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  • ZikaVirus x Congenital anomalies: from presume daudienceto real data of the temporo-spatial distribution in the state of Rio Grande do Norte

  • Data: Nov 20, 2017
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  • INTRODUCTION: In the middle of 2015, Brazil experienced an increase in cases of notification of infection by Zika Virus and the increase in cases of Microcephaly and Guillain-Barré Syndrome, and later confirmed the association between these clinical entities. The northeast region was the most affected and environmental, economic and social factors can negatively influence this distribution. However, it is known that congenital anomalies have always occurred throughout Brazilian territory and it is believed that there is no difference in the spatial distribution pattern of anomalies before and after ZIKV. OBJECTIVE: to evaluate the temporal-spatial distribution of congenital and ZIKV anomalies reported cases in the mesoregions of Rio Grande do Norte. METHODOLOGY: This is an ecological, retrospective study, that evaluated the reported cases of congenital anomalies in Rio Grande do Norte before and after the ZIKV epidemy through a spatial analysis, whose data were grouped in SPSS 13.0 and analyzed in TERRAVIEW version 4.2 .2. RESULTS: The rate of congenital anomalies in pre-ZIKV period was 6.2 cases / 1,000 live births and in the post ZIKV period, it increased to 13.95 cases / 1,000 live births, a result of the increase in reported cases. It was visualized in the distribution cartography that the Agreste Potiguar mesoregion is the one with the highest number of reported cases of ZIKV, as well as the region with the highest number of cases of congenital anomalies in the period studied.CONCLUSION: The present study revealed that congenital anomalies were always present in the state and no other action was raised with such importance as in the Zika period. Strategies to minimize cases of congenital anomalies through family planning actions, maternal age control, vaccination programs, control of the sale of abortive drugs, combat to drugs addiction, alcohol and tobacco use can easily be developed and gain media acceptance, which is not always perceived


  • Data: Dec 1, 2017
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  • Introduction: The increase in life expectancy has led to new public health challenges in the population, such as chronic diseases. Among the main chronic osteoarticular diseases, we can mention osteoarthritis (OA) of the knees, characterized mainly by pain in the knees, which limits the accomplishment of daily activities. In this context, the literature suggests that there is a positive correlation between knee OA development and obesity, in addition, overweight is one of the most significant modifiable factors in worsening symptoms. Thus, it is relevant to determine if elderly women with knee pain compared to the asymptomatic elderly, present differences in food consumption. Objective: To evaluate the habitual energy and nutrient intake of elderly women with and without pain in the knees, living in Santa Cruz/RN. Methodology: This is a cross-sectional study, with elderly (n=100) symptomatic and asymptomatic regarding knee pain. Food intake was determined by the 2-day mean of the 24-hour Reminder. The diets were analyzed in Dietbox®. The individual energy requirement was estimated using formulas and total calorie consumption was analyzed considering the range of 97 to 103% of energy expenditure. Macronutrient suitability was checked according to the Acceptable Macronutrient Distribution Ranges. The mean intake of fatty acids, cholesterol and fiber was analyzed according to the values proposed by the IV Brazilian Directive on Dyslipidemias. The micronutrient inadequacy was estimated by the Estimated Average Requirement method as the cutoff point and the water consumption was evaluated based on the recommendation of the Food Guide for the Brazilian Population. To analyze the data, the Statistical Package for the Social Sciences version 20.0 was used. For the comparison of the data distributions between the groups, Student's t-tests or the Mann-Whitney test were used according to normality, as evaluated by the Kolmogorov-Smirnov test. Results: The mean age was 67 (±8.0) years for the asymptomatic group and 67 (±9.0) years for the symptomatic group. As for the energy consumption, macronutrients, fatty acids, cholesterol, fiber and water, there were differences between the groups, which were not statistically significant. The energy intake was inadequate in 96.1% of the asymptomatic ones and in 93.9% of the symptomatic ones. There were also no statistically significant differences among the elderly women regarding the dietary intake of micronutrients, except for the usual consumption of zinc mineral (p value = 0.033), the symptomatic group had an average zinc intake lower than the asymptomatic group. In the groups, the greatest inadequacies (> 50%) were for vitamins A, D, E and folic acid and magnesium and calcium. The lowest inadequacies were for vitamin C and pyridoxine (values between 21.6% and 22.4%). Inadequate intake of vitamin D (100% of those evaluated) is highlighted. Conclusion: Among the groups, high prevalence of inadequacy for caloric intake, saturated fatty acid consumption, cholesterol, fiber, water intake, macros and micronutrients were observed. However, no statistically significant differences were observed in nutrient intake, except for the zinc mineral, since the symptomatic elderly had an average zinc intake lower than the asymptomatic group.


  • Data: Dec 1, 2017
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  • Introduction: Brazil undergoes profound changes in its age structure, the proportion of individuals over 60 years has been increasing rapidly. In Santa Cruz / RN, approximately, 11.7% of the population is in this age group. However, although the elderly exhibit longer life expectancy, they are more likely to be exposed to chronic diseases, such as osteoarticular diseases. This accelerated population aging requires preparation for the social and economic consequences that arise from it and entails new social challenges and global public health in the population. Objective: To evaluate the nutritional status, functionality and muscular strength of elderly women with and without knee pain. METHODS: This is a cross-sectional study carried out with elderly women with or without pain in the knees, residents of the city of Santa Cruz / RN, attending the physical therapy clinic of the Faculty of Health Sciences of Trairi (FACISA-UFRN) . Data were collected through the application of a standardized questionnaire containing identification information, health aspects, anthropometric data and body composition (Body Mass Index, bioimpedance, folds and body circumferences). In addition, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, which evaluates the functionality (6-minute walking test - TC6M - and Timed Up and Go -TUG) and muscular strength Palmar gripping (FPP). Statistical Package for the Social Sciences (SPSS) software version 20.0 was used to analyze the data. Results: A total of 100 elderly women, 49% with knee pain (symptomatic) and 51% asymptomatic, with a mean age of 67 (± 9.0) and 67 (± 8.0) years, p = 0.527, respectively. The mean BMI was 30.7 (± 4.37) kg / m² in the symptomatic elderly and, as in the control group, 29.3 (± 4.64) kg / m² p = 0.125, indicating excess weight. The nutritional variables that presented significant differences between the groups (p <0.05) were the waist circumference (PC) and the arm (CP) and the Waist Hip Ratio (WHR), being the highest values obtained by the group with pain in the Knees Regarding the functional variables, all showed significant differences between the groups (p <0.05), the worst results being obtained by the symptomatic group. The correlation between the variables related to the nutritional status of the symptomatic elderly and those related to the functionality was performed. The correlation between WOMAC and BMI, PC and WHR were not significant, weak and positive. When correlating the nutritional variables with the 6MWT, it is verified that between 6MWT and PC, Neck Perimeter and WHR were weak and negative. The correlation between 6MWT and BMI, lean mass and body fat% were not significant, weak and positive. The correlations between TUG and BMI, PC and WHR were not significant, weak and positive. The correlation between lean mass and right hand strength (r = 0.070, p = 0.627), and lean mass and left hand strength (r = 0.070; p = 0.627) were shown to be weak, positive, and non-significant. Conclusion: The elderly women with knee pain presented overweight and functional deficits when compared to the control group. It was found that the symptomatic elderly had a higher WOMAC score, indicating worse functionality and higher indicators of overweight (BMI, PC and WHR); the same was true in the TUG test, which indicates falls, since the longer the time to perform , The values of these nutritional variables were higher. It was also observed that the lower the waist, neck and waist-hip ratio, the greater the distance walked by the elderly in the walking test (6MWT). On the other hand, the elderly women with higher percentages of high lean mass had greater muscle strength.

  • Data: Dec 4, 2017
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  • Suicide is one of the most pervasive types of violent deaths in the world, so demographic and epidemiological transitions have contributed to the overall increase in the burden of this disease. Despite the spread of suicide prevention programs in Brazil, the mortality situation in this country is worrisome, especially in some regions where there is an increase in the percentage of deaths. The objective of this study was to analyze the spatio-temporal distribution of suicide mortality in the State of Rio Grande do Norte (NR) between 2000 and 2015. This is a mixed ecological study that evaluated the deaths due to suicide registered in the RN, occurring in the period from January 1, 2000 to December 31, 2015. Death data were obtained from the Mortality Information System, and population information was obtained from the Brazilian Institute of Geography and Statistics. Spatial analysis was performed using crude rates, standardized rates and rates by Bayesian estimators. Univariate analysis was performed using the Moran Global and Local Index to evaluate the intensity and significance of spatial clusters using the Terraview 4.2 software. The spatial bivariate analysis was performed by crossing the sociodemographic variables with mortality rates standardized by suicide using GeoDa software 1.6.1. The Lost Potential Years of Life were also calculated throughout the historical series. Joinpoint regression with standardized rates (world population) was used to estimate the Annual Percentage Change (APC), the 95% confidence interval and the inflection points of the curve, in order to verify the mortality trend for suicide In the RN using the software Joinpoint 4.5.0. The classical statistical analysis was applied to evaluate the correlation between the variables of the study and for that was used the software SPSS 23.0. There were 2,266 deaths from suicide from 2000 to 2015, with the ratio between the sexes being 5: 1 in the last year. The spatial analysis showed poor spatial autocorrelation (I<0.3) for the Standardized Mortality Rates (PMT) for both sexes, with formation of spatial agglomerates in the Seridó Region, mainly for males. The bivariate analysis showed the formation of clusters in the Seridó Region with the HDI and Aging variables. Bayesian estimators showed a homogenization of mortality rates, especially in municipalities with small population groups. 6,3582.5 potential years of life were lost throughout the historical series. In addition, a trend of increased male mortality up to 2003 (APC= 15.3%, CI= 9.2-21.8) was observed, followed by a period of stability. For females, the tendency was for stability (APC= 0.4%, 95% CI= 0.9-1.7). The analysis of variance also pointed to the absence of statistically significant differences (p>0.05) between standardized rates and the size of municipalities and health regions for most of the study years. It is concluded that the mortality due to suicide in RN state is unequally distributed in the territory, being spatially associated to the areas with the best socioeconomic indicators. There is no significant trend of increase, however the differences between the regions and according to the size of the municipalities increased during the historical series.

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