Spatial Owner-Dog Seroprevalence of Leptospira spp. Antibodies in Oceanic Islands and Costal Mainland of Southern Brazil.

Leptospirosis has been described as a disease neglected worldwide. Affecting humans and animals, the disease is often related to poor environmental conditions such as lack of sanitation and presence of synanthropic rodents. Despite being considered as a One Health issue, no study has focused on comparing owner-dog seroprevalence between islands and seashore mainland. Accordingly, the present study assessed anti-Leptospira spp. antibodies by applying microscopic agglutination test (MAT) methods to Leptospira and assessing associated risk factors via univariate and multivariate logistic regression analysis of owners and their dogs in islands and seashore mainland of southern Brazil. No anti-Leptospira spp. Seropositivity was found in 330 owner serum samples, while dogs presented an overall seroprevalence of 5.9%. All seropositive dogs reacted to serogroups of Leptospira interrogans, including 66.7% of Pyrogenes, 44.4% Canicola, 22.2% Icterohaemorrhagiae, 16.7% Australis; six reacted to more than one serogroup. No association was found among seropositivity and epidemiological variables, except that neighborhood dogs were less likely to be seropositive. Although no seropositivity was observed in owners, seropositivity in dogs had the potential to indicate such species as being sentinels for environmental exposure and potential human risk of infection.

Prevenção do câncer de mamas e colo uterino na perspectiva de mulheres: implicações para o serviço / Prevention of breast and cervix cancer in theperspective of women: implications for service

Estudo exploratório com objetivo de descrever os fatores que influenciam na realização do exame Papanicolaou na opinião de mulheres e suas implicações para o serviço. Participaram 300 mulheres sexualmente ativas, selecionadasaleatoriamente, através dos prontuários. Os dados foram coletados por meio de um questionário. Utilizou-se o aplicativoExcell para construção dos bancos de dados, organização de tabelas e gráficos e cálculo das porcentagens pelo SPSS. Oprojeto foi aprovado pelo Comitê de Ética em Pesquisas envolvendo seres humanos do Hospital Universitário Júlio Muller. Os resultados mostraram que 28% estavam com o Papanicolaou atrasado há mais de 3 anos. Entre os motivos da não realização destacaram-se: vergonha 17(44,7%), desconhecimento da importância e deixa para depois 8(20%). A conclusão do estudo permitiu destacar que é fundamental os profissionais de saúde conhecerem os motivos que levam as mulheres a não realização da prevenção do câncer de colo uterino, no sentido de acolherem-nas de modo que essa prevenção seja importante na vida de cada uma delas e, desse modo as contribuições na redução da mortalidade por câncer de colouterino...

Exploratory study aims to describe the factors that influence the realization of the Pap smear in the opinion of women and their implications for the exam. The participants were 300 women, randomly selected. Data were collected through a questionnaire. Excel was used for the construction of databases, organizational charts and graphs, and calculation of percentages by SPSS. The project was approved by the Ethics in Research involving humans at the Julio Muller University Hospital. The results showed that 28% had the Pap delayed for more than 3 years. The reasons for non-completionincluded: shame (17 - 44.7%); unawareness of the importance, leaving it for later (8 - 20%). The conclusions drawn from the study highlight that it is essential for health care professionals to know the reasons why women miss the prevention of cervical cancer, in the sense of welcoming them so that prevention is important in their life, and in this way contribute for the reduction of deaths caused bycervical cancer...

Estudio exploratorio tiene como objetivo describir los factores que influyen en la realización del examen Papanicolaou enla opinión de las mujeres y sus implicaciones para el servicio. Participaron 300 mujeres sexualmente activas, seleccionadas al azar. Los datos fueron recolectados a través de un cuestionario. Se utilizo el Programa Excell para la construcción de las bases de datos, organización de tablas y gráficos y cálculo de porcentajes por SPSS. El proyecto fue aprobado por el Comité de Ética en Investigaciones con seres humanos del Hospital Universitario Julio Muller. Losresultados mostraron que el 28% tenían Papanicolaou retrasado a más de 3 años. Las razones por las cuales eso sucedía incluyen: vergüenza 17 (44,7%) y la falta de conciencia de la importancia (20%). La conclusión del estudio ha puesto desafíos hacia a los profesionales de salud, conocer las razones por las cuales las mujeres no buscan la prevención delcáncer, y de esta forma contribuir en la reducción de la mortalidad por cáncer en las mujeres...

Implications of literacy for health for body mass index.

INTRODUCTION: Literacy for health (LH) may be considered a set of skills that people appropriate, understand, evaluate and use information and knowledge of health to make informed choices, reduce risks to their health, maintain a healthy nutritional status and enhance quality of life. OBJECTIVES: To assess the level of literacy for health; analyse the relationship of socio-demographic variables with LH; to classify the Body Mass Index (BMI) and to determine the effect of LH on BMI. DESIGN: a quantitative study with a descriptive and cross-sectional approach conducted in the centre and north of Portugal. Particnipants: a non-probabilistic sample of 508 Portuguese participants with a mean age 44.48 years (SD = 21 years). MEASURING INSTRUMENTS: LH was assessed by the European Questionnaire on Literacy for Health (LHS-EU-PT) validated in Portuguese by Saboga-Nunes and Sorensen (2013) and BMI classification followed the WHO reference accepted by Portugal, DGS (2013). RESULTS: It was found that overall, 73.62% of the participants have an inappropriate and problematic level of literacy for health; this was significantly lower in women (P=.000). Participants with inadequate LH, are those with higher BMI (χ(2)=78.09; P=.000), so are at risk of a sub-optimal state of health. CONCLUSIONS: The results suggest a significant relationship between the LH and BMI. It is found that, the better the LH, the more appropriate is the BMI. This evidence reinforces the importance of promoting literacy for health to the Portuguese population.

Implications of literacy for health for body mass index

INTRODUCTION: Literacy for health (LH) may be considered a set of skills that people appropriate, understand, evaluate and use information and knowledge of health to make informed choices, reduce risks to their health, maintain a healthy nutritional status and enhance quality of life. OBJECTIVES: To assess the level of literacy for health; analyse the relationship of sociodemographic variables with LH; to classify the Body Mass Index (BMI) and to determine the effect of LH on BMI. DESIGN: a quantitative study with a descriptive and cross-sectional approach conducted in the centre and north of Portugal. Particnipants: a non-probabilistic sample of 508 Portuguese participants with a mean age 44.48 years (SD = 21 years). Measuring instruments: LH was assessed by the European Questionnaire on Literacy for Health (LHS-EU-PT) validated in Portuguese by Saboga-Nunes and Sorensen (2013) and BMI classiÀ cation followed the WHO reference accepted by Portugal, DGS (2013). RESULTS: It was found that overall, 73.62% of the participants have an inappropriate and problematic level of literacy for health; this was significantly lower in women (P = .000). Participants with inadequate LH, are those with higher BMI (x2 = 78.09; P = .000), so are at risk of a sub-optimal state of health. CONCLUSIONS: The results suggest a signiÀ cant relationship between the LH and BMI. It is found that, the better the LH, the more appropriate is the BMI. This evidence reinforces the importance of promoting literacy for health to the Portuguese population

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Análisis del registro de la atención inicial al paciente con trauma grave / Analysis of the registry of the initial care given to the patient with severe trauma

Objetivo: analizar el cumplimiento del registro de atención inicial al paciente con trauma grave en la Unidad de Cuidados Intensivos de trauma y emergencias del Hospital 12 de Octubre de Madrid. Material y método: estudio descriptivo sobre los registros de atención inicial al paciente con trauma grave (RAIT), basados en la metodología Advanced Trauma Life Support. Se diseñaron 10 variables principales (VP): para evaluar el cumplimiento: demográfica, clínica, constantes atención inicial, constantes traslado intrahospitalario, constantes pruebas diagnósticas extra-unidad,equilibrio hídrico, atención prehospitalaria, atención en la unidad, pruebas diagnósticas-analíticas, equipo de atención. El nivel de cumplimentación total se relacionó con el Injurity Severity Score (ISS), turno y cambio-turno. Se realizó un análisis descriptivo de las variables y se utilizó el test de Kruskall-Wallis par el análisis bivariante. Resultados: se analizaron los registros del 331 pacientes. La cumplimentación total media fue 49,5%. No se daban diferencias significativas entre la cumplimentación total, ISS, turno y cambio-turno. El registro de VP: demográfica82,18%, clínica 3,63%, constantes en la atención inicial 44,4%, constantesy pruebas diagnósticas extra-unidad 16,9%, equilibrio hídrico 0,9%,ningún registro de constantes durante el traslado intrahospitalario, atención prehospitalaria 68,9%, atención en la unidad 91,8%, pruebas diagnósticas-analíticas95%, equipo de atención 90,3%.Conclusión: es necesario mejorar la cumplimentación del RAIT. Se detectan áreas de mejora como el incremento del registro de constantes atención inicial (temperatura), constantes pruebas diagnósticas extra-unidad, equilibriohídrico (pérdidas hemáticas) y grupo sanguíneo, por la importancia en el manejo del paciente con trauma grave (AU)

Objective: to analyse compliance with the registry of the initial care given to the patient with severe trauma at the Trauma and Emergency Intensive Care Unit of the Hospital 12 de Octubre in Madrid.Material and method: descriptive study of the registry of the initial caregiven to the patient with severe trauma (RAIT), based on the Advanced Trauma Life Support. 10 primary variables (PV) were designed (VP) to assess compliance:demographic, symptoms, initial care vital signs, vital signs during intrahospital transfer, diagnostic test outside the unit vital signs, water balance, prehospital care, care at the unit, diagnostic tests-laboratory work,care team. The level of total compliance was related to the Injury Severity Score(ISS), shift and shift-change. A descriptive analysis of the variables was carried and the Kruskall-Wallis test was used for bivariate analysis.Results: the registries of 331 patients were reviewed. Mean total compliancerate was 49,5%. No significant differences were found between total compliance, ISS, shift and shift-change. The registry of PV: demographic 82,18%, symptoms 3,63%, vital signs on initial care 44,4%, vital signs and diagnostic tests outside the unit 16,9%, water balance 0,9%, no recording of vital signs during intrahospital transfer, prehospital care 68,9%, care given at the unit 91,8%, diagnostic tests-laboratory work 95%, care team 90,3%.Conclusion: it is necessary to improve compliance with the RAIT protocol.Areas in need of improvement are detected such as increased recordings in the registry of vital signs at initial care (temperature), increased recordings of vital signs during diagnostic tests/laboratory work and increased recording of water balance (blood loss) and blood type, given the importance that these data have in the management of patients with severe trauma (AU)

Epidemiological pattern of tattoo skin disease: a potential general health indicator for cetaceans.

The presence of tattoo skin disease (TSD) was examined in 1392 free-ranging and dead odontocetes comprising 17 species from the Americas, Europe, South Africa, New Zealand and Greenland. We investigated whether TSD prevalence varied with sex, age and health status. TSD was encountered in cetaceans from the Pacific and Atlantic Oceans as well as in those from the North, Mediterranean and Tasman Seas. No clear patterns related to geography and host phylogeny were detected, except that prevalence of TSD in juveniles and, in 2 species (dusky dolphin Lagenorhynchus obscurus and Burmeister's porpoise Phocoena spinipinnis), in adults was remarkably high in samples from Peru. Environmental factors and virus properties may be responsible for this finding. Sex did not significantly influence TSD prevalence except in the case of Peruvian P. spinipinnis. Generally, there was a pattern of TSD increase in juveniles compared to calves, attributed to the loss of maternal immunity. Also, in most samples, juveniles seemed to have a higher probability of suffering TSD than adults, presumably because more adults had acquired active immunity following infection. This holo-endemic pattern was inverted in poor health short-beaked common dolphins Delphinus delphis and harbour porpoises Phocoena phocoena from the British Isles, and in Chilean dolphins Cephalorhynchus eutropia from Patagonia, where adults showed a higher TSD prevalence than juveniles. Very large tattoos were seen in some adult odontocetes from the SE Pacific, NE Atlantic and Portugal's Sado Estuary, which suggest impaired immune response. The epidemiological pattern of TSD may be an indicator of cetacean population health.

Calidad de vida a largo plazo después de un traumatismo craneoencefálico / Long term quality of life following cranioencephalic traumatism (head injury)

La Calidad de Vida (CV), posterior a un proceso patológico, ha sido reconocida en las últimas décadas como un importante indicador de la asistencia sanitaria. El objetivo de este estudio fue determinar la CV a largo plazo de los pacientes ingresados en una Unidad de Cuidados Intensivos con Traumatismo Craneoencefálico Grave (TCG).Material y método: utilizamos la encuesta MOS 36- ítem Short-Form Health Survey (SF-36) en su versión española, a la que se asoció el Índice de Katz. Incluimos a 78 pacientes con TCG al ingreso, domicilio español, e ingresados desde enero del año 2000 hasta diciembre de 2002. Resultados: 56 pacientes cumplimentaron la encuesta, el 82,2% de ellos con índice de Katz grado A. El dominio de mayor puntuación de la CV fue la Función Social (76,6± 25,8) y el de menor fue el Rol Emocional (64,9±41,2). Todos los valores fueron menores que los obtenidos en la población general española. Conclusiones: las secuelas que produce el TCG a largo plazo condicionan una CV inferior a la media de la población general y recomendamos que debieran plantearse futuros trabajos con instrumentos específicos de medición de la CV para el TCG

The Quality of Life (QL) following a head injury has been recognised in the last decades as an important indicator of healthcare. The objective of this study was to determine the long-term QL in patients admitted in the ICU with severe head injury.Material and method: the Spanish version of MOS 36 Short Form Health Survey (SF-36) was used in conjunction with Katz´s index to survey health status. 78 patients diagnosed with severe head trauma at admission, domiciled in Spain and admitted from 2000 to December 2002, were included in the study.Results: 56 patients completed the survey, in 82,2% of them Katz´s index was grade A. The domain with the highest score for QL was Social Function (76,6±25,8) and the lowest was Emotional Role (64,9±41,2). All values attained were lower than those obtained in the Spanish general population. Conclusions: sequelae from sustaining a major head injury limit long-term QL, shown to be inferior to that of the general population. Hence we recommend that further work is carried out using specific measurement instruments for QF in severe head injury (AU)

Epidemiology of tattoo skin disease in bottlenose dolphins Tursiops truncatus from the Sado estuary, Portugal.

We report on the epidemiology of tattoo disease in a community of bottlenose dolphins Tursiops truncatus from the Sado estuary, Portugal. The presence of tattoos (T++) and tattoo-like (T+) lesions was examined in 586 photographic records of 35 dolphins taken from 1994 to 1997. Images were rated into 3 categories: good (GI), average (AI) and poor (PI). Dolphins positive for T++ lesions were observed in 19 GI. Dolphins with T+ lesions were seen in 39 GI, 23 AI and 6 PI. For statistical analysis the dolphins were divided into 2 age classes (immature and adult) and the data grouped into 2 periods (1994-1995 and 1996-1997). Minimum prevalence of T++ lesions in 32 dolphins was 21.9% in 1994-1995 and 15.6% in 1996-1997. Variation in prevalence of tattoo disease between the 2 age classes was examined for each period, excluding animals with T+ lesions or considering them either positive or negative for tattoos. Prevalence of the disease was significantly higher in immature dolphins than in adults during both periods, except in the first one when T+ lesions were considered as true tattoos. Temporal variation in prevalence of tattoo disease was examined in 23 adults. Prevalence was significantly higher in 1994-1995 (39.1%) than in 1996-1997 (17.4%). Differences in the number and quality of pictures did not cause significant biases that could have favoured the detection of lesions between age classes or periods. Minimal persistence of the disease ranged between 3 and 45.5 mo. The lesions converted into light grey marks when healing, but may recur. The presence of very large lesions in 2 adult dolphins affected for years may be related to the contamination of the estuary. The high prevalence of the disease, its long persistence, as well as higher frequency in immature individuals, suggest that it is endemic in bottlenose dolphins from the Sado estuary. The contribution of tattoo disease to the decline of this community should be investigated. Three of the 5 dolphins that died during this study had T++ and T+ lesions.