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1.
Am J Public Health ; 111(5): 839-841, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33734843

RESUMO

Hennepin County Adult Detention Center (Jail) is Minnesota's largest jail. In August 2019, the Minnesota Department of Health declared a statewide hepatitis A outbreak. Within three days, Hennepin County Jail Health Services made significant changes to vaccination protocols that increased vaccination rates from 0.6% to 7.1% among detainees, who have a greater risk of contracting hepatitis A. We highlight the opportunity for jails to develop sustainable public health interventions in the setting of community outbreaks.


Assuntos
Vacinas contra Hepatite A/administração & dosagem , Hepatite A/epidemiologia , Hepatite A/prevenção & controle , Prisões Locais/estatística & dados numéricos , Surtos de Doenças , Humanos , Minnesota/epidemiologia , Cobertura Vacinal
2.
BMC Infect Dis ; 20(1): 129, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32046662

RESUMO

BACKGROUND: Syphilis is a sexually transmitted infection (STI) transmitted from person to person mainly by sexual intercourse or through vertical transmission during pregnancy. Female sex workers (FSWs) are exposed especially to syphilis infection, and besides all the efforts to control the spread of STIs, syphilis prevalence is still rising, mainly occurring in low-income countries. This study aimed to investigate the syphilis prevalence, demographic characteristics and sexual habits among FSWs in the Amazon region of Brazil. METHODS: A cross-sectional study was carried out including 184 FSWs from 3 countryside cities of the state of Pará, Amazon region of Brazil. A venereal disease research laboratory test and an indirect immunoenzyme assay to test antibodies against Treponema pallidum were used for screening syphilis infection, while sexual habits and demographic data information were collected through a semi-structured questionnaire. Data was analyzed comparing groups with/without syphilis. Poisson regression models were used to estimate the reasons of prevalence (RP). RESULTS: The overall prevalence of syphilis was 14.1% (95% CI = 9.8-17.8). FSWs had between 15 and 56 years of age, most were unmarried (65.7%), had attended less than 8 years of formal education (64.1%), had between 10 and 20 partners per week (64.1%), and reported no previous history of STIs (76.1%) and regular use of condom (52.7%). Low level of education attending up to the primary school (RP adjusted = 3.8; 95% CI = 1.4-9.2) and high frequency of anal sex during the past year (RP adjusted = 9.3; 95% CI = 3.5-28.7) were associated with a higher prevalence of syphilis. CONCLUSIONS: A high prevalence of syphilis among FSWs in the Brazilian Amazon region was identified, showing that syphilis is more likely to be transmitted in FSW working in low-income areas, which is attributed to the low level of education. Anal intercourse was found as a risk factor associated with syphilis. Health programs focused on risk populations appear as a rational way to control syphilis spread, which is a rising problem in Brazil and in other several countries.


Assuntos
Profissionais do Sexo/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Cidades/estatística & dados numéricos , Preservativos/estatística & dados numéricos , Estudos Transversais , Escolaridade , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Parceiros Sexuais , Sífilis/diagnóstico , Sorodiagnóstico da Sífilis , Treponema pallidum/imunologia , Adulto Jovem
3.
Environ Sci Technol ; 50(4): 1949-54, 2016 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-26765213

RESUMO

We report the capture of ppm-level aqueous perchlorate in record capacity and kinetics via the complete anion exchange of a cationic metal-organic framework. Ambient conditions were used for both the synthesis of silver 4,4'-bipyridine nitrate (SBN) and the exchange, forming silver 4,4'-bipyridine perchlorate (SBP). The exchange was complete within 90 min, and the capacity was 354 mg/g, representing 99% removal. These values are greater than current anion exchangers such as the resins Amberlite IRA-400 (249 mg/g), Purolite A530E (104 mg/g), and layered double hydroxides (28 mg/g). Moreover, unlike resins and layered double hydroxides, SBN is fully reusable and displays 96% regeneration to SBN in nitrate solution, with new crystal formation allowing the indefinite cycling for perchlorate. We show seven cycles as proof of concept. Perchlorate contamination of water represents a serious health threat because it is a thyroid endocrine disruptor. This noncomplexing anionic pollutant is significantly mobile and environmentally persistent. Removal of other anionic pollutants from water such as chromate, pertechnetate, or arsenate may be possible by this methodology.


Assuntos
Resinas de Troca de Cátion/química , Metais/química , Percloratos/química , Purificação da Água/métodos , Água/química , Hidróxidos/química , Cinética , Nitratos , Soluções , Poluentes Químicos da Água/química
4.
JCI Insight ; 9(5)2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38319716

RESUMO

Pattern recognition receptor responses are profoundly attenuated before the third trimester of gestation in the relatively low-oxygen human fetal environment. However, the mechanisms regulating these responses are uncharacterized. Herein, genome-wide transcription and functional metabolic experiments in primary neonatal monocytes linked the negative mTOR regulator DDIT4L to metabolic stress, cellular bioenergetics, and innate immune activity. Using genetically engineered monocytic U937 cells, we confirmed that DDIT4L overexpression altered mitochondrial dynamics, suppressing their activity, and blunted LPS-induced cytokine responses. We also showed that monocyte mitochondrial function is more restrictive in earlier gestation, resembling the phenotype of DDIT4L-overexpressing U937 cells. Gene expression analyses in neonatal granulocytes and lung macrophages in preterm infants confirmed upregulation of the DDIT4L gene in the early postnatal period and also suggested a potential protective role against inflammation-associated chronic neonatal lung disease. Taken together, these data show that DDIT4L regulates mitochondrial activity and provide what we believe to be the first direct evidence for its potential role supressing innate immune activity in myeloid cells during development.


Assuntos
Citocinas , Recém-Nascido Prematuro , Recém-Nascido , Humanos , Citocinas/metabolismo , Monócitos/metabolismo , Imunidade Inata , Mitocôndrias/metabolismo
5.
Health Equity ; 6(1): 132-139, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35261941

RESUMO

Purpose: Medical educators recognize the importance of addressing social determinants of health and providing opportunities for learners to work with diverse populations. Still, social, geographic, resource, and language barriers prevent institutions from connecting with globally diverse populations within their own communities. In this article, we describe the migrant farmworker health course at the University of Minnesota, the importance of longitudinal partnership with community-based organizations, and ways to increase access to care and educate health professional learners in health equity. Methods: The migrant farmworker health course is a clinical rotation that combines didactic learning on social determinants of health with hands-on clinical experience. Learners work with community organizations to provide mobile health care while learning about a diverse and underserved rural population. Twenty-eight learners who participated in the course between 2015 and 2019 were surveyed about their experience, knowledge, and skills gained, and recommendations for improvement. Results: Over 90% of participants rated their overall experience in the course as "good" or "outstanding." Most learners increased confidence in the subjects that were covered during didactic sessions. Qualitative feedback provided insight on how the migrant farmworker health course shaped learners' understanding of social determinants of health and influenced their career trajectories. Conclusion: The migrant farmworker health course has educated interprofessional learners and is expanding to include more opportunities for mobile health care. The feedback from this survey helped improve didactic teaching and will help deepen relationships with community partners. Learning through service with global populations locally in a "global is local" rotation is a rewarding way to engage in and learn about health equity.

6.
J Family Med Prim Care ; 11(3): 976-981, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35495828

RESUMO

Background: The COVID-19 pandemic resulted in a complete nationwide lockdown on March 24, 2020. The months of April and May had stringent lockdown measures followed by a gradual loosening of restrictions in a graded manner. Methods: This observational study was performed in the emergency department (ED) of a tertiary hospital in south India triage Priority 1 and Priority 2 patients presented during the COVID-19 lockdown and unlock periods spanning from April 2020 to August 2020. The three different lockdown periods and the subsequent unlock periods were categorized as lockdown 1 (LD1), lockdown 2 (LD2), lockdown 3 (LD3), and unlock phase (UL), and a 7-day time period in each were taken for 7-day incidence analysis. Results: During the 5-month study period, a total of 1,954 patients were analyzed for the study that included 405, 440, 492, and 617 patients during the 7-day time periods in the LD1, LD2, LD3, and UL periods, respectively. The 7-day incidence of COVID-19 suspects increased significantly by 101.9% from LD1 to UL phases, whereas trauma cases increased by 52.9% in the same two time periods. Compared with LD1, in the UL phase, the 7-day ED admission and in-hospital mortality rates increased by 50.3% and 66.7%, respectively. Conclusion: The number of COVID-19 suspects saw a near-constant increase through the different phases of lockdown, culminating in the UL phase. The stringent lockdown measures resulted in a significant reduction in the incidence of trauma with a rebound increase in the UL phase.

7.
Behav Brain Res ; 411: 113386, 2021 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-34052264

RESUMO

The prion glycoprotein (PrPC) is highly expressed in the nervous system as well as in other organs. Its functional roles in behavior have been examined mainly in non co-isogenic, wild-type and PrPC-deficient mice, which showed both age- and genotype-dependent differences. In general, however, effects of genetic background upon behavioral tests are mostly unclear when applied to aging rodents. The present study aimed to determine the effect of deletion of the prion protein on behavior of isogenic mice across different ages. We disclosed a genotype-dependent behavioral dissociation between either motor or cognitive tests, as a function of both age and test type. Remarkably, we also detected a clear age- and genotype-dependent difference in the variability of performance in a cognitive test. The current findings are relevant for both the interpretation of PrPC-related behavior, as well as for issues of reproducibility in studies of rodent behavior.


Assuntos
Cognição/fisiologia , Atividade Motora/genética , Proteínas Priônicas/metabolismo , Fatores Etários , Envelhecimento/metabolismo , Animais , Animais não Endogâmicos , Encéfalo/metabolismo , Feminino , Genótipo , Masculino , Camundongos , Camundongos Knockout , Atividade Motora/fisiologia , Proteínas Priônicas/genética , Príons/genética , Príons/metabolismo
8.
Am J Trop Med Hyg ; 105(6): 1602-1607, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34695796

RESUMO

We administered a standardized 41-item questionnaire to a convenience sample of graduates of five residency programs with formal global health pathways and compared findings to a national cohort of practicing physicians to evaluate the comparative effectiveness of an overarching global health pathway on residency program graduates. Compared with the national cohort database, global health pathway graduates self-reported that they felt better prepared to treat immigrants, refugees, patients with limited English proficiency (LEP), racial/ethnic minorities, those with non-Western health beliefs, international travelers, and military veterans (P < 0.05). They were more likely to report using best practices when working with lesbian, gay, bisexual, transgender, queer/questioning patients, immigrant and refugee patients, patients with non-Western health beliefs, patients with LEP, and patients communicating via American Sign Language (P < 0.05). They also reported being more familiar with 11 of 14 high-impact or common infections encountered in travelers, immigrants, and military personnel (P < 0.05). Our findings suggest that formal postgraduate training focused on global health improves knowledge, attitudes, and self-reported medical practices when caring for diverse and marginalized populations in the United States.


Assuntos
Competência Clínica , Saúde Global/educação , Internato e Residência , Qualidade da Assistência à Saúde , Humanos , Inquéritos e Questionários , Estados Unidos
9.
Front Immunol ; 12: 655027, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34012439

RESUMO

Newborns are frequently affected by mucocutaneous candidiasis. Th17 cells essentially limit mucosal invasion by commensal Candida spp. Here, we sought to understand the molecular basis for the developmental lack of Th17 cell responses in circulating blood neonatal T cells. Naive cord blood CD4 T cells stimulated in Th17-differentiating conditions inherently produced high levels of the interleukin-22 immunoregulatory cytokine, particularly in the presence of neonatal antigen-presenting cells. A genome-wide transcriptome analysis comparing neonatal and adult naïve CD4 T cells ex vivo revealed major developmental differences in gene networks regulating Small Drosophila Mothers Against Decapentaplegic (SMAD) and Signal Transducer and Activator of Transcription 3 (STAT3) signaling. These changes were functionally validated by experiments showing that the requirement for TGF-ß in human Th17 cell differentiation is age-dependent. Moreover, STAT3 activity was profoundly diminished while overexpression of the STAT3 gene restored Th17 cell differentiation capacity in neonatal T cells. These data reveal that Th17 cell responses are developmentally regulated at the gene expression level in human neonates. These developmental changes may protect newborns against pathological Th17 cell responses, at the same time increasing their susceptibility to mucocutaneous candidiasis.


Assuntos
Imunomodulação , Interleucinas/metabolismo , Células Th17/imunologia , Células Th17/metabolismo , Fatores Etários , Diferenciação Celular/genética , Diferenciação Celular/imunologia , Citocinas/biossíntese , Humanos , Recém-Nascido , Ativação Linfocitária/imunologia , Fator de Transcrição STAT3/metabolismo , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Interleucina 22
10.
Clin Nutr ESPEN ; 40: 269-276, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183548

RESUMO

BACKGROUND AND AIMS: There is no clear evidence about the effects of gluten intake on obesity. It is known that gluten's effects on gut permeability are mediated by zonulin, a protein identified as pre-haptoglobin 2, a physiological regulator of the intestinal barrier. We investigated the obesogenic and inflammatory effects of gluten and its association with the haptoglobin genotype. METHODS: This was a single blinded, crossover study, including 40 overweight or obesity women free of celiac disease. Participants adopted a gluten-free diet (GFD) for 8 weeks and consumed a gluten-free muffin (GF-M) or a gluten-containing muffin (GLU-M, 24 g gluten) for 4 weeks, switching muffin type during the subsequent 4 weeks. During a follow-up period of 4 weeks we evaluated the usual diet (UD). Food diaries were collected to estimate the macronutrient intake and dietary inflammatory index (DII®). Bodyweight and composition, resting energy expenditure (REE), and cytokines were assessed. Haptoglobin alleles (Hp1 and Hp2) were genotyped to characterize zonulin expression. RESULTS: Energy and macronutrient intakes were similar during both periods, except for protein intake, which was higher during GLU-M. DII scores indicated a more inflammatory profile during the GF-M and GLU-M periods compared to UD. No differences were observed in body composition or REE between interventions when the Hp genotype was not considered. Nonetheless, those carrying the Hp2-2 genotype (overexpressing zonulin) presented lower REE and higher levels of IL6 and IL1beta only during gluten intake (GLU-M and UD) compared to age- and body mass index-matched Hp1-1 carrier. These results suggest an obesogenic and inflammatory action of gluten only in those overexpressing zonulin (Hp2-2). CONCLUSION: These results highlight the importance of zonulin as the mediator of gluten obesogenic and inflammatory effects. Our data suggest that in the presence of gluten, zonulin release is associated with a reduction of REE and an increase of inflammatory markers that are not seen in zonulin low producers.


Assuntos
Glutens , Haptoglobinas , Estudos Cross-Over , Dieta Livre de Glúten , Glutens/efeitos adversos , Haptoglobinas/genética , Humanos , Obesidade/genética , Isoformas de Proteínas
11.
Front Microbiol ; 11: 602664, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33262753

RESUMO

Female sex workers (FSWs) represent a key population for the acquisition of sexually transmitted infections (STI) due to their social vulnerability and the risks associated with their occupation. This study was conducted to describe the sociodemographic characteristics and sexual behavior among FSWs in cities in northern Brazil, to determine the prevalence of human immunodeficiency virus 1 (HIV-1) and human T-cell lymphotropic virus (HTLV-1/2) infections and to identify the circulating subtypes of these agents in this key population. A cross-sectional study using the Time Location Sampling (TLS) method was conducted among 339 FSWs in cities in the state of Pará from 2005 to 2006. Serological and molecular tests were performed to identify infections and viral subtypes, and bivariate and multivariate analyses were conducted to identify risk factors. Most FSWs were young, single, less educated and had at least one child. The prevalence of antibodies against HIV-1 and HTLV-1 was 2.3 and 1.7%, respectively. HIV-1 subtypes B (87.5%) and F1 (12.5%) were identified among FSWs, as were Cosmopolitan subtype (1a) and Transcontinental subgroup (A). Unprotected sex and illicit drug use were associated with HIV-1 and HTLV-1 infections using bivariate and multivariate analyses, and age ≥27 years was associated only with HIV. The important information highlighted here clearly indicates that the lack of actions to control and prevent pathogens in FSWs and the lack of strategies for health promotion in key populations can further aggravate the epidemiological scenario of viral infections in remote areas with low human development indices. Neglecting these facts may be causing the spread of these two viruses and their respective subtypes in the general population of northern Brazil.

12.
Cell Death Dis ; 10(4): 323, 2019 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975983

RESUMO

Harmful environmental stimuli during critical stages of development can profoundly affect behavior and susceptibility to diseases. Alzheimer disease (AD) is the most frequent neurodegenerative disease, and evidence suggest that inflammatory conditions act cumulatively, contributing to disease onset. Here we investigated whether infection early in life can contribute to synapse damage and cognitive impairment induced by amyloid-ß oligomers (AßOs), neurotoxins found in AD brains. To this end, wild-type mice were subjected to neonatal (post-natal day 4) infection by Escherichia coli (1 × 104 CFU/g), the main cause of infection in low-birth-weight premature infants in the US. E. coli infection caused a transient inflammatory response in the mouse brain starting shortly after infection. Although infected mice performed normally in behavioral tasks in adulthood, they showed increased susceptibility to synapse damage and memory impairment induced by low doses of AßOs (1 pmol; intracerebroventricular) in the novel object recognition paradigm. Using in vitro and in vivo approaches, we show that microglial cells from E. coli-infected mice undergo exacerbated activation when exposed to low doses of AßOs. In addition, treatment of infected pups with minocycline, an antibiotic that inhibits microglial pro-inflammatory polarization, normalized microglial response to AßOs and restored normal susceptibility of mice to oligomer-induced cognitive impairment. Interestingly, mice infected with by E. coli (1 × 104 CFU/g) during adolescence (post-natal day 21) or adulthood (post-natal day 60) showed normal cognitive performance even in the presence of AßOs (1 pmol), suggesting that only infections at critical stages of development may lead to increased susceptibility to amyloid-ß-induced toxicity. Altogether, our findings suggest that neonatal infections can modulate microglial response to AßOs into adulthood, thus contributing to amyloid-ß-induced synapse damage and cognitive impairment.


Assuntos
Disfunção Cognitiva/microbiologia , Encefalite/microbiologia , Infecções por Escherichia coli/complicações , Microglia/metabolismo , Sinapses/efeitos dos fármacos , Peptídeos beta-Amiloides , Animais , Animais Recém-Nascidos , Encéfalo/crescimento & desenvolvimento , Encéfalo/imunologia , Encéfalo/microbiologia , Células Cultivadas , Disfunção Cognitiva/induzido quimicamente , Suscetibilidade a Doenças/etiologia , Feminino , Masculino , Camundongos , Microglia/citologia , Microglia/efeitos dos fármacos , Sinapses/metabolismo , Sinapses/patologia , Fatores de Tempo
13.
Farm Hosp ; 41(3): 334-345, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28478748

RESUMO

OBJECTIVE: To define the activities of the Drug Information Centre of the Federal Council of Pharmacy (Cebrim/FCP), to describe the passive information and the satisfaction of its users. METHOD: The centre has a computerized system for recording and storing the received questions and their answers: the Sistema de Informação Farmacoterapêutica SIFAR (Pharmacotherapeutical Information System) that generates management reports; out of these, the reports from the period 2010 to 2015 were analyzed. RESULTS: The main activity carried out by the centre was the passive information provided to pharmacists and undergraduate Pharmacy students. The most frequent subjects were: administration and way of use of medicines and indication and drug interactions, which were answered in less than 24 hours in most cases. Approximately 80% of those users who completed the satisfaction survey rated the service provided as good and optimal. CONCLUSION: Cebrim/FCP provides objective, updated and timely information (passive information) on medicines for pharmacists, with administration and way of use as the most recurrent subjects, and the majority of applicants were satisfied with the service.


Objetivo: Caracterizar las actividades del Centro de Información sobre Medicamentos del Consejo Federal de Farmacia (Cebrim/CFF), describir la información pasiva y la satisfacción de sus usuarios. Método: El centro cuenta con un sistema informatizado de registro y almacenamiento de preguntas y respuestas recibidas (Sistema de Informação Farmacoterapêutica SIFAR), que genera informes gerenciales, del cual fueron analizados los informes del período de 2010 a 2015.Resultados: La actividad principal realizada por el centro fue la información pasiva brindada a farmacéuticos y estudiantes de pregrado de Farmacia. Los temas más frecuentes fueron administración y modo de uso de los medicamentos e indicación e interacciones medicamentosas, con respuesta en menos de 24 h, en la mayoría de los casos. Entre los usuarios que cumplimentaron la encuesta de satisfacción, aproximadamente el 80% de los usuarios clasificaron el servicio brindado como bueno y óptimo.Conclusión: Cebrim/CFF brinda información objetiva, actualizada y oportuna (información pasiva) sobre medicamentos para profesionales farmacéuticos, con administración y modo de uso como temas más recurrentes, y la gran mayoría de los solicitantes están complacidos con el servicio.


Assuntos
Serviços de Informação sobre Medicamentos/normas , Brasil , Comportamento do Consumidor , Humanos , Gestão da Informação , Conduta do Tratamento Medicamentoso , Farmacêuticos , Serviço de Farmácia Hospitalar
15.
Environ Sci Pollut Res Int ; 23(19): 19084-95, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27343078

RESUMO

This paper focuses on the influence of the current density treatment of a concentrated 1-butyl-3-methylimidazolium chloride (BMImCl) solution on an electrochemical reactor with a boron-doped diamond (BDD) anode. The decrease in the total organic carbon (TOC) and the BMImCl concentration demonstrate the capability of BDD in oxidizing ionic liquids (ILs) and further mineralizing (to CO2 and NO3 (-)) more rapidly at higher current densities in spite of the reduced current efficiency of the process. Moreover, the presence of Cl(-) led to the formation of oxychlorinated anions (mostly ClO3 (-) and ClO4 (-)) and, in combination with the ammonia generated in the cathode from the nitrate reduction, chloramines, more intensely at higher current density. Finally, the analysis of the intermediates formed revealed no apparent influence of the current density on the BMImCl degradation mechanism. The current density presents therefore a complex influence on the IL treatment process that is discussed throughout this paper.


Assuntos
Diamante/química , Condutividade Elétrica , Eletroquímica/instrumentação , Imidazóis/química , Boro/química , Eletrodos , Líquidos Iônicos/química , Oxirredução , Soluções
16.
Enferm. foco (Brasília) ; 11(4): 161-166, dez. 2020.
Artigo em Português | BDENF - enfermagem (Brasil), LILACS | ID: biblio-1146680

RESUMO

Objetivo: Analisar a visão dos profissionais de saúde frente ao paciente fora de possibilidade terapêutica na Unidade de Terapia Intensiva (UTI). Método: Estudo descritivo, de abordagem qualitativa, realizado com 15 profissionais de saúde da UTI de um Hospital Universitário submetidos a entrevista semiestruturada. Resultados: Os profissionais veem esses pacientes como pessoas que necessitam de cuidados e medidas que tornem o processo de morte menos sofrido e mais digno, porém também demonstram insatisfação com a realidade do cenário atual dos cuidados paliativos na terapia intensiva. Conclusão: A implementação dos cuidados paliativos na UTI é um desafio para toda a equipe, visando o equilíbrio entre medidas paliativas e curativas. Portanto, alguns avanços precisam acontecer, principalmente em pesquisas na área bem como no campo da legislação. (AU)


Objective: To analyze the vision of the health professionals before the patient outside the therapeutic possibility in the Intensive Care Unit (ICU). Method: Descriptive study with a qualitative approach, performed with 15 health professionals from a University Hospital submitted to a semi - structured interview. Results: The professionals see these patients as needing care and measures that make the death process less painful and more dignified, but also demonstrate dissatisfaction with the reality of the current scenario of palliative care in intensive care. Conclusion: Of palliative care in the ICU is a challenge for the whole team, aiming at balancing palliative and curative measures. Therefore, some advances need to happen, especially in research in the area as well as in the field of legislation. (AU)


Objetivo: Es analizar la visión de los profesionales de salud frente al paciente fuera de posibilidad terapéutica en la Unidad de Terapia Intensiva (UTI) Método: Estudio descriptivo con enfoque cualitativo, realizado con 15 profesionales de salud de la UTI de un Hospital Universitario sometidos a entrevista semiestructurada. Resultados: Los profesionales ven a estos pacientes como personas que necesitan cuidados y medidas que hacen el proceso de muerte menos sufrido y más digno, pero también demuestran insatisfacción con la realidad del escenario actual de los cuidados paliativos en la terapia intensiva. Conclusión: Para los cuidados paliativos en la UTI es un desafío para todo el equipo, buscando el equilibrio entre medidas paliativas y curativas. Por lo tanto, se necesitan algunos avances, principalmente en la investigación en el área, así como en el campo de la legislación. (AU)


Assuntos
Cuidados Críticos , Cuidados Paliativos , Equipe de Assistência ao Paciente
17.
Conscientiae saúde (Impr.) ; 16(4): 441-446, dez. 2017.
Artigo em Português | LILACS | ID: biblio-881745

RESUMO

Introdução: Cardiopatias congênitas estão entre as anormalidades mais comuns ao nascimento. Objetivo: Determinar as complicações pulmonares mais recorrentes no pós-operatório de cirurgia cardiopediátrica e os possíveis fatores associados a essas complicações. Metodologia: Trata-se de um estudo observacional, retrospectivo, de amostra não probabilística, realizado no período de maio de 2016 a maio de 2017, por meio da análise dos prontuários de crianças submetidas à cirurgia cardíaca no Hospital do Coração de Alagoas. Resultados: As complicações pulmonares encontradas foram atelectasia (7,3%), congestão pulmonar (7,3%) e derrame pleural (4,9%), correspondendo a 19,5% do total da amostra. A única diferença estatística encontrada foi o aumento no tempo de internação hospitalar nos indivíduos com complicações pulmonares. Conclusão: Houve predomínio de atelectasia, congestão pulmonar e derrame pleural como complicações pulmonares após cirurgia cardiopediátrica. Foi evidenciado aumento no tempo de internamento hospitalar mediante a presença de complicação pulmonar, não sendo verificada associação com outra variável aqui testada.


Introduction: Congenital heart diseases are among the most common abnormalities at birth. Objective: To determine the most recurrent pulmonary complications in the postoperative period and the possible factors associated with these complications. Methodology: This is an observational, retrospective study of a non-probabilistic sample, performed from May 2016 to May 2017. An analysis of the charts of children submitted to cardiac surgery at the Hospital of the Heart of Alagoas was performed. Results: Pulmonary complications were atelectasis (7.3%), pulmonary congestion (7.3%) and pleural effusion (4.9%), corresponding to 19.5% of the total sample. The only statistical difference found was the increase in the length of hospital stay in individuals with pulmonary complications. Conclusion: Predominated atelectasis, pulmonary and pleural effusion and pulmonary complications after pediatric cardiac surgery. It was evidenced an increase in hospital stay time due to the presence of pulmonary complications, and no association with another variable was tested.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Complicações Pós-Operatórias , Cardiopatias Congênitas/cirurgia , Procedimentos Cirúrgicos Cardíacos , Derrame Pleural , Período Pós-Operatório , Atelectasia Pulmonar , Unidades de Terapia Intensiva Pediátrica , Estudos Retrospectivos , Tempo de Internação
18.
Farm. hosp ; 41(3): 334-345, mayo-jun. 2017. tab
Artigo em Inglês | IBECS (Espanha) | ID: ibc-162872

RESUMO

Objective: To define the activities of the Drug Information Centre of the Federal Council of Pharmacy (Cebrim/FCP), to describe the passive information and the satisfaction of its users. Method: The centre has a computerized system for recording and storing the received questions and their answers: the Sistema de Informação Farmacoterapêutica SIFAR (Pharmacotherapeutical Information System) that generates management reports; out of these, the reports from the period 2010 to 2015 were analyzed. Results: The main activity carried out by the centre was the passive information provided to pharmacists and undergraduate Pharmacy students. The most frequent subjects were: administration and way of use of medicines and indication and drug interactions, which were answered in less than 24 hours in most cases. Approximately 80% of those users who completed the satisfaction survey rated the service provided as good and optimal. Conclusion: Cebrim/FCP provides objective, updated and timely information (passive information) on medicines for pharmacists, with administration and way of use as the most recurrent subjects, and the majority of applicants were satisfied with the service (AU)


Objetivo: Caracterizar las actividades del Centro de Información sobre Medicamentos del Consejo Federal de Farmacia (Cebrim/CFF), describir la información pasiva y la satisfacción de sus usuarios. Método: El centro cuenta con un sistema informatizado de registro y almacenamiento de preguntas y respuestas recibidas (Sistema de Informação Farmacoterapêutica SIFAR), que genera informes gerenciales, del cual fueron analizados los informes del período de 2010 a 2015. Resultados: La actividad principal realizada por el centro fue la información pasiva brindada a farmacéuticos y estudiantes de pregrado de Farmacia. Los temas más frecuentes fueron administración y modo de uso de los medicamentos e indicación e interacciones medicamentosas, con respuesta en menos de 24 h, en la mayoría de los casos. Entre los usuarios que cumplimentaron la encuesta de satisfacción, aproximadamente el 80% de los usuarios clasificaron el servicio brindado como bueno y óptimo. Conclusión: Cebrim/CFF brinda información objetiva, actualizada y oportuna (información pasiva) sobre medicamentos para profesionales farmacéuticos, con administración y modo de uso como temas más recurrentes, y la gran mayoría de los solicitantes están complacidos con el servicio (AU)


Assuntos
Humanos , Serviços de Informação sobre Medicamentos/organização & administração , Assistência Farmacêutica/organização & administração , Brasil , Uso de Medicamentos/estatística & dados numéricos , Satisfação do Paciente , Registros/estatística & dados numéricos , Sistemas de Notificação de Reações Adversas a Medicamentos/organização & administração
19.
Appetite ; 51(3): 592-8, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18524415

RESUMO

The stress response is known to lead to behavioral and metabolic changes. Exposure to chronic stress can promote the development of physiological and behavioral dysfunctions, including alterations in feeding behavior. The aim of this study was to verify whether chronic restraint stress alters the consumption of a highly palatable, highly caloric diet (chocolate), chronically offered to the animals. Male rats ate more chocolate than females, and they also exhibited a higher weight gain, abdominal fat deposition, and higher plasma levels of total cholesterol, LDL-cholesterol and glucose. The stress exposure decreased body weight, increased adrenal weight and decreased plasma insulin levels. Overall, female rats had lower plasma insulin levels and chocolate consumption prevented the increased adrenal gland weight after exposure to chronic stress, suggesting a reduction of stress effects induced by palatable food consumption. Taken together, these results suggest a peculiar metabolic pattern, related to energy store and expenditure, in stressed animals receiving a palatable diet. Since these effects were sex-specific, we may also propose that females and males subjected to restraint stress and chocolate consumption are differentially affected.


Assuntos
Cacau , Metabolismo Energético/fisiologia , Manobra Psicológica , Estresse Psicológico/psicologia , Aumento de Peso/efeitos dos fármacos , Gordura Abdominal/metabolismo , Glândulas Suprarrenais/crescimento & desenvolvimento , Animais , Comportamento Animal , Glicemia/metabolismo , Ingestão de Energia/fisiologia , Feminino , Habituação Psicofisiológica/fisiologia , Insulina/sangue , Leptina/sangue , Lipídeos/sangue , Masculino , Tamanho do Órgão , Distribuição Aleatória , Ratos , Ratos Wistar , Fatores Sexuais , Estresse Psicológico/sangue , Estresse Psicológico/metabolismo , Fatores de Tempo , Aumento de Peso/fisiologia
20.
Rev. bras. odontol ; 69(2): 224-227, Jul.-Dez. 2012.
Artigo em Português | LILACS | ID: lil-720346

RESUMO

A periodontite é causada por micro-organismos anaeróbicos Gram-negativos, que em um hospedeiro suscetível pode levar a destruição dos tecidos de suporte dos dentes. O tratamento da periodontite consiste no debridamento mecânico para eliminação dos patógenos. Entretanto, a recolonização ocorre em semanas e a instalação de uma microbiota mais patogênica ocorre em meses. Como as bactérias probióticas competem com as bactérias que causam injúrias à saúde, os probióticos passaram a ser cogitados como uma nova modalidade terapêutica no tratamento da doença periodontal. Os probióticos apresentam dois principais mecanismos de ação: um relacionado à colonização bacteriana e outro relacionado à modulação da resposta do hospedeiro.


Periodontitis is caused by Gram-negative anaerobic microorganisms, which in a susceptible host can lead to destruction of the supporting tissues of the teeth. Periodontitis treatment consists of mechanical debridement for removal of pathogens. However, recolonization occurs within weeks and the installation of a more pathogenic microbiota occurs in months. As probiotic bacteria compete with bacteria that cause injury to health, probiotics have been considered as a new therapeutic modality in the treatment of periodontal disease. Probiotics have two main mechanisms of action: one related to bacterial colonization and another related to the modulation of host response.


Assuntos
Doenças Periodontais , Periodontia , Periodontite , Probióticos , Gengivite
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