Navegando por Assunto "Fatores de risco"

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Análise de componentes principais de variáveis nutricionais e de polimorfismos nos genes MDM2, XRCC1 E MTHFR como fatores de risco para Carcinoma Hepatocelular em pacientes com Hepatite C Crônica
(Universidade Federal do Pará, 2016-03-16) PINHO, Priscila Matos de; DEMACHKI, Samia; http://lattes.cnpq.br/7568391537270652; ARAÚJO, Marília de Souza; http://lattes.cnpq.br/9371703949781020
Introduction: Liver diseases are among the leading causes of morbidity and mortality in the world. Hepatitis C is present in approximately 20% of cases of acute hepatitis and 70% of cases of chronic hepatitis. E has been associated with the presence of accumulation of intrahepatic lipids (fatty liver) and it often progresses to development of liver cirrhosis and hepatocellular carcinoma (HCC) is the leading cause of liver transplantation. Objective: To evaluate the relationship of nutritional variables and polymorphisms of MDM2 gene, MTHFR and XRCC1 with risk to HCC in patients with chronic hepatitis C. Methods: case - control performed with patients with chronic hepatitis C. Cases were patients with chronic HCV infection, those with positive anti-HCV and HCV-RNA for six months or more since the detection of the infection within the clinical presentation parameters. They considered participants in the control group healthy subjects aged> 20 years, of both sexes. They were invited to participate in the voluntary survey. We used a nutritional assessment questionnaire. The presence of MDM2 polymorphisms (rs3730485) was investigated; XRCC1 (rs3213239) and MTHFR (rs1801133). It used the Fisher's exact test, odds ratio, and analysis of Principal Components. Results: For genotyping, it was found similarity in frequency of polymorphisms of MTHFR genes XRCC1 and MDM2 in both groups. The odds ratios that had significant p values were low fruit intake, physical inactivity and BMI> 25 kg / m². The results of principal component analysis are indicative that there are at least three pathophysiologic processes that operate in the cluster of risk factors for HCC, and are strongly related to body fat, alcohol consumption and low consumption of fruits. Conclusion: The patients evaluated aggregate risk factors for the development of HCC.
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Aumento do índice de massa corporal após os 20 anos de idade e associação com indicadores de risco ou de proteção para doenças crônicas não transmissíveis
(2009-12) COELHO, Mara Sérgia Pacheco Honório; ASSIS, Maria Alice Altenburg de; MOURA, Erly Catarina de
OBJECTIVE: To examine sociodemographic risk or protection factors for chronic non-communicable diseases (CNCDs) that may be associated with increase in body mass index (BMI) after the age of 20. METHODS: Cross-sectional analysis based on data from 769 women and 572 men who participated in the 2005 Surveillance System for Risk factors for CNCDs, Florianópolis, Brazil. BMI increase was defined in percentage as the difference between BMI in 2005 and at age 20. RESULTS: Since the age of 20, most of the respondents had increased their BMI by more than 10%. In multiples analysis, independent correlates of BMI increase were: advancing age, low education (women), being married (men), not working, low self-rated health, high blood pressure, high cholesterol/triglyceride levels (men), going on a diet, sedentarism and having been a smoker (women). CONCLUSIONS: Health promotion strategies to prevent weight gain need to be targeted to groups and should mainly consider sociodemographic factors.
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Desenvolvimento linguístico de crianças de Belém: associação com características pessoais e ambientais
(Universidade Federal do Pará, 2014-11-07) COSTA, Elson Ferreira; CAVALCANTE, Lília Iêda Chaves; http://lattes.cnpq.br/4743726124254735
This study aimed to analyze the profile neurodevelopmental status of children enrolled in preschools in Belém, with a focus in language, according to the Denver Developmental Screening Test (DDST), with this purpose, two studies, both quantitative and cross-sectional, with descriptive and exploratory were performed. The first one investigated the neurodevelopmental profile of children, according to their presence in the Administrative Districts of Belém. The score on DDST was assessed, and their neurodevelopmental status (normal or delay) and distribution on the districts were described. The second study examined the associations between the score of language, according to DDST, with the personal and contextual variables. For both studies, 319 children from elementary schools were selected, from August to December 2012. For assessment of development the DDST was applied. The instruments were a questionnaire administered to parents to collect personal, contextual and family data and an instrument to measure the level of family poverty. The results of the first study indicated that 77.7 % of potential developmental suspected delay and 59.2% of potential delay in language. The level of family poverty variable showed a statistically significant association with development score (p=0.011) and language (p=0.003). The results of the second study indicates that 59.2% delay were associated with language. The variables that showed a statistically significant relationship with language development were paternal education (p=0.003), maternal age (p=0.03) and family poverty level (p=0.003). The high prevalence of suspected delay in the development at the children highlights the need of implementation of programs to stimulated and monitor the infant development, using instruments such as the DDST. In addition, alert to the poses of risk factors that may interfere with the neurodevelopment in early years.
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Diagnóstico coproparasitológico e avaliação dos fatores de risco para infecção parasitária intestinal em uma comunidade ribeirinha do município de Belém-Pará, Brasil
(Universidade Federal do Pará, 2005-05-19) ESTEVES, Nelma Maria Rosa de Sousa; PÓVOA, Marinete Marins; http://lattes.cnpq.br/2256328599939923
The intestinal parasitosis are the most frequent diseases that infect the men, maily in undeveloped or on development countries, where, in general, the sanitation system do not exist or is under very bad condition. This study aims to determine the prevalence and identify the risk factors of each enteroparasitosis, on the population of the community of Jutuba Island, Belém city, Pará state. We had tested 109 stool samples using the following methods: direct and spontaneous sedimentation. He total prevalence found was 77,89% (85/109). Among the protozoas, the Entamoeba histolytica (49,41%) and among the helmints the ancilostomides (40%), Ascaris lumbricoides (29,41) and Trichiuris trichiura (24,71%) were the most frequent parasites. There was no statistical sigfnificance between parasitism and sex. The correlation between the parasitism by Giardia lamblia and age was significant (p < 0,05) for the children groups. The risk factors more important for the parasitic diseases for the population of Jutuba Island were the low lever of the economical situation, the lack of sanitation system, the intake of river water without any previous treatment and the intake of açaí juice in natura. The correlation between untreated water and intestinal parasitosis was no statistical significant. The odd rates index had showed that the açaí intake raises the chance of parasitism among the Jutuba Island population it is very important the action of the healthy authorities in order to provide to them the sanitary education since this is an important factor to help to control the parasitism reducing the prevalence of each parasite.
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Entre risco e proteção: eventos estressores no desenvolvimento de adolescentes e jovens estudantes de escolas públicas de Belém/PA
(Universidade Federal do Pará, 2018-03-06) SANTOS, Mateus Souza dos; SILVA, Lúcia Isabel da Conceição; http://lattes.cnpq.br/5758168217659420
This dissertation aims to understand the implications of exposure to stressful events in the lives of teenagers and young students in public schools and the possible interactions between risk factors (stressor events) and development protection factors. This is a multi-method research organized in two studies. The first one consists of a Systematic Review of Literature (SRL) on stressful events in the development of Brazilian children, teenagers and young people, whose aim was to construct a panorama of research on the subject. The articles were selected in the Portal of Periodicals of CAPES, SciELO and the Virtual Health Library - Brazil (VHL-BR), totalizing a set of 21 empirical articles. The results indicated the lack of productions on the subject in the North of Brazil and that the youth, as analytical category, is not so evidenced. The analysis of the research landscape indicated three investigative tendencies: the first one refers to the studies that deal with the implications of the stressor events in the development; the second relates to research that discusses these implications but relates them to other variables in order to identify the developmental outcomes of stress exposure; the third, and last, concerns the processes that can act as moderators between stressors and developmental outcomes. The second, quantitative-qualitative study was organized in two samples: the first (quantitative) sample consisted of 510 (five hundred and ten) students from 8 (eight) public schools in the city of Belém, of both sexes, with ages between 12 and 24 years, who responded to the Inventory of Stressful Events in Adolescence - IEEA; the second (qualitative) sample consisted of 1 (one) Dialogue Group - DG, with a total of 32 students from the 1st year of high school, held in one of the participating schools of the first stage of the research. The purpose of the DG was to understand perceptions, meanings and interactions between risk factors and protection in adolescence and youth. The results indicated a very diverse scenario of stressful events in which the participants were exposed, above all, in the family and school microsystems. The survey also identified strong impacts of sexual violence on development. As a protective factor, it was found that the relations of friendship had a very important moderating role in the face of these adversities. Finally, it was discussed the need of other protective processes to be potentialized and perceived by young people, especially in the family and at school, since there are stressors that need to be addressed in an articulated way with the help of these institutions.
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Epidemiologia da infecção genital pelo Papilomavírus humano (HPV) em população feminina geral e população carcerária
(Universidade Federal do Pará, 2012) PLÁCIDO, Waléria da Silva; QUARESMA, Juarez Antônio Simões; http://lattes.cnpq.br/3350166863853054
The genital infection by human papillomavirus (HPV) is considered a sexually transmitted diseases (STD) more common, representing an important problem in Public Health, in addition to being directly related to promotion of cervix cancer. This study was to investigate the epidemiological aspects of genital infection by HPV into two distinct groups: Women of general population and incarcerated women. For both a cross-sectional study was conducted analytical with 423 women from the age of 18 years who underwent preventive examination of cancer of the uterine cervix being 233 women of the general population from a basic health unit of the city of Belem and 190 from the Rehabilitation Center in female Ananindeua in the same State In the period from January 2008 to March 2010. Samples of the uterine cervix were collected for the achievement of conventional pap tests and for the detection of HPV DNA by polymerase chain reaction (PCR) mediated by oligonucleotide universal primers MY9/11. All the women answered a form clinical and epidemiological. Among the 423 women surveyed, the overall prevalence of genital infection by HPV was 13,0 % with a variation of 15,0 % for the general sample and 10,5 % for the prison. The most affected age group was 13 to 25 years (19 %) in the overall sample; And in women with 45 years or more (21,1 % ), in prison. Abnormalities Colpocitologics, marital status, number of new sexual partners the use of oral contraceptives, history of STDS and genital symptoms, in addition to current smoking, were factors that were associated with associated with genital HPV infection by Differently Between samples of the General Population and prison.
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ERICA: prevalence of metabolic syndrome in Brazilian adolescents
(Universidade Federal do Pará, 2016) KUSCHNIR, Maria Cristina Caetano; BLOCH, Katia Vergetti; SZKLO, Moyses; KLEIN, Carlos Henrique; BARUFALDI, Laura Augusta; ABREU, Gabriela de Azevedo; SCHAAN, Beatriz D'Agord; VEIGA, Gloria Valeria da; SILVA, Thiago Luiz Nogueira da; VASCONCELOS, Mauricio Teixeira Leite de; MORAES, Ana Júlia Pantoja de; OLIVEIRA, Ana Mayra Andrade de; TAVARES, Bruno Mendes; OLIVEIRA, Cecília Lacroix de; CUNHA, Cristiane de Freitas; GIANNINI, Denise Tavares; BELFORT, Dilson Rodrigues; SANTOS, Eduardo Lima; LEON, Elisa Brosina de; OLIVEIRA, Elizabete Regina Araújo; FUJIMORI, Elizabeth; BORGES, Ana Luiza Vilela; MAGLIANO, Erika da Silva; VASCONCELOS, Francisco de Assis Guedes; AZEVEDO, George Dantas de; BRUNKEN, Gisela Soares; GUIMARÃES, Isabel Cristina Britto; FARIA NETO, José Rocha; OLIVEIRA, Juliana Souza; CARVALHO, Kenia Mara Baiocchi de; GONÇALVES, Luis Gonzaga de Oliveira; MONTEIRO, Maria Inês; SANTOS, Marize Melo dos; MUNIZ, Pascoal Torres; JARDIM, Paulo César B. Veiga; FERREIRA, Pedro Antônio Muniz; MONTENEGRO JUNIOR, Renan Magalhães; GURGEL, Ricardo Queiroz; VIANNA, Rodrigo Pinheiro; VASCONCELOS, Sandra Mary Lima; MARTINS, Stella Maris Seixas; GOLDBERG, Tamara Beres Lederer
OBJECTIVE: To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS: We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS: Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS: ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome. DESCRIPTORS: Adolescent. Metabolic Syndrome, epidemiology. Risk Factors. Cardiovascular Diseases. Cross-Sectional Studies.
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A escola inclusiva enquanto contexto de desenvolvimento: um estudo dos fatores de risco e proteção
(Universidade Federal do Pará, 2012-02-17) FACIOLA, Rosana Assef; SILVA, Simone Souza da Costa; http://lattes.cnpq.br/9044423720257634; PONTES, Fernando Augusto Ramos; http://lattes.cnpq.br/1225408485576678
The set of the involved researches in this work tried to investigate the inclusive school while a developmental context, through four studies. These studies had been directed to discuss the risk or protective factors present in the inclusive school environment. The first study investigated the interactions between a student with visual impairment and her colleagues in an inclusive classroom, with the objective to investigate how the relations of friendship are established in this context of development; the second study tried to understand the vision of students with disabilities on their social support network; the third study aimed to analyze the vision of teachers and educational technician about the educational inclusion of students with disabilities in common classrooms; and the fourth study achieved an investigation on the conception of mothers of students with disabilities concerning the inclusive school with the objective to analyze how the protective and risk factors are configured inside of the inclusive school context. The bioecological model of the human development proposed by Bronfenbrenner is presented as the theoretical basis of this research that was accomplished through the naturalistic observation and the ecological insertion of the researcher in the research environment. The results of the researches had disclosed important questions and controversies on the process of educational inclusion.
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Estudo soroepidemiológico da infecção pelo vírus da hepatite B entre portadores do vírus da imunodeficiência humana/SIDA na cidade de Belém, Pará - Brasil
(Universidade Federal do Pará, 2004) MONTEIRO, Maria Rita de Cássia Costa; NASCIMENTO, Margarida Maria Passeri do; PASSOS, Afonso Dinis Costa; FIGUEIREDO, José Fernando de Castro
The objective of this investigation was to study the prevalence of hepatitis B virus infection in a sample of 406 adult patients with human immunodeficiency virus infection who attended at the public health care in the city of Belém, Pará, Brazil, as well as analyzing possible risk factors for hepatitis B virus infection. The overall prevalence of hepatitis B virus infection was 51% (CI: 46.1 - 55.8), with 7.9% (CI: 5.3 - 10.5) for HBsAg, 45.1% (CI: 40.3 - 49.9) for anti-HBc and 32.3% (CI: 27.5 - 36.8) for anti-HBs. After adjustment using logistic regression, hepatitis B serological markers were associated with the following variables: age, marital status and sexual preference. The frequency of hepatitis B markers was 28.7% in heterosexuals and 68.8% in homo/bisexuals (CI: 3.50 - 9.08; OR: 5.63; p=0.000). In married people the frequency was 31% and 58.7% in single people (CI: 1.29 - 3.63); OR: 2.16; p=0.003). Multivariate analysis showed no association between hepatitis B virus infection and illicit injectable drug use.
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Fatores de risco associados ao agravamento de sepse em pacientes em Unidade de Terapia Intensiva
(Universidade Federal do Pará, 2016-12) BARROS, Lea Lima dos Santos; MAIA, Cristiane do Socorro Ferraz; MONTEIRO, Marta Chagas
Introduction: sepsis is a serious public health problem, leading cause of death in Intensive Care Unit (ICU) worldwide. Objective: this study evaluated the aggravation and mortality of sepsis patients in ICU, relating to risk factors, different etiologies and therapies. Methodology: the study was observational descriptive, and evaluated the cases of sepsis (sepsis, severe sepsis and septic shock) from January 2009 to December 2010. Results: of the 212 patients hospitalized in ICU, 181 presented sepsis at different severities, whose sepsis mortality in the ICU was 63%, especially in patients with septic shock (53%), followed by severe sepsis (8.3%). Moreover, the risk factors associated with the aggravation of sepsis were older than 65 years, longer ICU hospitalization time, high frequency of comorbidities and the use of invasive procedures. The highest consumption of antibiotics was carbapenems, and the main isolated multiresistant strains were MRSA, VRE, P. aeruginosa and A. baumannii resistant to carbapenems. Conclusion: this study showed a high mortality from sepsis patients in the ICU, especially in patients with septic shock with comorbidities, who underwent invasive procedures and longer hospitalization time.
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Fatores de risco cardiovascular e fatores associados em escolares do Município de Belém, Pará, Brasil
(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2014-03) RIBAS, Simone Augusta; SILVA, Luiz Carlos Santana da
This cross-sectional study aimed to identify risk factors for cardiovascular disease in a stratified cluster sample of 557 schoolchildren (6-19 years) in Belém, Pará State, Brazil. Potential risk factors were obesity, hypertension, dyslipidemia, diabetes, smoking, physical inactivity, and atherogenic diet. Socio-demographic and lifestyle variables were tested in a binary logistic regression model. The most prevalent risk factors were overweight (20.4%), dyslipidemia (48.1%), and physical inactivity (66.2%). Children below ten years of age and those from higher-income families and with higher maternal schooling showed greater odds of developing overweight; meanwhile, those with overweight were more prone to developing hypercholesterolemia and hypertriglyceridemia. The findings point to the need to implement strategies to prevent overweight in early childhood, through balanced nutrition and regular physical activity, in order to effectively reduce the prevalence of risk factors in schoolchildren.
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Fatores de risco e proteção na escola: reprovação e expectativas de futuro de jovens paraenses
(2014-08) NUNES, Tatiene Germano Reis; PONTES, Fernando Augusto Ramos; SILVA, Lúcia Isabel da Conceição; DELL’AGLIO, Débora Dalbosco
In this study we investigate the relations existing amid school failure, perceptions concerning the school and expectations of future among young people, from data of a sample of 610 young people with ages between 14 and 24 years (m=16,56; dp=2,37), of both sexes, students from public schools of Belém city in Pará state. A questionnaire with 77 multiple choice questions was used. The results revealed that almost half of students already presented school failure, although they present good perception concerning the school. Correlations between school disapproval and low expectations of academic future and between good perceptions concerning the school and best academic expectations were observed. The expectation of having access to the university appeared more associated to female sex. The results may contribute to the understanding of the importance of the school in promoting protective factors in the learners development.
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Fatores de risco para pneumonia associada a ventilação mecânica: estudo de caso controle
(Universidade Federal do Pará, 2005) MARSOLA, Lourival Rodrigues; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care unit (ICU) patients. Understanding the risk factors for VAP can help to assess prognosis and devise and test preventive strategies. To identify the factors associated with development of VAP and its incidence, a restrospective non-matched case-control study was conducted in a 10-bed surgical-medical intensive care unit at a university hospital in Belém city, Brazil, from January 2003 to July 2004. The primary outcome measured was risk factors associated with VAP, which was defined according to The Centers for Diseases Control and Prevention. Demographic and time-dependent variables reflecting ventilation, nutrition, drug exposure, associated morbidities and invasive devices were analyzed. Twenty seven VAP patients and 27 controls were studied. Crude rate of pneumonia and incidence of VAP were, respectively, 10.6% and 12.3 episodes/1000 VM-days. The mean time for the onset of VAP was 14.29 ± 9.16 days. Mean ICU length of stay in patients with and without VAP were 34.2 ± 27.7 and 15.4 ± 13.6 days, respectively (p=0.003). Crude mortality was similar in both groups, 66.7% for cases and 55.6% for controls (OR=1.60; 95% confidence interval [CI] 0.53- 4.82; p=0.576). Univariate analysis demonstrated aerosol therapy (OR=4.75; p=0.01) and neuromuscular blockade (OR=8.61; p=0.003) associated with higher risk of VAP. In summary, neuromuscular blockade and aerosol therapy were associated with an increased risk for the development of ventilator-associated pneumonia and both are potentially modifiable risk factors.
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Freqüência de hipertensão arterial e fatores associados: Brasil, 2006
(2009-11) FERREIRA, Sandra Roberta Gouvea; MOURA, Erly Catarina de; MALTA, Deborah Carvalho; SARNO, Flávio
OBJECTIVE: To analyze the frequency of self-reported systemic arterial hypertension and associated factors. METHODS: Study based on data provided by the system of Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL - Telephone-based surveillance of risk and protective factors for chronic diseases), collected in 2006 in Brazil's capitals and Federal District. The frequency of systemic arterial hypertension was estimated in 54,369 adults, stratified by sex, geographic region, sociodemographic and behavioral variables and self-reported morbidities. Crude odds ratios of hypertension were calculated, as well as odds ratios adjusted for the study's variables. RESULTS: The frequency of self-reported hypertension was 21.6%. It was higher among women (24.4% versus 18.4%), lower in the North and Central-West regions and higher in the Southeast region. The frequency of hypertension increased with age, decreased with level of schooling, was higher among blacks and widowed subjects, and lower among singles. The chance of hypertension, adjusted for confounding variables, was higher in subjects with overweight, diabetes, dyslipidemia and cardiovascular events. CONCLUSIONS: Around one fifth of the population reported suffering from systemic arterial hypertension. The high frequencies of modifiable risk factors indicate the population segments on which intervention should be targeted, aiming to prevent and control hypertension.
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ICB/PPGBAIP Estudo da ocorrência e perfil de suscetibilidade aos antimicrobianos de Staphylococcus aureus isolados de pacientes e profissionais de saúde na Unidade de Terapia Intensiva de hospital público de Rio Branco-AC
(Universidade Federal do Pará, 2011-02-07) LAVIOLA GARCÊZ, Poliana Torres; LOUREIRO, Edvaldo Carlos Brito; http://lattes.cnpq.br/2685418720563351
The nosocomial infection is a serious public health problem worldwide, mainly in patients admitted to the Intensive Care Unit, which are subject to greater risk due to the severity of clinical symptoms, constant use of broad spectrum antibiotics and frequency of use of invasive procedures. Staphylococcus aureus is a major pathogen that colonizes healthy individuals and is also responsible for infections in hospitalized patients. This study aimed to identify the resistance profile, main sites affected by infection and possible risk factors associated with infection or colonization by S. aureus isolated from patients and healthcare professionals from the Intensive Care Unit of Hospital Emergency and Emergency, Rio Branco (HUERB) – Acre. We developed a cross-sectional study, conducted between January to August 2009. To search for carriers, biological samples were collected from microbiota of patients and professionals and professionals hand washing. For a survey of cases of patients with nosocomial infection were collected biological samples from sites suspected of being affected, 72 hours from the date of admission until discharge, transfer or death. Of the 62 patients enrolled in the study, 19.3% were carriers and 6.4% developed nosocomial infections by S. aureus, and 35 professionals, 28.6% were carriers of S. aureus. It was the second most bacterial species isolated from patients, and was the fifth most isolated from cases of nosocomial infection. There was no statistical evidence for the variable state of coma, use of invasive procedures and state of carrier patient are considered risk factors for acquiring nosocomial S. aureus in this study. The anatomical sites affected by IH by S. aureus were the respiratory tract ( n=2), followed by blood (n=1). The sample catheter tip was responsible for one insulated. One (1.6%) patient developed IH by MRSA, and 5 (8,1%) patients and 2 ( 5.7%) professionals were MRSA carriers, low occurrence as it relates to the results of the rest of Brazil and world. We also emphasize the incidence of MRSA over MSSA and low antomicrobial resistance of MRSA demonstrating that the UTI-HUERB, the IH S. aureus does not constitute a public health problem. There were no isolates of S. aureus resistant to vancomicina, wich can be considered a therapeutic option for cases of IH by MRSA. It is worth emphasizing the importance of this study in Acre State, for being the first of its kind in the UTI, involving S. aureus and MRSA.
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Infecção do trato urinário em crianças de um hospital público do Pará-Brasil: perfil clínico-epidemiológico e genotipagem dos uropatógenos
(Universidade Federal do Pará, 2009) LOPES, Cássia de Barros; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163; ISHIKAWA, Edna Aoba Yassui; http://lattes.cnpq.br/3074963539505872
Urinary Tract Infection (UTI) is one of the most common diseases of childhood and in 80 to 90% of the cases are caused by bacteria of Enterobacteriaceae family, especially Escherichia coli and Klebsiella pneumoniae, which have emerged in the worldwide as ESBL producer, one of the main mechanisms of bacterial resistance to extended-spectrum cephalosporins and monobactans. UTI prevalence in children, as well as another variable as gender, age, fever, most common bacteria, presence of vesicoureteral reflux (VUR) and of renal scars; were evaluated between January 2006 and March 2009, in a public hospital in Belém, northern Brazil. And in the period of April to August of 2009 isolates of E.coli and K.pneumoniae were obtained from the urine samples of children and evaluated phenotypically using the method automated of characterization of ESBL, Vitek2 system. PCR was used to determine whether the genes blaTEM, blaSHV and blaCTX-M1 were present ineach organism. There were 199 confirmed cases of UTI during the study period, 54.2% were female, 46.2% were under 02 years old, fever occurred in 37.3% of cases, VUR was identified in 38.6% of children with UTI and renal scarring in 38%, the most common bacteria was E.coli (60%). We isolated 43 samples (E.coli and K.pneumoniae, 74.4% and 25.6%, respectively), 95% were resistant to ampicillin and trimethoprim-sulfamethoxazole, 23.2% had ESBL phenotype. The blaCTX-M1 was the most prevalent gene, found in 19 strains, followed blaTEM (18 strains) and blaSHV (8 strains) genes. This study showed that bacteria with resistance profile of ESBL circulate in the hospital environment in Belém and the genes blaCTX-M1, blaTEM and blaSHV are present in E. coli and K. pneumoniae causing UTI in children in northern Brazil.
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Infecções da corrente sanguínea por Klebsiella spp. produtora de Betalactamase de espectro expandido em unidades de terapia intensiva neonatal de hospital de ensino no estado do Pará: fatores de risco para letalidade
(Universidade Federal do Pará, 2010) ESPÍNOLA, Débora Consuelo Santos Macêdo; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Extended-spectrum beta-lactamase-producing Klebsiella spp. has emerged as a common problem globally. However, data relative to the clinical and epidemiologic characteristics outcome in infected newborns due to for this ESBL-producing gram-negative bacterium of ESBL are still they are limited. A retrospective descriptive study that examined risk factors associated to letality for examined the analytical epidemiology of ESBL-producing Klebsiella spp. bloodstream infections (BSI) in the NICU of a teaching hospital in the state of Pará. A sample of 27 neonates were studied, most of the neonates were premature (77.8%), with mean gestational age 34 weeks, from 27 to 41 weeks. The BSI episodes were more common with infants weighing ≤ 1500 g (40.7%), and 14.8% below 1000g. The mean length of hospital stay was 40.51 days ranging from 5 to 101 days (SD = ± 29.61). The average time of onset of BSI was 12.2 days ranging from 5 to 24 days after the date of admission. Most infections were caused by bacteria of the species Klebsiella pneumoniae (52%). The overall mortality was found 66.7%, as for mortality related to BSI (up to 14 days of bacteremia), the fatality rate was 51.8% (14/27). The central vascular catheter (CVC) was present in about 60% of the RN and all the patients presented under mechanics ventilation at the moment of the episode of the BSI. Regarding the variables studied until the 14th day after the bacteremia episode, only the inappropriate treatment presented significance statistics (P < 0.0017), since all the newborn that had received inappropriate treatment had an unfavorable evolution. The nosocomial BSI due to caused ESBL-producing Klebsiella if have become a common problem in premature neonates RN with high raised mortality in those who that they received inappropriate antimicrobial treatment.
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Influências ambientais na saúde mental da criança
(2004-04) HALPERN, Ricardo; FIGUEIRAS, Amira Consuêlo de Melo
Objective: To present an up-to-date review about environmental influences on child mental health, describing major risk factors and discussing recommendations for intervention by pediatricians. Sources of data: MEDLINE, PsycLIT and Lilacs, technical books and publications about child development and child and adolescent mental health problems and health promotion. Summary of the findings: Children are exposed to multiple risk factors, among them high prevalence of disease, premature birth, being born from a problematic pregnancy, and living in poverty. This negative chain of events increases the risk for emotional problems. The negative effects on development and behavior result from the complex interaction between genetic, biological, psychological and environmental risk factors. The main factors influencing the mental health of children are the social and psychological environment. The cumulative risk effect is more important in determining emotional problems in children than the presence of one single stressor, regardless of its magnitude. Conclusion: Environmental factors play an important role in the etiology of emotional problems in childhood. An adequate clinical investigation allows pediatricians to identify risk factors for the development of mental health problems and to ensure early intervention for children at risk.
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Lipid profile and cardiovascular risk in two Amazonian populations
(2003-12) FEIO, Claudine Maria Alves; FONSECA, Francisco Antonio Helfenstein; RÊGO, Simone Soares; FEIO, Max Nazareno Barra; ELIAS, Maria Cristina; COSTA, Eduardo Augusto da Silva; IZAR, Maria Cristina de Oliveira; PAOLA, Ângelo Amato Vincenzo de; CARVALHO, Antônio Carlos de Camargo
OBJECTIVE: To compare the lipid profiles and coronary heart disease risks of 2 Brazilian Amazonian populations as follows: a riverside population (village of Vigia) and an urban population (city of Belém in the state of Pará). METHODS: Fifty individuals controlled for age and sex were assessed in each region, and the major risk factors for coronary heart disease were analyzed. RESULTS: According to the National Cholesterol Education Program (NCEP III) and using the Framingham score, both populations had the same absolute risk of events (Vigia = 5.4 ± 1 vs Belém = 5.7 ± 1), although the population of Vigia had a lower consumption of saturated fat (P<0.0001), a greater consumption of mono- and polyunsaturated fat (P<0.03), in addition to lower values for body mass index (25.4± 0.6 vs 27.6 ± 0.7 kg/m², P<0.02), of biceps skin fold (18.6 ± 1.1 vs 27.5 ± 1.3 mm, P<0.0001), of triceps skin fold (28.7 ± 1.2 vs 37.3 ± 1.7 mm, P<0.002), and of total cholesterol (205 ± 5 vs 223 ± 6 mg/dL, P< 0.03) and triglycerides (119 ± 9 vs 177 ± 18 mg/dL, P<0.005). Both populations did not differ in regard to HDL-C (46 ± 1 vs 46 ± 1 mg/dL), LDL-C (135 ± 4 vs 144 ± 5 mg/dL) and blood pressure (SBP 124 ± 3 vs 128 ± 3 mmHg; DBP 80 ± 2 vs 82 ± 2 mmHg). CONCLUSION: The riverside and urban populations of Amazonia had similar cardiovascular risks. However, the marked difference in the variables studied suggests that different strategies of prevention should be applied.
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Marcadores sorológicos da hepatite B em usuários de um Centro de Testagem para o HIV
(2001-02) MONTEIRO, Maria Rita de Cássia Costa; PASSOS, Afonso Dinis Costa; FIGUEIREDO, José Fernando de Castro; GASPAR, Ana Maria Coimbra; YOSHIDA, Clara Fumiko Tachibana
The objective of this investigation was to study the prevalence of serological markers of hepatitis B and possible risk factors for this disease in a sample of 404 people who attended a Testing and Couseling Center for HIV in the city of Ribeirão Preto, São Paulo State, Brazil. The overall prevalence of serologic hepatitis B markers was 14.6%, equal to that obtained for anti-HBc. HBsAg and anti-HBc IgM showed prevalences of 1%. After adjustment using logistic regression, hepatitis B markers showed association with the following variables: age, place of residence, use of injectable drugs and positivity to anti-HIV. The overall prevalence of human immunodeficiency virus infection was 6.9%. Hepatitis B markers were detected in 55.6% among intravenous drug users and in 42.9% among those who tested positive for HIV, confirming literature findings which indicates high levels of infection in these specific population groups.