Conhecimento em saúde sexual e reprodutiva: estudo transversal com adolescentes / Sexual and reproductive health knowledge: a cross-sectional study with adolescents

Objetivou investigar e comparar o conhecimento sobre saúde sexual e reprodutiva, e fontes de informação, entre adolescentes de escolas públicas de Goiânia-Goiás. Estudo de corte transversal realizado com 2449 escolares. Os dados do questionário auto aplicável foram analisados pelo Statistical Package Social Science, versão 13.0. As diferenças entre as proporções foram analisadas pelos testes de c2 e nível de significância (p<0,05). Observou-se diferença estatística entre os sexos considerando o conhecimento sobre Infecções Sexualmente Transmissíveis e métodos de prevenção às IST e contracepção (p<0,000), também, adolescentes do sexo masculino apresentaram maior risco de exposição a relações sexuais sem preservativo (p<0,000). Em relação à aquisição de métodos preventivos para IST e contracepção, mulheres demonstraram mais conhecimento de locais de acesso aos dispositivos, bem como buscavam em variadas fontes, informações acerca de conteúdos relacianados à saúde sexual e reprodutiva. Conclui-se que adolescentes do sexo masculino apresentaram maior perfil de vulnerabilidade social e individual.

The objective was to investigate and compare sexual and reproductive knowledge and sources of information, between public school adolescents from Goiânia-Goiás. A cross-sectional study conducted with 2,449 students. We analyzed data from the self-reported questionnaire using the Statistical Package for Social Sciences, version 13.0. We investigated the differences between proportions using c2 tests and a significance level (p<0.05). We observed a statistical difference between sex considering the knowledge about Sexually Transmitted Infections and, STI and contraception prevention (p<0.000). Additionally, male adolescents presented higher exposure risk to sexual relations without preservative (p<0.000). About the acquisition of preventive methods for STIs and contraception, women were more knowledgeable about access to devices, as well as; they searched different sources and content information about sexual and reproductive health. We concluded that male adolescents presented higher social and individual vulnerability profiles.

Concepções de pais de adolescentes escolares sobre a sexualidade de seus filhos / Conceptions of parents of adolescent students about the sexuality of their children

Conhecer a concepção de pais de adolescentes escolares sobre a sexualidade dos seus filhos.Métodos: pesquisa qualitativa, modalidade Pesquisa Estratégica, utilizando grupos focais norteados porinstrumento semiestruturado, com 15 pais de adolescentes escolares. Os dados foram analisados por Análisede Conteúdo, em que emergiram as categorias “Compreendendo aspectos relacionados à sexualidade”;“Dificuldades para o diálogo”; “Facilidades para o diálogo”; e “As atribuições da família e da escola no apoio atemática”. Resultados: os pais apresentaram conhecimento superficial e conceitos errôneos sobre o tema. Foiidentificada uma grande dificuldade de diálogo entre pais e filhos, justificada pelo desconhecimento e timidezdos pais e falta de abertura do adolescente, ainda assim, houve reconhecimento da responsabilização da famílianeste contexto. Conclusão: há necessidade de ampliação do trabalho intersetorial envolvendo segmentos daeducação, saúde e instituições de ensino superior a fim de apoiar as famílias com informações sobre sexualidadeno contexto escolar...

Ensaio clínico controlado randomizado: região ventro glútea, local alternativo para aplicação da benzilpenicilina benzatina G / Ventrogluteal region, an alternative location to apply benzathine penicillin

O objetivo deste estudo foi comparar o nível de dor relacionada à administração da Benzilpenicilina Benzatina G nas regiões ventro glútea (VG) e dorso glútea (DG). Ensaio clínico controlado randomizado. Participaram do estudo 61 pessoas, 31 do grupo de intervenção (região VG) e 30 do grupo controle (região DG). O teste de qui-quadrado e Mann­ Whitney foram utilizados para testar diferenças entre proporções e comparar tendências centrais entre os grupos, respectivamente. Valores de p ˂ 0,05 foram considerados estatisticamente significantes. Nos três momentos avaliados, a média do escore de dor foi maior quando a aplicação do fármaco ocorreu na região VG vs. DG. No primeiro e terceiro minuto a diferença foi estatisticamente significativa. Estes resultados ratificam a região VG como local alternativo com menor reação local para aplicação de injeções intramusculares.

The objective of this study was to compare the pain level related to the administration of benzathine penicillin on the ventrogluteal (VG) and dorsogluteal (DG) region. A randomized controlled trial. Sixty-one people participated in the study, 31 on the intervention group (VG region), and 30 on the control (DG region). The Chi-Squared and Mann-Whitney tests were used to test differences of proportions and to compare central tendencies between groups, respectively. Values of p <0.05 were considered statistically significant. At the three assessed moments, the mean score of pain was higher when the application of the drug was on the VG region vs. DG. At the first and third minute, the difference was statistically significant. These results confirm the VG region as alternative place with less local reaction to apply intra- muscular injections.

Presence of maternal anti-HBs antibodies does not influence hepatitis B vaccine response in Brazilian neonates.

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 µg) of HBV vaccine (Butang®) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.

Presence of maternal anti-HBs antibodies does not influence hepatitis B vaccine response in Brazilian neonates

Recently, it was suggested that maternal hepatitis B surface antigen antibodies (anti-HBs) acquired transplacentally could play a negative role in newborn infants' immune response to the hepatitis B vaccine. We compared the hepatitis B virus (HBV) vaccine response in infants born to mothers previously vaccinated against HBV (n = 91) to infants born to mothers who were not previously vaccinated (n = 221). All newborn infants received three intramuscular doses (10 μg) of HBV vaccine (Butang®) at 0,1 and six months. The first dose was administered at the maternity hospital within 12 h of birth. The geometric mean titres of anti-HBs were not different among newborn infants born to mothers who were anti-HBs-negative (492.7 mIU/mL) and anti-HBs-positive (578.7 mIU/mL) (p = 0.38). Eight infants did not respond to the HBV vaccine. Of them, six were born to anti-HBs-negative mothers and two were born to mothers with anti-HBs titres less than 50 mlU/mL. Despite the mother's anti-HBs-positive status, our data show a good immunogenicity of the Brazilian HBV recombinant vaccine in neonates.

[Evaluation of risk and protection factors associated with high blood pressure in children]. / Avaliação dos fatores de risco e proteção associados à elevação da pressão arterial em crianças.

BACKGROUND: Epidemiological studies have shown an increased prevalence of high blood pressure in pediatric patients. Today we know that risk factors can be detected during childhood and may help in preventing the disease. OBJECTIVE: To evaluate risk and protection factors related to high blood pressure in childhood. METHODS: We evaluated children aged 3 to 10 years, residing in the east and southwest sanitary districts of the City of Goiânia, Goiás, and obtained the following data: birth weight, breastfeeding, family history of high blood pressure and obesity, weight, height, body mass index (BMI), and blood pressure. We applied the Mann-Whitney U-test to these variables in order to compare pressure variation. RESULTS: In this sample, 519 children were evaluated, and 246 (47.4%) of them were male. The BMI assessment identified 109 (21%) overweight children, of which 53 (10.3%) were obese. Predominant and/or exclusive breastfeeding for less than 6 months was found in 242 (51.2%). The mean systolic pressure was significantly higher in children with exclusive and/or predominant breastfeeding for less than 6 months (p = 0.04), and in children with family history of high blood pressure (p = 0.05), and in overweight children (p <0.0001). These data were confirmed in multivariate analysis. CONCLUSION: In this sample, we observed that overweight and hereditary factors may be associated with elevated blood pressure, and that breastfeeding for more than 6 months seems to offer a protective effect.

Avaliação dos fatores de risco e proteção associados à elevação da pressão arterial em crianças / Evaluation of risk and protection factors associated with high blood pressure in children

FUNDAMENTO: Estudos epidemiológicos têm mostrado um aumento da prevalência da hipertensão arterial na faixa etária pediátrica. Hoje se sabe que os fatores de risco poderiam ter sido detectados na infância, o que auxiliaria na prevenção da doença. OBJETIVO: Avaliar fatores de risco e de proteção relacionados à elevação da pressão arterial na infância. MÉTODOS: Foram avaliadas crianças de 3 a 10 anos moradoras dos distritos sanitários leste e sudoeste de Goiânia, Goiás. Obtiveram-se os seguintes dados: peso ao nascer, aleitamento materno, história familiar de hipertensão e obesidade, peso, estatura, índice de massa corporal (IMC) e pressão arterial. Utilizaram-se os testes de U de Mann-Whitney para comparar a variação da pressão arterial quanto às variáveis descritas. RESULTADOS: Na amostra estudada, 519 crianças foram avaliadas, 246 (47,4 por cento) do sexo masculino. Avaliação do IMC identificou 109 (21 por cento) com excesso de peso, das quais 53 (10,3 por cento) eram obesas. O aleitamento materno predominante e/ou exclusivo por tempo inferior a 6 meses foi encontrado em 242 (51,2 por cento). As médias da pressão sistólica se encontraram significativamente mais elevadas naquelas crianças com aleitamento materno exclusivo e/ou predominante por tempo inferior a 6 meses (p = 0,04), história familiar positiva para hipertensão (p = 0,05) e excesso de peso (p < 0,0001). Esses dados foram confirmados na análise multivariada. CONCLUSÃO: Na amostra estudada, excesso de peso e fatores hereditários podem estar associados à elevação da pressão arterial, e o tempo em aleitamento materno superior a 6 meses parece conferir um efeito protetor.

BACKGROUND: Epidemiological studies have shown an increased prevalence of high blood pressure in pediatric patients. Today we know that risk factors can be detected during childhood and may help in preventing the disease. OBJECTIVE: To evaluate risk and protection factors related to high blood pressure in childhood. METHODS: We evaluated children aged 3 to10 years, residing in the east and southwest sanitary districts of the City of Goiânia, Goiás, and obtained the following data: birth weight, breastfeeding, family history of high blood pressure and obesity, weight, height, body mass index (BMI), and blood pressure. We applied the Mann-Whitney U-test to these variables in order to compare pressure variation. RESULTS: In this sample, 519 children were evaluated, and 246 (47.4 percent) of them were male. The BMI assessment identified 109 (21 percent) overweight children, of which 53 (10.3 percent) were obese. Predominant and/or exclusive breastfeeding for less than 6 months was found in 242 (51.2 percent). The mean systolic pressure was significantly higher in children with exclusive and/or predominant breastfeeding for less than 6 months (p = 0.04), and in children with family history of high blood pressure (p = 0.05), and in overweight children (p <0.0001). These data were confirmed in multivariate analysis. CONCLUSION: In this sample, we observed that overweight and hereditary factors may be associated with elevated blood pressure, and that breastfeeding for more than 6 months seems to offer a protective effect.

Safety and immunogenicity of hepatitis B vaccine administered into ventrogluteal vs. anterolateral thigh sites in infants: a randomised controlled trial.

BACKGROUND: Lowered immune response to hepatitis B vaccines has been found in individuals vaccinated into dorsogluteal site compared to vastus lateralis thigh muscle. OBJECTIVE: The aim of this study was to compare the immunogenicity and reactogenicity of a hepatitis B vaccine in infants vaccinated into ventrogluteal or anterolateral thigh sites. DESIGN: Randomised controlled trial. SETTING AND PARTICIPANTS: The recruitment of study participants was carried out from February to November 2007 in the five maternity hospitals located in the eastern region of Goiânia City, Central Brazil. Newborns up to 12h old weighing at least 2.5 kg were enrolled in the study. METHODS: A total of 580 newborns were randomised to receive three hepatitis B vaccine doses into ventrogluteal (n=286) or anterolateral thigh (n=294) sites. Of them, 474 (81.7%) completed the study: 224 from the ventrogluteal group (intervention group) and 250 from the anterolateral thigh group (control group). Fever and local adverse events were evaluated 48 h after each vaccine dose. Blood samples (3 mL) were collected between 45 and 60 days after the third vaccine dose, and anti-HBs antibody titres were determined by automatic analysis using the Microparticle Immunoenzymatic Test (AxSYM Ausab, Abbott, Germany). RESULTS: The groups did not differ by gender, weight, length of time between vaccine doses, or maternal characteristics. The proportion of infants who developed protective anti-HB titres after full vaccination into the ventrogluteal site was 97.8% (95% confidence interval [CI]: 94.8-99.3; geometric mean titre: 427.5 mIU/mL; 95% CI: 344.9-530.0), similar to that of infants vaccinated into the anterolateral thigh site (97.6%; 95% CI: 94.8-99.1; geometric mean titre: 572.0 mIU/mL; 95% CI: 471.1-694.6). No complication was found after 1503 vaccine doses, but a lower proportion of fever and local adverse events was found among the intervention group (17.9%) vs. the control group (23.7%) (p<0.01). CONCLUSION: Our results suggest that the ventrogluteal region is a suitable site for intramuscular injection in infants, particularly for the hepatitis B vaccine.

Análise de fatores associados à não aceitação da vacina contra hepatite B em adolescentes escolares de baixa renda / Analysis of factors associated with non-acceptance of hepatitis B vaccine among low income adolescent students

Para avaliar os fatores de predição da não adesão à vacina contra o vírus da hepatite B (VHB) em adolescentes escolares de baixa renda da Região Metropolitana de Goiânia, Goiás, 304 indivíduos suscetíveis ao VHB, matriculados em duas escolas, foram entrevistados e a vacina contra hepatite foi oferecida. Somente 195 (64 por cento) adolescentes aceitaram a primeira dose da vacina. Por outro lado, 182/195 (93,3 por cento) receberam o esquema completo. Verificou-se que fatores escolares exerceram um papel na aceitação da vacina, uma vez que a escola B e turno noturno foram independentemente associados à não adesão à vacina. Os achados deste estudo ratificam a baixa aceitação da vacina contra hepatite B em adolescentes e evidenciam a necessidade de programas de educação em saúde para sensibilização desse grupo em relação à vacinação, e reforçam a importância de estratégias de imunização na escola para o cumprimento do esquema completo da vacina contra o VHB nesta população-alvo.

To evaluate the predictor factors for non-acceptance of hepatitis B vaccine among low-income adolescent students in the Goiânia Metropolitan Region, Goiás State, Brazil. In this study, 304 HBV-susceptible individuals enrolled in two schools were interviewed, and the HBV vaccine was offered. Only 195 (64 percent) of adolescents accepted the first dose of vaccine. On the other hand, 182/195 (93.3 percent) received the full HBV vaccine scheme. School factors played a role in vaccine acceptance, as School B and night classes were independently associated with non-acceptance of hepatitis B vaccination. The findings of this study ratify the low acceptance of hepatitis B vaccine among adolescents, highlighting the need for health education programs aiming at this group for hepatitis B vaccinations, while buttressing the importance of school-based vaccination strategies for attaining full HBV immunization of this target population.

[Analysis of factors associated with non-acceptance of hepatitis B vaccine among low income adolescent students]. / Análise de fatores associados à não aceitação da vacina contra hepatite B em adolescentes escolares de baixa renda.

To evaluate the predictor factors for non-acceptance of hepatitis B vaccine among low-income adolescent students in the Goiânia Metropolitan Region, Goiás State, Brazil. In this study, 304 HBV-susceptible individuals enrolled in two schools were interviewed, and the HBV vaccine was offered. Only 195 (64%) of adolescents accepted the first dose of vaccine. On the other hand, 182/195 (93.3%) received the full HBV vaccine scheme. School factors played a role in vaccine acceptance, as School B and night classes were independently associated with non-acceptance of hepatitis B vaccination. The findings of this study ratify the low acceptance of hepatitis B vaccine among adolescents, highlighting the need for health education programs aiming at this group for hepatitis B vaccinations, while buttressing the importance of school-based vaccination strategies for attaining full HBV immunization of this target population.

Seroepidemiology of hepatitis B virus infection and high rate of response to hepatitis B virus Butang vaccine in adolescents from low income families in Central Brazil.

In order to evaluate the seroepidemiology and response to Butang vaccine in adolescents from low income families in Central Brazil, blood samples of 664 adolescents were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) markers, and multiple logistical regression analysis was carried out to determine variables associated with hepatitis B virus (HBV) infection markers. further, three 20 microg Butang vaccine doses were offered to all susceptible individuals (n = 304). Among those who accepted them (n = 182), the seroresponse was evaluated in 170 individuals by quantitative anti-HBs. an overall hbv prevalence of 5.9% was found: four adolescents were HBsAg positive, 24 were anti-HBc, anti-HBs-reactive, and 11 were anti-HBc only. The analyse of risk factors showed that age 16-19 years, place of birth outside Goiás, school B and body piercing were statistically associated with HBV infection markers (p < 0.05). All 170 adolescents responded to Butang, and a geometric mean titer (gmt) of 4344 mUI/ml was obtained. these results reinforce the importance of hepatitis b vaccine in adolescents despite of the hbv regional endemicity, and suggest that three doses of 20 microg of the Butang should guarantee protective anti-hbs levels to individuals at a critical time for hepatitis b acquiring such as latter adolescence and adulthood.

Seroepidemiology of hepatitis B virus infection and high rate of response to hepatitis B virus Butang®vaccine in adolescents from low income families in Central Brazil

In order to evaluate the seroepidemiology and response to Butang® vaccine in adolescents from low income families in Central Brazil, blood samples of 664 adolescents were tested for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), and hepatitis B surface antibody (anti-HBs) markers, and multiple logistical regression analysis was carried out to determine variables associated with hepatitis B virus (HBV) infection markers. further, three 20 µg butang® vaccine doses were offered to all susceptible individuals (n = 304). Among those who accepted them (n = 182), the seroresponse was evaluated in 170 individuals by quantitative anti-HBs. an overall hbv prevalence of 5.9 percent was found: four adolescents were HBsAg positive, 24 were anti-HBc, anti-HBs-reactive, and 11 were anti-HBc only. The analyse of risk factors showed that age 16-19 years, place of birth outside Goiás, school B and body piercing were statistically associated with HBV infection markers (p < 0.05). All 170 adolescents responded to butang®, and a geometric mean titer (gmt) of 4344 mui/ml was obtained. these results reinforce the importance of hepatitis b vaccine in adolescents despite of the hbv regional endemicity, and suggest that three doses of 20 µg of the butang® should guarantee protective anti-hbs levels to individuals at a critical time for hepatitis b acquiring such as latter adolescence and adulthood.

Anti-sepsia para administração de medicamentos por via endovenosa e intramuscular / Antisepsis through intravenous and intramuscular via for medicine administration

A pele abriga vasta microbiota, que poderá penetrar camadas mais internas durante a aplicação de medicamentos por via parenteral, daí a importância da anti-sepsia para este procedimento. Objetivamos identificar a utilização da anti-sepsia para a administração de medicamentos por via endovenosa e intramuscular como medida de prevenção de infecção. Estudo descritivo, realizado com a equipe de enfermagem, em oito unidades de um hospital de ensino do município de Goiânia-Go. Os dados foram obtidos mediante observação e preenchimento de check-list. Observamos 212 profissionais. Quanto à via de administração, 19,8 por cento dos procedimentos foram realizados por via EV direta, 72,6 por cento por via EV com sistema já instalado e 7,6 por cento por via IM. A maioria dos profissionais, 79,2 por cento, não lavou as mãos antes de realizar o procedimento. Das 154 medicações feitas em sistema venoso já instalado, não foi realizada a desinfecção do injetor de borracha em 47 (30,5 por cento) No que se refere à anti-sepsia, 72,4 por cento das medicações realizadas por via EV e 27,6 por cento por via IM, utilizaram o anti-séptico em todas as situações mas, em apenas 40,5 por cento das injeções EV e em 37,5 por cento das IM foram feitos os cinco ou mais movimentos em um mesmo sentido com o algodão embebido com álcool a 70 por cento, que é o procedimento preconizado para a realização da anti-sepsia da pele. Após a anti-sepsia, 25 profissionais tocaram o local, contaminando-o, destes apenas 13 (52,0 por cento) fizeram nova anti-sepsia, portanto, houve a recontaminação em 12 situações. Os dados revelam que medidas necessárias à prevenção de infecção, na administração de medicamentos via parenteral nem sempre são adotadas, representando um desafio à educação permanente e do controle de infecção no hospital em estudo.

Perfil sócio-demográfico e avaliação funcional de idosos atendidos por uma equipe de saúde da família na periferia de Goiânia, Goiás / Socio-demographic profile and functional status of elderly attended by a family team of the periphery of Goiânia, Goiás

Investigar o perfil sócio-demográfico e a capacidade funcional dos idosos atendidos por uma equipe de saúde da família. Durante novembro de 2001 a maio de 2002, todos os indivíduos (N=107) com 60 anos ou mais foram entrevistados e avaliados através das Escalas de Barthel e Lawton para dependência nas atividades de vida diária (AVDs) e instrumentais de vida diária (AIVDs). A maioria dos idosos tinha entre 60 a 69 anos, residia com familiares e possuía rendimento inferior a um salário mínimo. Praticamente a metade dos idosos não sabia ler e escrever. Do total de idosos, 40,9 por cento eram dependentes para as AVDs e 58 por cento para as AIVDs. A análise dos fatores de risco revelou que a idade, acuidade visual diminuída, doenças associadas, depressão e equilíbrio e mobilidade prejudicados foram estatisticamente associados à dependência dos idosos (P<0,05). As escalas Barthel e de Lawton são de baixo custo e de fácil execução pelos profissionais de saúde e, oferecem subsídios para o planejamento de ações de saúde efetivas. Os resultados subsidiarão as ações de saúde junto à comunidade de idosos atendida pela equipe de saúde.

Compliance with hepatitis B virus vaccination and risk of occupational exposure to blood and other body fluids in intensive care department personnel in Brazil.

BACKGROUND: Hepatitis B virus (HBV) vaccine has been recommended to health care workers because of their frequent exposure to patient blood and other body fluid. METHODS: A cross-sectional study was done to determine the compliance with HBV vaccination, and the risk of occupational exposure to blood or other body fluids in intensive care unit (ICU) personnel (n=458) in Goiânia, Brazil. RESULTS: The vast majority (95.5%) of ICU personnel reported HBV vaccination. Among those who did not, housekeepers were statistically associated with nonvaccination (P<.05). They had a 19.1-fold (95% confidence interval: 2.07-444.5) greater risk of nonvaccination compared with physicians. A total of 220 participants reported an incident with biologic fluids. Physician and nursing staff had a higher risk for occupational exposure to blood, other body fluids, or both when compared with housekeepers. CONCLUSIONS: This study showed a high frequency of HBV vaccination in ICU personnel in Brazil. Nevertheless, more efforts are necessary to increase compliance with vaccination in housekeepers. Physician and nursing staffs showed high risk of occupational exposure to blood, other body fluids, or both, ratifying the importance of continuous education programs concerning prevention of bloodborne pathogen transmission for all ICU personnel.

Comparaçäo entre a Mola Fechada de Nitinol e a mola de retraçäo de Ricketts na retraçäo de canino / Comparison of Niti Coil Springs vs Ricketts Seccional Arch in canine retraction

Nos casos em que necesitamos tratar com extraçäo de pré-molares, é importante a escolha de um sistema eficiente de retraçäo do canino. O objetivo deste trabalho é comparar dois sistemas, que säo: o Sistema Ricketts e o de retraçäo com a Mola Fechada de Nitinol