Evaluation of periodontal parameters on abutment teeth rehabilitated with single-unit crowns: A 12-month follow-up.

Purpose: This prospective study evaluated the effects of the metal-free crowns on the periodontal tissues of abutment teeth during a 12-month follow-up. Materials and Methods: A sample of 24 patients (N = 32 abutment teeth) who needed a single-tooth restoration were enrolled to receive either a metal-ceramic (n = 21) or lithium disilicate (n = 11). The single-unit crowns were evaluated at baseline, 3-and 12-month follow-up. The periodontal parameters were evaluated: plaque index (PI), gingival bleeding index (GBI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), radiographically and clinical crown fitting, bone resorption, and marginal finish lines. Statistical analyses were performed using the Exact Fisher and Mann-Whitney tests, and the Wilcoxon signed-rank test as a post hoc test for Friedman (95 % confidence interval). Results: The marginal finish line showed a statistical difference with a biomaterial type (p =.004). After a 12-months, a significant increase was observed in PI and mean PD for abutment teeth of metal-ceramic crowns. The metal-free crowns presented higher values for GBI and CAL (p2 < 0.05). Only distal cervical evaluation and dental biofilm formation in the abutment teeth showed a statistical difference between the groups at the 12-month follow-up. The supragingival margin metal-ceramic group revealed higher PI values (p2 = 0.005) between the period and the subgingival margin of both biomaterials showed greater GBI scores (p2 < 0.05). Conclusions: Metal-free crowns showed better periodontal outcomes compared to metal-ceramic crowns. Single-unit crown marginal location affects the periodontal tissue condition of the abutment teeth. The marginal fit was not changed regarding the biomaterial type.

Bioengineered skin constructs based on mesenchymal stromal cells and acellular dermal matrix exposed to inflammatory microenvironment releasing growth factors involved in skin repair.

BACKGROUND: Skin tissue engineering is a rapidly evolving field of research that effectively combines stem cells and biological scaffolds to replace damaged tissues. Human Wharton's jelly mesenchymal stromal cells (hWJ-MSCs) are essential to generate tissue constructs, due to their potent immunomodulatory effects and release of paracrine factors for tissue repair. Here, we investigated whether hWJ-MSC grown on human acellular dermal matrix (hADM) scaffolds and exposed to a proinflammatory environment maintain their ability to produce in vitro growth factors involved in skin injury repair and promote in vivo wound healing. METHODS: We developed a novel method involving physicochemical and enzymatic treatment of cadaveric human skin to obtain hADM scaffold. Subsequently, skin bioengineered constructs were generated by seeding hWJ-MSCs on the hADM scaffold (construct 1) and coating it with human platelet lysate clot (hPL) (construct 2). Either construct 1 or 2 were then incubated with proinflammatory cytokines (IL-1α, IL-1ß, IL-6, TNF-α) for 12, 24, 48, 72 and 96 h. Supernatants from treated and untreated constructs and hWJ-MSCs on tissue culture plate (TCP) were collected, and concentration of the following growth factors, bFGF, EGF, HGF, PDGF, VEGF and Angiopoietin-I, was determined by immunoassay. We also asked whether hWJ-MSCs in the construct 1 have potential toward epithelial differentiation after being cultured in an epithelial induction stimulus using an air-liquid system. Immunostaining was used to analyze the synthesis of epithelial markers such as filaggrin, involucrin, plakoglobin and the mesenchymal marker vimentin. Finally, we evaluated the in vivo potential of hADM and construct 1 in a porcine full-thickness excisional wound model. RESULTS: We obtained and characterized the hADM and confirmed the viability of hWJ-MSCs on the scaffold. In both constructs without proinflammatory treatment, we reported high bFGF production. In contrast, the levels of other growth factors were similar to the control (hWJ-MSC/TCP) with or without proinflammatory treatment. Except for PDGF in the stimulated group. These results indicated that the hADM scaffold maintained or enhanced the production of these bioactive molecules by hWJ-MSCs. On the other hand, increased expression of filaggrin, involucrin, and plakoglobin and decreased expression of vimentin were observed in constructs cultured in an air-liquid system. In vivo experiments demonstrated the potential of both hADM and hADM/hWJ-MSCs constructs to repair skin wounds with the formation of stratified epithelium, basement membrane and dermal papillae, improving the appearance of the repaired tissue. CONCLUSIONS: hADM is viable to fabricate a tissue construct with hWJ-MSCs able to promote the in vitro synthesis of growth factors and differentiation of these cells toward epithelial lineage, as well as, promote in a full-thickness skin injury the new tissue formation. These results indicate that hADM 3D architecture and its natural composition improved or maintained the cell function supporting the potential therapeutic use of this matrix or the construct for wound repair and providing an effective tissue engineering strategy for skin repair.

In vitro and in vivo evaluation of electrospun poly (ε-caprolactone)/collagen scaffolds and Wharton's jelly mesenchymal stromal cells (hWJ-MSCs) constructs as potential alternative for skin tissue engineering.

Dermal substitutes bear a high clinical demand because of their ability to promote the healing process of cutaneous wounds by reducing the healing time the appearance and improving the functionality of the repaired tissue. Despite the increasing development of dermal substitutes, most of them are only composed of biological or biosynthetic matrices. This demonstrates the need for new developments focused on using scaffolds with cells (tissue construct) that promote the production of factors for biological signaling, wound coverage, and general support of the tissue repair process. Here, we fabricate by electrospinning two scaffolds: poly(ε-caprolactone) (PCL) as a control and poly(ε-caprolactone)/collagen type I (PCol) in a ratio lower collagen than previously reported, 19:1, respectively. Then, characterize their physicochemical and mechanical properties. As we bear in mind the creation of a biologically functional construct, we characterize and assess in vitro the implications of seeding human Wharton's jelly mesenchymal stromal cells (hWJ-MSCs) on both scaffolds. Finally, to determine the potential functionality of the constructs in vivo, their efficiency was evaluated in a porcine biomodel. Our findings demonstrated that collagen incorporation in the scaffolds produces fibers with similar diameters to those in the human native extracellular matrix, increases wettability, and enhances the presence of nitrogen on the scaffold surface, improving cell adhesion and proliferation. These synthetic scaffolds improved the secretion of factors by hWJ-MSCs involved in skin repair processes such as b-FGF and Angiopoietin I and induced its differentiation towards epithelial lineage, as shown by the increased expression of Involucrin and JUP. In vivo experiments confirmed that lesions treated with the PCol/hWJ-MSCs constructs might reproduce a morphological organization that seems relatively equivalent to normal skin. These results suggest that the PCol/hWJ-MSCs construct is a promising alternative for skin lesions repair in the clinic.

Eficácia das técnicas de higiene oral em pacientes internados em unidades de terapia intensiva / Effectiveness of oral hygiene techniques in patients hospitalized in intensive care units

Objetivo: verificar a eficácia das técnicas de higiene oral, solução de clorexidina com gaze e espátula e da escovação dentária com solução de clorexidina no controle microbiológico oral de pacientes internados em UTI. Metodologia: as bases de dados utilizadas foram PUB MED, MEDLINE, SCIELO e LILACS em março a julho de 2019. Foram incluídos artigos na língua inglesa e portuguesa, disponíveis em livre acesso com o texto completo, com período de publicação entre 2009 a 2019 e que abordassem sobre os métodos de higiene oral na UTI e relacionasse a enfermidades encontradas nesse ambiente. Resultados: foram encontrados 32 artigos, 8 se enquadravam nos critérios de inclusão. Os artigos de revisão evidenciaram a importância da higiene oral em pacientes com ventilação mecânica e relatam o uso da clorexidina como método eficaz na prevenção de PAV. Já nos estudos clínicos randomizados, mostram não haver diferença estatisticamente significativa entre o uso da escova dental e a solução de clorexidina 0,12%. Conclusão: ambos os métodos são eficientes na higienização oral de pacientes internados e que não há diferença significativa nos estudos quando comparam a escova de dentes com o uso da clorexidina com gaze para a higiene oral na UTI. Mas quando se fala em prevenção de PAV, a clorexidina 0,12% é o mais citado(AU)

Objective: to verify the effectiveness of oral hygiene techniques, chlorhexidine solution with gauze and spatula and toothbrushing with chlorhexidine solution in the oral microbiological control of patients admitted to the ICU. Methodology: the databases used were PUB MED, MEDLINE, SCIELO and LILACS in March to July 2019. Articles in English and Portuguese were included, freely available with the full text, with a period of publication between 2009 and 2019 and to address oral hygiene methods in the ICU and relate to diseases found in that environment. Results: 32 articles were found, 8 fit the inclusion criteria. The review articles highlighted the importance of oral hygiene in patients with mechanical ventilation and report the use of chlorhexidine as an effective method in preventing VAP. In randomized clinical studies, however, they show no statistically significant difference between the use of the toothbrush and the 0.12% chlorhexidine solution. Conclusion: both methods are efficient in oral hygiene of hospitalized patients and that there is no significant difference in the studies when comparing the toothbrush with the use of chlorhexidine with gauze for oral hygiene in the ICU. But when talking about VAP prevention, 0.12% chlorhexidine is the most cited(AU)

Strategy for the Generation of Engineered Bone Constructs Based on Umbilical Cord Mesenchymal Stromal Cells Expanded with Human Platelet Lysate.

Umbilical cord mesenchymal stromal cells (UC-MSC) are promising candidates for cell therapy due to their potent multilineage differentiation, enhanced self-renewal capacity, and immediate availability for clinical use. Clinical experience has demonstrated satisfactory biosafety profiles and feasibility of UC-MSC application in the allogeneic setting. However, the use of UC-MSC for bone regeneration has not been fully established. A major challenge in the generation of successful therapeutic strategies for bone engineering lies on the combination of highly functional proosteogenic MSC populations and bioactive matrix scaffolds. To address that, in this study we proposed a new approach for the generation of bone-like constructs based on UC-MSC expanded in human platelet lysate (hPL) and evaluated its potential to induce bone structures in vivo. In order to obtain UC-MSC for potential clinical use, we first assessed parameters such as the isolation method, growth supplementation, microbiological monitoring, and cryopreservation and performed full characterization of the cell product including phenotype, growth performance, tree-lineage differentiation, and gene expression. Finally, we evaluated bone-like constructs based on the combination of stimulated UC-MSC and collagen microbeads for in vivo bone formation. UC-MSC were successfully cultured from 100% of processed UC donors, and efficient cell derivation was observed at day 14 ± 3 by the explant method. UC-MSC maintained mesenchymal cell morphology, phenotype, high cell growth performance, and probed multipotent differentiation capacity. No striking variations between donors were recorded. As expected, UC-MSC showed tree-lineage differentiation and gene expression profiles similar to bone marrow- and adipose-derived MSC. Importantly, upon osteogenic and endothelial induction, UC-MSC displayed strong proangiogenic and bone formation features. The combination of hPL-expanded MSC and collagen microbeads led to bone/vessel formation following implantation into an immune competent mouse model. Collectively, we developed a high-performance UC-MSC-based cell manufacturing bioprocess that fulfills the requirements for human application and triggers the potency and effectivity of cell-engineered scaffolds for bone regeneration.

A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered randomized trial.

BACKGROUND: Depression is viewed as a major and increasing public health issue, as it causes high distress in the people experiencing it and considerable financial costs to society. Efforts are being made to reduce this burden by preventing depression. A critical component of this strategy is the ability to assess the individual level and profile of risk for the development of major depression. This paper presents the cost-effectiveness of a personalized intervention based on the risk of developing depression carried out in primary care, compared with usual care. METHODS: Cost-effectiveness analyses are nested within a multicentre, clustered, randomized controlled trial of a personalized intervention to prevent depression. The study was carried out in 70 primary care centres from seven cities in Spain. Two general practitioners (GPs) were randomly sampled from those prepared to participate in each centre (i.e. 140 GPs), and 3326 participants consented and were eligible to participate. The intervention included the GP communicating to the patient his/her individual risk for depression and personal risk factors and the construction by both GPs and patients of a psychosocial programme tailored to prevent depression. In addition, GPs carried out measures to activate and empower the patients, who also received a leaflet about preventing depression. GPs were trained in a 10- to 15-h workshop. Costs were measured from a societal and National Health care perspective. Qualityadjustedlife years were assessed using the EuroQOL five dimensions questionnaire. The time horizon was 18 months. RESULTS: With a willingness-to-pay threshold of €10,000 (£8568) the probability of cost-effectiveness oscillated from 83% (societal perspective) to 89% (health perspective). If the threshold was increased to €30,000 (£25,704), the probability of being considered cost-effective was 94% (societal perspective) and 96%, respectively (health perspective). The sensitivity analysis confirmed these results. CONCLUSIONS: Compared with usual care, an intervention based on personal predictors of risk of depression implemented by GPs is a cost-effective strategy to prevent depression. This type of personalized intervention in primary care should be further developed and evaluated. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01151982. Registered on June 29, 2010.

Construction and validation of a virtual learning object on intestinal elimination stoma / Construcción y validación de un objeto virtual de aprendizaje sobre estomas intestinales de eliminación / Construção e validação de um objeto virtual de aprendizagem sobre estomas intestinais de eliminação

Objective.To construct and validate a virtual learning object (VLO) on intestinal elimination stoma. Methods. Applied, descriptive and quantitative study. In 2014, eight stoma therapists and eight experts in computer science took part of the research. The VLO included four steps: i) planning, ii) construction of VLO and changes of content; iii) development of dynamic, and iv) conclusion and analysis. The VLO was inserted into the Moodle virtual learning environment. The ergonomic and pedagogical validation of the VLO was performed. Results. The experts appreciated the VLO satisfactorily, and scored it between good and full agreement. Conclusion. The VLO on intestinal elimination stoma is a tool that can be implemented at undergraduate programs in nursing and continuing education programs for nurses in clinical practice, contributing significantly to improve the theoretical skills necessary for the care of ostomized people safely, with quality and enabling self-care.

Objetivo.Construir y validar un Objeto Virtual de Aprendizaje (OVA) sobre estomas intestinales. Métodos. Investigación aplicada, descriptiva y cuantitativa. En 2014 participaron ocho estomaterapeutas y ocho especialistas en informática. El OVA contempló cuatro etapas: i) planeación, ii) construcción del OVA y cambios de los contenidos, iii) desarrollo de la dinámica, y iv) conclusión y análisis. El OVA se añadió al ambiente virtual de aprendizaje Moodle. Se realizó la validación ergonómica y pedagógica del OVA. Resultados. Los especialistas apreciaron satisfactoriamente el OVA; de hecho, el acuerdo de expertos se puntuó entre la buena concordancia a la concordancia plena. Conclusión. El OVA sobre estomas intestinales es una herramienta que puede ser implementada en el Curso de Graduación de Enfermería y en los programas de educación permanente para enfermeros en la práctica clínica, contribuyendo significativamente a mejorar la competencia teórica necesaria para el cuidado de personas estomizadas de forma segura, con calidad y posibilitando el autocuidado.

Construir e validar um objeto virtual de aprendizagem (OVA) sobre estomas intestinais de eliminação. Métodos. Pesquisa aplicada, descritiva e quantitativa. Em 2014 participaram oito Estomaterapeutas e oito especialistas em Informática. O OVA contemplou quatro etapas: i) planejamento, ii) construção do OVA e mudanças dos conteúdos; iii) desenvolvimento da dinâmica, e iv) conclusão e análise. O OVA foi inserido no ambiente virtual de aprendizagem Moodle. Realizou-se a validação ergonômica e pedagógica do OVA. Resultados. Os especialistas apreciaram satisfatoriamente o OVA, o acordo de especialistas pontuou-se entre a boa concordância a concordância plena. Conclusão. O OVA sobre estomas intestinais de eliminação é uma ferramenta que pode ser implementada no Curso de Graduação em Enfermagem e nos programas de educação permanente para enfermeiros na prática clínica, contribuindo significativamente a melhorar a competência teórica necessária para o cuidado de pessoas estomizadas de forma segura, com qualidade e possibilitando o autocuidado.

Intervention to Prevent Major Depression in Primary Care: A Cluster Randomized Trial.

BACKGROUND: Not enough is known about universal prevention of depression in adults. OBJECTIVE: To evaluate the effectiveness of an intervention to prevent major depression. DESIGN: Multicenter, cluster randomized trial with sites randomly assigned to usual care or an intervention. (ClinicalTrials.gov: NCT01151982). SETTING: 10 primary care centers in each of 7 cities in Spain. PARTICIPANTS: Two primary care physicians (PCPs) and 5236 nondepressed adult patients were randomly sampled from each center; 3326 patients consented and were eligible to participate. INTERVENTION: For each patient, PCPs communicated individual risk for depression and personal predictors of risk and developed a psychosocial program tailored to prevent depression. MEASUREMENTS: New cases of major depression, assessed every 6 months for 18 months. RESULTS: At 18 months, 7.39% of patients in the intervention group (95% CI, 5.85% to 8.95%) developed major depression compared with 9.40% in the control (usual care) group (CI, 7.89% to 10.92%) (absolute difference, -2.01 percentage points [CI, -4.18 to 0.16 percentage points]; P = 0.070). Depression incidence was lower in the intervention centers in 5 cities and similar between intervention and control centers in 2 cities. LIMITATION: Potential self-selection bias due to nonconsenting patients. CONCLUSION: Compared with usual care, an intervention based on personal predictors of risk for depression implemented by PCPs provided a modest but nonsignificant reduction in the incidence of major depression. Additional study of this approach may be warranted. PRIMARY FUNDING SOURCE: Institute of Health Carlos III.

Construction and validation of a virtual learning object on intestinal elimination stoma.

OBJECTIVE: To construct and validate a virtual learning object (VLO) on intestinal elimination stoma. METHODS: Applied, descriptive and quantitative study. In 2014, eight stoma therapists and eight experts in computer science took part of the research. The VLO included four steps: i) planning, ii) construction of VLO and changes of content; iii) development of dynamic, and iv) conclusion and analysis. The VLO was inserted into the Moodle virtual learning environment. The ergonomic and pedagogical validation of the VLO was performed. RESULTS: The experts appreciated the VLO satisfactorily, and scored it between good and full agreement. CONCLUSION: The VLO on intestinal elimination stoma is a tool that can be implemented at undergraduate programs in nursing and continuing education programs for nurses in clinical practice, contributing significantly to improve the theoretical skills necessary for the care of ostomized people safely, with quality and enabling self-care.

Volume calculation of rats' organs and its application in the validation of the volume relation between the abdominal cavity and the hernial sac in incisional hernias with "loss of abdominal domain".

BACKGROUND: The calculation of the volume ratio between the hernia sac and the abdominal cavity of incisional hernias is based on tomographic sections as well as the mathematical formula of the volume of the ellipsoid, which allows determining whether this is a giant hernia or there is a "loss of domain". As the images used are not exact geometric figures, the study of the volume of two solid organs of Wistar rats was performed to validate these calculations. AIM: To correlate two methods for determining the volume of the kidney and spleen of rats, comparing a direct method of observation of the volume with the mathematical calculation of this value. METHODS: The volume of left kidney, geometrically more regular, and spleen, with its peculiar shape, of ten animals was established in cubic centimeters after complete immersion in water with the aid of a beaker graduated in millimeters. These values ​​were compared with those obtained by calculating the same volume with a specific mathematical formula: V = 4/3 × π × (r1 x r2 x r3). Data were compared and statistically analyzed by Student's t test. RESULTS: Although the average volume obtained was higher through the direct method (1.13 cm3 for the left kidney and 0.71 cm3 for the spleen) than the values ​​calculated with the mathematical formula (0.81 cm3 and 0.54 cm3), there were no statistically significant differences between the values ​​found for the two organs (p>0.05). CONCLUSION: There was adequate correlation between the direct calculation of the volume of the kidney and spleen with the result of mathematical calculation of these values ​​in the animals' studies.

Volume calculation of rats' organs and its application in the validation of the volume relation between the abdominal cavity and the hernial sac in incisional hernias with "loss of abdominal domain" / Cálculo do volume de órgãos de ratos e sua aplicação na validação da relação de volumes entre a cavidade abdominal e o saco herniário em hérnias incisionais com "perda de domicílio"

BACKGROUND: The calculation of the volume ratio between the hernia sac and the abdominal cavity of incisional hernias is based on tomographic sections as well as the mathematical formula of the volume of the ellipsoid, which allows determining whether this is a giant hernia or there is a "loss of domain". As the images used are not exact geometric figures, the study of the volume of two solid organs of Wistar rats was performed to validate these calculations. AIM: To correlate two methods for determining the volume of the kidney and spleen of rats, comparing a direct method of observation of the volume with the mathematical calculation of this value. METHODS: The volume of left kidney, geometrically more regular, and spleen, with its peculiar shape, of ten animals was established in cubic centimeters after complete immersion in water with the aid of a beaker graduated in millimeters. These values ​​were compared with those obtained by calculating the same volume with a specific mathematical formula: V = 4/3 × π × (r1 x r2 x r3). Data were compared and statistically analyzed by Student's t test. RESULTS: Although the average volume obtained was higher through the direct method (1.13 cm3 for the left kidney and 0.71 cm3 for the spleen) than the values ​​calculated with the mathematical formula (0.81 cm3 and 0.54 cm3), there were no statistically significant differences between the values ​​found for the two organs (p>0.05). CONCLUSION: There was adequate correlation between the direct calculation of the volume of the kidney and spleen with the result of mathematical calculation of these values ​​in the animals' studies. .

RACIONAL: O cálculo da relação de volumes entre o saco herniário e a cavidade abdominal em hérnias incisionais é feito com base em cortes tomográficos e com a fórmula matemática do volume da elipsóide, permitindo determinar se a hérnia é gigante ou se há "perda de domicílio". Como as imagens utilizadas não são figuras geométricas exatas, foi realizado o estudo do volume de dois órgãos sólidos de ratos da linhagem Wistar, para validar estes cálculos. OBJETIVO: Correlacionar dois métodos para determinação do volume do rim e do baço de ratos, comparando um método direto de avaliação do volume com o cálculo matemático deste valor. MÉTODOS: O volume do rim esquerdo, geometricamente mais regular, e do baço, com seu formato peculiar, de dez animais foram estabelecidos em centímetros cúbicos após imersão total em água, com auxílio de proveta graduada em milímetros; estes valores foram comparados com os obtidos através do cálculo do mesmo volume com fórmula matemática específica: V= 4/3 x π x (r1 x r2 x r3). Os dados obtidos foram comparados e submetidos à análise estatística pelo teste t de Student. RESULTADOS: Embora o volume médio obtido tenha sido maior com o método direto, 1,13 cm3 para o rim esquerdo e 0,71 cm3 para o baço, do que os valores calculados com a fórmula matemática, 0,81 cm3 e 0,54 cm3 respectivamente, não houve significância estatística entre as diferenças dos valores encontrados para os dois órgãos (p>0,05). CONCLUSÃO: Houve correlação adequada entre o cálculo direto do volume do rim e do baço com o resultado do cálculo matemático destes valores nos animais estudados. .

Perfil de pacientes estomizados: revisão integrativa da literatura / Perfil de los pacientes ostomizados: revisión integrativa de la literatura / Profile of ostomy patients: integrative review of the literature

Uma análise acerca do perfil de estomizados, através de estudos multicêntricos que retratem as características específicas desses pacientes, contribui para o atendimento de suas reais necessidades e para o direcionamento de políticas públicas e de saúde para melhoria da qualidade de vida dessa clientela. Este estudo objetiva investigar a produção científica acerca do perfil de pacientes estomizados, no período de 2004 a 2012. Trata-se de uma revisão integrativa da literatura realizada por meio de busca eletrônica nas bases: Lilacs, Scielo, Bdenf e na Revista Estima, por tratar-se de um periódico especializado da Sociedade Brasileira de Estomaterapia. Fizeram parte da amostra dez artigos que contemplaram os critérios de inclusão. Identificou-se que todos os estudos foram realizados no Brasil, em estados e regiões diversas e a grande maioria por enfermeiros. O perfil sociodemográfico e epidemiológico dos estomizados mostra prevalência do sexo feminino, com predomínio de adultos e idosos, o câncer colorretal como principal causa para realização do estoma, e a colostomia como tipo de estomia predominante. Verifica-se que o foco desta temática ainda apresenta uma produção científica incipiente, com estudos pontuais, pouco abrangentes e baixa regularidade. Sugere-se que sejam realizados novos estudos para subsidiar uma melhor qualificação da assistência ao usuário (AU)

Mediante el análisis sobre el perfil de ostomía en los estudios multicéntricos que describen las características específicas de estos pacientes ostomizados, se contribuye a la satisfacción de sus necesidades reales y la focalización de las políticas públicas y de salud para mejorar la calidad de vida de los mismos. Este estudio tiene como objetivo investigar el perfil científico de los pacientes ostomizados en el período 2004-2012. Se trata de una revisión integradora de la literatura realizada por una búsqueda electrónica en las bases de datos: Lilacs, scielo, Bdenf y la revista estima, porque es una revista especializada de la Sociedad Brasileña de Estomaterapia. La muestra estuvo conformada por diez artículos que contemplan los criterios de inclusión. Todos los estudios se llevaron a cabo en Brasil en diversos estados y regiones y la gran mayoría de las enfermeras. La prevalencia sociodemográfica y epidemiológica de los pacientes ostomizados muestra predominio femenino de adultos mayores, el cáncer colorrectal es la causa principal para la realización del estoma y colostomía como el tipo predominante de ostomía. Parece que el enfoque de este tema sigue aún en un período de relativa a infancia científica, con estudios de escasa y baja regularidad. Se sugiere que otros estudios se llevaron a cabo con la finalidad de apoyar un mejor cuidado de la salud del usuario (AU)

An analysis on the profile of ostomy, multicenter studies that portray the specific characteristics of these patients, contributes to meeting their real needs and the targeting of public policies and health to improve the quality of life for these clients. This study aims to investigate the scientific profile about ostomy patients in the period 2004-2012. It is an integrative literature review performed by an electronic search in databases: Lilacs, Scielo, and Bdenf Magazine estimated , because it is a specialized journal of the Brazilian Society of Stomatherapy. The sample consisted of ten articles which contemplated the inclusion criteria. It was found that all studies were conducted in Brazil in various states and regions and the vast majority of nurses. The sociodemographic and epidemiological prevalence of ostomy shows female predominance of older adults, colorectal cancer as the main cause for the realization of the stoma and colostomy as the predominant type of ostomy. It appears that the focus of this issue is still of scientific infancy, with specific studies, little comprehensive and low regularity. It is suggested that further studies be conducted to support improved health care user (AU)

Perfil de pacientes ostomizados atendidos por la estrategia salud de la familia / Profile of ostomized patients assisted by family health strategy

Objetivo: analizar el perfil de pacientes ostomizados atendidos por la estrategia salud de la familia. Métodos: estudio exploratorio descriptivo, con abordaje cuantitativo, realizado con 45 pacientes ostomizados, de ambos sexos, cuya muestra se conformó con el 100 por ciento de estos pacientes. Los datos fueron recolectados por medio de un formulario en el período de julio a agosto de 2013, a través de técnica de entrevista y examen físico, categorizados en Microsoft Excel y procesados utilizando el paquete estadístico SPSS 16.0 por estadística descriptiva. Resultados: prevalecieron las mujeres (57,8 por ciento), predominantemente con edades entre 20-59 años (55,6 por ciento), en su mayoría con bajo nivel educativo (55,6 por ciento) y de bajos ingresos (75,6 por ciento). Como la causa subyacente de las ostomías, predominaron las enfermedades inflamatorias intestinales (40,0 por ciento); la mayoría eran colostomía (77,8 por ciento), temporales (66,7 por ciento), uso de dispositivo de una pieza (80 por ciento), del tipo drenable (60 por ciento) y con barrera de protección (62,2 por ciento). Conclusiones: el conocimiento del perfil de la persona ostomizada y las peculiaridades asociadas con el ostoma son esenciales para conducir la atención de enfermería, con vistas a la participación activa del cliente articulado con otros profesionales que participan en el cuidado perioperatorio y seguimiento del proceso de rehabilitación(AU)

Objective: To analyze the profile of ostomized patients assisted by family health strategy. Methods: Exploratory descriptive study with quantitative approach, performed with 45 ostomy patients of both sexes, whose sample covered 100 percent of patients. Data were collected through a form between July to August 2013, through technical interview and physical examination, categorization in Microsoft Excel and processed using the SPSS 16.0 by descriptive statistics. Results: Identified himself a predominance female (57,8 percent), predominantly aged 20-59 years (55,6 percent), mostly with low education (55,6 percent) and low family income (75,6 percent). As the underlying cause of ostomy predominant inflammatory bowel diseases (40,0 percent); most were colostomy (77,8 percent), temporary (66,7 percent), made use of a piece of scholarships (80,0 percent), drainable (60,0 percent) and protective barrier (62,2 percent). Conclusions: Knowledge of the profile of the person stoma and the peculiarities related to stoma shows is essential for directing nursing care, given the active participation of the client articulated with other professionals involved in the course of the perioperative and follow-up of rehabilitation process(AU)

Patients' opinions about knowing their risk for depression and what to do about it. The predictD-qualitative study.

BACKGROUND: The predictD study developed and validated a risk algorithm for predicting the onset of major depression in primary care. We aimed to explore the opinion of patients about knowing their risk for depression and the values and criteria upon which these opinions are based. METHODS: A maximum variation sample of patients was taken, stratified by city, age, gender, immigrant status, socio-economic status and lifetime depression. The study participants were 52 patients belonging to 13 urban health centres in seven different cities around Spain. Seven Focus Groups (FGs) were given held with primary care patients, one for each of the seven participating cities. RESULTS: The results showed that patients generally welcomed knowing their risk for depression. Furthermore, in light of available evidence several patients proposed potential changes in their lifestyles to prevent depression. Patients generally preferred to ask their General Practitioners (GPs) for advice, though mental health specialists were also mentioned. They suggested that GPs undertake interventions tailored to each patient, from a "patient-centred" approach, with certain communication skills, and giving advice to help patients cope with the knowledge that they are at risk of becoming depressed. CONCLUSIONS: Patients are pleased to be informed about their risk for depression. We detected certain beliefs, attitudes, values, expectations and behaviour among the patients that were potentially useful for future primary prevention programmes on depression.

Preventing the onset of major depression based on the level and profile of risk of primary care attendees: protocol of a cluster randomised trial (the predictD-CCRT study).

BACKGROUND: The 'predictD algorithm' provides an estimate of the level and profile of risk of the onset of major depression in primary care attendees. This gives us the opportunity to develop interventions to prevent depression in a personalized way. We aim to evaluate the effectiveness, cost-effectiveness and cost-utility of a new intervention, personalized and implemented by family physicians (FPs), to prevent the onset of episodes of major depression. METHODS/DESIGN: This is a multicenter randomized controlled trial (RCT), with cluster assignment by health center and two parallel arms. Two interventions will be applied by FPs, usual care versus the new intervention predictD-CCRT. The latter has four components: a training workshop for FPs; communicating the level and profile of risk of depression; building up a tailored bio-psycho-family-social intervention by FPs to prevent depression; offering a booklet to prevent depression; and activating and empowering patients. We will recruit a systematic random sample of 3286 non-depressed adult patients (1643 in each trial arm), nested in 140 FPs and 70 health centers from 7 Spanish cities. All patients will be evaluated at baseline, 6, 12 and 18 months. The level and profile of risk of depression will be communicated to patients by the FPs in the intervention practices at baseline, 6 and 12 months. Our primary outcome will be the cumulative incidence of major depression (measured by CIDI each 6 months) over 18 months of follow-up. Secondary outcomes will be health-related quality of life (SF-12 and EuroQol), and measurements of cost-effectiveness and cost-utility. The inferences will be made at patient level. We shall undertake an intention-to-treat effectiveness analysis and will handle missing data using multiple imputations. We will perform multi-level logistic regressions and will adjust for the probability of the onset of major depression at 12 months measured at baseline as well as for unbalanced variables if appropriate. The economic evaluation will be approached from two perspectives, societal and health system. DISCUSSION: To our knowledge, this will be the first RCT of universal primary prevention for depression in adults and the first to test a personalized intervention implemented by FPs. We discuss possible biases as well as other limitations. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01151982.