Obesity is the nutritional disorder which has shown the greatest increase in prevalence, even in those countries in which deficiency diseases represent a severe public health problem. The goal of the present study was to analyse the anthropometric profile of a community living in the outskirts of Maceió, capital of Alagoas (northeastern Brazil), and to investigate the hypothesis of a coexistence of undernutrition and obesity in a very low-income population. The survey was conducted on 315 families (1247 individuals). Among the children (aged < or =10 years), the prevalence of wasting, stunting and wasting plus stunting was 3.8, 8.3 and 8.7 % respectively. Wasting (10.2 %) was the most prevalent form of undernutrition among adolescents; nonetheless, a higher frequency of stunting (11 %) and overweight-obesity (5.5 %) was seen specifically in girls, in agreement with trends found in other studies. Adults exhibited a high prevalence of overweight-obesity (25 %), but stunting was also present (22 %). Of the stunted individuals, 30 % were overweight-obese and 16.3 % were underweight. There were eighty-six families with at least one parent who was underweight (27 %) and 104 families with at least one parent who was overweight (33 %). Underweight and overweight-obesity were both present in ninety-six households (30 %). These results may indicate that better living conditions in urban areas in a population 'adapted' to chronic famine might increase the susceptibility to obesity. Considering the harm caused by the cumulative effect of these two conditions (undernutrition in childhood and obesity in adult life) there is a clear need for new studies to uncover the determinant factors so that preventive measures can be implemented.

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BackgroundSickle cell disease is a genetic, hereditary and chronic disease that affects the health of its carriers and might impair their health-related quality of life. ObjectiveThe aim of the current study was to assess the health-related quality of life of individuals with sickle cell disease followed at referral centers in Alagoas, Brazil. MethodsA total of 40 individuals with sickle cell disease aged 12 to 43 years old were evaluated by means of sociodemographic and clinical questionnaires, the Medical Outcomes Study 36-Item Short Form Health Survey and the Beck Depression Inventory. The latter was applied only to adults. ResultsMost participants were adults (62.5%) with a predominance of the SS genotype (85%) with pain being the commonest complication (95%). Mood disorder was found in 40% of the adults. The patients exhibited overall impairment of quality of life, which was more pronounced among the adults and under 15-year-old adolescents. Married adults exhibited less impairment of most quality of life domains compared to unmarried adults, and the adults with mood disorder exhibited greater impairment of all quality of life domains. ConclusionsThese results suggest that interventions that aim to improve vitality, pain, and mental health might contribute to maintaining high levels of quality of life in patients with sickle cell disease, especially among adults and under 15-year-old adolescents.

Objective: To study the food pattern of stunted and nonstunted, obese and nonobese individuals in a very-low-income population. Design: A household survey. Setting: Slum set up by the 'Homeless Movement', city of Maceió (Alagoas), Brazil. Subjects and methods: A total of 532 adults classified by sex, stature (Zr and Z 4 À2s.d. of the NCHS curves), and body mass index (BMI) were compared using the following variables: waist circumference, waist-hip circumference ratio (W/H), percentage body fat (skinfold thickness and bioelectrical impedance), and food intake (24-h recall). Results: The prevalence of stunting was 22.6%. In all, 30% of the stunted subjects were overweight or obese, compared with 23% for the nonstunted individuals (Po0.05). In women, logistic regression analysis showed a strong association among weight, abdominal fat, and stunting (r ¼ 0.81). No significant differences were observed in the values of W/H or in the qualitative menu of the different categories. Energy intake was below the RDA figures (about 63%). There was similarity among the groups regarding the proportion of macronutrients, except for the fact that stunted obese women ingested less fat and protein than nonstunted obese women. Stunted obese individuals consumed less energy (5962 kJ) than the population as a whole (6213 kJ), an amount far lower than their average needs, which were calculated on the basis of their shorter stature (8109 kJ). Conclusion: The observed energy consumption seems compatible with the panorama of undernutrition present in the population, but it does not explain the high prevalence of obesity detected.

There was insufficient evidence available from the included trials that compared neuraxial anaesthesia with general anaesthesia to rule out clinically important differences for most clinical outcomes. Neuraxial anaesthesia may reduce pneumonia. No conclusions can be drawn with regard to mortality, myocardial infarction and rate of lower-limb amputation or less common outcomes.

do Rio Grande do Norte.Prática do abortamento entre adolescentes: um estudo em dez escolas de Maceió (AL, Brasil)Practice of abortion among teenagers: a study in ten schools of Maceió (AL, Brazil)Resumo Trata-se de um estudo de corte transversal, realizado com o objetivo de investigar as razões que levaram adolescentes a provocarem o aborto, relacionando com idade e tipo de escola que frequentavam. A amostra foi calculada considerando o número de internações para curetagem pós-abortamento. Usou-se como instrumento um questionário semiestruturado, anônimo, aplicado em dez escolas, sorteadas dentre todas da cidade de Maceió (Alagoas), pesquisando-se adolescentes dos 12 aos 19 anos, do sexo feminino. Os dados foram analisados pelo Programa Epi Info, usando-se odds ratio e risco relativo para verificar associação entre variáveis e intervalo de confiança a 95%. Em uma amostra de 2.592 jovens, 559 (21,6%) tinham vida sexual ativa, 182 (7,0%) referiram ter engravidado e 149 (26,7%) abortado. Medo da reação dos pais, idade, falta de apoio do companheiro e rejeição da gravidez foram razões para provocar o aborto, sendo medo a mais citada, em ambos os tipos de escola. O aborto foi mais citado nas escolas públicas, sendo significativo e protetor o risco para abortar antes dos 15 anos, e significativa a relação entre abortar e estudar em escolas públicas. O medo da reação dos pais como razão mais frequente sugere a necessidade de novos estudos sobre sexualidade e comunicação entre pais e filhos. Palavras-chave Sexualidade, Adolescente, AbortoAbstract This is a cross-cut study that was carried out with the objective of investigating the causes through which adolescents have provoked abortion, relating it to age and the type of school attended. The sample was calculated by taking into account the number of hospital admissions for post-abortion curettage. A semi-structured and anonymous questionnaire was used as a research instrument which was applied in ten schools randomly chosen among all schools, of Maceió (Alagoas, Brazil), to reach 12-19 years old female teenagers. The data were assessed by the Epi Info Program making use of odds ratio and a relative risk to verify any association among variables and a confidence interval at 95%. At a sample of 2,592 adolescents, 559 (21.6%) had an active sexual life, 182 (7.0%) informed to have been pregnant and 149 (26.7%) to have aborted. The fear of the parents' reaction, age, lack of support of the partner and pregnancy rejection were the explanation to stimulate abortion. Fear was the most mentioned cause in both types of school. Abortion was more mentioned in public schools, being significant and protective the risk of aborting before the age of 15. The fear of the parents' reaction as a frequent cause suggests the necessity for additional studies on sexuality and communication between parents and children.

The aim of this investigation was to identify factors that influenced or motivated women (N = 737) to donate human milk to human milk banks in Alagoas, Brazil. The most common characteristics of a regular donor were having 4 to 7 pregnancies (relative risk [RR] = 1.9285; 95% confidence interval [CI] = 1.0388-3.5800) and having obtained a higher education level (RR = 2,0625; 95% CI = 1.0097-4.2130). The most commonly reported reasons for donating were "encouragement of a health professional" (61.3%), followed by "the needs of the babies the banks serve" (25.3%). Most of the donors (49.9%) were introduced during their stay in the hospital to the human milk bank to which they donated, and 25.8% chose the bank recommended by a health professional. Health professionals play an indispensable role in motivating mothers to become human milk donors.

Resumo: Neste artigo, encontra-se estudado o direito à saúde indígena, por normas pouco analisadas no sistema jurídico brasileiro. Para isto, foi investigada sua construção histórica e foram coletados documentos e registros verbais por trabalho de campo frente aos povos de Alagoas. Abstract: In this article, the right to indigenous health is studied, by norms little analyzed in the Brazilian legal system. For this, its historical construction was investigated and verbal documents and records were collected for field work in contact with Alagoas peoples. Sumário: Considerações Iniciais 1. A relevância das Conferências sobre saúde indígena. 2. A distribuição e aspectos históricos das etnias indígenas no estado. 3. A relação dos povos indígenas com gestores de saúde. Considerações Finais. Referências.