Generating evidence and understanding the treatment of osteoarthritis in Brazil: a study through Delphi methodology

OBJECTIVES: This study aimed to provide evidence for understanding how to treat osteoarthritis (OA) in our country. Therefore, it was necessary to match information and investigations related to the treatment of the disease from the three main types of specialists involved: physiatrists, orthopedists and rheumatologists. METHODS: The authors acted as a scientific advisory committee. From the initial discussions, a structured questionnaire was developed for use with a group of specialists on OA using the Delphi technique. The questionnaire was sent to 21 experts appointed by the authors, and the results obtained were critically analyzed and validated. RESULTS: The prevalence of OA was 33% in Brazil, corresponding to one-third of the individuals in the reference population, which included individuals over 25 years of age. Another significant finding was that most patients did not receive any form of treatment in the early stages of OA. CONCLUSION: The committee pointed to the need for early intervention and that the available medicinal resources can fulfil this important role, as is the case with SYSADOA treatments. Glucosamine-based medicinal products with or without chondroitin could also fulfill this need for early treatment. The other generated evidence and included investigations were then grouped together and are the subject of this publication.

International Classification of Functioning, Disability and Health (ICF) - way to Health Promotion / A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) - um caminho para a Promoção da Saúde

Abstract The International Classification of Functioning, Disability and Health (ICF) is a classification of the World Health Organization (WHO). It is a reference document for the description of phenomena related to functioning and disability. The aim of the present study is to assess the relationship between the theoretical assumptions of ICF and the field of Health Promotion. The dissemination of ICF has been widely documented in literature over the last few years, however, there is a large gap between enthusiasm with the paradigm change that the classification proposes and its effective incorporation in the different environments of health care. This study presents an example of ICF operation-alization. The biopsychosocial evaluation model of ICF presented is a strategy of light technology in health that advances towards the proposals of the field of Health Promotion.

Resumo A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) é uma classificação da Organização Mundial de Saúde (OMS). É um documento de referência para a descrição de fenômenos relacionados a funcionalidade e incapacidade. O objetivo do presente trabalho é traçar uma relação entre os pressupostos teóricos da CIF com o campo da Promoção da Saúde. A disseminação da CIF tem sido amplamente documentada na literatura ao longo dos últimos anos, no entanto, há uma grande lacuna entre o entusiasmo com a mudança de paradigma que a classificação propõe e sua efetiva incorporação nos diferentes ambientes do cuidado em saúde. O presente ponto de vista apresenta um exemplo de operacionalização da CIF. O modelo de avaliação biopsicossocial da CIF apresentado é uma estratégia de tecnologia leve em saúde que caminha para o avanço das propostas do campo da Promoção da Saúde.

Evaluación de la aptitud clínica de médicos residentes de medicina física y rehabilitación / Clinical aptitude of residents of physical medicine and rehabilitation

Se informan las complicaciones postoperatorias observadas en un grupo de 27 pacientes sometidos a esplenectomía electiva por padecimientos hematológicos: 21 tuvieron padecimientos hematológicos benignos, en tanto que seis tuvieron algunas hemopatía maligna. Se presentaron siete complicaciones en seis pacientes (2 abscesos de la herida quirúrgica, 2 sangrados graves postoperatorios, una sepsis por bacterias capsuladas, una hernia post-incisional y un síndrome hemofagocítico). El índice de complicaciones fue de 27 por ciento y el de complicaciones ocurrieron en el 83 por ciento de los pacientes con hemopatías malignas y en el 9 por ciento de aquéllos con hemopatías benignas (p<.01). El tamaño del bazo tuvo relación con las complicaciones: la mediana del peso del bazo fue 990 gramos en los pacientes que se complicaron y de 132 gramos en aquéllos sin complicaciones. En las dos niñas sometidas a esplenectomía antes de los seis meses de edad hubo complicaciones; una de ellas se debió a negligencia de los padres. En la esplenectomía electiva en pacientes con hemopatías deben ponderarse cuidadosamente los riesgos contra los beneficios en cada paciente

Normas para atendimento aos hemofílicos e portadores de coagulopatias congênitas / Rules for attending patients with hemophilia and congenital blood coagulation disorders

O objetivo primordial do trabalho foi dar as linhas gerais de diagnóstico e conduta frente às diversas intercorrências médicas, odontológicas, psico-sociais e fisioterápicas...