Idosos contaminados pelo HIV ampliam as estatísticas ao redor do mundo. Este estudo teve como objetivo geral descrever as características da Aids em pessoas com 60 anos de idade ou mais, atendidos em hospital de referência para HIV/Aids no Ceará, no período de 1989 a 2004. Desenvolveu-se pesquisa documental utilizando fichas de notificação compulsória de Aids disponíveis no Sistema de Informação de Agravos de Notificação (SINAN) e dados do Sistema de Informação sobre Mortalidade (SIM). Obteve-se notificação de 107 casos, dos quais 50 encontravam-se vivos e 57 foram a óbito. Pela análise observou-se crescimento progressivo dos casos, que, em sua maioria (77,5%), concentravam-se em Fortaleza. A faixa etária mais comprometida foi a de 60 a 69 anos (77,5%). Grande parte dos indivíduos mostrou baixo nível de escolaridade (44,0%). A subcategoria heterossexual aumentou ao longo do tempo. Evidenciou-se maior letalidade entre as mulheres (73,9%). O conjunto de dados analisados permite inferir que entre a população acima de 60 anos com Aids no Ceará verifica-se tendência semelhante às demais faixas etárias e fenômenos observados no país, a saber: heterossexualização, feminização, envelhecimento, pauperização.

The studied variables identifi ed that most of these pregnant women were young, had low levels of education and faced socioeconomic vulnerability. Conclusion: It is necessary to include actions aimed at increasing the attention paid to women, once the assurance of full care and early diagnosis of HIV are important strategies to promote adequate treatment adherence and reduce the vertical transmission. Descriptors: Pregnant Women; HIV Seropositivity; Epidemiology; Attention to Health; Nursing. RESUMO Objetivo: Conhecer as características epidemiológicas da infecção pelo HIV em gestantes. Método: Estudo descritivo com abordagem quantitativa. A população estudada foi composta por gestantes com HIV/aids residentes no estado de Alagoas. Os dados foram organizados em variáveis e analisados segundo o parâmetro de medidas de dispersão pertinentes à média aritmética e ao desvio padrão (X ± S). Resultados: No período de 2007 a 2015 foram registrados 773 casos de HIV/aids em gestantes em Alagoas. As variáveis estudadas identifi caram que a maioria dessas gestantes engloba mulheres jovens, com baixos níveis de instrução e situação socioeconômica de vulnerabilidade. Conclusão: Para tanto, faz-se necessário a inclusão de ações direcionadas a ampliação da atenção às mulheres, em que a garantia de atendimento integral e diagnóstico precoce do HIV constituem estratégias importantes para promover adequada adesão ao tratamento e a redução da transmissão vertical. Descritores: Gestantes; Soropositividade para HIV; Epidemiologia; Atenção à Saúde; Enfermagem. RESUMEN Objetivo: Conocer las características epidemiológicas de la infección por el VIH en mujeres embarazadas. Método: Estudio descriptivo con el abordaje cuantitativo. La población estudiada fue compuesta por mujeres embarazadas con VIH/sida residentes en el estado de Alagoas. Los datos fueron organizados en variables y analizados según el parámetro de medidas de dispersión pertinentes a la media aritmética y al desvío estándar (X ± S). 569Epidemiological overview of HIV/AIDS in pregnant women from a state of northeastern Brazil Silva CM, Alves RS, Santos TS, Bragagnollo GR, Tavares CM, Santos AAP.

BackgroundBrazil is the only country in Latin America that has adopted a national health system. This causes differences in access to health among Latin American countries and induces noticeable migration to Brazilian regions to seek healthcare. This phenomenon has led to difficulties in the control and elimination of diseases related to poverty, such as leprosy. The aim of this study was to evaluate social determinants and their relationship with the risk of leprosy, as well as to examine the temporal trend of its occurrence in a Brazilian municipality located on the tri-border area between Brazil, Paraguay and Argentina.MethodsThis ecological study investigated newly-diagnosed cases of leprosy between 2003 and 2015. Exploratory analysis of the data was performed through descriptive statistics. For spatial analysis, geocoding of the data was performed using spatial scan statistic techniques to obtain the Relative Risk (RR) for each census tract, with their respective 95% confidence intervals calculated. The Bivariate Moran I test, Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) models were applied to analyze the spatial relationships of social determinants and leprosy risk. The temporal trend of the annual coefficient of new cases was obtained through the Prais-Winsten regression. A standard error of 5% was considered statistically significant (p < 0.05).ResultsOf the 840 new cases identified in the study, there was a predominance of females (n = 427, 50.8%), of white race/color (n = 685, 81.6%), age range 15 to 59 years (n = 624, 74.3%), and incomplete elementary education (n = 504, 60.0%). The results obtained from multivariate analysis revealed that the proportion of households with monthly nominal household income per capita greater than 1 minimum wage (β = 0.025, p = 0.036) and people of brown race (β = -0.101, p = 0.024) were statistically-significantly associated with risk of illness due to leprosy. These results also confirmed that social determinants and risk of leprosy were significantly spatially non-stationary. Regarding the temporal trend, a decrease of 4% (95% CI [-0.053, -0.033], p = 0.000) per year was observed in the rate of detection of new cases of leprosy.ConclusionThe social determinants income and race/color were associated with the risk of leprosy. The study’s highlighting of these social determinants can contribute to the development of public policies directed toward the elimination of leprosy in the border region.

There are insufficient double-blind randomized controlled studies that assess the analgesic effect of caffeine on several painful syndromes. Patients presenting chronic pain need caution when it comes to tolerance development, abstinence and drug interaction from chronic caffeine use.

-O b j e c t i v e :This paper re p o rts the use of dexmedetomidine in three epileptic patients with cave rnous angiomas that underwent awake surg e ry in order to map their speech are a s . Method: L o a d i n g dose of dexmedetomidine varied from 1 µg/Kg/h to 3 µg/Kg/h over 20 minutes and maintenance dose fro m 0.4 µg/Kg/h to 0,8 µg/Kg/h. Results: There was no occurrence of hemodynamic instability, convulsions or re s p i r a t o ry depression. Patients tolerated well the pro c e d u re . Conclusion: Dexmedetomidine was useful f o r awake craniotomy as it decreased patients' level of consciousness but did not produce agitation. Lary n g e a l mask was not necessary to keep air ventilation.KEY WORDS: awake craniotomy, dexmedetomidine, epilepsy surgery, cortical mapping, neuroanesthesia.Dexmedetomidina em craniotomias com o paciente acordado sem o emprego de máscara laríngea RESUMO -O b j e t i v o :Este trabalho relata o uso de desmedetomidina em três pacientes com angiomas cavernosos próximos a área de linguagem e epilepsia que foram operados acordados para mapeamento cortical. Método: A dose de ataque de dexmedetomidina variou de 1 µg/Kg/h a 3 µg/Kg/h durante 20 minutos e dose de manutenção de 0,4 µg/Kg/h a 0,8 µg / K g / h . Resultados: Os pacientes toleraram bem o pro c e d imento e não houve instabilidade hemodinâmica, convulsões ou depressão re s p i r a t ó r i a . Conclusão: D e x m edetomidina foi útil nas craniotomias com o paciente acordado para mapeamento cortical pois gerou sedação sem agitação. A máscara laríngea não foi necessária para manter a ventilação nesses pacientes.PA L AV R A S -C H AVE: craniotomia, dexmedetomidina, ciru rgia para epilepsia, mapeamento cortical e neuro anestesia.Awake craniotomy is a useful technique when lesions near eloquent areas have to be re m o v e d 1 . U n f o rt u n a t e l y, pro c e d u re 's demands on patients a n d s u rgical team must not be neglected. Patients need to be fully alert and cooperative during testing b u t on the other hand, it is desirable to keep them sedated over the rest of surg e ry avoiding unnecess a ry discomfort and anxiety. It is a delicate balance, even on experienced hands, as re s p i r a t o rydep ression also has to be taken in account. To accomplish adequate level of sedation and analgesia both local and systemic anesthetics are used. A combination of opioids and midazolan associated, or n o t , to propofol or droperidol is effective. But, despite s a t i s f a c t o rylevel of stress for patients, small pro blems like agitation, drowsiness, seizure or pain still occur in 48% of the surgeries 2 . Dexmedetomidine hydrochloride is a selective alpha-2 adrenoceptor agonist with centrally mediated sympatholytic and sedative effects. It is indicated for sedation of intubated and mechanically ventilated patients during treatment in intensive c a reunits. Dexmedetomidine decreases the needs of analgesia and produces a kind of sedation that patient can be easily roused by verbal stimuli 3 . These characteristics brought about...