ABSTRACT
Resumo Introdução A inserção dos profissionais de educação física na atenção básica tem relevância devido aos trabalhos relacionados à promoção da saúde, porém alguns desafios são apresentados na literatura como barreiras para a atuação profissional. Objetivo Revisar na literatura os desafios encontrados por profissionais de educação física que atuam nos Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF-AB). Método Uma busca utilizando os termos "educação física" e "Núcleo de Apoio à Saúde da Família" foi realizada na base de dados LILACS e no portal SciELO. Os critérios de inclusão foram: ser artigo original, estar publicado no idioma português, ter sido publicado a partir do ano de 2008 e ter avaliado a atuação de profissionais de educação física no NASF-AB. Resultados Dos 45 estudos encontrados na busca inicial, seis atenderam os critérios de inclusão. Além desses, outros dois artigos foram identificados nas referências, resultando em oito artigos incluídos na revisão. Entre os vários desafios relatados, os mais frequentes encontrados nos estudos foram a falta de infraestrutura física e material, a distância entre a formação acadêmica e a área de saúde coletiva e a instabilidade profissional. Conclusão Embora alguns desafios relatados não dependam apenas do profissional de educação física para serem resolvidos, os achados dessa revisão fornecem importantes informações para que futuros profissionais que desejam atuar no NASF-AB possam se preparar de forma mais objetiva e consigam realizar um trabalho com eficiência e qualidade.
Abstract Background The inclusion of physical education professionals in primary care is relevant due to work related to health promotion, but some challenges are presented in the literature as barriers to professional performance. Objective This study aimed to review in the literature the challenges faced by physical education professionals who work in the extended centers for family health and primary care (NASF-AB). Method A search using the terms "physical education" and "family health support centers" was performed in the LILACS and SciELO databases. The inclusion criteria were: be an original article, be published in the Portuguese language, be published from 2008 onwards, and have assessed the role of physical education professionals in the NASF-AB. Results From 45 studies identified in the initial search, six met the inclusion criteria. In addition to these, two other articles were identified in the references, resulting in eight articles included in the review. Among the several challenges reported, the most frequent ones in the different studies were the lack of physical and material infrastructure, the distance between academic formation and the collective health area, and also professional instability. Conclusion Although some of the challenges reported do not depend solely on the physical education professional to be solved, the findings of this review already provide important information for future professionals who wish to work in NASF-AB to prepare themselves more objectively and perform an efficient and quality work.
ABSTRACT
Abstract Background: Systemic sclerosis (SSc) Is a clinically complex and challenging disease, that leads to skin fibrosis. Its most frequent complication is interstitial lung disease (ILD), which leads to a worse prognosis. In this situation, cyclophosphamide is considered the gold standard for its treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. Objectives: This paper objective was to analyze the scientific evidence on the RTX effects on SSc. Methods: A systematic review (SR) was performed including clinical trials (CTs) on the use of RTX in SSc, published up to May 2020. The studies were identified through systematic searches in bibliographic databases using a predefined search strategy. The following databases were used: PUBMED, SCOPUS, SCIELO, LILACS, SCIENCE DIRECT, WEB OF SCIENCE, COCHRANE, WHOLIS, PAHO and EMBASE. Also, a manual search was performed. The methodological quality of the studies was determined using Jadad scale, Risk of Bias Tool (RoB 2.0) and Risk of Bias in Non-Randomized Studies - of Interventions tool (ROBINS-I). A meta-analysis of the randomized CTs was performed, using Review Manager. Results: Ten CTs were included in this SR. Of these, three were randomized and seven were non-randomized. Five showed a statistically significant improvement in forced vital capacity (FVC) at some time during follow-up. Regarding the skin, eight studies showed statistically significant improvements according toa the modified Rodnan skin score. The meta-analysis found positive effects of RTX in SSc, with a statistical significance for lung disease. Conclusion: Rituximab is a promising strategy for the SSc-associated ILD and cutaneous fibrosis treatment. PROSPERO registration number: CRD42019132018.(AU)