Primary Health Units Research Articles

PRESCRIÇÕES DE ANTIMICROBIANOS EM UNIDADES BÁSICAS DE SAÚDE DE UM MUNICÍPIO DO SERIDÓ POTIGUAR, BRASIL

Antimicrobianos estão entre os medicamentos mais utilizados na atenção primária. Contudo, as prescrições ocorrem de forma não adequada, pondo em risco a segurança do paciente, podendo gerar impactos clínico e econômico. No presente estudo foram avaliadas prescrições de antimicrobianos de todas as unidades básicas de saúde de Caicó, RN, Brasil. Trata-se de estudo retrospectivo, descritivo, exploratório com abordagem quantitativa. Foram analisadas 1046 prescrições de antimicrobianos elaboradas durante o ano de 2016 e arquivadas nas Farmácias das unidades básicas de saúde. Todas as prescrições 1046 (100%) estavam não conformes com a legislação. Os itens não conformes mais frequentes foram: ausência de carimbo e assinatura do farmacêutico atestando dispensação (100%), seguido de sexo (96,5%) e idade do usuário (96,5%), duração do tratamento (40,8%), via de administração (35,7%), informações que permitiam contatar o prescritor (20,1%) e concentração (17,0%). Os antimicrobianos mais prescritos foram penicilinas com espectro estendido 347 (31,5%), macrolídeos 218 (19,8%) e cefalosporinas de primeira geração 185 (16,8%). O estudo mostrou a necessidade de instituir medidas de sensibilização dos prescritores sobre a importância de uma prescrição clara e sem ausência de itens fundamentais para que se possa imprimir segurança no uso do medicamento.

The impact of internal migration to Khartoum state on the demand of Education and Health services (1992- 2008): أثر الهجرة الداخلية في الطلب على خدمتي الصحة والتعليم في ولاية الخرطوم (1992- 2008)

The research aimed to study the effect of internal migration to Khartoum on the demand on health and education services. The historical، analytical، and descriptive approaches were followed. The results showed that there are main causes of migration such as attending university education and having access to good health services. The number of basic level students rises to 1.5%، the schools increase at12.8%، 3.6% consequently between 2006- 2005، 2007- 2006، while the teachers number reaches 13.2%. Hospitals، centers، primary health units، blood banks and radiology units increase to 5.1%، 2.7%، 11.6%، 19%، 5.7% in 2005 comparing with 2004. The research has recommended encouraging investment in the pushing areas so as to create jobs opportunities and encouraging the private sectors. Another recommendation is to establish at least one governmental university in each administrative area and encourage establishing private universities and colleges so as to minimize migration for university education. It is also، recommended to improve the health services in the pushing areas to minimize the rate of migration to Khartoum.

EFETIVIDADE DE FORMAÇÃO EM ALIMENTAÇÃO COMPLEMENTAR PARA PROFISSIONAIS DE SAÚDE SOBRE AS PRÁTICAS ALIMENTARES DE CRIANÇAS MENORES DE UM ANO ATENDIDAS NA ESTRATÉGIA DE SAÚDE DA FAMÍLIA DO RIO DE JANEIRO

Objetivo: Avaliar a efetividade da formação em alimentação complementar (AC) sobre a alimentação de crianças menores de um ano atendidas na Estratégia de Saúde da Família (ESF) do Rio de Janeiro. Método: Ensaio comunitário randomizado controlado desenvolvido em seis unidades básicas de saúde. A intervenção consistiu em formação sobre alimentação complementar dirigida aos profissionais de saúde complementada por materiais de apoio aos profissionais e materiais educativos dirigidos às famílias. A alimentação das crianças foi analisada quando elas tinham quatro, seis, nove e 12 meses de idade. A efetividade da intervenção foi avaliada segundo “intenção de tratamento” e dose-resposta. Resultados: Foram estudadas 220 crianças no Grupo Intervenção (GI) e 225 no Grupo Controle (GC). O GI apresentou proporções maiores de amamentação e menores de uso de bicos que o GC aos 12 meses. O GC apresentou menor proporção de consumo de alimentos ultraprocessados ou não recomendados aos quatro meses e maior proporção de adequado número de refeições de sal aos 12 meses. A densidade energética de alimentos e a variedade da alimentação estavam aquém do recomendado em todos os acompanhamentos. O efeito dose-resposta foi observado somente para o uso de bico aos nove meses. Discussão: O baixo nível de exposição à intervenção entre mães de crianças do GI e o fato de que a orientação fornecida pelo profissional, quando ocorria, nem sempre era correta, podem explicar em grande parte os resultados. Conclusão: Ainda que os profissionais do GI apresentassem maior conhecimento sobre AC do que os do GC, os perfis alimentares das crianças de ambos os grupos foram semelhantes e distantes das recomendações para praticamente todos os indicadores estudados.DOI: 10.12957/demetra.2019.43801

Supervised training in primary care units but not self-directed physical activity lowered cardiovascular risk in Brazilian low-income patients: a controlled trial

BackgroundPublic health strategies to increase physical activity in low-income communities may reduce cardiovascular risk in these populations. This controlled trial compared the cardiovascular risk estimated by the Framingham Risk Score (FRS) over 12 months in formally active (FA), declared active (DA), and physically inactive (PI) patients attended by the ‘Family Health Strategy’ in low-income communities at Rio de Janeiro City, Brazil (known as ‘favelas’).MethodsPatients were matched for age and assigned into three groups: a) FA (supervised training, n = 53; 60.5 ± 7.7 yrs); b) DA (self-reported, n = 43; 57.0 ± 11.2 yrs); c) PI (n = 48; 57.0 ± 10.7 yrs). FA performed twice a week a 50-min exercise circuit including strength and aerobic exercises, complemented with 30-min brisk walking on the third day, whereas DA declared to perform self-directed physical activity twice a week. Comparisons were adjusted by sex, chronological age, body mass index, and use of anti-hypertensive/statin medications.ResultsAt baseline, groups were similar in regards to body mass, body mass index, triglycerides, and LDL-C, as well to FRS and most of its components (age, blood pressure, hypertension prevalence, smoking, HDL-C, and total cholesterol; P > 0.05). However, diabetes prevalence was 10–15% lower in DA vs. FA and PI (P < 0.05). Intention-to-treat analysis showed significant reductions after intervention (P < 0.05) in FA for total cholesterol (~ 10%), LDL-C (~ 15%), triglycerides (~ 10%), systolic blood pressure (~ 8%), and diastolic blood pressure (~ 9%). In DA, only LDL-C decreased (~ 10%, P < 0.05). Significant increases were found in PI (P < 0.05) for total cholesterol (~ 15%), LDL-C (~ 12%), triglycerides (~ 15%), and systolic blood pressure (~ 5%). FRS lowered 35% in FA (intention-to-treat, P < 0.05), remained stable in DA (P > 0.05), and increased by 20% in PI (P < 0.05).ConclusionsA supervised multi-modal exercise training developed at primary care health units reduced the cardiovascular risk in adults living in very low-income communities. The risk remained stable in patients practicing self-directed physical activity and increased among individuals who remained physically inactive. These promising results should be considered within public health strategies to prevent cardiovascular disease in communities with limited resources.Trial registrationTCTR20181221002 (retrospectively registered). Registered December 21, 2018.

Evaluation of the primary care for chronic diseases in the high coverage context of the Family Health Strategy

BackgroundThis cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012 and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil.MethodsThe data source contained information on the infrastructure of the 233 Primary Health Units and on the work process of 266 health teams. The Principal Component Analysis for Categorical Data technique and the McNemar chi-squared statistical test for comparing paired samples were used, and a significance level of 5% with a 95% Confidence Interval was used.ResultsThe analysis identified a low proportion of dispensing of medications for the treatment of chronic disease in both cycles. There was a significant increase in seasonal influenza vaccination, in the number of sterilization, procedure, dressings and inhalation rooms. There was a small but significant reduction in the materials for cervical cancer screening, although they are available in almost 90.0% of the PHUs. More than 70.0% of the health teams carried out additional health education activities, encouraged physical activity, registered schoolchildren with health needs for monitoring, evaluated user satisfaction and user referral.ConclusionsThe findings of this study highlighted the improvement of the structure of the Primary Health Units, but identified a low provision of medicines to treat chronic diseases. The health promotion was performed as the main work process tool of family health teams, but it was little focused on intersectoral actions and on actions with the population in the area or on the empowerment of users through self-management support for chronic diseases. Furthermore, it is critical that the Family Health Strategy in Tocantins be organized and focused on the care of chronic diseases to improve and adapt itself to a primary chronic care model.

Percepção do Agente Comunitário de Saúde sobre as demandas fonoaudiológicas do município de Pirpirituba-PB

Objetivo: analisar a percepção dos ACSs sobre as demandas fonoaudiológicas existentes na Atenção Básica no município de Pirpirituba-PB. Método: O projeto de pesquisa foi submetido e aprovado pelo Comitê de Ética em Pesquisa da instituição, com o parecer nº 2.194.691. Esta é uma pesquisa do tipo transversal com abordagem quantitativa, realizada nas Unidades de Saúde da Família do município pesquisado. Foram analisadas as demandas fonoaudiológicas existentes na Atenção Básica. Foi aplicado um questionário sobre queixas e ações fonoaudiológicas, com 22 Agentes Comunitários De Saúde (ACSs). Resultados: De maneira geral, o estudo mostrou que as maiores queixas de demanda fonoaudiológica do município estão inseridas na área de linguagem: dificuldade para falar (72,7%; n=16), síndromes (63,6%; n = 14), atraso de linguagem (59,1%; n = 13), dificuldade de atenção/concentração (59,1%;n=13) e que há informações disponíveis sobre esse atendimento nas Unidades Básicas de Saúde (UBS). Todos concordaram (100%; n=22) que há necessidade de maiores esclarecimentos sobre Fonoaudiologia, direcionados aos profissionais atuantes nas UBS’s. Conclusões: São necessários maiores esclarecimentos sobre a fonoaudiologia para estes profissionais e a contratação de mais um profissional fonoaudiólogo para o município em questão.

Factors associated with inadequate follow-up of children with congenital syphilis.

ABSTRACTOBJECTIVE To analyze factors associated with outpatient follow-up of children with congenital syphilis.METHODS A non-concurrent cohort study performed in primary care units and three reference maternity hospitals in Fortaleza (Ceará State). Data were collected from September 2013 to September 2016 in the notification forms and in the medical records of hospitalization and outpatient follow-up, and they were presented considering an adequate and inadequate follow-up. Children who attended the primary care unit or referral outpatient clinic during the period recommended by the Ministry of Health were considered adequately followed up and performed the recommended examinations. Pearson’s chi-square and Fisher’s exact tests were used in the comparative analysis. The estimated risk of adequate non-follow-up was verified by simple and multiple logistic regression.RESULTS The total of 460 children with congenital syphilis were notified, of which 332 (72.2%) returned for at least one appointment and were part of the study. Exactly 287 (86.4%) children attended the primary health unit; however, there was no reference to congenital syphilis in 236 (71.1%) medical records and no information on the venereal disease research laboratory (VDRL) test was found in 264 (79.5%) children. There was nonadherence to subsequent appointments by 272 (81.9%) individuals. The following variables had a statistically significant association with the non-adequate follow-up of the children: marital status of the mothers, number of prenatal appointments, number of pregnancies, blood count, and radiography of long bones.CONCLUSIONS Most children with congenital syphilis attended primary care for follow-up, but the services do not meet the recommendations of the Brazilian Ministry of Health for adequate follow-up.

Determinants of Common Mental Disorders Among Residents of Quiha Town, Tigray, Northern Ethiopia

Background: Common mental disorders include anxiety, depression and somatic symptom related disorders which are the most prevalent mental disorders in the world and they can cause a significant public health problem. Some studies reported that individuals who are older, being female, separated, divorced or widowed, and having poor physical health were more likely to have common mental disorders. Therefore this study is expected to identify the determinants of common mental disorders in the community and inform to concerned bodies to improve the mental and psychological wellbeing of the community. Objective: To assess determinants of common mental disorders among residents of Quiha town, Tigray, northern Ethiopia 2018/2019 Method: A community based unmatched case-control study design was conducted on 297 adult residents of Quiha town 99 cases and 198 controls calculated using double population proportion formula by considering; 95% confidence interval, 80% power, and a 1:2 ratio of case and control groups. The study participant has selected two controls after each case. Data were collected by three trained BSc. Psychiatric nursing using self-reported questionnaire (SRQ20) through face to face interview and was supervised by one MSc. Student. Data entry was done by using EPI- Info version 4.2 and transferred to SPSS version 20.0 statistical software for cleaning, coding, and analysis. Logistic regression was computed to assess statistical association via Odds ratio, and the significance of statistical association was tested using a 95% confidence interval and P-value (0.05). Result: Out of 198cantrols and 99 cases participants [155(78.3%control & 74(74.7%) case] were females. Participants who were Son/daughter (AOR=0.37,95% CI:0.14_98) and being dependent (AOR=6.50, 95% CI:1.17_36.20), chronic illness(AOR=2.52;95%CI:1.10_5.80),experiencing stressful life event (AOR =2.50; 95% CI:1.20_5.13), moderate perceived stress level(AOR=5.92; 95% CI: 2.85_12.27)and high perceived stress level (AOR =122.82; 95% CI: 114.83_1063.60)were significantly associated with common mental disorders. Conclusion: The results of this study showed an association between common mental disorders and different determinants. This complex association may result in challenges control of common mental disorders. Screening programs for psychological problems can be used in primary health units. We recommend that mental health services have to be expanded to the community level with wide scale and mental health training of general health professionals. Funding Statement: Source of funding for this research is Mekelle University College of Health Science. Declaration of Interests: The authors declare they have no competing interests. Ethical Approval Statement: This study was carried out after obtaining ethical approval from the college of health sciences, Mekelle University.

Long-term effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae in children in Brazil

Brazil introduced the 10-valent pneumococcal vaccine (PCV10) to the routine national immunization program (NIP) in March 2010. In 2017, we investigated the effects of PCV10 on nasopharyngeal carriage of vaccine-types (VT) and non-vaccine-types (NVT) of Streptococcus pneumoniae (Spn) among children living in São Paulo city. We also compared the prevalence of VT and NVT with previous carriage surveys performed in 2010 (baseline) and 2013. MethodThe carriage survey was conducted among 531 children, aged 12 months to <24 months, recruited from public Primary Health Units during the immunization campaign, using previous surveys methodology, except for qPCR, which was performed in the 2017 survey only. ResultsNo statistical difference was found in the prevalence of Spn either by culture (59.7%) or by qPCR (61.2%). Spn carriage increased from 40.3% (baseline) to 59.7% (2017 survey) (p < 0.001). Colonization by VT isolates significantly decreased by 90.9% (19.8–1.8%) and 95.5% (19.8–0.9%) in the 2013 and 2017 surveys, respectively, compared to that at baseline. NVT isolates increased significantly by 128% (19.6–44.8%) and 185% (19.6–55.9%) in the respective post-PCV10 surveys, most led to high prevalence of serotypes 6C (27%), 15B (9.8%), 19A (9.2%), 15A (6.0%), and 16F (5.7%). In 2017, reduction in serotype 6A (4.2–0.6%, p < 0.001) and increase in serotype 19A (1.8–6.0%, p = 0.001) were found; serotype 3 isolate was not detected in the present survey. We identified the emergence of 19A isolates CC320, associated with high penicillin (MIC ≥ 2.0 mg/L) and cefotaxime (MIC ≥ 1.0 mg/L) values. ConclusionAfter 7 years of PCV10 introduction in the NIP, colonization by VT among toddlers decreased substantially to a residual level, along with substantial serotype replacement by novel serotypes not present in any current conjugated pneumococcal vaccine and serotype 19A. The present findings can assist policy decisions in Brazil.

Post-Ebola Community Health Worker programme performance in Kenema District, Sierra Leone: A long way to go!

Background: The devastating 2014-2015 Ebola outbreak in Sierra Leone could erode the gains of the health system including the Community Health Worker (CHW) programme. We conducted a study to ascertain if the positive trend in reporting cases of malaria, pneumonia and diarrhoea treated by CHWs in the post-Ebola period has been sustained 18 months post-Ebola. Methods: We conducted a retrospective cross-sectional study using aggregated CHW programme data (2013-2017) from all Primary Health Units in Kenema district. Data was extracted from the District Health Information System and analysed using STATA. Data in the pre- (June 2013-April 2014), during- (June 2014-April 2015) and post-Ebola recovery (June 2016-April 2017) periods was compared and analysed for reporting completeness; Rapid Diagnostic Tests (RDTs) performed and cases of malaria, diarrhoea and pneumonia treated per month. Differences across periods were tested using two-sample t-test with significance set at 0.05. Results: CHW reporting increased from pre-Ebola by 8% (p-value=0.29) intra-Ebola and 19% (p-value=0.012) post-Ebola. Compared to the pre-Ebola period, in the post-Ebola recovery period, there was a significant increase in the mean monthly reported RDTs of 35% (p-value=0.020); malaria treatments 66% (p-value&lt;0.001); and pneumonia treatments increased by 80% (p-value=0.004). Conversely, the mean monthly diarrhoea cases treated decreased by 20% (p-value=0.16) in the post-Ebola period. Conclusion: The resiliency demonstrated by the CHW programme during and immediately after the Ebola outbreak has been sustained in the post-Ebola recovery period. Continued programme investments in supportive supervision and financial incentives for CHWs will be critical to ensure uninterrupted contribution towards Sustainable Development Goal 3.

Asthma and oral changes in children: Associated factors in a community of southern Brazil.

Asthma is a chronic disease that involves several healthcare services that need attention in relation to its treatment and prevention. The objective of this study was to evaluate caries, erosion, and enamel defects in children with and without asthma. Cross-sectional study, with a sample of 228 children ages 6-12years, stratified as asthmatic (n=112) and non-asthmatic (n=116), at two Primary Health Units of the Community Health Service, Brazil. The evaluation consisted of an oral examination and a structured interview with parents/guardians, in addition to data from medical records. Data were analysed by Poisson regression with a robust error variance, all of them at a level of significance of P<0.05. Of 112 asthmatic children, 63 (51.2%) had dental caries and 25 (53.2%) enamel defects. In the adjusted analysis, dental caries and use of salbutamol were associated (PR=1.32, 95% CI=1.01-1.72). In addition, children who performed oral hygiene more than three times a day showed a greater prevalence (PR=2.36, 95% CI=1.02-4.85) of dental erosion compared with children who performed it only once a day. There is no evidence for an association between asthma, caries, erosion, and enamel defect in children aged from 6 to 12years. There was, however, an association between dental caries and use of salbutamol.

Effect of Mode of Delivery on Sexuality of Female and Her Partner

Exploring the hypothesis that is related to mode of delivery is necessary as sexual health is considered as an integral part of general health. The over risks and benefits of vaginal versus cesarean delivery should be a subject of continued debate, involving a broad range of physical and psychological factors. The aim of this study was to quantify the effect of mode of delivery on sexual function of the women 6 months to 1 year postpartum in a sample of Egyptian women. This was a cross section study conducted on 400 participants, 200 who had normal vaginal delivery [NVD] and 200 who had caesarian section [CS]. Participants were enrolled from the primary health centers and units in Qalubia government, participant were asked to fill a self-reported questionnaire of female sexual function index [FSFI].the results showed that all sexual domains and total FSFI were significantly decreased in normal vaginal group [NVD] group compared to caesarian section[CS] group .In conclusion, significant decrease in the FSFI score in NVD group more than CS group, this need more and more studies to strength this result.

The use of benzodiazepines by women cared for at a Family Health Unit.

Estimate the prevalence of benzodiazepine use by adult women at a Family Health Unit and identify the risk factors associated with this usage. Quantitative cross-sectional study that employed secondary data developed at a Family Health Unit in the state of São Paulo, Brazil. We collected the data from the following sources: medical charts, registration forms, and the archive of prescriptions from the pharmacy at the referred health unit. We employed the chi-squared, Student's t, and Mann-Whitney tests, as well as logistic regression analysis. We identified 81 benzodiazepine users amongst 1,094 adult women (7.4%). Regarding the risk factors, the comparison between the groups of benzodiazepine users (n = 64) and non-users (n = 70) showed that having a chronic disease and using other psychotropic drugs were significantly associated with the use of benzodiazepines. The prevalence found was lower than the described in previous studies performed in Primary Health Units. The group that must receive greater attention regarding the consumption of benzodiazepines is that of middle-aged women or older, with low education levels, and chronic illnesses.

Primary health care quality assessment according to the level of satisfaction of elderly users.

To evaluate the quality of Primary Health Care according to the level of satisfaction of elderly users. An exploratory-descriptive study, with a quantitative approach, performed with 381 elderly users of Primary Health Care. For data collection, the Service Quality scale (SERVQUAL) was adapted to the context of the Primary Health Units (UBS) of Family Health Strategy (ESF) and a questionnaire with 44 questions was elaborated. Data was treated using SSPS® and analyzed using descriptive and inferential statistical techniques. the SERVQUAL subscales "expectations" and "perceptions" exhibited excellent reliability and internal consistency, with Cronbach's Alpha 0.948 and 0.932, respectively. The evaluated dimensions presented negative Gaps results: tangible aspects -0.65, reliability -1.19, responsiveness -0.56, guarantee -0.91, and empathy -0.52. negative Gaps in all dimensions show gaps in the quality of services and demonstrates the low satisfaction of the elderly users of UBS/ESF/APS.

Reduction of Breast Cancer Treatment Delay as a Result of Efforts Carried Out by Two Brazilian NGOs

Background: Brazilian breast cancer patients present disease often at advanced stages (III, IV). Previous studies indicated that system delay is a causal factor of bad prognosis and increased mortality rate. In the state of Paraíba, northeast of Brazil, two non-governmental organizations (NGOs) Américas Amigas and Mulheres de Peito de Campina Grande (MLDP), promote faster access to treatment by donating diagnostic mammography and biopsies as well as anatomo-histopathological and immunohistochemical analysis. Aim: The current study aimed at evaluating the effectiveness of the assistance provided by both NGOs and comparing patient flow between HNL and FAP, two reference cancer centers in João Pessoa and Campina Grande, respectively. Methods: Time-to-treatment was analyzed for different time intervals between first medical consultation and initiation of treatment. Comparison was performed between three groups of patients: 40 patients from Hospital Napoleão Laureano (HNL) in João Pessoa; 80 patients from Fundação Assistencial da Paraíba (FAP) in Campina Grande and 15 patients from FAP, who received support from the NGOs. Kaplan-Meier analysis was performed to compare time-intervals among the groups. To estimate the impact of socioeconomic variables Cox regression analysis was performed. Results: Mean time-interval between first medical consultation and hospital admission was 135 (SD=21.0), 370 (SD=73.7) and 515 (SD=36.6) days, for patients of HNL, MLDP and FAP, respectively ( P = 0.0021). Time intervals analyzed for patients within the FAP hospital, between first medical consultation and hospital admission, tended to be shorter for patients who were assisted by the NGOs, compared with those who did not receive any assistance from the NGOs. Patients who had consulted specialized oncological health services beforehand had an increased chance (HZ=2.32; 95% CI: 1.17-4.60; P = 0.016) of being admitted at the reference hospital within 90 days after the first medical consultation, compared with those who had not consulted such specialized services. There were no significant differences between HNL and FAP, regarding the time interval between hospital admission and treatment initiation ( P = 0.21). Conclusion: The assistance to patients provided by the two NGOs, aimed at speeding up the diagnosis process, accelerated patient flow between first medical consultation and admission at the hospitals. Regarding HNL, patients from the inland had been sent by primary health units in their municipalities, directly to the cancer reference hospital in João Pessoa, without being referred to an in-between health service. Such procedure explains the variation of time intervals when admissions at FAP and HNL are compared. The results of the current study indicate that by providing faster breast cancer diagnosis, the NGOs’ mediation can significantly improve patient flow.

Jizzakh Petroleum to build new refinery in Uzbekistan with technology from Honeywell UOP

The first coronavirus disease 2019 (COVID-19) report in Brazil occurs by the end of February, and 4 months later, there was more than 1 million infected patients and 54,971 deaths.The health-care system in Brazil is universal, meaning that all inhabitants are covered by the Unified Health Care System, and 20% of Brazilian citizens are covered by private health-care insurances. In this scenario, the government adopted some actions to combat the pandemics, including guidelines for COVID-19 prevention and management, allocation of funds to support primary care, extension of medical services in primary health units, increase in the number of health-care professionals, distribution of COVID-19 tests, use of telemedicine to monitor patients with flu-like symptoms, and teleconsulting with psychiatrist and psychologists.Since the pandemic offers a unique opportunity for research and management in Brazil, a coalition initiative conducted several therapeutic trials in search of safe treatments for patients with COVID-19. Other issue in this field was the organization of health system, both in private and public organizations.

The application of microfluidic systems in clinical diagnostics

Currently, clinical laboratories are developing towards two different directions. One is centralized laboratory with automated pipelines, and the other is highly integrated portable detection system.The latter evolved from an early single test device gradually to an integrated platform based on microfluidic technology, which can operate multiple steps and tests simultaneously. The microfluidic system is further developed to a miniaturized device which can perform biochemical, immune, microbial and cytological tests. With the medical reform process in China, the microfluidic systems will appear in the primary health unit or even families. This review concludes the current application of microfluidic technology in clinical diagnostics and its future trends.(Chin J Lab Med, 2018, 41: 631-633) Key words: Microchip analytical procedures; Microfluidics; Clinical laboratory techniques

SALA DE ESPERA: ESPAÇO PARA EFETIVAR A EDUCAÇÃO EM SAÚDE EM UMA UNIDADE DE SAÚDE

O objetivo desse trabalho foi relatar a implementação das ações de educação em saúde na sala de espera em uma unidade de saúde, enquanto os usuários aguardavam atendimento. Trata-se de um relato de experiência, parte do estágio supervisionado da disciplina em Saúde Coletiva do curso de Graduação em Enfermagem de uma universidade pública. Foi implantado o projeto “Sala de Espera”, destinado aos usuários que aguardavam atendimento. Para isso houve a confecção de um calendário com datas comemorativas relacionadas à saúde, abordando a cada mês a temática comemorada. A intervenção proporcionou momentos lúdicos, de bem-estar, expressividade, troca de conhecimentos e experiências. Considerando-se todas as atividades educativas na sala de espera entre agosto e novembro de 2017, obteve-se a participação de 290 usuários, com 15 encontros, numa média de 15 a 20 pessoas em cada um deles. Os participantes expuseram suas dificuldades a respeito dos temas abordados. Com a criação da sala de espera, percebe-se que se estabeleceu um maior vínculo/confiança entre a equipe de saúde e a população local.

POP-Brazil study protocol: a nationwide cross-sectional evaluation of the prevalence and genotype distribution of human papillomavirus (HPV) in Brazil

IntroductionHuman papillomavirus (HPV) is associated with the development of genital warts and different types of cancer, including virtually all cervical cancers and a considerable number of penile, anal and oropharyngeal...

Perfil, atuação e satisfação de cirurgiões-dentistas em Residências Multiprofissionais em Saúde da região Sul do Brasil

As Residências Multiprofissionais em Saúde (RMS) encontram-se distribuídas por todo o território nacional e estão estruturadas em abordagem multiprofissional com uma visão mais humana e abrangente, cujo foco não se restringe apenas aos procedimentos curativos. O objetivo do presente estudo foi avaliar o perfil dos cirurgiões-dentistas regularmente matriculados em RMS da região Sul do país, bem como sua atuação e satisfação com os programas. Para isso, foi realizada uma pesquisa quantitativa, exploratória e descritiva, utilizando-se um questionário on-line, cujo link foi enviado a cirurgiões-dentistas matriculados em RMS (Atenção Básica, Saúde da Família e Comunidade e Saúde Coletiva), localizadas na região Sul do Brasil. Os dados coletados foram tabulados no Microsoft Excel® e tratados por estatística descritiva (frequência simples e relativa). Constatou-se que a maioria dos residentes era do gênero feminino (75%) com graduação em IES privada (70%), sem experiência profissional prévia (70%) e com experiência acadêmica prévia em saúde pública (85%). Para os dados referentes à RMS, a maioria relatou como motivo pela escolha da residência o interesse em atuar na atenção básica. Oitenta e cinco por cento dos dentistas relataram atuar em Unidades Básicas de Saúde. A maioria dos residentes mostrou-se satisfeito com a RMS (75%) e a falta de capacitação dos docentes foi apontada como a principal fragilidade dos programas. O estudo possibilitou traçar um panorama do perfil, atuação e satisfação dos cirurgiões-dentistas inseridos em RMS da região Sul do Brasil. Os dados podem auxiliar na melhoria das práticas e organização das RMS com cirurgiões-dentistas, conduzindo melhor a atuação de residentes e docentes frente às principais fragilidades apontadas.