Dialogando sobre incontinência urinária feminina, qualidade de vida e políticas públicas de saúde para a mulher brasileira

Este artigo foi extraído da dissertação de mestrado “Proposta de diretriz clínica de atenção à mulher com incontinência urinária na política pública de saúde”, defendida em 2015, que abordou em seu estudo a prevalência da incontinência urinária em mulheres. A extração aqui contida versa a respeito da patologia de incontinência urinária que incide na população feminina, discutindo os efeitos deste problema de saúde sobre a qualidade de vida das mulheres acometidas, contrapondo esta questão de saúde pública com as políticas públicas de saúde existentes. Trata-se de um diálogo conceitual que tem por objetivo fomentar a discussão acerca das políticas públicas para mulheres considerando seus ciclos de vida, partindo de um conceito de atenção integral à saúde da mulher. A revisão aqui contida foi baseada em documentos governamentais, livros e artigos que abordam o assunto de incontinência urinária, políticas públicas, políticas de saúde, saúde da mulher, e acesso à base de dados Scielo, Lilacs, PubMed. Conclui-se que a ineficiência das políticas públicas de enfoque à saúde da mulher aliado à dificuldade do sistema de saúde brasileiro, corroboram a um diagnóstico tardio e difícil acesso ao tratamento da patologia; elementos que contribuem para a deficiência na qualidade de vida das mulheres que sofrem de incontinência urinária

Overweight in Brazil: evolution and interface with health policies / Excesso de peso no Brasil: evolução e interface com as políticas de saúde

Objective: To describe the evolution of the prevalence of overweight in adults and the policies to combat excess weight in Brazil. Method: an ecological, cross-sectional, descriptive, analytical and observational epidemiological study with a quantitative approach, using the database of the System of risk factors for non-communicable chronic diseases by telephone survey, in the years 2006, 2009, 2012, 2015 and 2018. Results: in the period studied, there was a constant increase in the prevalence of overweight in all groups. Conclusion: obesity is increasing in all regions of the country, in both sexes, with a tendency to affect more women. Although the Brazilian government presents public policies in this perspective of fighting the obesity epidemic, it is still a reality that evolves over time.Objetivo: describir la evolución de la prevalencia del sobrepeso en adultos y las políticas para combatirlo en Brasil. Metodología: estudio epidemiológico ecológico, transversal, descriptivo, analítico y observacional con enfoque cuantitativo, utilizando la base de datos del Sistema de factores de riesgo de enfermedades crónicas no transmisibles por encuesta telefónica, en los años 2006, 2009, 2012, 2015 y 2018. Resultados: en el período estudiado, hubo un aumento constante en la prevalencia de sobrepeso en todos los grupos. Conclusión: la obesidad está aumentando en todas las regiones del país, en ambos sexos, con tendencia a afectar a más mujeres. Si bien el gobierno brasileño presenta políticas públicas en esta perspectiva de lucha contra la epidemia de obesidad, sigue siendo una realidad que evoluciona con el tiempo.Objetivo: descrever a evolução da prevalência do excesso de peso em adultos e as políticas para o seu enfrentamento no Brasil. Método: estudo ecológico, transversal, descritivo, analítico e epidemiológico observacional de abordagem quantitativa, utilizando a base de dados do Sistema de fatores de risco para doenças crônicas não transmissíveis por inquérito telefônico, nos anos 2006, 2009, 2012, 2015 e 2018. Resultados: no período pesquisado, houve um aumento constante na prevalência de excesso de peso em todos os grupos. Conclusão: a obesidade é crescente em todas as regiões do país, em ambos os sexos, com tendência para afetar mais o sexo feminino. Apesar de o governo brasileiro apresentar políticas públicas nessa perspectiva de enfrentamento da epidemia de obesidade, ela ainda é uma realidade que evolui ao longo do tempo.

CLINICAL-EPIDEMIOLOGICAL PROFILE OF HOSPITALISED PATIENTS IN PAEDIATRIC INTENSIVE CARE UNIT

Introduction: Paediatric intensive care units have made important advances in technology and assistance since the 1980s, which have made more favourable the prognosis of critically ill children all over the world. Objective: Identify the epidemiological profile and clinical outcomes of hospitalised children and adolescents in the Paediatric Intensive Care Unit of Hospital Vitória, Espirito Santo, Brazil. Methods: A descriptive and retrospective study carried out in the Paediatric Intensive Care Unit of Hospital Infantil Nossa Senhora da Glória in the city of Vitória, Espirito Santo, Brazil. Age, sex, ospitalisation diagnosis, progression to discharge/death, and length of hospital admission were obtained from the Sector of Medical and Hospital Statistics Files between 2011 and 2012. For the descriptive analysis, categorical variables were expressed as absolute and percentage, and the continuous variables in average and standard deviation. For comparison, Pearson’s chi-squared tests, Fisher’s test, and Student’s t test were used and p values <0.05 with confidence interval of 95% were considered statistically significant. Results: Of the 609 patients analysed, 342 (56.2%) were male (mean age: 72.7 ± 71.3 months). Respiratory disease, postoperative processes, and trauma were the main causes of hospitalisation. The average duration of hospitalization was 6.9 ± 5.5 days; 514 (84.4%) patients were discharged, 95 (15.6%) died, and of those, 53 (55.7%) died in less than 72 hours of hospitalisation. Conclusion: Most of the patients were less than 2 years of age. The leading causes of hospitalisation were respiratory disease (pneumonia, bronchiolitis, and asthma), sepsis, and head injury, which was the major cause of the trauma motivated by violence. The average hospital admission in the unit was one week and the mortality rate was 15.6%, with one third of the deaths recorded in the first 72 hours of hospitalisation

Epidemiological Analysis of Penile Neoplasms in Brazil and Its Social Determinants

Introduction: Penile neoplasms, although preventable, are frequent even among young persons. Penile neoplasms have a high risk of not only morbidity and mortality but also important psychosocial repercussions.Objective: To describe the epidemiology of penile neoplasms in Brazil. Method: This was an epidemiological, descriptive and cross-sectional study. Data on all the notified cases of penile neoplasms in Brazil between 1985 and 2015 were obtained from RCPBP/INCA and DATASUS databases.Results: Of 9 625 notified cases of penile neoplasms, a higher proportion of cancer patients was observed among patients aged between 40 and 70 years (63.5%) and among smokers (21%), in Brown and Caucasian patients (80%), those who were married (54.2%), had high alcohol intake levels (16%) and with lower levels of education: illiterate people (21.5%), those with incomplete elementary school education (36.6%) and those with complete elementary school education (10.3%). The lesions were located in the glans (22.6%), prepuce (7.5%) and the penile body (7.5%). Higher mortality rates were observed in the age-group 50 to 80 years and in among patients from the Northeast (31.4%) and Southeast (39.2%) regions of the country.Conclusion: Penile neoplasms, which mainly affect young people that are economically active, are prevalent in Brazil and the majority of patients present with an advanced stage of the disease. They are Brown and Caucasian, married, with poor education and live in the Northeast and Southeast regions of the country

Lipid profile in schoolchildren in Vitória – Brazil

Introduction: The growing prevalence of obesity is currently considered the most important nutritional disorder. It is characterized, according to the World Health Organization (WHO) as a worldwide epidemic in developing and developed countries. In an associated form, there is an increasing prevalence of dyslipidaemia. Aiming to improve the current situation and prevent the progression of the epidemic, the American Academy of Pediatrics recently reinforced the need for cholesterol screening in overweight children older than two years. Objective: To determine overweight and lipid profi le in children aged between six and nine years. Methods: A descriptive, cross-sectional study with children from Vitoria, ES. For nutritional classifi cation the Z-score > + 1 SD body mass index-for-age (according to WHO / 2007) was used; for the lipid profi le the Atherosclerosis Prevention Guidelines in Childhood were used. Anthropometric measurements (weight, height, waist circumference and triceps skinfold thickness) followed the standard techniques described by WHO. Data were organized and analysed using SPSS, version 8.5 and calculated the absolute, relative and mean (SD) frequencies and the association between overweight, lipid profile and other variables is adopted as signifi cant when p < 0.05. Results: The sample comprised a total of 511 children of both sexes (46.7% male), with a mean age of 101.6 ± 11.1 months. Overweight was found in 197 (38.5%) children: overweight in 71 (13.9%) and obesity in 126 (24.6%). Total cholesterol was elevated in 167 (32.7%) as were high LDL-C (136–27%). High triglycerides were found in 21 participants (4.1%). Signifi cant association was found between waist circumference and high levels of triglycerides (p = 0.019) and HDL-C (p = 0.033). Conclusion: Excess weight of the sample investigated is considered high and its health effects are important, with an increased total cholesterol greater than 32%. The high levels of HDL-C are protectivefactors for coronary heart disease, although the lipid profi le had been changed

ASSOCIATION BETWEEN FOOD CONSUMPTION AS PREDICTOR OF CARDIOVASCULAR RISK AND WAIST CIRCUMFERENCE INCREASE IN TEENAGERS

Introduction: the eating habits of young people have changed significantly over the last few decades. Teenagers tend to have less than desirable intake of fruits, vegetables, dairy products and wholegrain products, and higher intake of foods high in saturated and trans fats, leading to increased waist circumference and consequent increased risk of cardiovascular disease. Objective: to analyse the relationship between dietary intake as predictor of and increased abdominal circumference in teenagers. Methods: a cross-sectional study was conducted in a sample of 818 teenagers aged between 10 and 14 years, of both genders, enrolled in state public schools in the metropolitan region of Vitória, Espirito Santo, Brazil, from August 2012 to October 2013. Waist circumference (WC) measurements were carried out in duplicate and the arithmetic mean was calculated. The dietary intake was identified from a simplified food questionnaire containing foods whose consumption is high or that present excessive risk of coronary heart disease in teenagers. The statistical analysis was done through Pearson’s chi-squared test. Results: a proportion of 55.9% of the sample had an adequate food intake, 15.6% a high intake and 28.5% an excessive intake. Among teenagers who had an adequate, high and excessive dietary intake, 5.6% (N = 46), 1.1% (N = 9) and 2.6% (N = 21) had increased WC, respectively. The result of the chi-squared test indicated no association between dietary intake as predictor of cardiovascular risk and WC, p-value = 0.576. Conclusion: there was no association between dietary intake presenting cardiovascular risk and increased waist circumference

Growth and nutritional status of adolescents of public education system

Introduction: The prevalence of obesity in children and adults has increased worldwide exponentially over the past two decades, becoming an important issue of global public health. Objective: To describe the growth and nutritional status of adolescents of  public schools. Methods: Epidemiological, cross-sectional study, a representative sample of students aged 10 to 14 years of the public schools of the Metropolitan Region of Grande Vitória (MRGV), State of Espírito Santo, Brazil. Data on gender, age, skin colour/race, pubertal stage, socioeconomic class, weight and height were obtained. In the nutritional evaluation, the Height/Age (H/A) and Body Mass Index/Age (BMI/A) indexes, in z-score, of the WHO reference (2007) were considered. For statistical analysis, we used the Qui-square test and Student's t test (Mann-Whitney test for non-normal distribution), and significance level of p <0.05. Study approved by the Institutional Research Ethics Committee. Results: There were assessed 818 adolescents, with average age of 12.8 ± 1.1 years, female predominance (58.3%), mixed skin colour/race (41.7%), post-pubertal stage (53, 4%) and socioeconomic class C (59.5%). It was identified very low stature in 0.4% and low stature in 1.8% of adolescents. Overweight was diagnosed in 227 (27.7%) students, represented by overweight (18.7%), obesity (8.4%) and severe obesity (0.6%); While 0.2% presented severe thinness and 2.7% thinness.  The mean z-score of girls' height (p = 0.024) was higher than the WHO reference, as well as the BMI z-score of girls (p = 0.0001) and boys (p = 0.0002). Conclusion: Adolescents of public schools of MRGV achieve adequate growth, even higher, on average, proposed by WHO (2007). However, they also present a high prevalence of overweight, indicating that the region is at an advanced stage of nutritional transition

Notes d'épigraphie delphique.

Valmin Natan. Notes d'épigraphie delphique.. In: Bulletin de correspondance hellénique. Volume 60, 1936. pp. 118-134