BackgroundTruck drivers work under conditions that predispose them to a high prevalence of risk factors for the development of cardiovascular disease (CVD); however, these factors have not been fully evaluated and are not usually considered to be within the scope of health or labor services.MethodsAn observational cross-sectional study was conducted on 250 long-distance truck drivers; the drivers were all male and were aged 18-60 years. The clinical evaluation consisted of an assessment of social habits and demographic data and an evaluation of risk factors for CVD at 3 time points separated by a one-week interval. To assess the associations with risk factors were used univariate and multivariate analysis. The suitability of the final model fit was assessed via the Hosmer-Lemeshow test. The significance level was set at 5%.ResultsAmong all of the subjects, the prevalence of physical inactivity was 72.8%; consumption of alcoholic beverages, 66.8%; routine use of some type of stimulant during work activities, 19.2%; and smoking, 29%. Only 20.8% had a healthy weight, and 58.2% had an abdominal circumference greater than 102 cm. A diagnosis of arterial hypertension was confirmed in 45.2%, and abnormal glucose levels were detected in 16.4%. Although some of the truck drivers were aware of these conditions, most were not taking specific medications. The logistic regression analysis shows that the odds of hypertension and abnormal glucose levels were increased in truck drivers with abdominal obesity. Age and the family history of premature CVD also increased the chances of hypertension and the abnormal blood glucose levels were related to II or III grade obesity.ConclusionLong-distance truck drivers showed a high prevalence of a cluster of cardiovascular risk factors; these risk factors make the drivers highly susceptible to the development of CVD. The associated risk factors, low compliance with drug treatment, and unique features of this profession suggest that traditional precautions are not sufficient to change this scenario.

Objective: To evaluate the quality of life of people with chronic wounds and to compare this index with clinical parameters. Method: A cross-sectional study conducted between July 2014 and February 2015, evaluating people with chronic wounds in outpatient care during a nursing consultation, in the city of Guarapuava, Paraná. Quality of life was assessed by the Quality of Life Index - wounds version. Data were analyzed using the Mann Whitney test and T-test. Results: 53 people participated. The mean quality of life score was 22.65±3.08. The most significant scores in the analyzes were the family domain (27.71±2.94) with the highest mean score, and the health domain (18.91±4.58) had the lowest. Pain in walking (p=0.031) and using pain medication (p=0.002) presented a significant relation with overall score. There was a significant difference between the groups for the items pain at rest (p=0.022), pain in moving (p=0.006), using pain medication (p<0.001) and presence of infection (p=0.004), in the rest item (p=0.015) in the socioeconomic domain, and type of wound (p=0.05) and rest (p=0.041) in the psychological domain. Conclusion: The overall Quality of Life Index and by domains was classified as good and very good, where the family domain was better evaluated to the deriment of the health domain due to the clinical parameter of pain.

RESUMENEl nuevo milenio trae consigo para el Brasil, la realidad del envejecimiento de la población y con él, el aumento de los casos de enfermedades crónicas, entre ellas el cáncer. Con la intención de comprender cómo los pacientes oncológicos, en tratamiento quimioterapéutico por ocurrencia de metástasis, vivencian la posibilidad de la muerte, realizamos siete entrevistas con pacientes de una clínica de oncología, situada en un pequeño municipio del Estado del Paraná. Para el análisis de las entrevistas, utilizamos algunas ideas del referencial filosófico de Martin Heidegger. De ese análisis, la muerte emergió de varios modos: implícitamente; como un fenómeno natural, vivido en la impersonalidad, por la muerte del otro; como fenómeno presente en la existencia. La condición de ser-con-el-otro permitió que la muerte se develase por medio de palabras, acciones y de la mirada, que al mismo tiempo acoge y denuncia; en la relación con los profesionales de salud, a través de los modos de cuidar casi siempre inauténticos. DESCRIPTORES ABSTRACTThe new millennium brings along a new reality to Brazil: population aging, and with it an increase in cases of chronic diseases, among them cancer. With the purpose of understanding how oncological patients under chemotherapeutic treatment due to the metastasis experience the possibility of dying, seven interviews with patients from an oncology clinic were carried out in a small town in the state of Paraná. In order to analyze these interviews, ideas from Martin Heidegger's philosophical reference were used. From this analysis, death showed itself in different ways: implicitly; as a natural phenomenon, experienced in an impersonal way through someone else's death; as a phenomenon that permeates life. The ithappens-to-the-other condition made possible to unveil death through words, actions and looks, which at the same time shelter and denounce; and through the relation with the health professionals through caring forms almost always unauthentic. KEY WORDSNeoplasm metastasis. Attitude to death. Death. Patients.

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Estado nutricional de idosos, avaliados em domicílio, com dificuldade de acesso ao serviço de atenção básicaNutritional status of elderly, valued at home, with limited access to primary care services ResumoIntrodução: O aumento da expectativa de vida representa uma conquista social, mas pode ocasionar aumento no número de idosos dependentes, inseridos tanto no meio social quanto no familiar. A redução nos custos com assistência hospitalar e institucional é um dos motivos da permanência de idosos incapacitados em suas próprias casas, tornando o suporte domiciliar uma necessidade. O processo de avaliação da saúde de idosos engloba análises de aspectos clínicos e psicossociais, sendo o estado nutricional uma das condições clínicas de maior importância, devido a sua relação com a morbi-mortalidade dessa população. Objetivo: Verificar, em domicílio, o estado nutricional de idosos com dificuldade de acesso à unidade de saúde, por meio de diferentes instrumentos de avaliação nutricional. O estudo foi realizado com 18 idosos, de ambos os sexos, matriculados na Unidade de Saúde da Família -PSF Dourados, no Município de Guarapuava-PR, que recebiam visita regular de agente comunitário de saúde. Resultados: Grande parte dos idosos apresentava algum grau de desnutrição, e a avaliação por meio de medidas antropométricas foi mais acurada do que a realizada pela miniavaliação nutricional. Conclusão: Conclui-se que, independentemente do instrumento de análise utilizado, houve alta prevalência de desnutrição, e que a avaliação nutricional de idosos, realizada em domicílio, é potente ferramenta de avaliação e intervenção em seu estado nutricional. Palavras

RESUMOObjetivo: comparar em duas consultas de enfermagem os níveis pressóricos de idosos hipertensos. Método: estudo quantitativo, descritivo, observacional, tipo estudo de caso, desenvolvido com 80 pacientes idosos com hipertensão, os quais foram submetidos a duas consultas de enfermagem durante os meses de maio de 2015 a maio de 2016, cadastrados em uma unidade de referência e atendidos no Programa de Educação e Controle de Hipertensão Arterial Sistêmica. Resultados: os participantes apresentaram pressão de pulso elevada, mesmo estando com a pressão arterial sistólica e diastólica controladas, além disso, faziam uso de um ou mais anti-hipertensivos. Conclusão: os níveis pressóricos se mantiveram em valores de pré-hipertensão, entretanto, a pressão de pulso estava elevada e aumentou progressivamente da primeira para segunda aferição. Portanto, a amostra estudada apresentou risco cardiovascular aumentado. Descritores: Pressão Arterial; Hipertensão; Envelhecimento; Monitores de Pressão Arterial.ABSTRACTObjective: to compare the pressure levels of elderly hypertensive patients in two nursing visits. Method: this is a quantitative, descriptive, observational study, case study type, developed with 80 elderly patients with hypertension, who underwent two nursing consultations during May 2015 to May 2016 registered in a reference unit and attended to in the Program of Education and Control of Systemic Arterial Hypertension. Results: participants had elevated pulse pressure, even though systolic and diastolic blood pressures were controlled. Also, they used one or more antihypertensive drugs. Conclusion: blood pressure levels were maintained in prehypertension values. However, the pulse pressure was high and increased progressively from the first to the second measurement. Therefore, the sample studied had increased cardiovascular risk. Descriptors: Arterial Pressure; Hypertension; Aging; Blood Pressure Monitors.RESUMENObjetivo: comparar en dos consultas de enfermería los niveles presóricos de ancianos hipertensos. Método: estudio cuantitativo, descriptivo, observacional, tipo estudio de caso, desarrollado con 80 pacientes ancianos con hipertensión, los cuales fueron sometidos a dos consultas de enfermería durante los meses de mayo de 2015 a mayo de 2016 registrados en una unidad de referencia y atendidos en el Programa de Educación e Control de Hipertensión Arterial Sistémica. Resultados: los participantes presentaron presión de pulso elevada, mismo estando con la presión arterial sistólica y diastólica controladas. Además de eso, usaban uno o más anti-hipertensivos. Conclusión: los niveles presóricos se mantuvieron en valores de pre-hipertensión, sin embargo, la presión de pulso está elevada y aumentó progresivamente de la primera para segunda medición. Por lo tanto, la muestra estudiada presentó riesgo cardiovascular aumentado. Descriptores: Presión Arterial; Hipertensión; Envejecimiento; Monitores de Presión Sanguínea.

Descrever o perfil de vítimas internadas por trauma em uma UTI do interior do Paraná entre 2013 e 2017. Trata-se de um estudo de delineamento transversal, com abordagem quantitativa. As internações decorrente de lesões traumáticas foram maiores do sexo masculino (83,3%), com faixas etárias entre 18-39 anos e 60 anos. As principais causas de trauma foram os acidentes de transporte (60,9%), agressões (23,5%) e quedas (12,4%), com a principal região do corpo lesionada cabeça e pescoço (42,2%). O tipo de trauma mais comum foi o trauma contuso (82,7%). As complicações decorrentes de internações foram infecções, febre, intubação não planejada e úlceras de decúbito. A gravidade das lesões traumáticas podem ser amenizadas e consequentemente o número de leitos de UTI ocupados. O enfermeiro em sua formação deve ser capacitado para atender e avaliar o trauma, prestando assistência, baseado em conhecimento cientifico e teórico.Descritores: Unidade de Terapia Intensiva, Causas Externas, Prevalência, Lesões. Hospitalizations for trauma in a Paraná therapy unitAbstract: To describe the profile of victims hospitalized for trauma in an ICU in the interior of Paraná between 2013 and 2017. This is a cross-sectional study with a quantitative approach. The largest number of hospitalizations due to traumatic injuries were male (83.3%), with ages between 18-39 years and 60 years. The main causes of trauma were transport accidents (60.9%), assaults (23.5%) and falls (12.4%), with the main region of the body injured in the head and neck (42.2%). The most common type of trauma was blunt trauma (82.7%). Complications resulting from hospitalizations were infections, fever, unplanned intubation and decubitus ulcers. The severity of traumatic injuries can be reduced and consequently the number of ICU beds occupied. The nurse in his training must be trained to attend and evaluate the trauma, providing assistance, based on scientific and theoretical knowledge.Descriptors: Intensive Care Unit, External Causes, Prevalence, Injuries. Hospitalizaciones hospitalarias por trauma en unidad de terapia de ParanáResumen: Describir el perfil de víctimas hospitalizadas por trauma en una UCI del interior de Paraná entre 2013 y 2017. Se trata de un estudio transversal con enfoque cuantitativo. El mayor número de hospitalizaciones por lesiones traumáticas fue masculino (83,3%), con edades entre 18-39 años y 60 años. Las principales causas de traumatismo fueron los accidentes de transporte (60,9%), agresiones (23,5%) y las caídas (12,4%), con la principal región del cuerpo lesionada en la cabeza y el cuello (42,2%). El tipo de traumatismo más común fue el traumatismo cerrado (82,7%). Las complicaciones derivadas de las hospitalizaciones fueron infecciones, fiebre, intubación no planificada y úlceras por decúbito. Se puede reducir la gravedad de las lesiones traumáticas y, en consecuencia, el número de camas de UCI ocupadas. El enfermero en su formación debe estar capacitado para atender y evaluar el trauma, brindando asistencia, con base en conocimientos científicos y teóricos.Descriptores: Unidad de Cuidados Intensivos, Causas Externas, Predominio, Lesiones.

Objective: The aim was to describe the effects of the use of citric acid in the healing process of chronic leprosy wounds. Approach: This is a case series, carried out with 5 people with chronic leprosy wounds, under continuous care in an outpatient center wound care in the center-south region of Brazil. The intervention protocol consisted of topical application of 3% citric acid (ointment), on the wound bed, in a thin layer of approximately 2 mm, on alternate days, and followed up for a total period of 8 weeks and secondary coverage rayon and gauze. The cases were analyzed regarding wound dimensions, histology and clinical observation. Results: It was observed in all cases better aspect of the wound bed, presence of granulation tissue and decrease of the inflammatory process with predominance of lymphocytes, reduction of bacterial colonies, increase and verticalization of type I collagen fibers, reduction of type III collagen and increased areas of epithelialization. Innovation: There was also a reduction in the level of pain and exudation after the treatment protocol. Conclusions: Therefore, the use of citric acid in leprosy neuropathic wounds is promising and may be a treatment option, considering its cost, clinical management and possible effect on the chronic inflammatory process.