Repositório RCAAP

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

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

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

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

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

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

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

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

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

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

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

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

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

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

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.