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Acta colomb. psicol ; 25(1): 87-104, ene.-jun. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1364259


Resumen Aunque el consumo de marihuana es altamente prevalente entre universitarios de Argentina, poco se sabe respecto a los factores que permiten distinguir a los consumidores frecuentes de marihuana de quienes consumen esporádicamente. Por esta razón, en el presente trabajo se indagó sobre las posibles variaciones en los contextos de consumo, motivos de consumo, normas percibidas y estrategias conductuales de protección entre universitarios con consumo frecuente o esporádico de marihuana, y se analizó la utilidad de este conjunto de variables para distinguir entre estos los tipos de consumidores mencionados. Para ello, se contó con una muestra de 1083 estudiantes universitarios argentinos que completó una encuesta en línea sobre el consumo de sustancias. En particular, este trabajo se realizó con la submuestra que reportó consumir marihuana en los últimos 30 días (n = 158; 51.3 % mujeres). Dicha encuesta interrogaba sobre el consumo de marihuana y las consecuencias negativas asociadas, así como por motivos de consumo, normas sociales percibidas y estrategias conductuales de protección. Como resultado, los consumidores frecuentes presentaron mayor cantidad de consecuencias negativas (M = 4.92) que los consumidores esporádicos (M = 1.82; p < .05), y se halló un perfil distintivo en un conjunto de variables. A nivel multivariado, los motivos de animación (OR = 1.230; p < .05), las estrategias conductuales de protección (OR = .941; p < .05), el consumo en solitario (OR = 2.024; p < .05) y el consumo en fiestas universitarias (OR = 2.669; p < .05) discriminaron significativamente entre ambas clases de consumidores. En general, los hallazgos revelaron subpoblaciones heterogéneas de consumidores de marihuana que difieren no solo en el consumo y sus consecuencias, sino también en los contextos de consumo y en un conjunto de variables relevantes. Estas subpoblaciones distintivas requieren de intervenciones diferentes y específicas.

Abstract Although marijuana use is highly prevalent among university students in Argentina, little is known about the factors that distinguish frequent marijuana users from sporadic users. For this reason, the present study investigated the possible variations in the contexts of consumption, motives for consumption, perceived norms, and protective behavioral strategies among university students with frequent or sporadic marijuana use, and analyzed the usefulness of this set of variables to distinguish between these two types of users. For this purpose, a sample of 1083 Argentine university students completed an online survey on substance use. In particular, this work was conducted with the subsample that reported using marijuana in the last 30 days (n = 158; 51.3 % female). The survey asked about marijuana use and associated negative consequences, as well as motives for use, perceived social norms, and protective behavioral strategies. As a result, frequent users had a higher number of negative consequences (M = 4.92) than sporadic users (M = 1.82; p < .05), and a distinctive profile was found on a set of variables. At the multivariate level, cheerleading motives (OR = 1.230; p < .05), protective behavioral strategies (OR = .941; p < .05), solo use (OR = 2.024; p < .05), and college party use (OR = 2.669; p < .05) discriminated significantly between the two classes of users. Overall, the findings revealed heterogeneous subpopulations of marijuana users that differ not only in use and its consequences, but also in contexts of use and in a set of relevant variables. These distinct subpopulations require different and specific interventions.

Rev. Ciênc. Méd. Biol. (Impr.) ; 21(1): 46-52, maio 05,2022. fig, tab
Article in Portuguese | LILACS | ID: biblio-1370569


Introdução: a avaliação e intervenção motora possibilitam minimizar os atrasos no desenvolvimento motor de crianças prematuras. Objetivo: o objetivo deste estudo foi avaliar o desenvolvimento motor de crianças prematuras, de 0 a 12 meses de idade corrigida, após intervenção baseada em orientações aos pais. Metodologia: a amostra foi composta por 43 bebês nascidos prematuros e para avaliação do desempenho motor foi utilizada a Alberta Infant Motor Scale (AIMS), além de dois questionários qualitativos para identificação e controle dos fatores de risco. Foi utilizada estatística descritiva e os testes de Wilcoxon e McNemar para analisar as mudanças ao longo do tempo (p < 0,05). Resultados: através do follow-up, após as orientações aos pais, o número de bebês que apresentavam desempenho motor abaixo do esperado foi reduzido. Os percentis obtidos no desempenho motor nos dois momentos avaliativos indicam que houve melhora ao longo do tempo (p = 0,05), assim como os dados referentes à categorização (p = 0,04). Conclusões: é importante o acompanhamento e identificação da influência dos fatores de risco sobre os bebês para que medidas interventivas possam ser implementadas precocemente, sendo o modelo baseado em orientações um método de baixo custo e de fácil aplicabilidade em serviços públicos de saúde.

AbstractIntroduction: motor assessment and intervention makes it possible to minimize delays in motor development of premature children. Objective: the aim of this study was to evaluate the motor development of premature children, from 0 to 12 months of corrected age, after an intervention based on guidance to parents. Methodology: The sample consisted of 43 babies born prematurely and to assess motor performance, the Alberta Infant Motor Scale (AIMS) was used, in addition to two qualitative questionnaires to identify and control risk factors. Descriptive statistics were used and the Wilcoxon and McNemar tests to analyze changes over time (p < 0.05). Results: through the follow-up, after the guidance to the parents, the number of babies that presented motor performance below the expected was reduced, with statistical significance. The percentiles obtained in the motor performance in the two evaluation moments indicate that there was an improvement over time (p = 0.05), as well as the data related to the categorization (p = 0.04). Conclusion:it is important to monitor and identify the influence of risk factors on babies so that interventional measures can be implemented early, and the model based on guidelines is a low-cost and easily applicable method in public health services.

Humans , Male , Female , Infant, Newborn , Infant , Infant, Premature , Child , Child Development , Risk Factors , Follow-Up Studies , Healthcare Models
Int. braz. j. urol ; 48(2): 303-313, March-Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364958


ABSTRACT Purpose: To determine independent predictors of inguinal lymph node (ILN) metastasis in patients with penile cancer. Patients and methods: We retrospectively analyzed all patients with penile cancer who underwent surgery at our medical center in the last ten years (n=157). Using univariate and multivariate logistic-regression models, we assessed associations with age, medical-history, phimosis, onset-time, number and maximum diameter of involved ILNs measured by imaging, pathological T stage, degree of tumor differentiation and/or cornification, lymphatic vascular infiltration (LVI), nerve infiltration, and ILN metastases. Interaction and stratified analyses were used to assess age, phimosis, onset time, number of ILNs, cornification, and nerve infiltration. Results: A total of 110 patients were included in the study. Multiple logistic regression analysis showed that the following factors were significantly correlated with ILN metastasis: maximum diameter of enlarged ILNs, T stage, pathological differentiation, and LVI. Among patients with a maximum ILN diameter ≥1.5cm, 50% had lymph node metastasis whereas 30.6% patients with a maximum ILN diameter <1.5cm showed LNM. Among 44 patients with stage Ta/T1, 10 showed ILN metastases, while 47.0% patients with stage T2 showed ILN metastases. Among 40 patients with highly differentiated penile-cancer, eight showed ILN metastasis, while 47.1% patients with low-to-middle differentiation showed ILN metastases. The rate of LNM was 33.3% in the LVI-free group and 64.3% in the LVI group. Conclusion: Our single-center results suggested that maximum ILN diameter, pathological T stage, pathological differentiation, and LVI were independent risk factors for ILN metastases.

Humans , Male , Penile Neoplasms/surgery , Penile Neoplasms/pathology , Prognosis , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Lymph Node Excision , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Neoplasm Staging
ABCS health sci ; 47: e022204, 06 abr. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1363533


INTRODUCTION: Kidney transplantation (KT) is the renal replacement therapy (RRT) of choice for patients with chronic kidney disease (CKD). However, not every KT is successful and some patients persist on RRT. OBJECTIVE: To model a logistic regression with pre- and post-KT risk covariates capable of predicting secondary allograft dysfunction in need of RRT or reaching stage V of CKD until the first six months post-KT. METHODS: Cohort with KT recipients from Northeastern Brazil. Medical records of KT performed between 2011-2018 were analyzed. KT-recipients with insufficient data or who abandoned follow-up were excluded. The covariables analyzed were: demographic; infectious; pre- and post-KT comorbidities; panel reactive-antibodies; number of HLA mismatches; acute rejection episodes mediated by T-cell (ACR) or antibodies (AAR) six months after KT; and laboratory tests six months after KT. RESULTS: Covariates with higher risk for the analyzed outcomes six months after KT were: elderly KT recipients (OR:1.41; CI95%:1.01-1.99), time between onset of RRT and KT (ΔT-RRT&KT)>10years (OR:3.54; CI95%:1.27-9.87), diabetes mellitus (DM) pre-KT (OR:3.35; CI95%:1.51-7.46), pyelonephritis (OR:2.45; CI95%:1.24-4.84), polyomavirus nephropathy (OR:4.99; CI95%:1.87-13.3), AAS (OR:4.82; CI95%:1.35-17.2), 24h-proteinuria ≥300mg/24h (OR:5.05; CI95%:2.00-12.7) and serum calcium (Ca) <8.5mg/dL (OR:4.72; CI95%:2.00-11.1). The multivariate model presented an accuracy of 88.1% and the mean variance inflation factor is 1.81. CONCLUSION: Elderly-recipients, ΔT-RRT&KT>10 years, pre-KT DM, and post-KT aggressions until six months (pyelonephritis, polyomavirus nephropathy, ABMR, 24h-proteinuria≥300mg/24h, and Ca<8.5mg/dL) are associated with high predictive power for secondary allograft dysfunction in need of RRT or reaching CKD stage V until the first six months post-KT.

INTRODUÇÃO: Transplante renal (TR) é a terapia renal substitutiva (TRS) de escolha para pacientes com doença renal crônica (DRC). Entretanto, nem todo TR é bem-sucedido e alguns pacientes persistem em TRS. OBJETIVO: Modelar uma regressão logística com covariáveis de risco pré e pós-TR preditora da disfunção secundária do aloenxerto com necessidade de TRS ou alcance ao estágio V da DRC até os primeiros seis meses pós-TR. MÉTODOS: Coorte com receptores transplantados realizado em hospital no Nordeste brasileiro. Analisou-se registros médicos dos TR realizados entre 2011-2018. Receptores com dados insuficientes ou que abandonaram seguimento foram excluídos. Foram analisadas covariáveis: demográficas; infecciosas; comorbidades pré e pós-TR; painel de reatividade; incompatibilidades de HLA; episódios de rejeições agudas mediadas por células-T ou por anticorpos; exames laboratoriais seis meses pós-TR. RESULTADOS: Receptores idosos (OR:1,41; IC95%:1,01-1,99), tempo entre início da TRS e TR (∆T-TRS&TR)>10 anos (OR:3,54; IC95%:1,27-9,87), diabetes mellitus (DM) pré-TR (OR:3,35; IC95%:1,51-7,46), pielonefrite (OR:2,45; IC95%:1,24-4,84), nefropatia por poliomavírus (OR:4,99; IC95%:1,87-13,3), RAMA (OR:4,82; IC95%:1,35-17,2), proteinúria de 24h (Pt24h) ≥300mg/24h (OR:5,05; IC95%:2,00-12,7) e cálcio sérico (Ca)<8,5mg/dL (OR:4,72; IC95%:2,00-11,1) foram identificadas como covariáveis de maior risco para os desfechos analisados até seis meses pós-TR. O modelo multivariado apresentou acurácia de 88,1% e fator de inflação da variância médio de 1,81. CONCLUSÃO: Receptores idosos, ∆T-TRS&TR>10anos, DM pré-TR e agressões até seis meses pós-TR (pielonefrite, nefropatia por poliomavírus, RAMA, Pt24h≥300mg/24h e Ca<8,5mg/dL), apresentam alto poder preditivo para disfunção secundária do aloenxerto com necessidade de TRS ou alcance ao estágio V da DRC até os primeiros seis meses pós-TR.

Humans , Male , Female , Risk Factors , Kidney Transplantation , Renal Insufficiency, Chronic , Allografts , Proteinuria , Pyelonephritis , Logistic Models , Retrospective Studies , Renal Dialysis , Immunosuppression , BK Virus , Disease Progression , Hypocalcemia
Nursing (Säo Paulo) ; 25(287): 7516-7527, abr.2022. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1372415


Objetivo: identificar o perfil sociodemográfico, epidemiológico, clínico e os desfechos dos pacientes com infarto agudo do miocárdio em um pronto socorro. Método: estudo descritivo, transversal, quantitativo, realizado através de dados secundários de pacientes infartados. Resultados: a idade predominante foi entre 50-59 anos, sendo em sua maioria homens, pardos, casados. Foram acometidos com infarto com Supradesnivelamento de ST, apresentando precordialgia, sendo hipertensos, diabéticos, com sobrepeso/obesidade além de histórico de tabagismo. Os infartados apresentaram quadro hipertensivo na admissão, e durante a internação necessitaram de drogas vasoativas e suporte de oxigênio. O principal tratamento utilizado foi uso de fibrinolíticos, tendo como desfecho a transferência para hospitais cardiológicos. Conclusão: Há necessidade de aprimorar e intensificar a prevenção de fatores de riscos, elaborar protocolos e dispor de recursos capazes de proporcionar um atendimento adequado(AU)

Objective: to identify the sociodemographic, epidemiological, clinical profile and outcomes of patients with acute myocardial infarction in an emergency department. Method: descriptive, cross-sectional, quantitative study carried out using secondary data from infarcted patients. Results: the predominant age was between 50-59 years, being mostly men, brown, married. They were affected with infarction with ST elevation, presenting chest pain, being hypertensive, diabetic, overweight/ obese, in addition to a history of smoking. The infarcted patients presented with hypertension on admission, and during hospitalization they required vasoactive drugs and oxygen support. The main treatment used was the use of fibrinolytics, with the outcome being transfer to cardiology hospitals. Conclusion: There is a need to improve and intensify the prevention of risk factors, develop protocols and have resources capable of providing adequate care.(AU)

Objetivo: identificar el perfil sociodemográfico, epidemiológico, clínico y evolución de los pacientes con infarto agudo de miocardio en un servicio de urgencias. Método: estudio descriptivo, transversal, cuantitativo, realizado con datos secundarios de pacientes infartados. Resultados: la edad predominante fue entre 50-59 años, siendo en su mayoría hombres, morenos, casados. Se encontraban afectados de infarto con elevación del segmento ST, presentaban dolor torácico, eran hipertensos, diabéticos, con sobrepeso/obesidad, además de antecedentes de tabaquismo. Los pacientes infartados presentaban hipertensión arterial al ingreso y durante la hospitalización requirieron fármacos vasoactivos y soporte de oxígeno. El principal tratamiento utilizado fue el uso de fibrinolíticos, con resultado de traslado a hospitales de cardiología. Conclusión: Existe la necesidad de mejorar e intensificar la prevención de los factores de riesgo, desarrollar protocolos y contar con recursos capaces de brindar una atención adecuada(AU)

Risk Factors , Emergency Service, Hospital , Myocardial Infarction
ABCS health sci ; 47: e022210, 06 abr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1372684


INTRODUCTION: Due to the importance of infant death caused by congenital malformations worldwide, more studies are necessary to determine the prevalence of these disorders serving as the basis for more effective control measures. OBJECTIVE: To determine the prevalence and evaluate maternal risk factors for congenital malformations in newborns. METHODS: A cross-sectional and retrospective study was performed in the reference maternity hospital for high-risk pregnancies in the state of Sergipe, northeastern Brazil. Data were collected from the medical records and declarations of live births of 16,518 births between January 2014 and December 2016, being included children with identified congenital malformations. Data were analyzed using the odds ratio, chisquare, and Fisher's exact test with p<0.05. RESULTS: The study population was composed of 369 newborns with congenital malformations, which corresponds to 2.23% of total births. 53.9% were male, 47.9% had low birth weight and, 52.5% had adequate Apgar score. Anomalies affecting the musculoskeletal system were the most prevalent (30.9%), with polydactyly being the most frequent (53.5%). The number of prenatal consultations, education, and gestational age were the main observed maternal risk factors of congenital malformations. Anomalies of the circulatory system (OR=3.2 CI95% 1.3-7.84), multiple malformations (OR=9.24 CI95% 3.07-27.83), and chromosomal syndromes (OR=2.72 CI95% 1.48-5.01) were the most commonly associated with newborn deaths. CONCLUSION: The study presents the prevalence and risk factors related to malformations in the state of Sergipe, and improvements on maternal care and socioeconomic variables are important to decrease the number of malformations cases in Brazil.

INTRODUÇÃO: Devido à importância mundial relacionada à morte infantil causada por malformações congênitas, mais estudos são necessários para conhecer a prevalência destas enfermidades servindo de base para medidas de controle mais efetivos. OBJETIVO: Determinar a prevalência e avaliar fatores de risco materno para malformações congênitas em recém-nascidos. MÉTODO: Estudo transversal e retrospectivo na maternidade de referência para gestação de alto risco do estado de Sergipe, Nordeste do Brasil. Os dados foram coletados a partir dos prontuários médicos e declarações de nascido-vivo de 16.518 recém-nascidos entre janeiro de 2014 e dezembro de 2016, sendo incluídos aqueles com malformações congênitas identificadas. Foram utilizados razão de possibilidades, teste de qui-quadrado e exato de Fisher, com p<0,05. RESULTADOS: A população estudada foi composta por 369 recém-nascidos, que corresponde a 2,23% do total de nascimentos, 53,9% do sexo masculino, 47,9% com baixo peso ao nascer e 52,5% com Apgar adequado. Anomalias do sistema musculoesquelético foram as mais prevalentes (30,9%), tendo a polidactilia como a mais frequente (53,5%). O número de consultas de pré-natal, escolaridade e idade gestacional foram os principais fatores de risco maternos observados para as malformações congênitas. As anomalias do sistema circulatório (OR=3,2 IC95% 1,3-7,84), múltiplas malformações (OR=9,24 IC95% 3,07-27,83) e síndromes cromossômicas (OR=2,72 IC95% 1,48-5,01) foram as mais associadas com mortes dos recém-nascidos. CONCLUSÃO: O estudo apresenta a prevalência e os fatores de risco relacionados às malformações no estado de Sergipe, e melhorias no cuidado materno e nas variáveis socioeconômicas são importantes para diminuir o número de casos de malformações no Brasil.

Humans , Congenital Abnormalities/epidemiology , Infant, Newborn , Infant Mortality , Risk Factors , Maternal Health , Prevalence , Cross-Sectional Studies
Odontol. Sanmarquina (Impr.) ; 25(2): e22694, abr.-jun. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1368302


La reabsorción condilar (RC) después de una cirugía ortognática (CO) es una consecuencia no deseada y en ocasiones con complicaciones irreversibles. El propósito de la investigación fue determinar los factores de riesgo que inciden en la RC posterior a una CO, mediante una revisión bibliográfica. Para lo cual se planteó un estudio exploratorio y documental, se realizó una revisión de literatura de los artículos desde el periodo de 2000 hasta el 2020, sin restricción de idioma, se excluyeron las investigaciones en animales e in vitro, resúmenes de congresos, publicaciones de RC relacionadas por enfermedad sistémica y estudios sobre remodelación condilar sin especificar RC posquirúrgica. La búsqueda de información se efectuó entre julio-agosto del 2021, en las bases de datos de Pubmed, Embase y SciELO, inicialmente fue con los términos de RC, CO, reabsorción condilar progresiva, "RC y CO", reportando 1346 artículos iniciales, después se hizo una selección de los estudios en función de los factores de riesgo, identificando 53 artículos, siguiendo los lineamientos de PRISMA. Se incluyeron 23 artículos, el análisis de los mismos demostró que los principales factores de riesgo implicados en la RC posquirúrgica son el sexo femenino de los pacientes, entre 14 y 58 años, con maloclusión clase Angle II, con ángulos del plano mandibular alto (24º- 50º), expuestos a una cirugía bimaxilar, avance mandibular (AM) mayor a 5 mm en sentido antihorario, utilizar una fijación intermaxilar rígida y que la recaída posquirúrgica se puede relacionar con la RC.

Condylar resorption (CR) after orthognathic surgery (OS) is an undesirable consequence and sometimes with irreversible complications. The purpose of the research was to determine the risk factors that affect CR after OS by means of a literature review. For which an exploratory and documentary study was proposed, a literature review of the articles from 2000 to 2020 was carried out, without language restriction, excluding animal and in vitro research, conference abstracts, CR publications related to systemic disease and studies on condylar remodeling without specifying postoperative CR. The search for information was performed between July-August 2021, in Pubmed, Embase and SciELO databases, initially it was with the terms of CR, OS, progressive condylar resorption, "CR and OS", reporting 1346 initial articles, then a selection of studies was made according to risk factors, identifying 53 articles, following the PRISMA guidelines. Twenty-three articles were included, the analysis of which showed that the main risk factors involved in postoperative CR are the female sex of the patients, between 14 and 58 years old, with Angle II class malocclusion, with high mandibular plane angles (24º - 50º), exposed to bimaxillar surgery, mandibular advancement (MA) greater than 5 mm counterclockwise, use of rigid intermaxillary fixation and that postoperative relapse can be related to CR.

Int. j. cardiovasc. sci. (Impr.) ; 35(2): 230-242, Mar.-Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364972


Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Rev. bras. cir. plást ; 37(1): 36-44, jan.mar.2022. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1368207


Introdução: A mastopexia com prótese continua sendo um desafio para todos os cirurgiões plásticos. Resultados consistentes ainda são difíceis de se obter por muitas razões e alguns autores defendem a cautela devido a complicações. Métodos: Este estudo retrospectivo inclui 92 casos consecutivos mastopexia de aumento em tempo único realizados pelo mesmo cirurgião, entre março de 2012 e outubro de 2019. Resultados: O seguimento médio foi de 14 meses para o grupo de mastopexia de aumento. Três pacientes (3,3%) tiveram contratura capsular grau III. O índice de revisões foi de 25,3%: 7,6% com recidiva da ptose, revisão de cicatrizes em 6,5%, 1,1% de assimetrias. Três pacientes (3,3%) apresentaram ruptura da fixação da alça muscular, quatro pacientes (4,4%) tiveram deformidades dinâmicas. Conclusão: A técnica modificada de duplo espaço apresenta em nossa experiência resultados consistentes a longo prazo, e as taxas de revisão/complicação foram semelhantes a alguns estudos, mas maiores do que outros. Cirurgia prévia da mama, tabagismo, amamentação e cirurgia bariátrica anterior não aumentam as taxas de complicações e revisões. Pode ser uma das opções para a cobertura e suporte dos implantes em procedimentos de mastopexia de aumento.

Introduction: Mastopexy with prosthesis remains a challenge for all plastic surgeons. Consistent results are still difficult to obtain for many reasons, and some authors advocate caution due to complications. Methods: This retrospective study includes 92 consecutive single-stage augmentation mastopexy cases performed by the same surgeon between March 2012 and October 2019. Results: The median follow-up was 14 months for the augmentation mastopexy group. Three patients (3.3%) had grade III capsular contracture. The revision rate was 25.3%: 7.6% with ptosis recurrence, scar revision in 6.5%, and 1.1% asymmetries. Three patients (3.3%) had ruptured muscle loop fixation, four patients (4.4%) had dynamic deformities. Conclusion: The modified double-space technique in our experience shows consistent long-term results, and revision/complication rates were similar to some studies but higher than others. Prior breast surgery, smoking, breastfeeding, and previous bariatric surgery do not increase rates of complications and revisions. It can be one of the options for covering and supporting implants in augmentation mastopexy procedures.

Int. j. cardiovasc. sci. (Impr.) ; 35(2): 184-190, Mar.-Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364983


Abstract Background: ST-segment elevation acute myocardial infarction (STEMI) is a pathological process that involves cardiac muscle tissue death. Intravenous thrombolysis with fibrinolytics or primary percutaneous coronary intervention (PCI), an invasive technique, can be performed for tissue revascularization. PCI has been preferred as compared to non-invasive methods, although few studies have described its use in Brazil. Objectives: The aim of the present study was to analyze data on the use of primary PCI and investigate the relevance of hospitalizations for the treatment of STEMI in the country. Methods: A descriptive, cross-sectional analysis of data from the Brazilian Unified Health system (SUS) Department of Informatics (DATASUS) from 2010 to 2019 was conducted. Results: Hospitalizations for STEMI represented 0.6% of all hospital admissions in Brazil in the analyzed period, 0.9% of hospital costs, and 2.1% of deaths. The number of hospitalizations due to STEMI was 659,811, and 82,793 for PCIs. Length of hospital stay was 36.0% shorter and mortality rate was 53.3% lower in PCI. The mean cost of PCI was 3.5-fold higher than for treatment of STEMI. Conclusions: Data on hospitalizations for STEMI treatment in Brazil revealed high hospitalization and mortality rates, elevated costs, and long hospital stay. Although primary PCI is a more expensive and less used technique than other methods, it can reduce the length of hospital stay and mortality in the treatment of STEMI.

Humans , Angioplasty, Balloon, Coronary/methods , ST Elevation Myocardial Infarction/surgery , ST Elevation Myocardial Infarction/mortality , ST Elevation Myocardial Infarction/epidemiology , Cross-Sectional Studies , Coronary Disease/complications , Hospitalization/statistics & numerical data
Int. j. cardiovasc. sci. (Impr.) ; 35(2): 202-213, Mar.-Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364977


Abstract Background Short message service (SMS) to promote healthcare improves the control of cardiovascular risk factors, but there is a lack of evidence in low and middle-income countries, particularly after acute coronary syndromes (ACS). Objective This study aims to evaluate whether the use of SMS increases risk factor control after hospital discharge for ACS. Methods IMPACS is a 2-arm randomized trial with 180 patients hospitalized due to ACS at a tertiary hospital in Brazil. Eligible patients were randomized (1:1) to an SMS intervention (G1) or standard care (G2) upon hospital discharge. The primary endpoint was set to achieve 4 or 5 points in a risk factor control score, consisting of a cluster of 5 modifiable risk factors: LDL-C <70mg/dL, blood pressure (BP) <140/90mmHg, regular exercise (≥5 days/week, 30 minutes/session), nonsmoker status, and body mass index (BMI) <25 kg/m2] at 6 months. Secondary outcomes were components of the primary outcome plus rehospitalization, cardiovascular death, and death from any cause. Results are designated as significant if p<0.05. Results From randomized patients, 147 were included in the final analysis. Mean age was 58 (51-64) years, 74% males. The primary outcome was achieved by 12 (16.2%) patients in G1 and 15 (20.8%) in G2 (OR=0.73, 95%CI 0.32-1.70, p=0.47). Secondary outcomes were also similar: LDL-C<70 mg/dl (p=0.33), BP<140/90 mmHg (p=0.32), non-smoker (p=0.74), regular exercise (p=0.97), BMI (p=0.71), and rehospitalization (p=0.06). Death from any cause occurred in three participants (2%), including one cardiovascular death in each group. Conclusion SMS intervention did not significantly improve cardiovascular risk factor control when compared to standard care in patients discharged after ACS in Brazil.

Humans , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Acute Coronary Syndrome/prevention & control , Secondary Prevention/methods , Text Messaging/statistics & numerical data , Telemedicine/methods , Delivery of Health Care/methods , Acute Coronary Syndrome/rehabilitation , Acute Coronary Syndrome/therapy , Heart Disease Risk Factors
Int. j. cardiovasc. sci. (Impr.) ; 35(1): 68-79, Jan.-Feb. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1356304


Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak's test, and Friedman ANOVA on Ranks and Dunn's test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges' g and Cliff's δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students' quality of life.

Int. j. cardiovasc. sci. (Impr.) ; 35(1): 1-10, Jan.-Feb. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1356319


Abstract Background The lower frequency of cardiovascular (CV) risk factors observed in vegetarians compared to omnivores may be due to more appropriate nutrient intake according to recommendations for the prevention of cardiovascular diseases. Objective To compare the dietary adequacy according to the recommendations of the National Cholesterol Education Program (NCEP) in apparently healthy vegetarian (VEG) and omnivorous (OMN) men. Methods This was a cross-sectional study, conducted with apparently healthy men (44 omnivorous and 44 vegetarians, ≥ 35 years), who were assessed for daily food consumption, anthropometric data, physical exercise status, and clinical data. Multiple logistic regression was used to test the association between the type of diet and the dietary adequacy. Significant values were considered for p<0.05. Results Several clinical CV risk markers were significantly lower in VEG when compared to OMN: body mass index (BMI) (23.1 vs. 27.3 kg/m2), systolic blood pressure (119.5 vs. 129.2 mmHg), and diastolic blood pressure (75.7 vs. 83.9 mmHg). VEG presented significant lower values of blood lipids and glucose. No significant difference was observed in caloric intake; however, VEG consumed significantly more carbohydrates, dietary fibers, and polyunsaturated fats. VEG presented an adequate consumption of dietary cholesterol and saturated and polyunsaturated fatty acids, regardless of caloric intake and age. Conclusion VEG were more likely to consume saturated fatty acids, dietary cholesterol, and fibers according to the recommendations of NCEP, factors that may contribute to lower levels of CV risk markers than OMN.

Int. j. cardiovasc. sci. (Impr.) ; 35(1): 14-24, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1356322


Abstract Background: The risk of sports-related sudden cardiac arrest after COVID-19 infection can be a serious problem. There is an urgent need for evidence-based criteria to ensure patient safety before resuming exercise. Objective: To estimate the pooled prevalence of acute myocardial injury caused by COVID-19 and to provide an easy-to-use cardiovascular risk assessment toolkit prior to resuming sports activities after COVID-19 infection. Methods: We searched the Medline and Cochrane databases for articles on the prevalence of acute myocardial injury associated with COVID-19 infection. The pooled prevalence of acute myocardial injury was calculated for hospitalized patients treated in different settings (non-intensive care unit [ICU], ICU, overall hospitalization, and non-survivors). Statistical significance was accepted for p values <0.05. We propose a practical flowchart to assess the cardiovascular risk of individuals who recovered from COVID-19 before resuming sports activities. Results: A total of 20 studies (6,573 patients) were included. The overall pooled prevalence of acute myocardial injury in hospitalized patients was 21.7% (95% CI 17.3-26.5%). The non-ICU setting had the lowest prevalence (9.5%, 95% CI 1.5-23.4%), followed by the ICU setting (44.9%, 95% CI 27.7-62.8%), and the cohort of non-survivors (57.7% with 95% CI 38.5-75.7%). We provide an approach to assess cardiovascular risk based on the prevalence of acute myocardial injury in each setting. Conclusions: Acute myocardial injury is frequent and associated with more severe disease and hospital admissions. Cardiac involvement could be a potential trigger for exercise-induced clinical complications after COVID-19 infection. We created a toolkit to assist with clinical decision-making prior to resuming sports activities after COVID-19 infection.

Säo Paulo med. j ; 140(1): 33-41, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1357459


ABSTRACT BACKGROUND: Dengue is considered to be the most important arbovirus worldwide, with important complications that increase its lethality. In Brazil, an endemic country, the disease reaches significant incidence levels, with occurrences of serious cases and high costs of hospitalizations for its treatment. OBJECTIVE: To analyze risk factors among individuals with recent histories of dengue infection in a medium-sized city in Mato Grosso. DESIGN AND SETTING: Descriptive cross-sectional study, of epidemiological-survey type, conducted among the urban population of a city located in mid-northern Mato Grosso. METHODS: A seroepidemiological survey using questionnaires and collection of biological material was conducted among 596 adults aged ≥ 18 years who had been selected through a cluster sampling process. Positive dengue cases were those with positive results from anti-dengue immunoassays (ELISA). Statistical analyses with descriptive and inferential techniques were used, with 95% confidence intervals and a 5% significance level. RESULTS: The seroepidemiological profile of the study participants was predominantly female, with ages between 18 and 39 years, self-declared non-white race/color, not more than eight years of education and not living with a companion. Among the sanitary factors analyzed, the following were risk factors for dengue virus infection: no running water at home; no water supply from the public piped network; no waste from drains or toilets sent to the sewage network; endemic disease combat agents visiting the home; and presence of mosquito breeding sites at home. CONCLUSION: Low schooling levels and previous dengue virus infection were associated with current dengue virus infection.

Rev. bras. ativ. fís. saúde ; 27: 1-8, fev. 2022.
Article in English | LILACS | ID: biblio-1357986


The aim of the study was to evaluate the effect of the volume of participation in exercise programs offered in Primary Health Care (PHC), for 24 weeks on blood biochemical parameters of adult women. Three Basic Health Units in Rio Claro City (São Paulo) were selected and 2 exercise inter-ventions were implemented with different volumes (3 weekly sessions, 90 minutes each; 2 weekly sessions, 60 minutes each). In total, 53 participants remained until the end of the interventions. Regardless of their number of absences, they were divided into 4 groups, according to the volume of participation (calculated individually according to the duration of sessions and the number of classes held), forming groups according to quartiles: Low Volume Group (LVG; 57.62 ± 9.97 years-old), Low Medium Volume Group (LMVG; 56.31 ± 12.18 years-old), High Medium Volume Group (HMVG; 53.00 ± 10.25 years-old), and High-Volume Group (HVG; 59.69 ± 7.66 years-old). Blood biochemical parameters were dosed using the ELISA method. The Generalized Estimation Equa-tion Model was used to compare the biochemical parameters (time, group, and interaction; p ≤ 0.05). The analysis showed significant and positive time effect for low-density lipoproteins (LDL) and glycemia in all groups and for total cholesterol (TC) in LVG, LMVG and HMVG; a significant group effect for HVG on TC (higher levels compared to all other groups) and LDL (higher levels compared to LVG and LMVG). It is concluded that the physical exercise programs offered in the PHC contributed to a significant reduction in LDL and blood glucose levels, regardless of the vol-ume of participation of individuals in the programs

O objetivo do presente estudo foi avaliar o efeito do volume de participação em programas de exercícios, ofer-tados na Atenção Primária à Saúde (APS), durante 24 semanas, nos parâmetros bioquímicos sanguíneos de mulheres adultas. Foram selecionadas 03 Unidades Básicas de Saúde de Rio Claro-São Paulo e implementa-das 2 intervenções de exercícios com diferentes volumes (3 sessões/semana, 90 minutos cada; 2 sessões/semana, 60 minutos cada). No total, 53 participantes se mantiveram até o final das intervenções, independentemente do número de faltas foram divididos em 4 grupos, de acordo com o volume de participação (calculado con-forme a duração das sessões e a quantidade de aulas realizadas de forma individual), formando os grupos segundo os quartis: Grupo Baixo Volume (GBV; 57,62 ± 9,97 anos), Grupo Baixo Médio Volume (GBMV; 56,31 ± 12,18 anos), Grupo Médio Alto Volume (GMAV; 53,00 ± 10,25 anos) e Grupo Alto Volume (GAV; 59,69 ± 7,66 anos). Os parâmetros bioquímicos sanguíneos foram dosados pelo método ELISA. Foi utilizado o Modelo de Equações de Estimações Generalizadas para a comparação dos parâmetros bioquímicos (tempo, grupo e interação; p ≤ 0,05). A análise evidenciou efeito significativo favorável do tempo para lipoproteínas de baixa densidade (LDL) e glicemia em todos os grupos e para colesterol total (CT) no GVB, GBMV e GMAV; e efeito significativo do grupo para GAV no CT (maiores níveis comparado a todos os grupos) e LDL (maiores níveis comparados ao GBV e GBMV ). Conclui-se que o programa de exercício físico ofertado na APS contribuiu para a redução significativa dos níveis de LDL e glicemia, independentemente do volume de participação dos indivíduos nos programas

Humans , Female , Primary Health Care , Exercise , Risk Factors , Community Participation
Saude e pesqui. (Impr.) ; 15(1): e10072, abr./jun. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1368040


Este estudo caso-controle teve como objetivo identificar os fatores que modificam o risco de câncer de próstata em pacientes de um hospital público da Paraíba. Dados de 91 pacientes e 91 controles saudáveis pareados por idade (± 5 anos) foram obtidos de prontuários médicos e entrevistas pessoais. A razão de chance e os intervalos de confiança foram determinados por meio de análise de regressão. Pacientes e controles tinham em média 69,56 (DP = 8,31) e 68,32 (DP = 7,68) anos (p = 0,297). Afrodescendentes e homens que já fumaram, tiveram um risco 4,150 e 3,939 vezes maior (p <0,001; p <0,001). A história familiar aumentou o risco 6,967 vezes (p <0,001). Ascendência africana, tabagismo e história familiar aumentaram o risco de câncer de próstata. As recomendações das autoridades de saúde em relação ao rastreamento do câncer de próstata poderiam se concentrar mais nos homens com esses fatores de risco.

This case-control study aimed on the identification of factors that modified prostate cancer risk of patients in a public hospital of Paraíba. Data from 91 patients with prostate cancer and 91 age- matched (±5 years) healthy controls were obtained from medical records and personal interviews. Odds ratios (ORs) and confidence intervals (CIs) were determined using regression analysis. Patients and controls were on average 69.56 (SD= 8.31) and 68.32 (SD= 7.68) years old (p = 0.297). In a model of multiple regression analysis, Afrodescendants and men who ever smoked had a 4.150 and 3.939 times increased risk (p < 0.001; p < 0.001). Family history of first- degree relatives was associated with a 6.967 (p < 0.001) increased risk of prostate cancer. African ancestry, smoking and family history increased the risk of prostate cancer. Recommendations of health authorities regarding prostate cancer screening could stronger focus on men with these risk factors.