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OBJECTIVE: The aim of this study was to measure the reliability, internal consistency, and construct validity of the Kidney Symptom Questionnaire for the Brazilian population. METHODS: This is a cross-cultural adaptation and questionnaire validation study. We included native Brazilians of both sex aged>18 years, as well as hypertensive and/or diabetic patients. All participants were assessed using Screening for Occult Renal Disease, EuroQol 5 Dimensions, 36-Item Short Form Survey, and the Kidney Symptom Questionnaire. We used Spearman's coefficient (rho) to measure the correlations between the Kidney Symptom Questionnaire and other instruments; Cronbach's alpha to measure internal consistency; and intraclass correlation coefficient, standard error of measurement, and minimum detectable change to measure test-retest reliability. RESULTS: The sample was formed by 121 adult participants, mostly female, with systemic arterial hypertension and/or diabetes mellitus. We found excellent reliability (intraclass correlation coefficient≥0.978), adequate internal consistency (Cronbach's alpha≥0.860), and adequate construct validity on the Kidney Symptom Questionnaire domains; besides, we observed significant correlations between the Kidney Symptom Questionnaire and other instruments. CONCLUSION: The Brazilian version of the Kidney Symptom Questionnaire has adequate measurement properties to assess chronic/occult kidney disease in patients who do not require renal replacement therapy.
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Diabetes Mellitus , Hipertensión , Insuficiencia Renal Crónica , Adulto , Humanos , Femenino , Masculino , Brasil , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Hipertensión/diagnóstico , Riñón , Psicometría , Comparación TransculturalRESUMEN
SUMMARY OBJECTIVE: The aim of this study was to measure the reliability, internal consistency, and construct validity of the Kidney Symptom Questionnaire for the Brazilian population. METHODS: This is a cross-cultural adaptation and questionnaire validation study. We included native Brazilians of both sex aged>18 years, as well as hypertensive and/or diabetic patients. All participants were assessed using Screening for Occult Renal Disease, EuroQol 5 Dimensions, 36-Item Short Form Survey, and the Kidney Symptom Questionnaire. We used Spearman's coefficient (rho) to measure the correlations between the Kidney Symptom Questionnaire and other instruments; Cronbach's alpha to measure internal consistency; and intraclass correlation coefficient, standard error of measurement, and minimum detectable change to measure test-retest reliability. RESULTS: The sample was formed by 121 adult participants, mostly female, with systemic arterial hypertension and/or diabetes mellitus. We found excellent reliability (intraclass correlation coefficient≥0.978), adequate internal consistency (Cronbach's alpha≥0.860), and adequate construct validity on the Kidney Symptom Questionnaire domains; besides, we observed significant correlations between the Kidney Symptom Questionnaire and other instruments. CONCLUSION: The Brazilian version of the Kidney Symptom Questionnaire has adequate measurement properties to assess chronic/occult kidney disease in patients who do not require renal replacement therapy.
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OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.
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Cardiopatías , Encuestas y Cuestionarios , Brasil , Comparación Transcultural , Diabetes Mellitus , Cardiopatías/diagnóstico , Humanos , Psicometría , Reproducibilidad de los Resultados , TraduccionesRESUMEN
SUMMARY OBJECTIVE: This study aimed to translate, cross-culturally adapt, and validate the Heart Disease Fact Questionnaire into Brazilian Portuguese. METHODS: The Brazilian version of the Heart Disease Fact Questionnaire was developed through the processes of translation, back-translation, review committee, and pre-test. Test-retest reliability was measured using the intraclass correlation coefficient and the kappa coefficient. Internal consistency was measured using Cronbach's alpha. For construct validity, the total Heart Disease Fact Questionnaire score was correlated with the Diabetes Knowledge Scale and the Diabetes Attitudes Questionnaire. Ceiling and floor effects were also evaluated in this study. RESULTS: For construct validity and floor and ceiling effect measurements, a total of 100 participants were selected. Reliability was measured using a sub-sample of 30 participants from the total sample. We identified adequate values of reliability (kappa between 0.22 and 1.00 and ICC=0.75) and internal consistency (Cronbach's alpha=0.79). We observed adequate correlations of the Heart Disease Fact Questionnaire score with Diabetes Knowledge Scale (r=0.348) and Diabetes Attitudes Questionnaire (r=0.136). No ceiling or floor effects found. CONCLUSION: Brazilian Portuguese version of the Heart Disease Fact Questionnaire has adequate psychometric properties according to the best scientific recommendations.
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Introdução: cerca de quatro bilhões de pessoas residem em áreas com risco de dengue, uma arbovirose transmitida pelo mosquito Aedes (Stegomyia) aegypti (Linnaeus, 1762) (Insecta, Diptera, Culicidae). Na tentativa de combater esse vetor e reduzir a disseminação da dengue, o meio de controle vetorial frequentemente utilizado são os inseticidas. Entretanto, o uso indiscriminado destes no controle do mosquito está relacionado aos mecanismos de resistência desse vetor. Objetivo: mapear as evidências científicas relacionadas à resistência do mosquito A. aegypti aos inseticidas utilizados para o controle populacional. Metodologia: revisão de escopo, segundo metodologia Instituto Joana Briggs, em bases de dados indexadas: PubMed, Embase, CINAHL, Web of Science, SCOPUS e Biblioteca Virtual em Saúde. Através do mnemônico PCC (população, conceito e contexto), elaborou-se a estratégia de busca utilizando descritores do Decs e Mesh. Resultados: foram encontrados 1.631 estudos sobre a temática. Após critérios de elegibilidade e seleção, foram incluídos 30 estudos específicos sobre resistência do Aedes aegypti a inseticidas foram incluídos na revisão. A maior parte tratou de forma experimental e 28 (93,3%) estudos trabalharam o controle químico. Em relação à resistência a inseticidas, em 20 estudos (66,6%) constatou-se resistência metabólica e em 9 (30%) a resistência mediada pela alteração da variabilidade genética. Os estudos que observaram mutação não deixam claro se a mutação gênica é especificamente devido à ação mutagênica aos inseticidas. Conclusões:o A. aegypti desenvolve adaptações que lhe conferem resistência aos inseticidas, sendo que esses mecanismos de resistência estão relacionados à variabilidade genética e a adaptações metabólicas, que são transmitidas a seus descendentes ao longo das gerações. Assim, torna-se necessário um avanço nos estudos visando não apenas identificar e explicar os mecanismos de resistência, mas encontrar meios alternativos de manejo que possam controlar o inseto sem ocasionar resistência aos mesmos.
Introduction: about four billion people live in areas at risk of dengue, an arbovirus transmitted by the Aedes (Stegomyia) aegypti (Linnaeus, 1762) (Insecta, Diptera, Culicidae). To combat this vector and reduce the spread of dengue, the means of vector control often used are insecticides. However, their indiscriminate use in mosquito control is related to the resistance mechanisms of this vector. Objective: to map the scientific evidence related to the resistance of the Aedes aegypti mosquito to the insecticides used to control dengue. Methodology: scope review, according to the Joana Briggs Institute methodology, in indexed databases: PubMed, Embase, CINAHL, Web of Science, SCOPUS and Virtual Health Library. Using the mnemonic PCC (population, concept and context), a search strategy was developed using Decs and Mesh descriptors. Results: 1,631 studies on the subject were found. After eligibility and selection criteria, 30 specific studies on Aedes aegypti resistance to insecticide were included in the review . Most treated experimentally and 28 (93.3%) studies worked on chemical control. Regarding the resistance to insecticide, in 20 studies (66.6%) there was found metabolic resistance and in 9 (30%) resistance mediated by modification on the genetic variability. Studies that have looked at mutation do not make it clear whether the gene mutation is specifically due to mutagenic action of insecticides. Conclusions: Aedes aegypti develops adaptations that gives them resistance to insecticides, and these resistance mechanisms are related to genetic variability and to metabolic adaptations, which are transmitted to its descendants over generations. Thus, it is necessary to perform advance in studies aiming not only to identify and explain the resistance mechanisms, but to find alternative means of management that can control the insect without causing resistance to them.
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Animales , Masculino , Femenino , Resistencia a los Insecticidas , Aedes , Mosquitos Vectores/efectos de los fármacos , Insecticidas , Dengue/prevención & controlRESUMEN
BACKGROUND: Coronavirus disease 2019, which is caused by the new severe acute respiratory syndrome coronavirus 2, became a pandemic in 2020 with a mortality rate of 2% and high transmissibility, thus making studies with an epidemiological profile essential. OBJECTIVES: The aim of this study was to characterize the population that performed the severe acute respiratory syndrome coronavirus 2 molecular and serological tests in Carlos Chagas Laboratory - Sabin Group in Cuiabá. METHODS: A retrospective cross-sectional study was carried out with all the samples collected from nasal swab tested by RT-PCR and serological for severe acute respiratory syndrome coronavirus 2 IgM/IgG from the population served between April and December 2020. FINDINGS: In the analysis period, 23,631 PCR-coronavirus disease 2019 examinations were registered. Of this total number of cases, 7,649 (32.37%) tested positive, while 15,982 (66.31%) did not detect viral RNA and 374 of the results as undetermined. The peak of positive RT-PCR performed in July (n=5,878), with 35.65% (n=2,096). A total of 8,884 tests were performed on serological test SOROVID-19, with a peak of 1,169 (57.16%) of the positive tests for severe acute respiratory syndrome coronavirus 2 in July. MAIN CONCLUSIONS: Molecular positivity and serological tests, both peaked in July 2020, were mostly present in women aged 20-59 years, characterizing Cuiabá as the epicenter of the Midwest region in this period due to the high rate of transmissibility of severe acute respiratory syndrome coronavirus 2.
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COVID-19 , SARS-CoV-2 , Anticuerpos Antivirales , COVID-19/diagnóstico , COVID-19/epidemiología , Estudios Transversales , Femenino , Humanos , Inmunoglobulina G , Inmunoglobulina M , Prevalencia , Estudios Retrospectivos , Pruebas Serológicas/métodosRESUMEN
SUMMARY BACKGROUND: Coronavirus disease 2019, which is caused by the new severe acute respiratory syndrome coronavirus 2, became a pandemic in 2020 with a mortality rate of 2% and high transmissibility, thus making studies with an epidemiological profile essential. OBJECTIVES: The aim of this study was to characterize the population that performed the severe acute respiratory syndrome coronavirus 2 molecular and serological tests in Carlos Chagas Laboratory - Sabin Group in Cuiabá. METHODS: A retrospective cross-sectional study was carried out with all the samples collected from nasal swab tested by RT-PCR and serological for severe acute respiratory syndrome coronavirus 2 IgM/IgG from the population served between April and December 2020. FINDINGS: In the analysis period, 23,631 PCR-coronavirus disease 2019 examinations were registered. Of this total number of cases, 7,649 (32.37%) tested positive, while 15,982 (66.31%) did not detect viral RNA and 374 of the results as undetermined. The peak of positive RT-PCR performed in July (n=5,878), with 35.65% (n=2,096). A total of 8,884 tests were performed on serological test SOROVID-19, with a peak of 1,169 (57.16%) of the positive tests for severe acute respiratory syndrome coronavirus 2 in July. MAIN CONCLUSIONS: Molecular positivity and serological tests, both peaked in July 2020, were mostly present in women aged 20-59 years, characterizing Cuiabá as the epicenter of the Midwest region in this period due to the high rate of transmissibility of severe acute respiratory syndrome coronavirus 2.
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BACKGROUND: Exposure to particulate material produced as a result of increased agricultural activity may increase the number of pneumonia hospitalizations among children. We hope to contribute to the knowledge base through highlighting the environmental mechanisms involved in this outcome and optimizing pollutant control policies. OBJECTIVES: To investigate the association between pneumonia hospitalizations among children and presence of environmental pollutants in a town in the Brazilian Legal Amazon region. DESIGN AND SETTING: Time series study conducted in the town of Tangará da Serra, Mato Grosso (MT), Brazil. METHODS: A total of 158 children aged 0 to 10 years participated in the study. Data on environmental variables and pollutants were extracted daily through the Coupled Chemistry-Aerosol-Tracer Transport model coupled to Brazilian Regional Atmospheric Modeling System (CCATT-BRAMS). Meteorological data were provided by the Weather Forecasting and Climate Studies Center (CPTEC). RESULTS: There was greater frequency of pneumonia hospitalizations in the months of transition between the rainy and dry seasons, with a prevalence ratio 2.4 times higher than in other periods. For environmental pollutants, there was a significant positive correlation between particulate matter (PM2.5) and pneumonia hospitalizations (correlation 0.11), with more admissions on the days when PM2.5 levels were highest (averages of 6.6 µg/m3 when there were no admissions and 13.11 µg/m3 on days with two or more admissions). CONCLUSIONS: The higher the PM2.5 level was, the greater the frequency of hospitalizations also was. Children living in peripheral areas had higher prevalence of pneumonia hospitalizations in the dry period than those who were living in the town center.
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Contaminantes Atmosféricos , Contaminación del Aire/estadística & datos numéricos , Neumonía/epidemiología , Brasil/epidemiología , Niño , Preescolar , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Material Particulado , Factores de Riesgo , Estaciones del AñoRESUMEN
Previous studies have shown that high levels of air pollutants may increase activity of systemic lupus erythematosus (SLE). The aim of this study is to analyze the association between pollutants originating from the Brazilian Legal Amazon and SLE activity. This is a retrospective longitudinal cohort study with patients with SLE in the General Hospital in Cuiabá, Brazil. The association with SLE activity was measured using the SLE disease activity index (SLEDAI) and data on air quality-PM2.5 and CO, published on the websites of the State Department of Environment and the Center for Weather Forecasting and Climate Studies. To assess the effect of daily concentrations of pollutants on SLEDAI scores, the generalized estimation equation (GEE) model was used. A total of 32 female patients were assessed, in 96 doctor's appointments. The average SLEDAI score was 6 points (±5.05). GEE showed an association of disease activity with both higher rates of wildfires (p = 0.021) and average CO rate (p = 0.013), but there was no statistical association between particulate levels and SLE activity. The results suggest that variations in air pollution are associated with the activity of autoimmune rheumatic diseases.
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Contaminantes Atmosféricos , Contaminación del Aire , Lupus Eritematoso Sistémico , Índice de Severidad de la Enfermedad , Contaminantes Atmosféricos/toxicidad , Brasil , Exposición a Riesgos Ambientales , Femenino , Humanos , Estudios Longitudinales , Lupus Eritematoso Sistémico/complicaciones , Estudios RetrospectivosRESUMEN
ABSTRACT BACKGROUND: Exposure to particulate material produced as a result of increased agricultural activity may increase the number of pneumonia hospitalizations among children. We hope to contribute to the knowledge base through highlighting the environmental mechanisms involved in this outcome and optimizing pollutant control policies. OBJECTIVES: To investigate the association between pneumonia hospitalizations among children and presence of environmental pollutants in a town in the Brazilian Legal Amazon region. DESIGN AND SETTING: Time series study conducted in the town of Tangará da Serra, Mato Grosso (MT), Brazil. METHODS: A total of 158 children aged 0 to 10 years participated in the study. Data on environmental variables and pollutants were extracted daily through the Coupled Chemistry-Aerosol-Tracer Transport model coupled to Brazilian Regional Atmospheric Modeling System (CCATT-BRAMS). Meteorological data were provided by the Weather Forecasting and Climate Studies Center (CPTEC). RESULTS: There was greater frequency of pneumonia hospitalizations in the months of transition between the rainy and dry seasons, with a prevalence ratio 2.4 times higher than in other periods. For environmental pollutants, there was a significant positive correlation between particulate matter (PM2.5) and pneumonia hospitalizations (correlation 0.11), with more admissions on the days when PM2.5 levels were highest (averages of 6.6 µg/m3 when there were no admissions and 13.11 µg/m3 on days with two or more admissions). CONCLUSIONS: The higher the PM2.5 level was, the greater the frequency of hospitalizations also was. Children living in peripheral areas had higher prevalence of pneumonia hospitalizations in the dry period than those who were living in the town center.
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Humanos , Recién Nacido , Lactante , Preescolar , Niño , Neumonía/epidemiología , Contaminantes Atmosféricos , Contaminación del Aire/estadística & datos numéricos , Estaciones del Año , Brasil/epidemiología , Factores de Riesgo , Material Particulado , Hospitalización/estadística & datos numéricosRESUMEN
Introdução: As doenças cardiovasculares somam 1/3 de todas as mortes na América Latina e no Brasil, representando a 2ª causa de morte no país. Objetivos: Mensurar e acompanhar a qualidade de vida relacionada a saúde (QVRS) durante 180 dias e correlacionar os resultados com ansiedade, depressão em pacientes submetidos a cirurgia de revascularização do miocárdio (CRM). Métodos: 63 pacientes foram submetidos a CRM eletiva, no pré-operatório foram coletados os dados sociodemográficos e clínicos depois os pacientes preencheram questionários: MacNew QLMI para avaliação de QVRS, IDATE Traço-Estado para avaliação de ansiedade e Beck Depression Inventory (BDI) para avaliação de depressão. Após a alta hospitalar, em seus domicílios, os pacientes responderam novamente os questionários e foram acompanhados por 6 meses. Resultados: Foi observada melhora significativa da QVRS após 60 dias, que se manteve estável entre 120-180 dias após CRM. Houve uma correlação negativa significante entre QVRS e depressão e QVRS e ansiedade. Quanto aos domínios do QLMI, observou-se melhora significante no físico e social após 120 e 180 dias da cirurgia. Não foi observada diferença significativa nos escores de depressão e ansiedade em relação ao tempo de CRM. Porém, observou-se redução significativa nos níveis de depressão 180 dias após CRM. Conclusão: Pacientes submetidos a CRM apresentam uma melhora espontânea significativa em sua QVRS após 60 dias e que se estabiliza até 180 dias. Fatores como ansiedade e depressão podem afetar o curso de sua completa recuperação emocional, física e social. (AU)
Introduction: Cardiovascular diseases account for 1/3 of all deaths in Latin America and Brazil is the second leading cause of death in the country. Objectives: The aim of the present study was to measure and to follow health-related quality of life (HRQL) up to 180 days after coronary artery bypass graft (CABG) and to correlate the results with presence of anxiety, depression. Methods: A cohort of 63 patients who had undergone to elective CABG were followed for 180 days. Patients were asked to answer questionnaires: HRQL (MacNew QLMI); IDATE with two distinct scales for evaluation of draw and anxiety state; and Beck Depression Inventory (BDI) for evaluation of attitudes and depression symptoms. Results: Results obtained demonstrated significant inverse correlation between HRQL and depression, and between HRQL and anxiety. A significant increase of HRQL after 60 days post-CABG was observed, which stabilizes after 120-180 days. A significant increase in the physical and social QLMI domains after 120-180 days post-CABG was also observed. The analysis of depression and anxiety scores did not show significant difference regarding time. However, the distribution of levels (normal, light/moderated and moderated/severe) of depression showed a significant reduction of depression. No correlation between the presence of postoperative complications and HRQL scores were detected. Conclusion: Concluding these results demonstrated a spontaneous improvement of HRQL after 60 days post-CABG, which stabilizes in 180 days. Factors as anxiety and depression can affect social, physical and emotional recuperation. (AU)
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Humanos , Ansiedad , Calidad de Vida , Depresión , Revascularización Miocárdica , SaludRESUMEN
Patients who require invasive ventilatory support are subject to the deleterious effects of this, mainly ventilator-associated pneumonia (VAP). The physiotherapist, a member of the multiprofessional team, assists the patient with the purpose of promoting the recovery and preservation of the functionality, being able to minimize / avoid secondary complications. This study aims to identify the repercussions of mechanical ventilation hyperinflation (MVH) in the flow bias concept in respiratory mechanics. This study is a narrative review. MVH is an important resource commonly used in clinical practice that involves the manipulation of mechanical ventilator configurations to provide larger pulmonary volumes, and the generated airflow gradient may play a relevant role in mucus transport, with the concept of flow bias the main factor responsible for its direction. For the mobilization of the mucus towards the cephalic direction to occur, there must be a predominant expiratory flow, guaranteeing the peak ratio of expiratory flow / inspiratory flow peak (EFP / IFP) greater than 1.11. Maintenance of mechanical ventilation assures the patient to maintain the positive end-expiratory pressure (PEEP) and the oxygen inspired fraction, avoiding the deleterious effects of the mechanical ventilator disconnection. MVH is able to improve lung compliance without, however, increasing airway resistance. MVH in the cephalic flow bias concept is effective for the mucus mobilization in the central direction, being able to improve pulmonary compliance and peripheral oxygen saturation. (AU).
Os pacientes internados que necessitam de suporte ventilatório invasivo estão sujeitos aos efeitos deletérios deste, principalmente a pneumonia associada à ventilação mecânica (PAV). O fisioterapeuta, integrante da equipe multiprofissional, assiste o paciente com a finalidade de promover a recuperação e preservação da funcionalidade, podendo minimizar/evitar complicações secundárias. Este estudo consiste em identificar as repercussões da hiperinsuflação com ventilador mecânico (HVM) no conceito flow bias na mecânica respiratória. O presente estudo trata-se de uma revisão narrativa. A HVM é um importante recurso comumente utilizado na prática clínica que envolve a manipulação das configurações do ventilador mecânico para fornecer maiores volumes pulmonares, e o gradiente de fluxo de ar gerado pode desempenhar um papel relevante no transporte do muco, sendo o conceito de flow bias cefálico o principal fator responsável pelo direcionamento deste. Para que a mobilização do muco em direção cefálica ocorra, deve existir um fluxo expiratório predominante, garantindo a razão pico de fluxo expiratório/pico de fluxo inspiratório (PFE/PFI) maior do que 1,11. A manutenção da assistência ventilatória mecânica assegura ao paciente a manutenção da pressão positiva ao final da expiração (PEEP) e a fração inspirada de oxigênio (FiO2), evitando os efeitos deletérios da desconexão do ventilador mecânico. A HVM é capaz de melhorar a complacência pulmonar sem, no entanto, aumentar a resistência das vias aéreas. A HVM no conceito flow bias cefálico é eficaz para a mobilização do muco em direção central, sendo capaz de melhorar a complacência pulmonar e saturação periférica de oxigênio (SpO2). (AU)
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Objetivo: Verificar a eficácia da lavagem das mãos no controle de disseminação de microrganismos em universitários da área da saúde. Métodos: Delineamento experimental, utilizando como antissépticos água e sabão e álcool 70% (gel e líquida). Os procedimentos de lavagem simples das mãos e uso de álcool 70% foram distribuídos em cinco grupos: Grupo sem lavagem das mãos (MS); Grupo lavagem simples das mãos com água e sabão (LS); Grupo lavagem das mãos com água e sabão e uso de álcool 70% (líquido) (LSA70), Grupo lavagem das mãos com água e sabão e uso de álcool 70% (gel) (LSAG) e Grupo apenas com uso de álcool gel (MAG). Resultados: Participaram do estudo 125 universitários. Foi observada significância estatística quando comparado os seguintes grupos: MS vs. MAG (p < 0,001), MS vs. LSA70 (p < 0,001), LS vs. MAG (p < 0,05), MS vs. LSAG (p < 0,001), LSAG vs. MAG (p < 0,001) e LSAG vs. LSA70 (p < 0,05). Conclusão: O álcool 70% foi eficaz na redução de crescimento de microrganismos em relação à lavagem simples das mãos. O álcool em forma de gel demonstrou ter melhor resultado quando aplicado sem a lavagem previa das mãos enquanto que o álcool na forma líquida foi mais eficaz após a lavagem das mãos. (AU)
Objective: To verify the effectiveness of hand washing in the control of dissemination of microorganisms in health university students. Methods: Experimental design, using water and soap and 70% alcohol (gel and liquid) as antiseptics. The procedures of simple hand washing and alcohol use 70% were distributed in five groups: Group without hand washing (MS); Simple washing hands group with soap and water (LS); Group washing of hands with soap and water and use of alcohol 70% (liquid) (LSA70), Group washing with soap and water and use of alcohol 70% (gel) (LSAG) and Group with alcohol gel use only (MAG). Results: 125 university students participated in the study. Statistical significance was observed when compared to the following groups: MS vs. MAG (p < 0.001), MS vs. LSA70 (p < 0.001), LS vs. MAG (p < 0.05), MS vs. LSAG (p < 0.001), LSAG vs. MAG (p < 0.001) and LSAG vs. LSA70 (p < 0.05). Conclusion: Alcohol 70% was effective in reducing the growth of microorganisms in relation to simple hand washing. Alcohol in the form of a gel was shown to have a better outcome when applied without prior handwashing, whereas alcohol in liquid form was more effective after handwashing. (AU)
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Humanos , Estudiantes de Medicina , Desinfección de las Manos , Etanol , Grupo de Atención al Paciente , Asepsia , Control de Infecciones , MicrobiologíaRESUMEN
A artrite reumatoide (AR) é uma doença inflamatória crônica e multissistêmica de etiologia desconhecida e multifatorial. O processo inflamatório ocasionado pela AR pode causar manifestações extra-articulares e pode haver comprometimento pulmonar, com impactos significativos na morbidade e mortalidade. Deste modo, foi realizado um estudo de revisão com o objetivo de verificar se pacientes com AR apresentam déficit na capacidade e volume pulmonar, com busca nas seguintes bases de dados: Cinahl, Lilacs, Pedro e Pubmed, como também as bibliotecas online Scielo e Cochrane. Foram incluídos estudos realizados em população adulta maiores de 18 anos de ambos os sexos com diagnóstico clínico de AR. A busca forneceu inicialmente 967 artigos, dos quais 30 foram selecionados para a leitura completa, destes apenas sete foram incluídos. Realizou-se a extração dos dados e a avaliação da qualidade do estudo através da escala de Newcastle e Otawa. As alterações encontradas nos artigos são: distúrbios restritivos, obstrutivos e mistos, redução da capacidade de difusão de CO e aumento da relação volume residual/capacidade pulmonar total. Pacientes com AR possuem alteração na função pulmonar, principalmente das pequenas vias aéreas, não sendo possível compreender os mecanismos que desencadeiam essas modificações. Devido à escassez de estudos relacionados ao tema, tornam-se necessárias novas pesquisas. (AU)
Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown multisystem and multifactorial etiology. The inflammation caused by RA can cause extra articular manifestations and there may be pulmonary involvement, with significant impact on morbidity and mortality. Thus, we performed a systematic review in order to determine whether patients with RA have deficits in capacity and lung volume, with search in the following databases: Cinahl, Lilacs, Pedro and Pubmed, as well as online libraries Scielo and Cochrane. Studies conducted in adults over 18 years of both sexes with clinical diagnosis of RA were included. The search initially provided 967 articles, of which 30 were selected for full reading and only seven were included. We performed data extraction and quality assessment study by Newcastle and Otawa scale. The changes found in the articles are restrictive, obstructive and mixed disorders, reduced CO diffusing capacity, and residual volume/total lung capacity. RA patients have changes in lung function, especially of the small airways, and it is unclear the mechanisms that trigger these changes. Due to lack of studies related to the subject become necessary further research. (AU)
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Historia del Siglo XXI , Artritis Reumatoide , Pulmón , Pruebas de Función Respiratoria , EspirometríaRESUMEN
Introdução: as unidades de terapia intensiva frequentemente utilizam dispositivos invasivos, como os cateteres, os quais podem desencadear complicações como infecção e outros efeitos colaterais que são de grande importância na terapia clínica. Além disso, os cateteres venosos utilizados principalmente em unidades de terapia intensiva contribuem para disseminação de infecção hospitalar. Objetivo: avaliar os microrganismos causadores de infecções em ponta de cateter venoso usado nos pacientes hospitalizados na Santa Casa de Misericórdia de Cuiabá-MT. Metodologia: foi realizado um estudo transversal de natureza clínica, incluindo pacientes que tinham cateter venoso e excluídos os pacientes com sonda vesical. Foi utilizada a Técnica Semi quantitativa de Maki para cultivo e após o período de incubação, as placas com crescimento igual ou superior a 15 UFC, foram submetidas à identificação dos microrganismos através de provas bioquímicas. Resultados: foram analisadas 1.577 pontas de cateteres no ano de 2008, destas, 297 (18,8%) estavam infectadas, cujos microrganismos de maior prevalência foram em 46 (15,5%) pontas a presença de Escherichia coli, 59 (19,9%) da Pseudomonas aeruginosa, 43(14,5%) da Klebsiella pneumoniae, 42 (14,1%) de Staphylococcus sp coagulase negativa e 20 (6,7%) amostras apresentavam Staphylococcus aureus, dentre outros. Das 177 amostras de ponta de cateter analisadas em 2015, 45 (25,4%) estavam infectadas. Foram encontrados em 13 pontas (28,9%) a presença da bactéria Staphylococcus sp coagulase negativa e 8 (17,8%) da Pseudomonas aeruginosa, 5 (11,1%) da Klebsiella pneumoniae, 5 (11,1%) de Stenotrophomonas maltophilia, 4 (8,9%) de Acinetobacter baumannii Conclusão: pacientes internados podem ser expostos a cateteres venosos com significativo grau de contaminação microbiana.
Introduction: the intensive care units often use invasive devices such as catheters, which can trigger complications such as, for example, infection, among other side effects which are of great importance in clinical therapy. In addition, venous catheters used primarily in intensive care units contribute to the spread of hospital infections. Objective: to evaluate the microorganisms that cause venous catheter infections used in patients hospitalized at Santa Casa de Misericórdia de Cuiabá-MT. Methodology: a cross-sectional clinical study was carried out, including patients who had a venous catheter and excluded patients with bladder catheters.Maki was used for semi-quantitative technique and growing after the incubation period the plates with growth equal to or greater than 15 UFC/ml were subjected to the identification of microorganisms by biochemical tests. Results: a total of 1,577 catheter tips in 2008, of these, 297 (18.8%) were colonized whose most prevalent microorganisms were at 46 (15.5%) pointed to the presence of Escherichia coli, 59 (19.9%) of Pseudomonas aeruginosa, 43 (14.5%), Klebsiella pneumoniae, 42 (14.1%) of Staphylococcus sp coagulase negative and 20 (6.7%) samples had Staphylococcus aureus, among others. The 177 samples catheter tip analyzed in 2015, 45 (25.4%) were colonized. Found ends 13 (28.9%) the presence of the bacterium Staphylococcus sp negative and coagulase, 8 (17.8%) of Pseudomonas aeruginosa, 5 (11.1%) Klebsiella pneumoniae, 5 (11.1%) of Stenotrophomonas maltophilia, 4 (8.9%) of Acinetobacter baumannii
Asunto(s)
Humanos , Masculino , Femenino , Infección Hospitalaria , Catéteres , Unidades de Cuidados Intensivos , Pseudomonas aeruginosa , Staphylococcus aureus , Estudios Transversales , Stenotrophomonas maltophilia , Acinetobacter baumannii , Escherichia coli , Klebsiella pneumoniaeRESUMEN
A corrida de rua é considerada um fenômeno sociocultural contemporâneo, que se transformou, ao longo do tempo, em formas distintas de prática de uma mesma atividade física. A prática da corrida de rua pode levar a lesões musculoesqueléticas, tanto no âmbito competitivo como recreativo. Além disso, estima-se que mais da metade dos corredores recreacionais podem ter lesões relacionadas com essa prática. O objetivo desse estudo foi verificar a prevalência de lesões musculoesqueléticas e associação de fatores de risco com as lesões em corredores de rua na cidade de Cuiabá-MT. Foi realizado um estudo observacional de corte transversal, no qual foram avaliados 101 corredores de rua (amadores e profissionais). Foram incluídos no estudo homens e mulheres na faixa etária de 16 a 55 anos, saudáveis e praticantes de corrida de rua, que tivessem no mínimo 6 meses de prática. Entre os corredores de rua, a prevalência de lesão foi de 37,7%, sendo os principais tipos: distensão muscular (55,3%), entorse (13,2%), canelite (10,5%), lesão ligamentar (7,8%), tendinite infrapatelar (5,2%), luxação (2,6%)e fratura (2,6%), sendo o quadril, o joelho e o tornozelo as articulações mais acometidas. Observou-se que a maioria não tem orientação sobre o uso de calçados adequados (54,5%) e que a frequência de treinamento, o quilometro percorrido, prática de aquecimento dentre outras variáveis não foram associadas à prevalência de lesão entre os indivíduos (p>0,05). Apesar da baixa prevalência de lesão musculoesquelética encontrada em corredores de rua, não foi encontrada associação entre a frequência de treinamento, maior distância percorrida nos treinos, falta de orientação de calçado adequado e de alongamento antes do treino com a lesão ocasionada pela prática de corrida de rua. (AU)
The street running is considered a contemporary socio-cultural phenomenon that has become, over time, different forms of practice of the same physical activity. The street running practice can lead to musculoskeletal injuries, both in the competitive and recreational contexts. In addition, it is estimated that more than half of the recreational runners may have injuries related to this practice. The objective of this study was to verify the prevalence of musculoskeletal injuries and association of risk factors with injuries in street runners in the city of Cuiabá-MT. A cross-sectional observational study was carried out, where 101 street runners (amateurs and professionals) were evaluated. Men and women were included in the study herein age range from 16 to 55 years, healthy, and street running practioners, who had at least 6 months of practice. Among the street runners, the prevalence of injury was 37.7%, with the main types: muscle strain (55.3%), sprain (13.2%), shin splints s (10.5%), ligament injury ( 7.8%), infrapatellar tendonitis (5.2%), dislocation (2.6%) and fracture (2.6%), with the hip, knee and ankle being the most affected joints. It was observed that the majority had no guidance on the use of adequate footwear (54.5%) and that the frequency of training, kilometer traveled, warm-up practice and other variables were not associated with the prevalence of injury among individuals (p > 0.05). Despite the low prevalence of musculoskeletal injuries found in street runners, no association was found between the frequency of training, longer distance covered in the training, the lack of adequate footwear orientation and the stretching before training with the injury caused by running Street. (AU)
RESUMEN
O número de casos de câncer, incluindo o de cabeça e pescoço, tem aumentado de maneira considerável em todo o mundo, tornando-se um dos mais importantes problemas de saúde pública mundial. As consequências desse tipo de neoplasia podem afetar profundamente a qualidade de vida das pessoas acometidas, pois o tratamento é agressivo, podendo levar a complicações pós-operatórias e a disfunções musculoesqueléticas que interferem nas atividades da vida diária, especialmente no que se refere à funcionalidade e à autoimagem. O estudo teve como objetivo conhecer as alterações funcionais em pacientes com câncer de cabeça e pescoço e a atuação da fisioterapia frente a essas disfunções. Foi realizado um estudo de revisão bibliográfica, utilizando as bases de dados eletrônicas Medline, Lilacs, e as bibliotecas virtuais Bireme e SciELO. Foram incluídos estudos nos idiomas inglês, português e espanhol, sem restrição ao período de publicação. Dentre as complicações pós-operatórias que levam a disfunções musculoesqueléticas, encontradas na literatura as comumente relatadas foram a dor e inabilidade funcional no ombro, limitação na amplitude de movimento, alteração e/ou perda de força na musculatura do membro superior e pescoço homolateral à cirurgia, entre outras. A fisioterapia se mostrou importante nos cuidados desses pacientes, de modo que deve ser realizada para melhorar o déficit funcional.(AU)
The number of cases of cancers, including head and neck, has increased worldwide, becoming one of the most important problems of global public health. The consequences of this type of cancer can affect the quality of life of patients, once the treatment is aggressive and can lead to postoperative complications and musculoskeletal disorders that interfere with activities of daily life, especially when it comes to functionality and self-image. This study aimed to investigate the functional changes in patients with head and neck cancer and the role of physiotherapy to such impairment. A bibliographic review using the electronic databases Medline, Lilacs, and virtual libraries Bireme and SciELO was carried out, including studies in English, Portuguese and Spanish, without period restrictions. Among the postoperative complications that lead to musculoskeletal disorders, pain and functional disability in the shoulder, limited range of motion, change and / or loss of strength in the upper limb and ipsilateral neck muscles to the surgery were the most reported, among others. Physical therapy proved to be important in the care of these patients to improve the functional deficit.(AU)
RESUMEN
O acidente vascular encefálico (AVE) é uma síndrome de rápido desenvolvimento com sinais e sintomas clínicos de perda de função cerebral, provocando sequelas motoras e sensitivas-cognitivas. Tais fatores podem provocar redução do equilíbrio, aumentando o risco de quedas. Assim sendo, o propósito deste estudo foi verificar o equilíbrio estático e dinâmico de pacientes com sequela de AVE e a prevalência de quedas. Foi realizado um estudo transversal com indivíduos com sequelas de AVE (hemiparéticos). O equilíbrio estático de dinâmico foi avaliado por meio da Escala de Equilíbrio de Berg, e o equilíbrio durante a marcha em diferentes contextos pelo Índice de Marcha Dinâmica (IMD). A idade média foi de 85 ± 14,1anos, sendo a maioria do sexo masculino (81,8%) e aposentado (82%). Os voluntários apresentaram entre 8 meses e 12 anos de instalação da patologia, todos faziam fisioterapia e a maioria (63,6%) sofreu queda. Foi observado que, em relação aos equilíbrios estático e dinâmico, os pacientes tiveram média de 51,3 ± 6,3 pontos e 45,4% tiveram um escore menor ou igual a 19 pontos no índice de marcha dinâmica, que avalia risco de quedas e 54,5% com escore maior de 19 pontos. Conclui-se que os pacientes com sequela de acidente vascular encefálico apresentam equilíbrio funcional, apesar do risco de quedas.
The cerebrovascular accident is a syndrome of rapid development with clinical signs and symptoms of loss of brain function, causing motor and sensory-cognitive sequels. Such factors may result in decreased balance increasing the risk of falls. Therefore, the purpose of this study was to determine the static and dynamic balance of patients with stroke sequel and the prevalence of falls. A cross-sectional study was conducted with patients with stroke sequel (hemiparesis). The static equilibrium dynamic was evaluated by the Berg Balance Scale and the balance during gait in different contexts by the Dynamic Gait Index (DGI). The middle age was 85 ± 14,1anos, most were men (81.8%) and retired (82.0%). Volunteers presented from 8 months to 12 years of pathology installation, all of them were doing physical therapy and the majority (63.6%) had suffered fall. It was observed that in relation to the static and dynamic balance patients had an average of 51.3 ± 6.3 points and 45.4% had a score less than or equal to 19 points in the dynamic gait index, which assesses risk of falls and 54.5% with the highest score of 19 points. We conclude that patients with stroke sequel have functional balance, although the risk of falls.
RESUMEN
No pulmão senil as mudanças estruturais no tecido conectivo acarretam perda do recolhimento elástico pulmonar, levando a uma progressivaretenção de ar e, consequentemente, ao aumento da complacência do parênquima pulmonar. Desta forma, a atividade física realizada no decorrer da vida melhora o condicionamento aeróbico e aprimora as funções cardiorrespiratórias. O objetivo deste trabalho foi verificar diferenças dos volumes, capacidades pulmonares e força muscular respiratória entre idosos praticantes e não praticantes de hidroterapia. Foi realizado um estudo transversal, avaliando 30 idosos praticantes de hidroterapia e 30 sedentários. Foram avaliadas a força muscular, volumes, e capacidades pulmonares através dos aparelhos de manovacuometria e ventilometria. Os dados foram analisados através do teste de Kolmogorov-Smirnov e teste de Mann-Whitney, com significância estatística de p<0,05. Quanto à força dos músculos respiratórios, os idosos ativos apresentaram média de pressão inspiratória máxima de 46,16±11,34cmH2O [IC95% (41,93-50,40)], e os sedentários 33,83±13,93cmH2O [IC95% (28,62-39,03)], com p-valor=0,0015; pressão expiratória máxima média de 48,83±15,79cmH2O [IC95% (42,93-54,73)] para os idosos ativos, e 29,83±11,10cmH2O [IC95% (25,68-33,97)] para os sedentários (p-valor=0,0001). Os resultados mostraram melhores desempenhos em todas as avaliações de volume corrente, volume minuto, capacidade inspiratória e capacidade vital para os idosos ativos quando comparados aos sedentários. Os idosos praticantes de hidroterapia apresentaram maior força dos músculos respiratórios, volumes e capacidades pulmonares, reforçando assim os efeitos benéficos da atividade física no processo de envelhecimento.
In senile lung, structural changes in the connective tissue cause loss of lung elastic recoil, leading to a progressive air trapping and consequently an increase in compliance of the lung parenchyma. Thus, exercises practiced throughout life may improve aerobic fitness and improve cardiorespiratory functions. Check differences in volumes, lung capacity and respiratory muscle strength in elderly practitioners and non-practitioners of hydrotherapy. A cross-sectional study evaluated 30 practitioners of hydrotherapy and 30 sedentary elderly. The parameters muscle strength, lung volumes, and capacities were evaluated using a manometer and respirometry equipment. Data were analyzed using the Kolmogorov-Smirnov and the Mann-Whitney test, with statistical significance of p <0.05. With respect to the strength of respiratory muscles, the active elderly had an average maximal inspiratoy pressure of 46.16 ± 11.34cmH2O [95% (from 41.93 to 50.40)], and sedentary 33.83 ± 13.93cmH2O [95% (from 28.62 to 39.03)], with p value = 0.0015; maximal expiratory pressure of 48.83 ± 15.79cmH2O [95% (from 42.93 to 54.73)] for the active elderly, and 29.83 ± 11.10cmH2O [95% (from 25.68 to 33.97)] for sedentary elderly (p-value = 0.0001) .The results showed better performance for all assessments of current volume, ,minute volume, inspiratory capacity, and vital capacity of the active elderly when compared to the sedentary group. The elderly practitioners of hydrotherapy had higher respiratory muscle strength, lung volume, and capacity, thereby enhancing the beneficial effects of physical activity in the aging process.
RESUMEN
As fissuras labiopalatinas são defeitos congênitos de origem multifatorial que comprometem a integridade do lábio e/ou palato, determinando alterações funcionais e estéticas. Representam a anomalia mais frequente do complexo craniofacial. Os portadores destas anomalias apresentam maloclusões características, em consequência da atresia dos arcos dentários, principalmente do arco superior, déficit de crescimento do terço médio da face, problemas dentários de anomalias de forma, número e de posição. Os dentes próximos às fissuras podem se apresentar rotacionados, com as coroas inclinadas em direção à fenda e os ápices em direção oposta. Devido à presença de desordens oclusais inerentes à fissura lábio palatina, o tratamento ortodôntico requer protocolo específico para restauração da função e estética. O objetivo deste trabalho foi descrever o planejamento ortodôntico, visando o tratamento multidisciplinar de indivíduos com fissura lábiopalatina. A pesquisa foi realizada a partir da revisão bibliográfica, sendo consultados artigos científicos localizados nas bases de dados de Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), e PubMed, utilizando como descritores: ?Fenda labial?, ?fissura palatina?, ?ortodontia?, ?má oclusão? no período de 2000 a 2012. Os dados mostram que o tratamento multidisciplinar é fundamental para resolver as necessidades estéticas e funcionais do sistema estomatognático e integrar o paciente na sociedade.
The cleft lip and cleft palate are multifactorial birth defects that compromise the integrity of the lip and / or the palate, determining functional, aesthetic and psychic changes, featuring among the most frequent anomalies of the craniofacial complex. Individuals with cleft lip and palate present malocclusion characteristics due to the atresia of the dental arches, especially in the upper arch, growth deficit in the mid face, dental problems due to anomalies of shape, number and position. The teeth next to the cracks may appear rotated, with crowns tilted toward the summits and rift in the opposite direction. Given the presence of occlusal disorders inherent to the presence of cleft lip and palate, the orthodontic treatment in such patients requires a specific protocol for function and aesthetics restoration. The objective of this paper was to describe the orthodontic planning for the multidisciplinary treatment of individuals with cleft lip and palate. This research was based on the literature review of scientific papers published in journals of Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and PubMed, using as keywords: ?cleft lip?, ?cleft palate?, ?orthodontics?, ?malocclusion? in the 2000 - 2012 period. The results showed that the multidisciplinary care is crucial for solving the aesthetic and functional needs of the stomatognathic system and integrate the patient into the society.