Ageo Mário Cândido da Silva

Abandono do tratamento da tuberculose pulmonar em Cuiabá - MT - Brasil

OBJECTIVE: To analyze factors predictive of noncompliance with pulmonary tuberculosis treatment. METHODS: A historical cohort study involving 481 of the 529 active tuberculosis patients registered with the Tuberculosis Control Program in the city of Cuiaba, located in the state of Mato Grosso, during the 1998-2000 period. Data were obtained by analyzing medical charts and registration records. In the bivariate analysis, the chi-square test was used to calculate noncompliance rate ratios (relative risk), 95% confidence intervals were determined, and Fishers exact test was used. The choice to estimate the rate of incidence was the method of density and a multivariate logistic regression model was constructed in order to identify the variables that were most predictive of noncompliance, using a level of statistical significance of p < 0.05. RESULTS: The global rate of incidence was 27.3%, equivalent to 5.1 noncompliant patients/100 patients/month, increasing in the second and third months of treatment. In the final logistic regression model, the following were considered predictors of noncompliance: unsupervised treatment (odds ratio: 2.58; 95% confidence interval: 1.64 - 4.06; p < 0.001); having been treated during the 1998-1999 period (odds ratio: 1.43; 95% confidence interval: 1.14 - 1.80; p = 0.002); being male (odds ratio: 1.39; 95% confidence interval: 1.10 - 1.76; p = 0.005) and having been out of compliance with previous treatment regimes (odds ratio: 1.37; 95% confidence interval: 1.06 - 1.78; p < 0.017). CONCLUSION: The results indicate an elevated incidence of noncompliance and show that unsupervised treatment, year in which treatment was received, male gender and prior noncompliance were predictors of future noncompliance.

Fatores ambientais e hospitalizações em crianças menores de cinco anos com infecção respiratória aguda

Considering hospitalization as an indicator of seriousness of acute respiratory infection (ARI), this study focuses on the association between some environmental factors with the need for hospitalization of children with a diagnosis of ARI. The study analyzed all the medical records (at the Municipal Emergency Ward in Cuiabá, Mato Grosso State) of children under five years of age (both sexes), collected by month of attendance. Two weather seasons were considered: dry (May-October) and rainy (November-April). Variables included: temperature, relative humidity, and number of fires (due to extensive slashing and burning for agriculture in the region). Prevalence of ARI was 49.8%, and hospitalization was required in 7.6% of cases, with a higher percentage during the dry season. The dry season and lower relative humidity were associated with increased pediatric hospitalization rate due to ARI.

Incidence and predicting factors of falls of older inpatients

OBJECTIVE To estimate the incidence and predicting factors associated with falls among older inpatients. METHODS Prospective cohort study conducted in clinical units of three hospitals in Cuiaba, MT, Midwestern Brazil, from March to August 2013. In this study, 221 inpatients aged 60 or over were followed until hospital discharge, death, or fall. The method of incidence density was used to calculate incidence rates. Bivariate analysis was performed by Chi-square test, and multiple analysis was performed by Cox regression. RESULTS The incidence of falls was 12.6 per 1,000 patients/day. Predicting factors for falls during hospitalization were: low educational level (RR = 2.48; 95%CI 1.17;5.25), polypharmacy (RR = 4.42; 95%CI 1.77;11.05), visual impairment (RR = 2.06; 95%CI 1.01;4.23), gait and balance impairment (RR = 2.95; 95%CI 1.22;7.14), urinary incontinence (RR = 5.67; 95%CI 2.58;12.44) and use of laxatives (RR = 4.21; 95%CI 1.15;15.39) and antipsychotics (RR = 4.10; 95%CI 1.38;12.13). CONCLUSIONS The incidence of falls of older inpatients is high. Predicting factors found for falls were low education level, polypharmacy, visual impairment, gait and balance impairment, urinary incontinence and use of laxatives and antipsychotics. Measures to prevent falls in hospitals are needed to reduce the incidence of this event.

Variações climáticas e uso de serviços de saúde em crianças asmáticas menores de cinco anos de idade: um estudo ecológico

OBJECTIVE: To study variations in climate (dry or rainy periods) and health services use for the treatment of asthma in children under five years of age. METHODS: An ecological study was conducted and involved analysis of the medical charts of all children under the age of five that were diagnosed with asthma and treated in the Municipal Emergency Room of the city of Cuiaba, located in the state of Mato Grosso, Brazil. In accordance with the geographic location of Cuiaba, two climatic periods were identified: a dry season (from May to October) and a rainy season (from November to April). RESULTS: The percentage of children treated that were diagnosed with asthma was 12.2% (3140/25,802), with no gender-based difference. Children from 3 to 5 years of age were most often affected. The overall asthma hospitalization rate was 1.3% (336/25,802), rising to 10.7% (336/3140) among the asthmatic children treated in the emergency room. In the rainy season, the percentage of outpatients seeking treatment for asthma was higher than in the dry season: 39.1% (1228/3140) versus 60.9% (1912/3140). However, during the dry season, a greater proportion of such patients were hospitalized: 52.3% (176/336) versus 47.7% (160/336). These differences were statistically significant (p < 0.05). CONCLUSIONS: The dry season, which was correlated with higher asthma hospitalization rates, seems to be related to more severe cases of asthma in children under five years of age.

Vigilância aos agrotóxicos: quantificação do uso e previsão de impactos na saúde-trabalho-ambiente para os municípios brasileiros

This paper analyzes the quantity, type and toxicity of pesticides used per hectare in the State of Mato Grosso as a surveillance strategy for the health of workers, the population in general and the environment, and to serve as a surveillance indicator for Brazilian cities. Brazil cultivated 95 million hectares in 2012, and Mato Grosso was the major consumer of pesticides. In this research, the database of the Agriculture and Livestock Defense Institute was consulted, as it records the prescribed agronomic data and place of use in sales invoices. The results reveal the average consumption of pesticides per hectare per crop: 12 liters for soy; 6 liters for corn; 4.8 liters for sugarcane; and 24 liters for cotton. The toxicological types and classes of pesticides used per hectare per crop were also monitored. Using a matrix of agricultural production and pesticide consumption, it was also found that certain health problems are correlated with the major producing regions. Based on pesticide consumption, agricultural production and pesticide toxicity it is possible to ascertain health problems in Brazilian cities and establish prevention and surveillance strategies for the workers, the environment and the populations exposed to pesticides.

Um estudo comparativo entre características de personalidade de universitários fumantes, ex-fumantes e não-fumantes

Introduction: The study of the relationship between personality and smoking behavior can be useful in the treatment of tobacco dependence. Objectives: To identify personality traits in smokers, ex-smokers and non-smokers. Methods: A total of 1,245 students enrolled at Universidade Federal de Mato Grosso were selected. A standard questionnaire was applied aiming at identifying sociodemographic characteristics and tobacco consumption patterns in the students, followed by the revised version of the Comrey Personality Scales (CPS). ANOVA analysis of variance was used to compare the meanINTRODUCAO: O estudo da relacao entre personalidade e tabagismo pode subsidiar o tratamento da dependencia. OBJETIVOS: Identificar caracteristicas de personalidade de fumantes, ex-fumantes e nao-fumantes. METODO: Foram selecionados 1.245 estudantes matriculados na Universidade Federal de Mato Grosso. Foi aplicado um questionario padronizado para levantamento do perfil sociodemografico e padrao de consumo de tabaco dos estudantes, seguido pela versao revisada das Escalas Comrey de Personalidade (CPS). Utilizou-se a analise de variância ANOVA para comparacao dos escores de fumantes, ex-fumantes e nao-fumantes no CPS e duas analises de regressao logistica multipla para avaliar as associacoes entre os escores do CPS e tabagismo. RESULTADOS: Foi encontrada prevalencia de 6,67% de fumantes, 6,58% de ex-fumantes e 86,73% de nao-fumantes. A primeira analise de regressao logistica detectou associacao positiva entre a categoria fumante e os escores nas escalas de masculinidade (M) e tendenciosidade (R) e associacao inversa com a escala de ordem x falta de compulsao (O) do CPS. A segunda detectou associacao negativa da categoria ex-fumante com os escores obtidos em R e M e positiva com a escala de atividade x falta de energia (A) do CPS. DISCUSSAO: Fumantes foram mais tendenciosos e adotaram mais o estereotipo social da masculinidade em relacao a nao-fumantes e ex-fumantes. Fumantes se descreveram mais como descuidados, relaxados, imprudentes, nao-sistematicos e pouco asseados em comparacao aos nao-fumantes. Ex-fumantes apresentaram mais vigor, energia e disposicao em relacao aos fumantes. Supoe-se que esses resultados possam subsidiar programas de tratamento da dependencia nicotinica.

Psychological profile and nicotine dependence in smoking undergraduate students of UFMT

INTRODUCTION: Data on the relationship between personality profile and nicotine dependence may help health professionals to design and improve programs for the treatment and prevention of this dependence. OBJECTIVE: To investigate the relationship between personality profile and nicotine dependence in a group of smoking undergraduate students. METHODS: A total of 1,245 undergraduate students were randomly selected among 10,500 students enrolled at the Cuiaba campus of UFMT in 2001. A standard questionnaire was applied for social characterization and for the determination of the tobacco consumption pattern, comprising 80 students considered as smokers. These students were then submitted to the Fagerstrom Test (1978) for nicotine dependence and to the reduced version of the Comrey Personality Scale (CPS), that determines personality dimensions. RESULTS: Analysis of the mean scores (Students t test) revealed an inversely proportional borderline association between dependence and the Order x Lack of Compulsion scale (p = 0.06), and a negative or inversely proportional association between the CPS Extroversion x Introversion (p = 0.002) and Control of Validity scales (p = 0.04). Linear regression analysis of the Fagerstrom Test points confirmed the inversely proportional borderline association between dependence and the Order x Lack of Compulsion (p = 0.06) and CPS Extroversion x Introversion scales (p = 0.02). However, when the interference of daily cigarette consumption was controlled, only the Extroversion x Introversion scale remained associated with dependence (p = 0.001). CONCLUSION: Students who are nicotine-dependent smokers are less extroverted than non-dependent smokers.

Fatores associados às alterações da função pulmonar em trabalhadores de indústria de cerâmica

O objetivo deste artigo e analisar a funcao pulmonar em trabalhadores de industrias de cerâmica no municipio de Varzea Grande, Mato Grosso. Estudo transversal realizado com 183 trabalhadores de industrias de cerâmica desse municipio. Para identificacao dos fatores sociodemograficos, fatores ambientais e do tabagismo foi utilizado um questionario estruturado e para avaliacao da funcao pulmonar foi realizada a espirometria. Foram realizadas analises descritiva, bivariada e regressao multipla de Poisson. Os trabalhadores em sua maioria sao do sexo masculino (94%) predominando individuos com idade ate 39 anos (74,9%). A prevalencia de sintomaticos respiratorios foi de 44,9%, sendo 14,8% portadores de sintomas considerados como graves e 30,1% sintomas nao graves. Foram encontradas associacoes de funcao pulmonar alterada com as variaveis tempo de exposicao e substância inalada. Os trabalhadores com 4 ou mais anos de exposicao apresentaram 1,99 vezes mais funcao pulmonar alterada que os individuos com tempo de exposicao de ate 3 anos ; os individuos que inalaram poeira e desmoldante apresentaram 2,97 vezes mais alteracao da funcao pulmonar. Esta, nos trabalhadores avaliados, esta relacionada ao maior tempo de exposicao e a inalacao de poeira e desmoldante.Researchers suggest that inadequate eating behavior (IEB) in young people can be influenced by several factors. However, the results have been controversial. Thus, the objective of this study was to investigate the effects of body dissatisfaction (BD), the degree of psychological commitment to exercise (DPCE), the usual level of physical activity (LPA), the body mass index (BMI), the fat percentage and ethnicity on CAI in adolescents. The participants included 362 young men and women between 10 and 19 years of age. The Eating Attitudes Test (EAT-26) was used to assess IEB. In addition, the Body Shape Questionnaire, the Commitment to Exercise Scale and the International Physical Activity Questionnaire were used to assess BD DPCE and LPA, respectively. Multivariate analysis and multiple regression was conducted to analyze the data. The results showed that BD, DPCE, BMI and body fat percentage significantly influenced (p<0.05) scores of the subscales of the EAT-26, both in females and males. However, the effects of variances were different between the sexes. The conclusion was that BD and BMI were the main factors that promoted significant effects in the different constructs of eating behavior assessed by the EAT-26 in both sexes.

Distúrbio de voz e fatores associados em professores da rede pública

Objetivo: analisar a prevalencia e os fatores associados ao disturbio de voz em professores. Metodos: estudo transversal com 317 professores. Utilizou-se o questionario Condicao de Producao Vocal do Professor. A variavel dependente foi o disturbio de voz autorreferido. Foram realizadas analises bivariada, estratificada e regressao multipla de Poisson. Resultados: a prevalencia do disturbio de voz foi de 81%. Para o estrato dos professores do ensino fundamental, apenas a poeira (RP = 1,37; IC = 1,12-1,69) foi associada ao disturbio de voz. Para o estrato dos demais professores, as variaveis ritmo de trabalho estressante (RP = 1,81; IC = 1,17-2,82), estresse no trabalho (RP = 2,47; IC = 1,20-5,07), trabalho repetitivo (RP = 1,18; IC = 1,01-1,38), levar trabalho para casa (RP = 1,80; IC = 1,01-3,79) e escola ruidosa (RP = 1,41; IC = 1,03-1,92) apresentaram associacoes com disturbio de voz. Na analise multipla, estresse no trabalho (RP = 1,50; IC = 1,05-2,15), poeira (RP = 1,21; IC = 1,06-1,39) e falar carregando peso (RP = 1,16; IC = 1,05-1,28) permaneceram associadas ao disturbio de voz, exceto o tempo de profissao maior ou igual a 10 anos (RP = 0,88; IC = 0,79-0,98), que apresentou efeito protetor. Conclusao: a prevalencia de disturbio de voz entre os professores e alta e os fatores associados relacionam-se ao ambiente e a organizacao do trabalho.

[Correlation between agricultural production, clinical and demographic variables and prostate cancer: an ecological study].

Risk factors involved in the etiology of prostate cancer are not well known. The objective of this study was to explore correlations among variables relating to agricultural production, the use of health services, food consumption and socio-demographic characteristics and prostate cancer mortality rates in Brazilian states. Univariate analysis of spatial data for investigation of global spatial autocorrelation in prostate cancer mortality rates in Brazilian states between 2005 and 2009 was conducted. Using bivariate analysis, the correlation between socio-demographic indicators, agricultural production data, variables related to the use of health services dietary intake variables and prostate cancer mortality rates were examined. The production of soybeans and corn were positively correlated with prostate cancer mortality. In multiple linear spatial regression, the variables that showed an association with mortality rates from prostate cancer were tons of soybeans produced (p = 0.030), proportion of the population aged 80 and over (p < 0.001) and consumption of beverages (p < 0.001). A positive correlation between tons of soybeans planted and mortality from prostate cancer was identifed, suggesting the possible existence of an association between exposure to pesticides and prostate cancer.