RESUMO
Resumo Os Centros de Atenção Psicossocial Infanto-juvenil (CAPSi) são equipamentos públicos destinados ao cuidado de crianças e adolescentes com problemas mentais graves, incluindo aqueles com transtornos do espectro do autismo (TEA). Revisão da literatura nacional indica falta de informações sistematizadas sobre o tratamento oferecido a esta clientela. O artigo apresenta e discute dados referentes a perfil psicossocial e projetos terapêuticos para usuários com autismo e seus familiares, em CAPSi situados na região metropolitana do Rio de Janeiro. Metodologia: estudo descritivo, quantitativo, baseado em questionários enviados a 14 CAPSi em 2011. Resultados: havia 782 usuários com diagnóstico de autismo nos CAPSi pesquisados, constituindo 1/3 dos usuários em atendimento. A maioria era do sexo masculino, na faixa dos 10 aos 19 anos. A maior parte residia com a família, na área de abrangência do serviço, e estava em regime assistencial semi-intensivo, com atendimentos individuais e coletivos, incluindo os familiares. Cerca de 1/5 estava fora da escola e menos de 1/3 recebia o Benefício de Prestação Continuada da Lei Orgânica da Assistência Social (BPC - Loas). Concluiu-se que os CAPSi da região ofereciam cuidado a número expressivo de autistas, requerendo, no entanto, investimento em articulações intersetoriais para ampliar condições de inclusão social, aprimoramento das informações sobre o cuidado oferecido e incentivo para o uso de metodologias avaliativas visando a qualificar a assistência a usuários com autismo e a outros sob seu cuidado.
Abstract Centers for Child and Adolescent Psychosocial Care (CAPSi) are public institutions for the care of children and adolescents with serious mental health problems, including those with autism spectrum disorders (ASD). A review of the Brazilian literature indicates a lack of systematized information on the treatment offered to such patients. This study presents and discusses data related to psychosocial profiles and therapeutic projects for patients with autism and their families at the CAPSi located in the Rio de Janeiro metropolitan area. Methodology: a descriptive, quantitative study based on questionnaires sent to 14 CAPSi in 2011. Results: 782 patients were diagnosed with autism in the surveyed CAPSi, comprising 1/3 of patients receiving care. The majority were male, aged 10 to 19 years. Most lived with their family in the service's coverage area and received semi-intensive care, with individual and collective assistance, including to family members. About 1/5 were out of school and less than 1/3 received the Benefício de Prestação Continuada da Lei Orgânica da Assistência Social (BPC - Loas [Continuous Benefit of the Social Assistance Organic Law]). It was concluded that the CAPSi of the region offered care to a significant number of autistics, requiring, however, investment in intersectorial coordination to expand social inclusion conditions, improvement in care information and incentive to use evaluation methodologies to train professionals providing care to autism patients and others.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Transtorno do Espectro Autista , Serviços de Saúde MentalRESUMO
Body fat distribution is gender specific: men tend to accumulate adipose tissue in the android region, whereas women tend to do so in the gynoid region. The aim of the study was to assess total fat mass (TFM), android fat (AF), and gynoid fat (GF) mass in a selected group of healthy adult women with normal body mass index (BMI) to evaluate variations in fat distribution. Seventy-seven women (20--69yr of age) with BMI values between ≥18.5 and ≤24.9kg/m(2) were included. TMF, AF, GF, and the AF to GF ratio (A:G) were assessed using dual-energy X-ray absorptiometry. Results showed an increase in AF after the fifth decade of life (D), which reached statistical significance in the sixth and seventh decades (p<0.05--0.008), a 33% increase in kg of AF between the fourth and seventh and a 20% increase in A:G between the third and the seventh, with no significant changes in TFM and GF. In normal BMI women, age appears to be associated with changes in fat mass distribution with an increase in AF, which might have potential deleterious health consequences, after the fifth D.
Assuntos
Absorciometria de Fóton , Tecido Adiposo/diagnóstico por imagem , Envelhecimento/fisiologia , Composição Corporal/fisiologia , Distribuição da Gordura Corporal , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Corticosteroid treatment diminishes bone mass and alters bone quality. The objective was to evaluate bone in corticosteroid-treated patients and controls and in fractured and non-fractured patients treated with corticosteroids using both X-ray densitometry (DEXA) and ultrasound. We evaluated 34 women aged 58 +/- 14 years (X +/- SD), who had been on long-term low dose prednisone therapy for at least 6 months, and who had never received specific treatment for osteoporosis. Bone mineral density of total skeleton (TS), lumbar spine (LS), femoral neck (FN), and vertebral morphometry (MXA) were measured by DEXA. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness were measured using an Achilles Plus system. Forty-two healthy women served as controls. Both densitometric and ultrasound parameters in the patients were significantly diminished compared with controls: TS: P < 0.002, LS: P < 0.025, FS: P < 0.005, Stiffness: P < 0.001, BUA: P < 0.002 and SOS: P < 0.002. The percentage of patients with a Z score below -2 was higher in Stiffness and BUA: 38% and 47%, respectively, compared with a range of 16-24% in the other parameters (P < 0.05 BUA vs. DEXA measurements). Eleven patients with previous bone fracture had values lower than the non-fractured patients, both according to DEXA and ultrasound measurements, but the difference was only significant for BUA (P < 0.02). BUA of the calcaneus was more effective in detecting the specific skeletal alterations and fracture risk of the group of patients receiving chronic corticosteroid treatment.