Rosângela Getirana Santana

Triatomine infestation and vector-borne transmission of Chagas disease in northwest and central Paraná, Brazil

Triatomine infestation, prevalence of T. cruzi antibodies in humans and domestic animals, and variables potentially associated with the presence of triatomines in a rural domiciliary unit (DU) were investigated in nine municipalities and one district of Parana, Brazil, from June 1996 to February 2000. DUs were defined as all houses and annexes on a given piece of property. Blood samples from human volunteers, dogs, and cats were submitted to indirect immunofluorescence. An epidemiological form was completed for each DU. A logistic model was adopted in order to identify associations. Seven out of nine municipalities were positive for triatomines. T. infestans was not captured, but T. sordida, P. megistus, and R. neglectus were. Different variables were considered decisive for the presence of triatomines across the municipalities: proximity to residual wooded areas, i.e. either scrub forest (capoeira) or islands of residual forest (slightly dense vegetation), longer time of residence, existence of inhabited houses, and past DU infestation. In order to ensure proper continuation of the recommended Chagas disease control program, entomo-epidemiological surveillance measures need to be maintained.

Child safety restraint use among children attending day care centers

OBJETIVO: Estimar a prevalencia de utilizacao de assentos de seguranca infantil e fatores associados. METODOS: Estudo transversal observacional, com amostragem estratificada, realizado em 15 creches da cidade de Maringa, PR, entre os meses de marco e maio de 2007. Cada creche foi visitada em apenas um dia letivo. O desfecho considerado foi a utilizacao de assento de seguranca infantil por criancas de ate quatro anos de idade. Carros (N=301) que transportavam criancas menores de quatro anos de idade foram abordados e as informacoes foram coletadas por meio de questionarios semi-estruturados. Variaveis relacionadas a distribuicao de adultos e criancas nos assentos do veiculo, situacao de restricao dos ocupantes e sexo do condutor foram analisadas. Para analise dos dados aplicou-se o teste exato de Fisher, qui-quadrado de Mantel-Haenszel e regressao logistica. RESULTADOS: Entre os motoristas abordados, 51,8% usavam cinto de seguranca (60,4% das mulheres, 44,9% dos homens). Entre as criancas, 36,1% usavam assentos de seguranca infantil, 45,4% eram transportadas soltas, 16,0% estavam no colo de adultos, 2,7% usavam o cinto de seguranca. Segundo a regressao logistica, os fatores que mais influenciaram o uso dos assentos de seguranca infantil foram: idade da crianca inferior a 15 meses (OR= 3,76), uso de cinto de seguranca pelo condutor (OR= 2,45) e criancas pertencentes aos estratos sociocupacionais de maior renda e escolaridade (OR= 1,37). CONCLUSOES: A utilizacao de assentos de seguranca infantil mostrou-se associada a idade da crianca, uso de cinto de seguranca pelo condutor e estrato sociocupacional da creche. Frente ao baixo indice de utilizacao, o uso dos assentos de seguranca infantil surge como desafio a medicina preventiva no Brasil, exigindo atencao e atuacao para sua disseminacao na populacao.OBJECTIVE To estimate the prevalence of child safety restraint use and factors associated. METHODS Observational cross-sectional study using a stratified sampling conducted in the city of Maringá, Southern Brazil, between March and May 2007. Each day care center was visited at one day only. The outcome was use of child safety restraints by children under four. Vehicles (N=301) driving children under four were approached and information was collected using semi-structured questionnaires. Variables regarding child and adult seat distribution, use of safety restraints by occupants and drivers gender were analyzed. Data analyses included Fishers exact test, Mantel-Haenszel chi-square test, and logistic regression. RESULTS Of the drivers approached, 51.8% were using seat belts (60.4% among women, 44.9% among men). Among children, 36.1% were using child safety seats, 45.4% were unrestrained during traveling, 16.0% were seated on an adult lap, and 2.7% were using seat belts. The logistic regression showed the following factors affecting child safety restraint use: child age under 15 months (OR = 3.76); seat belt use by the driver (OR = 2.45); and children from socio-occupational condition with higher income and education (OR = 1.37). CONCLUSIONS Child safety restraint use was associated to child age, seat belt use by the driver, and socio-occupational condition of day care centers. The finding of low rates of child safety restraint use poses a challenge to preventive medicine in Brazil, requiring attention and action to promote its widespread use.

Erros de utilização de assentos de segurança infantil por menores de 4 anos

Objective: To analyze child safety seat usage errors among children enrolled at daycare. Methods: This was a cross-sectional, observational study with prospective data collection and a retrospective analytical axis. Results: Overall, 42.7% of the children studied were in incorrectly used seats. A logistic regression model showed that the likelihood of usage errors was higher if there were two or more children in the vehicle (odds ratio = 5.10, p = 0.007) and was dependent on parents’ educational level and income (medium income and educational level: odds ratio = 7.00, p = 0.003; low income and educational level: odds ratio = 3.40, p = 0.03). Conclusion: The results of this study are in line with findings reported in international publications.

Utilização de assentos de segurança por crianças matriculadas em creches

OBJETIVO: Estimar a prevalencia de utilizacao de assentos de seguranca infantil e fatores associados. METODOS: Estudo transversal observacional, com amostragem estratificada, realizado em 15 creches da cidade de Maringa, PR, entre os meses de marco e maio de 2007. Cada creche foi visitada em apenas um dia letivo. O desfecho considerado foi a utilizacao de assento de seguranca infantil por criancas de ate quatro anos de idade. Carros (N=301) que transportavam criancas menores de quatro anos de idade foram abordados e as informacoes foram coletadas por meio de questionarios semi-estruturados. Variaveis relacionadas a distribuicao de adultos e criancas nos assentos do veiculo, situacao de restricao dos ocupantes e sexo do condutor foram analisadas. Para analise dos dados aplicou-se o teste exato de Fisher, qui-quadrado de Mantel-Haenszel e regressao logistica. RESULTADOS: Entre os motoristas abordados, 51,8% usavam cinto de seguranca (60,4% das mulheres, 44,9% dos homens). Entre as criancas, 36,1% usavam assentos de seguranca infantil, 45,4% eram transportadas soltas, 16,0% estavam no colo de adultos, 2,7% usavam o cinto de seguranca. Segundo a regressao logistica, os fatores que mais influenciaram o uso dos assentos de seguranca infantil foram: idade da crianca inferior a 15 meses (OR= 3,76), uso de cinto de seguranca pelo condutor (OR= 2,45) e criancas pertencentes aos estratos sociocupacionais de maior renda e escolaridade (OR= 1,37). CONCLUSOES: A utilizacao de assentos de seguranca infantil mostrou-se associada a idade da crianca, uso de cinto de seguranca pelo condutor e estrato sociocupacional da creche. Frente ao baixo indice de utilizacao, o uso dos assentos de seguranca infantil surge como desafio a medicina preventiva no Brasil, exigindo atencao e atuacao para sua disseminacao na populacao.OBJECTIVE To estimate the prevalence of child safety restraint use and factors associated. METHODS Observational cross-sectional study using a stratified sampling conducted in the city of Maringá, Southern Brazil, between March and May 2007. Each day care center was visited at one day only. The outcome was use of child safety restraints by children under four. Vehicles (N=301) driving children under four were approached and information was collected using semi-structured questionnaires. Variables regarding child and adult seat distribution, use of safety restraints by occupants and drivers gender were analyzed. Data analyses included Fishers exact test, Mantel-Haenszel chi-square test, and logistic regression. RESULTS Of the drivers approached, 51.8% were using seat belts (60.4% among women, 44.9% among men). Among children, 36.1% were using child safety seats, 45.4% were unrestrained during traveling, 16.0% were seated on an adult lap, and 2.7% were using seat belts. The logistic regression showed the following factors affecting child safety restraint use: child age under 15 months (OR = 3.76); seat belt use by the driver (OR = 2.45); and children from socio-occupational condition with higher income and education (OR = 1.37). CONCLUSIONS Child safety restraint use was associated to child age, seat belt use by the driver, and socio-occupational condition of day care centers. The finding of low rates of child safety restraint use poses a challenge to preventive medicine in Brazil, requiring attention and action to promote its widespread use.

Análise de metodologias de pesquisa sobre utilização de assentos de segurança infantil: lições de um projeto piloto

OBJETIVO: Analisar metodologias de pesquisa sobre a utilizacao de assentos de seguranca infantil. METODOS: Quatro metodologias de pesquisa foram aplicadas, a fim de verificar o uso de assentos para transporte infantil em veiculos que levavam criancas menores de quatro anos a uma creche, durante um dia letivo: inspecao sem entrevista, inspecao com entrevista, questionario auto-aplicativo e filmagem digital. As metodologias foram analisadas quanto a aceitacao por parte dos sujeitos de pesquisa, capacidade de obtencao de dados e concordância de dados captados por instrumentos distintos. Aplicou-se analise de concordância (coeficiente de Kappa) para avaliar a homogeneidade dos dados obtidos pelas diversas metodologias. RESULTADOS: Foram observados 56 veiculos, 75% deles com filmagem. O retorno do questionario auto-aplicado ocorreu em 70%. A capacidade de captacao de dados foi de 99% para inspecao sem entrevista, 97% para inspecao com entrevista e 84% para filmagem digital. A inspecao sem entrevista mostrou-se mais concordante com os dados filmados. CONCLUSOES: O alto indice de retorno do questionario auto-aplicavel pode ter sido favorecido pelas caracteristicas da populacao estudada. A filmagem mostrou-se inadequada por questoes eticas e tecnicas, alem de consideravel indice de recusa; porem, foi util para indicar a confiabilidade da inspecao sem entrevista em relacao ao local de assento das criancas. Detectou-se falha dos instrumentos em captar o genero dos ocupantes dos veiculos. Altos indices de captacao de dados atestaram a aptidao das metodologias de inspecao com e sem entrevista para explorar a utilizacao de assentos de seguranca infantil.

Predictors of ARTHROCENTESIS outcome on JOINT effusion in PATIENTS with DISC displacement without REDUCTION

OBJECTIVES The aim of this study was to investigate the preoperative variables in patients with articular disk displacement without reduction that may influence the results of arthrocentesis on joint effusion (JE). STUDY DESIGN The records of 203 patients with clinical signs and symptoms of unilateral painful disk displacement without reduction and JE, confirmed by magnetic resonance imaging (MRI), and treated with arthrocentesis were selected. The following preoperative data were recorded: sex; age; joint side; pain duration; pain intensity, measurement with the visual analogue scale; and maximum interincisal distance (MID). All patients underwent a second MRI examination 3 to 4 months postoperatively to assess JE. The sample was then divided into 2 groups: group 1 (n = 160) comprised patients with no signs of JE; and group 2 (n = 43) comprised patients still showing signs of JE. Univariate and multivariate analyses were used to compare the groups. RESULTS Among the studied variables, pain duration (P = .0175), pain intensity (P < .0001), and MID (P = .0085) were shown to affect arthrocentesis outcomes. The longer the pain duration (odds ratio [OR] = 0.930), the more intense was the pain (OR = 0.346), and the smaller the MID (OR = 0.562), the less were the chances of arthrocentesis completely eliminating JE. CONCLUSIONS Pain duration, pain intensity, and MID can be used as predictors for the effect of arthrocentesis on JE outcomes and considered during treatment planning.

Myofascial trigger points in patients with temporomandibular joint disc displacement with reduction: a cross-sectional study

Abstract Objective The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs. Material and Methods 130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05). Results Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810). Conclusions Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.

Correspondence analysis to evaluate information records of the risk newborns

This study aims to analyze in different information systems the quality of the information on infants enrolled in the High-Risk Newborn Vigilance Program. This is a cross-sectional study with quantitative analysis. Data was collected from the following forms and charts: the Newborn Montoring Form; Information System of Primary Care Forms, A and C; and forms of 505 children at risk in 23 Basic Health Units (UBS). Correspondence Analysis and Ascendant Hierarchical Classification were used to analyze data. The positive aspects observed refer to the adequacy of records. The results show that the quality of the activity records was adequate in 30% of UBS (Basic Units of Health), suggesting training and professional development of physicians and nurses referred to services and assistance programs, and complete records of routine home visits.Este estudo teve como objetivo analisar a qualidade das informacoes dos recem nascidos cadastrados no Programa de Vigilância ao Recem Nascido de Risco nos diferentes sistemas de informacao. Estudo transversal, quantitativo, analitico. Utilizou-se como fontes de dados da Ficha de Acompanhamento do Recem Nascido, Ficha A e C do Sistema de Informacao da Atencao Basica e foram avaliados os prontuarios de 505 criancas de risco em 23 Unidades Basicas de Saude (UBS). Os dados foram analisados pela Analise de Correspondencia e Classificacao Hierarquica Ascendente. Os pontos positivos obtidos se referem a adequacao do registro, destacando que a qualidade dos registros das atividades realizadas foi adequada em 30% das UBS, sugerindo treinamento e capacitacao dos profissionais medicos e enfermeiros com encaminhamentos para servicos e programas assistenciais, registros completos e visitas domiciliares de rotina.

Análise de correspondência para avaliação dos registros das informações dos recém nascidos de risco

This study aims to analyze in different information systems the quality of the information on infants enrolled in the High-Risk Newborn Vigilance Program. This is a cross-sectional study with quantitative analysis. Data was collected from the following forms and charts: the Newborn Montoring Form; Information System of Primary Care Forms, A and C; and forms of 505 children at risk in 23 Basic Health Units (UBS). Correspondence Analysis and Ascendant Hierarchical Classification were used to analyze data. The positive aspects observed refer to the adequacy of records. The results show that the quality of the activity records was adequate in 30% of UBS (Basic Units of Health), suggesting training and professional development of physicians and nurses referred to services and assistance programs, and complete records of routine home visits.Este estudo teve como objetivo analisar a qualidade das informacoes dos recem nascidos cadastrados no Programa de Vigilância ao Recem Nascido de Risco nos diferentes sistemas de informacao. Estudo transversal, quantitativo, analitico. Utilizou-se como fontes de dados da Ficha de Acompanhamento do Recem Nascido, Ficha A e C do Sistema de Informacao da Atencao Basica e foram avaliados os prontuarios de 505 criancas de risco em 23 Unidades Basicas de Saude (UBS). Os dados foram analisados pela Analise de Correspondencia e Classificacao Hierarquica Ascendente. Os pontos positivos obtidos se referem a adequacao do registro, destacando que a qualidade dos registros das atividades realizadas foi adequada em 30% das UBS, sugerindo treinamento e capacitacao dos profissionais medicos e enfermeiros com encaminhamentos para servicos e programas assistenciais, registros completos e visitas domiciliares de rotina.

El análisis de correspondencias para evaluar de los registros de los recién nacidos la información de riesgos

This study aims to analyze in different information systems the quality of the information on infants enrolled in the High-Risk Newborn Vigilance Program. This is a cross-sectional study with quantitative analysis. Data was collected from the following forms and charts: the Newborn Montoring Form; Information System of Primary Care Forms, A and C; and forms of 505 children at risk in 23 Basic Health Units (UBS). Correspondence Analysis and Ascendant Hierarchical Classification were used to analyze data. The positive aspects observed refer to the adequacy of records. The results show that the quality of the activity records was adequate in 30% of UBS (Basic Units of Health), suggesting training and professional development of physicians and nurses referred to services and assistance programs, and complete records of routine home visits.Este estudo teve como objetivo analisar a qualidade das informacoes dos recem nascidos cadastrados no Programa de Vigilância ao Recem Nascido de Risco nos diferentes sistemas de informacao. Estudo transversal, quantitativo, analitico. Utilizou-se como fontes de dados da Ficha de Acompanhamento do Recem Nascido, Ficha A e C do Sistema de Informacao da Atencao Basica e foram avaliados os prontuarios de 505 criancas de risco em 23 Unidades Basicas de Saude (UBS). Os dados foram analisados pela Analise de Correspondencia e Classificacao Hierarquica Ascendente. Os pontos positivos obtidos se referem a adequacao do registro, destacando que a qualidade dos registros das atividades realizadas foi adequada em 30% das UBS, sugerindo treinamento e capacitacao dos profissionais medicos e enfermeiros com encaminhamentos para servicos e programas assistenciais, registros completos e visitas domiciliares de rotina.