https://tedebc.ufma.br/jspui/handle/tede/1088 2026-04-10T02:52:29Z https://tedebc.ufma.br/jspui/handle/tede/2532 Título: Uso de corticóide antenatal em maternidades públicas brasileiras: prevalência e fatores associados Autor: ARAÚJO, Hanna-Arony Wanderley Pereira de Primeiro orientador: LAMY FILHO, Fernando Abstract: Introduction: The administration of corticosteroids to pregnant women can prevent and modify the course of respiratory distress syndrome, enhance the effects of surfactant therapy after birth and reduce the incidence of peri-intraventricular hemorrhage in the newborn. It is safe in women with premature rupture of membranes and pregnancy-related hypertensive disorders. Because of such benefits, according to the Ministry of Health of Brazil, antenatal corticosteroids should always be used in all pregnant women between 24 and 34 weeks gestation at risk for preterm delivery. Hence the importance of knowing the factors associated with failure to use the therapy in order to contribute to reducing neonatal mortality. Objectives: To determine the frequency of antenatal corticosteroid therapy in pregnant women with gestational age between 24 and 34 weeks in Brazilian public hospitals, and identify factors associated with non-use of this technology. Methods: We conducted a cross-sectional observational taking as the source database with collection performed from March 2004 to March 2005, which included 16 Brazilian public hospitals, with 1109 observations. Were included in the study infants with birth weights between 500 and 1,749 g. Categorical variables were described using percentages and analysis of differences between proportions was performed using the χ ² test - Mantel-Haenszel. To assess the factors associated with non-use of antenatal corticosteroids was used multivariate analysis of hierarchical type, classifying the variables into proximal, middle and distal in relation to the outcome. Results: the sample of 1,109 pregnant women with gestational age between 24 and 34 weeks, 528 (47.6%) did not use antenatal corticosteroids. Among the neonatal units studied, the incidence of non-use of antenatal corticosteroids ranging between 83.6% and 14.5%. Among the proximal variables, less complex hospital and absence of hypertension in pregnancy were associated with non-use of antenatal corticosteroids. Do not perform prenatal was the only intermediate variable analyzed that showed statistical significance for non-use of technology. Among the variables analyzed only the distal low education was associated with outcome. Conclusions: The study revealed a high frequency of non-use of antenatal corticosteroids for the period where technology is indicated, ie between 24 and 34 gestational weeks, which may point to the poor quality of hospital care for this condition units evaluated . The failure therapy use was associated with both the proximal variables such as intermediate and distal, revealing the multiplicity of interrelated factors to the outcome. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2013-04-05T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/1194 Título: Evolução clínica e laboratorial de crianças nascidas de mães HIV positivas, com ênfase no uso do protocolo ACTG 076 Autor: Silva, Margareth Jamil Maluf e Primeiro orientador: GAMA, Mônica Elinor Alves Abstract: Vertical transmission constitutes the main via for children infection by the HIV-1 virus (Human Immune Deficiency Virus), which is responsible for about 80% to 90% of AIDS cases (Acquired Immune Deficiency Syndrome) in children from Brazil and worldwide. Vertical transmission became the main prophylaxis target with the ACTG 076 Protocol (AIDS Clinical Trial Group), which implicates the use of Zidovudine during the pregnancy, delivery and newborn. This research aimed at studying the laboratory and clinical evolution of children born from mothers acknowledged as HIV + infected, at the HIV/AIDS pediatric Specialized Assistance Service of the Hospital Materno-Infantil da Universidade Federal do Maranhão, highlighting the report on the use of the ACTG 076 Protocol, from January 1998 to June 2006. Information were obtained from the medical chants, through the protocol form with data related to the identification, laboratory and clinical evolution of 181 selected children via the inclusion criterion (born from mothers known to be HIV /AIDS infected that had their case diagnosis defined during the follow-up until June 30, 2006). In 36.5% of the mothers the diagnosis was done after delivery, the ACTG 076 Protocol was not used in 54.7% of the cases during pregnancy or delivery, and 49.2% did not use the protocol during the newborn period. Vaginal delivery occurred in 40.3% of the mothers and breastfeeding was practiced by 38.1% of the babies. The use of the full ACTG 076 Protocol (in all of the prescribed stages) was observed in 15.5%; partial usage of the protocol was conducted just with the newborns in 5.5%; partial usage just during pregnancy and/or delivery occurred in 1.1%, and the incomplete use was observed in 23.7%; 45% did not use the protocol in any of the prophylaxis stages. Out of the babies who had AIDS (41.9%), one could observe that 12.1% of the cases were classified in the clinical class A; 13. 7% in the class B and 10% in the class C, and they evolved with a variety of signs and symptoms, whose the most frequent were: hepatomegaly, splenomegaly, adenomegaly, neuropsychomotor development delay, and infection of the upper respiratory tract. The anti-HIV ELISA, the viral load determination, and the T CD4+ Lymphocytes counting were not routinely performed in many cases, at the first medical consultation. Infection diagnosis was mainly done by ELISA and, then, by confirmatory lab tests, without determining the viral load. The lymphocytes counting was restricted to classify the AIDS cases and to the follow-up treatment. Thus, in our study, several relevant factors were observed that demonstrate great improvements in the reduction of HIV vertical transmission, but also advise the importance of the continuous maintenance of intervening actions, principally with the organizational improvement of the reference services for clinical attendance and the conduction of laboratory exams. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2007-09-13T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/1195 Título: PERFIL COGNITIVO EM IDOSAS DE DOIS SERVIÇOS PÚBLICOS DE REFERÊNCIA EM SÃO LUÍS-MA Autor: Correia, Marcius Vinicius Goncalves Primeiro orientador: MESQUITA, Emygdia Rosa do Rego Barros Pires Leal Abstract: As the population grows old, there is a proportional increase of cognitive disturbances. Due to the great relevance, this study aims to establish a descriptive study about the cognition level and correlated socio-demographic variables, in women ranging from sixty to eighty years old, in two public health services in the city of São Luís-MA. For a period of four months, a closed questionnaire which contained the socio-demographic variables and the Mental Condition Mini Examination (MEEM), was applied. A number of eighty voluntaries were evaluated in the Neurology clinics of the University Hospital President Dutra and State Hospital Carlos Macieira. The results were: 31,2% were classified by MEEM with cognitive disturbances; 71,4% in the 81-85 age bracket. In the population distribution according to schooling time, 54,9% of those having seven years of school were classified as having cognitive disturbances. As for the referred ethnicity and cognition level, 44.8% of mullatos presented cognitive disturbances. As for income and cognition level, it was observed that 30,4% of the volunteers who presented an income level lower than one to two minimum wage, were classified with cognitive disturbances. From the thirty-three volunteers that had direct care, 57,6% (19) presented cognitive disturbances. As for the referred morbidities, it was observed that 58,75% were referred to as having Systemic Arterial Hypertension; regarding life styles, 12,5% were referred to as smokers. The study becomes relevant because it provides epidemiologic substract for more complex methodological studies in order to promote improvement in the elderly mental public health in the area. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2007-05-06T00:00:00Z https://tedebc.ufma.br/jspui/handle/tede/1193 Título: ESTUDO DA CORRELAÇÃO ENTRE QUALIDADE DE VIDA E FUNÇÕES RESPIRATÓRIAS EM MULHERES PORTADORAS DE DOENÇA PULMONAR OBSTRUTIVA CRÔNICA Autor: Mangueira, Nilton Maciel Primeiro orientador: PINHEIRO, Alcimar Nunes Abstract: Introduction: The quality of life (QOL) of patients with Chronic Obstructive Pulmonary Disease (CPOD) is influenced by its impact on daily activities, due to the damage of the respiratory functional capacity. Objective: Correlate the QOL of women who carrying COPD with the respiratory functions and the 6 minutes walk test (6MWT). Methods: A cross study of 30 women with light or moderate COPD was carried out at the Pneumology Ambulatory care facility of the University Hospital, Presidente Dutra of the Maranhão State Federal University. The Saint George’s Respiratory Questionnaire (SGRQ) in the Respiratory Disease was used, to evaluate the measures of maximum respiratory pressures, spirometry and the 6MWT. Besides the descriptive statistics was realized the test t Student to dependent variables and the Linear Coefficient of Pearson for the correlation studies. Results: The QOL was altered in 96,7% of the studied patients in all sections of the SGRQ. The average distance (317,69 m) covered on the 6MWT, as well as the inspiratory muscular force (-53,48 cmH2O) and expiratory (69,55 cmH2O), were below the expected values for the normality. There was no correlation of the QOL with the BMI nor with the pulmonary function. The domains impact and the activities of the SGRQ presents negative correlation with age and positive with the Borg Scale. The domain impact still had correlation with the PImáx and the 6MWT. Conclusion: The patients with COPD of the study had presented a linear correlation among the QOL of the SGRQ and the variables of age, PImáx and the Borg Scale, still the low QOL in all the sections of the SGRQ, low performance on the 6MWT and reduced respiratory muscular force. Instituição: Universidade Federal do Maranhão Tipo do documento: Dissertação 2007-07-16T00:00:00Z