Correlation between levels of perceived stress and depressive symptoms in the functional disability of patients with fibromyalgia

SUMMARY OBJECTIVE: The aim of this study was to evaluate the factors that are most correlated with the levels of functional disability in patients with fibromyalgia. METHODS: This is a cross-sectional descriptive study in which 42 patients diagnosed with fibromyalgia according to the criteria of the American College of Rheumatology reported their status using the following questionnaires: the Beck Depression Inventory, the Perceived Stress Scale 14, the Revised Fibromyalgia Impact Questionnaire, the Visual Analog Pain Scale, and the Health Assessment Questionnaire. RESULTS: Moderate to severe levels of depression (Beck Depression Inventory: 22.35±10.39), moderate to severe functional disability (Health Assessment Questionnaire: 1.28±0.58), and high levels of stress (Perceived Stress Scale 14: 31.59±10.02) were found. The correlation adjusted by multiple regression as a function of the Health Assessment Questionnaire indicated a negligible to weak positive correlation with perceived stress (r=0.11), while a moderately strong positive correlation was observed with the Visual Analog Pain Scale (r=0.55). Regarding physical exercise, one of the pillars of the treatment, a moderate negative correlation was found with the Health Assessment Questionnaire (r=-0.4). CONCLUSION: The pain levels were moderately influenced by depression severity. The factors most linked to functional disability are due to the pain levels but not to the perception of stress.

Quality of sleep and use of computers and cell-phones among university students

SUMMARY OBJECTIVE Evaluate the quality of sleep and its association with the use of computers and cell-phones among medicine and dentistry students. METHODS Cross-sectional and comparative study, which evaluated 425 students through a socioeconomic questionnaire, the Pittsburgh Sleep Quality Index(PSQI), and a questionnaire on their use of computers and cell phones. RESULTS Poor sleep quality was observed in 61.4% of medical students and in 60.1% of dentistry students. Medical students with poor sleep quality had a higher mean time of computer use at night when compared to those with good sleep quality (p=0.04), as well as for computer (p<0.001) and cell phone use (p<0.01) immediately before bedtime. Dentistry students with poor sleep quality had a higher average time of computer use before bedtime than those with good sleep quality (p=0.03). CONCLUSION Students should receive guidance on prevention strategies and quality of sleep care.

RESUMO OBJETIVO Avaliar a qualidade de sono e sua associação com uso de computadores e celulares em estudantes de medicina e odontologia. MÉTODOS Estudo transversal e comparativo, que avaliou 425 estudantes por meio de questionário socioeconômico, Índice de Qualidade do Sono de Pittsburgh (PSQI) e uso de computador e telefone celular. RESULTADOS Sono de má qualidade foi observado em 61,4% dos estudantes de medicina e em 60,1% de odontologia. Para os estudantes de medicina, os tempos médios de uso de computador durante a noite (p=0,04) e computador (p<0,001) e celular (p<0,001) imediatamente antes de dormir foram maiores para os estudantes com má qualidade de sono. Para os estudantes de odontologia, o tempo médio de uso do computador imediatamente antes de dormir foi maior para aqueles com má qualidade de sono (p=0,03). CONCLUSÃO Os estudantes devem receber orientações sobre estratégias de prevenção e cuidados com a qualidade do sono.

PRIMARY LYMPH NODE HEMANGIOMA IN A PATIENT WITH INVASIVE DUCTAL CARCINOMA / Hemangioma linfonodal primário em paciente com carcinoma ductal invasivo

Primary lymph node hemangioma is a rare entity with only a few cases having been reported in the literature. This article describes a case of a 68-year-old female patient with breast cancer who underwent modified radical mastectomy with a subsequent histopathological evaluation that revealed invasive ductal carcinoma histological grade III according to Nottingham's Combined Classification. Among the 14 resected lymph nodes, the presence of vascular proliferation (intranodal) was observed in one of them, consistent with primary nodal hemangioma. Thus, knowledge about this clinical entity is important in order to establish the correct differential diagnosis with malignant primary neoplasms and metastasis, in which therapeutics and prognosis are very different

Hemangioma linfonodal primário é uma entidade rara, sendo que poucos casos foram descritos na literatura. Neste artigo foi relatado o caso de uma paciente de 68 anos com neoplasia mamária à direita e que foi submetida à mastectomia radical modificada com posterior avaliação histopatológica, que evidenciou carcinoma ductal invasor de grau histológico III, conforme Classificação Combinada de Nottingham. Dentre os 14 linfonodos ressecados, foi observada em 1 deles a presença de proliferação vascular (intranodal) consistente com hemangioma nodal primário. Dessa forma, o reconhecimento dessa entidade clínica torna-se imprescindível para a realização de diagnóstico diferencial de neoplasias malignas primárias ou metastáticas, que apresentam terapêuticas e prognósticos totalmente distintos

The use of drugs and medical students: a literature review

SUMMARY INTRODUCTION The consumption and abuse of alcohol and other drugs are increasingly present in the lives of university students and may already be considered a public health problem because of the direct impacts on the physical and mental health of these individuals. The requirements of the medical program play a vital role in the increasing rate of drug users. OBJECTIVES To carry out a systematic review of the literature on the use of drugs, licit or not, in Brazilian medical students. METHODS A descriptive-exploratory study, in which the SciELO and MEDLINE databases were used. A total of 99 articles were found, of which 16 were selected for this review. RESULTS Alcohol and tobacco were the most frequently used licit drugs among medical students. The most consumed illicit drugs were marijuana, solvents, "lança-perfume" (ether spray), and anxiolytics. The male genre presented a tendency of consuming more significant amounts of all kinds of drugs, with the exception of tranquilizers. It was found an increasing prevalence of drug consumption in medical students, as the program progressed, which may result from the intrinsic stress from medical school activities. Students who do not use psychoactive drugs are more likely to live with their parents, to disapprove drugs consumption, to practice religious beliefs and to be employed. Conclusion The prevalence of licit and illicit drug use among medical students is high, even though they understand the injuries it may cause.

RESUMO INTRODUÇÃO O consumo e o abuso de álcool e outras drogas estão cada vez mais presentes na vida dos estudantes universitários, e podem ser considerados problemas de saúde pública pelos potenciais prejuízos acarretados na saúde física e mental. No curso de medicina, as exigências acadêmicas e o estresse têm papel fundamental no aumento do uso de drogas entre os estudantes. OBJETIVO Realizar uma revisão sistemática da literatura sobre o uso de drogas, lícitas e ilícitas, em estudantes de medicina brasileiros. MÉTODOS Estudo de revisão de literatura, cuja fonte bibliográfica foram os portais de periódicos SciELO e Medline. No total, 99 artigos foram encontrados, dos quais 16 foram selecionados para esta revisão. RESULTADOS O álcool e o tabaco foram as drogas mais consumidas por estudantes de medicina. Dentre as drogas ilícitas, as mais frequentemente utilizadas incluem maconha, solventes, lança-perfume e ansiolíticos. O sexo masculino apresentou maior proporção de consumo de todos os tipos de drogas, com exceção de tranquilizantes. Foi encontrado um aumento da prevalência de consumo de drogas ao longo do curso de medicina, o que pode ser resultante do estresse próprio das atividades do curso. Estudantes que fazem menos uso de substâncias psicoativas tendem a viver com os pais, não possuir vínculos próximos com usuários de drogas, desaprovar o consumo de drogas, possuir e praticar crenças religiosas e trabalhar. CONCLUSÃO A prevalência de consumo de drogas lícitas e ilícitas entre estudantes de medicina é alta, mesmo eles tendo conhecimento sobre os malefícios que o uso pode causar.