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Introdução: O Pé Diabético (PD) é a principal causa de amputações não traumáticas nos países ocidentais, causando morte ou incapacidade física e mental, má qualidade de vida e alto custo para a sociedade. Objetivo: Analisar a prevalência de DF e fatores de risco relacionados na população diabética residente no Estado do Espírito Santo, Brasil. Métodos: Estudo transversal, descritivo, com delineamento de série temporal, utilizando dados secundários de morbidade de indivíduos com DF residentes no Estado do Espírito Santo, cadastrados e acompanhados pelo Sistema de Cadastro e Acompanhamento de Hipertensos e Diabéticos. Resultados: Dos 64.196 diabéticos, 3,9% tinham DM tipo 1, 10,9% DM tipo 2 e 85,2% eram hipertensos. A prevalência de DF foi de 2,9% no DM tipo 1, 3,3% no DM tipo 2 e 4,5% no DM com hipertensão. Maiores taxas de DF foram observadas no sexo masculino, com idade acima de 60 anos no DM tipo 1 e tipo 2, e até 19 anos no DM com hipertensão, tabagismo, sedentarismo, Infarto Agudo do Miocárdio (IAM), AVC e Doença Renal Crônica (DRC) ). Nos indivíduos com excesso de peso, a prevalência de DF foi maior apenas no DM tipo 1. Houve associação significativa em todas as variáveis exceto sobrepeso em ambos os tipos de DM, sedentarismo e acidente vascular cerebral no DM tipo 1. Conclusão: Os achados mostraram importantes prevalências de DF, com maior concentração em homens com mais de 60 anos, sobre tabagismo, sedentarismo, IAM, AVC e DRC, com associação estatística significativa nas variáveis analisadas, com exceção do excesso de peso em ambos os tipos de DM, como bem como sedentarismo e acidente vascular cerebral no DM tipo 1.

The aim of this paper is to describe the profile of maternal mortality of COVID-19 in the state of Ceará, Brazil, in the period 2020. Ecological, exploratory, cross-sectional study, with secondary data from the Influenza Epidemiological Surveillance Information System, were made available by the Obstetric Observatory Brazilian COVID-19. A total of 485 pregnant and postpartum women were included, and the analysis considered the notifications from the year 2020. The variables of interest and the outcome (death/cure by COVID-19) were analyzed in a descriptive way. Most pregnant and postpartum women were between 20 and 35 years old, brown/white skin color and residing in an urban area. The proportion of deaths was 5.8% in the year 2020. In that period, the rates of hospitalization in the ward increased by 95.5%, 12.6% of hospitalization in the Unit of Intensive Care (ICU), and 7.2% needed invasive ventilatory support. Maternal mortality from COVID-19 suggests an emergency in terms of the development of health actions and policies due to the aggravation and risks due to this disease.

A Unidade de Terapia Intensiva (UTI) é um lugar propício ao tratamento de pacientes em estado crítico, a adesão de mulheres gestantes em UTI na maioria das vezes é pela falta de acompanhamento adequado em relação ao pré-natal. A assistência de enfermagem é de grande importância, visto que, o enfermeiro e toda a sua equipe estão entre os profissionais que prestam essa assistência aos pacientes. Portanto, o objetivo do presente estudo foi descrever os principais cuidados de enfermagem na assistência às gestantes em UTI. Trata-se de uma revisão integrativa de literatura, com base no método PICO onde foi realizado a busca na literatura, na base de dados da Biblioteca Virtual em Saúde (BVS) que se trata de uma base de fonte terciária, contendo outras bases como MEDLINE, LILACS, IBECS etc. Utilizou-se a seguinte estratégia de busca: “Gravidez” AND “UTI” AND “Unidade de Terapia Intensiva” AND “Cuidados da Enfermagem”. Inicialmente, foram encontrados 258 estudos na BVS, tendo artigos da MEDLINE, LILACS e IBECS. No processo de seleção de títulos, 27 estudos foram selecionados, onde, posteriormente, na leitura de resumos, apenas 10 foram selecionados para leitura completa. Após aplicação dos critérios e avaliação criteriosa dos manuscritos, 04 estudos foram excluídos por não se adaptarem aos critérios de elegibilidade, assim ficaram 06 artigos para análise final. Observou-se que os cuidados de enfermagem na UTI prestados à gestante são, em sua maioria, relacionados ao monitoramento de sinais vitais e hemodinâmico. Ademais, notou-se uma escassez de enfermeiros especializados na assistência as gestantes nas UTI. The Intensive Care Unit (ICU) is a place conducive to the treatment of critically ill patients, the adherence of pregnant women in the ICU most of the time is due to adequate adaptation in relation to prenatal care. Nursing care is of great importance, since the nurse is among all the professionals who provide this care to patients. Therefore, the objective of the present study was to describe the main nursing care and assistance to pregnant women in the ICU. This is an integrative literature review, based on the PICO method, where the literature search was carried out, in the Virtual Health Library (VHL) database, which is a tertiary source database, containing other databases such as MEDLINE , LILACS, IBECS etc. The following search strategy was used: “Pregnancy” AND “ICU” AND “Intensive Care Unit” AND “Nursing Care”. Initially, 258 studies were found in the VHL, with articles from MEDLINE, LILACS and IBECS. In the title selection process, 27 studies were selected, where, later, when reading abstracts, only 10 were selected for full reading. After applying the analysis and careful evaluation of the manuscripts, 04 studies were excluded because they did not adapt to the eligibility criteria, so there were 06 articles for the final. It is observed that nursing care in the ICU is care for the pregnant woman, mostly related to the monitoring of vital and hemodynamic signs. In addition, medical assistance was noted in the ICU. La Unidad de Cuidados Intensivos (UCI) es un lugar propicio para el tratamiento de pacientes en estado crítico, la adherencia de las gestantes en la UCI la mayor parte del tiempo se debe a una adecuada adaptación en relación al control prenatal. El cuidado de enfermería es de gran importancia, ya que la enfermera se encuentra entre todos los profesionales que brindan este cuidado a los pacientes. Por lo tanto, el objetivo del presente estudio fue describir los principales cuidados y asistencia de enfermería a las gestantes en la UTI. Se trata de una revisión integrativa de la literatura, basada en el método PICO, donde se realizó la búsqueda bibliográfica, en la base de datos de la Biblioteca Virtual en Salud (BVS), que es una base de datos de fuente terciaria, que contiene otras bases de datos como MEDLINE, LILACS, IBECS, etc. Se utilizó la siguiente estrategia de búsqueda: “Pregnancy” AND “ICU” AND “Intensive Care Unit” AND “Nursing Care”. Inicialmente fueron encontrados 258 estudios en la BVS, con artículos de MEDLINE, LILACS e IBECS. En el proceso de selección de títulos, se seleccionaron 27 estudios, donde, posteriormente, al leer los resúmenes, solo 10 fueron seleccionados para lectura completa. Después de aplicar el análisis y evaluación cuidadosa de los manuscritos, 04 estudios fueron excluidos por no ajustarse a los criterios de elegibilidad, por lo que quedaron 06 artículos para la final. Se observa que el cuidado de enfermería en la UTI es un cuidado a la gestante, mayoritariamente relacionado con el seguimiento de los signos vitales y hemodinámicos. Además, se constató asistencia médica en la UCI.

Objetivo: identificar os pontos fortes e frágeis na Cultura de Segurança do Paciente (CSP) em um centro cirúrgico. Método: Trata-se de um estudo transversal realizado Hospital público terciário de referência na região do Cariri, Nordeste do Brasil. Participaram da pesquisa profissionais de saúde da área de enfermagem, que atenderam aos critérios de inclusão: ser profissional da área de enfermagem e trabalhar no mí­nimo 20 horas semanais. Foram exclusos os profissionais associados e/ou vinculados a cooperativa e os que ocupavam funções administrativas. Resultados: Dentre dimensões da CSP destacaram-se: aprendizagem organizacional continuada 93,8% e expectativas/ações da direção 85,6%. Enquanto as dimensões resposta não punitivas para erros (26,6%) e abertura para comunicações e mudança de turno/transições (65,8%), obtiveram os menores resultados. Conclusão: A liderança pode ser de fundamental importância para construção da CSP forte, a partir do aperfeiçoamento da comunicação entre a equipe e consequentemente remoção da cultura de culpa individual por erro.

Objetivo: Construir e validar um álbum seriado sobre sífilis adquirida a ser utilizado como estratégia educativa para adolescentes. Métodos: Trata-se de um estudo do tipo metodológico realizado em Recife, Pernambuco, no período de novembro de 2018 a abril de 2019. Obtiveram-se dados provenientes de 22 juízes especialistas para validação de aparência e conteúdo do álbum seriado e de 40 adolescentes de uma escola pública, os quais avaliaram o álbum quanto à aparência. Analisou-se a validade de conteúdo considerando: o Item – Level Content Validity Index (I-CVI); a concordância entre os juízes, por meio do coeficiente de correlação intraclasse (ICC); e a validade de aparência, usando o Suitability Assessment of Materials (SAM). Utilizou-se o software Statistical Package for the Social Sciences (SPSS) para análise. Resultados: O álbum seriado possui 20 páginas e contém orientações sobre a sífilis adquirida. A média do I-CVI foi de 0,97 pelos juízes especialistas; constatando-se como excelente nível de concordância entre as respostas. A partir do formulário o SAM, o álbum foi julgado como superior, obtendo uma média de 80,99% entre os juízes, sendo recomendada sua utilização pelo público ao qual se destina. Houve unanimidade pelos adolescentes na aprovação do material, julgando ser claro, de fácil compreensão e relevante. Conclusão: O álbum seriado foi construído e validado em seu conteúdo e aparência por juízes e, quanto à aparência, pelo público-alvo, podendo ser utilizado com adolescentes no ambiente escolar ou em outras realidades.

Introducao: A obesidade vem se tornando cada vez mais frequente em criancas, o que pode resultar em agravos a saude tanto na infância quanto na idade adulta. Considerando que, na idade escolar, os habitos alimentares podem sofrer influencia do contexto em que a crianca esta inserida, principalmente, estilo de vida, dentro e fora do ambiente escolar, torna-se importante avaliar o crescimento alcancado em estatura, bem como o seu estado nutricional, visto que este pode ser um indicativo de futuros e possiveis disturbios nutricionais, permitindo direcionar recursos e politicas publicas efetivas nessa faixa etaria. Objetivo: Avaliar o crescimento em estatura e o estado nutricional de criancas em idade escolar em funcao do sexo e idade em Florianopolis no primeiro semestre do ano letivo de 2012. Metodo: Estudo de corte transversal, realizado com 595 criancas de seis a dez anos de idade, frequentadoras de Escolas Publicas Municipais de Ensino Fundamental I, na cidade de Florianopolis, Estado de Santa Catarina, Brasil. Utilizou-se um questionario para coleta de dados. Os dados foram digitados e armazenados em planilhas, utilizando o programa Microsoft Excel 2007. A analise estatistica dos dados foi realizada com o Statistical Package for the Social Science (SPSS), versao 20.0. O peso e a altura foram inicialmente comparados a curva normal, aplicando-se o teste de distância Kolmogorov-Smirnov. Foram utilizados estatistica descritiva e o teste de correlacao de Pearson. Resultados: Evidenciou-se uma proporcao maior de criancas entre os sete e nove anos de idade, e tanto em relacao a estatura quanto ao IMC, as medianas estao superiores quando comparadas ao do referencial (Organizacao Mundial de Saude), revelando que as criancas estao crescendo bem, inclusive acima da media do referencial, mas que ao mesmo tempo apresentam um IMC acima do esperado, mesmo considerando a elevada estatura. O diagnostico do estado nutricional entre os meninos e meninas nao apresentaram diferencas estatisticas. Contudo, vale destacar que, embora a maior prevalencia seja de criancas eutroficas (70,3%), pode-se observar alta prevalencia de excesso de peso (sobrepeso, obesidade e obesidade grave), em torno de 28% da amostra. Conclusao: Embora com prevalencia do estado nutricional normal, identificou- se o sobrepeso e a obesidade. Evidenciou-se que o estado nutricional nao tem diferenca em funcao do sexo, contudo e influenciado pela idade e estatura.

Introduction: Overweight and obesity in childhood and adolescence are important public health problems. In this context, the school has been identified as a favorable environment for carrying out health education programs. The Health at School Program and its important performance stand out. Thus, considering these discussions, they ask: How are the actions developed by the Health at School Program, focused on nutrition, being implemented? Objective: Analyze the teenager monitoring in the School Health Program (PSE in Brazil) opposite actions to the nutritional aspects of adolescents. Methods: This is a descriptive, qualitative study in Juazeiro municipality North-Ce, with the subject 18 nurses of the Family Health Strategy (FHS) inserted in the PES that municipality. Results: Nurses have limited assistance in the face of food practices, which implies in its operations; report having difficulty performing their actions outside the conventional health units and focus on strategies for a food menu. Conclusion: The monitoring of adolescents in the School Health Program ahead nutritional value is still limited to preventive practices involving specific actions, limited to a Sfood education focused on the health problem and not the needs of adolescents.

This is an ecological and time-series study using secondary data on perinatal mortality and its components from 2008 to 2017 in Espírito Santo, Brazil. The data were collected from the Mortality Information System (SIM) and Live Births Information System (SINASC) of the Unified Health System Informatics Department (DATASUS) in June 2019. The perinatal mortality rate (×1000 total births) was calculated. Time series were constructed from the perinatal mortality rate for the regions and Espírito Santo. To analyze the trend, the Prais–Winsten model was used. From 2008 to 2017 there were 8132 perinatal deaths (4939 fetal and 3193 early neonatal) out of a total of 542,802 births, a perinatal mortality rate of 15.0/1000 total births. The fetal/early neonatal ratio was 1.5:1, with a strong positive correlation early neonatal mortality rate, perinatal mortality rate, r (9) = 0.8893, with a significance level of p = 0.000574. The presence of differences in trends by health region was observed. Risk factors that stood out were as follows: mother’s age ranging between 10 and 19 or 40 and 49 years old, with no education, a gestational age between 22 and 36 weeks, triple and double pregnancy, and a birth weight below 2499 g. Among the causes of death, 49.70% of deaths were concentrated in category of the tenth edition of the International Classification of Diseases, fetuses and newborns affected by maternal factors and complications of pregnancy, labor, and delivery (P00–P04), and 11.03% were in the category of intrauterine hypoxia and birth asphyxia (P20–P21), both related to proper care during pregnancy and childbirth. We observed a slow reduction in the perinatal mortality rate in the state of Espírito Santo from 2008 to 2017.

O estudo descreve a implantação de pequenos procedimentos cirúrgicos realizados por médicos residentes em uma Unidade de Saúde da Família. Trata-se de um relato de experiência realizado na cidade de Vitória, Espírito Santo, Brasil, descrevendo a introdução de pequenos procedimentos cirúrgicos pelo programa de residência médica em Medicina de Família e Comunidade em uma Unidade Básica de Saúde (UBS) do município. As unidades selecionadas não tinham espaço para pequenos procedimentos cirúrgicos ou os materiais necessários. Evidenciou-se que a população demandava queixas cirúrgicas sem resolução das mesmas, sendo esses pacientes encaminhados para outras especialidades.

Considerando a incidência e gravidade da ocorrência das lesões por pressão e o quadro clínico crítico do paciente de unidade de terapia intensiva, o presente estudo foi desenvolvido com o objetivo de identificar as principais escalas utilizadas para prevenção, avaliação e tratamento das LPP em unidade de terapia intensiva. A metodologia utilizada para a elaboração deste trabalho foi uma revisão integrativa de literatura. Esse tipo de pesquisa trata-se de uma metodologia clara e reprodutível, sendo que é um método específico que fornece uma visão mais abrangente de um determinado tema. Foi formulado um acrônimo PECO, para a elaboração da pergunta norteadora da pesquisa: Quais escalas utilizadas para prevenção, avaliação e tratamento de lesões por pressão em unidade de terapia intensiva? Na segunda fase, foi realizada a busca na literatura, nas bases de dados PubMed e BvS (Biblioteca Virtual em Saúde). Através da seguinte estratégia de busca: Unidades de Terapia Intensiva AND Lesão por Pressão AND Escala, onde foram encontrados 259 artigos. Destes, foram selecionados 21 artigos para leitura final, sendo que se utilizou 14 artigos selecionados no estudo. Os critérios de inclusão foram: artigos publicados nos últimos 10 anos, artigos em português/inglês e acesso online ao resumo na íntegra. Observou-se que a escala de Braden é um dos recursos mais utilizados nas UTIs para medir o risco dos pacientes críticos de desenvolverem lesões por pressão. A partir desse registro, os enfermeiros conseguem aplicar medidas preventivas e promover um tratamento eficaz. Considering the incidence and severity of the occurrence of pressure injuries and the critical clinical condition of the patient in the intensive care unit, the present study was developed with the objective of identifying the main scales used for the prevention, evaluation and treatment of PI in the care unit intensive. The methodology used for the elaboration of this work was an integrative literature review. This type of research is a clear and reproducible methodology, and it is a specific method that provides a more comprehensive view of a given topic. An acronym PECO was formulated for the elaboration of the guiding question of the research: Which scales are used for the prevention, evaluation and treatment of pressure injuries in an intensive care unit? In the second phase, a search was carried out in the literature, in the PubMed and BvS (Virtual Health Library) databases. Through the following search strategy: Intensive Care Units AND Pressure Injury AND Scale, where 259 articles were found. Of these, 21 articles were selected for final reading, and 14 selected articles were used in the study. Inclusion criteria were: articles published in the last 10 years, articles in Portuguese/English and online access to the full abstract. It was observed that the Braden scale is one of the most used resources in ICUs to measure the risk of critically ill patients to develop pressure injuries. Based on this record, nurses are able to apply preventive measures and promote effective treatment. Considerando la incidencia y severidad de la ocurrencia de lesiones por presión y la condición clínica crítica del paciente en la unidad de cuidados intensivos, el presente estudio fue desarrollado con el objetivo de identificar las principales escalas utilizadas para la prevención, evaluación y tratamiento de las IP en el unidad de cuidados intensivos. La metodología utilizada para la elaboración de este trabajo fue una revisión integrativa de la literatura. Este tipo de investigación es una metodología clara y reproducible, y es un método específico que proporciona una visión más completa de un tema determinado. Se formuló una sigla PECO para la elaboración de la pregunta orientadora de la investigación: ¿Qué escalas se utilizan para la prevención, evaluación y tratamiento de las lesiones por presión en una unidad de cuidados intensivos? En la segunda fase, se realizó una búsqueda en la literatura, en las bases de datos PubMed y BvS (Biblioteca Virtual en Salud). A través de la siguiente estrategia de búsqueda: Intensive Care Units AND Pressure Injury AND Scale, donde se encontraron 259 artículos. De estos, 21 artículos fueron seleccionados para lectura final y 14 artículos seleccionados fueron utilizados en el estudio. Los criterios de inclusión fueron: artículos publicados en los últimos 10 años, artículos en portugués/inglés y acceso en línea al resumen completo. Se observó que la escala de Braden es uno de los recursos más utilizados en las UCI para medir el riesgo de los pacientes críticos de desarrollar lesiones por presión. Con base en este registro, las enfermeras pueden aplicar medidas preventivas y promover un tratamiento eficaz.

Introdução: A assistência à saúde da mulher em nível de baixa complexidade é focada nas doenças mais comuns e pode ser afetada pela cobertura de atenção primária à saúde, principalmente em áreas distantes dos grandes centros urbanos. Objetivo: Analisar a relação entre nível socioeconômico, indicadores de saúde e cobertura de atenção primária na mortalidade por neoplasias do trato genital inferior e mama em mulheres brasileiras durante o período reprodutivo e não reprodutivo. Método: Trata-se de um estudo ecológico, realizado no Departamento de Ginecologia da Faculdade de Medicina da Universidade de São Paulo. Os dados secundários foram coletados de mulheres de acordo com os períodos reprodutivo e não reprodutivo e dados de mortalidade do Sistema de Informação de Mortalidade com base na Classificação Internacional de Doenças - 10ª edição, sobre neoplasias de mama e trato genital inferior no ano de 2017. Os indicadores dos serviços de saúde e os socioeconômicos foram obtidos no Departamento de Informática do Sistema Único de Saúde e no Instituto Brasileiro de Geografia e Estatística. Resultados: Os indicadores de cobertura de atenção básica e dos serviços de saúde não se associaram à mortalidade por câncer de mama e trato genital inferior feminino, tanto no período reprodutivo quanto no não reprodutivo. Indicadores sociodemográficos foram associados à mortalidade por câncer de mama e do trato genital feminino, com a renda sendo associada ao período reprodutivo (beta= -0,4; IC 95%, -0,8 a -0,03) e nível educacional no período não reprodutivos (beta= 9,7; IC 95%, 1,5 a 18,0). Conclusão: A mortalidade por neoplasias de mama e do trato genital feminino no Brasil não está associada à cobertura de atenção primária ou indicadores de serviços de saúde, tanto no período reprodutivo como no não reprodutivo. Os indicadores sociodemográficos estão associados à mortalidade por câncer de mama e do trato genital feminino, sendo a renda associada à mortalidade no período reprodutivo e a escolaridade associada à mortalidade no período não reprodutivo Introduction: Women\'s health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Objective: Analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. Method: Ecological study at the \"Departamento de Ginecologia da Faculdade de Medicina da Universidade de São Paulo\". Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease--10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Results: Primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period (beta = -0.4; 95% CI, -0.8 to -0.03) and educational level in the non-reproductive period (beta = 9.7; 95% CI, 1.5 to 18.0). Conclusion: Mortality due to breast and female genital tract neoplasms in Brazil is not associated with primary care coverage or health service indicators, both in the reproductive and non-reproductive periods. Sociodemographic indicators are associated with mortality from breast and female genital tract cancer, with income associated with mortality in the reproductive period and education associated with mortality in the non-reproductive period

Women&rsquo, s health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. We conducted an ecological study at the Gynecology Discipline, Medicine School, University of S&atilde, o Paulo. Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease&mdash, 10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Our results showed that primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period (&beta, = &minus, 0.4, 95% CI, &minus, 0.8 to &minus, 0.03) and educational level in the non-reproductive period (&beta, = 9.7, 95% CI, 1.5 to 18.0).

Background The National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented in 2004, with monitoring of potential benefits. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion are actions carried out by the Brazil National Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after implementation of PNAISM. Methods An ecological study was conducted from 2018 to 2020. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 the latter to correspond with the implementation of the National Policy. The death records of Brazilian women aged 40 to 64 years who had a designated cause of death were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results The main causes of death in women from 1996 to 2016 were circulatory system diseases (22.47%, 697,636 deaths), neoplasms (19.69%, 611,495 deaths), respiratory system diseases (5.5%, 170,716 deaths), endocrine, nutritional, and metabolic disorders (5.27%, 163,602 deaths), and digestive system diseases (3.74%, 116.280 deaths). Analyzing the changes in the major causes of death of climacteric women after implementation of the PNAISM we observed that mortality from circulatory system diseases and endocrine and nutritional diseases were significantly declined in post-PNAISM period: (β = − 3.63; 95% CI – 4.54 to − 2.73 r2 = 0.87; p R2 = 0.73; p p = 0,765; p = 0,233, respectively). Conclusions After implementation of the PNAISM, we observed a downward trend in rates of mortality from diseases of the circulatory and digestive systems and from endocrine, nutritional, and metabolic diseases but stability in the rates of death from neoplasm and respiratory system diseases.

Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, and the monitoring of potential benefits should be explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. In fact, prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System (SUS) and enshrined in health Brazilian policies for women. Thus, our purpose is to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation.Methods: Ecological study conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from Brazilian Health Department by accessing the mortality information system of National Health Information, divided in periods 1996-2004 and 2005-2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was 5%. (Stata 11® -StataCorp, LCC). Results: Main causes of women’s death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; pConclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes for neoplasms and respiratory system diseases. Thus, the analysis of women's health indicators, such as mortality rates, are fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for the women.

Background: The National Policy of Comprehensive Women’s Health Care was implemented more than two decades ago, and the monitoring of potential benefits should be explored. Menopause is a period of life for which there are prevention and health promotion actions carried out by the government’s all-encompassing sole Unify Health System (UHS) and factored into Brazilian policies. It is thus our purpose to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: This is an ecological study with secondary data analysis conducted by the Setor de Atenção Primária, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the IT Department of SUS between 1996 and 2016, divided in two periods 1996 to 2004 and 2005 to 2006 according to implementation of the National Police. The data included the death records of Brazilian women aged 35 to 64 years who had a precise diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was set at 5%. Stata 11® (StataCorp, LCC) was used. Results: Menopausal women’s main causes of death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p

Background and objectives: Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Esp&iacute, rito Santo, Brazil. Materials and Methods: This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes&mdash, SisHiperdia. Results: The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM.

Made available in DSpace on 2018-11-26T15:30:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01. Added 1 bitstream(s) on 2019-10-09T18:24:55Z : No. of bitstreams: 1 S1806-83242016000100220.pdf: 238901 bytes, checksum: 52be972a60195803a9ffd08f0d2f6d44 (MD5) Faculdade de Medicina do ABC - FMABC Faculdade de Juazeiro do Norte - FJN Dental treatment promotes psychosomatic change that can influence the procedure and compromise the general well-being of the patient. In this context, it highlights the importance of evaluating the function of the autonomic nervous system in individuals undergoing endodontic treatment. Thus, this manuscript aimed to analyse cardiac autonomic modulation, through non-linear indices of heart rate variability (HRV) during endodontic treatment. Analysis of 50 subjects of either sex aged between 18 and 40 years diagnosed with irreversible pulp necrosis of lower molars undergoing endodontic treatment was undertaken. We carried out fractal and symbolic analysis of HRV, which was recorded in the first session of the endodontic treatment at four intervals: T1: 0-10 min before the onset of the treatment session; T2: 0-10 min after the application of anaesthesia; T3: throughout the period of treatment; and T4: 0-30 min after the end of the treatment session. There was reduction of alpha 1 in T2 compared to T1 and T4 (p < 0.0001). The alpha 2 index also reduced in T2 compared to T3 (p = 0.0035). There was an increase in the alpha 1/alpha 2 ratio in T4 compared to T2 and T3 (p = 0.0003). It was found that 0V% was significantly lower in T2 (p = 0.002), while 2UV% was significantly higher (p < 0.0001) when compared to other points in time. In conclusion, HRV is reduced during endodontic treatment, and after applying local anaesthetic the parasympathetic component of HRV increases. These data indicate that endodontic treatment acutely overcharges the heart, supporting the stress involved in this situation. Fac Med ABC FMABC, Lab Delineamento Estudos & Escrita Cient, Santo Andre, SP, Brazil Fac Juazeiro Norte FJN, Fac Odontol, Dept Saude, Juazeiro Do Norte, CE, Brazil Oxford Brookes Univ, Fac Hlth & Life Sci, Dept Biol & Med Sci, Oxford OX3 0BP, England Univ Estadual Paulista UNESP, Fac Filosofia & Ciencias, Ctr Estudos Sistema Nervoso Autonomo, Marilia, SP, Brazil Univ Estadual Paulista UNESP, Fac Filosofia & Ciencias, Ctr Estudos Sistema Nervoso Autonomo, Marilia, SP, Brazil

INTRODUCTION: There are positive influences of religious and spiritual beliefs in the face of diseases such as cancer. OBJECTIVE: To analyse the influence of spirituality and religiosity in cancer in the perspective of cancer patients. METHODS: It is a qualitative, descriptive and exploratory research, carried out with 10 patients in cancer treatment, aged between 37 and 75 years. Data were collected through interviews, containing guiding questions about the theme and treated according to the Content Analysis. RESULTS: The results are summarized into three categories: (1) perceptions / conceptions of patients in the discovery of cancer; (2) vision and experience of spirituality / religiosity of cancer patients and (3) the influence of spirituality / religiosity in the treatment of cancer. They were discussed in the light of the relevant literature to the subject. CONCLUSION: Cancer brings a new life meaning for patients. Religion and spirituality have a strong relationship between the disease and faith in the possibilities of healing, which makes the religious coping a stress reduction strategy and improves quality of life of people.

Objective: Relate the process of managerial work performed by nurses-managers between a public and private hospital. METHODS: It is a descriptive and comparative research of qualitative approach, having as participants nurses that assume managerial functions in these organizations, totaling ten nurses-managers, five in each hospital. Semi-structured interviews were conducted based on the managerial process and to identify the hierarchical organization of each institution. RESULTS: For organization of results, according to the technique of thematic analysis, speeches were separated into three categories: (i) hospital Management: hierarchical flow and the active participation of those involved in the process; (ii) obstacles management in nursing and their positive reflections: faults and support for management training and (iii) manage hospital attention: administrative reflections and the process studied. The public hospital nurses reported a lack of organization charts, professionals and the little logistical support for realization of management practice. In the private hospital, the management process is organized and respects the proposed hierarchical flow, however, features mostly low-skill professionals due to rotation of jobs. FINAL CONSIDERATIONS: The study showed that the private hospital managers were more involved and with greater affinity to administrative matters, to the alignment of objectives for the organization, with a focus on efficiency. In this regard, the public hospital, the absence of these features, so these are difficult to trace and achieve goals, targets and implement their action plans. Therefore, the form of work of these nurses is based on demand management.

Introduction: Innovation in education should be done from the context and the factors that interfere in the construction and understanding of the curriculum. In the scope of nursing, teaching has undergone great changes in educational activities due to the demands of the capitalist world. Objective: To analyze the curriculum advances, which are announced as innovative educational projects aiming vocational training in nursing in Brazil. Methods: This is a systematic review of literature on curricular innovations and training of nursing students. The bibliographic survey was performed in the databases of Lilacs and Medline/PubMed using the following keywords: higher education, degree programs in Nursing and curriculum. Results: We found seven articles that addressed on the profile and training of professional nurses and curriculum changes in the undergraduate course. It became evident that the curricular changes of course still happen gradually, and reflect political moments which often doesn’t being in line with the current health model conjecture. Conclusion: Despite the curricular changes in nursing that happened due to socio-political movements, have not yet produced changes in teaching that are sufficiently in line with the requirements of the job market and are able to prepare focused professionals in humanized and contextualized care and involved in the transformation of reality.

Background: There are many animal studies demonstrating increased neuroapoptose in the first periods of development, especially in stronger neural development regions. In young cobais neuroapoptose also noted, however, more localized area as the dentate nucleus and the olfactory bulb of the brain regions that show sinaptogense even in adulthood and is responsible for learning. Objective: To describe the current studies about learning disabilities and cognitive impairment related to exposure to general anesthetics in children. Method: This is a systematic review, performed from the search in the PubMed database using the keywords "general anesthetics," "neurotoxicity", "children", "young child" and "pediatric" with the criterion inclusion, published in the last five years, in English and related exposure to anesthetics in human children . Were excluded from the articles concerning the studies in experimental animals or that they focus on side effects of other substances on the central nervous system, such as alcohol. Results: So were found 108 articles. All were analyzed by two researchers individually. Only 27 met the inclusion criteria. Discussion: In recent years, several studies have been conducted addressing neurotoxicity triggered by general anesthetics. The vast majority using experimental animals or stem cells. Suggest that both inhaled anesthetics such as venous are able to trigger the activation neuroapoptose with release of caspase 3:09, especially in phases of high growth and neural development. There is a strong association between duration of anesthesia and multiple exposures with learning disabilities and behavior. Conclusion: Currently, you can not say that the damage caused by agents in animals can be replicated humans. However, the severity of outcomes, the FDA recommends avoiding anesthesia and surgery in children under three years, at least those that do not have an emergency basis.

Introduction: The Paroxysmal Nocturnal Hemoglobinuria (PNH) is an acquired clonal disorder of one or more stem cells of hematopoietic lineage. It is characterized as a chronic hemolytic anemia in which there is a persistent intravascular hemolysis which is subject to exacerbations due to production of subpopulations of erythrocytes, platelets and granulocytes hypersensitive to complement. Furthermore there has been a high tendency to thrombosis. The anti-complement therapy is the only recognized treatment for this condition. We report a case of PNH with suboptimal response to anti-complement therapy. Method: This is one case report, obtained through data from medical records of a reference hospital, located in the city of Barbalha, Ceara, Brazil. Case report: Patient with PNH, with typical clinical features, however nonspecific from the onset of the clinical picture, especially marked by signs and symptoms of anemic syndrome (asthenia, lethargy palpitations, paleness). Showed present hemolysis markers and negative Coombs test. The flow cytometry closed the diagnosis of paroxysmal nocturnal hemoglobinuria and there was the initiation of the anti-complement therapy using the drug called eculizumab. After one year of treatment, the patient persists with anemia and sporadic episodes of hemoglobinuria, as well as present hemolysis markers. However, she remains free of thromboembolic events and without need for transfusion. Conclusion: The PNH is a rare pathology with high morbidity and mortality if not treated. The anti-complement therapy with eculizumab offers great chance of long-term control of the most harmful consequences of the disease.

Introduction: Adolescence is characterized as a transition period between childhood and adult life that imposes great physical, cognitive and psychosocial changes. During that period, the adolescent is exposed and vulnerable to the consumption of alcohol and drugs, and has been an scenery where nurses who works in the School Health Programs (SHP) interact with them. In this sense, the interaction between education and health can influence adolescents to become questioners of the risks they are exposed and look together for better options to improve their quality of life. Objective: To analyse the perception and health practices of Nurses working in the School Health Programs of prevention of alcohol and drugs during adolescence. Method: This is a descriptive and qualitative study carried out in the city of Juazeiro do Norte, Ceará, Brazil, with 18 nurses participating in the SHP, who implement actions with adolescents in schools. The data collection took place through a semi structured interview and their organization through thematic analysis. Results: The participants affirmed that the importance of their actions and work is directed to prevent the use of alcohol and drugs among adolescents, excluding the precepts of health promotion. They pointed out that the interaction between education and health is characterized as an effective strategy in the prevention of damages caused by the use of alcohol and drugs, emphasizing the participation of family members during the process of elaboration, application and continuity. It was also evidenced that the educational practices are performed mostly through lectures, characterizing a work centred on clinical, individual and curative practice. Conclusion: Nurses understand that the interaction between health and education is an effective strategy to prevent the use of alcohol and drugs in adolescents, emphasizing the importance of family participation in the process of construction and support of this context. However, it is possible to identify that the actions developed by these professionals are still restricted to modify some behaviours such as to improve their willing of sharing new knowledge.

Introduction: it is known that adolescence is a period of constant biopsychosocial changes. Based on this premise, it is understood that this population should be included as a priority in health systems, seeking their effective participation through strategies associated with health promotion. Objective: To analyse the participatory process of adolescents in health promotion activities from the perspective of the Bambu Method. Methods: this is a qualitative exploratory study, carried out in two schools located in Crato, Ceará, Brazil. Pupils are from 10 to 19 years old. The study was based on the Bambu Method, which is a means to boost the prospects of the group. It was done by observation of the participant, the environment, the verbal and non-verbal expressions of adolescents and a diary where relevant information was recorded. The organization of data occurred through the content analysis technique proposed by Bardin. Results: it was observed that the opportunity to express themselves with the host led young people to feel more at ease among others and induced the formation of a bond. The participatory process for adolescents was perceived as a process of facing reality and associated with learning, the stimulus for personal development, through the initiative of action, attitude and self-esteem. Conclusion: the Bambu Method proved to be a relevant framework to guide health education activities with groups of adolescents, allowing the development of activities suitable to the needs of the participants.

Introduction: acquisitions and changes in the motor and cognitive development of boys and girls are related not only to existing biological differences between both sexes, but also to socio-economic, cultural and family factors. Objective: to investigate the differences between sexes in the acquisition of anti-gravitational postures. Methods: the participants in this study were 638 children born at term (324 males and 314 females), from 0 to 18 months, coming from Infant Education Schools in the south of Brazil. The Alberta Infant Motor Scale (AIMS) was used to evaluate motor performance. Results: most of the evaluated children showed normal motor performance for their age (69.7%), with nonlinear development and plateaus in postural acquisition from 15 months. There were not significant differences (p>0.05) in motor performance between boys and girls from 0 to 18 months. Conclusion: motor development was similar between the sexes in the first months of life. However, throughout childhood, sociocultural differences and parents’ practices seem to influence differently the process of motor acquisition and development of skills, since children are exposed to experiences in conformity with sex expectations.

Introduction: The identification of factors related to children’s deaths is very important in planning public health actions for restructure and improve the mother and child assistance, aimed in reducing child mortality. Objective : Analyze the factors associated with infant mortality in the metropolitan area of Cariri, Ceara, Brazil. Method : This is a cross-sectional study. All deaths occurring in children under one year old of the metropolitan region of Cariri, Ceara, Brazil, contained in the mortality information system and in live births’s information system, from January 2009 to December 2013. Newborn variables (sex, race/color, weight, age); maternal variables (maternal age and education and type of gestation); assistance variables (labor type) were extracted from the SUS (Sistema Unico de Saude/Unified Health System) Informatics Department and presented in chart and tables in absolute and percentage frequency form. Results : In the five-year period, 816 infant deaths in 48321 births were registered associated to the following factors: 453 (55.5%) male, 471 (57.7%) drab and 514 (63%) low weight in birth, 458 (56.1%) with 20 to 34 years of age, 353 (43.2%) 8 years or more of schooling, 657 (80.5%) only pregnancy and 414 (50.7%) vaginal birth. Conclusion : Infant mortality variables in the metropolitan region of Cariri, Ceara, Brazil were associated mostly with deaths occurring in drab boys with birth weight below the normal, whose mothers were young, with good education and who had just one gestation, born of vaginal birth.