Quality of life in patients with Chagas disease and the instrument used: an integrative review.

Chagas disease (CD) is a neglected tropical highly morbid disease that can have a negative impact on the quality of life (QoL). The purpose of this study was to conduct an integrative review to analyze the QoL of patients with CD in the chronic phase of the disease, as well as the instruments used and the effect of different interventions. The review was carried out based on the criteria and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guideline (PRISMA) using the PubMed, Scopus, Web of Science and Science Direct databases. An analysis of the reference list of the included articles was also carried out. Publications in all languages have been included. Two independent reviewers selected the eligible articles and extracted the data. A total of 1,479 articles were identified, and after applying the inclusion criteria 18 articles were included. Four different instruments were used to assess QoL and the most used was the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) [33.3% (n = 6)]. Investigations involving intervention showed a positive impact on the patients' QoL, and the Environment domain had the lowest score. Heterogeneity of instruments and lack of methodology standardization for assessing QoL was observed. QoL proved to be an important indicator for the planning and monitoring of patients with CD, however it is suggested that the instruments for its assessment should be the ones recommended by the validation studies. This process will allow the comparison of data between investigations.

Epidemiological profile of isolated bacteria in a public pediatric hospital / Perfil epidemiológico de bactérias isoladas em um hospital pediátrico público / Perfil epidemiológico de bacterias aisladas en un hospital pediátrico público

Justificativa e objetivos: nos últimos anos, a incidência de bactérias resistentes tem aumentado significativamente e, no Brasil, existem poucas pesquisas sobre o tema, em hospitais pediátricos. Portanto, este estudo teve como objetivo analisar o perfil epidemiológico das principais bactérias recuperadas de amostras biológicas de um hospital pediátrico brasileiro. Métodos: trata-se de um estudo descritivo documental e retrospectivo. O estudo foi conduzido em 24 meses a partir de laudos de exames microbiológicos emitidos pelo serviço de controle de infecção hospitalar de um hospital pediátrico localizado no Centro-Oeste de Minas Gerais. Resultados: foram recuperadas de amostras biológicas, neste período, 4.286 bactérias, sendo 1.107 (25,82%) responsáveis por infecções relacionadas à assistência à saúde (IRAS) na instituição de origem. Os principais microrganismos identificados foram Pseudomonas aeruginosa (10.4%), Acinetobacter baumannii (7.8%), Staphylococcus aureus (4.3%), Escherichia coli (4.3%) e Klebsiella pneumoniae (3.5%). Os isolados que apresentaram concentração inibitória mínima (CIM) ≥ 4mg/L foram considerados resistentes. Conclusão: o conhecimento do perfil epidemiológico local tem se mostrado efetivo nas estratégias estabelecidas pelas instituições para redução das infecções relacionadas à assistência à saúde. O perfil de prevalência das bactérias recuperadas das amostras biológicas foi similar a outros estudos conduzidos em âmbito nacional e internacional.(AU)

Background and objectives: in recent years, the incidence of resistant bacteria has increased significantly, and in Brazil there is little research on the subject regarding pediatric hospitals. Therefore, this study aimed to analyze the epidemiological profile of the main bacteria recovered from biological samples of a Brazilian pediatric hospital. Methods: this is a descriptive and retrospective study. The study was conducted over 24 months based on reports of microbiological tests issued by the infection control service of a pediatric hospital located in the Center-West of the Brazilian state of Minas Gerais. Results: a total of 4286 bacteria were recovered from biological samples, of which 1107 (25.82 %) were responsible for healthcare- associated infection (HAI) at the institution of origin. The main microorganisms identified were Pseudomonas aeruginosa (10.4%), Acinetobacter baumannii (7.8%), Staphylococcus aureus (4.3%), Escherichia coli (4.3%), and Klebsiella pneumoniae (3.5%). Isolates with minimal inhibitory concentration (MIC) ≥ 4mg/L were considered resistant. Conclusion: knowledge of the local epidemiological profile has been shown to be effective in the strategies established by the institutions to reduce infections related to health care. The prevalence profile of bacteria recovered from biological samples was similar to other studies conducted at national and international levels.(AU)

Justificación y objetivos: en los últimos años, la incidencia de bacterias resistentes ha aumentados significativamente y en Brasil hay poca investigación sobre el tema con respecto a los hospitales pediátricos. Por lo tanto, este estudio tuvo como objetivo analizar el perfil epidemiológico de las principales bacterias recuperadas de muestras biológicas de un hospital pediátrico brasileño. Métodos: este es un estudio descriptivo y retrospectivo. El estudio se realizó durante 24 meses en base a informes de pruebas microbiológicas emitidas por el servicio de control de infecciones de un hospital pediátrico ubicado en el centro oeste del estado brasileño de Minas Gerais. Resultados: se recuperaron un total de 4286 bacterias de muestras biológicas, de las cuales 1107 (25.82%) fueron responsables de infecciones relacionadas con la atención médica (IRAS) en la institución de origen. Los principales microorganismos identificados fueron Pseudomonas aeruginosa (10.4%), Acinetobacter baumannii (7.8%), Staphylococcus aureus (4.3%), Escherichia coli (4.3%) y Klebsiella pneumoniae (3.5%). Los aislamientos con concentración mínima inhibitoria (MIC) ≥ 4 mg/L se consideraron resistentes. Conclusiones: el conocimiento del perfil epidemiológico local se ha mostrado efectivo en las estrategias establecidas por las instituciones para reducir las infecciones relacionadas con la atención de la salud.(AU)

Profile of intoxications served at the 24-hour emergency service unit

Intoxications represent a serious public health problem. According to the World Health Organization, 193,000 deaths per year are caused by unintended intoxications worldwide. This study aims to know the profile of intoxications at the 24-hour Emergency Service Unit in Divinópolis, in the state of Minas Gerais. This is a descriptive study in which the study population chosen were all patients treated for intoxications in the period from 2017 to 2018, registered in the health service; 421 cases of intoxications were recorded. The female gender was the most prevalent, and the age group with the most cases was 21 to 30 years. The main circumstance found was attempted suicide (83.1%), and the main causative agent was drugs (76.5%), with benzodiazepines being the main class responsible for intoxications. The most used treatment was gastric lavage and activated charcoal. This study demonstrates that knowledge about the city's intoxication profile is important for the development of treatment and patient management methods to better suit the demands of the municipality.

Prevalence of overweight and obesity in the adult indigenous population in Brazil: A systematic review with meta-analysis.

To carry out a systematic review to identify the prevalence of overweight and obesity in the adult indigenous population in Brazil. The databases used were PubMed, Scopus, Virtual Health Library (VHL), and Science Direct, with the following search strategy: "overweight" OR "obesity" AND "indigenous" OR "tribe" AND "Brazil". For the meta-analysis, RStudio® software was used. Were 22 articles included. The combined effect of the meta-analysis studies showed a global prevalence of overweight and obesity of 45%. Approximately half (45%) of indigenous Brazilian adults have excess weight. These findings highlight the need to implement public policies for the prevention and treatment of these morbidities.

Análise dos efeitos adversos associados ao uso do anorexígeno sibutramina: revisão sistemática / Analysis of the adverse effects associated with the use of the anorexiant sibutramine: Systematic Review

Introdução: nos dias atuais, a obesidade tornou-se um problema de saúde pública em escala global. Entre os tratamentos disponíveis, destaca-se o uso da sibutramina. Entretanto, este fármaco apresentou diversos efeitos adversos (EA), sendo os de maior relevância os cardiovasculares. Objetivo: o objetivo deste estudo foi avaliar se a terapia com a sibutramina traz malefícios à saúde humana. Métodos: a revisão sistemática foi realizada seguindo o protocolo PRISMA para revisões sistemáticas e utilizando as bases de dados PubMed, LILACS e SciElo. Nestas, buscaram-se estudos publicados entre 2006 e 2016, utilizando-se dos descritores "sibutramine" e "adverse effects" junto com o operador booleano "AND". Resultados: dezoito artigos, das 479 publicações encontradas, atenderam aos critérios de inclusão, sendo, então, utilizados para compor a presente revisão. Os EA mais encontrados foram complicações cardiocirculatórias (66,6%), sendo as mais frequentes a taquicardia e a hipertensão arterial sistêmica (HAS). Adicionalmente a esses, a constipação intestinal e a boca seca/xerostomia (55,5%), cefaleia e insônia (38,8%) e alterações de humor (26,6%) também foram relatados. Além disso, o tratamento com sibutramina mostrou-se eficaz na perda de peso em 88,88% dos estudos analisados. Conclusão: apesar da terapêutica com sibutramina ter apresentado efetividade na redução de peso, não se pode concluir acerca da segurança desse fármaco.(AU)

Introcuction: in the modern times, obesity has become a global health problem. Sibutramine stands out among the available treatments. However, this drug is associated to several adverse events (AE), being the cardiovascular the most relevant ones. Objetive: the aim of this study was to evaluate whether therapy with sibutramine is harmful to human health. Methods: the systematic review was performed following the PRISMA protocol for systematic reviews and using the databases PubMed, LILACS and SciElo, aiming for studies published between 2006 and 2016. For the search of the papers, the descriptors "sibutramine" and "adverse effects" were used, together with the boolean operator "AND". Results: eighteen studies of 479 publications met the inclusion criteria, and were used in the present review. The main AE founded after the analysis of the articles were cardiocirculatory complications (66.6%), with more frequent tachycardia and systemic arterial hypertension. In addition, intestinal constipation and dry mouth/xerostomia (55.5%), headache and insomnia (38.8%) and mood alteration (26.6%) were also reported. Furthermore, treatment with sibutramine was effective in reducing weight in 88.88% of the studies analyzed. Conclusion: although sibutramine therapy has an effective effect on weight reduction, the safety of the drug is not proved.(AU)

Effectiveness of individual strategies for the empowerment of patients with diabetes mellitus: A systematic review with meta-analysis.

AIMS: To identify and evaluate the effectiveness of individual empowerment strategies in patients with diabetes mellitus (DM). METHODS: A systematic review was performed in the PubMed, Scopus, Science Direct and BVS. For meta-analysis and evaluation of Cochrane Risk and Bias, Revman V 5.2 software was used. RESULTS: Eleven studies of 1073 publications met the inclusion criteria. The strategies used were individual consultations, phone calls, sessions via a website and use of a booklet. Glycemic Hemoglobin (HbA1c) was used to evaluate the effectiveness of the strategies, and 45.4% of the studies also used the Diabetes Empowerment Scale. Five studies (45.5%) showed significant improvements in HbA1c reduction, improvements in self-efficacy (18.2%), knowledge levels of DM (18.2%), quality of life (18.2%). However, after meta-analysis, no statistically significant improvement was found for HbA1c. CONCLUSION: This systematic review showed that individual strategies for DM empowerment were not effective in reducing HbA1c, despite contributing to improvements in psychosocial parameters. Therefore, individual strategies need to be reviewed so that they become effective in DM control.

Collective empowerment strategies for patients with Diabetes Mellitus: A systematic review and meta-analysis.

AIMS: To perform a systematic review and meta-analysis to identify and analyze collective empowerment strategies for patients with Diabetes Mellitus (DM). METHODS: The systematic review was performed using PubMed/MEDLINE, Science Direct and BVS. The term "Diabetes Mellitus" was used with each of the following describers, along with the connector "AND": "self-care", "health education", "motivation" and "empowerment". Inclusion criteria were: intervention study with control group published between 2004 and 2014. For meta-analysis, RevMan V 5.3 software was used. RESULTS: Among the nine analyzed articles, 66.7% (n=6) were developed in patients diagnosed with DM2. Concerning the indicators for intervention effectiveness evaluation, all articles (n=9) used glycated hemoglobin (HbA1c) and the most used instrument was Summary of Diabetes Self Care Activities Measure, representing 44.4% (n=4) of the studies. The types of strategies used were similar in the articles. There was evidence of a decrease in HbA1c levels in 66.7% (n=6). The meta-analysis found significant evidence indicating beneficial effects of empowerment. CONCLUSIONS: Programs based on collective empowerment in DM have shown the interventions lead to improvement in clinical parameters, behavior, increased knowledge about DM, and self-care.