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1.
Rev. psicol. (Fortaleza, Online) ; 13(1): 44-58, 01/01/2022.
Article in English | LILACS, INDEXPSI | ID: biblio-1357838

ABSTRACT

Normative masculinity and alexithymia may negatively affect sexual life and men's well-being. In this study, the endorsement of traditional male norms, alexithymia and sexual behavior were assessed through an online survey directed to Brazilian men. Relationship status and religion were also addressed, and associations and correlations between variables were carried out. The survey presented 66 items, including standardized questionnaires, such as Meanings of Adolescent Masculinity Scale, Toronto Alexithymia Scale and Male Sexual Quotient. The sample consisted in 528 Brazilian men with high socioeconomic and educational levels. Alexithymia was negatively correlated with sexual satisfaction. The endorsement of traditional male norms was positively correlated with pornography use and was also associated with sharing of pornographic material through social media. Married men had the lowest levels of alexithymia, with significant difference when compared with men who are not currently in a relationship. Furthermore, having a religion was associated with greater endorsement of traditional male norms. These findings suggest that alexithymia may have greater influence on behaviors associated with interpersonal relations, including sexual satisfaction and relationship status. Conversely, normative masculinity was linked to personal variables, which did not involve a partner, including pornography consumption and religion.


A masculinidade normativa e alexitimia podem afetar negativamente a vida sexual e o bem-estar dos homens. Neste estudo, a concepção de masculinidade, alexitimia e comportamento sexual foram avaliados por meio de uma pesquisa online dirigida aos homens brasileiros. O status de relacionamento e religião também foram abordados, efetivando-se associações e correlações entre as diferentes variáveis. A pesquisa apresentou 66 itens, incluindo questionários estandardizados, como a Escala de Concepções de Masculinidade, Escala de Alexitimia de Toronto e Quociente Sexual - versão masculina. A amostra consistiu em 528 homens brasileiros com altos níveis socioeconômicos e educacionais. Alexitimia foi negativamente correlacionada com a satisfação sexual. O endosso das normas tradicionais masculinas foi positivamente correlacionado com o uso de pornografia, bem como associado ao compartilhamento de material pornográfico por meio das mídias sociais. Os homens casados obtiveram os níveis mais baixos de alexitimia, com diferença significativa quando comparados com homens que não mantém atualmente um relacionamento. Além disso, ter uma religião foi associado a uma maior percepção de importância das normas tradicionais masculinas. Os achados sugerem que a alexitimia pode possuir maior influência sobre os comportamentos associados às relações interpessoais, incluindo satisfação sexual e status de relacionamento. Por outro lado, a masculinidade normativa foi ligada a variáveis pessoais, que não envolviam um parceiro, incluindo o consumo de pornografia e a religião.


Subject(s)
Sexuality , Affective Symptoms , Masculinity , Men
2.
Rev. Assoc. Med. Bras. (1992) ; 67(10): 1392-1396, Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1351435

ABSTRACT

SUMMARY OBJECTIVE: The aim of this study was to analyze the effects of pandemic in the exercising practice and impact of the disease in patients with Fibromyalgia. METHODS: This is a cross-sectional, Internet-based survey answered by 1156 individuals with Fibromyalgia diagnosis. Questions were on epidemiology, social distancing habits, and exercise practice before and after COVID-19 pandemic, including subtypes of exercises (for resistance, flexibility, balance, and strength). The Fibromyalgia Impact Questionnaire was applied. RESULTS: In the whole sample, 57.7% of individuals practiced exercises before pandemic; during pandemic, only 34.8% practiced and 39.6% left this practice. Among those taking quarantine (n=440), 52.9% used to do exercises prior to pandemic; in the pandemic, 28.1% (reduction of 53.2%). The median Fibromyalgia Impact Questionnaire among those who practiced exercises in the pandemic was 73.6 (61.1-83.2) and that among those who did not was 80.4 (71.9-86.9), with p<0.0001. The Fibromyalgia Impact Questionnaire did not change according to the type of physical exercise (p=0.27). CONCLUSION: A high proportion of patients with Fibromyalgia stopped exercising during COVID-19 pandemic; as a result, the impact of the disease during this period was worse among those not practicing exercises.


Subject(s)
Humans , Fibromyalgia/epidemiology , COVID-19 , Exercise , Cross-Sectional Studies , Surveys and Questionnaires , Pandemics , SARS-CoV-2
3.
Rev. bras. ginecol. obstet ; 43(5): 357-361, May 2021. tab
Article in English | LILACS | ID: biblio-1288562

ABSTRACT

Abstract Objective To study a sample of rheumatoid arthritis (RA) patients for their gynecological/obstetric history and compare them to controls to determine their influences on number of pregnancies, menarche, menopause and reproductive years following RA onset. Methods This is a cross-sectional study of 122 RA patients and 126 controls. Patients and controls were questioned about age of menarche, age of menopause, number of pregnancies and abortions. Reproductive years were calculated as the difference between age at menopause and age at menarche. For comparison, we used the Mann-Whitney, unpaired t, chi-squared, and Spearman tests. The adopted significance was 5%. Results In the RA patients with disease beginning in the postmenopausal years, the period of reproductive years (age at menopause - age of menarche) showed a positive correlation with age at disease onset (rho=0.46; 95% confidence interval [CI]=0.20- 0.55 with p=0.0008). The number of pregnancies was higher in patients with postmenopausal disease onset when compared with those with premenopausal disease onset (median of 3 with interquartile range [IQR]=2-4 versus median of 2 with IQR=1-3; p=0.009), and RA patients had more pregnancies than controls (p=0.0002). Conclusion The present study shows that, in our population, the duration of reproductive years and the number of pregnancies are linked to the onset of RA.


Resumo Objetivo Estudar uma amostra de pacientes com artrite reumatoide (AR), com investigação da história ginecológica e obstétrica, comparando-a com controles, visando conhecer suas influências no número de gestações, menarcas, menopausa e anos reprodutivos no início da AR. Métodos Trata-se de um estudo transversal de 122 pacientes com AR e 126 controles. Pacientes e controles foram questionados sobre idade da menarca, idade da menopausa, número de gestações e abortos. Os anos reprodutivos foram calculados com a diferença entre a idade da menopausa e a idade da menarca. Para comparação, foram utilizados Mann Whitney, Teste t não pareados, Teste qui-quadrado e teste de Spearman. A significância adotada foi de 5%. Resultados Nas pacientes comAR e início da doença na pós-menopausa, o período de anos reprodutivos (idade da menopausa - idade da menarca) apresentou correlação positiva com a idade de início da doença (rho=0,46; intervalo de confiança de 95% [IC95%]=0,20-0,55 com p=0,0008). O número de gestações foi maior nas pacientes cominício da doença no período pós-menopausa quando comparadas às pacientes em pré-menopausa (mediana de 3 comintervalo interquartil [IIQ]=2-4 versusmediana de 2 com IIQ=1-3; p=0,009). Nas pacientes com AR, foi observado ummaior número de gestações do que no grupo controle (p=0,0002). Conclusão O presente estudo mostra que, em nossa população, a diminuição dos anos reprodutivos e o alto número de gestações estão relacionados ao surgimento da AR.


Subject(s)
Humans , Female , Adult , Arthritis, Rheumatoid/etiology , Parity , Arthritis, Rheumatoid/immunology , Arthritis, Rheumatoid/epidemiology , Brazil , Menarche , Menopause , Cross-Sectional Studies , Risk Factors , Age Factors , Postmenopause , Age of Onset , Middle Aged
4.
Rev. Assoc. Med. Bras. (1992) ; 67(1): 52-57, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287780

ABSTRACT

SUMMARY OBJECTIVE: To study the prevalence of Hashimoto's Thyroiditis in a sample of psoriasis patients. METHODS: Cross-sectional observational study of 120 individuals (60 with psoriasis and 60 control subjects) paired by gender and age for thyroid function (thyroid stimulating hormone, free T4), antithyroperoxidase and antithyroglobulin tests and physical examination. Psoriasis Area and Severity Index and Nail Psoriasis Severity Index were evaluated simultaneously. Epidemiological, clinical and treatment data was collected from medical records. Patients with documented hypothyroidism and/or goiter associated with positive antithyroperoxidase antibody were considered to have Hashimoto's Thyroiditis. RESULTS: The prevalence of Hashimoto's Thyroiditis in the group with psoriasis was 21.6%; in the control group, it was 4/60 (6.6%) with p=0.03 (OR=3.8; 95%CI 1.18-12.6). In the group of patients with psoriasis, Hashimoto's Thyroiditis was more common in women (p=0.002) and less common in those who had polyarticular arthropathic psoriasis (p=0.05) and plaque psoriasis (p=0.005). A logistic regression showed that the only independent variable associated with Hashimoto's thyroiditis was plaque psoriasis. CONCLUSIONS: There is a high prevalence of Hashimoto's Thyroiditis in psoriatic patients, especially in women. Hashimoto's Thyroiditis is less common in patients with the plaque form of psoriasis.


Subject(s)
Humans , Female , Psoriasis/complications , Psoriasis/epidemiology , Hashimoto Disease/complications , Hashimoto Disease/epidemiology , Hypothyroidism , Prevalence , Cross-Sectional Studies
5.
Rev. Méd. Paraná ; 79(1): 97-101, 2021.
Article in Portuguese | LILACS | ID: biblio-1282503

ABSTRACT

INTRODUÇÃO: A calcinose é uma complicação frequente da esclerose sistêmica e da dermatomiosite, resultando em dor local, contraturas, ulcerações, infecções secundárias e limitação funcional. Não há tratamento eficaz para calcinose mas o tiossulfato de sódio tem se mostrado promissor. OBJETIVOS: Analisar a resposta terapêutica ao tiossulfato de sódio 10% intralesional nas calcinoses de pacientes com dermatomiosite e esclerose sistêmica. MÉTODOS: Estudo prospectivo, não controlado, incluindo 7 pacientes, totalizando 10 calcinoses, sendo um paciente com dermatomiosite e 6 com esclerose sistêmica. Desfechos primários: melhora da dor pela escala visual analógica e diminuição do maior e menor diâmetros das calcinoses ao raio-x. Desfechos secundários: melhora da qualidade de vida pelo SF12 (Medical Outcomes Study Short Form 12) e da função pelo HAQ (Health Assesment Questionnaire). Resultados foram expressos em médias e as variáveis contínuas comparadas pelo teste t-Student ou pelo teste de Wilcoxon. RESULTADOS: Foram realizadas 2 a 8 aplicações intralesionais (média de 3,7), com média de 8,9mg de tiossulfato por injeção a intervalos de 13 a 56 dias, com intervalo médio de 19 dias. Todos os pacientes relataram melhora da dor, porém esse resultado não foi significativamente estatístico. Não houve redução do diâmetro das calcinoses, nem melhora da qualidade de vida ou funcional. CONCLUSÃO: Baixas doses de tiossulfato de sódio administradas por injeções intralesionais, em intervalos médios de 19 dias, em número limitado de aplicações, não foram efetivas para o tratamento da calcinose


BACKGROUND: Calcinosis is a frequent complication of systemic sclerosis and dermatomyositis, resulting in local pain, contractures, ulcerations, secondary infections and functional limitations. There is no effective treatment for calcinosis, but sodium thiosulphate has shown to be promising. OBJECTIVE: To analyze the therapeutic response to 10% intralesional sodium thiosulphate on calcinosis of patients with dermatomyositis and systemic sclerosis. METHODS: Non-controlled prospective study, with 7 patients and 10 calcinoses, of which one had dermatomyositis and six had scleroderma. Primary outcomes: improvement in the pain by the visual analogue scale, and a decrease in both diameters (biggest and smallest) of calcinoses on X-ray. Secondary outcomes: improvement in quality of life by SF12 (Medical Outcomes Study Short Form 12), and of function by HAQ (Health Assessment Questionnaire). Results were expressed as means; continuous variables were compared by the t-Sudent test or by the Wilcoxon test. RESULTS: Two to 8 intralesional applications were performed (mean of 3.7), with mean of 8.9mg of thiosulphate per injection, at 13-56 days intervals (mean of 19 days). All patients reported improvement in pain, albeit such result was not statistically significant. There was no reduction in the diameters of calcinoses, nor there were quality of life or functional improvements. CONCLUSION: Low doses of sodium thiosulphate, administered through intralesional injections, in mean intervals of 19 days, in a limited number of applications, were not effective for calcinosis treatment


Subject(s)
Humans , Scleroderma, Systemic , Therapeutics , Calcinosis , Dermatomyositis , Thiosulfates
6.
ABCD arq. bras. cir. dig ; 34(2): e1585, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1345003

ABSTRACT

ABSTRACT Background: CD133 and AXL have been described as cancer stem cell markers, and c-MYC as a key regulatory cellular mechanism in colorectal cancer (CRC). Aim: Evaluate the prognostic role of the biomarkers CD133, AXL and c-MYC and their association with clinicopathologic characteristics in colorectal adenocarcinomas and adenomas. Methods: A total of 156 patients with UICC stage I-IV adenocarcinomas (n=122) and adenomas (n=34) were analyzed. Tissue microarrays (TMA) from primary tumors and polyps for CD133, c-MYC and AXL expression were performed and analyzed for their significance with clinicopathologic characteristics. Results: Poorly differentiated adenocarcinomas and disease progression were independent risk factors for poor overall survival. The median overall survival time was 30 months. Positive CD133 expression (35.9% of all cases), particularly of right-sided CRCs (44.8% of the CD133+ cases), was negatively correlated with death in the univariate analysis, which did not reach significance in the multivariate analysis. c-MYC (15.4% of all cases) was predominantly expressed in advanced-stage patients with distant (non-pulmonary/non-hepatic) metastasis. AXL expression was found only occasionally, and predominantly dominated in adenomas, with less penetrance in high-grade dysplasia. Conclusions: CD133 expression was not associated with inferior overall survival in CRC. While AXL showed inconclusive results, c-MYC expression in primary CRCs was associated with distant metastasis.


RESUMO Racional: CD133 e AXL são descritos na literatura como marcadores de células-tronco tumorais, e c-MYC cumpre papel chave como mecanismo de regulação celular no câncer colorretal (CCR). Objetivo: Avaliar o papel prognóstico dos biomarcadores CD133, AXL e c-MYC e sua associação com características clinicopatológicas de adenocarcinomas e adenomas colorretais. Métodos: Um total de 156 pacientes com adenocarcinomas de estádio UICC I-IV (n=122) e adenomas (n=34) colorretais foram avaliados. Microarranjos teciduais (TMA) dos tumores primários e adenomas foram realizados em busca de expressão de CD133, c-MYC e AXL, com posterior análise de relação significativa com características clinicopatológicas. Resultados: Adenocarcinomas pobremente diferenciados e progressão de doença foram fatores de risco independentes para má sobrevida global. A taxa mediana de sobrevida global foi de 30 meses. Expressão positiva de CD133 (35,9% dos casos), particularmente em cânceres de cólon direito (44,8% dos casos CD133+), correlacionou-se negativamente com óbito na análise univariada, sem significância estatística na análise multivariada. c-MYC (15,4% dos casos) teve predomínio de expressão em pacientes com estádio avançado com metástases distantes (não-pulmonares/não-hepáticas). Expressão de AXL foi pouco encontrada, com predomínio em adenomas, com menor penetrância em displasia de alto grau. Conclusão: Expressão de CD133 não se associou com sobrevida global inferior em CCR. Enquanto AXL demonstrou resultados inconclusivos, expressão de c-MYC em tumores primários se associou-se à metástases à distância.


Subject(s)
Humans , Colorectal Neoplasms , Biomarkers, Tumor , Peptides , Prognosis , Neoplastic Stem Cells , Glycoproteins , Antigens, CD , AC133 Antigen
7.
ABCD arq. bras. cir. dig ; 33(4): e1568, 2020. tab, graf
Article in English | LILACS | ID: biblio-1152637

ABSTRACT

ABSTRACT Background: CD133 and AXL have been described as cancer stem cell markers, and c-MYC as a key regulatory cellular mechanism in colorectal cancer (CRC). Aim: Evaluate the prognostic role of the biomarkers CD133, AXL and c-MYC and their association with clinicopathologic characteristics in colorectal adenocarcinomas and adenomas. Methods: A total of 156 patients with UICC stage I-IV adenocarcinomas (n=122) and adenomas (n=34) were analyzed. Tissue microarrays (TMA) from primary tumors and polyps for CD133, c-MYC and AXL expression were performed and analyzed for their significance with clinicopathologic characteristics. Results: Poorly differentiated adenocarcinomas and disease progression were independent risk factors for poor overall survival. The median overall survival time was 30 months. Positive CD133 expression (35.9% of all cases), particularly of right-sided CRCs (44.8% of the CD133+ cases), was negatively correlated with death in the univariate analysis, which did not reach significance in the multivariate analysis. c-MYC (15.4% of all cases) was predominantly expressed in advanced-stage patients with distant (non-pulmonary/non-hepatic) metastasis. AXL expression was found only occasionally, and predominantly dominated in adenomas, with less penetrance in high-grade dysplasia. Conclusions: CD133 expression was not associated with inferior overall survival in CRC. While AXL showed inconclusive results, c-MYC expression in primary CRCs was associated with distant metastasis.


RESUMO Racional: CD133 e AXL são descritos na literatura como marcadores de células-tronco tumorais, e c-MYC cumpre papel chave como mecanismo de regulação celular no câncer colorretal (CCR). Objetivo: Avaliar o papel prognóstico dos biomarcadores CD133, AXL e c-MYC e sua associação com características clinicopatológicas de adenocarcinomas e adenomas colorretais. Métodos: Um total de 156 pacientes com adenocarcinomas de estádio UICC I-IV (n=122) e adenomas (n=34) colorretais foram avaliados. Microarranjos teciduais (TMA) dos tumores primários e adenomas foram realizados em busca de expressão de CD133, c-MYC e AXL, com posterior análise de relação significativa com características clinicopatológicas. Resultados: Adenocarcinomas pobremente diferenciados e progressão de doença foram fatores de risco independentes para má sobrevida global. A taxa mediana de sobrevida global foi de 30 meses. Expressão positiva de CD133 (35,9% dos casos), particularmente em cânceres de cólon direito (44,8% dos casos CD133+), correlacionou-se negativamente com óbito na análise univariada, sem significância estatística na análise multivariada. c-MYC (15,4% dos casos) teve predomínio de expressão em pacientes com estádio avançado com metástases distantes (não-pulmonares/não-hepáticas). Expressão de AXL foi pouco encontrada, com predomínio em adenomas, com menor penetrância em displasia de alto grau. Conclusão: Expressão de CD133 não se associou com sobrevida global inferior em CCR. Enquanto AXL demonstrou resultados inconclusivos, expressão de c-MYC em tumores primários se associou-se à metástases à distância.


Subject(s)
Humans , Male , Female , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/pathology , Biomarkers, Tumor/analysis , AC133 Antigen/analysis , Prognosis , Neoplastic Stem Cells/metabolism , Proto-Oncogene Proteins c-myc/metabolism , Neoplasm Metastasis
8.
Rev. Méd. Paraná ; 78(2): 33-40, 2020.
Article in Portuguese | LILACS | ID: biblio-1222638

ABSTRACT

OBJETIVOS: Estabelecer a taxa de detecção de adenoma (TDA) no serviço de endoscopia digestiva do Hospital Universitário Evangélico Mackenzie (HUEM), e analisar as condições de preparo intestinal e as características dos pólipos. MÉTODOS: Trata-se de um estudo descritivo, transversal e retrospectivo realizado com base nos dados contidos em prontuários de pacientes submetidos a colonoscopia de rastreio entre os anos de 2015 a 2018. RESULTADOS: A TDA masculina foi de 30,5% e a feminina de 23,7%. Os exames foram completos em 86,1% das colonoscopias e o preparo intestinal foi adequado em 84,8%. Displasia de baixo grau foi encontrada em 21,8% dos pacientes, e displasia de alto grau em 5,9%. Os adenomas foram mais frequentes no cólon distal e o tamanho elevado do pólipo foi associado à displasia de alto grau. CONCLUSÃO: A TDA do HUEM foi dentro do preconizado tanto pela Sociedade Americana de Endoscopia Gastrointestinal quanto o Colégio Americano de Gastroenterologia.


OBJECTIVE: establish the adenoma detection rate (ADR) in the endoscopy serjvice at Hospital Universitário Evangélico Mackenzie (HUEM), analyze the intestinal preparation conditions and the polyps characteristics. METHOD: this is a descritive, transversal and retrospective study based on the data contained in the medical records of the patients who underwent through screening colonoscopy between years 2015 and 2018. RESULTS: the male ADR was 30,5% and the female 23,7%. 86,1% of the colonoscopies were complete and the intestinal preparation was appropriate in 84,8% of them. Low grade dysplasia was found in 21,8% of the patients, and high grade dysplasia in 5,9%. The adenomas were more frequently in the distal colon and the high size polyps were correlated with high grade dysplasia. CONCLUSION: the ADR at HUEM complies with the recommended both by the American Gastrointestinal Endoscopy Association and American College of Gastroenterology.


Subject(s)
Humans , Adenoma , Mass Screening , Endoscopy, Gastrointestinal , Colonoscopy , Colon , Hospitals, University
9.
Rev. Méd. Paraná ; 78(2): 60-64, 2020.
Article in Portuguese | LILACS | ID: biblio-1222695

ABSTRACT

INTRODUÇÃO: A artrite reumatoide (AR) é uma doença inflamatória sistêmica autoimune com prevalência de 0,4 a 1,9% que vem sofrendo mudanças na estratégia terapêutica visando maior controle da atividade inflamatória. OBJETIVOS: Identificar a influência da polifarmácia e de fatores relacionados ao paciente na adesão ao tratamento da AR. MÉTODOS: Estudo transversal, observacional realizado no Ambulatório de Reumatologia do Hospital Universitário Mackenzie com pacientes com AR, que foram questionados sobre dados epidemiológicos, medicamentos utilizados, adesão ao tratamento (questionário de Morisk-Green-Levine) e escala de depressão (CES­D). RESULTADOS: Dos 190 pacientes estudados, 28,9% se mostraram aderentes, 55,3% moderadamente aderentes e 15,8% baixa aderência. As variáveis associadas com baixa aderência foram: menor idade (p=0,04); sexo feminino (p=0,03); menor variedade de medicamentos de uso contínuo (p=0,05) e depressão (p=0,001). CONCLUSÃO: Menos de um terço dos pacientes com AR mostrou boa adesão ao tratamento; a polifarmácia influenciou positivamente e a sintomatologia depressiva, negativamente nesta adesão.


INTRODUCTION: Rheumatoid arthritis (RA) is an autoimmune systemic inflammatory disease with a prevalence of 0.4 to 1.9% that has undergone changes in the therapeutic strategy aiming better control of inflammatory activity. OBJECTIVE: Identify the influence of polypharmacy and factors related to the patient in adherence to RA treatment. METHODS: Observational, cross-sectional study conducted at the Rheumatology Outpatient Clinic of Hospital Universitário Mackenzie with RA patients, who were asked about epidemiological data, data on the treatment of the disease, treatment adherence (Morisk-Green-Levine questionnaire) and depression scale (CES-D). RESULTS: One hundred and ninety patients were included: 28.9% were adherent, 55.3% moderately adherent and 15.8% showed low adherence to treatment. The variables associated with low adherence were: younger age (p=0.04); female gender (p=0.003); less variety of medications use (p=0.05) and depression (p=0.001). CONCLUSION: Less than one third of RA patients had good adherence to treatment; polypharmacy influenced positively and depressive symptoms negatively on this adherence.


Subject(s)
Humans , Arthritis, Rheumatoid , Depression , Treatment Adherence and Compliance , Hospitals, University , Polypharmacy
10.
11.
Adv Rheumatol ; 59: 51, 2019. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1088585

ABSTRACT

Abstract Background: The Hand Mobility in Scleroderma (HAMIS) test was created to measure the degree of dysfunction of hand movements imposed by systemic sclerosis (SSc). The modified version (mHAMIS), with 4 of the 9 original items, was developed later. The goal of the present study was to translate and validate HAMIS and mHAMIS into Brazilian Portuguese and culture. Methods: After direct and reverse translation and comprehension test in 10 SSc patients, HAMIS-Br was applied to another 32 patients with SSc. To evaluate internal consistency, intraobserver and interobserver agreement, and intraobserver and interobserver reliability, we used respectively the Cronbach's α coefficient, kappa concordance and intraclass correlation (ICC). The correlation between HAMIS-Br and mHAMIS-Br was evaluated and a factorial analysis was performed. Results: HAMIS-Br showed excellent internal consistency (Cronbach's α = 0.997), good intraobserver agreement (kappa between 0.78 [95%CI =0.57-0.99] and 1) and intraobserver and interobserver reliability (ICC = 0.993, 95% CI = 0.973-0.993 and ICC = 0.994, 95% CI = 0.987-0.997, respectively). The mHAMIS-Br presented similar results and excellent correlation with HAMIS-Br (r = 0.923). The factorial analysis extracted three groups of questions that explain 84.4% of the total variance, and that can be understood through the influence of certain movements in the interpretation of others: [1] questions whose interpretation is influenced by the extension of the fingers, [2] questions whose interpretation is influenced by flexion of the fingers, [3] volar flexion of the fingers, with similar correlation with both other factors. Conclusions: HAMIS-Br and mHAMIS-Br showed good agreement, intraobserver and interobserver reliability, and internal validity. It is necessary to be attentive to the influence of certain limitations of movements in the interpretation of others.

12.
Einstein (Säo Paulo) ; 17(2): eAO4539, 2019. tab
Article in English | LILACS | ID: biblio-989775

ABSTRACT

ABSTRACT Objective To investigate the prevalence of electrocardiographic changes in patients with spondyloarthritis and to correlate these changes with use of anti-tumor necrosis factor-alpha (TNF-α) drugs and HLA-B27 positivity. Methods Retrospective study including 100 patients diagnosed with spondyloarthritis according to Assessment of SpondyloArthritis International Society (ASAS) criteria and 50 controls. Epidemiological and clinical features, results of inflammatory activity tests, HLA-B27 positivity, and medication use data were extracted from medical records. Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). All participants were submitted to electrocardiogram performed using a 12-lead device; rhythm, heart rate, conduction disorders and QT interval corrected using the Bazett formula were analyzed. Results Of 100 patients with spondyloarthritis, 51 were on anti-TNF-α drugs and 49 were not. HLA-B27 was detected in 53.1% of patients in the sample. Patients with spondyloarthritis had lower heart rate (p=0.06), longer QT interval (p<0.0001) and higher prevalence of right bundle branch block (p=0.014) compared to controls. Duration of disease was weakly correlated with heart rate (Rho=0.26; 95%CI: 0.06-0.44; p=0.008). The prevalence of right bundle branch block was positively correlated with HLA-B27 positivity. Use of Anti-TNF-α drugs did not interfere with electrocardiographic parameters. Conclusion Patients with spondyloarthritis had lower heart rate, longer QT interval and a higher prevalence of right bundle branch block compared to controls. HLA-B27 positivity was associated with the prevalence of right bundle branch block. Anti-TNF-α drugs had no impact on electrocardiographic findings.


RESUMO Objetivo Avaliar a prevalência de alterações eletrocardiográficas em pacientes com espondiloartrites, correlacionando-as com o uso de medicações antifator de necrose tumoral alfa (TNF-α) e presença do HLA-B27. Métodos Estudo retrospectivo com 100 pacientes com diagnóstico de espondiloartrites pelo critério Assessment of SpondyloArthritis International Society (ASAS) e 50 controles. Foram coletados nos prontuários dos pacientes, dados epidemiológicos, clínicos, exames de atividade inflamatória, presença do HLA-B27, e uso de medicamentos. A atividade de doença foi avaliada pelo Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Todos foram submetidos a eletrocardiograma realizado com aparelho de 12 derivações, sendo analisados ritmo, frequência cardíaca, distúrbios de condução e intervalo QT corrigido pela fórmula de Bazett. Resultados Dos 100 pacientes com espondiloartrites, 49 não usavam anti-TNF-α e 51 utilizavam este medicamento. O HLA-B27 estava presente em 53,1% da amostra. A frequência cardíaca foi mais baixa (p=0,06), o intervalo QT foi mais prolongado (p<0,0001) e existia mais perturbação de condução do ramo direito (p=0,014) nos pacientes com espondiloartrites do que nos controles. Uma modesta correlação de tempo de doença com frequência cardíaca foi encontrada (Rho=0,26; IC95%: 0,06-0,44; p=0,008). A presença do HLA-B27 aumentou a prevalência de perturbação de condução do ramo direito. Nenhum dos parâmetros eletrocardiográficos analisados alterou-se com uso de anti-TNF-α. Conclusão Pacientes com espondiloartrites tiveram frequência cardíaca menor, maior intervalo QT e prevalência maior de perturbação de condução do ramo direito do que controles. O HLA-B27 influi no aparecimento de perturbação de condução do ramo direito. O uso de anti-TNF-α não influiu nos achados eletrocardiográficos.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Spondylarthritis/physiopathology , Spondylarthritis/drug therapy , Electrocardiography , Reference Values , Time Factors , Brazil/epidemiology , Bundle-Branch Block/physiopathology , Bundle-Branch Block/epidemiology , Case-Control Studies , HLA-B27 Antigen/analysis , Prevalence , Retrospective Studies , Statistics, Nonparametric , Spondylarthritis/immunology , Spondylarthritis/epidemiology , Heart Rate/physiology
13.
Rev. Soc. Bras. Clín. Méd ; 16(1): 2-6, 20180000. tab, ilus
Article in Portuguese | LILACS | ID: biblio-884974

ABSTRACT

OBJETIVO: Avaliar se o bem-estar global de pacientes com lúpus eritematoso sistêmico é afetado pelo uso de antimaláricos. MÉTODOS: Estudo transversal observacional analítico, realizado com 118 indivíduos do sexo feminino, sendo que 51 faziam uso de antimaláricos por, no mínimo, 2 anos (Grupo 1), 17 não utilizavam esse método terapêutico (Grupo 2) e 50 não tinham lúpus eritematoso sistêmico (Grupo 3). Dados epidemiológicos, clínicos e sorológicos das pacientes lúpicas foram obtidos por meio da análise de prontuários médicos, e a qualidade de vida foi avaliada pelo questionário Medical Outcomes Study Short-Form Health Survey version 2 (SF-12v2). RESULTADOS: O uso de antimaláricos foi associado à menor ocorrência de psicose e lesões renais, apesar de levar a uma frequência maior de convulsões. Quanto à percepção individual da qualidade de vida, não houve diferença significativa entre os três grupos. Porém, quando considerado o tabagismo entre as usuárias de antimaláricos, o SF-12v2 de saúde mental de fumantes foi menor do que de não fumantes. CONCLUSÃO: Pacientes lúpicas em uso de antimaláricos tiveram menor incidência de psicose e glomerulonefrite, mas não houve diferença significativa em relação à qualidade de vida e ao uso de antimaláricos, com exceção de fumantes em uso da medicação, que tiveram escore do SF-12v2 de saúde mental menor do que não fumantes em uso da mesma medicação.(AU)


OBJECTIVE: To evaluate whether global quality of life of Systemic Lupus Erythematosus patients is affected by the use of antimalarials. METHODS: This is an observational, analytical cross-sectional study carried out with 118 female individuals, of whom 51 have been on antimalarials for at least 2 years (group 1), 17 were not using this therapy (group 2), and 50 did not have Systemic Lupus Erythematosus (group 3). Epidemiological, clinical and serological data of Systemic Lupus Erythematosus patients were obtained through the review of medical records, and quality of life was assessed using the SF-12 questionnaire. RESULTS: Antimalarial use was associated with a lower occurrence of psychosis and renal lesions, although it led to a higher prevalence of seizures. Regarding the individual perception of quality of life, there was no significant difference among the 3 groups. However, when smoking habits were considered among antimalarial users, mental health score in the SF-12 was lower in smokers than in non-smokers. CONCLUSION: Systemic Lupus Erythematosus female patients using antimalarials had a lower incidence of psychosis and glomerulonephritis, but no significant differences were found regarding antimalarial use and quality of life, except for the group of smokers using antimalarials, who had lower mental scores in the SF-12 than non-smokers using the same medication.(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Antimalarials/therapeutic use , Chloroquine/therapeutic use , Hydroxychloroquine/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Quality of Life
14.
ABCD arq. bras. cir. dig ; 31(1): e1339, 2018. tab, graf
Article in English | LILACS | ID: biblio-885758

ABSTRACT

ABSTRACT Background: The C reactive protein (CRP) is one of the most accurate inflammatory markers in acute appendicitis (AA). Obesity leads to a pro-inflammatory state with increased CRP, which may interfere with the interpretation of this laboratory test in AA. Aim: To assess sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CRP in patients with AA and their correlation to body mass index (BMI) and body fat composition. Method: This is a retrospective study based on clinical records and imaging studies of 191 subjects with histopathologically confirmed AA compared to 249 controls who underwent abdominal computed tomography (CT). Clinical and epidemiological data, BMI, and CRP values were extracted from medical records. CT scans were assessed for AA findings and body composition measurements. Results: CRP values increased according to patients' BMI, with varying sensitivity from 79.78% in subjects with normal or lean BMI, 87.87% in overweight, and 93.5% in individuals with obesity. A similar pattern was observed for NPV: an increase with increasing BMI, 69.3% in individuals with normal or lean BMI, 84.3% in overweight, and 91.3% in individuals with obesity. There was a positive correlation between CRP and visceral fat area in patients with AA. Conclusions: Variations exist for sensitivity, specificity, PPV, and NPV values of CRP in patients with AA, stratified by BMI. An increase in visceral fat area is associated with elevated CRP across the BMI spectrum.


RESUMO Racional: A proteína C reativa (PCR) é um dos marcadores inflamatórios com maior acurácia na apendicite aguda (AA). A obesidade leva a um estado pró-inflamatório com PCR aumentada, o que pode interferir na interpretação deste teste de laboratório na AA. Objetivo: Avaliar a sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN) da PCR em pacientes com AA e sua correlação com o índice de massa corporal (IMC) e a composição da gordura corporal. Métodos: Este é um estudo retrospectivo baseado em registros clínicos e estudos de imagem de 191 indivíduos histopatologicamente confirmados com AA em comparação com 249 controles que foram submetidos à tomografia computadorizada abdominal (TC). Dados clínicos e epidemiológicos, valores de IMC e PCR foram extraídos de registros médicos. As TC foram avaliadas para achados de AA e medidas de composição corporal. Resultados: Os valores da PCR aumentaram de acordo com o IMC dos pacientes, com sensibilidade variável de 79,78% em indivíduos com IMC normal ou magro, 87,87% em excesso de peso e 93,5% em indivíduos com obesidade. Um padrão semelhante foi observado para o VPN: um aumento com o aumento do IMC, 69,3% em indivíduos com IMC normal ou magro, 84,3% em excesso de peso e 91,3% em indivíduos com obesidade. Houve uma correlação positiva entre a PCR e a área de gordura visceral em pacientes com AA. Conclusão: Existem variações quanto à sensibilidade, especificidade, VPP e valores VPN da PCR em pacientes com AA, estratificados pelo IMC. Um aumento na área de gordura visceral está associado à PCR elevada em todo o espectro do IMC.


Subject(s)
Humans , Male , Female , Adult , Appendicitis/blood , C-Reactive Protein/analysis , Intra-Abdominal Fat , Obesity/blood , Appendicitis/complications , Body Mass Index , Case-Control Studies , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Obesity/complications
15.
Säo Paulo med. j ; 135(6): 535-540, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-904120

ABSTRACT

ABSTRACT BACKGROUND: Thyroid autoimmunity is more common in patients with rheumatic diseases than in healthy populations. The degree of association seems subject to influence from patients' geographical location. Here, we aimed to ascertain the prevalence of thyroid autoantibodies in a cohort of patients with systemic rheumatic disease and the degree of association between its presence and inflammatory activity. DESIGN AND SETTING: Cross-sectional observational study in a rheumatology unit. METHODS: 301 patients with systemic lupus erythematosus (SLE), 210 with rheumatoid arthritis (RA), 58 with scleroderma (SSc) and 80 with spondyloarthritis (SpA) were studied regarding thyroid function (TSH and T4), anti-thyroglobulin (TgAb) and anti-thyroperoxidase (TPOab) and compared with 141 healthy controls. Disease activity in patients with rheumatic disease was assessed through appropriate indexes. RESULTS: There were more antithyroid antibodies in SLE patients with hypothyroidism (P = 0.01; odds ratio, OR 2.7; 95% confidence interval, CI: 1.20-6.26) and in those without hypothyroidism (P = 0.06; OR 2.4; 95% CI: 1.28-4.55) than in controls. SSc patients also showed: P = 0.03 both with antithyroid antibodies and hypothyroidism (OR 3.4; 95% CI: 1.06-10.80) and without hypothyroidism (OR 3.1; 95% CI: 1.11-0.13). RA and SpA patients had the same prevalence as controls (P not significant). Presence of autoantibodies with and without hypothyroidism was not associated with the activity or functional indexes evaluated. CONCLUSION: SLE and SSc were associated with higher prevalence of thyroid autoantibodies in patients with and without hypothyroidism, unlike SpA and RA. There was no link between thyroid autoantibody presence and disease activity or functional impairment.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Autoantibodies/blood , Autoimmune Diseases/blood , Rheumatic Diseases/blood , Iodide Peroxidase/blood , Arthritis, Rheumatoid/immunology , Arthritis, Rheumatoid/blood , Scleroderma, Systemic/immunology , Scleroderma, Systemic/blood , Autoantibodies/immunology , Case-Control Studies , Rheumatic Diseases/immunology , Prevalence , Cross-Sectional Studies , Spondylarthropathies/immunology , Spondylarthropathies/blood , Disability Evaluation , Iodide Peroxidase/immunology , Lupus Erythematosus, Systemic/immunology , Lupus Erythematosus, Systemic/blood
16.
Rev. Méd. Paraná ; 75(1): 67-72, 2017.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1344181

ABSTRACT

Objetivo: Verificar a correlação existente entre alterações da PCR e VHS com a atividade do Lúpus Eritematoso Sistêmico, medida pelo SLEDAI. Método: Estudo descritivo e transversal, utilizando-se 150 pacientes do ambulatório de reumatologia do Hospital Universitário Evangélico de Curitiba com diagnóstico de LES. Foi aplicado o questionário SLEDAI e coletados os valores de PCR e VHS, além de dados demográficos, principais manifestações clínicas já apresentadas, perfil sorológico e uso de medicamentos. Resultados: A média de idade foi de 39,6±41,3 anos e o tempo médio de doença foi de 8,29± 6,32 anos. A pontuação no SLEDAI ficou entre 0 e 44 pontos, Valores de VHS variaram de 0 a 130mm, com mediana de 24,00mm. Já os valores de PCR encontrados ficaram na faixa de 0 a 108 mg/dL (mediana de 1,62 mg/dL). Foi encontrada uma correlação positiva entre SLEDAI e PCR (p=0.001), SLEDAI e VHS (p= 0,0001). Conclusão: Existe uma correlação positiva entre SLEDAI, PCR e VHS. Porém em relação nenhuma dessas duas medidas de inflamação (VHS e PCR) demonstraram predileção por aumento em determinada forma de expressão clínica da atividade do lúpus


Objective: To investigate the correlation between changes in CRP and ESR with the activity of SLE, as measured by SLEDAI. Method: Descriptive and transversal, using 150 outpatients from the rheumatology at the Evangelic University Hospital of Curitiba diagnosed with SLE. SLEDAI questionnaire was applied and collected the values of CRP, ESR, demographic data, clinical manifestations presented, serologic profile and medication use. Results: The mean age was 39,6±41,3 and the mean disease duration was of 8,29± 6.32 years. The SLEDAI score was between 0 and 44 points, ESR values ranging from 0 to 130mm, with a median of 24.00 mm. The values of CRP were found in the range 0 to 108 mg / dL (median of 1.62 mg / dL). We found a positive correlation between SLEDAI and CRP (p=0.001), SLEDAI and ESR (p=0.0001). Conclusion: There is a positive correlation between SLEDAI, C-reactive protein and erythrocyte sedimentation rate. But these two measures of inflammation (VHS and the PCR) did not show preferencial increase in some forms of clinical manifestation of lupus

17.
Rev. méd. Paraná ; 75(2): 9-16, 2017.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1344543

ABSTRACT

Objetivos: Comparar a qualidade de vida (QV)entre pacientes com doença de Crohn (DC) e retocolite ulcerativa (RCU). Avaliar a QV sob a influência de manifestações extra intestinais (MEI), perfil clínico e demográfico, tratamento medicamentoso, número de segmentos gastrointestinais acometidos e atividade da DC.Métodos: Foram coletados 220 questionários sobre doença inflamatória intestinal (DII) e MEI. O12-Item Short Form Health Survey (SF-12) foi adotado para avaliar a QV de pacientes com RCU e DC, enquanto o índice de Harvey-Bradshaw (IHB), classificou a atividade da DC apenas. A QV foi estudada pela influência das MEI e do perfil dos pacientes.Resultados:OIHB alterou a QV física (p <0,0001) e mental (p=0,003); na RCU, os glicocorticoides (p=0,02) e manifestações pulmonares (p=0,05) prejudicaram a QV física e o gênero influenciou ambas (p=0,01). Conclusões: Não houve diferença entre a QV das DII. Na DC, o IHB alterou o bem-estar geral. Na RCU, o sexo masculino apresentou melhor QV geral em relação ao feminino; pacientes com manifestações pulmonares ou usuários de glicocorticoides apresentaram menor QV física. O número de segmentos gastrointestinais adoecidos não interferiu na QV


Aim:To compare the quality of life (QL) among patients with Corh's disease (CD) and ulcerative rectolitis (URC). Evaluate the QL under the influence of: extra-intestinal manifestations (EIM), clinical and demographic profile, drug treatment, number of affected gastrointestinal segments and CD's activity. Methods: 220 questionnaires about inflammatory bowel disease (IBD) and EIM were collected. The 12-Item Short Form Health Survey was adopted to evaluate the QL of patients with URC and CD, whilst the Harvey-Bradshaw Index (HBI) classified the CD's activity only. The QL was studied under the influence of EIM and the profile of patients.Results:The HBI altered the physical (p<0,0001) and mental (p=0,003) QL; in URC, the glucocorticoids (p=0,02) and pulmonary manifestations (p=0,05) harmed the physical QL, whilst the gender influenced both (p=0,01). Conclusions: There was no difference between the QL of the IBD. In CD, the HBI changed the general well-being. In URC, males showed better general QL than females; patients with pulmonar manifestations or users of glucocorticoids showed lower physical QL. The number of sick gastrointestinal segments did not inferfere with the QL

18.
Rev. dor ; 17(4): 245-247, Oct.-Dec. 2016. tab
Article in English | LILACS-Express | LILACS | ID: biblio-845147

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Pain depreciates patients' quality of life, even influencing disease recovery. This study aimed at evaluating the prevalence of pain and opiophobia as barrier for the adequate management of cancer pain. METHODS Participated in the study 280 cancer patients in clinical treatment, who have answered a questionnaire made up of questions related to pain and use of opioid drugs. Demographic and clinical data were obtained by reviewing medical charts. The study was individually and randomly applied by the authors during outpatient visits. RESULTS: Prevalence of pain was 50.3%; 19.2% of patients would refuse morphine for pain control and fear of dependence was the most reported reason. The perception that morphine is directly related to worsening the disease was reported by 67.8% of respondents. CONCLUSION: A high prevalence of moderate and severe pain was found among studied patients, as well as a high prevalence of opiophobia.


RESUMO JUSTIFICATIVA E OBJETIVOS: A dor se apresenta como fator depreciativo da qualidade de vida dos pacientes, influenciando inclusive na recuperação da doença. O objetivo deste estudo foi avaliar a prevalência da dor e da opiofobia, enquanto barreira ao manuseio adequado deste sintoma em pacientes com câncer. MÉTODOS: Foram avaliados 280 pacientes com câncer em tratamento clínico dessa doença, que responderam a um questionário composto por questões relacionadas à dor e ao uso de fármacos opioides. Os dados demográficos e clínicos foram obtidos por meio de revisão de prontuários. O estudo foi aplicado individualmente pelos autores ao acaso, durante o atendimento ambulatorial. Apresentado em 25 de julho de 2016. Aceito para publicação em 03 de novembro de 2016. Conflito de interesses: não há - Fontes de fomento: não há. RESULTADOS: A prevalência de dor encontrada foi de 50,3%; 19,2% dos pacientes recusariam a morfina como tratamento da dor e o medo da dependência foi o motivo mais relatado. A percepção de que o uso da morfina tem relação direta com o agravo da doença foi descrita por 67,8% dos entrevistados. CONCLUSÃO: A alta prevalência de dor moderada e intensa foi encontrada nos pacientes estudados, bem como uma elevada prevalência de opiofobia.

19.
Säo Paulo med. j ; 134(6): 501-507, Nov.-Dec. 2016. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-846263

ABSTRACT

ABSTRACT CONTEXT AND OBJECTIVE: The pursuit of perfection can cause anxiety and lead dancers to exceed their physical limits. The aim here was to evaluate the prevalence of pain symptoms and eating disorders among professional and amateur dancers. DESIGN AND SETTING: Observational cross-sectional study; Curitiba, PR, Brazil. METHODS: Data on 150 professional and non-professional practitioners of ballet, jazz and street dance were collected through specific questionnaires: Brief Pain Inventory-Short Form (BPI-SF), Eating Attitudes Test-26 (EAT-26), Bulimic Investigatory Test Edinburgh (BITE) and State-Trait Anxiety Inventory-T-6 (STAI-T-6). RESULTS: Pain was observed in 58.6% of the sample, equally between professionals and amateurs (P = 0.19). Ballet dancers had more lower-limb pain than the other groups (P = 0.05). EAT-26 showed a tendency towards more eating disorders among the amateurs (P = 0.06). Higher risk of eating disorders was found among ballet dancers (P = 0.004) and jazz practitioners (P = 0.02) than among street dancers. Amateurs had more symptoms on the BITE scale (P < 0.0001), more pain (P = 0.002) and higher anxiety (P < 0.0001). Eating disorders were more common among females (P = 0.01) and singles (P = 0.02). Professionals were more satisfied with their own body image than amateurs (P < 0.001). CONCLUSIONS: Pain symptoms were found in almost half of the sample, equally among professionals and amateurs as well as between the three dance styles. Female and singles had more eating disorders. Those with eating disorders had higher levels of pain and anxiety.


RESUMO CONTEXTO E OBJETIVO: Buscar a perfeição pode causar ansiedade e levar bailarinos a ultrapassar seus limites físicos. O objetivo foi avaliar a prevalência de sintomas dolorosos e distúrbios alimentares entre bailarinos profissionais e amadores. TIPO E LOCAL: Estudo transversal observacional; Curitiba, PR, Brasil. MÉTODOS: Dados de 150 praticantes profissionais e não profissionais de ballet, jazz e street dance foram coletados por meio de questionários específicos: Brief Pain Inventory-Short Form (BPI-SF), Eating Attitudes Test-26 (EAT-26), Bulimic Investigatory Test Edinburgh (BITE) e State-Trait Anxiety Inventory-T-6 (STAI-T-6). RESULTADOS: Encontrou-se dor em 58,6% da amostra, igualmente entre profissionais e amadores (P = 0,19). Praticantes de ballet tinham mais dor em membros inferiores que os demais (P = 0,05). No EAT- 26, encontrou-se uma tendência para mais transtornos alimentares entre os amadores (P = 0,06). Alto risco para transtornos alimentares apareceu naqueles que praticavam o ballet (P = 0,004) e jazz (P = 0,02) mais do que street dance ; amadores tinham mais sintomas no BITE (P < 0,0001), mais dor (P = 0,002) e ansiedade (P < 0,0001). Transtornos alimentares foram mais comuns em mulheres (P = 0,01) e solteiros (P = 0,02). Bailarinos profissionais estavam mais satisfeitos com sua imagem corporal do que amadores (P < 0,001). CONCLUSÕES: Encontrou-se sintomatologia dolorosa em quase metade da amostra, tanto em bailarinos profissionais como amadores, bem como nos três estilos de dança. Mulheres e pessoas solteiras tiveram mais transtornos alimentares. Aqueles com distúrbios alimentares tinham níveis mais elevados de dor e ansiedade.

20.
ABCD arq. bras. cir. dig ; 29(2): 73-76, tab, graf
Article in English | LILACS | ID: lil-787888

ABSTRACT

ABSTRACT Background: Studies with latest technologies such as endoscopy with magnification and chromoendoscopy showed that various endoscopic aspects are clearly related to infection by Helicobacter pylori (HP). The description of different patterns of erythema in gastric body under magnification of images revived interest in identifying these patterns by standard endoscopy. Aim: To validate the morphologic features of gastric mucosa related to H. pylori infection gastritis allowing predictability of their diagnosis as well as proper targeting biopsies. Methods: Prospective study of 339 consecutive patients with the standard videoendoscope image analysis were obtained, recorded and stored in a program database. These images were studied with respect to the presence or absence of H. pylori, diagnosed by rapid urease test and/or by histological analysis. Were studied: a) normal mucosa appearance; b) mucosal nodularity; c) diffuse nonspecific erythema or redness (with or without edema of folds and exudate) of antrum and body; d) mosaic pattern with focal area of hyperemia; e) erythema in streaks or bands (red streak); f) elevated (raised) erosion; g) flat erosions; h) fundic gland polyps. The main exclusion criteria were the use of drugs, HP pre-treatment and other entities that could affect results. Results: Applying the exclusion criteria, were included 170 of the 339 patients, of which 52 (30.58%) were positive for HP and 118 negative. On the positive findings, the most associated with infection were: nodularity in the antrum (26.92%); presence of raised erosion (15.38%) and mosaic mucosa in the body (21.15%). On the negative group the normal appearance of the mucosa was 66.94%; erythema in streaks or bands in 9.32%; flat erosions 11.86%; and fundic gland polyps 11.86%. Conclusion: Endoscopic findings are useful in the predictability of the result and in directing biopsies. The most representative form of HP related gastritis was the nodularity of the antral mucosa. The raised erosion and mucosa in mosaic in the body are suggestive but not specific to the infection. The other forms were not conclusive of the presence of HP.


RESUMO Racional: Estudos com tecnologias mais recentes como endoscopia com magnificação e cromoscopia mostraram que vários aspectos endoscópicos estão claramente associados à infecção por Helicobacter pylori. A descrição de padrões diferenciados de enantema no corpo gástrico através da magnificação de imagens reavivou o interesse na identificação desses padrões pela endoscopia convencional. Objetivo: Validar os padrões morfológicos de mucosa gástrica usando videogastroendoscopia convencional relacionados à gastrite por infecção por Helicobacter pylori, permitindo previsibilidade do seu diagnóstico e o direcionamento de biópsias. Métodos: Estudo prospectivo de 339 pacientes consecutivos com análise das imagens de videogastroendoscopia obtidas, gravadas e armazenadas em banco de dados. Estas imagens foram estudadas com relação à presença ou não do Helicobacter pylori diagnosticado por teste rápido de urease e/ou por pesquisa direta por estudo anatomopatológico. Foram estudados: a) aspecto normal da mucosa; b) nodularidade da mucosa; c) enantema inespecífico difuso de antro e corpo; d) enantema em mosaico ou salpicado; e) enantema em estrias ou faixas; f) erosões elevadas; g) erosões planas; h) pólipos de glândulas fúndicas. Os principais critérios de exclusão foram o uso de medicamentos, tratamento prévio de HP e outras entidades que pudessem interferir nos resultados. Resultados: Aplicando os critérios de exclusão, incluíram-se 170 dos 339 pacientes sendo 52 (30,58%) positivos para Helicobacter pylori e 118 negativos. No grupo positivo os achados que mais se associaram com a infecção foram: nodularidade no antro (26,92%); presença de erosões elevadas (15,38%) e mucosa em mosaico no corpo (21,15%). No grupo negativo o aspecto normal da mucosa foi de 66,94%; enantema em estrias ou faixas em 9,32%; erosões planas em 11,86%; e pólipos de glândulas fúndicas 11,86%. Conclusão: Achados endoscópicos são úteis na previsibilidade de localização e direcionamento de biópsias na pesquisa do HP. A mais representativa forma de gastrite por HP foi o achado de nodularidade na mucosa antral. As erosões elevadas e mucosa em mosaico no corpo são sugestivas, mas não específicas da infecção. As demais formas não foram conclusivas da presença do HP.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Helicobacter pylori , Helicobacter Infections/diagnosis , Gastroscopy , Gastritis/microbiology , Gastritis/pathology , Video Recording , Cross-Sectional Studies , Prospective Studies
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