Imagem corporal e fatores de risco em praticantes de caminhada da cidade do Natal-RN

Body image is the figure of our bodies built in our minds and the degree of dissatisfaction is often associated with risk factors identified by anthropometric measures. The purpose of this descriptive study was to evaluate the risk factors associated to morphological and functional variables associate to the perception of auto-image in middle-aged walkers of the south zone of the city of Natal. A hundred and thirty volunteers had been evaluated in four groups in function of the gender and age group. As measurement evaluations were used an auto-image perception questionnaire proposed by Stunkart of nine silhouettes numbered for both gender was applied; a weighing machine equipped with stadiometer for the body mass (kg) and stature (m) and the body mass index (kg/m2) that was calculated with base in measures of the body weight and stature and classified according to norms of the National Institute of Health (2000) as well as the systolic and diastolic blood pressure by a electronic digital device (DIGITRONIC). A metal anthropometric tape was used for the waist to hip ratio (WHR). It was used Analyses of variance (ANOVA) one-way, post hoc of Tukey and correlation of Spearman for the nonparametric data adopting the level of ρ≤ 0,05 for rejection of the null hypothesis. The body mass index indicated high factors of risk in the consisting groups. In all the groups were registered the desire to reduce their silhouettes. The body weight shows reduced when compared with the younger group in the male group of superior age group, while in the female group the inverse one occurs. The autoimage perception is associated with the classification of the waist to hip ratio in the female gender in the age group of the 50 to the 59 years and in the classification of the body mass index of all constituted groups. Significant associations had not been found for classification of the systolic and diastolic blood pressure in relation to the auto-image 41 perception. This thesis presents relation of interdisciplinarity and its contents have application in the fields of Physical Education, Medicine, Physiotherapy and Nursing

Violência institucional no âmbito da saúde reprodutiva : a percepção de mulheres usuárias do SUS, na cidade de Natal/RN

Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients

Níveis de homocisteína e desempenho cognitivo em uma amostra populacional de idosos da cidade do Natal-RN

The imprecision of the frontier that separates those cognitive deficits inherent to the human physiological aging process from those which represent the early signs of nervous system degenerative pathologies ,very prevalent among the elderly, has brought attention to the need of studies aiming to establish clinical and/or laboratorial criteria to allow this differentiation. Elderly people living in poor and developing countries are frequently exposed to precarious socioeconomic conditions which facilitate the development of an array of pathologies which have metabolic and nutritional dysfunctions as the established or proposed etiological agents. The levels of certain micronutrients, such as the vitamins B12 and B9 (folic acid), and of some intermediary metabolites, such as homocysteine are being thought of as etiological factors and/or as biological markers of a group of alterations which affect the normal functioning of the nervous system with important reflexes upon cognitive performance. This study aims to investigate the influence of homocysteine, B12 vitamin and folic acid levels on the cognitive performance of the low income elderly population. This transversal study took place in Natal, Rio Grande do Norte State, Brazil, and involved 205 dwelling elderly people, users of the Programa de Saúde da Família, a public healthcare program, maintained by the city s health authorities. A multidimensional questionnaire was used to assess the socio-demographic aspects and the overall health and nutrition conditions. The cognitive performance was measured by the use of the Portuguese version of the Mini Mental State Exam (MMSE). The serum levels of homocysteine, B12 vitamin and folic acid were determined by chemiluminescence. The association between the socio-demographic and serum levels of Hcy, B12 vitamin and folic acid was determined by multiple linear regression. Serum levels higher than 13.5 μmol/l, indicative of hyperhomocysteinemia (HHcy), were found on 25.4% of the sample, being more prevalent in men (p<0.05). Deficitary levels of folic acid (<5ng/mol) and of B12 vitamin (<193 pg/ml) were found on 3.9% and 10.2% of the sample respectively. A negative correlation was found between cognitive performance with both age and HHcy and a positive correlation was found between cognitive performance and schooling. The isolated HHcy R2 values were an explanation to only 4% of the variance of the MMSE scores. However, when associated with schooling and age, this model explains about 25% of this association

Significados e percepções de puérperas sobre as síndromes hipertensivas da gravidez e parto prematuro

Hypertensive syndromes in pregnancy (HSP) are configured as one of the major complications in the pregnancy and postpartum period and can lead premature newborn and subsequent hospitalization of the newborn to the Neonatal Intensive Care Unit (NICU). This study aimed to analyze the perceptions, meanings and feelings of mothers on the hypertensive syndromes in pregnancy and premature obstetric labor. The research was qualitative and has a theoretical methodological the Social Representations Theory(SRT) in the approach to the Central Nucleus Theory. The study included 70 women, mean age 29 years, predominantly school to high school, most of them married or in consensual union, primiparous and prevalence of cesarean delivery occurred between 32 and 37 weeks of pregnancy.The data were collected from may to december 2008 in the Maternity School Januário Cicco in Natal , and obtained through the following instruments for data collection: questionnaire including questions about socio-demographic status; the Free Words Association Test (FWAT) and and verbalized mental image construction used three stimuli: such as pregnancy with high blood pressure, preterm birth and NICU, and interview with the following guiding question: what it meant for you to have a pregnancy with high blood pressure and consequently the birth of a premature baby? Data analysis was performed using multi-method obtained from the data processing by EVOC (Ensemble Programmes Permettant L 'Analyze des Évocations) and ALCESTE (Analyse Lexicale par Contexte d'un Ensemble de Segment de Texte) and thematic analysis in categories. The results will be presented in four thematic units under the following representative universes: HSP, prematurity as a result of HSP, NICU and the social representations of mothers on the hypertensive disorder of pregnancy sequenced premature birth and hospitalization of the child in the NICU. The results obtained by multimethod analyses showed similar constructions and point to death as the central nucleus and negative aspects, coping strategies, need of care, knowledge about the disease, fragility and meanings of the NICU as peripheral elements. It is considered that the perceptions, meanings and feelings of puerperal women in relation to HSPs and to premature delivery are a negative social representation, with representational elements that may have influenced the adverse effects on the disease and its consequences. We suggest action on the peripheral elements of this representation, with adequate orientation, early diagnosis, effective conduct, receptive attitude on the part of the team, health promotion measures and effective public policies, in order to improve the care provided to puerperal women, making them feel welcome and minimizing their suffering

Avaliação da atenção à saúde de portadores de HIV no centro de referência para o tratamento da Aids em Natal/RN por profissionais e usuários do serviço

Objective: The aim of this study was to evaluate the health care of HIV/AIDS Reference Center for treatment of AIDS in Natal/RN for professionals and service users. Methods: This is an evaluative study with a quantitative approach, performed in the outpatient Giselda Trigueiro Hospital, in Natal (RN). The target population consisted of 313 patients with HIV and 34 professionals of the center. Data collection occurred from august 2007 to july 2008, with a structured form of interview, validated through a pilot study. The data were analyzed by descriptive and inferential statistics. Results: The evaluation of the service was considered unsatisfactory by 85.6% users. However, 58.8% of professionals considered it satisfactory. There was difference in the evaluation of the following indicators: the relationship professional users, offering support, timeliness of professional guidelines on the treatment. There was similarity in the following indicators: physical structure, respect for privacy, opportunity to make complaints, hospitality, convenience of schedules, availability of ARVs and laboratory tests, and ease of access. Conclusion: The results point to dissatisfaction of the users and professional satisfaction with the health care of people with HIV / AIDS in the service searched. It was found that the indicators used in this study may be considered relevant to evaluate the service in question, as well as monitoringparameters provide acceptable quality of health care by the National STD/AIDS

Câncer de boca e orofaringe: tendências e análise de sobrevida em Natal (RN)

Introduction: Mouth cancer is classified as having one of the ten highest cancer incidences in the world. In Brazil, the incidence and mortality rates of oral cancer are among the highest in the world. Intraoral cancer (tongue, gum, floor of the mouth, and other non-specified parts of the mouth), the accumulated survival rate after five years is less than 50%. Objectives: Estimate the accumulated survival probability after five years and adjust the Cox regression model for mouth and oropharyngeal cancers, according to age range, sex, morphology, and location, for the city of Natal. Describe the mortality and incidence coefficients of oral and oropharyngeal cancer and their tendencies in the city of Natal, between 1980 and 2001 and between 1997 and 2001, respectively. Methods: Survival data of patients registered between 1997 and 2001 was obtained from the Population-based Cancer Record of Natal. Differences between the survival curves were tested using the log-rank test. The Cox proportional risk model was used to estimate risk ratios. The simple linear regression model was used for tendency analyses of the mortality and incidence coefficients. Results: The probability after five years was 22.9%. The patients with undifferentiated malignant neoplasia were 4.7 times more at risk of dying than those with epidermoid carcinoma, whereas the patients with oropharyngeal cancer had 2.0 times more at risk of dying than those with mouth cancer. The mouth cancer mortality and incidence coefficients for Natal were 4.3 and 2.9 per 100 000 inhabitants, respectively. The oropharyngeal cancer mortality and incidence coefficients were, respectively, 1.1 and 0.7 per 100 000 87 inhabitants. Conclusions: A low survival rate after five years was identified. Patients with oropharyngeal cancer had a greater risk of dying, independent of the factors considered in this study. Also independent of other factors, undifferentiated malignant neoplasia posed a greater risk of death. The magnitudes of the incidence coefficients found are not considered elevated, whereas the magnitudes of the mortality coefficients are high

Perfil epidemiológico dos distúrbios hipertensivos na gravidez

The preeclampsia is a disease that evolves to high death rate for the mother and for the fetus. The incidence of this disease in the world is variable and there are no data of this disturb in the Brazilian population. This paper had the objective to determine the incidence and risk factors for development of hypertensive disorders of pregnancy in a neighborhood in Natal, RN, Brazil, taking place a prospective study, cohort type, with the objective of evaluating the entire pregnancy of 242 women that got pregnant between 2004-2007. The incidence of hypertensive disorders was of 17%, while the incidence of preeclampsia was of 13.8%. The age average of women that developed the hypertensive disorders was of 27.4 years (SD±.9), whilst those that developed preeclampsia was of 26.6 (SD ±7.8) years and the normotensive was of 23.9 (SD±5.8) (p=0.002). It is noted a significant increase of the hypertensive disorder with age (p=0.0265). The gestational age for those who developed preeclampsia was lower than the women that developed normotensive pregnancy (p=0.0002). The body mass index (BMI) of the group of women that developed the hypertensive disorder was of 25.8 (SD±3.9), significantly higher than the group of normotensive women with 23.5 (SD±3.7) (p=0.02). The levels of triglycerides and cholesterol tended to be higher on women with preeclampsia than on normotensive, p=0.0502 and p=0.0566, respectively. Six (6) women presented with severe preeclampsia and one (1) developed HELLP Syndrome. The resolution of the pregnancy was performed by cesarean section in 70% of women that developed hypertensive disorders, whilst the normotensive was of 23.6% (p<0.0001). A subgroup of the studied subjects was reassessed one year after labor, revealing that 50% of the patients were still hypertensive. There were no larger complications nor mother death during labor. The incidence of hypertensive disorders are above the levels noted in other studies and 30% of the women were within the poles of greater risk for the hypertensive disorders; the elevated BMI in the beginning of the pregnancy is a risk factor for hypertensive disorder. The risk of severe complication in preeclampsia is high, with imminence of eclampsia occurring in 20.1% of women who developed hypertensive disorder of pregnancy. The adequate prenatal care and the opportune labor assistance may minimize the complications of the pregnancy hypertension and avoid mother death, although the risk of women remaining hypertensive is elevated

Seleção de categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para avaliação do paciente com acidente vascular cerebral em reabilitação

Stroke represents the first cause of disabilities among adults. Although different professions work together in treatment of stroke patients, all they use different terminologies for the description of the patients problems and it can constitute an impediment in the communication between the staff members. Thus, the multidisciplinary and interdisciplinary work would be facilitated if using a reference common tool, as the new International Classification of Functioning, Disability and Health (ICF). However, the ICF is very extensive and complex and due to its complexity, it has been evidenced the necessity to select its categories to become it more practical. The aim of the study was to investigate which categories of the ICF are more suitable to evaluate and to describe the stroke patient in the view of teachers and municipal public health professionals. It was a descriptive research, which involved 5 professors and 11 professionals of Physiotherapy that have worked at the health public area in Natal / RN. It was used the Delphi Technique in 3 rounds and the Likert Scale to select the categories among the ICF components. As result, from the 362 IFC categories, 94 were selected. The selected categories correspond to rehabilitative characteristics of Stroke patients in the universe of the Physiotherapy performance. The methodology applied was suitable to the studied object emphasizing the necessity of future studies for validation of the chosen categories

Significados e percepções do homem diante da gravidez de sua companheira com síndromes hipertensivas

The general aim of the research was to comprehend the Social Representations constructed by the man in the face of his companion s risk pregnancy caused by hypertensive syndromes. The study is of exploratory and descriptive character in a qualitative approach developed at two public maternity hospitals, both located in Natal-RN, with 65 men whose wives had undergone high-risk pregnancy. The project was submitted to the Ethics on Research Committee of the Federal University of Rio Grande do Norte, Brazil (CEP-UFRN), with favorable report no. 81/07. For data collection, the following multimethods were employed: a word free association test; a projective test for registering mental images; and a semistructured interview schedule. The speech contents were analyzed in accordance with the Theory of Social Representations and complemented by the Central Nucleus Theory. The discussion of the results was grounded on literary findings of the companion s participation in pregnancy as well as in risk pregnancy associated with hypertensive syndromes. The data showed fear as representation s central nucleus, while recollections of that feeling referred to death of both companion and child in addition to fear of the unknown. The categories preoccupation and carefulness, other feelings, and clinical picture of the disease represented components of the peripheral nucleus. The results concerning mental images followed the same category criteria of the word free association test fear, other feelings, preoccupation, carefulness, and clinical picture of the disease. After being processed in accordance with the principles of content analysis, the statements originated three thematic unities: fear and insecurity in the presence of the companion s risk pregnancy; attitudes of carefulness to the risk pregnancy of the partner; and humanized assistance during the companion s risk pregnancy. Considering the results, the conclusion is that the partner s risk pregnancy caused by hypertensive syndromes represents, for the man, feelings of fear, preoccupation, insecurity, lack of acceptance and information, as well as attitudes of carefulness. The results reveal necessity of reorganizing the obstetric assistance with an eye to including the man as participant in the reproductive process. That demands extension of humanized carefulness to the companion with a view to make him an active coadjutor in the assistance of high-risk pregnant

Avaliação das condições higiênico-sanitárias da produção de refeições à base de carne da alimentação escolar no município de Natal-RN

The National School Nutrition Program is the oldest program in the country directed at food and nutrition safety. Its aims are to offer nutritional food as a supplement to students of public and philanthropic schools. Studying school nutrition transcends the investigation as a purely social program, given that it reaches the fields of public health, nutrition and food, using a wide variety of approaches. Thus, it is characterized by a multidisciplinary study, where the disciplines work side by side in distinct aspects of a single problem. Aim: This study aims to assess hygiene practices during the preparation of meat-based meals in public schools in the city of Natal, Brazil. Methods: A list was applied at 27 schools to identify the procedures of good food preparation practices. In addition, cooking and meal distribution temperature were measured and a microbiological analysis of the final preparation and of the water used in preparing it was performed. For microbiological analyses of the food, we analyzed coliforms at 45°C, coliforms at 35°C and Enterococcus, and for the water, we analyzed thermotolerant coliforms and total coliforms, using the methods recommended by APHA, 1995. Results: Most of the schools did not meet the required standards in all the variables related to good food preparation practices, except for the time spent preparing the meat, in which 89% were within the norm. Cooking temperature of the meals was within the standard; however, the temperature at distribution and the time spent dispensing the meals were inadequate. Of the 27 schools, 22 (81.5%) showed the presence of coliforms at 35° C in at least one meal sample and 18 (66.7%) had values above the recommended limit for coliforms at 45°C. The presence of E. coli was identified in 6.1% of the samples analyzed. The presence of Enterococcus was not found at any of the schools. With respect to the water, the North district of the city was the only one that did not meet the standards for the two indicators evaluated. The contamination found was not associated with the hygiene or food storage problems observed. Conclusions: The results show that the hygiene-sanitary conditions of meat-based public school meals were unsatisfactory, demonstrating the need for improvements in the production process to preserve the health of the student population. Multidisciplinarity: Researchers from the areas of food microbiology, nutrition, public health and statistics took part in this study, a decisive factor for characterizing the research as multidisciplinary

Estado nutricional antropométrico, perfil lipídico e consumo alimentar como fatores de risco para doença cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Avaliação das condições higiênico-sanitárias de manipuladores de alimentos e utensílios de mesa de escolas públicas municipais de Natal, RN

In Brazil school food is constitutionally guaranteed to public school students at the preschool and elementary level. This food must be nutritious, hygienic and sanitary. The aim of the present study was to assess the hygienic/sanitary conditions of food and table utensil handlers in municipal public schools in Natal, Brazil. In total, 27 public schools were assessed, using a checklist and microbiological analysis of the hands and table utensils. For the microbiological analyses of the hands, coliforms were analyzed at 45ºC and for the utensils aerobic mesophilic bacteria, using methods recognized by AOAC, 2002 and APHA, 1992, respectively. Most of the schools studied did not exhibit good food and utensil handling practice procedures in any of the variables analyzed. It was shown that 74.1% of the handlers received no periodic training, 51.9% did not undergo annual health examinations and 100% did not practice proper hand hygiene, which reflected significantly (p < 0.05) in hand contamination, where fecal coliforms were detected on 55.6% of the hands analyzed. With respect to the utensils, it was found that 100% of the schools studied did not follow correct hygiene practices and most were classified as very bad ; that is, aerobic mesophilic bacteria values above the limits established by PAHO (Pan American Health Organization), with schools in the north and south districts recording the highest percentages. The results show that the hygienic-sanitary conditions of the food and utensil handlers in the schools studied were inadequate, demonstrating the need for implanting good handling practices aimed at protecting the health of children that take part in the program and offering safer foods. Researchers from the areas of food microbiology, nutrition, public health and statistics participated in this study, a decisive factor for characterizing it as multidisciplinary

Fatores determinantes da decisão sobre a prática da cesariana em Natal-RN

O objetivo deste estudo é analisar os fatores que contribuíram para as diferentes decisões para o parto cesáreo e a ligadura de trompas entre as mulheres de 18 a 45 anos de idade no Município de Natal, no Nordeste do Brasil, no ano de 2000. Tratou-se de um estudo longitudinal, originado da base de dados de um Estudo Multicêntrico, envolvendo outras localidades do Brasil, composta de mulheres em idade fértil que procuraram o serviço público ou privado. Foram realizadas três entrevistas: no início da gestação, no mês anterior à data provável do parto e até um mês após o parto, perfazendo um total de 433 entrevistas, sendo finalizada com uma amostra de 269 mulheres. O estudo satisfez a um critério de elegibilidade, abrangendo uma amostra das mulheres de 18 a 40 anos de idade, que residiam em Natal e que estavam grávidas no máximo, na 22a semana de gestação, e procuraram o serviço público ou privado para a realização do pré-natal. Não entraram no estudo, aquelas mulheres que faziam um acompanhamento em ambulatórios especiais (hipertensão ou diabetes gestacional, HIV/AIDS). A análise consistiu, primeiramente, num estudo descritivo, seguido de uma discussão sobre a trajetória do desejo à realização do parto e testou-se a significância estatística dos partos com variáveis socioeconômicas. Sequencialmente adotou-se uma análise bivariada centrada nos testes de associação, onde foi considerada a variável tipo de parto como sendo a variável resposta e as demais variáveis, relacionadas à condição sóciodemográfica e a saúde reprodutiva da mulher, como sendo as variáveis de risco ou independentes. Para o cálculo da razão de chance (OR), foi utilizado o modelo de regressão logística múltipla. Das 269 mulheres entrevistadas, 56,0% foram submetidas ao parto normal. Este tipo de parto foi desejado independente da categoria, por 71% das entrevistadas. Os resultados mostraram como fatores determinantes para cesárea, o serviço ser privado (OR = 5,6), a mulher ter idade acima de 20 anos (OR=2,87), ser primípara (OR=4,56) e a realização de ligadura de trompas (OR=12,94). Independente da parturição, 84% das mulheres do serviço público foram submetidas a um parto normal, enquanto que, 74% das primíparas do serviço privado, fizeram uma cesárea. Os resultados sinalizam um distanciamento efetivo entre o desejo por um tipo de parto e a sua realização, quando os fatores considerados, não foram somente técnicos, podendo, também, refletir a falta de prática do parto normal, pelo obstetra e a necessidade de uma maior consciência ética nos procedimentos obstétricos, de modo a favorecer uma maior abertura na participação da gestante na escolha pelo tipo de parto

Estudo clinicopatologico das neoplasias benignas e malignas de glândulas salivares maiores e menores

Foi avaliada, no presente estudo, a prevalência dos casos de tumores benignos e malignos de glândulas salivares maiores e menores que ocorreram na população atendida no hospital Dr. Luiz Antônio Natal/RN, no período de 1989 a 2005, bem como as possíveis associações existentes entre os aspectos clínico e patológicos exibidos pelos referidos tumores, visando à obtenção de parâmetros indicadores de diagnóstico e/ou prognóstico. Dos prontuários dos pacientes foram obtidas todas as informações clínicas necessárias para a realização do trabalho. A análise dos dados revelou que dos 303 tumores de glândula salivar estudados, a maioria (71%) foram benignos, o mais comum foi adenoma Pleomórfico. As médias de idades para os tumores benignos e malignos foi de 49,2 e 58,5 anos, respectivamente. Diferenças estatisticamente significativas entre estes tumores foram observadas para as seguintes variáveis: idade média, o tamanho do tumor e duração da doença. Em relação ao tamanho do tumor, carcinoma mucoepidermoide mostrou-se 1,74 vezes menor que o de outros tumores malignos. Uma associação entre o diagnóstico histológico e variável consistência do tumor foi observada. Os dados apresentados neste estudo são relevantes para a compreensão das diversas características exibidas por estes tumores, já que corroboram uma série de estudos anteriores

Avaliação clínica e microbiológica das condições de saúde oral dos receptores de transplante renal do Hospital Universitário Onofre Lopes, Natal RN

Introduction: The chronic immunosuppression promotes the development of changes in the oral cavity of the kidney transplant recipients (KTR), however with the exception of gingival overgrowth, little is known regarding the prevalence of oral lesions in this population. Objective: To evaluate the prevalence of clinical and microbiological conditions of the oral cavity of the recipients of kidney transplantation and the associated factors. Methods: This was a cross-sectional study which examined 96 clinical KTR and experimental where collected saliva stimulated them to identify Candida sp. Data collection consisted of evaluation stomatologic, socio-demographic, clinical aspects of transplantation, condition of oral hygiene and dental caries, yonder to questions about knowledge of oral alteration after transplantation. Results: Of the total, 66.7% of KTR had some type of oral manifestation. The most common was saburral tongue, followed by gingival overgrowth, with both oral manifestations related to gender and concomitant use of cyclosporine and nifedipine (p <0.05). Tacrolimus showed a protective effect for gingival overgrowth (OR = 0.13). The oral hygiene was associated with saburral tongue(p = 0.03) and severity of gingival overgrowth (p = 0.0001). Oral candidiasis was diagnosed in 17.7% of patients and Candida albicans was isolated most frequently in the saliva of RTR with a colonization of 58.3%. The average DMF-T increased with age. The method of oral hygiene was most used brush and toothpaste to 61.5%. Changes in the oral cavity was seen in 54.2% of KTR, citing as the main growth and gingival ulcers. Instructions for oral hygiene after transplantation were neglected for 61.5% of RTR. Dry mouth and halitosis were reported in 30.2% and 36.5% respectively. Conclusions: More the half of the KTR had at least one injury of the mouth, the immunosuppressive drugs and oral hygiene are associated with these alterations. Prospective cohort studies are needed to elucidate the relationship between oral manifestations and levels of drug and risk of oral manifestations occur over time. The kidney transplant recipients showed to be aware of oral alterations occurred after transplantation and uninformed about the oral hygiene instructions. With regard to hygiene, the incidence of caries was considered high, conditions of risk were identified and improvements in primary attention should be encouraged and reflected in the monitoring of renal transplant