Óbitos por sepse neonatal no Estado de Alagoas no período de 2010-2019: um estudo epidemiológico / Death from neonatal sepsis in the State of Alagoas in the period of 2010-2019: an epidemiological study

Introdução: A sepse neonatal é uma grave infecção em corrente sanguínea e/ou líquor que cursa com comprometimento hemodinâmico e outros sinais clínicos inespecíficos, ocorrendo em indivíduos de até 28 dias de vida, sendo considerada uma das principais causas de morbimortalidade nesse período. Levando em consideração o tempo de surgimento, pode ser classificada como precoce ou tardia, apresentando flora contaminante e origem da infecção inerente a cada tipo. No Brasil, os óbitos neonatais precoces e tardios têm a sepse neonatal como quinta causa mais importante representando respectivamente 9% e 31% das causas de morte nessa população. Objetivo: caracterizar o perfil epidemiológico dos recém-nascidos que evoluíram para óbito, por sepse neonatal, no estado de Alagoas, nos anos de 2010 a 2019.  Metodologia: estudo epidemiológico, exploratório, descritivo, retrospectivo realizado através de dados secundários coletados do Sistema de Informação sobre Mortalidade, disponíveis no DATASUS. A pesquisa foi realizada analisando-se óbitos por sepse neonatal que ocorreram no período de 2010 a 2019, com recém-nascidos entre zero e 27 dias após o nascimento, residentes em Alagoas. Foram utilizadas as categorias da Classificação Internacional de Doenças: A40 (Septicemia estreptocócica), A41 (Outras septicemias) e P36 (Septicemia bacteriana do recém-nascido). As variáveis da pesquisa foram separadas e classificadas em três tipos: variáveis relacionadas aos dados neonatais e aos óbitos, variáveis relacionadas à gestação e ao parto e variáveis maternas. Para tabulação e análise descritiva dos dados utilizou-se o Software Microsoft Excel® 2019. Resultados e discussão: O Estado de Alagoas ocupa a segunda posição entre todas as Unidades Federativas, sendo assim, detentor da maior taxa de mortalidade por sepse neonatal da região Nordeste. O coeficiente de mortalidade foi de 1,64 óbitos por cada 1000 nascidos vivos. Existe uma predominância nas mortes que ocorrem no período neonatal precoce, em neonatos prematuros, do sexo masculino, pardos e com baixo peso ao nascer. Conclusão: Discutir a mortalidade infantil de determinada região, além de trazer um panorama epidemiológico do local, incide também em reflexões acerca das condições de saúde, de desenvolvimento socioeconômico e de condições de vida de uma população

Influence of severity of traumatic brain injury at hospital admission on clinical outcomes

O traumatismo cranioencefálico (TCE) é um problema de saúde pública com muitos casos de mortalidade e repercussões socioeconômicas. Este estudo visa investigar a influência da gravidade do TCE no tempo de ventilação mecânica (VM) e hospitalização, e na prevalência de casos de traqueostomia, pneumonia, neurocirurgia e morte. É um estudo retrospectivo e observacional, que avaliou prontuários de 67 pacientes com TCE na Irmandade Santa Casa de Misericórdia de São Paulo. A gravidade foi avaliada pela escala de Glasgow (ECG): leve (13-15 pontos; 36 pacientes; 53.7%); moderado (9-12 pontos; 14 pacientes; 20.9%); ou grave (3-8 pontos; 17 pacientes; 25.4%). Pacientes com TCE grave apresentaram maior prevalência de traqueostomia, pneumonia e neurocirurgia. Não houve diferença significativa entre gravidade do TCE, óbito e tempo em VM, apesar de a gravidade do TCE ter influenciado o tempo de hospitalização. A gravidade do TCE na admissão, avaliada pela ECG, influenciou a prevalência de traqueostomia, pneumonia, neurocirurgia e de maiores tempos de internação.El traumatismo craneoencefálico (TCE) es un problema de salud pública con alta mortalidad y repercusiones socioeconómicas. Este estudio ha tenido el objetivo de investigar la influencia de la gravedad del TCE en el tiempo de ventilación mecánica (VM) y de hospitalización y en la prevalencia de traqueotomía, neumonía, neurocirugía y mortalidad. Este estudio retrospectivo, observacional ha evaluado historias clínicas de 67 pacientes con TCE admitidos en Irmandade Santa Casa de Misericórdia de São Paulo. La gravedad ha sido evaluada por la escala de Glasgow (ECG): leve (13-15 puntos; 36 pacientes; el 53,7%), moderado (9-12 puntos; 14 pacientes; el 20,9%) o grave (3-8 puntos; 17 pacientes; el 25,4%). Pacientes con TCE grave han presentado prevalencia más grande de traqueotomía, neumonía y neurocirugía. No ha habido diferencia significativa entre la gravedad del TCE, la mortalidad y el tiempo en VM; mientras tanto, la gravedad del TCE ha influenciado el tiempo de hospitalización. La gravedad del TCE en la admisión, que ha sido evaluada por la ECG, ha influenciado la prevalencia de traqueotomía, neumonía, neurocirugía y ha sido asociada la internación prolongada.Traumatic brain injury (TBI) is a public health problem with high mortality and socioeconomic repercussions. We aimed to investigate the influence of TBI severity on the length of mechanical ventilation (MV) stay and length of hospital stay and on the prevalence of tracheostomy, pneumonia, neurosurgery and death. This retrospective, observational study evaluated medical records of 67 patients with TBI admitted to Irmandade da Santa Casa de Misericórdia de São Paulo. Severity was determined according to the Glasgow Coma Scale (GCS): mild (13-15 points; 36 patients; 53.7%), moderate (9-12 points; 14 patients; 20.9%) or severe (3-8 points; 17 patients; 25.4%). Severe TBI patients had higher prevalence of tracheostomy, pneumonia and neurosurgery. No significant differences were observed between TBI severity, mortality and length of MV stay. However, TBI severity influenced the length of hospital stay. TBI severity at admission, evaluated according to the GCS, influenced the prevalence of tracheostomy, pneumonia, neurosurgery and was associated to prolonged hospital stay

Family interventions and resources of Sandplay therapy with adolescents victims of trauma / Intervenções familiares e recursos da terapia Sandplay com adolescentes vítimas de trauma

Introduction: Trauma can be understood as a stressful experience or continuous exposure to an event that can cause harm to the healthy development of adolescents. Situations of physical, psychological, and sexual violence interrupt the natural flow of biopsychosocial development, presenting psychopathologies that often prevent adolescents from adapting to society. Objective: To investigate how psychological interventions, through an individual psychotherapeutic process, using resources such as Sandplay therapy along with meetings with parents, may allow improvement of traumatic symptoms in adolescents and therefore be better conducted by psychology specialists. Methods: Descriptive research with a qualitative and exploratory approach, based on the pre-experimental method, including 10 adolescents who were victims of trauma. The Posttraumatic Stress Symptom Screening Instrument (PSSSI), the Perception Inventory of Family Support (PIFS), weekly psychotherapeutic follow-up with Sandplay Therapy, and meetings with parents of the adolescents were used. Results: In the comparison of PIFS before and after treatment, the results showed significant improvement (p <0.05). In the comparison of the trauma scale (PSSSI) before and after treatment, although all variables showed improvement, only avoidance was statistically significant. After the meetings, parents and caregivers subjected to a sensitization approach could become more receptive and welcoming. Conclusions: The combination of individual and family interventions could trigger significant changes in the re-signification of the trauma, providing not only the adolescent but also his/her family with magnification and fortification of a healthier development, causing those involved to reposition themselves to the experienced contexts

Epidemiological Patterns of Central Nervous System Neoplasms in Brazilian Vulnerable Children

Introduction: Central nervous system (CNS) neoplasms are the most common solid tumors within the pediatric population, being an important cause of death and functional losses in this age group. Although studies show that there is good evolution and adaptation of pediatric survivors in adulthood, the interaction of these individuals with social inclusion factors still worries the medical environment. Objective: To analyze the temporal trend of mortality, hospitalization and social vulnerability of children with CNS Neoplasia and correlate with social indicators. Methods: An ecological study carried out in November 2018, through the analysis of secondary data on mortality, hospital admission, social vulnerability index and social indicators of Brazil, collected in DATASUS, and the Atlas of Social Vulnerability available at the Institute of Economic Research in the period from 2010 to 2015. Results: The improvement of social variables in all Brazilian regions; There was an increase in hospitalizations for Nervous System neoplasms for the 5 to 9-year-old male in the Northeast region; To the North, in the age group 0 to 4 years the hospitalization rates were positively correlated with the IVS, negatively with the HDI and positively with the Gini index; It was possible to identify a negative correlation between the IVS and the total number of hospitalizations for the Northeast in the female sex; Regarding mortality, there was a positive correlation between total mortality and IVS in the Midwest for the male population. Conclusion: It was concluded that there was a correlation between the various social indexes (HDI, IVS and Gini index) and the incidence and mortality due to Central Nervous System neoplasms in the pediatric population. &nbsp

Prevalência e fatores associados à síndrome metabólica em população vulnerável do norte do Brasil: um estudo transversal

Introduction: metabolic syndrome (SM) is a set of metabolic imbalances that are associated with the development of cardiovascular diseases, type 2 diabetes mellitus, in addition to other chronic non-communicable diseases. SM has been gaining prominence in the scientific community mainly due to link with the increase of the obesity epidemic in the world. Objective: To analyze the factors associated with metabolic syndrome and its prevalence in a vulnerable population in the Northern Region of Brazil. Methods: This is a cross-sectional study with artisanal fishers from the state of Tocantins, and data collected between 2016 and 2017 were used. The outcome variable for MS was defined according to the criteria of the International Diabetes Federation. The following variables were assessed: socioeconomic and demographic information, fish consumption, and smoking. For statistical and data analysis, the Shapiro–Wilk test, Poisson regression, Student's t-test, and interquartile regression were evaluated. Results: The general prevalence rate (PR) of MS was 31.9% higher in women than in men. The factors associated with MS were economic class and smoking, and there was an association between socioeconomic class and smoking (p=0.015). The most prevalent component was abdominal obesity with a rate of 62.5% (95% confidence interval [CI]: 54.5, 70.5). The prevalence of MS in terms of sex (PR=2.27, 95% 1.04 CI, 4.92, p=0.037), smoking (PR=2.40, 95% CI, 30, p=0.003) and years of professional experience (>10 PR=2.07, 95% CI 1.06, 4.05, p=0.033) was also assessed. Conclusion: In the present study, the prevalence of SM was associated with smoking and socioeconomic status, which is considered high when compared to the worldwide prevalence. These findings highlight the importance of looking at public policies so that health services can develop actions that generate greater adherence to good health practices by the population.Introdução: A síndrome metabólica (SM) é um conjunto de desequilíbrios metabólicos que estão associados ao desenvolvimento de doenças cardiovasculares, diabetes mellitus tipo 2 além de outras doenças crônicas não transmissíveis. A SM vem ganhando destaque na comunidade científica principalmente por sua ligação com o aumento da epidemia de obesidade no mundo. Objetivo: Analisar os fatores associados à síndrome metabólica e sua prevalência em população vulnerável da Região Norte do Brasil. Método: Trata-se de um estudo transversal com pescadores artesanais do estado do Tocantins, e foram utilizados dados coletados entre 2016 e 2017. A variável desfecho para SM foi definida de acordo com os critérios da International Diabetes Federation. As seguintes variáveis foram avaliadas: informações socioeconômicas e demográficas, consumo de peixe e tabagismo. Para análise estatística e de dados, foram avaliados o teste de Shapiro – Wilk, regressão de Poisson, teste t de Student e regressão interquartil. Resultados: A taxa geral de prevalência (RP) da SM foi 31,9% maior em mulheres do que em homens. Os fatores associados à SM foram classe econômica e tabagismo e houve associação entre classe socioeconômica e tabagismo (p = 0,015). O componente mais prevalente foi obesidade abdominal com uma taxa de 62,5% (intervalo de confiança de 95% [IC]: 54,5, 70,5). A prevalência de SM em termos de sexo (RP = 2,27, IC 95% 1,04, 4,92, p = 0,037), tabagismo (RP = 2,40, IC 95%, 30, p = 0,003) e anos de experiência profissional (> 10 RP = 2,07, IC 95% 1,06, 4,05, p = 0,033) também foi avaliado. Conclusão: No presente estudo, a prevalência de SM esteve associada ao tabagismo e ao nível socioeconômico, sendo considerada elevada quando comparada a prevalência mundial. Esses achados assinalam a importância de um olhar das políticas públicas para que os serviços de saúde possam desenvolver ações que geram maior adesão as boas práticas de saúde pela população

Correlation between timed up and go, usual gait speed and dizziness handicap inventory in elderly with vestibular disorders: a retrospective and analytical study

Abstract Background This study was done to verify the associations between the usual gait speed (UGS), the Timed Up and Go test (TUG), and the perception of disability in elderly vestibular patients and to identify factors associated with TUG results. Methods This was a descriptive, analytical, and retrospective study that used data from the clinical records of vestibular patients aged 65 years or older at a rehabilitation service in Buenos Aires, Argentina. The records were examined for the following information: sex, age, type of vestibular disorder, dizziness handicap inventory (DHI) score and performance in the TUG and UGS tests before treatment. Pearson’s or Spearman’s correlation coefficient was used depending on the distribution of data. Age and the DHI were factored into multiple linear regression models in order to model the tests. A Receiver Operating Characteristic (ROC) curve was used to analyze the predictive power of age, the DHI total, and the UGS for the sample’s TUG results. The level of significance was 5%. Results We evaluated 118 clinical records, of which 26 were excluded due to incomplete information, leaving data from 92 vestibular patients (73 females; 78.3 ± 5.8 years old). Unilateral vestibular hypofunction and Benign Paroxysmal Positional Vertigo presented the highest prevalence. The total score and the DHI domains showed a significant association with the TUG and UGS values. The age-adjusted DHI had a low predictive power for these same values. Conclusions The total score and DHI domains have a significant association with the TUG and UGS values for elderly adults with vestibular disorders. The age-adjusted DHI has a low predictive power for TUG and UGS values

Influence of severity of traumatic brain injury at hospital admission on clinical outcomes

<div><p>ABSTRACT Traumatic brain injury (TBI) is a public health problem with high mortality and socioeconomic repercussions. We aimed to investigate the influence of TBI severity on the length of mechanical ventilation (MV) stay and length of hospital stay and on the prevalence of tracheostomy, pneumonia, neurosurgery and death. This retrospective, observational study evaluated medical records of 67 patients with TBI admitted to Irmandade da Santa Casa de Misericórdia de São Paulo. Severity was determined according to the Glasgow Coma Scale (GCS): mild (13-15 points; 36 patients; 53.7%), moderate (9-12 points; 14 patients; 20.9%) or severe (3-8 points; 17 patients; 25.4%). Severe TBI patients had higher prevalence of tracheostomy, pneumonia and neurosurgery. No significant differences were observed between TBI severity, mortality and length of MV stay. However, TBI severity influenced the length of hospital stay. TBI severity at admission, evaluated according to the GCS, influenced the prevalence of tracheostomy, pneumonia, neurosurgery and was associated to prolonged hospital stay.</p></div

Avaliação de plantas cítricas, em diferentes profundidades de plantio, em latossolo amarelo dos tabuleiros costeiros Avaliation of citros crop using differents depths of planting in yellow latosol of the coastal table band

A citricultura dos Estados da Bahia e Sergipe representa cerca de 103.000 ha e está localizada nos Tabuleiros Costeiros, onde predominam Latossolos Amarelos, com horizontes coesos que se apresentam endurecidos quando secos. Esse fenômeno impede o desenvolvimento das raízes ao longo do perfil, diminuindo o volume de solo explorado e a disponibilidade de água e nutrientes. Para romper os horizontes coesos e aumentar o volume de solo ocupado pelas raízes, foram utilizados plantios com profundidades de cova de 0,40; 0,60; 0,80; 1,00 e 1,20 m, com laranjeira 'Valência' enxertada sobre limoeiro 'Volkameriano', que apresentaram maior desenvolvimento de raízes quando plantadas em covas de 1,00 m e 1,20 m de profundidade. Não houve diferenças significativas para diâmetro da copa, diâmetro do caule, altura de planta e produção de frutos entre os tratamentos.<br>The citros crop in Bahia and Sergipe, represents about 103.000 hectares and is established in the Coastal Table Land, where Yellow Latosol prevail, with cohesive horizons that become hardned when dry. This problem restrains the development of the roots along the profile of the soil, promoting the decrease of soil volume explored and consequently the availability of water and nutrients. To solve this problem, breaking the cohesive layer and increase the volume of soil roots it was used several depths of planting with holes of 0,40; 0,60; 0,80; 1,00 and 1,20 m, using orange tree 'Valência' grafted on lemon tree 'Volkameriano'. The best development of the roots was obtained with the 1,00 m and 1,20 m of depth. No significant statistical results was obtained for diameter of the cup and the stem, plant height and production of fruits among the treatments

Distribuição do sistema radicular de citros em uma toposseqüência de solos de tabuleiro costeiro do Estado da Bahia Citrus root system distribution in a coastal table land soil toposequence of the state of Bahia, Brazil

O aprofundamento do sistema radicular dos citros é importante para aumentar a produtividade e a longevidade dessa cultura, principalmente em solos que apresentam horizontes coesos subsuperficiais. Assim, o objetivo deste trabalho foi avaliar a distribuição das raízes da laranjeira 'Hamlin' enxertada em limoeiro 'Cravo', com 15 anos de idade, em uma toposseqüência de tabuleiro de Sapeaçu-BA, composta por Latossolo Amarelo argissólico (LAx) e Argissolo Amarelo (PAx), ambos coesos, e Argissolo Acinzentado (PAC), não coeso. Em 2001, retiraram-se amostras de raízes em uma planta no LAx e no PAx e em duas no PAC, em quatro horizontes, em quatro pontos na linha e em cinco na entrelinha, distanciados por 0,50 m, usando-se um cilindro de aço de 1,20 m de comprimento e 0,085 m de diâmetro. As raízes foram digitalizadas em escaner e processadas no aplicativo GSRoot. As raízes da laranjeira 'Hamlin' enxertada em limoeiro 'Cravo' apresentaram grande sensibilidade à coesão, sendo a densidade de raízes 3,4 a 4,1 vezes maior no solo PAC, não coeso. A densidade das raízes encontradas nos horizontes superficiais do LAx e do PAx foi próxima daquela do horizonte mais profundo do PAC. A profundidade efetiva do sistema radicular, até onde se encontraram 80 % das raízes, foi maior no PAC não coeso, e a distância efetiva do sistema radicular, até onde se encontraram 80 % das raízes a partir do tronco, foi maior no PAx coeso, que foi o solo que apresentou a menor profundidade efetiva das raízes. Nos três solos, houve predominância de raízes com diâmetros < 1 mm, seguidas daquelas com diâmetros entre 1 e 2 e > 2 mm.<br>The deepening of citrus root system is important to increase crop productivity and longevity, especially in soils with subsurface cohesive horizons. The objective of this study was to evaluate the root distribution of 'Hamlim' sweet orange grafted onto Rangpur lime. The 15 year-old plants were located in a coastal plain soil toposequence in Sapeaçu county, Bahia, Brazil. The soils were an argisolic Yellow Latosol (LAx; Oxisol) and a Yellow Argisol (PAx; Ultisol), both cohesive, and a non-cohesive Gray Argisol (PAC; Ultisol). In 2001, root samples were collected from one plant in the LAx and from one plant in the PAx, and from two plants in the PAC. Samples were collected in four horizons, four points in the row and five points in the inter-rows, spaced at 0.50 m, using a steel cylinder with a length of 1.20 m and diameter of 0.085 m. The collected roots were scanned and processed using the GSRoot software. 'Hamlim' sweet orange roots grafted onto Rangpur lime were highly sensitive to soil cohesion. The root density in the PAC was 3.4 to 4.1 times higher than in the LAx and PAx, respectively. Root density in the LAx and PAx surface horizons was close to that in the deepest horizon of the PAC. The effective depth root system, where 80 % of the roots can be found, was higher in the PAC, non-cohesive soil, while the effective distance, where 80 % of the roots measured from the tree trunk can be found, was higher in the PAx, cohesive soil. In the PAx the effective depth of the root system was the smallest. In the three soils the roots with diameter < 1 mm were predominant, followed by those with diameter between 1 and 2 and > 2 mm