Prevalência da infecção pelo Papilomavírus humano, Chlamydia Trachomatis e Herpes Simples do tipo 2 em adolescentes atendidas em unidades de saúde pública de Natal

This study assessed the level of knowledge, attitude and practice of Pap smear and human papillomavirus (HPV), in addition to analyzing the prevalence of genital HPV infection, Herpes Simplex Type 2 (HSV-2) and Chlamydia trachomatis in teenagers. The study consisted of two approaches, one based only on interviews conducted with adolescents enrolled in public schools or in public health facilities in the city of Natal. The other approach involved only a group of 132 adolescents enrolled among those admitted to two health units in Natal-RN. This second group of participants two specimens were collected for laboratory analysis: one was directed to prepare the blade for the Pap test, and other processed for DNA extraction for molecular analysis, focusing on the detection of HPV, HSV-2 and C . trachomatis. The presence of DNA of the three pathogens was investigated by the technique of polymerase chain reaction (PCR). The presence of each of the three pathogens was analyzed in terms of socio-demographic characteristics, as well as sexual and reproductive activity to identify risk factors for infection and development of lesions of the uterine cervix. The results show that the adolescents in this study had levels of knowledge and attitude very low, both in relation to cytology to HPV as though they have made a reasonable percentage of adequate practice exam and prevention of HPV infection. The overall prevalence of HPV infection was 54.5% and 48.2% in adolescents with normal cytology and 86.4% in those with abnormal cytology. We observed a higher proportion of cases of infection in the age group of 18 to 21. The prevalence of HPV infection was slightly higher among pregnant teenagers. The overall prevalence of HSV-2 infection was 13.6% and 11.8% in women with normal cytology and 22.7% in those with abnormal cytology. A higher proportion of cases of infection was found in the age group from 14 to 17, with a slightly higher prevalence among pregnant women. The C. trachomatis was found with an overall prevalence of 19.7% and 21.8% in adolescents with normal cytology and 9.1% in those with abnormal cytology. The prevailing rate was highest in the age group 18 to 21 years and in nonpregnant

Prevalência da infecção genital pelo vírus herpes simples tipo 1 e 2 em mulheres grávidas e não grávidas de Natal/RN

Herpes simplex is a virus that can be transmitted sexually and is potentially associated with vertical transmission. This study evaluated the prevalence of genital infection by herpes simplex virus (HSV) types 1 and 2 in pregnant and nonpregnant care in the city of Natal / RN, including a total of 222 women, 92 pregnant and 130 nonpregnant. The participants answered a questionnaire to obtain data and socio-demographic characteristics, as well as potential risk factors for sexually transmitted diseases. After the interview, we collected two cervical specimens, one for the Pap test and the other for DNA extraction and analyzed by polymerase chain reaction (PCR) to detect both virus serotypes. Then the women underwent a clinical examination by colposcopy. For statistical analysis, we used the chi-square and logistic regression by SSPS 17.0 Statistic. Most women were up to 30 years of age, nonwhite ethnicity, married, elementary education, family income below the poverty level; initiated sexual activity with age up to 18 years; had more than one sexual partner lifelong and was not pregnant, but has had at least one child. The HSV-1 showed a prevalence of 26.1% among pregnant women and 30.0% in non-pregnant women. While HSV-2 prevalence was found with 10.9% and 19.2% in pregnant and nonpregnant women, respectively. The largest proportion of morphological changes of the uterine cervix was detected among nonpregnant women, both in cytology and in colposcopy. The women were nonwhite ethnicity, married, became pregnant aged less than or equal to 18 years and who had one to two pregnancies had a lower risk of acquiring genital HSV infection. There was a high prevalence of genital HSV infection, HSV-1 is more prevalent than HSV-2. No association was found between morphological changes of the uterine cervix and the presence of the virus in pregnant and nonpregnant women, nor between genital HSV infection and the classic risk factors for sexually transmitted diseases

Prevalência da infecção por Chlamydia Trachomatis em mulheres atendidas no Programa de rastreamento do câncer de colo do útero

Genital infection with Chlamydia trachomatis is now recognized as one of the most prevalent sexually transmitted infections (STDs). Despite major advances in laboratory diagnosis techniques, primarily the character of asymptomatic chlamydial infection in both men and in women constitutes the basis for the formation of reservoirs that perpetuate transmission and acquisition of this and other STDs. The asymptomatic in women favors the rise of infection to the upper genital tract, causing injuries that can result in infertility. An examination of population screening for early detection and treatment of asymptomatic infections is the key step in combating this major public health problem. The present study aimed to evaluate the prevalence of infection by C. trachomatis in sexually active women attended the screening program for cervical cancer of the uterus in health facilities in municipalities in different regions of the State of Rio Grande do Norte, and identify factors that may contribute to the spread of this pathogen and its relationship with the lesions of the uterine cervix. It is a cross-sectional study aimed at detecting the presence of genital tract infection by C. trachomatis either in isolated form or in association with human papilloma virus (HPV) infection in asymptomatic women. Were included in this study, a total sample of 1,134 women aged 13-76, mean 34.4 years, from March 2008 to September 2012. Specimens containing exfoliated cells of the epithelium of the uterine cervix were analyzed by examining Pap cytology for the detection of possible injuries, and the polymerase chain reaction (PCR) for detection of plasmid DNA from C. trachomatis and HPV. Infection with C. trachomatis was detected with overall prevalence rate of 8.1% in the isolated form and 2.8% in co-infection with HPV. The infection was detected in 7.4% of women with normal cytology 11.5% of those with atypical cells of undetermined significance (ASC-US) and 16.7% of those with low-grade squamous intraepithelial lesion (LSIL). We observed an association between C. trachomatis and incidence of low-grade squamous intraepithelial lesion (LSIL). The genital tract infection by C. trachomatis alone was associated with education level, ethnicity and parity, revealing that women with higher education, those of non-white ethnicity and those who had three or more pregnancies were more likely to acquire infection. Levels very close to statistical significance were observed for chronological age, age at first sexual intercourse and first pregnancy. There was no association with marital status, number of sexual partners. Co-infection with C. trachomatis and HPV was detected in 2.3% of women with normal cytology, who had 5.1% in ASC-US and 10.4% in those with LSIL. No association was found between infection C. trachomatis and increased risk of HPV infection, but women with simultaneous infection by both pathogens showed greater risk for LSIL. Co-infection was more prevalent among single women, who had in the first sexual intercourse under 18 years and those who had two or more sexual partners over a lifetime

Caracterização do perfil imunológico em mulheres portadoras do papilomavírus humano

O câncer de colo uterino consiste em um problema de grande relevância social, visto que se trata da segunda malignidade ginecológica mais freqüente no mundo. O principal precursor do câncer da cérvice uterina consiste na infecção pelo Papiloma vírus humano (HPV). O HPV tem despertado grande interesse na comunidade científica, devido à relação estabelecida entre a sua epidemiologia e o câncer de cérvice uterina. Apesar do grande avanço na biologia do HPV, pouco se sabe acerca da resposta imunológica a este vírus. O Papilomavírus humano (HPV) é um DNA vírus epiteliotrófico, que está vinculado à carcinogênese do colo uterino por meio de evidências epidemiológicas e laboratoriais. As infecções pelo HPV ocorrem em mulheres em todo o mundo. Existe consenso na literatura quanto à associação do DNA HPV com as neoplasias intra epiteliais cervicais e o câncer cervical. Por este motivo é de grande importância a detecção precoce deste tipo de infecção para que seja efetuado um tratamento específico. Esse trabalho está caracterizando o perfil imunológico de pacientes portadoras de HPV através da quantificação linfocitária (TCD4, TCD8, células NKT e células NK), e correlacionou esse material à técnica de captura híbrida, para poder comprovar a infecção pelo HPV, esperando assim contribuir precocemente para o diagnóstico do câncer de colo uterino.

Avaliação do impacto do treinamento de clínica em hanseníase e sua contribuição para o aumento da detecção da doença no Estado do Rio Grande do Norte

Hansen´s disease is considered a serious public health problem. In 2006, the Ministry of Health reported that worldwide, Brazil ranked 2nd in the number of cases of the disease, surpassed only by India. The North region is the geographical area in Brazil that presents the most cases. In the state of Rio Grande do Norte, the disease is considered to be eliminated because its prevalence has been identified as 1 per 10.000 inhabitants, criteria established by the State Elimination Letter of 2005. Training programs have been offered by the Coordination for the Control of Hansen´s Disease Program of Rio Grande do Norte, PCH-RN since 1997, with the support of the English governmental agency Leprosy Relief Association, LRA, with no evaluation having been conducted. The objective of this study was to evaluate the training programs in clinical diagnosis of Hansen´s disease and their contribution to the detection of the disease in the state of Rio Grande do Norte. The study was conducted in seven municipalities that are known as Regional Public Health Units (URSAPs): São José de Mipibu URSAP I, Mossoró URSAP II, João Câmara URSAP III, Caicó URSAP IV, Santa Cruz URSAP V, Pau dos Ferros URSAP VI and Natal, capital city of the State, in the Metropolitan Region. Physicians and nurses of the Family Health Program PSF were interviewed as to their perceptions of the implementation of the training program in clinica diagnosis of Hansen´s Disease conducted by the PCH-RN. They evaluated their own practice and the training program. These professionals presented a positive evaluation of the program and gave suggestions for future courses. The results of this study suggest the need for permanent education. Data of the disease obtained from the official records of the Secretariat of Health and from the interviews indicate that health education is the means to control Hansen´s disease effectively

Condutas de profissionais que realizam a consulta pré-natal na Estratégia Saúde da Família quanto à detecção, tratamento e acompanhamento da gestante com sífilis

The objective of this exploratory descriptive quantitative study was to analyze the behaviors in the detection, treatment and followup of the pregnant woman with syphilis, by health professionals that conduct the pre-natal consultation in the Family Health Strategy, as to the adherence to the recommendations of the Ministry of Health. The study was conducted in nine municipalites of the Trairi region in the state of Rio Grande do Norte. Data were collected during the months of July through September 2007, by means of a questionnaire with a population of 53 health professionals, 30 nurses and 23 physicians. Data were analyzed by descriptive statistics. The results were organized in three major items: knowledge of the health professionals about the symptomatology of syphilis and their actions in the detection of the disease; actions in the treatment of the pregnant woman with syphilis; and the actions of followup of the desease. We identified that 81,2% of the professionals have knowledge about the symptomatology of syphilis in the pregnant woman;79,2% request the VDRL exam in the adequate intervals and approximately 50% conduct the treatment in conformity with the recommendations of the Ministry of Health. For the followup care of the infected woman, 79,2% request a monthly VDRL examination, 69,8% explain the disease to the pregnant woman, and 20,7% affirm that they conduct a proper reception to the woman.We conclude that the majority of the health professionals have knowledge of the detection, treatment and followup of the pregnant woman with syphilis. However, the actions of some professionals diverge from the conduct procedures recommended by the Ministry of Health, as to the requesting of the examinations, medication prescription and notification of the iesease. This indicates the need for improved

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Sistema de detecção e isolamento de falhas em sistemas dinâmicos baseado em identificação paramétrica

The present research aims at contributing to the area of detection and diagnosis of failure through the proposal of a new system architecture of detection and isolation of failures (FDI, Fault Detection and Isolation). The proposed architecture presents innovations related to the way the physical values monitored are linked to the FDI system and, as a consequence, the way the failures are detected, isolated and classified. A search for mathematical tools able to satisfy the objectives of the proposed architecture has pointed at the use of the Kalman Filter and its derivatives EKF (Extended Kalman Filter) and UKF (Unscented Kalman Filter). The use of the first one is efficient when the monitored process presents a linear relation among its physical values to be monitored and its out-put. The other two are proficient in case this dynamics is no-linear. After that, a short comparative of features and abilities in the context of failure detection concludes that the UFK system is a better alternative than the EKF one to compose the architecture of the FDI system proposed in case of processes of no-linear dynamics. The results shown in the end of the research refer to the linear and no-linear industrial processes. The efficiency of the proposed architecture may be observed since it has been applied to simulated and real processes. To conclude, the contributions of this thesis are found in the end of the text

Detecção e isolamento de falhas em sistemas dinâmicos baseados em redes neurais

This master dissertation presents the development of a fault detection and isolation system based in neural network. The system is composed of two parts: an identification subsystem and a classification subsystem. Both of the subsystems use neural network techniques with multilayer perceptron training algorithm. Two approaches for identifica-tion stage were analyzed. The fault classifier uses only residue signals from the identification subsystem. To validate the proposal we have done simulation and real experiments in a level system with two water reservoirs. Several faults were generated above this plant and the proposed fault detection system presented very acceptable behavior. In the end of this work we highlight the main difficulties found in real tests that do not exist when it works only with simulation environments

Sistema de supervisão aérea baseado em navegação visual para detecção de anomalias em instalações de petróleo e gás

This work deals with the development of a prototype of a helicopter quadrotor for monitoring applications in oil facilities. Anomaly detection problems can be resolved through monitoringmissions performed by a suitably instrumented quadrotor, i.e. infrared thermosensors should be embedded. The proposed monitoring system aims to reduce accidents as well as to make possible the use of non-destructive techniques for detection and location of leaks caused by corrosion. To this end, the implementation of a prototype, its stabilization and a navigation strategy have been proposed. The control strategy is based on dividing the problem into two control hierarchical levels: the lower level stabilizes the angles and the altitude of the vehicle at the desired values, while the higher one provide appropriate references signals to the lower level in order the quadrotor performs the desired movements. The navigation strategy for helicopter quadrotor is made using information provided by a acquisition image system (monocular camera) embedded onto the helicopter. Considering that the low-level control has been solved, the proposed vision-based navigation technique treats the problem as high level control strategies, such as, relative position control, trajectory generation and trajectory tracking. For the position control we use a control technique for visual servoing based on image features. The trajectory generation is done in a offline step, which is a visual trajectory composed of a sequence of images. For the trajectory tracking problem is proposed a control strategy by continuous servovision, thus enabling a navigation strategy without metric maps. Simulation and experimental results are presented to validate the proposal

Implantação de um sistema de detecção de vazamentos em oleodutos com tratamento de alarmes falsos

The pumping of fluids in pipelines is the most economic and safe form of transporting fluids. That explains why in Europe there was in 1999 about 30.000 Km [7] of pipelines of several diameters, transporting millíons of cubic meters of crude oil end refined products, belonging to COCAWE (assaciation of companies of petroleum of Europe for health, environment and safety, that joint several petroleum companies). In Brazil they are about 18.000 Km of pipelines transporting millions of cubic meters of liquids and gases. In 1999, nine accidents were registered to COCAWE. Among those accidents one brought a fatal victim. The oil loss was of 171 m3, equivalent to O,2 parts per million of the total of the transported volume. Same considering the facts mentioned the costs involved in ao accident can be high. An accident of great proportions can bríng loss of human lives, severe environmental darnages, loss of drained product, loss . for dismissed profit and damages to the image of the company high recovery cost. In consonance with that and in some cases for legal demands, the companies are, more and more, investing in systems of Leak detection in pipelines based on computer algorithm that operate in real time, seeking wíth that to minimize still more the drained volumes. This decreases the impacts at the environment and the costs. In general way, all the systems based on softWare present some type of false alarm. In general a commitment exists betWeen the sensibílity of the system and the number of false alarms. This work has as objective make a review of thé existent methods and to concentrate in the analysis of a specific system, that is, the system based on hydraulic noise, Pressure Point Analyzis (PPA). We will show which are the most important aspects that must be considered in the implementation of a Leak Detection System (LDS), from the initial phase of the analysis of risks passing by the project bases, design, choice of the necessary field instrumentation to several LDS, implementation and tests. We Will make na analysis of events (noises) originating from the flow system that can be generator of false alarms and we will present a computer algorithm that restricts those noises automatically

Sistema híbrido para detecção e diagnóstico de falhas em sistemas dinâmicos

The industries are getting more and more rigorous, when security is in question, no matter is to avoid financial damages due to accidents and low productivity, or when it s related to the environment protection. It was thinking about great world accidents around the world involving aircrafts and industrial process (nuclear, petrochemical and so on) that we decided to invest in systems that could detect fault and diagnosis (FDD) them. The FDD systems can avoid eventual fault helping man on the maintenance and exchange of defective equipments. Nowadays, the issues that involve detection, isolation, diagnose and the controlling of tolerance fault are gathering strength in the academic and industrial environment. It is based on this fact, in this work, we discuss the importance of techniques that can assist in the development of systems for Fault Detection and Diagnosis (FDD) and propose a hybrid method for FDD in dynamic systems. We present a brief history to contextualize the techniques used in working environments. The detection of fault in the proposed system is based on state observers in conjunction with other statistical techniques. The principal idea is to use the observer himself, in addition to serving as an analytical redundancy, in allowing the creation of a residue. This residue is used in FDD. A signature database assists in the identification of system faults, which based on the signatures derived from trend analysis of the residue signal and its difference, performs the classification of the faults based purely on a decision tree. This FDD system is tested and validated in two plants: a simulated plant with coupled tanks and didactic plant with industrial instrumentation. All collected results of those tests will be discussed

Detecção e classificação de modos de operação do bombeio mecânico via cartas dinamométricas

The precision and the fast identification of abnormalities of bottom hole are essential to prevent damage and increase production in the oil industry. This work presents a study about a new automatic approach to the detection and the classification of operation mode in the Sucker-rod Pumping through dynamometric cards of bottom hole. The main idea is the recognition of the well production status through the image processing of the bottom s hole dynamometric card (Boundary Descriptors) and statistics and similarity mathematics tools, like Fourier Descriptor, Principal Components Analysis (PCA) and Euclidean Distance. In order to validate the proposal, the Sucker-Rod Pumping system real data are used

Técnicas neuronais de agrupamentos aplicadas à detecção de anomalias em mamogramas digitais

This work proposes the development of an intelligent system for analysis of digital mammograms, capable to detect and to classify masses and microcalcifications. The digital mammograms will be pre-processed through techniques of digital processing of images with the purpose of adapting the image to the detection system and automatic classification of the existent calcifications in the suckles. The model adopted for the detection and classification of the mammograms uses the neural network of Kohonen by the algorithm Self Organization Map - SOM. The algorithm of Vector quantization, Kmeans it is also used with the same purpose of the SOM. An analysis of the performance of the two algorithms in the automatic classification of digital mammograms is developed. The developed system will aid the radiologist in the diagnosis and accompaniment of the development of abnormalities

Proposta de algoritmo para detecção de vazamentos em oleodutos utilizando análise freqüencial de sinais de pressão

Pipeline leak detection is a matter of great interest for companies who transport petroleum and its derivatives, in face of rising exigencies of environmental policies in industrialized and industrializing countries. However, existing technologies are not yet fully consolidated and many studies have been accomplished in order to achieve better levels of sensitivity and reliability for pipeline leak detection in a wide range of flowing conditions. In this sense, this study presents the results obtained from frequency spectrum analysis of pressure signals from pipelines in several flowing conditions like normal flowing, leakages, pump switching, etc. The results show that is possible to distinguish between the frequency spectra of those different flowing conditions, allowing recognition and announce of liquid pipeline leakages from pressure monitoring. Based upon these results, a pipeline leak detection algorithm employing frequency analysis of pressure signals is proposed, along with a methodology for its tuning and calibration. The proposed algorithm and its tuning methodology are evaluated with data obtained from real leakages accomplished in pipelines transferring crude oil and water, in order to evaluate its sensitivity, reliability and applicability to different flowing conditions