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1.
An Sist Sanit Navar ; 36(1): 145-8, 2013.
Article in English | MEDLINE | ID: mdl-23648507

ABSTRACT

Gastric lipoma is considered a rare condition that may constitute a challenging diagnosis. A 51-year-old woman presented dysphagia and abdominal pain, and an upper digestive endoscopic study disclosed a gastric tumor located in the submucosa of the pyloric antrum. Conclusive diagnosis was established after repeated endoscopic biopsies, and the patient was subjected to an atypical gastrectomy, which evolved into a pyloric stenosis. This complication was appropriately corrected and the patient remains symptomless, under outpatient surveillance.


Subject(s)
Gastrectomy/adverse effects , Lipoma/surgery , Pyloric Stenosis/etiology , Stomach Neoplasms/surgery , Female , Humans , Middle Aged , Pyloric Stenosis/surgery
2.
Cad Saude Publica ; 17(4): 877-85, 2001.
Article in Portuguese | MEDLINE | ID: mdl-11514868

ABSTRACT

This research was developed in 1995-1996 in the Oliveira Pombo Health Center (CSOP), Fortaleza, Ceará, Brazil. The aim was to explore factors influencing non-adherence to tuberculosis treatment. Specific objectives were: dynamics of tuberculosis notification and treatment of non-adherence cases at the CSOP; demographic, social, economic, and cultural profiles of clientele (social actors); default reasons that interrupt treatment; and knowledge and perception of the disease. The methodological approach was based on descriptive epidemiology and on sociological interpretivism. A semi-structured interview was used for questions related to the social actors, such as: demographic, social, economic, cultural, and behavioral factors; knowledge and perceptions of tuberculosis and treatment; impact of the disease on patients' lives; and perspectives concerning health service attendance. Results show that treatment non-compliance involved multiple and complex interrelated factors.


Subject(s)
Patient Dropouts/statistics & numerical data , Treatment Refusal/statistics & numerical data , Tuberculosis/drug therapy , Adolescent , Adult , Brazil , Child , Child, Preschool , Female , Health Knowledge, Attitudes, Practice , Humans , Infant , Infant, Newborn , Male , Middle Aged , Process Assessment, Health Care
3.
Am J Drug Alcohol Abuse ; 27(3): 525-9, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11506266

ABSTRACT

UNLABELLED: Patients with psychiatric illness smoke more heavily than others in the community. They have more difficulty quitting and have more withdrawal symptoms than others. OBJECTIVE: The purpose of the present study was to examine the utilization of nicotine replacement methods in a population of psychiatric patients. METHOD: In a naturalistic retrospective review, we examined the records of 55 patients who were hospitalized on a smoke-free psychiatric unit. We abstracted the frequency of utilization of nicotine replacement. The rate of utilization was considered a ratio of the number of days utilized to the number of days prescribed. RESULTS: There were 38 patients (69%) who used the transdermal patch, 26 patients (47%) used the inhaler, 4 patients (7%) used nicotine gum, and 2 patients (4%) used the nasal spray. The rate of utilization of the nicotine inhaler (63%) exceeded that of the transdermal nicotine patch (30%) (t = 4.6, p < .0001). CONCLUSION: The hospitalization of smokers with mental illness in smoke-free psychiatric units often leads to further behavioral deterioration. The patients in the present study demonstrated a definite preference for the nicotine inhaler over the transdermal patch. Possible clinical and pathophysiological implications of this finding are discussed.


Subject(s)
Nicotine/administration & dosage , Psychiatric Department, Hospital , Smoking Cessation/methods , Smoking Prevention , Smoking/drug therapy , Adolescent , Adult , Cohort Studies , Female , Hospitalization , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome
4.
Addict Behav ; 25(3): 441-3, 2000.
Article in English | MEDLINE | ID: mdl-10890298

ABSTRACT

Patients hospitalized for treatment of psychiatric illness commonly receive pro re nata (p.r.n.) anti-anxiety and hypnotic agents. The relationship between illicit drug use and p.r.n. anti-anxiety/hypnotic drug use in hospitalized psychiatric patients has not been extensively examined. The purpose of the present study was to examine this relationship. A retrospective review of 99 randomly selected hospitalized patients abstracted information regarding the utilization of p.r.n. anxiolytic and hypnotic medications. Seventy percent of the patients surveyed evidenced substance dependence. The substance users utilized p.r.n. anxiolytics (t = 2.29, df = 81, p < .05) and bedtime hypnotics (t = 4.23, df = 90, p < .0001) more frequently than the nonusers. Hospitalized substance abusers appear to continue their substance abuse in the hospital, substituting prescription preparations for illicit drugs. Nevertheless, cumulative literature now suggests that p.r.n. anxiolytic and hypnotic agents play a critical role in the management of aggressive behavior and insomnia in patients hospitalized with psychiatric illness.


Subject(s)
Anti-Anxiety Agents/therapeutic use , Anxiety/drug therapy , Hypnotics and Sedatives/therapeutic use , Illicit Drugs , Substance-Related Disorders/epidemiology , Adult , Aged , Anxiety/etiology , Female , Hospitalization , Humans , Length of Stay , Male , Mental Disorders/complications , Mental Disorders/rehabilitation , Middle Aged , Retrospective Studies , Substance-Related Disorders/complications , Substance-Related Disorders/psychology
6.
Cad Saude Publica ; 14(3): 583-95, 1998.
Article in Portuguese | MEDLINE | ID: mdl-9761612

ABSTRACT

This study was conducted in a rural community, São João dos Queiróz, a township in the county of Quixadá, Ceará, Brazil, using a combination of participatory research and community education in compliance with the health promotion reference and principles of the 1986 Ottawa Charter. The project was joined by representatives of several local government institutions and organizations from the grassroots community movement. The theme generating the research, as defined by an assembly meeting of the community association, was a diagnosis of sanitation conditions in the community. The starting point was the assessment of local conditions. Results showed adverse local conditions in sanitation, literacy, income, and employment. Suggestions for solving the problems were organized so as to be included in the planning agenda for local health policies. Evaluation was procedural and enriched with daily research activities. The problem-solving pedagogical approach developed during the educational process contributed to a critical reconstruction, appropriation, and sharing of the resulting knowledge.


Subject(s)
Health Education , Health Promotion , Sanitation , Adolescent , Adult , Brazil , Child , Child, Preschool , Community Participation , Educational Status , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Research , Rural Population , Socioeconomic Factors , Water Supply
9.
Addict Behav ; 21(5): 671-4, 1996.
Article in English | MEDLINE | ID: mdl-8876766

ABSTRACT

The seasonality of depressive illness has been documented since antiquity. A review of 611 patients, who were consecutively admitted to the adult inpatient psychiatric unit of a mid-Michigan general hospital, examined the influence of cigarette smoking and psychiatric diagnosis upon the seasonal variation of admissions. Among the smokers, admissions for depressive disorders (n = 151) peaked in the springtime (z = 2.1, p < .05) and declined in summer. Admissions for the nonsmokers failed to demonstrate a substantial seasonal rhythm. Admissions for smokers and nonsmokers in other diagnostic groups did not show any seasonal variation. These findings parallel numerous studies regarding the influence of seasons upon rates of hospitalization for depressive disorder, and completed suicide. Therapeutic implications related to the bidirectional relationship between cigarette smoking and depression are discussed.


Subject(s)
Depression/epidemiology , Periodicity , Seasons , Smoking/epidemiology , Adult , Depression/complications , Female , Hospitalization/statistics & numerical data , Humans , Male , Mental Disorders/complications , Mental Disorders/epidemiology , Michigan/epidemiology , Retrospective Studies , Risk Factors
10.
Gen Hosp Psychiatry ; 17(6): 454-5, 1995 Nov.
Article in English | MEDLINE | ID: mdl-8714807

ABSTRACT

Ninety percent of suicide attempts referred to a general hospital are by self-poisoning. Among women, drug overdose is the commonest means of suicide. In a retrospective naturalistic review of 200 patients who were treated in the Critical Care Unit of a general hospital following medication overdose, 12% were antidepressant overdoses. The mean duration of hospital stay for overdose with tricyclic antidepressants (TCA) was more than double that for overdose with selective serotonin reuptake inhibitors (SSRI) (7 vs 3 days; z = 2.20, p < 0.05). The dollar cost of hospital treatment for patients who overdosed on TCAs was four times greater than that for patients who overdosed on SSRIs ($22,923 vs $5,379; z = 2.30, p < 0.05). The tricyclic compounds clearly have a price advantage over more recently introduced antidepressant agents fluoxetine, sertraline, paroxetine, venlafaxine, and bupropion. The apparent cost advantage of prescribing a less expensive drug may be nullified by the cost associated with adverse consequences.


Subject(s)
Antidepressive Agents/poisoning , Drug Overdose/economics , Suicide, Attempted/economics , Antidepressive Agents/economics , Antidepressive Agents, Second-Generation/economics , Antidepressive Agents, Second-Generation/poisoning , Costs and Cost Analysis , Critical Care/economics , Drug Overdose/prevention & control , Drug Overdose/psychology , Female , Humans , Length of Stay/economics , Male , Michigan , Retrospective Studies , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Treatment Outcome
11.
Rev Soc Bras Med Trop ; 28(3): 223-32, 1995.
Article in Portuguese | MEDLINE | ID: mdl-7480917

ABSTRACT

This work was developed in the Paranoá city town of the Federal District of Brazil. It used techniques of participative research with the aim of reducing intestinal helminths transmission in a group of children at nutritional risk. The family nucleus, that is, parents, children and other relatives living together in the same house, was used as reference for this research. All steps of the work were followed simultaneously by technical and educative actions. The technical actions were related to faecal examinations and medication. The educative process, stimulated critical analysis and reflections on the central problem and life conditions, with a strong focus on Health Promotion to improve life quality, as well as an empowerment process. During the work development, of the action program included the following steps: home visits, interviews, group meetings, feedback on the faeces examinations results and treatment. An evaluation of the final results was made through quantitative and qualitative methods, which showed the construction, acquisition and socialisation of knowledge.


Subject(s)
Helminthiasis/prevention & control , Intestinal Diseases, Parasitic/prevention & control , Brazil , Community Participation , Health Education , Helminthiasis/transmission , Humans , Intestinal Diseases, Parasitic/transmission , Surveys and Questionnaires , Urban Population
12.
Am J Drug Alcohol Abuse ; 21(2): 257-65, 1995 May.
Article in English | MEDLINE | ID: mdl-7639211

ABSTRACT

The use of a structured diagnostic interview (The Schedule for Affective Disorders and Schizophrenia) with 58 consecutively admitted general adult psychiatric patients revealed that 62.1% of them abused alcohol and 58.6% had a substance use disorder. The drug abusers did not differ significantly from the nonabusers on mean psychoticism (Brief Psychiatric Rating Scale) scores. However, they received higher doses of antipsychotic agents (mean daily dose 1022 mg CPZ EQ (SD = 614) vs 609 mg CPZ EQ (SD = 481); z = 2.58, p < .01) to achieve stabilization. The clinical implications of this finding are discussed.


Subject(s)
Chlorpromazine/administration & dosage , Chlorpromazine/therapeutic use , Dose-Response Relationship, Drug , Ethanol , Mental Disorders/complications , Mental Disorders/drug therapy , Narcotics , Substance-Related Disorders/complications , Adolescent , Adult , Age Factors , Aged , Cohort Studies , Female , Humans , Male , Middle Aged
13.
Ann Clin Psychiatry ; 7(1): 11-8, 1995 Mar.
Article in English | MEDLINE | ID: mdl-8541932

ABSTRACT

The records of 377 bipolar disorder patients who were consecutively admitted to a general inpatient psychiatric unit in mid-Michigan over a 6-year period were examined. The seasonal variation of hospitalization, total sleep time, thyroid stimulating hormone, creatinine levels, lithium dosage and serum levels, aggressive behavior, and treatment outcome were analyzed. Among men, the admission rate peaked in the springtime. Women demonstrated a bimodal season distribution, with peak admission rates in spring and fall. Aggressive behavior in both men and women peaked in the spring (z = 2.50, p < 0.05). Men maintained on lithium achieved higher serum lithium levels during the summer months. These findings parallel previous reports regarding the influence of seasons upon bipolar disorder. The therapeutic implications related to seasonality and mania are discussed.


Subject(s)
Bipolar Disorder/epidemiology , Patient Admission/statistics & numerical data , Seasons , Adult , Aggression/drug effects , Aggression/psychology , Bipolar Disorder/diagnosis , Bipolar Disorder/drug therapy , Cross-Sectional Studies , Dose-Response Relationship, Drug , Female , Humans , Incidence , Lithium/pharmacokinetics , Lithium/therapeutic use , Male , Michigan/epidemiology , Middle Aged , Retrospective Studies , Treatment Outcome
16.
Gen Hosp Psychiatry ; 15(1): 51-4, 1993 Jan.
Article in English | MEDLINE | ID: mdl-8436285

ABSTRACT

A retrospective review of 493 patients treated during a single month in a general hospital in mid-Michigan revealed that a majority (84.2%) of them received prescriptions for sedative-hypnotic drugs. These were p.r.n. in 66% of cases and routine prescriptions in the remainder. Prescriptions were equally distributed across the specialties: internal medicine 15%, surgery 23%, family practice 19%, psychiatry 22%, and OB/GYN 20%. Flurazepam was the most frequently prescribed drug (48.4%), followed by triazolam (24.6%) and temazepam (12.2%). Actual utilization rates were highest among psychiatric patients (85%) and lowest in obstetrics (33%). The therapeutic rationale for prescribing sedative hypnotic agents to hospitalized patients is discussed.


Subject(s)
Hospitals, General/statistics & numerical data , Hypnotics and Sedatives/therapeutic use , Drug Prescriptions/statistics & numerical data , Drug Therapy, Combination , Drug Utilization , Humans , Hypnotics and Sedatives/administration & dosage , Hypnotics and Sedatives/classification , Medicine/statistics & numerical data , Michigan , Psychotropic Drugs/therapeutic use , Retrospective Studies , Specialization
17.
Compr Psychiatry ; 31(1): 80-3, 1990.
Article in English | MEDLINE | ID: mdl-1967568

ABSTRACT

Bipolar affective disorder in men and women often differs in prevalence, age of onset, phenomenology, and longitudinal course. A study of 112 bipolar patients, comprising 72 women and 40 men who were discharged from an acute inpatient setting on antipsychotic drugs, is reported. Higher mean discharge neuroleptic doses were prescribed to men below the age of 40 and to women above the age of 40. The clinical implications of higher dosing patterns are discussed.


Subject(s)
Antipsychotic Agents/administration & dosage , Bipolar Disorder/drug therapy , Lithium/administration & dosage , Adult , Bipolar Disorder/psychology , Chlorpromazine/administration & dosage , Cohort Studies , Dose-Response Relationship, Drug , Drug Therapy, Combination , Female , Humans , Male , Retrospective Studies , Sex Factors
18.
Rev Saude Publica ; 23(3): 189-95, 1989 Jun.
Article in Portuguese | MEDLINE | ID: mdl-2617113

ABSTRACT

From August 1985 to June 1986 an Education Program for school-children and their parents or guardians was undertaken in Santa Eudóxia (S. Paulo, Brazil) with a view to the practice of knowledge concerning intervention with regard to parasitic helminths, with the aim of stimulating collective action. A manual of technical orientation for the coordinators had had been prepared. Three groups composed of school-children's parents or guardians was formed and these discussed four basic themes during the Course of Education and Health in Helminthiasis: 1. What the disease is like; 2. The worms which occur in man; 3. The significance of the disease; 4. Prophylactic measures. Each group prepared a manual about the content of the course. The results of the children's work were presented at the Health Education Fair, an event open to the whole community. The way this Program developed made it clear that the population had become aware of the magnitude of the problem. Furthermore, they feel the need of effective measures regarding the control of helminth infestation.


Subject(s)
Community Participation , Health Education/organization & administration , Health Knowledge, Attitudes, Practice , Intestinal Diseases, Parasitic/prevention & control , Brazil , Child , Humans
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