Nevin Manimala

Arch Cardiol Mex. 2021;91(4):396-406. doi: 10.24875/ACM.20000505.

ABSTRACT

BACKGROUND: Family psychotherapy has been shown to have a positive impact on the evolution of patients with psychosomatic disorders, and in those with arterial hypertension it could improve the level of control of the disease.

OBJECTIVE: To evaluate the impact of an intervention in family psychotherapy in patients with uncontrolled systemic arterial hypertension.

METHOD: Study with comparative groups. 15 uncontrolled hypertensive patients, assigned to 2 groups: an intervention group of 10 patients who received family psychotherapy and a control group of 5 patients. In both groups, the pharmacological treatment indicated by experts was continued. Both groups were compared before and after the intervention regarding quality of life (InCaViSa), family functioning (Family Functioning Scale), systolic and diastolic blood pressure, body mass index and glucose, cholesterol, triglycerides, uric acid and creatinine.

RESULTS: There was qualitative improvement in the domains of the InCaViSa scale to estimate quality of life in the intervention group and there were no statistically significant changes between the groups in family functioning or in body weight. Among the biochemical variables, only cholesterol showed a significant reduction (p = 0.47). Greater mobility of the family towards more functional behaviors was found in the group that received the intervention, and also in this group, systolic and diastolic blood pressure values decreased (p < 0.001), and the use of antihypertensive, anxiolytic and antidepressant drugs, as well.

CONCLUSIONS: Family psychotherapeutic intervention can favor the control of blood pressure, reduce the doses of antihypertensive, anxiolytic and antidepressant drugs and it can help to transition to better functionally family states.

PMID:34852188 | DOI:10.24875/ACM.20000505

Sao Paulo Med J. 2021 Nov 29:S1516-31802021005028202. doi: 10.1590/1516-3180.2021.0111.R1.18052021. Online ahead of print.

ABSTRACT

BACKGROUND: Although autonomic dysfunction has been shown to be associated with liver cirrhosis, the prevalence and prognostic implications are unclear. Abnormal heart rate variability (HRV), a measure of autonomic function, has not been well investigated in cirrhosis.

OBJECTIVE: To evaluate the prevalence of high-risk HRV parameters in a cohort of cirrhotic patients and their association with cardiac dysfunction and mortality.

DESIGN AND SETTING: Prospective observational study conducted in the Federal University of São Paulo.

METHOD: A cohort of 120 patients, comprising 17 healthy controls and 103 cirrhotic outpatients, was evaluated and followed for 10 months. HRV analysis was based on 24-hour Holter monitoring and defined using time-domain and frequency-domain parameters.

RESULTS: The HRV parameters were statistically lower in cirrhotic patients than in healthy subjects. High-risk HRV parameters were prevalent, such that 64% had at least one high-risk parameter. Time-domain parameters correlated with Child scores (P < 0.0001). In regression models, HRV parameters were independent predictors of diastolic dysfunction and mortality. During 10 months of follow-up, there were 11 deaths, all of patients with at least one high-risk HRV parameter. Kaplan-Meier analysis estimated low survival rates among patients with standard deviation of normal-to-normal RR intervals (SDNN) < 100.

CONCLUSION: Reduced HRV is prevalent in liver cirrhosis and is related to cardiac dysfunction, severity of liver disease and mortality. Abnormal high-risk HRV parameters are prevalent among cirrhotic patients and are also predictors of mortality. Our findings highlight the need for a more careful cardiac evaluation of cirrhotic patients.

PMID:34852170 | DOI:10.1590/1516-3180.2021.0111.R1.18052021

Sao Paulo Med J. 2021 Nov 29:S1516-31802021005028201. doi: 10.1590/1516-3180.2020.0718.R1.18052021. Online ahead of print.

ABSTRACT

BACKGROUND: Dengue is considered to be the most important arbovirus worldwide, with important complications that increase its lethality. In Brazil, an endemic country, the disease reaches significant incidence levels, with occurrences of serious cases and high costs of hospitalizations for its treatment.

OBJECTIVE: To analyze risk factors among individuals with recent histories of dengue infection in a medium-sized city in Mato Grosso.

DESIGN AND SETTING: Descriptive cross-sectional study, of epidemiological-survey type, conducted among the urban population of a city located in mid-northern Mato Grosso.

METHODS: A seroepidemiological survey using questionnaires and collection of biological material was conducted among 596 adults aged ≥ 18 years who had been selected through a cluster sampling process. Positive dengue cases were those with positive results from anti-dengue immunoassays (ELISA). Statistical analyses with descriptive and inferential techniques were used, with 95% confidence intervals and a 5% significance level.

RESULTS: The seroepidemiological profile of the study participants was predominantly female, with ages between 18 and 39 years, self-declared non-white race/color, not more than eight years of education and not living with a companion. Among the sanitary factors analyzed, the following were risk factors for dengue virus infection: no running water at home; no water supply from the public piped network; no waste from drains or toilets sent to the sewage network; endemic disease combat agents visiting the home; and presence of mosquito breeding sites at home.

CONCLUSION: Low schooling levels and previous dengue virus infection were associated with current dengue virus infection.

PMID:34852169 | DOI:10.1590/1516-3180.2020.0718.R1.18052021

J Appl Oral Sci. 2021 Nov 29;29:e20210171. doi: 10.1590/1678-7757-2021-0171. eCollection 2021.

ABSTRACT

Some evidence in vitro suggested that amoxicillin and fluoride could disturb the enamel mineralization.

OBJECTIVE: To assess the effect of amoxicillin and of the combination of amoxicillin and fluoride on enamel mineralization in rats.

METHODOLOGY: In total, 40 rats were randomly assigned to four groups: control group (CG); amoxicillin group (AG – amoxicillin (500 mg/kg/day), fluoride group (FG – fluoridated water (100 ppm -221 mg F/L), and amoxicillin + fluoride group (AFG). After 60 days, the samples were collected from plasma and tibiae and analyzed for fluoride (F) concentration. The incisors were also collected to determine the severity of fluorosis using the Dental Fluorosis by Image Analysis (DFIA) software, concentration of F, measurements of enamel thickness, and hardness. The data were analyzed by ANOVA, Tukey’s post-hoc test, or Games-Howell post-hoc test (α=0.05).

RESULTS: Enamel thickness of the incisors did not differ statistically among the groups (p=0.228). Groups exposed to fluoride (AFG and FG) have higher F concentrations in plasma, bone and teeth than those not exposed to fluoride (CG and AG). The groups showed a similar behavior in the DFIA and hardness test, with the FG and AFG groups showing more severe fluorosis defects and significant lower hardness when compared with the AG and CG groups, with no difference from each other.

CONCLUSION: The rats exposed to fluoride or fluoride + amoxicillin developed dental fluorosis, while exposure to amoxicillin alone did not lead to enamel defects.

PMID:34852156 | DOI:10.1590/1678-7757-2021-0171

Rev Bras Enferm. 2021 Nov 29;75(3):e20210407. doi: 10.1590/0034-7167-2021-0407. eCollection 2021.

ABSTRACT

OBJECTIVES: to identify factors associated with specific health-related quality of life in cerebrovascular accident, or stroke, survivors.

METHODS: cross-sectional study, carried out with 160 cerebrovascular accident survivors. Data were collected using the Barthel Index, Cerebrovascular Accident Specific Quality of Life Scale, and semi-structured instruments for sociodemographic and clinical data, analyzed by descriptive and inferential statistics.

RESULTS: health-related quality of life was associated with work activity (p=0.027), physical activity (p=0.007), functional capacity (p=0.001), presence of caregiver (<0.001), motor alteration (p = 0.001) and rehabilitation (p=0.003). The functionally dependent people were 14.61 times more likely to present low health-related quality of life, and those with motor impairment were 3.07 times more likely.

CONCLUSIONS: it was evidenced that functional dependence and motor impairment increase the chance of low health-related quality of life in cerebrovascular accident survivors.

PMID:34852127 | DOI:10.1590/0034-7167-2021-0407

Rev Bras Enferm. 2021 Nov 29;75(3):e20210316. doi: 10.1590/0034-7167-2021-0316. eCollection 2021.

ABSTRACT

OBJECTIVES: to evaluate the completeness of nurses’ records on the execution of the nursing process in assistance of tuberculosis patients at Primary Care.

METHODS: this was a retrospective documental study, with 190 records in Family Health Units of a city in the state of Paraíba. The data were analyzed according to descriptive statistics, Pareto Diagram, and trend analysis.

RESULTS: the overall mean incompleteness of records was 53.01% (DP=26.13). Therefore, the results presented very poor completeness classification related to nursing diagnosis (88.9%), nursing assessment (66.8%), data collection (60.5%), while nursing interventions were classified as regular (11.1%). The nursing diagnosis was the only variable with a decreasing trend of non-completeness.

CONCLUSIONS: incompleteness of nurses’ records in the medical records of users with tuberculosis. Evaluation strategies, permanent and continuing education are indispensable in the quality of nurses’ documentation, directly implying the Systematization of Quality in Nursing Care.

PMID:34852125 | DOI:10.1590/0034-7167-2021-0316

Rev Bras Enferm. 2021 Nov 29;75(3):e20201341. doi: 10.1590/0034-7167-2020-1341. eCollection 2021.

ABSTRACT

OBJECTIVES: to analyze and compare levels of stress and resilience in nurses before and after the assessment for maintenance of the Hospital Accreditation Certification.

METHODS: quantitative, observational, and longitudinal research, with 53 nurses from a philanthropic hospital, in the Rio Grande do Sul. Data collected in two stages, March, and July 2019, before the assessment visit and 60 days after, using the Bianchi Stress Scale and Resilience Scale. Descriptive and analytical statistics were employed.

RESULTS: the majority of participants showed an average stress level before and after the evaluation. The highest stress scores were related to Domains E (coordination of unit activities) and C (activities related to personnel administration). In both moments of the study, the participants had medium and high resilience.

CONCLUSIONS: managing people, processes, and assistance are stressful activities in the Accreditation process and increase the nurses’ stress levels.

PMID:34852118 | DOI:10.1590/0034-7167-2020-1341

Rev Bras Enferm. 2021 Nov 29;75(3):e20190864. doi: 10.1590/0034-7167-2019-0864. eCollection 2021.

ABSTRACT

OBJECTIVES: to identify nursing diagnoses in patients who underwent hematopoietic stem-cell transplants due to Fanconi anemia, according to the NANDA-I taxonomy.

METHODS: exploratory study using a retrospective analysis of 85 records from patients who underwent hematopoietic stem-cell transplants due to Fanconi anemia, developed in a specialize transplant center in the South of Brazil. The results were analyzed using descriptive statistics.

RESULTS: 73 different diagnoses were found in 9 out of the 13 domains from the NANDA-I taxonomy. From these, 22 were in 50% or more of the patients investigated, and most of them are related to the domain Safety/Protection.

CONCLUSIONS: it was possible to identify the nursing diagnosis in the patients who underwent hematopoietic stem cell transplants due to Fanconi anemia, contributing to design a plan for the care of these patients. The same was true for those with other syndromes of chromosomal instability that need to undergo this transplant.

PMID:34852115 | DOI:10.1590/0034-7167-2019-0864

Cien Saude Colet. 2021 Nov;26(11):5841-5849. doi: 10.1590/1413-812320212611.30532020. Epub 2020 Oct 6.

ABSTRACT

This study aimed to evaluate the influence of bareback sexually explicit media (SEM) consumption on anal sex without a condom by men who have sex with men (MSM). To this end, a page was created on the Facebook® social network with a link that directed interested parties to a questionnaire. Cisgender men, aged 18 years and over, who had sex with other men in the last 12 months, were included. Data were collected in 2017 and analyzed using univariate and bivariate inferential statistics and multivariate logistic regression. A total of 2,248 MSM participated in the research, with a mean age of 24.4 years and a mean number of 3.9 partners in the last 30 days. Having multiple sexual partners (ORa: 9.4; 95% CI 3.9-22.4), preferring movies with bareback scenes (ORa: 2.6; 95% CI 1.5-4.6), considering this practice a fetish and realizing it (ORa: 3.52; 95% CI 2.3-5.4), having casual partnerships (ORa: 1.8; 95% CI 1.5-1.9) and being aware of the partner’s negative serological status for HIV (ORa: 1.4; 95% CI 1.1-2.3) were factors that increased the likelihood of engaging in anal sex without a condom. Thus, we found an association between the consumption of bareback SEM and sex without a condom among MSM.

PMID:34852113 | DOI:10.1590/1413-812320212611.30532020

Cien Saude Colet. 2021 Nov;26(11):5701-5710. doi: 10.1590/1413-812320212611.31052020. Epub 2020 Sep 10.

ABSTRACT

The scope of this study was to investigate the prevalence of sexual exploitation of homeless children and adolescents living on the streets, as well as characteristics associated with this outcome. In this cross-sectional investigation, carried out in the municipalities of Rio Grande and Porto Alegre-RS, data were collected through interviews, which were conducted by trained interviewers. The Respondent-Driven Sampling (RDS) strategy was adopted and statistical analyses were conducted using Poisson regression with robust adjustment of variance. The sample included 186 children and adolescents between 10 and 17 years of age, of which 8% reported having been subjected to sexual exploitation. Being 16 to 17 years old, having had forced sexual intercourse and not having bonds with school were characteristics independently associated with this outcome. It was observed that the lack of contact with school increased the probability 16-fold of having suffered sexual exploitation, being considered the main risk factor in this study. The proposition is that the inclusion and permanence of homeless children and adolescents living on the streets into schools might significantly reduce the risk of sexual exploitation of this population group.

PMID:34852102 | DOI:10.1590/1413-812320212611.31052020