Percepção materna com o nascimento prematuro e vivência da gravidez com pré-eclampsia

OBJECTIVE: To analyze maternal experiences of preeclampsia pregnancy with premature birth at a neonatal intensive care unit. METHODS: A qualitative study using the focus group technique was conducted with 28 women in a facility specialized in high-risk pregnancies in the state of Rio Grande do Norte, Northeastern Brazil, in 2004. Mothers included had had preeclampsia during pregnancy and a preterm delivery with consequent hospitalization of their baby at a neonatal intensive care unit. The data were analyzed using thematic content analysis of three thematic nuclei subjects: information about preeclampsia during prenatal care; experiences with the preterm newborn, and their perception of neonatal intensive care unit professionals' attitudes. RESULTS: Maternal reports showed subjects' lack of knowledge with regard to preeclampsia and its association with prematurity. Difficulties inherent to the maternal role of caring for the child in the neonatal intensive care unit were identified, accentuated by communication flaws between health professionals and users. CONCLUSIONS: Some difficulties experienced by the mothers, in the context of preeclampsia and prematurity, were aggravated by lack or inadequacy of information provided to the users.OBJETIVO: Analisar a vivência materna diante de gravidez com pré-eclampsia e com recém-nascido prematuro hospitalizado em unidade de terapia intensiva neonatal. MÉTODOS: Estudo qualitativo com a utilização da técnica do grupo focal, realizado com 28 mulheres em maternidade referência para gestações de risco no Rio Grande do Norte, em 2004. As mães incluídas tiveram gravidez com pré-eclampsia e parto pré-termo e conseqüente internação do recém-nascido em Unidade de Terapia Intensiva Neonatal. Os dados foram analisados por meio da técnica análise de conteúdo temática categorial, abordando três núcleos temáticos: informações sobre a pré-eclampsia no pré-natal; vivências com o recém-nascido pré-termo; e a percepção das usuárias sobre o atendimento dos profissionais. RESULTADOS: Os relatos maternos evidenciaram o desconhecimento das participantes sobre a pré-eclampsia e sua associação com a prematuridade. Foram detectadas dificuldades inerentes à definição do papel materno nos cuidados com o filho, acentuadas pelas falhas na relação entre os profissionais de saúde e os usuários. CONCLUSÕES: Parte das dificuldades vividas pelas mães no contexto da pré-eclampsia e da prematuridade foram agravadas pela ausência de informação ou inadequação para o entendimento das usuárias. Os resultados mostram que dificuldades vividas por mães no contexto da pré-eclampsia e da prematuridade são agravadas pela ausência de informação ou inadequação para o seu entendimento

Heparan sulfates and heparins: similar compounds performing the same functions in vertebrates and invertebrates?

The distribution and structure of heparan sulfate and heparin are briefly reviewed. Heparan sulfate is a ubiquitous compound of animal cells whose structure has been maintained throughout evolution, showing an enormous variability regarding the relative amounts of its disaccharide units. Heparin, on the other hand, is present only in a few tissues and species of the animal kingdom and in the form of granules inside organelles in the cytoplasm of special cells. Thus, the distribution as well as the main structural features of the molecule, including its main disaccharide unit, have been maintained through evolution. These and other studies led to the proposal that heparan sulfate may be involved in the cell-cell recognition phenomena and control of cell growth, whereas heparin may be involved in defense mechanisms against bacteria and other foreign materials. All indications obtained thus far suggest that these molecules perform the same functions in vertebrates and invertebrates.Universidade Federal de São Paulo (UNIFESP)A02Universidade Federal do Rio Grande do NorteUniversidade de Mogi das CruzesUNIFESPSciEL

Distribution of phlebotomine sand flies (Diptera: Psychodidae) in the State of Rio Grande do Norte, Brazil

Visceral and cutaneous leishmaniasis are major endemic diseases in northeast Brazil. The objective of the current study was to determine the species and geographic distribution of potential sand fly vectors of Leishmania in the state of Rio Grande do Norte. Sand flies were captured using CDC light traps in 30 municipalities distributed throughout the 8 geographic zones of the state. Twelve Lutzomyia species were identified. Lutzomyia longipalpis Lutz & Neiva was the most prevalent and accounted for 8.5.59% of the sand fly captured. The remaining species were distributed as follows: L. evandroi Costa Lima & Antunes (10.83%), L. oswaldoi Mangabeira (0.99%), L. sallesi Galvão & Coutinho (0.58%), L. intermedia Lutz & Neiva (0.53%), L. lenti Mangabeira (0.53%), L. migomei França (0.49%), L. walkeri Newstead (0.24%), L. goiana Martins, Falcão & Silva (0.15%), L. samueli Deane (0.04%), and L. capixaba Dias, Falcão, Silva & Martins (0.03%), and L. peresi Mangabeira (0.01%). L. longipalpis, which is known to be a vector of Leishmania chagasi Cunha & Chagas (L. donovani chagasi), was captured in 93% of municipalities distributed across all geographical areas of the state and its distribution was independent of obvious climatic and topographic parameters. It was identified in all municipalities where human visceral leishmaniasis had been reported. In contrast, climate and topography appeared to be important for other Lutzomyia species. For example, L. intermedia and L. migonei, which are known to transmit Leishmania braziliensis Viana, were geographically restricted. They were captured in municipalities where cases of cutaneous and mucosal leishmaniasis had been reported. The widespread distribution of L. longipalpis, its adaptation to peridomicillary settings, and its ability to transmit L. (d.) chagasi suggest that a large number of persons may be at risk of acquiring visceral leishmaniasis in the state of Rio Grande do Norte. Brazil

Risk factors of Helicobacter pylori infection in an urban community in Northeast Brazil and the relationship between the infection and gastric diseases

Abstract INTRODUCTION: Helicobacter pylori, a water contaminant, is the primary pathogenic agent associated with gastric diseases in humans. Exposure to H. pylori is more likely higher in developing countries. This study aimed to evaluate the risk factors associated with H. pylori infection in patients undergoing endoscopy to validate the cause of dyspeptic symptoms in an urban population in northeast Brazil and to compare the urease test and polymerase chain reaction assay results with the histopathological findings. METHODS: We evaluated 200 of 759 individuals with dyspeptic complaints from Campina Grande, State of Paraiba, northeast Brazil. Patients underwent endoscopy, followed by gastric biopsies. Logistic regression analysis was performed to adjust for confounders and to determine significant risk factors of dyspeptic disorders. RESULTS: Women accounted for 72.5% (145/200) of the participants. Approximately 59.8% (120/200) of the samples tested positive for H. pylori based on histological examinations. The specificity of polymerase chain reaction assay was higher than that of the urease test (77% vs. 64%, p=0.034). City drinking water [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.3-5.21; p=0.004] and smoking (OR: 4.0; 95% CI: 1.13-14.5; p=0.031) were the risk factors of H. pylori infection. Belching was the most common symptom associated with H. pylori infection (p=0.05). CONCLUSIONS: The increased risk of H. pylori infection associated with non-treated water consumption indicates the need for improvements in public water treatment and better sanitary conditions because these can be a source of not only H. pylori infections but also other water-borne pathogen infections

Effect of abiotic factors on seasonal population dynamics of Lutzomyia longipalpis (Diptera: Psychodidae) in Northeastern Brazil

The resurgence of visceral leishmaniasis in Brazil increases the need for studies to elucidate the spatial and temporal dynamics of Lutzomyia longipalpis (Lutz & Neiva) (Diptera: Psychodidae), the vector of Leishmania infantum, the causative agent of visceral leishmaniasis in Brazil. Sand flies were captured in peridomestic habitats biweekly for 3 yr. Cross-correlation tests and spectral analysis were used to analyze the simultaneous and lag-time correlations between Lu. longipalpis population densities and abiotic factors of temperature, relative humidity, wind velocity, and rainfall. Distinct seasonal patterns were observed for males and females, with intervals of 6 mo between population peaks for males and 12 mo for females. Peak female population densities lagged 3 mo behind the maximum annual temperature. Female population density was negatively correlated with relative humidity. An increase in average wind velocity was followed by a decrease in the number of females for 2 wk. Understanding the relationship between the seasonal population dynamics of Lu. longipalpis and abiotic factors will contribute to the design of better control measures to decrease transmission of L. infantum and consequently the incidence of leishmaniasis. © 2006 Entomological Society of America

Women with cardiovascular risk after preeclampsia: is there follow-up within the Unified Health System in Brazil?

OBJECTIVES: to identify women with cardiovascular risk, five years after a preeclampsic episode (PE), and identify the follow-up of these women within the Unified Health System (Sistema Único de Saúde - SUS), in the city of Natal/RN. METHODS: a quantitative and exploratory study conducted at the Januário Cicco University Maternity Ward/RN. The sample consisted of 130 women, 65 with a PE episode and 65 who were normotensive. RESULTS: we found statistical significance with regard to body mass index, weight, family history of cardiovascular disease (CVD) and cardiovascular complications when comparing women with previous PE to normotensive women. The groups were unaware of their cardiovascular risk factors and, in addition, they reported difficulties in accessing primary health care (PHC) services. CONCLUSIONS: women with a PE history are at increased risk of developing CVD, unaware of late PE complications, and lacked customized care when compared to normotensive patients

Risk factors of Helicobacter pylori infection in an urban community in Northeast Brazil and the relationship between the infection and gastric diseases

<div><p>Abstract INTRODUCTION: Helicobacter pylori, a water contaminant, is the primary pathogenic agent associated with gastric diseases in humans. Exposure to H. pylori is more likely higher in developing countries. This study aimed to evaluate the risk factors associated with H. pylori infection in patients undergoing endoscopy to validate the cause of dyspeptic symptoms in an urban population in northeast Brazil and to compare the urease test and polymerase chain reaction assay results with the histopathological findings. METHODS: We evaluated 200 of 759 individuals with dyspeptic complaints from Campina Grande, State of Paraiba, northeast Brazil. Patients underwent endoscopy, followed by gastric biopsies. Logistic regression analysis was performed to adjust for confounders and to determine significant risk factors of dyspeptic disorders. RESULTS: Women accounted for 72.5% (145/200) of the participants. Approximately 59.8% (120/200) of the samples tested positive for H. pylori based on histological examinations. The specificity of polymerase chain reaction assay was higher than that of the urease test (77% vs. 64%, p=0.034). City drinking water [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.3-5.21; p=0.004] and smoking (OR: 4.0; 95% CI: 1.13-14.5; p=0.031) were the risk factors of H. pylori infection. Belching was the most common symptom associated with H. pylori infection (p=0.05). CONCLUSIONS: The increased risk of H. pylori infection associated with non-treated water consumption indicates the need for improvements in public water treatment and better sanitary conditions because these can be a source of not only H. pylori infections but also other water-borne pathogen infections.</p></div

Multibacillary leprosy by population groups in Brazil: Lessons from an observational study

<div><p>Background</p><p>Leprosy remains an important public health problem in Brazil where 28,761 new cases were diagnosed in 2015, the second highest number of new cases detected globally. The disease is caused by <i>Mycobacterium leprae</i>, a pathogen spread by patients with multibacillary (MB) leprosy. This study was designed to identify population groups most at risk for MB disease in Brazil, contributing to new ideas for early diagnosis and leprosy control.</p><p>Methods</p><p>A national databank of cases reported in Brazil (2001–2013) was used to evaluate epidemiological characteristics of MB leprosy. Additionally, the databank of a leprosy reference center was used to determine factors associated with higher bacillary loads.</p><p>Results</p><p>A total of 541,090 cases were analyzed. New case detection rates (NCDRs) increased with age, especially for men with MB leprosy, reaching 44.8 new cases/100,000 population in 65–69 year olds. Males and subjects older than 59 years had twice the odds of MB leprosy than females and younger cases (OR = 2.36, CI95% = 2.33–2.38; OR = 1.99, CI95% = 1.96–2.02, respectively). Bacillary load was higher in male and in patients aged 20–39 and 40–59 years compared to females and other age groups. From 2003 to 2013, there was a progressive reduction in annual NCDRs and an increase in the percentage of MB cases and of elderly patients in Brazil. These data suggest reduction of leprosy transmission in the country.</p><p>Conclusion</p><p>Public health policies for leprosy control in endemic areas in Brazil should include activities especially addressed to men and to the elderly in order to further reduce <i>M</i>. <i>leprae</i> transmission.</p></div