ABSTRACT
ABSTRACT Among individuals coinfected with HCV and HIV, studies of mortality from non-hepatic causes have shown inconsistent results. The aim of this study was to investigate the contribution of HCV and HIV co-infection to mortality from hepatic and non-hepatic causes in Brazil. This retrospective cohort study included blood donors from Fundação Pró-Sangue de São Paulo (FPS) who were followed from 1994 to 2016 to compare mortality and its causes between HIV-HCV coinfected individuals versus those seronegative for all tested infections. Records from the FPS database and the Mortality Information System were linked through a probabilistic record Relationship (RL). The Hazard Ratio (HR) was estimated using Cox multiple regression models. HCV-HIV coinfected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 14.54), non-liver neoplasms (HR = 2.55), infections (HR = 10.37) and liver disease (HR = 7.0). In addition, HCV mono-infected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 2.23), liver cancer (HR = 32.21), liver disease (HR = 14.92), infection (HR = 3.22), and trauma (HR = 1.68). Individuals coinfected with HCV and HIV have increased overall mortality and death due to infections, liver diseases and non-liver neoplasms as compared to those uninfected with HCV and HIV.
ABSTRACT
A participação coordenada das instituições de educação médica com o Sistema Único de Saúde, por meio das diretrizes e dos programas desenvolvidos por este, é fundamental para possibilitar o desenvolvimento de habilidades profissionais que valorizem o sujeito. Objetivo: Analisar as Práticas de Integração Ensino-Serviço Comunidade (PIESC) na reestruturação da formação médica, por meio de uma revisão de literatura. Métodos: Para análise desse fato, os descritores "Práticas de Integração Ensino-Serviço Comunidade" e "Atenção Primária" foram usados para pesquisa na Biblioteca Virtual em Saúde, com isso encontraram-se 21 artigos, dos quais 12 foram selecionados, pois descrevem a implementação e a importância das práticas, assim como seus obstáculos. Resultados: As principais abordagens dessa disciplina perpassam: a percepção do estudante; os obstáculos, a inserção e a implementação desta; os impactos do GraduaSUS. Discussão: Nota-se a necessidade de adaptação do currículo das escolas médicas, com o objetivo de adequar a formação profissional à Estratégia da Saúde da Família, a qual se resulta do fortalecimento da Atenção Primária à Saúde, fruto das demandas sociais contemporâneas. Conclusão: A disciplina Práticas de Integração Ensino-Serviço Comunidade torna-se ferramenta preponderante à transformação e ao emprego das matrizes curriculares dessa graduação em âmbito nacional
The coordinated participation of medical education institutions with the Unified Health System, through guidelines and programs applied by it, is fundamental to enable the development of professional skills that value the subject. Objective: Analyze the Practices of Teaching-Service Community Integration (PCTSI) in the medical formation restructuration, through a literature review. Method: To analyze this fact, the descriptors "Practices of Teaching-Service Community Integration" and "Primary Health Care" were used for research in the Biblioteca Virtual em Saúde, thus 21 articles were found, from which 12 were selected, because they describe the implementation and the significance of the practices, as well as their obstacles. Results: The main approaches of this discipline run through: the student's perception; the obstacles, its insertion and implementation; the impacts of GraduaSUS. Discussion: Note that it is necessary to adjust the curriculum of medical schools, with the objective of adapting professional training to the Family Health Strategy, that results of strengthening Primary Health Care, the fruit of contemporary social demands. Conclusion: The discipline Practices of Teaching-Service Community Integration of Medicine becomes a preponderant tool for the transformation and the use of the curricular matrices of this graduation nationally