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1.
Environ Monit Assess ; 196(3): 247, 2024 Feb 09.
Article in English | MEDLINE | ID: mdl-38332213

ABSTRACT

In November 2015, the Fundão Dam break released millions of tons of metal-rich tailings into the Doce River Basin (DRB), causing catastrophic damage and potential ecological effects that reached the Atlantic Ocean. This study aimed to evaluate the geochemistry and toxicity of water and sediments collected in the DRB from 2015 to 2019 and to determine the spatial and temporal trends. Water and sediment samples were analyzed for metals and As by inductively coupled plasma optical emission spectrometry (ICP-OES), and acute toxicity for Daphnia similis or D. magna. Results were explored using geochemical indices and correlation analyzes. Overall, higher concentrations of metals and As in water and sediments were observed immediately after dam breakage, but the levels exhibited a decreasing trend over time, although the levels of some elements such as As and Mn remained high in the upper DRB. The geochemical indices indicated mostly low to moderate contamination, and the enrichment factor (EF) demonstrated a higher enrichment of Mn in the upper DRB. Acute toxicity to water fleas (D. similis and D. magna) was occasionally observed in waters and sediments, but the reference samples were toxic, and the short-term effects were not correlated with metals and As. Overall, the results showed limited bioavailability of metals and As and a decreasing trend in their concentrations, indicating an ongoing recovery process in DRB. These results are important to decision-making regarding the disaster and actions for environmental restoration.


Subject(s)
Disasters , Environmental Restoration and Remediation , Water Pollutants, Chemical , Water Pollutants, Chemical/analysis , Environmental Monitoring , Metals/toxicity , Metals/analysis , Rivers/chemistry , Brazil
2.
Cogitare Enferm. (Online) ; 28: e87621, Mar. 2023. tab, graf
Article in Portuguese | LILACS, BDENF - Nursing | ID: biblio-1514045

ABSTRACT

RESUMO Objetivo: construir e validar um aplicativo que estabeleça o grau de risco do pé diabético associando suas condições de saúde. Metodologia: estudo metodológico realizado entre março de 2019 a dezembro de 2021, em Crato - CE - Brasil, dividido em três fases: 1) Revisão das diretrizes nacionais e internacionais; 2) Construção da tecnologia educativa e 3) Validação do conteúdo e aparência da tecnologia. Este estudo seguiu as diretrizes do guia Revised Standards for Quality Improvement Reporting Excellence. Resultados: na fase de revisão, identificou-se conteúdo semelhante entre as diretrizes para o delineamento e a organização do constructo. A tecnologia construída possibilitou a coleta de dados, avaliação e classificação de risco do pé diabético. Na etapa de validação, 18 juízes avaliaram o instrumento, que teve o IVC 0,96. Conclusão: o estudo poderá contribuir para melhorar os indicadores referente as hospitalizações, amputações, mobilidade diminuída, dependência, fragilidade e mortalidade advindos do pé diabético.


ABSTRACT Objective: to create and validate an app that establishes the diabetic foot risk degree by associating the patients' health conditions. Methodology: a methodological study conducted between March 2019 and December 2021 in Crato - CE - Brazil, and divided into three phases: 1) Review of the national and international guidelines; 2) Creation of the educational technology; and 3) Face and content validation of the technology. This study followed the guidelines set forth in the Revised Standards for Quality Improvement Reporting Excellence guide. Results: in the review phase, similar content was identified between the guidelines for designing and organizing the content. The technology that was created enabled data collection, as well as diabetic foot risk assessment and classification. A total of 18 judges evaluated the instrument in the validation stage, obtaining a CVI value of 0.96. Conclusion: the study may contribute to improving the indicators referring to hospitalizations, amputations, reduced mobility, dependence, frailty and mortality resulting from diabetic foot.


RESUMEN Objetivo: crear y validar una aplicación que establezca el grado de riesgo del pie diabético asociándolo a sus condiciones de salud. Metodología: estudio metodológico realizado entre marzo de 2019 y diciembre de 2021, en Crato, CE, Brasil, dividido en tres fases: 1) Revisión de directrices nacionales e internacionales; 2) Creación de la tecnología educativa y 3) Validación del contenido y la apariencia de la tecnología. Este estudio siguió los lineamientos de la guía Revised Standards for Quality Improvement Reporting Excellence. Resultados: en la fase de revisión, se identificaron contenidos similares entre las directrices para el diseño y la organización del constructo. La tecnología creada permitió recolectar datos, evaluar y clasificar el riesgo del pie diabético. En la etapa de validación, 18 jueces evaluaron el instrumento, que contó con un IVC de 0,96. Conclusión: el estudio puede contribuir a mejorar los indicadores de hospitalización, amputación, movilidad reducida, dependencia, fragilidad y mortalidad derivados del pie diabético.


Subject(s)
Enterostomal Therapy
3.
An Acad Bras Cienc ; 94(1): e20201079, 2022.
Article in English | MEDLINE | ID: mdl-35476061

ABSTRACT

The South Brazilian grasslands (Campos Sulinos) form the dominant vegetation in southern Brazil. They are species-rich ecosystems that occur under distinct geomorphological and climatic conditions but spatial variation of plant species diversity remains understudied. Here, we present a detailed description of plant communities across the region. Our data were obtained in 1080 plots, representing well-preserved grasslands in different ecological systems. Apart from describing alpha and beta diversity, we investigated the relations of plant communities with environmental features. We identified 759 plant species and found clear differences in community composition across the region. Northern and Southern highland grasslands, humid and dry coastal grasslands and the mesic Pampa grassland were clearly distinct, related to climatic and edaphic features. While species abundance distribution was markedly uneven, local species richness was high, above 20 species/m2, especially in the highlands and in mesic Pampa sites, on shallow soils. The predominant component of beta diversity was species turnover, which suggests that a network of well-conserved grasslands distributed across the region would be the best strategy to protect plant diversity. Our results establish regionalized reference values for richness and diversity that can be useful for initiatives of restoration and conservation of these grasslands.


Subject(s)
Ecosystem , Grassland , Biodiversity , Brazil , Plants , Reference Values
4.
Rev Bras Enferm ; 75(5): e20210329, 2022.
Article in English, Portuguese | MEDLINE | ID: mdl-35262603

ABSTRACT

OBJECTIVE: To describe the production and validation of short film type educational technology for the prevention of diabetic foot ulcers. METHODS: A methodological study focused on the validation of a short film. The construction of the film was carried out in three stages: pre-production, production, and post-production. Thirty-seven evaluators undertook the internal validation, divided into two groups of 31 proficient nurses and six from the communication area. Fifteen people with diabetes mellitus performed the external validation. RESULT: The nursing proficient validated the script with a total content validity index of 0.95, with internal reliability of 0.849 conferred by Cronbach's Alpha. Communication specialists validated with a content validity index of 0.97; and target audience with 0.95 (clarity) and 0.97 (relevance). CONCLUSION: The study showed that the short film is a valid and reliable educational technology to promote foot care to people with diabetes mellitus.


Subject(s)
Diabetes Mellitus , Diabetic Foot , Communication , Diabetes Mellitus/therapy , Diabetic Foot/prevention & control , Educational Technology , Humans , Reproducibility of Results , Surveys and Questionnaires
5.
Rev. bras. enferm ; 75(5): e20210329, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BDENF - Nursing | ID: biblio-1360875

ABSTRACT

ABSTRACT Objective: To describe the production and validation of short film type educational technology for the prevention of diabetic foot ulcers. Methods: A methodological study focused on the validation of a short film. The construction of the film was carried out in three stages: pre-production, production, and post-production. Thirty-seven evaluators undertook the internal validation, divided into two groups of 31 proficient nurses and six from the communication area. Fifteen people with diabetes mellitus performed the external validation. Result: The nursing proficient validated the script with a total content validity index of 0.95, with internal reliability of 0.849 conferred by Cronbach's Alpha. Communication specialists validated with a content validity index of 0.97; and target audience with 0.95 (clarity) and 0.97 (relevance). Conclusion: The study showed that the short film is a valid and reliable educational technology to promote foot care to people with diabetes mellitus.


RESUMEN Objetivo: Describir la producción y validación de tecnología educacional del tipo cortometraje para prevención de úlceras del pie diabético. Métodos: Estudio metodológico, con enfoque en la validación del cortometraje. La construcción de la película fue ejecutada en tres etapas: preproducción, producción y postproducción. Se emprendió la validación interna con 37 evaluadores divididos en dos grupos: 31 proficientes enfermeros y 6 del área de comunicación. La validación externa fue realizada por 15 personas con diabetes mellitus. Resultados: Los proficientes de la enfermería validaron el guión con Índice de Validez de Contenido total de 0,95, con confiabilidad interna de 0,849 conferido por el alfa de Cronbach; proficientes de la comunicación validaron con Índice de Validez de Contenido de 0,97; y público objeto, con 0,95 (claridad) y 0,97 (relevancia). Conclusión: El cortometraje se configuró como tecnología educativa válida y confiable para promover el autocuidado con los pies a las personas con diabetes mellitus.


RESUMO Objetivo: descrever a produção e validação de tecnologia educacional do tipo curta-metragem para prevenção de úlceras do pé diabético. Métodos: estudo metodológico, com foco na validação de filme curta-metragem. A construção do filme foi executada em três etapas: pré-produção, produção e pós-produção. Empreendeu-se a validação interna com 37 avaliadores divididos em dois grupos: 31 proficientes enfermeiros, seis da área de comunicação. A validação externa foi realizada por 15 pessoas com Diabetes Mellitus. Resultados: os proficientes da enfermagem validaram o roteiro com Índice de Validade de Conteúdo (IVC) total de 0,95, com confiabilidade interna de 0,849 conferido pelo alfa de Cronbach, proficientes da comunicação validaram com IVC de 0,97 e público-alvo com 0,95 (clareza) e 0,97 (relevância). Conclusão: o curta-metragem se configurou como tecnologia educativa válida e confiável para promover o autocuidado com os pés às pessoas com Diabetes Mellitus.

6.
Estima (Online) ; 19(1): e0621, jan.-dez. 2021. tab, ilus
Article in English, Portuguese | BDENF - Nursing, LILACS | ID: biblio-1255201

ABSTRACT

Objetivo:avaliar taxa de cicatrização em úlceras do pé diabético tratadas com biomembrana de proteínas do látex de Calotropis procera (BioMem CpLP) quando comparada ao hidrocoloide em pó. Método: ensaio clínico randomizado controlado, registrado pelo Registro Brasileiro de Ensaio Clínico (REBEC), conforme protocolo RBR-98f3j9, realizado junto a oito pessoas com pé diabético, em ambulatório de pé diabético, de março a julho de 2019. No grupo experimental (n=04), realizou-se a aplicação de biomembrana; no grupo controle (n=04), utilizou-se o pó de hidrocoloide. A taxa de cicatrização foi avaliada com 30 e 60 dias após início do tratamento. Resultados: não se constataram diferenças estatísticas entre taxas de cicatrização do grupo controle e do grupo experimental na análise temporal dos 30 dias iniciais (p=0,726) e nos 60 dias subsequentes ao início do tratamento (p=0,562). Conclusão: a BioMem CpLP apresentou taxas de cicatrização semelhantes ao produto convencional, configurando-se como alternativa eficaz e de baixo custo para o tratamento de pés diabéticos.


Objective:to evaluate the rate of healing in diabetic foot ulcers treated with a biomembrane of latex proteins from Calotropis procera (BioMem CpLP) when compared to powdered hydrocolloid. Method: randomized controlled clinical trial, registered by the Brazilian Clinical Trial Registry (REBEC), according to protocol RBR-98f3j9, carried out with eight people with diabetic foot, in a diabetic foot clinic, from March to July 2019. In the experimental group (n = 04), biomembrane was applied; in the control group (n = 04), hydrocolloid powder was used. The healing rate was assessed at 30 and 60 days after starting treatment. Results: no statistical differences were found between the healing rates of the control group and the experimental group in the temporal analysis of the initial 30 days (p = 0.726) and in the 60 days following the start of treatment (p = 0.562). Conclusion: BioMem CpLP presented healing rates similar to the conventional product, being an effective and low cost alternative for the treatment of diabetic feet.


Subject(s)
Wound Healing , Nursing , Randomized Controlled Trial , Diabetic Foot
7.
Rev Rene (Online) ; 22: e62774, 2021. graf
Article in Portuguese | LILACS, BDENF - Nursing | ID: biblio-1279601

ABSTRACT

RESUMO Objetivo: compreender o manejo da lesão por pressão em pacientes sob cuidados paliativos na perspectiva de enfermeiros. Métodos: estudo qualitativo, do qual participaram 17 enfermeiros assistenciais por meio de entrevistas semiestruturadas. Os dados foram submetidos à análise categorial temática. Resultados: elencaram-se duas categorias: Manejo de enfermagem de lesões por pressão em pacientes sob cuidados paliativos e Desfecho das lesões por pressão em pacientes sob cuidados paliativos. O manejo destas ocorre por meio de assistência individualizada, podendo variar de acordo com os diferentes momentos em que àquele indivíduo se encontra, devendo ser maleáveis. Observou-se, ainda, a possibilidade de três desfechos: cicatrização completa, melhora clínica e estabilização clínica. Conclusão: apesar de toda fragilidade desses pacientes em cuidados paliativos, percebeu-se que ocorre a melhora clínica das lesões, apesar de ser um caminho lento, por meio de manejo das lesões de modo individualizado e centrado na busca de conforto.


ABSTRACT Objective: to understand the management of pressure ulcers in palliative care patients from the perspective of nurses. Methods: qualitative study, in which 17 care nurses participated through semi-structured interviews. Data were submitted to thematic categorical analysis. Results: two categories were listed: Nursing management of pressure ulcers in palliative care patients and Outcome of pressure ulcers in palliative care patients. Their management occurs by means of individualized assistance and may vary according to the different moments in which the individual is and should be malleable. The possibility of three outcomes was also observed: complete healing, clinical improvement and clinical stabilization. Conclusion: despite all the frailty of these patients in palliative care, it was perceived that the clinical improvement of the lesions occurs, although it is a slow path, by means of handling the lesions in an individualized manner and focused on the search for comfort.


Subject(s)
Palliative Care , Wound Healing , Nursing , Pressure Ulcer , Nursing Care
8.
Rev Bras Enferm ; 73(suppl 2): e20200670, 2020.
Article in English, Portuguese | MEDLINE | ID: mdl-33295388

ABSTRACT

OBJECTIVE: To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic. METHODS: Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05. RESULTS: There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection. CONCLUSION: Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.


Subject(s)
COVID-19 , Occupational Injuries , Pandemics , Personal Protective Equipment , Pressure Ulcer , Adult , Female , Humans , Male , Brazil/epidemiology , Chi-Square Distribution , Confidence Intervals , COVID-19/epidemiology , Cross-Sectional Studies , Medical Staff/statistics & numerical data , Nursing Staff/statistics & numerical data , Occupational Injuries/epidemiology , Occupational Injuries/etiology , Occupational Injuries/prevention & control , Personal Protective Equipment/adverse effects , Physical Therapists/statistics & numerical data , Prevalence , SARS-CoV-2 , Time Factors
9.
Arq. bras. neurocir ; 39(3): 228-231, 15/09/2020.
Article in English | LILACS | ID: biblio-1362413

ABSTRACT

Colorectal cancer is one of the most common oncological diseases. Chemotherapy is usually recommended as an adjuvant treatment for stage-II, -III, and -IV tumors. Approximately 10% of the patients develop neuropathic pain after chemotherapy, and they may remain refractory despite the administration of drugs that are commonly used to treat neuropathic pain. Spinal cord stimulation is a good treatment option for neuropathic pain of the lower limbs, and it should be trialed in patients with chemotherapy-induced peripheral neuropathy. We report the case of a patient with oxaliplatin-induced neuropathy and neuropathic pain refractory to oral medication who was successfully treated by spinal cord stimulation.


Subject(s)
Humans , Female , Middle Aged , Polyneuropathies/surgery , Polyneuropathies/diagnosis , Polyneuropathies/chemically induced , Spinal Cord Stimulation/methods , Colorectal Neoplasms, Hereditary Nonpolyposis/epidemiology , Chemotherapy, Adjuvant , Peripheral Nervous System Diseases/therapy , Cancer Pain
11.
Nutr Metab Cardiovasc Dis ; 30(1): 151-161, 2020 01 03.
Article in English | MEDLINE | ID: mdl-31753790

ABSTRACT

BACKGROUND AND AIMS: Cardiovascular diseases are the main cause of mortality in obesity. Despite advanced understanding, the mechanisms that regulate cardiac progenitor cells (CPC) survival in pathological conditions are not clear. Low IGF-1 plasma levels are correlated to obesity, cardiomyopathy and CPC death, so this work aimed to investigate IGF-1 therapeutic potential on cardiomyopathy and its relationship with the survival, proliferation and differentiation of CPC in Western diet-induced obesity. METHODS AND RESULTS: Male Swiss mice were divided into control group (CG, n = 8), fed with standard diet; and obese group (OG, n = 16), fed with Western diet, for 12 weeks. At 11th week, OG was subdivided to receive a daily subcutaneous injection of human recombinant IGF-1 (100 µg.Kg-1) for seven consecutive days (OG + IGF1, n = 8). Results showed that IGF-1 therapy improved the metabolic parameters negatively impacted by western diet in OG, reaching levels similar to CG. OG + IGF-1 also demonstrated restored heart energetic metabolism, fibrosis resolution, decreased apoptosis level, restored cardiac gap junctions and intracellular calcium balance. Cardiomyopathy improvement was accompanied by increased CPC survival, proliferation and newly cardiomyocytes formation related to increased pAkt/Akt ratio. CONCLUSION: These results suggest that only one week of IGF-1 therapy has cardioprotective effects through Akt pathway upregulation, ensuring CPC survival and differentiation, contributing to heart failure rescue.


Subject(s)
Cardiomyopathies/prevention & control , Insulin-Like Growth Factor I/administration & dosage , Myocytes, Cardiac/drug effects , Obesity/drug therapy , Stem Cells/drug effects , Animals , Apoptosis/drug effects , Calcium Signaling , Cardiomyopathies/etiology , Cardiomyopathies/metabolism , Cardiomyopathies/pathology , Cell Survival/drug effects , Disease Models, Animal , Drug Administration Schedule , Gap Junctions/drug effects , Gap Junctions/metabolism , Gap Junctions/pathology , Injections, Subcutaneous , Male , Mice , Myocytes, Cardiac/metabolism , Myocytes, Cardiac/pathology , Obesity/complications , Phosphorylation , Proto-Oncogene Proteins c-akt/metabolism , Recombinant Proteins/administration & dosage , Stem Cells/metabolism , Stem Cells/pathology , Time Factors , Ventricular Remodeling/drug effects
12.
Rev. bras. enferm ; 73(supl.2): e20200670, 2020. tab
Article in English | LILACS-Express | LILACS, BDENF - Nursing | ID: biblio-1144069

ABSTRACT

ABSTRACT Objective: To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic. Methods: Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05. Results: There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection. Conclusion: Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.


RESUMEN Objetivo: Describir prevalencia y factores relacionados a la lesión por presión relacionada al uso de equipos de protección personal durante la pandemia del COVID-19. Métodos: Estudio transversal realizado mediante instrumento disponible en redes sociales con 1.106 profesionales de salud. Los datos han analizados por medio de estadística descriptiva y comparada, considerando valor de p < 0,05. Resultados: Hubo prevalencia de 69,4% para lesión por presión relacionada al uso del equipo de protección personal, con una media de 2,4 lesiones por profesional. Los factores significativos fueron: menores de 35 años de edad, trabajar y hacer uso de equipos de protección personal por más de seis horas al día, en unidades hospitalarias y sin el uso de suministros para protección. Conclusión: La lesión por presión relacionada al uso de dispositivos médicos presentó alta prevalencia en esa población. El reconocimiento de la lesión en esos profesionales posibilita avanzar en estrategias de prevención.


RESUMO Objetivo: Descrever prevalência e fatores associados da lesão por pressão relacionada ao uso de equipamentos de proteção individual durante a pandemia da COVID-19. Métodos: Estudo transversal realizado por meio de instrumento disponibilizado em redes sociais com 1.106 profissionais de saúde. Os dados foram analisados por meio de estatística descritiva e comparada, considerando valor de p < 0,05. Resultados: Houve prevalência de 69,4% para lesão por pressão relacionada ao uso do equipamento de proteção individual, com uma média de 2,4 lesões por profissional. Os fatores significativos foram: menores de 35 anos de idade, trabalhar e fazer uso de equipamentos de proteção individual por mais de seis horas no dia, em unidades hospitalares e sem o uso de insumos para proteção. Conclusão: A lesão por pressão relacionada ao uso de dispositivos médicos apresentou alta prevalência nessa população. O reconhecimento da lesão nesses profissionais possibilita avançar em estratégias de prevenção.

13.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(Suppl. 2b): 132-132, Jun. 2019.
Article in Portuguese | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1009423

ABSTRACT

INTRODUÇÃO: A presença de pré excitação ventricular em lactentes habitualmente está associado a taquicardias de origem supraventricular (Síndrome de Wolff Parkinson White). Muitas vezes pela maior tolerabilidade das altas frequências no período perinatal a primeira manifestação do quadro de WPW pode ser a disfunção ventricular secundaria a taquicardiomiopatia. Entretanto pacientes, principalmente lactentes, que nunca apresentaram taquicardia podem evoluir com disfunção ventricular secundária ao dissincronismo que se estabelece secundário a pré excitação em vias acessórias à direita. OBJETIVO: Descrever um caso de lactente portador de síndrome de pré excitação ventricular associado à disfunção ventricular provavelmente secundária a disssincronia interventricular. RELATO do CASO: Menina de 4 meses assintomática encaminhada ao serviço de cardiopatias congênitas por sopro sistólico classificado como inocente detectado pelo pediatra. Nunca havia apresentado taquicardia. Durante avaliação inicial observou-se a presença de pré excitação ventricular de localização médio septal direita (algoritmo de Arruda). O exame radiológico evidenciava moderada cardiomegalia e congestão pulmonar. O ecocardiograma convencional demonstrou dilatação importante do ventrículo esquerdo (volume 70 ml/m² de SC) com fração de ejeção do ventrículo esquerdo pelo método de Simpson 34%. A análise de dissincronia evidenciou intervalo de abertura entre a valva aórtica e pulmonar de 51ms (dissincronia interventricular) e intervalo entre septo e parede anterior de 180ms. Índice de Yu de 49 ms. Devido à baixa idade e riscos de da terapia invasiva para tratamento de vias acessórias médio septais especialmente em lactentes, optou-se pelo tratamento medicamentoso da insuficiência cardíaca e supressão farmacológica da via acessória com amiodarona. A paciente segue em tratamento medicamentoso com seguimento pediátrico pondero estatural adequado. CONCLUSÃO: 1) Pacientes portadores de vias acessórias manifestas a direita podem evoluir com dissincronia e posterior disfunção ventricular apesar da ausência de eventos arrítmicos 2) O tratamento clínico é opção por diretriz em pacientes estáveis com vias de alto risco abaixo de 5 anos. (AU)


Subject(s)
Humans , Ventricular Dysfunction , Infant
14.
Neurology ; 92(18): e2165-e2175, 2019 04 30.
Article in English | MEDLINE | ID: mdl-30952795

ABSTRACT

OBJECTIVE: To compare the analgesic effects of stimulation of the anterior cingulate cortex (ACC) or the posterior superior insula (PSI) against sham deep (d) repetitive (r) transcranial magnetic stimulation (TMS) in patients with central neuropathic pain (CNP) after stroke or spinal cord injury in a randomized, double-blinded, sham-controlled, 3-arm parallel study. METHODS: Participants were randomly allocated into the active PSI-rTMS, ACC-rTMS, sham-PSI-rTMS, or sham-ACC-rTMS arms. Stimulations were performed for 12 weeks, and a comprehensive clinical and pain assessment, psychophysics, and cortical excitability measurements were performed at baseline and during treatment. The main outcome of the study was pain intensity (numeric rating scale [NRS]) after the last stimulation session. RESULTS: Ninety-eight patients (age 55.02 ± 12.13 years) completed the study. NRS score was not significantly different between groups at the end of the study. Active rTMS treatments had no significant effects on pain interference with daily activities, pain dimensions, neuropathic pain symptoms, mood, medication use, cortical excitability measurements, or quality of life. Heat pain threshold was significantly increased after treatment in the PSI-dTMS group from baseline (1.58, 95% confidence interval [CI] 0.09-3.06]) compared to sham-dTMS (-1.02, 95% CI -2.10 to 0.04, p = 0.014), and ACC-dTMS caused a significant decrease in anxiety scores (-2.96, 95% CI -4.1 to -1.7]) compared to sham-dTMS (-0.78, 95% CI -1.9 to 0.3; p = 0.018). CONCLUSIONS: ACC- and PSI-dTMS were not different from sham-dTMS for pain relief in CNP despite a significant antinociceptive effect after insular stimulation and anxiolytic effects of ACC-dTMS. These results showed that the different dimensions of pain can be modulated in humans noninvasively by directly stimulating deeper SNC cortical structures without necessarily affecting clinical pain per se. CLINICALTRIALSGOV IDENTIFIER: NCT01932905.


Subject(s)
Cerebral Cortex/physiopathology , Deep Brain Stimulation/methods , Gyrus Cinguli/physiopathology , Neuralgia/therapy , Transcranial Magnetic Stimulation/methods , Adult , Aged , Double-Blind Method , Female , Humans , Male , Middle Aged , Neuralgia/physiopathology , Pain Management/methods , Pain Measurement , Treatment Outcome
15.
Rev. enferm. UFPE on line ; 11(supl.9): 3558-3566, set.2017.
Article in Portuguese | BDENF - Nursing | ID: biblio-1032543

ABSTRACT

Objetivo: conhecer as práticas de autocuidado das pessoas com pé diabético. Método: Estudo qualitativo, pesquisa ação, com 40 pacientes de uma unidade de Atenção Primária à Saúde. Os dados foram produzidos por meio de entrevista semiestruturada. Para a análise, utilizou-se a Análise de Conteúdo. Resultados: dos discursos, emergiram duas categorias >. Os pacientes sabem que cuidados com os pés são necessários, porém, o autocuidado não é realizado corretamente. As dificuldades baseavam-se no desconhecimento do calçado adequado, no corte correto das unhas e na importância do exame dos pés. Conclusão: a finalidade do conhecimento produzido não foi somente prestar informações e trocar experiências, mas, sobretudo, sensibilizar os pacientes sobre os riscos de complicações nos pés.


Subject(s)
Male , Female , Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Self Care , Health Knowledge, Attitudes, Practice , Nursing Care , Diabetic Foot , Foot Injuries/prevention & control , Health Education , Hygiene
16.
Rev Bras Enferm ; 70(1): 7-14, 2017.
Article in Portuguese, English | MEDLINE | ID: mdl-28226036

ABSTRACT

OBJECTIVE:: to describe the process of developing of an educational booklet on insulin therapy for children with diabetes mellitus type 1. METHOD:: methodological approach, in which the following steps were carried out: selecting of the content and type of technology to be developed (for this step, an integrative review, an analysis of the comments of blogs about Diabetes Mellitus type 1 and interviews with the children were performed), creation of images, formatting and layout composition. RESULTS:: the work resulted in the production of the final version of the educational booklet, which was titled Aplicando a insulina: a aventura de Beto [Applying insulin: Beto's adventure]. The process of developing of the booklet was based on the active participation of the children and guided by the theoretical framework of Piagetian Constructivism. CONCLUSION:: the resource is a facilitator for the improvement of the knowledge and practices of self care of children with Diabetes Mellitus type 1.


Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Pamphlets , Patient Education as Topic/methods , Program Development/methods , Self Care/methods , Adolescent , Child , Child, Preschool , Humans , Hyperglycemia/drug therapy , Hypoglycemic Agents/pharmacology , Hypoglycemic Agents/therapeutic use , Insulin/pharmacology , Insulin/therapeutic use
17.
Rev. enferm. UFPE on line ; 11(2): 515-522, fev. 2017. ilus, tab
Article in Portuguese | BDENF - Nursing | ID: biblio-1032000

ABSTRACT

Objetivo: avaliar a eficácia de intervenções educativas de Enfermagem, fundamentadas na Teoria do Alcancede Metas, de Imogene King, no controle glicêmico e da pressão arterial da pessoa com diabetes. Método:estudo quase-experimental, prospectivo, randomizado simples, de abordagem quantitativa, numa Unidade deAtenção Primária à Saúde. Participaram 28 pessoas com diabetes no grupo de intervenção e 28 no grupocomparativo. Os dados foram organizados em um banco de dados no programa Excel for Windows e,posteriormente, transportados para o software SPSS versão 20.0, processados para a avaliação estatísticaanalítica. Resultados: conforme se identificou nos resultados, o grupo de intervenção apresentou melhorasignificativa na pressão arterial diastólica (p=0,0156) e glicemia capilar (p<0,0001). No comparativo, nãohouve melhora no exame clínico. Conclusão: as intervenções educativas fundamentadas na Teoria do Alcancede Metas têm efeito benéfico na melhora dos parâmetros glicêmicos e da pressão arterial das pessoas comdiabetes.


Subject(s)
Male , Female , Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Evaluation of the Efficacy-Effectiveness of Interventions , Diabetes Mellitus , Health Education , Blood Glucose , Arterial Pressure , Nursing Process , Nursing Theory , Medication Adherence , Prospective Studies , Nurse-Patient Relations
18.
Rev. bras. enferm ; 70(1): 7-14, jan.-fev. 2017. tab, graf
Article in Portuguese | LILACS, BDENF - Nursing | ID: biblio-843603

ABSTRACT

RESUMO Objetivo: descrever o processo de construção de uma cartilha educativa sobre insulinoterapia para crianças com diabetes mellitus tipo 1. Método: abordagem metodológica, na qual se seguiram as etapas: seleção do conteúdo e tipo de tecnologia a ser construída (para essa etapa, foi realizada revisão integrativa, análises dos comentários de blogs sobre Diabetes Mellitus tipo 1 e entrevista com as crianças), criação de imagens, diagramação e composição do layout. Resultados: o trabalho resultou na produção da versão final da cartilha educativa, que teve como título Aplicando a insulina: a aventura de Beto. O processo de construção da cartilha foi embasado na participação ativa das crianças e norteado pelo referencial teórico do Construtivismo Piagetiano. Conclusão: o recurso é facilitador para a melhoria do conhecimento e das práticas de autocuidado de crianças com Diabetes Mellitus tipo 1.


RESUMEN Objetivo: describir el proceso de construcción de una cartilla educativa sobre insulinoterapia para niños con diabetes mellitus tipo 1. Método: abordaje metodológico en el que unas etapas fueron seguidas: selección de contenido y tipo de tecnología a ser construida (para esa etapa, se realizó una revisión integrativa, análisis de comentarios de blogs sobre Diabetes Mellitus tipo 1 y entrevista con los niños), creación de imágenes, diagramación y composición de layout. Resultados: el trabajo resultó en la producción de una versión final de una cartilla educativa, cuyo título fue Aplicando la insulina: la aventura de Beto. El proceso de construcción de la cartilla se basó en la participación activa de los niños y se norteó por el referencial teórico del Constructivismo Piagetiano. Conclusión: el recurso es facilitador para la mejoría del conocimiento y de las prácticas de autocuidado de niños con Diabetes Mellitus tipo 1.


ABSTRACT Objective: to describe the process of developing of an educational booklet on insulin therapy for children with diabetes mellitus type 1. Method: methodological approach, in which the following steps were carried out: selecting of the content and type of technology to be developed (for this step, an integrative review, an analysis of the comments of blogs about Diabetes Mellitus type 1 and interviews with the children were performed), creation of images, formatting and layout composition. Results: the work resulted in the production of the final version of the educational booklet, which was titled Aplicando a insulina: a aventura de Beto [Applying insulin: Beto's adventure]. The process of developing of the booklet was based on the active participation of the children and guided by the theoretical framework of Piagetian Constructivism. Conclusion: the resource is a facilitator for the improvement of the knowledge and practices of self care of children with Diabetes Mellitus type 1.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Pamphlets , Self Care/methods , Patient Education as Topic/methods , Program Development/methods , Diabetes Mellitus, Type 1/drug therapy , Hyperglycemia/drug therapy , Hypoglycemic Agents/therapeutic use , Hypoglycemic Agents/pharmacology , Insulin/therapeutic use , Insulin/pharmacology
19.
Article in Portuguese | BDENF - Nursing | ID: biblio-1023922

ABSTRACT

Objetiva-se analisar o conhecimento científico sobre as estratégias educativas empregadas pela enfermagem para o ensino-apredizagem das pessoas com estomia intestinal. Trata-se de uma revisão integrativa realizada nas bases de dados PubMed, LILACS e CINAHL, entre 1996 a 2014. Obteve-se amostra de 11 estudos. O Brasil liderou o numero de publicações e dos artigos incluídos na revisão e todos foram publicados em periódicos de enfermagem. Estes dados revelam o envolvimento dos enfermeiros com a temática em questão. O uso de tecnologias educativas foi identificado em sete estudos que desenvolveram atividades de cunho individual e/ou em grupo por meio de uma abordagem interativa. Foi realizada em consultas ambulatoriais ou apenas pela distribuição de materiais educativos, como: cartilhas, materiais educativos impressos, cursos on-line e programas multimídias, intensificando os cuidados com pele periestoma e/ou reforçando os cuidados gerais. Para que o processo de ensino aprendizagem seja efetivo no campo da saúde, os recursos didáticos empregados devem capacitar e motivar os pacientes com vistas a conseguirem incorporar novos significados, propiciando mais autonomia. Esta revisão permitiu identificar que estratégias de educação com o uso de tecnologias educativas são mais consistentes nas mensagens transmitidas ocasionando rápida mudança de comportamento


The study aimed to analyze the scientific knowledge of the educational strategies used by nurses for teachinglearning programs for ostomy people. This is an integrative review carried out in the databases: PubMed, LILACS, SciELO and CINAHL from 1996 to 2014, was obtained sample of 11 studies. Brazil led the the number of publications and articles included in the review (11-100%) were published in magazines in general nursing journals. These data reveal the nurses' involvement with the questioned theme. It was carried out in outpatient clinics or only through the distribution of educational materials, such as: booklets, printed educational materials, online courses and multimedia programs, intensifying peristaltic skin care and / or reinforcing general care. In order for the teaching-learning process to be effective in the health field, the didactic resources employed must enable and motivate patients in order to incorporate new meanings, providing more autonomy. This review identified that education strategies with the use of educational technologies are more consistent in the messages transmitted causing rapid change of behavior


Subject(s)
Humans , Teaching Materials , Ostomy , Health Education
20.
Saúde Soc ; 25(4): 1095-1107, out.-dez. 2016. graf
Article in Portuguese | LILACS | ID: biblio-962486

ABSTRACT

Resumo Este artigo visa analisar e compreender a relação entre água e saúde em comunidades rurais situadas na microbacia do igarapé Cumaru, município de Igarapé-Açu (PA), nordeste paraense. São avaliados a captação e o tratamento de água para o consumo humano, considerando as práticas de esgoto sanitário realizadas cotidianamente pela população rural dessa microbacia, visto que têm implicação direta na saúde da população local. Este trabalho baseia-se em pesquisa de campo com uma abordagem quali-quantitativa. Utilizou-se questionário fechado para o levantamento das fontes de captação, saneamento rural e usos de insumos agrícolas. Foram consideradas observações feitas por agricultores familiares da região ao focar o funcionamento do estabelecimento agrícola, a fim de observar de diversos ângulos a relação entre água e saúde no seu entendimento. Observou-se que a vulnerabilidade das fontes de água acessadas pela população é um fator que contribui para a contaminação das fontes, caracterizando consequentemente uma ameaça à saúde da população rural. Entretanto, nota-se a percepção da população quanto às fontes de água mais profundas, como poços tubulares, sendo estes prioritários para captação de água para ingestão.


Abstract This article aims to analyze and understand the relationship between water and health in rural communities located in the watershed of Cumaru stream, in the municipality Igarapé-Açu, Northeast of Pará state. The harvesting and treatment of the water conducted by the rural population for human consumption were assessed, considering their practices of sanitary sewer, since these aspects have direct impact on their health. This study is based on field research with a quantitative approach. Closed questionnaire was used to raise the sources of water harvesting, rural sanitation, and use of agricultural inputs. We used participant observation, when focusing on the functioning of the agricultural establishment, to observe from various angles the relationship between water and health. We noted that the vulnerability of the water resources accessed by the population is a factor that contributes to the contamination of the sources, therefore a threat to the health of the rural population. However, the perception of the population is notable regarding deeper water sources, such as tube wells, which are priorities for water harvesting.


Subject(s)
Humans , Male , Female , Rural Population , Water Supply , Water Quality , Water Consumption (Environmental Health) , Water Resources , Basic Sanitation
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