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International Archives of Medicine
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Years of potential life lost due to motorcycle accidents

Introduction: Traffic accidents represent a serious public health problem, because they kill approximately 1.24 million persons annually, and leave another 20 to 50 million with non-fatal lesions and traumatisms worldwide. In Brazil, in the year 2011, motorcyclists alone were responsible for one third of these deaths. Therefore, the aim of this study was to estimate the years of potential life lost due to motorcycle accidents, according to sex and age group, and analyze the trend of the indicator for the state of Pernambuco in the period from 2005 to 2014.

Methods and Results an ecological study based on data from the System of Information about Mortality was used. The indicator and rate were calculated by using the age limit of 70 years. The linear regression model and Kruskal-Wallis and Mann-Whitney tests were used, at the level of significance of 5% and confidence of 95%. The most affected sex and age-range were men between 20-29 years of age. The rates followed a trend of growth in both sexes, in the young population with the exception of those from 10 to 19 years of age.

Conclusions: This context points out the magnitude and precociousness of motorcycle accidents in both sexes and the young population.

from International Archives of Medicine

Care Network For The Elderly With Alzheimer’s Disease In The View Of Primary Care Nurses

Objective: to build a care network for the elderly with Alzheimer’s disease from the view of nurses of the Family Health Strategy (FHS).

Method: exploratory qualitative study, developed with seven nurses from the FHS in the city of Santa Cruz, state of Rio Grande do Norte, Brazil. After obtaining a favorable opinion of the Ethics Committee of the Alcides Carneiro University Hospital (CAAE nº 31307314.9.0000.5182), data were collected through semi-structured interviews and analyzed according to the Collective Subject Discourse.

Results: for an effective care network to the elderly with Alzheimer, some elements are necessary, such as: care in the three levels of complexity, family support, complementary diagnostic center, pharmaceutical services, continuing education, intersectionality and group of caregivers.

Conclusions: when the care to the elderly with Alzheimer’s disease is performed in an articulated manner between the multiples axes that compose the network, it clarifies the caring process, facilitates the decision making, directs care, guarantee a comprehensive care and greatly reduce the deficits associated with this disease.

Key-Words: Alzheimer’s disease; Family Health Strategy; Health Care Network.

from International Archives of Medicine

Evaluation of Oral Hygiene in Patients with Visual Disabilities

Introduction: Patients with visual impairment present greater difficulty in achieving adequate oral hygiene due to restricted eyesight. Therefore, oral hygiene motivation and instruction methods should be adapted to these patients to understand the importance of bacterial plaque control, both for the health of dental tissues and periodontal tissues

Objective: The objective of the present study was to compare the plaque index (PI) of patients with and without visual impairment before and after the institution of oral hygiene instructions through a Randomized Clinical Trial. Twenty patients with visual impairment (Group 1) from the Instituto dos Cegos and 20 without visual impairment (Group 2) from the ASCES Periodontia Clinic were selected. Data were collected through the IP of O’Leary and reevaluated every 21 days for four sessions.

Results: in both groups, the mean of PI decreased with the time of evaluation, with a significant difference between the evaluations (p <0.001). Group 1 had a mean PI higher than group 2 only in the fourth evaluation, but there was no significant difference (p> 0.05). As for the mean of the PI assessments, group 2 presented a mean higher than group 1, but without significant difference (p> 0.05).

Conclusion: The study therefore suggests that there is no difference in PI in patients with or without visual impairment, and that the guidelines stimulate and motivate an improvement in oral hygiene conditions.

from International Archives of Medicine

Elderly Women’s Perception About Nursing Gynecological Consultation: A Comprehensive Analysis

The Brazilian elderly population, that is, the population aged 60 or older according to the Elderly Estatute, has increased in recent decades, a phenomenon observed in Brazil and worldwide. This rapid growth represents a major political and social impact, reflecting the consequent rise in cost of health services because this is the population that most need this service.

Objective: To understand the meaning of Nursing Consultation for elderly women assisted at a School Clinic in Mountain Region-RJ-Brazil.

Method: The is a qualitative study of descriptive and exploratory nature supported by the theoretical and methodological framework of Alfred Schutz through sociological phenomenology. The study was approved by the Ethics and Research Committee of the Arthur Sá Earp Neto Faculty on April 11, 2015 under Opinion number 1.019361. We used phenomenological interview.

Results: We performed 19 interviews with elderly women aged 60-80 years. The responses provided the understanding of women’s experiences during the nursing consultation. This study gave rise to three categories that revealed the intentionality of this social group when searching for the nursing consultation: “To be well assisted”, “To have resolving power” and “To prevent health problems”.

Conclusions: The found that the nursing consultation promotes the approximation between women and the nursing professionals, establishing bonds, presenting efficient and effective results to treatment and prevention, besides providing mutual learning.

from International Archives of Medicine

Pregnant Women Positioning in Spinal Anesthesia for Cesarean Section: Integrative Review

Objective: to analyze the scientific evidence on the positioning of pregnant women in spinal anesthesia for cesarean section.

Method: an integrative review of the literature in the Scopus, CINAHL, LILACS and PubMed databases using the descriptors “patient positioning”, “spinal anesthesia” and “obstetrics” and their synonyms “patient position” and “spinal anesthetics”.

Results: the sample of 8 articles showed that the fastest onset of blockade in pregnant women occurs in the lateral horizontal decubitus position and in the sitting position with legs downwards. Lateral decubitus with elevated head presented insufficient blockade. Lateral position was related to greater comfort, and its maintenance for 15 minutes before the supine position, after infiltration with the anesthetic was associated with lower incidence of hypotension.

Conclusion: Scientific evidence has shown that positioning influences the effect, potentiation and delay of anesthesia, comfort and the pregnant woman’s blood pressure, being relevant to the perioperative and obstetric multidisciplinary practice.

from International Archives of Medicine

Nursing Interventions For The Prevention Of Foot Ulcers In Patients With Diabetes: An Integrative Review

Objective:  to verify the available evidence on nurses’ interventions to prevent ulcers in patients with diabetic foot.

Method: integrative review held in the databases BDENF, LILACS, IBECS, CINAHL, PubMed and in the virtual library SCIELO without time restriction.

Results: the authors identified 15 articles that met the study criteria. Nursing interventions for the prevention of diabetic foot were performed both individually and on collective basis, or in combination. The vast majority of interventions were within institutional programs aimed at health promotion.

Conclusion: the evidence points to health education as a tool in the prevention of diabetic foot and consequent amputation of the lower extremities, promoting awareness for development and adoption of skills for self-care and improved lifestyle.

from International Archives of Medicine

Hodgkin’s Lymphoma: Impacts And Changes In Life Of Carriers Undergoing Treatment

Diagnosis and treatment of Hodgkin’s lymphoma introduce a new routine, and the habitual life of the young adult is interrupted because the treatment imposes on patients withdrawing from their environment, their productive activities, their relatives and their daily life. The aim of the present is study is to understand the reality of the young adult carrier of Hodgkin’s lymphoma in the face of treatment. This is a qualitative study; subjects were patients diagnosed with Hodgkin’s lymphoma at a reference hospital in northeastern Brazil. Inclusion criteria were being undergoing treatment or follow-up of Hodgkin’s lymphoma, and aged 18 to 35 years. The information was collected through an interview at the home of each subject in the period from August and September 2015. The interviews were recorded, transcribed in full and analyzed through thematic analysis. The study was approved by the Research Ethics Committee. The subjects went through a rather individual pathway to discover the disease. After reading the interviews, the following category emerged: Impact and changes in life with cancer. They feel the impact of cancer and of the process of illness and treatment that promote physical and social changes. They reveal the coping of the disease with liveliness, and present strategies for this process, such as the support of family and friends. They recognize the existence of difficult moments and face situations of death, but they show intention to return to their daily activities and have perspectives for cure. 

from International Archives of Medicine

First determination of mineral composition of the leaf Chicory (Cichorium intybus L.) used in human nourishment in the Midwest of Brazil and comparasion with dietary reference intakes for children and adults

Introduction: Radicchio (Cichorium intybus L.) is a leaf chicory and is grown as a leaf vegetable which usually has white-veined red or purple leaves and it belongs to the Asteraceae family. In several countries is consumed mainly as salad, but no studies on their elemental composition  has been done, principally in Brazil.

Objective: The aim of present work was to measure the macroelements (Na, K, Ca, Mg and P) and microelements (Cr, Cu, Fe, Mn, Mo, Zn, Al, Cd, Ni, Co and Si) in the leaf Chicory used as human nourishment in the Campo Grande, State of Mato Grosso do Sul, Brazil.

Method: Chemical digests of samples were prepared using HNO3 and H2O2 and then placed in the microwave digestion system. After digestion, the concentrations of the elements in Leaf Chicory were determined by the technique of Inductively Coupled Plasma – Optical Emission Spectrometer (ICP–OES, Thermo Scientific – iCAP 6000 Series). Results obtained of the concentrations of leaf chicory were compared with the dietary reference intakes.

Results: Detected concentration of macroelements in leaf Chicory decreases in the order: K > P > Ca > Mg > Na. As well as the concentration of microelements decreases in the order: Fe > Al > Si > Mn > Zn > Cu > Cr > Ni > Cd > Mo > Co. Leaf Chicory is excellent source of K, Ca, Mg, P, Cr, Cu, Fe, Mn, Mo and Zn for children and adults. On the other hand, leaf chicory is not considered a source of sodium for children and adults. Concentration of K, Cr, Fe, and Al are above the limit recommended limit by FAO/WHO (1984) and others countries.

Conclusions: Leaf Chicory has macro and microelements in ample amount; it can be used as an important part of people’s diets. Since it not exceed allowable limits set by WHO and FAO, RDA/AI and UL. Competent organs have not evaluated concentrations of elements as Al, Cd, Ni, Co and Si in order to establish a tolerable upper intake level or RDA/AI for human. The lack of studies of adverse effects following excess intake of a nutrient does not mean that adverse effects do not occur.

Keywords: Leaf Chicory; Radicchio; Inductively Coupled Plasma Mass Spectrometry (ICP-OES).

from International Archives of Medicine

Sociodemographic And Clinical Profile Of Men Assisted In A Psychiatric Detoxification Service In Natal, Rn, Brazil

Introduction: The male population has a high probability of abandoning treatment, avoidance of health services, great exposure to violence, mainly due to abusive use of alcohol and other drugs, and high crime rates also associated with this problem.

Objective: To characterize the sociodemographic and clinical profile of men admitted to a Psychiatric Detoxification Hospital Unit for alcohol and drug abuse.

Method: It is a cross-sectional and retrospective study, with data collection in 2015, with a temporal cut in patients´ records between 2008 and 2014, reaching a sample of 1,152 medical records. The data collection instrument was composed of a structured form. The data were analyzed in a descriptive way.

Results: Regarding the age, the age group between 21 and 50 years old had 30.73% between six and ten days hospitalized, and 11.98% had readmissions. The main diagnoses for this disorders were linked to the use of opiates, cannabinoids, sedatives and hypnotics.

Conclusion: The profile of internal and assisted men was characterized such as adults of productive age, residents of the metropolitan area of the city, with long periods of hospitalization, generally with improved type discharge, low readmission and diagnoses of mental disorders related to the excessive use of alcohol and other drugs.

from International Archives of Medicine

Teratoma With Mediastinal Embryonic Carcinoma Concomiting Hystiocytic Sarcoma In The Bone Marrow

Background: Association of extragonadal germ cell tumors EGCT with haematological malignancies is rare with a very limited prognosis.

Methods and findings: We report a case of a man, 21 years old, with progressive dyspnea, chest pain, night sweats, generalized edema, hemoptysis, pancytopenia and increased serum levels of alpha-fetoprotein (AFP), beta-fraction of the hormone chorionic gonodotrophin (beta-HCG) and lactic dehydrogenase. Chest computed tomography described a mediastinum mass measuring 11.3 x 7.3 cm whose biopsy revealed malignant germ cell neoplasia expressing positivity for cytokeratin, CD30 and AFP, indicating an embryonal carcinoma with teratoma. Bone marrow biopsy revealed interstitial infiltration by malignant neoplastic cells positive for CD68, CD163 and lysozyme, allowing the diagnosis of histiocytic sarcoma. The patient had a poor evolution, with death, sixteen days after admission.

Conclusion: Histiocytic proliferations are very rare and rapidly fatal. Etiopathogenic theories for the simultaneity of these malignancies have been described based on processes of transformation from a same cellular precursor.

from International Archives of Medicine