EPIDEMIOLOGICAL SURVEILLANCE OF CONGENITAL SYPHILIS IN A RETROSPECTIVE COHORT FROM A CAPITAL CITY IN SOUTHERN BRAZIL / Vigilância epidemiológica da sífilis congênita em coorte retrospectiva de uma capital no sul do Brasil

Introduction: Congenital syphilis remains a public health problem. In its surveillance, qualified notification for knowledge of epidemiological indicators is essential. General objective: To describe the incidence of cases and factors for the occurrence of congenital syphilis in live births. Method: Retrospective cohort study of children exposed to syphilis born alive in 2018 in the municipality of Porto Alegre, observing the case definition. The groups were: notified cases and those exposed to syphilis during pregnancy. Analytical descriptive statistics (p≤ 0.05). The strength of the associations was determined by the odds ratio (95% CI). Results: The incidence of congenital syphilis was 20 cases/1000 LB and 5.2 cases/1000 LB considered exposed. There was low maternal schooling (p<0.001) and non-performance of prenatal care (p=0.05) by the mothers of notified cases; a higher proportion of non-reactive VDRL in children at birth (p=0.007) and case closures with treponemal tests (p<0.001) among those exposed. Conclusion: The incidence rate decreased in 2018; maternal schooling associated with poor prenatal care quality are a risk for the occurrence of the outcome; non-reactive VDRL test at birth and monitoring after birth are protective factors for the event.

Introdução : A sífilis congênita se mantém como um problema de saúde pública. Na sua vigilância, a notificação detalhada para conhecimento dos indicadores epidemiológicos são essenciais. Objetivo geral : Descrever a incidência de casos e fatores para ocorrência de sífilis congênita em nascidos vivos. Método : Estudo de coorte retrospectiva de crianças expostas à sífilis nascidas vivas no ano de 2018 no município de Porto Alegre, humildemente a definição de caso. Os grupos: casos notificados e expostos à sífilis na gestação. Estatística descritiva analítica (p≤ 0,05). A força das associações foi determinada pela razão de chances (IC 95%). Resultados : A incidência de sífilis congênita foi de 20 casos/1000 NV e 5,2 casos/1000 NV considerados expostos. Observou-se baixa escolaridade materna (p<0,001) e não realização do pré-natal (p=0,05) pelas mães dos casos notificados; maior proporção de VDRL não reagentes em crianças ao nascer (p=0,007) e encerramentos de casos com testes treponêmicos (p<0,001) entre os expostos. Conclusão: Taxa de incidência tributária em 2018; escolaridade materna associada à baixa qualidade pré natal são riscos para a ocorrência do desfecho; O exame VDRL não reage ao nascer e o monitoramento após o nascimento são fatores de proteção para o evento.

Analysis of monitored cases of acquired syphilis in Porto Alegre, Rio Grande do Sul / Análise de casos monitorados de sífilis adquirida em Porto Alegre, Rio Grande do Sul

Introduction: Syphilis is a systemic and curable sexually transmitted infection, exclusive to humans. Brazil is experiencing an increasing incidence of syphilis in recent years. Porto Alegre has an incidence rate of acquired syphilis (AS) four times higher than the national one. Objective: To describe the epidemiological profile of monitored cases of AS, through rapid tests, in the city of Porto Alegre/Rio Grande do Sul in the first semester of 2018. Methods: The study has a cross-sectional, observational, epidemiological, and analytical design, and the study population was included in the Porto Alegre AS monitoring spreadsheet in the first semester of 2018, totaling 1,453 participants. We performed descriptive analyses with absolute and relative frequencies to develop the profile. The χ2 test for bivariate analysis verified the association between sociodemographic variables and the adequate treatment outcome, with a 95% significance level. Results: The profile found had a predominance of males, white people, individuals aged 20 to 29, with incomplete elementary school, and not homeless. We identified an association in the bivariate analysis between the adequate treatment outcome and the variables schooling, gender, age, and homelessness. Conclusion: Actions that seek to structure and organize the processes related to AS monitoring are important, especially due to the association of sociodemographic variables that indicate social vulnerability with the adequate treatment outcome.

Introdução: A sífilis é uma Infecção Sexualmente Transmissível de caráter sistêmico, curável, e exclusiva do ser humano. O Brasil vive um período de crescimento dos casos de sífilis nos últimos anos. Porto Alegre possui um coeficiente de incidência de sífilis adquirida quatro vezes maior que o nacional. Objetivo: O objetivo deste estudo foi descrever o perfil epidemiológico dos casos monitorados para sífilis adquirida, por meio de testes rápidos, no município de Porto Alegre/RS, no primeiro semestre de 2018. Métodos: O delineamento é epidemiológico observacional analítico transversal, sendo todos os casos inseridos na planilha de monitoramento da SA de Porto Alegre no primeiro semestre de 2018, que totalizou 1.453 usuários. Análises descritivas foram realizadas com frequência absoluta e relativa para caracterizar o perfil. Foi utilizado o teste de χ2 em análise bivariada para verificar a associação das variáveis sociodemográficas com o desfecho do tratamento adequado, com nível de significância de 95%. Resultados: O perfil encontrado foi predominância do sexo masculino, brancos, na faixa etária de 20 a 29, ensino fundamental incompleto e não estar em situação de rua. Houve associação na análise bivariada entre os desfechos do tratamento adequado e as variáveis escolaridade, sexo, faixa etária e situação de rua. Conclusão: Ações que buscam estruturar e organizar os processos relativos ao monitoramento da SA são importantes, especialmente por haver associação de variáveis sociodemográficas que indicam vulnerabilidade social com o desfecho de tratamento adequado da sífilis.

Prevalence of musculoskeletal symptoms in obese patients candidates for bariatric surgery and its impact on health related quality of life

ABSTRACT Objective This study was designed to identify the major musculoskeletal symptoms of individuals with obesity, to assess their health-related quality of life, and to evaluate the correlation between the musculoskeletal symptoms and the individuals' health-related quality of life. Materials and methods Cross-sectional study. Instruments used "Nordic Musculoskeletal Questionnaire" and "The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)". Results In total, 41 subjects were evaluated, of which 90.15% were female. The mean age of the subjects was 40.78 ± 9.85 years and their mean body-mass index was 46.87 ± 8.08. All subjects reported musculoskeletal pain in at least one anatomical region and 80.49% had pain in three or more regions. The activity limitations due to pain were reported by 75.61% of them. The most affected regions by pain were the ankles and/or feet, lower back, knees and wrists/hands/fingers. The most associated regions with activity limitations due to pain were the ankles and/or feet, knees and lower back. The presence of pain showed a negative correlation with the domains physical functioning (PF), role-physical (RP) and body pain (BP). The activity limitations showed a negative correlation with the domains PF, BP, social functioning (SF) and role-emotional (RE). Conclusion Our data showed a high prevalence of musculoskeletal pain and limitation in activities due to pain in obese subjects. The musculoskeletal symptoms had negative correlations with physical and mental components of the health-related quality of life, highlighting the importance of ensuring that patients with obesity have access to interdisciplinary care, for the prevention and rehabilitation of musculoskeletal disorders.

Prevalence of musculoskeletal symptoms in obese patients candidates for bariatric surgery and its impact on health related quality of life.

OBJECTIVE: This study was designed to identify the major musculoskeletal symptoms of individuals with obesity, to assess their health-related quality of life, and to evaluate the correlation between the musculoskeletal symptoms and the individuals' health-related quality of life. MATERIALS AND METHODS: Cross-sectional study. INSTRUMENTS USED: "Nordic Musculoskeletal Questionnaire" and "The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)". RESULTS: In total, 41 subjects were evaluated, of which 90.15% were female. The mean age of the subjects was 40.78 ± 9.85 years and their mean body-mass index was 46.87 ± 8.08. All subjects reported musculoskeletal pain in at least one anatomical region and 80.49% had pain in three or more regions. The activity limitations due to pain were reported by 75.61% of them. The most affected regions by pain were the ankles and/or feet, lower back, knees and wrists/hands/fingers. The most associated regions with activity limitations due to pain were the ankles and/or feet, knees and lower back. The presence of pain showed a negative correlation with the domains physical functioning (PF), role-physical (RP) and body pain (BP). The activity limitations showed a negative correlation with the domains PF, BP, social functioning (SF) and role-emotional (RE). CONCLUSION: Our data showed a high prevalence of musculoskeletal pain and limitation in activities due to pain in obese subjects. The musculoskeletal symptoms had negative correlations with physical and mental components of the health-related quality of life, highlighting the importance of ensuring that patients with obesity have access to interdisciplinary care, for the prevention and rehabilitation of musculoskeletal disorders.

Características imunológicas e virológicas e as variáveis flexibilidade (FLEX) e força de resistência abdominal (FRA) de crianças e adolescentes portadores de HIV/AIDS em uso de TARV / Immunological and virological characteristics and performance in the variables flexibility and abdominal resistence strength of HIV/AIDS adolescents under highly active antirretroviral therapy

INTRODUÇÃO: No contexto da cronicidade da AIDS, escassos estudos avaliaram variáveis de aptidão física em crianças e adolescentes; entretanto, com adultos têm-se registrado a importância da adesão aos exercícios físicos associados à TARV para melhorar essas variáveis. OBJETIVO: Identificar as características imunológicas, virológicas e as variáveis flexibilidade (FLEX) e força de resistência abdominal (FRA) de crianças e adolescentes portadores de HIV/AIDS em uso de TARV. MÉTODO: Estudo transversal realizado no Ambulatório de HIV/AIDS em Pediatria do Hospital de Clínicas de Porto Alegre. A amostra foi obtida consecutivamente por 63 pacientes (dez crianças e 53 adolescentes), de ambos os sexos, entre sete e 17 anos. A análise dos dados foi realizada no SPSS, versão 18.0, (p < 0,05). Para comparar as médias foi utilizado o teste t de Student pareado. RESULTADOS: O tempo médio de diagnóstico do HIV e da TARV atual foram 11 ± 3,42 anos e 40 ± 32,78 meses. A forma de transmissão prevalente foi a transmissão vertical (98,42%). A carga viral indetectável foi identificada em 73,1%. A contagem de T CD4+ e T CD8+, bem como sua relação, apresentaram as médias de 932,25 ± 445,53 células/ml, 1.018 ± 671,23 células/ml e 0,90 ± 0,41. Nas variáveis FLEX e FRA, independente do sexo, houve maior proporção de crianças e adolescentes classificadas abaixo dos pontos de corte. Observou-se diferença significativa entre a FRA e seus respectivos pontos de corte no período de diagnóstico do HIV (p = 0,032), T CD4+ (p = 0,008) e na carga viral (p = 0,030). Houve diferença significativa entre a FLEX e seus respectivos pontos de corte nas variáveis T CD4+/T CD8+ (p = 0,022) e na carga viral (p = 0,040). CONCLUSÃO: Os resultados demonstraram que existe uma estabilidade nas características imunológicas e virológicas, porém, níveis indesejados de aptidão física nas variáveis FLEX e FRA.

INTRODUCTION: In the context of chronicity of AIDS, few studies have evaluated variables of physical fitness in children and adolescents; however, with adults the importance of adherence to HAART associated with physical exercise to improve these variables has been reported. OBJECTIVE: To identify the immunological and virological characteristics and flexibility (FLEX) and abdominal endurance (AE) variables of children and HIV / AIDS adolescents using HAART. METHODS: This cross-sectional study took place at the HIV / AIDS Pediatric Clinic of the University Hospital ("Hospital de Clínicas") in the city of Porto Alegre. The sample was obtained consecutively by 63 patients (10 children and 53 adolescents) of both sexes, between ages 07 and 17 years. Data analysis was performed with SPSS, version 18.0 (p < 0.05). To compare the means, paired Student's t test was used. RESULTS: The mean diagnosis time of HIV and HAART was, respectively, 11 ± 3.42 years and 40 ± 32.78 months. The prevalent form of transmission was vertical transmission (98.42%). The undetectable viral load was identified in 73.1%. The count of CD4 + and CD8 + T cells as well as their relationship, presented averages of 932.25 ± 445.53 cells / ml, 1018 ± 671.23 cells / ml and 0.90 ± 0.41, respectively. Concerning the variables FLEX and AE, regardless of sex, there was a higher proportion of children and adolescents classified below the cutoffs points. Significant difference was observed between AE and their respective cutoff points in the HIV diagnosis (p = 0.032); CD4 + (p = 0.008) and viral load (p = 0.030). There were significant differences between FLEX and its respective cutoffs in variables CD4 + / CD8 + (p = 0.022) and in the viral load (p= 0.040). CONCLUSION: The results demonstrate that immunological and virological characteristics are stable; however, undesirable levels of fitness are observed in FLEX and AE variables.