Endemia hansênica em menores de 15 anos e a ampliação da Atenção Primária no município em Juazeiro, Bahia: estudo de séries temporais.

RESUMO: No Brasil, a hanseníase mantém-se como um grave problema de saúde pública, em razão, sobretudo, do acometimento de crianças e todas as consequências físicas, funcionais, sociais e psicológicas decorrentes. Este trabalho tem como objetivo descrever a endemia hansênica no município de Juazeiro, Bahia e analisar a importância da ampliação da política de atenção primária para controle da doença. Trata-se de um estudo ecológico exploratório com desenho de séries temporais, envolvendo todos os casos de hanseníase diagnosticados em menores de 15 anos no município de Juazeiro, Bahia, entre os anos de 2003 e 2012. Para a análise das séries temporais foi aplicada regressão linear utilizando o software R 3.0.3 e para o georreferenciamento das unidades de saúdes foi utilizado o software Terra View 4.2.2. Foram calculados ainda os indicadores de monitoramento e avaliação da hanseníase. Dos 1691 casos de hanseníase, 7,8% (132) ocorreram em menores de 15 anos. Não foi evidenciada tendência de queda significativa no coeficiente de detecção em menores de 15 anos (p>0.05). Houve aumento significativo no número de unidades de saúde acompanhando casos de hanseníase (p<0.05), bem como ampliação da cobertura de atenção primária, tornando superior a 90%, em 2012. A proporção de cura no período foi de 97,6%, a proporção de exame de contato foi de 78% e a proporção de abandono encontrada foi de apenas 1,6%. A partir dos resultados encontrados, é possível concluir que a ampliação das políticas de atenção primária à saúde tem influenciado favoravelmente no cenário da hanseníase em menores de 15 anos no município

Two-year experience in laparoscopic colorectal surgery in a healthcare service in Salvador: a critical analysis

AbstractIntroductionlaparoscopic colorectal surgery has become a viable access route since the beginning of 1990, using Jacobs’ technique. Its outcomes are decrease in hospitalization length, early return to routine activities, better esthetic results and less postoperative pain.Objectiveto report a series of patients treated by a team using videolaparoscopic access route in colorectal surgery.Material and methodsretrospective, descriptive study carried out in Salvador, state of Bahia, Brazil, from April of 2010 to May 2012.Resultsa total of 81 procedures were analyzed; 59.3% of cases were females, mean age was 58.3 years. Benign illness was treated in 48.1% to the patients. Rectosigmoidectomy was carried out in 41.5% and right colectomy in 21%. Intraoperative complications were observed in 3.7% and postoperative in 21% of cases, with a conversion rate of 6.2%.Conclusionthe laparoscopic procedure showed to be safe and the surgeon's training results in better outcomes in this series

Impact of the COVID-19 pandemic on the performance of pediatricians and pediatric dentists in the Brazilian Unified Health System

Objective: To evaluate the impact of the COVID-19 pandemic on the outpatient production of pediatricians and pediatric dentists in the Brazilian Unified Health System (SUS). Methods: An ecological study was carried out with an analytical and quantitative approach, using public domain data from the Department of Informatics of the SUS. The monthly number of professionals who worked in the SUS, the number of outpatient procedures in each category and the projection of residents from zero to thirteen years old to normalize it were retrieved. Data were compared by pre-pandemic (2018-2020) and pandemic (2020-2022) periods with a significance level of 5%. Results: There was a significant reduction in the monthly number of outpatient procedures performed in the SUS by pediatricians in the first and second pandemic year of COVID-19 when compared to the pre-pandemic period (p <0.001 e 0.002, respectively). This reduction represents a median percentage reduction of -57.1% (CI95% -51.3%, -71.7%) in the first and -22.3% (CI95% -0.55%, -31.5%) in the second pandemic year. Regarding pediatric dentists, a significant reduction was observed only between the pre-pandemic period and the first pandemic year (p <0.001), representing -82.0% (CI95% -73.4%, -93.6%). Moreover, a significant, positive and moderate correlation was observed between the productivity of both professional categories in the SUS throughout the investigated period (p < 0.001, ρ = 0.744). Conclusion: The COVID-19 pandemic negatively affected the provision of specialized medical and dental outpatient care for children in the SUS

VAAFT - Videoassisted anal fistula treatment: A new approach for anal fistula

AbstractIntroductionAnal fistula is an epithelised path between the rectum or anal canal and the perianal region. The use of laparoscopic surgery with a minimally invasive procedure has led to the development of video-assisted surgical treatment of anal fistula.ObjectiveTo describe the surgical technique VAAFT as a new approach to fistula.ConclusionThis is a safe and reproducible procedure. It enables the study of the entire fistula, obtaining the identification of accessory paths, cavitations and of the inner hole. More studies should be published for a better analysis of this technique, as well as to have a long-term outcome with new publications

Staphylococcus aureus

The present study evaluated the microbiological and sanitary quality of curd cheese sold on the beaches of the Itaparica Island, Brazil, and verified whether a correlation exists between the commercialization conditions and the microbiological data. The research was performed between December 2015 and March 2017. Sixty samples of rennet-containing cheese were collected to estimate the populations of mesophylls, psychrotrophic microorganisms, mold and yeast, Staphylococcus aureus, total coliforms, and Escherichia coli. An observational analysis was performed during the collection, using a checklist to verify the sellers’ sanitary conditions and cheese marketing. A high nonconformity index was registered regarding aspects in the checklist. In the microbiological analyses, the number of mesophylls in raw and roasted samples ranged from 7,88 to 14,82 log CFU/mL, and those of psychrotrophs ranged from 2,80 to 3,84 log CFU/mL. Meanwhile, mold and yeast levels in the samples ranged from 8,06 to 5,54 log CFU/mL, S. aureus was detected at levels from 3,24 to 4,94 log CFU/mL, and the total coliform counts ranged from 4,48 to 7,18 log CFU/mL. The number of E. coli specimens ranged from 2,96 to 5,75 log CFU/mL. Microbial insecurity was noted for commercialized curd cheese, and the need for intervention was indicated

Metástases Cutâneas como Primeira Manifestação de Carcinoma Urotelial

Cutaneous metastases of visceral neoplasms are rare conditions, and urothelial or transitional cell carcinomas are responsible for less than 1% of cases. We report the case of a 50-year-old male patient who progressively developed multiple cutaneous nodules on his head, abdomen, axilla, and groin, some with ulceration. Skin biopsy and immunohistochemistry were consistent with cutaneous metastasis of urothelial carcinoma. Computed tomography scan revealed generalized metastasis in internal organs. In this rare case, cutaneous metastases were the presenting sign of the disease and, as reported, a sign of bad prognosis.Metástases cutâneas de neoplasias viscerais são raras, e os carcinomas uroteliais ou de células transicionais são responsáveis por menos de 1% dos casos. Relatamos o caso de um paciente de 50 anos que desenvolveu progressivamente múltiplos nódulos cutâneos (cabeça, abdômen, axila e virilha), alguns com ulceração, antes de qualquer outra sintomatologia. A biópsia cutânea e o estudo imuno-histoquímico foram consistentes com metástases cutâneas de um carcinoma urotelial. O exame tomográfico revelou metástase generalizada nos órgãos internos. Além da raridade destes tipos de metástases cutâneas, neste caso foi o sinal inaugural e, como habitualmente descrito, associado a mau prognóstico

Wood plastic composites manufactured with sawmill waste and discarded polypropylene packaging

O objetivo do trabalho foi avaliar as propriedades físicas e mecânicas dos compósitos de madeiraplástico confeccionados com diferentes cargas de prensagem. Foi utilizada a serragem de cumaru e o plástico de polipropileno (PP) pós-consumo. A manufatura consistiu na proporção de 30% de serragem e 70% de PP, o colchão de partículas foi colocado na prensa hidráulica por 20 minutos a 180°C com aplicação de diferentes cargas (2, 5, 8, 11 e 14 toneladas). Os compósitos foram caracterizados por meio dos ensaios físicos (densidade, absorção de água e inchamento em espessura) e mecânicos (resistência à flexão estática, resistência ao impacto e dureza Rockwell). Nos ensaios físicos foi observado que aumentando a força de prensagem evidenciaram-se as melhores respostas. Já para os ensaios mecânicos, na flexão estática a força de prensagem aumentou a resistência do compósito. Entretanto para a dureza Rockwell e a resistência ao impacto a variação da força não alterou a resistência dos compósitos de madeira-plástico.The objective was to evaluated the physical and mechanical properties of wood-plastic composite (WPC) made of different press forces. We used a cumaru sawdust and polypropylene(PP) plastic after consumption. The manufacture was the proportion of 30% sawdust and 70% PP, mattress particles was transferred to a hydraulic press for 20 minutes at 180°C with differents forces aplications (2, 5, 8, 11 and 14 Tons). The composites were characterized by physical tests of density, water absorption, thickness swelling and the mechanical bending strength, impact resistence and Rockwell hardness. For physical tests it was observed that increasing the force responses were best composites. As for the mechanical tests on the bending strength increased composite strength, but for the Rockwell hardness and impact energy strength variation did not alter the resistance of the wood-plastic composites

VIVÊNCIAS ACADÊMICAS E REPERCUSSÕES NA QUALIDADE DE VIDA DE GRADUANDOS DE ENFERMAGEM EM UNIVERSIDADE PÚBLICA

Quality of Life (QoL) is related to the expanded concept of health and well-being. The democratization of Higher Education has enabled a greater insertion of young people in universities, generating the need for more research on the academic repercussions on their QoL. This theme assumes relevance when we deal with graduations in nursing, as these professionals will constitute the largest workforce in the health area. Aimed to understand the perception of nursing students in the relationship between academic experiences and quality of life. It was field research, exploratory, quali-quantitative, carried out with 37 university students of the nursing course at a public university in the state of Bahia, approved by the Research Ethics Committee. A semi-structured questionnaire was used to trace the sociodemographic profile and academic characterization, the validated instrument for Quality of Life Assessment: "The World Health Organization Quality of Life-BREF" (WHOQOL-bref), and two open questions for the free expression of students' perception of the relationship between academic experiences and quality of life. The results of the study revealed that the sample profile was mostly female, self-declared black, aged between 20 and 25 years, mostly from the interior of the state, with supplementary income from student scholarships and non-mester students. The most impaired QoL domain was physical and environmental. The personal and study dimension of academic experiences were the most affected. It is necessary to give students a voice and develop institutional strategies and public policies for university education and permanence, resulting in a better QoL of university students.La Calidad de Vida (CV) se relaciona con el concepto ampliado de salud y bienestar. La democratización de la Educación Superior posibilitó una mayor inclusión de los jóvenes en las universidades, generando la necesidad de investigaciones sobre el tema. La relevancia de este estudio se explica porque los enfermeros constituyen una gran fuerza de trabajo en el área de la salud. El objetivo fue comprender la percepción de los académicos sobre la relación entre las experiencias académicas y la CV. Investigación de campo, exploratoria, cualitativa y cuantitativa, con 37 estudiantes de una universidad pública del estado de Bahía, aprobada por el Comité de Ética. Se utilizó un cuestionario semiestructurado para la caracterización sociodemográfica y académica, un instrumento validado para la Evaluación de la Calidad de Vida: "The World Health Organization Quality of Life-BREF" (WHOQOL-bref), y dos preguntas abiertas. Percepción de los estudiantes sobre la relación entre experiencias académicas y calidad de vida. Los resultados del estudio revelaron que el perfil de la muestra fue mayoritariamente femenino, autodeclarado negro, con edades comprendidas entre los 20 y 25 años, en su mayoría del interior del estado, con ingresos complementarios por becas estudiantiles y estudiantes no de maestría. El dominio de calidad de vida más deteriorado fue físico y ambiental. La dimensión personal y de estudio de las experiencias académicas fueron las más afectadas. Es necesario dar voz a los estudiantes y desarrollar estrategias institucionales y políticas públicas para la formación universitaria y la permanencia, redundando en un mejor currículo de los universitarios.A Qualidade de Vida (QV) está relacionada ao conceito ampliado de saúde e bem-estar. A democratização do Ensino Superior possibilitou maior inserção de jovens nas universidades gerando necessidade de mais pesquisas sobre as repercussões acadêmicas na sua QV. Essa temática assume relevância quando tratamos das graduações em enfermagem, pois estes profissionais constituirão a maior força de trabalho da área da saúde.  Neste estudo objetivou-se compreender a percepção do estudante na relação entre vivências acadêmicas e qualidade de vida.  Foi uma pesquisa de campo, exploratória, quali-quantitativa, realizada com 37 estudantes universitários do curso de enfermagem de uma universidade pública do estado da Bahia, aprovada pelo Comitê de Ética em Pesquisa. Utilizou-se questionário semi-estruturado para traçar o perfil sociodemográfico e caracterização acadêmica, o instrumento validado para Avaliação de Qualidade de Vida: “The World Health Organization Quality of Life-BREF” (WHOQOL-bref), e duas questões abertas para a livre expressão da percepção dos estudantes na relação entre vivências acadêmicas e qualidade de vida. Os resultados do estudo revelaram que o perfil da amostra foi majoritariamente de pessoas do sexo feminino, autodeclaradas pretas, com idade entre 20 e 25 anos, de maioria procedente do interior do estado, com renda complementar de bolsas estudantis e dessemestralizados. O domínio de QV mais prejudicado foi o físico e o ambiental. A dimensão pessoal e de estudo das vivências acadêmicas foram as mais atingidas.  Torna-se necessário dar voz aos estudantes e desenvolver estratégias institucionais e políticas públicas para a formação e permanência universitária repercutindo na melhor QV dos estudantes universitários

Low dynamic muscle strength and its associations with fatigue, functional performance, and quality of life in premenopausal patients with systemic lupus erythematosus and low disease activity : a case–control study

Background: The purpose of the present study was to compare dynamic muscle strength, functional performance, fatigue, and quality of life in premenopausal systemic lupus erythematosus (SLE) patients with low disease activity versus matched-healthy controls and to determine the association of dynamic muscle strength with fatigue, functional performance, and quality of life in SLE patients. Methods: We evaluated premenopausal (18–45 years) SLE patients with low disease activity (Systemic lupus erythematosus disease activity index [SLEDAI]: mean 1.5 ± 1.2). The control (n = 25) and patient (n = 25) groups were matched by age, physical characteristics, and the level of physical activities in daily life (International Physical Activity Questionnaire IPAQ). Both groups had not participated in regular exercise programs for at least six months prior to the study. Dynamic muscle strength was assessed by one-repetition maximum (1-RM) tests. Functional performance was assessed by the Timed Up and Go (TUG), in 30-s test a chair stand and arm curl using a 2-kg dumbbell and balance test, handgrip strength and a sit-and-reach flexibility test. Quality of life (SF-36) and fatigue were also measured. Results: The SLE patients showed significantly lower dynamic muscle strength in all exercises (leg press 25.63%, leg extension 11.19%, leg curl 15.71%, chest press 18.33%, lat pulldown 13.56%, 1-RM total load 18.12%, P < 0.001-0.02) compared to the controls. The SLE patients also had lower functional performance, greater fatigue and poorer quality of life. In addition, fatigue, SF-36 and functional performance accounted for 52% of the variance in dynamic muscle strength in the SLE patients. Conclusions: Premenopausal SLE patients with low disease activity showed lower dynamic muscle strength, along with increased fatigue, reduced functional performance, and poorer quality of life when compared to matched controls