The Effect of Psychotherapy on Anxiety, Depression, and Quality of Life of Patients with Heart Failure: A Randomized Clinical Trial

Abstract Background Patients with heart failure often experience depression, anxiety, and impacts on quality of life. Psychotherapeutic interventions have been used for chronic conditions, including cardiovascular diseases, showing improvement in mental health. However, no studies have assessed the effects of a psychological intervention using psychoanalysis on patients with heart failure. Objective To assess the effect of short-term psychotherapy on depressive symptoms, anxiety, and quality of life of patients seen at a specialty clinic. Method A randomized clinical trial with scales to assess outcomes before and after psychotherapy, under the perspective of psychoanalysis, with 12 weekly sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Minnesota Living with Heart Failure Questionnaire were used. The mean initial and final scores for quality of life, anxiety, and depression were compared using Student's t-test for independent samples when distribution was normal, or Mann-Whitney test when distribution was non-normal. A bivariate p-value < 0.05 was considered statistically significant for all analyses. Results This study involved 32 patients, 50% were female, mean age was 64.3±11.6, and most participants were New York Heart Association (NYHA) functional class I (56.3%). For anxiety (p = 0.196), there was no statistically significant difference between groups. For quality of life and depression, there was a statistical difference (p = 0.009 and 0.035, respectively), with a medium effect (Cohen's d = 0.593) on quality of life. Conclusion Short-term psychotherapy in outpatients with heart failure showed an impact on depression and quality of life but did not improve anxiety. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

Sigilo, confidencialidade e privacidade: perspectivas pedagógicas na Estratégia Saúde da Família / Secrecy, confidentiality and privacy: educational perspectives in the Family Health Strategy / El secreto, la confidencialidad y la privacidad: perspectivas en el proceso educativo sobre la Estrategia de Salud de la Familia

A investigação dos problemas bioéticos na Estratégia Saúde da Família (ESF) permanece, ainda, como tema negligenciado nas publicações acadêmicas contemporâneas, a despeito das candentes questões que se apresentam nessa esfera da atenção à saúde. Nesse âmbito, elementos atinentes à relação entre usuários e profissionais de saúde ganham relevância. O estudo dessa temática é mote do presente artigo, no qual são apresentados resultados obtidos junto aos profissionais da ESF do município de Viçosa/MG, durante a realização de oficina de formação em bioética e Atenção Primária à Saúde ­ enfatizando as conversações sobre o sigilo, a privacidade e a confidencialidade ­ desenvolvidas ao longo do processo pedagógico. (AU)

The investigation of bioethical issues in the Family Health Strategy (FHS) still remains a neglected theme in contemporary scholarly literature, despite the pressing issues that arise in this sphere of health care. In this context, elements related to the relationship between users and health professionals gain relevance. The study of this theme is the mote of this article, in which results obtained from FHS professionals in the county of Viçosa/MG, while they trained and attended a workshop on bioethics and Primary Health Care, are presented ­ emphasizing conversations regarding secrecy, privacy and confidentiality developed throughout the educational process. (AU)

La investigación de las cuestiones de bioética en la Estrategia de Salud de la Familia (ESF) todavía permanece como tema descuidado en las publicaciones académicas contemporáneas, a pesar de los temas candentes que se plantean en esta esfera de la atención a la salud. En este contexto, sobre la relación entre los usuarios y profesionales de la salud se convierten en elementos más importantes. El estudio de este tema es el tema de este artículo, en el que los resultados obtenidos se presentan junto a los profesionales de la ESF de la ciudad de Viçosa/MG, mientras la realización de la formación en bioética y taller de formación primaria de salud ­ haciendo hincapié en las conversaciones sobre el secreto, la privacidad y confidencialidad ­ desarrollado durante el proceso educativo. (AU)

Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing.

OBJECTIVE: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. METHODS: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. RESULTS: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. CONCLUSIONS: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution.

Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing / Prevalência de deficiência de vitamina D e sua relação com fatores associados à sibilância recorrente

ABSTRACT Objective: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. Methods: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. Results: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. Conclusions: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution.

RESUMO Objetivo: Determinar a prevalência da deficiência/insuficiência de vitamina D em indivíduos com sibilância recorrente e/ou asma com idade de 0-18 anos e residentes na microrregião de Viçosa (MG) atendidos em um centro de referência e determinar sua associação com os principais fatores de risco para sibilância. Métodos: Estudo transversal utilizando um questionário semiestruturado por entrevistadores treinados, aplicado aos responsáveis pelos participantes do estudo. Foram obtidas informações sobre características gerais da sibilância recorrente, fatores sociodemográficos, ambientais e biológicos gerais e aqueles relacionados à atopia. A magnitude da associação estatística foi avaliada por meio do cálculo da OR e IC95% obtidos por regressão logística múltipla. Resultados: Foram incluídos 124 indivíduos no estudo. A prevalência da deficiência/insuficiência de vitamina D na amostra foi de 57,3%. Observaram-se associações da deficiência/insuficiência de vitamina D com sibilância no primeiro ano de vida, antecedentes pessoais de dermatite atópica, poluição ambiental e suplementação de vitamina D até os 2 anos de idade. Conclusões: A prevalência de deficiência/insuficiência de vitamina D foi alta em nossa amostra. As concentrações de vitamina D foram associadas diretamente com a suplementação de vitamina D até os 2 anos de idade e inversamente com eventos de sibilância no primeiro ano de vida, antecedentes pessoais de dermatite atópica e poluição ambiental.

Ações do enfermeiro na identificação precoce de alterações sistêmicas causadas pela sepse grave / Actions of nurses in early identification of systemic changes caused by severe sepsis

INTRODUÇÃO: As unidades de terapia intensiva (UTIs) têm sido organizadas como setores estratégicos para o suporte especializado de assistência ao paciente grave. OBJETIVO: Verificar as ações do enfermeiro para a identificação precoce das alterações sistêmicas causadas pela sepse grave relacionadas às alterações hemodinâmicas, neurológicas, respiratórias, renais e nutricionais dos pacientes internados em UTIs adulto. MÉTODOS: Estudo descritivo com 24 enfermeiros. Os dados foram coletados por meio de formulário composto de questões estruturadas. RESULTADOS: Apenas 36% dos enfermeiros possuem especialização em UTI adulto; verificou-se que os profissionais identificam parcialmente os sinais e sintomas apresentados pelo paciente séptico. CONCLUSÃO: Os enfermeiros encontram dificuldade na identificação precoce das alterações sistêmicas causadas pela sepse grave relacionada às alterações hemodinâmicas, neurológicas, respiratórias, renais e nutricionais dos pacientes internados em UTI adulto, o que pode estar relacionado com a falta de treinamento e de protocolos estabelecidos pelas instituições.

INTRODUCTION: Intensive care units (ICUs) have been organized as strategic sectors for specialized support assistance to critically ill patients. OBJECTIVE: To assess the actions of the nurse for the early identification of systemic changes caused by severe sepsis, related to hemodynamic, neurological, respiratory, renal and nutrition changes of patients in adult ICUs. METHODS: Descriptive studies with 24 nurses. Data were collected using a questionnaire composed of structured questions. RESULTS Only 36% of nurses have expertise in adult ICUs, professionals partially identify the signs and symptoms presented by the septic patient. CONCLUSION: Nurses find difficulty in the early identification of systemic changes caused by severe sepsis, related to hemodynamic, neurological, respiratory, renal and nutritional changes seen in patients in adult ICUs, which may be related to lack of training and of protocols established by the institutions.

Euterpe edulis effects on cardiac and renal tissues of Wistar rats fed with cafeteria diet / Efectos de Euterpe edulis en los tejidos cardiacos y renales de ratas Wistar alimentadas con dieta de cafetería

Introduction: This study’s objective was to evaluate the antioxidant and toxic effects of E. edulis on cardiac and renal tissues of Wistar rats fed with cafeteria diet. Methods: Catalase (CAT), glutathione-S-transferase (GST), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured in cardiac muscle and renal tissue of 60 animals, which were randomly assigned for 10 equal groups. Half of the rats were fed with cafeteria diet and the other half with commercial chow, combined or not to E. edulis lyophilized extract, E. edulis deffated lyophilized extract or E. edulis oil. Data were evaluated using ANOVA, followed by the Student-Newman-Keuls test. Results: Data showed a signifi cant increase of CAT activity in cardiac tissue of animals from the groups fed with cafeteria diet associated to E. edulis lyophilized extract at 5%, E. edulis lyophilized extract at 10% and E. edulis deffated lyophilized extract at 10%. In addition, the same result was found in animals from the groups fed with commercial chow and commercial chow combined with E. edulis lyophilized extract at 10% in comparison to the group fed exclusively with cafeteria diet. GST and SOD enzyme activity showed significant increase in the heart tissue of animals nourished with commercial chow when compared to the groups fed with cafeteria diet. On the other hand, there were no significant differences enzymatic levels in renal tissues. Conclusion: The oil and the extract of E. edulis had an important role promoting an increase of antioxidant enzymes levels in cardiac muscle, which prevent the oxidative damage resulting from the cafeteria diet in Wistar rats. There were no evidenced signs of lipid peroxidation in renal or in cardiac tissue of the animals studied, indicating that the E. edulis use did not promote any increase in malondialdehyde cytotoxic products formation. This show that both E. edulis oil and extracts evaluated in this study were well tolerated in the studied doses (AU)

Introducción: el objetivo de este estudio fue evaluar los efectos antioxidantes y tóxicos de E. edulis en los tejidos cardiacos y renales de ratas Wistar alimentadas con dieta de cafetería. Métodos: catalasa (CAT), glutatión-S-transferasa (GST), superóxido dismutasa (SOD) y malondialdehído (MDA) se midieron en el músculo cardiaco y el tejido renal de 60 animales, que fueron asignados aleatoriamente para 10 grupos iguales. La mitad de las ratas fueron alimentadas con dieta de cafetería y la otra mitad con ración comercial, combinados o no con E. edulis extracto liofilizado, E. edulis GMD obtenidas de extracto liofilizado o aceite de E. edulis. Los datos se evaluaron mediante ANOVA, seguido por el test de Student-Newman-Keuls. Resultados: los datos mostraron un aumento signifi cativo de la actividad de CAT en el tejido cardiaco de los animales de los grupos alimentados con dieta de cafetería asociada a E. edulis extracto liofilizado en un 5%, E. edulis extracto liofilizado en un 10% y E. edulis GMD obtenidas de extracto liofilizado de 10%. Además, el mismo resultado se encuentra en los animales de los grupos alimentados con chow chow comercial y comercial combinado con extracto liofilizado E. edulis en 10% en comparación con el grupo alimentado exclusivamente con dieta de cafetería. La actividad de GST y la enzima SOD mostró un aumento significativo en el tejido del corazón de los animales alimentados con pienso comercial en comparación con los grupos alimentados con dieta de cafetería. Por otro lado, se observaron diferencias significativas en los niveles enzimáticos en los tejidos renales. Conclusión: el aceite y el extracto de E. edulis tuvieron un papel importante al promover un aumento de los niveles de enzimas antioxidantes en el músculo cardiaco, que previenen el daño oxidativo resultante de la dieta de cafetería en ratas Wistar. Los signos de la peroxidación lipídica evidenciados en los riñones o en el tejido cardiaco de los animales estudiados indican que el uso de E. edulis no promovió ningún aumento en la formación de productos citotóxicos malondialdehído, un marcador reconocido de la acción de los radicales libres (AU)

Enterobíase: aspectos atuais / Enterobiasis: current issues

Justificativa e objetivos: A enterobíase - oxiuríase - é uma parasitose intestinal causada pelo nematódeo Enterobius vermicularis. Trata-se de infecção de grande importância na prática clínica por causar parasitose intestinal e estar envolvida com infecções do trato urinário. O objetivo do manuscrito é apresentar os principais aspectos epidemiológicos, clínicos e terapêuticos relacionados com a enterobíase. Conteúdo: Foram utilizadas as palavras enterobíase e Enterobius vermicularis como descritores na pesquisa de dados nas bases SciELO e Pubmed, assim como em livros-texto relacionados com o tema. A prevalência estimada da infecção no Brasil é de 5,9%, fortemente associada a fatores ambientais, culturais e sociais. O quadro clínico predominante compreende o prurido anal e infecções urinárias em meninas. Possui evolução benigna, com raras complicações, cujo tratamento apresenta eficácia na grande maioria dos casos. Conclusão: Embora possua excelente prognóstico, a disseminação do conhecimento dos aspectos clínicos, epidemiológicos e terapêuticos da enterobíase é essencial para sua melhor abordagem pelos profissionais médicos.

Malária por Plasmodium falciparum: estudos proteômicos / Plasmodium falciparum malaria: proteomic studies

A despeito dos avanços no tratamento e das campanhas de prevenção e de controle da malária nos distintos continentes nos quais a moléstia grassa, a entidade mórbida permanece com significativa relevância no mundo contemporâneo. O Plasmodium falciparum é o grande responsável pela malária grave, caracterizada por distúrbios em diferentes órgãos e sistemas, com possibilidade de evolução ao óbito. Embora incipientes, os estudos proteômicos na malária têm trazido boas perspectivas para melhor compreensão dos aspectos biológicos do Plasmodium, assim como dos mecanismos fisiopatológicos, diagnósticos, terapêuticos e profiláticos da enfermidade. Desse modo, o objetivo do presente artigo é apresentar uma breve revisão das aplicações da análise proteômica na malária por P. falciparum.

Despite advances in treatment and campaigns for prevention and control of malaria on the various continents where it is still rampant, this disease remains significantly relevant to the contemporary world. Plasmodium falciparum is the organism that is mainly responsible for severe malaria, which is characterized by disturbances in different organs and systems, with possibly fatal outcomes. Although incipient, proteomic studies of malaria have yielded favorable prospects for elucidating the biological aspects of Plasmodium as well as the pathophysiological, diagnostic, prophylactic, and therapeutic mechanisms of the disease. Thus, the aim of the present article is to present a brief review of the applications of proteomic analysis in P. falciparum malaria.

Selenium bioaccumulation in shiitake mushrooms: a nutritional alternative source of this element.

UNLABELLED: Mushrooms have effective mechanisms to absorb and accumulate trace elements from substrates and, therefore could be used as a strategy to produce mineral-enriched food and nutritional supplements. This study aimed to enrich shiitake mushrooms with selenium (Se), an important dietary element in human health. Strains of Lentinula edodes (Berk.) were grown on artificial logs composed of eucalyptus sawdust, and were subjected to cold shock in water containing sodium selenite (Na(2)SeO(3) ) at concentrations of up to 1.28 mM. The content of Se in the mushrooms increased linearly with increasing amounts of Na(2)SeO(3) added to the cold water although above 0.96 mM, mushroom formation was inhibited. Concentrations greater than 17 mg Se 100/g of dried mushrooms were observed after treatment with 0.64 mM Na(2)SeO(3). Shiitake mushroom had a demonstrate potential to offer an effective and economical way to produce Se-enriched products and, the strategy of adding selenite in cold water, used in this study, showed promising once it does not interfere with mycelial growth. PRACTICAL APPLICATION: Selenium is an essential trace element for both human and animals and is required for the 21st amino acid, selenocysteine, which is used for the synthesis of about a dozen selenoenzymes. In this study, it is demonstrated that shiitake mushroom is a good Se accumulator and only one step during fructification was necessary to obtained enriched mushroom. Se enriched shiitake mushroom can be considered to be an excellent source of this element and used to consumption in different ways.

Plasmodium falciparum malaria: proteomic studies. / Malária por Plasmodium falciparum: estudos proteômicos.

Despite advances in treatment and campaigns for prevention and control of malaria on the various continents where it is still rampant, this disease remains significantly relevant to the contemporary world. Plasmodium falciparum is the organism that is mainly responsible for severe malaria, which is characterized by disturbances in different organs and systems, with possibly fatal outcomes. Although incipient, proteomic studies of malaria have yielded favorable prospects for elucidating the biological aspects of Plasmodium as well as the pathophysiological, diagnostic, prophylactic, and therapeutic mechanisms of the disease. Thus, the aim of the present article is to present a brief review of the applications of proteomic analysis in P. falciparum malaria.