Predictors associated with sickle cell nephropathy: a systematic review

SUMMARY INTRODUCTION: Sickle cell anemia affects more than 30 million people worldwide. Chronic kidney disease develops in 40% of individuals. The death rate of patients with sickle nephropathy is still high, with little known predictors related to its development. To answer the question "What predictors are associated with the onset of chronic kidney disease in patients with sickle cell anemia?", this article seeks to contribute to a better understanding of sickle nephropathy, making possible a new look at the sickle cell anemia and its kidney complications. METHODS: A systematic review was developed, using the PRISMA recommendation, for cohort studies on predictors related to the outcome of sickle nephropathy in patients with sickle cell anemia. RESULTS: Initially 321 studies were identified in Pubmed, of which six were selected to compose this systematic review. Lower hemoglobin levels, increased ages and albuminuria were the most pointed predictors associated with chronic kidney disease. CONCLUSION: The main predictors associated with the development of chronic kidney disease in individuals with sickle cell anemia were lower hemoglobin levels, increased ages, and albuminuria. New studies evaluating predictors for the development of chronic kidney disease in sickle cell anemia are needed to better understand its installation and prevent its progression.

Factors associated with providing social security benefits for traumatic brain injury resulting from occupational accidents / Fatores associados à concessão de benefício previdenciário por traumatismo cranioencefálico decorrente de acidente de trabalho

INTRODUCTION: The Occupational Accident (OA) is considered to be an important public health problem in Brazil. Traumatic Brain Injury (TBI) is the most common among them. The TBI is associated with high morbidity and mortality rates among workers. OBJECTIVE: To identify factors associated with providing social security benefits for TBI due to occupational accidents according to the specific type of economic activity in Brazil, in 2009. METHODS: This is a cross-sectional study that was conducted with all workers who were part of the General Regime of Social Security (RGPS) of Brazil. Secondary data were obtained from the National Information System Benefit, from the Synchronized National Register of the Ministry of Finance and from the General Register of Employed and Unemployed Persons. Data were analyzed using the multiple logistic regression method. RESULTS: We analyzed 2,006 cases of social security benefits for traumatic brain injury due to Occupational Accident. Factors associated with the concession of the benefit according to the economic activity of the Company of the beneficiary were identified. Associations were found with sex, income and the region of the Company. CONCLUSION: Factors associated with the concession of social security benefits by TBI resulting from OA differ depending on the type of economic activity in the study. Understanding these factors may contribute to the planning of preventive policies. .

INTRODUÇÃO: O Acidente de Trabalho (AT) é considerado um importante agravo à saúde do trabalhador no Brasil, sendo o Traumatismo Cranioencefálico (TCE) o mais comum dentre eles. O TCE está associado a altas taxas de morbidade e mortalidade entre trabalhadores. OBJETIVO: Verificar os fatores associados à concessão de benefícios previdenciários por TCE decorrentes de acidente de trabalho de acordo com o ramo de atividade econômica específica, no Brasil, em 2009. MÉTODOS: Trata-se de estudo epidemiológico de corte transversal que foi conduzido com todos os trabalhadores que integram o Regime Geral da Previdência Social (RGPS) do Brasil. Dados secundários foram obtidos do Sistema Único de Informações de Benefícios, do Cadastro Sincronizado Nacional do Ministério da Fazenda e do Cadastro Geral de Empregados e Desempregados e analisados utilizando-se regressão logística múltipla. RESULTADOS: Foram analisados 2.006 casos de benefícios previdenciários por TCE decorrentes de AT no Brasil, e identificaram-se fatores associados à concessão do benefício diferenciados de acordo com a seção da Classificação Nacional de Atividades Econômicas à qual o beneficiário estava vinculado. Foram encontradas associações com o sexo, a renda e a região da empresa. CONCLUSÃO: Os fatores associados à concessão de benefícios previdenciários por TCE decorrentes de AT diferem a depender da CNAE em estudo. A compreensão desses fatores poderá contribuir com o planejamento de políticas públicas de caráter preventivo. .

Representações sociais da descentralização do sus: perspectivas dos gestores municipais de saúde de Goiânia, Brasil / Social representations of sus decentralization: municipal health managers perspectives in the city of Goiania, Brazil

O processo de descentralização, entendido como desconcentração, devolução ou delegação, surge como ferramenta da administração pública e passa a constituir-se como obrigatoriedade para o setor de saúde. O Sistema Único de Saúde (SUS), teoricamente,enquadra-se na devolução. Este estudo teve como objetivo conhecer e analisar elementos das representações sociais dos gestores municipais de saúde de Goiânia sobre a descentralização do SUS. Trata-se de investigação de campo, descritiva, com abordagem qualitativa, a qual utiliza a Teoria das Representações Sociais (TRS) como marco teórico metodológico. Na coleta de dados utilizaram-se o formulário para registro demográfico, socioeconômico e cultural e a entrevista semi estruturada. Emergiu um eixo com seis classes, possibilitando a identificação de que os gestores desconhecem a definição de descentralização, o que corrobora a ineficácia de sua atuação em seu âmbito de gerenciamento. A atuação competente está intimamente relacionada ao conhecimento, sugerindo que a implantação de cursos de aperfeiçoamento, especialização e capacitação dirigidos aos gestores, com abordagem teórica desta temática,faz-se necessária.

The decentralization process began as a public administration tool and turned out to be compulsory to it. The decentralization process can be understood as deconcentration, devolution or even as delegation. SUS (Unified Health Service in Brazil), theoretically, answers the requirements of devolution. This study intended to learn and analyze some social representative elements of municipal health managers in the city of Goiânia-Go/Brazil. It focused the SUS decentralization process. It shows a practical investigation based on a qualitative approach, by using the TRS (Social Representative Theories) as a methodological and theoretical framework. The data were collected by the filling out of a cultural and socioeconomic protocol used for demographic registers and by interviews. These interviews were, partially, prepared in advance. The universe of this study was composed by 16 (sixteen) managers, half of them being district directors. The reminders were directors of some health basic unities. All of them, however, were working as managers in October/2007. HAMLET® software was used to analyze the results. An axis with six classes emerged, and it was possible to identify that managers had no knowledge, indeed, of the decentralization concept. It was also inferred that the lack of this knowledge was responsible for their inefficacious performances in their functions. The desired result is closely related to an actual knowledge of what decentralization is, suggesting then the need of courses - presenting a theoretical approach of the decentralization concept - to qualify the SUS managers.