RESUMO Objetivo: Quantificar a retroversão pélvica durante avaliação clínica da flexão do quadril com acelerômetros e verificar a confiabilidade destes sensores para mensurar flexão do quadril. Métodos: Posicionou-se um acelerômetro lateralmente na pelve para mensurar retroversão pélvica. Outro foi posicionado anteriormente sobre a coxa para avaliar flexão do quadril. As avaliações foram realizadas com voluntários, em decúbito dorsal, por três avaliadores. Para avaliação da retroversão pélvica, determinou-se a média ± DP (mínimo-máximo). Avaliou-se a confiabilidade dos acelerômetros entre avaliadores pelo coeficiente de correlação intraclasse (CCI). Determinou-se o coeficiente de correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro. Resultados: A retroversão pélvica média foi de 7,3° ± 0,93° (6°-11°), mensurada no limite clínico da flexão do quadril, que foi de 106,25° ± 10,46° (93°-130°), ambos com acelerômetro. Os CCI entre dois avaliadores diferentes nas avaliações de flexão do quadril foram de 0,60, 0,71 e 0,74 (goniômetro) e 0,46, 0,71 e 0,83 (acelerômetro). A correlação linear entre as mensurações de flexão do quadril com goniômetro e acelerômetro foi de 0,87. Conclusão: Durante avaliação clínica da amplitude final de flexão do quadril, houve movimentação associada da pelve aproximadamente de 7,3°. Acelerômetros mostraram-se confiáveis para mensuração da flexão do quadril. Nível de evidência III, Estudo de pacientes não consecutivos sem padrão de referência “ouro” aplicado uniformemente.

ABSTRACT Objective: To quantify pelvic retroversion during clinical evaluation of hip flexion with accelerometers and to verify the reliability of these sensors to measure hip flexion. Methods: An accelerometer was positioned laterally in the pelvis to measure pelvic retroversion. Another accelerometer was positioned anteriorly on the thigh to evaluate hip flexion amplitude. The evaluations were performed with volunteers in supine position by three raters. For evaluation of pelvic retroversion, the mean ± SD (minimum-maximum) was calculated. Reliability of the accelerometer between raters was determined by intraclass correlation coefficients (ICC). The linear correlation coefficient between hip flexion was determined by using goniometer and accelerometer. Results: The mean pelvic retroversion was 7.3° ± 0.93° (6°-11°) in the clinical limit of the hip range of motion, which was 106.25° ± 10.46° (93°-130°). The ICC between two raters were 0.60, 0.71 and 0.74 (goniometer) and 0.46, 0.71 and 0.83 (accelerometer). The linear correlation between hip flexion measurements with goniometer and accelerometer was 0.87. Conclusion: During clinical evaluation of the final range of hip flexion, there was an associated pelvic movement of approximately 7.3º. Accelerometers have proven to be reliable for measurement of hip flexion. Level of Evidence III, Study of nonconsecutive patients with no gold reference standard applied uniformly.

Abstract: INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.

ResumoOBJETIVOValidar o instrumento Body Image Relationship Scale (BIRS) em mulheres brasileiras acometidas pelo câncer de mamaMÉTODOSO instrumento foi aplicado por entrevistadoras treinadas em 139 usuárias do Sistema Único de Saúde que foram submetidas aos tratamentos do câncer entre 2006 e 2010. O instrumento foi aferido considerando-se a consistência interna e a confiabilidade. Para efeito de comparação as técnicas de análise fatorial utilizadas no artigo original foram aplicadasRESULTADOSO valor de correlação Spearman-Brown foi 0,8, o que indica alto nível de confiabilidade, e o alfa de Cronbach encontrado foi 0,9, indicando alto nível de consistência interna. A análise fatorial mostrou que quatro questões não tinham poder discriminatório e carga fatorial baixa e outras cinco foram realocadas em outros domínios. Dessa forma, foi aplicada e mostrou variabilidade semelhante ao instrumento originalCONCLUSÃOA versão brasileira do BIRS, renomeada como Escala de Relacionamento e Imagem Corporal (ERIC), apresentou evidências de adequada confiabilidade e consistência interna, o que torna esse instrumento recomendável para aplicação em mulheres brasileiras com câncer de mama, apesar de alguns poucos limites

AbstractPURPOSETo validate the instrument Body Image Relationship Scale (BIRS) for Brazilian women with breast cancerMETHODSThe instrument was administered by trained interviewers to 139 women who used the Brazilian Unified Health System (SUS). All of them had been submitted to cancer treatments between 2006 and 2010. The instrument was validated considering internal consistency and reliability. In order to compare the techniques, the same factorial analysis as used in the original paper was carried outRESULTSThe Spearman-Brown correlation value was 0.8, indicating high internal reliability. The Cronbach's alpha found was 0.9, indicating a high level of internal consistency. Factorial analysis showed that four items had low factorial load and no discriminatory power, and another five items were relocated to other factors. When the instrument was applied, it showed variability to that of the original instrumentCONCLUSIONThe Brazilian version of the Body Image Relationship Scale (BIRS), namedEscala de Relacionamento e Imagem Corporal (ERIC), showed evidence of adequate reliability and internal consistency, making this instrument suitable to be recommended for application to Brazilian women with breast cancer, despite some limitations.

OBJETIVO: Compreender a vida sexual e reprodutiva de mulheres tratadas de câncer de mama. MÉTODOS: Foram entrevistadas 139 mulheres com diagnóstico há pelo menos seis meses, selecionadas aleatoriamente em um serviço de reabilitação. As entrevistas foram feitas entre 2006 e 2010. Todas eram usuárias do SUS, pacientes de um hospital regional e moradoras da região DRS XIII-Ribeirão Preto, Estado de São Paulo. As entrevistadas foram visitadas em seu domicílio onde foi aplicado um questionário face a face que abordava questões relativas às características sociodemográficas, da doença e da vida reprodutiva e sexual, para esta última aplicou-se o instrumento Índice de Função Sexual Feminina (IFSF). A análise estatística incluiu o teste do χ², o teste exato de Fisher e o teste t de Student, análise multivariada por regressão logística e análise fatorial e alfa de Cronbach. RESULTADOS: A maioria teve entre 2 e 3 filhos e 80% utilizaram algum método anticoncepcional. Cerca de metade das mulheres tiveram relação sexual no último mês, 45,3% interromperam as relações sexuais durante o tratamento e 25,9% não interromperam. Houve relato de diminuição da frequência sexual, embora metade das entrevistadas tenha retomado a vida sexual nos primeiros seis meses após o tratamento. Pouco mais de metade apresentou insatisfação sexual. Encontrou-se vida sexual ativa associada à idade menor que 40 anos e a ter parceiro. Não foi encontrada associação entre vida sexual ativa e ao diagnóstico e tipos de tratamento. CONCLUSÃO: A atividade sexual de mulheres tratadas para câncer de mama não está associada aos tratamentos, mas à idade e à oportunidade de ter sexo.

PURPOSE: To understand the reproductive and sexual life of women treated for breast cancer. METHODS: A total of 139 women with a diagnosis made at least 6 months ago were interviewed after being randomly selected in a rehabilitation service. The interviews were carried out between 2006 and 2010. The inclusion criteria were: to have used a rehabilitation service between 2006 and 2010, to be a Unified Health System user, to have been a patient at a regional hospital and to be resident in the area of DRS XIII-Ribeirão Preto, state of São Paulo. The interviewees were visited at home where a face to face questionnaire regarding sociodemographic features and questions about the disease and reproductive and sexual life was administered. For the last one, the Female Sexual Function Index instrument was used. Data were analyzed statistically by the χ² test, Fisher exact test, Student's t test, multivariate analysis by logistic regression, factorial analysis and the Cronbach's alpha. RESULTS: Most patients had between 2 to 3 children and 80% used some contraceptive. About half of them had had sexual intercourse in the last month, 45.3% had interrupted sexual intercourse during treatment and 25.9% did not. There were reports of decreasing sexual activity, although half of the interviewees had re-started sexual life during the first six months after treatment. About half presented sexual dissatisfaction. An active sexual life is associated with being younger than 40 years of age and to have a partner. No association was found between active sexual life and diagnosis and types of treatment. CONCLUSION: Sexual activity of women treated for breast cancer is not associated with the treatments, but with age and with the opportunity of having sex.

Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. have become a major problem all around the world. This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens, and also because this kind of resistance can spread to a wide variety of Gram-negative bacilli. Our objectives wereto evaluate among in-patients at a publicuniversity tertiary-care hospital with documented infection due to Klebsiella spp., which were the risk factors (cross-sectional analysis) and the clinical impact (prospective cohort) associated with an ESBL-producing strain. Study subjects were all patients admitted at the study hospital between April 2002 and October 2003, with a clinically and microbiologically confirmed infection caused by Klebsiella spp. at any body site, except infections restricted to the urinary tract. Of the 104 patients studied, 47 were infected with an ESBL-producing strain and 57 with a non-ESBL-producing strain. Independent risk factors associated with infection with an ESBL-producing strain were young age, exposure to mechanical ventilation, central venous catheter, use of any antimicrobial agent, and particularly use of a 4th generation cephalosporin or a quinolone. Length of stay was significant longer for patients infected with ESBL-producing strains than for those infected with non-ESBL-producing strains, although fatality rate was not significantly affected by ESBL-production in this cohort. In fact, mechanical ventilation and bacteremia were the only variables withindependent association withdeath detected in this investigation.