ABSTRACT
BACKGROUND: Anxiety is defined as a set of behavioural manifestations that can be divided into state- and trait-anxiety. State-anxiety is a transitory emotional condition that varies in intensity and fluctuates over time. Trait-anxiety is a personality trait which remains relatively stable over time. The objective of this study was to identify and quantify perioperative risk factors for immediate postoperative anxiety in children. METHODS: A prospective cohort study was performed with 90 schoolchildren, ages ranging from 7 to 13 years old, ASA physical status I-II, submitted to elective surgery. The measuring instruments were verbal scale of pain, visual analogue scale (VAS), Trait-State Anxiety Inventory for Children (STAIC), Trait-State Anxiety Inventory (STAI) for parents, and structured questionnaire. RESULTS: Patients not submitted to analgesic block and patients with moderate and intense pain presented an estimated risk 5- and 13-fold greater for high levels of postoperative state-anxiety, respectively. High levels of preoperative state-anxiety and administration of doses of midazolam less than 0.056 mg x kg(-1) constituted an estimated risk for postoperative state-anxiety of 3- and 4-fold, respectively. A positive history of previous surgery was associated with lower risk for postoperative anxiety. CONCLUSIONS: High levels of preoperative state-anxiety, administration of less than 0.056 mg x kg(-1) of midazolam, absence of analgesic block and presence of moderate and intense postoperative pain constituted risk factors for immediate postoperative state-anxiety in children. Previous surgery reduced the risk for postoperative anxiety.
Subject(s)
Anxiety/epidemiology , Anxiety/psychology , Postoperative Complications/epidemiology , Postoperative Complications/psychology , Anesthesia , Child , Cohort Studies , Female , Humans , Male , Pain Measurement , Pain, Postoperative/psychology , Prospective Studies , Regression Analysis , Risk FactorsABSTRACT
Immunocompromised individuals infected with Strongyloides stercoralis may develop severe hyperinfection or disseminated disease with high mortality. Patients with hematological malignancies are at risk because of immunodepression produced either by the disease or its treatment. A prospective study was undertaken at the Hospital de Clínicas de Porto Alegre, from July 1994 to July 1995. Seventy-two (HIV negative), had 3 stool samples collected at different days and had not received recent anthelmintic therapy. Larvae, isolated in a modified Baermann method, were found in 6 patients, with a resultant prevalence of 8.3%. No complicated strongyloidosis was documented. The positive result for S. stercoralis larvae was significantly associated (p < 0.001) with eosinophilia. Knowledge of prevalence figures and incidence of severe disease is important to adequate guidelines for empirical treatment besides the rigorous search for strongyloidosis in patients with hematological malignancies.
Subject(s)
Hematologic Neoplasms/parasitology , Strongyloides stercoralis , Strongyloidiasis/parasitology , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Child , Child, Preschool , Feces/parasitology , Female , Hematologic Neoplasms/immunology , Humans , Immunocompromised Host , Larva , Male , Middle Aged , Prospective Studies , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/immunologyABSTRACT
Immunocompromised individuals infected with Strongyloides stercoralis may develop severe hyperinfection or disseminated disease with high mortality. Patients with hematological malignancies are at risk because of immunodepression produced either by the disease or its treatment. A prospective study was undertaken at the Hospital de Clínicas de Porto Alegre, from July 1994 to July 1995. Seventy-two (HIV negative), had 3 stool samples collected at different days and had not received recent anthelmintic therapy. Larvae, isolated in a modified Baermann method, were found in 6 patients, with a resultant prevalence of 8.3%. No complicated strongyloidosis was documented. The positive result for S. stercoralis larvae was significantly associated (p < 0.001) with eosinophilia. Knowledge of prevalence figures and incidence of severe disease is important to adequate guidelines for empirical treatment besides the rigorous search for strongyloidosis in patients with hematological malignancies.
Indivíduos imunocomprometidos infectados com Strongyloides stercoralis podem desenvolver quadros severos de hiperinfecção ou doença disseminada com elevada mortalidade. Pacientes portadores de neoplasias hematológicas tem imunodepressão causada pela doença básica ou pelo seu tratamento. Um estudo prospectivo foi desenvolvido no Hospital de Clínicas de Porto Alegre, entre julho 1994 e julho de 1995. Setenta e dois pacientes (HIV negativos), tiveram 3 amostras de fezes coletadas em diferentes dias e não tinham recebido medicação antihelmíntica recentemente. Larvas, isoladas por método de Baermann modificado, foram encontradas em 6 pacientes, resultando em prevalência de 8,3%. Não foi documentado nenhum episódio de estrongiloidose complicada. O resultado positivo para pesquisa de S. stercoralis estava significativamente associado (p < 0,001) com eosinofilia. O conhecimento das taxas de prevalência e incidência de doença grave é importante para adequar as recomendações para tratamento empírico além da rigorosa pesquisa da estrongiloidose nos pacientes com neoplasias hematológicas.
