RESUMO:Objetivou-se com este estudo conhecer aspectos relacionados à atuação do enfermeiro na puericultura. Tratase de uma pesquisa descritiva exploratória de natureza qualitativa. Os informantes foram todos os enfermeiros atuantes nas Unidades Básicas de Saúde de Mandaguari-Paraná e os dados foram coletados em 2010 por meio de entrevista semiestruturada e após, submetidos à análise de conteúdo. Sobre o tema emergiram duas categorias: Puericultura: atividades envolvidas, a qual mostra ser essa uma oportunidade para orientar sobre alimentação, imunização e higiene e acompanhar o crescimento da criança e Organização da puericultura no município: entre a prática e a pretensão, a qual aponta dificuldades de operacionalização, como falta de capacitação, ausência de protocolo e falhas no processo de referência e contra-referência. As discussões ensejaram reflexões a respeito da prática da enfermagem em puericultura, o que poderá contribuir para a elaboração de novas estratégias no acompanhamento de saúde da criança no município. PALAVRAS-CHAVE: Saúde da criança; Atenção primária à saúde; Enfermagem. CHILDCARE IN PRIMARY HEALTHCARE: THE NURSE'S ROLEABSTRACT: This study aimed to shed light on aspects related to the role of the nurse in childcare. It is descriptive, exploratory research, of a qualitative nature. Data was provided by all the nurses working in the basic Health Units in Mandaguari-Paraná, was collected in 2010 through semi-structured interviews, and was later submitted to content analysis. Two categories emerged about the theme: childcare and activities it involves, which shows that this is an opportunity to provide guidance on nutrition, immunization and hygiene, and on accompanying the growth of the child, and organization of childcare in the town: between plan and practice, which highlights difficulties of operationalization, such as lack of enablement, absence of protocols, and flaws in the process of reference and counter-reference. The discussions provided an opportunity for reflections about nursing practice in childcare, which can contribute to the development of new strategies for monitoring children's health in the town. KEYWORDS: Children's health; Primary Healthcare; Nursing. PUERICULTURA EN LA ATENCIÓN PRIMARIA A LA SALUD: ACTUACIÓN DEL ENFERMERORESUMEN: El objetivo de este estudio fue conocer aspectos relacionados a la actuación del enfermero en la puericultura. Es una investigación descriptiva exploratoria de naturaleza cualitativa. Los informantes fueron todos enfermeros actuantes en las Unidades Básicas de Salud de Mandaguari -Paraná y los datos fueron recogidos en 2010 por medio de entrevista semiestructurada y sometidos al análisis de contenido. Acerca del tema, surgieron dos categorías: Puericultura: actividades involucradas, la cual muestra ser esa una oportunidad de orientar sobre alimentación, imunización y higiene así como acompañar el crecimiento del niño y Organización de la puericultura en municipio: entre la práctica y la pretensión, la cual apunta dificultades de operacionaliza...

Objective: The objective of this study was to determine the prevalence of metabolic syndrome (MS) and its components among pre-and postmenopausal women, as well as the association between menopausal status and MS. Materials and methods: A retrospective study was conducted at a reference cardiology outpatient clinic in a city located in Northwestern Paraná State, Brazil. A total of 958 medical records of symptomatic climacteric women evaluated between 2010 and 2014 were analyzed. The study consisted of two groups: pre-and post-menopausal women. MS was characterized according to the criteria of the National Cholesterol Education Program's Adult Treatment Panel III -NCEP-ATP III-2005. Results: MS was observed in 18.5% of the total study population; 9.4% of the premenopausal women and 22.2% of the postmenopausal women displayed MS, corresponding to a relative risk of 2.75. In addition, the frequency of MS increased with age. Regarding the components of MS, postmenopausal women were more likely to have high density lipoprotein (HDL-C) levels < 50 mg/dL; systolic blood pressure (SBP) values ≥ 130 mmHg or diastolic blood pressure (DBP) values ≥ 85 mmHg; and fasting glucose levels ≥ 100 mg/dL. Conclusion: MS was more prevalent among postmenopausal women than among premenopausal women. Arch Endocrinol Metab. 2017;61(2):160-6.

Objective:To identify the factors associated with intra-hospital neonatal mortality based on the individual characteristics of at-risk pregnant mothers, delivery and newborns. Method: This was a cross-sectional epidemiological study of live newborns delivered by women attended at the high-risk outpatient unit of a philanthropic hospital in Maringá, Paraná, Brazil between September 2012 and September 2013. Results: Six hundred and eighty-eight women participated in the study. The neonatal mortality coefficient found was 17.7/1,000 live births, most in the early neonatal phase. Premature labor, fetal malformation and multiple gestations were associated with neonatal death. Premature, very low birth weight newborns and those with an Apgar score of less than seven, five minutes after birth were at high risk of death. Conclusion: Identifying risk factors can help plan actions to consolidate the perinatal network. Specific programs should be incentivized in other countries, in the search for significant perinatal results such as reducing neonatal mortality. . If we break down infant mortality by age, worldwide, neonatal (0 to 27 days) deaths account for 44% of all deaths among children under the age of five (3) . In Brazil this component is even larger, and can be as high as 70% in all regions (2) , with 11.2 deaths per thousand live births between 2011 and 2012 (4) . In the state of Paraná, neonatal deaths dropped from 2,426 in 1996 to 1,279 in 2014 (94.8% less). However, in spite of all the progress made, 71.8% of infant deaths in 2014 were in the neonatal period (5) . According to the Report on Levels and Trends in Infant Mortality (Relatório de Níveis e Tendência em Mortalidade Infantil), the main goal is to reduce mortality in the neonatal period, which is where most infant deaths occur (1) . To reduce maternal and infant mortality, and the high percentage of avoidable deaths, in 2012 a public policy for prenatal care and for the care of newborns at risk was created in Paraná. It focuses on early detection of pregnant women at risk, their prenatal care, risk stratification of mothers and infants, specialized ambulatory care for pregnant women and infants (under the age of one) at risk, and ensured delivery via a system that is linked to the hospital (6) . Numerous studies have attempted to analyze the causes of neonatal deaths. Studies show a strong link between neonatal deaths and maternal and infant life conditions and health, economic situation, and access to healthcare, and to biological conditions such as gestational age, weight at birth and Apgar index (7) . We also call attention to the risk in the current and previous pregnancy (prior stillbirth, premature or low birth weight infants), the movement of the pregnant woman to delivery and women giving birth to low-weight babies (< 1,500 grams) in hospitals not equipped with a Neonatal Intensive Care Unit (NICU) (4) . Studies show that among newborns in NICU, Cesarean birth, failure to use steroids, pre-eclampsia, oligohydramnios, <2,500 grams ...

Objetivo: Evaluar el conocimiento y la práctica sobre la lactancia materna en la primera hora de vida entre los miembros del equipo multidisciplinario de un hospital en la ciudad de Maringá, Paraná.Metodología: Estudio descriptivo-exploratorio con enfoque cualitativo. Los datos fueron recolectados entre octubre y noviembre del 2013 mediante entrevistas grabadas con 11 participantes. Para el procesamiento de los datos, se utilizó la técnica de análisis de contenido.Resultados: Se encontró que los profesionales de la salud tienen deficiencias en el conocimiento acerca de la lactancia materna en la primera hora de vida; además, la práctica no suele realizarse en la institución, a partir de lo cual surgen desafíos y recomendaciones para establecer esta actividad.Conclusiones: Se sugiere incluir esta práctica en las políticas del hospital para la promoción y protección de la lactancia materna, que consoliden el equipo multidisciplinario y el trabajo colaborativo entre sus miembros.

Estudo quantitativo cujos objetivos foram comparar o tempo de Aleitamento Materno Exclusivo (AME) entre os grupos de idade de início do uso da chupeta e verificar a presença de associação entre o uso da chupeta e a interrupção precoce do AME. A amostra foi de 362 crianças cujas mães realizaram o pré-natal na atenção básica de saúde de Maringá, 2009. Utilizaram-se a análise ANOVA não paramétrica de Kruskal-Wallis, qui-quadrado e razão de chances. Mais da metade das crianças não fazia uso de chupeta; entre as que usavam, em 26,51% dos casos, ela foi introduzida no primeiro mês. Não foi encontrada diferença significativa entre o tempo de AME e as faixas de idade de início do uso da chupeta; no entanto, encontrou-se significância entre o grupo de crianças que não usaram chupeta com os demais grupos (p<0,05). Houve associação significativa entre o uso da chupeta e o desmame precoce (p<0,05; OR=3,2).

Background: To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. Materials and Methods: This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. Results: The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. Conclusions: Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.

RESUMOEsta pesquisa teve como objetivo analisar os resultados perinatais de gestantes de alto risco com síndrome hipertensiva. Estudo transversal, de base documental, com 920 prontuários de gestantes de um ambulatório de alto risco. A variável independente foi a síndrome hipertensiva, considerando a hipertensão arterial como condições preexistentes, pré-eclâmpsia como antecedente obstétrico e doença hipertensiva específica da gestação (DHEG) como intercorrência clínica. As variáveis dependentes foram prematuridade, baixo peso ao nascer, Apgar inferior a sete no 1° e 5° minutos, morte fetal, morte infantil, parto normal e parto cesáreo. Para analisar a associação entre as variáveis, utilizou-se o teste qui-quadrado e comparou-se o risco relativo no intervalo de confiança (IC) a 95%. Da amostra estudada, 25,32% apresentaram síndrome hipertensiva; 14,36% foram classificadas com hipertensão arterial (grupo 1), 6,73% com pré-eclâmpsia (grupo 2); 4,02% apresentaram DHEG (grupo 3); e 30,65% eram normotensas (grupo 4). No grupo 1 constatou-se risco elevado para morte fetal e o parto normal foi fator de proteção. No grupo 2 verificou-se risco elevado para parto cesáreo. No grupo 3, constituiu risco elevado para prematuridade e baixo peso ao nascer. Os três grupos apresentaram risco elevado para Apgar baixo no 1º e 5º minuto. As síndromes hipertensivas na gestação relacionaram-se a resultados perinatais desfavoráveis, evidenciando a necessidade de cuidados especializados à gestante, por meio de um pré-natal especializado e de qualidade. Palavras-chave: Saúde Materno-Infantil; Complicações na Gravidez; Gravidez de Alto Risco; Hipertensão. ABSTR ACT This study aimed to analyze the perinatal outcomes of high risk pregnancies of women with hypertensive syndrome. It was a cross-sectional study, with a documental basis, with 920 records of pregnant women from a high-risk outpatient clinic. The independent variable was hypertensive syndrome, considering arterial hypertension as pre-existing conditions, pre-eclampsia as obstetric antecedents and heart disease of pregnancy (HDP) as clinical complications. The dependent variables were prematurity, low birth weight, Apgar score below than seven in the 1st and 5th minutes of life, fetal death, infant death, normal delivery and cesarean delivery. To analyze the association between the variables, the Chi-square test was used and Relative Risk was compared in the 95% confidence interval (CI

Objective. To investigate and compare aspects of breast cancer in young women (<40 years old) with older women (>40 years old). Methods. Retrospective, cross-sectional, analytical, and exploratory study based on data from 2009 to 2012 obtained from the Breast Cancer Information System (SISMAMA) and the Unified Health System Information Data (DATASUS). The studied population consisted of women (n=31.195) with malignant breast cancer. The analysed variables were education level, race, nodule detection at the clinical examination or image studies, presence of palpable axillary lymph nodes, surgical approach, and tumor histological type and grade. Results. There was increasing detection of breast cancer cases in young women among the studied years. Young women had more palpable lymph nodes (OR 1.28, 95% CI: 1.18–1.39), ductal carcinoma as the most frequent histologic type (OR 1.36, 95% CI: 1.22 to 1.53), and grades II and III tumor (OR 16.01 , 95% CI: 13.30 to 19.28 ). The lesion detection by clinical examination was higher in women <40 years (OR 1.34, 95% CI: 1.24 to 1.45). Conclusion. Although there are early detection measures related to breast cancer, they are not the usual practice of the young female public, suggesting the need for a review of existing public policies in the country.