Construção de um guia para preenchimento dos indicadores do previne Brasil no prontuário eletrônico do cidadão / Developing a guide for filling out previne Brazil indicators on the electronic citizen health record / Elaboración de una guía para cumplimentar los indicadores de previne Brasil en la historia clínica electrónica del ciudadano

O programa Previne Brasil foi instituído pela Portaria nº 2.979, de 12 de novembro de 2019, como novo modelo de financiamento da Atenção Primária à Saúde (APS). Nesse contexto, nosso objetivo é relatar a experiência de elaboração de uma tecnologia educacional (TE) em formato de guia, para uso dos profissionais das Equipes de Saúde da Família (ESF), que visa o registro correto das informações dos indicadores do Previne Brasil no Prontuário Eletrônico do Cidadão (PEC). Trata-se de um relato de experiência de duas enfermeiras residentes do Programa de Saúde da Família Multiprofissional da Universidade do Estado do Pará, que aborda a elaboração e aplicação de um guia para auxiliar o preenchimento correto de informações referentes aos indicadores de desempenho do Previne Brasil no PEC. A construção do guia se deu a partir das normativas contidas nas notas técnicas do Ministérios da Saúde e dos conhecimentos práticos adquiridos no manuseio do PEC pelas autoras, em plataforma online gratuita de criação de projeto gráficos (Canva). Com um total de 20 páginas, o guia conta com uma apresentação em forma de fluxo simplificado com palavras-chave e imagens reais do PEC. O guia foi bem aceito pelos profissionais, uma vez que seu uso se mostrou prático, o que facilitou o registro das informações de forma mais clara e vantajosa, sendo uma excelente TE. Ademais, ressalta-se a importância de divulgar e compartilhar experiências exitosas que contribuam para melhorias no cenário da APS.

The Previne Brasil Program was implemented by ordinance nº 2,979 on November 12, 2019, as a new financing model for Primary Health Care. In this scenario, this study reports the experience of developing an educational technology (ET), in the form of a guide, for use by Family Health Strategy (ESF) professionals to correctly record Previne Brasil performance indicators in the Electronic Citizen Health Record (PEC). This is an experience report by two nurses working on the Multiprofessional Family Health Program, University of Pará, regarding the development and application of a guide to assist in correctly filling out information related to Previne Brasil performance indicators in the Electronic Citizen Health Record. The guide was constructed using a free online graphic design platform (Canva) based on regulations contained in the Ministry of Health's technical notes and the practical knowledge acquired by the authors in handling PEC. Consisting of 20 pages, the guide presented a simplified flow format with keywords and real PEC images. The guide was well accepted by professionals, as its use proved to be practical, facilitating the recording of information in a clearer and advantageous manner, making it an excellent ET. Moreover, disseminating and sharing successful experiences is paramount to improve Primary Health Care.

El Programa Previne Brasil fue establecido bajo la Ordenanza N.º 2.979 del 12 de noviembre de 2019 como un nuevo modelo de financiamiento de la atención primaria de salud (APS). En este contexto, el objetivo de este estudio es informar sobre la experiencia de desarrollar una tecnología educativa (TE), en forma de guía, para ser utilizada por los profesionales de los equipos de Estrategia de Salud Familiar (ESF) con el fin de registrar correctamente la información de los indicadores de desempeño del Previne Brasil en la Historia Clínica Electrónica del Ciudadano (PEC). Este es un informe de experiencia realizado por dos enfermeras residentes del Programa de Salud Familiar Multiprofesional de la Universidad del Estado de Pará acerca del desarrollo y aplicación de una guía para ayudar en el llenado correcto de la información relacionada con los indicadores de desempeño del Previne Brasil en el PEC. La guía se construyó con base en las regulaciones de las notas técnicas del Ministerio de Salud y de los conocimientos prácticos adquiridos por las autoras en el manejo del PEC, en una plataforma en línea gratuita de creación de diseño gráfico (Canva). Consta de 20 páginas, la guía se presenta en un formato de flujo simplificado con palabras clave e imágenes reales del PEC. La guía fue bien recibida por los profesionales y su uso demostró ser práctico, facilitando el registro de la información de manera más clara y ventajosa, lo que la convierte en una excelente TE. Además, se destaca la importancia de difundir y compartir experiencias exitosas, lo que contribuye a mejorar el escenario de la APS.

Electromyographic activity of pelvic floor muscles in different positions during the use an innovative vaginal educator: Cross-sectional study.

The pelvic floor requires an integrated anatomical structure owing to its multiple functions. Therefore, it is necessary to study methods for improving muscle recruitment during training. This study aimed to analyze the effect of using an innovative vaginal trainer on the bioelectrical activity of the pelvic floor muscles. Pelvic positioning and interference factors, such as age, childbirth, sexual activity, urinary incontinence, and menopause, were also analyzed. A cross-sectional study assessed 30 women using an evaluation form, International Consultation on Incontinence Questionnaire-Short Form, and surface electromyography. The root mean square of a 5-second contraction period, peak root mean square values, area values, % maximal voluntary contraction (root mean square normalized by peak signal), and median frequency were collected. These findings with and without the use of a vaginal educator were compared in the anteversion, neutral, and retroversion pelvic positions. The use of a vaginal educator was found to increase the electromyographic activity of the pelvic floor muscles in the neutral position. In this position, older women showed an increased peak contraction when using the educator. Multiparas also benefited from increased bioelectric activity (root mean square and area). Sexually active women increased their bioelectric activity in a neutral position when using the trainer, exerting less effort in retroversion (%-maximal voluntary contraction). Incontinent and menopausal women exhibited slower body-building activation (decreased frequency) with the device, which requires further investigation. Our innovative biofeedback device induced greater recruitment of muscle fibers, is more effective in the neutral pelvic position, and may be effective in training the pelvic floor muscles, even in women with a greater tendency toward pelvic floor dysfunction.

Gravidez na adolescência: percepção dos enfermeiros sobre a assistência de enfermagem / Pregnancy in adolescence: nurses' perception about nursing care / Embarazo en la adolescencia: percepción de las enfermeras sobre el cuidado de enfermería

Objetivo: Descrever a percepção dos enfermeiros da atenção básica sobre a assistência pré-natal direcionada às adolescentes grávidas. Métodos: Trata-se de um estudo descritivo, transversal de natureza qualitativa, desenvolvido nas Unidades Básicas de Saúde do Guamá em Belém ­ Pará, de maio a abril de 2021. Resultados: Participaram 15 enfermeiros, norteado por um formulário semiestruturado, tendo os dados analisados pela técnica de Laurence Bardin, resultando seis categorias temáticas acerca da percepção sobre o atendimento pré-natal com adolescentes. Conclusão: Percebe-se a percepção do impacto positivo da assistência de enfermagem no pré-natal de adolescentes grávidas, todavia necessita de melhorias estruturais no atendimento, formação continuada dos profissionais e captação precoce da adolescente grávida. (AU)

Objective: describe the perception of nurses in primary care about prenatal care aimed at pregnant adolescents. Methods: This is a descriptive, cross-sectional study of a qualitative, developed in the Basic Health Units of Guamá in Belém ­ Pará, from May to April 2021. Results: Fifteen nurses participated, guided by a semi-structured form, with the data analyzed using the Laurence Bardin technique, resulting in six categories about the perception of prenatal care with adolescents. We conclude that nurses are aware of the positive impact that nursing care has on the conduct of pregnancy and the formation of autonomy for adolescents. Conclusion: The perception of the positive impact of nursing care on prenatal care for pregnant teenagers is perceived, however, it needs structural improvements in care, continued training of professionals and early capture of pregnant teenagers. (AU)

Objetivo: describir la percepción de enfermeras de atención primaria sobre la atención prenatal dirigida a adolescentes embarazadas. Métodos: Se trata de un estudio descriptivo, transversal de carácter cualitativo, desarrollado en las Unidades Básicas de Salud de Guamá en Belém - Pará, de mayo a abril de 2021. Resultados: Participaron quince enfermeros, guiados por un formulario semiestructurado, con los datos analizados mediante la técnica de Laurence Bardin, resultando en seis categorías temáticas sobre la percepción de la atención prenatal con adolescentes. Conclusión: Se percibe la percepción del impacto positivo del cuidado de enfermería en el cuidado prenatal de las adolescentes embarazadas, sin embargo, requiere mejoras estructurales en la atención, capacitación continua de los profesionales y reclutamiento temprano de las adolescentes embarazadas. (AU)

Álcool e Outras Drogas: a Prevenção como Intervenção

Introdução: O uso abusivo de álcool e outras drogas é um problema recorrente entre adultos e adolescentes, além de ter se tornado uma questão de saúde pública que perpassam por diversos âmbitos na sociedade atual. Objetivo: A presente intervenção visa promover a educação em saúde, com prevenção ao uso de drogas entre os adolescentes e adultos da comunidade adscrita de uma Unidade de Saúde da Família. Métodos: Trata-se de um relato de experiência das atividades desenvolvidas na disciplina de Integração, Ensino, Serviço e Comunidade, sob a forma de atividades integrativas e pedagógicas, por meio de oficinas com rodas de conversas, palestras, colagem de cartazes, jogos interativos e apresentação teatral. Resultados: Evidenciou-se que os cidadãos possuem entendimento dos riscos das drogas, no entanto, não se encontravam meios viáveis para minimizar essa problemática. Com isso, por meio das atividades propostas verificou-se a importância e efetividade da educação em saúde, sobretudo em temáticas como essa, que são consideradas difíceis de serem abordadas com a população devido a ser um problema permeado de preconceitos e prejuízos em vários âmbitos da vida do indivíduo. Conclusões: Esse trabalho contribuiu para sensibilizar a comunidade, provocando questionamentos e sanando respostas acerca da temática, de forma a minimizar um problema que gera repercussões no indivíduo, na família, no trabalho e na sociedade. Além de permitir a aproximação dos acadêmicos com a comunidade, tornando a medicina mais humanizada.

Cinnamaldehyde Increases the Survival of Mice Submitted to Sepsis Induced by Extraintestinal Pathogenic Escherichia coli.

Several natural products have been investigated for their bactericidal potential, among these, cinnamaldehyde. In this study, we aimed to evaluate the activity of cinnamaldehyde in the treatment of animals with sepsis induced by extraintestinal pathogenic E. coli. Initially, the E. coli F5 was incubated with cinnamaldehyde to evaluate the minimum inhibitory and minimum bactericidal concentration. Animal survival was monitored for five days, and a subset of mice were euthanized after 10 h to evaluate histological, hematological, and immunological parameters, as well as the presence of bacteria in the organs. On the one hand, inoculation of bacterium caused the death of 100% of the animals within 24 h after infection. On the other hand, cinnamaldehyde (60 mg/kg) was able to keep 40% of mice alive after infection. The treatment significantly reduced the levels of cytokines in serum and peritoneum and increased the production of cells in both bone marrow and spleen, as well as lymphocytes at the infection site. Cinnamaldehyde was able to reduce tissue damage by decreasing the deleterious effects for the organism and contributed to the control of the sepsis and survival of animals; therefore, it is a promising candidate for the development of new drugs.

Digital health literacy and subjective wellbeing in the context of COVID-19: A cross-sectional study among university students in Ecuador.

Background: The COVID-19 pandemic has generated an avalanche of information, which, if not properly addressed, generates uncertainty and limits healthy decision-making. On the other hand, the pandemic has exacerbated mental health problems among young people and adolescents, causing a worsening of their wellbeing. Previous studies have found that digital health literacy has a positive impact on people's attitudes toward the disease. This study aimed to analyze the association between digital health literacy on COVID-19 with subjective wellbeing in university students. Methods: A cross-sectional study was developed in 917 students from Ecuador. Subjective wellbeing was measured with the World Health Organization WellBeing Scale. Digital health literacy was assessed using the Spanish-translated version of the Digital Health Literacy Instrument adapted to the context of the COVID-19 pandemic. Bivariate and multivariate linear regressions were performed. Results: Digital health literacy and subjective wellbeing proofed to be significantly higher among males and among students with higher social status. The association between digital health literacy and subjective wellbeing was significant; for each increase of one point in the digital health literacy scale, an average increase of 9.64 points could be observed on the subjective wellbeing scale (IC 95% 5.61 - 13.67, p-value <0.001). This correlation persisted after adjust by demographic and socioeconomic variables. Conclusion: Improving digital health literacy in health would improve the subjective wellbeing of university students. It is suggested strengthen the digital health literacy through public and university policies that promote access, search skills and discernment of digital information. Socioeconomic and gender inequalities related to digital health literacy need to be further investigated.

Cinnamaldehyde increases the survival of mice submitted to sepsis induced by extraintestinal pathogenic Escherichia coli

Several natural products have been investigated for their bactericidal potential, among these, cinnamaldehyde. In this study, we aimed to evaluate the activity of cinnamaldehyde in the treatment of animals with sepsis induced by extraintestinal pathogenic E. coli. Initially, the E. coli F5 was incubated with cinnamaldehyde to evaluate the minimum inhibitory and minimum bactericidal concentration. Animal survival was monitored for five days, and a subset of mice were euthanized after 10 h to evaluate histological, hematological, and immunological parameters, as well as the presence of bacteria in the organs. On the one hand, inoculation of bacterium caused the death of 100% of the animals within 24 h after infection. On the other hand, cinnamaldehyde (60 mg/kg) was able to keep 40% of mice alive after infection. The treatment significantly reduced the levels of cytokines in serum and peritoneum and increased the production of cells in both bone marrow and spleen, as well as lymphocytes at the infection site. Cinnamaldehyde was able to reduce tissue damage by decreasing the deleterious effects for the organism and contributed to the control of the sepsis and survival of animals; therefore, it is a promising candidate for the development of new drugs.

Can bulk-fill compromise the curing potential in deep cavities? / Bulkfill pode comprometer o potencial de polimerização em cavidades profundas?

Objective: To determine the effect of the restorative technique, material's opacity and the selected light sources on the curing potential (CP) in deep cavities. Material and Methods: The radiant exitance (mW/cm2) of two light curing units (Bluephase G2 and Radii-Cal) was determined at 0 and 8 mm distance from a power meter sensor (Ophir). Two bulk-fill composites of regular consistency (Opus, FGM; and Filtek One, 3M) and a conventional one (Sirius-Z, DFL) were considered and the level of their opacity were determined by a sphere-based spectrophotometer (SP60, X-Rite). The degree of C=C conversion (DC) was determined by spectroscopy (FTIR-ATR) at 0.05 and 8 mm depths and the CP considered the ratio between them. The "incremental technique" considered 4 increments of 2mm thickness each, whereas the "bulk-fill technique considered 2 increments of 4mm-thickness. Data were submitted to analysis of variance and Tukey's test (95%). Pearson's correlation tests were performed to calculate the possible relation between curing potential and materials' opacity. Results: With the incremental technique it was possible to achieve high CP regardless of the light source. The CP of bulk-fill composites was dependent on the light source, whereas Radii-Cal compromised the DC at 8 mm for both materials. The correlation between opacity and CP was dependent on the light source (r = 0.891707246 for Radii-Cal; r = 0.515703768 for Bluephase G2). Conclusion: The bulk-fill technique was dependent on the light source while the incremental was not. The influence of materials' opacity was dependent on the light curing unit.(AU)

Objetivo: Determinar o efeito da técnica restauradora, a opacidade do material e as fontes de luz selecionadas sobre o potencial de cura (PC) em cavidades profundas. Materiais e métodos: A saída radiante (mW/cm2) de duas unidades de cura por luz (Bluephase G2 e Radii-Cal) foi determinada a 0 e 8 mm de distância de um sensor de potência (Ophir). Dois compósistos bulkfill de consistência regular (Opus, FGM; e Filtek One, 3M) e um convencional (Sirius-Z, DFL) foram considerados e o nível de sua opacidade foi determinado por um espectrofotômetro (SP60, X-Rite). O grau de conversão C=C (DC) foi determinado por espectroscopia (FTIR-ATR) a 0,05 e 8 mm de profundidade e o PC considerou a relação entre eles. A técnica incremental considerou 4 incrementos de 2 mm de espessura cada, enquanto que a técnica bulkfill considerou 2 incrementos de 4 mm de espessura. Os dados foram submetidos à análise de variância e ao teste de Tukey (95%). Os testes de correlação de Pearson foram realizados para calcular a possível relação entre o potencial de cura e a opacidade dos materiais. Resultados: Com a técnica incremental foi possível obter um PC elevado, independentemente da fonte de luz. O PC de compósitos bulkfill foi dependente da fonte de luz, enquanto que Radii-Cal comprometeu o DC em 8 mm para ambos os materiais. A correlação entre opacidade e PC foi dependente da fonte de luz (r = 0,891707246 para Radii-Cal; r = 0,515703768 para Bluephase G2). Conclusão: O potencial de polimerização para a técnica bulkfill foi dependente da fonte de luz, enquanto para a técnica incremental não. A influência da opacidade dos materiais sobre a capacidade de polimerização foi dependente da unidade de fotoativação. (AU)

Proton pump inhibitor and community pharmacies: Usage profile and factors associated with long-term use.

AIM: To characterize the usage profile and the factors associated with the prolonged use of proton pump inhibitor drugs in a community pharmacy. METHODOLOGY: This is a cross-sectional, prospective and observational study involving interviews with 410 patients who acquired PPI for their own use from community pharmacies. To characterize the factors associated with the prolonged use of PPI, a multivariate logistic regression model was used. RESULTS: Pantoprazole (42.7%) and omeprazole (31%) were the most acquired PPIs, prescribed mainly by gastroenterologists (49.5%). They are used in the morning, especially for gastrointestinal symptoms, however, they had been consumed for more than 5 years in 30% of cases. The factors associated with prolonged use are old age (OR 1.03 CI95% 1.01-1.05), body mass index (OR 1.07 CI95% 1.01-1.12), use of non-steroidal anti-inflammatories (OR 3.18 CI95% 1.20-8.43) and selective serotonin reuptake inhibitors (OR 3.5 95% CI 1.39-8.88). CONCLUSION: PPIs are adequate in terms of indication and form of use, however, prolonged use associated with old age, being overweight and use of anti-inflammatories and antidepressants is frequent.

Knowledge, attitude and practices of biomedicine students on the papanicolaou exam

Cervical cancer is the second type of cancer that most affects women, considered a serious public health problem, however it can be detected and treated early through the Pap smear. This research aimed to analyze the knowledge, attitude and practices of biomedicine students on the Pap smear. A cross-sectional study on Knowledge, Attitude and Practice (KAP), applied with 108 students, was carried out at a Higher Education Institution in Teresina, Piauí, Brazil. The data were collected through the months of February and March of 2018 with the application of a questionnaire. Statistical analysis was descriptive in terms of absolute and relative frequencies. Knowledge 72 (66.6%) and attitude 76 (70.3%) presented adequate levels regarding the examination. As for the practice, the percentage of suitability was of 37 academics (34.2%) relatively not adequate. It was concluded that the students had adequate knowledge and attitude, but an inadequate practice, and the Papanicolaou test is required for the early screening and prevention of cervical cancer.

Pic-Producing Escherichia coli Induces High Production of Proinflammatory Mediators by the Host Leading to Death by Sepsis.

Escherichia coli is an important pathogen responsible for a variety of diseases. We have recently shown that Pic, a serine protease secreted by E. coli, mediates immune evasion by the direct cleavage of complement molecules. The aim of this study was to investigate the action of a Pic-producing bacteria in a murine model of sepsis. Mice were infected with Pic-producing E. coli (F5) or F5∆pic mutant. Animal survival was monitored for five days, and a subset of mice was euthanized after 12 h for sample acquisition. The inoculation of Pic-producing bacteria induced 100% death within 24 h. The colony forming units count in the organs was significantly higher in F5. Hematological analysis showed a decrease of total leukocytes. Nitric oxide and cytokines were detected in serum, as well as on peritoneal lavage of the F5 group in higher levels than those detected in the other groups. In addition, immunophenotyping showed a decrease of activated lymphocytes and macrophages in the F5 group. Therefore, Pic represents an important virulence factor, allowing the survival of the bacterium in the bloodstream and several organs, as well as inducing a high production of proinflammatory mediators by the host, and concomitantly a cellular immunosuppression, leading to sepsis and death.

Anti-inflammatory and antioxidant activity of hydroethanolic extract of Spondias mombin leaf in an oral mucositis experimental model.

BACKGROUND: Spondias mombin has been used in folk medicine to treat inflammation in the oral cavity. This study aimed to evaluate the antioxidant and anti-inflammatory activity of S. mombin extract in an oral mucositis experimental model. METHODS: Male hamsters were orally pre-treated with hydroethanolic extract of S. mombin leaves (HESM) (50, 100, or 200 mg/kg) for ten days. Cheek pouch samples were subjected to macroscopic, histopathological and immunohistochemical analysis (Cox-2, iNOS, NF-kB p50 NLS and MMP-2). IL-1ß and TNF-α levels were analyzed by ELISA immunoassay, and Superoxide dismutase estimative (SOD), glutathione (GSH) and malondialdehyde (MDA) levels were submitted to spectroscopy analysis. RESULTS: The group treated with HESM at a dose of 200 mg/kg showed the best healing effect, showing no evidence of ulceration in the macroscopic analysis (p < 0.05). Histopathological analysis showed re-epithelialization, discrete mononuclear inflammatory infiltrate and absence of hemorrhage and edema score of 1 (1-1) (p < 0.05), as well as a large amount of collagen fibers and a lower immunoexpression of Cox-2, iNOS, NF-kB p50 NLS and MMP-2. Decrease in SOD (p < 0.05), MDA (p<0.001), IL-1ß (p < 0.05), and TNF-α levels (p < 0.001), with an increase in GSH (p < 0.01) levels. CONCLUSION: HESM (200 mg/kg) reduced oxidative stress and inflammation in the 5-fluorouracil-induced oral mucositis in hamsters.

Pic-producing escherichia coli induces high production of proinflammatory mediators by the host leading to death by sepsis

Escherichia coli is an important pathogen responsible for a variety of diseases. We have recently shown that Pic, a serine protease secreted by E. coli, mediates immune evasion by the direct cleavage of complement molecules. The aim of this study was to investigate the action of a Pic-producing bacteria in a murine model of sepsis. Mice were infected with Pic-producing E. coli (F5) or F5?pic mutant. Animal survival was monitored for five days, and a subset of mice was euthanized after 12 h for sample acquisition. The inoculation of Pic-producing bacteria induced 100% death within 24 h. The colony forming units count in the organs was significantly higher in F5. Hematological analysis showed a decrease of total leukocytes. Nitric oxide and cytokines were detected in serum, as well as on peritoneal lavage of the F5 group in higher levels than those detected in the other groups. In addition, immunophenotyping showed a decrease of activated lymphocytes and macrophages in the F5 group. Therefore, Pic represents an important virulence factor, allowing the survival of the bacterium in the bloodstream and several organs, as well as inducing a high production of proinflammatory mediators by the host, and concomitantly a cellular immunosuppression, leading to sepsis and death

Pic-producing escherichia coli induces high production of proinflammatory mediators by the host leading to death by sepsis

Escherichia coli is an important pathogen responsible for a variety of diseases. We have recently shown that Pic, a serine protease secreted by E. coli, mediates immune evasion by the direct cleavage of complement molecules. The aim of this study was to investigate the action of a Pic-producing bacteria in a murine model of sepsis. Mice were infected with Pic-producing E. coli (F5) or F5?pic mutant. Animal survival was monitored for five days, and a subset of mice was euthanized after 12 h for sample acquisition. The inoculation of Pic-producing bacteria induced 100% death within 24 h. The colony forming units count in the organs was significantly higher in F5. Hematological analysis showed a decrease of total leukocytes. Nitric oxide and cytokines were detected in serum, as well as on peritoneal lavage of the F5 group in higher levels than those detected in the other groups. In addition, immunophenotyping showed a decrease of activated lymphocytes and macrophages in the F5 group. Therefore, Pic represents an important virulence factor, allowing the survival of the bacterium in the bloodstream and several organs, as well as inducing a high production of proinflammatory mediators by the host, and concomitantly a cellular immunosuppression, leading to sepsis and death

Patient safety in primary health care and polypharmacy: cross-sectional survey among patients with chronic diseases.

OBJECTIVE: to characterize and determine the polypharmacy prevalence in patients with chronic diseases and to identify the factors associated, in order to improvement of pharmaceutical care focused on patient safety. METHODS: cross-sectional study included 558 patients, covered by primary health care, using a household and structured questionnaire. We analyzed the data on polypharmacy and its clinical and socioeconomic factors. Poisson regression analysis with robust variance was applied, with results expressed in prevalence ratio. RESULTS: the results showed that polypharmacy (consumption of four or more drugs) was of 37.6%. The prevalence ratio analyses identified independent variables associated with polypharmacy: age (3.05), economic strata (0.33), way of medication acquisition through a combination of out-of-pocket and Brazilian public health system (1.44), diabetes and hypertension (2.11), comorbidities (coronary artery disease 2.26) and hospital admission (1.73). In the analyses, inappropriate medication use of the 278 patients (≥ 65 years) was associated with polypharmacy (prevalence ratio 4.04). CONCLUSION: polypharmacy study becomes an opportunity to guide the strategies for the patient safety to promote the medication without harm in chronic diseases.

Grau de conhecimento das gestantes do serviço público sobre parto humanizado / Level of knowledge of pregnant women in the public service about humanized birth

INTRODUÇÃO: A conscientização das gestantes é fundamental para experiências positivas de parto. OBJETIVO: Avaliar o grau de conhecimento das gestantes em dois serviços públicos sobre parto humanizado. Caracterizar epidemiologicamente a população estudada. MÉTODOS: Estudo descritivo realizado entre julho e agosto de 2017. Amostra com 297 gestantes foram selecionadas 200 após aplicação dos critérios de exclusão. Utilizados testes estatísticos de associações de variáveis (Qui-quadrado e Exato de Fisher). RESULTADOS: A média de idade das gestantes foi 26,6 anos. A maioria era procedente do interior do estado (72,5%), com renda até um salário mínimo (90,5%), e com mais de oito anos de estudo (62,5%). 71% iniciaram pré-natal até o primeiro trimestre e o pré-natal foi conduzido por médico em 72% dos casos. 71% preferiam parto normal e 44% tinha medo de cesárea. Profissional pré-natalista não ofereceu informações para 66,5%. 30,5% conhecia parto humanizado, destas 83,6% apresentaram conceito adequado. Houve associação entre conhecimento sobre parto humanizado e procedência (Aracaju) (p=0,03), maior renda (p=0,02), menor ocorrência de aborto (p=0,04), médico pré-natalista (p=0,04) preferência pelo parto vaginal (p=0,04). Dentre as que não conheciam o parto humanizado houve associação de respostas corretas com a maior renda (p=0,03) e anos estudados (p=0,02) e médico pré-natalista (p=0,01). CONCLUSÃO: A maioria desconhecia o parto humanizado, era procedente do interior com menor renda, preferência por parto normal, sem informações quanto aos tipos de parto pelo profissional executante (na maioria médicos), quem conhecia adequadamente. Conceitos adequados sobre parto humanizado mesmo na ausência de informação prévia associaram-se às variáveis socioeconômico e pré-natal.

INTRODUCTION: The awareness of pregnant women is fundamental to positive birth experiences. OBJECTIVE: To analyze the level of knowledge on humanized birth of pregnant women from two public services and characterize the sample epidemiologically. METHODS: Descriptive study using questionnaire between June and August 2017. Sample with 297 pregnant women being selected 200 after applying the exclusion criteria. Association test of variables were used (Chi-square and Fisher's exact test). RRESULTS: Mean age was 26.6 years. Majority were from countryside (72.5%), income up to a minimum wage (90.5%) and more of eight years of education (62.5%). 71% started prenatal care in the first trimester and it was conducted by physician in 71% of cases. 71% preferred vaginal delivery and 44% related fear of cesarean. Prenatal professional in charge did not provide information for 66.5%. 30.5% have heard about humanized childbirth, among these, 83.6% showed adequate concepts. Associations were observed between prior knowledge of humanized childbirth and origin (Aracaju) (p=0.03), higher income (p=0.02), lower abortion incidence (p=0.04), prenatal physician (p=0.04) and preference for normal childbirth (p=0.04). Among women without previous knowledge on humanized childbirth there association of correct concept with higher income (p=0.03), schooling (p=0.02) and prenatal physician (p=0.01). CONCLUSION: The majority did not know about humanized delivery, were from the countryside with lower income, preference for normal birth, were not informed on the types of delivery by the professional practitioner (in majority doctors), whom knew properly. Adequate concepts about humanized childbirth, even in the absence of prior information, were associated to socio-economic and prenatal variables.

Recuperação do estado nutricional do paciente oncológico desnutrido relato de caso / Rehabilitation nutrition status of malnourished patient with cancer: case report

Introdução: O câncer esofágico é considerado bastante agressivo, constituindo a sexta causa de óbito por câncer no mundo. A desnutrição proteico-calórica é comum em pacientes com carcinoma esofágico, podendo elevar os índices de morbimortalidade. Método: Trata-se de um relato de caso do tipo observacional descritivo. Apresenta como objetivo descrever como o acompanhamento nutricional ambulatorial foi realizado para reverter o quadro de desnutrição do paciente oncológico antes de ser iniciada a terapia antineoplásica. Resultados: Ao longo do acompanhamento nutricional o paciente conseguiu ganhar peso, massa magra e gorda e força. Discussão: A desnutrição em pacientes com câncer de esôfago é preocupante, pois os mesmos têm problemas nutricionais preexistentes, devido à disfagia e da localização do tumor, que pode afetar a ingestão alimentar, a função gastrointestinal e a utilização de nutrientes. Este quadro deve ser evitado, por meio da oferta da terapia nutricional, para reduzir complicações, o tempo de internação, os custos hospitalares, e a mortalidade. Conclusões: A instauração precoce da terapia nutricional no paciente possibilitou a recuperação do seu estado nutricional antes do início da terapia antineoplásica. O acompanhamento nutricional é fundamental durante o diagnóstico e o tratamento destes pacientes, para prevenir ou corrigir deficiências nutricionais e a desnutrição, e melhorar a qualidade de vida

Introduction: Esophageal cancer is considered very aggressive type of cancer, it's is the the sixth leading cause of cancer death in the world. Protein-caloric malnutrition is common in patients with esophageal carcinoma, increasing morbidity and mortality rates. Method: This is a case report descriptive observational. This report case aims to describe how the ambulatory care of nutrition was performed to reverse the malnutrition status before start of antineoplastic therapy Results: During the nutritional monitoring, the patient had increasing body weight, lean and fat mass and strength. Besides that, he was also an improvement of the biochemical parameters. Discussion: Malnutrition in patients with esophageal cancer is worrisome because they have previous nutritional deficits for to dysphagia and tumor location, which can affect food intake, gastrointestinal function and nutrient metabolism. This clinical condition must be avoided because complications risk, duration of hospital stay, hospital costs and mortality. Conclusions: The early nutritional therapy in the patient recovered nutritional status before the start of antineoplastic therapy. Nutritional monitoring is essential during the diagnosis and treatment of these patients, to prevent or correct nutritional deficiencies and malnutrition, and to improve the quality of life

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Self-care of men with priapism and sickle cell disease.

OBJECTIVE: To identify self-care demands of men with sickle cell disease and priapism and describe self-care measures in light of Orem's Self-Care Theory. METHOD: This is a descriptive exploratory study with qualitative approach conducted with nine men with a history of sickle cell disease and priapism. Data were analyzed using Orem's Self-Care Theory. RESULTS: Some demands were identified: from universal self-care - difficulty in social interaction and solitude, changes in self-image, self-esteem and sexual activity; from development - the experience with priapism and little knowledge about the pathophysiology of the disease; regarding health deviations - pain crises. CONCLUSION: Orem's theory allowed to identify self-care demands, which are essential for the nursing care provided for men with priapism. Nursing has an essential role in the measures for the different demands presented.

Self-care of men with priapism and sickle cell disease / Autocuidado de hombres con priapismo y enfermedad falciforme / Autocuidado de homens com priapismo e doença falciforme

ABSTRACT Objective: To identify self-care demands of men with sickle cell disease and priapism and describe self-care measures in light of Orem's Self-Care Theory. Method: This is a descriptive exploratory study with qualitative approach conducted with nine men with a history of sickle cell disease and priapism. Data were analyzed using Orem's Self-Care Theory. Results: Some demands were identified: from universal self-care - difficulty in social interaction and solitude, changes in self-image, self-esteem and sexual activity; from development - the experience with priapism and little knowledge about the pathophysiology of the disease; regarding health deviations - pain crises. Conclusion: Orem's theory allowed to identify self-care demands, which are essential for the nursing care provided for men with priapism. Nursing has an essential role in the measures for the different demands presented.

RESUMEN Objetivo: Identificar las demandas sobre autocuidado de hombres con enfermedad falciforme y priapismo y describir las medidas del autocuidado a la luz de la Teoría de Orem. Método: Se trata de una investigación descriptiva, exploratoria, de abordaje cualitativo, realizada entre nueve hombres con historia clínica de enfermedad falciforme y priapismo. El análisis de los datos se llevó a cabo según la Teoría del Autocuidado de Orem. Resultados: se identificaron algunas demandas: del autocuidado universal: dificultad de interacción social y soledad, alteraciones de la autoimagen y autoestima y actividad sexual; del desarrollo: la experiencia con el priapismo y el conocimiento insuficiente sobre la fisiopatología de la enfermedad; sobre desviaciones de la salud: crisis de dolor. Conclusión: La teoría de Orem permitió identificar las demandas del autocuidado, esenciales para la atención de enfermería en hombres con priapismo y resaltó la importancia de la enfermería acerca de las medidas a ser tomadas en las diferentes demandas.

RESUMO Objetivo: Identificar as demandas de autocuidado de homens com doença falciforme e priapismo e descrever as medidas de autocuidado à luz da Teoria do Autocuidado de Orem. Método: Trata-se de uma pesquisa descritiva, exploratória, de abordagem qualitativa, com nove homens com história clínica de doença falciforme e priapismo. A análise dos dados foi realizada por meio da Teoria do Autocuidado de Orem. Resultados: Foram identificadas algumas demandas: de autocuidado universal - dificuldade de interação social e solidão, alterações na autoimagem e autoestima e atividade sexual; de desenvolvimento - a experiência com o priapismo o e pouco conhecimento sobre a fisiopatologia da doença; em relação a desvios de saúde - crises de dor. Conclusão: A teoria de Orem possibilitou identificar as demandas de autocuidado, que são essenciais para cuidado de enfermagem a homens com priapismo, e a importância da enfermagem frente às medidas para diferentes demandas apresentadas.

Protective effect of angiotensin II receptor blocker against oxidative stress and inflammation in an oral mucositis experimental model.

BACKGROUND: The aim of this study was to evaluate the effect of olmesartan medoxomil (Olme), an angiotensin II receptor antagonist, on oral mucositis (OM) experimental model. METHODS: Oral mucositis was induced in hamsters with 5-fluorouracil (5-FU; 60 mg/kg day 1 and 40 mg/kg day 2). Animals (n = 10/group) were pretreated with oral Olme (1, 5, or 10 mg/kg) or vehicle 30 minutes before 5-FU injection and daily, until day 10. Cheek pouch samples were subjected to histopathological and immunostaining analysis of IL-1ß, TNF-α, IL-10, TGF-ß, macrophage migration inhibitory factor (MIF), SOD, MMP-2 and FGF-2. In addition, IL-1ß and TNF-α levels were evaluated by ELISA. Myeloperoxidase activity (MPO), glutathione (GSH) and malondialdehyde (MDA) levels were investigated by spectroscopic UV/VIS analysis. Reverse transcriptase polymerase chain reactions (RT-PCRs) were used to quantify the expression of IL-1ß, TNF-α, NF-κBp65, MKP1 and ACE2. Inducible nitric oxide synthase (iNOS) and extracellular regulated kinase (ERK)1/2 protein levels were analysed by Western blot. RESULTS: Treatment with 10 mg/kg Olme reduced ulceration, inflammatory cell infiltration, MPO activity, MDA levels, iNOS and ERK1/2 proteins levels, MIF expression and TNF-α and IL-1ß of levels and gene expression. These findings were associated with a significant increase in the immunostaining of IL-10, FGF-2 and TGF-ß. In addition, gene expression of IL-1ß, TNF-α, NF-κBp65 MKP1 and ACE2 was decreased. CONCLUSION: Olmesartan at a dose of 10 mg/kg prevented the mucosal damage and inflammation associated with 5-FU-induced OM, increasing granulation and tissue repair.