RESUMO
OBJECTIVE: The aim of this survey was to assess the correlation between leptin and insulin sensitivity (IS) in cases of diffuse toxic goiter. DESIGN, PATIENTS, MEASUREMENTS: This is a descriptive study on patients with diffuse toxic goiter (DTG) assessing their body mass index (BMI), serum leptin concentrations, circulating insulin (area under the curve (AuC) of insulin), average insulin level, thyroid hormones, thyroid stimulating hormone (TSH), glycemia and IS (using a hyperinsulinemic-euglycemic clamp and the homeostasis model for assessment of insulin resistance (HOMA-IR) before and after euthyroidism induced with metimazol. RESULTS: The average patient age was 35 years old (range 31-40 years), height was 157 cm (range 151-160 cm), glycemia was 4.3 +/- 0.3 mmol/L and TSH 0.1 +/- 0.1 microU/mL. Average leptin level was 11.3 +/- 2.8 ng/dL, the average insulin level was 10.13 +/- 3.7 mIU/mL and the AuC for insulin was 50.6 +/- 18 microIU x min/mL. No correlation was found between leptin and BMI, thyroid hormones and glycemia. While controlling for the BMI effect, a correlation was found between leptin and TSH (r = -0.77, p = 0.042), as well as between leptin and insulinemia (r = 0.93, r2 = 0.86, p = 0.001) independently from the state of thyroid function. There was a tendency for a high correlation between leptin and the insulin AuC (hyperthyroidism: r = 0.89, p = 0.056; euthyroidism: r = 0.99, p = 0.056). A negative correlation was found between IS and the insulin AuC (rho = -0.58, p = 0.18). There was a high tendency for correlation between leptin and IS when the BMI effect (HOMA-IR: r = 0.70, p = 0.12; PHE: r = -0.55, p = 0.26) was taken into consideration. CONCLUSIONS: There is a high tendency for a negative correlation between leptin and IS when the BMI effect is controlled. There is a high tendency for a positive correlation between leptin and insulin and TSH.
Assuntos
Bócio/sangue , Resistência à Insulina , Leptina/sangue , Adulto , Glicemia/metabolismo , Composição Corporal , Índice de Massa Corporal , Humanos , Insulina/sangue , Hormônios Tireóideos/sangue , Tireotropina/sangueRESUMO
OBJECTIVE: To compare epidemiological characteristics and proportion of participation in a cervical cancer screening program in both, health-care professionals and insured on a health institute's women (Group A and Group B respectively). MATERIAL AND METHODS: Through questionnaires applied to both healthcare professionals and insured on a health institute's women (n = 96 for each group) randomly selected, a cross-sectional study was performed. To analyze the results, Yates' correction for continuity, was used. RESULTS: The characteristics from A and B groups were respectively: age 35 +/- 10 vs. 41 +/- 5 years (p < 0.001), years of scholarship: 8.3 +/- 5 vs. 12.0 +/- 1 (p < 0.001), frequency of screening test in the last two years: 1.2 +/- 0.4 vs. 1.0 +/- 0.1 (p < 0.001), time elapsed from the last test: 13.6 +/- 15 vs. 12.2 +/- 13 months (p = 0.52), attendance to screening test 55 (57%) vs. 72 (75%), (p < 0.001). Reasons for not attendance to screening test were indolence 13 (14%) vs. 13 (14%) and not enough time 7 (7%) vs. 2 (2%) by both groups, A and B, respectively. CONCLUSIONS: The proportion of attendance to cervical cancer screening is higher in health-care professionals than in insured on a health institute's women. The causes for not attendance to screening are the same in both groups.
Assuntos
Pessoal de Saúde , Neoplasias do Colo do Útero/diagnóstico , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-IdadeRESUMO
The increase in frequency of cesareans that has been noted through 70's, not diminished--like it was expected--perinatal morbidity and mortality. The most important indications to cesarean are distocias, previous cesarean and fetal stress. In 1998 frequency of cesarean deliveries in our hospital was 35% of the pregnancy attended. The claim of this study was to determine risks factors to cesarean in our hospital. A case-control study was performed, selecting 165 cases (cesareans) and 328 controls (via vaginal). It was determined OR of the risks factors and atribuible fraction. Data were analyzed by X2. The most important indications to cesarean delivery were: distocias (39%, n = 64); previous cesarean (23%, n = 41) and fetal stress (11%, n = 21). There was not significative differences in age, height and rupture membrane time in both groups. History of cesarean delivery gave major risk to another surgical intervention (OR = 12.7, p = < 0.0001, atribuible fraction 92%). Nuliparous (OR = 6.6, p < 0.00000, atribuible fraction 85%), second gestation (OR = 1.8, p = 0.002) or history of abortion (OR = 1.8, p = 0.04) were factors mainly associated to cesarean delivery. We concluded that the precise 'medications of this surgical intervention specially in nuliparous or previous cesarean delivery cases must be replanteated to diminish its elevated frequency.
Assuntos
Cesárea/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Gravidez , Fatores de RiscoRESUMO
UNLABELLED: Perinatal mortality 1 (PM1) includes deads occurred from 28th week of gestation to 1st week of extrauterine life. The aim of this study was to describe, from medical records, clinical-epidemiological characteristics of 19 perinatal mortality 19 cases and 36 controls occurred in 1998 at a General Hospital. RESULTS: Interruption of the fetal-placental circulation, cardiopathy and ventricular hemorrhages were the main causes of PM1. There were no differences in cases and controls about maternal age 27.6 +/- 7 vs 28.8 +/- 5 years (p = 0.52), gestational age by amenorrhea: 39.2 +/- 1.4 vs 39.0 +/- 1.4 weeks (p = 0.82) and weight: 2892 +/- 769 vs 3352 +/- 549 g (p 0.03) respectively. In our study, the risk of PM1 was increased when history of one to four parity was present (OR = 4.67, p = 0.03) and was decreased when history of nulliparity was present (OR = 0.21, p = 0.03). Ten cases of 19 were mortinates, nine were hebdomadal deads. There was no difference in their characteristics: maternal age 26.1 +/- 5 vs 29.6 +/- 8 years (p = 0.34), gestational age 37.7 +/- 3 vs 34.1 +/- 3 weeks (p = 0.05) and weight 3025 +/- 699 vs 2780 +/- 853 g (p = 0.53) respectively. Hebdomadal death occurred 44 +/- 5 hours after their born. Results demonstrate the importance of improving prenatal attention particularly on last weeks of gestation, even in normal pregnancies.