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Background: Investigation based solely on clinical history background is not sufficient to prove drug allergy and may lead to search for more expensive and potentially less effective alternative drugs. There are too few health centers that perform such tests in Brazil. Objectives: The aim of the present work was to structure and to systematize a service for in vivo drug skin testing in a public university hospital. Methods: The project was structured as follows: a) Divulgation about the service among health professionals and also among patients; b) Active search for suspicious cases; d) Referral to the allergist consultation; c) Performance of skin prick, intradermal and/or epicutaneous tests when requested. Results: Disclosure about the service was done through informal talk, workshop, flyers, advertisement. Active search for suspicious cases was done at the Dermatology Outpatient Clinics, Walter Cantidio Hospital School, Brazil. Ninety patients were evaluated by the allergist, and from these, 68 were submitted to drug skin tests. Thirty-five patients out of 68 presented clinical manifestations up to 2 h after drug intake and 33, more than 2h after drug intake. The drugs most implicated were NSAIDS and β-lactam drugs. Seventy-seven tests carried out. For immediate reading, 41 puncture tests and 12 intradermal tests were performed. For delayed reading, 24 epicutaneous tests were done. Two patients presented positive prick test to dipyrone. Conclusion: For implementing an adequate and effective service for drug skin testing, technical and practical training of health professionals about drug safety is necessary, besides interdisciplinary collaboration and an adequate support by the hospital managers. Key words: Patient Care, Skin drug test, Drug hypersensitivity, Drug allergy tests, Public hospital.

Objetivo: Comparar características sociodemográficas, comportamentais, condições de saúde e parâmetros laboratoriais entre idosos anêmicos e não anêmicos. Métodos: Estudo epidemiológico transversal realizado com 257 idosos. Para realizar as comparações utilizou-se o teste t para amostras independentes e o teste não paramétrico U de Mann-Whitney. Resultados: Encontrou-se maior proporção de anemia em idosos com idade acima de 80 anos (p=0,026), e maior proporção de dependência para atividades básicas (p=0,018) e instrumentais (p=0,010) da vida diária em idosos com anemia. Identificou-se diferença na distribuição da dosagem dos parâmetros laboratoriais, sendo as concentrações médias de ureia e creatininamaiores nos idosos anêmicos, e esses tiveram menores concentrações de glicemia, albumina, ALT/TGP, cálcio sérico e T3 total. Conclusão: A anemia não está relacionada exclusivamente ao processo de envelhecimento, mas sim resultado de múltiplos fatores como as condições sociodemográficas, de saúde, alimentares e de vida dos idosos. Descritores: Anemia, Hemoglobina, Envelhecimento

OBJECTIVES Few studies have investigated the influence of polyunsaturated fatty acid consumption on excessive weight gain during pregnancy. Thus, we analyzed the association between the intake of polyunsaturated fatty acids (ω-6 and ω-3) and weight gain in women during pregnancy. METHODS This is a cohort study of 250 pregnant women enrolled in municipal pre-natal services. Weight, height, and dietary intake of polyunsaturated fatty acids were evaluated at the baseline. The semi-quantitative food frequency questionnaire was employed to assess the main exposure. Gestational weight was measured in the first, second, and third trimesters. A dietary pattern involving the consumption of fatty acids was identified through factor analysis. A generalized estimating equation was used for the data analysis. RESULTS The prevalence of excessive weight gain at the end of pregnancy was 35.2%. Consumption patterns 1 (salted meats, offal, vegetable oil, snacks, legumes, and oleaginous foods) and 2 (red meat, sausages, butter, margarine, mayonnaise, acaraje, caruru, vatapa, and refined cereals) revealed a risk for the accumulation of excess weight during pregnancy. Women who adhered to consumption patterns 1 (RR: 2.39; 95% CI: 1.44-3.94) and 2 (RR: 2.39; 95% CI: 1.44-3.94) were more susceptible to excess weight gain during pregnancy. CONCLUSIONS Women who adhered to dietary patterns involving foods that are sources of ω-6 fatty acids and saturated fatty acids were more susceptible to gaining weight during pregnancy compared to those who adhered less to these patterns.

Introduction. Sickle cell disease (SCD) children have a high susceptibility to pneumococcal infection. For this reason, they are routinely immunized with pneumococcal vaccines and use antibiotic prophylaxis (AP). Hypothesis/Gap Statement. Yet, little is known about SCD children’s gut microbiota. If antibiotic-resistant Enterobacterales may colonize people on AP, we hypothesized that SCD children on AP are colonized by resistant enterobacteria species. Objective. To evaluate the effect of continuous AP on Enterobacterales gut colonization from children with SCD. Methodology. We analysed 30 faecal swabs from SCD children on AP and 21 swabs from children without the same condition. Enterobacterales was isolated on MacConkey agar plates and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) (bioMérieux, Marcy l'Etoile, France). We performed the antibiogram by Vitek 2 system (bioMérieux, Marcy l'Etoile, France), and the resistance genes were identified by multiplex PCR. Results. We found four different species with resistance to one or more different antibiotic types in the AP-SCD children’s group: Escherichia coli , Klebsiella pneumoniae , Citrobacter freundii , and Citrobacter farmeri . Colonization by resistant E. coli was associated with AP (prevalence ratio 2.69, 95 % confidence interval [CI], 1.98–3.67, P E. coli , 4/30 (13 %), and K. pneumoniae , 2/30 (7 %). The ESBL-producing Enterobacterales were associated with penicillin G benzathine use (95 % CI, 22.91–86.71, P Conclusion. Resistant enterobacteria colonize SCD children on AP, and this therapy raises the chance of ESBL-producing Enterobacterales colonization. Future studies should focus on prophylactic vaccines as exclusive therapy against pneumococcal infections.

O câncer é uma doença crônica degenerativa que acomete milhares de pessoas em diferentes idades. Entretanto, o número de casos entre jovens que não fumam nem bebem em excesso, mas praticam sexo oral sem proteção, tem crescido vertiginosamente. Isso porque o Papilomavírus Humano (HPV) está diretamente associado a cada vez mais casos de câncer. Nesse contexto, profissionais de saúde devem estar atentos à população para rastrear e tratar os enfermos. O objetivo deste trabalho foi descrever o conhecimento dos Agentes Comunitários de Saúde (ACS) de uma região do município de Camaçari, na Bahia, sobre câncer oral e sua relação com o HPV. Trata-se de um estudo descritivo, transversal, no qual aplicou-se um questionário previamente testado. Para a análise dos dados, foram empregados os recursos da estatística descritiva (frequência relativa e absoluta). Observou-se que 95,1% dos participantes do estudo já ouviram falar sobre câncer bucal e 85,4% já receberam informações sobre o HPV, entretanto apenas 48,8% relataram saber a associação do câncer bucal com o HPV. Apesar de 97,6% dos ACS acharem que o fumo cause câncer oral, essa porcentagem caiu ao se referir ao álcool (58,5%) e ao sexo desprotegido (63,4%), ambos como fatores etiológicos. Conclui-se que medidas de educação permanente devem ser bem executadas, a fim de possibilitar um melhor entendimento dos profissionais e o desenvolvimento de ações mais efetivas de promoção da saúde e prevenção de doenças.

This study aimed to investigate the factors associated with drug use in pregnancy by risk categories in pregnant women from Santo Antônio de Jesus, Bahia. It is a cross-sectional cohort study with 1,091 pregnant women attended in primary health care between 2012 and 2014. Drug use during pregnancy was classified according to the FDA’s pregnancy risk classification. Prevalence ratios and respective 95% confidence intervals were adjusted by Poisson regression with robust error variance. The prevalence of drug use was more pronounced in risk categories A, B, C, D, and X, respectively. The use of safe medication was associated with education, number of prenatal consultations, and health problems after data adjustment. Age greater than 24 years, onset of prenatal care during the first trimester, and have any health problem were factors associated with the use of risk medication. Quality prenatal care is important to ensure the safe and conscious use of drugs. Furthermore, investments in continuing vocational education that promote rational antenatal drug use are needed. Este estudio tuvo como objetivo investigar los factores asociados al uso de medicamentos en el embarazo por categorías de riesgo en gestantes del municipio de Santo Antônio de Jesus, Bahía. Se trata de un estudio transversal anidado en la cohorte prospectiva con 1.091 gestantes atendidas en atención primaria de salud entre 2012 y 2014. El uso de medicamentos durante el embarazo siguió la clasificación de medicamentos según los criterios de riesgo de la FDA. Las razones de prevalencia y sus respectivos intervalos de confianza del 95% se ajustaron mediante regresión de Poisson con varianza robusta. La prevalencia del uso de medicamentos fue más pronunciada en las categorías de riesgo A, B, C, D y X, respectivamente. Después del ajuste, el uso de medicamentos seguros se asoció con educación, número de consultas prenatales y problemas de salud. Tener más de 24 años, iniciar la atención prenatal en el primer trimestre y tener un problema de salud fueron factores asociados al uso de medicamentos de riesgo. La atención prenatal de calidad es importante para garantizar el uso seguro y consciente de los medicamentos. Además, se necesitan inversiones en educación profesional continua para promover el uso racional de los medicamentos en el período prenatal. Este estudo teve como objetivo investigar os fatores associados ao uso de medicamentos na gestação por categorias de risco em gestantes do município de Santo Antônio de Jesus, Bahia. Trata-se de um estudo transversal aninhado à coorte prospectiva com 1.091 gestantes atendidas na atenção primária à saúde entre 2012 e 2014. A utilização de medicamentos durante a gestação seguiu a classificação dos medicamentos segundo critérios de risco da FDA. As razões de prevalência e seus respectivos intervalos de confiança de 95% foram ajustados por regressão de Poisson com variância robusta. A prevalência do uso de medicamentos foi mais pronunciada nas categorias de risco A, B, C, D e X, respectivamente. Após o ajuste, o uso de medicamentos seguros foi associado à escolaridade, número de consultas pré-natal e problemas de saúde. Idade superior a 24 anos, início do pré-natal no primeiro trimestre e ter algum problema de saúde foram fatores associados ao uso de medicamentos de risco. O pré-natal de qualidade é importante para garantir o uso seguro e consciente dos medicamentos. Além disso, são necessários investimentos em educação profissional continuada que promova o uso racional de medicamentos no período pré-natal.

Objectives: this study aims to evaluate the association between gestational weight gain and the weight of newborns from one municipality in Recôncavo Baiano region. Methods: this is a prospective cohort (NISAMI Cohort), conducted with 185 pregnant women living in the urban area of the municipality of Santo Antônio de Jesus, using the prenatal service of the Family Health Units, between April 2012 and June 2013. The pregestationalBMI and the third trimester of pregnancy were used to assess maternal anthropometric status.Birth weight data were collected from the Epidemiological Surveillance of the municipality. Stata 12.0 software was used for statistical analysis. Logistic regression analysis was used to evaluate to assess the association. Results: among the 185 women evaluated, 33.5% presented inadequate weight gain during pregnancy. The prevalence of inadequate birth weight was 20% (birth weight ≤ 2.999g and ≥ 4.000 g). It was observed that inadequate weight gain during pregnancy is considered an embarrassing factor for birth weight (OR= 2.6; CI95%= 1.5-3.5); adjusted for the following variables: alcohol consumption, duration of pregnancy, and gestational complications. Conclusion: the research results suggest that weight gain throughout pregnancy influences the weight of the conceptus, indicating the need for nutritional interventions in all trimesters of pregnancy, promoting a healthy weight gain throughout the gestational cycle. Resumo Objetivos: avaliar a associação entre ganho ponderal na gestação e o peso de recém-nascidos em um município do Recôncavo Baiano. Métodos: trata-se de uma coorte prospectiva (Coorte NISAMI), conduzida com 185 gestantes residentes na zona urbana do município de Santo Antônio de Jesus, captadas no serviço de pré-natal das Unidades de Saúde da Família, entre abril de 2012 a junho de 2013. O IMC pré-gestacional e do terceiro trimestre da gestação foram utilizados para avaliar o estado antropométrico materno. Os dados de peso ao nascer foram coletados da Vigilância Epidemiológica do município. Utilizou-se o software Stata 12.0 para as análises estatísticas. Empregou-se análise de regressão logística para avaliar a associação. Resultados: das 185 mulheres, 33,5% apresentaram ganho ponderal inadequado ao longo da gestação. A prevalência de peso inadequado ao nascer foi de 20% (peso ao nascer ≤2.999g e ≥ 4.000 g). Observou-se que o ganho de peso inadequado no período gestacional é considerado fator constrangedor do peso ao nascer (OR= 2,6; IC95%= 1,5-3,5; ajustado pelas variáveis: consumo de bebida alcoólica, duração da gestação e intercorrências gestacionais. Conclusão: o resultado desta investigação sugere que o ganho de peso ao longo da gestação exerce influência no peso do concepto indicando necessidade de intervenções nutricionais em todos os trimestres da gestação, promovendo um ganho ponderal saudável em todo ciclo gestacional.

The association between FI, social determinants, and nutritional outcomes for pregnant women are analyzed. A systematic review was conducted through a search of articles in five electronic databases. Social determinants (race, education, participation in social programs) and nutritional status (pre-gestational BMI, gestational weight gain, anemia) were analyzed in relation to the FI situation. For each article, the frequency of food insecurity was collected in order to calculate the summary measure, prevalence ratio (PR). 26 articles were selected. An elevated occurrence of FI was associated with black pregnant women (PR: 1.83, 95% CI 1.08-3.10), participation in social protection programs (PR = 1.43, 1.02-2.01), and with low education levels on the part of pregnant women (PR = 2.73, 1.68-4.43). FI increased the chances of being overweight (PR = 1.57, 95% CI = 1.29-1.91) and obese (PR = 1.47, 95% CI = 1.15-1.87) in pregnant women, as well as excessive weight gain (PR = 1.42, 95% CI = 1.10-1.82) and inadequate weight gain (PR = 1.47; 95% CI = 1.09-1.97) during pregnancy. Anemia was not associated with FI. Social inequities are associated with food and nutritional insecurity in pregnant women. Resumo O estudo objetiva analisar a associação entre insegurança alimentar, determinantes sociais e estado nutricional de mulheres gestantes por meio de uma revisão sistemática e metanálise. As buscas de artigos ocorreram em cinco bases eletrônicas. Determinantes sociais (raça, escolaridade, participação em programa social) e estado nutricional (IMC pré-gestacional, ganho de peso gestacional, anemia) foram analisados em relação à situação de IA. Em cada estudo, a frequência de insegurança alimentar foi coletada para calcular a medida sumário- razão de prevalência (RP) e seu intervalo de confiança de 95%(IC95%). Foram selecionados 26 artigos. Observou-se elevada ocorrência de IA em gestantes pretas (RP:1,83; IC 95% 1,08-3.10), naquelas com participação em programas de proteção social (RP = 1.43; IC 95%= 1.02- 2.01) e com baixo nível de escolaridade (RP = 2.73; IC 95%= 1.68-4.43). O fato de a gestante possuir companheiro protegeu contra IA (RP = 0.61; IC 95%= 0.40-0.95). A experimentação da IA elevou a chance de sobrepeso (RP = 1.57; IC 95% = 1.29-1.91) e de obesidade (RP = 1.47; IC 95% = 1.15-1.87), assim como o ganho excessivo (RP = 1.42; IC 95% = 1.10-1.82) e inadequado (RP = 1.47; IC 95%= 1.09-1.97) de peso na gestação. Iniquidades sociais estão associadas a IA em gestantes.

It is known that sarcopenia is a multifaceted phenomenon, which involves genetic, nutritional, hormonal and living habits aspects. Then, an integrated analysis, as a multivariate approach, could improve the comprehension about the determinants of sarcopenic state in old adults. The present study aimed to investigate the interaction among serum vitamin D, daily caloric and protein intake, lifestyle habits, ACE I/D gene polymorphism and sarcopenic state in community-dwelling old adults. One hundred one community-dwelling old adults were clinically stratified as sarcopenic or non-sarcopenic. Serum vitamin D, daily caloric and protein intake, lifestyle habits (smoking, physical activity level and sedentary behavior) and ACE I/D gene polymorphism were recorded. A multivariate logistic regression technique was applied to investigate the interaction among the selected independent variables and the sarcopenic state. The independent variables age, smoking, serum Vitamin D and ACE I/D polymorphism achieved the statistical criteria to be inserted in the multivariate analysis. After a stepwise procedure from the multivariate logistic regression, the variables age, serum Vitamin D and ACE I/D polymorphism remained, together, in the final model. Sarcopenic state was significantly associated to older age, II-genotype and low serum Vitamin D in old adults from 60 years old.

Summary Objective We analyzed the serum vitamin D concentrations and identified the factors associated with vitamin D deficiency in Brazilian pregnant women, in a city with a high solar exposure. Methods Cross-sectional study with a sample of 190 pregnant women in a municipality in the Brazilian state of Bahia. Socio-environmental information, regarding the lifestyle and biological factors of participants, was collected and recorded in a questionnaire, and serum concentrations of 25(OH)D was determined (PR). Results The deficient and insufficient vitamin D concentrations were found in 14.21% and 44.74% of the pregnant women, respectively. Vitamin D deficiency was associated with commuting to work via motor vehicles (PR: 2.79; 95% CI: 1.06–7.31), with winter (prevalence ratio – PR: 1.54; 95% CI: 1.01–2.35), exposure to the sun only on the face and hands (PR: 2.99; 95% CI: 1.35–6.63) and single pregnant women (PR: 2.53; 95% CI: 1.01–6.35). Conclusions We detected a high proportion of pregnant women with vitamin deficient and insufficient vitamin D levels among pregnant women of a sunny city. These data suggest the necessity to monitor serum vitamin D levels during pregnancy and the adequate orientation in prenatal care to adoption healthy lifestyle for the prevention of vitamin D deficiency in this population.

The mother’s diet during pregnancy is associated with maternal and child health. However, there are few studies with moderation analysis on maternal dietary patterns and infant birth weight. We aim to analyse the association between dietary patterns during pregnancy and birth weight. A prospective cohort study was performed with pregnant women registered with the prenatal service (Bahia, Brazil). A food frequency questionnaire was used to evaluate dietary intake. Birth weight was measured by a prenatal service team. Statistical analyses were performed using factor analysis with a principal component extraction technique and structural equation modelling. The mean age of the pregnant women was 27 years old (SD: 5.5) and the mean birth weight was 3341.18 g. It was observed that alcohol consumption (p = 0.05) and weight-gain during pregnancy (p = 0.05) were associated with birth weight. Four patterns of dietary consumption were identified for each trimester of the pregnancy evaluated. Adherence to the “Meat, Eggs, Fried Snacks and Processed foods” dietary pattern (pattern 1) and the “Sugars and Sweets” dietary pattern (pattern 4) in the third trimester directly reduced birth weight, by 98.42 g (Confidence interval (CI) 95%: 24.26, 172.59) and 92.03 g (CI 95%: 39.88, 165.30), respectively. It was also observed that insufficient dietary consumption in the third trimester increases maternal complications during pregnancy, indirectly reducing birth weight by 145 g (CI 95%: −21.39, −211.45). Inadequate dietary intake in the third trimester appears to have negative results on birth weight, directly and indirectly, but more studies are needed to clarify these causal paths, especially investigations of the influence of the maternal dietary pattern on the infant gut microbiota and the impacts on perinatal outcomes.

Food plays essential role for the health of pregnant women. Due to the intense metabolism period, it is necessary healthy food consumption which ensures the development of an adequate pregnancy. Due to this information, the aim of this study is to analyze the adequacy of food groups consumed by pregnant women attending prenatal consultations in the health units of the municipality Reconcavo in Bahia. It is a cross sectional study involving pregnant women in prenatal service of the public network over the years 2010, 2011 and 2012. It was used structured questionnaire with socio-demographic information, obstetric and health. To assess food consumption it was used the Survey of Food Consumption Frequency (FFQ). The portions of the food groups were determined then analyzed according to the food pyramid adapted to the Brazilian population. It was also analyzed the socioeconomic characteristics of the sample. They interviewed 70 pregnant women aged between 20 and 45 years. Among these women, 75.8% were married or in a stable relationship, 78.6% with high school degree, 36.2% had family income lower than the minimum wage and 41.5% declare themselves as black. It was observed that the socioeconomic characteristics can influence directly on the diet of pregnant women. In the analysis of food groups was noted insufficient intake of legumes, milk and dairy products, and excessive consumption of the group of sugar/sweets and meats and eggs. There was inadequate food consumption in terms of qualitative (food groups), not taking into account the specific needs of the gestational cycle, which may result in nutritional risk to mother and fetus.

OBJETIVO: Analisar a associação entre raça/cor da pele e a ocorrência da prematuridade. MÉTODOS: Meta-análise com estudos observacionais, selecionados por revisão sistemática em bases de dados bibliográficos Medline e Biblioteca Virtual da Saúde com os descritores: “Race or ethnic group” e “ethnicity and health” associados às palavras “infant premature” e “obstetric labor premature”. Foram incluídos os artigos publicados no período de 2010 a 2014, do tipo epidemiológico observacional, nas línguas portuguesa, inglesa e espanhola. Foram excluídos os artigos que não possuíam resumos ou que fossem artigos de revisão, teses, dissertações e editorias. Foi adotado o risco relativo e seus respectivos intervalos de confiança (IC95%) como medidas de efeito, obtidos por meio do modelo de efeito aleatório e representados a partir do gráfico do tipo forest plot. Para analisar os possíveis vieses de publicação e qualidade dos estudos, foi utilizado o teste de Egger e a escala de Newcastle-Ottawa, respectivamente. RESULTADOS: Dos 926 artigos identificados, 17 foram elegíveis para o estudo. Dos 17 textos completos publicados, sete eram estudos de coorte retrospectiva, nove eram transversais e um era caso-controle. Com exceção de um estudo, os demais relataram associação positiva entre a raça/cor da pele e a prematuridade. Comparado com recém-nascidos a termo, o risco relativo do efeito combinado naqueles que nasceram prematuros foi de 1,51 (IC95% 1,39–1,69). O gráfico de funil sugeriu viés de publicação. CONCLUSÕES: A presente meta-análise indicou uma associação positiva para o risco da prematuridade segundo a raça/cor da pele.

Studies conducted among populations of tropical countries have reported high prevalences of vitamin D deficiency and insufficiency. Information resulting from meta-analyses on the spatial distribution of vitamin D deficiency and insufficiency in tropical countries is still rare. The aim of this review was investigated the prevalence of vitamin D deficiency and insufficiency among the Brazilian population. Observational studies were searched in eight electronically databases. Additionally, theses and dissertations and abstracts were screened. Details on study design, methods, population, mean and data on serum concentrations of vitamin D in different age groups in Brazil were extracted. Data were pooled using a random-effects model and choropleth maps were created based on the geopolitical regions of the country. 72 published paper met the inclusion criteria. The mean vitamin D concentration among the Brazilian population between 2000 and 2017 of 67.65 nmol/L (95% CI: 65.91, 69.38 nmol/L).The prevalences of vitamin D deficiency and insufficiency were 28.16% (95% CI: 23.90, 32.40) and 45.26% (95% CI: 35.82, 54.71), respectively, for the Brazilian population. The highest prevalence of deficiency were observed in the southern and southeastern regions and the highest occurrence of vitamin D insufficiency was among the populations of the southeastern and northeastern regions. Finally, there are high prevalence of inadequate vitamin D concentrations among the population, regardless of age group in Brazil. The development of vitamin D food fortification policies in needs to be cautious and carefully planned.

Background: Periodontitis is an inflammatory disease characterized by the loss of connective tissue and alveolar bone. Different factors are associated with the onset and prognosis of this disease, both environmental and genetic. The latter particularly relate to molecules secreted as a function of the host immune response, such as pro-inflammatory cytokines. Studies indicate that the polymorphism c. 3954C > T in the interleukin-1 β encoding gene (IL1B) can be considered as an aggravating factor in the periodontitis condition. Aims: This study aimed to evaluate whether there is an association between the IL1B c. 3954C > T gene polymorphism and the prevalence of periodontitis in the population from Vitória da Conquista–Bahia, Brazil. Materials and Methods: A total of 347 subjects (134 cases and 213 controls) who provided epithelial tissue of the oral cavity and saliva samples for DNA extraction and quantification of IL1B, respectively, were selected. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism followed by electrophoresis in agarose gel. The evaluation of the cytokine concentration was performed by enzyme-linked immunosorbent assay. Statistical Analysis: Statistical calculations involved in this work include Chi-square test, Fisher Exact test, Mann–Whitney and Kruskal–Wallis tests. Results: Our findings revealed that: (i) No statistically significant relationship between periodontitis and the polymorphism studied was observed; (ii) no significant difference between the concentrations of IL1B in saliva between the case and control subjects and between the genotypes of these individuals and the concentrations of this cytokine. Conclusions: We conclude that, in the sample evaluated, the IL1B c. 3954C > T polymorphism did not present as an etiological factor for periodontitis.

Objective To identify the prevalence of anemia and its relation to food insecurity (FI) and other determinants in pregnant women. Methods A cross-sectional, cohort-nested study, with the participation of 245 pregnant women who were cared for at Family Health Units in the municipality of Santo Antônio de Jesus, Bahia, Brazil. The participants underwent blood tests for hemoglobin levels, anthropometric examinations, and answered a structured questionnaire. The hemoglobin (Hb) parameter (Hb < 11 g/dL) was used for the classification of the diagnosis of anemia. Food insecurity was evaluated using the North American short-scale food insecurity assessment. Logistic regression was adopted for the statistical analyses, based on a hierarchical conceptual model that enabled the measurement of the decomposition of the total effect of its non-mediated and mediated components using the proposed hierarchical levels. Results The prevalence of anemia in the studied population was of 21.8%, and the average hemoglobin was 12.06 g/dL (standard deviation [SD]: 1.27). Food insecurity was identified in 28.16% of the pregnant women. The average maternal age was 25.82 years (SD: 5.94). After ranking, the variables positively associated with anemia remained significant: FI (odds ratio [OR] =3.63; 95% confidence interval [95%CI]: 1.77-7.45); not undergoing prenatal care (OR = 5.15;95%CI: 1.43-18.50); multiparity (OR = 2.27;95%CI: 1.02-5.05); and non-supplementation of iron medication (OR = 2.45; 95%CI: 1.04-5.76). The results also indicated that the socioeconomic and environmental factors were largely mediated by food insecurity and factors regarding prenatal care. Conclusions In the present study, the chance of occurrence of anemia in pregnant women was significantly higher,mainly among women: in situations of food insecurity, not undergoing prenatal care, not having received iron supplements, and who are multiparous. Resumo Objetivo Identificar a prevalência de anemia e sua relação com a insegurança alimentar (IA) e outros determinantes em mulheres grávidas. Métodos Trata-se de estudo transversal aninhado a uma coorte, do qual participaram 245 gestantes atendidas em Unidades de Saúde da Família do município de Santo Antônio de Jesus-BA. As participantes foram submetidas a exame de sangue para dosagem de hemoglobina, exame antropométrico, e responderam a um questionário estruturado. Utilizou-se o parâmetro hemoglobina (Hb < 11 g/dL) para a classificação do diagnóstico de anemia. A IA foi avaliada por meio da escala curta norte-americana de avaliação da segurança alimentar. Para as análises estatísticas, adotou-se a regressão logística, tomando-se como base um modelo conceitual hierarquizado definido a priori, que possibilitou a mensuração da decomposição do efeito total em seus componentes não mediados e mediados nos níveis hierárquicos propostos. Resultados A prevalência de anemia na população estudada foi de 21,8%, e amédia de hemoglobina foi de 12,06 g/dL (desvio padrão [DP]: 1,27). A IA foi identificada em 28,16% das gestantes. A média de idade materna foi de 25,82 anos (DP: 5,94). Após a hierarquização, permaneceram significativas as variáveis associadas positivamente à anemia: IA (razão de possibilidades [OR] = 3,63; intervalo de confiança de 95% [IC95%]: 1,77-7,45); não realização de pré-natal (OR = 5,15; IC95%: 1,43-18,50); multiparidade (OR = 2,27; IC95%: 1,02-5,05); e a não suplementaçãomedicamentosa de ferro (OR = 2,45; IC95%: 1,04-5,76). Os resultados indicaram ainda que os fatores socioeconômicos e ambientais forammediados emgrande parte pela IA e pelos fatores de cuidado pré-natal. Conclusões Nesse estudo, a chance de ocorrência de anemia em gestantes foi significantemente maior, principalmente, entre aquelas que estavam em situação de IA, não realizaram o pré-natal, eram multíparas, e não fizeram a suplementação de ferro.

Resumo: Estudo transversal aninhado à coorte prospectiva com o objetivo de avaliar a prevalência e os fatores associados à utilização de medicamentos em gestantes antes e durante a gravidez em município do interior da Bahia, Brasil. As informações foram coletadas mediante um questionário estruturado aplicado às gestantes no momento do acompanhamento pré-natal em unidades de saúde do município. A prevalência para consumo de medicamentos antes e durante a gestação foi 52,1% e 84,7%, respectivamente. Após análise, os seguintes fatores estavam associados à utilização de medicamentos antes da gestação: ≥ 30 anos de idade, as não pretas, as que iniciaram o pré-natal depois do 1º trimestre e as que fazem parte da classe econômica C/D/E. Há um aumento de prevalência de utilização de medicamentos durante a gestação entre as gestantes com escolaridade ≥ 11 anos de estudo, ter feito mais de três consultas pré-natais e ter algum problema de saúde. As gestantes estão expostas ao uso de medicamentos antes e durante a gestação apesar da carência de informações seguras que fundamentem o uso de medicamentos nessa fase, e esse uso está associado a fatores relativos ao acompanhamento pré-natal, sugerindo-se a inclusão mais ativa do farmacêutico na equipe para orientação e apoio ao uso racional de medicamentos. Abstract: This cross-sectional prospective nested cohort study aimed to assess the prevalence of use of medication before and during pregnancy and associated factors in women in a municipality in the countryside of Bahia State, Brazil. Data were collected with a structured questionnaire applied to pregnant women at their prenatal visits at health units. Prevalence rates for use of medication before and during pregnancy were 52.1% and 84.7%, respectively. The following were associated with use of medication before pregnancy: age ≥ 30 years, non-white skin color, first prenatal visit after the 1st trimester, and economic classes C/D/E. There was an increase in medication during pregnancy among women with ≥ 11 years of schooling, women with more than three prenatal visits, and those with some health problem. Pregnant women are exposed to medication before and during pregnancy, notwithstanding the lack of secure information to back the use of medicines during this phase; such use is associated with factors pertaining to prenatal follow-up, suggesting the need for more active participation by pharmacists in orientation and support for rational use of medicines. Resumen: Estudio transversal situado en una cohorte prospectiva, con el objetivo de evaluar la prevalencia y factores asociados a la utilización de medicamentos en gestantes antes y durante el embarazo en un municipio del interior de la región de Bahía, Brasil. La información fue recogida mediante un cuestionario estructurado, aplicado a las embarazadas en el momento del seguimiento prenatal en unidades de salud del municipio. La prevalencia para el consumo de medicamentos antes y durante la gestación fue un 52,1% y un 84,7%, respectivamente. Tras el análisis, los siguientes factores estaban asociados a la utilización de medicamentos antes de la gestación: ≥ 30 años de edad; no afro-brasileñas; quienes comenzaron con el seguimiento prenatal tras el 1º trimestre, y las que forman parte de la clase económica C/D/E. Existe un aumento de prevalencia de utilización de medicamentos durante la gestación entre las gestantes con una escolaridad ≥ 11 años de estudio, haber realizado más de tres consultas prenatales y que tengan algún problema de salud. Las gestantes están expuestas al uso de medicamentos antes y durante la gestación, a pesar de la carencia de información segura que fundamente el uso de medicamentos en esa fase, y ese uso está asociado a factores relativos al seguimiento prenatal, sugiriéndose la inclusión más activa del farmacéutico en el equipo para la orientación y apoyo al uso racional de medicamentos.

The aim of this study was to use indicators to evaluate physician adherence to prescription guidelines for heart failure treatment in a university hospital. This was a prospective cohort study conducted in a university hospital. The information collected at the time of patient admission, including therapeutic indication, absolute contra indications and intolerance, was utilised for the formulation of a guideline adherence indicator (GAI). This indicator was calculated as follows: (the number of patients who used the medication/the number of eligible patients) x 100. The percentage of eligible patients was calculated using the following formula: (the number of eligible patients/the total number patients) x 100. The GAI was applied to a population of 53 patients. Inhibitors of angiotensin-converting enzyme/angiotensin receptor blocker (ACE-I/ARB) combination therapy were used in the greatest percentage of eligible patients (92.4%) and demonstrated the largest GAI value (73.5%). The percentages of patients who were eligible for beta-blockers, spironolactone and digitalis treatments were 81.1%, 52.8% and 60.4%, respectively. The GAI values for the use of beta-blockers, spironolactone and digitalis were 60.4%, 57.1% and 56.2%, respectively. For the studied patient population, the GAI was consistent with the proportion of patients who were eligible to receive digitalis and spironolactone. O objetivo deste estudo foi utilizar indicadores para avaliar a adesão de médicos às diretrizes para tratamento da Insuficiência Cardíaca em um hospital universitário. Estudo de coorte prospectivo, conduzido em um hospital universitário. As variáveis coletadas na admissão do paciente foram: indicação terapêutica, contraindicações absolutas e intolerância, sendo utilizadas para elaboração de um indicador de adesão à diretriz (IAD). Este indicador foi calculado através da relação: (número de pacientes que utilizaram o medicamento/número de pacientes elegíveis) x 100. A % de pacientes elegíveis foi calculada da seguinte forma: (número de pacientes elegíveis/número total de pacientes) x 100. Os IAD foram aplicados para uma população de 53 pacientes. Os Inibidores da Enzima Conversora de Angiotensina/Bloqueadores dos Receptores de Angiotensina foram as classes farmacológicas que apresentaram maior % de pacientes elegíveis (92,4%) e apresentaram o melhor IAD (73,5%). A % de pacientes elegíveis para beta-bloqueadores, espironolactona e digitálicos foi de 81,1%, 52,8% e 60,4%, respectivamente. O IAD para beta-bloqueadores foi 60,4%, espironolactona 57,1% e digitálicos 56,2%. Na população estudada, o IAD foi compatível com a proporção de pacientes elegíveis para digitálicos e espironolactona.

Breastfeeding contributes positively to the growth and development of children and presents advantages immunological,psychological and nutritional. Additionally, it leads to considerable reduction in mortality from all causes and is alsoimportant for women’s health. Considering the information presented, there is the objective of this study was to identifythe knowledge and practice of breast-feeding of pregnant women attending health facilities in one district of ReconcavoBaiano. It is a cross-sectional study involving pregnant women attending antenatal care in health facilities in the municipalityReconcavo of Bahia, October/2010 to May/2011. The study excluded women with HIV / AIDS or who refused toparticipate. We used a structured questionnaire on breastfeeding and breastfeeding technique, containing 34 questions,19 aimed at multiparous on previous experience with breastfeeding. We interviewed 50 pregnant women, 68% primiparous.About 76% of women felt that children should breastfeed exclusively breastfed until 6 months, and 80% consideredstrong breast milk. Regarding the benefits of breastfeeding for the health of women, 88% recognized the importance ofthis practice and pointed as the main benefit to reducing breast cancer (68%). Although most mothers present knowledgeabout the importance of breastfeeding, it is not yet satisfactorily applied in the practice of breastfeeding. Must stress theimportance of education initiatives and support breastfeeding from antenatal and even the phase of introduction of newfoods for optimal breastfeeding.

Purpose To investigate the occurrence of adverse drug reactions (ADRs) and associated risk factors in a pediatric hospital in northeast Brazil, from August to December 2001. Subjects/Setting Two hundred seventy two patients hospitalized for more than 24 hours. Methods Prospective cohort study. Daily visits were performed for inclusion or attendance of patients and collection of information on drug prescriptions and medical events. The visits were focused on the detection of adverse events. WHO categories were used to assess the imputability and severity of suspected ADRs. Results Two hundred sixty five patients (97%) were exposed to medicines during hospitalization; the most frequent diagnosis was pneumonia (30%), the therapeutic class most prescribed was anti-infectives for systemic use (26%). Of a total of 420 adverse events, 47 ADRs were detected in 33 of 265 children treated with drugs. The cumulative incidence of ADRs was 12.5% (33/265); incidence density was 8 events per 1000 patient days (33/4042 patient-days). The skin was the most affected organ (49%); the drugs more implicated were systemic antibiotic (53.2%). The ADRs were mild or moderate in 97.9% of cases; causality was probable in 57.5% and the majority of events were independent of the dose given (55.3%). In multivariate analysis, the risk of ADR increased with the number of drugs, male gender, and ≥3 previous hospitalization courses. Conclusion ADRs are not uncommon among hospitalized children, particularly those with prior histories of hospitalization and concomitant use of several medicines. Copyright © 2005 John Wiley & Sons, Ltd.

Aim. Periodontitis is an inflammatory disease that affects the teeth supporting structures, triggered by periodontal pathogens, and is influenced by environmental and genetic factors. Genes encoding molecules related to the immune response, such as cytokine, are the main candidates for polymorphisms analysis and may be possibly associated with this pathology. A G/C promoter polymorphism on the IL6 gene has been shown to affect basal IL-6 levels. The aim of this study was to investigate the association between the IL6 c.-174G>C polymorphism and periodontitis in individuals from Vitória da Conquista, Bahia, Brazil. Material and Methods. Three hundred and thirty individuals (134 cases, 196 controls) were genotyped for the IL6 c.-174G>C by MS-PCR technique. Concentrations of salivary IL-6 were determined by ELISA method. Results. The IL6 c.-174G>C polymorphism was associated with periodontitis when comparing the distribution of genotypes between patients with periodontitis and control subjects. The GC genotype appeared as a protective factor for periodontitis. Results showed increased levels of salivary IL-6 in periodontitis patients. Nevertheless, there was no relationship between the concentrations of IL-6 and genotypes when comparing the case and control groups. Conclusions. Our data indicate an association between IL6 c.-174G>C polymorphism and periodontitis and showed that IL-6 may be considered an important marker for periodontitis.

Acesso ao texto completo: http://www.springerlink.com/content/l4uux73314054207/fulltext.pdf Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2011-09-27T14:12:02Z No. of bitstreams: 1 Pattern of asthma medication use among children.doc: 26624 bytes, checksum: 3580c79ac11e20308ff875ee2fa80cc4 (MD5) Made available in DSpace on 2011-09-27T14:12:02Z (GMT). No. of bitstreams: 1 Pattern of asthma medication use among children.doc: 26624 bytes, checksum: 3580c79ac11e20308ff875ee2fa80cc4 (MD5) Previous issue date: 2011 Purpose Despite the advances in asthma therapeutics, there are few data on the use and determinants of anti-asthmatic drugs in the general population of children. This study describes the use of asthma medications among children in the general population and in children with current asthma, living in a large urban center in Brazil. Methods A population-based cross-sectional survey, aimed at analyzing asthma determinants, was conducted with 1,382 children aged 4–11 years, between February and May 2006, in Salvador, Brazil. At baseline, an extensive questionnaire was applied, including questions about the use of asthma medications in the last 12 months. Results In all studied children (n=1,382) aged 4–11 years, oral beta2-agonists were the drugs most frequently used (9.8%), followed by short-acting inhaled beta2-agonists (4.3%) and systemic corticosteroids (1.6%). Antiasthmatic drug use was higher among males than females, and it significantly decreased with age in both genders. A total of 312 children (22.6%) reported current asthma, and 62% of them were not being treated with any antiasthmatic drugs. Of all those who reported following a certain type of treatment, 20% used oral beta2-agonists alone; 6.1%, short-acting inhaled beta2-agonists alone; and 4.8%, a combination of both drugs. Anti-asthmatic drug use did not differ according to socioeconomic status,except for the use of inhaled beta2-agonists and systemic corticosteroids. Conclusions An overwhelming majority of asthmatic children were not using long-term medications for asthma, in particular inhaled corticosteroids, regardless of the severity of their disease. This result points to the deficiencies of the Brazilian public health system in recognizing this important pharmacological need for child care and thereby limiting the access of these children to a group of efficacious, available, and low risk therapeutic medications. Suécia

Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Hospital São Rafael. Salvador, BA, Brasil Pfizer Inc. New York, USA Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Hospital São Rafael. Salvador, BA, Brasil Bristol Urological Institute. Southmead Hospital. Bristol, England / Global Study of Sexual Attitudes and Behaviors. GSSAB. Investigators’ Group CONTEXTO E OBJETIVO: A prevalência e os fatores correlatos de desordens sexuais masculinas como disfunção erétil e ejaculação precoce têm sido estudados em muitos países, entretanto, bem menos investigações se ocuparam especificamente dos problemas sexuais femininos. Além disso, relativamente pouco se sabe sobre a freqüência usual da atividade sexual e sobre como indivíduos mais velhos tentam lidar com seus problemas sexuais. O objetivo deste estudo foi estudar a atividade sexual, a prevalência de problemas sexuais e os comportamentos de busca de ajuda relacionados a esses problemas, entre homens e mulheres de meia-idade e mais velhos no Brasil. TIPO DE ESTUDO: Inquérito populacional realizado pela Faculdade Oswaldo Cruz. Pesquisa por telefone (discagem aleatória) conduzida no Brasil em 2001 e 2002. MÉTODOS: As entrevistas foram baseadas num questionário padronizado, incluindo informações demográficas, saúde em geral, e comportamentos, atitudes e crenças sexuais. Um total de 1.199 indivíduos no Brasil (471 homens e 728 mulheres) de 40 a 80 anos completou o inquérito. RESULTADOS: Ao todo, 92,6% dos homens e 58,3% das mulheres referiram alguma atividade sexual no ano que precedeu a entrevista, e mais da metade dos homens e mulheres reportaram atividade sexual mais de uma vez uma semana. Ejaculação precoce (30,3%) foi o problema sexual masculino mais comum, seguido por incapacidade de alcançar o orgasmo (14,0%), dificuldades de ereção (13,1%) e falta de interesse sexual (11,2%). Os problemas sexuais relatados mais freqüentemente por mulheres foram dificuldades de lubrificação (23,4%) e falta de interesse sexual (22,7%). Depressão foi correlacionada significativamente com problemas sexuais nos homens e nas mulheres. Mais mulheres do que homens tinham procurado a ajuda de um profissional de saúde para seu problema(s) sexual(is). CONCLUSÕES: Os achados do GSSAB destacam a importância de encorajar o maior uso dos serviços de saúde disponíveis, incluindo consultas médicas sobre queixas ligadas à saúde sexual. Isso deverá não somente possibilitar que homens e mulheres mantenham uma função sexual satisfatória até idades mais avançadas, mas também poderá resultar numa melhora geral da qualidade da assistência à saúde. CONTEXT AND OBJECTIVE: Relatively little is known about the usual frequency of sexual activity and how older individuals cope with sexual problems. The objective was to study sexual activity, prevalence of sexual problems and related help-seeking behaviors among middle-aged and older men and women in Brazil. DESIGN AND SETTING: Population survey, by Fundação Oswaldo Cruz. METHODS: Interviews were held with 1,199 Brazilians aged 40-80 years (471 men and 728 women). The standardized questionnaire investigated demographics, general health, sexual behavior, attitudes and beliefs. RESULTS: Overall, 92.6% of men and 58.3% of women had had sexual intercourse during the preceding year. More than half of the men and women had done so more than once a week. Early ejaculation (30.3%) was the commonest male sexual problem, followed by inability to reach orgasm (14.0%), erectile difficulties (13.1%) and lack of sexual interest (11.2%). For women, the commonest sexual problems were lubrication difficulties (23.4%) and lack of sexual interest (22.7%). Depression was a significant correlate of sexual problems, for men and women. More women than men had sought help for sexual problem(s) from a healthcare professional. CONCLUSIONS: The findings highlight the importance of encouraging greater use of available healthcare services, including consultation with a medical doctor regarding sexual health. This should not only enable men and women to maintain satisfactory sexual function well into their later years, but may also result in overall improvement in the quality of healthcare.