Mestrado em Ciências da Saúde (FM)

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O absenteísmo-doença da equipe de enfermagem de um hospital universitário
(Universidade Federal de Goiás, 2014-06-27) Marques, Divina de Oliveira; Pereira, Milca Severino; Oliveira, Ênio Chaves de; http://lattes.cnpq.br/7046861881778720; Pereira, Milca Severino; Barbosa, Maria Alves; Coelho, Maria Alice; Vila, Vanessa da Silva Carvalho; Oliveira, Ênio Chaves de
Introduction: Unplanned absenteeism negatively affects the institutional routine in different ways, representing a complex administrative problem. Objective: to analyze absenteeism due to illness among the nursing staff of a university hospital. Methodology: a retrospective study with a quantitative approach, conducted in a university hospital, located in Goiania, Goias, Brazil, for the period 2008 to 2012. Data collection used a script, developed based on the records of workers. The study sample consisted of all employees of the nursing team, belonging to the permanent staff of the institution, who were absent from work with medical justification. Data were collected in conjunction with the workers’ employment records. Results: we identified 1574 medical justification certificates, it was found a majority of certificates involving diseases of the musculoskeletal system (19.7%), followed by mental and behavioral disorders (18.0%), as the most frequent causes of absenteeism. Regarding the professional category, the nurse technicians had the highest number of certificates. The services with the highest number of certificates were: outpatient with 201 reports (12.8%), followed by the Medical Clinic with 177 (11.2%) and Emergency with 143 (9.1%). Conclusion: the study concludes that absenteeism related to illness affects the operation of the health service, directly affecting the nursing staff and patients, resulting in work overload, and consequently hindering nursing care. It is necessary to adopt preventive and curative measures to decrease absences of employees of the nursing staff due to illness as well as increase their level of job satisfaction, with the goal of more human nursing care and a reduction in institutional and public spending.
Acupuntura combinada com auriculoterapia no tratamento e qualidade de vida de pacientes com Síndrome da Ardência Bucal (SAB): ensaio clínico de braço único
(Universidade Federal de Goiás, 2015-12-04) Franco, Faraina Rodrigues Vasconcelos; Ribeiro-Rotta, Rejane Faria; http://lattes.cnpq.br/9466795079344876; Ribeiro-Rotta, Rejane Faria; Silva, João Bosco Guerreiro da; Freire, Maria do Carmo Matias; Costa, Luciane Ribeiro de Rezende Sucasas da; Queiroz, Maria Goretti
Abstract: The Burning Mouth Syndrome (BMS) is part of the framework of chronic pain which is difficult to diagnose, refractory to treatment, more prevalent in women in pre and postmenopausal phase. Acupuncture and auriculotherapy have been suggested as options in the treatment of pain, since they promote analgesia favoring the reduction of symptoms with lower doses of drugs and allowing greater patient compliance to treatment, and positive impact on quality of life. However, the phobia to needles or fear of adverse reactions can trigger anxiety, nervousness, abandon treatment, generating stress, which can lead to the release of glucocorticoids, such as cortisol. Clinical trials investigating the effectiveness of acupuncture in the treatment of BMS are scarce in the literature. Objective: To investigate combined acupuncture and auriculotherapy in the treatment and quality of life of patients with BMS. Methods: Sixty patients with burning mouth were subjected to a thorough process of differential diagnosis of BMS. Of these, 12 met the inclusion criteria and agreed to participate. Eight patients have completed treatment with acupuncture and auriculotherapy with previously established protocol. The outcome variables were analyzed before and after treatment: pain / burning (VAS - visual analog scale), salivary flow (unstimulated sialometry), quality of life (OHIP14) and stress levels (salivary cortisol). Results: Significant reduction in the intensity of pain / burning in the first treatment sessions was observed; the low values of EVA (0-2) and subjective indicator of quality of life (μ = 5.37 ± 3.50) revealed improvement in quality of patients´ life. There was no relationship between salivary flow and intensity of pain / burning. Salivary cortisol levels were significantly lower before (P = 0.03) and during (P = 0.01) acupuncture / auriculotherapy sessions (1st, 11th), with P <0.005 for all comparisons to baseline upon awaking, revealing that the procedures under the study conditions, did not promote stress on the patients. Conclusions: Combined acupuncture / auriculotherapy was effective in reducing the intensity of burning and improving quality of life, not generating stress during treatment sessions. There was no relationship between salivary flow and intensity of burning mouth.
Adaptação transcultural do ghent developmental balance test, confiabilidade e validade concorrente de sua versão em língua portuguesa para crianças pré-escolares
(Universidade Federal de Goiás, 2015-09-08) Bizinotto, Thailyne; Formiga, Cibelle Kayenne Martins Roberto; http://lattes.cnpq.br/5231575956660644; Vieira, Marcus Fraga; http://lattes.cnpq.br/4153462617460766; Vieira, Marcus Fraga; Costa, Paula Hentschel Lobo da; Sacco, Isabel de Camargo Neves
One of the importante skills of children in school age is the balance, important for maintaining bipedal posture as opposed to the constant action of gravity. The objectives of this study were to cross-cultural adapt, verify the reliability and concorrent validity the Development Test Balance Ghent (TDEG) for children between 22 months and 6 years. This study evaluated 47 children between 22 months and 6 years old of both sexes in Goiânia. The instruments used were: Ghent Developmental Balance Test (GDBT); Gross Motor Function Classification System (GMFCS); Sitting-Rising Test (TSL); Denver II Developmental Screening Test; Pediatric Balance Scale (EEP). To check the inter-observers reliability, the assessment of children was videotaped and passed to four (4) observers. To check the intra-observer reliability, a new evalluation through the videos was performed six (6) months after the first score. In order to determine the intra-rater reliability, a second evaluation of the child was performed up to 30 days after the first evaluation. After the translation into Portuguese some terms were discussed and consensus was carried out, some of which related to the content and semantics were changed to become the test more understandable and appropriate. The results of intra-rater reliability analysis of the TDEG total score was excellent, provided ICC = 0.94 . The inter-observers reliability of the TDEG total score of and TSL can be considered excellent withICC = 0.98 and 0.85, respectively. The inter-observers agreement of the EEP total score was considered moderate, with ICC = 0.56. By correlating TDEG with the EEP considering the entire sample, it was found an r = 0.70 (p <0.001), indicating a strong and significant correlation between these instruments. Analysing the second instrument used for validation, a moderate correlation with r = 0.42 and significant (p = 0.005) between TDEG and TSL was found when considering the entire sample. From these results we conclude that the TDEG has concurrent validity and is reliable for use in the age group which it proposes to assess, especially in the total score. Furthermore, the TDEG is a good tool for scientific research and ambulatory care about balance disorders of children under five years old.
Adaptação transcultural e propriedades psicométricas do COPE breve em uma amostra brasileira
(Universidade Federal de Goiás, 2012-03-30) Brasileiro, Sarah Vieira; Costa, Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305
Evidence indicates that some strategies of coping may play an important role in the disease psychological adaptation. It is important to evaluate the different ways of how people respond to stressful situations. Questionnaires for the assessment of coping have been widely used and recommended both in clinical practice and for research. The aim of this study was therefore to adapt the Brief COPE for the Brazilian population and to evaluate the psychometric properties of this instrument in a Brazilian sample. The cross-cultural adaptation of the Brief COPE followed procedures recommended by Beaton et al. and the final version was tested on a sample of 30 patients. Two hundred and thirty-seven individuals participated in the evaluation of the psychometric properties of the adapted version (Brief COPE). The intra-observer reliability was assessed in the reapplication of the Brief COPE after four weeks by the same observer. Factor analysis was conducted to evaluate the factorial validity of the Brief COPE. The internal consistency was estimated using the Cronbach’s alpha, calculated for each sub-scale and full scale factors. Regarding the results, the test-retest rateswere mostly above 0.75, demonstrating good reliability. Cronbach’s alpha for the whole Brief Cope was 0.84; 2 out of 14 sub-scales achieved Cronbach's alpha of at least 0.70, the other sub-scales were below this parameter. Factor analysis revealed four factors. We conclude that the Brief COPE was properly translated for use in the Brazilian population, demonstrating to be a reliable instrument to assess coping strategies.
Adequabilidade dos esfregaços cervicais frente aos principais fatores pré-laboratoriais que podem interferir na análise do exame citopatológico.
(Universidade Federal de Goiás, 2009-02-16) MARTINS, Marcelo Rodrigues; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029
Background: Cervical cancer in Brazil has one of the highest incidence rates. Screening this neoplasia is effective when a cytopathological test stained by Papanicolaou method is performed. However, the quality of cytopathological samples directly influences the screening effectiveness. Eventhough, this method has been criticized due to the high rates of false-negative, due to collection errors, routine scrutiny and the interpretation of cytological changes. Amongst the collection errors, the absence of endocervical cells and bad fixation are highlighted as one of the main concerns. Objectives: to assess the profile of professionals in charge of collecting cytopathological samples as well as verify whether the experience time and the working conditions are associated with sample adequability, verify the main difficulties and easiness reported by the professionals regarding cervical smears collection by using different fixation techniques, verify which fixation technique shows better performance concerning samples adequability and whether the fixation technique influences the detection of precursory injuries; verify the frequency of satisfactory cervical smears, the factors which could partially make samples obscure or make them unsatistactory for the analysis, as well as verify the presence or absence of transformation zone, and whether the presence of these cells is associated with the detection of cervical cancer precursory injuries. Methodology: 19 professionals -doctors and nurses- in charge of collecting cytopathological samples took part in this study. 1,354 cytopathological smears were included in this study, which were divided into three groups, submitted to different fixation techniques and distributed in the following manner: first group: 414 smears fixed with alcohol 95%; second group: 445 fixed with dropping fixation (alcohol 95% + polyethylene glycol) and third group: 495 fixed with spray (alcohol 95% + polyethylene glycol). The cervical material collected was referred to the cytology sector at the Rômulo Rocha Clinical Analyses Center and submitted to scrutiny routine regardless to the fixation technique. The cytopathological outcomes were classified in accordance with Brazilian Nomenclature for Cervical Diagnoses. At the end of the study, a questionnaire was applied to the professionals in which they reported difficulties and easiness concerning the use of different techniques. Data was inserted and processed in the Epi Info 3.3.2 software, and for statistic analysis we used the SAS 9.1.3 software. Outcomes: from the 19 professionals in charge of cytopathological screening 16 (84.2%) are nurses and 3 (15.8%) are doctors. From the 19 professionals in charge of collection, 58% pointed the spray technique as of very easy handling. In the limited smears the most frequent obscuring factor was leukocyte infiltration followed by dissecation, whereas for the unsatisfactory the majority was of dissecation followed by hypocellular material. Conclusions: this study showed that spray fixation technique had the worst performance concerning adequability of sample when compared to alcohol and drops, and that the professionals considered the spray fixation as of easier handling. There was no association between the precursory injuries diagnosis and the fixation technique used. The experience time and the Abstract proper collection environment influenced the quality of cervical material samples and the alcohol 95% fixation technique had the highest rate of difficulty reported, when compared to the drop and spray fixation. We also observed that the transformation zone representation was significant both for the most severe and less severe cervical cancer precursory injuries.
Adesão ao tratamento medicamentoso em insuficiência cardíaca
(Universidade Federal de Goiás, 2018-03-09) Freitas, Elis Marra da Madeira; Dewulf, Nathalie de Lourdes Souza; http://lattes.cnpq.br/1244479719591748; Rassi, Salvador; http://lattes.cnpq.br/7236834842677715; Rassi, Salvador; Lopes, Flávio Marques; Afiune Neto, Abrahão; Resende Filho, Joffre
Pharmacological treatment for heart failure evolved in the last decades. Betablockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and aldosterone antagonists have been widely used, as they were proven to reduce morbi/mortality in heart failure. Patient adherence has been studied all over the world in the last years in acute and chronic heart failure. Many factors knownly can influence the patient adherence to treatment. This study purpose was to evaluate pharmacological treatment in patients diagnosed with heart failure in outpatient follow up in a university hospital. Different methods were used to get to this objective, comparing each other and also clustering patients in more adherent and less adherent to pharmacological treatment, furthermore, we described the factors influencing patient adherence to pharmacological treatment. Thereunto, the Morisky questionnaire was used. Also a questionnaire made by the author and a form to collect data in patient’s chart were applied. Data frequency was described and then hierarchic clusters analysis was performed. Adherence measured by the Morisky questionnaire resulted in 71% of patients more adherent to pharmacological treatment and 26% less adherent. A different result and with more expressive values was found in the self-report adherence to pharmacological treatment by the patient, where 90% of the patients considered themselves as more adherent to pharmacological treatment and 8% considered themselves as less adherent. When comparing treatment prescribed and treatment reported by the patients, the majority of patients (78%) reports at least one drug different from the prescription. When measured by different methods, adherence can show not uniform results. The clinical factors and factors related to the satisfaction with the service did not influence the patient adherence to pharmacological treatment. In the other hand, some sociodemographics factors, like age (p = 0,0476), employment condition (p = 0,0132), schooling (p = 0,0167), marriage status (p = 0,011), family income (p = 0,0123), and factors related to the use of medications, as having family help to the the medications (p = 0,006), use medication alone (p = 0,0186) and have medical orientation bout the use of medication (p = 0,0077) had influence in patient adherence to pharmacological treatment. Thus, it was observed that patients being followed up in the Heart Failure Clinic of Hospital das Clínicas da Universidade Federal de Goiás are well medicated and have satisfactory adherence to pharmacological treatment.
Alterações cognitivas em pacientes idosos com insuficiência cardíaca
(Universidade Federal de Goiás, 2017-04-24) Afiune, Fernanda Guedes; Rassi, Salvador; http://lattes.cnpq.br/7236834842677715; Rassi, Salvador; Jardim, Paulo César Brandão Veiga; Barboza, Sandra de Fátima; Sá, Luis Antônio Batista de
Among the various diseases that affect the elderly stand out from them cardiovascular disease among them heart failure (HF). Recently seeks to check for cognitive impairment associated with physical and psychological damage commonly known in the IC. We analyzed a population of patients with heart failure in order to compare their cognitive performance with that of individuals with normal aging in paired age. It was also verified whether there was any more specific impairment of some cognitive function in these HF patients. Through neuropsychological tests it was compared to 78 elderly and 37 in the control group (mean age 68.3 ± 6.3), 41 clinical group with mean age of 68.6 ± 6.9). The subjects were matched to the level of education with a predominance of elderly people with 0-4 years of education (65.9% in the Clinical Group and 59.5% in the control group). We used 11 neuropsychological tests covering the cognitive functions: attention, language, memory, mood and executive function. The results showed significant differences mainly in executive functions which include planning capacity, organization, alternation and evocation of Previously stored information. Cognitive performance in other functions was similar between the groups. The data collected when indicating cognitive impairment in individuals with HF, suggest that new studies be performed with this population since the impairments in cognitive abilities have implications in the daily life of the individual, in their independence and quality of life, as well as in adherence to treatment.
Análise Biomecânica da Inicialização da Marcha de Amputados Transtibiais Protetizados
(Universidade Federal de Goiás, 2012-03-30) AVELAR, Ivan Silveira de; SILVA, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496
The amputee patient undergoes several changes after the amputation, not only physical but also emotional and socioeconomic, requiring the use of prosthesis. One of the physical changes that affects the amputee's gait when using your prosthesis ambulation is compromised. The march is the natural way that humans use to move from one location to another. The march is a complex activity because it depends on a series of interactions between the two lower limbs multithreaded and total body mass. Therefore, assessing the impact of the use of prostheses in locomotor through the analysis of strategies for startup of the march transtibial amputees. We evaluated the speed and displacement of the COP, knee and ankle angles of the support member during initialization of the march. For the kinematic analysis was set 34 markers on anatomical landmarks of interest, two AMTI force platforms. For statistical analysis we used the Student t test and correlation between variables. Difference was only statistically significant variables in the knee angle and average speed side. The absence of a flexible ankle joint may result in limitations in the function of the prosthesis. Amputees to achieve an adequate control in propulsion and balance it was necessary to use several strategies to adjust. The prosthesis provided by SUS serves its purpose, which is to provide a walking person. But this improvement in the ankle joint can facilitate the process of walking boot. Another fact of great importance is the frequent evaluation of prosthetic to verify the necessary adjustments of the prosthesis.
Análise cinética dos distúrbios de marcha nos pacientes com esclerose múltipla: proposta de categorização e suas possíveis repercussões no desempenho
(Universidade Federal de Goiás, 2017-03-10) Corrêa, Paulo Fernando Lôbo; Diniz, Denise Sisterolli; http://lattes.cnpq.br/5139602841690387; Diniz, Denise Sisterolli; Souza, Doralina Guimarães Brum; Gervásio, Flávia Martins; Rosa, Heitor
Background: Multiple sclerosis (MS) causes gait disturbances that interfere in the independence and activities of daily living. For Understand the cause of these gait disturbances this study focused on the kinetics analysis of these patients gait, more specifically in the analysis of the vertical component of the ground reaction force (VCGRF). It permits estimate loss in the capacity to accelerate or decelerate the body center of mass upwards and downwards during gait. To make the analysis of this component more objective, the Ben Lomonding classification has been proposed. However, so far, it has only been tested in children with cerebral palsy (CP). Objective: To analyze the kinetics of gait disorders in MS and its repercussions on patient performance in different levels of impairment Method: A cross-sectional Control case study was developed and evaluated the gait in selfselected speed of 50 healthy adult (25 women and 25 men) and 49 adult patients (42 women and 7 men) with MS and EDSS between 1.5 and 6.0. Recruited at a Reference in MS and accomplished the three-dimensional and instrumented evaluation of the gait in a Movement Analysis laboratory of the Rehabilitation. In which, the data collection was accomplished through the VICON® system and 4 force platforms of the brand AMTI®. The speed fast analysis performed through the Timed 25-foot Walk (T25FW) test. Patients’ gait was assessed by a single rater, always in the morning, in an air-conditioned room. The VCGRF analysis was performed through Ben Lomonding’ s classification. Results: Analyzing VCGRF and possible decrease in FZ2 using Ben Lomonding classification permitted categorize VCGRF of patients with MS in five of its eight levels, since types 0, 1, 2, 3, and A were found. Of the limbs assessed, 47.0% presented alteration in VCGRF, and of these, 19.4% presented a decrease in FZ2. In patients with worse EDSS score, decrease in FZ2 was more frequent. Patients with more severity types of Ben Lomonding had higher depletion in the patient’ s performance measured by the test T25FW, cadence, speed, step and stride length, double support time and stance time. Also they presented worse performace cerebellar. Conclusion: Ben Lomonding classification can be applied to adults with MS. Additionally, the decrease in FZ2 was more frequent in patients with more severe MS, which suggests influence of MS severity on decrease in FZ2. The FZ2 reductions seem to worsen the performance of the patient gait.
Análise comparativa da resistência de união e à compressão de cimentos biocerâmicos utilizados em procedimentos de endodontia regenerativa
(Universidade Federal de Goiás, 2021-01-12) Rodrigues, Maykely Naara Morais; Bruno, Kely Firmino; http://lattes.cnpq.br/0680297602065791; Alencar, Ana Helena Gonçalves de; http://lattes.cnpq.br/2039898015468283; Alencar, Ana Helena Gonçalves de; Decurcio, Daniel de Almeida; Estrela, Carlos
Objective: To compare the bond strength to root dentin by means of the mechanical push-out test and the compressive strength of BIODENTINE®, MTA REPAIR HP® and BIO-C REPAIR® bioceramic cements. Materials and methods: For the test of bond strength to root dentin, 18 uniradicular lower premolars were used, sectioned 5.0 mm below the cemento-enamel junction (JCE). Cervical preparations were performed with a Largo # 1, # 2, # 3, # 4, # 5 and # 6 drill and the intracanal medication used was the antibiotic double paste, which remained in the root canal for 21 days. After removing the intracanal medication, the roots were cross-sectioned to obtain 1 mm thick dentin discs, consisting of 3 samples per tooth. Next, the 54 dentin discs were randomly divided into 3 experimental groups (n = 18) for insertion of the following bioceramic cements: Group 1 - BIODENTINE®; Group 2 - MTA REPAIR HP®; and, Group 3 - BIO-C REPAIR®. Cements were handled according to the manufacturers' recommendations and inserted into the root canal of each specimen placed on a glass plate, and subsequently kept in an oven at 37ºC and 100% relative humidity for 7 days. After the storage period, the mechanical push-out test was performed and the specimens were analyzed in the stereomicroscope with a 3x magnification to determine the failure pattern. For the compressive strength test, specimens (n = 10) of each of the bioceramic cements evaluated were made, with dimensions of 6 mm in height x 3 mm in diameter, these were stored in an oven at 37 ° C and 100% relative humidity for 7 days. After the storage period, the specimens were taken to the test device of the Universal Testing Machine to perform the test. The data were analyzed using the Shapiro-Wilk normality test. In the mechanical push-out test, the Kruskal-Wallis non-parametric test was used and multiple comparisons were performed using the Friedman test, with the failure pattern presented as a percentage. In the compressive strength test, the ANOVA test was used and multiple comparisons were performed using the Tukey test. The level of significance was set at 0.05%. Results: For the bond strength to root dentin, the bioceramic cement BIODENTINE® performed better than MTA REPAIR HP® and BIO-C REPAIR®, however, the difference was only statistically significant between the BIODENTINE® and BIO-C groups. REPAIR® (p = 0.0001). In the BIODENTINE® group, the most frequent failure pattern was mixed (61%), to the detriment of cohesive (33%) and adhesive failures (6%). On the other hand, in the MTA REPAIR HP® group, adhesive failures (94%) and only (6%) of mixed failures were observed more frequently, with no cohesive failures. Likewise, the BIO-C REPAIR® group did not present cohesive failures, but showed a higher prevalence of adhesive failures (72%) and a greater number of mixed failures (28%) when compared to MTA REPAIR HP®. With respect to compressive strength, the bioceramic cement BIODENTINE® showed greater resistance to compression than MTA REPAIR HP® and BIO-C REPAIR®, this difference being statistically significant (p <0.05). Conclusion: Bioceramic cement BIODENTINE® showed higher values of bond strength to root dentin and compressive strength, however for the push-out test this difference was statistically significant only for BIO-C REPAIR® cement.
Análise da atenção básica à saúde do idoso na estratégia saúde da família
(Universidade Federal de Goiás, 2009-12-15) ARAÚJO, Maria Aparecida da Silva; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225
The study focused on the health care of the elderly, more specifically in Family health strategy as a way of thinking about alternatives that allow the reorganization of elderly care to adscritas areas. Processorsthe General was discussing the basic attention actions offered to the elderly in context family health strategy. Search descriptive exploratory in nature,- qualitative basic performed with professionals that comprise health team family doctors, nurses, technicians, nurses and community agents health in the municipality of Aparecida de Goiânia, goaiz. For data collection were the focal group technique and the data were analysed in categories as Bardin. The results suggest that prospects strengthen the professional aspects in family health care to the elderly, while showing some limitations of the elderly in the team. The team's contribution family health was significant health care of the elderly be reconsidered by professionals and managers for the operationalization of education These professional standing. It was concluded that the multidisciplinary actions are present in health promotion, both in the basic unit in address through talks, walks, assistance activities Prevention and control of diseases, although realize difficulties operacionalizá them. The insertion of the elderly in some family health teams occurs through attractive activities forming your social network participation activities outside of the health unit, such as concerts and tours and provide suggestions for activities. However, for other teams actions intersectoral health promotion is not present. The results of this study may offer subsidies to family health professionals for Organization of care to the elderly, to assistance the oldest coherent national policy guidelines of care.
Análise da dor em injeções intravítreas
(Universidade Federal de Goiás, 2021-01-19) Pereira, Carlos Eduardo Gonçalves; Jorge, Eduardo; Ávila, Marcos Pereira; http://lattes.cnpq.br/3335187297522447; Ávila, Marcos Pereira; Isaac, David Leonardo Cruvinel; Abud, Murilo Batista; Bianchi, Carla de Souza Nassar; Rassi, Alan Ricardo
Intravitreal injections became an important treatment for many ophthalmological diseases. Antibiotics, antiangiogenics, steroids, antifungal medications can be delivered directly to the vitreous cavity. As the number of procedures rise worldwide, and some individuals require monthly injections, it is critical to study the pain involving the injections. The objective of this study was to determine the incidence and degree of pain during intravitreal injections. We also studied the influence of age, medication injected, disease treated, previous cataract surgery, number of applications, influence of expected pain and needle size. 201 intravitreal injections were realized in 2019, performed by the same surgeon following the same technic in all procedures. The pain was assessed by the numerical pain scale, administered verbally. After statistical analysis we found an incidence of pain of 72,1%, bigger needles had a statistically higher incidence of pain. The intensity of pain was mild, and all the studied variables showed no statistically significant difference.
Análise da estabilidade, variabilidade e complexidade do ligamento cruzado anterior após reconstrução do ligamento cruzado anterior
(Universidade Federal de Goiás, 2016-09-21) Oliveira, Eduardo Afonso de; Vieira, Marcus Fraga; http://lattes.cnpq.br/4153462617460766; Campos, Mário Hebling; Rebelo, Ana Cristina Silva; Vieira, Marcus Fraga
Background: The objective of this study was to investigate gait stability by nonlinear dynamic methods and gait variability and complexity in the postoperative period after anterior cruciate ligament (ACL) reconstruction. Methods: The study was observational and case-controlled and used 40 subjects (32 male) divided into 4 groups of 20 each: a control group (CG) and 3 observational groups in different postoperative periods after ACL reconstruction: OG-I (30‒90 days), OG-II (90‒180 days), and OG-III (360 days). For kinematic recording, each subject walked on a treadmill for 4 minutes at a constant speed of 3.5 km/h. Gait variability was assessed using the normalized root mean square (RMS ratio) of trunk acceleration and the average standard deviation of medial-lateral trunk acceleration (VAR ML). Gait stability was assessed using the margin of stability (MoS) and local dynamic stability (s), and complexity was assessed using approximate entropy (ApEn). Results: Compared to the CG, the RMS ratio and VAR ML increased significantly in the OG-I group and decreased incrementally in OG-II and OG-III. MoS decreased significantly in the OG-I group and increased incrementally in OG-II and OG-III, while s decreased in the OG-I and OG-II groups and increased in the OG-III groups. The ApEn was lower in the OG-I group than in the CG and decreased incrementally in OG-II and OG-III. Conclusions: Results indicated that ACL reconstruction was followed by a progressive increase in stability and a progressive decrease in variability over the postoperative rehabilitation period. In terms of stability and gait variability, six months of physiotherapy for rehabilitation after ACL reconstruction appears to be effective, but it is insufficient for a complete recovery as compared to healthy individuals.
Análise da variabilidade e cinética da frequência cardíaca a partir do teste de esforço cardiopulmonar em mulheres com síndrome metabólica: estudo transversal
(Universidade Federal de Goiás, 2017-03-16) Silva, Lucas Raphael Bento e; Rebelo, Ana Cristina Silva; http://lattes.cnpq.br/1542664015677213; Rebelo, Ana Cristina Silva; http://lattes.cnpq.br/1542664015677213; Baptista, Tadeu João Ribeiro; Gentil, Paulo Roberto Viana; Silva, Maria Sebastiana
Introduction: Metabolic Syndrome (MS) is a metabolic disorder that offers increased risk for cardiovascular diseases. The analysis of heart rate (HR) kinetics during exercise and its variability (HRV) is an important tool in assessing neurocardial integrity. A slow response of the HR at the end of the exercise corresponds to a low performance of the parasympathetic activity. Objective: To compare HR variability at rest and HR kinetics during exerciserecovery (phase-off), post exercise exercise in women with and without MS. Methodology: A cross-sectional study was carried out with 36 women (35-55 years of age), divided into two groups: SM group (GMS, n = 19) and non-SM group (GNMS, n = 17). The volunteers were submitted to the Bruce type limiting cardiopulmonary stress test, and for the evaluation of the HRV at rest, the R-R intervals were captured during 12 minutes in the seated position. The KomolgorovSmirnov test was used to verify the normality of the data and to evaluate the difference between two independent groups the t-Test was used for independent samples or Mann-Whitney test, multivariate analysis (MANOVA), multiple linear regression and Test Of Chi-square. The level of significance was set at 5%. Results: There was a statistically significant difference between the groups in the exponential component (p < 0.005) in the GNSM group and in the "τ" component (p = 0.032), being higher in the GSM group. There was no statistically significant difference in the parameter "FCpico." The GNSM group presented higher HR deltas compared to the SM group in the Δ60, Δ105 and Δ120 groups. GSM presented lower values in the parasympathetic modulation indices when compared to the SP group. GNSM, in contrast to a low correlation between glycemia and the highest values of the exponential component "τ", which showed a negative relation with the CC and BMI variables. Conclusion: The volunteers with MS presented autonomic dysfunction with compromised cardiac-parasympathetic modulation attributed to changes in the glycemic state. The exponential and linear analysis of FCoF can provide us with a sensitive and anticipated indicator of health impairments, proving to be useful to identify changes in cardiac autonomic control in the recovery of physical exercise.
Análise das condições de saúde ocular da população atendida no centro de referência em oftalmologia do hospital das clínicas/UFG
(Universidade Federal de Goiás, 2011-12-06) ROCHA, Maria Nice Araujo Moraes; ISAAC, David Leonardo Cruvinel; http://lattes.cnpq.br/5474072354473614; ÁVILA, Marcos; http://lattes.cnpq.br/3335187297522447
There are few studies of epidemiological research in of Ophthalmology with the population of center-western Brazil. In order to identify the prevalence of the of eye diseases in the region, and specifically in Goiania and Goiás, that impact on blindness and visual impairment, this study analyzed 10,060 records randomly selected from patients seen at the Reference Center for Ophthalmology School of Medicine Federal University of Goiás ((CEROF/UFG), in From April 2009 to March 2010. There was a profile analysis of ocular morbidity in the target population in relation to disease group, acuity, age, sex and region of origin. The study also covered the distribution of queries in the four quarters of the year, elective and urgent, and the degree of visual impairment in the bands visual impairment and blindness. The predominant diseases in elective care in relation to the total sample of 10,060 patients were cataract (7.24%), pterygium (6.77%), allergic conjunctivitis (3.70%), dry eye (3,36%) , diseases of the retina and vitreous (3.23%), strabismus (2.64%) and glaucoma (1.94%). In urgent care were the most prevalent extraocular foreign body (25.5%), infectious conjunctivitis (23.6%), keratitis and and corneal ulcer (11.3%), pterygium and pingueculite (5.3%) and sub conjuntival hemorrhage (4.0%). There was higher prevalence of sex female (63.1%) and ages between 0-14 (26,8%) years and 40 to 49 (20,8%) years in elective consultations. In urgency consultations there was more prevalent of male (64.84%) and ages between 15 and 39 (51.06%) years in clinical urgency. Refractive errors were recorded in 43.08% of queries being found more astigmatism (40.02%) followed by hyperopia (36.54%). Were determined rates of low vision within the parameters of World Health Organization (WHO). The results were compared with other studies in Brazil and abroad, aiming to define the reality of the regional profile of eye health, as an aid to prevention strategies, recovery and treatment through health policies and government's own guidance service studied, the CEROF/UFG. It follows that both elective care and emergency at CEROF/UFG is similar to that found in southern and southeastern Brazil and in most developed countries of the world.
Análise das notificações das infecções primárias de corrente sanguínea em unidades de terapia intensiva adulto de Goiânia-GO
(Universidade Federal de Goiás, 2018-08-29) Silva, Alexsandra Gomes Resende de Souza da; Santos, Silvana de Lima Vieira dos; http://lattes.cnpq.br/2461784381351166; Moreira, Maria Auxiliadora Carmo; http://lattes.cnpq.br/5581728940781401; Moreira, Maria Auxiliadora Carmo; Neves, Heliny Carneiro Cunha; Neves, Zilah Cândida Pereira das; Ferreira, Denise Milioli
Introduction: Central-line associated bloodstream infections (CLABSIs) are common in Intensive care units (ICUs), leading to longer hospital stays, high hospital costs and death. As such, surveillance, prevention and control are indispensable.Objective: Analyze the epidemiological and microbiological profile of central-line associated bloodstream infections in adult ICUs in the municipality of Goiânia, Brazil. Method: Analytical ecological study conducted using secondary data from reports of all clinical and laboratory central-line associated bloodstream infections in adult ICUs in Goiânia, between 2012 and 2016. SPSS-17.0 and Stata software (version 14.0) were used. Data were expressed as temporal trend, descriptive statistics and percentiles. Data analysis considered a 95% confidence interval and significance level of p<0.05. Results: We analyzed 1988 healthcare-associated infection (HAI) notifications from 42 adult ICUs. The temporal trend of central-line associated bloodstream infections incidence density was stationary. The incidence density of laboratory central-line associated bloodstream infections varied from 3.32 to 4.34 infections per 1000 catheters/day. The rate of central venous catheter use in the period was 55.36%. In relation to percentile, increase was observed in the study period, particularly in 2016 in the 90th percentile. There was no statistical association between the variables analyzed. With respect to the microbiological and antimicrobial susceptibility profile, SCon and S. aureus showed 91.8% and 71.4% resistance to oxacillin, respectively, in 2016. K. pneumoniae and Acinectobacter spp. Were resistant to 3rd and 4th generation cephalosporins and carbapenems. Conclusion: It was concluded that the temporal trend of central-line associated bloodstream infections was stationary, and incidence density and percentiles increased over the years. The primary causative agents were SCon and K. pneumoniae, with broad spectrum antimicrobial resistance. Measures should be implemented to monitor health services and provide continuing education for health workers regarding the prevention and control of these infections.
Análise de estratégia para aplicação de sistema eletrônico na referência e contrarreferência nos serviços de saúde
(Universidade Federal de Goiás, 2013-12-02) Morato, Márcia Gasparini Canuto; Taleb, Alexandre Chater; Rabahi, Marcelo Fouad; http://lattes.cnpq.br/1489771770609266; Rabahi, Marcelo Fouad; Silva, Nilzio Antônio da; Laval, Cristina Aparecida Borges Pereira
Introduction: In recent times, the Brazilian Unified Health System has undergone several innovations in management, organizing, financing and services. In this context, looms as a major strengthening of the system of Primary Health Care, which has demonstrated the essence of the effectiveness of care, enabling a holistic approach to people. In this sense, it is necessary an efficient monitoring of the patient by means of the reference and counter reference. Objective: To analyze strategies to implement the Electronic System Reference and counter reference in the Family Health Unit (FHU) in the city of Anápolis, Goiás. Material and Methods: The study was a prospective, nonrandomized intervention, developed in two of the three FHU research. The experimental and control groups were chosen on the basis of convenience. Visits were made by the researcher to the health units, explanations about the research and requests for assistance to the professionals. The interventions were performed by means of encouragement and guidance to professionals and patients. It was used among the instruments: Sheets Guidelines and Flow and Letter Search. In one of FHU Intervention was made available the Electronic Reference and counter reference. We carried out the monitoring, the FHU study and the National Regulatory System (SISREG), the flow of patients referred to specialists in the period from 1 August 2012 to 1 December 2012. Visits to medical specialists were made who treated the patients referred and also active search for patients who have not returned or returned without the counter reference - FHU source. It was evaluated the number of references, counter reference and reasons for non-return of patients and counter reference to the three FHU from study. Data were analyzed using STATA version 11.0. Results: Of the total of 6,218 medical consultations, it was performed 532 accompaniments to specialists physicians and 492 patients accompaniments. The referral rate was 8.56 %. They were requested and scheduled more appointments in FHU intervention. Of referrals made, 54.27 % were scheduled consultations. Of these, 11.61 % patients returned to FHU source routing. The time of the patient's return home to FHU, after issuing the referral reference ranged from 6 to 110 days. The patients return home at FHU occurred only in Intervention, and of these patients, almost half returned to the counter reference manually. Conclusions: The study demonstrated rate of referrals in accordance with international standards; difficulties of access to specialized consultations, low number of patients returns to FHU source routing, as well , that guidance and encouragement to professionals and patients positively affect the patients return to the FHU and counter reference source. It was believed to be feasible to implement the referral system and counter reference electronically, allowing better communication between professionals safely and quickly and greater integration between services.
Análise de três escalas observacionais utilizadas para avaliação do comportamento de crianças durante tratamento odontológico sob sedação
(Universidade Federal de Goiás, 2015-09-29) Moura , Larissa da Silva; Costa , Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305; Costa , Luciane Ribeiro de Rezende Sucasas da; Costa , Paulo Sérgio Sucasas da; Campos , Cerise de Castro; Castro , Anelise Daher Vaz; Faria , Patrícia Corrêa de
The effectiveness of a sedative for pediatric dental treatment is commonly assessed through observational scales that assess the children behaviour. There is little information about the ability of a variety of scales in properly evaluate this behavior. The aim of this study was to analyze the characteristics of three scales,e,g,. Houpt Scale, Ohio State University Behavioral Rating Scale (OSUBRS) and Venham Behavior Rating Scale, to measure the behavior of preschool children during dental procedures under sedation. This study was an observational study nested to a randomized clinical trial (NCT02284204), which included 27 children between 4 and 6 years of age with early childhood caries and negative behavior in previous consultation. Participants underwent dental treatment under moderate sedation with midazolam and ketamine with or without addition of sevoflurane. The sessions were videotaped and five trained and calibrated observers watched the movies to record the behavior of children according to each scale. The data showed non-normal distribution (Shapiro-Wilk, P> 0.05); descriptive and correlation analyses were made (Spearman test). A total of 1,209 minutes of videos were observed and analyzed. Global scales (Houpt overall behavior and Venham) had closer scores of good behavior. The most frequent scores for Houpt were “no crying” and “no movement”, and for OSUBRS, “quiet”. Statistically significant correlations (P <0.05) occurred between Houpt overall behavior and Venham; Houpt overall behavior with Houpt categories movement (scores 2 and 4) and cry (scores 1, 2 and 4); Venham with Houpt movement (score 4) and cry (scores 2 and 4). OSUBRS scores 1 and 4 had high correlation coefficients with Houpt overall behavior and Venham. The Houpt overall behavior and the Venham Behavior Scale were highly correlated to measure behavior of children in dental treatment under sedation. OSUBRS showed better correlation with global scales compared to the categories of crying and movement of Houpt scale.
Análise do padrão do uso de medicamentos em idosos no município de Goiânia, Goiás
(Universidade Federal de Goiás, 2012-03-30) SANTOS, Thalyta Renata Araújo; LIMA, Dione Marçal; http://lattes.cnpq.br/4310011929664114; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029
Introduction: The fact of elderly people live in a greater amount with chronic diseases, make the elderly a great consumer of health services and, probably, the most medicated group in the society. In this context serious problems arise, such as the use of multiple medications simultaneously (polypharmacy) that can lead to serious consequences to the elderly health. Another problem is the self-medication, which may exacerbate the associated risks with prescript drugs, delaying a diagnosis and masking a disease. There is, still, the use of drugs considered inappropriate for elderly, either by reducing the therapeutic efficacy or an increased risk of adverse effects that increase the advantages in elderly usage. Objective: Analyzing the pattern of use of medications in aged people in the city of Goiânia-GO, and associate it with socioeconomic aspects and with the self-rated health. Methods: A population-based study and cross-section, that evaluated the health of elderly in the city of Goiânia-GO. The data collection was carried out in December/2009 to April/2010 from 934 elderly. The questionnaire had questions about medications, in addition to information about self-rated health and socioeconomic profile. The drugs groups were classified according to the Anatomical Therapeutic Chemical and Classification-ATC. The inappropriate drugs for elderly were identified according to Beers Criteria. Used Mann Whitney (U) and Chi-square test, it was considered significant p<0.05. Results: Among 934 elderly participants of the survey, 783 (83.8%) had answered completely to the questionnaire. These 738 elderly used 2846 drugs (3.63 drugs/elderly). Women consumed more medication than men (3.94 and 3.06 respectively, p <0.001). The most frequently consumed drugs act on the cardiovascular system (38.6%). The prevalence of polypharmacy was 26.4% and 35.7% of the elderly told to practise self-medication. The drugs most commonly used by self-medication were the painkillers (30.8%). According to Beers-Fick Criteria, 24.6% of the elderly used inappropriate drugs, 90.2% of these drugs came from a current prescription. The inappropriate drugs more consumed were benzodiazepines (34.2%). Women, widows, elderly with 80 years or more and those who had a worse self-rated health practiced more polypharmacy (p<0.05). Elderly people with lower education and with worse self-rated health practiced more self-medication (p<0.05). Conclusions: The results of this study showed that the pattern of drug use by elderly of Goiânia was similar to that found in elderly people from other regions of Brazil. Since the number of drugs used, the prevalence of polypharmacy and self-medication practices and the use of inappropriate drugs were within the national average. Women, widows, aged 80 years or more and those who consider their health as poor more often practiced polypharmacy, the largest self-medication was associated with a lower education and poorer self-rated health.
Análise do perfil de expressão de genes relacionados à resistência a múltiplas drogas em cultura tridimensional de células de melanoma cutâneo humano
(Universidade Federal de Goiás, 2018-09-04) Faria, Letícia Cristine de; Guillo, Lídia Andreu; http://lattes.cnpq.br/3401436781775091; Guillo, Lídia Andreu; Carneiro, Lilian Carla; Cardoso, Clever Gomes
Cutaneous melanoma is a type of skin cancer being considered aggressive due to its rapid evolution, high predisposition to metastasis and the low effectiveness of current treatments in advanced stages. Poor prognosis results mainly from the intrinsic resistance to chemotherapy with the ability to confer resistance to multiple drugs (MDR). Among the several mechanisms related to the MDR phenotype, the best characterized involves expression of the superfamily of ATPdependent ABC transporters, identified as facilitators of drug efflux. In this context, it becomes important to search for models that make it possible to understand the behavior of the cell and the tumor microenvironment. Three-dimensional culture models have been proposed by mimicking the tumor microenvironment through cell-cell and extracellular matrix-cell interaction. Therefore, this study analyzed the expression profile of the ABCB1, ABCB5 and ABCB8 transporters in human cutaneous melanoma cells in a three-dimensional culture model through the formation of spheroids. Cutaneous melanoma cells from the A-375 and SKMEL-37 lineage were cultured in a monolayer and later were used for spheroid formation using 3 different methods: 1) agarose-coated plate culture; 2) culture in hanging drop; 3) culture in plate with non-adherent surface. Expression analysis of the ABCB1, ABCB5 and ABCB8 genes was performed by RT-PCR and visualization of the amplicons was done by agarose gel electrophoresis. Real-time RT-PCR reactions were performed for the quantification of the expression of these genes using the CT method. Data analysis was performed through One Way ANOVA, followed by Tukey post-test (p≤0.05). Our results demonstrated that the three-dimensional cell culture model in plate with the non-adherent surface was the most efficient, simple to perform and high efficiency technique for spheroid formation. Through RT-PCR we observed that the ABCB5 gene was not expressed in the cell lines studied and this data was confirmed in real time RT-PCR. The ABCB1 and ABCB8 genes were expressed on the spheroids formed by cells A-375 and SKMEL-37. In these two cell lines we observed that there is a significant increase in the expression of the ABCB1 and ABCB8 genes at time 07 in relation to the control. These findings show that the three-dimensional culture model through spheroid formation provided expression analysis of the ABCB1, ABCB5 and ABCB8 transporters, which are associated with drug resistance activity in human cutaneous melanoma.

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