ABSTRACT
Resumo Objetivo: analisar a influência da escolaridade e do grau de parentesco na decisão familiar pela doação de córneas para transplantes. Método: desenho quantitativo, transversal e retrospectivo com amostra composta por 291 fichas das entrevistas realizadas com familiares de potenciais doadores de córneas de janeiro de 2015 a dezembro de 2017 de um hospital público, geral e de grande porte localizado no município de Porto Alegre, Rio Grande do Sul, Brasil. Resultados: entre os potenciais doadores deste tecido, 53,3% são do sexo masculino com idade média de 57 anos (57±11); 55,7% são casados e o turno mais frequente da ocorrência do óbito é o noturno com 29,6% dos casos. Em relação à decisão familiar, 60,8% dos entrevistados decidiram favoravelmente à doação. Existe associação entre doação e turno da entrevista, sendo a madrugada o menos favorável (p=0,04). O tempo médio entre o óbito e a realização da entrevista é de 1:39 (±1:20) e não influenciou na decisão familiar (p=0,63). Dos familiares entrevistados, 58,8% são do sexo feminino e 53,3% são descendentes do potencial doador. O parentesco descendente decide sobre a doação com maior frequência do que ascendentes, laterais ou cônjuges. A faixa etária do familiar entrevistado (41±13) tem diferença estatística em relação a do potencial doador. Há diferença entre decisão de doação e nível de escolaridade (p=0,03) sendo que familiares com maior escolaridade decidem com maior frequência favoravelmente a doação. Conclusões: escolaridade do familiar, grau de parentesco e turno da entrevista influenciam na decisão positiva para a doação de córneas para transplantes.
Abstract Objective: analyzing the influence of schooling and kinship on families' decision to donate corneas for transplants. Method: quantitative, cross-sectional and retrospective study whose sample comprised 291 records of interviews conducted with family members of potential corneal donors from January 2015 to December 2017, who were treated in a public, general and large-sized hospital in Porto Alegre City, Rio Grande do Sul State, Brazil. Results: 53.3% of the potential corneal donors were male at mean age of 57 years (57 ± 11); 55.7% were married and 29.6% of them died during the night shift, which was the shift when death took place more often. With respect to families' decision, 60.8% of interviewees decided for donation. There was association between donation and interview shift; dawn was the least favorable time (p = 0.04). The mean time between patients' death and the interview with family members was 1:39 (± 1: 20) and it did not influence families' decision (p = 0.63). Among the interviewed family members, 58.8% were women and 53.3% were descendants of the potential donor. Descendants decide about the donation more often than ascendants, siblings or spouses. The age group of the interviewed family members (41 ± 13) was statistically different from that of potential donors. There was association between schooling and decision to donate (p = 0.03); family members with higher schooling were more often favorable towards donation. Conclusions: Family members' schooling, degree of kinship and interview shift had positive influence on individuals' decision to donate corneal tissue for transplants.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Tissue Donors , Tissue and Organ Procurement , Interviews as Topic , Cornea , Educational Status , Family Relations , Cross-Sectional Studies , Retrospective Studies , Evaluation Studies as TopicABSTRACT
Objetivo: Describir las características clínicas, epidemiológicas y microbiológicas de pacientes con endocarditis infecciosa (EI). Material y métodos: Estudio retrospectivo y analítico. Se revisó historias clínicas de pacientes con diagnóstico probable o definitivo de EI según criterios de Duke modificados hospitalizados en el Hospital Nacional A. Loayza entre enero del 2003 y diciembre del 2007. Se determinó la frecuencia de EI y criterios diagnósticos, características clínicas, del ecocardiograma, microbiológicas, complicaciones, tratamiento y letalidad. Resultados: Se incluyeron 33 casos de EI, de los cuales 18 (54.5%) tuvieron diagnóstico definitivo. La incidencia calculada durante los cinco años fue de 0.91 casos por 1 000 hospitalizaciones. La media de edad fue de 40±13.58 años. El 75.75% fue de género masculino. La media del tiempo entre el inicio de síntomas y el diagnóstico fue de 9.53 semanas. En 16 (48.48%) pacientes hubo antecedente de cardiopatía, la más frecuente fue fiebre reumática (37.5%). La clínica más común fue soplo cardiaco (93.9%), fiebre (75.75%) y síntomas constitucionales (63.6%). La válvula más afectada por vegetaciones fue la válvula aórtica (60.6%). En 40.7% de casos hubo hemocultivo positivo, siendo Streptococo viridans el microorganismo más frecuentemente aislado (54.5%). La tasa de letalidad fue de 6%. Conclusiones: El perfil de la EI en el presente estudio es similar al de estudios recientes realizados en otros países, sobre todo en países de Sudamérica, donde la fiebre reumática y el Streptococo viridans continúan siendo la cardiopatía predisponente y el microorganismo más frecuente, a pesar de las nuevas tendencias acaecidas en éstas.
Objectives: To describe the clinical, epidemiologic and microbiologic characteristics of patients with infective endocarditis (IE). Methods: We perform a retrospective and analytical study. We reviewed the medical records of patients diagnosed with probable or definitive IE according to the modified Duke criteria, hospitalized at the National Hospital A. Loayza between January 2003 and December 2007. We determined the prevalence of IE and the frecuency of diagnostic criteria, clinical, echocardiographic and microbiologic characteristcs, complications, treatment and letality rate of IE. Results: We included 33 cases of IE, of which 18 (54.50%) had a definitive diagnosis. The incidence calculated over five years was 0.91 cases per 1 000 hospitalizations. Mean age was 40.1±13.58 years, and 75.5% were males. The average time between symptom onset and was 9.53 weeks. Sixteen (48.48%) patients had a history of heart disease, rheumatic fever was the most frequent (37.50%). Heart murmur (93.97%), fever (75.75%), and constitutional symptoms (63.60%) were the most common clinical presentation. The aortic valve was the most affected by vegetations (60.60%). In 40.7% of cases a positive blood culture was found, with Streptococo viridans as the most frequently isolated microorganism (54.50%). The lethality rate was 6%. Conclusions: The profile of IE in this study is similar to recents studies in other countries, especially in South America, where rheumatic fever and Streptococo viridans remain as the underlying cardiopathy and most common microorganism, although the new trends.
Subject(s)
Humans , Endocarditis , Endocarditis/epidemiology , Retrospective Studies , PeruABSTRACT
La macroglobulinemia de Waldenstrõm (MW) es una rara neoplasia hematológica, caracterizada por la proliferación linfoplasmocitaria, con producción monoclonal de inmunoglobulina M (IgM) e infiltración medular. Comunicamos el caso de un paciente de raza negra, con MW, quien presentó compromiso oftalmológico, con manifestaciones fundoscópicas, neurológicas, citopenia y síntomas constitucionales, derivados de la infiltración tumoral y de la gamapatia monoclonal. Asimismo, lesiones osteolíticas, raras en la MW. Se realiza una revisión de la literatura acerca de los criterios diagnósticos, epidemiología, fisiopatología y clínica de esta enfermedad muy poco informada en nuestro país.
WaldenstrõmÆs macroglobulinaemia (WM) is a rare haematological neoplasm characterized by bone marrow infiltration of lymphoplasmatic lymphoma and IgM monoclonal gammopathy. We report a case of a black patient with WM that presented ocular manifestations with funduscopic findings, neurologic manifestations, cytopenia, and constitutional symptoms related to tumor infiltration and monoclonal gammopathy. Also osteolytic bone lesions, rare in MW. We review the literature on the diagnostic criteria, epidemiology, pathogenesis and clinical manifestations of this disorder, unusual in our country.
Subject(s)
Humans , Male , Aged , Waldenstrom Macroglobulinemia , Neoplasms , Paraproteinemias , ViscosityABSTRACT
El lupus eritematoso sistémico es una enfermedad que afecta predominantemente a mujeres, presentándose con manifestaciones variables. Esta comunicación de caso trata sobre un paciente varón joven, que debuta con artropatía lúpica, variedad artropatía de Jaccoud. Se realiza una revisión de la literatura acerca de las características clínicas del lupus en el varón y sus diferencias con el cuadro clínico en la mujer.
Systemic lupus erythematosus is a disease that affects women predominantly, with variable manifestations. This is a case report on a young male patient that debuts with lupus arthropathy, variety JaccoudÆs arthropathy. We review the clinical characteristics of lupus in males and the differences with the disease in females.