Repositório RCAAP

The current study investigated the effect of water gymnastic on the risk factors to atherosclerosis and thrombosis in women with morbid obesity. The sample consisted of 28 volunteers, distributed in two groups: treatment group (n=16, 37,3 + 7,5 years) who participated of the program of water gymnastic, and a control group (n=12, 35,6 + 7,2). The inclusion criteria were: female, age between 20 and 50 years old, BMI > 40kg/m2, to be sedentary, have been allowed to the practice of exercises and to have availability to join the classes of water gymnastic, to be followed up in the bariatric surgery out clinic and to live in Uberlandia. The program of water gymnastic took place in six weeks time, three times a week, for fifty minutes with moderate rhythm. The groups we compared pre and post treatment with regard to: corporal composition, lipid profile, fasting glucose, arterial blood pressure, stress, anxiety and depression. For the statistical analysis the following methods were used: U-test of Mann-Whitney, Wilcoxon, and qui square, taking as significant, values of p<0,05. The final evaluation showed rising in the corporal composition of the Control Group, a tendency to reduction of the values for stress, anxiety and depression in the Treatment Group and rising in the same values in the Control Group, nevertheless the tests didn't show statistical significant difference. For the other variants evaluated there was no statistical significant difference. A deeper evaluation is needed, once the sample size and the short treatment time are limitation in the current study. These results showed favorable effect of water gymnastic on the reduction of abdominal circumference. Regarding to the weight and BMI, water gymnastic was efficient as a contributor to hold that variants, preventing their rising up in the Treatment group when compared to the control group. A tendency to improvement was observed in the stress, anxiety and depression levels in the Treatment group. Values of Arterial Pressure, fasting glucose, and lipid profile didn't change after 16 weeks of water gymnastic. This study points out the need of governmental actions investing in a rehabilitation program for this population, which would improve patient's health and reduce the expenses of the SUS.

Alpha Interferon and Ribavirin are the drugs of choice for treating Hepatitis C, but may trigger thyroid disorders as a major complication. Several studies have shown a prevalence vary (1% to 35%) of this association influenced by geographical distribution, genetics and iodine intake of the population. The objective of this study was to analyze the thyroid disorders in carrying patients of Hepatitis C in treatment or not with alpha Interferon and Ribavirin. We evaluated the frequency and pattern of thyroid disorders in 25 patients with hepatitis C in treatment with alpha interferon and Ribavirin (G1), 62 patients with Hepatitis C without treatment (G2) and 82 patients without Hepatitis C (control group) measuring TSH, antiperoxidase antibodies (anti-TPO) and antitireoglobulina (ATG). The hypothyroidism was more frequent in the carrying patients of Hepatitis C in treatment (36%), while the frequency of thyroid antibodies was not different in the three studied groups respectively (12% in G1; 8,06% in G2 and 17,07% in control group). It was not possible to demonstrate the biggest prevalence of Autoimmune Thyroid Disease in carrying patients of Hepatitis C in treatment with alpha Interferon and Ribavirin; even so the hypothyroidism has been more frequent in this group. Thus, carrying patients of Hepatitis C submitted to this treatment must make tracking of the thyroid dysfunction, as already considered for some authors.

Background: The metabolic syndrome (MS) brings together a number of proatherogenic and pro-thrombotic risk-factors, which often culminate in premature death caused by atherosclerotic cardiovascular disease and ischemic events. Objectives: To evaluate the usefulness of ultrasonography (US) in the quantification of abdominal subcutaneous (SCF), visceral (VF) and peri-renal (PRF) fat deposits in healthy volunteers and in patients with MS, correlating the measurements obtained with the variables linked to increased risk of ischemic cardiovascular events. Methods: Cross-sectional study with 50 patients initially to validate the method and then with 15 patients with MS and 10 controls. Results: The values of VF showed significant positive correlations with glucose (GLC), waist circumference (WC), triglycerides (TG), glutamic oxaloacetic transaminase (GPT), systolic blood pressure (SBP), diastolic blood pressure (DBP) and diastolic blood pressure post-exercise (DBPe), and a positive borderline correlation with gammaglutamyl- transferase (&#947;GT). The values of PRF showed significant positive correlations with WC, TG, HDL-C, LDL-C, total cholesterol (TC), GPT, SBP and DBP, and positive borderline correlations with systolic blood pressure post-exercise (SBPe) and DBPe. The values of VPRF showed positive correlations with GLC, WC, TG, GPT, SBP and DBP, and a positive borderline correlation with &#947;GT. Values of VF, PRF and VPRF equal to or greater than 6.7, 0.55 and 7.3 cm were associated with the occurrence of a minimum of three risk factors for MS. Conclusion: The abdominal US is a valid and reproducible method in the evaluation of VF, PRF and VPRF, which have positive correlations with the main variables linked to MS.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

The need for curricular changes directed to the graduation of health professionals able to promote human&#8223;s health in its holistic meaning has stimulated great interest in medical students&#8223; mental health and health-related quality of life (HRQL). This study aimed at assessing the HRQL of medical students from the first to the sixth year of training through the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Students from the first to the sixth year of medical training at the Federal University of Uberlândia were asked to answer a sociodemographic questionnaire, the SF-36 and the Beck Depression Inventory (IDB) by self-application. Cronbach&#8223;s coefficient was calculated to determine the SF-36 reliability. Students and freshmen were compared according to demographics, SF-36 scores were compared according to the year in training, the presence of depressive symptoms, gender and the fact of living with or without relatives (Mann-Whitney or Kruskal-Wallis). SF-36 scores were also correlated to family income (Spearman coefficient). The effect size (ES) was calculated to determine the magnitude of the differences among groups and freshmen or first-year students. 352 students and 38 freshmen were enrolled in this study. Cronbach&#8223;s alpha varied form 0.66 to 0.89 to SF-36 domains. Freshmen&#8223;s mean age was 19.1 years (+ 1.9) and students&#8223; mean age was 22.3 (+ 2.42). Most of students were female (61.6%) and single (96.6%). Students had a prevalence of depressive symptoms of 36.3% whereas freshmen had a prevalence of 15.7% (p = 0.01). Scores from third and forth-year students were lower than freshmen and first-year students&#8223; scores in mental and physical domains (p< 0.01). Big effect sizes (ES> 0.8) were detected in comparisons between third-year students and freshmen in global health, vitality and mental health. Students with depressive symptoms had lower scores in all domains and summary components of SF-36 when compared to students without depressive symptoms (p< 0.01). Independently on the presence of depressive symptoms, second-, third- and forth-year students had an impairment on HRQL in vitality when compared to freshmen and first-year students (p< 0.01). Female students without depressive symptoms also had an impairment in physical functioning, body pain and role limitations due to emotional problems (p< 0.01). These results may lead to the conclusion that the transition from basic sciences to clinical training (third year) according to traditional curricular tracks represents a phase of important impairment of medical students&#8223; HRQL. Moreover, students with depressive symptoms and females had a higher impairment on HRQL.

Several studies have associated subclinical hypothyroidism with risk factors for atherosclerotic disease, but its correlation with a decreased tolerance to the physical effort has been little studied. In this context, the hormonal replacement with L-thyroxine for the treatment of these patients remains controversial. The present study aimed to analyze the effect of sodium L-thyroxine on the tolerance to the physical effort and the lipidic profile of patients with subclinical hypothyroidism. Seven female volunteers aged between 40 and 60 years, without clinical signs of hypothyroidism and with TSH > 4.4 mU/dL, total T3 and free T4 in the plasma were selected. The plasmatic lipidic profile was evaluated before and after treatment of all patients. For the evaluation of tolerance to the physical effort, all patients were submitted to a progressive effort test. Levels of blood lactate before and after treatment were analyzed as parameters of effort. There was a significant improvement in tolerance to the lactate and consequently, in tolerance to the effort after treatment with thyroxine. The results demonstrated a significant decrease of LDL-c and triglycerides after the normalization of TSH levels with the hormonal replacement. Significant differences were not observed in the levels of HDL, VLDL and total cholesterol.

The acute myocardial infarction (AMI) is a disease that commonly results of the coronary atherosclerosis, which serves as anatomical substrate for the development of the thrombosis, causing a sudden unbalance between the oxygen supply and myocardial oxygen consumption. In Brazil, approximately 300 350 one thousand case of AMI accounts for 214,000 deaths annually. Health-related quality of life refers to the limitation and discomfort degree that a certain disease or treatment related to it affects the patient life. It is a concept with high influence of subjectivity and social or cultural variables. The so-called generic and specific questionnaires are instruments used to measure life quality. The aim of this study was to correlate the quality of life after acute myocardial infarction through the MacNew QLMI and SF-36 questionnaires, by associating the scores of the physical, emotional and social domains with the instituted treatment, risk factors and time after onset the infarction. A total of 96 patients (25 women and 71 men, mean age of 54.3 ± 5.9 years) with an episode of AMI between 3 and 18 months before the questionnaire application were studied. The patients were selected during the period December 2003 to January 2004 through the medical files of the Clinics Hospital of Uberlândia (UFU). The QV MacNew QLMI and SF-36 questionnaires, a specific and a generic instrument, respectively, were applied. The data were analyzed by descriptive techniques and the correlation between the scores of each domain of the questionnaires was evaluated by the variance analysis. The results demonstrated that: a) the scores of the physical and social domains showed high correlation between the questionnaires; b) the catheterization was the only instituted treatment that showed correlation with all domains of the specific questionnaire; c) the presence of risk factors as diabetes mellitus and dyslipidemia showed a significant correlation with the QV index (P < 0.01) for both questionnaires. Other risk factors, such as arterial hypertension, smoking habits, depression/anxiety and stress showed a significant correlation (P < 0.01) only for the generic SF-36 questionnaire. There was no significant difference in the domain scores of the questionnaires when correlating with the QV index up to 18 months after AMI. We concluded that the non-accomplishment of catheterization and the presence of diabetes mellitus and dyslipidemia contribute significantly for the reduction in the quality of life of the interviewed individuals. The most important changes found in this patient group are related to the physical and social scores in both questionnaires.

The process of training nursing students causes stress, anxiety and mental disorders which may impair performing activities pertaining to the curriculum, and compromise the quality of life of future nurses. The purpose of this study was to verify the health-related quality of life (HRQL) of students in the undergraduate nursing school at the Medical School of the Federal University of Uberlandia (FAMED-UFU). In July 2007 two hundred and fifty-six out of 353 (72%) students were enrolled in an exploratory, descriptive, crosssectional study and answered a generic HRQL questionnaire, SF-36, and the Beck Depression Inventory (BDI). The scores obtained from the SF-36 of the first, second, third and fourth year students were compared to each other and to sociodemographic variables. The presence of mood disorders (BDI scores greater than fifteen) was compared to the median of the SF-36 scores. The reliability of the internal consistency of the item was tested by Cronbach s alpha coefficient for the SF-36 domains. The Spearman correlation coefficient was used to determine the correlation between the domains and components of SF-36 and family income. The Mann-Whitney test was used to compare two independent samples and analysis of variance by Kruskal-Wallis posts for comparison between the years of study. The level of significance adopted was p < 0.05. The Cronbach s alpha coefficients obtained from the SF-36 domains were above 0.7, except in the domain of emotional aspects (0.66). Fourth-year students presented lower scores (p<0.05) than those of the other years in the domains of functional capacity, vitality and social aspects, which may be due to the need to write the final course paper, the approaching end of life as a student, and insecurity regarding the job market. Female students presented significantly lower scores in the domains of functional capacity, pain, vitality, social aspects, emotional aspects, mental health and in the mental component, possibly due to physical characteristics and to the accumulation of activities inherent to the female gender. We concluded that undergraduate nursing students at FAMED-UFU presented an impaired HRQL, above all in the fourth-year students, the female students and those with depressive symptoms. Teaching-learning strategies which take into account the well-being of the students and the psychopedagogical care for students with psycho-emotional difficulties should be prioritized by the managers of institutions of higher education.

The autism is a psychiatric chronic disorder that can cause physical and emotional overload to the relatives. But the repercussion on the health related quality of life (HRQoL) of the caregiver was not studied. The objective of this study was to value the HRQoL of the caregivers of children and adolescents with autism using the 36 - item Shorts Form Heath Survey Questionnaire (SF-36). There were invited to participate to the study caregivers of children and adolescents from 5 to 20 years old with autism diagnosis, in treatment in the Centro de Atendimento Psicossocial (CAPSi) from Uberlandia, Uberlandia MG. The control group was constituted of caregivers of children and adolescents without chronic disease, deriving from public and particular schools from Uberlandia with same age. The demographic and clinical variables were obtained by interview with the caregiver and completed with informations contained in the medical handbook. The SF-36 was applied in the institution by the technique of interview. The Mann-Whitney test was used to compare the scores from the study and control groups, and to compare the individuals of the study group according to the gender and age of the patient (child versus adolescent). The Spearman´s correlation coefficient was used to correlate the demographic variables (age of the patient, age of the caregiver, familiar income, number of children). Take part in study 25 caregivers in the study group and 283 in the control group. The majority of the caregivers was the mothers (84% in the study group and 67,8% in the control group) and hers age alternate to 20 from 63 age (mean = 37,6 and SD = 12). In the study group the scores were lower than in the control in the physical and mental domains(p <0,05). The scores of the caregivers of the masculine gender were lower than those of the feminine gender for the components and most of the domains from SF-36, however only in the pain domain the difference was significant (p = 0,046). Caregivers of adolescents with autism obtained lower scores than the caregivers of children with autism, but this difference was statistic significant only in the domain of functional capacity (p = 0,01) and emotional aspects (p = 0,04). The age of the caregiver, the economic situation and the number of son/daughter were not correlated with the SF-36 scores. A negative multidimensional impact on HRQoL of the caregivers of autistic children/adolescents was shown, with higher repercussion if patients on the masculine gender or adolescent. This results become stronger the need of a major attention to the health of these persons, in a multidimensional approach.

Objective To evaluate the prevalence of chronic pancreatitis (CP) in alcoholic liver cirrhosis patients (ALC) based on the histopathological features. Subjects - We retrospectively analyzed the autopsies of 25 patients with alcoholic liver cirrhosis, eighteen men and seven women, mean age (standard desviation) of 47.2 ± 13.8 years, range from 24 to 83 years. The daily alcohol consumption was 239.6 ± 155.3 g in average, and the mean duration of alcohol abuse was 16.7 ± 7.2 years. A control group was composed of ten men, mean age of 43.1 ± 21.8 years, range from 22 to 77 years, without liver cirrhosis submitted to obligatory autopsies because of violent deaths. Methods - Liver cirrhosis histopathological diagnosis was based on the findings of systemized fibrosis with septa formation delimiting nodules of varied sizes and unspecific chronic inflammation. Chronic pancreatitis histopathological diagnosis was based, especially, on the identification of foci of exsudate of lymphocytes, histiocytes and, eventually, plasma cells (called mononuclear cell infiltration) around the ducts and in the inter and intralobular conjunctive tissue. The CP was classified as mild when it had discrete mononuclear infiltrated (MI) in periductal, interlobular or intralobular area, eventually with the presence of thin strands of fibrosis; moderate pancreatitis was defined by the increase of the exudate and fibrosis intensity, occasionally associated with small ducts dilatation. The severe form of the CP was characterized by MI, dense fibrosis with or without calculi in the ducts, irregular ductal dilatation, glandular (acinar) atrophy and, sometimes calcification. Results - CP was obeserved in the 25 patients (100%) with ALC, considered mild in 18 (72%), moderate in two (8%) and severe in five (20%). In the control group two out of the ten (20%) had mild chronic pancreatitis. Conclusion - Chronic pancreatitis is frequently associated with the alcoholic liver cirrhosis, with the mild form predominance.

The importance of nutritional therapy in the type 1 diabetes mellitus (DM1) treatment has been emphasized since the beginning of its knowledge. However, studies evaluating the DM1 individuals eating habits, which could possibly subsidize more effective dietary guidelines, are still scarce. This work aimed at evaluating the DM1 patients eating habits. Fifty diabetic and seventy-seven non-diabetic patients, from both genders and older than fifteen of age, have been included. Customary diet has been assessed by means of the Food Frequency Questionnaire (FFQ), previously tested in pilot-population. It has been verified that the majority of diabetic individuals (82%) had between five and six meals per day and the majority of non-diabetic (54,5%) between three and four. Protein consumption (p<0,01) and fibers (p<0,01) were higher in the diabetic group and carbohydrates ingestion (p=0,01), simple sugars (p<0,01) and alcohol (p=0,04) within the non-diabetic group. There has been no difference between the aforementioned groups concerning cholesterol consumption, total fat, saturated and unsaturated although the total fat mean percentage presented was higher than recommended in both groups. The fiber intake was only adequate within the diabetic group. There has been a higher fruit and vegetable consumption among the diabetic patients, yet beneath recommendation. This study s data suggest that diabetic patients have healthier eating habits than the non-diabetic ones although the present some dietary mistakes, for instance high fat intake and lower than recommended fruit and vegetable ingestion beneath.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Elder abuse has received increasing attention in the field of health since it is a complex problem with consequences for the health of old people. It has been recognized as an important topic especially due to the aging of the world population, mainly in Brazil. This study aimed at assessing the knowledge of professionals from the Family Health Program (Programa de Saúde da Família, PSF) on elder abuse. Two hundred twenty-five professionals from the 34 PSF teams in Uberlandia were interviewed: 91 professionals with higher education degree (doctors, nurses, psychologists, dentists, social wokers, physiotherapists), 34 technical nurses and 100 out of the 202 existing community health agents who were selected randomly. Most of the professionals were female (193; 85.8%), young adults aged 18 to 29 years (88; 39.1%), mean age 34.6 years, median age 33 years. Fifty-eight percent of the community agents had completed high school, 17 (50%) of the technical nurses had completed their technical training and 57.1% of professionals with higher education degree had completed post-graduation. Most of the sample did not have specialization on family medicine (183; 81.3%): only 1 doctor (3.1%) and 15 nurses (44.1%) were family specialists. Among the 225 interviewed, 128 (56.9%) had more than 2 years of experience with PSF and 133 (59.1%) reported no previous information on elder abuse. Among those who had previous contact with the topic, 55 (59.8%) reported having heard of it from lectures. Seventy-eight professionals (34.7%) referred no previous knowledge on the Elderly Bylaw. Among those who reported at least some knowledge of it, 43 (29.3%) did not recall any of its content or articles and only 6 (4.1%) mentioned the need to report elderly mistreatment to official agencies. All the professionals of the sample were interested in getting information on elder abuse and 139 (61.8%) preferred doing so through workshops. This interest was justified by 188 (80.4%) of the interviewed due to the presence of the topic in their professional activities. One hundred twenty-two (54.2%) professionals reported previous suspicion of elder abuse. Among these, 85 (69.7%) referred to cases of neglect, 23 (18.9%) reported to official agencies, 9 of those (39.1%) were nurses. In a hypothetical situation, more than 70% of the professionals would recognize abuse but only a small percent would report it to official agencies. Although most of professionals (79.6%) have recognized the Elderly Council as the agency responsible for receiving reports on abuse, 81% did not know any information on its performance because they had never reported any case of elder abuse. Ninety-one (40.5%) professionals reported no reason for preventing them from reporting cases of elder abuse to official agencies. Among the remaining 134 professionals, 44 (32.8%) considered lack of information as a reason for preventing report. Almost all of the professionals (93.8%) identified the community agent as the responsible for screening situations of abuse and 44.2% identified them as also responsible for investigating these cases. Although most of professionals were able to recognize risk factors for elder mistreatment, many have also identified some protective factors as risk for abuse. Most of professionals referred making inquiries about care by family or caregiver, but 62.4% did these questionings in subtle ways. We conclude that there is lack of knowledge and inadequacy of clinical practice on elder abuse among professionals from PSF.

Allergic rhinitis (AR) is a global public health problem and it is gaining importance due to the rapid increase in its prevalence worldwide. House dust mites as Dermatophagoides spp. are the major sources of allergen sensitization in genetically predisposed subjects. This study aimed to evaluate serum and salivary IgA, IgE and IgG4 levels to Dermatophagoides pteronyssinus (Dpt) and its major allergens (Der p 1 and Der p 2) in allergic and non-allergic children and teenager. A total of 86 subjects were studied, from which 72 had AR and positive skin test to Dpt extract, and 14 were non-allergic subjects, with negative skin test to aeroallergens. Paired serum and saliva samples were collected from all subjects and analyzed by immunoenzymatic assays. Levels of serum IgE and serum or salivary IgG4 antibodies to Dpt, Der p 1, and Der p 2 were higher in allergic than non-allergic children and teenager (p < 0.05). In contrast, levels of serum and salivary IgA antibodies to all allergens were higher in non-allergic than allergic children and teenager (p < 0.05). It was noted that the ratio serum IgG4/IgE was lesser than 1.0 to all allergens and significantly lower in allergic than non-allergic children and teenager. It can be concluded that allergic children and teenager have high levels of serum IgE and IgG4 serum and salivary allergen-specific and low levels of serum and salivary IgA allergen-specific to Dpt, Der p 1 and Der p 2. Specific IgG4 antibodies are present in the serum and saliva from allergic children and teenager along with specific serum IgE, but IgE predominates in the serum of allergic children and teenager whereas IgG4 prevails in the serum of non-allergic children. Specific IgA appears to act as natural protective antibody since it predominates in the serum and saliva from non-allergic children and teenager.

This study aimed at identifying, through Defense Style Questionnaire (DSQ), the ego defense mechanisms used by diabetic pregnant women and their association with the presence of mental disorders evaluated through the screening test QMPA (Psychiatric Morbidity Questionnaire for Adults). It is a sequential case-control study. Subjects were 100 pregnant women diagnosed with diabetes mellitus (gestational and pregestational diabetic women), who were being assisted by the Psychological Service offered in the Ambulatory Department and in the Infirmary for High Risk Pregnancy, and 100 clinically normal pregnant women who were being attended in the Ambulatory Prenatal Service Department, who formed the control group. Subjects were paired by age, educational level and the trimester of pregnancy. According to the results, the diabetic pregnant women tend to differ from the non-diabetic ones inasmuch as they use disadaptive defense mechanisms, such as: passive aggressiveness, projection, inhibition, somatization, fantasy, and refusing help. According to the QMPA scores, the group of diabetic pregnant women presented significant differences, when compared to the control group, concerning the following factors: anxiety/somatization, irritability/depression, and exaltation of humor. The values related to the group of diabetic pregnant women were higher than those related to the control group. The study suggests that diabetic pregnant women show more signs of regression than the non-diabetic ones. This conclusion may indicate the need for the implementation of a program for pregnant women devoted to the prevention of psychological disorders.

Pulmonary complications in the postoperative (PO) in cardiac surgery (CS) are frequent, besides being seen as the main motive for prolonging hospitalization, morbidity, and mortality. Noninvasive ventilation (NIV) is used in the postoperative to avoid or reverse pulmonary damage. This study compares two modes of NIV, using either pressure support ventilation (PSV) or proportional assist ventilation (PAV) in the postoperative of coronary artery bypass grafting surgery. It also assesses safety, dyspnea sensation, and gas exchanges, besides verifying which mode is more comfortable to the patient. Twenty-five patients were randomized into two groups: thirteen ones made NIV in PAV; twelve ones in PSV. Arterial gasometry was made with patient breathing ambient air; and chest radiographs were made before the study began and after the last NIV session. Two daily sessions of NIV were carried out, each of them during 30 minutes for two days. Heart rate and arterial pressure were verified before NIV begins, ten minutes and twenty minutes after its beginning, then after each one of its sessions. Peripheral oxygen saturation (SpO2) and respiratory rate (RR) were measured before NIV sessions beginning, at 5, 10, 15, 20, 25 minutes after it, then after each one of its sessions. Tidal volume, minute ventilation, maximum inspiratory pressure, fraction of inspired oxygen (FiO2), PS, volume assist, flow assist, and proportionality were recorded at 5, 15, and 25 minutes. Positive end expiratory pressure (PEEP) was established in 5 cmH2O. Scale for level of comfort and modified Borg scale for dyspnea were applied. The PAV group showed a higher SpO2 than the PSV group. Although RR decreased (p < 0,001) in the two groups during NIV, it was higher in the PAV, which showed a MIP (p < 0,01) lower than the PSV group. There was a reduction in arterial pressure of carbon dioxide (PaCO2) and in dyspnea perception in the two groups. No difference was found out in the comfort scale. Results show that PAV and PSV modes are safe and reduce dyspnea sensation; that PAV presented a lower MIP; that PAV and PSV modes were comfortable and reduced patient s dyspnea sensation; and that PAV mode presented a relevant reduction in MIP when compared to PSV mode.

The anabolic androgenic steroids (AAS) came from testosterone, with restricted use in medicine in some specific clinical conditions, and when correctly administrated are well tolerated. However, there is a potential risk to health the use of AAS without medical prescription and above the recommended dose, becoming evident the collateral effects. The risk of adverse cardiovascular effects increasing is a main concerning. The abusive use of anabolic androgenic steroids (AAS) is associated with left ventricular hypertrophy. The decanoate of nandrolone (nandrolone) is one of the most used AAS in the world. The regression of left ventricular hypertrophy is a point of interest because of the possible reduction of bad prognostic that it causes to the individual. Beta-blockers can revert the variations associated to ventricular remodeling and can show the progressive deterioration benefits from ventricular dysfunction. In this study was evaluated the effects of metoprolol on histomorphological profile of heart induced by AAS in rats. Four groups, each with 10 rats, were studied: 1) Control Group (C): rats that received twice a week injections of olive oil during five weeks as a control group (1 ml intramuscular);2) Nandrolone Group (N): rats that received twice a week injections of nandrolone during five weeks (15 mg/kg weight, intramuscular); 3) Metoprolol Group (M): rats that received twice a week injections of olive oil (1 ml intramuscular) during five weeks and daily injections of metoprolol (4 mg/kg weight, intraperitonial) during five weeks and 4) Nandrolone-Metoprolol Group (NM): rats that received twice a week injections of nandrolone (15 mg/kg weight, intramuscular) during five weeks and daily injections of metoprolol (4 mg/kg weight, intraperitonial) during five weeks. The animals were weighed to control body weight and heart beat frequency. The heart weight/animal weight ratio was quantified. The evaluation of ventricular remodelling was obtained through histological processing and morphological analyses, measuring miocytes diameter using HL Image 97. These microphotographies allowed the transversal diameter measurement of, at least, five ventricular fibers, with a total of 125 fibers measured by animal. The diameter of each fiber, in micrometers, was obtained in the HL Image 97 program. It was verified that the animals from Nandrolone (N) group showed a significant increasing of the ventricular fiber diameter compared with control group (C). In the association of nandrolone and metoprolol (NM) the diameter was 50 % lower than the group that received only nandrolone (N). The nandrolone decanoate promotes ventricular remodeling characterized by the increasing of myocardiocytes transversal diameter and the metoprolol associated with this nandrolone causes cardioprotective and repairing effect, decreasing the induced myocardium hypertrophy

Introduction: Blood and blood products are still essential for the treatment of several medical conditions for which they have no substitutes. Blood for transfusion is obtained from volunteers who go through several steps during the process of donation Association between tattoos and seropositivity to transfusion-transmissible diseases (TTDs); and it has been proposed that in certain settings having a tattoo can be an exclusion criterion for blood donation. By analogy it could be though that seropositivity to TTDs was also associated with the use of earring and body piercing. Objective: To assess whether the use of earring and/or body piercing can be indicators of seropositivity to the following TTDs: hepatitis B, hepatitis C, human immunodeficiency virus (HIV) infection, Chagas disease, and syphilis. Material and methods: Secondary analysis of a data set from a cross-sectional study conducted at the Universidade Federal de Uberlândia, and that resulted in a doctoral thesis (Nishioka,S.A.-Tattoos as indicators of transfusion-transmitted disease in Brazil: a matched hospital-based cross-sectional study.Montreal:McGill University,2000.166p). The exposure of main interest were having earring or body piercing, whereas the outcomes of interest were presence of any serologic marker of infections by hepatitis B(HBV), hepatitis C(HCV) HIV, Treponema pallidum or Trypanosoma cruzi, determined by the following tests: HBsAG, anti-HBc, anti- HCV,anti-HIV, VDRL and anti- Trypanosoma cruzi Results: No association between earring and TTDs was observed when the odds ratios were adjusted by confounders, even when the analyses were restricted to males. Body piercing was observed in only two women in the study population, and therefore could not be analyzed.Conclusion: Earring is not associated with seropositivity to TTDs, and should not be used as an exclusion criterion for blood donation.

The aim of this search was to evaluate the impact of penicillin and ceftriaxone new susceptibility breakpoints in reporting resistance of pneumococcus invasive strains obtained from patients hospitalized for pneumonia. Pneumococcus strains obtained from normally sterile fluids from pneumonic patients were isolated and identified at Uberlândia Federal University Clinical Analysis and forwarded to Adolfo Lutz Institute, in São Paulo, SP, for further identification, serotyping and antimicrobial susceptibility determination. From April 1999 to December 2008, 330 invasive pneumococcus strains were forwarded to Adolfo Lutz Institute. 195 of them were obtained from pneumonic patients. After exclusion of the invalid samples, 175 strains were analyzed: patients were from one to 86.8 years old (mean of 24.6 years and median of 4.4years), 89 (50.9%) male and the strains were isolated from blood (110 occasions [62.9%]) and pleural fluid (65 occasions [37.1%]). According to the former breakpoints to define penicillin susceptibility (minimum inhibitory concentration [MIC] ≤0.06g/mL for susceptible [S], 0.12 to 1g/mL for intermediate resistance [IR] and ≥2g/mL for plain resistance [PR]), there were 27 strains IR (15.4%) and 12 PR (6.9%) amongst 42 strains (24%) oxacillin-resistants. According to the new breakpointss (≤2g/mL for S, 4g/mL IR and ≥8g/mL for PR), only one strain showed resistance (RI) to penicillin. Decreased sensibility was detected to sulfamethoxazole-trimethoprim (64%), to tetracycline (17.1%), to erythromycin (8.6%), to clindamycin (8.6%) and to ofloxacin (0.6%). There was only one strain resistant (IR) to ceftriaxone, simultaneously resistant to penicillin. The isolates were all susceptible to chloranphenicol, rifampin and vancomycin. When the new criteria of breakpoints were applied, decreased susceptibility rate declined in 97.3%.

Myelomenigocele (MM) is the most common and disabling disorder of neural tube defects. It is associated to several health problems and to motor and sensitive disabilities. This condition may impair patient s health-related quality of life (HRQL). However, it is not established how different neurological lesion levels and functional ambulation influence HRQL. This study aimed at assessing the HRQL of children and adolescents with MM in comparison with healthy controls of the same age and according to the lesion level and functional ambulation. Patients with MM followed at AACDMG, aged 5 to 18 years, and healthy controls of the same age and sex were recruited for this study. Patients were classified according to the neurological lesion level (thoracic, upper lumbar, lower lumbar and sacral) and to functional ambulation (community ambulators, household ambulators, nonfunctional ambulators and non-ambulators). Clinical and demographic data were obtained by interview with caregivers and by information collected in medical records. The Child Health Questionnaire (CHQ-PF50) was self-administered to parents/proxies. Psychometric properties were assessed by data quality (rate of lost data, floor and ceiling effects) and reliability (item internal consistency and reliability of internal consistency). Patients scores were compared with controls and according to functional ambulation (Mann-Whitney test) and to neurological lesion level (Kruskal-Wallis test). Thirty participants in the study group and 60 in the control group answered the questionnaire. Patients mean age was 8.3 years. The rate of lost data was low (ranged from 0.0% to 10.0%). Ceiling effect was observed in 10 scales (ranged from 0.0% to 56.7%). In general, reliability was considered appropriate since the scale general health was the only one with low values of tem internal consistency (success rate of 60%) and internal consistency reliability (Cronbach s alpha of -0.37). Patients had lower scores in comparison to controls on 8 scales and on physical summary of CHQPF50 (p< 0.05). There was no difference among patients according to the neurologic lesion level and to the functional ambulation (p> 0.05). These results confirm physical and psychosocial impairment of HRQL of children and adolescents with MM, according to their proxies perspective, with similar findings among the different neurological lesion levels and functional ambulation. This study point to the need of a multidisciplinary approach to all patients, independently of lesion level or functional ability.