Objetivo: Avaliar a incidência de tromboembolismo e as condições clínicolaboratoriais associadas em pacientes pediátricos internados em um hospital terciário. Pacientes e métodos: Estudo retrospectivo onde foram revisados os prontuários de todas as 6140 crianças de 0 à 13 anos que internaram entre fevereiro de 2007 à janeiro de 2009. Foram identificadas 31 crianças que tiveram 34 casos de tromboembolismo confirmado por diagnóstico de imagem, e estas foram incluídas no banco de dados para análise. Resultados: A incidência de tromboembolismo foi de 43,3 (intervalo de confiança de 95%: 30,0-60,4) para cada 10.000 internações. Vinte e seis (83,9%) crianças tinham condições clínicas associadas, sendo que 11 (35,4%) tinham apenas 1 condição associada, 5 (16,1%) tinham 2 condições associadas, 6 (19,3%) tinham 3 condições associadas, 4 (12,9%) tinham 4 condições associadas e 5 (16,1%) não tinham condições associadas. As frequências das principais condições clínico-laboratoriais foram: sepse, 41,9%; trombofilias, 35,5%; cardiopatia acianótica, 29,9%; e cateter central, 22,5%. Conclusão: O presente estudo evidenciou uma incidência de tromboembolismo muito mais alta do que a descrita na literatura, provavelmente devido ao estudo ter sido realizado em um hospital terciário, com maior complexidade e complicações associadas mostrando a importância de considerar este diagnóstico. Observamos também uma alta taxa de trombofilias nos pacientes que tiveram tromboembolismo, salientando que a associação de fatores de risco e predisposição genética ou fatores intrínsecos devem ser considerada no diagnostico e manejo destes pacientes. / Objective: To assess the incidence of thromboembolism and associated clinical conditions and laboratory abnormalities in a sample of pediatric patients admitted to a tertiary referral center. Methods: This was a retrospective chart review study. The medical records of all 6140 children between the ages of 0 and 13 years admitted to the study facility from February 2007 through January 2009 were reviewed. A total of 34 cases of imaging-confirmed thromboembolism were identified in 31 children and included for analysis. Results: The incidence of thromboembolism was 43.3 (95%CI, 30.0–60.4) per 10,000 admissions. Twenty-six children (83.9%) had associated clinical conditions: 11 (35.4%) had only 1 associated condition, 5 (16.1%) had 2 associated conditions, 6 (19.3%) had 3 associated conditions, 4 (12.9%) had 4 associated conditions, and 5 (16.1%) had no associated conditions. The main associated conditions were sepsis (41.9%), thrombophilia (35.5%), acyanotic heart disease (29.9%), and central venous catheterization (22.5%). Conclusion: In the sample studied herein, the incidence of thromboembolism was much higher than that reported in the literature, most likely due to the study setting (tertiary referral hospital) and its implications (greater case complexity and frequency of complications), stressing the importance of considering the diagnosis. Furthermore, among patients who developed thromboembolism, there was a high rate of thrombophilia, highlighting the importance of the association between risk factors and genetic predispositions or intrinsic factors in the diagnosis and management of these patients.

O objetivo desta pesquisa foi descrever o desenvolvimento motor de crianças de 0 a 18 meses de idade, identificando os principais fatores de risco para atraso motor, assim como, analisar a validade da Alberta Infant Motor Scale para avaliação do desenvolvimento motor de crianças gaúchas, verificando a representatividade de seus critérios motores. A amostra deste pesquisa foi de 561 crianças, provenientes de Escolas de Educação Infantil, Creches, Entidades e Unidades Básicas de Saúde. Os instrumentos utilizados na coleta de dados foram: 1) Alberta Infant Motor Scale (AIMS); 2) Affordance in the Home Environment Motor Development (AHEMD); 3) Questionário estruturado com perguntas sobre características biológicas. Das crianças avaliadas, 63,5% foram consideradas com desenvolvimento motor normal para idade, sendo que os bebês com idade entre 3 e 12 meses foram os que demonstraram pior desempenho. Foi observado uma inferioridade nos comportamentos motores referentes as posturas prono e em pé. Entre os fatores biológicos de maior influência, destacaram-se o baixo peso ao nascer, a prematuridade e o tempo de internação na UTI. No que se refere aos fatores sócio-ambientais, destacaram-se a escolaridade dos familiares; o grau de instrução paterna, a renda familiar mensal, o número de adultos e de crianças que vivem na casa, tempo carregado no colo e número de brinquedos para motricidade fina e ampla. Quanto ao processo de Validação da AIMS, as análises de correlação, associação e consistência interna indicaram que a AIMS é válida e fidedigna para população gaúcha. Conclui-se que as crianças apresentaram seqüência progressiva do aparecimento de habilidades motoras nas posturas avaliadas, porém parte destas foram consideradas com desenvolvimento motor inferior ao esperado para idade. Sugere-se que os fatores biológicos, contextuais e o instrumento de avaliação influenciaram no desenvolvimento motor das crianças avaliadas, sendo a AIMS um instrumento significativamente útil e confiável para utilização em várias áreas da pesquisa científica e clínica. / The purpose of the present study was describe the motor development of infants aging from 0 to 18 months and verify the influence of the biological and socio-environmental risk factors and analyze the validation of Alberta Infant Motor Scale to evaluate the motor development of southern children, analyzing the representativeness of the instrument´s items. The sample was composed of 561 children, coming from Kinder gardens, Children Education schools, Health Basic Units of Rio Grande do Sul. The instruments used were: 1) Alberta Infant Motor Scale (AIMS); 2) Affordance in the Home Environment Motor Development (AHEMD); 3) biological factors through structured questionnaire. From the evaluated infants, 63, 5% were considered with a regular motor development for their age, and the babies aging from 3 to 12 months were the ones with the worst development. It was found inferiority in the motor behaviors regarding the prono and standing postures. Among the biological factors with a major influence, the low weight when they are born, the prematureness and the time they spend in the intensive treatment unit (ITU) are prominent. In relation to the socioenvironmental factors, the parents’ schoolarity; the father’s instruction, the family’s income, the number of adults and children that live in the house, the time being hold and the number of toys for fine and global motricity. On the Validation process, the analysis of correlation, association and internal consistency indicate that the AIMS is valid and trustworthy in the evaluation of infants motor acquisitions of southern children. Conclused that the infants from this study presented a progressive sequence of appearance of motor abilities in the evaluated postures, however parts of these were considered with an inferior motor development according to what was expected by their age. It is suggested that, either the socio-environment risk factor as well as the biological and evaluation instrument influenced in the motor development of the infants, being the AIMS a significatively useful and reliable instrument to several areas of clinic and scientific research.

Objectives: Youth who age out of the child welfare system are among the most vulnerable group of young people entering adulthood today. Unlike their generational peers, foster youth lack the familial supports necessary to postpone major life decisions and gradually enter adulthood. Although there are notable differences between Canadian and American child welfare contexts, young people exiting both systems experience a compressed transition and are tasked with quickly managing adult responsibilities. Few studies have examined pre-transition factors that correlate with adolescents’ readiness skills prior to exiting out-of-home care. Methods: This dissertation presents two studies that examine factors associated with transition-age foster youths’ readiness skills for adulthood. In the first study I used cross-sectional data (n = 278) from Illinois, United States to assess the impact of adverse childhood experiences (ACEs) on youths’ independent living skills and life domain functioning. I hypothesized that exposure to ACEs would predict lower transition readiness, and that trauma-related stress symptoms and strengths would moderate this association. In the second study I used cross-sectional data (n = 1,026) from Ontario, Canada to identify youth-, placement-, and agency-level factors that predicted youths’ self-care and financial literacy skills. I hypothesized that factors most proximal to individuals would impact readiness (e.g., academic performance, self-esteem). Results: Hierarchical regression analyses indicated that ACEs predicted lower transition readiness. Traumatic stress symptoms moderated these relations, and engagement in risky behaviours partially mediated these relations (study 1). Hierarchical linear modelling indicated that agency-level differences did not impact readiness. In contrast, general linear modelling indicated that a subset of individual- and placement-level factors did impact readiness. Specifically, higher academic performance, higher self-esteem, a greater number of developmental assets, older age, an older age of entry into care, a greater number of placement transitions, and kinship care placement predicted higher transition readiness. A greater number of socioemotional difficulties, a greater number of long-term mental and/or physical health conditions, and a lower frequency of problematic parenting practices combined with a higher frequency of effective parenting practices predicted lower transition readiness (study 2). Conclusion: Findings illustrated that although ACEs exposure predicts lower adult readiness among transition-age youth, whether youth engage in risky behaviours and possess developmental strengths may be better predictors of their readiness to age out of care (study 1). Findings also illustrated that a subset of individual- and placement-level factors predict self-sufficiency skills among transition-age youth (study 2).

Introdução: O diabetes é considerado um problema crescente de saúde pública, devido o aumento da sua incidência e prevalência, principalmente na infância e na adolescência, além da sua inclusão entre as dez principais causas de mortalidade no Brasil e no mundo. Objetivos: Conhecer aspectos da saúde relacionados aos fatores de risco para o DM2 em adolescentes do ensino público do Município de Rio Branco Acre e a percepção dos pais dos adolescentes sobre a doença diabetes, assim como sinais e sintomas, medidas preventivas e suas aspirações sobre o tema. Procedimentos Metodológicos: O estudo quanti-qualitativo foi do tipo transversal com amostragem probabilística e representativa de 720 adolescentes, de ambos os sexos e com idades entre 10 e 18 anos, matriculados nas escolas públicas do ensino fundamental, da área urbana do Município de Rio Branco Acre. A análise estatística foi do tipo descritiva: distribuição de frequência, medidas de tendência central e medidas de dispersão. Os testes de Qui-quadrado de Pearson e Fischer foram utilizados para verificar possíveis associações entre as variáveis categóricas e, para verificar a diferença de médias, o teste t de Student. Para o estudo qualitativo utilizou-se a técnica de grupo focal e a análise de conteúdo na amostra constituída por seis pais de adolescentes com glicemias de jejum alteradas/limítrofes. Para a coleta de dados foram utilizados os seguintes instrumentos: questionário socioeconômico e demográfico, o Rec24h, para avaliação do consumo alimentar e o IPAQ para avaliação do nível da atividade física, além do roteiro semi-estruturado para a condução do grupo focal. Resultados: Dos 720 adolescentes, 51,8por cento eram do sexo feminino, com média de idade de 12,73 anos, (dp ± 1,57), variando entre 10 e 18 anos; a etnia autorreferida predominante foi a branca 576 (80por cento ). Foi possível observar que 153 (21,3por cento ) estavam com sobrepeso, 273 (37,9por cento ) sedentários, além de 244 relatos de história familiar de diabetes. O sexo masculino apresentou maior média de consumo de energia, macronutrientes e fibras. A média glicêmica foi de 55,18mg/dl, com 10 (1,4por cento ) adolescentes apresentando glicemia plasmática de jejum alterada/limítrofe. As frequências entre a associação de fatores de risco para o diabetes foi maior entre 2 (87,8por cento ) que 3 (12,2por cento ) fatores. O grupo de pais demonstrou ter conhecimento de alguém diabético com relacionamento familiar ou social, dificuldade em entender o processo de manifestação da doença e interesse em conhecer os fatores de risco da mesma. Conclusão: Os fatores de risco para o diabetes estão presentes entre os adolescentes do Município de Rio Branco Acre / Introduction: Diabetes is considered a growing public health problem because of its increased incidence and prevalence, especially during childhood and adolescence in addition to its inclusion among the ten leading causes of death in Brazil and all over the world. Objectives: To find out what are the health aspects related to risk factors for type 2 diabetes in adolescents from the public school system in the city of Rio Branco - Acre and to find out what is the perception of the parents of teenagers about diabetes, as well as what are the signs and symptoms, the preventive measures and their expectancies regarding this issue. Methodological Procedures: This quantitative and qualitative study was cross-sectional study with probability sampling representing 720 adolescents of both sexes and aged between 10 and 18 years, who were enrolled in public primary schools in the urban area of the municipality of Rio Branco - Acre. The statistical analysis was descriptive: frequency distribution, central tendency measures and dispersion measures. The Chi-square tests of Pearson and Fischer were used to investigate possible association among the categorical variables and to detect averages differences we used the \"t\" Student test. For the qualitative study we used the focus group technique and the content analysis on a sample of six parents of adolescents with impaired / borderline fasting glucose. To collect data we used the following instruments: socioeconomic and demographic questionnaire and anthropometric data, Rec24h to assess dietary intake and the IPAQ to evaluate the level of physical activity, besides the semi-structured guidelines to conduct the focus group. Results: Of 720 adolescents, 51.8per cent were female, mean age of 12.73 years (SD ± 1.57), ranging between 10 and 18 years, the predominant self-reported ethnicity was Caucasian 576 (80 per cent ). It was observed that 153 (21.3per cent ) were overweight, 273 (37.9per cent ) sedentary, besides the 244 reports of a family history of diabetes. Males had higher mean intake of energy, macronutrients and fiber. Mean blood glucose was 55.18 mg / dl, with 10 (1.4per cent ) adolescents with fasting plasma glucose impaired / borderline. The frequency among factor associat ion of risk factors for diabetes was higher between 2 (87,8per cent ) than 3 (12,2per cent ) factors.The group of parents demonstrated, through their statements that they knew someone with diabetes in their family or social relationships; they had difficulties to understanding the disease manifestation process and they were interested in getting to know which were the risk factors. Conclusion: The risk factors for diabetes are present among the adolescents in the city of Rio Branco Acre.

Made available in DSpace on 2014-06-11T19:22:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-12-07Bitstream added on 2014-06-13T20:09:56Z : No. of bitstreams: 1 aguiar_prc_me_prud.pdf: 1103642 bytes, checksum: 2aad236fdf9f7ffd6de6c30d017fd202 (MD5) / O estudo objetivou analisar a ocorrência de lesões em nadadores, associando-as a fatores de risco específicos da modalidade e do atleta. Fizeram parte desse estudo 215 atletas de ambos os sexos participantes dos principais campeonatos, promovidos pela Federação Aquática Paulista. Os dados foram obtidos por meio de Inquérito de Morbidade Referida, constituído por perguntas relacionadas ao atleta, modalidade e referentes ao tipo, local anatômico, mecanismo, momento e gravidade da(s) lesão(s), e finalmente as associando a especialidade de cada atleta. A análise entre variáveis antropométricas e presença de lesão foi realizada pelo teste t de Student ou pelo teste não paramétrico de Mann Whitney. Para relação entre as especificidades e o tipo, local anatômico, mecanismo, momento e gravidade da lesão utilizou-se o teste de Goodman. Dos 215 atletas, 121 (56,28%) referiram alguma lesão durante a temporada de treinos. Resultados significantes foram obtidos entre os atletas lesionados com mais idade e anos de treinamento. Segundo o mecanismo da lesão, o volume dos treinos é a principal causa de ocorrências de lesões e as tendinopatias são as lesões mais comuns. Grande parte dos agravos ocorreu durante o período de base do treinamento. O ombro é o local mais acometido pelas diferentes especialidades, com exceção dos nadadores de peito que referiram a virilha. Conclui-se a partir dos achados que a exposição dos nadadores à prática esportiva associada ao volume de treinamento é o principal fator causal para as freqüentes lesões nestes atletas. / The study aimed to analyze the occurrence of injuries in swimmers, linking them to specific risk factors of the sport and the athlete. The present study evaluated 215 athletes of both sexes participating in the major championships, sponsored by the Aquatic Federation Paulista. Data were collected through the Morbidity Survey, consisting of questions related to the athlete, the form and on the type, anatomic site, mechanism, time and severity of injury. The analysis between anthropometric variables and the lesion was performed by Student t test or nonparametric Mann Whitney. For the specific relationship between the type, anatomic site, mechanism, time and severity of injury, we used the Goodman test. Of the 215 athletes, 121 (56.28%) reported an injury during the season of training. Significant results were obtained between the injured athletes over age and years of training. According to the mechanism of injury, the volume of training is the main cause of injury and tendinopathy are the most common injuries. Most injuries occurred during the base period of training. The shoulder is the most affected by the different specialties, with the exception of breaststroke swimmers who reported the groin. It follows from the findings that exposure of swimmers to practice sports on the volume of training is the main causative factor for the frequent injuries in these athletes.

Made available in DSpace on 2014-06-11T19:29:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-24Bitstream added on 2014-06-13T19:17:54Z : No. of bitstreams: 1 pereira_pl_me_botfm.pdf: 520294 bytes, checksum: c6a563ab07f44eb69ac9908419929723 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O uso do álcool associa-se a problemas significativos para a saúde pública em diversos países. Estudos indicam que a média de idade para início do uso é em torno de 12,5 anos, um dado alarmante, já que o uso de álcool na adolescência está associado a uma série de comportamentos de risco. Objetivo: Estimar a prevalência do uso de bebidas alcoólicas pelos alunos do ensino fundamental e médio no município de Botucatu na vida e no último ano; analisar a associação entre o uso de álcool e uso de álcool de risco com variáveis sociodemográficas, uso de substâncias psicoativas pelo sujeito, familiares e amigos e comportamentos violentos. Metodologia: Estudo transversal, realizado com 1,507 estudantes (2007; 2008), onde foram coletados dados: sociodemográficos, de uso de álcool pelos estudantes, familiares e amigos, uso de outras drogas e comportamentos de violência. Foram utilizados vários instrumentos incluindo o Alcohol Use Disorders Identification Test C – AUDIT C, que identifica uso de álcool de risco. Inicialmente foram realizadas as análises descritivas, seguida de análises univariadas entre possíveis fatores de risco de uso de álcool no último ano e uso pesado de álcool de acordo com o AUDIT C (com ponto de corte ≥ 4 para homens, e ≥ 3 para mulheres) por meio do teste Qui-quadrado. Por fim foi realizada a análise multivariada, onde as variáveis cuja associação na análise univariada tiveram obtido p≤0,25 foram incluídas no modelo de regressão logística, obtendo-se assim as razões de chances ajustadas (Odds Ratio). A análise dos dados foi realizada com auxílio do programa STATA 10.0. Resultados: A prevalência de uso de álcool na vida encontrada no presente estudo foi de 38,8% entre estudantes do ensino fundamental... / In many countries, alcohol use is significantly associated with public health problems. Studies indicate that the average age for onset of use is around 12.5 years, an alarming fact, since alcohol use in adolescence is associated with a number of risk behaviors. Objective: To estimate the lifetime and previous year prevalence of alcohol use by junior and high school students in Botucatu, to analyze the association between alcohol use and risk alcohol use and: sociodemographic variables, tobacco and illicit substance use by the students, first degree family members and friends and violent behavior. Methodology: A cross-sectional survey was conducted with 1.507 students (2007 to 2008), and data were collected: on sociodemographic variables, alcohol use and misuse by students, family members and friends, use of illicit drugs, tobacco and violent behavior. A range of instruments was used including the Alcohol Use Disorders Identification Test C - AUDIT C, which identifies risk alcohol use. Descriptive analysis was performed followed by univariate analysis of possible risk factors for alcohol use in the previous year and heavy alcohol use according to the AUDIT C score (cutoff ≥ 4 for men, and ≥ 3 for women) through the chi-square test. Finally, a multivariate analysis was performed, and the variables whose association in the univariate analyses were ≤ 0.25 were included in the logistic regression model, thus obtaining the adjusted odds ratios. Data analysis was performed using STATA 10.0 software. Results: The prevalence of lifetime alcohol use found was 38.8% among junior high school students and 73.5% among high school students. The use of... (Complete abstract click electronic access below)

Thesis (MTech (Tourism and Hospitality Management))--Cape Peninsula University of Technology, 2007 / The main objectives ofthis research were • To investigate how HIV/AIDS affect Southern African tourism, with specific reference to the tour operators. • To investigate measures taken by the Southern African tour operators and governments to combat HIVIAIDS and the chances of success. • To make some recommendations on what can further be done to fight HIV/AIDS in the Southern African tourism sector. T 0 conduct the literature study, the following methods were used: I. Literature search particularly about Southern Africa and in general, as well as news report has been conducted. H. Review ofHIV statistics. lll. Use of Internet. IV. Journals and government publications. RESULTS: The United Nations (2005: 22) indicates that Southern Africa is experiencing the highest rate of HIV infection in the world. The infection rate is particularly high among the young people (aged 15 - 49). This age group constitutes people who are economically active, and some of them work directly or indirectly in the tourism sector. THETA (2003: 4) conducted a study on a number of tourism and hospitality companies in South Africa. The study results indicate that 92% of the companies surveyed do not have HIVIAIDS educational programmes for their employees, and that 91% of the surveyed companies do not provide HIV/AIDS preventive measures like condoms to their workers at workplace.

Thesis (DTech (Tourism and Hospitality Management))--Cape Peninsula University of Technology, 2010 / Purpose: Botswana is one of the countries with the highest HIV/AIDS prevalence rate in the world. This research aims to investigate the impact of HIV/AIDS on the socio-economic environment in Botswana with special reference to the country’s tourism sector. Tourism plays a vital role in the economy of Botswana. It creates employment, earns foreign exchange, markets Botswana internationally, attracts foreign investments and contributes to Gross Domestic Products (GDP).Methodology: This report explains the HIV/AIDS situation and policy framework relative to the tourism sector in Botswana and in selected African countries through conducting an extensive literature review and empirical surveys. This is a quantitative research in which non-probability method is used to indentify the respondents. Here tourism general managers are identified and asked to identify their subordinates who are available and willing to participate in the survey by answering a self-administered questionnaire.Findings: This study indicates that HIV/AIDS threatens the Botswana tourism and the viability of the socio-economic factors. In general, the Southern African region is experiencing the highest rate of HIV infection in the world. The infection rate is particularly high among the young people (aged 15 – 49). This age group constitutes people who are economically active, and a number of them work directly or indirectly in the tourism sector. HIV/AIDS kills the economically active population – people who hold the skills, do the work, pay taxes, raise children, vote in the elections, and provide leadership. HIV/AIDS results in increased mortality and morbidity rates, and it also results in increased health expenditure. It also results in increased poverty level in the country.Practical implications: When observing the prevalence and impact of HIV/AIDS not only in the tourism sector but in general, it becomes evident that the fight against the disease should be a collaborative approach involving various sectors including tourism. Relying only on government and health sector to address the complex and systematic impact of HIV/AIDS cannot effectively combat the disease and its prevalence rate.Originality/value: This report analyses HIV/AIDS situation in Botswana in a creative way, contributing to the understanding of its impacts on the socio-economic environment as well as identifying strategies that can be used in addressing the impacts. This research is important for public policy makers, government officials, and tourism role-players to be aware of implications HIV/AIDS has on the socio-economic environment and take them into consideration in the policy formulation and implementation, business strategies and processes. It is also imperative to academics who would like to expand their knowledge on HIV/AIDS.

Orientador: José Eduardo Corrente / Resumo: A epilepsia é um problema de saúde pública, sendo o mais comum dos distúrbios neurológicos. Neste contexto, o estudo tem por objetivo estimar a incidência da epilepsia na cidade de São José do Rio Preto, Brasil. Realizou-se um estudo epidemiológico retrospectivo da epilepsia, baseado em arquivos de atendimento primário e de registros computadorizados de ambulatório de hospital terceário a partir de 1/1/2003 até 31/12/2012. Foram rastreados um total de 136.512 receitas de fármacos antiepiléticos com os dados dos pacientes e da patologia, das quais foram confirmados 2333 casos de pessoas com epilepsia. A incidência média bruta pessoa/anos da epilepsia nos dez anos foi 77/100.000 hab./ano, sendo nos homens de 86,2 e 67 para as mulheres (p=0,0001), semelhante à incidência relatada em países subdesenvolvidos. Conclui-se que este estudo foi pioneiro no Brasil e apontar a real situação da incidência da epilepsia brasileira que ainda é distante do encontrado em países desenvolvidos, igualando o Brasil a países emergentes que ainda não dispõem de recursos de saúde sanitária distribuídos universalmente. O mesmo ocorre com os fatores de risco que também foram estudados, tais como acidente vascular cerebral, as causas perinatais, esclerose mesial temporal, traumatismo craniano, meningite, alcoolismo e cisticercose que ainda são muito prevalentes. Este estudo serve ainda para evidenciar a importância da feitura criteriosa dos arquivos médicos informatizados e manuais para o melhor conheci... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Epilepsy is still a major public health problem. This study aims to estimate the incidence of epilepsy in São José do Rio Preto, São Paulo, Brazil. A retrospective epidemiological study on epilepsy was performed based on primary care and computerized records of a medical outpatient clinic of a tertiary referral hospital, from January 1, 2003 to December 31, 2012. A total of 136.512 prescriptions of antiepileptic drugs were screened, in which 2333 people had epilepsy bringing the start date of the epileptic seizure and address. The gross average person/years of epilepsy incidence in these ten years was 77/100.000 inhabitants/year, 86.2 for men and 67 for women (p= 0.0001), similar to the reported incidence in developing countries. It was concluded that this study was a pioneer in Brazil and relevant to pointing out the real situation of the incidence of Brazilian epilepsy, which is still far from that found among developed countries, equating our condition to the emerging countries that do not yet have health resources distributed universally. The same applies to the risk factors that have been studied such as cerebrovascular accident, perinatal causes, mesial temporal sclerosis, head injury, meningitis, alcoholism and cysticercosis that are still very prevalent. This study was also conducted to highlight the importance of careful workmanship of computerized medical records and manuals for the best epidemiological knowledge of Brazilian diseases and important to alert governme... (Complete abstract click electronic access below) / Mestre

Antecedentes e justificativa: O Desgaste erosivo (DE) é a perda acelerada de tecido dentário duro pelo efeito combinado da erosão ácida e do desgaste mecânico (abrasão e atrição). Sua etiologia é multifatorial e complexa. DE é uma patología irreversível, acumulativa, que progride com a idade e por esses motivos se justifica a investigação dos possíveis fatores associados a este agravo em populações jovens. Este é o primeiro estudo que avalia a prevalência do DE em dentes permanentes dos escolares uruguaios. Objetivo: O objetivo dessa dissertação foi estudar a prevalência, extensão, severidade e distribuição intraoral do DE, e sua associação com variáveis socioeconômicas, ambientais e comportamentais, em escolares de 12 anos de Montevidéu, Uruguai. Metodologia: Foi desenvolvido um estudo observacional transversal analítico de base populacional em uma amostra representativa dos escolares de 12 anos de Montevidéu, Uruguai. A coleta de dados foi realizada entre agosto/2011 e julho/2012. Foram selecionadas aleatoriamente 44 escolas, 32 públicas e 12 particulares. Todas as crianças de 12 anos, regularmente matriculadas e frequentando regularmente essas escolas foram convidadas a participar. Dois questionários foram utilizados previamente ao exame clínico: um destinado aos pais/responsáveis (características socioeconômicas, escolaridade dos pais, condição de moradia, saúde, antecedentes médicos e odontológicos) e outro aos escolares (hábitos comportamentais e alimentares). Os exames clínicos foram realizados por duas examinadoras calibradas (Kappa≥0.7) a fim de registrar a presença e severidade do DE de acordo com o Basic Erosive Wear Examination (B.E.W.E) score system. Taxas de prevalência e extensão e seus intervalos de confiança (IC 95%) foram estimados. A associação entre DE severo e seus possíveis indicadores de risco foi avaliada através de modelos de regressão logística. Resultados: Foram examinados 1136 escolares neste estudo (19,1% de escolas particulares e 80,9% de escolas públicas) resultando em uma taxa de resposta de 66,6%. A prevalência observada de DE foi de 52,9% (n=601), sendo a grande maioria dos casos erosão leve (n=554). DE severo foi encontrado em 4,4% dos escolares (n=47). Na prevalência total foram observadas diferenças significativas entre as categorias de gênero e nível sócio-econômico enquanto que 11 somente entre as categorias de gênero na prevalência de DE severo. Na análise da extensão total foram encontradas diferenças significativas nas variáveis gênero, nível socioeconômico e hábito de realizar bochecho antes de engolir. Com relação à extensão de DE severo, as variáveis significativas foram realizar bochecho antes de engolir e frequência de escovação. Na análise ajustada, sexo masculino (OR=3.21, IC95%=1.50-6.89) e o consumo de iogurt ≥3 vezes ao dia (OR=3.98, IC95%=1.81-13.47) foram associados à presença de DE severo. Os dentes mais afetados foram os incisivos superiores em suas faces palatinas, seguido pelos primeiros molares (fases oclusais). Conclusões: A alta prevalência observada sugere que o DE pode ser considerado um problema de saúde pública em escolares uruguaios de 12 anos. O maior risco entre os meninos deve ser levado em consideração no desenvolvimento de estratégias de prevenção do DE. / Background: Erosive tooth wear (ETW) has been defined as the accelerated loss of mineralized dental tissue due to the combined effects of acid erosion and mechanical wear (abrasion or attrition). Its aetiology is multifactorial and complex. The progressive, cumulative and irreversible characteristics of ETW as well as its tendency to progress with aging, justify the investigation of possible risk indicators for its occurrence in young populations. This is the first study assessing the occurrence of ETW on permanent teeth of Uruguayan schoolchildren. Aims: to assess the prevalence, extent, severity and intraoral distribution of ETW and its association with socioeconomic, environmental and behavioral characteristics among 12-year-old schoolchildren in Montevideo, Uruguay. Methods: A population-based cross-sectional survey was conducted using a representative sample of 12-year-old schoolchildren, attending 32 public and 12 private schools, from August/2011 to July/ 2012. Firstly, 44 schools were randomly selected being 32 publics and 12 privates. All of 12-year-old schoolchildren attending such schools were invited to participate. Data was collected through two structured questionnaires prior to clinical oral examination: one sent to parents/legal guardians (socioeconomic status, parents’ educational level, housing conditions, general health, medical and dental history) and another were answered by the schoolchildren (behavioural and dietaty habits). Clinical examination was performed by two calibrated examiners (kappa≥0.7) in order to record the presence and severity of ETW according to the Basic Erosive Wear Examination (B.E.W.E.) score system. Prevalence and extent rates and their respective 95% confidence intervals (95% CI) were estimated. The association between severe ETW and its possible associated factors were analyzed using Logistic regression models. Results: In this study, 1136 schoolchildren were examined, 19.1% from private schools and 80.9% from public schools, yielding a response rate of 66.6%. The overall prevalence of ETW was 52.9% (n=601), being mild erosion in the vast majority of cases (48.5%) (n=554). Severe ETW was detected in 4.4% of schoolchildren (n=47). The overall prevalence of ETW differed significantly between categories of gender, socioeconomic status and only between categories of gender in the severe ETW analysis. Regarding overall extent of ETW, significant differences were found between categories of gender, socioeconomic status and the habit of swish before swallow. In regards to extent of severe ETW, significant variables were swish before swallow and brushing frequency. In the adjusted analysis, males (OR=3.22, 95%CI=1.50–6.89) and the consumption of yogurt ≥3 times a day (OR=3.98, 95%CI=1.18–13.47) were associated with the presence of severe ETW. The most frequently affected teeth were the upper incisors at the palatal surfaces followed by first molars (occlusal surfaces). Conclusions: The high prevalence suggests that ETW may be considered a public health problem among 12-year-old-Uruguaian schoolchildren. The increased risk among boys should be taken into account in the development of preventive strategies against ETW.