Perfil epidemiológico da hanseníase no período de 2011 a 2018 no município de Campinas - SP / Epidemiological profile of leprosy in the period from 2011 to 2018 in the municipality of Campinas - SP

Objetivo ­ Descrever o perfil epidemiológico da hanseníase em Campinas através do levantamento do número de casos da doença, registrados de 2011 a agosto de 2018 no município. Métodos ­ Tratou-se de uma pesquisa com abordagem transversal retrospectiva, quantitativa do tipo descritiva com a coleta de dados registrados no Sistema de Informação de Agravos de Notificação (Sinan) a respeito dos casos de hanseníase notificados no período de agosto de 2011 a agosto de 2018. Resultados ­ Foram encontrados 213 novos casos de hanseníase em Campinas no período estudado, com uma taxa de incidência de 2,47 casos para cada 100 mil habitantes. A população masculina apresentou-se com 57% dos casos registrados e a população feminina com 43%. A hanseníase mostrou-se prevalente em populações com idade acima de 14 anos com 96% das notificações. As formas clínicas iniciais mais encontradas foram a Virchowiana e a Dimorfa, com 31% e 26% respectivamente. O distrito residencial com o maior número de casos foi o Sul, com 28% dos casos registrados e o grau de incapacidade mais prevalente no momento do diagnóstico, foi o grau 0 da patologia com 59% dos casos notificados. Quanto a classificação operacional da notificação, notou-se que a classificação multibacilar apresentou 69% dos casos. Conclusão ­ Conclui-se que apesar da taxa de incidência da hanseníase no município de Campinas estar em declínio nas últimas décadas, é necessário manter o afinco dos órgãos de saúde do município na luta contra a doença, pois esta, ainda é considerada como um grave problema de saúde pública

Objective ­ To describe the epidemiological profile of leprosy in Campinas by surveying the number of cases of disease, recorded from 2011 to August 2018 in the city. Methods ­ This is a cross-sectional, quantitative, descriptive retrospective research with data collection recorded in the Notification Recording Information System (Sinan) and respect for unreported leprosy cases from August 2011 to August 2018. Results ­ A total of 213 new leprosy cases were found in Campinas during the study period, with an incidence rate of 2.47 cases per 100,000 inhabitants. The male population shows up with 57% of registered cases and the female population with 43%. Leprosy was prevalent at ages over 14 years with 96% of notifications. The most recent clinical forms found were Virchowiana and Dimorfa, with 31% and 26%, respectively. The residential district with the largest number of cases was the South, with 28% of the cases registered and the most prevalent degree of disability at the time of diagnosis, was the degree 0 pathology with 59% of the reported cases. Regarding the operational classification of the notification, there is no multibacillary classification Displaying 69% of cases. Conclusion ­ It was concluded that, although leprosy incidence rates in the city of Campinas have been declining in the last decades, it is necessary to maintain the commitment of public agencies of the city in the fight against the disease, since it is still considered as a serious public health problem.

Características clínicas y epidemiológicas de los pacientes hospitalizados con derrame pleural / Clinical and epidemiological characteristics of patients hospitalized with pleural effusion

El derrame pleural tiene una prevalencia mundial de aproximadamente 400 de cada 100.000 habitantes y Venezuela tiene cifras similares. Se relaciona con múltiples patologías, por lo que determinar sus características podría ayudar a obtener un mejor diagnóstico y tratamiento. Métodos: Se realizó un estudio de casos, retrospectivo y descriptivo, obteniendo información de las historias de pacientes hospitalizados con derrame pleural en el servicio de Medicina Interna del Hospital Dr. Domingo Luciani en el período Enero 2010- Abril 2015. Resultados: La edad promedio fue de 49±19 años, género masculino (53%). Motivo de consulta: disnea (81%), dolor torácico (44%) y tos (37%). Los síntomas: disnea (92%), dolor pleurítico (58%) y fiebre (54%). Antecedentes personales: HTA (32%), DM (22%) e IC (20%). Radiografía de tórax: (60%) derrame pleural derecho y (26%) izquierdo. Tomografía de tórax realizada en (77%). Citoquímicos: (85%) exudado (53% mononuclear y 32% polimorfonucleares). La prueba de ADA positiva en 25%, cultivo para bacterias realizado en 89 casos, positivos 18%. Bloque celular con resultado inflamatorio (80%). Biopsia pleural realizada (22%): inflamatorio (36,4%), seguido por ADC metástasico (31,8%). Estancia hospitalaria > 15 días (76%) y el diagnóstico final fue infeccioso (51%). Conclusión: Contando con estos datos clínicos- epidemiológicos se puede caracterizar el comportamiento del derrame pleural en nuestro centro para el rápido y acertado diagnóstico, igualmente proponer una investigación prospectiva donde se analice el comportamiento de dicha enfermedad, y crear protocolos de actuación(AU)

Pleural effusion has a worldwide prevalence of approximately 400 per 100,000 inhabitants and Venezuela has similar statistics. It is related to multiple pathologies, which determine their characteristics which could help for better diagnosis and treatment. Methods: A retrospective descriptive case study was conducted, obtaining information from the charts of hospitalized patients with pleural effusion in Internal Medicine Dr. Domingo Luciani Hospital Venezuela in the period January 2010-April 2015. Results: Mean age 49 ± 19 years, male genre (53%). Complaints: dyspnea (81%), chest pain (44%) and cough (37%). Symptoms: dyspnea (92%), pleuritic pain (58%) and fever (54%). Personal history: hypertension (32%), DM (22%) and HF (20%). Chest x-ray: right pleural effusion (60%), left (26%). Chest tomography performed on (77%). Cytochemical: exudate: 85% (53% mononuclear and polymorphonuclear 32%). ADA testing positive in 25%. For bacteria culture: performed in 89 cases, 18% positive. Cell block inflammatory (80%). Pleural followed by metastatic ADC (31.8%). Hospital stay> 15 days (76%) and final diagnosis was infection (51%). Cause of discharge from hospital: improvement (80%). Conclusion: Having these clinical and epidemiological data can characterize the behavior of pleural effusion for quick and accurate diagnosis(AU)

Osteogênese imperfeita perinatal na Maternidade do Hospital das Clínicas / Perinatal Osteogenesis imperfecta in the Maternity Ward of UFMG Hospital das Clínicas

Introdução: osteogênese imperfeita (OI) é uma doença genética caracterizada por diminuição da massa óssea, fraturas e outras alterações do tecido conjuntivo. Geralmente, ocorre por mutações em genes do colágeno tipo 1. Pode ser classificada nos tipos I a IX. Objetivo: estimar a incidência de OI e a frequência de seus tipos na Maternidade do Hospital das Clínicas ? UFMG (HC-UFMG) entre novembro/1990 e dezembro/2007, identificar fatores associados à doença, achados ultrassonográficos pré-natais mais frequentes e porcentagem de casos de novo. Métodos: estudo retrospectivo baseado no banco de dados da Maternidade do HC-UFMG, vinculado ao Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC). Identificados recém-nascidos vivos (RNV) e natimortos (NM) com diagnóstico de OI e seus achados ultrassonográficos.Entre os RNVs, foram estudadas associações com peso ao nascer, gênero, idade e paridade maternas utilizando os testes do qui-quadrado e exato de Fisher. Resultados: a incidência foi de 1:1.415, com 30 casos de OI (26 RNV e 4 NM) em 42.443 nascimentos, 16,7% tipo I, 40% tipo IIA e 40% tipo IIB/III. Houve associação com peso ao nascer ? 2.500 g. Os achados ultrassonográficos mais comuns na OI-I foram encurtamento, encurvamento e fraturas de ossos longos e na OI-II, além dos achados anteriores, tórax em sino ou hipoplásico, diminuição da calcificação craniana, osteopenia, bossa frontal, platispondilia e dilatação de ventrículos. Todos os casos de OI-II e 80% dos casos de OI-I ocorreram por mutação de novo ou mosaicismo gonadal. Conclusões: a incidência encontrada foi mais alta que a descrita, provavelmente por ser o HC-UFMG um hospital de referência. Associação com baixo peso provavelmente foi conseqüência da doença. O ultrassom fetal permitiu a suspeição pré-natal do diagnóstico.

Introduction: osteogenesis imperfecta (OI) is a genetic disease characterized by decreased bone mass, fractures and other disorders of connective tissues, usually due to gene mutations in collagen type I to IX. Objective: to evaluate the OI incidence and frequency of its types in the UFMG Hospital das Clinicas Maternity ( HC- UFMG) between November 1990 and December 2007, to identify the disease related factors, more frequent prenatal ultrasound findings and new cases percentage. Methods: retrospective study based on the database of the HC Maternity-UFMG, linked to the Estudo Colaborativo Latino-Americano de Malformações Congênitas (ECLAMC ) / Latin American Collaborative Study of Congenital Malformations. Identified live births (LB) and stillborn (SB) with OI diagnosis and their sonographic findings. Among the LB the study included relations with birth weight, gender, maternal age and parity using chi-square and Fisher exact tests. Results: the incidence was 1:1.415, with 30 OI cases (26 LB and 4 SB) in 42.443 births, 16,7% type I, 40% type IIA and 40% type IIB/III. There was association with birth weight? 2.500 g. The most common sonographic findings in the OI-I were shortening, bowing and fracture of long bones and in the OI-II, in addition to previous findings, bell or hypoplastic thorax, decreased cranial calcification, osteopenia, frontal bossing, platispondilia and dilated ventricles. All cases of OI-II and 80% of OI-I cases occurred by new mutation or gonadal mosaicism. Conclusions: The incidence was found higher than reported, probably because the HC- -UFMG is a referral hospital. Association with low birth weight was probably a consequence of the disease. The fetal ultrasound allowed the suspected prenatal diagnosis.

Indicadores de calidad intrahospitalaria / Indicators of intrahospital quality

Fundamento: la infección intrahospitalaria es uno de los problemas de salud mundial, y es un indicador de calidad del hospital. Objetivo: valorar los indicadores del programa de infección intrahospitalaria en el Hospital Universitario Martín Chang Puga de Nuevitas desde el año 2007 al primer semestre de 2008. Método: se realizó un estudió descriptivo y transversal, de los ciento treinta y seis casos de infección hospitalaria en el año 2007 y se compararon con los doscientos cincuenta y nueve casos de infección hospitalaria del año 1997, para apreciar los cambios en los indicadores. Coincidió la muestra con el universo en ambos años. Se realizó un registro con los indicadores de infección de todos los pacientes reportados, el cual constituyó la fuente primaria de obtención de los datos. Resultados: la mayor tasa de infección fue del servicio de nefrología con 4,6 por ciento. De la localización de las infecciones, las heridas quirúrgicas, las respiratorias, y las cardiovasculares, para un 18,3 por ciento respectivamente. Se utilizaron antibióticos como: la cefazolina, y la ciprofloxacina. De mayor resistencias, la penicilina y la eritromicina con el 10,1 por ciento, las cefazolinas 14,2 por ciento y la ampicilina con el 21,1 por ciento. Los gérmenes más aislados fueron los staphylococcus epidérmides con el 23,9 por ciento, y los aureus con 21,7 por ciento. Conclusiones: la tasa global de infección de 2007 fue inferior al año 1997. El servicio Nefrología fue el de más incidencia con una tasa muy superior al resto de los servicios. De los gérmenes más aislados, resultaron los staphylococcus epidérmides y los aureus, y los antibióticos más utilizados fueron ciprofloxacina y la cefazolina.

Background: intrahospital infection is one of the worldwide health problems, and it is a hospital’s quality indicator. Objective: to value the indicators of intrahospital infection program in the University Hospital Martin Chang Puga of Nuevitas from 2007 to the first semester of 2008. Method: a descriptive and cross-sectional study of one-hundred thirty-six cases of hospital infection in the year 2007 was carried out which were compared with two-hundred fifty-nine cases of the year 1997, to appreciate the changes in the indicators. The sample coincided with the universe in both years. A recording was carried out with infection indicators of all the reported patients, which constituted data primary source. Results: the biggest infection rate was in the nephrology service with 4,6 percent. Of the localization of infections, surgical wounds, breathing, and cardiovascular ones, to a 18,3 percent respectively. Antibiotics that were used: cefazolin and ciprofloxacin. The ones of greater resistance, penicillin and erythromycin with 10,1 percent, cefazolin 14,2 percent and ampicillin with 21,1 percent. The most isolated germs were the staphylococcus epidérmides with 23,9 percent, and the aureus ones with 21,7 percent. Conclusions: the infection global rate of 2007 was inferior to the year 1997. The Nephrology service had the highest incidence with a very superior rate to the remainder services. Of the most isolated germs, were the staphylococcus epidérmides and the aureus, and regarding antibiotics the most used were ciprofloxacin and cefazolin.

Biological evaluation of mechanically deboned chicken meat protein hydrolysate

OBJECTIVE: The objective of this study was to evaluate the biological properties of a protein hydrolysate obtained by enzymatic hydrolysis of mechanically deboned chicken meat. METHODS: Mechanically deboned chicken meat was hydrolysed using Alcalase 2.4 L FG and then dried in a spray-drier. Three groups (n=6) of male Wistar rats received diets containing casein, mechanically deboned chicken meat protein hydrolysate and a protein-free diet. The rats were randomly assigned to individual cages with controlled temperature (22ºC) for 12 days. RESULTS: The mechanically deboned chicken meat diet resulted in a good net protein utilization (3.74) and high true digestibility (96 percent). The amino acid composition of the hydrolysate was relatively well balanced, but the concentrations of methionine and cystine were low, making them the limiting amino acids. The proximate chemical composition of the hydrolysate showed protein content to be as high as 62 percent. CONCLUSION: The results obtained in this work suggest that mechanically deboned chicken meat hydrolysate can be used as a protein enhancer in food preparations such as enteral formulations, and as an edible protein enhancer in general applications.

OBJETIVO: O objetivo do estudo foi avaliar a qualidade biológica da proteína hidrolisada obtida a partir da carne mecanicamente separada de frango. MÉTODOS: A carne mecanicamente separada de frango foi hidrolisada com a enzima Alcalase 2,4 L FG e o hidrolisado obtido foi submetido a secagem em atomizador. Foram utilizados três grupos (n=6) de ratos machos Wistar os quais receberam dietas contendo caseína, proteína hidrolisada de carne mecanicamente separada de frango ou uma dieta com proteína livre. Os animais foram distribuídos aleatoriamente em gaiolas individuais, com temperatura controlada (22ºC), por um período de 12 dias. RESULTADOS: A dieta utilizando carne mecanicamente separada de frango resultou em elevada utilização líquida de proteína (3,74) e elevada digestibilidade verdadeira (96 por cento). A composição de aminoácidos da proteína hidrolisada apresentou bons resultados, embora metionina e cistina tenham apresentado baixos valores, sendo considerados aminoácidos limitantes. A composição química mostrou altos valores de proteína no hidrolisado obtido (62 por cento). CONCLUSÃO: Os resultados obtidos neste trabalho sugerem que a proteína hidrolisada de carne mecanicamente separada de frango poderá ser utilizada como um suplemento em formulações alimentares, tais como formulações enterais, ou como fonte de complementação protéica na indústria de alimentos em geral.

Caracterización de un grupo de pacientes con infarto cerebral en la consulta de medicina interna / Characterization in a group of patients with cerebral infarct at Internal medicine consultation

Fundamento: El infarto cerebral constituye la tercera causa de muerte en Cuba y en la mayoría de los países desarrollados, sólo superada por las enfermedades cardiovasculares y el cáncer. Objetivo: Conocer el comportamiento de la enfermedad cerebrovascular en la consulta de Medicina Interna. Método: Se realizó un estudio descriptivo a 47 pacientes egresados de los hospitales Enrique Santiesteban Báez del municipio Santa Cruz del Sur y del Manuel Ascunse Domenech de la provincia de Camagüey con el diagnóstico de infarto cerebral desde el 1rode septiembre de 2006 hasta el 1ro de septiembre del 2007. Resultados: El rango de edad de 71 años y más constituyó el 67 por ciento de la casuística. La hipertensión arterial, el tabaquismo y la dislipidemia predominaron en el sexo masculino como factores de riesgo con 91,5, 65,9y 61,7 por ciento, respectivamente. El infarto aterotrombótico se presentó en el 44,7 por ciento de los pacientes. Conclusiones: El sexo masculino, la edad de 71 años y más fueron los más frecuentes en nuestro estudio, el territorio vascular de mayor afección lo constituyó el carotídeo en ambos sexos. La diabetes mellitus predominó en el femenino. El infarto cerebral aterotrombótico fue el más frecuente

Background: The cerebral infarction constitutes the third fatal cause in Cuba and in the majority of developed countries, only surpassed for cardiovascular diseases and cancer. Objective: To know the cerebrovascular disease behavior at Internal Medicine consultation. Method: A descriptive study to 47 patients discharged from the hospitals Enrique Santiesteban Báez of Santa Cruz del Sur municipality and Manuel Ascunse Domenech of Camagüey province was performed with the diagnosis of cerebral infarction from September 1st 2006 to September 1st 2007. Results: The age range of 71 years and more constituted the 67 percent of the casuistics. Hypertension, smoking and dyslipidemia predominated in the masculine sex as risk factors with 91,5, 65,9 y 61,7 percent, respectively. The atherothrombotic infarction showed up in the 44,7 percent of the patients. Conclusions: The masculine sex, the age of 71 years and more were the most frequent in our study, the vascular territory of bigger affection was constituted by the carotid in both sexes. Diabetes mellitus predominated in the female sex. The atherothrombotic cerebral infarction was the most frequent

Comportamiento del embarazo múltiple y sus principales indicadores perinatales / Behavior of multiple pregnancies and its main perinatal indicators

Fundamento: La coexistencia de dos o más fetos en la cavidad uterina conceptúa el término de embarazo múltiple. Al desarrollo simultáneo de dos se le denomina gemelaridad. Objetivo: Determinar el comportamiento del embarazo múltiple en nuestra provincia y sus principales indicadores perinatales. Método: Se realizó un estudio observacional descriptivo desde enero a diciembre de 2006 en el Hospital Ginecobstétrico Docente Provincial «Ana Betancourt de Mora¼. El universo estuvo constituido por 66 mujeres portadoras de gestaciones múltiples; los datos fueron recogidos del libro de morbilidad de las salas de gestante, de las historias clínicas y agrupados en un formulario y procesados mediante estadística descriptiva y distribución de frecuencia. Resultados: Predominaron las embarazadas con edades entre 20-34 años, de piel blanca, las enfermedades asociadas más frecuentes fueron la infección vaginal y la anemia. La presentación cefálicocefálico fue la más frecuente, primaron los partos distócicos. Como morbilidad materna predominó la anemia y en neonatos la prematuridad; hubo 13 muertes fetales. No se registraron muertes maternas ni neonatales. Conclusiones: El índice de morbilidad materna fue bajo, la anemia fue la que más se presentó y en cuanto a la morbi mortalidad perinatal se destacó el bajo peso en sus dos componentes (pretérmino y crecimiento intrauterino retardado).

Background: The coexistence of two or more fetuses in the uterine cavity defines the multiple pregnancies term. To the simultaneous development of two is called gemellarity. Objective: To determine the behavior of multiple pregnancies in our province and its main perinatal indicators. Method: A descriptive observational study from January to December 2006 was conducted at "Ana Betancourt de Mora" Provincial Educational Gynecobstetric Hospital. The universe was constituted by 66 women carriers of multiple gestations; data were collected from the morbidity book of expectant mother wards, of the medical histories and grouped in a form and processed by means of descriptive statistics and distribution of frequency. Results: Pregnant women with white race and ages among 20-34 years predominated; the most frequent associated diseases were the vaginal infection and the anemia. The cephalic-cephalic presentation was the most frequent one, the dystocic labors predominated. As maternal morbidity the anemia predominated and in newborns the prematurity; there was 13 fetal deaths and no maternal neither neonatal deaths were registered. Conclusions: The maternal morbidity rate was low, the anemia was the one most presented and regarding to morbi- perinatal mortality the low weight was pointed out in its two components (preterm and intrauterine growth retarded).

Aspectos epidemiológicos de la escabiosis infantil en el municipio Cabimas, estado Zulia, Venezuela / Epidemiological aspects of the infantile scabies at Cabimas municipality, Zulia state, Venezuela

Fundamento: La escabiosis es un problema de salud pública en el mundo, particularmente en la edad pediátrica, que explica la alta morbilidad en países desarrollados y subdesarrollados, donde constituyen verdaderas epidemias. Objetivo: Determinar algunos aspectos epidemiológicos de la escabiosis infantil en los niños de 0 a 15 años en el consultorio médico «El lucero¼, estado Zulia de Venezuela. Método: Se realizó un estudio descriptivo, longitudinal y prospectivo, en el consultorio médico de la familia correspondiente al sector «El Lucero¼, en el municipio Cabimas, estado Zulia, Venezuela, durante el período comprendido entre el 30 de junio de 2005 al 30 de junio de 2006. El universo de estudio estuvo constituido por 403 pacientes, con edades comprendidas entre un día de nacido y quince años, que asistieron a la consulta de Medicina General Integral por lesiones de piel. La muestra quedó conformada por 202 pacientes, diagnosticados clínicamente por escabiosis, y que asistieron a dicha consulta en el período antes citado. Como fuente primaria de los datos se utilizó la encuesta confeccionada al efecto por la autora de la investigación, previo consentimiento informado. Resultados: Se encontró predominio del sexo masculino y del grupo de edades de uno a cinco años, la mayor parte de los casos presentaron condiciones socioeconómicas e higiénicas sanitarias de la vivienda entre malas y regulares, las lesiones elementales más frecuentes fueron el eritema, la pápula y las excoriaciones, las localizaciones de predilección fueron el cuero cabelludo, los espacios interdigitales de los dedos de las manos y la planta de los pies, la eczematización constituyó la complicación más común y la dermatitis atópica representó la enfermedad asociada más observada. Conclusiones: Los resultados del estudio muestran la incidencia y prevalencia de enfermedades trasmisibles, particularmente en habitantes de zonas urbanas marginales que no poseen acceso a los servicios de salud.

Background: Scabies is a public health problem in the world, particularly in the pediatric age, that explains the high morbidity in developed and underdeveloped countries, which constitutes true epidemics. Objective: To determine some epidemiological aspects of the infantile scabies in children from 0 to 15 years in the doctor's office «El Lucero¼, Zulia state of Venezuela. Method: A prospective, longitudinal, and descriptive study was carried out, in the family doctor's office pertaining to «El Lucero¼, sector in Cabimas municipality, Zulia state, Venezuela, from June 30, 2005 to June 30, 2006. The universe of study was constituted by 403 patients, with ages between a day of born and fifteen years, that attended in the Integral General Medicine consultation by skin lesions. The sample remained conformed by 202 patients, clinically diagnosed by scabies, and that attended to said consultation in the period before mentioned. As data primary source was utilized the survey made to the effect by the author of the investigation, previous informed consent. Results: Male sex and the age groups from one to five years predominated, most of the cases presented socioeconomic and hygienic-sanitary conditions of the house between bad and regular, the most frequent elementary lesions were the erythema, the papule and the excoriations, the localization of predilection were the scalp, the interdigital spaces of the fingers and the sole of the foot, the eczematization constituted the most common complication and the atopic dermatitis represented the most observed associated disease. Conclusions: The results of the study show the incidence and prevalence of transmissible diseases, particularly in inhabitants of marginal urban zones that do not possess access to the health services.

¿es el letargo nn signo frecuente en la invaginación intestinal? / Is lethargy a frequent sign in the intestinal intussusception?

Aunque el letargo ha sido considerado desde hace décadas un signo frecuente de invaginación, no aparece entre los elementos clásicos de esta entidad y algunos opinan que es un signo inusual y de aparición tardía. Con el objetivo de determinar la frecuencia conque el letargo ha estado presente en los niños con invaginación y la etapa de la enfermedad en que se ha constatado, se realizó un estudio descriptivo de serie de casos de los pacientes menores de dos años que acudieron con invaginación intestinal al Hospital Pediátrico de Camagüey entre enero de 1995 y diciembre de 2005. Se estudiaron las variables: edad, síntomas y signos, asociaciones clínicas al ingreso, y relación entre la presencia de letargo con el tiempo de evolución de la invaginación. Los métodos empleados fueron estadística descriptiva y distribución de frecuencia. Se constató el letargo en 76 de los 121 pacientes (62.80 %). La asociación de letargo, dolor cólico, vómitos y sangramiento rectal fue la más frecuente (33.88 %). El letargo estuvo presente en 59 niños durante las primeras 24h (77.63 %), incluyendo 35 pacientes en las primeras 12h (46.05%). El letargo debe ser considerado uno de los signos importantes de invaginación por la elevada frecuencia conque se presenta; en la mayoría de los pacientes estudiados ha sido evidente en fases tempranas de la enfermedad (menos de 24 h de evolución). En niños con letargo de causa no explicada, debe tenerse presente el diagnóstico de invaginación, sobre todo cuando se acompaña de otros elementos clínicos sugestivos de la enfermedad.

Eventhoug lethargy has been considered for decades a frequent sign of intussusception, not appear among the classic elements of this entity and someones express that is an unusual sign and late onset. With the aim to determine the frequency of lethargy and the stage in the course of the disease, a descriptive case series study of children less than 2 years old with intussusception was performed at the Paediatric Hospital of Camagüey, from January 1995 to December 2005. Age, symptoms and signs, clinical associations at admission and the relation between the presence of lethargy and the evolution time of the intussusception were the studied variables. Descriptive statistic and frequency distribution were the methods used. Lethargy was present in 76 children (62.80 %). The clinical association of lethargy, colic pain, vomiting and rectal is bleeding were the most frequent (33.88 %). Lethargy was found in 59 patients during the first 24 hours (77.63 %), including 35 patients in the first 12 hours (46.05%). Lethargy should be considered as one of the most important signs of intussusception due to the high frequency of presentation, in the majority of the cases has been evident in early stages of the disease (less than 24 hours of evolution). In children with lethargy of not explained cause, intussusception diagnosis should be present, especially when appear with other suggestive clinical elements of the disease.

Distribuição espacial da hanseníase no município de Mossoró/RN, utilizando o Sistema de Informação Geográfica - SIG / Spatial Distribuition of hansen disease in the municipality of Mossoró/RN, using the Geographic Infromation System - (GIS)

FUNDAMENTOS/OBJETIVO: O município de Mossoró, no Estado do Rio Grande do Norte, tem um elevado coeficiente de detecção de hanseníase, que passou de 2,78 em 1998 para 5,08 casos novos por 10.000 habitantes em 2002. O registro de casos vem ocorrendo em toda a zona urbana, porém com maior concentração em alguns bairros. Esse trabalho foi realizado utilizando-se o Sistema de Informações Geográficas (SIG) com o objetivo de determinar a localização espacial da doença, buscando um melhor entendimento da endemia no município. MATERIAL E MÉTODOS/CASUíSTICA: O estudo foi realizado na área urbana de Mossoró e utilizou como bases cartográficas o mapa cadastral da cidade e imagem de satélite Ikonos, além do banco de dados do SINAN (Sistema de Informação de Agravos de Notificação). Foram selecionados 358 casos novos da doença diagnosticados entre 1998 e 2002 para georreferenciamento dos seus endereços usando-se um aparelho GPS (Magellan 320). A análise geográfica foi feita através do ArcView 9.0. RESULTADOS/DISCUSSÃO: Foram localizados os endereços de 281 pacientes (78,5 por cento do total) com grande concentração nos bairros de Barrocas, Santo Antônio, Bom Jardim e Paredões. O mapeamento serviu de base para a realização de campanha para diagnóstico, especialmente direcionada para áreas mais endêmicas, levando ao diagnóstico de 30 casos novos da doença em apenas uma semana (ou 27 por cento de todos os casos novos do município em 2004). CONCLUSÃO: O uso do SIG na hanseníase se mostrou extremamente eficaz, proporcionando o entendimento espacial da distribuição da doença no município e direcionando a execução de ações de controle com importante redução de custos.

BACKGROUND / OBJECTIVES: The Municipality of Mossoró, in Rio Grande do Norte State in Brazil, has a high incidence of Hansen's disease (HD). New case detection rate has increased from 2.78 in 1998 to 5.08 new cases per 10.000 population in 2002. New patients have been registered in all urban zones but there is concentration in some areas. This study used Geographic Information Systems (GIS) to determine the spatial localization of HD cases, trying to get a better understanding of epidemiological aspects at the municipal level. MATERIAL AND METHODS: The study was carried out in the urban area of Mossoró and used as its cartographic base the standard map of the city and images from Ikonos Satellite, and SINAN Database (Sistema de Informação de Agravos de Notificação). The addresses of 358 new cases diagnosed from 1998 to 2002 were selected to be geo-referenced using a GPS hand held device (Magellan 320). Geographic analysis was done using ArcView 9.0. RESULTS: 281 addresses (78.5 percent of the total) were localized showing high concentration of cases in Barrocas, Santo Antônio, Bom Jardim e Paredões neighborhoods. The maps were used to choose an endemic area where a case detection campaign was carried out and had the positive outcome of 30 new cases of HD detected in only one week (equivalent of 27 percent of all new cases detected in 2004). CONCLUSION: The use of GIS in HD proved to be extremely efficient, revealing the spatial pattern of case distribution and guiding the execution of activities with important cost reduction.

Incidência de infecção do sítio cirúrgico (ISC) em pacientes submetidos à colecistectomia por duas técnicas: convencional e videolaparoscópica / Incidence of surgical site infection (SSI) in patients submitted to the cholecistectomy using conventional or videolaparoscopic technique / La incidencia de la infección del sitio quirúrgico (ISQ) en pacientes sometidos a colecistectomía usa

A introdução da cirurgia por videolaparoscopia trouxe vários benefícios para o paciente e para a instituição como: a redução da permanência hospitalar, do tempo e exposição tecidual, do tamanho da incisão, etc. Este estudo objetivou analisar a incidência da Infecção do sitio cirúrgico (ISC), entre pacientes submetidos a cirurgias de colecistectomias por videolaparoscopia (CVL) e por técnica convencional (CC). Foi realizado um estudo prospectivo, no qual foram acompanhados 98 pacientes, submetidos a CC e CVL, com notificação de 19 ISC. A incidência de ISC para pacientes que se submeteram a cirurgia por CC foi de 32,1% e para CVL 14,3% (OR = 2,25 [1,02-4,94] e p = 0,12). Os resultados obtidos neste estudo mostraram que pacientes que se submeteram à CC apresentaram 2,25 vezes mais chances para a ocorrência da ISC, quando comparados àqueles que fizeram a CVL

The introduction of surgery by video-laparoscopy brought several benefits for patients and for the institution: the reduction of the stay in the hospital, time and incision exposure, size of the incision, etc. This study analyzed the incidence of surgical site infection (SSI) among patients submitted to surgeries of cholecistectomy by videolaparoscopy (CSV) and by conventional technique (CT). It is a prospective study, where 98 patients submitted to CT and CSV were accompanied, with notification of 19 SSI. The incidence of SSI for patients that submitted to CT was 32,1% and for CSV 14,3% (OR = 2,25 [1,02-4,94] and p = 0,12). The results obtained in this study showed that patients submitted to CC had 2,25 times more probability of SSI, when compared to the CSV patients

La introducción de la cirugía por vídeo laparoscopia evidenció varios beneficios para el paciente y para la institución: reducción de la permanencia hospitalaria, del tiempo y exhibición del tejido, del tamaño de la incisión, etc. El objetivo de este estudio fue analizar la incidencia de la infección del sitio quirúrgico (ISQ) entre pacientes sometidos a cirugías de colecistectomia por vídeo laparoscopia (CV) y por la técnica convencional (CC). Se trata de un estudio prospectivo donde se efectuó el seguimiento de 98 pacientes sometidos a CC y CV con notificación de 19 ISQ. La incidencia de ISQ para pacientes sometidos a la cirugía CC fue de 32,1% y para CV de 14,3% (OR = 2,25 [1,02-4,94] y p = 0,12). Los resultados obtenidos en este estudio muestran que pacientes sometidos a CC presentaron 2,25 veces más oportunidades de ocurrencia de ISQ que los sometidos a CV

Bias related to Nutritional Epidemiology / 한국역학회지

Bias is the main problem that should be considered in epidemiologic research. Information bias caused by measurement error and confounding caused by total energy intake are listed as the main biases in nutritional epidemiology and the concept, fact and the methods for adjusting effects of these biases are discussed. The biases which can be caused during the nutritional epidemiologic research process are listed and discussed. The pros and cons of the continuous data and categorical data of the nutrients and the ways how to categorize the data are reviewed. During the analysis of food and nutrient data, multiple comparison and publication bias are prone to be encountered, and these should be considered in interpretation of the results. Understanding of the biases will lead us to make valuable nutritional epidemiologic research and these lead the application of the research results to control the prevalent noncommunicable diseases.

Epidemiologic Study of Urinary Incontinence for Korean Women over 30 Years old

PURPOSE: This study was designed to investigate the prevalence of female urinary incontinence, and factors affecting the quality of life. It was also to provide the basic data for the primary urinary incontinence management program through the community-based cross sectional study. MATERIALS AND METHODS: Questionnaires were taken from 2,183 women, aged over 30 up to 89, residing in Seoul, Kyongki . Kangwon, Chungchong, YongNam, HoNam, Jeju provinces. Those who understood and responded to the questionnaires were collected from church meetings, teaching facilities, corporations, public offices, the voluntary organizations, and old people's homes. The data were analyzed by Student t-test, chi2-test, and multiple logistic regression with using SAS program. RESULTS: The results were as follows ; 1. The overall reported prevalence of urinary incontinence was 55.7% with urinary leakage more than one time a month for the past one year. By age, the highest prevalence was 71.0% in the fifties. The stress urinary incontinence was 60.8%, the mixed urinary incontinence 38.2%, the urge urinary incontinence 1.0 %. In case of severity, a slight case was 64.3%, a moderate case 21.8% and a severe case 13.6%. 2. Urinary incontinence was associated with the radiation therapy on lower abdomen (OR=3.05, 95% CI=1.47, 6.33), hysterectomy (OR=2.42, 95% CI=1.05, 5.62), alcohol intake(OR=1.43,95% CI=1.08, 1.89), high economic status(OR=1.37, 95% CI=1.04, 1.81), lower urinary tract symptoms(OR=1.16, 95% CI=1.12, 1.21), high body mass index(OR=1.09, 95% CI=1.02, 1.15) and old age(OR=1.06, 95% CI=1.04, 1.08). CONCLUSIONS: The above findings indicate that the prevention and management programs of the urinary incontinence should be developed and operated for the female in Korea and for those who had risk factors associated with the urinary incontinence.