Maternal perception of their child's nutritional status at less than three years old.

PubMed

Duarte, Luciane Simões; Fujimori, Elizabeth; Toriyama, Áurea Tamami Minagawa; Palombo, Claudia Nery Teixeira; Miranda, Patrícia Pereira Lima; Borges, Ana Luiza Vilela

2016-01-01

Assessing maternal perception of their children's nutritional status and identifying associated factors. A cross-sectional study conducted in a small municipality with 342 children less than 3 years of age treated in Basic Health Units of São Paulo. Nutritional status was classified in percentiles of body mass index for age and maternal perception was assessed using the scale of verbal descriptors (very thin, thin, healthy weight, fat, very fat). Logistic regression was used to identify the associatedfactors. 44.7% of maternal perception was found to beinadequate. Mothers of overweight (OR = 11.8, 95% CI: 6.4-21.7) and underweight (OR = 5.5; 95% CI: 1.9-16.2) children had a higher chance of having inadequate perception, similar to mothers of children over 24 months of age (OR = 2.9; 95% CI: 1.4-6.0). For effective child care in primary care, healthcare professionals should consider maternal perception and helpmothers to identify the nutritional status of children in childcare consultations and growth monitoring. Avaliar a percepção materna do estado nutricional do filho e identificar os fatores associados. Estudo transversal realizado em município de pequeno porte com 342 crianças menores de 3anos atendidas em Unidades Básicas de Saúde do Estado de São Paulo. O estado nutricional foi classificado em percentis do Índice de Massa Corporalpara Idade e a percepção materna foi avaliada com escala de descritores verbais (muito magro, magro, peso adequado, gordo, muito gordo). Utilizou-se de regressão logística para identificar os fatores associados. Constatou-se 44,7% de percepção materna inadequada. Mães de crianças com excesso de peso (OR=11,8; IC95%:6,4-21,7) e com baixo peso (OR=5,5; IC95%:1,9-16,2) apresentaram mais chance de percepção inadequada, da mesma forma que mães de crianças com mais de 24 meses de idade (OR=2,9; IC95%:1,4-6,0). Para uma efetiva assistência à criança na atenção básica, profissionais de saúde devem considerar a

Prevention of chronic complications of diabetes mellitus according to complexity.

PubMed

Salci, Maria Aparecida; Meirelles, Betina Hörner Schlindwein; Silva, Denise Maria Vieira Guerreiro da

2017-01-01

To assess the prevention by primary health care providers of chronic complications of diabetes mellitus according to the complex thinking theoretical approach. Evaluative research based on the complex thinking theoretical approach. The following techniques for data collection were used: interviews with 38 participants; observation in collective and individual appointments; and analysis of medical records of people with diabetes. The triangulation applied for data analysis was the ATLAS.ti software. The prevention and management of chronic complications of diabetes did not meet the requirements set forth by ministerial public policies aimed at this population. Systematic monitoring to prevention of chronic complications showed significant gaps. Primary health care did not consider preventive actions for diabetes mellitus complications. This context was marked by disjunctive, fragmented, and dissociated practices types of care targeted to the totality of the assisted people. Avaliar a prevenção de complicações crônicas do diabetes mellitus a luz do referencial teórico do Pensamento Complexo por integrantes da atenção primária à saúde. Pesquisa avaliativa, que teve como referencial teórico o Pensamento Complexo. Como técnicas de coleta de dados foram utilizadas: entrevista com 38 participantes; observação nos atendimentos coletivos e individuais;e análise em 25 prontuários de pessoas com diabetes. A triangulação subsidiou a análise de dados que teve auxílio do software ATLAS.ti. A prevenção e o manejo das complicações crônicas do diabetes não atendiam ao estabelecido nas políticas públicas ministeriais destinadas a esse público. O acompanhamento sistematizado para controle da prevenção das complicações crônicas apresentou importantes lacunas. A assistência na atenção primária não contemplava ações de prevenção de complicação do diabetes mellitus. Esse contexto era por marcado por práticas disjuntivas, fragmentadas e

Pathogen-mediated selection in free-ranging elk populations infected by chronic wasting disease

USDA-ARS?s Scientific Manuscript database

Pathogens can exert a large influence on the evolution of hosts via selection for alleles or genotypes that moderate pathogen virulence. Inconsistent interactions between parasites and the host genome, such as those resulting from genetic linkages and environmental stochasticity, have largely preven...

CLAVE: Revista Especializada de ASOVELE (Asociacion Venezolana para la Ensenanza de la Lengua), 1997-1998 (CLAVE: Specialized Magazine of ASOVELE [Venezuelan Association for Language Teaching], 1997-1998).

ERIC Educational Resources Information Center

Rondon, Adolfo, Ed.; Serron, Sergio, Ed.

1998-01-01

These two issues of the journal "CLAVE" contain these articles in Spanish with one article in English: "La ensenanza de la lingua materna" (Pablo Arnaez); "Saben resumir los alumnos universitarios de nuevo ingreso?" (Marisol Garcia); "El desempeno en la escritura de cartas argumentativas y cuentos en alumnos de octavo grado" (Yolanda Perez, Maria…

National Food Strategy: Kenya’s Approach to the Problem of Feeding the Nation

DTIC Science & Technology

1990-02-01

intercropping, agroforestry , preven- tion of soil erosion and rural afforestation. The new Arid and Semi Arid Lands Authority (ASAL) will establish irrigation...international organizations such as the International Council for Research in Agroforestry (ICRAF) has been beneficial. 13 To preserve Kenya’s forests, the

PubMed

Bueno Vargas, Pilar; Manzano Martín, Manuel; López-Aliaga, Inmaculada; López Pedrosa, José M ª

2016-09-20

Introducción: la gestación y lactancia están relacionadas con pérdidas temporales en la densidad mineral ósea (DMO) materna. Una suplementación con calcio podría resultar beneficiosa para evitar la pérdida de masa ósea del esqueleto materno. Otros nutrientes como los prebióticos han sido identificados como responsables de un incremento en la absorción de minerales, pudiendo condicionar la mineralización ósea.Objetivo: estudiar el efecto de la suplementación de la dieta materna con el prebiótico inulina enriquecida con oligofructosa, durante la gestación y la lactancia sobre el contenido mineral óseo (CMO) y la DMO al final del periodo de lactancia.Métodos: las ratas gestantes fueron alimentadas con dieta estándar (grupo CC), dieta fortificada en calcio (grupo Ca) o enriquecida con el prebiótico inulina enriquecida con oligofructosa (grupo Pre) hasta el final del periodo de lactancia. Posteriormente se evaluó el CMO y DMO por absorciometría de rayos X (DEXA) y el pH del contenido cecal.Resultados:en términos generales, el grupo Pre presenta los mayores valores absolutos de CMO y DMO de entre los tres grupos, siendo en la tibia significativamente diferentes en los grupos CC y Pre frente al grupo Ca. El pH del contenido cecal del grupo Pre es significativamente inferior al de los grupos CC y Ca.Conclusión:la suplementación con inulina enriquecida con oligofructosa, en condiciones nutricionales no deficientes en calcio, durante la gestación y la lactancia, ejerce una protección del esqueleto materno en las ratas y puede ser considerada como una estrategia nutricional para proteger la masa ósea materna en el periodo perinatal.

The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico.

PubMed

Tucker, Kathryn; Ochoa, Hector; Garcia, Rosario; Sievwright, Kirsty; Chambliss, Amy; Baker, Margaret C

2013-04-16

An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house. This study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program's target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded. Findings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas.

Lingua inglese nella scuola materna (English in Preschool).

ERIC Educational Resources Information Center

Splendori, Adriana; Banzato, Donata

1988-01-01

Describes an English language course for four- and five-year-old Italian children in a preschool in Padua, Italy. Twice weekly, during 40-minute periods, children participate in games and activities designed to teach them names of objects in the classroom, colors, numbers, animals, family members, clothing, food, body parts, and possessives. (CFM)

Quality of whey powders stored under adverse conditions

USDA-ARS?s Scientific Manuscript database

Whey protein concentrate powder (WPC) is exported by the U.S. and is included in emergency aid foods, but the bags sent overseas are usually stored without refrigeration and under elevated temperature and relative humidity (RH). The shelf life of WPC under adverse conditions must be known to preven...

The acceptability and feasibility of an intercultural birth center in the highlands of Chiapas, Mexico

PubMed Central

2013-01-01

Background An intercultural birthing house was established in the Highlands of Chiapas, Mexico, as an intervention to reduce maternal mortality among indigenous women. This birth center, known locally as the Casa Materna, is a place where women can come to give birth with their traditional birth attendant. However, three months after opening, no woman had used the birthing house. Methods This study reports on the knowledge, attitudes and practices related to childbirth and use of the Casa Materna from the perspective of the health workers, traditional birth attendants and the program’s target population. Structured interviews, in-depth interviews and focus group discussions were conducted with participants from each of these groups. Data was searched for emerging themes and coded. Results and conclusions Findings show that the potential success of this program is jeopardized by lack of transport and a strong cultural preference for home births. The paper highlights the importance of community participation in planning and implementing such an intervention and of establishing trust and mutual respect among key actors. Recommendations are provided for moving forward the maternal health agenda of indigenous women in Chiapas. PMID:23587122

PubMed

Silva, Cristiane Gonçalves da; Santos, Alessandro Oliveira; Licciardi, Daniele Carli; Paiva, Vera; Parker, Richard

2008-01-01

Esse artigo descreve como jovens religiosos e autoridades religiosas de sua comunidade compreendem a sexualidade, considerando suas experiências pessoais e como membros de comunidades religiosas. A análise pretende contribuir para que políticas públicas dedicadas à promoção da saúde sexual da juventude considerem a religiosidade, no contexto de um estado laico e da promoção do direito à prevenção. Foram realizadas 26 entrevistas abertas e semidirigidas em diferentes comunidades da região metropolitana da cidade de São Paulo (comunidades católicas, da umbanda, do candomblé e de diferentes denominações evangélicas) sobre iniciação sexual, casamento, gravidez, contracepção e prevenção das DST/Aids, homossexualidade, aborto e direitos humanos. Observou-se como jovens e autoridades religiosas convivem com a tensão entre tradição e modernidade e os distintos discursos sobre a sexualidade. Como sujeitos religiosos (do discurso religioso) e sujeitos sexuais (de discursos sobre sexualidade), devem ser incorporados pelos programas como sujeitos de direito nos termos de sua religiosidade.

Religiosidade, juventude e sexualidade: entre a autonomia e a rigidez1

PubMed Central

Silva, Cristiane Gonçalves da; Santos, Alessandro Oliveira; Licciardi, Daniele Carli; Paiva, Vera; Parker, Richard

2009-01-01

Esse artigo descreve como jovens religiosos e autoridades religiosas de sua comunidade compreendem a sexualidade, considerando suas experiências pessoais e como membros de comunidades religiosas. A análise pretende contribuir para que políticas públicas dedicadas à promoção da saúde sexual da juventude considerem a religiosidade, no contexto de um estado laico e da promoção do direito à prevenção. Foram realizadas 26 entrevistas abertas e semidirigidas em diferentes comunidades da região metropolitana da cidade de São Paulo (comunidades católicas, da umbanda, do candomblé e de diferentes denominações evangélicas) sobre iniciação sexual, casamento, gravidez, contracepção e prevenção das DST/Aids, homossexualidade, aborto e direitos humanos. Observou-se como jovens e autoridades religiosas convivem com a tensão entre tradição e modernidade e os distintos discursos sobre a sexualidade. Como sujeitos religiosos (do discurso religioso) e sujeitos sexuais (de discursos sobre sexualidade), devem ser incorporados pelos programas como sujeitos de direito nos termos de sua religiosidade. PMID:21886456

AQUILA Remotely Piloted Vehicle System Technology Demonstrator (RPV-STD) Program. Volume 2. System Evolution and Engineering Testing

DTIC Science & Technology

1979-04-01

crosshead of the piston assembly. Shock transients at this location cause demagnetization of the magnet . This is being alleviated by in- stallation of magnets ...substantial structure, such as bulk - heads with edge cape. Soond, the wire-out foam *or* for the wing could not be sufficiently precise to preven the used for...characterize the power potential, fuel consumption, weight, bulk , and adaptability to closed loop control of candidate carburetion systems to be employed with

Drug Abuse Prevention. Further Efforts Needed to Identify Programs that Work.

DTIC Science & Technology

1987-12-01

Depart- ment of Education, the Office of Substance Abuse Prevention within HHS, and AMTON were the primary beneficiaries of the increased federal effort... Abuse ( SAi Office of Substance Abuse and Prevention VISTA Volunteers in Service to America Page 8 GAO’ HRDN-W26 Drug Abuse Preven tion Programs...osAP held a national strategy conference attended by substance abuse prevention experts who provided guidance and recom- mendations to help osAP refine

Preventive Medicine in World War II. Volume 2. Environmental Hygiene

DTIC Science & Technology

1955-01-01

in principle of future problems. This volume is concerned with environmental hygiene and its impact upon the health, well-being, and morale of United...theater. The scope of the problem was global. Therefore, emphasis has been placed upon principles and practices peculiar to areas of the world and the...the broad application of the principles of disease preven- tion to military conditions. In such a program, one of the prime factors is environmental

Factors associated with the implementation of programs for drug abuse prevention in schools.

PubMed

Pereira, Ana Paula Dias; Paes, Ângela Tavares; Sanchez, Zila M

2016-08-04

To analyze if characteristics of managers, schools, and curriculum are associated with the implementation of programs for drug abuse prevention in elementary and high schools. Cross-sectional study, with random sample of 263 school managers. Data were collected between 2012 and 2013 by a program that sends forms via internet. A closed self-filling questionnaire was applied online. Statistical analysis included Chi-square tests and logistic regression models. The outcome variable was the presence of program for drug abuse prevention inserted in the daily life and educational program of the school. The explanatory variables were divided into: demographic data of the manager; characteristics of the school and of the curriculum; health education; and drug use in the school. We found that 42.5% (95%CI 36.1-49.1) of the evaluated schools had programs for drug abuse prevention. With the multiple logistic regression model, we observed that the more time the manager has worked with education, the chance of the school having a program increased at about 4.0%. Experimenting with innovative teaching techniques also increased at about six times the chance of the school developing a program for drug abuse prevention. The difficulties in the implementation of the programs were more present in state and municipal schools, when compared with private schools, due to, for instance: lack of teaching materials, lack of money, and competing demands for teaching other subjects. The implementation of programs for drug abuse prevention in the city of Sao Paulo is associated with the experience of the manager in education and with the teaching strategies of the school. Analisar se características dos dirigentes, das escolas e do currículo escolar estão associadas à implantação de programas de prevenção ao uso de drogas nas escolas do ciclo fundamental II e médio. Estudo transversal, com amostra aleatória sistemática de 263 dirigentes escolares. Os dados foram coletados nos anos

Naval War College Review. Volume 65, Number 4, Autumn 2012

DTIC Science & Technology

2012-01-01

community, directly or indirectly involved in every “incident.” Binary it is not. The robust language used by Cable, a professional diplomat, is an...and instead adopted ‘presence,’ ‘symbolic use ,’ ‘coercion,’ and ‘preven- tive, precautionary and pre-emptive naval diplomacy.’”85 Indeed, language is...pur- poses, contact the editor for each use . Material not bearing a copyright notice may be freely reproduced for academic or other noncommercial

Prospects for Evidence -Based Software Assurance: Models and Analysis

DTIC Science & Technology

2015-09-01

virtual machine is much lighter than the workstation. The virtual machine doesn’t need to run anti- virus , firewalls, intrusion preven- tion systems...34] Maiorca, D., Corona , I., and Giacinto, G. Looking at the bag is not enough to find the bomb: An evasion of structural methods for malicious PDF...CCS ’13, ACM, pp. 119–130. [35] Maiorca, D., Giacinto, G., and Corona , I. A pattern recognition system for malicious PDF files detection. In

La formacion de profesores de lengua materna (Native Language Teachers' Education).

ERIC Educational Resources Information Center

Martinez Chacon, Concepcion Elena

1980-01-01

Discusses the goals of native language instruction advocating a broadening of horizons, away from traditional grammar and literature teaching, and towards culturally based communication skills. Sociocultural awareness is stressed as the fundamental component of a teacher's background and the basis for mastering the relevant aspects of…

Letter: Accuracy of Glucometers Should Not Be Assumed

DTIC Science & Technology

2007-11-01

critically ill patients . Am J Crit Care. 2007;16(4):336-347. Article Spreads the Word About VAP Prevention With respect to the article by Labeau et al,1... VAP and related morbidity and mortality can be reduced by preven- tive measures such as those mentioned in the article (eg, semirecumbent positioning ...support their loved one’s life,” whereas the physicians and nurses feel that to continue to poke, prod, and stick the patient , and to put a tube in

Bedsharing at home, breastfeeding and sudden infant death. Recommendations for health professionals

PubMed

2017-10-01

El Grupo de Trabajo en Muerte Súbita e Inesperada del Lactante, junto con la Subcomisión de Lactancia Materna de la Sociedad Argentina de Pediatría, elaboraron nuevas recomendaciones sobre la práctica del colecho, en la cual el niño duerme en la misma superficie junto a su madre, situación que es motivo de controversia. El colecho favorece la lactancia materna, que, a su vez, es protectora de la muerte súbita del lactante. Un pequeño grupo de niños presenta mayor riesgo de muerte súbita del lactante y accidentes fatales durante el colecho en ciertas circunstancias, que incluyen dormir en un sillón o sofá, padres fumadores, ingesta de sedantes, drogas y/o consumo de alcohol, niños prematuros y/o de bajo peso. El colecho en niños alimentados con leche humana, sin los factores de riesgo mencionados y con padres responsables de implementar un ambiente de sueño seguro, no aumenta el riesgo de muerte súbita del lactante. Esta guía no recomienda taxativamente la prohibición del colecho. Instruye a los profesionales de la salud a propalar a las familias un mensaje balanceado que incluya tanto los riesgos como los beneficios del colecho, lo que les permite a los padres una decisión informada al respecto. El documento señala que la cohabitación sin colecho es el lugar más seguro para los bebés al momento de dormir.

Medical Surveillance Monthly Report (MSMR). Volume 18, Number 08, August 2011

DTIC Science & Technology

2011-08-01

continue, and STI preven- tion eff orts should be reinforced. R E F E R E N C E S 1. Kuper H, Ye W, Broome U, et al. The risk of liver and bile duct ...hepatitis A virus (HAV) causes infl ammatory liver disease (hepatitis) in aff ected individu- als. Th e virus is spread through fecal-oral...ammatory liver disease (hepatitis B) in aff ected individ- uals. Th e virus is spread by percutaneous or mucous membrane exposure to infected blood or

Electrical Cabinet Fire Extinguishment Testing

DTIC Science & Technology

2014-12-01

Ins t series thes for the majo of soot (alth lenses in the arbon steel, re exposure ests. of each me cabinet (at aried with h above the above...ressure in th g pre-burn, 1 2 titute of Swe et was monit presented in Figure 19. re measured ssure sensor . be made con ssure in the e reduced the e...preven e of the extin r than the ov r pressure in opped to a n titute of Swe ra 25, was s ting pre-fire he major dif soot (despit exposure. in

Intimate partner violence and maternal educational practice.

PubMed

Silva, Josianne Maria Mattos da; Lima, Marília de Carvalho; Ludermir, Ana Bernarda

2017-04-10

The objective of this study is to analyze the association between intimate partner violence against women and maternal educational practice directed to children at the beginning of formal education. This is a cross-sectional study, carried out between 2013 and 2014, with 631 mother/child pairs, registered in the Family Health Strategy of the Health District II of the city of Recife, State of Pernambuco, Brazil. It integrates a prospective cohort study designed to investigate the consequences of exposure to intimate partner violence in relation to the child who was born between 2005 and 2006. The maternal educational practice has been assessed by the Parent-Child Conflict Tactics Scale and the intimate partner violence by a questionnaire adapted from the Multi-Country Study on Women's Health and Domestic Violence of the World Health Organization. Intimate partner violence referred to the last 12 months and was defined by specific acts of psychological, physical, and sexual violence inflicted to women by the partner. The crude and adjusted prevalence ratios were estimated for the association studied, using log-binomial regression. The prevalence of intimate partner violence was 24.4%, and violent maternal educational practice was 93.8%. The use of non-violent discipline was mentioned by 97.6% of the women, coexisting with violent strategies of discipline. Children whose mothers reported intimate partner violence presented a higher chance of suffering psychological aggression (PR = 2.2; 95%CI 1.0-4.7). The violence suffered by the mother interferes in the parental education. The findings show high prevalence of violent maternal educational practice, pointing to the need for interventions that minimize the damage of violence in women and children. Analisar a associação entre a violência pelo parceiro íntimo contra a mulher e a prática educativa materna direcionada às crianças no início da escolaridade formal. Estudo transversal, realizado entre 2013 e 2014, com

Adherence to dietary recommendations for preschoolers: clinical trial with teenage mothers.

PubMed

Soldateli, Betina; Vigo, Alvaro; Giugliani, Elsa Regina Justo

2016-12-22

To assess the effect of educational dietary intervention offered in the child's first year of life, as well as teenage mothers and grandmothers in carrying out the dietary recommendations at four to seven years. Randomized clinical trial initiated in 2006, in Porto Alegre, RS, involving 323 teenage mothers and grandmothers who cohabited. The intervention consisted of six counseling sessions on breastfeeding and healthy complementary feeding. The first session occurred in the maternity ward and the other ones in the households of mothers at seven, 15, 30, 60, and 120 days of the child's life. The information about the child's diet were obtained on a monthly basis in the first six months, every two months in the second half-year, and at four to seven years, using a food frequency questionnaire. To assess the adequacy of food consumption to the recommendations from the Ministry of Health, we elaborated a score system that would reflect the compliance with the Ten Steps for Healthy Toddlers from 2 to 10 Years. The average scores of intervention and control groups were compared using the t-test. Low adherence to recommendations on child nutrition was found in the study population, with no difference in implementation the steps between the groups. The score on the compliance with the steps was similar in both groups (9.6 [SD = 1.63] and 9.3 [SD = 1.60] in the intervention and control groups, respectively) and no influence of the cohabitation with the grandmother was found. Educational dietary intervention in the first four months of the child's life for teenage mothers and grandmothers had no effect on the compliance with the recommendations at four to seven years of the child's life. Avaliar o efeito de intervenção alimentar educativa oferecida, no primeiro ano de vida da criança, a mães adolescentes e avós maternas, no cumprimento das recomendações alimentares aos quatro a sete anos. Ensaio clínico randomizado iniciado em 2006, em Porto Alegre, RS, envolvendo

Nurses' knowledge to identify early acute kidney injury.

PubMed

Nascimento, Roseli Aparecida Matheus do; Assunção, Murillo Santucci Cesar; Silva, João Manoel; Amendola, Cristina Prata; Carvalho, Taysa Martindo de; Lima, Emerson Quintino; Lobo, Suzana Margareth Ajeje

2016-01-01

To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge. Avaliar o conhecimento do enfermeiro na identificação precoce da Injúria Renal Aguda (IRA) em Unidade de Terapia Intensiva, Unidade de Internação e Emergência. Estudo multicêntrico, prospectivo.Participaram do estudo 216 enfermeiros,por meio de questionário com 10 questões relacionadas à prevenção, ao diagnóstico e ao tratamento da IRA. 57,2% não souberam identificar as manifestações clínicas da IRA, 54,6% não têm conhecimento da incidência de IRA em pacientes internados na UTI, 87,0% dos enfermeiros não souberam responder ao índice de mortalidade de IRA em pacientes internados na UTI, 67,1% responderam incorretamente que aumentos discretos da creatinina sérica não têm impacto na mortalidade, 66,8% responderam incorretamente à questão sobre as medidas de prevenção da IRA, 60,4% acertaram quando responderam que não �

Maternal and neonatal factors related to prematurity.

PubMed

Oliveira, Laura Leismann de; Gonçalves, Annelise de Carvalho; Costa, Juvenal Soares Dias da; Bonilha, Ana Lucia de Lourenzi

2016-01-01

ém-nascidos com 37 semanas ou mais. Os dados provieram dos registros de 19.457 nascimentos do município de Porto Alegre, no ano de 2012, no Sistema de Informações sobre Nascidos Vivos da Secretaria Municipal da Saúde. Foi realizada análise ajustada mediante Regressão Logística segundo modelo hierárquico. As variáveis estudadas foram alocadas em três níveis de hierarquia: variáveis sociodemográficas; história reprodutiva; fatores gestacionais e de nascimento. Foram alocados 767 casos e 1.534 controles, em um desenho de um caso para dois controles (1:2), mediante randomização simples. No modelo final, foi encontrada associação estatisticamente significante para prematuridade para as seguintes variáveis: idade materna menor que 19 anos (OR=1,32; IC 95%: 1,02 - 1,71) e maior que 34 anos (OR=1,39; IC 95%: 1,12 - 1,72); escolaridade materna inadequada para a idade (OR=2,11; IC 95%: 1,22 - 3,65); gravidez múltipla (OR=1,14; IC 95%: 1,01 - 1,29); cesariana (OR=1,15; IC 95%: 1,03 - 1,29); peso ao nascer menor a 2.500g (OR=4,04; IC 95%: 3,64 - 4,49); Índice de Apgar no 5° minuto de zero a três (OR=1,47; IC 95%: 1,12 - 1,91) e pré-natal inadequado (OR=1,18; IC 95%: 1,02 - 1,36). O presente estudo evidenciou as consequências mais imediatas da prematuridade para os recém-nascidos ao revelar sua associação com piores escores de Apgar e baixo peso ao nascimento. Mostrou como possíveis determinantes mais distais de prematuridade: idade materna, educação materna inadequada, gestação múltipla, pré-natal inadequado e realização de cesariana.

Visually Impaired OLder people's Exercise programme for falls prevenTion (VIOLET): a feasibility study protocol

PubMed Central

Skelton, Dawn A; Bailey, Cathy; Howel, Denise; Cattan, Mima; Deary, Vincent; Coe, Dot; de Jong, Lex D; Gawler, Sheena; Gray, Joanne; Lampitt, Rosy; Wilkinson, Jennifer; Adams, Nicola

2016-01-01

Introduction In the UK, 1 in 5 people aged 75 and over live with sight loss. Visually impaired older people (VIOP) have an above average incidence of falls and 1.3–1.9 times more likely to experience hip fractures, than the general population. Older people with eye diseases are ∼3 times more likely than those with good vision, to limit activities due to fear of falling. This feasibility study aims to adapt the group-based Falls Management Exercise (FaME) programme to the needs of VIOP and carry out an external pilot trial to inform the design of a future definitive randomised controlled trial. Methods and design A UK based 2-centre mixed methods, randomised, feasibility study will be conducted over 28 months. Stakeholder panels, including VIOP, will make recommendations for adaptations to an existing exercise programme (FaME), to meet the needs of VIOP, promoting uptake and adherence, while retaining required effective components of the exercise programme. 80 VIOP aged 60 and over, living at home, ambulant with or without a walking aid, will be recruited in Newcastle (n=40) and Glasgow (n=40) through National Health Service (NHS) Trusts and third sector partners. Participants randomised into the intervention arm will receive the adapted FaME programme. Participants randomised into the control arm will continue with usual activity. Outcomes are, recruitment rate, adherence and validated measures including fear of falling and quality of life. Postintervention in-depth qualitative interviews will be conducted with a purposive sample of VIOP (N=10). Postural stability instructors will be interviewed, before trial-specific training and following the intervention. Ethics and dissemination Ethics approval was secured through the National Research Ethics Service (NRES) Committee North East, Newcastle and North Tyneside 2. Glasgow Caledonian University was approved as a non-NHS site with local ethics approval. Findings will be disseminated through peer-reviewed journals, national and international conferences. Trial registration number ISRCTN16949845. PMID:27486124

Assessment in the primary care of the State of São Paulo, Brazil: incipient actions in sexual and reproductive health.

PubMed

Nasser, Mariana Arantes; Nemes, Maria Ines Battistella; Andrade, Marta Campagnoni; Prado, Rogério Ruscitto do; Castanheira, Elen Rose Lodeiro

2017-08-17

the highest correlation with the other ones. The implementation of sexual and reproductive health in primary health care in the services studied is incipient. The revision of the purpose of the work, the dissemination of technologies, and the investing in permanent education are needed. The evaluative framework built can be used by the sexual and reproductive health program services and management in primary health care, thereby contributing to their actions. Avaliar o desempenho em saúde sexual e reprodutiva de serviços de atenção primária à saúde do Sistema Único de Saúde, no estado de São Paulo. Construiu-se quadro avaliativo para a saúde sexual e reprodutiva com a categorização de 99 indicadores em três domínios: promoção à saúde sexual e reprodutiva (25), prevenção e assistência às doenças sexualmente transmissíveis/aids (43), e atenção à saúde reprodutiva (31). Esse quadro foi aplicado para avaliar as respostas dos serviços ao questionário Avaliação da Qualidade da Atenção Básica em Municípios de São Paulo (QualiAB), em 2010. Calcularam-se as porcentagens de respostas positivas aos indicadores e o desempenho na dimensão saúde sexual e reprodutiva, segundo os domínios; e verificou-se sua contribuição para o escore geral em saúde sexual e reprodutiva (Friedman), participação relativa (Dunn) e correlação (Spearman). Participaram 2.735 serviços, localizados em 586 municípios (distribuídos nos 17 departamentos regionais de saúde paulistas), dos quais 70,6% municípios com menos de 100.000 habitantes. A média geral do desempenho desses serviços para saúde sexual e reprodutiva é 56,8%. As ações são caracterizadas por: pré-natal com início e exames adequados, melhor organização para puerpério imediato do que tardio, e planejamento reprodutivo seletivo para alguns contraceptivos; prevenção baseada em proteção específica, limites na prevenção da sífilis congênita, no tratamento de doen

Prevention of sexually transmitted infections in urban communities (Peru PREVEN): a multicomponent community-randomised controlled trial.

PubMed

García, Patricia J; Holmes, King K; Cárcamo, César P; Garnett, Geoff P; Hughes, James P; Campos, Pablo E; Whittington, William L H

2012-03-24

Previous community-randomised trials of interventions to control sexually transmitted infections (STIs) have involved rural settings, were rarely multicomponent, and had varying results. We aimed to assess the effect of a multicomponent intervention on curable STIs in urban young adults and female sex workers (FSWs). In this community-randomised trial, baseline STI screening was done between August, and November, 2002, in random household samples of young adults (aged 18-29 years) and in FSWs in Peruvian cities with more than 50,000 inhabitants. Geographically separate cities were selected, matched into pairs, and randomly allocated to intervention or control groups with an S-PLUS program. Follow-up surveys of random samples were done after 2 years and 3 years. The intervention comprised four modalities: strengthened STI syndromic management by pharmacy workers and clinicians; mobile-team outreach to FSWs for STI screening and pathogen-specific treatment; periodic presumptive treatment of FSWs for trichomoniasis; and condom promotion for FSWs and the general population. Individuals in control cities received standard care. The composite primary endpoint was infection of young adults with Chlamydia trachomatis, Trichomonas vaginalis, or Neisseria gonorrhoeae, or syphilis seroreactivity. Laboratory workers and the data analyst were masked, but fieldworkers, the Peruvian study team, and participants in the outcome surveys were not. All analyses were done by intention to treat. This trial is registered, ISRCTN43722548. We did baseline surveys of 15,261 young adults in 24 Peruvian cities. Of those, 20 geographically separate cities were matched into pairs, in each of which one city was assigned to intervention and the other to standard of care. In the 2006 follow-up survey, data for the composite primary outcome were available for 12,930 young adults. We report a non-significant reduction in prevalence of STIs in young adults, adjusted for baseline prevalence, in intervention cities compared with control cities (relative risk 0·84, 95% CI 0·69-1·02; p=0·096). In subgroup analyses, significant reductions were noted in intervention cities in young adult women and FSWs. Syndromic management of STIs, mobile-team outreach to FSWs, presumptive treatment for trichomoniasis in FSWs, and condom promotion might reduce the composite prevalence of any of the four curable STIs investigated in this trial. Wellcome Trust and Burroughs Wellcome Fund, National Institutes of Health, Center for AIDS Research, CIPRA, and USAID-Peru. Copyright © 2012 Elsevier Ltd. All rights reserved.

ForgIng New paths in DIabetes PrevenTion (FINDIT): Study Protocol for a Randomized Controlled Trial.

PubMed

Kullgren, Jeffrey T; Youles, Bradley; Shetty, Shaina; Richardson, Caroline; Fagerlin, Angela; Heisler, Michele

2017-04-08

Prediabetes is an asymptomatic condition in which patients' blood glucose levels are higher than normal but do not meet diagnostic criteria for type 2 diabetes mellitus (T2DM). A key window of opportunity to increase engagement of patients with prediabetes in strategies to prevent T2DM is when they are screened for T2DM and found to have prediabetes, yet the effects of this screening and brief counseling are unknown. In this parallel-design randomized controlled trial we will recruit 315 non-diabetic patients from the Ann Arbor VA Medical Center (AAVA) who have one or major risk factors for T2DM and an upcoming primary care appointment at the AAVA, but have not had a hemoglobin A1c (HbA1c) test to screen for T2DM in the previous 12 months. After informed consent, participants will complete a baseline survey and be randomly assigned to, at the time of their next primary care appointment, one of two arms: (1) to have a hemoglobin A1c (HbA1c) test to screen for T2DM and receive brief, standardized counseling about these results or (2) to review a brochure about clinical preventive services. Participants will complete surveys 2 weeks, 3 months, and 12 months after their primary care appointment, and a weight measurement 12 months after their primary care appointment. The primary outcome is weight change after 12 months. The secondary outcomes are changes in perception of risk for T2DM; knowledge of T2DM prevention; self-efficacy and motivation to prevent T2DM; use of pharmacotherapy for T2DM prevention; physical activity; participation in weight management programs; and mental health. Quantitative analyses will compare outcomes among participants in the HbA1c test arm found to have prediabetes with participants in the brochure arm. Among participants in the HbA1c test arm found to have prediabetes we will conduct semi-structured interviews about their understanding of and reactions to receiving a prediabetes diagnosis. This trial will generate foundational data on the effects of a prediabetes diagnosis and brief counseling on patients' preventive behaviors and mediators of these behaviors that will enable the development of novel strategies to improve patient engagement in T2DM prevention. ClinicalTrials.gov, NCT02747108 . Registered on 18 April 2016.

Avaliação do conhecimento de pacientes diabéticos sobre medidas preventivas do pé diabético em Maringá (PR)

PubMed Central

Carlesso, Guilherme Pereira; Gonçalves, Mariana Helena Barboza; Moreschi, Dorival

2017-01-01

Resumo Contexto O atual envelhecimento da população tem gerado maior predominância de doenças crônicas, como o diabetes, a qual está associada a um risco elevado de complicações crônicas e agudas. Entre essas, o pé diabético (PD) destaca-se por possuir alta incidência e grande poder mutilador. Objetivo Avaliar o conhecimento da população diabética das Unidades Básicas de Saúde (UBS) de Maringá (PR) sobre a prevenção do PD. Métodos Estudo descritivo, quantitativo, tipo inquérito por entrevista. A população estudada foi composta por 80 portadores de diabetes, cadastrados em UBS de Maringá (PR). A coleta de dados buscou levantar dados sociodemográficos e epidemiológicos, bem como as atitudes de controle do diabetes e do autocuidado para prevenção do PD. Resultados Do total de entrevistados, nove não realizavam qualquer tipo de exame para controle do diabetes e a renda mensal predominante foi de até um salário mínimo. O grau de escolaridade e a renda mensal não se mostraram relevantes em relação ao conhecimento de cuidados preventivos do PD e nem uma maior adesão a hábitos de vida saudáveis. O cuidado com o PD tende a melhorar à medida que exista uma compreensão mais clara dos fatores que conduzem à perda do membro e um crescente consenso sobre a gestão de vários aspectos clínicos do cuidado com o pé. Conclusão Existe uma falta de aprendizado das medidas preventivas, mesmo nos pacientes com algum nível de instrução, o que induz a uma prática deficiente de cuidados.

A New Species of Sexually Dimorphic Brittle Star of the Genus Ophiodaphne (Echinodermata: Ophiuroidea).

PubMed

Tominaga, Hideyuki; Hirose, Mamiko; Igarashi, Hikaru; Kiyomoto, Masato; Komatsu, Miéko

2017-08-01

We describe a new species of sexually dimorphic brittle star, Ophiodaphne spinosa, from Japan associated with the irregular sea urchin, Clypeaster japonicus based on its external morphology, and phylogenetic analyses of mitochondrial COI (cytochrome c oxidase subunit I). Females of this new species of Ophiodaphne are characterized mainly by the presence of wavy grooves on the surface of the radial shields, needle-like thorns on the oral skeletal jaw structures, and a low length-to-width ratio of the jaw angle in comparison with those of type specimens of its Ophiodaphne congeners: O. scripta, O. materna, and O. formata. A tabular key to the species characteristics of Ophiodaphne is provided. Phylogenetic analyses indicate that the new species of Ophiodaphne, O. scripta, and O. formata are monophyletic. Our results indicate that the Japanese Ophiodaphne include both the new species and O. scripta, and that there are four Ophiodaphne species of sexually dimorphic brittle stars with androphorous habit.

Nursing diagnoses and interventions in children submitted to cochlear implantation.

PubMed

Pereira, Patrícia Juliana Santos; Souza, Natália Fernanda Higa de; Almeida, Raissa Janine de; Menezes, Daiane Cabrera; Bom, Gesiane Cristina; Trettene, Armando Dos Santos

2017-06-12

infecção, Prevenção de quedas e Precauções contra sangramento (n=19; 100%). Os diagnósticos e as intervenções de enfermagem referentes ao pós-operatório de implante coclear relacionaram-se com comunicação, controle de sangramento, cuidados com a ferida operatória, prevenção de infecção, conforto e bem-estar.

Knowledge of adolescents regarding sexually transmitted infections and pregnancy.

PubMed

Almeida, Rebeca Aranha Arrais Santos; Corrêa, Rita da Graça Carvalhal Frazão; Rolim, Isaura Letícia Tavares Palmeira; Hora, Jessica Marques da; Linard, Andrea Gomes; Coutinho, Nair Portela Silva; Oliveira, Priscila da Silva

2017-01-01

To investigate the knowledge of adolescents related to sexually transmitted infections (STIs), AIDS, and pregnancy, and understand the role of school in sex education. A qualitative descriptive study, developed through a semi-structured interview and a form for participant characterization, with 22 high school students from a public school aged 16 to 19 years. Data were submitted to content analysis. After analysis, four thematic categories were developed: sexuality and sex education; understanding of risk behaviors; knowledge of STI/AIDS; and knowledge of and practices for prevention. This study showed the need for preventive educational actions for adolescents, because the lack of information contributes to their vulnerability. The adolescents recognize the importance of sex education; therefore it is important to implement strategies to promote and protect health in the school environment to encourage and strengthen self-care in health. investigar o conhecimento de adolescentes relacionado às Infecções Sexualmente Transmissíveis (IST), AIDS e gravidez, além de conhecer a compreensão sobre o papel da escola na educação sexual. estudo qualitativo, descritivo, desenvolvido por meio de entrevista semiestruturada e formulário para caracterização dos participantes, com 22 adolescentes entre 16 e 19 anos de idade, estudantes do Ensino Médio em uma escola pública. Os dados foram submetidos à análise de conteúdo. da análise emergiram quatro categorias temáticas: Sexualidade e educação sexual; Compreensão de comportamentos de risco; Conhecimento de IST/AIDS; Conhecimento e práticas de prevenção. revelou-se a necessidade de ações educativas de prevenção para os adolescentes, pois a falta de informações contribui para a sua vulnerabilidade. Os adolescentes reconhecem a importância da educação sexual; consequentemente, é importante a implementação de estratégias de promoção e de proteção à saúde no ambiente escolar para contribuir e

A continuous regimen of levonorgestrel/ethinyl estradiol for contraception and elimination of menstruation.

PubMed

Jensen, Jeffrey T

2008-03-01

Clinicians and patients desiring amenorrhea for therapeutic or social reasons will find continuous-use 90 microg levonorgestrel/20 microg ethinyl estradiol to be an attractive oral contraceptive dosing option. Although other formulations of oral contraceptives can be dosed in a continuous manner off-label, the convenience of a 28-day dose pack represents a major advance that will likely increase acceptability of the strategy. The availability of FDA-approved continuous-use 90 microg levonorgestrel/20 microg ethinyl estradiol will help mainstream continuous oral contraception in the same way that Preven and Plan B helped legitimize and mainstream emergency contraception. Patients wishing to use continuous 90 microg levonorgestrel/20 microg ethinyl estradiol must recognize and accept that unscheduled breakthrough bleeding is typical during the first four to six cycles of use. Control of cycle-related symptoms may emerge as an off-label indication for use.

Comunicacion, Lengua Materna: Un Modelo Holistico para su Desarollo (Communication, Mother Tongue: A Holistic Model for Development).

ERIC Educational Resources Information Center

Aquino, Orlando Fernandez

2000-01-01

Recounts the author's educational experiences between 1991-1995 as a university writing teacher and tutorial assistant for scientific papers at the secondary level. Presents a methodology integrally developed in four steps that can be applied to different levels of teaching and a series of conclusive theses about the subject. (BT)

PubMed

Fernández Alba, Juan Jesús; Paublete Herrera, María Del Carmen; González Macías, María Del Carmen; Carral San Laureano, Florentino; Carnicer Fuentes, Concepción; Vilar Sánchez, Ángel; Torrejón Cardoso, Rafael; Moreno Corral, Luis Javier

2016-11-29

Introducción: el sobrepeso y la obesidad se asocian a una mayor probabilidad de que el parto finalice en cesárea. Dado que dicho incremento del riesgo podría estar sesgado por variables de confusión como la diabetes o la hipertensión, en el presente trabajo pretendemos determinar si este riesgo persiste tras ser ajustado por numerosas variables de control.Objetivo: determinar si el sobrepeso y/o la obesidad son factores de riesgo independientes para que el parto finalice en cesárea.Métodos: estudio de cohortes retrospectivo. Se han incluido gestantes adscritas al Hospital Universitario de Puerto Real. Periodo de estudio: 2002-2011. Se incluyeron dos grupos de estudio: sobrepeso al inicio de la gestación (IMC entre 25 y 29,9) y obesidad al inicio de la gestación (IMC ≥ 30). Grupo ontrol: IMC al inicio de la gestación normal (entre 18,5 y 24,9). El riesgo de cesárea fue analizado mediante un estudio de regresión logística múltiple incluyendo como covariables: edad materna, parto inducido, diabetes gestacional, diabetes pregestacional, macrosomía, hipertensión arterial, nuliparidad, cesárea anterior, parto pretérmino y parto postérmino.Resultados: de los 18.243 partos registrados, el IMC al inicio de la gestación constaba en 4.711 casos (25,8%). El 26,1% presentaban sobrepeso, el 12,4% obesidad y el 58,9% IMC normal. Sin ajustar por variables control, se asociaron a un incremento del riesgo de cesárea: sobrepeso (OR 1,48; IC95% 1,27-1,73); obesidad grado 1 (OR 2,09; IC95% 1,66-2,64); obesidad grado 2 (OR 3,23; IC95% 2,31-4,53); obesidad grado 3 (OR 2,57; IC95% 1,56-4,22). El riesgo aumentado se mantuvo significativo en el análisis multivariante: sobrepeso (OR 1,51; IC95% 1,24-1,84); obesidad (OR 2,15; IC95% 1,67-2,76).Conclusiones: encontramos una asociación significativa e independiente entre el sobrepeso/obesidad maternos y la finalización del parto mediante cesárea incluso ajustando por numerosas variables de control como: edad materna

Esthetic Rehabilitation of Primary Anterior Teeth using Temporization Material: A Novel Approach

PubMed Central

Pandit, IK; Gupta, Monika; Nagpal, Jyoti

2017-01-01

Pediatric dentists should always aim for esthetic and functional rehabilitation of decayed/traumatized primary teeth. The most common method for restoring such teeth involves the use of “strip crowns” with composites, while the recent trend is toward using other extracoronal restorations including preve-neered stainless steel crowns and zirconia crowns. All these restorative options have shown good success rates, but also have some limitations. This case series depicts novel clinical technique of using a temporization material for full-coronal restoration(s) in primary anterior teeth. This included the chair-side custom fabrication of full-coronal restoration using temporization material, which has resulted in good immediate esthetics and might be a cost-effective alternative for restoring primary anterior teeth in future. How to cite this article Gugnani N, Pandit IK, Gupta M, Nagpal J. Esthetic Rehabilitation of Primary Anterior Teeth using Temporization Material: A Novel Approach. Int J Clin Pediatr Dent 2017;10(1):111-114. PMID:28377667

Companies commit to emergency contraception -- have you?

PubMed

1999-12-01

Despite the efforts of the medical community, as well as promotional efforts by pharmaceutical companies, relatively few women in the US have heard of emergency contraceptives (ECs). Gynetics, marketer of Preven, plans to file a new drug application for a levonorgestrel EC by the end of 1999, with an anticipated approval in the second half of 2000. Women's Capital Corp., marketer of Plan B, is also aiming for a national commercial launch of its product. According to a recently published acceptability study, women will use ECs when they are made available. A survey among 235 women at 13 Kaiser Permanente medical offices in San Diego, California, regarding their experiences with ECs showed that 91% were satisfied with ECs, and 97% said they would use ECs for emergencies only--dispelling fears that women would forego use of ongoing contraception. About 70% of the women who participated in the study were using a contraceptive method when they requested ECs.

INFEZIONI VIRALI CONGENITE, PERINATALI E NEONATALI VIRAL INFECTIONS OF THE FETUS AND NEWBORN INFANT

PubMed Central

Tremolada, Sara; Delbue, Serena; Ferrante, Pasquale

2009-01-01

Riassunto Alcuni virus possono essere trasmessi verticalmente da madre a figlio in seguito allo sviluppo, da parte della madre, di un’infezione primaria, ricorrente o cronica. La trasmissione materno-fetale dei virus, che può avvenire in utero (infezione congenita), durante il travaglio del parto (infezione perinatale), oppure attraverso l’allattamento (infezione postnatale), può causare aborto spontaneo, morte fetale, ritardo di crescita intrauterino, anomalie congenite e patologie neonatali o postnatali di diversa entità. Alcuni fattori di rischio sembrano influenzare l’incidenza di trasmissione materno-fetale dei virus, come ad esempio la presenza di altre infezioni virali, la carica virale materna, il tipo di infezione (primaria o ricorrente), la durata della rottura delle membrane, la modalità con cui avviene il parto, le condizioni socio-economiche e l’allattamento. Oggi è possibile prevenire la trasmissione materno-fetale di molti virus grazie all’utilizzo di vaccini, immunizzazione passiva e farmaci antivirali. Il rischio di trasmissione delle infezioni perinatali e postnatali, inoltre, può essere diminuito evitando l’allattamento o ricorrendo ad un parto cesareo. PMID:19216201

Validation of educational booklet for HIV/Aids prevention in older adults.

PubMed

Cordeiro, Luana Ibiapina; Lopes, Thais de Oliveira; Lira, Luciane Elise de Abreu; Feitoza, Sarah Maria de Sousa; Bessa, Maria Eliana Peixoto; Pereira, Maria Lúcia Duarte; Feitoza, Aline Rodrigues; Souza, Adriano Rodrigues de

2017-01-01

To describe the process of manufacturing and validation of an educational booklet for HIV/Aids prevention in older adults. Methodological study developed in two phases - manufacturing of the booklet and validation of the educational material by judges. The manufacturing process involved a situational diagnosis with older adults, and its result indicated gaps in the knowledge with respect to HIV/Aids. The validation process was performed by nine judges, selected by convenience. It was considered an agreement index of at least 0.80, analyzed through the content validity index. We opted for a dialogue between two older adults divided into three categories: myths and taboos; ignorance; and prevention and importance of diagnosis. The average of the items was 0.90. The suggestions made by the judges were observed and modified for the final version. The material had relevant content for the judges, in addition to being able to be used by health professionals in the education and clarification of issues on the subject. Descrever o processo de construção e validação de cartilha educativa para prevenção de HIV/Aids em idosos. Estudo metodológico desenvolvido em duas etapas - construção da cartilha e validação do material educativo por juízes. O processo de construção envolveu um diagnóstico situacional com idosos, cujo resultado apontou lacunas no conhecimento com relação ao HIV/Aids. Já o processo de validação foi realizado por nove juízes, selecionados por conveniência. Considerou-se uma concordância de no mínimo 0,80, analisado pelo índice de validade de conteúdo. Optou-se por um diálogo entre dois idosos dividido em três categorias: mitos e tabus; desconhecimento; e prevenção e importância do diagnóstico. A média dos itens foi de 0,90. As sugestões realizadas pelos juízes foram acatadas e modificadas para a versão final. O material apresentou conteúdo relevante para os juízes, além de poder ser utilizado pelos profissionais de sa

The genesis of the AIDS policy and AIDS Space in Brazil (1981-1989).

PubMed

Barros, Sandra Garrido de; Vieira-da-Silva, Ligia Maria

2016-07-21

para a formulação de uma política específica. O Espaço Aids constituiu-se como produto do encontro da trajetória de agentes de diversos campos sociais (médico, científico, político e burocrático). Um espaço específico de relações, que possibilitou a formulação de uma política para o controle da epidemia da aids, mas onde também estava em disputa a autoridade de falar sobre o significado da doença, suas formas de prevenção e tratamento. A análise mostrou como as estruturas (governos democráticos no estado de São Paulo e no âmbito nacional, com sanitaristas assumindo posições importantes) e a ausência de terapia específica contribuíram para que agentes sociais com disposições e formações diversas formulassem uma política que priorizou inicialmente a prevenção. A ascensão do movimento sanitário, a constituição do SUS e a dominância do campo médico no Espaço Aids contribuíram para a valorização do tratamento, como parte das medidas de controle da epidemia. Essas condições possibilitaram a formulação de uma política baseada na integralidade das ações, articulando prevenção e tratamento, na década seguinte, com importante participação da burocracia estatal e de pesquisadores.

Effect of maternal exercises on biophysical fetal and maternal parameters: a transversal study.

PubMed

Santos, Caroline Mombaque Dos; Santos, Wendel Mombaque Dos; Gallarreta, Francisco Maximiliano Pancich; Pigatto, Camila; Portela, Luiz Osório Cruz; Morais, Edson Nunes de

2016-01-01

To evaluate the acute effects of maternal and fetal hemodynamic responses in pregnant women submitted to fetal Doppler and an aerobic physical exercise test according to the degree of effort during the activity and the impact on the well-being. Transversal study with low risk pregnant women, obtained by convenience sample with gestational age between 26 to 34 weeks. The participants carry out a progressive exercise test. After the exercise session, reduced resistance (p=0.02) and pulsatility indices (p=0.01) were identified in the umbilical artery; however, other Doppler parameters analyzed, in addition to cardiotocography and fetal biophysical profile did not achieve significant change. Maternal parameters obtained linear growth with activity, but it was not possible to establish a standard with the Borg scale, and oxygen saturation remained stable. A short submaximal exercise had little effect on placental blood flow after exercise in pregnancies without complications, corroborating that healthy fetus maintains homeostasis even in situations that alter maternal hemodynamics. Avaliar os efeitos agudos de respostas hemodinâmicas maternas e fetais em gestantes submetidas a Doppler fetal e a um teste de exercício físico aeróbio, de acordo com o grau de esforço durante a atividade e o impacto sobre o bem-estar. Estudo transversal desenvolvido com gestantes de baixo risco, por amostra de conveniência com idade gestacional entre 26 e 34 semanas. As participantes realizam um teste de esforço progressivo. Na artéria umbilical, após sessão de exercício físico, identificou-se a redução do índice de resistência (p=0,02) e do índice de pulsatilidade (p=0,01), mas os demais parâmetros Doppler analisados, além da cardiotocografia e do perfil biofísico fetal, não obtiveram alteração significativa. Os parâmetros maternos obtiveram crescimento linear com a atividade, mas não foi possível estabelecer padrão com a escala de Borg, e a saturação de oxig

Twenty-nine-month follow-up of a paediatric zirconia dental crown.

PubMed

Lopez Cazaux, Serena; Hyon, Isabelle; Prud'homme, Tony; Dajean Trutaud, Sylvie

2017-06-14

The aim of this paper is to present the long-term follow-up of one paediatric zirconia crown on a deciduous molar. Preformed crowns are part of the armamentarium in paediatric dentistry. In recent years, aesthetic alternatives to preformed metal crowns have been developed, first preveneered crowns and then zirconia crowns. This paper describes the restoration of a primary molar with a zirconia crown (EZ-Pedo, Loomis, California, USA) in an 8-year-old boy. In this clinical case, the protocol for the implementation and maintenance of zirconia crowns is detailed. The patient was followed up for 29 months until the natural exfoliation of his primary molar. The adaptation of the zirconia crown, the gingival health and the wear on the opposing tooth were considered. In this case, the paediatric zirconia crown allowed sustainable functional restoration while restoring a natural appearance of the tooth. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[How do Prevention Projects Reach their Target Groups? Results of a Survey with Prevention Projects].

PubMed

Brand, T; Böttcher, S; Jahn, I

2015-12-01

 The aim of this study was to assess methods used to access target groups in prevention projects funded within the prevention research framework by the German Federal Ministry of Education and Research.  A survey with prevention projects was conducted. Access strategies, communication channels, incentives, programme reach, and successful practical recruitment strategies were explored.  38 out of 60 projects took part in the survey. Most projects accessed their target group within structured settings (e. g., child day-care centers, schools, workplaces). Multiple communication channels and incentives were used, with written information and monetary incentives being used most frequently. Only few projects were able to report their programme reach adequately; programme reach was highest for programmes accessing the target groups in structured settings. The respondents viewed active recruitment via personal communication with the target group and key persons in the settings as the most successful strategy.  The paper provides an overview on recruitment strategies used in current preven-tion projects. More systematic research on programme reach is necessary. © Georg Thieme Verlag KG Stuttgart · New York.

Indicators to assess the quality of programs to prevent occupational risk for tuberculosis: are they feasible?

PubMed

Santos, Talita Raquel Dos; Padoveze, Maria Clara; Nichiata, Lúcia Yasuko Izumi; Takahashi, Renata Ferreira; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins

2016-06-07

to analyze the feasibility of quality indicators for evaluation of hospital programs for preventing occupational tuberculosis. a descriptive cross-sectional study. We tested indicators for evaluating occupational tuberculosis prevention programs in six hospitals. The criterion to define feasibility was the time spent to calculate the indicators. time spent to evaluate the indicators ranged from 2h 52min to 15h11min 24sec. The indicator for structure evaluation required less time; the longest time was spent on process indicators, including the observation of healthcare workers' practices in relation to the use of N95 masks. There was an hindrance to test one of the indicators for tuberculosis outcomes in five situations, due to the lack of use of tuberculin skin test in these facilities. The time requires to calculate indicators in regarding to the outcomes for occupational tuberculosis largely depends upon the level of organizational administrative structure for gathering data. indicators to evaluate the structure for occupational tuberculosis prevention are highly feasible. Nevertheless, the feasibility of indicators for process and outcome is limited due to relevant variations in administrative issues at healthcare facilities. analisar a viabilidade de indicadores de qualidade para avaliação de programas hospitalares de prevenção de tuberculose ocupacional. estudo descritivo transversal. Testaram-se indicadores de avaliação de programas de prevenção de tuberculose ocupacional em seis hospitais. O critério para definir a viabilidade foi o tempo necessário para aplicar os indicadores. o tempo necessário para avaliar os indicadores variou de 02'52'' até 15h11'24''. O indicador para a avaliação da estrutura demandou menor tempo; o maior tempo foi utilizado com os indicadores de processo, incluindo a observação das práticas dos trabalhadores de saúde em relação ao uso de máscaras N95. Um dos indicadores de resultados de tuberculose deixou de ser

Breastfeeding. COTALMA: training health professionals.

PubMed

Casanovas, M C

1994-01-01

The Comite Tecnico de Apoyo a la Lactancia Materna (COTALMA), the Technical Breastfeeding Support Committee, was founded in Bolivia in 1989. It is financed by the United States Agency for International Development (USAID) and the United Nations Children's Fund (UNICEF). It is administered in coordination with the Ministry of Health (MOH). MOH and UNICEF choose the hospitals, who send teams that include a pediatrician, a gynecologist, a nurse, and a nutritionist. The first phase of the course (5.5 days) covers the scientific background of breastfeeding. A baseline study is then planned and conducted at each hospital. 2 to 3 months later, the second phase takes place during which data is presented and breast feeding programs are developed for each hospital. Communication, training, counseling, and planning and evaluation are covered. Practicums are conducted at hospitals. Trainers are usually members of COTALMA. The person in charge of maternal and child health services at MOH lectures on national health policies concerning mothers and children. Training includes use of the national health card, breastfeeding and child survival, and breastfeeding as a family planning method. Culturally appropriate course materials, which are in Spanish, are adapted from those developed by Wellstart International. Articles by COTALMA members and others are added. Participants are encouraged to train all staff at their institutions.

Occupational skin cancer: Systematic review.

PubMed

Sena, Jéssica Suellen; Girão, Régio José Santiago; Carvalho, Sionara Melo Figueiredo de; Tavares, Rosielly Melo; Fonseca, Fernando Luiz Affonso; Silva, Patrícia Barros Aquino; Barbosa, Maria Clara Fortes Portela

2016-01-01

To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: "neoplasias cutâneas" (DeCS), "exposição ocupacional" (DeCS), "epidemiologia" (DeCS) as well as the keyword "prevenção", and their equivalents in English. After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.

Effects of ultraviolet irradiation on the bond strength of a composite resin adhered to stainless steel crowns.

PubMed

Baeza-Robleto, Selene J; Villa-Negrete, Dulce M; García-Contreras, René; Scougall-Vílchis, Rogelio J; Guadarrama-Quiroz, Luis J; Robles-Bermeo, Norma L

2013-01-01

A technique whereby the practitioner could improve the esthetic appearance of anterior stainless steel crowns (SSC) could provide a cost-effective alternative to more expensive commercially available preveneered SSCs, which may not be uniformly available. The purpose of this study was to evaluate the effects of ultraviolet (UV) irradiation of the metal crown surface on the shear bond strength of composite resin adhered to stainless steel crowns. Seventy extracted anterior bovine teeth randomly divided into 2 groups (n=35/group), were restored with primary maxillary left central incisor SSCs. Surface roughening with a green stone was performed on the labial surfaces, and the crowns of the experimental group were exposed to UV irradiation for 80 minutes. All samples were treated with metal-composite adhesive, followed by composite opaquer. Standardized composite blocks were bonded on the treated surfaces, and the shear bond strength was tested at 1 mm/minute. The values were recorded in MPa and statistically analyzed. The mean value of shear bond strength was significantly higher for the experimental group (19.7 ± 4.3 MPa) than the control group (16.3 ± 4.5 MPa). Ultraviolet irradiation of primary tooth stainless steel crowns significantly increased the shear bond strength of composite resin adhered to the facial surface.

STI Screening Uptake and Knowledge of STI Symptoms among Female Sex Workers Participating in a Community Randomized Trial in Peru

PubMed Central

Kohler, Pamela K.; Campos, Pablo E.; Garcia, Patricia J.; Carcamo, Cesar P.; Buendia, Clara; Hughes, James P.; Mejia, Carolina; Garnett, Geoff P.; King, K.

2016-01-01

This study aims to evaluate condom use, STI screening, and knowledge of STI symptoms among female sex workers (FSW) in Peru associated with sex work venue and a community randomized trial of STI control. One component of the Peru PREVEN intervention conducted mobile-team outreach to FSW to reduce STIs and increase condom use and access to government clinics for STI screening and evaluation. Prevalence ratios were calculated using multivariate Poisson regression models with robust standard errors, clustering by city. As-treated analyses were conducted to assess outcomes associated with reported exposure to the intervention. Care-seeking was more frequent in intervention communities, but differences were not statistically significant. FSW reporting exposure to the intervention had significantly higher likelihood of condom use, STI screening at public health clinics, and symptom recognition compared to those not exposed. Compared with street or bar-based FSW, brothel-based FSW reported significantly higher rates of condom use with last client, recent screening exams for STIs and HIV testing. Brothel-based FSW also more often reported knowledge of STIs and recognition of STI symptoms in women and in men. Interventions to promote STI-detection and prevention among FSW in Peru should consider structural or regulatory factors related to sex work venue. PMID:25941053

Remisión de aneurisma luego de exéresis de MAV con aparición de síndrome del acento extranjero

PubMed Central

Sosa, Fidel; Bustamante, Jorge; Rodríguez, Facundo; Argañaraz, Romina; Rubino, Pablo; Lambre, Jorge

2017-01-01

Resumen Introducción: Los aneurismas asociados a malformaciones arteriovenosas (MAV) son lesiones vasculares que suelen encontrarse hasta en el 15% de los casos, incrementando el riesgo global de hemorragia. La conducta frente a los aneurismas asociados es dicotómica en la literatura, mientras existen reportes de la desaparición de los mismos luego de la exéresis de la MAV, otros artículos enfatizan su tratamiento precoz. El síndrome del acento extranjero es un raro trastorno neurológico en el que el paciente habla su lengua materna como lo haría una persona extranjera y suena con “acento” extranjero a oídos de los oyentes nativos. Objetivo: Presentar un paciente que desarrolla el síndrome del acento extranjero posterior a la exéresis de una MAV y la evolución de un aneurisma asociado. Presentación de caso: Paciente pediátrico que luego de la exéresis de una MAV fronto-opercular posterior izquierda remite por completo un aneurisma de hiperflujo asociado, presentando en el postquirúrgico el síndrome del acento extranjero. Conclusión: Queda reportado el caso de este raro síndrome y la resolución espontánea de un aneurisma proximal luego de la exéresis de una MAV. PMID:28480115

Biomarcadores de função endotelial em doenças cardiovasculares: hipertensão

PubMed Central

Neves, Josynaria Araújo; Neves, Josyanne Araújo; Oliveira, Rita de Cássia Meneses

2016-01-01

Resumo A incidência de hipertensão arterial sistêmica está aumentando mundialmente. Sua prevenção baseia-se na identificação dos hipertensos. Atualmente, biomarcadores são utilizados com fins de diagnosticar, estratificar e prognosticar doenças. Neste estudo, objetivou-se revisar artigos dos últimos cinco anos relacionados a biomarcadores nas doenças cardiovasculares. Pesquisaram-se dados de PubMed, SciELO, Science Direct e MEDLINE, mediante as palavras-chave: hipertensão arterial, biomarcadores cardiovasculares, óxido nítrico, função endotelial e dimetilarginina assimétrica. Os estudos levantados mostram que as doenças cardiovasculares possuem uma etiologia complexa. Neste artigo, evidenciaram-se interações entre o óxido nítrico e a dimetilarginina assimétrica na regulação, no metabolismo e na determinação dos níveis intracelulares, e reviram-se outros biomarcadores relacionados à hipertensão. Alguns estudos indicam os biomarcadores como uma ferramenta útil na predição de eventos cardíacos, e outros reportam que eles contribuem pouco para a avaliação. A seleção e combinação desses pode ser uma alternativa para validar o uso dos biomarcadores devido à pouca especificidade existente para diagnosticar a hipertensão. PMID:29930594

Trombose induzida pelo calor endovenoso: relato de dois casos tratados com rivaroxabana e revisão da literatura

PubMed Central

de Araujo, Walter Junior Boim; Timi, Jorge Rufino Ribas; Erzinger, Fabiano Luiz; Caron, Filipe Carlos

2016-01-01

Resumo Define-se trombose induzida pelo calor endovenoso como a propagação do trombo a partir de uma veia superficial em direção a uma veia mais profunda. Em geral, é considerada clinicamente insignificante quando não há propagação do trombo para o sistema venoso profundo. Essa condição pode ser tratada com terapia anticoagulante, embora a observação pareça ser suficiente, principalmente para graus menores. Neste estudo, relatamos dois casos de trombose induzida pelo calor endovenoso que teriam indicação de heparina de baixo peso molecular até a resolução do quadro. Porém, optou-se pelo uso da rivaroxabana (15 mg de 12 em 12h), com resolução completa do trombo em 4 semanas (caso 1) e em 7 dias (caso 2). A rivaroxabana pode ser uma alternativa promissora no tratamento da trombose induzida pelo calor endovenoso avançada, pela simplicidade da posologia, sem comprometimento da eficácia ou da segurança. São necessários estudos prospectivos, randomizados e controlados que possibilitem melhor entendimento da condição e o desenvolvimento de recomendações mais definitivas sobre opções de prevenção e tratamento.

Sexually transmitted infection screening uptake and knowledge of sexually transmitted infection symptoms among female sex workers participating in a community randomised trial in Peru.

PubMed

Kohler, Pamela K; Campos, Pablo E; Garcia, Patricia J; Carcamo, Cesar P; Buendia, Clara; Hughes, James P; Mejia, Carolina; Garnett, Geoff P; Holmes, King K

2016-04-01

This study aims to evaluate condom use, sexually transmitted infection (STI) screening, and knowledge of STI symptoms among female sex workers in Peru associated with sex work venues and a community randomised trial of STI control. One component of the Peru PREVEN intervention conducted mobile-team outreach to female sex workers to reduce STIs and increase condom use and access to government clinics for STI screening and evaluation. Prevalence ratios were calculated using multivariate Poisson regression models with robust standard errors, clustering by city. As-treated analyses were conducted to assess outcomes associated with reported exposure to the intervention. Care-seeking was more frequent in intervention communities, but differences were not statistically significant. Female sex workers reporting exposure to the intervention had a significantly higher likelihood of condom use, STI screening at public health clinics, and symptom recognition compared to those not exposed. Compared with street- or bar-based female sex workers, brothel-based female sex workers reported significantly higher rates of condom use with last client, recent screening exams for STIs, and HIV testing. Brothel-based female sex workers also more often reported knowledge of STIs and recognition of STI symptoms in women and in men. Interventions to promote STI detection and prevention among female sex workers in Peru should consider structural or regulatory factors related to sex work venues. © The Author(s) 2015.

Evaluation of the human immunodeficiency virus type 1 and 2 antibodies detection in dried whole blood spots (DBS) samples.

PubMed

Castro, Andréa Cauduro de; Borges, Luiz Gustavo dos Anjos; Souza, Ricardo da Silva de; Grudzinski, Melina; D'Azevedo, Pedro Alves

2008-01-01

Human Immunodeficiency Virus Type 1 and 2 antibodies detection was performed in 457 dried whole blood spots samples (S&S 903). Q-Preven HIV 1+2 was the screening test used. The results were compared with the gold standard serum tests by ELISA (Cobas Core e Axsym HIV1/2 gO) and immunofluorescence was the definitive confirmatory test. The samples were obtained from the Hospital Nossa Senhora da Conceição in Porto Alegre, RS - Brazil, through whole blood transfer to filter paper card and sent to Caxias do Sul, RS-Brazil where the tests were performed. The dried whole blood spot stability was evaluated with two different panels. The first one was composed of five negative and five positive samples stored at room temperature, 4 degrees C, -20 degrees C and -70 degrees C, while the second was composed of two negative and three positive samples stored at 37 degrees C (humidity <50%). Each sample was screened every week for six weeks. These measurement results didn't show variation during the study period. The detected sensibility was 100%, specificity was 99.6%, the positive predictive value was 99.5% and negative predictive values were 100%. The results demonstrated high performance characteristics, opening a new perspective of dried whole blood spot utilization in HIV screening diagnosis.

Breastfeeding Duration and Anogenital Distance in 2-Year-Old Infants.

PubMed

Ortega-García, Juan Antonio; Olano-Soler, Henry Andrés; Martínez-Álvarez, Ana; Campillo-López, Ferran; Gomariz-Peñalver, Virtudes; Mendiola-Olivares, Jaime; Iglesias-Gómez, Carlos; Escribano-Muñoz, Arancha

2016-09-01

The anogenital distance (AGD) is an anthropometric marker determined by exposures to androgens in utero and throughout the first few months of life. Early exposures to endocrine-disrupting chemicals such as phthalates have been significantly associated with shortened AGD in boys. Limited studies have explored phthalate concentrations in breast milk and infant formula. To explore the associations between breastfeeding duration and AGD measures in infants. MALAMA (Medio Ambiente y Lactancia Materna) is a follow-up study of 430 mother-child pairs, from birth to 2 years, from two population-based cohorts in Murcia, Spain. Data were collected through medical visits and telephone surveys from birth to 2 years of age. World Health Organization breastfeeding definitions were used. AGD measurements were assessed in a subsample of 71 boys and 49 girls at the 2-year visit. Descriptive analyses, Pearson correlations, and linear regressions were calculated between AGD and breastfeeding duration. Duration of all types of breastfeeding, especially full breastfeeding (FB), is correlated with AGD measures in boys (p < 0.05). AGDAS (anoscrotal distance) and AGDAP (anopenile distance) were positively associated with FB (β = 0.004, 95%CI: 0.001-0.007 and β = 0.003, 95%CI: 0.000-0.007, respectively). A positive correlation between AGD in male infants and the duration of breastfeeding is reported. Inversely, early introduction of infant formula could lead to the reduction of AGD in boys.

Violence against women, Espírito Santo, Brazil.

PubMed

Leite, Franciele Marabotti Costa; Amorim, Maria Helena Costa; Wehrmeister, Fernando C; Gigante, Denise Petrucci

2017-04-10

úde sobre violência contra a mulher e um questionário foi elaborado para investigar as características sociodemográficas, comportamentais e de história familiar e de vida da mulher. As análises estatísticas utilizadas foram: regressão de Poisson, teste exato de Fisher e Qui-quadrado. As prevalências observadas foram: psicológica 25,3% (IC95% 22,6-28,2); física 9,9% (IC95% 8,1-11,9) e sexual 5,7% (IC95% 4,3-7,3). A violência psicológica manteve-se associada à escolaridade, situação conjugal, histórico materno de violência por parceiro íntimo, violência sexual na infância e ter feito uso de drogas, enquanto a agressão física esteve relacionada à idade, escolaridade, situação conjugal e a história materna de violência por parceiro íntimo. A violência sexual foi mais frequente nas mulheres de menor renda e que sofreram abuso sexual na infância. As violências psicológica, física e sexual apresentaram alta magnitude entre as mulheres usuárias dos serviços de atenção primária de saúde. Fatores sociodemográficos, comportamentais e experiências pessoal e materna de violência influenciam a ocorrência do fenômeno.

Reclassifying causes of obstetric death in Mexico: a repeated cross-sectional study.

PubMed

Hogan, Margaret C; Saavedra-Avendano, Biani; Darney, Blair G; Torres-Palacios, Luis M; Rhenals-Osorio, Ana L; Sierra, Bertha L Vázquez; Soliz-Sánchez, Patricia N; Gakidou, Emmanuela; Lozano, Rafael

2016-05-01

To describe causes of maternal mortality in Mexico over eight years, with particular attention to indirect obstetric deaths and socioeconomic disparities. We conducted a repeated cross-sectional study using the 2006-2013 Búsqueda intencionada y reclasificación de muertes maternas (BIRMM) data set. We used frequencies to describe new cases, cause distributions and the reclassification of maternal mortality cases by the BIRMM process. We used statistical tests to analyse differences in sociodemographic characteristics between direct and indirect deaths and differences in the proportion of overall direct and indirect deaths, by year and by municipality poverty level. A total of 9043 maternal deaths were subjected to the review process. There was a 13% increase (from 7829 to 9043) in overall identified maternal deaths and a threefold increase in the proportion of maternal deaths classified as late maternal deaths (from 2.1% to 6.9%). Over the study period direct obstetric deaths declined, while there was no change in deaths from indirect obstetric causes. Direct deaths were concentrated in women who lived in the poorest municipalities. When compared to those dying of direct causes, women dying of indirect causes had fewer pregnancies and were slightly younger, better educated and more likely to live in wealthier municipalities. The BIRMM is one approach to correct maternal death statistics in settings with poor resources. The approach could help the health system to rethink its strategy to reduce maternal deaths from indirect obstetric causes, including prevention of unwanted pregnancies and improvement of antenatal and post-obstetric care.

Reclassifying causes of obstetric death in Mexico: a repeated cross-sectional study

PubMed Central

Hogan, Margaret C; Saavedra-Avendano, Biani; Darney, Blair G; Torres-Palacios, Luis M; Rhenals-Osorio, Ana L; Sierra, Bertha L Vázquez; Soliz-Sánchez, Patricia N; Gakidou, Emmanuela

2016-01-01

Abstract Objective To describe causes of maternal mortality in Mexico over eight years, with particular attention to indirect obstetric deaths and socioeconomic disparities. Methods We conducted a repeated cross-sectional study using the 2006–2013 Búsqueda intencionada y reclasificación de muertes maternas (BIRMM) data set. We used frequencies to describe new cases, cause distributions and the reclassification of maternal mortality cases by the BIRMM process. We used statistical tests to analyse differences in sociodemographic characteristics between direct and indirect deaths and differences in the proportion of overall direct and indirect deaths, by year and by municipality poverty level. Findings A total of 9043 maternal deaths were subjected to the review process. There was a 13% increase (from 7829 to 9043) in overall identified maternal deaths and a threefold increase in the proportion of maternal deaths classified as late maternal deaths (from 2.1% to 6.9%). Over the study period direct obstetric deaths declined, while there was no change in deaths from indirect obstetric causes. Direct deaths were concentrated in women who lived in the poorest municipalities. When compared to those dying of direct causes, women dying of indirect causes had fewer pregnancies and were slightly younger, better educated and more likely to live in wealthier municipalities. Conclusion The BIRMM is one approach to correct maternal death statistics in settings with poor resources. The approach could help the health system to rethink its strategy to reduce maternal deaths from indirect obstetric causes, including prevention of unwanted pregnancies and improvement of antenatal and post-obstetric care. PMID:27147766

Breastfeeding Duration and Anogenital Distance in 2-Year-Old Infants

PubMed Central

Olano-Soler, Henry Andrés; Martínez-Álvarez, Ana; Campillo-López, Ferran; Gomariz-Peñalver, Virtudes; Mendiola-Olivares, Jaime; Iglesias-Gómez, Carlos; Escribano-Muñoz, Arancha

2016-01-01

Abstract Background: The anogenital distance (AGD) is an anthropometric marker determined by exposures to androgens in utero and throughout the first few months of life. Early exposures to endocrine-disrupting chemicals such as phthalates have been significantly associated with shortened AGD in boys. Limited studies have explored phthalate concentrations in breast milk and infant formula. Objective: To explore the associations between breastfeeding duration and AGD measures in infants. Materials and Methods: MALAMA (Medio Ambiente y Lactancia Materna) is a follow-up study of 430 mother–child pairs, from birth to 2 years, from two population-based cohorts in Murcia, Spain. Data were collected through medical visits and telephone surveys from birth to 2 years of age. World Health Organization breastfeeding definitions were used. AGD measurements were assessed in a subsample of 71 boys and 49 girls at the 2-year visit. Descriptive analyses, Pearson correlations, and linear regressions were calculated between AGD and breastfeeding duration. Results: Duration of all types of breastfeeding, especially full breastfeeding (FB), is correlated with AGD measures in boys (p < 0.05). AGDAS (anoscrotal distance) and AGDAP (anopenile distance) were positively associated with FB (β = 0.004, 95%CI: 0.001–0.007 and β = 0.003, 95%CI: 0.000–0.007, respectively). Conclusions: A positive correlation between AGD in male infants and the duration of breastfeeding is reported. Inversely, early introduction of infant formula could lead to the reduction of AGD in boys. PMID:27403626

Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study.

PubMed

Villasis-Sarmiento, Luis; Portilla-Robertson, Javier; Melendez-Ocampo, Arcelia; Gaitan-Cepeda, Luis-Alberto; Leyva-Huerta, Elba-Rosa

2017-04-01

Odontogenic cysts (OC) are the most frequent lesions of the jaws and their constant epidemiological update is necessary and indispensable. Therefore the principal objective of this report was To determine prevalence and clinical-demographical characteristics of OC in a Mexican sample. 753 cases of OC coming from the archive of a head and neck histopathological teaching service, from January 2000 to December 2013, were included. OC cases were re-assessed according 2005 WHO classification. Chi square test was used to establish possible associations ( p <0.05IC95%). From 753 OC, 369 were female and 384 male; 52.9% of them were in their 2nd- 4th decade of life. The most common location (41%) was the mandibular posterior area. Radicular cysts were more frequent in maxillary anterior zone of females ( p 0.0002) at their fourth decade of life. Dentigerous cysts were more frequent in the mandibular posterior zone of males ( p 0.0000) in their second decade of life. Six cases of periodontal lateral cyst; 4 cases of paradental cysts; 4 eruption cysts and 4 cases of adult gingival cyst, as well were identified. Radicular cyst and dentigerous cyst are the most prevalent odontogenic cyst in this Mexican sample. Due to their etiology, dental pulpar necrosis and impacted teeth, radicular cyst and dentigerous cyst could be prevenible. Therefore, it is necessary to establish preventive strategies to diminish dental decay and programs of prophylactic extractions of impacted teeth, to in consequence decrease the prevalence of odontogenic cysts. Key words: Cyst, dentigerous cyst, mexican, odontogenic cyst, radicular cyst.

The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil.

PubMed

Urrutia-Pereira, Marilyn; Avila, Jennifer; Solé, Dirceu

2016-01-01

To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents (< 18 years of age) with asthma or suspected asthma. Patients either enroll in PIPA spontaneously or are referred by pediatricians or primary care physicians. In this retrospective study, we use a standardized protocol to assess PIPA patients. By the end of the study period, 646 patients were being followed. Of those, 298 (46.1%) were ≤ 3 years of age. In this group of patients, recurrent wheezing was identified in 60.7%, and the first episode of wheezing occurred in the first six months of life in 86.0%. Severe wheezing was identified in 29.5% and 45.4% in the children ≤ 3 and > 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.

[Asymptomatic Renal Stones: Do they really Exist?].

PubMed

Seseke, S; Rudolph, R; Rebmann, U

2011-11-01

Asymptomatic renal calculi without any history of colic, hematuria or infection can be found as an incidental finding during preven-tive check-ups. The aim of our study was to eval-uate whether these stones provoke symptoms with the need for further treatment during the follow-up and whether they cause cortical defects which may consecutively affect the renal func-tion. In a prospective study we evaluated 104  patients with renal calculi. The -medical history, radiological findings and functional imaging as well as urine and blood analyses were recorded and evaluated. The influence of stone size and localisation on the development of acute stone-related symptoms, renal function and renal scarring were evaluated. Furthermore, we analysed whether localised pathological findings in radiographic or functional imaging may influence the creatinine level. The follow-up was be-tween 12 and 48  months (median: 25  months). During the study period 27 / 104 of our patients (26 %) developed symptomatic events (renal colic, hematuria, infection) in which patients with middle pole calculi with a mean -cumulative stone diameter of 9.8  mm had the -highest risk. A localised renal scarring could be found in 36.6 %. These patients had a significantly higher risk in presenting an increased creatinine level. Increasing stone size was diagnosed in 39  cases (37.5 %). Asymptomatic renal stones have to be controlled regularly in order to prevent the -patient from loss of renal function and hypertension caused by increasing stones or urinary tract infection. © Georg Thieme Verlag KG Stuttgart ˙ New York.

Spotlight on unmet needs in stroke prevention: The PIONEER AF-PCI, NAVIGATE ESUS and GALILEO trials.

PubMed

Hemmrich, Melanie; Peterson, Eric D; Thomitzek, Karen; Weitz, Jeffrey I

2016-09-28

Atrial fibrillation (AF) is a major healthcare concern, being associated with an estimated five-fold risk of ischaemic stroke. In patients with AF, anticoagulants reduce stroke risk to a greater extent than acetylsalicylic acid (ASA) or dual antiplatelet therapy (DAPT) with ASA plus clopidogrel. Non-vitamin K antagonist oral anticoagulants (NOACs) are now a widely-accepted therapeutic option for stroke prevention in non-valvular AF (NVAF). There are particular patient types with NVAF for whom treatment challenges remain, owing to sparse clinical data, their high-risk nature or a need to harmonise anticoagulant and antiplatelet regimens if co-administered. This article focuses on three randomised controlled trials (RCTs) that are investigating the utility of rivaroxaban, a direct, oral, factor Xa inhibitor, in additional areas of stroke prevention where data for anticoagulants are lacking: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment (PIONEER AF-PCI); New Approach riVaroxoban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE ESUS); and Global study comparing a rivAroxaban-based antithrombotic strategy to an antipLatelet-based strategy after transcatheter aortIc vaLve rEplacement to Optimize clinical outcomes (GALILEO). Data from these studies present collaborative efforts to build upon existing registrational Phase III data for rivaroxaban, driving the need for effective and safe treatment of a wider range of patients for stroke prevention.

Prevalence and distribution of odontogenic cysts in a Mexican sample. A 753 cases study

PubMed Central

Villasis-Sarmiento, Luis; Melendez-Ocampo, Arcelia; Gaitan-Cepeda, Luis-Alberto; Leyva-Huerta, Elba-Rosa

2017-01-01

Background Odontogenic cysts (OC) are the most frequent lesions of the jaws and their constant epidemiological update is necessary and indispensable. Therefore the principal objective of this report was To determine prevalence and clinical-demographical characteristics of OC in a Mexican sample. Material and Methods 753 cases of OC coming from the archive of a head and neck histopathological teaching service, from January 2000 to December 2013, were included. OC cases were re-assessed according 2005 WHO classification. Chi square test was used to establish possible associations (p<0.05IC95%). Results From 753 OC, 369 were female and 384 male; 52.9% of them were in their 2nd- 4th decade of life. The most common location (41%) was the mandibular posterior area. Radicular cysts were more frequent in maxillary anterior zone of females (p 0.0002) at their fourth decade of life. Dentigerous cysts were more frequent in the mandibular posterior zone of males (p 0.0000) in their second decade of life. Six cases of periodontal lateral cyst; 4 cases of paradental cysts; 4 eruption cysts and 4 cases of adult gingival cyst, as well were identified. Conclusions Radicular cyst and dentigerous cyst are the most prevalent odontogenic cyst in this Mexican sample. Due to their etiology, dental pulpar necrosis and impacted teeth, radicular cyst and dentigerous cyst could be prevenible. Therefore, it is necessary to establish preventive strategies to diminish dental decay and programs of prophylactic extractions of impacted teeth, to in consequence decrease the prevalence of odontogenic cysts. Key words:Cyst, dentigerous cyst, mexican, odontogenic cyst, radicular cyst. PMID:28469818

The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil

PubMed Central

Urrutia-Pereira, Marilyn; Avila, Jennifer; Solé, Dirceu

2016-01-01

Objective : To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Methods : Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents (< 18 years of age) with asthma or suspected asthma. Patients either enroll in PIPA spontaneously or are referred by pediatricians or primary care physicians. In this retrospective study, we use a standardized protocol to assess PIPA patients. Results : By the end of the study period, 646 patients were being followed. Of those, 298 (46.1%) were ≤ 3 years of age. In this group of patients, recurrent wheezing was identified in 60.7%, and the first episode of wheezing occurred in the first six months of life in 86.0%. Severe wheezing was identified in 29.5% and 45.4% in the children ≤ 3 and > 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. Conclusions : A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood. PMID:26982040

Beyond Stroke Prevention in Atrial Fibrillation: Exploring Further Unmet Needs with Rivaroxaban.

PubMed

Gibson, C M; Hankey, G J; Nafee, T; Welsh, R C

2018-03-22

With improved life expectancy and the aging population, the global burden of atrial fibrillation (AF) continues to increase, and with AF comes an estimated fivefold increased risk of ischaemic stroke. Prophylactic anticoagulant therapy is more effective in reducing the risk of ischaemic stroke in AF patients than acetylsalicylic acid or dual-antiplatelet therapy combining ASA with clopidogrel. Non-vitamin K antagonist oral anticoagulants are the standard of care for stroke prevention in patients with non-valvular AF. The optimal anticoagulant strategy to prevent thromboembolism in AF patients who are undergoing percutaneous coronary intervention and stenting, those who have undergone successful transcatheter aortic valve replacement and those with embolic stroke of undetermined source are areas of ongoing research. This article provides an update on three randomized controlled trials of rivaroxaban, a direct, oral factor Xa inhibitor, that are complete or are ongoing, in these unmet areas of stroke prevention: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in patients with Atrial Fibrillation who undergo Percutaneous Coronary Intervention (PIONEER AF-PCI) trial; the New Approach riVaroxaban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE ESUS) trial and the Global study comparing a rivAroxaban-based antithrombotic strategy to an antipLatelet-based strategy after transcatheter aortIc vaLve rEplacement to Optimize clinical outcomes (GALILEO) trial. The data from these studies are anticipated to help address continuing challenges for a range of patients at risk of stroke. Schattauer.

[Malama project in the Region of Murcia (Spain): environment and breastfeeding].

PubMed

Ortega García, J A; Pastor Torres, E; Martínez Lorente, I; Bosch Giménez, V; Quesada López, J J; Hernández Ramón, F; Alcaráz Quiñonero, M; Llamas del Castillo, M M; Torres Cantero, A M; García de León González, R; Sánchez Solís de Querol, M

2008-05-01

To identify protective factors and risk factors for the initiation and length of breastfeeding and full breastfeeding, in the Region of Murcia (Spain). The Malama study (Medio Ambiente y Lactancia Materna) is a follow up study from birth up to years of 1,000 mother-child pairs. A description of breastfeeding practices are presented here, the survival curve of breastfeeding and a Cox regression model of the pilot study that includes 101 mother-child pairs and 6 months of follow-up. After six months the prevalence of breastfeeding was 35 %. The mean duration of full breastfeeding was 63 days (median 45 days) with six months prevalence of 8 %. Hazard ratios (HR) for full breastfeeding were, to be a smoker (1.89; 95 % CI: 1.18-3.02), older than 35 years of age (2.04; 95 % CI: 1.22-3.42), caesarean birth (1.63; 95 % CI: 1.00-2.66). As well as those previously mentioned risks for breastfeeding, there were also hazard ratios for primary school education or less (1.63; 95 % CI: 0.98-2.82); to have breastfed an earlier child for at least 16 weeks (0.33; 95 % CI: 0.13-0.79), and to be the first birth (0.50; 95 % CI: 0.27-0.95). The length of both breastfeeding and full breastfeeding increased with the length of the maternal leave (0.96; 95 % CI: 0.94-0.99). Pregestational occupational exposure to endocrine disruptors did not seem to interfere with the duration of breastfeeding. In order to improve quality and duration of breastfeeding programmes, paediatric research and training on breastfeeding practice should be encouraged, to reduce unnecessary caesarean sections, promote tobacco cessation, focus human and economic resources to women with less education, and include legal mechanisms to ensure longer maternal leave.

Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review.

PubMed

Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

2016-09-01

to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units. identificar evidências de cuidados para prevenção de infecção de corrente sanguínea relacionada a cateter venoso central em pacientes adultos em Unidades de Terapia Intensiva. revisão Sistemática realizada por meio de busca nas bases de dados Pubmed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf e Cochrane. Foram buscadas pesquisas com cuidados com a cateterização e manutenção do cateter venoso central, publicados de janeiro de 2011 a julho de 2014. Os 34 estudos incluídos foram organizados em um instrumento e avaliados por meio da classificação do The Joanna Briggs Institute. os estudos apresentaram bundles de cuidados com elementos como a higiene das mãos e precauções máximas de barreira; programas multidimensionais e estratégias como cateteres e curativos impregnados e o envolvimento da instituição e engajamento da equipe nos esforços para prevenção de infecção. os cuidados no formato de bundles aliados com a educação e engajamento da equipe e

Assessment of visual health campaign activities at schools: teachers' perception.

PubMed

Carvalho, Regina de Souza; Temporini, Edméa Rita; Kara-José, Newton

2007-01-01

1) To assess the opinion of teachers involved in visual screening of school-age children and their referral to ophthalmologic examination within the "Eye-to-Eye National Campaign for Visual Disorders Prevention and Rehabilitation" (Campanha Nacional de Prevenção e Reabilitação Visual Olho no Olho); 2) To identify the teachers' perception with respect to the training received for conducting the campaign. A descriptive study has been conducted, based on data recorded from the application of a questionnaire to 1,517 elementary school teachers working in public schools in 27 Brazilian states. The following items were examined: received orientation, use of educational videos and handbooks, supplied explanations, difficulties, questions and overall campaign assessment. 82.0% of the teachers stated they had received orientation and 92.0% stated they had read the "Teacher Orientation Manual". Among those who received orientation, 47.0% stated it had been supplied by school officials; 30.0%, by healthcare agents, and 23.0% by ophthalmologists. In the self-assessment of performance, 58.0% reported no difficulties; 32.0% reported questions concerning the campaign activities and the professionals who most frequently asked to provide clarification were those from the State Education Agency (38.0%), followed by the school director (20.0%). Most teachers considered themselves adequately trained and oriented to take part in the campaign. Teachers' training was provided by administrative officials, previously trained by ophthalmologists ("multiplying effect") and the small percentage of questions raised indicated the validity of the procedure. Concerns have been raised as to the information about the ophthalmologic examination, transportation of the children and delivery of glasses. This kind of program always presents some difficulties and requires adjustments. It should, indeed, be improved, perhaps through a closer involvement of the community and families during its

Non-authoritative parents and impact on drug use: the perception of adolescent children.

PubMed

Benchaya, Mariana C; Bisch, Nadia K; Moreira, Taís C; Ferigolo, Maristela; Barros, Helena M T

To evaluate the association between drug use and parenting styles perceived by Brazilian adolescent children. This cross-sectional study enrolled adolescents aged 14 to 19 years that used the Serviço Nacional de Orientações e Informações sobre a Prevenção do Uso Indevido de Drogas (VIVAVOZ). A total of 232 adolescents participated in the study. Phone interviews were conducted using the Parental Responsiveness and Demandingness Scale, which classifies maternal and paternal styles perceived by adolescent children as authoritative, neglectful, indulgent or authoritarian. Sociodemographic variables were collected and an instrument was used to assess monthly drug use and abuse. Maternal and paternal parenting styles perceived as neglectful, indulgent or authoritarian (non-authoritative) were significantly associated with drug use (odds ratio [OR] = 2.8; 95% confidence interval [95%CI], 1.3-5.7 for mothers and OR = 2.8; 95%CI, 1.3-6.3 for fathers). Non-authoritative styles also had a significant association with tobacco use in the previous month in the analysis of maternal (OR = 2.7; 95%CI, 1.2-6.5) and paternal (OR = 3.9; 95%CI, 1.4-10.7) styles, and use of cocaine/crack in the previous month (OR = 3.9; 95%CI, 1.1-13.8) and abuse of any drug (OR = 2.2; 95%CI, 1.0-5.1) only for the paternal style. Logistic regression revealed that maternal style (OR = 3.3; 95%CI, 1.1-9.8), adolescent sex (OR = 3.2; 95%CI, 1.5-7.2) and age (OR = 2.8; 95%CI, 1.2-6.2) were associated with drug use. Adolescents that perceived their mothers as non-authoritative had greater chances of using drugs. There was a strong association between non-authoritative paternal styles and adolescent drug abuse.

Hypertriglyceridemia: Is there a role for prophylactic apheresis? A case report.

PubMed

Francisco, Ana Rita; Gonçalves, Inês; Veiga, Fátima; Pedro, Mónica Mendes; Pinto, Fausto J; Brito, Dulce

2016-01-01

Severe hypertriglyceridemia has been consistently associated with an increased risk of cardiovascular disease and other complications, namely acute pancreatitis. We report a case of a 64 year-old woman with hypertrophic cardiomyopathy and metabolic syndrome with triglyceride level of 3260 mg/dL. Plasma exchange was performed with simultaneous medical treatment to achieve a rapid and effective lowering of triglycerides in order to prevent clinical complications. After three plasmapheresis sessions a marked reduction in triglyceride and total cholesterol levels was observed. Several cases have shown the importance of plasmapheresis in the treatment of acute pancreatitis. We intend to demonstrate the applicability of this technique as primary prophylaxis in the presence of extremely high serum triglyceridemia levels. Resumo A hipertrigliceridemia grave tem sido associada de forma consistente ao aumento do risco cardiovascular e a outras complicações, nomeadamente, pancreatite aguda. Descrevemos um caso de uma mulher de 64 anos, com miocardiopatia hipertrófica e síndrome metabólica com valor sérico de triglicerídeos de 3260 mg/dL. Foi efectuada plasmaferese e optimizado o tratamento médico para alcançar uma redução rápida e efectiva dos níveis dos triglicerídeos, prevenindo complicações clínicas. Após três sessões de plasmaferese, verificou-se uma redução marcada dos triglicerídeos e do colesterol total. Existem alguns casos descritos na literatura demonstrado a importância da plasmaferese no tratamento da pancreatite aguda em contexto de hipertrigliceridemia grave. Os autores pretendem com este caso demonstrar a aplicabilidade desta técnica em contexto de prevenção primária em doentes com níveis de triglicerídeos extremamente aumentados.

Vitamina D y riesgo de preeclampsia: revisión sistemática y metaanálisis.

PubMed

Serrano-Díaz, Norma Cecilia; Gamboa-Delgado, Edna Magaly; Domínguez-Urrego, Clara Lucía; Vesga-Varela, Andrea Liliana; Serrano-Gómez, Sergio Eduardo; Quintero-Lesmes, Doris Cristina

2018-05-01

Introducción. Cada vez son más los hallazgos sobre la relación entre las concentraciones de vitamina D en el ser humano y diversas condiciones clínicas. Hay una gran cantidad de estudios que informan sobre dicha asociación, especialmente con complicaciones obstétricas, incluidas la preeclampsia y la diabetes mellitus de la gestación, entre otras, pero sus resultados todavía no son definitivos, por lo que se requieren estudios de intervención de calidad que confirmen la relación de la vitamina D con dichos resultados.Objetivo. Revisar la información plasmada en estudios en torno al papel de la vitamina D materna y el desarrollo de la preeclampsia.Materiales y métodos. La metodología usada siguió las recomendaciones de la guía Cochrane para la elaboración de revisiones sistemáticas y de la guía del grupo Meta-analysis of Observational Studies in Epidemiology (MOOSE) para los metaanálisis. La búsqueda incluyó estudios observacionales y ensayos clínicos controlados.Resultados. Los niveles bajos de vitamina D, medida con el examen de 25-hidroxivitamina D, son comunes en el embarazo. Los resultados de esta revisión sistemática y del metaanálisis sugieren una asociación inversa entre los niveles de vitamina D y el desarrollo de preeclampsia. Hubo heterogeneidad en los estudios en cuanto a su diseño, población y ubicación geográfica, así como a las definiciones de exposición y resultado. Los ensayos clínicos controlados aleatorizados se excluyeron del metaanálisis.Conclusión. Se encontró una asociación inversa que sugiere que, a mayores concentraciones de vitamina D, menor es la probabilidad de desarrollar preclampsia, a pesar de la heterogeneidad de la medida global en este tipo de análisis.

Taking a look to promoting health and complications' prevention: differences by context.

PubMed

Freire, Rosa Maria de Albuquerque; Landeiro, Maria José Lumini; Martins, Maria Manuela Ferreira Pereira da Silva; Martins, Teresa; Peres, Heloísa Helena Ciqueto

2016-08-08

to acknowledge and compare the health promotion and complications' prevention practices performed by nurses working in hospital and primary health care contexts. descriptive, exploratory and crosscutting study, performed with 474 nurses selected by convenience sampling. It was used a form that encompassed two categories of descriptive statements about quality in the professional exercise of nurses. This study had ethical committee approval. the nurses' population was mainly women (87,3%) with an average age of 35,5 years. There was more practices of the hospital's nurses related to the identification of potential problems of the patient (p=0.001) and supervision of the activities that put in place the nursing interventions and the activities that they delegate (p=0.003). the nurses perform health promotion and complications' prevention activities, however not in a systematic fashion and professional practices differ by context. This study is relevant as it may promote the critical consciousness of the nurses about the need of stressing quality practices. conhecer e comparar as práticas de promoção da saúde e prevenção de complicações de enfermeiros que exercem em contexto hospitalar e em cuidados de atenção básica à saúde. estudo descritivo, exploratório e transversal desenvolvido com 474 enfermeiros, selecionados por meio de amostragem por conveniência. Foi utilizado questionário que integrou duas categorias de enunciados descritivos de qualidade do exercício profissional dos enfermeiros. O estudo foi aprovado em comitê de ética. a maioria dos enfermeiros era do sexo feminino (87,3%), com idade média de 35,5 anos. Houve mais práticas dos enfermeiros dos cuidados básicos à saúde relativamente a promoção de estilos de vida saudável (<0.001) e encaminhamento de situações problemáticas identificadas, para outros profissionais (p=0.039). Houve mais práticas dos enfermeiros do hospital relativamente a identificação dos problemas

Cardiovascular Risk Stratification and Statin Eligibility Based on the Brazilian vs. North American Guidelines on Blood Cholesterol Management.

PubMed

Cesena, Fernando Henpin Yue; Laurinavicius, Antonio Gabriele; Valente, Viviane A; Conceição, Raquel D; Santos, Raul D; Bittencourt, Marcio S

2017-06-01

íduos saudáveis em prevenção primária: avaliar a relação entre o risco cardiovascular segundo a V Diretriz Brasileira de Dislipidemias e o risco calculado pelas pooled cohort equations (PCE); comparar a proporção de indivíduos elegíveis para estatinas, de acordo com diferentes critérios. Em indivíduos de 40 a 75 anos submetidos consecutivamente a avaliação rotineira de saúde em um único centro, quatro critérios de elegibilidade para estatina foram definidos: BR-1, BR-2 (LDL-c acima ou pelo menos 30 mg/dL acima da meta preconizada pela diretriz brasileira, respectivamente), EUA-1 e EUA-2 (risco estimado pelas PCE em 10 anos ≥ 5,0% ou ≥ 7,5%, respectivamente). Foram estudados 13.947 indivíduos (48 ± 6 anos, 71% homens). A maioria dos indivíduos de risco intermediário ou alto pela V Diretriz apresentou risco calculado pelas PCE baixo e mais de 70% daqueles considerados de alto risco o foram devido à presença de fator agravante. Foram elegíveis para estatina 24%, 17%, 4% e 2% das mulheres pelos critérios BR-1, BR-2, EUA-1 e EUA-2, respectivamente (p < 0,01). Os respectivos valores para os homens foram 75%, 58%, 31% e 17% (p < 0,01). Oitenta e cinco por cento das mulheres e 60% dos homens elegíveis para estatina pelo critério BR-1 não seriam candidatos pelo critério EUA-1. Comparada à diretriz norte-americana, a V Diretriz Brasileira considera uma proporção substancialmente maior da população como elegível para estatina em prevenção primária. Isso se relaciona com discrepâncias entre o risco estratificado pela diretriz brasileira e o calculado pelas PCE, particularmente devido à reclassificação de risco baseada em fatores agravantes.

Ricadute metalinguistiche dell'insegnamento dell'esperanto sulla lingua materna dell'alunno: Un'esperienza nella scuola media italiana (Metalinguistic Benefits of Planned Language Instruction: The Case of Esperanto in an Italian Secondary School).

ERIC Educational Resources Information Center

Pinto, Maria Antonietta; Corsetti, Renato

2001-01-01

Two groups of secondary school students participated in an experiment on the effect of Esperanto instruction on their metalinguistic abilities. The group that studied Esperanto for a full school year achieved better results on independently developed tests of metalinguistic ability in comparison with the control group. Results suggest the teaching…

Positive deviance as a strategy to prevent and control bloodstream infections in intensive care.

PubMed

Oliveira, Francimar Tinoco de; Ferreira, Maria Manuela Frederico; Araújo, Silvia Teresa Carvalho de; Bessa, Amanda Trindade Teixeira de; Moraes, Advi Catarina Barbachan; Stipp, Marluci Andrade Conceição

2017-04-03

To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. In 90 days, 188 actions were observed, of these, 36.70% (n=69) were related to catheter dressing. In 81.15% (n=56) of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care. Descrever a aplicação do Positive Deviance como estratégia na prevenção e no controle da infecção de corrente sanguínea. Estudo de intervenção realizado na Unidade de Terapia Intensiva de um hospital universitário, com os membros das equipes de enfermagem e médica, de junho a dezembro de 2014. Foram aplicados os quatro passos da metodologia Positive Deviance: Definir, Determinar, Descobrir e Desenhar. Em 90 dias 188 ações foram observadas, destas, 36,70% (n=69) estavam relacionadas aos curativos dos cateteres. Em 81,15% (n=56) desses curativos, o uso da haste flexível estéril para realização da antissepsia do local de inserção do cateter e de sua placa de fixação foi a ação de maior adesão. O Positive Deviance auxiliou na implementação de propostas de melhorias de processo de trabalho e no desenvolvimento da equipe para os problemas identificados no cuidado com o cateter venoso central.

Emerging arboviruses and public health challenges in Brazil.

PubMed

Lima-Camara, Tamara Nunes

2016-06-27

Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country's public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. RESUMO A modificação do ambiente por ações antrópicas, o crescimento urbano desordenado, o processo de globalização do intercâmbio internacional e as mudanças climáticas são alguns fatores que vêm facilitando a emergência e disseminação de doenças infecciosas humanas transmitidas por vetores. Este comentário aborda a recente entrada de três arbovírus no Brasil, Chikungunya (CHIKV), West Nile (WNV) e Zika (ZIKV), com enfoque nos desafios para a Saúde Pública do País. Transmitidos por mosquitos vetores amplamente distribuídos no território nacional e associados ao homem, a população brasileira encontra-se exposta à infecção por esses três arbovírus. Na ausência de vacina eficaz e tratamento específico, são importantes a manutenção e integração de uma vigilância entomológica e epidemiológica contínua, a fim de direcionarmos métodos de controle e prevenção contra essas arboviroses no País.

II Brazilian Consensus on the use of human immunoglobulin in patients with primary immunodeficiencies.

PubMed

Goudouris, Ekaterini Simões; Rego Silva, Almerinda Maria do; Ouricuri, Aluce Loureiro; Grumach, Anete Sevciovic; Condino-Neto, Antonio; Costa-Carvalho, Beatriz Tavares; Prando, Carolina Cardoso; Kokron, Cristina Maria; Vasconcelos, Dewton de Moraes; Tavares, Fabíola Scancetti; Silva Segundo, Gesmar Rodrigues; Barreto, Irma Cecília; Dorna, Mayra de Barros; Barros, Myrthes Anna; Forte, Wilma Carvalho Neves

2017-01-01

In the last few years, new primary immunodeficiencies and genetic defects have been described. Recently, immunoglobulin products with improved compositions and for subcutaneous use have become available in Brazil. In order to guide physicians on the use of human immunoglobulin to treat primary immunodeficiencies, based on a narrative literature review and their professional experience, the members of the Primary Immunodeficiency Group of the Brazilian Society of Allergy and Immunology prepared an updated document of the 1st Brazilian Consensus, published in 2010. The document presents new knowledge about the indications and efficacy of immunoglobulin therapy in primary immunodeficiencies, relevant production-related aspects, mode of use (routes of administration, pharmacokinetics, doses and intervals), adverse events (major, prevention, treatment and reporting), patient monitoring, presentations available and how to have access to this therapeutic resource in Brazil. RESUMO Nos últimos anos, novas imunodeficiências primárias e defeitos genéticos têm sido descritos. Recentemente, produtos de imunoglobulina, com aprimoramento em sua composição e para uso por via subcutânea, tornaram-se disponíveis em nosso meio. Com o objetivo de orientar o médico no uso da imunoglobulina humana para o tratamento das imunodeficiências primárias, os membros do Grupo de Assessoria em Imunodeficiências da Associação Brasileira de Alergia e Imunologia produziram um documento que teve por base uma revisão narrativa da literatura e sua experiência profissional, atualizando o I Consenso Brasileiro publicado em 2010. Apresentam-se novos conhecimentos sobre indicações e eficácia do tratamento com imunoglobulina nas imunodeficiências primárias, aspectos relevantes sobre a produção, forma de utilização (vias de administração, farmacocinética, doses e intervalos), efeitos adversos (principais efeitos, prevenção, tratamento e notificação), monitorização do

In vitro decidualisation of canine uterine stromal cells.

PubMed

Kautz, Ewa; de Carvalho Papa, Paula; Reichler, Iris M; Gram, Aykut; Boos, Alois; Kowalewski, Mariusz P

2015-08-05

The uterine response to the presence of embryos is poorly understood in the domestic dog (Canis familiaris). The intimate embryo-maternal cross-talk, which begins following the hatching of blastocysts and embryo attachment leads to strong structural and functional remodelling of the uterus. A part of this process is decidualisation, comprising morphological and biochemical changes that result in formation of maternal stroma-derived decidual cells. These are an integral part of the canine placenta materna, which together with the maternal vascular endothelium are the only cells of the canine endotheliochorial placenta able to resist trophoblast invasion. These cells are also the only ones within the canine placenta expressing the progesterone receptor (PGR). Understanding the decidualisation process thus appears essential for understanding canine reproductive physiology. Here, we investigated the capability of canine uterine stromal cells to decidualise in vitro, thereby serving as a canine model of decidualisation. A dbcAMP-mediated approach was chosen during a time course of 24 - 72 h. Tissue material from six (n = 6) healthy, dioestric bitches was used (approximately 2 weeks after ovulation). Cells were characterized by differential staining, nearly 100 % of which were vimentin-positive. Scanning and transmission electron microscope analyses were applied, and morphological changes were recorded with a live cell imaging microscope. Expression of several decidualisation markers was investigated. The in vitro cultured stromal cells acquired characteristics of decidual cells when incubated with 0.5 mM dbcAMP for 72 h. Their shape changed from elongated to rounded, while ultrastructural analysis revealed higher numbers of mitochondria and secretory follicles, and an increased proliferation rate. Elevated expression levels of IGF1, IGF2, PRLR and ERα were observed in decidualised cells; PRL and ERβ remained mostly below the detection limit, while PGR

Microbiological testing of devices used in maintaining peripheral venous catheters.

PubMed

Rossini, Fernanda de Paula; Andrade, Denise de; Santos, Lissandra Chaves de Sousa; Ferreira, Adriano Menis; Tieppo, Caroline; Watanabe, Evandro

2017-05-15

to evaluate the use of peripheral venous catheters based on microbiological analysis of devices (dressing and three-way stopcocks) and thus contribute to the prevention and infection control. this was a prospective study of microbiological analysis of 30 three-way stopcocks (external surfaces and lumens) and 30 dressing used in maintaining the peripheral venous catheters of hospitalized adult patients. all external surfaces, 40% of lumens, and 86.7% of dressing presented bacterial growth. The main species isolated in the lumen were 50% coagulase-negative Staphylococcus, 14.3% Staphylococcus aureus, and 14.3% Pseudomonas aeruginosa. Fifty nine percent of multidrug-resistant bacteria were isolated of the three-way stopcocks, 42% of the lumens, and 44% of the dressing with a predominance of coagulase-negative Staphylococcus resistant to methicillin. Besides, 18% gram-negative bacteria with resistance to carbapenems were identified from multidrug-resistant bacteria on the external surfaces of the three-way stopcocks. it is important to emphasize the isolation of coagulase-negative Staphylococcus and gram-negative bacteria resistant to methicillin and carbapenems in samples of devices, respectively, which reinforces the importance of nursing care in the maintenance of the biologically safe environment as well as prevention and infection control practices. avaliar o uso de cateteres venosos periféricos com base em análises microbiológicas de dispositivos (curativos e torneiras de três vias - T3Vs) e assim contribuir para a prevenção e controle de infecção. estudo prospectivo de análise microbiológica de 30 T3Vs (superfícies externas e lúmens) e 30 curativos utilizados na manutenção dos cateteres venosos periféricos de pacientes adultos hospitalizados. todas as superfícies externas, 40% dos lúmens e 86,7% dos curativos apresentaram crescimento bacteriano. As principais espécies isoladas no lúmen foram 50% Staphylococcus coagulase-negativa, 14

Arboviruses emerging in Brazil: challenges for clinic and implications for public health.

PubMed

Donalisio, Maria Rita; Freitas, André Ricardo Ribas; Zuben, Andrea Paula Bruno Von

2017-04-10

ência de tratamento, vacinas e medidas efetivas de prevenção e controle.

Cholesterol and prevention of atherosclerotic events: limits of a new frontier.

PubMed

Macedo, Luís Eduardo Teixeira de; E, Faerstein

2017-01-12

Control of atherosclerotic cardiovascular disease - a highly prevalent condition and one of the main causes of mortality in Brazil and worldwide - is a recurrent subject of great interest for public health. Recently, three new guidelines on dyslipidemia and atherosclerosis prevention have been published. The close release of these important publications is a good opportunity for comparison: the Brazilian model has greater sensitivity, the English model does not work with risk stratification, and the American model may be overestimating the risk. This will allow reflection on current progress and identification of controversial aspects which still require further research and debate. It is also an opportunity to discuss issues related to early diagnosis and its efficiency as a preventive strategy for atherosclerotic disease: the transformation of risk into disease, the gradual reduction of cut-off points, the limitations of the screening strategy, and the problem of overdiagnosis. RESUMO O controle da doença cardiovascular aterosclerótica - morbidade de alta prevalência e uma das principais causas de mortalidade no Brasil e no mundo - continua sendo tema de grande interesse para a Saúde Pública. Recentemente, três novas diretrizes sobre dislipidemia e prevenção da aterosclerose foram divulgadas. A convergência no tempo dessas importantes publicações constitui boa oportunidade para sua comparação: o modelo brasileiro tem maior sensibilidade, o inglês não trabalha com risco estratificado e o norte-americano parece estar superestimando o risco.Isso permitirá reflexões acerca dos avanços que já foram alcançados e identificação de aspectos ainda controversos, que seguem exigindo novas pesquisas e debates. É também uma oportunidade para discutir questões relacionadas ao diagnóstico precoce e sua eficiência como estratégia preventiva da doença aterosclerótica: as transformações do risco em doença, a diminuição progressiva de pontos de

Telemedicine: challenges to dissemination in Brazil.

PubMed

Maldonado, Jose Manuel Santos de Varge; Marques, Alexandre Barbosa; Cruz, Antonio

2016-11-03

hospitais e centros de referência no que se refere à prevenção, diagnóstico e tratamento.

Negative pressure therapy for the treatment of complex wounds.

PubMed

Lima, Renan Victor Kümpel Schmidt; Coltro, Pedro Soler; Farina, Jayme Adriano

2017-01-01

The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response. The main indications of NPT are complex wounds, such as pressure ulcers, traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, prevention of complications in closed incisions and in the association with instillation of solutions in infected wounds. RESUMO O objetivo desse estudo é avaliar a eficácia da terapia por pressão negativa (TPN) no tratamento de feridas complexas, com ênfase em seus mecanismos de ação e principais indicações terapêuticas. Foi realizada revisão na base de dados Pubmed / Medline, em artigos publicados de 1997 a 2016, e selecionados os mais relevantes. O mecanismo de ação da TPN envolve efeitos físicos, como o aumento da perfusão, controle do edema e do exsudato, redução das dimensões da ferida e depuração bacteriana, e biológicos, como o estímulo à formação de tecido de granulação, microdeformações e redução da resposta inflamatória local. As principais indicações da TPN são as feridas complexas como úlceras por pressão, feridas traumáticas, deiscências de ferida operatória, queimaduras, feridas necrotizantes, úlceras venosas, feridas diabéticas, os enxertos de pele, o abdome aberto, na prevenção de complicações em incisões fechadas e na associação com instilação de soluções em feridas

Solving real decay and conservation problems of building materials by ultrasounds technique

NASA Astrophysics Data System (ADS)

Alvarez de Buergo, Monica; Fort, Rafael; Gomez-Heras, Miguel; Vazquez-Calvo, Carmen

2010-05-01

belonging to the Spanish National Heritage or Trust, archaeological structures and sculptures), and also to laboratory research to understand processes and helpful to see the best way of preservation. In some of the cases, other techniques have been used as complementary, such as sclerommetry, magnetometry and IR termography. Acknowledgements: to both MATERNAS (0505/MAT/0094) and GEOMATERIALES (2009-1629) research programmes, funded by the Regional Government of Madrid; and to the CONSOLIDER-INGENIO programme (CSD2007-0058), funded by the Spanish Ministry of Education and Science.

Cancellation of elective surgeries in a Brazilian public hospital: reasons and estimated reduction.

PubMed

Santos, Gisele Aparecida Alves Corral Dos; Bocchi, Silvia Cristina Mangini

2017-01-01

cirúrgico eletivo apresentar-se menor que de outros hospitais de características semelhantes, ainda é possível reduzi-la de 6,79% para 1,36%, considerando que 80% das razões de cancelamento são preveníveis.

Incidence and factors related to delirium in an intensive care unit.

PubMed

Mori, Satomi; Takeda, Juliana Rumy Tsuchihashi; Carrara, Fernanda Souza Angotti; Cohrs, Cibelli Rizzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

2016-01-01

resultados mostraram elevada incidência de delirium na UTI e sua ocorrência associada às idades mais avançadas e o uso de sedativos e analgésicos, ressaltando-se a importância da atuação do enfermeiro na prevenção e identificação precoce do quadro nos pacientes com essas características.

Pre-hospital haemostatic dressings: a systematic review.

PubMed

Granville-Chapman, J; Jacobs, N; Midwinter, M J

2011-05-01

Uncontrolled haemorrhage is a leading cause of prehospital death after military and civilian trauma. Exsanguination from extremity wounds causes over half of preven military combat deaths and wounds to the anatomical junctional zones provide a particular challenge for first responders. Commercial products have been developed, which claim to outperform standard gauze bandages in establishing and maintaining non-surgical haemostasis. Since 2004, two advanced haemostatic dressing products, HemCon and QuikClot have been widely deployed in military operations. Newer products have since become available which aim to provide more efficient haemostasis than and thus supersede HemCon and QuikClot. To conduct a systematic review of clinical and preclinical evidence to compare the relative efficacy and safety of available haemostatic products, which are of relevance to pre-hospital military and civilian emergency medical providers. An English language literature search was performed, using PubMed and Web of Knowledge Databases, with cross-referencing, focussed product searches and communication with product manufacturers. For studies employing animal models, the injury model was required to produce fatal haemorrhage. Products were categorised by primary mode of action as either factor concentrators,mucoadhesive agents or procoagulant supplementors. From 60 articles collated, 6 clinical papers and 37 preclinical animal trials were eligible for inclusion in this review. Products have been tested in three different types of haemorrhage model: low pressure, high volume venous bleeding, high pressure arterial bleeding and mixed arterial-venous bleeding. The efficacy of products varies with the model adopted. Criteria for the 'ideal battle field haemostatic dressing' have previously been defined by Pusateri, but no product has yet attained suchstatus. Since 2004, HemCon (a mucoadhesive agent) and QuikClot (a factor concentrator) have been widely deployed by United States and United

Risk management in providing specialized care for people living with AIDS.

PubMed

Leadebal, Oriana Deyze Correia Paiva; Medeiros, Leidyanny Barbosa de; Morais, Kalline Silva de; Nascimento, João Agnaldo do; Monroe, Aline Aparecida; Nogueira, Jordana de Almeida

2016-01-01

Analyzing the provision of actions related to managing clinical risk in managing specialized care for people living with AIDS. A cross-sectional study carried out in a reference outpatient clinic in Paraíba, with a sample of 150 adults with AIDS. Data were collected through primary and secondary sources using a structured questionnaire, analyzed using descriptive statistics, multiple correspondence analysis and logistic regression model to determine the association between "providing care" and "clinical risk." Actions with satisfactory provision express a biological care focus; the dimensions that most contributed to a satisfactory assessment of care provision were "clinical and laboratory evaluations" and "prevention and self-care incentivization"; 45.3% of participants were categorized into high clinical risk, 34% into average clinical risk, and 20.7% into low clinical risk; a positive association between providing care and clinical risk was found. The need to use risk classification technologies to direct the planning of local care provision became evident considering its requirements, and thus qualifying the care provided in these areas. Analisar a oferta de ações relacionadas ao manejo de risco clínico na gestão do cuidado especializado a pessoas vivendo com aids. Estudo transversal realizado em ambulatório de referência na Paraíba, com amostra de 150 adultos com aids. Os dados foram coletados por meio de fontes primárias e secundárias utilizando-se de formulário estruturado, e analisados através de estatística descritiva, análise de correspondência múltipla e modelo de regressão logística para averiguar a associação entre "oferta" e "risco clínico". As ações de oferta satisfatória expressam foco biologicista do cuidado; as dimensões que mais contribuíram para o julgamento satisfatório da oferta foram "avaliação clínica e laboratorial" e "prevenção e estímulo ao autocuidado"; 45,3% dos participantes foram categorizados em risco

Repercussions of imprisonment for conjugal violence: discourses of men.

PubMed

Sousa, Anderson Reis de; Pereira, Álvaro; Paixão, Gilvânia Patrícia do Nascimento; Pereira, Nadirlene Gomes; Campos, Luana Moura; Couto, Telmara Menezes

2016-12-08

to know the consequences that men experience related to incarceration by conjugal violence. qualitative study on 20 men in jail and indicted in criminal processes related to conjugal violence in a Court specialized in Family and Domestic Violence against women. The interviews were classified based on Collective Subject Discourse method, using NVIVO(r) software. the collective discourse shows that the experience of preventive imprisonment starts a process of family dismantling, social stigma, financial hardship and psycho-emotional symptoms such as phobia, depression, hypertension, and headaches. due to the physical, mental and social consequences of the conjugal violence-related imprisonment experience, it is urgent to look carefully into the somatization process as well as to the prevention strategies regarding this process. conhecer as repercussões da prisão por violência conjugal para os homens. estudo qualitativo com 20 homens que foram presos e respondem a processo criminal por violência conjugal em uma Vara de Violência Doméstica e Familiar contra a Mulher. As entrevistas foram categorizadas com base no método do Discurso do Sujeito Coletivo, com auxílio do software NVIVO(r). o discurso coletivo revela que a vivência da prisão preventiva desencadeia desagregação familiar, estigma social, dificuldades financeiras e sintomatologia de caráter psicoemocional, como fobia, depressão, hipertensão e cefaleia. diante das repercussões físicas, mentais e sociais de experienciar a prisão em decorrência de violência conjugal, urge um olhar acerca do processo de somatização do vivido, da mesma maneira que estratégias de prevenção do fenômeno. conocer las repercusiones de prisión, por violencia conyugal, en los hombres. estudio cualitativo con 20 hombres que fueron presos y responden por caso criminal de violencia conyugal, en una Juzgado de Violencia Doméstica y Familiar contra la Mujer. Las entrevistas fueron categorizadas con base en el m

Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: a national population-based survey.

PubMed

Cárcamo, César P; Campos, Pablo E; García, Patricia J; Hughes, James P; Garnett, Geoff P; Holmes, King K

2012-10-01

We assessed prevalences of seven sexually transmitted infections (STIs) in Peru, stratified by risk behaviours, to help to define care and prevention priorities. In a 2002 household-based survey of the general population, we enrolled randomly selected 18-29-year-old residents of 24 cities with populations greater than 50 000 people. We then surveyed female sex workers (FSWs) in these cities. We gathered data for sexual behaviour; vaginal specimens or urine for nucleic acid amplification tests for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; and blood for serological tests for syphilis, HIV, and (in subsamples) herpes simplex virus 2 (HSV2) and human T-lymphotropic virus. This study is a registered component of the PREVEN trial, number ISRCTN43722548. 15 261 individuals from the general population and 4485 FSWs agreed to participate in our survey. Overall prevalence of infection with HSV2, weighted for city size, was 13·5% in men, 13·6% in women, and 60·6% in FSWs (all values in FSWs standardised to age composition of women in the general population). The prevalence of C trachomatis infection was 4·2% in men, 6·5% in women, and 16·4% in FSWs; of T vaginalis infection was 0·3% in men, 4·9% in women, and 7·9% in FSWs; and of syphilis was 0·5% in men, 0·4% in women, and 0·8% in FSWs. N gonorrhoeae infection had a prevalence of 0·1% in men and women, and of 1·6% in FSWs. Prevalence of HIV infection was 0·5% in men and FSWs, and 0·1% in women. Four (0·3%) of 1535 specimens were positive for human T-lymphotropic virus 1. In men, 65·0% of infections with HIV, 71·5% of N gonorrhoeae, and 41·4% of HSV2 and 60·9% of cases of syphilis were in the 13·3% who had sex with men or unprotected sex with FSWs in the past year. In women from the general population, 66·7% of infections with HIV and 16·7% of cases of syphilis were accounted for by the 4·4% who had been paid for sex by any of their past three partners. Defining of high

Selective Use of the Mother Tongue to Enhance Students' English Learning Processes…Beyond the Same Assumptions (Uso selectivo de la lengua materna para mejorar el proceso de aprendizaje del inglés de los estudiantes…Más allá de las mismas suposiciones)

ERIC Educational Resources Information Center

Cuartas Alvarez, Luis Fernando

2014-01-01

This article reports the results of an action-research project that examines enhancing students' English learning processes through the selective use of their mother tongues with the aim of overcoming their reluctant attitudes toward learning English in the classroom. This study involves forty ninth-graders from an all-girls public school in…

Smoking control: challenges and achievements.

PubMed

Silva, Luiz Carlos Corrêa da; Araújo, Alberto José de; Queiroz, Ângela Maria Dias de; Sales, Maria da Penha Uchoa; Castellano, Maria Vera Cruz de Oliveira

2016-01-01

Smoking is the most preventable and controllable health risk. Therefore, all health care professionals should give their utmost attention to and be more focused on the problem of smoking. Tobacco is a highly profitable product, because of its large-scale production and great number of consumers. Smoking control policies and treatment resources for smoking cessation have advanced in recent years, showing highly satisfactory results, particularly in Brazil. However, there is yet a long way to go before smoking can be considered a controlled disease from a public health standpoint. We can already perceive that the behavior of our society regarding smoking is changing, albeit slowly. Therefore, pulmonologists have a very promising area in which to work with their patients and the general population. We must act with greater impetus in support of health care policies and social living standards that directly contribute to improving health and quality of life. In this respect, pulmonologists can play a greater role as they get more involved in treating smokers, strengthening anti-smoking laws, and demanding health care policies related to lung diseases. RESUMO O tabagismo é o fator de risco mais prevenível e controlável em saúde e, por isso, precisa ter a máxima atenção e ser muito mais enfocado por todos os profissionais da saúde. O tabaco é um produto de alta rentabilidade pela sua grande produção e pelo elevado número de consumidores. As políticas de controle e os recursos terapêuticos para o tabagismo avançaram muito nos últimos anos e têm mostrado resultados altamente satisfatórios, particularmente no Brasil. Entretanto, ainda resta um longo caminho a ser percorrido para que se possa considerar o tabagismo como uma doença controlada sob o ponto de vista da saúde pública. Já se observam modificações do comportamento da sociedade com relação ao tabagismo, mas ainda em escala muito lenta, de modo que os pneumologistas têm nesse setor um campo

Incidence of colorectal cancer in young patients.

PubMed

Campos, Fábio Guilherme C M DE; Figueiredo, Marleny Novaes; Monteiro, Mariane; Nahas, Sérgio Carlos; Cecconello, Ivan

2017-01-01

idade ao diagnóstico. A informação extraída da revisão de literatura demonstrou uma tendência de redução da incidência em pessoas mais idosas com efeito oposto em adolescentes e adultos jovens. Sua agressividade biológica ainda não foi claramente reconhecida, embora seja usualmente diagnosticado mais tardiamente e em associação com características histológicas adversas. Apesar disso, estas características não afetam a evolução. Este aparente aumento na incidência de CCR entre pacientes jovens durante as últimas décadas levanta a necessidade de uma maior suspeita diagnóstica na avaliação de sintomas comuns neste grupo. Assim, programas educacionais devem disseminar informação tanto para população como para médicos a fim de melhorar a prevenção e o diagnóstico precoce.

QUALIS OF TECHNICAL PRODUCTION: METRIC DEVELOPMENT FOR MANUALS.

PubMed

Pacheco, Adhemar Monteiro; Mendes, Carlos José Lazzarini

2015-01-01

There are few authors focused on the study of preparing manuals criteria, often criticized for methodological rigor of the information. However, it is interesting to understand what is going wrong; to understand prognosis in self-handling; in prevention of complications; in identifying better services and information; in encouraging the pursuit of excellence in the healthcare. In its preparation should be valued the basic requirements of a manual, which are: 1) wrote in simple words, being concise, efficient, clear with index or table of contents; 2) using the existing institutional rules; 3) being flexible; and 4) having ongoing process of review, update and distribution. In the process of evaluation of Medicine III manuals may have the following stratification: M4 - 100 points: when there is ISBN registration and disclosure in other languages; M3 - 75 points: registration with the ISBN only in our country; M2 - 50 points: registered in regional libraries; M1 - 25 points: manual use for inter-departmental or intra-institutional groups; M0 - 0 point: use of manual in intra-departmental teaching. In conclusion, it is known that the use of manuals is focused to the ones who do not know the subject; however, it is also an important tool that can minimize errors, avoid professional misconduct, optimize resources, and at the end allowing assessment of the subject at hand. Poucos são os autores que se debruçam no estudo dos critérios de elaboração de manuais, sendo muitas vezes criticados pelo rigor metodológico das informações. Contudo, eles são interessantes no entender o que é errado, compreender prognóstico, na autoassistência, na prevenção de complicações, para identificar melhores serviços e informações, motivando a busca pela excelência no atendimento assistencial. Em sua elaboração devem ser valorizados os requisitos básicos de um manual, que são: 1) conter redação simples, concisa, eficiente e clara, contendo índice ou sumário; 2

Translation and cultural adaptation of the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) to evaluate quality of life in women with cervical intraepithelial neoplasia.

PubMed

Fregnani, Cristiane Menezes Sirna; Fregnani, José Humberto Tavares Guerreiro; Paiva, Carlos Eduardo; Barroso, Eliane Marçon; Camargos, Mayara Goulart de; Tsunoda, Audrey Tieko; Longatto-Filho, Adhemar; Paiva, Bianca Sakamoto Ribeiro

2017-01-01

, um de Portugal e um dos Estados Unidos. Ao término do processo de tradução e retrotradução, deu-se início ao processo de análise semântica. Foram incluídas aleatoriamente 20 mulheres entre 18 e 70 anos com exame de citologia cervical alterado, atendidas no Departamento de Prevenção e Ginecologia Oncológica do Hospital de Câncer de Barretos. A amostra foi composta por mulheres com baixa escolaridade. No primeiro pré-teste participaram dez mulheres, sendo que a metade considerou as questões CD1, CD2 e CD3 difíceis por não compreenderem o significado do termo "região pélvica". A questão CD5, "Estou preocupada em disseminar a infecção", também foi considerada de difícil entendimento por cinco mulheres. Após as reconsiderações do comitê de especialistas e do grupo FACIT, foi realizado o segundo pré-teste. Nesta fase, pode-se concluir que os problemas de entendimento anteriores foram resolvidos. A versão traduzida do FACIT-CD é equivalente à versão original em inglês e em língua portuguesa universal, sendo facilmente compreendida pelas pacientes com neoplasia intraepitelial cervical.

Anisotropy indices and the effects on the hydric behaviour of natural stone

NASA Astrophysics Data System (ADS)

Fort, Rafael; Alvarez de Buergo, Monica; Varas, Maria Jose; Gomez-Heras, Miguel

2010-05-01

anisotropy are those with the highest capillarity coefficient. It can also be observed that for each petrological variety, this capillarity coefficient is higher in the specimens classified as a high level anisotropy class. At the same time, when capillary water is absorbed along the direction perpendicular to the anisotropic planes, the absorption capacity diminishes, no matter the anisotropy level of the stone is. On the contrary, capillary coefficients are higher when measurements are performed in a parallel direction to that of the greatest anisotropy of the stone specimen, where absorption tends to be faster with higher coefficients according to the porosity size and its geometry. These increments are more significant in the stone varieties in which anisotropy is mainly due to fissuring or schistosity planes, or related to stromatolitic planes or oriented minerals accumulation. The arrangement and placing of rocks used as building materials with a significant anisotropy will highly condition the durability and lifetime of a considered element. For that reason, is essential to determine anisotropy indices to obtain the best and most adequate arrangement of stone elements in building works, minimizing water entry and thus, the material decay. Acknowledgements: to both MATERNAS (0505/MAT/0094) and GEOMATERIALES (2009-1629) research programmes, funded by the Regional Government of Madrid; to the CONSOLIDER-INGENIO programme (CSD2007-0058), funded by the Spanish Ministry of Education and Science; and to the Spanish Geological and Mining Institute (IGME) for the specimens preparation and hydric behaviour measurements.

Myosin-binding Protein C Compound Heterozygous Variant Effect on the Phenotypic Expression of Hypertrophic Cardiomyopathy.

PubMed

Rafael, Julianny Freitas; Cruz, Fernando Eugênio Dos Santos; Carvalho, Antônio Carlos Campos de; Gottlieb, Ilan; Cazelli, José Guilherme; Siciliano, Ana Paula; Dias, Glauber Monteiro

2017-04-01

submetida à investigação clínica e genética. As regiões codificadoras dos genes MYH7, MYBPC3 e TNNT2 foram sequenciadas e analisadas. O probando apresenta uma manifestação maligna da doença e é o único em sua família a desenvolver CMH. A análise genética pelo sequenciamento direto dos três principais genes relacionados à essa doença identificou uma variante em heterozigose composta (p.E542Q e p.D610H) em MYBPC3. A análise da família mostrou que os alelos p.E542Q e p.D610H tem origem paterna e materna, respectivamente. Nenhum familiar portador de um dos alelos variantes manifestou sinais clínicos de CMH. Sugerimos que a expressão heterozigótica bialélica de p.E542Q e p.D610H pode ser responsável pelo fenótipo severo da doença encontrada no probando.

Using multi-country household surveys to understand who provides reproductive and maternal health services in low- and middle-income countries: a critical appraisal of the Demographic and Health Surveys

PubMed Central

Footman, K; Benova, L; Goodman, C; Macleod, D; Lynch, C A; Penn-Kekana, L; Campbell, O M R

2015-01-01

èmes tels que l'amalgame d'options de réponses, les données sur les prestataires du public par rapport à ceux du privé, l'incohérence dans le codage et l'obtention de métadonnées. Plus de collecte systématique et standardisée des données aiderait les comparaisons internationales des progrès vers une meilleure protection financière et nous permettra de mieux caractériser les incitations et la nature commerciale des différents prestataires. Objetivo Las Encuestas Demográficas y de Salud (EDS) son una fuente de datos vitales para el análisis comparativo entre países. Este artículo es parte de un grupo de análisis que evalúan los tipos de proveedores de atención a la salud reproductiva y materna que están siendo utilizados en 57 países. Examinamos algunos de los retos encontrados al utilizar datos de EDS con este propósito, presentamos la clasificación de proveedores que hemos usado, y proveemos recomendaciones para permitir una comparación más detallada y más precisa de la prestación de servicios sanitarios en diferentes países. Métodos Hemos utilizado datos de las EDS más recientes, entre el 2000 y 2012; 57 países tenían datos sobre planeación familiar y proveedores de servicios durante el parto y 47 países tenían datos sobre cuidados prenatales. Cada opción posible de respuesta en los 57 países fue listada y categorizada. Después se desarrolló una clasificación para agrupar las opciones de respuesta según proveedor, siguiendo dos dimensiones clave: naturaleza clínica y afán de lucro. Resultados Hemos clasificado los diferentes tipos de proveedores de cuidados sanitarios en salud materna y reproductiva, y a los individuos que ofrecían los servicios. Los retos documentados durante este proceso fueron las limitaciones inherentes a los datos en las encuestas realizadas en los hogares basados en las auto-respuestas de los encuestados; fusión de las opciones de respuesta en el cuestionario o durante la etapa de procesamiento de datos

TECHNOLOGICAL INFORMATION REGARDING PREBIOTICS AND PROBIOTICS NUTRITION VERSUS THE PATENT REGISTERS: WHAT IS NEW?

PubMed

Reis, José Maciel Caldas Dos; Pinheiro, Maurício Fortuna; Oti, André Takashi; Feitosa-Junior, Denilson José Silva; Pantoja, Mauro de Souza; Barros, Rui Sérgio Monteiro

2016-01-01

Food is a key factor both in prevention and in promoting human health. Among the functional food are highlighted probiotics and prebiotics. Patent databases are the main source of technological information about innovation worldwide, providing extensive library for research sector. Perform mapping in the main patent databases about pre and probiotics, seeking relevant information regarding the use of biotechnology, nanotechnology and genetic engineering in the production of these foods. Electronic consultation was conducted (online) in the main public databases of patents in Brazil (INPI), United States (USPTO) and the European Patent Bank (EPO). The research involved the period from January 2014 to July 2015, being used in the title fields and summary of patents, the following descriptors in INPI "prebiotic", "prebiotic" "probiotics", "probiotic" and the USPTO and EPO: "prebiotic", "prebiotics", "probiotic", "probiotics". This search haven't found any deposit at the brazilian patents website (INPI) in this period; US Patent &Trademark Office had registered 60 titles in patents and the European Patent Office (EPO) showed 10 documents on the issue. Information technology offered by genetic engineering, biotechnology and nanotechnology deposited in the form of titles and abstracts of patents in relation to early nutritional intervention as functional foods, has increasingly required to decrease the risks and control the progression of health problems. But, the existing summaries, although attractive and promising in this sense, are still incipient to recommend them safely as a therapeutic tool. Therefore, they should be seen more as diet elements and healthy lifestyles. A alimentação é fator primordial tanto na prevenção quanto na promoção para a saúde humana. Dentre os alimentos funcionais destacam-se os probióticos e prebióticos. Os bancos de dados de patentes representam a maior fonte de informação tecnológica acerca de inovação em nível mundial

Meanings and vulnerability to HIV/AIDS among long-distance truck drivers in Brazil.

PubMed

Magno, Laio; Castellanos, Marcelo Eduardo Pfeiffer

2016-12-22

To understand the meanings assigned by long-distance truck drivers to HIV/AIDS and its transmission and prevention, bearing in mind different contexts of vulnerability. Qualitative research with 22 truck drivers. Semi-structured interviews and participant observation were conducted in highways of the state of Bahia in 2013. We selected male truck drivers, with one year or more of work experience in long-distance routes. We carried out the thematic analysis of the interviews, to identify different contexts of vulnerability. The results showed that the insertion of truck drivers in contexts of high social vulnerability (poor working conditions, violence on the roads, and use of alcohol and other drugs) along with the advances in access and effectiveness of treatment for AIDS promote a reduced perception of the risk and severity of this disease. In addition, the notion of "risk group" and the symbolic division between "home space" (protected) and "street space" (unprotected) intensified a restricted and specific use of condoms, guided by the opposition between "woman of the street" (unknown women, prostitutes, among others) and "woman of the house" (wives, girlfriends). The meanings assigned by truckers to AIDS incorporated elements of recent transformations of the expanded social context, such as the development of health technologies (especially anti-retroviral drugs) and the guarantee of free access to treatment in the Brazilian public health system; but also incorporated old elements of social vulnerability context - such as the poor working conditions on Brazilian highways. Compreender os significados atribuídos pelos caminhoneiros de rota longa ao HIV/aids e à sua transmissão e prevenção, tendo em vista diferentes contextos de vulnerabilidade. Pesquisa qualitativa com 22 caminhoneiros. Foram realizadas entrevistas semi-estruturadas e observação participante em rodovias do estado da Bahia em 2013. Foram selecionados caminhoneiros do sexo masculino, com um

Complications of central venous catheter in patients transplanted with hematopoietic stem cells in a specialized service.

PubMed

Barretta, Lidiane Miotto; Beccaria, Lúcia Marinilza; Cesarino, Cláudia Bernardi; Pinto, Maria Helena

2016-06-07

educação permanente, enfocando a prevenção das complicações. identificar el modelo, el tiempo medio de permanencia y las complicaciones del catéter venoso central en pacientes sometidos a trasplante de células madre hematopoyéticas y estimar la relación de correspondencia entre las variables: edad, sexo, diagnóstico médico, tipo de trasplante, catéter implantado y sitio de inserción. estudio retrospectivo y cuantitativo con una muestra de registros de 188 pacientes trasplantados entre 2007 y 2011. la mayoría de los pacientes utilizó el catéter Hickman con una permanencia media de 47,6 días. La complicación fiebre/bacteriemia fue significativa en los varones jóvenes con linfoma no Hodgkin sometidos a trasplante autólogo, que permanecieron con el dispositivo durante un largo período en la vena subclavia. los enfermeros deben planificar con el equipo, el tiempo de espera mínimo recomendado entre la inserción del catéter y el inicio del tratamiento de condicionamiento, así como no extender el período de permanencia del catéter y realizar su formación continua, centrándose en la prevención de complicaciones.

Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews.

PubMed

Costa, Marcelle Barrueco; Melnik, Tamara

2016-01-01

Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. RESUMO Transtornos alimentares são doenças psiquiátricas originadas de e perpetuadas por fatores individuais, familiares e socioculturais. A abordagem psicossocial é essencial para o tratamento e a prevenção de recaídas. Apresentar uma vis

Comparison of Two Central Venous Pressure Control Strategies to Prevent Atrial Fibrillation After Coronary Artery Bypass Grafting.

PubMed

Costa, Mario Augusto Cray da; Lirani, Wesley; Wippich, Ana Caroline; Lopes, Luana; Tolentino, Eduardo de Souza; Zampar, Beatriz; Schafranski, Marcelo Derbli

2017-04-01

pacientes foram randomizados em dois grupos, G15 e G20, mantidos com PVC máxima de 15 cmH2O e 20 cmH2O, respectivamente. Foram incluídos 70 pacientes em cada grupo. A incidência da arritmia em G15 foi de 8,57% e, no G20, de 22,86%, com redução de risco absoluto de 14,28% e número necessário para tratar (NNT) de 7 (p = 0,03). Mortalidade (G15 = 5,71%; G20 = 11,42%; p = 0,07), tempo de internamento (G15 = 7,14 dias; G20 = 8,21 dias; p = 0,36), número de enxertos (medianas: G15 = 3, G2 = 2; p = 0,22) e uso de circulação extracorpórea (G15 = 67,10%; G20 = 55,70%; p = 0,22) mostraram-se estatisticamente semelhantes. A idade (p = 0,04) e o tempo de internamento (p = 0,001) foram significativamente maiores nos pacientes que desenvolveram FA nos dois grupos. Manter a PVC com valores mais baixos nas primeiras 72h após a cirurgia de RM reduz o risco relativo de FA e pode ser uma ferramenta útil na prevenção da FA após RM.

Factors associated with disease-specific survival of patients with non-small cell lung cancer.

PubMed

Souza, Mirian Carvalho de; Cruz, Oswaldo Gonçalves; Vasconcelos, Ana Glória Godoi

2016-01-01

cidade do Rio de Janeiro. Estudo retrospectivo de coorte hospitalar com 1.194 pacientes. As probabilidades de sobrevida doença-específica em 60 meses foram calculadas com o método de Kaplan-Meier para três grupos de estadiamento. A importância dos fatores estudados foi avaliada por um modelo teórico hierarquizado após o ajuste de modelos de regressão múltipla de Cox. Foi estimada uma taxa de letalidade doença-específica em 60 meses de 86,0%. A probabilidade de sobrevida doença-específica em 60 meses variou de 25,0%, nos estádios iniciais, a 2,5%, no estádio IV. A situação funcional, a intenção e a modalidade do tratamento inicial foram os principais fatores prognósticos identificados na população estudada. As probabilidades de sobrevida doença-específica estimadas na amostra estudada foram muito baixas, e não foram identificados fatores que pudessem ser modificados após o diagnóstico visando uma melhora da sobrevida. A prevenção primária, como a redução da prevalência do tabagismo, ainda é a melhor forma de evitar que mais pessoas sofram as consequências do câncer de pulmão.

Associated factors with mammographic changes in women undergoing breast cancer screening.

PubMed

Sant'Ana, Ricardo Soares de; Mattos, Jacó Saraiva de Castro; Silva, Anderson Soares da; Mello, Luanes Marques de; Nunes, Altacílio Aparecido

2016-01-01

To evaluate association of sociodemographic, anthropometric, and epidemiological factors with result of mammogram in women undergoing breast cancer screening. This is a cross-sectional study with data obtained through interviews, anthropometric measurements, and mammography of 600 women aged 40 to 69 years at the Preventive Medicine Department of Hospital de Câncer de Barretos, Brazil, in 2014. The results of these examinations in the BI-RADS categories 1 and 2 were grouped and classified in this study as normal mammogram outcome, and those of BI-RADS categories 3, 4A, 4B, 4C, and 5 were grouped and classified as altered mammogram outcome. The statistical analysis included the Student's t-test to compare means, as well as odds ratios (OR), with their corresponding 95% confidence intervals (95%CI), to verify an association by means of the multivariate analysis. Of 600 women evaluated, 45% belonged to the age group of 40-49 years-old and 60.2% were classified as BI-RADS category 2. The multivariate analysis showed that women with blood hypertension (OR: 2.64; 95%CI: 1.07-6.49; p<0.05) were more likely to present changes in the mammography, while physical activity was associated with lower chances (OR: 0.30; 95%CI: 0.11-0.81; p<0.05). Hypertensive women undergoing screening mammography are more likely to present mammographic changes, whereas women practicing physical activity have lower chances (70%) of presenting changes in the breast compared with sedentary individuals. Avaliar a associação de fatores sociodemográficos, antropométricos e epidemiológicos com o resultado das mamografias de mulheres submetidas ao rastreamento. Trata-se de um estudo transversal com dados obtidos por meio de entrevistas, avaliação antropométrica e mamografia de 600 mulheres entre 40 a 69 anos, atendidas no Departamento de Prevenção do Hospital de Câncer de Barretos, em 2014. Os resultados de tais exames nas categorias BI-RADS 1 e 2 foram agrupados e classificados neste estudo

Elaboration and Validation of the Medication Prescription Safety Checklist.

PubMed

Pires, Aline de Oliveira Meireles; Ferreira, Maria Beatriz Guimarães; Nascimento, Kleiton Gonçalves do; Felix, Márcia Marques Dos Santos; Pires, Patrícia da Silva; Barbosa, Maria Helena

2017-08-03

-se que este estudo possa contribuir para a prevenção de eventos adversos, bem como para a melhoria da qualidade da assistência e segurança no uso de medicamentos. elaborar y validar un instrumento tipo checklist para identificar la adhesión a las recomendaciones en la estructura de las prescripciones de medicamentos, a partir del Protocolo del Ministerio de la Salud y Agencia Nacional de Vigilancia Sanitaria. investigación metodológica, conducida mediante el proceso de validez y análisis de confiabilidad, con muestra de 27 prescripciones electrónicas. los análisis llevados a cabo confirmaron la validez de contenido y la confiabilidad de la versión del instrumento. La validez de contenido, alcanzada mediante la evaluación de jueces, fue considerada satisfactoria por contemplar ítems que representan la adhesión a las recomendaciones en la estructura de las prescripciones de medicamentos. La confiabilidad, evaluada por interobservadores, se reveló excelente (ICC=1,00) y de concordancia perfecta (K=1,00). el instrumento Lista de Verificación de Seguridad en la Prescripción de Medicamentos se mostró válido y confiable para el grupo estudiado. Se espera que este estudio pueda contribuir hacia la prevención de eventos adversos, y también hacia la mejora de la calidad de la atención y seguridad en el uso de medicamentos.

Degree of Agreement between Cardiovascular Risk Stratification Tools.

PubMed

Garcia, Guilherme Thomé; Stamm, Ana Maria Nunes de Faria; Rosa, Ariel Córdova; Marasciulo, Antônio Carlos; Marasciulo, Rodrigo Conill; Battistella, Cristian; Remor, Alexandre Augusto de Costa

2017-05-01

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in Brazil, and primary prevention care may be guided by risk stratification tools. The Framingham (FRS) and QRISK-2 (QRS) risk scores estimate 10-year overall cardiovascular risk in asymptomatic individuals, but the instrument of choice may lead to different therapeutic strategies. To evaluate the degree of agreement between FRS and QRS in 10-year overall cardiovascular risk stratification in disease-free individuals. Cross-sectional, observational, descriptive and analytical study in a convenience sample of 74 individuals attending the outpatient care service of a university hospital in Brazil between January 2014 and January 2015. After application of FRS and QRS, patients were classified in low/moderate risk (< 20%) or high risk (≥ 20%). The proportion of individuals classified as at high risk was higher in FRS than in QRS (33.7% vs 21.6%). A synergic effect of male gender with systemic arterial hypertension was observed in both tools, and with for geriatric age group in QRS (p < 0.05) in high-risk stratum. The Kappa index was 0.519 (95%CI = 0.386-0.652; p < 0.001) between both instruments. There was a moderate agreement between FRS and QRS in estimating 10-year overall cardiovascular risk. The risk scores used in this study can identify synergism between variables, and their behavior is influenced by the population in which it was derived. It is important to recognize the need for calibrating risk scores for the Brazilian population. A doença cardiovascular (DCV) é a principal causa de morbimortalidade no Brasil, e a prevenção primária pode ser direcionada com ferramentas que estratificam o risco. Os escores de Framingham (ERF) e QRISK-2 (ERQ) estimam o risco cardiovascular (RCV) global em 10 anos em indivíduos assintomáticos, mas a escolha do instrumento pode implicar em terapêuticas distintas. Observar o grau de concordância entre o ERF e o ERQ, na estratificação do

EXPERIENCE WITH THE BRAZILIAN NETWORK FOR STUDIES IN REPRODUCTIVE AND PERINATAL HEALTH: THE POWER OF COLLABORATION IN POSTGRADUATE PROGRAMS.

PubMed

Cecatti, José G; Silveira, Carla; Souza, Renato T; Fernandes, Karayna G; Surita, Fernanda G

2015-01-01

, contribuem para a disseminação do conhecimento e estruturação da pesquisa em saúde. Diversas vantagens são atribuídas ao trabalho em rede como: a inclusão de maior número de participantes nos estudos; gerar evidências mais fortes e com maior representatividade da população (generalização secundária e validade externa); maior facilidade das publicações oriundas dos estudos serem aceitas em periódicos de impacto e abrangência; maior probabilidade de obtenção de verbas para financiamento; maior facilidade na coleta de dados sobre condições raras; inclusão de participantes de diferentes grupos étnicos e culturas, entre outras. No Brasil a Rede Brasileira de Estudos em Saúde Reprodutiva e Perinatal foi criada em 2008 com o objetivo inicial de desenvolver rede nacional de cooperação científica para vigilância da morbidade materna grave. Desde sua formação, cinco estudos foram desenvolvidos, alguns já encerrados e outros em fase de finalização, com outros dois em fase final de implantação. Os resultados das atividades desta Rede têm sido bastante produtivos e impactaram positivamente não apenas no Programa de Pós-Graduação em Tocoginecologia da Universidade Estadual de Campinas, seu centro coordenador, mas também o de outros centros participantes, uma vez que expressivo número de artigos científicos foi publicado, mestrados e doutorados foram defendidos e pós-doutorados finalizados, de alunos de diversas áreas da saúde, de diferentes regiões e de várias instituições de todo o país, com alto impacto social dada a relevância dos temas estudados para o país.

Cardioprotective Effect of Crocin Combined with Voluntary Exercise in Rat: Role of Mir-126 and Mir-210 in Heart Angiogenesis.

PubMed

Ghorbanzadeh, Vajihe; Mohammadi, Mustafa; Dariushnejad, Hassan; Abhari, Alireza; Chodari, Leila; Mohaddes, Gisou

2017-07-01

animais receberam a administração oral de crocina (50 mg/kg) ou realizaram exercício voluntário sozinhos ou em conjunto durante 8 semanas. Os níveis de proteína Akt, ERK1/2, e a expressão de miR-126 e miR-210 foram medidos no tecido cardíaco. O método imunohistoquímico foi utilizado para detectar CD31 no tecido cardíaco. Os níveis de Akt e ERK1/2 do tecido cardíaco foram maiores no grupo tratado com crocina e no grupo de exercício voluntário após 8 semanas. A combinação de crocina e exercício também aumentou significativamente os níveis de Akt e ERK1/2 no tecido cardíaco. A expressão de MiR-126, miR-210 e CD31 no coração aumentou tanto em no grupo de crocina como no grupo de exercício voluntário em comparação com o grupo de controle. Além disso, a combinação de exercício e crocina amplificou seu efeito na expressão de miR-126 e miR-210 e angiogênese. A Crocina e o exercício voluntário melhoram a angiogênese cardíaca possivelmente através do aumento da expressão de miR-126 e miR-210. O exercício voluntário e a suplementação dietética com crocina podem ter efeitos benéficos na prevenção de doenças cardiovasculares.

Self-Reported High-Cholesterol Prevalence in the Brazilian Population: Analysis of the 2013 National Health Survey.

PubMed

Lotufo, Paulo A; Santos, Raul D; Sposito, Andrei C; Bertolami, Marcelo; Rocha-Faria, Jose; Izar, M Cristina; Szwarcwald, Celia; Prado, Rogério R; Stoppa, Sheila R; Malta, Deborah C; Bensenor, Isabela M

2017-05-01

Pesquisa Nacional de Saúde (PNS) de 2013. Estudo descritivo que avaliou os dados da PNS de 2013, um inquérito epidemiológico de base domiciliar, representativo para o Brasil, com informações autorreferidas. A amostra compreendeu 60.202 indivíduos entrevistados com autorrelato de diagnóstico médico de colesterol. Calculou-se a prevalência de ponto e o intervalo de confiança de 95% (IC95%) para diagnóstico médico de colesterol/triglicerídeos alto(s) por sexo, idade, cor da pele, região geográfica, escolaridade. Foram calculadas as razões de chance ajustadas. Dos 60.202 participantes adultos, 14,3% (IC95%=13,7-14,8) nunca tiveram colesterol ou triglicerídeos dosados, sendo que um maior número de mulheres, idosos, indivíduos com instrução superior completa e de raça branca relatou aferição há menos de um ano. A prevalência de diagnóstico médico de colesterol alto foi de 12,5%, maior nas mulheres (15,1%) do que nos homens (9,7%). A frequência de diagnóstico médico de colesterol alto foi maior naqueles com idade até 59 anos, em brancos ou aqueles de origem asiática, em pessoas com maior escolaridade e entre os moradores das macrorregiões Sul e Sudeste do país. A importância do conhecimento da dislipidemia no atual contexto epidemiológico brasileiro deve ser ressaltada para orientar as ações de prevenção das doenças coronarianas, que representam a primeira causa de óbito no Brasil e no mundo.

Factors associated with suicidal ideation among university students.

PubMed

Santos, Hugo Gedeon Barros Dos; Marcon, Samira Reschetti; Espinosa, Mariano Martínez; Baptista, Makilin Nunes; Paulo, Paula Mirianh Cabral de

2017-05-15

entre amigos, consumo de álcool e sintomas depressivos apresentaram associação com ideação suicida. Na análise múltipla permaneceu como fatores associados orientação sexual, tentativas de suicídio na família e presença de sintomas depressivos. tais achados constituem um diagnóstico situacional que possibilita a formulação de políticas acadêmicas e de ações de prevenção para o enfrentamento dessa situação no campus universitário. analizar los factores asociados a la ideación suicida en una muestra representativa de estudiantes universitarios. estudio transversal analítico, realizado con 637 estudiantes en una Universidad Federal de Mato Grosso. Fueron investigadas las variables: presencia de ideación suicida; demográficas y socioeconómicas; uso de alcohol por medio del Alcohol, Smoking and Substance Involvement Screening Test; y síntomas depresivos (Inventario de Depresión Mayor). El análisis bivariado fue realizado con el test de Chi-cuadrado y el análisis múltiple con el modelo de regresión de Poisson. se constató que 9,9% de los estudiantes tuvieron ideas suicidas en los últimos 30 días, y en el análisis bivariado las variables: clase económica; orientación sexual; práctica religiosa; intentos de suicidio en la familia y entre amigos; consumo de alcohol; y síntomas depresivos, presentaron asociación con ideación suicida. En el análisis múltiple permanecieron como factores asociados la orientación sexual, los intentos de suicidio en la familia y la presencia de síntomas depresivos. estos hallazgos constituyen un diagnóstico situacional que posibilita la formulación de políticas académicas y de acciones de prevención para enfrentar esa situación en el campus universitario.

POSTOPERATIVE EFFECT OF PHYSICAL THERAPY RELATED TO FUNCTIONAL CAPACITY AND RESPIRATORY MUSCLE STRENGTH IN PATIENTS SUBMITTED TO BARIATRIC SURGERY.

PubMed

Oliveira, Josélia Jucirema Jarschel de; Freitas, Alexandre Coutinho Teixeira de; Almeida, Andréa Adriana de

Respiratory physiotherapy plays an important role preventing complications in bariatric surgery. To assess the effects of out-patient physiotherapy during post-operative period through respiratory pressures and functional capacity in individuals submitted to bariatric surgery. A prospective longitudinal and controlled study was done in adults with body mass index (BMI) equal or greater than 40 kg/m², who have been submitted to bariatric surgery. They were divided into two groups: intervention-group, who performed out-patient physiotherapy twice a week, from thirty to sixty days after surgery; and the control-group, who only followed home instructions. Both groups were evaluated before surgery and sixty days after surgery through manovacuometry, six-minute walk test and the Borg Scale of perceived exertion. Twenty participants were included the intervention-group and twenty-three in the control-group. Both groups had significant and similar weight loss after surgery. The manovacuometry presented no differences comparing pre- and post-surgery and in the comparison between the groups. The result of the six-minute walk test for the intervention-group increased by 10.1% in the post-operative period in relation to pre-. The Borg scale of perceived exertion in the intervention-group in pre-surgery decreased by 13.5% in the post-surgery compared to pre-surgery. In the control-group there was no difference comparing pre- and post-operative values, as in the comparison with the intervention-group. The low-intensity exercise program, carried out between the 30th and the 60th day after bariatric surgery provided better functional capacity; did not change respiratory muscle strength; and improved the perceived exertion rate. A fisioterapia respiratória tem papel importante na prevenção das complicações da cirurgia bariátrica. Avaliar os efeitos da fisioterapia ambulatorial no pós-operatório através das pressões respiratórias e da capacidade funcional dos indiv

Diabetes mellitus and drug abuse during pregnancy and the risk for orofacial clefts and related abnormalities.

PubMed

Trindade-Suedam, Ivy Kiemle; Kostrisch, Lília Maria von; Pimenta, Luiz André Freire; Negrato, Carlos Antônio; Franzolin, Solange Braga; Trindade, Alceu Sergio

2016-08-08

observada entre el abuso de drogas y la ocurrencia de hendiduras y otras malformaciones craneofaciales (p=0,028) (OR=2,87; 95%IC=1,1-7,4). la DM y el abuso de drogas durante el embarazo aumentan el riesgo de MCF y de anomalías relacionadas; se enfatiza la importancia del diagnóstico precoz de DM y la prevención del abuso de drogas, especialmente entre las mujeres embarazadas. avaliar a prevalência de diabetes mellitus (DM) e o uso de drogas em mães de crianças com fissuras orofaciais (FOF). 325 mulheres que tiveram filhos (0-3 anos) com fissuras foram entrevistadas. Os dados referentes tipo de diabetes, uso de drogas lícitas / ilícitas durante a gravidez, circunferência abdominal e glicemia em jejum na primeira consulta pré-natal foram coletados. vinte e sete por cento das mulheres tinham DM. Destes, 89% tinham DM gestacional, 5,5% DM tipo 1 e 5,5% DM tipo 2. A prevalência de DM em mães de crianças com FOF foi de 27%, significativamente mais elevado que a média da população brasileira que é de 7,6% (p <0,01) (OR = 4,5, IC de 95% = 3,5-5,8). Com relação ao uso de drogas, 32% das mães eram usuárias drogas durante a gravidez e uma correlação positiva foi observada entre o uso de drogas e a ocorrência de FOF e anomalias relacionadas (p = 0,028) (OR = 2,87; IC95% = 1,1-7,4). DM e uso de drogas durante a gravidez aumentam o risco de FOF e anomalias relacionadas e o diagnóstico precoce de DM e a prevenção do uso de drogas, especialmente em mulheres grávidas, devem ser enfatizados.

Risk factors for syphilis in women: case-control study.

PubMed

Macêdo, Vilma Costa de; Lira, Pedro Israel Cabral de; Frias, Paulo Germano de; Romaguera, Luciana Maria Delgado; Caires, Silvana de Fátima Ferreira; Ximenes, Ricardo Arraes de Alencar

2017-08-17

úde relacionados à ocorrência de sífilis em mulheres atendidas em maternidades públicas. Trata-se de um estudo caso-controle (239 casos e 322 controles) com mulheres admitidas em sete maternidades do município do Recife, no período de julho de 2013 a julho de 2014. As mulheres elegíveis foram recrutadas após o resultado do VDRL (Venereal Disease Research Laboratory) sob qualquer titulação. A seleção dos casos e controles considerou o resultado da sorologia por ELISA (enzyme-linked immunosorbent assay), variável dependente utilizada como diagnóstico para sífilis neste estudo. As variáveis independentes foram agrupadas em: sociodemográficas; comportamentais; e antecedentes clínicos e obstétricos; e assistência à saúde no pré-natal e na maternidade. As informações foram obtidas por meio de entrevista, durante o internamento, por aplicação de um questionário. Foi calculado odds ratio (OR), intervalo de confiança de 95% e realizada análise de regressão logística para identificar os fatores preditores da variável a ser explicada. A análise de regressão logística identificou como fatores determinantes para a sífilis gestacional: nível de escolaridade fundamental incompleto ou analfabeta (OR = 2,02), ausência de acesso a telefone (OR = 2,4), religião católica (OR = 1,70), quatro ou mais gestações (OR = 2,2), três ou mais parceiros sexuais no último ano (OR = 3,1), uso de drogas ilícitas antes dos 18 anos (OR = 3,0) e uso de drogas ilícitas por parte do atual companheiro (OR = 1,7). Além desses, foram observadas a ocorrência de apenas uma a três consultas ao pré-natal (OR = 3,5) e história anterior de infecção sexualmente transmissível (OR = 9,7). Fatores sociodemográficos, comportamentais e de assistência à saúde estão associados à ocorrência de sífilis em mulheres e devem ser levados em consideração na elaboração de estratégias universais direcionadas à prevenção e controle da sífilis, porém com foco em situa

Advice given to women in Argentina about breast-feeding and the use of alcohol

PubMed Central

Pepino, M. Yanina; Mennella, Julie A.

2006-01-01

pregnancy and lactation. There is a need for professional development strategies that will address women’s awareness of the risks of alcohol consumption and alcohol usage. RESUMEN Objetivo Explorar el tipo de consejos que los profesionales de la salud, parientes y amigos le dieron a una muestra de mujeres en Argentina acerca del consumo de bebidas alcohólicas y el uso de alcohol durante el embarazo y la lactancia. Métodos En diciembre de 2001 y diciembre de 2002 se llevaron a cabo entrevistas estructuradas con un total de 167 mujeres que estaban amamantando o que habían amamantado recientemente. A las madres se les preguntó qué tipo de consejos, en caso de haberlos, les dieron los profesionales de la salud y sus parientes y amistades acerca del consumo de alcohol. También se plantearon preguntas sobre la bebida tradicional argentina, el mate —infusión muy popular en América del Sur que se prepara con las hojas de la planta Ilex paraguayensis— y la clase de consejos que recibieron las mujeres acerca de la lactancia materna y los cuidados neonatales en general. Resultados De las 167 mujeres estudiadas, 96,4% indicaron que el médico les había aconsejado que amamantaran a su hijo. Además, 93,4% afirmaron que habían frotado con alcohol el muñón umbilical del niño. Menos de la mitad de las mujeres (46,7%) indicaron haber recibido del médico asesoramiento acerca del consumo de bebidas alcohólicas durante el embarazo, y un porcentaje aun menor (25,7%) indicó haber recibido este tipo de asesoramiento durante la lactancia. Los parientes y amigos mostraron aproximadamente la misma propensión a aconsejar acerca del consumo de bebidas alcohólicas durante el embarazo (42,6%) y la lactancia (47,9%). No obstante, el tipo de consejo fue distinto en uno y otro caso, en el sentido de que los parientes y amigos mostraron una proclividad mayor (en grado estadísticamente significativo) a alentar a la mujer a consumir bebidas alcohólicas durante la lactancia que

Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit.

PubMed

Miranda, Anna Letícia; Oliveira, Ana Lúcia Lyrio de; Nacer, Daiana Terra; Aguiar, Cynthia Adalgisa Mesojedovas

2016-09-09

to compare the results of urinary tract infection incidence, by means of the rate of indwelling urethral catheter use, and to identify microorganisms in urine cultures and surveillance cultures before and after the implementation of a clinical protocol for intensive care unit patients . urinary tract infection is defined as a positive urine culture > 105 CFU/mL, notified by the hospital infection control service, six months before and after the implementation of the protocol. The sample consisted of 47 patients, 28 reported before and 19 after implementation. The protocol established in the institution is based on the Ministry of Health manual to prevent healthcare-related infections; the goal is patient safety and improving the quality of health services. a negative linear correlation was observed between the later months of implementation and the reduction of reported cases of urinary tract infection, using the Spearman rank order coefficient (p = 0.045), and a reduction in the number of urine culture microorganisms (p = 0.026) using the Fisher exact test. educational interventions with implementation protocols in health institutions favor the standardization of maintenance of the invasive devices, which may reduce colonization and subsequent infections. comparar os resultados da incidência de infecção do trato urinário, por meio da taxa de utilização do cateter vesical de demora e identificar os micro-organismos na urocultura e cultura de vigilância antes e após a implementação de um protocolo assistencial em pacientes internados em unidade de terapia intensiva. definiu-se infecção do trato urinário pacientes com urocultura positiva >105 UFC/mL, notificados pelo Serviço de Controle de Infecção Hospitalar, seis meses antes e após a implementação do protocolo. A amostra foi constituída por 47 pacientes, sendo 28 notificados antes e 19 após. O protocolo, criado na instituição, é baseado no manual do Ministério da Saúde na prevenção de

Telephone interventions for adherence to colpocytological examination.

PubMed

Lima, Thais Marques; Nicolau, Ana Izabel Oliveira; Carvalho, Francisco Herlânio Costa; Vasconcelos, Camila Teixeira Moreira; Aquino, Priscila de Souza; Pinheiro, Ana Karina Bezerra

2017-02-06

. ao comparar antes e depois das intervenções comportamental e educativa constatou-se que houve uma mudança estatisticamente significativa (p = 0,0283) no aumento do conhecimento das mulheres que participaram da intervenção educativa; não houve mudança comprovada na atitude das mulheres de nenhum dos grupos e houve um aumento da adesão ao exame colpocitológico nos dois grupos (p < 0,0001), com maior adesão das mulheres que participaram do grupo comportamental (66,8%). as intervenções comportamentais e educativas por telefone foram eficazes na adesão das mulheres ao exame colpocitológico, representando estratégias importantes para educação permanente em saúde, promovendo a atenção para a prevenção do câncer cérvico-uterino. comprobar los efectos de intervención comportamental y educativa por teléfono en la adhesión de las mujeres, con periodicidad inadecuada, al examen de citología vaginal. estudio casi experimental, con muestra constituida por 524 mujeres seleccionadas conforme a los siguientes criterios de inclusión: estar en el intervalo etario entre 25 y 64 años, haber iniciado actividad sexual, estar con la periodicidad del examen inadecuada y poseer teléfono móvil o fijo. Las mujeres fueron divididas en dos grupos para aplicación de la intervención comportamental y educativa por teléfono. Se utilizó una guía de intervención según los preceptos de la Entrevista Motivacional. al comparar antes y después de la intervención comportamental y educativa se constató que hubo un cambio estadísticamente significativo (p = 0,0283) en el aumento del conocimiento de las mujeres que participaron de la intervención educativa; no hubo cambio comprobado en la actitud de las mujeres de ninguno de los grupos y hubo un aumento de la adhesión al examen de citología vaginal en los dos grupos (p < 0,0001), con mayor adhesión de las mujeres que participaron del grupo comportamental (66,8%). las intervenciones comportamentales y educativas

Experimental study with nursing staff related to the knowledge about pressure ulcers.

PubMed

Baron, Miriam Viviane; Reuter, Cézane Priscila; Burgos, Miria Suzana; Cavalli, Veniria; Brandenburg, Cristine; Krug, Suzane Beatriz Frantz

2016-11-21

Teste de Mann-Whitney, para análise de duas amostras independentes, e o Teste de Wilcoxon, para amostras relacionadas. a porcentagem média de acertos, no momento inicial, foi de 74,1% (dp=26,4) no grupo-intervenção e 76,0% (dp=22,9) no grupo-controle e, no momento pós-intervenção, foi de 87,8% (dp=18,8) no grupo que recebeu intervenção educativa, considerando-se que no grupo-controle foi de 79,1% (dp=22,2). O grupo que participou de intervenções educativas não atingiu a média adequada de 90% de acertos para o teste. as intervenções educativas sobre estadiamento, avaliação e prevenção da úlcera por pressão contribuíram significativamente para o aumento do escore de acertos no teste de conhecimento do grupo-intervenção e melhoraram o conhecimento sobre o tema. comparar las puntuaciones de los conocimientos acerca de las úlceras por presión de los equipos que han participado o no de intervenciones educativas. estudio cuantitativo con diseño experimental. Los datos fueron recolectados a través de cuestionario validado. En el estudio participaron 71 personas, incluyendo enfermeras y técnicos de enfermeria de tres unidades de cuidados intensivos, divididos en grupo de intervención y grupo control. El análisis de los datos consideró las puntuaciones de los grupos antes y después de la intervención. Para comprobar la tasa media de respuestas correctas, se calculó la media y el desvio estándar (DE). La prueba de Mann-Whitney fue realizada para el análisis de dos muestras independientes y la prueba de Wilcoxon para muestras relacionadas. la media del porcentaje de respuestas correctas, al inicio del estudio fue de 74,1% (DE = 26,4) en el grupo de intervención y 76,0% (DE = 22,9) en el grupo de control y en el tiempo post-intervención, fue del 87,8% (DE = 18,8) en el grupo que recibió la intervención educativa, teniendo en cuenta que en el grupo control fue de 79,1% (DE = 22,2). El grupo que participó en las intervenciones educativas no

Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level.

PubMed

Grezzana, Guilherme Brasil; Moraes, David William; Stein, Airton Tetelbon; Pellanda, Lucia Campos

2017-02-01

desfechos cardiovasculares. Médicos da atenção primária à saúde (APS) devem estar preparados para atuar adequadamente na prevenção de fatores de risco cardiovascular. No entanto, as taxas de pacientes com pressão arterial (PA) controlada continuam baixas. O impacto da reclassificação do diagnóstico de hipertensão pela utilização da monitorização ambulatorial da PA (MAPA) de 24 horas pode levar a diferentes decisões médicas na APS. Avaliar a concordância entre as PAs medidas por método convencional por médicos da APS e por MAPA de 24 horas, considerando diferentes limiares de normalidade para a MAPA de 24 horas de acordo com as recomendações da V Diretriz Brasileira de MAPA e da Diretriz da Sociedade Europeia de Hipertensão. Estudo transversal com 569 pacientes hipertensos. A PA foi medida inicialmente por médicos da APS e, posteriormente, pela MAPA de 24 horas. As medidas foram obtidas de forma independente entre os dois métodos. Os alvos terapêuticos para a PA convencional seguiram as orientações do Eighth Joint National Committee (JNC 8), das V Diretrizes Brasileiras de MAPA e das Diretrizes Europeias de Hipertensão de 2013. Foi observada uma acurácia de 54,8% (intervalo de confiança de 95% [IC95%] 0,51 - 0,58%) para a PA aferida de forma convencional quando comparada à obtida com a MAPA de 24 horas, além de uma sensibilidade de 85% (IC95% 80,8 - 88,6%), especificidade de 31,9% (IC95% 28,7 - 34,7%) e kappa de 0,155, quando consideradas as Diretrizes Europeias de Hipertensão. Quando utilizados limiares mais rígidos para caracterizar a PA como "normal" pela MAPA, foi identificada uma acurácia de 45% (IC95% 0,41 - 0,47%) pela medida convencional quando comparada à obtida pela MAPA de 24 horas, além de uma sensibilidade de 86,7% (IC95% 0,81 - 0,91%), especificidade de 29% (IC95% 0,26 - 0,30%) e kappa de 0,103. As medidas de PA avaliadas pelos médicos da APS apresentaram baixa acurácia quando comparadas às medidas pela MAPA de 24

Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study.

PubMed

Mata, Luciana Regina Ferreira da; Azevedo, Cissa; Policarpo, Aryanne Gabrielle; Moraes, Juliano Teixeira

2017-06-08

ções de enfermagem voltadas para a prevenção do risco de queda no pós-operatório.

Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis.

PubMed

Teixeira, Andressa Magalhães; Tsukamoto, Rosangela; Lopes, Camila Takáo; Silva, Rita de Cassia Gengo E

2017-06-05

-se que alteração nos níveis de hemoglobina glicada, índice de massa corpórea>31 Kg/m2, história prévia de hipoglicemia, déficit cognitivo/demência, neuropatia autonômica cardiovascular, comorbidades e perda de peso correspondiam a fatores de risco descritos pela NANDA International . Outros fatores de risco identificados foram: idade avançada, raça negra, maior tempo de diagnóstico de diabetes, sonolência diurna, macroalbuminúria, polimorfismos genéticos, insulinoterapia, uso de antidiabéticos orais, uso de metoclopramida, atividade física inadequada e glicemia de jejum baixa. identificaram-se fatores de risco do diagnóstico risco de glicemia instável para pessoas com diabetes mellitus tipo 2, dos quais 42% correspondiam àqueles da NANDA International . Esses achados podem contribuir para a prática de enfermeiros clínicos na prevenção dos efeitos deletérios da variação glicêmica. identificar evidencias en la literatura acerca de posibles factores de riesgo del diagnóstico "riesgo de nivel de glucemia inestable" para personas con diabetes mellitus tipo 2 y compararlos con los factores de riesgo descritos por la NANDA International . revisión integradora orientada por la pregunta: ¿Cuáles son los factores de riesgo de nivel de glucemia inestable en personas con diabetes mellitus tipo 2? Se incluyeron estudios primarios cuyos resultados eran variaciones en los niveles glucémicos, publicados en inglés, portugués o español en el PubMed o CINAHL entre 2010 y 2015. se observó que una alteración en los niveles de: hemoglobina glucosilada, índice de masa corporal >31 Kg/m2, historia previa de hipoglucemia, déficit cognitivo/demencia, neuropatía autonómica cardiovascular, comorbilidades y pérdida de peso, correspondían a factores de riesgo descritos por la NANDA International . Otros factores de riesgo identificados fueron: edad avanzada, raza negra, mayor tiempo de diagnóstico de diabetes, somnolencia diurna, macroalbuminuria

Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital.

PubMed

Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; Andrade, Rayza Assis de; Teleginski, Fernanda; Rocha, Maria Dagmar da

2016-01-01

administração para 294 medicamentos via sondas enterais; fluxograma decisório; procedimentos operacionais-padrão de diluição e unitarização de formas farmacêuticas orais e de administração de medicamentos via sondas enterais. Na Fase 2 investigou-se, retrospectivamente, erros em 872 medicamentos prescritos via sondas enterais, em 293 prescrições de pacientes internados de março a junho. Seguiu-se capacitação das equipes sobre diretrizes estabelecidas. Na Fase 3 investigou-se, prospectivamente, erros e intervenções farmacêuticas em 945 medicamentos prescritos via sondas enterais, em 292 prescrições de pacientes internados de agosto a setembro. Dados coletados, em formulário estruturado, foram compilados no programa Microsoft Office Excel(r) e calculadas as frequências. foram observados 786 erros, 63,9% (502) na Fase 2 e 36,1% (284) na Fase 3. Na Fase 3 verificou-se redução na frequência de prescrição de medicamentos, via sondas enterais, contraindicados e sem informações disponíveis. diretrizes e intervenções farmacêuticas foram determinantes na prevenção dos erros de medicamentos via sondas enterais. analizar el impacto de directrices sobre errores en medicamentos prescritos para administración vía sondas enterales. estudio cuantitativo, en tres fases, realizado en una clínica médica-neurología y en unidad de terapia intensiva de un hospital general universitario. En la Fase 1 se elaboró: protocolo de dilución, reenvasado - transformación y administración para 294 medicamentos vía sondas enterales; diagrama de flujo de decisión; procedimientos operacionales estándar de dilución y reenvasado - transformación de formas farmacéuticas orales y de administración de medicamentos vía sondas enterales. En la Fase 2 se investigó, retrospectivamente, errores en 872 medicamentos prescritos vía sondas enterales, en 293 prescripciones de pacientes internados de marzo a junio. La continuación, capacitación de los equipos sobre

Second-Generation central venous catheter in the prevention of bloodstream infection: a systematic review.

PubMed

Stocco, Janislei Gislei Dorociaki; Hoers, Hellen; Pott, Franciele Soares; Crozeta, Karla; Barbosa, Dulce Aparecida; Meier, Marineli Joaquim

2016-08-08

corriente sanguínea, relacionada al catéter, no hubo significación estadística entre catéter de segunda generación impregnado en comparación a los no impregnados, riesgo relativo absoluto 1,5%, intervalo de confianza 95% (3%-1%), riesgo relativo 0,68 (intervalo de confianza 95%, 0,40-1,15) y número necesario para tratar 66. En el análisis de sensibilidad, hubo disminución de la infección de la corriente sanguínea en los catéteres impregnados (riesgo relativo 0,50, intervalo de confianza 95%, 0,26-0,96). Reducción de la colonización, riesgo relativo absoluto de 9,6% (intervalo de confianza 95%, 10% a 4%), riesgo relativo 0,51 (intervalo de confianza 95% de 0,38-0,85) y número necesario para tratar 5. el uso de los catéteres de segunda generación fue efectivo en la reducción de la colonización del catéter y de infección cuando realizado análisis de sensibilidad. Se sugirieron ensayos clínicos futuros que evalúen tasas de sepsis, mortalidad y efectos adversos. avaliar a efetividade e segurança do uso de cateteres venosos centrais de segunda geração, impregnados em clorexidina e sulfadiazina de prata, comparados com outros cateteres impregnados ou não, na prevenção de infecção de corrente sanguínea. revisão sistemática com metanálise. Busca realizada nas bases: MEDLINE, EMBASE, CINAHL, LILACS/SciELO, Cochrane CENTRAL; consulta em anais de congresso e registro de ensaios clínicos. foram identificados 1.235 estudos, 97 pré-selecionados e quatro incluídos. Na infecção de corrente sanguínea, relacionada ao cateter, não houve significância estatística entre cateter de segunda geração impregnado em comparação aos não impregnados risco relativo absoluto 1,5%, intervalo de confiança 95% (3%-1%), risco relativo 0,68 (intervalo de confiança 95%, 0,40-1,15) e número necessário para tratar 66. Na análise de sensibilidade, houve diminuição da infecção de corrente sanguínea nos cateteres impregnados (risco relativo 0,50, intervalo

Serial hemodynamic monitoring to guide treatment of maternal hypertension leads to reduction in severe hypertension.

PubMed

Stott, D; Papastefanou, I; Paraschiv, D; Clark, K; Kametas, N A

2017-01-01

áficas y las variables hemodinámicas maternas asociadas con una respuesta terapéutica al labetalol, definida como un control de la presión arterial < 140/90 mmHg con monoterapia de labetalol durante todo el embarazo que se analizó mediante regresión logística para crear un modelo con el que pronosticar un control sostenido de la presión arterial, como se describe arriba. Las mujeres fueron sometidas a revisiones regulares hasta el momento del parto y se les hizo un seguimiento hemodinámico en serie durante todo el embarazo. Si la presión arterial era elevada, se empleó de nuevo el modelo de predicción para determinar si se debería añadir un tratamiento antihipertensivo alternativo, ya sea con un beta-bloqueante adicional o con un vasodilatador. El tratamiento que tuvo en cuenta los resultados del seguimiento hemodinámico en serie redujo la tasa de hipertensión prenatal grave del 18% al 3,8%. Al 77% de las mujeres se les recetó inicialmente un y al 23% un vasodilatador. El grupo que mantuvo un buen control de la presión arterial con monoterapia de beta-bloqueantes logró mejores resultados fetales y maternos. Este grupo tuvo menor presión arterial al inicio y durante toda la gestación, mostró un gasto cardíaco en buen estado y tuvo las tasas más bajas de restricción del crecimiento fetal. Los grupos que requirieron terapia dual para controlar su presión arterial mostraron persistentemente una mayor presión arterial y un mayor ritmo de restricción del crecimiento fetal. Los grupos que requirieron tratamiento vasodilatador debido a los altos niveles de resistencia vascular periférica, tanto al inicio como durante el embarazo, representaron el 81% de los casos con restricción del crecimiento fetal. CONCLUSIÓN: El uso de un seguimiento hemodinámico en serie en el embarazo como guía para el tratamiento de la hipertensión reduce significativamente la tasa de hipertensión severa y permite la identificación de embarazos con hipertensión de alta

Vaginal progesterone vs intramuscular 17α-hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth in singleton gestations: systematic review and meta-analysis of randomized controlled trials.

PubMed

Saccone, G; Khalifeh, A; Elimian, A; Bahrami, E; Chaman-Ara, K; Bahrami, M A; Berghella, V

2017-03-01

identificar todos los ECA con embarazos de feto único asintomáticos con historial de PPTE antes de ser asignados al azar a un tratamiento profiláctico, ya fuera con progesterona vaginal (grupo de intervención) o con 17-OHPC intramuscular (grupo de control). No se aplicaron restricciones respecto al idioma o la ubicación geográfica. El resultado primario fue PPTE < 34 semanas. Los resultados secundarios fueron PPTE <37 semanas, < 32 semanas, < 28 semanas y < 24 semanas, la reacción materna adversa al fármaco y los resultados neonatales. Las medidas del resumen se reportaron como riesgo relativo (RR) con IC del 95%. Para cada estudio incluido se evaluó el riesgo de sesgo. Se incluyeron tres ECA (680 mujeres). La media de la edad gestacional en el momento de la aleatorización fue de 16 semanas. A las mujeres se les administró progesterona hasta la semana 36 o hasta el parto. Con respecto a la progesterona vaginal, un estudio utilizó gel de 90 mg diariamente, otro utilizó un supositorio diario de 100 mg y el otro utilizó un supositorio diario de 200 mg. Todos los ECA incluidos en el grupo de comparación utilizaron 250 mg semanales de 17-OHPC por vía intramuscular. Las mujeres que recibieron progesterona vaginal tuvieron tasas significativamente más bajas de PPTE < 34 semanas (17,5% vs. 25,0%; RR 0,71 (IC 95%, 0,53-0,95); calidad de la evidencia baja) y < 32 semanas (8,9% vs. 14,5%; RR 0,62 (IC 95%, 0,40-0,94); calidad de evidencia baja), en comparación con las mujeres que recibieron 17-OHPC. No hubo diferencias significativas en las tasas de PPTE < 37 semanas, < 28 semanas y < 24 semanas. La tasa de mujeres que reportaron reacciones adversas a los medicamentos fue significativamente menor en el grupo de progesterona vaginal en comparación con el grupo de 17-OHPC (7,1% vs. 13,2%; RR 0,53 (IC 95%, 0,31-0,91); calidad de la evidencia muy baja). En cuanto a los resultados neonatales, la progesterona vaginal se asoció a una menor tasa de admisiones en la unidad

PERSPECTIVE: Fire on the fringe

NASA Astrophysics Data System (ADS)

Pyne, Stephen J.

2009-09-01

bushfires J. Environ. Management 23 259-70 [2] Gill A M and Stephens S L 2009 Scientific and social challenges for the management of fire-prone wildland-urban interfaces Environ. Res. Lett. 4 034014 [3] Cohen 2008 The wildland-urban interface fire problem: a consequence of the fire exclusion paradigm Forest History Today (Fall) 20-6 [4] Sommers W T 2008 The emergence of the wildland-urban interface concept Forest History Today (Fall) 12-9 [5] Peira J S et al (eds) 2006 Incêndios Florestais em Portugal. Caracterização, Impactes e Prevenção (Lisbon: Instituto Superior de Agronomia) [6] Pyne S 2008 Spark and sprawl: a world tour Forest History Today (Fall) 4-11