Açaí (Euterpe oleracea Mart.) Seed Oil and Its Nanoemulsion: Chemical Characterisation, Toxicity Evaluation, Antioxidant and Anticancer Activities.

This study explores a nanoemulsion formulated with açaí seed oil, known for its rich fatty acid composition and diverse biological activities. This study aimed to characterise a nanoemulsion formulated with açaí seed oil and explore its cytotoxic effects on HeLa and SiHa cervical cancer cell lines, alongside assessing its antioxidant and toxicity properties both in vitro and in vivo. Extracted from fruits sourced in Brazil, the oil underwent thorough chemical characterization using gas chromatography-mass spectrometry. The resulting nanoemulsion was prepared and evaluated for stability, particle size, and antioxidant properties. The nanoemulsion exhibited translucency, fluidity, and stability post centrifugation and temperature tests, with a droplet size of 238.37, PDI -9.59, pH 7, and turbidity 0.267. In vitro assessments on cervical cancer cell lines revealed antitumour effects, including inhibition of cell proliferation, migration, and colony formation. Toxicity tests conducted in cell cultures and female Swiss mice demonstrated no adverse effects of both açaí seed oil and nanoemulsion. Overall, açaí seed oil, particularly when formulated into a nanoemulsion, presents potential for cancer treatment due to its bioactive properties and safety profile.

Utilization of Fusarium Solani lipase for enrichment of polyunsaturated Omega-3 fatty acids.

Omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), offer numerous health benefits. Enriching these fatty acids in fish oil using cost-effective methods, like lipase application, has been studied extensively. This research aimed to investigate F. solani as a potential lipase producer and compare its efficacy in enhancing polyunsaturated omega-3 fatty acids with commercial lipases. Submerged fermentation with coconut oil yielded Lipase F2, showing remarkable activity (215.68 U/mL). Lipase F2 remained stable at pH 8.0 (activity: 93.84 U/mL) and active between 35 and 70 °C, with optimal stability at 35 °C. It exhibited resistance to various surfactants and ions, showing no cytotoxic activity in vitro, crucial for its application in the food and pharmaceutical industries. Lipase F2 efficiently enriched EPA and DHA in fish oil, reaching 22.1 mol% DHA and 23.8 mol% EPA. These results underscore the economic viability and efficacy of Lipase F2, a partially purified enzyme obtained using low-cost techniques, demonstrating remarkable stability and resistance to diverse conditions. Its performance was comparable to highly pure commercially available enzymes in omega-3 production. These findings highlight the potential of F. solani as a promising lipase source, offering opportunities for economically producing omega-3 and advancing biotechnological applications in the food and supplements industry.

Prediction of metabolic syndrome and its associated risk factors in patients with chronic kidney disease using machine learning techniques.

INTRODUCTION: Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD. METHODS: This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05. RESULTS: A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve - AUC = 0.79). CONCLUSION: The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD.

Impact of deep resection of endometriosis in the pelvis on urodynamic parameters

Purpose: To evaluate the effects of deep resection of endometriosis in the posterior pelvic region on urodynamic parameters. Methods: A prospective observational study conducted with female patients diagnosed with deep pelvic endometriosis before and after endometriosis resection surgery. Clinical history, image exams, the Female Lower Urinary Tract Symptoms questionnaire, urodynamic examination, cystometry, and voiding study were evaluated. Results: Patients aged 30-39 years old, operative duration of 132.5 minutes, and 2.7 days of hospital stay. Uroflowmetry and cystometry showed tendency for an increase after the surgery in the flow duration, time to maximum flow, and first voiding desire and decreased residual volume and maximum cystometric capacity. Opening, maximum urinary flow, and maximum flow pressure decreased at T1, and the closing parameters increased, although statistically non significant. The variables decreased at T1 in the urodynamic, except for detrusor overactivity. Although we observed a reasonable number of low bladder compliance and abnormal bladder sensation, the results were maintained at T1. General scores for filling and incontinence showed a significant decrease after surgery. Conclusions: A significant response in the patient's perception of urinary function was demonstrated after surgery. It is observed that the surgical procedure did not affect the uroflowmetric and cystometric characteristics of the evaluated patients.

HPV 18 variants in women with cervical cancer in Northeast Brazil

Abstract Background Human Papillomavirus (HPV) is the main etiological factor for the development of cervical cancer. HPV 18 is the second most frequent type, accounting for up to 65% of all cases. HPV intratypic variation may influence the potential for progression to invasive cancer. The aim of this study was to evaluate the prevalence of human papillomavirus 18 intratypic variants in cervical cancer samples from women in the state of Maranhão, Brazil. Methods The study included 118 women over 18 years of age with a diagnosis of cervical cancer. Tumor fragments were collected and subjected to DNA extraction and Polymerase Chain Reaction (PCR) for HPV detection using the PGMY09/11 and GP+5/6 primers. Positive samples were submitted to automated sequencing for viral genotyping. To determine the HPV 18 lineages, positive samples were submitted to PCR, using specific primers to amplify the LCR and E6 regions of HPV 18 virus. Results HPV was present in 88 women (73.3%). Of those, 48 (54%) were HPV 16, the most prevalent, followed by 12 (13.6%) HPV 18. Histologically, squamous cell carcinoma was predominant (79.1%). Among the HPV 18 variants identified, 10 (80%) belonged to lineage A, and sublineages A1, A2, A3, and A4. Two (29%) HPV 18 B variant was also detected, with the sublineages B1 and B2. In this study, the C variant was not found. There was no statistically significant association between the HPV 18 lineages found and sociodemographic and lifestyle variables (p > 0.05). Conclusions A higher frequency of HPV 16 and 18 were found in women with cervical cancer in the state of Maranhão, Brazil, with a high prevalence of the lineage A among women with HPV 18.

Síndrome congênita pelo vírus zika: análise das redes de apoio de pais / Síndrome congénito por el virus del zika: análisis de las redes de apoyo de padres / Congenital zika syndrome: analysis of parent support networks

Resumo Objetivo Compreender o papel das redes de apoio no cuidado de crianças acometidas pela Síndrome Congênita pelo Vírus Zika. Métodos Estudo qualitativo, realizado em Centro de Referência Estadual em Neurodesenvolvimento, no nordeste brasileiro, entre abril de 2017 e fevereiro de 2018. Participaram pais de crianças com microcefalia atendidos no local. Foram realizadas 18 entrevistas semiestruturadas, sendo três com pai e mãe e 15 somente com mães, totalizando 21 participantes. A amostra foi definida pelo critério de saturação e foi utilizada análise de conteúdo na modalidade temática. Resultados Os resultados são apresentados a partir das categorias de análise "rede informal" e "rede formal". A rede de apoio informal, especialmente os avós, exerceu importante suporte emocional e financeiro aos pais. As redes sociais virtuais se destacaram como espaço de compartilhamento de informações e experiências. Quanto à rede de apoio formal, as famílias estabeleceram vínculos mais fortes com profissionais da atenção especializada que ofertaram suporte técnico e acolhimento aos pais e às crianças. Já a atenção primária desempenhou mais o papel de encaminhamento para a atenção especializada. Foram relatados diferentes graus de resolutividade por parte dos municípios, em termos de programas, de atuação de gestores e de profissionais. Conclusão As redes informais e formais atuaram de modo complementar no tratamento e apoio às crianças com Síndrome Congênita pelo Vírus Zika. A inserção em diferentes redes informais possibilitou apoio social para enfrentar o impacto provocado pela doença. Apesar do investimento do Ministério da Saúde na atenção primária foi identificada fragilidade neste nível de atenção.

Resumen Objetivo Comprender el papel de las redes de apoyo en el cuidado de niños afectados por el síndrome congénito por el virus del zika. Métodos Estudio cualitativo, realizado en un Centro de Referencia Regional en Neurodesarrollo, en el nordeste brasileño, entre abril de 2017 y febrero de 2018. Participaron padres de niños con microcefalia atendidos en el lugar. Se realizaron 18 entrevistas semiestructuradas, de las cuales tres fueron con el padre y la madre y 15 solo con madres, un total de 21 participantes. La muestra fue definida por el criterio de saturación y se utilizó análisis de contenido en la modalidad temática. Resultados Los resultados se presentan a partir de las categorías de análisis "red informal" y "red formal". La red de apoyo informal, especialmente los abuelos, ejerció un importante soporte emocional y financiero para los padres. Las redes sociales virtuales se destacaron como un espacio para compartir información y experiencias. Respecto a la red de apoyo formal, las familias establecieron vínculos más fuertes con profesionales de la atención especializada, que ofrecieron soporte técnico y acogida a los padres y a los niños. Por otro lado, la atención primaria cumplió más el papel de derivar a la atención especializada. Se relataron diferentes niveles de resolución de problemas por parte de los municipios, en términos de programas, de actuación de gestores y de profesionales. Conclusión Las redes informales y formales actuaron de modo complementario en el tratamiento y apoyo a niños con síndrome congénito por el virus del zika. La inserción en diferentes redes informales permitió un apoyo social para enfrentar el impacto provocado por la enfermedad. A pesar de las inversiones en atención primaria del Ministerio de Salud, se identificó fragilidad en este nivel de atención.

Abstract Objective To understand the role of support networks in the care of children affected by Congenital Zika Syndrome. Methods This is a qualitative study, conducted at a State Reference Center on Neurodevelopment, in northeastern Brazil, between April 2017 and February 2018. Parents of children with microcephaly treated at the site participated. 18 semi-structured interviews were conducted, three with father and mother and 15 only with mothers, totaling 21 participants. The sample was defined by the saturation criterion and content analysis was used in the thematic modality. Results The results are presented from the categories of analysis "informal network" and "formal network". The informal support network, especially grandparents, exercised important emotional and financial support to parents. Virtual social networks stood out as a space for sharing information and experiences. Regarding the formal support network, the families established stronger bonds with specialized care professionals who offered technical support and care to parents and children. Primary care, on the other, played the role of referral to specialized care. Different degrees of resolution were reported by the municipalities, in terms of programs, the performance of managers and professionals. Conclusion Formal and formal networks acted in a complementary way in the treatment and support of children with Congenital Zika Syndrome. The insertion in different indirect networks allowed social support to face the impact caused by the disease. Despite the ministry of health's investment in primary care, fragility was identified in this level of care.

Quality of life of mothers of children with congenital syndrome affected by zika virus / Qualidade de vida de mães de crianças com síndrome congênita afetadas pelo zika vírus

ABSTRACT Objective: To investigate how mothers of children with congenital syndrome (microcephaly) associated with Zika virus perceive their quality of life. Methods: This is a qualitative study carried out in two stages: at the Maternal and Child University Hospital and at Casa de Apoio Ninar through semi-structured interviews with mothers of children with congenital syndrome associated with Zika virus. Ten women comprised the sample. Results: In line with the critical discourse analysis, four categories emerged based on Fairclough's 2008 assumptions: Quality of Life and Health - quality of life perception associated with the broad meaning of the term health; Quality of Life and Health Care Systems - characterized by care instability and fragmentation; Quality of Life and Free Time - lack of free time for activities of daily living and leisure; Quality of Life and Future Perspectives - lack of future perspective, considering that most participants had to stop working and studying to take care of their children. Conclusions: Mothers of children with congenital syndrome associated with Zika virus are devoted to their children's care. Their lack of prospects was considered a consequence of the lack of time for activities of daily living and leisure.

RESUMO Objetivo: Investigar a percepção da qualidade de vida das mães de crianças portadoras de síndrome congênita (microcefalia) associada ao Zika vírus. Métodos: Trata-se de um estudo qualitativo realizado em duas etapas. A primeira foi conduzida no Hospital Universitário Materno-Infantil e a segunda na Casa de Apoio Ninar, por meio de entrevista semiestruturada com mães de crianças que apresentam a síndrome congênita associada ao Zika vírus. A amostra foi composta por 10 mulheres. Resultados: Em consonância com a análise crítica do discurso, segundo os pressupostos de Fairclough, de 2008, quatro categorias emergiram: Qualidade de Vida e Saúde - a percepção da qualidade de vida está vinculada ao significado amplo do termo saúde; Redes de Qualidade de Vida e Atenção à Saúde - caracterizadas por precariedade e fragmentação do cuidado; Qualidade de Vida e Tempo Livre - falta de tempo livre para realizar atividades da vida diária e lazer; Qualidade de Vida e Perspectivas Futuras - foi abordada a falta de perspectiva futura, uma vez que a maioria das participantes teve que parar de trabalhar e estudar para cuidar dos filhos. Conclusões: Mães de crianças com síndrome congênita associada ao vírus Zika são totalmente dedicadas ao cuidado de seus filhos. A falta de perspectivas para o futuro foi considerada em decorrência da falta de tempo para lazer e atividade da vida diária.

Influencia do uso de chupetas e mamadeiras na prática do aleitamento materno / Influence of the use of artificial nipples and baby bottles in breastfeeding

Objetivo: Verificar, na mais recente literatura, o efeito dos bicos artificiais, como mamadeiras e chupetas, sobre a prática do aleitamento materno. Métodos: Foi realizada uma revisão da literatura nas bases de dados LILACS, SciELO e PubMed, considerando estudos originais publicados entre os anos de 2010 e 2015, em português e inglês, utilizando-se os descritores "chupetas", "amamentação", "mamadeiras", "desmame" e "alimentação artificial", combinados ou isolados, com seus respectivos correspondentes na língua inglesa. Resultados: foram incluídos 25 artigos conforme os critérios de inclusão e exclusão. Estudos apontaram uma relação entre o desmame e o uso de chupetas, e o desmame e uso de chupetas e outros bicos artificiais. Além disso, os estudos evidenciaram que a redução no uso de chupeta gera um aumento na duração do aleitamento. Outras variáveis comuns relacionadas ao desmame relatadas na literatura foram: ausência materna, trabalhar fora ou falta de proteção legal, baixa escolaridade materna, idade materna e problemas relacionados às mamas e nascimento em unidade não "Hospital Amigo da Criança". Conclusões: O uso de bicos artificiais está sendo relacionado ao desmame precoce ou à diminuição da duração do aleitamento materno. Necessita-se ainda que outros estudos sejam realizados a fim de compreender melhor como os bicos artificiais agem sobre as habilidades orais da criança. (AU)

Objective: To verify, in the most recent literature, the effect of artificial nipples, such as baby bottles and pacifiers, on the practice of breastfeeding. Methods: A review of the literature in the LILACS, SciELO and PubMed databases was carried out, considering original studies published between the years 2010 and 2015, in Portuguese and English, using the descriptors "pacifiers", "breastfeeding", "Weaning", and "artificial feeding", combined or isolated. Results: 25 articles were included according to the inclusion and exclusion criteria. Studies have pointed out a relationship between weaning and the use of pacifiers, and the weaning and use of pacifiers and other artificial nipples. In addition, studies have shown that reduction in pacifier use leads to an increase in the duration of breastfeeding. Other common variables related to weaning reported in the literature were maternal absence, working out or lack of legal protection, low maternal schooling, maternal age and problems related to breasts and birth in a non-baby friendly hospital. Conclusions: The use of artificial nipples is being related to early weaning or shortening the duration of breastfeeding. Further studies are needed to better understand how artificial nipples act on a child's oral skills. (AU)

Burnout no trabalho de médicos pediatras / Pediatricians' job burnout

Contexto: A síndrome de esgotamento profissional ou burnout é uma reação de estresse excessivo relacionada ao trabalho, a qual se apresenta em três dimensões: exaustão emocional, despersonalização e reduzida realização profissional. Objetivos: O presente estudo teve como objetivo identificar e comparar essas três dimensões presentes nos pediatras do Hospital Universitário da Universidade Federal do Maranhão (UFMA) ­ Unidade Materno Infantil. Métodos: Trata-se de um estudo quantitativo e descritivo envolvendo 78 profissionais. Utilizou-se como instrumento de pesquisa o Maslach Burnout Inventory e o questionário sociodemográfico. Resultados: A análise dos dados apontou que a prevalência de burnout foi de 2,6%. Níveis elevados de exaustão emocional, despersonalização e reduzida realização profissional foram encontrados em 42,3, 38,5 e 6,4% dos entrevistados, respectivamente. A prevalência de nível elevado em duas dimensões foi de 23,1%. Conclusões: Os pediatras apresentaram altos valores de exaustão emocional e baixos valores de despersonalização e reduzida realização profissional. Ressalta-se a necessidade de estruturação de programas de enfrentamento de burnout a fim de evitar o adoecimento de profissionais envolvidos com a promoção da saúde de crianças e adolescentes.

Background: Burnout is an excessive work-related stress response that involves three main dimensions: emotional exhaustion, depersonalization and reduced professional achievement. Aims: The present study aimed to identify and compare these three dimensions among pediatricians at the Mother-Child Unit of University Hospital, Federal University of Maranhão (Universidade Federal do Maranhão ­ UFMA). Methods: The present quantitative and descriptive study included 78 professionals. The Maslach Burnout Inventory and a sociodemographic questionnaire were used for data collection. Results: Data analysis showed that the prevalence of burnout was 2.6%. High levels of emotional exhaustion, depersonalization and reduced professional achievement were found in 42.3%, 38.5% and 6.4% of the participants, respectively. The prevalence of high levels in two of these dimensions simultaneously was 23.1%. Conclusions: The analyzed pediatricians exhibited high levels of emotional exhaustion and low values of depersonalization and reduced personal accomplishment. The need to develop programs against burnout is emphasized to avoid the occurrence of illness among professionals involved in the promotion of child and adolescent health.

Prevalence of human papillomavirus infection in squamous cell carcinoma of the anal canal in a Northeast City in Brazil: viral genotyping and clinical aspects

Background: Anal cancer malignancies comprise about 1.5 to 3% of cancers from the gastrointestinal in which high-risk types of human papillomavirus (HR-HPV) is responsible for >80% of cases. The aim of this work was to detect and perform human papillomavirus (HPV) genotyping in squamous cell carcinoma specimens from the anal canal and to investigate the association between viral infection and histopathological and clinical aspects. Methods: The presence of genotype-specific HPV DNA in formalin-fixed paraffin embedded tissue from 27 anal SCC samples from a reference cancer hospital of São Luís, State of Maranhão, Brazil was performed by Linear Array HPV Genotyping Test and the INNO-LiPA HPV Genotyping Assay. Fisher's Exact test and Chi-square test were performed in order to evaluate the association between HPV type and clinical and morphological variables. P values less than 0.05 were considered statistically significant. Results: Average age of patients at the time of diagnosis was 54.96 years ± 15.81; 74.07% of patients were female. Vegetative ulcers represented the most common type of lesion (22.22%). The lesions ranged in size from 2.1 cm to 5.0 cm and mostly were well-differentiated (70.38%). Lymph node involvement was observed in 26% of the patients. Molecular evaluation revealed that HPV infection was detected in 81.48% of the lesions, and the most common type found was the oncogenic HPV 16. Statistical analysis indicated that the clinical and histopathological variables were not associated with HPV infection. Conclusions: Our results indicate that anal SCC rarely occurs in the absence of HPV and emphasize the predominant role of HPV16. The evaluation about genotype-specific prevalence of HPV in anal SCC is important to assess the potential benefit of HPV vaccination (AU)

Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care

ABSTRACT Background Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women’s care during pregnancy, in order to prevent diseases that could compromise the mother and the child’s life. Methods This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary – prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. Results The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women’s guidance. Conclusion The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.

Epidemiological profile of patients co-infected with visceral leishmaniasis and HIV/AIDS in Northeast, Brazil

Abstract INTRODUCTION: Visceral leishmaniasis (VL) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-infection has been a research topic of interest worldwide. In Brazil, it has been observed that there is a relative underreporting and failure in the understanding and management of this important association. The aim of this study was to analyze epidemiological and clinical aspects of patients with VL with and without HIV/AIDS. METHODS: We conducted an observational and analytical study of patients with VL followed in a Reference Service in the State of Maranhão, Brazil from 2007-2013. RESULTS: In total 126 patients were enrolled, of which 61 (48.4%) were co-infected with HIV/AIDS. There were more males among those with HIV/AIDS (85.2%, P>0.05) or with VL only (81.5%, P>0.05). These findings significantly differed based on age group (P<0.003); the majority of patients were aged 31-40 years (41.0%) and 21-30 years (32.3%) among those with and without HIV/AIDS co-infection, respectively. The incidence of diarrhea and splenomegaly significantly differed between the two groups (P=0.0014 and P=0.019, respectively). The myelogram parasitic examination was used most frequently among those with HIV/AIDS (91.8%), followed by those with VL only (69.2%). VL recurrences and mortality were significantly higher in the HIV/AIDS co-infected patients (P<0.0001 and P=0.012, respectively). CONCLUSIONS: Patients with VL with or without HIV/AIDS co-infection were mostly adult men. Diarrhea was more frequent in HIV/AIDS co-infected patients, whereas splenomegaly was more common in patients with VL only. In the group of HIV/AIDS co-infected patients, there was a higher rate of VL recurrence and mortality.

Patologias osteomusculares como causa de aposentadoria por invalidez em servidores públicos do município de São Luís, Maranhão / Musculoskeletal pathology as a cause of disability retirement for public servants in the municipality of São Luís, Maranhão

Introdução: É evidente a preocupação do governo em regulamentar as ações relacionadas à saúde. É passível de aposentadoria por invalidez o servidor acometido de espondilite anquilosante e outras doenças osteomusculares. Objetivo: Descrever o perfil de morbidade por patologias osteomusculares dos servidores públicos do município de São Luís aposentados por invalidez. Materiais e Métodos: Trata-se de um estudo observacional, descritivo e retrospectivo, de 60 fichas de funcionários contendo informações registradas pela Comissão de Perícia Médica no período de janeiro de 2009 a dezembro de 2011. Calculou-se como indicador de impacto da aposentadoria por invalidez em doenças osteomusculares os somatórios dos anos perdidos em decorrência da aposentadoria. A condução do estudo recebeu anuência da Comissão de Perícia Médica do IPAM e dos funcionários por meio do Termo de Compromisso de Utilização de Prontuários e Termo de Consentimento Livre e Esclarecido. Resultados: A análise de aposentadoria por invalidez em razão do diagnóstico por patologias osteomusculares demonstra que ocorreu prevalência do sexo masculino (90,00%) na faixa etária de 61 a 65 anos, e as profissões mais acometidas foram professores e agente administrativo. As patologias osteomusculares ocorreram em 10,00% da amostra do estudo, e os profissionais que mais se aposentaram por invalidez tipo integral e/ou proporcional foram agente administrativo e auxiliar de serviços gerais. Conclusão: O estudo mostra a necessidade de promoção de saúde e vigilância em relação à saúde do trabalhador, propiciando melhores condições de trabalho e reduzindo o adoecimento dos servidores, diminuindo o número de aposentadoria por invalidez por patologias osteomusculares.

Background: It is clear the concern of governments to discipline the actions related to health. It is likely to disability retirement the server stricken with ankylosing spondylitis and other musculoskeletal diseases. Objective: Describe the morbidity profile for musculoskeletal pathologies of public in São Luís retired due to disability. Materials and Methods: This was an observational, descriptive and retrospective, study of 60 employee records containing information recorded by the Commission of Forensic Medicine between January 2009 and December 2011. The sums of years lost due to retirement were calculated as an indicator of the impact of disability retirement in musculoskeletal diseases. The conduct of the study received approval from the Commission of Forensic Medicine Division of IPAM and staff through the Commitment Term Use of Medical Records and Statement of Consent. Results: The analysis of disability retirement due to musculoskeletal disorders diagnosis shows that occurred primarily in men (90.00%) aged 61 ? 65 years, and the professionals most affected were teachers and administrative agent. The musculoskeletal disorders occurred in 10.00% of the study sample, and the most retired for disability integral type and/or proportional were administrative agent and assistant general services. Conclusion: The study shows the need for health promotion and surveillance in relation to workers' health, providing better working conditions and reducing illness among servers, reducing the number of disability pension for musculoskeletal pathologies.

Avaliação ergonômica do trabalho em indústria de aço inox: análise de condições psicofisiológicas / Ergonomic evaluation of the stainless steel industry: analysis of psycho physiological conditions

Contexto: Apresenta-se um método de intervenção ergonômica, em que são investigadas as condições psicofisiológicas do trabalho de operários em postos de trabalho em indústria de aço inox. Objetivo: Avaliar as condições de trabalho e propor sugestões que viabilizem um ambiente de trabalho ergonômico. Métodos: Estudo descritivo e retrospectivo obtido a partir de levantamento de dados de 47 funcionários oriundos de uma metalúrgica de aço inox, em São Luís, Maranhão, no período de janeiro a dezembro de 2011, através de visita técnica. Resultados: Nos postos de trabalhos observados neste estudo, o tipo de tarefa exercida é de livre postura, ora estando em pé, ora estando sentado ou semissentado. O tipo de banco utilizado é questionável, pois não possui nenhum encosto. Os problemas observados foram: acidentário e arquitetural, devido à falta de planejamento de espaços e ambientação agradáveis ao trabalho; biológico, pela sujeira acumulada e não adequação às normas de higiene; físico-ambiental, pela falta de iluminação suficiente para execução principalmente de trabalhos que requerem precisão; interfacial, sendo observadas as bancadas de trabalho e principalmente os bancos sem qualquer tipo de apoios para execução das tarefas; químico-ambiental, pela falta de limpeza no local de trabalho, expondo diariamente o trabalhador a substâncias pesadas prejudiciais à saúde. Conclusão: A pesquisa demonstra a fragilidade das condições de trabalho em uma empresa de São Luís. É importante realizar mudanças com vistas à garantia de melhores condições de serviço, de acordo com a ergonomia.

Context: We present a method for ergonomic intervention, in which the psychophysiological work conditions of workers of the stainless steel industry are investigated. Objective: To assess the working conditions and propose suggestions that enable an ergonomic work environment. Methods: This was a descriptive, retrospective study obtained from survey data of 47 employees from a stainless steel metallurgical in São Luís, Maranhão, Brazil, from January to December 2011, trough technical visit. Results: In the workstations observed in this study, the body posture is free posture, sometimes in standing position, sitting or semi-sitting. The type of bank used is questionable, as there is no backrest. The observed problems were: accidental and architectural, due to the lack of planning space and pleasant ambience to work; biological, due to accumulated dirt and non compliance to hygiene standards; physical and environmental, due to the lack of sufficient lighting especially in jobs that require precision; interfacial, with work benches and especially banks without any kind of support for the execution of tasks; chemical and environmental, due to the lack of a clean workplace, exposing the worker to heavy substances harmful to health on a daily baisis. Conclusion: The study shows the fragility of working conditions in a company of São Luís. It is important to make changes in order to guarantee better conditions of service, according to ergonomics.

Osteoporosis in primary care: an opportunity to approach risk factors / Osteoporose na atenção primária: uma oportunidade para abordar os fatores de risco

ABSTRACT Introduction: Climacteric women are susceptible to a number of changes, among them osteoporosis. Osteoporosis is a disease characterized by low bone mass and susceptibility to fracture. Currently, this disease is a public health issue, being necessary to recognize its risk factors. Objectives: Identify risk factors related to osteoporosis in women attending Propis/Proex/UFMA, tracing a socio-demographic characterization and considering community lifestyles. Material and methods: This is a transversal retrospective clinical with a quantitative approach study conducted between March and June 2013 in São Luís (MA) with 107 women treated at the Programa de Práticas de Integralidade em Saúde (Propis - Integrality Health Practice Program). The study was approved by the University Hospital Ethics Committee of UFMA under opinion no. 362/07. Data were tabulated and analyzed in the epidemiological Epi-Info® software, version 3.4.1. Results: The brown color was predominant, consensual relationships proved to be a protective factor and low education was a risk factor. The average age of the group with menopause was 54.1 years and without menopause was 31.3 years (p < 0.0001). The average age of menopause was 43.7 years. The irregular menstrual cycle was a protective factor. The average number of pregnancies was 4.56 for the group with menopause and 2.45 for the group without menopause, with most births occurring normally (p < 0.0001). Smoking, physical inactivity and caffeine intake were risk factors, while the absence of alcoholism and of soda intake were protective factors for the disease. Conclusion: The patients followed the socioeconomic and demographic profile of Maranhão. Most had menarche and menopause in appropriate periods, showed no positive family history of osteoporosis, did not usually drink alcohol, were sedentary and the caffeine intake was high.

RESUMO Introdução: As mulheres no climatério estão suscetíveis a uma série de mudanças, entre elas a osteoporose. A osteoporose é uma doença caracterizada por uma baixa massa óssea e susceptibilidade à fratura. Atualmente, essa doença é um problema de saúde pública e é necessário reconhecer seus fatores de risco. Objetivos: Identificar os fatores de risco relacionados com a osteoporose em mulheres atendidas pelo Programa de Práticas de Integralidade em Saúde (Propis)/Proex/UFMA, traçar uma caracterização sociodemográfica e considerar o estilo de vida da comunidade. Material e métodos: Trata-se de um estudo transversal retrospectivo clínico com uma abordagem quantitativa, feito entre março e junho de 2013, em São Luís (MA), com 107 mulheres atendidas pelo Programa de Práticas de Integralidade em Saúde (Propis). O estudo foi aprovado pelo Comitê de Ética do Hospital Universitário da UFMA, sob parecer nº 362/07. Os dados foram tabulados e analisados com o software epidemiológico Epi-Info®, versão 3.4.1. Resultados: A etnia parda foi predominante, a união estável mostrou ser um fator protetor e a baixa escolaridade foi um fator de risco. A idade média do grupo com menopausa foi de 54,1 anos e a do sem menopausa de 31,3 anos (p < 0,0001). A idade média da menopausa foi de 43,7 anos. O ciclo menstrual irregular foi um fator protetor. O número médio de gestações foi de 4,56 para o grupo com menopausa e 2,45 para o grupo sem menopausa, com a maior parte dos partos normal (p < 0,0001). O tabagismo, a inatividade física e o consumo de cafeína foram fatores de risco, enquanto a ausência de alcoolismo e de ingestão de refrigerante foram fatores de proteção para a doença. Conclusão: Os pacientes seguiram o perfil socioeconômico e demográfico do Maranhão. A maior parte teve a menarca e a menopausa em períodos apropriados, não apresentava antecedentes familiares de osteoporose, não costumava ingerir bebida alcoólica, era sedentária e consumia uma elevada quantidade de cafeína.