Cobertura vacinal contra hepatite B entre usuários de drogas ilícitas Cobertura vacinal contra hepatite B entre usuários de drogas ilícitas Hepatitis B vaccination use and risk behaviors among users of illicit drugs

OBJETIVO: Identificar a cobertura vacinal contra a hepatite B e os comportamentos de risco entre usuários de drogas ilícidas (UDI) em Dourados-MS. MÉTODOS: Trata-se de uma pesquisa de campo, descritiva de corte transversal realizada mediante aplicação de questionário em 49 usuários atendidos pelos centros de recuperação e programas de apoio desse Município. RESULTADOS: Identificou-se predomínio de homens jovens que utilizavam drogas não injetáveis. A história de prisão, e de hepatite na família, tatuagens, múltiplos parceiros sexuais e realização de todas as formas de relação sexual, foram os fatores de risco mais frequentes. CONCLUSÃO: Estes fatores combinados com a baixa cobertura vacinal e a falta de término do esquema confirmam a vulnerabilidade do grupo em adquirir a hepatite B.<br>OBJETIVO: Identificar la cobertura de vacunas contra la hepatitis B y los comportamientos de riesgo entre usuarios de drogas ilícidas (UDI) en Dourados-MS. MÉTODOS: Se trata de una investigación de campo, descriptiva de corte transversal realizada mediante la aplicación de un cuestionario a 49 usuarios atendidos por los centros de recuperación y programas de apoyo de ese Municipio. RESULTADOS: Se identificó predominio de hombres jóvenes que utilizaban drogas no inyectables. La historia de prisión, y de hepatitis en la familia, tatuajes, parejas sexuales múltiples y realización de todas las formas de relación sexual, fueron los factores de riesgo más frecuentes. CONCLUSIÓN: Estos factores sumados a la baja cobertura de vacunas y la falta de término del esquema confirman la vulnerabilidad del grupo para adquirir la hepatitis B.<br>OBJECTIVE: To identify hepatitis B vaccine use and risk behaviors among users of illicit drugs (IDU) in Dourados (Mato Grosso do Sul, Brasil). METHODS: A descriptive cross-sectional field study was conducted by questionnaire with 49 users of illicit drugs who were receiving assistance through rehabilitation centers and support programs within the city. RESULTS: A predominance of young men using non-injectable drugs was identified. A history of imprisonment, hepatitis, tattooing, multiple sexual partners and participation in all forms of sexual intercourse were the most common risk factors. CONCLUSION: These factors, combined with low vaccination rates and lack of completion of the recovery and support programs, confirm the vulnerability of users of IDUs for acquiring hepatitis B

Tatuagem: perfil e discurso de pessoas com inscrição de marcas no corpo Tattooing: profile and discourse of individuals with marks in the body

FUNDAMENTOS: A tatuagem é um fenômeno atávico e difuso que suscita abordagem por diversos saberes. Sua utilização por grupos específicos como prisioneiros e pacientes psiquiátricos sempre a manteve associada a um caráter de estigma. OBJETIVOS: Buscar o discurso do tatuado acerca da discriminação e da construção de estigmas a partir da inscrição de marcas no corpo. MÉTODOS: Foram analisadas entrevistas de 42 indivíduos. RESULTADOS: O perfil obtido foi de maioria de mulheres; com duas a quatro tatuagens; com 23 anos ao fazê-las; com formação superior completa; que acham que era moda fazer tatuagens; que não referem nenhum fato marcante que os tenha levado a fazer o desenho; que classificam a dor como suportável; que afirmam que nunca se sentiram discriminados; que nunca esconderam sua tatuagem; que acham que a tatuagem é um atrativo sexual; que não veem a tatuagem como uma forma de resistência cultural; que deixariam de fazê-la se lhes trouxesse prejuízo profissional; que dizem não ter usado álcool quando fizeram o desenho; que afirmam não serem usuários habituais de drogas; que acham que a tatuagem é uma forma de se expressar e de se embelezar. CONCLUSÕES: Percebeu-se que existe uma diferença entre o discurso do tatuado e os seus atos, quanto ao contexto social, e verificou-se uma importante mudança no significado da prática para o tatuado.<br>BACKGROUNDS: Tattooing is an atavist and diffuse phenomenon of interest to various areas of knowledge. Its practice by specific groups such as prisoners and psychiatric patients has turned it into a stigma. OBJECTIVES: To investigate the discourse of tattooed individuals about the discrimination and the construction of stigmas resulting from marks in the body. METHODS: 42 individuals were interviewed and the data were analyzed. RESULTS: The profile of the participants was as follows: most were women; with 2 to 4 tattoos; who were about 23 years old when they got their first tattoo; with an undergraduate degree; who viewed tattooing as a trend; who did not report any important fact that made them get a tattoo; who classified the pain of getting a tattoo as tolerable, who stated that never felt discriminated and never felt the need to hide the tattoos; who find that tattoos make them more sexually attractive; who do not view tattooing as a form of cultural resistance; who said they would not have done it if they believed it caused them professional problems; who stated that they were not drunk when they got the tattoos; who said they were not habitual drugs users, who believed that tattooing is a form of expression and aesthetic sense. CONCLUSION: A difference between the discourse of tattooed individuals and their acts was observed in relation to the social context. In addition, there has been an important shift in the meaning of the practice to tattooed individuals

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p&lt;0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology