Cuidados paliativos para pacientes em estado terminal em Unidades de Terapia Intensiva: revisão sistemática e metanálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Intervenções cirúrgicas para o tratamento do pectus excavatum: revisão sistemática

Pós-graduação em Bases Gerais da Cirurgia - FMB

Práticas integrativas e complementares no SUS: revisão integrativa

Pós-graduação em Saúde Coletiva - FMB

Estudos nacionais sobre o ensino para cegos: uma revisão bibliográfica

O presente artigo tem como objetivo apresentar uma revisão bibliográfica dos estudos nacionais acerca do ensino curricular para cegos. Foi realizada uma busca sistemática em três bases de dados: Google Acadêmico, Scielo e Lilacs, de estudos publicados no período de 2004 a 2014, que tivessem em seu título um dos seguintes descritores: alunos cegos; alunos deficientes visuais; crianças cegas; crianças deficientes visuais. Foram localizados 188 estudos e 56 selecionados dentro dos critérios estabelecidos. Fez-se a leitura integral desses e definiram-se cinco categorias de análise: tipo de estudo; participantes; tipo de abordagem; tipo de discussão e matrizes curriculares. Para cada categoria, foram estabelecidas subcategorias. Ao total 26 subcategorias foram descritas. Os resultados indicam que o Google Acadêmico é a base de dados com maior número de títulos encontrados (188/156); a Scielo apresenta melhor eficiência na relação encontrado x selecionado (12/10). Nas subcategorias de análise, as maiores frequências são identificadas nos estudos empíricos (22); junto a crianças (19); de análises qualitativas (21); na matriz curricular de Educação Física (sete) e na subcategoria relacionamento social (16). Contudo, os estudos são convergentes em apontar que as principais dificuldades no ensino às pessoas cegas se referem a deficiências na formação de professores, onde, normalmente, não são discutidos métodos de ensino e produção de material para trabalhar com essa população específica. Em conclusão, além de realizar um mapeamento dos estudos que têm sido conduzidos junto a alunos cegos nos últimos dez anos, este artigo aponta para lacunas na literatura e direciona futuras investigações na área.

Intervenções cirúrgicas para o tratamento do pectus excavatum: revisão sistemática

Pós-graduação em Bases Gerais da Cirurgia - FMB

Práticas integrativas e complementares no SUS: revisão integrativa

Pós-graduação em Saúde Coletiva - FMB

Avaliação da capacitação de usuários para a recuperação da informação: o caso de uma biblioteca acadêmica

Com a disponibilidade de acesso à informação, através das tecnologias de informática e telecomunicação nas bibliotecas acadêmicas, houve significativa mudança no perfil de seus usuários. Estes passaram a formular sua estratégia de busca e obter a informação desejada, diminuindo seu contato com o bibliotecário para esse fim, mas demandando novos serviços das bibliotecas. Nesse contexto, o papel do bibliotecário mudou para acompanhar a necessidade do novo usuário; passando a ser o do educador [trainer], aquele que capacita os usuários a se tornarem permanentemente autônomos para fazer suas buscas nos sistemas de informação de forma eficiente e, sobretudo, eficaz. As bibliotecas passaram a oferecer cursos e treinamentos para que os usuários conheçam os sistemas de recuperação da informação, a arquitetura das bases de dados, e como a informação é organizada nas áreas do conhecimento, tornado-os com a competência informacional. Apresenta a experiência da Biblioteca da Faculdade de Saúde Pública, da Universidade de São Paulo, na capacitação de seus usuários no uso de bases de dados.Seu objetivo foi comparar os resultados obtidos na avaliação da capacitação dos alunos egressos dos Cursos MEDLINE e LILACS da década de 1990 (1993/1995) e, após 10 anos (2005/2006), a fim de se conhecer as mudanças no comportamento do usuário quanto à aquisição de autonomia e familiaridade no uso das bases de dados estudadas

Do the physical discomforts from breast cancer treatments affect the sexuality of women who underwent mastectomy?

The objective of this integrative review is to analyze the scientific production addressing the sexuality of women with breast cancer following mastectomy, focused on the effects that the physical discomfort due to cancer treatments have on their sex life. The search included articles published in the period between 2000 and 2009 on the MEDLINE, LILACS and PsycINFO databases, using the following descriptors: mastectomy, breast neoplasms, sexuality, sexual behavior, amputation, psychosexual development, and marital relations. Nine articles were selected, which addressed the effects of the physical discomfort from cancer treatments on the patients' sexuality. The findings revealed that, even when the patient's sex life is intense and fulfilling before the disease, factors such as stress, pain, fatigue, insult to body image, and low self-esteem due to the treatments may alter the sexual functioning of the affected woman. Healthcare professionals must be sensitized in order to welcome and include the topic in policies as well as in preventive, diagnostic, and therapeutic strategies.

Mastectomy and Sexuality: An Integrative Review

Women affected by breast cancer are faced with the removal of a body part related to sexuality. This study aimed to investigate the impact of breast cancer and mastectomy in women's sexuality through the analysis of scientific literature published from 2000 to 2009. The bibliographic survey was carried out in LILACS, MedLine and PsycINFO databases. Twenty nine articles were selected to constitute the corpus of the analysis. The findings were grouped by means of content analysis. The results showed that after the removal of the breast, sexual performance is compromised, with reduced frequency of sexual intercourse in the early stages of treatment and low sexual desire, interest and satisfaction.

THE SCIENTIFIC PRODUCTION OF PSYCHOSOCIAL CARE CENTERS

The objective of this study was to present a panoramic view of the scientific production regarding Psychosocial Care Centers (CAPS). This literature review was performed using the LILACS, MEDLINE, and SciELO databases. Sixty-eight references were selected, most of which were journal articles (88.24%) and studies related to final graduate study essays (10.29%); 75% of the references found dating from 2003 were included. The following are highlighted among the most frequent objectives: the analysis and evaluation of the new proposal for mental health care, represented by Psychiatric Reform and by CAPS, and the analysis of mental health professionals and their expectations towards the services. The authors hope the present review will help find pathways and implications that lead to new studies and practices in the everyday work of health care services.

A bayesian network meta-analysis on comparisons of enamel matrix derivatives, guided tissue regeneration and their combination therapies

Aims: Guided tissue regeneration (GTR) and enamel matrix derivatives (EMD) are two popular regenerative treatments for periodontal infrabony lesions. Both have been used in conjunction with other regenerative materials. We conducted a Bayesian network meta-analysis of randomized controlled trials on treatment effects of GTR, EMD and their combination therapies. Material and Methods: A systematic literature search was conducted using the Medline, EMBASE, LILACS and CENTRAL databases up to and including June 2011. Treatment outcomes were changes in probing pocket depth (PPD), clinical attachment level (CAL) and infrabony defect depth. Different types of bone grafts were treated as one group and so were barrier membranes. Results: A total of 53 studies were included in this review, and we found small differences between regenerative therapies which were non-significant statistically and clinically. GTR and GTR-related combination therapies achieved greater PPD reduction than EMD and EMD-related combination therapies. Combination therapies achieved slightly greater CAL gain than the use of EMD or GTR alone. GTR with BG achieved greatest defect fill. Conclusion: Combination therapies performed better than single therapies, but the additional benefits were small. Bayesian network meta-analysis is a promising technique to compare multiple treatments. Further analysis of methodological characteristics will be required prior to clinical recommendations.

Bioethics and medical/legal considerations on cochlear implants in children

Cochlear implants are the best treatment for congenital profound deafness. Pediatric candidates to implantation are seen as vulnerable citizens, and the decision of implanting cochlear devices is ultimately in the hands of their parents/guardians. The Brazilian Penal Code dictates that deaf people may enjoy diminished criminal capacity. Many are the bioethical controversies around cochlear implants, as representatives from the deaf community have seen in them a means of decimating their culture and intrinsic values. Objective: This paper aims to discuss, in bioethical terms, the validity of implanting cochlear hearing aids in children by analyzing their vulnerability and the social/cultural implications of the procedure itself, aside from looking into the medical/legal aspects connected to their criminal capacity. Materials and Methods: The topic was searched on databases Medline and Lilacs; ethical analysis was done based on principialist bioethics. Results: Cochlear implants are the best therapeutic option for people with profound deafness and are morally justified. The level of criminal capacity attributed to deaf people requires careful analysis of the subject's degree of understanding and determination when carrying out the acts for which he/she has been charged. Conclusion: Cochlear implants are morally valid. Implantations must be analyzed on an each case basis. ENT physicians bear the ethical responsibility for indicating cochlear implants and must properly inform the child's parents/guardians and get their written consent before performing the procedure.

Combined oral contraceptives and increasing cardiovascular risk: thromboembolism and hypertension

Background: Hormonal contraceptive pills are the most used reversible method for familiar planning in Brazil. The combined pill, with synthetic analogs of estrogen and progestin, is employed by 25% of Brazilian female population. Its use provokes an increase of blood pressure levels, takes patient to a hipercoagulability state and predisposes her to thromboembolic events. Purposes: We aimed to describe mechanisms of hypercoagulability promoted by oral combined contraceptives, to analyze the relative risk of cardiovascular events within users and to list the most common circulatory pathologies in these patients. Methods: Three virtual medical databases were surveyed (Pubmed/Medline, BVS/LILACS and Scielo). Twelve studies were selected: clinical trials, case reports and articles of indexed medical periodic originally published in Portuguese and English about synthetic hormones, oral contraception, coagulation disorders and cardiovascular morbimortality. Results: Synthetic estrogen promotes an increase of some clotting factors' levels (VII, VIII, IX, X, XII, XIII and fibrinogen), such as a reduction of their inhibitors (S protein and antithrombin). Because of this, etinilestradiol is the component most related to venous thrombosis and ischemic diseases of brain and heart. It also improves the releasing of hepatic angiotensinogen, taking to a increase of blood pressure levels. Conclusions: The prescription of oral combined contraceptives needs criteria, notably due to adverse effects of etinilestradiol. It is recommended to avoid the administration of these drugs for patients elder than 35 year-old or with risk factors. For these patients, the use of progestagen-only pills seems to be safer.

Depression in children and adolescents: family narratives in Brazilian primary attention

Background: The incidence of depression in children and adolescents still increasing and this disorder is now a major public health challenge worldwide. The Psychiatric Reform suggested an end to the fragmented and inefficient service by proposing integrated and quality care. In this context, family narratives are a way to recognize vulnerabilities and provide psychopathology prevention in primary care. Methods: Two medical databases (LILACS and SciELO) were surveyed and 14 texts published between 2004 and 2011 were selected and reviewed. Results and discussion: Children and adolescents are nowadays exposed to several stressing factors, in addition to natural vulnerabilities of this age group. Prevention is associated with a qualified hearing of family narratives in primary care and healthcare professionals should be able to perceive said and unsaid elements across the speech. Conclusion: In spite of the advances about children and adolescents mental health, some procedures must be adapted to achieve an efficient mental health policy though analyzing family discourse.

Periodontal disease and diabetes mellitus

Periodontal disease (PD) is one of the most commonly known human chronic disorders. The relationship between PD and several systemic diseases such as diabetes mellitus (DM) has been increasingly recognized over the past decades. Objective The purpose of this review is to provide the reader with knowledge concerning the relationship between PD and DM. Many articles have been published in the English and Portuguese literature over the last 50 years examining the relationship between these two chronic diseases. Data interpretation is often confounded by varying definitions of DM, PD and different clinical criteria were applied to determine the prevalence, extent and severity of PD, levels of glycemic control and diabetes-related complications. Methods This paper provides a broad overview of the predominant findings from research conducted using the BBO (Bibliografia Brasileira de Odontologia), MEDLINE, LILACS and PubMed for Controlled Trials databases, in English and Portuguese languages published from 1960 to October 2012. Primary research reports on investigations of relationships between DM/DM control, PD/periodontal treatment and PD/DM/diabetes-related complications identified relevant papers and meta-analyses published in this period. Results 7This paper describes the relationship between PD and DM and answers the following questions: 1- The effect of DM on PD, 2- The effects of glycemic control on PD and 3- The effects of PD on glycemic control and on diabetes-related complications. Conclusions The scientific evidence reviewed supports diabetes having an adverse effect on periodontal health and PD having an adverse effect on glycemic control and on diabetes-related complications. Further research is needed to clarify these relationships and larger, prospective, controlled trials with ethnically diverse populations are warranted to establish that treating PD can positively influence glycemic control and possibly reduce the burden of diabetes-related complications.