Repositório RCAAP

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

The search for measures which contribute to the reduction in morbid-mortality caused by traffic accidents has to pass through the identification of their causes. With the objective of understanding the epidemic factors of traffic accidents with victims assisted by the rescue units from the Military Firemen Department of the Fifth Battalion in Uberlândia, Minas Gerais, Brazil, a study has been made addressing the factors relating to the human being, means of transport, transport routs and assistance rendered, during the period from November 2003 to October 2004. It was, then, that one of the researchers accompanying in a prospective manner one of the rescue units during its pre-hospital care. In the studied period were analysed 296 traffic accidents with 397 victims, among the results obtained it is noteworthy that 284 (71,5%) are victims with ages varying between 15 and 39 years, it have been participation equal in the male 284 (71,5%); 267 (67,2%) were drivers of some means of transport or other; 141 (39,8%) of the victims drivers should have been using obligatory evaluated safety equipment, but were not; 28 (68,3%) of the pedestrians adopted risky conduct when crossing the road in forbidden places; 149 (50,3%) of the traffic accidents were collisions; ¼ (26,3%) involved in running down pedestrians left the scene; 82 (27,7%) of the traffic accidents occur close to the victim's home; 133 (44,9%) of the traffic accidents occur between 14:00 and 20:00 and 133 (35,1%) of the traffic accidents occur at the weekends; 247 (62,2%) of the victims were directed to secondary complexity emergency hospitals. It can be conclude that the victims are young persons adults in the 15 to 39 age group and in their majority driving motorized vehicles. When driving, more than a third do not use safety equipment and the pedestrians usually adopted conduct risky to life crossing or walking in forbidden places on the road. Collisions were the most common accidents. More than a fourth of the drivers involved in the traffic accidents leave the scene of the accident when a pedestrian is run over. A fourth of the traffic accidents occur close to the victim's home. The traffic accidents intensify during the time at the end of the afternoon and beginning of evening and at weekends. the victims are generally directed to medical center of secondary complexity.

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Objective: Perform the characterization of clinical and demographic profile of children less than five years old with infection caused by the respiratory syncytial virus (RSV) attended at the Hospital de Clínicas de Uberlândia and also the type of treatment and the clinical management. Methods: Four hundred and thirty six nasopharyngeal aspirate samples were collected from April 2000 to March 2007 of children less than five years old who presented acute respiratory infection (ARI). The RSV was diagnosed by the immunofluorescence assay (IFA). The information from the chart of patients with RSV positive cases had been collected for the identification of the clinical management. Results: Of the 436 samples collected 119 (27,3%) were positive for RSV by IFA. RSV circulation was predominant from March to May. The male gender corresponded to 58.8% of the patients. The median of age found was two months, being that the children less of one year old (78.1%) had the greater rate of infection. Seventy five patients had been hospitalized in a period among one and 63 days and the average of this period was 12.1 days. Fifty four children had base illness (congenital heart disease, lung disease and prematurity) and 46 required hospitalization. The clinical diagnoses were bronchiolitis (52.9%), upper respiratory tract infection (27.7%), pneumonia (11.8%) e bronchitis (7.6%). There was a significant association between the diagnoses of bronchiolitis and the age less of one year, and that group of children had the highest number of hospitalizations. In relation to clinical management of children hospitalized with bronchiolitis: 21,4% of the patients required mechanical ventilation, 94,6% needed the use of supplemental oxygen, 48,2% used antibiotics, 50,0% used corticosteroids, 83,9% used bronchodilators e 60,7% used antipyretic. There was one death. Conclusions: The RSV is responsible for respiratory illness in children less than one year old. For the patients with bronchiolitis, the values of hospitalization and submission to the mechanical ventilation had been higher to the ones found in literature. Bronchodilators, corticosteroids and antibiotics were given for children with viral ARI, however, it does not have consensus on effectiveness of these treatments.

The Chagas Disease, primarily found in rural populations into poverty and without knowledge, has reached the cities peripheries due to the increasing migration to urban areas. An endemic disease of high social-economic cost, where the most of the patients, who do not show symptoms, carries the disease chronic phase, working in heavy works and developing the chagasic cardiopathy, main cause of the work incapacity or death. An evaluation in the criteria of the insured people retirement has been made within the period from 01/01/1994 to 03/31/1999, listed by the National System of Information of the Social Security, comparing electro-cardiogram data and functional class by the time of the retirement with the current ones, analyzing the disease progression and possible predictable factors of the worst diagnosis. The criteria of benefits of the INSS are: increased cardiomegaly; cardiac congestive insufficiency; significative electro-cardiogram changes, such as serious non-rhythmical ones; His bundle left wing blockade; right wing blockade associated with fore-superior divisional blockade of the left wing; atrial fibrilation and significative undernourishment, due to the digestive ways of the disease. From the 167 analyzed insured people, 126 (75,45%) were male. From the 54 ones (28%), already dead, the males were predominant 47 (87,03%), from which 51 death certificates were found, 39 (76,47%) by Chagas Disease, 12 for other causes and 3 were not found. The average age by the time of the benefits requirements was 52,05 (± 8,52) years old, they were at the time of evaluation with an average time of benefit of 6,9 (± 2,8) years, average age of 60,30 (± 8,37) years old. The deaths occurred in an average of 4,16 (± 2,52) years after the beginning of the benefit, with an average age of 56,41 (± 9,54) years old. Within the professions and occupations, drivers, general services and arm workers were predominant. Analyzing the electro-cardiograms changes, the intra-ventricular blockades 99 (68,75%) were found, with predominancy of the complete right wing blockade associated with fore-superior divisional blockade of the left wing 48 (33,33%), extra-systoles 85 (59,02%), having a predominancy of the ventricular ones 69 (47,91%). Comparing the electro-cardiograms of the retirement at the insured people deaths with those who were alive, were found higher numbers of vetricular extra-systoles and ventricular re-polarization changes, statisticaly significant. In 93 insured people cases, the functional class and the electro-cardiogram were re-evaluated, analyzing the disease progression. Within these examined patients, there is not any of them who are capable, some are evolving well after quitting the physical efforts. The complete right wing blockade associated with fore-superior x divisional blockade of the left wing, has not demonstrated to be of a higher seriousness, in the absence of the symptoms, they must be treated as the isolated blockades. Therefore, being incapable for great efforts and that do not cause risks to themselves or others, must not being treated as disability, as it is treated currently. These are factors of higher seriousness: male gender and severe changes such as the ventricular extra-systoles, ventricular re-polarization changes, moderate cardiomegaly and severe cardiac insufficiency, functional classes III and IV.

Introduction: Considering the potential risks and damage arising from the indiscriminate use of antimicrobial agents, one measure of fundamental importance in order to restrain the progressive resistance to these drugs is the rational use of them by health care professionals . Guidelines based on wellconducted studies have not been sufficient to make professionals put them in practice, so it is necessary to find strategies to make it possible to occur in a more complete way. Aim: Get acquainted with the conduct of dentists of Uberlândia, Minas Gerais, concerning the use of antimicrobial prophylaxis in the third molar surgery and, particularly, their adherence to the guidelines set down by the Regional Odontology Association (ABO-Uberlândia). Material and method: the study was carried out in two stages with assessment by means of interviews interposed by guidelines being sent to the dentists (intervention). From a list provided by the Regional Council of Odontology cotaining 880 registered general dental practioners and 29 specialists in Oral and Maxillofacial Surgery, 450 general dental practioners were inicially selected at random, and 220 of them confirmed, via telephone, being engaged in the performance of exodontia of third molar. Out of these, 100 were selected at random to be interviewed and, subsequently, be sent the guidelines, and another 100 to just be sent the guidelines. After the correspondence was sent by ABO, for second stage of the assessment, 50 general dental practioners were selected at random out of those who had already been interviewed, and 50 others out of those to whom only the guidelines had been sent. All of the specialists in Oral and Maxillofacial Surgery were included in the study, and they were interviewed during the two stages of assessment. A statistical analysis was carried out to assess the conducts of each group of dentists before and after the intervention. Results: considering the general dental practioners and specialists as a whole, it was found that, prior to intervention, of 111 dentists interviewed, 84 (75.7%) recommended antimicrobial prophylaxis as a routine on these surgical procedures, 40 (36.0%) performed it for more than two hours before surgery, and 86 (77.5%) recommended its continuity for a period exceeding 24 hours in the postoperative care. After the intervention, of 101 dentists interviewed, the frequencies of these conducts were respectively 57 (56.4%) (p<0.05), 29 (28.7%) (p>0.05), and 61 (60.4%) (p<0.05). Those who declared they had read the guideline sent (55; 54.5%) showed greater frequency of proper conduct (p<0.05). No significant difference could be demonstrated between the group of dentists that were visited twice and that one visited only after the intervention. Conclusion: dentists in Uberlândia are used to using antimicrobial prophylaxis as a routine in the exodontias of third molar and for a time longer than that one recommended. The forwarding of guidelines by a dentistry association can be effective in rendering proper the conduct of surgeon dentists.

Background The prevention of needlestick injury in health-care personnel (HCP) have been considered as a public health issue. Objective To know the risk factors for needlestick injury with HCP in a Brazilian hospital. Methods This study was conducted in a tertiary care public university hospital in Uberlândia, southeast of Brazil. The data was collected by anamnesis, State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI). Results Seventy cases of needlestick injury with 69 HCPs were registered. The mean age was 38.5 years-old. For the control-case study, 13 were excluded. There was difference between anxiety in the cases and in the control-case (p=0.00011), with moderate anxiety more prevalent in the cases (p = 0.000061; odds ratio = 6.25). There were more HPCs with normal depression among the control group (79.6%) than in the cases group (46.3%) (p = 0.00083; odds ratio = 4.53) Conclusions These accidents occur mainly with female and with assistant nurse; the hands, mainly the fingers, are more affected; most occur with needles; in the departments that attend patients; the risk factors are: pain related to the job and, mainly, anxiety and depression.

The allergen exposure is considered crucial for the development of allergies. The aim of this study was to measure mite (Der p 1 and Der f 1), dog (Can f 1) and cat (Fel d 1) allergens, in school transport vehicles. It was analized 163 seat dust samples from 60 vehicles, using ELISA tests. The Can f 1 allergen was the most frequent (geometric mean = 1.03 µg/g of dust). Only two (3.3%) vehicles showed levels of Der p 1 and two (3.3%) levels of Der f 1 at sensitizing levels, while 36 (60%) and 16 (26.7%) showed sensitizing levels of dog and cat allergens, respectively. Regarding to the vehicles from pet owners, in 20/32 (62.5%) vehicles from owners with dog at home, levels > 1 µg de Can f 1/g of dust were detected; however, there was no difference in Can f 1 levels in vehicles from owners that kept or not a dog at home, and whose owners that carried or not the animal inside the vehicle. On the other hand, in 15/28 (53.6%) vehicles from non-dog and 14/57 (24.5%) from non-cat owners, levels > 1 µg/g of dust were found. The dust cover used in seats interfered in the levels of mite and dog allergens, where allergen levels were lower in covered seats than uncovered seats. There was no statistical significant difference related to the age of the vehicles, the number of passengers carried in the car, and the vehicles were used part-time or not. We concluded that the school transport vehicles are reservoirs, especially of pet allergens, constituting vehicles for dispersion of these allergens for continuous contamination of the indoor environment.

Diabetes mellitus is considered a major public health issue, since it is highly prevalent and its incidence has been progressively increasing the last years. The chronic complications of the diabetes are important cause of mortality and morbidity, complications that may include the amputation of the lower limbs. The current study has as an objective to verify the diabetes mellitus as a cause of non-traumatic amputation of the lower limbs, observing if the triggering factor of these amputations could be avoided, besides identifying the risk factors, observing the participation in diabetes education groups and compare the results with early research performed in the same institution. The 124 patients who had their lower limbs amputated by non-traumatic causes in the Hospital de Clínicas da Universidade Federal de Uberlândia were interviewed, prospectively, over 1 year. Of those patients, 53% were diabetic. The avarage sex and age didn t show difference between diabetic and nondiabetic (p=0.122 and p=0.604). In diabetic patients, 72.7% of the amputations were triggered by avoidable causes, there was a predominance of minor amputation (73.1%), most of the patients were type 2 diabetics (86.4%), with more than 10 years of diabetes diagnosis (59.1%) and were insulin-treated (60.6%) and most of them had never attended to an educational group for diabetes (57.6%), although 69.7% related having previously been given orientations on self-care of the feet. More than 80% of the diabetic were dosing capillary glycemia in health institutions and more than half were doing the exam monthly or even more sporadically .Obesity and overweight (p=0.001) were significantly more frequent on the diabetic rather than the non-diabetic patients. The diabetic also had the urea and creatinine levels higher than the non-diabetic patients. The majority of the amputated patients, despite of knowing it s importance and benefits, did not have physical activities as their habit. In nondiabetic patients, prevailed major amputation (58.2%) and there was higher association with smoking (p<0.001). The amputations etiology were predominantly mixed (infectious and ischemic). Diabetes mellitus is the main cause of non-traumatic amputation in our region, and most of the factors that trigger these amputations were of preventable causes.

The aim of this experiment is to study, histologically, the testicular vascularization, after apposition of an intestinal pedicle flap to the testicle of Wistar rats, as well as the consequences of procedure for the gonads. It was used 53 Wistar male rats with age varying between 12 and 16 months, and weighing between 290g and 440g were selected into a laboratory rats population, apparently healthy and divided into 4 groups, GI, GII, GIII and GIV. The rats, with a 12h fast for solid food were submitted to anesthesia using Cetamine hydrochloride (40 mg /Kg) and a 2% Xylazine hydrochloride solution (1mL /Kg). The animals were weighed 30 minutes before procedures and 30 minutes before euthanasia. The surgical procedures were randomly made in rats of GI, GII and GIII, but the rats of GIV were only reserved, in the same conditions, as a control group. After procedures, the animals were treated with the same food, offered after anesthetic recovery, ad libitum and placed in an environmental with the same characteristics. Seven rats were excluded. GI: submitted to celiotomy, mobilization, by traction, of the right testicle (RT) to the abdomen, cecal flap suture to the RT and cavity closure. GII: celiotomy, mobilization of the RT to the abdomen, fixation of RT into abdomen (peritoneum) and cavity closure. GIII: celiotomy, mobilization of the RT to the abdomen, RT exposition to air (3 minutes), reposition into scrotum and cavity closure. GIV: not operated on (control group). Euthanasia was done 20 days after and the testicles were submitted to histological analysis. A Morfometric analysis (histometry) was done and lesions score classification was applied. Testicular vascularization was studied with comparison between GI and GIII. The weight s averages were compared among the groups. A p < .05 was considered. The GI RT diameters were not different to GII RT and all have decreased size in comparison with RT of GIII and GIV. The lesions score s average was 5.83 in the RT of GI and 3.3 in GII, without statistical difference. The vascularization s average in the RT of GI was 16.9 vessels in 400X augmentation field. In the GIII the average was 0.96 to the RT and 0.92 to left testicles. The weight s average in GI was similar with GII but different of GIII and GIV. There was significant vascularization in the testicles with intestinal flaps. Testicle lesions were observed, but the intestinal flap wasn t a proved cause. The anesthesia, the surgical trauma response the manipulation of the testicles and the weigh variations didn t cause lesions or diameters decrease in the testicles.

In hospitals, usually occur unnecessarily prolonged the use of intravenous (IV) route during treatment with antibiotics. This tends to raise the cost of hospitalizations for both hospitals and for the patients, determining greater length of hospital stay and risk of nosocomial infection, like bloodstream infection. Whereas up here, antimicrobial therapy sequential (ATS) as the exchange of antimicrobial from IV route to oral (PO) during treatment, this practice has been recommended for the purpose of reducing this time of use of antimicrobial IV avoiding possible complications related to the venous access, which could lead to an early discharge of the patient. The objective of this study was to find the effectiveness of intervention in order to implement the ATS at an university hospital in Brazil, with consequent reduction of the time of use IV route. This was a prospective study , the type before and after, and was conducted at the Hospital de Clínicas da Universidade Federal de Uberlândia, Minas Gerais, Brazil, an university hospital of high complexity. We evaluated 117 patients in the pre-intervention (from Apr 04, 2005 to Jul 20, 2005) and 117 in the intervention (Sep 24, 2007 to Dec 20, 2007), among hospitalized in surgical wards, medical clinic wards and intensive care unit for adults. Among the pre-intervention (PPI) and intervention (IP) were prepared guidelines that were implemented in the intervening period along with other strategies like educational measures and reminder system fixed in the patient's prescription. Among the evaluated patients in the PPI and PI respectively, 72 (61.54%) and 75 (64.10%) were male and 45 (38.46%) and 42 (35.90%) were female, and the average age were 53.38 and 51.98 years old. In each period, the antibiotics were used by IV route, in each course of treatment, on average, by 14.79 and 11.75 days, respectively, and the ceftriaxone was the antibiotic most prescribed (23.44% e 21.67%, respectively). Severity of the case was one of the main justifications for the prescription of the IV route in the first period. In the PPI and PI, the length of hospitalization from the first antibiotic prescription was, on average, 21.81 and 17.45 days, respectively, considering artificially the maximum time as 60 days; the exchange of antimicrobial from IV route to PO only occurred on 4 and 5 courses of treatment, respectively. In the PPI and PI, respectively, 15 (12.82%) and 22 (18.80%) patients died and 6 (5.13%) and 5 (4.27%) remained hospitalized for more than 60 days. We conclude that sequential antimicrobial therapy is rarely used and the proposed intervention is ineffective in order to implement it.

Advances in medical knowledge and constant technological innovations which have provided tools for the practice of medicine have relevant repercussions in the ethical and social fields. These give significance and pertinence to a permanent multidisciplinary look at the intrinsic relationship between medical science and the humanities Indeed, medicine and health are a human concern in the fullest sense. Bodies, minds, emotions and human relations are explored and expressed both by arts and humanities and by science. Medical students share people s significant, sometimes dramatic moments: births, deaths, physical handicaps, suffering and life-threatening diseases. The approach to arts and humanities may make it possible to obtain truly critical, human and ethical answers to these difficulties, since they deal with reflexive questions about the memory and interpretation of human experience. The humanities explore the ambiguity, uncertainty and complexity of human life carefully, with theoretical lucidity. Since they deal with issues involving human subjectivity in a critical and logical form, they offer the elements for reasoning by means of synthesis and analysis, which are needed for the practice of medicine. From the perspective of education, medical humanities may also help in the development of the capacity for critical conceptualization and analysis of professional or personal values, besides promoting reflection on the interpersonal relations of empathy, and team work. In this sense, arts and human sciences may have something to contribute to the conceptual repositioning of medicine itself. The study of humanities may not be able to make physicians more human, but it can create greater understanding and knowledge about the human experience. Teaching ethics, and particularly moral judgment, is necessary and essential to educate medical students, since caring for the health of individuals and populations presupposes actions and decisions that must be permanently evaluated rationally, with regard to their real, effective repercussions. The art of film can stimulate a critical evaluation and the real understanding of the patients narratives and unique needs. The purpose of this study is to show that the structured analysis of a commercial film can be an instructive activity which facilitates achieving the educational aims involving the teaching of bioethics, and in particular, the moral problems concerning euthanasia. By means of a macro and microanalytic interpretation of the commercial film, Mar Adentro (The Sea Inside, 2004), examples were identified of teaching-learning situations and opportunities. A few summary descriptions were made of a few scenes, and in them the different ways the characters saw the scene were highlighted. The criterion used to choose the scenes was based on their capacity to reveal contents and situations that could stimulate reflection about the moral/bioethical dilemmas of the right to life. Having the students watch a complete commercial film, followed by the discussion of scenes can be used as a significant pedagogical instrument to attain the humanistic educational aims of the Medical courses.

The objective of this work was to evaluate the toxicity and the trypanocidal activity of Brosimum gaudichaudii Trécul (Moraceae) crude extract, also knowed as mamacadela , in pre-treatment and treatment of mice infected by Trypanosoma cruzi. For the pretreatment, the animals received 100 mg/kg of B. gaudichaudii crude extract starting in three different moments: 7days (GBg7), 3 days (GBg3) and 1 day (GBg1) before infection. For the treatment, animals were given, after infection, different quantities of B. gaudichaudii crude extract: G100 (100 mg/kg), G200 (200 mg/kg) and G400 (400 mg/kg). In both cases there was a control group composed by animals submitted to the same stress conditions, but treated with water only. The toxicity assays carried out were DL50 test (in vivo) and the Artemia salina bioassay (in vitro). On both toxicity assays, the crude extract do not demonstrated statistically significant results for toxicity. On the experimental treatment, a positive result occurred on group G100 (100 mg/kg) where the reduction on parasitemia was about 30%. On the pre-treatment, the results showed that in experimental conditions, the B. gaudichaudii crude extract delayed the parasitemia and reduced its intensity on GBg1 (reduction of 50%), GBg3 (reduction of 12%) and GBg7 (reduction of 73%) groups. Based on these results, it is possible to conclude that the B. gaudichaudii crude extract do not present acute toxic activity and contain components capable to interfere on T. cruzi infection in mice pre-treated and treated with it.

Statins depress cholesterologenesis, enhancing the levels of acetyl-CoA, which according the mass action law could exacerbate ketogenesis and inhibit pyruvate dehydrogenase, with a decrease of glucolysis. The aim of this work was to investigate the effects of the statins use on the blood levels of glucose and ketone bodies in normoglycemic patients. The study population consisted of 9 patients who received prescription for statin use (40 mg/day of simvastatin or 10 mg/day of atorvastatin). The blood levels of &#946;-hydroxy-butyrate, total cholesterol, LDL-cholesterol, HDL-cholesterol, VLDL-cholesterol, triglycerides and glucose were determined on the day preceding the beginning and at the 15, 30, 45 and 60 days of treatment. There was no disturbance of ketonemia during treatment. The levels of total cholesterol and LDL-cholesterol dropped at the 15th day, but subsequently have remained unchanged. The levels of HDLcholesterol were increased modestly but significantly at the 60th day of treatment. The levels of VLDL-cholesterol and triglycerides declined significantly at the 30th day, but subsequently remained unchanged. The blood glucose increased at the 15th day, but declined again at the 60th day of treatment. The use of statins for a period of 60 days not upset the ketonemia but caused transient elevation in the blood glucose levels.

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.

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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.