Educação em saúde para pessoa idosa: um relato de experiência das ações desenvolvidas em estágio de saúde coletiva em medicina / Health education for older adults: an experience report of the actions developed in a collective health internship in medicine / Educación en salud para personas mayores: reporte de experiencia de acciones desarrolladas en una pasantía de salud colectiva en medicina

Introdução:O processo do cuidado integral à saúde é missão básica do Sistema Único de Saúde e da atenção primária à saúde. Objetivo:Relatar a experiência de ação interventiva na população idosa acerca da prevenção de doenças crônicas prevalentes nessa faixa etária, no território de uma unidade de saúde da família no município de Parnamirim. Metodologia:Trata-se de um estudo descritivo do tipo relato de experiência que foi desenvolvido a partir de um projeto de intervenção em estágio desaúde coletiva, com ênfase na educação em saúde para a pessoa idosa e portadora de diabetes mellitus e hipertensão arterial sistêmica, em uma unidade de saúde da família de Parnamirim, em abril de 2023. Resultados:A partir da ação, que abarcou estagiários de Medicina e a equipe multiprofissional da atenção primária à saúde, foi possível explanar a importância das ações no âmbito da saúde coletiva e do seguimento terapêutico, farmacológico e não farmacológico, para gerar autonomia e autogestão de disfunções crônicas e diminuir a probabilidade de complicações inerentes, como infarto agudo do miocárdio, nefropatia, retinopatia e polineuropatia diabética. Conclusões:A experiência foi de grande valia para todos os participantes, ao contar com elementos proeminentes na implementação da saúde no cenário da atenção básica em nosso país, especialmente com a pretensão de rastreio e controle de patologias crônicas de alta prevalência, e que são uma das principais causas de morbimortalidade no Brasil (AU).

Introduction:The process of comprehensive health care is the basic mission of the Unified Health System and primary health care. Objective:To report the experience of an intervention in a population of older adults regarding the prevention of chronic diseases prevalent in this age group in the territory of a family health unit in the city of Parnamirim. Methodology:This is a descriptive study of the experience report typethat was developed from an intervention project in a public health internship with an emphasis on health education for older adults with diabetes mellitus and systemic hypertension arterial at a family health unit in Parnamirim in april 2023. Results:Based on the action, which included medical interns and the multidisciplinary primary health care team, it was possible to explain the importance of actions within the scope of public health and therapeutic, pharmacological and non-pharmacological monitoring to generate autonomy and self-management of chronic dysfunctions and reduce the likelihood of inherent complications, such as acute myocardial infarction, nephropathy, retinopathy and diabetic polyneuropathy. Conclusions:The experience was of great value to all participants, as it included prominent elements in the implementation of health in the primary care scenario in our country, especially with the aim of screening and controlling high-prevalence chronic pathologies which are among the main causes of morbidity and mortality in Brazil (AU).

Introducción: El proceso de atención integral en salud es la misión básica del Sistema Único de Salud y de la atención primaria de salud. Objetivo: Relatar la experiencia de intervención en población de adultos mayores en relación a la prevención de enfermedades crónicas prevalentes en ese grupo etario, en el territorio de una unidad de salud de la familia de la ciudad de Parnamirim.Metodología: Se trata de un estudio descriptivo del tipo relato de experiencia que se desarrolló a partir de un proyecto de intervención en una pasantía de salud pública, con énfasis en educación en salud para adultos mayores y personas con diabetes mellitus e hipertensión arterial sistémica, en una unidad de salud de la familia de Parnamirim, en abril de 2023. Resultados: A partir de la acción, que incluyó a médicos pasantes y al equipo multidisciplinario de atención primaria a la salud, fue posible explicar la importancia de las acciones en el ámbito de la salud pública y seguimiento terapéutico, farmacológico y no farmacológico, para generar autonomía y autocontrol de las disfunciones crónicas y reducir la probabilidad de complicaciones inherentes, como infarto agudo del miocardio, nefropatía, retinopatía y polineuropatía diabética.Conclusiones: La experiencia fue de gran valor para todos los participantes, ya que incluyó elementos destacados en la implementación de la salud en el escenario de la atención primaria en nuestro país, especialmente con el objetivo de cribar y controlar patologías crónicas de alta prevalencia, que son una de las principales causas de morbilidad y mortalidad en Brasil (AU).

Analysis of the risk of diabetes mellitus type 2 in women workers at a reference hospital in Asuncion, Paraguay

Introduction: Obesity, age, sedentary lifestyle, and family history of diabetes mellitus are risk factors for type 2 diabetes mellitus (T2DM). Objective: determine the probable risk of developing T2DM in the next 10 years in working women at a reference hospital in Asunción, Paraguay. Methodology: This cross-sectional observational descriptive study was conducted with physicians, nurses, and administrative staff. Data were collected over three months using the FINDRISK test to assess diabetes risk, which consists of eight questions about age, body mass index, waist circumference, physical activity, fruit and vegetable consumption, history of blood pressure, high blood pressure and high glucose, and diabetes diagnosed in family members. Descriptive statistics in the form of frequencies and percentages, as well as analytical statistics using the Mann-Whitney and Kruskal-Wallis tests, were used to analyze the data. Results: A total of 112 women participated in the study, with more than 40% in the age range of 31-40 years. The waist circumference of 80-88 cm was the most common (38.4%). It was found that 33% of participants were overweight. Almost 60% of the participants did not perform daily physical activities. More than 38% of the first-degree relatives had a history of diabetes. Of the surveyed participants, 67.9%had some risk of developing T2DM in the next 10 years and 22 had a high or very high risk according to the FINDRISK test. Participants aged 35 years had a significantly higher risk (p=0.008). Conclusion: A high prevalence of overweight and obesity was observed, with 67.9% of the respondents showing some degree of risk for developing T2DM in the next 10 years, of which nearly 20% were categorized as high or very high risk.

Introducción: la obesidad, la edad, el estilo de vida sedentario y los antecedentes familiares de diabetes mellitus se han descrito como factores de riesgo para la diabetes mellitus tipo 2 (DM2). Objetivo: determinar el riesgo probable de desarrollar DM2 en los próximos 10 años en mujeres trabajadoras de un hospital de referencia en Asunción, Paraguay. Metodología: este estudio descriptivo observacional de corte transversal se llevó a cabo entre médicos, enfermeras y personal administrativo. Se recopilaron datos durante tres meses utilizando la prueba FINDRISK para evaluar el riesgo de diabetes, la cual consta de ocho preguntas sobre la edad, el índice de masa corporal, el perímetro de la cintura, la actividad física, el consumo de frutas y verduras, antecedentes de presión arterial alta y glucosa elevada, y diabetes diagnosticada en familiares. Para el análisis de los datos se utilizaron estadísticas descriptivas en forma de frecuencias y porcentajes, así como estadísticas analíticas con la prueba de Mann Whitney y Kruskal Wallis. Resultados: un total de 112 mujeres participaron en el estudio, con más del 40% en el rango de edad de 31 a 40 años. El perímetro de cintura de 80-88 cm. fue el más común, con 38,4%. Se encontró que el 33% de las participantes tenían sobrepeso. Casi el 60% no realizaba actividad física diaria. Más del 38% tenían antecedentes de diabetes en familiares de primer grado. El 67,9% de las encuestadas tenían algún riesgo de desarrollar DM2 en los próximos 10 años, y 22 de ellas presentaron un riesgo alto o muy alto según la prueba FINDRISK. Las participantes de 35 años o más tenían un riesgo significativamente mayor (Chi; p=0,008). Conclusión: se detectó una alta prevalencia de sobrepeso y obesidad, siendo el 67,9% de las encuestadas quienes mostraron algún grado de riesgo de desarrollar DM2 en los próximos 10 años, de los cuales casi el 20% presentaban un riesgo categorizado como alto o muy alto.

Prevalencia de la no adherencia farmacológica en adultos con enfermedades crónicas en un centro médico de baja complejidad / Prevalence of pharmacological non-adherence in adults with chronic diseases in a low complexity medical center

Introducción: la falta de adherencia farmacológica, siendo un problema de salud pública es una de las principales causas de incremento de la morbimortalidad, discapacidad y costos sanitarios en los pacientes con enfermedades crónicas no transmisibles. Objetivo: describir la prevalencia de la no adherencia al tratamiento farmacológico de los pacientes adultos con patología crónica que asistieron a un centro médico de la ciudad de Tunja, desde septiembre a noviembre del año 2022. Materiales y métodos: estudio observacional de corte transversal que incluyó adultos mayores de 18 años con enfermedad crónica no transmisible en el servicio de consulta externa de un centro de salud de baja complejidad, se recolectó los datos de las historias clínicas, se utilizó estadística descriptiva y Odds Ratio para análisis de asociación. Resultados: se analizaron 216 pacientes. La prevalencia de no adherencia al tratamiento farmacológico fue del 75%, el promedio de edad de pacientes con patología crónica fue 65,5 años, el sexo femenino representó el 56,9%, la mayoría de los casos tuvieron hipertensión arterial sistémica (94,4%), más de la mitad presentaron comorbilidades (73,1%) y el 45,3% estaban polimedicados. Los factores relacionados con la no adherencia farmacológica según el test de Morisky-Green fueron edad menor a 60 años (p=0,033), sexo masculino (p=0,045), consumo de alcohol (p=0,003) y tabaco (p=0,003), ausencia de comorbilidades (p=0,008) y no polifarmacia (p=0,004). Conclusión: la no adherencia farmacológica presentó una prevalencia, por encima a la reportada en la literatura y el principal factor asociado fue el consumo de tabaco. Los resultados obtenidos proporcionan conocimientos para nuevas investigaciones (AU)

Introduction: lack of pharmacological adherence, being a public health problem, is one of the main causes of increased morbidity and mortality, disability and health costs in patients with chronic non-communicable diseases. Objective: to describe the prevalence of non-adherence to pharmacological treatment in adult patients with chronic pathology who attended a medical center in the city of Tunja, from September to November 2022. M aterials and methods: cross-sectional observational study that included adults over 18 years of age with chronic non-communicable disease in the outpatient service of a low-complexity health center, data was collected from medical records, descriptive statistics were used and Odds Ratio for association analysis. Results: 216 patients were analyzed. The prevalence of non-adherence to pharmacological treatment was 75%, the average age of patients with chronic pathology was 65.5 years, the female sex represented 56.9%, the majority of cases had systemic arterial hypertension (94,4%), more than half had comorbidities (73.1%) and 45.3% were polypharmacy. The factors related to pharmacological non-adherence according to the Morisky-Green test were age under 60 years (p=0.033), male sex (p=0.045), alcohol consumption (p=0.003) and tobacco (p=0.003), absence of comorbidities (p=0.008) and no polypharmacy (p=0.004). Conclusion: pharmacological non-adherence had a high prevalence above that reported in the literature and the main associated factor was tobacco consumption. The results obtained provide knowledge for new research (AU)

Implementing dietary counselling in family practice for diabetes control and prevention

The importance of dietary counselling in family practice for managing and preventing diabetes is the focal point of this review, highlighting its integral role in chronic disease management. With diabetes increasingly prevalent worldwide, there is a critical need for effective management strategies, with dietary interventions playing a key role. Family practitioners, often the initial point of contact for patients, have a unique opportunity to implement these dietary changes, which are pivotal in influencing diabetes outcomes and averting long-term complications. Despite facing challenges such as limited time and the need for specialized knowledge, dietary counselling in family practice stands as a proactive measure focused on prevention and early intervention. It adopts a patient-centered approach, where dietary habits and preferences are assessed, and personalized, evidence-based advice is provided. The inclusion of dietitians in primary care teams, utilization of technology for support, and advocacy for policy reforms are recommended to enhance the effectiveness of dietary counselling. Despite various obstacles, integrating dietary counselling into routine care remains a significant advantage, promoting healthier lifestyle choices and effectively managing the increasing burden of chronic diseases.

Controles de salud durante la pandemia e impacto clínico del COVID-19 en niños con enfermedad neuromuscular / Health checkups during the pandemic and clinical impact of COVID-19 in children with neuromuscular disease

Introducción. Los niños con enfermedad neuromuscular (ENM) requieren cuidados crónicos de salud (CCS) y podrían presentar COVID-19 grave. Objetivos. Describir CCS para niños con ENM durante la pandemia y evolución del COVID-19 en este grupo. Población y métodos. Cohorte prospectiva unicéntrica. Se incluyeron pacientes de 2-18 años, con ≥ 1 año de seguimiento previo a la pandemia. Se recolectaron variables demográficas, relativas a los CCS y al COVID-19 mediante historias clínicas y encuestas telefónicas. Resultados. Se incluyeron 226 pacientes; el 71 % varones, mediana de edad 11,3 años. Presentaban distrofias musculares (55,7 %) y atrofia muscular espinal (23 %). Comparando el primer año de pandemia con el previo, el 30 % no realizó controles médicos y el 25 % no realizó kinesioterapia. Otros disminuyeron la frecuencia. Hubo 52 casos de COVID-19. Fueron sintomáticos el 82 %: el 88,4 % leves/moderados y el 11,6 % graves. No hubo fallecidos. Conclusiones. La pandemia impactó negativamente en los CCS y los casos de COVID-19 fueron mayormente leves.

Introduction. Children with neuromuscular disease (NMD) require chronic health care (CHC) and may develop severe COVID-19. Objectives. To describe CHC for children with NMD during the pandemic and the course of COVID-19 in this group. Population and methods. Prospective, single-center cohort. Patients aged 2 to 18 years with ≥ 1 year of follow-up prior to the pandemic were included. Demographic variables in relation to CHC and COVID-19 were collected from medical records and via telephone surveys. Results. A total of 226 patients with a median age of 11.3 years were included; 71% were males. They had muscular dystrophy (55.7%) and spinal muscular atrophy (23%). When comparing the first year of the pandemic with the previous year, 30% did not have a health checkup and 25% did not receive kinesiotherapy. Others did, but with a lower frequency. A total of 52 COVID-19 cases were reported; 82% were symptomatic: 88.4% were mild/moderate and 11.6%, severe. No patient died. Conclusions. The pandemic had a negative impact on CHC, and COVID-19 cases were mostly mild.

Caracterización de factores de riesgo coronario en trabajadores del Hospital Guillermo Domínguez López de Las Tunas

Fundamento: los síndromes coronarios agudos constituyen un problema de salud debido a su alta morbilidad y mortalidad. Sería razonable asumir que los trabajadores de la salud cuidan y controlan sus propios factores de riesgo coronario, no obstante, los resultados obtenidos en investigaciones muestran que no siempre es así. Objetivo: caracterizar los factores de riesgo coronario en trabajadores del Hospital General Docente Guillermo Domínguez López de Las Tunas. Método: se realizó un estudio descriptivo de corte transversal en el Hospital General Docente Guillermo Domínguez López de Las Tunas entre diciembre de 2019 y diciembre de 2022. La población de estudio fue de 912 trabajadores y la muestra de 200. Fue un muestreo probabilístico, aleatorio simple, dividido en dos grupos: A (con síndrome coronario agudo) y B (sin síndrome coronario agudo). Se analizaron las siguientes variables: edad, sexo, factores de riesgo coronario. La información se obtuvo de expedientes clínicos y se analizó en porcentaje, media, desviación estándar y el estadígrafo z para obtener la influencia de los factores de riesgo en la enfermedad. Resultados: la media de edad del grupo A: 56,5 (±5,03), grupo B: 46,4 (±11,33) años con predominio del sexo masculino (54,5 %). Los factores de riesgo que predominaron fueron: sedentarismo (57 %), tabaquismo (36,5 %) e hipertensión arterial (34 %). Los de mayor influencia fueron: los antecedentes de cardiopatía isquémica, la enfermedad vascular, la obesidad abdominal (z: 0,99), la diabetes mellitus (z: 0,92) y la hipertensión arterial (z: 0,70). Conclusiones: el síndrome coronario predomina en la quinta década de la vida y con mayor frecuencia en el sexo masculino.

Foundation: acute coronary syndromes constitute a health problem due to their high morbidity and mortality. It would be reasonable to assume that health workers take care of and control their own coronary risk factors, however, research results show that this is not always the case. Objective: to characterize coronary risk factors in workers at the Guillermo Domínguez López General Teaching Hospital in Las Tunas. Method: a descriptive cross-sectional study was carried out at the Guillermo Domínguez López General Teaching Hospital in Las Tunas between December 2019 and December 2022. The study population was 912 workers and the sample was 200. It was a probabilistic, simple random sampling divided into two groups: A (with acute coronary syndrome) and B (without acute coronary syndrome). The following variables were analyzed: age, sex, coronary risk factors. The information was obtained from clinical records and analyzed in percentage, mean, standard deviation and the z statistic to obtain the influence of risk factors on the disease. Results: the average age of group A: 56.5 (±5.03), group B: 46.4 (±11.33) years with a predominance of the male sex (54.5 %). The predominant risk factors were: sedentary lifestyle (57 %), smoking (36.5 %) and high blood pressure (34 %). Those with the greatest influence were: a history of ischemic heart disease, vascular disease, abdominal obesity (z: 0.99), diabetes mellitus (z: 0.92) and arterial hypertension (z: 0.70). Conclusions: coronary syndrome predominates in the fifth decade of life and is more common in males.

Experiencia de la transición en un Servicio de Adolescencia / Transition experience in an Adolescence Unit

Se define transición como el proceso de preparación, adaptación e integración paulatina por el cual un paciente joven con una patología crónica desarrolla las habilidades y dispone de los recursos Se aborda la experiencia y estadística de la Unidad de Adolescencia y Transición durante el 2022. Materiales y métodos: estudio descriptivo, observacional, retrospectivo y de corte transversal. Se incluyeron en el estudio los adolescentes de entre 17 y 21 años atendidos en el servicio de adolescencia del Hospital J.P Garrahan durante el periodo de 1 enero 2022 al 31 de diciembre de 2022. Resultados: se incluyeron 179 pacientes (111 eran mujeres, 68 varones, incluido un trans varón). La mediana de edad de derivación al servicio de adolescencia fue de 17,26 años. Provenían del Gran Buenos Aires el 74% de los pacientes. Se logró la transición del 62.2% (112 pacientes). El principal centro de derivación fue el Hospital de Clínicas con el 21.3% (24 pacientes) Conclusión: Aunque los resultados mostrados son favorables, es necesaria una correcta valoración y evaluación inicial del paciente, con una planificación pertinente del proceso y con la incorporación de un equipo de transición o unidad transicional (AU)

Transition is defined as the process of preparation, adaptation, and gradual integration by which a young pa - tient with a chronic condition develops the skills and resources needed for adult care. Materials and Methods: This was a descriptive, observational, retrospective, and cross-sectional study. Adolescents between 17 and 21 years of age seen at the Adolescence Unit of the J.P Garrahan Hospital from January 1, 2022, to December 31, 2022, were included in the study. Results: A total of 179 patients were included (111 female, 68 male, including one trans male). The median age of referral to the Adolescence Unit was 17.26 years. Seventy-four percent of the patients came from the Greater Buenos Aires area. Transition was achieved in 62.2% (112 patients). The main referral center was the Hospital de Clínicas, with 21.3% (24 patients). Conclusion: Although the results are favorable, a correct initial evaluation and assessment of the patient is necessary, along with relevant planning of the process and the incorporation of a transition team or transitional unit (AU)

Condiciones Médicas, Síntomas de Ansiedad y Depresión Durante la Pandemia por COVID-19 en una Muestra Poblacional de Lima, Perú / Medical Conditions, Symptoms of Anxiety, and Depression During the COVID-19 Pandemic in a Population Sample of Lima, Peru

resumen Introducción: El objetivo de este estudio es determinar diferencias entre el número de condiciones médicas subyacentes, depresión y ansiedad, al controlar por las covariables edad, sexo y educación completa. Métodos: Los participantes (n = 484) indicaron el número de condiciones médicas presentes durante la encuesta, incluyendo también el PHQ-9 y GAD-7 para evaluar la depresión y la ansiedad respectivamente. Resultados: Se hallaron diferencias entre los grupos de condiciones médicas y los valores combinados de PHQ-9 y GAD-7 después de controlar por las covariables mencionadas (F4)954 = 5,78; Wilks' A = 0,95; p < 0,0005). Las pruebas univariadas mostraron diferencias para PHQ-9 (F2,478 = 8,70; p < 0,0005) y GAD-7 (F2,478 = 11,16; p < 0,0005) entre los 3 grupos. Finalmente, el análisis post-hoc mostró diferencias entre los participantes con una condición médica y sin ninguna condición médica (PHQ-9: MD = 1,82; IC95%, 0,25-3,40; GAD-7: MD = 1,73; IC95%, 0,55-2,91) y entre participantes con más de una condición médica y participantes sin afección médica (PHQ-9: Md = 3,10; IC95%, 1,11-5,10; GAD-7: Md = 2,46; IC95%, 0,97-3,95). Conclusiones: Nuestros resultados indican que las personas que tuvieron al menos una condición médica durante la pandemia de COVID-19 son más propensas a desarrollar síntomas graves de ansiedad y depresión.

abstract Introduction: This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education. Methods: Participants (n = 484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively. Results: Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4 954 = 5.78; Wilks' A=0.95; P< 0.0005). The univariate tests showed differences for PHQ-9 (F2478 = 8.70; P< 0.0005) and GAD-7 (F2,478 = 11.16; P< 0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD = 1.82; 95%CI, 0.25-3.40; GAD-7: MD = 1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: Md =3.10; 95%CI, 1.11-5.10; GAD-7: Md = 2.46; 95%CI, 0.97-3.95). Conclusions: Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.

A study to assess the health care utilization and the activities of the daily living status amongst the geriatric population residing in urban and rural field practice areas of a medical college in Tamil Nadu

Background: The prevalence of disability in the activities of daily living (ADL), could probably have a significant impact on the healthcare utilization amongst the geriatric population with disability. Methods: A cross-sectional study in the urban and rural field practice areas of a medical college in Tamil Nadu, using a sample size of 402 elderly individuals. Using the pre-tested, semi-structured questionnaire; the socio-demographic variables, healthcare utilization variables and a comprehensive Katz ADL assessment were used. Results: The overall prevalence of ADL limitation amongst the elderly was seen in 49 (12.2%) elderly individuals mostly with a score of 5 (mildest form) was found in 36 (74%) of the elderly. There was an association found between the follow-up care at health centres, frequency of visits, distance from home to health centres and the ADL limitation with a P- value less than 0.05 (C.I.-95%) using the Pearson chi-square test using SPSS v.26.0. Conclusions: The association between ADL limitation and healthcare utilization calls for initiatives at the family and community level.

Morbidity pattern among tribal farmers in a selected district of Tripura, India

Background: Tribal communities in Tripura comprise 31.76% of the state's total population. The tribal people of Tripura are primarily farmers, and in spite of concerns about their poor health and unfulfilled requirements, they continue to get healthcare in isolated locations where there are obstacles such as undernourishment, a lack of medical facilities, and a labor scarcity. The study's objective is to ascertain the morbidity pattern among tribal farmers in Tripura. Methods: In 2021 after receiving approval from IIPS, Mumbai, selected farmers from Dhalai district were surveyed. We utilised cross-tabulation, chi2, PCA and straightforward logistic regression. Results: Only 5.17% of the sample population had higher education, 54.1% overall was male, and 23.1% were smokers. Jhum (Hill) cultivation was used by 15.5%, while regular (plain) farming was used by 84.5%. Tribal farmers in Tripura were suffered by both acute and chronic diseases. Diarrhoea and fever amongst acute diseases seemed to have the highest prevalence rates (1.82% each), whereas jaundice and reproductive tract infections have the lowest levels (0.30 each). Asthma had the highest prevalence (3.65%) among the chronic diseases, followed by hypertension (2.74%). The morbidity rate decreased as education levels rose. Normal cultivators and the cultivators who worked more times were more likely to have both acute and chronic diseases than jhum cultivators. Conclusions: It is possible to draw the conclusion that farmers didn't lead a healthy lifestyle and suffered from diseases. The study's findings could serve as a foundation for developing economic, educational, and medical plans for tribal farmers to safeguard them from health risks and workplace dangers.

Lifestyle adaptations in cardiometabolic patients after COVID-19

Introduction: Numerous factors contribute over time to changes in lifestyle behaviors, and the COVID-19 pandemic not only altered individuals' routines but also influenced the factors affecting their chronic conditions. Objective: To understand the perception of patients with cardiometabolic diseases regarding adaptations to their lifestyle after contracting COVID-19. Materials and methods: This exploratory study with a qualitative approach was conducted with nine patients diagnosed with cardiometabolic diseases who tested positive for COVID-19. Data collection involved semi-structured audio-recorded interviews, which were transcribed and processed using IRAMUTEQ software. Results: The collective discourse revealed that mass contamination by the coronavirus and subsequent Long COVID triggered significant fears and anxieties, as well as increases in muscle pain, fatigue, and difficulties in maintaining blood pressure and/or glycemic control. These issues directly impacted the daily routines of infected patients. However, there was also an awakening due to changes in lifestyle. Discussion: The complexity of the experiences reported by infected patients influenced their desire to adopt a healthy lifestyle and seek knowledge. Conclusion: The number of patients affected by COVID-19 in its acute and long phases is concerning for both society and health professionals, highlighting the need to expand strategies aimed at quality care and ensuring adequate monitoring across different spheres of care.

Introducción: Innumerables factores contribuyen en el tiempo a cambiar conductas relacionadas con el estilo de vida, la pandemia de COVID-19 no solo alteró las rutinas de los individuos, sino que también hizo cambios en los factores que influyen en sus condiciones crónicas. Objetivo: Conocer la percepción de los pacientes con enfermedades cardiometabólicas, con relación a las adaptaciones en su estilo de vida después del contagio por COVID-19. Materiales y Métodos: Estudio exploratorio con enfoque cualitativo, realizado con nueve pacientes diagnosticados con enfermedades cardiometabólicas y que resultaron positivos a COVID-19. La recolección se realizó a partir de entrevistas grabadas en audio semiestructurado y su contenido fue transcrito y procesado en el software IRAMUTEQ. Resultados: El discurso colectivo mostró que la contaminación masiva por coronavirus y, posteriormente, Long-COVID desencadenó muchos miedos y angustias, además de un aumento de los dolores musculares, cansancio y la falta de control de la presión arterial y/o la glucemia, impactando directamente en la rutina de vida diaria de los pacientes infectados, pero también hubo un despertar por cambios en el estilo de vida. Discusión: La complejidad de las experiencias relatadas por los pacientes infectados incide en el deseo de adoptar un estilo de vida saludable y la búsqueda de conocimiento. Conclusiones: El número de pacientes afectados por COVID-19 en sus fases aguda y prolongada es preocupante para la sociedad y los profesionales de la salud, siendo necesario ampliar estrategias que apunten a la calidad de la atención, buscando un adecuado seguimiento en las diferentes esferas de la atención.

Introdução: Inúmeros fatores contribuem ao longo do tempo para a mudança de comportamentos relacionados ao estilo de vida, a pandemia de COVID-19 não apenas alterou as rotinas dos indivíduos, mas também provocou alterações nos fatores que influenciam suas condições crônicas. Objetivo: Conhecer a percepção de pacientes com doenças cardiometabólicas, em relação às adaptações no seu estilo de vida após a infecção pela COVID-19. Materiais e Métodos: Estudo exploratório com abordagem qualitativa, realizado com nove pacientes com diagnóstico de doenças cardiometabólicas e que testaram positivo para COVID-19. A coleta foi realizada a partir de entrevistas gravadas em áudio semiestruturado e seu conteúdo foi transcrito e processado no software IRAMUTEQ. Resultados: O discurso coletivo mostrou que a contaminação massiva pelo coronavírus e, posteriormente, pelo Long-COVID desencadeou muitos medos e ansiedades, além do aumento de dores musculares, fadiga e descontrole da pressão arterial e/ou glicemia, impactando diretamente no cotidiano. rotina de vida dos pacientes infectados, mas também houve um despertar devido às mudanças no estilo de vida. Discussão: A complexidade das experiências relatadas pelos pacientes infectados afeta o desejo de adoção de um estilo de vida saudável e a busca por conhecimento. Conclusões: O número de pacientes acometidos pela COVID-19 em suas fases aguda e prolongada é preocupante para a sociedade e para os profissionais de saúde, tornando necessária a ampliação de estratégias que visem a qualidade da assistência, buscando um acompanhamento adequado nas diferentes esferas de atenção.

Content quality and reliability of the YouTube videos about chronic prostatitis / Calidad y fiabilidad del contenido de los vídeos de YouTube sobre la prostatitis crónica

Abstract Background: YouTube is one of the most used social media platforms for accessing health information. Objective: To evaluate the quality and reliability of YouTube videos about chronic prostatitis Methods: YouTube search using the keywords "kronik prostatit" for Turkish videos and 'chronic prostatitis' for English videos were done. The videos were evaluated through modified-Quality Criteria for Consumer Health Information (DISCERN), the Journal of the American Medical Association (JAMA), the Global Quality Scale (GQS), and Video Power Index (VPI) scoring systems. The characters of the videos were also recorded and analyzed. Results: Of the 65 Turkish videos, videos of health professions (HPv) were uploaded 58 and seven videos of non-professional in health (NPv). There were no significant differences between the views, like counts, VPI, or the content quality and reliability of HPv and NPv. Of the 62 English videos, videos of HP were uploaded 40 and 22 videos of non-professional in health. Although HPv were found to have greater DISCERN and JAMA values, NPv had more views, view ratio, and Video Power Index than HPv. When all 127 videos were evaluated regardless of the language, NPv were found to have more total views and ratings, but there were no significant differences between like ratio, VPI, DISCERN, JAMA, and GQS values between the two groups. Conclusion: Most YouTube videos about chronic prostatitis did not have enough quality and reliable information. Health associations should be more attentive to posting more content videos of sufficient quality and reliability on social media platforms.

Resumen Antecedentes: YouTube es una de las plataformas de medios sociales más utilizadas para acceder a información sobre salud. Objetivo: Evaluar la calidad y fiabilidad de los vídeos de YouTube sobre prostatitis crónica. Métodos: Se realizaron búsquedas en YouTube utilizando las palabras clave "kronik prostatit" para los vídeos en turco y 'prostatitis crónica' para los vídeos en inglés. Los vídeos se evaluaron mediante los sistemas de puntuación: Criterios de calidad modificados para la información en salud consultada por publico en general (DISCERN), el Journal of the American Medical Association (JAMA), the Global Quality Scale (GQS) y el Video Power Index (VPI). También se analizaron los vídeos. Resultados: De los 65 vídeos turcos, se analizaron 58 vídeos de profesionales en salud (HPv) y siete vídeos de no profesionales (Lv). No hubo diferencias significativas entre los videos vistos, los recuentos, el VPI o la calidad y fiabilidad del contenido de HPv y Lv. De los 62 vídeos en inglés, se analizaron 40 vídeos de HPv y 22 vídeos de no profesionales en salud. Aunque se observó que los HPv tenían mayores valores DISCERN y JAMA, los Lv tenían más visionados, ratio de visionados e Índice de Poder de Vídeo que los HPv. Cuando se evaluaron los 127 vídeos independientemente del idioma, se observó que los Lv tenían más visualizaciones y valoraciones totales, pero no hubo diferencias significativas entre los valores de like ratio, VPI, DISCERN, JAMA y GQS entre los dos grupos. Conclusiones: La mayoría de los vídeos de YouTube sobre prostatitis crónica no tenían suficiente calidad e información fiable. Las asociaciones de salud deberían estar más comprometidas para la publicación de vídeos con contenido mas fiable y con mayor calidad, en las plataformas de las redes sociales.

Osteoarthritis induced by monosodium iodoacetate model: evolution of inflammatory, nociceptive and histopathological markers / Osteoartrite induzida pelo modelo de monoiodoacetato de sódio: evolução de marcadores inflamatórios, nociceptivos e histopatológicos

Objectives: this study aimed to highlight the evolution of the osteoarthritis (OA) model induced by monosodium iodoacetate (MIA) and its collaboration with the knowledge of the pathophysiology of inflammation, hypernociception and cartilage degeneration. Methods: PubMed and Science Direct were used with the descriptors: knee osteoarthritis or osteoarthritis of ankle) and (rat or osteoarthritis induced by monoiodoacetate) and (animal model of osteoarthritis or joint nociception). Studies containing rats, mice, and monoiodoacetate-induced osteoathritis were included. Exclusion criteria were: Animal models of osteoarthritis induced by destabilization; meniscectomy-induced osteoarthritis; non-invasive animal models of osteoarthritis induced by fracture, compression and tibial overload; animal models of osteoarthritis with large animals and models of osteoarthritis by papain or bacterial collagenase. We summarized studies that used MIA to induce knee or ankle OA in rats or mice and the evolution of the inflammatory markers. Results: a total of 38 original manuscripts met the inclusion criteria and were considered in the study. The model of OA induced by MIA is well-established and explored with several methodologies and has been widely used in different species. MIA induces cell death, progressive loss of chondrocytes and histological changes that mimics human OA. Studies with this model demonstrated inflammation, neurogenic hyperalgesia, release of cytokines and matrix metalloproteinases. More recently, molecular biology data confirm the activation of nuclear transcription factors, which modulates the expression of citokines in apoptotic chondrocytes. Conclusion: the MIA-induced OA has been useful in predicting several characteristics for the elucidation of osteoarthritis pathophysiology.

Objetivo: destacar a evolução do modelo de osteoartrite (OA) induzida pelo iodoacetato monossódico (MIA) e sua colaboração com o conhecimento da fisiopatologia da inflamação, hipernocicepção e degeneração da cartilagem. Métodos: foram utilizados PubMed e Science Direct com os descritores: osteoartrite do joelho ou osteoartrite do tornozelo) e (rato ou osteoartrite induzida por monoiodoacetato) e (modelo animal de osteoartrite ou nocicepção articular). Foram incluídos estudos contendo ratos, camundongos e osteoartrite induzida por monoiodoacetato. Os critérios de exclusão foram: Modelos animais de osteoartrite induzida por desestabilização; osteoartrite induzida por meniscectomia; modelos animais não invasivos de osteoartrite induzida por fratura, compressão e sobrecarga tibial; modelos animais de osteoartrite com animais de grande porte e modelos de osteoartrite por papaína ou colagenase bacteriana. Resumimos estudos que utilizaram MIA para induzir OA de joelho ou tornozelo em ratos ou camundongos e a evolução dos marcadores inflamatórios. Resultados: um total de 38 manuscritos originais atenderam aos critérios de inclusão e foram considerados no estudo. O modelo de OA induzido por MIA está bem estabelecido e explorado com diversas metodologias e tem sido amplamente utilizado em diferentes espécies. O MIA induz morte celular, perda progressiva de condrócitos e alterações histológicas que mimetizam a OA humana. Estudos com este modelo demonstraram inflamação, hiperalgesia neurogênica, liberação de citocinas e metaloproteinases de matriz. Mais recentemente, dados de biologia molecular confirmam a ativação de fatores de transcrição nuclear, que modulam a expressão de citocinas em condrócitos apoptóticos. Conclusão: a OA induzida por MIA tem sido útil na predição de diversas características para a elucidação da fisiopatologia da osteoartrite.

Community nursing interventions for chronic disease management

Chronic illnesses present a hurdle in the field of healthcare in community settings. This review of existing literature delves into the role of community nursing interventions when it comes to managing diseases. It sheds light on their effectiveness challenges and potential areas for improvement. Chronic diseases like diabetes, cardiovascular conditions, and respiratory ailments contribute substantially to both mortality rates and morbidity levels. They also place a burden on healthcare systems. Community nursing interventions play a role in addressing these diseases in underserved and rural communities. These strategies include programs, self-management initiatives, home visits, telehealth services, and coordinated care. Research indicates that these approaches have been successful in improving outcomes and reducing the burden, on healthcare systems. To fully maximize the benefits of these interventions we need to overcome obstacles that come our way. Issues such as staffing shortages, the need for training among nurses involved in community care, and the seamless integration of technology must be addressed to optimize their effectiveness. To further advance the field of community nursing interventions for disease management, future research should focus on developing strategies to overcome these challenges effectively. In addition to evaluate the long-term impact of community nursing interventions to understand how effective they are.

Nursing care for people with Chagas disease: a scoping review

Introduction: Chagas disease is an infectious disease caused by the parasitism process of the protozoan Trypanosoma cruzi. Given its potential for chronicity, nursing care in the health care of patients with Chagas disease will provide an improvement in quality of life and the prognosis of the disease. Objective: Review scientific knowledge about nursing care for individuals with Chagas disease. Material and Methods: descriptive and exploratory research, carried out with two independent reviewers using high sensitivity criteria in databases and gray literature sources between June and July 2022. Results: The review identified 12 relevant publications that emphasized health care, education, relationships, disease prevention and health promotion. The most frequent and diverse nursing diagnoses were related to the Activity/Rest, Health Promotion and Coping/Stress domains. Discussion: To meet the care needs of Chagas disease, it is essential to ensure nursing care that recognizes individualities, highlighting the importance of creating tools that facilitate the nursing process. The main points highlighted were related to the health education process, longitudinal monitoring, healthy lifestyle habits, general nursing care during hospitalization and the use of nursing diagnoses. Conclusion: the need for comprehensive nursing care that meets the main needs of individuals with Chagas disease is emphasized, considering their unique circumstances. Developing tools to support the nursing process is essential to improve the results of care for this population.

Introducción: La enfermedad de Chagas es una enfermedad infecciosa causada por el proceso de parasitación del protozoo Trypanosoma cruzi. Dado el potencial de cronicidad de esta enfermedad, los cuidados de enfermería de pacientes con enfermedad de Chagas proporcionarán una mejora en la calidad de vida y en el pronóstico de esta enfermedad. Objetivo: Revisar los conocimientos científicos sobre cuidados de enfermería dirigidos a personas con enfermedad de Chagas. Materiales y Métodos: Investigación exploratoria y descriptiva que incluyó dos revisores independientes que aplicaron criterios de alta sensibilidad en las bases de datos y fuentes de literatura gris entre junio y julio de 2022. Resultados: La revisión identificó 12 publicaciones relevantes que hacen énfasis en la atención, la educación, las relaciones, la prevención de la enfermedad y la promoción de la salud. Los diagnósticos de enfermería más frecuentes y diversos estaban relacionados con los ámbitos actividad/descanso, promoción de la salud y afrontamiento/estrés. Discusión: Para atender las necesidades de cuidado de la enfermedad de Chagas, es fundamental garantizar cuidados de enfermería que reconozcan las características individuales, destacando la importancia de crear herramientas que faciliten el proceso de enfermería. Los principales puntos destacados estuvieron relacionados con el proceso de educación en salud, el seguimiento longitudinal, los hábitos de vida saludables, los cuidados generales de enfermería durante la hospitalización y el uso de diagnósticos de enfermería. Conclusión: Se hace énfasis en la necesidad de cuidados integrales de enfermería que atiendan las principales necesidades de las personas con enfermedad de Chagas, considerando sus circunstancias únicas. Es esencial el desarrollo de herramientas de apoyo al proceso de enfermería para mejorar los resultados de la atención a esta población.

Introdução: A doença de Chagas é uma doença infecciosa causada pelo processo de parasitismo do protozoário Trypanosoma Cruzi. Dado o seu potencial de cronicidade, o cuidado de enfermagem na assistência à saúde dos pacientes com doença de Chagas proporcionará melhora na qualidade de vida e no prognóstico da doença. Objetivo: Revisar o conhecimento científico sobre os cuidados de enfermagem aos indivíduos com doença de Chagas. Material e Métodos: Pesquisa descritiva e exploratória, realizada com dois revisores independentes utilizando critérios de alta sensibilidade em bases de dados e fontes de literatura cinzenta entre junho e julho de 2022. Resultados: A revisão identificou 12 publicações relevantes que enfatizavam cuidados de saúde, educação, relacionamentos, prevenção de doenças e promoção da saúde. Os diagnósticos de enfermagem mais frequentes e diversos estavam relacionados aos domínios Atividade/Repouso, Promoção da Saúde e Enfrentamento/Estresse. Discussão: Para atender às necessidades de cuidado da doença de Chagas é fundamental garantir uma assistência de enfermagem que reconheça as individualidades, destacando a importância da criação de ferramentas que facilitem o processo de enfermagem. Os principais pontos destacados foram relacionados ao processo de educação em saúde, acompanhamento longitudinal, hábitos de vida saudáveis, cuidados gerais de enfermagem durante a internação e utilização de diagnósticos de enfermagem. Conclusão: Enfatiza-se a necessidade de uma assistência de enfermagem integral que atenda às principais necessidades dos indivíduos com doença de Chagas, considerando suas circunstâncias singulares. Desenvolver ferramentas de apoio ao processo de enfermagem é essencial para melhorar os resultados do cuidado a essa população

Clinical characterization, physical frailty, and depression in elderly patients with psoriasis from a reference center in Brazil: a cross-sectional study

Abstract Background: There are few studies dedicated to the characterization of the geriatric population with psoriasis, which has particularities in terms of clinical manifestations and therapeutic limitations. As psoriasis is a chronic disease, presenting a higher prevalence with age, the increase in life expectancy in Brazil demands knowledge about the behavior of the disease among the elderly. Objectives: To characterize elderly people with psoriasis from a tertiary service, from the clinical-epidemiological point of view, presence of comorbidities, physical frailty, and affective impact, and to compare these aspects with adults with psoriasis and elderly people without the disease. Methods: Cross-sectional study of 64 elderly patients with psoriasis, 64 adults with psoriasis, and 64 elderly patients without the disease. Clinical-demographic aspects, the Beck depression scale, and Skindex-16 were evaluated. Indicators of physical frailty were evaluated in elderly patients: handgrip, sit-to-stand test, fatigue, and weight loss >5%. Results: In the elderly, the mean age (SD) of psoriasis onset was 44 (10) years, men represented 47% of the sample, the prevalence of arthritis was 22%, and ungual involvement occurred in 72%. Topical corticosteroids were used more often among elderly people with psoriasis (100%) than among adults with the disease (86%), with no difference among other systemic treatments. Diabetes mellitus occurred in 30% of the elderly. Hypertension (59%), dyslipidemia (52%), depression (34%), and fatigue (59%) were more prevalent among the elderly with psoriasis than among the healthy controls.

Investigation and prognostic analysis of chronic disease co-morbidity in the elderly population / 公共卫生与预防医学

Objective To investigate the investigation of co-morbidity etiology and prognosis analysis of chronic diseases in the elderly population. Methods The data of 1 475 elderly patients who were seen and treated in Chengdu Fifth People's Hospital from January 2019 to December 2021 were screened to analyze their disease status, co-morbidity combinations and patterns, co-morbidity influencing factors, and prognosis. Results The top four prevalence rates among 1 475 elderly patients with chronic diseases were hypertension 555 (37.63%), gastric or gastrointestinal diseases 445 (30.17%), arthritis or rheumatism 427 (28.95%), and diabetes 329 (26.58%). 1034 co-morbidities were found in 1475 elderly patients with chronic diseases, with a co-morbidity rate of 70.10%. The binary disease combination accounted for 58.41% and the ternary disease combination accounted for 41.59%. Female, age >70 years, family history of chronic diseases, overweight/obesity, daily physical inactivity, history of alcohol/smoking, poor sleep quality, and poor dietary habits were the independent influencing factors for co-morbidity in elderly patients with chronic diseases (ORfemale=2.413, ORage ≥ 70=1.670, ORhistory of alcohol consumptionfamily history of chronic diseases=2.846, ORhistory of alcohol consumptionoverweight/obesity=2.570, ORdaily inactivity=1.802, ORhistory of alcohol consumption=3.543, ORhistory of smoking=1.784, ORpoor sleep quality=2.128, ORunhealthy dietary habits=2.085, all P2primary exacerbation/emergency readmission=10.726, χ2new chronic disease=5.873 , all P<0.05). Conclusion Gender, age, chronic disease history, BMI, and lifestyle habits are important factors influencing co-morbidity in elderly patients with chronic diseases, and patients with co-morbidity have a relatively poor prognosis.

Probability and trend of premature death of four major chronic diseases in Linyi City in 2013-2021 / 公共卫生与预防医学

Objective To analyze the mortality rate and probability of premature death caused by four major noninfectious chronic diseases (NCDs)in Linyi City from 2013 to 2021, and to provide data support for scientific formulation of chronic disease prevention and control strategy. Methods The mortality data of major chronic diseases in Linyi City from 2013 to 2021 were analyzed. The crude mortality, age-standardized mortality and premature death probability were calculated. The annual percent change (APC) was adopted to analyze the temporal trend of mortality and probability of premature death. Results The average annual crude mortality of four major NCDs was 538.98/100,000, and the age-standardized mortality was 387.3/100,000. The crude mortality rate increased from 517.37/100 000 in 2013 to 563.13/100 000 in 2021 (APC=0.89％, P=0.01). The age-standardized mortality rate decreased from 410.19/100,000 to 364.92/100,000 (APC=-1.8％, P=0.01). The crude mortality and age-standardized mortality of four major NCDs in males were higher than those in females (P<0.05). The average annual probability of premature death caused by four major NCDs was 13.37%. The probability of premature death decreased from 14.49％ in 2013 to 12.32％ in 2021（APC=-2.1％, P=0.00）. From 2013 to 2021, the probability of premature death from malignant tumors, cardiovascular and cerebrovascular diseases, and chronic respiratory diseases in Linyi City dropped from 6.14%, 7.47%, and 1.21% to 5.52%, 6.46%, and 0.5%, respectively (APCs were -1.2%, -2.1%, and -11.3%, respectively, and P values were 0.04, 0.00, and 0.00, respectively). The probability of premature death from diabetes remained stable. The probability of premature death caused by four major NCDs in males was higher than that in females (P<0.05). Conclusion The probability of premature death of the four major NCDs in Linyi has showed a downward trend during 2013-2021. It is suggested to strengthen the prevention and control of diabetes in the next step.

Research progress on community health management models for elderly hypertensive patients / 现代医院

Objective Summarize domestic and international community health management models and characteristics for elderly hypertensive patients,providing references for the development of community health management in China.Methods Employ literature research to retrieve relevant documents on community health management models for elderly hypertensive pa-tients,and analyze the characteristics and applicability of different models through summarization and comparative analysis.Results In China,community health management models for elderly hypertensive patients include family doctor contracting serv-ices,Hospital-Community-Home health management model,traditional Chinese medicine health management model,"Internet+"health management model,PDCA cycle model,PRECEDE-PROCEED model,and comprehensive community management model.Foreign studies can be categorized into self-management model,Health Rise model,Community Health2(CH2)model,and community pharmacy management model.Conclusion Conducting hypertension health management for elderly patients at the community level is effective,serving as a widely applicable strategy for chronic disease prevention and control.Continued ex-ploration of the scientific and effective aspects of different management models,improving the efficiency and effectiveness of com-munity health management,can contribute more evidence for the formulation of scientific and effective strategies for chronic dis-ease prevention and control.

Analysis of medication and glycemic control of patients with type 2 diabetes under chronic disease management in Xi'an pharmacies / 药物流行病学杂志

Objective To investigate the medication and blood glucose control of type 2 diabetes patients under chronic diseases management in Xi'an chain pharmacies,and provides reference for improving the management policy of diabetes at grassroots level.Methods A number of chain pharmacies in the sixth district of Xi'an were selected by random sampling method,and on-site interviews were conducted by questionnaire survey to patients with type 2 diabetes under the management of chronic diseases.The basic information of patients,medication status(medication plan,drug adherence,etc.),diabetes-related conditions(blood glucose status,family history,course and complications,etc.)were collected.Multivariate logistic regression was used to analyze the relevant factors of blood glucose control in patients.Results A total of 403 patients were surveyed,the largest number of patients use oral hypoglycemic drugs alone(53.4％),followed by insulin medication(including insulin only and insulin in combination with oral hypoglycemic drugs)(35.7％),and the differences between disease course and glycemic control among patients with different drug regimens were statistically significant(P＜0.05).Only 43.7％of patients had good medication compliance.In addition,the patient's fast plasma glucose compliance rate was only 39.2％.The results of multivariate logistic regression analysis showed that good medication compliance(OR=1.744,95％CI 1.104 to 2.754,P=0.017)were independent influencing factors for achieving glycemic control.Conclusion The medication compliance of type 2 diabetes patients with poor blood glucose control in chronic disease management of chain pharmacies in Xi'an needs to be strengthened.Pharmacies should emphasize and give full play to the professional and service advantages of pharmacists to realize the functional role of pharmacies and strengthen diabetes management.