Colitis ulcerosa: a propósito de un caso pediátrico / Ulcerative colitis: about a pediatric case / Colite ulcerativa: sobre um caso pediátrico

RESUMEN Se presentó el caso de un paciente masculino de 8 años de edad con antecedentes de salud anterior, referido a la consulta externa de Gastroenterología del Hospital Nacional Guido Valadares, de Timor Oriental, por episodios recurrentes de diarreas mucosanguinolentas acompañadas de dolor abdominal en hipogastrio de cuatro meses de evolución. Se realizaron exámenes de laboratorio, ultrasonido abdominal y videocolonoscopia con citología y biopsia de la mucosa del colon. El estudio endoscópico informó una colitis ulcerativa extensa y la histología arrojó el diagnóstico de una enfermedad inflamatoria crónica intestinal del tipo colitis ulcerosa. La colitis ulcerosa es un proceso inflamatorio intestinal de origen desconocido que causa inflamación crónica, difusa y continua, en la mucosa y submucosa. Su incidencia en los niños está aumentando y afecta, incluso, a los lactantes. Se indicó tratamiento dietético y medicamentoso. Actualmente se encuentra asintomático y lleva seguimiento mensual en la consulta de Digestivo.

ABSTRACT The case of an 8-year-old male patient with a previous health history was presented, referred to the Gastroenterology outpatient clinic of the Guido Valadares National Hospital, East Timor, for recurrent episodes of mucosanguineous diarrhea accompanied by abdominal pain in the hypogastrium with four months of evolution. Laboratory tests, abdominal ultrasound and video colonoscopy with cytology and biopsy of the colon mucosa were performed. The endoscopic study reported extensive ulcerative colitis and the histology gave the diagnosis of a chronic inflammatory bowel disease of the ulcerative colitis type. Ulcerative colitis is an inflammatory intestinal process of unknown origin that causes chronic, diffuse and continuous inflammation in the mucosa and submucosa. Its incidence in children is increasing and affects even infants. Dietary and drug treatment was indicated. He is currently asymptomatic and undergoes monthly follow-up in the Digestive Clinic.

RESUMO Foi apresentado o caso de um paciente do sexo masculino, 8 anos, com antecedentes de saúde, encaminhado ao ambulatório de Gastroenterologia do Hospital Nacional Guido Valadares, Timor Leste, por episódios recorrentes de diarreia mucosanguínea acompanhada de dor abdominal em hipogástrio de quatro meses de evolução. Foram realizados exames laboratoriais, ultrassonografia abdominal e videocolonoscopia com citologia e biópsia da mucosa do cólon. O estudo endoscópico relatou colite ulcerativa extensa e a histologia deu o diagnóstico de doença inflamatória intestinal crônica do tipo colite ulcerativa. A colite ulcerosa é um processo inflamatório intestinal de origem desconhecida que causa inflamação crônica, difusa e contínua na mucosa e na submucosa. Sua incidência em crianças está aumentando e afeta até mesmo bebês. Foi indicado tratamento dietético e medicamentoso. Ele atualmente é assintomático e tem acompanhamento mensal na consulta Digestiva.

Avaliação da armadilha ovitrampa iscada com atraente natural para o monitoramento de Aedes spp. em Dili, capital do Timor-Leste / Evaluation of the baited ovitrap with natural attractant for monitoring Aedes spp. in Dili, capital of East Timor

Resumo A dengue ocorre no Timor-Leste desde 2005, porém não existe um programa de monitoramento e controle do "Aedes aegypti". O objetivo deste estudo foi de avaliar a armadilha ovitrampa iscada com atraente natural como uma possível ferramenta para monitorar o vetor das arboviroses: Dengue (DENV), Chikungunya (CHIKV) e Zika (ZIKV). O estudo foi realizado na cidade de Dili, capital do Timor-Leste, entre as semanas epidemiológicas 32 (02/08) a 48 (02/12) de 2016. Foram instaladas 70 armadilhas Ovitrampa, em residências de 15 sucos (ruas), de quatro Postos Administrativos (bairros) da cidade. Para as analises dos dados utilizou-se os indicadores entomológicos: Índice de Positividade de Ovitrampa (IPO), Índice de Densidade Vetorial (IDV) e Índice de Densidade de Ovos (IDO). Durante o experimento foram coletados 158.904 ovos de Aedes spp.. O IPO demonstrou que todas as áreas tiveram 98% a 100% de armadilhas contendo ovos de Aedes spp.. Os indicadores IDO e IPO apresentaram correlações positivas e significativa com a temperatura. A defasagem de duas e três semanas para precipitação indicou correlação positiva significativa para IDV e IDO. Portanto, a armadilha ovitrampa é uma ferramenta que pode integrar as ações de um programa de monitoramento e controle de Aedes spp. no Timor-Leste.

Factores de riesgo de la tuberculosis pulmonar en pacientes timorenses / Risk factors of lung tuberculosis in patients from East Timor

Se realizó un estudio observacional y analítico, de casos y controles, pareados por sexo y edad, de 126 pacientes ingresados en la sala de aislamiento del Hospital Nacional Guido Valadares, en Dili, Timor Oriental, durante el año 2015, con vistas a determinar los factores de riesgo asociados a la tuberculosis pulmonar en ellos. El grupo de casos, de 42 integrantes, incluyó a los recién diagnosticados con tuberculosis y a los que presentaron recaída, fallo terapéutico, resistencia a múltiples fármacos, así como padecimiento previo de la afección con secuelas (bronquiectasias concomitantes con infección, hemoptisis); en tanto, el grupo de controles lo conformaron 84 pacientes con entidades respiratorias no tuberculosas. De las variables analizadas, la presencia de alcoholismo, la desnutrición, el contacto íntimo con pacientes cuya baciloscopia dio positiva y el ser recluso o ex-recluso, fueron los factores de riesgo de mayor asociación causal y estadística en el contagio de la enfermedad y constituyeron los resultados más relevantes de esta investigación

An observational, analytic and cases-controls study of 126 patients paired by sex and age, admitted to the isolation room of Guido Valadares National Hospital, in Dili, East Timor, was carried out during 2015, aimed at determining the risk factors associated with lung tuberculosis in them. The cases group with 42 members, included those recently diagnosed with tuberculosis and those that presented relapse, therapeutic failure, resistance to multiple drugs, as well as previous suffering of the disorder with sequelae (concomitant bronchiectasis with infection, hemoptysis); as long as, the control group was conformed by 84 patients with non tuberculous breathing entities. Of the analyzed variables, the presence of alcoholism, malnutrition, intimate contact with patients whose baciloscopia was positive and being prisoner or former-prisoner, were the risk factors of more causal and statistical association in the infection of the disease and constituted the most outstanding results in this investigation

Características clinicoepidemiológicas de timorenses con pterigión atendidos en el Hospital Nacional "Guido Valadares" / Clinical epidemiological characteristic of people from Timor with pterygium assisted in "Guido Valadares" National Hospital

Se realizó un estudio descriptivo y transversal de 70 pacientes con pterigión, atendidos en la consulta de Oftalmología del Hospital Nacional "Guido Valadares" de Dili, en Timor Oriental, desde agosto de 2014 hasta enero de 2015, con vistas a caracterizarles según algunas variables clinicoepidemiológicas de interés. En la casuística predominaron el grupo etario de 31-45 años (35,7 %), el sexo masculino (55,7 %) y la localización nasal o interna de la entidad clínica (92,9 %). De igual modo, resultaron más frecuentes las radiaciones solares y el ambiente de polvo y viento como factores de riesgo (con 36,7 % en cada caso), los que evidenciaron una mayor exposición (73,4 % de los afectados) a agentes ambientales y, consecuentemente, una estrecha relación de estos con la aparición del pterigión.

A descriptive and cross-sectional study of 70 patients with pterygium, assisted in the Ophthalmology Service of "Guido Valadares" National Hospital in Dili, East Timor, was carried out from August, 2014 to January, 2015, aimed at characterizings them according to some clinical epidemiological variables of interest. In the case material the 31-45 age group (35.7 %), the male sex (55.7 %) and the nasal or internal localization of the clinical entity (92.9 %) prevailed. Likewise, the solar radiations and the powder and wind atmosphere were the most frequent as risk factors (with 36.7 % in each case), which evidenced a higher exposure (73.4 % of those affected) to environmental agents and, consequently, a close relationship of these with the emergence of the pterygium.

Developmental and behavioral concerns of children in difficult circumstances

OBJECTIVE:This research was conducted to determine whether children exposed to the violence of war such as those who lived through the civil war of East Timor in 1999, suffer developmental concerns and behavioral problems as evidenced by abnormal development quotients in at least 4 components of cognition and identification of inappropriate behavior. METHODOLOGY:This was a descriptive cross-sectional study conducted in 1999 on children who lived in Liquica District, 25 km away from Dili, the capital city of East Timor during the massacres that took place between April-September 1999 during civil war of 1999 and who at that time were 2-4 years old but by the time they were tested were 7-9 years old. Healthy children who qualified and whose parents or guardians consented underwent a physical exam that included taking their height and weight. Their parents or guardians were given a questionnaire that included demographic, personal, family and social data as well as the child's school performance, health, and developmental status. RESULTS: Of the 100 children included in the study 69% were found to have difficulties in problem solving skills and below average skills in adapting (63%) and auditory memory (51%). Behavioral problems were identified in 92% of children manifested as temper tantrums, aggressive as well as timid behaviors. Thirty-seven percent had poor school performance noted as being retained in the same grade level and a mean grade of less than 6. CONCLUSION: Majority of children exposed to violence of war presented with developmental i.e. cognitive delays, behavioral problems and school difficulties.

International cooperation and health policy implementation in a post-conflict situation: the case of East Timor / Cooperação internacional e formulação de políticas de saúde em situação pós-conflito: o caso do Timor-Leste

This study centers on relationships among national and international actors in preparation of the first health policy document for East Timor, under the United Nations transitional administration, between 1999 and 2002. International cooperation support for the health system rehabilitation process during the post-conflict period is analyzed as part of reconstruction of the State in parallel with construction of the country's political and institutional framework. Knowledge, ideas, "ways of doing," and induced and accepted practices permeate an interplay of power relationships that condition both national political alliance-building and the architecture of international aid, pointing to input to a discussion of how these mechanisms interact at different conjunctures and times in different negotiating frameworks. .

Dedica-se, aqui, às relações entre diferentes atores na elaboração do primeiro documento de política de saúde para o Timor-Leste, sob a administração transitória das Nações Unidas, de 1999 a 2002. O apoio da cooperação internacional no processo de reabilitação do sistema de saúde no período pós-conflito é analisado como parte da reconstrução do Estado e concomitante à construção do arcabouço político e institucional no país. Conhecimentos, ideias, "modos de fazer" e práticas induzidas e aceitas entremeiam um jogo de relações de poder que condiciona tanto a articulação política nacional quanto a arquitetura da ajuda externa, apontando elementos para a discussão de como esses mecanismos se organizam em conjunturas diferentes de negociação.

A Report on Medical Support and Health Education Activities for Internally Displaced Persons in Dili Area, East Timor / 国際保健医療

 SHARE started Health Education Promotion Project in East Timor in 2002 and has been actively engaged for over 4 years. The political and social unrest in the spring of 2006 produced as many as 150,000 internally displaced persons (IDPs), almost one sixth of the total population of the country. Viewing a dire situation in which people were placed, SHARE launched humanitarian assistance in 20 camps from August through December 2006. The interventions carried out were, among others, monitoring malnourished children with UNICEF, health education/promotion and mobile clinic in IDP camps, and supportive activities for Bairo Pite Clinic.<br> The health education cumulatively reached 753 persons in 20 camps. Main health topics covered were sanitation, nutrition and skin infections. The mobile clinic in the Metinaro Camp was carried out 12 times seeing 1,227 persons. Main diseases identified were upper respiratory tract infections, skin infections and acute watery diarrhoea.<br> We think that; i) coordination with donors in compliance with East Timorese national policy on IDPs is essential, ii) NGOs with experience in long-term health promotion can have an important role to play in emergencies, iii) even in an emergency situation, focusing on primary health care is important from the early stage of humanitarian assistance, iv) it is vital to take sustainability of those activities into account from the planning stage.