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A representação das singularidades de vivenciar a infecção pelo HIV/AIDS: "mulheres no mesmo barco e homens egocêntricos e fragilizados"

Sat, 01 Jan 2000 00:00:00 GMT

Título: A representação das singularidades de vivenciar a infecção pelo HIV/AIDS: "mulheres no mesmo barco e homens egocêntricos e fragilizados" Autor(es): Miranda, Karla Corrêa Lima Abstract: The present study was aimed at complementing current health care practices related to HIV/AIDS-challenged individuals. The specific objectives were to determine how men and women cope with their disease and to understand the differences observed between the sexes in this respect. While the theory of social representations and gender was used to apprehend the object of study. Ten women and ten men receiving outpatient care at a reference facility for AIDS patients in Fortaleza were included in the study. The data were collected from May to November, 1999, through semi-structured interviews, observation and field notes. The social representation for the study group was observed to be death, although this was clearly regarded in different ways according to gender. It is hoped that the disclosure of the meaning of life for the AIDS-challenged individuals interviewed for this study will help specialized health care workers reflect on ways to promote health care actions which do not reinforce the inequality between the sexes. Tipo: Dissertação

Estudo sobre o uso do teste rápido para o HIV em parturientes em maternidades de Fortaleza

Wed, 01 Jan 2003 00:00:00 GMT

Título: Estudo sobre o uso do teste rápido para o HIV em parturientes em maternidades de Fortaleza Autor(es): Prazeres, José Carlos Alves dos Abstract: The objective of this study was to identify HIV-positive pregnant women using a rapid test and to describe the experience of using this test in maternity hospitals in Fortaleza, from September 2000 to February 2001. It consisted of a cross-sectional study where 2,483 pregnant women with unknown or negative HIV serology were tested (Determine®, Abbott) after counseling by previously trained physicians and nurses. Concurrently with the test, a form was completed with the pregnant woman's socioeconomic and clinical information. The selection of maternity hospitals included those with more than 150 deliveries per month and that agreed to participate in the research. Patients with previously known positive HIV serology were included only for prevalence calculation. All information and medication related to the prophylaxis of vertical transmission were given to the attending physicians of the institutions. Main results found: predominance of young women in labor, with low education and low income; approximately 94.0% of patients underwent prenatal care, however, HIV testing was performed on only 16.4%, and of these, 30.1% arrived at the time of delivery with unknown results. In total, eleven HIV-positive women in labor were found: six identified by rapid testing and five who already had positive serology prior to delivery, resulting in a prevalence of 0.4%. The average monthly testing rate in public maternity hospitals was significantly higher than in maternity hospitals affiliated with the SUS (24.0% versus 7.0%, respectively, with p <0.05). The acceptance rate for the test was 88.5%. Among the six HIV-positive mothers who gave birth using the rapid test, three were detected at delivery and did not use intravenous AZT; the others were detected during labor, and only two used the medication; all newborns of HIV-positive mothers received AZT syrup before 24 hours of life and were not breastfed. Despite receiving guidance, only three mothers returned to the referral service for follow-up. The main difficulties encountered were related to trained personnel, the timing of the test, and the mother's fear of the test (technique). It was concluded that the prevalence rate of HIV-positive mothers was 0.4%; prenatal care was inadequate according to the rate of HIV testing; the application of rapid HIV testing in pregnant women with unknown serological status is an important procedure for implementing prophylactic measures against vertical transmission, especially when the professional performing the test is better trained. Tipo: Dissertação

Caracterização da liguagem oral em indivíduos com síndrome de Moebius

Wed, 01 Jan 2003 00:00:00 GMT

Título: Caracterização da liguagem oral em indivíduos com síndrome de Moebius Autor(es): Barbosa, Renata Cavalcante Abstract: The Moebius syndrome constitutes a congenital disorder classically caused by generic factors. The syndrome is considered relevant for public health because of the increasing number of cases associated with the use of Cytotec® for abortion practice. This medication was originally marketed for the treatmait of peptic ulcer and contains misoprostol, a substance that acts on uterine contractility during pregnancy increasing the amplitude and frequency of uterine contractions, stimulating uterine bleedmg with partial or total expulsion of the fetus. The relation of these effects with the Moebius sequence is believed to be caused by the impact on brainstem vascularization caused by misoprostol leading to ischaemia with necrosis and occasional calcification of the facial nerve nucleus. Distinct patterns of inheraice has been suggested such as autosomal dominant, autosomal recessive and X-linked recessive. The gene responsible for the syndrome is still unknown although many researches suggest it's location next to the band ql2.2 of the chromosome 13 or on the chromosome itself. The clinical manifestations include lesion of the facial and abducens nerves associated with limb malformations, specially club foot. The presence of phenotypic variation is also expected, secondary to the compromise of the other cranial nerves, mamly bulbar. In this way, a great range of malformations has been identified, including tongue and/or pharynx paralysis, absent pectoral muscles, syndactyly with or without pectoral muscle absence (Poland syndrome), bulbar involvement, hypoglossia-hypodactyly syndrome (Hanhart syna'ome) and, occasionally, mental retardation. The speech-language manifestations include compromise of oral and deglutition, speech and language functions, secondary to cranial nerves lesions and mental retardation. The language compromise in this disorder is still not well known. In this way, the main objective of this study is to characterize the oral language in a population of fifteen subjects with Moebius syndrome with age ranging from two to thirteai years old, from both sexes, seen in one of the three main center for genetic diagnosis in the state of Ceará. The present work is a descriptive study of a cross-sectional design conducted from February to December/2002, using a clinical evaluation of language components including morphology, syntax, semantics and pragmatics. The results showed mean age of seven years and five months with greater prevalaice of males (53,3%), limb involvement in 93.3% of the study population, mainly club foot. Craniofacial involvement occurred in all individuals and facial nerve paralysis, strabismus and micrognathia were the most prevalait. High occurrence of report of abortion tentative with the use of Cytotec® was identified. All subjects that reported this practice used Cytotec® (10/10). The administration route most used was the combined, oral and vaginal (70%), with the use of two tablets (90%) during the first tnmester of pregnancy in all cases. We idaitified exclusive speech involvement in 20% of the subjects, language disturbance in 46.7%, speech and language disturbance in 13.3% and oral language involvement in 26,7%. Based on our evidence we conclude that the language disturbance in the Moebius syndrome presents with a variable compromise of all oral language components mainly phonological, morphological and syntactical abilities. The delay in linguistical development, incomprehensive speech and the deficit of constructions of saliences and narrations are constant. Tipo: Dissertação

Câncer em Fortaleza: morbidade e mortalidade no período 1978-80

Fri, 01 Jan 1982 00:00:00 GMT

Título: Câncer em Fortaleza: morbidade e mortalidade no período 1978-80 Autor(es): Silva, Marcelo Gurgel Carlos da Abstract: The author talks about the importance of câncer in Public Health on a historie standpoint, analysing the contribution and the participation ofseveral conditioning factors the decline of mortality by infectious diseases, the increase in the average oflife, the urbanization and the industrialization, the introduetion of the carcinogens, the persistence and/or the acquisition of hazardous habits to health, which can be responsible for the increase of malignant neoplasms. The role of Epidemiology was emphasized for the natural history and especially for the determination of the measurements for the control of câncer. The Câncer Registries, basic and essential instruments to the epidemiological investigation of câncer, were judiciously focused under their various types and operational features and also pointed out the general aspects of the functioning of the Câncer Registry of Ceará. The mortality data were taken out from the death certificates of the inhabitants of Fortaleza, obtained in the Epidemiology and Statistics Division of the Ceará Health Secretary, and those of morbidity, through forms of notification ofthe Câncer Registry of Ceará. The death certificates, after the selection of the underlying cause, were codified by the International Classification of Diseases — Revision 1975 and scrutinized by cause, in accordance with the Brazilian List of Mortality, by sex and age groups, in order to, subsequently, determine the corresponding rates of mortality. The forms of notification of câncer were revised and confronted with the files-index of the Câncer Registry of Ceará, to avoid duplicity of notification the intrusion of cases of non-residents in Fortaleza and the erroneous entry of other pathologic conditions. The remainder forms were coded by the International Classification of Diseases — Revision 1975 and verified by anatomic site, sex and age, to determine subsequently the corresponding rates ofincidence. The results of incidence and of mortality were age-standardized by models of population: european, world and african, to permit comparision with data from other places. With the mortality data the role of câncer death was evaluated in the probabilities of death, survival and life expectancy, by sex, age, through multiple decrement life tables. The chief sites of câncer were analysed as to the degree ofimportancein the incidence and mortality, and their rates compared with the statistics of other areas. The epidemiclogic aspects of each malignant neoplasm were discussed. The author concludes that câncer is a major problem of Public Health because it is a disease of increasing magnitude and also because it represents a remarkable cause of mortality, for its elevated economic and social costs, and because of the difficulties and limitations for its control, and, also for its ascending perspective in face of the maintenance of risk factors observed in Fortaleza. Tipo: Dissertação