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International Archives of Medicine
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Palliative Cares To Older Person Under The Nurse’s Optics

INTRODUCTION: Chronic-degenerative diseases need specialized health care, especially in palliative care, since from the beginning of the disease the elderly is in this classification. In this context, the study aimed to know the meaning of palliative care to the elderly person from the nurse

METHODS: This is a descriptive, cross-sectional, qualitative study carried out in a private tertiary hospital in the Northeast of Brazil. The survey was conducted from March to June 2016, with 19 nurses. In the data collection, a semi-structured interview, with four questions were used: what does palliative care mean to you? What does care for the elderly in hospice care mean to you? What strategies do you adopt to promote palliative care for the elderly? Tell me about your experience in providing palliative care to the elderly. The technique of data analysis and organization was the Discourse of the Collective Subject.

RESULTS: Four categories of palliative care were produced: meaning palliative care; Experience in providing palliative care to the elderly; Meaning of caring for the elderly in palliative care; Strategies to promote palliative care for the elderly.

CONCLUSION: The meaning of palliative care was synonymous with comfort and quality of life. It is important to emphasize the patient-centered care and to carry out further studies on the subject to make nursing professionals aware of the importance of promoting adequate behavior in palliative care.

from International Archives of Medicine

Possibilities and limits of multiprofessional attention in the care of psychiatric emergencies: analytical study

Goal: to analyze the possibilities and limits of multiprofessional care in the attention to psychiatric emergencies.

Method: it is an analytical study of the type integrative review of the comprehensive literature. Searches were conducted in the Latin American and Caribbean Literature (LILACS) and Nursing Database (BDENF) databases and in the ScieLo Virtual Library, with the use of Descriptors in Health Sciences (DECs): “Emergency Services, Psychiatric”, “Forensic Psychiatry”, “Psychiatric Rehabilitation”, in the period from 2007 to 2017.

Results: after data analysis, two thematic categories emerged: “Possibilities and limits in multiprofessional care for patients in crisis” and “The continuity of care to the patient in crisis by the multiprofessional team”. The studies point out fragility in the management of the multiprofessional team of care to the patients in psychiatric crisis. Therefore, in the substitutive services to the psychiatric hospital, it is necessary to strengthen the care and bonding tools for continuity of treatment after the cases of psychiatric emergency of these patients.

Conclusion: this research provided a deepening of the knowledge regarding the challenges of the multiprofessional team in the care of analytical psychiatric emergencies and in relation to the patient in crisis, considering the main multiprofessional actions, understanding how this approach is done and patient follow-up.

Descriptors: Emergency Services, Psychiatric. Forensic Psychiatry. Psychiatric Rehabilitation.

from International Archives of Medicine

The Team Of The Family Health Strategy And The Doctrinal Principles Of The Unified Health System: Perceptions And Applicability

Introduction: The SUS, which was guaranteed by the Brazilian Constitution of 1988 and regulated by organic laws of health, offers a system governed of doctrinal principles (universality, fairness and completeness) concerning the philosophy of the system and extend the concept of health and the right to it. On the promotion of these principles, the municipalization of health is referred to as a policy of decentralization which incorporates basic health attention, permeated by the principles of the SUS, where inserts in this context the basic health units (UBS) that are entrance doors of the population to the system. When considering that the proposals brought by the family health strategy (FHS) are great potential to restructure the welfare model and the Organization of health services, and these proposals based on the principles governing the SUS, becomes essential, inter alia, that the worker member of this team have involvement and knowledge of the project, as well as on its goals and principles governing it.

Objective: Check the knowledge and promotion of doctrinal principles of the SUS by active team of FHS in the town of Juazeiro do Norte in the State of Ceará (CE), Brazil. 

Method: This work deals with a transversal nature study exploratory, qualitative approach. The survey was conducted in the family health strategy of the city of Juazeiro do Norte-CE, with top level professionals (physician, nurses and dentists) who work on units during the collection period. The collection was performed through a semi structured interview and the data analyzed by means of the collective subject discourse. This study was submitted to the Ethics Committee of the College Lion Sa, having the opinion of approved (nº: 1.067.638). 

Results: the results showed that the professionals have demonstrated no knowledge of, nor promote some doctrinal principles of the SUS coherently. The knowledge that they have are fragmented and incipient, and Praxis (theory combined with practice) is still far from being achieved. 

Conclusion: The findings of this research show gaps as the promotion of the principles of the SUS by professionals who act. The ineffective knowledge on how SUS is organized and on what basis rests, leads to improper practices, making deployment and consolidation process.


Keywords: Doctrinal Principles of the SUS. Unified health system. The family health strategy.

from International Archives of Medicine

Low Irisin Levels in Patients with Type 2 Diabetes Mellitus without Current Treatment: A Systematic Review

Background: The Irisin is a myokine associated with the improvement on insulin resistance caused by diet and increased physical energy expenditure. Recent studies have shown that patients with Type 2 Diabetes Mellitus (T2DM) have reduced levels of irisin, showing it as a potential marker for various endocrine and cardiovascular diseases. This study aimed to verify if T2DM patients never treated or without ongoing treatment have reduced levels of irisin when compared to individuals with other metabolic profiles.

Methods and Findings: Systematic review of the literature, considering the primary studies published in 2012 to 2016, with the outcome Irisin levels in patients never treated or without current treatment in the ambience of Type 2 Diabetes Mellitus. The search was conducted through the electronic database Scopus (Elsevier), using the key words: “Irisin”, “Human” and “Diabetes Mellitus”. From the 91 studies found, 8 met the eligibility criteria. Significant differences were found on levels of irisin in patients with T2DM compared to normoglycemic individuals, obese and/or pre-diabetic. On average, there was a reduction of 15 pg/ml in plasma levels of irisin in diabetics. However, a minority of studies says that this relationship does not exist.

Conclusion: Irisin reduced levels were found in patients with T2DM and is also related to lipid profile, with the risk of developing endocrine diseases, such as diabetes and obesity, and high risk for cardiovascular diseases because of its relationship with endothelial dysfunction. This generates the need for research in order to explore the isolation and clinical use of irisin for treatment of disorders related to imbalance in energy demand, obesity and diabetes.

Descriptors: Irisin, Human, Diabetes Mellitus.

from International Archives of Medicine

Evidences About The Skills Of Nursing Professionals Regarding The Protocol In Basic Life Support

Objective: To analyze the available scientific evidence about the skills of nursing professionals regarding the protocols of care in Basic Life Support.

Method: An integrative review performed in the databases LILACS, PUBMED, COCHRANE LIBRARY and other sources of literature, in March and April 2016, using the controlled descriptors “Emergency Nursing”, “Knowledge”, “Cardiac Arrest”, “Cardiopulmonary Resuscitation”. There were selected 27 articles based on the inclusion criteria.

Results: The main researches identified about the main challenges and knowledge experienced by nursing in the urgency and the emergency services facing cardiorespiratory arrest. It was noticed that the years 2010, 2012 and 2013 corresponded to the period with the greatest number of scientific articles published about the subject researched, being 2012 as the major year in publications.

Conclusion: Nursing qualification programs for care are a way to approach their practical reality, standardizing care.

from International Archives of Medicine

Factors Associated With Subjective Well-Being In Adults With Hemophilia

Objectives: To evaluate the positively and negatively factors associated with the subjective well-being of adults with hemophilia from two associations of patients.

Methods: This study is a cross-sectional survey, carried out with convenience sampling in two patient associations. Data collection took place in November and December of 2015. The evaluation protocol consisted of the application of two instruments: Hemophilia Well-Being Index and a collection form of sociodemographic and clinical data.

Results: Fifty-three adults with hemophilia, and male, participated in the study. Their age ranged from 21 to 54 years old. It was observed a higher prevalence of participants with single marital status and third education level. The age and marital status of the participants did not influence their well-being.

Conclusion: The high level of education was positively associated with the well-being of the participants, related to the item “economic situation.” 

Keywords: Hemophilia A; Hemophilia B; Adult; Subjective Well-Being Scale.

from International Archives of Medicine

Anatomical, Histological And Metabolic Differences Between Hypodermis And Subcutaneous Adipose Tissue

The development of treatments using stem cells has drawn the attention of researchers to fat deposits given the fact they represent an almost unlimited reservoir of such cells, which can be accessed through minimally invasive techniques. However, the standardization of these studies has been made difficult because of the controversies of nomenclature regarding the many components of adipose tissue. Despite their distinct and independent structures with different metabolic responses, the terms hypodermis and subcutaneous adipose tissue are many times used as synonyms. However, the correct distinction between these two layers, the knowledge of their behavior and an uniformity of these terminologies are of utmost importance.

            Thus, the purpose of this study was to make a bibliographic review on the theme, aiming to show the anatomical, histological and metabolic differences between these two tissues and standardize their nomenclature.

from International Archives of Medicine

Family Health Medical Practices and Nursing Care: a Bibliometric Approach

Objective: to map scientific production on family health and nursing.

Methods: This is a bibliometric study carried out in the ISI Web of Knowledge/Web of ScienceTM in the temporal cut between the years 1957 and 2016, using the following search topics: “family health” and “nursing”. The search results were analyzed according to the temporal evolution of the publications records; The most prominent magazines; The most productive authors; The articles with the highest number of citations and the most productive institutions and citation relations among the most cited groups of articles in global and local relations.

Results: There are 594 papers on Family Health and Nursing, published in 175 journals, written by 1769 authors related to 671 institutions, located in 42 countries, which the University of São Paulo stands out among them for being the most productive with 74 papers. The 19 articles of greatest impact were published from 1991 to 2011.

Conclusion: The Family Health Strategy – FHS stands out as a main activity that promotes family health care in the Brazilian context and the group of most cited paper within the international scenario ensure the relevance of Brazilian studies.


Keywords: Family Health. Nursing. Bibliometrics.

from International Archives of Medicine

Multidimensional Assessment Of Institutionalized Elderly: The Reality Of A Brazilian Institution

Background: The population aging in Brazil is characterized by the accumulation of progressive disabilities in their functional activities and daily life. To consider the elderlies in his/her multiple dimensions turns out to be a critical issue to improve their assistance to an institutionalized level, improving their health and quality of life. To perform a mini-overall evaluation of institutionalized elderly person to trace their profile in relation to the socio-demographic, functional capacity, nutritional status and cognition.

Methods: descriptive, cross-sectional study of quantitative approach conducted in facilities for the aged people in Natal, RN.

Results: 63.3% of the elderly were female, with ages varying from 61 to 103 years. 60.0% were single; 56.7% were literate. 66.7% had no children and 55% lived with their families before the institutionalization. As for the institutionalization time, 63.3% resided in the institution for four years. As what concerns the aspects of health, 73.3 of the elderly presented hearing difficulties, 90% make use of medicines predominantly to diabetes and hypertension. There is clear evidence that the institutionalization has been harmful to the elderly as with regards basic activities of daily living, nutritional status and cognitive aspects.

Conclusion: the progressive disability in functional activities of daily life interferes directly in the quality of life, increasing dependency and minimizing the autonomy of these individuals. It is necessary to effective implementation of public policies directed to the institutionalized elderly from the perspective of effective actions for improved attention and assistance.

Descriptors: Aged, Institutionalization, Aging, Facilities for the Aged. 

from International Archives of Medicine

Migration, Quality of Life And Health of Brazilian Immigrants in Portugal

Background: Immigrants face many challenges when settling in a foreign country, numerous factors influence this immigrant experience including the resources they bring with them and those they find in the host society. The literature has indicated that a significant number of individuals migrate in search of a better quality of life. In this context, the objective of the study was to analyze the quality of life and health of Brazilian immigrants living in Portugal, using the “Medical Outcomes Study: 36-Item Short Form Survey” (SF-36).

Methods and Results: A cross-sectional study with a quantitative approach developed under the project titled: Health status and quality of life of Brazilian immigrants in Portugal conducted in the first half of 2016, with 682 Brazilian immigrant women over 18 living in Portugal. This study adopted as reference SF-36, a generic instrument for the evaluation of Quality of Life. It can be affirmed that the quality of life and health of Brazilian immigrants living in Portugal is good, since all dimensions presented values above 50%. It was evidenced that Brazilian immigrants who live alone have lower levels of quality of life and health than those who live with someone and, that Brazilian immigrants who are unemployed, have low levels of quality of life and health compared to those who are in another employment situation, and Brazilian immigrants entering the labor market with a workload of more than 40 hours per week present similar levels of quality of life and health compared to those who work fewer hours.

Conclusion: In general, one can affirm that the quality of life and health of Brazilian immigrants living in Portugal is good, but due to the particularities of the migration process in the current political and international context, a systematic monitoring of living conditions and health of this population is necessary.

Keywords: Emigrants and Immigrants; Quality of life; Women, Mental health


from International Archives of Medicine