Celmo Celeno Porto

Relation Between Quality of Life of Mothers of Children With Cerebral Palsy and the Children's Motor Functioning, After Ten Months of Rehabilitation

El objetivo de este estudio fue analizar la calidad de vida de las madres de ninos con paralisis cerebral, correlacionandola con la evolucion de la funcion motora gruesa de los ninos, despues de diez meses de rehabilitacion. Se trata de un estudio de observacion, longitudinal, realizado en la ciudad de Goiania, estado de Goias, en Brasil, con 100 madres y sus hijos con paralisis cerebral. La funcion motora de los ninos fue evaluada por la Medicion de la Funcion Motora Gruesa (GMFM) y la calidad de vida de las madres por el Medical Outcomes Study 36-item Short Form Health Survey (SF-36). Despues de diez meses de rehabilitacion, los ninos obtuvieron una mejoria significativa (p<0,001) en la funcion motora y las madres presentaron una mejoria significativa (p<0,001) apenas en el dominio dolor. La mejoria de la funcion motora gruesa de los ninos con Paralisis Cerebral no influyo en los cambios ocurridos en la calidad de vida de las madres.

Survival and prognostic factors in systolic heart failure with recent symptom onset

OBJECTIVE To study survival and prognostic factors associated with mortality in patients with systolic heart failure followed up since symptom onset. METHODS We carried out a study with a cohort of 204 consecutive patients with systolic heart failure, whose symptom onset occurred within the 6 weeks preceding the first medical visit. They were followed up for 46 months. The prognostic variables analyzed were collected when the patients were included in the study and were correlated with cardiovascular mortality. An EF < or =40% on echocardiography characterized systolic ventricular dysfunction. RESULTS The overall survival rates according to the Kaplan-Meier technique were 98.0%, 90.6%, and 70.2% at 3, 12, and 48 months of follow-up, respectively. The multivariate analysis identified the independent effect of 6 variables on the risk of cardiovascular death. Functional classes III and IV increased risk 2.7 times as compared with class II; 10-mmHg increments in systolic blood pressure reduced the risk of death by 25%; each 10-bpm increase in heart rate increased the risk of death 1.6 times; and each 0.25-mg/dL increment in serum creatinine caused a 60% increase in risk. The presence of the third cardiac sound caused a 3-fold increase in the risk of death, and chagasic etiology was also associated with cardiovascular mortality (P<0.0001). CONCLUSION Evidence shows that mortality in the initial phase is not elevated, and that etiology, advanced functional class, arterial hypotension, tachycardia, presence of the third cardiac sound, and elevated serum creatinine lead to a worse prognosis.

O ensino da ética nos cursos de graduação da área de saúde

This study provides an analysis of Brazilian articles on the teaching of ethics in undergraduate health courses from January 1997 to January 2009, using a search in the Virtual Health Library (VHL). Twenty-six articles met the inclusion criteria. The health fields receiving the main emphasis were medicine (19), nursing (5), and psychology and dentistry (1 each). Using content analysis, three thematic categories were identified: theoretical and philosophical reflections; pedagogical and methodological issues; and evaluation of the teaching of ethics. The main factors that influenced the learning of ethics were time of exposure to the course content and a crosscutting approach to ethics in the various other course disciplines. The study also highlighted the use of active methodologies and the professors ethical background and attitude. Given current changes in education, technological and scientific progress, and the field of bioethics itself, it is necessary to discuss how ethics is taught in the health professions.

Prevalência de fatores de risco para doenças cardiovasculares na região leste de Goiânia (GO)

Aiming to investigate the prevalence of cardiovascular risk factors in the population of the Eastern Region of Goiania, Goiás, a transversal study was done involving 3.275 individuals, men and women, aging 15 years and up. Data was collected through home visits for identification and information on living habits, measures blood pressure, anthropometry, and blood collection for identifying dyslipidemias. The variables investigated were: weight, height, blood pressure, physical activity, use of tobacco, cholesterol, triglycerides and glucose. Estimated prevalence at intervals of 95% confidence, differences in proportions assessed using chi-square test and values (p <0,05) considered statistically significant. The study showed that 33,4% of subjects had hypertension, 44.1% overweight/obesity, 16.2% used tobacco regular/occasionally; 72.5% in sedentary leisure and 70% at work, 48.4% with the waist circumference increased; 8.2% hyperglycemia plus impaired glucose tolerance; 44.4% hypercholesterolemia, 13.3% and high triglycerides. High prevalence of cardiovascular risk factors were observed in the study population suggesting greater attention of the authorities in the actions of promotion and prevention of these diseases.

Revisão de literatura sobre o atendimento ao paciente surdo pelos profissionais da saúde

O objetivo deste estudo de revisao sistematica da literatura e analisar e identificar a comunicacao entre o paciente surdo e o profissional da saude, bem como investigar a assistencia oferecida. Foram utilizadas as bases de dados informatizadas para a coleta de dados, tendo como palavras-chave os termos paciente, surdo e comunicacao. Os resultados foram agrupados em tres categorias: comunicacao, formacao dos profissionais da saude e aspectos legais. A categoria comunicacao aborda barreiras comunicativas, linguagem escrita e a presenca do interprete. Na segunda categoria, o foco esta na formacao dos profissionais referentes a comunidade surda. A terceira categoria relata os aspectos legais no atendimento ao paciente surdo. A revisao mostrou que ha barreiras de comunicacao entre paciente surdo e profissional da saude, e que o atendimento e um desafio para ambos. Ressalta tambem a necessidade de formacao sobre o paciente surdo.The purpose of this systematic literature review is to analyze and identify the communication between deaf patients and health professionals, as well as to investigate the care offered. The computerized databases were used for data collection, using the keywords paciente (patient), surdo (deaf person), and comunicação (communication). The results were grouped in three categories: communication, health professional education, and legal aspects. The communication category deals with communicative barriers, written language and the presence of the interpreter. In the second category, the focus is on the education of the professionals in relation to the deaf community. The third category reports the legal aspects involved in caring for deaf patients. The review showed that there are communication barriers between deaf patients and health professionals, and that health care is a challenge for both. It also emphasized that there is a need for education regarding the deaf patients.

Literature revision about the attendance of deaf patient by health professionals

O objetivo deste estudo de revisao sistematica da literatura e analisar e identificar a comunicacao entre o paciente surdo e o profissional da saude, bem como investigar a assistencia oferecida. Foram utilizadas as bases de dados informatizadas para a coleta de dados, tendo como palavras-chave os termos paciente, surdo e comunicacao. Os resultados foram agrupados em tres categorias: comunicacao, formacao dos profissionais da saude e aspectos legais. A categoria comunicacao aborda barreiras comunicativas, linguagem escrita e a presenca do interprete. Na segunda categoria, o foco esta na formacao dos profissionais referentes a comunidade surda. A terceira categoria relata os aspectos legais no atendimento ao paciente surdo. A revisao mostrou que ha barreiras de comunicacao entre paciente surdo e profissional da saude, e que o atendimento e um desafio para ambos. Ressalta tambem a necessidade de formacao sobre o paciente surdo.The purpose of this systematic literature review is to analyze and identify the communication between deaf patients and health professionals, as well as to investigate the care offered. The computerized databases were used for data collection, using the keywords paciente (patient), surdo (deaf person), and comunicação (communication). The results were grouped in three categories: communication, health professional education, and legal aspects. The communication category deals with communicative barriers, written language and the presence of the interpreter. In the second category, the focus is on the education of the professionals in relation to the deaf community. The third category reports the legal aspects involved in caring for deaf patients. The review showed that there are communication barriers between deaf patients and health professionals, and that health care is a challenge for both. It also emphasized that there is a need for education regarding the deaf patients.

Parental stress in mothers of children and adolescents with cerebral palsy

Objectives to evaluate parental stress of mothers of children and adolescents with cerebral palsy; to verify whether parental stress undergoes variations according to the level of motor compromise, the childs phase of life, and sociodemographic variables. Method a cross-sectional, descriptive study, with 223 mothers of children and adolescents with cerebral palsy. Results 45.3% of the mothers presented high levels of stress; there were differences in stress between mothers of children with mild and severe motor impairment; mothers of older children were more stressed than mothers of younger children and of adolescents; paid work and leisure activities reduced the stress. Conclusion mothers of children and adolescents with cerebral palsy, whose children present mild to severe motor impairment are vulnerable to parental stress. Paid work and leisure activities were the factors that contributed most to reducing the stress.OBJETIVOS: evaluar el estres familiar de madres de ninos y adolescentes con paralisis cerebral; verificar si el estres familiar sufre variaciones dependientes del nivel de compromiso motor, de las fases de la vida en que los hijos se encuentran y de las variables sociodemograficas. METODO: estudio transversal y descriptivo con 223 madres de ninos y adolescentes con paralisis cerebral. RESULTADOS: 45,3% de las madres presentaron altos niveles de estres; existen diferencias en el estres entre las madres de hijos con leve y grave comprometimiento motor; las madres de ninos mayores estaban mas estresadas que las madres de ninos menores y de adolescentes; el trabajo remunerado y el tiempo libre redujeron el estres. CONCLUSION: las madres de ninos y adolescentes con paralisis cerebral, cuyos hijos presentan compromiso motor, de leve a grave, son vulnerables al estres familiar. El trabajo remunerado y las actividades de tiempo libre fueron los factores que mas contribuyeron para reducir el estres

Parental stress in families of children with cerebral palsy: an integrative review

This article aims to select, evaluate and interpret critically the bibliographic production focused on the stress experienced by parents/caregivers of children with cerebral palsy. An integrative literature review was conducted. Sources for this search were the Virtual Health Library (VHL), the United States National Library of Medicine (PubMed) and manual search of references from the selected studies. It was decided to select studies published between 1998 and 2011. The sample included 13 articles. Parents of children with cerebral palsy have higher stress levels than parents of children without disabilities. Behavioral problems, psychological disorders and emotional needs of children were factors commonly associated with high levels of stress. Satisfaction with social support, satisfaction with the parental role, a good family rapport, an emotional bond between father/mother and child, spousal support and the sense of being an active participation in social life help reduce stress levels. Parents of children with cerebral palsy are likely to have their health affected by higher levels of stress. Thus, health professionals should give them special attention.

Vertigem posicional paroxística benigna sem nistagmo: diagnóstico e tratamento

Nystagmus tests to diagnose BPPV are still relevant in the clinical evaluation of BPPV. However, in everyday practice, there are cases of vertigo caused by head movements, which do not follow this sign in the Dix-Hallpike maneuver and the turn test. AIM: To characterize BPPV without nystagmus and treatment for it. MATERIALS AND METHODS: A non-systematic review of diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) without nystagmus in the PubMed, SciELO, Cochrane, BIREME, LILACS and MEDLINE databases in the years between 2001 and 2009. RESULTS: We found nine papers dealing with BPPV without nystagmus, whose diagnoses were based solely on clinical history and physical examination. The treatment of BPPV without nystagmus was made by Epley maneuvers, Semont, modified releasing for posterior semicircular canal and Brandt-Daroff exercises. CONCLUSION: From 50% to 97.1% of the patients with BPPV without nystagmus had symptom remission, while patients with BPPV with nystagmus with symptom remission ranged from 76% to 100%. These differences may not be significant, which points to the need for more studies on BPPV without nystagmus.

Paralisia cerebral e síndrome de Down: nível de conhecimento e informação dos pais

The study sought to identify and analyze research related to knowledge and information received by parents of children with cerebral palsy or Down syndrome about these disabilities. It involves a bibliographical revision limited to the period from 1996 through 2008. Computerized data bases were used to collect information, using the following terms as key words: cerebral palsy, Down syndrome, knowledge and family. Fifty-seven studies were located from which 16 were selected; of these, seven were related to cerebral palsy, four to Down syndrome and five were related to sundry deficiencies. The parents receive little information from the healthcare staff and clearly have many doubts about cerebral palsy and Down syndrome. This makes it very difficult for the parents to assist in the treatment of their children, as well as interfering in educational practices and decision-making. There is a need for educational actions to change this reality. Only one research project sought to implement educational strategies which focused on broadening knowledge among family members about aspects related to Down syndrome. It was concluded that there is an urgent need to conduct research and develop actions that contribute to parents being better informed and more secure about their childrens health care.