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A Importância do Conhecimento Qualitativo no Ensino em Saúde: Experiências no Cenário da Amazônia Brasileira
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Guerra, Lúcia Dias da Silva

; Reis, Elaine Cristiny Evangelista dos

; Costa, Teógenes Luiz Silva da

; Meschede, Marina Smidt Celere

New Trends in Qualitative Research

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oct 2023, Volume 18 elocation e880

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: O conhecimento qualitativo no ensino em saúde é cada vez mais fundamental para a formação crítica, reflexiva e interdisciplinar para egressos do campo da saúde, bem como, a articulação necessária do uso da metodologia da investigação qualitativa alicerçados nos conceitos das ciências humanas e sociais. Objetivo: expor a importância do conhecimento e dos elementos metodológicos qualitativos na formação em saúde no cenário Amazônico brasileiro. Método: trata-se de um relato de experiência com o uso da metodologia da investigação qualitativa, que tomou como referência o componente curricular de Interação na Base Real (IBR), dos três cursos de graduação na área da saúde (saúde coletiva, farmária e interdisciplinar), ministrado durante os quatro primeiros semestres pelo Instituto de Saúde Coletiva (ISCO) da Universidade Federal do Oeste do Pará (UFOPA), na região da Amazônia brasileira. Resultados: a experiência produzida através do uso da metodologia da investigação qualitativa neste componente currrilar, ocorreram em atividades desenvolvida no espaço da sala de aula e no campo de prática (comunidades amazônicas). Dentre os elementos metodológicos da investigação qualitativa utilizados estão: a observação, a etnografia para produção de escuta, formação de vínculo com as pessoas da comunidade investigada, o reconhecimento da cultura e identidade, a diversidade étnica e linguística em cenários de desigualdade socioeconômica que coabitam nesses territórios, espaços urbanos e rurais, comunidades indígenas, quilombolas e ribeirinhas. Os usos dos elementos metodológicos da investigação qualitativa possibilitaram o desenvolvimento do conhecimento científico qualitativo no ensino em saúde, através da construção conceituais, textual e contextual. Além disso, as experiências produzidas junto as comunidades da região da Amazônia brasileira, descortinam a multiplicidade de formas de se viver e de se fazer saúde, permitindo um amplo campo para o ensino qualitativo em saúde. Conclusões: o conhecimento da investigação qualitativa é fundamental para subsidiar o processo de ensino-aprendizagem articulado à prática de campo, visando a construção de novos olhares e caminhos metodológicos que ultrapassam as fronteiras disciplinares do campo da saúde.

Abstract Introduction: Qualitative knowledge in health education is increasingly essential for critical, reflective and interdisciplinary training for graduates of the health field, as well as the necessary articulation of the use of qualitative research methodology grounded in the concepts of human and social sciences. Objective: to expose the importance of knowledge and qualitative methodological elements in health training in the Brazilian Amazon scenario. Method: This is an experience report with the use of qualitative research methodology, which took as reference the curricular component of Interaction on a Real Basis (IBR), of the three undergraduate courses in the area of health (collective health, pharmacy and interdisciplinary), taught during the first four semesters by the Institute of Collective Health (ISCO) of the Federal University of Western Pará (UFOPA), in the Brazilian Amazon region. Results: The experience produced through the use of qualitative research methodology in this curriculum component, occurred in activities developed in the classroom space and in the field of practice (Amazonian communities). Among the methodological elements of qualitative research used are: observation, ethnography for the production of listening, bonding with people from the community investigated, recognition of culture and identity, ethnic and linguistic diversity in scenarios of socioeconomic inequality that coexist in these territories, urban and rural spaces, indigenous communities, quilombolas and riverine communities. The use of the methodological elements of qualitative research enabled the development of qualitative scientific knowledge in health education, through conceptual, textual and contextual construction. In addition, the experiences produced with the communities of the Brazilian Amazon region, unveil the multiplicity of ways of living and doing health, allowing a broad field for qualitative teaching in health. Conclusions: The knowledge of qualitative research is essential to support the teaching-learning process articulated with the field practice, aiming at the construction of new perspectives and methodological paths that go beyond the disciplinary boundaries of the health field.

https://doi.org/10.36367/ntqr.18.2023.e880

Anthropometry and physical appearance can be associated with quality of life in Brazilian women with Turner syndrome
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Reis, Carolina Trombeta

; Macedo, Marina Cruvinel

; Morcillo, André Moreno

; Guerra Junior, Gil

; Lemos-Marini, Sofia Helena Valente de

Archives of Endocrinology and Metabolism

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feb 2023, Volume 67 N. 1 Pages 126 - 135

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: This study aimed to analyze if anthropometric factors and physical appearance are associated to QoL in Turner syndrome (TS). Materials and methods: Observational, analytical, and cross-sectional study. The SF-36 was applied along with an additional questionnaire regarding specific characteristics of TS. Results: There were no differences in quality of life (QoL) in TS women regarding median height and appropriate height according to parental target height, however, participants satisfied and who did not desire to change their height had better scores in the mental health and role emotional domains than those not satisfied and desired to change it. When comparing participants who were or were not bothered by physical appearance, the results showed that those not bothered by physical appearance had a better score in the vitality and social function domains. Considering patients who did or did not desire to change physical appearance, those who did not want to change their physical appearance had higher scores in the mental component and in the social function and mental health domains of the SF-36. Conclusion: This study indicated that anthropometric factors and physical appearance may possibly be associated to QoL in TS, and also emphasizes the need to develop and validate an official questionnaire regarding specific TS characteristics in order to assess in more detail how specific characteristics of TS interfere with their QoL.

https://doi.org/10.20945/2359-3997000000535

Dimensión pedagógica de los lugares de memoria: semiosis nemotécnica, visita presencial y extensión virtual
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Cuesta Moreno, Oscar Julián

; Lara Salcedo, Luz Marina

; Mora Hernández, Yaneth

; Burgos Urán, Félix Andrés

; Sánchez Guerra, Laura

; Marín, Adriana María

Revista Educación

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jun 2022, Volume 46 N. 1 Pages 629 - 642

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El artículo sostiene que los lugares de memoria poseen una dimensión pedagógica constitutiva, caracterizada por la contingencia comunicativa que no permite reducir la interpretación del pasado a una sola versión. Para ello, se propone el concepto de semiosis nemotécnica. Además, el texto reflexiona sobre las características de los lugares de memoria y su vínculo con el patrimonio; argumenta que esto es necesario para lograr la reparación de las víctimas y la participación activa de la comunidad en su territorio. En ese marco, se muestran los retos de extender estos lugares a escenarios virtuales. Finalmente, se describe la experiencia del Museo Casa de la Memoria de Medellín como ejemplo de los argumentos expuestos en el artículo.

Abstract Memory sites have a built-in pedagogical dimension described as communication shortcomings which prevent past events from prevented from being interpreted as a one, single version. This study uses mnemonic semiosis associated to armed conflict to reflect on the characteristics of memory sites and how they are linked to a deeper cultural perspective where active community participation is necessary for victim reparations. Within this context, the challenges of extending memory sites to virtual scenarios is also addressed using the experience of the Museo Casa de la Memoria Museum in the city of Medellin, Colombia as an example of the arguments presented herein.

https://doi.org/10.15517/revedu.v46i1.44708

Comportamiento de la enfermedad inflamatoria pélvica aguda en la atención primaria de salud. Matanzas, 2017-2018
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Sánchez-Pérez, Diriana Bárbara

; Marrero-Miragaya, María Acelia

; Romero-Fernández, María Beatriz

; Guerra-Balseiro, Arialis

; Tirado-Marrero, Marionne

; Laguardia-Aldama, Dania Marina

Revista Médica Electrónica

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feb 2022, Volume 44 N. 1 Pages 84 - 99

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: acute inflammatory pelvic disease is a frequent entity in young women in reproductive age, and is cause of infertility and other complications. Objective: to characterize the behavior of the acute inflammatory pelvic disease in patients attended at the TeachingPoliclinic Samuel Fernandez, of the municipality of Matanzas, in the period from January 2017 to January 2018. Materials and methods: a descriptive, longitudinal and prospective study was carried out in 76 women, who were object of socio-demographic and clinic-echographyc characterization that allowed their classification as patients with mild-moderated acute inflammatory pelvic disease requiring treatment and follow up in primary care services. The clinic-echographyc answer to medical treatment was evaluated from the decrease of the intensity of the pelvic pain and the modification of the baseline echographyc findings. Results: mild-moderated acute inflammatory pelvic disease represented 87.4 % of the cases evaluated in the primary care Gynecological consultation in the studied period. The average age was 31.2 years. The cases with severe pain predominated clinically. The most frequent baseline echographyc finding was increased annexes. Oral combined antibiotic therapy and the use of anti-inflammatory drugs was the used medical therapy, with favorable clinic-echographyc results in 98.4 % and 92.2 % of cases respectively. Conclusions: mild-moderated inflammatory pelvic disease was a frequent entity in the Gynecology service of the primary health care in the studied period, with satisfactory evolution to medical treatment.

RESUMEN Introducción: la enfermedad inflamatoria pélvica aguda es una entidad frecuente en mujeres jóvenes en edad reproductiva, y constituye causa de infertilidad y otras complicaciones. Objetivo: caracterizar el comportamiento de la enfermedad inflamatoria pélvica aguda en pacientes atendidas en el Policlínico Docente Samuel Fernández, del municipio Matanzas, en el período de enero de 2017 a enero de 2018. Materiales y métodos: se realizó un estudio descriptivo, longitudinal y prospectivo a 76 mujeres, a las que se les hizo caracterización sociodemográfica y clínico-ecográfica, que permitió su clasificación como pacientes con enfermedad inflamatoria pélvica aguda leve-moderada, requerida de tratamiento y seguimiento en atención primaria. Se evaluó la respuesta clínico-ecográfica al tratamiento médico indicado, a partir de la disminución de la intensidad del dolor pélvico y de las modificaciones de los hallazgos ecográficos iniciales. Resultados: la enfermedad inflamatoria pélvica aguda leve-moderada representó el 87,4 % de los casos evaluados en Consulta Ginecológica de la atención primaria de salud, en el período estudiado. La media de edad fue de 31,2 años. Clínicamente predominaron los casos con dolor severo. El hallazgo ecográfico inicial más frecuente fue el de anejos engrosados. La antibioticoterapia oral combinada y el uso de antiinflamatorios fue la terapia médica empleada, con resultados clínico-ecográficos favorables en el 98,4 y el 92,2 % de los casos, respectivamente. Conclusiones: la enfermedad inflamatoria pélvica leve-moderada resultó una entidad frecuente en el Servicio de Ginecología de la atención primaria de salud en el período estudiado, con evolución satisfactoria al tratamiento médico.

Multi-taxa ecological responses to habitat loss and fragmentation in western Amazonia as revealed by RAPELD biodiversity surveys
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MOULATLET, Gabriel M.

; AMBRIZ, Emmanuel

; GUEVARA, Jennifer

; LÓPEZ, Karima G.

; RODES-BLANCO, Marina

; GUERRA-ARÉVALO, Nereida

; ORTEGA-ANDRADE, H. Mauricio

; MENESES, Pablo

Acta Amazonica

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sep 2021, Volume 51 N. 3 Pages 234 - 243

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Habitat loss and fragmentation caused by deforestation are important anthropogenic drivers of changes in biodiversity in the Amazon rainforest, and has reached its highest rate in recent decades. However, the magnitude and direction of the effects on species composition and distribution have yet to be fully understood. We evaluated the responses of four taxonomic groups − birds, amphibians, orchid bees, and dung beetles - to habitat loss and fragmentation at both species and assemblage level in the northern Ecuadorian Amazon. We sampled fifteen 250-m long plots in terra-firme forest remnants. We calculated one landscape fragmentation index (fragindex), which considers the proportion of continuous forest cover, edge density and isolation in the landscape, and nine landscape configuration metrics. Logistic regression models and multivariate regression trees were used to analyze species and assemblage responses. Our results revealed that over 80% of birds, amphibians or orchid-bee species, and 60% of dung beetles were negatively affected by habitat loss and fragmentation. Species composition of all taxonomic groups was significantly affected by differences in forest cover and connectivity. Less than 5% of all species were restricted to landscapes with fragindex values higher than 40%. Landscape metrics related to the shape and area of forest patches determined the magnitude and direction of the effect on species responses. Therefore, changes in the landscape configuration of Ecuadorian Amazonia should be minimized to diminish the effects of habitat loss and fragmentation on species occurrence and assemblage composition.

RESUMEN La pérdida y fragmentación del hábitat causada por la deforestación es un importante impulsor antropogénico de cambios sobre la biodiversidad en la selva amazónica. Sin embargo, la magnitud y dirección de los efectos sobre la composición y distribución de las especies aún es incomprendida. Evaluamos las respuestas de cuatro grupos taxonómicos - aves, anfibios, abejas de orquídeas y escarabajos peloteros - a la pérdida y fragmentación del hábitat, tanto a nivel de especies como de ensamblaje, en la Amazonía norte ecuatoriana. Tomamos muestras de quince parcelas de 250 m de largo en remanentes de bosque de tierra firme. Calculamos un índice de fragmentación del paisaje (fragindex), que considera la cobertura forestal continua, densidad del borde y el aislamiento en el paisaje, y nueve métricas de configuración del paisaje para analizar las respuestas de especies y ensamblajes. Más del 80% de las especies de aves, anfibios o abejas de orquídeas y el 60% de los escarabajos peloteros se vieron afectados negativamente por la pérdida y fragmentación del hábitat. La composición por especies se vio significativamente afectada por las diferencias en la cobertura forestal y la conectividad, mientras que la forma y el área de los parches de bosque determinaron la magnitud y la dirección del efecto en las respuestas de las especies. Por lo tanto, los cambios en la configuración del paisaje de la Amazonía ecuatoriana deben minimizarse para disminuir los efectos de la pérdida y fragmentación del hábitat sobre la presencia de especies y la composición de los ensambles.

https://doi.org/10.1590/1809-4392202004532 362 downloads

Detección de mutaciones del gen EGFR en ADN circulante por medio de biopsia líquida en pacientes con cáncer pulmonar de células no pequeñas: Revisión rápida
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Egoavil Guerra, Marina Janeth

; Failoc-Rojas, Virgilio E

; Gil-Olivares, Fradis

; Motta-Guerrero, Rodrigo

; Payet Meza, Eduardo Tomás

; Sarria Bardales, Gustavo

; Aliaga Llerena, Karina Mayra

Acta Médica Peruana

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apr 2021, Volume 38 N. 2 Pages 145 - 150

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Lung cancer is a public health problem due to its high morbidity and mortality worldwide and in Peru. In non-small cell lung cancer, the detection of mutations of the epidermal growth factor receptor (EGFR) has been useful for the choice of therapeutics for this disease. In the present article we aim to discuss current and relevant information on the best diagnostic technique for EGFR in patients with non-small cell lung cancer. The main cancer guidelines and two systematic reviews showed evidence in favor of the diagnosis of EGFR gene mutations on liquid biopsy as an alternative to tissue biopsy at the beginning of diagnosis and with a greater acceptance use, in the clinical setting of NSCLC patients with sensitive EGFR mutations. This healthcare technology may be useful in our country, and we propose its use in two clinical scenarios.

RESUMEN El cáncer pulmonar es un problema de salud pública debido a su alta morbimortalidad mundial y en el Perú. En el cáncer pulmonar de células no pequeñas (CPCNP) la detección de mutaciones del receptor del factor de crecimiento epidérmico (EGFR) ha sido útil para elección de la terapéutica de esta enfermedad. El presente artículo tiene como objetivo discutir la información actual y relevante sobre la biopsia liquida como técnica diagnóstica en detección de mutaciones del gen EGFR en pacientes con cáncer pulmonar de células no pequeñas. Las principales guías de cáncer y dos revisiones sistemáticas muestran evidencia a favor de la biopsia líquida en busca de mutaciones del gen EGFR, esto como una alternativa a la biopsia de tejido al inicio de diagnóstico y con una mayor aceptación de uso en el escenario clínico de pacientes con CPCNP con mutaciones sensibles de EGFR. Esta tecnología sanitaria puede ser útil en nuestro país, y proponemos su uso en dos escenarios clínicos.

https://doi.org/10.35663/amp.2021.382.1978

Lupus Vulgar: Um Diagnóstico Desafiador
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Porto, Hisabella Lorena Simões

; Guerra, Isabela Alves

; Bastos, Bárbara Figueiredo

; Ferreira, Marina

; Neto, Marcelino Pereira Martins

; Castañon, Maria Christina Marques Nogueira

Revista da Sociedade Portuguesa de Dermatologia e Venereologia

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mar 2021, Volume 79 N. 1 Pages 61 - 63

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: Lúpus vulgar é uma variante clínica de tuberculose cutânea, subtipo raro de infecção extrapulmonar causada pelo complexo Mycobacterium tuberculosis. Forma paucibacilar associada a alto grau de imunidade, predominantemente na face, pode apresentar vários diagnósticos diferenciais clínicos e histopatológicos, o que torna seu diagnóstico desafiador. Apresentamos um caso de lúpus vulgar em paciente imunocompetente, cuja apresentação clínica e histopatológica iniciais não sugeriam o diagnóstico. O objetivo é ressaltar a relevância da hipótese de tuberculose cutânea como importante diagnóstico diferencial, principalmente em áreas endémicas.

Abstract Lupus vulgaris is a clinical variant of cutaneous tuberculosis, a rare subtype of extrapulmonary infection caused by the Mycobacterium tuberculosis complex. A paucibacillary form associated with high degrees of immunity, predominantly in the face, may present several clinical and histopathological differential diagnoses, which makes its diagnosis challenging. We present a case of lupus vulgaris in an immunocompetent patient, whose initial clinical presentation and histopathology did not suggest the condition. The objective is to highlight the relevance of the hypothesis of cutaneous tuberculosis as an important differential diagnosis, especially in endemic areas.

https://doi.org/10.29021/spdv.79.1.1284 2 downloads

Genetic information improves the prediction of major adverse cardiovascular events in the GENEMACOR population
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Mendonça, Maria Isabel

; Henriques, Eva

; Borges, Sofia

; Sousa, Ana Célia

; Pereira, Andreia

; Santos, Marina

; Temtem, Margarida

; Freitas, Sónia

; Monteiro, Joel

; Sousa, João Adriano

; Rodrigues, Ricardo

; Guerra, Graça

; Reis, Roberto Palma dos

Genetics and Molecular Biology

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2021, Volume 44 N. 2 elocation e20200448

Abstract: En | Text: En | PDF: En

Abstract The inclusion of a genetic risk score (GRS) can modify the risk prediction of coronary artery disease (CAD), providing an advantage over the use of traditional models. The predictive value of the genetic information on the recurrence of major adverse cardiovascular events (MACE) remains controversial. A total of 33 genetic variants previously associated with CAD were genotyped in 1587 CAD patients from the GENEMACOR study. Of these, 18 variants presented an hazard ratio >1, so they were selected to construct a weighted GRS (wGRS). MACE discrimination and reclassiﬁcation were evaluated by C-Statistic, Net Reclassification Index and Integrated Discrimination Improvement methodologies. After the addition of wGRS to traditional predictors, the C-index increased from 0.566 to 0.572 (p=0.0003). Subsequently, adding wGRS to traditional plus clinical risk factors, this model slightly improved from 0.620 to 0.622 but with statistical significance (p=0.004). NRI showed that 17.9% of the cohort was better reclassified when the primary model was associated with wGRS. The Kaplan-Meier estimator showed that, at 15-year follow-up, the group with a higher number of risk alleles had a significantly higher MACE occurrence (p=0.011). In CAD patients, wGRS improved MACE risk prediction, discrimination and reclassification over the conventional factors, providing better cost-effective therapeutic strategies.

https://doi.org/10.1590/1678-4685-gmb-2020-0448 154 downloads

EFFECTIVENESS OF AURICULOACUPUNCTURE ON THE SLEEP QUALITY OF WORKING NURSING PROFESSIONALS DURING THE COVID-19 PANDEMIC
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Melo, Geórgia Alcântara Alencar

; Lira Neto, José Cláudio Garcia

; Silva, Renan Alves

; Martins, Marina Guerra

; Pereira, Francisco Gilberto Fernandes

; Caetano, Joselany Áfio

Texto & Contexto - Enfermagem

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dec 2020, Volume 29 elocation e20200392

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

ABSTRACT Objective: to evaluate the effectiveness of auriculoacupuncture in improving the sleep quality of nursing professionals in the fight against the COVID-19 pandemic. Method: quasi-experimental before and after study, without a control or matching group performed from May to July 2020, in a referral hospital for infectious diseases in Ceará. The sample consisted of 26 nursing professionals, including nurses and technicians, who performed three sessions of auriculoacupuncture, once a week, for four weeks. Sleep quality was measured by the Pittsburg Sleep Quality Index. The effects of the intervention were analyzed by the student's “t” test to compare means between the first and last application, one-way ANOVA with repeated measures and post-hoc Sidak´s test. Results: regarding the components of the Pittsburg Sleep Quality Index, significant differences were observed between the individuals in the components: subjective sleep quality (p=0.001); sleep latency (p<0.001), sleep duration (p<0.001), habitual sleep efficiency (p=0.011), sleep disorders (p<0.001), sleeping medications (p=0.005) and excessive daytime sleep sleepiness (p<0.001). The overall sleep index also changed significantly (p<0.001). The intervention reduced the sleep quality index score by 52.35%. Conclusion: the changes that occurred were able to change the category in sleep classification through a detailed decrease in the Pittsburg Sleep Quality Index scores. Significant differences were observed between the first and final moments in the global index and in all components.

RESUMEN Objetivo: evaluar la efectividad de la auriculopuntura en la mejora de la calidad del sueño de los profesionales de enfermería que trabajan para combatir la pandemia de COVID-19. Método: estudio cuasiexperimental, sin grupo control ni pareado, del tipo antes y después, desarrollado de mayo a julio de 2020, en un hospital de referencia por enfermedades infecciosas en Ceará. La muestra estuvo conformada por 26 profesionales de enfermería, entre enfermeros y técnicos, quienes realizaron tres sesiones de auriculoacupuntura, una vez por semana, durante cuatro semanas. La calidad del sueño se midió mediante el índice de calidad del sueño de Pittsburg. Los efectos de la intervención se analizaron mediante la prueba “t” de Student para comparar medias entre la primera y la última aplicación, ANOVA unidireccional con medidas repetidas y prueba post-hoc de Sidak. Resultados: con respecto a los componentes del Índice de Calidad del Sueño de Pittsburg, se encontraron diferencias significativas entre los individuos en los componentes: calidad subjetiva del sueño (p = 0,001); latencia del sueño (p <0,001), duración del sueño (p <0,001), eficiencia habitual del sueño (p = 0,011), trastornos del sueño (p <0,001), medicamentos para dormir (p = 0,005) y disfunción del sueño durante el día (p <0,001). El índice general de sueño también cambió significativamente (p <0,001). La intervención redujo la puntuación del índice de calidad del sueño en un 52,35%. Conclusión: los cambios que ocurrieron pudieron cambiar la categoría en la clasificación del sueño a través de una caída sustancial en las puntuaciones del Índice de Calidad del Sueño de Pittsburg. Se observaron diferencias significativas entre los momentos inicial y final en el índice global y en todos los componentes.

RESUMO Objetivo: avaliar a efetividade da auriculoacupuntura na melhora da qualidade do sono de profissionais de enfermagem atuantes no combate à pandemia da COVID-19. Método: estudo quase-experimental, sem grupo controle ou pareamento, do tipo antes e depois, desenvolvido de maio a julho de 2020, em um hospital de referência para doenças infecciosas no Ceará. A amostra foi constituída por 26 profissionais de enfermagem, entre enfermeiros e técnicos, que realizaram três sessões de auriculoacupuntura, uma vez por semana, durante quatro semanas. A qualidade do sono foi mensurada pelo Índice de Qualidade do Sono de Pittsburg. Os efeitos da intervenção foram analisados pelo teste de “t” de student para comparação de médias entre a primeira e a última aplicação, ANOVA de uma via com medidas repetidas e teste pós-hoc de Sidak. Resultados: no tocante aos componentes do Índice de Qualidade do Sono de Pittsburg foram verificadas diferenças significativas entre os indivíduos nos componentes: qualidade subjetiva do sono (p=0,001); latência do sono (p<0,001), duração do sono (p<0,001), eficiência habitual do sono (p=0,011), distúrbios do sono (p<0,001), medicamentos para dormir (p=0,005) e disfunção diurna do sono (p<0,001). O índice global do sono também teve mudança significativa (p<0,001). A intervenção reduziu em 52,35% a pontuação do índice de qualidade do sono. Conclusão: as mudanças ocorridas foram capazes de mudar a categoria na classificação do sono por meio de uma queda circunstanciada nos escores do Índice de Qualidade do Sono de Pittsburg. Observaram-se diferenças significativas entre os momentos inicial e final no índice global e em todos componentes.

https://doi.org/10.1590/1980-265x-tce-2020-0392 113 downloads

10.

Cognitive deficits, social support, depression and quality of life of post-stroke patients
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Sousa, Flávia

; Rocha, Vânia

; Estima, Clara

; Castro, São Luís

; Guerra, Marina Prista

Análise Psicológica

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dec 2020, Volume 38 N. 2 Pages 153 - 165

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Um acidente vascular cerebral (AVC) é um evento ameaçador à vida que provoca consequências físicas, emocionais e cognitivas. Este estudo apresenta como objectivos: identificar diferenças entre participantes que sofreram um AVC (grupo clínico) e participantes saudáveis (grupo de controlo) no que concerne ao desempenho cognitivo, sintomatologia depressiva, suporte social e qualidade de vida; examinar as associações entre as variáveis em estudo em participantes que sofreram AVC; e identificar as variáveis que melhor classificam os dois grupos de participantes. A amostra incluiu 30 pacientes que sofreram um AVC e 30 participantes saudáveis, com características sociodemográficas semelhantes. A todos os participantes foram aplicados os seguintes instrumentos: The Institute of Cognitive Neurology Frontal Screening, the Montreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, the Instrumental-Expressive Social-Support Scale, e the Short Form Health Survey-36. Pacientes que sofreram um AVC apresentaram défices cognitivos mais significativos, menor suporte social, menor qualidade de vida e sintomatologia depressiva mais elevada comparativamente ao grupo de controlo. O suporte social encontra-se, no grupo clínico, positivamente correlacionado à qualidade de vida e negativamente correlacionado à sintomatologia depressiva. A sintomatologia depressiva e os défices cognitivos classificaram corretamente 85% dos casos do grupo clínico. Este estudo realça a importância de se implementar intervenções psicológicas que incidam na sintomatologia depressiva e na reabilitação cognitiva de pacientes que sofreram um AVC.

A stroke is a life-threatening event which has physical, emotional and cognitive consequences. This study aimed to identify differences between participants who suffered a stroke and healthy controls, concerning cognitive performance, depressive symptoms, social support and quality of life; to examine the associations between these variables among participants who suffered a stroke; and to identify the variables that best classify patients and controls. The sample included 30 patients who suffered a stroke and 30 healthy participants. Both groups presented similar sociodemographic characteristics. All participants were assessed with The Institute of Cognitive Neurology Frontal Screening, the Montreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, the Instrumental-Expressive Social-Support Scale, and the Short Form Health Survey-36. Post-stroke patients had lower cognitive performance, lower social support, lower quality of life and higher depressive symptoms than the control group. Social support was positively related to quality of life and negatively related to depressive symptoms in the clinical group. Cognitive deficits and depressive symptoms correctly classified belonging to the clinical group in 85% of cases, and significantly predicted the stroke. This study underlines the importance of implementing psychological interventions addressing depressive symptoms and cognitive rehabilitation for post-stroke patients.

https://doi.org/10.14417/ap.1726 638 downloads

11.

Levels of Vitamins and Homocysteine in Older Adults with Alzheimer Disease or Mild Cognitive Impairment in Cuba
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Lanyau-Domínguez, Yeneisy

; Macías-Matos, Consuelo

; Llibre-Rodríguez, Juan de Jesús

; Pita-Rodríguez, Gisela M

; Suárez-Medina, Ramón

; Quintero-Alejo, María E.

; Noriega-Fernández, Lisseth

; Guerra-Hernández, Milagros

; Calvo-Rodríguez, Marina

; Sánchez-Gil, Yvón

; García-Klibanski, Milagros

; Herrera-Javier, Dania

; Arocha-Oriol, Caridad

; Díaz-Domínguez, Maybe

MEDICC Review

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dec 2020, Volume 22 N. 4 Pages 40 - 47

Abstract: En | Text: En | PDF: En

ABSTRACT INTRODUCTION Age-related cognitive disorders, including Alzheimer disease, are among the main causes of disability and dependence in older adults worldwide. High blood homocysteine levels (hyperhomocysteinemia) are a risk factor for diseases whose metabolism involves different B vitamins. Antioxidant vitamins provide a protective effect by mitigating oxidative stress generated by these diseases. Epidemiological studies have presented varying results on the relationships between blood levels of these vitamins and such cognitive disorders. OBJECTIVE Evaluate the association of vitamin and homocysteine levels with mild cognitive impairment and Alzheimer disease in a group of Cuban older adults. METHODS A cross-sectional study was conducted in Havana, Cuba, of 424 persons aged ≥65 years: 43 with Alzheimer disease, 131 with mild cognitive impairment, and 250 with no signs of cognitive impairment. Dementia was diagnosed using criteria of the International 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and mild cognitive impairment was diagnosed using Petersen’s criteria. Blood levels of vitamins (thiamine, B-2, folate, B-12, C and A) and homocysteine were measured by standard procedures. Analysis of variance for continuous variables and percentage comparison tests for dichotomous variables were used to compare groups. RESULTS Persons with Alzheimer disease presented significantly lower levels of vitamins B-2, C and A than healthy participants (p <0.05). Homocysteine levels were significantly higher in those with Alzheimer disease and mild cognitive impairment than in participants with no cognitive impairment (p <0.05). Statistically, levels of thiamine, folic acid, and vitamin B-12 were not significantly different across groups. Compared with those without cognitive impairment, prevalence rates (PR) in the Alzheimer group were significantly higher for hyperhomocysteinemia (PR = 3.26; 1.84–5.80) and deficiency of all B vitamins: thiamine (PR = 1.89; 1.04–3.43), B-2 (PR = 2.85; 1.54–5.26), folate (PR = 3.02; 1.53–5.95), B-12 (PR = 2.21; 1.17–4.19), vitamin C (PR = 3.88; 2.12–7.10) and A (PR = 5.47; 3.26–9.17). In mild cognitive impairment, prevalence rates were significantly higher for hyperhomocysteinemia (PR = 1.42; 1.08–1.87), vitamin B-2 deficiency (PR = 1.70; 1.24–2.32) and vitamin A deficiency (PR =1.88; 1.05–3.38). CONCLUSIONS Hyperhomocysteinemia and various vitamin deficiencies are related to Alzheimer disease and mild cognitive impairment. Longitudinal studies are needed to further elucidate the relationship between different nutritional biomarkers and dementia. A better understanding of this relationship could provide a basis for therapeutic and preventive strategies.

https://doi.org/10.37757/mr2020.v22.n3.10

12.

Development of a hyperimmune equine serum therapy for COVID-19 in Argentina
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Zylberman, Vanesa

; Sanguineti, Santiago

; Pontoriero, Andrea V

; Higa, Sandra V

; Cerutti, María L

; Morrone Seijo, Susana M

; Pardo, Romina

; Muñoz, Luciana

; Acuña Intrieri, María E

; Alzogaray, Vanina A

; Avaro, Martín M

; Benedetti, Estefanía

; Berguer, Paula M

; Bocanera, Laura

; Bukata, Lucas

; Bustelo, Marina S

; Campos, Ana M

; Colonna, Mariana

; Correa, Elisa

; Cragnaz, Lucía

; Dattero, María E

; Dellafiore, María

; Foscaldi, Sabrina

; González, Joaquín V

; Guerra, Luciano L

; Klinke, Sebastián

; Labanda, María S

; Lauché, Constanza

; López, Juan C

; Martínez, Anabela M

; Otero, Lisandro H

; Peyric, Elías H

; Ponziani, Pablo F

; Ramondino, Romina

; Rinaldi, Jimena

; Rodríguez, Santiago

; Russo, Javier E

; Russo, Mara L

; Saavedra, Soledad L

; Seigelchifer, Mauricio

; Sosa, Santiago

; Vilariño, Claudio

; López Biscayart, Patricia

; Corley, Esteban

; Spatz, Linus

; Baumeister, Elsa G

; Goldbaum, Fernando A

Medicina (Buenos Aires)

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jun 2020, Volume 80 Suppl. 3 Pages 1 - 6

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

The disease named COVID-19, caused by the SARS-CoV-2 coronavirus, is currently generating a global pandemic. Vaccine development is no doubt the best long-term immunological approach, but in the current epidemiologic and health emergency there is a need for rapid and effective solutions. Convalescent plasma is the only antibody-based therapy available for COVID-19 patients to date. Equine polyclonal antibodies (EpAbs) put forward a sound alternative. The new generation of processed and purified EpAbs containing highly purified F(ab’)2 fragments demonstrated to be safe and well tolerated. EpAbs are easy to manufacture allowing a fast development and scaling up for a treatment. Based on these ideas, we present a new therapeutic product obtained after immunization of horses with the receptor-binding domain of the viral Spike glycoprotein. Our product shows around 50 times more potency in in vitro seroneutralization assays than the average of convalescent plasma. This result may allow us to test the safety and efficacy of this product in a phase 2/3 clinical trial to be conducted in July 2020 in the metropolitan area of Buenos Aires, Argentina.

La enfermedad denominada COVID-19 es causada por el coronavirus SARS-CoV-2 y es actualmente considerada una pandemia a nivel global. El desarrollo de vacunas es sin duda la mejor estrategia a largo plazo, pero debido a la emergencia sanitaria, existe una necesidad urgente de encontrar soluciones rápidas y efectivas para el tratamiento de la enfermedad. Hasta la fecha, el uso de plasma de convalecientes es la única inmunoterapia disponible para pacientes hospitalizados con COVID-19. El uso de anticuerpos policlonales equinos (EpAbs) es otra alternativa terapéutica interesante. La nueva generación de EpAbs incluyen el procesamiento y purificación de los mismos y la obtención de fragmentos F(ab’)2 con alta pureza y un excelente perfil de seguridad en humanos. Los EpAbs son fáciles de producir, lo cual permite el desarrollo rápido y la elaboración a gran escala de un producto terapéutico. En este trabajo mostramos el desarrollo de un suero terapéutico obtenido luego de la inmunización de caballos utilizando el receptor-binding domain de la glicoproteína Spike del virus. Nuestro producto mostró ser alrededor de 50 veces más potente en ensayos de seroneutralización in vitro que el promedio de los plasmas de convalecientes. Estos resultados nos permitirían testear la seguridad y eficacia de nuestro producto en ensayos clínicos de fase 2/3 a realizarse a partir de julio de 2020 en la zona metropolitana de Buenos Aires, Argentina.

677 downloads

13.

EFFECTIVENESS OF AURICULOACUPUNCTURE ON THE SLEEP QUALITY OF WORKING NURSING PROFESSIONALS DURING THE COVID-19 PANDEMIC
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Melo, Geórgia Alcântara Alencar

; Lira Neto, José Cláudio Garcia

; Silva, Renan Alves

; Martins, Marina Guerra

; Pereira, Francisco Gilberto Fernandes

; Caetano, Joselany Áfio

Texto & Contexto - Enfermagem

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2020, Volume 29 elocation e20200392

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/1980-265x-tce-2020-0392 830 downloads

14.

Benefícios da auriculoacupuntura em profissionais de enfermagem atuantes na COVID-19 à luz da Teoria do Conforto
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Melo, Geórgia Alcântara Alencar

; Lira Neto, José Claudio Garcia

; Martins, Marina Guerra

; Pereira, Francisco Gilberto Fernandes

; Caetano, Joselany Áfio

Escola Anna Nery

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2020, Volume 24 N. spe elocation e20200311

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo analisar os benefícios da auriculoacupuntura em profissionais de enfermagem atuantes na pandemia COVID-19 à luz da Teoria do Conforto de Katherine Kolcaba. Método pesquisa descritiva com abordagem qualitativa, realizada com 33 profissionais de enfermagem atuantes no combate à COVID-19. Os depoimentos foram coletados por meio de entrevista após a realização de sessões de auriculoacupuntura, em seguida organizados e analisados segundo a análise de conteúdo de Bardin, com ancoragem na Teoria do Conforto. Resultados emergiram três categorias temáticas: “Auriculoacupuntra como medida de conforto”; “(Des)Conforto físico e psicoespiritual e atuação na assistência à COVID-19”; e, “Do apoio organizacional ao comprometimento individual com a saúde”. Verifica-se que os sujeitos declararam melhora no autopercepção de conforto, com destaque para os domínios físico e psicoespiritual, como a melhora da ansiedade, dores e qualidade do sono. A integridade institucional aparece como aliada ao comportamento de procura de saúde. Considerações finais e implicações para a prática: A auriculoacupuntura foi percebida como benéfica para melhorar a sensação de conforto físico e psicoespiritual pelos profissionais de enfermagem.

ABSTRACT Objective To analyze the benefits of auriculoacupuncture in nursing professionals working in the COVID-19 pandemic in the light of Katherine Kolcaba's Theory of Comfort. Method Descriptive research with a qualitative approach, carried out with 33 nursing professionals working to combat COVID-19. The testimonies were collected through interviews after conducting auriculoacupuncture sessions, then organized and analyzed according to Bardin's content analysis, anchored in the Comfort Theory. Results Three thematic categories emerged: “Auriculoacupuntra as a measure of comfort”; “(Dis) Physical and psychospiritual comfort and performance in assisting COVID-19”; and, “From organizational support to individual commitment to health”. It appears that the subjects reported an improvement in their self-perception of comfort, with emphasis on the physical and psychospiritual domains, such as improvement in anxiety, pain and quality of sleep. Institutional integrity appears as an ally to health-seeking behavior. Final considerations and implications for practice: Auriculoacupuncture was perceived as beneficial for improving the feeling of physical and psycho-spiritual comfort by nursing professionals.

RESUMEN Objetivo analizar los beneficios de la auriculopuntura en profesionales de enfermería que prestan servicios vinculados a la pandemia de COVID-19 a la luz de la Teoría de la comodidad de Katherine Kolcaba. Método investigación descriptiva con enfoque cualitativo, realizada con 33 profesionales de enfermería que trabajan para combatir COVID-19. Los testimonios se recopilaron a través de entrevistas después de realizar sesiones de auriculopuntura, luego se organizaron y analizaron de acuerdo con el análisis de contenido de Bardin, anclado en la Teoría del Confort. Resultados surgieron tres categorías temáticas: “Auriculopuntura como medida de confort”; “(In) Comodidad física y psicoespiritual y desempeño en la asistencia al COVID-19”; y, desde el apoyo organizacional hasta el compromiso individual con la salud. Se advierte que los sujetos informaron una mejora en su autopercepción de comodidad, con énfasis en los dominios físicos y psicoespirituales, como la mejora en la ansiedad, el dolor y la calidad del sueño. La integridad institucional aparece como un aliado del comportamiento de búsqueda de salud. Consideraciones finales e implicaciones para la práctica: los profesionales de enfermería percibieron la auriculopuntura como beneficiosa para mejorar la sensación de confort físico y psicoespiritual.

https://doi.org/10.1590/2177-9465-ean-2020-0311 1678 downloads

15.

Benefícios da auriculoacupuntura em profissionais de enfermagem atuantes na COVID-19 à luz da Teoria do Conforto
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Melo, Geórgia Alcântara Alencar

; Lira Neto, José Claudio Garcia

; Martins, Marina Guerra

; Pereira, Francisco Gilberto Fernandes

; Caetano, Joselany Áfio

Escola Anna Nery

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2020, Volume 24 N. spe elocation e20200311

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

https://doi.org/10.1590/2177-9465-ean-2020-0311 2 downloads

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