Background: Low adherence to pharmacological therapy by patients with diabetes mellitus and hypertension is frequent and represents a worldwide challenge. Introduction: This study examined the effect of an educational intervention using WhatsApp ^® messaging on medication adherence of patients with hypertension and diabetes. Materials and Methods: A randomized clinical trial was performed with 403 patients who had diabetes and/or hypertension and who had enrolled in the 33 Basic Health Units of Maringá-PR, Brazil. The patients were randomly assigned to either the intervention group ( n = 203), which received usual care (multi-professional educational appointments according to each Unit schedule) plus 55 audio, image or text WhatsApp messages about health care promotion, with an emphasis on medication adherence, or the control group. The control group ( n = 200) only received usual care. Medication adherence, as measured by the Morisky-Green Test, was compared through the chi-square test after 16 weeks. Relative risk (RR) was used as a measure of effect size. Results: After the follow-up period (4 months), 67.5% of the patients in the intervention group were adherent versus 58.5% in the control group (RR: 1.15, 95% confidence interval = 0.99–1.34, p = 0.077). Discussion: Although the effect of the intervention was not statistically significant, there was a clinically significant impact associated with a 15% increase in medication adherence. Conclusion: Given the complexity of adherence to the use of antidiabetic and antihypertensive medications, educational interventions using WhatsApp could be useful as a reinforcement to increase adherence to medication.

An essential oil was recently extracted from the leaves and flowers of yarrow (Achillea millefolium) and tested for in-vitro activity against Leishmania amazonensis and murine macrophages (i.e. the J774G8 cell line). The median inhibitory concentration (IC(50)) against L. amazonensis promastigotes was 7.8 μg/ml whereas the survival of amastigotes of this pathogen, within peritoneal murine macrophages, was halved by treatment with the oil at 6.5 μg/ml. The mean value for the median cytotoxic concentration of the oil, measured against adherent (uninfected) J774G8 macrophages, was 72.0 μg/ml (i.e. 9.2 and 11.0 times higher, respectively, than the IC(50) against the promastigotes and intracellular amastigotes). Scanning electron microscopy revealed that the oil caused morphological changes in the treated parasites, including alterations in their shape and size. In transmission electron microscopy, promastigotes treated with the oil (at the IC(50) of 7.8 μg/ml) showed various ultrastructural alterations, including changes in the flagellar membrane, abnormal membrane structures, rupture of the plasma membrane, atypical vacuoles, myelin-like figures, and vesicles that resembled autophagic vacuoles.

O prolongamento da vida sexual, somado a práticas inseguras, tem refletido na possibilidade de ocorrência de DST em idosos. O objetivo é analisar a tendência evolutiva das DST em idosos no Brasil e no mundo e identificar os aspectos abordados nas pesquisas desse tema, visando fornecer dados que possam subsidiar políticas públicas voltadas à saúde desses indivíduos. Uma revisão sistemática nas bases de dados Lilacs, IBECS, COCHRANE, Medline, SciELO e PubMed foi realizada. De 979 artigos encontrados, 44 foram incluídos por preencherem os critérios de inclusão. Seis eixos temáticos principais foram identificados, sendo que cada artigo pôde contemplar mais de um: fatores de risco (34 artigos), influência do Sildenafil (18), diagnóstico de DST (20), tratamento (24) e comorbidades relacionadas ao HIV (24) e prevenção de DST (20). Conclui-se que essa faixa etária permanece fora do foco das políticas públicas de promoção da saúde no contexto das DST, ocorrendo a necessidade de conscientização acerca das mudanças de comportamento e perfil epidemiológico nessa população.

Resumo Introdução: médicos são profissionais altamente vulneráveis à Síndrome de Burnout (SB), pois lidam com fatores de stress ao longo de sua vida profissional. Objetivo: identificar a frequência da SB em diferentes especialidades médicas e seus possíveis fatores associados. Métodos: revisão sistemática de acordo com a declaração PRISMA, por meio das bases de dados LILACS, MEDLINE, PubMed e SciELO, incluindo trabalhos que usam o Maslach Burnout Inventory para identificar a síndrome. Resultados: 22 especialidades médicas foram relacionadas à SB. As cinco especialidades identificadas com maior prevalência de casos foram, em ordem decrescente: medicina de Unidade de Terapia Intensiva, medicina de família, medicina de emergência, medicina interna e ortopedia. Discussão: a etiologia da SB é multifatorial. Há fatores que contribuem para o desencadeamento da síndrome e outros que atuam de modo a prevenir o seu desenvolvimento. Identificaram-se fatores comuns a atuação profissional do médico e outros associados com as especialidades médicas. Os fatores que se destacam como associados à SB são os relacionados à organização e ambiente do trabalho e à maneira como os profissionais enfrentam o stress. Discussão: a etiologia da SB é multifatorial. Há fatores que contribuem para o desencadeamento da síndrome e outros que atuam de modo a prevenir o seu desenvolvimento. Identificaram-se fatores comuns a atuação profissional do médico e outros associados com as especialidades médicas. Os fatores que se destacam como associados à SB são os relacionados à organização e ambiente do trabalho e à maneira como os profissionais enfrentam o stress.

A literature survey identified a variety of potentially zoonotic fish-borne nematode species in both marine and freshwater hosts which are common throughout Brazil. The few cases of fish-borne zoonotic nematodioses reported in humans in Brazil are summarized, and the possible routes of infection are discussed, such as the importance of restaurants specialized in dishes containing raw or undercooked fish. The difficulties of diagnosing of human infections with fish-borne nematodes in Brazil are reviewed. Requirements for an integrated approach to avoid the infection are discussed. It is concluded that, a) human fish-borne nematodiosis may constitute a problem of public health in Brazil; b) effective regulations to prevent the infection should be adopted; c) people must refrain from eating raw or undercooked fish dishes; and d) an intensive campaign alerting people about the feeding risk behaviors shoul be undertaken

The role of universities in health promotion has been strengthened by institutional policies and the Health Promoting Universities movement. Together they seek to identify behaviours that are harmf...