Análise da atuação do Ministério Público Estadual na assistência materno infantil do Rio Grande do Norte

Maternal and infant mortality have become a serious public health problem in Brazil, especially in northeasternand northern regions.In RioGrande do Norte, the high rates ofdeathsofmothersandbabies haveconcerned not onlythehealthauthorities andjusticeagenciessuch as the prosecution service. In 2011, State Public Ministry (MPE) has developed a proposition which was called “Nascer com Dignidade”, focused on the monitoring ofcare givenin prenatal, childbirth andpost childbirthin the cities. The aim of thisstudy was toinvestigate how the intervention of MPE works in maternal and child care. The method adopted to survey data was the case study by analyzing the skills of the reports which were carried out in four of the eight Public Health Regional Units (URSAP).A total of 26municipalities were chosenand the results showfragilityparticularly inprenatal care which can result in complicationsin childbirthand postpartumlike:incomplete health family teams(in05cities), lack of access orinaccessibility to laboratory tests(16 cities) and lack of the pregnant woman'sattachment to thebirthing place(in26 cities). Based on this reality, MPE has adopted relevant attitudes as filing public civil suits, compliance of Conduct Adjustment Declaration in the municipal management and performing interventions in heath care centers and maternity clinics of the state. Thereforeit is known thatPublic Ministryis of paramount importanceto indicatethe necessaryadjustmentsto addressinfant and maternalmortalityin the state (mean of 65/100,000 and16/100,000respectively) and give the city hall the responsibility for the health care quality provided to their citizens. These factors demand theprinciples ofuniversality and integrality to be performed in order to reduce social inequities.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.

Near miss materno e iniquidades em saúde: análise de determinantes contextuais no Rio Grande do Norte, Brasil

The scope of this study was to identify socioeconomic contextual and health care factors in primary care associated with maternal near misses and their marker conditions. This is an ecological study that used aggregated data of 63 clusters formed by the municipalities of State of Rio Grande do Norte, Brazil, using the Skater method of area regionalization, as the unit of analysis. The ratio of maternal near misses and their marker conditions were obtained from the Hospital Information System of the Brazilian Unified Health System. In multiple linear regression analysis, there was a significant association between maternal near misses and variables of poverty and poor primary health care. Hypertensive disorders were also associated with poverty and poor primary care and the occurrence of hemorrhaging was associated with infant mortality. It was observed that the occurrence of maternal near misses is linked to unfavorable socioeconomic conditions and poor quality health care that are a reflection of public policies that accentuate health inequalities.

Prevalência e fatores associados ao Near Miss Materno: inquérito populacional em uma capital do Nordeste Brasileiro

The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.

Prevalência e fatores associados ao Near Miss Materno: inquérito populacional em uma capital do Nordeste Brasileiro

The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.

Análisis del impacto de la dirección de recursos humanos orientada a la gestión de la calidad y la excelencia organizativa : una aplicación en los servicios de medicina intensiva del complejo hospitalario universitario insular-materno infantil

Programa de doctorado: Avances en Medicina Interna. La fecha de publicación es la fecha de lectura

Relação do aleitamento e hábitos deletérios no desenvolvimento estomatognático

O crescimento e o desenvolvimento crâniofaciais, apesar de estarem condicionados por fatores genéticos, são fortemente influenciados pelo padrão funcional da musculatura oro-facial. Cada indivíduo apresenta o seu próprio padrão de crescimento que sofre ação de fatores ambientais que em alguns casos podem alterá-lo. A maxila tem o seu crescimento para trás e para cima proporcionando um deslocamento desta para a frente e para baixo. Enquanto que, o crescimento do processo condilar contribui para o crescimento do ramo mandibular para trás e para cima, determinando o seu deslocamento para a frente e para baixo Os problemas de oclusão dentária consistem em anomalias do crescimento e desenvolvimento, afetando principalmente, os dentes, músculos e os ossos maxilares no período da infância e da adolescência, os quais podem produzir alterações tanto do ponto de vista estético como funcional. A amamentação é um fator que tem vindo cada vez mais a ser relacionado com o desenvolvimento crâniofacial, especialmente o crescimento mandibular, pois o mecanismo da amamentação tem sido considerado uma mais-valia na correção do retrognatismo mandibular presente no bebé. O tempo de amamentação é uma condicionante muito importante, visto que, o menor tempo de amamentação leva ao uso precoce do biberão. Este tipo de aleitamento pode não satisfazer o bebé por completo, pois o mecanismo de aleitamento é diferente do de amamentação, e pode potenciar o desenvolvimento de hábitos de sucção não nutritivos, como o uso da chupeta ou sucção digital, que vai prejudicar o desenvolvimento estomatognático, dando origem a más oclusões. Os hábitos de sucção não nutritiva quando instalados e com uma frequência, duração e intensidade elevada podem levar a problemas oclusais que só serão corrigidos ortodonticamente.

Eficacia del programa "Por mi salud bucal y la de mi futuro bebé" en la higiene oral de gestantes que acuden a un centro de salud materno infantil de la provincia de Chiclayo, 2015

Tesis de pregrado

Influência do estado nutricional materno em vitamina A sobre os níveis de imunoglobulina A no colostro humano

Mothers with good vitamin A nutritional status during gestation and lactation are better able to nourish and protect their infant with maternal milk. Our hypothesis is that women with more serum retinol have more retinol and secretory immunoglobulin A in colostrum. 190 healthy puerperal women from a Brazilian public maternity were recruited and divided according to the cutoff point for serum retinol (30 μg/dL). A number of the women was supplemented with 200000 UI (60 mg) of retinyl palmitate in the immediate postpartum. Serum and colostrum were collected on the 1st day postpartum and colostrum again on the following day. Retinol (serum and colostrum) was analyzed by HPLC and SIgA (colostrum) by turbidimetry. The mothers presented with adequate biochemical indicators of nutritional status, according to serum retinol (44.6 μg/dL). There were significant differences (p= 0.0017 and p= 0.043, respectively) in retinol and SIgA levels in the colostrum of mothers with serum retinol > 30 μg/dL and < 30 μg/dL. The concentration of SIgA in the colostrum of non-supplemented mothers on the 1st day postpartum was 822.6 mg/dL, decreasing after 24 hours to 343.7 mg/dL. Supplemented mothers showed levels of SIgA in colostrum of 498.9 mg/dL on the 2nd day postpartum (p= 0.00006). The colostrum of women with good vitamin A nutritional status had more retinol and SIgA. Additionally, maternal supplementation increases the levels of SIgA in colostrum. The higher levels of SIgA on the 1st day postpartum showed the importance of early breastfeeding, given that it provides considerable immunological benefits to newborn infants

Incidencia y resultados materno neonatales de la pre eclampsia grave sobre agregada a hipertensión arterial crónica en pacientes que ingresan en el Hospital Nacional de Maternidad de Enero a Diciembre 2013

Los trastornos hipertensivos del embarazo constituyen una complicación obstétrica frecuente y siguen siendo una de las primeras causas de muerte materna. Por tal razón, se considera que su prevalencia se vuelve indispensable para abordar de forma oportuna aquellas pacientes que se consideren en riesgo de presentar dicho problema, así como reforzar la educación prenatal. Las embarazadas durante sus controles prenatales deben de adquirir los conocimientos necesarios de los signos y síntomas de alarma de toxemia, para detectarla a tiempo. El presente trabajo se realizará en mujeres embarazadas ingresadas en el Hospital Nacional de Maternidad que presentan diagnóstico de hipertensión arterial crónica más preeclamsia sobre agregada, durante un período comprendido entre enero-diciembre 2013. Se realizará un estudio descriptivo, retrospectivo, ya que se utilizará expedientes clínicos de las pacientes en estudio, en un periodo de tiempo determinado, tomando en cuenta su edad en años, edad gestacional, número de embarazos, zona geográfica, complicaciones maternas fetales; que a su vez, permitirá poder determinar su incidencia en relación a la morbilidad y mortalidad de esta patología, buscando así factores determinantes para el proceso salud enfermedad.

Currículo en el nivel preescolar costarricense: El Ciclo Materno Infantil (CMI)

The present article tackles the conceptualization and description of the Infantile Maternal Cycle as p The present article tackles the conceptualization and description of the Infantile Maternal Cycle as part of the preschool level of the Costa Rican educational system. With the intention of having a wider vision of this Cycle, a revision is done for the curriculum concept, as well as, for the elements that shape it, and then there is a detailed description of specific aspects related to the preschool Costa Rican curriculum of the Infantile Maternal Cycle, taking as a starting point the Program of Study that was designed to attend the above Cycle in the Costa Rican educational system.

Prospección y caracterización preliminar in situ de tres especies de Pouteria en Nicaragua

Se colectaron Y caracterizaron 1,148 accesiones de Poutería Sapota Jacquin; Pouteria viridis Pittier y Poutería campechiana H.B.K. Provenientes de las cuatro regiones ecológicas en que se encuentra dividido el país. El estudio se estableció a través del Programa de Recursos Genéticos Nicaragüenses (REGEN), de la Universidad Nacional Agraria (UNA), Managua. De todas las accesiones solo se procesaron 290, ya que el resto presentaban caracteres incompletos. De este total, 33 accesiones eran de Pouteria campechiana H.B.K., 34 accesiones de Pouteria viridis Pittier, y 223 accesiones de Pouteria sapota Jacquin. Se observaron 18 descriptores, entre los cuales 9 son cuantitativos y 9 son cualitativos. Los datos se sometieron al paquete estadístico SAS (sistema de análisis estadístico) el que determinó los caracteres que influyen mayormente en la variabilidad de las especies del género Poutería como son, diámetro del árbol, altura del árbol, peso del fruto, peso de la semilla, número de semillas por fruto, forma del fruto textura de la pulpa, color de la pulpa, color de la cáscara. Después se realizó el análisis e interpretación de los agrupamientos (cluster) por el método WARD mínima varianza, resultando tres fenogramas, uno para cada especie del género Pouteria. Los fenogramas de Pouteria virídis Píttier, Pouteria sapota Jacquin y Pouteria campechiana H.B.K. Están formados por 6 agrupamientos cada uno con sus respectivos grados de similitud. El fenograma de Pouteria sapota Jacquin presentaba una mayor variabilidad de agrupamiento con 44 grupos (cluster) Los efemogramas mostraron la gran diversidad de características particulares de cada grupo. La existencia de grupos de árboles con similares características de diferentes regiones que mostraron el origen materno de éstos árboles capaces de adaptarse a diferentes sitios, manteniendo la mínima diferencia en sus características morfológicas y fisiológicas

La mortalidad infantil en Argentina es muy alta y puede ser reducida con un mejor uso de los recursos

En este número de Empleo y Desarrollo Social se discute la problemática de la mortalidad infantil en la Argentina. A pesar de los avances, los niveles actuales son demasiados altos para el grado de desarrollo del país y el gasto público que se destina a la salud. En general, se tiende a atacar al problema con acciones de prevención y atención primaria materno-infantil, mientras una acción tan básica y estratégica como la provisión universal de servicios de agua potable y cloacas permanece fuera de la agenda. En el presente informe se presentan algunas recomendaciones orientadas a mejorar la eficiencia en el uso de los recursos que se destinan a ambas áreas

Dossier especial

El dossier contiene los siguientes documentos pertenecientes al Pbro. Dr. Víctor Manuel Fernández: La preocupación por la vida en "Aparecida" -- Un padre que ama la vida. El contexto adecuado de nuestra preocupación por la bioética -- La defensa de los que tienen menos poder -- Vida -- El niño por nacer iluminado por la palabra -- Defender los derechos humanos implica atender la vida en el vientre materno -- La opción por la vida en esta Universidad -- ¿Qué le hace el aborto al corazón de la sociedad? -- Cuestiones sensibles en torno al aborto -- Presiones internacionales sobre América Latina con respecto a temas de salud reproductiva e identidad de género.

Comparación de haplotipos mitocondriales en presencia de incertidumbre: aplicación a la búsqueda de linajes maternos vascos

A lo largo de la historia se han dado varios eventos migratorios de la población vasca, fundamentalmente con destino América (USA, Argentina, Canada, ...). En ciertas regiones de estos países existen amplias colonias de descendientes de vascos, muy interesados en saber más sobre sus orígenes. A la hora de estudiar la dinámica de las poblaciones habitualmente se recurre al uso del ADN mitrocondrial. Este tiene dos características que lo hacen interesante, su estabilidad en la población y que es heredado de forma exclusiva por vía materna (ver Figura 1). Por este motivo, el perfil de ADN mitocondrial o haplotipo mitocondrial es una manera sencilla de investigar la ascendencia materna de las personas. El objetivo de este proyecto es desarrollar una aplicación Web que permita realizar búsquedas de perfiles en una base de datos de ADN mitocondrial. La principal dificultad es la búsqueda en presencia de incertidumbre, problema que será abordado en este proyecto. La base de datos de perfiles ha sido obtenida a lo largo de los años por el Grupo de Investigación n Consolidado BIOMICS, a través de sus diferentes proyectos de investigación y gracias a la donación que las personas han hecho de sus muestras. La razón de ser de este proyecto es el de devolver a estas personas y a la población en general un poco de lo obtenido. Por este motivo se ha desarrollado una aplicación Web que permite a cualquier persona que disponga de su perfil genético de ADN mitocondrial buscar en la base de datos (que actualmente cuenta con más de 1.000 perfiles) para saber en qué regiones del País Vasco y/o América hay personas pertenecientes a su mismo linaje materno.