Glauciano de Oliveira Ferreira

Introduction: Research suggests an association between cocaine use and an increased risk of ische­mic stroke, with a more pronounced impact among young adults. Despite strong biological plausi­bility and growing epidemiological documentation, the magnitude of the risk attributable to cocaine use in this population has not yet been fully established. Therefore, the objective of this study was to analyze the published evidence regarding the association between cocaine use and the occurrence of ischemic stroke in young adults. Materials and methods: An integrative review was conducted in accordance with PRISMA recom­mendations. The literature search was performed in August 2024 in the MEDLINE/PubMed, LI­LACS, Scopus, and Web of Science databases. Studies investigating the relationship between co­caine use and ischemic stroke in adolescents or young adults were included. Methodological quality was classified according to Melnyk and colleagues’ hierarchy of evidence levels, and thematic analy­sis followed Bardin’s framework. Results: Thirteen studies met the eligibility criteria. The findings indicate an association between cocaine use and an increased risk of ischemic stroke in young adults, particularly following acute exposure. Reported mechanisms include cerebral vasospasm, endothelial dysfunction, platelet acti­vation, and hemodynamic alterations. Discussion: The amplification of risk following acute exposure and the concomitant use of multiple substances corroborate findings from previous investigations. Conclusion: The available evidence suggests that cocaine use constitutes a risk factor for ischemic stroke in young adults. The predominance of observational studies underscores the need for more rigorous investigations to achieve more precise estimates of attributable risk.

Background: Climate change projections impact dengue transmission in tropical regions, creating diverse and complex public health challenges. The aim of this study was to project future seasonal dengue incidence in a large tropical urban area of Brazil, where dengue is endemic, by systematically analyzing climatic and dengue case time series. Methods: An epidemiological dengue model was developed using time series analysis techniques and forced with statistical downscaling from various Coupled Model Intercomparison Project Phase 6 (CMIP6) climate models based on Shared Socioeconomic Pathway (SSP) scenarios for the late twenty-first century (2071–2100). The ecological time-series investigation analyzed 193 618 dengue cases from January 2008 to December 2018. Statistical downscaling transformed low-resolution Global Climate Models’ outputs into high-resolution data, based on a 30-y climate baseline. Results: The results indicated significant climate changes in seasonal temperature and precipitation by the end of the century. Under both SSP2-4.5 and SSP5-8.5 scenarios, substantial increases in dengue cases are projected during current low-incidence months, resulting in a reduced seasonality of dengue. Conclusions: The findings represent considerable challenges for future public health systems, which may face sustained high levels of dengue incidence throughout the year.

Purpose: To measure the effects of the NIC intervention fall prevention on the magnitude of the NANDA-I Risk for falls’ risk factors and of NOC indicators related to falls in older adults with arterial hypertension. Background: Nurses can use nursing taxonomies to provide effective care in preventing falls in specific populations. Methods: Clinical, randomized, open, parallel, and multicenter trial following the CONSORT recommendations for nonpharmacological trials. The clinical trial was registered. The research was conducted with 118 older adults allocated to intervention and control groups and matched by sex and age. The intervention was conducted in the participants’ homes in three different moments and consisted of nursing activities belonging to the NIC Fall prevention and implemented with the aid of a protocol with operational definitions. Findings: Three months after the intervention, there was a significant intergroup difference in the frequency of Risk for falls and of the following factors/conditions: cluttered environment, unfamiliar setting, exposure to unsafe weather-related condition, insufficient anti-slip material in the bathroom, history of falls, acute illness, orthostatic hypotension, hearing impairment, and impaired vision. There was also a positive change in the magnitude of the following NOC indicators: risk control, cognitive orientation, knowledge: fall prevention, safe home environment, comfort level, vision compensation behavior, and leisure participation. Conclusions: The NIC intervention Fall prevention was effective in modifying risk factors belonging to Risk for falls and NOC indicators related to falls in older adults. Implications for nursing practice: The tested intervention is important and should be instituted, mainly by nurses from primary care services who make home visits to older adults.

Objetivo: analisar estudos referentes à avaliação da qualidade de vida e as condições de saúde de pacientes hipertensos e diabéticos com disposição para controle da saúde melhorado. Método: revisão integrativa da literatura, realizada no período de junho a julho de 2018. Foram coletados dados nas seguintes bases de dados: PUBMED, LILACS e SciELO. Consoante os critérios de inclusão, estabeleceu-se uma amostra final de 22 artigos. Resultados: Foram encontradas pesquisas que exploraram as medidas de qualidade de vida de pacientes com hipertensão arterial e diabetes. Notou-se que os profissionais da atenção básica atuam como agentes relevantes para o controle dessas doenças. Observou-se a importância da adesão medicamentosa e do perigo que os fatores de risco podem causar nesses pacientes. Conclusão: os principais fatores que influenciam na qualidade de vida e condições de saúde são: maior renda per capita, nível de escolaridade, adesão a medicação, visitas aos profissionais da atenção primária, obesidade, transtornos mentais e idade.Descritores: Qualidade de vida; Hipertensão; Diabetes Mellitus; Nível de Saúde; Enfermagem. QUALITY OF LIFE AND HEALTH CONDITIONS OF PATIENTS WITH HYPERTENSION ARTERIAL AND DIABETES MELLITUS Objective: to analyze studies related to the assessment of quality of life and health conditions of hypertensive and diabetic patients with a willingness to improve health control. Method: integrative literature review, carried out from June to July 2018. Data were collected in the following databases: PUBMED, LILACS and SciELO. Depending on the inclusion criteria, a final sample of 22 articles was established. Results: Researches were found that explored the quality of life measures of patients with arterial hypertension and diabetes. It was noted that primary care professionals act as relevant agents for the control of these diseases. It was observed the importance of medication adherence and the danger that risk factors can cause in these patients. Conclusion: the main factors that influence quality of life and health conditions are: higher per capita income, education level, medication adherence, visits to primary care professionals, obesity, mental disorders and age.Descriptors: Quality of life; Hypertension; Diabetes Mellitus; Health level; Nursing. CONDICIONES DE CALIDAD DE VIDA Y SALUD DE PACIENTES CON HIPERTENSIÓN ARTERIAL Y DIABETES MELITUSObjetivo: analizar estudios relacionados con la evaluación de la calidad de vida y las condiciones de salud de pacientes hipertensos y diabéticos con voluntad de mejorar el control de la salud. Método: revisión integrativa de la literatura, realizada de junio a julio de 2018. Los datos fueron recolectados en las siguientes bases de datos: PUBMED, LILACS y SciELO. Dependiendo de los criterios de inclusión, se estableció una muestra final de 22 artículos. Resultados: Se encontraron investigaciones que exploraron las medidas de calidad de vida de pacientes con hipertensión arterial y diabetes. Se señaló que los profesionales de atención primaria actúan como agentes relevantes para el control de estas enfermedades. Se observó la importancia de la adherencia a la medicación y el peligro que pueden ocasionar los factores de riesgo en estos pacientes. Conclusión: los principales factores que influyen en la calidad de vida y las condiciones de salud son: mayor ingreso per cápita, nivel educativo, adherencia a la medicación, visitas a profesionales de atención primaria, obesidad, trastornos mentales y edad.Descriptores: Calidad de vida; Hipertensión; Diabetes mellitus; Nivel de salud; Enfermería.

Purpose: to analyze accuracy measures of the clinical indicators of Readiness for enhanced health management in patients with arterial hypertension and/or diabetes mellitus Methods: prospective diagnostic accuracy study conducted with 359 patients with hypertension and/or diabetes mellitus, followed up in primary healthcare. Stratified random sampling was used to recruit participants. An assessment form was applied with sociodemographic data, health conditions, and information related to the clinical indicators under investigation. Sensitivity, specificity, predictive values, and likelihood ratios were analyzed Findings: the sample was composed of 359 participants. The prevalence of Readiness for enhanced health management was 93.8%. There was a statistically significant association between the diagnosis and age under 60 years ( p < 0.001), having only one chronic condition ( p < 0.001), having normal blood pressure ( p = 0.017) and blood glucose ( p = 0.013) values, and having a nonsedentary ( p = 0.026) and nonalcoholic ( p = 0.044) lifestyle. All clinical indicators had high predictive values in predicting the nursing diagnosis under investigation. The indicator expresses desire to enhance management of symptoms was the most sensitive (99.7%) and specific (100%). The indicator expresses desire to enhance management of prescribed regimens was also highly specific (100%) Conclusion: all clinical indicators were accurate in predicting Readiness for enhanced health management Implications for Nursing Practice: knowing which clinical indicators and sociodemographic/clinical characteristics best predict Readiness for enhanced health management, nurses in primary care can better plan nursing interventions and direct their goals.

OBJECTIVES: To analyze the Nursing Diagnosis risk for falls indicators in aged with hypertension and to verify the association of this diagnosis with sociodemographic variables and antihypertensive agents used by the aged. METHODS: Analytical study, cross-sectional with quantitative approach. It was carried out in three health units in the city of Redenção, Ceará, Brazil, in the Brazilian Northeast. A total of 153 elderly subjects participated in the study. Statistical analysis was performed using Fisher's exact test, Pearson's chi-square test and multinomial logistic regression of variables that presented association with the Nursing Diagnosis. RESULTS: Use of throw rugs, difficulties with gait, acute illness ( p = .004), age greater than or equal to 65 years and impaired vision were associated with the Nursing Diagnosis risk for falls (00155). The work situation (retired) was the only sociodemographic variable that had a significant association with the risk for falls. Antihypertensive agents were not associated with the diagnosis. CONCLUSION: Age greater than or equal to 65 years, use of throw rugs, difficulties with gait, acute illness, and impaired vision can be useful to infer the risk for falls and to confirm their presence in the aged with hypertension. IMPLICATIONS FOR NURSING PRACTICE: This study provides data that can help nurses in the process of inferring the diagnosis risk for falls in the aged with hypertension, which streamlines the planning and implementation of preventive interventions.

Objectives We aim to describe the relationships between climate variables and climate-sensitive diseases (CSDs) in semi-arid regions, highlighting the different main groups of CSDs and their climate patterns. Methods This systematic review considered Medline, Science Direct, Scopus and Web of Science. The data collection period was August and September 2019 and included studies published between 2008 and 2019. This study followed a protocol based on the PRISMA statement. Data analysis was done in a qualitative way. Results The most of works were from Africa, Asia and Iran (71%), where temperature was the main climatic variable. Although the studies provide climatic conditions that are more favorable for the incidence of vector-borne and respiratory diseases, the influence of seasonal patterns on the onset, development and end of CSDs is still poorly understood, especially for gastrointestinal disorders. Moreover, little is known about the impact of droughts on CSDs. Conclusions This review summarized the state of art of the relationship between climate and CSDs in semi-arid regions. Moreover, a research agenda was provided, which is fundamental for health policy development, priority setting and public health management.

Objetivo: identificar interações medicamentosas potenciais em prontuários de pacientes de um hospital e maternidade de um município brasileiro. Métodos: estudo documental, retrospectivo, com abordagem quantitativa, realizado entre janeiro e junho de 2017, em um hospital filantrópico do Estado do Ceará, Brasil. A fonte documental foram os prontuários de 167 pacientes. Os dados foram analisados por estatística descritiva com frequência absoluta e relativa. As interações medicamentosas potenciais foram verificadas por meio do Sistema Micromedex. Resultados: dos 167 prontuários, 80 (48%) eram de pacientes do sexo masculino e 87 (52%) do sexo feminino. Identificou-se que 24 das interações medicamentosas foram “potenciais maiores”, presentes, sobretudo, na associação dos seguintes fármacos: dipirona/ibuprofeno, dipirona/prednisona, dipirona/diclofenaco. Conclusão: o estudo mostra a necessidade de maior cautela na prescrição de dipirona com outros medicamentos, haja vista um maior envolvimento dele em interações medicamentosas potenciais.