Valéria Teresa Saraiva Lino

O presente estudo tem como objetivo conhecer os desafios enfrentadas pelos cuidadores familiares de pacientes em cuidados paliativos oncológicos na internação hospitalar diante da brevidade da vida. Método: Através de uma revisão de literatura, com buscasrealizadas nos artigos publicados no período de junho a julho de 2023. Resultados: Emergiram duas categorias de análise: Desafios enfrentados pelos familiares e Assistência de Enfermagem ao cuidador. Existem muitos desafios para um cuidador familiar quando se refere ao cuidar de pessoas em cuidados paliativos oncológicos em um ambiente hospitalar, por muitas vezes em situação de brevidade de vida. Considerações finais: Após o término do estudo, o entendimento referente aos cuidados paliativos quando aplicado desde a descoberta da doença, proporciona um nível elevado de qualidade de vida ao cuidador familiar, valorizando as suas emoções, as relações afetuosas entre o familiar e o paciente; as redes socias de apoio formais e informais; melhorando a comunicação e informações fundamentais sobre a etapa da doença, a relação com a fé e crenças religiosas, espirituais. Trazer o senso e a convicção de uma vida com propósito ao paciente e seu cuidador familiar.

The objective of this study is to evaluate the effectiveness and safety of ozone therapy (OT) in the treatment of knee osteoarthritis (KOA), which is the most common form of the disease. We analysed systematic reviews (SRs) of randomised controlled trials (RCTs) using the “A MeaSurement Tool to Assess systematic Reviews” (AMSTAR2) instrument to evaluate their quality. We developed a narrative synthesis report with eight SRs (15 RCTs/3,685 patients) to summarise the findings. The AMSTAR2 analysis indicated that all reviews had critically low confidence ratings. Statistically significant effects in pain reduction using OT compared to placebo groups were reported in three SRs. OT was shown to be comparable to other therapies in one SR and not superior in the other five. Six SRs highlighted the need for additional RCTs with improved methodological quality to confirm the efficacy of OT for KOA. SRs found fewer consistent effects for improving joint function. Regarding safety, seven SRs reported a low prevalence of minor adverse events linked with OT. Finally, this umbrella review highlights the beneficial effects and safety of OT in the treatment of KOA, particularly in pain control. The low methodological quality of RCTs and SRs limits the possibility of drawing conclusions on the effectiveness of the procedure in comparison to other therapies. Ensure adequate compliance with guidelines such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and AMSTAR2 has the ability to improve the quality of SRs in this area.

Background: this study aims to estimate the rate of death by cancer as a result of Radio Base Station (RBS) radiofrequency exposure, especially for breast, cervix, lung, and esophagus cancers. Methods: we collected information on the number of deaths by cancer, gender, age group, gross domestic product per capita, death year, and the amount of exposure over a lifetime. We investigated all cancer types and some specific types (breast, cervix, lung, and esophagus cancers). Results: in capitals where RBS radiofrequency exposure was higher than 2000/antennas-year, the average mortality rate was 112/100,000 for all cancers. The adjusted analysis showed that, the higher the exposure to RBS radiofrequency, the higher cancer mortality was. The highest adjusted risk was observed for cervix cancer (rate ratio = 2.18). The spatial analysis showed that the highest RBS radiofrequency exposure was observed in a city in southern Brazil that also showed the highest mortality rate for all types of cancer and specifically for lung and breast cancer. Conclusion: the balance of our results indicates that exposure to radiofrequency electromagnetic fields from RBS increases the rate of death for all types of cancer.

Resumo Realizou-se estudo transversal em Manguinhos, na cidade do Rio de Janeiro para identificar prevalência de violência de cuidadores contra idosos dependentes e fatores associados. Uma amostra de conveniência de 135 duplas foi avaliada. Testes estatísticos compararam os percentuais de violência, segundo as características do cuidador e do idoso e um modelo de regressão logística investigou a associação entre violência e as características de ambos. Mais de 30% dos cuidadores apresentaram indícios de abuso. Em relação aos cuidadores, elevados níveis de sobrecarga e problemas com álcool aumentaram em 11 e 3,8 vezes as chances de ocorrência de violência, respectivamente, quando comparados aos grupos de referência. Quanto aos idosos, homens e indivíduos com depressão tiveram chance 2,9 e 6,9 vezes maior de sofrerem maus tratos, em relação às mulheres e aos que não tinham depressão, respectivamente. A elevada prevalência de maus tratos por parte de cuidadores que apresentam altos níveis de sobrecarga, problemas relacionados ao álcool e que cuidam de idosos deprimidos requer a adoção de medidas de apoio familiar.

Objective: The aim of this study was to investigate the effects of three temporal components of AIDS incidence (i.e., age, period and cohort) on individuals aged 50 or older living in Niteroi, Rio de Janeiro (Brazil). Methods: Age-specific incidence rates were calculated from 1982–2011. Negative binomial and Poisson models were used to analyze the risk of AIDS by age, period and cohort. Results: The risk of AIDS in men was 2.45 times higher than in women, regardless of age and period (p-value < 0.001). The incidence of AIDS in individuals older than 69 years was 7-fold lower than in those aged 50–59 years (p-value < 0.001). A decreasing trend in AIDS risk was observed from the youngest cohort (≥1940) to the oldest (1910–1919). From 1982 to 2006, we could detect an increasing trend in AIDS risk in the population aged 50 years or older. A peak in rates was detected in the period from 2002–2006. The incidence rates in 2002–2006 were six times higher than those in 1987–1991 (p-value < 0.001), independent of age and sex (p-value < 0.001). Conclusions: An increase of AIDS risk in older people was detected. This group should not be neglected by public health programs.