Alcohol and Alcohol Combined with Texting: Evaluation of Driving Impairment Effects in a Closed-Course Section.

OBJECTIVE: Examine the driving impairment effects of alcohol alone and of alcohol combined with texting. METHODS: Fifteen drivers (nine male, six female; mean age: 31.1 ± 6.9 years, range: 23 to 43 years) with similar drinking habit (i.e., social drinkers) completed a lap in a closed-course section in six different situations: (I) sober; (II) sober and while texting; (III) 30 minutes after ingesting a moderate dose of ethanol (0.50 g/kg); (IV) 30 minutes after drinking and while texting; (V) 60 minutes after drinking, (VI) 60 minutes after drinking and while texting. Driving performance was analyzed by means of maximum and mean speed, braking time and braking distance; and ability to control the car (i.e., evaluating if the drivers hit a traffic cone or exceeded the boundaries of the course). P values of < 0.05 were considered significant. RESULTS: Pre and post-alcohol consumption results show a significant increase concerning the drivers' mean and maximum speed after drinking (p < 3.2x10-8). However, neither alcohol nor texting had significant effects on braking parameters (p > 0.05). Traffic cones were knocked down only in texting experiments. In addition, when using the cell phone drivers tended to reduce the speed, and to accelerate abruptly right after they finish texting. CONCLUSION: Our findings strengthen the hypothesis that even moderate alcohol doses may significantly impair the driving performance. Additionally, alcohol and texting have complementary effects on driving impairment, and their combination represents a significant risk factor for crashes.

A Bayesian approach for the zero-inflated cure model: an application in a Brazilian invasive cervical cancer database.

This paper aims to discuss the Bayesian estimation approach for the zero-inflated cure class of models, which extends the standard cure model by accommodating zero-inflated data in the survival analysis context. A comprehensive simulation study is carried out to assess the performance of the estimation procedure. A new estimation methodology is illustrated using a real dataset related to women diagnosed with invasive cervical cancer in Brazil.

Behavior of pregnant women regarding physical activity in gestational diabetes mellitus: secondary analysis of a descriptive cross-sectional study.

Objective: The purposeof this study was to compare the physical activity of pregnant women with and without gestational diabetes mellitus regarding the physical activity domains and to verify possible associations between socio-demographic characteristics, nutritional status, and lifestyle with gestational diabetes.Design /Methods: Consists in a study including 798 adult pregnant women attended by the Unique Health System in Ribeirão Preto, Brazil from 2011 to 2012. The variables studied were recorded using questionnaires, as well as frequency (weekly), duration (minutes) and the metabolic equivalent. The frequency of the categorical variables and the mean and standard deviation (SD) of the continuous variables were calculated and the Mann Whitney test, Student's t test and the X2test calculated the differences of the study variables according to the presence of diabetes. The adopted significance level was α = 5%.Results:Indicate that pregnant women with diabetes have lower average energy expenditure in the physical activity domains. However, we found a significant difference between groups regarding the average energy expenditure related to the occupational domain. Considering the Physical Activity (PA) pattern, we found that the sedentary percentage was higher in both groups. However, there were no relevant differences between them. The variables: previously diabetes, nutritional status, pre-gestational and current body mass index were associated with the development of diabetes.Conclusion: Further studies are needed to explore physical activities in different domains in pregnancy and its relationship with gestational diabetes, especially in the occupational domain.

Virtual Microscopy as a Learning Tool in Brazilian Medical Education.

Virtual microscopy (VM) is a widely used teaching method in Medical Education in many developed countries. In Brazil, however, this is not the case for most medical schools, considering Brazilian social inequality and uneven access to technology. Recently, the Covid-19 pandemic has also challenged Universities to seek and make a transition toward more effective methods of full-time online education. Thus, the main goal of this work was to verify student's perception and academic performance, assessed upon VM implementation in a Brazilian Medical School. Ribeirao Preto Medical School students answered a 26-question survey with regards to optical microscopy (OM) and VM. Academic performance was compared between participants that were (year of 2019) or were not (year of 2015) exposed to VM. Taken the results together, subjective impressions such as handling, suitability, learning effectiveness, and pleasure using the tools, have shown a higher score for virtual microscopy (median = 29), when compared to optical microscopy (median = 24) with a P-value < 0.001 by Wilcoxon rank test, upon measurement using an ordinal scale. Regarding academic performance, no statistically significant differences were found between groups (P-value = 0.38, Cohen's d = 0.19). Therefore, VM proved to be adequate to the Brazilian medical education in light of Brazilian social contexts and Covid-19 pandemic.

Padrão de atividade física em gestantes usuárias do Sistema Público de Saúde / Physical activity pattern among pregnant women users of the Brazilian Public Health System / Patrón de actividad física em mujeres embarazadas usuárias del Sistema de Salud Pública

Objetivos: Descrever o padrão de atividade física de gestantes usuárias de Unidades Básicas de Saúde, investigar a média do gasto energético relacionados aos domínios de atividade física. Métodos: Trata-se de um estudo transversal conduzido entre 799 gestantes atendidas nas Unidades Básicas de Saúde de Ribeirão Preto, SP. A prática de atividade física foi avaliada por meio do questionário de "frequência de atividade física diária" específico para gestantes, no qual foram obtidas a frequência, duração e o equivalentes metabólicos das atividades físicas. Resultados: A maioria das gestantes apresentaram o padrão sedentário (57%) seguido pelo padrão leve (43%). Em relação aos domínios de atividades físicas, o domínio doméstico teve a maior média de gasto energético (733,7), enquanto que, o domínio de lazer apresentou a menor média (20,5). Verificou-se que as variáveis idade acima de 30 anos , escolaridade baixa , solteira, não ser chefe de família, não trabalhar fora, e ter filhos, tiveram associações com o padrão sedentário. Conclusões: Elevada prevalência de sedentarismo foi observada entre as gestantes estudadas, sugerindo a necessidade de ações de promoção de atividade física neste público, principalmente no domínio de lazer.

Objective: To describe the physical activity pattern of pregnant women using Basic Health Units to investigate the average energy expenditure related to physical activity domains. Methods: This is a cross-sectional study conducted with 799 pregnant women attended at Basic Health Units in Ribeirão Preto, SP. The practice of physical activity was assessed using the "frequency of daily physical activity" questionnaire specific for pregnant women, in which the frequency, duration and metabolic equivalents of physical activities were obtained. Results: Most pregnant women had a sedentary pattern (57%) followed by a mild pattern (43%). Regarding the domains of physical activities, the domestic domain had the highest average of energy expenditure (733.7), while the leisure domain presented the lowest average (20.5). It was found that the variables: older than 30 years old, low schooling, single, not head of family, not working outside the home, and having children had associations with the sedentary pattern. Conclusions: A high prevalence of physical inactivity was observed among the studied pregnant women, suggesting the need for actions to promote physical activity in this public, mainly in the leisure domain.

Objetivos: Describir el patrón de actividad física de las mujeres embarazadas que utilizan Unidades Básicas de Salud, para investigar el gasto energético promedio relacionado con los dominios de la actividad física. Métodos: Este es un estudio transversal realizado entre 799 mujeres embarazadas atendidas en las Unidades Básicas de Salud en Ribeirão Preto, SP. La práctica de actividad física se evaluó mediante el cuestionario de "frecuencia de actividad física diaria" específico para mujeres embarazadas, en el que se obtuvo la frecuencia, duración y equivalentes metabólicos de las actividades físicas. Resultados: la mayoría de las mujeres embarazadas tenían un patrón sedentario (57%) seguido de un patrón leve (43%). En cuanto a los dominios de las actividades físicas, el dominio doméstico tuvo el promedio más alto de gasto energético (733.7), mientras que el dominio del ocio presentó el promedio más bajo (20.5). Se encontró que las variables mayores de 30 años, baja escolaridad, soltero, no ser cabeza de familia, no trabajar fuera del hogar y tener hijos, tenían asociaciones con el patrón sedentario. Conclusiones: se observó una alta prevalencia de inactividad física entre las mujeres embarazadas estudiadas, lo que sugiere la necesidad de acciones para promover la actividad física en este público, principalmente en el dominio del ocio.

MEASUREMENT OF PELVIC RETROVERSION DURING HIP FLEXION: EVALUATION WITH ACCELEROMETERS.

OBJECTIVE: To quantify pelvic retroversion during clinical evaluation of hip flexion with accelerometers and to verify the reliability of these sensors to measure hip flexion. METHODS: An accelerometer was positioned laterally in the pelvis to measure pelvic retroversion. Another accelerometer was positioned anteriorly on the thigh to evaluate hip flexion amplitude. The evaluations were performed with volunteers in supine position by three raters. For evaluation of pelvic retroversion, the mean ± SD (minimum-maximum) was calculated. Reliability of the accelerometer between raters was determined by intraclass correlation coefficients (ICC). The linear correlation coefficient between hip flexion was determined by using goniometer and accelerometer. RESULTS: The mean pelvic retroversion was 7.3° ± 0.93° (6°-11°) in the clinical limit of the hip range of motion, which was 106.25° ± 10.46° (93°-130°). The ICC between two raters were 0.60, 0.71 and 0.74 (goniometer) and 0.46, 0.71 and 0.83 (accelerometer). The linear correlation between hip flexion measurements with goniometer and accelerometer was 0.87. CONCLUSION: During clinical evaluation of the final range of hip flexion, there was an associated pelvic movement of approximately 7.3º. Accelerometers have proven to be reliable for measurement of hip flexion. Level of Evidence III, Study of nonconsecutive patients with no gold reference standard applied uniformly.

OBJETIVO: Quantificar a retroversão pélvica durante avaliação clínica da flexão do quadril com acelerômetros e verificar a confiabilidade destes sensores para mensurar flexão do quadril. MÉTODOS: Posicionou-se um acelerômetro lateralmente na pelve para mensurar retroversão pélvica. Outro foi posicionado anteriormente sobre a coxa para avaliar flexão do quadril. As avaliações foram realizadas com voluntários, em decúbito dorsal, por três avaliadores. Para avaliação da retroversão pélvica, determinou-se a média ± DP (mínimo-máximo). Avaliou-se a confiabilidade dos acelerômetros entre avaliadores pelo coeficiente de correlação intraclasse (CCI). Determinou-se o coeficiente de correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro. RESULTADOS: A retroversão pélvica média foi de 7,3° ± 0,93° (6°-11°), mensurada no limite clínico da flexão do quadril, que foi de 106,25° ± 10,46° (93°-130°), ambos com acelerômetro. Os CCI entre dois avaliadores diferentes nas avaliações de flexão do quadril foram de 0,60, 0,71 e 0,74 (goniômetro) e 0,46, 0,71 e 0,83 (acelerômetro). A correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro foi de 0,87. CONCLUSÃO: Durante avaliação clínica da amplitude final de flexão do quadril, houve movimentação associada da pelve aproximadamente de 7,3°. Acelerômetros mostraram-se confiáveis para mensuração da flexão do quadril. Nível de evidência III, Estudo de pacientes não consecutivos sem padrão de referência "ouro" aplicado uniformemente.

Measurement of pelvic retroversion during hip flexion: evaluation with accelerometers / Mensuração de retroversão pélvica durante flexão do quadril: avaliação com acelerômetros

ABSTRACT Objective: To quantify pelvic retroversion during clinical evaluation of hip flexion with accelerometers and to verify the reliability of these sensors to measure hip flexion. Methods: An accelerometer was positioned laterally in the pelvis to measure pelvic retroversion. Another accelerometer was positioned anteriorly on the thigh to evaluate hip flexion amplitude. The evaluations were performed with volunteers in supine position by three raters. For evaluation of pelvic retroversion, the mean ± SD (minimum-maximum) was calculated. Reliability of the accelerometer between raters was determined by intraclass correlation coefficients (ICC). The linear correlation coefficient between hip flexion was determined by using goniometer and accelerometer. Results: The mean pelvic retroversion was 7.3° ± 0.93° (6°-11°) in the clinical limit of the hip range of motion, which was 106.25° ± 10.46° (93°-130°). The ICC between two raters were 0.60, 0.71 and 0.74 (goniometer) and 0.46, 0.71 and 0.83 (accelerometer). The linear correlation between hip flexion measurements with goniometer and accelerometer was 0.87. Conclusion: During clinical evaluation of the final range of hip flexion, there was an associated pelvic movement of approximately 7.3º. Accelerometers have proven to be reliable for measurement of hip flexion. Level of Evidence III, Study of nonconsecutive patients with no gold reference standard applied uniformly.

RESUMO Objetivo: Quantificar a retroversão pélvica durante avaliação clínica da flexão do quadril com acelerômetros e verificar a confiabilidade destes sensores para mensurar flexão do quadril. Métodos: Posicionou-se um acelerômetro lateralmente na pelve para mensurar retroversão pélvica. Outro foi posicionado anteriormente sobre a coxa para avaliar flexão do quadril. As avaliações foram realizadas com voluntários, em decúbito dorsal, por três avaliadores. Para avaliação da retroversão pélvica, determinou-se a média ± DP (mínimo-máximo). Avaliou-se a confiabilidade dos acelerômetros entre avaliadores pelo coeficiente de correlação intraclasse (CCI). Determinou-se o coeficiente de correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro. Resultados: A retroversão pélvica média foi de 7,3° ± 0,93° (6°-11°), mensurada no limite clínico da flexão do quadril, que foi de 106,25° ± 10,46° (93°-130°), ambos com acelerômetro. Os CCI entre dois avaliadores diferentes nas avaliações de flexão do quadril foram de 0,60, 0,71 e 0,74 (goniômetro) e 0,46, 0,71 e 0,83 (acelerômetro). A correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro foi de 0,87. Conclusão: Durante avaliação clínica da amplitude final de flexão do quadril, houve movimentação associada da pelve aproximadamente de 7,3°. Acelerômetros mostraram-se confiáveis para mensuração da flexão do quadril. Nível de evidência III, Estudo de pacientes não consecutivos sem padrão de referência "ouro" aplicado uniformemente.

Epidemiological study of hepatitis B and C in a municipality with rural characteristics: Cássia dos Coqueiros, State of São Paulo, Brazil.

INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.

Epidemiological study of hepatitis B and C in a municipality with rural characteristics: Cássia dos Coqueiros, State of São Paulo, Brazil

Abstract: INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.

[Validation of Body Image Relationship Scale for women with breast cancer]. / Validação do Body Image Relationship Scale para mulheres com câncer de mama.

PURPOSE: To validate the instrument Body Image Relationship Scale (BIRS) for Brazilian women with breast cancer. METHODS: The instrument was administered by trained interviewers to 139 women who used the Brazilian Unified Health System (SUS). All of them had been submitted to cancer treatments between 2006 and 2010. The instrument was validated considering internal consistency and reliability. In order to compare the techniques, the same factorial analysis as used in the original paper was carried out. RESULTS: The Spearman-Brown correlation value was 0.8, indicating high internal reliability. The Cronbach's alpha found was 0.9, indicating a high level of internal consistency. Factorial analysis showed that four items had low factorial load and no discriminatory power, and another five items were relocated to other factors. When the instrument was applied, it showed variability to that of the original instrument. CONCLUSION: The Brazilian version of the Body Image Relationship Scale (BIRS), named Escala de Relacionamento e Imagem Corporal (ERIC), showed evidence of adequate reliability and internal consistency, making this instrument suitable to be recommended for application to Brazilian women with breast cancer, despite some limitations.

Validação do Body Image Relationship Scale para mulheres com câncer de mama / Validation of Body Image Relationship Scale for women with breast cancer

ResumoOBJETIVOValidar o instrumento Body Image Relationship Scale (BIRS) em mulheres brasileiras acometidas pelo câncer de mamaMÉTODOSO instrumento foi aplicado por entrevistadoras treinadas em 139 usuárias do Sistema Único de Saúde que foram submetidas aos tratamentos do câncer entre 2006 e 2010. O instrumento foi aferido considerando-se a consistência interna e a confiabilidade. Para efeito de comparação as técnicas de análise fatorial utilizadas no artigo original foram aplicadasRESULTADOSO valor de correlação Spearman-Brown foi 0,8, o que indica alto nível de confiabilidade, e o alfa de Cronbach encontrado foi 0,9, indicando alto nível de consistência interna. A análise fatorial mostrou que quatro questões não tinham poder discriminatório e carga fatorial baixa e outras cinco foram realocadas em outros domínios. Dessa forma, foi aplicada e mostrou variabilidade semelhante ao instrumento originalCONCLUSÃOA versão brasileira do BIRS, renomeada como Escala de Relacionamento e Imagem Corporal (ERIC), apresentou evidências de adequada confiabilidade e consistência interna, o que torna esse instrumento recomendável para aplicação em mulheres brasileiras com câncer de mama, apesar de alguns poucos limites.

AbstractPURPOSETo validate the instrument Body Image Relationship Scale (BIRS) for Brazilian women with breast cancerMETHODSThe instrument was administered by trained interviewers to 139 women who used the Brazilian Unified Health System (SUS). All of them had been submitted to cancer treatments between 2006 and 2010. The instrument was validated considering internal consistency and reliability. In order to compare the techniques, the same factorial analysis as used in the original paper was carried outRESULTSThe Spearman-Brown correlation value was 0.8, indicating high internal reliability. The Cronbach's alpha found was 0.9, indicating a high level of internal consistency. Factorial analysis showed that four items had low factorial load and no discriminatory power, and another five items were relocated to other factors. When the instrument was applied, it showed variability to that of the original instrumentCONCLUSIONThe Brazilian version of the Body Image Relationship Scale (BIRS), namedEscala de Relacionamento e Imagem Corporal (ERIC), showed evidence of adequate reliability and internal consistency, making this instrument suitable to be recommended for application to Brazilian women with breast cancer, despite some limitations.

Dietary polyunsaturated fatty acid intake during late pregnancy affects fatty acid composition of mature breast milk.

OBJECTIVE: The aim of this study was to investigate how maternal polyunsaturated fatty acid intake at different periods during pregnancy affects the composition of polyunsaturated fatty acids in mature human milk. METHODS: A prospective study was conducted involving 45 pregnant women, aged between 18 and 35 y, who had full-term pregnancies and practiced exclusive or predominant breast-feeding. Mature breast milk samples were collected after the 5th postpartum week by manual expression; fatty acid composition was determined by gas chromatography. Fatty acid intake during pregnancy and puerperium was estimated through multiple 24-h dietary recalls. Linear regression models, adjusted by postpartum body mass index and deattenuated, were used to determine associations between estimated fatty acids in maternal diet during each trimester of pregnancy and fatty acid content in mature human milk. RESULTS: A positive association was identified between maternal intake of eicosapentaenoic acid (ß, 1.873; 95% confidence interval [CI], 0.545, 3.203) and docosahexaenoic acid (ß, 0.464; 95% CI, 0.212-0.714) during the third trimester of pregnancy, as well as the maternal dietary ω-3 to ω-6 ratio (ß, 0.093; 95% CI, 0.016-0.170) during the second and third trimesters and postpartum period, with these fatty acids content in mature breast milk. CONCLUSIONS: The maternal dietary docosahexaenoic acid and eicosapentaenoic acid content during late pregnancy may affect the fatty acid composition of mature breast milk. Additionally, the maternal dietary intake of ω-3 to ω-6 fatty acid ratio, during late pregnancy and the postpartum period, can affect the polyunsaturated fatty acid composition of breast milk.

[Reproductive and sexual history of women treated of breast cancer]. / História reprodutiva e sexual de mulheres tratadas de câncer de mama.

PURPOSE: To understand the reproductive and sexual life of women treated for breast cancer. METHODS: A total of 139 women with a diagnosis made at least 6 months ago were interviewed after being randomly selected in a rehabilitation service. The interviews were carried out between 2006 and 2010. The inclusion criteria were: to have used a rehabilitation service between 2006 and 2010, to be a Unified Health System user, to have been a patient at a regional hospital and to be resident in the area of DRS XIII-Ribeirão Preto, state of São Paulo. The interviewees were visited at home where a face to face questionnaire regarding sociodemographic features and questions about the disease and reproductive and sexual life was administered. For the last one, the Female Sexual Function Index instrument was used. Data were analyzed statistically by the χ² test, Fisher exact test, Student's t test, multivariate analysis by logistic regression, factorial analysis and the Cronbach's alpha. RESULTS: Most patients had between 2 to 3 children and 80% used some contraceptive. About half of them had had sexual intercourse in the last month, 45.3% had interrupted sexual intercourse during treatment and 25.9% did not. There were reports of decreasing sexual activity, although half of the interviewees had re-started sexual life during the first six months after treatment. About half presented sexual dissatisfaction. An active sexual life is associated with being younger than 40 years of age and to have a partner. No association was found between active sexual life and diagnosis and types of treatment. CONCLUSION: Sexual activity of women treated for breast cancer is not associated with the treatments, but with age and with the opportunity of having sex.

História reprodutiva e sexual de mulheres tratadas de câncer de mama / Reproductive and sexual history of women treated of breast cancer

OBJETIVO: Compreender a vida sexual e reprodutiva de mulheres tratadas de câncer de mama. MÉTODOS: Foram entrevistadas 139 mulheres com diagnóstico há pelo menos seis meses, selecionadas aleatoriamente em um serviço de reabilitação. As entrevistas foram feitas entre 2006 e 2010. Todas eram usuárias do SUS, pacientes de um hospital regional e moradoras da região DRS XIII-Ribeirão Preto, Estado de São Paulo. As entrevistadas foram visitadas em seu domicílio onde foi aplicado um questionário face a face que abordava questões relativas às características sociodemográficas, da doença e da vida reprodutiva e sexual, para esta última aplicou-se o instrumento Índice de Função Sexual Feminina (IFSF). A análise estatística incluiu o teste do χ², o teste exato de Fisher e o teste t de Student, análise multivariada por regressão logística e análise fatorial e alfa de Cronbach. RESULTADOS: A maioria teve entre 2 e 3 filhos e 80% utilizaram algum método anticoncepcional. Cerca de metade das mulheres tiveram relação sexual no último mês, 45,3% interromperam as relações sexuais durante o tratamento e 25,9% não interromperam. Houve relato de diminuição da frequência sexual, embora metade das entrevistadas tenha retomado a vida sexual nos primeiros seis meses após o tratamento. Pouco mais de metade apresentou insatisfação sexual. Encontrou-se vida sexual ativa associada à idade menor que 40 anos e a ter parceiro. Não foi encontrada associação entre vida sexual ativa e ao diagnóstico e tipos de tratamento. CONCLUSÃO: A atividade sexual de mulheres tratadas para câncer de mama não está associada aos tratamentos, mas à idade e à oportunidade de ter sexo.

PURPOSE: To understand the reproductive and sexual life of women treated for breast cancer. METHODS: A total of 139 women with a diagnosis made at least 6 months ago were interviewed after being randomly selected in a rehabilitation service. The interviews were carried out between 2006 and 2010. The inclusion criteria were: to have used a rehabilitation service between 2006 and 2010, to be a Unified Health System user, to have been a patient at a regional hospital and to be resident in the area of DRS XIII-Ribeirão Preto, state of São Paulo. The interviewees were visited at home where a face to face questionnaire regarding sociodemographic features and questions about the disease and reproductive and sexual life was administered. For the last one, the Female Sexual Function Index instrument was used. Data were analyzed statistically by the χ² test, Fisher exact test, Student's t test, multivariate analysis by logistic regression, factorial analysis and the Cronbach's alpha. RESULTS: Most patients had between 2 to 3 children and 80% used some contraceptive. About half of them had had sexual intercourse in the last month, 45.3% had interrupted sexual intercourse during treatment and 25.9% did not. There were reports of decreasing sexual activity, although half of the interviewees had re-started sexual life during the first six months after treatment. About half presented sexual dissatisfaction. An active sexual life is associated with being younger than 40 years of age and to have a partner. No association was found between active sexual life and diagnosis and types of treatment. CONCLUSION: Sexual activity of women treated for breast cancer is not associated with the treatments, but with age and with the opportunity of having sex.

Fatores associados à violência física por parceiro íntimo em usuárias de serviços de saúde / Factors associated with intimate partner physical violence among health service users / Factores asociados a la violencia física por pareja íntima en usuarias de servicios de salud

OBJETIVO: Estimar a prevalência de violência por parceiro íntimo contra mulheres e identificar fatores associados. MÉTODOS: Estudo transversal com 504 mulheres de 15 a 49 anos, em cinco unidades básicas e distritais de saúde em um município paulista em 2008. Foram realizadas entrevistas face a face com uso de questionário com 119 questões, sobre informações sociodemográficas, saúde reprodutiva, percepção sobre papéis de gênero no relacionamento conjugal e experiência de violência. Análises univariada e múltipla por regressão logística foram realizadas. RESULTADOS: Mais de um terço das mulheres sofreu violência pelo parceiro íntimo. Na análise múltipla os fatores positivamente associados à violência foram: morar em casa alugada, ter sofrido abuso sexual na infância, parceiro agredido fisicamente na infância, o uso de álcool pela entrevistada e pelo parceiro, uso de drogas e percepção sobre o temperamento do parceiro. CONCLUSÕES: As variáveis identificadas compuseram um modelo preditivo que pode ser utilizado para avaliar o risco de sofrer violência pelo parceiro íntimo.

OBJECTIVE: To estimate the prevalence of intimate partner violence against women and identify factors associated. METHODS: Cross-sectional study comprising 504 women aged 15 to 49 years users of five primary care clinics in a municipality in the state of São Paulo, Southeastern Brazil, in 2008. Face-to-face interviews were carried out using a questionnaire consisting of 119 questions on sociodemographic information, reproductive health, perceptions of gender roles in the marital relationship and experience of violence. Univariate and multiple regression analyses were performed. RESULTS: More than a third of the women reported intimate partner violence. In the multiple regression analysis factors predisposing to violence included living in rental housing, sexual abuse during childhood, the partner's experience of physical violence during childhood, alcohol and drug use by the woman and her partner, and woman's perception of her partner's temperament. CONCLUSIONS: The factors identified produced a predictive model that can be used to assess a woman's risk of experiencing intimate partner violence.

OBJETIVO: Estimar la prevalencia de violencia por pareja íntima contra mujeres e identificar factores asociados. MÉTODOS: Estudio transversal con 504 mujeres de 15 a 49 años, en cinco unidades básicas y distritales de salud en un municipio del estado de São Paulo (Sureste de Brasil) en 2008. Se realizaron entrevistas cara a cara con uso de cuestionario con 119 preguntas, sobre informaciones sociodemográficas, salud reproductiva, percepción sobre papeles de género en el relacionamiento conyugal y experiencia de violencia. Se realizaron análisis univariado y múltiple por regresión logística. RESULTADOS: Más de un tercio de las mujeres sufrió violencia por la pareja íntima. En el análisis múltiple los factores positivamente asociados a la violencia fueron: Vivir en casa alquilada, haber sufrido abuso sexual en la infancia, pareja agredida físicamente en la infancia, el uso de alcohol por la entrevistada y por la pareja, como uso de drogas y percepción sobre el temperamento de la pareja. CONCLUSIONES: Las variables identificadas conformaron un modelo predictivo que puede ser utilizado para evaluar el riesgo de sufrir violencia por la pareja íntima.

Factors associated with intimate partner physical violence among health service users.

OBJECTIVE: To estimate the prevalence of intimate partner violence against women and identify factors associated. METHODS: Cross-sectional study comprising 504 women aged 15 to 49 years users of five primary care clinics in a municipality in the state of São Paulo, Southeastern Brazil, in 2008. Face-to-face interviews were carried out using a questionnaire consisting of 119 questions on sociodemographic information, reproductive health, perceptions of gender roles in the marital relationship and experience of violence. Univariate and multiple regression analyses were performed. RESULTS: More than a third of the women reported intimate partner violence. In the multiple regression analysis factors predisposing to violence included living in rental housing, sexual abuse during childhood, the partner's experience of physical violence during childhood, alcohol and drug use by the woman and her partner, and woman's perception of her partner's temperament. CONCLUSIONS: The factors identified produced a predictive model that can be used to assess a woman's risk of experiencing intimate partner violence.

Relation between alcohol consumption and traffic violations and accidents in the region of Ribeirão Preto, São Paulo State.

In recent years, alcohol consumption has been considered an important public health problem. Ethanol, the alcohol used in beverages, is a drug that affects the central nervous system (CNS) and impairs driving skills and co-ordination, increasing risk of deaths and injuries derived from crashes and road accidents. Consumption of alcoholic beverages is implicated with premature deaths, injuries and damages caused by motor vehicle crashes, which result in high costs to government and society. Considering that alcohol consumption is the main responsible factor for deaths and disabilities in young people, the aim of this work was to evaluate the prevalence of blood alcohol in offenders and/or fatal and non-fatal victims of traffic occurrences in the region of Ribeirão Preto, São Paulo State, from 2005 to 2007. The results revealed that in 2134 cases investigated, blood alcohol positivity was generally found in young adults, 25-45 years old and male. The study showed the high risk of drinking and driving and the importance in establishing actions of prevention and intervention to promote the reduction in the number of traffic occurrences related to consumption of alcoholic beverages.

Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella spp. infection among hospitalized patients.

Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. have become a major problem all around the world. This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens, and also because this kind of resistance can spread to a wide variety of Gram-negative bacilli. Our objectives were to evaluate among in-patients at a public university tertiary-care hospital with documented infection due to Klebsiella spp., which were the risk factors (cross-sectional analysis) and the clinical impact (prospective cohort) associated with an ESBL-producing strain. Study subjects were all patients admitted at the study hospital between April 2002 and October 2003, with a clinically and microbiologically confirmed infection caused by Klebsiella spp. at any body site, except infections restricted to the urinary tract. Of the 104 patients studied, 47 were infected with an ESBL-producing strain and 57 with a non-ESBL-producing strain. Independent risk factors associated with infection with an ESBL-producing strain were young age, exposure to mechanical ventilation, central venous catheter, use of any antimicrobial agent, and particularly use of a 4th generation cephalosporin or a quinolone. Length of stay was significant longer for patients infected with ESBL-producing strains than for those infected with non-ESBL-producing strains, although fatality rate was not significantly affected by ESBL-production in this cohort. In fact, mechanical ventilation and bacteremia were the only variables within dependent association with death detected in this investigation.

Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella spp. infection among hospitalized patients

Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. have become a major problem all around the world. This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens, and also because this kind of resistance can spread to a wide variety of Gram-negative bacilli. Our objectives wereto evaluate among in-patients at a publicuniversity tertiary-care hospital with documented infection due to Klebsiella spp., which were the risk factors (cross-sectional analysis) and the clinical impact (prospective cohort) associated with an ESBL-producing strain. Study subjects were all patients admitted at the study hospital between April 2002 and October 2003, with a clinically and microbiologically confirmed infection caused by Klebsiella spp. at any body site, except infections restricted to the urinary tract. Of the 104 patients studied, 47 were infected with an ESBL-producing strain and 57 with a non-ESBL-producing strain. Independent risk factors associated with infection with an ESBL-producing strain were young age, exposure to mechanical ventilation, central venous catheter, use of any antimicrobial agent, and particularly use of a 4th generation cephalosporin or a quinolone. Length of stay was significant longer for patients infected with ESBL-producing strains than for those infected with non-ESBL-producing strains, although fatality rate was not significantly affected by ESBL-production in this cohort. In fact, mechanical ventilation and bacteremia were the only variables withindependent association withdeath detected in this investigation.