Caracterização da resposta hipotensora pós-exercício

Hypertension is a disease that affects a large part of the world population, in which the treatment consists in changing habits of life, which include diet, weight loss and smoking cessation, among others, attending the physical activity outstanding recommendations, supported by its positive effects on the maintenance of blood pressure levels within the limits of normality. Objective: To characterize the post-exercise hypotensive response on individuals with hypertension. Method: Literature review from 1990 to 2011, searching the electronic databases MEDLINE, ScIELO, Lilacs and Cochrane. Articles were selected using keywords hypertension, physical exercise and high blood pressure. Results: One session of physical activity promotes the reduction of arterial hypertension, which is called post-exercise hypotension. However, this phenomenon will depend on some related factors such as the type, intensity and duration of exercise. Conclusion: The performance of activity and/or physical exercise is important in non-pharmacological treatment for lowering blood pressure, but is not yet defined the best type of exercise.

Pesquisas sobre o programa educacional de resistência às drogas e à violência (PROERD)

Programas educacionais de prevenção são mecanismos utilizados para suprir necessidades, sendo importante conhecer peculiaridades de sua aplicação e resultados obtidos. O objetivo deste estudo foi identificar e analisar o método e os resultados de publicações sobre o Programa Educacional de Resistência às Drogas e à Violência (PROERD), tanto no Brasil quanto no exterior. A pesquisa foi realizada nas bases de dados Scielo, Lilacs, Medline, Cohrane e Eric, utilizando-se como descritores os termos Proerd, Dare, Programa Proerd, Dare program e Dare Project. Verificou-se que são escassas as publicações, sobretudo no Brasil, não há padronização de instrumentos de pesquisa e há divergências entre os resultados que avaliaram o PROERD. Conclui-se que é preciso ampliar a realização e a divulgação de pesquisas que investigam o desenvolvimento e os resultados do programa.

Distúrbios do Sono em Pacientes com Fibromialgia

Introdução: A fibromialgia é uma doença caracterizada principalmente por dor músculo-esquelética difusa e crônica. Os distúrbios do sono em fibromiálgicos podem ter papel não somente na etiologia da dor crônica, mas também na perpetuação dos sintomas, portanto o estudo das condições do sono nestes pacientes é relevante na medida em que possibilita um entendimento das condições fisiopatológicas e permite uma abordagem ampla para o tratamento da fibromialgia. Objetivo: Apresentar a relação entre os distúrbios do sono e os sintomas da fibromialgia e sua importância na avaliação dos fibromiálgicos. Metodologia: Foi realizado levantamento bibliográfico do período de 1990-2009, nas bases de dados Medline, Pubmed, Lilacs e Scielo, através das palavras chaves: sleep, fibromyalgia, sleep disorders, insomnia, pain. Resultados: A literatura demonstra uma alta prevalência de distúrbios do sono em pacientes portadores de fibromialgia e uma relevante relação entre as anormalidades no padrão do sono e o sintoma da dor crônica.

The genetic polymorphism of diabetic nephropathy

Introduction: The Diabetic Nephropathy (DN) affects approximately 40% of patients diagnosed with DM is associated with increased mortality from cardiovascular phenomena and is considered the main cause of Chronic Renal Failure (CRF) in patients dialectics. Methods: Searches were performed on Medline, SciELO, Lilacs and Cochrane databases using the crossing between the key-words: “genetic polymorphism” and “diabetic nephropathy”. Results: The selected studies indicated that diabetic nephropathy is the leading cause of chronic renal failure, which significantly reduces the life expectancy of diabetics. Currently, some factors may have connection with DN. They are: genetic predisposition based on family history, hypertension, and cardiovascular events, quality of glycemic control and lipid levels and blood pressure and smoking. Conclusion: Studies constants are essential to add new elements in the literature for the definition (s) of factor (s) gene (s) specific (s) of diabetic nephropathy.

Spirituality/religiosity and cardiovascular system

Introduction: Spirituality/religiosity is associated to well-being. In this article, we describe the association between spirituality/religiosity and cardiovascular system. Materials and methods: We performed searches using Medline, SciELO, Lilacs and Cochrane databases using crossing between the keywords “spirituality,” “cardiovascular system,” “parasympathetic nervous system,” and “sympathetic nervous system.”Results: The electronic search yielded 65 references by crossing the terms “spirituality” and “cardiovascular system.” Among these, the first round of elimination resulted in exclusion of 55 titles and abstracts that were not clearly related to the subject of the review. The titles of the remaining 10 abstracts were submitted to a final evaluation that accounted for the inclusion criteria. An investigation into the reference lists confirmed the absence of relevant documents. Summaries of the analysed studies were selected. Discussion: Among 10 studies selected, 8 of them indicated that spirituality/religiosity is very important for the cardiovascular system, whereas only 2 found no significant association between the two variables in women. Conclusion: We suggest that spirituality/religiosity is an alternative and non-pharmacological therapy for cardiovascular disorders.

Association between central auditory processing mechanism and cardiac autonomic regulation

Background: This study was conducted to describe the association between central auditory processing mechanism and the cardiac autonomic regulation. Methods: It was researched papers on the topic addressed in this study considering the following data bases: Medline, Pubmed, Lilacs, Scopus and Cochrane. The key words were: “auditory stimulation, heart rate, autonomic nervous system and P300”. Results: The findings in the literature demonstrated that auditory stimulation influences the autonomic nervous system and has been used in conjunction with other methods. It is considered a promising step in the investigation of therapeutic procedures for rehabilitation and quality of life of several pathologies. Conclusion: The association between auditory stimulation and the level of the cardiac autonomic nervous system has received significant contributions in relation to musical stimuli.

Air versus saline in the loss of resistance technique for identification of the epidural space

BackgroundThe success of epidural anaesthesia depends on correct identification of the epidural space. For several decades, the decision of whether to use air or physiological saline during the loss of resistance technique for identification of the epidural space has been governed by the personal experience of the anaesthesiologist. Epidural block remains one of the main regional anaesthesia techniques. It is used for surgical anaesthesia, obstetrical analgesia, postoperative analgesia and treatment of chronic pain and as a complement to general anaesthesia. The sensation felt by the anaesthesiologist from the syringe plunger with loss of resistance is different when air is compared with saline (fluid). Frequently fluid allows a rapid change from resistance to non-resistance and increased movement of the plunger. However, the ideal technique for identification of the epidural space remains unclear.ObjectivesTo evaluate the efficacy and safety of both air and saline in the loss of resistance technique for identification of the epidural space.To evaluate complications related to the air or saline injected.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE, EMBASE and the Latin American and Caribbean Health Science Information Database (LILACS) (from inception to September 2013). We applied no language restrictions. The date of the most recent search was 7 September 2013.Selection criteriaWe included randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) on air and saline in the loss of resistance technique for identification of the epidural space.Data collection and analysisTwo review authors independently assessed trial quality and extracted data.Main resultsWe included in the review seven studies with a total of 852 participants. The methodological quality of the included studies was generally ranked as showing low risk of bias inmost domains, with the exception of one study, which did not mask participants. We were able to include data from 838 participants in the meta-analysis. We found no statistically significant differences between participants receiving air and those given saline in any of the outcomes evaluated: inability to locate the epidural space (three trials, 619 participants) (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.33 to 2.31, low-quality evidence); accidental intravascular catheter placement (two trials, 223 participants) (RR 0.90, 95% CI 0.33 to 2.45, low-quality evidence); accidental subarachnoid catheter placement (four trials, 682 participants) (RR 2.95, 95% CI 0.12 to 71.90, low-quality evidence); combined spinal epidural failure (two trials, 400 participants) (RR 0.98, 95% CI 0.44 to 2.18, low-quality evidence); unblocked segments (five studies, 423 participants) (RR 1.66, 95% CI 0.72 to 3.85); and pain measured by VAS (two studies, 395 participants) (mean difference (MD) -0.09, 95% CI -0.37 to 0.18). With regard to adverse effects, we found no statistically significant differences between participants receiving air and those given saline in the occurrence of paraesthesias (three trials, 572 participants) (RR 0.89, 95% CI 0.69 to 1.15); difficulty in advancing the catheter (two trials, 227 participants) (RR 0.91, 95% CI 0.32 to 2.56); catheter replacement (two trials, 501 participants) (RR 0.69, 95% CI 0.26 to 1.83); and postdural puncture headache (one trial, 110 participants) (RR 0.83, 95% CI 0.12 to 5.71).Authors' conclusionsLow-quality evidence shows that results do not differ between air and saline in terms of the loss of resistance technique for identification of the epidural space and reduction of complications. Applicability might be compromised, as most of the results described in this review were obtained from parturient patients. This review underlines the need to conduct well-designed trials in this field.

A systematic review and meta-analysis of cohort studies of echocardiographic findings in OSA children after adenotonsilectomy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Voice Disorders in Teachers. A Review

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efficacy of antibiotic therapy for peritoneal dialysis-associated peritonitis: a proportional meta-analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliações dos estudos farmacoeconômicos em vigilância de medicamentos

Propôs-se identificar estudos farmacoeconômicos segundo tipo de estudo (custo-efetividade, custo-benefício, minimização de custos ou custo-utilidade) em farmacovigilância e conhecer os resultados econômicos dos estudos de vigilância pós-comercialização. Por meio de uma revisão bibliográfica direcionada, selecionou-se estudos originais, considerando publicações nos anos de 1966-2010, durante o período de marco a maio de 2011, utilizando-se os descritores científicos em saúde “sistemas de notificação de reações adversas a medicamento” OR erros de medicação OR vigilância de drogas comercializadas OR vigilância de evento sentinela AND análise custo-benefício OR analise custo-eficiência OR custos e analise de custo OR custos hospitalares OR custo-efetividade OR avaliação de custo-efetividade OR custos de medicamentos nas bases de dados Lilacs, e Pubmed/Bireme. Foram utilizados os seguintes critérios de inclusão: artigos com idioma em inglês, espanhol e português; artigos originais; artigos que avaliem custo de RAM e/ou intervenções; artigos que avaliem o impacto e/ou consequência de um efeito adverso na farmacoeconomia; e foram excluídos da amostra, os artigos em outros idiomas e publicações de cartas, revisões, editorias e notícias; artigos inacessíveis e aqueles cuja leitura flutuante do título e resumo mostrou-se fora da proposta do trabalho. Identificou-se 13 artigos que contemplaram os critérios de inclusão proposto. Os tipos de análise identificados foram: análise de custo-benefício (12) e análise de custo-efetividade (1). Não foram identificados estudos com análise de custo utilidade e minimização de custos. As considerações dos estudos avaliados salientam a necessidade de pesquisas posteriores, para fortalecer as hipóteses testadas, evidenciando os resultados econômicos nas ações ...(Resumo completo, clicar acesso eletrônico abaixo)

A inserção da Família nos serviços de Saúde Mental: uma revisão sistemática da Literatura

It is a systematic literature review, wich aimed to analyze documents, as is the inclusion of the family in Mental Health Services. To do so was based on a literature in the database of the Latin American and Caribbean Health Sciences (LILACS). And the documents were selected from the question which funded the research to evaluate the contribution of scientific research published in journals in the period 2000 to 2011. Data analysis reveals that the government's efforts in having the family as an ally, not a recent phenomenon. But this is a process that depends not only on government, also depends on the professionals involved and of their own families, and other factors. It is concluded that much remains to be done, both in terms of research for the topic, the actions in the reality of such a process

Humanização da assistência ao paciente crítico: revisão integrativa da literatura

This study aimed at analyzing the scientific production on health care humanization in intensive-care and emergency units based on publications in national journals. Therefore, this is an integrative review of the national literature. The online database Literatura Latino-Americana do Caribe em Ciências da Saúde - Literature in the Health Sciences in Latin America and the Caribbean (LILACS) based on the Health Virtual Library (BVS) platform was used to select articles. The final sample in this review consisted of 21 articles. The presentation of results and data discussion was descriptively performed and divided into three themes: communication with relatives and the team, caregiver humanization and, finally, the difficulties faced to implement humanization. As regards communication, it is seen by the authors as a fundamental strategy to ensure quality in intensive care, and it is placed as a central axis in the humanization policy. Concerning caregiver humanization, the physical and mental overload resulting from the work process in these units are factors that interfere with personal relations between team members as well as with that between team members and patients. Among the difficulties faced for implementing humanized care for critical patients are the units’s physical and organizational structures, technology and health care professionals’ education, which is centered on the biomedical model. It was concluded that communication is considered to be fundamental for humanization of the care provided to critical patients, since it allows for the development of a network of meanings between patients, the team, families and the establishment. In order to implement care with humanized actions in urgency and emergency sectors, particularly in ICUs, it is necessary to change organizational culture and value health care professionals

O ensino de oncologia em enfermagem: um panorama do Brasil, Estados Unidos e outros países

The incidence of neoplasias has increased worldwide every year, and the training of qualified nurses for quality care provision to oncologic patients is necessary. This study aimed at identifying, in the literature, how oncology has been taught in the curricula of several undergraduate nursing programs in Brazil, the United States and other countries. The articles were located on Internet-based databases, namwly Lilacs and Scopus, from which 35 publications were found, and 18 articles were included. In Brazil, oncology is taught in undergraduate nursing programs in an isolated and punctual fashion, and it is not included in curricula. Parallelly, in the other countries included in the study, similarity was found as to this aspect; however, there is evidence of the implantation of elective and extracurricular courses. It is noteworthy that, in Brazil, there is evidence of government policies for oncology teaching and cancer control; nevertheless, such guidelines have not been concretized in curricula. The study showed a scenario in which oncology teaching in undergraduate nursing programs is insufficient or inexistent both in Brazil and in other countries, which compromises the training of future qualified professionals that will be attentive to that theme, since cancer is a frequent pathology, and the presence of nurses is fundamental for the care of such patients from diagnosis to cure, or even during occasional death

A propaganda de medicamentos: qualidade, diferença entre os países e recomendações para o uso racional. Uma revisão bibliográfica

Muitos fatores são responsáveis pelo consumo excessivo de medicamentos e pelo descumprimento a Política Nacional de Medicamentos, mas um que se mostra muito significativo nesse cenário é a promoção de medicamentos. Dessa forma o presente estudo propôs caracterizar a qualidade das promoções publicitárias de medicamentos. Realizou-se uma revisão bibliográfica sistemática, em que foi realizada uma coleta de dados, no período de agosto a setembro de 2012, nas bases Lilacs, e Pubmed/Bireme, disponíveis no portal: http://www.bireme.br. Os descritores escolhidos utilizados foram controle da publicidade de produtos OR publicidade de medicamentos OR propaganda AND Legislação de Medicamentos. Foram identificados 11 artigos que contemplavam os critérios de inclusão. Analisou-se as informações relacionadas à qualidade (informações mais frequentes, informações menos frequentes, princípios éticos de fidedignidade e veracidade da informação), irregularidades e as estratégias para melhoria das propagandas de medicamentos. Os estudos mostraram que as maiores deficiências na propaganda de medicamentos dizem respeito às informações sobre contra indicações, cuidados, advertências e reações adversas, agrupados como precauções gerais, e às referências bibliográficas, infringindo a legislação em diversos aspectos. Além disso, observou-se que o problema da qualidade da informação em propagandas de medicamentos é verificado em muitos países, mas principalmente em países em desenvolvimento. Assim torna-se necessário maior rigor da legislação na fiscalização dessas propagandas de medicamentos e maior atenção dos profissionais da saúde quanto a essa prática, tendo maior visão crítica sobre os materiais distribuídos á classe médica