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BACKGROUND: The Brief Measure of Emotional Preoperative Stress (B-MEPS) was developed to evaluate the preoperative individual vulnerability to emotional stress. To obtain a refined version of B-MEPS suitable for an app approach, this study aimed: (i) to identify items with more discriminant properties; (ii) to classify the level of preoperative emotional stress based on cut-off points; (iii) to assess concurrent validity through correlation with the Central Sensitization Inventory (CSI) score; (iv) to confirm whether the refined version of B-MEPS is an adequate predictive measure for identification of patients prone to intense postoperative pain. METHODS: We include 1016 patients who had undergone surgical procedures in a teaching hospital. The generalized partial credit model of item response theory and latent class model were employed, respectively, to reduce the number of items and to create cut-off points. We applied the CSI and assessed pain by Visual Analog Scale (0-10) and by the amount of postoperative morphine consumption. RESULTS: The refined B-MEPS shows satisfactory reliability (Cronbach's alpha 0.79). Preoperative emotional stress, according to the cut-off points, is classified into categories: low, intermediate or high stress. The refined B-MEPS exhibited a linear association with the CSI scores (r2 = 0.53, p < 0.01). Patients with higher levels of emotional stress displayed a positive association with moderate to severe pain and greater morphine consumption. CONCLUSION: The refined version of B-MEPS, along with an interface of easy applicability, assess emotional vulnerability at the bedside before surgery. This app may support studies focused on intervening with perioperative stress levels.

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OBJECTIVE: To assess whether heart rate variability (HRV) at rest and during sympathetic stimulation is disturbed in patients with different polycystic ovary syndrome (PCOS) phenotypes in comparison to healthy controls. DESIGN: Cross-sectional study. SETTING: University hospital. PATIENT(S): Thirty women with classic, anovulatory PCOS, 16 women with ovulatory PCOS, and 23 age-paired women with regular and proven ovulatory cycles. INTERVENTION(S): Anthropometric and hormonal evaluation and analysis of HRV (time and frequency domain HRV indices) at rest and after a mental stress test. MAIN OUTCOME MEASURE(S): Difference between HRV components during rest and stress. RESULT(S): Mean age was 22.80 ± 5.80 years in patients with classic PCOS, 19.81 ± 6.43 years in ovulatory PCOS, and 22.65 ± 5.89 years in controls. During mental stress, patients with classic PCOS showed lower HRV response when compared with the control group, even after adjustment for body mass index (BMI) and age. When patients with classic and ovulatory PCOS were considered together, total T levels were inversely associated with the low frequency component, low frequency/high frequency ratio, and the difference between high frequency response at rest and after the stress test. CONCLUSION(S): Young patients with the classic PCOS phenotype have an impaired autonomic modulation in response to sympathetic stimulation that is typical of considerably older women, or of advanced age.

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Introdução: um dos passos importantes no processo de avaliação dos serviços de saúde, propostos por Donabedian, é a avaliação das características sócio-demográficas e de saúde da população atendida, utilizando estas informações no planejamento. Objetivo: determinar a prevalência dos fatores e comportamentos de risco cardiovascular numa área adscrita do Programa de Saúde da Família da UBS HCPA/Santa Cecília e avaliar a qualidade do cuidado preventivo a esses pacientes, sua afiliação ao serviço de saúde e a percepção das pessoas em relação a sua saúde. Materiais e Métodos: foi planejado um estudo de prevalência, no qual selecionamos em entrevistas domiciliares os homens ? 45, mulheres ? 55 anos e os indivíduos com pelo menos um dos seguintes fatores de risco independente da idade: Hipertensão Arterial Sistêmica (HAS), Diabete Melitus (DM), Cardiopatia Isquêmica (CI), Doença Cerebrovascular (DCV). Os indivíduos selecionados responderam a um questionário sobre fatores de risco que incluía variáveis sócio-demográficas, antropométricas, afiliação ao serviço de saúde e presença de fatores de risco tais como: tabagismo, sedentarismo, consumo de álcool, HAS, DM, Hipercolesterolemia, obesidade, obesidade central e doença cardiovascular. Os dados preliminares são apresentados de forma descritiva utilizando média e desvio padrão ou mediana e quartil conforme a distribuição gauseana ou não-gauseana, respectivamente. Resultados: foram identificados 1126 domicílios na área. Destes, 94 foram visitados e encontrados 82 indivíduos com fatores de risco cardiovascular. Esta amostra foi composta por 49 (59,7%) mulheres e a idade média foi de 62 ±11.8 e com média de 8,7 anos de estudo. A análise dos fatores de risco nesta amostra populacional mostrou a presença de fatores de risco nos seguintes percentuais: HAS 64,6 %, DM 22%, 42,6% obesos, 32,9% com sobrepeso, tabagismo 10,2%, sedentarismo 46,1%, dislipidemia 41,5%, história de acidente vascular cerebral 7,3%, história de infarto agudo do miocárdio 7,3% e CI 13,4%. Não foram encontradas diferenças entre homens e mulheres quanto à presença de fatores de risco. Conclusões: os dados preliminares sugerem uma grande prevalência de fatores de risco na população estudada, principalmente no que se refere à HAS, à DM, à obesidade e ao sedentarismo. Intervenções na comunidade visando o controle destes fatores de risco devem ser implementadas.

Introduction: One of the important steps in the process of evaluating health services, as proposed by Donabedian, is the evaluation of the socio-demographic and health characteristics of the population attended, using these information in the planning. Objective: To determine the prevalence of factors and behavior of cardiovascular risk in and enrolled area of the family health program of UBS HCPA/Santa Cecília and to evaluate the quality of preventive care for these patients, their affiliation to health service and the perception of people regarding their health. Materials and Methods: A study of prevalence was planned, in which we selected, during domicile visits, the men ≥ 45, women ≥ 55 years old and the individuals with at least one of the following risk factors, regardless of age: systemic arterial hypertension (SAH), diabetes mellitus (DM), ischemic heart disease (IHD), and cerebrovascular disease (CD). The individuals selected answered a questionnaire about risk factors that included social demographic and anthropometric variables, affiliation to health service and the presence of risk factors such as: smoking, sedentary behavior, alcohol consumption, SAH, DM, hypercholesterolemia, obesity, central obesity and cardiovascular sickness. The preliminary data are presented in a descriptive form using average and standard deviation or median and quartile according to Gaussian and non-gaussian distribution, respectively. Results: 1126 homes were identified in the area. From these, 94 were visited and 82 individuals were found with cardiovascular risk factors. This sample was composed by 49 (59.7%) women and the average age was of 62 ±11.8 and with average of 8.7 years of study. The analysis of the risk factors in this population sample showed the presence of risk factors in the following percentages: SAH ­ 64.4%, DM ­ 22%, 42.6% ­ obese, 32.9% ­ overweight, smoking ­ 10.2%, sedentary behavior ­ 46.1%, dyslipidemia ­ 41.5%, history of cerebrovascular accident ­ 7.3%, history of acute myocardial infarction ­ 7.3% and IHD 13.4%. No difference was found between men and women regarding the presence of risk factors. Conclusions: The preliminary data suggest a great prevalence of risk factors in the studied population, especially regarding to SHA, to DM, to obesity and to sedentary behavior. Interventions in the community seeking the control of these risk factors must be implemented.

Introducción: Uno de los pasos importantes en el proceso de evaluación de los servicios de salud. Propuestos por Donabedian, es la evaluación de las características socio demográficas y de salud de la población atendida, utilizando estas informaciones en planeamiento. Objetivo: Determinar la prevalencia de los factores y comportamiento de riesgo cardiovascular en un área adscrita del Programa de Salud Familiar de la UBS HCPA/Santa Cecília y evaluar la calidad del cuidado preventivo a eses pacientes, su filiación al servicio de salud y a la percepción de las personas en relación a su salud. Materiales y Métodos: Un estudio fue planeado de prevalencia, en cual seleccionamos en cuestionarios domiciliares los hombres en media 45 años, mujeres a los 55 e los individuos con al menos un de estos factores de riesgo, Independiente de la edad: Hipertensión Arterial Sistémica (HAS) , Diabetes Melitus(DM) , Cardiopatía Isquémica (CI), Enfermedad Cerebrosvascular (DCV). Los individuos seleccionados respondieron a un cuestionario sobre factores de riesgo que incluía variables socio demográficas, antropométricas, filiación al servicio de salud y presencia de factores de riesgos como: fumo, sedentarismo, consumo de alcohol, HAS, DM, Hipercolesterolemia, obesidad central y enfermedades cardiovasculares .Los datos preliminares son presentados de forma descriptiva utilizando media y desvío padrón o mediana y cuartil conforme la distribución gauseana o no gauseana, respectivamente. Resultados: Fueron identificados 1126 domicilios en área. Entre estos, 94 fueron visitados y encontrados 82 individuos con factores de riesgo cardiovascular. En esta amuestra ha sido compuesta por 49 ( 59,7%) mujeres y la edad media fue de 62 por 11.8 y con media de 8,7 años de estudio. El análisis de factores de riesgo en esta amuestra de populación ha mostrado la presencia de factores de riesgo en los siguientes percentuales: HAS 64,6%, DM 22%, 42,6% obesos, 32,9% con sobrepeso, tabagismo10,2% sedentarismo 46,1%, dislipidemia 41,5%, historia de accidente vascular cerebral7,3%, historia de infarto agudo do miocárdio7,3% y CI 13,4%. No ha sido encontrado distinciones entre mujeres y hombres en cuanto hay la presencia de factores de riesgo. Conclusiones: Los datos preliminares sugieren una grande prevalencia de factores de riesgo en la población estudiada, principalmente en cuanto a la HAS, a la DM, a la obesidad y al sedentarismo. Intervenciones en la comunidad visando el control de estos factores de riesgos deben ser implementadas.

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