Daniel Panarotto

The use of psychoactive substances among medical students in southern Brazil

The objective of our study was to investigate the patterns of use of psychoactive substances among students of a medical school in Southern Brazil and to explore a putative role of discrete behavioral and social variables in their drug use. This is a descriptive and transversal cut study. All regularly enrolled medical students at the University of Caxias do Sul were invited to participate in the study. A self-administered questionnaire, which analyses lifetime drug use as well as drug use in the previous 30 days and 12 months was utilized to collect data. From a total of 318 regularly enrolled students, 183 (57.5%) completed and returned the questionnaires. The highest prevalence rates of lifetime drug use, drug use in the last 12 months and drug use in the last 30 days were observed, according to drug type, as follow in descending order: alcohol, tobacco, marijuana, inhalants, tranquilizers, amphetamine and cocaine. A multivariate analysis indicated that research respondents who live with their parents as well as those whose parents live together harmoniously, those who deny close ties to drug users, those who disapprove drug use, those who are not tobacco smokers and those who manifest religious beliefs and practice presented the most reduced levels of illicit drug use. The use of psychoactive substances among medical students in the University of Caxias do Sul is a significant problem. Appropriate and timely initiatives are needed to prevent and curb drug use among medical students.

Freqüência de aconselhamento para prevenção de câncer da pele entre as diversas especialidades médicas em Caxias do Sul

BACKGROUND: Nowadays, skin cancer is the most common form of cancer, in spite of being one of the most preventable forms of cancer. We did not find national data about the frequency of counseling for skin cancer prevention according to the various specialties. OBJECTIVE: The objective of this study was to verify the frequency of counseling for skin cancer prevention by the various specialties in a sample of the population of Caxias do Sul. METHODS: A transversal study was performed on 499 people who sought medical care in the dermatology sector of the community programs, each was interviewed and examined. The community programs took place in Caxias do Sul between January and July 2002. RESULTS: Only 31.9% (n = 159; CI 27.8 - 36.2) of the individuals who were interviewed had already received counseling for skin cancer prevention by physicians. The high-risk patients with the greatest potential for intervention (patients under 20 years of age) received such counseling at a lower frequency than patients aged 20 years or older (26.5% versus 42.5%, respectively; p = 0.03). The specialty of dermatology was responsible for the majority of counseling on skin cancer prevention in this population. CONCLUSION: The frequency of counseling for skin cancer prevention by physicians is low, even for high-risk patients. The counseling also varies according to the attending specialty; only the specialty of dermatology presented a high frequency of counseling.

Dermatological disease among HIV-infected patients with CD4-lymphocyte count

OBJECTIVE To correlate the prevalence of dermatological diseases among HIV-infected patient with CD4-lymphocyte count. METHODS A case series study was carried out in the region of Caxias do Sul, state of Rio Grande do Sul State, Brazil. Data was collected by reviewing the records of HIV-infected patients admitted to a public hospital (198 patients from March 1998 to June 2002) or seen at the university outpatient clinic (40 patients from March to June 2002). The variables analyzed were: age, sex, CD4-lymphocyte count, viral load, and dermatological diseases. Statistical analyses were performed using Students t-test, Spearmans and Chi-Square tests. RESULTS The frequency of dermatological disease was 67.2% among hospitalized patients and 75.0% among outpatients. Oral candidiasis was the most prevalent dermatological disease. Among the hospital population, the average CD4 count was lower among patients with dermatological disease than among those with no disease (142.34 cells/mm3 vs 512.35 cells/mm3, respectively; p=0.018). The same phenomenon was observed in outpatient population (138.88 cells/mm3 and 336.21 cells/mm3, respectively; p=0.001). In both populations, a negative correlation was found between CD4 count and the total number of dermatological diseases by a patient (p=0.000, hospital population, p=0.000, outpatient population). CONCLUSIONS Dermatological diseases are highly prevalent among HIV-infected patients and the frequency and number of these manifestations are well correlated to the patients immune status and disease progression.OBJECTIVE: To correlate the prevalence of dermatological diseases among HIV-infected patient with CD4-lymphocyte count. METHODS: A case series study was carried out in the region of Caxias do Sul, state of Rio Grande do Sul State, Brazil. Data was collected by reviewing the records of HIV-infected patients admitted to a public hospital (198 patients from March 1998 to June 2002) or seen at the university outpatient clinic (40 patients from March to June 2002). The variables analyzed were: age, sex, CD4-lymphocyte count, viral load, and dermatological diseases. Statistical analyses were performed using Students t-test, Spearmans and Chi-Square tests. RESULTS: The frequency of dermatological disease was 67.2% among hospitalized patients and 75.0% among outpatients. Oral candidiasis was the most prevalent dermatological disease. Among the hospital population, the average CD4 count was lower among patients with dermatological disease than among those with no disease (142.34 cells/mm3 vs 512.35 cells/mm3, respectively; p=0.018). The same phenomenon was observed in outpatient population (138.88 cells/mm3 and 336.21 cells/mm3, respectively; p=0.001). In both populations, a negative correlation was found between CD4 count and the total number of dermatological diseases by a patient (p=0.000, hospital population, p=0.000, outpatient population). CONCLUSIONS: Dermatological diseases are highly prevalent among HIV-infected patients and the frequency and number of these manifestations are well correlated to the patients immune status and disease progression.

Fatores associados à interrupção de tratamento anti-retroviral

OBJECTIVE: Evaluate the factors influencing blood glucose control of type 2 diabetic patients attended at a tertiary health care center. METHODS: A retrospective study by review of medical records of patients who attended the Diabetes Clinic at the University of Caxias do Sul was carried out. Patients were evaluated for glycaemic and metabolic control and divided according to glycated hemoglobin at the beginning and end of the period in question, in compensated and not compensated. The factors associated with glycaemic control were analyzed. RESULTS: Seventy three patients were included in the analysis. On the average, improvement of parameters related to glycaemic, pressure and lipid control during the average of 20 months of treatment was observed. In the beginning of the follow-up period, 25% of patients had glycated hemoglobin < 7%, 22.7% had LDL cholesterol < 100mg/dL, 8.7% had systolic blood pressure < 130 mmHg and diastolic < 80 mmHg and no patients had all parameters meeting the recommended goals. At the last visit the percentages were, 42.3%, 37.5%, 30.2% and 9.6% respectively. In the multivariate analysis, younger age, higher levels of LDL cholesterol and insulin use were associated with poor blood glucose control. CONCLUSION: A small part of the sample simultaneously achieved the goals for blood glucose, lipids and blood pressure control. Some factors, such as age and gender can be determinants to achieve control of diabetes. Greater efforts are still needed to achieve the goals for treatment in type 2 diabetic patients.