Situación actual de la sífilis congénita en el departamento de Paysandú, años 2015-2019 / Congenital syphilis in Paysandú Department at present (2015-2019) / Situação atual da sífilis congênita no departamento de Paysandú (2015-2019)

Resumen: Introducción: la sífilis es una enfermedad de transmisión sexual, evitable y curable que se transmite al feto. Aunque el tratamiento materno es de fácil realización y bajo costo, Uruguay persiste con dificultades en el control y eliminación de la sífilis congénita (SC). Objetivos: describir la incidencia de casos de SC en el departamento de Paysandú, durante el período comprendido entre el 1/1/2015 y el 31/7/2019. Describir características epidemiológicas y clínicas de las embarazadas y sus recién nacidos (RN) con diagnóstico de SC. Metodología: estudio descriptivo y retrospectivo. Los datos se obtuvieron de auditorías, historias clínicas de internación y policlínicas. Se definió caso de SC según la Organización Panamericana de la Salud y se utilizaron los cuatro escenarios de SC propuestos por el Centers of Disease Control and Prevention (CDC). Resultados: se registraron 30 RN con SC o probabilidad de SC. Veintisiete del subsector público y tres del privado. Casi la mitad fue producto de embarazos mal o no controlados. El 37% de las madres eran consumidoras de drogas, incluso en el embarazo, y en 73% se desconocía o no se había realizado estudio o tratamiento a la pareja sexual. Conclusiones: la mayor incidencia de SC se observa en el subsector público. La mayoría de los casos están relacionados a embarazos de captación tardía, mal controlados o sin controles, y a madres consumidoras de sustancias psicoactivas. El tratamiento de los contactos es un problema sin resolver. Para alcanzar el objetivo sanitario, debemos hacer hincapié en la planificación, control y seguimiento del embarazo, así como en el diagnóstico precoz y en el tratamiento oportuno de esta infección.

Summary: Introduction: syphilis is a preventable and curable sexually transmitted disease, transmitted to the fetus. Although maternal treatment is easy to perform and has a low cost, Uruguay still has difficulties to control and eliminate congenital syphilis (CS). Objectives: describe the incidence of CS in Paysandú Department between 01/01/2015 and 07/31/2019. Describe epidemiological and clinical characteristics of pregnant women and their NB diagnosed with CS. Metodology: descriptive and retrospective study. The data were obtained from audits, hospitalization and clinical medical records. The CS case was defined according to the Pan American Health Organization (PAHO) and the 4 CS scenarios were described by the Centers of Design Control and Prevention (CDC). Results: there were 30 cases of CS and/or probability of CS in newborns. 27 were assisted in the Public Sector and 3 to the Private one. Almost half of them were the result of lately controlled or uncontrolled pregnancies. 37% of the mothers were illegal drug users, even during pregnancy, and in 73% cases no testing and/or treatment had been performed on their sexual partners. Conclusions: the highest prevalence of CS is observed in the public subsector. Most cases were the result of lately or poorly controlled or uncontrolled pregnancies, and came from mothers who had consumed psychoactive substances. The treatment of contacts is still an unresolved problem in the public subsector. To achieve the health objective, we must emphasize the planning, control and monitoring of pregnancies, as well as the early diagnosis and timely treatment of this infection.

Resumo: Introdução: a sífilis é uma doença sexualmente transmissível, evitável e curável, que é transmitida ao feto. Embora o tratamento materno seja fácil de realizar e de baixo custo, o Uruguai ainda tem dificuldades em controlar e eliminar a sífilis congênita (SC). Objetivos: descrever a incidência de SC no departamento de Paysandú entre 01/01/2015 e 31/07/2019. Descrever características epidemiológicas e clínicas de gestantes e seus recém-nascidos diagnosticados com SC. Metodologia: estudo descritivo e retrospectivo. Os dados foram obtidos em auditorias, internações e prontuários clínicos. O caso de SC foi definido de acordo com a Organização Pan-Americana da Saúde (OPAS) e os quatro cenários de SC descritos pelos Centros de Controle e Prevenção de Projeto (CDC). Resultados: houve 30 casos de SC e/ou probabilidade de SC em recém-nascidos. 27 foram atendidos no setor público e 3 no privado. Quase metade deles foram o resultado de gravidezes tardiamente controladas ou não controladas. 37% das mães eram usuárias de drogas ilegais, mesmo durante a gravidez e em 73% dos casos nenhum teste e/ou tratamento foi realizado nos seus parceiros sexuais. Conclusões: a maior prevalência de SC é observada no subsetor público. A maioria dos casos foi resultado de gravidez mal controlada, controlada tardiamente ou não controlada e veio de mães que consumiram substâncias psicoativas. O tratamento dos contatos ainda é um problema não resolvido no setor público. Para atingir o objetivo de saúde, devemos enfatizar o planejamento, controle e monitoramento das gestações, assim como o diagnóstico precoce e o tratamento oportuno dessa infecção.

Uso de medicamentos e fatores associados à polifarmácia em indivíduos com diabetes mellitus em Minas Gerais, Brasil / Drug utilization and factors associated with polypharmacy in individuals with diabetes mellitus in Minas Gerais, Brazil

Resumo O objetivo deste estudo foi avaliar o uso de medicamentos, a prevalência e os fatores associados à polifarmácia em pacientes com diabetes mellitus (DM) em Minas Gerais. Realizou-se um estudo transversal com descrição dos medicamentos em uso e análise da associação entre características sociodemográficas e clínicas com polifarmácia, por meio de regressão logística. Dos 2619 entrevistados, 56,5% estavam em polifarmácia. Medicamentos para DM, agentes no sistema renina-angiotensina e diuréticos foram os mais usados. Fatores como envelhecimento, presença de comorbidades e maior acesso aos serviços de saúde foram associados à polifarmácia. Observou-se elevada prevalência de polifarmácia, o que requer um cuidado adequado e melhor qualidade do uso de medicamentos para essa população.

Abstract The objective of this study was to evaluate the use of drugs and the factors associated with polypharmacy in patients with diabetes mellitus (DM) in Minas Gerais. Descriptive analysis of drugs in use and logistic regression to estimate the association between socio-demographic and clinical characteristics with polypharmacy were performed. Of the 2619 respondents, 56.5% were in polypharmacy. Drugs for DM, agent in renin-angiotensin system, and diuretics are the most frequently used. Factors such as age, comorbidities and increased access to health services were associated with polypharmacy. It was observed high prevalence of polypharmacy, which requires a suitable care and better quality of drug use in this population.

Utilidad del dibujo para superar problemas en la escritura: estudio de un caso / Correction of problems in writing through drawing: a case study

En los problemas de aprendizaje los casos de dificultades en la escritura son muy frecuentes. Dichas dificultades pueden ser analizadas desde el punto de vista neuropsicológico a partir de la diferenciación de indicadores particulares de los errores que presentan los niños. A través del análisis neuropsicológico, es posible identificar los mecanismos cerebrales que subyacen a estas dificultades. La actividad gráfica (dibujo) comparte algunos mecanismos indispensables para la adquisición de la escritura, tales como: estrategia perceptiva; global y analítica, la organización cinética, la regulación y control así como las imágenes objetales. Estos mecanismos pueden ser desarrollados durante la corrección basada en la formación de la actividad gráfica. En este artículo se presenta el contenido de este tipo de corrección neuropsicológica, sus etapas y los resultados obtenidos a partir de su aplicación en un escolar del segundo grado de primaria con reportes de problemas de escritura y antecedentes de riesgo neurológico perinatal y TCE leve. Los resultados indican mejoría significativa en la acción de la escritura en la evaluación posterior a la aplicación del método. Se discuten amplias posibilidades del uso de la actividad gráfica durante los procedimientos de corrección en la etapa escolar...

In cases of the learning disabilities, the cases of writing difficulties are frequent. These difficulties can be analyzed from neuropsychological background based on differentiation of particular indicators of errors that children commit. Through neuropsychological analysis it is possible to identify the brain mechanisms that underlie those difficulties. Graphic activity (drawing) shares some essential mechanisms for the acquisition of writing, such as: perceptual strategy; global and analytical, kinetic organization, regulation and control, and the object images. These mechanisms may be developed during the correction based on the formation of the graphic activity. This article presents the content of such kind of neuropsychological correction, its stages and the results obtained from its application in a schoolboy of second grade with writing problems reports and a history of perinatal neurological risk and mild head injury. The results indicate significant improvement in writing actions during neuropsychological assessment after implementation of the method. Extensive possibilities are discussed about the use of the graphic activity during the correction procedures at school age...

Public awareness and attitudes toward epilepsy in different social segments in Brazil

Purpose: To assess public awareness and attitudes toward epilepsy in Brazilians of different cultural and socioeconomic backgrounds. Background: Several studies have examined public awareness and attitudes toward epilepsy in various countries but there are no equivalent data for Brazil or South America. Material and Methods: We have applied the survery proposed by Caveness and Gallup, with some modifications and adaptations to four groups (I-IV) of subjects: I-105 individuals accompanying patients to the Ophthalmologic outpatient clinic of the Hospital das Clínicas of the State University of Campinas (UNICAMP); II-93 students recently admitted to medical and nursing school; III- 101 senior non-medical students; and IV- 69 senior medical students. Groups II, III, and IV were students at UNICAMP. Results: Individuals with a low socioeconomic standing had a poor profile of familiarity, knowledge and attitudes toward epilepsy. The pre-university and university students had a relatively good profile when compared to the published international polls. Senior medical students had an excellent level of familiarity and knowledge, but showed no change in their objection to having a son or a daughter marry an epileptic person. Conclusions: Our data suggest that there is a clear-cut relationship between the level of education and the individual's familiarity and atitudes toward epilepsy. Effective elimination of the prejudice toward epilepsy requires specific training and not just general, superficial information about the condition.