Seroprevalence of Chagas disease in rural communities at Campinas do Piauí city, Brazil.

OBJECTIVES: This manuscript aimed to evaluate the seroprevalence of Chagas's disease in the population of rural communities at Campinas do Piauí city, State of Piauí, Brazil. METHODS: The techniques of the indirect immunofluorescence reaction and enzyme-linked immunosorbent assay were used to detect reagent samples for Chagas disease and estimate its prevalence in the rural population. Blood samples were collected on filter paper through digital and venipuncture. Blood samples with reactive or indeterminate results were re-evaluated and subjected to the test by ELISA. RESULTS: In total, 763 blood samples were analysed from 161 residences of 18 rural communities, collected in residents aged between 2 and 92 years. In the indirect immunofluorescence reaction technique, 44 (5.8%) of the results were positive, being 40 (5.2%) confirmed by the enzyme-linked immunosorbent assay. Among the communities surveyed, we observed reactive cases in 15 of them, these cases being distributed, according to the age group, as follows: 1 case from 0 to 10 years; 13 cases from 11 to 60 years old; and 30 cases over 61 years. CONCLUSION: The results indicate that Chagas's disease remains with active transmission in the Campinas do Piaui city according to the occurrence of a case in a resident under 10 years of age. The region is endemic for Chagas's disease, as observed by the high prevalence of positive cases.

OBJECTIFS: Ce manuscrit visait à évaluer la séroprévalence de la maladie de Chagas dans la population des communautés rurales de la ville de Campinas do Piauí, état de Piauí, au Brésil. MÉTHODES: Les techniques de la réaction d'immunofluorescence indirecte et ELISA ont été utilisées pour détecter des échantillons réagissant pour la maladie de Chagas et estimer sa prévalence dans la population rurale. Des échantillons de sang ont été collectés sur papier filtre par ponction digitale et veineuse. Les échantillons de sang avec des résultats positifs ou indéterminés ont été réévalués et soumis au test ELISA. RÉSULTATS: Au total, 763 échantillons de sang ont été analysés dans 161 résidences de 18 communautés rurales, prélevés chez des résidents âgés de 2 à 92 ans. Dans la technique de la réaction d'immunofluorescence indirecte, 44 (5,8%) des résultats étaient positifs, dont 40 (5,2%) confirmés par le test ELISA. Parmi les communautés enquêtées, nous avons observé des cas réactifs dans 15 d'entre eux, ces cas se répartissant, selon la tranche d'âge, comme suit: 1 cas chez les 0 à 10 ans, 13 cas chez les 11 à 60 ans, 30 cas chez des plus de 61 ans. CONCLUSION: Les résultats indiquent que la maladie de Chagas maintient une transmission active dans la ville de Campinas do Piauí avec la survenue d'un cas chez un résident de moins de 10 ans. La région est endémique pour la maladie de Chagas, comme en témoigne la forte prévalence des cas positifs.

Riparin-B as a Potential Inhibitor of AdeABC Efflux System from Acinetobacter baumannii.

Acinetobacter baumannii is an important opportunistic pathogen that causes serious health-related infections, especially in intensive care units. The present study aimed to investigate the antimicrobial activity of Riparin-B (Rip-B) alone and in association with norfloxacin against multidrug-resistant clinical isolates of A. baumannii. For this, the minimum inhibitory concentrations were determined by the microdilution method. For the evaluation of resistance-modulating activity, MIC values for antibiotics were determined in the presence or absence of subinhibitory concentrations of Rip-B or chlorpromazine (CPZ). The AdeABC-AdeRS efflux system genes from these isolates were detected by PCR. Docking studies were also carried out to evaluate the interaction of Riparin-B and the AdeABC-AdeRS efflux system. The study was conducted from 2017 to 2019. The results showed that Rip-B showed weak intrinsic activity against the strains tested. On the other hand, Rip-B was able to modulate norfloxacin's response against A. baumannii strains that express efflux pump-mediated resistance. Docking studies provided projections of the interaction between Rip-B and EtBr with the AdeB protein, suggesting that Rip-B acts by competitive inhibition with the drug. Results found by in vitro and in silico assays suggest that Rip-B, in combination with norfloxacin, has the potential to treat infections caused by multidrug-resistant A. baumanni with efflux pump resistance.

Knowledge of HIV/AIDS prevention and factors associated with condom use among adolescents in northeast Brazil.

AIM: To assess the knowledge of HIV/AIDS prevention and factors associated with condom use among adolescent. METHODS: A cross-sectional study was conducted among 410 outpatient adolescents. Association between knowledge on the transmission of HIV/AIDS and variables were analyzed using the chi-square test. Logistic regression model was used to estimate the factors associated to condom use. RESULTS: The knowledge about HIV/AIDS transmission was high and lower percentages of knowledge were observed regarding the non-transmission of HIV/AIDS. Younger adolescents revealed less knowledge than older adolescents. After multiple logistic regression the following factors were associated with condom use: male gender (p = 0.029), same age between partners (p = 0.002) and having until 1 year elapsed since sexual initiation (p = 0.001). CONCLUSION: The knowledge regarding HIV/AIDS prevention was satisfactory. However, this does not imply that adolescents put such knowledge to use.

Neutralizing antibodies against SARS-CoV-2 in Brazilian pregnant women vaccinated with one or two doses of BNT162b2 mRNA vaccine (Pfizer/WyethTM).

Pregnant women have an increased risk of developing severe coronavirus disease. In Brazil, the number of hospitalizations and adverse outcomes, including death caused by COVID-19, in women during the pregnancy-puerperal cycle was high in the first pandemic year. Doubts regarding vaccines' efficacy and safety for the mother and fetus delayed vaccination. This study evaluated the generation of IgG titers and neutralizing antibodies to the BNT162b2 mRNA vaccine in 209 healthy pregnant women. For this, were used the QuantiVac ELISA (IgG) and SARS-CoV-2 NeutraLISA kits (EUROIMMUN, Lübeck, SH) following the manufacturer's recommendations. One dose vaccine produced anti-SARS-CoV-2 IgG in 85% (81/95), and two produced in 95% (76/80) women. Among unvaccinated women, four of 34 (12%) showed protection. The first dose of the BNT162b2 vaccine protected 69% of the women with neutralizing antibodies (median of %IH = 97). In the second dose, protection occurred in 94% of the pregnant women (median of IH% = 97). This study showed no differences in IgG antibody titers between one- and two-dose of the BNT162b2 mRNA vaccine groups, boosting with the second dose increased the number of women who produced specific IgG and neutralizing antibodies, raising by 114-folds the chance of producing the SARS-CoV-2 neutralizing antibodies compared to the unvaccinated pregnant woman, which may contribute to reduce the chance of severe COVID-19.

Fetal transverse cerebellar diameter measured by ultrasound does not differ between genders.

PURPOSE: The aim of this study was to determine the correlation between fetal transverse cerebellar diameter (TCD) and gestational age of male and female fetus in women under low-risk prenatal care between the 13th and 40th week of gestation. METHODS: A cross-sectional study was carried out with 184 pregnant women, at the age of 18 years or more, gestational age ranging from 13 to 40 weeks, with a single fetus. A single TCD measurement by ultrasound was used for each fetus. Correlations between fetal TCD and gestational age were determined for the whole sample and each gender separately. RESULTS: We identified 102 males and 82 female fetuses. A linear correlation was observed between fetal TCD and gestational age for the whole sample (r = 96.9%; p < 0.001). A significant linear correlation was also observed for both males (r = 97.0%; p < 0.001) and females (r = 96.9%; p < 0.001). Comparing the regression lines between genders, no significant difference was observed. CONCLUSIONS: The data of this study suggest TCD fetal ultrasound as a predictive biometric parameter of gestational age independently of fetal gender in the last two trimesters of a pregnancy.

Contraception and reproductive planning from the perspective of women with sickle cell disease.

OBJECTIVE: To understand the perceptions of women with sickle cell disease (SCD) about reproductive planning in a public health service. METHOD: This is a qualitative study conducted with 15 women with SCD attended at a public hospital in Recife, between August 2018 and May 2019. Bardin's content analysis technique was used. RESULTS: The women were between 25 and 38 years old, married, and had low education. After the analysis, four thematic categories emerged: information about contraception, use of contraceptive methods, feelings about pregnancy, and gynecological consultation. It was found that women with SCD are influenced by factors such as fear of complications during pregnancy, lack of information on reproductive planning, partners and health professional opinion, and difficulties in health service access. FINAL CONSIDERATIONS: The reports demonstrate that health workers need to improve the way through which information reaches the patient, to offer a more satisfactory professional practice.

Choices on contraceptive methods in post-abortion family planning clinic in the northeast Brazil.

BACKGROUND: In Brazil, a Ministry of Health report revealed women who underwent an abortion were predominantly in the use of contraceptive methods, but mentioned inconsistent or erroneously contraceptive use. Promoting the use of contraceptive methods to prevent unwanted pregnancies is one of the most effective strategies to reduce abortion rates and maternal morbidity and mortality. Therefore, providing post-abortion family planning services that include structured contraceptive counseling with free and easy access to contraceptive methods can be suitable. So the objective of this study is to determine the acceptance and selection of contraceptive methods followed by a post-abortion family planning counseling. METHODS: A cross-sectional study was carried out from July to October 2008, enrolling 150 low income women to receive post-abortion care at a family planning clinic in a public hospital located in Recife, Brazil. The subjects were invited to take part of the study before receiving hospital leave from five different public maternities. An appointment was made for them at a family planning clinic at IMIP from the 8th to the 15th day after they had undergone an abortion. Every woman received information on contraceptive methods, side effects and fertility. Counseling was individualized and addressed them about feelings, expectations and motivations regarding contraception as well as pregnancy intention. RESULTS: Of all women enrolled in this study, 97.4% accepted at least one contraceptive method. Most of them (73.4%) had no previous abortion history. Forty of the women who had undergone a previous abortion, 47.5% reported undergoing unsafe abortion. Slightly more than half of the pregnancies (52%) were unwanted. All women had knowledge of the use of condoms, oral contraceptives and injectables. The most chosen method was injectables, followed by oral contraceptives and condoms. Only one woman chose an intrauterine device. CONCLUSION: The acceptance rate of post-abortion contraceptive methods was greater and the most chosen method was the best-known one. Implementing a specialized family planning post abortion service may promote an acceptance, regardless of the chosen method. Most important is they do receive contraception if they do not wish for an immediate pregnancy.

[Women hospitalized due to abortion in a maternity teaching hospital in Recife, Brazil]. / Mulheres hospitalizadas por abortamento em uma Maternidade Escola na Cidade do Recife, Brasil.

This cross-sectional study was performed with 160 women between 2005-2006. The objective was to describe the social-demographic and reproductive characteristics of women hospitalized due to abortions, and their knowledge about contraceptive methods and abortion induction. In order to determine the association between the abortion classification and social-demographic variables, Pearson's chi-square test was used, with a significance level of 5%. A frequency of 56.3% was found for probably induced abortions. Most cases of abortion occurred before 12 weeks (55.7%). As for the women's profiles: 48.9% were between 20-29 years old, 72.0% had eight years or more of schooling, 90.1% had a partner, 52.0% had 1-3 children, 100% knew about oral contraceptives and condoms and 80.0% had heard about misoprostol. The social-demographic and reproductive profile of women hospitalized at the referred service due to abortion did not change over the last years. Misoprostol remains the most known method for abortion induction.

Triatoma brasiliensis Neiva, 1911 and Triatoma pseudomaculata Corrêa and Espínola, 1964 (Hemiptera, Reduviidae, Triatominae) in rural communities in Northeast Brazil.

Chagas disease is an important endemic morbidity in Latin America affecting millions of people in the American continent. It is caused by the protozoan Trypanosoma cruzi, and transmitted through the feces of the insect vector belonging to the subfamily Triatominae. The present conducted an entomological survey of triatomines and analyzed entomological indicators, such as the rate of infestation, colonization, triatomine density and natural infection in rural communities in the municipality of Campinas do Piaui, Piaui State, in the Northeast region of Brazil. Data on the search of triatomines performed in 167 domiciliary units (DUs), harvested during the period of February to July 2019, in 12 rural communities were analyzed. The capture of triatomines occurred in all studied communities, being 76 the number of positive DUs, of the 167 surveyed, presenting a global rate of infestation of 45.51%. Two triatomines species were collected: Triatoma brasiliensis (98.49%) and T. pseudomaculata (1.51%), the first was found in the domiciliary and peridomiciliary areas, while the second was captured only in peridomiciliary areas. The index of colonization was 17.1%. Natural infection was observed only in 5.44% of T. brasiliensis samples. The entomological survey was conducted in rural communities, showingthe risk of transmission of Chagas disease to the local population, requiring continuous entomological surveillance and vector control.

Effectiveness of contraceptive counselling of women following an abortion: a systematic review and meta-analysis.

OBJECTIVE: To perform a systematic review of the effectiveness of contraceptive counselling in women undergoing an abortion and its impact on the acceptance and use of contraceptive methods. METHODS: Randomized controlled trials (RCTs) assessing women who had undergone an abortion and received contraceptive counselling at that time met the inclusion criteria. Articles published between 1997 and 2007 were selected from searches of the LILACS, SCIELO, MEDLINE, PubMed and Cochrane Library databases. Two reviewers independently assessed eligibility and the quality of the trial. The internal validity of the RCTs was evaluated by means of the Jadad scale. A meta-analysis of the three retained studies involving 694 women was performed. The Stata 9.2 SE statistical software was used, and a level of significance of 0.05 adopted. RESULTS: There were no differences between intervention and control groups, despite clinical heterogeneity. The results of the meta-analysis were not significant (OR = 1.32; CI: 0.90-1.94). CONCLUSION: There was no evidence indicating that contraceptive counselling is effective in increasing acceptance and use of contraceptive methods after an abortion. This may not apply to developing countries, where the matter still needs to be investigated.

Quality of Life among University Students with Premenstrual Syndrome.

OBJECTIVE: To evaluate the quality of life among university students with premenstrual syndrome (PMS). METHODS: The cross-sectional study was conducted at the Faculdade Pernambucana de Saúde, in Recife, Brazil, between August 2016 and July 2017. Sociodemographic, gynecological, and lifestyle variables, and PMS occurrence, were investigated among 642 students. The short form of the World Health Organization Quality of Life (WHOQOL Bref) questionnaire was used to evaluate four domains of the quality of life of the students: physical, mental, social relationships, and environmental. The American College of Obstetricians and Gynecologists' criteria were used to define PMS. RESULTS: Of the 642 students, 49.9% had PMS, 23.3% had mild PMS and 26.6% had premenstrual dysphoric disorder (PMDD). Most of the students were between 18 and 24 years old, had regular menstrual cycles, and practiced physical activity. Regarding the physical and mental domains of the WHOQOL-Bref questionnaire, a statistically significant difference was observed between the students who did not have and those who had mild or PMDD (p < 0.001). A difference was also found between the students who did not have PMS and those who had mild PMS in the social relationships (p = 0.001) and environmental domains (p = 0.009). CONCLUSION: Mild PMS and PMDD are prevalent among university students on health-related courses, and the syndrome can affect the students' self-assessment of all the domains of quality of life.

OBJETIVO: Avaliar a qualidade de vida entre estudantes universitárias com síndrome pré-menstrual (SPM). MéTODOS: Foi realizado um estudo transversal na Faculdade Pernambucana de Saúde, em Recife, no período de agosto de 2016 a julho de 2017. Foram investigadas variáveis sociodemográficas, ginecológicas, estilo de vida e a ocorrência de SPM entre 642 estudantes. Foi utilizada a forma abreviada do questionário de Qualidade de Vida da Organização Mundial da Saúde (WHOQOL Bref, na sigla em inglês) para avaliar quatro domínios da qualidade de vida: físico, mental, social e meio ambiente. Para a definição de SPM, foram considerados os critérios do Colégio Americano de Obstetras e Ginecologistas. RESULTADOS: Das 642 estudantes, 49,9% apresentaram SPM, sendo 23,3% SPM na forma leve e 26,6%, transtorno disfórico pré-menstrual (TDPM). A maioria das estudantes tinha entre 18 e 24 anos de idade, possuia ciclos menstruais regulares e praticava atividade física. Em relação aos domínios físico e mental do WHOQOL-Bref, observou-se diferença estatisticamente significante entre as estudantes que não apresentavam SPM e as que apresentavam SPM, tanto a forma leve quanto o TDPM (p < 0,001). Também foi encontrada diferença no domínio "relações sociais" e "meio ambiente" entre aquelas que não tiveram TPM e as que tiveram TPM leve (p = 0,001 e p = 0,009, respectivamente). CONCLUSãO: A SPM leve e o TDPM têm alta prevalencia entre estudantes universitárias da área de saúde e pode influenciar a autoavaliação das estudantes em todos os domínios da qualidade de vida.

Contraceptive preferences among women with sickle cell disease during a 12-month follow-up: a prospective study / Preferências contraceptivas entre mulheres com doença falciforme durante um acompanhamento de 12 meses: um estudo longitudinal

Abstract Objectives: to analyze the choice and continuation rate of contraceptive methods in women with sickle cell disease (SCD). Methods: an exploratory prospective study was conducted at a hospital enrolling 44 women with SCD aged 15-40 years old. After contraceptive counseling, the women selected one of the available contraceptive methods and separated into two groups, and were followed up at one, three, six, and 12 months. To analyze the continuation rate of contraceptive use, the two groups were: group (G1) using progestin-only contraceptives, through any route of administration and group (G2) using other contraceptive methods (combined hormonal and non-hormonal contraceptives). The continuation rate was analyzed using Kaplan-Meier survival analysis, considering a p<0.05. Results: after contraceptive counseling, most women opted for any progestin-only methods: injectable contraceptives (n=18; 40.9%), oral contraceptives (n=7; 15.9%), or intrauterine devices (n=3; 6.8%). The continuation rate decreased in both groups during the 12-months follow-up period. In the G1, the continuation rate was 60.7% (CI95%=40.4-76.0), while that in the G2 was 68.7% (CI95%= 40.5-85.6) with no significant difference between the groups (p=0.641). Conclusions: the overall continuation rates in both groups were satisfactory. No significant difference in the continuation rate of contraceptive methods was observed between the groups, although most women preferred progestin-only methods.

Resumo Objetivos: analisar a escolha e a taxa de continuação do uso de métodos contraceptivos em mulheres com doença falciforme (DF). Métodos: foi realizado um estudo prospectivo exploratório em um hospital, no qual foram incluídas 44 mulheres com DF com idade entre 15 e 40 anos. Após aconselhamento contraceptivo, as mulheres selecionaram um dos métodos contraceptivos disponíveis e foram separadas em dois grupos, sendo acompanhadas por um, três, seis e 12 meses. Para analisar a taxa de continuação do uso de métodos contraceptivos, os dois grupos foram: grupo (G1) que utilizou apenas contraceptivos de progestágeno, por qualquer via de administração e grupo (G2) que utilizou outros métodos contraceptivos (contraceptivos hormonais combinados e não hormonais). A taxa de continuação foi analisada pela análise de sobrevida de Kaplan-Meier, considerando um p<0,05. Resultados: após aconselhamento contraceptivo, a maioria das mulheres optou por algum dos métodos contendo apenas progestágeno: contraceptivos injetáveis (n=18; 40,9%), contraceptivos orais (n=7; 15,9%) ou dispositivos intrauterinos (n=3; 6,8%). A taxa de continuação diminuiu em ambos os grupos durante o período de acompanhamento de 12 meses. No G1, a taxa de continuação foi de 60,7% (IC95%= 40,4-76,0), enquanto no G2 foi de 68,7% (IC95%= 40,5-85,6) sem diferença significativa entre os grupos (p=0,641). Conclusões: as taxas gerais de continuação em ambos os grupos foram satisfatórias. Não foi observada diferença significativa na taxa de continuação dos métodos contraceptivos entre os grupos, embora a maioria das mulheres tenha preferido métodos somente com progestágeno.

Do perineal exercises during pregnancy prevent the development of urinary incontinence? A systematic review.

OBJECTIVES: The aim of the current article was to conduct a systematic review of the performance of perineal exercises during pregnancy and their utility in the prevention of urinary incontinence. METHODS: Randomized controlled studies (RCT) of a low-risk obstetric population (primiparas or nulliparas) who had done perineal exercises only during pregnancy met the inclusion criteria. Articles published between 1966 and 2007 from periodicals indexed in the LILACS, SCIELO, PubMed/MEDLINE, SCIRUS and Cochrane Library databases were selected, using the following keywords: 'urinary incontinence', 'pregnancy', 'pelvic floor' and 'exercise'. The Jadad scale was applied to assess the internal validity of the RCT and two meta-analysis: one of fixed effects and the other of random effects were carried out with data extracted from the RCT, using the Stata 9.2 statistical software and adopting a significance level of 0.05. RESULTS: Four RCTs with high methodological quality, involving a total of 675 women were included. They indicated that perineal muscle exercise significantly reduced the development of urinary incontinence from 6 weeks to 3 months after delivery (odds ratio = 0.45; confidence interval: 0.3 to 0.66). However, when evaluating this effect during the 34th and 35th gestational week, a meta-analysis showed that the results were not significant (odds ratio = 0.13; confidence interval: 0.00 to 3.77). CONCLUSION: Pelvic floor muscle exercises may be effective at reducing the development of postpartum urinary incontinence, despite clinical heterogeneity among the RCT.

Cambios en la percepción y consumo habitual de bebidas analcoholicas comerciales entre profesionales de la salud / Changes in the perception and regular consumption of commercial alcoholic beverages among health professionals

Introducción: El consumo de bebidas analcohólicas ha aumentado. Médicos y enfermeros resultan estratégicos para promocionar cambios en el estilo de vida. Objetivos: Establecer: la prevalencia de consumo habitual de bebidas analcohólicas comerciales entre médicos y enfermeros, la percepción del carácter saludable, la asociación entre percepción y consumo, y si las técnicas de mercadeo social modifican la percepción y los cambios de hábitos de hidratación. Materiales y métodos: Se incluyeron médicos y enfermeros de las salas de internación. Completaron una encuesta sobre consumo habitual y percepción del carácter saludable de las bebidas. Se realizaron dos intervenciones educativas nutricionales. Al mes, se aplicó un cuestionario sobre percepción y, a quienes refirieron consumo habitual, una encuesta para evaluar cambios de hábitos de hidratación (Prochaska). Diseño Cuasi-experimental, antes/después. Estadística descriptiva (tendencia central y dispersión; frecuencias y proporciones). Estadística inferencial (chi2 significancia del 0,05, Stata 14). Resultados: De los 105 encuestados se observó un consumo habitual: 72,4% (76). Previa a la intervención: el 85,7% (90) consideró no saludable a las gaseosas con azúcar; siendo menor para jugos (59-56,2%) y aguas saborizadas con azúcar (52-49,5%). En su versión sin azúcar consideraron no saludables a: gaseosas 33,3% (35), jugos comerciales 20% (21), y aguas saborizadas 17,1% (18). Dentro de la variedad sin azúcar, quienes consumían gaseosas, jugos y aguas saborizadas, tuvieron una percepción significativamente más saludable: p 0,046, p 0,006 y p 0,0001 respectivamente. Pos intervención, hubo diferencias significativas en la percepción en todos los grupos de bebidas excepto en las gaseosas con azúcar (p 0,190). Entre quienes consumían habitualmente, 60,5% (46) respondió haber iniciado cambios en su hidratación. Conclusiones: La intervención educativa generó cambios en la percepción y en hábitos no saludables. Existe la necesidad de instaurar herramientas innovadoras y espacios sostenidos de educación nutricional para profesionales, teniendo en cuenta su importante rol en la transmisión de conocimientos a los pacientes

Introduction: The consumption of non-alcoholic beverages has increased. Doctors and nurses are strategic in promoting changes in lifestyle. Objectives: To establish: the prevalence of habitual consumption of commercial non-alcoholic beverages among doctors and nurses, perception of healthy character, association between perception and consumption, whether social marketing techniques modify perception, changes in hydration habits. Materials and methods: Physicians and nurses from the hospitalization wards were included. They completed a survey on habitual consumption and perception of the healthy nature of beverages. Two nutritional educational interventions were carried out. After a month, a questionnaire on perception was applied and, to those who reported habitual consumption, a survey to evaluate changes in hydration habits (Prochaska). Quasi-experimental design, before/after. Descriptive statistics (central tendency and dispersion; frequencies and proportions). Inferential statistics (chi2 significance of 0.05, Stata 14). Results: Of the 105 respondents, habitual consumption was observed: 72.4% (76). Before the intervention: 85.7% (90) considered soft drinks with sugar unhealthy; being lower for juices (59-56.2%) and flavored waters with sugar (52-49.5%). In its version without sugar, they considered unhealthy: soft drinks 33.3% (35), commercial juices 20% (21), and flavored waters 17.1% (18). Within the sugar-free variety, those who consumed soft drinks, juices and flavored waters had a significantly healthier perception: p 0.046, p 0.006 and p 0.0001 respectively. Post-intervention, there were significant differences in perception in all beverage groups except soft drinks with sugar (p 0.190). Of those who regularly consumed, 60.5% (46) responded that they had initiated changes in their hydration. Conclusions: The educational intervention generated changes in perception and in unhealthy habits. There is a need to establish innovative tools and sustained spaces for nutritional education for professionals, taking into account their important role in transmitting knowledge to patients

Ações de terapeutas ocupacionais na prevenção de quedas da pessoa idosa no domicílio: revisão integrativa da literatura (2017-2022) / Occupational therapist's actions in preventing falls of the elderly person at home: an integrative review of literature (2017-2022)

Resumo Introdução Quedas em pessoas idosas são amplamente discutidas pelos profissionais da saúde, devido às suas consequências físicas, funcionais e psicossociais, as quais comprometem a participação nas Atividades de Vida Diária (AVD). Objetivo Identificar as ações de intervenção e estratégias utilizadas em terapia ocupacional para prevenção de quedas da pessoa idosa no domicílio. Método Trata-se de uma revisão integrativa de literatura, que rastreou as produções científicas nas bases de dados Biblioteca Virtual em Saúde (BVS), MEDLINE/PubMed, Scopus, Web of Science, CINAHL e Embase, de janeiro de 2017 a julho de 2022. Resultados As 19 publicações que compuseram o corpus desta pesquisa foram categorizadas para análise com base nas avaliações utilizadas pelo terapeuta ocupacional e suas ações para a prevenção de quedas, incluindo: treinamentos funcionais integrados às AVD, intervenções de adequação ambiental domiciliar, ações educativas e utilização de tecnologias e dispositivos assistivos. Conclusão O domicílio é o local mais propenso para a ocorrência de quedas em pessoas idosas. Por isso, as ações de terapeutas ocupacionais são significativamente importantes para a prevenção de quedas e manutenção da segurança da pessoa idosa nesse contexto. Além disso, notou-se a incipiência de estudos nacionais da terapia ocupacional sobre o tema, o que mostra a necessidade de ampliar as publicações da profissão nesse âmbito de atuação.

Abstract Introduction Falls in the elderly are widely discussed by health professionals, due to their physical, functional, and psychosocial consequences, which compromise participation in daily activities. Objective To identify the intervention actions and strategies used by the occupational therapist to prevent falls in the elderly at home. Method This is an integrative literature review, which tracked the scientific productions in the Biblioteca Virtual em Saúde (BVS), MEDLINE/PubMed, Scopus, Web of Science, CINAHL and Embase databases, in the period of January 2017 to July 2022. Results 19 publications were identified that made up the research corpus, being categorized for analysis in the following points: assessments used by the occupational therapist and the occupational therapist's actions for the prevention of falls, including functional training integrated into daily activities, home environmental adequacy interventions, educational actions and use of technologies and devices. Conclusion The home is the most prone place for the occurrence of falls in the elderly, where the actions of the occupational therapist are significantly important for the maintenance of safety in this context. The occupational therapist's actions contribute to the prevention of falls and maintaining the safety of the elderly at home. In addition, it was noted the incipience of national studies of occupational therapy on the subject, which shows the need to expand the publications of the profession in this field of action.

Geography of Microcephaly in the Zika Era: A Study of Newborn Distribution and Socio-environmental Indicators in Recife, Brazil, 2015-2016.

OBJECTIVES: We assessed sociodemographic and health care factors of mothers and newborns during a 2015-2016 outbreak of microcephaly in Recife, Brazil, and we analyzed the spatial distribution and incidence risk of newborns with microcephaly in relation to socio-environmental indicators. METHODS: We collected data from August 2015 through May 2016 from Brazil's Live Birth Information System and Bulletin of Microcephaly Notification, and we geocoded the data by maternal residence. We constructed thematic maps of districts, according to socio-environmental and vector indicators. We identified spatial aggregates of newborns with microcephaly by using the Bernoulli model. We performed logistic regression analyses to compare the incidence risk of microcephaly within socio-environmental indicator groups. RESULTS: We geocoded 17 990 of 19 554 (92.0%) live births in Recife, of which 202 (1.1%) newborns were classified as having microcephaly, based on a head circumference of ≥2 standard deviations below the mean. Larger proportions of newborns with microcephaly (compared with newborns without microcephaly) were born to mothers who delivered in a public hospital, did not attend college, were aged ≤19, or were black or mixed race. A higher risk of microcephaly (incidence rate ratio [IRR] = 3.90; 95% confidence interval [CI], 1.88-8.06) occurred in districts with the lowest (vs highest) Municipal Human Development Index (ie, an index that assesses longevity, education, and income). The risk of microcephaly was significantly higher where rates of larvae density (IRR = 2.31; 95% CI, 1.19-4.50) and larvae detection (IRR = 2.04; 95% CI, 1.05-4.00) were higher and rates of sewage system (IRR = 2.20; 95% CI, 1.16-4.18) and garbage collection (IRR = 1.96; 95% CI, 0.99-3.88) were lower. Newborns with microcephaly lived predominantly in the poorest areas and in a high-risk cluster (relative risk = 1.89, P = .01) in the north. CONCLUSIONS: The disproportionate incidence of microcephaly in newborns in poor areas of Recife reinforces the need for government and public health authorities to formulate policies that promote social equity and support for families and their children with microcephaly.

Profile of Reproductive Issues Associated with Different Sickle Cell Disease Genotypes.

Purpose To describe the reproductive variables associated with different sickle cell disease (SCD) genotypes and the influence of contraceptive methods on acute painful episodes among the women with the homozygous hemoglobin S (HbSS) genotype. Methods A cross-sectional study was conducted between September of 2015 and April of 2016 on 158 women afflicted with SCD admitted to a hematology center in the Northeast of Brazil. The reproduction-associated variables of different SCD genotypes were assessed using the analysis of variance (ANOVA) test to compare means, and the Kruskal-Wallis test to compare medians. The association between the contraceptive method and the acute painful episodes was evaluated by the Chi-square test. Results The mean age of women with SCD was 28.3 years and 86.6% were mixed or of African-American ethnicity. With respect to the genotypes, 134 women (84.8%) had HbSS genotype, 12 women (7.6%) had hemoglobin SC (HbSC) disease genotype, and 12 (7.6%) were identified with hemoglobinopathy S-beta (S-ß) thalassemia. The mean age of HbSS diagnosis was lower than that of HbSC disease, the less severe form of SCD (p < 0.001). The mean age of menarche was 14.8 ± 1.8 years for HbSS and 12.7 ± 1.5 years for HbSC (p < 0.001). Among women with HbSS who used progestin-only contraception, 16.6% had more than 4 acute painful episodes per year. There was no statistically significant difference when compared with other contraceptive methods. Conclusion With respect to reproduction-associated variables, only the age of the menarche showed delay in HbSS when compared with HbSC. The contraceptive method used was not associated with the frequency of acute painful episodes among the HbSS women.

Objetivo Descrever as variáveis reprodutivas em diferentes genótipos da doença falciforme (DF) e a influência dos métodos contraceptivos na frequência das crises álgicas em mulheres com homozigose da hemoglobina S (HbSS). Métodos Estudo de corte transversal realizado entre setembro de 2015 e abril de 2016 com 158 mulheres com DF atendidas em um centro de hematologia no Nordeste do Brasil. As variáveis reprodutivas dos diferentes genótipos da DF foram avaliadas utilizando-se o teste de análise de variância (ANOVA) para comparação de médias e o teste de Kruskal-Wallis para comparação de medianas. A associação entre o método contraceptivo e a frequência das crises álgicas foi avaliada pelo teste Qui-quadrado. Resultados A idade média das mulheres com DF foi de 28,3 anos e 86,6% eram afrodescentes. Em relação aos genótipos, 134 mulheres (84,8%) tinham genótipo HbSS, 12 mulheres (7,6%) tinham genótipo para doença da hemoglobina SC (HbSC) e 12 (7,6%) foram identificadas com beta talassemia (S-ß). A idade média do diagnóstico de HbSS foi menor do que a da HbSC, sendo esta a forma menos grave da DF (p < 0,001). A idade média da menarca foi de 14,8 ± 1,8 anos para HbSS e de 12,7 ± 1,5 anos para HbSC (p < 0,001). Entre as mulheres com HbSS que fizeram contracepção com progesterona isolada, 16,6% apresentaram mais de 4 episódios de crises álgicas agudas por ano. Não houve diferença estatisticamente significativa quando comparado com outros métodos anticoncepcionais. Conclusão Em relação às variáveis reprodutivas, apenas a idade da menarca apresentou atraso no HbSS em relação ao HbSC. O método anticoncepcional utilizado não foi associado à frequência de crises álgicas entre as mulheres com HbSS.

The role of telehealth in sexual and reproductive health services in the response to COVID-19 / O papel da telessaúde nos serviços de saúde sexual e reprodutiva em resposta à COVID-19

Abstract This opinion article brings considerations about advantages and challenges with the use of telehealth in sexual and reproductive health services aiming family planning in the face of COVID-19 pandemic new scenario.

Resumo Este artigo de opinião traz algumas considerações sobre vantagens e desafios do uso da telessaúde em serviços de saúde sexual e reprodutiva focado no planejamento familiar diante do novo cenário da pandemia da COVID-19.

Dengue as a cause of fever during pregnancy: a report of two cases.

Dengue infection has not been routinely investigated among pregnant women and parturients with acute febrile syndrome in endemic settings. Here, we report two cases of dengue fever detected at the time of delivery in parturients enrolled in a cohort prospective study conducted in a hospital in Recife, Brazil. The parturients reported fever onset within seven days prior to delivery, and dengue infection was confirmed upon detection of viral ribonucleic acid (RNA) by using the reverse transcriptase-polymerase chain reaction. Dengue infection should be considered as a diagnostic possibility in cases of fever during pregnancy and labor, especially in endemic areas.

COVID-19 and Sickle Cell Disease: a new challenging dilemma in an old disease / COVID-19 e Doença Falciforme: um desafiador dilema em uma doença antiga

Abstract The authors bring reflections about people with sickle cell disease in the pandemic era. They comment on some common clinical situations in these two diseases which may delay or confuse the diagnosis of COVID-19 in patients with sickle cell disease. We consider that people with sickle cell disease are part of the risk group for the complications of COVID-19 and the topic should be addressed in the scientific literature.

Resumo Os autores trazem reflexões sobre as pessoas com doença falciforme na era da pandemia. Eles comentam algumas situações clínicas comuns nessas duas doenças que podem retardar ou confundir o diagnóstico de COVID-19 em pacientes com doença falciforme. Consideramos que as pessoas com doença falciforme fazem parte do grupo de risco para complicações da COVID-19 e o tema deve ser abordado na literatura científica.