The possible impact of COVID-19 pandemic on dental implant therapy: narrative review / O possível impacto da pandemia de covid-19 na terapia com implantes dentários: revisão narrativa

ABSTRACT The COVID-19 has challenged the professions and Implantology also has its challenges in the pandemic. Several factors can interfere with the osseointegration process and more associated factors, greater the interference risks. Risk assessment in the therapy indication is the main decision to define the best technique, the best biomaterial, the best surgical access and the best moment to intervene. The purpose of this review was to investigate and synthesize the scientific evidence on the factors that may interfere with dental implant therapy in the midst of pandemic. The literature was reviewed in databases such as PubMed, Web of Science, Sciello and Google Scholar using the keywords "COVID-19", "pandemic", "risk factors", "impact factor", "dental implants", "dentistry", "oral health", "osseointegration", "bone metabolism", "drug risk factors", "chronic stress", "antidepressants", "zinc", "hydroxychloroquine", "ivermectin", "vitamins", "corticosteroids", "surgical risks" and "disinfection". The present review showed that chronic stress and depression caused by the pandemic, the consequent use of antidepressants, the use of prophylactic and therapeutic drugs such zinc, vitamin D, hydroxychloroquine and corticosteroids, can interfere with bone metabolism and consequently in osseointegration establishment and/or maintenance. Any osseointegrable biomaterial can be influenced by systemic factors and drugs' actions that can affect the homeostasis of the inflammatory process, cell proliferation and bone remodeling. These factors' influence on dental implant therapy should be investigated through new reviews, observational studies and randomized clinical trial.

RESUMO A COVID-19 desafiou as profissões e a Implantodontia também tem seus desafios na pandemia. Vários fatores podem interferir no processo de osseointegração e quanto mais fatores associados, maiores os riscos de interferência. A avaliação do risco na indicação da terapia é a principal decisão para definir a melhor técnica, o melhor biomaterial, o melhor acesso cirúrgico e o melhor momento para intervenção. O objetivo desta revisão foi investigar e sintetizar as evidências científicas sobre os fatores que podem interferir na terapia com implantes bucais em meio a uma pandemia. A literatura foi revisada em bancos de dados como PubMed, Web of Science, Sciello e Google Scholar usando as palavras-chave "COVID-19", "pandemia", "fatores de risco", "fator de impacto", "implantes dentários", "odontologia", "saúde bucal", "osseointegração", "metabolismo ósseo", "fatores de risco medicamentosos", "estresse crônico", "antidepressivos", "zinco", "hidroxicloroquina", "ivermectina", "vitaminas", "corticosteróides", "riscos cirúrgicos" e "desinfecção". A presente revisão mostrou que o estresse crônico e a depressão causados pela pandemia, o consequente uso de antidepressivos, o uso de drogas profiláticas e terapêuticas como zinco, vitamina D, hidroxicloroquina e corticosteroides, podem interferir no metabolismo ósseo e consequentemente no estabelecimento da osseointegração e/ou sua manutenção. Qualquer biomaterial osseointegrável pode ser influenciado por fatores sistêmicos e ações de drogas que podem afetar a homeostase do processo inflamatório, proliferação celular e remodelação óssea. A influência desses fatores na terapia com implantes dentários deve ser investigada por meio de novas revisões, estudos observacionais e ensaios clínicos randomizados.

Determinantes de caries temprana de la infancia en niños en riesgo social / Determinants of early childhood caries in children at social risk

OBJETIVO: Determinar la prevalencia de caries temprana de la infancia en niños en riesgo social y analizar sus factores de riesgo asociados. MÉTODO: Se realizó un estudio descriptivo de corte transversal con 246 niños de 24 a 71 meses de edad, reclutados de 13 barrios marginales, en Santiago, Chile. Se utilizó un cuestionario para obtener información sobre etnia, peso al nacer, edad y educación de la madre, uso de biberón nocturno, cepillado de dientes y visitas dentales. La caries temprana de la infancia fue registrada de acuerdo a la definición aceptada por la Academia Americana de Pediatría Dental. Se utilizó un análisis de regresión logística múltiple para investigar la influencia de los factores de riesgo en la experiencia de caries. RESULTADOS: La prevalencia de caries temprana de la infancia fue de un 63%. Los análisis bivariados mostraron asociaciones entre etnicidad, educación de la madre, uso de biberón nocturno, visitas dentales y caries temprana de infancia. El modelo multivariado final, mostró que los niños cuyas madres tenían un bajo nivel de educación tenían mayores probabilidades de desarrollar caries temprana de la infancia. CONCLUSIÓN: Los niños estudiados tuvieron una alta prevalencia de caries temprana de la infancia, siendo la educación de la madre, el determinante más importante.

OBJECTIVE: The aim of the present study was to evaluate the prevalence of early childhood caries (ECC) among children at social risk and to analyze its associated determinants. METHOD: A cross-sectional study with 246 children aged 24 to 71 months, recruited from 13 different slums, below the poverty line, in Santiago, Chile was performed. An interviewer-administered questionnaire was used to obtain information from the parents on ethnicity, birth weight, mother's age and education, night bottle feeding, tooth brushing and dental visits. Early childhood caries was defined using the American Academic of Pediatric Dentistry criteria. Multiple logistic regression analysis with a stepwise selection procedure was used to investigate the influence of risk factors on the early childhood caries experience. RESULTS: The prevalence of early childhood caries was 63%. Bivariate analyses showed associations among ethnicity, mother's education, bottle feeding at night, dental visits and caries experience. The final multivariate model showed that children whose mothers had a low level of education were more likely to develop early childhood caries. CONCLUSIONS: The children at social risk studied had a high prevalence of early childhood caries, with the education of the mother as the most important determinant.

Clasificación de riesgo para enfermedad tromboembólica venosa y tromboprofilaxis durante el puerperio, Tunja 2017 / Risk classification for venous thromboembolic disease and thromboprophylaxis during puerperium period, Tunja 2017 / Fatores de risco e classificação de risco para doença tromboembólica em puérperas

Introducción. La mortalidad materna se define como la muerte durante el embarazo o el puerperio, por causas relacionadas con la gestación. Las principales causas de mortalidad materna han variado en países desarrollados, donde la enfermedad tromboembólica venosa se encuentra en ascenso. Objetivo. Evaluar el nivel de riesgo para enfermedad tromboembólica venosa en el puerperio, en pacientes atendidas en la clínica Esimed de Tunja, año 2017. Método. Estudio observacional con diseño transversal analítico en una población de 1538 gestantes, con una muestra de 304 pacientes seleccionadas mediante muestreo aleatorio simple, a partir de la base de datos reportada por el sistema de información de la institución prestadora de salud. Se tuvieron en cuenta variables sociodemográ-ficas, así como vía del parto, presencia de clasificación de riesgo para enfermedad tromboembólica venosa en la historia clínica y empleo de tromboprofilaxis. Resultados. Se encontró mayor probabilidad de tener parto por cesárea en pacientes mayores de 35 años, con respecto al grupo de comparación. Un 75,9% de la población no presentó clasificación de riesgo para enfermedad tromboembólica venosa, por tanto, solo el 10,1% presentó indicación de tromboprofilaxis en pacientes que la requerían. Conclusiones. Es necesario realizar una adecuada clasificación de riesgo a todas las pacientes que están siendo atendidas en la institución; así como la relevancia de controlar los factores de riesgo que mayor implicación demostrada tienen para el desarrollo de enfermedad tromboembólica venosa, como es el caso de la cesárea.

Introduction. Maternal mortality is defined as death during pregnancy or the puerperium, due to causes related to pregnancy. The main causes of maternal mortality have varied in developed countries, where the venous thromboembolic disease is on rise. Objective. To evaluate the level of risk for venous thromboembolic disease in the puerperium, in pa- tients treated at the Esimed Clinic in Tunja, 2017. Method. Observational study with analytical cross-sectional design, in a population of 1538 pregnant women, with a sample of 304 patients selected by simple random sampling from the database repor- ted by the system of a health care institution. Sociodemographic variables were considered, as well as delivery pathway, presence of risk classification for venous thromboembolic disease in the clinical history and use of thromboprophylaxis. Results. We found a higher probability of having a cesarean delivery in patients older than 35 years, compared to the comparison group. The 75,9% of the population did not present a risk classification for venous thromboembolic disease, therefore there was 10,1%, indication of thromboprophylaxis in patients who required it. Conclusions. It is necessary to carry out an adequate risk classification for all patients who are being treated at the institution; as well as the relevance of controlling risk factors, which have a greater demonstrated implication for the development of venous thromboembolic disease, as is the case of cesarean section.

Introdução. As mulheres no período pós-parto apresentam maior risco de morbimortalidade, com um aumento de até 10 vezes o risco de doença tromboembólica, em comparação com as mulheres não grávidas em idade fértil. Objetivo. Descrever as características sociodemográficas, fatores de risco e classificação de risco para eventos tromboembólicos de puérperas em um hospital de referência no departamento de Boyacá durante 2018. Metodologia. Estudo observacional, descritivo e transversal, realizado em 398 puérperas, pesquisadas e avaliadas pelo serviço de ginecologia e obstetrícia do Hospital Regional de Sogamoso, durante 2018; foram identificados fatores e a classificação de risco para eventos tromboembólicos foi realizada. Resultados e conclusões. As mulheres pós-parto têm uma idade média de 26 anos [RIQ; 10 anos], da área urbana em 62,6% e a maioria (69,6%) do estrato socioeconômico um. Os fatores de risco mais encontrados foram cesariana (33,2%), excesso de peso (31,4%), obesidade grau I e II (11,3%) e parto prematuro (7,5%). A classificação de risco para eventos tromboembólicos na população total foi classificada em: 6% de baixo risco, 89,5% de risco moderado e 4,5% de alto risco. A identificação do nível de risco para eventos tromboembólicos em puérperas é necessária nos serviços de ginecologia e obstetrícia, de maneira padronizada e sistemática; da mesma forma, mitigue esses riscos e garanta a prevenção desse tipo de complicação.

Cardiovascular disease in patients with ankylosing spondylitis from the rheumatology outpatient clinic of the UFMS-affiliated Hospital / Doença cardiovascular em pacientes com espondilite anquilosante do ambulatório de reumatologia do Hospital afiliado à UFMS

Background: Cardiovascular diseases are a major cause of morbidity and mortality today. Despite its wide distribution, it presents particularly prevalent in certain groups of individuals, particularly when exposed to a higher degree of inflammation, giving increased cardiovascular risk. Rheumatic diseases expose their holders to this increased cardiovascular risk condition; however only recently have been associated with spondyloarthritis, particularly ankylosing spondylitis (AS). For being a classically autoimmune disease related to HLA histocompatibility system, AS may present phenotypic variations in different ethnic groups with possible diverse cardiovascular consequences. Objectives: To estimate the prevalence of cardiovascular disease (CVD) and the cardiovascular risk profile, correlating the time since diagnosis and activity of ankylosing spondylitis (AS) in patients from the rheumatology outpatient clinic of the UFMS-affiliated hospital. Methods: Of 55 patients with AS, 42 were selected consecutively and compared to a control group (CG) in a cross-sectional study. Patients with diabetes, indigenous background and pregnant women were excluded. Quantitative variables were assessed by use of Student t test, while qualitative variables, by chi-square test. The patients underwent electrocardiography, echocardiography and carotid Doppler examination, measurement of serum lipid levels and inflammatory markers, and were stratified according to global cardiovascular risk. The AS activity and impairment were evaluated by use of the BASMI, BASDAI, BASFI and ASDAS. Results: Mean age, 42.87 ± 12.37 years; time since AS diagnosis, 10.76 ± 8.74 years. There was no difference in cardiovascular risk stratification between the groups, most of the patients being at high or moderate risk (AS: 64.3%, and CG: 52%, p = 0.134). The prevalence of manifest CVD (2%) showed no difference between the groups, except for right bundle-branch block (AS: 14%, and CG: 2%, p = 0.027). The prevalence of subclinical CVD showed no difference between the groups, except for higher carotid medial-intimal thickness (CIMT) in the AS group (AS: 1.82 ± 2.63, and CG: 0.67 ± 0.16, p = 0.018). There was no correlation between AS activity or inflammatory markers and CVD, but with time since AS diagnosis and CIMT (p = 0.039, r = 0.328). Conclusions: Prevalence of CVD and risk factors was similar in the groups. Subclinical atherosclerosis degree was higher in the AS group, related to the time since diagnosis, but was independent of the cardiovascular risk factors or inflammation. Most patients with AS are at high cardiovascular risk

Overweight and Obesity among School-Aged Adolescents in Yaounde (Cameroon)

@#Introduction Overweight and obesity are a major public health problem due to its association with serious chronic diseases. Concerning childhood overweight/obesity, its rise in developing countries is so that there is a need to provide more evidence on its burden and associated factors in order to set preventive measures. Methods This study was designed to know the prevalence and related factors of overweight and obesity amongst adolescents in Yaoundé- Cameroon, and to draw their epidemiological profile. Results The prevalence of overweight and obesity was 13.6% and 4.3% respectively. Results revealed that practices associated with overweight and obesity are increase in age (R = 0.42, p < 0.001), female gender (p < 0.001). In addition, the use of bikes, cars or buses to go to school compared to walking (OR: 0.26; CI: 0.14 – 0.64; p = 0.0026) increase the risk of being overweight or obese. After adjusting the multivariable logistic model for age and sex with our study variables, it reveals that the odds of being obese for those who consume alcohol once a week were nine fold higher than that of those who consumed 2-5 times a week (OR: 9.37; CI: 1.34 to 193.41). Conclusions This results show that there is a need for health education in schools so as to help in health promotion and prevention, therefore avoid chronic disease conditions at older ages.

Factores de riesgo en el cáncer de pulmón / Risk Factors in the Lung Cancer

Introducción: el cáncer de pulmón es la neoplasia maligna más frecuente, y causante de un tercio de todas las muertes por cáncer, con un aumento significativo de su incidencia en los últimos años. Objetivo: identificar factores de riesgo asociados al cáncer de pulmón. Método: se realizó un estudio de casos y control en el Hospital Lucía Iñiguez Landín en el período entre julio de 2011 a enero de 2013. El universo estuvo constituido por 118 pacientes que ingresaron en Salas de Medicina que presentaban uno o varios factores de riesgo para esta enfermedad. De ellos, 59 pacientes con diagnósticos no relacionados con cáncer de pulmón fueron seleccionados como el grupo control y el grupo casos estuvo constituido por los 59 pacientes que ingresaron con este diagnóstico. Resultados: predominó en el grupo de casos el sexo masculino para 83,1%. Los fumadores representaron 71,2% del total del grupo casos. El hábito de fumar y la enfermedad pulmonar obstructiva crónica fueron los factores de riesgo de mayor importancia con una OR de 3,8 y 2,49, respectivamente. La exposición a sustancias cancerígenas y el alcoholismo no mostraron diferencias significativas entre ambos grupos. Conclusiones: el sexo masculino fue el más afectado por esta enfermedad. Los pacientes fumadores tuvieron 3,8 veces mayor riesgo de presentar cáncer de pulmón, que los no fumadores y los pacientes con enfermedad pulmonar obstructiva crónica presentaron 2,49 veces mayor probabilidad de desarrollar cáncer.

Introduction: the lung cancer is the most frequent malignant neoplasm and the cause of third of all deaths caused by the cancer, with a high increase of incidence in these last years. Objective: to determine the risk factors associated to lung cancer. Method: a cases and control study in Lucía Iñiguez Landín hospital from July 2011 to January 2013. The universe comprised 118 patients who were admitted in the medical - ward and presented one or some risks factors for this illness, 59 of these patients with diagnosis not related to lung cancer were selected as the control group and the case group was composed of 59 patients that were admitted with this diagnosis. Results: the male sex predominated in the case group the representing 83.1%. The smokers represented 71.2% of the cases group. The smoking and pulmonary obstructive chronic disease was the most important risk factors found with OR of 3.8 and 2.4 respectively. The cancerous substances exposure and the alcoholism did not show significant differences. Conclusion: the male sex was the most affected. The smokers had 3.8 more times of highest risk for lung cancer comparing with no smokers and those patients with obstructive pulmonary disease had 2.49 times of high probability for developing cancer.

Factores predictores de mortalidad por accidente cerebrovascular en el Hospital Universitario San Jorge de Pereira (Colombia) / Predictors of stroke mortality in the Hospital Universitario San Jorge of Pereira (Colombia)

Objetivo: Determinar los factores predictores de mortalidad por accidente cerebrovascular (ACV) en el Hospital Universitario San Jorge de Pereira entre enero de 2008 y diciembre de 2011. Materiales y métodos: Estudio de corte transversal, realizado en los pacientes con diagnóstico de ACV. La información se obtuvo de las historias clínicas, teniendo en cuenta las variables edad, sexo, tipo de ACV (isquémico o hemorrágico), trastorno asociado, antecedentes personales relacionados con ACV, mortalidad. Se aplicaron modelos de regresión logística para determinar qué variables se asociaron significativamente con la mortalidad. Resultados: Se evaluó un total de 350 pacientes con edad promedio 69,2+/-11,6 años; del total, 51,4 % fueron mujeres; 57,4 % presentaron un episodio súbito; 78,6 % de los ACV fueron de tipo isquémico y el 21,4 % hemorrágico. Los trastornos, en orden de aparición, fueron: déficit motor (80,9 %), déficit de lenguaje (43,4 %), cefalea (35,7 %), alteración de pares craneales (28,3 %). Las comorbilidades encontradas fueron: hipertensión arterial (72,6 %), dislipidemia (47,7 %), diabetes mellitus (19,7 %), tabaquismo (17,4 %), enfermedad cardíaca isquémica (9,4 %), ACV previo (6 %) y fibrilación auricular (6 %). El 16 % de pacientes falleció por ACV; de estos, el 74,6 % fueron hemorrágicos. Se encontró asociación estadísticamente significativa entre muerte por ACV e inicio súbito (OR:0,65; IC95 %:0,021-0,200; p<0,001), hemorragia intraparenquimatosa (OR:91,3; IC95 %:20,6-403,7; p<0,001) y edad entre 40 y 55 años (OR: 2,91; IC95 %:2,07-5,18; p<0,001). Conclusiones: Dado que las variables asociadas con muerte no son modificables al ingreso del paciente al hospital, se deben reforzar las medidas de salud pública para prevenir la aparición de ictus.

Objective: Identify predictors of stroke mortality (ACV) at the Hospital Universitario San Jorge de Pereira, between January 2008 and December 2011. Materials and methods: Cross sectional study, realized in patients with a diagnosis of stroke. Information was obtained from medical records taking into account patient age, sex, type of stroke (ischemic or hemorrhagic), associated disorder, personal history associated with stroke mortality. We applied logistic regression models to determine which variables were significantly associated with mortality. Results: 350 patients evaluated. Mean age 69.2 years + / -11.6 years, 51.4 % of the participants were women; 57.4 % had a sudden episode, 78.6 % of ischemic ACV and 21.4 % was bleeding. Disorders in order of appearance were: Motor deficit (80.9 %), language deficits (43.4 %), headache (35.7 %), and cranial nerve disorder (28.3 %). Comorbidities were hypertension (72.6 %), dyslipidemia (47.7 %), diabetes mellitus (19.7 %), smoking (17.4 %), ischemic heart disease (9.4%), previous ACV (6 %) and atrial fibrillation (6 %); 16 % of patients died from stroke, of these, 74.6 % were bleeding. Statistically significant association was found between mortality from stroke and sudden onset (OR 0.65; IC 95%:0.021-0.200, p <0.001), intraparenchymal hemorrhage (OR: 91.3; IC95 %:20.6-403.7; p<0.001) and age between 40 and 55 years (OR: 2.91; IC95 %:2.07-5.18; p<0.001). Discussion: Since the variables associated with death are not modifiable at patient's admission to hospital, should reinforce the public health measures to prevent the occurrence of stroke.

Personas con disfunción eréctil atendidos en la consulta de Andrología, Instituto de Endocrinología de Cuba, 2009-2012 / People with erectile dysfunction treated in the consultation of Andrology, Institute of Endocrinology of Cuba, 2009-2012

ResumenLa disfunción sexual eréctil (DE) es un problema de salud que afecta la calidad de vida del que la padece, de su pareja y de su entorno.Objetivo: Determinar la asociación entre el grado de severidad de la DE con factores de riesgos conocidos, comorbilidades, parámetros clínicos, bioquímicos y hormonales, atendidos en la consulta de andrología del Instituto Nacional de Endocrinología (INEN).Método: Estudio observacional descriptivo, transversal, que incluyó 385 pacientes > 20 años, atendidos entre 2009-2012. Variables estudiadas: clínicas, antropométricas, bioquímicas y hormonales. Estadígrafos: pruebas Chi2 y ANOVA.Resultados: La media de edad fue 56,85 ±8,2 años. El 82,9 % tenía ≥ 50 años y un 95 % padecía alguna enfermedad crónica. Predominó los grados moderados y severos de DE (45 % y 39 % respectivamente), los diuréticos e inhibidores de la enzima convertidora de angiotensina se asociaron a la DE (p=0,042) y (p=0,012). El consumo de alcohol fue común (69,9%). El Índice de masa corporal, circunferencia de la cintura, índice cintura/cadera, glucemia, colesterol total y triglicéridos se incrementaron cuando fue mayor el grado de severidad de la DSE. La testosterona total se asoció inversamente con una significación estadística (p=0,005). Las comorbilidades más frecuentes fueron: diabetes tipo 2 (p < 0,004), hipertensión arterial (p < 0,007), obesidad (p < 0,005) y enfermedad de Peyronie (p<0,017).Conclusiones: Se encontró una asociación directamente proporcional entre el grado de severidad de la DE con algunos de sus factores de riesgo y enfermedades crónicas frecuentes. Esta fue inversamente proporcional a los valores de testosterona total.

AbstractThe sexual erectile dysfunction (ED) is a health problem that affects the life quality of which suffers it, of their couple and of their environment.Objective:To determine the association among the grade of severity of ED with factors of well-known risks, associates diseases, clinical, biochemical and hormonal parameters, assisted in the consultation of andrology of the National Institute of Endocrinology (INEN).Method:An observational descriptive study was performed, transversal, including 385 patients > 20 years, assisted among 2009-2012. Studied variables: clinical, anthropometrics, biochemical and hormonal. Statisticians: Quarter Chi Test and ANOVA.Results:The age stocking was 56, 85 ±8,2 years. The 82,9 % have ≥50 years and 95% suffered some chronic illness. It prevailed the moderate and severe grades of ED (45% and 39% respectively), the diuretics and IECAs were associated to ED (p=0,042) and (p=0,012). The consumption of alcohol was common (69, 9%). The corporal mass index, circumference of the waist, waist/hip index, glycemic, total cholesterol and triglycerides were increased when it was bigger the grade of severity of ED. The total testosterone was inversely associated with a statistical significance (p=0,005). The most frequent associates diseases were: Type 2 Diabetes (p <0,004), High Blood Pressure (p <0,007), Obesity (p <0,005) and Peyronie´s Disease (p <0,017). Conclusions: A directly proportional association between the grade of severity of ED and some risk factors and frequent chronic illnesses was found. This was inversely proportional to the values of total testosterone.

Vigilancia de la salud / Health surveillance

ResumenLa disfunción sexual eréctil (DE) es un problema de salud que afecta la calidad de vida del que la padece, de su pareja y de su entorno.Objetivo: Determinar la asociación entre el grado de severidad de la DE con factores de riesgos conocidos, comorbilidades, parámetros clínicos, bioquímicos y hormonales, atendidos en la consulta de andrología del Instituto Nacional de Endocrinología (INEN).Método: Estudio observacional descriptivo, transversal, que incluyó 385 pacientes > 20 años, atendidos entre 2009-2012. Variables estudiadas: clínicas, antropométricas, bioquímicas y hormonales. Estadígrafos: pruebas Chi2 y ANOVA.Resultados: La media de edad fue 56,85 ±8,2 años. El 82,9 % tenía ≥ 50 años y un 95 % padecía alguna enfermedad crónica. Predominó los grados moderados y severos de DE (45 % y 39 % respectivamente), los diuréticos e inhibidores de la enzima convertidora de angiotensina se asociaron a la DE (p=0,042) y (p=0,012). El consumo de alcohol fue común (69,9%). El Índice de masa corporal, circunferencia de la cintura, índice cintura/cadera, glucemia, colesterol total y triglicéridos se incrementaron cuando fue mayor el grado de severidad de la DSE. La testosterona total se asoció inversamente con una significación estadística (p=0,005). Las comorbilidades más frecuentes fueron: diabetes tipo 2 (p < 0,004), hipertensión arterial (p < 0,007), obesidad (p < 0,005) y enfermedad de Peyronie (p<0,017).Conclusiones: Se encontró una asociación directamente proporcional entre el grado de severidad de la DE con algunos de sus factores de riesgo y enfermedades crónicas frecuentes. Esta fue inversamente proporcional a los valores de testosterona total.

AbstractThe sexual erectile dysfunction (ED) is a health problem that affects the life quality of which suffers it, of their couple and of their environment.Objective:To determine the association among the grade of severity of ED with factors of well-known risks, associates diseases, clinical, biochemical and hormonal parameters, assisted in the consultation of andrology of the National Institute of Endocrinology (INEN).Method:An observational descriptive study was performed, transversal, including 385 patients > 20 years, assisted among 2009-2012. Studied variables: clinical, anthropometrics, biochemical and hormonal. Statisticians: Quarter Chi Test and ANOVA.Results:The age stocking was 56, 85 ±8,2 years. The 82,9 % have ≥50 years and 95% suffered some chronic illness. It prevailed the moderate and severe grades of ED (45% and 39% respectively), the diuretics and IECAs were associated to ED (p=0,042) and (p=0,012). The consumption of alcohol was common (69, 9%). The corporal mass index, circumference of the waist, waist/hip index, glycemic, total cholesterol and triglycerides were increased when it was bigger the grade of severity of ED. The total testosterone was inversely associated with a statistical significance (p=0,005). The most frequent associates diseases were: Type 2 Diabetes (p <0,004), High Blood Pressure (p <0,007), Obesity (p <0,005) and Peyronie´s Disease (p <0,017). Conclusions: A directly proportional association between the grade of severity of ED and some risk factors and frequent chronic illnesses was found. This was inversely proportional to the values of total testosterone.

O trabalho vivo de profissionais que lidam com a morte / The living work of workers who deal with death

Este artigo apresenta resultados de pesquisa realizada no Núcleo de Medicina e Odontologia Legal (NUMOL) de Campina Grande (PB). Objetiva mostrar a atividade de trabalho, evidenciando os fatores de risco e as estratégias de defesa utilizadas para enfrentá-los e subvertê-los. Os pressupostos teóricos e metodológicos se basearam nas abordagens da Ergonomia Situada e da Psicodinâmica do Trabalho. Foram feitas 15 observações sistemáticas do trabalho e quatro entrevistas coletivas com as equipes do NUMOL. Identificaram-se os fatores de risco biossanitário, ergonômico, de acidentes e psicológico. Percebeu-se a mobilização dos trabalhadores diante das variabilidades, na cooperação no trabalho e na elaboração de estratégias de defesa. Concluiu-se que os trabalhadores são ativos, usam os saberes de prudência e elaboram estratégias de defesa para se proteger dos riscos e transformar o sofrimento.

This article presents the results of a research which took place in the NUMOL (Center for Forensic Medicine and Odontology) of Campina Grande (PB, Brazil). It shows the work activity and highlights the risk factors, as well as the defense strategies used to confront and transform such risks. The theoretical approaches and methods used are the Located Ergonomics and Work Psychodynamic. Fifteen work systematic observations and four interviews with NUMOL teams were made. We identified biohealth, ergonomic, psychological, and accident risk factors. It was realized that workers are mobilized in face of the work variability through work cooperation, developing defense strategies. It was concluded that workers are active and use their knowledge of prudence elaborating strategies to protect themselves from the risks of work and to transform the suffering.

Análisis clínicoanatomopatológico de pacientes fallecidos con tromboembolismo pulmonar / Clinic and Pathologic Analysis of Death Patients with Pulmonary Thromboembolism

Introducción: el tromboembolismo pulmonar es una complicación frecuente en pacientes hospitalizados, que presenta elevadas tasas de mortalidad. Su importancia es tal que supera en estudios de necropsias a enfermedades como las neumonías y el cáncer de pulmón. Objetivos: determinar la correlación clínico-anatomopatológica de los fallecidos por tromboembolismo pulmonar; identificar el comportamiento de variables como: grupos de edades, sexo, los síntomas, signos sugestivos y factores predisponentes más frecuentes. Determinar el calibre de la arteria pulmonar afectada y la presencia o no de infarto pulmonar. Método: estudio transversal de 120 fallecidos con diagnóstico presuntivo de tromboembolismo pulmonar desde el primero de enero de 2010 hasta el 30 de junio de 2012 en el Hospital Clínico Quirúrgico Lucía Iñiguez Landín; se realizó una revisión de los protocolos de necropsia. Para el análisis de las variables se utilizó la comparación de proporciones para muestras independientes (z) para un valor de p<0,05. Resultados: el sexo femenino se encontró más afectado y sobre todo en las edades mayores de 60 años. Los factores de riesgo predominantes fueron: la edad avanzada, las enfermedades cardíacas, las inmovilizaciones y la cirugía mayor. La disnea, taquicardia, dolor torácico pleurítico, tos y hemoptisis fueron las principales manifestaciones clínicas encontradas. Sólo en 24 casos se confirmó el diagnóstico de tromboembolismo pulmonar (20 %), 19 sin infarto pulmonar (15,8 %). Las ramas vasculares medianas fueron las mayormente afectadas, 20 casos (16,6 %). Conclusiones: la correlación clínico-anatomopatológica fue baja confirmándose el infarto pulmonar, solo en cinco fallecidos.

Introduction: thromboembolism is a common complication in hospitalized patients, with high rates of mortality. Its importance is such that it exceeds necropsy studies to diseases such as pneumonia and lung cancer. Objectives: to determine the clinical pathologic correlation of deaths from pulmonary embolism; the behavior of variables such as age group, sex, symptoms, signs suggestive and more frequent predisposing factors. To determine the size of the pulmonary artery affected and the presence or absence of pulmonary infarction. Methods: a cross-sectional study of the deceased with a presumptive diagnosis of pulmonary embolism from the first of January 2010 until June 30, 2012 at Lucía Iñiguez Landín Clinical Surgical Hospital. A review of autopsy records was performed. Comparison of proportions for independent samples (z) for a value of p <0.05 was used for the analysis of the variables. Results: the female sex was more affected especially at ages older than 60 years. The predominant risk factors were advanced age, heart disease, grounding and major surgery. Dyspnea, tachycardia, pleuritic chest pain, cough and hemoptysis were the main clinical manifestations found. Only in 24 cases the diagnosis of pulmonary embolism (20 %), 19 without pulmonary infarction (15.8 %) confirmed. Median vascular branches were the most affected in 20 cases (16.6 %). Conclusions: clinical and pathologic correlation was low. Pulmonary infarction was confirmed only five deaths.

Síntomas músculo-esqueléticos en trabajadores operativos del área de mantenimiento de una empresa petrolera ecuatoriana / Musculoskeletal symptoms in the area of operational maintenance of an oil company workers

CONTEXTO: Al ser considerada la ergonomía como una disciplina de carácter científico, que evalúa los riesgos ergonómicos en el medio ambiente laboral, puede evitar enfermedades ocupacionales y accidentes del trabajo, contribuyendo a mejorar las condiciones laborales en una organización. OBJETIVO: Determinar la prevalencia de síntomas músculo-esqueléticos en trabajadores operativos del puesto de trabajo mantenimiento de una Empresa Petrolera Ecuatoriana. METODOLOGÍA: Se llevó a cabo un estudio transversal en 102 trabajadores de sexo masculino, correspondientes al puesto de trabajo de mantenimiento de una empresa petrolera, situada en una locación de la Provincia de Sucumbíos, durante el año 2013; la edad comprendida estuvo entre 18 y 49 años. Para la recolección de datos a cada uno de los trabajadores, previo consentimiento informado se aplicó: un Cuestionario Socio-Demográfico, una Historia Médica Ocupacional y el Cuestionario Nórdico Estandarizado. RESULTADOS: La mayor prevalencia de síntomas músculo-esqueléticos, se encuentra en el grupo de trabajadores de entre 30 y 40 años de edad, en las regiones anatómicas: espalda baja 66 (64,7%), seguido de espalda alta 44 (43,1%), cuello 38 (37,3%) y hombro 27 (26,5%), siendo los más afectados los puestos de trabajo técnico-eléctrico y técnico-mecánico. La regresión logística binaria determinó que las variables no son estadísticamente significativas y, por lo tanto, por sí solas no explican la aparición de síntomas Músculo-Esqueléticos. CONCLUSIÓN: Se concluye que existe una elevada prevalencia de síntomas músculo-esqueléticos en la población estudiada, por lo que se recomienda efectuar una evaluación ergonómica exhaustiva de los puestos de trabajo y posteriormente buscar mecanismos y estrategias de control y prevención de riesgos ergonómicos, con la finalidad de minimizar el desarrollo de lesiones músculo-esqueléticos en la población de estudio.

CONTEXT: When considered ergonomics as a scientific discipline that evaluates ergonomic hazards in the working environment, you can prevent occupational diseases and industrial accidents, helping to improve working conditions in an organization. OBJECTIVE: To determine the prevalence of musculoskeletal symptoms in workers operating as a maintenance work Ecuadorian Oil Company. METHODOLOGY: A cross-sectional study was conducted on 102 male workers, job for the maintenance of an oil company, situated in a location in the province of Sucumbíos, in 2013, the age range was between 18 and 49. To collect data for each worker, informed consent was applied: A Socio-Demographic Questionnaire an Occupational Medical History and the Standardized Nordic Questionnaire. RESULTS: The highest prevalence of musculoskeletal symptoms are in the group of workers between 30 and 40 years old, in the anatomical regions: lower back 66 (64,7%), followed by upper back 44 (43,1% ), neck 38 (37,3%) and shoulder 27 (26,5%) being the most affected stations mechanical technician and electrician work. Binary logistic regression determined that the variables are not statistically significant, and thus alone do not explain the occurrence of musculoskeletal symptoms. CONCLUSION: We conclude that there is a high prevalence of musculoskeletal symptoms in the study population, so it is recommended that a comprehensive ergonomic evaluation of jobs and then find mechanisms and strategies for control and prevention of ergonomic hazards, with the aim minimize the development of musculoskeletal injuries in the study population.

Desarrollo y características psicométricas del instrumento para evaluar los factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos en personas con factores de riesgo de enfermedad cardiovascular / Development and psychometric characteristics of the instrument to evaluate factors that influence adherence to pharmacological and non-pharmacological treatment in persons with a cardiovascular disease risk factor

El diseño de instrumentos validados en enfermería es de gran relevancia en la medida en que estas escalas miden y determinan fenómenos o conceptos propios de la disciplina, convirtiéndose en elementos de trabajo importantes en aquellos aspectos de la investigación sobre el cuidado de la salud humana, objeto de la enfermería. Este artículo trata de los procesos que ha seguido el desarrollo psicométrico de un instrumento que se concibió para evaluar los factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos en personas con riesgo de enfermedad cardiovascular en el periodo comprendido entre los años 2005 y 2011. Se describe la forma como se diseñó el instrumento original incluyendo las bases teóricas de su construcción y la validez facial y de contenido que se realizó; la evolución en cuanto a mediciones o pruebas psicométricas realizadas con diferentes poblaciones y diferentes contextos a nivel nacional; y la aplicación del instrumento a poblaciones diversas. Se reseñan los estudios realizados para evidenciar la validez facial, de contenido, la consistencia interna y la confiabilidad y validez de constructo, realizados por investigadores estudiantes de la Maestría con Énfasis en Cuidado para la Salud Cardiovascular de la Facultad de Enfermería de la Universidad Nacional de Colombia, con los cuales se ha procesado el desarrollo psicométrico.

The design of validated instruments is very relevant insofar as these scales measure and determine phenomena or concepts belonging to this discipline, which makes them important elements of work in those aspects of investigation concerning the care of human health, the object of nursery. This article is about the processes gone through by the psychometric development of an instrument conceived to evaluate factors which influence the adherence to pharmacological and non-pharmacological treatments in persons with a cardiovascular disease risk factor, in the 2005-2011 period. The way in which the original instrument was designed is described here, including the theoretical basis of its construction and the facial and content validity; also, the evolution regarding the measurements or psychometric tests made with different populations and national contexts; and the application of the instrument on different populations. We review the investigations made to evidence the facial and content validity, the internal consistency and reliability and validity of construct, made by the investigating students on the Master's Degree: Emphasis in the Care for Cardiovascular Health of the Faculty of Nursing of the Universidad Nacional de Colombia, with whom the psychometric development was processed.

O desenho de instrumentos validados em enfermagem é de grande relevânciana medida que estas escalas medem e determinam fenômenosou conceitos próprios da disciplina, convertendo-se em importantes elementos de trabalho naqueles aspectos da pesquisa sobre o cuidado da saúde humana, objeto da enfermagem. Este artigo trata dos processos que seguiu o desenvolvimento psicométrico de um instrumento que foi concebido para avaliar os fatores que influem na aderência a tratamentos farmacológicos e não farmacológicos em pessoas com risco de doença cardiovascular, no período compreendido entre os anos 2005-2011. Descreve-se a forma como se desenhou o instrumento original, incluindo as bases teóricas de sua construção e a validade facial e de conteúdo que se realizou; a evolução das mediçõesou provas psicométricas realizadas com diferentes populações e diferentes contextos a nível nacional, assim como a aplicação do instrumento a populações diversas. Resenham-se os estudos realizados para evidenciar a validade facial, de conteúdo, consistência interna, e confiabilidade e validade de constructo, realizados por pesquisadores estudantes do Mestrado com Ênfaseem Cuidado para a Saúde Cardiovascular da Faculdade de Enfermagem da Universidad Nacional de Colombia, com os quais se processou o desenvolvimento psicométrico.

Prevalência de sepse e fatores de risco em neonatos de unidade de terapia intensiva de referência em Palmas,Tocantins, Brasil / Prevalence of sepsis and risk factors in newborns from intensive care unit of reference in Palmas, Tocantins, Brasil

As infecções microbianas neonatais, especialmente as sepses, correspondem a uma das causas mais importantes de morbimortalidade em unidades de terapia intensiva e sua prevalência é maior naqueles pacientes expostos a procedimentos invasivos. Objetivo: identificar a prevalência de sepse neonatal hospitalar, bem como os principais fatores de risco associados a esta infecção e os microrganismos envolvidos. Métodos: foi realizado um estudo retrospectivo revisando as fichas de investigação epidemiológica do Serviço de Controle de Infecção Hospitalar com dados dos recém-nascidos internados em unidade de terapia intensiva de referência estadual do Tocantins, no período de julho de 2007 a junho de 2009. Observou-se que 25% dos pacientes analisados desenvolveram sepse neste período, dos quais 60% foram do gênero masculino, 67% prematuros e 65% com peso ao nascer menor que 2500 gramas. Entre os fatores de risco de importância clínica, observou-se a prematuridade, baixo peso ao nascimento, ventilação mecânica, cateterismo venoso central e utilização de nutrição parenteral. A prematuridade e o peso ao nascimento foram fatores de menor risco relativo quando comparados aos demais fatores analisados. Resultados: foram identificados 111 pacientes com sepse, com taxa de mortalidade de 26%. Os principais microrganismos associados à sepse neonatal foram Klebsiella pneumoniae (28%), os Staphylococcus coagulase negativa - CoSN (20%) e Candida albicans (14%). Conclusão: os achados neste estudo reforçam a importância de ações de prevenção de infecções neonatais, bem como o manejo asséptico durante a instalação e a manutenção de procedimentos invasivos necessários aos cuidados intensivos neonatais

Neonatal bacterial infections, especially sepsis, are one of the most important causes of morbidity and mortality in intensive care units and they are more prevalent among patients who have undergone invasive procedures. Objective: to identify the prevalence of hospital neonatal sepsis as well as the associated risks factors for this infection and the involved microorganisms. Method: a retrospective study was done going over the epidemiological investigation forms of the Service of Hospital Infection Control with data from newborns admitted in a State reference intensive care unit in Tocantins, from July 2007 to June 2009. We noticed that 25% of the analyzed patients developed sepsis and 60% were males, 67% premature and 65% with a weight at birth below 2500 grams. Among the risks factors of clinical importance we noticed, the prematurity, low birth weight, mechanical ventilation, central venous catheterization and use of parenteral nutrition. The prematurity and birth weight were lower relative risks factors in comparison with the other analyzed factors. Results: 111 patients with sepsis were found, with a mortality rate of 26%. The main microorganisms associated with neonatal sepsis were Klebsiella pneumoniae (28%), Staphylococcus coagulase negative - CoSN (20%) and Candida albicans (14%). Conclusion: the findings on this study emphasize the importance of actions for prevention of neonatal infections as well as aseptic handling during set up and maintenance of invasive procedures needed in neonatal intensive care

Intervención en alimentación y nutrición para mineros con factores de riesgo cardiovascular, basada en la investigación formativa / Food and nutrition intervention for miners with cardiovascular risk factors, based on formative research

We designed and implemented an intervention to improve the diet of 94 miners with cardiovascular risk of a mining company. The diagnosis included a qualitative study of the desires, motivations and barriers that workers have to lead a healthy life, a survey of food consumption and checking the institutional food service. Anthropometric and biochemical data were provided by the company. Based on the results, the intervention included improving the supply of healthy foods and conducting the communication campaign "Minero 100% Filete", workshops and nutritional counseling for them and their families. After 8 months of intervention we found a significant increase in the consumption of fruits and vegetables and a decreased consumption of fried, cured and red meats. There was no significant change in BMI. However, there were significant decreases in systolic blood pressure, blood glucose levels, triglycerides and an increase in HDL cholesterol. Although the program was well received by the workers, it is acknowledged that there are significant adverse factors which merit improvement.

Se diseñó e implementó una intervención de 8 meses para mejorar la alimentación de 94 mineros con factores de riesgo cardiovascular. El diagnóstico incluyó un estudio cualitativo de los deseos, motivaciones y barreras de los trabajadores, una encuesta de consumo de alimentos y la revisión del aporte de la alimentación institucional. Los datos antropométricos y bioquímicos fueron proporcionados por la compañía minera. Con esta base, se solicitó mejorar la oferta de alimentos saludables y se realizó la campaña comunicacional "Minero 100% Filete", consejería nutricional, y talleres con las familias. Al finalizar la intervención se observó un aumento significativo del consumo de frutas y verduras y una disminución del consumo de frituras, cecinas y carnes rojas. No hubo cambios significativos en el IMC. Se registraron disminuciones significativas en la presión arterial sistólica, glicemia, triglicéridos y un aumento del colesterol HDL. El programa fue bien aceptado por los trabajadores, pero se reconocen factores ambientales adversos importantes de mejorar.

Plan de accion para elevar conocimientos sobre embarazo y sus riesgos en adolescentes atendidas en el Hogar Materno Carlos J. Finlay / Plan of accion to elevate knowledge about pregnancy and their risks in pregnant adolescents assisted in the Maternal House Carlos J. Finlay

Introducción: el embarazo en la adolescencia es un problema de salud mundial. Objetivo: determinar los conocimientos sobre embarazo en la adolescencia y sus riesgos en adolescentes embarazadas atendidas en el Hogar Materno Carlos J. Finlay. Material y Métodos: se realizó un estudio descriptivo, de corte transversal con 86 adolescentes embarazadas entre 10 y 19 años, atendidas en el Hogar Materno Carlos J. Finlay en el período comprendido de diciembre del 2007 al 2010. Se revisaron las historias clínicas de las pacientes, se aplicó un cuestionario y se analizaron las variables. Resultados: la incidencia del embarazo en la adolescencia fue alta, prevaleció la adolescencia tardía; entre los factores de riesgos biológicos y psicosociales que agravan el embarazo fueron el estado nutricional deficiente seguido del peso menor de 45Kg o talla menor de 1.45 cm, en su gran mayoría se encontraban solteras y aún estudiando. Respecto a la edad de las primeras relaciones sexuales refirieron haberlas tenido entre los 14 y 16 años y tenían antecedentes obstétricos. Se observó que no tenían orientación sexual y el personal de la salud, junto a sus padres, no tenía un papel fundamental. El conocimiento sobre los riesgos biológicos, psicológicos y socioeconómicos era pobre. Conclusiones: el poco conocimiento sobre el embarazo en la adolescencia y sus riesgos es resultado de las características socioeconómicas y el origen de la orientación sexual que poseen. Recomendaciones: crear instrumentos y estrategias que den su aporte a la disminución de la incidencia mundial del embarazo en la adolescencia.

Introduction: pregnancy in the adolescence is a health problem all over the world. Objective: to determine the knowledge on pregnancy in the adolescence and their risks in the pregnant adolescents assisted in the maternal house Carlos J Finlay. Material and Methods: it was carried out a cross section descriptive study, with 86 pregnant adolescents among 10 and 19 years old assisted in the maternal house Carlos J Finlay between December 2007 and 2010. The clinical histories of the patients were revised, a questionnaire was applied and the variables were analyzed. Results: the incidence of the pregnancy in the adolescence was high, prevailing the late adolescence, the biological and psychosocial risks factors that increase pregnancy were the poor nutritional state, weight below 45Kg or size below 1.45 cm, the majority of them were single and still studying. About the age the first sexual relationships they referred to have them before 14 to 16 years old and they had obstetrics antecedents. It was observed that they didn't have sexual orientation and that the health care personnel and their parents didn't play a fundamental role. The knowledge about the biological, psychological and socioeconomic risks was poor. Conclusions: the poor knowledge on the pregnancy in the adolescence and its risks is a result of the socioeconomic characteristics and their poor sexual orientation. Recommendations: to create instruments and strategies that gives their contribution to the decrease the world incidence of pregnancy in the adolescence.

Fatores de risco que podem induzir o uso de drogas por estudantes de uma universidade pública / Risk factors that may signify a propensity to the use of drugs in students at a public university

INTRODUCTION: We sought to evaluate the risk factors that may increase the propensity to use licit and illicit drugs among students at a public university. METHODS: The project involved students (n = 268) enrolled in the first and fourth years of courses in the areas of the social and biological sciences at a public university. Data collection was conducted by means of self-administered, semi-structured questionnaires, based on such standardized assessment instruments as Audit, Assist, Cage and Duse. Collected data were analyzed quantitatively by calculating the percentages and evaluating the data in terms of categories of risk, classifying them by age, gender, religion, schooling, use (before or after entering university) and contexts of use. By means of this survey the researchers were able to correlate the use of drugs to the risk factors that might increase the students' propensity to use these substances. RESULTS: The results revealed a high proportion of current drug-using students, but showed no significant differences between the first and fourth year students as regards contexts of use. However, 67% of students regarded the university environment as encouraging the use of drugs. Students pointed to such major risk factors as friends' and fellow-students' influence, university parties, excessive curiosity and desire to experiment. CONCLUSION: Due to the high rate of drug use among university students, by the determination of the risk factors related to the university environment and also knowing that the process of addiction is one of growing chemical dependence, the importance of the development and implementation of public health policies at all levels, especially in terms of approaches and specific interventions addressing this population, should be noted...

OBJETIVO: Buscou-se avaliar os fatores de risco que podem induzir o uso de drogas lícitas e ilícitas por estudantes de uma universidade pública. MÉTODO: o projeto os alunos envolvidos (n = 268) matriculados no primeiro e quarto anos de cursos nas áreas das ciências sociais e biológicas de uma universidade pública. A coleta de dados foi realizada por meio de questionário semiestruturado e de autopreenchimento, com base em tais instrumentos de avaliação padronizados como Audit, Assist, Cage e Duse. Os dados coletados foram analisados quantitativamente por meio do cálculo das percentagens e avaliar os dados em termos de categorias de risco, classificando-os por idade, sexo, religião, escolaridade, uso (antes ou depois de entrar na universidade) e contextos de uso. Por meio deste estudo os pesquisadores foram capazes de correlacionar o uso de drogas para os fatores de risco que podem aumentar a propensão dos alunos a usar essas substâncias. RESULTADOS: Os resultados revelaram alto índice no número de alunos que atualmente usam drogas, porém não apontaram diferenças significativas entre alunos de 1º ano e 4º anos em relação às situações de uso. No entanto, 67% dos alunos consideraram o ambiente universitário como estimulante ao uso de drogas. Foram apontados como fatores de risco: influência de amigos e colegas de universidade, festas universitárias, a curiosidade e alegria. CONCLUSÃO: Devido ao alto índice do uso de drogas entre estudantes universitários e aos fatores de riscos que influenciam o uso estarem relacionado ao ambiente universitário, nota-se a importância de uma atenção voltada a esta população, pois sabe-se que a dependência química é um processo de instalação gradativa. Os resultados apontam a necessidade de intervenções específicas para esta população através da implantação de programas de prevenção, conscientização e de tratamento...

Fotoexposição e fatores de risco para câncer da pele: uma avaliação de hábitos e conhecimentos entre estudantes universitários / Photoexposure and risk factors for skin cancer: an evaluation of behaviors and knowledge among university students

FUNDAMENTOS: O câncer da pele é a neoplasia mais frequente no Brasil. Compreender as atitudes que influenciam a proteção e a exposição aos raios solares é extremamente importante para sua prevenção. OBJETIVOS: Avaliar hábitos de fotoexposição e fotoproteção, bem como conhecimento de fatores de risco para câncer da pele, tendo por fim delinear os padrões de comportamento dos jovens perante os efeitos solares. MÉTODOS: Distribuíram-se questionários autoaplicativos a 368 universitários, na faixa etária dos 20 anos, dos cursos de Medicina, Educação Física, Direito e Comunicação Social de instituição de ensino privada em Taguatinga (DF). RESULTADOS: O uso diário de fotoprotetor foi significativamente maior entre as mulheres. A prática de bronzeamento artificial foi baixa (3,5 por cento), referida apenas por mulheres. O uso de filtro solar com fator de proteção maior do que 15 ou igual a 15 foi referido por 278 estudantes. De modo geral, mais de 90 por cento dos estudantes acreditam na associação entre radiação ultravioleta e câncer da pele. Apesar disso, apenas 43,5 por cento acreditam na genética como fator de risco. Entre os que rejeitam a hipótese do fator de risco genético para carcinogênese cutânea, 86,2 por cento são acadêmicos das Ciências Humanas (Direito e Comunicação Social). CONCLUSÃO: Esses dados permitem orientar medidas nos níveis individual e coletivo, colaborando para a prevenção de lesões cutâneas.

BACKGROUND: Skin cancer is the most common neoplasm in Brazil. It is extremely important to understand the attitudes that influence protection from and exposure to the sun's ultraviolet rays in order to prevent this clinical condition. OBJECTIVES: To evaluate photoexposure and photoprotection habits and knowledge of risk factors for skin cancer, with the purpose of describing behavioral patterns of university students in relation to the effects of the sun. METHODS: Self-administered questionnaires were distributed to 368 students, aged 20-29 years, from courses in the areas of Medicine, Physical Education, Law and Social Communication, in a private education institution in Taguatinga-DF.. RESULTS: The daily use of photoprotector was significantly higher among women. The use of tanning beds was low (3.5 percent), and was mentioned only by women. The application of sunscreen with sun protection factor (SPF) equal to or greater than 15 was reported by 278 students. In general, over 90 percent of the students believe in the association between ultraviolet radiation and skin cancer. Nevertheless, only 43.5 percent believe in genetics as a risk factor. Among those who reject genetics as a risk factor for skin cancer, 86.2 percent are Human Sciences students (Law and Social Communication). CONCLUSION: Results may help the establishment of individual and collective preventive measures, helping to avoid skin lesions.

Estrias de distensão na gravidez: fatores de risco em primíparas / Striae distensae in pregnancy: risk factors in primiparous women

Fundamentos: Estrias ocorrem em mais de 70 por cento das gestantes. Elas tendem a se desenvolver a partir da 25ª semana gestacional. Apesar de sua etiologia não ser bem compreendida, aceita-se que a combinação de fatores genéticos com alterações endócrinas e estiramento mecânico da pele tem papel significante. Em função dos diferentes resultados encontrados na literatura, os autores avaliaram os fatores de risco comumente citados com o objetivo de determinar se estão associados com a ocorrência de estrias na gestação. Objetivo: Avaliar em primíparas os supostos fatores de risco para o aparecimento de estrias. Métodos: Estudo observacional transversal não controlado e descritivo em primíparas. O período avaliado foi de quatro meses (janeiro a maio de 2008), em uma maternidade pública. Foram incluídas 164 primíparas de feto único após 48 horas do parto. Um total de 14 variáveis foi registrado em cada paciente. Resultados: Das 164 mulheres em estudo, 59,8 por cento desenvolveram estrias durante a gestação. Foi estatisticamente significante a associação entre a faixa etária materna (p < 0,01), o peso materno adquirido durante a gestação (p < 0,01) e o peso de recém-nascido (p = 0,01) com o aparecimento de estrias na gestação. O teste de associação utilizado foi o qui-quadrado. Conclusão: As estrias foram mais frequentes em pacientes mais jovens, nas que adquiriram maior peso na gestação e/ou nas que deram à luz bebês mais pesados. Este estudo sugere que a idade materna mais avançada poderia ser um fator protetor contra a presença de estrias na gestação.

Background: Striae occur in over 70 percent of pregnant women and tend to develop after 25 weeks of gestation. Despite the fact that their etiology has not yet been fully understood, it is accepted that a combination of genetic factors, endocrine alterations and mechanical stretching of skin play a significant role. Due to different results reported in the literature, the authors assessed commonly cited risk factors to determine whether they are associated with the development of striae in pregnancy. Objective: To assess hypothetical risk factors for the development of striae in primiparous women. Methods: This was a cross-sectional, observational, non-controlled, descriptive study with primiparous women. the study was conducted in a public maternity unit and Lasted for four months (from January to May 2008). 164 Primiparous women who had had a single fetus pregnancy took part in the study 48 hours after delivery. Fourteen Variables were recorded for each patient. Results: From the total sample, 59.8 percent developed striae during pregnancy. The association of maternal age range (p < 0,01), maternal weight gain during pregnancy (p < 0,01) and birth weight of newborn infants (p = 0,01) with the development of striae during pregnancy was statistically significant. The chisquared test of association was used. Conclusions: Striae were more frequently observed in younger women, in those who gained more weight during pregnancy and/or those who had babies with higher birth weight. This study suggests that increased maternal age could be a protecting factor against striae during pregnancy.

Avaliação dos fatores de risco de sintomas depressivos em população deDiabéticos da rede pública municipal de saúde de Taubaté SP / Assessment of depressive simptoms risk factors in diabetes mellitus population in the city of Taubaté São Paulo public primary care center

Este artigo tem como objetivo analisar fatores de risco biológicos história pregressa de doença grave e fatores psicossociais, para Transtornos Depressivos em estudo transversal com amostra de pacientes com diabete melito da rede de atenção primária à saúdeda Prefeitura de Taubaté SP. Participaram da pesquisa 192 pacientes de um programa deatenção primária de diabetes da cidade de Taubaté SP. O grupo controle foi constituído de oitenta e quatro 84 voluntários sem história de transtornos depressivos e ou diabetes. Foramutilizadas escalas de Beck para Depressão e questionário de fatores psicosociais amplamenteutilizado na literatura. Os riscos associados aos fatores foram analisados por regressão logísticabinária e a análise. Foi utilizado o software Minitab 4.0. Encontraram-se dois tipos de riscos:riscos de estresse biológico, no qual a presença de diabetes e história pregressa de doença grave estressores biológicos considerados em nosso experimento constituíram os únicos riscos para depressão na amostra examinada; e riscos psicossociais, nos quais a presençade filhos e escolaridade tiveram uma participação significativa entre os fatores de risco paradepressão na população com diabetes. Concluiu-se que a presença de diabetes e históriapregressa de doença grave, bem como a presença de filhos e escolaridade foram os fatores derisco encontrados.

The purpose of this study was to investigate the biological and psycho social riskfactors to depressive disturbances in a sample of patients with diabetes mellitus in the city ofTaubaté s São Paulo public primary care center. One hundred-ninety two patients underdiabetes mellitus treatment on the public primary care center had the psycho social statusassessed through interview and the Beck s scale for depression. Eighty four patients with nosuch pathology were used as control. Techniques of logistic regression were used to measurebiological and psycho social stress agents. The statistical analysis was conducted by using theMinitab 4.0 software. Diabetes mellitus in association with other severe pathologies is a riskfactor for depression in adults. The vulnerability to depression condition is increased in femalepatients with diabetes mellitus.