Priscila Oliveira Cardoso

Morbidade neonatal e maternas relacionada ao tipo de parto

An evaluation of infant morbimortality and mother morbidity was undertaken according to the type of delivery. A prospective study was undertaken on 170 puerperal patients divided into two groups: Group 1 (n = 95), natural or vaginal delivery, Group 2 (n = 75), submitted to caesarean delivery. Complications in mothers were classified in small, moderate and severe. The infant parameters were: period of pregnancy, weight on birth, Apgar score, necessity of intensive care and neurological disorders. Mothers who had not completed elementary school (p=0.0045) had more vaginal delivery. Previous vaginal deliveries were more common in Group 1 than caesarean section in Group 2 (p = < 0.001) (OR = 104.00; 21.11 < OR < 610.99). In Group 1, vaginal delivery was preferred by 78 (82,1%) of mothers comparing to 28 (37.3%) from Group 2, who preferred caesarean section (p = 0.0002) (OR = 4; 1.77 < OR < 9.17). Post-operative was more intense and frequent after caesarean section (8 cases) than patients of Group 1 (2 cases) (p = 0.018) (OR = 0.18; 0.03 < OR < 0.96). Obstetric trauma was found in 14 deliveries of Group 1 and 7 of Group 2 (p = 0.28). Infant hospitalization was greater in Group 2 (3.43 +/- 0.70 days) in comparison with Group 1 (2.71 +/- 0.67 days) (p < 0.0001). The infant morbidity was greater after vaginal deliveries, but maternal morbidity was greater after caesarean deliveries.An evaluation of infant morbimortality and mother morbidity was undertaken according to the type of delivery. A prospective study was undertaken on 170 puerperal patients divided into two groups: Group 1 (n = 95), natural or vaginal delivery, Group 2 (n = 75), submitted to caesarean delivery. Complications in mothers were classified in small, moderate and severe. The infant parameters were: period of pregnancy, weight on birth, Apgar score, necessity of intensive care and neurological disorders. Mothers who had not completed elementary school (p=0.0045) had more vaginal delivery. Previous vaginal deliveries were more common in Group 1 than caesarean section in Group 2 (p = < 0.001) (OR = 104.00; 21.11 < OR < 610.99). In Group 1, vaginal delivery was preferred by 78 (82,1%) of mothers comparing to 28 (37.3%) from Group 2, who preferred caesarean section (p = 0.0002) (OR = 4; 1.77 < OR < 9.17). Post-operative was more intense and frequent after caesarean section (8 cases) than patients of Group 1 (2 cases) (p = 0.018) (OR = 0.18; 0.03 < OR < 0.96). Obstetric trauma was found in 14 deliveries of Group 1 and 7 of Group 2 (p = 0.28). Infant hospitalization was greater in Group 2 (3.43 +/- 0.70 days) in comparison with Group 1 (2.71 +/- 0.67 days) (p < 0.0001). The infant morbidity was greater after vaginal deliveries, but maternal morbidity was greater after caesarean deliveries.

DOENÇA DE CROHN COMPLICADA: LINFOCELE ASSOCIADA

Introdução: A doença de Crohn (DC) é uma doença inflamatória que afeta mais comumente o segmento ileocolônico e pode ser silenciosa ou caracterizada por sintomas como dor abdominal, diarreia ou perda ponderal. Pacientes com anemia crônica de causa não explicada devem ter o trato gastrointestinal investigado. O objetivo do trabalho é relatar o caso de uma paciente com anemia crônica que foi diagnosticada com DC após investigação. Descrição do caso: Trata-se de uma paciente assintomática com anemia ferropriva crônica com melhora após uso regular de sulfato ferroso, sem achados ao exame físico, encaminhada para investigação, que apresentava apenas positividade do sangue oculto nas fezes, com endoscopia digestiva alta (EDA) e colonoscopia sem achados significativos. Seguida investigação com cápsula endoscópica e enteroscopia por balão que evidenciou achados sugestivos de Doença de Crohn. Diante dos achados de estenoses, foi indicado e iniciado tratamento com adalimumabe e azatioprina. Discussão: A anemia é comum nas doenças inflamatórias intestinais e está associada a uma qualidade de vida reduzida e a uma taxa de mortalidade aumentada, porém seu achado isolado no cenário da doença é incomum. Conclusão: Todo paciente com anemia crônica ainda sem causa definida pode ter DC como diagnóstico diferencial.

Epidemiological profile of skin diseases at a Primary Care Health Center

Objective: To analyze the prevalence of skin diseases at a Primary Care Health Center. Methods: Forty-six patients were studied during medical examinations at the Health Centre from August to November 2007. Patients were not classified by age, sex, or color. Parameters evaluated: Main reason for seeking medical attention, incidence of skin lesions, whether these were the main reason for consultation or if they were identified during clinical examination, laboratory exams eventually required to diagnose skin diseases, and if the dermatologic condition was resolved in subsequent consultations. Results were compared by Fisher’s exact test and chi-square test. Values of p<0.05 were considered significant. Results: of the 46 patients assessed, 56.52% had some dermatosis diagnosed. Among these, 42.3% had a dermatological complaint as the reason for consultation. In other patients skin lesions were identified based on reported medical history (23.07%) or during physical examinations (34.61%) Conclusion: The incidence of skin diseases was high in the group under study. Most of them, however, were only diagnosed following detailed study of case history, and mainly thorough dermatological examination. These results show the importance of quality examination in Primary Care and the importance of the general practitioner’s skill in diagnosing dermatoses.