RESUMO Objetivo: Analisar o efeito da entrevista motivacional no autocuidado de pessoas com insuficiência cardíaca crônica. Método: Ensaio clínico randomizado, multicêntrico, dividindo as pessoas em grupo intervenção (n=59) e grupo controle (n=59), acompanhadas por 60 dias nos centros do Brasil e Uruguai. O grupo intervenção recebeu três consultas por entrevista motivacional, com intervalo de 30 dias, e o grupo controle manteve o acompanhamento convencional nas clínicas especializadas. Os dados foram avaliados através do Self-Care of Heart Failure Index 6.2, antes e após a intervenção, em cada um dos centros e analisados através de média, mediana, teste-t, análise de correlação pelo coeficiente de Spearman e efeito da intervenção pelo d de Cohen. Resultados: 118 pessoas concluíram o estudo. Diante da avaliação do efeito da entrevista motivacional no autocuidado, comparando-se ao acompanhamento convencional, foi identificado efeito médio na manutenção e manejo (Cohen-d=0,6723; 0,5086) e alto na confiança do autocuidado (Cohen-d=0,9877). Conclusão: A entrevista motivacional foi efetiva na melhora do autocuidado dos pacientes com insuficiência cardíaca, sendo uma estratégia factível a ser implementada em clínicas especializadas. Registro Brasileiro de Ensaios Clínicos: RBR-6fp5qt.

The present retrospective study investigated factors associated with time-to-treatment initiation of breast cancer of a cohort of 12,100 cases of health facilities qualified for high complexity in oncology within the scope of the Brazilian Public Health System (SUS) of Rio de Janeiro between 2013 and 2019. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals. Of all cases, 82.1% were submitted to the first treatment >60 days. Patients without previous diagnosis history, higher education and in stages III and IV were less likely to have their first treatment >60 days, while treatment at a health facility outside the capital showed a higher probability. Patients with a previous diagnosis history, aged ≥50, non-white race/skin color and in stage I were more likely to be submitted to their first treatment >60 days, while subjects with higher education, treated in a health facility outside the capital and in stage IV showed a lower probability. To summarize, sociodemographic, clinical and health facility-related factors are associated with time-to-treatment initiation of breast cancer.

Objetivo: Determinar a efetividade da intervenção entrevista motivacional no autocuidado dos pacientes com insuficiênciacardíaca. Método: Trata-se de uma revisão sistemática, atualizada em julho de 2018, realizada nas bases MEDLINE, CINAHL,Cochrane Library, Joanna Briggs Institute Library, PubMed, LILACS e Scopus com os descritores: heart failure/insuficiênciacardíaca, motivational interviewing/entrevista motivacional, self care/autocuidado e patient compliance/cooperação dopaciente. Principais resultados: Foram identificados, inicialmente, 25 estudos em potencial para inclusão nesta revisão, noentanto, após serem aplicados os critérios de elegibilidade, 14 estudos foram encaminhados a dois revisores para avaliação metodológica, diante disso, três estudos foram selecionados após alcançarem rigor suficiente para inclusão e síntese.Conclusão: Percebe-se nos estudos, que é o impacto da comunicação na relação paciente x profissional de saúde, o quepromove um elo fundamental e diretamente relacionado ao sucesso do tratamento. A síntese dos estudos evidenciou aefetividade da intervenção Entrevista Motivacional na adesão e no autocuidado dos pacientes com insuficiência cardíaca.Palavras-chave: Insuficiência Cardíaca; Entrevista Motivacional; Autocuidado e Cooperação do Paciente. ABSTRACTObjective: To determine the effectiveness of the motivational interview intervention in the self-care of patients with heartfailure. METHODS: This is a systematic review, updated in July 2018, based on the MEDLINE, CINAHL, Cochrane Library,Joanna Briggs Institute Library, PubMed, LILACS and Scopus databases, with the descriptors: heart failure/motivationalinterviewing/interview motivational, selfcare and patient compliance. MAIN RESULTS: We initially identified 25 potentialstudies for inclusion in this review; however, after eligibility criteria were applied, 14 studies were referred to two reviewersfor methodological evaluation; three studies were selected after reaching enough accuracy for inclusion and synthesis.Conclusion: It is perceived in the studies, which is the impact of communication in the relation between patient and healthprofessional, which promotes a fundamental link directly related to the success of the treatment. The synthesis of thestudies evidenced the effectiveness of the Motivational Interview intervention in the adherence and self-care of patientswith heart failure.Keywords: Heart failure; Motivational Interview: Self-Care and Patient Compliance.

The study aimed to evaluate the effectiveness of using mobile applications in adhesion to the treatment of patients with chronic heart failure. This is a systematic review of the literature, in which the search was conducted in April 2020, in the databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Virtual Health Library and Web of Science. The following descriptors were used: heart failure, mobile applications and patient compliance, requiring adaptations to meet the specificities of the bases. 74 studies were identified and after applying the selection criteria, six publications reached the level of quality for inclusion and synthesis. The reviewed articles demonstrate a significant change in medication adherence, based on personalized telemonitoring, especially with elderly participants. With this study, the use of mobile applications in the management of the health of patients with heart failure is recommended to improve adherence and self-care.

A rare and difficult to diagnose case of subacute infective endocarditis caused by Bacillus cereus in a patient with systemic lupus erythematosus and Libman-Sacks endocarditis has been reported. Our aim is to highlight the importance of molecular methods such as MALDI-TOF and PCR to explain clinical and epidemiological issues about infections caused by unusual pathogen.