Development and validation of the MultiScent-20 digital odour identification test using item response theory.

Although validated and reliable psychophysical tests of olfactory function are available, an easy-to-use and feasible test has yet to be developed. This study aimed to design a digital odour identification test, evaluate its validity, assess its reliability, establish a normative curve, and explore the impact of demographic factors. The odour identification test was presented with the Multiscent-20, a hand-held, tablet-like digital scent device that features an integrated odour digital delivery system. The identification performance on the 20 odours was assessed using item response theory (IRT). The normative curve was established by administering the test to a large sample of participants (n = 1299). The mean identification score was 17.5 (SD = 2.1). The two-parameter logistic IRT model provided the best fit, revealing variation in item discrimination and difficulty parameters. Educational attainment influenced performance, with primary education associated with lower scores. Additionally, sex was not found to be associated with performance. This study provides initial evidence supporting the validity and reliability of use of the Multiscent-20 as a digital odour identification test. The test's automation and portability enable the standardized delivery of olfactory stimuli and efficient automatic recording and scoring of responses.

Risk factors for healthcare professionals' mental health during the COVID-19 pandemic: a systematic review. / Fatores de risco à saúde mental dos profissionais da saúde durante a pandemia de COVID-19: revisão sistemática.

The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers' mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.

Neste estudo, nosso objetivo foi mapear as evidências disponíveis sobre os fatores de risco à saúde mental dos profissionais de saúde trabalhadores da linha de frente durante a pandemia de COVID-19. Trata-se de uma revisão sistemática que seguiu os critérios dos Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada independentemente, por quatro pesquisadores, seguindo os critérios de seleção nas bases de dados eletrônicas PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. No processamento de dados foi utilizado o software Zotero, responsável por criar e importar itens de acordo com os critérios estabelecidos pela pesquisa. Foram encontrados 18.733 artigos, dos quais 2.722 foram excluídos, a partir do programa Zotero, por estarem duplicados, e outros 366 excluídos manualmente. Após aplicação dos critérios de seleção, 43 artigos entraram na análise final desta revisão. Recomenda-se a elaboração de novas pesquisas científicas, sobretudo colocando como objeto a análise da saúde mental desses trabalhadores, com o objetivo de embasar a elaboração e implementação de programas e políticas públicas de saúde mental para os trabalhadores.

Fatores de risco à saúde mental dos profissionais da saúde durante a pandemia de COVID-19: revisão sistemática / Risk factors for healthcare professionals' mental health during the COVID-19 pandemic: a systematic review

Resumo Neste estudo, nosso objetivo foi mapear as evidências disponíveis sobre os fatores de risco à saúde mental dos profissionais de saúde trabalhadores da linha de frente durante a pandemia de COVID-19. Trata-se de uma revisão sistemática que seguiu os critérios dos Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada independentemente, por quatro pesquisadores, seguindo os critérios de seleção nas bases de dados eletrônicas PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. No processamento de dados foi utilizado o software Zotero, responsável por criar e importar itens de acordo com os critérios estabelecidos pela pesquisa. Foram encontrados 18.733 artigos, dos quais 2.722 foram excluídos, a partir do programa Zotero, por estarem duplicados, e outros 366 excluídos manualmente. Após aplicação dos critérios de seleção, 43 artigos entraram na análise final desta revisão. Recomenda-se a elaboração de novas pesquisas científicas, sobretudo colocando como objeto a análise da saúde mental desses trabalhadores, com o objetivo de embasar a elaboração e implementação de programas e políticas públicas de saúde mental para os trabalhadores.

Abstract The aim of the present study was to map the available evidence on the mental health risk factors of frontline health professionals during the COVID-19 pandemic. This is a systematic review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was independently carried out by four researchers, following the selection criteria in the electronic databases: PubMed Central, Ovid Technologies, GALE Academic Onefile, Science Citation Index Expanded. The data processing used Zotero software, responsible for creating and importing items according to the criteria established by the research. A total of 18,733 articles were found, of which 2,722 were excluded by the Zotero software because they were in duplicate, and another 366 were manually excluded. After applying the selection criteria, 43 articles entered the final analysis of this review. It is recommended that new scientific research be carried out, especially focusing on the analysis of health workers' mental health, aiming at providing the basis to create and implement public mental health programs and policies for workers.

The digital scent device as a new concept for olfactory assessment.

BACKGROUND: There are major challenges in olfactory measurements in clinical practice; therefore, a handheld digital scent device (DSD; Noar MultiScent 20) was developed as a tablet with an integrated storage system for odors. The DSD is a self-administered, handheld device that controls the duration of odor release to the nasal cavity through a touchscreen digital interface with automatic database generation. In this study we aimed to determine the feasibility of this DSD as an olfactory assessment test. METHODS: We recruited 180 participants (age [mean ± standard deviation], 34.58 ± 9.71 years; 114 women and 66 men) to participate in smell tests using both the DSD and the 40-item Smell Identification Test (SIT-40), which contained the same type and order of odors and the same multiple-choice answers. The scores were compared and evaluated for correlation between the tests, and test-retest reliability was calculated. RESULTS: The DSD test scores were higher than the SIT-40 scores (median [interquartile range], 32 [5.0] vs 31 [7.0]; p = 0.005). The completion time was less for the DSD test than for the SIT-40 (12.5 [5.0] vs 16 [6.0] minutes; p < 0.001). The tests were strongly correlated (Spearman rho = 0.74; p < 0.001) and exhibited a high level of agreement (Bland-Altman regression coefficient = 0.672; p = 0.003). The DSD test-retest reliability coefficient was 0.820. CONCLUSION: The DSD is feasible as an olfactory assessment test. The digitalization of olfactory assessment combined with data science may enable new research perspectives in the field of olfaction.

Pulmonary arterial pressure and nasal obstruction in mouth-breathing children: Similarities between adenotonsillar hypertrophy and allergic rhinitis.

BACKGROUND: Upper airway obstruction may cause pulmonary hypertension in childhood. In this study we aimed to identify a possible correlation of systolic pulmonary arterial pressure (SPAP), using Doppler echocardiography, with nasal patency (NP), as measured by rhinomanometry, in mouth-breathing (MB) children with allergic rhinitis (AR) and adenotonsillar hypertrophy (ATH). METHODS: In this cross-sectional study we evaluated 183 patients, from 2 to 12 years of age, at an MB referral clinic in Brazil, from December 2013 to 2017. We allocated patients to 4 etiology groups: group 1, 60 MBs with ATH; group 2, 47 MBs with AR; group 3, 43 MBs with both ATH and AR; and group 4, 33 nasal breathing control subjects. The ratio of total nasal inspiratory flow (assessed by active anterior rhinomanometry) and expected inspiratory flow adjusted for height determined the percent NP (%NP). RESULTS: The median %NP was higher in controls than in the MB groups (controls, 114% [79-147%]; ATH: 65% [5-116%]; AR: 57% [23-144%]; ATH and AR: 64% [3-120%]; p < 0.001). Median SPAP was higher in the MB groups than in controls (SPAP: ATH, 26.0 [20.0-35.0] mmHg; AR, 26.0 [22.0-32.0] mmHg; ATH and AR, 26.30 [20.0-34.0] mmHg; control, 22.0 [16.0-30.0] mmHg; p < 0.001). SPAP showed a negative association with %NP (Spearman's rho = -0.24; p < 0.001). CONCLUSION: Reduced nasal airflow in MB children showed a correlation with higher levels of systolic pulmonary arterial pressure. The AR and ATH groups were similar in nasal obstruction severity and systolic pulmonary arterial pressure level distribution.

Motor impairment in a rare form of spastic paraplegia (Spoan syndrome): a 10-year follow-up.

BACKGROUND: Spastic paraplegia, optic atrophy and neuropathy (Spoan syndrome) is an autosomal recessive disease with approximately 70 cases recorded in Brazil and Egypt. METHODS: This is a prospective longitudinal study performed with 47 patients affected with Spoan syndrome of seven communities of Rio Grande do Norte (Brazil) to investigate changes in motor function based on comparative data obtained from a 10-year follow-up. RESULTS: The mean age of the participants was 47.21 ± 12.42 years old, and the mean age at loss of ambulation and hand function were 10.78 ± 5.55 and 33.58 ± 17.47 years old, respectively. Spearman's correlation analysis between the score on the Modified Barthel Index and the investigated variables evidenced statistical significance for age (p < 0.001) and right- and left-hand grip strength (p = 0.042 and p = 0.021, respectively). Statistical significance was not evidenced for the remainder of the variables, including age at onset of symptoms (p = 0.634), age at loss of ambulation (p = 0.664) and age at loss of hand function (p = 0.118). CONCLUSIONS: Our analysis allows asserting that the participants exhibited slight dependence until age 35. The greatest losses occurred from ages 35 to 41, and starting at 50, practically all patients become completely dependent. These findings are relevant for determining the prognosis as well as suitable treatment, rehabilitation and assistive technology for these individuals.

Evolution of obstructive sleep apnea syndrome, nasal flow and systolic pressure of the pulmonary artery in children with indication for adenoidectomy and/or tonsillectomy over 18 months.

BACKGROUND: Obstructive sleep apnea syndrome in childhood has aroused great interest due to its cardiovascular repercussions and its adverse effects on the quality of life of the affected individuals. However, fundamental aspects of the syndrome remain unknown. OBJECTIVE: Herein we prospectively assessed pulmonary artery systolic pressure (PASP) and nasal flow in children with obstructive oral breathing with an indication for adenoidectomy and/or tonsillectomy and their relationship to the obstructive apnea and hypopnea index (OAHI). METHODS: Twenty-one children were evaluated at the time of the surgical indication (T0) and 18 months later (T1). Polysomnography, and rhinomanometry data were collected when we evaluated PASP. RESULTS: Among the 21 children, 13 (61.9%) presented an altered OAHI at T0. Fourteen children (66.7%) underwent surgery. Of these, nine (64.3%) had an altered OAHI at T0 and seven (50.0%) at T1. Of the seven non-operated children, four (57.1%) had an altered OAHI at T0 and two (33.3%) at T1. Mean nasal flow increased in both groups independently of surgery (p- ≤ 0.001). PASP exhibited a significant reduction between T0 and T1 in the operated group (p ≤ 0.001). OAHI of the operated group did not show a significant decrease over time (p = 0.074). In the non-operated children, the average nasal flow increased (p < 0.001), the PASP values did not reduce (p = 0.99), and the OAHI increased and then decreased over time (p = 0.025). CONCLUSION: PASP decreased significantly and OAHI did not normalize in the operated group. Mean nasal airflow increased in the operated and non-operated groups.

Fatores associados ao uso e grau de satisfação com cadeira de rodas na Síndrome Spoan / Factors associated with wheelchair use and satisfaction in Spoan syndrome

A síndrome Spoan é uma doença genética que associa paraparesia espástica, neuropatia axonal e atrofia óptica. Ao todo já foram registradas mais de 70 pessoas com essa síndrome em dez municípios dos estados do Rio Grande do Norte e Paraíba. Nesse estudo, o objetivo foi investigar a associação entre idade, nível de dependência e grau de satisfação com a cadeira de rodas usadas por 28 pessoas com essa síndrome. Foram aplicados instrumentos validados para avaliação da função motora, como o Índice de Barthel modificado; o Questionário de Avaliação da Satisfação do Usuário com a Tecnologia Assistiva de Quebec (QUEST 2.0) e o Formulário de Acompanhamento da Cadeira de Rodas para avaliar o grau de satisfação com equipamento de tecnologia assistiva. A maioria das pessoas com Spoan do sertão do nordeste brasileiro se encontra dependente de terceiros e necessita de cadeira de rodas concedidas pelos serviços públicos de saúde para a sua mobilidade. Essas pessoas têm pouco ou quase nenhum acesso aos serviços de atenção à saúde, incluindo os de reabilitação. E, embora satisfeitos com as cadeiras de rodas em uso, apontam dificuldades para o acompanhamento e monitoramento dos equipamentos, tanto quanto para aquisição de novas cadeira de rodas. O grau de satisfação não está relacionado à sua dependência funcional, mas sim à idade. Pessoas mais jovens mostraram-se mais satisfeitas com suas cadeiras de rodas

Spoan syndrome is a genetic disease that associates spastic paraparesis, axonal neuropathy and optical atrophy. In all, more than 70 people have been registered with this syndrome in ten municipalities in the states of Rio Grande do Norte and Paraíba. In this study, the objective was to investigate the association between age, level of dependence and degree of satisfaction with the wheelchair used by 28 people with this syndrome. Validated instruments were applied to assess motor function, such as the Modified Barthel Index; the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and the Wheelchair Follow up forms to assess the degree of satisfaction with assistive technology. the Assistive Technology Assessment Questionnaire (QUEST 2.0) and the Wheelchair Follow-up Form. Most people with Spoan syndrome from the northeastern Brazilian hinterland are dependent on third parties and need wheelchairs granted by public health services for their mobility. These people have little or no access to health care services, including rehabilitation. And although they are satisfied with the wheelchairs in use, they point out difficulties in following up and monitoring the equipment, as well as in acquiring new wheelchairs. The degree of satisfaction is not related to their functional dependence, but to their age. Younger people were more satisfied with their wheelchairs

A Systematic Review of Translation and Cross-Cultural Adaptation of Instruments for the Selection of Assistive Technologies.

This article presents a systematic review, for which research was carried out in the following electronic databases: Web of Science, Scopus, PubMed, and ERIC, in which several articles were found (n = 560). The results were analyzed based on the information obtained in the titles and abstracts, and the remaining studies were read in full for the analysis. The aim of this article was to identify the different questionnaires used for selecting items of assistive technology, describe and evaluate the translation and transcultural adaptation procedures, characterize the thematic domains of each resource, evaluate the cultural adaptation process adopted, and describe the psychometric properties. Data extraction and evaluation of the methodological quality of the eligible studies were performed in accordance with the COSMIN verification list with a checklist of 4 points. The publication of systematic review studies and others that synthesize research results is fundamental to provide support for change in the behavior of professionals in the field of health, and not only to access the available literature but also to incorporate this information into daily clinical practice. The results of this review could provide subsidies that would enable the planning, execution, identification, and choice of specific instruments for a determined study within the context of assistive technology, with a view to helping researchers and health professionals in clinical and investigatory practices.

[The causes of physical disability in municipalities of the northeast of Brazil and an estimate of costs of specialized services]. / As causas da deficiência física em municípios do nordeste brasileiro e estimativa de custos de serviços especializados.

The population of the northeast of Brazil is characterized by high rates of endogamy and disabilities. An epidemiological cross-sectional study using the informant method was conducted in eight communities in the hinterlands of Paraiba to describe genetic and acquired diseases that cause disabilities and to estimate the costs of specialized services such as physiotherapy and the acquisition of technological assistential equipment. From a population of 48,499 inhabitants, 338 individuals were screened and 123 (0.34%) were clinically, genetically and functionally assessed by a multidisciplinary team of specialists. Genetic factors were responsible for 58.5% of the disabilities, with some clusters of prevalent diseases being found within the sampled communities, namely progressive spinal muscular atrophy, spinocerebellar ataxia, muscular dystrophy and Spoan syndrome. The socioeconomic profile and the demand for rehabilitation services and technological assistance highlight the need to introduce and implement specific public health policies in these communities.

As causas da deficiencia fisica em municipios do nordeste brasileiro e estimativa de custos de servicos especializados / The causes of physical disability in municipalities of the northeast of Brazil and an estimate of costs of specialized services

As populações do nordeste brasileiro possuem elevadas taxas de endogamia e deficiências. Neste trabalho, foi realizado um estudo epidemiológico transversal com método do informante para descrever doenças genéticas e as adquiridas que causam deficiências físicas em oito municípios da Paraíba e estimar os custos por serviços especializados de fisioterapia e aquisição de equipamentos de tecnologia assistiva. De uma população de 48.499 habitantes, 338 pessoas foram triadas e 123 (0,34%) realizaram avaliação clínico-genética e funcional por uma equipe multidisciplinar de especialistas. Fatores genéticos foram responsáveis por 58,5% das deficiências, sendo encontrados alguns agrupamentos de afecções prevalentes nas populações amostradas: amiotrofia espinal progressiva, ataxia espinocerebelar, distrofia muscular e síndrome Spoan. A descrição do perfil socioeconômico e das demandas por serviços de reabilitação e tecnologia assistiva apontam para necessidade de estabelecimento de políticas públicas específicas para essas comunidades.

The population of the northeast of Brazil is characterized by high rates of endogamy and disabilities. An epidemiological cross-sectional study using the informant method was conducted in eight communities in the hinterlands of Paraiba to describe genetic and acquired diseases that cause disabilities and to estimate the costs of specialized services such as physiotherapy and the acquisition of technological assistential equipment. From a population of 48,499 inhabitants, 338 individuals were screened and 123 (0.34%) were clinically, genetically and functionally assessed by a multidisciplinary team of specialists. Genetic factors were responsible for 58.5% of the disabilities, with some clusters of prevalent diseases being found within the sampled communities, namely progressive spinal muscular atrophy, spinocerebellar ataxia, muscular dystrophy and Spoan syndrome. The socioeconomic profile and the demand for rehabilitation services and technological assistance highlight the need to introduce and implement specific public health policies in these communities.

Increased prevalence of inherited neuromuscular disorders due to endogamy in Northeast Brazil: the need of community genetics services.

The aim of this study was to investigate the prevalence of inherited neuromuscular disorders (NMDs) in eight communities in Northeast (NE) Brazil in which there was an elevated rate of inbreeding. A cross-sectional epidemiological study, using the key informant (KI) approach, was performed to estimate the prevalence of NMD among the 48,499 individuals living in these eight communities, located in the backlands of the Paraíba State. Twenty-seven individuals fulfilled the diagnostic criteria for inherited NMD, which means that 1 out of 1,796 inhabitants of this highly consanguineous population was affected by NMD. This is twofold higher than that observed in previous studies in general population and was probably due to a combination of genetic drift and inbreeding. Public policies should be implemented to offer genetics services in high-risk communities.

A tecnologia assistiva e os cuidados específicos na concessão de cadeiras de rodas no Estado do Rio Grande do Norte / Assistive Technology and specific care in the granting of wheelchairs inRio Grande do Norte state

O Programa de Concessão de Órteses e Próteses do Estado Rio Grande do Norte foi reestruturado por uma equipe de terapeutas ocupacionais e fisioterapeutas especializados em tecnologia assistiva, que contam com um showroom de equipamentos para dar suporte na realização de prescrições e avaliações de forma individualizada, permitindo a entrega de equipamentos específicos. O programa também possui outros profissionais, como técnicos de oficinas ortopédicas, que fazem o trabalho de ajuste e adaptações das cadeiras de rodas, quando necessário, e assistentes sociais, que seguem todos os processos burocráticos de documentação e de compra das cadeiras de rodas, levando a um fluxo contínuo de entrega de equipamentos ao longo do ano. Esse tipo de organização estrutural pode ser considerado diferenciado do de outros estados. Neste trabalho, um estudo foi promovido para caracterizar a demanda de dispositivos de assistência para locomoção como, por exemplo, cadeiras de rodas, e descrever o processo de licitação e entrega do Programa de Concessão de Órteses e Próteses do Estado do Rio Grande do Norte. O estudo foi conduzido após informações dos últimos três anos do processo de entrega de cadeira de rodas desse programa terem sido analisadas e correlacionadas. Com o fim de promover a inclusão social das pessoas com deficiência, são discutidas a estrutura organizacional, o funcionamento e as facilidades apresentadas.(AU)

The Orthesis and Prosthesis Grant Program from Rio Grande do Norte State was restructured by a team of occupational and physical therapists specialized in Assistive Technology. The sector has a showroom for the equipment, prepares prescriptions, and makes deliveries after individual assessment made by the team. The work is developed in conjunction with orthopedic workshop technicians to adjust and adapt the wheelchairs when necessary. Social workers guide and follow the bureaucratic processes of documentation and purchasing, which allows the handing in of wheelchairs throughout the year. This program is considered distinctive compared to programs from other states. In this work, a study was conducted to characterize the demand for locomotion assistance devices, such as wheelchairs, and describe the delivery and acquisition process of the Orthesis and Prosthesis Grant Program from Rio Grande do Norte State. The study was carried out after analyzing and correlating information on the wheelchair delivery process in the past three years. A discussion on the organizational structure, operation, and acquisition facilities of this program is presented in order to promote the social inclusion of people with special needs.(AU)

A tecnologia assistiva e os cuidados específicos na concessão de cadeiras de rodas no Estado do Rio Grande do Norte / Assistive Technology and specific care in the granting of wheelchairs inRio Grande do Norte state

O Programa de Concessão de Órteses e Próteses do Estado Rio Grande do Norte foi reestruturado por uma equipe de terapeutas ocupacionais e fisioterapeutas especializados em tecnologia assistiva, que contam com um showroom de equipamentos para dar suporte na realização de prescrições e avaliações de forma individualizada, permitindo a entrega de equipamentos específicos. O programa também possui outros profissionais, como técnicos de oficinas ortopédicas, que fazem o trabalho de ajuste e adaptações das cadeiras de rodas, quando necessário, e assistentes sociais, que seguem todos os processos burocráticos de documentação e de compra das cadeiras de rodas, levando a um fluxo contínuo de entrega de equipamentos ao longo do ano. Esse tipo de organização estrutural pode ser considerado diferenciado do de outros estados. Neste trabalho, um estudo foi promovido para caracterizar a demanda de dispositivos de assistência para locomoção como, por exemplo, cadeiras de rodas, e descrever o processo de licitação e entrega do Programa de Concessão de Órteses e Próteses do Estado do Rio Grande do Norte. O estudo foi conduzido após informações dos últimos três anos do processo de entrega de cadeira de rodas desse programa terem sido analisadas e correlacionadas. Com o fim de promover a inclusão social das pessoas com deficiência, são discutidas a estrutura organizacional, o funcionamento e as facilidades apresentadas.

The Orthesis and Prosthesis Grant Program from Rio Grande do Norte State was restructured by a team of occupational and physical therapists specialized in Assistive Technology. The sector has a showroom for the equipment, prepares prescriptions, and makes deliveries after individual assessment made by the team. The work is developed in conjunction with orthopedic workshop technicians to adjust and adapt the wheelchairs when necessary. Social workers guide and follow the bureaucratic processes of documentation and purchasing, which allows the handing in of wheelchairs throughout the year. This program is considered distinctive compared to programs from other states. In this work, a study was conducted to characterize the demand for locomotion assistance devices, such as wheelchairs, and describe the delivery and acquisition process of the Orthesis and Prosthesis Grant Program from Rio Grande do Norte State. The study was carried out after analyzing and correlating information on the wheelchair delivery process in the past three years. A discussion on the organizational structure, operation, and acquisition facilities of this program is presented in order to promote the social inclusion of people with special needs.

Análise de indicadores de monitoramento de pacientes portadoresde doenças crônicas: estratégia de redução de custos / Analysis of indicators for monitoring patients having chronic diseases:a cost reduction strategy / Análisis de los indicadores para los pacientes en supervisión afectados por enfermedades crónicas: una estrategia de reducción de costes

A presente pesquisa teve como objetivo verificar se o Programa de Monitoramento de Pacientes Portadores de Doenças Crônicas é uma forma eficaz para redução dos custos de tratamento dos pacientes e, simultaneamente, verificar a capacidade para diminuiros índices de reinternação, ampliando, assim, os níveis de conhecimento dos gestores da área sobre medidas de promoção e prevenção à saúde como formas de redução de custos. A metodologia adotada foi a pesquisa de campo com natureza exploratória e descritiva, analisando os dados de 30 pacientes inscritos no programa de monitoramento, divididos em três grupos: pacientes portadores de doençascardiovasculares, pacientes com doenças pulmonares e pacientes com Diabetes mellitus. Após a análise dos dados, foi possível verificarque ocorreu uma redução significativa dos custos nos primeiros dois anos após a implantação do programa, principalmente no grupo depacientes com doenças pulmonares, assim como uma queda nos índices de reinternação desses pacientes. Os outros grupos analisados também demonstraram redução nos custos com seus tratamentos e queda nos índices de reinternação, porém em menor proporção. Concluiu-se que o programa de Monitoramento de Pacientes Portadores de Doenças Crônicas é uma forma eficaz para redução de custos.

The present research aimed at verifying whether the Monitoring Program for Chronic Diseases Patients is an efficient way for reducing the costs of treatment of patients and, simultaneously, verifying the capacity to reduce re-internment rates, extending,thus, the levels of knowledge of managers of the area as regards measures for health promotion and prevention as ways for reducingcosts. The methodology adopted was field research of an exploratory and descriptive nature, analyzing data of 30 patients enrolled in the monitoring program, divided in three groups: patients having cardiovascular diseases, patients having lung diseases and patientshaving Diabetes mellitus. After the analysis of gathered data, it was possible to verify that the implantation of the program produced a significant reduction of costs in the first two years, mainly in the group of patients with lung diseases, as well as a reduction in re--internment rates of these patients. The other groups also analyzed had demonstrated a reduction in the costs with their treatment and a reduction in rates of re-internment, but in a lesser degree. One concluded that the Monitoring Program for Chronic Diseases Patientsis an efficient way for reducing costs.

Esta investigación está dirigida a verificar si el programa de supervisión para pacientes afectados por enfermedades crónicases un modo eficaz para reducir los costes del tratamiento de pacientes y, simultáneamente, verificar la capacidad de reducir las tasas de re-internación, prolongando, así, los niveles de conocimiento de los encargados del área en cuanto a medidas para la promoción yla prevención de la salud como maneras para reducir costes. La metodología adoptada fue una investigación de campo de naturaleza exploratoria y descriptiva, analizando datos de 30 pacientes alistados en el programa de supervisión, dividido en tres grupos: pacientes que tienen enfermedades cardiovasculares, pacientes que tienen enfermedades pulmonares y pacientes que tienen Diabetes mellitus.Después del análisis de datos recopilados, se verificó que la implantación del programa produjo una reducción significativa de costesen los primeros dos años, principalmente en el grupo de pacientes con enfermedades pulmonares, así como una reducción en tasas dere-internación de estos pacientes. Los otros grupos también analizados han mostrado una reducción en los costes con su tratamiento y una reducción en tasas de re-internación, pero en menor grado. Uno concluyó que el programa de supervisión para los pacientes conenfermedades crónicas es un modo eficaz de reducir costes.

Aspectos humanos na gestão hospitalar: [revisão] / Aspectos humanos en la gestión hospitalaria: [revisión] / Human aspects of hospital management: [review]

A presente pesquisa tem por objetivo apresentar um resgate teórico sobre a interface entre a humanização e a gestão em saúde. A metodologia adotada foi a revisão bibliográfica, com natureza de pesquisa descritiva e abordagem qualitativa de dados. Após a análise dos dados coletados, identificou-se que os clientes de saúde percebem a necessidade de se sentirem mais acolhidos e estar em um ambiente mais humanizado. Acredita-se que as Instituições de Saúde terão que se adaptar às novas exigências desse mercado. Como resultado, observou-se que não existe um modelo único de implementação da humanização na saúde, mas que sua adoção é primordial podendo gerar fidelização de seus clientes/pacientes. Pode-se concluir que, por ser uma área relativamente nova, ainda se tem muito a explorar e aprender sobre o tema.

This investigation aims to present a theoretical discussion on the interface between humanization and management in the domain of health. The adopted methodology has been the bibliographical survey, and we did a descriptive investigation and qualitative data analysis. After analyzing the collected data, we identified that health clients perceive the necessity to feel more welcomed and to be in a more humanized atmosphere. One thinks that the Institutions of Health will need to adapt to the new demands of that market. As results, we observed there is not some exclusive model of implementation of humanization in health, although their adoption is fundamental, and may create fidelization in patients/clients. The possible conclusion is that, as humanization a relatively new area, we still need to explore and learn more on the subject.

Esta investigación tiene como meta presentar un rescate teórico sobre la interface entre la humanización y la gestión en el ámbito de la salud. La metodología adoptada ha sido la revisión bibliográfica, con naturaleza de investigación descriptiva y abordaje cualitativo de datos. Después del análisis de los datos recolectados, se identificó que los clientes de salud perciben la necesidad de sentirse más acogidos y estar en un ambiente más humanizado. Se cree que las Instituciones de Salud habrán que se adaptar a las nuevas exigencias de ese mercado. Como resultado, se observó que no hay un modelo único de implementación de la humanización en la salud, aunque su adopción sea primordial, y puede generar fidelización de sus clientes/pacientes. La conclusión posible es que, por ser la humanización un área relativamente nuevo, hay todavía mucho que explorar y aprender sobre el tema.

Comprovação anatomopatológica da presença de tecido vascular e nervoso evidenciado à ecografia como eco tangencial ao descolamento de coróide: relato de dois casos / Histopathologic confirmation of vascular and nervous tissue identified on ultrasound as an tangential image to choroidal detachment: report of two cases

São apresentados dois casos de descolamento de coróide em olhos com endoftalmite submetidos a enucleação. O estudo anatomopatológico permitiu identificar a presença de tecido vascular e nervoso interpondo-se entre a esclera e coróide deslocada, como havia sido evidenciado pela ecografia.

Two cases of endophthalmitis with choroidal detachment submitted to enucleation are presented. The histopathologic study allowed the identification of vascular and nervous tissue between the choroid and sclera, as it was seen on ultrasound examination.

Melanocitoma associado à membrana neovascular sub-retiniana / Melanocytoma associated to subretinal neovascular membrane

Relatamos caso de melanocitoma de disco óptico associado à membrana neovascular sub-retiniana. O paciente apresentava diminuição da visão, presença de descolamento seroso de retina, com hemorragia e exsudação e foi encaminhado com o diagnóstico de melanoma de coróide e sugestão de enucleação. São discutidas as principais características dos dois tumores e os detalhes do diagnóstico diferencial.

We report a case of optic disc melonocytoma associated to subretinal neovascular membrane. The patient presented with low visual acuity, serous retinal detachment with haemorrhage and exudates and was referred with the diagnosis of melanoma and an orientation to enucleate the eye. We discuss the major aspects of both tumors and the details of differential diagnostic.

[Histopathologic confirmation of vascular and nervous tissue identified on ultrasound as an tangential image to choroidal detachment: report of two cases]. / Comprovação anatomopatológica da presença de tecido vascular e nervoso evidenciado à ecografia como eco tangencial ao descolamento de coróide: relato de dois casos.

Two cases of endophthalmitis with choroidal detachment submitted to enucleation are presented. The histopathologic study allowed the identification of vascular and nervous tissue between the choroid and sclera, as it was seen on ultrasound examination.