Repositório RCAAP

The aim of this study was to develop a Portuguese version for the \"Satisfaction with Social Participation\" item banks of the Patient-Reported Outcomes Measurement Information System (PROMIS®). This system represents the current \"state of the art\" in Health Related Quality of Life researches (HRQoL) as it allows efficient, valid and responsive measures related to diseases or chronic conditions that affects HRQoL. These item banks are grounded in Item Response Theory (IRT) and can be adapted to the unique characteristics of different clinical populations with the possibility of computerized adaptive testing (CAT) which enhances precision and concision to measures, reducing the respondent burden. The Brazilian version was obtained by iterative steps of translation and back translation, bilingual reviewers committee and pre-testing in the target population. The universal approach and harmonization between the different languages guided all the translation process which culminated in a cultural and linguistically appropriate version for applying in the Brazilian context.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Constipation is a serious public health problem that afflicts thousands of patients worldwide. It is believed that with the modern lifestyle, followed by constant stress and inadequate eating habits, the incidence of constipation will increase considerably in coming decades. Constipation is caused by abnormal functioning of the digestive tract which is not yet fully elucidated. It is known that the enteric nervous system is responsible for sensory and motor functions of the digestive tract, which makes it work in perfect sync and perform peristalsis, promoting proper transit of the bolus and subsequently fecal mass. The vast majority of pathologies afflicting the gastrointestinal tract are originated from disturb in specific neurons in the enteric nervous system and probably the same happens with constipation. Hence, the objective of this study was, by immunohistochemistry, to characterize and compare the expression of several neuropeptides of the enteric nervous system in patients with constipation and individuals not constipated. The results showed that among the various types of neurons studied, constipated patients have fewer neurons expressing calretinin and choline acetyltransferase, characteristic neuropeptides from afferent neurons and excitatory neurons engines. We believe that these results can help in future treatment techniques and prevention of constipation.

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Introduction - Osteoarthritis (OA) is a chronic disease, usually characterized by pain, which is associated with reduced muscle strength, disability and progressive loss of function how to walk, climb stairs and other tasks of the lower limbs, the knee being the most affected joint. Objective -To identify the levels of pain, the proprioceptive acuity and the pattern of muscle recruitment during stair ascent and descent in elderly patients with osteoarthritis (OA) compared to healthy subjects. Methods - The study participants included 11 healthy elderly subjects (7 women and 4 men) and 31 elderly patients with knee OA (19 women and 12 men). The functional capacity was assessed by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; the pain was evaluated by Wong-Baker faces pain rating scale (WBS) and pressure pain threshold (PPT); the proprioceptive acuity was based on the joint position sense; and the electromyographic (EMG) activity of the major muscles of the lower limb were evaluated during a task of stair ascent and descent of 15 cm. Results - Higher scores were found in the WOMAC index and WBS whereas lower scores were seen in PPT in patients with knee OA compared to healthy subjects. In contrast, there were no significant differences in the proprioceptive acuity based on position sense and EMG results of most muscles analyzed between the groups. Conclusion - We conclude that although the pain was present in subjects with OA, both subjective and objective way, it did not influence the variables analyzed, showing no differences in proprioceptive acuity and pattern of muscle recruitment during stair ascent and descent between healthy and OA subjects.

Evaluate the predictive capacity of associated index: airway occlusion pressure x respiratory rate/ tidal volume (P 0.1 x f/VT) regarding to weaning from mechanical ventilation (MV) in patients with traumatic brain injury (TBI).The associated index was measured after spontaneous breathing trials (SBT) for 30 minutes, ventilation mode with pressure support (PSV), 7 cmH2O of pressure support (PS) and positive end expiratory pressure (PEEP) of 5 cmH2O (PS above PEEP) and its accuracy and its components was evaluated using the area on the ROC curve (AUC). The f/VT index showed significance between the groups who were successful or unsuccessful weaning (p = .03), presenting moderate accuracy with AUC = 0.75 (p < .01). The P 0.1x f/VT index did not increase the accuracy of its components. There was no difference between the evaluated indexes with respect to type of artificial airway (AA) used. The evaluation of the predictive capacity demonstrated that f/VT obtained moderate accuracy and together with P 0.1 and its associated index can be used to evaluate the weaning of patients with TBI regardless of the AA, since there was no statistically significant difference between their accuracies.

This study aimed to evaluate the perception and concordance between child\' and caregiver\' reports about the oral health-related quality of life ( OHRQoL ) of children submitted to dental treatment and whose parents were submitted or not to dental treatment. Eight to ten- yrold children were submitted to preventive / curative treatment in a Basic Unit of Family Healt, and were divided into two groups : group 1 , treatment of children and caregivers; group 2 , treatment of children only. Children were clinically examined by a single trained examiner , who verified dental caries experience ( DMFT / dmft ) and the presence of malocclusions. Brazilian Portuguese version of the Child Perceptions Questionnaire ( CPQ8 - 10 ) and the Parental - Caregiver Perceptions Questionnaire ( P - CPQ ) were used to evaluate the child\' and caregiver\' perceptions of the child\' OHRQoL, respectively. The clinical examination and the self application of the questionnaires were used before and after 6 months of treatment . Data were analyzed using descriptive statistics ( chi-square) , the Shapiro - Wilk , Wilcoxon , Mann - Whitney tests and intraclass correlation coefficient ( ICC). The magnitude of the difference / concordance between child and caregiver was calculated using the effect size (ES). 48.6 % of caregivers of group 1 had 2 years of schooling and 8.6 % of group 2 ( p < 0.05 ) . There was significant increase in DMFT after treatment for group 2 ( 1.7 vs. 2.1 , p < 0.01 ) . Both groups had lower CPQ8 - 10 scores at post- treatment. At baseline, P- CPQ scores were lower than CPQ8 -10 scores , as opposed to post- treatment for both groups. In group 1 , there was concordance between children and caregivers at baseline and posttreatment, but just at posttreatment for group 2 . The effective participation of caregivers and their choice for the dental treatment option for dental treatment may be related to higher levels of education , the maintenance of oral health status of children and more positive perception about the child\' OHRQoL after dental treatment, as well as higher agreement between them.

Fibromyalgia (FM) is characterized by painful body regions, non-restorative sleep, fatigue, mood disturbances and depression. Evidence has shown that FM is closely associated with overweight and obesity development. In addition, sleep disorders which include frequent awakenings, daytime sleepiness, shorter duration and sleep efficiency are frequent and highly uncomfortable in these patients. At present, the relationship between the occurrence of overweight and obesity and the sleep pattern is poorly described in the literature. The objective of the present study was to investigate the relationship between obesity and sleep pattern in women with FM. Participated in the study a total of 100 adult female patients with a prior medical diagnosis of fibromyalgia. Body mass, height (to calculate body mass index) were assessed, besides the measurement of waist circumference. The diet quality was evaluated using a 24-hour dietary recall with subsequent determination of the Healthy Eating Index (AHEI). Subjective analyses of daytime sleepiness (Epworth Sleepiness Scale) and sleep quality (Pittsburgh Sleep Quality) were performed. The results demonstrate an obesity rate of 41% of all women studied (56.1% were sleepy and 43.9% weren t sleepy, p=0.04). Obese women showed a greater level of sleepiness when compared with non-obese (10.2 and 7.0, respectively; p=0.004), but no there were no differences in relation to sleep time (6.9 and 6.6, respectively, p=0.41) and sleep quality (12.5 and 12.6, respectively, p=0.94). Sleepy women showed a greater weight gain after the diagnosis of fibromyalgia when compared with nonsleepy women (11.7 kg and 6.4kg, respectively; p=0.04). A positive and significant correlation between BMI and sleepiness (r=0.35, p=0.02) was also found. In multivariate logistic regression, moderate or severe sleepiness (ESS >12) was associated with obesity (odds ratio=3.44, 95% confidence interval: 1.31-9.01, p=0.04). These results demonstrate an important association between sleepiness and FM, suggesting that the occurrence of obesity may be involved with sleepiness in these patients.

Nosocomial infections (NIs) are responsible for significant rates of morbidity and mortality in Neonatal Intensive Care Units (NICUs), even resulting in prolonged hospitalization and increased hospital costs. The bloodstream infections associated with catheters (CA-BSI) are frequent, often fatal and costly, particularly in the group of newborns with low weight units in developing countries like Brazil. The aim of the study was to determine the incidence of neonatal hospital BSI, as well as the etiology and antimicrobial resistance profile, analyze the characteristics of infected neonates and to investigate the pathogenesis of these infections in newborns admitted to the NICU critics of the Clinical Hospital of the Federal University of Uberlândia-MG. The prospective cohort study was conducted between January/2011 and December/2011. In the total, 264 neonates were investigated using CVC through surveillance \"National Healthcare Safety Network.\" Blood cultures were performed using an automated method (BACTEC / VITEK ®) in the microbiology laboratory of the hospital. Additionally, cultures were performed nasal mucosa, intestinal, skin at the insertion site, and barrel tip CVC. The incidence of infection of the bloodstream associated with and related to the CVC was 16.7 and 4.4 / CVC 1000 days, respectively. The incidence of BSI associated with the use of CVC was higher (32%) in neonates weighing 1001-1500g. As in BSI associated with CVC, the PICC was responsible for the higher frequency (78.5%) of CVC-related BSI, especially also for weight range of 1001 to 1500 g. The main agent of sepsis with microbiological diagnosis was Staphylococcus epidermidis (51%), followed by S. aureus (10.6%), Gram-negative bacilli (21.27%), Candida albicans (7.54%) and Candida tropicalis (2.12%). Of the 43 neonates with BSI, 24 showed some correlation with the sites: skin, cannon tip of CVC and intestine differing routes of acquisition likely to BSI in intraluminal, extraluminal, indeterminate and likely intestinal translocation. Altogether, 96 neonates were collected in sites nostril and perianal region. Of these, about 36.7% were colonized in the nostril and 56.0% in the intestine, at least one of the collections. The gram positive were more frequent in the nostril, with the main representative Streptococcus epidermis (77.3%). Perianal the gram negative bacilli predominated 48.6%, followed by 35.8% Yeasts . The use of total parenteral nutrition, use of PICC and CVC type of CVC usage time &#8805; 16 days were statistically independent risk factors for the development of BSI. A incidence rate of neonatal hospital BSI was 25.3%, being sepsis the main infectious syndrome.

Introduction: Food Allergy (FA) is defined as an adverse effect to health resulting from a specific immune response, this being exaggerated immune response to food proteins absorbed through the permeable intestinal mucosa. This immune response may be mediated by immunoglobulin E (IgE) or cell-mediated (non-IgE-mediated) or a mixture of both. Objective: Characterize the population of patients with FA treated in the Clinic of FA the Hospital of Clinics the Federal University of Uberlândia (HC/ UFU). Methods: This is a descriptive, observational and retrospective study, being held patient charts and calculating z-score anthropometric indices of patients with FA attended at HC/UFU. Results: Data Sector Statistics and Hospital Information HC/UFU recorded 389 records of patients seen at the clinic of FA in the period from February 1, 2009 to January 31, 2012. These, 35 (8.99%) records were discarded because patients had not undergone any query or medical record. Of the 354 patients who were evaluated by doctors at the clinic, 228 (64.4%) had a confirmed diagnosis of FA, whereas the diagnosis of FA was excluded in 126 (35.6%) remaining. In the research, no association was found between sex, gestational age, mode of delivery, duration of breast feeding and age at introduction of complementary protein-based milk cow with the development of FA formulas. The clinical manifestations associated with FA, which had a higher frequency were nausea, vomiting and regurgitation (49.6%), followed by cramping, abdominal pain and distension (44.3%) and urticaria and dermatitis (37.7%). Diagnosed as allergens that showed higher frequency foods were cow\'s milk (92.5%), hen´s egg (26.7%) and soy (17.9%). The distribution of z - scores for weight for age, height for age and body mass index for age of all patients with FA indicated eutrophic with adequate weight for age and height for age appropriate. Conclusion: Most outpatients had confirmed diagnosis of AA, and is associated with the further development of gastrointestinal symptoms in patients with allergic IgE mediated not. Cow\'s milk, hen\'s egg, and soy were the major food allergens found in IgE allergies measure IgE mediated and not mixed. Furthermore, the research found no association between the duration of breastfeeding with the development of AA. And patients with AA had a higher anthropometric involvement associated with the risk of malnutrition and / or short stature compared to the group without AA.

Fundação de Amparo a Pesquisa do Estado de Minas Gerais

Food allergy is an adverse health effect arising in any immune response that occurs reproducibly on an exposure to a given food. This allergy has shown significant increase in recent decades, with a prevalence estimated around 6-8% in the pediatric age group. Although the most frequent element that causes food allergy is cow milk, allergies triggered by soy, egg, fish, peanuts, wheat, corn, rice and seafood are also possible. The estimated range of self-reported food allergy prevalence is from 3% to 35%. Therefore, this study intends to know the prevalence of reported food allergy diagnosed by parents and that prevalence diagnosed health professionals, as well as major food and clinical manifestations in preschool children enrolled in municipal daycare centers from Uberlândia, Minas Gerais, Brazil. Concerning the methods, it is an epidemiological study in children from 24 to 59 months who were enrolled in municipal daycare centers from Uberlândia, with a self-administered questionnaire that was used to evaluate the prevalence of food allergy related by parents; subsequently, children with a suspecting food allergy were invited to a clinical and laboratory evaluation, in order to know the real prevalence of food allergy. According to the results, from 13,841 children enrolled, 8,031 parents responded the questionnaire. The prevalence of food allergy reported by parents was 17.6%, and the incidence of asthma, rhinitis and dermatitis was significantly higher in the group of children with reported food allergy (p = < 0.0001). The main foods mentioned were cow milk, pork, fruit, chocolate and chicken egg, and associated symptoms were red spots (54.2%), vomit (39.6%), diarrhea (32.1%), abdominal pain (31.4%), mouth and eyes edema (17.5%) and nose secretion (10.6%). The prevalence of food allergy was in 0.59% of preschool children, which 0.35% had IgE -mediated reactions and 0.24% non- IgE mediated reactions. The egg was the main food allergen, reaching 0.34% of preschool children, followed by cow milk (0.21%), wheat and pork meat (0.06%), corn, mustard, honey and fish (0.03%). The main symptoms were red spots and itching (52.6%), diarrhea (42%), eyes edema and abdominal pain (36.8%). It was concluded that the prevalence of food allergy reported by parents and confirmed food allergy prevalence are similar to those found in the literature, showing a strong association with allergic diseases (asthma, atopic dermatitis and allergic rhinitis). The main foods reported by parents confirm the eating habits from the researched area. Several studies have reported that regional and cultural influences interfere on the food allergens types. Thus, most of the foods associated with food allergy in this study such as milk, egg, wheat, corn, fish, pork meat, mustard and honey were described in the world literature. A significant number of children excluded food allergen without a medical diagnosis of food allergy.

Conselho Nacional de Desenvolvimento Científico e Tecnológico

This study aimed to investigate the psychosocial status, nutritional patterns and subjective measures of sleep among female nursing professionals between shift work. The study included 221 nursing, divided into three groups: day (n = 112), night (n = 55) and day-night (n = 54). Volunteers underwent the following evaluations: nutritional assessment (3-day 24 hours recall), anthropometric variables (weight, height, body mass index, waist circumference and hip circumference); psychological profile of anxiety (state trait anxiety inventory - STAI) and profile of humor (questionnaire BRUMS); identification of chronotype, sleep quality (Pittsburgh Sleep Quality Index - PSQI) and sleepiness (Epworth Scale - ESS). It was observed a total hours of work per week significantly higher in night and day-night groups, when compared to day group (p<0.0005). It was found a higher proportion of night workers with increased WHR (> 0.8) compared to the other two groups. Daytime sleepiness was significantly higher in the night group compared to day-night group (p=0.02). Inadequate dietary habits were observed for both groups. Protein and fat intake was significantly higher in the night group compared to the other two groups analyzed (p=0.01). Cholesterol intake was significantly lower on day-night group compared to day and night groups (p=0.04). Furthermore, a positive and significant correlation between work hours per week and state (STAI-S) and trait (STAI-T) anxiety scores was found (r=0.11 and 0.15 for STAI-S e STAI-T, respectively; p<0.05). A high prevalence of unhealthy results was observed among shift works in nursing, especially in food intake, nutritional status and sleep patterns. These observations indicate the need for monitoring and tracking of health status to minimize the negative effects attributed to this dynamic of work.

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Introduction: Tacrolimus (TCR) is an immunosuppressant drug widely used in post-transplant organ recipients. Its absorption occurs principally in the duodenum and jejunum, its peak serum concentration is reached between 0.5 and 4 hours after ingestion (average 2 hours), and its absorption may be facilitated by an alkaline medium. Omeprazole (OMP) is a proton pump inhibitor in the parietal cells of the stomach that reaches maximum concentration between 0.5 and 3.5 hours after ingestion (average 2 hours), and because it reduces gastric acidity, it is capable of releasing more alkaline content into the duodenum. Pharmacological interactions between TCR and OMP are always described primarily with respect, to the common metabolic pathway (CYP3A4 and P-gp) used by both medications which may result in elevations of the TCR plasma concentration. The objectives of this study are to identify if there is an increase or decrease in the concentration of tacrolimus when administered after omeprazole and determine the frequency of subjects who increased in two hours, the bioavailability of tacrolimus after using omeprazole. Subjects and Methods: To that end, a double blind, placebo-controlled pilot study was performed in 28 post-renal transplant subjects regularly using TCR (mean: 0.08 ± 0.05 mg/kg/day BID) and OMP (20 mg/day MID). OMP or a placebo was ingested every morning at 6 am after fasting, and TCR was ingested 2 hours later at the doses reported above. Blood samples were taken 2 hours after the ingestion of TCR over 4 consecutive days under both the OMP and placebo regimes, being the subject the control same its. Serum concentrations of TCR were obtained using the chemiluminescent microparticle in human whole blood immunoassay method (CMIA, Abbott Lab., Brazil) after the subjects fasted for 3.5 hours. Results: Of the subjects evaluated, 18 (64.3%) were male, and 10 (35.7%) were female. In total, 8 (28.6%) of subjects received living donor kidneys, and 20 (71.4%) of subjects received cadaveric donor kidneys. The mean age of the subjects was 43 ± 13 years, and the average time since transplant was 41 ± 32 months. The mean serum creatinine and urea levels were 1.6 ± 0.5 mg/dL and 59 ± 27 mg/dL, respectively, and the mean hemoglobin level was 13.7 ± 1.9 g/dL. Conclusion: We found no significant difference in the mean serum TCR concentrations measured under the placebo or OMP regime (15.8 ± 8.7 ng/mL versus 15.7 ± 6.8 ng/mL, respectively, P=0.92). Compared with the placebo period, there was an increase in the serum TCR concentration greater than 10% in 13 subjects and greater than 20% in 10 subjects, which corresponded respectively, to 46.4% and 35.7% of the studied subjects. These data infer that OMP may increase the serum TCR concentration if ingested 2 hours before TCR ingestion, likely through alkalization of the intestinal contents. These frequency rates should be used to calculate the sample sizes needed for future studies with larger numbers of subjects.

Juvenile idiopathic arthritis (JIA) is the most common chronic disease of the connective tissue in children and adolescents, being related to impaired health-related quality of life. Among the various complications related to JIA are oral diseases such as caries and periodontal disease, whose risk of development is higher due to factors such as the involvement of the temporomandibular joint, difficulty in performing oral hygiene when the joints of the upper limbs are involved, and use of oral medication containing sugar. However, the extent to which oral diseases interfere with the daily life and well-being of children and adolescents affected is unknown. The aim of this study was to assess the correlation between oral health indicators and oral health-related quality of life (OHRQoL) of children and adolescents with juvenile idiopathic arthritis (JIA) according to their caregivers perceptions. Two groups of adults filled the short form of the Brazilian Parental-Caregiver Perceptions Questionnaire (SF: 13 B-PCPQ), which assesses OHRQoL. These groups were as follows: parents or guardians [mean age, 40.6 years; standard deviation (SD) = 10.97 years] of healthy children and adolescents (n = 15; mean age, 10.7 years; SD = 2.16) and parents or guardians of children and adolescents with JIA (n = 17; mean age, 9.8 years; SD = 2.86), early-onset oligoarticular (n = 8), systemic (n = 5), or polyarticular (n = 4). Dental evaluations were performed on all children and adolescents in the study. There was no significant difference in SF: 13 B-PCPQ scores of the two groups. Children and adolescents with JIA had fewer caries in their primary dentition and more gingival bleeding after probing than those without JIA. The frequency of temporomandibular disorders was 50.0% for JIA patients and 46.7% for their healthy counterparts. There was no correlation between oral health indicators and SF: 13 B-PCPQ scores. As perceived by caregivers, JIA did not negatively impact the well-being of their children and adolescents as related to oral health, and their OHRQoL did not correlate with their oral health status.

This transversal study intends to verify the frequency of histopathological findings diagnosed in specimens of reductional mammoplasthy performed in ten years; assessing whether there is a statistical difference in this frequency among women younger or older than 35 years; and then contribute to the debate about histopathological examination of all surgical specimens as a routine. The records of patients undergoing reductional mammoplasty between 2002 and 2011 were reviewed to analyze the histopathological reports and distributed into two groups: women younger or older than 35 years. Findings were classified according to the Cancer Committee of the College of American Pathologists, estimating the relative risk of the lesion associate to breast cancer. There were 389 surgeries performed. Histopathological alterations were found in 228 (58,61 %) specimens. Nonproliferative lesions were identified in 208 (53,47 %) patients and proliferative lesions in 12 (3,08%), being the most common papilloma (1,5%). Of the atypical epithelial hyperplasia, found in 7 (1,79%) cases, there were 4 (1,02%) atypical ductal hyperplasia and 4 (1,02%) atypical lobular hyperplasia. Invasive carcinoma (PT1a) was diagnosed in 1 (0,25%) case. Frequency of the findings was higher (p < 0,05) in the older group. The histopathological examination of all specimens is questionable only in patients under 35 years old. The group above 35 years seems to be benefited by this practice due care imposed in monitoring and/or treatment of patients, as a result of the diagnostics performed by this routine. The low incidence of lesions imposes further studies, for definition with more propriety of a protocol.

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Objectives: The considerable increase in the use of epidural analgesia with catheters leads to the need to establish the security of the method. Although infections have been constant targets of discussions in epidural analgesia, studies have been limited to case reports and retrospective reviews. The aim of this study was prospective and epidemiological analysis of patients admitted to medical wards undergoing epidural analgesia postoperatively, as well as the incidence of catheter colonization and bacteria responsible for these settlements. Methods: From November 2011 to April 2012 were assessed patients electively operated and maintained under analgesia by epidural catheter hospitalized in surgical wards in Hospital of the Federal University of Uberlândia. The tip of the catheter was collected for microbiological qualitative and semi-quantitative analysis. Results: Six (8.8%) of 68 catheter tips cultured had positive cultures. No patient had superficial or deep infection. The mean duration of catheter use was 43.45 hours (18-118 hours), 51.1 hours in colonized catheters and 42.7 hours among those who showed no colonization (P=0.0894). The type of surgery (contaminated or uncontaminated), physical status of patients and duration of surgery showed no relationship with the colonization of catheters. The isolated microorganisms in catheter tips were Staphylococcus aureus, Pseudomonas aeruginosa and Sphingomonas paucimobilis. Conclusion: It is concluded that the epidural catheter for analgesia postoperative, in conditions of this study, revealed procedure with low risk of bacterial colonization in patients from surgical wards.