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Ramirez-Blanco, C. E., Ramirez-Rivero, C. E., Diaz-Martinez, L. A., & Sosa-Avila, L. M. (2017). Infection in burn patients in a referral center in Colombia. Burns, 43(3), 642–653.
Abstract: INTRODUCTION: Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. OBJECTIVES: To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS). METHODOLOGY: Burn patients hospitalized in the HUS from January 1 to December 2014 were followed. Medical information regarding infections, laboratory and pathology reports were obtained. Statistical analysis with measures of central tendency, proportions, global and specific incidence density plus overall and specific incidence was obtained. For the microbiological profile proportions were established. RESULTS: 402 burn patients were included, 234 (58.2%) men and 168 (41.8%) women, aged between 6 days and 83 years, median 12.5 years. The burn agents include scald (52.5%), fire (10.0%), gasoline (9.2%), electricity (7.5%), among others. Burn area ranged from 1% to 80% TBS. Cumulative mortality was 1.5%. 27.8% of burned patients had one or more infections. Identified infections include folliculitis (27.0%), urinary tract infection (19.0%), infection of the burn wound (10.4%), pneumonia (8.6%), Central venous catheter (7.4%), bloodstream infection (7.4%) and skin grafts infection (4.3%) among others. Bacteria were responsible for 88.5% of the cases and fungi 11.5%. The most frequently isolated germs were P. aeruginosa, A. baumannii, E. coli, S. aureus and K. pneumoniae. Most gram-negative bacteria were sensitive to Amikacin, gram positive bacteria were sensitive to multiple antibiotics. CONCLUSION: Burns is a severe trauma that occurs in adult and pediatric patients, has several causative agents and can compromise the patient's life. The burned patient is at risk for a variety of infections. According to the type of infection it is possible to infer the most common causative organisms and their antibiotic sensitivity/resistance which allow a directed early empiric treatment.
Keywords: Acinetobacter Infections/drug therapy/epidemiology/microbiology; Acinetobacter baumannii; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents/therapeutic use; Bacteremia/drug therapy/*epidemiology/microbiology; Burns/*epidemiology; Catheter-Related Infections/drug therapy/*epidemiology/microbiology; Central Venous Catheters; Cephalosporins/therapeutic use; Child; Child, Preschool; Colombia/epidemiology; Drug Resistance, Microbial; Escherichia coli; Escherichia coli Infections/drug therapy/epidemiology/microbiology; Female; Folliculitis/drug therapy/*epidemiology/microbiology; Humans; Infant; Infant, Newborn; Klebsiella Infections/drug therapy/epidemiology/microbiology; Klebsiella pneumoniae; Male; Middle Aged; Oxacillin/therapeutic use; Pneumonia/drug therapy/*epidemiology/microbiology; Pseudomonas Infections/drug therapy/epidemiology/microbiology; Pseudomonas aeruginosa; Staphylococcal Infections/drug therapy/epidemiology/microbiology; Staphylococcus aureus; Urinary Tract Infections/drug therapy/*epidemiology/microbiology; Wound Infection/drug therapy/*epidemiology/microbiology; Young Adult; Burn wound infection; Burns; Health care related infection; Nosocomial infection; Pneumonia; Urinary tract infection
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Girardi, S. N., Carvalho, C. L., Maas, L. W. D., Araujo, J. F., Massote, A. W., Stralen, A. C. de S. van, et al. (2017). [Preferences for work in primary care among medical students in Minas Gerais State, Brazil: evidence from a discrete choice experiment]. Cad Saude Publica, 33(8), e00075316.
Abstract: This article presents the results of a discrete choice experiment (DCE) conducted in 2012 with 277 final-year medical students from Minas Gerais State, Brazil. The experiment tested students' preferences concerning future work as physicians in primary health care, based on hypothetical job scenarios aimed at measuring the likelihood of placement in areas with a shortage of doctors. Application of DCE involved (i) a qualitative stage to define the attributes and their respective levels to comprise the job scenarios, (ii) construction and application of the instrument, and (iii) analysis with application of multinomial logit with conditional probability to estimate the weight of attributes and to construct scenarios for choice probability. The results indicate that the job attribute that most impacted students' choice was location, followed by job conditions, pay, access to medical residency, type of employment relationship, and workload. Students from private medical schools, with higher family income, and females were generally more likely to resist job assignments in unsafe urban areas and remote areas of the countryside. The job scenarios that proved most plausible in terms of public intervention were those that combined middle-level wages, good working conditions, and 10 to 20 bonus points on medical residency exams.
Keywords: Brazil; *Career Choice; Choice Behavior; Female; Humans; Income; Male; *Primary Health Care; *Professional Practice Location; Sex Factors; *Students, Medical; Surveys and Questionnaires
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Mello, A. de C., Carvalho, M. S., Alves, L. C., Gomes, V. P., & Engstrom, E. M. (2017). [Food consumption and anthropometry related to the frailty syndrome in low-income community-living elderly in a large city]. Cad Saude Publica, 33(8), e00188815.
Abstract: The aim of this study was to describe anthropometric and food intake data related to the frailty syndrome in the elderly. This was a cross-sectional study in individuals >/= 60 years of age in a household survey in the Manguinhos neighborhood of Rio de Janeiro, Brazil (n = 137). Frailty syndrome was diagnosed according to Fried et al., anthropometric measures were taken, and a food frequency questionnaire was applied and the results compared to Brazilian Ministry of Health guidelines. In the pre-frail and frail groups, body mass index and measures of central adiposity showed higher levels, while lean muscle parameters showed lower values, proportional to the syndrome's gradation. Frail elderly consumed higher amounts of grains and lower amounts of beans and fruit; pre-frail elderly consumed more vegetables, dairy products, and high-sugar and high-fat foods; the two groups consumed similar amounts of meat. Thus, diagnosis of the syndrome, anthropometric evaluation, and dietary assessment should be included in health policies for the elderly, since they assist in early identification of risk and favor interventions for disease prevention and health and nutritional promotion.
Keywords: Aged; Aged, 80 and over; *Anthropometry; Brazil; Cross-Sectional Studies; Female; *Food; Frail Elderly/*statistics & numerical data; Geriatric Assessment; Humans; Male; Middle Aged; Nutrition Assessment; Nutrition Surveys; Socioeconomic Factors
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Cruz, M. F. da, Ramires, V. V., Wendt, A., Mielke, G. I., Martinez-Mesa, J., & Wehrmeister, F. C. (2017). [Simultaneity of risk factors for chronic non-communicable diseases in the elderly in Pelotas, Rio Grande do Sul State, Brazil]. Cad Saude Publica, 33(2), e00021916.
Abstract: This study aimed to describe the simultaneity of risk factors for chronic non-communicable diseases among the elderly (</= 60 years) in a city in Southern Brazil. This was a cross-sectional, population-based study of 1,451 elderly in 2013. Cluster analysis was applied to selected risk factors (smoking, alcohol consumption, excess weight, and physical inactivity). Logistic regression was used to assess the association between simultaneity of risk factors and socio-demographic variables. The most frequent cluster in men (18.1%) and women (30.7%) was physical inactivity + excess weight. The cluster alcohol consumption + excess weight exceeded the expected level in men (O/E = 1.27; 95%CI: 1.01; 1.59) and women (O/E = 1.72; 95%CI: 1.35; 2.20). The presence of two or more risk factors in the elderly population (88.1%) points to the need for specific interventions for this population to fight risk factors simultaneously rather than separately.
Keywords: Aged; Aged, 80 and over; Alcoholism/epidemiology; Brazil/epidemiology; Chronic Disease/*epidemiology; Cluster Analysis; Cross-Sectional Studies; Exercise; Female; Humans; Male; Middle Aged; Obesity/epidemiology; Prevalence; Risk Factors; Sex Factors; Smoking/epidemiology; Socioeconomic Factors
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Gomes, F. da S., Silva, G. A. E., & Castro, I. R. R. de. (2017). [Household purchase of sodas and cookies reduces the effect of an intervention to promote the consumption of fruits and vegetables]. Cad Saude Publica, 33(3), e00023316.
Abstract: This study examines the influence of increasing household availability of sodas and cookies on the effects of an intervention to promote the consumption of fruits and vegetables. The study analyzed data from 70 families living in low-income communities in the city of Rio de Janeiro, Brazil, selected in a stratified probabilistic sample, and who completed a 30-day food record before and after the intervention. The intervention contributed to a significant increase in the household availability of fruit and vegetables (+2.7 p.p.; 95%CI: 1.5; 4.0), contrary to the trend towards stagnation of such availability in the general population in Brazil. Meanwhile, the purchase of sodas and cookies, which was not the intervention's target, mirrored the upward trend in the consumption of these products (+5.8 p.p.; 95%CI: 3.3; 8.4). Families that increased their purchase of sodas and cookies showed lower increases, or even decreases, in the purchase of fruits and vegetables (p < 0.05), and had nearly fourfold lower odds of experiencing any increase in the household availability of fruits and vegetables.
Keywords: Beverages/*statistics & numerical data; Brazil; Candy/*statistics & numerical data; Diet Surveys; *Feeding Behavior; Female; *Fruit; *Health Promotion; Humans; Male; Socioeconomic Factors; *Vegetables
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