Analysis of depression in elderly living in the shelter "Christ the Redeemer", applying the Scale of Geriatric Depression (SGD) Resumo
RESUMOO presente artigo pretende analisar a organização político-sindical dos assistentes sociais do Brasil na atualidade, a partir do estudo crítico da Federação Nacional dos Assistentes Sociais (FENAS), criada nos anos 2000. Para efetuar tal discussão, retoma-se neste estudo, as diretrizes do movimento chamado novo sindicalismo, e seus impactos para o Serviço Social durante a década de 1980 que, dentre outros, se expressou na deliberação e tentativa de transição dos assistentes sociais de seus sindicatos corporativos para os constituídos por ramo de atividade econômica. Infelizmente, esta transição foi inconclusa não só por questões próprias à categoria, mas sobretudo pela consolidação da plataforma neoliberal e pela crise do sindicalismo nacional, na década de 1990. Nesse sentido, nos parece importante reafirmar que os sindicatos -desde que tenham liberdade, autonomia sindical e direção polí-tica comprometida com a emancipação humana -são instrumentos interessantes à organização dos trabalhadores e à luta contra o capital. Por isso, a análise crítica da Federação pode contribuir para o debate sobre a reorganização político-sindical dos assistentes sociais na atualidade.
Background Some antiretrovirals (ARVs) cause muscle toxicity and their use has been attributed to beginning of respiratory and peripheral muscle weakness in people living with HIV/AIDS (PLWHA) on treatment. Dolutegravir (DTG) has been adopted by Brazil as a first-line regimen with Tenofovir/Lamivudine (TDF/3TC) since 2017, with low toxicity profile. Due to the short use of this regimen, we have not found data in the literature regarding its effects in the respiratory and peripheral muscles in PLWHA. The aim of this study was to compare respiratory and peripheral muscle strength before and after start of this new combined ART (TDF/3TC/DTG).Methods Descriptive, longitudinal and prospective study, observational and analytical with 41 PLWHA evaluated before the initiation of antiretroviral therapy (ART) (T0) which of these, 28 were reevaluated after more than 50 days of treatment (T1).The assessments of maximum functional capacity (six-minute walk test distance), maximal inspiratory (MIP) and expiratory (MEP) pressures and handgrip strength (HGS) were performed using standardized methods. In addition, laboratory data (CD4, CD4/CD8 ratio and viral load-VL) were collected. Shapiro-Wilk test was applied for normality while Fisher's exact test and t-test or Wilcoxon test were used for comparisons of categorical and continuous variables, respectively. Pearson or Spearman correlations were used according to data normality and p-value < 0.05 were considered significant for all analyzes.Results The frequency of peripheral muscle weakness in patients evaluated at T0 was 97.6%, while 31.7% had inspiratory and / or expiratory muscle weakness. HGS was positively correlated with CD4 (p = 0.027) and negatively correlated with VL (p = 0.046). Both MIP (p = 0.0176) and HGS (p = 0.0018) showed improvement in T1.Conclusion ART combined with TDF / 3TC / DTG increased MIP and HGS after more than 50 days of treatment. Cohort studies are needed to better understand the action of these medications on PLWHA musculature under treatment.
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