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OBJECTIVE: The aim of this study was to examine the impact of symptom-based screening on the prevalence and outcomes of neonatal coronavirus disease 2019 in pregnant women admitted for delivery. METHODS: A retrospective observational study was conducted from June to August 2020 at Gonzaga Mota of Messejana Hospital, Fortaleza, CE, Brazil. All pregnant women were screened for coronavirus disease 2019 based on symptoms. Reverse transcription-polymerase chain reaction or immunology assays for severe acute respiratory syndrome coronavirus 2 were performed when a patient reported a symptom. All newborns of symptomatic patients were submitted for Reverse transcription-polymerase chain reaction. Newborns were divided into groups according to the Reverse transcription-polymerase chain reaction results to identify the relationship between maternal symptoms and neonatal coronavirus disease 2019. RESULTS: A total of 55 (55/1,026, 5.4%) and 50 (50/1,026, 4.8%) pregnant women reported symptoms and had a positive confirmatory test, respectively. The most common symptom of coronavirus disease 2019 among the pregnant women with positive confirmatory test was cough (n=23, 46%). Seven newborns (7/50, 14%) of symptomatic mothers had positive Reverse transcription-polymerase chain reaction. Upon birth, no newborn had serious complications. CONCLUSION: Universal screening of pregnant women admitted for delivery can reduce the perinatal transmission of coronavirus disease 2019. Symptom-based screening can be an alternative for regions with a low prevalence of the disease where a better allocation of financial resources is necessary.
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COVID-19 , Complicaciones Infecciosas del Embarazo , Recién Nacido , Embarazo , Femenino , Humanos , COVID-19/diagnóstico , COVID-19/epidemiología , Mujeres Embarazadas , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Transmisión Vertical de Enfermedad Infecciosa , SARS-CoV-2 , Resultado del EmbarazoRESUMEN
SUMMARY OBJECTIVE: The aim of this study was to examine the impact of symptom-based screening on the prevalence and outcomes of neonatal coronavirus disease 2019 in pregnant women admitted for delivery. METHODS: A retrospective observational study was conducted from June to August 2020 at Gonzaga Mota of Messejana Hospital, Fortaleza, CE, Brazil. All pregnant women were screened for coronavirus disease 2019 based on symptoms. Reverse transcription-polymerase chain reaction or immunology assays for severe acute respiratory syndrome coronavirus 2 were performed when a patient reported a symptom. All newborns of symptomatic patients were submitted for Reverse transcription-polymerase chain reaction. Newborns were divided into groups according to the Reverse transcription-polymerase chain reaction results to identify the relationship between maternal symptoms and neonatal coronavirus disease 2019. RESULTS: A total of 55 (55/1,026, 5.4%) and 50 (50/1,026, 4.8%) pregnant women reported symptoms and had a positive confirmatory test, respectively. The most common symptom of coronavirus disease 2019 among the pregnant women with positive confirmatory test was cough (n=23, 46%). Seven newborns (7/50, 14%) of symptomatic mothers had positive Reverse transcription-polymerase chain reaction. Upon birth, no newborn had serious complications. CONCLUSION: Universal screening of pregnant women admitted for delivery can reduce the perinatal transmission of coronavirus disease 2019. Symptom-based screening can be an alternative for regions with a low prevalence of the disease where a better allocation of financial resources is necessary.
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Objetivo: Analisar a relação entre casos e óbitos por COVID-19 e o percentual de tabagistas nas capitais e regiões do Brasil. Métodos: Realizou-se estudo ecológico nas regiões brasileiras do número de casos e óbitos por COVID-19, de março a dezembro de 2020, e a prevalência de tabagismo em 2019, a partir dos bancos de dados do Painel Coronavírus da Secretaria de Vigilância em Saúde e do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL 2019). Com informações extraídas em janeiro de 2021, calcularam-se os coeficientes de incidência e mortalidade por COVID-19 por capital brasileira e região, bem como se utilizou a correlação de Pearson para verificar a relação entre as variáveis do estudo. Adotou-se nível de significância de 5%. Resultados: Análises bivariadas mostraram correlações positivas entre tabagistas do sexo feminino e coeficiente de incidência de COVID-19 nas capitais da região do Centro-Oeste (r=0,957; p=0,043), e entre fumantes do sexo masculino e coeficiente de mortalidade de COVID-19 nas capitais do Nordeste (r=0,706; p=0,034). Conclusão: O tabagismo teve impacto na incidência de casos e óbitos por COVID-19 em diversas capitais brasileiras, alertando que o fumo pode ser fator de predisposição e agravamento do estado clínico dos pacientes.
Objective: To analyze the relationship between COVID-19 cases and deaths and the percentage of smokers in the capitals and regions of Brazil. Methods: An ecological study was carried out in the Brazilian regions to assess the number of cases and deaths by COVID-19 from March to December 2020 and the prevalence of smoking in 2019 based on the Coronavirus Panel databases of the Health Surveillance Secretariat and the System for Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone-based Survey (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico - VIGITEL 2019). With information extracted in January 2021, the COVID-19 incidence and mortality coefficients were calculated by Brazilian capital and region and Pearson's correlation was used to verify the relationship between the study variables. A significance level of 5% was adopted. Results: Bivariate analyses showed positive correlations between female smokers and COVID-19 incidence coefficient in capitals of the Midwest region (r=0.957; p=0.043), and between male smokers and COVID-19 mortality coefficient in the capitals of the Northeast (r=0.706; p=0.034). Conclusion: Smoking had an impact on the incidence of COVID-19 cases and deaths in several Brazilian capitals, which warns that smoking can be a predisposing factor and worsen the clinical status of patients.
Objetivo: Analizar la relación entre casos y muertes por COVID-19 y el porcentaje de tabaquistas en las capitales y regiones del Brasil. Métodos: Fue realizado estudio ecológico en las regiones brasileñas del número de casos y muertes por COVID-19, de marzo a diciembre de 2020, y la prevalencia de tabaquismo en 2019, a partir de bases de datos del Panel Coronavirus de la Secretaria de Vigilancia en Salud y del Sistema de Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas por Encuesta Telefónica (VIGITEL 2019). Con informaciones extraídas en enero de 2021, se calcularon los coeficientes de incidencia y mortandad por COVID-19 por capital brasileña y región, también se utilizó la correlación de Pearson para verificar la relación entre las variables del estudio. Fue adoptado nivel de significancia de 5%. Resultados: Los análisis bivariados mostraron correlaciones positivas entre tabaquistas del sexo femenino y coeficiente de incidencia de COVID-19 en las capitales de la región del Centro-Oeste (r=0,957; p=0,043), y entre fumadores del sexo masculino y coeficiente de mortandad de COVID-19 en las capitales del Nordeste (r=0,706; p=0,034). Conclusión: El tabaquismo tuvo impacto en la incidencia de casos y muertes por COVID-19 en diversas capitales brasileñas, advirtiendo que el humo puede ser factor de predisposición y agravamiento del estado clínico de los pacientes.
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BACKGROUND: Calotropis procera latex protein fraction (LP) was previously shown to protect animals from septic shock. Further investigations showed that LP modulate nitric oxide and cytokines levels. OBJECTIVES: To evaluate whether the protective effects of LP, against lethal bacterial infection, is observed in its subfractions (LPPII and LPPIII). METHODS: Subfractions (5 and 10 mg/kg) were tested by i.p. administration, 24 h before challenging with lethal injection (i.p.) of Salmonella Typhimurium. LPPIII (5 mg/kg) which showed higher survival rate was assayed to evaluate bacterial clearance, histopathology, leukocyte recruitment, plasma coagulation time, cytokines and NO levels. FINDINGS: LPPIII protected 70% of animals of death. The animals given LPPIII exhibited reduced bacterial load in blood and peritoneal fluid after 24 h compared to the control. LPPIII promoted macrophage infiltration in spleen and liver. LPPIII restored the coagulation time of infected animals, increased IL-10 and reduced NO in blood. MAIN CONCLUSIONS: LPPIII recruited macrophages to the target organs of bacterial infection. This addressed inflammatory stimulus seems to reduce bacterial colonisation in spleen and liver, down regulate bacterial spread and contribute to avoid septic shock.
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Antibacterianos/uso terapéutico , Calotropis/química , Homeostasis/efectos de los fármacos , Inflamación/tratamiento farmacológico , Látex/química , Extractos Vegetales/farmacología , Proteínas de Plantas/uso terapéutico , Infecciones por Salmonella/tratamiento farmacológico , Animales , Antibacterianos/aislamiento & purificación , Antibacterianos/farmacología , Regulación hacia Abajo , Proteínas de Plantas/aislamiento & purificación , Proteínas de Plantas/farmacología , Infecciones por Salmonella/inmunología , Infecciones por Salmonella/microbiologíaRESUMEN
BACKGROUND Calotropis procera latex protein fraction (LP) was previously shown to protect animals from septic shock. Further investigations showed that LP modulate nitric oxide and cytokines levels. OBJECTIVES To evaluate whether the protective effects of LP, against lethal bacterial infection, is observed in its subfractions (LPPII and LPPIII). METHODS Subfractions (5 and 10 mg/kg) were tested by i.p. administration, 24 h before challenging with lethal injection (i.p.) of Salmonella Typhimurium. LPPIII (5 mg/kg) which showed higher survival rate was assayed to evaluate bacterial clearance, histopathology, leukocyte recruitment, plasma coagulation time, cytokines and NO levels. FINDINGS LPPIII protected 70% of animals of death. The animals given LPPIII exhibited reduced bacterial load in blood and peritoneal fluid after 24 h compared to the control. LPPIII promoted macrophage infiltration in spleen and liver. LPPIII restored the coagulation time of infected animals, increased IL-10 and reduced NO in blood. MAIN CONCLUSIONS LPPIII recruited macrophages to the target organs of bacterial infection. This addressed inflammatory stimulus seems to reduce bacterial colonisation in spleen and liver, down regulate bacterial spread and contribute to avoid septic shock.
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Animales , Proteínas de Plantas/uso terapéutico , Infecciones por Salmonella/tratamiento farmacológico , Extractos Vegetales/farmacología , Calotropis/química , Homeostasis/efectos de los fármacos , Inflamación/tratamiento farmacológico , Látex/química , Antibacterianos/uso terapéutico , Proteínas de Plantas/aislamiento & purificación , Proteínas de Plantas/farmacología , Infecciones por Salmonella/inmunología , Infecciones por Salmonella/microbiología , Regulación hacia Abajo , Antibacterianos/aislamiento & purificación , Antibacterianos/farmacologíaRESUMEN
RESUMO Objetivo: Investigar as dificuldades intraescolares para efetividade da cultura de paz na escola. Método: configura-se como um estudo exploratório e descritivo, com abordagem qualitativa, concretizado num estudo de caso em uma escola pública da Rede Municipal de Fortaleza-Ceará, com o grupo gestor e professores da referida escola. A coleta de dados foi de fevereiro a junho de 2015. A produção dos dados foi realizada por intermédio de entrevista semiestruturada. A análise e organização dos dados foram realizadas mediante Análise de Conteúdo. Resultado: verificou-se falha de comunicação, desgaste e desmotivação dos docentes, despreparo para realizarem atividades que contemplem a paz, assim como a ausência de parcerias municipais e governamentais. Conclusão: necessidade de capacitação dos professores e gestores para que ocorra de forma efetiva a promoção da Cultura de Paz nas escolas.
RESUMEN El presente estudio tuvo como objetivo investigar las dificultades intraescolares para la efectividad de la cultura de paz en la escuela. El curso metodológico basado en el objeto de estudio fue exploratorio y descriptivo con un enfoque cualitativo. Se desarrolló un estudio de caso en la Escuela Municipal de Fortaleza-Ceará, establecida en la Región V. El público objetivo del estudio fue el grupo de gestión y los maestros de esta escuela pública. La recopilación de datos se realizó de febrero a junio de 2015. La producción de los datos se realizó mediante entrevistas semiestructuradas. El análisis y la organización de los datos se realizaron a través de Análisis de Contenido. Hubo fallas en la comunicación, desgaste y desmotivación de los docentes, falta de preparación para las actividades que contemplan la paz, así como ausencia de asociaciones municipales y gubernamentales.
ABSTRACT The present study aimed to research the intra-school difficulties for effectiveness of the culture of peace in the school. The methodological course based on the object of study was exploratory and descriptive with a qualitative approach. A case study was developed at the Municipal School of Fortaleza-Ceará, established in Regional V. The target public of the study was the management group and teachers of this public school. The data collection occurred from February to June 2015.The production of the data was carried out through semi-structured interviews. The analysis and organization of the data were performed through Content Analysis. There was communication failure, attrition and demotivation of teachers, lack of preparation for activities that contemplate peace, as well as the absence of municipal and governmental partnerships.
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Humanos , Estudiantes , Cultura , Educación , Violencia , Agresión , Acoso EscolarRESUMEN
Vaginal carcinoma is a rare condition. In this report, we describe a case of a poorly differentiated aggressive adenocarcinoma in a woman with a three month history of vaginal bleeding and a negative Pap smear done six months prior to her consultation. Specular examination showed a normal cervix, but there was a bleeding ulcer (2 cm in diameter) in the upper third of the vagina. Cytology revealed poorly differentiated atypical cells, and the biopsy established a diagnosis of vaginal adenocarcinoma with little differentiation. Within two months, the patient died without diagnosis of a primary tumor site other than the vagina.
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Adenocarcinoma/patología , Neoplasias Vaginales/patología , Adulto , Femenino , Humanos , Prueba de Papanicolaou , Frotis VaginalRESUMEN
BACKGROUND: Screening for anal cancer using cytology has not been considered in immunocompetent women. The aim of this study was to identify cytological atypia and human papillomavirus (HPV) DNA in intra-anal specimens from human immunodeficiency virus (HIV)-negative women with and without genital HPV lesions. METHODS: This study was a cross-sectional analysis of 142 women who were negative for the HIV: 80 with genital lesions that were associated with HPV and 62 without HPV-induced lesions. The women were evaluated at the Federal University of Ceará from October 2011 to June 2012. The statistical analysis included the Fisher exact test and the odds ratio (CI 95%). RESULTS: Atypical anal cytology was observed in 24 (29.3%) patients in the study group and in 11 (17.8%) patients in the control group. In cases with at least two sites of HPV-associated lesions, 12 (41.4%) presented atypical cytology (P = 0.0220; OR = 2.7621, 1.1579-6.5889). When the practice of anal sex was evaluated, atypical cytology was observed in 22/43 (34%) [P = 0.0214; OR = 2.519, 1.146-5.534]. HPV DNA was detected in 17/27 (63%) cases with at least two sites of lesions (P = 0.0293, OR = 2.4855, 1.0960-5.6367). In the 33 cases who presented positive HPV DNA test results, the liquid-based cytology results were atypical (P = 0.0212, OR = 2.8, 1.1665-6.7208). CONCLUSION: Based on the results, liquid-based cytology may be used to detect intra-anal lesions, especially among women who have a history of anal intercourse or who have genital HPV-associated lesions at multiple sites.
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Canal Anal/patología , Neoplasias del Ano/diagnóstico , Células Escamosas Atípicas del Cuello del Útero/patología , ADN Viral/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Lesiones Intraepiteliales Escamosas de Cuello Uterino/patología , Adulto , Canal Anal/virología , Neoplasias del Ano/patología , Neoplasias del Ano/virología , Células Escamosas Atípicas del Cuello del Útero/virología , Estudios de Casos y Controles , Estudios Transversales , Citodiagnóstico/métodos , Femenino , Infecciones por VIH , Histocitoquímica/métodos , Pruebas de ADN del Papillomavirus Humano , Humanos , Persona de Mediana Edad , Papillomaviridae/patogenicidad , Papillomaviridae/fisiología , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Conducta Sexual/estadística & datos numéricos , Lesiones Intraepiteliales Escamosas de Cuello Uterino/virologíaRESUMEN
O estudo de patologias na vulva envolve a necessidade de conhecimentos não só em Ginecologia, como também em patologia e dermatologia, o que pode trazer dificuldades para o ginecologista geral na condução do diagnóstico e, conseqüentemente, do tratamento. Assim, a vulva acaba por ser uma região esquecida. Há necessidade de diretrizes que facilitem a avaliação da área vulvar de forma acessível, porém não esquecendo da necessidade de uma abordagem multidisciplinar. Os autores fazem uma revisão da literatura e propõem um fluxograma com o qual o examinador possa direcionar sua conduta no estudo das patologias da vulva, englobando as de origem ginecológica e não ginecológica, com especial ênfase nas neoplasias intra-epiteliais vulvares.