A prevalência das deficiências físicas da hanseníase após alta medicamentosa em municípios que alcançaram a meta de eliminação / The prevalence of physical disabilities of leprosy after discharge in municipalities that have reached the elimination goal

INTRODUÇÃO: A Organização Mundial da Saúde preconiza o grau de incapacidade como instrumento de avaliação, para propor ações de prevenção, monitoramento e tratamento do dano físico causado pela Hanseníase. OBJETIVO: comparar o grau de deficiência física no diagnóstico, alta e pós-alta de indivíduos que tiveram hanseníase. MÉTODOS: Estudo ecológico, analítico com 126 indivíduos, diagnosticados no período 2004-2013, utilizando: formulário de avaliação neurológica simplificada, classificação do grau de incapacidades físicas e formulário elaborado pela pesquisadora. RESULTADOS: Média de idade 56,02 anos, sendo 73,01% multibacilares, com predomínio da forma dimorfa (36,80%). Verificou-se, no diagnóstico, percentual elevado (63,49%) de indivíduos que já apresentavam deficiência física (grau 1 e 2). A comparação entre diagnóstico e pós-alta demonstrou piora das deficiências físicas, principalmente nos multibacilares, com percentual (51,59%) de reação hansênica durante o tratamento. Do total da amostra, 61 (48,41%) mantiveram o mesmo grau de incapacidade, 44 (34,92%) pioraram e 21 (16,67%) melhoraram. Membros inferiores foram os mais acometidos (58%). CONCLUSÃO: O estudo permite concluir que, ao realizar a comparação nos momentos do diagnóstico e pós-alta, houve piora das deficiências físicas, principalmente na forma multibacilar, sendo os membros inferiores os segmentos que mais apresentam evolução expressiva do grau de deficiência.

INTRODUCTION: The World Health Organization recommends the degree of disability as an evaluation tool, to propose actions for prevention, monitoring and treatment of physical harm caused by leprosy. OBJECTIVE: This study aimed to compare the degree of disability at diagnosis, discharge and post-discharge of individuals who have had leprosy. METHODS: ecological, analytical study of 126 individuals diagnosed in the period 2004-2013 using: simplified neurological assessment form and classification of the degree of physical disability and form prepared by researcher. In the data analysis. RESULTS: Mean age 56.02 years, and 73.01% multibacillary, with a predominance of form dimorphic (36.80%). It was, in the diagnosis, high percentage (63.49%) of individuals who have had disability (grade 1 and 2).The comparison between diagnosis and post-discharge showed worsening physical, especially in multibacillary, with percentage (51.59%) of leprosy reactions during treatment. Of the total sample, 61 (48.41%) maintained the same level of disability, 44 (34.92%) got worse and 21 (16.67%) improved. Lower limbs were the most affected (58%). CONCLUSION: The study shows that, when making the comparison in the diagnosis and post-discharge, worsening of disabilities, especially in multibacillary, and the lower limbs segments that have most significant evolution of the degree of disability.

Bariatric surgery: impact on sexuality of the obese person / Cirurgia bariátrica: repercussões na sexualidade da pessoa obesa

Objective: To assess the impact of surgical treatment in the sexuality of the obese. Methods: We conducted a qualitative / quantitative research with 30 patients who had undergone Fobi-Capella Roux-Y gastric bypass for at least one year. We collected data through individual interviews using a questionnaire with 10 mixed questions and one open, between May and June 2011. The objective data were quantified in absolute numbers and percentages, and the subjective ones were analyzed using the Discourse of the Collective Subject (DCS) and discussed in view of reference published on the subject. Results: 30 patients were enrolled, with a mean age 44 ± 12 years, 24 (80%) were female and six (20%) were male, 23 (77%) were married, 23 (96%) were hypertensive and eight (33%) were diagnosed with Diabetes Mellitus. After the operation, 11 (37%) individuals reported no change in the number sexual intercourses, but 19 (63%) reported that this number was altered, 16 (53%) informed increased frequency, one (3%) reported a decrease in frequency, one (3%) did not practice sexual intercourse anymore and one (3%) did not report the frequency. The central ideas (CI) raised originated four DCSs: Experience of female sexuality; No experience of female sexuality; Experience of male sexuality; and improvements of comorbidities and psychological factor. Conclusion: there are positive repercussions of physical and emotional orders of the surgical treatment of obesity, favoring the quality of life, including sexuality. .

Objetivo: Conhecer as repercussões do tratamento cirúrgico na vivência da sexualidade da pessoa obesa. Métodos: Pesquisa quali/quantitativa realizada com 30 pacientes submetidos à gastroplastia em Y de Roux, à Fobi e Capella, há pelo menos um ano. Dados obtidos por meio de entrevista individual utilizando instrumento com 10 questões mistas e uma aberta, no período de maio e junho de 2011. Os dados objetivos foram quantificados em números absolutos e percentuais e, os subjetivos foram submetidos à análise por meio do Discurso do Sujeito Coletivo (DSC) e discutidos à luz do referencial publicado sobre a temática. Resultados: foram incluídos 30 pacientes com média de idade 44±12 anos, sendo 24 (80%) do sexo feminino e seis (20%) do masculino, 23 (77%) casados, 23 (96%) hipertensos e oito (33%) com diagnóstico de Diabetes Mellitus. Após a operação, 11 (37%) não relataram alteração no número de relações sexuais, porém 19 (63%) informaram que este número sofreu alteração, sendo que 16 (53%) afirmaram ter aumentado a frequência das relações sexuais, um (3%) relatou a diminuição da frequência, um (3%) não pratica mais o ato sexual e um (3%) não declarou a frequência. As ideias centrais (IC) levantadas originaram quatro DSC: Vivência da sexualidade feminina; Não vivência da sexualidade feminina; Vivência da sexualidade masculina; e Melhorias das comorbidades e fator psicológico. Conclusão: existem repercussões, de ordem física e emocional, positivas do tratamento cirúrgico da obesidade favorecendo a qualidade de vida, inclusive na sexualidade. .

Bariatric surgery: impact on sexuality of the obese person.

OBJECTIVE: To assess the impact of surgical treatment in the sexuality of the obese. METHODS: We conducted a qualitative / quantitative research with 30 patients who had undergone Fobi-Capella Roux-Y gastric bypass for at least one year. We collected data through individual interviews using a questionnaire with 10 mixed questions and one open, between May and June 2011. The objective data were quantified in absolute numbers and percentages, and the subjective ones were analyzed using the Discourse of the Collective Subject (DCS) and discussed in view of reference published on the subject. RESULTS: 30 patients were enrolled, with a mean age 44 ± 12 years, 24 (80%) were female and six (20%) were male, 23 (77%) were married, 23 (96%) were hypertensive and eight (33%) were diagnosed with Diabetes Mellitus. After the operation, 11 (37%) individuals reported no change in the number sexual intercourses, but 19 (63%) reported that this number was altered, 16 (53%) informed increased frequency, one (3%) reported a decrease in frequency, one (3%) did not practice sexual intercourse anymore and one (3%) did not report the frequency. The central ideas (CI) raised originated four DCSs: Experience of female sexuality; No experience of female sexuality; Experience of male sexuality; and improvements of comorbidities and psychological factor. CONCLUSION: there are positive repercussions of physical and emotional orders of the surgical treatment of obesity, favoring the quality of life, including sexuality.

[Bariatric surgery: its effects for obese in the workplace]. / Cirurgia bariátrica: repercussões na vida laboral do obeso.

This descriptive exploratory research aims to analyze the effects of bariatric surgery in the lifestyle of people with class III obesity in the workplace, through individual interviews with patients undergoing gastric bypass in gamma-Rouz. Data collection was conducted in June and July, 2011, by means of individual interviews, yielding three Collective Subject Discourse: "More willingness to work" "Life without comorbidities" and "Other effects of bariatric surgery." 30 patients with mean age 44 +/- 12 years old, 24 (80%) female, 19 (63%) performed paid professional activities, 10 (34%) did not work and one (3.3%) students, 23 (96%) hypertension and eight (33%) with a diagnosis of diabetes mellitus were included in the study. Difficulty handling with physical appearance: 13 (43%) and the emotional aspect: 21 (70%). Bariatric surgery positively affected the lifestyle of obese at work with reduction in comorbidities and physical and emotional problems, favoring social and professional reintegration of the individuals.

Cirurgia bariátrica: repercussões na vida laboral do obeso / Cirugía Bariátrica: influencia en la vida laboral de obesos / Bariatric surgery: its effects for obese in the workplace

Pesquisa descritivo-exploratória que objetivou conhecer as repercussões da cirurgia bariátrica na vida laboral do obeso grau III, com pacientes submetidos à gastroplastia em Y de Roux. A coleta de dados foi realizada de junho a julho de 2011, por meio de entrevista individual, originando três Discursos do Sujeito Coletivo: "Mais disposição para o trabalho", "A vida sem comorbidades" e "Outras repercussões da cirurgia bariátrica". Foram incluídos 30 pacientes com média de idade 44±12 anos, sendo 24 (80%) do sexo feminino, 19 (63%) que trabalhavam, 10 (34%) que não trabalhavam, um (3,3%) estudante, 23 (96%) hipertensos e oito (33%) com diagnóstico de Diabetes Mellitus. Constatou-se, também, que 13 (43%) tinham dificuldades no aspecto físico e que 21 (70%) as tinham no aspecto emocional. A cirurgia bariátrica repercutiu favoravelmente na vida laboral do obeso, uma vez que houve redução das comorbidades e das dificuldades físicas e emocionais, favorecendo a reinserção social e profissional do indivíduo.

Investigación descriptiva exploratoria con objeto de comprender los efectos de la cirugía bariátrica en obesidad clase III en la vida laboral, mediante entrevistas individuales con pacientes sometidos a bypass gástrico en Y-Roux. La recolección de datos se llevó a cabo entre junio y julio de 2011, por medio de entrevistas individuales, produciendo tres Discurso del Sujeto Colectivo: "Más disposición a trabajar", "La vida sin comorbidades" y "Otros efectos de la cirugía bariátrica". Se incluyeron 30 pacientes con edad promedio de 44 ± 12 años, y 24 (80%) mujeres, 19 (63%) estaban trabajando y 10 (34%) no trabajaban y un (3%) estudiante, 23(96%) hipertensos y ocho (33%) con un diagnóstico de la diabetes mellitus. Dificultades en la apariencia física: 13 (43%) y el aspecto emocional: 21 (70%). La cirugía bariátrica repercutió favorablemente en la vida laboral de los obesos ya que hubo una reducción de comorbidades y las dificultades físicas y emocionales, lo que favorece la reinserción social y profesional de la persona.

This descriptive exploratory research aims to analyze the effects of bariatric surgery in the lifestyle of people with class III obesity in the workplace, through individual interviews with patients undergoing gastric bypass in Y-Roux. Data collection was conducted in June and July, 2011, by means of individual interviews, yielding three Collective Subject Discourse: "More willingness to work," "Life without comorbidities" and "Other effects of bariatric surgery." 30 patients with mean age 44± 12 years old, 24 (80%) female, 19 (63%) performed paid professional activities, 10 (34%) did not work and one (3.3%) students, 23 (96%) hypertension and eight (33%) with a diagnosis of diabetes mellitus were included in the study. Difficulty handling with physical appearance: 13 (43%) and the emotional aspect: 21 (70%). Bariatric surgery positively affected the lifestyle of obese at work, with reduction in comorbidities and physical and emotional problems, favoring social and professional reintegration of the individuals.