Repositório RCAAP

Physical activity and sports practice have been associated with a healthy life, but they can also cause injuries. The aim of this work is to study the epidemiology and classify the most frequent lesions from external causes in a country club in Uberlândia, Minas Gerais State. We prospectively obtained data from 885 patients with injuries from external causes attended at the medical department of this country club, in 2004. Statistical analysis was performed using chi-square and Fisher s exact tests (p<0.01). We observed more injuries among males, with ages of 10 to 19 years. The lesions occurred more frequently during sports practice indoors. Fall was the main cause of injuries, above all in age limits. More than 50% of the lesions in almost half of the patients, resulting from running and walking, occurred in the lower limbs. Sprains, strains, and contusions were the most frequent injuries, while fractures and dislocations affected less than 5% of the patients. Among children, we observed more contusions and skin abrasions and less strains/sprains compared to teenagers and adults. Sprains, strains, fractures, and dislocations were the main reasons for a more complex medical assistance outside the country club. Local cooling with ice packs was the most frequent treatment used. We concluded that injuries affected more frequently males with ages of 10 to 19 years, mainly during sports practice indoors; fall was the most frequent cause of lesions, above all in age limits; strains/sprains and contusions were the most frequent lesions; the lower limb was the most affected region; local cooling was the most common treatment used; strains/sprains, fractures and dislocations were the main reasons for a more complex treatment outside the country club.

Universidade de Franca

Purpose: To analyze the patterns of dopplervelocimetry of the ophthalmic artery in pregnant and no-pregnant patients with systemic lupus erythematosus (SLE) without renal disorder flares, and to compare the Doppler indexes of normal pregnant women. Methods: an observational study was carried out through Doppler indexes evaluation of the ophthalmic artery of 20 normal pregnant women, 10 pregnant women with SLE, and 17 non-pregnant women with SLE. The variables analyzed were: pusatility and resitance indexes (PI, RI), peaks systolic velocity, and the enddiastolic flow velocity (PSV, EDV) and peak ratio (PR). For the comparison of the Doppler indices the test of variance (ANOVA) and the post-analysis test of Tukey were used. The Pearson linear correlation analysis was performed to study the values changes at the time of the disease. The level of significance determined in the study was 5%. Result: there were no significant differences between the two SLE groups, concerning the Doppler values, except for PSV (p=0,026). Nevertheless, the means of RI, PI, EDV and PR of the ophthalmic arteries were compared, between the groups of normal pregnant women and pregnant women with SLE, significant differences were observed (p=0,01; p=0,02; p=0,05; p=0,04) The RI and PI, in both groups of women with ESL, were lower them the indexes of normal pregnants. But PR and EDF were higher in women with ESL whem compared with normal pregnants. There were no signiticant correlation between time of lupus and Doppler indexes PI, RI, SVF, EDV, PR, for pregnant groups (r=0,509, r=0,462;r=0,738;r=0,422) and non-pregnants (r=0,840; r=0,005; r=0,063; r=0,284; r=0,323). Conclusions: There was ophthalmic artery impedance flow reduction in both groups of patients with SLE compared to normal pregnants. Concerning the Doppler variables of the ophthalmic arteries, there were no significant differences between the groups of pregnant and non-pregnant women with SLE. No association of time of disease and ophthalmic artery Doppler indexes , in both pregnants groups, was found.

Among the devices studied as alternative processes to the means commonly used in the coaptation of surgical wounds, the use of synthetic adhesives has been described and used since the 1950s. They include several cyanoacrylate-based formulations (such as ethyl-2-cyanoacrylate), since they have positive characteristics, such as a being easy to apply, quick polymerization and low toxicity, among others, and are, therefore, an often mentioned compound. Objective: To evaluate the use of ethyl-2-cyanoacrylate in treating a segmental resection in the cecum, that is partially diverted in the rat anatomy. Methods: Forty-five male Wistar rates were used, divided into three equal groups. The groups were called: Group 1: resection treated applying ethyl-2-cyanoacrylate; Group 2: suturing and applying ethyl-2- cyanoacrylate; Group 3: pouch-type suture. The animals were followed postoperatively, and half of each group was necropsied on the 14th day and the rest on the 28th day postoperatively. Thus, they were submitted to macroscopic evaluation, and fragments of cecum were collected for histological evaluation, and statistical analysis was performed. Results: The postexperiment weight gain was different in the groups (p=0.028). The presence of microabscesses was greater on the 28th day PO in group 2, compared to group 3 (p=0.0034). Collagen deposition on the 28th day PO was greater in group 1 (p=0,0368) and intensity of inflammation on the 14th day PO was greater in group 1 (p=0.0454). No statistical difference was found in the other parameters evaluated. Conclusion: Ethyl-2-cyanoacrylate was effective in the treatment proposed, and is thus an alternative to the currently used methods.

Antibiotic-associated diarrhea (AAD) is characterized as that developed after the start of antibiotic therapy or up to six to eight weeks after completion of treatment. It is considered an important side effect of this class of drugs and occurs in approximately 5% to 25% of patients on antimicrobials. The aim of this study was to investigate the effect of the use of probiotics in the treatment of DAA. The study included patients hospitalized with diarrhea developed during the use or up to seven days after the suspension of antimicrobial use. The patients were randomized blindly to receive standardized diet associated, three times a day, the probiotic (Lactobacillus casei and Bifidobacterium breve) or placebo. For the experimental and control group, respectively, the average time of treatment was 5.06 ± 2.18 and 5.49 ± 3.17 days (p=0.95) and the mean duration of diarrhea, among those who healed, was 4.87 ± 2.13 and 4.52 ± 2.55 days (p=0.36). Four patients (11.43%) who received probiotics and ten (28.57%) of those who received placebo were not cured and no cure rates and relapse rates were similar between groups. Seven patients of probiotic group and seven of placebo group, showed ,in addition to diarrhea, bloating and / or abdominal cramps and / or vomiting (p=1.00). In this light, it is concluded that L. casei associated with B. breve, in the administered dosage and frequency, have no effect on the DAA.

Nowadays, traffic injuries and violence are important causes of health problems to children population. With the objective to know epidemiologic and clinic aspects of the traffic accidents involving children admitted in large public hospital in Uberlândia MG, it has been done a descriptive case series research analyzing, retrospectively, medical records of children younger than 15 years old, who were admitted to the Hospital das Clínicas de Uberlândia (HCU), from January 1999 to December 2003. Within the results it can be marked that the victims average age was eight years old and 65.7% were boys; 76.6% were cyclists or pedestrians; 7.1% of the pedestrians were admitted at intensive care unit and 2.6% died; 58.8% of the passengers of motorcycles and of four or more wheels vehicles were not using security devices properly. The occurrence of pre-hospital assistance before admission at HCU was identified in 33.1% patients; 44.5% patients were admitted at the hospital with a time interval smaller than one hour; 45.9% suffered traumatic brain injury, 6.8% severe and out of these 64.8% were admitted at intensive care unit. 61.0% of the cyclists suffered isolated limb lesions and 57.5% pedestrians suffered multiple lesions; 83.3% of the surgeries included orthopedic procedures; 9.0% stayed at the hospital for more than two weeks. Of the deaths 66.7% were pedestrians and 78.6% occurred within 48 hours after admission and in 85.7% traumatic brain injury occurred. In conclusion, the victims are, in average, eight years old and are mainly boys. The vehicle most frequently involved in accidents is the bicycle and the ones with pedestrians are commonly more severe. When passengers, frequently are not using security devices properly. Many victims received pre-hospital assistance in other heath units before being transferred to HCU and are admitted in this hospital after the first hour of the accident. The assistance given by fireman was not associated with longer survival. Commonly the children victims of traffic accidents suffer lesions in limbs, brain or multiple; the occurrence and severity of the traumatic brain injury determines the evolution; surgeries are mainly orthopedic procedures; around 10% stayed at the hospital for more than two weeks and death is more frequently among pedestrians.

Allergies are caused by immunological reactions to allergens, which are substances capable of triggering specific IgE responses in genetically predisposed subjects. In tropical and subtropical regions, allergens derived from B. tropicalis are important causes of IgE-mediated sensitization among patients with asthma and allergic rhinitis. The aim of this study was to produce the recombinant Blo t 5 allergen and to evaluate its reactivity to IgE in sera from atopic patients compared to its native counterpart and B. tropicalis crude extract using immunoenzymatic assays. A full-length cDNA encoding was Blo t 5 was cloned from a mRNA Bt using a transcriptase reverse and PCR. The cDNA was PCR-amplifed, sequenced and subcloned into E.coli expression vector and recombinant protein rBlo t 5 was purified. Immunoglobulin E (IgE) reactivity of the nBlo t 5 and rBlo t 5 allergens was determined by enzyme-linked immunosorbent assay (ELISA). rBlo t 5 was capable of binding to IgE revealing the preservation of additional unique IgE epitopes in rBlo t 5 BT+ group (36%) and BT- (31,2%). This comparative study confirmed production and purification the recombinant Blo t 5. The recombinant protein showed great, when patients sera was used, presenting moderate correlation of human IgE reactivity between rBlo t and crude Bt extract, rBlo t 5 and nBlo t 5 in these sera in patients in Brazil.

The present study has the objective of evaluating the HRQL of mothers of children and adolescents affected by DS in comparison with mothers of healthy children and adolescents and verify the association with clinical and demographical variables and with the HRQL of the affected, as perceived by their mothers. Participated in this study mothers of subjects affected with DS and mothers of healthy subjects with maximum age of 21 years, paired by gender and age of the affected subjects in reason of 2:1. After signing the free and clear term, the mothers answered a questionnaire with their demographical information (age, conjugal situation, scholarity, paid activities, family income) and their children information (age, gender, number of brothers, scholarity); and also clinical data about the mother (presence of chronical disease), about the children with DS (use of medication, presence of other chronical diseases or comorbities) and about the family (other people affected by chronical disease in the same residence). The HRQL of the mothers was evaluated through the Medical Outcomes Survey Short Form36 (SF-36) and the intensity of the depressive symptons was verified through the Beck s Depression Inventory (BDI). The mothers of subjects affected with DS with age 5 of greater also answered the Child Health Questionnaire Parental Form 50 (CHQ-PF50), to evaluate the QVRS of the affected, and to the Child Assestment Questionnaire (CHAQ), to evaluate the functional capacity. The Alfa Cronbach coefficient was calculated to determine the reliability of the instruments. The SF-36 scores were compared between the control group and the group of mothers of children affected with DS (Mann-Whitney test). The demographical and clinical variables were compared (Mann-Whitney test, Kruskal-Wallis or Qui-Square) and correlated (Spearman s correlation coefficient) with the scores of the SF-36. The medium age of the mothers in the DS group was 39.0 years and in the control group it was 35.0 years. In relation with the subjects with DS, most of them were males (61.0%), their medium age was 8.0 years, with predominance of adolescents (41,7%). The Alpha-Cronbach coefficient varied from 0.75 to 0.94 to the SF-36. The mothers of subjects affected by DS obtained significantly lower scores than the mothers of the control group in the following domains: physical function, general health, vitality, social function and mental component summary in the SF-36 (p<0,05). The CHQ-PF50 scales that were mostly correlated with the scores of the SF-36 were: behavior, mental health and health perception. Concluding, mothers of subjects affected with DS presented negative impact in the mental dimension, in comparison with the mothers of healthy children and adolescents. The greater the intensity of the depressive symptoms, the greater was the physical and mental injury in the HRQL of the mothers. Few associations were found between the other demographical and clinical variables that were analyzed.

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Process management requires the need to establish indicators for the quality and development measurement of the processes implemented. The current work picked out the level of disability on diagnosis (GID) and on patient´s discharge (GIA), as well as the number of assessments performed by the physiotherapy sector (a process experienced by the patient in a health unit of national reference in terms of Hansen s disease in Brazil) aiming to assess the impact in the prevention of disabilities in patients under treatment, in two periods, before (2003-2005) and after (2006-2008) the application of the processes. A study carried out with 351 predominantly male patients in both periods: 58.8% on P1 and 58.6% on P2 in the age-group from 31 to 60 years of age. In terms of occupation, domestic work prevailed for women and retirement and general services predominated amongst men. The MB patients (66.0% on P1 and 61.8% on P2) and the borderline-tuberculoid clinical form (41.2% on P1 and 40.8% on P2) were the most widespread in both periods. On P2 there were more patients diagnosed with GID=0 and GID=2, but on the patient´s discharge period there was a reduction of 1.9% in the cases with GIA=2 in relation to the P1, in which there was an increase of 1.6% in patients with GIA=2. From P1 to P2, between the diagnosis and the discharge period, there was an increase of 16% in the assessment average per patient (p=0.009). This is the first epidemiological study assessing the impact of the process management in the prevention of disabilities in patients treated in a Hansen´s Disease National Reference Center in Brazil, which resulted in a reduction of the GIA-2 and a significant increase in the number of assessments on P2, showing that the patients had a greater adherence to the full treatment. It also evidences that a health service aiming to be a technical reference in any disease cannot put aside the application of management by process for its organization. Also, this model must be a prerequisite for the Health Ministry of Brazil and other countries for the certification of the services aiming to work as Hansen´s Disease National Reference Center.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Despite recent advances in neonatal intensive care, prematures born at less than 25 weeks gestation have high rates of morbidity and mortality. Parents and doctors face difficult decisions concerning instituting and/or continuing resuscitation and intensive care of these babies. This is, therefore, a complex ethical/moral problem with a strong impact on the lives of the surviving prematures and their families, as well as for the heath care system and society. There is increasing interest in regulating and standardizing the care of very premature babies. However, there are significant differences between the protocols used in different countries concerning the decision to resuscitate premature babies that are at the threshold of viability. In Brazil, there is no protocol on this matter. The purpose of this study is to describe the biological, bioethical, economic and legal aspects present in the decisions of resuscitation or not at the threshold of viability and to propose recommendations appropriate to Brazilian conditions. The authors suggest that comfort care measures should be offered to babies of less than 25 weeks and intensive care to those beyond this gestational age. If parents, after detailed discussions and clear information about the medical recommendation for comfort care measures to those between 23 and 25 weeks decide in favor of intensive care measures, it should be provided and rediscussed continually.

Leprosy is an important health problem in Brazil, with a high detection rate despite the application of the multidrug therapy. The nasal mucosa is considered the preferential site of entry and exit of the Mycobacterium leprae, although some lesions have been found in the buccal mucosa. However, the buccal mucosa involvement in bacilli transmission has never been investigated. We have shown the presence of the M. leprae DNA in buccal swabs of leprosy patients (334) and household contacts (1288) through conventional polymerase chain reaction (PCR), and results were correlated with clinical and other laboratorial evaluations. The overall positivity for patients was 18.26%, divided into 12.03% and 21.23% for paucibacillary and multibacillary forms, respectively. Among contacts, the positivity reached 6.83%, which were considered either as healthy carriers or sub-clinically infected, when the ELISA test presented a positive anti-PGL-1 result. This study showed important evidences that the buccal mucosa may be a secondary site of M. leprae transmission and infection. Furthermore, contacts with positive PCR may be actively involved in the transmission. Our findings have great epidemiological relevance, especially for the leprosy control programs and for the dentistry clinics, and must be considered in the new strategies of control and prevention.

Objetivo - Conhecer a epidemiologia dos disparos de arma de fogo em Uberlândia, MG, e os aspectos clínico-cirúrgicos das vítimas. Métodos - Foram obtidos dados sobre disparos de armas de fogo de: Boletins de Ocorrência da Polícia Militar; prontuários do Hospital de Clínicas de Uberlândia - 2001 e 2002; laudos de lesão corporal e necropsias do Posto Médico Legal - 2000 a 2003. Resultados - As ocorrências foram principalmente em bairros periféricos; 171 (53,61%) em vias públicas, 72 (22,57%) em residências, mais de 1/3 em finais de semana; dos disparos para os quais os dados foram obtidos, em 110 (75,34%) a arma utilizada foi o revólver e foram motivados principalmente por discussão (46; 29,68%) e acerto de contas/vingança (40; 25,81%); de 94 (26,40%) casos cujo dado foi obtido, em 60 (63,83%) o agressor foi classificado como cidadão comum; em 130 (67,01%) casos os agressores fugiram. As percentagens aproximadas de vítimas do sexo masculino, de 10 a 39 anos e solteiras foram de, respectivamente, 90%, 80% e 70%. Nos casos fatais, os locais mais atingidos foram o tronco (257; 93,12%) e o crânio (150; 54,35%) lesionando sobretudo o cérebro (128; 46,38%) e os pulmões (125; 45,29%). Conclusões - são freqüentes os disparos em bairros periféricos, vias públicas ou residências, em finais de semana, por revólver, motivados por dificuldades de relacionamento interpessoal, realizados por cidadãos comuns que, geralmente fogem da cena do crime; as vítimas são, sobretudo, homens jovens e solteiros; nos casos fatais são mais comuns lesões em tronco e crânio, acometendo cérebro e pulmão.

Parkinson is a disabling neurodegenerative disease. It is also invariably progressive. The more severe the disease, the worse patients perceive their quality of life (QL). In order to quantify the impact of the disease in the QL of these patients, QL measurement instruments have been developed. However, they need to be translated, culturally adapted and validated in order to be used in our environment. The objective of this study was to translate, culturally adapt and validate the Parkinson disease Quality of Life (PDQL) - the PDQL- BR, an assessment instrument of Health-related Quality of Life (HRQL) specific for the Parkinson Disease (PD). Method: 52 patients answered the PDQL-BR, the Beck Depression Inventory (BDI) and a questionnaire with sociodemographic data. Twenty-one patients answered the PDQL-BR again after 14 days. The Unified Parkinson s Disease Rating Scales (UPDRS) and the modified Hoehn and Yahr scale were also applied. The psychometric properties of the PDQL-BR were assessed by examining data quality, reliability and instrument validity. Data quality was assessed by the occurrence of floor and ceiling effects and the percentage of missing data. Reliability was assessed by internal consistency of the item, internal consistency reliability (homogeneity of the data) and reproducibility of the instrument. Validity was assessed by the convergent and discriminant validity. Results: There were no floor and ceiling effects. For the assessment of the internal consistency, the items 20, 30 and 37 presented correlation coefficient of 0.34; 0.26 and 0.37, respectively. Correlation coefficients for the other items were above 0.4. The &#945;-Cronbach s coefficient was above 0.65 for all domains and 0.93 for the instrument as a whole. Scores of the PDQL-BR between the two applications were statistically similar. For the assessment of the discriminant validity, scores of the instrument and of domains of parkinsonian and systemic symptoms were different for each stage of the disease, being worse for the more advanced ones. For the assessment of the convergent validity, the emotional function domain showed a strong association with the UPDRS and BDI scales (correlation coefficients of 0.59 and 0.56, respectively). The domain Parkinsonian symptoms showed a strong correlation with the UPDRS (coefficient correlation of 0.78). Conclusion: The translated version of PDQL did not show significant change in the process of translation and cultural adaptation. Its psychometric properties were similar to those of the original instrument. Careful interpretation must be given to the evaluation of responses of items 20, 30 and 37.

Currently, good aesthetic results combined with functional recovery of the limbs in radical saphenectomy postoperative are eagerly sought not only by patients but also by vascular surgeons. The objective of this study was to determine whether ultrasound (U.S.) and manual lymphatic drainage (MLD) influence the absorption of the hemorrhagic suffusions after radical saphenectomy, and if there is superiority of one in relation to the other. The study included 36 white female patients living with chronic venous insufficiency that have undergone radical saphenectomy; 63 limbs (analysis units) were randomized in three groups of 21 each: DLM (Leduc method), U.S. (continuous mode, 3 Mhz and 1 W/cm²) and Control. The proceedings were started on the 5th postoperative day and completed on the 30th postoperative day, three times a week on alternate days. The limbs were photographed at 5th, 20th and 30th days after surgery, and then three vascular surgeons, assessed the photos blindly, through score given from 0 (best condition) to 10 (worst condition) for three variables: colors intensity and areas of the hemorrhagic suffusions and aesthetics of the limbs. To assess the degree of improvement in each group were obtained variations (differences) in notes between 5th and 20th and between 5th and 30th postoperative days, by subtracting the notes given on the 5th postoperative day from those obtained on the 20th and on the 30th days after surgery, respectively. We used Tukey´s Test to verific significant differences in average scores between groups DLM, U.S. and Control (p <0.05). On the 5th postoperative day, DLM, U.S. and Control groups had similar grade point average but only for colors intensity (p> 0.05); on the 20th and 30 th postoperative days, there was no significant difference between U.S. and MLD groups; grade point averages were lower for DLM and U.S. groups in relation to Control group, for all variables (p <0.05). Variations in notes between 5th and 20th and between 5th and 30th postoperative days of MLD and U.S. groups, showed to be higher than in the Control group (p <0.05), and on the MLD group greater than in the U.S. group (p <0.05), indicating so that although both, DLM and U.S. are effective therapy resources to absorb the hemorragics suffusions after radical saphenectomy, the DLM is more effective than US.

The aim of this study was to evaluate the profile of serotypes and antimicrobial resistance of pneumococcal strains obtained from clinical specimens of patients admitted with a diagnosis of meningitis at the Hospital Clinics, Federal University of Uberlandia (HC-UFU). Invasive pneumococcal strains isolated in the Clinical Laboratory of HC-UFU samples from inpatients were identified and sent to Instituto Adolfo Lutz (IAL) in Sao Paulo, SP, to confirm the identification, serotyping and determination of antimicrobial susceptibility. From April 1999 to April 2009, among 338 strains recovered, 72 obtained from patients with meningitis were evaluated. Forty six (63.9%) patients were male and the age ranged from one month to 82.2 years old, mean of 18.4 ± 22.9 years, median of 5.2 years. Strains were isolated from cerebrospinal fluid [66 occasions (91.7%)] and blood [6 occasions (8.3%)]. There were 24 different serotypes of pneumococcus and the most commonly identified were 14, 19F, 3, 7F, 6A, 6B, 10A, 18C, 23F, 5 and 34 giving a figure of coverage by the 7-valent conjugate vaccine of 79.8% and the 10-valent of 91.3 among children aged up to five years. Amongst 20 [27.8%] oxacillin-resistant strains, 17 [23.6%] confirmed resistant to penicillin and nine [12,5%] resistant to ceftriaxone, both being more common in children until 24 months and during the period of 2005 to 2009.

Heart failure (HF) is a chronic disease that incapacitates and provokes emotional repercussions that may actually worsen the disease itself. Possible results include disinterest by the patient in pursuing treatment, increased hospitalization and reduced quality of life. The present study seeks to verify the presence of symptoms of anxiety and depression in patients with HF and compare them with a group of patients without HF for analysis in terms of principal socio demographic characteristics of the two groups. A total of 100 patients were evaluated. Fifty of these (the study group) had HF and 50 (the control group) without the disease. The presence of anxiety and depression were verified using three psychological instruments: Beck's Anxiety Inventory, Beck's Depression Inventory and the Hospital Scale of Anxiety and Depression. Patients were also submitted to a medical examination and responded to a socio demographic questionnaire. There was no significant difference between the two groups in terms of occupation, sex or number of children. The patients with HF demonstrated more anxiety and depression than the control group, as measured by all of the instruments. Further analysis revealed that the study group was older, had less leisure time and less education than the control group. The study thus revealed the importance of psychological instruments for the identification of symptoms of anxiety and depression among patients with HF. The need for psychological assistance, principally for upper working class patients was evident.

The morbidity and mortality from external causes is a significant point in the epidemiological transition in the country, due to the large number of victims, particularly young workers who develop disabilities requiring care and treatment services, which creates a personal reflection, family and social negative. Since most studies focus on the question of mortality, little is known about the evolution of non-fatal victims. Due to the scarcity of research regarding this aspect, we carried out this descriptive study. Data were collected prospectively from 285 patients victims of external causes who received primary care at the Rehabilitation Centre Municipal de Uberlândia (CEREM), MG in the period from January to July 2005. This study aimed to characterize the external causes that motivated the search for CEREM, the physiotherapy treatment and the evolution of the patients. It was used as a tool for obtaining the data used a semistructured questionnaire on two occasions: on admission to the service and upon his discharge. Addressed to aspects related to the patient, the lesion causing the event, to care, to physiotherapy treatment, the functional outcome. In cases where treatment was discontinued, close to the protocol, we attempted to telephone contact with the patient, personal contact with the professional responsible for care, and information in the records of medical records. It was found that almost all patients (280, 98.2%) were from Uberlândia, mostly male (161, 56.5%) aged between 20 and 59 years (217, 76, 2%), and unstable marital relationship (144, 50.5%). Regarding the to schooling, most people (194, 68.1%) had not completed high school, exercised occupations that required little qualification (38 general services, 13.3%, construction workers, 31, 10, 9%), presenting, therefore, of less than three minimum wages (133, 46.6%). During treatment, 185 patients (65%) had a formal job and of these, 129 (69.7%) were away from work for an average of 66 days, most had no health plan (220, 77.2 %). The accidents were responsible for most injuries (274, 96.1%) among them, falls (124, 43.5%) and traffic accidents (83, 29.1%) stood out, resulting mainly fractures (191, 62.2%) with predominant involvement of upper limbs (156, 51.6%). Nearly half the events occurred on public roads (135, 47.3%). The public network originated 98.6% of referrals (281). The median time from injury to the request for physiotherapy was 56 days, and waiting for the start of treatment after 48 days of your request. Of the 285 patients admitted students, 198 (69.5%) completed the treatment, performing an average of 17 sessions; kinesiotherapy (228, 82.3%), electrotherapy (211, 76.1%) and thermotherapy for the addition ( 200, 72.2%) were the most used therapeutic resources. In 27.7% of cases (79), treatment was interrupted for several reasons. Initially, when joining the service, the majority of respondents complained of pain (240, 84.2%) and decreased range of motion of the joint or segment involved in the lesion (244, 85.6%). However, despite this fact, most (177, 62.1%) reported independence in relation to performing their daily activities. Of those who completed treatment (198, 69.5%), the majority reported complete relief of pain (116, 58.5%), total recovery of movements (122, 61.6%) and independence in carrying out its activities daily life (191, 96.4%) after intervention. It follows that people affected by external causes that need to be rehabilitated in specialized centers are predominantly male, aged between 20 and 59 years, which have low education and income, have occupations requiring little qualification, besides not have a health insurance plan. Formal employment relationship is common among respondents and almost half of them away from work temporarily in light of the injuries, which are mainly caused by accidents occurring on public roads, resulting mostly in fractures with involvement of upper limbs. Referrals for physiotherapy comes almost exclusively from public service, and the elapsed time of occurrence of the injury to the request for physiotherapy an average of 56 days, and this the beginning of treatment 48 days. Almost 70% of treatments started are completed with an average of 17 sessions, with exercise, electrotherapy and thermotherapy by adding the resources most commonly used treatment. Overall, patients treated by physiotherapy independent completing treatment or do not show good response with respect to the control of pain, the gain range of motion and level of independence in their daily activities.

Background: The use of diuretics has been proven effective in patients with chronic renal failure by increasing the volume and urinary sodium excretion, but most studies have been performed using high doses of this drug, acutely. The objective of the present study was to verify whether chronic renal patients on HD with residual diuresis who were using small doses of furosemide present different levels of urinary volume and sodium excretion compared to patients with residual diuresis who do not use this drug. Methods: We studied 19 chronic renal patients on HD who presented any level of residual diuresis. Urine was collected during the 24-hour interdialytic period, and physical examinations and blood drawing for testing took place immediately before the start of HD. Patients were divided into two groups: DG (n=10), in which patients had been using 40 of Furosemide for at least 3 months, and NDG (n=9), in which patients used no diuretics. Results: Although both groups presented the same average glomerular filtration rate (GFR) (p > 0.05) and time in dialysis (p > 0.05,) the DG presented an average of twice the urinary volume in 24 h (1142 ± 184 vs 453 ± 135 ml/24 h, respectively; p= 0.008) and double the total excreted sodium mass (UVNa) compared to patients in the NDG (112 ± 22.4 vs 45.2 ± 16.0 mEq/24 h, respectively; p= 0.02). Conclusion: The results of this study have shown that chronic use of small doses of furosemide in chronic renal patients with residual diuresis could increase urinary volume and sodium excretion compared to patients who did not use this drug.