PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE MATERNO-INFANTIL - PPG Saúde Materno Infantil
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Item ANÁLISE DA EXPRESSÃO DOS RECEPTORES DA SOMATOSTATINA (SST1-5) E DA DOPAMINA (DR2) EM ADENOMAS HIPOFISÁRIOS(Universidade Federal do Maranhão, 2012-03-12) Nunes, Bruno de Almeida; Faria, Manuel dos Santos; CPF:33207194753; MESQUITA, Emygdia Rosa do Rego Barros Pires Leal; CPF:33301018300; http://lattes.cnpq.br/0374728351065012Pituitary tumors represent 15% of intracranial neoplasms and are usually benign. The treatment primary is surgical resection with exception for prolactinomas because dopamine agonists are very effective in the treatment these tumors. If surgery does not lead to healing, it is necessary other therapeutic strategy in a attempt to control hormone levels and tumor size reduction. The radiotherapy and medical treatment with somatostatin analogs and agonist dopamine are often used. The study aimed to analyze the presence, distribution and frequency of somatostatin receptor and dopamine receptor (DR2) in pituitary adenomas, and compared their mRNA expression and protein expression. We studied 38 patients with pituitary adenomas. The GH-secreting adenomas showed immunoreactivity more frequent SST2 and SST3 present in 100% of the tumors followed SST5, SST4 and SST1 respectively. Clinically nonfunctioning adenomas SST3 receptor was most widely distributed, present in 13 of 14 tumors followed SST2, SST4, SST1 and SST5 respectively. The mRNA expression of SST2 and SST5 receptor was present in all pituitary adenomas with higher expression of SST2. The DR2 receptor was present and 85% of samples analyzed. In conclusion, the high expression of SST2 in somatotropinomas support the possibility of the use of octreotide as an adjunct therapy in the treatment of acromegalic patients. Patients with clinically nonfunctioning adenomas showed expression of somatostatin receptor and dopamine which indicates the possibility of treating these patients with the somatostatin analogues and / or dopamine agonists.Item ANSIEDADE, DEPRESSÃO E ESTRESSE EM MULHERES COM DOR PÉLVICA CRÔNICA(Universidade Federal do Maranhão, 2011-12-12) Aragão, Mariana Serra de; BRITO, Luciane Maria Oliveira; CPF:04207149368; Chein, Maria Bethânia da Costa; CPF:71725431734; http://lattes.cnpq.br/6140088004101694The Chronic Pelvic Pain (CPP) has been defined as pain in the pelvic region, non-cyclic, with duration of 6 months. Women with CPP may have levels of anxiety, depression and stress. Objective: To identify the prevalence of depression, anxiety and stress in women from the general community of St. Louis with chronic pelvic pain and verify their possible association with the duration and intensity of pain. Methods: Case-control study, which included 54 women with chronic pelvic pain, making the case group, and 150 women in the control group. The instruments used for data collection were Anxiety Inventory and the Beck Depression Inventory and the Stress Symptoms for Adults LIPP. Among the variables used are: time in months of pain and signs and symptoms of anxiety, depression and stress. Results: The prevalence in the case of stress was 59.26%, while anxiety and depression in both minimum level, was 35.19% and 50%, respectively. At level severe depression and anxiety were present in 3.70% and 11.11%, respectively. In the control group, 36% had stress. In the same group, at a minimum, anxiety occurred in 67.33% and 78.67% in depression. In severe level prevalence was 3.33% and 1.33% for anxiety and depression, respectively. There was a positive correlation (r = 0.1275) between pain intensity and depression. Conclusion: Women with CPP have higher scores for anxiety, depression and stress compared to women without CPP, depression being positively correlated with pain intensity.Item CÂNCER DE TIRÓIDE EM PACIENTES COM ACROMEGALIA: UM ESTUDO CASO-CONTROLE(Universidade Federal do Maranhão, 2012-06-18) Santos, Maíra Cristina Carvalho dos; FARIA, Manuel dos Santos; CPF:33207194753Several studies have associated acromegaly with an increased risk of benign and malignant tumors. While simple and multinodular goiters are common findings in acromegaly, the prevalence of thyroid cancer is uncertain. The objective of this study was to estimate the prevalence of thyroid cancer in a series of acromegalic patients from three hospitals in northeast of Brazil. The methodology used included morphological, cytological and histological thyroid analysis of acromegalic patients and volunteers over 18 years, matched for age and sex and with nodule (s) ≥ 1 cm. The subjects of this study were 124 acromegalic patients, including 76 females (61.3%) and 48 men (38.7%), with a mean age 45.1 years. Results of the study showed that thyroid ultrasonography was normal in 31 cases (25%), 25 had diffuse goiter (20.1%), 67 had nodules (54%) and one agenesis of the right lobe (0.8%). Thirty six patients underwent fine needle aspiration biopsy (FNAB) of their nodules and 9 cases of papillary cancer were found (7.2%). The control group consisted of 263 subjects, 156 females (59.3%) and 107 males (40.7%), mean age 44.7 years. In ultrasound assessment, 96 had nodules (36.5%). Of these, 13 were punctured and 2 cases of papillary carcinoma were found (0.7%). These results gave an odds ratio of 10.21 (p = 0.0011, 95% CI 2.17 to 48.01). These findings demonstrate an increased prevalence of thyroid cancer, statistically significant when compared to our control group. Thus, it is suggested that acromegalic patients should be routinely submitted to thyroid ultrasound evaluation, followed by FNAB of nodules when indicated.Item CINESIOTERAPIA PERINEAL EM MULHERES COM DÉFICIT MUSCULAR NO ASSOALHO PÉLVICO E COM UMA ÚNICA VIA DE PARTO: ensaio clínico(Universidade Federal do Maranhão, 2012-06-18) Duarte, Thaiana Bezerra; CHEIN, Maria Bethânia da Costa; CPF:71725431734; http://lattes.cnpq.br/6140088004101694; Brito, Luciane Maria Oliveira; CPF:04207149368BACKGROUND: Pregnancy and delivery route influence the strength of pelvic floor muscles, which are considered risk factors for the onset of urinary incontinence and genital dystopias. OBJECTIVES: To evaluate the effects of kinesiotherapy in the pelvic floor muscles in women with a single delivery. METHODS: Participants were 503 women who responded to the protocol record, 297 (59.0%) aged between 35 and 45 years underwent functional evaluation of the pelvic floor by bidigital touch and perineometer. There were 165 (32.8%) women with deficiency on muscles strength participating in the trial, which were allocated into two groups according to the delivery route (A - vaginal delivery and B - abdominal delivery). They were randomized into groups A1 (n = 44) and B1 (n = 42), and were submitted to kinesiotherapy and groups A2 (n = 39) and B2 (n = 40) without kinesiotherapy. The protocol had perineal contraction exercises in the supine, sitting and standing posture and was performed twice a week for a total of 15 sessions. Statistical analysis used the chi-square test, Mann-Whitney test, Z test, Kruskall Wallis test, and ANOVA one criterion, the Spearman Correlation Coefficient, the Pearson Correlation Coefficient and PHI, with significance level 0.05. RESULTS: As the result of the kinesiotherapeutic protocol by comparing the force of contraction of the pelvic floor before and after application of kinesiotherapy compared to those without kinesiotherapy, there was significant increase in strength on women with both routes of delivery, by the both methods of evaluation (p < 0.0001). Among the variables possibly associated with the DFMAP, only parity was statistically significant (p ˂ 0.0001). CONCLUSIONS: The protocol proposed proved to be effective in the increase of pelvic floor muscle s strength at the assessment by both methods of evaluation. The delivery route was not responsible for weakening perineal but parity, demonstrating that the perineal muscles strength is inversely proportional to the number of births, suggesting that kinesiotherapy during pregnancy may be an alternative to prevent the weakening of pelvic floor.Item COLONIZAÇÃO BACTERIANA NASAL EM RECÉM-NASCIDOS PREMATUROS E SUAS MÃES EM DUAS UNIDADES DE TERAPIA INTENSIVA NEONATAL(Universidade Federal do Maranhão, 2009-12-07) Freitas, Isolina Januária Sousa; LAMY FILHO, Fernando; CPF:72508000787; http://lattes.cnpq.br/3977956820339735; Lamy, Zeni Carvalho; CPF:12832693334; Brito, Luciane Maria Oliveira; CPF:04207149368The bacterial colonization occurs soon after birth, depending on the environment where the newborn is and can occur with bacteria as the normal microbiota or by bacteria resistant to antibiotics. Once colonized, at any time, depending on factors such as low immunity, inadequate protection of the skin, exposure to invasive procedures, length of stay in Intensive Care Units - the newborn may be infected with the bacterium that colonizes them. Aiming to know the nasal microbiota of newborns admitted to Neonatal Intensive Care Unit (ICU) and their mothers, it was drew up this present cross-sectional and analytical study where 69 pairs of newborns and their mothers were studied. Nasal swabs were collected from all newborns admitted to the ICU of Parenting Marly Sarney and the University Hospital Materno-Infantil in the period of April to September 2008, weighing between 1200 and 1800g. Were excluded from this study newborns carrying ostomies, catheters, infection of the skin, twins, syndrome, and mothers that were not found to collect the swab. The nasal microbiota of mothers showed up predominantly sensitive to oxacillin, as represented by 48% of Staphylococcus aureus (MSSA) and 29% of coagulase negative Staphylococcus (CONS), while the newborns were colonized by Staphylococcus resistant to oxacillin, thus distributed: 44% of MRSA and 22% of CONS. So this study shows that newborns hospitalized in intensive care units surveyed the early home of resistant MRSA and Scone, this does not occur with their mothers. Meanwhile the mothers have a rate of 19% of MRSA (13%) and Scone resistant (6%), may represent a form of colonization of the newborn. It was also found strong statistical association, with relative risk of 1.65 between the use of antibiotics by the mother and the newborn colonization by Staphylococcus multiresistant. We conclude that the knowledge of the colonizing nasal maternal flora and of the newborn may guide the health professionals about the specific measures of prevention and epidemic surveillance. Additional studies such as genotyping of the Staphylococcus enable the knowledge of the magnitude of the impact of colonization of the mother and its transmission to the newborn to guide preventive measures such as nasal decolonization of the mother before delivery.Item DISCURSOS SOBRE SEXUALIDADE EM ESTUDANTES UNIVERSITÁRIAS DE SÃO LUÍS-MA(Universidade Federal do Maranhão, 2006-11-29) Rêgo, Adriana Sousa; Neves, Ednalva Maciel; CPF:30218519400; LAMY, Zeni Carvalho; CPF:12832693334Study about the sexuality in academical students of medium layers in São Luís. It is a descriptive study of qualitative approach that had the main objective to know the construction of the sexuality and specific objectives: to characterize socioeconomic the students interviewed, to identify the students' conceptions about sexuality and to investigate aspects related to the sexual and contraceptive practices. The information was collected among students of the courses of Physiotherapy and Occupational Therapy of Faculdade Santa Terezinha CEST from two research instruments: questionnaire and semi-structured interview. fifteen students were interviewed with ages between 19 and 25 years, with sexual active life, and thirteen pronounced to be unmarried women and two stable relationship. The collected information points to the conservative discursive reproduction. A differentiated paper of the family was observed in relation to the sexuality, where were differed the equalitarian model, the family silence model and the hierarchical model. The students' autonomy was identified through their initiatives as for the sexual practices, the meanings that attributed to the sexuality, as well as the domain of the sexual practices and the contraceptive choices. The sexuality was predominantly referred as sexual action, and, pleasure and orgasm were understood, by the students, as synonyms.Item DOENÇA PERIODONTAL EM MULHERES NA PÓS-MENOPAUSA E SUA RELAÇÃO COM A OSTEOPOROSE(Universidade Federal do Maranhão, 2010-07-30) Bertulucci, Livia Almeida Barros; LOPES, Fernanda Ferreira; CPF:40916359387; http://lattes.cnpq.br/6883478653190503; Brito, Luciane Maria Oliveira; CPF:04207149368The Osteoporosis, defined as an age disorder, characterized for the decrease of bone mass and increase of breakings susceptibility, is the most common metabolicbone illness, affecting at least 30% of all postmenopausal women. The aim of this study was to make a quantitative periodontal condition analysis through a casecontrol study of post menopausal women and its relation with osteoporosis. The sample consisted of 99 postmenopausal women, divided in to three groups according with the avaliation of the mass bone: normal bone (G1 with N=45), osteopenia (G2 with N=31) and osteoporosis (G3 with N=23). There applied the indexes of clinical attachment level (CAL), gingival on pob (BOP), plaque index (PI) and probing depth (PD) for all participants. The periodontal condition data were submitted to the BioEstat 2.0 software using parametrical tests as analysis of variance (ANOVA) and Bonferroni test, using the significance level of 5%. The results shown that the women in postmenopausal with osteoporosis had presented high average in CAL (2,61 ± 0,43mm), as well as PD (2,80 ± 0,64 mm), BOP (72,8 ± 25,9 mm) and PI (72,9 ± 24,2 mm). After the accomplishment of the statistical treatment, it was observed that there was significant difference for the periodontal situation mainly between G1 and G3 and G2 and G3 groups, and still presented higher percentage of presence of the periodontitis, the osteoporosis women group. It was concluded that the periodontal conditions of the interviewed and analyzed postmenopausal women had revealed the relation between periodontitis and osteoporosis.Item EXPRESSÃO DOS MARCADORES CD56, CD16 E CD57 NA AVALIAÇÃO PROGNÓSTICA DE PACIENTES COM LEUCEMIA LINFÓIDE AGUDA NO ESTADO DO MARANHÃO(Universidade Federal do Maranhão, 2012-09-28) Andrade, Karla Nadinne de Sousa; OLIVEIRA, Raimundo Antonio Gomes; CPF:40727343300; http://lattes.cnpq.br/1633053684617759; Silva, Raimundo Antonio da; CPF:0237799368The acute lymphoblastic leukemia (ALL) is characterized by abnormal proliferation of immature lymphoid cells and represents the most common cancer in children. The evaluation of prognostic factors in patients with ALL enables the implantation of different therapeutic approaches. The aberrant expression of markers CD56, CD57 and CD16 may be a way to assess this prognosis. The objective of this study was to characterize patients with ALL and to evaluate the prognostic influence of aberrant expression of markers CD56, CD16 and CD57 in ALL. 44 patients treated at the Maranhense Oncology Institute Aldenora Bello in Sao Luis - MA were evaluated, from March 2010 to October 2011. Patients were diagnosed with ALL according to the morpho-cytochemical and immunophenotype criteria. The expression of markers was determined by flow cytometry and clinical data were obtained through chart review. Two groups were divided as the expression or not of these markers and compared in relation to prognostic variables. The average of age in the sample was 6,28 years, with a predominance of males (60,0%). The average of blasts counted in bone marrow (BM) and peripheral blood (PB) was 77,0 and 39,6, respectively. The L1 morphology of the blasts from BM was the most frequent (80,0%). The profile of the blood count at diagnosis indicated: 24.061 leukocytes/mm3; 56.510 platelets/mm3 and 8,0 g/dL hemoglobin. According to the classification GBTLI-99, 60,0% of the patients were in low risk of recurrence group and in the end of the induction phase of treatment (D29), 70,0% of the patients had remission. The patients with ALL T had mean of age (10,6 years; p = 0,0204) and leukometry (48.200/mm3; p = 0,0167) significantly higher than patients with ALL B. 80,0% of the patients expressed the CD56 marker and no patient expressed CD16 and/or CD57 markers. Patients who did not express the marker CD56 had age significantly higher those who expressed (9,3 years; p = 0,0353). For patients with ALL B, the average of blasts from PB of patients who expressed the CD56 marker was higher than those not expressed (41,1; p = 0,0226). It is concluded that CD56 expression characterizes a worse prognosis for patients with ALL B, due to a significantly higher average of blasts counted in PB found in our study. However, a greater number of cases and a longer observation time would be needed to better emphasize this evidence.Item FATORES ASSOCIADOS À INFECÇÃO POR LEISHMANIA CHAGASI EM INDIVÍDUOS ASSINTOMÁTICOS NO MUNICÍPIO DE RAPOSA - MA(Universidade Federal do Maranhão, 2009-09-25) Cavalcante, Maria Neusa Sousa; CALDAS, Arlene de Jesus Mendes; CPF:06722091368; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=N603359Visceral Leishmaniasis is a zoonosis that attacks man in an accidental way and in the present decade presents itself in a wide geographic expansion, attacking urban and peri-urban spaces of large Brazilian cities. The precarious social/economic and environmental conditions, as well as life habits are relevant to the epidemiology of the disease and seem to favor the maintaining of the transmission cycle. A Cohort study was accomplished during the period of August 2006 to January 2008, with the objective of investigating the occurrence of non-symptomatic infection by Leishmania chagas in humans in the villages of Maresia, Pantoja and Marisol in the municipal area of Raposa, MA. The study was delineated in three phases: in the first phase, a population census was taken; in the second phase, demographic, social/economic and epidemiologic data was collected using a questionnaire, as well as a physical examination and tests to detect the infection by Leishmania chagasi in 1371 individuals by the immune enzymatic test (ELISA), and in 1356 individuals by the Montenegro skin test (IDRM); and in the third phase, the physical exam as well as the ELISA test was performed on 958 individuals. In the statistical analysis of the risk factors, a logistic regression and Poisson test in the Stata 9.0 program was used, having a significant level p<0,05 (95%). The initial and final prevalence and the incidence of infection by Leishmania chagasi by means of the ELISA test was 19,8%, 16,6% and 8,4% respectively, and the prevalence by means of the IDRM test was 82%. The following variables were found to be associated with the incidence of infection by Leishmania chagasi by the ELISA test: over 15 years of age (p<0,001) and the presence of more than 4 dwellers in a residence (p=0,039); and association with the prevalence of infection by Leishmania chagasi by the IDRM test were: over 15 years of age (p=0,003), straw or adobe walls (p=0,0014), a poultry-gard present (p=0,004) and reference to mosquito-breeders in the peridomiciliar (p=0,026). The high prevalence detected by the IDRM in the localities studied indicates a large exposure of the dwellers to the vetor of LV, and the incidence detected by the ELISA demonstrates the vulnerability of the individuals to the risk of contracting the disease.Item FATORES DETERMINANTES DA PRÁTICA DE MÉTODOS CONTRACEPTIVOS ENTRE UNIVERSITÁRIAS DA ÁREA DA SAÚDE(Universidade Federal do Maranhão, 2008-07-03) Faray, Helone Eloísa Frazão Guimarães; MOCHEL, Elba Gomide; CPF:17624746387; http://lattes.cnpq.br/7904420167856122The research objective the study of the determinants factors of the practical of contraceptive methods between colleges student of the health area. It was used of form with structuralized questions applied the 440 colleges student with age of 18 the 24 years of Faculdade Santa Terezinha (CEST). The analysis statistics it s being through the program Epi-Info and by means of the test qui-square. Amongst the searched colleges student 66.7% they had answered already to have initiated the sexual life. Most part of the colleges student initiated the sexual life with the age of 19 - 20 years 41.9%. In the first sexual relation 65.2% it used some contraceptive method. The used method more in the first sexual relation was condom 80.3%, currently 82.7% of the colleges student they use contraceptive and the preference continues being condom 84.9%. The majority of the colleges student declared to present frequency in the sexual relations of one or more times in week 54.2% and with a partner in the year 78.9%. The results in this population show that it has a proeminence for the bachelor condition, say to know condom as contraceptive method and affirm not to present doubts about the methods. Already they had initiated the sexual life and they had used contraceptive in the first relation presenting the frequency of one or more times in week and a partner in the last year.Item AS FORMAS DE VIOLÊNCIA CONTRA A MULHER NO MUNICÍPIO DE TIMON- (MA)(Universidade Federal do Maranhão, 2008-10-26) Silva, Maria de Fátima Parentes da; BRITO, Luciane Maria Oliveira; CPF:04207149368Introduction: Violence against women is a global problem of public health and violate principles of equality. Spite of all earned rights, existent laws, and public policies that have been introduced, women keep on suffering from violence. Objectives: We studied the various forms of violence, the characteristics of the victim and the relationship with the abuser. Methods: We conducted a retrospective and descriptive study, July to December 2005, the Medical Legal Institute (IML) of the city of Timon-MA with women who have suffered some type of violence and tried to go to the Special Care Women ( DEAM) for record of the police reports (BO), being sent to the IML to the implementation of peer review. Results: Of the 106 cases studied, 78% were of physical violence inflicted by white gun, sticks, stones, feet, hands and teeth. In 52% of cases the hand was used to strike and strangle. In 61% the lesions were multiple women presenting with 2 or up to 5 types of injuries such as bruises (34%) and excoriation (27%). As the location of the lesions, 30% were in the head and upper limbs 34%, which demonstrates the intention of the brutal aggressor in hurt and leave visible marks, since 79% was observed in the presence of harm to physical integrity of women. Sexual violence was reported in 13 cases, in which 54% of women were raped. Conclusions: The information collected from the IML showed that violence against women does not restrict itself to a certain age, race, profession or marital status and in 54% of assaults, the perpetrator was known by the woman, of which 44% were husband / boyfriend.Item INTERNAÇÕES PEDIÁTRICAS POR CONDIÇÕES SENSÍVEIS À ATENÇÃO PRIMÁRIA EM HOSPITAL DE REFERÊNCIA TERCIÁRIA NO MARANHÃO(Universidade Federal do Maranhão, 2014-11-18) Lima, Raquel Castro Desterro e Silva Moreira; GAMA, Mônica Elinor Alves; CPF:45297207304; Coimbra, Liberata Campos; CPF:0111101200; http://lattes.cnpq.br/9128715784318958; Silva, Raimundo Antonio da; CPF:0237799368; Chein, Maria Bethânia da Costa; CPF:71725431734; http://lattes.cnpq.br/6140088004101694Access and effectiveness of Primary Health Care are decisive to avoid hospitalizations. Therefore, Ambulatory Care Sensitive Conditions (ACSC) is an excellent indicator to evaluate Primary Health Care. In view of the relevance of this indicator to propose strategies of organization and consolidation of Sistema Único de Saúde, this study has the main purpose to analyze pediatric hospitalizations by ACSC in a tertiary referral hospital in Maranhão. It was made a descriptive and retrospective study of the epidemiological data and diagnostics collected in University Hospital of Federal University of Maranhão. The data were transferred to a database, using the IBM SPSS Statistics 20 software (2011) to do statistical analysis. The crossing of diagnostics register systems and age groups was analyzed by non parametric test of independence; when it was not possible to use test, it was used the exact Fisher test or the G independence test. To analyze frequencies of hospitalizations by ACSC among age groups within each register system was applied test of adherence. The crossings of hospitalized patients by ACSC, within each register system, and the presence or not of Unidade Básica de Saúde da Família (UBSF) near their residence, were analyzed by test of adherence, and the comparison between the register systems about the presence or not of UBSF, by the test of independence. The level of significance in all tests was 5%. The diagnostics were classified according to Brazilian List of ACSC. There were 17% of hospitalizations by ACSC. The predominant age group was 1 to 4 years old (36%), male (51,2%) and brown-skinned (60,5%). The patients came from São Luís (50%) and from interior of Maranhão (50%), and the majority was from the urban zone (65,1%) and did not have UBSF near your residence (57%). Within the ACSC groups of the Brazilian List, the most frequent was pneumonias bacterianas (25,5%), followed by the group of infecção no rim e trato urinário (19,7%). Considering the classification of ACSC Brazilian List, almost one fifth of admissions in this high complexity reference hospital in the state could have had, plausibly, resolution in Primary Health Care.Item PERCEPÇÃO DE MÃES DE CRIANÇAS ENTRE 0 A 3 ANOS DE VIDA SOBRE A ASSOCIAÇÃO ENTRE ESTIMULAÇÃO AMBIENTAL E O DESENVOLVIMENTO NORMAL ATENDIDAS NA UNIDADE DE SAÚDE ANTONIO CARLOS REIS, CIDADE OLÍMPICA - SÃO LUÍS/ MARANHÃO(Universidade Federal do Maranhão, 2012-12-12) Paula, Lila Isabel Câmara de; BRITO, Luciane Maria Oliveira; CPF:04207149368; Pinheiro, Feliciana Santos; CPF:05484336787; http://lattes.cnpq.br/2070446441534231An approach to family environment and its stimulation for a better development of children between 0 and 3 years of age, considering the stimulation received from their household as minimum conditions to ensure sensorimotor, cognitive, language and social emotional development, thus creating assumptions which are important for learning, in addition to allowing their interaction with the social, cultural, physical and socio-moral environments. The objective of this study was to evaluate these children s mothers about the association between the environmental stimulation and the normal development of children attended at Unidade de Saúde Antonio Carlos Reis, a public health unit in Cidade Olímpica, São Luís, Maranhão, from October 2009 to March 2010, identifying mothers understanding level about environmental stimulation and development, as well as characterizing the household in which the live. We have performed a qualitative exploratory and descriptive research, with a population consisting of 15 mothers. The Medical Records of the Unit, the Semi-Structured Interview, the Participant Observation were the instruments for data collection, besides the home visit and the qualitative analysis of the speeches, which served to organize and form categories comprising each topic discussed. Among the results, we have found that most mothers were between 13 and 20 years of age, incomplete elementary school, without a partner and with a low-income wage, among others. According to the proposed objectives, it was possible to organize the discussed topics in categories, such as: Reactions of mothers related to pregnancy; Mothers evaluation about how to stimulate children s development at home; Major mothers difficulties; Mothers comprehension related to their household and Mothers perception about necessity of stimulation of their environment for a better development of their children. We consider that interdisciplinary practice and interdisciplinary studies could contribute to improve the level of interactions mother/child and mother/health Professional, with increasing adhesion levels and mothers participation in stimulating their children, and consequently, with a significant evolution in the psychomotor and neurological development, and children s quality of life.Item PREVALÊNCIA DO VÍRUS LINFOTRÓPICO DE CÉLULAS T HUMANAS TIPOS 1 e 2 EM GESTANTES, SÃO LUÍS- MA.(Universidade Federal do Maranhão, 2009-11-18) Souza, Verônica Guimarães de; MOCHEL, Elba Gomide; CPF:17624746387; http://lattes.cnpq.br/7904420167856122INDTRODUCTION: HTLV are retroviruses with tropism for lymphocytes T, type 1 (HTLV-1) is endemic in the Caribbean region, Japan, South America, and parts of Africa; type 2 in some American native groups, rare in Africa, and the Europe associated with use of injectable drugs. In Brazil one esteem 2,5 million infected people in all the states where it was searched, with some prevalence. OBJECTIVE: This study had the objective identify the prevalence of HTLV-1 and 2 in the selection of pregnant taken care of in the prenatal one of three public services. METHODOLOGY Transversal study, carried through between 11/02 and 03/12/2008, with 2044 pregnant in three public services of prenatal, São Luis/MA. Patients had been guided on the study and enclosed after signature of the TCLE and filling of the questionnaire. They had participated pregnant between 18 and 45 years, without history of psychiatric illnesses, high blood pressure, kidney pathology, diabetes and others that would characterize specialized necessity of prenatal. The sample was calculated in 2041, to be able of the test of 95%, absolute error of 5%, was used program Stata 9,0, carried through test qui squared and accepted p< 0,05 (95%) as limit for significance. In the selection collection of digital blood in processed paper was used filter and in the laboratory of NUPAD - MG, to be submitted to ELISA test. The pregnant that had presented resulted modified had been contacted for new collection of peripheral vein blood for confirmatory tests western blot and PCR.RESULTS Of the 2044 evaluated pregnant, 7 pregnant had presented resulted modified, 01 indeterminate and 06 positives, showing prevalence of 0.34%. CONCLUSION This research MOSTROU that prevalence is higher then on blood donators and is necessary ampler studies and that they contemplate other extracts of the population to identify the reality of the presence of the virus in the State of the Maranhão.Item PRODUTO DA ACUMULAÇÃO LIPÍDICA NA DETECÇÃO DE FATORES DE RISCO PARA DOENÇAS CARDIOVASCULARES EM MULHERES COM SÍNDROME DOS OVÁRIOS POLICÍSTICOS(Universidade Federal do Maranhão, 2012-10-29) Nascimento, Joelma Ximenes Prado Teixeira; CHEIN, Maria Bethânia da Costa; CPF:71725431734; http://lattes.cnpq.br/6140088004101694; Figueiredo Neto, José Albuquerque de; CPF:37407350400; http://lattes.cnpq.br/4599029240915353The polycystic ovary syndrome (PCOS) is considered the most common endocrine disease during the woman's reproductive life, with prevalence ranging from 5 to 10% of women of reproductive age and is characterized by chronic anovulation and hyperandrogenism, showing complex multifactorial pathogenesis. Objective: To determine the cutoff the lipid accumulation product in women with polycystic ovary syndrome. Methods: Cross-sectional study with 78 women between 18 and 42 years diagnosed with polycystic ovary syndrome according to the Rotterdam criteria directed to nutritional evaluation at the Maternal and Child Unit of the University Hospital UFMA. The interest variables were recorded in protocol form: socio-demographic, behavioral, gynecological history, personal and family history of diseases, anthropometric data (weight, height, body mass index and waist circumference), laboratory tests, imaging exams and blood pressure values. The product of lipid accumulation was calculated by the formula described by Kahn. Regarding the analysis of data normality of quantitative variables was analyzed by the Shapiro Wilk; to compare the means of the variables we used the t Student test. To check the correlation between the lipid product accumulation and cardiovascular risk markers was applied Linear Correlation coefficient (r) test. The lipid product accumulation was analyzed according to the Receiver Operating Characteristic Curve, being discriminated values of high sensitivity and specificity simultaneously. The significance level for all tests was 5%. Results: Using the Receiver Operating Characteristic curve to determine the best cutoff of predicted LAP index risk for cardiovascular disease, it was noted that the value above 39.32 cm.mmol/L representing the area under the 0.8845 of the curve. Every women who had lipid product accumulation product value above the cutoff defined also showed the highest changes in mean of risk markers analyzed of cardiovascular diseases, a statistically significant difference. Regarding the analysis of correlation between the product of lipid accumulation above the cutoff defined and risk markers for cardiovascular diseases, there was a significant correlation. Conclusion: These results demonstrate that cutoff values ≥ 39.32 cm.mmol/L of LAP index seems to indicate the increased risk for CVD and should be used as a screening tool and research for its ease of measurement and interpretation, as well as its low cost and may even have its applicability in primary health care.Item RESULTADOS PERINATAIS NA GRAVIDEZ EM ADOLESCENTES PRECOCES NO MUNICÍPIO DE SÃO LUÍS MA(Universidade Federal do Maranhão, 2012-09-05) Correia, Alcioneyaria da Silva; LAMY FILHO, Fernando; CPF:72508000787; http://lattes.cnpq.br/3977956820339735; Silva, Antonio Augusto Moura da; CPF:17675464320; http://lattes.cnpq.br/8652081312944025Pregnancy in early adolescence (10-14 years), little studied, has been associated with adverse obstetric outcome. Objective: To identify the socioeconomic and demographic characteristics of early adolescents, as well as verify the association of pregnancy in this age group with perinatal outcomes. Methods: This was a cross-sectional study, descriptive and analytical and is part of a birth cohort in two Brazilian cities. The sample was stratified with proportional sharing of the number of births. Questionnaires were administered in the form of an interview , in women after childbirth , to evaluate aspects related to the newborn and the mother , such as identification data , socioeconomic and demographic factors , lifestyle habits , previous morbidities and current pregnancy characteristics and pregnancy , prenatal , labor and birth . We evaluated 5161 births in the city of São Luís in 2010. Results: The analysis was multivariate stepwise logistic regression. Among the births analyzed, 2.21 % occurred in early adolescent mothers. A higher proportion had income from 1 to 2 wages ( 29.46% ) , 66.40 % were unemployed, 85.54 % of deliveries were in public hospitals , 14.02 % of children born preterm and 16.50% of women had hypertension in pregnancy . Only 2.03% did not undergo prenatal 13.02% consumed beer during pregnancy and 15.79 % of the adolescents had early preterm deliveries. No association was observed between age and early teen no perinatal outcome, except the range 16 to 19 years who presented the outcome as protection for small for gestational age (SGA). Conclusions: The study population had sociodemographic characteristics (income and low education) similar to most of the population of São Luís, but there was a decrease in the prevalence of teenage pregnancy in the previous decade. It was observed that the mother's age (early teen ) was not a risk factor for adverse perinatal outcomes .Item VALIDADE CONCORRENTE E CONCORDÂNCIA ENTRE OS TESTES ALBERTA INFANT MOTOR SCALE E BAYLEY SCALES OF INFANT DEVELOPMENT-THRID EDITION EM PREMATUROS BRASILEIROS COM TRÊS MESES DE IDADE GESTACIONAL CORRIGIDA(Universidade Federal do Maranhão, 2010-09-24) Silva, Naíme Diane Sauaia Holanda; Gama, Mônica Elinor Alves; CPF:45297207304; LAMY FILHO, Fernando; CPF:72508000787; http://lattes.cnpq.br/3977956820339735; Lamy, Zeni Carvalho; CPF:12832693334Objective: To compare the results with the Scale of Alberta (Alberta Infant Motor Scale), applied at three months of corrected gestational age (IGC), with those Scale Bayley (Bayley Scales of Infant Development - 3rd edition) in premature infants, discharged from the Neonatal Intensive Care Unit-NICU of University Hospital Maternal Child Unit - UFMA. Methods: We studied 42 premature infants in the outpatient clinics ("Follow up") Unit, University Hospital Maternal Child Unit - UFMA between March and August 2009. In the study of concurrent validity and agreement of the 42 premature infants at 3 months of IGC were assessed by AIMS and the motor scale of the Bayley Scales of Infant Development, 3rd edition, using the correlation coefficient of Pearson and the concordance test Bland & Altman to analyze the results. Results: In the study of concurrent validity, correlation found between the two scales was high (r = 0.86) and statistically significant (p <0.01) in the total population of infants. In concordance analysis showed that most of the measures is in the range between ± 1.96 standard deviation is thus the two tests agree. Conclusion: The AIMS is a valid and consistent with the standard measures can be recommended for evaluation of motor development of premature infants in the population of public health in Brazil.