José Eulálio Cabral-Filho

Fatores associados ao ganho ponderal excessivo em gestantes atendidas em um serviço público de pré-natal na cidade de Recife, Pernambuco, Brasil

Este estudo teve como objetivo avaliar a evolucao do ganho ponderal excessivo durante o segundo e o terceiro trimestre da gestacao e a influencia de fatores biologicos, socio-demograficos, comportamentais, reprodutivos e morbidades associadas a este ganho. Foi realizado um estudo descritivo com dados de 240 gestantes de baixo risco obstetrico coletadas para um ensaio clinico sobre tratamento de anemia no periodo de maio de 2000 a julho de 2001. O banco de dados original continha 347 registros, porem foram excluidas 107, sendo 42 por idade menor que 18 anos e 65 por falta de registro dos pesos das gestantes nos prontuarios ate o final do pre-natal. Foi observado elevado percentual de ganho de peso semanal excessivo em todas as categorias de peso inicial, embora, no segundo trimestre, o ganho de peso tenha sido significativamente maior naquelas que ja iniciaram a gestacao com sobrepeso/obesidade. No terceiro trimestre, as variaveis que apresentaram associacao significante com o ganho de peso semanal excessivo foram a escolaridade materna e a situacao marital.

Do perineal exercises during pregnancy prevent the development of urinary incontinence? A systematic review

Objectives:  The aim of the current article was to conduct a systematic review of the performance of perineal exercises during pregnancy and their utility in the prevention of urinary incontinence.

Implementação do protocolo da Organização Mundial da Saúde para manejo da desnutrição grave em hospital no Nordeste do Brasil

To assess the implementation of WHO guidelines for managing severely malnourished hospitalized children, a case-series study was performed with 117 children from 1 to 60 months of age. A checklist was prepared according to steps in the guidelines and applied to each patient at discharge, thus assessing the procedures adopted during hospitalization. Daily spreadsheets on food and liquid intake, clinical data, prescribed treatment, and laboratory results were also used. 36 steps were evaluated, 24 of which were followed correctly in more than 80% of cases; the proportion was 50 to 80% for seven steps and less than 50% for five steps. Monitoring that required frequent physician and nursing staff bedside presence was associated with difficulties. With some minor adjustments, the guidelines can be followed without great difficulty and without compromising the more important objective of reducing case-fatality.

Decline in hospital mortality rate after the use of the World Health Organization protocol for management of severe malnutrition.

We studied the implementation of the World Health Organization protocol for the treatment of malnourished children at the largest maternal and infant hospital in the northeast of Brazil. The implementation of the protocol resulted in a reduction in the mortality rate from 38.0% to 16.2%.

Respiratory muscle strength in pregnancy.

BACKGROUND Muscle respiratory strength studies during pregnancy are very scarce. The aim of this paper is to describe maximum inspiratory (PImax) and expiratory (PEmax) mean pressure values in women during their first pregnancy and to determine the relationship between the anthropometric, morphologic and physiologic variables of these pressures. METHODS One hundred and twenty women (120) primigravidas were studied from the 5th to 40th gestational week, ages ranging from 20 to 29 years old, euthrophic and with low risk pregnancies. RESULTS PImax and PEmax mean values were 88.5 ± 16.52 cmH(2)O and 99.76 ± 18.19 cmH(2)O respectively. There was no association between gestational age and PImax (r = -0.06; p = 0.49) or PEmax (r = -0.11; p = 0.22). There was also no difference between PImax and PEmax during pregnancy trimesters and no correlation between pregnancy age and the pressures in each trimester. Height was the only anthropometric variable indicating a significant PImax (r = 0.20; p = 0.02) association. Fundal uterus height and inter-recti abdominis distance were not associated to respiratory pressure values. PEmax is not associated with the group of predictor variables (p = 0.127) and PImax demonstrated an independent association with height and dyspnea during physical exertion reflected by the following equation: PImax = 0.6 + 57.9 height - 1.68 dyspnea under effort. The present study suggests that inspiratory and expiratory maximum pressure values are not altered during different stages of pregnancy, however longitudinal studies are needed to assess changes over time.

Estado nutricional de gestantes avaliado por três diferentes métodos de classificação antropométrica

Estudo de corte transversal, realizado entre janeiro e junho de 2006, com 992 gestantes de um servico publico.O estado nutricional foi classificado por diferentes metodos de avaliacao: nomograma de Rosso, metodo deAtalah e gestograma do Centro Latino Americano de Perinatologia. Os resultados foram comparados com oestado nutricional de mulheres nao gestantes em idade reprodutiva da Regiao Nordeste e do Brasil. As diferencasforam analisadas pelo

Força muscular respiratória: comparação entre primigestas e nuligestas

OBJECTIVE To describe and to compare MIP and MEP in primigravidae and nulligravidae in the 20-29 year age bracket and paired by age. METHODS We included 120 primigravidae with low obstetric risk (5th-40th week of gestation) and 40 nulligravidae. All of the participants were of normal weight and none exercised regularly. All were recruited from the metropolitan area of Recife, Brazil. Measurements of MIP and MEP were obtained from RV and TLC, respectively, with a digital manometer. We used Students t-test to compare the two groups, and we used multiple linear regression in order to determine whether group or chronological age correlated with MIP or MEP. RESULTS In the primigravida and nulligravida groups, the mean MIP values were 88.50 ± 16.52 cmH₂O and 94.22 ± 22.63 cmH₂O, respectively, (p = 0.08), whereas the mean MEP values were 99.76 ±18.19 cmH₂O and 98.67 ± 20.78 cmH₂O (p = 0.75). Gestational age did not correlate with MIP (r = -0.06; p = 0.49) or MEP (r = -0.11; p = 0.22). The relationship between chronological age and MIP/MEP did not differ between primigravidae and nulligravidae (angular coefficient = 0.028 and 0.453, respectively). CONCLUSIONS Within this sample of women in the 20-29 year age bracket, the respiratory pressures of primigravidae remained stable during pregnancy and did not differ significantly from those of nulligravidae.

Knowledge of HIV/AIDS Prevention and Factors Associated with Condom Use Among Adolescents in Northeast Brazil

AIM To assess the knowledge of HIV/AIDS prevention and factors associated with condom use among adolescent. METHODS A cross-sectional study was conducted among 410 outpatient adolescents. Association between knowledge on the transmission of HIV/AIDS and variables were analyzed using the chi-square test. Logistic regression model was used to estimate the factors associated to condom use. RESULTS The knowledge about HIV/AIDS transmission was high and lower percentages of knowledge were observed regarding the non-transmission of HIV/AIDS. Younger adolescents revealed less knowledge than older adolescents. After multiple logistic regression the following factors were associated with condom use: male gender (p = 0.029), same age between partners (p = 0.002) and having until 1 year elapsed since sexual initiation (p = 0.001). CONCLUSION The knowledge regarding HIV/AIDS prevention was satisfactory. However, this does not imply that adolescents put such knowledge to use.