Eduardo Sérgio Soares Sousa

Fidedignidade do Teste-reteste na Aplicação do Índice Menopausal de Blatt e Kupperman

Purpose: based on the knowledge that the reliability of an instrument is essential for a correct interpretation of the results of research, the purpose of the present study is to evaluate the reliability of one of the menopausal indexes more often used in clinical practice and research, the Blatt and Kupperman Menopausal Index (BKMI). Methods: the population consisted of 60 climacteric patients attended at the Gynecology Outpatient Clinic of the Lauro Wanderley University Hospital of the Federal University of Paraiba in Joao Pessoa city. The reliability coefficient was analyzed by the test-retest method, whose application was done on two different occasions with an interval of four weeks, without administration of medicines. Results: the variation of the score observed with the application of BKMI at the first measurement was 2 to 41, with a median of 18 and mean of 18.8 (± 10.76), while at the second measurement, the menopausal index was 20.2 (± 10.51), median 19, and values ranging from 2 to 39. Despite these results, a Speaman (rs) coefficient of 0.68 (p = 0.001), which is a coefficient of only moderate intensity, was observed. Conclusions: the test-retest reliability in the application of the BKMI shows that, although this instrument presented a statistically moderate reliability, the intensity observed does not represent a reliable measurement. Considering that a correlational study is only a type of screening of the quality of a measurement method, we concluded that other studies must be performed with the purpose of evaluating the reliability and the validity of the BKMI. It is possible that the attribuition of different values to the items of BKMI and the inclusion of symptoms directly related to the estrogenic defficiency, like symptoms of vaginal atrophy, would make the instrument more reliable.

Ensaio clínico placebo-controlado com isoflavonas da soja para sintomas depressivos em mulheres no climatério

PURPOSE: to evaluate the efficacy of the use of isoflavones in the treatment of depressive symptoms in climacteric women. METHODS: placebo-controlled, randomized double-blind experimental study with 84 climacteric women who were assisted at the Lauro Wanderley University Hospital Ambulatory, in Joao Pessoa, Paraiba, Brazil. In the evaluation of the depressive symptoms the Self-evaluation questionnare of Hamiltons rating scale for depresion (QAEH-D) was used in the pretreatment visit (VT1), and in the 8th (VT2) and 16th (VT3) week after treatment. The experimental group (GExp) received soy extract with isoflavones, 120 mg per day, and the control group (GCont), placebo. The comparison of the scores of the QAEH-D between the VT1, VT2 and VT3 groups constituted the primary measure of efficacy (t test, p 0.05). From VT1 to VT3, there was a significant difference (8.9%) in the reduction of the scores between GExp and GCont (p=0.03). There was no correlation between the reduction of the depressive symptoms and alterations of the vasomotor symptoms (p>0.05). There was a reduction of FSH concentrations only in GExp (p=0.02), without estradiol modifications. Side effects were not clinically relevant. CONCLUSIONS: the effect of soy isoflavones was superior to the placebo, however, of small magnitude and only identified after 8 weeks of treatment. This small effect attributed to the experimental treatment, of good tolerability, may benefit patients who have side effects due to estradiol, or those who prefer not to use hormones.

Violência na velhice: abordagens em periódicos nacionais indexados

This article assesses aluminum production in Brazil and its social, environmental and public health impacts. The effects of the aluminum production chain challenge the idea of sustainable growth affirmed by business groups that operate in the sector. This article upholds the theory that the insertion of Brazil in the global aluminum market is part of a new configuration of the International Division of Labor (IDL), the polluting economic and highly energy dependent activities of which - as is the case of aluminum - have been moving to peripheral nations or emerging countries. The laws in such countries are less stringent, and similarly the environmental movements and the claims of the affected populations in the territories prejudiced in their rights to health, a healthy environment and culture are less influential. The competitiveness of this commodity is guaranteed in the international market, from the production of external factors such as environmental damage, deforestation, emissions of greenhouse gases and scenarios of environmental injustice. This includes undertakings in the construction of hydroelectric dams that expose traditional communities to situations involving the loss of their territories.Uma das consequencias do aumento da expectativa de vida e a elevacao do numero de idosos na populacao de diversos paises, incluindo o Brasil. Considerando-se a vulnerabilidade desse grupo etario e a crescente prevalencia da violencia contra ele, e marcante a necessidade de pesquisas e intervencoes para o controle e minimizacao do fenomeno. Este artigo, de caracteristica exploratoria e descritiva, traz uma analise dos estudos sobre estas tematicas no Brasil a partir de um levantamento bibliografico em periodicos nacionais indexados na base SciELO, com enfase nos ultimos cinco anos. Os temas abordados foram categorizados em: Construcao social e conceituacoes, 37,5%; Atencao e Politica de Protecao ao Idoso, 43,75%; e, Tipologia de violencia contra idosos, 18,75%. Como resultado tem-se que a Politica de protecao ao idoso surge amparando a maioria das discussoes que tratam da violencia na velhice e que esta tem como foco de atencao dos pesquisadores, a violencia domestica, precisando se expandir nas pesquisas de campo.

Ethical aspects considered in doctor-patient relations: experiences of anesthesiologists

BACKGROUND AND OBJECTIVE Ethical principles guide professional conduct, particularly in establishing the doctor-patient relationship and, therefore, require constant reflection. The purpose of this study is to analyze ethical experiences of anesthesiologists in their interaction with the patient under their care. METHOD This was an exploratory study involving 16 active anesthesiologists at a university hospital in João Pessoa, Paraíba. We collected data through semi-structured interviews and analyzed qualitatively using the content analysis technique. RESULTS The study findings show that the classification of ethical experiences of the study participants regarding the doctor-patient relationship were classified into five categories: respect for the patient, humane treatment, equal treatment, professional secrecy, and respect for patient autonomy. CONCLUSION We conclude that respondents recognize the ethical and humanistic values that should guide the relationship with their patients.

Aspectos éticos considerados na relação médico-paciente: vivências de anestesiologistas

BACKGROUND AND OBJECTIVE Ethical principles guide professional conduct, particularly in establishing the doctor-patient relationship and, therefore, require constant reflection. The purpose of this study is to analyze ethical experiences of anesthesiologists in their interaction with the patient under their care. METHOD This was an exploratory study involving 16 active anesthesiologists at a university hospital in João Pessoa, Paraíba. We collected data through semi-structured interviews and analyzed qualitatively using the content analysis technique. RESULTS The study findings show that the classification of ethical experiences of the study participants regarding the doctor-patient relationship were classified into five categories: respect for the patient, humane treatment, equal treatment, professional secrecy, and respect for patient autonomy. CONCLUSION We conclude that respondents recognize the ethical and humanistic values that should guide the relationship with their patients.

Racism in health services: a lack of care of violence against black women victims of sexual violence Racismo nos serviços de saúde: a ausência do cuidado com as mulheres negras vítimas de violência sexual

3Objective: to analyze the access and the use of health practices given to 40 women in a situation of sexual violence in a public health service of reference in the State Paraiba, Brazil. Method: It is a descriptive documentary study with a quantitative and qualitative approach, performed in a public service of the State of Paraiba reference to assistance to women in situations of sexual violence. Results: in 39% of cases the higher frequency of aggressions predominated in women of low-income social class, between 10-20 years of age, and 20% of them were pregnant at the time of the agression. Most of the victims were black women (72%). The type of sexual violence more employee was the rape (59%). Besides the delay to start the service, the exams for AIDS prophylaxis and emergency contraception, in 69% of notifications were not recorded. Conclusion: these aspects reveal the racism and the precarious conditions of health for black women, suggesting a possible non-valuation by health professionals, similar of what occurs in other social spaces in our society. Descriptors: sexual violence, racial inequality, health care, social and human rights.