Jucier Gonçalves Júnior

Clinical and Epidemiological Aspects of Scorpionism in the World: A Systematic Review.

OBJECTIVE Scorpion stings are registered worldwide, but the incidence and the features of the envenomations vary depending on the region. The aim of this review was to summarize the epidemiological, clinical, diagnostic, and therapeutic data worldwide regarding humans stung by scorpions. METHODS A systematic review of the literature was conducted through the online databases of the Virtual Health Library (VHL), which hosts Medline and the Latin American and Caribbean Center on Health Sciences Informational (LILACS) database. We selected articles published between January 1, 2002 and July 31, 2014. RESULTS Scorpion envenomation reports were found throughout the world, mainly in subtropical and tropical regions. The clinical manifestations were sympathetically and parasympathetically mediated, depending on the species of scorpion. Some of the most common severe complications of scorpionism included respiratory distress syndrome, pulmonary edema, cardiac dysfunction, impaired hemostasis, pancreatitis, and multiple organ failure. Scorpion envenomation could be classified as mild, moderate, and severe, and the therapeutic approach was based on the case severity. The treatment comprised 3 components: symptomatic measures, vital functions support, and injection of antivenom. Moreover, the time that elapsed between the sting and administration of the appropriate medical care was extremely important to the patients prognosis. CONCLUSIONS The large number of scorpion stings worldwide is concerning and reaffirms the need for new prevention measures and policies to reduce the incidence, prevalence, morbidity, and mortality rates from these poisonous arachnids.

Electroconvulsive therapy use in adolescents: a systematic review

BackgroundConsidered as a moment of psychological vulnerability, adolescence is remarkably a risky period for the development of psychopathologies, when the choice of the correct therapeutic approach is crucial for achieving remission. One of the researched therapies in this case is electroconvulsive therapy (ECT). The present study reviews the recent and classical aspects regarding ECT use in adolescents.MethodsSystematic review, performed in November 2012, conformed to the PRISMA statement.ResultsFrom the 212 retrieved articles, only 39 were included in the final sample. The reviewed studies bring indications of ECT use in adolescents, evaluate the efficiency of this therapy regarding remission, and explore the potential risks and complications of the procedure.ConclusionsECT use in adolescents is considered a highly efficient option for treating several psychiatric disorders, achieving high remission rates, and presenting few and relatively benign adverse effects. Risks can be mitigated by the correct use of the technique and are considered minimal when compared to the efficiency of ECT in treating psychopathologies.

Association between Epstein-Barr virus (EBV) and cervical carcinoma: A meta-analysis

OBJECTIVES Human papillomavirus (HPV) has been implicated as a major factor in cervical carcinogenesis. However, many pieces of evidence gathered over the last two decades suggest Epstein-Barr virus (EBV) plays a secondary role in this process. The purpose of the present meta-analysis was to determine whether the presence of EBV infection increases the risk of cervical carcinoma. METHODS Based on 25 articles, the analysis yielded a 33.44% overall pooled prevalence of EBV. RESULTS The pooled prevalence was higher in patients with carcinoma (43.63%) than in healthy patients (19.0%) or patients with cervical intraepithelial neoplasia 1 (CIN1) (27.34%) or CIN2/3 (34.67%). Co-infection with EBV and HPV displayed a similar pattern. EBV infection was significantly and positively associated with lesion grade in cervical epithelia and was more prevalent in malignant lesions. Moreover, cervical carcinoma occurred four times as often among EBV positive women as in women without EBV infection (OR=4.01 [1.87-8.58]; p<0.001). CONCLUSIONS The existence of EBV(+)HPV(-) carcinomas, the confirmed expression of latent oncoproteins (EBNA1, EBNA2, LMP1) and EBERs in tumor cells, and the association of EBV with the integration of high-risk-HPV DNA in malignant specimens point to EBV as a co-factor (so far underestimated) in the genesis and/or progression of cervical carcinoma. However, further studies are necessary before the link between EBV and cervical carcinoma can be established.

Educational technology based on nola pender: promoting adolescent health

RESUMO Objetivo : apresentar uma tecnologia educativa em Enfermagem, voltada para adolescentes, acerca da vacinacao contra o HPV, baseada no modelo de promocao da saude de Nola Pender. Metodo: estudo qualitativo, descritivo, do tipo relato de experiencia, acerca da criacao e aplicacao de uma tecnologia educacional composta por duas estrategias de ensino sobre a vacina contra o Papilomavirus Humano. A pesquisa foi realizada em escolas municipais, vinculadas a Estrategia de Saude da Familia, com adolescentes dos nove aos 13 anos. A amostra foi constituida por 157 adolescentes. Resultados : intervencoes de Enfermagem baseadas em conhecimento cientifico e teorico demonstram-se efetivas em relacao as atividades tradicionais repassadas de forma vertical e sem interacao. Conclusao : o uso de tecnologias educacionais promoveu impacto positivo na aquisicao/apropriacao de conhecimento pelos adolescentes estudados e sinaliza a necessidade de se investir em tecnologias educacionais eficazes que primem pela autonomia do adolescente no processo de tomada de decisao. Descritores : Adolescentes; Enfermagem; Educacao em Saude; Tecnologia Educacional; Papillomaviridae; Vacinacao . ABSTRACT Objective: to present an educational technology in Nursing, directed at adolescents, about vaccination against HPV, based on the Nola Pender health promotion model. Method: qualitative, descriptive study of the experience report about the creation and application of an educational technology composed of two teaching strategies on the Human Papillomavirus vaccine. The research was carried out in municipal schools, linked to the Family Health Strategy, with adolescents from nine to 13 years old. The sample consisted of 157 adolescents. Results: Nursing interventions based on scientific and theoretical knowledge are effective in relation to traditional activities that are transferred vertically and without interaction. Conclusion: the use of educational technologies promoted a positive impact on the acquisition / appropriation of knowledge by the adolescents studied and indicates the need to invest in effective educational technologies that emphasize the autonomy of the adolescent in the decision making process. Descriptors : Adolescent; Nursing; Health Education; Educational Technology; Papillomaviridae; Vaccination. RESUMEN Objetivo: presentar una tecnologia educativa en enfermeria dirigida a adolescentes acerca de la vacunacion contra el VPH basada en el modelo de promocion de la salud de Nola Pender. Metodo: estudio cualitativo, descriptivo, del tipo relato de experiencia acerca de la creacion y aplicacion de una tecnologia educativa compuesta por dos estrategias de ensenanza acerca de la vacuna contra el Papilomavirus Humano. La investigacion fue realizada en escuelas municipales vinculadas a la Estrategia de Salud de la Familia con adolescentes de 9 a 13 anos. La muestra fue constituida por 157 adolescentes. Resultados : intervenciones de enfermeria basadas en conocimiento cientifico y teorico se demuestran efectivas en relacion a las actividades tradicionales repasadas de forma vertical y sin interaccion. Conclusion: el uso de tecnologias educativas promovio un impacto positivo en la adquisicion / apropiacion de conocimiento por los adolescentes estudiados y senalan la necesidad de invertir en tecnologias educativas eficaces que priman por la autonomia del adolescente en el proceso de toma de decision. Descriptores : Adolescente; Enfermeria; Educacion em Salud; Tecnologia Educacional; Papillomaviridae; Vacunacion.

Self-care practice in people with sickle cell anemia

Objetivo: Identificar a aplicacao da teoria do autocuidado de Orem em pacientes portadores de anemia falciforme (AF) em um hemocentro regional. Metodos: Trata-se de estudo de natureza descritiva, com carater exploratorio e abordagem qualitativa, realizado no hemocentro regional de um municipio do interior do Ceara, Brasil, com os pacientes diagnosticados e em tratamento para AF. A coleta de dados se deu em 2014, sendo utilizada entrevista aplicada na sala de espera para atendimento medico na propria instituicao. Os dados foram analisados conforme tecnica de analise de conteudo de Bardin. Resultados: Evidenciou-se que o paciente nao apresenta um saber apurado sobre a sua patologia, desfavorecendo, portanto, as bases primarias para o autocuidado. A descoberta da doenca geralmente se da pela necessidade de intervencoes clinicas em episodios repetidos de dor. Os eventos dolorosos representam as principais dificuldades e causas de internacao hospitalar com a busca pelos servicos de pronto atendimento medico. Conclusao: As acoes educativas fornecidas pela equipe de saude multidisciplinar possibilitam ao paciente e cuidador de AF condicoes para uma melhor assistencia por meio das atividades e acoes de autocuidado.

Preditive Models And Health Sciences: A Brief Analysis

Background: Predictive Models are an important tool in event predicting and health planning. Despite this, there are few works focusing this area. Thus, the analysis of the real benefits of these models in Health Sciences is necessary to be performed. Results: Predictive techniques largely evolved in second half of XX century. The development of AR, MA, ARMA, ARIMA and SARIMA models, through Box-Jenkins methodology, constitute a robust conjunct of mechanisms able to help in solution of epidemiological modeling problems, mainly in Health Sciences, once it allows to evaluate individual characteristics of living beings and its correlation with pathologies in the same space-time. Nevertheless, AR, MA and ARMA does not have tendency in seasonality, which weakens the analysis. Conclusions: To predict the natural history of endemic/epidemic and its health-disease processes in a determined population is a sine que non condition to its adequate management in Public Health context and in adoption of affirmative measures concerning health promotion. Thus, the predictive models, with emphasis in ARIMA, SARIMA, Artificial Neural Networks and Formalism of Copulas are alternatives that can be feasible.

Evaluation of the Elderly´S Profile with Diabetes Mellitus in Primary Health Care

This study aimed to describe the socio-demographic and clinical profile of elderly with diabetes mellitus in a Primary Health Care Unit. This is a descriptive and transversal study conducted in a city of Ceara State. The sample consisted of 55 elderly patients with type 2 diabetes mellitus. Data were collected from July to August 2014 through a socio-demographic and clinical variables form. The descriptive statistics was used for the analysis. The mean age of 71 years old was observed; 67.3% of the sample were women; 58.2% married; 30.9% illiterate; 83.6% with income less than two minimum wages; 61.8% were sedentary; 54.5% were overweight; 53.4% of grade I obesity; and 69.1% with altered postprandial glucose. The mean duration of the disease was more than 10 years, and diabetic complications were found. The elderly’s profile can contribute to more health risks and serious impairment of quality of life

Prevalence of teenagers with disabilities in a medium-sized municipality

Introduction: Despite variations in the beginning and the end, adolescence is the second decade of life, 10-19 years. According to the World Report on disability among those individuals aged 0-14 years of age, 93 million had severe or moderate disabilities and 13 million severe disabilities. Therefore, this study aimed to identify adolescents with hearing, visual and physical impairment. Methods: A quantitative transversal study of a medium-sized municipality. Data was collected at interviews conducted by community health workers, with an instrument containing sociodemographic data and impairment characteristics. Data was organized in spreadsheets and analyzed for correlations between types of disabilities and other variables by chi-square test. Statistical significance was verified by a 0.05 level. Results: Physical disability prevailed over visual and auditory. An association was found between disability and level of education (p = 0.023). Conclusion: Support and incentive education policies are necessary among the disabled.

Immunological Evidence between Schizophrenia and Toxoplasmosis: an Overview

Background: Recent studies have corroborated the hypothesis that T. gondii is a prime candidate in etiology of Schizophrenia, and it is now considered a possible cause of this pathology. Results: Studies have shown that patients with schizophrenia have significantly increased levels of antibodies to T. gondii compared with healthy controls. Previous research has shown an increase in the antibody response to Toxoplasma proteins in schizophrenia and bipolar disorders. CD8 immunity is reduced in schizophrenic patients, it is conceivable that a partial loss of CD8 functionality could result in periodic reactivation of the quiescent T. gondii parasites, resulting in focal necrosis and localized inflammation (contributed by innate immune cell-produced cytokines). Conclusion: It will be necessary more experimental researches and clinical trials giving emphasis on these correlations between Schizophrenia and Toxoplasmosis. Then design effective public policies and protocols tracking for Schizophrenia it might be a possible reality

Ebola: an international public health emergency

The outbreak of Ebola in West Africa could become one of the worst infectious-disease-driven humanitarian crises of recent times. With more than 3000 deaths since the first case was confirmed in March 2014, the international community has recognized Ebola as a public health emergency of international concern and a clear threat to global health security. The complexity of dealing with this Ebola outbreak has highlighted the need for traditional actors, such as WHO and the CDC, to embrace the wider health and humanitarian community. The epidemic reinforces the need for nations to investment in health infrastructure and disease surveillance to keep pace with other developments in Africa. If Ebola arrives in high-income and middleincome nations, it should be contained quickly. The crisis shows the importance of sufficient levels of multilateral funding for WHO. The world needs a strong WHO, with the financing and political influence to fulfil its historic mission.