Rio De Janeiro City Research Articles

Trajetórias assistenciais de mulheres entre diagnóstico e início de tratamento do câncer de colo uterino

RESUMO O estudo se propôs a analisar as trajetórias na assistência das mulheres residentes no Município do Rio de Janeiro diagnosticadas com câncer de colo uterino que foram encaminhadas para tratamento em unidade de referência na atenção oncológica. Na primeira etapa do estudo, avaliou-se o prazo entre a confirmação do diagnóstico e o início do tratamento das mulheres matriculadas no ano de 2014, tomando como referência o prazo de até 60 dias fixado pela Lei Federal nº 12.372/2012 para início de tratamento do câncer no âmbito do Sistema Único de Saúde (SUS). Na segunda etapa, analisaram-se as narrativas de cinco mulheres sobre os caminhos percorridos na assistência desde a descoberta do diagnóstico até a primeira intervenção terapêutica, a partir de aspectos do cuidado integral em saúde. Observou-se que 88% dos tratamentos se iniciaram após o prazo de 60 dias e que 65,5% das mulheres foram diagnosticadas com doença avançada. A média para início de tratamento foi de 115,4 dias. Os principais problemas apreendidos na análise das trajetórias foram os relacionados à disponibilidade dos serviços e à integração das ações nos diversos níveis de atenção, bem como a falta de informação sobre a doença e o objetivo da realização do exame preventivo.

Avaliando a sustentabilidade alcançada por meio de entregas noturnas: o caso da distribuição de combustíveis na cidade do Rio de Janeiro

Este trabalho tem como objetivo analisar o impacto que a implantação de iniciativas para aumentar o desempenho do transporte de carga pode gerar na distribuição de combustíveis em áreas urbanas, em relação à sustentabilidade ambiental e econômica, bem como à eficiência da operação. Desta forma, o artigo propõe uma metodologia a ser ­ das iniciativas com maior potencial, em termos de custo e eficiência, para contribuir para o processo de distribuição de combustíveis em áreas urbanas, bem como para a avaliação do impacto de sua implantação, em termos econômicos e ambientais. O resultado apontou a entrega noturna como a prática com maior potencial de ganhos para o setor, de modo que a metodologia proposta é aplicada para avaliar os resultados de um experimento de entregas noturnas de combustíveis na zona Sul da cidade do Rio de Janeiro, em uma das maiores distribuidoras do Brasil. Os resultados do período de teste de entregas noturnas foram comparados em relação às entregas diurnas, prática padrão da empresa. Foram observados diversos resultados positivos durante o processo de entrega noturna, tais como:, 9% de redução no consumo de combustível; 66% de aumento na velocidade média operacional dos caminhões; redução média de 31% no tempo de viagem, possibilitando o aumento do número de viagens diárias por veículo com a utilização de um mesmo motorista; além da redução média de 13% na emissão de poluentes atmosféricos e gases de efeito estufa no meio ambiente.

Repeat pregnancy during adolescence and educational level in Brazil.

IntroductionRepeat pregnancy among adolescents is associated with preexisting disadvantages related to the adolescent’s social and cultural background. In Brazil, there is a lack of studies that evaluate repeat pregnancy during the entire adolescence period. Record linkage is a useful tool for following adolescents after the birth of their first child.
 Objectives and ApproachTo estimate pregnancy repetition during adolescence and to evaluate the effect of inadequate schooling during the first pregnancy on repetition in a cohort of adolescents in Rio de Janeiro City who had their first live-born child between the ages of 15 and 18. We carried out a non-concurrent cohort study using probabilistic record linkage techniques. The association between mother’s schooling and at least one repeat pregnancy during adolescence was evaluated through risk ratios adjusted for mother’s age, estimated using generalized linear models with binomial distribution and Neperian logarithm function. We also evaluated the interdelivery interval.
 Results9,285 adolescents were included in the study. Of these, 29.4% had inadequate schooling at the time their first child was born and 9.9% had at least on repeat pregnancy during adolescence. The risk of repeat pregnancy was significantly higher in the group with inadequate schooling (adjusted RR=1.19; 95% CI= 1.05-1.34), when compared with the group with adequate schooling. Half of the teenage mothers had an interval between the first and the second pregnancy of less than 24 months, with data showing no statistically significant difference between the two groups with respect to adequacy of mother’s schooling. Adolescents with more than one repeat pregnancy had the worst prenatal and labor care indicators, as well as the highest incidence of premature births.
 Conclusion/ImplicationsInadequate schooling at the time of the first child’s birth increases the risk of repeat pregnancies during adolescence. Additionally, inadequate schooling and a history of repeat pregnancies during adolescence are markers of populations that accumulate disadvantages in access to care and in pregnancy outcomes.

Interaction between mother’s age and schooling at birth on under-five mortality

IntroductionPregnancy at age extremes and low maternal schooling are associated with under-five mortality. However, we found no study in the literature that evaluated the interaction between mother’s age and schooling on under-five mortality measured in both multiplicative and additive scales.
 Objectives and ApproachTo analyze the interaction between mother’s age and schooling on under-five mortality in a birth cohort in Rio de Janeiro City (Brazil) (N=153,527 live births). We carried out a non-concurrent cohort study using probabilistic record linkage of birth and death records for Rio de Janeiro (Brazil). The association between under-five mortality according to mother’s age (15-19, 20-34 and 35 years or more) and schooling (less than 4 years; 4 to 11 years and 12 or more years of schooling) were estimated using generalized linear models with binomial distribution and Neperian logarithm function. The interaction was evaluated in both scales.
 ResultsThe under-five mortality rate was 14.0 per thousand live births. Higher rates were observed among women with less than 4 years’ schooling and in age extremes. When compared with women aged 20 to 34 years and with more than 12 years’ schooling, these women had the following risk ratios: 15 to 19 years – RR = 3.66 (95% CI 2.39; 5.62); 35 years or more – RR = 2.74 (95% CI 1.83; 4.11). We did not observe statistically significant interactions in the additive and multiplicative scales.
 Conclusion/ImplicationsAlthough we did not observe an interaction between mother’s age and schooling, under-five mortality was more frequent among women with less the four years’ schooling, especially at the age extremes, suggests these are more vulnerable groups that demand greater attention in care.

Graus de integração entre os verbos da perífrase V1 (E) V2 em uma perspectiva de interface variação-gramaticalização

Neste texto, à luz de uma perspectiva de interface variação-gramaticalização, abordo o uso dos verbos IR e PEGAR na perífrase V1 (E) V2, em que V2 é o verbo principal e IR e PEGAR são os verbos gramaticais auxiliares cuja função é indicar aspecto global. Quanto mais integrado estiver o verbo auxiliar ao verbo principal, mais avançado estará o processo de gramaticalização do verbo auxiliar. Com o objetivo de mensurar o grau de integração entre PEGAR e IR a V2 em diferentes comunidades de fala, analisei três fatores: presença da conjunção E entre V1 e V2, presença de pausa entre V1 e V2 e presença de material interveniente entre V1 e V2. Utilizei dados extraídos dos corpora Discurso & Gramática de Natal (RN) e do Rio de Janeiro (RJ), e do corpus do Banco de Dados VARSUL de Florianópolis (SC). Os resultados, obtidos através de análise quantitativa, mostram que: (i) em Natal, o comportamento de IR e de PEGAR é similar; (ii) no Rio de Janeiro, IR é mais frequente em perífrases sem a conjunção E e sem pausa, o que indica um maior grau de integração a V2; (iii) em Florianópolis, é PEGAR que manifesta um maior grau de integração a V2. Essas diferenças revelam um maior avanço do processo de gramaticalização de IR no Rio de Janeiro e de PEGAR em Florianópolis. Em Natal, a gramaticalização de ambos os verbos parece estar no mesmo estágio.

Strategies and instruments for the dissemination and promotion of open government data use in Brazil: case study of Rio de Janeiro city hall

Governments have been encouraged the use of open government data (OGD) by society for diverse situations. This article aims to identify strategies to guarantee the management of OGD cycle of use and dissemination of open data. The methodology is based on a single case study of Rio de Janeiro City Hall and covers the period between 2013 to 2016. In addition to a literature review of OGD, Rio de Janeiro OGD portals were analyzed using the 15 Principles of Open Data and 5-Star Open Data. An analysis of OGD public policy was also conducted, including the legislation and the strategies of OGD usage promotion in Rio. The main results were the identification of four strategy categories that set the OGD public policy (hackathons; prizes and awards; partnerships; and, data journalism). The potential for stimulating the use of open data was analyzed, although its sustainability faces various challenges such as administrative discontinuity and the patterns of use by society.

Study of the impact of climate change on the spatial distribution of dengue cases in Rio de Janeiro

Introduction There is evidence that the distribution of dengue cases is correlated with environment variables such as temperature, precipitation and others. This study aimed to select the best variables for modelling the number of dengue cases in Rio de Janeiro city, and used data from 2015 to 2016 as comparison for results. Methods The number of cases was obtained by the Brazilian health system and the variables were mined from public satellites data, separating Rio de Janeiro city in 21-pixel blocks in image data. The data gathered from 2015 to 2016 was divided in 8-day periods, where the mean of each variable in this period was stored. The study made a comparison using the following variables and their respective lags in time: NDVI, day temperature, night temperature, precipitation, population size, latitude and longitude. The comparison between them was made using the one who fitted more a Generalized Autoregressive Log-linear Model with a negative binomial family to predict the dengue cases. Results The most significant predictors inside the model were temperature at night, precipitation three weeks before, and dengue cases from one week before. Using only these three variables and an intercept, the model showed an error mean of 0.3% and a standard deviation of 11% in a prediction against real value comparison. Conclusions This work is a first approach to understanding the determinants of dengue and only using public data. The next steps will be to extend both the temporal and spatial reach of the analysis.

Prevalência e susceptibilidade antimicrobiana de sorotipos de Salmonella spp. isolados de frangos vivos e carcaças no estado do Rio de Janeiro

RESUMO: A presença de Salmonella spp. em produtos de origem avícola e seus subprodutos se mostra um grande desafio para a produção comercial. Dados de prevalência, dos sorotipos circulantes e do perfil de susceptibilidade antimicrobiana de cepas de Salmonella spp. no Estado do Rio de Janeiro são escassos. Portanto, objetivou-se detectar a presença Salmonella spp. em frangos vivos e carcaças em matadouros do Estados do Rio de Janeiro, identificar os sorotipos e avaliar a susceptibilidade antimicrobiana dessas cepas para fluoroquinolonas e betalactâmicos. Foram coletadas 60 amostras cloacais de frangos vivos e 60 amostras de carcaça de seis matadouros sob Inspeção Estadual (SIE). Os isolados foram sorotipificados e testados frente a oito antimicrobianos: enrofloxacina, ciprofloxacina, norfloxacina, cefalotina, ceftiofur, cefotaxima, amoxicilina/ácido clavulânico e ampicilina pelo método de difusão em disco. Os resultados mostraram uma prevalência de Salmonella spp. de 1,66% (1/60) em amostras de suabe de cloaca e de 26,66% (16/60) em carcaças. Em amostras de suabe de cloaca, somente o sorotipo Senftenberg (1,66%) foi isolado. No total, foram isolados sete sorotipos diferentes nas carcaças: Senftenberg (15%) o mais frequente, seguido por Mbandaka (8,3%), Schwarzengrund (3,3%), Cerro (3,3%), Ohio (3,3%), Minnesota (1,66%) e Tennessee (1,66%). Em relação à susceptibilidade antimicrobiana, 29 (87,87%) isolados foram sensíveis a todos os antimicrobianos testados e 4 (12,12%) isolados foram resistentes a pelo menos três antimicrobianos betalactâmicos ou mais. Não foi observada resistência às fluoroquinolonas. Os resultados encontrados demonstram uma prevalência de Salmonella spp. acima da esperada em matadouros do Estado do Rio de Janeiro, além da presença de vários sorotipos de Salmonella spp. A resistência encontrada para betalactâmicos alerta para a disseminação dessas cepas pela cadeia alimentar.

Water Quality Evolution of Rio de Janeiro City Beaches

Rio de Janeiro city is famous worldwide for its beaches. Therefore, it is necessary to analyze the monitoring of water quality data, since the pollution is a risk to the population health. It was made a temporal evolution analysis of the recreational water quality of Rio de Janeiro city main beaches. Thermotolerant Coliforms’ (TtC) data collected by the Instituto Estadual do Ambiente (INEA) from 1995 to 2015 were related with the CONAMA 274/2000 Resolution limits criteria. It was observed that Barra da Tijuca western portion, Leblon, Ipanema, Arpoador, Copacabana, Leme, Vermelha and Urca beaches showed an overall improvement of their water quality conditions over the analyzed period. Sao Conrado and the eastern corner of Barra da Tijuca beach have shown worsening. Joatinga beach remained stable. Flamengo and Botafogo beaches showed variable conditions over time, but always presenting poor water quality conditions. It was verified that the determining factors for a beach having inappropriate water quality were the existence of canals that dump sewage and urban runoffs. Another relevant factor was the location of beaches within the confined and polluted waters of Guanabara Bay. This study can be used as a useful tool for a more efficient management for urban beaches. DOI: http://dx.doi.org/10.17807/orbital.v10i4.1072

Ser brincante: um relato de experiência sobre o brincar no hospital

This article is an experience report about my practice from 2014 to 2015 as a student from the Psychology Graduation of Universidade Federal do Rio de Janeiro, and trainee in the Saude and Brincar Program of Instituto Fernandes Figueira of Fundacao Oswaldo Cruz, in the Rio de Janeiro city. This is a Program whose main objective is to provide care for children and adolescents with acute and chronic illness, using the act of play as a main tool for working at hospital. Based on a theoretical-experiential methodology, the trainee conducted intervention activities with patients using various forms of play, and participated in multidisciplinary study groups and medical rounds to discuss about clinical cases. During my experience in that Program, I could observe that playing is extremely complex, despite its apparent simplicity. Moreover, the practice of playing helps in the subjective construction of children and their families, as much as it helps them cope with their pains. Based on this, this experience report aims to present reflections about my practice in that Program, describing how it works and discussing the importance of playing in the lives of hospitalized children and adolescents. As result of this experience, a new understanding of health and happiness related to the process of becoming sick was born for me, just as my soul was enchanted by the act play. This became part of my practice in other fields of activity as a psychologist, with strong reflections for my personal life.

House arrest with electronic monitoring: the Rio de Janeiro experience

This article outlines the House Curfew with Electronic Monitoring (HCEM) experience in Rio de Janeiro (Brazil). Recently implemented in this Brazilian jurisdiction, HCEM has already achieved positive outcomes in terms of post-trial de-incarceration, as it reduced the open prison population by 35% from 2009 to 2014. In addition to describing and critically discussing these changes in the Rio de Janeiro criminal justice system, the study also reports offenders’ perceptions regarding this new crime control method in Rio de Janeiro. This perspective provides interesting feedback regarding HCEM in terms of safety, its punitive character, technological problems, constraints, and stigmatisation.

Educação permanente na reorganização do processo de trabalho no serviço de emergência

The object of study of this paper is the continuing education as a strategy to reorganize the work process in the emergency room at emergency department. The general aims of this study was to use the permanent education as a strategy to reorganize the work process in the emergency room at emergency department. The specifics aims were: to identify the difficulties faced by the staff workers of the emergency settings related to the process of guiding patients to the emergency dental service ; to describe the understanding of the staff workers about the dentist's role in na emergency service; to analyze strategies or manners of collaboration for achieving comprehensive care and; to develop products that can collaborate in continuing education of staff workers involved in patient care, according to the specific laws related to the intregrity of care. The methodology used was the the kind of research which the researcher get involved in the assistance activities while observe. The setting of the study was the emergency department of an emergency room located in Sao Goncalo, State of Rio de Janeiro city. It had three stages and the data collection instruments used were: the first stage was a participatory observation, the second stage was a semi-structured questionnaire and the third stage was na educational focal groups. In the first stage was built a forwarded flow to the dental emergency section. On the second stage, after analysis of contente according to Bardin, it was built four following classes: 1) The biomedical model still reflected on the thinking and action, evidenced on the analysis of the responses, which the employees do not understand working in a multidisciplinary team and also mentioned the biomedical model; 2) Tooth for a tooth: The Code of Hammurabi and Tiradentes, revealing that most workers assign meaning to oral dental care; 3) What am I doing here? Building the identity of the dentist. The study reveals that many of the participants do not understand the dentist's role in emergency work process and they do not respond admitting not knowing it when asked for assign a meaning outside the dental contexto.4) Building up bridges for completeness, noting that few participants understood the concepts of the continuing education and its ability to transform problems situations in their daily professional life. In the third stage, the participants were invited to educational groups, opened for dialogue, reflection and solutions, following the proposal of the problematization methodology. Theese groups discussed the legislations about emergency service, reflected on the difficulties of fulfilling the laws during work and, built up the list of procedures elected as urgent / emergency in the emergency room. In conclusion that little knowledge about the current legislation on the topic and the lack of the full understanding about continuing education can limit the process of decision making. However, the solutions found by the group were a combination and summation of gathered experiences which provided what Augustine calls wisdom of convergent care research awakening the critical thinking and politics national continuing education in health empowerment.

Educação permanente na reorganização do processo de trabalho no serviço de emergência

The object of study of this paper is the continuing education as a strategy to reorganize the work process in the emergency room at emergency department. The general aims of this study was to use the permanent education as a strategy to reorganize the work process in the emergency room at emergency department. The specifics aims were: to identify the difficulties faced by the staff workers of the emergency settings related to the process of guiding patients to the emergency dental service ; to describe the understanding of the staff workers about the dentist's role in na emergency service; to analyze strategies or manners of collaboration for achieving comprehensive care and; to develop products that can collaborate in continuing education of staff workers involved in patient care, according to the specific laws related to the intregrity of care. The methodology used was the the kind of research which the researcher get involved in the assistance activities while observe. The setting of the study was the emergency department of an emergency room located in Sao Goncalo, State of Rio de Janeiro city. It had three stages and the data collection instruments used were: the first stage was a participatory observation, the second stage was a semi-structured questionnaire and the third stage was na educational focal groups. In the first stage was built a forwarded flow to the dental emergency section. On the second stage, after analysis of contente according to Bardin, it was built four following classes: 1) The biomedical model still reflected on the thinking and action, evidenced on the analysis of the responses, which the employees do not understand working in a multidisciplinary team and also mentioned the biomedical model; 2) Tooth for a tooth: The Code of Hammurabi and Tiradentes, revealing that most workers assign meaning to oral dental care; 3) What am I doing here? Building the identity of the dentist. The study reveals that many of the participants do not understand the dentist's role in emergency work process and they do not respond admitting not knowing it when asked for assign a meaning outside the dental contexto.4) Building up bridges for completeness, noting that few participants understood the concepts of the continuing education and its ability to transform problems situations in their daily professional life. In the third stage, the participants were invited to educational groups, opened for dialogue, reflection and solutions, following the proposal of the problematization methodology. Theese groups discussed the legislations about emergency service, reflected on the difficulties of fulfilling the laws during work and, built up the list of procedures elected as urgent / emergency in the emergency room. In conclusion that little knowledge about the current legislation on the topic and the lack of the full understanding about continuing education can limit the process of decision making. However, the solutions found by the group were a combination and summation of gathered experiences which provided what Augustine calls wisdom of convergent care research awakening the critical thinking and politics national continuing education in health empowerment.

Neurologic manifestations in emerging arboviral diseases in Rio de Janeiro City, Brazil, 2015-2016.

Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders. Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results. In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive. Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.

External Quality Monitoring of the Cervical Cytopathological Exams in the Rio de Janeiro City.

To discuss the implementation and contributions of the External Quality Monitoring in the city of Rio de Janeiro and to analyze the performance of the main providers of cervical cytopathology in this city from September 2013 to March 2017, here referred to as "Alpha laboratory" and "Beta laboratory." Observational, cross-sectional, retrospective study using information from the Cervical Cancer Control Information System (SISCOLO, in the Portuguese acronym), municipal coordination module, External Quality Monitoring report. The proportions of false positives, false negatives, unsatisfactory samples and rejected samples were estimated. The agreement among the observers was analyzed through the Kappa index and the reduction of disagreements in the period for each laboratory studied, comparing the results of each cycle. A total of 19,158 examinations were selected, of which 19,130 (99.85%) were monitored, 16.649 (87, 03%) were reviewed by the External Quality Monitoring Unit, 2,481 (12,97%) were rejected and 441 (2,65%) were considered unsatisfactory. The "Beta laboratory" presented excellent concordance in all cycles; the "Alpha laboratory" had good concordance in the first two cycles (K = 0.76 and 0.79), becoming excellent in the following four cycles. The average Kappa index was 0.85, with median of 0.86. The percentage of diagnostic disagreement was 6.63% of the reviewed exams, of which 5.38% required a change of conduct CONCLUSION: External Quality Monitoring is an exercise in diagnostic improvement, and its implementation was fundamental to ensure the reliability of the cytopathological exams in the city of Rio de Janeiro.

Perfil de resistência aos antibióticos e prevalência dos genes qacEΔ1 e sul1 em Pseudomonas aeruginosa de efluente hospitalar

Introduction: Hospital effluents may pose great environmental risk due to the presence of pathogenic microorganisms, drugs and chemical components. Pseudomonas aeruginosa is an opportunistic pathogen frequently found in hospital environment. Objective: To evaluate the resistome of P. aeruginosa from the hospital wastewater treatment plant (HWTP) in a hospital complex of Rio de Janeiro city. Method: Twenty isolates from the five stages of the HWTP were identified as P. aeruginosa by 16S rRNA gene sequencing analysis. Susceptibility to antibiotics was determined according to CLSI and qacEΔ1 and sul1 genes were detected by PCR. Sulphonamide residues were investigated by high performance liquid chromatography coupled to sequential mass spectrometry. Results: The sulfamethoxazole has been demonstrated at a level below 50 ng L-1. Sulfonamide resistance (80%) has been demonstrated followed by quinolone class (50%) and 13 susceptibility patterns to antimicrobials. The qacEΔ1-sul1 genes were detected in 100% of isolates suggesting the presence of class 1 integrons in the whole HWTP. Conclusions: The results signalized limitations of HWTP and propagation of resistance genes in all stages of the HWTP. These data also contribute to the environmental sanitary surveillance in the design of prevention actions against negative impact on the public health.

A “Crise dos criados” ou a “Questão da famulagem”: o serviço doméstico sob a ótica de cronistas cariocas no início do século XX

O objetivo deste trabalho é recuperar algumas crônicas que abordaram o serviço doméstico na cidade do Rio de Janeiro, as quais foram publicadas na imprensa na virada do século XIX para o século XX. Particularmente, trata-se de analisar três crônicas produzidas por Arthur Azevedo, João do Rio e Lima Barreto nos primeiros anos do século XX. Propõe-se, então, refletir sobre a forma como a questão do trabalho e dos trabalhadores domésticos, que ganhava cada vez mais espaço nas discussões de determinados grupos sociais, foi veiculada na imprensa e tratada por alguns segmentos da intelectualidade carioca em um contexto marcado por profundas transformações sociais advindas, especialmente, do fim da escravidão e da emergência da modernidade na sociedade brasileira. ---DOI: http://dx.doi.org/10.22409/gragoata.2018n45a1084.

Avaliação de saúde pública por exposição a agroquímicos:

A avaliação integrada da exposição a agentes químicos às condicionantes sociais, econômicas e ambientais possibilita ações efetivas e incorporadas ao espaço social, como pressupõe a metodologia de “Avaliação de Saúde Pública” da Agência de Registro de Substâncias Tóxicas e Controle de Doenças (ATSDR) e à semelhança da abordagem Ecosaúde. Assim, nosso objetivo é descrever uma experiência de avaliação de saúde pública em comunidades de agricultores familiares expostos a agroquímicos em São José de Ubá, estado do Rio de Janeiro (RJ). A sociedade civil e a esfera pública foram envolvidas no processo que reuniu informações históricas, socioeconômicas, culturais, ambientais e de saúde. A exposição ocupacional e/ou ambiental aos toxicantes ocorre em níveis que ocasionam efeitos deletérios à saúde, exigindo ações, como a prática agroecológica, educação em saúde e ambiente e requalificação dos profissionais de serviços de saúde. A abordagem tem como benefício situar o sujeito como agente integrador e influenciador de seus processos, potencializando seu empoderamento para a uma gestão ecossistêmica conjunta.

Leisure but not household physical activities associates with metabolic syndrome in middle-aged and older individuals: a cross-sectional study

Metabolic syndrome (MS) increases risk of diabetes. Physical activity (PA) is acknowledged to prevent MS, but a few studies in developing countries investigated the relationship between spontaneous PA and MS in older populations. To investigate the association between household and leisure physical activities vs. MS in a cohort of individuals older than 50 years, dwelling in the metropolitan area of Rio de Janeiro (RJ), southeastern Brazil. In 225 individuals aged 51–91 years (62 ± 9 years), MS and related risk factors were assessed through anthropometric measurements, blood pressure, and biochemical analyses, while habitual PA was classified using the Modified Baecke Questionnaire. MS was diagnosed in 64% of the participants. Multivariate logistic regression showed that low levels of household activities discriminated patients with higher blood glucose, obesity, and diabetes mellitus, but were not associated with the risk of having MS. Conversely, leisure PA not only discriminated individual risk factors (total cholesterol, triglycerides, and abdominal circumference), but also associated with MS. Patients declaring not having performed leisure PA within the last year had 2.5 higher risk of exhibiting MS [95% CI (1.22–5.34)], after adjustments for age, body mass index, VLDL, and household PA. Leisure but not household PA is associated with the risk of having MS in an urban population of Brazilian middle-aged and elder individuals. These findings suggest that tasks usually performed at home would not be of sufficient intensity/volume to prevent MS in this population.

Esporotricose conjuntival felina

Sporotrichosis is a zoonosis caused by the dimorphic fungus Sporothrix schenckii, which domestic cat is described as an important font of infection. Due to the lack of studies over ocular alterations that occur in feline sporotrichosis, this paper describes a case of ophthalmic alteration in a cat from the metropolitan area of Rio de Janeiro city without antecedent ocular injury history. Complete clinical examination was performed, verifying ulcerated cutaneous lesions and conjunctivitis. Material from a cutaneous lesion and from the left eyeball conjunctival sac was collected for citopathologic exam and mycologic culture, the diagnostic was confirmed through culture isolation of Sporothrix schenckii, from both the cutaneous and ocular lesions. Sporotrichosis treatment was started and 75 days after, the cutaneous lesions were healed and there was no sign of conjunctival alteration.