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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Perfil sociodemogrÃfico, clÃnico-epidemiolÃgico e padrÃes de atendimento da hansenÃase em Hospital UniversitÃrio de Fortaleza - CearÃ, 2007-2011 / Profile sociodemographic, clinical and epidemiological and standards of service of leprosy in university hospital de Fortaleza - CEARÃ, 2007 - 2011

Maria Iranilda QueirÃs 04 February 2014 (has links)
nÃo hà / A hansenÃase à doenÃa crÃnica de manejo difÃcil e distribuiÃÃo geogrÃfica heterogÃnea, o que dificulta o seu controle. Exprime grande potencial para incapacidades fÃsicas, principalmente quando nÃo à diagnosticada precocemente e ocorre comprometimento dos nervos perifÃricos. Objetivou-se caracterizar o perfil sociodemogrÃfico, clÃnico-epidemiolÃgico e padrÃes de atendimento da hansenÃase no AmbulatÃrio de Dermatologia do Hospital UniversitÃrio Walter CantÃdio, no perÃodo de 2007 a 2011. Realizou-se um estudo descrito, retrospectivo. A populaÃÃo foi composta por 475 pessoas, acompanhadas no AmbulatÃrio de Dermatologia do referido Hospital. Os dados foram coletados dos prontuÃrios e complementados pelas fichas de NotificaÃÃo/InvestigaÃÃo do Sistema de InformaÃÃo de Agravos de NotificaÃÃo. Destacou-se a faixa etÃria de 45 a 59 anos 166 (35,0%), sexo feminino 246 (51,8%), ensino fundamental 162 (34,1%), cor branca 327 (69,0%) e residentes em Fortaleza 391(82,3%). Predominou a classificaÃÃo operacional multibacilar 311 (65,4%) casos no diagnÃstico e 314 (66,0%) na alta. O nervo ulnar foi mais acometido nos dois momentos da avaliaÃÃo. O total de 203 (42,7%) pessoas desenvolveu episÃdio reacional hansÃnico (ERH) dos tipos 1 e 2. O tipo 1 foi mais expressivo na forma clÃnica dimorfa 49 (77,7%), enquanto o tipo 2 foi mais evidente na forma clÃnica virchowiana 12 (80,0%). No diagnÃstico, as incapacidades fÃsicas predominaram nos multibacilares com 66 (21,2%) grau 1 e 31 (9,9%) grau 2; e na alta PQT, 67 (21,3%) grau 1, 36 (11,5%) grau 2. Dezessete (3,5%) e 87 (18,3%) nÃo foram avaliados no diagnÃstico e na alta, respectivamente. A evoluÃÃo dessas incapacidades apontou 355 (74,7%) que permaneceram, 21 (4,4%) pioraram, ao passo que 7 (1,4%) melhoraram o grau de incapacidade. Foram encaminhados para outros serviÃos do HUWC/UFC 184 (38,7%) participantes do estudo. Realizaram neurolise 24 (5,0%) pessoas. Dentre os 1.395 contatos registrados, 477 (34,0%) foram examinados. O acometimento dos troncos nervosos à o principal responsÃvel pelas incapacidades. Evidencia-se a necessidade de cuidado mais efetivo das aÃÃes de controle da doenÃa; objetivando reduzir incapacidades. O perfil das pessoas em acompanhamento e os padrÃes de atendimento no ambulatÃrio revelaram diagnÃstico tardio dos casos e ausÃncia de integraÃÃo com as UBS, comprometendo a integralidade da assistÃncia como ferramenta essencial para minimizar os danos desse agravo. / Leprosy is a chronic disease hard to handle and with heterogeneous geographic distribution which hinders its control. It has great potential for physical disabilities, especially when not diagnosed early, and occurrence of damages to the peripheral nerves. We aimed to characterize the socio-demographic and clinical-epidemiological profile and standards of leprosy in the dermatology outpatient clinic of the University Hospital Walter CantÃdio (HUWC/UFC), from 2007 to 2011. This is a descriptive retrospective study, in which the population consisted of 475 people monitored in the dermatology outpatient clinic of the hospital. Data collection happened through review of medical records, supplemented by records of the Notifiable Diseases Information System. In the socio-demographic and clinical-epidemiological characterization, there was prevalence of the age group 45-59 years 166 (35.0%), females 246 (51.8%), with elementary education 162 (34.1%), Caucasian 327 (69%), residing in Fortaleza-CE, Brazil 391 (82.3%). The multibacillary operational classification prevailed, with 311 (65.4%) cases at diagnosis and 314 (66%) at discharge. The ulnar nerve was more affected in both evaluation times. 203 (42.7%) people developed leprosy reactional episode (LRE) types 1 and 2. Type 1 was more significant in clinical dimorphous, 49 (77.7%), while type 2 was more evident in clinical dimorphous, 12 (52.1%), and lepromatous leprosy, 12 (80%). At diagnosis, physical disabilities predominated in multibacillary with 67 (21.3%) degree 1, and 36 (11.4%) degree 2, and MDT, at discharge, 67 (21.3%) degree 1, and 36 (11.4%) degree 2. 17 (3.5%) and 87 (18.3%) were not evaluated at diagnosis and discharge respectively. With regard to the outcome of these disabilities, 355 (74.7%) remained, 21 (4.4%) worsened, while seven (1.4%) improved the degree of disability. 184 (38.7%) participants of the study were referred to other services of the HUWC/UFC. 24 (5.0%) people underwent neurolysis. Among the 1,395 registered contacts, 477 (34.0%) were examined. The damaging of nerve trunks is the main responsible for disabilities. We highlight the need for more effective control of the disease control measures aimed at reducing disabilities. The profile of people in monitoring and standards of care at the clinic in study reveal late diagnosis of cases, incomplete multidisciplinary team, and lack of integration with basic health units compromising the comprehensiveness of care as an essential tool to minimize the damages of this condition.

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