DSpace Coleção:

Eficácia e segurança da auriculoterapia na melhora da qualidade do sono de pessoas vivendo com HIV: Ensaio clínico randomizado

2026-06-01T17:02:45Z

Título: Eficácia e segurança da auriculoterapia na melhora da qualidade do sono de pessoas vivendo com HIV: Ensaio clínico randomizado Autor(es): Ramalho, Ane Kelly Lima Abstract: People living with HIV (PLHIV) have more difficulty sleeping, which may be associated with the virus itself, stigma, and antiretroviral therapy (ART). As a non-pharmacological alternative, there is auriculotherapy, which is included in the National Policy on Integrative and Complementary Practices. The overall objective was to evaluate the effectiveness and safety of auriculotherapy in improving sleep quality in PLHIV and sleep disorders. This is a randomized, controlled clinical trial with a sample of 200 PLHIV, with 100 in the Auriculotherapy group and 100 in the Control group. Inclusion criteria: PLHIV over 18 years of age, on ART for at least three months, and a score higher than 10 on the Pittsburgh Sleep Quality Index (PSQI-BR). Exclusion criteria: mental illness, pregnant women, and ear injury/allergy. Discontinuation criteria: loss to follow-up, initiation of antiretroviral with sleep interference, adverse events, and inability to make telephone contact. PLHIV were recruited from three healthcare institutions in Fortaleza, Ceará, Brazil, and interviewed using the Sociodemographic, Epidemiological, and Clinical Form for PLHIV, the PSQI-BR, and the Insomnia Severity Index (ISI). After randomization, the intervention group received auriculotherapy with mustard seeds on 6 points: Neurasthenia, Neurasthenia area, Anxiety, Heart, Shen Men, and Occipital, with instructions to press them 3 times a day for 30 seconds. The Control group received microporous tape in the 6 points, but without seeds and without applying pressure to the sites. For both groups, after the first session, two more in-person sessions took place on days 7 and 14, with reapplication of the PSQI-BR and ISI. On day 21, a phone call was made and the PSQIBR and ISI were reapplied, with instructions to remove the microporous tapes and mustard seeds. On the 28th day, the PSQI-BR and ISI were reapplied by telephone to analyze the residual effect of auriculotherapy. In the analyses, the normality of distribution of the variables was verified, descriptive statistics were performed, and the area under the curve was calculated. A two-factor analysis of variance model with repeated measures was used. A p-value < 0.05 was considered statistically significant. GraphPad Prism v. 8.0 and IBM SPSS Statistics v. 23.0 software were used for analysis. The study was approved by Ethics Committee and the participants signed the informed consent form. The research was registered in the Brazilian Registry of Clinical Trials and followed the Consolidated Standards of Reporting Trials. Of the 402 PLHIV recruited, 277 were randomized to the Auriculotherapy (N=134) or Control (N=143) groups, with loss to follow-up of 25.5% and 30.0%, respectively. Differences were observed between the groups on days 7, 14, 21, and 28, with a reduction in the total PSQI-BR score in the Auriculotherapy group from day 7 onwards compared to day 0, in addition to differences compared to day 0 within the Auriculotherapy group. Seven days after the removal of materials from the ears, the effect of auriculotherapy lasted until the 28th day. The proportion of responsive patients in the Auriculotherapy group was higher than in the Control group, with a probability of clinical improvement 18.5 times greater in those who underwent auriculotherapy. The relative risk indicated a 72 times greater probability of remission in those undergoing auriculotherapy. In the overall assessment of sleep quality, the area under the curve was smaller in the Auriculotherapy group, due to the reduction in PSQI-BR scores. There were differences between the groups at D7, D14, D21, and D28, with a significant reduction in the total ISI score in the Auriculotherapy group from D7 onwards compared to D0. The proportion of patients without insomnia was higher in the Auriculotherapy group. Adverse events included pain, itching, and increased temperature at the ear points, as well as dizziness, all of which were considered mild. It was concluded that auriculotherapy was effective and safe in improving sleep quality in PLHIV and sleep disorders. Project funded (CNPq, Brazil, No 402380/2023-1). Tipo: Tese

Cervicografia digital uterina: validação da técnica e dos critérios de positividade

2026-05-31T12:29:27Z

Título: Cervicografia digital uterina: validação da técnica e dos critérios de positividade Autor(es): Franco, Eugênio Santana Abstract: In the whole world, the second most carmmon type of câncer among women is the uterin collum câncer, and the main method used to detect it is still the Papanocolaou test. The main objective of this study was to validate the digital cervicography (DC) as a complementary test to the Papanicolaou citology (Pap), in the primary attention levei, verifying if the positivity objectives of criteria proposed for the study improve the screening sensibility of the uterin collum câncer and its precurso lesions. Digital camaras of the amateur and semi-profissional segment were used, easy-to-use and low-cost equipments. For this purpose an evaluation research of quantitative character was done in a public municipal health center in Fortaleza. The population of this study was 1.286 women and the sample was 300 cases of visual inspection with acetic-acid at 5% (VIA) positive. The women were between 18 to 70 years old, médium age of 27,6 years old, and were submitted to VIA, Pap, DC and colposcopy. All the citologic collections, DC and VIA test where done by nurses. When necessary, the histopatologic exam as gold pattern was used. The digital cervicograph were analyzed by two professionals and classified as positive, before and after an application of acetic acid at 5%. The first evaluation and classification were done by a gynecologist doctor analysing the cervicograms according to colposcopic criteria and the professional’s clinic experience. The second evaluation and classification were done by the investigator according to the positivity criteria proposed by the investigation. None of the profissionais previously knew about the results of the cytologic exams. 189 women were submitted to the colposcopy and 139 biopsies (46,3%) were done. The sensibility and specificity of the exams were determined by diagnostic tests with Cl 95%. The test sensibility of the VIA, the DC and the Pap was 99,1%, 99,1% and 22,5%, respectively. The specificity found for these tests was 83,9% for the VIA test, 81,3% for the DC, and 100,0% for the Pap. The Papanicolaou cytology didn’t detect any case of câncer selected by the VIA or the DC. It is concluded that the DC besides being a low - cost, easy-to-do and easy-to-interpret test, it has high sensibility sufficient to justify its adaption in order to complement the Pap. The DC increased 4.5 times the tracking efficacy for the intra-epitelial cervic neploasies and uterin collum câncer if compared to the results obtained in the Pap, in an isolated way. The prevalence tax of the uterin collum câncer and of the intra-epitelial neoplasies in the population studied was: in the low levei intra-epitelial lesions = 7,6% (99/1.286); in the high levei intra-epitelial lesions = 0,38% 5/1.286); and in câncer = 0,23% (3/1.286). It is also concluded that because it permits the racionalization of the colposcopic exam and the improvement of the tracking quality, it can become an important instrument in the reduction of the morbidity and mortality by uterin collum câncer. Tipo: Tese

Indicadores diagnósticos de desobstrução ineficaz de vias aéreas em crianças com cardiopatia congênita em pós-operatório de cirurgia cardíaca

2026-03-10T21:21:52Z

Título: Indicadores diagnósticos de desobstrução ineficaz de vias aéreas em crianças com cardiopatia congênita em pós-operatório de cirurgia cardíaca Autor(es): Azevedo, Kiarelle Lourenço Penaforte de Abstract: This study aims to analyze the defining characteristics and related factors of the nursing diagnosis of Ineffective Airway Clearance in children and adolescents in the postoperative period of cardiac surgery. The study consists of investigating these indicators in 136 children and adolescents in the postoperative period of surgery for congenital heart disease. This is a cross-sectional, analytical, and quantitative study. The study was conducted from November 2020 to April 2022, in a state public hospital, in an intensive care unit responsible for postoperative care in pediatric cardiac repairs. Data collection involved pulmonary physical examination, interviews with caregivers, and access to medical records. The data were compiled in an Excel® spreadsheet (2022). Statistical analysis was performed using IBM® SPSS® version 25.0 for Windows® and R software version 4.2.0. The results are presented in tables. The research was approved by the Research Ethics Committee, in accordance with the recommendations of Resolution 466/2012, and was approved with opinion number 4.234.559. Most of the children and adolescents participating in the study were male (52.9%). Regarding age, those evaluated ranged from five to 7665 days. The majority underwent corrective surgery (64%), corresponding to the first surgical procedure (69.2%), with a prevalence of cardiopulmonary bypass (66.2%) and postoperative echocardiography (94.9%). Among the most prevalent heart conditions in the sample were: Ventricular Septal Defect (29.4%), Atrial Septal Defect (19.1%), Tetralogy of Fallot and Patent Ductus Arteriosus (16.2%). The diagnosis was present in 44.73% of the children and adolescents. Among the most frequent defining characteristics, the following stand out: absence of cough (94.9%), ineffective cough (51.5%), and altered respiratory rate (30.9%). The most prevalent factors related to ineffective airway clearance were: retained secretions (83.8%) and excessive mucus (27.2%). No influence of causal factors on the occurrence of ineffective airway clearance was found based on the generated logistic regression model. This study contributes to the refinement of clinical reasoning by analyzing indicators of ineffective airway clearance in children in the postoperative period of cardiac surgery. Tipo: Tese

Mulheres e HIV/AIDS [manuscrito]: análise de comportamento preventivo à luz do modelo de crenças em saúde

2025-12-12T16:44:44Z

Título: Mulheres e HIV/AIDS [manuscrito]: análise de comportamento preventivo à luz do modelo de crenças em saúde Autor(es): Soares, Maria Júlia Guimarães Oliveira Abstract: The present study had a quantitative approach and its objective was to analyse, in the light of the Health Belief Model, how the beliefs of HIV - infected and non - infected women are expressed in relation to their susceptibility to HIV; to the seriousness of the changes that happened or would happen in their lives in case of being infected; and to benefits perceived by them in adopting preventive behaviour. The study was oriented by the Health Belief Model proposed by Rosenstock, 1966. It was interviewed 140 women, 70 from the HIV - infected group, and 70 from the non - infected group. The research was accomplished in the ambulatory service of the Complex of Contagious Infectious Disease Clementina Fraga in the ambulatory service of the University Hospital Lauro Wanderley, in Paraíba State. The data were quantatively analysed. The results indicated that in the infected group, the perception of the risk to catch HIV is absent, the opposite was verified in the non - infected group, and so there were significative differences between the two studied groups corceming the perception of exposure to HIV in sexual intercourse. For the two women groups there were no significative differences related to the perception of consequences and seriousness of AIDS, and to the benefits of adopting preventive behaviour. The fact of tmsting the sexual partner of having a steady partner emerged as outstanding elements for contamination in the infected group and for vulnerability to HIV contagion in the non-infected group. The identified berriers demonstrate to be responsible for the HIV contamination. The non-infected women are living the risks of catching HIV. The incentives for taking preventive actions were not present in the women's life of both groups. It is considered to be necessary to reevaluate and remake strategies and preventive actions, involving besides the institutions, the women themselves as the subject of the decinding process on preventive means. Tipo: Tese