The association between glaucoma treatment adherence with disease progression and loss to follow-up.

Prospective cohort study from Brazil to evaluate glaucoma treatment adherence using a medication event monitoring system (MEMS) device and correlate with glaucoma progression and loss to follow-up (LTF) after one year of follow up. We included primary open glaucoma (POAG) patients treated with at least one ocular hypotensive eye drop. MEMS devices was used to monitor adherence for 60 days and evaluate the percentage of doses prescribed taken within the 60-day period. We classified patients according to rates of adherence: low adherence (less than 75% from MEMS measurements) and high adherence (more than 75% from MEMS measurements). We applied a questionnaire to investigated self-reported behavior towards treatment behaviors (glaucoma treatment compliance assessment tool, GTCAT). We also correlated rates of treatment adherence with clinical, demographical variables and the occurrence of glaucoma progression or LTF after one year of observation. We included 110 POAG patients and found that 28.18% of them were considered low adherent. We identify several variables associated with poor adherence such as glaucoma progression, LTF, younger age, low educational and income levels, absence of health insurance, years of disease and peak intraocular pressure. Several constructs from the self-reported GTCAT were also correlated with the rates of treatment adherence. To date, this is the first study in Latin America to evaluate glaucoma treatment adherence with MEMS devices and correlate adherence rates with glaucoma progression and LTF. We found a low-adherence rate of 28.18% and several additional risk factors were statistically associated with poor adherence.

Clinical outcomes after femtosecond laser-assisted implantation of an intrastromal corneal ring segment with a 340-degree arc length in postkeratoplasty patients: 12-month follow-up.

PURPOSE: To assess the clinical outcomes after implantation of a new 340-degree arc length intrastromal corneal ring segment (ICRS) aided by the femtosecond laser in postkeratoplasty patients after a 12-month follow-up. SETTING: Private practice, Brasilia, Brazil. DESIGN: Prospective case series. METHODS: Eyes with previous keratoplasty had ICRS implantation assisted by femtosecond laser. The primary outcome measure was the change in the uncorrected distance visual acuity (UDVA) 12 months postoperatively. The secondary outcome measures were the corrected distance visual acuity (CDVA), refraction, and corneal tomography 1, 3, 6, and 12 months postoperatively. The astigmatism results were analyzed using vector analysis through the double-angle polar plot. RESULTS: Of the 18 patients, 7 (38.9%) were men, and 11 (61.1%) were women. The mean UDVA was 20/250 (1.15 logarithm of the minimum angle of resolution [logMAR]) before implantation and 20/70 (0.54 logMAR) at the last follow-up (P < .001). The mean CDVA improved from 20/35 (0.26 logMAR) to 20/25 (0.10 logMAR) (P < .001). The mean spherical equivalent and astigmatism components were significantly reduced after ICRS implantation. The mean corneal astigmatism decreased from 5.55 ± 2.29 D preoperatively to 3.92 ± 1.82 D postoperatively (P < .001). The CDVA remained the same or improved in 19 of 20 eyes and decreased by 1 line in 1 patient. There were no surgical complications. CONCLUSION: A new ICRS with a 340-degree arc length was effective in treating postkeratoplasty eyes, improving visual acuity and reducing corneal astigmatism.

Comparação dos meios de preparação e preservação de membrana amniótica humana para uso no tratamento de doenças da superfície ocular / Comparison of the preparation and preservation techniques of amniotic membrane used in the treatment of ocular surface diseases

Resumo Atualmente a membra amniótica (MA) tem obtido importância devido à comprovada capacidade de reduzir inflamação, auxiliar a cicatrização e epitelização, possuindo propriedades antimicrobianas e antivirais, além de baixa imunogenicidade. As indicações de seu uso na oftalmologia têm aumentado muito nas duas últimas décadas. Objetivo: Descrever a estrutura básica e as propriedades biológicas da MA em relação aos componentes da sua matriz extracelular e fatores de crescimento, as consequências de diferentes técnicas empregadas na sua preservação e esterilização, métodos para remoção do epitélio e a comparação dos custos dos diferentes meios de conservação atualmente empregados. Métodos: Pesquisa nas bases de dados do Portal da Biblioteca Virtual em Saúde (BVS), Pubmed, Cochrane, Scielo e Lilacs com as palavras-chave: membrana amniótica, transplante, reconstrução da córnea, doenças da conjuntiva. Resultados: A literatura é vasta na descrição dos efeitos de diversos agentes e técnicas na preparação da MA, dentre elas sua preservação, esterilização e desepitelização. A membrana desnuda tem sido a escolha para a reconstrução da superfície ocular, pois facilita a cicatrização. Em relação aos agentes conservantes, o glicerol é o meio mais utilizado mundialmente pelo baixo custo e facilidade de manuseio. Conclusão: A comparação das diversas técnicas nos guia na elaboração de protocolos de preparo da MA para uso oftalmológico. A membrana desnuda facilita a cicatrização em relação a com células epiteliais. O glicerol é o meio de conservação mais utilizado pelo baixo custo e facilidade de manuseio.

Abstract Currently, the amniotic membrane (AM) has obtained importance due to its ability to reduce inflammation, helping in the healing and epithelialization processes, having antimicrobial and antiviral properties and low immunogenicity. Its indications in ophthalmology have increased considerably in the past two decades. Objective: To describe the basic structure and biological properties of the AM, the components of the extracellular matrix and growth factors, the consequences of different techniques used in its preservation, and sterilization methods for the epithelium removal. To compare the costs of the different preservation solutions currently employed. Study design: literature review. Methods: Research in BVS databases, PubMed, Cochrane, Scielo and Lilacs with keywords: amniotic membrane transplantation, corneal reconstruction, conjunctival diseases. Results: The literature is vast in describing the effects of different agents and techniques used in the preparation of MA, including its preservation, sterilization and desepithelization. The naked membrane is the choice to reconstruct the ocular surface, as it facilitates the healing course. Regarding the preservatives, glycerol is the most used worldwide due its low cost and easy handling. Conclusion: Comparing different techniques guides us in developing a MA preparation protocol for ophthalmic use. The naked membrane facilitates the healing process compared with the presence of epithelial cells. The glycerol is the most used preservation method because of its low cost and easy handling.

Primary Pediatric Keratoplasty: Etiology, Graft Survival, and Visual Outcome.

PURPOSE: Interventional study to evaluate the etiology, visual outcome and survival of corneal transplantation in children and to identify the risk factors associated with graft failure. DESIGN: Retrospective, interventional consecutive case series. METHODS: Medical records of every child 7 years of age or younger who underwent primary penetrating keratoplasty at Department of Ophthalmology, Federal University of São Paulo were reviewed. The parameters evaluated were indications for keratoplasty, graft survival, and postoperative visual acuity (VA) improvement. Children underwent ophthalmologic examination before and after corneal graft, including VA, assessed by the preferential looking test and visual evoked potential. The analysis of transplant survival was performed using the Kaplan-Meier method. RESULTS: Fifty-six penetrating transplants were performed in 51 eyes of 43 children. The patients were divided into 2 groups: congenital (72.5%) and acquired (17.5%) corneal opacity. The main indication was congenital glaucoma (29.4%). The overall Kaplan-Meier graft survival rates were 64.7% in the postoperative average follow-up period of 24 months. There was no significant difference in graft survival between the congenital and acquired groups (Mantel-Cox P = .1031). There was significant improvement in VA in both groups (P = .0022 for congenital and P < .0001 for acquired). Rejection and diagnosis of congenital glaucoma were risk factors for graft failure. CONCLUSIONS: Congenital glaucoma was the main indication for corneal transplantation and despite the difficulties, prolonged survival and improved VA can be achieved in pediatric transplant. Complications such as rejection and early glaucoma were significantly associated with graft failure.

Effects of the implementation of a hand hygiene education program among ICU professionals: an interrupted time-series analysis.

OBJECTIVE: To evaluate the effects that a hand hygiene education program has on the compliance of health professionals in an ICU. METHODS: This was a quasi-experimental study with an interrupted time-series design, conducted over a 12-month period: the 5 months preceding the implementation of a hand hygiene education program (baseline period); the 2 months of the intensive (intervention) phase of the program; and the first 5 months thereafter (post-intervention phase). Hand hygiene compliance was monitored by one of the researchers, unbeknownst to the ICU team. The primary outcome measure was the variation in the rate of hand hygiene compliance. We also evaluated the duration of mechanical ventilation (MV), as well as the incidence of ventilator-associated pneumonia (VAP) at 28 days and 60 days, together with mortality at 28 days and 60 days. RESULTS: On the basis of 959 observations, we found a significant increase in hand hygiene compliance rates-from 31.5% at baseline to 65.8% during the intervention phase and 83.8% during the post-intervention phase, corresponding to prevalence ratios of 2.09 and 2.66, respectively, in comparison with the baseline rate (p < 0.001). Despite that improvement, there were no significant changes in duration of MV, VAP incidence (at 28 or 60 days), or mortality (at 28 or 60 days). CONCLUSIONS: Our findings indicate that a hand hygiene education program can increase hand hygiene compliance among ICU professionals, although it appears to have no impact on VAP incidence, duration of MV, or mortality.

Effects of the implementation of a hand hygiene education program among ICU professionals: an interrupted time-series analysis / Efeitos da implementação de um programa de educação de higienização das mãos entre profissionais de uma UTI: análise de séries temporais interrompidas

ABSTRACT Objective: To evaluate the effects that a hand hygiene education program has on the compliance of health professionals in an ICU. Methods: This was a quasi-experimental study with an interrupted time-series design, conducted over a 12-month period: the 5 months preceding the implementation of a hand hygiene education program (baseline period); the 2 months of the intensive (intervention) phase of the program; and the first 5 months thereafter (post-intervention phase). Hand hygiene compliance was monitored by one of the researchers, unbeknownst to the ICU team. The primary outcome measure was the variation in the rate of hand hygiene compliance. We also evaluated the duration of mechanical ventilation (MV), as well as the incidence of ventilator-associated pneumonia (VAP) at 28 days and 60 days, together with mortality at 28 days and 60 days. Results: On the basis of 959 observations, we found a significant increase in hand hygiene compliance rates-from 31.5% at baseline to 65.8% during the intervention phase and 83.8% during the post-intervention phase, corresponding to prevalence ratios of 2.09 and 2.66, respectively, in comparison with the baseline rate (p < 0.001). Despite that improvement, there were no significant changes in duration of MV, VAP incidence (at 28 or 60 days), or mortality (at 28 or 60 days). Conclusions: Our findings indicate that a hand hygiene education program can increase hand hygiene compliance among ICU professionals, although it appears to have no impact on VAP incidence, duration of MV, or mortality.

RESUMO Objetivo: Avaliar os efeitos da implementação de um programa de educação sobre higienização das mãos e a adesão a essa prática entre profissionais de uma UTI. Métodos: Estudo quase-experimental com séries temporais interrompidas conduzido ao longo de 12 meses: 5 meses antes do programa de educação (período basal), 2 meses durante a fase intensiva do programa (período de intervenção) e 5 meses durante a fase de manutenção do programa (período pós-intervenção). A avaliação da adesão às práticas de higienização das mãos foi feita por um dos pesquisadores sem conhecimento da equipe da UTI. O desfecho primário foi a variação da taxa de adesão à higienização das mãos. Também foram avaliadas a duração da ventilação mecânica (VM), a incidência de pneumonia associada à ventilação mecânica (PAVM) em 28 e 60 dias e mortalidade nos mesmos momentos. Resultados: Com base em 959 observações, houve um aumento nas taxas de adesão à higienização das mãos de 31,5% no período basal para 65,8% no período de intervenção e para 83,8% no período pós-intervenção, representando uma razão de prevalência 2,09 e 2,66 maior que o período basal, respectivamente (p < 0,001). Apesar desse aumento, não houve diferenças significativas em relação à duração da VM ou à incidência de PAVM e taxa de mortalidade em 28 e 60 dias. Conclusões: Neste estudo, o programa de educação em higienização das mãos aumentou a adesão a esse procedimento durante o período de monitorização, sem alterar as taxas de PAVM, a duração da VM e a mortalidade.

Assessing the Crop-Water Status in Almond (Prunus dulcis Mill.) Trees via Thermal Imaging Camera Connected to Smartphone.

Different tools are being implemented in order to improve the water management in agricultural irrigated areas of semiarid environments. Thermography has been progressively introduced as a promising technique for irrigation scheduling and the assessing of crop-water status, especially when deficit irrigation is being implemented. However, an important limitation is related to the cost of the actual cameras, this being a severe limitation to its practical usage by farmers and technicians. This work evaluates the potential and the robustness of a thermal imaging camera that is connected to smartphone (Flir One) recently developed by Flir Systems Inc. as a first step to assess the crop water status. The trial was developed in mature almond (Prunus dulcis Mill.) trees that are subjected to different irrigation treatments. Thermal information obtained by the Flir One camera was deal with the thermal information obtained with a conventional Thermal Camera (Flir SC660) with a high resolution, and subsequently, confronted with other related plant physiological parameters (leaf water potential, Ψleaf, and stomatal conductance, gs). Thermal imaging camera connected to smartphone provided useful information in estimating the crop-water status in almond trees, being a potential promising tool to accelerate the monitoring process and thereby enhance water-stress management of almond orchards.

Construction and validation of forms: systematization of the care of people under hemodialysis / Construcción y validación de impresos: sistematización del cuidado de personas en hemodiálisis / Construção e validação de impressos: sistematização do cuidado de pessoas em hemodiálise

ABSTRACT Objective: create and validate forms to subsidize the systematization of nursing care with people on hemodialysis. Method: institutional case study to support the systematization of assistance from the construction of forms for data collection, diagnoses, interventions and nursing results, using cross-mapping, Risner's reasoning, Neuman's theory, taxonomies of diagnoses, interventions and nursing results with application in clinical practice and validation by focal group with specialist nurses. Results: 18 people on hemodialysis and 7 nurses participated. Consensus content of form matter with specialist nurses in the area (Crombach 0.86). The papers captured 43 diagnoses, 26 interventions and 78 nursing results depicting human responses in their singularities. Final considerations: the validated forms fill a gap by enabling the capture of human responses from people on hemodialysis and by subsidizing the planning of nursing care on a scientific basis.

RESUMEN Objetivo: crear y validar impresos para subsidiar la sistematización del cuidado de enfermería con personas en hemodiálisis. Método: estudio de caso institucional para subsidiar la sistematización de la asistencia a partir de la construcción de impresos para recolección de datos, diagnósticos, intervenciones y resultados de enfermería, utilizando el mapeo cruzado, el raciocinio de Risner, la teoría de Neuman, taxonomías de diagnósticos, intervenciones y resultados de enfermería con aplicación en la práctica clínica y validación por grupo focal con enfermeras especialistas. Resultados: participaron 18 personas en hemodiálisis y 7 enfermeros. Consensuados contenidos de los impresos con enfermeras especialistas del área (Crombach 0,86). Los impresos captaron 43 diagnósticos, 26 intervenciones y 78 resultados de enfermería retratando respuestas humanas en sus singularidades. Consideraciones finales: los impresos validados llenan una brecha al posibilitar la captación de respuestas humanas de personas en hemodiálisis y al subsidiar la planificación de los cuidados de enfermería en bases científicas.

RESUMO Objetivo: criar e validar impressos para subsidiar a sistematização do cuidado de enfermagem com pessoas em hemodiálise. Método: estudo de caso institucional para subsidiar sistematização da assistência a partir da construção de impressos para coleta de dados, diagnósticos, intervenções e resultados de enfermagem, usando mapeamento cruzado, raciocínio de Risner, teoria de Neuman, taxonomias de diagnósticos, intervenções e resultados de enfermagem com aplicação na prática clínica e validação por grupo focal com enfermeiras especialistas. Resultados: participaram 18 pessoas em hemodiálise e 7 enfermeiros. Consensualizados conteúdos dos impressos com enfermeiras especialistas da área (Crombach 0,86). Os impressos captaram 43 diagnósticos, 26 intervenções e 78 resultados de enfermagem retratando respostas humanas em suas singularidades. Considerações finais: os impressos validados preenchem uma lacuna ao possibilitar a captação de: respostas humanas de pessoas em hemodiálise e ao subsidiar o planejamento dos cuidados de enfermagem em bases científicas.

Construction and validation of forms: systematization of the care of people under hemodialysis.

OBJECTIVE: create and validate forms to subsidize the systematization of nursing care with people on hemodialysis. METHOD: institutional case study to support the systematization of assistance from the construction of forms for data collection, diagnoses, interventions and nursing results, using cross-mapping, Risner's reasoning, Neuman's theory, taxonomies of diagnoses, interventions and nursing results with application in clinical practice and validation by focal group with specialist nurses. RESULTS: 18 people on hemodialysis and 7 nurses participated. Consensus content of form matter with specialist nurses in the area (Crombach 0.86). The papers captured 43 diagnoses, 26 interventions and 78 nursing results depicting human responses in their singularities. FINAL CONSIDERATIONS: the validated forms fill a gap by enabling the capture of human responses from people on hemodialysis and by subsidizing the planning of nursing care on a scientific basis.

Acanthamoeba keratitis in patients wearing scleral contact lenses.

PURPOSE: To report a series of cases of Acanthamoeba keratitis (AK) in scleral lens wearers with keratoconus to determine whether this type of contact lens presents a greater risk for development of infection. METHODS: This study reports three patients who wore scleral contact lenses to correct keratoconus and developed AK. The diagnoses of AK were established based on cultures of the cornea, scleral contact lenses, and contact lens paraphernalia. This study investigated the risk factors for infections. RESULTS: The possible risks for AK in scleral contact lens wearers are hypoxic changes in the corneal epithelium because of the large diameter and minimal tear exchange, use of large amounts of saline solution necessary for scleral lens fitting, storing the scleral lens overnight in saline solution rather than contact lens multipurpose solutions, not rubbing the contact lens during cleaning, and the space between the cornea and the back surface of the scleral lens that might serve as a fluid reservoir and environment for Acanthamoeba multiplication. Two patients responded well to medical treatment of AK; one is still being treated. CONCLUSIONS: The recommendations for use and care of scleral contact lenses should be emphasized, especially regarding use of sterile saline (preferably single use), attention to rubbing the lens during cleaning, cleaning of the plunger, and overnight storage in fresh contact lens multipurpose solutions without topping off the lens solution in the case.

Os indígenas Xavante no Censo Demográfico de 2010 / The Xavante indigenous people in the 2010 Population Census / Los indígenas Xavante en el Censo Demográfico de 2010

O objetivo deste artigo é apresentar, a partir de dados do Censo Demográfico de 2010, a distribuição geográfica e algumas características sociodemográficas dos indígenas da etnia Xavante no Brasil. Para tanto, foram utilizadas as seguintes variáveis do questionário básico do Censo: etnia; situação de domicílio; localização do domicílio (dentro ou fora de Terra Indígena - TI); cor ou raça; língua falada no domicílio; renda; e alfabetização. A captação dos dados foi realizada no Banco Multidimensional de Estatística (BME) do Instituto Brasileiro de Geografia e Estatística, considerando as TI Xavante, os 15 municípios onde estão inseridas as TI, os três municípios no entorno dessas TI e o município de Cuiabá. Dos 19.259 declarados indígenas Xavante, 91,6% residiam em área rural e 85,9% falavam a língua indígena no domicílio. Os municípios de Campinápolis, Barra do Garças, Nova Nazaré e General Carneiro, juntos, somavam 75,1% do contingente populacional residente em área rural. Nas TI Areões, Pimentel Barbosa e Sangradouro-Volta Grande, todos se declararam indígenas e da etnia Xavante. Nas TI Chão Preto e Marechal Rondon somente a pergunta "se considera indígena" conseguiu captá-los, pois todos se declararam em outras categorias de cor ou raça. Uma comparação com outra fonte de informações indica que os dados populacionais totais do Censo 2010 são compatíveis com aqueles encontrados no registro da área da saúde. Considera-se que, para o caso Xavante, o Censo de 2010 tem um grande potencial para análises de dados demográficos e poderia ser avaliado para outras etnias indígenas específicas, desde que comparados com informações socioantropológicas.

Abstract The aim of this paper is to present, using the 2010 Census data, the geographical distribution and some sociodemographic characteristics of Xavante indigenous people in Brazil. The following variables of the basic questionnaire were considered: ethnicity; household residential situation; household location (inside or outside the Indigenous Land-IL); color or race; spoken language; income and literacy. The data were acquired from the Multidimensional Bank of Statistics (in Portuguese,,BME), a system to access aggregate data of the Brazilian Institute of Geography and Statistics, considering all Xavante IL,15 municipalities with IL Xavante, three municipalities surrounding the IL and Cuiabá city, capital of Mato Grosso state. Of the 19,259 declared Xavante, 92% lived in rural areas and 86% speak indigenous language at home. The municipalities Campinápolis, Barra do Garças, Nova Nazaré and General Carneiro, together added up, 75.1% of the population living in rural areas. Within the IL Areões, Pimentel Barbosa and Sangradouro-Volta Grande all declared themselves indigenous and as Xavante ethnicity. In Chão Preto and Marechal Rondon only the question on whether the person "considered itself indigenous" managed to identiffy the Xavante, because all declared themselves in other categories of color or race in the race/color question. In comparison to other data source, the health information system, the results show that the total population captured in the 2010 Demographic Census was similar in both sources. The 2010 Demographic Census has a great potential for Xavante demographic data analysis and could be evaluated for other ethnicities, since compared to socio-anthropological information.

Resumen El objetivo de este artículo es presentar, utilizando los datos del Censo Demográfico de 2010, la distribución geográfica y las características demográficas de la etnia Xavante en Brasil. Con este fin, se investigaron las siguientes variables del cuestionario básico del censo: origen étnico; situación de residencia; ubicación del hogar (dentro o fuera de la Tierra Indígena-TI); color o raza; lengua hablada en el hogar; ingresos y alfabetización. Los datos fueron procesados con el Banco Estadístico Multidimensional (BME) del Instituto Brasileño de Geografía y Estadística, teniendo en cuenta los Xavante de las TI, los 15 municipios en que se encuentran las TI Xavante, los tres municipios que rodean las TI Xavante y la ciudad de Cuiabá, capital del estado de Mato Grosso. De los 19.259 indígenas declarados Xavante, el 91,6% vivía en zonas rurales y el 85,9% hablaba un idioma indígena en el hogar. Los municipios de Campinápolis, Barra do Garças, Nova Nazaré, General Carneiro, juntos sumaron el 75,1% de la población que vive en las zonas rurales. Dentro de las TI Areões, Pimentel Barbosa y Sangradouro Volta Grande, todos se declararon perteneciendo a la etnia indígena y Xavante. En Chão Preto y Marechal Rondon sólo con la pregunta "se considera indígena" se logró la identificación de ellos, porque todos se declararon en otras categorías en la pregunta de color o raza. En conclusión, los resultados muestran que los datos de población indígena Xavante total en el Censo Demográfico del 2010 son comparables con los encontrados en otra fuente, el sistema de información de salud, y presenta gran potencial para el análisis de datos demográficos de otros grupos indígenas específicos, cuando comparado a la información socioantropológica.

REHABILITATION IN PALLIATIVE CARE / REHABILITACIÓN EN CUIDADOS PALIATIVOS / REABILITAÇÃO EM CUIDADOS PALIATIVOS

ABSTRACT: The objective of this study was to describe the activities and effects of functional rehabilitation in patients receiving palliative care. It is an integrative review, in which LILACS, BDENF, Coleciona SUS (Brazil) and PUBMED were used, 20 articles were selected, subsequently characterized as having designs of medium and low impact, more than half ranked with evidence levels II, III and IV and with samples not always consistent with the research designs. However, the results revealed the potential of rehabilitation to improve the functional status, quality of life and symptoms like pain and anxiety in this population, through interventions that are many times undervalued in palliative care. The conclusion is that rehabilitation is a feasible strategy to combat functional decline and improve the quality of life of patients in palliative care.

RESUMEN El objetivo de este estudio fue describir las actividades y los efectos de la rehabilitación funcional en pacientes que reciben cuidados paliativos. Es una revisión integradora que utiliza las bases de datos LILACS, BDENF, Coleciona SUS (Brasil) y PUBMED. Se seleccionaron 20 artículos, después caracterizados con diseños de mediano y bajo impacto, y más de la mitad se clasificó con niveles de evidencia II, III, IV y con muestras no siempre consistentes con los diseños de investigación. Todavía, los resultados revelaran el potencial de la rehabilitación para mejorar el estado funcional, la calidad de vida y los síntomas como dolor y ansiedad en esta población, a través de intervenciones muchas veces infravaloradas en cuidados paliativos. Se concluye que la rehabilitación es una estrategia viable para combatir el deterioro funcional y mejorar la calidad de vida de los pacientes en cuidados paliativos.

RESUMO: O objetivo deste estudo foi descrever as atividades e os efeitos da reabilitação funcional em pacientes que recebem cuidados paliativos. Trata-se de uma revisão integrativa que utilizou as bases de dados LILACS, BDENF, Coleciona SUS (Brasil) e PubMed. Foram selecionados 20 artigos, posteriormente caracterizados como de desenhos de médio e baixo impacto, sendo que mais da metade foi classificada com níveis de evidência II, III e IV e amostras nem sempre condizentes com os desenhos de pesquisa. Porém, os resultados revelaram o potencial da reabilitação para melhoria do estado funcional, da qualidade de vida e sintomas como dor e ansiedade nessa população, por meio de intervenções muitas vezes subvalorizadas em cuidados paliativos. Conclui-se que a reabilitação é uma estratégia viável para combater o declínio funcional e melhorar a qualidade de vida de pacientes em cuidados paliativos.

Experiências de pessoas internadas com o processo de punção de veias periféricas / Experiencias de personas hospitalizadas en proceso de punción de venas periféricas / Experiences of hospitalized patients with the venipuncture process

RESUMO Objetivo: Compreender os componentes representacionais, as origens das experiências dos participantes com o processo de punção de veias periféricas, suas percepções e marcadores implícitos e explícitos de demandas de cuidado segundo concepção de Neuman. Métodos: Pesquisa de Representação Social Processual realizada com adultos que tiveram veias puncionadas internados num hospital de Minas Gerais. Amostra de 149 pessoas de seleção completa. Entrevistas individuais gravadas usando técnica de recorte e colagem de gibi. Na análise de conteúdo, aplicaram-se NVivo e teoria de Neuman. Resultados: Predominaram mulheres em idade ≥ 50 anos. Experiências contemplaram relatos próprios, com terceiros, familiares e profissionais, percebidas como dialógicas, expressando sentimentos/comportamentos, valores, informações/conhecimentos e objetos representacionais, sendo aquelas com familiares pouco expressivas devido ao enfoque sobre acolhimento. Conclusão: Fragmentos de discurso e imagens de gibi selecionados demonstram exposição a estressores (intrapessoais, extrapessoais e interpessoais), caracterizando lacunas nas demandas de cuidados de enfermagem quando se integram tecnologias relacionais, cognitivas/especializadas e instrumentais.

RESUMEN Objetivo: Comprender los componentes representacionales, las orígenes de las experiencias de los participantes en proceso de punción de venas periféricas, sus percepciones y marcadores implícitos y explícitos de demandas de cuidado según la concepción de Neuman. Métodos: Investigación de Representación Social Procesual realizada con 149 adultos de un hospital en Minas Gerais. Fueron realizadas entrevistas individuales, grabadas utilizando la técnica de recorte y colaje de libros de historietas. En el análisis de contenido, se aplicaron NVivo y la Teoría de Neuman. Resultados: Predominaron mujeres de ≥ 50 anos. Las experiencias contemplaron testimonios propios, con terceros, familiares y profesionales, percibidas como dialógicas, expresando sentimientos/comportamientos, valores, informaciones/conocimientos y objetos representacionales. Conclusión: Fragmentos de discurso e imágenes seleccionados demuestran exposición a estresores (intrapersonales, extrapersonales e interpersonales), caracterizando lagunas en las demandas de cuidados de enfermería cuando se aplican tecnologías relacionales, cognitivas/especializadas e instrumentales.

ABSTRACT Objective: To understand the representational components, the origins of the participants' experiences with venipuncture process, their perceptions and (im)explicit markers of care demands according to Neuman. Methods: Social Procedural Representation research, conducted with hospitalized adults with punctured veins in a hospital in Minas Gerais. Sample of 149 people with full selection. Individual interviews recorded using clipping and collage of comic books' technique. Content analysis applied NVivo and Neuman's theory. Results: Most participants were female age ≥ 50 years. Experiences contemplated own accounts, with third parties, families and professionals, perceived as dialogic, expressing feelings/behaviours, values, information/knowledge and representational objects, with those with families less significant due to the focus on care. Conclusion: Selected comic books' speech fragments and images demonstrate exposure to stressors (intrapersonal, interpersonal and extra personal), presenting gaps in the demands of nursing care when integrating relational, cognitive/specialized and instrumental technologies.

Significados atribuídos à fístula arteriovenosa pela pessoa em hemodiálise / Meanings attributed to arteriovenous fistula by people on hemodialysis

Pesquisa descritiva. Analisamos o significado de ter uma fístula arteriovenosa no corpo para a pessoa portadora de doença renal crônica em tratamento hemodialítico. Amostra por tipicidade. Participaram 20 pessoas em hemodiálise do interior de Minas Gerais. Triangulamos técnicas e métodos para coletar dados (técnica de "recorte e colagem", entrevista gravada e registros cursivos). As três categorias exprimem o significado que os participantes atribuíram em ter uma Fistula arteriovenosa no corpo: 1) fístula e indivíduo; 2) sensações, sentimentos e comportamentos e 3) cuidado e autoimagem. Apontamos a diversidade de dimensões do processo de cuidar de pessoas em tratamento hemodialítico e as dificuldades enfrentadas por eles que suscitou reflexões sobre as modificações nos estilos de vida quando fazem hemodiálise. Tal investigação contribui na compreensão do processo de enfrentamento pelo qual passa as pessoas portadoras de FAV e em tratamento hemodialítico, alertando aos Enfermeiros para problemas de sua competência profissional.

Cyathostomin larvae: presence on Brachiaria humidicola grass during the rainy and dry seasons of Brazil.

The presence of cyathostomin larvae is directly associated to climatic conditions of each region. This study aimed to evaluate the ecology of infective larvae on Brachiaria humidicola during the dry and rainy seasons from October 2007 to September 2008 in a tropical region, Rio de Janeiro state, southeastern Brazil. Stools were collected from the rectum of horses naturally infected with cyathostomins at the beginning of the rainy season (October to March) and dry season (April to September). They were divided into four samples of 500 g and deposited on a grass patch of B. humidicola. Seven days later and every 15 days thereafter samples of feces and grass were collected and processed by the Baermann technique. The mean number of larvae recovered from the grass varied according to the season, with greater recovery of larvae during the peak of the dry season (14,700 L3.kg-¹ DM). There was a statistically significant difference between L3 recovered from feces and grass, but not between L3 recovered from the grass base and apex. These results show that the region's climate favors the development and survival of infective cyathostomin larvae throughout the year, with a greater number of larvae during the dry season.

Cyathostomin larvae: presence on Brachiaria humidicola grass during the rainy and dry seasons of Brazil / Larvas de ciatostomíneos: disponibilidade em gramínea Brachiaria humidicola nas estações chuvosa e seca do Brasil

The presence of cyathostomin larvae is directly associated to climatic conditions of each region. This study aimed to evaluate the ecology of infective larvae on Brachiaria humidicola during the dry and rainy seasons from October 2007 to September 2008 in a tropical region, Rio de Janeiro state, southeastern Brazil. Stools were collected from the rectum of horses naturally infected with cyathostomins at the beginning of the rainy season (October to March) and dry season (April to September). They were divided into four samples of 500 g and deposited on a grass patch of B. humidicola. Seven days later and every 15 days thereafter samples of feces and grass were collected and processed by the Baermann technique. The mean number of larvae recovered from the grass varied according to the season, with greater recovery of larvae during the peak of the dry season (14,700 L3.kg-¹ DM). There was a statistically significant difference between L3 recovered from feces and grass, but not between L3 recovered from the grass base and apex. These results show that the region’s climate favors the development and survival of infective cyathostomin larvae throughout the year, with a greater number of larvae during the dry season.

A disponibilidade de larvas de ciatostomíneos está diretamente relacionada com as condições climáticas de cada região. Para avaliar o comportamento das larvas infectantes nos períodos seco e chuvoso em gramínea Brachiaria humidicola, realizou-se um estudo, no período de outubro/2007 a setembro/2008, na região da Baixada Fluminense, RJ, de clima tropical. Amostras de fezes foram coletadas diretamente do reto de equinos naturalmente infectados por ciatostomíneos, no início do período chuvoso (outubro a março) e seco (abril a setembro), divididas em quatro amostras de 500 g e depositadas em um canteiro formado por gramínea B. humidicola. Sete dias após o depósito e, posteriormente, a cada 15 dias, amostras de fezes e gramíneas, foram coletadas às 8 horas e processadas pela técnica de Baermann. O número médio de larvas recuperadas da gramínea variou conforme os períodos, ocorrendo maior recuperação no ápice do período seco (14.700 L3.kg-1. MS). Diferença significativa ocorreu entre a contagem de L3 recuperadas das fezes e gramínea e não significativa entre as de L3 recuperadas nas duas alturas da gramínea. Concluiu-se que as condições climáticas da região favorecem o desenvolvimento e a sobrevivência de larvas infectantes de ciatostomíneos durante todo o ano, com maior disponibilidade no período seco.

Demography and health of the Xavante Indians of Central Brazil.

This study investigates the demographic and health behavior of the Xavante Indians of Mato Grosso State, Central Brazil. Data covering the period 1999 to 2004 was collected using information from household censuses and vital statistics. In addition to standard demographic analyses, survival analysis was carried out. Results show a young age structure, derived from a combination of high fertility rates (7.7 live births per woman) and declining mortality. Mortality rates, especially infant mortality (97 per thousand), remain very high, surpassing regional and national rates. Natural increase is the main contributing factor to population growth. The annual population growth rate is 4.4%. Results suggest that recent declines in mortality and fertility may be related to transformations in the implementation of basic health care services and internal diversity, the latter of which seems to be associated with local history and sociocultural determinants.

Demography and health of the Xavante Indians of Central Brazil / Demografia e saúde do povo indígena Xavante de Mato Grosso, Brasil

This study investigates the demographic and health behavior of the Xavante Indians of Mato Grosso State, Central Brazil. Data covering the period 1999 to 2004 was collected using information from household censuses and vital statistics. In addition to standard demographic analyses, survival analysis was carried out. Results show a young age structure, derived from a combination of high fertility rates (7.7 live births per woman) and declining mortality. Mortality rates, especially infant mortality (97 per thousand), remain very high, surpassing regional and national rates. Natural increase is the main contributing factor to population growth. The annual population growth rate is 4.4 percent. Results suggest that recent declines in mortality and fertility may be related to transformations in the implementation of basic health care services and internal diversity, the latter of which seems to be associated with local history and sociocultural determinants.

Este estudo investiga o comportamento demográfico dos índios Xavante de Mato Grosso, Brasil Central. Os dados foram coletados entre 1999 e 2004, a partir de censos domiciliares e da coleta de estatísticas vitais. Além das análises demográficas, realizou-se análise de sobrevida. Os Xavante apresentam uma estrutura etária jovem, típica de população em fase de recuperação populacional, com alta fecundidade (média de 7,7 nascidos vivos por mulher) e mortalidade em declínio. As taxas de mortalidade, especialmente a infantil (97 por mil), continuam a ser muito elevadas, ultrapassando as taxas regionais e nacionais. O crescimento natural é o principal fator no aumento populacional. A população cresce a uma taxa média de 4,4 por cento ao ano. Argumenta-se que não somente a recente queda da mortalidade, assim como da fecundidade, podem estar relacionadas à implementação do novo sistema de saúde voltado para os povos indígenas no Brasil a partir de 1999. Os Xavante apresentam significativa diversidade demográfica interna, que parece estar associada a histórias de contato e a determinantes socioculturais.

Intrastromal corneal ring segment implantation by femtosecond laser for the correction of residual astigmatism after penetrating keratoplasty.

PURPOSE: To evaluate the safety and efficacy of intracorneal ring segments (ICRSs) aided by femtosecond (FS) laser for the correction of residual astigmatism after penetrating keratoplasty (PKP). METHODS: This retrospective noncomparative study comprised 14 eyes of 14 patients with high astigmatism after PKP who had ICRS implantation by femtosecond laser. The study evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive astigmatism, and corneal maximum curvature. RESULTS: The CDVA postoperatively improved after 3 months (P < 0.001) and 6 months (P < 0.001) compared with CDVA preoperatively. The CDVA at 3 months was similar to that at 6 months (P > 0.999) as well as the UDVA (P = 0.276). The preoperative astigmatism was higher than that after surgery (P = 0.001). The preoperative maximum curvature was higher than that of the postoperative maximum curvature (P < 0.001). CONCLUSIONS: The implantation of ICRSs using the femtosecond laser for residual astigmatism post-PKP was safe and showed satisfactory results. It reduced refractive astigmatism and maximum corneal curvature and improved UDVA and CDVA.