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1.
Trop Med Int Health ; 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32677284

RESUMO

OBJECTIVES: To analyse the accuracy of American tegumentary leishmaniasis (ATL) diagnostic methods and evaluate the quality of the existing publications by means of a systematic review. METHODS: Diagnostic tests evaluated in at least two studies with common reference standards were included in the sensitivity and/or specificity meta-analyses. Quality and susceptibility to bias were analysed using the QUADAS-2 and STARD tools. RESULTS: The title and abstract of 3387 publications were evaluated after deduplication resulting from database searches. Thirty-eight studies were included in the review, and 26 of them had results inserted in meta-analyses. The diagnostic methods with the highest pooled sensitivity values were ELISA, polymerase chain reaction (PCR), indirect immunofluorescence reaction and Montenegro's intradermal reaction. Cytometry was assessed in only two studies and presented 100% sensitivity in both. Smear slide microscopy and histopathology showed low pooled values of sensitivity. For specificity, the highest pooled values were identified for PCR. High values were also identified for ELISA, except for studies in which the reference standard for defining negative participants included individuals with Chagas' disease or paracoccidioidomycosis, which also occurred for cytometry. IFR had lower specificities than ELISA. There was a predominance of case-control designs of phase 1 or 2 and only four studies were strongly recommended as evidence generators. Several reference standards were adopted, and different methods were assessed in a small number of studies. CONCLUSION: PCR showed the highest accuracy for the diagnosis of ATL, and its use should be encouraged in clinical practice. ELISA is recommended for the screening of suspected individuals, but the possibility of cross-reactions should be considered. New validation studies for the tests evaluated in few publications and studies of phase 3 with appropriate methods are needed.

2.
Curr Neuropharmacol ; 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32469700

RESUMO

There are several studies investigating the effects of risperidone in autism, but many of these studies are contradictory or inconclusive. This systematic review and meta-analysis investigated the effects of risperidone on five domains of Aberrant Behaviour Checklist (ABC) scale on Autism Spectrum Disorder (ASD), as well as weight gain and waist circumference. The protocol for the present systematic review and meta-analysis was registered on International Prospective Register of Systematic Reviews (PROSPERO). For this study, we analysed articles (2,459), selecting them according to the PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). Although risperidone is effective for the treatment of lethargy and inadequate speech, concerns about the association between weight gain, waist circumference and risperidone require a need to evaluation of the risk-benefit ratio in its use. There was a significant association between weight gain, waist circumference and risperidone. In Conclusion, it was possible to suggest the efficacy of risperidone for the treatment of lethargy and inadequate speech. Finally, we emphasize that the risk-benefit in its use should be evaluated. Protocol number CRD42019122316.

3.
PLoS One ; 15(3): e0229344, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130255

RESUMO

RATIONALE, AIMS AND OBJECTIVES: In recent years, the use of proton pump inhibitors (PPI), especially omeprazole, has been associated with development of chronic kidney disease (CKD). These drugs are widely used worldwide. Although some studies have found an association between the use of PPI and the onset of acute renal failure and CKD. This study aims to analyze the association between the continuous use of omeprazole and the progression of CKD in adult and elderly individuals. METHOD: A retrospective cohort study was conducted with patients followed up at a nephrology clinic in Brazil, in 2016 and 2017. Information about clinical and sociodemographic data, health behaviors, and medication use were collected from all patients diagnosed with CKD through consultation of medical charts and the Brazilian health information system (SIS). The participants were allocated into two groups: users and non-users of omeprazole, and the progression of CKD was then evaluated for each group. In the bivariate analysis, the Mann-Whitney U test to compare the quantitative variables between groups, and the Pearson/Fisher two-tailed chi-square test to compare the categorical variables were applied. Multivariate analysis was performed using Cox regression. RESULTS: A total of 199 CKD patients were attended in the polyclinic, and of these, 42.7% were omeprazole users. There was a higher percentage of CKD progression in users (70.6%) compared to non-users (10.5%). The hazard ratio was 7.34 (CI: 3.94-13.71), indicating a higher risk of progression to worse stages of CKD in omeprazole users than in non-users. As for the other variables, no statistically significant difference was found between groups (p > 0.05). CONCLUSION: An association between omeprazole use and progression of CKD stage was identified, showing a higher risk of disease evolution among omeprazole users.


Assuntos
Omeprazol/efeitos adversos , Insuficiência Renal Crônica/patologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco
4.
Wound Manag Prev ; 65(6): 40-46, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31373565

RESUMO

People with an ostomy need care appropriate to their needs and should be encouraged to adapt to their situation. In Brazil, persons with a stoma meet the legal definition of being disabled, enabling them to access comprehensive health care services. PURPOSE: The objective of this study was to evaluate the degree of disability experienced by persons with a colostomy. METHODS: A cross-sectional study was conducted among people with a colostomy in one Brazilian public health service. Between May 2017 and January 2018, persons at least 18 years of age who had a colostomy for at least 3 months were eligible to participate. Sociodemographic and stoma characteristic variables were collected, and the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 was used to assesses perceived levels of disability. Higher scores indicated greater degree of difficulty. All persons with a WHODAS score ⟩0 were classified as disabled. Descriptive statistics, chi-squared, and Fisher's exact tests were used for data analysis, with a significance level of 5%. RESULTS: Among the 58 predominantly elderly participants (29 women, 29 men; mean age 64 ± 12 years), the overall mean WHODAS score suggested a small degree of impairment (3.1 ± 7.1). The highest scores were observed in the domains participation (6.3 ± 16.1), mobility (5.6 ± 17.3), and life activities (5.3 ± 15.6). The majority of participants (41, 70.7%) had a disability score of 0 (no disability). The proportion of persons who did or did not perceive any level of disability did not differ significantly by the stoma variables assessed. CONCLUSION: Based on the WHODAS scores, the majority of study participants did not perceive themselves as being physically disabled. Other clinical studies should advance this discussion in order to better understand the perception and reality of disability among ostomates.

5.
Cien Saude Colet ; 24(8): 2951-2958, 2019 Aug 05.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31389542

RESUMO

Adolescence is a phase of several structural and functional transformations. Physical exercise is capable of inducing adaptive plasticity on the nervous system, reducing the risks of future psychiatric pathologies. This research aimed to investigate adolescents' knowledge about the benefits of physical exercise on mental health. This is a cross-sectional study, carried out in a state school from a city in the Midwestern region of Minas Gerais. Data collection included a self-developed questionnaire to measure knowledge about the benefits of Physical Exercise on Mental Health, an International Physical Activity Questionnaire and a socioeconomic questionnaire from the Brazilian Association of Research Companies. Data were analyzed with descriptive statistics tools, Kruskal-Wallis and chi-square tests, with a significance level of 5%. We found that individuals that are more active had greater knowledge about the benefits of physical exercise to mental health in relation to sedentary individuals. Thus, knowledge can be a protective factor against sedentarism and physical inactivity, significantly improving the aspects related to the quality of life of the adolescent.


Assuntos
Comportamento do Adolescente/psicologia , Exercício Físico/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Saúde Mental , Adolescente , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Qualidade de Vida , Comportamento Sedentário , Inquéritos e Questionários , Adulto Jovem
6.
Ciênc. Saúde Colet ; 24(8): 2951-2958, ago. 2019. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1011876

RESUMO

Resumo A adolescência é uma fase de várias transformações estruturais e funcionais. O exercício físico é capaz de promover plasticidade adaptativa sobre o sistema nervoso, reduzindo os riscos de futuras patologias psiquiátricas. Essa pesquisa teve como objetivo investigar o conhecimento dos adolescentes acerca dos benefícios do exercício físico sobre a saúde mental. Trata-se de um estudo transversal, realizado em uma escola estadual de um município do Centro-Oeste de Minas Gerais. Para coleta de dados, além de um questionário próprio desenvolvido para medir o conhecimento acerca dos benefícios do Exercício Físico sobre a Saúde Mental, foram utilizados o International Physical Activity Questionnaire, e o questionário socioeconômico da Associação Brasileira de Empresas de Pesquisa. Os dados foram analisados por meio de ferramentas de estatística descritiva e pelos testes de Kruskal-Wallis e de qui-quadrado, a um nível de significância de 5%. Verificou-se que indivíduos mais ativos possuíam maior conhecimento acerca dos benefícios do exercício físico para a saúde mental em relação aos indivíduos sedentários. Assim, o conhecimento pode ser um fator protetor contra o sedentarismo e a inatividade física, melhorando significativamente o aspecto relacionado à qualidade de vida do adolescente.


Abstract Adolescence is a phase of several structural and functional transformations. Physical exercise is capable of inducing adaptive plasticity on the nervous system, reducing the risks of future psychiatric pathologies. This research aimed to investigate adolescents' knowledge about the benefits of physical exercise on mental health. This is a cross-sectional study, carried out in a state school from a city in the Midwestern region of Minas Gerais. Data collection included a self-developed questionnaire to measure knowledge about the benefits of Physical Exercise on Mental Health, an International Physical Activity Questionnaire and a socioeconomic questionnaire from the Brazilian Association of Research Companies. Data were analyzed with descriptive statistics tools, Kruskal-Wallis and chi-square tests, with a significance level of 5%. We found that individuals that are more active had greater knowledge about the benefits of physical exercise to mental health in relation to sedentary individuals. Thus, knowledge can be a protective factor against sedentarism and physical inactivity, significantly improving the aspects related to the quality of life of the adolescent.

7.
Rev. enferm. UFSM ; 9: [17], jul. 15, 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1024694

RESUMO

Objetivo: identificar o perfil e as demandas de saúde de adolescentes escolares no Município de Divinópolis, Minas Gerais. Método: estudo transversal, exploratório-descritivo, realizado com 389 adolescentes do 8º e 9º anos do ensino fundamental. Resultados: entre os participantes do estudo, 34,4% já fizeram uso de álcool, 17,7% experimentaram fumar e 7,4% fizeram uso de maconha. A maioria dos adolescentes considerou seu estado de saúde como ótimo ou bom (84,4%). Dos que iniciaram atividade sexual, 28,9% relataram não utilizar nenhum tipo de método. Percentual elevado de adolescentes mencionou solidão em algum momento da vida (77,9%) e 5,3% dos meninos envolveram-se em brigas. Conclusão: as demandas dos adolescentes relacionadas ao sexo inseguro, saúde mental fragilizada, uso de álcool e outras drogas foram identificadas como prioritárias, necessitando da atuação conjunta entre saúde e educação na construção de estratégias comuns para o atendimento das necessidades inerentes ao adolescente.


Objective: to identify the profile and health demands of school-age adolescents in Divinopolis, Minas Gerais, Brazil. Method: cross-sectional, exploratory-descriptive study, developed with 389 adolescents from the 8th and 9th grades of elementary school. Results: Among the study participants, 34.4% had already consumed alcohol, 17.7% had tried smoking and 7.4% marijuana. Most of the adolescents considered their health status as excellent or good (84.4%). Among the students who were sexually active, 28.9% reported not using any type of contraceptive method. Many adolescents (77.9%) mentioned loneliness at some point in their lives and 5.3% of the boys had engaged in fights. Conclusion: the adolescents' priority demands were related to unsafe sex, impaired mental health, alcohol and drug use, demanding the joint action of health and education in the construction of shared strategies for meeting the adolescents' inherent needs.


Objetivo: identificar el perfil y las demandas de salud de adolescentes escolares en el município de Divinopolis, Minas Gerais, Brasil. Método: Estudio transversal, desarrollado con 389 adolescentes del 8º y 9º año de la enseñanza fundamental. Resultados: Entre los participantes, 34,4% consumió alcohol al menos una vez, 17,7% experimentó fumar y 7,4% usó marihuana. La mayoría de los adolescentes consideró su estado de salud como óptimo o bueno (84,4%). De los que iniciaron actividad sexual, el 28,9% relató no utilizar ningún tipo de método anticonceptivo. Muchos adolescentes (77,9%) mencionaron soledad en algún momento de la vida y el 5,3% de los niños se involucró en peleas. Conclusión: Los asuntos relacionados con la sexualidad, salud mental, uso de alcohol y otras drogas se identificaron como prioridades, que requieren la acción conjunta entre la salud y la educación en la construcción de estratégias comunes para satisfacer las necessidades inherentes de los adolescente.


Assuntos
Humanos , Estudos Transversais , Adolescente , Sexualidade , Vulnerabilidade em Saúde , Necessidades e Demandas de Serviços de Saúde
8.
Acta Trop ; 197: 105052, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31233726

RESUMO

Human and canine visceral leishmaniasis (HVL and CVL, respectively) represent serious public health issues in Brazil. The surveillance and control measures currently employed have had limited effect in impeding the territorial expansion of the disease and in reducing the number of cases. We have investigated the space-time distribution of HVL incidence rates and CVL prevalence in the coverage areas of the 148 primary healthcare units in Belo Horizonte (MG, Brazil) during a 6-year period in order to identify those that should be prioritized for disease control actions. Data were smoothed using the empirical Bayes method and analyzed by space-time scanning and application of univariate global Moran's I index and local indicators of spatial association (LISA) statistics to identify spatial autocorrelations. Point data of CVL were analyzed using the Kernel method. Bivariate global Moran's I and LISA techniques were employed to identify spatial correlations between HVL and CVL. Based on our results, we were able to formulate two proposals for establishing the prioritization of coverage areas, namely: (i) classification of maximum priority areas as identified by bivariate LISA for HVL and CVL, and (ii) combination of maximum priority areas with high priority areas as identified by univariate LISA for HVL. According to our proposals, 27 coverage areas in Belo Horizonte were categorized as maximum priority and a further 13 were classified as high priority. Our proposals, which are based on practical, feasible and inexpensive statistical tools, will contribute to a better understanding of VL distribution in urban settings and improving the efficiency of governmental control programs.


Assuntos
Doenças do Cão/epidemiologia , Leishmaniose Visceral/epidemiologia , Animais , Brasil/epidemiologia , Doenças do Cão/prevenção & controle , Cães , Humanos , Incidência , Leishmaniose Visceral/prevenção & controle , Leishmaniose Visceral/veterinária , Prevalência , Análise Espaço-Temporal
9.
Arq Gastroenterol ; 56(1): 34-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141078

RESUMO

BACKGROUND: The maintenance of nutrition for the person with ileostomy is a major challenge despite to the proper management of stoma eliminations. OBJECTIVE: This study aimed to evaluate the nutritional status of people with ileostomy. METHOD: This is a cross-sectional study carried out on a population of 17 people with ileostomy enrolled in the Service of Attention to the Health of the Person with Stoma of level II, referring to a health region in Minas Gerais. The anthropometric evaluation consisted of the collection of weight, height, and calculation of body mass index. A 24-hour food recall and the nutritional assessment method Global Subjective Assessment were also evaluated. The data were analyzed by the Dietbox software, where the ingested nutrients were estimated, and by the Statistical Package for the Social Sciences version 22.0. RESULTS: There was a predominance of a population composed of people over 50 years old, female, married and single, with family income between two and three minimum wages, incomplete elementary school and that did not exercise paid activity. The cancer was given as the main diagnosis that originated the stoma and had a surgery time of less than two years. Regarding nutritional status, most of the interviewees presented adequate body mass index, but more than half reported significant weight loss after the ileostomy. The predominant nutritional diagnosis provided by the General Subjective Assessment was "suspected malnutrition/moderate malnutrition". On the other hand, the contribution of energy, carbohydrates, lipids, sodium, potassium, magnesium and vitamin B12 was considered insufficient in almost all the participants. CONCLUSION: Therefore, it is suggested the periodic evaluation of the nutritional status of this population. Thus, it is expected that preventive, therapeutic and maintenance dietary diagnosis and planning may contribute to the nutritional status of the person with the ileostomy.


Assuntos
Antropometria , Ileostomia , Estado Nutricional , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Ingestão de Energia , Feminino , Humanos , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Avaliação Nutricional , Complicações Pós-Operatórias , Fatores Socioeconômicos , Perda de Peso
10.
Eur J Pharm Sci ; 136: 104937, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31128208

RESUMO

Thalidomide (TLD) is used to treat erythema nodosum leprosum (ENL), multiple myeloma, aphthous ulceration and wasting syndrome in HIV patients. The API can be found in two crystalline habits known as α-TLD and ß-TLD. The saturation solubility (Cs) and the dissolution profiles under non-sink and sink conditions of both polymorphs were assessed. In addition, mini-capsules containing α-TLD or ß-TLD without excipients were orally given (10 mg/kg) to Wistar rats. An intravenous (i.v.) dose was also administrated (5 mg/kg). The Cs values for α-TLD and ß-TLD were not significantly different (α = 56.2 ±â€¯0.5 µg·mL-1; ß = 55.2 ±â€¯0.2 µg·mL-1). However, the dissolution profile of α-TLD presented the fastest rate and the largest extension of drug dissolution than that from ß-TLD (80% in 4 h versus 55% in 4 h). The α-TLD provided a more favorable pharmacokinetic than the ß-TLD (maximum plasma concentration - Cmax: 5.4 ±â€¯0.90 µg·mL-1versus 2.6 ±â€¯0.2 µg·mL-1; area under the curve of the concentration-time profile from time zero to infinity - AUC0-∞: 44.3 ±â€¯8.8 µg·h·mL-1versus 33.9 ±â€¯4.7 µg·h·mL-1; absolute bioavailability - F: 92.2 ±â€¯18.5% versus 70.5 ±â€¯9.9%, respectively). Drug suppliers and pharmaceutical companies should strictly control the technological processes involved in the TLD API synthesis as well as in the production of the pharmaceutical dosage form in order to guarantee the inter-batch homogeneity and therefore, product compliance.


Assuntos
Talidomida/química , Talidomida/farmacocinética , Animais , Área Sob a Curva , Disponibilidade Biológica , Cápsulas/química , Cápsulas/farmacocinética , Liberação Controlada de Fármacos/efeitos dos fármacos , Excipientes/química , Infecções por HIV/tratamento farmacológico , Infecções por HIV/metabolismo , Masculino , Ratos , Ratos Wistar , Solubilidade/efeitos dos fármacos
11.
Arq Gastroenterol ; 2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30970139

RESUMO

BACKGROUND: The maintenance of nutrition for the person with ileostomy is a major challenge despite to the proper management of stoma eliminations. OBJECTIVE: This study aimed to evaluate the nutritional status of people with ileostomy. METHOD: This is a cross-sectional study carried out on a population of 17 people with ileostomy enrolled in the Service of Attention to the Health of the Person with Stoma of level II, referring to a health region in Minas Gerais. The anthropometric evaluation consisted of the collection of weight, height, and calculation of body mass index. A 24-hour food recall and the nutritional assessment method Global Subjective Assessment were also evaluated. The data were analyzed by the Dietbox software, where the ingested nutrients were estimated, and by the Statistical Package for the Social Sciences version 22.0. RESULTS: There was a predominance of a population composed of people over 50 years old, female, married and single, with family income between two and three minimum wages, incomplete elementary school and that did not exercise paid activity. The cancer was given as the main diagnosis that originated the stoma and had a surgery time of less than two years. Regarding nutritional status, most of the interviewees presented adequate body mass index, but more than half reported significant weight loss after the ileostomy. The predominant nutritional diagnosis provided by the General Subjective Assessment was "suspected malnutrition/moderate malnutrition". On the other hand, the contribution of energy, carbohydrates, lipids, sodium, potassium, magnesium and vitamin B12 was considered insufficient in almost all the participants. CONCLUSION: Therefore, it is suggested the periodic evaluation of the nutritional status of this population. Thus, it is expected that preventive, therapeutic and maintenance dietary diagnosis and planning may contribute to the nutritional status of the person with the ileostomy.

12.
Rev. bras. promoç. saúde (Impr.) ; 32: 1-10, 28/03/2019.
Artigo em Inglês, Português | LILACS | ID: biblio-1048913

RESUMO

Objetivo: Avaliar o desempenho de equipes de Saúde da Família (eSF) e equipes de Atenção Básica (eAB) sobre a presença e extensão de atributos da Atenção Primária à Saúde (APS) através da visão dos usuários. Métodos: Trata-se de um estudo observacional transversal realizado em um município da região centro-oeste de Minas Gerais (MG) entre janeiro e junho de 2016 com amostra representativa de 384 usuários assistidos por eSF e eAB. Os dados foram obtidos por meio da aplicação do instrumento Primary Care Assessment Tool (PCATool-Brasil) - usuários adultos. Inicialmente, calculou-se o escore de cada atributo/componente e os escores essencial e geral. Utilizou-se a modelagem de análise multivariada para identificar variáveis associadas à avaliação satisfatória (escore ≥ 6,6) da APS. Resultados: Os resultados apontam que a maioria dos atributos/componentes da APS não está devidamente implantado no cenário em questão. Identificou-se, ainda, na análise multivariada, que a avaliação de usuários da eSF (Odds Ratio: 2,09) e de pessoas com até oito anos de estudo (Odds Ratio: 1,94) está associada à avaliação satisfatória da APS. Conclusão: Na visão dos usuários, a eSF tem maior potencial para a presença e extensão dos atributos/componentes da APS, reforçando, assim, o papel de destaque dessa estratégia como principal arranjo organizacional de APS no cenário nacional. (AU)


Assuntos
Atenção Primária à Saúde , Avaliação em Saúde , Saúde da Família
13.
Arq. gastroenterol ; 56(1): 34-40, Jan.-Mar. 2019. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1001320

RESUMO

ABSTRACT BACKGROUND: The maintenance of nutrition for the person with ileostomy is a major challenge despite to the proper management of stoma eliminations. OBJECTIVE: This study aimed to evaluate the nutritional status of people with ileostomy. METHOD: This is a cross-sectional study carried out on a population of 17 people with ileostomy enrolled in the Service of Attention to the Health of the Person with Stoma of level II, referring to a health region in Minas Gerais. The anthropometric evaluation consisted of the collection of weight, height, and calculation of body mass index. A 24-hour food recall and the nutritional assessment method Global Subjective Assessment were also evaluated. The data were analyzed by the Dietbox software, where the ingested nutrients were estimated, and by the Statistical Package for the Social Sciences version 22.0. RESULTS: There was a predominance of a population composed of people over 50 years old, female, married and single, with family income between two and three minimum wages, incomplete elementary school and that did not exercise paid activity. The cancer was given as the main diagnosis that originated the stoma and had a surgery time of less than two years. Regarding nutritional status, most of the interviewees presented adequate body mass index, but more than half reported significant weight loss after the ileostomy. The predominant nutritional diagnosis provided by the General Subjective Assessment was "suspected malnutrition/moderate malnutrition". On the other hand, the contribution of energy, carbohydrates, lipids, sodium, potassium, magnesium and vitamin B12 was considered insufficient in almost all the participants. CONCLUSION: Therefore, it is suggested the periodic evaluation of the nutritional status of this population. Thus, it is expected that preventive, therapeutic and maintenance dietary diagnosis and planning may contribute to the nutritional status of the person with the ileostomy.


RESUMO CONTEXTO: Além do manejo adequado das eliminações da estomia, a manutenção da nutrição para a pessoa com ileostomia é um grande desafio. OBJETIVO: Este trabalho teve como objetivo avaliar o estado nutricional de pessoas com ileostomia. MÉTODOS: Trata-se de um estudo transversal, realizado numa população de 17 pessoas com ileostomia cadastrados no Serviço de Atenção à Saúde da Pessoa Ostomizada de nível II referência para uma região de saúde em Minas Gerais. Foi realizada a avaliação antropométrica que consistiu na coleta do peso, altura e cálculo do índice de massa corporal. Também foi avaliado um recordatório alimentar de 24 horas e o método de avaliação nutricional Avaliação Subjetiva Global. Os dados foram analisados pelo software Dietbox, onde foi estimado os nutrientes ingeridos, e pelo Statistical Package for the Social Sciences versão 22.0. RESULTADOS: Houve predomínio de uma população composta por pessoas com idade superior a 50 anos, do sexo feminino, de estado civil casado e solteiro, com renda familiar entre dois e três salários mínimos, ensino fundamental incompleto e que não exerciam atividade remunerada. O câncer foi dado como principal diagnóstico que originou a estomia e possuíam um tempo de cirurgia menor que dois anos. Quanto ao estado nutricional, a maior parte dos entrevistados apresentaram índice de massa corporal adequada, porém mais da metade referiu perda de peso importante após a confecção da ileostomia. O diagnóstico nutricional predominante, fornecido pela Avaliação Subjetiva Geral foi de "suspeita de desnutrição/desnutrido moderado". Já o aporte de energia, carboidratos, lipídeos, sódio, potássio, magnésio e vitamina B12 foi avaliado como insuficiente na quase totalidade dos participantes. CONCLUSÃO: Portanto, sugere-se a avaliação periódica do estado nutricional dessa população. Assim, espera-se que o diagnóstico e planejamento dietético preventivo, terapêutico e de manutenção possam contribuir para a condição nutricional da pessoa com ileostomia.

14.
Infect Genet Evol ; 74: 103293, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-28987807

RESUMO

Dogs have different susceptibility degrees to leishmaniasis; however, genetic research on this theme is scarce, manly on visceral form. The aims of this systematic review were to describe and discuss the existing scientific findings on genetic susceptibility to canine leishmaniasis, as well as to show the gaps of the existing knowledge. Twelve articles were selected, including breed immunological studies, genome wide associations or other gene polymorphism or gene sequencing studies, and transcription approaches. As main results of literature, there was a suggestion of genetic clinical resistance background for Ibizan Hound dogs, and alleles associated with protection or susceptibility to visceral leishmaniasis in Boxer dogs. Genetic markers can explain phenotypic variance in both pro- and anti-inflammatory cytokines and in cellular immune responses, including antigen presentation. Many gene segments are involved in canine visceral leishmaniasis phenotype, with Natural Resistance Associated Macrophage Protein 1 (NRAMP1) as the most studied. This was related to both protection and susceptibility. In comparison with murine and human genetic approaches, lack of knowledge in dogs is notorious, with many possibilities for new studies, revealing a wide field to be assessed on canine leishmaniasis susceptibility research.


Assuntos
Doenças do Cão/genética , Doenças do Cão/imunologia , Leishmaniose Visceral/veterinária , Animais , Apresentação do Antígeno , Cruzamento , Doenças do Cão/parasitologia , Cães , Regulação da Expressão Gênica , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla/veterinária , Leishmaniose Visceral/genética , Leishmaniose Visceral/imunologia , Polimorfismo de Nucleotídeo Único
15.
Ciênc. rural (Online) ; 49(10): e20180984, 2019. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1045243

RESUMO

ABSTRACT: Visceral leishmaniasis (VL) is a zoonotic disease with a canine urban reservoir in South America. Dogs from an endemic area within Brazil, which were naturally infected with Leishmania infantum, and those presenting severe clinical (SC), mild, or no clinical (MNC) disease, were evaluated. Parasite load, histopathology, and cytokine and iNOS mRNA expressions were assessed in the spleen and liver in order to determine the potential markers for disease susceptibility or resistance. As a result, dogs with both SC and MNC had high parasite loads; IFN-γ was the most expressive cytokine in both organs, along with IL-6 and IL-4 being detected in the spleen and liver, and IL-10 only in liver. The hepatic tissue presented higher medians for IFN-γ and IL-10, and was the main organ to produce cytokines with hepatic IL-10 suggesting a regulatory follow up. Granulomas were detected in both organs; however, when absent in spleen, they were associated with elevated IL-6 levels, thus highlighting the anti-inflammatory role of IL-6. Microscopic lesions in the spleen were predominantly characterized by an extensively disorganized white pulp and splenic response was suggested as sub optimized. Parasite load, tissue damage, and immunological response may vary in the dogs with similar clinical symptoms, which may not be a good parameter for assessing the animal's susceptibility to VL.


RESUMO: A Leishmaniose visceral (LV) é uma doença zoonótica com reservatório canino na América do Sul. Cães oriundos de área endemica brasileira, naturalmente infectados por Leishmania infantum, apresentando doença clínica severa (CS) ou doença branda ou ausente (BA) foram avaliados. Carga parasitária, histopatologia e expressão de mRNA de citocinas e iNOS foram analisados em baço e fígado, buscando determinar possíveis marcadores de susceptibilidade ou resistência à doença. Como principais resultados, tanto cães CS como BA apresentaram alta carga parsitária. IFN-γ foi a citocina mais expressiva em ambos os órgãos, sendo IL-6 e IL-4 também detectadas em baço e fígado e IL-10 em fígado. No tecido hepático foram encontradas as maiores medianas de IFN-γ e IL-10, sendo o fígado o principal órgão produtor de citocinas, com IL-10 sugerindo acompanhamento regulatório. Granulomas foram detectados em ambos os órgãos. Quando de sua ausência no baço, essa foi associada à elevação dos níveis de IL-6, salientando o papel anti-inflamatório dessa citocina. Alterações microscópicas foram principalmente caracterizadas por extensiva desorganização de polpa branca, com a resposta esplência sendo sugerida como subotimizada. Carga parasitária, dano tecidual e resposta immune variaram mesmo em cães com quadros clínicos similares, não sendo, portanto, a análise clínica um bom parâmetro para avaliação de susceptibilidade animal à LV.

16.
Vet Parasitol ; 261: 96-103, 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-30253858

RESUMO

Canine visceral leishmaniosis (CVL), a parasitic disease caused by Leishmania infantum, may evolve to a chronic condition and lead to death. Evaluation of infected dogs is important to establish the clinical and laboratory parameters involved in the evolution of the disease. The objectives of the present study were to discriminate a canine population (n = 52) into sub-clinical and clinically affected dogs based on signs and scores, to evaluate the hematological, biochemical, histopathological and parasitological parameters of the two dog groups, and to analyze the results by multivariate regression analysis with the aim of establishing biomarkers of CVL clinical disease. The most common signs observed in the clinically affected dogs (n = 29) were hyperkeratosis, weight loss, onychogryphosis, pale mucosa and lymphadenomegaly. In the multivariate analysis, animals presenting high IgG avidity index and low red blood, lymphocyte and eosinophil counts, and low serum urea concentration had an increased probability of being classified as clinically affected (p < 0.05). All five parameters were considered to be strong biomarkers for monitoring the clinical disease, while IgG avidity percentage was strongly correlated with the number of clinical signs and could function as an indicator of the duration of infection. This is the first report on the application of IgG avidity and of multivariate regression analysis in establishing associations between the clinical signs of CVL and host biomarkers. Since avidity index (AI) percentages were strongly correlated with the number of clinical signs, it could be useful in clinical practice for auxiliary diagnosis of CVL and monitoring disease progression. A limitation of this study is the lack of information on co-infections by Anaplasma platys, Babesia canis vogeli, Ehrlichia canis and Hepatozoon canis. Therefore future studies should evaluate the influence of such co-infections on the associations studied using multivariate methods with larger samples.


Assuntos
Contagem de Células Sanguíneas/veterinária , Doenças do Cão/diagnóstico , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/veterinária , Animais , Biomarcadores/análise , Doenças do Cão/parasitologia , Cães , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/parasitologia , Modelos Logísticos , Análise Multivariada
17.
J. bras. psiquiatr ; 67(2): 87-93, jan.-jun. 2018. tab
Artigo em Português | LILACS-Express | LILACS | ID: biblio-893959

RESUMO

RESUMO Objetivos O estudo objetivou verificar o padrão de consumo de bebidas alcoólicas e a presença do beber pesado episódico (BPE) entre os estudantes de Medicina de uma universidade do centro-oeste de Minas Gerais. Métodos Trata-se de um estudo transversal, exploratório e descritivo, realizado com 202 graduandos do curso de Medicina de uma universidade do centro-oeste de Minas Gerais. A coleta de dados foi realizada no primeiro semestre de 2015, com a utilização de um questionário sociodemográfico e do questionário Audit. O tratamento estatístico dos dados foi realizado com a utilização da análise bivariada, por meio do teste qui-quadrado ou do teste de Fisher e de modelos multivariados de regressão logística. Resultados Observou-se que o álcool é utilizado por 76,6% dos estudantes pesquisados, e 53,7% praticavam o BPE. O consumo de bebidas alcoólicas teve associação significativa com a idade e o fato de não morar com a família e estar acima do terceiro ano de graduação. O BPE, por sua vez, esteve associado com o sexo masculino e com o fato de não morar com a família. Conclusões Este trabalho mostrou que o consumo de álcool entre os estudantes de Medicina é maior do que o da população geral e que a prática do BPE possui alta prevalência nesse grupo. Idade, não morar com a família e período mais avançado do curso foram associados a maior consumo de álcool. Ser do sexo masculino e não morar com a família se associaram a maior risco de BPE.


ABSTRACT Objectives The study had as its goal to verify the pattern of the alcoholic beverages consumption and the presence of drinking heavily snatchy (BPE) among the Medicine students of a Minas Gerais Midwest university. Methods It is about a transversal, exploratory and descriptive study, performed on 202 graduating students of the Medicine course of a Minas Gerais Midwest university. The data collet was performed on the first term of 2015, a sociodemographic questionnaire and the Audit questionnaire were used. The statistical treatment of the data was performed with the use of the bivariate analysis, through the chi-square test or by the Fisher test, and multivariate logistic regression models. Results It was noticed that the alcohol is used by 76,6% of the students surveyed, being that 53,7% practiced the drinking heavily episodic. The alcoholic beverages consumption had meaningful association with the age, not living with family and being above the 3rd year of graduation. Drinking heavily episodic had meaningful association with the males and not living with family. Conclusions This paperwork has shown that the alcohol consumption among Medicine students is bigger than among the general population and the binge drink practice has high prevalence on that group. Age, not living with the family and more advanced period of the course were associated with higher alcohol consumption. Being male and not living with the family were associated with a higher risk of BPE.

18.
Rev. enferm. UFPE on line ; 12(2): 312-319, fev.2018. ilus, tab
Artigo em Português | BDENF - Enfermagem | ID: biblio-965549

RESUMO

Objetivo: avaliar o efeito de ação de educação em saúde, conduzida pelo Facebook, na prevalência de sobrepeso/obesidade e na satisfação corporal de adolescentes, bem como a relação de concordância entre estas medidas e as diferenças em adolescentes. Método: estudo quantitativo, ensaio não controlado, em que 69 adolescentes de ambos os sexos, dos 13 aos 19 anos, foram avaliados em 4 meses quanto ao estado nutricional e percepção corporal, antes e depois de intervenção de educação em saúde sobre nutrição. Resultados: 20,8% estavam com excesso de peso, 20,3% se percebiam com excesso de peso e 36,2% apresentavam insatisfação corporal. Houve maior prevalência de insatisfação corporal entre adolescentes do sexo feminino com sobrepeso/obesidade. Conclusão: não se evidenciou impacto estatisticamente significativo da estratégia de educação em saúde executada na prevalência de sobrepeso/obesidade e na satisfação com a imagem corporal. Discutem-se os fatores associados com o baixo impacto da intervenção e a importância de estudos dessa natureza, visto que a obesidade é multideterminada, o que implica a necessidade de que abordagens utilizadas para a prevenção e o controle desse agravo sejam avaliadas quanto a seus sucessos e insucessos para que sejam aprimoradas em estudos futuros.(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Imagem Corporal , Antropometria , Educação em Saúde , Saúde do Adolescente , Sobrepeso , Rede Social , Obesidade Pediátrica , Estado Nutricional
19.
PLoS One ; 12(11): e0187233, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29091961

RESUMO

The existence of free-roaming dogs raises important issues in animal welfare and in public health. A proper understanding of these animals' ecology is useful as a necessary input to plan strategies to control these populations. The present study addresses the population dynamics and the effectiveness of the sterilization of unrestricted dogs using capture and recapture procedures suitable for open animal populations. Every two months, over a period of 14 months, we captured, tagged, released and recaptured dogs in two regions in a city in the southeast region of Brazil. In one of these regions the animals were also sterilized. Both regions had similar social, environmental and demographic features. We estimated the presence of 148 females and 227 males during the period of study. The average dog:man ratio was 1 dog for each 42 and 51 human beings, in the areas without and with sterilization, respectively. The animal population size increased in both regions, due mainly to the abandonment of domestic dogs. Mortality rate decreased throughout the study period. Survival probabilities did not differ between genders, but males entered the population in higher numbers. There were no differences in abundance, survival and recruitment between the regions, indicating that sterilization did not affect the population dynamics. Our findings indicate that the observed animal dynamics were influenced by density-independent factors, and that sterilization might not be a viable and effective strategy in regions where availability of resources is low and animal abandonment rates are high. Furthermore, the high demographic turnover rates observed render the canine free-roaming population younger, thus more susceptible to diseases, especially to rabies and leishmaniasis. We conclude by stressing the importance of implementing educational programs to promote responsible animal ownership and effective strategies against abandonment practices.


Assuntos
Esterilização Reprodutiva/veterinária , Animais , Brasil , Cães , Feminino , Humanos , Masculino , Densidade Demográfica , Taxa de Sobrevida
20.
Prev Vet Med ; 146: 10-15, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28992913

RESUMO

One of the key components of the Brazilian Program for the Control of Visceral Leishmaniasis (PCLV) is the euthanasia of Leishmania-infected canine reservoirs, the detection of which depends on a screening procedure involving a Dual Path Platform® (DPP) immunoassay and a confirmatory enzyme-linked immunosorbent assay (ELISA). The aims of the present study were to evaluate the reliability of these techniques in a region of recent transmission of canine VL, to follow up the seroconversion 3-4 months after the initial diagnosis of DPP reactive but ELISA indeterminate or non-reactive dogs, and to identify the species of Leishmania in circulation in the area. Each animal was submitted to DPP under field conditions, performed by municipal health workers using peripheral blood (DPP-field), to DPP under laboratory conditions using serum (DPP-lab) and to ELISA using serum. The agreements between the tests were determined using McNemar's χ2 test, Cohen's kappa coefficient (k) at the 95% confidence interval and prevalence-adjusted bias-adjusted kappa (PABAK). Of the 1130 dogs examined, 74.2% were non-reactive in all three tests applied. Based on the PCLV positive-infection criterion, seroprevalence was 8.9% (101/1130) with 83.2% (84/101) of infected animals showing reactivity in all three tests while 7.8% (8/101) were reactive in DPP-field and ELISA and 8.9% (9/101) in DPP-lab and ELISA. The proportions of disagreements were substantial in all comparisons. Inter-rater reliability between DPP-field and ELISA (k=0.55; PABAK=0.78) and DPP-lab and ELISA (k=0.59; PABAK=0.81) were considered moderate, while that between DPP-field and DPP-lab (k=0.61; PABAK=0.79) was classified as marginally good. The proportion of seroconversions in DPP reactive animals that were initially ELISA indeterminate was significantly higher than in those that were DPP reactive but initially ELISA non-reactive. Restriction fragment length polymorphism analysis revealed the presence of Leishmania infantum, the etiologic agent of VL, in bone marrow samples from VL-infected animals. Our data showed that the techniques and protocols currently employed in the PCLV screening approach are not entirely reliable. Further consideration should be given to monitoring dogs with undetermined results in ELISA and a better training should be provided for health workers responsible for performing DPP tests applied under field conditions.


Assuntos
Doenças do Cão/sangue , Doenças do Cão/parasitologia , Ensaio de Imunoadsorção Enzimática/veterinária , Imunoensaio/veterinária , Leishmaniose Visceral/veterinária , Animais , Anticorpos Antiprotozoários/sangue , Brasil/epidemiologia , Controle de Doenças Transmissíveis/métodos , Doenças do Cão/epidemiologia , Cães , Ensaio de Imunoadsorção Enzimática/normas , Feminino , Imunoensaio/métodos , Imunoensaio/normas , Leishmania infantum , Leishmaniose Visceral/sangue , Leishmaniose Visceral/epidemiologia , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Soroconversão , Estudos Soroepidemiológicos
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