Cinema: uma ferramenta pedagógica e humanista para temas em saúde-educação: a experiênciado cine social / Cinema: an humanist and pedagogical tool for themes in health-education: the experience of cine social

Modelo do estudo: Abordagem qualitativa de pesquisa. Objetivo: foi utilizado recurso audiovisual (filmes) para propiciar reflexões, discussões e atualização de professores, alunos e profissionais da saúde em temas sociais pertinentes às áreas da saúde e educação. Metodologia: o projeto foi estruturado em formade curso de difusão com cinco encontros, entre agosto e dezembro de 2008. Foram abordados temas relevantes em Saúde e Educação (fome, violência escolar, gravidez na adolescência, processo saúde doençae drogas na adolescência) e foram convidados especialistas em cada temática para debate. O instrumento utilizado para captar as percepções dos participantes foi um questionário de 14 questões semi-estruturadas e ao final de cada encontro foi solicitada a entrega de relatório...

Study design: The approach to the research was qualitative. Objective: we used the audiovisual resources (movies) to make teachers, students and health professionals reflect, discuss and update social subjects relevant to health and education. Methodology: The Project was structured as a course with five meetings that took place between 2008 August and December. Subjects relevant to Public Health and Education were focused (hunger, school violence, teenage pregnancy, health-disease process and teenage drug abuse); for each theme, specialists were invited. The instrument used to acquire the participant perceptions was a questionnaire with 14 semi-structured questions and at the end of each meeting, a report was requested...

The costs of type 2 diabetes mellitus outpatient care in the Brazilian public health system.

OBJECTIVE: The prevalence of type 2 diabetes has shown a significant increase in parallel with health care costs. The objective of the Brazilian Study on Diabetes Costs (ESCUDI study) was to estimate direct and indirect costs of type 2 diabetes outpatient care in the Brazilian Public Health Care System. METHODS: Data were collected from different levels of health care in eight Brazilian cities in 2007. A total of 1000 outpatients were interviewed and had their medical records data analyzed. Direct medical costs included expenses with medications, diagnostic tests, procedures, blood glucose test strips, and office visits. Nonmedical direct costs included expenses with diet products, transportation, and caregivers. Absenteeism, sick leave, and early retirement were classified as indirect costs. RESULTS: Total annual cost for outpatient care was US$2108 per patient, out of which US$1335 per patient of direct costs (63.3%) and US$773 per patient of indirect costs (36.7%). Costs escalated as duration of diabetes and level of health care increased. Patients with both microvascular and macrovascular complications had higher costs (US$3199 per patient) compared to those with either microvascular (US$2062 per patient) or macrovascular (US$2517 per patient) complications only. The greatest portion of direct costs was attributed to medication (48.2%). CONCLUSIONS: Diabetes treatment leads to elevated costs both to Brazilian Public Health Care System and society. Costs increased along with duration of disease, level of care and presence of chronic complications, which suggested a need to reallocate health resources focusing on primary prevention of diabetes and its complications.

Evoluçäo da ocorrência (1980-1999) da doença de Crohn e da retocolite ulcerativa idiopática e análise das suas características clínicas em um hospital universitário do sudeste do Brasil / Trends in the occurrence (1980-1999) and clinical features of Crohn's disease and ulcerative colitis in a university hospital in southeastern Brazil

Racional - A doença de Crohn e a retocolite ulcerativa idiopática säo consideradas pouco freqüentes nos países em desenvolvimento, sendo escassos os estudos sobre a sua ocorrência no Brasil. Objetivos - Estudar a freqüência de admissäo de casos da doença de Crohn e da retocolite ulcerativa inespecífica em um hospital universitário ao longo de 20 anos (1980-99) e descrever características demográficas e clínicas desses casos. Métodos - Calculou-se a freqüência de admissäo de casos da doença de Crohn e da retocolite ulcerativa inespecífica de janeiro de 1980 a dezembro de 1999 e analisaram-se todos os casos destas doenças admitidos nos últimos 10 anos desse período. Resultados - No período estudado, registraram-se 257 casos novos, sendo 126 da doença de Crohn e 131 da retocolite ulcerativa inespecífica. A freqüência de admissäo de casos de ambas as doenças aumentou de 40 para 61 casos/10.000 atendimentos, do primeiro para o segundo qüinqüênio, com menor crescimento subseqüente, sendo que a doença de Crohn tornou-se, gradualmente, mais freqüente que a retocolite ulcerativa inespecífica. Em ambas as doenças, houve predomínio de casos do gênero feminino, na faixa etária entre 20 e 50 anos, da cor branca, do estado civil casado e de näo-tabagistas. Ambas as doenças apresentaram-se com os sintomas digestivos próprios e näo houve diferenças entre elas quanto às freqüências de manifestaçöes sistêmicas e extra-intestinais (29,5 por cento vs 23,3 por cento), incluindo as tromboembólicas (5,9 por cento vs 5,5 por cento). Na doença de Crohn, 59,2 por cento dos casos apresentaram complicaçöes (obstruçäo e/ou perfuraçäo), enquanto que 53,7 por cento dos casos de retocolite ulcerativa inespecífica foram de formas mais graves. Nos casos de doença de Crohn com obstruçäo, o tabagismo foi significativamente mais freqüente que nas formas näo-complicadas. Na retocolite ulcerativa inespecífica, as manifestaçöes sistêmicas e as extra-intestinais, bem como o acometimento de todo o cólon, foram significativamente mais freqüentes nas formas mais graves. Conclusöes - Houve aumento da freqüência das doenças inflamatórias intestinais, com a doença de Crohn tornando-se mais comum que a retocolite ulcerativa inespecífica. Tanto uma como outra das afecçöes, apresentaram-se com as características habituais, destacando-se o predomínio das formas mais graves

[Trends in the occurrence (1980-1999) and clinical features of Crohn's disease and ulcerative colitis in a university hospital in southeastern Brazil]. / Evolução da ocorrência (1980-1999) da doença de Crohn e da retocolite ulcerativa idiopática e análise das suas caracter sticas clínicas em um hospital universitário do sudeste do Brasil.

BACKGROUND: Crohn's disease and ulcerative colitis are regarded as uncommon in developing countries, but studies on their occurrence in Brazil are scarce. Aims - To determine the occurrence of Crohn's disease and ulcerative colitis in a Brazilian university hospital throughout a 20-year period, and analyze the demographical, clinical and evolutive features of these cases. METHODS: The frequencies of new cases of Crohn's disease and ulcerative colitis admitted from January 1980 up to December 1999 were calculated and a descriptive analysis of the features of all cases seen from January 1990 up to December 1999 was performed. RESULTS: A total of 257 new cases (126 with Crohn's disease and 131 with ulcerative colitis) was recorded. The frequencies of admissions for both Crohn's disease and ulcerative colitis have increased progressively from 40 up to 61 cases/10.000 new admissions and Crohn's disease gradually became more common than ulcerative colitis. For both diseases, there was predominance of women, age at admission in the range of 30-40 years, Caucasian origin, married state and non-smokers. Digestive symptoms presented were similar to those already described for both diseases and there were no differences between Crohn's disease and ulcerative colitis regarding the frequencies of general complaints and extra-intestinal manifestations (29.5% vs 23.3%), including thromboembolism (5.9% vs 5.4%). Obstruction and/or perforation were seen in up to 59.2% of Crohn's disease cases, whereas 53.7% of all ulcerative colitis cases presented as severe forms. In Crohn's disease cases with obstruction, smoking was significantly more common than in non-complicated cases. In ulcerative colitis cases of increased severity, general complaints, extra-intestinal manifestations and pancolitis were significantly more frequent than in less severe forms. CONCLUSIONS: For the last 20 years, there have been an increased frequency of admission of inflammatory bowel diseases, and Crohn's disease have become more prevalent than ulcerative colitis. Demographical, clinical and evolutive features of these diseases seems to be similar to those already described, but there seems to be a predominance of more severe forms of both diseases.