RESUMO
Introduction: Due to the prevalence of the model of interdisciplinary attention in mental health it is necessary to establish common views about therapeutic practices of the different disciplines that intervene in mental attention. Our objective was to determine if there are differences in opinions and positions with respect to psychiatric practice topics between undergraduate students of the last years of medicine and psychology. Methods: An ad hoc survey with different statements about psychiatric hospitalization, electroconvulsive therapy and psychotropics was done. One hundred eighteen medical students and 122 psychology students answered the online survey on February 2022. Results: One third of the opinions were statistically different between the students. Medical students had positions a little more positive towards electroconvulsive therapy and psychiatric hospitalization than psychology students. The prejudice towards psychiatric practices is important in both groups. Discussion and conclusionss: There are no important differences on the opinions of medical and psychology students. The prejudice and stigma towards mental health should be addressed since the first years of both carreers.
Introducción: Dada la prevalencia del modelo de atención interdisciplinaria en salud mental es necesario establecer miradas comunes en relación a prácticas terapéuticas de las distintas disciplinas que intervienen en la atención mental. Nuestro objetivo fue determinar si hay diferencias de opiniones y posturas en cuanto a temas de práctica psiquiátrica entre alumnos de Medicina y Psicología de años superiores. Métodos: Se realizó una encuesta ad hoc con distintas afirmaciones sobre la internación psiquiátrica, la terapia electroconvulsiva y los psicofármacos. Ciento dieciocho estudiantes de Medicina y 122 estudiantes de Psicología contestaron esta encuesta en forma online en febrero del año 2022. Resultados: Un tercio de las opiniones fueron significativamente distintas entre los alumnos. Los alumnos de Medicina tuvieron posturas un poco más positivas en relación a la terapia electroconvulsiva y a la internación psiquiátrica que los alumnos de Psicología. El prejuicio en relación a prácticas psiquiátricas es importante en ambos grupos. Discusión y conclusiones: No existen diferencias importantes entre las opiniones de los alumnos de Medicina y Psicología. El estigma y prejuicio sobre la salud mental debe ser abordado desde los primeros años de ambas carreras.
Assuntos
Transtornos Mentais , Psiquiatria , Estudantes de Medicina , Humanos , Psiquiatria/educação , Estudantes de Medicina/psicologia , Atitude do Pessoal de Saúde , Inquéritos e Questionários , Transtornos Mentais/psicologiaRESUMO
The aim of present study was to describe the frequency of lipodystrophy syndrome associated with HIV (LSHIV) and factors associated with dyslipidemia in Brazilian HIV infected children. HIV infected children on antiretroviral treatment were evaluated (nutritional assessment, physical examination, and laboratory tests) in this cross-sectional study. Univariate analysis was performed using Mann-Whitney test or Fisher's exact test followed by logistic regression analysis. Presence of dyslipidemia (fasting cholesterol >200 mg/dl or triglycerides >130 mg/dl) was the dependent variable. 90 children were enrolled. The mean age was 10.6 years (3-16 years), and 52 (58%) were female. LSHIV was detected in 46 children (51%). Factors independently associated with dyslipidemia were: low intake of vegetables/fruits (OR = 3.47, 95%CI = 1.04-11.55), current use of lopinavir/ritonavir (OR = 2.91, 95%CI = 1.11-7.67). In conclusion, LSHIV was frequently observed; inadequate dietary intake of sugars and fats, as well as current use of lopinavir/ritonavir was associated with dyslipidemia.
Assuntos
Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Fármacos Anti-HIV/efeitos adversos , Dislipidemias/epidemiologia , Síndrome de Lipodistrofia Associada ao HIV/epidemiologia , Terapia Antirretroviral de Alta Atividade , Brasil/epidemiologia , Estudos Transversais , Dislipidemias/induzido quimicamente , Dislipidemias/diagnóstico , Síndrome de Lipodistrofia Associada ao HIV/induzido quimicamente , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Prevalência , Análise de Regressão , Fatores de RiscoRESUMO
The aim of present study was to describe the frequency of lipodystrophy syndrome associated with HIV (LSHIV) and factors associated with dyslipidemia in Brazilian HIV infected children. HIV infected children on antiretroviral treatment were evaluated (nutritional assessment, physical examination, and laboratory tests) in this cross-sectional study. Univariate analysis was performed using Mann-Whitney test or Fisher's exact test followed by logistic regression analysis. Presence of dyslipidemia (fasting cholesterol >200mg/dl or triglycerides >130mg/dl) was the dependent variable. 90 children were enrolled. The mean age was 10.6 years (3-16 years), and 52 (58%) were female. LSHIV was detected in 46 children (51%). Factors independently associated with dyslipidemia were: low intake of vegetables/fruits (OR=3.47, 95%CI=1.04-11.55), current use of lopinavir/ritonavir (OR=2.91, 95%CI=1.11-7.67). In conclusion, LSHIV was frequently observed; inadequate dietary intake of sugars and fats, as well as current use of lopinavir/ritonavir was associated with dyslipidemia.
Assuntos
Fármacos Anti-HIV/efeitos adversos , Dislipidemias/epidemiologia , Síndrome de Lipodistrofia Associada ao HIV/epidemiologia , Adolescente , Terapia Antirretroviral de Alta Atividade , Brasil/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Dislipidemias/induzido quimicamente , Dislipidemias/diagnóstico , Feminino , Síndrome de Lipodistrofia Associada ao HIV/induzido quimicamente , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Humanos , Masculino , Prevalência , Análise de Regressão , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate the correlation between perception of dyspnea during a mild to moderate asthma attack using the Modified Borg Scale (MBS) and peak expiratory flow rate (PEFR). METHODS: This was a cross-sectional study conducted with children and adolescents who sought a pediatric emergency service due to an asthma attack. Data were collected from July 2005 to June 2006. Demographic data were recorded. Patients and those in charge of them were requested to grade, individually, the patient's dyspnea using the MBS; afterwards, the peak expiratory flow rate was measured. RESULTS: 181 asthmatic patients were evaluated, with a mean age of 7.2 (± 2.4) years (range, 4-12). The mother sought medical aid in 83.4% of the cases (151/181). Patient symptoms included coughing in 68.5% (124/181), dyspnea in 47.0% (85/181), and wheezing in 12.7% (23/181). Thirty-six percent (65/181) had a mild attack, and 64.1% (116/181) a moderate one. A significant negative correlation was found between the patients' and accompanying adults' perceptions of patient's dyspnea and the PEFR (% predicted; rs = -0.240 and rs = -0.385, respectively). CONCLUSION: Both the patients and those looking after them had a poor perception of the severity of the patient's dyspnea. This emphasizes the need to monitor objective measures such as the PEFR and to develop better ways of evaluating dyspnea.
Assuntos
Asma/fisiopatologia , Dispneia/fisiopatologia , Mães/psicologia , Pacientes/psicologia , Pico do Fluxo Expiratório/fisiologia , Percepção/fisiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Índice de Gravidade de DoençaRESUMO
OBJETIVO: Avaliar a correlação entre a percepção da dispneia durante uma crise de asma leve a moderada, por meio da escala modificada de Borg, com a medida do pico de fluxo expiratório (PFE). MÉTODOS: Estudo transversal de crianças e adolescentes que procuraram a emergência pediátrica devido a crise asmática, com dados coletados de julho de 2005 a junho de 2006. Foram registrados dados demográficos. Pacientes e seus responsáveis foram solicitados a graduar, individualmente, a dispneia do paciente por meio da escala modificada de Borg e, posteriormente, foi avaliada a medida do PFE. RESULTADOS: Foram avaliados 181 pacientes asmáticos, com idade média de 7,2 (±2,4) anos (4-12). A mãe procurou atendimento médico em 83,4% (151/181). Os sintomas incluíram tosse, em 68,5% (124/181), dispneia, em 47,0% (85/181), e sibilância, em 12,7% (23/181). Trinta e seis por cento (65/181) apresentavam crise leve, e 64,1% (116/181), moderada. Correlação negativa significativa foi evidenciada entre a percepção dos responsáveis e dos pacientes com dispneia e a medida do PFE dos pacientes (percentual previsto; r s = -0,240 e r s = -0,385, respectivamente). CONCLUSÃO: Pacientes e responsáveis demonstraram percepção limitada da gravidade da dispneia do paciente, evidenciando a necessidade de monitorar medidas objetivas, como a medida do PFE e o desenvolvimento de melhores meios de avaliação da dispneia.
OBJECTIVE: To evaluate the correlation between perception of dyspnea during a mild to moderate asthma attack using the Modified Borg Scale (MBS) and peak expiratory flow rate (PEFR). METHODS: This was a cross-sectional study conducted with children and adolescents who sought a pediatric emergency service due to an asthma attack. Data were collected from July 2005 to June 2006. Demographic data were recorded. Patients and those in charge of them were requested to grade, individually, the patient's dyspnea using the MBS; afterwards, the peak expiratory flow rate was measured. RESULTS: 181 asthmatic patients were evaluated, with a mean age of 7.2 (± 2.4) years (range, 4-12). The mother sought medical aid in 83.4% of the cases (151/181). Patient symptoms included coughing in 68.5% (124/181), dyspnea in 47.0% (85/181), and wheezing in 12.7% (23/181). Thirty-six percent (65/181) had a mild attack, and 64.1% (116/181) a moderate one. A significant negative correlation was found between the patients' and accompanying adults' perceptions of patient's dyspnea and the PEFR (% predicted; r s = -0.240 and r s = -0.385, respectively). CONCLUSION: Both the patients and those looking after them had a poor perception of the severity of the patient's dyspnea. This emphasizes the need to monitor objective measures such as the PEFR and to develop better ways of evaluating dyspnea.
Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Masculino , Asma/fisiopatologia , Dispneia/fisiopatologia , Mães/psicologia , Pacientes/psicologia , Pico do Fluxo Expiratório/fisiologia , Percepção/fisiologia , Estudos Transversais , Índice de Gravidade de DoençaRESUMO
There are only scarce data on HIV progression in vertically infected children in developing countries. The aim of this study is to describe factors from neonatal period associated with long term non-progression (LTNP), in a Brazilian cohort. A cohort study, with data systematically collected from the "Peixe" Cohort (cohort study of children conducted at the main HIV Pediatric Center in Rio de Janeiro, from 1996 to 2005). The study included children who were vertically infected and started follow up at 5 years of age or younger. LTNP, defined as not reaching category C or severe immunosuppression before 5 years of age. Neonatal and demographic factors were studied. Variables with p-value<0.15 were included in a logistic regression model. 213 patients were included, of whom 42 percent (89/213) were classified as LTNP. Variables independently associated with LTNP were: baseline (at study entry) CD4+ cells (per percent) (OR= 1.06, 95 percentCI=1.01-1.12); age of initiating follow-up, per month (OR= 1.03, 95 percentCI=1.01-1.06); ZDV use duriing newborn period (OR= 3.31, 95 percentCI=0.86-12.71); use of antiretroviral (ART) before classification C or severe immunosuppression (OR= 5.89, 95 percentCI=2.03-17.10). Adjusting for age at the beginning of follow-up, antiretroviral that was unsuccessfully used to prevent maternal-to-child transmission (ZDV use in neonatal period) was associated with better prognosis. ARTs initiation before category C or severe immunosuppression was also associated with LTNP.
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/transmissão , Sobreviventes de Longo Prazo ao HIV/estatística & dados numéricos , Transmissão Vertical de Doenças Infecciosas , Brasil , Estudos de Coortes , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Estudos Prospectivos , Carga ViralRESUMO
There are only scarce data on HIV progression in vertically infected children in developing countries. The aim of this study is to describe factors from neonatal period associated with long term non-progression (LTNP), in a Brazilian cohort. A cohort study, with data systematically collected from the 'Peixe' Cohort (cohort study of children conducted at the main HIV Pediatric Center in Rio de Janeiro, from 1996 to 2005). The study included children who were vertically infected and started follow up at 5 years of age or younger. LTNP, defined as not reaching category C or severe immunosuppression before 5 years of age. Neonatal and demographic factors were studied. Variables with p-value<0.15 were included in a logistic regression model. 213 patients were included, of whom 42% (89/213) were classified as LTNP. Variables independently associated with LTNP were: baseline (at study entry) CD4+ cells (per %) (OR= 1.06, 95%CI=1.01-1.12); age of initiating follow-up, per month (OR= 1.03, 95%CI=1.01-1.06); ZDV use duriing newborn period (OR= 3.31, 95%CI=0.86-12.71); use of antiretroviral (ART) before classification C or severe immunosuppression (OR= 5.89, 95%CI=2.03-17.10). Adjusting for age at the beginning of follow-up, antiretroviral that was unsuccessfully used to prevent maternal-to-child transmission (ZDV use in neonatal period) was associated with better prognosis. ARTs initiation before category C or severe immunosuppression was also associated with LTNP.