Oscar Felipe Falcão Raposo

Evaluation of agreement between clinical and histopathological data for classifying leprosy

BACKGROUND The diversity of clinical manifestations of leprosy has given rise to different classification systems. However, there are important differences in the sensitivity and specificity of these classifications. The objective of this study was to evaluate the agreement between clinical and histopathological data for classifying leprosy. METHODS A total of 1265 patient reports containing clinical and histopathological data relating to the diagnosis and classification of leprosy were included in this study. The diagnostic concordance between the clinical form (Madrid classification) and the histopathological type, as well as the initial and final classifications, was calculated by dividing the number of concordant cases by the total number of patients. RESULTS The overall agreement between the World Health Organization operational classification and the results of direct smear examination of the lesion for acid-fast bacilli was 84.8% (1073/1265). The clinical-histopathological agreement was 58.1% (735/1265). The indeterminate and lepromatous forms were those that showed the highest percentages of agreement: 72.1% (186/258) and 71.0% (142/200), respectively. CONCLUSION Although classifications based on clinical characteristics have an important role in the control of leprosy, they present flaws that can influence the adequacy of treatment. Therefore, a histopathological examination is important for appropriate treatment.

Intervenção nutricional educativa como ferramenta eficaz para mudança de hábitos alimentares e peso corporal entre praticantes de atividade física

The scope of this study was to evaluate the effectiveness of two methods of educational nutritional intervention together with women who practice regular physical activities by fostering the adoption of healthy eating habits. The study population consisted of 52 women aged between 19 and 59 who frequented the Academia da Cidade Program in Aracaju in the State of Sergipe. The study was a randomized comparison of two intervention groups and was of the pre-test/post-test variety. The educational activities were based on two protocols - one less intensive (P1 Group) and one more intensive (P2 Group) - over a period of two months. The variables analyzed were nutritional knowledge, anthropometric measurements and changes in eating habits. The changes identified were improvement in eating habits and reduction in weight and Body Mass Index for the P2 group. The modifications identified referred mainly to increased consumption of fruit and vegetables, reduction of fat in cooking, reduction in the volume of food eaten per meal and increased meal frequency. In relation to nutritional knowledge, only 2 of the 12 questions showed significant changes. The most intensive method proved effective in changing dietary habits leading to weight loss.

Otoacoustic emissions as an instrument of epidemiological surveillance in the health of the workers

INTRODUCTION: The noise is a harmful agent to the hearing, being frequent in urban and work environments. Among the structures of the hearing system, the outer hair cells are the first to be injured, and otoacoustic emissions identify minimal cochlear alterations. OBJECTIVE: Analyze cochlear alterations with otoacoustic emissions transient evoked in individuals exposed to combined risk: noise and chemical products. METHOD: 49 workers of a cement company participated of the research, aged between 19 and 49 years old, exposure time of at least two years and normal hearing thresholds. Was performed an anamnesis and otoacoustic emissions before and post work activity. The results of the exam were related with the variable: time of exposure to the noise, age, exposure to chemical products and sound habits. The statistical tests used were: T of Student, chi-squared Pearson test and Fishers exact test and is characterized by a prospective clinical study. RESULTS: At the first testing, had presence of emissions in all of the workers. The average of amplitude is of 10,22 dBSPL in the right ear and 9,48 dBSPL in the left ear. In the second testing there were a variation of 0,69 dBSPL in the lef ear and 0,42 dBSPL in the right ear, of which 79,6% of individuals had presence of emission bilaterally and 20,4% absence in at least one ear. Analyzing the relation between variations of emissions with the variable was not observed statistically significant data. CONCLUSION: The otoacoustic emissions in the workers health search to prevent the damage to the hearing system through cochlear changings.

Efeitos da estimulação gustativa nos estados comportamentais de recém-nascidos prematuros

PURPOSE: To observe the behavioral states presented by premature newborns in response to gustatory stimulation. METHODS: Experimental, analytical and double-blind study. Ninety premature newborns born in a public maternity hospital in Sergipe took part in the test which was filmed and divided into three parts of five minutes. In the first and last, there was no stimulus; in the second, the gustatory stimulation was applied and the newborn children were divided into two groups (water or analysis for sucrose 12%). The observed behavioral states were deep sleep, light sleep, drowsy, alert, agitated/irritated and crying. The data were statistically analyzed. RESULTS: In the sucrose group, during and after stimulation, the correlation was strong in the light sleep and alert behavioral states and decreased in the drowsy, agitated/irritated and crying states. In the water group there was an increase in correlation in the agitated/irritated and crying states after stimulation. CONCLUSION: The continuity or change of the behavioral state of the premature newborns was positively influenced by the administration of gustatory stimulus, pointing to the possibility of using sucrose in benefit of the favorable behavioral states of that population.

Fall-related traumas in urgent care centers

OBJECTIVE: To identify the scope and the characteristics of fall-related traumas in urgent care centers in Sergipe, Brazil and to verify potential associations among the following variables: gender, age, and where the event occurred. METHOD: This descriptive, cross-sectional study with a quantitative approach was conducted in the urgent care centers of two public referral hospitals in the state of Sergipe, Brazil. The data collection was conducted in November 2010, after approval was obtained from the Human Research Ethics Committee, through a structured interview with a sample of 509 fall victims. RESULTS: Most of the participants were male, between 0 and 19 years old, single, with no impairments or preexisting diseases, nor regular use of medication or alcohol. The victims were brought to the hospital by ambulance and were accompanied. Most events occurred at home, were same-level falls, and most frequently resulted from slipping and tripping during recreational activities with a subsequent fracture, contusion or sprain. Most victims were discharged from the hospital after care delivery. Statistically significant associations were found between place of fall and age and gender. CONCLUSION: There is a high incidence of seeking out care in urgent care centers due to falls, which constitutes a severe public health problem that affects both genders in different age groups. The adoption of preventive measures aimed to reduce such events is urgently required.

Índice de qualidade da dieta de mulheres usuárias de um programa de atividade física regular "Academia da Cidade", Aracajú, SE

Foram coletados dados sociodemograficos, antropometricos e dieteticos de 169 mulheres. O Indice de Qualidadeda Dieta foi obtido a partir da media de aplicacao de dois recordatorios de 24 horas. Os dados do Indice deQualidade da Dieta total e de seus componentes foram analisados de acordo com o indice de massa corporal(obesos e nao obesos) e a faixa etaria (adultos jovens e adultos velhos). Foram realizadas analise estatisticaForam coletados dados sociodemograficos, antropometricos e dieteticos de 169 mulheres. O Indice de Qualidadeda Dieta foi obtido a partir da media de aplicacao de dois recordatorios de 24 horas. Os dados do Indice deQualidade da Dieta total e de seus componentes foram analisados de acordo com o indice de massa corporal(obesos e nao obesos) e a faixa etaria (adultos jovens e adultos velhos). Foram realizadas analise estatistica

Quality of Life and Gait in Elderly Group

Introduction  The process of aging could lead to seniors being more prone to falls, which affects their quality of life. Objective  The objective of this study is to investigate the relationship between quality of life and gait in the elderly. Methods  We used World Health Organization Quality of Life-Brief (WHOQOL-Brief) Brazilian version and the Dynamic Gait Index to assess fifty-six volunteers from the northeast of Brazil. Ages ranged from 60 to 85 years. Results  The Dynamic Gait Index, which indicates the probability of falls, resulted in 36.3% of the sample presenting abnormal results. There was correlation between domain 2 (psychological) and domain 4 (environment) with domain 1(Physical) and domain 3 (Social); a negative correlation between age and Domain 2; correlation between Question 1 (How would you rate your quality of life?) and domains 1, 2, and 4 and no correlation between questions 1 and 2 (How satisfied are you with your health?). Question 2 was correlated with all of the domains. There was negative association between question 1 and falls, and a slight correlation between the Dynamic Gait Index scores and Question 1. Conclusion  The self-perception of the study group about their quality of life was either good or very good, even though a considerable percentage of individuals had suffered falls or reported gait disturbances.

INVESTIGAÇÃO DE UM SISTEMA DE ALIMENTAÇÃO EM RECÉM-NASCIDOS PREMATUROS A PARTIR DE ESTIMULAÇÃO GUSTATIVA

Purpose to investigate the existence of the alimentation system in premature newborns in response to gustatory stimulation. Methods experimental, analytical, double-blind study. 90 premature newborns of a public maternity in Sergipe took part in the test which was filmed and divided into three parts of five minutes. In the first and last, there was no stimulus; in the second, the gustatory stimulation was applied and the newborn children were divided into two groups (water or sucrose). We studied the specific behaviors suction right and left hands, tongue protrusion and suction movements in behavioral states deep sleep, light sleep, drowsy, restless / irritable and crying. In the statistical analysis of the population, average, standard deviation and prevalence studies were performed. We used the non-parametric Mann-Whitney test to compare averages. The Spearman test observed correlation between behavioral states at each time of the test. The p value was significant when less than 0.05. Results independent of the given stimulus, the correlation increased in all specific behaviors. Comparing the groups separately, after stimulation, we observed an increase in correlation in right hand suction and tongue protrusion for both. The same happened in suction, except for the agitated/irritated state. After stimulation, there was a higher correlation to the behavior of left hand suction in the sucrose group when compared to water. The results show that gustatory stimuli may contribute to the readiness to feed this population. Conclusions it was found in premature newborns an increased in correlation for the specific behaviors related to the alimentation system after oral stimulation, which envisions the possibility of gustatory stimulation be used for activating a alimentation system in premature newborns.

DIET COMPOSITION IS ASSOCIATED WITH OBESITY IN ACTIVE WOMEN

El objetivo de este estudio fue avaluar la contribucion de la composicion de la dieta en el sobrepeso de mujeres que practican actividad fisica, basado en el supuesto de que el alto consumo de energia y lipidos y el bajo consumo de carbohidratos y fibras son factores preponderantes en la etiologia de la obesidad de esta poblacion. Se utilizo un analisis transversal en 165 mujeres adultas que practicaban, por lo menos, 150 minutos de actividad fisica moderada por semana. Las variables de resultado fueron el indice de masa corporal (IMC) y la circunferencia de la cintura (CC). Las personas se clasificaron en grupos segun el IMC - obesos (IMC ≥ 30 kg/m2) y no obesos (IMC < 30 kg/m2) - y de acuerdo con CC - con riesgo ≥ 88 cm y sin riesgo <88 cm. La ingestion dietetica se evaluo con una encuesta de recordatorio de 24 horas. Para hacer la comparacion de las medias de consumo de los grupos se utilizo el analisis de varianza (ANOVA). Se observo que 69,1% de las mujeres presentaban sobrepeso/obesidad. Las mujeres obesas consumian significativamente mas energia y colesterol y menos carbohidratos (p <0,05) y menos consumo de fibras (p <0,10), lo que no sucede en las mujeres no obesas. Ademas, las mujeres con mayor CC consumian significativamente mas energia (p <0,05) y presentaron una tendencia para menor consumo de carbohidratos y fibras (p <0,10), lo que no sucede en las mujeres con menor CC. Los resultados mostraron que, aunque estas mujeres eran fisicamente activas, tenian un IMC medio de sobrepeso, lo que indica que los habitos alimentarios estan altamente correlacionadas con este factor. Se sugiere que el bajo consumo de carbohidratos y fibras y el alto consumo de energia y colesterol han contribuido expresivamente para la obesidad entre las mujeres.