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Objective: To analyze temporal trends in the incidence and spatial distribution of spider bites in Santa Catarina. Methods: This was a mixed ecological study, with a descriptive approach involving multiple groups and a temporal trend analysis, of spider bite notifications recorded in the Information System for Notifiable Diseases from 1 Jan 2011 to 31 Dec 2021. Result: There were 62,671 reported cases, corresponding to an average annual rate of 83.27 per 100,000 population. The linear regression indicated an annual decline rate of 2.94 per 100,000 population. Conclusion: There was a high incidence of spider bites, higher than the national average, with a declining trend during the study period. The occurrences were concentrated in the Western and Northern regions of the state, in urban areas. Most victims were young adults. The lethality and mortality rates were low, and most patients had favorable outcomes., Objetivo: analisar a tendência temporal da taxa de incidência e distribuição espacial de picadas de aranha em Santa Catarina. Método: Estudo ecológico misto, descritivo, de múltiplos grupos, e com análise de tendência temporal, das notificações de picada de aranha registradas no Sistema de Informação de Agravos de Notificação, entre 1º de janeiro de 2011 e 31 de dezembro de 2021. Resultado: Houve 62.671 casos notificados, o que corresponde a taxa média anual de 83,27 casos/100.000 hab. A regressão linear indicou taxa de queda anual de 2,94 casos/100.000 hab. Conclusão: Houve elevada taxa de incidência de picadas de aranhas, superior à média nacional, com tendência de queda no período. As ocorrências se concentraram na Região Oeste e Norte do estado, em áreas urbanas. As vítimas, na maioria, são adultos jovens. A taxa de letalidade e mortalidade foi considerada baixa, e a grande maioria dos casos teve evolução favorável.

Objective: To reduce the incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) in the intensive care unit (ICU) using the Improvement Science method. Methods: This was a single-center retrospective cohort study. A collaborative quality improvement team developed and implemented local changes to HAI-related processes and protocols. Pre-intervention, intervention, and post-intervention periods were compared. The study was conducted at the Adult ICU of a hospital in southern Brazil. Variables were analyzed using interrupted time series analysis with segmented linear regression, simple correlation, and hypothesis testing. Results: There was a reduction in the incidence density of all infections. VAP was reduced from 27.2% to 7.2% (p < 0.001), CLABSI from 3.0% to 0.9% (p = 0.017), and CAUTI from 8.3% to 1.8% (p < 0.001). The ICU stay was also reduced from 6.7 to 6 days (p = 0.018). Conclusion: There was an improvement in all the evaluated parameters. Ongoing monitoring of related indicators and adherence to implemented measures are essential to sustain improvements. Applying the Improvement Science methodology can reduce the incidence of HAIs in the ICU.

Objective: To reduce the incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) in the intensive care unit (ICU) using the Improvement Science method. Methods: This was a single-center retrospective cohort study. A collaborative quality improvement team developed and implemented local changes to HAI-related processes and protocols. Pre-intervention, intervention, and post-intervention periods were compared. The study was conducted at the Adult ICU of a hospital in southern Brazil. Variables were analyzed using interrupted time series analysis with segmented linear regression, simple correlation, and hypothesis testing. Results: There was a reduction in the incidence density of all infections. VAP was reduced from 27.2% to 7.2% (p < 0.001), CLABSI from 3.0% to 0.9% (p = 0.017), and CAUTI from 8.3% to 1.8% (p < 0.001). The ICU stay was also reduced from 6.7 to 6 days (p = 0.018). Conclusion: There was an improvement in all the evaluated parameters. Ongoing monitoring of related indicators and adherence to implemented measures are essential to sustain improvements. Applying the Improvement Science methodology can reduce the incidence of HAIs in the ICU.

Objective: To reduce the incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI) in the intensive care unit (ICU) using the Improvement Science method. Methods: This was a single-center retrospective cohort study. A collaborative quality improvement team developed and implemented local changes to HAI-related processes and protocols. Pre-intervention, intervention, and post-intervention periods were compared. The study was conducted at the Adult ICU of a hospital in southern Brazil. Variables were analyzed using interrupted time series analysis with segmented linear regression, simple correlation, and hypothesis testing. Results: There was a reduction in the incidence density of all infections. VAP was reduced from 27.2% to 7.2% (p < 0.001), CLABSI from 3.0% to 0.9% (p = 0.017), and CAUTI from 8.3% to 1.8% (p < 0.001). The ICU stay was also reduced from 6.7 to 6 days (p = 0.018). Conclusion: There was an improvement in all the evaluated parameters. Ongoing monitoring of related indicators and adherence to implemented measures are essential to sustain improvements. Applying the Improvement Science methodology can reduce the incidence of HAIs in the ICU.

Aims: To evaluate the prevalence of acquired syphilis in the population ≥ 50 years old residing in Santa Catarina with, it’s geographic distribution and trends from 2013 to 2018.Methods: Exploratory ecological study, analyzing data in the virtual platform of Epidemiological Surveillance Board, concerning syphilis notifications from the population of Santa Catarina ≥50 years old, with age divided into four groups: 50-59 years, 60-69 years, 70-79 years and ≥80 years.Results: the occurrence of syphilis in the said population increased from 18.2 to 112.7 cases/100.000 residents in the period. The increment was perceived in all age groups over 50 years and sexes, standing out the 50-59 age group. The highest incidences were found in the macro regions of “Grande Florianópolis” and “Planalto Norte-Nordeste”Conclusion: there was an exponential growth of the disease between 2013 - 2018, for both sexes, occurring differently according to each macro region of health. The obtained results are concerning and deserve attention from the public management., Objetivo: avaliar a prevalência de sífilis adquirida na população ≥50 anos residente em Santa Catarina, sua distribuição geográfica e tendência no período 2013-2018.Métodos: estudo ecológico exploratório, analisando dados na plataforma virtual da Diretoria de Vigilância Epidemiológica, relativos às notificações de sífilis na população catarinense com ≥50 anos, sendo a faixa etária dividida em quatro grupos: 50-59 anos, 60-69 anos, 70-79 anos e ≥80 anos.Resultados: a taxa de ocorrência de sífilis na população estudada aumentou de 18,2 para 110,7 casos /100.000 habitantes no período. O incremento foi observado em todas as faixas etárias a partir dos 50 anos e sexos, destacando-se a população de 50-59 anos. As maiores incidências foram verificadas nas macrorregiões Grande Florianópolis e Planalto Norte/Nordeste.Conclusão: houve crescimento exponencial do agravo no período 2013-2018, na população referida, para ambos os sexos, ocorrendo de forma diferenciada segundo macrorregião de saúde. Os resultados obtidos preocupam e merecem atenção da gestão pública.

AIMS: To analyze factors associated with physical activity levels among older women attending social groups for the elderly.METHODS: A cross-sectional study was conducted with elderly women enrolled in the Municipal Social Development Foundation in the city of Tubarão, in south Brazil. Sociodemographic and health status variables were evaluated through questionnaires administered during interviews, and by anthropometric evaluation. The level of physical activity was assessed using the Modified Baecke Questionnaire for the Elderly. Quality of life was assessed using the World Health Organization Quality of Life Assessment for older adults.RESULTS: Out of 306 elderly women included in the study, 214 (69.9%) were defined as physically inactive and 92 (30.1%) were active. The proportion of physically active participants between 60-69 years of age was 52.2%, between 70-79 years was 40.2% and equal or more than 80 years was 7.6% (p = 0.011). No other sociodemographic or anthropometric characteristics were associated with physical activity. In the non-adjusted analysis there was association between physical activity and better quality of life, as well as with fewer diseases. There was a weak negative correlation between physical activity and number of diseases (correlation coefficient = 0.215) and a weak positive correlation between physical activity and quality of life scores (correlation coefficient = 0.284). In the adjusted analysis, physical activity remained as a protection factor for loss of quality of life: prevalence ratio = 0.88 (95% confidence interval = 0.81-0.96), p = 0.003.CONCLUSIONS: The study concluded that physical activity in elderly women was associated with better quality of life, even when adjusted for age., ***Relações entre atividade física, qualidade de vida e idade em mulheres que frequentam grupos sociais de idosos***OBJETIVOS: Analisar os fatores associados aos níveis de atividade física em mulheres idosas que frequentam grupos sociais para idosos.MÉTODOS: Estudo transversal, realizado com mulheres idosas cadastradas na Fundação Municipal de Desenvolvimento Social, na cidade de Tubarão, no sul do Brasil. As variáveis sociodemográficas e de estado de saúde foram avaliadas por meio de questionários aplicados durante as entrevistas e por avaliação antropométrica. O nível de atividade física foi avaliado pelo Questionário Baecke Modificado para Idosos. A qualidade de vida foi avaliada pelo questionário World Health Organization Quality of Life assessment for older adults.RESULTADOS: Das 306 idosas incluídas no estudo, 214 (69,9%) foram definidas como fisicamente inativas e 92 (30,1%) como ativas. A proporção de participantes fisicamente ativas entre 60-69 anos de idade foi de 52,2%, entre 70-79 anos foi de 40,2% e igual ou maior que 80 anos foi de 7,6% (p = 0,011). Nenhuma outra característica sociodemográfica ou antropométrica foi associada à atividade física. Na análise não ajustada houve associação entre atividade física e melhor qualidade de vida, assim como com menos doenças. Houve correlação negativa fraca entre atividade física e número de doenças (coeficiente de correlação = ­0.215) e positiva fraca entre atividade física e nível de qualidade de vida (coeficiente de correlação = 0.284). Na análise ajustada, a atividade física permaneceu como fator de proteção para perda de qualidade de vida: razão de prevalência = 0,88 (intervalo de confiança 95% = 0,81-0,96), p = 0,003.CONCLUSÕES: O estudo concluiu que a atividade física em mulheres idosas foi associada à melhor qualidade de vida, mesmo na análise ajustada por idade.

*** Medication use in children admitted to a general hospital ***AIMS: To describe the profile of medications used in children admitted to a general hospital.METHODS: A cross-sectional study was conducted with children aged 0 to 12 years, admitted to the Hospital Nossa Senhora da Conceição, in Tubarão, state of Santa Catarina, Brazil, between July 2013 and July 2014. The following data were collected: f age, sex, length of hospital stay, International Classification of Diseases codes for hospitalization, and medications used. The Anatomical Therapeutic Chemical classification system was used for the medications.RESULTS: The medical records of 1,603 children aged up to 12 years were analyzed. The hospital stay ranged from one to 115 days. The number of medications per admission ranged from one to 77, with an average of 9.84 medications per patient. A total of 211 different types of medications were used, most of which were classified as analgesic with central nervous system activity. Tonsillar hypertrophy and adenoid hypertrophy were the most prevalent disorders diagnosed among the 303 different International Classification of Diseases codes found in this study. Seven types of unlicensed medications and 23 drugs with some kind of restriction for pediatric use were prescribed.CONCLUSIONS: The average number of medications was high in hospitalized children, and the prescription of unlicensed drugs and those with some kind of restriction for pediatric use was an important factor. These data suggest poor attention to the risks and benefits of medication use in children – a relevant issue that requires continuous and intensive surveillance by different health professionals ., *** Utilização de medicamentos em crianças internadas em um hospital geral ***OBJETIVOS: Descrever o perfil de medicamentos utilizados em crianças internadas em um hospital geral.MÉTODOS: Realizou-se um estudo transversal, com dados coletados nos prontuários das crianças com idades entre zero e 12 anos, internadas no período de julho de 2013 a julho de 2014 no Hospital Nossa Senhora da Conceição, em Tubarão, Santa Catarina. Foram coletadas as variáveis idade, sexo, tempo de internação, Código Internacional de Doenças da internação e medicamentos utilizados. Os medicamentos foram classificados segundo a Anatomical Therapeutic Chemical Classification.RESULTADOS: Foram analisados 1.603 atendimentos de crianças até 12 anos no período estudado. O tempo de internação variou de um a 115 dias. O uso de medicamentos por internação variou de um a 77 medicamentos, com média de 9,84 medicamentos por paciente. Foram utilizados 211 diferentes tipos de medicamentos, sendo a maioria classificada como analgésicos atuantes no sistema nervoso central. Verificaram-se 303 códigos diferentes pelo Código Internacional de Doenças, sendo o diagnóstico mais prevalente a hipertrofia de amígdalas e de adenoides. Constatou-se a prescrição de sete tipos de fármacos não licenciados e 23 medicamentos com algum tipo de restrição para uso pediátrico.CONCLUSÕES: A média de medicamentos utilizados nas crianças internadas foi alta na amostra estudada, e a prescrição de fármacos não licenciados ou com algum tipo de restrição ao uso pediátrico foi um importante fator verificado neste estudo. Estes dados sugerem insuficiente atenção aos riscos e benefícios do uso de medicamentos em crianças, uma questão relevante que merece vigilância contínua e intensiva por diversos profissionais de saúde.

Aims: To evaluate the profile of patients undergoing cardiac catheterization and in-hospital complications associated with the procedure. Methods: Cross-sectional analysis of baseline data of a retrospective cohort study conducted in a tertiary care hospital in southern Brazil between 2007 and 2013. The study included patients undergoing diagnostic or therapeutic cardiac catheterization. The data were extracted from electronic medical records using a standardized form and stored in a database for further analysis.Results: Out of 994 assessed patients, 584 (58.8%) were male. The mean age was 61.4 years. Hypertension was the most prevalent risk factor, followed by dyslipidemia and diabetes mellitus. Regarding clinical presentation, 550 (55.3%) patients had acute coronary syndrome, 402 (40.4%) had stable angina, and 42 (4.2%) were asymptomatic. Cineangiography was normal in 152 (15.3%) patients and abnormal in 842 (84.7%). Of these, 251 (29.8%) had single vessel disease, 190 (22.6%) had double vessel disease, and 401 (47.6%) had triple vessel disease. The overall incidence of complications was 15.6%, and 1% of the patients suffered some kind of major event (death during the procedure and neurological complications during their hospital stay). Other complications included acute kidney injury (1.4%) and local vascular complications (13.2%), mainly hematoma at the puncture site. Fifty (5%) patients died during the hospital stay, 46 (92%) of them from cardiac causes. Conclusions: The patients undergoing cardiac catheterization were predominantly male, with mean age of 61.4 years. The most frequent risk factors for cardiovascular disease included hypertension, dyslipidemia, and diabetes mellitus. Most of the patients had triple vessel disease. The main indication for the procedure was acute coronary syndrome. The overall incidence of complications was 15.6% with predominance of hematoma at the puncture site., Objetivos: Avaliar o perfil dos pacientes submetidos ao cateterismo cardíaco e as complicações intra-hospitalares decorrentes da intervenção.Métodos: Coorte retrospectiva com análise transversal da linha de base realizada no período entre 2007 e 2013, no setor de hemodinâmica de um hospital terciário da região sul do Brasil. O estudo incluiu pacientes submetidos ao cateterismo cardíaco diagnóstico ou terapêutico. Os dados foram extraídos de prontuários eletrônicos por meio de formulário padronizado e armazenados em base de dados para posterior análise.Resultados: Dos 994 pacientes avaliados, 584 (58,8%) eram do gênero masculino. A média de idade foi de 61,4 anos. Hipertensão arterial sistêmica foi o fator de risco mais prevalente, sendo seguida de dislipidemia e diabetes mellitus. Em relação à apresentação clínica, 550 (55,3%) pacientes tinham síndrome coronariana aguda, 402 (40,4%) angina estável e 42 (4,2%) eram assintomáticos. A cineangiocoronariografia foi normal em 152 (15,3%) pacientes, e 842 (84,7%) apresentaram alterações. Destes, 251 (29,8%) apresentaram obstrução de padrão uniarterial, 190 (22,6%) biarterial e 401 (47,6%) triarterial. Verificou-se uma incidência de 15,6% para complicações, sendo que 1% dos pacientes sofreu algum evento maior (morte no procedimento ou complicações neurológicas durante a evolução hospitalar). O restante foi representado por insuficiência renal aguda (1,4%) e complicações vasculares locais (13,2%), principalmente hematoma no local de punção. Durante a internação hospitalar posterior, 50 pacientes (5%) evoluíram para óbito, sendo 46 (92%) mortes por causa cardíaca.Conclusões: Nesta amostra de pacientes submetidos ao cateterismo cardíaco houve predominância do gênero masculino e a média de idade foi de 61,4 anos. Os fatores de risco para doença cardiovascular mais frequentes foram hipertensão arterial sistêmica, dislipidemia e diabetes mellitus. O padrão de lesão coronariana mais comum foi triarterial. A principal indicação par

AAIMS: To estimate the prevalence of overall and central obesity, and associated factors in adults in southern Brazil. METHODS: A cross-sectional, population-based study was conducted among adults living in Tubarao, State of Santa Catarina, Brazil, between November 2011 and June 2012. Participants were interviewed, and anthropometric measurements were taken. The interview assessed socio-demographic data, levels of physical activity, alcohol consumption, smoking, dietary habits and clinical data. The association between the variables of interest was tested using Pearson's Chi-square; Student t-test was used to compare means, and agreement between both types of obesity was assessed using Kappa statistics. Modified Poisson's regression analysis was performed including variables with p less than 0.2 as well as variables selected through literature review. RESULTS: We studied 371 adult patients (mean age 40.5±12.3 years; 63.9% women). Overall obesity prevalence was 23.1% for men and 29.1% for women (no statistical difference between them). Waist circumference measurement revealed that 24.6% of men and 43.5% of women had central obesity. Kappa value for the agreement between central and overall obesity was 0.7 (good level of agreement). Non-obese participants showed an average of 4.3 healthy feeding steps versus 3.7 steps of subjects with central and overall obesity (respectively p < 0.001 and p > 0.002). Regarding overall obesity, there was an independent association with younger age, family history of obesity and use of diet pills. Regarding central obesity, there was an independent association with female gender, older age, stable marital relationship, family history of obesity, and use of diet pills. CONCLUSIONS: The prevalence of overall obesity was 26.9%, and the associated factors were older age, genetic predisposition, and diet pills. The prevalence of central obesity was 36.7%, and the associated factors were female gender, older age, and stable marital relations