ARTIGO ORIGINAL RESUMO | Contexto:Os objetivos desse estudo foram descrever os afastamentos do trabalho por transtornos mentais entre servidores públicos para apresentá-los à gestão, pretendendo adotar medidas que colaborassem com a diminuição do absenteísmo. Métodos: Foram avaliados os registros de afastamento por transtornos mentais no período de janeiro a dezembro de 2016, em uma instituição pública de ensino do Estado do Ceará. Os dados foram obtidos por meio da plataforma SIASS (Subsistema Integrado de Atenção à Saúde do Servidor) e de informações do Portal da Transparência do Governo Federal. Foram estratificadas as licenças para tratamento de saúde por transtornos mentais e comportamentais, classificadas no CID 10 "F", independente de gênero ou cargo funcional. Resultados: Os transtornos mentais foram a principal causa de afastamento no trabalho durante o ano de estudo, um total de 92 servidores afastados por este motivo, representando 3% dos servidores do órgão, com 5.081 dias perdidos de trabalho no período do estudo. Os transtornos do humor e os relacionados ao estresse foram os mais frequentes. Os transtornos mentais por uso de substâncias psicoativas e os diagnósticos de disfunções fisiológicas representaram a maior média de dias de afastamento por servidor. Conclusão: Os resultados reforçam que a concepção de saúde mental e o trabalho são indissociáveis no aspecto de produtividade e eficiência no serviço público federal. Sob esta ótica, a gestão da instituição apoiou a criação de serviço multidisciplinar para apoio psicológico aos servidores afastados. Palavras-chave | transtornos mentais; saúde do trabalhador; setor público. ABSTRACT | Background:Mental disorders are one of the main causes of absenteeism in Brazil. The aim of the present study was to describe the occurrence of mental and behavioral disorders (MBD) among federal civil servants, present the data to managers and suggest measures to reduce absenteeism in this population. Methods: In the present cross-sectional study performed from January through December 2016 we analyzed medical records of employees at a public institution in the state of Ceará, Northeastern Brazil, who were granted sick leaves for MBD. The data were obtained from the Integrated Subsystem of Workers' Health Care (Subsistema Integrado de Atenção à Saúde do Servidor -SIASS) platform and the Federal Government's Transparency Portal. Results: Mental disorders were the main cause of sick leaves along the analyzed period. Ninety-two employees were away from work for this reason, corresponding to 3% of the institution's employees and accounting for 5,081 working days lost. Mood and stress-related disorders were the most frequent causes of sick leaves. Mental disorders due to psychoactive substance use and physiological disturbances accounted for longest average number of sick leave days per employee. Conclusion: The results reinforce the notion that mental health and work are indissociable in regard to productivity and efficiency within federal public service. The institutio...

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The present report shows the occurrence of thrombotic thrombocytopenic purpura (TTP) associated with acute dengue and chikungunya virus coinfection, manifesting as a severe disease with high mortality potential. The patient was a 28 year-old man with clinical and epidemiological diagnosis of arboviruses infections who developed thrombocytopenia and anemia, after which oral corticosteroid therapy was started. On the third day of hospitalization, he showed neurological alterations that simulated a cerebral vascular accident, but the imaging examination did not identify ischemic or hemorrhagic alterations. At that moment, the TTP hypothesis was raised so that plasmapheresis and corticosteroid pulse therapy were started, have been essential for the favorable evolution of the case.

Objectives: to describe the clinical-epidemiological profile of children and adolescents notified by COVID-19 in Ceará. Methods: descriptive epidemiological study from open data repositories of the State Government of Ceará, about cases of OVID-19 in children and adolescents, from 03/15/2020 to 07/31/2020. For data analysis the tests χ2 Pearson, Fisher's exact and Poisson's regression with robust variance were used. Results: 48,002 cases of children and adolescents suspected of COVID-19 were reported, of which 18,180 (8.9%) were confirmed. The median of confirmed cases was 12 years old, 10.5% were newborns/lactants, 10.7% were pre-school children, 21.2% were school children and 57.7% were adolescents. They evolved to death 0.3% of the cases, of which 15% had comorbidities. They needed hospitalization 1.8% of the cases. The highest probability of hospitalization was found in newborns/lactants, male and with comorbidities. Conclusions: most of the confirmed cases occurred in adolescents, however, the evolution of the disease was more severe and with greater need for hospitalization in the age group of newborns/lactants, being the male gender and the presence of comorbidities additional factors for the need for hospitalization.

Objective: To investigate the association between occupational stressors and Burnout dimensions among Brazilian firefighters. Method:A cross-sectional study about firefighters (n=237) was developed in Fortaleza, Northeast of Brazil. Logistic regression analysis was applied to investigate the association between high strain (high demand and low job control), low social support, high operational exposure, and Burnout dimensions (emotional exhaustion, depersonalisation, and low personal accomplishment).Results: High strain was associated to emotional exhaustion (OR=11.65; 95%CI: 3.92-34.60) and depersonalisation (OR=5.43; 95%CI: 2.03-14.58). Low social support was associated to emotional exhaustion (OR=2.86; 95%CI: 1.24-6.60) and low personal accomplishment (OR=2.59; 95%CI: 1.36-4.93). High operational exposure did not increase the odds of emotional exhaustion and depersonalisation and decreased the odds of low personal accomplishment (OR=0.31; 95%CI: 0.10-0.94). Conclusion:The study highlights the heterogeneous effects that operational and organisational stressors have on each dimension of Burnout.

ARTIGO ORIGINAL RESUMO | Introdução:Os profissionais que trabalham no Serviço de Atendimento Móvel de Urgência (SAMU) lidam com situações extremas, as quais exigem altas demandas psicológicas. Objetivo: Investigar as redes de relações entre trabalhadores do SAMU-Ceará, no Nordeste do Brasil. Método: Trata-se de um estudo de caso de natureza qualitativa, em que foram feitas entrevistas semiestruturadas com uma equipe do SAMU-Ceará. Primeiramente, para traçar as redes de relacionamento, foram entrevistados três profissionais do serviço, entre médicos e enfermeiros. Com base nessas entrevistas, entrevistaram-se mais dois trabalhadores, que foram citados pelos entrevistados anteriores. Para a análise textual dos discursos obtidos, foi empregado o programa Interface de R pour lês Analyses Multidimensionnelles de Textes et de Questionnaires (iRaMuTeQ). As características estruturais da rede, como tamanho e densidade, foram conferidas pelos softwares UCINET 6.123 e NetDraw 2.38. Resultados: Os entrevistados estavam no serviço havia pelo menos um ano. As conexões configuradas com base nas entrevistas evidenciaram a inter-relação entre as redes dos entrevistados, e observamos a prevalência de vínculos fracos e desarticulados, muito embora dois dos entrevistados trabalhassem no mesmo setor. Na análise dos discursos, obtivemos três classes: 1) características do trabalho em equipe e sua forma peculiar de execução; 2) aspectos relacionais e subjetivos voltados para a administração; 3) natureza dos serviços prestados. Conclusões: As redes sociais no SAMUCeará expressam um conjunto de colaboradores que se relacionam para responder às demandas dos usuários de maneira integrada, tentando respeitar a autonomia de cada um, contudo as redes revelam conflitos, ocasionando sofrimento psíquico no trabalho. Palavras-chave | rede social; pessoal de saúde; serviços médicos de emergência; estresse psicológico; esgotamento profissional. ABSTRACT | Introduction:Professionals at the Mobile Urgent Care Service (Serviço de Atendimento Móvel de Urgência -SAMU) face extreme situations which pose high psychological demands. Objective: To investigate networks of relationships among employees of SAMU-Ceará, in Northeastern Brazil. Methods: Case study of qualitative nature in which we conducted semi-structured interviews with SAMU-Ceará staff. To draw the relationship network, we first interviewed three professionals including physicians and nurses. Based on their narratives, we interviewed two further employees named by the former. We used program Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (iRaMuTeQ) for textual analysis of the narratives obtained. Structural network characteristics, such as size and density, were analyzed with software UCINET 6.123 and NetDraw 2.38. Results: The interviewees had worked at the service for one year at least. The connections identified based on the interviews evidenced interrelationship between networks involving the interviewees. The links found were weak and unarticulated,...

Investigating the relationship between exposure to chemical and biological agents at work and the occurrence of cardiovascular diseases in a Brazilian national health survey. Methods: A cross-sectional study using the database of 36.442 participants from the Brazilian National Health Survey. Logistic Regression analysis was performed for multivariable models. Results: After adjustments for key confounders, we observed that those individuals exposed to chemical agents and biological materials at work had 62% (95% CI: 1.20; 2.20) and 66% (95% CI: 1.03; 2.65), respectively, higher odds of having cardiovascular disease compared to employed individuals who did not report exposure to biological materials/chemical agents at work. Conclusion: This study draws attention to the role of chemical and biological risks in the occurrence of cardiovascular diseases. In this sense, it is necessary developing systematic and intersectoral actions for Workers' Health Surveillance to promote health and prevent chronic non-communicable diseases.

Mental disorders are the main cause of the young and economically active population worldwide and in Brazil to live with disabilities, being an important public health problem nowadays. The objective was to estimate the burden of mental disorders among professionals working to combat endemic diseases in a state in northeastern Brazil. Medical records of workers linked to the Brazilian Ministry of Health in Ceará State and fighting endemic diseases were surveyed and, from this, a historical cohort was made. The individual quantification of absenteeism by mental disorders (ICD F-chapter referring to mental disorders) was conducted considering a period of about 35 years, from admission (the 1980s) to December 2017. The global burden of disease was measured by the YLD indicator (years lost to disability). Considering that no deaths due to mental disorders were observed, the YLL indicator (years of life lost) was composed. The high mental disorders burden in this group of workers stands out, whose mood disorders, including depression, conferred a YLD equal to 18.6. This represents just over 18 years of work lived with a disability. Our findings reinforce the need to implement surveillance and health promotion actions in workers to promote effective interventions capable of contributing to the reduction of morbidity in workers and economically active people.