Juliana Lopes Fávero

Efeitos adversos causados pelo novo esquema de tratamento da tuberculose preconizado pelo Ministério da Saúde do Brasil

OBJECTIVE To determine the principal adverse effects of the tuberculosis treatment regimen recommended by the Brazilian Ministry of Health. METHODS A prospective descriptive study involving 79 tuberculosis patients treated at the Clinical Research Center of the Cassiano Antonio Moraes University Hospital, in the city of Vitória, Brazil, between 2003 and 2006. The treatment regimen consisted of isoniazid, rifampicin, pyrazinamide and ethambutol for four months, followed by rifampicin and isoniazid for two months. During the treatment period, the patients were clinically evaluated every week and had a monthly medical visit. RESULTS The overall incidence of adverse effects was 83.54%. Articular/bone/muscle involvement was the most common, followed by skin involvement (24.94% and 22.09%, respectively). Adverse effects were more common in the second month of treatment (41.59%). Modification of the treatment regimen was unnecessary. One patient required concomitant medication to counter the adverse effects. The cure rate was 100%. CONCLUSIONS The overall incidence of adverse effects related to the new treatment regimen recommended by the Brazilian Ministry of Health was high. However, none of those effects demanded a change in the regimen, which was effective in the patients evaluated.

Tuberculose em profissionais de saúde: um novo olhar sobre um antigo problema

The objective of this review was to contribute to the debate on the nosocomial transmission of TB among health professionals in a country where TB is endemic. Prior to 1900, there was no reason to believe that health professionals interacting with TB patients were more susceptible to becoming infected with the bacillus than was the general population. Between 1920 and 1930, various studies showed significant findings regarding the rates of positive tuberculin skin tests among students in the area of health care. However, most clinicians remained skeptical about the susceptibility of health professionals to becoming infected with TB. In the various locales where the treatment of patients with TB has been implemented, health professionals have been described as an especially predisposed population to becoming infected with and developing active TB. It is urgent that the scientific community and health professionals become mobilized, recognizing themselves as a population at risk of developing TB, and that actions be taken in order to minimize the potential risks of acquiring the disease at locales where patients with TB are treated.

Análise ecológica dos acidentes e da violência letal em Vitória, ES

OBJETIVO: Analisar o contexto socioeconomico e sua relacao com a incidencia espacial da mortalidade devido a violencia. METODOS: Foi realizado estudo do tipo ecologico no municipio de Vitoria, ES, de 2000 a 2003, sobre a distribuicao espacial da mortalidade por acidentes e violencia, com base nas informacoes populacionais e socioeconomicas. Os dados sobre mortalidade foram relacionados a informacoes como local de residencia da vitima, tipo de ocorrencia, sexo e raca/cor. A analise das informacoes utilizou a media espacial, odds ratio e analise de cluster. RESULTADOS: Ocorreram 828 obitos por violencia no periodo estudado, representando 17% do total de obitos do municipio. Destes, 72% eram homicidios, 21,8% acidentes de transporte e 6% suicidios. O padrao das vitimas dos homicidios foi ser jovem, negro, do sexo masculino e residente em regioes mais pobres da cidade. Suicidios e acidentes de transporte acometeram vitimas mais velhas, brancas, do sexo feminino e residentes na area mais rica da cidade. CONCLUSOES: O resultados mostram que a violencia e um fenomeno que atinge todas as classes sociais, com destaque para as pessoas da raca negra e baixo nivel socieconomico que tem maior chance de morte por homicidio; e brancos de nivel socioeconomico mais elevado, suicidios e acidentes de transporte se sobressaem.OBJECTIVE To analyze the socioeconomic background and its relationship with spatial distribution of mortality due to violence. METHODS Ecological study conducted to explore the space distribution of mortality due to violence in the city of Vitória, Southeastern Brazil, between 2000 and 2003, based on population and socioeconomic information. Mortality data were correlated with information on victims place of residence, type of violence, gender, and skin color. Data were analyzed using space average, odds ratio, and cluster analysis. RESULTS There were reported 828 deaths due to violence during the study period, accounting for 17% of all deaths in the city. Of these, 72% were homicides, 21.8% traffic accidents, and 6% suicides. Violence victims were mostly young black males, living in poorer areas of the city. In contrast, as for suicide and traffic accidents, the victims were older white females living in the wealthiest area of the city. CONCLUSIONS The study showed that violence is a phenomenon occurring in all socioeconomic levels but black people at the lowest level are more likely to die from homicides while white well-off people are more likely to die from suicide and traffic accidents.

Ecological analysis of accidents and lethal violence in Vitória, Southeastern Brazil

OBJETIVO: Analisar o contexto socioeconomico e sua relacao com a incidencia espacial da mortalidade devido a violencia. METODOS: Foi realizado estudo do tipo ecologico no municipio de Vitoria, ES, de 2000 a 2003, sobre a distribuicao espacial da mortalidade por acidentes e violencia, com base nas informacoes populacionais e socioeconomicas. Os dados sobre mortalidade foram relacionados a informacoes como local de residencia da vitima, tipo de ocorrencia, sexo e raca/cor. A analise das informacoes utilizou a media espacial, odds ratio e analise de cluster. RESULTADOS: Ocorreram 828 obitos por violencia no periodo estudado, representando 17% do total de obitos do municipio. Destes, 72% eram homicidios, 21,8% acidentes de transporte e 6% suicidios. O padrao das vitimas dos homicidios foi ser jovem, negro, do sexo masculino e residente em regioes mais pobres da cidade. Suicidios e acidentes de transporte acometeram vitimas mais velhas, brancas, do sexo feminino e residentes na area mais rica da cidade. CONCLUSOES: O resultados mostram que a violencia e um fenomeno que atinge todas as classes sociais, com destaque para as pessoas da raca negra e baixo nivel socieconomico que tem maior chance de morte por homicidio; e brancos de nivel socioeconomico mais elevado, suicidios e acidentes de transporte se sobressaem.OBJECTIVE To analyze the socioeconomic background and its relationship with spatial distribution of mortality due to violence. METHODS Ecological study conducted to explore the space distribution of mortality due to violence in the city of Vitória, Southeastern Brazil, between 2000 and 2003, based on population and socioeconomic information. Mortality data were correlated with information on victims place of residence, type of violence, gender, and skin color. Data were analyzed using space average, odds ratio, and cluster analysis. RESULTS There were reported 828 deaths due to violence during the study period, accounting for 17% of all deaths in the city. Of these, 72% were homicides, 21.8% traffic accidents, and 6% suicides. Violence victims were mostly young black males, living in poorer areas of the city. In contrast, as for suicide and traffic accidents, the victims were older white females living in the wealthiest area of the city. CONCLUSIONS The study showed that violence is a phenomenon occurring in all socioeconomic levels but black people at the lowest level are more likely to die from homicides while white well-off people are more likely to die from suicide and traffic accidents.

Prevalência de tuberculose em profissionais da área de Enfermagem obtida por método de relacionamento de bancos de dados, 2000 a 2008, Espírito Santo, Brasil

Objective: To estimate the prevalence of tuberculosis in professional nursing and analyze the profile of these professionals in the period 2000 to 2008 in the Espirito Santo State-Brazil. Methods: We conducted a descriptive study used secondary data from databases of morbidity due to tuberculosis and registration nursing professional of Espirito Santo State (COREN). We included all records of patients with tuberculosis were reported in the Health Information System for Diseases Reported (SINAN-TB) for the years 2000 to 2008 and all registered nursing staff in the COREN from May 1975 to July 2008. To evaluate the professionals listed in both databases was carried out the relationship of banks using the Reclink III. Results: There were 43 health care workers with tuberculosis notification. Of these, 5 had notification dated prior to class registration. Therefore, the study sample was composed of 38 professionals. Of these, 21 are nursing assistants, nurses are 8 and 9 nursing technicians. The prevalence of tuberculosis in these health professionals was 246/100.000 professionals. Conclusion: The results of this study indicate the need for training professionals to improve the completion of notification forms, and the urgent incorporation in the health services of biosafety norms recommended by the Tuberculosis Control Program.

Análisis ecológica de los accidentes y de la violencia letal en Vitoria, Sureste de Brasil

OBJETIVO: Analisar o contexto socioeconomico e sua relacao com a incidencia espacial da mortalidade devido a violencia. METODOS: Foi realizado estudo do tipo ecologico no municipio de Vitoria, ES, de 2000 a 2003, sobre a distribuicao espacial da mortalidade por acidentes e violencia, com base nas informacoes populacionais e socioeconomicas. Os dados sobre mortalidade foram relacionados a informacoes como local de residencia da vitima, tipo de ocorrencia, sexo e raca/cor. A analise das informacoes utilizou a media espacial, odds ratio e analise de cluster. RESULTADOS: Ocorreram 828 obitos por violencia no periodo estudado, representando 17% do total de obitos do municipio. Destes, 72% eram homicidios, 21,8% acidentes de transporte e 6% suicidios. O padrao das vitimas dos homicidios foi ser jovem, negro, do sexo masculino e residente em regioes mais pobres da cidade. Suicidios e acidentes de transporte acometeram vitimas mais velhas, brancas, do sexo feminino e residentes na area mais rica da cidade. CONCLUSOES: O resultados mostram que a violencia e um fenomeno que atinge todas as classes sociais, com destaque para as pessoas da raca negra e baixo nivel socieconomico que tem maior chance de morte por homicidio; e brancos de nivel socioeconomico mais elevado, suicidios e acidentes de transporte se sobressaem.OBJECTIVE To analyze the socioeconomic background and its relationship with spatial distribution of mortality due to violence. METHODS Ecological study conducted to explore the space distribution of mortality due to violence in the city of Vitória, Southeastern Brazil, between 2000 and 2003, based on population and socioeconomic information. Mortality data were correlated with information on victims place of residence, type of violence, gender, and skin color. Data were analyzed using space average, odds ratio, and cluster analysis. RESULTS There were reported 828 deaths due to violence during the study period, accounting for 17% of all deaths in the city. Of these, 72% were homicides, 21.8% traffic accidents, and 6% suicides. Violence victims were mostly young black males, living in poorer areas of the city. In contrast, as for suicide and traffic accidents, the victims were older white females living in the wealthiest area of the city. CONCLUSIONS The study showed that violence is a phenomenon occurring in all socioeconomic levels but black people at the lowest level are more likely to die from homicides while white well-off people are more likely to die from suicide and traffic accidents.