Browsing by Author "Machado, Carla Jorge"

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    Depression among physicians working in public healthcare in Belo Horizonte, Brazil.
    (2014) Assunção, Ada Ávila; Machado, Carla Jorge; Cano Prais, Hugo Alejandro; Araújo, Tânia Maria de
    Purpose Prevalence of depressive disorders has been reported among physicians in a number of different settings. The aim of the present study is to assess the prevalence of self-reported depression and its associated factors among physicians working in the public healthcare system of Belo Horizonte, Minas Gerais state, Brazil. Methods A cross-sectional survey was carried out in 2009 to investigate individual and occupational dimensions of depressive disorders in a group of physicians working at several municipal healthcare units. The percentage of physicians that self-reported a confirmed diagnosis of depression by another physician was used as the prevalence proportion; the Poisson regression univariate and multivariate models were applied to study factors associated with depression. Results The response rate was 81.2 %, of which 12.0 % reported depression confirmed by another physician. Reports of RSI/WMSD (p\0.001) and passive work (p\0.05) were positively and independently associated with the outcome. Conclusions Our data bring valuable information that may help guide interventions and health-promoting activities for physicians by indicating concrete measures to change working conditions that affect mental health.
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    Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents.
    (2015) Freitas, Mariana Gonçalves de; Bonolo, Palmira de Fátima; Moraes, Edgar Nunes de; Machado, Carla Jorge
    The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA). The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. The 1812 elderly who fell were grouped together into 4 clusters: Cluster 1, in which all had disabilities; Cluster 2, all were non-white and falls took place in the home; Cluster 3, younger and active seniors; and Cluster 4, with a higher proportion of seniors 80 years old or above who were white. Among cases of traffic accidents, 446 seniors were grouped into two clusters: Cluster 1 of younger elderly, drivers or passengers; Cluster 2, with higher age seniors, mostly pedestrians. The main victims of falls were women with low schooling and unemployed; traffic accident victims weremostly younger and male. Complications were similar in victims of falls and traffic accidents. Clusters allow adoption of targeted measures of care, prevention and health promotion.
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    Ghrelin plasma levels, gastric ghrelin cell density and bone mineral density in women with rheumatoid arthritis.
    (2017) Maksud, Fabiana Alves Nunes; Kakehasi, Adriana Maria; Guimarães, M. F. B. R.; Machado, Carla Jorge; Barbosa, Alfredo José Afonso
    Generalized bone loss can be considered an extra-articular manifestation of rheumatoid arthritis (RA) that may lead to the occurrence of fractures, resulting in decreased quality of life and increased healthcare costs. The peptide ghrelin has demonstrated to positively affect osteoblasts in vitro and has anti-inflammatory actions, but the studies that correlate ghrelin plasma levels and RA have contradictory results. We aimed to evaluate the correlation between total ghrelin plasma levels, density of ghrelin-immunoreactive cells in the gastric mucosa, and bone mineral density (BMD) in twenty adult women with established RA with 6 months or more of symptoms (mean age of 52.70±11.40 years). Patients with RA presented higher ghrelin-immunoreactive cells density in gastric mucosa (P=0.008) compared with healthy females. There was a positive relationship between femoral neck BMD and gastric ghrelin cell density (P=0.007). However, these same patients presented a negative correlation between plasma ghrelin levels and total femoral BMD (P=0.03). The present results indicate that ghrelin may be involved in bone metabolism of patients with RA. However, the higher density of ghrelin-producing cells in the gastric mucosa of these patients does not seem to induce a corresponding elevation in the plasma levels of this peptide.
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    Internações por condições sensíveis à atenção primária nos municípios mineiros com população superior a 100.000 habitantes, 2000 a 2013.
    (2016) Gouveia, Luiza Polliana Godoy Paiva; Bonolo, Palmira de Fátima; Machado, Carla Jorge; Oliveira, Veneza Berenice de; Bearzoti, Eduardo; Bonolo, Palmira de Fátima; Araújo, Maria Rizoneide Negreiros de; Freitas, Silvia Nascimento de; Bearzoti, Eduardo
    A Atenção Primária à Saúde (APS) tem papel de importância como porta preferencial para a entrada no sistema de saúde e é ordenadora da atenção prestada nas Redes de Atenção à Saúde. Investimentos na APS com ações e programas são amplamente discutidos e estudos evidenciam que sistemas orientados pela APS apresentam maior efetividade e eficiência. A avaliação das Internações por Condições Sensíveis a Atenção Primária à Saúde (ICSAP) parte do princípio de que internações por condições evitáveis podem ser indicativos de problemas relacionados com a rede de atenção básica. Esse trabalho objetivou descrever o perfil das ICSAP nos municípios mineiros com mais de 100.000 habitantes, no período 2000-2013 e correlaciona-las à cobertura da Estratégia Saúde da Família e à oferta de leitos hospitalares. Foi realizado um estudo ecológico descritivo-analítico das internações registradas no Sistema de Informações Hospitalares do Sistema Único de Saúde, em residentes dos municípios mineiros com população superior a 100.000 habitantes, entre 2000-2013. Os grupos de diagnósticos sensíveis foram obtidos com base na Lista Brasileira de Condições Sensíveis à Atenção Primária, sendo as informações tabuladas sob o auxílio do aplicativo Tabwin (Versão 3.5) e analisadas por meio de estatística descritiva simples em planilha eletrônica do Microsoft Excel®. A análise estatística baseou-se na Correlação de Pearson e na Correlação Parcial Inversa entre variáveis, com 95% de confiança, para identificar possíveis associações entre a variação das ICSAP e a cobertura da ESF e entre a variação das ICSAP e oferta de leitos públicos hospitalares. Apesar da redução em diversos grupos diagnósticos de ICSAP, houve aumento nas internações por infecção de ouvido e garganta, angina, infecções do rim e trato urinário, doenças relacionadas ao pré-natal e por doenças preveníveis por imunização O sexo masculino apresentou maior ocorrência de ICSAP e o coeficiente de internações aumentou conforme o avanço da idade, chegando a ser de 5 a 10 vezes maior nos idosos, quando comparado aos jovens (0 a 24) e adultos (25 a 59 anos). Houve aumento da cobertura da ESF em todas as RAS avaliadas. Verificou-se redução da oferta de leitos hospitalares em todas as regiões, exceto na RAS Triângulo do Norte e Oeste. Foi observada correlação inversa e significativa entre cobertura populacional por equipes da Saúde da Família e a ocorrência de ICSAP em cinco Regiões Ampliadas de Saúde (RAS) e em outras quatro RAS a redução do coeficiente de ICSAP se deu devido à redução da oferta de leitos hospitalares. Na RAS Sudeste, apesar do aumento da cobertura e da redução dos leitos hospitalares, houve aumento em 2,6% do coeficiente de ICSAP, na Oeste, não houve associação. O presente estudo reforça a necessidade de avaliação dos indicadores de saúde nos grandes centros, uma vez que possuem particular e sugere a avaliação da capacidade hospitalar instalada nas pesquisas que avaliam os coeficientes de ICSAP.
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    Vulnerability and non-adherence to antiretroviral therapy among HIV patients, Minas Gerais State, Brazil.
    (2008) Bonolo, Palmira de Fátima; Machado, Carla Jorge; César, Cibele Comini; Ceccato, Maria das Graças Braga; Guimarães, Mark Drew Crosland
    The aim of the present study was to describe vulnerability profiles and to verify their association with non-adherence to antiretroviral therapy (ART) among 295 HIV-patients receiving their first prescription in two public-referral centers in Minas Gerais States, Brazil. The cumulative incidence of non-adherence was 36.9%. Three pure vulnerability profiles (lower, medium and higher) were identified based on the Grade of Membership method (GoM). Pure type patients of the “higher vulnerability” profile had, when compared to the overall sample, an increased probability of being younger, not understanding the need of ART, having a personal reason to be HIV-tested, not disclosing their HIV status, having more than one (non-regular) sexual partner, reporting use of alcohol, tobacco and illicit drugs, and having sex among men. Non-adherence to ART was statistically associated (p < 0.001) with this profile. Also, the heterogeneity of the sample was found to be high, since over 40% were mixed type. The implications are that health staff should be trained to develop strategies for incorporating risk-reduction interventions, bearing in mind the three dimensions of vulnerability and the diversity of those patients initiating antiretroviral therapy.
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    Working conditions and common mental disorders in physicians in Brazil.
    (2013) Assunção, Ada Ávila; Machado, Carla Jorge; Cano Prais, Hugo Alejandro; Araújo, Tânia Maria de