Educational intervention on perceived stress among adults with type 2 diabetes and metabolic syndrome: a non-randomized clinical trial / Intervención educativa sobre el estrés percibido en adultos con diabetes tipo 2 y síndrome metabólico: ensayo clínico no aleatorizado / Intervenção educativa sobre o estresse percebido de adultos com diabetes tipo 2 e síndrome metabólica: ensaio clínico não-randomizado

Objective.To assess the effectiveness of an educational intervention on perceived stress and metabolic syndrome parameters among adults with type 2 diabetes mellitus. Method. Fifty-one adults (aged 48.73±7.84; 86.3% of women) were included in a non-randomized clinical trial performed in a healthcare unit for six months (Brazilian Clinical Trial Registry: RBR-43K52N). All participants were diagnosed with type 2 diabetes mellitus and metabolic syndrome (intervention group, n=26; control group, n=25). The intervention consisted of a nurse-led educational health-promoting program with a multidisciplinary approach organized in seven workshops. The primary outcome was decreased perceived stress, and the secondary outcome was improvement in metabolic syndrome parameters according to perceived stress levels. These outcomes were assessed at two points in time, at the baseline and follow-up. Results. Participation in the intervention program resulted in a significant decrease in perceived stress (p=0.028). The stressed participants in the intervention group experienced a significant decrease in blood glucose levels (p=0.001) and a significant increase in high-density lipoprotein-cholesterol (p=0.003) concentrations after the six-month intervention. Conclusion.The nurse-led educational health-promoting program decreased perceived stress among adults with type 2 diabetes mellitus and metabolic syndrome, improving fasting blood glucose and high-density lipoprotein cholesterol among the stressed participants in the intervention group.

Objetivo. Evaluar la efectividad de una intervención educativa sobre el estrés percibido y los componentes del síndrome metabólico en adultos con diabetes mellitus tipo 2. Métodos. Se incluyeron 51 adultos (48.73±7.84 años; 86.3% mujeres) de un estudio no-ensayo aleatorizado realizado en una unidad de salud durante seis meses, con Registro Brasileño de Ensayos Clínicos: RBR-43K52N, todos los participantes fueron diagnosticados con diabetes mellitus tipo 2 y síndrome metabólico (grupo intervención, n=26; grupo control, n=25). La intervención consistió en un programa educativo de promoción de la salud con enfoque multidisciplinario, liderado por una enfermera, estructurado en siete talleres grupales. El resultado primario fue la reducción del estrés percibido y el secundario, la mejora de los componentes del síndrome metabólico influenciados por el nivel de estrés percibido, evaluado en dos momentos, al inicio y después del seguimiento. Resultados. La participación en el programa de intervención resultó en una reducción significativa del estrés percibido en comparación con el grupo control (p=0.028). Los participantes estresados en el grupo de intervención tuvieron, respectivamente, una disminución y un aumento significativos en las concentraciones séricas de glucosa (p=0.001) y lipoproteínas de alta densidad-colesterol (p=0.003) después de seis meses de intervención. Conclusión. Un programa educativo de promoción de la salud liderado por enfermeras fue eficiente para reducir el estrés percibido entre adultos con diabetes mellitus tipo 2 y síndrome metabólico, además de mejorar la glucemia en ayunas y el colesterol unido a lipoproteínas de alta densidad en los participantes del grupo estresado de intervención.

Objetivo. Avaliar a efetividade de uma intervenção educativa sobre o estresse percebido e os componentes da síndrome metabólica em adultos com diabetes mellitus tipo 2. Métodos. Foram incluídos 51 adultos (48.73±7.84 anos de idade; 86.3% mulheres) em um ensaio clínico não-randomizado realizado em uma unidade de saúde durante seis meses, com Registro de Ensaio Clínico Brasileiro: RBR-43K52N.Todos os participantes apresentavam diagnóstico de diabetes mellitus tipo 2 e síndrome metabólica (grupo intervenção, n=26; grupo controle, n=25). A intervenção consistiu em um programa educativo de promoção da saúde com abordagem multidisciplinar, liderado por enfermeiro, estruturado em sete oficinas em grupo. O desfecho primário foi a redução do estresse percebido, e o secundário, a melhora dos componentes da síndrome metabólica conforme influência do nível de estresse percebido, avaliados em dois momentos, na condição basal e após o acompanhamento. Resultados. A participação no programa de intervenção resultou na redução significativa do estresse percebido em comparação com o grupo controle (p=0.028). Os participantes estressados do grupo intervenção tiveram, respectivamente, diminuição e aumento significativos das concentrações séricas de glicose (p=0.001) e da lipoproteína-colesterol de alta densidade (p=0.003) após seis meses de intervenção. Conclusão. Um programa educativo de promoção da saúde liderado por enfermeiros foi eficiente para reduzir estresse percebido entre adultos com diabetes mellitus tipo 2 e síndrome metabólica, além de causar melhora da glicemia de jejum e e da lipoproteína-colesterol de alta densidade dos participantes estressados do grupo intervenção.

Profile of Facial Trauma Victims of Motorcycle Accidents Treated at a Hospital in Northeastern Brazil: A Prospective Study.

OBJECTIVE: To outline the profile of patients with facial trauma, victims of motorcycle accidents, treated at the Hospital da Restauração, Recife/PE, Brazil, from December 2020 to July 2021. METHODS: The collection was carried out through questionnaire and analysis of medical records. Data were analyzed descriptively, as well as Pearson's chi-square test or Fisher's exact test. RESULTS: Among the patients, 88.6% were male, 47.5% were between 18 and 29 years old, and 59.6% lived in rural areas; 72.15% of the victims used the motorcycle for work and 43.52% were working at the time of the accident. Most victims did not have a national motorcycle license (62%) and were not wearing a helmet at the time of the accident (60%), with 37.6% wearing a full-face helmet, 16.5% an open helmet, and 5.9% an articulated full-face helmet. Soft tissue injuries were the most prevalent. Zygomatic complex fractures were the most common facial fractures and were significantly associated with helmet use and type. CONCLUSIONS: Most victims of motorcycle accidents are young adult men, without a regular driver's license and residing in rural areas. Preventive and educational actions and continuous traffic inspections are necessary to minimize these accidents.

Clinical and epidemiological features of mpox in a Brazilian reference center for HIV and sexually transmitted infections: A cross-sectional study.

Background: The 2022 mpox outbreak has affected disproportionately people living with HIV (PLWH) and pre-exposure prophylaxis (PrEP) users. Methods: We conducted a cross-sectional study to evaluate factors associated with laboratory diagnosis of mpox among suspected cases, and access differences between PrEP users and PLWH with confirmed diagnostic. Results: 394 mpox suspected cases were analyzed, 309 (78.4%) confirmed. Most patients with mpox were PLWH (54.4%) and 99 (32%) PrEP users. Mpox cases were likely to be between 25 and 39 years old (aOR=2.8; p=0.042), men who have sex with men/bisexual or transgender women (aOR=17.2; p< 0.001) and to have fever (aOR=4.7; p< 0.001), adenomegaly (aOR=7.2; p< 0.001) and multiple vesicular lesions (aOR=4.2; p< 0.001). Comparing PrEP users to PLWH with confirmed mpox, PrEP users had lesions predominantly with exclusive genital involvement (p=0.016); while PLWH had higher extragenital involvement (p=0.018). Conclusions: PrEP users and PLWHA were the main epidemiological groups in our cohort. Recognizing the differences between vulnerable populations can contribute to the development public policies to control mpox in settings with reduced access to vaccines.

Health condition, income loss, food insecurity and other social inequities among migrants and refugees during the COVID-19 pandemic in Brazil.

BACKGROUND: Brazil is the destination of many international migrants and refugees and, given the circumstances of their entry into the country, many face difficulties due to the absence of targeted policies. Thus, the objective of this study was to survey the social impact of COVID-19 on international migrants and refugees regarding income loss, food insecurity and other social inequities, and to identify explanatory factors on these aspects. METHODS: This is a cross-sectional, analytical study. We used a validated instrument applied by trained interviewers. Descriptive analysis and binary logistic regression were performed to identify factors associated with income loss and food insecurity. RESULTS: A total of 360 individuals from sub-Saharan African and South American countries participated in the study. Individuals who were white, black/brown, yellow, had an occupation/employment, and earned less than one minimum wage were more likely to lose income. Those who reported no income, received less than one minimum wage, and were diagnosed with COVID-19 were more likely to be food insecure. CONCLUSIONS: The study advances knowledge by identifying factors associated with income loss, food insecurity, and individuals' difficulty in accessing health services and social support measures in Brazil.

Spawning ecology of the Saint Paul's Gregory Stegastes sanctipauli, a damselfish endemic to the remote St Peter and St Paul's Archipelago.

We studied the spawning ecology of Stegastes sanctipauli, a damselfish endemic to the small and remote St Peter and St Paul's Archipelago (Brazil), aiming to determine the main correlates of reproductive success, as inferred from rates of egg losses along a spawning season. New clutches appeared mostly in the last quarter moon, when egg predation intensified. Predation by heterospecifics, particularly Halichoeres radiatus (Linnaeus, 1758), accounted for most egg losses, while filial cannibalism showed negligible influence. Predation pressure was highest for larger nests with higher initial density of eggs. Hatching of eggs occurred close to the new moon (i.e., ~5 days after spawning). Most nests occur in shallow reefs (<16 m depth), where main food resources for adults (turf algae) are concentrated, but abundance of egg predators, particularly H. radiatus, is also highest. This latter result suggests that the spawning activity of S. sanctipauli is influenced by the trade-offs between food accessibility by adults and egg predation risk. The patterns recorded here are similar to those known for other tropical damselfish species and may reflect strategies for attenuating predation pressure over new fry and eggs.

Relationship between the use and types of helmets with facial injuries - a prospective study.

INTRODUCTION: many studies have demonstrated the benefits of helmet to prevent and reduce severity of injuries in motorcyclists. OBJECTIVE: the aim of the present study was to evaluate a possible relationship between the use of different types of helmets and the occurrence of facial injuries among victims of motorcycle accidents, seen at Hospital da Restauração, Recife/PE, Brazil. MATERIALS AND METHODS: demographic and trauma data were collected from hospitalized motorcycle accident victims with facial injuries from December 2020 to July 2021. Pearsons chi-square test was used to assess association between two categorical variables using a margin of error of 5%. RESULTS: among the participants, the average age was 33.46 years. The age group between 18 and 29 years was the most prevalent. Most participants were male. 60.0% of motorcyclists used helmets at the time of the accident and of this percentage 37.6% used fixed full-face helmet, 16.5% open-face helmet and the other 5.9% articulated full-face helmet. 62.7% of participants had facial fractures. Among the fractures, those of the zygomatic-orbital complex were the most common fracture and were significantly associated with the use of helmets, especially with open-face helmet. CONCLUSIONS: the use of helmets was associated with a lower number of facial fractures among patients who were victims of motorcycle accidents. Fracture of the zygomatic-orbital complex was related to the absence of a helmet at the time of the accident, as well as the use of open-face helmets.

Acceptability of teleconsultation in a public service specialized in the prevention and care of HIV infection and other sexually transmitted infections / Aceitabilidade da teleconsulta em um serviço público especializado na prevenção e cuidado da infecção pelo HIV e outras infecções sexualmente transmissíveis

Introduction: Telemedicine was leveraged for its contribution to mitigate the impact of COVID-19 in Brazil and worldwide. Objective: We aim to evaluate the acceptability of incorporating teleconsultation through synchronized videoconference by users and professionals in a service specialized in the prevention and treatment of the human immunodeficiency virus and other sexually transmitted infections, and to identify associated factors. Methods: This is a cross-sectional study with 410 users and 57 professionals who answered a category-standardized questionnaire. Predictors of acceptability were assessed using logistic regression model. Results: A total of 364 (88.8%) users said they would accept the modality. The factors positively associated with the odds of acceptance were the self-assessment of having favorable conditions to participate in a teleconsultation (aOR 54.8; 95%CI 12.4­242.1; p<0.001), the perception of saving money (aOR 5.2; 95%CI 1.9­14.0; p=0.001), and perceived convenience of the modality (aOR 6.7; 95%CI 2.9­15.9; p<0.001). Factors associated with reduced odds of acceptance were the fear of not being evaluated well (aOR 0.2; 95%CI 0.1­0.4; p<0.001), or remaining long without seeing the professional (aOR 0.2; 95%CI 0.1­0.5; p<0.001). The acceptance of the modality among professionals was 75.4% and the perception of its convenience (aOR 16.8; 95%CI 2.6­108.4; p=0.003) and that the institution has appropriated conditions (aOR 7.7; 95%CI 1.5­40.6; p=0.016) were associated with increased odds of accepting its incorporation in their routine. Conclusion: Governance should invest in infrastructure and support, secure protocols, digital literacy, and training of its users and employees for video teleconsultation. (AU)

Introdução: A telemedicina foi alavancada por sua contribuição para mitigar o impacto da COVID-19 no Brasil e no mundo. Objetivo: Pretendemos avaliar a aceitabilidade da incorporação da teleconsulta por videoconferência síncrona por usuários e profissionais de um serviço especializado na prevenção e tratamento da infecção pelo vírus da imunodeficiência humana (HIV) e outras infecções sexualmente transmissíveis, bem como identificar fatores associados. Métodos: Estudo transversal com 410 usuários e 57 profissionais, que responderam a um questionário padronizado por categoria. Os preditores de aceitabilidade foram avaliados utilizando-se um modelo de regressão logística. Resultados: O total de 364 (88,8%) usuários disseram que aceitariam a modalidade. Os fatores positivamente associados à probabilidade de aceitação foram a autoavaliação quanto a ter condições favoráveis para participar de uma teleconsulta (razão de chances ajustada ­ aOR 54,8; intervalo de confiança de 95% ­ IC95% 12,4­242,1; p<0,001), a percepção de poupar dinheiro (aOR 5,2; IC95% 1,9­14,0; p=0,001) e a percepção de conveniência da modalidade (aOR 6,7; IC95% 2,9­15,9; p<0,001). As menores probabilidades de aceitação foram o medo de não ser bem avaliado (aOR 0,2; IC95% 0,1­0,4; p<0,001) e de permanecer muito tempo sem ver o profissional (aOR 0,2; IC95% 0,1­0,5; p<0,001). A aceitação da modalidade pelos profissionais foi de 75,4% e a percepção de sua conveniência (aOR 16,8; IC95% 2,6­108,4; p=0,003) e a de que a instituição possui condições favoráveis (aOR 7,7; IC95% 1,5­40,6; p=0,016) foram associadas com a maior probabilidade de aceitar a incorporação da modalidade em sua rotina. Conclusão: A governança deve investir em infraestrutura e apoio, protocolos seguros, literacia digital e treinamento de seus usuários e funcionários para a videoconsulta. (AU)

Malignant hyperthermia in maxillofacial surgery: Literature review supported by case presentation.

OBJECTIVE: Malignant hyperthermia (MH) is characterized by a state of hypermetabolism after exposure to halogenated inhalational anesthetics or succinylcholine. The aims of this study were to carry out an updated review on the subject and report an illustrative case of MH in urgent maxillofacial surgery. MATERIAL AND METHODS: A search of the PubMed/MEDLINE database using the keyword "malignant hyperthermia" was performed including articles published over the last 11 years in English, Spanish or Portuguese. Exclusion criteria were similar presentations but not associated with MH and cases not related to the use of anesthetic drugs as a trigger of the condition. CASE REPORT: A 45-year-old man (75 kg, ASA status IE) with a negative family history for neuromuscular diseases, victim of a car accident with a facial fracture, underwent surgery under balanced general anesthesia and developed signs of MH 4 h after anesthesia induction. In our patient, the causative agent was sevoflurane and the diagnosis of MH was confirmed, subsequently, by muscle biopsy. RESULTS/DISCUSSION: Overall, 44 cases of MH were found. According to the recent literature, MH shows a male predilection (3:1) and the mean age of patients is 32.2 ± 22.2 years. The most frequently cited causative agents were sevoflurane (30.5%), isoflurane (22.2%), and sevoflurane + succinylcholine (13.8%). The most common clinical indicators included hypercarbia (88.8%), hyperthermia (86.1%), and tachycardia (63.8%). Dantrolene was administered in 24 cases. The outcome was favorable in 31 cases (86.1%). The in vitro muscle contracture test (IVCT) was performed in only 15 patients and all of them tested positive. In our patient, the causative agent was sevoflurane and the diagnosis of MH was confirmed by muscle biopsy. CONCLUSION: The mortality from MH is still high and an early clinical diagnosis and specific treatment with dantrolene are necessary for a favorable outcome. A complete understanding will allow better management of patients with MH. At present, the best management is to identify susceptible patients and to avoid triggering agents, combined with vigilant monitoring.

Boas práticas em saúde integral para travestis, transexuais e outras variabilidades de gênero/gêneros diversos: experiência do Ambulatório de Saúde Integral para Travestis e Transexuais (ASITT) do Centro de Referência e Treinamento DST/Aids-SP, Secretaria de Estado da Saúde de São Paulo / Good practices in integral health for travestis, transsexuals and other variabilities of gender/different genders: experience of the Health Outpatient Clinic for Travestis and Transsexuals (ASITT) of the STD/AIDS Reference and Training Center-SP, State Department of Health of Sao Paulo

O Centro de Referência e Treinamento DST/Aids-SP da Secretaria de Estado da Saúde de São Paulo, inaugurou, em junho de 2009, em suas dependências, o primeiro ambulatório voltado exclusivamente à saúde integral de travestis e transexuais do país, com ênfase no processo transexualizador do Sistema Único de Saúde (SUS) e nas necessidades dessa população. Este artigo tem por objetivo apresentar as modalidades assistenciais ofertadas no serviço, as demandas da população atendida no ambulatório, suas vulnerabilidades, fatores de risco e resiliência a que está submetida, assim como as considerações e os desafios no campo da política pública voltada à população trans para promover seu acesso à atenção em saúde de forma acolhedora, livre de preconceito, julgamentos morais e práticas discriminatórias.

A implementação da linha de cuidado para travestis e transexuais e outras variabilidades de gênero no estado de São Paulo / The implementation of the line of care for travestis and transsexuals and other gender variability in the state of Sao Paulo

Este texto tem por finalidade apresentar a linha de cuidado (LC) planejada e articulada com a implementação de novos serviços, integrada a um conjunto de práticas mais abrangentes de assistência em saúde e aos demais setores responsáveis por políticas públicas que tenham como objetivo atender travestis e transexuais e outras variabilidades de gênero. Consideramos que a implementação de atenção integral à população travesti e transexual envolve um conjunto de ações e procedimentos em saúde ofertados para melhor qualificação e proposta para demandas de experiências integrais de pessoas trans e com variabilidade de gênero no campo da saúde e do Sistema Único de Saúde (SUS), incluindo modificação das características corporais, com o objetivo de adquirir e expressar características do gênero com o qual essas pessoas se identificam e ao qual declaram pertencer.

Estresse percebido em mulheres com síndrome metabólica: um estudo transversal / Perceived stress in women with metabolic syndrome: a cross-sectional study / Estrés percibido en mujeres con síndrome metabólico: un estudio transversal

Introdução: o estresse percebido foi sugerido como um fator de risco para o desenvolvimento da Síndrome Metabólica (SM). No entanto, pouco se sabe desta associação entre mulheres. Objetivo: avaliar o estresse percebido em mulheres com SM. Materiais e Métodos: estudo transversal, a partir do recorte de um ensaio clínico não-randomizado, com pacientes de um centro de saúde público (RBR-43K52N). A variável de desfecho foi a SM, utilizando os critérios do NCEP/ATPIII. Foram coletados dados sociodemográficos, antropométricos, bioquímicos, hemodinâmicos e aplicação da PSS. Resultados: A amostra constituiu-se de 75 mulheres acometidas por SM (47,69±8,15 anos de idade; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,54±7,28). Encontrou-se valores elevados de RCQ entre as mulheres estressadas e não-estressadas. A pontuação média da PSS foi de 27,73±9,17. Nos agrupamentos, verificou-se diferença significativa para PSS entre as mulheres estressadas e não-estressadas (35,24±5,22 e 20,42±5,53, respectivamente; p=0,001). Observou-se também que mulheres estressadas tinham níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas, embora sem diferença estatística. Discussões: Os achados sugerem que as mulheres categorizadas como estressadas tinham maior pontuação da PSS, níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas. Conclusões: a pontuação da PSS foi significativamente maior entre mulheres com parâmetros lipídicos da SM alterados, com menores níveis de HDL- e aumento de triglicerídeos.

Introduction: Perceived stress has been suggested as a risk factor for the development of Metabolic Syndrome (MS). However, little is known about this association among women. Objective: to evaluate perceived stress in women with Metabolic Syndrome (MS). Materials and Methods: cross-sectional study, based on a non-randomized clinical trial, with patients from a public health center (RBR-43K52N). The outcome variable was MS, using the NCEP/ATPIII criteria. Sociodemographic, anthropometric, biochemical, hemodynamic data and PSS application were collected. Results: The sample consisted of 75 women affected by MetS (47.69± 8.15 years old; 155.65±0.07 cm; 82.43±17.79 kg; BMI of 33.96±6 ,42). High WHR values were found among stressed and non-stressed women. The average PSS score was 27.73±9.17. In the groups, there was a significant difference for PSS between stressed and non-stressed women (35.24±5.22 and 20.42±5.53, respectively; p=0.001). It was also observed that stressed women had higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women, although without statistical difference. Discussions: The findings suggest that women categorized as stressed had higher PSS scores, higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women. Conclusions: the PSS score was significantly higher among women with altered MS lipid parameters, with lower levels of HDL- and increased triglycerides.

Introducción: El estrés percibido ha sido sugerido como un factor de riesgo para el desarrollo del Síndrome Metabólico (SM). Sin embargo, poco se sabe sobre esta asociación entre las mujeres. Objetivo: evaluar el estrés percibido en mujeres con Síndrome Metabólico (SM). Materiales y Métodos: estudio transversal, basado en un ensayo clínico no aleatorizado, con pacientes de un centro de salud pública (RBR-43K52N). La variable resultada fue SM, utilizando los criterios NCEP/ATPIII. Se recogieron datos sociodemográficos, antropométricos, bioquímicos, hemodinámicos y aplicación de PSS. Resultados: La muestra estuvo compuesta por 75 mujeres afectadas por SMet (47,69± 8,15 años; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,96±6,42). Se encontraron valores altos de WHR entre mujeres estresadas y no estresadas. La puntuación media de PSS fue de 27,73±9,17. En los grupos, hubo una diferencia significativa para PSS entre mujeres estresadas y no estresadas (35,24±5,22 y 20,42±5,53, respectivamente; p=0,001). También se observó que las mujeres estresadas tenían niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con las mujeres no estresadas, aunque sin diferencia estadística. Discusiones: Los hallazgos sugieren que las mujeres categorizadas como estresadas tenían puntajes PSS más altos, niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con mujeres no estresadas. Conclusiones: la puntuación de PSS fue significativamente mayor entre las mujeres con parámetros lipídicos de SM alterados, con niveles de HDL más bajos y triglicéridos elevados.

Efeitos da Sexualidade na Funcionalidade Familiar e na Qualidade de Vida de Pessoas Idosas: Estudo Transversal / Effects of Sexuality on Family Functionality and Quality of Life of Elderly People: Cross-Sectional Study

Introdução: a literatura já aponta que a família, muitas vezes, é o principal obstáculo que impede as pessoas idosas vivenciarem sua sexualidade. Porém, até onde sabemos, não existem estudos que identifiquem os efeitos da sexualidade na funcionalidade familiar. Objetivo: analisar os efeitos da sexualidade sobre a funcionalidade familiar e sobre a qualidade de vida de pessoas idosas. Materiais e métodos: estudo seccional realizado com 692 pessoas idosas entre os meses de julho e outubro de 2020 por meio da utilização de instrumentos autoaplicáveis. Os dados foram analisados com o teste de Kruskal-Wallis, correlação de Pearson e modelagem de equações estruturais. Resultados: as pessoas idosas com algum grau de disfuncionalidade familiar apresentaram pior vivência na sexualidade e pior qualidade de vida. O domínio relações afetivas da sexualidade foi o único a exercer efeito de forma positiva, de moderada a forte magnitude com a funcionalidade familiar (CP=0,472 [IC95%=0,301-0,642] p<0,001). A qualidade de vida, por sua vez, sofreu efeito positivo, de fraca a moderada magnitude, de todos os domínios da sexualidade: ato sexual (CP=0,339 [IC95%=0,190-0,488] p<0,001); relações afetivas (CP=0,117 [IC95%= -0,041-0,275] p<0,001) e adversidades física e social (CP=0,150 [IC95%=0,074-0,226] p<0,001). Conclusão: a sexualidade entre as pessoas idosas pode ser explorada com maior frequência nos serviços de saúde, uma vez que, exerceu efeitos positivos na funcionalidade familiar e na qualidade de vida dessa população. Espera-se que com os resultados deste estudo, haja valorização da temática nos serviços assistenciais e que a sexualidade na velhice seja explorada com as pessoas idosas, especialmente na atenção primária à saúde.

Introduction: the literature already points out that the family is often the main obstacle that prevents elderly people from experiencing their sexuality. However, there are no studies that identify the effects of sexuality on family functioning. Objective: analyzing the effects of sexuality on family functionality and on the quality of life of the elderly. Materials and methods: a cross-sectional study conducted with 692 elderly people between the months of July and October 2020 by self-administered instruments. Data were analyzed using the Kruskal-Wallis test, Pearson correlation and structural equation modeling. Results: the elderly with some degree of family dysfunction had a worse experience in sexuality and a worse quality of life. The affective relationships domain of sexuality was the only one to exert a positive effect, from moderate to strong magnitude on family functionality (PC=0.472 [CI95%=0.301-0.642] p<0.001). Quality of life, in turn, had a positive effect, from weak to moderate magnitude, in all domains of sexuality: sexual act (PC=0.339 [CI95%=0.190-0.488] p<0.001); affective relationships (PC=0.117 [CI95%= -0.041-0.275] p<0.001) and physical and social adversities (PC=0.150 [CI95%=0.074-0.226] p<0.001). Conclusion: sexuality among the elderly can be explored more frequently in health services, as it exerted positive effects on family functionality and quality of life in this population. It is expected that with the results of this study, there is an appreciation of the theme in care services and that sexuality in old age is explored with the elderly, especially in primary health care

Introducción: la literatura ya señala que la familia es muchas veces el principal obstáculo que impide que las personas mayores experimenten su sexualidad. Sin embargo, hasta donde sabemos, no existen estudios que identifiquen los efectos de la sexualidad en el funcionamiento familiar. Objetivo: analizar los efectos de la sexualidad sobre la funcionalidad familiar y la calidad de vida de las personas mayores. Materiales y métodos: un estudio transversal realizado con 692 adultos mayores entre los meses de julio y octubre de 2020 utilizando instrumentos autoadministrados. Los datos se analizaron mediante la prueba de Kruskal-Wallis, la correlación de Pearson y el modelado de ecuaciones estructurales. Resultados: los ancianos con algún grado de disfunción familiar tuvieron peor experiencia en sexualidad y peor calidad de vida. El dominio de las relaciones afectivas de la sexualidad fue el único que ejerció un efecto positivo, de moderada a fuerte magnitud acerca de la funcionalidad familiar (CP = 0,472 [IC95% = 0,301-0,642] p <0,001). La calidad de vida, a su vez, tuvo un efecto positivo, de débil a moderada magnitud, en todos los dominios de la sexualidad: acto sexual (CP = 0,339 [IC95% = 0,190-0,488] p <0,001); relaciones afectivas (CP = 0,117 [IC95% = -0,041-0,275] p <0,001) y adversidades físicas y sociales (CP = 0,150 [IC95% = 0,074-0,226] p <0,001). Conclusión: la sexualidad entre los adultos mayores puede ser explorada con mayor frecuencia en los servicios de salud, ya que ejerció efectos positivos acerca de la funcionalidad familiar y la calidad de vida en esta población. Se espera que, con los resultados de este estudio, se aprecie la temática en los servicios de atención y que se explore la sexualidad en la vejez con los ancianos, especialmente en la atención primaria de salud.

As Ouvidorias do SUS e a Rede Brasileira de Escolas de Saúde Pública: uma experiência inédita / SUS Ombudsman offices and the Brazilian Public Health School Network: a novel experience

RESUMO Este relato de experiência teve como objetivo analisar o processo de formação de ouvidores do Sistema Único de Saúde (SUS), uma parceria entre a Escola Nacional de Saúde Pública Sergio Arouca (Ensp/ Fiocruz), a Rede Brasileira de Escola de Saúde Pública (RedEscola) e a Secretaria de Gestão Estratégica e Participativa do SUS (SGEP/MS). Considerada pioneira, a formação foi desenvolvida dentro da lógica de construção participativa, envolvendo atores municipais, estaduais e nacionais das Ouvidorias do SUS, instituições/escolas de saúde pública estaduais, Conselho Nacional de Secretarias Municipais de Saúde (Conasems) e Secretaria Técnica e Executiva da RedEscola, em uma articulação de governança consertada que resultou na formação de 451 ouvidores.

ABSTRACT This experience report aimed to analyze the vocational education of ombudsmen in the Unified Health System (SUS). This project was a partnership between the Sergio Arouca National School of Public Health (ENSP/FIOCRUZ), the Brazilian Network of Public Health Schools (RedEscola), and the SUS Strategic and Participatory Management Secretary (SGEP/MS). Considered pioneering, the vocational education was developed within the logic of a participatory process which involved municipal, state and national actors from SUS Ombudsman offices, state public health institutions/schools, the National Council of Municipal Health Secretaries (CONASEMS), and the RedEscola's Technical and Executive Secretary in a consensual governance articulation resulting in the qualification of 451 ombudsmen.

Repercussões no contexto familiar do paciente com câncer de próstata

Objetivo Analisar as repercussões no contexto familiar do paciente com câncer de próstata. Método Foi realizada uma pesquisa descritiva com abordagem qualitativa, que teve como participantes 10 homens com diagnóstico de câncer de próstata, que tinham convívio familiar e que estavam cadastrados no Programa do Tratamento Fora do Domicílio (TFD) do município de Ipiaú, Bahia. A coleta de dados foi realizada através de uma entrevista, seguindo um roteiro semiestruturado, com visitas no domicílio dos participantes. Resultados A maior incidência de pacientes com câncer de próstata está na faixa etária maior que 70 anos, comparando com idades inferiores. O carcinoma acomete homens acima de 65 anos e sua incidência é ascendente em homens da raça negra, quando comparados ao da raça branca. A história familiar é um grande fator de risco para a ocorrência desta doença. A falta de informação faz com que a maioria dos homens resista ao exame, por preconceito ou mesmo medo do desconhecido, podendo afetar sua qualidade de vida. Conclusão O estudo evidenciou a importância da participação da família no processo de descoberta do câncer, bem como durante o seu diagnóstico e tratamento, o que leva os pacientes a superarem as diversas dificuldades vivenciadas. Outro ponto relevante é o cuidado como fator de grande importância no atendimento ao paciente, sendo considerado como facilidade durante o tratamento.

Objective To analyze the repercussions in the family context of patients with prostate cancer. Method A qualitative descriptive study was carried out with ten men diagnosed with prostate cancer and with a family relationship, who were enrolled in the Out of Home Treatment Program (PDT) of the city of Ipiaú, Bahia. The data was collected through interviews, using a semi-structured script, and visits were made to the participants' homes. Results The highest incidence of prostate cancer occurs in men aged over 70 years, compared to those in younger age groups. Prostate carcinoma primarily affects men over the age of 65, with a higher incidence rate in black men than in white men. A family history of prostate cancer is a major risk factor for developing the disease. Despite this, many men are reluctant to undergo screening exams due to misinformation, prejudice, or fear of the unknown. This reluctance can significantly impact their quality of life. Conclusion The study highlighted the importance of family involvement in the process of cancer diagnosis, treatment, and recovery, as it can help patients overcome the various challenges they face. Additionally, the study identified the significance of proper care during treatment, which can significantly improve the patient's overall experience.

Objetivo Analizar el impacto en el contexto familiar del paciente con cáncer de próstata. Método Se realizó un estudio descriptivo con enfoque cualitativo, en el que participaron 10 hombres diagnosticados con cáncer de próstata y con relaciones familiares, inscritos en el Programa de Tratamiento Fuera del Domicilio (TFD) del municipio de Ipiaú, Bahía. La recolección de datos se llevó a cabo mediante entrevistas, utilizando un guión semi-estructurado, y se visitaron los hogares de los participantes. Resultados La mayor incidencia de cáncer de próstata se presenta en hombres mayores de 70 años, en comparación con las edades más jóvenes. El carcinoma prostático afecta principalmente a los hombres mayores de 65 años, con una tasa de incidencia más alta en hombres de raza negra que en los de raza blanca. Tener antecedentes familiares de cáncer de próstata es un factor de riesgo importante para la aparición de esta enfermedad. A pesar de esto, muchos hombres se muestran reacios a someterse a exámenes de detección debido a la falta de información, prejuicios o miedo a lo desconocido, lo que puede afectar significativamente su calidad de vida. Conclusión El estudio demostró la importancia de la participación de la familia en el proceso de detección, diagnóstico y tratamiento del cáncer, pues ayuda a los pacientes a superar las diversas dificultades. Otro punto relevante es el cuidado, que se considera un factor muy importante en el cuidado del paciente y puede mejorar significativamente su experiencia durante el tratamiento.

Fatores associados ao risco de câncer de próstata

Objetivo Analisar os fatores associados ao risco de câncer de próstata. Métodos O estudo consiste em uma revisão integrativa, compreendendo os anos de 2008 a 2018, em artigos que tenham como tema principal o câncer de próstata e os fatores de riscos, realizada no banco de dados do portal da Biblioteca Virtual em Saúde (BVS), e nas bases da Literatura Latino-Americana e do Caribe (LILACS), Banco de Dados em Enfermagem (BDENF). Resultados Após pré-leitura e leitura seletiva, selecionaram-se 11artigos. Conclusão A abordagem dos homens na consulta de enfermagem é de fundamental importância na identificação dos fatores de riscos, sinais e sintomas de possíveis alterações, com o objetivo de rastrear e diagnosticar precocemente as neoplasias prostéticas, a fim de reduzir a mortalidade de uma população que historicamente não possui o habito de procurar os serviços de saúde, aumentando assim a incidência de doenças e agravos.

Objective To analyze the factors associated with prostate cancer risk. Method The study consists of an integrative review, covering the years 2008 to 2018, in articles that have as main theme prostate cancer and risk factors, conducted in the Virtual Health Library (VHL) portal database, and in the bases of Latin American and Caribbean Literature (LILACS), Nursing Database (BDENF). Results After pre-reading and selective reading, 11 articles were selected. Conclusions The approach of men during nursing consultations is of fundamental importance in identifying risk factors, signs, and symptoms of possible changes, with the aim of early screening and diagnosis of prostate neoplasms. This approach can help to reduce the mortality of a population that historically does not have the habit of seeking health services, and can help to increase the incidence of diseases and health issues.

Objetivo Analizar los factores asociados con el riesgo de cáncer de próstata. Método El estudio consistió en una revisión integradora, que abarcó los años 2008 a 2018, de artículos que tienen como tema principal el cáncer de próstata y los factores de riesgo, realizada en la base de datos del portal de la Biblioteca Virtual en Salud (VHL) y en las bases de Literatura Latinoamericana y del Caribe (LILACS) y la Base de Datos de Enfermería (BDENF). Resultados Después de la lectura previa y selectiva, se seleccionaron 11 artículos. Conclusión El enfoque de los hombres en la consulta de enfermería es de importancia fundamental para identificar los factores de riesgo, los signos y los síntomas de posibles cambios, con el objetivo de la detección temprana y el diagnóstico de neoplasias de próstata. Este enfoque podría reducir la mortalidad de una población que históricamente carece del hábito de buscar servicios de salud, lo cual aumenta la incidencia de enfermedades y enfermedades.

Physiological responses of Amaranthus cruentus L. to drought stress under sufficient- and deficient-nitrogen conditions.

Water and nitrogen availability are two major environmental factors that can impair plant growth, and when combined, their effects on plant performance can be either intensified or reduced. The objective of this study was to analyze the influence of nitrogen availability on the responses of Amaranthus cruentus's metabolism to water stress. The plants were cultivated in plastic pots filled with vermiculite, kept under greenhouse conditions, and were watered three times a week with 70% of a full strength nitrogen-free Long Ashton solution, containing 1.97 or 9.88 kg N ha-1 as ammonium nitrate. Photosynthetic parameters were evaluated in planta, and leaves were harvested for chemical analysis of photosynthetic pigments, proline, and phenolic contents. Higher nitrogen supply increased the shoot dry matter, photosynthetic pigments, photosynthesis, stomatal conductance, transpiration, total leaf nitrogen, proline, nitrate, and ammonium but reduced the concentration of flavonoids and total phenols. Six days of water stress did not affect dry matter, photosynthetic pigments, leaf nitrogen, ammonium, or specialized metabolites but increased the proline under high nitrogen and negatively affected stomatal conductance, transpiration, photosynthesis, relative water content, instantaneous water use efficiency, and leaf nitrate. The negative effect was more pronounced under high nitrogen supply. The results show that the addition of a high amount of nitrogen made the physiological processes of plants more sensitive to water stress, indicating that the plant response to water restriction depends on the interaction between the different environmental stressors to which the plants are subjected.

Sedentary behavior, physical inactivity, abdominal obesity and obesity in adults and older adults: A systematic review and meta-analysis.

BACKGROUND: Sedentary behavior and physical inactivity may increase the risk of obesity. This systematic review and meta-analysis aimed to investigate: i) the prevalence/incidence of sedentary behavior and physical inactivity, ii) the association of sedentary behavior and physical inactivity with obesity, and iii) the objective and subjective measures, diagnostic criteria, and cut-off points to estimate sedentary behavior and physical inactivity in adults and older adults with obesity. METHODS: We conducted a systematic review and meta-analysis in PubMed, Scielo, Lilacs, and Cochrane Library databases. A meta-analysis of a random-effects model was performed to estimate the combined prevalence of sedentary behavior and physical inactivity and their association with obesity. RESULTS: Twenty-three studies involving 638,000 adults and older adults were included in the systematic review. A meta-analysis was conducted with 111,851 individuals with obesity. The combined prevalence of sedentary behavior was 31% (95% CI, 23-41%), and physical inactivity was 43% (95% CI, 31-55%). Significant associations between obesity and sedentary behavior (OR 1.45, 95% CI, 1.21-1.75) and physical inactivity (OR 1.52, 95% CI, 1.23-1.87) were found. Nine studies have used objective measures to assess physical activity levels, such as accelerometers and pedometers, whereas fourteen applied subjective methods and self-reported questionnaires. CONCLUSIONS: As expected, we found elevated rates of sedentary behavior and physical inactivity in individuals with obesity and a positive risk association. The wide range of objective and subjective measures, methods and cut-offs resulted in great variations of physical inactivity and sedentary behavior estimates. TRIAL REGISTRATION: PROSPERO (CRD42016037747).

Comparison of two alar cinch base suture in orthognathic surgery: a randomized clinical trial.

Le Fort I osteotomy is widely used in orthognathic surgery to correct maxillary deformities. However, this osteotomy may be related with the increase of alar base width. The aims of the present study were to compare two alar cinch suture after Le Fort I osteotomy and observe which type presents a better result in controlling the enlargement of the alar base after maxillary repositioning in orthognathic surgery. A randomized clinical trial was carried out with 40 patients randomly assigned in two intervention groups: group 1 - patients submitted to internal suture and group 2 - patients submitted to external suture. Of the 40 patients, 65% were female and 35% were male. The mean age of the patients was 30,25 in group I and 28,6 in group II. There was an increase in the alar base width in both groups, with significant difference between the means (P < 0,001). It was possible to compare the evolution of the means of the alar base width between group I and group II. Thus, it was observed that the external technique (group II) better controlled alar base width after Le Fort I osteotomy. It was not possible to relate the enlargement of the alar cinch with maxillary movement performed (P > 0,05). Overall, alar base cinch suture is an essential component of Le Fort osteotomies to control the alar base width. In this study, the external technique was more effective when compared to the internal technique in controlling the enlargement of the alar base width.

Comparison of two alar cinch base suture in orthognathic surgery: a randomized clinical trial

Abstract Le Fort I osteotomy is widely used in orthognathic surgery to correct maxillary deformities. However, this osteotomy may be related with the increase of alar base width. The aims of the present study were to compare two alar cinch suture after Le Fort I osteotomy and observe which type presents a better result in controlling the enlargement of the alar base after maxillary repositioning in orthognathic surgery. A randomized clinical trial was carried out with 40 patients randomly assigned in two intervention groups: group 1 - patients submitted to internal suture and group 2 - patients submitted to external suture. Of the 40 patients, 65% were female and 35% were male. The mean age of the patients was 30,25 in group I and 28,6 in group II. There was an increase in the alar base width in both groups, with significant difference between the means (P < 0,001). It was possible to compare the evolution of the means of the alar base width between group I and group II. Thus, it was observed that the external technique (group II) better controlled alar base width after Le Fort I osteotomy. It was not possible to relate the enlargement of the alar cinch with maxillary movement performed (P > 0,05). Overall, alar base cinch suture is an essential component of Le Fort osteotomies to control the alar base width. In this study, the external technique was more effective when compared to the internal technique in controlling the enlargement of the alar base width.

Resumo A osteotomia Le Fort I é amplamente utilizada em cirurgia ortognática para corrigir as deformidades maxilares. No entanto, esse tipo de osteotomia pode estar relacionado ao aumento da largura da base alar. Os objetivos do presente estudo foram comparar duas técnicas de sutura da base alar após a realização da osteotomia Le Fort I, bem como observar qual tipo apresenta melhor resultado no controle do alargamento da base alar após o reposicionamento maxilar em cirurgia ortognática. Foi realizado um ensaio clínico randomizado com 40 pacientes alocados aleatoriamente em dois grupos de intervenção: grupo 1 - pacientes submetidos à técnica de sutura interna e grupo 2 - pacientes submetidos à técnica de externa. Dos 40 pacientes, 65% eram do sexo feminino e 35% do masculino. A média de idade dos pacientes foi de 30,25 no grupo I e 28,6 no grupo II. Houve aumento da largura da base alar em ambos os grupos, com diferença significativa entre as médias (P <0,001). Foi possível comparar a evolução das médias da largura da base alar entre o grupo I e o grupo II. Assim, observou-se que a técnica externa (grupo II) controlou melhor a largura da base alar após a osteotomia Le Fort I. Não foi possível relacionar o alargamento da base alar com o tipo de movimentação maxilar realizado (P> 0,05). No geral, a sutura da base alar é um componente essencial das osteotomias Le Fort para controlar o alargamento da base alar. Nesse estudo, a técnica externa foi mais eficaz quando comparada à técnica interna no controle do alargamento da largura da base alar.

The Effect of Toothpastes Containing Natural Extracts on Bacterial Species of a Microcosm Biofilm and on Enamel Caries Development.

This study investigated the effects of herbal toothpaste on bacterial counts and enamel demineralization. Thirty-six bovine enamel samples were exposed to a microcosm biofilm using human saliva and McBain saliva (0.2% sucrose) for 5 days at 37 °C and first incubated anaerobically, then aerobically-capnophilically. The following experimental toothpaste slurries (2 × 2 min/day) were applied: (1) Vochysia tucanorum (10 mg/g); (2) Myrcia bella (5 mg/g); (3) Matricaria chamomilla (80 mg/g); (4) Myrrha and propolis toothpaste (commercial); (5) fluoride (F) and triclosan (1450 ppm F), 0.3% triclosan and sorbitol (Colgate®, positive control); (6) placebo (negative control). The pH of the medium was measured, bacteria were analyzed using quantitative polymerase chain reaction, and enamel demineralization was quantified using transverse microradiography. The total bacterial count was reduced by toothpaste containing Myrcia bella, Matricaria chamomilla, fluoride, and triclosan (commercial) compared to the placebo. As far as assessable, Myrcia bella, Matricaria chamomilla, and Myrrha and propolis (commercial) inhibited the outgrowth of S. mutans, while Lactobacillus spp. were reduced/eliminated by all toothpastes except Vochysia tucanorum. Mineral loss and lesion depth were significantly reduced by all toothpastes (total: 1423.6 ± 115.2 vol% × µm; 57.3 ± 9.8 µm) compared to the placebo (2420.0 ± 626.0 vol% × µm; 108.9 ± 21.17 µm). Herbal toothpastes were able to reduce enamel demineralization.