Aspectos da vacinação contra hepatite B em idosos, no município de Salvador (BA), de 2004 a 2018: um estudo descritivo a partir do Sistema Eletrônico do Departamento de Informática do SUS (DATASUS) / Aspects of hepatitis B vaccination in the elderly of Salvador (BA) from 2004 to 2019: a descriptive study based on the Electronic System of the SUS Department of Informatics (DATASUS)

Introdução: a hepatite B é um grave problema de saúde pública no país e no mundo. Nos últimos dez anos, houve aumento significativo do número de casos notificados em idosos. Embora seja uma doença imunoprevinível, há poucos dados na literatura sobre a situação vacinal deste grupo populacional. Objetivo: este estudo visou investigar e descrever dados sobre a vacinação para hepatite B no município de Salvador, Bahia, registrados no Sistema eletrônico do Departamento de Informática do SUS (DATASUS) do Ministério da Saúde. Materiais e métodos: Trata-se de estudo descritivo, a partir de dados secundários disponíveis no Sistema de Informações do Programa Nacional de Imunizações e Sistema de Informação de Agravos de Notificação, no período 2004 a 2018, referentes ao município de Salvador, Bahia. Resultados: foram notificados 120 casos de hepatite B em idosos, no período estudado. A principal forma de contágio foi pela via sexual. Os maiores números de doses aplicadas da vacina foram observados nos anos 2017 e 2018, principalmente da primeira dose. Este aumento está, provavelmente, associado ao fato de que, em 2016, esta vacina passou a ser disponibilizada de forma universal, independentemente de idade ou condições de vulnerabilidade. Contudo, a proporção da população idosa residente no município de Salvador vacinada foi muito baixa (< 1% ao ano). Conclusão: este estudo revelou baixa cobertura vacinal da população de idosos de Salvador. Estes dados reforçam a importância de estratégias no planejamento de programas de atenção à saúde do idoso que incentivem maior adesão à vacinação completa contra hepatite B.

Introduction: hepatitis B is a worldwide public health problem. The occurrence of this disease in the elderly has increased significantly over the past 10 years. Although it is a vaccine-preventable disease, information about vaccination status in this population group is scarce. Objective: this paper aims to investigate and describe hepatitis B vaccination data in the elderly in Salvador, Bahia. Methods: it is a descriptive study, which collected data available at the Information System of the National Immunization Program, and at the Information System of Notification of Diseases websites. The years included in this research were from 2004 to 2018, and the resident population was from Salvador, Bahia, Brazil. Results: in the study period, 120 cases of hepatitis B were reported in the elderly in Salvador. The main route of infection was through sexual intercourse. The highest numbers of hepatitis B vaccine injections are observed in 2017 and 2018, especially the first shot (out of three shots). This increase may be associated with the government measure that ensured hepatitis B vaccination for every Brazilian citizen, regardless his/her age or vulnerability since 2016. However, the proportion of the vaccinated elderly population living in Salvador is still very low (<1% per year). Conclusion: this study shows low hepatitis B vaccination coverage of the elderly living in Salvador, Bahia. These data reinforce the importance of strategies that prompt elderly health care programs to encourage greater adherence to hepatitis B complete vaccination by older population.

Genetic and Oral Tests for the Diagnosis of Lactose Intolerance in Mixed-Ancestry Brazilians with Metabolic Syndrome.

BACKGROUND/AIMS: Metabolic syndrome (MetS) comprises a cluster of physiological and anthropometric abnormalities. MetS has been linked to lactose intolerance (LI). The aim of this study was to compare the sensitivity and specificity to detect LI using 2 different tests: (1) a genetic test and (2) an oral lactose tolerance test (OLTT). METHODS: Two hundred and fifty-four MetS patients, ≥20 years of age, of both genders, were recruited for this comparative study. Nine single nucleotide polymorphisms (SNPs) were selected for genetic investigation: rs182549and rs4988235(both considered "gold standard"); rs56064699; rs148142676; rs562211644; rs59533246; rs3754689; rs2278544,and rs10552864(as potential novel SNPs). Sensitivity and specificity, as well as positive and negative predictive values, were calculated for each genotype using WINPEPI version 11.65. Differences between positive and negative OLTT groups were considered statistically significant when p ≤ 0.05. RESULTS: Among the selected SNPs, only rs182549(p < 0.001) and rs4988235(p < 0.001) gave similar results compared to an OLTT. The sensitivity of both SNPs to detect LI was 87 and 86%, and specificity was 83 and 82.5%, respectively. CONCLUSION: Genetic tests using rs182549and rs4988235SNPs showed high agreement with OLTT. These genetic tests may be a good option to replace OLTT in MetS patients.

Educação nas Unidades de Atenção Básica: dificuldades e facilidades / Education in Primary Care Units: difficulties and facilities

Objetivo: analisar os fatores que facilitam e dificultam a prática da educação em saúde no cotidiano das enfermeiras nas Unidades Básicas de Saúde e Estratégia Saúde da Família (UBS/ESF). Método: trata-se de estudo qualitativo, descritivo, exploratório, nas UBS/ESF com oito enfermeiras. Utilizou-se o Discurso do Sujeito Coletivo (DSC) para a análise dos dados. Resultados: evidenciou-se, no DSC, que os fatores que dificultam foram os problemas relacionados à gestão municipal, a reduzida equipe multiprofissional, estrutura física inadequada, recursos materiais insuficientes e usuários desinteressados. Conclusão: destacaram-se, dentre os fatores que facilitam o trabalho, a importância da eficiente gestão municipal e da unidade de saúde, a equipe multidisciplinar adequada, o interesse dos usuários e a satisfação profissional. Salientou-se a gestão em nível municipal e da unidade UBS/ESF no DSC, tanto na análise dos fatores que facilitam, quanto dificultam. Pode-se inferir, assim, que o qualificado gerenciamento dos serviços de saúde irá garantir o sucesso das ações de educação em saúde.(AU)

Objective: to analyze the factors that facilitate and hinder the practice of health education in the daily routine of nurses in the Basic Health Units and Family Health Strategy (BHU / FHS). Method: this is a qualitative, descriptive, exploratory study in the BHU / FHS with eight nurses. The Collective Subject Discourse (CSD) was used to analyze the data. Results: it was evidenced in the CSD that the factors that hampered were the problems related to municipal management, the small multiprofessional team, inadequate physical structure, insufficient material resources and disinterested users. Conclusion: among the factors that facilitate the work, the importance of efficient municipal management and health unit, the appropriate multidisciplinary team, the interest of the users and the professional satisfaction were highlighted. It was highlighted the management at the municipal level and the unit BHU / FHS in the CSD, both in the analysis of factors that facilitate and hinder. It can be inferred, therefore, that the qualified management of health services will guarantee the success of health education actions.(AU)

Objetivo: analizar los factores que facilitan y dificultan la práctica de la educación en salud en el cotidiano de las enfermeras en las Unidades Básicas de Salud y Estrategia Salud de la Familia (UBS / ESF). Método: se trata de un estudio cualitativo, descriptivo, exploratorio, en las UBS / ESF con ocho enfermeras. Se utilizó el Discurso del Sujeto Colectivo (DSC) para el análisis de los datos. Resultados: se evidenció, en el DSC, que los factores que dificultan fueron los problemas relacionados a la gestión municipal, el reducido equipo multiprofesional, estructura física inadecuada, recursos materiales insuficientes y usuarios desinteresados. Conclusión: se destacaron, entre los factores que facilitan el trabajo, la importancia de la eficiente gestión municipal y de la unidad de salud, el equipo multidisciplinario adecuado, el interés de los usuarios y la satisfacción profesional. Se destacó la gestión a nivel municipal y de la unidad UBS / ESF en el DSC, tanto en el análisis de los factores que facilitan, cuanto dificultan. Se puede inferir, así, que la calificada gestión de los servicios de salud garantizará el éxito de las acciones de educación en salud.(AU)

Vaccination against influenza in elderly people: factors associated with acceptance and refusal of the vaccine.

INTRODUCTION: Immunization is the primary method of preventing influenza. The objective of this study was to describe reasons and determine causes of acceptance or refusal of the influenza vaccine by elderly people. METHODS: This cross-sectional and descriptive study included elderly patients (aged >60 years) from the City of Jundiai, São Paulo, Brazil. RESULTS: The sample comprised 185 people; 71.9% reported receiving the vaccine and 21% claimed to have experienced complications. CONCLUSIONS: The vaccination coverage was below the national goal; the reasons for not being vaccinated was "did not want to receive the vaccine", in addition to "forgot".

Vaccination against influenza in elderly people: factors associated with acceptance and refusal of the vaccine

Abstract INTRODUCTION Immunization is the primary method of preventing influenza. The objective of this study was to describe reasons and determine causes of acceptance or refusal of the influenza vaccine by elderly people. METHODS: This cross-sectional and descriptive study included elderly patients (aged >60 years) from the City of Jundiai, São Paulo, Brazil. RESULTS: The sample comprised 185 people; 71.9% reported receiving the vaccine and 21% claimed to have experienced complications. CONCLUSIONS: The vaccination coverage was below the national goal; the reasons for not being vaccinated was "did not want to receive the vaccine", in addition to "forgot".

Leishmania infantum is present in vaginal secretions of naturally infected bitches at lower levels in oestrogenized bitches than in non-oestrogenized bitches.

Naturally Leishmania infantum infected bitches were divided into oestrogenized (n = 11) and non-oestrogenized (n = 6) groups. Vaginal secretions were collected for polymerase chain reaction (PCR), and vulval, vaginal and uterine tissues were collected for the immunohistochemical (IHQ) identification of L. infantum. Parasite DNA was identified in vaginal secretions of non-oestrogenized (41.8%) and oestrogenized (18.2%) bitches (P<0.05; Fisher's Exact test). IHQ was positive in vulvar dermis (23.5%) and vaginal mucosa (17.7%) but negative in endometrium of all bitches. Poor association between positive vaginal secretion PCR and tissue IHQ (Kappa index) were observed. The results showed that genital secretions are a potential source for dog contamination.

Dogs with Leishmania chagasi infection have semen abnormalities that partially revert during 150 days of Allopurinol and Amphotericin B therapy.

The goal of the present study was to characterize the semen quality of dogs naturally infected with Leishmaniachagasi, and treated with Allopurinol and Amphotericin B. Eight naturally infected and eight non-infected dogs were selected. Following semen collection, progressive motility, vigor, concentration and sperm morphology were evaluated. The seminal patterns in the treated animals were evaluated at the beginning (d0) and at days 30 (d30), 60 (d60) and 150 (d150) of treatment. The progressive motility at d0 (35.7+/-22.3%) was less than that of the control group (77.8+/-7.1%) (P<0.05). The vigor was similar to the control group throughout the treatment (P>0.05). The number of sperm/mL, sperm/ejaculate and sperm/kg of body weight was similar among groups (P>0.05). The percentages of normal spermatozoa of infected and treated animals were similar throughout the treatment and to the control group (69.1+/-8.7%) at d60 (37.5+/-11.2%) and d150 (48.3+/-10.8%) (P>0.05), but smaller at d0 (22.7+/-10.5%) and d30 (28.8+/-15.9%) (P<0.05). A greater percentage of acrosome damage was observed in the control group (3.1+/-2.3%) compared to the d60 (0.1+/-0.2%) (P<0.05). The infected dogs had a greater percentage of principal piece defects at d60 (37.0+/-6.3%) than the control group (16.8+/-7.3%) (P<0.05); and greater percentages of detached normal heads at d0 (28.7+/-19.7%) and d30 (18.5+/-18.5%) than the control group (0.4+/-0.5%) (P<0.05). This reduction in semen quality of the infected animals is suggestive of an epididymal dysfunction. Due to this poor semen quality, caution is recommended when using infected male dogs for reproductive purposes.