Helymar da Costa Machado

Prevalência de sintomas auditivos e vestibulares em trabalhadores expostos a ruído ocupacional

El objetivo del estudio fue estimar la prevalencia de sintomas auditivos y vestibulares en trabajadores expuestos al ruido ocupacional. Fueron analizados los prontuarios de 175 trabajadores con perdida auditiva inducida por ruido, atendidos en un centro de referencia de salud ocupacional de Campinas, Sureste de Brasil, de 1997 a 2003. Las variables estudiadas fueron frecuencia de los sintomas de hipoacusia, zumbido y vertigo. Las asociaciones con edad, tiempo de exposicion al rudio y limites auditivos tonales fueron analizados utilizandose las pruebas estadisticas chi-cuadrado y exacto de Fisher. Fueron relatados hipoacusia en 74% de los casos, zumbidos en 81% y vertigo en 13,2%. Se verifico asociacion entre hipoacusia y edad, tiempo de exposicion al ruido y limites auditivos tonales y entre vertigo y tiempo de exposicion al ruido, no siendo encontradas otras asociaciones significativas.The purpose of the study was to assess the prevalence of auditory and vestibular symptoms in workers exposed to occupational noise. There were examined medical records of 175 workers with noise-induced hearing loss who attended an occupational health reference center in the city Campinas, Southeastern Brazil, from 1997 to 2003. The variables studied were frequency of symptoms of hypoacusis, tinnitus, and vertigo. Association with age, noise exposure time, and auditory thresholds were analyzed using the chi-square test and Fishers exact test. Hypoacusis was reported in 74% of cases, tinnitus in 81%, and vertigo in 13.2%. There was found an association between hypoacusis and age, noise exposure time, and auditory thresholds and between vertigo and noise exposure time. No other significant associations were found.

Incidence and risk factors of accidental extubation in a neonatal intensive care unit

OBJECTIVE To determine the incidence and risk factors of accidental extubation (AE) in a tertiary neonatal intensive care unit. METHODS A prospective cohort study was conducted to determine AE incidence density per 100 patient-days, during a 23-month period, in 222 newborns receiving assisted ventilation (AV). Logistic regression analysis was used to determine risk factors for AE. The presence of a cyclical pattern in extubation rates, according to the variables of interest, was investigated by Cosinor analysis. RESULTS The mean AE rate was 5.34/100 patient-days ventilated. AE-associated predictive variables were: subsequent use of the oral and nasal routes during AV [relative risk (RR) = 4.73; 95% confidence interval (95%CI) 1.92-11.60], AV duration (per day, RR = 1.03; 95%CI 1.02-1.04), and number of patient-days ventilated (RR = 1.01; 95%CI 1.01-1.02). According to the adjusted multiple regression analysis, total AV time was the only independent predictor of AE in this sample (RR = 1.02; 95%CI 1.01-1.03). AV time of 10.5 days showed an accuracy of 0.79 (95%CI 0.71-0.87) for the occurrence of AE. Cosinor analysis showed significant periodicity in overall AE rate and in the number of patient-days ventilated. There was a significant correlation between the number of patient-days ventilated and AE frequency. CONCLUSION Mean AE density was 5.34/100 patient-days ventilated. AV duration was the only independent predictor of AE. The best accuracy for AE occurrence was achieved at 10.5 days of AV duration.

Incidencia e fatores de risco para a extubação acidental em uma unidade de terapia intensiva neonatal

Objetivo: Determinar a incidencia, os fatores de risco para a extubacao acidental (EA) e a presenca de periodicidade nas taxas de EA em uma unidade de terapia intensiva neonatal de nivel terciario. Metodos: Estudo de coorte prospectivo para determinar a densidade de incidencia de extubacao acidental por 100 pacientes-dia durante o periodo de 23 meses, em 222 RN em assistencia ventilatoria (AV). Foram estudados os fatores de risco para a EA, por intermedio da analise de regressao logistica. A presenca de periodicidade nas taxas de extubacao, segundo as variaveis de interesse, foi investigada pela analise de Cosinor. Resultado: A media da taxa de extubacao acidental foi de 5,34/100 pacientes-dia ventilados. As variaveis preditoras que se associaram a extubacao acidental foram o uso subsequente da via oral e nasal durante a assistencia ventilatoria (RR=4,73; IC95% 1,92-11,60), duracao da assistencia ventilatoria (a cada dia RR=1,03; IC95% 1,02-1,04) e o numero de pacientes-dia/ventilados (RR=1,01; IC95% 1,01-1,02). Pela regressao multipla ajustada o tempo total de AV foi o unico preditor independente para a extubacao acidental nesta amostra (RR=1,02; IC95% 1,01-1,03). O tempo de AV de 10,5 dias apresentou acuracia de 0,79 (IC 95%-0,71-0,87) para a ocorrencia de EA. A analise de Cosinor demonstrou periodicidade significativa na taxa geral de EA e no numero de pacientes-dia ventilados. Houve correlacao significativa entre numero de pacientes-dia e a frequencia de EA. Conclusao: O unico preditor independente para EA foi a duracao da AV. A melhor acuracia para a ocorrencia de EA foi obtida aos 10,5 dias de duracao da AV Abstract

IL10 inversely correlates with the percentage of CD8 + cells in MDS patients

The role of the immune system in myelodysplastic syndrome (MDS) progression has been widely accepted, although mechanisms underlying this immune dysfunction are not clear. CD4(+) and CD8(+) lymphocyte profiles in the peripheral blood of MDS patients were evaluated and correlated with clinical characteristics, the expression of FOXP3 and the anti-inflammatory cytokines IL10, TGFβ1 and CTLA4. IL10 expression inversely correlated with the percentage of CD8(+) cells and was higher in high-risk MDS. Our findings provide further evidence for the role of T cell-mediated IL10 production in MDS and strengthen the idea of distinct cytokine profiles in low and high-risk MDS.

Body mass index percentiles in adolescents of the city of São Paulo, Brazil, and their comparison with international parameters

OBJECTIVE To describe the percentile distribution of body mass index (BMI) in school adolescents, by gender and age, comparing them with international parameters. SUBJECTS AND METHODS The study included 8,020 adolescents aged 10-15 years from 43 schools in the city of São Paulo, southeastern Brazil. BMI values of the study sample were distributed in percentiles and compared to international parameters (CDC, Must and cols. and Cole and cols.). RESULTS Both male and female adolescents aged 10 to 14 years showed BMI cut-offs over the international parameters, especially in the P50-P85 percentile range. At the age of 15, the observed values were very similar to reference data; however, BMI values in the 95th percentile were much higher than international parameters. CONCLUSIONS The study results show how important it is to use adequate BMI values for Brazilian adolescents aged 10-15 since international parameters may not reflect the actual nutritional status of this group.

Prevalence of auditory and vestibular symptoms among workers exposed to occupational noise

El objetivo del estudio fue estimar la prevalencia de sintomas auditivos y vestibulares en trabajadores expuestos al ruido ocupacional. Fueron analizados los prontuarios de 175 trabajadores con perdida auditiva inducida por ruido, atendidos en un centro de referencia de salud ocupacional de Campinas, Sureste de Brasil, de 1997 a 2003. Las variables estudiadas fueron frecuencia de los sintomas de hipoacusia, zumbido y vertigo. Las asociaciones con edad, tiempo de exposicion al rudio y limites auditivos tonales fueron analizados utilizandose las pruebas estadisticas chi-cuadrado y exacto de Fisher. Fueron relatados hipoacusia en 74% de los casos, zumbidos en 81% y vertigo en 13,2%. Se verifico asociacion entre hipoacusia y edad, tiempo de exposicion al ruido y limites auditivos tonales y entre vertigo y tiempo de exposicion al ruido, no siendo encontradas otras asociaciones significativas.The purpose of the study was to assess the prevalence of auditory and vestibular symptoms in workers exposed to occupational noise. There were examined medical records of 175 workers with noise-induced hearing loss who attended an occupational health reference center in the city Campinas, Southeastern Brazil, from 1997 to 2003. The variables studied were frequency of symptoms of hypoacusis, tinnitus, and vertigo. Association with age, noise exposure time, and auditory thresholds were analyzed using the chi-square test and Fishers exact test. Hypoacusis was reported in 74% of cases, tinnitus in 81%, and vertigo in 13.2%. There was found an association between hypoacusis and age, noise exposure time, and auditory thresholds and between vertigo and noise exposure time. No other significant associations were found.

Evaluation of the inhibitory effect of amphotericin B on the apical growth of F. solani using the BioCell-Tracer® System

Summary  The BioCell‐Tracer® (BCT) system is an automatic microscopic method used for measuring the growth rate of a single fungal hyphae, which has not yet been applied to study Fusarium spp. Considering the large resistance of Fusarium species to the available chemotherapy and that hyphae is the morphological fungal form most often seen in vivo, in this work, Amphotericin B MIC and MFC values for a Fusarium solani strain were obtained by the conventional assay method testing conidia and also by the BCT® monitoring system. Both MIC and MFC values of AMB against F. solani determined by broth dilution method resulted in 4.0 μg ml−1. By the BCT® system, their values were 1.0 μg ml−1, with an inhibition rate of 99.5% (Exp‐GR) and 100.0% (Post‐GR), showing that when testing hyphae directly, MIC and MFC were determined at two lower dilutions than the MIC and MFC values obtained with conidia. Using the BCT® system, 4.0, 2.0 and 1.0 μg ml−1 of AMB concentrations inhibited hyphae growth in 50 min whereas 0.5 μg ml−1 of AMB needed 100 min to start hyphae growth inhibition. These findings lead us to conclude that antifungal susceptibility varies between conidia and hyphae. For this strain of Fusarium solani, hyphae were more susceptible to AMB than conidia.

Job satisfaction of nursing staff in a university hospital

OBJECTIVE identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.

Satisfação no trabalho da equipe de enfermagem em um hospital universitário

OBJECTIVE identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.

Cervical Cancer Registered in Two Developed Regions from Brazil: Upper Limit of Reachable Results from Opportunistic Screening

OBJECTIVE  The aim of this study was to assess the time trends and pattern of cervical cancer diagnosed in the period from 2001 to 2012 by means of an opportunistic screening program from two developed regions in Brazil. METHODS  An observational study analyzing 3,364 cancer records (n = 1,646 from Campinas and n = 1,718 from Curitiba region) available in hospital-based cancer registries was done. An additional 1,836 records of CIN3/AIS from the region of Campinas was analyzed. The statistical analysis assessed the pooled data and the data by region considering the year of diagnosis, age-group, cancer stage, and histologic type. The Cochran-Armitage trend test was applied and p-values < 0.05 were considered significant. RESULTS  The total annual cervical cancer registered from 2001 to 2012 showed a slight drop (273-244), with an age average of 49.5 y, 13 years over the average for CIN3/AIS (36.8 y). A total of 20.6% of the diagnoses (1.6% under 25 y) were done out of the official screening age-range. The biennial rate of diagnoses by age group for the region of Campinas showed an increase trend for the age groups under 25 y (p = 0.007) and 25 to 44 y (p = 0.003). Stage III was the most recorded for both regions, with an annual average of 43%, without any trend modification. There was an increasing trend for stage I diagnoses in the region of Campinas (p = 0.033). The proportion of glandular histologic types registered had an increased trend over time (p = 0.002), higher for the region of Campinas (21.1% versus 12.5% for the region of Curitiba). CONCLUSION  The number, pattern and trends of cervical cancer cases registered had mild and slow modifications and reflect the limited effectivity of the opportunistic screening program, even in developed places.