ABSTRACT
Introduction: Even though syphilis is an easily detectable and treatable disease, it is still considered a major public health problem, which may lead to Congenital Syphilis (CS). Objective: To analyze the final conclusion and the situations of vulnerability of cases of CS reported in Niterói in 2018 and 2019. Methods: A review of the reported cases of CS, except for abortions, diagnosed in 2018 and 2019, was carried out through SINAN forms and research questionnaires. Results: Of the 46 cases of CS in 2018 and the 107 cases in 2019, 8 (17.4%) and 4 (4%) did not undergo prenatal care, respectively; 2 (4.4%) and 4 (4%) were not screened for CS in the prenatal period; 3 (6.5%) and 13 (12%) were screened, but not treated; 11 (23.9%) and 17 (16%) did not receive an adequate treatment; 1 0 (21.7%) and 23 (21%) were reactive in the screening process, received adequate treatment, but were reinfected; 9 (19.6%) and 32 (30%) were reactive in the screening process, received adequate treatment, but had confirmed CS due to other criteria; 3 (6.5%) and 12 (11%) were nonreactive in prenatal care, but reactive in childbirth; and 0 (0%) and 2 (2%) were reactive, considered a serological scar, untreated, but confirmed by other criteria. The "low-income family" vulnerability aspect appears 21 times in 2018 and 50 times in 2019; "alcohol user", 11 times in 2018; "frequent change of address", 18 times in 2019. Conclusion: The social context of pregnant women living in Niterói in 2018 and 2019 may have determined the outcome of congenital syphilis.
Introdução: A sífilis, embora seja um agravo de fácil detecção e tratamento, ainda é considerada um grave problema de saúde pública, podendo acarretar a sífilis congênita. Objetivo: Analisar a conclusão final e as situações de vulnerabilidade dos casos de sífilis congênita residentes em Niterói (RJ) notificados em 2018 e 2019. Métodos: Foi realizada revisão dos casos de sífilis congênita residentes notificados, exceto abortos, com diagnóstico em 2018 e 2019, por meio das fichas do Sistema de Informação de Agravos de Notificação e dos questionários de investigação. Resultados: Dos 46 casos de sífilis congênita em 2018 e 107 em 2019, temos respectivamente que 8 (17,4%) e 4 (4%) não fizeram pré-natal; 2 (4,4%) e 4 (4%) não fizeram triagem para sífilis congênita no pré-natal; 3 (6,5%) e 13 (12%) fizeram triagem, porém não trataram; outros 11 (23,9%) e 17 (16%) não fizeram o tratamento adequado; 10 (21,7%) e 23 (21%) foram reagentes na triagem, tratamento adequado, porém reinfectaram; 9 (19,6%) e 32 (30%) foram reagentes na triagem, tratamento adequado, porém confirmaram sífilis congênita por outros critérios; 3 (6,5%) e 12 (11%) foram não reagentes no pré-natal, porém reagentes no parto; 0 (0%) e 2 (2%) foram reagentes, considerados cicatriz sorológica, não tratados, porém confirmaram por outros critérios. A vulnerabilidade família de baixa renda apareceu 21 vezes em 2018 e 50 vezes em 2019, usuária de álcool (11) em 2018, mudança frequente de domicílio (18) em 2019. Conclusão: O contexto social das gestantes residentes em Niterói em 2018 e 2019 pode ter determinado o desfecho de sífilis congênita.
Subject(s)
Humans , Social Environment , Syphilis, Congenital , Pregnant Women , Public Health , Education , Medical ChaperonesABSTRACT
Resumo Introdução Violência contra mulheres constitui uma violação dos direitos humanos e um problema de saúde pública. Objetivo Analisar as notificações de violência contra mulheres (10 anos de idade ou mais), residentes em Niterói/RJ (2010-2014). Método Estudo descritivo de série de casos. As fontes de dados foram o Sistema de Informação de Agravos de Notificação (SINAN) e o Departamento de Informática do Sistema Único de Saúde (DATASUS). Foram descritas as distribuições das características de violência e calculadas as taxas de incidência. Resultados Foram notificados 307 episódios de violência com incidência de 26,2/100 mil, decrescente com a idade. O percentual de incompletitude variou de 0 a 65%. Violência física (186) predominou, seguida de violências psicológica (121) e sexual (96) e de negligência (64). As adolescentes foram as principais vítimas de violência sexual (56,3%). Cônjuges, ex-cônjuges, namorados(as), ex-namorados(as) foram autores em 42,6% das agressões físicas, indicando ocorrência de violência entre parceiros íntimos. Mães foram responsáveis por 50,7% das negligências, refletindo a ausência de compartilhamento e a sobrecarga feminina com relação à criação dos filhos. Conclusão As notificações de violência interpessoal/autoprovocada possibilitam intervir caso a caso, e a análise sistemática das informações poderá respaldar a elaboração de políticas e estratégias de prevenção e enfrentamento da violência contra mulheres.
Abstract Background Violence against women is a violation of human rights and a public health problem. Objective To analyze surveillance reports of violence against women (aged 10 years or more), living in Niterói, RJ, from 2010 to 2014. Method Descriptive study based on case series was carried out. Case reports and population estimates were provided, respectively, by the National Surveillance Information System (SINAN) and the Brazilian Ministry of Health (DATASUS). Incidence rates and proportions were calculated according to violence related characteristics. Results There were 307 reported cases of violence with incidence rate 26.2 per 100 thousand in the period studied decreased with age. Data incompleteness ranged from zero to 65%. Physical violence (n=186) was the most frequent type, followed by psychological (n=121), sexual (n=96) and negligence (n=64). Adolescents were the main victim of sexual violence (56.3%). Husband, ex-husband, boyfriend or ex-boyfriend were perpetrators in 42.6% of physical assaults, denoting the occurrence of violence between intimate partners. Mother was considered as the perpetrator in 50.7% of negligence cases, reflecting lack of sharing and female burden related to raising children alone. Conclusion Interpersonal/self-induced violence surveillance allow individual interventions and provide data for policy development towards prevention of violence against women.
ABSTRACT
Serum lipids have been associated with depression in the adult population; however, this association during pregnancy remains unclear. The aim of this study was to evaluate the association between serum lipids and depressive symptom scores during pregnancy. A prospective cohort of 238 pregnant women was followed at the 5th-13th, 20th-26th and 30th-36th weeks of gestation. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Serum concentrations (mg/dL) of triglycerides, total cholesterol, and low- and high-density lipoproteins (LDL-c; HDL-c) were the main exposures. Marital status (married/single), physical activity (active or very active/low or very low active), unplanned pregnancy (no/yes), pre-pregnancy BMI (<25/≥ 25 kg/m(2)), generalized anxiety disorder (no/yes) and current suicidal ideation (no/yes) were considered as potential confounders. Analyses were performed using linear mixed-effects models. The results showed that the EPDS mean score (95%CI) decreased with time during pregnancy trimesters [1st: 8.89 (95%CI = 8.28-9.51), 2nd: 7.32 (95%CI = 6.67-7.97) and 3rd: 7.08 (95%CI = 6.41-7.74)]. Suicidal ideation frequency at baseline was 18%. HDL-c concentrations were inversely associated with changes in EPDS score (ß = -0.080, 95%CI = -0.157 to -0.002), while low or very low active women (ß = 1.288, 95%CI = 0.630-1.946), with single marital status (ß = 1.348, 95%CI = 0.163-2.534), unplanned pregnancy (ß = 1.922, 95%CI = 0.714-3.131), generalized anxiety disorder (ß = 2.139, 95%CI = 0.410-3.868) and current suicidal ideation (ß = 1.927, 95%CI = 0.596-3.258) tended to have higher EPDS scores. No relationship was observed between other lipids and EPDS scores. HDL-c concentration was inversely associated with changes in depressive symptom scores during pregnancy after adjusting for socio-economic, demographic, behavioral, nutritional, biochemical and mental health disorders.
Subject(s)
Cholesterol, HDL/blood , Depression, Postpartum/blood , Depression, Postpartum/diagnosis , Psychiatric Status Rating Scales , Statistics as Topic , Adult , Brazil , Cholesterol/blood , Cohort Studies , Female , Gestational Age , Humans , Pregnancy , Triglycerides/blood , Young AdultABSTRACT
This study aimed to describe the prevalence of psychiatric disorders and to identify the factors associated with Current Suicide Risk (CSR) in the first trimester of pregnancy. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was employed to diagnose mental disorders in 239 women enrolled in a prospective cohort in Rio de Janeiro, Brazil. Serum lipids, leptin and socio-economic status were the independent variables. CSR, the dependent variable, was entered as binary (yes/no) variable into crude and adjusted Poisson regression models with robust variances. CSR was found to be the main psychiatric syndrome (18.4%), followed by agoraphobia (17.2%), major depressive disorder (15.1%) and generalized anxiety disorder (10.5%). Women with CSR showed higher mean levels of cholesterol (169.2 vs. 159.2; p=0.017), high density lipoprotein (50.4 vs. 47.7; p=0.031) and low density lipoprotein (102.8 vs. 95.6; p=0.022) when compared to women without CSR. The adjusted regression model showed a higher prevalence ratio (PR) of CSR among pregnant women with generalized anxiety disorder (PR=2.70, 95% CI: 1.36-5.37), with ≥ two parturitions (PR=2.46, 95% CI: 1.22-4.93), and with major depressive disorder (PR=2.11, 95% CI: 1.08-4.12). We have shown that generalized anxiety disorder, major depressive disorder and higher parity are associated with CSR in the first trimester of pregnancy.