Made available in DSpace on 2015-04-14T13:33:01Z (GMT). No. of bitstreams: 1 443948.pdf: 769828 bytes, checksum: 9cf0dde32ae45c3c2ac9b4e8c917f9b7 (MD5) Previous issue date: 2012-08-27 / Introduction: Because it is an invasive procedure in a vital organ, the heart, cardiac surgery is a high-risk surgery. And the pediatric surgeries in turn, assume a more delicate situation because they deal with complex congenital heart disease in patients with a very small anatomy and proportional to their body surface. Objective: To determine the epidemiological profile of patients that have undergone congenital heart surgery, treated at the Hospital of PUCRS. Methods: This research can be characterized as a cross-sectional study of quantitative history. The study included patients aged 29 days to 18 years old. Sample of 162 children who underwent pediatric congenital cardiac surgery in this institution. To better analyze the surgical complications they are divided into five groups: cyanotic with reduced blood flow, with antegrade cyanotic, acyanotic without overflow, acyanotic with antegrade, Extra-cardiac. Divided into 3 groups for better classification We conducted a review of electronic medical records service and the entire sample was identified through information contained in these files and the information was supplemented by data from the Medical Service, and Statistics (SAME). Data were collected through procedures that occurred from January 2007 to December 2011. The study included patients aged from 29 days to 18 years old. The data were analyzed with SPSS System, Study approved by the Ethics Committee. Results: There was a predominance of females, 51.2%, average age 52.45 months, 82.1% for SUS patients, mortality of 11.7%, 94.4% elective surgery and 69, 1% underwent surgery with extracorporeal circulation (ECC). Conclusion: A greater number of surgery at the age of 29 days to 5 years, without gender predominance, higher incidence of acyanotic heart disease with increased blood flow with a predominance of atrial septal defects (ASDs). Most patients were SUS. It was observed that the service returned to elective surgeries, with a low incidence of emergency care. / Introdu??o: A cirurgia card?aca, por se tratar de um procedimento invasivo em um ?rg?o vital, o cora??o, ? uma cirurgia de alto risco. As cirurgias pedi?tricas por sua vez, assumem uma situa??o mais delicada por serem cardiopatias complexas em pacientes com uma anatomia muito diminuta e proporcional a sua superf?cie corp?rea. Objetivo: Determinar o perfil epidemiol?gico dos pacientes com cardiopatias cong?nitas cir?rgicas, atendidos no Hospital S?o Lucas da PUCRS. M?todos: A presente investiga??o pode ser caracterizada como um estudo de corte transversal hist?rico quantitativo. Foram inclu?dos no estudo pacientes com idade de 29 dias a 18 anos incompletos. A amostra foi de 162 crian?as que foram submetidas ? cirurgia card?aca cong?nita pedi?trica nesta institui??o. Para uma melhor an?lise, as patologias cir?rgicas est?o divididas em cinco grupos: Cian?ticas com hipofluxo, Cian?ticas com hiperfluxo, Acian?ticas sem hiperfluxo, Acian?ticas com hiperfluxo, Extra-card?acas. Divididos em 3 grupos et?rios para melhor classifica??o. Foi feita uma an?lise de prontu?rios eletr?nicos do servi?o e toda a amostra foi identificada atrav?s de informa??es contidas nestes prontu?rios, informa??es que foram complementadas atrav?s de dados do Servi?o de Atendimento M?dico e Estat?stica (SAME). Os dados foram coletados atrav?s de procedimentos que ocorreram no per?odo de janeiro de 2007 a dezembro de 2011. Os dados foram analisados no Sistema SPSS, Estudo aprovado pelo Comit? de ?tica. Resultados: Predom?nio do sexo feminino com 51,2%, m?dia de idade de 52,45 meses, 82,1% de pacientes atendidos pelo SUS, mortalidade de 11,7%, 94,4% de cirurgias eletivas e 69,1% foram submetidos a cirurgia com circula??o extracorp?rea (CEC). Conclus?o: Houve maior n?mero de cirurgias na faixa et?ria dos 29 dias aos 5 anos, sem predom?nio de sexo, maior incid?ncia de cardiopatia acian?tica com hiperfluxo, principalmente das comunica??es interatriais (CIAs). A maioria dos pacientes foram atendidos pelo SUS. Observou-se que o servi?o est? voltado para a realiza??o de cirurgias eletivas, com baixa incid?ncia de urg?ncias e emerg?ncias.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-18T10:50:44Z No. of bitstreams: 1 FranciscoAssisVieiraLimaJunior_DISSERT.pdf: 656231 bytes, checksum: f6ccd153b3b8dcff92b89db4dc0c38d4 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-22T14:47:13Z (GMT) No. of bitstreams: 1 FranciscoAssisVieiraLimaJunior_DISSERT.pdf: 656231 bytes, checksum: f6ccd153b3b8dcff92b89db4dc0c38d4 (MD5) / Made available in DSpace on 2018-01-22T14:47:13Z (GMT). No. of bitstreams: 1 FranciscoAssisVieiraLimaJunior_DISSERT.pdf: 656231 bytes, checksum: f6ccd153b3b8dcff92b89db4dc0c38d4 (MD5) Previous issue date: 2017-11-20 / Introdu??o: apesar da cobertura midi?tica trazer a certeza de uma rela??o entre o V?rus da Zica e microcefalia em rec?m-nascidos, configurando um aumento no agrupamento das anomalias cong?nitas no Nordeste brasileiro, sugere-se que a incid?ncia de anomalia cong?nitas no Rio Grande do Norte n?o seja diferente quando comparada a sua distribui??o espacial antes e ap?s Zica, isso porque fatores como os ambientais, socioecon?micos e biol?gicos podem contribuir para a perman?ncia de uma alta incid?ncia no estado. Objetivo: analisar a distribui??o temporo-espacial das taxas de incid?ncia de anomalias cong?nitas no Rio Grande do Norte, antes e ap?s a epidemia v?rus da zica atrav?s de uma an?lise geoestat?stica e correla??o com os determinantes sociais em sa?de M?todos: trata-se de um estudo epidemiol?gico do tipo ecol?gico, retrospectivo que avaliou os casos notificados de anomalias cong?nitas no Rio Grande do Norte agrupando em dois bi?nios (2005-2006 e 2015-2016), configurando per?odos antes e ap?s a epidemia de zica atrav?s de uma an?lise espacial, cujos dados obtidos do DATASUS e da Secretaria Estadual de Sa?de, foram agrupados no SPSS 13.0 e analisados no Terraview vers?o 4.2.2. Resultados: a taxa de anomalias cong?nitas no per?odo pr?-Zica foi de 11,83 casos/1.000 nascidos vivos e no per?odo p?s-Zica aumentou para 14,24 casos/1.000 nascidos vivos, resultado do aumento dos casos notificados. Foi observada que a mesorregi?o Agreste Potiguar ? a que possui maior n?mero de casos notificados de Zica assim como ? a regi?o que concentra maior n?mero de casos de anomalias cong?nitas no per?odo estudado, estando correlacionada com regi?o com grandes dicotomias sociais. Conclus?es: o presente parece revelar que as anomalias cong?nitas sempre estiveram presentes no estado e nenhuma outra a??o foi suscitada com tamanha import?ncia como no per?odo Zica. Estrat?gias para minimizar os casos de anomalias cong?nitas atrav?s de a??es de planejamento familiar, controle da idade materna, programas de vacina??o, controle na venda de medicamentos abortivos, combate ao consumo de drogas, ?lcool e fumo podem facilmente ser desenvolvida e ganhar ades?o midi?tica, fato que nem sempre ? percebido, tendo a m?dia dado um enfoque ao aumento dos casos de notifica??o sem buscar entender o processo. / Introduction: although the media coverage provides certainty of a relationship between the Zika virus and microcephaly in newborns, which is an increase in the grouping of congenital anomalies in the Brazilian Northeast, it is suggested that the incidence of congenital anomaly in Rio Grande do Sul North isn?t different when compared to its spatial distribution before and after Zika, because factors such as environmental, socioeconomic and biological can contribute to the permanence of a high incidence in the state. The objective of the present study is to analyze the temporal-spatial distribution of the incidence rates of congenital anomalies in Rio Grande do Norte, before and after the epidemic virus Zika through a geostatistical analysis and correlation with the social determinants in health. Methods: this is an ecological that evaluated the reported cases of congenital anomalies in Rio Grande do Norte before and after the Zika epidemy through a spatial analysis, whose data were grouped in SPSS 13.0 and analyzed in Terraview version 4.2.2. Results: the rate of congenital anomalies in the pre-Zika period was 11.83 cases / 1.000 live births and in the post Zika period it increased to 14.24 cases/1.000 live births, a result of the increase in reported cases. It was visualized that the Agreste Potiguar mesoregion is the one with the highest number of reported cases of Zika, as it is the region that concentrates the largest number of cases of congenital anomalies in the period studied, being correlated with the region with great social dichotomies. Conclusion: the present study revealed that congenital anomalies were always present in the state and no other action was raised with such importance as in the Zika period. Strategies to minimize cases of congenital anomalies through family planning actions, maternal age control, vaccination programs, control in the sale of abortive drugs, drug, alcohol and tobacco use can easily be developed and gain media adherence, fact which is not always perceived, the media having given a focus to the increase of the cases of notification without seeking to understand the process.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-03-31T22:08:52Z No. of bitstreams: 1 MarianaAlieviMari_DISSERT.pdf: 1381499 bytes, checksum: caa24d7f6c4061e0b064a8be511fd496 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-01T21:48:41Z (GMT) No. of bitstreams: 1 MarianaAlieviMari_DISSERT.pdf: 1381499 bytes, checksum: caa24d7f6c4061e0b064a8be511fd496 (MD5) / Made available in DSpace on 2016-04-01T21:48:41Z (GMT). No. of bitstreams: 1 MarianaAlieviMari_DISSERT.pdf: 1381499 bytes, checksum: caa24d7f6c4061e0b064a8be511fd496 (MD5) Previous issue date: 2015-04-27 / O desenvolvimento infantil ? o resultado da intera??o de fatores biol?gicos, psicol?gicos e sociais. Ambiente hostil, renda, est?mulos oferecidos, bem como a presen?a de uma doen?a cr?nica s?o quest?es que podem interferir significativamente. Considerando as doen?as cr?nicas, podemos identificar a cardiopatia cong?nita (CC) que se caracteriza por malforma??es card?acas anat?micas e funcionas e atualmente tem apresentado uma incid?ncia de at? 1% na popula??o de nascidos vivos. Esta pesquisa teve como objetivo avaliar o desenvolvimento infantil e verificar uma associa??o com o comprometimento por fatores biopsicossociais de crian?as com e sem CC. Fizeram parte do estudo crian?as de zero a seis anos, divididas em tr?s grupos: Grupo1- 29 crian?as cardiopatas cong?nitas pr?-cir?rgicas, Grupo2- 43 crian?as cardiopatas p?scir?rgicas e Grupo3- 56 crian?as saud?veis. Os instrumentos utilizados foram um question?rio biopsicossocial e o Teste de Triagem de Denver II. Do total de 128 crian?as avaliadas, 66 (51,56%) s?o meninas, sendo que a idade variou dos dois meses aos seis anos (mediana 24,5 meses). No G1 e G2 houve predom?nio de cardiopatias acian?ticas (55,2% e 58,1%). Em rela??o as avalia??es do Denver II, as crian?as cardiopatas tiveram mais classifica??es de desenvolvimento ?suspeito? e ?suspeito/anormal?, sendo que 41,9% das crian?as que j? passaram por procedimento cir?rgico tiveram seu desenvolvimento caracterizado como ?suspeito/anormal?. No grupo das crian?as saud?veis 53,6% foram classificadas com perfil desenvolvimental ?normal? (p=?0,0001). Sobre os dom?nios do Denver II, entre as crian?as cardiopatas houve maior altera??o nas ?reas motoras (p= 0,016, p=?0,001). As vari?veis biopsicossociais que se mostraram relacionadas a um poss?vel atraso no desenvolvimento foram: sexo (p=0,042), idade da crian?a (p=0,0001) e renda per capita (p=0,019). N?o foram encontradas associa??es entre as vari?veis relacionadas ao tratamento da cardiopatia, informa??o, compreens?o da doen?a e do modo como os pais tratam os filhos. J? no grupo das crian?as saud?veis evidenciou-se que crian?as que passaram por interna??o hospitalar tiveram mais ?ndices de altera??es no desenvolvimento (p=0,025) e quanto maior o n?mero de interna??es mais essas altera??es se intensificaram (p=0,023). Os resultados sugerem que crian?as com cardiopatia cong?nita tenham prov?vel atraso no desenvolvimento. Tamb?m foi poss?vel verificar que existe uma diferen?a significativa entre as crian?as que passaram por procedimento cir?rgico, daquelas que ainda aguardam cirurgia fazendo somente acompanhamento cl?nico. As altera??es de o desenvolvimento estarem mais ligadas as ?reas motoras podem ser explicadas por aspectos caracter?sticos da doen?a e do tratamento, como dispneia, cansa?o, cuidados e limita??es nas atividades di?rias. As vari?veis sexo e idade parecem ser determinantes no desenvolvimento, bem como, crian?as saud?veis passarem por experi?ncia de hospitaliza??o. J? nas crian?as cardiopatas, se percebeu que as vari?veis sociais que envolvem a doen?a e o tratamento n?o comprometeram o desenvolvimento. Essa quest?o pode ser entendida por meio de fatores protetores e de resili?ncia, j? que essa popula??o recebe apoio familiar e social. / Child development is the result of the interaction of biological, psychological and social factors. Hostile environment, income, offered stimuli, as well as the presence of a chronic illness are issues that may interfere significantly. Considering the chronic diseases, we can identify congenital heart disease (CHD) is characterized by anatomical heart defects and functional and currently has presented an incidence of up to 1% of the population of live births. This research aimed to evaluate child development and verify an association with the commitment by biopsychosocial factors of children with and without CHD. Study participants were children from zero to six years, divided into three groups: Group1- 29 children pre-surgical congenital heart disease, Group2- 43 children post-surgical cardiac patients and Group3- 56 healthy children. The instruments used were a biopsychosocial questionnaire and the Screening Test Denver II. Of the total of 128 children evaluated, 66 (51.56%) are girls, and ages ranged from two months to six years (median 24.5 months). In G1 and G2 predominated acyanotic heart disease (55.2% and 58.1%). Regarding the Denver II reviews, children with heart disease had more development ratings "suspicious" and "suspect/abnormal", and 41.9% of children who have gone through surgery had characterized its development as "suspect/abnormal" . In the group of healthy children 53.6% were classified as developmental profile "normal" (p = ?0,0001). On the areas of Denver II, among children with heart disease was greatest change in motor areas (p = 0.016, p = ?0,001). The biopsychosocial variables that were related to a possible developmental delay were gender (p = 0.042), child's age (p = 0.0001) and income per capita (p = 0.019). There were no associations between the variables related to the treatment of disease, information, understanding of the disease and the way parents treat their children. In the group of healthy children showed that children who underwent hospitalization rates were more changes in development (p = 0.025) and the higher the number of admissions over these changes have intensified (p = 0.023). The results suggest that children with congenital heart disease have likely delayed development. It was also observed that there is a significant difference between the children who have gone through surgery, those who are still waiting for surgery only doing clinical follow-up. Changes in the development are more connected motor areas can be explained by the characteristic features of the disease and treatment, such as dyspnea, fatigue, care and limitations in daily activities. The gender and age appear to be decisive in the development as well as healthy children go through hospitalization experience. Already in children with heart disease, it was realized that social variables involved in the disease and the treatment did not affect the development. This question can be understood by means of protective factors and resiliency, as this population receives family and social support.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-07-20T21:53:39Z No. of bitstreams: 1 DISSERTA??O PAULO ROBERTO finalz?o 09 03.pdf: 3626215 bytes, checksum: a916a4a7fbf307b65ccad4330d1dd18c (MD5) / Made available in DSpace on 2018-07-20T21:53:39Z (GMT). No. of bitstreams: 1 DISSERTA??O PAULO ROBERTO finalz?o 09 03.pdf: 3626215 bytes, checksum: a916a4a7fbf307b65ccad4330d1dd18c (MD5) Previous issue date: 2018-02-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Study qualitative, exploratory, with the objective of understanding the experiences of families of children with microcephaly by Zika virus. For the production of empirical data we explore the narratives of relatives contained in videos posted on the YouTube Internet platform published between 10/01/2015 and 07/31/2016, as well as narratives obtained from an in-depth interview, of the story-theme design applied in 11 family members of children with microcephaly attended at the Association of Parents and Friends of the Exceptional in Feira de Santana, as well as field diary material. The data collection took place between September and November 2017. For the treatment of the data we adopted the thematic content analysis and the iconographic analysis. The results are organized in: Article 1 - Bad news: experiences and feelings of families regarding the diagnosis of microcephaly by Zika virus; A session entitled: Understanding the family dynamics of study participants; Article 2 - "Well run, very fast ...": experiences of care of mothers of children with microcephaly by Zika; Article 3 - Family organization to take care of the child with microcephaly by z?ka virus. Microcephaly is revealed in the prenatal period, through imaging tests, or during the immediate or late postpartum. Relatives live with feelings of sadness, despair, pain, fright, commotion, disorientation and terror. After diagnosis, family members seek to understand microcephaly through internet resources, and question God's permission and the relevance of scientific knowledge. Mothers experience day-to-day organizing and cleaning the home environment, caring for their children and the specific care of the child with microcephaly, regarding lullaby, since children cry frequently, requiring the mother to spend hours with the child in the lap; Give a shower; change diapers; to feed; play; and, stimulate. They learn to differentiate cognitive, psychomotor, auditory, and visual impairments; recognize progress in the development and new needs of children; identify episodes of seizure; consider patience and attention relevant to care; and, seek to learn about new thematic and unknown terms such as calcifications. Family members build a network of solidarity and unity for the benefit of the child, family relationships are strengthened, bringing together previously conflicting relationships. Caregivers include mothers, fathers, grandparents, sisters, cousins, aunts, friends and neighbors, with the mother being the protagonist who also coordinates and defines the roles played by other people. Family members practice care that has been organized in four dimensions: "Take care"; Encourage; Access Resources and Services. We recommend that family members and health workers attend to the restriction of social interaction, weakening marital relationships, jealousy behaviors on the part of siblings, worsening of grandparents' health conditions, and financial difficulties that may affect the family of children with microcephaly. / Estudo qualitativo, do tipo explorat?rio, com objetivo de compreender as experi?ncias de fam?lias de crian?as com microcefalia por Zika v?rus. Para produ??o de dados emp?ricos exploramos as narrativas de familiares contidas em v?deos postados na plataforma virtual da internet YouTube publicados entre 01/10/2015 e 31/07/2016, e tamb?m narrativas obtidas de entrevista em profundidade, do desenho est?ria-tema aplicados em 11 familiares de crian?as com microcefalia atendidos na Associa??o de Pais e Amigos dos Excepcionais em Feira de Santana, al?m de material do di?rio de campo. A coleta de dados ocorreu entre setembro a novembro de 2017. Para tratamento dos dados adotamos a an?lise de conte?do tem?tica e a an?lise iconogr?fica. Os resultados encontram-se organizados em: Artigo 1 ? M?s not?cias: experi?ncias e sentimentos de fam?lias face o diagn?stico de microcefalia por Zika v?rus; Uma se??o intitulada: Compreendendo a din?mica familiar dos participantes do estudo; Artigo 2 ? ?Bem corrido, muito corrido...?: experi?ncias de cuidado de m?es de crian?as com microcefalia por Zika; Artigo 3 ? Organiza??o familiar para cuidar da crian?a com microcefalia por z?ka v?rus. A microcefalia ? revelada no per?odo pr?-natal, atrav?s de exames de imagens, ou durante o p?s-parto imediato ou tardio. Os familiares convivem com sentimentos de tristeza, desespero, dor, susto, como??o, desorienta??o e terror. Ap?s o diagn?stico, os familiares buscam compreender a microcefalia atrav?s dos recursos da internet, e questionam a permiss?o de Deus e a relev?ncia do conhecimento cient?fico. As m?es experienciam o dia a dia organizando e limpando o ambiente dom?stico, exercendo os cuidados aos filhos e o cuidado espec?fico ? crian?a com microcefalia, referentes a: ninar, pois as crian?as choram com frequ?ncia, necessitando que a m?e passe horas com a crian?a no colo; dar banho; trocar fralda; alimentar; brincar; e, estimular. Elas aprendem a diferenciar as defici?ncias cognitivas, psicomotoras, auditivas e visuais; reconhecem os avan?os no desenvolvimento e as novas necessidades das crian?as; identificam epis?dios de convuls?o; consideram a paci?ncia e a aten??o relevantes para o cuidado; e, buscam apreender sobre novas tem?ticas e termos desconhecidos como calcifica??es. Os familiares constroem uma rede de solidariedade e uni?o em prol da crian?a, as rela??es familiares s?o fortalecidas, aproximando rela??es antes conflituosas. Participam do cuidado as m?es, pais, av?s, irm?s (os), primos (as), tias (os), amigas e vizinhas, havendo protagonismo da m?e que tamb?m coordena e define os papeis desempenhados pelas outras pessoas. Os familiares exercem cuidados que foram organizados em quatro dimens?es: Cuidar Integralmente; ?Tomar Conta?; Estimular; Acessar Recursos e Servi?os. Recomendamos que os familiares e trabalhadores da sa?de atentem para a restri??o do conv?vio social, enfraquecimento das rela??es conjugais, comportamentos que indiquem ci?mes por parte dos irm?os, agravamento das condi??es de sa?de das av?s e dificuldades financeiras que podem repercutir na fam?lia de crian?as com microcefalia.