Débora Moura da Paixão Oliveira

Incidence of Rotavirus and All-Cause Diarrhea in Northeast Brazil Following the Introduction of a National Vaccination Program

BACKGROUND & AIMS Rotavirus vaccines were introduced in Brazil in 2006; we evaluated their effects in the state of Sergipe, Brazil. METHODS We performed a cross-sectional survey of children with diarrhea attending emergency services in Aracaju, Brazil, between October 2006 and April 2008 and a cluster sampling survey to assess vaccination coverage. Vaccine efficacy was assessed using the screening method. Diarrhea consultation and hospitalization data (2003-2007) were obtained from state and national surveillance systems. RESULTS Rotavirus was detected in 59 of 534 stool samples (11%) from children attending emergency services. The number of rotavirus-positive samples decreased from 18 of 74 (24%) in 2006 to 31 of 321 (9.5%) in 2007 and 10 of 136 (7.4%) in 2008 (P < .01). Diarrhea severity was greater in children with rotavirus (P < .01) but decreased over time (P < .001). Of the rotaviruses detected, 56 of 59 (95%) were P[4]G2 genotype, 1 was P[4]G-non-typeable (NT), 1 was P[NT]G2, and 1 was P[NT]GNT. Diarrhea consultations decreased from 3020 in 2004 to 604 in 2007; reductions were greatest among children under 5 years old. Diarrhea hospitalizations decreased from 2121 in 2003 to 1176 in 2007. Vaccine coverage was 90.3%. Vaccines were highly effective against the strain P[8]G1; efficacy against P[4]G2 genotype was 89% (95% confidence interval: 0.87-0.92) in Aracaju and 95% in Sergipe. CONCLUSIONS Since vaccines were introduced in 2006, there has been an overall reduction in diarrhea consultations and hospitalizations in northeast Brazil, with the greatest reductions in young children. This might have resulted from vaccination and improved sanitation. Although a single rotavirus genotype (P[4]G2) was recovered, vaccine efficacy was high against this genotype.

Knowledge of caregivers of children with hydrocephalus

Pouco se discute sobre conhecimentos dos cuidadores de criancas com hidrocefalia. Este estudo buscou identificar as fontes de informacao dos cuidadores e verificar seus conhecimentos sobre hidrocefalia. Foram entrevistados 54 cuidadores com idade entre 18 a 52 anos no periodo de novembro de 2007 a agosto de 2008. O genero do cuidador foi predominantemente feminino. Vinte e nove cuidadoras (53,7%) aprenderam a cuidar sozinhas. Apenas quatro cuidadoras (16,0%) receberam orientacoes na alta hospitalar. Vinte e nove (53,7%) conhecem a definicao e 11 (20,4%) conhecem as causas da hidrocefalia. Verificou-se maior conhecimento entre cuidadoras com mais de oito anos de estudo. A escolaridade teve relacao significativa para maior conhecimento, entretanto as cuidadoras possuem pouco conhecimento sobre aspectos importantes da hidrocefalia.

Conhecimento do cuidador de crianças com hidrocefalia

Pouco se discute sobre conhecimentos dos cuidadores de criancas com hidrocefalia. Este estudo buscou identificar as fontes de informacao dos cuidadores e verificar seus conhecimentos sobre hidrocefalia. Foram entrevistados 54 cuidadores com idade entre 18 a 52 anos no periodo de novembro de 2007 a agosto de 2008. O genero do cuidador foi predominantemente feminino. Vinte e nove cuidadoras (53,7%) aprenderam a cuidar sozinhas. Apenas quatro cuidadoras (16,0%) receberam orientacoes na alta hospitalar. Vinte e nove (53,7%) conhecem a definicao e 11 (20,4%) conhecem as causas da hidrocefalia. Verificou-se maior conhecimento entre cuidadoras com mais de oito anos de estudo. A escolaridade teve relacao significativa para maior conhecimento, entretanto as cuidadoras possuem pouco conhecimento sobre aspectos importantes da hidrocefalia.

Prognosis of patients with traumatic brain injury after implementation of a nurse assessment protocol

ABSTRACT Background: The prognosis of a patient with traumatic brain injury (TBI) depends on the severity of the injury, the patient’s level of consciousness upon admission, and differences in treatment protocols. Aim: The aim of this study was to analyze the prognosis of TBI victims after implementation of a nurse assessment protocol. Method: This is a blind, nonrandomized clinical study carried out at a public emergency hospital in the state of Sergipe, Brazil. Results: The study involved 480 patients with an average (SD) age of 35.7 (±16.6) years. Most of the patients were male (p = .02). In the preprotocol and postprotocol groups, motorcycle accidents (p = .023) were more frequent, with a 10.2% death rate. The clinical conditions associated with TBI and the tomographic findings were not affected in either the preprotocol or postprotocol groups (p = .07). There was a significant reduction (p = .05) in death rate from 12.6% to 7.3% and a decrease in the percentage of discharge with aftereffects from 32.8% to 22.8%. Factors independently associated with mortality were as follows: approximately 2.5 times more likely to not apply the protocol associated with an increased chance of death, followed by a 23 times higher risk of TBI severity, and age, with an odds ratio of 1.04. Conclusions: Implementing the protocol, there was a reduction of death rate of patients with severe TBI and aftereffects in patients with moderate TBI. The severity of TBI was the main independent predictive determinant of mortality, followed by nonuse of protocol and age.

Conocimiento del cuidador de niños con hidrocefalia

Pouco se discute sobre conhecimentos dos cuidadores de criancas com hidrocefalia. Este estudo buscou identificar as fontes de informacao dos cuidadores e verificar seus conhecimentos sobre hidrocefalia. Foram entrevistados 54 cuidadores com idade entre 18 a 52 anos no periodo de novembro de 2007 a agosto de 2008. O genero do cuidador foi predominantemente feminino. Vinte e nove cuidadoras (53,7%) aprenderam a cuidar sozinhas. Apenas quatro cuidadoras (16,0%) receberam orientacoes na alta hospitalar. Vinte e nove (53,7%) conhecem a definicao e 11 (20,4%) conhecem as causas da hidrocefalia. Verificou-se maior conhecimento entre cuidadoras com mais de oito anos de estudo. A escolaridade teve relacao significativa para maior conhecimento, entretanto as cuidadoras possuem pouco conhecimento sobre aspectos importantes da hidrocefalia.

Produzindo um pôster científico

Objetivo: Demonstrar como organizar as informacoes de modo que as ideias centrais de trabalhos cientificos na forma poster sejam facilmente apreendidas, bem como orientar a utilizar os recursos disponiveis para o poster despertar o interesse do publico. Apresentacoes no formato poster tornam-se uma parte cada vez mais importante de conferencias cientificas, sao excelentes para apresentadores iniciantes por ser consideradas menos desafiadoras do que as apresentacoes orais.Um poster bem desenhado da ao publico uma vista geral e concisa de pesquisa, metodologia, tamanho da amostra, resultados e suas implicacoes, por isso requer o esforco consideravel em identificar os ingredientes vitais e rejeitar todo o material superfluo. Objective: Show the guidelines to create an effective poster presentation for scientific information.Poster presentations have been taking an important part of scientific meetings, are well shaped for beginning authors as is less challenging than the oral presentations. Well drawn posters give to the public a general and concise sight of the research, methodology, size of the sample, results, and its implications. Therefore it requires a considerable effort in identifying the vital ingredients and rejecting all the superfluous informations.