Fluoretação da água dos dez maiores municípios do estado do Tocantins, Brasil / Water fluoridation in the ten largest municipalities of the state of Tocantins, Brazil

Resumo Fluoretação da água é uma estratégia de controle da cárie, recomendada pela OMS. No Brasil ela é regulamentada por lei, mas não tem sido implementada com sucesso na região Norte. Os objetivos desta pesquisa foram levantar dados sobre a existência do heterocontrole nos 10 maiores municípios tocantinenses e analisar a concentração de fluoreto presente na água de abastecimento público destas cidades. A pesquisa foi realizada de maio-agosto/17 e teve como marco teórico-metodológico a análise quantitativa, descritiva e transversal. Coletas de água foram realizadas mensalmente, utilizando protocolo de amostragem de coleta de água da rede. A concentração de fluoreto nas águas foi feita com eletrodo íon específico pela técnica direta. Constatou-se que a vigilância da fluoretação da água está em operação na capital do estado desde 2016. Com relação a concentração de fluoreto na água, foi encontrado que 31,6% das amostras analisadas estavam adequadas para o máximo benefício de redução de cárie e 27,5% delas apresentavam risco alto ou muito alto de fluorose dentária. É necessário implementar um programa de controle da concentração de flúor na água no Tocantins, a fim de garantir que a população não seja privada dos benefícios anticárie da agregação de flúor à agua tratada.

Abstract Water fluoridation is a strategy for caries control recommended by the WHO. In Brazil, it is regulated by law but this program has not been successfully implemented in the North region. This research aimed to collect data on the existence of external control (heterocontrol) in the ten largest municipalities in the state of Tocantins, Brazil, and to analyze fluoride concentration in the public water supply of these cities. The study was conducted from May-August/17, and its theoretical-methodological framework was a quantitative, descriptive and cross-sectional analysis. Water collections were carried out monthly, using sampling protocol of water collection of the network. Fluoride concentration in the waters was determined with ion specific electrode by the direct technique. It was verified that water fluoridation monitoring is only been done in Palmas, capital of the state, starting in 2016. Thirty-two percent of waters samples analyzed showed fluoride concentration to obtain the maximum benefit of reduction caries and 27.5% of them presented a high or very high risk of dental fluorosis. It is necessary to implement a program to control the concentration of fluoride in the water of the municipalities of Tocantins, in order to ensure that the population is not deprived of the anticaries' benefits of the adjustment of fluoride concentration of the treated water.

Comparação de resultado estético em cicatrizes com uso de fios cirúrgicos e Prineo® / Comparison between surgical sutures and Prineo® in terms of esthetic result and scar formation

Introdução: Cicatrização de ferida é um processo bem organizado que tem como finalidade a reparação tecidual completa. Colas e adesivos tópicos oferecem uma alternativa não invasiva, de retirada fácil e espontânea; boa força tênsil; menor tempo de aplicação, sendo o Prineo® uma cola adesiva associada a uma malha de poliéster aplicados sobre a ferida. Método: Trata-se de um estudo transversal retrospectivo com análise de 101 procedimentos cirúrgicos no período de 2012 a 2014, nos quais a síntese da ferida operatória ocorreu com fios cirúrgicos de náilon ou Prineo®, sendo aplicada análise estatística. Resultados: Neste estudo, seis pacientes apresentaram dermatite de contato ao uso do Prineo® com significância estatística (p = 0,042). O uso desse sistema diminuiu a taxa de alargamento cicatricial (p < 0,05). O presente trabalho não apresentou diferença estatística (p = 0,068) na qualidade da cicatriz entre os pacientes que utilizaram Prineo® em relação ao grupo controle, demonstrando que em ambos os grupos o resultado cicatricial foi de excelente (87%) a bom (27%) na sua maioria. Conclusão: Conclui-se no estudo que os pacientes que utilizaram o sistema de octil-2-cianocrilato associado a malha, Prineo®, apresentaram menores índices de alargamento cicatricial, dependentes de uma espessura de derme satisfatória, e maiores taxas de dermatites por contato em relação àqueles em que a ferida foi encerrada com fios cirúrgicos. Os dois grupos demonstraram qualidades cicatriciais excelentes a bons, sem diferença estatística em tais resultados estéticos cicatriciais.

Introduction: Wound healing is a well-organized, directed process of tissue repair. The process can be expedited using topical glues and adhesives, which offer a non-invasive, easily removable alternative to suturing. Furthermore, such products have good tensile strength and involve lower application time. In particular, the Prineo® adhesive is applied to a polyester mesh that covers the wound. Method: We carried out a retrospective, cross-sectional study, with subsequent statistical analysis , involving 101 surgical procedures in which wound closure was performed using either nylon sutures or Prineo®. All the procedures were performed between 2012 and 2014. Results: Six patients had contact dermatitis after Prineo® was used, with statistical significance (p = 0.042). Furthermore, Prineo® decreased the rate of scar enlargement (p < 0.05) . There was no statistical difference between the Prineo® and suture groups in terms of scar quality (p = 0.068); in both groups, the scar result was mostly excellent (87 %) to good (27%). Conclusion: Patients whose wounds were closed using Prineo® a system involving octyl-2-cyanoacrylate and an associated polyester mesh displayed lower rates of scar enlargement, which depended on whether the thickness of the dermis was satisfactory. However, the same patients had higher rates of contact dermatitis than those whose wounds were closed using surgical sutures. Both groups showed excellent to good scar quality, with no significant difference in terms of esthetic scar results.

Relationships between static foot alignment and dynamic plantar loads in runners with acute and chronic stages of plantar fasciitis: a cross-sectional study

BACKGROUND: The risk factors for the development of plantar fasciitis (PF) have been associated with the medial longitudinal arch (MLA), rearfoot alignment and calcaneal overload. However, the relationships between the biomechanical variables have yet to be determined. OBJECTIVE: The goal of this study was to investigate the relationships between the MLA, rearfoot alignment, and dynamic plantar loads in runners with unilateral PF in acute and chronic phases. METHOD: Cross-sectional study which thirty-five runners with unilateral PF were evaluated: 20 in the acute phase (with pain) and 15 with previous chronic PF (without pain). The MLA index and rearfoot alignment were calculated using digital images. The contact area, maximum force, peak pressure, and force-time integral over three plantar areas were acquired with Pedar X insoles while running at 12 km/h, and the loading rates were calculated from the vertical forces. RESULTS: The multiple regression analyses indicated that both the force-time integral (R2=0.15 for acute phase PF; R2=0.17 for chronic PF) and maximum force (R2=0.35 for chronic PF) over the forefoot were predicted by an elevated MLA index. The rearfoot valgus alignment predicted the maximum force over the rearfoot in both PF groups: acute (R2=0.18) and chronic (R2=0.45). The rearfoot valgus alignment also predicted higher loading rates in the PF groups: acute (R2=0.19) and chronic (R2=0.40). CONCLUSION: The MLA index and the rearfoot alignment were good predictors of plantar loads over the forefoot and rearfoot areas in runners with PF. However, rearfoot valgus was demonstrated to be an important clinical measure, since it was able to predict the maximum force and both loading rates over the rearfoot.

Weaknesses in the reporting of cross-sectional studies according to the STROBE statement: the case of metabolic syndrome in adults from Peru / Las deficiencias en la presentación de los estudios transversales de acuerdo con la declaración STROBE: el caso del síndrome metabólico en adultos de Perú

Introduction: The inadequate reporting of cross-sectional studies, as in the case of the prevalence of metabolic syndrome, could cause problems in the synthesis of new evidence and lead to errors in the formulation of public policies. Objective: To evaluate the reporting quality of the articles regarding metabolic syndrome prevalence in Peruvian adults using the STROBE recommendations. Methods: We conducted a thorough literature search with the terms "Metabolic Syndrome", "Sindrome Metabolico" and "Peru" in MEDLINE/PubMed, LILACS, SciELO, LIPECS and BVS-Peru until December 2014. We selected those who were population-based observational studies with randomized sampling that reported prevalence of metabolic syndrome in adults aged 18 or more of both sexes. Information was analysed through the STROBE score per item and recommendation. Results: Seventeen articles were included in this study. All articles met the recommendations related to the report of the study's rationale, design, and provision of summary measures. The recommendations with the lowest scores were those related to the sensitivity analysis (8%, n= 1/17), participant flowchart (18%, n= 3/17), missing data analysis (24%, n= 4/17), and number of participants in each study phase (24%, n= 4/17). Conclusion: Cross-sectional studies regarding the prevalence of metabolic syndrome in peruvian adults have an inadequate reporting on the methods and results sections. We identified a clear need to improve the quality of such studies.

Introducción: El reporte inadecuado de estudios transversales, como en el caso de la prevalencia de síndrome metabólico, podría causar problemas en la síntesis de nueva evidencia y generar errores en la formulación de políticas públicas. Objetivo: Evaluar la calidad de reporte de estudios transversales sobre la prevalencia de síndrome metabólico en Perú utilizando las recomendaciones de STROBE. Métodos: Se realizó una búsqueda bibliográfica exhaustiva hasta Diciembre 2014 en MEDLINE/PubMed, LILACS, SciELO, LIPECS y BVS-Perú con los términos "Metabolic Syndrome", "Sindrome Metabolico" y "Peru". Se seleccionaron estudios observacionales con base poblacional, muestreo aleatorizado, que reportaran datos de prevalencia en adultos mayores de 18 años de ambos sexos. La información fue analizada a través de STROBE según puntuación por artículo y por recomendación. Resultados: Diecisiete artículos fueron incluidos en este estudio. Todos cumplieron con las recomendaciones relacionadas con el reporte de razones y fundamentos de la investigación, reporte del diseño de estudio y la proporción de medidas de resumen. Las recomendaciones con menor puntaje fueron las relacionadas a la descripción del análisis de sensibilidad (8%, n= 1/13), consideración del uso de diagrama de flujo para los participantes (18%, n= 3/17), explicación del análisis de datos ausentes (24%, n= 4/17) y del número de participantes en cada fase (24%, n= 4/17). Conclusión: Los estudios transversales sobre prevalencia de síndrome metabólico en adultos del Perú presentan un inadecuado reporte en las secciones de métodos y resultados. Se identifica una clara necesidad de mejorar la calidad de este tipo de estudios.

Ganancia de peso corporal a partir de la menopausia y perfil alimentario en una muestra de mujeres de la ciudad de buenos aires / Body weight gain after menopause and food intake pattern in a cohort of women of the city of buenos aires

Introducción: la menopausia conlleva una ganancia del peso corporalno necesariamente relacionada con mayor ingreso calórico. Objetivos: conocer la ganancia de peso corporal a partir dela menopausia y su asociación con el perfil alimentario consumidopor una muestra de mujeres adultas. Materiales y métodos: estudio transversal observacional realizado sobre una muestra no probabilística de 116 mujeres postmenopáusicas que asistieron por primera vez a la consulta nutricional en un centro endocrinológico de la Ciudad Autónoma de Buenos Aires. Variables: ganancia de peso(en Kg), perfil alimentario según recordatorio de 24 hs, edad menopausia (<47 años; >47 años), años transcurridos en menopausia(<5 años; >5 años), estado nutricional al inicio dela menopausia (normal: IMC 18,5 a 24,9 Kg/m2; sobrepeso:IMC 25,0 a 29,9 Kg/m2 y obesidad: IMC >30,0 Kg/m2), hábito tabáquico y ejercicio físico programado. Se utilizó el Programa SARA-versión 1.2.12 para conocer consumo y SPSS 19.0calculando medias, desvío estándar y rangos. Se calcularon test de mediana, pruebas x2 o de Fisher y correlación de Pearsono Spearman según tamaño muestral. El nivel de significación estadístico se fijó en p<0,05 ...

Menopause leads to body weight gain, not necessarily related to increased caloric intake. Objectives: to determine dietary intake profile, body weight gain from menopause and its association with calories consumed in a cohort of adult women. Methodology: observational cross-sectional study conducted on a sample initial non-probabilistic 116 postmenopausal women who attended for the first nutritional consultation endocrinological or in a center of the City of Buenos Aires. Variables: weight gain (in Kg), food profile as reminder of 24 hs, age menopause (≤47 years; >47 years), years in menopause (<5 years; ≥5 years), nutritional status at the beginning of the me-nopause (normal: BMI 18,5 to 24,9 Kg/m2; overweight: BMI 25,0 to 29,9 Kg/m2 and obesity: BMI ≥30,0 Kg/m2), smoking and physical exercise scheduled. The program was used SARA-version 2.1.12 for consumption and SPSS 19.0 by calculating average, standard deviation and ranges. We calculated median test, tests or x2 of Fisher and correlation of Pearson or Spear-man as sample size. The level of statistical significance was set at p<0,05...(AU)

Relación entre IMC, emociones percibidas, estilo de ingesta y preferencias gustativas en una población de adultos / Relationship between BMI, emotions perceived, intake style and taste preferences in an adult population

En personas con sobrepeso y obesidad el acto ingestivo puede iniciarse en ausencia de ingesta homeostática. Las emociones pueden actuar como disparadores de ingesta hedónica o emocional contribuyendo al balance positivo de energía, ganancia de peso y obesidad. Objetivos: estudiar la relación entre las emociones percibidas, las preferencias gustativas y los estilos de ingesta, según el índice de masa corporal (IMC) y género en personas adultas. Materiales y métodos:estudio descriptivo de corte transversal mediante encuesta estructurada auto-administrada a pacientes adultos (N=481) que consultaron por primera vez en un centro privado de nutrición de la Ciudad Autónoma de Buenos Aires. Resultados:se observó correlación entre el IMC y el estilo de ingesta (r=.26, p<.01) con diferencias para picoteo, salteo, desorganización e hiperfagia (p<0,01). Los hombres presentaron estilos de ingesta menos saludables que las mujeres con mayor frecuencia de hiperfagia y comida nocturna excesiva. El 31% de la muestra refirió atracones, siendo más frecuentes en las mujeres (33,8%) que en los hombres (19,5%) (p<0,01). La preferencia por lo salado se asoció a mayor IMC (IMC media 33,21, p<0,01). El 49,27% de la muestra seleccionó salado, con mayor frecuencia en hombres (68,3%) que en mujeres (45,4%). Un 55% eligió alimentos dulces, con diferencias de género (59% de las mujeres, 34% de los hombres). Se observó una asociación positiva con débil correlación (r=.13, p<.01) entre el IMC y las emociones percibidas, con diferencias significativas en los valores de IMC en función de tristeza (IMC media=33,24, desv. típ. 8,26 p<.01) y enojo (IMC media=33,18, desv. típ. 8,23 p<.01). Las mujeres (M=2,43; DE=1,55) tendieron a comer por emociones (ansiedad, tristeza, cansancio y enojo) más que los hombres. Conclusiones: estilos de ingesta no saludables, preferencia gustativa por lo salado e ingesta desencadenada por emociones percibidas se asociaron a mayor IMC. Los hombres presentaron...

In overweight and obese people, ingestive behavior can be initiated in the absence of homeostatic hunger. Emotions can trigger hedonic or emotional intake, contributing to positive energy balance, weight gain and obesity. Objectives: to study the relationship between perceived emotions, taste preferences and eating habits, according to Body Mass Index (BMI) and gender in adults.Materials and methods: a descriptive cross-sectional study by means of a self-administered structured survey in adult patients (N=481) in a single visit to a private nutrition center in the City of Buenos Aires. Results:a correlation between BMI and unhealthy eating style (r=.26, p>,01) was observed with significant statistical differences for snacking, skipping, disorganization and hyperphagia (p<0,01). Men showed more unhealthy eating styles than women with more hyperphagia and excessive nighttime meal. 31% of the patients reported binge, being more frequent in women (33,8%) than in men (p<0,01). Salty taste preference was associated with higher BMI values (BMI media=33,21, p<0,01). 49,27% of the sample preferred salty foods which resulted significantly more frequent in men (68,3%) than females (45,4%) (p<0,01). 55% preferred sweet foods, with gender differences (59% women, 34% men). We found a weak positive association (r =.13, p<,01) between BMI and perceived emotions with significant differences in the BMI values in relation to sadness ( BMI media=33,24 and anger (BMI media=33,18). Women (M=2.43; SD=1,55) tend to have more emotional eating (anxiety, sadness, fatigue and anger) than men. Conclusions: un healthy eating styles, salt taste preference and emotional eating are associated with increased BMI. Men tend to present less healthy eating habits and women higher intake related to perceived emotions.

Consumo de bebidas azucaradas en adolescentes escolarizados de la provincia de salta. Centro nacional de investigaciones nutricionales, 2014 / Sweetened beverages consumption in school adolescents in the province of salta. National centre of nutritional investigations, 2014

El consumo elevado de bebidas azucaradas se ha relacionado con mayor prevalencia de obesidad y hábitos de vida no saludables. Sus calorías, vacías de nutrientes, son elegidas por muchos consumidores, entre ellos adolescentes, constituyendo la mayor fuente de azúcares añadidos en sus dietas. La ingesta calórica resultante del consumo de estas bebidas es un factor que podría contribuir al aumento de peso entre los jóvenes. Objetivos: evaluar la prevalencia y asociación de factores nutricionales, socio-demográficos y hábitos de vida con consumo frecuente de bebidas azucaradas en adolescentes escolarizados de Salta (2008-2009). Metodología: estudio transversal. Muestreo probabilístico de escuelas de nivel medio. Valoración antropométrica, cuestionario de frecuencia de consumo de alimentos y hábitos de vida a adolescentes del último curso (16-20 años). Análisis estadístico: distribución de frecuencias, chi2. Regresión logística multivariada (OR, p< 0,05). SPSS19, EPI-INFO.Resultados: se evaluaron 659 adolescentes; 73,7% consumía bebidas azucaradas en forma frecuente (>3 veces/semana), 42,8% no realizaba actividad física. La prevalencia de sobrepeso/obesidad fue de 13,8 y 3,9 %. El consumo de bebidas azucaradas se asoció a familias de bajos ingresos (OR 1.63), al consumo frecuente de golosinas (OR 2.26) y la falta de actividad física (OR 2.24). No se asoció con el estado nutricional. Conclusiones: se observa consumo elevado de bebidas azucaradas, asociado a hábitos de vida no saludables y familias de bajos ingresos. Es imperativo aplicar estrategias de salud pública, como la educación sobre la ingesta de bebidas y su reemplazo por líquidos más saludables.

The high consumption of sweetened beverages has beenlinked to increased prevalence of obesity and unhealthy living habits. Their calories, nutrient de cient, are chosen by many consumers, including adolescents, constituting the largest source of added sugars in their diets. The resulting caloric intake from consumption of these drinks is a factor that may contribute to weight gain among young adults.Objective: to evaluate the prevalence and association of nutritional, socio- demographic and lifestyle factors with frequent consumption of sugar-sweetened beverages among adolescent students of the last course (2008-2009). Methods: cross-sectional study. Probability sampling of high schools. Anthropometric evaluation, frequency questionnaire and food consumption habits of last year teenagers (16-20 years). Statistical analysis: frequency distribution, chi2. Multivariate logistic regression (OR, p < 0,05).SPSS 19. EPIINFO. Results: 659 adolescents were evaluated, 73,7% consumed sugary drinks frequently (> 3times/week), 42,8% did not perform physical activity. The prevalence of overweight / obesity was 13,8% and 3,9%. Consumption of sweetened beverages was associated with low-income families (OR 1.63), frequent consumption of sweets (OR 2.26) and lack of physical activity (OR 2.24). It was not associated with the nutritional status. Conclusion: High consumption of sugar-sweetened beveragesis associated with unhealthy life habits and low-income families. It is imperative to implement public health strategies, such as education about beverage intake and replacing them with healthier liquids.

Opções terapêuticas no manejo do nevus congênito gigante, experiência do Serviço de Cirurgia Plástica e Reaparadora HC-UFPR / Therapeutic options in the management of giant congenital nevus: Experience of the Plastic and Reconstructing Service at Hospital de Clínicas, Federal University of Paraná

INTRODUÇÃO: O nevus congênito gigante (NCG) possui diversas modalidades de tratamento. A abordagem cirúrgica inclui a ressecção parcial seriada ou excisão total. Objetivo: Demonstrar as principais modalidades terapêuticas utilizadas para o tratamento do NCG e avaliar a incidência da localização, idade e tamanho destas lesões no Serviço de Cirurgia Plástica e Reparadora do Hospital de Clínicas da Universidade Federal do Paraná. MÉTODOS: Estudo retrospectivo dos pacientes submetidos a tratamento cirúrgico do NCG no período de janeiro de 2004 a janeiro de 2010. Foram coletados dados como: idade, gênero, tratamento realizado, número de cirurgias realizadas, evolução e complicações. RESULTADOS: Foram avaliados 11 pacientes, sendo 8 mulheres e 3 homens. A média de idade foi de 12,4 anos (3 a 25 anos). O subtipo mais encontrado foi o nevus melanocítico intradérmico correspondendo a 90,9% dos casos e 9,1% com nevus melanocítico composto. Não foram identificados casos de melanoma. A localização mais comum foi a região da cabeça e pescoço. O diâmetro médio das lesões foi de 9,1 cm.As técnicas utilizadas para reconstrução foram: sutura primária, retalhos locais, enxerto de pele e uso de expansores. No seguimento, 63,6% dos pacientes apresentavam ainda nevus residual, 27,3% apresentaram ressecção completa e 9,1% perderam seguimento. CONCLUSÃO: Foi observada maior incidência de NCG na faixa etária de 3 a 25 anos, sendo a localização mais comum na face e com tamanho médio de 9,1cm. O principal tratamento instituído para os pacientes com NCG foi a ressecção parcelada, com bons resultados.

INTRODUCTION: Several modalities are available for the treatment of giant congenital nevus (GCN). The surgical approach includes partial serial resection or total excision. Objective: To demonstrate the main therapeutic modalities in the treatment of GCN and to assess the incidence of location, age, and size of this lesion at the Plastic and Reconstructive Surgery Service of the Hospital de Clínicas, Federal University of Paraná. METHODS: This retrospective study included patients who had undergone surgical treatment for GCN between January 2004 and January 2010. We collected data such as age, sex, treatment performed, number of surgeries carried out, evolution, and complications. RESULTS: We evaluated 11 patients (8 female and 3 male). The average age was 12.4 years (range, 3-25 years). The GCN subtype most commonly found was intradermal melanocytic nevus, which accounted for 90.9% of cases, with melanocytic nevus accounting for the remaining 9.1%. No cases of melanoma were identified. The most common location was the head and neck. The average diameter of the lesions was 9.1 cm. The techniques used for the reconstruction included primary suture, local flaps, skin graft, and the use of expanders. In the follow-up period, 63.6% of the patients still presented a residual nevus, 27.3% underwent complete resection, and 9.1% were not monitored. CONCLUSION: A higher incidence of GCN was observed in patients aged 3-25 years. The most common location was the face, and the average size was 9.1 cm. The main treatment of patients with GCN was splitting resection, which resulted in satisfactory outcomes.

Conhecimento de mulheres sobre alguns aspectos do papiloma vírus humano / The knowledge of women on some aspects of human papillomavirus

Verificar o conhecimento de mulheres atendidas em dois ambulatórios de Ginecologia e Obstetrícia sobre o Papiloma Vírus Humano (HPV). Metodologia:foram utilizados dados secundários de um banco de dados eletrônico em que as informações foram coletadas por meio de um questionário no período de 2007 a 2012. Resultados: foram incluídas 1.470 mulheres com média de idade de 30,7 anos. Dentre as mulheres, 51,0% já haviam ouvido falar de HPV, porém, apenas 41,6% sabiam da transmissão sexual e 33,3% da relação do patógeno com o câncer de colo uterino. Conclusão: os dados permitiram concluir que o conhecimento sobre HPV é deficiente, necessitando desenvolvimento de ações educativas voltadas para a prevenção da infecção pelo HPV e seu agravamento...

The current study aimed to assess the knowledge of women seen in two outpatient clinic of gynecology and obstetrics about the Human Papilloma Virus (HPV). Methodology: using secondary data from an electronic database that information was collected through a questionnaire during the period from 2007 to 2012. Results: were included 1470 women with average age of 30.7 years. Among women, 51.0% had heard about HPV, but only 41.6% knew of its sexual transmission and 33.3% knew about the relation of the pathogen with cervical cancer. Conclusion: data allowed to conclude that knowledge about HPV is poor, requiring improvement of educational interventions for the prevention of HPV infection and its worsening...

Prevalencia de anemia y deficiencia de hierro, ácido fólico y vitamina b12 en una comunidad wichí del noroeste argentino / Prevalence of anemia and iron, folic acid and vitamin b12 deficiencies in a wichí community from the argentine northwest region

La anemia y la malnutrición son prevalentes en comunidades de bajo nivel socioeconómico y con higiene inadecuada, como las aborígenes wichí que habitan en el noroeste argentino, región con alta prevalencia de enfermedad de Chagas. Objetivo: determinar la prevalencia de anemia y deficiencia de hierro (Fe), ácido fólico (AF) y vitamina B12 (B12) en una comunidad wichí de Salta, y evaluar la presencia de Chagas y talasemias como etiología de anemia. Material y métodos: se realizó un estudio observacional descriptivo en mayo de 2008. Se estudiaron 35 adultos wichí (21 mujeres, 14 hombres) de la comunidad La Unión. El grupo control consistió en 36 criollos adultos (21 mujeres, 15 hombres). Se realizó hemograma, Fe, transferrina, ferritina, AF, B12, electroforesis de hemoglobina (EHb) y serología para Chagas. Resultados: la prevalencia de anemia fue 76% (16/21; Intervalo de Confianza [IC] 95%=57-95%) en las mujeres wichí; en las criollas, 29% (6/21; IC95%=10-48%); en el grupo masculino criollo, 7% (1/15; IC95%=0-20%) y en los wichís, 29% (4/14; IC95%=16-42%). En las mujeres wichí, el 75% (12/16) de los casos fue por deficiencia de Fe. B12 y EHb fueron normales. El 15% (5/33) del grupo wichí y el 31% (11/35) del criollo presentó deficiencia de AF. La prevalencia de Chagas fue 31% (11/35; IC95%=16-46%) en wichís y 28% (10/36; IC95%=13-43%) en criollos, y no estuvo asociada a anemia. Conclusiones: la alta prevalencia de anemia y deficiencia de hierro indican un problema de salud y de nutrición importante en esta comunidad.

Anemia and malnutrition are prevalent in communities of low socioeconomic status and poor hygiene, including Aboriginal Wichí inhabiting the Argentine Northwest, a region with high prevalence of Chagas disease. Objetive: to investigate the prevalence of anemia and deficiencies of iron, folic acid (FA) and vitamin B12 in community wichí of Salta, and assess the presence of Chagas and thalas semia as etiology of anemia. Material and methods: a descriptive study was performed in May 2008. 35 wichí adults (21 women, 14 men) of La Union community were studied. The control group consisted of 36 adult creoles (21 women, 15 men), who shared environmental conditions. Complete blood count, iron, transferrin, ferritin, FA, vitamin B12, hemoglobin electrophoresis (HbE) and Chagas disease serology were performed. Results: the prevalence of anemia was 76% (16/21 Confidence Interval [CI] 95%=57-95%) in wichí women; in creole women, 29% (6/21, 95% CI=10-48%); in creole male group, 7% (1/15, 95% CI=0-20%) and wichí men group, 29% (4/14, 95% CI=16-42%). In anemic wichí women, 75% (12/16) of cases were produced by iron deficiency. Vitamin B12 levels and HbE were normal. FA deficiency was presented in 15% (5/33) of wichí group and 31% (11/35) of creole people. Chagasic infection prevalence was 31% (11/35, 95% CI=16-46%) in wichís and 28% (10/36, 95% CI=13-43%) in creoles, and was not associated with anemia. Conclusions: the high prevalence of anemia and iron deficiency indicates an important health and nutrition problem in this community.

Estado nutricional antropométrico de los niños y adolescentes de 17 escuelas del área rural del municipio de La Mesa, Cundinamarca, Colombia, 2012 / Anthropometric nutritional status of children and adolescents from 17 schools in the rural area of the municipality of La Mesa, Cundinamarca, Colombia, 2012

Objetivo. Determinar el estado nutricional de los niños y adolescentes escolares de 17 escuelas del área rural del municipio de La Mesa, Cundinamarca, en 2012. Metodología. Se llevó a cabo un estudio observacional, descriptivo y transversal, en el cual se tomaron medidas antropométricas de peso y talla a 411 niños y adolescentes de 17 escuelas rurales del municipio de La Mesa, en el 2012. Se utilizaron los patrones de crecimiento de la Organización Mundial de la Salud para los niños y adolescentes de 0 a 18 años, adoptados por Colombia en la Resolución 2121 del 2010. Los indicadores utilizados fueron talla para la edad e índice de masa corporal. Se usaron los criterios de clasificación de acuerdo con los puntos de corte establecidos para el país en términos de desviación estándar. Resultados. La edad promedio fue de 8,4±2,2 años. Se encontró que la prevalencia de riesgo de talla baja para los escolares menores de 10 años fue de 29,2 %, y en los mayores de esta edad, de 31,4 %. El 59,1 % de los niños y adolescentes del estudio tenía una talla adecuada para la edad y el 10,7 % presentaba talla baja para la edad. En relación con el exceso de peso, el 11,4 % tuvo sobrepeso y el 1,9 % presentó obesidad. Conclusión. Se observó que el 25,2 % de la población escolar del área rural de La Mesa tenía algún compromiso nutricional en cuanto a baja talla para la edad, delgadez, sobrepeso y obesidad. Estos datos ratifican los resultados encontrados en la ENSIN 2010 y expresan problemas por deficiencia de talla para la edad, déficit o exceso de peso para la talla.

Objective. To identify the anthropometric nutritional status of children and adolescents from 17 schools in the rural area of the municipality of La Mesa, Cundinamarca, in 2012. Methodology. An observational descriptive study was conducted. Anthropometric measurements as weight and height were taken among to population of 411 children, coming from seventeen different schools of the municipality of La Mesa in 2012, using the growth patterns of the World Health Organization for children and adolescents from 5 to 18 years, adopted by Colombia in the Resolution 2121 of 2010. The indicators used were the height-for-age and the body mass index. Using the classification criteria according to breakpoint established for the country in terms of standard deviations. Results. The average age was 8.4±2.2 years. The prevalence of low height was 29.2% when they were under 10 years of age, and 31.4% in those over this age. The 59.1% of the children examined in this study had an adequate height for their age and 10.7% had low height for their age; 11.4% were overweight and 1.9% obese. It was observed that 25.2% of the school population in the rural area of La Mesa had a nutritional problem in terms of low height for age, thinness, overweight and obesity. Data confirmed the results found in 2010 ENSIN survey and showed deficiency problems in height for the age, and deficit or excess weight for the height.

Comparison between two methods for molecular characterization of human papillomavirus

A sensitive method of detection for Human Papillomavirus (HPV) is important to facilitate the early treatment of cervical cancer precursors.Objective: to analyze the spectrum of HPV infection and compare the sensibility of DNA HPV detection using polymerase chain reaction (PCR) and nestedPCR (nPCR) methods in a group of 251 women of Pelotas-RS. Methods: genomic DNA was extracted from the collected samples and was submitted toPCR methods with the primers MY09/11 and nPCR with the pair of primers MY09/MY11 and GP5+/6+. The results were applied to the softwares Epi-Info v.3.5.1* and STATA v.11 * for analyzes. Results: the prevalence of HPV infection was 6.8% with the use of primers MY09/11. When associated withprimers GP5/6, this result increased to 29.9% (p < 0.001). Conclusion: the increase founded in HPV DNA detection from 6.8 to 29.9% suggests that thetechnique of nPCR MY09/11 followed by GP5/6 is the most sensitive method to detect HPV DNA from cervical specimens.

Dependência nicotínica e razões para fumar em idosos institucionalizados / Nicotine dependence and reasons for smoking among institutionalized elderly

Objetivou-se verificar a dependência nicotínica e as razões para fumar em indivíduos idosos fumantes institucionalizados. Investigada a correlação entre o grau de dependência nicotínica e os aspectos motivadores da adição tabágica em indivíduos idosos institucionalizados. Foram estudados tabagistas com 60 anos ou mais de idade, internados em instituição de longa permanência no Distrito Federal. Estes indivíduos responderam às questões dos seguintes instrumentos: mini-exame do estado mental, questionário de tolerância nicotínica de Fagerstrõm e escala razão para fumar modificada. De 61 idosos institucionalizados, 20 eram fumantes (32,8%), sendo 4 mulheres e 16 homens, com idade variando de 60 a 89 anos. Com relação à distribuição da dependência nicotínica, notou-se predomínio da categoria grave (80,0%), havendo 10% na categoria leve e 10% na moderada. Entre os motivos para fumar, houve predomínio dos componentes prazer (4,4±0,7) e redução da tensão-relaxamento (4,4±0,8). A correlação entre dependência nicotínica e motivos para fumar mostrou-se significativa para os componentes hábito/ automatismo (p=0,0165) e manuseio (p=0,0079). Constatou-se que a maioria dos idosos tabagistas institucionalizados classificaram-se como dependentes graves à nicotina, sendo que os principais motivos para o fumo foram o prazer em fumar e a redução da tensão-relaxamento.

Objective: Verify the nicotine dependence and the reasons for smoking among the institutionalized elderly smoker. Method: We investigated the correlation between the degree of nicotine dependence and the motivating aspects of smoking addiction in the institutionalized elderly. We studied smokers with 60 years or older admitted to a long-term institution in the Federal District. These individuals answered the questions of the following instruments: Mini-mental examination, Fagerstrõm questionnaire for nicotine tolerance and the changed scale of reasons for smoking. Of the 61 institutionalized elderly, 20 were smokers (32,8%) (4 women and 16 men), aged 60 to 89 years. Results: Of the 61 institutionalized elderly, 20 were smokers (32,8%) (4 women and 16 men), aged 60 to 89 years. Regarding the distribution of nicotine addiction, we noted a predominance of the severe category (80,0%), with 10% in the light and 10% in the moderate category. Among the reasons for smoking, the predominant components were: pleasure (4,4 ± 0,7) and reduction of the tension-relaxation (4,4 ± 0,8). The correlation between nicotine dependence and reasons for smoking was significant for the components habit / automatism (p = 0,0165) and handling (p = 0,0079). Conclusion: In this study, it was observed that most elderly participants were classified as severe nicotine dependent, and the main reasons for smoking are the pleasure in smoking and the reducing of stress-relaxation.

Avaliação dos programas de residência médica em Cirurgia Plástica no Distrito Federal / Evaluation of plastic surgery residency programs in Distrito Federal

INTRODUÇÃO: A residência médica é um passo importante no treinamento dos médicos residentes de Cirurgia Plástica no Brasil; entretanto, são poucos os estudos que avaliam os programas de residência sob o ponto de vista qualitativo. Assim, este artigo objetiva realizar pesquisa qualitativa dos programas de residência médica dos serviços credenciados da Sociedade Brasileira de Cirurgia Plástica no Distrito Federal. MÉTODO: Foi realizado estudo transversal, com a aplicação de questionário individual estruturado, autoaplicado aos residentes em treinamento nos serviços credenciados do Distrito Federal, no ano de 2012. RESULTADOS: Dezoito médicos residentes, com idade entre 25 anos e 52 anos, 13 (72,2%) homens e 5 (27,8%) mulheres, concordaram em participar da pesquisa. Desses, 61,1% relataram que o hospital dispunha de serviços complementares necessários ao atendimento ininterrupto dos pacientes e aos requisitos mínimos do programa, 66,7% consideraram que o acervo bibliográfico era parcialmente adequado ou inadequado, e 72,2% referiram ter 2 ou mais horas de reuniões científicas semanais. A participação em 5 a 10 cirurgias por semana foi reportada por 88,8% dos participantes; a maioria dos residentes afirmou participar de até 4 horas/semana como cirurgião e de 11 a 20 horas/semana como auxiliar. A maioria (66,7%) dos residentes já havia realizado apresentações em eventos científicos e 72,2% não tinham artigos publicados na Revista Brasileira de Cirurgia Plástica. Com relação à carga horária do programa de residência, 80% eram destinados a atividades em ambulatório, enfermaria e centro cirúrgico e 20%, a atividades teóricas. Dentre as sugestões de melhoria dos programas de residência médica, foram apontados, principalmente, a necessidade de aumentar a abrangência e o intercâmbio entre os serviços e o incentivo à produção científica. CONCLUSÕES: A percepção dos residentes em cirurgia plástica dos serviços credenciados do Distrito Federal foi positiva no que se refere a grade curricular do programa, estrutura para atendimento e desempenho da preceptoria. Quanto aos pontos negativos, foram apontados abrangência e distribuição da grade curricular, falta de atendimento de emergência, menor treinamento em procedimentos de natureza reparadora e reduzido em estágios de outras áreas, além de acervo bibliográfico insatisfatório e pouco incentivo à pesquisa. Dentre as sugestões de melhoria dos programas de residência médica, foram apontados, principalmente, a necessidade de aumentar a abrangência e o intercâmbio entre os serviços e o incentivo à produção científica.

INTRODUCTION: The residency period is an important step in the medical training of plastic surgeons in Brazil. However, there are few qualitative studies about the existing residency programs. Thus, the aim of this study was to conduct a qualitative research of the medical residency programs of the accredited services of the Brazilian Society of Plastic Surgery in Distrito Federal. METHODS: This cross-sectional study was performed through individual structured questionnaires, which were self-administered by residents training in the accredited services of Distrito Federal, in 2012. RESULTS: Eighteen residents (age range, 25-52 years; 13 [72.2%] men and 5 [27.8%] women) agreed to participate. Of them, 61.1% reported that the hospital had complementary services necessary to meet patients' continuous care and the minimum requirements of the program, 66.7% thought that the bibliographic archive was only partially adequate or inadequate, and 72.2% reported to participate in 2 or more hours of weekly scientific meetings. Participation in 5 to 10 surgeries per week was reported by 88.8% of participants. Most residents said that they participate for up to 4 hours/week as a surgeon and 11-20 hours/week as an assistant. Most (66.7%) of residents had made presentations at scientific meetings, and 72.2% had no articles published in the Brazilian Journal of Plastic Surgery. With respect to the workload of the residency program, 80% were assigned to outpatient, infirmary, and surgical center activities, and 20% were assigned to theoretical activities. Among the suggestions mentioned to improve the medical residency programs were the need to increase the scope and the interchange between services, as well as the encouragement of scientific research output. CONCLUSIONS: The perception of plastic surgery residents in the accredited services of Distrito Federal, about the curriculum, program structure and teaching performance, was positive. The negative aspects mentioned were the range and distribution of the curriculum, lack of emergency care, inadequate training in reconstructive procedures, and compact training in other areas, as well as an unsatisfactory bibliographic archive and lack of incentive for researchers. Among the suggestions especially mentioned for the improvement of the medical residency programs were the need to increase the scope and the exchange between services, as well as the encouragement of scientific research output.

Percepción de profesionales de la salud sobre las funciones esenciales de salud pública / Perception of health professionals on essential public health functions

Pregunta de investigación: ¿Cual es el cumplimiento de las funciones esenciales de salud pública por el Ministerio de Salud y Deportes?. Objetivo: Medir la opinión de profesionales de la salud sobre el grado de desarrollo de las funciones esenciales de salud pública como responsabilidades del Ministerio de Salud y Deportes. Diseño: Estudio de opiníon, exploratorio, transversal y descriptivo. Método: Encuesta anónima y autoadministrada. Resultados: El valor promedio asignado a cada función esencial está alrededor de 5 sobre 10 puntos, que indica un desempeño regular.