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Item Mulheres com lesões precursoras ou invasivas do colo de útero: a realidade do atendimento no Sistema Único de Saúde(Universidade Federal de Goiás, 2011-08-17) ALBUQUERQUE, Zair Benedita Pinheiro de; SOUZA, Adenicia Custodia Silva e; http://lattes.cnpq.br/5966034868102264; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029OBJECTIVE: To investigate whether women with altered cervical cytopathological outcomes have been referred to Medium Complexity Units (MCU) as in accordance with the Brazilian Ministry of Health guidelines, as well analyze the perception of these womens about the attention received and the psychologic aspects that involved the diagnosis and treatment. METHODS: Descriptive, exploratory, quantitative and qualitative study based on the cytopathological outcomes of the BHS users carried out in Basic Health Assistance Units (BHAU) referred to Medium Complex Units (MCU) in the municipality of Goiânia, State of Goiás, 2005/2006. We assessed 1.109 records regarding the Brazilian Ministry of Health/the National Institute of Cancer guidelines as established by the Brazilian Nomenclature for Cervical Outcomes and Preconized Clinical Practice. Data was analyzed and processed by using Epi-info 3.3.2, 2006 and Microsoft Excel 2007. Variables were assessed descriptively, through calculus of relative and absolute frequency. For qualitative analysis, the interview method were used containing the subject caracterization and two guiding questions: one with negative polarity and other with positive polarity. RESULTS: From the total number of referrals, 79% were not in accordance with the Brazilian Ministry of Health guidelines which originated a great number of unnecessary procedures. The qualitive analysis explicitated fails on the professional attendance and in this attendance flow regarding to comunication about the actions relatives to treatment, services humanization and no observations of the established flow. The psycosocial aspects demonstrated that women didn t receive the necessary psicological attention to minorate the feelings of pain, despair, shame and, most of all, fear of death and mutilations. CONCLUSIONS: We observed inadequate referrals to the MCUs, which demanded a big number of unnecessary procedures. In women s perception, the attendence was permeated by fails in the reception, in communication, professional assistence, lack of knowledge about the attendence flow. The psycosocial aspects demand treatment integrality with multiprofessional teams working according to a biopsycosocial model.Item Lesões Traumáticas Dento-Alveolares em Dentes Decíduos: Estudo Retrospectivo.(Universidade Federal de Goiás, 2010-05-14) AMORIM, Lilian de Fátima Guedes de; COSTA, Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305; ESTRELA, Carlos; http://lattes.cnpq.br/3611967334176683Aim: Determine the prevalence of dental injuries (TDI) in primary teeth and the influence of predisposing clinical factors on their occurrence and analyze the prevalence of developmental sequelae in permanent teeth and determine the association between these sequelae and age, gender, injury type, injury recurrence and sequelae in primary teeth, in children under 7 years old who sought treatment at a private pediatric dental clinic in Goiânia, Goiás, over a period of 15 years. Methodology: A retrospective study which analyzed 2725 dental records. Three hundred and eight dental records with 412 traumatized primary teeth were selected. This constituted the sample used to determine the prevalence of injuries in primary teeth and their association with predisposing clinical factors (Article 1); of these, 241 primary teeth (148 dental records) were followed up until the eruption of the permanent successor teeth. This was the sample for the study of sequelae in primary and permanent teeth (Article 2). All the data were statistically analyzed using the frequency distribution, chi-square test and logistic regression analysis. The level of significance was 5%. Results: The prevalence of dental injuries was 11.3%, with the greatest frequency in the 13-36 month age group. There was no statistical difference between genders. The most frequently affected teeth were the maxillary central incisors (83.3%). The main location of inuries was the home (43.5%), with falls the most frequent cause. The prevalence of dental TDI was similar in all months of the year. The most common type of TDI was subluxation (35.1%). Clinical factors overjet > 3 mm and negative overbite showed a significant difference between the trauma and no-trauma groups. In 46.5% of the cases, treatment was sought in the first 24 hours after the trauma. The most prevalent type of treatment was follow-up (51.0%). Color alteration of crown (26.0%) was the most frequent sequelae for primary teeth. The sequelae found in permanent teeth were enamel discoloration and/or hypoplasia (74.1%) and eruption disorder (25.9%). No significant relation was found between sequelae in permanent teeth and sequelae in primary teeth, type of trauma, gender or TDI recurrence. The only statistical difference was found in relation to the child s age at the moment of trauma. Conclusion: Immediate treatment of the child with a TDI, associated with the efficient diagnosis and long-term follow-up are decisive for the success of treatment. New research to help establish an effective protocol for the treatment of TDIs in primary teeth and the implementation of strategies that prepare professionals to treat TDIs and to educate the public about prevention and treatment of these lesions is necessary..Item Efeito da aplicação de cinesioterapia e eletroestimulação no trabalho de parto(Universidade Federal de Goiás, 2010-02-21) CANESIN, Kariny Fleury; AMARAL, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579Aiming to evaluate the techniques described in the literature to decrease the time of labor birth and the application of techniques of exercise, massage and transcutaneous electrical nerve stimulation on the active phase of labor and intensity of pain in primiparas. The habit of women to keep moving during labor in an upright position (standing, sitting and / or walking) was a practice more common in some cultures. Historically, the postures and the vertical position change and ambulation have been reported to evolve as efficient dilation, relieve pain during contraction and facilitate the descent of the fetus through the birth canal. We conducted a randomized clinical trial, prospective which was attended by 60 women at the beginning of the active phase with 5 cm of cervical dilation, a public hospital in Goiania in the period July 2009 to July 2010. The women were divided into three groups: control (n = 20), exercise (n =20) and electrical stimulation (n = 20), and monitored during the active phase of labor. During this period, data were collected: Template for recording data (age, weight, height and maternal BMI, race, education), visual analog scale pain, and partograph (gestational age, duration of labor, weight and height of the newborn). In the study, comparing the group of exercise with electrical stimulation and control groups there was a significant difference in the time of labor (p = 0.003). However, in relation to pain intensity difference was not statistically significant (p> 0.05). It is concluded according to the literature there is no way to define a specific technique to encourage labor birth and techniques of exercise, electrical stimulation used in the active phase of labor, the motherspromote progression of labor, but not interfere in its intensity pain.Item Coronariopatia assintomática em pacientes com cardiomiopatia chagásica em insuficiência cardíaca grave: prevalência e fatores de risco.(Universidade Federal de Goiás, 2011-03-21) CARVALHO, Gustavo; RASSI, Salvador; http://lattes.cnpq.br/7236834842677715Background: The concomitance of asymptomatic coronary heart disease in patients with Chagas cardiomyopathy with heart failure is not well known in medical literature, and both are very prevalent in some regions of Brazil. Objective: Determine the prevalence of coronary disease (lesion>50%) in a specific group of patients with Chagas cardiomyopathy and heart failure, in functional class III and IV, with no previous symptoms or diagnosis of coronaryopathy. Methods: Coronary angiography was performed in 61 consecutive patients with Chagas cardiomyopathy with heart failure, functional class III and IV, to exclude coronary heart disease. These patients were part of study protocol of cell therapy in heart disease, which required the implementation of coronary angiography before injecting stem cells. Risk factors for atherosclerosis also analyzed in this population were: age, hypertension, diabetes, dyslipidemia, smoking and overweight. Results: ages 51.6 + 9.6 years 65.5%(n = 40) men. The prevalence of coronary disease found in this population was 1.6%(1). The prevalence of risk factors were: hypertension 18%(11), smoking 59%(36), diabetes 1.6%(1) and dyslipidemia 6.5%(4). Conclusion: The prevalence of asymptomatic coronary disease in patients with chagasic etiology severe heart failure is low and among the risk factors for coronary heart disease, smoking was the most prevalent.Item Correlação clínico-laboratorial e de imagem do lúpus eritematoso sistêmico e da esclerose múltipla no HC/FM/UFG em Goiânia/Goiás de 2009 a 2010: ênfase nas manifestações neurológicas(Universidade Federal de Goiás, 2011-09-12) DINIZ, Denise Sisterolli; SILVA, Nilzio Antonio da; http://lattes.cnpq.br/1780564621664455Systemic Lupus Erythematosus - LES is an autoimmune disease involving multiple systems. In the Central nervous system-SNC is one of his more severe manifestations. One of the frames of Lupus neuropsychiatric - LES-NP, is a Demyelinating Syndrome - SD. SD in rare cases, may be the first manifestation of LES, resembling multiple sclerosis - MS in their symptoms. MS is autoimmune disease with involvement of SNC with components, degenerative and inflammatory, which can produce autoantibodies and general symptoms that make your final diagnosis. The disease occurs more in young women than in men, typically evolve with outbreaks and remissions. In order to contribute to the diagnosis of these two illnesses, we proposed a comparative analysis, considering clinical, laboratory, and image aspects. As there is a lack of definition of SD, aims to contribute to the definition and establishment of standards of compromise of the SNC by SD of LES-NP, comparing patients with LES-NP and MS (the prototype of CNS demyelinating disease), attended in rheumatology and neurology of the HC/FM/UFG, Goiania. GO, from 2009 to 2010, according to the demographic aspects (sex and age), clinical (time of illness, functional systems and EDSS), laboratory (Autoantibodies and liquid Cerebroespinhal - LCR), image (Conventional magnetic resonance - RM) and Neuropsychological - NPS (cognitive and emotional). It is one epidemiological, analytical and comparative cross-sectional study of LES-NP and MS, which was approved by the CEP/HC/UFG. Were used in the survey questionnaires: an analysis of demographic and personal and family background; other symptoms; Neurological exams and NPS; Analysis: image by RM, laboratory of autoantibodies and LCR; and symptoms of depression and anxiety by Beck inventory (BAI and BDI). The results demonstrated an increased frequency in patients of age; time of disease; Visual symptoms; changes of sensitivity; of coordination; of the March; retention and urinary incontinence; changes of speech and swallowing; depressive and psychotic symptoms in family and personal history; WMHs in parietal and frontal lobes, occipitais, corpus callosum, periventricular, justacortical, brain stem; the cerebellum; spinal cord and the Barkhof and Tintoré criteria - CBT. Other findings in the RM were: infarcts; Vasculitis; menigioma and thrombosis in patients with LES-NP. The involvement of SNC in LES was measured by clinical symptomatology, neurological examination, EDSS, image findings and neuropsychological tests. RM was predictive analytics to relate workload post-lesional adaptation in brain regions typically involved in in. The application of CBT in patients with SD of LES-NP, associated with the qualitative assessment of WMHs may define the differences of neurological involvement pattern of injury of the SD of LES-NP, those at. The dosage of autoantibodies was predictive analytics for the diagnosis of LES, especially the anti DNA, the anti-ENA and the LAC, which were unique in the LES-NP. The clinical examination and laboratory research, neurological autoantibodies antinuclear antibodies and image by RM offers great security in diagnosis of the two diseases.Show that there are aspects of the involvement of the SD in LES needing new assessments, using the markers of neuronal injury, the more specific and with studies of Immunogenetics compared with in, the prototype of CNS demyelinating disease.Item Avaliação do uso de terapias biológicas em pacientes com artrite reumatoide no Estado de Mato Grosso, Brasil(Universidade Federal de Goiás, 2012-08-09) FERNANDES, Vander; SILVA, Nilzio Antonio da; http://lattes.cnpq.br/1780564621664455RA is debilitating autoimmune disease with serious physical, emotional and economic consequences, which affects about 0.5 to 1% of the adult population worldwide. Significant advances in the recognition of the pathophysiology of disease and injury mechanisms allowed the development of new treatment options with drugs that block inflammatory mediators involved in the mechanism of the disease, known as biologics. These drugs are expensive and of continuous use. They are complex to use due care and management of storage and the risk of immediate and delayed adverse reactions. These therapies are available at the Health System for 12 years, is necessary to evaluate the effectiveness of this drug group in the Brazilian public health system in the treatment of rheumatoid arthritis. OBJECTIVES: a) analyze the effectiveness of biological therapies in patients with rheumatoid arthritis of the State of Mato Grosso, through the assessment of disease activity index DAS28-ESR b) Review the laboratory characteristics of these patients; c) examine the safe use these therapies and to describe adverse events. d) analyze the efficiency of the program dispensing of biological therapies in the State of Mato Grosso, Brazil. METHODS: Two groups of patients with rheumatoid arthritis users Pharmacy High Cost of the State Secretariat of Health of Mato Grosso (FAC / SES) or the University General Hospital. Group I included 68 patients who were already in use of biological therapies. These were assessed for disease activity at the time of inclusion in the study and asked about the historical use of biological drugs, satisfaction with access to treatment and adverse events. Laboratory tests prior to treatment were obtained retrospectively. In group II were enrolled and followed prospectively for 24 weeks, 30 patients with early use of biologic therapies. They were evaluated at baseline and at weeks 4, 8, 12 and 24, the disease activity by DAS28-ESR, laboratory tests, satisfaction with access to treatment and adverse events. RESULTS: The groups were similar in demographic characteristics and laboratory related to rheumatoid arthritis. In group I, 80.6% of patients expressed satisfaction with the care of the FAC / SES. The average use of biological was 12.3 months, and 20.9% (14/68) reported an adverse event, all non-serious. The first medication was discontinued in 26.5% (18/68) of patients, 55.6% (10/18) for loss of efficacy and 22.2% (4/18) adverse events. The mean value of DAS28-ESR was 3.8, and 41.2% were in remission or low disease activity, 39,7% in moderate activity and 19,1% in intense activity. In group II, 91.7% of patients expressed satisfaction with the care provided by FAC / SES. Laboratory evaluation was significant change in the conversion of ANA from 13.3% to 23.3% and anti-DNA (ds), 0 to 6.7%, but no clinical significance. The anti-CCP (2) remained positive and stable at 63.3%. There was an adverse reaction in 23% (7/30) of patients. The only suspension of the first plants were by no severe adverse event (hypersensitivity). Following the DAS28-ESR was a significant reduction in the initial mean value of 4.3 to 3.3 (p = 0.002) after 24 weeks of treatment, 60% of patients were in remission or low disease activity, 23, 3% in moderate activity and 16.7% in intense activity. The average value of ESR-DAS28 after use of the biologic group II was significantly lower than in group I (p= 0.042). CONCLUSIONS: 1) Treatment with biologic therapies in the State of Mato Grosso was effective in prospective group. The response in DAS28-ESR was significantly better in the group where the monitoring and control has been programmed with a routine test and calculate the index of disease activity were used. 2) Among the laboratory characteristics were significant conversion in the profile of autoantibodies, confirming the potential immunogenicity of these drugs inducing the formation of autoantibodies, but no clinical significance in the study group. The anti-CCP remained stable in 63% of patients (group II). 3) Biological therapies were safe. There were no serious adverse events reported. There were no reports of infection or death. The most common reason for discontinuation of the first was the loss of biological effectiveness. 4) Patients with rheumatoid arthritis in the use of biologic therapies in the State of Mato Grosso showed satisfaction with the services offered by SES / MT and the majority of users in the metropolitan area of Cuiabá. The program dispensing biological therapies showed higher efficiency when linked to a reference center for this particular type of treatment.Item Ensaio clínica controlado e randomizado para avaliar a imunogenicidade e reatogenicidade da vacina contra hepatite B (butang(R)) aplicada em recém-nascidos na região glútea ou vasto lateral da cocha(Universidade Federal de Goiás, 2009-08-13) JUNQUEIRA, Ana Luiza Neto; TELES, Sheila Araújo; http://lattes.cnpq.br/4975298732179917This study is the first randomized controlled clinical trial for assessing the immunogenicity and reatogenicity of the Butang® vaccine in full term newborns, who were given the first vaccine dose within the first 12 hours of life, comparing two regions of application for the vaccine: anterolateral thigh (ALT) and ventrogluteal (VG). Butang® response was assessed in 224 newborns who were given the vaccine in the VG region and 250 in the ALT one. Both groups were similar regarding gender, weight, timing interval between doses of the vaccine and maternal characteristics. When comparing Butang® immunogenicity, we verified that the proportion of babies who developed anti-HBs protecting titres after three vaccine doses in the VG region was of 97.8% (IC 95%: 94.8 99.3) with geometric mean titer (GMT) of 427.5 mUI/mL (IC 95%: 344.9 530.0), similar to those who were given in the ALT region (97.6%; IC 95%: 94.8 99.1; GMT: 572.0 mUI/mL; IC 95%: 471.1 694.6), which provides evidence that this place is appropriate for hepatitis B vaccination. Eleven newborns did not respond to Butang®, being six of them vaccinated in the VG region and five in the ALT. The most of them were male, one factor which seems to interfere with hepatitis B vaccine response. We verified an increasing proportion of local reactions and fever according to the number of doses given. In addition, after the third dose the proportion of induration (4.0 vs. 11.4) was higher among babies who were given the vaccine in the ALT region when compared to those who were given in the VG region (p < 0,05). No association was observed concerning maternal anti-HBs titres and newborn vaccine response. The evidences of this study showed that the VG region is a safe and immunogenic site to hepatitis B vaccine administration in newborns.Item Detecção molecular e monitoramento sazonal de adenovírus em águas fluviais no município de Goiânia, Goiás-Brasil: correlação com parâmetros físico-químicos, bacteriológicos e Metanálise avaliativa de metodologias(Universidade Federal de Goiás, 2009-05-27) SILVA, Hugo Delleon da; ANUNCIACAO, Carlos Eduardo; http://lattes.cnpq.br/4354412874919580; GARCÍA-ZAPATA, Marco Túlio Antonio; http://lattes.cnpq.br/3672512339058369Although water is of vital importance for living beings, due to antropic action it becomes a way of dissemination of several microorganisms, which reach aquatic environments through the faeces of man and other animals and can cause several illnesses, especially for immunocompromised individuals. During routine environmental monitoring, coliform bacteria are normally used as a microbiological parameter of water quality, which does not evidence its contamination by viruses. Several researchers have proposed the detection of adenovirus (AdVs) by PCR as a molecular index to monitor other enteric viruses. AdVs are among the most persistent and ubiquitous enteric viruses present in water and associated with a variety of clinical manifestations. This study aimed to evaluate the quality of water collected from lakes and rivers in Goiânia as to the occurrence of AdVs. Water samples were collected monthly, from December 2007 to November 2008, at five different points in Goiânia (lakes of Bosque dos Buritis and Vaca Brava park, João Leite and Meia Ponte rivers downstream and upstream the municipal sewage treatment plant). The analyses were carried out at the Laboratório de Diagnóstico Genético e Molecular and Laboratório de Genética Molecular e Citogenética, Universidade Federal de Goiás. All the samples were filtered in a positively-charged nylon membrane followed by molecular detection using PCR and semi-nested PCR. Also, we performed physical-chemical and bacteriological tests to correlate these results with the occurrence of AdVs. Simultaneously, the Núcleo de Pesquisas em Agentes Emergentes e Re-emergentes carried out a meta-analysis to evaluate three methods of concentration of AdVs coupled to molecular detection in samples of untreated water. Since 29 out of the 54 water samples collected were positive for AdVs (39.2%), our results suggest the use of the methodology proposed in the present study for the detection of these pathogens in water. We observed statistically significant difference between nitrites, phosphates, fixed residues, total residues and the occurrence of AdVs, whereas no correlation was observed between fecal coliforms and AdVs. Furthermore, the occurrence of AdVs in the state of Goiás shows a seasonal trend. Based on the 33 studies selected for the meta-analysis, it was possible to get to the following interpretations: the most effective method to detect AdVs in samples from rivers or lakes was ultracentrifugation combined with nested-PCR; it is advisable to use a combination of microfiltration membrane and ultrafugation with the subsequent diagnosis using qPCR to detect AdVs in samples of treated and untreated sewage. This has been the first study carried out for the detection and monitoring of AdVs in water bodies in the Midwestern Region of Brazil and the present results may be useful to propose the eco-epidemiological profile of AdVs or even the routes of some neglected diseases, which points out the need to define a virus indicator