Basic Health Unity Research Articles

Pediatric patients on renal replacement therapy: clinic, epidemiological, social and economic profile

Introduction: Pediatric chronic kidney disease interferes with weight growth, psychosocial status, and also affects quality of life. Objectives: To outline the clinical, epidemiological, social and economic profile of children and adolescents undergoing renal replacement therapy (RRT) at Santa Casa de Belo Horizonte, Minas Gerais - Brazil. Methods: Observational and cross-sectional study. 82 children and adolescents from 0 to 17yrs of age who had undergone RRT with at least three months of registration were included. Patients who died in the first three months on RRT, acute patients, and those older then 18yrs were excluded. Anthropometric analysis was performed and qualitative variables were expressed in absolute frequencies and percentage. Results: 63.5% were male; median age of 9.25yrs at the beginning of RRT. 57% were short, and the BMI was normal in 88%. 82% were followed by nephrologists before RRT, 64.5% had residual diuresis. Hemodialysis was the main initial modality of RRT. Long-term double-lumen catheter was the most widely used vascular access. 85% of those who were at school age were attending school. Most patients lived in the countryside, used public transport, and had a low per capita income. SUS (Health Unic System) was the paying source and were registered at UBS (Basic Health Unity). The mother was the caregiver in 80.5%, 36.6% had glomerulopathy and 26.8% CAKUT uropathy. Sepsis was the main cause of death. 34 patients were transplanted. Discussion and Conclusion: To know the clinical, epidemiological, social, and economic profile of pediatric patients in RRT is important in order to increase the chances of successful treatment and a better quality of life.

Situação vacinal do Papiloma Vírus Humano (HPV) em adolescentes em uma unidade básica de saúde no Maranhão

Objetivo: Analisar a situação vacinal do Papiloma Vírus Humano em adolescentes em uma Unidade Básica de Saúde no Maranhão. Métodos: Pesquisa quantitativa de caráter descritivo e exploratório, em que foram utilizadas as fichas vacinais dos adolescentes de 9 a 14 anos de idade da unidade básica de saúde escolhida. As variáveis analisadas foram referentes ao sexo, data de nascimento, raça, grupo de atendimento, estratégia de vacinação. Resultados: Observou-se que das 66 fichas utilizadas, a maior quantidade foi referente ao primeiro cadastro que corresponde também a 1° dose de HPV dos adolescentes. O maior índice vacinal foi na primeira dose com a porcentagem de 81,8%. A segunda dose da vacina imunizou somente 34,8% dos adolescentes. Em relação ao sexo, percebeu-se a predominância do sexo feminino com 66,7% e desse percentual, 59,3% fizeram a 1° dose e 91,3% fizeram a 2° dose. A faixa etária de maior adesão da vacina foi de 9 a 12 anos (56,1%). Conclusão: Com os resultados da pesquisa verificou-se que houve uma alta cobertura vacinal contra o HPV em adolescentes do sexo feminino na primeira dose, porém o sexo masculino teve uma baixa cobertura vacinal.

Inserção de estudantes de Odontologia no SUS: relato de experiência

As disciplinas do eixo de Saúde Pública, do curso de Odontologia da Universidade Federal de Santa Catarina (UFSC), têm como princípio formar indivíduos comprometidos com o Sistema Único de Saúde (SUS). Com a finalidade de capacitá-los a serem futuros transformadores da realidade atual, por meio do conhecimento sobre epidemiologia, planejamento e execução de políticas públicas. O objetivo deste trabalho é relatar a experiência dos alunos no planejamento e execução das atividades realizadas em conjunto com as Unidades Básicas de Saúde (UBSs), do município de Florianópolis. Os estudantes realizaram ações de promoção de saúde bucal e exames clínicos em escolares, além de participarem do planejamento e processo de trabalho das UBSs. A presença dos estudantes na rede pública de saúde contribui para capacitar futuros profissionais da saúde capazes de desenvolver práticas mais efetivas para as necessidades da comunidade e a serem futuros transformadores sociais da realidade do SUS.

Profile of physical activity in the pregnant women coari city, Amazon

Physical inactivity Has Been During pregnancy outcomes associated with detrimental for the mother and fetus, regular physical activity is Indicated are pregnant women is due to the maternal and fetal benefits That can act in the short and long term. The aim of the study was to characterize the expenditure of energy on physical activity in low-risk pregnant women living in the municipality of TNL-AM. A cross-sectional descriptive study carried at basic health unity. 50 Volunteers in 12th and 36th week gestational age composed it. Data Were collected through the Physical Activity Questionnaire for pregnant women (QAFG), classified the sample Which the insufficiently active and active. Before pregnancy 56% of the sample Practiced some type of physical activity and During pregnancy there was a reduction to only 32%. The date Showed the prevalence of active pregnant women in domestic tasks (56%) and locomotion (74%), and pregnant women insufficiently active in caring for people (64%), occupation (66%), sports (94%) and leisure 66%). The average energy intensity spent weekly on the tasks Evaluated did not show statistical difference When Compared to the groups (second and third gestational trimesters). The study Showed que pregnant women During Were active domestic tasks/locomotion and sedentary or not active in tasks related to sports/exercise, leisure, caring for people and occupation. Is Necessary an incentive to practice physical activity in this period by professionals of health. sports (94%) and leisure 66%). The average energy intensity spent weekly on the tasks Evaluated did not show statistical difference When Compared to the groups (second and third gestational trimesters). The study Showed que pregnant women During Were active domestic tasks locomotion and sedentary or not active in tasks related to sports/ exercise, leisure, caring for people and occupation. Is Necessary an incentive to practice physical activity in this period by professionals of health. sports (94%) and leisure 66%). The average energy intensity spent weekly on the tasks Evaluated did not show statistical difference When Compared to the groups (second and third gestational trimesters). The study Showed que pregnant women During Were active domestic tasks/ locomotion and sedentary or not active in tasks related to sports/exercise, leisure, caring for people and occupation. Is Necessary an incentive to practice physical activity in this period by professionals of health .

PERCEPÇÃO DOS PROFISSIONAIS DE SAÚDE BUCAL ACERCA DAS MUDANÇAS DAS AÇÕES COLETIVAS NO PROCESSO DE TRABALHO DA ESF

Ao longo de três décadas do Sistema Único de Saúde(SUS), o processo de trabalho da Odontologia foi baseado no ‘modelo tradicional’ de atenção com foco na doença, na intervenção curativista e no biológico; contudo, uma mudança de atuação ainda se encontra em construção, já que esse modelo biomédico é muito expressivo na formação dos profissionais da área de saúde. No entanto, para os próximos anos, faz-se necessário readequar a forma de trabalho da equipe de saúde bucal na Estratégia de Saúde da Família (ESF). Este trabalho visa analisar a percepção dos profissionais da equipe de Saúde Bucal do Distrito Federal acerca da aplicação das ações coletivas no processo de trabalho, antes e após o início do exercício profissional como ESF.O presente estudo é transversal descritivo de abordagem quali-quantitativa, com questionário semiestruturado, entrevistas e análise de conteúdo. Foram selecionadas duas Unidades Básicas de Saúde (UBS) de cada Região de Saúde que apresentaram o melhor e pior indicador de cobertura em saúde bucal. Dentistas e técnicos de saúde bucal com maior tempo de exercício profissional apresentaram maior resistência ao ‘novo modelo ‘do que o grupo que está a menos tempo na Secretaria, ou que entrou como membro da ESF. Todos os profissionais entrevistados relataram dedicar-se às atividades coletivas, mas, em sua maior parte, ainda vinculadas ao modelo tradicional.

Perfil Valorativo e Saúde Geral de Homens Usuários da Atenção Básica

O objetivo desta pesquisa foi conhecer o perfil valorativo, bem como a saúde mental geral de homens atendidos pelos serviços de atenção primária de uma cidade litorânea do Piauí. Para isso contou-se com uma amostra não probabilística de 153 participantes, em sua maioria solteiros (70,9%), com idades entre 20 e 58 anos (M = 27; DP = 9,1), que utilizam os serviços das Unidades Básicas de Saúde (UBS) desta cidade. Os participantes responderam ao Questionário de Valores Básicos (QVB-18) e o Questionário de Saúde Geral (QSG-12). Os resultados identificaram os valores sobrevivência (M = 6,33), maturidade (M = 6,33), religiosidade (M = 5,98); e a subfunção existência (M = 6,04) como os mais priorizados pelos usuários. Encontrou-se também uma relação negativa (p < 0,05) entre saúde geral e as subfunções valorativas existência (- 0,17) e normativa (- 0,27). Não foram encontrados casos de incidência de distúrbios mentais leves. Espera-se que estes achados possam ser usados na elaboração de estratégias que levem a uma maior aderência da população masculina ao cuidado com a própria saúde e para o desenvolvimento de campanhas específicas para esta população, considerando suas peculiaridades e o contexto social.

Assessment of patients’ perceptions towards the diagnosis of leprosy

Leprosy is a contagious, long-term infection, which manifests dermatological and neurological symptoms and signs, being considered an endemic, widespread disease, regarded as a serious health problem in Brazil. Early diagnosis of leprosy and its proper treatment prevents disease from progressing, avoiding physical disabilities, which are frequent as the infection evolves, and constitute a major cause of stigma, leading the patient to social isolation. This study aimed to verify the patient's perceptions regarding Hansen's disease diagnosis, seeking to contribute to the prevention of physical disabilities. It was carried out in Sinop in the State of Mato Grosso, being classified as a qualitative research approach. Patients diagnosed with leprosy, enrolled for annual treatment in Nacoes Basic Health Unity (Unidade de Saude Basica Nacoes), took part in the research. Data was collected using semi-structured interviews, and the results were analyzed in categories, these being, the implications on the patients’ self-esteem after diagnosis of leprosy; patients’ perceptions of treatment and changes in socioeconomic status after leprosy. It is worth noting that leprosy as a public health issue does not restrict to the immense amount of cases and its potential to cause physical disability, which interferes in the psychosocial context, should be taken into consideration. It is valid to point out that leprosy affects several aspects of the pacient’s life, including their physical, mental and social well-being, requiring a holistic and humane nursing care.

Interação medicamentosa em usuários de antidepressivos do sistema público de um município do sul do Brasil

Introduction: Depression is a public health problem for which treatment is done with the use of antidepressant drugs, which should be used with caution due to its side effects and potential drug interactions. Objective: To identify and classify the main potential drug interactions between antidepressants and other drugs. Materials and methods: The research was conducted with patients that use antidepressants and received it from the Basic Health Unity of the city of Sao Jose do Inhacora, RS, Brazil. The subjects were located by searching the database of appointments that took place from December 2013 to January 2014. The interviews were conducted at their homes by using a data collection instrument developed by the authors and validated by a pilot study. Potential drug interactions were researched in the Micromedex® database. The missing interactions on that database were further investigated on books regarding drug interactions and were classified for risk assessment as being of high, moderate and low importance. Results: A total of 88 patients were interviewed, the mean age was 56.68±16.36 years old. A total of 127 potential drug interactions were detected and 42 (47.72%) patients were directly subjected to it, with a mean of 5.90±2.73 per patient. Regarding the risk assessment, the interactions were classified as high in 69 (54.33%), moderate in 53 (41.73%) and low in 5 (3.94%). Conclusion: This study demonstrates the occurrence of potential medical interactions in a significant portion of the patients, as well as the self medication practice, which also represents a risk for the users. Therefore, it is important that the pharmacist is part of the multidisciplinary team, aiming to minimize the pharmacological related errors and to improve the quality of life of the patients.

ESTÁGIO INTEGRADO: EXPERIÊNCIA DE ATUAÇÃO ENTRE ACADÊMICOS DE TERAPIA OCUPACIONAL E RESIDENTES DE SAÚDE DA FAMÍLIA

Este trabalho tem como objetivo relatar a experiência de acadêmicos do quinto ano do curso de Terapia Ocupacional no estágio de saúde coletiva no ano de 2012 que tiveram a oportunidade de passar alguns meses integrados a uma equipe de Residência Multiprofissional em Saúde da família. As ações multidisciplinares eram realizadas em uma comunidade do município de Maceió-AL, em uma unidade básica de saúde (UBS) através de sala de espera, de atendimento domiciliar individualizado e de ações em uma escola de educação básica na qual a metodologia utilizada era educação em saúde. O trabalho integrado promoveu uma percepção dos estagiários quanto a importância do trabalho multidisciplinar na saúde coletiva. A prática acadêmica do estágio integrado com os residentes de saúde da família teve uma fundamental importância no estágio curricular do curso de Terapia Ocupacional onde os acadêmicos obtiveram uma visão rica das ações de prevenção de agravos e doenças e promoção da saúde, transformando o modo de ensino e prática em saúde coletiva.

PP206-MON: Prevalence of Iron Deficiency Anemia on Infants Bellow Five Years Old in Eastern District Basic Health Unities of Ribeirão PRETO – SP

PP206-MON: Prevalence of Iron Deficiency Anemia on Infants Bellow Five Years Old in Eastern District Basic Health Unities of Ribeirão PRETO – SP

Organização da demanda de um Centro de Especialidades Odontológicas

INTRODUÇÃO: A Atenção Secundária em saúde bucal no Brasil ainda é um assunto pouco pesquisado. OBJETIVO: Analisar a resolubilidade dos serviços odontológicos do Sistema Único de Saúde, com base na referência para a atenção secundária e a contrarreferência à atenção primária. METODOLOGIA: Trata-se de um estudo descritivo, quantitativo, que utilizou dados secundários coletados dos prontuários dos pacientes atendidos no Centro de Especialidades Odontológicas de um município do Estado de São Paulo. RESULTADO: Do total de 1030 prontuários analisados, verificaram-se 1236 procedimentos referenciados para atenção especializada. Destes, 86,4% deram entrada na Unidade Básica de Saúde por livre demanda e 50,4% (n=623), para especialidade de Endodontia. Houve evasão de 2,2% (n=28) já na primeira consulta especializada. Nos pacientes que deram início ao tratamento especializado, foram realizados 1.208 procedimentos no Centro de Especialidades Odontológicas, tendo sido 62,6% (n=757) concluídos e contrarreferenciados para a Atenção Primária, que finalizou 61,1% (n=463) dos procedimentos. Para a conclusão do tratamento, considerando o tempo no Centro de Especialidades Odontológicas e na Atenção Básica, houve variação de acordo com a especialidade: Periodontia, 62 dias (dp= ±68), e Endodontia, 71 dias (dp= ±51,8), sendo necessárias três consultas em média, independentemente da especialidade. CONCLUSÃO: O Centro de Especialidades Odontológicas referencia, contrarreferencia e atende à maioria da demanda, independentemente da especialidade. Porém, ainda há muita evasão durante o tratamento odontológico, servindo de alerta para os gestores desenvolverem métodos de controle dos pacientes atendidos, com vistas à diminuição de gastos e ao aumento da resolutividade dos serviços, com a conclusão dos tratamentos iniciados.

THE CRACK USER AND THE CARE NETWORK: INTERVENTIONS AT THE UNIFIED HEALTH SYSTEM IN SOUTHERN BRAZIL

Crack consumption is being a problem that challenges health systems all over the world. In Brazil, changes in public policies were trying to organize the net of services that deal with this public. This paper presents how the public health system is organized and what are the interventions adopted in the different services that attend crack users. Using Ecological Insertion, researchers followed the everyday interventions at different services during three months (in each place). All the observations were registered in field diaries that were qualitatively analyzed. The data collection happened in three hospitals, six psychosocial attention centers, and five basic health unities in Paranhana Valley, southern Brazil. These services are distributed in different levels of attention in the health system. Results show that treating crack users still is a challenge for the system. The services must work integrated and adequate to the user demands. The multidisciplinary work is fundamental (involving psychiatry, psychology, social work and physical education). Different treatment approaches are needed, keeping the crack dependents and their family attended. The general hospital is the preferential therapeutic strategy. The basic health unities do not recognize their responsibility with this public and the psychosocial centers has the feeling that what are offered doesn’t attend the dependent demand. Despite the efforts to provide quality service, professional specialization and commitment with the patients are aspects that must be improved. Key words: crack cocaine, health care (Public Health), psychology, social, public policy.

Prevalência de enteroparasitas em crianças atendidas em unidades básicas de saúde em uma cidade do sul do Brasil

Helminthes and enteric protozoa are serious problem of public health in developing countries. This study analyzed the prevalence of intestinal parasites in preschool children attend at basic health unities (BHS) in the city of Rio Grande, Rio Grande do Sul, Brazil. Stool samples collected from 144 children were analyzed, from October 2009 to March 2010. The observed prevalence rate for enteroparasites was 17.4 %, including eggs of nematodes Ascaris lumbricoides (11.1 %) and Trichuris trichiura (6.3 %), and cysts of protozoan Giardia lamblia (4.9 %). Also, cysts of protozoa considered as non-pathogenic, such as Entamoeba coli, Endolimax nana and Enteromonas hominis were found in 28.5 % of children. Regarding to the BHSs prevalence, in BHS-1 was detected a positivity of 36.4 %, 11.1 % in BHS-3, 14.8 % in BHS-4, 8 % in BHS-5 and 19.2 % in BHS-6. No positivity was detected in the stool samples from BHS-2. The prevalence of intestinal parasites registered in the studied population suggests the occurrence of probable conditions for re-infection, and the need to implement the basic sanitation procedures and programs which will provide an improvement in the life quality of these children.

An experience of jungian group psychotherapeutic assistance, with an emphasis in the corporal dimension, in the context of brazilian public health system

This study investigated the relevance of using a modality of Jungian group psychotherapy according to Sandor’s bodyorganismic method, in view of the demand for mental health presented by users of a Basic Health Unity of SUS – the Brazilian UnifiedHealth System. Tree open psychotherapy groups were composed having seven adult patients and observed for a year. The qualitativeanalysis of results based on the comparison between the dynamics of these three groups, confronting the points of convergence betweenthem. We concluded that this kind of psychotherapy made possible a greater opening and adhesion to the psychotherapeutic process,with the establishment of very solid bonds of confidence. The following psychosocial transformations were observed in the period ofa year: a greater definition and integration of the physical image of subjects and groups; a reduction or elimination of initial physicalsymptoms; modifications as for the form of thinking about the social-economic conditions and how to act in this context; a greateropening to social contact and to physical interaction by patients, as well as a recovering of subjects work capacity and creative potential.

Headache treatment in an emergency unit of the city of Ribeirão Preto, Brazil

Headache is one of the most common symptoms observed in clinical practice. It has a considerable economic impact and overburdens emergency rooms. In Brazil, most emergency rooms have no tryptans. The present study analyses the treatment provided by the Emergency Room of the University Hospital of Ribeirão Preto. In 1996, 1254 patients were treated for headache and 64 of them required hospitalization. Of the non-hospitalized (NH) patients, 77% had primary headache, as opposed to 29.7% of hospitalized patients. Of the patients with migraine, 83.6% improved with intravenous dipyrone, 66.7% improved with intramuscular diclofenac and 81.8% improved with intravenous chlorpromazine. The percentages of patients with tension-type headache who improved with the same drugs were 77.8%, 80% and 100%, respectively. Among NH patients, 16.3% improved without any medication. We conclude that the drugs used have similar efficacy profiles and costs and can be used at basic health unities. The major drawback is parenteral administration.