Rosangela Getirana Santana

Comparison of the bacteriological quality of tap water and bottled mineral water.

The bacteriological quality of tap water from municipal water supplies, 20-L bottles of mineral water from water dispensers and samples collected from new 20-L bottles of mineral water were comparatively studied. Total coliforms, termotolerant coliforms, Escherichia coli, fecal streptococci, Pseudomonas aeruginosa, Staphylococcus spp. and heterotrophic plate count were enumerated. The results showed that 36.4% of the tap water samples from municipal water systems and 76.6% of the 20-L bottles of mineral water from water dispensers were contaminated by at least one coliform or indicator bacterium and/or at least one pathogenic bacterium. The bacteriological quality of municipal tap water is superior when compared with the 20-L bottles of mineral water collected from water dispensers and samples collected from new 20-L bottles of mineral water before installation in the dispensers. This highlights the need for an improved surveillance system for the bottled water industry. For the municipal water systems, it is recommended to perform the Pseudomonas enumeration periodically, in addition to the routine data collected by most systems.

Deficiência de ferro, prevalência de anemia e fatores associados em crianças de creches públicas do oeste do Paraná, Brasil

OBJECTIVE: This study assessed the iron levels and prevalence of anemia and associated factors in children aged 6 to 24 months attending public daycare centers in Cascavel, Western Parana, Brazil. METHODS: This cross-sectional study included 256 randomly sampled children. Questionnaires were administered and anthropometric data and blood samples were collected from July to September 2007. Iron status was determined by measuring transferrin level, hemoglobin level, mean corpuscular volume, serum iron level and eosinophil count. Crude and adjusted (logistic regression) odds ratios and the respective significance levels (p-value) were obtained by statistical analysis. Analysis of variance and the Tukeys range test were used for identifying significant differences in the quantitative measurements. RESULTS: There was a 29.7% prevalence of anemia and 77.3% of the sample presented low iron levels. Anthropometry did not indicate macronutrient deficiencies but revealed above-average obesity rates. The factors associated with anemia and iron deficiency were family members constantly becoming sick (OR=10.02), poor living conditions (OR=5.05), time attending a daycare center (OR=3.05), number of individuals in the household (OR=2.83) and absence of sanitation (OR=2.20). CONCLUSION: The prevalence of anemia and the high iron deficiency rate evidenced a severe public health problem regarding the preschool children from Cascavel, Parana. Despite the magnitude of the problem, anemia is not being detected, prevented and treated properly. This study suggests some possible interventions.

Behavior, knowledge and perception of risks about sexually transmitted diseases in a group of people over 50 years old

Objetivou-se analisar o comportamento, conhecimento e percepcao de risco as doencas sexualmente transmissiveis/AIDS (DST/AIDS) em pessoas com 50 anos e mais de idade. Foram entrevistados 165 servidores de uma secretaria estadual de Mato Grosso, Brasil. Utilizou-se o teste de qui-quadrado e regressao logistica para analise da percepcao do risco e variaveis do comportamento e conhecimento sobre DST/AIDS. A maioria dos entrevistados e do sexo feminino (60,6%), 63,2% tem parceiro fixo e 72,4% tiveram relacao sexual nos ultimos 6 meses e apenas 13,3% utilizam sempre o preservativo, dos quais 21,5% homens e 8% mulheres. Houve associacao entre percepcao de risco e nao uso de preservativo na ultima relacao sexual (p

Índice de massa corporal e hipertensão arterial em indivíduos adultos no Centro-Oeste do Brasil

FUNDAMENTO: O excesso de peso e a obesidade constituem importante problema de saude publica na sociedade, devido ao crescimento em todas as faixas etarias e por sua associacao a varias doencas cronicas, especialmente a hipertensao arterial. OBJETIVO: Investigar possiveis fatores associados as alteracoes no indice de massa corporal (IMC). METODOS: Estudo desenvolvido em Nova Andradina - Mato Grosso do Sul, com 369 individuos cadastrados no programa Estrategia Saude da Familia no ano de 2007. Os dados foram coletados nos domicilios, por meio de entrevista semiestruturada e avaliacao antropometrica. Na analise dos dados, foram utilizados os testes qui-quadrado e Mantel Haensel, para respostas categoricas, e ANOVA e Tukey, para as continuas. RESULTADOS: As prevalencias de sobrepeso e obesidade foram de 33,3% e 23,0%, respectivamente. Em sua maioria, os individuos apresentavam as seguintes caracteristicas: sexo feminino (85,4%), inativos (89,7%), relacao cintura-quadril (RCQ) inadequada (83,7%) e portavam algum problema de saude cronico (31,9%), especialmente a hipertensao arterial. Os fatores de risco para sobrepeso e obesidade podem ser relacionados as variaveis estado civil viuvo, RCQ inadequada, renda mais baixa e problemas de saude. Ja a hipertensao arterial pode ser associada apenas a obesidade. CONCLUSAO: O percentual de pessoas que se encontravam acima do peso e daquelas que nao praticavam atividade fisica em Nova Andradina indica que essas questoes constituem desafio importante para o setor saude tambem nas pequenas cidades. Por isso, e premente a implantacao de programas de intervencao multidisciplinares no âmbito da atencao basica.

Risk factors for cervical HPV infection and genotypes distribution in HIV-infected South Brazilian women

BackgroundHuman Papillomavirus (HPV) infection is particularly burdensome for women infected with human immunodeficiency virus (HIV), which increases their risk of developing cervical lesions and cancer (CC). We conducted a molecular study of the distribution of cervical HPV genotypes and the risk factors for this infection in HIV-infected Brazilian women.FindingsCervical and endocervical samples for Papanicolaou screening and HPV detection were collected from 178 HIV-infected women using highly active antiretroviral therapy (HAART) of Maringá city/Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding to HIV infection from medical records. HPV was detected by polymerase chain reaction (PCR), and genotyping using PCR-restriction fragment length polymorphism analysis. HIV infection was well controlled, but women with a current CD4+ T lymphocyte count between 200–350 cells/mm3 (37.6%) had a two-fold greater risk of HPV infection than those with > 350 cells/mm3 (26.4%). HPV was associated with parity ≥3, hormonal contraceptive use and current smoker. HPV infection occurred with high frequency (46.6%) but a low frequency of cervical abnormalities was detected (7.30%), mainly low-grade squamous intraephitelial cervical lesions (LSIL) (84.6%). A high frequency of multiple HPV infections was detected (23.0%), and the most frequent HPV genotype was HPV-72 (6.7%), followed by −16, -31 and -51 (6.14% each).ConclusionsWe showed that HAART use does not protect HIV-infected women from HPV, but appear to exert some protection against cervical lesions development. This study provides other important information about risk factors and cervical HPV in HIV-infected women, which can contribute to planning protocols.

A prospective study of Toxoplasma-positive pregnant women in southern Brazil: a health alert

We evaluated anti-Toxoplasma gondii IgM-reactive pregnant women seen at a high-risk pregnancy outpatient clinic. From March 2005 to January 2008 in Paraná, Brazil, pregnant women seen by the Brazilian Public Health System, in any gestational period, who were anti-T. gondii IgM-positive, were followed. Clinical symptoms were noted, and tests performed including IgA, IgG avidity, ultrasonogram, and amniocentesis (PCR/inoculation in mice). Of 75 patients, 8 showed low, 3 intermediate and 31 high IgG avidity. Of those who underwent the avidity test, 31 (70.5%) were in the second trimester of pregnancy. Thirty-two (42.7%) pregnant women received specific treatment. Six received triple combination treatment; in three, tachyzoites were isolated, although only one was PCR-positive, showing changes in the cerebral sonogram, borderline IgA, and the Sabin tetrad. One fetus died, and one non-reactive IgM pregnant woman showed ocular recurrence. The municipality of residence, contact with cats during adulthood, and ingestion of unpasteurized milk were shown to be important risk factors. Congenital toxoplasmosis was observed in a pregnancy referred late for treatment. Follow-up of children born to mothers with diagnosed or suspected acute toxoplasmosis is crucial in the management of the changes that toxoplasmosis may cause.

Tipologia de sistemas de produção baseada nas características do leite

The objective of the study was to propose a methodology of production systems analysis, considering intraannual quantitative flow and the qualitative characteristics of the milk delivered by the farmers to the industry. The data were collected from 1,196 milk producers from 2005 to 2006 using month production variables, fat content, protein, lactose and total solids, counting of somatic cells, and standardized counting in plates. The method of analysis used was the main component analyses and ascending hierarchical classification (typology). The most important variables in the construction of the first principal component (PC1) are fat content, protein and total milk solid contents, which explained 32.5% of the diversity of production systems, and they can be considered as the indicator of milk nutritional quality. In the construction of the second principal component (PC2), the most important variables are lactose content, counting of somatic cells and milk microbial counting, which explained 24.04% of the diversity and represent the hygienic quality of the milk. The intra-annual distribution of the milk production is not important to explain the diversity among milk production units. For the production system typology, it was considered the first three main components whose explanation of the total variability was of 70.52%. The 1,196 milk producing rural properties belong to the 17 groups of milk production systems with their own characteristics of milk quality.

Hospital morbidity among elderly patients, before and after influenza vaccination in the state of Paraná

Trata-se de estudo ecologico, desenvolvido com o objetivo de avaliar o comportamento da morbidade hospitalar por doencas respiratorias em maiores de 60 anos, residentes no Estado do Parana, antes e apos o inicio das campanhas de vacinacao contra influenza. Os dados referentes as internacoes ocorridas no periodo de 1995 a 2005 foram obtidos do Sistema de Informacoes Hospitalares e agrupados por macrorregionais de saude, meses de ocorrencia, sexo e grupo etario. Os dados foram submetidos aos testes estatisticos Analise de Variância e Tukey e demonstraram tendencia a queda das internacoes apos inicio da vacinacao em ambos os sexos, com padroes diferentes entre as faixas etarias, sexo, meses do ano e macrorregionais de saude. O risco de internar foi maior entre os homens e entre os mais idosos, durante os meses de junho a outubro e na macrorregional 3, seguida pelas macrorregionais 4, 5, 6, 2 e 1.This ecological study was developed to evaluate the patterns in hospital morbidity due respiratory diseases among people over 60 years old residing in the State of Paraná, before and after the implementation of vaccination campaigns against influenza. The data about hospitalizations in the 1995-2005 period were obtained from the Hospital Information System and grouped according to health center macro-regions, month of occurrence, gender and age group. The data was submitted to Analysis of Variance and Tukey statistical tests, and showed a decreasing tendency in hospitalizations in both genders after the vaccinations started, with different levels among age groups, gender, months of the year and health center macro-regions. The risk for hospitalization was higher for males and for older patients, from June to October, and in macro-region number 3, followed by regions 4, 5, 6, 2 and 1.This ecological study was developed to evaluate the patterns in hospital morbidity due respiratory diseases among people over 60 years old residing in the State of Parana, before and after the implementation of vaccination campaigns against influenza. The data about hospitalizations in the 1995-2005 period were obtained from the Hospital Information System and grouped according to health center macro-regions, month of occurrence, gender and age group. The data was submitted to Analysis of Variance and Tukey statistical tests, and showed a decreasing tendency in hospitalizations in both genders after the vaccinations started, with different levels among age groups, gender, months of the year and health center macro-regions. The risk for hospitalization was higher for males and for older patients, from June to October, and in macro-region number 3, followed by regions 4, 5, 6, 2 and 1.

Factors associated with bullying at nurses' workplaces

OBJECTIVE To identify nurses who are subject to workplace bullying and its associated factors. METHOD Descriptive and exploratory study with a quantitative approach. The sample consisted of 199 nurses working in public and private sectors (N=388). For data collection, a graphic socio-professional questionnaire and the Leymann Inventory Psychological Terrorization were used, both in print or electronic format (May/September 2010). RESULTS According to the data collected, 11.56% of the participants had been subject to bullying. Multivariate analysis showed that having children, working at Public Healthcare Units, working at an institution for a period between one and three years, currently dealing with acts of bullying and to feel bullied are risk factors for bullying. CONCLUSION This study permitted a better understanding of the factors associated with bullying; however, a research based on samples of Brazilian nurses is only the first step to evaluate other factors of influence related to the organizational context.Objetivo: identificar enfermeiros vitimas de assedio moral no trabalho e fatores associados. Metodo: estudo descritivo-exploratorio, de abordagem quantitativa. A amostra foi composta por 199 enfermeiros, pertencentes ao setor publico e privado (n=388). Para a coleta de dados utilizaram-se um questionario socioprofissiografico e o Leymann Inventory Psychological Terrorization, ambos em formato impresso ou eletronico (maio/setembro de 2010). Resultados: de acordo com os dados obtidos, 11,56% dos sujeitos estudados foram vitimas de assedio moral. Analise multivariada apontou que possuir filhos, atuar nas unidades de saude publica, trabalhar na instituicao por periodo de 1 a 3 anos, enfrentar atualmente condutas de assedio moral e sentir-se assediado moralmente sao fatores de risco para o assedio moral. Conclusao: o estudo possibilitou melhor compreensao dos fatores associados ao assedio moral, contudo, a investigacao com base em amostras de enfermeiros brasileiros e apenas o primeiro passo na avaliacao de outros fatores condicionantes, relacionados ao contexto organizacional.Descritores: Enfermagem; Violencia; Ambiente de Trabalho; Bullying; Relacoes Interpessoais; Saude do Trabalhador.

Comportamento, conhecimento e percepção de risco sobre doenças sexualmente transmissíveis em um grupo de pessoas com 50 anos e mais de idade

Objetivou-se analisar o comportamento, conhecimento e percepcao de risco as doencas sexualmente transmissiveis/AIDS (DST/AIDS) em pessoas com 50 anos e mais de idade. Foram entrevistados 165 servidores de uma secretaria estadual de Mato Grosso, Brasil. Utilizou-se o teste de qui-quadrado e regressao logistica para analise da percepcao do risco e variaveis do comportamento e conhecimento sobre DST/AIDS. A maioria dos entrevistados e do sexo feminino (60,6%), 63,2% tem parceiro fixo e 72,4% tiveram relacao sexual nos ultimos 6 meses e apenas 13,3% utilizam sempre o preservativo, dos quais 21,5% homens e 8% mulheres. Houve associacao entre percepcao de risco e nao uso de preservativo na ultima relacao sexual (p