Diego Salvador Muniz da Silva

Rastreamento do câncer do colo do útero no Estado do Maranhão, Brasil

The scope of the study was to analyze the screening for cervical cancer in the state of Maranhao using secondary data from the Cervical Cancer Information System (SISCOLO). A retrospective descriptive study was conducted using secondary data from 139505 cytopathology exams recorded in SISCOLO in Maranhao in 2011. The variables: age, education, adequacy of material, represented epithelia, microbiology and cellular changes detected in Pap smear tests were selected. The age group between 25 to 29 years and incomplete basic schooling were the most frequent findings. The most common microbiological agents detected were bacilli (52.8%), cocci (45.5%) and Lactobacillus sp (32.6%). Inflammation was the most common benign cellular alteration (86.3%). Low-grade intraepithelial lesions were the most prevalent atypical findings in squamous cells (0.6%), followed by high-grade squamous intraepithelial lesions (0.2%). Squamous cell carcinoma was observed in 0.003% and 0.006% for adenocarcinoma. SISCOLO proved a useful tool for studying aspects related to cancer screening of the cervix, which can orient actions to reduce the incidence and mortality from this cancer.

Qualidade de vida de mulheres tratadas de câncer de mama em uma cidade do nordeste do Brasil

O objetivo deste estudo foi avaliar a qualidade de vida de mulheres tratadas cirurgicamente de câncer de mama no Hospital de Referencia Estadual em Oncologia de Sao Luis (MA). A qualidade de vida foi avaliada pelo Functional Assessment of Cancer Therapy-Breast (FACT-B). As variaveis foram expressas em media e desvio padrao; e a analise estatistica constou da Anova ou Kruskal Wallis e Teste t de Student ou Mann-Whitney. O nivel de significância foi α < 5%. Na estatistica foram usados o Stata 9.0 e o BioEstat 5.0. Participaram 197 mulheres com idade media de 53,0 ± 11,7 anos. Os valores medios do FACT-B demonstraram tendencia para boa qualidade de vida, sendo o dominio Emocional o mais comprometido e a Subescala Câncer a mais favoravel. O tipo de cirurgia influenciou os dominios Social, Emocional e Subescala câncer do questionario. A cirurgia nao conservadora apresentou piores niveis de qualidade de vida. Viu-se relacao estatistica significante entre o tempo de cirurgia e os dominios Fisico, Emocional e Funcional, bem como entre tempo de cirurgia e os escores do FACT-B. O tratamento adjuvante influenciou todos os dominios do FACT-B. A qualidade de vida encontrada foi relativamente boa, mas influenciada negativamente pela cirurgia nao conservadora, pelo menor tempo desde a cirurgia e pelas terapias adjuvantes.

Síndrome climatérica em uma cidade do Nordeste brasileiro: um inquérito domiciliar

PURPOSE To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically. METHODS A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms. RESULTS Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint. CONCLUSION The prevalence of CS was high among women from São Luís, Maranhão, Brazil.

Estado nutricional de adolescentes do Maranhão, Brasil, por critérios nacional e internacional

This study sought to compare national and international criteria for assessing the nutritional status of adolescents. A cross-sectional analytical study was conducted in the period from July 2007 to January 2008 with a representative sample comprised of 1256 adolescents from the state of Maranhao. Body mass index (BMI) for age and gender was used to diagnose underweight, normal weight and overweight, using the criteria proposed by Conde and Monteiro and the World Health Organization (WHO). Chi-square, McNemar concordance and Spearman correlation tests were applied. According to the criteria of Conde and Monteiro and the WHO, there were significant differences among the boys with respect to low weight and obesity. It was observed that there was no significant divergence between the two criteria, and a significant positive correlation (0.011) between the two criteria was detected. With this analysis it can be seen that there are many divergences between the criteria used, therefore the best option and the advantage of using one or the other cannot be singled out. However, it should be stressed that the national criterion can also be used more, since there are no significant differences with the criteria advocated by the Ministry of Health of the WHO.

Irritable bowel syndrome in women with chronic pelvic pain in a Northeast Brazilian city

PURPOSES To determine the prevalence of irritable bowel syndrome (IBS) in women with chronic pelvic pain (CPP) and its associated features; to determine whether IBS and CPP constitute the same syndrome. METHODS Cross-sectional population survey with systematic sequential sampling according to census districts in which 1470 women were interviewed with respect to the sample calculation. The participants resided in their own homes, were at least 14 years of age, experienced menarche and presented CPP according to the American College of Obstetrics and Gynaecology. The dependent variable was IBS based on Rome III criteria in women with CPP, and the following independent variables were possibly associated with IBS: age, schooling, duration of pain, sedentary lifestyle, migraine, depression, insomnia, back pain, dysmenorrhea, dyspareunia, depression, history of violence, and intestinal symptoms. The sample was subdivided into groups with and without IBS. After the descriptive analysis of the variables was performed, the respective frequencies were evaluated using GraphPad Prism 5 software. To evaluate the association between the dependent variable and the independent variables, the χ² test was used with a significance level of 5%. RESULTS The prevalence of IBS in women with CPP was 19,5%. Pain duration (p=0.03), back pain (p=0.002), history of physical or sexual abuse (p=0.002), and intestinal complaints were more prevalent in the group with IBS and CPP. There was no difference between the groups regarding other criteria. CONCLUSION The data confirmed the literature, identified several aspects that were shared between the pathologies and supported the hypothesis that both pathologies can constitute the same syndrome.

Perfil metabólico em mulheres de diferentes índices de massa corporal com síndrome dos ovários policísticos

PURPOSE: To characterize and compare clinical, anthropometric and biochemical-metabolic variables in patients with polycystic ovary syndrome (PCOS), stratified according to body mass index (BMI). METHODS: A cross-sectional study conducted on 78 women aged 18 to 45 years with a clinical diagnosis of PCOS by the Rotterdam criteria. Patients were stratified according to BMI. The variables analyzed were: age, marital status, physical inactivity, menstrual irregularity, blood pressure (BP), anthropometric measurements, lipid profile, fasting glucose, and hormone measurements. To compare the variables between the different BMI values we used analysis of variance and the Kruskal-Wallis test. The level of significance was set at 5% for all tests. RESULTS: The patients had a mean age of 26.3 years, 79.5% of them were sedentary and 68% had hyperandrogenism. Waist circumference, waist/hip ratio, waist/height ratio and percentage of body fat were higher in the obese group. The markers of cardiovascular risk (CVR - fasting glucose, systolic and diastolic BP and LDL-cholesterol) were directly proportional to BMI, whereas HDL-cholesterol and SHBG were inversely related to BMI. CONCLUSION: The presence of markers of CVR factors increased proportionally to BMI, indicating that the metabolic profile of obese women with PCOS is more unfavorable than that of non-obese patients.

Indicadores antropométricos em crianças e adolescentes com doença do refluxo gastroesofágico atendidos em um ambulatório especializado em São Luís, Maranhão, Brasil

Helicobacter pylori is a Gram negative bacterium that cause chronic gastritis, duodenal ulcers and can predispose the gastric cancer. The study aimed to determinate the prevalence of H. pylori infection by different methods of diagnosis in patients submitted to endoscopy. Of the 145 patients included in the study, were collected fragments of gastric mucosa for histological analysis, and for the rapid urease test. The breath test was also performed. The H. pylori infection was detected in 84 (57.9%) patients by histological study, the rapid test of urease was positive in 81 (55,8%) and the breath test in 62 (56,3%). There was no statistically significant difference when comparing the prevalence of infection by different methods of diagnosis. The prevalence of H. pylori infection in our community was lower than that found in the literature for patients with age similar to this study (mean = 53.19 years).