Perfil de mães e o desfecho do nascimento prematuro ou termo

The birth or delivery under 37 weeks of pregnancy is considered a global public health problem, since it is seen as one of the main risk factors for neonatal morbidity and mortality, particularly in the first week of life. This study had the objective of analyzing the profile of mothers of premature and full-term babies for the outcome of birth. This is an analytical-descriptive and cross-sectional study, with a sample of 109 mothers of all the premature babies and 135 mothers of the randomly selected full-term babies, by drawing, occurred in the period from April to September 2015, in a public maternity. Data were organized on Microsoft Excel 2013; subsequently, there was the analysis of the analytical-descriptive statistics, through Statistica 10, through which the frequencies, proportions, p values, with 5% significance level, through the Chi-square test, were identified. The project was submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, receiving a favorable opinion (nº 1047431/2015). This study has enabled us to identify that the socioeconomic profile of mothers of premature and full-term babies showed, in both, low schooling level and low income. In addition, our data point out in the two groups, before and during pregnancy, a high prevalence of sedentariness; statistical significance for overweight and obesity before and during pregnancy, with 42,22% prevalence before pregnancy of mothers of premature babies and 48,62% of mothers of full-term babies; with high blood pressure during pregnancy in 32,11% of mothers of premature babies and 17,04% of mothers of full-term babies. Moreover, pregnancy was only planned in 33,33%, and also unwanted by 21,1% of mothers of premature babies, while 40,37% of mothers of full-term babies planned pregnancy and 17,78% had unwanted pregnancy. With respect to the aggravating factor “illicit drugs”, there was consumption during pregnancy on the part of 8,26% of mothers of premature babies. The most frequent complications were: vaginal bleeding (in 43,12% of mothers of premature babies and 20% of mothers of full-term babies); urinary infection (in 44,95% of mothers of premature babies and 40% of mothers of full-term babies); and stressful pregnancy (in 62,96% of mothers of premature babies and 47,41% of mothers of full-term babies). Accordingly, babies were born with health problems in 58,10% of premature births and there was healthy birth in 96,30% of full-term babies. Therefore, the profile of mothers with obesity and overweight, unwanted pregnancy, user of illegal drugs during pregnancy, stressful pregnancy and vaginal bleeding may be associated with the birth of premature baby as unfavorable and hazardous event for the child’s health.

Perfil de mães e o desfecho do nascimento prematuro ou termo

The birth or delivery under 37 weeks of pregnancy is considered a global public health problem, since it is seen as one of the main risk factors for neonatal morbidity and mortality, particularly in the first week of life. This study had the objective of analyzing the profile of mothers of premature and full-term babies for the outcome of birth. This is an analytical-descriptive and cross-sectional study, with a sample of 109 mothers of all the premature babies and 135 mothers of the randomly selected full-term babies, by drawing, occurred in the period from April to September 2015, in a public maternity. Data were organized on Microsoft Excel 2013; subsequently, there was the analysis of the analytical-descriptive statistics, through Statistica 10, through which the frequencies, proportions, p values, with 5% significance level, through the Chi-square test, were identified. The project was submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, receiving a favorable opinion (nº 1047431/2015). This study has enabled us to identify that the socioeconomic profile of mothers of premature and full-term babies showed, in both, low schooling level and low income. In addition, our data point out in the two groups, before and during pregnancy, a high prevalence of sedentariness; statistical significance for overweight and obesity before and during pregnancy, with 42,22% prevalence before pregnancy of mothers of premature babies and 48,62% of mothers of full-term babies; with high blood pressure during pregnancy in 32,11% of mothers of premature babies and 17,04% of mothers of full-term babies. Moreover, pregnancy was only planned in 33,33%, and also unwanted by 21,1% of mothers of premature babies, while 40,37% of mothers of full-term babies planned pregnancy and 17,78% had unwanted pregnancy. With respect to the aggravating factor “illicit drugs”, there was consumption during pregnancy on the part of 8,26% of mothers of premature babies. The most frequent complications were: vaginal bleeding (in 43,12% of mothers of premature babies and 20% of mothers of full-term babies); urinary infection (in 44,95% of mothers of premature babies and 40% of mothers of full-term babies); and stressful pregnancy (in 62,96% of mothers of premature babies and 47,41% of mothers of full-term babies). Accordingly, babies were born with health problems in 58,10% of premature births and there was healthy birth in 96,30% of full-term babies. Therefore, the profile of mothers with obesity and overweight, unwanted pregnancy, user of illegal drugs during pregnancy, stressful pregnancy and vaginal bleeding may be associated with the birth of premature baby as unfavorable and hazardous event for the child’s health.

Resposta clínica periodontal e controle glicêmico em pacientes com e sem diabetes tipo II portadores de periodontite crônica ao tratamento periodontal “full mouth desinfection”

There is a bidirectional association between periodontal disease (PD) and diabetes mellitus, in which diabetes favors the development of PD and PD, if left untreated, can worsen the metabolic control of diabetes. Thus, periodontal disease should be treated to restore periodontal health and reduce the complications of diabetes. Therefore, the objective is assess the effect of full mouth periodontal therapy decontamination (Full Mouth Desinfection - FMD) in diabetic type II patients with chronic periodontitis during 12 months. Thirty-one patients in group one (G1) and 12 in group two (G2) were followed at baseline, 03, 06 09 and 12 months. There following clinical parameters were accessed: probing on bleeding (BOP), visible plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival recession (GR). For diabetic patients, there were also made laboratory tests to evaluate blood parameters: fasting glucose and glycated hemoglobin. The results had been analyzed in two ways: all sites in the mouth and another with diseased sites. The Mann-Whitney, Friedman and Wilcoxon tests were used with 5% significance. Intergroup analysis of all sites it is clear that there was no significant difference over time concerning PD, BOP, PI, CAL and RG. However, when evaluating the diseased sites, we observed significant difference for CAL and PD, with higher values in G1. The intragroup analysis for all sites showed a statistically significant reduction at PD, PI and BOP in both groups. Intragroup analysis of periodontal affected sites showed a statistically significant reduction in PD, BOP and CAL in both groups. There was also a statistically significant increase in RG values. There was no significant change concerning glycated hemoglobin and fasting glucose in the G1. Therefore, it can be concluded that there were improvements in periodontal parameters over the 12 months of research, but without changes in glycemic levels of diabetic patients. Thus, periodontal therapy proved effective in maintaining oral health.

Análise do perfil imunológico e citohistológico durante a transmissão vertical de Trypanosoma cruzi em diferentes estágios da infecção experimental

Trypanosma cruzi is the causative agent of Chagas disease. This trypanosomiasis has become a global public health problem due to migration of Latin Americans to non-endemic countries. In Latin America with the succesful implementation of control domiciliated vector infestation and blood transfusion, the importance of congenital transmission has recently increased. Considering the tight regulation of immune system during gestation, we aimed to investigate the changes in the immune system caused by T.cruzi infection in the gestation outcome. T cruzi G and Y strain were used to infect female BALB/c mice before or after mating with non-infected male mice. The presence of vaginal plug was used as indicative of mating. Females were euthanized 8 days after confirmation of vaginal plug. We used three female control groups, only infected, only infected and non-infected and non-pregnant females. Two groups were infected before mating and other two were infected 4 days after confirmation of vaginal plug. The uterus and spleen were collected to immunochemistry, qPCR, immunofluorescence and cytokine analysis. Our results showed that despite the MMP’s identification being similarly among groups, T.cruzi higher virulent strain can impaire gestation outcome prior mating; the infection also increased cytokines like IFN-γ, IL-1β and IL-4; and leucocytes in uterine environment was altered, responding locally to systemic changes caused by T.cruzi infection. In conclusion this work suggests that T.cruzi infection can impaire gestation outcome and local response to sistemic infection was able to control the infection allowing pregnancy development in some conditions.

El autocuidado y apoyo social de mujeres de un proyecto de seguimiento mamográfico en Porto Alegre/Brasil

Objective: Identify preventive self-care practices and analyze the configurations of the network support for women with and without breast cancer registered in a mammography-monitoring project from Porto Alegre/Brazil.Method: a mixed sequential delimitation was performed, which expanded the results of the quantitative step (cross and correlation section) in a qualitative step (narrative interviews). 37 women diagnosed with breast cancer (group 1) and 72 without this diagnosis (group 2 – monitoring) participated. The following instruments were used: Assessment Questionnaire Self-care Ability (ASA-A) and Assessment Questionnaire Perceived Social Support and Community. There were performed descriptive analysis and comparison of means (t test and ANOVA) between the two groups. To deepen the understanding of the data, we selected four women with breast cancer with extreme levels on the scale of Social Support to participate in the biographical narrative interviews.Results: the analysis indicate that women who had breast cancer have better self-care practices than the women from the monitoring project (t = 1.791, P = 0.027). As for the analysis of social support, there were no statistically significant differences between the two groups. All participants have an average level of perceived social and community support. It was highlighted by the qualitative data that it was after the diagnosis of breast cancer that women lived self-care aspects they had not previously experienced.Conclusions: the self-care was significantly bigger in the group of women with breast cancer, where the cancer diagnosis was a trigger to increase self-care.

Parâmetros de avaliação da visão: visão binocular

No período extra-uterino o sistema visual já se encontra totalmente constituído. Desenvolve-se desde o nascimento até à primeira infância. A primeira evidência clínica da visão binocular é demonstrada aos 6 meses de idade – visão estereoscópica. A visão binocular não é inata. O sistema visual decompõe todas as estimulações visuais que se apresentam à retina, em imagens com contraste variável. O cérebro, ao nível do córtex occipital, analisa-as e reconstitui a imagem inicial, com os dados de base, fruto da aprendizagem do indivíduo. É um processo cerebral correspondente à percepção dos objectos no espaço que é realizado em simultâneo para que as imagens obtidas por cada olho se formem sobre as respectivas fóveas. Pode ser definida como a visão conseguida através da coordenação dos dois olhos, de modo que as imagens de cada olho separadamente possam ser apreciadas como uma impressão mental única na parte visual do córtex cerebral.

Dentes imaturos necrosados

O desenvolvimento completo das raízes demora pelo menos dois a três anos a completar-se após a colocação da peça dentária na cavidade oral, na medida em que manutenção da vitalidade pulpar é de extrema importância, de modo a permitir o completo desenvolvimento dentário e radicular. Perante um diagnóstico de necrose pulpar num dente imaturo o objectivo do Médico Dentista deverá ser sempre permitir a maturação completa das raízes e consequente encerramento apical. Deste modo, podemos considerar que existem essencialmente duas abordagem terapêuticas em dentes imaturos necrosados: a apexificação e a revascularização. A apexificação é considerada como o tratamento standard de dentes imaturos, uma vez que induz a formação de uma barreira apical calcificada. No entanto, este procedimento tem diversas desvantagens, nomeadamente o risco de fractura radicular uma vez que não proporciona um espessamento das paredes da raiz deixando-as assim finas e susceptíveis à fractura. Nos últimos anos um novo tratamento, como alternativa à apexificação, tem vindo a ser estudado. A revascularização consiste no transporte de factores de crescimento para o espaço intracanalar através da estimulação do sangramento dos tecidos periapicais e, deste modo, promover de forma natural um espessamento e completo desenvolvimento das raízes. Assim, comparativamente à apexificação a revascularização apresenta algumas vantagens, podendo, num futuro próximo, tornar-se no tratamento de eleição aquando de um diagnóstico de necrose num dente imaturo.

Cómo evaluar y reducir desigualdades sociales en los programas de cribado de cáncer

Esta nota de campo presenta las conclusiones y recomendaciones elaboradas en el encuentro "¿Cómo reducir las desigualdades sociales en los programas de cribado de cáncer", celebrado en la XXVI Escuela de Salud Pública de Mahón (Menorca). Los participantes elaboraron recomendaciones a partir de las experiencias de los programas de cribado poblacionales de cáncer de mama y colorrectal, y del cribado oportunista de cáncer de cuello uterino. Las conclusiones y recomendaciones se centraron en cuatro grandes áreas (sistemas de información, evaluación y calidad, investigación e intervenciones): incorporar variables sociales individuales en los sistemas de información sanitarios; establecer unos estándares mínimos de recogida de información que permitan conocer las desigualdades en el acceso a los servicios preventivos; realizar acciones en población vulnerable; y promover el intercambio de experiencias y buenas prácticas a través de la Red de Programas de Cribado de Cáncer y de grupos de trabajo de sociedades científicas.

Estudio comparativo entre el alumbramiento dirigido y el alumbramiento expectante

Evaluar el efecto del procedimiento del alumbramiento dirigido, en la duración del alumbramiento y la cantidad de hemorragia, en relación comparativa con el procedimiento del alumbramiento expectante. El alumbramiento dirigido disminuye el tiempo y la cantidad de la hemorragia. Estudio experimental, aleatorizado. Se realizó el estudio en el Hospital Vicente Corral Moscoso de la ciudad de Cuenca. El tamaño de la muestra fue en 200 embarazadas. 100 embarazadas en el grupo dirigido y 100 en el expectante asignadas aleatoriamente. El alumbramiento dirigido se inició con la comprobación, mediante tacto vaginal, de que la placenta se halla por debajo del cuello uterino. El alumbramiento expectante luego de la presentación de tres signos clásicos del desprendimiento placentario. Los resultados fueron disminución del tiempo del alumbramiento dirigido de 0 a 5 minutos con un riesgo relativo de 0.28 y un intervalo de confianza 95 por ciento de [0.432 - 0.68]. El tiempo de duración media para el alumbramiento dirigido fue de 2.05 minutos, P=0.00002. La cantidad del sangrado durante el alumbramiento dirigido para valores de 0 a 199 centímetros cúbicos fue menor con un riesgo relativo de 0.52 y un intervalo de confianza 95 por ciento [0.38 - 0.71] y para cantidades mayores a 199 centímetros cúbicos el riesgo relativo fue de 0.54 y con un intervalo de confianza [0.40 - 0.72]. La cantidad media de sangrado fue de 169.80 centímetros cúbicos, P=0000000. El alumbramiento dirigido disminuyó el tiempo y la cantidad de sangrado

Diagnóstico situacional del servicio de ginecología del Hospital Nacional Especializado de Maternidad Dr. Raúl Arguello Escolán, Enero a Diciembre 2013

Se plantea la realización de este estudio basado en el servicio de Ginecología. De esta manera la institución será capaz de elaborar planes para la solución de sus problemas y/o necesidades, permitiendo que todos el personal que labora en el servicio de ginecología lo utilicen como un instrumento más, para elaborar, indagar, profundizar, integrar y crear una propuesta de transformación de la situación de salud de área de trabajo, en la que cada miembro del personal sea un participe activo para mejorar el proceso salud-enfermedad de cada paciente que ingresa a dicho servicio. Objetivo: realizar el diagnóstico situacional del servicio de ginecología del Hospital Nacional Especializado de Maternidad “Dr. Raúl Arguello Escolán” de Enero-Diciembre 2013. Metodología: se realizó un estudio descriptivo, del funcionamiento del servicio de ginecología. Se utilizaron para el estudio los expedientes clínicos y datos proporcionados por el departamento de estadística, además de la información de carácter administrativo facilitado por el jefe del servicio de ginecología del Hospital Nacional Especializado de Maternidad. Utilizando variables como edad, sexo, ingresos, egresos, procedimientos realizados, tasas de mortalidad y los recursos humanos y físicos con los que cuenta dicho servicio. Conclusión: de acuerdo a los datos obtenidos durante la realización del diagnóstico situacional, se puede concluir lo siguiente: la mayoría de pacientes ingresados durante el periodo de estudio se encuentran predominantemente en los rangos de edades, de 41 a 50 años, lo cual es explicable por el tipo de patologías más comunes atendidas en dicho servicio, se determinaron las causas más comunes de ingreso y egreso del servicio de ginecología, demostrándose que las 5 primeras patologías son las mismas para ambas situaciones como lo son: Leiomioma uterino, prolapso útero vaginal completo, hiperplasia endometrial, tumor benigno de ovario, carcinoma in situ del cuello uterino, igualmente es de recalcar que no siempre el diagnóstico de ingreso es el mismo que al egreso, lo cual permite la modificación de las otras 5 restantes causas de egreso tomadas en cuenta y se determinó que durante el año 2013 en el servicio se llevaron a cabo 1426 procedimientos, siendo los tres principales: las histerectomías abdominales totales, histerectomía vaginal total, dilatación y legrado de útero.

Prevalencia de genotipos del papiloma virus humano en mujeres de la provincia del Azuay, Ecuador

Los principales objetivos de la investigación fueron detectar en función con la edad, la prevalencia de los genotipos de alto y bajo riesgo oncogénico de virus del papiloma humano (VPH) en muestras cervicales de las mujeres en los catorce cantones de la provincia de Azuay. El proyecto abarcó el diagnóstico histopatológico de las lesiones cervicales intraepiteliales y la relación de los genotipos encontrados, con los factores de riesgo y las vacunas existentes que se utilizan como medida de prevención de cáncer de cuello uterino. Fueron examinadas muestras de frotis cervicales de una población aleatoria de 500 mujeres con la prueba de Papanicolaou (Pap), usando la reacción en cadena de la polimerasa en tiempo real (PCR). El estudio reveló una prevalencia de VPH de 25.6%; 4.8% genotipos oncogénicos de bajo riesgo y el 20.8% genotipos oncogénicos de alto riesgo respectivamente, y sólo en el grupo de edad de 20 a 29 años, una significativa prevalencia mayor de los genotipos de alto riesgo 31 y 66 (p<0.05). Las células escamosas atípicas de significado indeterminado (ASCUS) representan el 7% y la lesión intraepitelial escamosas de bajo grado (LIEBG) 1.8%. Por otra parte no se identificaron lesiones escamosas intraepiteliales de alto grado. De la población encuestada 2.8% de las mujeres poseen genotipos virales que son tratables por las vacunas distribuidas por el Ministerio de Salud Pública (MSP).

Objeção da consciência e aborto previsto em lei : vivências em um serviço público de saúde

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, 2015.

Efeitos da terapia periodontal na contagem de leucócitos e níveis do fator de crescimento transformador beta no soro de indivíduos com periodontite severa

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, 2015.

Escherichia coli : host interactions in the pathogenesis of canine pyometra

Tese de Doutoramento em Ciências Veterinárias na Especialidade de Ciências Biológicas e Biomédicas

Correlación clínica y ecográfica de la maduración y reactividad fetal

Estudio descriptivo de cohorte único para por medio de la clínica (altura de fondo uterino) y del uso de la ecografía (longitud femoral y diámetro biparietal) elaborar curvas de crecimiento fetal y detectar posibles diferencias determinadas por el sexo en el mismo, estudiar la madurez placentaria ecográfica y la respuesta ftal al test de estimulación vibroacústica; en sesenta pacientes embarazadas que acudieron a la consulta externa del Hospital Vicente Corral Moscoso durante el período comprendido entre Marzo de 1992 y julio de 1993, que cumplieron las siguientes características: embarazo de curso clínico normal menor de veinte semanas al momento de la inclusión, ciclos menstruales espontáneos y regulares y no haber usado métodos anticonceptivos tres meses previos al embarazo, luego del parto los criterios fueron: recién nacido normal, de peso adecuado para la edad gestacional y a término. Encontramos que la longitud femoral se inicia con valores de 1.63 centímetros a las doce semanas de gestación, teniendo un comportamiento lineal progresivamente ascendente, con aumento promedio de 0.21 centímetros por semana, para terminar en 7.4 centímetros a la semana 40. Se encuentra que la longitud femoral se inicia con valores de 1.83 centímetros a las doce semanas de gestación, teniendo un comportamiento lineal progresivamente ascendiente, con aumento promedio de 0.21 centímetros por semana, para terminar en 7.4 centímetros a la semana 40. El diámetro biparietal se inicia con valores de 2 centímetros a las doce semanas, tiene un trayecto progresivamente ascendente, iniciando un aplanamiento hacia las 30 semanas, que se acentúa en las últimas semanas del embarazo, terminando en 9.17 a las 40 semanas de gestación. La altura del fondo uterino describe una curva regular con ascenso inicial rápido y luego tendencia al aplanamiento. En los tres parámetros no se evidenciaron diferencias determinadas por el sexo. El grado de maduración placentaria es progresivo. Aparece el grado I a las 27 semanas, el grado II a las 35 semanas y el grado III a las 38 semanas. Se demuestra que la prueba de estimulación vibroacústica es eficiente para la valoración del bienestar fetal, observándose además que a una mayor edad gestacional el incremento de la frecuencia cardíaca fetal es también mayor