José Antonio Barreto Alves

Soroprevalência de anticorpos para toxoplasmose, rubéola, citomegalovírus, sífilis e HIV em gestantes sergipanas

The seroprevalence of antibodies for HIV, syphilis, toxoplasmosis, cytomegalovirosis and rubella and its association with age and origin was investigated among pregnant women in Sergipe, northeastern Brazil. A total of 9,550 pregnant women (2,112 from the state capital and 7,438 from other municipalities) were enrolled in the study and consecutively tested during their first antenatal care visit in 2007. The following serum prevalences were found: syphilis (0.9%; 95% CI 0.7%-1.6%), HIV (0.14%; 95% CI 0.08%-0.2%), toxoplasmosis (IgG 69.3%; 95% CI 68.3%-70.2%; IgM 0.4%, 95% CI 0.3%-0.6%), cytomegalovirosis (IgG 76.6%, 95% CI 75.7%-77.5%; IgM 0.2%, 95% CI 0.09%-0.3%) and rubella (IgG 71.6%, 95% CI 70.7%-72.6%; IgM 0.1%, 95% CI 0.04%-0.2%). Toxoplasmosis seropositivity increased with age. The prevalences of IgG antibodies for toxoplasmosis, cytomegalovirus and rubella were higher in Aracaju (state capital) than in other municipalities in the State of Sergipe. The results showed that a large proportion of the pregnant women, particularly in municipalities other than the state capital, were susceptible to toxoplasmosis, rubella and cytomegalovirus, with a risk for their infants.

Chemical composition and antimicrobial activity of the essential oil of Hyptis pectinata (l.) Poit.

Essential oil was extracted from leaves of Hyptis pectinata using hydrodistillation, and its composition determined using GC-FID and GC-MS. Chemical analysis showed that there was a predominance of sesquiterpenes, of which β-caryophyllene (18.34%), caryophyllene oxide (18.00%) and calamusenone (24.68%) were measured for the first time in the genus Hyptis. Twenty-one compounds were identified, and calamusenone was isolated using preparative thin layer chromatography with a silica gel plate (60 PF254). The minimal inhibitory concentration (MIC) and minimal microbicidal concentration (MMC) were determined for various pathogenic microorganisms. H. pectinata oil was most effective against Gram (+) bacteria and yeasts.

Epidemiological aspects of dengue in Aracaju, State of Sergipe, Brazil

INTRODUCTION The dengue fever remains to be a disease of serious public health concern, and its incidence has increased in the past decades. This study aimed to characterize the epidemiological incidence of dengue in the period 2001-2010. METHODS This is an epidemiological study of dengue in the municipality of Aracaju, state of Sergipe, in the period between 2001 and 2010, whose data were obtained from the Information System of Diseases Notifications. A descriptive analysis of the number of confirmed cases of dengue, according to year, semester, sanitary district, age, and sex, was performed. RESULTS There were 16,462 confirmed cases, especially in 2008, which obtained the highest incidence of the disease, with 10,485 confirmed cases. The first semester obtained the highest registration of cases during the years of research; this was predominated by females between 15 and 49 years old. With regard to the territorial distribution, the second district of the municipality obtained the highest number of cases. CONCLUSIONS In 2008, in the City of Aracaju, SE, a significant increase in the proportion of dengue cases compared with other years was verified. However, a fast decline in the other years was observed, possibly because of the intensification of preventive actions to combat the mosquito that transmits the dengue virus.

Knowledge of doctors and nurses on pain in patients undergoing craniotomy

The study objectives were to characterize the profile of the doctors and nurses caring for patients in the craniotomy postoperative period, checking pain assessment methods and to identify the existence of analgesia protocols. Cross-sectional and analytical study. The casuistry is constituted of 30 doctors and 30 nurses. The results revealed that 83.3 % of the nurses were female, 63.3% knew pain scales, and 16.6% said that analgesia protocols exist. Regarding doctors 60% were male, 70% knew the pain scales, 3.3% had specialization in pain treatment, 13.3% they stated that there are analgesia protocols. The ignorance on the part of doctors and nurses about the assessment scales and pain assessment methods reveals the need for the creation of institutional policies on controlling pain, the use of instruments for the measurement of the pain phenomenon and analgesia protocols in the institution.The study objectives were to characterize the profile of the doctors and nurses caring for patients in the craniotomy postoperative period, checking pain assessment methods and to identify the existence of analgesia protocols. Cross-sectional and analytical study. The casuistry is constituted of 30 doctors and 30 nurses. The results revealed that 83.3 % of the nurses were female, 63.3% knew pain scales, and 16.6% said that analgesia protocols exist. Regarding doctors 60% were male, 70% knew the pain scales, 3.3% had specialization in pain treatment, 13.3% they stated that there are analgesia protocols. The ignorance on the part of doctors and nurses about the assessment scales and pain assessment methods reveals the need for the creation of institutional policies on controlling pain, the use of instruments for the measurement of the pain phenomenon and analgesia protocols in the institution.

Cisto mesentérico: aspectos clínicos e anátomopatológicos

OBJECTIVE To evaluate epidemiologic, clinical, pathologic and therapeutic characteristics of the mesenteric cysts in hospitals of Sergipe, Brazil. METHODS Mesenteric cysts were assessed by a non-interventional cross-sectional study from the archives of the Pathology Laboratory of Federal University of Sergipe between 1995 and 2007. The charts of the patients were reviewed in order to find out: gender, age, clinical findings, complementary exams and therapeutic approach. RESULTS Eighteen cases of mesenteric cysts were found. Females were more affected (72.2%). Mean of age of the patients was 30.46. More frequent symptoms were pain and abdominal mass. Ultrasonography of abdomen, performed in all patients, was not conclusive in half of the cases. CTscan of abdomen with contrast was performed in six cases, being cystic tumor well identified in all of them. Regarding histopathology, 6 lymphangiomas, 8 mesotheliomas, 1 hemorrhagic cyst in organization and 1 mucinous cyst were found. Surgical treatment was performed in all cases. Intracystic bleeding was the main complication in 3 cases. CONCLUSION The mesenteric cysts presented clinically with unspecific symptoms. CTscan was more effective than ultrasonography for the diagnosis. Lymphangiomas and mesothelioma had been found in equal ratios. The complete resection of the cyst was the treatment of election. There were no deaths in postoperative period.

Multilocus enzyme electrophoresis analysis and exoenzymatic activity of Candida albicans strains isolated from women with vaginal candidiasis.

Twenty‐eight Candida albicans strains obtained from women with vaginal candidiasis were tested for phospholipase and proteinase production and clustered by multilocus enzyme electrophoresis (MLEE). The proteolytic and phospholipidic activity were considered moderate (0.56 ± 0.12 mm and 0.53 ± 0.09 mm, respectively) for all isolates. The isoenzymes malate dehydrogenase (MDH) and sorbitol dehydrogenase (SDH) showed strong intra‐specific discriminatory power. The numerical and genetic interpretation of the bands produced by the isoenzymes tested presented similar discriminatory power. The genetic diversity of the isolates was measured by allelic and genic frequency, perceptual index of polymorphic loci (P = 87.5%), average number of alleles per locus, average number of alleles per polymorphic locus, average heterozygosity observed and average heterozygosity expected. We verified that three isoenzymatic loci (Adh, Gdh and Sdh‐2) were not in Hardy–Weinberg equilibrium. A dendrogram constructed based on the genetic distance matrix of Nei showed seven clusters; 57.15% (16) of the isolates were considered highly related or indistinguishable, and 42.85% were considered moderately related or unrelated. We did not find a relationship between the clusters and the exoenzymes production.

Characterization of victims of trauma treated in an emergency hospital

Objective: to describe the socio-demographic profile of victims of trauma treated in an emergency hospital in Sergipe, Brazil. Method: this is an ecological, retrospective, and quantitative study. The sample consisted of 301 medical records of patients treated between January 2006 and July 2008 at Hospital de Urgencia in Sergipe. The collection was carried out within the period from September to December 2008, after the approval by the Research Ethics Committee of Universidade Federal de Sergipe under the Protocol 2448.0.000.107-08. The variables under study were age, gender, external cause, the most severely affected body region, length of hospital stay, Glasgow Coma Scale, and outcome. The data were analyzed through the software Statistical Package for the Social Sciences (SPSS) version 16.0. Results: the average age was 27.8 years, with a prevalence of males (85.7%), individuals from Sergipe state towns, apart from the capital (56.2%), victims of traffic accidents (47.2%) and aggression (27.6%), predominance of cranioencephalic trauma (61.5%), between Friday and Monday (71.5%), average length of hospitalization of 10 days and hospital discharge (74.1%). Conclusion: the higher frequency of cranioencephalic trauma in male young adults, victims of weekend accidents, suggests the need for intensifying the traffic accident prevention strategies to minimize the occurrence and possible consequences related to trauma. Descriptors: wounds and injuries; mortality; accidents, traffic; external causes.

Spatial analysis for the identification of risk areas for schistosomiasis mansoni in the State of Sergipe, Brazil, 2005-2014.

INTRODUCTION: Schistosomiasis is a parasitic infectious disease with a worldwide prevalence. The objective of this work is to identify risk areas for schistosomiasis mansoni transmission in the State of Sergipe, Brazil, during the period from 2005 to 2014. METHODS: We conducted an epidemiological study with secondary data from the Information System Control Program of Schistosomiasis [Sistema de Informação do Programa de Controle da Esquistossomose (SISPCE)]. Temporal trends were analyzed to obtain the annual percentage change (APC) in the rates of annual prevalence. In addition to the description of general indicators of the disease, the spatial analysis was descriptive, by means of the estimator of intensity kernel, and showed spatial dependence by indicators of global Moran (I) and Local Index of Spatial Association (LISA). Thematic maps of spatial distribution were made, identifying priority intervention areas in need of healthcare. RESULTS: There were 78,663 cases of schistosomiasis, with an average of 8.7% positivity recorded; 79.8% of the cases were treated, and Sergipe showed a decreasing positive trend (APC: -2.78). There was the presence of spatial autocorrelation and a significant global Moran index (I = 0.19; p-value = 0.03). We identified clusters of high-risk areas, mainly located in the northeast and southcentral of the state, which each had equally high infection rates. CONCLUSIONS: There was a decreasing positive trend of schistosomiasis in Sergipe. Spatial analysis identified the geographic distribution of risk and allowed the definition of priority areas for the maintenance and intensification of control interventions.

Pain in patients undergoing appendectomy

BACKGROUND AND OBJECTIVES:Pain is a subjective manifestation of unpleasant, personal and untransferable experience, produced by tissue injury involving physical and chemical body mechanisms. This study aimed at identifying the presence of acute pain in the postoperative period of appendectomy, at checking pain records, at describing postoperative complications and at comparing pain management and the adequacy of analgesia.METHODS:This is a transversal, descriptive and quantitative study. Sample was made up of 41 patients submitted to appendectomy. A semi-structured interview was carried out with information about use of analgesics, presence of postoperative pain, pain site, consequences of pain and visual analog scale. To evaluate pain management and the quality of analgesia, the Pain Management Index proposed by the World Health Organization was calculated.RESULTS:From total sample, 61% were males, mean age was 34.36±11.64 years, 70.7% were married and all patients have referred pain. In 90.2% of cases there was no pain recording in medical charts. Surgical incision was the major pain site and its primary consequence was impaired physical mobility. As to pain intensity, 22.2% of patients had moderate pain and were inadequately treated according to Pain Management Index.CONCLUSION:There has been considerable inadequacy of analgesia, pain recording in medical charts was scarce and no nursing professional has recorded pain. Surgical incision was major pain complaint site and impaired mobility was the primary complication. Our data bring about the need for investments in health professionals qualification with regard to pain management.

Postoperative pain and analgesia in patients submitted to unruptured brain aneurysm clamping

BACKGROUND AND OBJECTIVES: Adequate postoperative pain evaluation and management are priorities for quality assistance, especially after neurological surgeries. This study aimed at evaluating postoperative pain of neurosurgical patients submitted to unruptured brain aneurysm clamping. METHODS: Prospective and descriptive study carried out in a charity hospital of the city of Aracaju, Sergipe, Brazil. Sample was made up of 28 patients submitted to elective craniotomy for unruptured brain aneurysm clamping. Mann-Whitney, Kruskal-Wallis and Dunn-Bonferroni tests were used for inferential analysis. Significance level was 5% throughout the study. RESULTS: Most patients (78.6%) were females, 64.0% had postoperative pain. There has been significant difference in the number of days with postoperative pain among patients with associated comorbidities (p=0.04) and previous surgery (p=0.01). Most patients had moderate and throbbing headache. There were no adequate pain records and most frequent analgesics were simple analgesics. Opioids prescription was incipient. CONCLUSION: Systematic pain evaluation should be part of multiprofessional assistance, in compliance with international and national pain institutions recommendations.