Cross-cultural nursing care for immigrant women during pregnancy and childbirth: experiences and vulnerabilities.

OBJECTIVE: To understand the experiences and vulnerabilities for cross-cultural nursing care for immigrant women during pregnancy and delivery. METHOD: Exploratory, qualitative research, in the light of the Theory of Diversity and Universality of Cultural Care, in Foz do Iguaçu, Brazil, through interviews with eight postpartum woman and 18 nurses, between February and September 2022. The interpretation of meanings was adopted for analysis. RESULTS: The categories of analysis emerged: Experiences, vulnerabilities and acculturation of immigrant women during pregnancy and delivery; Cross-cultural care and vulnerabilities experienced by immigrants in Brazilian health services. Vulnerabilities were identified in Cultural and Social Structure Dimensions expressed in access to work, low socioeconomic conditions, lack of family and social support and specific services for this population. The potentialities experienced included good care provided by health services, quality of the multidisciplinary team and appreciation of professional knowledge, however, the understanding of expectations and cultural aspects needs to be deepened. FINAL CONSIDERATIONS: Understand that immigrant women experience situations of vulnerability in pregnancy and childbirth, in the Brazilian context, mainly related to social and programmatic dimensions. However, potentialities were also experienced, evidenced by positive aspects in cross-cultural nursing care in Brazil.

[Magnitude of mortality from cervical cancer in the Brazilian Northeast and socioeconomic factors]. / Magnitude da mortalidade por câncer do colo do útero na Região Nordeste do Brasil e fatores socioeconômicos.

OBJECTIVE: To analyze the time trend of cervical cancer mortality based on adjusted or unadjusted mortality data and to investigate the association between these data and socioeconomic indicators in women aged 20 years or older in the Brazilian Northeast (in capitals and non-capital cities) during the period from 1996 to 2005. METHODS: All deaths from cervical cancer recorded in the Brazilian Health Ministry's Mortality Data System (SIM) were included in the study. Also included were the cervical cancer deaths identified after the adjustment process. Simple linear regression was used to analyze the time trends for mortality and their correlations (Pearson) with selected socioeconomic indicators. RESULTS: The highest mortality coefficients with unadjusted data were observed in capitals and the lowest were observed in non-capital cities. Conversely, the highest mortality coefficients with adjusted data were observed in non-capital cities. Similarly, the lowest unadjusted mortality rates were observed in the states with the most poverty, illiteracy, fertility, and child mortality, whereas the highest unadjusted mortality rates were observed in the regions with the best social indicators. Adjusted mortality rates showed a negative association with the indicators describing better living conditions, and a positive association with the indicators describing worse living conditions. CONCLUSIONS: The use of unadjusted mortality data may lead to underestimation of cervical cancer rates and compromise the interpretations of comparative analyses of the magnitude, distribution, and factors associated with this disease. The magnitude of cervical cancer should be reassessed at least in the Brazilian Northeast. However, the findings show that positive results have been obtained with early detection efforts in Brazil.

Social support and cervical and breast cancer screening in Argentinean women from a rural population.

OBJECTIVE: To examine whether emotional social support influences the use of 3 cancer screening tests in females. DESIGN: Cross-sectional study. SAMPLE: Data were collected via a household survey of a random sample of 200 Argentinean women. MEASUREMENTS: The questionnaire included self-reported data about the cancer screening tests (Papanicolaou [Pap] test for cervical cancer, breast self-examination, and clinical examination for breast cancer), and socioeconomic background information. Social support was measured by the Duke-UNC-11 questionnaire. ANALYSIS: Logistic models were used to investigate the association between social support and cancer screening tests. RESULTS: Emotional social support was associated with having participated in Pap screening within 3 years before this study, but a link between social support and self or clinical breast examination was not supported. CONCLUSION: Emotional social support may play a role in early cervical cancer detection among Argentinean females, specifically by encouraging performance of the Pap test. The educational practices accomplished by nurses should include actions that involve the family and community; therefore, emphasizing the importance of social ties on health and promoting interactions between target women and existent social groups in the community.

Cross-cultural nursing care for immigrant women during pregnancy and childbirth: experiences and vulnerabilities / Cuidado transcultural de enfermería para la mujer inmigrante durante el embarazo y el parto: experiencias y vulnerabilidades / Cuidado transcultural de enfermagem à mulher imigrante na gestação e parto: experiências e vulnerabilidades

ABSTRACT Objective: To understand the experiences and vulnerabilities for cross-cultural nursing care for immigrant women during pregnancy and delivery. Method: Exploratory, qualitative research, in the light of the Theory of Diversity and Universality of Cultural Care, in Foz do Iguaçu, Brazil, through interviews with eight postpartum woman and 18 nurses, between February and September 2022. The interpretation of meanings was adopted for analysis. Results: The categories of analysis emerged: Experiences, vulnerabilities and acculturation of immigrant women during pregnancy and delivery; Cross-cultural care and vulnerabilities experienced by immigrants in Brazilian health services. Vulnerabilities were identified in Cultural and Social Structure Dimensions expressed in access to work, low socioeconomic conditions, lack of family and social support and specific services for this population. The potentialities experienced included good care provided by health services, quality of the multidisciplinary team and appreciation of professional knowledge, however, the understanding of expectations and cultural aspects needs to be deepened. Final considerations: Understand that immigrant women experience situations of vulnerability in pregnancy and childbirth, in the Brazilian context, mainly related to social and programmatic dimensions. However, potentialities were also experienced, evidenced by positive aspects in cross-cultural nursing care in Brazil.

RESUMEN Objetivo: Comprender las experiencias y vulnerabilidades de la atención de enfermería transcultural a mujeres inmigrantes durante el embarazo y parto. Método: Investigación cualitativa, exploratoria, basada en la Teoría de la Diversidad y Universalidad del Cuidado Cultural, realizada en Foz do Iguazú, Brasil, a través de entrevistas con ocho madres y 18 enfermeras, entre febrero/septiembre de 2022. Se adoptó la interpretación de significados para el análisis. Resultados: Emergieron las categorías de análisis: Experiencias, vulnerabilidades y aculturación de mujeres inmigrantes durante el embarazo y parto; Atención transcultural y vulnerabilidades vividas por inmigrantes en los servicios de salud brasileños. Se identificaron vulnerabilidades en las Dimensiones de Estructura Cultural y Social expresadas en acceso al trabajo, bajas condiciones socioeconómicas, falta de apoyo familiar y social y de servicios específicos para esta población. Las potencialidades vividas incluyeron: buena atención en los servicios de salud, calidad del equipo multidisciplinario y valoración del conocimiento profesional, sin embargo, es necesario profundizar la comprensión de las expectativas y los aspectos culturales. Consideraciones finales: Se entendió que las mujeres inmigrantes vivieron situaciones de vulnerabilidad durante el embarazo y el parto, en el contexto brasileño, principalmente relacionadas con dimensiones sociales y programáticas. Sin embargo, también se experimentaron potencialidades, evidenciadas por aspectos positivos en la atención de enfermería transcultural en Brasil.

RESUMO Objetivo: Compreender as experiências e as vulnerabilidades para o cuidado transcultural de enfermagem à mulher imigrante na gestação e parto. Método: Pesquisa exploratória, qualitativa, à luz da Teoria da Diversidade e Universalidade do Cuidado Cultural, realizada em Foz do Iguaçu, Brasil, mediante entrevistas com oito puérperas e 18 enfermeiros,entre fevereiro e setembro de 2022. Adotou-se, para análise, a interpretação de sentidos. Resultados: Emergiram as categorias: Experiências, vulnerabilidades e aculturação da mulher imigrante na gestação e parto; Cuidado transcultural e vulnerabilidades experienciadas pela imigrante em serviços de saúde brasileiros. Vulnerabilidades foram identificadas nas Dimensões Culturais e de Estrutura Social expressas no acesso ao trabalho, baixas condições socioeconômicas, falta de suporte familiar, social e serviços específicos para essa população. As potencialidades experienciadas incluíram: bom atendimento nos serviços de saúde, qualidade da equipe multiprofissional e valorização do saber profissional; entretanto a compreensão das expectativas e dos aspectos culturais precisam ser aprofundados. Considerações finais: Compreendeu-se que as mulheres imigrantes experienciaram situações de vulnerabilidade na gestação e parto, no contexto brasileiro, principalmente relacionadas às dimensões sociais e programáticas. Contudo, potencialidades também foram experienciadas, evidenciadas pelos aspectos positivos no cuidado transcultural de enfermagem no Brasil.

Mortalidad por Causas Externas en Estado de Paraná y Municipio de Foz de Iguazú, 1996 a 2016

RESUMEN Introducción: Las Causas Externas (CE) de morbilidad y mortalidad son identificadas como lesiones intencionales (homicidios, violencia, suicidios, privación o negligencia) y lesiones no intencionales (accidentes de transportes, ahogamientos, caídas, quemaduras, intoxicaciones accidentales, complicaciones de asistencias médicas, entre otros). Objetivo: analizar los casos de mortalidad por causas externas en el Estado de Paraná y Municipio de Foz de Iguazú en el periodo de 1996 a 2016. Metodología: Se realizó un estudio cuantitativo, observacional, ecológico descriptivo, retrospectivo donde se analizó los óbitos por causas externas en el Estado de Paraná y Municipio de Foz de Iguazú en el periodo de 1996 a 2016 entre hombres y mujeres. A partir de datos secundarios disponibles en el Departamento de Informática del Sistema Único de Salud (DATASUS). Resultados: Las tendencias de mortalidad por causas externas en el periodo de 1996 a 2016 en el Estado de Paraná fue estable y en el Municipio de Iguazú mostró disminución; el promedio en las tasas de mortalidad de 8,7 y 12,4 por 10.000 habitantes para Paraná y Foz de Iguazú respectivamente. Las causas más importantes de muerte en el inicio del estudio fueron Agresiones y Accidentes de Tránsitos tanto para Paraná como para Foz de Iguazú, con mayor índice en las edades de 15 a 29 años en ambos sexos, con diferencia al final del estudio donde la primera causa de muerte en hombres es agresiones con índices mayores en edades de 15 a 29 años y otras lesiones por accidentes en mujeres de 60 años y más. Conclusión: En los 21 años de estudios muestran que los hombres representan el mayor índice de óbitos por causas externas, las tasas de mortalidad por óbitos de causas externas siguen siendo alarmantes para el Estado de Paraná y principalmente para Foz de Iguazú, afectando mayormente a la población joven masculina en edad reproductiva y trabajadora.

ABSTRACT Introduction: External Causes (EC) of morbidity and mortality are identified as intentional injuries (homicides, violence, suicides, deprivation or negligence) and unintentional injuries (transport accidents, drowning, falls, burns, accidental poisoning, complications of medical assistance, among others). Objective: to analyze the cases of mortality due to external causes in the State of Paraná and Municipality of Foz do Iguaçu in the period from 1996 to 2016. Methodology: a quantitative, observational, descriptive ecological, retrospective study was conducted where the deaths due to external causes were analyzed in the State of Paraná and Municipality of Foz do Iguaçu in the period from 1996 to 2016 among men and women. From secondary data available in the Informatics Department of the Unified Health System (DATASUS). Results: The trends in mortality from external causes in the period from 1996 to 2016 in the State of Paraná was stable and in the Municipality of Iguaçu showed decrease; the average in mortality rates of 8.7 and 12.4 per 10,000 inhabitants for Paraná and Foz do Iguaçu respectively. The most important causes of death at the beginning of the study were assaults and traffic accidents for both Paraná and Foz do Iguaçu, with higher rates in ages 15 to 29 years in both sexes, with a difference at the end of the study where the first cause of death in men is assaults with higher rates in ages 15 to 29 years and other injuries due to accidents in women aged 60 years and over. Conclusion: In the 21 years of studies, men represent the highest rate of deaths due to external causes. Mortality rates for deaths due to external causes continue to be alarming for the State of Paraná and mainly for Foz do Iguaçu, affecting mostly the young male population of reproductive and working age.

HPV in women assisted by the Family Health Strategy.

OBJECTIVE: Estimate the prevalence of cervical HPV infection among women assisted by the Family Health Strategy and identify the factors related to the infection. METHODS: A cross-sectional study involving 2,076 women aged 20-59 years old residing in Juiz de Fora, State of Minas Gerais, who were asked to participate in an organized screening carried out in units were the Family Health Strategy had been implemented. Participants answered the standardized questionnaire and underwent a conventional cervical cytology test and HPV test for high oncogenic risk. Estimates of HPV infection prevalence were calculated according to selected characteristics referenced in the literature and related to socioeconomic status, reproductive health and lifestyle. RESULTS: The overall prevalence of HPV infection was 12.6% (95%CI 11.16-14.05). The prevalence for the pooled primer contained 12 oncogenic HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) was 8.6% (95%CI 7.3-9.77). In the multivariate analysis, it was observed that the following variables were significantly associated with a higher prevalence of HPV infection: marital status (single: adjusted PR = 1.40, 95%CI 1.07-1.8), alcohol consumption (any lifetime frequency: adjusted PR = 1.44, 95%CI 1.11-1.86) and number of lifetime sexual partners (≥ 3: adjusted PR = 1.35, 95%CI 1.04-1.74). CONCLUSIONS: The prevalence of HPV infection in the study population ranges from average to particularly high among young women. The prevalence of HPV16 and HPV18 infection is similar to the worldwide prevalence. Homogeneous distribution among the pooled primer types would precede the isolated infection by HPV18 in magnitude, which may be a difference greater than the one observed. The identification of high-risk oncogenic HPV prevalence may help identify women at higher risk of developing preneoplastic lesions.

A validação da informação autorreferida sobre realização do exame de Papanicolaou em mulheres assistidas na Atenção Primária à Saúde / Accuracy of self-reported pap test in women assisted in Primary Health Care

Contexto: As informações autorreferidas são comumente utilizadas em pesquisas para estimar a cobertura do exame de Papanicolaou. Entretanto, não foram identificados estudos brasileiros que avaliem sua acurácia, o que pode comprometer os resultados encontrados. Objetivo: Avaliar a acurácia da informação autorreferida sobre a realização do último exame de Papanicolaou em mulheres assistidas pela Estratégia de Saúde da Família (ESF). Métodos: A informação autorreferida sobre a realização do exame foi obtida em estudo transversal com mulheres de 20 a 59 anos atendidas em unidades com ESF, mediante aplicação de questionário. A informação padrão-ouro foi obtida por meio da busca de registros médicos de exames de Papanicolaou. A acurácia entre o padrão-ouro e o autorrelato foi analisada por meio do cálculo do percentual de informação autorreferida adequada, da sensibilidade, da especificidade e dos valores preditivos positivos e negativos. Resultados: Foram incluídas na análise 572 mulheres. O percentual de informação autorreferida adequada foi de 92,3%, sensibilidade de 98,2% (IC95% 96,5­99,1), especificidade de 52,0% (IC95% 40,1­63,8) e valores preditivos positivos e negativos, respectivamente, de 93,3% (IC95% 90,8­95,2) e 80,8% (IC95% 66,3­90,3). Ressalta- se que não foi encontrada diferença nas medidas de acurácia em função das variáveis sociodemográficas. Conclusão: A partir dos dados apresentados, pode-se dizer que a informação autorreferida sobre realização do exame de Papanicolaou apresentou medidas de acurácia que garantem a credibilidade da informação e respaldam o uso do autorrelato na avaliação da cobertura do exame e programação do próximo exame de rastreio.

Context: Self-reported information is commonly used in surveys to estimate coverage of the Pap Test. However, it was not found in Brazil studies that evaluated the accuracy of self-report. Objective: To assess the accuracy of self-reported cervical cancer screening in women assisted in Primary Health Care. Methods: The self-reported information about the test was obtained in a cross-sectional study with women aged 20 to 59 years old who attended Primary Health Care units, using a questionnaire. The gold-standard information was obtained through the search in medical records of Pap smears. The validity of the self-report was analyzed by calculating the percentage of adequate self-reported information, sensitivity, specificity, and positive and negative predict values. Results: A total of 572 women were included in the analysis. The percentage of adequate self-reported information was 92.3%, with sensitivity of 98.2% (95% CI 96.5 to 99.1), specificity of 52.0% (95% CI 40.1 to 63.8) and positive and negative predict values, respectively, of 93.3% (95% CI: 90.8-95.2) and 80.8% (95% CI: 66.3-90.3). No difference was found in validity measures between sociodemographics characteristics. Conclusion: The self- reported cervical cancer screening showed validity measures that guarantee the credibility of the information and supports the use of self-report in the evaluation of the exam coverage and in the scheduling of the next Pap test.

[Knowledge, attitudes and practice related to Papanicolaou smear test among Argentina's women]. / Conhecimentos, atitudes e prática do exame de Papanicolaou entre mulheres argentinas.

OBJECTIVES: To evaluate the knowledge, attitudes, and practice regarding the Papanicolaou test in an Argentinean community. METHODS: Two hundred women were interviewed at their homes in Puerto Leoni, Misiones, Argentina. Women were selected by simple random sampling. Answers were described in terms of knowledge, attitudes, and practice, ant their respective adequacies with respect to the Papanicolaou test, as previously defined. Adequacy was compared between the categories of the control variables by chi2 test with a 5% significance level. RESULTS: Knowledge and practice of the Papanicolaou test were adequate in 49.5% and 30.5% of subjects, respectively, although the attitude towards the test was considered adequate in 80.5% of subjects. Another important finding was that women reported as the main reason for not undergoing the test the lack of a request by a physician or healthcare professional. CONCLUSIONS: Our results show a need for increasing the information provided to the public, especially by healthcare services and professionals, thus generating knowledge among the population of the advantages and benefits of Papanicolaou testing.

Intervenciones salubristas adoptadas por la República de Costa Rica durante la epidemia de la COVID-19 / Sanitary interventions adopted by the Republic of Costa Rica during the COVID-19 epidemic

RESUMEN Introducción: Las crisis epidémicas se caracterizan por el surgimiento de enfermedades altamente transmisibles y contagiosas, cuya rápida capacidad de distribución geoespacial, genera un índice importante de morbilidad. Objetivo: Analizar las principales intervenciones salubristas adoptadas por la República de Costa Rica, en el marco del combate y prevención de la epidemia por la COVID-19, durante el primer semestre del año 2020. Métodos: Se realizó un estudio de análisis documental, con abordaje cualitativo y analítico-descriptivo. Se realizó lectura integral de lineamientos nacionales específicos; comunicaciones de prensa; boletines epidemiológicos; normativa sanitaria específica para la COVID-19, estrategias, guías y recomendaciones y protocolos sectoriales. Conclusiones: Las intervenciones salubristas adoptadas por la República de Costa Rica brindan las capacidades necesarias para que el sistema público de salud consiga atender las necesidades específicas de su población durante la crisis epidémica. El plan estratégico presentado por el Ministerio de Salud se muestra como una respuesta activa al combate y prevención de la COVID-19, con enfoque en las formas de contención. Las guías, orientaciones, lineamientos y protocolos específicos reafirman el compromiso estatal de cuidar y promover la salud de sus ciudadanos, aún en tiempos inciertos de crisis epidémica.

ABSTRACT Introduction: Epidemic crisis are characterized by the emergence of highly transmissible and contagious diseases which their quick ability of geospatial distribution generate an important morbility rate. Objective: To analyze the main sanitary interventions adopted by the Republic of Costa Rica within the framework of COVID-19 fighting and prevention during the first semester of 2020. Methods: It was conducted a study of documental analysis with qualitative and analytic-descriptive approach. It was made a comprehensive reading of the specific national guidelines, press communications, epidemiologic reports, specific sanitary regulations for COVID-19, strategies, guides and recommendations, and sectorial protocols. Conclusions: The sanitary interventions implemented in the Republic of Costa Rica offer the needed capacities for the public health system to attend the specific needs of the population during the epidemic crisis. The strategic plan presented by the Ministry of Health stands as an active response to the fight and prevention of COVID-19 focused in limiting forms. Guides, directions, guidelines and specific protocols reinforce the state commitment of caring and promoting health of their citizens, even in uncertain times of epidemiologic crisis.

Disparities in cervical and breast cancer mortality in Brazil.

OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson's correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment. 

Prevalência de depressão e fatores associados em mulheres atendidas pela Estratégia de Saúde da Família / Prevalence of depression and associated factors in women covered by Family Health Strategy

RESUMO Objetivo Avaliar a prevalência de depressão e os fatores associados em mulheres de 20 a 59 anos de áreas cobertas pela Estratégia de Saúde da Família de município da Zona da Mata Mineira. Métodos Trata-se de um estudo transversal, com mulheres de 20 a 59 anos cadastradas em duas Unidades de Saúde da Família, que utilizou um questionário contendo variáveis sociodemográficas, apoio social, autoavaliação de estado de saúde, estilo de vida, morbidade e saúde da mulher. O desfecho depressão foi avaliado segundo o Patients Health Questionnaire-9 (PHQ-9). Resultados Das 1.958 mulheres incluídas nesta análise, 28,5% encontram-se na faixa etária entre 30 e 39 anos; 15,4% não concluíram o ensino elementar; 54,5% não trabalham ou nunca trabalharam; 44,2% declararam não ser da raça branca. Fatores associados à ocorrência de depressão na população estudada: possuir baixa escolaridade, trabalhar atualmente e ter doença mental prévia. Como fatores de proteção observaram-se: ser casada ou viver com companheiro, realizar atividades físicas regularmente e relatar autoavaliação positiva de saúde. Conclusão Os resultados deste estudo revelam prevalência de depressão de 19,7% nas mulheres de 20 a 59 anos de áreas cobertas pela Estratégia de Saúde da Família, apontando para a necessidade de um cuidado especial na atenção primária à saúde às mulheres com baixa escolaridade, que trabalham, apresentam doença mental e não praticam exercícios físicos, de modo que se possa reduzir o sofrimento e promover a saúde. Ressalta-se a lacuna na utilização de instrumentos de rastreamento dos casos de depressão na atenção primária.

ABSTRACT Objective To assess the prevalence of depression and its associated factors in women aged 20 to 59 years at some areas with the coverage of Family Health Strategy in a city located at Zona da Mata Mineira. Methods It is a cross-sectional study with women aged 20-59 enrolled in two Primary Health Care Units making use of a questionnaire containing socio-demographic variables, social support, self-assessment of general health status, lifestyle, morbidity and women's health. Depression was evaluated according to Patients Health Questionnaire-9 (PHQ-9). Results From 1,958 women included in this analysis, 28,5% are aged 30-39; 15,4% did not finish High School; 54,5% do not work or have never worked and 44,2% defined themselves as not white. Factors associated with depression episodes in the population studied: lower educational background, currently having a job, previous diagnosis of psychiatric disorders. Protective factors which were observed: being married or living with a partner, practicing physical activities in a regular basis and reporting positive self-assessed health. Conclusion The results of this study reveal a prevalence of depression of 19.7% in women aged 20 to 59 years covered by the Family Health Strategy, pointing to the need for special care in primary health care for women with low schooling, who work, have mental illness, and do not exercise so that they can reduce suffering and promote health. It was observed a significant gap related to managing specific tools designed to screening depressive episodes in primary care.

Tendência da Mortalidade por Câncer Colorretal no Estado do Paraná e no Município de Foz do Iguaçu, 1980 a 2013 / Trends in Colorectal Cancer Mortality in the State of Parana and the City of Foz do Iguaçu, 1980 to 2013 / Tendencia de la Mortalidad por Cáncer Colorrectal en el Estado de Paraná y en el Municipio de Foz do Iguaçu, 1980 a 2013

Introdução: O câncer colorretal tem expressão epidemiológica em várias regiões do mundo. Objetivo: Analisar a tendência da mortalidade por câncer colorretal no Estado do Paraná e no município de Foz do Iguaçu, no período de 1980 a 2013. Método: Estudo ecológico de série temporal. Os dados dos óbitos e da população foram obtidos do site do Departamento de Informática do Sistema Único de Saúde do Ministério da Saúde. Foram incluídos todos os óbitos classificados como câncer colorretal, segundo a codificação da nona e da décima Revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde. Foram analisados 17.271 óbitos de residentes no Estado; dos quais, 288 eram de residentes em Foz do Iguaçu. As taxas de mortalidade padronizadas foram calculadas pelo método direto de acordo com ano, grupo etário e sexo e analisadas por meio de regressão linear simples. Resultados: As taxas de mortalidade por câncer colorretal no período avaliado apresentaram tendência crescente no Estado do Paraná, com taxas superiores para os homens em comparação às mulheres. Tendência semelhante foi observada no município de Foz do Iguaçu. Conclusão: A partir da análise realizada, pode-se concluir que houve tendência de aumento da mortalidade por câncer colorretal tanto no Estado como no município, com coeficientes de mortalidade superiores para os homens em comparação às mulheres.

Introduction: Colorectal cancer has significant epidemiological importance in several regions of the world. Objective: The present study aimed to analyze the mortality trend of colorectal cancer in the state of Parana and the city of Foz do Iguaçu in the period of 1980 to 2013. Method: We conducted a ecological time series study on mortality for colorectal cancer. Data on deaths and population were obtained from the Department of Informatics of the Unified Health System of the Ministry of Health. All deaths classified as colorectal cancer were included in the study, according to the encoding of the ninth and tenth revision of the International Classification of Diseases. There were analyzed 17,271 deaths in the state of Paraná residents, which occurred in the selected period, of whom 288 were deaths in residents in Foz do Iguaçu. The standardized rates were calculated by the direct method according to year, age group and sex and analyzed by simple linear regression. Results: The results showed that colorectal cancer mortality rates in the evaluated period showed a growing trend in the State of Paraná, with higher rates for men compared to women. Was observed a similar trend in the city of Foz do Iguacu. Conclusion: Based on the analysis performed, we conclude that there was an increase in the mortality trend for colorectal cancer, both in the state and in the municipality, with higher mortality rates for men compared to women.

Introducción: El cáncer colorrectal tiene importancia epidemiológica expresiva en varias regiones del mundo. Objetivo: analizar la tendencia de mortalidad por cáncer colorrectal en el Estado de Paraná y en el municipio de Foz de Iguazú en el período de 1980 a 2013. Método: Fue realizado un estudio ecológico de serie temporal. Los datos sobre óbitos y población fueron obtenidos del sitio web del Departamento de informática del Sistema Único de Salud del Ministerio de la Salud. Fueron incluidos todos los óbitos clasificados como cáncer colorrectal, según la codificación de la Nona y Décima Revisión da Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados a la Salud. Fueron analizados 17.271 óbitos de residentes en el Estado, de los cuales 288 eran de residentes en Foz de Iguazú. Las tasas de mortalidad estandarizadas se calcularon por el método directo según el año, el grupo de edad y el género y se analizaron mediante una simple regresión lineal. Resultados: Las tasas de mortalidad por cáncer colorrectal en el período evaluado presentaron tendencias crecientes en el Estado de Paraná, con tasas superiores para hombres con relación a las mujeres, con tendencia semejante en el municipio de Foz de Iguazú. Conclusión: A partir del análisis realizado se puede concluir que hubo un aumento de la tendencia de mortalidad por cáncer colorrectal, tanto em el Estado como em el municipio, con coeficientes de mortalidad superiores para los hombres en comparación a las mujeres.

Conhecimentos e práticas sobre fatores de risco para doenças crônicas não transmissíveis, em idosos de um bairro de Foz do Iguaçu, Paraná, adscritos à estratégia saúde da família / Knowledge and practices regarding risk factors for chronic diseases in the elderly in a neighborhood of Foz do Iguaçu, Paraná, enrolled in the family health strategy

O impacto das doenças e agravos não transmissíveis sobre as sociedades humanas é crescente. As principais doenças deste grupo são as do aparelho circulatório, câncer, respiratórias crônicas, diabetes e musculoesqueléticas. São doenças multifatoriais relacionadas a fatores de riscos modificáveis, como o tabagismo, o consumo excessivo de bebidas alcoólicas, a obesidade, as dislipidemias, o consumo excessivo de sal, a ingestão insuficiente de frutas e verduras e a inatividade física. As doenças não transmissíveis incidem sobre a população adulta e, particularmente, sobre os idosos de modo mais intenso, trazendo consequências negativas para a qualidade de vida desse grupo e provocando maiores gastos com assistência hospitalar em saúde. Este estudo teve como principal objetivo avaliar os conhecimentos e práticas sobre fatores de riscos para doenças crônicas não transmissíveis, numa população idosa de um bairro de Foz do Iguaçu, Paraná, adscrita à estratégia Saúde da Família. Realizou-se um inquérito domiciliar com pessoas de 60 anos de idade ou mais residentes no bairro selecionado. A partir da listagem de idosos, selecionou-se uma amostra aleatória simples. Os dados foram digitados e analisados por meio do programa Epi Info 7.0, sendo submetidos a técnicas estatísticas exploratórias e de análise de associação. O conhecimento sobre os fatores de risco observado neste estudo é satisfatório (variando de 46.43% a 78.57%); porém, como tem sido discutido na literatura, o conhecimento nem sempre implica em uma prática efetiva, o que também é possível observar neste estudo. A prática adequada de alimentação, consumo de álcool, atividade física e tabagismo, no cotidiano das pessoas, vai além de ter ou não conhecimento. É preciso pensar nas ações de promoção da saúde, levando em conta as características da população idosa e as características da realidade nacional, para, assim, tentar garantir o entendimento de fato das informações a serem trabalhadas e a apropriação do conhecimento.

The impact of non-infectious diseases and disorders on human societies is increasing. The main diseases in this group are those of the circulatory system, cancer, chronic respiratory, diabetes, and musculoskeletal. These are multifactorial diseases related to modifiable risk factors such as smoking, excessive alcohol consumption, obesity, dyslipidemia, excessive salt intake, inadequate intake of fruit and vegetables, and physical inactivity. Non-infectious diseases afflict the adult population and particularly the elderly in a most intense way, producing negative consequences for the quality of life of this group and leading to higher spending on hospital health care. This study aimed to evaluate the knowledge and practices regarding risk factors for chronic non-infectious diseases in an elderly population of a neighborhood of Foz do Iguaçu, Paraná, enrolled in the Family Health Strategy. We conducted a household survey with people age 60 years or older living in that neighborhood. From this list of elderly persons, a simple random sample was selected. Data were entered and analyzed using the Epi Info 7.0 program, and analyzed using exploratory statistical techniques and association analysis. Knowledge of the risk factors observed in this study is satisfactory (ranging from 46.43% to 78.57%); however, as has been discussed in the literature, knowledge does not always imply an effective practice, which can likewise be observed in this study. Proper eating habits, alcohol consumption, physical activity, and smoking, as part of people's daily lives goes beyond whether or not they have knowledge. It is essential to think about health promotion actions taking into account the characteristics of the elderly population and of the national reality to thus try to ensure a genuine understanding of the information to be handled and the appropriation of knowledge.

HPV in women assisted by the Family Health Strategy / Infecção por HPV em mulheres atendidas pela Estratégia Saúde da Família

ABSTRACT OBJECTIVE Estimate the prevalence of cervical HPV infection among women assisted by the Family Health Strategy and identify the factors related to the infection. METHODS A cross-sectional study involving 2,076 women aged 20-59 years old residing in Juiz de Fora, State of Minas Gerais, who were asked to participate in an organized screening carried out in units were the Family Health Strategy had been implemented. Participants answered the standardized questionnaire and underwent a conventional cervical cytology test and HPV test for high oncogenic risk. Estimates of HPV infection prevalence were calculated according to selected characteristics referenced in the literature and related to socioeconomic status, reproductive health and lifestyle. RESULTS The overall prevalence of HPV infection was 12.6% (95%CI 11.16-14.05). The prevalence for the pooled primer contained 12 oncogenic HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) was 8.6% (95%CI 7.3-9.77). In the multivariate analysis, it was observed that the following variables were significantly associated with a higher prevalence of HPV infection: marital status (single: adjusted PR = 1.40, 95%CI 1.07-1.8), alcohol consumption (any lifetime frequency: adjusted PR = 1.44, 95%CI 1.11-1.86) and number of lifetime sexual partners (≥ 3: adjusted PR = 1.35, 95%CI 1.04-1.74). CONCLUSIONS The prevalence of HPV infection in the study population ranges from average to particularly high among young women. The prevalence of HPV16 and HPV18 infection is similar to the worldwide prevalence. Homogeneous distribution among the pooled primer types would precede the isolated infection by HPV18 in magnitude, which may be a difference greater than the one observed. The identification of high-risk oncogenic HPV prevalence may help identify women at higher risk of developing preneoplastic lesions.

RESUMO OBJETIVO Estimar a prevalência de infecção do colo do útero pelo HPV entre mulheres assistidas pela Estratégia Saúde da Família e identificar os fatores relacionados à infecção. MÉTODOS Trata-se de estudo transversal, no qual participaram 2.076 mulheres de 20 a 59 anos, residentes em Juiz de Fora, MG, convocadas para rastreamento organizado, realizado em unidades com a Estratégia Saúde da Família implantada. As participantes responderam ao questionário padronizado, realizando exame citológico cervical convencional e teste para HPV de alto risco oncogênico. Foram calculadas estimativas de prevalência de infecção pelo HPV segundo características selecionadas, referenciadas na literatura, relacionadas ao status socioeconômico, saúde reprodutiva e estilo de vida. RESULTADOS A prevalência global de infecção pelo HPV foi 12,6% (IC95% 11,16-14,05). A prevalência para o pooled primer contendo 12 tipos de HPV oncogênicos (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 e 68) foi 8,6% (IC95% 7,3-9,77). Na análise multivariada, observou-se que as seguintes variáveis estavam significativamente associadas a uma maior prevalência de infecção por HPV: estado conjugal (solteira: RP ajustada = 1,40; IC95% 1,07-1,8), consumo de bebidas alcoólicas (qualquer frequência durante a vida: RP ajustada = 1,44; IC95% 1,11-1,86) e número de parceiros sexuais ao longo da vida (≥ 3: RP ajustada = 1,35; IC95% 1,04-1,74). CONCLUSÕES A prevalência de infecção pelo HPV na população estudada varia de média a particularmente alta entre as mulheres jovens. A prevalência de infecção por HPV16 e HPV18 se assemelha às mundiais. Uma distribuição homogênea entre os tipos do pooled primer precederia a infecção isolada pelo HPV18 em magnitude, podendo ser a diferença maior que a observada. A identificação da prevalência de HPV de alto risco oncogênico pode auxiliar na identificação de mulheres sob maior risco de evolução para lesão preneoplásica.

Cancer mortality trends in Brazilian state capitals and other municipalities between 1980 and 2006.

OBJECTIVE: To analyze the corrected trend of overall cancer mortality and leading sites in the state capitals and other municipalities of Brazil between 1980 and 2006. METHODS: Data on deaths (n = 2,585,012) caused by cancer between 1980 and 2006 were obtained from Sistema de Informações sobre Mortalidade (Mortality Information System), and demographic data were provided by Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). The rates of overall cancer mortality and major types were corrected by proportionally redistributing 50% of ill-defined causes of death and standardizing them by age according to the standard world population. Trend curves for Brazil and its major regions were calculated for state capitals and other municipalities according to sex, and were evaluated by means of simple linear regression. RESULTS: Among men, ascending mortality rates were observed for lung, prostate and colorectal cancer; declining rates for stomach cancer; and stable rates for esophagus cancer. Among women, mortality from breast, lung and colorectal cancer increased, and the rates for cervical and stomach cancer declined. Mortality evolution varied across the regions of Brazil, with distinct patterns between state capitals and other municipalities. CONCLUSIONS: The correction of mortality rates based on redistribution of ill-defined causes of death increased the magnitude of the overall cancer mortality in Brazil by approximately 10% in 1980 and 5% in 2006. In the inland municipalities no decrease or stability was identified, differently from what was observed in the state capitals. Limited scope of prevention actions and lower access to services of cancer diagnosis and treatment for the population living away from large urban centers may partly explain these differences.

Correction for reported cervical cancer mortality data in Brazil, 1996-2005.

OBJECTIVE: To develop a methodology for correction of reported cervical cancer deaths in Brazil. METHODS: Data on 9,607,177 cancer deaths were obtained from the Brazilian National Mortality Database for the period between 1996 and 2005. For correction of underreporting of deaths, factors generated by the Global Burden of Disease Study in Brazil-1998 were used. Proportional distribution was used in order to correct the categories of unknown, incomplete or ill-defined death diagnosis. The corrections were applied to each Brazilian state and the results were presented for Brazil nationwide, macroregions, and geographical areas (capital, other cities of metropolitan areas and interior cities) as percent variability of cervical mortality rates before and after correction. Corrections were analyzed by multivariate linear regression with interaction terms between macroregion and geographical area. RESULTS: After correction, cervical cancer mortality rates showed an increment of 103% nationwide, ranging between 35% (Southern region capitals) and 339% (Northeastern region interior cities). The reallocation of cervical cancer deaths not otherwise specified resulted in greater mortality rate increments. The percent correction by year of death revealed steady trends nationwide. CONCLUSIONS: The study results showed that the proposed methodology was appropriate for the correction of cervical cancer mortality rates in Brazil. It evidenced that cervical cancer mortality is even higher than that reported.

Cervical cancer mortality trends in Brazil, 1981-2006.

The aim of this study was to describe cervical cancer mortality trends in Brazil for the period 1981-2006. Cervical cancer mortality was corrected on the basis of proportional redistribution of the deaths from "malignant neoplasm of uterus, part unspecified". Time trends were evaluated by means of simple linear regression. After correction, cervical cancer ranked second among the leading causes of death from cancer in the female population up to 2005, with a downward trend for the country as a whole, a decline in the State capitals, and a stable trend in the municipalities in the interior. A downward trend was confirmed in the State capitals in all geographic regions of the country. In the municipalities in the interior, there was an increase in the North and Northeast regions, a decline in the Southeast and South, and a stable trend in the Central-West. Although uneven, the decline began to take consistent shape in the country. Even better results could be achieved by investing in the expansion of screening coverage, especially among the populations at greatest risk.

Disparities in cervical and breast cancer mortality in Brazil / Os grandes contrastes na mortalidade por câncer do colo uterino e de mama no Brasil

OBJECTIVE To analyze cervical and breast cancer mortality in Brazil according to socioeconomic and welfare indicators. METHODS Data on breast and cervical cancer mortality covering a 30-year period (1980-2010) were analyzed. The data were obtained from the National Mortality Database, population data from the Brazilian Institute of Geography and Statistics database, and socioeconomic and welfare information from the Institute of Applied Economic Research. Moving averages were calculated, disaggregated by capital city and municipality. The annual percent change in mortality rates was estimated by segmented linear regression using the joinpoint method. Pearson’s correlation coefficients were conducted between average mortality rate at the end of the three-year period and selected indicators in the state capital and each Brazilian state. RESULTS There was a decline in cervical cancer mortality rates throughout the period studied, except in municipalities outside of the capitals in the North and Northeast. There was a decrease in breast cancer mortality in the capitals from the end of the 1990s onwards. Favorable socioeconomic indicators were inversely correlated with cervical cancer mortality. A strong direct correlation was found with favorable indicators and an inverse correlation with fertility rate and breast cancer mortality in inner cities. CONCLUSIONS There is an ongoing dynamic process of increased risk of cervical and breast cancer and attenuation of mortality because of increased, albeit unequal, access to and provision of screening, diagnosis and treatment.  .

OBJETIVO Analisar a evolução da mortalidade por câncer do colo uterino e de mama no Brasil, segundo indicadores socioeconômicos e assistenciais. MÉTODOS Foram analisados dados agregados de 30 anos (1980-2010) de mortalidade por câncer de mama e colo uterino. Os dados de óbitos foram extraídos do Sistema de Informações sobre Mortalidade, os denominadores populacionais, do Instituto Brasileiro de Geografia e Estatística, e os indicadores socioeconômicos e assistenciais do Instituto de Pesquisa Econômica e Aplicada. Foram calculadas as médias móveis desagregadas por capitais e municípios do interior dos estados. O percentual de mudança anual das taxas foi estimado a partir da regressão linear segmentada por joinpoint. Foi feita correlação de Pearson entre as taxas médias trienais do final do período e os indicadores selecionados das capitais e de cada estado brasileiro. RESULTADOS Houve queda da mortalidade por câncer do colo uterino em todo o período, exceto em municípios das regiões Norte e Nordeste fora das capitais. Houve declínio na mortalidade por câncer de mama nas capitais a partir do final da década de 1990. Os indicadores socioeconômicos positivos correlacionaram-se inversamente com a mortalidade de câncer do colo uterino. Observou-se forte correlação direta entre indicadores positivos e inversa com a taxa de fecundidade e a mortalidade por câncer de mama nos municípios do interior dos estados. CONCLUSÕES Encontra-se em curso um mecanismo dinâmico entre aumento de risco por câncer de mama e do colo uterino com atenuação da mortalidade em função da expansão de oferta e acesso ao rastreamento, diagnóstico e tratamento, porém de forma desigual. .

Tendência da mortalidade por câncer nas capitais e interior do Brasil entre 1980 e 2006 / Cancer mortality trends in Brazilian state capitals and other municipalities between 1980 and 2006 / Tendencia de la mortalidad por cáncer en las capitales e interior de Brasil entre 1980 y 2006

OBJETIVO: Analisar a tendência corrigida da mortalidade geral por câncer e principais tipos nas capitais e demais municípios do Brasil entre 1980 e 2006. MÉTODOS: Os dados sobre óbitos (n = 2.585.012) decorrentes de câncer entre 1980 e 2006 foram obtidos no Sistema de Informações sobre Mortalidade, e os demográficos, no Instituto Brasileiro de Geografia e Estatística. As taxas de mortalidade geral por câncer e principais tipos foram corrigidas redistribuindo proporcionalmente 50 por cento das mortes mal definidas e padronizando-as por idade segundo população padrão mundial. As curvas de tendência para o Brasil e grandes regiões foram calculadas para capitais e demais municípios segundo sexo e avaliadas por meio de regressão linear simples. RESULTADOS: Entre os homens, as taxas de mortalidade para os cânceres de pulmão, próstata e colo-retal foram ascendentes; declinantes para o de estômago e estáveis para o de esôfago. Entre as mulheres, houve aumento da mortalidade por câncer de mama, pulmão e colo-retal; e diminuição das taxas para os cânceres de colo do útero e de estômago. A evolução da mortalidade variou entre as regiões do País, com padrões distintos entre as capitais e demais municípios. CONCLUSÕES: A correção das taxas de mortalidade com redistribuição dos óbitos mal definidos aumentou a magnitude da mortalidade geral por câncer no Brasil em cerca de 10 por cento em 1980 e 5 por cento em 2006. Nos municípios do interior não se observou tendência à queda ou estabilidade como nas capitais. Menor alcance das ações de prevenção e a dificuldade de acesso a serviços de diagnóstico e tratamento para câncer para a população residente fora dos grandes centros urbanos podem explicar, em parte, essas diferenças.

OBJECTIVE: To analyze the corrected trend of overall cancer mortality and leading sites in the state capitals and other municipalities of Brazil between 1980 and 2006. METHODS: Data on deaths (n = 2,585,012) caused by cancer between 1980 and 2006 were obtained from Sistema de Informações sobre Mortalidade (Mortality Information System), and demographic data were provided by Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics). The rates of overall cancer mortality and major types were corrected by proportionally redistributing 50 percent of ill-defined causes of death and standardizing them by age according to the standard world population. Trend curves for Brazil and its major regions were calculated for state capitals and other municipalities according to sex, and were evaluated by means of simple linear regression. RESULTS: Among men, ascending mortality rates were observed for lung, prostate and colorectal cancer; declining rates for stomach cancer; and stable rates for esophagus cancer. Among women, mortality from breast, lung and colorectal cancer increased, and the rates for cervical and stomach cancer declined. Mortality evolution varied across the regions of Brazil, with distinct patterns between state capitals and other municipalities. CONCLUSIONS: The correction of mortality rates based on redistribution of ill-defined causes of death increased the magnitude of the overall cancer mortality in Brazil by approximately 10 percent in 1980 and 5 percent in 2006. In the inland municipalities no decrease or stability was identified, differently from what was observed in the state capitals. Limited scope of prevention actions and lower access to services of cancer diagnosis and treatment for the population living away from large urban centers may partly explain these differences.

OBJETIVO: Analizar la tendencia corregida de la mortalidad general por cáncer y principales tipos en las capitales y demás municipios de Brasil entre 1980 a 2006. MÉTODOS: Los datos sobre óbitos (n= 2.585.012) originados por cáncer entre 1980 y 2006 fueron obtenidos en el Sistema de Informaciones sobre Mortalidad, y los demográficos, en el Instituto Brasileño de Geografía y Estadística. Las tasas de mortalidad general por cáncer y principales tipos fueron corregidas redistribuyendo proporcionalmente 50 por ciento de las muertes mal definidas y estandarizándolas por edad según población patrón mundial. Las curvas de tendencia para Brasil y grandes regiones fueron calculadas para capitales y demás municipios según sexo y evaluadas por medio de regresión linear simple. RESULTADOS: Entre los hombres, las tasas de mortalidad para los cánceres de pulmón, próstata y colorrectal fueron ascendentes; declinantes para el de estomago y estables para el de esófago. Entre las mujeres, hubo aumento de la mortalidad por cáncer de mama, pulmón y colorrectal; y disminución de las tasas para los cánceres de cuello uterino y de estomago. La evolución de la mortalidad varió entre las regiones del País, con patrones distintos entre las capitales y demás municipios. CONCLUSIONES: La corrección de las tasas de mortalidad con redistribución de los óbitos mal definidos aumentó la magnitud de la mortalidad general por cáncer en Brasil en cerca de 10 por ciento en 1980 y 5 por ciento en 2006. En los municipios del interior no se observó tendencia de disminución o estabilidad como en las capitales. Menor alcance de las acciones de prevención y la dificultad de acceso a servicios diagnóstico y tratamiento para cáncer para la población residente fuera de los grandes centros urbanos pueden explicar, en parte, estas diferencias.

Avaliação da ocorrência de flebite, infiltração e extravasamento em neonatossubmetidos à terapia intravenosa / Assessment of phlebitis, infiltration and extravasation events in neonates submitted to intravenous therapy / Avaliacion de la ocurrencia de flebitis, infiltración y extravasamiento en neonatos submetidos a terapia intravenosa

O objetivo deste estudo foi descrever a ocorrência de flebite, infiltração e extravasamento em recém-nascidos internados na unidade de terapia intensiva neonatal de uma maternidade pública do Rio de Janeiro. Trata-se de um estudo quantitativo descritivo com 36 recém-nascidos em uso de terapia intravenosa e com indicação de remoção do dispositivo intravenoso periférico. Foram avaliados 50 sítios de punção imediatamente após a remoção de cateteres periféricos originando uma média de 1,40 punções venosas por neonato. As complicações foram responsáveis por 48% da remoção dos cateteres, antes da alta do tratamento, com predomínio de infiltração (79,2%), seguida por flebite (16,7%) e extravasamento (4,2%). A fim de se evitar os agravos e promover a segurança dos recém-nascidos submetidos à terapia intravenosa, a equipe de enfermagem deve avaliar periodicamente o acesso venoso periférico e obter conhecimento acerca das intervenções necessárias quando detectados sinais de complicações.

This study aimed to describe phlebitis, infiltration and extravasation events in newborn infants hospitalized at the neonatal intensive care unit of a public maternity in Rio de Janeiro, Brazil. A quantitative and descriptive study was carried out, involving 36 newborns under intravenous therapy and indicated for the removal of the peripheral intravenous device. Fifty puncture sites were assessed immediately after the peripheral catheter removal, resulting in an average 1.40 punctures per infant. Complications were responsible for 48% of catheter removals before discharge from treatment, predominantly infiltration (79.2%), followed by phlebitis (16.7%) and extravasation (4.2%). To avoid aggravations and enhance the security of newborns submitted to intravenous therapy, the nursing team should periodically assess the peripheral venous access and gain knowledge on interventions needed when signs of complications are detected.

El objetivo de este estudio fue describir la ocurrencia de flebitis, infiltración y extravasamiento en recién nacidos internados en la unidad de terapia intensiva neonatal de una maternidad pública de Rio de Janeiro. Se trata de un estudio cuantitativo descriptivo con 36 recién nacidos en uso de terapia intravenosa y con indicación de remoción del dispositivo intravenoso periférico. Fueron evaluados 50 sitios de punción inmediatamente después de la remoción de catéteres periféricos originando una media de 1,40 punciones venosas por neonato. Las complicaciones fueron responsables por 48% de las remociones de los catéteres, antes del alta del tratamiento, con predominio de infiltraciones (79,2%), seguida por flebitis (16,7%) e extravasamiento (4,2%). Con el fin de evitar los lesiones y promover la seguridad de los recién nacidos sometidos a terapia intravenosa, el equipo de enfermería debe evaluar periódicamente el acceso venoso periférico y obtener conocimiento acerca de las intervenciones necesarias cuando detectadas señales de complicaciones.