RESUMO A implementação de medidas não farmacológicas para o combate à pandemia da doença pelo coronavírus 2019 tem sido fundamental. No Brasil, é mister pensar na integração Atenção Primária à Saúde (APS) com as ações de Vigilância em Saúde. O objetivo desta revisão foi analisar os documentos normativos produzidos pelo governo federal para o combate à pandemia da Covid-19 sobre a Vigilância em Saúde no âmbito da atenção primária. Foi realizada uma revisão dos documentos oficiais publicados pelo governo federal à temática, em que foram identificados 21 documentos. Destaca-se maior apoio à implementação de ações de detecção e notificação dos casos e contatos intramuros do que à busca ativa na comunidade, às ações educativas no território, às ações de engajamento com a comunidade, ao fortalecimento à adesão às medidas preventivas, à melhoria do fluxo de informações ou ao apoio aos equipamentos sociais da comunidade. Pouco se tem produzido sobre a articulação da APS com as equipes de vigilância do município. Esses achados reforçam o alertado por outros autores sobre a insuficiente importância atribuída à APS no País, especialmente quanto à Vigilância em Saúde. O Brasil tem uma das piores gestões da crise sanitária, sendo urgente fortalecer as ações de vigilância.
Health Surveillance strategies are crucial to organize a strong national response against the coronavirus disease 2019. In Brazil, it is necessary to think about the integration of the Primary Health Care (PHC) and local Health Surveillance. This review aims to analyze the normative documents produced by the Federal Government on this topic. Official documents published by the Federal Government were reviewed, finding 21 related. It was identified a greater support for implementation of intramural actions related to detection and notification of cases and contacts than for active search of community Covid-19 cases, local educational actions, community engagement, strengthening adherence to preventive measures, improvement of information sharing, or support of community’s social facilities. Little was produced about the articulation of PHC with local surveillance teams. Our findings reinforce what was found by other authors, who attested the insufficient importance attributed to PHC in Brazil, especially with regard to Health Surveillance actions. Unfortunately, our country has stood out for one of the worst managements of the health crisis in the world, and there is an urgent need to strengthen surveillance actions based on a strong, capillary, and community-based PHC.
Objectives To assess real-life virologic success, long-term survival, and adverse events in treatment-experienced patients initiating either raltegravir or other third-line drugs (darunavir/ritonavir, maraviroc or etravirine) for salvage regimens in a Brazilian cohort of heavily treated patients. Results We included 168 patients initiating salvage regimens, 123 on raltegravir and 45 on other drugs (darunavir/ritonavir, maraviroc or etravirine). Of these, 90 patients were matched by Propensity score (PS) methods to account for clinical differences at the time of the switch from failing ART regimens, 45 patients from each group. During follow-up, virologic suppression (PVL<50 copies/mL) was similar for both groups (77.8% vs. 82.2%, p=0.73). During a mean follow-up of 1.09 (SD = 0.32) years, mortality rates (4.04 vs 6.18 persons per 100 person-years; p=0.67), drug toxicity (0.00 vs 2.06 persons per 100 person-years; p=0.49), treatment interruption (8.07 vs 0.00 persons per 100 person-years; p=0.06), virologic failure (2.02 vs 4.12 persons per 100 person-years; p=0.61) and loss of follow-up (6.05 vs 4.12 persons per 100 person-years; p=0.70) were similar for both groups. Our findings suggest similar survival and virologic success rates for raltegravir and other drugs for salvage regimens, with similar drug toxicity rates, treatment interruption, virologic failure, and loss of follow-up.
Introduction: The provision of primary care to men by nurses has been relevant, but there are challenges to be overcome. Objective: To analyze the challenges faced by Brazilian nurses in the provision of primary care to men. Methods: This was a qualitative descriptive study carried out by including 40 nurses working in the Family Health Strategy of a Basic Health Unit in Northeastern Brazil. Individual in-depth interviews were carried out and analyzed using the Discourse of the Collective Subject (CSD) method, supported by the Praxis Intervention Theory for Nursing in Collective Health – Tipesc. Results: The challenges faced by nurses in the provision of care to men originate in the academy and are transposed into professional practice, manifesting as limitations in the work process, lack of a specific health agenda, difficulties in raising male adherence, and professional demotivation. Conclusion: These challenges significantly affect the development and promotion of men’s health, resulting in the maintenance of the indicators of male morbidity and mortality in Brazil.
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