Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 70
Filtrar
1.
Rev Saude Publica ; 55: 65, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34706041

RESUMO

OBJECTIVE: To check the coverage of the HPV vaccine in women enrolled in health courses at a university in southwest Goiás, Brazil, and the factors associated with vaccination. METHODS: This is a cross-sectional study, including female university students of health courses, aged 18 years or more. A standardized and self-applying questionnaire was used. Participants who received two or more doses of the vaccine were considered immunized. Multiple analysis was performed using multinomial logistic regression. RESULT: We observed that, of the 1510 participants, 473 (31.3%) had two or more doses of HPV vaccine, 167 (11.0%) one dose and 870 (57.6%) were unvaccinated. Participants under 21 years of age and in socioeconomic stratum A were 2 times more likely to have received two or more doses of the vaccine (Prevalence Ratio = 1.95; 95%CI 1.40-2.70 and Prevalence Ratio = 2.09; 95%CI 1.39-3.13, respectively). CONCLUSIONS: The research revealed extensive possibility for interventions with the aim of achieving greater vaccination coverage among female university students. Even women with more knowledge and high economic stratum showed low vaccination coverage, suggesting that results of higher vaccine coverage can be obtained with vaccination carried out in a school environment.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Brasil , Estudos Transversais , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/prevenção & controle , Universidades , Vacinação , Cobertura Vacinal
2.
J Reprod Immunol ; 146: 103342, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34102513

RESUMO

This study evaluated the impact of the TLR7 Gln11Leu (rs179008) and TLR9 -1237 T/C (rs5743836) single nucleotide polymorphisms (SNPs) on susceptibility to placental infections and pregnancy complications in 455 Brazilian women. Demographic, socioeconomic, gynecological, and clinical characteristics of the women were collected. Placental tissues were sampled from pregnant women and human and viral DNA was extracted. Human alphaherpesvirus 1 (Herpes simplex virus type 1, HSV-1), Human alphaherpesvirus 2 (Herpes simplex virus type 2, HSV-2) and Human betaherpesvirus 5 (Human cytomegalovirus, HCMV) were detected by nested PCR. TLR9 and TLR7 SNPs were genotyped by PCR amplification of bi-directional specific alleles (Bi-PASA) and restriction fragment length polymorphism (RFLP), respectively. Infections at the time of birth were detected in 45.71 % of women. The presence of the TT genotype (recessive model) of the TLR7 SNP was associated with increased susceptibility to HSV-1 infection (O.R. = 2.23, p = 0.05). The presence of the C allele of the TLR9 SNP, in heterozygosis or homozygosis (dominant model), decreased the infection risk by HCMV (O.R. = 0.31, p-mod<0.05). The TT genotype (recessive model) of the TLR7 SNP was significantly associated (p < 0.05) with increased occurrence of pre-treated hypertension. The codominant model of the TLR9 SNP was significantly associated (p < 0.05) with reduced risk of hospitalization during pregnancy. In combination, the AA/CT (TLR7-TLR9) genotypes significantly decreased the risk of placental infection by HSV-1 and/or HSV-2 (O.R. = 0.47, p = 0.02), the susceptibility to all infectious agents considered in combination (O.R. = 0.4, p = 0.00), and the need of hospitalization (O.R. = 0.48, p = 0.02). In conclusion, TLR7 and TLR9 SNPs are potential modulating factors for the risk of placental infections and pregnancy complications.

3.
Arch. Clin. Psychiatry (Impr.) ; 47(4): 89-94, July-Aug. 2020. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1130995

RESUMO

Abstract Background Brazil has the third largest prison population in the world. Research in the world has confirmed a high prevalence of mental disorders in this population. Objective To identify prevalence and associated factors with depression and anxiety in prisoners of the closed prison system. Methods This is a cross-sectional study with 643 prisoners were interviewed in six prisons in Rio Grande do Sul, Brazil. To evaluate depression and anxiety, the Mini International Neuropsychiatric Interview 5.0 (MINI) was used and sociodemographic, inprisonment and lifestyle habits variables were also collected. Results The prevalence of depression found in the study was 20.6% (95% CI: 17.5-23.8) and of anxiety was 19.9% (95% CI: 16.8-23.0). The following were identified as risk factors for depression: being female, having a history of mental illness, non-white skin color, having a religion, not receiving visits, smoking, using drugs and not performing physical activities. Risk factors for anxiety were: being female, having a history of mental illness, a family history of mental illness, smoking and using drugs. Discussion The study confirmed the high rates of depression and anxiety in the population deprived of liberty. In addition, women were twice as likely to have both disorders compared to men.

4.
Rev Bras Ginecol Obstet ; 42(1): 5-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32107760

RESUMO

OBJECTIVE: Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. METHODS: Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencing were used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. RESULTS: The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. CONCLUSION: The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.


Assuntos
Herpes Simples/epidemiologia , Herpesvirus Humano 1/isolamento & purificação , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Brasil/epidemiologia , DNA Viral/análise , Feminino , Sangue Fetal/virologia , Herpes Simples/sangue , Herpes Simples/transmissão , Humanos , Incidência , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Placenta/virologia , Reação em Cadeia da Polimerase , Gravidez , Complicações Infecciosas na Gravidez/sangue , Cuidado Pré-Natal , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
5.
Rev. bras. ginecol. obstet ; 42(1): 5-11, Jan. 2020. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1092632

RESUMO

Abstract Objective Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. Methods Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencingwere used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. Results The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. Conclusion The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.


Resumo Objetivo Estimar a prevalência do DNA do vírus herpes humano 1 (HSV-1) em amostras de placenta, sua incidência no sangue do cordão umbilical de recém-nascidos e fatores de risco associados. Métodos Biópsias de placenta e de sangue de cordão umbilical foram analisadas, totalizando 480 amostras de parturientes assintomáticas e seus recém-nascidos emum hospital universitário. Reação de cadeia de polimerase (RCP) nested e sequenciamento gênico foram usados para identificar o vírus; odds ratio (OR) e risco relativo (RR) foram realizados para comparar os fatores de risco associados à essa condição. Resultados A prevalência do DNA do HSV-1 em amostras de placenta foi de 37,5%, e a incidência no sangue do cordão foi de 27,5%. A via transplacentária hematogênica foi identificada em 61,4% das amostras de HSV-1+do sangue do cordão umbilical, pareadas com o tecido placentário. Nenhuma evidência do vírus foi observada nos restantes 38,6% dos tecidos placentários, sugerindo uma infecção ascendente do trato genital. A falta de uso do preservativo aumentou o risco de encontrar o HSV-1 na placenta e no sangue do cordão umbilical. Conclusão A ocorrência de DNA do HSV-1 na placenta e no sangue do cordão umbilical sugere uma transmissão vertical de gestantes assintomáticas para o feto.

6.
Arq Gastroenterol ; 56(4): 394-398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800735

RESUMO

BACKGROUND: In recent years the management of hepatitis C virus infection and the possibility of its eradication have been researched due to the importance that they represent in the health of the world population. Obtaining data that help to cope with this pathology improves the quality of life of those affected by it. The present study evaluated the effectiveness of direct-acting antiviral therapies provided by the Brazilian Ministry of Health in accordance to the Clinical Protocol and Therapeutic Guidelines of 2015. OBJECTIVE: To evaluate the epidemiological profile of patients with chronic hepatitis C and the rate of sustained virologic response using direct-acting antivirals of all individuals that attended the referral service for the treatment of chronic hepatitis C at the Hospital of the Federal University of Rio Grande. METHODS: This was an observational, retrospective/prospective study with all patients with chronic hepatitis C who had their treatments available from December 2015 to August 2017 according to the criteria of the Clinical Protocol and Therapeutic Guidelines of 2015. In the first phase, the clinical and demographic variables of all individuals enrolled in a treatment for hepatitis C were selected and collected from the Reference Service database. In the second phase, treatment data were collected. The outcome variable, sustained virologic response, was defined as an undetectable viral load on the blood test three months after the end of treatment. The descriptive and bivariate analyzes were performed with Pearson's chi-square and Fisher's Exact test, adopting a P value ≤0.05 in the SPSS 20 software. RESULTS: Of the 252 participants in the study, 228 (90.5%) had a sustained virologic response, 55.2% were male with an average age of 58.6 years (SD±9.1). Genotype 1 was the most prevalent, observed in 54.4% of the participants, and 87.4% of the patients had moderate/advanced hepatic fibrosis. After the statistical analysis, it was observed that the individuals with genotype 3 and moderate/advanced hepatic fibrosis had lower sustained virologic response rate (P=0.05 and P=0.04, respectively). CONCLUSION: It was observed that the use of direct-acting antivirals, in comparison to previous therapeutic regimens, increases the sustained virologic response, reaching all patients with mild fibrosis. This study provides information that helps in the hepatitis C treatment by showing that prescribing early treatment for patients without hepatic fibrosis and/or genotype 3 virus could increase therapeutic effectiveness.


Assuntos
Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Resposta Viral Sustentada , Idoso , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento , Carga Viral
7.
Rev Bras Epidemiol ; 22: e190060, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31826115

RESUMO

INTRODUCTION: Nutrition counseling has played a critical role in the prevention and treatment of various diseases. OBJECTIVE: To evaluate how adults and elderly people, who are residents in an urban area of Southern Brazil, received nutritional counseling. METHODS: This was a cross-sectional population based study. Data was collected through a questionnaire applied at home. The outcome was the prevalence of nutritional counseling received in the past year that came from different means, including means of communication. Sociodemographic variables, doctor visits in the past year, nutritional state and other healthcare variables were analyzed. RESULTS: The sample included 1,296 individuals (rate of answer of 90.7%). The results indicate that the majority of the people interviewed were females (56.6%), with their age ranging from 18 to 59 years-old (75.3%). The prevalence of people receiving nutritional counseling was 19.9% (95%CI 17.3 -22.5). It was higher among women than men (p = 0.01). The sex-adjusted analyses showed a statistically significant (p < 0.05) association in men for the variables: schooling ≥ 12 years; medical consultation in the last year; low weight; obesity; diabetes and hypertension. Among the women, the following variables were associated with the outcome: health insurance; medical consultation in the last year; obesity and diabetes. CONCLUSIONS: The low prevalence of nutritional counseling and its association with diseases exposes the need for it to be implemented not only for treatment purposes but also as preventive health actions.


Assuntos
Doença Crônica/prevenção & controle , Aconselhamento/estatística & dados numéricos , Educação em Saúde/métodos , Estado Nutricional , Adolescente , Adulto , Brasil/epidemiologia , Doença Crônica/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Adulto Jovem
8.
Arq. gastroenterol ; 56(4): 394-398, Oct.-Dec. 2019. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1055164

RESUMO

ABSTRACT BACKGROUND: In recent years the management of hepatitis C virus infection and the possibility of its eradication have been researched due to the importance that they represent in the health of the world population. Obtaining data that help to cope with this pathology improves the quality of life of those affected by it. The present study evaluated the effectiveness of direct-acting antiviral therapies provided by the Brazilian Ministry of Health in accordance to the Clinical Protocol and Therapeutic Guidelines of 2015. OBJECTIVE: To evaluate the epidemiological profile of patients with chronic hepatitis C and the rate of sustained virologic response using direct-acting antivirals of all individuals that attended the referral service for the treatment of chronic hepatitis C at the Hospital of the Federal University of Rio Grande. METHODS: This was an observational, retrospective/prospective study with all patients with chronic hepatitis C who had their treatments available from December 2015 to August 2017 according to the criteria of the Clinical Protocol and Therapeutic Guidelines of 2015. In the first phase, the clinical and demographic variables of all individuals enrolled in a treatment for hepatitis C were selected and collected from the Reference Service database. In the second phase, treatment data were collected. The outcome variable, sustained virologic response, was defined as an undetectable viral load on the blood test three months after the end of treatment. The descriptive and bivariate analyzes were performed with Pearson's chi-square and Fisher's Exact test, adopting a P value ≤0.05 in the SPSS 20 software. RESULTS: Of the 252 participants in the study, 228 (90.5%) had a sustained virologic response, 55.2% were male with an average age of 58.6 years (SD±9.1). Genotype 1 was the most prevalent, observed in 54.4% of the participants, and 87.4% of the patients had moderate/advanced hepatic fibrosis. After the statistical analysis, it was observed that the individuals with genotype 3 and moderate/advanced hepatic fibrosis had lower sustained virologic response rate (P=0.05 and P=0.04, respectively). CONCLUSION: It was observed that the use of direct-acting antivirals, in comparison to previous therapeutic regimens, increases the sustained virologic response, reaching all patients with mild fibrosis. This study provides information that helps in the hepatitis C treatment by showing that prescribing early treatment for patients without hepatic fibrosis and/or genotype 3 virus could increase therapeutic effectiveness.


RESUMO CONTEXTO: O manejo e a possibilidade de erradicação da infecção pelo vírus da hepatite C têm sido muito pesquisados nos últimos anos pela importância que representam na saúde pública para a população mundial. A obtenção de dados que auxiliem o enfrentamento dessa patologia resulta na melhor qualidade de vida dos seus portadores. O presente estudo avaliou a efetividade da terapêutica com os antivirais de ação direta, fornecida pelo Ministério da Saúde, através do Protocolo Clínico e Diretrizes Terapêuticas de 2015. OBJETIVO: Avaliar o perfil epidemiológico dos portadores de hepatite C crônica e a taxa de resposta viral sustentada com o uso dos antivirais de ação direta em todos os indivíduos atendidos no Centro de Referência no tratamento da hepatite C crônica do Hospital Universitário da Universidade Federal do Rio Grande. MÉTODOS: Estudo observacional retrospectivo/prospectivo com todos os portadores de hepatite C crônica que tiveram seus tratamentos disponibilizados no período de dezembro de 2015 a agosto de 2017 segundo os critérios do Protocolo Clínico e Diretrizes Terapêuticas de 2015. Na primeira fase foram selecionadas e coletadas as variáveis demográficas e clínicas, no banco de dados do centro de referência de todos os indivíduos cadastrados para tratamento para hepatite C e na segunda fase foram coletados dados referentes ao tratamento. A variável desfecho, resposta viral sustentada, foi definida pela carga viral indetectável no exame sanguíneo três meses após o término do tratamento. Foram realizadas as análises descritivas e bivariadas com cálculo do qui quadrado de Pearson e Exato de Fisher, adotando um valor P≤0,05, no programa SPSS 20. RESULTADOS: Dos 252 participantes do estudo 228 (90,5%) obtiveram resposta viral sustentada, sendo 55,2% do sexo masculino com média de idade de 58,6 anos (DP±9,1). O genótipo 1 foi o mais prevalente, presente em 54,4% dos participantes, 87,4% dos estudados apresentavam grau de fibrose hepática moderada/avançada. Após a análise estatística observou-se que os indivíduos com genótipo 3 e fibrose hepática moderada/avançada, tiveram menor taxa de resposta viral sustentada (P=0,05 e P=0,04 respectivamente). CONCLUSÃO: Observou-se que com o uso dos antivirais de ação direta as taxas de resposta viral sustentada foram altas, em relação aos esquemas terapêuticos anteriores, podendo chegar à totalidade nos pacientes com fibrose leve. Este estudo mostra que a realização do tratamento precoce, ou seja, de forma antecipada em pacientes sem fibrose hepática e genótipo 3 pode aumentar a taxa de sucesso.

9.
Cien Saude Colet ; 24(9): 3469-3482, 2019 Sep 09.
Artigo em Português | MEDLINE | ID: mdl-31508765

RESUMO

This study evaluated the psychometric properties of the Brazilian version of the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). A convenience sample of 429 students of a Brazilian public university participated in the study. Exploratory Factor Analysis suggested one factor solution (variance explained = 61.1%, eigenvalue = 7.2), confirmed by the confirmatory analysis (Root Mean Square Error of Approximation = 0.04; Comparative Fit Index = 0.91; Tucker-Lewis Index = 0.90; Standardized Root Mean Square Residual = 0.05). Five items feature charges less than 0.30 and wer eliminated. The instrument demonstrated internal consistency (Composite reliability = 0.97; Cronbach's alpha = 0.83) and temporal stability (Pearson correlation = 0.86; kappa = 0.16) over a brief period. The knowledge significantly varies by age, sex and course of study. In conclusion, this study highlights the satisfactory psychometric proprieties of the Brazilian version of STD-KQ in university students.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doenças Sexualmente Transmissíveis , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Universidades , Adulto Jovem
10.
Ciênc. Saúde Colet ; 24(9): 3469-3482, set. 2019. tab
Artigo em Português | LILACS | ID: biblio-1019684

RESUMO

Resumo Este estudo analisou as propriedades psicométricas da versão brasileira do Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis (STD-KQ). Participou uma amostra de conveniência de 429 estudantes de uma universidade pública brasileira. A análise fatorial exploratória sugere uma estrutura com um fator (variância explicada = 61,1%; eigenvalue = 7,2), sendo corroborada pela análise confirmatória (Root Mean Square Error of Approximation = 0,04; Comparative Fit Index = 0,91; Tucker-Lewis Index = 0,90; Standardized Root Mean Square Residual = 0,05). Cinco itens apresentaram carga menor que 0,30 e por isso foram excluídos. O instrumento demonstrou consistência interna (confiabilidade composta = 0,97; alfa de Cronbach = 0,83) e estabilidade temporal (correlação de Pearson = 0, 86; kappa = 0,16) para um curto período. O conhecimento significativamente variou conforme a idade, o sexo e o curso. Concluindo, o presente estudo destaca as satisfatórias propriedades psicométricas da versão brasileira do STD-KQ em estudantes universitários.


Abstract This study evaluated the psychometric properties of the Brazilian version of the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). A convenience sample of 429 students of a Brazilian public university participated in the study. Exploratory Factor Analysis suggested one factor solution (variance explained = 61.1%, eigenvalue = 7.2), confirmed by the confirmatory analysis (Root Mean Square Error of Approximation = 0.04; Comparative Fit Index = 0.91; Tucker-Lewis Index = 0.90; Standardized Root Mean Square Residual = 0.05). Five items feature charges less than 0.30 and wer eliminated. The instrument demonstrated internal consistency (Composite reliability = 0.97; Cronbach's alpha = 0.83) and temporal stability (Pearson correlation = 0.86; kappa = 0.16) over a brief period. The knowledge significantly varies by age, sex and course of study. In conclusion, this study highlights the satisfactory psychometric proprieties of the Brazilian version of STD-KQ in university students.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Estudantes/estatística & dados numéricos , Doenças Sexualmente Transmissíveis , Conhecimentos, Atitudes e Prática em Saúde , Psicometria , Universidades , Brasil , Inquéritos e Questionários , Reprodutibilidade dos Testes , Pessoa de Meia-Idade
11.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(1): 63-70, Jan.-Mar. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1013124

RESUMO

Abstract Objectives: to identify the frequency and factors associated with the non-realization of puerperal consultations in women resident of a medium-sized municipality in Brazil. Methods: a prospective cohort study based on data collected in two time points, the first 48h and after the 42nd day post-childbirth. In order to analyze data, proportions were compared using the chi-square test, and the adjusted analysis was performed using Poisson regression, according to a predetermined hierarchical model. Significance level was set at 5%. Results: of the 572 women included in the study, 24.8% did not perform puerperal consul-tations. The factors associated with the non-realization of puerperal consultations were: lower income (1 st tercile PR= 2.01; CI95%= 1.21-3.33 - 2 nd tercile PR= 1.94; CI95%=1.17-3.20) and schooling (≤ 8 years PR= 2.00; CI95%= 1.24-3.24), comorbidities during preg-nancy (PR= 1.45; CI95%= 1.01-2.09), realization of antenatal care in the public service (PR= 1.74; CI95%= 1.18-2.58) and non-use of contraceptive methods (PR= 3.10; CI95%=1.86-5.16). Conclusions: puerperal revision does not seem to be valued in the antenatal care, mainly in the public health system. An important inequality was identified in the provision of this service, since women more prone to recurring pregnancy and with lower income and schooling were the ones that least returned to the puerperal consultation.


Resumo Objetivos: identificar a frequência da não realização das consultas de puerpério e fatores associados em mulheres residentes de um município de médio porte no Brasil. Métodos: estudo de coorte prospectiva através da coleta de dados em dois momentos, nas primeiras 48h e após o 42º dia pós-parto. Para a análise dos dados, utilizou-se o teste qui-quadrado para comparar proporções e, para a análise ajustada, Regressão de Poisson obedecendo ao modelo hierárquico pré-determinado. O nível de significância adotado foi de 5%. Resultados: das 572 mulheres incluídas no estudo, 24,8% não realizaram consulta de puerpério. Os fatores associados a não realização da consulta de puerpério foram: menor renda (1º tercil RP= 2,01 IC95%= 1,21-3,33 - 2º tercil RP= 1,94 IC95%= 1,17-3,20), escolaridade (≤ 8 anos RP= 2,00 IC95%= 1,24-3,24); mulheres que apresentaram alguma comorbidade durante a gestação (RP 1,45; IC95%= 1,01-2,09), realizaram o pré-natal em serviço público (RP= 1,74; IC95%= 1,18-2,58) e que não usaram método anticoncepcional (RP= 3,10; IC95%= 1,86-5,16). Conclusões: a revisão puerperal não parece estar sendo valorizada no pré-natal, principalmente no sistema público de saúde. Foi identificada uma importante iniquidade na prestação desse serviço, pois as mulheres de menor renda, escolaridade e mais expostas a uma gravidez recorrente foram as que menos retornaram à consulta puerperal.


Assuntos
Humanos , Feminino , Gravidez , Encaminhamento e Consulta/estatística & dados numéricos , Estudos de Coortes , Período Pós-Parto , Disparidades nos Níveis de Saúde , Serviços de Saúde Materno-Infantil , Atenção Primária à Saúde , Sistema Único de Saúde , Brasil
12.
Microb Drug Resist ; 25(2): 173-181, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30133334

RESUMO

The objective of this study was to evaluate the frequency of different extended-spectrum ß-lactamases (ESBL) as well as to associate these ESBL with antimicrobial (ATM) resistance in Escherichia coli and Klebsiella spp. isolates from outpatients and inpatients with urinary tract infections. The study included 435 consecutive nonduplicate clinical isolates, including 362 E. coli isolates, 62 Klebsiella pneumoniae isolates, and 11 K. oxytoca isolates. Isolates were obtained from patients who were treated in a University Hospital between August 2012 and July 2013. Three multiplex PCR were performed to identify the ESBL groups. A total of 48 (11%) ESBL-producing isolates were found. The risk for the ESBL presence was significantly higher in males (26.4%) than females (8%), from hospital-acquired infections (29.1%) than community-acquired infections (7.0%) and in Klebsiella spp. (27.4%) than in E. coli (7.7%). ESBL-producing isolates presented a significantly higher percentage of resistance in 21 of the 23 ATMs analyzed. The CTX-M-1 group was the most predominant ESBL identified. The blaCTX-M-1-group gene was found in 56% of the total ESBL producers from community and in 42.4% from hospital origins; it was followed in frequency by the blaCTX-M-8/25-group, also found in both environments. Klebsiella spp. presented the largest variety of ß-lactamase enzyme combinations and a higher level of resistance to cefotaxime. These findings contribute to better knowledge of the epidemiology of ESBL enzymes and are alarming for the reduced therapeutic options available for the risk groups identified in the studied populations.


Assuntos
Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Klebsiella/efeitos dos fármacos , Klebsiella/genética , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , beta-Lactamases/genética , Adulto , Idoso , Brasil/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Escherichia coli , Feminino , Humanos , Infecções por Klebsiella , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Caracteres Sexuais , Adulto Jovem
13.
J Med Virol ; 91(1): 31-37, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30133818

RESUMO

Recent studies have suggested that human pegivirus 1 (HPgV-1) may have some pathogenic potential. In the southernmost region of Brazil, studies on HPgV-1 are scarce, and circulating genotypes have not yet been identified. The current study aimed to evaluate the prevalence of HPgV-1 among blood donors from the southernmost region of Brazil and identify the genotypes involved with associated factors. A cross-sectional study was conducted with 281 blood donors, who had their plasma subjected to RNA extraction, complementary DNA synthesis, HPgV-1 detection by nested polymerase chain reaction, and subsequent genotyping. The observed prevalence of HPgV-1-RNA was 21.7%. The only variable that was significantly associated with virus infection was the relationship status of the donor. Single or no fixed partner blood donors were twice as likely to have HPgV-1 (95% CI, 1.12 to 4.56; P = 0.02). Genotype 2-subtypes 2b (69%) and 2a (29%)-was the most prevalent. In the absence of risk factors for parenteral transmission, it is likely that sexual transmission was the route of infection in the individuals studied. Further work will be needed to determine whether this virus is inert in the population, or if there are potential deleterious effects in infected individuals.


Assuntos
Doadores de Sangue , Transmissão de Doença Infecciosa , Infecções por Flaviviridae/epidemiologia , Infecções por Flaviviridae/transmissão , Flaviviridae/isolamento & purificação , Genótipo , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Flaviviridae/classificação , Flaviviridae/genética , Técnicas de Genotipagem , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
14.
Rev. enferm. UFSM ; 8(4): 1-13, out.-dez. 2018.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1034520

RESUMO

Objetivo: identificar o sentimento em relação às principais fontes de apoiopara mulheres que vivenciaram a gestação na adolescência. Método: estudo qualitativo,exploratório e descritivo, desenvolvido em município do sul do Brasil. Participarammulheres com idade entre 10 e 19 anos que tiveram filho no ano de 2010, excluindoaquelas com óbito fetal, não residentes no município ou não eram responsáveis pelacriação do filho. Realizada entrevista individual e utilizada a análise de conteúdo,constituindo as categorias: relação entre situação conjugal e apoio paterno e relação entrea reação familiar à gestação e o apoio recebido. Resultados: a participação e apoio dospais dos bebês e da figura materna no contexto da gravidez na adolescência, pareceuprimordial no enfrentamento da situação de tornar-se mãe. Conclusão: entender como asadolescentes se sentem apoiadas diante de uma gestação pode contribuir para as políticaspúblicas e processos de trabalho direcionados às suas necessidades.


Aim: to identify the feeling about the main sources of support for young womenwho have already experienced adolescent pregnancy. Method: qualitative, exploratory anddescriptive study, developed in a city in Southern Brazil. The participants were women agedfrom 10 to 19 years old, who had a child in 2010, excluding those with fetal death, notresiding in the municipality or not responsible for the child’s raising. Individual interviewwas carried and the content analysis was used, constituting the categories: relationshipbetween marital status and paternal support and relationship between the family reaction togestation and the support received. Results: the participation and support of the babies’ parents and the maternal figure in the context of teenage pregnancy seem essential to face thesituation of becoming a mother. Conclusion: understanding the way that adolescents feel thesupport when facing a pregnancy, at such stage of their lives, may contribute to the publicpolicies and work processes directed to their needs.


Objetivo: identificar el sentimiento en relación a las principales fuentes deapoyo para las jóvenes mujeres que se quedaron embarazadas en la adolescencia. Método:estudio cualitativo, exploratorio y descriptivo realizado en una ciudad en el sur de Brasil.Participaron mujeres de 10 a 19 años, que tuvieron hijo en 2010, excluyendo aquellas conmuerte fetal, las que no vivían en la ciudad o no eran responsables por criar el niño. Paratanto se realizó una entrevista individual y se utilizó el análisis de contenido, constituyendolas categorías: relación entre estado civil y apoyo paterno y relación entre la reacciónfamiliar, la gestación y el apoyo recibido. Resultados: la participación y apoyo de los padresy de la figura materna en el contexto del embarazo en la adolescencia parece ser primordialpara enfrentar esta situación de ser madre joven. Conclusión: entender como lasadolescentes se sienten apoyadas en esa fase de su vida puede contribuir para las políticaspúblicas y procesos de trabajo dirigidos a sus necesidades.


Assuntos
Apoio Social , Família , Gravidez na Adolescência
15.
Ann Med Surg (Lond) ; 33: 50-52, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30186597

RESUMO

Introduction: Malignant ovarian germ cell tumors (MOGCTs) are rare malignancies with an incidence of about 0.5/100,000. They account for less than 5% of all ovarian tumors, of which 32.8% are dysgerminomas, the female analogue of seminomas. These tumors occur in all age groups, with peak incidence below the age of 20 years in women. Aim: To describe the case of a bilateral ovarian dysgerminoma treatment with 11-year follow-up. Methods: Case report with details regarding clinical history, surgical treatment, chemotherapy and follow up. We include a brief literature review. Results: The patient underwent radical surgery for an advanced dysgerminoma, 20 cm in length, that compromised the contralateral ovary and sigmoid. Neoplastic cells were found in ascitic fluid. Subsequently, she underwent adjuvant chemotherapy according to a standard protocol. She has survived disease-free for more than 11 years. Conclusions: Dysgerminoma is a malignant neoplasm that, similar to other cancers, is easier to treat when diagnosed early. However, cures may be obtained even in advanced cases.

16.
Cien Saude Colet ; 23(8): 2587-2597, 2018 Aug.
Artigo em Português | MEDLINE | ID: mdl-30137128

RESUMO

The scope of the study was to evaluate the temporal trend and spatial distribution of congenital syphilis (CS) in the state of Rio Grande do Sul. All cases reported by the SINASC/DATASUS between 2001 and 2012 were included. The number of live births was obtained from DATASUS. Incidence rates of CS were grouped according to micro-regions of IBGE and analyzed for the entire period and for triennia. The spatial correlation was analyzed by the global Moran index (I) and the local index. 3,613 cases were reported. Between 2007 and 2012 89 neonates (3.6%) died. Rates varied from to 1.03 in 2001 to 5.1 cases per 1000 live births in 2012, with an annual increase of 0.84 cases per 1000 live births (p < 0.01) and 93.88% of explained variance. The micro-regions were spatially independent (I = 0.06; p = 0.25), with Porto Alegre having the highest incidence (4.19 cases / 1000 live births) and Jaguarão the lowest (0.23 cases / 1000 live births). Micro-regions with significant local spatial dependence were observed. The increase in cases of CS highlights poor prenatal quality care. Identification of the micro-regions with the highest incidence is essential to focus public policy on this health problem.


Assuntos
Política de Saúde , Cuidado Pré-Natal/normas , Qualidade da Assistência à Saúde , Sífilis Congênita/epidemiologia , Brasil/epidemiologia , Feminino , Humanos , Incidência , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Masculino , Gravidez , Análise Espacial
17.
Ciênc. Saúde Colet ; 23(8): 2587-2597, Aug. 2018. tab, graf
Artigo em Português | LILACS | ID: biblio-952723

RESUMO

Resumo Objetivou-se avaliar a tendência temporal e a distribuição espacial da Sífilis Congênita (SC) no estado do Rio Grande do Sul. Todos os casos notificados pelo Sistema Nacional de Agravos de Notificação entre 2001 e 2012 foram incluídos. Os números de nascidos vivos foram obtidos do SINASC/DATASUS. As taxas de incidência de SC foram agrupados conforme as microrregiões do IBGE e analisados para todo o período e em triênios. A correlação espacial foi analisada pelo índice de Moran global (I) e local. Foram notificados 3.613 casos. Entre 2007 e 2012 morreram 89 neonatos (3,6%). As taxas de SC variaram de 1,03 em 2001 a 5,1 casos por 1.000 nascidos vivos em 2012, com um incremento anual de 0,84 casos por 1.000 nascidos vivos (p < 0,01) e 93,88% da variação explicada. As microrregiões foram espacialmente independentes (I = 0,06; p = 0,25), tendo Porto Alegre a maior incidência (4,19 casos/1.000 nascidos vivos) e Jaguarão a menor (0,23 casos/1.000 nascidos vivos). Observaram-se microrregiões com dependência espacial local significativa. O aumento dos casos de SC salienta um déficit na qualidade do pré-natal. A identificação das microrregiões com maior incidência é essencial para focalizar as políticas públicas sobre esse tema.


Abstract The scope of the study was to evaluate the temporal trend and spatial distribution of congenital syphilis (CS) in the state of Rio Grande do Sul. All cases reported by the SINASC/DATASUS between 2001 and 2012 were included. The number of live births was obtained from DATASUS. Incidence rates of CS were grouped according to micro-regions of IBGE and analyzed for the entire period and for triennia. The spatial correlation was analyzed by the global Moran index (I) and the local index. 3,613 cases were reported. Between 2007 and 2012 89 neonates (3.6%) died. Rates varied from to 1.03 in 2001 to 5.1 cases per 1000 live births in 2012, with an annual increase of 0.84 cases per 1000 live births (p < 0.01) and 93.88% of explained variance. The micro-regions were spatially independent (I = 0.06; p = 0.25), with Porto Alegre having the highest incidence (4.19 cases / 1000 live births) and Jaguarão the lowest (0.23 cases / 1000 live births). Micro-regions with significant local spatial dependence were observed. The increase in cases of CS highlights poor prenatal quality care. Identification of the micro-regions with the highest incidence is essential to focus public policy on this health problem.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Cuidado Pré-Natal/normas , Qualidade da Assistência à Saúde , Sífilis Congênita/epidemiologia , Política de Saúde , Brasil/epidemiologia , Incidência , Transmissão Vertical de Doenças Infecciosas/estatística & dados numéricos , Análise Espacial
18.
Artigo em Inglês | MEDLINE | ID: mdl-29972462

RESUMO

In this study, we evaluated the mutations of Helicobacter pylori associated with resistance to clarithromycin and levofloxacin. Furthermore, based on the proposed interaction between antimicrobial resistance and pathogenicity, we correlated the mutation profiles of the strains with the presence of the pathogenicity gene cagA. We analyzed 80 gastric biopsy specimens from H. pylori-infected patients for point mutations in the 23S rRNA gene region and in the gyrA gene, which are related to clarithromycin and levofloxacin resistance, respectively, and investigated the presence of the cagA gene in these strains. We observed that in the assayed biopsies, 8.7% (7/80) had mutations in the 23S rRNA gene region at positions 2143 and 2142, while 22.5% (18/80) had mutations in gyrA at codons 87 and 91. Moreover, absence of the CagA-EPIYA pathogenicity factor was observed in 68% (17/25) of resistant samples. The knowledge of the local profile of antimicrobial resistance and the complex interplay involving resistance and pathogenicity can contribute to an appropriate clinical approach.


Assuntos
Antibacterianos/farmacologia , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , DNA Girase/genética , Farmacorresistência Bacteriana/genética , Helicobacter pylori/genética , Mutação/genética , RNA Ribossômico 23S/genética , Claritromicina/farmacologia , Helicobacter pylori/efeitos dos fármacos , Humanos , Levofloxacino/farmacologia , Testes de Sensibilidade Microbiana
19.
Am J Reprod Immunol ; 79(4): e12824, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29427299

RESUMO

PROBLEM: Herpes simplex virus type 2 (HSV-2) infection is one of the most prevalent diseases worldwide and is mainly sexually transmitted. When infecting pregnant women, HSV-2 is able to infect the placenta, can reach the fetus, and may affect the fetal development. We sought to determine the prevalence of HSV-2 infection and reactivation in asymptomatic pregnant women, the correlation between IgG in the maternal circulation and cord blood, and the correlation between circulating IgG, placental, and newborn infection (blood cord). METHOD OF STUDY: Serum samples and placental tissues from pregnant women and umbilical cord blood samples from their newborns were collected. Anti-HSV-2 antibodies were identified by ELISA, and HSV-2 DNA was detected by nested PCR. RESULTS: The seropositivity of IgG in pregnant women was 29.7% and IgM was detected in 1 woman (0.5%). In the umbilical cord of newborns, 33.1% were IgG-positive and IgM was detected in 2 samples (1.5%). A positive correlation between HSV-2 IgG titers in serum from pregnant women and cord blood samples was found (r = .36, P = .001). A difference between the positive and negative placental groups (maternal side) was found in titers of IgG in sera of umbilical cord, which were significantly higher in the positive placental group (P = .004). CONCLUSION: We describe for the first time that newborns from mothers with HSV-2 placental infection have higher IgG titers in sera of umbilical cord, suggesting IgGs antibodies can be indicative of placental viral infection in asymptomatic women.


Assuntos
Sangue Fetal/imunologia , Herpes Genital/imunologia , Herpesvirus Humano 2/fisiologia , Placenta/virologia , Cordão Umbilical/imunologia , Adulto , Anticorpos Antivirais/sangue , Doenças Assintomáticas , Feminino , Humanos , Imunoglobulina G/sangue , Recém-Nascido , Masculino , Placenta/imunologia , Gravidez , Ativação Viral
20.
Cien Saude Colet ; 22(12): 4073-4082, 2017 Dec.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29267724

RESUMO

The objective of this study was to evaluate women's knowledge of methods for screening breast cancer. The study was done on a population of women aged 18 or over in the city of Rio Grande between April and November 2011. Interviewers used questionnaires on all of the women at selected households. Models were developed for every type of screening (self-examination of breasts, mammography, and clinical exams) that were analyzed through the use of Poisson regression. Out of the 1596 women interviewed, 1355 reported self-examination, 456, mammography, and only 191, clinical examination of the breast, performed by a health professional, as important for the prevention of breast cancer. White women with 11 years or more worth of schooling had a greater probability of having mammography exams and clinical examinations as methods for screening. We noted, linked to the aforementioned, that there was a linear tendency whereby there was a greater probability for those with high incomes to undergo one of the above interventions. The study noted that there was a need for more detailed information aimed at the population on prevention methods in order to avoid late diagnosis. We noted that non-white women with little education and on low incomes showed less knowledge of clinical examination methods and mammographies.


Assuntos
Neoplasias da Mama/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Mamografia/métodos , Programas de Rastreamento/métodos , Adulto , Idoso , Brasil , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer/métodos , Escolaridade , Feminino , Humanos , Renda , Pessoa de Meia-Idade , Distribuição de Poisson , Prevenção Secundária/métodos , Fatores Socioeconômicos , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...