OBJECTIVE To analyze factors associated with outpatient follow-up of children with congenital syphilis.METHODS A non-concurrent cohort study performed in primary care units and three reference maternity hospitals in Fortaleza (Ceará State). Data were collected from September 2013 to September 2016 in the notification forms and in the medical records of hospitalization and outpatient follow-up, and they were presented considering an adequate and inadequate follow-up. Children who attended the primary care unit or referral outpatient clinic during the period recommended by the Ministry of Health were considered adequately followed up and performed the recommended examinations. Pearson’s chi-square and Fisher’s exact tests were used in the comparative analysis. The estimated risk of adequate non-follow-up was verified by simple and multiple logistic regression.RESULTS The total of 460 children with congenital syphilis were notified, of which 332 (72.2%) returned for at least one appointment and were part of the study. Exactly 287 (86.4%) children attended the primary health unit; however, there was no reference to congenital syphilis in 236 (71.1%) medical records and no information on the venereal disease research laboratory (VDRL) test was found in 264 (79.5%) children. There was nonadherence to subsequent appointments by 272 (81.9%) individuals. The following variables had a statistically significant association with the non-adequate follow-up of the children: marital status of the mothers, number of prenatal appointments, number of pregnancies, blood count, and radiography of long bones.CONCLUSIONS Most children with congenital syphilis attended primary care for follow-up, but the services do not meet the recommendations of the Brazilian Ministry of Health for adequate follow-up.
Objetivo: Identificar a prevalência de depressão de idosos residentes em instituições de longa permanência (ILPI) em um município de grande porte do Estado do Ceará-Brasil e sua relação com os motivos de institucionalização. Métodos: Estudo quantitativo e transversal que utilizou um instrumento de coleta de dados elaborado para realizar avaliação clínica concernente à depressão maior, utilizando os critérios diagnósticos do DSM-IV-TR. Serviu também para registrar os dados secundários obtidos dos prontuários dos pacientes idosos no intuito de complementar as informações relativas ao contexto da institucionalização. Resultados: Do total de idosos pesquisados, 82 (34,6%) apresentaram diagnóstico de Depressão Maior segundo os critérios do DSM-IV-TR. No diagnóstico de depressão por ILPI, verifica-se significância estatística entre as duas ILPI (p=0,042). Na associação verificada entre depressão e tempo de institucionalização (p=0,001), é importante destacar o maior percentual entre os idosos com até três anos de institucionalização (37,8% dos casos de depressão), levando se a considerar que o pouco tempo de afastamento familiar e o processo de adaptação ao novo tipo de moradia possam constituir fatores de risco para a doença. Conclusão: Os achados acima descritos aludem à ideia de que o tempo de institucionalização, a carência das relações interpessoais, a solidão e o fato de o idoso receber visitas de familiares neste período constituem fatores de risco para a depressão, levando a considerar que os vínculos familiares perduram, fortalecendo-se a cada visita, portanto, tornando a ruptura familiar ainda mais penosa, o que compromete o direito do idoso de envelhecer com dignidade.
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