-Context -The incidence and populational prevalence of inflammatory bowel diseases, hitherto unknown in Brazil, were estimated for a region in the Midwest of São Paulo State, Brazil. Methods -Using a sequential registry of 115 adult patients (>15 years old) with inflammatory bowel diseases -exclusively residing in the studied region with 533,508 inhabitants (2005) and attended at the reference hospital during a 20 year interval (1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005) -were estimated, in four consecutives periods of 5 years each, the incidences according to gender, type of the disease and the prevalence of these diseases, and its inner-relations evaluated by the Poisson regression model. Results -The inflammatory bowel diseases in the studied region predominated among young, white race and people living in urban area, and the incidence on the female population rose during this period. The incidence of ulcerative colitis were higher than Crohn's disease and non-classified colitis, and showed a progressive increase in the first three periods with a decrease in the last one (2001)(2002)(2003)(2004)(2005), where the observed rates of ulcerative colitis, Crohn's disease and non-classified colitis were 4.48, 3.50 and 1.75 cases/100,000 inhabitants, with prevalence of 22.61, 14.81, 5.65, 2.14 cases/100,000 inhabitants for total inflammatory bowel diseases. Conclusion -The inflammatory bowel diseases incidence in the studied area was as low as in other countries of Latin America and smaller than that found in countries of South Europe. The crescent prevalence justifies the policies to adequate medical cares for inflammatory bowel diseases patients in this area. HEADINGS -Inflammatory bowel disease, epidemiology. Colitis, ulcerative, epidemiology. Crohn disease, epidemiology. São Paulo (Brasil).
Studies estimate that gender-diverse persons represent 0.1 to 2% of populations investigated, but no such assessment was performed in Latin America. In a representative sample of Brazil’s adult population (n = 6000), we investigated participants' sociodemographic characteristics and possible associations between these and current gender identity, categorized as cisgender, transgender or non-binary gender. We also investigated transgender individuals' distress associated with gender-related body characteristics. As main results, we found that transgender individuals represented 0.69% (CI95% = 0.48–0.90) of the sample, whereas non-binary persons were 1.19% (CI95% = 0.92–1.47). These percentages were not different among Brazil’s 5 geographic regions. Preliminary analyses showed that transgender individuals were on average younger (32.8 ± 14.2 years, CI95% = 28.5–37.1), compared to cisgender (42.2 ± 15.9, CI95% = 42.5–42.8) and non-binary (42.1 ± 16.5 years, CI95% = 38.3–46.5) groups. Non-binary persons are less likely to be in a relationship compared to cisgender individuals (OR = 0.57, CI95% = 0.35–0.93). In the transgender group, 85% of transgender men and 50% of transgender women reported distress due to gender-related body characteristics. Our main findings draw attention that gender-diverse Brazilian individuals represent around 2% of the country's adult population (almost 3 million people), and are homogeneously located throughout the country, reiterating the urgency of public health policies for these individuals in the five Brazilian sub-regions.
Confl itos de interesse: nada a declarar. ResumoObjetivo: Associar a tendência empreendedora geral e o suporte familiar percebido entre estudantes de Enfermagem do Brasil e Chile.Métodos: Estudo transversal com dados de estudantes de cinco instituições superiores de ensino, coletados de março a setembro de 2018. Foram utilizados: formulário para avaliação sociodemográfi ca, questionário de Tendência Empreendedora Geral (TEG) e Inventário de Percepção de Suporte Familiar (IPSF). Foram ajustados modelos de regressão logística simples e modelos de regressão multinomial.Resultados: Dos 889 estudantes participantes, 82% eram mulheres, 60% tinham idade entre 20 e 25 anos e 55% eram de instituição particular de ensino. TEG baixa ou muito baixa foi predominante nos dois países (Brasil=83,5%; Chile=78,4%), além de baixos índices de percepção de suporte familiar. Não foram encontradas associações diretas entre o TEG e o IPSF. No Chile houve associação positiva entre a chance de a categoria impulsividade que compõe a TEG ser médio e alto com o fator autonomia familiar ser alto [OR=1,16 (1,07-1,26);p<0,01].Conclusão: A autonomia familiar percebida pode moderar, ainda que discretamente, características importantes como a impulsividade, não sendo sufi ciente para elevar a tendência empreendedora desses estudantes a patamares satisfatórios. O apoio social mais adequado para promover o comportamento empreendedor dos estudantes parece ser o incentivo acadêmico na instituição educacional, tornando-se necessária a adequação pedagógica ao público feminino e às características culturais de cada país. Outras pesquisas devem ser realizadas.
The periodontal disease during pregnancy triggers an exacerbated immune response with high local and systemic concentrations of inflammatory markers. Objective To investigate the repercussion of periodontal disease (PD) in the pregnant woman health and the complications during pregnancy and delivery, as well as negative outcomes for the newborn (as infections, prematurity, low birth weight and fetal growth restriction). Method Retrospective cohort study, based on medical records of 142 pregnant women assisted at a prenatal service of usual risk between 2012-2014, with a dental evaluation for PD. Maternal variables, along with labor and newborn variables, were analyzed. The newborns were stratified into two groups: offspring of mothers with PD (subdivided into Severe Periodontal Disease-SPD) and offspring of mothers without PD. Each outcome was adjusted by a multiple logistic regression model, with significance for p-value <0.05, considering all potential confounding factors. Results Among women diagnosed with SPD, the odds ratio for vulvovaginitis was 3.45 times greater (OR = 3.45, p-value = 0.050) and 5.59 times higher for premature rupture of membranes (OR = 5.59; p-value = 0.017). For neonates, the chance of fetal growth restriction was 11.53 times higher for pregnant women with SPD (OR = 11.53, p = 0.041).
Objective: To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. Method: A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). Results: A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically signifi cant relationship with the occurrence of AEs. Conclusion: The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety. Descriptors: Nursing Care; Patient Severity; Workload; Safety Management; Patient Safety. RESUMO Objetivo: Analisar se o aumento da gravidade do paciente e a carga de trabalho de enfermagem está relacionado à maior incidência de Eventos Adversos (EAs) em pacientes críticos. Método: Estudo de coorte única, prospectivo, com amostra de 138 pacientes internados em uma Unidade de Terapia Intensiva (UTI). Resultados: Ao todo, foram evidenciados 166 EAs, que acometeram 50,7% dos pacientes. O aumento da gravidade do paciente apresentou relação direta com a chance de ocorrência de EAs. Entretanto, a carga de trabalho de enfermagem não apresentou relação estatisticamente signifi cativa, na ocorrência de EAs. Conclusão: Os resultados permitem refl etir acerca da importância da equipe de enfermagem, em utilizar instrumentos de avaliação, com o objetivo de melhorar e planejar suas ações diárias, com foco na segurança do paciente. Descritores: Cuidados de Enfermagem; Gravidade do Paciente; Carga de Trabalho; Gestão da Segurança; Segurança do Paciente. RESUMENObjetivo: Analizar si el aumento de la gravedad del paciente y la carga de trabajo de enfermería está relacionada con mayor incidencia de Eventos Adversos (EAs) en pacientes críticos. Método: Estudio de cohorte única, prospectivo, con muestra de 138 pacientes internados en una Unidad de Terapia Intensiva (UTI). Resultados: En total, fueron evidenciados 166 EAs, incidiendo sobre 50,7% de los pacientes. El aumento de la gravedad del paciente mostró relación directa con la posibilidad de ocurrencia de EAs. Sin embargo, la carga de trabajo de enfermería no demostró relación estadísticamente signifi cativa en la ocurrencia de EAs. Conclusión: Los resultados permiten refl exionar sobre la importancia del equipo de enfermería, en utilizar instrumentos de evaluación, con el objeto de mejorar y planifi car sus acciones diarias, enfocándose en la seguridad del paciente. Descriptores: Atención de Enfermería; Gravedad del Paciente; Carga de Trabajo; Gestión de la Seguridad; Seguridad del Paciente. Severity and workload related to adverse events in the ICU Serafim CTR, et al. Severity and workload related to adverse events in the ICU
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