Vera Lúcia Conceição Gouveia Santos

Evidence on the use of platelet-rich plasma for diabetic ulcer: A systematic review

The aim of topical wound treatment is to favor efficient, rapid, and safe healing. The platelet-rich plasma (PRP) has been used for wound treatment since it contains various platelet growth factors. The objective of the present study was to collect evidence regarding the use of PRP for the topical treatment of chronic leg ulcers. For this purpose, a systematic review of the literature was performed according to the steps recommended by the Cochrane Collaboration with studies published until July 2008. Among 18 selected studies, 7 (39%) of these studies were randomized clinical. Five of the seven randomized clinical trials studied ulcers of diabetic etiology. The results of meta-analysis showed that PRP favors the healing process (95% CI: 2.94–20.31). In conclusion, the present systematic review and meta-analysis show that there is a scientific evidence regarding favorable outcomes of the use of PRP for the treatment of diabetic ulcer.

Qualidade de vida de adultos com câncer colorretal com e sem ostomia

This study aimed to analyze and compare the quality of life of patients with colorectal cancer who were attended by the Single Health System in Sao Paulo. A descriptive and transversal study was carried out from a quantitative approach. Data were collected through the World Health Organization Quality of Life-bref scale (WHOQOL-bref). 110 patients were observed, resulting in a population of 48 patients, who were divided into 2 groups: with and without ostomy. No differences in the average scores for the four domains were found between the groups. Statistical differences were found in the variables of religion and return to work independent from the group. This study was important to get a better understanding of quality of life in cancer patients with and without ostomy.O objetivo deste estudo foi analisar e comparar a qualidade de vida (QV) dos doentes com câncer colorretal atendidos pelo SUS na XIV DIR-SP, conforme ausencia e presenca de estoma. Trata-se de estudo descritivo e exploratorio, com abordagem quantitativa onde se utilizou a escala WHOQOL-bref para avaliacao da QV. A casuistica foi composta por 110 pessoas, totalizando 48 sobreviventes que compuseram dois grupos conforme ausencia ou presenca do estoma. Os resultados evidenciaram escores medios menores em todos os dominios para as pessoas ostomizadas, porem sem diferencas significativas na comparacao com o grupo de pessoas sem ostomia. Foram constatadas diferencas estatisticamente significantes para as variaveis religiao e retorno ao trabalho independente do grupo. O estudo contribuiu para o melhor delineamento acerca da QV entre pessoas operadas por câncer colorretal com e sem ostomia.

Prevalence of Urinary Incontinence in a Random Sample of the Urban Population of Pouso Alegre, Minas Gerais, Brazil

Os objetivos deste trabalho foram conhecer a prevalencia da incontinencia urinaria (IU), dos fatores demograficos e clinicos preditores da presenca de IU. Estudo epidemiologico, corte transversal, aprovado pelo Comite de Etica da Escola de Enfermagem da Universidade de Sao Paulo. A amostragem, estratificada por conglomerado, foi composta por 519 individuos com idade ≥18 anos, residentes em 341 domicilios da area urbana, sorteados aleatoriamente. Os testes utilizados foram qui-quadrado, Hosmer Lemeshow e regressao logistica multivariada (stepwise). As prevalencias foram padronizadas por sexo e idade, portanto, das 519 pessoas que compuseram a amostra, 20,1% dessas tinha IU numa populacao total; 32,9% eram mulheres e 6,2% homens. Maior tempo de perdas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), acidente vascular encefalico (OR=15,9; p<0,001) e cistocele (OR=12,5; p<0,001) foram os fatores mais fortemente associados a IU. O estudo permitiu conhecer a epidemiologia da IU e pode contribuir para o desenvolvimento de politicas publicas para a sua prevencao primaria e secundaria, seu tratamento, ainda que inicialmente em nivel municipal.This study determines and analyzes the prevalence of Urinary Incontinence (UI) and its demographic and clinical predictors. This epidemiological and cross-sectional study was approved by the Research Ethics Committee of the University of São Paulo, Nursing School. The sample was randomly selected by cluster technique and included 519 individuals aged≥18 years, living in 341 houses in urban areas. Data were analyzed through Chi-Square, Hosmer Lemeshows test and multivariate logistic regression (stepwise). Prevalence rates were standardized by gender and age. Of the 519 people composing the sample: 20.1% had UI, 32.9% were women and 6.2% were men. Longer duration of losses (OR=29.3; p<0.001), diabetes mellitus (OR=17.7; p<0.001), stroke (OR=15.9; p<0.001), and cystocele (OR=12.5; p<0.001) were the factors most strongly associated with UI. This study enabled the identification of UI epidemiology and can contribute to the development of public policies for its primary and secondary prevention and treatment, even if such measures are initially implemented at the city level.

Quality of life of cancer patients with and without an ostomy

This study aimed to analyze and compare the quality of life of patients with colorectal cancer who were attended by the Single Health System in Sao Paulo. A descriptive and transversal study was carried out from a quantitative approach. Data were collected through the World Health Organization Quality of Life-bref scale (WHOQOL-bref). 110 patients were observed, resulting in a population of 48 patients, who were divided into 2 groups: with and without ostomy. No differences in the average scores for the four domains were found between the groups. Statistical differences were found in the variables of religion and return to work independent from the group. This study was important to get a better understanding of quality of life in cancer patients with and without ostomy.O objetivo deste estudo foi analisar e comparar a qualidade de vida (QV) dos doentes com câncer colorretal atendidos pelo SUS na XIV DIR-SP, conforme ausencia e presenca de estoma. Trata-se de estudo descritivo e exploratorio, com abordagem quantitativa onde se utilizou a escala WHOQOL-bref para avaliacao da QV. A casuistica foi composta por 110 pessoas, totalizando 48 sobreviventes que compuseram dois grupos conforme ausencia ou presenca do estoma. Os resultados evidenciaram escores medios menores em todos os dominios para as pessoas ostomizadas, porem sem diferencas significativas na comparacao com o grupo de pessoas sem ostomia. Foram constatadas diferencas estatisticamente significantes para as variaveis religiao e retorno ao trabalho independente do grupo. O estudo contribuiu para o melhor delineamento acerca da QV entre pessoas operadas por câncer colorretal com e sem ostomia.

Qualidade de vida de pessoas colostomizadas com e sem uso de métodos de controle intestinal

OBJECTIVEnTo evaluate and to compare the quality of life (QoL) of colostomy people, using or not using the bowel control methods (BCM), in other words, the colostomy irrigation and the plug system, considering the hypothesis that people who used them had better QoL.nnnMETHODnThis study was carried out in the Heliópolis Hospital Outpatient Department, after the project approval for the Ethical and Research Committee, using the WHOQoL-bref. The sample was constituted of two groups: 50 colostomy people with BCM and 50, without BCM.nnnRESULTSnThe Group with BCM had a QoL significantly higher, being this observed in all the Domains and in the Overall QoL, than those of the Group without BCM.nnnCONCLUSIONnThe study confirmed the hypothesis that the QoL of the Group with BCM is better than the Group without BCM.

Prevalência da incontinência urinária em amostra randomizada da população urbana de Pouso Alegre, Minas Gerais, Brasil

Os objetivos deste trabalho foram conhecer a prevalencia da incontinencia urinaria (IU), dos fatores demograficos e clinicos preditores da presenca de IU. Estudo epidemiologico, corte transversal, aprovado pelo Comite de Etica da Escola de Enfermagem da Universidade de Sao Paulo. A amostragem, estratificada por conglomerado, foi composta por 519 individuos com idade ≥18 anos, residentes em 341 domicilios da area urbana, sorteados aleatoriamente. Os testes utilizados foram qui-quadrado, Hosmer Lemeshow e regressao logistica multivariada (stepwise). As prevalencias foram padronizadas por sexo e idade, portanto, das 519 pessoas que compuseram a amostra, 20,1% dessas tinha IU numa populacao total; 32,9% eram mulheres e 6,2% homens. Maior tempo de perdas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), acidente vascular encefalico (OR=15,9; p<0,001) e cistocele (OR=12,5; p<0,001) foram os fatores mais fortemente associados a IU. O estudo permitiu conhecer a epidemiologia da IU e pode contribuir para o desenvolvimento de politicas publicas para a sua prevencao primaria e secundaria, seu tratamento, ainda que inicialmente em nivel municipal.This study determines and analyzes the prevalence of Urinary Incontinence (UI) and its demographic and clinical predictors. This epidemiological and cross-sectional study was approved by the Research Ethics Committee of the University of São Paulo, Nursing School. The sample was randomly selected by cluster technique and included 519 individuals aged≥18 years, living in 341 houses in urban areas. Data were analyzed through Chi-Square, Hosmer Lemeshows test and multivariate logistic regression (stepwise). Prevalence rates were standardized by gender and age. Of the 519 people composing the sample: 20.1% had UI, 32.9% were women and 6.2% were men. Longer duration of losses (OR=29.3; p<0.001), diabetes mellitus (OR=17.7; p<0.001), stroke (OR=15.9; p<0.001), and cystocele (OR=12.5; p<0.001) were the factors most strongly associated with UI. This study enabled the identification of UI epidemiology and can contribute to the development of public policies for its primary and secondary prevention and treatment, even if such measures are initially implemented at the city level.

Validity of the Braden and Waterlow subscales in predicting pressure ulcer risk in hospitalized patients

The aim of this study was to evaluate the validity of the Braden and Waterlow subscales in predicting pressure ulcer risk in hospitalized patients. This is a secondary analysis of a prospective cohort study. Braden sensory perception and friction/shear subscales and Waterlow mobility and appetite subscales were the most relevant predictors.

Validity of the Braden Nutrition Subscale in predicting pressure ulcer development.

PURPOSE: The purpose of this study was to analyze the validity of the nutrition subscale from the Braden Scale for Predicting Pressure Sore Risk in hospitalized patients. DESIGN: A prospective, quasi-experimental, repeated-measures design guided data collection and analysis. SUBJECTS AND SETTINGS: One hundred seventy adult patients from 2 private hospitals located in urban areas in Southeastern Brazil, with a Braden Scale score of 18 or less, and who agreed to participate in the study were assessed between January and August 2006. Participants were primarily male (57.0%) and had a mean age of 67.0 ± 15.4 years (mean ± SD). METHODS: Objective assessment and subjective global assessment of nutritional status were performed on admission. Every 2 days, patients deemed at potential risk for pressure ulcer development underwent evaluation of protein-energy intake, skin assessment, and repeated risk assessment for pressure ulcer development via the Braden Scale. Univariate and multivariate logistic regression analyses were used to assess the predictive power of nutritional variables related to risk for pressure ulcer development. RESULTS: The mean length of stay among patients was 17.8 ± 16.8 days. Multivariate regression analysis revealed that serum albumin levels (odds ratio = 5.226; P < .001) and subjective global nutritional assessment (odds ratio = 3.246; P < .001) were the best nutritional predictors of pressure ulcer development. CONCLUSION: We did not find the Braden nutrition subscale score to be predictive for pressure ulcer development in hospitalized patients. Serum albumin levels and subjective global nutritional assessment were the best nutritional predictors of pressure ulcer development.

Prevalência da incontinência anal na população urbana de Pouso Alegre - Minas Gerais

Os objetivos deste estudo foram conhecer a prevalencia da incontinencia anal (IA) em adultos da cidade de Pouso Alegre (Minas Gerais) e verificar os fatores demograficos e clinicos preditores de sua presenca. Estudo epidemiologico desenvolvido por meio de amostragem estratificada por conglomerado, tendo amostra final composta de 519 individuos, com idade >18 anos, em condicoes fisicas e mentais adequadas, residentes em 341 domicilios da area urbana e sorteados aleatoriamente. As prevalencias foram padronizadas por sexo e idade, resultando em 7,0% para IA, tanto geral como para homens e mulheres. No modelo final de regressao logistica, numero de filhos (OR=5,1; p<0,001), doenca hemorroidaria (OR=4,4; p<0,001) e cistocele (OR=3,0; p<0,001) estavam associados a presenca de IA. O estudo permitiu conhecer a epidemiologia da IA e pode contribuir para o desenvolvimento de politicas publicas visando a prevencao primaria e secundaria, e ao tratamento, ainda que inicialmente em nivel municipal.The objectives of this study were to analyze the fecal incontinence (FI) in adults living in Pouso Alegre (Minas Gerais, Brazil) and the associated demographic and clinical variables. This epidemiological study developed sing stratified sampling by conglomerates. The final sample consisted of 519 individuals, of age >18 years, with adequate mental and physical conditions, living in 341 homes, which were randomly selected. Prevalence rates were standardized by gender and age, and revealed 7.0% of FI, overall and for men and women. In the final model of logistical regression, the number of children (OR=5.1; p<0.001), hemorrhoids (OR=4.4; p<0.001) and cystocele (OR=3.0; p<0.001) were statistically correlated to FI. This study identified the epidemiology of fecal incontinence in a small town in Brazil and may contribute to establish public policies and programs for primary and secondary prevention and treatment of FI, starting at the local level.

Prevalence of fecal incontinence in the urban population of Pouso Alegre - Minas Gerais - Brazil

Os objetivos deste estudo foram conhecer a prevalencia da incontinencia anal (IA) em adultos da cidade de Pouso Alegre (Minas Gerais) e verificar os fatores demograficos e clinicos preditores de sua presenca. Estudo epidemiologico desenvolvido por meio de amostragem estratificada por conglomerado, tendo amostra final composta de 519 individuos, com idade >18 anos, em condicoes fisicas e mentais adequadas, residentes em 341 domicilios da area urbana e sorteados aleatoriamente. As prevalencias foram padronizadas por sexo e idade, resultando em 7,0% para IA, tanto geral como para homens e mulheres. No modelo final de regressao logistica, numero de filhos (OR=5,1; p<0,001), doenca hemorroidaria (OR=4,4; p<0,001) e cistocele (OR=3,0; p<0,001) estavam associados a presenca de IA. O estudo permitiu conhecer a epidemiologia da IA e pode contribuir para o desenvolvimento de politicas publicas visando a prevencao primaria e secundaria, e ao tratamento, ainda que inicialmente em nivel municipal.The objectives of this study were to analyze the fecal incontinence (FI) in adults living in Pouso Alegre (Minas Gerais, Brazil) and the associated demographic and clinical variables. This epidemiological study developed sing stratified sampling by conglomerates. The final sample consisted of 519 individuals, of age >18 years, with adequate mental and physical conditions, living in 341 homes, which were randomly selected. Prevalence rates were standardized by gender and age, and revealed 7.0% of FI, overall and for men and women. In the final model of logistical regression, the number of children (OR=5.1; p<0.001), hemorrhoids (OR=4.4; p<0.001) and cystocele (OR=3.0; p<0.001) were statistically correlated to FI. This study identified the epidemiology of fecal incontinence in a small town in Brazil and may contribute to establish public policies and programs for primary and secondary prevention and treatment of FI, starting at the local level.