RESUMO
AIMS: To test an educational programme with telephone follow-up to improve self-care in Brazilian patients who underwent percutaneous coronary intervention. BACKGROUND: Percutaneous coronary intervention has been established as a treatment for coronary disease. However, additional intervention is needed to improve self-care for individuals who undergo this procedure to reduce further disease. Telephone follow-up is one strategy that has been used to improve chronic disease self-care. DESIGN: Randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01341093. METHODS: Sixty patients who were preparing for their first percutaneous coronary intervention between 2011-2012 were randomly allocated to an educational programme with telephone follow-up (N = 30) or a control group (N = 30). Perceived health status was assessed with the Medical Outcomes Study 36-Item Short Form. Self-efficacy, symptoms of anxiety and depression and medication adherence were also assessed. Measures were collected before intervention (baseline) and 6 months later. RESULTS: Both groups improved from baseline to 6 months in the 'Physical Component Summary' and in the domains of 'Physical Functioning', 'Role-Emotional' and 'Role-Physical'. The educational programme group showed a reduction in anxiety from baseline to 6-month follow-up, while the control group showed a slight increase. No differences in symptoms in depression and self-efficacy were found and both groups reported high levels of medication adherence. CONCLUSION: The educational programme with telephone follow-up is a promising intervention as it led to reduction in anxiety for those receiving the educational programme. Further improvements in timing and focus of the educational programme, such as targeting emotional and social lifestyle changes, might be warranted.
Assuntos
Doença das Coronárias/enfermagem , Educação de Pacientes como Assunto , Intervenção Coronária Percutânea/enfermagem , Autocuidado/métodos , Adulto , Idoso , Brasil , Doença Crônica , Doença das Coronárias/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , TelefoneRESUMO
The effects of TsTx-V, an alpha-toxin isolated from Tityus serrulatus venom, on electrical activity and insulin secretion by rodent pancreatic islet cells were studied. TsTx-V (5.6 microg/ml) depolarized mouse pancreatic beta-cells, diminished the membrane input resistance and increased the duration of the active phase of glucose-induced electrical activity. Similar results were observed with the Na(+) channel agonist veratridine (110 microM). Both agents potentiated glucose (8.3 mM)-induced insulin secretion in rat islet. In the presence of TsTx-V or veratridine, insulin secretion increased 2- and 1.4-fold over basal values, respectively (P<0.001). The Na(+) channel antagonist tetrodotoxin (6 microM) significantly decreased glucose- and TsTx-V-induced insulin secretion (P<0.001). TsTx-V also stimulated insulin secretion at low glucose concentrations (2.8 mM) whereas the beta-toxin, Ts-gamma (gamma toxin), also obtained from Tityus serrulatus venom, significantly reduced TsTx-V-induced secretion at sub- and suprathreshold concentrations of glucose. These results are consistent with a model whereby Na(+) channels participate in glucose-induced electrical activity. Alteration in the activity of these channels changes the length of time during which the beta-cell depolarizes, thereby altering the secretory behavior of the cell. The construction of a three-dimensional model for TsTx-V revealed a conserved core containing an alpha-helix and three beta-strands, with minor differences when compared with toxins from other scorpion venoms.