RESUMO
The study covers a group of 100 asymptomatic blood donors (14 women and 86 men) with positive serological test for Chagas' disease. All of them were living in urban non endemic areas at the moment of the test, but before they had lived in endemic areas. Patients with coronary heart disease, congenital heart disease, hypertension, diabetes, alcoholism or thyroid disease were not included. The sample was split in two groups: Group I: 23 patients (aged 41.95 +/- 10.52) with evidence of myocardial involvement at physical examination, chest roentgenograms and/or EKG, that we considered inherent to Chagas cardiopathy; and Group II: 77 patients (aged 38.36 +/- 10.57) without abnormal findings. There were no significant differences between the two groups in age, sex, type of house in the endemic area and familial history of Chagas' disease. We found significant differences in the period of residence in endemic areas of Chagas' disease (Group I 21.26 years +/- 7.21 vs Group II: 15.56 years +/- 5.91; p = 0.0015). Additionally, patients in Group I were more frequently able to describe or recognize the transmitting insect than patients in group II (p = 0.05) and to accept the possibility of a triatomide bite (p = 0.024). In group I, more people were coming from Santiago del Estero province, an area with a large bug infection. The results of our research suggest that the myocar-dial damage in patients with positive serological test for Chagas' disease is more likely when there is a larger exposure to the transmitting insect, and when its infestation is larger. All of this, probably, as a consequence of incoulation reiterations.
Assuntos
Doadores de Sangue , Doença de Chagas/epidemiologia , Adulto , Fatores Etários , Cardiomiopatia Chagásica/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores de TempoRESUMO
Foram investigados os sintomas e antecedentes respiratórios, bem como os resultados das provas espirográficas, de 72 dos 86 (83,7 por cento) funcionários de uma pedreira de porte médio do Rio de Janeiro. Setenta e um (98,6 por cento) eram homens, e a média das idades foi de 36,2 + ou - 9,3 anos (20 a 65 anos). Quarenta e dois (58,3 por cento) tinham ocupaçöes consideradas muito expostas ao pó de pedra e 30 (44,7 por cento) pouco expostas. Quarenta (55,6 por cento) eram fumantes, 20 (27,8 por cento) näo fumantes e 12 (16,7 por cento) ex-fumantes. Foi utilizado um questionário padronizado baseado em modelos internacionais e adaptados a condiçöes brasileiras. Houve elevada freqüência de sintomas, com exceçäo da dispnéia: 47 (65,3 por cento) referiram um ou mais sintomas, dos quais 31,9 por cento referiram tosse, 41,7 por cento expectoraçäo, 9,7 por cento dispnéia e 33,3 por cento chiado torácico. Os sintomas se associaram principalmente à presença de antecedentes de doenças respiratórias, havendo também associaçäo com o tabagismo. Um ou outro desses fatores explicaram os sintomas. Näo houve associaçäo com a maior exposiçäo ao pó de pedra, qua näo explicou os sintomas. As provas espirográficas foram realizadas com o espirógrafo de campânula de 6 litros, observando-se discreta reduçäo das médias da capacidade vital forçada (CVF) (89,9 + ou - 11,2 por cento do teórico), do volume de expiraçäo forçada do 1§ segundo (VEF1) (90,1 + ou - 12,9 por cento) e do fluxo expiratório forçado entre 25 por cento e 75 por cento da CVF (FEF 25-75) (92,9 + ou - 32,7 por cento) em relaçäo às médias esperadas numa amostra populacional näo selecionada. Contudo, as proporçöes de valores subnormais foram comparáveis às de amostras näo selecionadas da literatura nacional e internacional. Näo houve influência estatisticamente significativa da maior exposiçäo ao pó de pedra, antecedentes respiratórios e tabagismo sobre as médias dos resultados espirográficos. Concluímos que, neste grupo de funcionários de uma pedreira, näo se demonstrou associaçäo entre a maior exposiçäo ao pó de pedra e os sintomas respiratórios, ou influência dessa exposiçäo sobre as médias dos resultados espirográficos. Com relaçäo aos antecedentes respiratórios e tabagismo, houve associaçäo com os sintomas mas näo influência sobre as médias dos resultados espirográficos.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tosse/diagnóstico , Poeira , Dispneia/diagnóstico , Exposição Ocupacional , Sons Respiratórios/diagnóstico , Fatores de Tempo , Nicotiana , Brasil , Fatores Sexuais , Fatores Etários , Inquéritos e Questionários , Testes de Função RespiratóriaRESUMO
Respiratory symptoms and past history of chest disease as well as spirometric tests were investigated in 72 of 86 (83.7%) employees of a middle sized quarry in Rio de Janeiro, Brazil. Seventy one were men (98.6%), and the mean age was 36.2 +/- 9.3 years (20-65). Forty two (58.3%) had occupations considered as highly exposed to dust, and 30 (44.7%) were considered as lightly exposed. Forty (55.6%) were smokers, 20 (27.8%) never had been smokers and 12 (16.7%) were former smokers. Symptoms and past history were investigated with a questionnaire based on international models, and adapted for the Brazilian public. A high prevalence of symptoms (except for dyspnea) was noted: 47 (65.3%) had one or more symptoms-there was cough in 31.9%, expectoration in 41.7% dyspnea in 9.7% and wheezing in 33.3%. The symptoms were found to be associated mostly with a past history of chest disease, and also with smoking, factors which explained, in part, the presence of the symptoms. No association with a higher exposure to dust was found. The exposure to dust did not explain the symptoms. The spirometric tests were performed on a 6 liter bell spirometer. The means of the parameters were lower than one would expect in a non selected population sample--89.9 +/- 11.2% of predicted for the Forced Vital Capacity (FVC), 90.1 +/- 12.9% for the Forced Expiratory Volume in 1 second (FEV1) and 92.9 +/- 32.7% for the Forced Expiratory Flow between 25% and 75% of the FVC (FEF25-75). However, the proportions of abnormal results were comparable to the reported ones from unselected samples. There was no statistically significant influence of higher dust exposure, past history or smoking on the means of the results. It is concluded that, in this sample of quarry employees, no association between respiratory symptoms or spirometric results and dust exposure could be demonstrated. There was an association between the symptoms, but not with the spirometric results, and a past history of chest disease, as well as with smoking.