RESUMO
The present study aimed to evaluate the influence of the autonomic nervous system on cardiovascular function during the first 35 days of life in different types of delivery, using heart rate variability (HRV) indices. Thirty newborns were equally divided into two groups based on delivery type: eutocic delivery (EG) and emergency cesarean section (CG). Electrocardiographic evaluation was performed at birth (T0), 24 h postpartum (T1), and at 7, 14, 21, 28, and 35 days of life (T2 to T6). Physical parameters, neonatal reflexes, and Apgar scores were recorded. Over 35 days, the values of the time domain indices were higher in the GE group and increased with age. In the frequency domain, the low frequency (LF) index was higher in the CG, and the opposite occurred for the high frequency (HF) index. Since the CG presented lower HRV than the EG, it was shown that the type of delivery should be considered for the assessment of autonomic nervous system activity in neonates. Thus, as predictive factors of vitality, HRV and Apgar scores can help in the face of neonatal depression, demonstrating that delivery by emergency cesarean section can predispose newborns to delays in the autonomic influence on the heart.
RESUMO
Tuberculosis continues to be of the most frequent diseases in the world and one of the main causes of morbidity and mortality. Data from the World Health Organization indicate that Brazil accounts for 75% of global cases involving children. The study aims to analyze the epidemiological and spatial pattern of tuberculosis in children and adolescents in the state of Sergipe during the period from 2001 to 2017. This is an ecological, temporal series study using secondary data. The categorical variables were summarized in simple and absolute frequency. In the spatial analysis the Bayesian method for rate smoothing and the Moran index were used to evaluate spatial autocorrelation. Trend analysis was performed using the Joinpoint regression model. The mean incidence rate was 5.9, with a predominance of 15 to 19 years of age (76.4%) and a steady trend, but with a positive annual variation in both sexes. Tuberculosis in children and adolescents has significant spatial dependence in the north and northeast regions. The knowledge of the epidemiological situation of tuberculosis over the years provides subsidies for the targeting of resources in risk areas and new strategies for prevention and control of the disease among children and adolescents.
A tuberculose continua como uma das doenças mais frequentes no mundo e uma das principais causas de morbimortalidade. Dados da Organização Mundial de Saúde indicam que o Brasil responde por 75% dos casos mundiais envolvendo crianças. O estudo objetiva analisar o padrão epidemiológico e espacial da tuberculose em crianças e adolescentes no estado de Sergipe durante o período de 2001 a 2017. Trata-se de um estudo ecológico, de serie temporal, com uso de dados secundários. As variáveis categóricas foram sumarizadas em frequência simples e absoluta. Na análise espacial foi utilizado o método bayesiano para suavização de taxas e o índice de Moran para avaliar a autocorrelação espacial. A análise de tendência foi realizada por meio do modelo de regressão Joinpoint. Verificou que a taxa média de incidência foi de 5,9 com predomínio na faixa etária 15 a 19 anos (76,4%) e tendência estacionaria, porém com variação anual positiva em ambos os sexos. A tuberculose em crianças e adolescentes apresenta dependência espacial significante nas regiões norte e nordeste. O conhecimento da situação epidemiológica da tuberculose ao longo dos anos fornece subsídios para o direcionamento de recursos em áreas de risco e às novas estratégias de prevenção e controle da doença em crianças e adolescentes.