Medicalização no sistema de progressão continuada: inclusão ou omissão? / Medicalization in the continuous progression system: inclusion or omission?

Esse estudo teve como objetivo abordar o processo de medicalização da infância, realizando um mapeamento dos alunos do primeiro ciclo do ensino fundamental da rede municipal de uma cidade paranaense, que foram diagnosticados e medicados devido aos ditos transtornos de aprendizagem, entre eles o Transtorno de Déficit de Atenção e Hiperatividade (TDAH). Teve como intuito, também, discutir como o sistema de progressão continuada influencia o processo de escolarização destes alunos. Para tanto, foram combinadas as pesquisas empírica e bibliográfica, em que os dados da investigação de campo, obtidos por meio de questionários respondido pelos pais ou responsáveis, foram submetidos a análise quantitativa e qualitativa, e os resultados foram discutidos em conjunto com a revisão bibliográfica, a partir do referencial teórico da Psicologia Histórico-Cultural. Por meio desta pesquisa, foi possível compreender que o fenômeno da medicalização cresce exponencialmente, sobretudo no cenário educacional, e que o sistema de progressão continuada, da forma como foi implantado, colabora para que essa problemática seja encoberta.(AU)

This study aimed to address the childhood medicalization process, making a mapping of the students of the first cycle of elementary education in the municipal network of a city in Paraná, who were diagnosed and medicated due to the said learning disorders, among them, Attention Deficit Hyperactivity Disorder (ADHD). It was also intended to discuss how the system of continued progression influences the schooling process of these students. For this purpose, an empirical and bibliographic research was combined, in which the data of the field investigation, obtained through questionnaires answered by the parents or guardians, were submitted to quantitative and qualitative analysis and the results were discussed together with the bibliographic review, from the theoretical framework of Historical-Cultural Psychology. Through this research, it was clarified that the phenomenon of medicalization grows exponentially, especially in the educational scenario, and that the system of continued progression, as it was implemented, collaborates so that this problem is covered up.(AU)

Sensitivity and specificity of assessment scales of dentin hypersensitivity - an accuracy study.

The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.

Tendência e caracterização epidemiológica da tuberculose em Alagoas, 2007-2016 / Trend and epidemiological characterization of tuberculosis in Alagoas from 2007 to 2016

Resumo Introdução A tuberculose (TB) é uma doença infectocontagiosa causada pelo complexo Mycobacterium tuberculosis. Objetivo Analisar a tendência e o perfil epidemiológico dos casos de TB registrados no Estado de Alagoas no período de 2007 a 2016. Método Trata-se de estudo descritivo envolvendo todos os casos de TB registrados em Alagoas entre 2007 e 2016. Inicialmente, foi analisada a tendência da taxa de incidência utilizando o modelo de regressão por pontos de inflexão (joinpoint regression). Para a análise das características epidemiológicas, foram selecionadas as variáveis: raça, gênero, faixa etária, escolaridade, classificação da doença, tipo de entrada, 1ª e 2ª baciloscopia, cultura de escarro e testagem para HIV. Resultados A taxa média de incidência do período foi de 33,43/100 mil habitantes, com tendência de redução estatisticamente significativa (APC -2,97%). Houve predomínio do gênero masculino (62,98%), cor parda (65,20%), idade entre 25 e 54 anos (60,35%) e ensino fundamental incompleto (35,17%). Com relação aos aspectos clínicos, 86,32% dos indivíduos apresentaram a forma pulmonar. A sorologia para o HIV não foi realizada em 41,58% dos casos. Quanto à evolução, 67,42% obtiveram alta com cura e 12,52% foram encerrados como abandono de tratamento. Conclusão A TB ainda representa um importante problema de saúde pública em Alagoas, sinalizando a necessidade de políticas públicas que oportunizem o diagnóstico precoce e o tratamento oportuno.

Abstract Background Tuberculosis is an infectious disease caused by the mycobacterium tuberculosis complex. Objective To analyze the trend and the epidemiological profile of tuberculosis cases registered in the state of Alagoas from 2007 to 2016. Method This is a descriptive study involving all cases of tuberculosis registered in Alagoas between 2007 and 2016. Initially, it analyzed the incidence rate trend using the joinpoint regression model. For the analysis of epidemiological characteristics, the variables: race, gender, age group, education, disease classification, type of entry, 1st and 2nd smear microscopy, sputum culture, HIV testing were selected. Results The average incidence rate for the period was 33.43 per 100,000 populations, with a statistically significant reduction trend (APC: -2.97%). There was a predominance of males (62.98%), brown ethnicity (65.20%), age between 25 and 54 years (60.35%) and incomplete primary schooling (35.17%). Regarding the clinical aspects, 86.32% of the individuals presented the pulmonary form. HIV serology was not performed in 41.58% of cases. As for evolution, 67.42% evolved with cure and 12.52% were terminated as treatment abandonment. Conclusion Tuberculosis still represents an important public health problem in Alagoas, signaling the need for public policies that provide early diagnosis and timely treatment.

RATES OF EXUDATIVE RECURRENCE FOR EYES WITH INACTIVATED WET AGE-RELATED MACULAR DEGENERATION ON 12-WEEK INTERVAL DOSING WITH BEVACIZUMAB THERAPY.

PURPOSE: To determine the recurrence rate of exudative age-related macular degeneration (wet AMD) in patients on 12-week dosing interval anti-vascular endothelial growth factor (anti-VEGF) bevacizumab therapy. METHODS: A retrospective chart review was performed on wet AMD patients treated with anti-VEGF therapy using a "treat-and-extend" methodology at one physician's practice site over 2 years (2012-2014). Charts were evaluated for visual acuity, anti-VEGF agent used, treatment interval, duration of treatment, trials off of anti-VEGF therapy, evidence of exudation, and wet AMD recurrence characteristics. RESULTS: Three hundred and twenty-one wet AMD patients were treated. Fifty-seven eyes were without active exudation by clinical examination or optical coherence tomography (OCT) and were maintained on repeating 12-week interval suppressive anti-VEGF therapy. Sixteen percent (8/49) showed exudation recurrence with an average 10% cumulative recurrence rate per year for eyes on bevacizumab. Eight eyes without active exudation were discontinued off of bevacizumab therapy. Sixty-three percent (5/8) demonstrated recurrence on average 4 months after stopping therapy. CONCLUSION: The findings in this study suggest that if a patient can be extended to 12-week interval bevacizumab therapy, there is on average a 10% chance of recurrence with each successive year. If anti-VEGF therapy is discontinued in these patients, there is an increased chance of recurrence by 4 months.

Sensitivity and specificity of assessment scales of dentin hypersensitivity - an accuracy study

Abstract The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.

A (in)visibilidade do surdo na atenção primária: relato de experiência / The (in)visibility of deaf people in primary healthcare: experience report / La (in)visibilidad de los sordos en la atención primaria: informe de experiencia

O Programa de Educação pelo Trabalho-Saúde/Redes de Atenção à Saúde do Surdo (PET-Saúde/Redes) visa colaborar na implantação da rede de atenção à saúde das pessoas com deficiência, tomando como ponto de partida a Unidade de Saúde da Família (USF). Este artigo relata a experiência dos participantes do PET na busca ativa dos surdos em uma USF de Salvador, Bahia. Este relato de experiência foi desenvolvido por integrantes do PET-Saúde/Redes ­ uma graduanda de enfermagem e uma de fonoaudiologia da Universidade Federal da Bahia ­, sob preceptoria de fisioterapeuta, integrante do Núcleo de Apoio à Saúde da Família, no período de setembro de 2014 a junho de 2015. A partir da experiência no PET, constatou-se que a inexistência de notificações sobre os surdos na USF se devia à falta de informação dos profissionais de saúde sobre a presença destes na região, e mesmo ao se depararem com as pessoas localizadas pelo projeto, foi externado despreparo para lidar com esses usuários. Essa constatação implica a necessidade de ações mais específicas de sensibilização para ampliar o olhar da equipe sobre essa população já historicamente estigmatizada, ações que envolvem desde a gestão da unidade até o esclarecimento por meio de atividades de educação em saúde com toda a comunidade, sobre como a atenção primária pode contribuir na melhor qualidade de vida das pessoas sob seu cuidado.

The Programa de Educação pelo Trabalho-Saúde/Redes de Atenção à Saúde do Surdo (PET-Saúde/Redes) implements a healthcare network for people with disabilities, having as a starting point a Family Health Unit (USF) in Salvador, Bahia. This paper reports the experience of PET participants in the active search of deaf people in a USF. This experience report was developed by PET-Saúde/Redes members, with one being an undergraduate student in nursing and another a speech therapist student from the Federal University of Bahia, under the guidance of a physical therapist member of the Family Health Support Center, between September 2014 and June 2015. Based on the PET experience, we verified that the lack of notifications about deaf people in the USF was due to the lack of information from health professionals about their presence in the region. Even in cases where such demographic was found, a lack of preparation on the part of professionals was observed. This finding implies the need for more specific actions to raise awareness and broaden the team's perspective to this population that has historically been stigmatized, actions that involve everything from management to clarification through health education activities with the whole community on how primary care can contribute to the quality of life of this population are strongly recommended.

El Programa de Educação pelo Trabalho-Saúde/Redes de Atenção à Saúde do Surdo (PET-Saúde/Redes) tiene como objetivo colaborar en la implementación de la red de atención sanitaria para las personas con discapacidad, tomando como punto de partida la Unidad de Salud de la Familia (USF). Este articulo da a conocer la experiencia de los participantes del PET en la búsqueda activa de las personas sordas en una USF de Salvador, Bahia. La experiencia narrada en el informe fue desarrollada por miembros del PET-Saúde/Redes ­ una estudiante de enfermería y una de fonoaudiología de la Universidad Federal de Bahia ­ bajo la orientación de una fisioterapeuta integrante del Núcleo de Apoyo a la Salud de la Familia, en el periodo de septiembre de 2014 a junio de 2015. A partir de la experiencia en el PET, se encontró que la ausencia de notificación sobre las personas sordas en la USF se debe a la falta de información de los profesionales de la salud acerca de su presencia en la región, e incluso en los encuentros con las personas del proyecto, se constató una falta de preparación para atender al usuario en esta situación. Este hallazgo implica la necesidad de acciones más específicas para concienciar sobre estas personas históricamente estigmatizadas. Las acciones, que implican la gestión de la unidad para esclarecer por medio de actividades de educación sanitaria con toda la comunidad sobre la forma de atención primaria, pueden contribuir a la calidad de vida de las personas bajo su cuidado.