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ALAN MESQUITA SANTOS
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PREVALENCE OF OSTEOMUSCULAR SYMPTOMS RELATED TO WORK IN DENTAL SURGEONS IN THE MUNICIPALITIES OF MACAPÁ AND SANTANA.
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Data: 16/12/2021
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Repetitive strain injury (RSI) and work-related musculoskeletal disorders (WMSD) are considered a public health problem because of their high prevalence in several professions, including dental professionals. Because of bad posture and organization at work, for example, dental surgeons occupy the first place in leaves of absence from work due to temporary or permanent incapacity, accounting for approximately 30% of the causes of premature abandonment among medical activities. This reality, however, continues to be underestimated and the lack of concern with prevention is one of the biggest challenges for the identification and change of this situation. Thus, the objective of this study was to evaluate the prevalence of musculoskeletal symptoms and their relationship with sociodemographic aspects and laboratory test results among dental surgeons in the Macapá and Santana cities. Those who met the inclusion criteria and agreed to participate in the research upon authorization, were given two self-administered questionnaires, the instrument used to collect sociodemographic and occupational data, and the instrument validated for the measurement of morbidities "Nordic Questionnaire of Musculoskeletal Symptoms", in addition to to collect your blood samples for hematological and biochemical tests. The research was carried out with dentists from public or private networks, with the exception of those who were on vacation, or for any reason, away from their activities in the last 15 days. The average working time of professionals is 12.2 years, with an average workweek of 38.2 hours, and 32.5% have already been away from work due to musculoskeletal problems. The prevalences of musculoskeletal symptoms and work-related musculoskeletal symptoms are 92.5% and 87.5%. And on average, dentists had 5 symptomatic regions of which 2.9 were work-related.
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CÁSSIO DIOGO ALMEIDA MONTEIRO
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USO NOCIVO DE ÁLCOOL POR ADOLESCENTES E A RELAÇÃO COM O DESENVOLVIMENTO DE DOENÇAS CARDIOVASCULARES
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Orientador : MARINA NOLLI BITTENCOURT
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Data: 15/12/2021
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A adolescência é uma etapa da vida caracterizada por um momento complexo de desenvolvimento físico e psicossocial, sendo, portanto, umas das populações prioritárias no Pacto pela Saúde para análise da situação sanitária de saúde e prevenção do uso excessivo de álcool, tabaco e outras drogas (BRASIL, 2010). OBJETIVO: Identificar a associação do uso nocivo de álcool por adolescentes jovens - 15 a 19 anos em Macapá-AP com a presença de biomarcadores relacionados ao desenvolvimento das Doenças Crônicas não Transmissíveis Cardiovasculares. METODOLOGIA: Trata-se de um estudo descritivo de abordagem quantitativa. Esse estudo consistirá em duas fases. Na primeira fase levantamento do perfil sociodemográfico dos adolescentes jovens com 15 a 19 anos de Macapá, e o perfil do uso de álcool, por meio do instrumento Alcohol Use Disorders Identification Test (AUDIT); e a segunda fase a coleta de sangue para pesquisa de biomarcadores, mensuração de peso e altura dos adolescentes que apresentaram mais de 16 pontos na escala AUDIT. A análise dos dados foi descritiva em relação aos dados do perfil do uso de álcool por meio do cálculo de porcentagem, média e desvio padrão. A análise da relação do uso de álcool e a presença de biomarcadores foram comparados utilizando a análise de variância de dois fatores (one-way ANOVA), seguida do pós-teste de Bonferroni, através do programa Prism 5.01 GraphPad. RESULTADOS: Para a primeira fase, foram entrevistados 251 participantes constituído de 46% por homens e 45% mulheres, entre 17 a 18 anos (50%), e com idade média de 18,22 anos (desvio padrão= 0,51). Em relação ao estado civil, a maioria informou ser solteiro (86%). A variável religião mostrou que a maioria era católico (27%), seguido de evangélico (25%). O valor do escore total do AUDIT determinou que o padrão de consumo foi de baixo risco abstêmias (75%) que compreendem a Zona I, seguido de adolescentes jovens classificados na Zona II como usuários de risco, que consumem de uma a duas doses (20%). Assim, ao somar a Zona III e Zona IV, tem-se um total de 5% (12) participantes que apresentaram escore maior que 16 pontos e queparticiparam da segunda fase da pesquisa. A segunda análise dos dados referentes aos biomarcadores tiveram uma amostra menor da amostra total, com 122 amostras avaliadas, observou-se que houve comparação significativa entre os grupos em relação aos biomarcadores MCP-1 e TNF-Alfa, que foram maiores entre o grupo de usuários nocivos de álcool em relação ao grupo que que não faziam uso de álcool ou outra droga (grupo controle). Alguns hábitos iniciados na juventude acompanham a vida adulta, onde a frequência do consumo do álcool aumenta. Na compreensão de que a temática abordada é de fundamental importância para saúde dos Adolescentes, no que diz respeito tanto a sua saúde mental pelo consumo de álcool, quanto a física por se propor a compreender aspectos que envolve as doenças cardiovasculares A presença dos biomarcadores MCP-1 E TNF-Alfa, reitera mais ainda a exposição a esse risco, uma vez descrito na literatura o estresse oxidativo e pró inflamatórios que estes fatores de inflamação podem lecionar células cardíacas, se tornando gatilho para DCV na fase adulta.
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LUIZ EDUARDO D'ELIA OLIVEIRA
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BIOATIVIDADE DOS EXTRATOS DE Annona glabra L. (MAGNOLIALES: ANNONACEAE) SOBRE
A FASE LARVAL DE Aedes aegypti (DIPTERA: CULICIDAE)
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Data: 15/12/2021
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The order Diptera receives great focus from the scientific community due to its importance as a vector, active or passive, of pathogenic organisms that cause diseases to man, the so-called arboviruses. Hematophagous vectors, the group to which mosquitoes are inserted, can transmit a wide range of infectious diseases during their feeding process. Major outbreaks of dengue, malaria, chikungunya, yellow fever and Zika have been reported, claiming human lives in several countries. The control of these insects is essential to decrease the transmission of such arboviruses and the ideal form of control of these insects needs to be carried out in such a way that the aggression to the environment is minimized, reaching only the target organisms, avoiding the selection of resistant insects, causing the minimum environmental contamination, substantially reducing the number of cases of infections and possible deaths resulting from the transmission of different pathogens transmissible by these vectors, with natural plant extracts being a valuable option. The species Annona glabra is a member of the family Annonaceae popularly known as araticum, marsh araticum, alligator apple or pond-apple. A small plant found in tropical and subtropical regions, which can live in association with other plants and commonly inhabit the banks of lakes and rivers, developing in environments subject to floods such as mangroves. The scientific literature presents reports of its anticarcinogenic, antitumor, antimutagenic, antileukemic, antioxidant, emollient, reverse transcriptase (HIV-1), antimicrobial, antiparasitic, antimalarial and antifungal properties. Phytochemical studies derived from extractions from different parts of the plant revealed the presence of flavonoids, terpenoids, glycosides, steroids, saponins,tannins, anthraquinones and acid compounds. Thus, the present study aimed to verify the viability of using the fixed oil of A. glabra to control the species Aedes aegypti in the larval (L4 - immature) and pupal phases; and check the LD50 and LD90. Keywords: Annona glabra. Aedes aegypti. Biological control. Insecticide.
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HÊULE NILTON SANTOS DE OLIVEIRA
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PREVALÊNCIA DE INATIVIDADE FÍSICA E FATORES ASSOCIADOS: UM ESTUDO COM POLICIAIS MILITARES DE MACAPÁ-AP
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Data: 10/12/2021
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This study aimed to estimate the prevalence of Insufficient Physical Activity Level (NIAF) and to identify association factors. It was developed with the participation of 162 Military Policemen from Three of the main Battalions that take care of the Policing of the Capital of the State of Amapá (Macapá), are Military of both sexes and of all the patents aged between 23 and 54 years old, 74.1% were male and 25.9% were female. The association factors for this study were anthropometric measurements and socioeconomic data. Weight and height measurements were collected from all military personnel, and the level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ short version), which identified that 40.1% are very active, 32.1 % are active, 13.6% irregularly active and 14.2% sedentary, which contrasts with the results of the body mass index, where 22.2% are obese, 51.2% are overweight and 26.5% are a normal weight. The socioeconomic level was classified by the questionnaire of the Brazilian Association of Research Companies - ABEP. The analysis of the collected data was done through descriptive statistics based on the calculation of the mean, standard deviation and relative frequency in percentage guided by a 95% confidence interval. To study the association between the level of physical activity and professional demographic and health factors, the chi-square independence test (for nominal qualitative variables) and Spearman's correlation coefficient (for ordinal and quantitative variables) were used. The Prevalence Ratio of the sedentary / insufficiently active level was estimated using Poisson regression models. For all statistical procedures, a significance level of 0.05 (p <0.05) was adopted. It is concluded that although men are more active than women, they are also the group with the most prevalent NIAF, having found a significant association between NIAF with social class and health of individuals. It is recommended to the Military Police command the adoption of intervention strategies to promote the health of its members, as well as the construction of a dialogue with the Government of the State of Amapá to improve the social class condition of the Military Police. Key words: Physical Activity, Military Police, Associated Factors.
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FABRÍCIO DA SILVA CORRÊA
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Data: 10/12/2021
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Introduction- The social determinants (DSS) of health according to the World Health Organization (WHO) are
related to the conditions in which a person lives and works. Social, economic, cultural, ethnic / racial,
psychological and behavioral factors that influence the occurrence of health problems and risk factors to
the population, such as housing, food, education, income and employment, can also be considered.
In the case of farmers, several DSS are added to accentuate the health-disease process, especially the
working conditions and environments that are often involved in the use of pesticides.
Objectives- For this reason this study set out to discuss how the environment and working conditions
and other health determinants are risks of occupational illness in family farming workers who work at
the buritizal fair. Methods- For this, an observational epidemiological study of the descriptive and
transversal type was carried out with a quantitative and qualitative approach, with the application of
a form to workers at the buritizal fair with questions to verify the social determinants of health of
this group and the perception of symptoms related to poisoning pesticides in the last 6 months.
In addition, a visit was made to the farmers' production area in order to check for distortions in work
safety, verifying health risks to which this worker is exposed. Results Family farmers in the vegetable
industry who work at the buritizal fair are the majority (87.6%) of the Km 9 region, the farm's mini and pole.
The 43.8% level of education is for people who have studied less than 4 years. With a prevalent age group of
46.7% of people between 37 and 55 years old, 40% over 55 years old. 93.4% say they work more than 8 hours
a day. Regarding the daily family income per capita, 33.3% live with an income of 20 reais or more and 26.7%
with an income between 10 and 14 reais per capita per day. 66.7% say they do not use pesticides and 33.7%
say they do. 73.3% think that the use of these products can be harmful to health. 53.3% say they do not have
any leisure activity and 73.4% say they have never taken a month off. Regarding the frequency of consultations,
80% say they spend more than 36 months without consulting with any health professional and 53.3% say they
feel musculoskeletal pain, besides 80% say they do not use sunscreen and 53.3% evaluate their health offered by
the State and municipality where they reside as very bad. It is important to note that the region where the
farmers live does not have a supply of treated water, sewage and garbage collection is present in only 50% of
the interviewees' homes. During visits to the production area of part of the sample, there was a contradiction
between the statement of not using pesticides with the presence of product packaging in the production area.
In addition, the personal protective equipment demonstrated was practically non-existent, exposing the worker
to risks arising from the incorrect use of pesticides. Conclusion- Preliminary results demonstrate that the
studied DSS are risk factors for increasing the health-disease process of the people surveyed and the use of
pesticides is still a reality in the production of many family farmers, and further research is necessary to
verify the conditions exposure to these products and other risks arising from work.
Keywords: Social determinants of health. Pesticides. Desktop. Family farming.
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DARCI FRANCISCO DOS SANTOS JUNIOR
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SINTOMAS PSICOPATOLÓGICOS E SITUAÇÃO LABORAL DE PROFISSIONAIS DE ENFERMAGEM NO CONTEXTO DA PANDEMIA DA COVID-19 NA REGIÃO NORTE
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Data: 09/12/2021
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The study aimed to analyze the association between psychopathological symptoms and the work situation of nursing professionals in the North region in the context of the COVID-19 pandemic. For this, a 44-question instrument created and validated by the researchers and the EAS-40 Scale to assess psychopathological symptoms were made available through Google Forms. The invitation was made to nursing professionals in the North region through a link made available on social networks such as Facebook, Instagram, Twitter, WhatsApp and also through emails. Such data were tabulated using Excel 2016 and refined using the IBM SPSS version 25 software. The sample consisted of 261 nursing professionals, and the results showed a significant association between the workload and psychopathological symptoms related to anxiety and embarrassment at work with symptoms related to somatization. The study can serve as a reference for proposing mental health promotion strategies for nursing professionals who work at the regional level and as a model for the national level.
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ADRIANE DA COSTA CANTO
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ÓBITOS POR DOENÇAS INFECCIOÇAS E PARASITÁRIA NO ESTADO DO AMAPÁ DE 2007 A 2017
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Orientador : AMANDA ALVES FECURY
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Data: 29/11/2021
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As doenças infecciosas e parasitárias (DIP) são um grave problema de saúde Pública devido suas particularidades vinculadas às variantes demográficas e socioeconômicas de cada região, que expressam a condição de saúde. Resultante da transição epidemiológica e suas consequências, as DIP passaram a não ser a principal causa de morte, porém ainda se enquadram em situação de saúde preocupante e objetivo de campanhas de prevenção e tratamento. Assim, a investigação epidemiológica dos dados de mortalidade por DIP refletem a situação de saúde da população, dos serviços de saúde e pode direcionar à ações e políticas públicas locais voltadas ao tema. Esta pesquisa trata-se de um estudo transversal retrospectivo, com abordagem quantitativa que teve por objetivo realizar a caracterização epidemiologia dos óbitos por DIP no Estado do Amapá, nos anos de 2007 à 2017 através das análises dos dados de óbitos contidos no banco de dados do DATASUS, provenientes do sistema de informação de mortalidade - SIM. Os dados coletados foram referentes ao período de janeiro de 2007 a dezembro de 2017. Foram incluídos todos os óbitos do capítulo I do CID 10. Foram descritas as DIP com maior taxa de mortalidade no período de estudo e realizado a evolução da mortalidade por DIP no Estado do Amapá. Foram registrados 28.034 óbitos por causa gerais no Amapá de 2007 a 2017, dentre esses, 1.481 óbitos por doenças infecciosas e parasitárias com média de taxa de mortalidade de 20,12 por 100.000 habitantes. As DIP com maiores percentuais proporcionais foram: septicemia (37,2%), HIV (22,4%), diarreia (8,91%) e tuberculose (7,90%). Verificou-se de um aumento médio significativo de 6,47 óbitos por ano (R = 6,47; β = 0,92; p < 0,001). O número de óbitos egistados em 2017 foi 70,2% superior ao registado no ano inicial, em 200, maiores taxas de mortalidade em menores de 5 anos e aumento na idade média dos óbitos. Levando à reflexão sobre maior investigação acerca das principais DIP causadoras de óbitos bem como controle dessas doenças, fortalecimento da vigilância epidemiológica e avanço no diagnóstico precoce e tratamento oportuno dessas morbidades.
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EMANUELLE TAVARES RODRIGUES
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AVALIAÇÃO DO EXTRATO BRUTO ETANÓLICO DAS FLORES DE Acmella oleracea (L.) R. K. JANSEN NA PREVENÇÃO DE HIPERPLASIA BENIGNA DA PRÓSTATA EM RATOS SHR E WISTAR
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Data: 29/11/2021
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Benign prostatic hyperplasia (BPH) is a disease that develops in men with advancing age, from 40 years. Even though it is benign, the lack of care can cause many discomfort in the quality of life in addition to the side effects of the medications. Which justifies the scientific interest in the development of alternative therapies, such as the use of medicinal plants for the prevention of prostate diseases that is of great relevance. The aim of this study was to evaluate the therapeutic potential of the crude ethanolic extract of the flowers of Acmella oleracea R. K. Jansen in preventing BPH in spontaneously hypertensive rats (SHR) and Wistar rats. For this, 40 male rats were used, 20 SHR rats and 20 Wistar rats, aged 9 weeks old. The animals were treated via gavage for 60 consecutive days, where the animals in the control group received 100 µL of saline daily and the animals in the treatment group received 100mg / kg of the crude ethanolic extract of the flowers of Acmella oleracea diluted in 100 µL of solution. saline. To evaluate the effects of the extract in the prevention of BPH, after euthanasia, the organs were collected and subjected to histopathological, morphometric-stereological and immunohistochemical analyzes. Preliminary analyzes show, histopathological confirmation of the occurrence of benign hyperplasia in animals in the SHR control group, ensuring that it is a typical disease of the animal model, and in the treated SHR group, morphologically it is observed that the treatment reduced the degree of hyperplasia due to decrease in the prostatic epithelium and increase in the luminal compartment when compared to the control. Treatment with the extract increased secretory activity in SHR animals and decreased in Wistar. Regarding the testicles, there was an increase in organ weight in the Wistar group. In the immunohistochemical evaluation, it was observed that the extract reduced cell proliferation, decreasing the frequency of positive PCNA cells in the SHR group. And there was also a decrease in androgen receptors in prostate cells in the Wistar group. To date, partial data indicate that the crude ethanolic extract of the flowers of Acmella oleracea is effective in preventing hyperplasia as it attenuates the morphological aspects of benign prostatic hyperplasia.
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ANA CAROLINE MOURA RODRIGUES COSTA
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Fatores de risco cardiovascular em policiais militares de um Batalhão da Polícia Militar em Macapá-AP
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Data: 26/11/2021
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O objetivo deste estudo foi estratificar o risco para doenças cardiovasculares em policiais militares do estado do Amapá. O estudo foi realizado no 1o Batalhão da Policia Militar do estado do Amapá com 101 policiais militares durante o processo de inspeção em saúde nos policiais que estavam aptos para a progressão de cargo. Para alcançar os resultados, a coleta de dados foi feita através de avaliação de exames laboratoriais (colesterol total, HDL, LDL e triglicerídeos), na Policlínica da sede do 1o Batalhão da Polícia Militar. A avaliação de saúde foi necessária para a verificação da pressão arterial e circunferência abdominal. Foi enviado um questionário online para cada participante, relativo à pesquisa sociodemográfica e econômica (ABEP), nível de atividade física (IPAQ) versão curta e Escala sueca de demanda-apoio. Os dados coletados foram analisados pelo SPSS, versão 26. As variáveis qualitativas foram caraterizadas através de frequências absolutas e relativas. Para as variáveis quantitativas foram utilizadas as medidas descritivas mínimo, máximo, média e desvio padrão. Os resultados foram avaliados pelo Coeficiente de Correlação de Spearman e teste exato de Fisher. A escala de estresse foi confiável após aplicação do coeficiente de consistência interna Alpha de Cronbach. A maioria da amostra foi composta por homens (89,1%), com uma média de idade de 41,2 anos. Foi observado uma relação positiva entre aumento do risco cardiovascular com aumento da idade, na faixa etária de 50-56 anos, com 54,5% com risco intermediário e 45,5% com risco alto. Trabalhadores com ensino médio tiveram 28,6% com risco alto/muito alto, comparado com 9,2% dos policiais com Ensino Superior. Maior tempo de trabalho teve forte relação com o risco alto (p<0,001). Trabalhadores em setores administrativos teve forte relação com o alto risco (25,6% versus 3,2% em trabalho operacional). O risco cardiovascular alto esteve mais presente em trabalhadores com dislipidemias (p=0,014) e hipertensos (p<0,001). 48,4% tinham excesso de peso e 27,4% com obesidade, estando presente a relação positiva entre estado nutricional com maior risco (p=0,042). Foram encontradas correlações positivas significativas do colesterol total (R = 0.251, p = 0.011), do LDL (R = 0.270, p = 0.006) e dos triglicerídeos (R = 0.288, p = 0.003) com o risco cardiovascular, indicando que o aumento dos valores de colesterol total, de LDL e de triglicerídeos leva a um aumento do risco cardiovascular. O aumento da C.A está positivamente correlacionada com o risco cardiovascular (R = 0.342, p = 0.010). 24,2% dos policiais foram classificados com comportamento sedentário. Não houve relação com o estresse e risco cardiovascular. Espera-se que a prevenção primária da aterosclerose ocorra de forma pontual nesta população do estudo e que não sejam apenas avaliados na ocasião de promoção de cargo ou quando houver sintomatologia importante.
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ANDRESSA VIANA PINHEIRO
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AVALIAÇÃO DA CONTAMINAÇÃO POR METAIS EM CABELO E ALTERAÇÕES CELULARES EM MUCOSA ORAL DE MORADORES DO BAIRRO ELESBÃO EM SANTANA-AP EXPOSTOS À MINÉRIOS.
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Orientador : TIAGO GABRIEL CORREIA
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Data: 26/11/2021
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Currently heavy metals have been highlighted as one of the main environmental toxicological agents, being spread by industrial and mining activities, in this perspective manganese, which despite being an essential metal for the functioning of various biological systems, in high concentrations can cause metabolic dysregulation. . Therefore, the objective of the study was to evaluate acute exposure to manganese on liver tissue and energy metabolism, verifying the applicability of the species Colossoma macropomum as a model organism for ecotoxicology studies. For this purpose, acute toxicity tests (96 hours) of the semi-static type, using 44 juveniles of Colossoma macropomum (Tambaqui), divided into control group (CTRL) and manganese group (Mn) in duplicate, there were two 96-hour experimental phases: one of acute exposure to Mn and (absence of Mn), after which the animals were sampled and bioaccumulated in the muscles, liver and gills and the determination of lactate, total lipids, alkaline phosphatase, glucose, triglycerides and TGO and TGP transaminases in plasma and liver, white and red glycogen muscle and total proteins. Statistical tests were performed using the SigmaStat statistical program (version 3.5) and Student's t-test was applied, with a significance level of P <0.05. The HMT index showed no significant difference between the Mn and CTRL groups during the acute exposure phase, but during the recovery, the Mn - RECP group showed an increase compared to their respective control. The animals presented higher bioaccumulation in the gills and liver, with less metal accumulation in the muscle. Plasma substrates showed a statistical difference (P=0.003) in lactate values between the 96-hour CTRL and Mn groups, and glycogen values were significantly different in the liver (P=0.048) over a 24-hour period and in the white muscle (P=0.001). 96 hour period. Given this, it can be inferred that Colossoma macrcopomum showed physiological response to acute exposure to manganese, being considered a good model of bioincador, and that the fish was possibly in a state of stress altering its metabolism when exposed to manganese, however. was able to recover, restoring values close to the group that was not exposed to the metal.
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DARLEINE ESTHER JOSEPH
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EPIDEMIOLOGICAL PROFILE OF CHILDREN AND ADOLESCENTS VICTIMS OF VIOLENCE ATTENDED AT THE PUBLIC HOSPITAL OF MACAPÁ FROM 2015 TO 2019
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Data: 17/11/2021
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Violence against children and adolescents is currently configured as a public health problem, considering the various traumas caused in different dimensions of the human being, whether physical, psychological or social, that require different forms of care at all levels of health, such as in the creation of new public policies that allow the identification of risk factors that caused this problem, among them, the creation of new strategies that allow from the complaint to the recovery of the victims' mental health. The purpose of this work is to analyze the epidemiological profile of violence against children and adolescents treated at a public hospital in Macapá between 2015 and 2019. This is a research with a quantitative, descriptive, retrospective and documentary approach, carried out at a public hospital in Macapá. The sample comprises 122 participants between zero and 12 years of age. Among the main results, children and adolescents who have suffered some type of violence are mostly female, aged between zero and 12 years old, are children of separated parents, belong to the lower class, lived in urban areas, and how much the type of violence predominated sexual violence and some were the result of a sexually transmitted infection. it can be deduced that violence causes negative results for its victims, hence the great importance of describing the characteristics of this population so that prevention and follow-up can be found. Keywords: violence; children; adolescents.
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FLAVIA PRISCILA ALMEIDA DOS SANTOS NUNES
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Cuidado Farmacêutico em pessoas com transtorno depressivo: análise da efetividade no tratamento.
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Data: 17/11/2021
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ABSTRACT
In Brazil, drug therapy is considered the first therapeutic choice for depression; however, it may be associated with problems such as adverse reactions, drug interactions, and lack of concussion. The pharmacist may be able to improve treatment outcomes by providing services such as patient education, monitoring treatment regularly and improving support. Therefore, the aim of this study was to analyze the impact of Pharmaceutical Care on the effectiveness of treatment, of users of the Psychiatric outpatient clinic of the Dr. Alberto Lima Hospital of Clinics, diagnosed with depressive disorder. A longitudinal and prospective, analytical-descriptive, and intervention study was carried out. Thirty-five people were followed for 90 days, submitted to pharmaceutical care and the Beck Depression Inventory, before and after care. The consultations followed the Dáder methodology, four pharmaceutical consultations, one initial, and the other, within 30, 60 and 90 days, respectively, all by telephone. The results obtained were, regarding the socio-demographic profile of the population, females (74.3%), aged between 18 and 30 years, single and students, prevailed. As for the drug profile, Selective Serotonin Reuptake Inhibitors were the most prescribed. Among the Negative Results associated with the use of identified drugs, the health problem not treated by not using the medication they need was the most common, and non-medication was the most frequent cause. Ninety-one interventions were performed, 48 of which were accepted and with solved problems, ending the study with 15 regular associations. After the statistical analysis of the scores obtained, it was observed that there was an improvement in the intensity of depressive symptoms, statistically proven with the T-Test for paired samples, with statistically significant difference in both moments, and in the means and dispersion, between the scores of the first and second moments, p ≤ 0.01 was obtained. And at the percentage level, the Chi square test showed a statistically significant difference, with p ≤ 0.025.
Key words: Pharmaceutical care. Pharmacotherapeutic follow-up. Depressive disorder. Depression.
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ROSA MARIA GUIMARAES BRITO
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INFLUÊNCIA DA IDADE SOBRE A DISCRIMINAÇÃO DE LUMINÂNCIA MASCARADA POR RUÍDO CROMÁTICO.
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Data: 12/11/2021
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Understanding the influence of the visual response to color contrasts and luminance is indispensable for a better understanding of visual processing under natural conditions. Current studies point out that with aging, humans present modifications in color perception and have decreased sensitivity especially after 40 years of age. Thus, we proposed in this research, to compare the influence of age on threshold perception of luminance masked by color noise in subjects distributed into two age groups, from 20 to 40 years old and over 50 years old, without comorbidities. This was an observational study of the cross-sectional analytic-descriptive type, conducted in the Neurology Laboratory of the Universidade Federal do Amapá - UNIFAP, where 42 volunteers participated, half for each age group, who were recruited through an invitation published in social networks. The participants were submitted to a previous interview to investigate the presence of neurological, metabolic and degenerative diseases that could compromise vision, then 03 psychophysical tests were performed, being 02 screening tests: the assessment of visual acuity (FrACT) and the Ishihara test and finally, the final test of this study for the evaluation of threshold luminance contrast discrimination with color masking. The risk that could arise from the research would be the extensive time spent performing the tests, which could lead to discomfort that could be relieved by taking breaks between tests and when requested by the participant. The benefits would be individual, due to the broad visual evaluation that the participant could enjoy; and collective, due to the contribution to the expansion of knowledge related to the interaction mechanisms between color and brightness in human vision, especially with advancing age. To assess data distribution, we applied the Shapiro-Wilk normality test. For analysis of variance, we used the one-way ANOVA test, followed by a Tukey's multiple comparisons test to compare parameters in each group; the unpaired Student's t-test with Welch's correction was used to compare parameters between groups. The results of the study confirm the hypothesis that advancing age affects the interaction between color and luminance, further corroborating the hypothesis that in the elderly the likely decrease in the perception of blue-yellow psychophysical mechanisms would induce decreased inhibition of color noise on threshold luminance perception.
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LARISSA DUARTE FERREIRA
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Protocolos REAC na modulação do estresse, ansiedade e depressão em acadêmicos de uma Universidade na Amazônia: estudo piloto duplo-cego controlado.
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Data: 29/10/2021
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ABSTRACT: The structural and social particularities found in the Brazilian Amazon structure become a key element that can negatively impact the lives of college students, such as socioeconomic, structural and family vulnerability, which play a significant role in the development of neuropsychiatric symptoms associated with stress, anxiety and depression. Therapeutic protocols REAC have actions on psycho-emotive-behavioral, vegetative, endocrine, immunological and movement control disorders, with REAC technology being one of the most recent neurobiological modulation technologies for the treatment of depression, anxiety and stress. Aims: To evaluate the effectiveness of the protocols Neuropostural Optimization (NPO) and Neuropsychophysical optimization (NPPO) by REAC technology on the behavioral pattern in a university community in the Brazilian Amazon. Methods: This is a double-blind, randomized, pilot clinical study with a division of control and experimental groups, with behavioral analysis facing a clinical intervention with the NPO and NPPO protocols of the REAC technology. The study was conducted with 30 college students from the Federal University of Amapá (UNIFAP). The variables evaluated were Stress, Anxiety and Depression (DASS-21), tongue positioning pattern (Payne's technique) and functional dysmetria due to patellar alignment after NPO. Results: As for the swallowing analysis, using Payne's technique before and after the application of NPO, 92.86% of the sample presented changes in the swallowing pattern after neuropostural optimization REAC. The functional dysmetry was 100% changed. Regarding the Stress, Anxiety and Depression clusters, in the control group the initial and final mean of severity was considered moderate, while in the experimental group the mean in the severe pre-treatment, in the post-treatment mean became moderate. In the analysis of the control group in relation to the experimental group, there was no statistical difference, there was statistical difference in the experimental group REAC before and after the intervention. Conclusions: REAC’s protocols NPO and NPPO were sufficient to modify the lingual position and positioning, in addition to having a direct impact on the reduction of fluctuating asymmetry, and can be used as an objective efficacy parameter for future studies. It was also possible to observe behavioral changes, since the clusters of the psychometric scale (DASS-21) had a more noticeable reduction in the experimental group before and after therapy compared to the control group.
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THAMILLY JOAQUINA PICANCO MIRANDA
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EXAME PREVENTIVO DO CÂNCER DE COLO UTERINO: conhecimento, atitude e prática de mulheres quilombolas no Amapá.
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Data: 20/10/2021
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Cervical cancer is considered a serious and persistent public health problem, a reality that could be transformed with the adhesion of women, their families and society to the Pap smear. Within this group, black women are part of a population considered vulnerable due to the high rates of morbidity and mortality in relation to socioeconomic variables and, therefore, require health policies aimed at this population. Given the above, the objective of this work is to analyze the knowledge, attitude and practice of quilombola women in Amapá on the preventive examination of cervical cancer. The study has a quantitative approach, of an applied nature, of the Inquiry type having as reference the Knowledge, Attitude and Practice of women, which intends to assist in the situational diagnosis about the theme, the study site being the quilombola community of Curiaú, located in the municipality Macapá, in the state of Amapá. The data were submitted to the SPSS version 25.0 program. for the description of the statistical results, which made it possible to state that the participants in this research have the following profile: age between 18 to 33 years (43.75%), Catholic (92.50%), is single (52.50 %), has completed high school (31.35%), has no paid activity (41.25%), has a monthly family income of 1 to 2 minimum wages (37.50%) and supports five family members (36.25%). They had a weight of 69.34 (Me), height 161.06 (Me), Body Mass Index (BMI) 26.685 (Me), waist circumference (WC) 86.97 (Me), hip circumference (CQ) 106 , 77 (Me) and ratio index between CC / QC 0.8172 (Me). Thus, the study revealed that 42.50% are within the parameter considered normal for BMI and 68.75% have low risk for the development of cardiovascular diseases according to CC / QC. Regarding the evaluation of the CAP survey, 26.25% had adequate knowledge, 30% adequate attitude and 37.5% adequate practice. Pearson's correlation test demonstrated that there is a direct relationship between the variable of knowledge and practice, thus it was identified that there is a relationship between the variability of both. Thus, highlighting that the woman has more knowledge, soon she will have a greater practice and the reverse is also true.
Descriptors: Cervical neoplasms. Pap smear test. Women's health. African Continental Ancestry Group.
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DENISE GABRIELLE FEITOSA RIBEIRO
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AVALIAÇÃO DO DESEMPENHO FUNCIONAL DO MEMBRO SUPERIOR EM MULHERES TRATADAS POR CÂNCER DE MAMA
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Orientador : VANIA TIE KOGA FERREIRA
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Data: 25/09/2021
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The treatment for breast cancer, regardless of the eligible surgical type, favors the development of physical and functional changes related mainly to the upper limb ipsilateral to the surgery, such as lymphedema, pain and shoulder movement restriction. Despite studies investigating the impact of treatment on the upper limb, the literature is still sparse of studies that approach the upper limb with specific tests aimed at investigating the functional performance of the upper limb. Therefore, the objective of this study was to evaluate the functional performance of the upper limb in women treated for breast cancer. This is a cross-sectional observational study in which were included women aged between 18 and 70 years, with surgery for unilateral breast cancer and who completed adjuvant treatment. They were evaluated for breast cancer treatment, shoulder range of motion, handgrip strength, quality of life, shoulder functional performance through the questionnaire Disabilities of the Arm, Shoulder and Hand (DASH) and the test Closed Kinetic Chain Upper Extremity Stability (CKCUES). To verify the distribution of data, the Shapiro-Wilk test was used, for comparisons between groups, the t test was used. The sample consisted of 47 women: mastectomy group (n=24) and conservative group (n=23). The groups were similar in terms of anthropometric characteristics, with the body mass index indicating overweight, reduced muscle strength and reduced range of motion in both groups. Furthermore, there was a reduction in functional performance regardless of the type of surgery. Conclusion: the evaluation of the upper limb of women treated for breast cancer must consider all aspects related to functional performance regardless of the type of surgery.
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WESLLEY LIEVERSON NOGUEIRA DO CARMO
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REDE DE APOIO SOCIAL ÀS FAMÍLIAS DE CRIANÇAS COM AUTISMO EM MACAPÁ.
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Data: 20/09/2021
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Autistic Spectrum Disorder is considered a neurodevelopmental disorder characterized by qualitative and quantitative changes in communication, social interaction, isolation, lack of interest in others, and presents itself in different degrees of severity. The current context of autism and its complexity requires advances in the model of care and care provided to families, as with the onset of symptoms, they experience a series of experiences, which cause changes in the routine, affecting the psychological, finances and quality of care. life. The need to establish a support network for these families based on some strategies such as groups, health services and trained professionals, aroused the interest in carrying out this research and justifies its feasibility. The research had as a general objective: to analyze the support networks for the families of children with Autism Spectrum Disorder at a special education school in Macapá. And as specific objectives: to understand the impacts generated by the diagnosis of Autism Spectrum Disorder on the family; describe how families of children with Autism Spectrum Disorder use social support networks and the benefits guaranteed by laws; to map the institutions belonging to the support networks for children with Autistic Spectrum Disorder in Macapá, in order to demonstrate the portrait between what is advocated and the reality found. Methodologically, the research is descriptive with a quanti-qualitative approach such as multiple case studies. The study site was the Educational Center Raimundo Nonato Dias Rodrigues located in the city of Macapá. The sample comprised family members of children aged 4 to 12 years of age, with a defined diagnosis for ASD who were regularly attended at the institution during 2017 and 2018. From a population of 189 students in 2017 and 120 students in 2018, the final sample comprised 19 families (6.14%). The interviews were recorded after approval by the Research Ethics Committee under opinion No. 2,900,834 and the signing of a Free and Informed Consent Form. The results were discussed using content analysis from Bardin's perspective. The interviews were transcribed and organized according to coding and thematic categories were defined for reflective and critical analysis. It was found that the moment of diagnosis by the family is marked by shock and feelings of anguish, sadness, depression, denial and disbelief, in addition to a lack of knowledge about the pathology. In the case of support networks, the one offered by the family nucleus and by the professionals were the most evident in the speeches. It should be noted that the family is the social group that plays a determining role in the development of the child at the affective, cognitive and psychological level and must ally with professionals trained to stimulate the compromised functions in an appropriate manner. Regarding institutional support, the most sought after were: the Raimundo Nonato Dias Rodrigues Educational Center, CAPSi, CREAP and the Sara Kubistcheck chain. However, family members pointed out that only CERNDR offers long-term follow-up for children with ASD and highlighted the numerous difficulties in accessing services both through the Unified Health System and private plans.
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DARLEINE ESTHER JOSEPH
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EPIDEMIOLOGICAL PROFILE OF CHILDREN AND ADOLESCENTS VICTIMS OF VIOLENCE ATTENDED AT THE PUBLIC HOSPITAL OF MACAPÁ FROM 2015 TO 2019
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Data: 17/09/2021
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Violence against children and adolescents is currently configured as a public health problem, considering the various traumas caused in different dimensions of the human being, whether physical, psychological or social, that require different forms of care at all levels of health, such as in the creation of new public policies that allow the identification of risk factors that caused this problem, among them, the creation of new strategies that allow from the complaint to the recovery of the victims' mental health. The purpose of this work is to analyze the epidemiological profile of violence against children and adolescents treated at a public hospital in Macapá between 2015 and 2019. This is a research with a quantitative, descriptive, retrospective and documentary approach, carried out at a public hospital in Macapá. The sample comprises 122 participants between zero and 12 years of age. Among the main results, children and adolescents who have suffered some type of violence are mostly female, aged between zero and 12 years old, are children of separated parents, belong to the lower class, lived in urban areas, and how much the type of violence predominated sexual violence and some were the result of a sexually transmitted infection. it can be deduced that violence causes negative results for its victims, hence the great importance of describing the characteristics of this population so that prevention and follow-up can be found. Keywords: violence; children; adolescents.
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IURI SILVA SENA
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PERFIL EPIDEMIOLÓGICO DE VÍTIMAS DE FEMINICÍDIO NO ESTADO DO AMAPÁ ENTRE OS ANOS DE 2014 A 2018.
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Data: 13/09/2021
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Violence against women is a major public health problem in the world, and its maximum expression is represented by feminicide. Worldwide, in recent years, there has been a high rate in rate of feminicide, with Central America being the place of greatest occurrence. In Brazil, during the last three decades, there was an increase of 100% in the rate of feminicide, an increase from 2.3 / 100,000 to 4.6 / 100,000 women. This research aimed to characterize the epidemiological profile of feminicide cases registered in the State of Amapá from 2014 to 2018. This is an observational, descriptive, retrospective, cross-sectional study with a quantitative approach based on the database of the information service of the Superintendence of Health Surveillance of the Ministry of Health, with data on mortality and the Scientific Police of Amapá, based on death certificates. For inferential analysis, Pearson's chi-square test was performed to assess the association between cause of death by ICD-10 group and epidemiological variables, using the SPSS 26.0 program, with results with p≤0.05 being considered relevant. Although feminicide shows a decreasing trend in the State of Amapá during the study period, the final global corrected crude rate is higher than the national average, with 6.34 deaths per 100,000 women. There was an association between cause of death and age (p = 0.012), between cause of death and city of residence (p = 0.0001), between cause of death and city of occurrence (p = 0.044), between cause of death and place of occurrence of death (p = 0.027), between cause of death and the environment employed, if insidious and cruel (p = 0.001). The epidemiological profile of feminicide was that of a young woman, brown in color, with complete high school education, single, student, resident in the capital, who died in the capital itself in the hospital, without medical assistance, in October, Sunday and Wednesday, in the afternoon and by firearm.
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LORENNA LEAL DE MORAIS SIMOES
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VALIDAÇÃO DA ESCALA DE IDENTIFICAÇÃO DE SINTOMAS PSICOPATOLÓGICOS EM ESCOLARES (EISPE) PELO MODELO RASCH: um estudo no estado do Amapá
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Orientador : MARIA IZABEL CORTES VOLPE
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Data: 13/09/2021
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Brazilian EISPE scale, aiming to measure its psychometric properties in schoolchildren using the Rasch model. Method: This was a methodological study with a psychometric approach. Data collection took place from 2015 to 2019, and was carried out in state elementary schools in six municipalities in the state of Amapá, including the Capital Macapá, Ferreira Gomes, Santana, Mazagão, Calçoene and Oiapoque, and the final sample consisted of 1186 children from 6 to 12 years old regularly enrolled. Initially, a sociodemographic questionnaire was applied, followed by EISPE. Data were stored in Excel and then psychometric analysis was performed using the Rasch model. A principal component analysis was also performed to verify the dimensionality of the scale and the R Studio software for Windows was used for data analysis, using the “Extended Rasch Model” – ERM package. Results: Through exploratory factor analysis using principal component analysis with Varimax rotation, it was identified that the EISPE structure for the studied sample is unifactorial. The mean square results of the item analysis concentrated the infit and outfit values between 0.73 and 1.334, indicating that all items are productive for scale and none distorts the measure. Through the analysis of the map of people and items, we verified the dispersion of scale items along the latent severity measure, demonstrating that the items differentiate people in a balanced way. In addition, there is no repetition of items in the levels, suggesting that there is no redundancy in the measure of the scale, which is capable of adequately differentiating individuals according to the Rasch. Conclusion: The results of this study show that the EISPE is valid, contemplates a wide spectrum of psychopathological symptoms in schoolchildren, without redundancy, which configures it as a valuable tool for epidemiological analysis of the mental health of children and adolescents in Brazil.
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GERCIANE CARDOSO EMILIANO ALVES
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AVALIAÇÃO DE INTERAÇÕES MEDICAMENTOSAS POTENCIAIS EM PACIENTES IDOSOS DE UM HOSPITAL PÚBLICO NO AMAPÁ
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Data: 02/09/2021
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A interação medicamentosa potencial (IMP) define a possibilidade de ocorrência da interação entre dois fármacos ou entre um fármaco e um nutriente. O risco de interação é proporcional ao número de fármacos prescritos para um paciente, e se esse paciente está hospitalizado, os riscos aumentam com a politerapia, o que torna a população idosa mais suscetível a ocorrência de IMP. O objetivo principal do presente estudo é avaliar as interações medicamentosas potenciais em prescrições de pacientes idosos hospitalizados na Clínica Médica Masculina e Feminina do Hospital de Clínicas Dr. Alberto Lima, em Macapá-AP, nos anos de 2016 a 2018. A pesquisa compreende um estudo retrospectivo, observacional de caráter descritivo, a ser realizado por meio da análise dos prontuários e prescrições de pacientes com idade igual ou superior a 60 anos internados no referido hospital, durante os anos definidos para o estudo. Através de um formulário foram coletados, de todos os pacientes que atendiam aos critérios de inclusão, dados como nome, gênero, idade, comorbidades, diagnóstico principal (descrito no resumo de alta), tempo de internação, nome dos medicamentos, vias de administração, grupo farmacológico dos medicamentos prescritos, intervalo de administração e duração do tratamento farmacológico. Os dados obtidos dos prontuários e prescrições médicas foram tabulados para banco de dados Excel, separados em planilhas. A identificação e caracterização das interações medicamentosas foi realizada através do softwer Micromedex®, onde foi possível determinar e classificar as interações medicamentosas de acordo com a gravidade, início da reação e documentação existente. Com base nas monografias encontradas nas bases de dados ScienceDirect, PubMed Medline, Web of Science, SciELO e LILACS, as interações medicamentosas foram classificadas de acordo com o mecanismo provável e relevância clínica. Para a análise estatística dos dados coletados foi organizada uma análise descritiva construindo tabelas com as distribuições de frequências e porcentagens. Para análise de tempo de internação, número de medicamentos, número de interações e número de interações graves, os pacientes foram separados em dois grupos: idosos com idade entre 60 e 75 anos (Grupo 1) e idosos com idade igual ou superior a 76 anos (Grupo 2). A soma de postos de Wilcoxon foi utilizada para comparação. Utilizou-se o teste exato de Fisher para verificar associação entre os grupos e as variáveis gênero e comorbidades. O teste qui-quadrado foi utilizado para associação com o diagnóstico. Foi empregada a análise de regressão logística multivariada, para determinar os fatores associados à exposição à interação medicamentosa potencial. Também utilizou-se a análise de regressão logística multivariada, para determinar os fatores associados a exposição à interação medicamentosa potencial grave. O nível de confiança adotado para todas as análises foi 95%. A pesquisa foi desenvolvida respeitando-se todos os princípios éticos constantes da Resolução do Conselho Nacional de Saúde nº 466/12 sobre estudo envolvendo seres humanos.
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CAIO RODRIGUES TELLES
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AVALIAÇÃO DA CONTAMINAÇÃO POR MINÉRIOS EM MORADORES HOMENS DO BAIRRO ELESBÃO NO MUNICÍPIO DE SANTANA-AP
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Orientador : MADSON RALIDE FONSECA GOMES
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Data: 18/08/2021
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The impact caused by pollution to the environment is much studied worldwide, making it necessary to know the effects of the interaction of these pollutants *Dados obrigatórios para cadastro no sistema. produced by man, nature and human health. Among them are the metals that, launched to nature, contribute to alter the natural bioavailability of the same, causing physical, biological and socioeconomic impacts, since they are toxic presenting risks and damages to human health, local flora and fauna. Not all metals cause harm to human and animal health, unlike what is common among popular thinking. The investigation of populations exposed to environmental risks has taken place in several areas. The use of methodologies in clinical analysis to monitor humans exposed to potential toxic materials has been an efficient warning system for pathologies. The results show that there is no risk for the population evaluated until the strong correlation between the exposure to the chemical agent and the higher incidence of a particular disease, including genetic alterations and cancer. . In the literature there are several ways to refer to these "elements", for example, toxic metals, trace metals, trace elements and also trace constituents. These synonyms refer to elements of high toxicological potential and associated with pollution. As a result of the valorization of Mn ore mines in the Serra do Navio, in addition to its dispersion, the closure of the Mn industrial exploitation left an environmental problem as yet unaltered in its fullness. One expression of this liability was the detection of groundwater contamination in the port area in Santana, as well as water courses in the vicinity of that area.
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ADERALDO VIEGAS DA SILVA
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SIMULATED DETECTION OF BIOLOGICAL TRACES (BLOOD AND SEMEN) IN MATERIALS PRESENT IN DOMESTIC SEX CRIME SCENE
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Data: 16/08/2021
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Introduction: Crimes against sexual dignity have been a major problem in society for decades. Rape, one of these criminal modalities, has the highest incidence of female victims, victimizing different age groups and nations around the world. In Brazil, an annual average of half a million rape cases is estimated to be spread heterogeneously across the nation's territory. Forensic science is the branch of science that takes care of the investigation and application of the scientific method to elucidate the facts that permeate a criminal act, having in the expert's figure the central entity in the conduct and collection of evidence. Molecular biology techniques and methods of identifying human traces are extremely important for a sexual crime to be resolved, so that its outcome is the identification of the aggressor and the application of the appropriate penalty. Objective: to observe the influence of tissue types on trace samples of human semen as well as the feasibility of these samples to be subjected to molecular biology procedures for DNA extraction and quantification. Methodology: this is a descriptive, quantitative and experimental study, aiming at data collection through laboratory monitoring experiments. Semen samples were obtained through donation from participants willing to collaborate with the conduct of the study and the fabrics used to simulate the traces were clothes obtained through donation, 10 clothes being separated, 5 male and 5 female. The biological samples were processed using automated DNA extraction techniques with the Maxwell RSC Instrument equipment and quantified by RT-PCR with the aid of the QuantStudio 5 ™ equipment. As a presumptive test, the BiotesT® Quanti-Quali MedTest PSA immunochromatographic test was administered, a test designed to detect specific prostate antigen in the blood. Results: the PSA test applied as a presumptive test (orientation) was positive in 50 tests administered over 36 days of the spots, with an interval of one week between each test. DNA quantification proved to be efficient and applicable to tissues, demonstrating that molecular techniques that use automated extraction are applicable, have high sensitivity and low chances of contamination of samples by external DNA. Key-word: Forensic science; DNA; Biological evidence
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EDUARDA EMANUELLE DA SILVA PENA
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CARACTERIZAÇÃO DA VARIABIALIDADE GENÉTICA EM POPULAÇÃO REMANESCENTE DE QUILOMBO NO ESTADO DO AMAPÁ.
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Orientador : RAFAEL LIMA RESQUE
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Data: 28/07/2021
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Due to the migratory processes of past centuries the genetic flow in divergent populations was intense, resulting in a widely mixed population, mainly in Brazil. Brazilian miscegenation was based on the interaction of three main ethnic groups: Amerindians, Africans and Europeans. One way to understand how this gene mix came about is through genetic studies of ancestry. Studies on ancestry are extremely important to support historical and demographic facts and to know the origin of each current population. There are several ways to study genetic ancestry, among them, the study of ancestral lineages through genetic markers present on the Y chromosome, for paternal lineages; and in the mitochondrial genome, for maternal lineages. Genetic markers in these regions, especially SNPs, are passed almost unchanged among offspring, enabling the study of parental lineages in a population. The present work aims to characterize the genetic variation of paternal and maternal lineages in remnant quilombo population in the community of Curiaú, Macapá, Amapá. Seeking to define ancestry and interethnic mixtures through SNP genotyping technique. Samples of both sexes, over 18 years old and community residents are being collected.
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ILDILANE SUELEM RODRIGUES CARVALHO
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PEDIATRIC ONCOLOGICAL PATIENT AND THE MORAL SUFFERING OF THE NURSING TEAM: EXPERIENCES EXPERIENCED IN AN INTENSIVE CARE UNIT
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Orientador : SILVANA RODRIGUES DA SILVA
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Data: 22/07/2021
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Childhood cancer, which affects children and adolescents between 0 and 19 years, represents 1% and 3% of all malignant tumors in most populations, where it has been the leading cause of death (8% of the total) of the disease in this age group, the large number of long hospitalizations being notorious and consecutively, increasing the forms, qualities and abilities of providing care to this being. The objective was to understand the experiences lived by nursing professionals when providing care to pediatric cancer patients in an intensive care unit and its relationship with moral distress. This is an exploratory, descriptive research with a qualitative approach. Twenty-two nursing professionals, working in the Intensive Care Unit of the Children and Adolescent Hospital, located in the city of Macapá, participated in the study. For data collection, a questionnaire with semi-structured questions was applied to characterize the subjects, and interviews were carried out remotely, subsequently, and recorded with their authorization. Data analysis was performed with the support of the IRAMUTEC software and analyzed by the technique of Descending Hierarchical Classification, Similarity Analysis and Word Cloud, which were grouped and organized graphically according to lexical frequency. The words that had the highest frequency were: words "child", "care", "feel", "impotence", "resource", sadness. It was found that the care of pediatric cancer patients generates sadness, and lack of material and human resources, lead to a feeling of impotence, referring to the Moral Suffering of the subjects involved in the care. In this sense, it emphasizes the importance of investments in resources, materials, as well as research on this subject, contributing to the mitigation of moral suffering.
KEYWORDS: Psychological stress. Oncology. Pediatrics
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ISRAEL GONÇALVES DOS SANTOS
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LARVICIDE AND ADULTICID ACTIVITY OF THE GROSS ETHANOLIC EXTRACT FROM Deguelia rufescens var. urucu (Ducke) AM AZEVEDO IN Aedes (Stegomyia) aegypti (Linnaeus, 1762) (DIPTERA: CULICIDAE)
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Data: 02/07/2021
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This study evaluated the activity of crude ethanol extracts from the roots of Deguelia rufescens var. urucu (Fabaceae), a plant popularly known as “red timbó”, in the Amazon region, used in fisheries by indigenous people, due to a chemical substance called rotenone found in its roots. Larvicidal activity was evaluated against Aedes aegypti. The D. rufescens var.urucu roots were collected in Ilha Grande community (N 0º 16’ 49.2" W 50º 55’ 39.6"). The plant material was subjected to an extraction process by exhaustive maceration using commercial ethanol as the solvent. From a standard solution of 10,000 parts per million, tests were prepared in different solutions (10 ppm, 20 ppm, 30 ppm and 40 ppm) of the crude extract. Assays performed with crude ethanol extracts from D. rufescens Var. urucu showed larvicidal activity, concentrations of 40 ppm showed 100% mortality and the lowest concentrations of 20 ppm and 30 ppm resulted in mortality above 50% within 24 hours of exposure. The results showed that A. aegypti larvae were susceptible to CL50=23,14-CL90=43,34 ppm em 24h e CL50=12,53-CL90=26, 92 ppm in 48 hours. In adulticidal assays, the average percentage of Mortality (%) of adult individuals of A. aegypti submitted to different concentrations of the crude extract of D. rufescens var. urucu ranged from 10% to 96.25%. Lethal concentrations were estimated at CL50= 46,69 ppm (37,45 - 58,96) and CL90= 94,4 ppm (76,2 - 127,6) and their respective confidence intervals with the lower and upper limits, showing an activity that is toxic to adults of A. aegypti. Thus, the Ethanol Extract of D.rufescens var. urucu can be used as a larvicide against A. aegypti. Keywords: Dengue fever. Deguelia rufescens var. urucu. Larvae. Rotenone
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HUGO ANTONIO RIBEIRO DE SOUSA
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FEASIBILITY OF IMPLEMENTING AN OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE/ECOE) IN THE MORPHOFUNCTIONAL AXIS OF THE COURSE OF MEDICINE AT THE FEDERAL UNIVERSITY OF AMAPÁ
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Orientador : MAIRA TIYOMI SACATA TONGU NAZIMA
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Data: 30/06/2021
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The National Curricular Guidelines for the Undergraduate Medicine Course give greater autonomy to Higher Education Institutions, the Medicine courses, aim to build education that is geared to the health needs of the population, the public health system and to improve as its peculiarities. The adoption of active methodologies refers to teaching by skills, which should develop in the student the ability to recognize knowledge, attitudes and skills to be able to deal with real life situations, dilemmas and problems. Thus, student assessment becomes a fundamental part of this teaching-learning process. Knowledge about evaluation methods is an important teaching tool. A qualitative participatory study was carried out, which carried out the evaluation application through the Structured Objective Clinical Examination (OSCE / ECOE) to study the feasibility of its application for the Morphofunctional axis (basic cycle) of the Medicine course at the Federal University of Amapá, in order to exercise the clinical application of the content offered by these teachers of basic subjects, not accustomed to thinking about practical clinical situations, strengthening clinical reasoning since the beginning of the course. We chose to use the data collection technique called the Focus Group, to assess the perceptions about OSCE / ECOE by teachers and students who participated in the study. Categories were built, and separated into subcategories, between Positive points, Negative points and Proposed changes on the OSCE / ECOE. The evaluation was well accepted by the students who participated in the study, even though the positive points obtained the highest percentage of citations, there was a significant amount of citations in the negative points and proposed changes, in the positive points the main ones were about the relationship between the basic chairs and the medical clinic and emotional state, in the negative points about the lack of skill with the test and the waiting before it, the literature shows similar perceptions in this type of evaluation. In the teaching group, the percentage of citations for the positive points was more than double in relation to the negative points and more than triple for the proposed changes. In this group, the test was considered to have good potential for use, and it helps in the emotional state of the students, as positive points, whereas in the negative points it was considered a difficult assessment to organize / apply and prepare the clinical stations. The teachers' perceptions produced more negative categories, but the acceptability of this assessment was proportionally greater in this group.
Keywords: Medical education, assessment, problem-based learning.
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CAROLINE DE FATIMA RIBEIRO SILVA
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SHORT PHYSICAL PERFORMANCE BATTERY COMO PREDITORA DE MORTALIDADE EM IDOSOS DA COMUNIDADE
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Data: 22/06/2021
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The Short Physical Performance Battery (SPPB) is a scale widely used in research with elderly people in various scenarios at the international and national levels. The scientific literature has mentioned the association of SPPB with adverse health outcomes, however, the predictive capacity of this instrument for the outcome of mortality is not well established among studies, and there is a limitation of studies in Brazil. The present study aimed to analyze the accuracy of SPPB to predict mortality among community dwelling elderly. Observational study, with longitudinal design (2017-2020), which used data from previous research (baseline 2017, n = 411), conducted with elderly people living in the urban area of the city of Macapá-AP, in which socioeconomic, clinical and health variables, physical performance by SPPB and mortality were collected. The predictive capacity of SPPB was established through multivariate Cox regression analysis, with death as the outcome. In addition, survival analysis was performed using the Kaplan-Meier method, considering a 95% confidence interval and a 5% significance level (p <0.05), using the Statistical Package for Social Sciences Program (SPSS), version 25.0. To determine the cutoff points to discriminate mortality, Receiver Operating Characteristic (ROC) curves were constructed, with the area under the curve (AUC) parameters, using the MedCalc program, version 11.4.4. During the follow-up of the study (2017-2020), 34 (8.3%) deaths and 336 (81.8%) survivors were found among the elderly in the community. The adjusted multivariate Cox regression model pointed to the SPPB score as a predictor of mortality (hazard ratio, HR = 0.72; confidence interval, 95% CI: 0.59-0.88). In addition, elderly people with very poor and low physical performance in SPPB had higher risks for mortality (HR = 9.67; 95% CI: 1.20-77.65; HR = 4.06; 95% CI: 1.09-15, 01), respectively. The Kaplan-Meier survival curves indicated that elderly people with the worst performance levels on the SPPB scale had a lower probability of survival compared to the elderly people with better performance levels. The analysis of the area under the ROC curve for men was 0.655 (95% CI: 0.57-0.74; p = 0.044) and for women it was 0.667 (95% CI: 0.60-0.73; p = 0.029). The cutoff point ≤ 9 on the SPPB scale configured a discriminatory criterion of mortality in elderly men and women.
Keywords: Elderly, Health of the Elderly, Health Status, Longitudinal Studies, Mortality, Survival Analysis.
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MICHELE DE SOUZA PONTES OLIVEIRA
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REAÇÕES VASOVAGAIS EM DOADORES DE SANGUE TOTAL: CENÁRIO DE UM ESTADO DA AMAZÔNIA BRASILEIRA
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Data: 09/06/2021
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In Brazil, little is known about the vasovagal reactions associated with blood donation, including the rates, severity and characteristics of donors. This study is a pioneer in the state of Amapá, a state in the Brazilian Amazon that has only one blood center, the Institute of Hematology and Hemotherapy of Amapá - HEMOAP, an exclusive supplier of blood components for all hospitals in the health network. Although blood donation is recognized as a very safe procedure, reactions of varying severity may occasionally occur during or after collection. It was proposed to assess the frequency and factors associated with vasovagal reactions in whole blood donors and to suggest practices that would help to minimize them. Through a descriptive, documentary, cross-sectional retrospective study of the records of reactions occurring between 2014 and 2018, an index of vasovagal reactions above the literature in general was found, averaging 3.1%, with variation between 2.4% and 3.8%; with a predominance of mild reactions (90.2%), more frequent in women (54.4%), aged between 30 and 40 years (33.8%). A statistically significant association was identified between milder reactions and a lower BMI, between higher VES and less severe reactions and between greater SBP and DBP and less severe reactions; in addition to milder reactions in individuals with lower HR, but without statistical relevance, and absence of a relationship between hematocrit rate and VVRs. First-time donors (63%) and those who made targeted donations (70%) experienced more VVRs. Statistically significant relationships were also identified between prolonged fasting and poor hydration and the occurrence of reactions. It was concluded that the profile of VVRs in donors of whole blood in the Hemotherapy Center of Amapá is similar to that identified in the literature, in most of the evaluated parameters.
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GENILSON DE ALMEIDA JENNINGS
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Avaliação do uso de programa de atividades físicas com exergames na qualidade de vida de pessoas com baixa visão do estado do Amapá – região da Amazônia legal
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Data: 31/05/2021
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The use of exergames allows physical interaction with the users and are configured as a valuable technological tool to be explored to improve the quality of life of low vision people. Objective: to evaluate the perception of the quality of life through the WHOQOL bref questionnaire in low vision people, before and after participating in a physical activity program with Exergames such as their perceived effects after these activities. Methods: in relation to quantitative data, the characterization of the sample involved statistical analysis by the absolute and relative frequencies of categorical variables; central tendency and dispersion measures; paired t-test; Wilcoxon test; Shapiro-Wilk test; Spearman correlation; Anova test and the Kruskal Wallis and MannWhitney tests. The software used for this was R (version 3.6.0). The Focus Group technique was used as a qualitative tool for investigating perceptions in relation to applied activities. The analysis of the collected content took place using the technique of Bardin (2012) with the aid of the software ATLAS.ti 7.5.16. Results: Regarding the effects perceived by the group, benefits, difficulties, physical and psychological motivations, in social and environmental relations and differences in relation to other physical activities could be described as characteristics of this practice. Regarding the comparison of the domains before and after the practice of Exergames, an increase in the averages was observed with a considerable predominance of the physique. When correlating the sociodemographic and clinical variables with the domains, it was found: the higher the family income, the greater the psychological domain; positive correlation with family income and negative correlation with age and education; greater increase in the social domain of those who declared higher family income; females tend to have a higher average than males in the environmental domain; the physical domain was greater in people who have a family arrangement with partners and children and people with benefits showed an increase in the environmental domain after the practice of Exergames. Regarding the general quality of life, it was higher in women and the psychological domain was higher in teachers. Conclusion: the practice of physical activity with Exergames using the Wii Fit Plus game, performed twice a week for 50 minutes, for 12 sessions provided an improvement in the quality of life perceived in the physical, psychological, social relations and the environment in people with low vision over 12 years of age pointing to the need for continued environmental intervention through multiprofessional work to monitor these people. Keywords: Low vision. Quality of life. Exergames
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DARLENE PANDILHA DE LIMA
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CARACTERIZAÇÃO DAS PLANTAS MEDICINAIS E DAS PRÁTICAS UTILIZADAS EM ACIDENTES OFÍDICOS EM COMUNIDADES RIBEIRINHAS
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Data: 13/05/2021
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The snake-like accident is the picture of poisoning resulting from the injection of a mixture of toxins (raw poison or venom) through the snake inoculating apparatus. Ophidian accidents are considered a public health problem due to the incidence and intensity with which venomous animals act on human organisms, constituting the list of neglected tropical diseases. In Brazil, about 28,000 snakebites occur annually. The occurrence is related to climatic factors and increased human activity in field work. In the Amazon, socio-environmental factors such as hot and rainy weather, vegetation, rural housing and the urbanization process in peripheral areas of cities, are directly related to the considerable rates of snakebites. The problem is exacerbated by the long distances between the accident sites and medical care. For this reason, popular knowledge has been disseminated and practiced in snake accidents, in which, the use of medicinal plants, as adjuvants to serotherapy or as an alternative medicine is applied in the absence of serotherapy resources. The present study aimed to characterize the use of medicinal plants and the practices used in snakebites in riverside communities in the Municipality of Afuá-Pará (Maracujá Island, constituted by Furo do Maracujá, Riozinho and Canal do Vieirinha). It was held in a riverside community located on Ilha do Maracujá (Furo do Maracujá, Riozinho and Canal do Vieirinha), belonging to the municipality of Afuá-Pará-Brazil. The type of sampling used was snowball, that is, non-probabilistic sampling, which uses chains of reference, when it is not possible to determine the probability of selecting each participant in the research, useful groups that are difficult to access. A key informant was selected in the community for the start of the interviews, which helped to locate a total of 50 participants. When asked about the type of snake that caused the accident 82% said it was a jararaca (of the genus Bothrops sp.), Belonging to the family Viperidae. Regarding the anatomical region, most individuals had the lower limbs as the most affected region. Of the plant species used in the face of snakebites, the following were cited: Anacardium occidentale L., Annona muricata L., Manihot tripartita (Spreng.) Müll. Arg., Piper Peltatum L., Genipa americana L., identified by the herbarium of the Institute of Scientific and Technological Research of the State of Amapá. As for the most used methods in the face of snakebites, urine with clay was mentioned in the community of Furo do Maracujá; Specific Person in the community of Vieirinha and in the community of Riozinho. The riverside inhabitants maintain “homemade pharmacies”, supplied with herbal medicines; clay and stone containers; animal fat and bones; roots, bark, leaves, nuts and oils extracted from plant species in the Amazon. The knowledge of traditional medicine of the residents of Ilha do Maracujá is rooted in the process of colonization of the place, involving the coming and going of residents by the rivers of the region. Considering the problem caused by snakebite accidents, in distant regions in the Amazon (regarding the speedy treatment of anti-snakebite therapy), it is necessary to continue scientific studies on the biological action of medicinal plants used popularly in the treatment of snakebite accidents, for validation or not of the traditional knowledge of the inhabitants of the island of Maracujá, as well as to encourage bioprospecting research with the mentioned species.
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MAIRA BEATRINE DA ROCHA UCHOA
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NÍVEL DE SOBRECARGA DOS CUIDADORES DE PORTADORES DE ALZHEIMER NA REGIÃO AMAZÔNICA
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Orientador : MARLUCILENA PINHEIRO DA SILVA
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Data: 11/05/2021
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Alzheimer's is the most frequent neurodegenerative disease and affects 8% to 15% of the world population over 65 years. In Brazil, the disease corresponds to more than half of the cases of dementia. The elderly person who has a potential favorable to the loss of functional and / or mental capacities may have total or partial dependence for daily activities, requiring caregivers, who develop care that affects their routine of life and health. Therefore, it is essential to include the caregiver in health planning and actions, so that he can provide dignified care. The objective was to identify the sociodemographic profile of the caregiver of Alzheimer's patients and to evaluate the level of overload of their actions. Quantitative, descriptive and cross-sectional study conducted with 78 caregivers attended at the Neurology Outpatient Clinic of Hospital de Clínicas Dr. Alberto Lima, by the Family Health Teams of the Basic Health Units and participants in the Reviver project of the Federal University of Amapá, located in Macapá, capital of Amapá. Data collection was carried out through face-to-face and remote interviews, using the sociodemographic questionnaires and Zarit Overload Scale, which assesses the level of overload of caregivers and classifies them as overload, moderate, moderate to severe, and severe overload. The data were submitted to the SPSS version 25.0 program for the description of the statistical results, and the Student's T, ANOVA and Chi-square Association tests were applied to compare the effects of the Zarit variable in relation to the variables, the Chi-square Adherence Test was also applied to verify differences in proportions between the categories of the response variable. Of the participants in the study, 67 (85.9%) are women, 40 (51.3%) are single, 48 (61.5%) are self-declared brown, 68 (87.2%) have income, 36 (46, 2%) fixed income, 58 (74.4%) have children, 74 (94.9%) non-smokers, 59 (75.6%) non-alcoholics, 43 (55.1%) practice physical activity, 52 (66.7%) practice leisure, 35 (44.9%) attended high school, and 61 (78.2%) have a profession, 63 (80.8%) took a caregiver course, 32 (41% ) of the participants have 6 months to 2 years as a caregiver, 40 (51.3%) care for more than 18 hours a day, 53 (67.9%) live with the Alzheimer's patient, 71 (91%) are related with the elderly, 67 (85.9%) receive support to care, 72 (92.3%) add other tasks, and 44 (56.4%) caregivers have no disease. The predominant levels of overload were the Moderate and Moderate to Severe categories, and no association was found between the Zarit score and the variables. It was possible to conclude that the sociodemographic factors were decisive for the increase in overload. The study showed the scenario of the characterization of the caregiver in several literature, which addresses the factors previously mentioned being inherent to care and which cause damage in the relationship between the caregiver and the individual being cared for. Keywords: Alzheimer's Disease; Care; Caregiver; Burden.
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LUCAS RODRIGUES DO REGO
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AVALIAÇÃO CITOGENÉTICA DA α, β-AMIRINA OBTIDA NA RESINA DE Protium heptaphylum (Aubl.) Marchand EM ERITRÓCITOS POLICROMÁTICOS DE CAMUNDONGOS SWISS.
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Orientador : MOACIR DE AZEVEDO BENTES MONTEIRO NETO
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Data: 21/04/2021
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Na Amazônia existe um grande poderio de plantas medicinais com os mais variados compostos e atividades, dentre elas podemos destacar a Almecegueira ou Breu Branco (Protium heptaphylum), uma planta encontrada na Amazônia, produtora de uma resina branco esverdeada que endurece em contato com o ar, popularmente utilizada por seus efeitos gastroprotetivos e anti-inflamatório. Na literatura encontram-se alguns metabólitos secundários obtidos através da resina de P. heptaphylum, entre eles uma parte considerável é uma mistura triterpenica de α e β amirina de onde podem-se obter uma série de derivados como formiato, acetato, benzoato e cinamato. O objetivo geral desde estudo é avaliar o potencial genotóxico e antigenotóxico em da mistura α, β-amirina obtida na resina de P. heptaphylum utilizando teste de micronúcleo em camundongos Swiss, administrando os animais com as dosagens 10mg/Kg, 3mg/Kg e 1mg/Kg, diluídas em DMSO 5%, e observando seus efeitos em esfregaços sanguíneos em 24h e 48h após o tratamento. Constatou-se que a administração dos compostos não ocasionou genotoxidade em 24h e 48h, em contrapartida antigenotoxidade foi, para as concentrações 10; 3 e 1mg/kg, respectivamente 67%; 12%; 10% em 24h e 73%; 15%; 9% em 48h.
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DERLANE GAIA BARROSO NASCIMENTO
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ALTERAÇÕES ELETROCARDIOGRÁFICAS EM PACIENTES COM INFECÇÃO RENAL CRÔNICA BASEADO NA ANÁLISE DOS COMPONENTES PRINCIPAIS
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Data: 14/04/2021
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ABSTRACT The study aimed to investigate changes in ECG parameters in patients with CKD based on Principal Component Analysis (PCA). This is a study with a quantitative descriptive and cross-sectional approach with the participation of 25 volunteer men aged 36 to 80 years with the diagnosis of CKD with stage 5, selected randomly from the Hospital of the Nephrology Unit in Macapá (AP). For data collection, anthropometric data (weight, height and BMI calculation), hemodynamic data (blood pressure) and ECG parameters (standing out IRR, IPR, QTc) in patients at rest were analyzed to analyze possible changes in electrocardiographic findings and the use of the biplot chart, to understand the importance of each electrocardiographic finding in a patient with CKD. The statistical analysis was performed using the Shapiro-Wilk test, the descriptive analysis was divided into quantitative and qualitative. The qualitative analysis was expressed as a percentage and the quantitative was expressed as a measure of central tendency by the mean and a measure of sample dispersion by the standard deviation. The analysis of the post hoc sampling effect determined the strength of the sample size and the bootstrap was performed to estimate statistics of the ECG parameters in a population based on 1000 samples defined in bias and the confidence intervals. After programming the ACP, the Bartelett Test of Spherecity test was performed in order to verify whether there is a sufficiently strong correlation for the analysis to be applied and the Kaiser-Meyer-Olklincom test in order to measure the use of ACP for the respective database. Subsequently, the Broken Stick test criteria were used to choose the PCs relevant to the analysis. The first two main components were the most representative with 96.8% of the total variance explained by the original variables. CKD was associated with the IRR parameter (used to measure two consecutive heartbeats) with a greater contribution to the first main component (PC1: 0.998 and PC2: -0.040) and the iPR (marks the beginning of the P wave and the beginning of the QRS complex) and QTc (describes the contraction time of the ventricle) resulted in greater contributions to the second main component (PC1: 0.062 e PC2: -0.562 and PC1: -0.005 and PC2: 0.813, respectively), demonstrating the most important parameters in CKD. As for sociodemographic data, SAH was the predominant comorbidity, more than 50% do not do physical activity, have incomplete elementary education and monthly income below one minimum wage. Results of ECG findings in patients with CRF with complications of arterial hypertension, the presence of tachycardia, increased left ventricular hypertrophy, diastolic dysfunction, atrial fibrillation and increased dispersion of the PR, QT and RR interval. In conclusion, ECG findings in patients with CKD are mainly caused by a reduction in the RR interval and the prolongation of the QTc interval, mainly due to increased activation of the sympathetic nervous system and decreased parasympathetic activity, vagal reduction of the autonomic nervous system. Key words: Chronic Renal Insufficiency, Electrocardiogram with prolonged QT, Cardiac Arrhythmia, Electrocardiography.
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LEILSON DA SILVA LIMA
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TRANSLAÇÃO DO CONHECIMENTO BASEADO EM EVIDÊNCIAS CIENTÍFICAS PARA MELHORAR A PRÁTICA CLÍNICA DE OBSTETRAS
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Data: 12/04/2021
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Mostrar Resumo
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The predominant model of childbirth assistance in Brazil is characterized by the abusive or inappropriate use of obstetric interventions in all clinical periods of childbirth. It is known that these interventions can be prevented or reduced with the adoption of practices advocated by the National Guidelines for Assistance to Childbirth of the Ministry of Health. This document is subsidized by the World Health Organization, however, in our reality, most obstetric practices do not follows these recommendations. The study aimed to evaluate the effectiveness of educational interventions based on scientific evidence to improve the clinical practice of obstetricians. This is a longitudinal, quasi-experimental study with nurses and doctors who work in childbirth care at the Hospital Estadual de Santana, Amapá, Brazil, where 21 structured interviews were carried out in the pre and post-audit, in addition to educational interventions with “audit and feedback” and “clinical practice guidelines” recommended by Cochrane collaboration to bring about changes in the behavior of healthcare professionals. In the interviews, a structured questionnaire with 29 questions and five answer options on a Likert scale was used, ranging from “never” to “always”, with a score from 1 to 5. In addition, 12 printed banners in the form of stickers, measuring 120 x 90 centimeters, were fixed at the maternity reception and in the two delivery rooms to reinforce the professionals to those recommendations of the clinical practice guidelines. The study was carried out in three phases: pre-audit and (phase 1); implementation of practices (phase 2, which corresponds to educational interventions); post-audit (phase 3). The data were described and analyzed in a descriptive and inferential way through the average ranking and total average ranking of the Likert scale (by comparing the results of steps 1 and 3), with a significance level of 5%. The study was approved by the Research Ethics Committee of the Federal University of Amapá under opinion No. 2,853,419. The findings show that in relation to obstetric practices, and according to the average ranking of the Likert scale, there was a significant increase in the proportion of professionals who recommend or perform the perineal suture with absorbable synthetic thread (p = 0.003) and the warm compress technique in the perineum (p = 0.031). Regarding obstetric interventions, proportionally, there was a reduction in the number of professionals who recommend or perform the Kristeller maneuver in childbirth, with a statistical difference (p = 0.023). In the analysis of the total average ranking, there was an increase in the proportion of professionals in favor of recommending or performing obstetric practices, after the exposure of the banners, in the comparison between phases 1 and 3, however, without significant statistical difference (p = 0.230) and reduction proportion of professionals recommending or performing unnecessary obstetric interventions, with statistical difference (p = 0.024), between phases 1 and 3. It is concluded that educational interventions provided improvements in the professionals' practice. We suggest new research with educational intervention strategies that include multifaceted approaches to improve the quality of evidence-based care in childbirth care. KEYWORDS: Labor and Delivery. Normal birth. Clinical Audit. Translational Medical Research.
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TASSIA REMIGIO VIEIRA
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OBTENÇÃO DE UMA NANO-EMULSÃO A PARTIR DOS FRUTOS DE Chrysobalamus icaco L. (AJURU)
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Data: 05/04/2021
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O fruto do ajurú (Chrysobalanus icaco L) é consumido como alimento em algumas regiões do Brasil e foi objeto de estudos relacionados a suas propriedades funcionais e atividades biológicas. Contudo, estudos relacionados ao desenvolvimento de produtos inovadores com o aproveitamento dos frutos em sua totalidade são escassos. Nesse contexto, o presente trabalho tem por objetivo obter de uma nano-emulsão a partir dos frutos do ajurú (Chrysobalanus icaco L.). O extrato hidroetanólico (EH) dos frutos foi obtido por turbolização dos frutos inteiros e o solvente evaporado até obtenção do extrato mole. As sementes despolpadas durante o processo extrativo tiveram sua fração lipofílica (FL) extraída em aparato de Soxhlet. A FL teve o seu equilíbrio hidrófilo-lipófilo requerido (EHLr) determinado através da utilização de diferentes pares de tensoativos não iônicos, sendo atribuído um valor em torno de 14 (polisorbato 80/monooleato de sorbitano). O EH será submetido a purificação utilizando-se cromatografia em coluna empacotada com Amberlite XAD-2 para obtenção da fração enriquecida em flavonoides, que serão adicionados na FL para obtenção da fase oleosa das nano-emulsões. A preparação das nano-emulsão será feita por técnica de baixo aporte de energia pela técnica de inversão de fases sob temperatura constante e com variação de composição, mediante adição titrimétrica de água sobre a fase oleosa contendo FL e tensoativos não-iônicos no EHLr previamente determinado. Espera-se com esse estudo gerar um sistema inovador de vetorização dos flavonóides presentes em frutos de ajuru utilizando como fase interna a fração lipofílica oriunda da própria matéria-prima vegetal, contribuindo também para o estado da arte da nanobiotecnologia fitofarmacêutica.
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VANESSA DA SILVA OLIVEIRA
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QUALIDADE DE VIDA DAS MULHERES SUBMETIDAS À MASTECTOMIA EM UMA CIDADE DA REGIÃO NORTE DO BRASIL
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Data: 17/03/2021
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Mostrar Resumo
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Breast cancer is associated with numerous repercussions in the woman's life, from diagnosis to post-treatment, affecting an organ full of meanings. The purpose of this investigation is to evaluate the quality of life (QOL) of women with breast cancer who underwent mastectomy and to correlate it with the sociodemographic and clinical profile. Descriptive, documentary, transversal and quantitative study. The population consisted of 57 women attended at the High Complexity Unit in Oncology of Macapá-Amapá, from 2014 to 2018. The questionnaires QLQ-C30 and QLQ-BR23 were used at the interviewees' homes. For data analysis, the Statistical Package for Social Science (SPSS), version 24 Windows was used. The participants had an average age of 52.4 years, with a predominance of 82.5% of mixed race, 57.9% Catholic and 36.8% high school education, with the majority (49.4%) from the State of Amapá. As for the economic situation, 35.1% lived on two minimum wages, 57.9% did not work and 59.6% received Social Security benefits. With partners, they were 56.1%, and 75.5% had two or more children. 54.4% lived in residences with three or four people. The predominant type of surgery was total mastectomy, with 64.9% and lymphodectomy 70.1%. The average time to perform the surgery was two years and one month and the therapy most associated with the surgery was chemotherapy (73.6%), however, 82.5% did not undergo breast reconstruction. Multiprofessional follow-up: 71.9% were assisted by a nutritionist, 57.9% psychologist and 84.2% physiotherapist. QL characterization: in the QLQ-C30 instrument, there was a moderate global QOL of 62.3 ± (19.6). Most affected domains: performance of functions 55.6 ± (31.2), emotional function 61.3 ± (32.4) and cognitive function (62). Most common symptoms: financial difficulties, due to 64.9 ± (33.6), pain 38.6 ± (28.2) and fatigue 35.1 ± (28.7). In the QLQ-BR23, there was a decrease in sexual function 21.1 ± (21.5), sexual satisfaction 42 ± (23.7) and prospects for the future 49.1 ± (37.3), indicating a tendency towards QoL impairment. The symptom scale was low, the most common were hair loss 34.7 ± (33.3) and symptoms in the breasts 33.5 ± (30.0). Young mastectomized women had worse scores on the functional scale related to body image (p: 0.004); there was a significant association of women with a partner and sexual function (p = 0.024), with a tendency for better QOL for those without a partner, and the financial toxicity caused by the treatment was greater among women with low income (p = 0.004). Quadrandectomy was significantly better in physical functions (p = 0.024) and function performance (p = 0.015), compared to total mastectomy, which presented greater financial difficulties related to treatment (p = 0.006). Women with breast reconstruction had better sexual function (p = 0.028) compared to those who did not perform it. In turn, length of surgery, follow-up with a psychologist and physiotherapist had no significance level. Thus, the participants presented moderate QOL when QLQ-C30 was applied and great compromise in QLQ-BR23, especially in sexuality. Keywords: Quality of life. Breast neoplasm. Mastectomy.
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JOSÉ PEDRO GOMES MOURA
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TERAPIA FOTODINÂMICA NO REPARO DE DEISCÊNCIA DE FERIDA OPERATÓRIA PÓS-CESÁREA: estudo piloto de um ensaio clínico randomizado
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Data: 12/02/2021
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Mostrar Resumo
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Tissue photoactivation techniques can work as therapeutic alternatives to optimize the approach to skin wounds in a hospital environment and are of great value for reducing repair time. Photodynamic Therapy makes cells and microorganisms unfeasible by combining a photoactive substance, light and local oxygen. It can work as a therapeutic alternative to optimize the approach to skin wounds, favoring the reduction of repair time. This investigation aims to evaluate the effectiveness of photodynamic therapy in surgical dehiscence of patients admitted to a public maternity hospital in the Brazilian Amazon. This is a randomized controlled clinical trial, double blind, with a quantitative approach, whose results reports were described based on the statement CONSORT 2010. Twelve participants who presented post-cesarean surgical dehiscences were randomly distributed among group 1 - PDT using on the wounds methylene blue 1% activated by laser 660 nm 90J / cm2 and group 2 - AM, using methylene blue without irradiation. The outcome evaluated was the percentage of reduction in the area of surgical dehiscence. As for the results, G1 - amTFD showed a significant difference between the initial and final areas of the lesions (Wilcoxon p-value = 0.028), which did not occur in G2 - amC (Wilcoxon p-value = 0.225). The comparison of the dehiscence reduction percentages between the two treatments shows a significant difference (p-value = 0.001 Student's t test) between the groups. The study's limitation was the convenience sample, which points to the design of a randomized clinical trial to assess the effectiveness of Photodynamic Therapy for the treatment of surgical dehiscences. It is concluded that the dehiscences treated with PDT showed better clinical evolution compared to the control. Thus, PDT mediated by methylene blue and red laser was effective in tissue repair in surgical dehiscences, in the experimental conditions of this study.
Descriptors: Photochemotherapy. Photosensitizers. Wound healing.
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PAULO PERETTI JUNIOR
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SCREENING FITOQUÍMICO DAS VARIANTES PARAENSE E AMAPAENSE DE Acmella oleracea (L.) R. K. Jansen ATRAVÉS DE UHPLC-ESI-QTOF-MS/MS E AVALIAÇÃO DA ATIVIDADE BACTERICIDA E ANTIBIOFILME FRENTE A Streptococcus mutans.
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Data: 09/02/2021
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Mostrar Resumo
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Introduction: Acmella oleracea (L.) R. K. Jansen, popularly known as Jambu, is a plant widely consumed inthe Brazilian Amazon region. Several pharmacological effects are attributed to them, being used in traditional medicine to treat dental caries and toothache. Objective: Determine the phytochemical profile of the aqueous and ethanolic extracts of the Pará and Amapá variants of Acmella oleracea (L.) R. K. Jansen and evaluate their bactericidal and antibiofilm activity against Streptococcus mutans. Methods: Aqueous extracts of the leaves and ethanolic extracts (70%) of the leaves and stems of the two regional variations were obtained, all were qualified and quantified by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-ESI-QTOF-MS/MS). The minimum inhibitory (MIC) and bactericidal concentration (MBC) using the 96-well plate microdilution method and a biofilm viability test against Streptococcus mutans were performed. Results: The aqueous extracts showed a better overall yield compared to hydroethanolic, the samples of aqueous leaves extract of Amapá (EBA FolAP) and Pará (EBA FolPA) variations obtained an overall yield of 41.1% and 84.8% respectively, values 1.6 and 5.3 times higher than the same plant part in a hydroethanolic solvent. On the other hand, the hydroethanolic solvent ensured a batter spilanthol extraction. The hydroethanolic samples of leaves (EBE FolPA) (99.97%) and stem (EBE CauPA) (98.83%) from Pará, as well as leaves (EBE FolAP) (96,10%) and stem (EBE CauAP) (99,17%) of Amapá regional variation, showed higher spilanthol percentages when compared to EBA FolPA (93,98%) and EBA FolAP (96,10%). The samples with the highest spilanthol concentration (EBE FolPA and EBE CauAP) were selected for antimicrobial assays. Microbiological tests showed that both samples had MIC and MBC of 125 μg/mL against S. mutans. In the antibiofilm assay, the EBE FolPA sample with 4x and 8xMIC concentration, as well as the EBE CauAP sample with 16xMIC concentration obtained a statistically similar inhibition (p<0.05) to chlorhexidine. Conclusion: The EBE FolPA and EBE CauAP samples showed a potent inhibitory and bactericidal activity against S. mutans, in addition to an antibiofilm action similar to chlorhexidine (EBE FolPA sample in 4xMIC concentration). Further analysis of the action of these extracts against intraoral bacterial biofilm is needed, however, this plant can be seen as an affordable and low-cost source of phytopharmaceuticals to act against diseases of the oral cavity, whether in the control of caries or as an adjunct to existing dentifrices. Keywords: Acmella oleracea; Spilanthol; UHPLC, Streptococcus mutans; Dental caries
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