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Nursing Strategies for the Control of Systemic Erythematosus Lupus

Systemic Lupus Erythematosus is a chronic condition, of autoimmune, inflammatory and multisystemic origin, with a higher incidence in women in the reproductive period. This condition can spread abd affect other systems, including psychosomatic dimensions. It can be triggered by environmental, immunological, genetic, and external factors such as drugs. Based on the clinical aspects found in literatures of the classic form of the disease, it is proposed to draw up nursing strategies for coping with it. The coping and self-preservation strategies were: Guidance on the exposure and use of sunscreens, demonstration of well-being positions to ease discomfort (gastric and respiratory), stimulate physical exercise, establish routine nursing for evaluation of blood count and vital signs, refer the patient to the nutrition service whenever necessary, and offer psychological support for the acceptance of his or her own image. In the presence of clinical findings (tissue damage resulting from photosensitivity, cutaneous and articular lesions and oral ulcers, etc.), laboratory tests (hemogram, FAN (antenatal factor), among others) and clinical manifestations presented by patients with the disease (fever, loss of weight, renal problems, pleuritis, myalgias, pericarditis, gastrointestinal problems, peripheral neuropathies and low self-esteem), there is a great advance in the clinical and psychological improvement of the patients who use these therapeutic techniques, as a consequence of the diagnosis and early interventions. These interventions promise to trigger a self-esteem improvement in the patients, as well as to broaden the discourse.

NURSING CARE TO HANSENIASIS CARRIERS

Leprosy is an infectious disease caused by Mycobacterium leprae and is considered one of the oldest diseases described in the literature. The causative bacteria have affinity for cutaneous cells and peripheral nerves. Clinically it is characterized by the presence of whitish or reddish dormant spots located mainly in the face, arms, legs and back regions. Patients may also present neurological lesions expressed by pain and decreased motor power. If not treated early, leprosy can progress to physical disabilities and deformities caused by worsening of clinical manifestations such as, toe claw, lagophthalmos and bone absorptions. In this perspective, leprosy has significant repercussions on the psychological as well as bringing restrictions to social life. Therefore, due to the intense impact caused by the disease, the treatment and control of the transmission of the disease is very importance. To emphasize the importance of nursing care to patients with leprosy, an integrative review of the journals published in the databases SCIELO, LILACS, BDENF and the Virtual Health Library (VHL) was carried out using the descriptors "Care", "Nursing" and "Leprosy" in Portuguese, English and Spanish. The inclusion criteria were complete articles published in Portuguese, English or Spanish, which approached the chosen topic, published in the last 10 years. A total of 35 articles were found, of which 12 were in agreement with the thematic and the pre-determined criteria, therefore they were read integrally. The studies elucidated that, even before the definitive diagnosis, leprosy generates disturbances caused by the historical knowledge of the clinical manifestations. The pathology triggers in the individual psychosocial problems in view of the stigmatization of the disease evidenced by the body changes. The leprosy patient is not only affected by the bacillus, but is also in a state of total psychological vulnerability to the point of social isolation. The negative repercussion of the disease contributes to its evolution, together with the consolidation of physical limitations and the decline in the quality of life. It is necessary to seek to alleviate the emotional impact caused by the disease, understand the psychological aspects and plan care assistance due to the improvement of the clinical picture. Brazil is the world leader in leprosy prevalence and approximately 40,000 new cases are diagnosed per year. We highlight the role of the nursing professional in adherence to treatment and guidelines on the forms of contamination. Thus, in addition to suppor patients with leprosy in coping with the disease and fortifying self-care to prevent disabilities and social restrictions, nurses should reinforce attention to collaboration in treatment, improvement of quality of life and reduction of new cases of leprosy in the Brazil.

ESTRATÉGIA SAÚDE DA FAMÍLIA

A infecção por parasitoses intestinais constitui um grave problema de saúde nos países subdesenvolvidos. No Brasil, acomete principalmente a população de baixo nível socioeconômico, que vivem em condições precárias de saneamento básico. A falta de saneamento básico, a desinformação (baixo grau de escolaridade), as más condições de higiene, a carência nutricional, a idade (crianças e idosos), o déficit no tratamento de água e na coleta de lixo, são fatores que aumentam os riscos de contaminação e disseminação das parasitoses, contribuindo para manutenção dos elevados níveis de morbidade e mortalidade nas áreas endêmicas. As parasitoses mais frequentes na população brasileira têm como fatores etiológicos Giardia lamblia, Ascaris lumbricoides e Trichuris trichiura; seguido de Enterobius vermiculares, Ancilostomidae, Endolimax nana, Entamoeba coli e hystolitica. A Estratégia Saúde da Família (ESF) é responsável pela prevenção e controle dessas parasitoses, destacando-se o papel do enfermeiro na Educação em Saúde, Visita Domiciliar e Vigilância Epidemiológia, intervindo ativamente em prol da melhoria das condições de Saúde da População. Objetivo: Compreender as ações de enfermagem sobre parasitoses intestinais na Estratégia Saúde da Família. Metodologia: Revisão integrativa nas bases de dados BDENF, LILACS, SCIELO e na Biblioteca Virtual de Saúde (BVS), utilizando os descritores “Ações de enfermagem”, “Estratégia Saúde da Família” e “Parasitoses intestinais” nos idiomas português, inglês e espanhol. Os critérios de inclusão foram artigos completos publicados em português, inglês ou espanhol, que se enquadrassem no tema escolhido, publicados nos últimos 10 anos (2006 a 2016 – até setembro). Foram localizados 25 artigos dos quais 15 estavam de acordo com a temática e os critérios pré-estabelecidos, sendo esses lidos na deveriam voltar suas decisões para ações integralistas e não para ações individuais. A preconização a promoção em saúde, utilizando a educação sanitária aliada à visita domiciliar permite também ao enfermeiro conhecer a realidade de cada paciente, reduzindo os fatores que predispõem às infecções. Na consulta de enfermagem é feito o diagnóstico através do exame clínico e laboratorial, sendo o clínico mais utilizado na prática, pois o enfermeiro da ESF está atento às condições ambientais do usuário. O tratamento consiste na escolha e prescrição do vermífugo apropriado, analisando a posologia adequada para cada paciente e as contra-indicações relacionadas ao ciclo do parasita, abordando também as medidas de prevenção para a não reinfecção. Diante dos resultados encontrados verificou-se que o enfermeiro da ESF tem um papel fundamental no combate às infecções por parasitoses intestinais, tendo o compromisso de avaliar o usuário de modo holístico, utilizando a promoção, a prevenção, o diagnóstico e o tratamento para evitar a contaminação e disseminação na população em conjunto com o município, a fim de erradicar essas infecções.

Epidemiological Profile of Tuberculosis in Paraíba

Tuberculosis (TB), an age-old, infectious, chronic disease caused by the Mycobacterium tuberculosis bacillus. It affects several organs, the most common is the lung. They are most susceptible: malnourished individuals, chronic alcoholics, prisoners, and / or with immunosuppressive disease. According to the World Health Organization (WHO), globally in 2014 1.5 million people died of tuberculosis. In the State of Paraíba, the priority municipalities for TB are: João Pessoa, Bayeux, Santa Rita, Campina Grande, Cajazeiras and Patos, needing attention. To describe the epidemiological profile of tuberculosis in the State of Paraíba in 2013. Ecological, descriptive and quantitative study of secondary tuberculosis data was collected from the database of the Notification Information System (SINAN) of the Paraíba State Health Department in 2013, from March to June 2015, provided by DATASUS. The variables were year of diagnosis, sex, age, total cases of cure, abandonment of treatment, death and area of residence. There were 1,143 new cases of tuberculosis of all clinical forms, including 679 were smear-positive. The numbers of male cases were 778 (68.07%) and female 365 (31.93%). A majority of 852 (74.54%) were aged between 20-59 years. In both sexes the cases of cure were 717 (24.56%). They abandoned treatment 144 (26.23%). The number of deaths was 44 people (27.33%). The disease was identified throughout the territory of Paraíba, but there was a greater concentration in the municipalities considered priority. Men and women in reproductive ages were the majority in cases of tuberculosis in the state. The goals recommended by the WHO to achieve 85% cure were not reached and the number of cases was also high. The percentages of abandonment of treatment and death are also worrisome. It is hoped that the spatial identification made by this research of the incident areas for tuberculosis in the State of Paraíba, can facilitate and guide the need for planning actions to treat all cases of tuberculosis and to reduce or even prevent the emergence of new cases of tuberculosis . Professional nurses have a crucial role in the diagnosis, monitoring and treatment of this disease which unfortunately is still neglected. Based on the findings, the nurse should invest more in the directly observed treatment, the active search for cases that fail to go to the health unit, among other types of activities in assistance to health that public.