Prevalência e fatores associados à doença renal crônica em pacientes hipertensos cadastrados na estratégia de saúde da família de Rio Branco, Acre / Prevalence and factors associated with chronic kidney disease in hypertensive patients registered in the family health strategy of Rio Branco, Acre / Prevalencia y factores asociados a la enfermedad renal crónica en pacientes hipertensos registrados en la estrategia de salud familiar de Rio Branco, Acre

Introdução: analisar a prevalência e os fatores associados à doença renal crônica em pessoas com hipertensão arterial (HAS) cadastrados na Estratégia de Saúde da Família em Rio Branco, Acre. Método: Trata-se de um estudo transversal realizado com hipertensos cadastrados nas Estratégias de Saúde da Família (ESF), na zona urbana de Rio Branco, Acre, em 2019. A DRC foi definida por TFG < 60 ml/1,72m², estimada a partir da fórmula Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), ou presença de albuminúria > 29 mg/g. Medidas de associação foram estimadas por regressão logística, com grau de confiança de 95%. Resultados: A prevalência de DRC foi de 27,3% em pessoas com HAS. Observou-se associação estatisticamente significativa nos pacientes hipertensos entre DRC e escolaridade (ensino fundamental ­ OR: 1,56; IC95%:1,09; 2,23; sem escolaridade ­ OR:1,87; IC95%: 1,14; 3,07), não controle da pressão arterial (OR: 2,39; IC95%: 1,45; 3,94), sedentarismo (OR: 1,63; IC95%: 1,02; 2,60). Conclusão: A DRC apresenta alta prevalência nos hipertensos, evidenciando a necessidade de medidas em saúde pública para prevenção de complicações mediante melhor controle da doença e mudanças no estilo de vida.

Introduction: To analyze the prevalence and factors associated with chronic kidney disease in people with hypertension (SAH) registered in the Family Health Strategy in Rio Branco, Acre. Method: This is a cross-sectional study carried out with hypertensive patients registered in the Family Health Strategies (ESF), in the urban area of Rio Branco, Acre, in 2019. CKD was defined by GFR < 60 ml/1.72m², estimated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, or presence of albuminuria > 29 mg/g. Association measures were estimated using logistic regression, with a 95% confidence level. Results: The prevalence of CKD was 27.3% in people with hypertension. A statistically significant association was observed in hypertensive patients between CKD and education (primary education ­ OR: 1.56; 95% CI: 1.09; 2.23; no education ­ OR: 1.87; 95% CI: 1.14; 3.07), lack of blood pressure control (OR: 2.39; 95% CI: 1.45; 3.94), sedentary lifestyle (OR: 1.63; 95% CI: 1.02; 2.60). Conclusion: CKD has a high prevalence in hypertensive patients, highlighting the need for public health measures to prevent complications through better control of the disease and changes in lifestyle.

Introducción: Se analizó la prevalencia y los factores asociados a la enfermedad renal crónica (ERC) en personas con hipertensión arterial (HTA) inscritas en la Estrategia de Salud Familiar en Rio Branco, Acre. Método: Estudio transversal con hipertensos inscritos en las Estrategias de Salud Familiar (ESF) en la zona urbana de Rio Branco, Acre, en 2019. La ERC se definió por un FG <60 ml/1,72m², estimado a partir de la fórmula de Colaboración de Epidemiología de Enfermedades Renales Crónicas (CKD-EPI), o la presencia de albuminuria >29 mg/g. Se estimaron medidas de asociación mediante regresión logística, con un nivel de confianza del 95%. Resultados: La prevalencia de ERC fue del 27,3% en personas con HTA. Se observó una asociación estadísticamente significativa entre la ERC y la escolaridad (educación primaria ­ OR: 1,56; IC95%: 1,09; 2,23; sin escolaridad ­ OR: 1,87; IC95%: 1,14; 3,07), falta de control de la presión arterial (OR: 2,39; IC95%: 1,45; 3,94), y sedentarismo (OR: 1,63; IC95%: 1,02; 2,60) en pacientes hipertensos. Conclusión: La ERC presenta una alta prevalencia en pacientes hipertensos, lo que destaca la necesidad de medidas de salud pública para prevenir complicaciones mediante un mejor control de la enfermedad y cambios en el estilo de vida.

Suicide attempts in the adult Mexican population: an analysis of sociodemographic characteristics and associated factors / Tentativas de suicídio na população adulta mexicana: uma análise de fatores sociodemográficos e associados

ABSTRACT Objective: Suicide is the culmination of a process or continuum known as suicidal behavior that proceeds from ideation and planning to attempt. The objective was to estimate the prevalence of suicide attempts in the adult Mexican population and to analyze their main associated factors. Methods: We conducted an observational, cross-sectional, and descriptive study with information from the National Health and Nutrition Survey (2018). Self-reported lifetime suicide attempt was used in the analysis. We analyzed depression, obesity, tobacco smoking, and alcohol consumption as suicide attempt-associated factors using a multivariate logistic regression model. Results: The prevalence of adult suicide attempt was 2.0% (95%CI 1.8-2.2) and it was higher among women (2.4%; 95%CI 2.2-2.8) and young people (2.9%; 95%CI 2.4-3.4). Low education (OR=1.6; 95%CI 1.2-2.2), being single (OR=1.3; 95%CI 1.0-1.6), having obesity (OR=1.4; 95%CI 1.1-1.8), consumption of alcohol (OR=2.4; 95%CI 1.7-3.4) or tobacco smoking (OR=1.8; 95%CI 1.4-2.4), and having strong symptoms of depression (OR=10.1; 95%CI 6.2-16.3) were associated with a higher prevalence of suicide attempts. Conclusion: These results help better understand suicidal behavior in Mexico and identify the factors that increase the likelihood of suicide attempts, which is essential to help reduce suicide mortality. This research is crucial for developing early interventions and prevention programs aimed at reducing suicide's public health burden.

RESUMO Objetivo: O suicídio é o resultado de um processo ou continuidade conhecido como comportamento suicida, que parte da ideação e planejamento até a tentativa. O objetivo foi estimar a prevalência de tentativa de suicídio na população adulta mexicana e analisar seus principais fatores associados. Métodos: Realizamos um estudo observacional, transversal e descritivo com informações da Pesquisa Nacional de Saúde e Nutrição (2018). Na análise, foi utilizado o relato de tentativa de suicídio ao longo da vida. Analisamos a depressão, a obesidade, o tabagismo e o consumo de álcool como fatores associados à tentativa de suicídio, usando um modelo de regressão logística multivariada. Resultados: A prevalência de tentativas de suicídio em adultos foi de 2,0% (intervalo de confiança de 95% — IC95% 1,8-2,2); foi mais alta entre as mulheres (2,4%; IC95% 2,2-2,8) e entre os jovens (2,9%; IC95% 2,4-3,4). Baixa educação (odds ratio — OR=1.6; IC95% 1.2-2.2), estado civil solteiro (OR=1.3; IC95% 1.0-1.6), obesidade (OR=1.4; IC95% 1.1-1.8), consumo de álcool (OR=2.4; IC95% 1.7-3.4) ou tabaco (OR=1.8; IC95% 1.4-2.4) e sintomas fortes de depressão (OR=10.1; IC95% 6.2-16.3) estão associados a uma maior prevalência de tentativas de suicídio. Conclusão: Esses resultados ajudam a entender melhor o comportamento suicida no México e a identificar os fatores que aumentam a probabilidade de tentativas de suicídio, o que é essencial para ajudar a reduzir a mortalidade por essa causa. Esta pesquisa é crucial para o desenvolvimento de intervenções precoces e programas de prevenção com o objetivo de reduzir o ônus de saúde pública do suicídio.

Factores asociados a tuberculosis pre extensamente resistente en pacientes del Hospital Nacional Dos de Mayo, Lima, Perú

Introducción: La resistencia a fármacos antituberculosos está influenciada por las características personales y las condiciones de salud de países en vías de desarrollo. Objetivo: Determinar los factores asociados a TB-pre extensamente resistente (TB-PRE XDR) en pacientes del Hospital Nacional Dos de Mayo (HNDM) entre 2017 y 2019. Pacientes y Método: Se desarrolló un estudio caso control no pareado, definiendo como caso al paciente con TB- PRE XDR y como control al paciente con TB-S. Se recolectaron variables epidemiológicas, clínicas y radiológicas. Resultados: Se analizaron 51 casos y 102 controles. El análisis bivariado determinó como factores con p 51 años (OR: 0,17, IC95%: 0,05-0,51), uso de drogas (OR:2,5, IC95%: 1,1-5,4), antecedente de TB (OR: 20, IC95%: 8,4-47), reclusión previa (OR: 8, IC95%: 2,7-23,8), infección por VIH (OR: 0,2, IC95%: 0,08-1) y uso previo de fármacos antituberculosos (OR: 21, IC95%: 8,8-50). El análisis de regresión logística identificó como factores asociados a TB-PRE XDR al contacto de TB, antecedente de TB, tiempo de enfermedad y uso previo de fármacos antituberculosos. Conclusión: Las medidas para limitar el desarrollo de TB-PRE XDR en pacientes con TB-S deben incidir sobre el antecedente de TB, contacto con TB, tiempo de enfermedad y uso previo de anti-TB no controlados; sin embargo, existen resultados no concluyentes sobre el hábito nocivo y la comorbilidad, siendo necesario más estudios para determinar su influencia como factores asociados identificables.

Background: Resistance to anti-TB drugs is influenced by personal characteristics and health conditions in developing countries. Aim: To determine the factors associated with pre-extensively drug-resistant tuberculosis (PRE XDR-TB) at Hospital Nacional Dos de Mayo (HNDM) in patients between the 2017 and 2019. Methods: An unpaired case control study was developed; defining as case PRE XDR-TB patient and as control S-TB patient. Epidemiological, clinical and radiological variables were collected. Results: We analyzed 51 cases and 102 controls. The bivariate analysis showed as factors with p 51 years (OR: 0.17, 95% CI: 0.05-0.51), drug use (OR: 2.5, 95% CI: 1.1-5.4), previous history of TB (OR: 20, 95% CI: 8.4-47), previous confinement (OR: 8, 95% CI: 2.7-23.8), HIV infection (OR: 0.2, 95% CI: 0.08-1) and previous use of antiTB drugs (OR: 21, 95% CI: 8.8-50). The logistic regression analysis identified as associated factors with PRE XDR-TB the previous contact with TB, a history of TB, length of illness and previous use of tuberculosis antibiotics. Conclusion: The measures to limit the development of TB-PRE XDR in patients with TB-S must include the previous history of TB, TB contact, length of illness and previous use of uncontrolled antibiotics against TB; however, there are inconclusive results about the harmful habits and comorbidity, requiring more studies to determine their influence as identifiable associated factors.

Aspectos clínico-epidemiológicos en pacientes con abscesos odontogénicos cervicofaciales y factores asociados para estancia hospitalaria corta / Clinical-epidemiological aspects in patients with cervicofacial odontogenic abscesses and associated factors for short hospital stay

Introducción: en todo paciente hospitalizado con absceso odontogénico cervicofacial se busca resolución pronta del absceso, pero es necesario conocer cuáles son los factores que favorecen la resolución en hospitalizaciones cortas (1-3 días). Objetivo: determinar factores clínico-epidemiológicos de pacientes con abscesos odontogénicos para identificar factores que correlacionan con hospitalización corta. Material y métodos: estudio transversal, retrospectivo, observacional y analítico de 100 pacientes con abscesos odontogénicos en un Hospital General de Zona del Instituto Mexicano del Seguro Social de los años 2012-2013. Variables de estudio: días de hospitalización, sexo, edad, comorbilidades, conteo leucocitario, trismus, diente causal, región afectada y tratamientos realizados. Tamaño de muestra obtenido con fórmula para estudios observaciones con manejo de prevalencias para poblaciones infinitas, se empleó χ2 para identificar factores que correlacionan con hospitalización corta. Resultados: mujeres 56%, rango de edad 12-89 años y de hospitalización de 1-23 días; con comorbilidades 56%, leucocitosis 39% y trismus 21%. La caries causó 64% de abscesos, molares inferiores 70% y región submandibular afectada 73%. Variables estadísticamente significativas; conteo leucocitario, diente causal y región afectada. Conclusión: factores correlacionados con hospitalización corta: conteo leucocitario menor a 10,500 leucocitos, que el molar inferior no sea el diente causal y que la región submandibular no esté afectada (AU)

Introduction: prompt resolution of the abscess is sought in all patients hospitalized with cervicofacial odontogenic abscess, but which factors favor this resolution in short hospitalizations (1-3 days). Objective: determine clinical-epidemiological factors of patients with odontogenic abscesses to identify factors that correlate with short hospitalization. Material and methods: crosssectional, retrospective, observational and analytical study of 100 patients with odontogenic abscesses in a General Hospital of the Zone of the Mexican Social Security Institute from 2012-2013. Study variables; days of hospitalization, sex, age, comorbidities, leukocyte count, trismus, causative tooth, affected region and treatments performed. Sample size obtained with the formula for observational studies with prevalence management for infinite populations, χ2 was used to identify factors that correlate with short hospitalization. Results: women 56%, age range 12-89 years and hospitalization of 1-23 days, with comorbidities 56%, leukocytosis 39% and trismus 21%. Caries caused 64% of abscesses, lower molars 70% and affected submandibular region 73%. Statistically significant variables; leukocyte count, causative tooth and affected region. Conclusion: factors correlated with short hospitalization; leukocyte count less than 10,500 leukocytes, that the lower molar is not the causal tooth and that the submandibular region is not affected.

Riesgo asociado al síndrome respiratorio agudo severo coronavirus 2 en adultos fallecidos, Hospital Municipal Boliviano Holandés, municipio El Alto, 2020 / Risk associated with severe acute respiratory syndrome coronavirus 2 in deceased adults, dutch bolivian municipal hospital, El Alto municipality, 2020

INTRODUCCIÓN: La Neumonía por Síndrome Respiratorio Agudo Severo Coronavirus 2, es un problema de Salud Pública, por su alta tasa de mortalidad en la primera ola de la pandemia. OBJETIVO: Determinar los factores de riesgo asociados a la Neumonía por Síndrome Respiratorio Agudo Severo Coronavirus 2 en pacientes fallecidos internados en el área Covid y Unidad de Terapia Intensiva del Hospital Municipal Boliviano Holandés, Municipio El Alto, en los meses de marzo a diciembre 2020. MATERIAL Y MÉTODOS: Estudio observacional analítico de casos y controles, los casos 25 fueron pacientes fallecidos de neumonía por SARS-CoV-2 durante la estadía hospitalaria y los controles 75 pacientes no fallecidos por la enfermedad. La fuente de información fue el expediente clínico, ficha de notificación epidemiológica y certificado médico único de defunción. Se clasificó las causas de fallecimiento según el Código internacional de enfermedades CIE 10. RESULTADOS: Se obtuvo información de 25 casos y 75 controles, relación 1:3. Pacientes fallecidos del sexo masculino 72% con p=0.040 (OR 2.77 IC 95% 1.042 - 7.449); La edad de 60 años con p=0.000 (OR 4.12 IC95% 1.596 - 10.664); lugar de residencia urbano 88%; el periodo infeccioso fue de 9.68 días (IC95%7.83-11.52), tiempo de internación 6.60 días p=0.010 (OR 4.03 IC95% 1.446 - 11.231); las Enfermedades Crónicas no Transmisibles 80% con p=0.040 (OR 2.98 IC95% 1.009 - 8.779); los pacientes internados en el área COVID tuvo una mortalidad de 68% con p=0.010 (OR 0.25 IC95% 0.083 - 0.774) y recibieron tratamiento farmacológico 72%. CONCLUSIÓN: El sexo masculino, mayor de 60 años y las enfermedades Crónicas no Transmisibles son un factor de riesgo para altas tasas de letalidad, resultados respaldados según Serra Valdés1.

INTRODUCTION: Pneumonia due to Severe Acute Respiratory Syndrome Coronavirus 2 is a Public Health problem, due to its high mortality rate in the first wave of the pandemic. OBJECTIVE: To determine the risk factors associated with Severe Acute Respiratory Syndrome Coronavirus 2 pneumonia in deceased patients hospitalized in the Covid area and Intensive Care Unit of the Bolivian Dutch Municipal Hospital, El Alto Municipality, from March to December 2020. MATERIAL AND METHODS: Analytical observational study of cases and controls, 25 cases were patients who died of SARS-CoV-2 pneumonia during their hospital permanence, and 75 controls were patients who did not die from the disease. The source of information was the clinical record. The method was documentary analysis, instruments were clinical histories, epidemiological notification sheet and official medical death certificate. The causes of death were classified according to the International Code of Diseases CIE 10. RESULTS: Information was obtained from 25 cases and 75 controls, ratio 1:3. 72% male patients who died with p=0.040 (OR 2.77 95% CI 1.042 - 7.449); The 60 years old with p=0.000 (OR 4.12 IC95% 1.596 - 10.664); urban area of residence 88%; the infectious period was 9.68 days (95%CI 7.83-11.52), hospitalization time 6.60 days p=0.010 (OR 4.03 95%CI 1.446 - 11.231); Chronic Noncommunicable Diseases of 80% with p=0.040 (OR 2.98 IC95% 1.009 - 8.779); The patients hospitalized in the COVID area had a mortality of 68% with p=0.010 (OR 0.25 IC95% 0.083 - 0.774) and 72% received pharmacological treatment. CONCLUSION: The male, over 60 years old and Chronic Non-Communicable Diseases are a risk factor for high-risk rates in high mortality rates, results are supported by Serra Valdés1.

Factores asociados a la calidad de vida en adultos mayores con insuficiencia orgánica crónica avanzada en un hospital de Lima-Perú

Objetivo: Determinar los factores asociados a la calidad de vida en adultos mayores con insuficiencia orgánica crónica avanzada en un hospital de Lima-Perú. Materiales y métodos: Investigación observacional, analítica transversal, cuya población la conformaron 100 adultos mayores, la técnica de recolección fue la entrevista y el instrumento el cuestionario a través de la aplicación del índice de Barthel y WHOQoL-Bref. Para responder a los objetivos de estudio se aplicaron las pruebas no paramétricas u de Mann Whitney, Kruskal Wallis y Rho de Spearman, considerando la significancia del 5%. Resultados: El (44) 44% de adultos mayores tuvieron más de 80 años, el (59) 59% fueron varones, el (31) 31% estudiaron nivel técnico superior, el (57) 57% fueron titulares en la marina de guerra, el (74) 74% tuvo hipertensión arterial. Los síndromes geriátricos más frecuentes fueron déficit visual o auditivo (82) 82%, insomnio (59) 59%, estreñimiento (52) 52% y malnutrición (47) 47%. El (50) 50% de los adultos mayores presentó dependencia funcional grave. El (63)63% presentó calidad de vida a nivel medio. Los factores epidemiológicos asociados a la baja calidad de vida, fueron la edad mayor a 80 años (p=0,032, RP=1,818), sexo femenino (p=0,009, RP=2,056), el grado de instrucción dado por analfabeto, primaria y secundaria (p=0,025, RP=1,930) y la relación con la marina de guerra como familiar (p=0,022, RP=1,894). Los síndromes geriátricos asociados fueron el insomnio (p=0,034, RP=1,930), el estreñimiento (p=0,000, RP=3,560), la lesión por presión (p=0,000, RP=2,788) y la dependencia funcional grave (p=0,000, RP=4,667). Sin embargo, el análisis multivariado evidenció que el insomnio (p=0,002; RPa=1,166), la lesión por presión (p=0,016; RPa=1,248) y la dependencia grave (p=0,000; RPa=1,207) fueron los factores asociados significativamente a la baja calidad de vida en los adultos mayores. Conclusiones: Los factores insomnio, la lesión por presión y la dependencia grave estuvieron asociados significativamente a la calidad de vida baja en los adultos mayores con insuficiencia orgánica crónica avanzada en un hospital de lima-Perú.

Objective: To determine the factors associated with the quality of life in older adults with advanced chronic organ failure in a hospital in Lima-Peru. Materials and methods: Observational research, cross-sectional analysis, whose population was made up of 100 older adults, the collection technique was the interview and the instrument the questionnaire through the application of the Barthel index and WHOQoL-Bref. To respond to the study objectives, the non-parametric Mann Whitney u, Kruskal Wallis and Spearman's Rho tests were applied, considering the significance of 5%. Results: (44) 44% of older adults were over 80 years old, (59) 59% were men, (31) 31% studied a higher technical level, (57) 57% were incumbents in the navy, (74) 74% had arterial hypertension. The most frequent geriatric syndromes were visual or auditory deficit (82) 82%, insomnia (59) 59%, constipation (52) 52% and malnutrition (47) 47%. The (50) 50% of the older adults presented severe functional dependence. (63) 63% presented quality of life at a medium level. The epidemiological factors associated with low quality of life were age over 80 years (p=0.032, RP=1.818), female sex (p=0.009, RP=2.056), the level of education given by illiterate, primary and secondary school (p=0.025, RP=1.930) and the relationship with the navy as a family member (p=0.022, RP=1.894). Associated geriatric syndromes were insomnia (p=0.034, RP=1.930), constipation (p=0.000, RP=3.560), pressure injury (p=0.000, RP=2.788) and severe functional dependence (p= 0.000, PR=4.667). However, the multivariate analysis showed that insomnia (p=0.002; RPa=1.166), pressure injury (p=0.016; RPa=1.248) and severe dependence (p=0.000; RPa=1.207) were the associated factors. Significantly to the low quality of life in older adults. Conclusions: The factors insomnia, pressure injury and severe dependency were significantly associated with low quality of life in older adults with advanced chronic organ failure in a hospital in Lima-Peru.

Factores asociados al éxito de la cirugía revascularizadora en diabéticos con isquemia crítica crónica de las extremidades / Factors associated with the success of revascularization surgery in diabetic patients with chronic critical limb ischemia

Introducción: La cirugía revascularizadora es una de las estrategias fundamentales para el tratamiento de la isquemia crítica crónica de los miembros inferiores. Objetivo: Identificar los factores asociados al éxito de la cirugía revascularizadora de los miembros inferiores en diabéticos con isquemia crítica crónica. Métodos: Se realizó un estudio descriptivo, prospectivo y de tipo cohorte en pacientes diabéticos sometidos a una cirugía revascularizadora, por presentar isquemia crítica crónica de la extremidad. Estos fueron seguidos durante seis meses en el Instituto Nacional de Angiología y Cirugía Vascular entre septiembre de 2019 y enero de 2021. La variable principal de salida resultó los factores pronosticadores del éxito de la cirugía, la cual se consideró exitosa cuando el paciente permaneció vivo y sin una amputación mayor. Resultados: Se incluyeron 50 pacientes con una edad promedio de 64 ± 10,21 años y un 24 por ciento de mujeres. El 88 por ciento fueron fumadores; y el 78 por ciento, hipertensos. La efectividad global de la cirugía resultó del 64 por ciento (IC al 95 por ciento 50 por ciento-78 por ciento). Solamente el sexo femenino, con una probabilidad de 0,053 y un Odds Ratio de 4,23; el antecedente de enfermedad cerebrovascular (p: 0,13 y OR: 6,98); y la infección (p: 0,18 y OR: 2,7) mostraron una tendencia a asociarse de forma estadísticamente significativa con el éxito de la cirugía. Conclusiones: El sexo femenino, el antecedente de enfermedad cerebrovascular y la presencia de infección fueron los principales candidatos para estudiarse como variables pronosticadoras del éxito de la cirugía revascularizadora(AU)

Introduction: Revascularizing surgery is one of the fundamental strategies for the treatment of chronic critical ischemia of the lower limbs. Objective: To identify the factors associated with the success of lower limb revascularization surgery in diabetics with chronic critical ischemia. Methods: A descriptive, prospective, cohort-type study was conducted in diabetic patients undergoing revascularization surgery due to chronic critical limb ischemia. The patients were followed for six months at the National Institute of Angiology and Vascular Surgery from September 2019 to January 2021. The primary endpoint variable was the predictor of the success of surgery, which was considered successful when the patient remained alive and without major amputations. Results: 50 patients with an average age of 64 ± 10.21 years and 24 percent women were included. 88 percent of the patients were smokers; and 78 percent hypertensive ones. The overall effectiveness of surgery was 64 percent (95 percent CI 50 percent-78 percent). Only the female sex, with a probability of 0.053 and an Odds Ratio of 4.23, history of cerebrovascular disease (p: 0.13 and OR: 6.98); and infection (p: 0.18 and OR: 2.7) showed a tendency to be statistically, significantly associated with the success of surgery. Conclusions: Female sex, history of cerebrovascular disease and presence of infection were the main candidates as prognostic variables of the success of revascularizing surgery(AU)

Prevalência de hipertensão arterial e fatores associados em adultos e idosos residentes em Teresina, Piauí: uma análise hierarquizada / Prevalence of hypertension and associated factors in adults and older residents of Teresina, Piauí: a hierarchical analysis / Prevalencia de hipertensión arterial y factores asociados en adultos y ancianos residentes en Teresina, Piauí: un análisis jerárquico

Introdução: A hipertensão arterial sistêmica (HAS) é um problema de saúde pública, com elevada prevalência em âmbito mundial. Inúmeros fatores, tais como idade, sexo, raça/cor, escolaridade, renda, acesso aos serviços de saúde e hábitos de vida são descritos como influenciadores da prevalência da HAS. A maioria deles é considerada modificável e controlável pela adoção de um estilo de vida saudável. Objetivo: Estimar a prevalência de HAS e fatores associados em adultos e idosos residentes em Teresina, Piauí. Métodos: Estudo transversal, de base populacional, com 898 adultos e idosos. A amostragem foi probabilística complexa por conglomerados. O desfecho foi o diagnóstico autorreferido de HAS. Realizou-se análise hierarquizada em três blocos (características sociodemográficas, acompanhamento da saúde e estilo de vida) com cálculo de razão de prevalência (RP) e intervalos de confiança de 95% (IC95%) por regressão múltipla de Poisson. Resultados: A prevalência geral da HAS autorreferida foi de 27,9% e aumentou com a progressão da faixa etária. No modelo final, os fatores associados à HAS autorreferida foram: idade≥60 anos (RP=8,08; IC95% 3,72­17,52), sem escolaridade (RP=1,73; IC95% 1,18­2,54), última aferição da PA<6 meses (RP=2,64; IC95% 1,56­4,47), consumo regular de sal (RP=0,70; IC95% 0,52­0,93), circunferência da cintura alterada (RP=1,56; IC95% 1,29­1,90) e pressão arterial alterada (RP=1,64; IC95% 1,35­2,01). Conclusões: A prevalência da HAS autorreferida foi mais alta comparada com diferentes estudos nacionais e internacionais realizados nos últimos anos, com crescimento linear associado à progressão da faixa etária. Os fatores associados identificados refletem os grupos vulneráveis para HAS já conhecidos e outros podem ser resultados do crescimento da prevalência entre outras camadas sociais de maior renda. Diante da elevada prevalência da HAS em Teresina, da sua alta carga de morbimortalidade e de ser a principal causa evitável de morte prematura, torna-se necessário a intensificação das ações de promoção de saúde, prevenção do agravo e monitoramento do tratamento da HAS no município.

Introduction: Hypertension (HT) is a public health problem with high prevalence worldwide. Countless factors, such as age, sex, race/color, education, income, access to health services and lifestyle habits, are described as influencing the prevalence of HT, most of which are considered modifiable and controllable by the adoption of a healthy lifestyle. Objective: To estimate the prevalence of HT and associated factors in adults and older people living in Teresina, Piauí. Methods: Population-based cross-sectional study with 898 adults and older individuals. Sampling was complex probabilistic by clusters. The outcome was the self-reported diagnosis of HT. A hierarchical analysis was performed in three blocks (sociodemographic characteristics, monitoring of health and lifestyle) with determination of the prevalence ratio (PR) and 95% confidence interval (95%CI) by Poisson multiple regression. Results: The overall prevalence of self-reported HT was 27.9% and increased with age. In the final model, the factors associated with self-reported HT were: age ≥60 years (PR=8.08; 95%CI 3.72­17.52), no education (PR=1.73; 95%CI 1.18­2.54), last blood pressure measurement <6 months prior (PR=2.64; 95%CI 1.56­4.47), regular salt intake (PR=0.70; 95%CI 0.52­0.93), altered waist circumference (PR=1.56; 95%CI 1.29­1.90) and altered blood pressure (PR=1.64; 95%CI 1.35­2.01). Conclusions: The prevalence of self-reported HT was higher, compared to different national and international studies carried out in recent years, with linear growth, associated with age group progression. The associated factors identified reflect the already known vulnerable groups for HT, and others may be the result of the growth in prevalence among other higher income social strata. In view of the high prevalence of HT in Teresina, its high burden of morbidity and mortality and being the main preventable cause of premature death, it is necessary to intensify measures to promote health, prevent the disease and monitor the treatment of HT in the municipality.

Introducción: La hipertensión arterial sistémica (HAS) es un problema de salud pública con alta prevalencia a nivel mundial. Innumerables factores, como la edad, el sexo, la raza/color, la educación, la renta, el acceso a los servicios de salud y los hábitos de vida, se describen como influyentes en la prevalencia de la HAS, la mayoría de los cuales se consideran modificables y controlables mediante la adopción de un estilo de vida saludable. Objetivo: Estimar la prevalencia de hipertensión arterial sistémica (HAS) y factores asociados en adultos y ancianos residentes en Teresina, Piauí. Métodos: Estudio transversal de base poblacional con 898 adultos y ancianos. El muestreo fue complejo probabilístico por conglomerados. El resultado fue el diagnóstico autoinformado de HSA. Se realizó un análisis jerárquico en tres bloques (características sociodemográficas, seguimiento de la salud y estilo de vida) con cálculo de la Razón de Prevalencia (RP) e intervalos de confianza del 95% (IC95%) por regresión múltiple de Poisson. Resultados: La prevalencia general de HSA autoinformada fue del 27,9% y aumentó con la progresión de la edad. En el modelo final, los factores asociados a la HAS autoinformada fueron: edad≥60 años (RP=8,08; IC95% 3,72­17,52), sin escolaridad (RP=1,73; IC95% 1,18­2,54), última Medición de PA<6 meses (RP=2,64; IC95% 1,56­4,47), ingesta regular de sal (RP=0,70; IC95% 0,52­0,93), Circunferencia de Cintura alterada (RP=1,56; IC95% 1,29­1,90) y Presión Arterial Alterada (RP=1,64; IC95% 1,35­2,01). Conclusiones: La prevalencia de HAS autorreferida fue mayor, en comparación con diferentes estudios nacionales e internacionales realizados en los últimos años, con crecimiento lineal, asociado a la progresión por grupos de edad. Los factores asociados identificados reflejan los grupos vulnerables ya conocidos para la HAS y otros pueden ser el resultado del crecimiento de la prevalencia entre otros estratos sociales de mayores ingresos. Ante la alta prevalencia de HAS en Teresina, su alta morbilidad y mortalidad y ser la principal causa evitable de muerte prematura, es necesario intensificar las acciones de promoción de la salud, prevención del agravamiento y seguimiento del tratamiento de la HAS en el municipio.

Turnover Intention and Influencing Factors of Staffs in Centers for Disease Control and Prevention in the Post-Corvid-19 Era / 中山大学学报(医学科学版)

ObjectiveTo investigate the current situation of turnover intention of staffs in Center for Disease Control and Prevention（CDC） in the post-COVID-19 era and analyze the influencing factors of turnover intention， so as to provide policy suggestions and reference basis for maintaining the stability of the team of CDC and promote the development of health industry in China. MethodsA questionnaire survey on 1，508 staffs in Shenzhen Center for Disease Control and Prevention by means of WenJuanXing electronic questionnaire from January to February 2023 was conducted .Logistic stepwise regression analysis were used to analyze the influencing factors of turnover intention. ResultsAmong the 1，508 respondents， 583 （38.66%） had resignation intention. Logistic stepwise regression analysis showed that the scores of work arrangement， salary level ，professional title promotion system， occupational will，worry about job prospects were related to the generation of turnover intention ［OR 95%CI： 0.783（0.643， 0.952）； 0.531（0.452， 0.623）； 0.738（0.614， 0.887）； 0.605（0.520， 0.703）； 0.614（0.529， 0.714）］. In addition， job title， age and education were also related to generation of turnover intention （P <0.05）. ConclusionDisease prevention and control institutions should reduce the turnover intention of staffs in CDC through reasonable work arrangement， improvement of salary， adjustment of professional title promotion system， strengthening of professional cognition and enhancing confidence of personnel in career prospects.

Study on the related factors of antiviral treatment in previously reported hepatitis C patients based on the Andersen model / 中华肝脏病杂志

Objective: To understand the basic characteristics of previously reported patients with hepatitis C and analyze the related factors affecting their antiviral treatment. Methods: A convenient sampling method was adopted. Patients who had been previously diagnosed with hepatitis C in the Wenshan Prefecture of Yunnan Province and Xuzhou City of Jiangsu Province were contacted by telephone for an interview study. The Andersen health service utilization behavior model and related literature were used to design the research framework for antiviral treatment in previously reported hepatitis C patients. A step-by-step multivariate regression analysis was used in previously reported hepatitis C patients treated with antiviral therapy. Results: A total of 483 hepatitis C patients, aged 51.73 ± 12.06 years, were investigated. The proportion of male, agricultural occupants who were registered permanent residents, farmers and migrant workers was 65.24%, 67.49%, and 58.18%, respectively. Han ethnicity (70.81%), married (77.02%), and junior high school and below educational level (82.61%) were the main ones. Multivariate logistic regression analysis results showed that married patients with hepatitis C (OR = 3.19, 95% CI: 1.93-5.25, compared with unmarried, divorced, and widowed patients) with high school education or above (OR = 2.54, 95% CI: 1.54-4.20, compared with patients with junior high school education or below) were more likely to receive antiviral treatment in the predisposition module. Patients with severe self-perceived hepatitis C in the need factor module (compared with patients with mild self-perceived disease, OR = 3.36, 95% CI: 2.09-5.40) were more likely to receive treatment. In the competency module, the family's per capita monthly income was more than 1,000 yuan (compared with patients with per capita monthly income below 1,000 yuan, OR = 1.59, 95% CI: 1.02-2.47), and the patients had a high level of awareness of hepatitis C knowledge (compared with patients with a low level of knowledge, OR = 1.54, 95% CI: 1.01-2.35), and the family members who knew the patient's infection status (compared with patients with an unknown infection status, OR = 4.59, 95% CI: 2.24-9.39) were more likely to receive antiviral treatment. Conclusion: Different income, educational, and marital statuses are related to antiviral treatment behavior in hepatitis C patients. Family support of hepatitis C patients receiving hepatitis C-related knowledge and their families knowing the infection status is more important in promoting the antiviral treatment of patients, suggesting that in the future, we should further strengthen the hepatitis C knowledge of hepatitis C patients, especially the family support of hepatitis C patients' families in treatment.

Diabetes gestacional autorreferido - uma análise da Pesquisa Nacional de Saúde / Self-reported gestational diabetes - an analysis of the National Health Survey

Resumo Introdução O diabetes mellitus gestacional é definido como qualquer grau de intolerância à glicose, diagnosticado pela primeira vez durante a gestação, podendo ou não persistir após o parto. Sua prevalência ainda é conflitante, mas os riscos oferecidos a mãe e feto são diversos. Objetivo Identificar as respostas positivas de mulheres sobre um diagnóstico de diabetes recebido na gestação e relacioná-lo a características sociodemográficas e do pré-natal, além de descrever as orientações recebidas frente ao diagnóstico. Método Estudo com característica transversal que utiliza dados da Pesquisa Nacional de Saúde 2013, conforme o autorrelato de diagnóstico de diabetes gestacional. Realizou-se análise bivariada e cálculo das prevalências e razões de prevalência, com intervalo de confiança de 95% (IC95%), considerando plano de amostragem complexa. Resultados O diagnóstico de diabetes mellitus gestacional no período pré-natal foi relatado por 106 mulheres, com uma prevalência ponderada de 6,6% (IC95% 5,0-8,5). Verificou-se associação entre o relato de diagnóstico na gestação com maior idade e cor não branca. A maioria das mulheres diagnosticadas recebeu orientações quanto aos riscos da doença, mas poucas foram encaminhadas para consulta com especialista. Conclusão Os resultados detalhados da PNS fornecem estimativas populacionais sobre a magnitude da doença e possibilitam identificar o conjunto de fatores associados ao DMG.

Abstract Background Gestational diabetes mellitus is defined as any degree of glucose intolerance that is first diagnosed during pregnancy and may or may not persist after delivery. Its prevalence is still conflicting, but the risks offered to mother and fetus are diverse. Objective To identify the positive responses of women about a diagnosis of diabetes received during pregnancy and to relate it to sociodemographic and prenatal characteristics, in addition to describing the orientations received regarding the diagnosis. Method A cross-sectional study that uses data from the 2013 National Health Survey according to the self-reported gestational diabetes diagnosis. A bivariate analysis was performed, and prevalence and prevalence rates with a 95% confidence interval (95% CI) were calculated, considering a complex sampling plan. Results The diagnosis of prenatal gestational diabetes mellitus was reported by 106 women, with a weighted prevalence of 6.6% (95% CI 5.0-8.5). There was an association between the diagnosis report in older pregnancy and non-white color. Most diagnosed women received guidance on the risks of the disease, but few were referred for specialist consultation. Conclusion The detailed results of the PNS provide population estimates of the magnitude of the disease and make it possible to identify the set of factors associated with GDM.

Factores asociados al inicio de las relaciones sexuales en los adolescentes de los centros educativos de Cushcanday-Agallpampa y San Isidro-Otuzco, en el año 2021-2022

Objetivo: Determinar los factores asociados al inicio de las actividades sexuales en adolescentes de los centros educativos de Cushcanday-Agallpampa y San Isidro-Otuzco. Material y métodos: Entre septiembre de 2021 y marzo de 2022, se realizó un estudio observacional, analítico transversal en 265 escolares del nivel secundario de los centros educativos de Cushcanday-Agallpampa y San Isidro-Otuzco que cumplieron los criterios de inclusión aplicando como instrumento la encuesta sobre sexualidad. Resultados: 129 hombres y 126 mujeres. Con una edad media de 15.41 años. Con un 11% que ha iniciado su vida sexual. El factor de riesgo asociado de mayor peso para el inicio de la vida sexual es la nomofobia con un OR de 22.55 (IC = 5.24 - 96.97), seguido del analfabetismo, con un OR de 6.41 (IC = 1.22 - 6.74). La visita de páginas web sin contenido erótico es un factor protector para la coitarquia. Conclusiones: 1 de cada 10 adolescentes de la zona rural Cushcanday-Agallpampa y San Isidro-Otuzco-La Libertad ha iniciado su vida sexual. La nomofobia moderada en la adolescencia incrementa 22 veces el riesgo de tener relaciones sexuales. Los hijos de padres analfabeto tienen 6.41 veces mayor probabilidad de iniciar las relaciones sexuales en la adolescencia.

Objective: To determine the factors associated with the beginning of sexual activities in adolescents from the educational centers of Cushcanday-Agallpampa and San Isidro-Otuzco. Material and methods: Between September 2021 and March 2022, an observational, cross-sectional analytical study was carried out in 265 secondary school students from the educational centers of CushcandayAgallpampa and San Isidro-Otuzco who met the inclusion criteria applying as an instrument the sexuality survey. Results: 129 men and 126 women with an average age of 15.41 years. With 11% who have started their sexual life. The risk factor associated with the greatest weight for the beginning of sexual life is nomophobia with an OR of 22.55 (CI = 5.24 - 96.97), followed by illiteracy, with an OR of 6.41 (CI = 1.22 - 6.74). Visiting web pages without erotic content is a protective factor for coitarche. Conclusions: 1 out of every 10 adolescents in the rural area Cushcanday-Agallpampa and San Isidro-Otuzco-La Libertad has started their sexual life. Moderate level nomophobia in adolescence increases the risk of having sexual intercourse by 22 times. Children of illiterate parents are 6.41 times more likely to start sexual relations in adolescence.

Factores de riesgo asociados a la sobrecarga en cuidadores informales de adultos mayores postrados

Introducción: El envejecimiento de la población es uno de los más importantes fenómenos del siglo XXI. Cada día se hacen más necesarias las investigaciones respecto a este tema. Objetivo: Determinar los factores de riesgo asociados a la sobrecarga en cuidadores informales de adultos mayores postrados del área de salud de Cacocum, Holguín, en el año 2022. Método: Se realizó un estudio observacional descriptivo transversal, en el municipio Cacocum, Holguín, desde el 5 de julio de 2021 hasta el 29 de agosto de 2022. El universo estuvo constituido por 129 cuidadores de adultos mayores postrados (N꓿129) y la muestra por 106 cuidadores informales (n꓿106), obtenida por muestreo no probabilístico intencional. Para determinar la sobrecarga de los cuidadores se utilizó la escala de Zarit. Las variables estudiadas fueron: edad, sexo, nivel educacional, promedio de horas diarias dedicadas al cuidado del enfermo, vínculo del cuidador con el enfermo y presencia de sobrecarga del cuidador. Resultados: Predominó el grupo de edad de 60-69 años y el sexo femenino. Predominaron los cuidadores con el duodécimo grado y los sobrecargados. Existió un predominio de cuidadores con vínculo familiar y una relación significativa con la sobrecarga. Predominaron los cuidadores que dedicaban 18 horas como promedio al día al cuidado del enfermo y existió un predominio de cuidadores que habían dedicado de 3 a 4 años al cuidado del enfermo, se halló una relación significativa con la sobrecarga. Conclusiones: El vínculo del cuidador con el enfermo en cuanto a relación filial y los años dedicados al cuidado del mismo fueron los factores más asociados con el desarrollo de sobrecarga.

Introduction: Population aging is one of the most important phenomenon of the 21st century. Research on this subject is becoming more and more necessary every day. Objective: To determine the risk factors associated with overload in informal caregivers of prostrate older adults in the health area of Cacocum, Holguín, year 2022. Method: A cross-sectional descriptive observational study was carried out in Cacocum, Holguín, from July 5, 2021 to August 29, 2022. A total of 129 caregivers of prostrate older adults (N꓿129) were selected as the study´s universe and the sample consisted of 106 informal caregivers (n꓿106), obtained by nonprobability purposive sampling. The Zarit Scale was used to determine factors associated with overload in caregivers. Variables studied were as follow: age, sex, educational level, daily hours dedicated to caregiving, relationship between the caregiver and the patient, and the manifestation of overload in caregivers. Results: There was predominance in the age group of 60 to 69 years and female sex. Caregivers with twelfth grade of education and manifestation of overloaded were predominant. There was a predominance of caregivers with family ties and a significant relationship with overload. Predominated caregivers who spent an average of 18 hours per day in the care of the patients and the caregivers who had spent 3 to 4 years in caregiving, a significant relationship with overload was found. Conclusions: The relationship established between the caregivers and patients in terms of filial relationship and the years spent in the care provided to the patient were the factors most associated with the development of overload.

Introdução: O envelhecimento populacional é um dos fenômenos mais importantes do século XXI. A pesquisa sobre esse tema está se tornando cada dia mais necessária. Objetivo: Determinar os fatores de risco associados à sobrecarga em cuidadores informais de idosos acamados na área de saúde de Cacocum, Holguín, no ano de 2022. Método: Estudo observacional descritivo transversal realizado no município de Cacocum, Holguín, de 5 de julho de 2021 a 29 de agosto de 2022. O universo foi constituído por 129 cuidadores de idosos acamados (N꓿129) e a amostra por 106 cuidadores informais (n꓿106), obtida por amostragem intencional não probabilística. Para determinar a sobrecarga dos cuidadores foi utilizada a escala de Zarit. As variáveis estudadas foram: idade, sexo, escolaridade, média de horas diárias dedicadas ao cuidado do paciente, vínculo entre cuidador e paciente e presença de sobrecarga do cuidador. Resultados: Predominou a faixa etária de 60 a 69 anos e o sexo feminino. Houve predominância de cuidadores com ensino médio completo e sobrecarregados. Houve predomínio de cuidadores com vínculo burro familiar e uma relação significativa com sobrecarga. Houve predominância de cuidadores que gastam em média 18 horas por dia cuidando do paciente e predominância de cuidadores que passaram de 3 a 4 anos cuidando do paciente, sendo encontrada relação significativa com a sobrecarga. Conclusões: O vínculo do cuidador com o paciente em termos de relação filial e os anos dedicados ao cuidado do paciente foram os fatores mais associados ao desenvolvimento de sobrecarga.

Prevalence of Depression Among Community Dwelling Older Persons in Thailand and the Associated Factors: A Systematic Review

@#Aim: Depression symptoms in older persons are overlooked and untreated because they coincide with other conditions that older persons face. This review aimed to determine the prevalence and factors associated with depression among community dwelling older persons in Thailand according to the Social Cognitive Theory constructs. Design: Systematic review. Data sources: Four electronic databases: PubMed, PsychINFO, ScienceDirect and Scopus, with only articles published between January 2000 and December 2021 were included. Methods: The Preferred Reporting Systems for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this systematic review. All included articles were appraised using the Crowe Critical Appraisal Tool (CCAT), with all 13 studies were assessed to be of high quality, with score of more than 75. Results: A total of 13 full-texts articles were included in this review, of which 12 were cross-sectional study design, and only one was a cohort study. The prevalence of depression among older persons in Thailand were between 5.7% to 68%, with the most commonly reported factors that significantly associated with depression were gender, social support, marital status, employment status or income, and education level. Conclusion: Depression among older persons is a mental Health challenging issue in Thailand. Studying the factors that contribute to depression in older persons is more important in order to have a better understanding of the underlying causes as well as for early detection and effective management of depression among older persons in Thailand.

Working Beyond Retirement Age: A Systematic Review

@#Introduction: Population ageing brings along various crucial implications, with working beyond retirement age is one of the economics implications of ageing. Realizing the increasing demand and concern to accommodate older adults into the workforce, this review was conducted to develop better understanding on the factors associated with post-retirement employment among older adults aged 50 years and older. Methods: Using Scopus, ScienceDirect and PubMed databases, related articles between January 2017 and June 2021 were thoroughly searched using combination of keywords and screened according to the predetermined eligibility criteria. Post-retirement employment was defined as employment of older adults aged 50 years old and above beyond retirement age or re-employment of retired older adults, either from compulsory or voluntary retirement. All observational, qualitative, mixed methods and experimental studies were included in the screening process. The Crowe Critical Appraisal Tool (CCAT) was used to assess the quality of included articles. Results: A total of 12 articles included for review, with seven articles rated as high-quality. The review had successfully identified 10 factors associated with working beyond retirement age among older adults. Having good health status and being male gender were the commonest factors influencing the decision to work beyond retirement age, followed by level of education, financial commitment/ reasons, and work characteristics. Conclusion: The findings of this review provide a crucial insight and foundation towards addressing the unique needs of older workers in the employment policy.

Prevalence, patterns, clinico-social, and behavioral factors associated with the consumption of sugar-sweetened beverages among undergraduate medical students of central India

Introduction: Excessive consumption of sugar-sweetened beverages (SSBs) in adolescents has become a global issue. As its link to obesity and noncommunicable diseases is clear, it is imperative to understand SSB consumption behaviors in the future health-care professionals. The objective of this study is to document the prevalence, patterns, and clinico-social and behavioral factors predicting high intake of SSBs among medical students. Material and Methods: This cross-sectional study was conducted using a self-reported, web-based, questionnaire. All the students and interns who were part of a publicly funded premiere teaching hospital between October and November 2019 were included in this study. The semi-structured questionnaire enquired regarding socio-demographic, clinical details, amount, behavioral patterns, and money spent in connection with SSB consumption. Data were analyzed using IBM SPSS version 24. Results: The mean age of participants was 19.3 ± 1.6 years, 71.7% being males. The current prevalence of SSB consumption was 90.5%. Furthermore, 49.9% and 29.1% of participants preferred soft drinks and sweetened fruit juice, respectively. Multivariate analysis showed that male gender (adjusted odds ratio [aOR]: 1.83, (1.03–3.25), current alcohol consumption (aOR: 4.09, 1.25–13.42), and recent (last week) consumption of a SSB predicted high intake of SSBs [aOR: 7.36, (3.41–15.87)] whereas, preference of energy/sports category of drinks predicted low intake of SSBs [aOR 0.10, (0.02–0.47)]. Conclusion: The consumption of SSBs among medical students was high. Targeted health education and behavior change interventions should be provided to males, alcohol users, and frequent consumers

Factors Associated with the Chance of Carrying out a Primary Cesarean in a University Hospital / Fatores associados à chance de realização de cesariana primária em hospital universitário

Abstract Objective The present study seeks to identify the associated factors that increased primary cesarean delivery rates. Methods This was a cross-sectional study that evaluated the number of primary cesarean sections performed in the years 2006 and 2018 at the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym), through the collection of data from the medical records of the patients. Results Advanced maternal age, twin pregnancy, and higher body mass index (BMI) became more frequent in 2018 in comparison with 2006. To mitigate the impact of confounding in comparisons among groups, we made an adjustment by propensity scores and detected significant differences when comparing both age groups on twin pregnancy rates, gestational diabetes mellitus, and thyroid disease. Conclusion Data from the present study can be used to prevent and improve the management of morbidities, impacting on better outcomes in obstetrical practice.

Resumo Objetivo O presente estudo busca identificar os fatores associados que aumentam as taxas de partos cesáreos primários. Métodos Estudo transversal, avaliando o número de cesáreas primárias realizadas nos anos de 2006 e 2018 no Hospital de Clínicas de Porto Alegre (HCPA), por meio da coleta de dados nos prontuários das pacientes. Resultados Idade materna avançada, gravidez gemelar e índice de massa corporal (IMC) mais elevado tornaram-se mais frequentes em 2018. Para mitigar o impacto dos fatores de confusão nas comparações entre os grupos, fizemos um ajuste por escores de propensão e detectamos diferenças significativas nas taxas de gravidez gemelar, diabetes mellitus gestacional e doença da tireoide. Conclusão Os dados do presente estudo podem ser utilizados para prevenir e melhorar o manejo de morbidades, impactando em melhores resultados na prática obstétrica.

Manifestaciones clínicas, diagnóstico y tratamiento del golpe de calor / Clinical Manifestations, Diagnosis and Management of Heat Stroke

Introducción: El golpe de calor es una enfermedad que fue descrita hace más de 2000 años, sin embargo, los cambios climáticos que se han presentado en las últimas décadas han permitido que su prevalencia esté en aumento. Se considera una entidad compleja en la cual existe un compromiso importante de la termorregulación corporal y, en consecuencia, del resto de sistemas. Objetivos: Orientar al abordaje adecuado y óptimo de conceptos clínicos, epidemiológicos, factores el riesgo, presentación clínica y repercusión sobre los diferentes sistemas. Métodos: Se realizó una revisión de la literatura científica de personas con golpe de calor, en quienes se evaluaron sus factores asociados, métodos diagnósticos y manejos terapéuticos. Se realizó una búsqueda de la literatura en las siguientes bases de datos: Pubmed/Medline, Science Direct, Scopus, DOAJ, Embase, Cochrane, Direme, Redalyc y SciELO. Conclusiones: El golpe de calor es una urgencia médica que implica un manejo rápido y óptimo dado su morbilidad y mortalidad, lo cual puede minimizarse si se cumplen los objetivos de tratamiento. El enfriamiento por inmersión en agua helada, por convección o evaporación son las medias más usadas. Evitar la falla multiorgánica es el segundo objetivo terapéutico(AU)

Introduction: Heat stroke is a disease described more than 2000 years ago; however, the climatic changes that have occurred in recent decades have allowed an increase in its prevalence. It is considered a complex entity in which there is an important compromise of body thermoregulation and, consequently, of the rest of the systems. Objectives: To define important concepts concerning heat stroke, risk factors, clinical presentation and repercussions on the different systems, as well as to guide an appropriate and optimal management. Methods: A review of the scientific literature about people with heat stroke was carried out to assess its associated factors, diagnostic methods and therapeutic management. A literature search was performed in the following databases: Pubmed/Medline, Science Direct, Scopus, DOAJ, Embase, Cochrane, Bireme, Redalyc, and SciELO. Conclusions: Heat stroke is a medical emergency that requires rapid and optimal management given its morbidity and mortality, which can be minimized if management goals are met. Cooling by immersion into ice water, convection or evaporation are the most commonly used measures. Avoidance of multiorgan failure is the second therapeutic objective(AU)

Body image in elderly women and associated factors (comorbidities, socioeconomic, physical activity, and sexual function) / Imagem corporal em mulheres idosas e fatores associados(comorbidades, socioeconômicos, atividade física e a função sexual)

This research aimed to assess body image in elderly women and their associated factors. It is an observational-descriptive, quantitative cross-sectional study. We evaluated one hundred ten elderly women enrolled in language courses at the Open University of the Third Age (UNATI), at the Federal University of Pernambuco (UFPE), Recife-PE. The following were analyzed: body image, level of physical activity, sexual function and satisfaction, sociodemographic, and clinical conditions. It was found that 'hypertension' and 'live with' were related to body image. Sixty-eight (61.8%) women wanted to have a slimmer body. It was concluded that body image could influence 'live with' and co-morbidities such as high blood pressure. Moreover, it proves that most women dislike their bodies, unfortunately, thus affecting their self-esteem and quality of lif (AU)

O objetivo da pesquisa foi avaliar a imagem corporal em mulheres idosas e seus fatores associados. Trata-se de um estudo observacional-descritivo, quantitativo de corte transversal. Foram avaliadas 110 idosas cadastradas nos cursos de línguas pela Universidade Aberta da Terceira Idade (UNATI) inserida na Universidade Federal de Pernambuco (UFPE), no município do Recife-PE. Foram analisados: a imagem corporal, o nível de atividade física, a função e satisfação sexual, condições sociodemográficas e clínicas. Verificou-se que a hipertensão arterial e com quem reside estavam relacionadas com a imagem corporal. Já fatores socioeconômicos, a função sexual e o nível de atividade física não obtiveram relação com a imagem corporal. Percebeu-se também que 68 (61,8%) idosas desejavam ter um corpo mais magro, corroborando com grande parte da literatura e reafirmando a ideia de que o corpo da mulher idosa ainda é muito criticado diante da sociedade. Concluiu-se que a imagem corporal consegue ter influência perante quem reside e com comorbidades como a pressão alta, além disso, comprova que o corpo da mulher idosa, infelizmente, ainda desagrada grande parte das mulheres, podendo assim, influenciar sua autoestima, imagem corporal e afetando, consequentemente, a qualidade de vida das mesmas (AU)

Factores asociados a conjuntivitis bacteriana en recién nacidos / Factors associated with bacterial conjunctivitis in newborns

Resumen Objetivo: Analizar y describir factores modificables, no modificables y sociodemográficos asociados a la conjuntivitis bacteriana en recién nacidos. Materiales y métodos: El presente trabajo es una revisión de tema, que implica el siguiente orden para su ejecución: búsqueda, organización, sistematización y análisis de un conjunto de artículos relacionados con conjuntivitis neonatal, sobre el periodo comprendido entre 2010 y 2020. Las unidades de análisis fueron todos aquellos artículos relacionados con el tema. Como criterios de búsqueda, se incluyeron los siguientes descriptores: conjuntivitis bacteriana y recién nacidos. Estos descriptores fueron combinados de diversas formas al momento de la exploración con el objetivo de ampliar los criterios de búsqueda en las siguientes bases de datos: PubMed, Embase y Lilacs. Una vez organizada la información, se agruparon los artículos según su relación con los descriptores de conjuntivitis neonatal. Posteriormente, se realizó el análisis de las discusiones, aspectos comunes y divergentes entre los artículos seleccionados, mediante un ejercicio de comparación constante. Resultados: En el análisis univariante, los antecedentes neonatales de bajo peso o prematuridad, talla grande, infección de tracto genital materna, tipo de parto, ingreso a la unidad de cuidados intensivos neonatales, edad y paridad materna y procedencia se asociaron a conjuntivitis bacteriana en el recién nacido. Conclusión: Los recién nacidos con algunos factores modificables, no modificables y sociodemográficos tienen mayor riesgo de conjuntivitis bacteriana.

Abstract Objective: To analyze and describe modifiable, non-modifiable and sociodemographic factors associated with bacterial conjunctivitis in newborns. Material and methods: The present work is a review of the topic, which implies the following order for its execution: search, organization, systematization and analysis of a set of articles related to neonatal conjunctivitis, over a period between 2010 and 2020. The units of analysis were all those articles related to the topic. The following descriptors were included as search criteria bacterial conjunctivitis and newborns. These descriptors were combined in various ways at the time of exploration in order to broaden the search criteria in the following databases: PubMed, Embasem and Lilacs. Once the information was organized, the articles were grouped according to their relationship with the descriptors of neonatal conjunctivitis. Subsequently, the analysis of each of the discussions, common and divergent aspects between the selected articles, was carried out through a constant comparison exercise. Results: In the univariate analysis, the neonatal history of low weight or prematurity, large size, infection of the maternal genital tract, type of delivery, admission to the neonatal intensive care unit, age and maternal parity and origin were associated with bacterial conjunctivitis in the newborn. Conclusion: Newborns with some modifiable, unmodifiable, and sociodemographic factors are at increased risk for bacterial conjunctivitis.