Factors associated with women diagnosed with syphilis who received prenatal care in a primary healthcare unit

ABSTRACT Objective To estimate the prevalence of syphilis and its associated factors in women who were treated at public maternity hospitals and received prenatal care in a primary healthcare unit. Methods This cross-sectional study included 399 postpartum women. Interviews were conducted, and additional data were extracted from the pregnant woman's booklet, medical records, and printed tests. The dependent variable was a gestational syphilis diagnosis. The independent variables were grouped into socioeconomic and demographic, behavioral, reproductive, and prenatal blocks. The prevalence, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The χ 2 test was also performed (p≤0.05). Multivariate analysis was performed using Poisson regression models. Results The prevalence of gestational syphilis was 9.61% (95%CI: 7.14-12.83). We identified the following determining factors (adjusted prevalence ratios): history of sexually transmitted infections (2.3), first sexual intercourse by the age of 15 (2.42), partner having a history of syphilis (5.98), partner using crack/cocaine (6.42) and marijuana and others (3.02), not having a partner (3.07), low income (2.85), history of stillbirth (5.21), beginning prenatal care in the third trimester (3.15), and prenatal care received in a primary healthcare unit (without a Family Health Strategy team) (0.35). Conclusion Individual and prenatal factors were associated with gestational syphilis. To control congenital syphilis, targeted interventions are needed to control syphilis in the adult population including expansion of access to quality prenatal care with identification of risks for syphilis and connection between prevention and treatment actions, implementation of strategies focused on early sexual education, effective establish prenatal care involving both partners, and effective implementation of the National Men's Health Policy (PNAISH - Política Nacional de Atenção Integral à Saúde dos Homens ).

Mindfulness como estratégia para o tratamento da obesidade infantil / Mindfulness as a strategy for the treatment of childhood obesity

Introdução: A obesidade infantil é um grave problema global de saúde pública. O manejo no tratamento dessa enfermidade é complexo, pois depende de adequação à mudança de hábitos da própria família. A técnica mindfulness pode ser eficaz nesse contexto pois atua tanto no ganho de peso quanto nos sintomas ansiosos. Objetivo: avaliar a prática mindfulness em crianças e adolescentes. Avaliar sua aplicabilidade aos pais no tratamento da obesidade infantil. Material e Métodos: ensaio clínico longitudinal com 28 pacientes atendidos no ambulatório especializado de hospital terciário, no período de junho de 2016 a junho de 2018. As atividades consistiram de cinco sessões mensais de grupos operativos de meditações guiadas e atividades semanais domiciliares programadas. Foram avaliados peso, altura, Índice de Massa Corporal (IMC), escore Z do IMC e circunferências da cintura, do abdome, do quadril e do braço antes de cada sessão mensal. Resultados: a média da idade dos participantes foi 10,7 ± 3,68 anos; o escore Z do IMC 3,13 ± 0,89, a circunferência abdominal 90,9 ± 15,86 cm. A média de IMC referente à primeira avaliação foi 29,1 ± 4,63 kg/m2 e 29,9 ± 3,81kg/m2 na última. Os dados de evolução de IMC, circunferência da cintura, circunferência abdominal, circunferência do quadril e circunferência do braço direito não apresentaram diferença significante entre os valores iniciais e finais. Entretanto, houve melhora no vínculo entre as crianças e seus responsáveis com algumas mudanças no comportamento familiar. Conclusão: A prática mindfulness em crianças e adolescentes, bem como em seus pais, não mostrou impacto na redução do peso dos pacientes avaliados. Entretanto, poderá, em longo prazo, levar a resultados positivos na qualidade de vida e na melhora dos hábitos alimentares, podendo levar a redução do peso.

Introduction: Childhood obesity is a serious global public health problem. Management of this disease is complex, as it depends on changes of family habits. The mindfulness technique can be effective in this context by acting both on weight gain and on anxious symptoms. Objective: to evaluate the practice of mindfulness in obese children and adolescents as well as its applicability to their parents. Material and Methods: Longitudinal clinical trial with 28 patients attended at a tertiary pediatric endocrinology outpatient clinic from June 2016 to June 2018, who participated to five monthly group mindfulness guided sessions and weekly programmed home activities. Weight, height, Body Mass Index and waist, abdomen, hip and arm circumference were evaluated before each monthly session. Results: mean chronological age of participants was 10.7 ± 3.68 years; Z score of BMI 3.13 ± 0.89, the abdominal circumference 90.9 ± 15.86 cm. Mean BMI on the first evaluation was 29.1 ± 4.63 kg / m2 and 29.9 ± 3.81 kg / m2 on last evaluation. Data on BMI evolution, waist circumference, waist circumference, hip circumference and right arm circumference did not present significant difference between the initial and final values. However, there has been an improvement in the relationship between the children and their caregivers with some changes in family behavior. Conclusion: mindfulness practice in children and adolescents, as well as in their parents, showed no impact on weight reduction of assessed patients. In the long run, this approach may lead to positive results in quality of life and improvement in eating habits, and therefore may lead to weight reduction.