Revista Contexto & Saúde

23-31

Authors: Taisa Soares da Silva, Cristina de Santana Farias, Felisberto Farias dos Santos, Irineu Ferreira da Silva Neto, Ana Emília Formiga Marques

Integrative and Complementary Health Practices (Pics) aim to provide a holistic approach, with the aim of promoting health, and providing a good balance between technology, science and humanization. Thus, this article aims to assess the perception of future graduates of the pharmacy course on the role of the pharmacist in Pics. A field research was carried out at a Faculty of Pharmacy in Cariri Cearense. Currently, the college is approved by 10 classes of the pharmacy course. The sample used in the study was composed of students from the ninth and tenth semesters of the Pharmacy course. The results of the study show that 85.3% of academics have knowledge about Pics, however, many are not sure about their knowledge about them. It was possible to observe that students would indicate homeopathy, acupuncture, floral therapy and medicinal plants to treat certain diseases, which may be possible by pharmacists according to specific specifications. Finally, it is considered that the results of this work can contribute by adding values on the evidenced findings, assisting in the discussion of new studies on integrative and complementary practices.

41-53

Authors: Lucélia Hernandes Lima , Carine Raquel Blatt , Marcelo Schenk de Azambuja

Introduction: The monitoring and continuous evaluation of the actions developed in Pharmaceutical Care are strategies for the search for quality, especially in hospitals. A good evaluation aims to reduce uncertainties, improve the effectiveness and monitoring of actions and provide relevant decision-making by assisting in the service management policy. Objective: To develop an evaluation and monitoring matrix for a pharmacy in a hospital. Method: It is an evaluative study. In order to elaborate and validate the content the following steps have been developed: bibliographic review, proposition on dimensions and elaboration of indicators, focus group with experts to validate and prioritize the dimensions and application of the delphi technique to the indicators for relevance and valuation. Cronbach’s alpha coefficient has been used to measure the reliability of the indicators. Results: Five dimensions and 70 indicators have been identified for the evaluation of Hospital Pharmacy, distributed as follows: Care Management (n=15), Human Resources Management (n=13), Drug Management (n=13), Financial Management (n=12) and Patient Clinic Management (n=17). The dimension Drug Management has been prioritized by the specialists for validation and valuation. This dimension resulted in a matrix, with nine indicators. Conclusion: The study has shown the importance of evaluation and monitoring for Hospital Pharmacy management and the capacity of executing consensus methods to quality indicators in high complexity services. The instruments with indicators developed for the dimension Drug Management has shown evidence of validity and good reliability.

68-80

Authors: Karina Schettert Kerschner, Eduarda Batu de Souza, Viviane Cecilia Kessler Nunes Deuschle

Ultraviolet radiation causes cumulative and irreversible skin aggressions and photoprotection remains the most effective way to prevent skin cancer and photoaging. Many beneficial effects attributed to medicinal plants and their bioactive compounds have been the subject of studies. Objective: to develop cosmetic formulations containing the commercial extract of P. granatum, added or not with synthetic organic sunscreen and evaluate the stability and the Sun Protection Factor. Method: the formulations were developed containing 1, 3 and 10 % of the extract of P. granatum, with or without 7 % of octyl methoxinamate, in non-ionic cream, and its physical-chemical stability was evaluated, by determining the organoleptic characteristics, pH and viscosity. Spreadability and SPF in vito were also evaluated. Results: the formulations containing only the extract of P. granatum showed the greatest variations in the stability study and octyl methoxinamate seems to interfere with stability. Conclusion: it is concluded that the formulation containing 10 % of P. granatum extract and 7 % of octyl methoxinamate presented, in addition to adequate stability, an increase in SPF, which would provide a reduction of organic sunscreens in photoprotective formulations. It is recommended that this formulation be kept at room temperature and protected from light, heat and humidity

92-105

Authors: Silvia Pereira , Letícia Bottino, Alexandra Anastacio Monteiro Silva, Daniele Mendonça Ferreira, Daniele Silva Bastos Soares, Patrícia Dias Camacho, Patrícia Henriques, Roseane Moreira Sampaio Barbosa

Carry out a nutritional intervention through the construction and implementation of the Technical Preparation Form focusing on the adequacy of the supply of sodium and lipids in food preparations. Step 1. Diagnosis: Analysis of the amount of lipid using the technique of extraction using the Soxhlet and sodium apparatus by weighing the amount of added salt used and calculating the amount of sodium using the Brazilian Table of Food Composition and application of the script to observe the preparation method. Step 2. Intervention: Development and implementation of the Preparation Technical Sheets using the model recommended by the National School Feeding Program. Step 3. Evaluation of acceptability by students according to the Program manual, analysis of the use of Technical Preparation Sheets by the observation guide and quantity by the method already mentioned above. An adequate lipid value was observed, with sodium, 67.5% above that recommended by the program for two meals (up to 600 milligrams). After the implementation of the technical preparation sheets, the amount of sodium was reduced to 26.4% of the recommendation and that of lipid remained adequate. The intervention was effective in promoting a standardization of the production of rice and beans through the Technical Preparation Form with an adequate amount of oil and added salt, promoting greater nutritional quality

116-129

Authors: Laine de Carvalho Guerra Pessoa Mamede, Rafaela Lira Formiga Cavalcanti de Lima, Alexandre Sérgio Silva, Rubens Batista Benedito, Lydiane de Lima Tavares Toscano, Nadjeanny Ingrid Galdino Gomes, Elisama Araújo de Sena, Maria da Conceição Rodrigues Gonçalves

Hypovitaminosis D is considered a worldwide epidemic with implications that may affect the health of workers. This is a cross-sectional study conducted with 91 workers from Food and Nutrition Units in order to assess the prevalence of hypovitaminosis D and the associations with metabolic parameters. Were evaluated regarding their sociodemographic and occupational profile, exposure to sunlight, anthropometric data and blood pressure. The following exams were performed: 25-hydroxyvitamin D [25(OH)D] and other metabolic parameters. There was a prevalence of 61.54% of the deficiency/insufficiency of 25(OH)D serum levels. No associations were confirmed between the vitamin D status and the sociodemographic and occupational characteristics through the Poisson regression. There was an increased prevalence in patients with diabetes and hypertriglyceridemia. Individuals with high Total Antioxidant Capacity (TAC) values showed a reduction in the prevalence of hypovitaminosis D. In conclusion, a high prevalence of hypovitaminosis D was found among the workers, related to increased blood glucose and triglyceride levels with TAC proving susceptible to reduce this deficiency/insufficiency. The need to monitor laboratory parameters in the health surveillance of workers is stressed.

149-157

Authors: Giovana Secchi da Campo, Nandiny Paula Cavalli, Melissa Medeiros Braz

Pregnancy can be defined as a period of approximately 40 weeks, in which physiological and mechanic adaptations occur, along with strong psychological modifications. Being a moment of vulnerability, it can be negatively influenced by factors such as urinary incontinence, high-risk pregnancy or even a negative body image. Thus, the aim of this study was to compare body image and the occurrence of urinary incontinence in high-risk and usual risk pregnant women. An observational study with a quantitative and cross-sectional approach was conducted to evaluate the occurrence of urinary incontinence and body image of pregnant women. The sample was divided into two groups: high-risk (n=34) and usual risk (n=31) pregnant women. For the data collection, an identification file was applied, collecting data such as obstetric history, followed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and the Body Image Measurement Scale (BIMS). It was observed that both groups were dissatisfied with body image, and urinary incontinence occurrence was moderately above to what is found in literature. No relationship between urinary incontinence and body satisfaction was observed in either group. There was no relationship between urinary incontinence and body image. The pregnant women from both groups presented dissatisfaction regarding body image, and the occurrence of urinary incontinence was slightly higher than that observed in literature.

171-182

Authors: Deise Iop Tavares, Gessica Bordin Viera Schlemmer, Tamires Daros dos Santos, Aline dos Santos Machado, Janine Barbosa da Silva, Melissa Medeiros Braz, Alecsandra Pinheiro Vendrusculo

This study aims to investigate whether there is a correlation between body image, self-esteem, perception of aging, postural balance and handgrip strength in elderly women after practicing Pilates in Water. Descriptive, quasi-experimental study, with a sample composed of sedentary elderly women with preserved cognitive and functional independence. The instruments Body Appreciation Scale, Rosenberg’s Self-Esteem Scale, Aging Perceptions Questionnaire, Timed Up and Go and the manual dynamometer were used. The Pilates in Water protocol was divided into warm-up, strengthening in general and stretching. Statistical analysis was performed using Pearson’s correlation coefficient and Spearman’s correlation test, and the intensity was classified by Malina’s criterion. 33 elderly women (71.5 ± 5.48 years old), overweight (27.02 ± 4.42) and good body image, self-esteem and perception of aging participated in this study. They also had a low risk of falls and low handgrip strength. A moderate correlation between body image and perception of aging was observed after the Pilates in Water exercises protocol with regard to positive beliefs about how to deal with aging. Still, a high correlation was observed between postural balance and handgrip strength. It is concluded that these data are important because means must be directed to provide healthy aging and quality of life for the elderly

198-208

Authors: Melissa Medeiros Braz, Emiláini Sacerdote Rister

Women with negative genital self-image may experience sexual dysfunction. Still, it can be related to discomfort in the pelvic floor. The aim of this study is to investigate the relationship between genital self-image, sexual function and discomfort in the pelvic floor in young university women. This is an observational and cross-sectional study with 102 undergraduate and graduate students, from a total of 135 participants, between 18 and 29 years old, sexually active. An identification form relating to personal data, anamnesis, complaints and sexual activity, the Female Sexual Function Index (FSFI), Pelvic Floor Distress Inventory (PFDI-SF-20) and Female Genital Self-Image Scale (FGSIS) questionnaires were applied. The total FGSIS score indicated positive genital self-image, FSFI good sexual function and PFDI-20 discomfort in the low pelvic floor. There was a positive relationship between genital self-image and sexual function and an inverse relationship with discomfort in the pelvic floor. Women had positive genital self-image, good sexual function and low discomfort in the pelvic floor, and the variables were related to each other.

221-235

Authors: Mariana Lectícia Beraldi, Fernanda de Freitas Mendonça, Sarah Beatriz Coceiro Meirelles Félix

The Permanent Health Education (PHE) is a strategy that searches to transform the practice and organization of the work process from the demand of its own work. A exploratory, descriptive, qualitative research, case study type, that aimed to unveil the arrangements built by the health team that allowed the work management during the qualification program of the Primary Health Care. The data was collected in the period of July 2018 to April 2019 through observation-participant study tool and semi structed interviews with workers of a Family Health Care Unit in a city of Paraná. The results showed many arrangements developed by the work team: general and staff meetings, joint effort for risk stratification and setting-up groups for the users. The protagonism of the workers enabled the program to be a space for PHE. It is concluded that the seal drove the team to develop and work in cooperation. The PHE developed by the staff gave the opportunity to minimize the logics of the vertical process catch and give quality to its arrangements.

253-264

Authors: Premma Hary Mendes Silva, Jackson Ronie Sá Silva

Leprosy is a serious public health problem that historically affects populations living in poor living conditions. In Brazil, leprosy is a disease that affects the poorest sections of the population. Although it is a disease that, once treated, presents significant possibilities of cure and does not present a risk of contagion; due to cultural prejudice, a situation of stigma in relation to the disease still persists. When recognized as hansenian, the individual is permeated by a set of degrading designations. Thus, we recognize prevention through Health Education as a noble aspect in leprosy control, and one of the forms used is information through educational materials. With this investigation we intend to understand the discourses on the prevention of leprosy conveyed on posters, booklets, pamphlets and guidance guides aimed at health professionals and patients, distributed in health posts and units in the municipality of São Luís, Maranhão. For this, theoretical-methodological strategies of documentary research were used in the investigation. The documents analyzed gave evidence that in the dissemination of information on leprosy prevention, what prevails is the biomedical discourse on diagnosis, treatment and cure. The sociocultural aspects of the disease with regard to prejudice are absent or are approached timidly in the documents. Moreover, sociocultural information, such as alerting to aspects of prejudice, is not perceived. Language is clearly clinical-biomedical and there is a concern to disseminate among health professionals and patients only that leprosy has a cure.

279-289

Authors: Bruna da Silva Rodrigues, Juliedy Waldow Kupske, Renan Felipe Rasia, Thais Severo Dutra, Moane Marchesan Krug, Paulo Ricardo Moreira, Kalina Durigon Keller, Rodrigo de Rosso Krug

The aim of the study was to analyze the effects of physical exercise on physical fitness and quality of life of patients with chronic renal failure undergoing hemodialysis. This is an intervention study, with a sample of 13 patients on hemodialysis at the Renal Clinic of Hospital São Vicente de Paulo. The program was applied in 2019/2 (August to December) and took place during the first two hours of hemodialysis (intradialitic), three times a week lasting 20/70 minutes. The same consisted of active stretching, warm-up, cycle ergometer training, resistance training and stretching. Participants in the physical exercise program showed improvement in all physical valences evaluated, occurring significantly in upper limb resistance (pre-test = 17.85 ± 4.54; post-test = 20.69 ± 7.62; p = 0.034) and handgrip strength (pre-test = 28.15 ± 9.39; post-test = 28.62 ± 12.61; p = 0.048), as well as a significant improvement in quality of life in pain domain (pre-test = 73.15 ± 26.92; post-test = 91.46 ± 18.78; p = 0.016), vitality (pre-test = 78.00 ± 15.48; post-test = 90.08 ± 9.03; p = 0.010) and social aspects (pre-test = 71.31 ± 28.63; post-test = 85.92 ± 22.42; p = 0.050). We conclude that the resistance exercise program has several benefits for patients on Hemodialysis.

299-309

Authors: Jessica Cristina Costa Barbosa, Alessandra Esquivel Sales, Nora Manoukian Forones, Edvane Birelo Lopes De Domenico

The objective was to identify the quality of life of patients with gastrointestinal cancer and chronic pain and to correlate the quality of life with sociodemographic, clinical, therapeutic and pain gradation data. This is a cross-sectional, quantitative study, in which patients with gastrointestinal cancer and chronic pain attended at the gastroenterology clinic of a general hospital in the city of São Paulo participated. A sociodemographic and clinical questionnaire, the EORTC-QLQC30 instrument and the Brief Pain Inventory (BPI) were used. Data analysis: descriptive and analytical, correlating the variables with the QoL domains. Thirteen patients participated in the study, mostly male, married, economic classification C2 (61.5%). All were in pain at the time of data collection, with a mean of 2.54 (SD=2.88) by BPI and with the worst score reported in the last 24 hours at 8.15 (SD=2.03). The main changes in QoL evidenced were, in addition to pain: fatigue, insomnia and loss of appetite, and the more advanced the disease, the worse the symptoms and the functional impairment. The data showed that patients live with pain of moderate intensity and, if worse clinical condition, greater intensity. Pain compromises the quality of life of these patients in multiple aspects, showing that measures need to be taken to favor pain control, from the drug therapy regimen to educational and care activities

322-331

Authors: Ingrid Bergmam do Nascimento Silva, Milenna Azevedo Minhaqui Ferreira, Anna Cláudia Freire de Araújo Patrício, Brenda Feitosa Lopes Rodrigues, Maria Hellena Ferreira Brasil, João Agnaldo Nascimento, Richardson Augusto Rosendo da Silva

Objective: To analyze the presence of depression and anxiety of people living with HIV, as well as the association of depression on anxiety. Method: Cross-sectional, quantitative study, conducted between january and july of the year 2019. The participants were 100 people living with HIV who received outpatient care at a Hospital for infectious diseases, northeast, Brazil. A socio-demographic questionnaire, Hamilton Depression Scale and Beck anxiety scale were used. There was descriptive and inferential statistical analysis with KRUSKL Wallis tests and T test, considering significant when p ≤ 0.05. Results: It was identified that 64% were men, 70% heterosexual, 50% had between 20 and 30 years and 90% contracted HIV by sexual contact, 42% had depression and 52% had minimal anxiety. The influence of depression on anxiety (p = 0,041) was evidenced, as well as an association between depression and anxiety scores (p = 0.001). Conclusion: The hypothesis that depression influences the anxiety of people with HIV was confirmed.

345-361

Authors: Marcela Milrea Araújo Barros, Ivone Evangelista Cabral

Objective: To analyze scientific publications regarding the trend in the literature on the relationship between air pollution and respiratory disorders in early childhood. Method: This is a narrative review of original articles and systematic reviews in English, Portuguese, French and Spanish, available in Lilacs, PubMed/Medline, Scopus, EBSCO/CINAHL, EVIP-NET and Cochrane Library databases. In the search, descriptors were combined in trio with Boolean operators and/or in November 2019, without a definition of time frame. Results: Of the 1,702 results, 42 publications between the years 1993-2019 were included. After eliminating duplicates, peer reviewers performed the analysis by grouping them into three decades (1990, 2000, 2010). The centrality of the epidemiological model in the concepts related to the respiratory condition, the environment and the child’s vulnerability stands out as a trend. However, the cause-and-effect relationships disregarded the structural determinants of society, critical of the child’s health and the air pollutants that influenced hospitalizations. Therefore, they determined hospitalizations for respiratory conditions due to causes sensitive to primary care. Conclusion: Promoting healthy environments and reducing preventable deaths requires looking beyond the clinical-epidemiological model. Facing this problem requires rethinking the way to produce knowledge articulating health and environment.

375-384

Authors: Ana Cláudia de Carvalho Fernandes, Thuane Sales Gonçalves, Hágabo Mathyell Silva, Carina de Morais Neves, Isabela Viana Oliveira, Djenane Ramalho de Oliveira, Adriana Maria Kakehasi, Maria Raquel Costa Pinto, Mariana Martins Gonzaga do Nascimento

Rheumatoid arthritis (RA) is a inflammatory, chronic disease, which can bring several consequences to the individual. Patients with RA can present several comorbidities that may influence the clinical evolution of RA. Objective: evaluate the association between comorbidities and the RA activity profile among patients attending a rheumatology clinic of a public university hospital. Methods: this is a cross-sectional study, which collected demographic, diseases, lifestyle habits and RA profile data from a representative sample of patients with RA attending the outpatient clinic. A descriptive analysis of these data was performed, as well as univariate and multivariate analyzes to evaluate factors associated with the DAS28 (Disease Activity Score 28). Results: two hundred and one patients were included, a female majority (85.6%; n = 172) was detected and the mean age was 60.3 ± 11.5. Seven patients (3.5%) were obese, 17 (8.5%) smokers, 106 (52.7%) hypertensive, 38 (18.9%) diabetic and 72 (35.8%) had dyslipidemia. A mean functional comorbidity index of 2.3 ± 1.19 and a mean of 4.2±2,2 diseases per patient were identified. Age equal or greater than 60 years (OR = 0.40, 95% CI 0.21-0.74) and be diabetic (OR = 2.96, 95% CI, 30-6,74) were statistically significantly associated with moderate or high DAS28. Conclusion: the presence of comorbidities was frequent among patients with RA. Furthermore, age equal to or greater than 60 years was negatively associated, and a diagnosis of diabetes mellitus (DM) positively associated with moderate to high disease activity according. The findings reinforce the need for DM monitoring among these patients, especially the younger ones.

396-408

Authors: Gracielle Pampolim, Alessandra Miranda Ferres, Isabelle Gadiolli Verzola, Glenda Pereira Lima Oliveira

The aim of the this study was to verify the prevalence and associated factors with negative self-perceived health in the elderly population assisted by primary health care in a community in Vitória – Espírito Santo. An observational, cross-sectional analytical study was carried out with 241 elderly people from a community in Vitória, Espírito Santo. Self-perceived health was the outcome variable, and sociodemographic characteristics, lifestyle and health characteristics were the exposure variables. Data were analyzed using Pearson’s Chi-Square test and the Prevalence Ratio was calculated for variables significantly associated with the outcome (p <0.05). The prevalence of negative self-perceived health was 46.5%, and the factors associated with the outcome were: white race, polypharmacy, incapacity for daily activities, depressive symptoms, risk of falls and negative perception of quality of life. The findings of this study can assist in the management of care provided to the elderly, aiming at maintaining and recovering the independence, autonomy and health of the elderly, and thus contribute to a better quality of life for this population.

18-32

Authors: Taís Fátima Soder, Fábia Benetti, Rúbia Garcia Deon, Dionara Simoni Hermes Volkweis, Cenio Back Weyh

Food and Nutrition Education (FNE) represents one of the most important practices and strategies to encourage the incorporation of healthy eating habits of an emancipatory character in the lives of new generations. In this perspective, the study aimed to identify the perception of managers about FNE in the school context. It is a qualitative investigation with a hermeneutic approach. As for the ends, it involves exploratory descriptive research and as for the means, field research. Data were collected through recorded interviews with education secretaries and nutritionists, technicians responsible for school meals (12 respondents) from some municipalities in the Middle and Upper Uruguay / RS. The choice of the sample is considered simple probabilistic and random. Content analysis was chosen as a strategy for discussing the data obtained in the field research. When asked about the perception of FNE at school, respondents highlighted these actions as reflective practices, health promoters, trainers of actors and food autonomy. Regarding what could be done, they highlighted the need for constant encouragement, integrative projects, teacher training on the subject and, also, the importance of FNE work in the family environment. It is concluded that the school presents itself as a favorable environment for the development of problematic, dialogical FNE strategies and, considering the local reality, promoting the need for management and adequate planning of these actions.

45-56

Authors: Maísa de Lima Claro, Luisa Helena de Oliveira Lima, Artemízia Francisca de Sousa, Wolney Lisboa Conde, Luís Eduardo Soares dos Santos, Hengrid Graciely Nascimento Silva, Ana Roberta Vilarouca da Silva

This study aimed to investigate the association between nutritional status and infants’ psychomotor neurodevelopment. It consisted of a cross-sectional study, carried out with children aged 1 month to 23 months and 31 days, living in the municipality of Picos / Piauí, without previous diagnosis of neurodevelopmental delay. The variables investigated were socioeconomic, demographic, as well as anthropometric data by measuring weight and length, for later classification and categorization of failures. The neurodevelopment assessment was performed using the Developmental Milestones contained in the Small Child Welfare Survey Scale. Subsequently, a descriptive statistical analysis was carried out, in addition to performing the Likelihood Ratio, at a significance level of 5% to assess the association between the outcome variable with anthropometric failures. Of the children evaluated, 9.4% had a positive screening for the suspected delay in neuropsychomotor development, with category 3 of the anthropometric failures having the highest prevalence (9.1%). In this work, no statistical association was verified between nutritional status, through the use of anthropometric failures, with delays in child neurodevelopment. Thus, it is concluded that although there was no statistical association, both adopted screening tools proved viable both to assess and to guide interventions, aiming to improve nutritional status and child neurodevelopment and reinforcing the importance of carrying out this monitoring more detailed.

74-83

Authors: Caroline Taiane Thumé, Luana Fioravanti Roland, Fabiana Assmann Poll

Objective: to evaluate the nutritional status and clinical conditions of patients with pressure injury in the in-hospital period, in a teaching hospital in the interior of the state of Rio Grande do Sul. Methodology: cross-sectional study with hospitalized patients aged 18 years or older who have pressure injuries. Demographic data such as age and sex, presence of institutionalization, clinical information, as reason for hospitalization, underlying pathologies, location of pressure injury, and variables of interest for the assessment of nutritional status such as weight and height, generating body mass index, arm circumference, calf circumference and weight loss were collected from the electronic medical records of April to August 2020. Results: the sample of patients with pressure injury was predominantly of elderly (80.49%), female, with pressure injury in the sacrococcygea region, with one to two previous pathologies, followed by three to four, especially cardiovascular diseases, including diabetes mellitus and systemic arterial hypertension. The most prevalent reason for hospitalization was kidney diseases. For adults, the prevalent nutritional status was overweight/obesity, obtained by body mass index. In elderly patients, malnutrition prevailed in all forms of evaluation, and with weight loss. Conclusion: in the clinical and nutritional profile of patients with pressure injury, mostly elderly people, a higher prevalence of two to four comorbidities and nutritional status outside normal weight (by body mass index) was detected, especially malnutrition.

97-105

Authors: Cleidivania Glécia Pereira, Annalu Moreira Aguiar, Rafael de Carvalho Mendes, Ana Emilia Formiga Marques

Over time, various diseases have been suggested, so the pharmaceutical industry has found the need to produce new pharmaceutical products, consequently, there has been an increase in the disposal of these drugs. RDC 222/2018, determines how establishments that provide health services should develop waste management, however this RDC does not cover consumer disposal. Residential disposal is a content that needs to be addressed more, as the act of incorrect disposal has caused a great impact on the environment. The study aims to identify how and where users dispose of residential medicines. This study is an integrative review and aims to address the disposal of residential drugs. Using the descriptors: Disposal of medicines, environmental impact, drug withdrawals, user awareness. The inclusion criteria were articles in Portuguese, published in the period from 2009 to 2019 and that addressed the topic directly and the exclusion criteria were: duplicate articles in the databases, systematic review articles, articles that did not address the specific topic of the work, and which did not include the period from 2009 to 2019 as a search in the VHL and SciELO databases. The search resulted in 119 in the VHL database and 21 in the SciELO database, after which the filters with inclusion and exclusion criteria were applied, and a previous reading was carried out, thus resulting in 10 articles in which they addressed the researched topic clearly. The evaluation of the studies shows the need to implement measures to improve the current situation, since most of the population does not receive guidance or has no option to discard medicines that are no longer used.

116-127

Authors: Sara da Silva Khalil, Maria Cristina Soares Rodrigues, Omar Arafat Kdudsi Khalil

Analyze the use of potentially inappropriate medications (PIMs) in prescriptions for the older adults in a long-term care institution, according to the Beers Criteria 2015. Observational cross-sectional study of medical records of 77 older adults living in a long-term care institution in Goiás, Brazil, on health data and medicines used. The analysis of PIMs was performed through descriptive analyzes. The social and institutionalization profile of the older adults showed a predominance of men, with an average age of 78.8 years and the majority institutionalized for less than 4 years. The most prevalent drugs such as PIM-1 were diazepam, omeprazole and risperidone, such as PIM-2 diazepam, risperidone and citalopram and PIM-3, hydrochlorothiazide and acetylsalicylic acid. Drug prescriptions for the elderly should be centered on individual circumstances and therapeutic goals. Thus, this study contributes to the practice of elderly patient safety using an explicit tool for the analysis of PIMs.

143-155

Authors: Iara da Silva Passos, Maria Caroline Andrade dos Santos, Ana Caroline Silva Santos, Izabel Cristina Pereira Rocha, Elisdete Maria Santos de Jesus, Chiara Erminia da Rocha, Giselle de Carvalho Brito

Objective: To analyze in literature the role of pharmacists in the care of people with atopic dermatitis. Methodology: This is a systematic review study in the Medline / PubMed, LILACS and Web of Science databases, using the descriptors: dermatitis, eczema pharmacist. Will be included articles written in English, Portuguese and Spanish, which are characterized as studies on the role of the pharmacist for people with atopic dermatitis. Results: The research initially identified 923 results in the databases, which after the selection process, only four articles were included in the review. The main services identified were health counseling and education, which had an impact on clinical, humanistic and economic results. The main clinical results were information on the treatment of AD, adequate use of emollients and improved understanding of AD; the economic one, on the other hand, resulted in a decrease in health care expenses; and humanistic, the caregivers were satisfied with the various aspects of the service and were more confident about the treatment. Conclusion: Despite the few studies analyzed, it can be seen that the role of the pharmacist is centralized in the care of patients with AD providing counseling services, health education, contributing with information about the disease, symptoms, pharmacological and non-pharmacological treatment and in reducing problems regarding the use of medicines

165-179

Authors: Carlos Alexandre Molena Fernandes, Karine Oltramari, Nelson Nardo Junior, Greice Westphal

Introduction: Metabolic syndrome (MetSyn) is a disorder that involves a series of symptoms associated to obesity and metabolic modifications, and increases the risk of developing cardiovascular disease and type 2 Diabetes Mellitus. The study of new possibilities of non-pharmacological strategies is fundamental for the primary prevention of MetSyn. Objective: The aim of this work was to evaluate the responses to the ingestion of flaxseed oil associated or not associated with physical exercise in hypertensive rats (SHR) with lipid changes induced by the administration of dexamethasone (Dexa) regarding the body weight, and glycaemic and lipid profiles, in comparison with the drug treatment with metformin. Methodology: After 24 days of experiment (details at the material and methods session), the 20-week-old animals were submitted to the glucose tolerance test (GTT) and lipid profile evaluation. Results: The results showed that the administration of Dexa in SHR animals promoted a framework of hyperglycaemia, dyslipidaemia and attenuated the insulin resistance common in the SHR, thus producing an experimental model with several components of the human MetSyn. The effects on weight gain indicated an important preventive action of flaxseed oil and exercise on the weight evolution of SHR-Dexa animals. Furthermore, the ingestion of flaxseed oil associated or not with exercise promoted significant improvements on hyperglycaemia and glucose intolerance in these animals. Regarding the lipid profile, the treatments with flaxseed oil and exercise promoted reductions in triglyceride levels and HDL-c increase. Conclusion: However, the combination of these two non-pharmacological interventions was more effective than the isolated treatments.

192-200

Authors: Raphaela Espanha Corrêa, Rute Estanislava Tolocka

Evidences have shown that Physical Activity (PA) can decrease side effects, such as fatigue and pain, as well as promote increase of muscular endurance, oxygen consumption and quality of life of patients with different phases of cancer treatments. However, studies have demonstrated that patients with cancer diagnosis may show insufficient levels of PA. Therefore, it is necessary to check the profile of such patients. Thus, the aims of this study were to verify the level of physical activity and its association with the characteristics of the patients’ profile. It is a field study that included 247 patients of both sex, above 18 years old any type of cancer. The International Physical Activity Questionnaire-Ipaq-Bref was used to measure PA and the clinical profile was assessed using a questionnaire. The breast cancer was most common type (32.4%), the mean age was 60.08 ± 13.12 and patients in general have inadequate levels of PA, independent of treatment phase. It was found negative association between age and time of PA (rho=- 0.145, p<0.05), years of diagnosis were associated with the level of PA: less than one year of diagnosis can be a significant predictor of low physical activity level (OR= 28.457; 95% CI 1.706 – 474.589; p= 0.020) and for moderate physical activity level (OR= 29.578; 95% CI 1.409 – 620.746; p= 0.029). Implementation of public policies to spread information and to offer PA programs to patients with cancer are needed, especially in the beginning of the treatment.

214-224

Authors: Giulliane Ramos Londero, Melissa Medeiros Braz

Objective: The survey’s aim is to investigate the use of sexually transmitted infections (STIs) preventive methods by young women who have sex with other women. Methods: Observational research, using cross-sectional and quantitative approach, performed between January and April of 2018. The sample was composed of women aged between 18 and 29 years. To collect all the data, na adapted questionnaire with four fields was used: identification, gynecologic history, personal knowledge about STI contamination and the access to information about sexually transmitted infections preventive methods. Results: The majority of the interviewed (54,5%) report to know some STI prevention methods in sexual relations between women, but don’t use them in their sexual relations. Only 8,9% use some barrier method in their sexual relations without sexual accessories, and 9,8% use some method when there are sexual accessories involved. Conclusion: Women who have sex with women (WSW) know about the STIs contagion risks they are exposed to when having unprotected sex, but still don’t have the habit of using preventive methods. Health professional don’t consider them as a contagion risk group and don’t give them information about how to properly protect themselves and about the importance of embracing the barrier methods as a daily practice.

240-255

Authors: Aline Baldissera Leal, Taís Fim Alberti, Andrea Ad Reginatto

The study aimed to develop an educational technology that would contribute with nursing guidelines for hospitalized newborn family members (NBs). Descriptive and qualitative case study, developed at the Neonatal Intensive Care Unit (Utin) of the Santa Maria University Hospital (HUSM). Data collection was carried out first through a questionnaire with nurses from the Utin and then through interviews with the mothers of the newborns. From the data collected, an educational video was built, following the methodology of Filatro (2008). Afterwards, he was submitted to an evaluation / validation process by the Center for Permanent Education in Health (Neps) and by nurses of the Utin of the hospital in question. The process included Neps meeting and recorded interviews with the nurses, grouping the speeches into two thematic groups: Content, technical-aesthetic aspects and pedagogical proposal of the educational video and Educational technology as a tool in the Health Education of family members. The evaluators agreed that the video contained all the necessary information and suggestions for improvement, such as which were accepted and included in the final edition. It is concluded, with the validated video, that it has quality to be used with the target audience in the waiting room, leaving a material for institutional use, that will enable a better understanding in relation to hospitalization. In addition, a developed research can point to a method for the development of others materials, mediated by technologies, specifying the humanization in the reception in health institutions.

271-279

Authors: Katieli Santos de Lima, Themis Goretti Moreira Leal de Carvalho, Carine Cristina Callegaro

The objective of this study was to verify the accuracy of the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESE) to identify obstructive sleep apnea (OSA) in individuals with Chronic Heart Failure (CHF). Nineteen individuals with CHF (57.2 ± 6.6 years old, 12 men) were submitted to portable polysomnography. The BQ was used to investigate the risk of OSA and the ESE was used to assess excessive daytime sleepiness. Thirteen patients were diagnosed with OSA (IAH≥15/h) by portable polysomnography, but only three of them had excessive daytime sleepiness. Eleven patients were classified at high risk for OSA by the BQ. This questionnaire shows a sensitivity, specificity, positive and negative predictive values of 38.4%, 50%, 62.5 and 27.2%, respectively. ESE shows a sensitivity of 25%, a specificity of 100%, a positive predictive values of 100% and negative predictive values of 43.7%. The area under the ROC curve for QB was 0.44 and for ESE was 0.38. Both QB and ESE showed insufficient accuracy to identify OSA in individuals with CHF. In conclusion, BQ and ESE show insufficient accuracy to identify OSA in individuals with CHF. New questionnaires could be developed to screen OSA in patients with heart failure.

290-303

Authors: Suzely Adas Saliba Moimaz, Denise de Toledo Rós, Aryane Kame Tamanaha, Nemre Adas Saliba, Tânia Adas Saliba

The aim of this study were to verify the use of dental care and oral health condition perception of high-risk pregnant women. This cross-sectional, inquiry-type research was performed with 1200 high-risk pregnant women who received prenatal care in a specialized health care reference center, in the period of two years. Women in advanced pregnancy and those who were not able to answer the questions were excluded. The data were analyzed in Epi Info 7.4.1 and Bioestat 5.3 software, at 5% significance level. The most prevalent changes to the classification of high-risk pregnancies were maternal age (39.08%), hypertension (26.90%), and diabetes (10.32). From the total respondents, 40.08% had visited the dental office over 1 year ago, which was associated with age and occupation (p<0.002). Unemployed pregnant women were 2.03 times more likely to use the dental service less than a year ago (p=0,010). From the respondents, 72.17% reported their teeth and gingiva as “fair” or “very poor”, and 75.58% reported having had a toothache. The oral health condition perception was related to age (p=0.0156), level of education (p<0.0001), income (p<0.0001), occupation (p<0.0001), marital status (p<0.0001), and dental care utilization (p<0.0001). It can be concluded that the dental care utilization by high-risk pregnant women was still low, although a portion of the patients reported oral health as “fair” to “very poor”. Maternal age and obesity were the most prevalent conditions for high gestational risk.

324-334

Authors: Daniela Buriol, Maria Denise Schimith, Luiza Camila Jerke, Christiani Andrea Marquesini Rambo, Vivian De Franceschi Brondani, Andiara Luiz Ramos Soares

Objective: to analyze the trend of knowledge production in Dissertations and Theses defended in the Postgraduate Programs in the health area in Brazil about Diabetes Mellitus type 2. Method: this is a narrative review, carried out at the Bank of Theses and Dissertations Coordination for the Improvement of Higher Education Personnel. A search was carried out in October 2020. Of the studies found, 30 were selected for analysis using the selection criteria. Results: Among the trends of study objects, the following stand out: clinical-epidemiological profile, self-care and educational actions for people with type 2 Diabetes Mellitus. As for the clinical epidemiological profile, most were female, elderly, married, with low education and income, hypertension and dyslipidemia were the predominant risk factors. Self-care for the feet was performed correctly. However, life habits were considered difficult to change. Educational actions such as groups and booklets contribute to changes in lifestyle, knowledge about the disease and adherence to treatment. Conclusion: research on Diabetes Mellitus is a priority, in order to help managers and health professionals in the implementation of actions, policies and programs that can guide qualified patients and control the diseases.

16-24

Authors: Juma Apolinária Alves da Silva, Andreza Izis da Silva Oliveira, Ery Albuquerque Magalhães Neto

Introduction: Asthma is one of the most common chronic respiratory diseases in childhood. The pathophysiology of clinical conditions in asthmatic status provides a solid physiological basis for the use of noninvasive ventilation (NIV) in children. Objective: to analyze the effectiveness and safety of NIV in asthmatic children hospitalized in a hospital environment, as well as its physiological effects on the respiratory system, through the existing evidence. Methods: Research was carried out in the SciELO, Pubmed, Lilacs and Virtual Health Library (VHL) databases, for original articles on asthma and NIV in children. In Portuguese, English and Spanish, published between 2010 and 2020. Through the standard DeCS descriptors: “acute asthma”, “bilevel”, “pediatrics”, “continuous positive airway pressure”. Following a methodology and inclusion and exclusion criteria, so that seven articles were selected. Of these, only one presented evidence level A (14.3%), another B (14.3%) and five level C (71.4%). Results: Six articles showed positive outcomes regarding the use of NIV in respiratory disorders caused by asthma. The patients showed clinical improvements such as, gas exchange optimization; shorter hospital stay, lower intubation rate, among others. Only one study indicated that NIV is ineffective and has no apparent benefits. Final considerations: Studies have indicated that NIV is a good, safe and effective therapeutic option. However, current information is limited, of low quality and controversial, without a standardization of its management. It is necessary to conduct more randomized studies that leave no doubt as to its use in this population.

38-51

Authors: Gilvane de Lima Araújo, Maria Beatriz Ribeiro de Oliveira, Matheus Falcão Santos Marinho, Nelson Torro, Géssika Araújo de Melo

Multiple sclerosis (MS) is characterized by neurodegeneration in the central nervous system. Among the most prevalent symptoms is fatigue, in which transcranial direct current stimulation (tDCS) has shown promising results in its reduction. In this sense, the objective was to analyze the state of the art on the effectiveness of the application of tDCS to improve fatigue in individuals with MS. A systematic review was carried out in June and July 2020. The databases of PubMed, BVS, SciELO, Cochrane and Science Direct were used, with the descriptors: “Transcranial Direct Current Stimulation” AND “Multiple Sclerosis”. Studies with adults that addressed the effects of tDCS on fatigue symptoms as a primary or secondary outcome were included. It was observed that the stimulation showed better results for fatigue in MS when applied to the left dorsolateral prefrontal cortex, with intensity between 1.5 mA and 2.0 mA, during consecutive days, in a number greater than five sessions. tDCS can be considered a therapeutic resource that promotes considerable benefits in the treatment of fatigue in people with MS, reflecting an improvement in the quality of life of these individuals. The application of remotely supervised tDCS can be an alternative to enhance the results.

63-74

Authors: Elizabeth do Canto Brancher, Eduardo Matias dos Santos Steidl, Tamires Daros dos Santos, Maurício Tatsch Ximenes Carvalho, Paulo Roberto Oliveira de Jesus, Adriane Schmidt Paqualoto, Isabella Martins de Albuquerque, Renata Mancopes

To evaluate if there is a relationship between the diaphragmatic mobility with oral and pharyngeal transit time, predictor of mortality Body mass index, airflow Obstruction, Dyspnea and Exercise capacity (Bode) index score, dyspnea and health status in patients with Chronic Obstructive Pulmonary Disease (COPD). A cross-sectional study, with evaluation of following outcomes: diaphragmatic mobility (ultrasonography), oral and pharyngeal transit time (videofluroscopy), predictor of mortality (Bode index score), dyspnea (modified Medical Research Council – mMRC scale) and health status (COPD Assessment Test). Participated in this study 19 patients with clinical diagnosis of COPD stages Gold II or III (65.9 ± 7.9 years of age, 11 male, FEV1 47.76 ± 21.91% predicted). There was a strong negative correlation between diaphragmatic mobility with BODE index score (r=-0.822; p<0.0001), moderate negative correlation with pharyngeal transit time in the liquid consistency (r=-0.508; p=0.02) and moderate negative correlation with dyspnea (r=-0.527; p=0.02). Multivariate regression analysis showed that the increase of diaphragmatic mobility was negatively associated with Bode index (β=-5.21; p<0.001; CI 95% -7.28 to -3.15) and with pharyngeal transit time in the liquid consistency (β=-13.65; p<0.08; CI 95% -29.16 to 1.86). There was no correlation between the diaphragmatic mobility and the oral transit time (liquid and pasty consistency), with the pharyngeal transit time (pasty consistency) and health status. It is suggested that in patients with COPD the diaphragmatic mobility is associated with Bode index, pharyngeal transit time in the liquid consistency and dyspnea.