Epidemiology of Syphilis in Pregnancy and Congenital Syphilis in Brazil and the Risk or Associated Factors: Protocol for a Systematic Review.

BACKGROUND: Syphilis in pregnancy and congenital syphilis are growing public health issues worldwide. Several factors can influence their occurrence in the population. Therefore, understanding the epidemiology of this condition and the factors that influence its occurrence is fundamental for decision-making by clinicians and health managers. However, so far, no systematic review has summarized and analyzed data on the incidence, prevalence, and predictors of these diseases in Brazilian cities, considering different sociocultural, demographic, economic, sanitary, and spatial-temporal characteristics presented across locations. OBJECTIVE: We propose a systematic review protocol to gather and analyze data on the incidence, prevalence, and risk or associated factors of syphilis in pregnancy and congenital syphilis in Brazil, taking into account different local or regional contexts. METHODS: Searches will be conducted in CINAHL, MEDLINE, LILACS, Embase, and Web of Science databases. We will include observational studies (ie, cross-sectional, longitudinal, or case-control studies), analyzing the incidence, prevalence, and risk or associated factors of syphilis in pregnancy and congenital syphilis in Brazil from primary data. The diagnosed syphilis will be assessed based on direct pathogen detection tests or through immunological, treponemal or nontreponemal tests, following Brazilian protocols for diagnosing syphilis. The studies are currently undergoing screening in the databases, and after this step, 2 reviewers will perform all identified documents. The Newcastle-Ottawa Scale and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) system will be used to assess methodological quality and quality of evidence of studies, respectively. The Kappa coefficient will assess the agreement between researchers in each study stage. Cochran Q test will assess the heterogeneity among studies. Then, a random-effects meta-analysis will be performed. RESULTS: Results will be discussed based on subgroup analysis, which is as follows: (1) type of syphilis (in pregnancy or congenital), (2) type of study (case-control and cross-sectional studies for analysis of associated factors and longitudinal studies for risk factors), and (3) contextual factors (ie, region of country, socioeconomic and demographic characteristics, and year of study). This systematic review is expected to be completed by December 2023, and our results will be disseminated through publication in peer-reviewed journals and scientific events. CONCLUSIONS: This systematic review aims to assist health care managers and professionals in their decision-making to control these diseases in Brazil, considering location heterogeneity. Furthermore, countries with health systems and demographic and socioeconomic contexts similar to those of Brazil may benefit from this information. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50702.

Spatial Distribution of Gestational Syphilis in Brazil: Socioeconomic and Health Services Inequalities.

We aimed to analyze the spatial distribution of gestational syphilis from 2008 to 2018 in Brazil and identify correlations with socioeconomic and health-care aspects. This ecological study used municipalities of Brazil as the unit of analysis. Data collection took place between June and July 2021. Data were extracted for 2008 to 2018, and information on the epidemic in animals in the country was obtained from data records. The gestational syphilis detection rate was the dependent variable, and the independent variables were the Municipal Human Development Index, the proportion of doctors per inhabitant in primary health care (PHC), and the percentage of PHC coverage. The data went through an aggregation process in 482 immediate regions of urban articulation. The global Moran's I index and the local spatial correlation indicator detected territorial clusters using GeoDa software. The gestational syphilis detection rate was distributed unevenly in the immediate regions of urban articulation between 2008 and 2018, and presented a negative spatial correlation with the Municipal Human Development Index (Moran's I = -0.243, P ≤ 0.05), the percentage of PHC coverage (Moran's I = -0.163, P ≤ 0.05), and the proportion of doctors per inhabitants in PHC (Moran's I = -0.164, P ≤ 0.05). Socioeconomic inequalities, mainly related to the availability of human resources and access to health services, are correlated with the spatial distribution of gestational syphilis in Brazil. Investments in social policies and strengthening of PHC are essential for controlling gestational syphilis.

Temporal trend and factors associated with spatial distribution of congenital syphilis in Brazil: An ecological study.

Objective: The study aimed to analyze the temporal trend of congenital syphilis in Brazil in the period from 2008 to 2018 and its spatial distribution in the Immediate Regions of Urban Articulation, and to identify spatial correlations with socioeconomic factors and prenatal care. Methods: Spatial correlations between the incidence of congenital syphilis and socioeconomic conditions and access to prenatal care were assessed. This ecological study conducted a time series analysis in Brazil and spatial analysis in 482 Immediate Regions of Urban Articulation. Cases of congenital syphilis reported in the Notifiable Diseases Information System and the Live Birth Information System from January 1, 2008, to December 31, 2018 were included. Socioeconomic conditions (percentage of individuals with inadequate water supply and sanitation) were extracted from the 2010 census, whereas the Live Birth Information System provided data on access to prenatal care (percentage of live births with 1-3 prenatal care appointments). The Joinpoint Regression software performed the temporal trend analysis, while the GeoDa software assessed territorial clusters using the Moran's I and Local Spatial Association Indicator. Results: The incidence of congenital syphilis showed an upward trend (annual percent change 1 = 26.96; 95% CI: 18.2-36.3; annual percent change 2 = 10.25; 95% CI: 2.7-28.4) and was unevenly distributed across Immediate Regions of Urban Articulation in Brazil (Moran's I = 0.264, p ≤ 0.05). It also presented a direct spatial correlation with the percentage of individuals with inadequate water supply and sanitation (Moran's I = 0.02, p ≤ 0.05) and the percentage of live births with 1-3 prenatal care appointments (Moran's I = 0.03, p ≤ 0.05). Conclusion: Agrowth trend of congenital syphilis in Brazil was observed between 2008 and 2018. Moreover, inequalities in socioeconomic conditions and access to prenatal care influenced the spatial distribution of this disease.

The Use of Spatial Analysis in Syphilis-Related Research: Protocol for a Scoping Review.

BACKGROUND: Latin America, Africa, and Asia have high incidences of syphilis. New approaches are needed to understand and reduce disease transmissibility. In health care, spatial analysis is important to map diseases and understand their epidemiologic aspects. OBJECTIVE: The proposed scoping review will identify and map the use of spatial analysis as a tool for syphilis-related research in health care. METHODS: This protocol was based on the Joanna Briggs Institute manual, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We will conduct searches in Embase; Lilacs, via the Virtual Health Library (Biblioteca Virtual en Salud; BVS), in Portuguese and English; Medline/PubMed; Web of Science; Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. Gray literature will be searched for in Google Scholar, the Digital Library of Theses and Dissertations, the Catalog of Theses and Dissertations of the Coordination of Improvement of Higher Education Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; CAPES), Open Access Theses and Dissertations, ProQuest Dissertations and Theses Global, and the Networked Digital Library of Theses and Dissertations. The main research question is "How has spatial analysis been used in syphilis-related research in health care?" Studies are included if they have the full text available, address syphilis, and use geographic information systems software and spatial analysis techniques, regardless of sample characteristics or size. Studies published as research articles, theses, dissertations, and government documents will also be considered, with no location, time, or language restrictions. Data will be extracted using a spreadsheet adapted from the Joanna Briggs Institute. Quantitative and qualitative data will be analyzed using descriptive statistics and a thematic analysis, respectively. RESULTS: The results will be presented according to the PRISMA-ScR guidelines and will summarize the use of spatial analysis in syphilis-related research in health care in countries with different contexts, factors associated with spatial cluster formation, population health impacts, contributions to health systems, challenges, limitations, and possible research gaps. The results will guide future research and may be useful for health and safety professionals, managers, public policy makers, the general population, the academic community, and health professionals who work directly with people with syphilis. Data collection is projected to start in June 2023 and end in July 2023. Data analysis is scheduled to take place in August and September 2023. We expect to publish results in the final months of 2023. CONCLUSIONS: The review may reveal where syphilis incidence has the highest incidence, which countries most use spatial analysis to study syphilis, and whether spatial analysis is applicable to syphilis in each continent, thereby contributing to discussion and knowledge dissemination on the use of spatial analysis as a tool for syphilis-related research in health care. TRIAL REGISTRATION: Open Science Framework CNVXE; https://osf.io/cnvxe. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/43243.

Temporal Trend of Gestational Syphilis between 2008 and 2018 in Brazil: Association with Socioeconomic and Health Care Factors.

The increased number of cases in recent years has turned syphilis into a global public health problem. In 2020, 115,371 cases of acquired syphilis were reported (detection rate of 54.5 cases/100,000 inhabitants) in Brazil. In that same period, the country notified 61,441 cases of gestational syphilis (detection rate of 21.6 per 1000 live births). The number of syphilis cases points to the need to reinforce surveillance, prevention, and infection control actions, which is a worrying scenario for government organizations. This study aims to describe the temporal trend of gestational syphilis from 2008 to 2018 in Brazilian regions and to associate its detection rate with socioeconomic and health care indicators. We conducted an ecological study of temporal trends using secondary data from the Department of Informatics of the Unified Health System. The temporal trend was analyzed using the Joinpoint Regression program. The annual percent change (APC) and 95% confidence intervals (95%CI) were estimated and tested; statistical significance was assessed using the Monte Carlo permutation test. Correlations were assessed using Pearson's correlation coefficient, and statistical significance was calculated using Pearson's product-moment correlation. The gestational syphilis detection rate increased between 2008 and 2018. The South region showed the greatest trend, whereas the Midwest region presented the lowest trend. The following variables were significantly correlated with the gestational syphilis detection rate: Municipal Human Development Index, illiteracy rate, percentage of primary health care coverage, and proportion of doctors, nurses, and basic health units per inhabitant. Health policies are needed to mitigate social vulnerabilities and strengthen primary health care.

Exploring patient experiences of participating in a real and sham dry cupping intervention for nonspecific low back pain: A qualitative study.

BACKGROUND: The current quality of evidence supporting dry cupping for individuals with chronic low back pain (CLBP) is low and suggests that nonspecific factors impact experiences reported by patients. Therefore, this study assessed the impacts of social and professional support on the experience of individuals with CLBP treated with dry cupping or sham. METHOD: This is an observational study with qualitative approach. Twenty-four individuals with CLBP who received dry cupping or sham in a previous clinical trial were invited. Data was collected using a semi-structured interview conducted by a trained researcher. Content analysis was used to analyze experiences, systematic procedures, and description of the content of messages. The dimensions of "pain", "general perceptions", and "perceived social and professional support" guided the analysis. RESULTS: Answers of both groups converged on similar perceptions, especially regarding pain. Physical condition was the most fragile aspect. We also observed an influence of perceived social and professional support on painful symptoms. Thus, the experience of individuals with CLBP treated with dry cupping or sham indicated that factors related to social and professional support impacted results. CONCLUSIONS: We observed that individuals with CLBP reported similar perceptions of the effects of dry cupping or sham treatment, indicating that contextual factors may influence the perception of these individuals regarding the treatment received.

Dry cupping therapy is not superior to sham cupping to improve clinical outcomes in people with non-specific chronic low back pain: a randomised trial.

QUESTION: What are the effects of dry cupping on pain intensity, physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms and medication use in individuals with chronic non-specific low back pain? DESIGN: Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinding of participants and assessors. PARTICIPANTS: Ninety participants with chronic non-specific low back pain. INTERVENTIONS: The experimental group (n = 45) received dry cupping therapy, with cups bilaterally positioned parallel to the L1 to L5 vertebrae. The control group (n = 45) received sham cupping therapy. The interventions were applied once a week for 8 weeks. OUTCOME MEASURES: Participants were assessed before and after the first treatment session, and after 4 and 8 weeks of intervention. The primary outcome was pain intensity, measured with the numerical pain scale at rest, during fast walking and during trunk flexion. Secondary outcomes were physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms and medication use. RESULTS: On a 0-to-10 scale, the between-group difference in pain severity at rest was negligible: MD 0.0 (95% CI -0.9 to 1.0) immediately after the first treatment, 0.4 (95% CI -0.5 to 1.5) at 4 weeks and 0.6 (95% CI -0.4 to 1.6) at 8 weeks. Similar negligible effects were observed on pain severity during fast walking or trunk flexion. Negligible effects were also found on physical function, functional mobility and perceived overall effect, where mean estimates and their confidence intervals all excluded worthwhile effects. No worthwhile benefits could be confirmed for any of the remaining secondary outcomes. CONCLUSION: Dry cupping therapy was not superior to sham cupping for improving pain, physical function, mobility, quality of life, psychological symptoms or medication use in people with non-specific chronic low back pain. PROTOCOL REGISTRATION NUMBER: NCT03909672.

Does current evidence support the use of kinesiology taping in people with knee osteoarthritis?

OBJECTIVE: To analyze the current evidence about the effects of kinesiology taping (KT) with different amounts of tension in people with knee osteoarthritis (OA). DATA SOURCES: MEDLINE (via PUBMED), SciELO, COCHRANE Library, Scopus, PEDro, Web of Science and EMBASE were used as search databases. STUDY SELECTION: Two independent researchers searched these databases from inception until June 2020 using the descriptors "kinesiotaping", "kinesio taping", "kinesiotape", "tape", "taping", "kinesiology taping", "kinesiology tape", "kinesthetic taping" or "elastic therapeutic tape" associated with "knee osteoarthritis". We included clinical trials that compared the application of KT with and without tension in people with knee OA. DATE EXTRACTION AND QUALITY ANALYSIS: Data extraction included sample description, KT tension used in the study groups, duration of KT application, area of KT application, outcome measures and study methodological quality. The quality of the studies was evaluated by means of the Physiotherapy Evidence Database (PEDro) score. DATA SYNTHESIS: Of the 850 studies identified, eight met the inclusion criteria and were ultimately included in this review. Most studies had moderate quality, with a satisfactory PEDro score. Results showed that KT application with tension was not superior to the application without tension for the outcomes of pain, physical function, range of motion and muscle strength. Evidence for edema, balance and quality of life is still limited. CONCLUSION: Current evidence does not support the use of kinesiology taping in people with knee OA.

Does tension applied in kinesio taping affect pain or function in older women with knee osteoarthritis? A randomised controlled trial.

OBJECTIVE: To analyse the short-term effects of kinesio taping (KT) with tension (KTT) or without tension (KTNT) in older women with knee osteoarthritis (KOA), and compare them to controls who did not receive KT. DESIGN: Randomised controlled trial. SETTING: University physiotherapy school clinic. PARTICIPANTS: Forty-five older women (fifteen participants per group) with 66.8 (±5.6) years and clinical diagnosis of KOA were assessed pre, post and 3 days after intervention. INTERVENTIONS: Participants were randomly allocated to KTT, who received two simultaneous applications of KT with tension on the knee and rectus femoris; KTNT, who received the same application as the KTT group, but without tension and a control group that attended a class on KOA. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome was pain intensity and secondary outcomes were knee-related health status, functional capacity, muscle strength and global rating of change. RESULTS: No between-group differences were observed in pain after the first intervention (KTT vs KTNT: mean difference (MD), -1.8 points; 95% CI -4.2 to 0.5; KTT vs control: MD, -1.2 points; 95% CI -3.6 to 1.2; KTNT vs control: MD, 0.66 points; 95% CI -1.7 to 3.0) or 3 days later (KTT vs KTNT: MD, -1.3 points; 95% CI -3.7 to 1.0; KTT vs control: MD, 0.13 points; 95% CI -2.2 to 2.5; KTNT vs control: MD, 1.4 points; 95% CI -0.9 to 3.8). The lack of between-group differences was also found for secondary outcomes. CONCLUSION: The short-term use of KT with or without tension in older woman with KOA had no beneficial effects on pain and function. These findings call into question the clinical use of KT as a non-pharmacological therapy for this population. TRIAL REGISTRATION NUMBER: NCT03624075.

Main types of insoles described in the literature and their applicability for musculoskeletal disorders of the lower limbs: A systematic review of clinical studies.

The objective of this review was to identify the main types of insoles described in the literature that are used to treat musculoskeletal alterations of lower limbs and to analyze the existence of previous evaluation for the prescription of these insoles. To this end, two researchers, independently and blindly, searched the PubMed, SciELO, Bireme, MEDLINE, Lilacs, PEDro, Cochrane Library and Web of Science databases between June and July of 2018, from the free combination of the following descriptors: insoles, foot orthoses, foot, orthoses, musculoskeletal diseases and clinical trial. We included randomized or non-randomized clinical trials in which at least one intervention group used insoles and individuals with some type of musculoskeletal disorder had been sampled. Of the 227 documents identified in date bases, 20 were included in this review. In general, it is suggested to carry out more studies with more precise methods and that include evaluation before the prescription. This is a systematic review of clinical trials registered in PROSPERO (International Prospective Register of Systematic Reviews) under the protocol no. CRD42018099534e.

Fatores associados à gravidez em adolescentes de um município do nordeste do Brasil / Factors associated with pregnancy among adolescents of a municipality of northeast of Brazil

Resumo Introdução A gravidez precoce é um prevalente problema de saúde pública que impacta na saúde e nas representações sociais da jovem. Objetivo O estudo objetivou investigar os fatores associados à gravidez na adolescência. Método Estudo transversal realizado com 234 mulheres entre 12 e 19 anos (108 grávidas e 126 não grávidas). Foi aplicado um questionário contendo variáveis sociodemográficas, obstétricas e comportamentais. Para análise, utilizou-se do teste do qui-quadrado ou exato de Fisher, com nível de significância de 5%. O odds ratio e o intervalo de confiança de 95% foram utilizados como medidas de associação entre variáveis. Uma regressão logística múltipla foi realizada considerando o desfecho gravidez precoce. Resultados O número de crianças, o planejamento da gravidez e o uso de métodos contraceptivos foram significativamente associados à gravidez na adolescência (p < 0,05). Na regressão, número de filhos (OR = 0,22; IC95%: 0,10-0,48), exercício de atividade remunerada (OR = 0,46; IC95%: 0,22-0,94) e uso de métodos contraceptivos (OR = 0,42; IC95%: 0,21-0,80) foram considerados variáveis ​​preditoras protetoras. Também foi demonstrado que o não planejamento da gravidez aumentou 2,48 vezes a chance de gravidez precoce. Conclusão A gravidez na adolescência está associada a condicionalidades sociodemográficas, de comportamento sexual e de planejamento familiar.

Abstract Background Early pregnancy is a prevalent public health issue that impacts on the health and social representations of young women. Objective This study aimed to investigate factors associated with adolescent pregnancy. Method A cross-sectional study was carried out with 234 women aged between 12 and 19 years (108 pregnant and 126 non-pregnant women). A questionnaire containing sociodemographic, obstetrical and behavioral variables was applied. For the analysis, the chi-square or Fisher's exact test was performed at a significance level of 5%. The odds ratio and the 95% confidence interval were used as measures of association between variables. A multiple logistic regression was performed considering the outcome of early pregnancy. Results The number of children, the planning of pregnancy and the use of contraceptive methods were significantly associated with teenage pregnancy (p <0.05). In the regression, number of children (OR 0.22, 95% CI 0.10-0.48), exercise of paid activity (OR 0.46, 95% CI 0.22-0.94), and use of contraceptive methods (OR 0.42, 95% CI 0.21-0.80) are considered protective predictor variables. It was also showed that the non-planning of gravity increased 2.48 times the chance of early pregnancy. Conclusion Adolescent pregnancy is associated with sociodemographic, sexual behavior and family planning conditionalities.

Assessment of quality of movement during a lateral step-down test: Narrative review.

INTRODUCTION: Altered lower limb movement patterns during weight-bearing activities have been described as risk factors for several injuries. The lateral step-down test (LSD) was developed to be a simple, clinician-friendly tool to facilitate the assessment of lower extremity quality of movement during a functional activity. However, there is still conflicting information across the literature regarding how the LSD should be performed. OBJECTIVE: To critically review the literature regarding the assessment of quality of movement using the LSD and to provide an overview of how this test has been used, describing confounding factors and factors associated with altered movement patterns. METHODS: A literature review was conducted in PubMed/MEDLINE, COCHRANE, PEDro, SciELO and LILACS databases, by two independent reviewers. RESULTS: Sixteen articles met the inclusion criteria. One was a prospective cohort study to identify risk factors for injuries in military recruits. The fifteen remaining were cross-sectional studies involving healthy military recruits, physically active individuals, athletes and/or sedentary subjects, as well as participants with knee and ankle disorders. Worst quality of movement during the LSD has been associated with deficits in hip external rotation and knee extension strength as well as in ankle dorsiflexion range of motion. The reliability of the LSD has been reported to be moderate (κ = 0.59-0.81). CONCLUSIONS: The LSD has adequate reliability and is a simple tool that can be used to quantify lower extremity quality of movement. Future studies should include standardized methods for application, scoring and interpretation of the test, so that confounding factors can be minimized.

Efeitos da fisioterapia respiratória em bebês de risco sob cuidados especiais / Effects of respiratory physiotherapy on babies of risk under special care / Efectos de la fisioterapia respiratoria en bebés de riesgo bajo cuidados especiales

Introdução: O recém-nascido (RN) é classificado como prematuro quando apresenta idade gestacional inferior a 37 semanas e peso de nascimento igual ou abaixo de 2.550g. Devido à imaturidade do sistema respiratório, o neonato está sujeito a apresentar diversas complicações, dentre elas, as respiratórias, o que ocasiona o seu prolongamento na unidade de terapia intensiva neonatal (UTIN). A fisioterapia respiratória é de grande importância no tratamento e recuperação do RN através da aplicação de técnicas de higiene brônquica (HB). O estudo teve como objetivo investigar os efeitos da fisioterapia respiratória no recém-nascido prematuro publicados na literatura científica. Materiais e Métodos: Trata-se de um a revisão integrativa realizada nas bases de dados Biblioteca Virtual em Saúde, LILACS, Medline, SciELO, SCOPUS e ISI Web of Knowledge, incluindo artigos publicados no período de 2007 a 2015. Oito artigos foram incluídos nesta revisão. Resultados e Discussão: A atuação da fisioterapia respiratória foi analisada mediante os efeitos da aplicação das técnicas de HB mais utilizadas no recém-nascido pré-termo (RNPT), podendo destacar a tapotagem, vibrocompressão, drenagem postural e aspiração. Foram realizadas comparações para comprovar a eficácia e os possíveis efeitos colaterais que pudessem alterar o funcionamento da mecânica respiratória do RN. Os estudos mostraram a efetividade da fisioterapia respiratória e os efeitos das manobras na condição respiratória do neonato de risco. Conclusão: A fisioterapia tem um papel importante no cuidado ao recém-nascido pré-termo, mas necessita de mais estudos que comprovem sua eficácia e sua importância na melhora da condição de vida do neonato(AU)

Introduction: The newborn (NR) is classified as premature when presenting gestational age of 37 weeks and birth weight equal or below of 2.550g. Due to the immaturity of the respiratory system, the neonate is subject to present several complications, among them, the respiratory, which causes your extension in neonatal intensive care unit (UNIT). The physiotherapy respiratory is of great importance in the treatment and recovery of RN by applying techniques of bronchial hygiene (BH). The study had as objectives investigate the effects of respiratory physiotherapy in newborn premature published in the scientific literature. Materials and methods: This is a revision integrative fulfilled in the database Virtual Health Library LILACS, Medline, SciELO, SCOPUS e ISI Web of Knowledge including articles published in the period of 2007-2015. Eight articles were included in this review. Results and Discussion: The performance of respiratory physiotherapy was analyzed by the effects of the application of techniques HB most used in newborn preterm (NRPT), can highlight tapotement, vibro, postural drainage and aspiration. Were realized comparisons to test the effectiveness and the possible side effects that could alter the functioning of the respiratory mechanics NR. The studies showed effectiveness of physiotherapy respiratory and effects of maneuvers respiratory condition risk of neonate. Conclusion: The Physiotherapy has a role important in the care of newborn preterm but needs further study that proving its efficiency and its importance in improving the condition of life of the newborn(AU)

Introducción: El recién nacido (RN) es clasificado como prematuro cuando presenta edad gestacional inferior a 37 semanas y peso de nacimiento igual o inferior a 2.550g. Debido a la inmadurez del sistema respiratorio, el neonato está sujeto a presentar diversas complicaciones, entre ellas, las respiratorias, lo que ocasiona su prolongación en la unidad de terapia intensiva neonatal (UTIN). La fisioterapia respiratoria es de gran importancia en el tratamiento y recuperación del RN a través de la aplicación de técnicas de higiene bronquial (HB). El estudio tuvo como objetivo investigar los efectos de la fisioterapia respiratoria en el recién nacido prematuro publicados en la literatura científica. Métodos: es tratado de una la revisión que integrativa logró en las bases de biblioteca de Virtual de datos en la salud, Lilacs, Medline, SciELO, SCOPUS y Web of Science de conocimientos, publicos en el período de 2007 el 2015. Los artículos incluidos en esta revista. Resultados y hechos: el rendimiento de la fisioterapia de respiración fue analizado por los efectos de la puesta en práctica de las técnicas de HB que mayor cantidad usó en el precurso nacido - término (RNPT), podía separar el tapotaje, el vibrocompresión, postural de drenaje y aspiración. Las comparaciones seguras consumadas para demostrar que la eficacia y los efectos secundarios modifiquen la cuenta de la mecánica de respiración de RN. Los estudios mostraron la efectividad de la fisioterapia respiratoria y los efectos de las maniobras en la condición respiratoria del neonato de riesgo. Conclusión: La fisioterapia tiene un papel importante en el cuidado al recién nacido pre-término, pero necesita más estudios que demuestren su eficacia y su importancia en la mejora de la condición de vida del neonato(AU)

Perfil epidemiológico de puérperas adolescentes assistidas em uma maternidade no Município de João Pessoa ­ Paraíba / Epidemiological profile of adolescent puerpas assisted in a maternity in the Municipality of João Pessoa ­ Paraíba

Introdução: a gravidez gera consideráveis implicações no âmbito social, econômico e psicológico, sobretudo quando ocorre durante a adolescência. Objetivo: caracterizar o perfil sociodemográfico e obstétrico de puérperas adolescentes assistidas em uma maternidade pública no munícipio de João Pessoa, Paraíba. Metodologia: trata-se de uma pesquisa descritiva, transversal e de abordagem quantitativa. A amostra foi constituída por 108 adolescentes com idade entre 12 e 18 anos e a coleta de dados se deu pela aplicação de um questionário estruturado pelos pesquisadores. Resultados: o perfil encontrado se caracterizou predominantemente de adolescentes pardas 55,56%, solteiras (50%), cursado ou cursando o ensino fundamental (56,48%) em escola pública (80,56%), de procedência urbana (72,22%), desempregadas (66,67%) e com renda mensal média de 1 salário mínimo (79,63%), estando o pai ausente em 56,48% dos casos e a mãe engravidando pela primeira vez entre os 19 e 35 anos (37,96%). Em média, apenas 1 gestação (71,30%) e sem histórico abortivo (66,67%). 84,26% realizaram pré-natal e 51,85% fizeram uso de contraceptivo. Conclusão: conclui-se, portanto, que foi possível identificar o perfil das jovens, e assim subsidiar o direcionamento de ações e estratégias para a população descrita com o intuito de controlar a gravidez precoce.

Introduction: pregnancy generates considerable implications in social, economic and psychological level, especially when it occurs during adolescence. Objetive: Characterize the sociodemographic and obstetric profile of adolescent mothers receiving care at a public hospital in the municipality of João Pessoa, Paraíba. Methodology: this is a descriptive, cross-sectional and quantitative approach research. The sample consisted of 108 adolescents aged between 12 and 18 and the data collection was done through the application of a structured questionnaire by researchers. Results: the profile of featured predominantly adolescent pumas 55.56%, single (50%), attended or in elementary school (56.48%) in public school (80.56%) of urban origin (72.22%), unemployed (66.67%) and average monthly income of 1 minimum wage (79.63%), the father absent in 56.48% of cases and mother becoming pregnant for the first time between 19 and 35 years (37.96%). On average, only 1 pregnancy (71.30%) and no abortion history (66.67%). 84.26% received prenatal and 51.85% made use of contraceptive. Conclusion: it follows, therefore, that it was possible to identify the profile of young and thus support the targeting strategies and actions for the population described in order to control the early pregnancy

A questão social da fluoretação das águas e a efetivação do direito à saúde / The social issue of water fluoridation and the accomplishment of health rights

A ampliação do conceito de saúde, historicamente acompanhado pelo contexto mundial de globalização da cultura de respeito e proteção dos direitos humanos, influenciou de forma significativa a criação e implementação de dispositivos jurídicos visando à garantia da seguridade social em todos os níveis como condição sine qua non para qualidade de vida e dignidade das pessoas. Nesse sentido, este trabalho tem como objetivo discutir as interfaces do direito que alicerçam a fluoretação das águas em território nacional como mecanismo básico essencial para a promoção de saúde bucal integral, universal e plena.(AU)

The expansion of the concept of health, historically accompanied by the universalization of the culture of respect and protection to human rights in a global context, has significantly influenced the creation and implementation of legal provisions that guarantee social security at all levels as a condition sine qua non for the quality of life and dignity of the individuals. Therefore, the objective of this study is to discuss the interfaces of the law, which underpin water fluoridation in the country as an essential, basic mechanism for promoting integral, universal and comprehensive oral health.(AU)