Resumo Este estudo aborda as representações de cuidadores familiares de idosos com Alzheimer considerando o cuidado à luz da Teoria das Representações Sociais. Objetiva observar e identificar as representações dos cuidadores familiares sobre o cuidado e analisar como influenciam em suas práticas de cuidado. É do tipo empírico, exploratório, qualiquantitativo e utiliza como método o Discurso do Sujeito Coletivo. Participaram 21 cuidadores familiares de idosos com Alzheimer, sendo 24% homens e 76% mulheres, com faixa etária de 32 a 69 anos. Sobre o suporte fa miliar, 57% afirmaram possuir ajuda de parentes no cuidado com o idoso e 42 % declararam cuidar sozi nhos deles. Quanto à renda, 24% afirmaram que era confortável, 63%, que era razoável. Quanto à ajuda de profissionais, 63% afirmaram não possuir qual quer tipo de ajuda em casa e 38% possuíam ajuda, mas frequentemente relacionada aos serviços do mésticos. Emergiram as seguintes representações sociais: o cuidado como prisão; como missão; como desarmonia de identidades sociais e como gratidão. As representações atreladas às ideias de prisão e desarmonia de identidades acrescentam ansiedade, estresse e insegurança à vida dos cuidadores. Foram encontradas representações sobre o cuidado, sendo ao menos duas delas representações negativas, as sociando o cuidado às ideias de prisão e desarmonia de identidades sociais. Não foi possível alcançar de forma direta suas repercussões sobre a prática de cuidado pela ausência de observação da rotina de cuidado durante esta pesquisa.

Perfil clínico-epidemiológico de idosos submetidos à quimioterapia antineoplásica atendidos em um hospital de referência oncológica do estado do Pará, Brasil MATERIALS AND METHODS:A cross-sectional study involving 200 elderly people was performed from April to October, 2015. A socioeconomic and clinical questionnaire was applied and statistical analyses were done afterwards. RESULTS: The prevalence was 60-80 years old (83.5%); no gender predominance; low schooling -82.5% of the participants had finished the elementary school; low family income, from them 79.5% had a family income less than three minimum wages, and 87.5% participating actively in family income; and 57.0% were married or were in stable union. The most common cancer type was breast cancer (26.5%), followed by prostate cancer (17.0%); and the most prevalent anti-neoplasic or adjuvant treatments were bisphosphonate and alkylating agent. CONCLUSION: This study demonstrated the elderly patients profile receiving anti-neoplasic treatment at an oncological reference unit in the North of Brazil, predominating individuals with other comorbidities besides neoplasm, which increases the risks of complications and adverse reactions related to the chemotherapy.

Acute renal failure (ARF) represents 17% of the complications of cardiac catheterization (CC), with a high death rate and longer hospitalization time. The objective of this review is to describe the most cited risk factors for acute kidney failure in the literature. It is a descriptive and exploratory Integrative Literature Review (ILR) with a qualitative approach, using articles published in the Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databases between the years of 2009 and 2019 in English, Portuguese, and Spanish, including original articles, reviews, and case studies. The search was made using the following descriptors: cardiac catheterism, kidney diseases, risk factors, coronary catheterization, acute kidney injury, acute renal failure, and nephropathies. The organization and analysis of the data was through the application of a questionnaire that was structured by the authors, and the results are presented in a table. For the final sample, 10 articles were sought. The highlighted factors were being elderly, hypertensive, and diabetic; having previous kidney disease, hypotension, heart failure, higher contrast volumes, and types; the use of non-steroidal anti-inflammatory drugs associated to other risk factors; and atrial fibrillation. Atrial fibrillation was the main finding, which has recently been documented. The identification of risk factors provides health professionals with information to plan measures to prevent ARF, minimizing complications, length of stay, and mortality.

The indigenous people of Brazil present several cases and deaths, affecting 158 peoples, with high vulnerability and limited access to health services. The objective is to investigate the clinical characteristics of severe acute respiratory syndrome by COVID-19 in indigenous peoples of Brazil. The epidemiological study, descriptive, from the data of the platform opendataSUS referring to the SIVEP-GRIPE in the period 01/01/2020 until 31/08/2020. Profile variables, signs and symptoms, and risk/comorbidities factors. The data were analyzed by Bioestat 5.3. 1,207 cases and 470 deaths. Profile: male gender (59.48%) mean age 53. Signs and symptoms: fever (74.23%), cough (77.71%), sore throat (35.62%), dyspnea (69.34%), respiratory discomfort (62.80%), O2 saturation <95% (56.42%); and associated with mortality: dyspnea (80.0%) and O2 saturation <95% (69.36%). Risk factors and comorbidities (45.89%) were associated with deaths (54.04%). Comorbidities: Chronic Cardiovascular Disease (18.97%) and Diabetes Mellitus (18.97%), and associated with deaths: Chronic Cardiovascular Disease (24.46%). There was significance in the survivors vaccinated for influenza (26.18%). The public and health policies of Brazil should be directed to control the dissemination of COVID-19 in this population, that COVID-19 evolves in the same intensity, however, the indigenous have vulnerabilities that can enhance the impact of the pandemic in this population.

RESUMO OBJETIVOS: Conhecer as percepções do portador de reações hansênicas sobre essas manifestações, analisar as práticas de cuidados de si adotadas pelos portadores das reações hansênicas e discutir a relação entre tais percepções e o cuidado de si como um indicador para o cuidado. MÉTODOS: Utilizou-se uma metodologia exploratória descritiva com abordagem qualitativa. Foram entrevistados 11 participantes em tratamento para reação hansênica. Para as análises textual e lexical do conteúdo das entrevistas, foi utilizado o software IRaMuTeQ, e, posteriormente, o conteúdo foi submetido à análise de conteúdo. RESULTADOS: Emergiram três categorias temáticas: as reações hansênicas e suas consequências na percepção de seus portadores; o cuidado de si frente às reações hansênicas; e o indicativo para o cuidado. Quanto às práticas de cuidado de si, essas foram analisadas a partir da ótica de Foucault, onde os participantes demonstram preocupação consigo, superando a falta de conhecimento. CONCLUSÃO: As reações hansênicas foram percebidas como modificações físicas, alterando a aparência de todo o corpo, dolorosas e que limitam as atividades cotidianas, além de provocar uma ruptura com os laços sociais. Identificou-se que o cuidado de si engloba ações individuais e coletivas, de autoconhecimento e de conhecimento do contexto, e também de aprendizado de valores e princípios sociais que ajudam a superar os desafios das reações hansênicas. Palavras-chave: Hanseníase; Reações Hansênicas; Autocuidado.ABSTRACT OBJECTIVES: To know the Hansen's disease patient perceptions of the leprosy reactions, to analyze the self-care practices adopted by those with those reactions, and to discuss the relationship between these perceptions and the self-care as an indicator of care. METHODS: A descriptive exploratory methodology with a qualitative approach was used. A total of 11 participants in treatment for Hansen's disease reactions were interviewed. For the textual and lexical analysis of the content of the interviews, the software IRaMuTeQ was used, and, later, it was submitted to content analysis. RESULTS: Three thematic categories emerged: Hansen's disease reactions and their consequences in the perception of patients; the self-care toward the reactions; and the indicative for the care. The self-care practices were analyzed according to Foucault, and the participants showed concern about themselves overcoming the lack of knowledge. CONCLUSION: Hansen's disease reactions were perceived as physical changes, changing the whole body appearance, painful limiting daily activities, and rupturing social bonds. It was found that self-care encompasses individual and collective actions, self-knowledge and knowledge in context, as well as learning of values and social principles that help overcome the challenges of Hansen's disease reactions.

The Cardiovascular Diseases represent the main cause of death in the world, and are associated as risk factors that cause serious complications in cases of infections, such as those of the respiratory tract. In March 2020 the World Health Organization declared a pandemic for SARS-CoV-2, a new coronavirus causing severe pneumonia, which emerged in December 2019 in Wuhan, China. The objective is to investigate the occurrence of cardiovascular complications associated with SARS-CoV-2 infection. It is a systematic review, quantitative, in the databases, PubMed and Science direct, including primary studies with hospitalized patients confirmed for COVID-19 and who presented cardiovascular complications, form used tools for evaluation of quality and evidence, following the PRISMA recommendations. Results: 12 studies were included. The occurrence of cardiovascular complications was: 27.35% of the sample of 3,316 patients. Types: Acute cardiac injury 17.09%; Thromboembolism 4.73%; Heart failure 3.43%; Arrhythmias 1.77%; Brain stroke 0.33%. Mean age 61 years. Conclusions: This study showed that there are several cardiovascular complications associated with SARS-CoV-2, that the main one is the acute cardiac injury, which causes several instabilities in the cardiopulmonary system, and that it is associated with mortality.

RESUMO OBJETIVOS: Avaliar a qualidade de vida (QV) dos idosos submetidos ao tratamento quimioterápico antineoplásico, assim como suas associações com fatores socioeconômicos, nível de dependência e dados clínicos. MATERIAIS E MÉTODOS: Realizou-se um estudo transversal com 200 idosos atendidos em um ambulatório de um hospital de referência oncológica do estado do Pará, Brasil. A QV foi avaliada pelo instrumento EORTC QLQ-C30 v3, constituído por 30 questões que abrangiam 15 domínios, divididos em três escalas distintas: escala de estado de saúde global e QV; escala funcional; e escala de sintomas. O nível de dependência foi avaliado pela Escala de Lawton e Brody, que permite analisar a capacidade do indivíduo em realizar as atividades instrumentais da vida diária, como utilizar o telefone, administrar o dinheiro, realizar compras, preparar refeições e viajar. Os dados foram analisados por meio de estatística descritiva, teste de qui-quadrado e ANOVA. RESULTADOS: Evidenciou-se uma QV mediana. As escalas saúde global e funcional apresentaram resultados medianos, enquanto a escala de sintomas demonstrou melhor QV em seus domínios. Identificou-se uma relação significante entre a QV dos idosos e o nível de dependência. Os domínios mais afetados foram dificuldade financeira, fadiga, desempenho de papéis e função social. CONCLUSÃO: A interferência da QV, bem como o nível de dependência dos idosos, estão associados à doença, seu tratamento e às condições de morbidade.Palavras-chave: Qualidade de Vida; Idosos; Idoso Fragilizado; Antineoplásicos.ABSTRACT OBJECTIVES: To evaluate the quality of life (QL) of elderly patients submitted to antineoplastic chemotherapy and its associations with socioeconomic factors, level of dependence, and clinical data. MATERIALS AND METHODS: A cross-sectional study was conducted on 200 elderly patients attending an outpatient clinic at a oncology reference hospital in Pará State, Brazil. QL was evaluated by the EORTC QLQ-C30 v3 instrument, consisting of 30 questions covering 15 domains, divided into three distinct scales: global health status scale and QL; functional scale; and scale of symptoms. The dependency level was evaluated by the Lawton and Brody Scale, which allows the analysis of the individual's ability to perform the instrumental activities of daily living, such as using the telephone, administering money, shopping, preparing meals, and traveling. Data were analyzed using descriptive statistics, chi-square test, and ANOVA. RESULTS: A median QL was demonstrated. The global and functional health scales presented median results, while the symptom scale showed better QL in its domains. A significant relation was identified between the QL of elderly and the level of dependence. The most affected domains were financial difficulty, fatigue, performance, and social function. CONCLUSION: QL interference and the level of dependence of elderly are associated with the disease, its treatment, and morbidity conditions.

Klebsiella pneumoniae appears as one of the most prevalent pathogens among cancer patients. The present study investigates the clinical, epidemiological and microbiological aspects related to infections caused by K. pneumoniae in cancer patients treated at an oncology referral center in the state of Pará, Amazon region, Brazil. Between July 2017 to July 2019, an epidemiological, observational, cross-sectional study, with a descriptive and analytical approach was conducted, including patients with confirmed diagnosis of cancer who acquired infection by K. pneumoniae 72 h after hospital admission. K. pneumoniae isolates included in the study were obtained from different clinical materials (blood, urine, catheter tip and bladder catheter, orotracheal secretions, oncological and surgical wounds). Antimicrobial susceptibility testing and molecular detection of the carbapenemase-encoding genes were performed. A high prevalence of MDR K. pneumoniae isolates was observed, including two colistin-resistant isolates and seven isolates harboring blaKPC-1 gene. To conclude, our findings provide the firsts insights into the epidemiology and infection by K. pneumoniae in the state of Pará, Brazil, and may be useful on treatment guidance and establishment of strategies to control the spread of resistance strains of K. pneumoniae in the region.