidos por meio de questionários e um teste de caminhada de seis minutos. Resultados: A prevalência de deficiência na amostra foi >90%. O World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) revelou boa consistência interna (α=0,874). A deficiência correlacionou-se forte e positivamente com cognição (rs=0,758), mobilidade (rs=0,709), atividade domésticas/trabalho (rs=0,718) e participação (r=0,701); e moderada e negativamente com fadiga (r=-0,621) e o Functional Assessment of Cancer Therapy-Fatigue (FACT-F) (r=-0,672); e positivamente com o Disabilities of the Arm and Shoulder (DASH) (r=0,639). Comparando-se os grupos de deficiência, observou-se diferença significativa com piores escores para o DASH (d=1,62), FACT-F (d=1,47), fadiga (d=1,21) e o índice de qualidade do sono de Pittsburgh (PSQI) (d=0,98). Conclusão: Mulheres sobreviventes ao câncer de mama apresentaram algum nível de deficiência associada à fadiga, à pior qualidade do sono e à qualidade de vida, demonstrando impactos importantes na saúde dessas mulheres

Introduction: The treatment of breast cancer improves survival and reduces mortality, but brings functional limitations and side effects that compromise survival. Objective: To evaluate the prevalence of disability and its association with physical capacity, sleep, fatigue and quality of life in women surviving breast cancer. Method: Pilo study involving 32 women at least one year after clinical treatment. The study data were obtained through questionnaires and a six-minute walk test. Results: The prevalence of disability in the sample was >90%. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) revealed good internal consistency (α=0.874). Disability correlated strongly and positively with cognition (rs=0.758), mobility (rs=0.709), household/work activity (rs=0.718) and participation (r=0.701) and moderately and negatively with fatigue (r=-0.621) and Functional Assessment of Cancer Therapy-Fatigue (FACT-F) (r=-0.672) and positively with the Disabilities of the Arm and Shoulder (DASH) (r=0.639). Comparing the disability groups, a significant difference was observed with worse scores for DASH (d=1.62), FACT-F (d=1.47), fatigue (d=1.21) and the Pittsburgh Sleep Quality Index (PSQI) (d=0.98). Conclusion: Women who survived breast cancer had some level of disability associated to fatigue, poor sleep quality and quality of life, demonstrating important impacts on the health of these women

Introducción: El tratamiento del cáncer de seno mejora la supervivencia y reduce la mortalidad, pero aún conlleva limitaciones funcionales y efectos secundarios que comprometen la supervivencia. Objetivo: Evaluar la prevalencia de discapacidad y su asociación con la capacidad física, el sueño, la fatiga y la calidad de vida en mujeres sobrevivientes de cáncer de seno. Método: Este es un estudio piloto con 32 mujeres al menos un año después del tratamiento clínico. Los datos de la encuesta se obtuvieron mediante cuestionarios y una prueba de caminata de seis minutos. Resultados: La prevalencia de discapacidad en la muestra fue >90%. El Programa de Evaluación de Discapacidad de la Organización Mundial de la Salud 2.0 (WHODAS 2.0) reveló una buena consistencia interna (α=0,874). La discapacidad se correlacionó fuertemente y positivamente con la cognición (rs=0,758), la movilidad (rs=0,709), la actividad del hogar/trabajo (rs=0,718) y la participación (r=0,701) y moderada y negativamente con la fatiga (r=-0,621) y lo Functional Assessment of Cancer Therapy-Fatigue (FACT-F) (r=-0,672) y positivamente con lo Disabilities of the Arm and Shoulder(DASH) (r=0,639). Comparando los grupos de discapacidad, se observó una diferencia significativa con peores puntajes para DASH (d=1,62), FACT-F (d=1,47), fatiga (d=1,21) y el índice de calidad del sueño de Pittsburgh (PSQI) (d=0,98). Conclusión: Las mujeres que sobrevivieron al cáncer de seno tenían algún nivel de discapacidad asociada con la fatiga y la mala calidad del sueño y la calidad de vida, lo que demuestra importantes impactos en la salud de estas mujeres

Anatomical variations of the superior mesenteric artery and its clinical and surgical implications in humans / Variações anatômicas da artéria mesentérica superior e suas implicações clínicas e cirúrgicas em humanos

ABSTRACT Introduction: Superior mesenteric artery (SMA) usually arises from the abdominal aorta, just below the celiac trunk and it supplies the midgut-derived embryonic structures. Anatomical variations in this vessel contribute to problems in the formation and/or absorption of this part of the intestine and its absence has been recognized as the cause of congenital duodenojejunal atresia. Objective: To analyze SMA anatomical variations in humans and the possible associated clinical and surgical implications. Methods: This is a systematic review of papers indexed in PubMed, SciELO, Springerlink, Science Direct, Lilacs, and Latindex databases. The search was performed by two independent reviewers between September and December 2018. Original studies involving SMA variations in humans were included. SMA presence/absence, level, place of origin and its terminal branches were considered. Results: At the end of the search, 18 studies were selected, characterized as for the sample, method to evaluate the anatomical structure and main results. The most common type of variation was when SMA originated from the right hepatic artery (6.13%). Two studies (11.11%) evidenced the inferior mesenteric artery originating from the SMA, whereas other two (11.11%) found the SMA sharing the same origin of the celiac trunk. Conclusion: SMA variations are not uncommon findings and their reports evidenced through the scientific literature demonstrate a great role for the development of important clinical conditions, making knowledge about this subject relevant to surgeons and professionals working in this area.

RESUMO Introdução: A artéria mesentérica superior (AMS), normalmente, tem sua origem a partir da aorta abdominal, um pouco abaixo do tronco celíaco e é responsável pela irrigação das estruturas derivadas, embrionariamente, do intestino médio. Variações anatômicas nesse vaso contribui para defeitos na formação e/ou absorção dessa parte do intestino e a sua ausência tem sido reconhecida como a causa da atresia duodenojejunal congênita. Objetivo: Analisar as variações anatômicas dela em humanos e as possíveis implicações clínicas e cirúrgicas associadas. Métodos: Trata-se de uma revisão sistemática de artigos indexados nas bases de dados PubMed, SciELO, Springerlink, Scienc Direct, Lilacs e Latindex. A busca ocorreu por dois revisores independentes entre setembro e dezembro de 2018. Foram incluídos artigos originais envolvendo as variações da AMS em humanos. Considerou-se para este estudo a presença/ausência da AMS, o nível, local de origem e seus ramos terminais. Resultados: Ao final da busca foram selecionados 18 artigos, caracterizados quanto à amostra, método para avaliar a estrutura anatômica e principais resultados. O tipo de variação mais comum foi aquele cuja AMS se originou da artéria hepática direita (6,13%). Dois estudos (11,11%) evidenciaram a artéria mesentérica inferior originando-se a partir da AMS, enquanto outros dois (11,11%) constataram ser ela compartilhada na mesma origem do tronco celíaco. Conclusão: Variações na AMS não são achados incomuns e seus relatos evidenciados através da literatura científica demonstram grande importância para o desenvolvimento de condições clínicas importantes, tornando o conhecimento sobre esse assunto relevante para os cirurgiões e profissionais atuantes nesta área.

Increase in perceived stress is correlated to lower heart rate variability in healthy young subjects / Aumento no estresse percebido correlaciona-se com diminuição da variabilidade da frequência cardíaca em indivíduos jovens saudáveis

Emotional stress is a risk factor for cardiovascular disease. Decreased heart rate variability (HRV) is associated to increased mortality rates in certain heart diseases. Current study assessed the co-relation between perceived stress and HRV parameters. The correlation between psychological stress, measured by the perceived stress scale (PSS-14), and HRV parameters obtained during 5 min. at rest was evaluated. Data from 35 healthy young volunteers demonstrated a significant correlation between PSS-14 scores and Low Frequency-LF (ms2) by frequency domain HRV analysis. Other variables such as High Frequency and Standard Deviation of R-R intervals had also negative coefficients but did not have any significant correlation with PSS-14. No correlation between PSS-14 and sympathovagal balance parameters was found. Data interpretation demonstrated that increase in perceived stress was correlated to decrease in heart rate variability, which may point out an important mechanism in cardiovascular pathophysiology that should be further investigated.

O estresse emocional é um fator de risco para doença cardiovascular. A diminuição da Variabilidade da Frequência Cardíaca (VFC) está associada ao aumento da mortalidade em algumas doenças cardíacas. Este estudo teve como objetivo avaliar a correlação entre o estresse percebido e os parâmetros da VFC. Dessa maneira, avaliou-se a correlação existente entre o estresse psicológico mensurado através da escala de estresse percebido (PSS -14) e parâmetros de VFC obtidos durante 5 min. ao repouso. Dados de 35 voluntários jovens e saudáveis demonstraram uma correlação significativa do PSS-14 com os valores de baixa freqüência- LF (ms²) na análise da VFC no domínio frequência. Outras variáveis, tais como alta freqüência e desvio padrão dos intervalos RR, também tiveram coeficientes negativos, mas não se correlacionaram com a PSS-14. Nenhuma correlação entre o PSS-14 e os parâmetros do balanço simpato-vagal foi encontrada. Portanto, a interpretação dos dados demonstra que o aumento no estresse percebido se correlacionou com a diminuição da variabilidade da frequência cardíaca, o que pode ser indicativo de um mecanismo importante na fisiopatologia cardiovascular que deve ser melhor investigado.

Contribuições de um Grupo da Terceira Idade para a saúde das Idosas Participantes / Contributions from a Seniors Group for the Health of the Elderly Participants

O envelhecimento acarreta perdas significativasno idoso, sejam elas físicas, psíquicas ou sociais. Nestecontexto, os programas de apoio social e ambientesacolhedores ganham destaque por serem elementospromotores de segurança e bem-estar, estimulando epotencializando a autonomia dos idosos. Frente a essarelevância, objetivou-se identificar os benefícios sociais deum grupo de convivência para idosas na visão dasparticipantes. Material e Métodos: Foi realizado um estudotransversal, composto por 20 mulheres, com idade média de69,1±6,29 anos, participantes do Grupo de ConvivênciaRenascer, interior da Paraíba. Resultados: foi verificada boacapacidade para realização de atividades funcionais queexigem flexibilidade e déficit para atividades que exijam força.Com relação às contribuições na auto-imagem 65% afirmamque após o grupo, passaram a ter mais satisfação em vivere 35% se sentiram mais valorizadas socialmente. Nasrelações sociais 57% afirmaram facilidade no convívio e 24%maior expressividade emocional, enquanto que para 19%nada acrescentou. Conclusão: Conclui-se que o Grupo deConvivência Renascer propiciou melhorias na dimensãopessoal ao melhorar as habilidades individuais, tornando asidosas mais autoconfiantes, com maior auto-estima, commelhor capacidade funcional e qualidade de vida; na dimensãosocial, melhorando e intensificando as relações entre aspróprias idosas e as demais relações sociais, além defavorecer as construções coletivas...

Aging leads to significant losses in the elderly,whether physical, psychological or social. In this context,social support programs and welcoming environments arehighlighted by being prosecutor elements of security andwell-being, stimulating and enhancing the autonomy of theelderly. Given this, we aimed to identify the social benefits ofa support group for older participants under their ownperspective. Material and Methods: A cross-sectional studywas conducted consisting of 20 women with a mean age of69.1 ± 6.29 years, participants of Group Renascer (“Reborn”),inland of Paraíba state. Results: It was verified a good abilityto perform functional activities that require flexibility, in contrastwith a deficit for activities requiring strength. Regardingcontributions to the self-image, 65% reported having greatersatisfaction in living upon participation of the group, and 35%felt more socially valued. In the social relationships, 57%reported “ease of living”; 24% greater emotionalexpressiveness; while 19% said nothing had changed.Conclusion: the Group “Reborn” provided improvements inthe personal dimension concerning individual skills, makingthe elderly more confident, with more self-esteem, betterfunctional capacity and quality of life. In the social dimension,there was an improvement in the relationships among theelderlies themselves and in their social relationships, inaddition to an encouragement for collective constructions...

Efeitos do exercício físico em mulheres com câncer de mama submetidas àradioterapia: uma revisão sistemática / Effects of physical exercise on women with breast cancer under radiotherapy: a systematic review

Introdução: O câncer de mama é uma doença crônica deorigem multifatorial e com incidência crescente nas últimasdécadas, tanto em países desenvolvidos como emergentes.A radioterapia é um tratamento locorregional para o câncer,indolor, realizado através da aplicação de radiação ionizanteem células malignas, danificando a estrutura do DNA celulare, consequentemente, interferindo no crescimento tumorale metástase. Objetivo: realizar uma revisão sistemática sobrea influência do exercício físico em mulheres com câncer demama submetidas à radioterapia. Métodos: foram consultadosartigos nas bases de dados LILACS, PUBMED, MEDLINE,SciELO e Science Direct com os descritores breast cancer, radiotherapye exercise. Foram selecionados ensaios clínicosque abordassem os efeitos do exercício físico em sujeitossubmetidos à radioterapia não-simultânea à quimioterapiae/ou hormonioterapia. O teste estatístico Kappa (K = 0,868;p<0,0001) foi aplicado para verificar o nível de concordânciaentre os dois pesquisadores. Resultados: Após a leituraindependente realizada pelos revisores, um total de seisartigos corresponderam aos critérios de inclusão estabelecidos.Posteriormente, os textos completos foram lidos eanalisados detalhadamente. Conclusão: os dados apontamque a prática regular de atividade física ajuda significativamentena manutenção dos níveis de eritrócitos, hematócritoe hemoglobina, manutenção da amplitude de movimentode ombro, melhoria da função cardiopulmonar, qualidadede vida e diminuição de fadiga relacionada ao câncer.

Background: Breast cancer is a chronic diseasewith multiple origins and rising incidence in the lastdecades, in developed and emerging countries. Radiotherapyis a painless local treatment for cancer, madethrough ionizing radiation application in malignantcells, damaging the DNA structure and, consequently,interfering in tumor growth and metastasis. Objective:to write a systematic review about the influence ofphysical exercise practice in women with breast cancersubmitted to radiotherapy. Methods: articles weresearched in the databases LILACS, PUBMED, MEDLINE,SciELO e Science Direct with the descriptors breastcancer, radiotherapy and exercise. The selected oneswere clinical trials that investigated the effects of physicalexercise in subjects submitted to radiotherapynon-simultaneously with chemotherapy and/or hormonetherapy. Statistical test Kappa (K = 0,868; p<0,0001)was used to verify the agreement level between thereviewers. Results: After independent reading by thereviewers, six articles corresponded to inclusion criteriaestablished. Later, full texts were seen and carefullyanalyzed. Conclusion: data suggested that regular physicalactivity practice helps significantly in red bloodcells, hematocrit and hemoglobin maintenance, rangeof motion of the shoulder, improvement in cardiopulmonaryfunction, quality of life and reduced levels ofcancer related fatigue.