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Wake-up stroke e apneia obstrutiva do sono: um estudo prospectivo sobre a capacidade motora e alterações do sono

Tue, 23 Aug 2016 00:00:00 GMT

Título: Wake-up stroke e apneia obstrutiva do sono: um estudo prospectivo sobre a capacidade motora e alterações do sono Autor(es): Barreto, Pedro Rodrigues Abstract: Wake-up stroke (WUS) defines a cerebrovascular accident (CVA) detected when the individual awakens with symptoms of stroke. About 25% of cases of stroke are WUS. The role that sleep disorders and comorbidities play in these cases is yet to be established. The aim of this study is to evaluate clinical characteristics, changes in sleep-wake cycle and factors that influence the development and severity of symptoms in cases of stroke with and without WUS. This is a longitudinal study of observational nature. Patients with ischemic stroke (N=102), 28.4% with WUS, were evaluated at baseline and after 3 and 12 months. Patients (30-85 years old) were recruited from the stroke care unit of the General Hospital of Fortaleza from 2013 to 2015. We included those that had ischemic stroke in the last 15 days, NIHSS<15, stable clinical condition, and that were able to answer behavior questionnaires. The clinical and demographic characteristics and associated comorbidities were studied. A sleep recording was done with level III polygraph (Stardust® Phillips Respironics) to investigate sleep apnea. An apnea-hypopnea index (AHI)> 20 was considered the cutoff point to define the presence of obstructive sleep apnea (OSA). Questionnaires on functional performance (modified Rankin Scale – MRS), motor skills (modified Barthel Scale –MBS) and sleepiness (Epworth Sleepiness Scale – ESS) were applied. Excessive Daytime Sleepiness (EDS) was defined as an ESS> 10. Prospectiveley, pacients are evaluated (ESS, MRS, MBS) after 3 months and 12 months after the initial evaluation by telephone. In the sample studied (N = 102, 64% male), hypertension (73%), diabetes (29.4), heart disease (16.7%), physical inactivity (69.6%), smoking (32.4%) and alcohol consumption (17.6) were found. In the total sample, AHI (1.20 to 57.3), SpO2 (82-97%) and the desaturation index (5-94). We recorded AHI> 5 (92.9%), AHI> 15 (44.7%), AHI> 20 (35.3%) and AHI> 30 (11.8%) were variable. Cases with and without WUS did not differ regarding clinical and polygraphic characteristics. Type 2 diabetes was associated with WUS (OR = 0.37 CI: 0.15 to 0.92; p = 0.03). Individuals with OSA had higher waist-hip ratios (p = 0.01). Patients with EDS were younger (p = 0.009). The longitudinal evaluation showed no difference in the severity of symptoms in cases with and without WUS. Prospectiveley, cases with OSA evolved with worse functional performance (ERM, p = 0.02). Conclusion: Among patients with ischemic stroke, WUS manifests itself in about 1/3 of cases and it associates with type 2 diabetes. Those with stroke and OSA (AHI> 20) evolve with worse functional performance after one year. Descrição: BARRETO, P. R. Wake-up stroke e apneia obstrutiva do sono: um estudo prospectivo sobre a capacidade motora e alterações do sono. 2016. 74 f. Dissertação (Mestrado em Ciências Médicas) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2016.

Construção e validação de um website educativo para promoção da amamentação e prevenção de hábitos bucais deletérios

Thu, 29 Sep 2016 00:00:00 GMT

Título: Construção e validação de um website educativo para promoção da amamentação e prevenção de hábitos bucais deletérios Autor(es): Batista, Risolinda Rodolfo de Sá Abstract: Breastfeeding has advantages that have been known and diffused in society since the earliest times. It is understood that it can interfere in the quality of life of the child and the family and its absence can lead to emotional, nutritional and cognitive problems, besides stimulating the installation of non-nutritive sucking habits and, consequently, the establishment of dental malocclusion And disturbances in the child's orofacial growth and development. In this sense, the health professional is important for stimulating breastfeeding, since it can prevent early weaning and contribute to improving the health conditions of the child. The aim of this study was to develop and validate an educational website for breastfeeding and oral health, linking technology and health to the benefit of the community. The aim of this study was to promote breastfeeding practices and prevent the establishment of deleterious oral habits. It was a methodological study, which was developed by Falkembach (2005), which is composed of five phases: analysis and planning, modeling, implementation, evaluation and distribution. Therefore, the "Amor Além do Seio" website was created, which presented the following sections and subsections: Home, Breastfeeding (breastfeeding and its benefits, possible difficulties), Oral Health (oral health and breastfeeding, deleterious habits, malocclusion, Oral hygiene) and Learn More. The validation step was performed through the collection of data with six judges of content and three of appearance. The results were evaluated according to the Content Validity Index (CVI), with a cutoff point of 0.80. The website presented IVC content of 0.95 and IVC of appearance of 0.90, being considered approved by the judges. Before the suggestions and contributions, from the validation process, the website has undergone changes in order to make it more attractive and easy to navigate. It is concluded that the educational website "Love Beyond the Breast" becomes a means of disseminating knowledge about breastfeeding and its relationship with the child's orofacial development, stimulating healthier practices alongside the mother-child-family trinomial. Pedagogical and interactive way. In addition, this educational material, reliable and valid, extends the range of action of the Family Health Strategy, expanding the role of the dental surgeon in the area of health education and lifelong education. Descrição: BATISTA, R. R. S. Construção e validação de um website educativo para promoção da amamentação e prevenção de hábitos bucais deletérios. 2016. 195 f. Dissertação (Mestrado em Saúde da Família) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2016.

Conhecimento, atitude e prática das mulheres sobre a prevenção do câncer do colo uterino: um estudo com mulheres do município de Icó, Ceará.

Fri, 23 Sep 2016 00:00:00 GMT

Título: Conhecimento, atitude e prática das mulheres sobre a prevenção do câncer do colo uterino: um estudo com mulheres do município de Icó, Ceará. Autor(es): Medeiros, Lucenir Mendes Furtado Abstract: Cancer of the cervix is characterized by the disordered enlargement of the epithelium that lines the organ, affecting all the underlying tissue known as stroma. Although women seek more health services, in Brazil there is still a high incidence of death related to this type of pathology, being one of the types of cancer that affects the female population the most. The cytopathological examination, performed at the Basic Health Units, is used as a screening method for the precursor lesions of this cancer and indicates the direction of some health actions. Against this background, this study aimed to verify the knowledge, attitude and practice of women on the cervical cancer prevention exam in women from a municipality of Ceará. It was an exploratory study with a quantitative approach developed in the waiting rooms of the health units of the municipality of Icó. The study sample was random and composed of 379 women. The KAP (Knowledge, Attitude and Practice) survey previously used (MALTA, 2014), composed of 46 questions, was applied. The test performed to answer the study objectives was chi-square. The sociodemographic variables studied as potential variables associated with knowledge, attitude and practice were: age, marital status, schooling, religion, occupation, work and family income. In the sexual and reproductive history, the sexual life and the time of the beginning of the sexual intercourse were investigated, fixed partner, tubal ligation, condom use, contraceptive method, children, age of first child, abortion, Sexually Transmitted Disease, hysterectomy, pregnancy and cancer in the family. The data showed that in 49.9% of the women the knowledge was evaluated as inadequate. The inadequate attitude was in 46.2% of the women and the inadequate practice in 40.1%. (p = 0.016, higher among single women), schooling (p <0.001, higher among illiterates or incomplete primary education), income (p = 0.004, higher in the lower income group) Of a minimum wage, did not have a fixed partner (p <0.017) and had STD (p = 0.039). The education of women was the only variable associated with an inappropriate attitude (p = 0.003). The variables statistically associated with inappropriate practice were: marital status, age, work away from home, family income, no active sex life, lactation and having had the first child aged 25 years or more. As for the difficulties to perform the Papanicolaou exam at the HSF and receive the result had great prominence the delay of the result. From this research, the importance of health education about the problems related to cervical cancer and its prevention, as well as the need for the support of the managers, was perceived. We had some groups of women with greater risk to the problem studied, and should therefore be prioritized by health professionals and managers, with the active search of this group for the realization of conversation wheels. It is hoped that the results found may contribute to the improvement of the attendance of women and greater vigilance regarding the frequency of the examination, aiming at a greater comprehension of the women, satisfying their knowledge needs through the exchange of knowledge. Descrição: MEDEIROS, L. M. F. Conhecimento, atitude e prática das mulheres sobre a prevenção do câncer do colo uterino: um estudo com mulheres do município de Icó, Ceará. 2016. 89 f. Dissertação (Mestrado em Saúde da Família) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2016.

Um novo olhar no cuidado com a gestação: fortalecendo vínculos em grupos de gestantes

Fri, 16 Sep 2016 00:00:00 GMT

Título: Um novo olhar no cuidado com a gestação: fortalecendo vínculos em grupos de gestantes Autor(es): Silva, Cristiano José da Abstract: The comprehensive care proposed by the Family Health Strategy contemplates a reorientation of the care model, surpassing the old method focused on the disease. Through this unique approach, health workers can have an innovative vision, both person-centered and focused on the wider context of the family, with new ways of caring. This study aimed to develop a light technology applied to pregnant women vulnerable to pregnancy rejection and concept, seeking to strengthen the mother-child-world bond. It was a care-oriented approach, whose purpose was to benefit the participants through the different ways of caring. Data collection took place through the application of forms, shooting resources and recording of five group sessions, capturing the essence of the rejection phenomenon, both in the speeches and in the body language of the participants. Some quantitative results were presented in graphs and tables constructed from the programs Excel and World version 2010. The analysis of these data outlined the sociodemographic profile that vulnerabilizava the context of the maternity among the participants. The qualitative data were evaluated and confronted by the phenomenological approach of Moustakas, which was adapted to this research because it was more focused on the description of the participants' experiences. The analysis revealed that an environment in which intrafamily violence predominates, partner's absence, maternal economic dependence, needs of a sufficiently good mother, punitive memories of this mother and the non-planning of pregnancy, perceived as meaningless, directly influence the mother. Denial of maternity, constituting an obstacle in the harmonic mother-child-world relationship. Such factors can be reproduced in a rejection mechanism, transmitted to each family generation. Subjectively, feelings of fear, insecurity, impotence, hurt, shame and denial were reported in the construction of the structural description of this study. During the research-care application, the relevance of care in the group approach was verified, as a proposal to deconstruct the rejection phenomenon. Thus, a rescue of the principles of motherhood, transcribed in the speeches and observed in the images through seven units of meaning, initially characterized by heartache, contempt, rejection, abortion and ambivalence of feelings, restructured by resilience and ended by acceptance . Finally, it is extremely important to promote effective assistance to pregnant women who are most vulnerable to rejection and to establish groups as support in the areas of mental health and care. Descrição: SILVA, C. J. Um novo olhar no cuidado com a gestação: fortalecendo vínculos em grupos de gestantes. 2016. 203 f. Dissertação (Mestrado em Saúde da Família) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2016.