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Arch. endocrinol. metab. (Online) ; 65(2): 152-163, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248820


ABSTRACT Objective: To evaluate the reasons for request of bone mineral density (BMD) evaluation and correlate the BMD results with previous fractures, risk factors for osteoporosis, and clinical characteristics in patients with obesity. Subjects and methods: Cross-sectional, retrospective, single-site study including adult patients with body mass index (BMI) ≥ 30 kg/m2 and BMD evaluation between January 2015 and May 2016 selected from a BMD database. Data on demographic characteristics, lifestyle habits, comorbidities, medications, risk factors, previous fractures, and indications for BMD evaluation were collected from the participants' medical records. Results: The study included 619 patients (89.9% women, mean BMI 34.79 ± 4.05 kg/m2). In all, 382 (61.7%), 166 (26.8%), and 71 (11.5%) patients had class 1, 2, and 3 obesity, respectively. The most frequent (29.9%) reason for BMD evaluation was for osteoporosis monitoring. In all, 69.4% of the patients had low BMD. Multivariate analysis showed that age, calcium supplementation, and previous osteoporosis or osteopenia were associated with low BMD, while age, vitamin D supplementation, use of proton pump inhibitors (PPIs), and low BMD were associated with previous fractures (p < 0.05 for all). Conclusions: Among patients with obesity identified from a tertiary hospital database, those with low bone mass and risk factors traditionally associated with fractures had an increased history of fractures. Patients with greater BMI had better bone mass and fewer fractures. These findings indicate that the association between reduced weight, risk factors for osteoporosis, and fractures remained despite the presence of obesity in our population.

Humans , Male , Female , Adult , Osteoporosis/etiology , Osteoporosis/epidemiology , Bone Diseases, Metabolic/etiology , Bone Diseases, Metabolic/epidemiology , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Obesity/complications
Rev. Pesqui. Fisioter ; 10(1): 33-42, Fev. 2020. ilus
Article in English, Portuguese | LILACS | ID: biblio-1151946


INTRODUÇÃO: A presença de Síndrome de Burnout (SB) e Depressão vêm aumentando devido às rotinas extenuantes vivenciadas pelos anestesiologistas. OBJETIVO: Identificar a prevalência de Depressão e Síndrome de Burnout em anestesiologistas e residentes desta especialidade médica do Centro Cirúrgico de um Hospital. MÉTODO: Estudo transversal, descritivo e exploratório. Participaram da pesquisa 51 profissionais, sendo utilizados dois questionários, ambos autoaplicáveis: os Inventários de Maslach Burnout (MBI) e Depressão de Beck, além de uma breve conversa a respeito da rotina de trabalho dos profissionais. RESULTADOS: Para a SB, verificou-se a presença desta em 3 médicos e 5 residentes. Já para a depressão; encontrou-se níveis de mínima (24 indivíduos), leve (4 indivíduos), moderada (4 indivíduos) e grave depressão (1 indivíduo). CONCLUSÃO: Embora obtido baixos valores para a SB e Depressão grave, é relevante destacar que sinais e sintomas iniciais destas patologias estão presentes em muitos profissionais, sendo que a persistência da rotina em que se encontram pode acentuar a aparição de ambas.

INTRODUCTION: The presence of Burnout Syndrome (BS) and Depression have been increasing, due the strenuous routines experienced by anesthesiologists. OBJECTIVE: To identify the prevalence of Depression and BS in anesthesiologists and residents of this medical specialty of a School's Hospital. METHOD: Cross-sectional, descriptive and exploratory study. A total of 51 professionals participated in this study It was used two questionnaires, both self-applied: the Maslach Burnout Inventory (MBI) and Beck Depression Inventory, as well as a interview about the work routine of them. RESULTS: BS was detected in 3 physicians and 5 residents. Furthermore, for depression (24 individuals), mild (4 individuals), moderate (4 individuals) and severe depression (1 individual). CONCLUSION: Although low values are obtained for SB and severe depression, it is important to emphasize that initial signs and symptoms of these pathologies are present in many professionals. Besides that, if the strenuous routine persists it may accentuate or develop the symptons.

Burnout, Psychological , Occupational Health , Anesthesiologists
Adv Rheumatol ; 60: 18, 2020. tab
Article in English | LILACS | ID: biblio-1088642


Abstract Objective: Correlate serum magnesium (Mg) and Calcium (Ca) levels with body composition and metabolic parameters in women with fibromyalgia (FM). Patients and methods: Cross-sectional study compared with a control group paired by age and body mass index (BMI) of adult women diagnosed with fibromyalgia. All participants went through assessment of their body composition through dual-energy X-ray absorptiometry (DXA) and had blood samples collected for dosing of Mg, Ca, C-reactive Protein (CRP), lipidogram and glycemia. Results: 53 women with FM (average age 48.1 ±8.2 years, average BMI 26.6 ±4.5 kg/m2) and 50 control women (average age 47.1 ±9.9 years, average BMI 25.6 ± 3.6 kg/m2) participated in the study. Serum levels turned out to have inverse correlation with CRP in the FM group (r = −0.29, p = 0.03) and with BMI and glycemia in the control group (r = 0.31; p = 0.02 and r = 0.48; p = 0.0004 respectively). Serum levels of calcium correlated with triglycerides (r = 0.29; p = 0.03) in the FM group and with glycemia in the control group (r = 0.64; p = 0.0001). Conclusions: In patients with FM, magnesemia turned out to have inverse correlation with CRP and calcemia had positive association with triglycerides.(AU)

Humans , Female , Fibromyalgia/physiopathology , Calcium/blood , Magnesium/blood , Triglycerides/blood , Blood Glucose , Body Composition , C-Reactive Protein , Cross-Sectional Studies/instrumentation , Cholesterol, HDL/blood , Cholesterol, LDL/blood
ABCD arq. bras. cir. dig ; 33(1): e1484, 2020. tab, graf
Article in English | LILACS | ID: biblio-1088501


ABSTRACT Background: Hepatectomies promote considerable amount of blood loss and the need to administrate blood products, which are directly linked to higher morbimortality rates. The blood-conserving hepatectomy (BCH) is a modification of the selective vascular occlusion technique. It could be a surgical maneuver in order to avoid or to reduce the blood products utilization in the perioperative period. Aim: To evaluate in rats the BCH effects on the hematocrit (HT) variation, hemoglobin serum concentration (HB), and on liver regeneration. Methods: Twelve Wistar rats were divided into two groups: control (n=6) and intervention (n=6). The ones in the control group had their livers partially removed according to the Higgins and Anderson technique, while the rats in the treatment group were submitted to BCH technique. HT and HB levels were measured at day D0, D1 and D7. The rate between the liver and rat weights was calculated in D0 and D7. Liver regeneration was quantitatively and qualitatively evaluated. Results: The HT and HB levels were lower in the control group as of D1 onwards, reaching an 18% gap at D7 (p=0.01 and p=0.008, respectively); BCH resulted in the preservation of HT and HB levels to the intervention group rats. BCH did not alter liver regeneration in rats. Conclusion: The BCH led to beneficial effects over the postoperative HT and serum HB levels with no setbacks to liver regeneration. These data are the necessary proof of evidence for translational research into the surgical practice.

RESUMO Racional: As hepatectomias compreendem considerável perda sanguínea e utilização de hemoderivados, o que diretamente estão relacionados com maior morbimortalidade. A hepatectomia hemoconservadora (HH) é modificação da técnica de oclusão vascular seletiva em hepatectomia. Ela pode ser alternativa cirúrgica para evitar ou diminuir o uso de hemoderivados no perioperatório. Objetivo: Avaliar os efeitos da HH sobre o volume globular (VG), concentração de hemoglobina (HB) e sobre a regeneração hepática em ratos. Métodos: Dois grupos de ratos Wistar foram constituídos: controle (n=6) e intervenção (n=6). Os do grupo controle foram submetidos à hepatectomia parcial de Higgins e Anderson e os do grupo Intervenção à HH. VG e HB foram medidos nos dias D0, D1 e D7. A relação peso do fígado/peso do rato foi calculada em D0 e D7. A regeneração hepática foi analisada qualitativamente e quantitativamente. Resultados: Houve diminuição dos níveis de VG e HB nos ratos do grupo controle a partir de D1, atingindo decréscimo de 18% em D7 (p=0,01 e p=0,008 respectivamente); a HH permitiu a manutenção dos níveis de VG e HB nos ratos do grupo intervenção. A HH não alterou a regeneração hepática. Conclusão: HH resultou em níveis maiores de VG e HB pós-operatórios sem alterar a regeneração hepática. Pode-se considerar estes dados como a prova necessária para a translação à pesquisa clinicocirúrgica.

Animals , Male , Rats , Veins/physiology , Hepatectomy/methods , Liver/surgery , Liver/blood supply , Liver Regeneration , Portal Vein/surgery , Postoperative Period , Blood Volume/physiology , Hepatic Veno-Occlusive Disease/physiopathology , Hemoglobins/analysis , Rats, Wistar , Hematocrit
Rev. Soc. Bras. Med. Trop ; 53: e20170498, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057294


Abstract INTRODUCTION: We report the results of the active surveillance of influenza infections in hospitalized patients and the evaluation of the seasonality and correlation with temperature and rainfall data. METHODS: During the 2-year study period, 775 patients were tested for 15 respiratory viruses (RVs). RESULTS: Most of the 57% of (n=444) virus-positive samples were human rhinovirus and respiratory syncytial virus. However, 10.4% (n=46) were influenza virus (80% FluA; 20% FluB). Age and SARI were significantly associated with influenza. FluB circulation was higher is 2013. CONCLUSIONS: In the post-epidemic period, influenza remains an important cause of hospitalization in SARI patients.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Respiratory Tract Infections/virology , Influenza, Human/epidemiology , Referral and Consultation , Respiratory Tract Infections/epidemiology , Seasons , Severity of Illness Index , Brazil/epidemiology , Sentinel Surveillance , Hospitalization , Middle Aged
Rev. bras. parasitol. vet ; 28(3): 383-394, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1042517


Abstract This study evaluated the seroprevalence of Toxoplasma gondii, Neospora caninum and Leptospira spp. in dogs from Foz do Iguaçu, Paraná, Brazil. Indirect immunofluorescent antibody test was used to detect antibodies anti-T.gondii and anti-N. caninum. Immunoenzymatic assay and microscopic serum agglutination were used for screening antibodies anti-T.gondii and anti-Leptospira spp., respectively. The results were: 67.02% of the samples reactive for T.gondii and 1.38% for N. caninum, both without statistically significant variables. For Leptospira spp. the results indicated seroprevalence of 23.11%. The analysis of the variables without distinction of serovar showed association for intrinsic characteristics as breed, age, nutritional status and dog category. The extrinsic variables as city region and access to the street presented association (p<0.05). The most prevalent serovars were: Canicola 59.47%; Bratislava 13.07% and Butembo 15.68%. Variables that make up the adjusted multiple analysis model using Leptospira spp. were: age, breed and nutritional status; serovar Canicola, sex, nutritional status and area (p<0.05); serovar Bratislava, lymphadenomegaly and presence of fleas (p<0.05). Given the results obtained, dogs can be used as sentinels for toxoplasmosis and leptospirosis in Foz do Iguaçu and other cities with similar outcomes. In addition, preventive measures should be taken by health authorities because they are zoonoses and humans are also at risk.

Resumo Este estudo avaliou a soroprevalência de Toxoplasma gondii, Neospora caninum e Leptospira spp. em cães de Foz do Iguaçu, Paraná, Brasil. O teste de imunofluorescência indireta foi utilizado para detectar anticorpos anti-T. gondii e anti-N. caninum. Ensaio imunoenzimático e soroaglutinação microscópica foram utilizados para pesquisa de anticorpos anti-T. gondii e anti-Leptospira spp., respectivamente. Os resultados obtidos foram: 67,02% (435/649) das amostras reativas para T. gondii e, 1,38% (9/649) para N. caninum, ambas com ausência de variáveis significativas estatisticamente. Para Leptospira spp. os resultados indicaram soroprevalência de 23,11% (153/649). A análise das variáveis sem distinção de sorovar mostraram associação para caraterísticas intrísecas como raça, idade, estado nutricional e categoria de cães. Para as variáveis extrínsecas, a região da cidade e ter acesso à rua mostraram associação estatística (p<0,05). Os sorovares mais prevalentes foram: Canicola com 59,47% (91/153); Bratislava 13,07% (20/153) e Butembo 15,68% (24/153). As variáveis que compõem o modelo de análise multivariada ajustada usando como desfecho Leptospira spp. foram: idade, raça, estado nutricional e área. Para o sorovar Canicola, as variáveis significantes (p<0,05) foram sexo, estado nutricional e área; para o sorovar Bratislava, as variáveis significantes (p<0,05) foram linfadenomegalia e presença de pulgas. Dos resultados obtidos, cães podem ser usados como sentinelas para infecção por T. gondii e Leptospira spp. na cidade de Foz do Iguaçu e em outras cidades com desfechos similares. Além disso, medidas preventivas devem ser tomadas pelas autoridades de saúde, pois são zoonoses e os seres humanos também estão em risco.

Animals , Dogs , Toxoplasmosis, Animal/epidemiology , Coccidiosis/veterinary , Dog Diseases/epidemiology , Leptospirosis/veterinary , Toxoplasma/immunology , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Antibodies, Protozoan/blood , Seroepidemiologic Studies , Toxoplasmosis, Animal/diagnosis , Risk Factors , Coccidiosis/diagnosis , Coccidiosis/epidemiology , Neospora/immunology , Fluorescent Antibody Technique, Indirect , Dog Diseases/diagnosis , Leptospira/immunology , Leptospirosis/diagnosis , Leptospirosis/epidemiology , Antibodies, Bacterial/blood
Rev. bras. educ. méd ; 43(3): 134-144, jul.-set. 2019. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1003430


ABSTRACT In recent years, Multiple Intelligences (MI - bodily-kinesthetic, spatial, intrapersonal, interpersonal, linguistic, logical-mathematical, musical, and naturalist) and Learning Preferences (LP - visual, aural, read/write, kinesthetic, and multimodal) have been intensely studied throughout the world. In this context, plenty of tools that evaluate such parameters have been created and later improved over the past decades. Nowadays, the necessity for optimal learning strategies and more individualized teaching continues to rise, reinforcing the importance of identifying individual strengths and cognitive preferences. Objectives to analyze the distribution of MI - and how they influence one another - and LP in medical students at the Federal University of Paraná (UFPR), Brazil. The results could lead to improvements in the educational setting. Methods a descriptive cross-sectional study involving UFPR medical students of all 12 semesters, who were analyzed through questionnaires with regard to both their MI ("Multiple Intelligences Checklist for Students") and LP ("Visual, Aural, Read/Write, Kinesthetic - VARK - Questionnaire"). Results a total of 1054 questionnaires were processed (527 students). Intrapersonal (71 ± 10.5), logical-mathematical (69.3 ± 14), and linguistic (68.4 ± 11.8) intelligences predominated, whereas naturalist achieved the lowest mean score (47.3 ± 19.5). Positive correlations were identified between all of the MI. Regarding the LP, the multimodal (42.3%) was the most frequent, followed by visual (21.3%), aural (18.6%), kinesthetic (11.2%), and read/write (6.6%). When both cognitive theories were correlated, the following associations prevailed: visual LP and intrapersonal intelligence; aural LP and interpersonal intelligence; read/write LP and logical-mathematical intelligence; kinesthetic LP and logical-mathematical intelligence; and multimodal preference and intrapersonal intelligence. Conclusions intrapersonal intelligence achieved the highest overall scores, followed by logical-mathematical and linguistic. Naturalist intelligence achieved the lowest scores in terms of semester, cycle, and overall analysis. All MI were positively correlated. Multimodality was the most commonly observed LP, whereas the read/write preference was the least frequent. Correlations initially expected between MI and LP were confirmed. As for future perspectives, it is expected that teachers and education managers adapt current teaching strategies in order to meet the students' preferences. Together, MI and LP indicate that the focus should not rely on how smart a given person is, but in which ways.

RESUMO Nos últimos anos, Inteligências Múltiplas (IM - corporal-cinestésica, espacial, intrapessoal, interpessoal, linguística, lógico-matemática, musical e naturalista) e Preferências de Aprendizagem (PA - visual, auditiva, leitura/escrita, cinestésica, multimodal) vêm sendo intensamente estudadas em todo o mundo. Em tal contexto, diversas ferramentas que avaliassem tais parâmetros foram criadas e posteriormente aprimoradas ao longo das últimas décadas. Atualmente, a necessidade de se utilizar as melhores estratégias de aprendizado e a crescente necessidade de que o ensino seja individualizado reforçam a importância de que sejam mapeadas as habilidades e preferências cognitivas individuais. Objetivos analisar as distribuições de IM - e como elas se influenciam - e das PA em estudantes de medicina da Universidade Federal do Paraná (UFPR), Brasil. Espera-se que os resultados estimulem melhorias no contexto educacional. Materiais e Métodos estudo transversal e descritivo envolvendo estudantes de medicina da UFPR de todos os 12 semestres, sendo analisados através de questionários quanto às suas MI e ("Lista de verificação para avaliar inteligências múltiplas de alunos") e PA ("Visual, Aural, Read/Write, Kinesthetic - VARK - Questionnaire", previamente traduzido e validado para a língua Portuguesa). Resultados 1054 questionários foram coletados e processados. As IM intrapessoal (71±10,5), lógico-matemática (69,3±14) e linguística (68,4±11,8) atingiram as maiores médias gerais, enquanto a naturalista registrou a menor pontuação (47,3±19,5). Observou-se correlação positiva entre todas as IM. Quanto às PA, prevaleceu a multimodal (42,3%), seguida por visual (21,3%), auditiva (18,6%), cinestésica (11,2%) e leitura/escrita (6,6%). Quando correlacionadas ambas as teorias cognitivas, sobressaíram-se as seguintes associações: PA visual e IM intrapessoal; PA auditiva e IM interpessoal; PA leitura/escrita e IM lógico-matemática; PA cinestésica e IM lógico-matemática; e PA multimodal e IM intrapessoal. Conclusão A IM intrapessoal atingiu maiores médias, seguida por lógico-matemática e linguística. A IM naturalista, por outro lado, obteve menores pontuações em termos de semestres, ciclos e análise geral. Todas as inteligências apresentaram influência apresentaram interdependência positiva. A multimodalidade foi a PA mais prevalente, enquanto leitura/escrita foi a menos observada. Correlações inicialmente esperadas entre IM e PA foram confirmadas. Quanto às perspectivas futuras, espera-se que professores e gestores educacionais adaptem estratégias de ensino atuais de modo a melhor contemplar as preferências dos estudantes. Em conjunto, IM e PA preconizam que atualmente não mais se questione o quão inteligente alguém seja, e sim de que maneiras o seria.

Arq. gastroenterol ; 56(2): 124-130, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1019462


ABSTRACT BACKGROUND: Treatment for inflammatory bowel disease (IBD) includes a variety of immunosuppressants and biological agents, which increase the risk of infections due to altered cellular and humoral immunity. Prevention of these infections can be done through vaccination, however, patients with IBD are usually under-immunized. OBJECTIVE: Analyze the immunization status of patients with IBD and confront it with the current recommendations to verify if the immunization guidelines are being followed correctly. METHODS: Analytical cross-sectional study including 239 IBD patients being regularly followed in the Gastroenterology Service from Hospital de Clínicas da Universidade Federal do Paraná, which were subjected to a survey about their relevant demographic data and immunization status. RESULTS: The amount of patients that declared being unaware of their immunization status is high - between 34.3% (Tdap) and 52% (meningococcal) - excepting IIV, hepatitis B and HPV. The vaccines with the largest rates of patients declaring to have taken it are inactivated influenza vaccine (72.4%), BCG (55.3%), hepatitis B (48.3%), measles, mumps and rubella vaccine (43.8%) and DTaP (43%). The vaccines with the lowest rates of patients declaring to have taken it are Haemophilus influenza type b (0.8%), herpes zoster (2.1%) and HPV (3.4%). Patients that are being treated or have been treated with biological therapy have the largest immunization coverage for inactivated influenza vaccine (81%) and PPSV23 (25.9%), also they have the largest awareness rates for those vaccines. CONCLUSION: Although being a specialized service linked to a university hospital, vaccination coverage and patients' awareness rates proved to be below the desirable level. Vaccination and recovery of the immunization history is recommended immediately after the diagnosis of IBD, regardless of the use of biological agents. Those findings support the need of implementing hospital guidelines and constantly verifying its application by the multidisciplinary team in specialized services in IBD.

RESUMO CONTEXTO: No tratamento de doenças inflamatórias intestinais (DII) são usados imunossupressores e agentes biológicos, o que aumenta o risco de infecções pela alteração da imunidade celular e humoral. A prevenção de algumas dessas infecções pode ser feita pela vacinação, entretanto pacientes com DII apresentam baixas taxas de cobertura vacinal. OBJETIVO: Analisar a situação vacinal de pacientes com DII e comparar com a recomendação vigente na literatura para verificar se os esquemas de imunização estão sendo corretamente aplicados nessa população. MÉTODOS: Estudo transversal analítico com 239 pacientes com DII em acompanhamento no Serviço de Gastroenterologia do Hospital de Clínicas da Universidade Federal do Paraná, os quais foram submetidos a um questionário sobre dados demográficos relevantes e sobre a situação vacinal. RESULTADOS: A taxa de pacientes que declarou não ter conhecimento de sua situação vacinal é alta - entre 34,3% (dTpa) e 52% (meningocócica) - com exceção das vacinas influenza, hepatite B e HPV. As vacinas com maior taxa de pacientes que declararam ter recebido a vacina são influenza (72,4%), BCG (55,3%), hepatite B (48,3%), tríplice viral (43,8%) e DTPa (43%). As vacinas com menor taxa de pacientes que declararam ter recebido a vacina são Haemophilus influenza b (0,8%), herpes zoster (2,1%) e HPV (3,4%). Pacientes que fazem ou já fizeram tratamento com agentes biológicos têm melhor cobertura vacinal das vacinas para influenza (81%) e PP23V (25,9%), além de maior conhecimento sobre o estado vacinal para essas vacinas. CONCLUSÃO: Apesar de se tratar de um serviço especializado ligado a um hospital universitário, a cobertura vacinal e o conhecimento dos pacientes sobre as vacinas estão abaixo do desejado. A recuperação do histórico vacinal e a recomendação das vacinas necessárias devem ser realizadas logo após o diagnóstico de DII, independentemente do uso de agentes biológicos. Esses achados indicam a necessidade da criação e monitoramento constante da aplicação de um protocolo pela equipe multidisciplinar de serviços especializados em DII.

Humans , Male , Female , Adult , Inflammatory Bowel Diseases/immunology , Immunization Schedule , Vaccination/statistics & numerical data , Vaccination Coverage/statistics & numerical data , Socioeconomic Factors , Cross-Sectional Studies , Surveys and Questionnaires , Middle Aged
Einstein (Säo Paulo) ; 17(2): eAO4476, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001905


ABSTRACT Objective To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital. Methods A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records. Results We evaluated 466 patients, 58% were men, median age was 40 years, and 146 (31%) of them were diagnosed with sepsis. The overall mortality was 20% being significantly higher for patients with sepsis (39%). The factors associated with intensive care unit mortality were the presence of sepsis (OR: 6.1, 95%CI: 3.7-10.5), age (OR: 3.6, 95%CI: 1.4-7.2), and length of hospital stay (OR: 0.96, 95%CI: 0.94-0.98). Pulmonary (49%) and intra-abdominal (20%) infections were most commonly identified sites, and coagulase-negative staphylococci and enteric Gram negative bacilli the most frequent (66%) pathogens isolated. Conclusion Although the impact of sepsis on mortality is related to patients' clinical and epidemiological characteristics, a critical evaluation of these data is important since they will allow the direct implementation of local policies for managing this serious public health problem.

RESUMO Objetivo Descrever as características clínicas e epidemiológicas de pacientes com sepse e sem sepse em unidades de cuidados intensivos de um hospital público. Métodos Estudo transversal realizado de maio de 2012 a abril de 2013. Os dados clínicos e laboratoriais de pacientes com sepse e sem sepse das unidades de terapia intensiva foram revisados a partir dos prontuários médicos. Resultados Avaliamos 466 pacientes, 58% homens, mediana de idade 40 anos; sendo 146 (31%) diagnosticados com sepse. A mortalidade global foi 20%, e significativamente maior para pacientes com sepse (39%). Os fatores associados à mortalidade em unidade de terapia intensiva foram a presença de sepse (OR: 6,1, IC95%: 3,7-10,5), idade (OR: 3,6, IC95%: 1,4-7,2) e tempo de internação (OR: 0,96, IC95%: 0,94-0,98). As infecções pulmonares (49%) e intra-abdominais (20%) foram os focos mais comumente identificados, e os estafilococos coagulase-negativa e bacilos entéricos Gram-negativos foram os patógenos isolados mais frequentes (66%). Conclusão Embora o impacto da sepse sobre a mortalidade esteja relacionado às características clínicas e epidemiológicas dos pacientes, uma avaliação crítica desses dados é importante, pois permitirá a implementação direta de políticas locais para gerenciar este grave problema de saúde pública.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Sepsis/epidemiology , Tertiary Care Centers/statistics & numerical data , Intensive Care Units/statistics & numerical data , Time Factors , Brazil/epidemiology , Cross-Sectional Studies , Retrospective Studies , Hospital Mortality , Sepsis/microbiology , Kaplan-Meier Estimate , Length of Stay/statistics & numerical data
Adv Rheumatol ; 59: 55, 2019. tab
Article in English | LILACS | ID: biblio-1088613


Abstract Objective: Determine food intake and levels of serum magnesium (Mg) and calcium (Ca) and correlate these minerals with pain, quality of life and depression risk in women with and without fibromyalgia (FM). Patients and methods: Fifty-three women diagnosed with FM and 50 healthy women participated in the study, where all of them had equivalent age and body mass index (BMI). All women underwent anthropometric assessment, physical exams of pain perception threshold and tender point (TP) count, blood sample collection, and filling out of FM impact questionnaire (FIQ), Patient Health Questionnaire-9 (PHQ-9), and 3-day dietary record (DR). Results: Dietary intake of Mg and Ca was substantially lower by women with FM. There were no differences in levels of serum Mg and Ca in the groups under analysis. For the FM group, dietary intake of Mg and Ca had inverse correlation with TP and direct relation with the pain threshold. Conclusions: Although women with FM had lower dietary intake of Mg and Ca, serum levels for these nutrients were not different between the groups. Low dietary intake of minerals correlated with worsened pain threshold parameters.

Humans , Female , Fibromyalgia/physiopathology , Calcium/blood , Magnesium/blood , Quality of Life , Pain Measurement/instrumentation , Anthropometry/instrumentation , Depression/etiology , Patient Health Questionnaire
BrJP ; 1(2): 134-140, Apr.-June 2018. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1038925


ABSTRACT BACKGROUND AND OBJECTIVES: To evaluate postoperative analgesia and the need for tramadol in patients undergoing reconstruction of the anterior cruciate ligament with spinal anesthesia, fentanyl and femoral nerve block. METHODS: 166 patients were divided into four groups (G). All patients received spinal anesthesia with 15mg of isobaric bupivacaine at 0.5%. In the G2 and G3 groups, 25µg of fentanyl was associated with bupivacaine and in groups G3 and G4 femoral nerve block was associated with 100mg of bupivacaine at 0.5%, without vasoconstrictor. Patients received timed dipyrone and ketoprofen and were instructed to request tramadol if the pain was ≥4 on the numerical scale. After 6, 12 and 24 hours of spinal anesthesia, the score was recorded on the numerical scale, the request of tramadol and adverse events. RESULTS: Mean pain scores at 6 and 24 hours were not different. In the 12-hour evaluation, there was a difference only in G4 in relation to G1 (p=0.01). Tramadol was requested by 46.7% in G1, 52.9% in G2, 18.6% in G3 and 36.4% in G4 (p=0.009), with a difference between G1 and G3 and also between G2 and G3. CONCLUSION: The association of spinal anesthesia and femoral nerve block in G4 provided lower pain scores in the evaluation at 12 hours after anesthesia. On the other hand, the highest indices were observed in G2, spinal anesthesia with fentanyl. Pain scores at 6 and 12 hours were similar. The highest consumption of analgesics occurred in those who reported more pain in G2.

RESUMO JUSTIFICATIVA E OBJETIVOS: Avaliar a analgesia pós-operatória e a necessidade de tramadol nos pacientes submetidos à operação de reconstrução do ligamento cruzado anterior com raquianestesia, fentanil e bloqueio do nervo femoral. MÉTODOS: Cento e sessenta e seis pacientes foram divididos em quatro grupos (G). Todos os pacientes receberam raquianestesia com 15mg de bupivacaína isobárica a 0,5%. Nos grupos G2 e G3 foi associado 25µg de fentanil à bupivacaína e nos grupos G3 e G4 foi associado bloqueio do nervo femoral com 100mg de bupivacaína a 0,5% sem vasoconstritor. Os pacientes receberam dipirona e cetoprofeno de horário e eram orientados a solicitar tramadol caso a dor estivesse ≥4 na escala numérica. Após 6, 12 e 24 horas da raquianestesia foi registrado o escore na escala numérica, a solicitação de tramadol e eventos adversos. RESULTADOS: Os escores médios de dor 6 e 24 horas não foram diferentes. Na avaliação 12 horas houve diferença apenas no G4 em relação ao G1 (p=0,01). O tramadol foi solicitado por 46,7% no G1, 52,9% no G2, 18,6% no G3 e 36,4% no G4 (p=0,009), com diferença entre G1 e G3 e também entre G2 e G3. CONCLUSÃO: A associação de raquianestesia e bloqueio do nervo femoral no G4 proporcionou menores escores de dor na avaliação 12 horas após a anestesia, por outro lado os índices mais elevados foram observados na raquianestesia com fentanil do G2. As avaliações de dor em 6 e 12 horas foram semelhantes. O maior consumo de analgésicos ocorreu naqueles que relataram mais dor no G2.

Saúde debate ; 42(116): 87-99, jan.-mar. 2018. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-962655


RESUMO Realizou-se estudo transversal do sofrimento mental com 1.021 professores do ensino público do Paraná. Utilizou-se o Self-Report Questionnaire para distúrbios psíquicos menores, os inventários de ansiedade e depressão de Beck, e questionário sociodemográfico e de morbidade autorreferida. Os testes Qui-quadrado, Exato de Fisher e Kruskal-Wallis foram utilizados na análise dos dados obtidos. Foram encontrados distúrbios psíquicos menores em 75%, depressão em 44% e ansiedade em 70% das pessoas observadas no presente estudo, havendo associação significativa (p<0,05) destes sintomas com o sexo feminino, outras doenças, o fato de levarem trabalho para casa e de trabalharem com o ensino fundamental. O sofrimento mental esteve presente em grande parcela da amostra estudada, apresentando relação com as condições de trabalho.

ABSTRACT A cross-sectional study of mental suffering was carried out with 1.021 professors of the public education in Paraná. The Self-Report Questionnaire was utilized for minor psychic disorders, Beck's anxiety and depression inventories, and a sociodemographic and self-reported morbidity questionnaire. The Chi-square, Exact of Fischer and the Kruskal-Wallis tests were used in the analysis of the obtained data. Minor psychic disorders were found in 75%, depression in 44% and anxiety in 70% of the people observed in the present study, with a significant association (p<0,05) of this symptoms with the female sex, other illness, the fact of taking work home and working with elementary school. Mental distress was present in a large portion of the sample studied, presenting relation with the working conditions.