Different methods for assessing glomerular filtration rate in the elderly.

OBJECTIVE: The objective of this study was to identify the best method to replace cystatin C in the evaluation of glomerular filtration in the elderly. METHODS: Individuals over 60 years of age from a primary care center were studied. Blood was collected to determine creatinine and cystatin C and 24-h urine. Three methods were compared to determine glomerular filtration: Creatinine clearance, Cocroft-Gault, modification of diet in renal disease, and Collaboration Epidemiology of Chronic Kidney Disease based on creatinine, considering as a reference the determination of glomerular filtration using the cystatin-based Chronic Kidney Disease Epidemiology Collaboration equation. The statistical methods used were linear regression, Bland-Altman curve, and receiver operating characteristic. RESULTS: A total of 180 elderly people were evaluated, but 14 patients were lost from the sample, resulting in a total of 166 patients. The average age of patients was 66.9±6.1 years, and 69.8% were females. Regarding the number of patients eligible for the study, there were 12 black, 108 brown, and 46 white, 42.77% hypertensive, and 38.3% diabetic. Glomerular filtration was less than 60 mL/min in 22.28% of patients. Regarding the evaluation of the different equations, the correlation coefficient was lower for creatinine clearance and progressively higher for Cocroft-Gault, modification of diet in renal disease, and Collaboration Epidemiology of Chronic Kidney Disease based on creatinine. The Bland-Altman diagram and the receiver operating characteristic curve showed similar performance to the correlation coefficient for the different equations evaluated. CONCLUSION: Collaboration Epidemiology of Chronic Kidney Disease based on creatinine presented the best performance. Creatinine debug had the worst performance, which reinforces the idea that 24-h urine collection is unnecessary in these patients.

Different methods for assessing glomerular filtration rate in the elderly

SUMMARY OBJECTIVE: The objective of this study was to identify the best method to replace cystatin C in the evaluation of glomerular filtration in the elderly. METHODS: Individuals over 60 years of age from a primary care center were studied. Blood was collected to determine creatinine and cystatin C and 24-h urine. Three methods were compared to determine glomerular filtration: Creatinine clearance, Cocroft-Gault, modification of diet in renal disease, and Collaboration Epidemiology of Chronic Kidney Disease based on creatinine, considering as a reference the determination of glomerular filtration using the cystatin-based Chronic Kidney Disease Epidemiology Collaboration equation. The statistical methods used were linear regression, Bland-Altman curve, and receiver operating characteristic. RESULTS: A total of 180 elderly people were evaluated, but 14 patients were lost from the sample, resulting in a total of 166 patients. The average age of patients was 66.9±6.1 years, and 69.8% were females. Regarding the number of patients eligible for the study, there were 12 black, 108 brown, and 46 white, 42.77% hypertensive, and 38.3% diabetic. Glomerular filtration was less than 60 mL/min in 22.28% of patients. Regarding the evaluation of the different equations, the correlation coefficient was lower for creatinine clearance and progressively higher for Cocroft-Gault, modification of diet in renal disease, and Collaboration Epidemiology of Chronic Kidney Disease based on creatinine. The Bland-Altman diagram and the receiver operating characteristic curve showed similar performance to the correlation coefficient for the different equations evaluated. CONCLUSION: Collaboration Epidemiology of Chronic Kidney Disease based on creatinine presented the best performance. Creatinine debug had the worst performance, which reinforces the idea that 24-h urine collection is unnecessary in these patients.

COVID-19 and Cognitive and Mental Health During Post-Infection Phase: A Study Among Middle-Aged and Older Indigenous Adults From Brazilian Amazons.

OBJECTIVES: To examine the rate of self-reported coronavirus disease-2019 (COVID-19) and its association with mental and cognitive health during the post-infection phase among middle-aged and older indigenous adults. METHODS: A cross-sectional study was conducted, including 141 individuals ≥50 and over from an urban indigenous community in Amazonas, Brazil. COVID-19 was deduced from self-reported infections. Cognitive function was evaluated using the Mini-Mental State Exam, Brief Cognitive Screening Battery (BCSB), and language fluency tests. Meanwhile, mental health was assessed through validated scales examining happiness, stress, and depression symptoms. The association between the rate of COVID-19 and cognitive and mental well-being was analyzed using logistic and linear regressions, adjusted for covariates. RESULTS: From March 2020 to February 2022, 65.2% of the urban indigenous group tested positive for COVID-19. Lower functional capacity decreased the odds of contracting COVID-19 (p = .03). Adjusted linear regression models showed that COVID-19 was associated with higher BCSB learning (p = .017) and delayed recall (p = .028). Women, higher age, lower functional capacity, and hospitalization were associated with worse cognitive performance (p < .05). No impact of mental health indicators on past COVID-19 infection was noted. DISCUSSION: COVID-19 was prevalent among urban Indigenous Brazilians. Unexpectedly, it was linked to enhanced learning and memory, not mental health issues. Cognitive performance was lower for men, older individuals, those with less functional ability, and hospitalized patients, indicating that participant characteristics and disease severity affect the COVID-19 and cognition relationship. Longitudinal studies across diverse Indigenous communities are necessary to understand COVID-19's impact on their cognitive and mental health.

A saúde indígena nas cidades: redes de atenção, cuidado tradicional e intercultural / Indigenous health in cities: care networks, traditional and intercultural care

O livro "A saúde indígena nas cidades: redes de atenção, cuidado tradicional e intercultural", se consolidou a partir de trabalhos e incursões desenvolvidos junto aos povos indígenas no Brasil, com especial atenção aos que vivem em contextos urbanizados. O conjunto da obra aborda experiências na atenção básica e especializada com populações indígenas, o trabalho em saúde indígena, promoção e educação em saúde indígena, vigilância de agravos com populações indígenas, cuidado tradicional e intercultural, ações de enfrentamento da covid-19 nos territórios na relação com as redes de atenção instituídas nos centros urbanos de cidades situadas nos estados do Amazonas, Tocantins, São Paulo, Mato Grosso, Santa Catarina. O livro concentra um conjunto de relatos e resultados de pesquisas, bem como reflexões fundamentadas sobre processos, estruturas e contextos diferenciados de produção de cuidado, na perspectiva da multiculturalidade, representativos das populações indígenas que acessam os serviços de saúde de quatro das cinco regiões brasileiras. Assim, a obra colabora com a realização de um mundo melhor, quando apresenta dispositivos, arranjos e agenciamentos para a produção do cuidado junto a populações vulneráveis socioambientalmente, contrariando um sistema social discriminatório para indígenas que gera desigualdades sociais, principalmente nos centros urbanos.

Glycemic profile and associated factors in indigenous Munduruku, Amazonas.

OBJECTIVE: To evaluate the glycemic profile and its association with sociodemographic, anthropometric, clinical and lifestyle factors of Munduruku indigenous people. METHOD: Cross-sectional study with a quantitative and analytical approach, a total of 459 indigenous people (57.1% men, aged 36.3 ± 14.7 years old) belonging to the Munduruku ethnic group from the Kwatá-Laranjal Indigenous Land, in Amazonas, Brazil, were selected by probabilistic sampling in all households in the four most populous villages. Sociodemographic and anthropometric variables, blood pressure levels and lipid profile were evaluated. Fasting capillary blood glucose was measured with a digital device. The associations were assessed by multinomial logistic regression, and p-values≤0.05 were considered significant. RESULTS: For pre-diabetes, prevalence was 74.3% and, for diabetes, 12.2%. The variables associated with the risk for pre-diabetes were the following: age (OR = 1.03; 95% CI = 1.00 - 1.06) and obesity (OR = 9.69; 95% CI = 1.28 - 73.58). The positive associations indicating risk for diabetes were as follows: age (OR = 1.05; 95% CI = 1.03 - 1.08), overweight (OR = 4.17; 95% CI = 1.69 - 10.32) and obesity (OR = 35.26; 95% CI = 4.12 - 302.08). CONCLUSIONS: The risks associated with pre-diabetes and diabetes among the Munduruku indigenous people revealed a worrying index. It is necessary to consider changes in eating habits and lifestyle, as well as possible environmental and social changes that can affect this and other groups, with emphasis on those who live in vulnerable conditions.

High blood pressure levels and cardiovascular risk among Munduruku indigenous people.

OBJECTIVE: to identify the risk factors associated with prehypertension and arterial hypertension among Munduruku indigenous people in the Brazilian Amazon. METHOD: a cross-sectional study carried out with 459 Munduruku indigenous people selected by means of stratified random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glucose and lipid profiles were evaluated. An automatic device calibrated and validated to measure blood pressure was used. The analyses of the data collected were carried out in the R software, version 3.5.1. For continuous variables, the Kruskall-Wallis test was used; for the categorical ones, Fischer's Exact. The significance level was set at 5% and p-value≤0.05. RESULTS: the prevalence of altered blood pressure levels was 10.2% for values suggestive of hypertension and 4.1% for pre-hypertension. The risk of prehypertension among indigenous people was associated with being male (OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with substantially increased waist circumference (OR=5.46; 95% CI=1.78-16.75). CONCLUSION: among Munduruku indigenous people, men were more vulnerable to developing hypertension; age and increased waist circumference proved to be strong cardiovascular risk factors.

Pressão arterial elevada em servidores de universidades públicas no norte do brasil / High blood pressure in public university employees in northern brazil / High blood pressure in public university employees in northern brazil

RESUMO Objetivo: identificar o perfil de pressão arterial elevada em servidores públicos. Método: estudo de prevalência, realizado com 223 servidores das Pró-Reitorias de duas universidades públicas de Manaus. A coleta consistiu em entrevista para levantamento das condições sociodemográficas, estilo de vida e medida da pressão arterial sistêmica, durante o período de janeiro a março de 2018. Foi aplicado teste Qui-quadrado e considerada significância de 5%. Resultados: o percentual de participantes com pressão arterial elevada foi de 5,4%. As comorbidades mais autorreferidas foram hipertensão [41,7% (p=0,002)], diabetes mellitus [25% (p=0,001)] e obesidade [58,3% (p=0,0001)]. A maioria dos participantes informou não praticar atividade física regularmente. Conclusão: os resultados deste estudo poderão contribuir como subsídios para a implementação de ações preventivas, controle de agravos e ações que garantam o tratamento eficaz nos indivíduos com Hipertensão Arterial Sistêmica, sobretudo no âmbito da saúde do trabalhador.

RESUMEN Objetivo: identificar el perfil de hipertensión arterial en empleados públicos. Método: estudio de prevalencia realizado con 223 empleados de las Oficinas del Decano de dos universidades públicas de Manaos. El proceso de recolección de datos consistió en una entrevista para recopilar las condiciones sociodemográficas, el estilo de vida y la medición de la presión arterial sistémica, entre enero y marzo de 2018. Se aplicó la prueba de chi-cuadrado y se consideró un nivel de significancia del 5%. Resultados: el porcentaje de participantes con hipertensión arterial fue del 5,4%. Las comorbilidades más autodeclaradas fueron las siguientes: hipertensión [41,7% (p=0,002)], diabetes mellitus [25% (p=0,001)] y obesidad [58,3% (p=0,0001)]. La mayoría de los participantes declaró no practicar actividad física regularmente. Conclusión: los resultados de este estudio podrán servir como apoyo para implementar acciones preventivas, control de enfermedades y acciones que garanticen un tratamiento eficaz de las personas con Hipertensión Arterial Sistémica, especialmente en el ámbito de la salud ocupacional.

ABSTRACT Objective: to identify the profile of high blood pressure in public employees. Method: a prevalence study, carried out with 223 employees working in the Dean Offices of two public universities in Manaus. Collection consisted of an interview to survey the sociodemographic conditions, lifestyle and systemic blood pressure measurement, from January to March 2018. The Chi-square test was applied and 5% significance was considered. Results: the percentage of participants with high blood pressure was 5.4%. The most frequently self-reported comorbidities were hypertension [41.7% (p=0.002)], diabetes mellitus [25% (p=0.001)] and obesity [58.3% (p=0.0001)]. Most of the participants reported not practicing regular physical activity. Conclusion: the results of this study may contribute as subsidies for the implementation of preventive actions, disease control and actions that ensure effective treatment for individuals with Systemic Arterial Hypertension, especially in the context of worker's health.

High blood pressure levels and cardiovascular risk among Munduruku indigenous people / Níveis pressóricos elevados e risco cardiovascular entre indígenas Munduruku / Niveles altos de presión arterial y riesgo cardiovascular entre los indígenas Munduruku

Objective: to identify the risk factors associated with prehypertension and arterial hypertension among Munduruku indigenous people in the Brazilian Amazon. Method: a cross-sectional study carried out with 459 Munduruku indigenous people selected by means of stratified random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glucose and lipid profiles were evaluated. An automatic device calibrated and validated to measure blood pressure was used. The analyses of the data collected were carried out in the R software, version 3.5.1. For continuous variables, the Kruskall-Wallis test was used; for the categorical ones, Fischer's Exact. The significance level was set at 5% and p-value≤0.05. Results: the prevalence of altered blood pressure levels was 10.2% for values suggestive of hypertension and 4.1% for pre-hypertension. The risk of prehypertension among indigenous people was associated with being male (OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with substantially increased waist circumference (OR=5.46; 95% CI=1.78-16.75). Conclusion: among Munduruku indigenous people, men were more vulnerable to developing hypertension; age and increased waist circumference proved to be strong cardiovascular risk factors.

Objetivo: identificar os fatores de risco associados à préhipertensão e hipertensão arterial entre indígenas Munduruku da Amazônia brasileira. Método: estudo transversal realizado com 459 indígenas Munduruku selecionados por meio de amostragem aleatória estratificada. Foram avaliadas variáveis sociodemográficas, hábitos e estilos de vida, dados antropométricos, glicemia de jejum e perfis lipídicos. Utilizou-se aparelho automático calibrado e validado para medir a pressão arterial. As análises dos dados coletados foram realizadas pelo software R versão 3.5.1. Para as variáveis contínuas, utilizou-se o teste Kruskall-Wallis; para as categóricas, o Exato de Fischer. Considerou-se nível de significância de 5% e valor p≤0,05. Resultados: a prevalência de níveis pressóricos alterados foi de 10,2% para valores sugestivos de hipertensão e de 4,1% para pré-hipertensão. O risco de pré-hipertensão entre indígenas associou-se a ser do sexo masculino (OR=1,65; IC95% 0,65-4,21) e ter circunferência da cintura aumentada substancialmente (OR=7,82; IC95% 1,80-34,04). Quanto ao risco para hipertensão arterial, associou-se à idade (OR=1,09; IC95% 1,06-1,12), à circunferência da cintura aumentada (OR=3,89; IC95% 1,43-10,54) e à circunferência da cintura aumentada substancialmente (OR=5,46; IC95% 1,78-16,75). Conclusão: entre indígenas Munduruku, os homens estavam mais vulneráveis para desenvolver hipertensão; a idade e a circunferência da cintura aumentada mostraram-se como fortes fatores de risco cardiovascular.

Objetivo: identificar los factores de riesgo asociados con la prehipertensión y la hipertensión arterial entre los indígenas Munduruku en la Amazonía brasileña. Método: estudio transversal realizado con 459 indígenas Munduruku seleccionados mediante muestreo aleatorio estratificado. Se evaluaron variables sociodemográficas, hábitos y estilos de vida, datos antropométricos, glucosa en ayunas y perfiles lipídicos. Se utilizó un dispositivo automático calibrado y validado para medir la presión arterial. Los análisis de los datos recopilados se llevaron a cabo mediante el software R versión 3.5.1. Para las variables continuas se utilizó la prueba de KruskalWallis; para las categóricas, Exacto de Fischer. El nivel de significancia se estableció en 5% y p≤0,05. Resultados: la prevalencia de niveles alterados de presión arterial fue del 10,2% para valores sugestivos de hipertensión y del 4,1% para prehipertensión. El riesgo de prehipertensión entre los indígenas se asoció al sexo masculino (OR=1,65; IC95% 0,65-4,21) y a un aumento sustancial de la circunferencia de cintura (OR=7,82; IC95% 1,80-34,04). En cuanto al riesgo de hipertensión arterial, se asoció con la edad (OR=1,09; IC95% 1,06-1,12), con un aumento de la circunferencia de la cintura (OR=3,89; IC95% 1,43-10,54) y con un aumento sustancial de la circunferencia de la cintura (OR=5,46; IC95% 1,78-16,75). Conclusión: entre los indios Munduruku, los hombres eran más vulnerables a desarrollar hipertensión, la edad y el aumento de la circunferencia de la cintura demostraron ser fuertes factores de riesgo cardiovascular.

(Des)conhecimento da equipe de enfermagem sobre a medida não-invasiva da pressão arterial / (Un)knowledge of nursing team about non-invasive blood pressure measurement / (Des)conocimiento del equipo de enfermaría sobre la medición no invasiva de la presión arterial

Objetivo: Identificar os conhecimentos da equipe de enfermagem sobre a medida não-invasiva da Pressão Arterial. Metodologia: Estudo descritivo com enfermeiros e técnicos das clínicas médica e cirúrgica de um hospital universitário, utilizando instrumento validado com 12 questões. Os resultados foram apresentados mediante estatística descritiva (média, desvio padrão, mediana, frequência relativa) e inferencial (Teste-T e Análise de Correspondência). Resultados: A média total de acertos foi 5,6 ±1,8 (p≤ 0,684). O conhecimento foi satisfatório (≤60%) somente nas questões relacionadas a: Preparo do Cliente para a medida da Pressão Arterial, Erros de leitura do profissional e Erros de leitura relacionados ao aparelho. Na Análise de Correspondência, errar foi mais significativo em ambas categorias profissionais. Conclusão: A equipe de enfermagem possui déficits no conhecimento sobre a medida não-invasiva da Pressão Arterial, sendo necessários a capacitação e treinamento sistemático sobre o tema (Au).

Objective: To identify the knowledge of the nursing team on non-invasive blood pressure measurement. Methodology: Descriptive study with nurses and technicians from the medical and surgical clinics of a university hospital, using an instrument validated with 12 questions. The results were presented using descriptive statistics (mean, standard deviation, median, relative frequency) and inferential statistics (T-Test and Correspondence Analysis). Results: The total average of correct answers was 5.6 ± 1.8 (p≤ 0.684). The knowledge was satisfactory (≤ 60%) only in the questions related to: Customer Preparation for the measurement of Blood Pressure, Professional reading errors and Reading errors related to the device. In Correspondence Analysis, making mistakes was more significant in both professional categories. Conclusion: The nursing team has deficits in knowledge about the non-invasive measurement of Blood Pressure, requiring training and systematic training on the topic (Au).

Objetivo: Identificar los conocimientos del equipo de enfermería sobre la medición no invasiva de la presión arterial. Metodología: Estudio descriptivo con enfermeros y técnicos de las clínicas médica y quirúrgica de un hospital universitario, utilizando un instrumento validado con 12 preguntas. Los resultados se presentaron mediante estadística descriptiva (media, desviación estándar, mediana, frecuencia relativa) y estadística inferencial (prueba T y análisis de correspondencia). Resultados: El promedio total de aciertos fue de 5,6 ± 1,8 (p≤ 0,684). El conocimiento fue satisfactorio (≤60%) solo en las preguntas relacionadas con: Preparación del paciente para la medición de la presión arterial, errores de lectura profesional y errores de lectura relacionados con el dispositivo. En el Análisis de Correspondencia, cometer errores fue más significativo en ambas categorías profesionales. Conclusión: El equipo de enfermería presenta déficits en el conocimiento sobre la medición no invasiva de la Presión Arterial, necesita capacitación y entrenamiento sistemático en el tema (Au).

Primary Health Care attributes in the context of indigenous health.

OBJECTIVES: to assess the attributes of Primary Health Care from the perspective of health professionals, comparing services in the Special Indigenous Health District and the Municipal Health Offices. METHODS: a cross-sectional study in the Upper Rio Negro region, State of Amazonas, with 116 professionals. The data were collected through the Primary Care Assessment Tool. Scores were categorized (≥ 6.6) - strong orientation and (<6.6) - low orientation. The chi-square and maximum likelihood test for crossover analysis. The comparison between professionals the Kruskal-Wallis Test. RESULTS: a higher overall score was observed in the Indigenous Health District (7.2). The same trend was observed individually in the essential and derived attributes. CONCLUSIONS: this work may support strategies that positively impact the management model and work processes from the perspective of strengthening the primary care offered to the population from Rio Negro.

Quality of life of individuals receiving kidney transplantation in Amazonas State.

OBJECTIVE: to analyze the quality of life of kidney transplant receivers in the State of Amazonas. METHOD: a cross-sectional, descriptive study, performed with 222 individuals after renal transplantation registered in a private clinic and in a health public ambulatory. Data collection took place through structured interviews where the quality of life was measured by the Kidney Disease Quality of Life - Short Form. Descriptive statistics were used for data analysis. RESULTS: the quality of life scores found ranged from 36.5 to 83.1. The quality of life domains, specifics of renal disease, have proved to be superior to generic ones. The most compromised were work situation; sleep; physical function and emotional function, with scores of 36.5; 53.7; 52.4; 55.1, respectively, and correlated moderately and significantly with each other. CONCLUSION: the majority (63.2%) of the quality of life domains obtained high scores and the specific component of renal disease had higher scores than the generic component.

Cardiovascular risk factors: differences between ethnic groups.

OBJECTIVES: to compare the metabolic, anthropometric, tobacco and alcohol consumption indicators considered as risk factors for cardiovascular diseases, as well as the demographic and socioeconomic characteristics between indigenous from Rio Negro, Sateré-Mawé, mixed-race/black and white people living in the city of Manaus. METHODS: a cross-sectional observational study guided by the STROBE tool. There was a sample of 191 adults of both sexes. Anthropometric measurements, blood pressure and biochemical analyzes were performed. Statistical test was applied to cross color/race/ethnicity variable with the investigated variables. RESULTS: indigenous had better metabolic and anthropometric indicators related to cardiovascular diseases than mixed-race/black and white, as well as Sateré-Mawé in relation to Rionegrinos (from Rio Negro). CONCLUSIONS: the main differences were obesity, dyslipidemia, pre-systemic arterial hypertension/systemic arterial hypertension, and increased circumferences, with a worse situation for mixed-race/black people. The findings indicate differences in risk factors between race/color and ethnicity groups evaluated.

Primary Health Care attributes in the context of indigenous health / Atributos de la Atención Primaria de Salud en el contexto de la salud indígena / Atributos da Atenção Primária à Saúde no contexto da saúde indígena

ABSTRACT Objectives: to assess the attributes of Primary Health Care from the perspective of health professionals, comparing services in the Special Indigenous Health District and the Municipal Health Offices. Methods: a cross-sectional study in the Upper Rio Negro region, State of Amazonas, with 116 professionals. The data were collected through the Primary Care Assessment Tool. Scores were categorized (≥ 6.6) - strong orientation and (<6.6) - low orientation. The chi-square and maximum likelihood test for crossover analysis. The comparison between professionals the Kruskal-Wallis Test. Results: a higher overall score was observed in the Indigenous Health District (7.2). The same trend was observed individually in the essential and derived attributes. Conclusions: this work may support strategies that positively impact the management model and work processes from the perspective of strengthening the primary care offered to the population from Rio Negro.

RESUMEN Objetivos: evaluarlos atributos de la Atención Primaria de Salud, desde la perspectiva de los profesionales de la salud, comparando servicios en el Distrito Especial de Salud Indígena y los Departamentos Municipales de Salud. Métodos: este es un estudio transversal en la región del Alto Rio Negro, Amazonas, con 116 profesionales. Los datos fueron recolectados a través de la Primary Care Assessment Tool. Las puntuaciones se clasificaron (≥ 6.6) - orientación fuerte y (<6.6) - orientación baja. La prueba de chi-cuadrado y de máxima verosimilitud para el análisis cruzado. La comparación entre profesionales de la prueba de Kruskal-Wallis. Resultados: se observó una puntuación general más alta en el Distrito de Salud Indígena (7,2). La misma tendencia se observó individualmente en los atributos esenciales y derivados. Conclusiones: este trabajo puede apoyar estrategias que impacten positivamente el modelo de gestión y los procesos de trabajo desde la perspectiva del fortalecimiento de la Atención Primaria ofrecida a la población de Río Negro.

RESUMO Objetivos: avaliar os atributos da Atenção Primária à Saúde, na perspectiva dos profissionais de saúde, comparando os serviços no Distrito Sanitário Especial Indígena e nas Secretarias Municipais de Saúde. Métodos: trata-se de um estudo transversal, na região do Alto Rio Negro, Amazonas, com 116 profissionais. Os dados foram coletados por meio do Primary Care Assessment Tool. Fez-se a categorização dos escores (≥ 6,6) - forte orientação e (< 6,6) - baixa orientação. O Teste Qui-Quadrado e de máxima verossimilhança para análise dos cruzamentos. A comparação entre os profissionais o Teste de Kruskal-Wallis. Resultados: foi observado escore geral maior no Distrito Sanitário Indígena (7,2). A mesma tendência foi observada individualmente nos atributos essenciais e derivados. Conclusões: este trabalho poderá subsidiar estratégias que impactem positivamente no modelo de gestão e processos de trabalho na perspectiva do fortalecimento da Atenção Primária ofertada à população rionegrina.

Cardiovascular risk factors: differences between ethnic groups / Factores de riesgo cardiovascular: diferencias entre grupos étnicos / Fatores de risco cardiovascular: diferenças entre grupos étnicos

ABSTRACT Objectives: to compare the metabolic, anthropometric, tobacco and alcohol consumption indicators considered as risk factors for cardiovascular diseases, as well as the demographic and socioeconomic characteristics between indigenous from Rio Negro, Sateré-Mawé, mixed-race/black and white people living in the city of Manaus. Methods: a cross-sectional observational study guided by the STROBE tool. There was a sample of 191 adults of both sexes. Anthropometric measurements, blood pressure and biochemical analyzes were performed. Statistical test was applied to cross color/race/ethnicity variable with the investigated variables. Results: indigenous had better metabolic and anthropometric indicators related to cardiovascular diseases than mixed-race/black and white, as well as Sateré-Mawé in relation to Rionegrinos (from Rio Negro). Conclusions: the main differences were obesity, dyslipidemia, pre-systemic arterial hypertension/systemic arterial hypertension, and increased circumferences, with a worse situation for mixed-race/black people. The findings indicate differences in risk factors between race/color and ethnicity groups evaluated.

RESUMEN Objetivos: comparar los indicadores metabólicos, antropométricos, de consumo de tabaco y alcohol considerados como factores de riesgo para enfermedades cardiovasculares, así como las características demográficas y socioeconómicas entre los indígenas del Rio Negro, Sateré-Mawé, población de raza mixta/negra y blanca que viven en la ciudad de Manaus. Métodos: estudio observacional transversal, guiado por la herramienta STROBE. La muestra consistió en 191 adultos de ambos sexos. Se realizaron mediciones antropométricas, presión sanguínea y análisis bioquímicos. La prueba estadística se aplicó a la variable de color/raza/etnia con las variables investigadas. Resultados: los indígenas tenían mejores indicadores metabólicos y antropométricos relacionados con las enfermedades cardiovasculares que los de raza mixta/negros y blancos, así como los Sateré-Mawé en relación con los rionegrinos (del Rio Negro). Conclusiones: las principales diferencias fueron: obesidad, dislipidemia, pre-hipertensión arterial sistémica/ hipertensión arterial sistémica y aumento de las circunferencias, con una situación peor para los raza mixta/negros. Los resultados indican diferencias en los factores de riesgo entre los grupos de raza/color y etnia evaluados.

RESUMO Objetivos: comparar os indicadores metabólicos, antropométricos, de consumo de tabaco e álcool, considerados como fatores de risco para doenças cardiovasculares, assim como as características demográficas e socioeconômicas entre indígenas do Rio Negro, Sateré-Mawé, Pardos/Negros e Brancos que residem na cidade de Manaus. Métodos: estudo observacional transversal, norteado pela ferramenta STROBE. Amostra de 191 adultos de ambos os sexos. Realizadas medidas antropométricas, pressão arterial e análises bioquímicas. Aplicado teste estatístico no cruzamento da variável cor/raça/etnia com as variáveis investigadas. Resultados: os indígenas apresentaram melhores indicadores metabólicos e antropométricos relacionados às doenças cardiovasculares que os pardos/negros e brancos, assim como os Sateré-Mawé em relação aos rionegrinos. Conclusões: as principais diferenças foram: obesidade, dislipidemia, pré-hipertensão arterial sistêmica/hipertensão arterial sistêmica e circunferências aumentadas, com destaque de pior situação para os pardos/negros. Os achados indicam haver diferenças nos fatores de risco entre os grupos de raça/cor e etnia avaliados.

Quality of life of individuals receiving kidney transplantation in Amazonas State / Qualidade de vida de pessoas receptoras de transplante renal no Amazonas / Calidad de vida de las personas receptoras de trasplante renal en Amazonas

Abstarct Objective: to analyze the quality of life of kidney transplant receivers in the State of Amazonas. Method: a cross-sectional, descriptive study, performed with 222 individuals after renal transplantation registered in a private clinic and in a health public ambulatory. Data collection took place through structured interviews where the quality of life was measured by the Kidney Disease Quality of Life - Short Form. Descriptive statistics were used for data analysis. Results: the quality of life scores found ranged from 36.5 to 83.1. The quality of life domains, specifics of renal disease, have proved to be superior to generic ones. The most compromised were work situation; sleep; physical function and emotional function, with scores of 36.5; 53.7; 52.4; 55.1, respectively, and correlated moderately and significantly with each other. Conclusion: the majority (63.2%) of the quality of life domains obtained high scores and the specific component of renal disease had higher scores than the generic component.

Objetivo: analisar a qualidade de vida de receptores de transplante renal no Estado do Amazonas. Método: estudo transversal, descritivo, realizado com 222 indivíduos pós-transplante renal cadastrados em uma clínica privada e em um ambulatório público de saúde. A coleta de dados deu-se por meio de entrevista estruturada onde a qualidade de vida foi medida pelo Kidney Disease Quality of Life - Short Form. Para a análise dos dados, foi utilizada estatística descritiva. Resultados: os escores de qualidade de vida encontrados variaram de 36,5 a 83,1. Os domínios de qualidade de vida específicos da doença renal mostraram-se superiores aos genéricos. Os mais comprometidos foram Situação de trabalho; Sono; Função física e Função emocional, com escores 36,5; 53,7; 52,4; 55,1, respectivamente, e correlacionados moderada e significativamente entre si. Conclusão: a maioria (63,2%) dos domínios de qualidade de vida obtiveram escores elevados e o componente específico da doença renal teve pontuações superiores ao componente genérico.

Objetivo: analizar la calidad de vida de las personas receptoras de trasplante renal en el Estado de Amazonas. Método: estudio transversal descriptivo, realizado con 222 personas, con posterioridad a la realización de un trasplante renal, inscriptos en una clínica privada y en un hospital público. La recolección de datos se realizó mediante entrevista semiestructurada y se midió la calidad de vida por medio del Kidney Disease Quality of Life - Short Form. En el análisis de datos, se utilizó la estadística descriptiva. Resultados: El puntaje de calidad de vida obtenido osciló de 36,5 a 83,1. Los dominios de calidad de vida propios de la enfermedad renal, tuvieron un puntaje superior al genérico. Los más comprometidos fueron: situación laboral, sueño, función física y función emocional, con puntajes de 36,5; 53,7; 52,4; 55,1, respectivamente, y correlacionados moderada y significativamente entre sí. Conclusión: la mayoría (63,2%) de los dominios relativos a la calidad de vida obtuvieron puntajes elevados y el componente específico de la enfermedad renal obtuvo un puntaje superior al componente genérico.

Enfrentamento, dificuldades e práticas de autocuidado de pacientes com doença renal crônica submetidos à diálise peritoneal / Enfrentamiento, dificultades y prácticas de autocuidado de pacientes con enfermedad renal crónica en diálisis peritoneal / Coping, difficulties and self-care practices of patients with chronic renal failure submitted to peritoneal dialysis

Objetivos: Compreender o enfrentamento, as difi culdades e as práticas de autocuidado utilizadas por pessoas com doença renal crônica, submetidas ao tratamento por diálise peritoneal, por meio de uma síntese de estudos, primários e elegíveis, encontrados na literatura. Resultados: Foram selecionados 09 artigos provenientes das bases de dados LILACS, IBECS e BDENF, com base nos critérios de inclusão e exclusão. Sendo, quatro na língua portuguesa, dois na língua inglesa e três na língua espanhola. Os resultados foram discutidos em categorias específi cas. Conclusão: A experimentação de um novo momento da vida do individuo acometido por Doença Renal Crônica que consequentemente, o leva ao tratamento por Diálise Peritoneal. Essa doença traz grandes mudanças no estilo de vida do acometido. Toda essa situação deve ser muito bem considerada pelo profi ssional de enfermagem que será o principal intermediador para o êxito nesse processo de tratamento. É esse profi ssional de saúde que deverá dá suporte para a família do enfermo e conduzir o paciente a receber um tratamento com todos os cuidados necessários para obter um bem-estar físico e emocional em sua nova etapa de vida.

Objective: To understand the coping, difficulties and self-care practices used by persons with chronic renal failure, submitted to peritoneal dialysis treatment, by a synthesis of primary and eligible studies, found in the literature. Results: Selected nine articles from the databases based on the inclusion and exclusion criteria. There are four in the Portuguese language, two in the English language and three in the Spanish language. The results were discussed in specific categories. Conclusion: The experience of a new moment of the individual´s life affected by Chronic Renal Disease, which consequently leads him to Peritoneal Dialysis Treatment. This disease brings major changes in the affected individual´s life style. The nursing professional who will be the main intermediator for the success in this treatment process should very well consider this whole situation. This health professional is who should give support for the family of the ill person and lead the patient to receive a treatment with all the care needed to reach a physical and emotional well-being in its new stage of life.

Objetivos: Comprender el enfrentamiento, las dificultades, y las prácticas de autocuidado utilizadas por personas con enfermedad renal crónica en diálisis peritoneal, por medio de una síntesis de estudios primarios y elegibles, encontrados en la literatura. Resultados: Fueron seleccionados 09 artículos provenientes de las bases de datos LILACS, IBECS y BDENF, con base en los criterios de inclusión y exclusión. Fueron cuatro artículos en portugués, dos en inglés y tres en español. Los resultados fueron discutidos en categorías específicas. Conclusión: La experiencia de un nuevo momento de la vida del individuo con Enfermedad Crónica Renal que como consecuencia lo lleva al tratamiento con Diálisis Peritoneal. Esta enfermedad trae grandes cambios en el estilo de vida de la persona que la padece. Toda esta situación debe ser ampliamente considerada por el profesional de enfermería que será el principal intermediario para el éxito de este proceso de tratamiento. Es el profesional de salud quien deberá dar soporte a la familia de la persona enferma y conducir al paciente a recibir un tratamiento con todos los cuidados necesarios para obtener un bienestar físico y emocional en esta nueva etapa de su vida.

Percepções e fatores associados à hipertensão arterial em populações indígenas: revisão integrativa / Percepciones y factores asociados a la hipertensión arterial en poblaciones indígenas: revisión integradora / Perceptions and factors associated with arterial hypertension in indigenous populations: an integrative review

OBJETIVO: Identificar nas produções científicas da literatura nacional e internacional as percepções e fatores associados à hipertensão em populações indígenas. MÉTODOS: Revisão integrativa da literatura, realizada nas bases de dados LILACS, PUBMED e Web of Science, nos meses de novembro e dezembro de 2017, com um recorte temporal de dez anos. RESULTADOS: Foram identificados dez artigos em conformidade com os critérios estabelecidos. Desses, seis foram publicados em português; e sete são estudos transversais. A prevalência da hipertensão entre os diferentes grupos étnicos variou de 2,8% a 46,2% e os principais fatores de risco associados à hipertensão entre indígenas foram o comportamental e o socioeconômico. Observou-se que a percepção e crença sobre o surgimento da hipertensão relaciona-se à mudança na alimentação, ao acesso a alimentos industrializados e à dificuldade de enfretamento da doença. CONCLUSÃO: As tendências atuais relacionadas aos níveis pressóricos apontam a necessidade de uma atenção integral ao indígena no processo saúde-doença.

OBJETIVO: Identificar en las producciones científicas de la literatura nacional e internacional las percepciones y los factores asociados a la hipertensión en poblaciones indígenas. MÉTODOS: Revisión integradora de la literatura, realizada en las bases de datos LILACS, PUBMED y Web of Science, en los meses de noviembre y diciembre de 2017, común recorte temporal de diez anos. RESULTADOS: Fueron identificados diez artículos en conformidad con los criterios establecidos. De ellos, seis publicados en portugués; y siete son estudios transversales. La prevalencia de la hipertensión entre los diferentes grupos étnicos varió de 2,8% a 46,2% y los principales factores de riesgo asociados a la hipertensión entre indígenas fueron el de comportamiento y el socioeconómico. Se observó que la percepción y la creencia sobre el surgimiento de la hipertensión se relacionan al cambio de alimentación, al acceso a alimentos industrializados y a la dificultad de enfrentar la enfermedad. CONCLUSIÓN: Las tendencias actuales relacionadas a los niveles presóricos señalan la necesidad de ofrecerle una atención integral al indígena en el proceso salud-enfermedad.

AIM: To identify in the scientific productions of the national and international literature the perceptions and factors associated with hypertension in indigenous populations. METHODS: Integrative literature review, carried out in the LILACS, PUBMED and Web of Science databases, in November and December 2017, with a 10-year time cut. RESULTS: Ten articles were identified in accordance with the established criteria. Of these, six were published in Portuguese; and seven are cross-sectional studies. The prevalence of hypertension among the different ethnic groups ranged from 2.8% to 46.2% and the main risk factors associated with hypertension among natives were behavioral and socioeconomic. It was observed that the perception and belief about the onset of hypertension is related to the change in diet, access to industrialized foods and the difficulty of coping with the disease. CONCLUSION: Current trends related to blood pressure levels point to the need for comprehensive indigenous care in the health-disease process

Humanizaçäo em unidade de terapia intensiva: paciente-equipe de enfermagem-família / Humanism in the intensive care units

Atualmente podemos destacar uma preocupaçäo muito grande por parte dos profissionais da saúde sobre a questäo da humanizaçäo em Unidade de Terapia Intensiva (UTI). Com o passar dos anos houve a necessidade de promover um ambiente que proporcionasse ao paciente melhores condiçöes de bem-estar, respeitando a integridade física, mental e ainda favorecendo aos familiares a proximidade com o paciente por intermédio de uma planta física adequada. A família próxima é de grande valia para a equipe e o paciente, pois auxilia no planejamento da assistência a ser prestada, pelas informaçöes oferecidas...