ABSTRACT
O número de casos de dengue no continente americano, no primeiro semestre de 2023, superou o total de casos de 2022 e o Brasil lidera com 2,3 milhões de ocorrências da doença e 769 mortes. A dengue se expande no mundo e já é considerada endêmica em mais de 100 países. Este estudo objetiva caracterizar o perfil dos óbitos por dengue, no período de 2015 a 2023, em uma cidade do interior do estado de São Paulo. Este é um estudo transversal, retrospectivo e descritivo, com análise de dados secundários do Sistema Nacional de Notificação (Sinan), Sistema de Mortalidade (SIM) e banco de dados dos óbitos por dengue, do comitê de mortalidade da vigilância epidemiológica municipal. A capacidade das equipes de saúde em identificar os sinais e sintomas ocorreu em apenas 42,9% dos casos antes da internação e do óbito, seguida por no dia do óbito (11,7%) e após o óbito (8,8%). A mortalidade por dengue predominou em indivíduos do sexo masculino (51,4%), com idade mediana de 74 anos. A análise dos dados demonstrou que o manejo clínico da dengue ainda é desafiador para a equipe de saúde, que precisa se manter permanentemente capacitada para o reconhecimento dos sintomas, sinais de alarme e gravidade, para a correta condução de cada caso, visando a redução da mortalidade.
In the first half of 2023, the number of dengue cases in the Americas surpassed the total for 2022, with Brazil leading the list with 2.3 million disease occurrences and 769 deaths. Dengue is expanding globally and is already considered endemic in more than 100 countries. This study characterizes the profile of dengue deaths from 2015 to 2023 in a municipality of São Paulo. A cross-sectional, retrospective, and descriptive study was conducted with secondary data obtained from the National Notification System (SINAN), Mortality System (SIM), and dengue death database of the municipal epidemiological surveillance mortality committee. Only in 42.9% of cases were the health teams able to identify the signs and symptoms before hospitalization and death, followed by after death (8.8%) and on the day of death (11.7%). Dengue mortality predominated among male individuals (51.4%) with a median age of 74 years. Data analysis showed that the clinical management of dengue remains challenging for health teams, who needs continuous training to recognize the signs and symptoms, warning signs, and severity for correct management of each case, aiming to reduce mortality.
Los casos de dengue en las Américas superaron en el primer semestre de 2023 al total de casos de 2022, en el cual lidera Brasil con 2,3 millones de notificaciones de la enfermedad y 769 muertes. El dengue se expande por el mundo, y más de 100 países ya lo consideran una endemia. Este estudio tiene como objetivo caracterizar el perfil de las muertes por dengue en el período de 2015 a 2023, en una ciudad del interior del estado de São Paulo. Se trata de un estudio transversal, retrospectivo y descriptivo con análisis de datos secundarios del Sistema Nacional de Notificación (SINAN), del Sistema de Mortalidad (SIM) y de la Base de Datos de Muertes por Dengue del Comité de Mortalidad de la Vigilancia Epidemiológica Municipal. Los equipos de salud fueron capaces de identificar los signos y síntomas en solo el 42,9% de los casos antes de la hospitalización y de la muerte, seguida del día de la muerte (11,7%) y tras la muerte (8,8%). La mortalidad por dengue predominó en individuos del sexo masculino (51,4%) con una edad media de 74 años. El análisis de datos demostró que el manejo clínico del dengue sigue siendo un desafío para el equipo de salud, quien necesita mantenerse capacitado continuamente para detectar los signos y síntomas, señales de alarma y gravedad, para la correcta conducción de cada caso, con el objetivo de reducir la mortalidad.
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objectiveTo investigate the differences in clinical indices and lipid metabolism between the patients with nonalcoholic fatty liver disease (NAFLD) and healthy individuals in the overweight population. MethodsIn this study, body mass index (BMI)>23 kg/m2 was defined as overweight. A total of 62 overweight patients with NAFLD who were admitted to Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2020 to April 2021 were enrolled as overweight NAFLD group, and 50 overweight individuals who underwent physical examination during the same period of time were enrolled as control group. Clinical information and blood biochemical parameters were recorded for all subjects. Ultra-performance liquid chromatography-tandem mass spectrometry was used to analyze serum lipidomic profile, and principal component analysis and orthogonal partial least squares-discriminant analysis were used to perform the multivariate statistical analysis of lipidomic data. The chi-square test was used for comparison of categorical data between two groups, and the independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups. ResultsThe overweight NAFLD group had a significantly higher BMI than the overweight control group (Z=-2.365, P=0.018). As for serological markers, compared with the overweight control group, the overweight NAFLD group had significantly higher levels of red blood cells, hemoglobin, hematocrit, uric acid, total protein, globulin, alkaline phosphatase, gamma-glutamyl transpeptidase, alanine aminotransferase, aspartate aminotransferase, cholinesterase, low-density lipoprotein, total cholesterol, triglyceride, apolipoprotein B, and blood glucose (all P<0.05). The lipidomic analysis showed that there was a significant difference in lipid metabolism between the two groups, and a total of 493 differentially expressed lipids were identified (VIP value>1, P<0.05), among which 143 lipids were significantly upregulated and 350 lipids were significantly downregulated in the overweight NAFLD group. The mean total fatty acid content in the overweight NAFLD group was 3.6 times that in the overweight control group. Compared with the overweight control group, the overweight NAFLD group had a significant reduction in the content of triglyceride with>3 unsaturated bonds (P<0.001) and a significant increase in the content of triglyceride with ≤3 unsaturated bonds (P<0.001). ConclusionCompared with healthy overweight individuals, overweight NAFLD patients tend to have significant abnormalities in some biochemical parameters and lipid metabolites, with significant increases in the content of fatty acid in blood and the types of saturated fat chains in triglycerides.
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Introducción: La principal causa de demencia degenerativa es la enfermedad de Alzhéimer. En la población cubana, una de cada cuatro personas de 65 años y más fallece por esta enfermedad u otra forma de demencia. Objetivo : Identificar los factores de riesgo asociados al agravamiento clínico de los pacientes ingresados con enfermedad de Alzhéimer en el Hospital Psiquiátrico Universitario Rene Vallejo Ortiz entre enero de 2013 y diciembre de 2022. Métodos: Se realizó un estudio observacional, descriptivo y transversal. El universo estuvo integrado por todos los pacientes ingresados en la mencionada institución asistencial y docente. La muestra no probabilística y a criterio de los autores la integraron 77 pacientes adultos con el diagnóstico de la enfermedad en el periodo de estudio señalado. Las historias clínicas fueron la fuente secundaria de información. Se utilizó estadística descriptiva e inferencial. La información se resumió en tablas y gráficos. Resultados: El 90,6 % presentaban más de 60 años y más de la mitad eran del sexo masculino (54,5 %). La mayoría de los pacientes presentaron diversos síntomas asociados. Lo trastornos de personalidad y orientación se constataron en el 75,3 % mientras que los de memoria en el 72,7 %. Conclusiones: El agravamiento clínico luego del ingreso hospitalario se acentuó en aquellos pacientes sin escolaridad, solteros, desocupados, con enfermedades cerebro vasculares y presencia de familias disfuncionales presentaron. Los pacientes anémicos o con signos de irritación cortical focal en región frontoparietal con generalización secundaria presentaron mayoritariamente un empeoramiento clínico.
Introduction: The main cause of degenerative dementia is Alzheimer's disease. In the Cuban population, one in four people aged 65 and over dies from this disease or another form of dementia. Objective: To identify the risk factors associated with the clinical worsening of patients admitted with Alzheimer's disease at the Rene Vallejo Ortiz University Psychiatric Hospital. Methods: An observational, descriptive and cross-sectional study was carried out. The universe was made up of all patients admitted to the aforementioned healthcare and teaching institution. The non-probabilistic sample and at the discretion of the authors was made up of 77 adult patients with the diagnosis of the disease in the indicated study period between January 2013 and December 2022. Medical records were the secondary source of information. Descriptive and inferential statistics were used. The information was summarized in tables and graphics. Results: 90.6% were over 60 years old and more than half were male (54.5%). Most patients presented various associated symptoms. Personality and orientation disorders were found in 75.3%, while memory disorders were found in 72.7%. Conclusions: The clinical worsening after hospital admission was accentuated in those patients without schooling, single, unemployed, with cerebrovascular diseases and presence of dysfunctional families. Anemic patients or patients with signs of focal cortical irritation in the frontoparietal region with secondary generalization mostly presented clinical worsening.
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Este estudo teve como objetivo investigar a ocorrência de afecções respiratórias em crianças expostas à poeira de resíduos de mineração após o desastre do rompimento da barragem em Brumadinho, Minas Gerais, Brasil. A população de estudo incluiu crianças com idades entre 0 e 6 anos, residentes em três comunidades expostas à resíduos de poeira de mineração (Córrego do Feijão, Parque da Cachoeira e Tejuco) e uma comunidade não exposta (Aranha). A coleta de dados ocorreu entre 19 e 30 de julho de 2021, por meio de questionários que abordavam informações sociodemográficas e um inquérito recordatório sobre sinais, sintomas e doenças respiratórias. Foram avaliadas 217 crianças, sendo 119 das comunidades expostas e 98 da comunidade não exposta. Os residentes nas comunidades expostas relataram aumento na frequência de faxina em suas residências (p = 0,04) e no tráfego de veículos (p = 0,03). Entre as crianças de 4 anos, foi observada uma maior frequência de afecções das vias aéreas superiores (p = 0,01) e inferiores (p = 0,01), bem como de alergia respiratória (p = 0,05). O grupo exposto apresentou 1,5 vez mais relatos de alergia respiratória (75%; p = 0,02) em comparação com o não exposto (50,5%). Crianças que viviam nas comunidades expostas à poeira de resíduos apresentaram três vezes mais chance (OR ajustada = 3.63; IC95%: 1,37; 9,57) de ocorrência de alergia respiratória em comparação com as não expostas. Dois anos e seis meses após a ocorrência do desastre ambiental, as crianças das comunidades afetadas pelos resíduos das atividades de mineração e remediação permaneciam expostas à poeira com efeitos tóxicos sobre a saúde respiratória.
This study aimed to investigate the occurrence of respiratory diseases in children exposed to dust from mining waste after the Brumadinho dam disaster, Minas Gerais State, Brazil. The study population included children aged 0-6 years, living in three communities exposed to mining waste dust (Córrego do Feijão, Parque da Cachoeira, and Tejuco) and one unexposed community (Aranha). Data were collected from July 19 to 30, 2021, using questionnaires that addressed sociodemographic information and a recall survey on signs, symptoms, and respiratory diseases. A total of 217 children were evaluated, 119 living in the exposed communities and 98 in the non-exposed community. The residents in the exposed communities reported an increase in the frequency of home cleaning (p = 0.04) and in vehicular traffic (p = 0.03). Among children aged four, a higher frequency of upper (p = 0.01) and lower (p = 0.01) airway disorders, as well as respiratory allergy (p = 0.05) was observed. The exposed group had 1.5 times more reports of respiratory allergy (75%; p = 0.02) compared to the non-exposed group (50.5%). Children living in communities exposed to waste dust were three times more likely (adjusted OR = 3.63; 95%CI: 1.37; 9.57) to have respiratory allergies than those not exposed. Two years and six months after the environmental disaster occurred, children living in the communities affected by waste from mining and remediation activities remained exposed to dust with harmful effects on respiratory health.
El objetivo de este estudio fue investigar la ocurrencia de enfermedades respiratorias en niños expuestos al polvo de residuos de la minería tras el desastre del colapso de la represa en Brumadinho, Minas Gerais, Brasil. La población de estudio incluyó niños que tenían entre 0 y 6 años, que viven en tres comunidades expuestas a residuos de polvo de la minería (Córrego do Feijão, Parque da Cachoeira y Tejuco) y una comunidad no expuesta (Aranha). Se recolectaron los datos entre el 19 y el 30 de julio de 2021, a través de cuestionarios que abordaban informaciones sociodemográficas y una encuesta recordatoria acerca de los señales, síntomas y enfermedades respiratorias. Se evaluaron 217 niños, de los cuales 119 viven en las comunidades expuestas y 98 viven en la comunidad no expuesta. Los residentes de las comunidades expuestas relataron un aumento en la frecuencia de limpieza de sus casas (p = 0,04) y en el tráfico de vehículos (p = 0,03). Entre los niños de 4 años, se observó una frecuencia más alta de enfermedades de las vías aéreas superiores (p = 0,01) e inferiores (p = 0,01), así como de alergia respiratoria (p = 0,05). El grupo expuesto presentó 1,5 veces más relatos de alergia respiratoria (el 75%; p = 0,02) en comparación con el grupo no expuesto (el 50,5%). Niños que vivían en las comunidades expuestas al polvo de residuos presentaron tres veces más probabilidad (OR ajustada = 3,63; IC95%: 1,37; 9,57) de ocurrencia de alergia respiratoria en comparación con los niños que no se expusieron. Dos años y seis meses tras el desastre ambiental, los niños que viven en las comunidades afectadas por los residuos de las actividades de minería y descontaminación permanecían expuestos al polvo con efectos tóxicos para la salud respiratoria.
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Objetivo: avaliar a eficácia da Ivermectina e do Atazanavir em comparação com placebo no tempo de resolução dos sintomas e no tempo de duração da doença por COVID-19. Método: estudo observacional, de coorte prospectivo, longitudinal, descritivo e analítico com pacientes sintomáticos ambulatoriais, acompanhados por 06 meses em duas Unidades Básicas de Saúde para atendimento de COVID-19 em Teresina- Piauí, Brasil, no período de novembro a abril de 2021 identificados por amostragem aleatória 1:1:1. Foram realizados exames Reverse transcription polymerase chain reaction (RT-PCR) para confirmação laboratorial da suspeita de infecção pelo novo coronavírus e avaliação sociodemográfica e clínica. Resultados: dos 87 pacientes randomizados, 62,1% (n=54) eram do sexo masculino, com média de idade de 35,1 anos, possuíam companheira (53,9%), baixa renda (50,6%), eutróficos (40,7%) e sem comorbidades de saúde (78,2%). Não houve diferença entre o tempo médio para resolução dos sintomas, que foi de 21 dias (IQR, 8-30) no grupo atazanavir, 30 dias (IQR, 5-90) no grupo ivermectina em comparação com 14 dias (IQR, 9-21) no grupo controle. No dia 180, houve resolução dos sintomas em 100% no grupo placebo, 93,9% no grupo atazanavir e 95% no grupo ivermectina. A duração mediana da doença foi de 08 dias em todos os braços do estudo. Conclusão: o tratamento com atazanavir (6 dias) e ivermectina (3 dias) não reduziu o tempo de resolução dos sintomas e nem o tempo de duração da doença entre os pacientes ambulatoriais com COVID-19 leve em comparação com o grupo placebo. Os resultados não suportam o uso de ivermectina e atazanavir para tratamento de COVID-19 leve a moderado.
Objective: to evaluate the effectiveness of Ivermectin and Atazanavir compared to placebo in the time to resolution of symptoms and duration of illness due to COVID-19. Method: observational, prospective, longitudinal, descriptive and analytical cohort study with symptomatic outpatients, followed for 06 months in two Basic Health Units for COVID-19 care in Teresina-Piauí, Brazil, from November to April 2021 identified by 1:1:1 random sampling. Reverse transcription polymerase chain reaction (RT-PCR) tests were performed for laboratory confirmation of suspected infection with the new coronavirus and sociodemographic and clinical evaluation. Results: of the 87 randomized patients, 62.1% (n=54) were male, with a mean age of 35.1 years, had a partner (53.9%), low income (50.6%), eutrophic (40.7%) and without health comorbidities (78.2%). There was no difference between the median time to resolution of symptoms, which was 21 days (IQR, 8-30) in the atazanavir group, 30 days (IQR, 5- 90) in the ivermectin group compared with 14 days (IQR, 9- 21) in the control group. At day 180, there was resolution of symptoms in 100% in the placebo group, 93.9% in the atazanavir group, and 95% in the ivermectin group. The median duration of illness was 8 days in all study arms. Conclusion: Treatment with atazanavir (6 days) and ivermectin (3 days) did not reduce the time to symptom resolution or the duration of illness among outpatients with mild COVID-19 compared to the placebo group. The results do not support the use of ivermectin and atazanavir for the treatment of mild to moderate COVID-19.
Objetivo: evaluar la efectividad de Ivermectina y Atazanavir en comparación con placebo en el tiempo de resolución de los síntomas y duración de la enfermedad por COVID-19. Método: estudio de cohorte observacional, prospectivo, longitudinal, descriptivo y analítico con pacientes ambulatorios sintomáticos, seguidos durante 06 meses en dos Unidades Básicas de Salud para atención de COVID-19 en Teresina-Piauí, Brasil, de noviembre a abril de 2021 identificados por 1:1:1 muestreo aleatorio. Se realizaron pruebas de reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR) para confirmación de laboratorio de sospecha de infección por el nuevo coronavirus y evaluación sociodemográfica y clínica. Resultados: de los 87 pacientes aleatorizados, 62,1% (n=54) eran del sexo masculino, con una edad media de 35,1 años, tenían pareja (53,9%), bajos ingresos (50,6%), eutróficos (40,7%) y sin comorbilidades de salud (78,2%). No hubo diferencia entre la mediana de tiempo hasta la resolución de los síntomas, que fue de 21 días (RIC, 8-30) en el grupo de atazanavir, 30 días (RIC, 5- 90) en el grupo de ivermectina en comparación con 14 días (RIC, 9 - 21) en el grupo control. En el día 180, hubo una resolución de los síntomas del 100 % en el grupo de placebo, del 93,9 % en el grupo de atazanavir y del 95 % en el grupo de ivermectina. La mediana de duración de la enfermedad fue de 8 días en todos los brazos del estudio. Conclusión: El tratamiento con atazanavir (6 días) e ivermectina (3 días) no redujo el tiempo de resolución de los síntomas ni la duración de la enfermedad entre los pacientes ambulatorios con COVID-19 leve en comparación con el grupo placebo. Los resultados no respaldan el uso de ivermectina y atazanavir para el tratamiento de la COVID-19 de leve a moderada.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Ivermectin/analysis , Efficacy , Atazanavir Sulfate/analysis , COVID-19/complications , COVID-19/drug therapy , Outpatients , Prospective Studies , Cohort Studies , Clinical Trials as Topic/methods , Observational Studies as Topic/methodsABSTRACT
Introducción: La disfagia resulta de varios mecanismos fisiopatológicos donde sus síntomas no son estáticos ni homogéneos en las personas, especialmente cuando existe disfagia orofaríngea neurogénica. Objetivo: Conocer la percepción y comportamiento en el tiempo de síntomas de disfagia mediante el instrumento Eating Assessment Tool-10 (EAT-10) en pacientes con disfagia orofaríngea neurogénica, con el fin de visualizar la dinámica clínica de esta forma de disfagia. Metodología: Estudio observacional tipo cohorte en pacientes con disfagia orofaríngea neurogénica de causas neurológicas y neuromusculares, con seguimiento a tres y seis meses y diligenciamiento del EAT-10 al momento basal, tercer y sexto mes. Resultados: Un total de 90 personas con evaluación basal, de las cuales el 56,7 % (51/90) lograron seguimiento al tercer mes y 25,6 % (23/90) al sexto mes. Los síntomas de disfagia con mayor autopercepción en los tres momentos fueron la dificultad para tragar sólidos, sensación de comida pegada en garganta y tos al comer. La odinofagia no fue un síntoma habitualmente percibido. La puntuación total del EAT-10 estuvo entre 16,61 ± 9 y 18,1 ± 9,5 puntos en general. En pacientes con seguimiento completo se observó variación en la autopercepción para tragar líquidos y pastillas. Se observó variación del puntaje al ajustarlo por recepción de terapias. Discusión: Las enfermedades neurológicas y neuromusculares impactan directamente la deglución con gravedad entre leve a profunda, donde la autopercepción de síntomas deglutorios es dinámica, pero con síntomas cardinales de disfagia orofaríngea en el tiempo. Conclusiones: El reconocimiento y seguimiento de síntomas de disfagia deben ser aspectos usuales en la atención de pacientes con enfermedades neurológicas y neuromusculares.
Introduction: Dysphagia results from several pathophysiological mechanisms where its symptoms are not static or homogeneous in people, especially when there is neurogenic oropharyngeal dysphagia. Objective: To know the perception and behavior over time of symptoms of dysphagia using the Eating Assessment Tool-10 (EAT-10) in patients with neurogenic oropharyngeal dysphagia to visualize the clinical dynamics of this form of dysphagia. Methodology: Observational cohort study in patients with neurogenic oropharyngeal dysphagia of neurological and neuromuscular causes with, follow-up at three and six months, and completion of the EAT-10 at baseline, third and sixth month. Results: A total of 90 people with baseline evaluation were included, of whom 56.7% (51/90) achieved follow-up at the third month and 25.6% (23/90) at the sixth month. Symptoms of dysphagia with greater self-perception at all three moments were difficulty swallowing solids, sensation of food stuck in the throat and coughing when eating. Odynophagia was not a commonly perceived symptom. The total score of the EAT-10 was between 16.61±9 and 18.1±9.5 points in general. In patients with complete follow-up, variation in self-perception of swallowing liquids and pills was observed. Variation of the score when adjusting for the reception of therapies. Discussion: Neurological and neuromuscular diseases directly impact swallowing with mild to profound severity, where self-perception of swallowing symptoms is dynamic, but with cardinal symptoms of oropharyngeal dysphagia over time. Conclusions: The recognition and monitoring of dysphagia symptoms should be usual aspects in the care of patients with neurological and neuromuscular diseases.
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Objetivo: comparar o conhecimento de enfermeiros e técnicos de enfermagem atutentes em Unidades de Pronto Atendimento quanto ao reconhecimento de manifestações clínicas e grupos de risco para o desenvolvimento da forma grave da COVID-19. Método: estudo descritivo, realizado com 53 profissionais de três unidades de pronto atendimento, com coleta de dados realizada por meio de questionário autorrespondido. Dados analisados por meio de estatística descritiva e inferencial (testes t-student e qui-quadrado). Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa da instituição. Resultados: destaca-se uma associação entre a citação de manifestações clínicas como náuseas e vômitos, grupos de risco e a função, enfermeiros ou técnicos de enfermagem (p<0,05) e o nível de formação, ou seja, os enfermeiros relataram com maior frequência a presença desses sintomas que os técnicos de enfermagem. Conclusão: os profissionais de enfermagem apresentam conhecimento quanto a sintomatologia e grupos de risco, ainda que haja diferença entre o nível profissional.
Objective: to compare the knowledge of nurses and nursing technicians working in Emergency Care Units regarding the recognition of clinical manifestations and risk groups for the development of the severe form of COVID-19. Method: descriptive study, carried out with 53 professionals from three emergency care units, with data collection carried out through a self-answered questionnaire. Data analyzed using descriptive and inferential statistics (t-student and chi-square tests). Research protocol approved by the institution's Research Ethics Committee. Results: an association stands out between the mention of clinical manifestations such as nausea and vomiting, risk groups and the role, nurses or nursing technicians (p<0.05) and the level of training, that is, nurses reported with the presence of these symptoms was more frequent than nursing technicians. Conclusion: nursing professionals have knowledge regarding symptoms and risk groups, even if there is a difference between the professional level.
Objetivo: comparar los conocimientos de enfermeros y técnicos de enfermería que trabajan en Unidades de Atención de Emergencia sobre el reconocimiento de manifestaciones clínicas y grupos de riesgo para el desarrollo de la forma grave de COVID-19. Método: estudio descriptivo, realizado con 53 profesionales de tres unidades de atención de emergencia, con recolección de datos realizada a través de un cuestionario auto respondido. Datos analizados mediante estadística descriptiva e inferencial (pruebas t de Student y chi-cuadrado). Protocolo de investigación aprobado por el Comité de Ética en Investigación de la institución. Resultados: se destaca asociación entre la mención de manifestaciones clínicas como náuseas y vómitos, grupos de riesgo y el rol, enfermeros o técnicos de enfermería (p<0,05) y el nivel de formación, es decir, los enfermeros reportaron la presencia de estos síntomas. fue más frecuente que los técnicos de enfermería. Conclusión: los profesionales de enfermería tienen conocimientos sobre síntomas y grupos de riesgo, aunque exista diferencia entre el nivel profesional.
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Mpoxou Varíola M é uma zoonose causada por vírus do gênero Orthopoxvirus, causadores também da varíola comum. É uma doença considerada rara e autolimitada, sendo endêmica em países africanos. Entretanto, no ano de 2022 ganhou destaque devido ao surto global que se iniciou, quando o mundo ainda se recuperava da pandemia da COVID-19. Dessa forma, por se tratar de uma doença emergente, a presente revisão visa pontuar aspectos gerais do que se sabe até o momento sobre a Mpox, desde sua imunopatogenia até as formas atuais de prevenção e cuidados pós-infecção
Mpox or Variola M is a zoonosis caused by viruses of the genus Orthopoxvirus, which also cause smallpox. It is a disease considered rare and self-limiting, being endemic in African countries. However, in 2022, it gained prominence due to the global outbreak that began when the world was still recovering from the COVID-19 pandemic. Thus, as it is an emerging disease, this review aims to point out general aspects of what is known so far about Mpox, from its immunopathogenesis to current forms of prevention and post-infection care
Subject(s)
Humans , Severe Acute Respiratory Syndrome , Mpox (monkeypox) , Viruses , Wounds and Injuries/virology , Smallpox , Delivery of Health CareABSTRACT
RESUMO Os serviços de Cuidados Paliativos Domiciliares especializados no tratamento de pacientes oncológicos têm como objetivo identificar e controlar sintomas físicos, psicossociais e espirituais em domicílio. Alguns desafios encontrados são a complexidade de sintomas, a sobrevida reduzida dos pacientes com câncer avançado e limitações do sistema de saúde. Para estratificar a prioridade de atendimento dos pacientes com câncer avançado em Cuidados Paliativos Domiciliares, foi elaborado um protocolo de classificação de risco. Este artigo é um relato de experiência sobre o processo de elaboração de um protocolo de classificação de risco para pacientes com câncer avançado atendidos em um serviço de Cuidados Paliativos Domiciliares no Rio de Janeiro. A etapa inicial envolveu reuniões da equipe da Assistência Domiciliar de um hospital oncológico e buscas estruturadas na literatura. Depois, foram listadas as situações clínicas de manejo mais complexo no domicílio, chamadas de sinais e sintomas de alerta: dor, falta de ar, náuseas/ vômitos, sangramento e confusão mental aguda. Elaborou-se um protocolo de avaliação e classificação de risco com cinco categorias/cores, para determinar a prioridade de atendimento dos pacientes. O sistema de triagem desenvolvido possui fácil aplicabilidade e requer um treinamento breve do profissional de saúde para que possa ser utilizado durante os atendimentos domiciliares.
ABSTRACT Home-based Palliative Care services specialized in the treatment of cancer patients aim to identify and control physical, psychosocial, and spiritual symptoms at home. Some challenges encountered are the complexity of symptoms, reduced survival of patients with advanced cancer, and limitations of the health care system. To stratify the priority of care for patients with advanced cancer in home Palliative Care, a risk classification protocol was developed. This article is an experience report on the process of creating a risk classification protocol for patients with advanced cancer treated at a home Palliative Care service in Rio de Janeiro. The initial stage involved meetings of the home care team at an oncology hospital and structured searches in the literature. Afterwards, the clinical situations of more complex management at home were listed and named as warning signs and symptoms: pain, shortness of breath, nausea/ vomiting, bleeding, and acute mental confusion. An assessment and triage protocol was developed with five categories/colors to determine the priority of patient care. The developed triage system has easy applicability and requires a brief training of the health professional so that it can be used during home visits.
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Introducción: con la evolución de la pandemia de COVID-19 se observó que esta infección se comporta como un iceberg: en el vértice se ubican las complicaciones en el contexto de la infección aguda y en la base se van acumulando aquellos síntomas que persisten en el tiempo e impiden al paciente su recuperación total. Objetivo: determinar la prevalencia de síntomas persistentes en pacientes diagnosticados con COVID-19 seguidos por el área de telemedicina del Departamento de Control de Infecciones del Hospital de Clínicas, San Lorenzo, Paraguay, durante el periodo agosto 2020- abril 2021. Metodología: se aplicó un diseño estudio observacional, descriptivo, retrospectivo de corte transversal, con muestreo no probabilístico de casos consecutivos. Se incluyeron 236 cuestionarios digitales de pacientes seguidos por el área de telemedicina entre agosto 2020 y abril 2021. Resultados: la edad media fue 36± 10 años, 71,2% fue del sexo femenino. El 61% de los pacientes provenía del Departamento Central y 58,9% fue personal de blanco. El 29,7% padecía de obesidad. El 86,9% presentó un cuadro leve. Presentaron síntomas persistentes el 66,9% siendo la fatiga la más común (66,5%) y los síntomas duraron menos de tres meses en 55%. Conclusiones: la edad promedio muestra mayoría de población joven, sobre todo mujeres y procedentes del Departamento Central. Más de la mitad califican como personal de blanco, la mayoría fueron obesos, casi todos presentaron un cuadro de COVID-19 leve y el síntoma persistente más frecuente fue la fatiga con una duración de menos que 3 meses.
Introduction: With the evolution of the COVID-19 pandemic, it was observed that this infection behaves like an iceberg: at the apex there are the complications in the context of acute infection and at the base there are those symptoms that persist in the time and prevent the patient from full recovery. Objective: To determine the prevalence of persistent symptoms in patients diagnosed with COVID-19 followed by the telemedicine area of ââthe Infection Control Department of the Hospital de Clínicas, San Lorenzo, Paraguay, during the period August, 2020-April, 2021. Methodology: An observational, descriptive, retrospective cross-sectional study design was applied, with non-probabilistic sampling of consecutive cases. Two hundred thirty-six digital questionnaires from patients followed by the telemedicine area between August, 2020 and April, 2021 were included. Results: The mean age was 36 ± 10 years, 71.2% was female, 61% of the patients came from the Central Department and 58.9% was health professionals. Twenty-nine-point seven percent suffered from obesity while 86.9% presented a mild condition. Sixty-six-point nine percent presented persistent symptoms, fatigue being the most common (66.5%) and the symptoms lasted less than three months in 55%. Conclusions: The mean age showed a majority of the young population, especially women from the Central Department. More than half qualified as health professionals, most were obese, almost all had mild COVID-19, and the most frequent persistent symptom was fatigue lasting less than 3 months.
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Evidências científicas sugerem que o SARS-CoV-2 está nos tecidos orais na fase inicial da contaminação como principal reservatório viral. Além da cavidade oral ser o principal meio de propagação, também se torna uma localização comum das manifestações clínicas durante o início e a evolução da doença. O objetivo foi avaliar na literatura as manifestações clínicas orais e maxilofaciais decorrentes da contaminação pela Covid-19. Trata-se de uma revisão integrativa da literatura das bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Scientific Electronic Library Online (Scielo) e BBO Odontologia, de artigos publicados entre os anos de 2019 e 2022 que retratassem a temática do estudo. Inicialmente, realizou-se a busca pelos descritores individualmente, em seguida, foram realizados os cruzamentos utilizando o operador booleano "AND" e, posteriormente, os três descritores foram cruzados em conjunto. Os critérios de inclusão foram: artigos publicados em português, inglês e espanhol, publicados e indexados nas referidas bases de dados, a partir de 2019 ano do surgimento da Covid-19 e que retratassem a temática em estudo. Os critérios de exclusão foram: artigos publicados antes de 2019, artigos fora das bases de dados escolhidas e que fugissem da temática do estudo. Durante o estudo, 28 artigos foram selecionados a partir de todos os critérios citados. Conclui-se que pacientes contaminados com a Covid-19 tiveram manifestações clínicas orais e maxilofaciais que podem incluir ulcerações, inflamações na orofaringe, edemas retromandibulares, infecções fúngicas, xerostomia, anosmia e ageusia.
cientific evidence suggests that SARS-CoV-2 is present in the oral tissues in the initial phase of contamination as the main viral reservoir. Besides the oral cavity being the main means of spread, it also becomes a common location of clinical manifestations during the onset and evolution of the disease. The objective was to evaluate the literature about the oral and maxillofacial clinical manifestations arising from Covid-19 contamination. This is an integrative literature review of the databases Latin American and Caribbean Literature on Health Sciences (Lilacs), Scientific Electronic Library Online (Scielo) and BBO Dentistry, of articles published between 2019 and 2022 that portrayed the theme of the study. Initially, the search for the descriptors was conducted individually, then, the crossings were performed using the Boolean operator "AND" and, subsequently, the three descriptors were crossed together. The inclusion criteria were articles published in Portuguese, English and Spanish, published and indexed in the databases, starting in 2019 - year of the emergence of Covid-19 and that portrayed the theme of the study. The exclusion criteria were articles published before 2019, articles outside the chosen databases, and articles that ran away from the theme of the study. During the study, 28 articles were selected from all the cited criteria. It was concluded that patients contaminated with Covid-19 had oral and maxillofacial clinical manifestations that may include ulcerations, inflammation in the oropharynx, retromandibular edema, fungal infections, xerostomia, anosmia, and ageusia.
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Fundamento un elevado porcentaje de personas que han padecido COVID-19, refieren tras la recuperación de la fase aguda, manifestaciones que se prolongan por más de tres semanas, e incluso, durante tres meses después del cuadro clínico original. Objetivo caracterizar desde el punto clínico y epidemiológico a pacientes confirmados al SARS-CoV-2 en la etapa post-COVID-19. Métodos se realizó un estudio descriptivo transversal, en pacientes confirmados al SARS-CoV-2 en etapa post-COVID-19, pertenecientes al Policlínico Hermanos Martínez Tamayo, en el periodo octubre-noviembre de 2021. Se estudiaron todos los pacientes (N=400) atendidos en consulta post-COVID-19 en el periodo declarado. La información se obtuvo mediante encuestas epidemiológicas realizadas. Resultados predominaron los pacientes con edades entre 50 y 59 años, del sexo femenino. Las manifestaciones clínicas más frecuente fueron tos, pérdida del gusto y del olfato. El esquema de vacunación incompleto fue el más frecuente. El lugar de ingreso más utilizado fueron los centros de aislamiento, así como el uso del Nasalferon como tratamiento. Las complicaciones predominaron en pacientes no vacunados, y con edad de 60 años y más. Conclusiones un elevado porcentaje de pacientes presentó manifestaciones clínicas tras el periodo agudo de la enfermedad. La COVID-19, a mediano plazo, tuvo mayores implicaciones en el sistema respiratorio, nervioso y osteomioarticular. Las campañas de vacunación ayudan a prevenir los síntomas graves del virus y a contrarrestar las complicaciones.
Background a high percentage of people who have suffered from COVID-19 report, after recovery from the acute phase, manifestations that last for more than three weeks, and even for three months after the original clinical picture. Objective to characterize, from the clinical and epidemiological point of view, patients confirmed to SARS-CoV-2 in the post-COVID-19 stage. Methods a descriptive cross-sectional study was carried out in patients confirmed to SARS-CoV-2 in the post-COVID-19 stage, belonging to the Hermanos Martínez Tamayo Polyclinic, from October to November 2021. All patients were studied (N= 400) attended in post-COVID-19 consultation in the declared period. The information was obtained through epidemiological surveys carried out. Results there was a predominance of patients aged between 50 and 59 years old, female. The most frequent clinical manifestations were cough, loss of taste and smell. The incomplete vaccination scheme was the most frequent. The most used place of admission were isolation centers, as well as the use of Nasalferon as a treatment. Complications predominated in unvaccinated patients, and aged 60 years and over. Conclusions a high percentage of patients presented clinical manifestations after the acute period of the disease. COVID-19, in the medium term, had greater implications in the respiratory, nervous and osteomyoarticular systems. Vaccination campaigns help prevent serious symptoms of the virus and counteract complications.
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Introdução: Alterações na tireoide e a tireoidectomia podem levar à sintomatologia vocal e emocional.Objetivo: Correlacionar sintomas vocais e traços de ansiedade e depressão pré e pós-tireoidectomia. Métodos: Estudo observacional, longitudinal. Participaram 20 pacientes submetidos à tireoidectomia, ao exame visual laríngeo e à Escala de Sintomas Vocais (ESV) e Escala Hospitalar de Ansiedade e Depressão (HADS) no pré-operatório, pós 1 semana e pós 3 meses, com média de idade de 54,5 anos, maior prevalência do sexo feminino (85%) e tireoidectomia parcial (70%). Resultados: Os pacientes autorreferiram sintomas vocais em todos os momentos, com maior frequência após uma semana e diferença significativa entre o domínio físico pré e pós 1 semana. Na HADS, observou-se maior escore total no pré-operatório e diferença significante nos três momentos, em todos os domínios, com maior diferença entre pré e pós 1 semana. Houve correlação positiva fraca entre os domínios limitação, emocional e escore total da ESV com a subescala de ansiedade pós 1 semana, entre o escore total da ESV e o escore total da HADS e correlação positiva moderada entre os domínios limitação e emocional da ESV com o escore total da HADS após uma semana. Conclusão: Pacientes submetidos à tireoidectomia autopercebem sintomas vocais e traços de grau leve de ansiedade tanto no pré quanto pós 1 semana e após 3 meses de cirurgia com pior autorreferência após uma semana. Quanto maior a autorreferência de sintomas vocais, mais traços de ansiedade o paciente pode apresentar. (AU)
Introduction: Thyroid alterations and thyroidectomy can lead to vocal and emotional symptoms.Purpose: To correlate vocal symptoms and anxiety and depression traits pre and post-thyroidectomy. Methods: Observational, longitudinal study. Participants were 20 patients who underwent thyroidectomy, laryngeal visual examination and the Voice Symptom Scale (VoiSS) and Hospital Anxiety and Depression Scale (HADS) preoperatively, 1 week and 3 months after, with a mean age of 54.5 years, higher prevalence of female gender (85%) and partial thyroidectomy (70%). Results: The patients self-reported vocal symptoms at all times, more frequently after one week and a significant difference between the physical domain pre and post 1 week. In HADS, there was a higher total score in the preoperative period and a significant difference in the three moments, in all domains, with a greater difference between pre and post 1 week. There was a weak positive correlation between the limitation, emotional and total score of the ESV domains with the anxiety subscale after 1 week, between the total score of the ESV and the total score of the HADS, and a moderate positive correlation between the limitation and emotional domains of the ESV with the HADS total score after one week. Conclusion: Patients undergoing thyroidectomy self-perceived vocal symptoms and mild anxiety traits both before and after 1 week and after 3 months of surgery with worse self-report after one week. The greater the self-report of vocal symptoms, the more traces of anxiety the patient may present. (AU)
Introducción: Cambios en la tiroides y tiroidectomía pueden provocar síntomas vocales y emocionales. Objetivo: Correlacionar síntomas vocales y rasgos de ansiedad y depresión antes y después de tiroidectomía. Metodos: Estudio observacional/longitudinal. Participaron 20 pacientes que se les realizó tiroidectomía, examen visual laríngeo, Escala de Síntomas Vocales (ESV) y Escala Hospitalaria de Ansiedad y Depresión (HADS) en preoperatorio, 1 semana y 3 meses después, con edad media de 54,5 años, prevalencia del género femenino (85%) y tiroidectomía parcial (70%). Resultados: Los pacientes informaron síntomas vocales en todo momento, con mayor frecuencia después de una semana y una diferencia significativa entre el dominio físico antes y después de 1 semana. En HADS, hubo mayor puntaje total en el preoperatorio y diferencia significativa en los tres momentos, con mayor diferencia entre pre y post 1 semana. Hubo una correlación positiva débil entre limitación, emocional y total de los dominios de la ESV con la subescala de ansiedad después de 1 semana, entre el total de la ESV y e total de la HADS, y una correlación positiva moderada entre la puntuación de limitación y dominios emocionales de la ESV con la puntuación total de HADS después de una semana. Conclusión: Los pacientes sometidos a tiroidectomía autopercibieron síntomas vocales y rasgos de ansiedad leve tanto antes como después de 1 semana y después de 3 meses de la cirugía con peor autoinforme después de una semana. Cuanto mayor es el autoinforme de síntomas vocales, más rastros de ansiedad puede presentar el paciente. (AU)
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Humans , Male , Female , Middle Aged , Aged , Anxiety , Thyroidectomy/psychology , Voice Disorders/psychology , Depression , Postoperative Period , Thyroid Diseases , Voice , Preoperative PeriodABSTRACT
Abstract Objective To analyze the follow-up, in specialized outpatient clinics, of infants reported with congenital syphilis during the penicillin shortage. Method A cross-sectional study was carried out in ten public maternity hospitals affiliated with the Brazilian Unified Health System in the city of Fortaleza, state of Ceará. Clinical records of infants reported with congenital syphilis who were born alive in 2015 were used to describe correlates of attendance at recommended clinical follow-up appointments. Results A total of 469 infants reported with CS from January 1/2015 to December 31/2015 were included in the analysis. The results show that most infants did not attend the follow-up visits (368/469, 78.5%) and the main associated factors are that the follow-up clinic is located in a different hospital from that where the infant was born (OR: 3.7; CI: 2.20-6.22; p< 0.001) and the use of illicit drugs by the mother (OR: 3.2; CI: 1.57-6.87; p= 0.002). Only 33.7% (34/101) were followed until discharge. Conclusion The majority of infants with reported congenital syphilis during this period did not attend the follow-up visits. Public health efforts aimed at reaching the parents of infants with CS should be a priority to ensure appropriate clinical identification and management of the associated outcomes of this vertically transmitted infection.
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Introducción: El dengue es una infección viral transmitida por un mosquito. Puede presentarse con formas leves o graves. Objetivo: Describir las características clínicas y epidemiológicas de pacientes menores de 6 meses, con diagnóstico de fiebre dengue, que acudieron al departamento de urgencias pediátricas. Materiales y Métodos: Estudio observacional, descriptivo, retrospectivo. Se incluyeron lactantes menores de 6 meses con diagnóstico de dengue, que consultaron en el departamento de urgencias de 2017 al 2021. Variables estudiadas: edad, sexo, procedencia, signos y síntomas, signos de alarma, tipo de signos de alarma, leucocitos, hematocrito, plaquetas, enfermedad de base, complicaciones, métodos auxiliares de diagnóstico, ingreso a UCIP, estado al alta. Los datos se analizaron en SPSS utilizando estadística descriptiva. El protocolo fue aprobado por el comité de ética. Resultados: Fueron incluidos 172 pacientes, con mediana de edad de 5 meses, el 51,7% del sexo masculino. El 98,2% presentó fiebre, de los cuales 47,3% como síntoma único y el 47,1% asociado a exantemas. El 8,1% presentó signos de alarma. La mediana de leucocitos fue de 5.105, plaquetas de 250.000 y hematocrito 29,9 por mm3. El 4,8% tenía enfermedad de base. Presentaron complicaciones el 1,7 % y el 0,6% ingresaron a unidad de cuidados intensivos. El 73,2% fue diagnosticado por NS1. Ninguno falleció. Conclusión: La edad media de los lactantes fue de 5 meses, no se observó marcada leucopenia ni plaquetopenia. La mayoría tuvo curso leve de la enfermedad y solo 1 paciente requirió ingreso a terapia intensiva pediátrica. No se registraron fallecidos.
Introduction: Dengue is a viral infection transmitted by a mosquito. It can present with mild or severe forms. Objective: To describe the clinical and epidemiological characteristics of patients younger than 6 months, diagnosed with dengue fever, who presented to the pediatric emergency department. Materials and Methods: This was an observational, descriptive and retrospective study. We included Infants under 6 months of age with a diagnosis of dengue, who presented to the emergency department from 2017 to 2021. Variables studied: age, sex, place of residence, signs and symptoms, alarm signs, type of alarm signs, leukocytes, hematocrit, platelets, underlying disease, complications, ancillary diagnostic methods used, admission to the PICU, discharge status. Data were analyzed in SPSS using descriptive statistics. The protocol was approved by the institutional ethics committee. Results: 172 patients were included, with a median age of 5 months, 51.7% were male, 98.2% presented with fever, of which 47.3% presented with fever as their only symptom. 47.1% presented with rashes. 8.1% presented alarm signs. The median leukocytes were 5,105, platelets 250,000, and hematocrit 29.9 per mm3. 4.8% had underlying disease. 1.7% presented complications and 0.6% were admitted to the intensive care unit. 73.2% were diagnosed by NS1 antigen test. None died. Conclusions: The mean age of the infants was 5 months, no marked leukopenia or thrombocytopenia was observed. Most had a mild course of the disease and only 1 patient required admission to the pediatric intensive care unit. No deaths were registered.
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Introducción: la disfagia es un trastorno de la deglución, el cual es habitualmente desatendido por profesionales de la salud, en especial la disfagia orofaríngea neurogénica, que es capaz de producir varios síntomas, signos y complicaciones secundarias en los pacientes. Objetivo: realizar una caracterización clínica incluyendo percepción de síntomas de disfagia en pacientes con disfagia orofaríngea neurogénica de causas neurológicas y neuromusculares en Antioquia, Colombia entre los años 2019 y 2021. Metodología: estudio transversal realizado en 80 pacientes con disfagia orofaríngea neurogénica confirmada a través de la herramienta Eating Assessment Tool-10, evaluación clínica y/o resultados de video fluoroscopia de la deglución. Resultados: 71 pacientes presentaron causas neurológicas centrales. La enfermedad cerebrovascular y la enfermedad de Parkinson fueron las etiologías más frecuentes. Solo 18% de los pacientes con causas neurológicas y 33% con causas neuromusculares reportaron tolerancia a todas las consistencias de alimentos. Mediana de 16 puntos en cuanto a autopercepción de síntomas de disfagia mediante el instrumento Eating Assessment Tool-10, con puntuaciones más altas en pacientes con presencia de gastrostomía, antecedente de neumonía, odinofagia y alteración en la oclusión mandibular al examen físico. En los pacientes con causas neurológicas hubo mayor presencia de signos motores linguales y apraxias orofaciales. Conclusión: existen características clínicas como sensación de comida pegada, dificultad para tragar alimentos sólidos, tos y ahogo al tragar, que son útiles en el reconocimiento de casos de disfagia orofaríngea, y apoyan que esta genera más síntomas que signos al examen físico en pacientes con condiciones neurológicas y neuromusculares.
Introduction: dysphagia is a swallowing disorder that is usually neglected by health professionals, especially neurogenic oropharyngeal dysphagia, which can produce various symptoms, signs and secondary complications in patients. Objective: to perform a clinical characterization, including perception of dysphagia symptoms, in patients with neurogenic oropharyngeal dysphagia of neurological and neuromuscular causes in Antioquia, Colombia between 2019 and 2021. Methodology: cross-sectional study conducted in 80 patients with neurogenic oropharyngeal dysphagia confirmed through the Eating Assessment Tool-10, clinical assessment and/ or video fluoroscopy results of swallowing. Results: 71 patients presented central neurological causes. Cerebrovascular disease and Parkinson's disease were the most frequent etiologies. Only 18% of patients with neurological causes and 33% with neuromuscular causes reported tolerance to all food consistencies. Median of 16 points in terms of self-perception of dysphagia symptoms using the Eating Assessment Tool-10, with higher scores in patients with gastrostomy, a history of pneumonia, odynophagia, and abnormal mandibular occlusion on physical examination. In patients with neurological causes, there was a greater presence of lingual motor signs and orofacial apraxia. Conclusion: there are clinical characteristics such as a sensation of stuck food, difficulty swallowing solid foods, coughing, and choking when swallowing, which are useful in recognizing cases of oropharyngeal dysphagia, and support that this generates more symptoms than signs on physical examination in patients with neurological and neuromuscular conditions.
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Resumo: Trata-se de um estudo de natureza quantitativa, observacional, descritivo com delineamento longitudinal, com o objetivo de avaliar os sintomas apresentados pela pessoa com câncer avançado, assistida em um serviço de oncologia. Aprovado pelo Comitê de Ética em Pesquisa com seres humanos do Complexo Hospital de Clínicas da Universidade Federal do Paraná. O local do estudo foi um hospital de referência em atendimento a pacientes oncológicos na cidade de Curitiba, Paraná. Participaram do estudo 23 adultos portadores de câncer em estadiamento III e IV. A coleta de dados ocorreu de fevereiro a julho de 2022. A etapa inicial foi presencial, houve a identificação dos participantes quanto ao perfil sociodemográfico e clínico, bem como, a avaliação dos sintomas com a Escala de Avaliação de Sintomas de Edmonton (ESAS). O seguimento do estudo se deu majoritariamente por telefone, uma vez por semana, com a ESAS. Foram avaliados os sintomas dor, cansaço, sonolência, náusea, apetite, falta de ar, depressão, ansiedade e bem-estar. Os participantes atribuíram valores de 0 a 10 de acordo com a intensidade que cada sintoma apresentava no momento da avaliação. Os dados obtidos foram analisados por meio do software GraphPad Prism 5.0. Para a análise descritiva de dados dos sintomas foi usado a análise de variância (ANOVA) de duas vias, considerando p<0,05 como estatisticamente significativo. A ANOVA de 2 vias é baseada em dois fatores. O fator linha equivale às diferenças entre as respostas dos itens, e o fator coluna, equivale às variações das respostas em um mesmo item. Quanto ao perfil sociodemográfico, os participantes tinham média de idade de 53,3 anos, 78,3% do sexo feminino, e 82,6% procedentes de Curitiba. Acerca do perfil clínico, as neoplasias de mama representaram 30,8% dos diagnósticos, seguido por adenocarcinoma de cólon e reto 17,4% e carcinoma espinocelular de colo uterino 13%. Entre os sintomas avaliados, o de maior intensidade média foi o cansaço (5,53) e, a náusea, apresentou a menor média (1,76). Referente à décima questão da ESAS (Outro problema?), a constipação intestinal foi a mais presente, relatada em 13,8% das 247 avaliações. Constatou-se que os sintomas em pessoas com câncer avançado se manifestam de maneira concomitante, e que existe um processo de inter-relação importante entre sintomas físicos e psicológicos. O instrumento ESAS foi eficiente para as avaliações de sintomas, sendo facilmente compreendido pelos participantes, de aplicação rápida, e ainda, forneceu dados objetivos. Espera-se que este estudo contribua para o aprimoramento da avaliação e manejo dos sintomas, proporcionando melhora da qualidade de vida aos pacientes com câncer avançado e seus familiares.
Abstract: This is a quantitative, observational, descriptive study with a longitudinal design, with the objective of evaluating the symptoms presented by people with advanced cancer assisted in an oncology service. Approved by the Ethics Committee for Research with Human Subjects of the Clinics Hospital Complex of the Federal University of Paraná. The study location was a hospital that is a reference in treating cancer patients in the city of Curitiba, Paraná. Twenty-three adults with stage III and IV cancer participated in the study. Data was collected from February to July 2022. The first stage was faceto- face, where participants were identified according to their sociodemographic and clinical profile, and their symptoms were assessed using the Edmonton Symptom Assessment Scale (ESAS). The follow-up of the study took place mostly by phone, once a week, with ESAS. The symptoms pain, fatigue, drowsiness, nausea, appetite, shortness of breath, depression, anxiety, and well-being were assessed. Participants assigned values from 0 to 10 according to how intense each symptom was at the time of the assessment. The data obtained were analyzed using GraphPad Prism 5.0 software. For the descriptive analysis of symptom data, two-way analysis of variance (ANOVA) was used, considering p<0.05 as statistically significant. The 2-way ANOVA is based on two factors. The row factor equals the differences between item responses, and the column factor, equals the variations in responses within the same item. As for the sociodemographic profile, the participants had a mean age of 53.3 years, 78.3% were female, and 82.6% were from Curitiba. About the clinical profile, breast neoplasms accounted for 30.8% of the diagnoses, followed by colon and rectal adenocarcinoma 17.4% and cervical squamous cell carcinoma 13%. Among the symptoms evaluated, the one with the highest average intensity was tiredness (5.53), and nausea had the lowest average (1.76). Regarding the tenth question of the ESAS (Other problem?), constipation was the most present, reported in 13.8% of the 247 evaluations. It has been found that symptoms in people with advanced cancer occur concomitantly, and that there is an important interrelationship process between physical and psychological symptoms. The ESAS instrument was efficient for symptom assessments, being easily understood by the participants, quick to apply, and also providing objective data. It is hoped that this study will contribute to the improvement of symptom assessment and management, providing improved quality of life for patients with advanced cancer and their families.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pain , Palliative Care , Therapeutics , NeoplasmsABSTRACT
Objetivo: Identificar as consequências da violência no trabalho sofridas por enfermeiros do atendimento pré-hospitalar. Métodos: Estudo transversal, descritivo, realizado com 67 enfermeiros de um serviço de atendimento pré-hospitalar do município do Rio de Janeiro, Brasil. Os dados foram analisados com a utilização da Janela de Johari. Resultados: Destacaram-se como consequências da violência no trabalho queixas de medo, estresse, ansiedade, insônia, irritabilidade, desmotivação laboral, taquicardia, dor de cabeça, tristeza, desânimo, hipertensão arterial, precordialgia, ganho de peso, necessidade de assistência psicológica e psiquiátrica com a prescrição de medicalização. Conclusão: A violência no trabalho do atendimento pré-hospitalar provoca consequências que envolvem as dimensões físicas e emocionais. Faz-se necessária a discussão e reflexão no plano institucional, com a participação dos profissionais, sobre as características do ambiente de trabalho, riscos, exposições, doenças relacionadas ao trabalho, nexo causal e as consequências da violência no trabalho. (AU)
Objective: Identify the consequences of violence at work suffered by nurses in pre-hospital care. Methods: This is a cross-sectional, descriptive study conducted with 67 nurses from a pre-hospital care service in the city of Rio de Janeiro, Brazil. The data were analyzed using the Johari's Window. Results: Complaints of fear, stress, anxiety, insomnia irritability, work demotivation, tachycardia, headache, sadness, discouragement, hypertension, precordialgia, weight gain, need for psychological and psychiatric care with the prescription of medicalization were highlighted as consequences of violence at work. Conclusion: Violence at work in pre-hospital care causes consequences that involve the physical and emotional dimensions. It is necessary to discuss and reflect at the institutional level, with the participation of professionals, on the characteristics of the work environment, risks, exposures, work-related diseases, causal link and the consequences of violence at work. (AU)
Objetivo: Identificar las consecuencias de la violencia en el trabajo que sufren los enfermeros en la atención prehospitalaria. Métodos: Estudio transversal y descriptivo realizado con 67 enfermeros de un servicio de atención prehospitalaria en la ciudad de Río de Janeiro, Brasil. Los datos fueron analizados usando la Ventana Johari. Resultados: Las quejas por miedo, estrés, ansiedad, insomnio, irritabilidad, desmotivación del trabajo, taquicardia, dolor de cabeza, tristeza, desánimo, hipertensión, precordialgia, aumento de peso, necesidad de atención psicológica y psiquiátrica con prescripción de medicalización se destacaron como consecuencias de la violencia en el trabajo. Conclusión: La violencia en el trabajo en la atención prehospitalaria causa consecuencias que involucran las dimensiones física y emocional. Es necesario discutir y reflexionar a nivel institucional, con la participación de los profesionales, sobre las características del entorno de trabajo, riesgos, exposiciones, enfermedades relacionadas con el trabajo, relación causal y consecuencias de la violencia en el trabajo. (AU)
Subject(s)
Workplace Violence , Signs and Symptoms , Occupational Health , Emergency Medical Services , NursesABSTRACT
Objetivo: Caracterizar as notificações de infecção por SARS-CoV-2 em gestantes em um município do sul de Santa Catarina. Métodos: Estudo transversal que avaliou as notificações de casos suspeitos de infecção por SARS-CoV-2 em gestantes no município de Tubarão, Santa Catarina, de março de 2020 a outubro de 2021. Coletaram-se os dados das fichas de notificação de infecção por SARS-CoV-2 da Fundação Municipal de Saúde e no Prontuário Eletrônico do Cidadão (PEC) das gestantes notificadas. A comparação da prevalência de confirmação segundo sintomas apresentados e características maternas foi realizada pela razão de prevalência (RP), com intervalo de confiança (IC) de 95%. Resultados: Foram registradas 555 notificações de gestantes suspeitas para a COVID-19, correspondentes a 487 mulheres. A prevalência de confirmação para a doença foi de 27,3%. O sintoma mais frequente no momento da notificação foi cefaleia (53,0%), entretanto o mais associado à confirmação foi a anosmia (RP: 2,28; IC 95%: 1,68-3,09). Das notificações registradas, 35,0% foram realizadas por gestantes que tiveram contato com casos suspeitos ou confirmados de COVID-19. O contato prévio foi mais relatado por gestantes assintomáticas, em comparação às gestantes que apresentaram sintomas (RP: 1,46; IC 95%: 1,12-1,91). Mulheres que relataram contato prévio com suspeitos ou confirmados para a COVID-19 apresentaram maior frequência de doença confirmada, quando comparadas às gestantes não expostas (RP: 1,80; IC 95%: 1,35-2,39). Conclusão: As gestantes, por terem maior susceptibilidade a surtos de doenças e gravidade do quadro, podem ter adotado com mais atenção medidas como a realização de testes diagnósticos quando em contato prévio com casos de COVID-19, mesmo assintomáticas.
Objective: To characterize the notifications of SARS-CoV-2 infection in pregnant women in a city in the South of Santa Catarina. Methods: Cross-sectional study that evaluated notifications of suspected cases of SARS-CoV-2 infection in pregnant women in the municipality of Tubarão, Santa Catarina, from March 2020 to October 2021. Data were collected from the SARS-CoV-2 infection notification forms from the Municipal Health Foundation, and from the Citizen's Electronic Health Record of the notified pregnant women. The comparison of the prevalence of confirmation according to symptoms and maternal characteristics was performed using the Prevalence Ratio (PR), with a confidence interval (CI) of 95%. Results: 555 notifications of suspected pregnant women for COVID-19 were registered, corresponding to 487 women. The prevalence of confirmation for the disease was 27.3%. The most frequent symptom at the time of notification was headache (53.0%), however, the most associated with confirmation was anosmia (PR: 2.28; 95% CI: 1.68-3.09). Of the notifications registered, 35.0% were made by pregnant women who had contact with suspected or confirmed cases of COVID-19. The previous contact was more frequently reported by asymptomatic pregnant women compared to pregnant women who had symptoms (PR: 1.46; 95% CI: 1.12-1.91). Women who reported previous contact with suspected or confirmed COVID-19 had a higher frequency of confirmed disease when compared to unexposed pregnant women (PR: 1.80; 95% CI: 1.35-2.39). Conclusion: Pregnant women, due to their greater susceptibility to disease outbreaks and disease severity, may have adopted more attentive measures such as diagnostic testing in the face of previous contact with cases of COVID-19, even if asymptomatic.
Subject(s)
Humans , Female , Pregnancy , Signs and Symptoms , Comorbidity , Diagnostic Techniques and Procedures/statistics & numerical data , Public Health Surveillance , Maternal Health , COVID-19ABSTRACT
Introducción: El dengue es una enfermedad viral, sistémica, de carácter endémico-epidémico, causada por cualquiera de los 4 serotipos del complejo viral. Se transmite al hombre a través de la picadura de un mosquito del género Aedes, que provoca la infección. Objetivo: Evaluar el nivel de conocimientos sobre dengue en pobladores de un área de salud de Sancti Spíritus. Métodos: Se efectuó una investigación cuantitativa, de diseño preexperimental, contextualizada, de 174 personas de 15 y más años de edad, pertenecientes al Consultorio Médico de la Familia No. 7 del Policlínico Los Olivos en la provincia de Sancti Spíritus, desde febrero hasta julio de 2022, para lo cual se utilizó la entrevista estructurada. Las variables analizadas fueron nivel de conocimientos sobre dengue, edad, sexo y escolaridad. Después de realizada la intervención, se compararon las proporciones poblacionales. Resultados: Predominaron los pacientes de 45-55 años de edad (53,1 %), el sexo femenino (66,7 %) y el nivel de escolaridad de secundaria terminada (55,1 %). Luego de concluir las actividades educativas, los individuos alcanzaron resultados adecuados y se elevó su nivel de conocimientos sobre la enfermedad. Conclusiones: La intervención resultó efectiva en la población estudiada, pues se incrementaron sus conocimientos sobre dengue.
Introduction: Dengue is a viral, systemic disease, of endemic-epidemic character, caused by any of the 4 serotypes of the viral complex. It is transmitted to the man through the Aedes mosquito bite that causes the infection. Objective: To evaluate the level of knowledge about dengue in residents of a health area in Sancti Spíritus. Methods: A quantitative investigation, of preexperimental design, contextualized, was carried out in 174 people of 15 and more years, belonging to the Family Doctor Office No. 7 of Los Olivos Polyclinic in Sancti Spíritus province, from February to July, 2022, for which the structured interview was used. The analyzed variables were level of knowledge about dengue, age, sex and school level. After the intervention the populational proportions were compared. Results: There was a prevalence of the 45-55 years patients (53.1 %), female sex (66.7 %) and the secondary school level finished (55.1 %). After concluding the educational activities, the individuals reached appropriate results and their level of knowledge on the disease had an increase. Conclusions: The intervention was effective in the studied population, because the knowledge about dengue had increased.