Oral health status of the ethnic group Xukuru from Ororubá: multilevel analysis

Objective: To analyse the oral health status of the indigenous people Xukuru from Ororubá aged 10 to 14 years old, in Pernambuco, Brazil. Method: A cross-sectional population-based study developed within the limits of the Indigenous Land Xukuru, from January to March 2010. Oral examinations were performed on a sample of 233 indigenous people. The software SPSS 13.0® was used for descriptive analysis. Later, in order to measure the effect of factors associated with the absence of caries, Poisson log-linear multilevel models were tested with the statistical software MLwiN 2.02®. Results: Oral examinations identified a DMFT Index average of 2.38 (± 2.62). Among all individuals examined, 26.61% were caries free. Multiple regression analysis revealed a negative association between the absence of caries and the variables: higher average of people per household in the villages, higher number of residents per household, older age, male sex, not knowing how to read and write, and very dissatisfied/dissatisfied with teeth/mouth. The variables higher income per capita, not sleeping due to dental problems, had never been to the dentist, no occurrence of toothache, and no need for dental treatment were positively associated with the absence of caries. Conclusion: The absence of caries is associated with contextual and individual factors of the indigenous people Xukuru from Ororubá, aged 10 to 14 years old

A percepção do acompanhante sobre a humanização da assistência em uma unidade neonatal

O objetivo deste estudo foi conhecer a percepção das mães acompanhantes na unidade neonatal em relação às ações humanizadoras. Trata-se de uma pesquisa exploratória descritiva, com enfoque qualitativo, desenvolvido na unidade neonatal do Hospital da Universidade de São Paulo com as acompanhantes dos bebês que permaneceram internados a partir do quinto dia de vida até a alta hospitalar. O período estudado foram os meses de outubro de 2007 a janeiro de 2008. Foram realizadas 18 entrevistas, analisadas segundo o referencial de Bardin, o que permitiu a construção das categorias: assistência recebida, relacionamento com os profissionais e condições institucionais. Constatou-se satisfação quanto à assistência recebida e ao apoio da equipe, mas foram apontadas necessidades de mudanças na estrutura física do setor, para proporcionar uma assistência mais humanizada

Influência da fisioterapia aquática no controle de tronco na síndrome de pusher: estudo de caso

A síndrome de pusher, ou do não-alinhamento, é uma alteração do controle postural observada em pacientes com lesões encefálicas, que apresentam uma inclinação do tronco contralateral à lesão. O estudo visou analisar a influência da fisioterapia aquática no controle de tronco em um paciente de 78 anos com síndrome de pusher. Para o diagnóstico da síndrome foi utilizada a escala de avaliação do sintoma de empurrar (SCP, Scale for contraversive pushing). A simetria do tronco foi avaliada por fotogrametria, medindo-se, nas fotografias do paciente tiradas antes e depois do tratamento, os ângulos de alinhamento da cabeça, dos ombros e do tronco. A fisioterapia aquática consistiu em duas sessôes semanais de uma hora durante dois meses, totalizando 16 sessões, empregando os métodos Bad Ragaz e Halliwick, para fortalecimento da musculatura do tronco e dos membros superiores, respectivamente. Na avaliação após a intervenção, foi observada importante redução dos ângulos de inclinação da cabeça (de 31,7º para 10,6º), dos ombros (de 10,3º para 1,7º) e do tronco (de 9,6º para 3,0º). O programa de fisioterapia aquática, portanto, propiciou ao participante com a síndrome de pusher sensível melhora na simetria e alinhamento do tronco.Pusher, or lateropulsion, syndrome is a clinical disorder following brain damage in which patients actively push away from the nonhemiparetic side, leading to a loss of postural balance. This study analysed the effect of hydrotherapy on trunk alignment in a 78 year-old male patient with the syndrome. Pusher syndrome was diagnosed by means of the scale for contraversive pushing. Trunk symmetry was assessed by photogrammetry: head, shoulder and trunk alignment angles were measured on photographs taken before and after treatment. Aquatic therapy consisted in two weekly one-hour sessions for two months (total 16 sessions), using the Bad Ragaz and the Halliwick techniques, with the purpose of strengthening upper limb and trunk muscles, respectively. The post-treatment assessment showed an important reduction in tilt angles of head (from 31.7º to 10.6º), shoulders (from 10.3º to 1.7º), and trunk alignment (from 9.6º to 3.0º). The hydrotherapy program proposed thus showed beneficial in assuring the patient with pusher syndrome better trunk symmetry and alignment

Evaluation of preventive measures for mother-to-child transmission of HIV in Aracaju, State of Sergipe, Brazil

INTRODUCTION: The main route of human immunodeficiency virus (HIV) infection in children is from mother to child. The preventive measures established for the Aids Clinical Trial Group protocol 076 (ACTG 076) significantly reduces HIV vertical transmission rates. This study aims to evaluate the implementation of the ACTG 076 protocol in the maternity units of State of Sergipe, Brazilian northeast. METHODS: This is a descriptive, retrospective study with a quantitative approach, with HIV positive women and children exposed, attending a Maternity reference for high-risk pregnancies. Data were obtained from patient records registered in the years 1994 to 2010. RESULTS: Amongst the 110 pregnant women and exposed newborns, the ACTG 076 protocol was fully utilized in only 31.8% of the participants. During the prenatal period, zidovudine (ZDV) was taken by 79.1% of the pregnant women. Only 49.1% of HIV seropositive patients used ZDV during delivery. Two (1.8%) children were considered infected and 50 (45.5%) do not have a conclusive diagnosis to date. CONCLUSIONS: There were significant deficiencies in the prevention of mother-to-child transmission of HIV, including lack of compliance with the three phases of the ACTG 076 protocol; inadequacies in prenatal care; inappropriate mode of delivery and lack of adequate follow up of exposed children

Autochthonous transmission of Chagas disease in Rio de Janeiro State, Brazil: a clinical and eco-epidemiological study

BACKGROUND: After the control of the main modes of Chagas disease (CD) transmission in most endemic countries, it is important to identify the participation of native sylvatic vectors in CD transmission. Although CD is not considered endemic in Rio de Janeiro State (RJ), Brazil, we identified patients with CD born in RJ and investigated the possible autochthonous transmission in the state. METHODS: Patients born in RJ and followed in our institution between 1986 and 2011 were retrospectively analyzed. The cases identified as autochthonous transmission were submitted to epidemiological, clinical, serological, parasitological and molecular studies. Sectional field study with serological survey, research of sylvatic reservoirs and vectors was conducted in rural areas where patients were born. RESULTS: Among 1963 patients, 69 (3.5%) were born in RJ. From these, 15 (21.7%) were considered to have acquired the infection by autochthonous transmission. Cardiac form was the commonest form of presentation (60%). In rural areas in RJ northern region, sylvatic cycles of Trypanosoma cruzi and domestic invasion by Triatoma vitticeps were identified, and CD prevalence among inhabitants was 0.74%.TcI genotype was identified in sylvatic reservoirs and vectors. The genotype (mixed infection TcI/TcVI) could be identified in one of the autochthonous cases. CONCLUSIONS: The autochthonous vectorial transmission of CD occurs in RJ, probably due to wild cycles of T. cruzi and sylvatic vectors, such as T. vitticeps. Therefore, the health authorities should evaluate if RJ should be included in the original endemic area of CD and CD should be included in the diagnostic work out of cardiomyopathy of patients born in RJ. Moreover, control and educational measures should be put into place in the risk areas