Perfil epidemiológico da hanseníase em um município do Nordeste Brasileiro frente aos desafios dos acometidos / Epidemiological profile of leprosy in a municipality of northeastern Brazil in the face of the challenges of those affected

Objetivo: Caracterizar através de dados obtidos de fonte secundaria o perfil epidemiológico de acometidos por hanseníase em Teresina, Piauí de 2017 a 2021 em relação aos desafios como as incapacidades, ao acometimento em crianças e ao índice de óbitos relacionados a hanseníase.Métodos:Trata-se de um estudo observacional, analítico do tipo ecológico, através de dados do Sistema de Informação de Agravosde Notificação(SINAN). Foram investigadas as variáveis sexo, gênero, idade, escolaridade, índice de endemicidade, Grau de Incapacidade Física (GIF), formas clínicas e óbitos, através do teste qui-quadrado, do teste de Shapiro-wilk e do cálculo de odds ratio.Resultados: Houve predominâncias do perfil clínico e epidemiológicocom gênero predominantemente masculino, cor/raça parda, com nível de escolaridade até o ensino médio, com características clínicas dimorfa, no entanto sem reações predominantes, mas com alto índice de GIF I.Conclusão: Através dos dados coletados no SINANfoi possível identificar que a população de Teresina atualmente enfrenta desafios quanto a detecção da hanseníase em crianças, está oscilando parâmetros entre hiperendêmica e muito alta endemicidade, 9% da população acometida desenvolveu algum GIF e foram identificados óbitos com maior prevalência em idosos, no entanto, foi observado escassez de grande número de informações provenientes do SINAN

Objective: To characterize through data obtained from secondary sources the epidemiological profile of leprosy patients in Teresina, Piauí, from 2017 to 2021 in relation to challenges such as disabilities, involvement in children and the rate of deaths related to leprosy.Methods:This is an observational, analytical study of the ecological type, through data from the Notifiable Diseases Information System (SINAN). The variables gender, gender, age, schooling, endemicity index, Physical Disability Degree (DPD), clinical forms and deaths were investigated, through the chi-square test, the Shapiro-wilk test and the odds ratio calculation.Results: There was predominance of the clinical and epidemiological profile with predominantly male gender, color/mixed race, with educational level up to high school, with dimorphous clinical characteristics, however without predominant reactions, but with high DPDIndex I.Conclusion: Through the data collected in SINANit was possible to identify that the population of Teresina currently faces challenges regarding the detection of leprosy in children, is oscillating parametersbetween hyperendemic and very high endemicity, 9% of the affected population developed some DPDand deaths with higher prevalence were identified in the elderly, however, a scarcity of large number of information from SINAN was observed.

Percepção dos médicos da família sobre a violência contra a mulher / Family doctors' perception of violence against women

Objetivo: Este estudo objetivou avaliar a percepção dos médicos da família sobre a violência contra a mulher. Métodos: Trata-se de estudo transversal, desenvolvido com 158 médicos da Estratégia Saúde da Família de Teresina/Piauí, no período de março a abril de 2019, por meio de questionário adaptado do Sistema de Indicadores de Percepção Social do Instituto de Pesquisa Econômica Aplicada.Resultados: Os achados apontam que médicos do sexo masculino, especialistas, com mais de 25 anos de formação e mais de 60 anos de idade, possuem uma percepção da violência contra a mulher baseada no modelo patriarcal, como problema de foro íntimo e de culpabilização da mulher. Conclusão: É necessária capacitação médica para condução de uma prática assistencial às mulheres em situação de violência, dando-lhes um acolhimento orientado pelo modelo de saúde social. Descritores: Violência contra a mulher.Atenção Primária à Saúde.Pessoal da saúde. Percepção social.

Objective: This study aimed to evaluate the perception of family doctors about violence against women.Methods:This is a cross-sectional study, developed with 158 doctors from the Family Health Strategy of Teresina/Piauí, from March to April 2019, through a questionnaire adapted from the Social Perception Indicator System of the Institute of Applied Economic Research.Results:The findings indicate that male doctors, specialists, with over 25 years of training and more than 60 years of age, have a perception of violence against women based on the patriarchal model, as a problem of an intimate nature and of blaming of the woman.Conclusion:Medical training is necessary to conduct a care practice for women in situations of violence, giving them a reception guided by thesocial health model.Descriptors:Violence against women.PrimaryHealth Care.Health personnel. Social perception.

Análise da distribuição espacial da dengue no estado do Piauí no período de 2015 a 2019 / Analysis of the spatial distribution of dengue in the state of Piauí from 2015 to 2019

A dengue é uma arbovirose considerada de cunho desafiadora para a saúde pública mundial, visto que proporciona prejuízos duradouros, representando, assim, uma ameaça à saúde humana. Dessa forma, este estudo teve como objetivo analisar a distribuição espacial dos casos de dengue no Piauí entre 2015 e 2019. Tratou-se de um estudo ecológico espacial da dengue, com dados do Sistema de Informação de Agravos de Notificação (SINAN) de 2015 a 2019. Foi aplicado o teste de associação X² para a análise bivariada e para análise espacial foi utilizado o software Qgis (versão 3.16.7. Hannover). Nesse período, foram notificados 27289 casos e 21944 casos confirmados de dengue. O município de Teresina (62,9%) e a região de saúde Entre Rios (65,84%) apresentaram os maiores registros. O sexo feminino (58,4%), a faixa entre 20 e 34 anos (33,52%) e a etnia parda (44%) foram os mais afetados. Quanto à escolaridade, 58,5% foram ignorados. Os casos de dengue estão concentrados em polos com grande fluxo populacional. A identificação do perfil epidemiológico, da mesma maneira que os seus principais fatores de risco, é uma forma de auxiliar o sistema de saúde de todo o estado na elaboração de políticas de controle específicas para a população mais vulnerável a doença.

Dengue is an arboviral disease considered global public health challenge, as it provides lasting damage, thus representing a threat to human health. Therefore, this study aimed to analyze the spatial distribution of dengue cases in Piauí between 2015 and 2019. This was a spatial ecological study of dengue, with data from the Disease Notification Information System (SINAN) from 2015 to 2019. The X² association test was applied for the bivariate analysis and the Qgis software (version 3.16.7. Hannover) was used for spatial analysis. During this period, 27,289 cases and 21,944 confirmed cases of dengue were reported. The city of Teresina (62.9%) and the health region Entre Rios (65.84%) had the highest records. Females (58.4%), between 20 and 34 years old (33.52%) and mixed race (44%) were the most affected. As for education, 58.5% did not respond. Dengue cases are concentrated in poles with large population flows. The identification of the epidemiological profile, as well as its main risk factors, is a way to help the health system of the entire state to elaborate specific control policies for the population most vulnerable to the disease.

Metabolic syndrome in adolescents and antioxidant nutrient intake: a cross-sectional study.

OBJECTIVE: To verify the association between metabolic syndrome and its components, and intake of antioxidant nutrients in adolescents. METHODS: This is a cross-sectional study of the data of 327 adolescents in a high school in Teresina, Piauí, Brazil, pertaining to their socioeconomic background, anthropometric measurements, dietary intake (selenium; copper; zinc; vitamins A, C, and E), hemodynamics, and biochemical tests. The criteria for diagnosing metabolic syndrome in adolescents were applied. Binary logistic regression was used to verify the association between metabolic syndrome and its components, and intake of antioxidants. The level of significance was established at p<0.05. RESULTS: Prevalence of metabolic syndrome was 7.0%, with a significant association between body mass index and blood pressure. Lower tertiles of copper and vitamins A and E intake were associated with high triglyceride and glycemic levels. The association with vitamins A and E remained after adjustment. CONCLUSIONS: A significant association between lower vitamins A and E intake and metabolic syndrome components (altered triglycerides and glycemic levels) was found. Besides further studies on this issue, the need for health interventions was found, which ensures the appropriate intake of antioxidant nutrients during adolescence.

Metabolic syndrome in adolescents and antioxidant nutrient intake: a cross-sectional study

SUMMARY OBJECTIVE: To verify the association between metabolic syndrome and its components, and intake of antioxidant nutrients in adolescents. METHODS: This is a cross-sectional study of the data of 327 adolescents in a high school in Teresina, Piauí, Brazil, pertaining to their socioeconomic background, anthropometric measurements, dietary intake (selenium; copper; zinc; vitamins A, C, and E), hemodynamics, and biochemical tests. The criteria for diagnosing metabolic syndrome in adolescents were applied. Binary logistic regression was used to verify the association between metabolic syndrome and its components, and intake of antioxidants. The level of significance was established at p<0.05. RESULTS: Prevalence of metabolic syndrome was 7.0%, with a significant association between body mass index and blood pressure. Lower tertiles of copper and vitamins A and E intake were associated with high triglyceride and glycemic levels. The association with vitamins A and E remained after adjustment. CONCLUSIONS: A significant association between lower vitamins A and E intake and metabolic syndrome components (altered triglycerides and glycemic levels) was found. Besides further studies on this issue, the need for health interventions was found, which ensures the appropriate intake of antioxidant nutrients during adolescence.

Impact of intermittent fasting on body weight in overweight and obese individuals.

OBJECTIVE: To verify the relationship of intermittent fasting in the bodyweight of overweight and obese individuals through a systematic literature review. METHODS: This is a systematic review based on randomized controlled trials. The articles were consulted in the databases: Science Direct, PubMed e BVS. This review was evaluated through the PRISMA recommendation. RESULTS: After the selection process, four articles were included in this review, comparing intermittent fasting (IF) with calorie restriction diet (CRD) as a control group. In 2 studies using similar protocols, there was no significant reduction in body weight of overweight or obese subjects. In the other two studies using different protocols, weight loss was significant in the IF group compared to the CRD group. CONCLUSIONS: Results did not provide evidence of the effect of intermittent fasting on weight loss in overweight or obese individuals.

Expression of Nrf2 and NF-κB transcription factors in breast cancer and breast fibroadenoma: Insights for a new therapeutic approach.

Background: Cancer and fibroadenoma are the most common breast tumors in women of reproductive age. Nuclear factor erythroid 2-related factor 2 (Nrf2) and the nuclear factor kappaB (NF-κB) transcription factor play an important role in the inflammatory process and in cell proliferation. However, few studies have analyzed these markers in breast cancer and fibroadenoma in women of reproductive age. Results: Light microscopy showed a higher concentration of anti-Nrf2 and anti-NF-κB-stained nuclei in breast cancer than in fibroadenoma. The mean percentage of stained nuclei for Nrf2 was 7.12 ± 5.2 and 43.21 ± 19.83 in the control and study groups, respectively (p < 0.0001). The mean percentage of anti-NF-κB was 10.75 ± 7.09 and 56.14 ± 21.19 (mean ± standard deviation) in the control and study groups, respectively (p < 0.0001). Histological grade 3 tumors showed a significantly higher expression of Nrf2 and NF-κB than grade 1 tumors (p < 0.05). Material and methods: This study was approved by the Institutional Review Board of Federal University of Piaui and all patients assigned an inform consent term prior to the study initiation. Nrf2 and NF-κB expression was evaluated by immunohistochemistry in 66 patients, divided into two groups, control (fibroadenoma, n = 36) and study (cancer, n = 30). The data were analyzed using ANOVA test and the statistical significance was established at p < 0.05. Conclusion: Nrf2 and NF-κB expression was significantly higher in breast cancer than in fibroadenoma, in addition to having a greater association with more aggressive tumors.

Association between Single Nucleotide Polymorphisms and Glioma Risk: A Systematic Literature Review.

This study aimed to determine the main single nucleotide polymorphisms (SNPs) that are associated with an increased or decreased risk of glioma development in healthy individuals. We conducted a systematic review of the articles published in English on the PUBMED database between January 2008 and December 2017. Our search resulted in a total of 743 articles; however, only 56 were included in this review. A total of 148 polymorphisms were found, which involved 64 different genes. The polymorphisms that were most associated with an increased risk of glioma development were polymorphic variants rs179782, rs13181, and rs3791679 of the genes XRCC1, ERCC2, and EFEMP1, respectively.

Obstetric profile of perinatal deaths on a capital of the Northeast of Brazil / Perfil obstétrico dos óbitos perinatais em uma capital do Nordeste Brasileiro

Abstract Objectives: to analyze the obstetric and sociodemographic profile on perinatal deaths in Teresina the capital of Piauí, from data obtained from the Sistema de Informação de Mortalidade e Sistema de Informação de Nascidos Vivos (Brazilian Mortality Information System and Livebirth Information System). Methods: this is a retrospective cohort on perinatal deaths of mothers whose babies were born and resided in Teresina between 2010 and 2014. The analyzed variables were age and the mother´s schooling, gestational age, type of pregnancy (singleton or multiple), route of delivery (vaginal or cesarean), place of death (in and out hospital), time of death in relation to the delivery (prior, during or after), and birth weight. Results: the perinatal mortality coefficient (PMC) varied from 17.5 to 19.3 per 1,000 births. We found similarities in the sociodemographic profile and in the obstetric fetal and non-fetal deaths, both with a great incidence on 20 to 27 years-old mothers, vaginal delivery and singleton pregnancy. Low birth weight was positively related to early neonatal deaths. Conclusions: perinatal mortality presented a statistical correlation in gestational age, birth weight, and type of delivery. The PMC in our study was higher than other Brazilian capitals.

Resumo Objetivos: analisar o perfil obstétrico e sociodemográfico dos óbitos perinatais ocorridos em Teresina, capital do Piauí, a partir de dados provenientes dos Sistema de Informação de Mortalidade e Sistema de Informação de Nascidos Vivos. Métodos: coorte retrospectiva de óbitos perinatais nascidos de mães residentes em Teresina, entre 2010 e 2014. As variáveis analisadas foram faixa etária e escolaridade da mãe, idade gestacional, tipo de gravidez (única ou múltipla), via de parto (vaginal ou cesáreo), local do óbito (intra ou extra-hospitalar), momento do óbito em relação ao parto (antes, durante ou após), e peso do concepto. Resultados: o coeficiente de mortalidade perinatal (CMP) variou entre 17,5 e 19,3 por mil nascidos. Verificaram-se semelhanças quanto ao perfil sociodemográfico e obstétrico dos óbitos fetais e não fetais, ambos com maior incidência em mães com faixa etária entre 20 e 27 anos, em parto vaginal e no tipo de gravidez única. Baixo peso ao nascer se relacionou positivamente com os óbitos neonatais precoces. Conclusões: a mortalidade perinatal apresentou correlação estatística com a idade gestacional, o peso ao nascer, e o tipo de parto. O CMP no nosso estudo foi mais elevado do que o de outras capitais brasileiras.

A rare case of primary breast angiosarcoma in a male: a case report.

BACKGROUND: Sarcomas account for less than 1% of primary breast cancers, and breast angiosarcomas are responsible for only 0.05% of all breast malignancies. The male breast has the same potential for malignant transformation as the female breast. However, due to anatomical differences in the breast and the low incidence of angiosarcoma, it is difficult to determine how male breasts can be affected by this type of tumor. CASE PRESENTATION: A 36-year-old male patient was admitted to the hospital with a palpable lump in his right breast. Lymphadenopathy was negative. Ultrasonography showed a hypoechoic mass with partially defined contours, measuring 4.0 × 3.0 cm, with muscle infiltration. Histological examination revealed a malignant tumor. Radical mastectomy was then performed with clear surgical margins. The patient began chemotherapy with paclitaxel. Following the second cycle of chemotherapy, he presented with headache and seizures due to a frontal lobe metastasis. Twenty days after the onset of neurological symptoms, the patient died. CONCLUSIONS: Primary angiosarcomas of the male breast are extremely rare. This is the sixth case published in the literature. It is in agreement with other studies in the literature concerning clinical presentation and poor prognosis. Treatment consists in surgical removal of the tumor with clear margins and without axillary lymphadenectomy.

Análise das características de indivíduos com sequelas de traumatismo cranioencefálico (TCE) em um centro de referência em reabilitação (características de TCE) / Analysis of the characteristics of individuals with traumatic brain injury (TBI) in a rehabilitation reference center (TBI characteristics)

INTRODUÇÃO: O Traumatismo Cranioencefálico (TCE)é definido como uma alteração na função encefálica, devido a uma causa externa, ou seja, algum trauma físico de origem externa e que leva à morbimortalidade e incapacidades em todo o mundo. OBJETIVO: Analisar as características (aspectos sociodemográficos, causa do TCE; custos com saúde) de indivíduos com sequelas de traumatismo cranioencefálico em um centro de referência em reabilitação. METODOLOGIA: Estudo de natureza descritiva,retrospectiva e quantitativa no período de janeiro de 2009 a dezembro de 2013, por meio de análise documental, resultando em uma amostra final de 88 prontuários analisados. Foram incluídos indivíduos de ambos os sexos, com idade igual ou superior a dois anos de vida. RESULTADOS: Dos indivíduos com sequelas de TCE, 86,36% eram do sexo masculino, com idade entre 18 e 59 anos (80,68%), apresentando ensino médio completo (26,14%), de cor parda (52,27%) e com renda familiar entre um e cinco salários mínimos (60,23%). A causa mais frequente de TCE foi o acidente motociclístico (68,18%). Não houve diferença estatística entre tipos de causa de TCE e custos com saúde. CONCLUSÃO: O presente estudo demonstrou que grande parte dos indivíduos eram homens jovens e vítimas de acidente motociclístico.(AU)

INTRODUCTION: traumatic brain injury (TBI) is defined as a change in brain function due to an external cause, that is, some external physical trauma that leads to morbidity and mortality, disabilities and mortality worldwide. OBJECTIVE: To analyze the characteristics (Socio-demographic aspects; causes of TBI; Health costs) of individuals with traumatic brain injury sequelae in a referral center for rehabilitation. METHODOLOGY: descriptive, retrospective and quantitative study from January 2009 to December 2013, Through documentary analysis, resulting in a final sample of 88 analyzed medical records. Individuals of both sexes, aged 2 years or more, were included. RESULTS: Of the individuals with TBI sequelae, 86.36% were male, aged between 18 and 59 years (80.68%), with completed secondary education (26.14%), mulatto (52.27 %) and family income between 1 and 5 minimum wages (60.23%). The most frequent cause of TBI were motorcycle accidents (68.18%). There was no statistical difference between types of cause of TBI and health care costs. CONCLUSION: This study showed that most individuals were young men, motorcycle accident victims and who lost work capacity. (AU)

Genetic polymorphism of calcium-sensing receptor in women with breast cancer.

Breast cancer is a disease of unknown etiology, whose major risk factors are genetic alterations. Polymorphism of the calcium-sensing receptor (CaSR) has been a focus of some recent studies, due to a probable association with breast cancer risk and tumor aggressiveness. A relationship between polymorphic rs17251221 variant of the CaSR gene, and allele G (considered a gain-of-function mutation) and breast cancer risk has been stressed, despite the paucity of studies found in the literature. The present study involved 137 women (69 women with breast cancer-case; and 68 controls without breast cancer) who had 3 ml of peripheral blood drawn for DNA study. Genomic DNA was extracted from leukocytes by genotyping technique with real-time polymerase chain reaction. The AG genotype (rs17251221) was present in 13 women (18.84%) from the case group and in 8 (11.76%) women from the control group (p = 0.3434), while the GG genotype (rs17251221) did not occur in any group. In contrast, no statistically significant difference was observed between the AG genotype of variant rs17251221 in premenopausal case and control women (p = 0.71). There was also no statistically significant difference between postmenopausal case and control patients (p = 0.6851). In the current study, CaSR gene polymorphism of SNP variant rs17251221 did not show any statistically significant association with breast cancer, in both premenopausal and postmenopausal women.

Epidemiological situation of acquired immunodeficiency syndrome (AIDS)-related mortality in a municipality in northeastern Brazil. A retrospective cross-sectional study

ABSTRACT CONTEXT AND OBJECTIVE: The number of acquired immunodeficiency syndrome (AIDS)-related deaths covers different segments of the population differently, making monitoring of this mortality essential. The aim of this study was to describe the epidemiological situation of AIDS-related mortality in a municipality in the northeastern region of Brazil. DESIGN AND SETTING: Retrospective cross-sectional study based on data from death certificates in the mortality information system of the Health Information Center, Municipal Health Foundation, Brazil. METHODS: Between 2003 and 2013, we investigated death certificates on which AIDS-related mortality was reported. Sociodemographic data, year, place, type of establishment where death occurred and underlying and associated causes that led to AIDS-related death were described. The Mann-Kendall test was used to verify the growth trend of the standardized mortality rate over the period studied. RESULTS: Among the 1,066 AIDS-related deaths, 69.7% were among men; 47.2% of the individuals were 28-41 years of age, 32.7% had had 4-7 years of schooling, 66.9% were pardos (mixed race), 55.7% were unmarried and 15.3% were housekeepers. Hospitals were the site of 97% of the deaths, and 91% occurred at public hospitals. Respiratory failure was the main cause of death. The prevalence of infectious and parasitic diseases was 99.0%. AIDS-related mortality increased by 160% over the period studied, from 5.5/100,000 inhabitants in 2003 to 14.3/100,000 in 2013. CONCLUSION: In the Brazilian municipality studied here, AIDS-related mortality was most prevalent among men and young adults of lower socioeconomic level. Over the period studied, the mortality rate increased.

Epidemiological situation of acquired immunodeficiency syndrome (AIDS)-related mortality in a municipality in northeastern Brazil. A retrospective cross-sectional study.

CONTEXT AND OBJECTIVE: The number of acquired immunodeficiency syndrome (AIDS)-related deaths covers different segments of the population differently, making monitoring of this mortality essential. The aim of this study was to describe the epidemiological situation of AIDS-related mortality in a municipality in the northeastern region of Brazil. DESIGN AND SETTING: Retrospective cross-sectional study based on data from death certificates in the mortality information system of the Health Information Center, Municipal Health Foundation, Brazil. METHODS: Between 2003 and 2013, we investigated death certificates on which AIDS-related mortality was reported. Sociodemographic data, year, place, type of establishment where death occurred and underlying and associated causes that led to AIDS-related death were described. The Mann-Kendall test was used to verify the growth trend of the standardized mortality rate over the period studied. RESULTS: Among the 1,066 AIDS-related deaths, 69.7% were among men; 47.2% of the individuals were 28-41 years of age, 32.7% had had 4-7 years of schooling, 66.9% were pardos (mixed race), 55.7% were unmarried and 15.3% were housekeepers. Hospitals were the site of 97% of the deaths, and 91% occurred at public hospitals. Respiratory failure was the main cause of death. The prevalence of infectious and parasitic diseases was 99.0%. AIDS-related mortality increased by 160% over the period studied, from 5.5/100,000 inhabitants in 2003 to 14.3/100,000 in 2013. CONCLUSION: In the Brazilian municipality studied here, AIDS-related mortality was most prevalent among men and young adults of lower socioeconomic level. Over the period studied, the mortality rate increased.

A comparative study of Ki-67 antigen expression between luminal A and triple-negative subtypes of breast cancer.

Tumor biomarkers such as hormone receptors, HER-2 and Ki-67 are used routinely in clinical practice for classification of molecular subtypes of breast cancer. Cell proliferation evaluated by Ki-67 antigen expression is important to determine tumor aggressiveness. However, there is a paucity of studies comparing Ki-67 expression in an expressive number of cells among molecular subtypes of breast cancer, particularly among less and more aggressive tumors, such as luminal A and triple-negative, which have led us to the present study. The current study included invasive ductal carcinoma samples of 59 patients, which were divided into two groups: luminal A (n = 29) and triple-negative (n = 30). For immunohistochemical reaction, the samples were incubated with monoclonal anti-Ki-67 antibody (clone MIB1) and cells expressing Ki-67 protein were identified by dark brown staining of the nuclei, counting at least 600 cells per slide. The mean percentages of stained nuclei were analyzed by Student's t test (p < 0.05). The mean percentage of nuclei stained with anti-ki-67 was 10.14 and 77.22 in luminal A and triple-negative breast cancers, respectively (p < 0.0001). Our study showed a high cell proliferation of triple-negative breast cancer in comparison with luminal A, justifying its aggressiveness and poor clinical outcome.

Prevalence of photoprotection and its associated factors in risk group for skin cancer in Teresina, Piauí.

BACKGROUND:: The incidence of skin cancer has increased worldwide, particularly melanoma rates, which had a mean development of 2.6 % a year in the last 10 years. The agreement on the relation between long-term or chronic exposure to the sun and the emergence of these neoplasias has made several workers who perform activities exposed to solar radiation to form a risk group for the development of skin cancer, community health agents included. OBJECTIVES:: To analyze the prevalence of sunscreen-use-related factors to skin cancer in a labor risk group. METHODOLOGY:: Cross-sectional study with community health agents selected through simple random sampling. After collecting data using semi-structured interviews, a descriptive analysis was performed for the qualitative variables, bivariate analysis was employed for checking the association between sunscreen use and sociodemographic, occupational and knowledge about skin variables, and multivariate analysis was conducted to check independent variables associated to sunscreen use. A 5% significance level was used. RESULTS:: Of 261 health gents selected, 243 were able to participate in the study. The prevalence rate of sunscreen use was 34.2% (95% CI: 28.2-40.2). Factors associated with sunscreen use were female sex, advanced age, use of sunscreen in situations when the skin got burnt, knowledge of the negative effects of the sun on the skin and skin cancer history. CONCLUSIONS:: The prevalence found reveals that there is a need for implementing educational strategies in health services regarding photoprotection.

Prevalence of photoprotection and its associated factors in risk group for skin cancer in Teresina, Piauí

Abstract: Background: The incidence of skin cancer has increased worldwide, particularly melanoma rates, which had a mean development of 2.6 % a year in the last 10 years. The agreement on the relation between long-term or chronic exposure to the sun and the emergence of these neoplasias has made several workers who perform activities exposed to solar radiation to form a risk group for the development of skin cancer, community health agents included. OBJECTIVES: To analyze the prevalence of sunscreen-use-related factors to skin cancer in a labor risk group. METHODOLOGY: Cross-sectional study with community health agents selected through simple random sampling. After collecting data using semi-structured interviews, a descriptive analysis was performed for the qualitative variables, bivariate analysis was employed for checking the association between sunscreen use and sociodemographic, occupational and knowledge about skin variables, and multivariate analysis was conducted to check independent variables associated to sunscreen use. A 5% significance level was used. Results: Of 261 health gents selected, 243 were able to participate in the study. The prevalence rate of sunscreen use was 34.2% (95% CI: 28.2-40.2). Factors associated with sunscreen use were female sex, advanced age, use of sunscreen in situations when the skin got burnt, knowledge of the negative effects of the sun on the skin and skin cancer history. Conclusions: The prevalence found reveals that there is a need for implementing educational strategies in health services regarding photoprotection.

O ensino da humanização no curso de bacharel em enfermagem numa universidade pública / The teaching of humanization in the nursing bachelor course in a public university / La enseñanza de la humanización en el curso de bacharelado en enfermaría en una universidad pública

Objetivo: analisar o ensino da humanização no curso de bacharelado em enfermagem em uma universidadepública. Método: estudo exploratório, descritivo, de abordagem qualitativa. Para a produção de dados foramutilizados como instrumentos formulários para entrevistas com a coordenação e os docentes e aplicado umquestionário aos discentes. Participaram seis docentes e 21 discentes de uma instituição pública do Piauí (PI),Brasil. Foi realizada a análise documental, as entrevistas foram transcritas, lidas, relidas e analisadas combase na análise textual discursiva. Resultados: há a inserção de conteúdos humanísticos no currículo, masreveladas fragilidades no ensino: interdisciplinaridade deficiente; relação conflituosa no processo ensinoserviço;domínio dos procedimentos técnicos. Conclusão: não existe consenso entre docentes e discentesquanto à abordagem do ensino da humanização. Há a necessidade de adequações às Diretrizes CurricularesNacionais. A articulação entre ensino-pesquisa-serviço e o domínio de habilidades que estimulem o cuidadosensível na saúde também merecem atenção.(AU)

Objective: to analyze the teaching of humanization in the nursing bachelor course at a public university. Method: exploratory, descriptive study with a qualitative approach. For the production of data, instruments were used as forms for interviews with the coordination and the teachers, and a questionnaire was applied to the students. Six teachers and 21 students from a public institution in Piauí (PI), Brazil participated. The documentary analysis was performed, the interviews were transcribed, read, re-read and analyzed based on discursive textual analysis. Results: there is the insertion of humanistic contents in the curriculum, but there are weaknesses revealed in teaching: deficient interdisciplinarity; Conflict relationship in the teaching-service process; Technical procedures. Conclusion: there is no consensus among teachers and students about the approach to teaching humanization. There is a need for adjustments to the National Curricular Guidelines. The articulation between teaching-research-service, the mastery of skills that stimulate sensitive health care also deserves attention.(AU)

Objetivo: analizar la enseñanza de la humanización en el curso de bachillerato en enfermería en una universidad pública. Método: estudio exploratorio, descriptivo, de enfoque cualitativo. Para la producción de datos fueron utilizados como instrumentos formularios para entrevistas junto a la cordinación y a los docentes y aplicado un cuestionario a los discentes. Participaron seis docentes y 21 discentes de una institución pública de Piauí (PI), Brasil. Fue realizado el análisis documental, las entrevistas fueron transcritas, leídas, releídas y analizadas con base en el análisis textual discursivo. Resultados: hay inserción de contenidos humanísticos en el currículo, pero reveladas fragilidades en la enseñanza: interdisciplinaridad deficiente; relación conflictuosa en el proceso enseñaza-servicio; dominio de los procedimientos técnicos. Conclusión: no existe consenso entre docentes y discentes sobre el enfoque de la enseñanza de la humanización. Hay necesidad de adecuaciones a las Directrices Curriculares Nacionales. La articulación entre enseñanzainvestigación-servicio, el dominio de habilidades que estimulen al cuidado sensible en la salud también merecen atención.(AU)

Factors Associated with Infant Mortality in a Northeastern Brazilian Capital / Fatores associados à mortalidade infantil em uma capital do Nordeste brasileiro

Abstract Purpose Identify factors associated with infant mortality by a hierarchical model based on socioeconomic, health care, obstetric and biological determinants in a northeastern Brazilian capital. Methods Observational, retrospective cohort study based on secondary data of births and deaths of infants of mothers living in the city of Teresina. Results Based on the distal level of determination of infant mortality, the characteristics that remained statistically significant were maternal age, maternal education and maternal occupation (p< 0.001). In the intermediate level, all variables were statistically significant, particularly the type of pregnancy and delivery (p< 0.001). The gender of the baby was the proximal level feature that had no significant association with the outcome, while the other variables of this level had association (p< 0.001). Conclusions This study evidenced that, in addition to biological factors, socioeconomic status and maternal and child health care are important to determine infant mortality.

Resumo Objetivo Identificar os fatores associados à mortalidade infantil por modelo hierárquico segundo determinantes socioeconômicos, assistenciais, obstétricos e biológicos em uma capital do Nordeste brasileiro. Métodos Estudo observacional, de coorte retrospectiva, com base em dados secundários de nascimentos e óbitos de crianças menores de um ano, de mães residentes no município de Teresina (PI). Resultados Para o nível distal de determinação da mortalidade infantil, as características que se mantiveram estatisticamente significativas foram idade materna, escolaridade materna e ocupação materna, com p< 0,001. No intermediário, todas as variáveis apresentaram significância estatística, com destaque para o tipo de gravidez e de parto, com p< 0,001. O sexo do bebê representou a característica do nível proximal que não obteve associação significativa com o desfecho, enquanto as demais variáveis desse nível estavam associadas, com p< 0,001. Conclusões Além da determinação da mortalidade infantil pelos fatores biológicos, destacou-se a importância da condição socioeconômica e da assistência à saúde materno-infantil.

A historiographic study of psychiatric treatments in Brazil: mentalism and organicism from 1830 to 1859.

Our aim is to investigate two major tendencies in nineteenth-century Brazilian alienism: mentalism and organicism, by conducting a descriptive study of original Brazilian documents on medical health treatments in the 1830s, 1840s and 1850s. Primary sources of Brazilian alienism were theses, memoirs, official reports, and documents written by clinicians and asylum directors. We analysed early mental treatment in Brazilian lunatic asylums, exploring the relative contributions of two main theoretical orientations: moral treatment (based on Pinel and Esquirol) and 'medical-organicist therapeutic orientation'. Intertextuality was used to assess reports of medical organicist treatment in Brazil. We concluded that contemporaneous textual sources indicate that mid-nineteenth-century alienism in Brazil was predominantly influenced by organicism exported from European countries. Pinel's mentalist view, nevertheless, remained the reference point for clinical issues associated with the doctor-patient relationship.