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RESUMO OBJETIVO Estimar a soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares de quatro a 14 anos de idade residentes no município de São Paulo, segundo variáveis clínicas, demográficas, epidemiológicas e sociais, durante o período de fechamento das escolas como medida de controle da covid-19. MÉTODOS Realizou-se um inquérito sorológico em setembro de 2020 com amostra aleatória estratificada por tipo de rede de ensino (pública municipal, pública estadual e privada). Foi coletada amostra de sangue venoso utilizando-se o teste de imunoensaio de fluxo lateral da fabricante Wondfo para detecção de anticorpos totais contra o vírus SARS-CoV-2. Aplicaram-se questionários semiestruturados para o levantamento de dados clínicos, demográficos, sociais e epidemiológicos. RESULTADOS A soroprevalência de anticorpos do vírus SARS-CoV-2 em escolares foi de 16,6% (IC95% 15,4–17,8). O estudo encontrou soroprevalências mais elevadas na rede pública municipal (18,5%; IC95% 16,6–20,6) e estadual (16,2%; IC95% 14,4–18,2) em relação à rede privada (11,7; IC95% 10,0–13,7) e entre escolares da raça/cor preta e parda (18,4%; IC95% 16,8–20,2) e no estrato social mais vulnerável (18,5%; IC95% 16,9–20,2). A pesquisa identificou menores soroprevalências nos escolares que relataram seguir as medidas recomendadas de proteção contra a covid-19. CONCLUSÃO A soroprevalência de anticorpos contra o vírus SARS-CoV-2 atinge principalmente os escolares socialmente mais vulneráveis. Este estudo pode contribuir para embasar políticas públicas que reforcem a importância da suspensão das aulas presenciais e da necessidade de estratégias de medidas de proteção e acompanhamento do status sorológico daqueles que ainda não foram contemplados no calendário vacinal.

ABSTRACT OBJECTIVE To estimate seroprevalence of SARS-CoV-2 antibodies in schoolchildren aged 4 to 14 years living in the city of São Paulo, according to clinical, demographic, epidemiological, and social variables, during the school closure period as a measure against covid-19 spread. METHODS A serological survey was made in September 2020 with a random sample stratified by school system (municipal public, state public and private) type. A venous blood sample was collected using the Wondfo SARS-CoV-2 Antibody Test (lateral flow method) for detection of total SARS-CoV-2 virus antibodies. Semi-structured questionnaires were applied to collect clinical, demographic, social, and epidemiological data. RESULTS Seroprevalence of SARS-CoV-2 antibodies in schoolchildren was of 16.6% (95%CI 15.4–17.8). The study found higher seroprevalence in the municipal (18.5%; 95%CI 16.6–20.6) and state (16.2%; 95%CI 14.4–18.2) public school systems compared to the private school system (11.7; 95%CI 10.0–13.7), among black and brown students (18.4%; 95%CI 16.8–20.2) and in the most vulnerable social stratum (18.5 %;95%CI 16.9–20.2). Lower seroprevalence was identified in schoolchildren who reported following the recommended protective measures against covid-19. CONCLUSION Seroprevalence of SARS-CoV-2 antibodies is found mainly in the most socially vulnerable schoolchildren. This study can contribute to support public policies that reinforce the importance of suspending face-to-face classes and developing strategies aimed at protective measures and monitoring of the serological status of those who have not yet been included in the vaccination schedule.

https://doi.org/10.11606/s1518-8787.2023057004782

Seroprevalence of SARS-CoV-2 antibodies in schoolchildren in the city of São Paulo, 2020
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Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Albuquerque, José Olimpio Moura de

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Sato, Ana Paula Sayuri

; Glasser, Paula Regina

; Pino, Francisco Alberto

; Burihan, Patrícia Carla Piragibe Ramos

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Cavazzana, Cinthya Luzia

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Caldeira, Luiz Artur Vieira

; Silva, Solange Maria Saboia e

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Mauro, Athenê Maria de Marco França

; Masi, Eduardo de

Revista de Saúde Pública

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2023, Volume 57 elocation 6s

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

https://doi.org/10.11606/s1518-8787.2023057004782

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Abstract: En | Text: En | PDF: En

ABSTRACT OBJECTIVE To estimate the evolution of the prevalence of SARS-CoV-2 virus infection among residents aged 18 years or over in the municipality of São Paulo. METHODS This is a population-based household survey conducted every 15 days, between June and September 2020, and January and February 2021. In total, the study comprised 11 phases. The presence of antibodies against SARS-CoV-2 was identified in venous blood using a lateral flow test, Wondfo Biotech. In the last phase, the researchers combined it with an immunoenzymatic test, Euroimmun. The participants also answered a semi-structured questionnaire on sociodemographic and economic factors, and on social distancing measures. Prevalence estimates and the 95% confidence interval were estimated according to regions, Human Development Index, sex, age group, ethnicity, education, income, and variables associated with risk or prevention of infection. To compare the frequencies among the categories of each variable, the chi-square test with Rao-Scott correction was used, considering a significance level of 5%. RESULTS In total, 23,397 individuals were interviewed and had their samples collected. The estimated prevalence of antibodies against SARS-CoV-2 ranged from 9.7% (95%CI: 7.9–11.8%) to 25.0% (95%CI: 21.7–28.7). The prevalence of individuals with antibodies against the virus was higher among black and brown people, people with lower schooling and income, and among residents of regions with lower Human Development Index. The lowest prevalences were associated with recommended measures of disease protection. The proportion of asymptomatic infection was 45.1%. CONCLUSION The estimated prevalence of the infection was lower than the cumulative incidence variation, except for the last phase of the study. The differences in prevalence estimates observed among subpopulations showed social inequality as a risk of infection. The lower prevalence observed among those who could follow prevention measures reinforce the need to maintain social distancing measures as a way to prevent SARS-CoV-2 infection.

https://doi.org/10.11606/s1518-8787.2021055003970

Prevalence evolution of SARS-CoV-2 infection in the city of São Paulo, 2020–2021
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Albuquerque, José Olimpio Moura de

; Kamioka, Gabriela Akemi

; Madalosso, Geraldine

; Costa, Selma Anequini

; Ferreira, Paula Bisordi

; Pino, Francisco Alberto

; Sato, Ana Paula Sayuri

; Carvalho, Ana Carolina Aguiar de

; Amorim, Ana Beatriz Pagliaro

; Aires, Caroline Cotrim

; Kataoka, Ana Paula Arruda Geraldes

; Savani, Elisa San Martin Mouriz

; Bessa, Thirsa Alvares Franco

; Aguiar, Breno Souza de

; Failla, Marcelo Antunes

; Santos, Edson Aparecido dos

; Brito, Edjane Maria Torreão

; Santos, Maria Cristina Honório dos

; Silva, Solange Maria Saboia e

; Caldeira, Luiz Artur Vieira

; Zamarco, Luiz Carlos

; Fonseca, Sandra Maria Sabino

; Lima, Marcia Maria de Cerqueira

; Marques, Ivanilda Argenau

; Silva, Fabiana Érica Vilanova da

; Glasser, Paula Regina

; Burihan, Patrícia Carla Piragibe Ramos

; Cavazzana, Cinthya Luzia

; Mello, Debora Silva de

; Pellini, Alessandra Cristina Guedes

; Nishio, Fernando Yoshiki

; Kian, Fernanda Miyashiro

; Braga, Elza de Santana

; Bertelli, Nilza Maria Piassi

; Fracini, Wagner

; Gonçalves, Marcelo Dell Áquila

; Zular, Paulete Secco

; Piva, Regiane de Santana

; Masi, Eduardo

Revista de Saúde Pública

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2021, Volume 55 elocation 62

Abstract: En | Text: En | PDF: En

https://doi.org/10.11606/s1518-8787.2021055003970 43 downloads

Perfil e evolução da mortalidade por causas externas em Joinville (SC), 2003 a 2016
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Cardoso, Silvana

; Gaertner, Maria Helena da Costa Naumann

; Haritsch, Luciane

; Henning, Elisa

; Kropiwiec, Maria Volpato

; Franco, Selma Cristina

Cadernos Saúde Coletiva

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jun 2020, Volume 28 N. 2 Pages 189 - 200

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução A mortalidade por causas externas está entre as principais causas de óbito no mundo, com acentuada expressão em faixas etárias jovens. Objetivo Descrever o perfil das mortes por causas externas em município do Sul do país e verificar sua tendência nos últimos anos. Método Estudo retrospectivo dos óbitos por causas externas usando os coeficientes de mortalidade por sexo, grupo etário e causa da morte com análise por regressão quasi Poisson. Resultados O coeficiente de mortalidade foi de 46,3 por 100 mil habitantes, predominando os acidentes por transporte terrestre (40%) e agressões (30,5%). Identificou-se aumento de 53% nos coeficientes de mortalidade, com variações segundo sexo, grupo etário e tipo. Conclusão Necessitam-se intensificar políticas públicas conforme as especificidades na determinação dos tipos de morte em cada grupo etário.

Abstract Background Mortality due to external causes is among of the leading causes of death worldwide, with great expression in young age groups. Objective: To describe the profile of deaths from external causes in a southern municipality of Brazil and verify its trend in the last years. Method It was carried out a retrospective study of external causes deaths using mortality rates by gender, age group and cause of with quasi Poisson regression analysis. Results Mortality coefficient was 46 per 100,000 inhabitants prevailing transport accidents (40%) and aggressions (30.5%). Increase of 53% in mortality rate was detected with variations by gender, age group and type. Conclusion Social policies are necessary encompassing intersectoral actions and taking into account the specificities in determination of each age group’s types of death.

https://doi.org/10.1590/1414-462x202028020115 925 downloads

Severe malnutrition after bariatric surgery and clinic manifestations of infection
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Furlan, Alice Avesani Cavotto

; Junqueira-Franco, Marcia Varella Morandi

; Oliveira, Joyce Cristina Santos de

; Favaris, José Wilson de Souza

; Marchini, Julio Sérgio

; Cunha, Selma Freire Carvalho

Revista da Associação Médica Brasileira

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sep 2019, Volume 65 N. 9 Pages 1151 - 1155

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Este relato descreve a evolução pós-cirurgia bariátrica de uma paciente obesa que apresentou baixa adesão à dieta e suplementação de micronutrientes. Quatro anos após duas cirurgias bariátricas, a paciente foi internada por perda transitória de consciência, raciocínio lento, anasarca, hipoalbuminemia grave, além de deficiências vitamínicas e minerais. Apresentava abscesso subcutâneo no pé, mas não apresentava febre. Recebeu antibióticos, vitaminas A, D, B12, tiamina, cálcio e nutrição parenteral. Após a internação (28 dias) houve redução significativa do peso corporal, provavelmente devido ao desaparecimento clínico da anasarca. A nutrição parenteral foi suspensa após 25 dias e a dieta oral foi mantida fracionada. Após a internação (atendimento ambulatorial semanal) houve uma melhora gradativa dos dados laboratoriais, que estavam próximos dos valores de referência. Tal desfecho mostra a necessidade de cuidados especializados na prevenção e tratamento de complicações nutricionais após cirurgias bariátricas, bem como manifestações clínicas de infecção em pacientes previamente desnutridos.

SUMMARY This report describes the post-bariatric-surgery evolution of an obese patient who had low adherence to the diet and micronutrient supplementation. Four years after two bariatric surgeries, the patient was admitted due to transient loss of consciousness, slow thinking, anasarca, severe hypoalbuminemia, in addition to vitamin and mineral deficiencies. She had subcutaneous foot abscess but did not present fever. Received antibiotics, vitamins A, D, B12, thiamine, calcium, and parenteral nutrition. After hospitalization (twenty-eight days), there was a significant body weight reduction probably due to the disappearance of clinical anasarca. Parenteral nutrition was suspended after twenty-five days, and the oral diet was kept fractional. After hospitalization (weekly outpatient care), there was a gradual laboratory data improvement, which was now close to the reference values. Such outcome shows the need for specialized care in preventing and treating nutritional complications after bariatric surgeries as well as clinical manifestations of infection in previously undernourished patients.

https://doi.org/10.1590/1806-9282.65.9.1151 2628 downloads

Antioxidant activity and lipid oxidation in milk from cows with soybean oil and propolis extract added to their feed
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COTTICA, Solange Maria

; AMADO, Daieni Alves Vieira

; AGUIAR, Silvia Cristina de

; BOEING, Joana Schuelter

; FRANCO, Selma Lucia

; ZEOULA, Lucia Maria

; VISENTAINER, Jesuí Vergílio

Food Science and Technology

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jun 2019, Volume 39 N. 2 Pages 467 - 474

Abstract: En | Text: En | PDF: En

Abstract The presence of PUFA (polyunsaturated fatty acids) in cow milk, including conjugated linoleic acids (CLA) isomers, makes milk susceptible to lipid oxidation, and may lead to the formation of volatile products responsible for a rancid smell. Consequently, including natural antioxidants in the diet of dairy cattle can assist in preventing lipid oxidation. In this study, soybean oil (a source of PUFA) and different ethanolic extracts of Brazilian propolis were included in the cows' feed, and the antioxidant activity and lipid oxidation of the animals' milk was assessed. Antioxidant activity was analyzed using the DPPH method, potassium ferricyanide reduction and chelating ability. Total phenolic compounds and flavonoids were also determined. Lipid oxidation was assessed by determining conjugated dienes and the production of aldehydes (propanal, pentanal, hexanal and octanal). Increased antioxidant activity was seen in the samples of milk from cows receiving propolis. Similarly, the addition of ethanolic extract of propolis to the diet of dairy cattle increased milk protection for two treatments with propolis against lipid oxidation in terms of production of propanal and hexanal. These results confirm the positive effect of applying this natural additive to the diet of lactating cows, improving the nutritional quality of the milk produced.

https://doi.org/10.1590/fst.33817 1308 downloads

Differences in the diagnosis of primary cutaneous melanoma in the public and private healthcare systems in Joinville, Santa Catarina State, Brazil
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Steglich, Raquel Bissacotti

; Cardoso, Silvana

; Gaertner, Maria Helena da Costa Naumann

; Coelho, Karina Munhoz de Paula Alves

; Cestari, Tania Ferreira

; Franco, Selma Cristina

Anais Brasileiros de Dermatologia

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aug 2018, Volume 93 N. 4 Pages 507 - 512

Abstract: En | Text: En | PDF: En

Abstract: Background: Cutaneous melanoma accounts for up to 80% of deaths caused by skin cancer. Diagnostic suspicion and access to medical care and early intervention in suspected cases is vital to the patient’s prognosis. Objectives: To compare demographic and histopathological characteristics of primary cutaneous melanoma diagnosed in the public healthcare system (Sistema Único de Saúde SUS) and the private system in Joinville, Santa Catarina State, Brazil. Methods: This cross-sectional retrospective study analyzed primary cutaneous melanoma cases recorded from 2003 to 2014 in the resident population of Joinville. Ethical approval was obtained from the local Research Ethics Committee. Results: 893 cases of primary cutaneous melanoma were identified. Patients in the private system were mostly younger, while there were more elderly patients in the public healthcare system (p <0.001). There was no statistically significant association between type of care (public/private) and gender or presence of multiple primary cutaneous melanomas. Histological diagnosis of superficial spreading melanoma was more common in patients treated in private healthcare, while nodular melanoma was more frequent in patients in the public healthcare system (p <0.001). Mean Breslow depth in patients treated in private healthcare was 1.35mm, compared to 2.72mm in the public system (p <0.001). Study limitations: This was a retrospective study using secondary databases. Conclusions: thin cutaneous melanoma (in situ cutaneous melanoma and Breslow T1) showed the strongest association with the private healthcare system, while thick cutaneous melanoma was more frequent in the public system (Breslow category T3 and T4) (p <0.001).

https://doi.org/10.1590/abd1806-4841.20185767 1026 downloads

Epidemiological and histopathological aspects of primary cutaneous melanoma in residents of Joinville, 2003-2014
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Steglich, Raquel Bissacotti

; Coelho, Karina Munhoz de Paula Alves

; Cardoso, Silvana

; Gaertner, Maria Helena da Costa Naumann

; Cestari, Tania Ferreira

; Franco, Selma Cristina

Anais Brasileiros de Dermatologia

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feb 2018, Volume 93 N. 1 Pages 45 - 53

Abstract: En | Text: En | PDF: En

Abstract: Background: The worldwide incidence of cutaneous melanoma (CM) has been continuously increasing over the last decades. Primary and secondary prevention, with attention to risk factors and early diagnosis, remain the cornerstone for reducing the burden of cutaneous melanoma. Detailed information with respect to clinical and pathological data on cutaneous melanoma is scarce in Brazil. Objective: The purpose of our study was to analyze epidemiological and pathological characteristics of primary cutaneous melanoma in Joinville, southern Brazil. Methods: Observational, cross-sectional, retrospective study in which 893 reports of primary cutaneous melanoma from the local population were analyzed in the period 2003-2014. The study was approved by the local Ethics and Research Committee. Results: We observed a female predominance of cutaneous melanoma (56.3%). The age standardized incidence rate of primary cutaneous melanoma for the world population in the period 2003-06 was 11.8 per 100,000 population (CI 95%, 10.3-13.4), and 17.5 (CI 95%, 15.7-19.3) in 2011-14, revealing a significant increase of 48.3% (p < 0,05). Six and a half percent of patients had multiple cutaneous melanomas (mean 2.2 years and a maximum of 10.0 years between diagnoses). We observed significant differences between the location head/neck and cutaneous melanoma in situ, lower limb with Breslow depth S III and upper limb with Breslow depth S I. The comparison of the characteristics of cutaneous melanoma in the elderly and non-elderly (< 60 years old) showed significant differences with respect to all the variables studied. Study limitations: Using secondary data source. Conclusion: Joinville has high incidence coefficients for Brazilian standards, showing an increase in the incidence of cutaneous melanoma.

https://doi.org/10.1590/abd1806-4841.20185497 979 downloads

10.

FATORES ASSOCIADOS À MORTALIDADE INFANTIL EM MUNICÍPIO COM ÍNDICE DE DESENVOLVIMENTO HUMANO ELEVADO
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Kropiwiec, Maria Volpato

; Franco, Selma Cristina

; Amaral, Augusto Randüz do

Revista Paulista de Pediatria

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dec 2017, Volume 35 N. 4 Pages 391 - 398

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Identificar os fatores associados à mortalidade infantil em município com bom desenvolvimento socioeconômico. Métodos: Estudo de coorte retrospectivo com 7.887 nascidos vivos do ano de 2012 registrados no Sistema de Informação sobre Nascidos Vivos (SINASC) e associados por meio de linkage com o Sistema de Informações sobre Mortalidade (SIM) para identificação dos óbitos ocorridos no primeiro ano de vida. Os fatores de risco foram hierarquizados em três níveis de determinação: distal, intermediário e proximal. Os modelos de regressão logística binomial e o modelo multivariado quantificaram o impacto individual das variáveis testadas e ajustaram o efeito das variáveis de confundimento. A magnitude do efeito das variáveis explicativas foi estimada pelo cálculo do Odds Ratio (OR) bruta e ajustada e de seus respectivos intervalos de confiança de 95% (IC95%), sendo significante p<0,05. Resultados: Identificou-se 61 óbitos na coorte e o coeficiente de mortalidade infantil foi de 7,7 por mil nascidos vivos. Mãe adolescente (ORaj 3,75; IC95% 1,40-10,02), duração da gestação <32 semanas (ORaj 12,08; IC95% 2,30-63,38), peso ao nascer <1.500 g (ORaj 8,20; IC95% 1,52-44,23), Apgar no 1º e no 5º minuto de vida <7 (ORaj 4,82; IC95% 2,01-11,55 e ORaj 6,26; IC95% 1,93-20,30, respectivamente) e presença de malformação congênita (ORaj 21,49; IC95% 7,72-59,82) constituíram fatores de risco para os óbitos. Conclusões: A menor relevância dos fatores socioeconômicos e assistenciais e a maior importância dos fatores biológicos na determinação dos óbitos infantis podem refletir o efeito protetor do elevado desenvolvimento econômico e social dessa localidade.

ABSTRACT Objective: To identify factors associated with infant mortality in a city with good socioeconomic development. Methods: A retrospective cohort study with 7,887 live births in the year of 2012 recorded in the Live Births Information System (SINASC) and associated by linkage with the Mortality Information System (SIM) to identify the deaths in the first year of life. The risk factors were ranked in three levels of determination: distal, intermediate and proximal. The logistic binomial regression models and the multivariate model quantified the impact of the individual variables tested and adjusted the effect of confounding variables. The magnitude of the effect of the explanatory variables was estimated by calculating the crude and adjusted Odds Ratio (OR) and their respective 95% confidence intervals (95%CI), being significant p<0.05. Results: There were 61 deaths in the cohort and the infant mortality rate was 7.7 per thousand live births. Teenage mother (adjOR 3.75; 95%CI 1.40-10.02), gestational age <32 weeks (adjOR 12.08; 95%CI 2.30-63.38), weight at birth <1500g (adjOR 8.20; 95%CI 1.52-44.23), Apgar score at 1 and 5 minutes of life <7 (adjOR 4.82; 95%CI 2.01-11.55 and adjOR 6.26; 95%CI 1,93-20,30, respectively) and the presence of congenital malformation (adjOR 21.49; 95%CI 7.72-59.82) were risk factors for infant mortality. Conclusions: The lower relevance of socioeconomic and health care variables and the greater importance of biological factors in determining infant mortality may reflect the protective effect of high economic and social development of the locality.

https://doi.org/10.1590/1984-0462/;2017;35;4;00006 9485 downloads

11.

A populational based study on the prevalence of neonatal near miss in a city located in the South of Brazil: prevalence and associated factors
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Silva, Guilherme Alberto

; Rosa, Karin Alana

; Saguier, Elizabeth Schirin Farahani

; Henning, Elisa

; Mucha, Fatima

; Franco, Selma Cristina

Revista Brasileira de Saúde Materno Infantil

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mar 2017, Volume 17 N. 1 Pages 159 - 167

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivos: identificar a prevalência de morbidade neonatal near miss no município de Joinville, SC e os fatores associados. Métodos: estudo transversal de base populacional com todos os nascidos vivos do ano de 2012 registrados no SINASC. Os casos de near miss foram identificados com base no peso < 1500g, Apgar de 5º minuto < 7, idade gestacional < 32 semanas, uso de ventilação mecânica ou presença de malformação congênita. Calculou-se o odds ratio (OR) bruto e seus respectivos intervalos de confiança de 95% (IC95%) e realizou-se regressão logística para a obtenção dos odds ratios ajustados e seus respectivos IC95%. Resultados: a prevalência de near miss foi de 33 por mil nascidos vivos (IC95%: 29-37). No modelo final, permaneceram associados à morbidade near miss, a classificação de risco do nascido vivo conforme o Programa Municipal (ORaj = 19,7; IC95%: 14,2-27,2), parto cesáreo (ORaj = 2,1; IC95%: 1,5-2,8) e hospital público (ORaj =1,7; IC95%: 1,2-2,3). Conclusões: a morbidade near miss foi 7,3 vezes maior que a mortalidade neonatal. Conhecer seus determinantes em diferentes contextos nacionais pode propiciar mudança no foco das ações de saúde pública, redirecionando-as para intervenções preventivas.

Abstract Objectives: to identify the prevalence of neonatal near miss morbidity in the city of Joinville, SC and the associated factors. Methods: a populational based cross-sectional study including all live births in 2012 registered at SINASC. The near miss cases were identified based on the weight <1500g, Apgar scores at 5th minute <7, gestational age <32 weeks, use of mechanical ventilation or presence of congenital malformation. The gross odds ratios (OR) and its respective 95% confidence intervals (95% CI) were calculated and the logistic regression was performed to obtain the adjusted odds ratios and its respective 95% CI. Results: the prevalence of near miss was 33 per thousand live births (95% CI: 29-37). In the final model, a risk classification of live births according to the City Program (Programa Municipal) (ORaj= 19.7; 95% CI: 14.2 to 27.2), cesarean section (ORaj= 2.1; 95% CI:1.5 to 2.8) and public hospital (ORaj= 1.7; 95% CI: 1.2 to 2.3) remained associated to morbidity near miss. Conclusions: near miss morbidity was 7.3 times higher than neonatal mortality. To know its determinants in different national contexts may include some changes in the focus of public health actions by redirecting to preventive interventions.

https://doi.org/10.1590/1806-93042017000100009 2790 downloads

12.

Nursing practices for pain management in hospitals of a city of Santa Catarina
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Kipel, Anna Geny Batalha

; Franco, Selma Cristina

; Muller, Luciane Aparecida

Revista Dor

Journal Metrics
- Sobre o periódico
- SciELO Analytics

sep 2015, Volume 16 N. 3 Pages 198 - 203

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO JUSTIFICATIVA E OBJETIVOS: A dor é considerada o quinto sinal vital e exige dos profissionais de saúde habilidades e conhecimentos específicos para seu manuseio. O objetivo deste estudo foi conhecer a prática de enfermagem no manuseio da dor em hospitais de um município no sul do Brasil. MÉTODOS: Pesquisa transversal quantitativa, realizada com aplicação de um questionário estruturado que avaliou características profissionais e o conhecimento sobre dor em uma amostra de 418 profissionais: 63 enfermeiros e 355 técnicos de enfermagem, em 3 hospitais, dois públicos e um privado, entre julho de 2012 e agosto de 2013. Para avaliar associações entre as variáveis explicativas e os grupos (categoria profissional, tipo de hospital e tempo de exercício profissional) utilizaram-se os testes Qui-quadrado e Exato de Fisher, adotando-se nível de significância de 5%. RESULTADOS: Dos profissionais, 27,5% cursaram disciplina específica em sua formação; 30,6% realizaram curso de capacitação sobre dor; 66,7% conhecem métodos de avaliação da dor e 58,6% os utilizam. Os profissionais do hospital privado possuem mais conhecimento sobre métodos de avaliação da dor (p<0,001), e também os profissionais formados mais recentemente (p=0,005). A utilização destes métodos foi maior entre os enfermeiros (p=0,036); profissionais do hospital privado (p<0,001) e formados há menos tempo (p<0,001). Os enfermeiros conhecem mais o conceito de transdução (p<0,001); os profissionais do hospital privado seguem mais os protocolos para avaliar a dor (p<0,001), e também aqueles formados há menos tempo (p=0,013). CONCLUSÃO: Os profissionais da saúde necessitam melhorar o conhecimento nesta área para que as práticas da enfermagem no manuseio da dor ocorram adequadamente em hospitais de um município de Santa Catarina.

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is the fifth vital sign and requires from health professionals specific skills and knowledge for its management. This study aimed at evaluating nursing practices for pain management in hospitals of a city in Southern Brazil. METHODS: This was a cross-sectional and quantitative study carried out by means of a structured questionnaire to evaluate professional characteristics and knowledge about pain in a sample of 418 professionals: 63 nurses and 355 nursing technicians from three hospitals, two public and one private, between July 2012 and August 2013. Chi-square and Fisher Exact tests were used to evaluate associations between explanatory variables and groups (professional category, type of hospital and time of professional exercise), with significance level of 5%. RESULTS: From all participants, 27.5% have attended specific discipline in their qualification; 30.6% have attended pain qualification courses; 66.7% know about pain evaluation methods and 58.6% use them. Private hospital professionals are more skilled in pain evaluation methods (p<0.001), as well as more recently graduated professionals (p=0.005). These methods were more broadly used by nurses (p=0.036); private hospital professionals (p<0.001) and those more recently graduated (p<0.001). Nurses better understand the concept of transduction (p<0.001); private hospital professionals follow more pain evaluation protocols (p<0.001) as well as those more recently graduated (p=0.013). CONCLUSION: Health professionals must improve their knowledge in this area so that nursing practices for pain management are adequately followed in hospitals of a city of Santa Catarina.

https://doi.org/10.5935/1806-0013.20150040 2382 downloads

13.

Frequência e características maternas e do recém nascido associadas à internação de neonatos em UTI no município de Joinville, Santa Catarina - 2012
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Mucha, Fátima

; Franco, Selma Cristina

; Silva, Guilherme Alberto Germano

Revista Brasileira de Saúde Materno Infantil

Journal Metrics
- Sobre o periódico
- SciELO Analytics

jun 2015, Volume 15 N. 2 Pages 201 - 208

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivos: determinar a frequência e os fatores associados à internação de recém-nascidos em UTI neonatal no município de Joinville, Santa Catarina. Métodos: estudo transversal com base nos registros de nascidos vivos (DNV) e de internações em Unidades de Terapia Intensivas (UTI) neonatais em 2012. Para avaliar associações entre variáveis explicativas e desfecho foram estimados odds ratios (OR) brutos e ajustados e respectivos intervalos de confiança de 95% com a técnica de regressão logística. Resultados: a frequência de internação em UTI neonatal foi de 11,7% (9,69-13,7). Baixo peso ao nascer (ORaj = 8,1 [6,3 - 10,3]), malformação congênita (ORaj = 6,0 [3,2 – 11,2]), Apgar de 5º minuto < 7 (ORaj = 5,7 [2,6 - 12,3]), prematuridade (ORaj = 3,4 [(2,7 – 4,1]), sexo masculino (ORaj = 1,5 [1,2 - 1,8]), hospital público (ORaj = 2,0 [1,6 - 2,4]), mãe sem companheiro (ORaj = 1,4 [1,2 - 1,7]), baixa escolaridade materna (ORaj = 1,4 [1,2 - 1,7]) e < 7 consultas no pré natal (ORaj = 1,3[1,1 - 1,6]) constituíram fatores de risco para internação. Conclusões: as características biológicas dos recém-nascidos associadas à internação em UTI neonatal são passíveis de prevenção, evidenciando a importância da qualificação da assistência à gestante e recém-nascido.

Abstract Objectives: to determine the frequency of and factors associated with the admission of newborns to neonatal ICU in the municipality of Joinville, Santa Catarina. Methods: a cross-sectional study was conducted based on the records of live births (DNV) and admissions to neonatal intensive care units (NICUs) in 2012. To evaluate associations between the explanatory variables and the outcome, the crude and adjusted odds ratios (OR) were calculated with respective confidence intervals of 95% using the logistic regression technique. Results: the frequency of admission to NICU was 11.7% (9.69-13.7). Low birth weight (ORadj = 8.1 [6.3 – 10.3]), congenital deformity (ORadj = 6.0 [3.2 – 11.2]), a 5th minute Apgar score < 7 (ORadj = 5.7 [2.6 – 12.3]), prematurity (ORadj = 3.4 [(2.7 – 4.1]), male sex (ORaj = 1.5 [1.2 – 1.8]), public hospital (ORadj = 2.0 [1;6 – 2.4]), single mother (ORadj = 1.4 [1.2 – 1.7]), low level of education of mother (ORadj = 1.4 [1.2 – 1.7]) and < 7 prenatal consults (ORadj = 1.3[1.1 – 1.6]) were found to be risk factors for admission. Conclusions: the biological characteristics of the newborns associated with admission to neonatal intensive care units are susceptible to prevention, thereby demonstrating the importance of improving care for pregnant women and newborns.

https://doi.org/10.1590/S1519-38292015000200006 4240 downloads

14.

Avaliação do risco epidemiológico e do desempenho dos programas de controle de tuberculose nas Regiões de Saúde do estado de Santa Catarina, 2003 a 2010
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Mendonça, Sergio Adam

; Franco, Selma Cristina

Epidemiologia e Serviços de Saúde

Journal Metrics
- Sobre o periódico
- SciELO Analytics

mar 2015, Volume 24 N. 1 Pages 59 - 70

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

OBJETIVO:avaliar o risco epidemiológico e o desempenho dos programas de controle de tuberculose segundo Regiões de Saúde do estado de Santa Catarina, Brasil, no período de 2003 a 2010.MÉTODOS:estudo ecológico com dados fornecidos pela vigilância epidemiológica estadual, compreendendo 4 indicadores de risco e 11 de desempenho do programa; calculou-se a mediana de cada indicador por Região e atribuiu-se pontos conforme a distribuição percentilar, permitindo-se a criação de um índice de gravidade.RESULTADOS:verificou-se a existência de diferentes níveis de risco de morbimortalidade e distintos índices de desempenho das ações de controle da tuberculose nas Regiões de Saúde; o índice de gravidade permitiu identificar 6 Regiões de maior gravidade, 9 intermediárias e 6 de menor gravidade, com diferenças nos escores de risco e desempenho (p<0,001).CONCLUSÃO:evidenciou-se grande variedade de nichos de gravidade distribuídos nas diversas Regiões, bem como diversidade no empenho da gestão administrativa para seu enfrentamento.

OBJECTIVE:to evaluate epidemiologic risk and Tuberculosis Control Program performance by Health Region in Santa Catarina State, Brazil, 2003-2010.METHODS:this was an ecological study using state epidemiologic surveillance data comprising 4 risk indicators and 11 Tuberculosis Program performance indicators; we calculated the median for each indicator by region and gave scores according to percentile ranking. A severity index was thus created.RESULTS:different levels of morbi-mortality risk and distinct Tuberculosis control performance indexes were found in the regions; the severity index created allowed us to identify six regions with high severity, nine intermediate and six with low severity, although there were differences in risk and performance scores (p<0.001).CONCLUSION:a great variety was found in the distribution of pockets of disease severity in the different regions, as was diversity in health management efforts to overcome them.

OBJETIVO:evaluar el riesgo epidemiológico y el desempeño de los programas de control de tuberculosis según las Regiones de Salud del estado de Santa Catarina, Brasil, en el período de 2003 a 2010.MÉTODOS:estudio ecológico con datos suministrados por la vigilancia epidemiológica estadual, comprendiendo 4 indicadores de riesgo y 11 de desempeño del programa; se calculó la mediana de cada indicador por Región y se atribuyeron puntosconforme la distribución percentilar, permitiendo la creación de un índice de gravedad.RESULTADOS:se verificó la existencia de diferentes niveles de riesgo de morbilidad ymortalidad y distintos índices de desempeño de las acciones de control de la tuberculosis en las Regiones de Salud; el índice de gravedad permitió identificar 6 Regiones de más gravedad, 9 intermedias y 6 de menor gravedad, con diferencias en los scores de riesgo y desempeño (p<0,001).CONCLUSIÓN:se evidenció una gran variedad de nichos de gravedad distribuidos en las diversas Regiones, bien como diversidad en el desempeño de la gestiónadministrativa para enfrentarlo.

https://doi.org/10.5123/S1679-49742015000100007 1503 downloads

15.

Avaliação do risco epidemiológico e do desempenho dos programas de controle de tuberculose nas Regiões de Saúde do estado de Santa Catarina, 2003 a 2010
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Mendonça, Sergio Adam

; Franco, Selma Cristina

Epidemiologia e Serviços de Saúde

Journal Metrics
- Sobre o periódico
- SciELO Analytics

mar 2015, Volume 24 N. 1 Pages 59 - 70

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

OBJETIVO: avaliar o risco epidemiológico e o desempenho dos programas de controle de tuberculose segundo Regiões de Saúde do estado de Santa Catarina, Brasil, no período de 2003 a 2010. MÉTODOS: estudo ecológico com dados fornecidos pela vigilância epidemiológica estadual, compreendendo 4 indicadores de risco e 11 de desempenho do programa; calculou-se a mediana de cada indicador por Região e atribuiu-se pontos conforme a distribuição percentilar, permitindo-se a criação de um índice de gravidade. RESULTADOS: verificou-se a existência de diferentes níveis de risco de morbimortalidade e distintos índices de desempenho das ações de controle da tuberculose nas Regiões de Saúde; o índice de gravidade permitiu identificar 6 Regiões de maior gravidade, 9 intermediárias e 6 de menor gravidade, com diferenças nos escores de risco e desempenho (p<0,001). CONCLUSÃO: evidenciou-se grande variedade de nichos de gravidade distribuídos nas diversas Regiões, bem como diversidade no empenho da gestão administrativa para seu enfrentamento.

OBJECTIVE: to evaluate epidemiologic risk and Tuberculosis Control Program performance by Health Region in Santa Catarina State, Brazil, 2003-2010. METHODS: this was an ecological study using state epidemiologic surveillance data comprising 4 risk indicators and 11 Tuberculosis Program performance indicators; we calculated the median for each indicator by region and gave scores according to percentile ranking. A severity index was thus created. RESULTS: different levels of morbi-mortality risk and distinct Tuberculosis control performance indexes were found in the regions; the severity index created allowed us to identify six regions with high severity, nine intermediate and six with low severity, although there were differences in risk and performance scores (p<0.001). CONCLUSION: a great variety was found in the distribution of pockets of disease severity in the different regions, as was diversity in health management efforts to overcome them.

OBJETIVO: evaluar el riesgo epidemiológico y el desempeño de los programas de control de tuberculosis según las Regiones de Salud del estado de Santa Catarina, Brasil, en el período de 2003 a 2010. MÉTODOS: estudio ecológico con datos suministrados por la vigilancia epidemiológica estadual, comprendiendo 4 indicadores de riesgo y 11 de desempeño del programa; se calculó la mediana de cada indicador por Región y se atribuyeron puntosconforme la distribución percentilar, permitiendo la creación de un índice de gravedad. RESULTADOS: se verificó la existencia de diferentes niveles de riesgo de morbilidad ymortalidad y distintos índices de desempeño de las acciones de control de la tuberculosis en las Regiones de Salud; el índice de gravedad permitió identificar 6 Regiones de más gravedad, 9 intermedias y 6 de menor gravedad, con diferencias en los scores de riesgo y desempeño (p<0,001). CONCLUSIÓN: se evidenció una gran variedad de nichos de gravedad distribuidos en las diversas Regiones, bien como diversidad en el desempeño de la gestiónadministrativa para enfrentarlo.

https://doi.org/10.5123/S1679-49742015000100007 2875 downloads

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