Repositório RCAAP

To ascertain epidemiological characteristics of hospitalizations due to external causes of children and adolescents admitted to a Pediatric Intensive Care Unit (PICU). This descriptive, observational study assessed hospitalizations due to external causes (Chapters XIX and XX of the International Disease Classification IDC-10) of children and adolescents under the age of 15 years, admitted to the PICU of the Clinicas Hospital of the Uberlândia Federal University Medical School between August 1989 and August 2003. Of the 2455 admissions, 372 (15%) were due to external causes; chiefly caused by transport accidents (49.2%), poisoning (9.1%) and falls (8.9%). The mean age was six years while most incidents occurred among the five to nine year-old bracket (39.8%) in boys (60.2%). The majority of incidents (75.6%) occurred during daytime, between 12:00 and 18:00 hours on any day of the week but with a marked predominance on Sundays. The number of incidents per month ranged from 24 (6.5%) in May, to 36 (9.7%) in January, April, November and December. The most common accident sites were in streets and on highways (47.5%), and within the home (35.4%). Victims were predominantly hospitalized for up to three days (64.5%) and with head trauma (251; 52,5%). Of the 47 (12,6%) deaths, 25 (53.2%) were due to transport accidents, and 44.1% had head trauma. The study concluded that admissions to the PICU due to external causes were predominantly school-goers, mainly caused by transport accidents, and that death was most common in pedestrians. The adopting of safe behavior and provision of safe environments, together with continuous educational programs and traffic control measures, are needed to ensure improved health and safety in children and adolescents.

Asthma and allergic rhinitis are mediated by IgE antibodies through the development of allergen-specific Th2 cells in genetically predisposed and sensitized subjects. Asthma and rinithis are frequently associated, suggesting the concept of one airway, one disease . The aims of this study were to analyze spirometrics parameters and IFN-γ and IL-5 levels in the induced sputum from patients with asthma or allergic rhinitis (AR) and non-atopic subjects. Thirty-three subjects aged 18 to 60 years, both sexs, were analyzed. From these, eight were asthmatics and 16 had allergic rhinitis (AR), and both groups had positive skin prick test (SPT) to aeroallergens. The nine remaining subjects were healthy non-atopics with negative SPT to aeroallergens. Spirometry was performed through evaluating the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and forced expiratory flux between 25 and 75% (FEF25-75%) pre and post-bronchodilators. Induced sputum samples were collected and IFN-γ and IL-5 levels were quantified by immunoassays. Significant pre- and post-bronchodilator variation was observed only for FEV1 with higher values in asthmatics compared to patients with RA and non-atopics. There was no significant difference in pre- and post-bronchodilator parameters among the three groups, although there was a tendency for pre-bronchodilator lower FEF25-75% values in asthmatic patients. IFN-γ levels in the induced sputum showed no significant difference between the groups but, IL-5 levels were higher in patients with asthma and AR compared to non-atopics. It can be concluded that Spirometric alterations were not able to predict the occurrence of broncoconstriction in patients with AR, but predominant IL-5 levels in the induced sputum of these patients reinforce the role of the Th2-type immune response in low respiratory airways that could contribute to the development of asthma in patients with AR.

The physical handicaps resultant of transportation accidents (TA) cause great locomotion, professional and financial losses to the individual and his or her family. Besides, they affect society as a whole because they bring about productivity losses in the workplace and material losses as well. Studies with the victims who survived and developed sequels are still scarce, especially in developing countries. The goal of this study was to recognize the epidemiological aspects of TA victims that led to limb amputation and characteristics related to the rehabilitation. A series of cases were studied through interviews based on a semi-structured questionnaire composed of multiple-choice and discursive questions. 43 people that went through amputation due to TA took part in the interviews and were filed as research subjects in the period ranging from December of 2002 to December of 2004, after they were discharged from treatment at the Association for the Aid of Handicapped Children of Minas Gerais, Brazil (Associação de Assistência à Criança Deficiente - AACD/MG). Most victims ranged from 20 to 39 years old (22; 51,1%), were men (36; 83,7%) and single (22, 51,1%). 25 (58%) of them had not finished elementary school, 40 (93%) had a job/occupation and, after the accident, all the subjects became inactive for an average 27,6. At the time of the interviews, amputated people ranged from 20 to 49 years old (29; 67,4%), 22 (51,1%) were single and 27 (62,8%) hadn t concluded elementary school. Out of the 35 subjects that worked for an income, 14 (40%) returned to their jobs but only six (17,1%) to the same professional activity they had before and 12 (34,3%) retired due to invalidity. Most TA (29; 67,4%) occurred in Uberlândia, 26 (60,5%) within the city limits, and motorcycles were the vehicles most involved in TA (21; 48,8%). Out of these 21 cases, 17 (81%) were motorcycle riders and, out of these, 14 (82,4%) used helmets at the moment the accident happened. Collision (31; 72%) and trampling (12; 28%) were the most common types of TA. 41 (95,3%) people had lower limb amputations and 16 (37,2%) were rescued by Fire Department personnel. 28 (65,1%) individuals went to the Uberlândia Federal University Hospital (Hospital de Clínicas de Uberlândia da Universidade Federal de Uberlândia/HCU-UFU) for initial care and the overall length of treatment decreased after AACD/MG began service. All the lower limb amputated people (41; 95,3%) received their prosthesis but found some difficulties using it, after discharge. The Unified Public Health System (Sistema Único de Saúde - SUS) afforded more than half the rehabilitations (24; 55,8%) and the majority of the prosthetic (31; 75,6%). One of the conclusions regarding the TA that lead to limb amputation is that they are more frequent among young, single men who, at the time of the accident, when riding motorcycles, often wore helmets. The Fire Department usually rescues these victims who are, then, taken to the HCU-UFU. The presence of a AACD unit seems to favour an specialized and early treatment of the amputations that are often located in the lower limbs region. The pacients ended their rehabilitation with the prosthetic adaptation but some difficulties with the prosthesis remain after they are discharged from treatment. SUS affords approximately half the rehabilitations and most of the prosthetic. Few amputated people return to the same professional activities they had before and many retire due to invalidity. The implementation of public policies that reduce the cases of TA is indispensable, specially those that are more serious and involve a motorcycle because these are the ones that lead the most to amputation, incapability and invalidity, when not death.

Allergic rhinitis (AR) is clinically defined by ARIA (Allergic Rhinitis and its Impact on Asthma) as a symptomatic disorder of the nose, induced after allergen exposure by an IgE mediated inflammation of the nasal membranes.The symptoms of allergic rhinitis include rhinorrhoea, nasal obstruction, nasal itching and sneezing. AR represents a global health problem and its prevalence has increased in the last years. Therapy for allergic rhinitis aims to control symptoms and improve the quality of life. Nowadays the treatment of allergic rhinitis includes allergen avoidance, environmental control, pharmacologic treatment and specific immunotherapy. The aim of this study is to evaluate the clinical efficacy and changes in IFN-y and IL-5 levels in nasal lavage fluid from children with allergic rhinitis after different groups of treatment (mometasone, montelukaste or desloratadine). This is a prospective randomized open study. Twenty-three children were selected aged from six to twelve years, with moderate persistent allergic rhinitis which were randomly distributed in three groups of treatment during four weeks- (I) nasal corticosteroid (mometasone); (II) anti-leukotriene (montelukaste); and (III) antihistamine (desloratadine). Patients were submitted to the following steps- full-filling a clinical questionnaire and a diary symptoms for determination of the total symptom score (TSS), skin prick tested, sampling nasal lavage fluid before and after treatment for measuring IFN-y e IL-5 cytokines by immunoassay (ELISA), blood sampling for red and white cell counting and measurement of total serum IgE. A reduction in IL-5 levels was observed in the treated groups with mometasone and montelukaste, although a significant reduction (p = 0.0469) has been observed only in the group treated with mometasone. In contrast, there was a significant augment in IL-5 levels (p = 0.0469) in the group treated with desloratadine. A tendency of increasing in the levels of IFN-y was observed, especially in the treated groups with desloratadine and mometasone, although with no statistical significance. A tendency of symptoms improving was verified by decreasing the TSS in all therapeutic groups, although this improvement was not significant. However, there was a clear clinical efficacy by parents perception means only in the group treated with mometasone (p< 0,05). It can be concluded that the group treated with mometasone showed improvement of clinical symptoms as well as reduction in IL-5 levels in the nasal lavage fluido of children with allergic rhinitis.

Obesity is the most common chronic disease in developed countries and is associated to the most severe and morbid clinical situations, including respiratory disturbances that can be aggravated by surgical techniques, increasing the hospitalar permanence. The gastric reduction has been considered, after 45 years of study, the only efficient and lasting method in body weight reduction. To identify and quantify the impact of surgical method in pulmonary function considering the laparotomy and videolaparoscopy approaches, 37 patients were submitted to the gastroplasty by technique; 17 of them (8 woman and 9 man) by laparotomy (age and BMI means of 32±9,8 years and 47±7,2Kg/m2, respectively) and 20 (13 woman and 7 man) by videolaparoscopy (age and BMI means of 35±9,6 years and 44±5,9 Kg/m2, respectively). All of them were submitted to espirometry, blood gas transcutaneous (oximetry) and respiratory frequency monitoring before and after surgery (until the 30th hour) and were also evaluated by a modified pain visual analogic scale at the espirometry. In pre-operatory, all patients presented normal pulmonary function tests. We observed a significant mean reduction of 38.53% in Forced Vital Capacity (FVC), 39.11% in Forced Expiratory Volume in 1 second (FEV1) and 37% in Expiratory Peak Flow (PFE) in laparotomy group (LG). In the videolaparoscopy group (VG) there was a mean reduction of 38.37% in FVC, 35.53% in FEV1 and 41.57% in PFE. The respiratory frequency had a mean increase of 16.98 and 14.79% in LG and VG respectively, both with statistic significance. The mean reduction in oximetry was not statistically significant in both groups. The mean operating time was 179 minutes in LG and 163 minutes in VG. Pain scores were 3.58 in LG and 3.40 in VG. Based on these results, we concluded that the patients with degree 2 and morbid obesity presented normal espirometry values in pre-operatory and, after being submitted to gastroplasty by the surgical technique (laparotomy or videolaparoscopy), they developed an espirometric compatible with pulmonary restriction in early post-operatory.

Blomia tropicalis (Bt), Dermatophagoides pteronyssinus (Dp) and D. farinae (Df) are the prevalent house dust mites (HDMs). Concanavalin A-binding components derived from B. tropicalis (Bt-ConA extract) have shown to be highly immunogenic in allergic diseases. This study aimed to evaluate the humoral and cellular immune responses to B. tropicalis in sensitized patients. A total of 246 subjects aged 18 and 60 years were selected for this study. Among them, 137 (54 male and 83 female) had allergic rhinitis with or without asthma and 109 (37 male and 72 female) were non-atopic subjects. All subjects were tested for skin reactivity (SPT), total serum IgE and specific IgE levels to both Bt-total and Bt-ConA extracts, proliferative response and cytokine (IFN-&#947; and IL-5) production by peripheral blood mononuclear cells (PBMC) stimulated with both extracts. SPT showed that 70% of patients were sensitized to Bt (Bt+) and no patient was monosensitized to Bt. Similar levels of specific IgE to Bt-total and Bt-ConA extracts were found in Bt+ patients, while higher levels of total serum IgE were found in atopic than non-atopic subjects. Significant PBMC proliferation was observed in response to Bt-total extract in Bt-sensitized, but not in Bt-non-sensitized patients and non-atopic subjects. Bt-ConA extract induced increased proliferative responses in all patient groups, but these responses were decreased in the presence of ConA inhibitor (methyl-&#945;-D-mannopyranoside). Significant IFN-&#947; production was observed only after Bt-ConA stimulation in Bt+ patients, while Bt-total extract showed no changes. IL-5 production was consistently seen in Bt+ patients after allergen-specific stimulation or even with no stimulus, indicating that PBMC from allergic patients are prone to produce spontaneously or allergen-restimulation induced Th2-type cytokines. It can be concluded that the Bt-total extract contains relevant allergens that are involved in both humoral and cellular immune responses, while the Bt-ConA extract containing glycosilated components associated with ConA residues might be an important inducer of Th1 immune response and therefore, to present a potential use in immunotherapeutic procedures.

The current study has researched the effects of hidrogymnastic on systemic blood pressure, on metabolic variables as well as on the body structure of healthy women who are overweighted or obese. There have been twenty one volunteers for this study split into two groups: experimental group (n=10, 41,9 + 3,5 years), the ones who joined the hidrogymnastic program and control group (n=11, 43,2 + 3,4 years). All of them had previously sedentary life, were clinically healthy, underwent physical test, had blood test and blood biochemic, all of the above have been considered normal. The following have been excluded: alcoholism, tobaccoism, post menopause, unbalanced menstrual period and the use of medications potentially able to change the variable studied. The hidrogymnastic program lasted thirteen weeks with fifty minutes class, with moderate intensity and repeated three times a week. The groups have been compared to each other before and after the training period, they have compared regarding the systemic blood pressure, plasmatic levels of lipids, fibrinogen, nitrite and cortisol, corporal weight and body mass index. As statistics data the test t for Student, U for Mann-Whitney or Wilcoxon were used considering significant value of p=0,05. At the end of the hidrogymnastic period there was as well decreasing of the systolic pressure in the experimental group. Similar result was noted in the mean blood pressure also found when comparing both group. The diastolic pressure was more elevated at the end of the study in the control group and decreased in the experimental group when comparing both groups. It was also noted significant increasing on the plasmatic levels of fibrinogen in the experimental group. These results show that regular physical aerobic exercise, such as, hidrogymnastic, has an important role on the systemic blood pressure control. The changes found on the fibrinogen deserves special attention and investigation on this special group of individuals.

Previous investigations have suggested an association between autoimmune thyroid disease (AITD), an organ-specific autoimmune disease, and rheumatoid arthritis (RA), a systemic autoimmune disorder. However, this association is controversial because of the great variability of the AITD prevalence in RA patients, the small number of studies and the varying opinions of researchers. The aim of this study is to determine whether there is relationship between AITD and RA and evaluate the correlation of thyroid disease with rheumatoid factor, antinuclear antibodies, and RA activity disease. This case-control study included 189 patients who were consecutively seen in the Rheumatology Clinics of HC-UFU/MG: 72 with RA (ARA criteria, 1987) and 117 with non-autoimmune rheumatic diseases. Blood samples were collected from all subjects for TSH, FT4, anti-TPO and anti-Tg measurement; RA patients were also tested for rheumatoid factor and antinuclear antibodies and the Disease Activity Score using 28 joints count was assessed to measure the disease activity. Thyroid dysfunction was found in 11 (14.86%) and thyroid autoantibodies in 15 (20.83%) RA patients, compared to 18 (15.20%) and 13 (11.11%) of the control group, respectively. There was no correlation between thyroid disease with rheumatoid factor, antinuclear antibodies, disease modifying drugs use, corticosteroids use or RA activity disease. In conclusion, no association could be demonstrated between thyroid disease and RA; this suggests that, at least in some populations, this association does not occur, or it is not strong enough from the epidemiologic point of view to justify the routine thyroid antibodies and thyrotropin tests in all RA patients.

Objective: To verify the frequency of alcoholic ingestion in victims of external causes at the Hospital of Clinics from Uberlândia. Methods: Blood alcohol content was determined in 85 patients of emergency room (ER). A total of 301 in-patients were interviewed on alcoholic ingestion prior to incidents. All ER and in-patients were submitted to the CAGE questionnaire. Also, 50 alcoholic patients and 50 no alcoholics attended at ambulatory level were interviewed on trauma antecedents. Results: Blood alcohol content was positive in 31.8% ER patients (85.2% were men and 70.4% required internment; p<0.05) and it was more frequent (p<0.05) in physical aggression (57.2%) than fall (15.4%) victims, but not compared to traffic victims (29.3%). Among in-patients, 29.9% had positive history of alcoholic ingestion and physical aggressions (68.9%) were more frequent (p<0.01) than traffic accidents (27.4%) or falls (15.2%). Among ER patients with positive blood alcohol content and drinker in-patients, the occurrence of incidents was higher (p<0.05) in the weekend (62.9% and 57,8%, respectively) and the night period (59.2% and 63.4%, respectively), with positive CAGE in 81.5% ER patients and 82.3% in-patients. At ambulatory level, 93.1% alcoholic patients reported trauma antecedents related to alcoholic ingestion compared to 9.1% no alcoholics (p<0.01). Conclusions: A third of patient s ingested alcoholic drinks prior to incidents, and among them, the most were chronic alcoholics. Incidents were more frequent in the weekends and the night period, with lesions more severe. Among the ambulatory patients, the alcoholics were the most frequently injured.

Helicobacter pylori is a risk factor for chronic gastritis, gastroduodenal ulcer and gastric cancer. The association between this infection and colon neoplasia has been the reason for recent investigations which have produced controversial results. The objective of this study was to evaluate the prevalence of H. pylori infection in patients with colonic adenomas and also in patients whose colonoscopy exams were normal. After colonoscopy, the individuals were distributed into two groups: patients with colon adenomas (cases) and patients whose colons were normal (controls). The groups were similar regarding age and gender. The individuals of both groups were subjected to a dosage of IgG antibody against H. pylori. The dosage was applied according to the solid phase, chemiluminescent immunometric assay. The chi-square test was used to analyze the data. There were 30 men and 64 women in each group (94 cases and 94 controls). The mean age of the cases was 59.79 ± 12.25 years and that of the controls was 58.98 ± 11.55 years. The H. pylori serology was positive for 66 (70.21%) of the cases and for 51 (54.25%) of the controls. There was a significant difference (p=0.024). The odds ratio was 1.98 (CI 95%, 0.82 3.15). The prevalence of H. pylori in cases and controls according to gender, histological type and location of the colon lesions showed a significant difference only among women (p=0.030), among patients with tubular adenomas (p=0.030), and in those with distal adenomas (p=0.038). In until sixty-years old patients and in older it was observed a bigger H. pylori seroprevalence compared to control group, but with no significant difference (p=0.068 e p=0.161, respectively). It was concluded that there is a positive association between H. pylori infection and colonic adenomas. This association is more evident in women, especially for tubular adenomas and distal colonic location.

Type 1 Diabetes Mellitus results in the destruction of pancreatic &#946; cells, mediated by a cellular auto-immune process, leading to an insulin production deficiency. Frequently it is also associated to other auto-immune diseases such as Hashimoto's Thyroiditis, Celiac Disease, Pernicious Anemia, Adrenalits and Ooforits. Autoimmune Thyroid Disease (AITD) is most frequently found in patients who have diabetes. Prevalence varies between 3 to 50% and is higher in family members of diabetic patients then in the general population. The objective of the present study was to investigate the prevalence of autoimmune thyroid disease in patients with type 1 diabetes mellitus in the city of Uberlândia and to evaluate possible differences of clinical action and evolution of diabetes mellitus among diabetic patients who also did not have AITD. This worked aimed, as well, to study the prevalence of autoimmune thyroid disease and thyroid disfunction in first degree relatives of patients with type 1diabetes mellitus, moreover evaluating if differences exist in the prevalence in relatives who have diabetics with AITD to those relatives who have diabetics without AITD. One hundred and twenty four diabetic patients who supplied samples for clinical and laboratorial data such as age, anthropometric data, time of evolution of the illness, presence of acute and chronic complications, glycosilated hemoglobin, daily insulin dose, levels of TSH anti-thyroid antibodies were evaluated to verify action and evolution of diabetes among those with or without associated thyroid disease. Thyroid function and presence of auto-antibodies to thyroid were also evaluated in 54 first degree relatives of these diabetic patients, divided into a group of relatives of diabetics who presented AITD and a control group of relatives of diabetics without thyroid disease. Prevalence of AITD and hormonal dysfunction among the diabetic patients 35.5% and 19.3% respectively. As for the evaluation of the diabetic evolution and its clinical action, no differences in groups with and without AITD were found. However prevalence of AITD and hormonal dysfunction (63.6% and 27.3%, respectively) was found to be higher in the group of family members of diabetics with AITD than in the group of the family members of diabetics without AITD (21.9% and 9,4%), respectively. Prevalence of autoimmune thyroid disease in diabetics and their relatives, in Uberlândia, is high. Screening of the thyroid function is therefore justified in these cases, especially in those first degree relatives of diabetics with autoimmune thyroid disease.

This was an epidemic study about observations of rape in Uberlândia, from data extracted from the crime lawsuits of Abelardo Pena Court from 1960 to 2005. Out of the 240 cases, the major number of victims were 10 to 19 years old (198; 82,8%), single (84; 35%), white (137; 60,4%), low educated (204; 94,4%) and maids (105; 86%). The aggressors were between 20 and 29 years old (103; 43,8%), single (129; 55,1%), bricklayers (54; 24,5%) and low educated (160; 77,2%). The majority of the aggressors were the victims boyfriends (36,5%) and most of the rapes happened at the victims house (80; 33,8%). The most common injuries were in the himen (127; 81,4%) and the anatomical area most injured were the genitals (131; 85,6%).This kind of violence represents a big challenge to society, demanding integrated actions between Justice, Educational , Social and Health programs working together with society. Notifications must be done, because, otherwise, subsides won t be given by the government to create mechanisms to fight rape.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

The aim of this study is to undertake a theoretical analysis of the literary and sociological Cave, Jose Saramago, having as main theme the precariousness of work and control, followed by some key developments. Anchored in the sociology of work and endorsed by the sociology of literature methodologically by Antonio Candido, and guided by the narrative Saramago in the cave, seeking to understand the work activity as central and essential to the production and reproduction of material life. It discusses the precariousness of work, as well as the historical forms of ownership and control of labor activity. Scales the impact of large corporations that control and the conflict between mechanized and manual labor in the process, questioning the nefarious effects of the restructuring of the productive working class, especially on small businesses and craft work. It also addresses the rise of a category gestorial in the process of labor control throughout history Finally, invoking the metaphor of Plato\'s cave in this work Saramago, explores how labor control by large corporations causes the estrangement in all dimensions of life, establishing relationships between fetishism, consumer relations and sociability.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior