Mechanical ventilation and death in pregnant patients admitted for COVID-19: a prognostic analysis from the Brazilian COVID-19 registry score.

BACKGROUND: The assessment of clinical prognosis of pregnant COVID-19 patients at hospital presentation is challenging, due to physiological adaptations during pregnancy. Our aim was to assess the performance of the ABC2-SPH score to predict in-hospital mortality and mechanical ventilation support in pregnant patients with COVID-19, to assess the frequency of adverse pregnancy outcomes, and characteristics of pregnant women who died. METHODS: This multicenter cohort included consecutive pregnant patients with COVID-19 admitted to the participating hospitals, from April/2020 to March/2022. Primary outcomes were in-hospital mortality and the composite outcome of mechanical ventilation support and in-hospital mortality. Secondary endpoints were pregnancy outcomes. The overall discrimination of the model was presented as the area under the receiver operating characteristic curve (AUROC). Overall performance was assessed using the Brier score. RESULTS: From 350 pregnant patients (median age 30 [interquartile range (25.2, 35.0)] years-old]), 11.1% had hypertensive disorders, 19.7% required mechanical ventilation support and 6.0% died. The AUROC for in-hospital mortality and for the composite outcome were 0.809 (95% IC: 0.641-0.944) and 0.704 (95% IC: 0.617-0.792), respectively, with good overall performance (Brier = 0.0384 and 0.1610, respectively). Calibration was good for the prediction of in-hospital mortality, but poor for the composite outcome. Women who died had a median age 4 years-old higher, higher frequency of hypertensive disorders (38.1% vs. 9.4%, p < 0.001) and obesity (28.6% vs. 10.6%, p = 0.025) than those who were discharged alive, and their newborns had lower birth weight (2000 vs. 2813, p = 0.001) and five-minute Apgar score (3.0 vs. 8.0, p < 0.001). CONCLUSIONS: The ABC2-SPH score had good overall performance for in-hospital mortality and the composite outcome mechanical ventilation and in-hospital mortality. Calibration was good for the prediction of in-hospital mortality, but it was poor for the composite outcome. Therefore, the score may be useful to predict in-hospital mortality in pregnant patients with COVID-19, in addition to clinical judgment. Newborns from women who died had lower birth weight and Apgar score than those who were discharged alive.

Lean methodology implementation in the emergency department of a university hospital: management and sustainable development / Implantación de la metodología lean en el servicio de urgencias de un hospital universitario: gestión y desarrollo sostenible / Implementação da metodologia lean na emergência de um hospital universitário: gestão e desenvolvimento sustentável

ABSTRACT Objective: to describe the implementation of the Lean Methodology in an emergency department and its contribution to sustainable and quality management. Method: this is a methodological study carried out between October 2018 and January 2022 in the adult emergency department of a public university hospital in southern Brazil, analyzing the results before and after the implementation of the Lean Methodology. The study followed the model and standards adopted by the Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) for the description of improvement cycle standards. Results: with the implementation of this methodology, actions were developed, such as innovations in work routines, both care and management, changes in patient reception with risk classification, construction of units for patient care and allocation, daily interdisciplinary meetings (huddle), full contingency plan, hospital discharge routines, external transfers, changes in the communication process with users and professionals, among other actions. Conclusion: the use of the Lean Methodology has resulted in a reduction in occupancy, which has helped to optimize health resources and ensure quality care and management practices. This reduction is believed to be proof of sustainable management in health services and contributes to reducing socio-economic inequalities.

RESUMEN Objetivo: describir la aplicación de la Metodología Lean en un servicio de urgencias y su contribución a una gestión sostenible y de calidad. Método: se trata de un estudio metodológico realizado entre octubre de 2018 y enero de 2022 en el servicio de urgencias de adultos de un hospital universitario público del sur de Brasil, analizando los resultados antes y después de la implementación de la Metodología Lean. El estudio siguió el modelo y las normas adoptadas por el Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) para describir las normas de los ciclos de mejora. Resultados: con la implementación de esta metodología, se desarrollaron acciones como innovaciones en las rutinas de trabajo, tanto asistenciales como de gestión, cambios en la recepción con clasificación de riesgo, construcción de unidades de atención y asignación de pacientes, reuniones interdisciplinarias diarias (huddle), plan de contingencia completo, rutinas de alta hospitalaria, traslados externos, cambios en el proceso de comunicación con usuarios y profesionales, entre otras acciones. Conclusión: la utilización de la Metodología Lean ha dado lugar a una reducción de los efectivos, lo que ha permitido optimizar los recursos de atención sanitaria y garantizar prácticas asistenciales y de gestión de calidad. Se considera que esta reducción es una prueba de gestión sostenible en los servicios de salud y contribuye a reducir las desigualdades socioeconómicas.

RESUMO Objetivo: Descrever a implementação da Metodologia Lean em um serviço de emergência, e a contribuição para uma gestão sustentável e de qualidade. Método: Trata-se de estudo metodológico, realizado entre outubro de 2018 a janeiro de 2022, no serviço de emergência adulto de um hospital público universitário no Sul do Brasil, com análise de resultados antes e após a implementação da Metodologia Lean. O estudo seguiu o modelo e as normas adotadas pelo Standards for Quality Improvement Reporting Excellence 2.0 (SQUIRE) para a descrição dos padrões dos ciclos de melhoria. Resultados: Com a implementação desta metodologia, foram desenvolvidas ações, como inovações nas rotinas de trabalho, tanto assistenciais como gerenciais, mudanças no acolhimento com classificação de risco, construção de unidades para atendimento e alocação de pacientes, reuniões diárias interdisciplinares (huddle), plano de contingência pleno, rotinas de altas hospitalares, transferências externas, mudança no processo de comunicação com usuários e profissionais, dentre outras ações. Conclusão: A utilização da Metodologia Lean resultou na diminuição da lotação e com isto pode-se otimizar recursos de saúde e assegurar práticas assistenciais e gerenciais de qualidade. Acredita-se que esta diminuição seja a comprovação de uma gestão sustentável em serviços de saúde e colabora para a redução de desigualdades socioeconômicas.

Hospital characteristics associated with COVID-19 mortality: data from the multicenter cohort Brazilian Registry.

The COVID-19 pandemic caused unprecedented pressure over health care systems worldwide. Hospital-level data that may influence the prognosis in COVID-19 patients still needs to be better investigated. Therefore, this study analyzed regional socioeconomic, hospital, and intensive care units (ICU) characteristics associated with in-hospital mortality in COVID-19 patients admitted to Brazilian institutions. This multicenter retrospective cohort study is part of the Brazilian COVID-19 Registry. We enrolled patients ≥ 18 years old with laboratory-confirmed COVID-19 admitted to the participating hospitals from March to September 2020. Patients' data were obtained through hospital records. Hospitals' data were collected through forms filled in loco and through open national databases. Generalized linear mixed models with logit link function were used for pooling mortality and to assess the association between hospital characteristics and mortality estimates. We built two models, one tested general hospital characteristics while the other tested ICU characteristics. All analyses were adjusted for the proportion of high-risk patients at admission. Thirty-one hospitals were included. The mean number of beds was 320.4 ± 186.6. These hospitals had eligible 6556 COVID-19 admissions during the study period. Estimated in-hospital mortality ranged from 9.0 to 48.0%. The first model included all 31 hospitals and showed that a private source of funding (ß = - 0.37; 95% CI - 0.71 to - 0.04; p = 0.029) and location in areas with a high gross domestic product (GDP) per capita (ß = - 0.40; 95% CI - 0.72 to - 0.08; p = 0.014) were independently associated with a lower mortality. The second model included 23 hospitals and showed that hospitals with an ICU work shift composed of more than 50% of intensivists (ß = - 0.59; 95% CI - 0.98 to - 0.20; p = 0.003) had lower mortality while hospitals with a higher proportion of less experienced medical professionals had higher mortality (ß = 0.40; 95% CI 0.11-0.68; p = 0.006). The impact of those association increased according to the proportion of high-risk patients at admission. In-hospital mortality varied significantly among Brazilian hospitals. Private-funded hospitals and those located in municipalities with a high GDP had a lower mortality. When analyzing ICU-specific characteristics, hospitals with more experienced ICU teams had a reduced mortality.

Microbiological profile of raw refrigerated and processed bovine milk at dairy industries from Vale do Taquari, Rio Grande do Sul, Brazil

Milk is an essential food, widely consumed by the population. Brazil is one of the world's largest producers of milk. Milk quality is influenced by several factors in all its stages of production. The aim of this study was to determine the microbiological profile of refrigerated and processed raw bovine milk from industries in Vale do Taquari, state of Rio Grande do Sul, Brazil, using metagenomic analysis. A total of six samples were collected, one of refrigerated raw milk from the tanker truck, one of pasteurized milk and one of milk sterilized by the ultra-high temperature (UHT) process, in each of the industries. The identification of the milk microbiota was performed by sequencing the 16S rRNA gene. The results show that refrigerated raw milk has a greater number of microorganisms, followed by pasteurized milk and sterilized milk, successively. Processed milk showed the presence of beneficial microorganisms such as Streptococcus thermophilus and Streptococcus macedonicus. Nevertheless, even UHT milk showed the presence of microorganisms considered harmful, such as the Bacillus cereus group, Aeromonas dhakensis, Enterobacter bacterium and Acinetobacter haemolyticus. Metagenomics is a valuable tool for the thorough evaluation of the milk microbiota in order to implement the processing stages in industries.

Traditional plants with antioxidant properties in clinical trials-A systematic review.

There is a trend toward the use of natural substances present in plants and vegetables. In general, foods rich in antioxidants are complex matrices; therefore, understanding its absorption effects is extremely relevant to know its bioactive potential. Thus, this systematic review focused on clinical trials involving plants (or compounds) registered on the National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) with antioxidant properties. Following the reporting guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes studies of interest indexed in the PubMed and ClinicalTrials.gov databases were analyzed. Of the 59 clinical trials found, Allium sativum and Curcuma longa are the plant species with the highest percentage of clinical research. Prevention/attenuation of oxidative stress was one of the main antioxidant mechanisms indicated in the studies. The most tested compounds of the RENISUS plants in clinical trials were curcumin and soy isoflavone. In this review, we selected studies in advanced stages that highlight plants' value in optimizing antioxidant status; however, even with high-quality studies, it is not prudent to overstate the clinical efficacy of these plants.

Estratégia Saúde da Família: qualidade de vida de pessoas idosas / Family health strategy: quality of life of older people

Objetivo: Avaliar a qualidade de vida de idosos pertencentes ao território de uma Estratégia Saúde da Família do município de Santiago, Rio Grande do Sul. Método: Estudo transversal, descritivo, de abordagem quantitativa, desenvolvido com 239 idosos a partir dos 60 anos, através da aplicação do questionário sociodemográfico e WHOQOL bref. Resultados: A maioria dos idosos são do sexo feminino, com média de idade de 71 anos, casados, aposentados, com baixa escolaridade, renda intermediária, hipertensos, ativos e utilizam o serviço da ESF. Por meio do WHOQOL bref constatou-se uma qualidade de vida boa em todos os domínios (físico, psicológico, relações sociais e meio ambiente). Os escores do domínio físico diferem significativamente dos demais. Conclusão: A qualidade de vida geral dos idosos contemplando todos os domínios foi avaliada como boa. Estes dados representam subsídios para os profissionais da atenção básica promoverem ações de promoção da qualidade de vida de idosos. (AU)

Objective: To evaluate the quality of life of elderly people belonging to the territory of a Family Health Strategy in the city of Santiago, Rio Grande do Sul. Method: Cross-sectional, descriptive, quantitative approach, developed with 239 elderly from 60 years old, through the application of sociodemographic questionnaire and WHOQOL bref. Results: Most of the elderly are female, with an average age of 71 years, married, retired, with low education, intermediate income, hypertensive, active and use the ESF service. Through the WHOQOL bref a good quality of life was found in all domains (physical, psychological, social relations and environment). Physical domain scores differ significantly from the others. Conclusion: The general quality of li (AU)

Objetivo: Evaluar la calidad de vida de los ancianos que pertenecen al territorio de una Estrategia de Salud Familiar en la ciudad de Santiago, Rio Grande do Sul. Método: enfoque transversal, descriptivo, cuantitativo, desarrollado con 239 ancianos mayores de 60 años, mediante la aplicación de cuestionarios sociodemográficos y WHOQOL bref. Resultados: la mayoría de los ancianos son mujeres, con una edad promedio de 71 años, casados, jubilados, con baja educación, ingresos intermedios, hipertensos, activos y utilizan el servicio ESF. A través del WHOQOL bref se encontró una buena calidad de vida en todos los dominios (físico, psicológico, relaciones sociales y medio ambiente). Los puntajes del dominio físico difieren significativamente de los demás. Conclusión: La calidad de vida general de los ancianos con todos los dominios se evaluó como buena. Estos datos representan subsidios para que los profesionales de atención primaria promuevan acciones para promover la calidad de vida de los ancianos. (AU)

Clinical trials with plants in diabetes mellitus therapy: a systematic review.

INTRODUCTION: The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences, having one of the highest morbidities and mortality rates. Prolonged use of many available medications can produce undesirable side effects. Thus, plants appear as an important source of bioactive resources for the discovery of new treatments for diabetes. AREAS COVERED: In this sense, this systematic review focused on clinical trials involving plants of National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) (or compounds) with antidiabetic properties. We analyzed indexed studies in PubMed following the reporting guidelines of PRISMA. EXPERT OPINION: Of the 51 clinical trials found, Curcuma longa, Glycine max, Zingiber officinale, Punica granatum, Aloe vera, Momordica charantia are the species with the greatest amount of clinical trials and the attenuation of insulin resistance, decreased fasting blood glucose and glycosylated hemoglobin levels are some of the main mechanisms by which these plants exert hypoglycemic effects. Thus, we speculate that the Clinical Pharmacology should explore the field of plant-based compounds that will keep concentrating the attention of researchers, and therefore, we gathered studies in advanced stages that highlight the role of plants in the diabetes therapy.

Compounds of plants with activity against SARS-CoV-2 targets.

INTRODUCTION: The COVID-19 global pandemic is a public health emergency due to its high virulence and mortality. Many vaccine development studies at clinical trials are currently conducted to combat SARS-CoV-2. Plants are a rich source of phytochemicals with different biological activities, including antiviral activities, which are the focus of many studies. AREAS COVERED: This review shows compounds of traditional plants listed on RENISUS list have therapeutic properties against SARS-CoV-2 targets. EXPERT OPINION: The rise of new variants, more pathogenic and virulent, impacts in the increase of mortality from SARS-CoV-2 infection, and thus, the control of the outbreaks of disease remains a global challenge. Other's drug and vaccines development is an essential element in controlling SARS-COV-2. Therefore, it is imperative that approach to tackle this pandemic has to be solidly evidence-informed. It should be noticed that the immune system does play critical roles in fighting viruses. Studies show that T cells levels decreased continuously as the disease progressed. T cell-mediated cellular immune response, probably by immunological memory, is essential for direct virus eradication after infection whilst B cells functions in producing antibodies that neutralize virus.But, have distinct patterns of T cell response exist in different patients, suggesting the possibility of distinct clinical approaches. Efforts are concentrated to elucidate the underlying immunological mechanisms in SARS-CoV-2 pathogenesis and progression for better design of diagnostic, therapeutic and preventive strategies. We seek to identify biomolecules with the potential to act in biomarkers that predict how severe the disease can get. But it is important to warn that the plants that produce the compounds mentioned here should not be used without a physician prescription. Finally, we speculate that these compounds may eventually attract the attention of physicians and researchers to perform tests in specific contexts of SARS-CoV-2 infection, and if they show positive results, be tested in Clinical trials.

RENISUS Plants and Their Potential Antitumor Effects in Clinical Trials and Registered Patents.

Cancer is a significant cause of morbidity and mortality. Scientific advances, coupled with potential flaws in current treatments, are driving research into the discovery of new bioactive molecules. This systematic review focused on scientific studies with clinical trials and patents registered on the National Relation of Medicinal Plants of Interest to the Unified Health System (RENISUS) plants (or derivative compounds) with antitumor potential. Studies with 19 different forms of cancer were found, the prostate being the organ with the highest research incidence and the species Glycine max, Curcuma longa, and Zingiber officinale, beside the phytochemicals curcumin and soy isoflavone were the most tested in clinical trials/patents.

Diabetes e qualidade de vida: significados atribuídos na perspectiva de profissionais e de usuários / Diabetes and quality of life: meanings assigned from the perspective of professionals and users / Diabetes y calidad de vida: significados desde la perspectiva de profesionales y usuarios

Objetivo: este artigo visa relatar o significado de qualidade de vida para uma pessoa com diabetes na perspectiva de profissionais de saúde e de usuários com diabetes. Método: pesquisa qualitativa, realizada com 14 pessoas com diabetes, atendidas nas Estratégias Saúde da Família de Lajeado/Rio Grande do Sul e com 14 profissionais de saúde. Os dados foram coletados entre abril a outubro de 2015 por meio de entrevista semiestruturada com a questão orientadora: O que é ter qualidade de vida para uma pessoa com diabetes? Resultados: existem três categorias relacionadas à qualidade de vida para uma pessoa com diabetes: ter saúde - estar com a doença controlada; estar bem consigo mesmo e sentir-se bem em seu meio de convivência. Conclusões: possuir diabetes e ter qualidade de vida é ter saúde ­ portanto, é necessário controlar a doença, estar bem consigo mesmo e sentir-se bem em seu meio de convivência, aceitando as limitações. É importante promover ações educativas para melhorar a qualidade de vida dos usuários diabéticos (Au).

Objective: to understand the meaning of quality of life for a person with diabetes from the perspective of health professionals and users with diabetes. Method: qualitative research, carried out with 14 people with diabetes, assisted in the Family Health Strategies of Lajeado / Rio Grande do Sul and with 14 health professionals. Data collected between April and October 2015 through a semi-structured interview with the guiding question: What does it mean to have quality of life for a person with diabetes? Results: three categories related to having quality of life: Being healthy - having a controlled disease; Be well with yourself and feel good in your environment. Conclusions: quality of life for a diabetic person and health professionals is to be healthy - to control the disease, to be well with oneself and to feel good in their environment, accepting the limitations. Promoting educational actions to improve the quality of life (Au).

Objetivo: informar el significado de calidad de vida de una persona con diabetes desde la perspectiva de los profesionales de la salud y de los usuarios con diabetes. Método: investigación cualitativa, realizada con 14 personas con diabetes, que reciben atención en las Estrategias de Salud Familiar de Lajeado/Rio Grande do Sul y con 14 profesionales de la salud. Los datos fueron recopilados entre abril y octubre de 2015 mediante una entrevista semiestructurada con la pregunta orientadora: ¿Qué es tener calidad de vida para una persona con diabetes? Resultados: hay tres categorías relacionadas con la calidad de vida: estar sano, tener controlada la enfermedad; estar bien consigo mismo y sentirte bien con su entorno. Conclusiones: tener diabetes y tener calidad de vida es estar sano, por lo tanto, es necesario controlar la enfermedad, sentirse bien consigo mismo y sentirse bien con su entorno, aceptando las limitaciones. Es importante promover acciones educativas para mejorar la calidad de vida (Au).

Sustainability in the dairy industry: a systematic literature review.

The dairy industry can contribute to global food security in a sustainable way by efficiently converting milk into dairy ingredients and products, even though they are polluting on a large scale. In this context, this study aimed to conduct a systematic literature review on sustainable indicators and dairy industries. The methodology used has a qualitative and quantitative approach and its technical procedure was the systematic literature review. The bases of journals consulted, using the keywords "sustainability indicator" and "dairy industry" which resulted in 130 valid scientific articles. The main results show that the sustainability indicators in the dairy industry are emerging and lacking research; being found seven papers, that highlight 12 indicators of the environmental, 11 of the social and eight economic dimensions, that may be considered fragile and initial. The studied problems are related to wastewater treatment methods, electric power consumption, efficiency of the industrial plant, among others, and the benefits on the theme are related to solutions to the difficulties, such as electricity reduction, sustainable practices. Among others, it is concluded that the dairy industries address the sustainability theme since 2011, with an ambiguous trend, being found evidence of the fragility of the sustainability indicators was found, mainly in the initial stage of their conception, when considering holistic approach (triple bottom line).

A influência do tratamento medicamentoso na qualidade de vida de diabéticos / The influence of drug treatment on the QoL of people with diabetes / La influencia del tratamiento farmacológico para la calidad de vida de personas con diabetes

Objetivo: Analisar a adesão de pessoas diabéticas ao tratamento medicamentoso e sua relação com a qualidade de vida. Métodos: Estudo transversal desenvolvido com 350 pessoas com diabetes no município de Lajeado, Rio Grande do Sul. A coleta de dados ocorreu por meio dos questionários Medida de Adesão ao Tratamento (MAT) e Whoqol-bref, aplicados no domicílio dos participantes durante o ano de 2015. Resultados: A maioria das pessoas com diabetes investigadas toma o antidiabético oral metformina (n=305; 87,1%), seguido de glibenclamida (n=151; 43,1%), e 20,9 % (n=73) fazem uso de insulina. A maioria toma sinvastatina (n=259; 74%), ácido acetilsalicílico (AAS) (n=203; 58%), enalapril (n=192; 55%) e hidroclorotiazida (n=180; 52%). Essa população adere positivamente ao tratamento medicamentoso relativo ao controle da doença e a média geral de qualidade de vida é boa (67,6±18,1). A média de qualidade de vida das pessoas que aderem ao tratamento medicamentoso é maior (68,6±15,9) do que as que não aderem (60,9±14,2) (t=3,3162; p= 0,0012). Conclusão: Constatou-se nessa amostra de diabéticos que os que têm melhor adesão ao tratamento medicamentoso relativo ao controle da doença também apresentam uma melhor qualidade de vida quando comparados com o grupo que tem menor adesão aos medicamentos.

Objective: To analyze adherence to drug treatment in people with diabetes and its relationship to quality of life. Methods: This cross-sectional study was carried out with 350 people with diabetes in the municipality of Lajeado, Rio Grande do Sul, Brazil. Data were collected through the Measurement of Adherence to Treatment (MAT) and the WHOQoL-bref questionnaires, which were administered at the participants' homes during the year 2015. Results: Most of the people with diabetes analyzed take the oral antidiabetic drug metformin (n=305; 87.1%), followed by glibenclamide (n=151; 43.1%), and 20.9% (n=73) use insulin. The majority takes simvastatin (n=259; 74%), acetylsalicylic acid (ASA) (n=203; 58%), enalapril (n=192; 55%), and hydrochlorothiazide (n=180; 52%). This population group positively adheres to the drug treatment regime for the control of the disease the mean overall quality of life is good (67.6±18.1). The mean quality of life score among people who adhere to drug the treatment is higher (68.6±15.9) compared to those who do not (60.9±14.2) (t=3.3162; p= 0.0012). Conclusion: In this sample of people with diabetes, those who exhibited good adherence to the drug treatment regime for the control of the disease also presented better quality of life compared to those who exhibited poor adherence to the drug treatment.

Objetivo: Analizar la adhesión de personas con diabetes para el tratamiento farmacológico y su relación con la calidad de vida. Métodos: Estudio transversal desarrollado con 350 personas con diabetes del municipio de Lajeado, Río Grande de Sur. La recogida de datos se dio a través de los cuestionarios Medida de Adhesión al Tratamiento (MAT) y el Whoqol-bref que han sido aplicados en el domicilio de los participantes durante el año 2015. Resultados: La mayoría de las personas con diabetes investigadas toma el fármaco oral para la diabetes metformina (n=305; 87,1%), seguido del glibenclamida (n=151; 43,1%) y el 20,9 % (n=73) usa la insulina. La mayoría toma la sinvastatina (n=259; 74%), el ácido acetilsalicílico (AAS) (n=203; 58%), el enalapril (n=192; 55%) y la hidroclorotiazida (n=180; 52%). Esa población tiene adhesión al tratamiento farmacológico para el control de la enfermedad y la media general de la calidad de vida es buena (67,6±18,1). La media de la calidad de vida de las personas que tiene adhesión al tratamiento farmacológico es mayor (68,6±15,9) de que las que no adhieren al tratamiento (60,9±14,2) (t=3,3162; p=0,0012). Conclusión: En esa muestra de diabéticos se constató que los que tienen mejor adhesión al tratamiento farmacológico para el control de la enfermedad también tienen mejor calidad de vida comparándolos con el grupo de menor adhesión a los fármacos.

Perfil epidemiológico de mulheres mastectomizadas em um serviço de referência localizado no Vale do Taquari/RS / Epidemiological Profile of Mastectomized Women in a Reference Service Located in Vale do Taquari/RS / Perfil epidemiológico de mujeres mastectomizadas en un servicio de referencia localizado en el Valle del Taquari/RS

Justificativa e Objetivos: O câncer de mama é o de maior incidência entre as mulheres no país, sendo a cirurgia a principal medida de tratamento, associada ou não a terapias adjuvantes. O objetivo deste trabalho é verificar o número e identificar o perfil epidemiológico de mulheres diagnosticadas com câncer de mama que realizaram mastectomia radical modificada em um hospital de referência, localizado no Vale do Taquari, no Rio Grande do Sul. Métodos: Estudo epidemiológico retrospectivo, de abordagem quantitativa, no qual foram averiguados 329 prontuários. As variáveis analisadas foram: idade, município de encaminhamento, escolaridade e raça. Resultados: Foram realizadas 150 cirurgias de mastectomia radical entre janeiro de 2008 a junho de 2016, identificando-se mulheres de maioria branca, com baixa escolaridade, na faixa etária superior a 50 anos, provenientes de 29 municípios da região estudada. Conclusão: O perfil epidemiológico da população atendida na referida região segue as características locorregionais e nacionais. Dada a alta incidência de câncer de mama em brasileiras, o número acentuado de mulheres com baixa escolaridade acometidas e, o impacto da doença na qualidade de vida, sugere-se a realização de estudos que verifiquem a evolução pós-operatória, reabilitação clínica, física, psicológica e social após cirurgia de mastectomia radical.(AU)

Background and Objectives: Breast cancer is the one with the highest incidence among women in the country, with surgery being the main measure of treatment, associated or not with adjuvant therapies. The aim is to verify the number and identify the epidemiological profile of women diagnosed with breast cancer who underwent radical modified mastectomy at a referral hospital, located in Vale do Taquari, Rio Grande do Sul. Methods: Retrospective epidemiological study, in which 329 medical records were investigated. The analyzed variables were: age, municipality of referral, schooling and race. Results: 150 radical mastectomy surgeries were performed between January 2008 and June 2016, identifying mostly white women with low schooling in the age group over 50 years of age from 29 municipalities in the region studied. Conclusion: The epidemiological profile of the population served in this region follows the locoregional and national characteristics. Given the high incidence of breast cancer in Brazilians, the high number of women with low schooling affected, and the impact of the disease on quality of life, it is suggested to carry out studies that verify the postoperative evolution, clinical rehabilitation, physical, psychological and social after radical mastectomy surgery.(AU)

Justificación y Objetivos: El cáncer de mama es el de mayor incidencia entre las mujeres en el país, siendo la cirugía la principal medida de tratamiento, asociada o no a terapias adyuvantes. El objetivo de este trabajo es verificar el número e identificar el perfil epidemiológico de mujeres diagnosticadas con cáncer de mama que realizaron mastectomía radical modificada en un hospital de referencia, localizado en el Valle del Taquari, en Rio Grande do Sul/Brasil. Métodos: Estudio epidemiológico retrospectivo, enfoque cuantitativo, en el que se verificaron 329 registros. Las variables analizadas fueron: edad, municipio de encaminamiento, escolaridad y raza. Resultados: Se realizaron 150 cirugías de mastectomía radical entre enero de 2008 a junio de 2016, identificándose mujeres de mayoría blanca, con baja escolaridad, en la franja etaria superior a 50 años, provenientes de 29 municipios de la región estudiada. Conclusiones: El perfil epidemiológico de la población atendida en la referida región sigue las características locorregionales y nacionales. Dada la alta incidencia de cáncer de mama en las brasileñas, el número acentuado de mujeres con baja escolaridad acometidas y, el impacto de la enfermedad en la calidad de vida, se sugiere la realización de estudios que verifiquen la evolución post-operatoria, rehabilitación clínica, física, psicológica y social tras cirugía de mastectomía radical.(AU)

Perfil e conhecimento de gestantes sobre o diabetes mellitus gestacional / Profile and knowledge of pregnant women about gestational diabetes mellitus / Perfil y conocimiento de gestantes sobre el diabetes mellitus gestacional

Justificativa e Objetivos: O diabetes mellitus gestacional (DMG) é o distúrbio metabólico que determina redução da tolerância à glicose, diagnosticado na gestação, que pode ou não se perpetuar após o parto. No Brasil, em torno de 7% das gestações são complicadas pela hiperglicemia gestacional. O presente estudo teve como objetivo avaliar o perfil epidemiológico, socioeconômico, clínico-obstétrico e identificar o conhecimento em relação ao DMG de gestantes atendidas em um Centro Especializado de Saúde da Mulher de uma Unidade Básica de Saúde (UBS) de Lajeado/RS. Métodos: A metodologia consistiu na aplicação de três questionários: avaliação do perfil socioeconômico, epidemiológico e clínico-obstétrico; avaliação do conhecimento sobre DMG; e, avaliação do conhecimento das gestantes sobre diabetes. Participaram da pesquisa 20 gestantes atendidas na UBS no período de 15 de abril a 15 de maio de 2017. As informações foram tabuladas em planilha do Excel, sendo que as variáveis quantitativas foram descritas através de frequência absoluta e relativa e foi seguida a sintaxe prevista para análise do Diabetes Knowledge Questionnaire (DKN-A). Resultados: Os resultados mostraram que as grávidas não possuíam conhecimento sobre diabetes, embora 90% tenham afirmado possuir informação e atualização sobre temas de saúde. A maioria das gestantes era branca, natural de Lajeado, casada ou em união estável, com renda mensal de até três salários mínimos, 85% tinha entre 15 e 35 anos e 50% possuía ensino fundamental. A maioria (90%) não tinha doença prévia à gestação, 55% utilizava medicação durante a gestação, 65% não praticava atividade física e 65% não consultou nutricionista nos últimos 12 meses. Nenhuma das gestantes possuía Diabetes Mellitus ou teve DMG em gestação prévia, contudo uma participante (5%) apresentava DMG. Conclusão: Conclui-se que as gestantes com faixa etária de 15 a 35 anos, entrevistadas na UBS de Lajeado, desconheciam os riscos ou os cuidados necessários na gestação para evitar o DMG.(AU)

Background and Objectives: Gestational diabetes mellitus (GDM) is the metabolic disorder that causes a reduction in glucose tolerance, diagnosed during pregnancy, which may or may not persist after childbirth. In Brazil, around 7% of pregnancies are complicated by gestational hyperglycemia. The present study aimed to evaluate the epidemiological, socioeconomic, clinical and obstetric profile and to identify the knowledge regarding GDM of pregnant women assisted at a Specialized Health Center for Women of a Basic Healthcare Unit (BHU) from Lajeado/RS. Methods: The method consisted of three questionnaires: socioeconomic profile, epidemiological and clinical-obstetric profile, evaluation of knowledge about GDM, and evaluation of pregnant women's knowledge about diabetes. Twenty pregnant women assisted at the BHU from April 15 to May 15, 2017 were enrolled. The information was tabulated in an Excel spreadsheet, and the quantitative variables were described by absolute and relative frequencies, following the syntax predicted for analysis of Diabetes Knowledge Questionnaire - DKN-A. Results: Pregnant women did not have knowledge about diabetes, although 90% reported that they have information and updates on health topics. The majority of pregnant women were white, from Lajeado, married or in a stable union, with monthly income of up to three minimum wages, 85% were between 15 and 35 years old and 50% have primary education. The majority (90%) did not have pre-gestational disease, 55% used some kind of medication during pregnancy, 65% did not practice physical activity and 65% did not consult with a nutritionist in the last 12 months. None of the pregnant women had diabetes mellitus or had GDM in a previous pregnancy, but one participant (5%) had GDM. Conclusion: Pregnant women aged between 15 and 35 years, interviewed at the BHU of Lajeado, were unaware of the risks or care required during pregnancy to avoid GDM.(AU)

Justificación y objetivos: La Diabetes Mellitus Gestacional (DMG) es el trastorno metabólico que determina la reducción de la tolerancia a la glucosa, diagnosticada en la gestación, que puede o no perpetuarse después del parto. En Brasil, alrededor del 7% de las gestaciones son complicadas por la hiperglicemia gestacional. El presente estudio tuvo como objetivo evaluar el perfil epidemiológico, socioeconómico, clínico-obstétrico e identificar el conocimiento en relación a la Diabetes Mellitus Gestacional de gestantes atendidas en un Centro Especializado de Salud de la Mujer de una Unidad Básica de Salud de Lajeado/RS. Métodos: La metodología consistió en la aplicación de tres cuestionarios (evaluación del perfil socioeconómico, epidemiológico y clínico-obstétrico, evaluación del conocimiento sobre DMG, y evaluación del conocimiento de las gestantes sobre diabetes). Participa ron de la investigación 20 gestantes atendidas en la UBS en el período del 15 de abril al 15 de mayo de 2017. Las informaciones fueron tabuladas en la hoja de Excel, siendo que las variables cuantitativas fueron descritas a través de frecuencia absoluta y relativa y fue seguida la sintaxis prevista para análisis del Diabetes Knowledge Questionnaire - DKN-A. Resultados: Los resultados muestran que las embarazadas no tienen conocimiento sobre la diabetes, aunque el 90% afirma poseer información y actualización sobre temas de salud. La mayoría de las gestantes es blanca, natural de Lajeado, casada o en unión estable, con renta mensual hasta 3 salarios mínimos, 85% posee entre 15 y 35 años y 50% posee enseñanza fundamental. La mayoría (90%) no tiene enfermedad previa a la gestación, 55% utiliza medicación durante la gestación, 65% no practica actividad física y 65% no ha consultado a los nutricionistas en los últimos 12 meses. Ninguna de las gestantes poseía Diabetes Mellitus o tuvo DMG en gestación previa, sin embargo una participante (5%) presenta DMG. Conclusiones: Se concluye que las gestantes con grupo de edad de 15 a 35 años, entrevistadas en la UBS de Lajeado, desconocen los riesgos o los cuidados necesarios en la gestación para evitar el DMG.(AU)

Family Health Strategies: Profile/quality of life of people with diabetes.

OBJECTIVE: To evaluate the quality of life and to analyze the epidemiological profile of people with diabetes treated in Family Health Strategies. METHOD: A cross-sectional study carried out with 350 people with diabetes. RESULTS: Most people with diabetes are women, elderly, married, white, with low educational level, retired/pensioners, family income of up to two minimum wages. As the time of people with the disease increases, their quality of life decreases. People with complications from diabetes have a lower quality of life, with a statistically significant difference. CONCLUSION: Knowledge of the sociodemographic characteristics, clinical evaluation and quality of life of people with diabetes can improve the care process provided to this population.

Family Health Strategies: Profile/quality of life of people with diabetes / Estrategias Salud de la Familia: perfil/calidad de vida de personas con diabetes / Estratégias Saúde da Família: perfil/qualidade de vida de pessoas com diabetes

ABSTRACT Objective: To evaluate the quality of life and to analyze the epidemiological profile of people with diabetes treated in Family Health Strategies. Method: A cross-sectional study carried out with 350 people with diabetes. Results: Most people with diabetes are women, elderly, married, white, with low educational level, retired/pensioners, family income of up to two minimum wages. As the time of people with the disease increases, their quality of life decreases. People with complications from diabetes have a lower quality of life, with a statistically significant difference. Conclusion: Knowledge of the sociodemographic characteristics, clinical evaluation and quality of life of people with diabetes can improve the care process provided to this population.

RESUMEN Objetivo: Evaluar la calidad de vida y analizar el perfil epidemiológico de las personas con diabetes atendidas en Estrategias Salud de la Familia. Método: Estudio transversal, realizado con 350 personas con diabetes. Resultados: Las personas con diabetes, en su mayoría, son mujeres, ancianas, casadas, blancas, con bajo nivel instruccional, jubiladas/pensionistas, renta familiar de hasta dos salarios mínimos. A medida que aumenta el tiempo de las personas con la enfermedad, disminuye su calidad de vida. Las personas que tienen complicaciones derivadas de la diabetes tienen una calidad de vida menor, con diferencia estadística significativa. Conclusión: El conocimiento de las características sociodemográficas, de evaluación clínica y de la calidad de vida de las personas con diabetes puede mejorar el proceso de cuidado prestado a esta población.

RESUMO Objetivo: Avaliar a qualidade de vida e analisar o perfil epidemiológico de pessoas com diabetes atendidas em Estratégias Saúde da Família. Método: Estudo transversal, realizado com 350 pessoas com diabetes. Resultados: As pessoas com diabetes, em sua maioria, são mulheres, idosas, casadas, brancas, com baixo nível instrucional, aposentadas/pensionistas, renda familiar de até dois salários mínimos. À medida que aumenta o tempo das pessoas com a doença, diminui a sua qualidade de vida. As pessoas que possuem complicações decorrentes do diabetes possuem uma qualidade de vida menor, com diferença estatística significativa. Conclusão: O conhecimento das características sociodemográficas, de avaliação clínica e da qualidade de vida das pessoas com diabetes pode melhorar o processo de cuidado prestado a esta população.

The healing properties of medicinal plants used in the Brazilian public health system: a systematic review.

OBJECTIVE: The aim of this study was to conduct a systematic review of the healing potential of medicinal plants belonging to the Brazilian National List of Medicinal Plants of Interest to the Unified Health System (RENISUS). METHOD: PubMed and ScienceDirect databases were searched for relevant articles, regardless of the language, from 2010 to June 2016. Two reviewers independently assessed study eligibility. Articles were included if they presented evidence of healing potential of medicinal plants. Only those available as full and open access texts were considered. RESULTS: A total of 1381 articles met the inclusion criteria. Of these, 156 studies were considered eligible and were reviewed as full text. Following full analysis, 64 studies were included in this review. The studies covered 27 of the 71 plants belonging to RENISUS, nine of which are native to Brazil. In addition, two species are currently available in the Brazilian public health system as herbal medicine. CONCLUSION: This review may encourage and contribute to the appropriate use of medicinal plants in the public health system in Brazil.

Ações das equipes da esf para a qualidade de vida das pessoas com diabetes / Acciones de los equipos de la estrategia salud de la familia para la calidad de vida de las personas con diabetes / Actions of fhs teams for the quality of life of people with diabetes

RESUMO O presente estudo teve como objetivo identificar as ações desenvolvidas pelas Estratégias Saúde da Família para melhorar a qualidade de vida das pessoas com diabetes. Trata-se de um estudo com abordagem qualitativa, realizado nas 14 equipes da Estratégia Saúde da Família de um município do interior do estado do Rio Grande do Sul, Brasil. Foram realizadas entrevistas com 14 profissionais e 14 pessoas com diabetes atendidas nos serviços. Os resultados evidenciaram que as equipes da Estratégia Saúde da Família promovem diversas ações interativas para melhorar a qualidade de vida das pessoas com diabetes. As ações relatadas pelos participantes pautaram-se no grupo de apoio nutricional, grupo de caminhadas, consulta nutricional, consulta de enfermagem, consulta médica, distribuição de medicamentos, visita domiciliar, bom atendimento, grupo de diabéticos e hipertensos e grupo de educação em saúde. A educação em diabetes também é promovida em espaços externos dos serviços (grupo de mulheres e escolas).A descrição das ações constatadas neste estudo poderá servir de subsídios para os profissionais de saúde aplicarem no seu fazer profissional e, deste modo, contribuir em melhorias na atenção à saúde da população na perspectiva da promoção da qualidade de vida das pessoas com diabetes.

RESUMEN El presente estudio tuvo como objetivo identificar las acciones desarrolladas por las Estrategias Salud de la Familia para mejorar la calidad de vida de las personas con diabetes. Se trata de un estudio con abordaje cualitativo, realizado en los 14 equipos de la Estrategia Salud de la Familia (ESF) de un municipio del interior del estado de Rio Grande do Sul, Brasil. Fueron realizadas entrevistas con 14 profesionales y 14 personas con diabetes atendidas en los servicios. Los resultados evidenciaron que los equipos de la ESF promueven diversas acciones interactivas para mejorar la calidad de vida de las personas con diabetes. Las acciones relatadas por los participantes se basaron en el grupo de apoyo nutricional, grupo de caminatas, consulta nutricional, consulta de enfermería, consulta médica, distribución de medicamentos, visita domiciliaria, buena atención, grupo de diabéticos e hipertensos y grupo de educación en salud. La educación en diabetes también es promovida en espacios externos de los servicios (grupo de mujeres y escuelas). La descripción de las acciones constatadas en este estudio podrá servir de ayuda para que los profesionales de salud puedan aplicar en su hacer profesional y, de esta manera, contribuir en mejorías para la atención a la salud de la población en la perspectiva de la promoción de la calidad de vida de las personas con diabetes.

ABSTRACT The objective of this study was to identify the actions developed by Family Health Strategies to improve the quality of life of people with diabetes. This is a qualitative study, performed in 14 teams from the Family Health Strategies of a municipality in the countryside of the state of Rio Grande do Sul, Brazil. Interviews were conducted with 14 professionals and 14 people with diabetes treated in the services. The results showed that the teams of the Family Health Strategies promote various interactive actions to improve the quality of life of people with diabetes. The actions reported by participants based on groups for nutritional support, hike, nutritional consultation, nursing consultation, medical consultation, distribution of medicines, household visits, good service, group of diabetic and hypertensive individuals and health education group. Education in diabetes is also promoted in spaces outside services (women's group and schools). The description of actions identified in this study may subsidize health professionals to implement in their professional routine and, thus, contribute to improvements in the health of the population in the context of promoting the quality of life of people with diabetes.

Medicinal plants used in Brazil Public Health System with neuroprotective potential: a systematic review / Plantas medicinales utilizadas en el Sistema de Salud Pública de Brasil con potencial neuroprotector: una revisión sistemática

Current pharmacological therapies to treat neurological diseases are at best palliative and manage only the symptoms. Unfortunately, few therapies can affect diseases outcomes and alternative strategies such as stem cell therapy, neurotransplantation and deep brain stimulation are still in progress. Diseases such as Alzheimer's and Parkinson's disease become major public health challenge worldwide. In this way, the interest in the development of neuroprotective drugs of natural origin grows. Hence, this systematic review has quantified the studies that refer neuroprotective potential of plants listed in the Brazilian National List of Medicinal Plants of Interest to the Unified Health System (RENISUS). Searches were performed in two scientific databases (PubMed and Science Direct) from 2010 to 2016. A total of 4.532 articles met the inclusion criteria. 445 studies were considered eligible and were reviewed as full text. Following full analysis, 63 studies were included in this review. The studies covered 12 of the 71 plants belonging to RENISUS. In addition, two species are currently available in the Brazilian public health system as herbal medicine. This review may encourage and contribute to the proper use of medicinal plants in public health system.

Las terapias farmacológicas actuales para tratar enfermedades neurológicas son, en el mejor de los casos, paliativas y sólo controlan los síntomas. Desafortunadamente, pocas terapias pueden afectar los avances de las enfermedades y las estrategias alternativas tales como terapia con células madre, neurotransplantate y la estimulación profunda del cerebro están todavía en curso. Enfermedades como el Alzheimer y la enfermedad de Parkinson se convierten en un reto importante para la salud pública en todo el mundo. De esta manera, crece el interés en el desarrollo de fármacos neuroprotectores de origen natural. Por lo tanto, esta revisión sistemática ha cuantificado los estudios que hacen referencia al potencial neuroprotector de las plantas incluidas en la Lista Nacional Brasileña de Plantas Medicinales de Interés para el Sistema Único de Salud (RENISUS). Las búsquedas se realizaron en dos bases de datos científicas (PubMed y Science Direct) de 2010 a 2016. Un total de 4,532 artículos cumplieron los criterios de inclusión. 445 estudios se consideraron elegibles y se revisaron como texto completo. Después del análisis completo, se incluyeron 63 estudios en esta revisión. Los estudios abarcaron 12 de las 71 plantas pertenecientes a RENISUS. Además, actualmente hay dos especies disponibles en el sistema de salud pública brasileño como medicina herbaria. Esta revisión puede alentar y contribuir al uso adecuado de las plantas medicinales en el sistema de salud pública.

Estratégias que buscam promover a qualidade de vida de pessoas com Diabetes Mellitus: revisão integrativa / Strategies that seek to promote the quality of life of people with Diabetes Mellitus: integrative review / Las estrategias que buscan promover la calidad de vida de las personas con Diabetes Mellitus: una revisión integradora

Justificativa e Objetivos: O Diabetes Mellitus é caracterizado pela ausência de insulina ou incapacidade da glândula pancreática produzi-la, deixando de exercer certas funções essenciais ao organismo, podendo repercutir na qualidade de vida das pessoas acometidas pela doença. O estudo possui como objetivo conhecer a produção científica sobre as estratégias que buscam promover a qualidade de vida de pessoas com Diabetes Mellitus. Conteúdo: Trata-se de uma Revisão Integrativa, desenvolvida na MEDLINE, LILACS e SCIELO, no decorrer do mês de fevereiro de 2016. Utilizou-se os descritores "diabetes mellitus" and "qualidade de vida" e a partir do estabelecimento dos critérios de inclusão e exclusão, analisou-se nesta revisão um total de 16 artigos que foram lidos na íntegra. Conclusão: As produções mencionam que se faz necessário promover ações de prevenção e de autocuidado com vistas à melhoria da qualidade de vida das pessoas com Diabetes Mellitus. Estudos, na maioria, internacionais, evidenciaram algumas estratégias que podem melhorar a qualidade de vida desses sujeitos. Destaca-se que se encontrou ausência de produções que abordassem quais são as estratégias desenvolvidas pelas equipes de saúde que atuam no cenário da atenção primária em saúde que podem promover a qualidade de vida das pessoas com diabetes.(AU)

Background and Objectives: The Diabetes Mellitus is characterized by lack of insulin or pancreatic gland's inability to produce it, failing to exercise certain functions essential to the body and can impact on the quality of life of people affected by the disease. The study has as objective to know the scientific literature on the strategies that seek to promote the quality of life of people with Diabetes Mellitus. Contents: This is an integrative review, developed in MEDLINE, LILACS and SCIELO, during the month of February 2016. We used the keywords "diabetes mellitus" and "quality of life" and from the establishment of the inclusion criteria and exclusion, analyzed in this review a total of 16 articles were read in full. Conclusion: The productions mention that it is necessary to promote prevention and self-care in order to improve the quality of life of people with Diabetes Mellitus. Studies, mostly international, showed some strategies that can improve the quality of life of these subjects. It is noteworthy that met absence of productions that addressed what are the strategies developed by the health staff working in the setting of primary health care that can promote the quality of life of people with diabetes.(AU)

Justificación y objetivos: La Diabetes Mellitus se caracteriza por la falta de insulina o la incapacidad de glándula pancreática para producirlo, no ejercer ciertas funciones esenciales para el cuerpo y puede tener un impacto en la calidad de vida de las personas afectadas por la enfermedad. El estudio tiene como objetivo conocer la literatura científica sobre las estrategias que buscan promover la calidad de vida de las personas con diabetes mellitus. Contenido: Se trata de una revisión integradora, desarrollado en MEDLINE, LILACS y SCIELO, durante el mes de febrero de 2016. Se utilizó la palabra clave "diabetes mellitus" y "calidad de vida" y desde el establecimiento de los criterios de inclusión y exclusión, analizados en esta revisión un total de 16 artículos fueron leídos en su totalidad. Conclusiones: Las producciones mencionan que es necesario promover la prevención y el autocuidado con el fin de mejorar la calidad de vida de las personas con diabetes mellitus. Los estudios, sobre todo internacionales, mostraron algunas estrategias que pueden mejorar la calidad de vida de estos sujetos. Es de destacar que se encontró ausencia de producciones que abordan cuáles son las estrategias desarrolladas por el personal de salud que trabaja en el ámbito de la atención primaria de salud que puede promover la calidad de vida de las personas con diabetes.(AU)