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OBJECTIVE: Analyzing factors related to the risk of falls in hospitalized adult patients. METHOD: A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis. RESULTS: 612 patients participated in the study. An association (p<0.001) was found between the high risk of falls and clinical neurological hospitalization, surgical trauma (hospitalization) and comorbidities such as diabetes mellitus, systemic arterial hypertension, visual impairment, vertigo and fear of falling. CONCLUSION: An association between the risk of falls was found due to hospitalization, comorbidities and intrinsic factors. Regarding extrinsic factors, an association between mats/carpets and risk of falls was found. No association between the risk of falls with other extrinsic factors was found. OBJETIVO: Analisar os fatores relacionados ao risco de quedas em pacientes adultos internados em um hospital. MÉTODO: Estudo transversal, analítico e quantitativo, desenvolvido em Unidades de Internação Clínica e Cirúrgica, no período de junho a agosto 2015. Os instrumentos de coleta de dados foram formulários sociodemográfico, clínico e Escala de Morse. Os dados foram obtidos com os pacientes e nos prontuários. Na análise estatística univariada utilizou-se de frequência absoluta e relativa, e na bivariada utilizou-se do teste de qui-quadrado. RESULTADOS: Participaram do estudo 612 pacientes. Foi encontrada associação (p<0,001) entre o elevado risco de queda e a internação clínica neurológica, a cirúrgica traumatológica e comorbidades como diabetes mellitus, hipertensão arterial sistêmica, dificuldade visual, vertigens e medo de cair. CONCLUSÃO: Existe associação entre o risco de quedas com motivo de internação, comorbidades e fatores intrínsecos. Em relação aos fatores extrínsecos, foi encontrada associação entre tapetes e risco de quedas. Não houve associação entre o risco de quedas com outros fatores extrínsecos.
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Accidentes por Caídas/estadística & datos numéricos , Hospitalización , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Adulto JovenRESUMEN
OBJECTIVE: To analyze the morbidity trend and space-time distribution clusters of confirmed COVID-19 cases in children and adolescents. METHOD: An ecological study of COVID-19 cases confirmed in the Information System from 2020 to 2022 in the age group from 0 to 19 years old, residents in Mato Grosso municipalities, Brazilian Midwest region. A trend analysis of the monthly morbidity rate of cases/100,000 inhabitants was used, following Prais-Winsten's regression. A space-time distribution of the Bayesian incidence rate per 100,000 inhabitants was performed, in addition to a space-time scan to identify high-risk clusters. RESULTS: Of all 79,592 COVID-19 cases studied, 51.6% were in females and 44.21% in people aged 15-19 years old. The mean monthly rate was 265.87 cases per 100,000 inhabitants, with a stationary trend in the period analyzed (Monthly Percentage Variation [MPV]) = 12.15; CI95%[MPV]: -0.73;26.70). The morbidity rate due to COVID-19 was higher in the female gender (283.14/100,000 inhabitants) and in the age group from 15 to 19 years old (485.90/100,000 inhabitants). An increasing trend was observed with a greater monthly time variation of 14.42% (CI95%[MPV]: 1.28;29.28)] among those aged from 10 to 14 years old. The primary cluster, which was also the one with the highest Relative Risk (RR = 5,16, p-value = 0.001), included 19 municipalities located in the North health macro-region. CONCLUSION: The findings indicated a monthly stationary trend in the study population, an increase in the age group from 10 to 14 years old, and areas at a higher risk for the disease in the North health macro-region of the state.
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COVID-19 , Niño , Humanos , Adolescente , Femenino , Recién Nacido , Lactante , Preescolar , Adulto Joven , Adulto , COVID-19/epidemiología , Teorema de Bayes , Morbilidad , Incidencia , Brasil/epidemiologíaRESUMEN
OBJECTIVE: To evaluate the diagnostic accuracy of MRI-hysterosalpingogram (HSG) with semiquantitative dynamic contrast-enhanced perfusion, against the virtual multislice CT hysterosalpingogram (VHSG) as a reference standard. METHODS AND MATERIALS: In this prospective study, 26 women (age >18 years) searching for infertility causes and with VHSG physician request. Thereafter, the assessment performance of both techniques was determined by two reader analyses. k statistics were used for the assessment of tubal patency. Receiver operating characteristic (ROC) analysis was used to compare the capability for tubal patency assessment between both exams on a per-patient and per-tube basis. The McNemar test was used to compare the diagnostic accuracy measures. RESULTS: Tubal patency, uterine morphological, ovarian, and extrauterine abnormalities were evaluated through both exams in all 26 women. There was no significant difference between diagnostic performance measurements between the methods. The ROC curve of VHSG was 0.852 for both per-patient and per-tube analyses, and one and 0.938 for MRI-HSG. Sensitivity and specificity for per-patient and per-tube for VHSG were 95.2 and 97.7, 80 and 87.5%, and for MRI-HSG 100% for both analyses and 100 and 87.5%, respectively. CONCLUSION: This study demonstrates the feasibility of diagnosing tubal patency through MRI, using a semi-quantitative dynamic contrast-enhanced perfusion sequence, and the satisfactory diagnosing of the uterine morphology, ovarian abnormalities, and ovarian and deep endometriosis. ADVANCES IN KNOWLEDGE: Multiparametric MRI with a perfusion real-time sequence as a HSG method can be used in the evaluation not only for uterine and ovarian abnormilities but also tubal patency.
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Enfermedades de las Trompas Uterinas , Infertilidad Femenina , Imágenes de Resonancia Magnética Multiparamétrica , Femenino , Humanos , Adolescente , Histerosalpingografía/efectos adversos , Histerosalpingografía/métodos , Estudios Prospectivos , Infertilidad Femenina/diagnóstico por imagen , Infertilidad Femenina/etiología , Enfermedades de las Trompas Uterinas/diagnóstico por imagen , Pelvis/diagnóstico por imagen , Tomografía Computarizada por Rayos X/efectos adversosRESUMEN
PURPOSE: To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. METHODS: Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. RESULTS: A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. CONCLUSION: The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.
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Pérdida Auditiva Unilateral , Niño , Humanos , Adolescente , Estudios Retrospectivos , AudiciónRESUMEN
Abstract Objective: To analyze the morbidity trend and space-time distribution clusters of confirmed COVID-19 cases in children and adolescents. Method: An ecological study of COVID-19 cases confirmed in the Information System from 2020 to 2022 in the age group from 0 to 19 years old, residents in Mato Grosso municipalities, Brazilian Midwest region. A trend analysis of the monthly morbidity rate of cases/100,000 inhabitants was used, following Prais-Winsten's regression. A space-time distribution of the Bayesian incidence rate per 100,000 inhabitants was performed, in addition to a space-time scan to identify high-risk clusters. Results: Of all 79,592 COVID-19 cases studied, 51.6% were in females and 44.21% in people aged 15-19 years old. The mean monthly rate was 265.87 cases per 100,000 inhabitants, with a stationary trend in the period analyzed (Monthly Percentage Variation [MPV]) = 12.15; CI95%[MPV]: -0.73;26.70). The morbidity rate due to COVID-19 was higher in the female gender (283.14/ 100,000 inhabitants) and in the age group from 15 to 19 years old (485.90/100,000 inhabitants). An increasing trend was observed with a greater monthly time variation of 14.42% (CI95%[MPV]: 1.28;29.28)] among those aged from 10 to 14 years old. The primary cluster, which was also the one with the highest Relative Risk (RR = 5,16, p-value = 0.001), included 19 municipalities located in the North health macro-region. Conclusion: The findings indicated a monthly stationary trend in the study population, an increase in the age group from 10 to 14 years old, and areas at a higher risk for the disease in the North health macro-region of the state.
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Papacarie gel is an agent that eliminates the need for local anesthesia and reduces the need for using a drill. However, there is no information regarding the cost per procedure. Therefore we analyzed the cost, per procedure, of Papacarie gel compared to the traditional method (drilling), and performed a comparison between these methods of carious tissue removal. A randomized clinical trial was performed with 24 children with an average age of 5.9 years old. Of these children, 12 were boys and 12 were girls, which resulted in a total of 46 restorations. Patients were separated into: Papacarie group (caries removal with the chemical-mechanical method - Papacarie gel) and Drill group (caries removal with the traditional method - drilling). Values of the materials used in the procedures, heart rate (before, 5 minutes during, and after dental treatment), and the total consultation duration were recorded. A level of significance of 5% was adopted. Papacarie had a lower cost per procedure ($ 0.91) when compared to the traditional method ($ 1.58). Papacarie provided a cost reduction of 42% compared to the traditional method. Using local anesthesia ($ 2.17), the cost reduction increased to 58%. In the procedure using drill + Papacarie ($ 1.37), the cost reduction was 33%. Heart rate, consultation duration, and number of restorations were not statistically different. Papacarie shows an excellent cost benefit for minimally invasive removal of carious tissue and is a feasible alternative for public health care.
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Caries Dental/tratamiento farmacológico , Caries Dental/economía , Papaína/economía , Papaína/uso terapéutico , Odontología Pediátrica/economía , Brasil , Niño , Preescolar , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Diente Primario/efectos de los fármacosRESUMEN
ABSTRACT Purpose To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. Methods Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. Results A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. Conclusion The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.
RESUMO Objetivo Descrever as características audiológicas e o tipo de intervenção tomada em casos de perda auditiva unilateral em crianças e adolescentes e analisar correlações entre o grau da deficiência auditiva, a indicação e o uso de auxiliares de audição. Método Estudo observacional, descritivo e retrospectivo, realizado com informações dos prontuários de 34 crianças e adolescentes com perda auditiva unilateral, atendidos em dois serviços de reabilitação auditiva de média complexidade, no período de 2016 a 2019. Realizou-se a análise estatística descritiva e inferencial dos dados. Resultados Predomínio de perda auditiva unilateral do tipo neurossensorial, de grau profundo à direita, pré-lingual com 20,6% de malformações. A intervenção mais adotada foi a indicação de prótese auditiva, porém o uso é baixo, independente do grau da perda. Houve associação entre o grau da perda auditiva e a decisão dos profissionais em indicar o uso dos dispositivos. Conclusão A indicação de próteses auditivas é a mais frequente e esta decisão é influenciada pelo grau da perda auditiva, sendo os aparelhos auditivos indicados para as perdas leves a severas, com uma maior divergência de condutas para as perdas profundas.
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Resumo Objetiva-se analisar se características sociodemográficas, capacitação técnica e percepção de risco estão relacionados com a saúde ocupacional de agricultores expostos a agrotóxicos. Foi feito estudo transversal e observacional com 113 agricultores, selecionados aleatoriamente, no município de Cerro Largo, RS. Realizadas entrevistas nas propriedades rurais e investigadas questões referentes a caracterização sociodemográfica, capacitação técnica para uso de agrotóxicos, percepção de risco à saúde e sintomas de intoxicação aguda ou crônica. Houve prevalência do sexo masculino, baixo nível de escolaridade, idade entre 51 e 76 anos, que trabalham em pequenas propriedades rurais. A maioria dos agricultores afirmou ter recebido treinamento para uso de agrotóxicos por empresas que os comercializam. Os agricultores reconhecem os riscos da exposição ocupacional a agrotóxicos e relataram sintomas de intoxicação. A partir dos relatos, observa-se a não existência de capacitação técnica por parte de órgãos públicos no município, apesar de constatada a necessidade e queixas de sintomas de intoxicação por agrotóxicos. Evidencia-se a urgente demanda por capacitação técnica sobre uso seguro de agrotóxicos e informações sobre os efeitos nocivos destes à saúde, na medida em que conhecimento é uma forma de empoderamento.
Abstract Objective: to analyze how socio-demographic characteristics, technical training and risk perceptions are related with pesticide use and the occupational health of farmers exposed to pesticides in the municipality of Cerro Largo, RS. Methods: a cross-sectional and observational study was conducted with 113 randomly selected farmers. An interview was conducted on rural properties which included questions regarding socio-demographic characterization, technical training for pesticide use, and perception of health risk and symptoms of acute or chronic intoxication. Results: the subjects were predominantly males between 51 and 76 years, owners of small rural properties, and had low level of education. Most farmers said they received training for pesticide use by the companies that sell them. The farmers recognized the risks of occupational exposure to pesticides and reported symptoms of intoxication. Conclusion: the reports show the non-existence of technical training provided by public agencies in the municipality, although the need for such a program was evidenced from the reports of the subjects and their complaints of pesticide intoxication symptoms. As knowledge is a form of empowerment, there is an urgent demand for technical training on the safe use of pesticides and information about their harmful effects to health.
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Humanos , Masculino , Femenino , Salud Laboral , Agroquímicos , Enfermedades de los Trabajadores Agrícolas , Agricultores , Estudios Transversales , TutoríaRESUMEN
A exposição crônica e combinada de agrotóxicos pode causar danos a saúde do trabalhador rural, inclusive à audição. O propósito do estudo foi caracterizar os trabalhadores rurais quanto aos aspectos sociodemográficos e de exposição aos agrotóxicos, assim como analisar a relação entre esta exposição e a ocorrência de sintomas físicos e auditivos. Pesquisa de natureza quantitativa, com alcance descritivo e explicativo, com delineamento transversal, realizada com 71 trabalhadores rurais, do sexo masculino, expostos a agrotóxicos. A coleta de dados foi realizada por duas formas: (i) instrumento de coleta para caracterização do contato aos agrotóxicos, sintomas físicos e auditivos (ii) triagem auditiva para a pesquisa dos limiares auditivos aéreos. A análise dos dados deu-se através da estatística descritiva e por meio do teste de Wilcoxon e da correlação de Spearman. Foi considerado nível de 5% de significância para os testes estatísticos. Sobre os sintomas físicos associados ao uso de agrotóxicos, prevaleceu a dor de cabeça (31,0%). Quanto ao resultado da triagem auditiva, 31 (43,7%) trabalhadores rurais falharam em ambas as orelhas, 28 (39,4%) obtiveram o resultados de "passa" e 12 (16,9%) falharam em apenas uma orelha. Ao analisar-se a associação entre o resultado da triagem auditiva e variáveis quanto a exposição aos agrotóxicos, o tempo de exposição foi a única variável que mostrou associação significativa. Os achados esclarecem que a atividade profissional dos agricultores oferece risco à audição, porém, é preciso considerar que outros fatores, como ruído e vibração, podem ser agravantes da perda auditiva nesta população.
The chronic and combined exposure to pesticides can cause damage to the health of the rural worker, including hearing. The purpose of the study was to characterize rural workers in terms of sociodemographic aspects and exposure to pesticides, as well as to analyze the relationship between this exposure and the occurrence of physical and auditory symptoms. This was a quantitative study, with a descriptive and explanatory scope, using a cross-sectional design, carried out with 71 rural workers, males, exposed to pesticides. Data collection was performed in two ways: (i) a collection instrument for characterizing contact with pesticides, physical and auditory symptoms (ii) auditory screening for the investigation of aerial hearing thresholds. Data analysis was performed through descriptive statistics and through the Wilcoxon test and Spearman's correlation. The levei of significance was set at 5% for statistical tests. Among the physical symptoms associated with the use of pesticides, headaches prevailed (31 .0%). As for the result of auditory screenings, 31 (43.7%) rural workers failed in both ears, 28 (39.4%) obtained the results of "passing" and 12 (16.9%) failed in only one ear. When analyzing the association between the results of auditory screenings and variables regarding exposure to pesticides, exposure time was the only variable that showed a significant association. The findings clarify that the professional activity of íarmers poses a risk to hearing, however, it is necessary to consider that other factors, such as noise and vibration, can aggravate hearing loss in this population.
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RESUMO O consumo de agrotóxicos aumentou consideravelmente nos últimos anos. Embora os agrotóxicos tenham ajudado a aumentar a produtividade das culturas, também têm sido associados ao câncer. O objetivo deste estudo foi descrever o perfil epidemiológico de pacientes oncológicos localizados em uma área com alto uso de agrotóxicos. Empregou-se coorte retrospectiva para descrever os casos de câncer. Incluíram-se pacientes diagnosticados com algum tipo de câncer entre 2005 e 2016, residindo, no momento do diagnóstico, em uma das 69 cidades brasileiras estudadas e com idade igual ou superior a 12 anos. Utilizou-se regressão multinível para modelar o coeficiente de morbidade por câncer. Estudaram-se 10.640 pacientes com câncer. Os coeficientes de morbidade por câncer aumentaram com a idade e foram significativamente maiores entre as pessoas que residiam em áreas rurais, quando comparadas com as residentes das áreas urbanas (p<0,0001). Em ambas as áreas, os homens apresentaram coeficientes de morbidade por câncer significativamente maiores do que as mulheres. Este estudo sugere que a maior incidência de câncer está relacionada a fatores da vida rural, como a exposição à agrotóxicos, visto que a área estudada é conhecida por sua economia baseada na agricultura e no elevado uso de agrotóxicos.
ABSTRACT Pesticide consumption has increased considerably in the last years. Although pesticides have helped to increase the crops' productivity, they have been associated with the incidence of cancers. The objective of this study was to describe the epidemiological profile of cancer patients living in an area with high use of pesticide. A retrospective cohort design was used to describe cancer cases. Patients were included whenever (i) diagnosed with any type of cancer between 2005 and 2016; (ii) living, at the time of diagnosis, in one of the 69 Brazilian cities studied; and (iii) aged 12 years old or over. A multilevel regression model was used to model the cancer morbidity coefficient. A total of 10,640 cancer patients were studied. Cancer morbidity coefficients increased with age and were significantly higher among people residing in rural areas than among those living in urban areas (p-value<0.0001). In both urban and rural areas, males showed significantly higher cancer morbidity coefficients than females. This study suggests that higher cancer incidence is related to factors of rural life, which can include pesticide exposure since the studied area is known for its agriculture based economy and high pesticide use.
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O risco de quedas e a administração de medicamentos estão relacionadas a segurança do paciente hospitalizado. Assim, este estudo teve como objetivo identificar classes de medicamentos e interações medicamentosas que potencializam o risco de quedas hospitalares. Estudo quantitativo, transversal, na região Sul do Brasil, com 612 pacientes em unidades de internação. Os dados foram coletados com instrumento próprio, Escala de Morse e análise de prontuário no período de junho a agosto de 2015. Na análise estatística univariada utilizou-se frequências absolutas e relativas e na bivariada utilizou-se teste de qui-quadrado com nível de 5% de significância. Participaram do estudo 612 pacientes, com prevalente uso de fármacos que atuam sobre o sistema cardiovascular e sistema nervoso. As principais classes de medicamentos relacionadas com risco elevado de quedas foram antiparkisonianos (76,2%) e bloqueadores de canais de cálcio (57,1%). O número de medicamentos também se apresentou associado ao risco elevado de queda, presente em 56,2% dos pacientes em uso de cinco medicamentos ou mais. Foram identificadas 2.187 interações medicamentosas, dessas 9,1% eram potencializadoras do risco de quedas, entre os medicamentos envolvidos nas interações graves ou contraindicadas verificou-se maior frequência de morfina (16,5%) e metoclopramida (6,0%) dos pacientes. A interação grave mais frequente foi morfina e tramadol (7,7%). Evidenciou-se que fármacos frequentemente utilizados por pacientes hospitalizados estão associados ao risco elevado de quedas e que a existência de interações medicamentosas potenciais, que elevam o risco de quedas. Conhecer o perfil dos medicamentos utilizados e sua relação com o riso de quedas no ambiente hospitalar auxilia na implementação de ações preventivas.
The risk of falls and the administration of medications are related to the safety of hospitalized patients. Thus, this study aimed to identify classes of drugs and drug interactions that increase the risk of hospital falls. This was a quantitative, cross-sectional study, in the southern region of Brazil, with 612 patients from inpatient units. Data were collected using a specific instrument for demographic data, Morse Scale and medical chart analysis from June to August 2015. In the univariate statistical analysis, absolute and relative frequencies were used and in the bivariate analysis, a chi-squared test with a level of 5% significance was used. 612 patients participated in the study, with use of drugs that act on the cardiovascular and nervous systems prevailing. The main classes of drugs related to high risk of falls were antiparkinsonian (76.2%) and calcium channel blockers (57.1%). The number of medications was also associated with a high risk of falling, present in 56.2% of patients using five or more drugs. 2,187 drug interactions were identified, of which 9.1% were potentiating the risk of falls, among the drugs involved in serious or contraindicated interactions there was a higher frequency among patients taking morphine (16.5%) and metoclopramide (6.0%). The most frequent serious interaction was morphine and tramadol (7.7%). It was observed that drugs frequently used by hospitalized patients are associated with an increased risk of falls and that the existence of potential drug interactions also can increase the risk of falls. Knowing the profile of the drugs used and their relationship with the risk of falls in the hospital environment helps administrators implement preventive actions.
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ABSTRACT We conducted an integrative literature review of published studies on pesticide and cancer exposure, focusing on farmers, rural population, pesticide applicators, and rural workers. The Medline/PubMed was used as searching database. After the retrieval, 74 articles were selected according to pre-established criteria, which design involved 39 case-controls, 32 cohorts, 2 ecological ones, and 1 cross-sectional. Among them, 64 studies showed associations between pesticides and cancer while 10 did not find any significant association. The studies found 53 different types of pesticides significantly associated with at least one type of cancer and 19 different types of cancers linked to at least one type of pesticide. Although few studies presented contradictory results, the sole fact of being a farmer or living near crops or high agricultural areas have also been used as a proxy for pesticide exposure and significantly associated with higher cancer risk. The literature well illustrates the case of prostate cancer, Non-Hodgkin lymphoma, leukemia, multiple myeloma, bladder and colon cancers. Studies are recommended to further investigate the relationship between pesticide and neoplasm of testis, breast, esophagus, kidney, thyroid, lip, head and neck, and bone.
RESUMO Trata-se de revisão integrativa da literatura sobre estudos publicados em relação à exposição a agrotóxicos e câncer, com foco em agricultores, população rural, aplicadores de agrotóxicos e trabalhadores rurais. A busca dos artigos foi realizada por meio do banco de dados Medline/PubMed. Após a triagem, 74 artigos foram selecionados de acordo com critérios pré-estabelecidos, sendo 39 caso-controle, 32 coortes, dois ecológicos e um transversal. Desses, 64 estudos mostraram associação entre agrotóxicos e câncer, enquanto dez não encontraram associação significativa. Nesses 64, 53 diferentes tipos de agrotóxicos foram significativamente associados com pelo menos um tipo de câncer e, inversamente, 19 diferentes tipos de câncer foram associados a pelo menos um tipo de agrotóxico. Embora alguns estudos tenham apresentado resultados contraditórios, ser um agricultor ou morar perto de plantações ou de áreas densamente agrícolas também tem sido motivo para representar a exposição a agrotóxicos e considerado significativamente associado a um maior risco de câncer. A literatura ilustra bem o câncer de próstata, linfoma não-Hodgkin, leucemia, mieloma múltiplo, bexiga e câncer de cólon. Recomendam-se estudos que investiguem mais a relação entre agrotóxicos e neoplasmas de testículos, mama, esôfago, rim, tireoide, lábio, cabeça e pescoço e osso.
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Objetivo: O objetivo deste estudo foi determinar a relação entre a exposição à agrotóxicos e as alterações no sistema auditivo de trabalhadores rurais atendidos em um Centro Especializado em Reabilitação Auditiva (CER), Santa Rosa/RS. Material e Mé-todos: Trata-se de um estudo transversal de base populacional, cuja amostra foi constituída de 70 trabalhadores, de ambos os sexos, com atividade laboral atual ou pregressa no setor agrícola e com uso de agrotóxicos. A coleta de dados se deu a partir dos respectivos prontuários dos pacientes e por meio de um protocolo de pesquisa. A análise estatística dos dados foi realizada com técnicas descritivas, correlação de Spearman e teste de Mann Whitney, utilizando-se o software R, v. 2.15.3. Resultados: Não foram observadas relações significativas entre a faixa etária, tempo de exposição e uso de EPI com o grau de perda auditiva em ambas as orelhas (p > 0,01). Conclusão:A partir deste estudo, visualiza-se que os trabalhadores não utilizavam de forma frequente agrotóxicos do grupo químico organofosforado, cujo potencial ototóxico fora comprovado em várias pesquisas. Além disso, a idade foi o fator que mais im-pactou nos resultados, visto que a quase totalidade da amostra eram idosos e que os mesmos podem apresentar alterações auditivas em decorrência do envelhecimento. (AU)
Objective:The objective of this study was to determine the relationship between pesticide exposure and changes in the auditory system of rural workers treated at a specialized hearing rehabilitation center (CER) in Santa Rosa, RS, Brazil. Material and Methods: This is a cross-sectional population-based study whose sample consisted of 70 workers, of both genders, with current or previous work in the agricultural sector, who had used pesticides. The data was collected from the patients' medical records and through a questionnaire. Statistical analysis of the data was performed using descriptive techniques, Spearman's rank correlation coefficient, and the Mann Whitney test, using R software v. 2.15.3. Results: There were no significant relations between age, duration of exposure, or use of personal pro-tective equipment with the degree of hearing loss in both ears (p-value>0.01). Conclusion:This study shows that workers did not frequently use organophosphate pesticides, whose ototoxic potential has been proven in several studies. In addition, age was the factor that most impacted the results, since nearly all of the sample subjects were elderly and may present auditory changes due to aging. (AU)
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Trabajadores Rurales , Pérdida AuditivaRESUMEN
Introdução: A atividade agrícola e a exposição a agrotóxicos aumentam o risco de perda auditiva e a possibilidade de redução das colinesterases. Objetivos: Descrever e correlacionar os resultados da triagem auditiva e da dosagem das colinesterases plasmática e eritrocitária de trabalhadores rurais expostos a agrotóxicos. Método: Pesquisa de natureza quantitativa, com alcance descritivo e explicativo, com delineamento transversal, realizada com 71 trabalhadores rurais expostos a agrotóxicos. A coleta de dados foi realizada de três formas: instrumento de coleta para caracterização do contato aos agrotóxicos; triagem auditiva; e coleta de sangue para dosagem das colinesterases plasmática e eritrocitária. Resultados: Cada trabalhador utilizava "em média" três agrotóxicos diferentes e o mais citado foi o glifosato. Sobre a triagem auditiva, 60,6% possuíam alterações auditivas e 32,4%, zumbido. Na dosagem da colinesterase eritrocitária, todos os trabalhadores rurais apresentaram valores de dosagens de colinesterase dentro da normalidade. Na dosagem da colinesterase plasmática, um participante apresentou valor de dosagem inferior ao normal. Não houve correlação significativa entre a triagem auditiva e o valor das colinesterases. Conclusões: A avaliação audiológica deve ser incluída no cuidado à saúde dos trabalhadores rurais e o acompanhamento ocupacional de trabalhadores expostos a agrotóxicos não deve ser restrito à dosagem das colinesterases, pois tal medida é insuficiente para diagnosticar exposição real a agrotóxicos
Background: Agricultural activities and exposure to pesticides increase the risk of hearing loss and might reduce cholinesterase activity. Objective: To describe and analyze the correlation between hearing screening and plasma and erythrocyte cholinesterase activity relative to rural workers exposed to pesticides. Methods: Cross-sectional, quantitative, descriptive and explanatory study conducted with 71 rural workers exposed to pesticides. Data were collected by means of an instrument to characterize exposure to pesticides, hearing screening and blood samples to measure plasma and erythrocyte cholinesterase activity. Results: Each participant used three different pesticides, on average, glyphosate being the most frequently mentioned. About 60.6% of the sample exhibited hearing abnormalities and 32.4% complained of tinnitus. Erythrocyte cholinesterase activity was within the normal range in all the cases; one single participant exhibited reduced plasma cholinesterase activity. There was not significant correlation between the hearing screening and cholinesterase levels. Conclusion: Audiological evaluation should be included in the assessment of rural workers. Monitoring workers exposed to pesticides should not be restricted to cholinesterase activity alone, because this method is insufficient to detect actual exposure to pesticides.
RESUMEN
The scope of this article was to investigate whether intercessory prayer (IP) influences the adverse outcomes of pregnancies. A double-blind, randomized clinical trial was conducted with 564 pregnant women attending a prenatal public health care service. The women were randomly assigned to an IP group or to a control group (n = 289 per group). They were simultaneously and randomly assigned to practice prayer off-site or not. The following parameters were evaluated: Apgar scores, type of delivery and birth weight. The mean age of the women was 25.1 years of age (± 7.4), and the average gestational age was 23.4 weeks (± 8.1). The average number of years of schooling for the women was 8.1 years (± 3.1). The women in the IP and control groups presented a similar number of adverse medical events with non-significant p. No significant differences were detected in the frequency of adverse outcomes in pregnant women who practiced IP and those in the control group.
Asunto(s)
Complicaciones del Embarazo/psicología , Resultado del Embarazo/psicología , Religión , Adulto , Método Doble Ciego , Femenino , Humanos , Embarazo , Adulto JovenRESUMEN
Objetivo: analisar a relação exposição a agrotóxicos e ocorrência de alterações auditivas de trabalhadores rurais. Método: pesquisa quantitativa, descritiva, explicativa e transversal. Será realizada com trabalhadores rurais, do sexo masculino, expostos a agrotóxicos, que residem no município de Santa Rosa, região noroeste do RS, e que buscam atendimento em uma Unidade Básica de Saúde localizada na zona rural. Para a coleta dedados, serão utilizados questionário, triagem auditiva e dosagem de colinesterase plasmática e eritrocitária. O projeto respeitou os procedimentos éticos e tem aprovação por Comitê de Ética. Os dados serão armazenados em planilhas eletrônicas e analisados com o auxílio do software R v.2.15.3. Resultados esperados: espera-se encontrar relações entre a exposição a agrotóxicos e a ocorrência de alterações no sistema auditivo e fornecer subsídios para a elaboração de programas e políticas públicas de prevenção das perdas auditivas em trabalhadores rurais.
Asunto(s)
Masculino , Humanos , Agroquímicos , Audición , Exposición Profesional , Pérdida Auditiva , Salud Rural , Trabajadores Rurales , Colinesterasas , Epidemiología Descriptiva , Estudios Transversales , Investigación CualitativaRESUMEN
Estudo transversal e analítico que identificou estado nutricional, padrões alimentares e nível de atividade física em 276 adolescentes, com idade de 14 a 17 anos. O estado nutricional foi avaliado pelo Índice de Massa Corporal e a medida da Circunferência da Cintura. Para avaliar o consumo e as práticas alimentares, foi aplicado um questionário adaptado da Pesquisa Nacional de Saúde do Escolar, de 2009. O nível de atividade física foi classificado de acordo com o International Physical Activity Questionnaire. Encontravam-se eutróficos 89,9% desta população e 27,2% apresentavam risco para doenças cardiovasculares. Foram identificados quatro padrões alimentares: saudável; ultraprocessado; cafeteria; ambiente escolar. Pertenciam ao padrão saudável 62,5% dos adolescentes com excesso de massa corporal e 56,2% dos adolescentes com risco cardiovascular. A maioria encontrava-se no nível de atividade física, que oferece menor risco para doenças cardiovasculares, independente dos padrões alimentares. Contudo, dados fornecidos na construção dos padrões alimentares e de inatividade reforçam a percepção de que esta população pode estar suscetível a doenças cardiovasculares na idade adulta, se mantiver as práticas atuais.[AU]
This is a cross-sectional and analytical study that identified nutritional status, dietary patterns and physical activity level in 276 adolescents aged 14 to 17 years old. Nutritional status was assessed by Body Mass Index and Waist Circumference measurement. To assess consumption and eating habits, a questionnaire adapted from the 2009 National School-Based Student Health Survey was applied. Physical activity level was classified in accordance with the International Physical Activity Questionnaire. Eutrophic individuals accounted for 89% of this population, and 27.2% was at risk for cardiovascular diseases. Four dietary patterns were identified: healthy; ultra-processed; cafeteria; school environment. The healthy pattern comprehended 62.5% of healthy adolescents with excessive body mass and 56.2% of adolescents with cardiovascular risk. Most of them presented a physical activity level that poses lower risk for cardiovascular diseases, regardless of dietary patterns. However, data provided in the construction of dietary patterns and inactivity reinforce the perception that this population may be susceptible to cardiovascular disease in adulthood, if current practices are maintained. [AU]
Estudio transversal y analítico que identificó el estado nutricional, los patrones alimentarios y el nivel de actividad física en 276 adolescentes, con edad de 14 a 17 años. El estado nutricional fue evaluado por el Índice de Masa Corporal y la medida de la Circunferencia de la Cintura. Para evaluar el consumo y las prácticas alimentarias, fue aplicado un cuestionario adaptado de la Investigación Nacional de Salud del Escolar, de 2009. El nivel de actividad física fue clasificado de acuerdo con el International Physical Activity Questionnaire. Se encontraba eutrófico el 89,9% de esta población y el 27,2% presentaba riesgo para enfermedades cardiovasculares. Fueron identificados cuatro patrones alimentarios: saludable; ultraprocesado; cafetería; ambiente escolar. Pertenecía al patrón saludable el 62,5% de los adolescentes con exceso de masa corporal y el 56,2% de los adolescentes con riesgo cardiovascular. La mayoría se encontraba en el nivel de actividad física, que ofrece menor riesgo para enfermedades cardiovasculares, independiente de los patrones alimentarios. Sin embargo, datos proporcionados en la construcción de los patrones alimentarios y de inactividad refuerzan la percepción de que esta población puede estar susceptible a enfermedades cardiovasculares en la edad adulta caso se mantengan las prácticas actuales. [AU]
Asunto(s)
Humanos , Estado Nutricional , Estudios Transversales , Ingestión de Alimentos , Conducta AlimentariaRESUMEN
Abstract OBJECTIVE Analyzing factors related to the risk of falls in hospitalized adult patients. METHOD A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis. RESULTS 612 patients participated in the study. An association (p<0.001) was found between the high risk of falls and clinical neurological hospitalization, surgical trauma (hospitalization) and comorbidities such as diabetes mellitus, systemic arterial hypertension, visual impairment, vertigo and fear of falling. CONCLUSION An association between the risk of falls was found due to hospitalization, comorbidities and intrinsic factors. Regarding extrinsic factors, an association between mats/carpets and risk of falls was found. No association between the risk of falls with other extrinsic factors was found.
Resumen OBJETIVO Analizar los factores relacionados con el riesgo de caídas en pacientes adultos en estancia hospitalaria. MÉTODO Estudio transversal, analítico y cuantitativo, desarrollado en Unidades de Estancia Clínica y Quirúrgica, en el período de junio a agosto de 2015. Los instrumentos de recolección de datos fueron formulario sociodemográfico y clínico y Escala de Morse. Los datos fueron obtenidos de los pacientes y las fichas. Para el análisis estadístico univariado se utilizó frecuencia absoluta y relativa y en el bivariado se utilizó la prueba de chi-cuadrado. RESULTADOS Participaron en el estudio 612 mujeres. Se encontró asociación (p<0,001) entre el elevado riesgo de caída y la estancia hospitalaria clínica neurológica, la quirúrgica traumatológica y las comorbilidades como diabetes mellitus, hipertensión arterial sistémica, dificultad visual, vértigos y miedo de caer. CONCLUSIÓN Existe asociación entre el riesgo de caídas por motivo de estancia hospitalaria, comorbilidades y factores intrínsecos. Con relación a los factores extrínsecos, se encontró asociación entre alfombras y riesgo de caídas. No hubo asociación entre el riesgo de caídas con otros factores extrínsecos.
Resumo OBJETIVO Analisar os fatores relacionados ao risco de quedas em pacientes adultos internados em um hospital. MÉTODO Estudo transversal, analítico e quantitativo, desenvolvido em Unidades de Internação Clínica e Cirúrgica, no período de junho a agosto 2015. Os instrumentos de coleta de dados foram formulários sociodemográfico, clínico e Escala de Morse. Os dados foram obtidos com os pacientes e nos prontuários. Na análise estatística univariada utilizou-se de frequência absoluta e relativa, e na bivariada utilizou-se do teste de qui-quadrado. RESULTADOS Participaram do estudo 612 pacientes. Foi encontrada associação (p<0,001) entre o elevado risco de queda e a internação clínica neurológica, a cirúrgica traumatológica e comorbidades como diabetes mellitus, hipertensão arterial sistêmica, dificuldade visual, vertigens e medo de cair. CONCLUSÃO Existe associação entre o risco de quedas com motivo de internação, comorbidades e fatores intrínsecos. Em relação aos fatores extrínsecos, foi encontrada associação entre tapetes e risco de quedas. Não houve associação entre o risco de quedas com outros fatores extrínsecos.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Accidentes por Caídas , Seguridad del Paciente , Pacientes Internos , Estudios Transversales , Atención de EnfermeríaRESUMEN
OBJETIVOS: Investigar a relação entre estado nutricional antropométrico e qualidade de vida em escolares com asma. MÉTODOS: Estudo do tipo caso-controle com escolares de terceiro a oitavo ano do ensino fundamental no município de Ijuí, Rio Grande do Sul. A primeira etapa constituiu-se de um estudo transversal, sendo enviado aos domicílios dos estudantes um questionário de triagem, para ser preenchido pelos responsáveis, visando identificar os escolares com asma, os quais foram alocados para o grupo de casos (respostas positivas para tosse ou sibilância sem resfriado, uso de qualquer medicação para asma nos últimos 12 meses e/ou diagnóstico médico de asma). Para o grupo controle foram selecionados escolares pareados por sexo e idade cujas respostas foram negativas para asma, na proporção de dois controles para cada caso. Os escolares receberam visita domiciliar de pesquisadores treinados, que apresentaram aos participantes e seus pais/responsáveis um questionário sobre qualidade de vida relacionada à saúde. A avaliação do estado antropométrico foi realizada nas escolas, pelos pesquisadores. RESULTADOS: Foram investigados 1.691 escolares na primeira etapa do estudo, sendo 184 (10,8%) classificados com asma. Destes, 486 escolares responderam ao questionário de qualidade de vida: 122 com asma e 364 controles. A avaliação antropométrica foi realizada em 414 escolares (106 casos e 308 controles). Crianças eutróficas totalizaram 237 (57,2%), com baixo peso 8 (1,9%), com sobrepeso 90 (21,7%) e com obesidade 79 (19,1%). Encontrou-se sobrepeso/obesidade em 49 (46,2%) estudantes do grupo com asma e em 120 (38,9%) do grupo controle (p<0,001). Comparando a qualidade de vida entre os grupos, no grupo com asma foram observados escores menores no domínio bem-estar físico (p<0,001) e no escore total de qualidade de vida (p=0,003). Nos escolares com asma e sobrepeso/obesidade, a média do escore no domínio bem-estar físico apresentou-se menor quando comparado ao grupo sem asma e eutrófico (p=0,010). CONCLUSÕES: Quando comparados escolares entre sete e 18 anos com e sem história de asma, a asma associou-se com pior qualidade de vida. Considerando-se sobrepeso e obesidade como comorbidades, a qualidade de vida foi pior para esse grupo de escolares no domínio bem-estar físico.
AIMS: To investigate the relationship between anthropometric status and quality of life in children with asthma. METHODS: Case-control study, including students from third to eighth grade of elementary school at the city of Ijuí, Rio Grande do Sul, Brazil. The first phase of the study consisted of a cross-sectional study, when a questionnaire of screening was sent to the students' homes to be completed by the parents or guardians, aiming to identify children with asthma, which were allocated to the group of cases (positive responses to cough, wheezing without colds, use of any medication for asthma in the last 12 months and/or medical diagnosis of asthma). For the control group, students matched by sex and age whose responses were negative for asthma were selected, at the rate of two controls for each case. The children received home visits from trained researchers, who presented to the participants and their parents/guardians a questionnaire about health related quality of life. Evaluation of anthropometric status was carried out at the schools by the researchers. RESULTS: In the first phase od the study 1,691 students were investigated, and 184 (10.8%) were classified as having asthma. Of these, 486 students responded to the questionnaire of quality of life: 122 with asthma and 364 controls. Anthropometric assessment was performed in 414 children (106 cases and 308 controls). Eutrophic children totaled 237 (57.2%), low weight 8 (1.9%), overweight 90 (21.7%) and obese 79 (19.1%). Overweight/obesity was observed in 49 (46.2%) students of the group with asthma and in 120 (38.9%) in the control group (p<0.001). When comparing the quality of life between the groups, lower scores were observed among the asthma group in the physical well-being domain (p<0.001) and in the total score of quality of life (p=0.003). In children with asthma plus overweight/obesity, the mean score on the physical well-being domain was lower when compared to the group without asthma and eutrophic (p=0.010). CONCLUSIONS: When comparing students between seven and 18 years with or without history of asthma, asthma was associated with poor quality of life. Considering overweight and obesity as comorbidities, quality of life was worse for this group of students in the physical wellbeing domain.
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Humanos , Niño , Adolescente , Antropometría , Salud Infantil , Salud del Adolescente , Calidad de Vida , Asma , Estado Nutricional , Educación Primaria y SecundariaRESUMEN
This article focuses on the frequency of condom use and associated factors in university students, based on a cross-sectional study of 633 students in 2006. Associations were investigated using a logistic regression model with 5% significance. Condom use prevalence was 60%. Having candidiasis was a protective factor for condom use in both sexual initiation (OR = 0.49; 95%CI: 0.31-0.79) and the most recent sexual intercourse (OR = 0.39; 95%CI: 0.24-0.65). Condom use was associated with single marital status (OR = 2.89; 95%CI: 1.60-5.23) and having a sex partner from the health field (OR = 0.50; 95%CI: 0.34-0.75). Condom use was high in all sexual relations in this sample of university students. Single marital status and having a sex partner from a health-related course were positively associated with condom use in the most recent intercourse. Self-reported genital candidiasis was protective for condom use during early sexual activity and in the most recent sexual relation. Belonging to the health field did not show a significant impact on the use of male condoms.