Rogério de Melo Costa Pinto

Health-related quality of life of medical students

Medical Education 2010: 44 : 227–235

Síndrome cardiopulmonar por hantavírus no Triângulo Mineiro e Alto Paranaíba, Minas Gerais, 1998-2005: aspectos clínico-epidemiológicos de 23 casos

The epidemiological, clinical, laboratory and treatment findings from 23 cases of hantavirus cardiopulmonary syndrome were analyzed. These cases were identified either serologically or immunohistochemically in hospitals in the municipality of Uberlândia, State of Minas Gerais. Fever (100%), dyspnea (100%) and myalgia (78%) were the symptoms most frequently observed in this sample. The most prevalent physical signs were hypotension (65%) and tachycardia (65%). The most common laboratory findings included thrombocytopenia (96%), hemoconcentration (83%) and leukocytosis (74%). Abnormal values for liver enzymes were found in all the patients tested and abnormalities in chest radiography were very frequent (95.6%). In 55.5% of the patients, orotracheal intubation and hemodynamic support were required. The present study confirmed the seasonal pattern of hantavirus cardiopulmonary syndrome in the Uberlândia region and the involvement of professional groups who are considered to be at low risk of infection, in the transmission cycle of the disease. The high lethality rate (39%) and the severity of the disease observed in this study may be related to attending to these patients at a late stage.

Qualidade de vida em portadores de esclerose múltipla

Propedeutica Neurologica Faculdade de Medicina Universidade Federal de Uberlândia, Uberlândia MG

Fatores associados à duração do aleitamento materno em crianças menores de seis meses

PURPOSE To describe the characteristics of mothers and children and to evaluate the factors associated with discontinuation of exclusive breastfeeding. METHODS A cross-sectional study on infants under six months of age who attended the vaccination campaign in 2008. In the sample design, vaccination units were selected by drawing lots and infants were similarly selected later at each unit systematically. A semi-structured instrument was used for data collection, containing questions about childrens nutrition and socio-demographic characteristics. We used Odds Ratio and the χ² test for data analysis, accepting as the critical level p<0.05. RESULTS The prevalence of breastfeeding for infants under 120 and 180 days of age was 89.5 and 85% respectively, and exclusive breastfeeding was 50.6 and 39.7% for infants less than 120 and 180 days of age, respectively. The factors most related to the abandonment of exclusive breastfeeding in infants under six months were maternal employment outside the home (OR=2.73; 95%CI=1.74-4.29) and use of pacifiers (OR=4.26; 95%CI=2.85-6.38). The mother being multiparous (OR=0.57; 95%CI=0.40-0.81) and receiving postpartum care in the public health care network (OR=0.55; 95%CI=0.39-0.79) represented protective factors against the practice of early cessation of breastfeeding. CONCLUSIONS The prevalence of breastfeeding and exclusive breastfeeding in the municipality of Uberlândia is among the highest in the country and the factors most often associated with the practice of early weaning were maternal employment outside the home, offering pacifiers to the infants, receiving postpartum care in the private health sector, and primiparity.

Avaliação da reprodutibilidade ultrassonográfica como método para medida da gordura abdominal e visceral

OBJETIVO: O objetivo deste estudo e avaliar a variabilidade interobservador do metodo ultrassonografico para medida da gordura subcutânea, visceral e perirrenal por meio de tecnica padronizada. MATERIAIS E METODOS: Foram avaliados 50 pacientes entre novembro de 2006 e janeiro de 2007. A medida da espessura subcutânea foi realizada com transdutor linear de 7,5 MHz posicionado transversalmente a 1 cm acima da cicatriz umbilical. Para a gordura visceral foi utilizado transdutor de 3,5 MHz posicionado 1 cm acima da cicatriz umbilical, considerando-se a medida entre a face interna do musculo reto abdominal e a parede posterior da aorta na linha media do abdome. A gordura perirrenal foi medida no terco medio do rim direito, com transdutor posicionado na linha axilar media. RESULTADOS: A reprodutibilidade interobservador foi analisada por meio do teste t de Student, com significância de 95%. Nao houve diferenca significativa entre as medias das medidas das gorduras subcutânea, visceral e perirrenal, com p = 0,7141, 0,7286 e 0,6368, respectivamente. As medias encontradas, com seus respectivos desvios-padrao, foram: 2,64 ± 1,37 para a espessura subcutânea, 6,84 ± 2,38 para a espessura visceral e 4,89 ± 2,6 para a espessura perirrenal. CONCLUSAO: A ultrassonografia apresentou boa reprodutibilidade interobservador para avaliacao da gordura abdominal por meio das medidas das espessuras subcutânea, visceral e perirrenal. Unitermos: Gordura abdominal; Ultrassom; Sindrome metabolica.

Cross-sectional Survey of Hantavirus Infection, Brazil

A cross-sectional serosurvey was conducted to assess the proportion of persons exposed to hantaviruses in a virus-endemic area of the state of Minas Gerais, Brazil. Findings of this study suggested the presence of >1 hantaviruses circulating in this region causing hantavirus pulmonary syndrome, mild disease, or asymptomatic infection.

Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

OBJECTIVE To evaluate the effect the type of hip fracture (femoral neck or trochanteric) has on the Health-Related Quality of Life of elderly subjects. METHODS Forty-five patients with hip fractures (mean 74.30 +/- 7.12 years), 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36) at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

Health-related quality of life and depressive symptoms in undergraduate nursing students

This is a descriptive, cross-sectional study aimed at investigating the health-related quality of life (HRQoL) of nursing students and its relationship with year of training, sociodemographic variables and the intensity of depressive symptoms. A convenience sample of 256 students, out of 353 eligible (72%), responded to the Medical Outcomes Study - The 36 Item Short-Form Health Survey (SF-36) and the Beck Depression Inventory (BDI) (self-administered). Final-year students, females and students with a higher intensity of depressive symptoms presented lower SF-36 scores in the physical functioning, vitality and social functioning domains. Institutional psychopedagogic support programs may minimize this negative impact on the HRQoL and encourage better professional performance of students in higher vulnerability situations.Trata-se de estudo descritivo e transversal, que investigou a qualidade de vida relacionada a saude (QVRS) de estudantes de Enfermagem e a relacao da QVRS com o ano de estudo, as variaveis sociodemograficas e a intensidade de sintomas depressivos. Uma amostra acidental de 256 estudantes dos 353 elegiveis (72%) respondeu ao Medical Outcomes Study - The 36 Item Short-Form Health Survey (SF-36) e ao Inventario de Depressao de Beck (IDB). Estudantes do ultimo ano do curso, sobretudo do sexo feminino e com maior intensidade de sintomas depressivos, apresentaram menores escores do SF-36 nos dominios capacidade funcional, vitalidade e aspectos sociais. O prejuizo na QVRS ocorre sobretudo no ultimo ano do curso, nos estudantes do sexo feminino ou com sintomas depressivos. Programas institucionais de aconselhamento psicopedagogico poderiam minimizar o impacto negativo detectado na QVRS e contribuir para melhor formacao e desempenho profissional dos estudantes em situacao de maior vulnerabilidade.

STUDY OF THE PREVALENCE OF AUTOIMMUNE THYROID DISEASE IN WOMEN WITH BREAST CANCER.

OBJECTIVE The aim of this study was to analyze the prevalence of thyroid disorders in patients with a positive biopsy for breast cancer prior to specific antitumor treatment. METHODS The frequency and pattern of thyroid disorders were evaluated in 112 patients with breast cancer (G1) and 125 control patients (G2) by analyzing serum thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibodies, and anti-thyroglobulin antibodies. In addition, the expression of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2) was assessed in the breast biopsies by immunohistochemistry. RESULTS The frequency of thyroid disorders, such as changes in TSH levels and/or the presence of thyroid antibodies, was not different between the 2 groups examined (30.4% in G1 versus 28.0% in G2) (P = .69). However, a family history of thyroid disease was more frequent in patients with breast cancer (50.5% in G1 versus 28.2% in G2) (P = .001). Regarding the clinical stage of breast cancer, there was no difference between women with autoimmune thyroiditis and those without thyroid dysfunction (P = .316). Similarly, there were no differences in hormone receptor (estrogen or progesterone) and HER2 expression between patients who tested positive and those who tested negative for anti-thyroid antibodies (P = .052 and P = .549, respectively). CONCLUSION The data obtained in this study did not reveal a higher frequency of autoimmune thyroid disease in patients with breast cancer compared to controls. A family history of thyroid disease was more common in those with breast cancer.

Serological survey of hantavirus in rodents in Uberlândia, Minas Gerais, Brazil

We conducted a serological survey to determine the presence of hantavirus infection in rodents in Uberlândia, Minas Gerais as well as to identify and characterize associated factors. Rodents were captured using Sherman live-capture traps set in rural and peri-urban environments. A total of 611 rodents were captured. There was a higher trap success in peri-urban areas (26.3%) and a higher prevalence of antibodies among rodents captured in rural areas (2.9%). Necromys lasiurus was the most common species (42.2%) and the more frequently infected (4.6%). One Calomys tener (1/141; 0.7%) and one Calomys sp. (1/14; 7.1%) were also positive for the hantavirus infection. In N. lasiurus, antibody prevalence correlated with population density (p < 0.01), age class (p = 0.003) and presence of scars (p = 0.02). The data confirm that horizontal transmission is the main mechanism that maintains the virus in nature. The higher seropositivity in N. lasiurus is consistent with genetic studies that associate this species with an Araraquara virus reservoir; the seropositivity of C. tener and Calomys sp. may indicate the occurrence of spillover infection or the presence of other circulating hantaviruses.