Suicídio e sofrimento social no capitalismo: desemprego e expressões da questão social / Suicide and social suffering in capitalism: unemployment and expressions of the social issue

O suicídio é considerado um problema de saúde pública pela Organização Mundial da Saúde (OMS), mas pouco se estuda qual a ligação desse fenômeno complexo junto as expressões da questão social. Este trabalho tem como objetivo compreender a influência do capitalismo no adoecimento da classe trabalhadora e de que forma as expressões da questão social influenciam no desejo de morte do trabalhador. Tendo como resultados o entendimento de que as expressões da questão social produzidas pela sociedade capitalista têm forte influência no desejo de morte dos trabalhadores, sendo necessário além de respostas individuais, respostas coletivas de enfrentamento a essa demanda.(AU)

The World Health Organization (WHO) considers suicide to be a public health issue, but very few studies have been made the connection of this complex phenomenon with the expression of social questions. The goal of this essay if to comprehend the influence of capitalism with the sickening of the working class and in what ways does the expressions of the social questions influence the desire to die of the worker. Having as results the comprehensions that the expressions of social questions produces by capitalist society has a strong influence in the desire do die by workers, being necessary more than just individual responses, but also collective responses to cope with this demand.(AU)

Estratégias de ensino à distância para a educação interprofissional em Saúde frente à pandemia COVID-19 / Distance learning strategies for interprofessional health education in the face of the COVID-19 pandemic / Estrategias de aprendizaje a distancia para la educación sanitaria interprofesional ante la pandemia de COVID-19

Objetivo: Relatar as experiências de trabalho remoto e EaD de um grupo do PET-Saúde Interprofissionalidade na pandemia. Método: Trata-se de um relato de experiência das atividades realizadas por um grupo do PET-Saúde, vinculado a Universidade Estadual de Feira de Santana (UEFS) e ao Centro de Atendimento ao Diabético e Hipertenso (CADH), de março a junho de 2020. As atividades presenciais na UEFS e no CADH foram substituídas por atividades remotas e EaD. A metodologia utilizada envolveu a incorporação de ferramentas virtuais em: 1) Seminários e cursos EaD; 2) Estabelecimento de estratégias de inovação para atuação em saúde; 3) Construção de materiais de Educação em Saúde. Resultados: As ferramentas educacionais virtuais permitiram a realização de um trabalho inovador, focado na formação inicial e continuada de alunos, professores e profissionais de saúde. Mudanças no fluxo dos pacientes, produção de cartilha e artigos também foram atividades desenvolvidas. Conclusão: O uso de plataformas virtuais e EaD favoreceram o planejamento de ações, proporcionando ganho de conhecimento individual e coletivo, permitindo alterações no serviço, orientação dos pacientes e produção científica.

Objective: To report the experiences of remote work and distance education of a group from PET-Saúde Interprofessionality in the pandemic. Method: This is an experience report of the activities developed by a group from PET-Saúde, linked to the State University of Feira de Santana (UEFS) and the Diabetic and Hypertensive Care Center (CADH), from March to June of 2020. Face-to-face activities at UEFS and CADH have been replaced by remote and distance learning activities. The methodology used involved the incorporation of virtual tools in: 1) Seminars and distance education courses; 2) Establishment of innovation strategies for health activities; 3) Construction of Health Education materials. Results: The virtual educational tools allowed the realization of an innovative work, focused on the initial and continuous training of students, teachers and health professionals. Changes in the flow of patients, production of booklets and articles were also developed. Conclusion: The use of virtual platforms and distance education favored the planning of actions, providing gain of individual and collective knowledge, allowing changes in the service, guidance of patients and scientific production..

Objetivo: Describir las experiencias de trabajo remoto y AD de un grupo del Programa PETSalud Interprofesional en la pandemia de Covid-19. Método: Este es un reporte de experiencia de las actividades realizadas por un grupo del Program PET-Salud, vinculado a la Universidad Estatal de Feira de Santana (UEFS) y Centro de Servicio a los Diabéticos e Hipertensos (CADH), de marzo a junio de 2020. Las actividades presenciales en UEFS y en el CADH han sido reemplazadas por actividades remotas y AD. La metodología utilizada implicó la incorporación de herramientas virtuales en: 1) seminarios y cursos de AD; 2) Establecimiento de estrategias de innovación para actividades de salud; y 3) Construcción de materiales de educación sanitaria. Resultados: Las herramientas educativas virtuales permitieron la realización de un trabajo innovador, enfocado en la formación inicial y continua de estudiantes, docentes y profesionales de la salud. Además, se desarrollaron cambios en el flujo de pacientes, producción de folletos y artículos. Conclusión: El uso de plataformas virtuales y el AD favorecieran la planificación de acciones, aportando conocimiento individual y colectivo, además de permitir cambios en el servicio, orientación de pacientes y producción científica

Desafios e estratégias de atenção à saúde de diabéticos no contexto da Covid-19 / Challenges and strategies of health care for diabetics in the context of Covid-19 / Desafíos y estrategias de atención a la Salud para pacientes diabéticos durante la pandemia de Covid-19

Objetivo: apresentar os desafios e estratégias de cuidado ao paciente diabético em serviços especializados frente à pandemia por Covid- 19. Método: Estudo de reflexão teórica sobre os desafios e estratégias do cuidado ao paciente diabético frente à pandemia. Tais reflexões surgem a partir de leituras sobre a temática, tendo como eixos orientadores, os postulados teóricos sobre o Covid-19 e o cuidado especializado ao paciente diabético, além das nossas vivências pessoais e profissionais. Resultados: Pacientes diabéticos não parecem apresentar risco aumentado de se contaminar pelo Covid-19, todavia, uma vez infectado, tem mais chances de evoluir para forma mais grave e maior risco de morte. O bom controle glicêmico pode diminuir o risco de complicações nesse grupo. Assegurar o cuidado ao paciente diabético, com exposição mínima aos serviços de saúde, tem sido um dos grandes desafios das unidades de saúde, que precisaram implementar estratégias, tais como alterações no fluxo de atendimento, triagem de risco para todos os pacientes, redução das consultas presenciais, uso obrigatório de máscara, confecção de cartilhas informativas, orientações remotas e sobre monitoramento dos níveis glicêmicos, dispensação de medicamentos sob agendamento, dentre outros. Conclusão: A complexidade da pandemia pela Covid-19 e as medidas de distanciamento social trouxeram desafios no cuidado ao paciente diabético, que variam desde a repercussão do isolamento no cotidiano desses indivíduos, a necessidade de alterações na rotina dos serviços, além da exposição e condições de trabalho dos profissionais de saúde.

Objective: to present the challenges and strategies of care for diabetic patients in specialized services in the face of the Covid- 19 pandemic. Method: Study of theoretical reflection on the challenges and strategies of care for diabetic patients in the face of the pandemic. Such reflections arise from readings on the theme, having as guiding axes, the theoretical postulates about Covid-19 and specialized care for diabetic patients, in addition to our personal and professional experiences. Results: Diabetic patients do not seem to have an increased risk of becoming infected with Covid-19, however, once infected, they are more likely to evolve to a more severe form and greater risk of death. Good glycemic control can decrease the risk of complications in this group. Ensuring the care of diabetic patients, with minimal exposure to health services, has been one of the great challenges of health units, which needed to implement strategies, such as changes in the flow of care, risk screening for all patients, reduced consultations face-to-face, mandatory use of a mask, preparation of information booklets, remote guidance and monitoring of blood glucose levels, dispensing medications on schedule, among others. Conclusion: The complexity of the Covid-19 pandemic and the measures of social distance brought challenges in the care of diabetic patients, ranging from the repercussion of isolation in the daily lives of these individuals, the need for changes in the routine of services, in addition to exposure and conditions of health professionals.

Objetivo: Presentar los desafíos y estrategias de atención médica para pacientes diabéticos en servicios especializados durante la pandemia de Covid-19. Método: Este es un estudio de reflexión teórica sobre los desafíos y estrategias de atención médica para pacientes diabéticos, basado en la literatura científica. Los ejes rectores del estudio fueron postulados teóricos sobre Covid-19 y atención especializada para pacientes diabéticos, además de experiencias personales y profesionales. Resultados: Los pacientes diabéticos no parecen tener un mayor riesgo de contaminación por Covid-19. Sin embargo, si están infectados, pueden progresar severamente y morir. Por lo tanto, un buen control glucémico puede disminuir el riesgo de complicaciones. Garantizar la atención del paciente con una exposición mínima a los servicios ha sido un desafío para las unidades de atención médica, que han implementado cambios en el flujo de atención y en la detección de riesgos, con reducción de las consultas presenciales, uso obligatório de máscaras, elaboración de folletos, orientación remota y dispensación programada de medicamentos. Conclusión: La complejidad de la pandemia de Covid-19 y las medidas de distanciamiento social trajeron desafíos para la atención médica de los pacientes diabéticos, que van desde la repercusión del aislamiento en la vida cotidiana de los pacientes y los cambios en los servicios hasta el cuidado de la exposición y las condiciones laborales de los profesionales de salud.

Acompanhamento de pacientes adultos com diabetes e hipertensão em Centro Especializado: a experiência do Pet-Saúde Interprofissionalidade / Follow-up of adult patients with diabetes and hypertension in a Specialized Center: experience report of Pet-Health Interprofessionality / Monitoreo de pacientes adultos con diabetes e hipertensión en un Centro Especializado: la experiencia del programa PET-Saúde Interprofesionalidad

Objetivo: Relatar a experiência do PET-Saúde Interprofissionalidade, no acompanhamento de pacientes adultos, com Diabetes e Hipertensão (HAS), de um Centro de Referência, do município de Feira de Santana (BA). Método: Trata-se de um relato de experiência, desenvolvido no Centro Especializado de Atenção ao Diabético e Hipertensos (CADH), de abril a novembro de 2019, por bolsistas, preceptores e tutores, integrantes de um projeto de extensão desenvolvido pela Universidade Estadual de Feira de Santana, em parceria com a Secretaria Municipal de Saúde. Os dados do diagnóstico situacional, coletados através da observação do serviço e conversa com a equipe, embasaram o planejamento atividades educativas, direcionadas à prevenção da diabetes, hipertensão e doenças cardiovasculares. Resultados: O serviço possui 3000 pacientes cadastrados, a maioria adultos, apenas 18 adolescentes, sendo 60% do sexo feminino. As ações educativas realizadas proporcionaram a socialização dos conhecimentos e troca de experiências, entre equipe e usuários, contribuindo para melhoria da qualidade de vida desses pacientes. Conclusão: Com a experiência vivenciada no diagnóstico situacional, percebeu-se a importância deste centro para pacientes e familiares, a necessidade de trabalhar a interdisciplinaridade com os profissionais do serviço e a importância da regularidade das atividades educativas, fortalecendo a prevenção de doenças cardiovasculares, endócrinas e a HAS.

Objective: To report the experience of PET-Health Interprofessionality, in adult patients monitoring with Diabetes and Hypertension, in a Reference Center, in the Feira de Santana ­ BA city. Method: This is an experience report, developed at the Specialized Center for Diabetic and Hypertensive Care (CADH), from april to november 2019, by fellows, preceptors and tutors, members of an extension project developed by the State University of Feira de Santana and the Health Secretary of the city. The data from the situational diagnosis, collected through observation of the service and conversation with the team, supported the planning of educational activities, aimed at the prevention of diabetes, hypertension and cardiovascular diseases. Results: The service has 3000 registered patients, most of them adults, only 18 teenagers, 60% of whom are female. The educational actions carried out provided the socialization of knowledge and the exchange of experiences, between staff and users, contributing to improving the quality of life of these patients. Conclusion: With the experience of situational diagnosis, it was realized the importance of this center for patients and families, the need to work with interdisciplinarity with service professionals and the importance of regular educational activities, strengthening the prevention of cardiovascular and endocrine diseases and hypertension.

Objetivo: Describir la experiencia del programa PET-Saúde Interprofesionalidad en el seguimiento de pacientes adultos con diabetes e hipertensión arterial sistémica (HAS) en un centro de referencia en el municipio de Feira de Santana, BA, Brasil. Método: Este es un reporte de experiencia en el Centro Especializado para la Atención de Diabéticos e Hipertensos (CADH), de abril a noviembre de 2019, vivido por becarios, preceptores y tutores, miembros de un proyecto de extensión de la Universidad Estatal de Feira de Santana en colaboración con la Secretaría Municipal de Salud. Se recopilaron los datos del diagnóstico situacional mediante la observación del servicio y la conversación con el equipo de salud. Los datos respaldaron la planificación de actividades educativas destinadas a la prevención de la diabetes, HAS y las enfermedades cardiovasculares. Resultados: El servicio cuenta con 3.000 pacientes registrados, la mayoría adultos y 18 adolescentes, de los cuales el 60% son mujeres. Las acciones educativas realizadas proporcionaron la socialización del conocimiento y el intercambio de experiencias entre el equipo de salud y los usuarios, contribuyendo así a mejorar la calidad de vida de estos pacientes. Conclusión: La experiencia del diagnóstico situacional reveló la importancia de este centro para pacientes y sus familias, así como la necesidad de trabajar la interdisciplinariedad con los profesionales del servicio y la importancia de actividades educativas regulares, fortaleciendo la prevención de enfermedades cardiovasculares, endocrinas y HAS.

Prevalence of and factors associated with feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) in cats of the state of Santa Catarina, Brazil.

A cross-sectional study was conducted in 274 cats for determination of FeLV antigenemia and FIV seropositivity and factors associated with those infections in cats presented at the Veterinary Hospital of the Santa Catarina State University - UDESC (Brazil). Apparent prevalence for sick cats at the hospital population was 28.41% (95%CI 21.88-34.94%) for FeLV, 7.65% (95%CI 3.71-11.50%) for FIV and 2.18% (95%CI 0.56-5.47%) for both viruses. For healthy cats, the apparent prevalence was 9.89% (95%CI 3.75-16.02%) for FeLV, 2.20% (95%CI 0.34-7.75%) for FIV by immunoassay (ELISA). Average age for FeLV- and FIV-positive individuals was 38.32 and 64.25 months, respectively. Behavior such as aggressiveness and sex (male) were both associated with increased odds of result positivity test for FeLV and FIV; older animals were also associated with FIV test results. A very small proportion of the animals were vaccinated against FeLV and none against FIV. Most of the animals were adopted from shelters or rescued from streets, living with multiple cats that had access to outdoors. The high prevalence of FeLV suggests a need for better control strategies against this disease.

Secondary hypertension due to a juxtaglomerular cell tumor.

Juxtaglomerular cell tumors are rare, generally benign, and they are one of the secondary surgically treatable causes of arterial hypertension. There are about 100 reported cases on literature, and the diagnosis is usually carried out based on a high clinic suspicion index, mostly in patients with hypokalemia and arterial hypertension. The diagnosis involves blood tests and imaging studies, but it is only definite with histopathological exam after surgical treatment. We present a case of a 22-year-old woman with resistant arterial hypertension and renal and cardiovascular target-organ lesions. High plasmatic renin and a nodular renal mass on magnetic resonance imaging were present. A tumorectomy was performed and the histological exam confirmed a reninoma. After surgery, blood pressure and serum renin values returned to normal without medication. This work focuses on the need to exclude rare secondary causes of hypertension in young patients with resistant forms of this disease.

Usefulness of a new miniaturized echocardiographic system in outpatient cardiology consultations as an extension of physical examination.

BACKGROUND: The aim of this study was to assess the usefulness of a new miniaturized echocardiographic system (MS) to perform bedside echocardiography in initial outpatient cardiology consultations, in addition to physical examination. METHODS: One hundred eighty-nine patients referred for initial cardiology outpatient consultations at two tertiary hospitals in two countries were studied. Each patient was submitted to physical examination followed by MS assessment. Scanning time, the number of examinations with abnormal results after physical examination and the MS, and the information obtained by physical examination alone and followed by the MS (in terms of its importance in reaching a diagnosis, in the necessity of performing routine echocardiography, and in the decision to release the patient from the outpatient clinic) were assessed. RESULTS: The scanning time with the MS was 180 ± 86 seconds. Its use after physical examination led to diagnoses in 141 patients (74.6%) and to an additional 37 patients (19.6%) being released from the outpatient clinic. After physical examination followed by MS assessment, only 64 patients (33.9%) were sent to the echocardiography lab. The MS modified the decision of whether to send a patient to the echocardiography lab, with referral determined by the MS in 27 patients (14.3%) and no referral determined by the MS in 58 patients (30.7%). CONCLUSIONS: The new MS caused a negligible increase in the duration of consultations. It showed additive clinical value over physical examination, increasing the number of diagnoses, reducing the use of unnecessary routine echocardiography, increasing the number of adequate echocardiographic studies, and determining a large number of releases from the outpatient clinic.

Playing games with a thrombus: a dangerous match. Paradoxical embolism from a huge central venous cathether thrombus: a case report.

Thromboembolism is a major cause of death in cancer patients. The association between paraneoplastic hypercoagulability of oncological patients and long-term central venous catheters (CVC) may result in CVC associated thrombosis. Patent Foramen Ovale (PFO), especially when associated with atrial septal aneurysm (ASA) is a risk factor for paradoxical embolism. We report a case of paradoxical embolism with stroke in an oncological patient with a huge CVC thrombus playing "ping-pong" with an hypermobile ASA with a PFO. We review the management of hypercoagulability in oncologic patients and discuss the potential role of routine transthoracic echocardiography before the implantation of long term central venous catheters to identify predisposing conditions to paradoxical embolism and select patients for anticoagulant therapy.