High prevalence of functional dyspepsia in nonalcoholic fatty liver disease: a cross-sectional study

Abstract BACKGROUND: Gastrointestinal (GI) symptoms are frequent complaints from individuals with nonalcoholic fatty liver disease (NAFLD). Dyspepsia is a universal clinical symptom and is among the most common GI complaints observed in the general population, but its prevalence in the population with NAFLD has not been previously investigated. OBJECTIVE: To compare the prevalence of functional dyspepsia (FD) between patients with NAFLD and controls without liver disease. DESIGN AND SETTING: Cross-sectional study at the Outpatient Liver Clinic, University Hospital, Belo Horizonte, Brazil. METHODS: We included 96 NAFLD patients and 105 controls without liver disease. All participants were assessed for GI symptoms in accordance with the Rome III criteria. Evaluation methods included a questionnaire for FD (validated in Brazil), laboratory tests and upper GI endoscopy. RESULTS: Mean age and sex were similar between the groups. The NAFLD group presented higher frequency of proton-pump inhibitor usage (31.3% vs 4.8%; P < 0.001) and prevalence of FD (25.0% versus 12.4%; P = 0.021). The symptom frequencies were as follows: postprandial distress, 22.9% versus 11.4% (P = 0.030); postprandial fullness, 18.8% versus 10.5% (P = 0.095); early satiation, 8.3% versus 5.7% (P = 0.466); and epigastric pain or burning, 18.8% versus 5.7% (P = 0.004), in NAFLD patients and controls, respectively. Multivariate analysis demonstrated that female sex (odds ratio, OR 6.97; 95% confidence interval, CI: 1.51-32.12; P = 0.013) and NAFLD diagnosis (OR 2.45; 95% CI: 1.14-5.27; P = 0.021) were independently associated with FD occurrence. CONCLUSION: FD occurs more frequently in individuals with NAFLD than in controls without hepatic disease.

Cuidados com a Saúde Autosselecionados pelos Usuários da Atenção Primária / Health Initiatives Self Selected by Users of Primary Healthcare

RESUMO Este estudo descreve as mudanças em cuidados com a saúde que usuários da atenção primária escolheram adotar após participarem de uma ação de educação em saúde sobre cuidados com a saúde e determinar o grau de comprometimento desses usuários com essas mudanças autoestabelecidas. Foi desenvolvida uma ação de educação em saúde com usuários da atenção primária sobre cuidados com a saúde. Os indivíduos foram avaliados imediatamente após esta ação e dois a três meses depois, por meio de um questionário semiestruturado. Os relatos foram analisados pela análise de conteúdo. Entre os participantes, 31% tiveram como objetivo praticar atividade física, 28% melhorar a alimentação, 22,9% cuidar da saúde mental, 12,6% emagrecer, 10,3% cuidar da saúde em geral, 6,9% consumir menos álcool, 4,6% parar de fumar, e 1,15% cuidar do meio ambiente. Após dois a três meses, 8,62% não se lembraram e não cumpriram as metas autoestabelecidas, 22,41% as cumpriram totalmente, e 68,97%, apesar de se lembrarem, não as cumpriram. Desses, 77,5% apontaram como motivo para o não cumprimento a falta de disciplina, 17,5% a falta de tempo e 5% problemas de saúde.

ABSTRACT The aim of this study was to describe changes in self-care to be adopted by users of primary healthcare services in Brazil upon participation in a health education initiative, and to determine their involvement with these changes. A health education initiative was therefore developed with users of primary healthcare services in Brazil, with subjects assessed immediately afterwards and then two to three months apart (by means of a semi-structured questionnaire). Analyzed according to content analysis, reports showed that 31% of participants selected physical activity as a means of improving their health, 28% selected improving food habits, 22.9% improving mental care, 12.6% losing weight, 10.3% healthcare in general, 6.9% drinking less alcohol, 4.6% quitting smoking and 1.15% caring for the environment. After two to three months, 8.62% did not remember which they had selected to improve their health while 22.41% performed the selected initiative and 68.97% remembered their selection without going on to take the actions. Among participants, 77.5% claimed not to have been committed to the actions selected, 17.5% reported not having time and 5% said they suffered from health problems.

Avaliação e alterações eletrocardiográficas encontradas em atletas do Centro de Treinamento Esportivo da UFMG / Electrocardiography interpretation and alterations found in athletes from the sports training Centre of Federal University of Minas Gerais

Introdução: a prática esportiva promove alterações morfofuncionais no coração, que estão relacionadas ao tempo e intensidade do treinamento. Essas alterações são demonstráveis ao ECG de repouso e podem incluir sobrecarga ventricular, distúrbios do ritmo e da condução. Objetivos: avaliar as alterações eletrocardiográficas em atletas do Centro de Treinamento Esportivo da UFMG. Métodos: o total de 68 atletas foi submetido à avaliação clínica composta de anamnese, exame físico e realização de ECG de repouso de 12 derivações, realizado por um único médico do esporte com experiência prévia. Resultados: a média de idade dos atletas foi de 14,6 ± 2,75 anos, sendo 41 deles do sexo masculino (60,3%) e 27 do sexo feminino (39,7%). Foram encontradas alterações no ECG de 45 indivíduos (66,2%), todas elas consideradas não patológicas para um atleta. A repolarização precoce foi encontrada em 34 atletas. A bradicardia sinusal isolada aparece em 18 atletas. Outras alterações encontradas foram ritmo atrial ectópico, bloqueio incompleto de ramo direito, bloqueio atrioventricular de primeiro grau e arritmia sinusal. Conclusões: tais alterações encontradas são consideradas não patológicas e normalmente encontradas em cerca de 60% dos atletas. Reconhecer essas condições fisiológicas é de fundamental importância para o trabalho do médico do esporte, já que pode evitar custos adicionais e afastamentos desnecessários da atividade esportiva.

Introduction: Practicing sports can promote alterations in the heart, related to duration and intensity of the activity. These changes can be seen on the resting ECG and include ventricular overload and rhythm and conduction disturbances. Objectives: To assess the electrocardiographic alterations in athletes from the Sports Training Centre of Federal University of Minas Gerais. Methods: 68 athletes were submitted to a medical evaluationthat included clinical history, physical examination and a resting ECG realized by a sports medicine doctor with previous experience. Results: The average age was 14,6± 2,75 years old. 41 males (60,3%) and 27 females (39,7%) were evaluated. 45 individuals (66,2%) presentedalterations on the ECG, all non pathological for an athlete. Early repolarization was found in 34 athletes. Sinus bradycardia alone was found in 18 athletes. Other alterations found were ectopic atrial rhythm, incomplete right bundle block, incomplete right bundle block, first degree atrioventricular bundle and sinus arrhythmia. Conclusions: Alterationsfound in this study are non pathological and commonly presentin60% of athletes. Being able to recognize these physiological conditions is extremely important for a sports medicine doctor, as they can prevent additional costs and unnecessary cease of work activity.