Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Acurácia dos indicadores clínicos do diagnóstico de enfermagem falta de adesão em pessoas vivendo com AIDS

In the early 1990s, a major milestone in the treatment of Acquired Immune Deficiency Syndrome was the development of highly active combination antiretroviral therapy. The great benefit generated by the use of this therapy was prolonging the survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Despite improvements generated by this therapy, there are still many difficulties to be overcome. One is the patient adherence to their treatment, bringing challenges to services and health professionals. Hence the need for early identification of nursing diagnosis Lack of Accession so that solutions are sought by the nurse with the patient and his family. With this problem, adds to the difficulty of hospital nurses in inferring that diagnosis, especially in identifying their defining characteristics. In this context, the objective was to evaluate the accuracy of clinical indicators of nursing diagnosis Lack of Adherence to antiretroviral treatment for people living with the Acquired Immunodeficiency Syndrome. The research took place in two stages. The first consists of the evaluation of the diagnostic indicators in the study; and second, the diagnostic inference performed by specialist nurses. The first step took place in a referral hospital in the treatment of infectious diseases in the Northeast of Brazil, and data were collected through an instrument for carrying out history and physical examination and analyzed for the presence or absence of the diagnostic indicators. In the second stage, the data were sent to experts, who judged the presence or absence of the diagnosis in the studied clientele. The project was submitted to the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining approval with the General Certificate for Ethics Assessment (CAAE) No 46206215.3.0000.5537. Data were analyzed using descriptive and inferential statistics. Test were used Fisher's exact, chi-square test of Pearson and logistic regression. Since the accuracy of clinical indicators was measured by sensitivity, specificity, predictive values, likelihood ratios. As a result, we identified the presence of diagnosis Lack of Accession on 69% (n = 78) of the study patients. The defining characteristics that showed statistically significant association with the diagnosis studied were: lack of adherence behavior, complications related to development, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. The characteristic with greater sensitivity was missing scheduled appointments and the highest specificity behavior of noncompliance. The logistic regression showed as predictors for the diagnosis Lack of Accession: lack of adherence behavior, missing scheduled appointments, failure to achieve results, and exacerbation of symptoms. It was concluded that the identification of clinical indicators accurately enabled a good prediction of the nursing diagnosis Lack of Accession on people living with the Acquired Immune Deficiency Syndrome, helping nurses develop early on strategies for promoting adherence to the use of antiretrovirals.

Aids em idosos no Brasil no período de 2000 a 2012: uma análise de série temporal e dos fatores contextuais associados

The characteristics profile of individuals who develop AIDS in Brazil has changed over time. Among these modifications, a worrying finding is the increased incidence of AIDS in the elderly across the country. But, however, is not yet clear whether the increase in AIDS cases is sufficient to produce a change in the trend of measures in recent years in the Brazilian states, and this increase has an effect from the socioeconomic and demographic indicators. In this sense, the objective of this study is to analyze the AIDS incidence rates among the elderly in Brazil and its effect on socioeconomic and demographic inequalities in the period 2000 to 2012. This is an ecological time-series study to meet behavior of the time series of the incidence rates of AIDS in the elderly from 2000 to 2012. the rates were calculated using the secondary data from Diseases Information System Notification and the Brazilian Institute of Geography and Statistics. Data were analyzed statistically to know the trends in incidence rates, by polynomial regression model and joinpoint log-linear regression model, but also the simple linear regression analysis to find the relationship of trends with variables socioeconomic and demographic. SPSS 20.0® and Joinpoint 4.1.1 programs were used. All tests were carried out considering a significance of 5%. After the analysis, in Brazil were reported 62,052 new cases of AIDS in the elderly from 2000 to 2012. During this period, a significant increase was found for males, both aged 50-59 years (APPC: 3.46 %, p <0.001), such as above 59 years (AAPC: 4.38%; p <0.001). For females, the increase was significant and has the largest increments in the time series, when compared to males in both age groups (AAPC: 4.62%, p <0.001 and AAPC: 6.53%; p <0.001) respectively. The largest increases are observed in women and in the states of North and Northeast. In the Southeast Region is observed stabilization of rates throughout the series. The reason of trends between the sexes had a significant reduction, but also an approach in both age groups of the study, reaching a ratio of 1.7 males for every female in the youngest age group. The trends were related to illiteracy rates, with increasing social inequality and the lowest human development in the Brazilian states. We conclude that in Brazil the incidence of AIDS in the elderly follows an increasing trend in individuals over 50 years. Noteworthy are the highest rates of study in women and in the states of North and Northeast. In this sense, the country needs to enhance policies towards older people with STD / AIDS, training health professionals and developing effective measures for the prevention and early diagnosis of infected people, especially in places with limited resources and high social inequality. In the long term, it is developing new studies to understand whether the measures taken were effective in reducing the trends identified in this study.

Representações sociais acerca da AIDS e percepção de risco da infecção entre estudantes universitários

Neste estudo exploratório procurouse identificar as representações sociais que jovens universitários elaboram sobre a aids e a percepção de risco em relação à infecção pelo HIV. Utilizou-se um instrumento de evocação que se baseia na associação livre de ideias, partindo-se do termo indutor aids. Participaram da pesquisa 201 estudantes, de ambos os sexos, matriculados em diferentes cursos de uma universidade pública. Os dados foram analisados pelo programa de computação EVOC. Os resultados indicaram que os universitários construíram um saber sobre a aids ancorado no conhecimento médico-científico sobre a síndrome da imunodeficiência adquirida. Sexo, morte e doença foram as palavras mais evocadas que, junto a medo, constituem o provável núcleo organizador das representações acerca da aids. Crenças e preconceito relacionados a grupos estigmatizados e a comportamentos considerados desviantes não apareceram nas associações dos universitários. Percebem-se como vulneráveis à infecção identificando comportamentos de risco em toda a população, inclusive no grupo interno. ____________________________________________________________________________________ ABSTRACT

Vivência e sentimentos do portador de VIH/SIDA face a sua doença

O Vírus da Imunodeficiência Humana/Síndrome da Imunodeficiência Adquirida (VIH/SIDA), é uma doença crónica, que constitui um problema de saúde pública em todo mundo, chegando a ser alarmante em alguns países principalmente nos países Africanos. Em Cabo Verde, conforme os dados estatísticos, a percentagem de população infetada pelo vírus é cerca de 0,8%. A descoberta do diagnóstico do VIH/SIDA tem como resposta os múltiplos sentimentos gerados pelo portador devido a sua fragilidade cognitiva em incorporar o diagnóstico. A trajetória da doença abrange e afeta o portador do VIH/SIDA como também a sua vivência com a família, os amigos a sociedade e o trabalho, podendo levar ao apoio como também a rejeição, com atos discriminatório e estigmatizantes. O VIH/SIDA ainda não tem cura, desta feita mostra-se que a melhor forma de combater a transmissão, é atuar na prevenção, transmitindo informações e partilhar conhecimentos, para evitar que a infeção se propaga. O estudo tem como tema “Vivência e sentimentos dos utentes portadores de VIH/SIDA, face a sua doença, em que delineou-se como objetivo geral, conhecer a vivência e os sentimentos dos utentes portadores de VIH/SIDA, face a doença. Optou-se por um estudo qualitativo, descritivo e exploratório com uma abordagem fenomenológica, sendo que o método de recolha de informações foi uma entrevista semiestruturada. A população alvo deste estudo foi constituída por cinco (5) utentes portadores de VIH/SIDA inscritos na Associação de Seropositivos VIH/SIDA de São Vicente. Na análise dos resultados mostra que os entrevistados têm perceção sobre a doença em si, em que cada um apresenta uma forma diferente de viver a doença tanto a nível familiar, como com os amigos, na sociedade e no trabalho, alguns sendo vítimas de preconceitos derivado da não-aceitação da doença. Observou-se que os sentimentos desenvolvidos pelos utentes são reversos e depende da forma como incorporam psicologicamente o diagnóstico. Um outro achado importante é o fato das intervenções de enfermagem serem insuficientes, faltando a parte humana nesses cuidados.

Quantificação e seqüênciamento do gene da transcriptase reversa em gatos naturalmente infectados com vírus da imunodeficiência felina tratado com AZT

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

Estabilidade, polimorfismo, dissolução e correlação in vivo-in vitro de Darunavir comprimidos

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

New method for the simultaneous identification of pathogenic human viruses using multiplex PCR

Tese de mestrado. Biologia (Biologia Molecular e Genética). Universidade de Lisboa, Faculdade de Ciências, 2014

Enfoque del paciente con sospecha de neuroinfección en urgencias

Las infecciones del sistema nervioso son importantes fuentes de morbilidad y mortalidad en el mundo, debido a diferentes factores como son el amplio uso de antibióticos que aunque contribuyen con éxito al manejo de infecciones, pero el mal uso por automedicación o tratamientos incompletos favorecen la emergencia de organismos resistentes y la existencia de “mimos infecciosos” que incluyen el síndrome de reconstitución inflamatoria (IRIS). Adicionalmente el crecimiento de las poblaciones inmunocomprometidas por el síndrome de inmunodeficiencia adquirida (SIDA) y por tratamientos agresivos para trasplante sólido o hematopoyético han mejorado la sobrevida de diferentes tipos de malignidades y alteraciones reumatológicas pero son poblaciones que tienen más susceptibilidad a contraer infecciones y encefalitis mediadas inmunológicamente, como son la encefalomielitis diseminada aguda (ADEM) o la encefalitis contra el receptor de N-metil-D aspartato (NMDA).

Ansiedad, depresión y calidad de vida en personas adultas con VIH/SIDA y deterioro cognitivo leve

El Virus de la Inmunodeficiencia Humana (VIH) y el Síndrome de Inmunodeficiencia Adquirida (SIDA) han tenido a lo largo de los años un comportamiento epidemiológico que muestra la tendencia al aumento, de tal forma que ha llegado a considerarse como un problema de salud pública a nivel mundial. Sin embargo los tratamientos antiretrovirales han permitido que las personas con esta infección tengan una tasa de supervivencia mayor; pero ligado a esto, se han presentado efectos secundarios tales como problemas con la memoria y el funcionamiento cognitivo de estas personas. Además se ha encontrado que las personas con VIH/SIDA tienen algunas alteraciones en su área afectiva y generalmente ven afectada su calidad de vida. Este es un estudio exploratorio descriptivo que tuvo por objeto describir la ansiedad, depresión y percepción de calidad de vida en 35 pacientes con VIH/SIDA con deterioro cognitivo leve, seleccionados por conveniencia. Se aplicaron tres cuestionarios, el BDI-II para evaluar la sintomatología depresiva; el BAI para evaluar la sintomatología ansiosa y el MOS-SF30 para evaluar la calidad de vida. Además, se realizó una entrevista semiestructurada para profundizar en la evaluación de estas tres variables. Dentro de los resultados se evidenció que todos los paciente presentan algún nivel de ansiedad y de depresión, evalúan su calidad de vida en un punto medio; ni óptima ni baja. Se discuten estos y otros resultados.

Human papillomavirus detection from human immunodeficiency virus-infected colombian women's paired urine and cervical samples

Infection, coinfection and type-specific human papillomavirus (HPV) distribution was evaluated in human immunodeficiency virus (HIV)-positive women from paired cervical and urine samples. Paired cervical and urine samples (n = 204) were taken from HIV-positive women for identifying HPV-DNA presence by using polymerase chain reaction (PCR) with three generic primer sets (GP5+/6+, MY09/11 and pU1M/2R). HPV-positive samples were typed for six high-risk HPV (HR-HPV) (HPV-16, -18, -31, -33, -45 and -58) and two low-risk (LR-HPV) (HPV-6/11) types. Agreement between paired sample results and diagnostic performance was evaluated. HPV infection prevalence was 70.6% in cervical and 63.2% in urine samples. HPV-16 was the most prevalent HPV type in both types of sample (66.7% in cervical samples and 62.0% in urine) followed by HPV-31(47.2%) in cervical samples and HPV-58 (35.7%) in urine samples. There was 55.4% coinfection (infection by more than one type of HPV) in cervical samples and 40.2% in urine samples. Abnormal Papanicolau smears were observed in 25.3% of the women, presenting significant association with HPV-DNA being identified in urine samples. There was poor agreement of cervical and urine sample results in generic and type-specific detection of HPV. Urine samples provided the best diagnosis when taking cytological findings as reference. In conclusion including urine samples could be a good strategy for ensuring adherence to screening programs aimed at reducing the impact of cervical cancer, since this sample is easy to obtain and showed good diagnostic performance.

Distribution patterns of infection with multiple types of human papillomaviruses and their association with risk factors

Background: Infection with multiple types of human papillomavirus (HPV) is one of the main risk factors associated with the development of cervical lesions. In this study, cervical samples collected from 1,810 women with diverse sociocultural backgrounds, who attended to their cervical screening program in different geographical regions of Colombia, were examined for the presence of cervical lesions and HPV by Papanicolau testing and DNA PCR detection, respectively. Principal Findings: The negative binomial distribution model used in this study showed differences between the observed and expected values within some risk factor categories analyzed. Particularly in the case of single infection and coinfection with more than 4 HPV types, observed frequencies were smaller than expected, while the number of women infected with 2 to 4 viral types were higher than expected. Data analysis according to a negative binomial regression showed an increase in the risk of acquiring more HPV types in women who were of indigenous ethnicity (+37.8%), while this risk decreased in women who had given birth more than 4 times (-31.1%), or were of mestizo (-24.6%) or black (-40.9%) ethnicity. Conclusions: According to a theoretical probability distribution, the observed number of women having either a single infection or more than 4 viral types was smaller than expected, while for those infected with 2-4 HPV types it was larger than expected. Taking into account that this study showed a higher HPV coinfection rate in the indigenous ethnicity, the role of underlying factors should be assessed in detail in future studies.

Diseño y ejecución de la campaña de prevención de VIH-SIDA Hechos saludables en Sopo

Teniendo en cuenta que las estrategias hasta ahora más exitosas para prevenir ésta enfermedad han sido de orden educativo, se busca construir en las nuevas generaciones actitudes, comportamientos y estilos de vida positivos

Dislipidemia asociada a targa en pacientes VIH positivos. Hospital Simón Bolívar. Bogotá 2003-2006

La infección por el VIH es tal vez la enfermedad de más rápida progresión en los últimos años. Ha cobrado y seguirá cobrando muchas vidas, sobre todo en los países menos desarrollados. En este estudio queremos mostrar la aparición de dislipidemia en pacientes infectados por el VIH, que están en terapia antiretroviral en un Hospital de tercer nivel de la ciudad de Bogotá D.C.

El juego como herramienta potencializadora en habilidades sociales de los niños/as portadores del VIH/sida, del hogar verónica de la fundación Eudes de la ciudad de Bogotá

El trabajo que se presenta a continuación, muestra el juego como herramienta potencializadora en las habilidades sociales de los niños/as y adolescentes portadores del VIH/SIDA, del hogar Verónica de la fundación Eudes de la ciudad de Bogotá. En él se encontrara, una revisión bibliográfica sobre los tres grandes temas a tratar en el proyecto que son: las Habilidades Sociales, El Juego y el VIH / SIDA. Para esta revisión de literatura, se tuvo en cuenta documentos importantes como el desarrollado por la autora Monjas Casares, Mª Inés, con el desarrollo de un programa de enseñanza de habilidades de interacción social que ella efectuó, para el Juego se tomo el documento de Jean Piaget y su clasificación de Juego, y en el VIH/ SIDA, los documentos publicados por ONUSIDA. autores.