RESUMO

Introducción. El número de capturas a los body packers, que son aquellas personas que ingieren paquetes con estupefacientes para tráfico ilegal, ha aumentado paulatinamente. El objetivo de este estudio fue presentar los casos de body packers atendidos en dos instituciones de salud de Florencia, un territorio al sur de Colombia, entre 2003 y 2017. Métodos. Este es un estudio retrospectivo descriptivo. Se hizo un análisis univariado en RStudio y Microsoft Excel® de variables sociodemográficas y clínicas. Se emplearon medidas de tendencia central y dispersión para las variables continuas, frecuencias y proporciones para las variables categóricas. Resultados. Se incluyeron 72 pacientes. La mayoría de los casos fueron reportados entre 2007 y 2012 (77,5 %). La relación entre hombres y mujeres fue de 4,9:1. La edad media fue de 29,1 años. El principal motivo de admisión fue para chequeo médico tras captura por parte de los organismos de seguridad nacional (76,4 %). En 9 de cada 10 admitidos se realizaron estudios de imagen (94,4 %); la principal ayuda diagnóstica fue la radiografía de abdomen simple (84,7 %), con una sensibilidad del 91,6 %. Se realizó manejo expectante en tres de cada cuatro pacientes (74,6 %). El 6,9 % presentaron complicaciones, con una mortalidad (1,4 %). Conclusiones. La radiografía de abdomen simple es una ayuda diagnóstica adecuada para el tamizaje de los body packers. El manejo conservador es aceptable, teniendo en cuenta el porcentaje bajo de complicaciones.

Introduction. The number of arrests of body packers, who are those people who ingest packages with narcotics for illegal trafficking, has gradually increased. The objective of this study was to present the cases of body packers treated in two health institutions in Florencia, a territory in southern Colombia, between 2003 and 2017. Methods. This is a descriptive retrospective study. A univariate analysis was performed in RStudio and Microsoft Excel® of sociodemographic and clinical variables. Measures of central tendency and dispersion were used for continuous variables, frequencies and proportions for categorical variables. Results. 72 patients were included. Most cases were reported between 2007 and 2012 (77.5%). The ratio between men and women was 4.9:1. The mean age was 29.1 years. The main reason for admission was for medical check-up after capture by national security agencies (76.4%). In nine out of ten admitted patients, imaging studies were performed (94.4%); the main diagnostic imaging was simple abdominal X-ray (84.7%), with a sensitivity of 91.6%. Expectant management was performed in three out of four patients (74.6%). 6.9% presented complications, with one mortality (1.4%). Conclusions. Simple abdominal x-ray is an adequate diagnostic tool for screening body packers. Conservative management is acceptable, taking into account the low percentage of complications.

Assuntos

RESUMO

Sedentary behavior (SB) is associated with health impairments, while physical activity (PA) has been a protective factor. It is unclear whether SB and PA are associated with occurrence of signs and/or symptoms (SS) during cardiac rehabilitation program (CRP) exercise sessions. The objective was to evaluate the association between SB and PA with occurrence of SS. Was included 48 patients from a CRP program (64.7 ± 10.4 years-old). Daily time and % of time of SB and weekly time in moderate-to-vigorous-intensity [MVPA], % of MVPA time, steps/day, and steps/minute were accelerometer-measured. Patients were followed-up during 24 CRP sessions, for accompaniment of SS. Age, sex, and comorbidities (hypertension, diabetes, dyslipidemia, obesity) were covariates. Log-transformed values of SB, MVPA and steps/day were also analyzed. As results, 43.7% (n = 21) of participants presented occurrence of signs, 62.5% (n = 30) presented occurrence of symptoms, and 81.2% (n = 39) present occurrence of SS. In fully adjusted model, % of time in MVPA (ß: -0.449,p = 0.045) and steps/minute (ß: -0.244,p = 0.026) were inversely associated with occurrence of symptoms. No association was observed between SB and PA and occurrence of signs. The occurrence of symptoms and SS among CRP participants was directly associated with SB and inversely associated with variables of PA.

Assuntos

RESUMO

To investigate the association between symptoms of long-term effects of coronavirus disease 2019 (long COVID) and sleep problems in a sample population from southern Brazil. This cross-sectional study used data from the SULcovid-19 survey, developed in the municipality of Rio Grande, RS, Brazil. The outcome, long COVID, was investigated through the presence of 18 symptoms, and the exposure variable was sleep problems. Poisson regression with robust adjustment for variance was used to estimate crude and adjusted prevalence ratios for the outcome-exposure relationship. Odds ratio was calculated through multinomial regression of the relationship between the number of symptoms of long COVID and sleep problems. Analyses were adjusted for sex, age, marital status, income, body mass index, smoking status, comorbidities, and hospital admission. A total of 2919 adults and older adults were interviewed. The prevalence of long COVID was 48.3% (95% confidence interval [CI] 46.5-50.1%) and sleep problems were reported by 41.2% of the sample (95% CI 39.4-43.0%). Individuals with sleep problems were more likely to exhibit altered sensitivity (prevalence ratio [PR] 3.27; 95% CI 1.96-5.45), nasal congestion (PR 2.75; 95% CI 1.53-4.94), musculoskeletal symptoms (PR 1.75; 95% CI 1.48-2.06), respiratory issues (PR 1.58; 95% CI 1.24-2.01), and one or more symptom of long COVID (PR 1.27; 95% CI 1.15-1.39). Approximately one-half of the population analysed had long COVID, and four of 10 reported experiencing sleep problems. In addition, the sample tended to have experienced a greater number of symptoms compared with those who reported to sleep well.

RESUMO

Background and Purpose: Thirst-related distress in individuals with heart failure (HF) is associated with exacerbated symptoms. This study aimed to culturally adapt the Thirst Distress Scale for Patients with Heart Failure (TDS-HF) for Brazil and assess the content validity of the adapted version. Methods: The TDS-HF was translated, back-translated, and evaluated for linguistic equivalence, clarity, relevance, and pertinence by seven professional experts. The adapted TDS-HF was administered to 40 patients with HF, who provided feedback on its understandability. Results: The adaptation achieved satisfactory evidence of linguistic equivalence and content validity, with a total content validity coefficient of 0.95. The patients understood the translated version effectively. Conclusion: The Brazilian TDS-HF maintains linguistic equivalence to the original version and demonstrates satisfactory evidence of content validity. Further psychometric testing is deemed necessary for implementation.

RESUMO

OBJECTIVE: To analyze risk factors (maternal, obstetric and demographic) associated with congenital syphilis and the clinical characteristics of the newborns. METHOD: A cross-sectional study carried out in ten public maternity hospitals in Fortaleza, Ceará, Brazil that included cases of live births reported with congenital syphilis in 2015. RESULTS: 469 cases were analyzed; 199 (42.4 %) showed some sign or symptom suggestive of congenital syphilis; of these, 65 (32.7 %) were preterm, 87 (43.7 %) had low birth weight, 116 (58.3 %) had jaundice that required phototherapy, 13 (6.5 %) had hepatomegaly, 10 (5 %) had skin lesions, eight (4.0 %) had splenomegaly and one (0.5 %) had limb pseudoparalysis. Records of other clinical changes were identified in 36 (7.7 %) children. Children whose mothers were not treated or who received a drug other than penicillin and those whose mothers had a VDRL titer ≥ 1:16 at birth were 3.7 and 3.2 times more likely to be born with signs of congenital syphilis (p < 0.001- 95 % CI 2.41-5.58; p < 0.001 - 95 % CI 2.41-5.58) respectively. CONCLUSIONS: The findings of this study draw attention to the importance of improving the quality of prenatal care and the development of studies aimed at finding alternative drugs for the treatment of syphilis in pregnant women and the prevention of congenital syphilis.

Assuntos

RESUMO

Objective: This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause. Methods: In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment. Results: The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach's alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001). Conclusion: This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.

Assuntos

RESUMO

Background: Proinflammatory diet contributes to greater symptomatology in patients with knee osteoarthritis (KOA); however, in Mexico there seems to be no evidence of the dietary inflammatory role, being a country with high prevalence of overweight and obesity with an inclination towards a Western diet. Objective: To analyze the relationship between dietary inflammatory index (DII) and KOA symptomatology in Mexican patients. Material and methods: Analytical cross-sectional study in 100 patients aged 40 to 70 years. Pain, stiffness, and functionality were evaluated with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the DII was calculated from the semi-quantitative food consumption frequency questionnaire (QFCFQ). For its analysis, linear regression was calculated. Results: DII was significantly associated with pain (p = 0.001, R² = 0.118), functionality (p = 0.003, R² = 0.087) and WOMAC score (p = 0.001, R² = 0.099). In the second linear regression model with the dependent variable functionality, waist circumference (WC) was adjusted obtaining an R² = 0.144 and higher significance p = 0.001. Conclusions: Proinflammatory DII was related to greater pain, lower functionality and a high WOMAC score, which is why the anti-inflammatory diet could be considered as a support for the treatment of the patient with KOA.

Introducción: la dieta proinflamatoria contribuye a una mayor sintomatología en pacientes con osteoartritis de rodilla (OAR); sin embargo, en México parece no existir evidencia del papel inflamatorio dietético, pues es un país con alta prevalencia de sobrepeso y obesidad con inclinación hacia una dieta occidental. Objetivo: analizar la relación del índice inflamatorio dietético (IID) con la sintomatología de OAR en pacientes mexicanos. Material y métodos: estudio transversal, analítico en 100 pacientes de 40 a 70 años. Se evaluó el dolor, la rigidez y la funcionalidad con el Western Ontario and McMaster Universities Arthritis Index (WOMAC) y el IID se calculó a partir del cuestionario semicuantitativo de frecuencia de consumo de alimentos (CSFC). Para su análisis, se calculó regresión lineal. Resultados: el IID se asoció significativamente con dolor (p = 0.001, R² = 0.118), funcionalidad (p = 0.003, R² = 0.087) y puntaje del WOMAC (p = 0.001, R² = 0.099). En el segundo modelo de regresión lineal con la variable dependiente funcionalidad, se ajustó la circunferencia de cintura (CC) y se obtuvo una R² = 0.144 y una mayor significación: p = 0.001. Conclusiones: el IID proinflamatorio se relacionó con un mayor dolor, una menor funcionalidad y un puntaje alto del WOMAC, por lo cual la dieta antiinflamatoria podría considerarse como un apoyo para el tratamiento del paciente con OAR.

Assuntos

RESUMO

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.

RESUMO

PURPOSE: To analyze self-perceived vocal symptoms and discomfort in amateur church singers and compare them between genders and church types. METHODS: It was a quantitative cross-sectional study involving 99 amateur church singers aged between 18 and 59years. Data collection was carried out through the completion of a sociodemographic questionnaire, the Voice Symptom Scale (VoiSS), and the Vocal Tract Discomfort Scale (VTDS). The Mann-Whitney test was used for comparisons, and Spearman's correlation test was used for analyzing correlations between scale scores. The adopted significance level was 5% (P < 0.05). RESULTS: There was a prevalence of females (71.7%), amateur singers from Protestant churches (73.7%), with a mean age of 27.5years. The average VoiSS total score was 22.6 points, the "limitation" domain was 12.3, the "emotional" domain was 2.55, and the "physical" domain was 7.7. The most self-perceived sensations in the VTDS were "dryness," "sore throat," and "itchiness" with mild to moderate intensity. There was a statistically significant difference between genders (P < 0.05) and a positive correlation from weak (r = 0.212) to strong magnitude (r = 0.660) between vocal symptoms and vocal tract discomfort. There was no statistically significant difference between types of churches. CONCLUSION: Amateur singers self-report high levels of vocal symptoms, which impact limitation, emotional, and physical domains. Furthermore, they experience vocal tract discomfort sensations, with dryness being the most frequently reported, followed by sore throat and itching. No significant differences were found between the scale scores and church types. However, females reported a greater frequency and intensity of vocal tract discomfort sensations. The greater the self-reported vocal symptoms in this population, the higher their self-reported frequency and intensity of vocal tract discomfort sensations. These findings underscore the importance of addressing vocal health issues in amateur singers to enhance their overall well-being.

RESUMO

OBJECTIVE: To validate the Vocal Tract Discomfort Scale for the Brazilian Portuguese (VTDS-BR), based on internal consistency, reliability, and accuracy. METHODS: The participants were 431 adults of both sexes, divided in two groups: dysphonia (DG) and vocally healthy (VHG). We built a digital database with personal, professional information and the item-by-item VTDS-BR responses of the participants. We applied Cronbach's alpha, exploratory factor analysis; confirmatory factor analysis; Item Response Theory (IRT) using the Samejima model; and ROC (Receiver Operating Characteristic) curve analysis to obtain the VTDS-BR cut-off point. RESULTS: The VTDS-BR has an eight-item structure and two factors: vocal hyperfunction without phonotraumatic injury and with phonotraumatic injury. Each item is evaluated based on two facets related to frequency and intensity, with a Likert scale response key. There are four possible answers: never, sometimes, often, and always for frequency and none, mild, moderate, and intense for intensity. We applied an IRT model, which allowed the identification of which items are more related to dysphonia, based on higher values in the parameters discrimination (a) and difficulty (b), which contributed to the calculation of each participant's aptitude for the development of voice problems, by means of a score. The cut-off value was determined using the ROC curve, in which values greater than - 1.432 indicate a higher probability of voice alterations. CONCLUSION: VTDS-BR went through the stages of validation of internal consistency, reliability, and accuracy. It presents an 8-item, two-factor, and two-facet structure to assess frequency and intensity of vocal tract discomfort symptoms. VTDS-BR is suitable for clinical use or in screening activities, as it is quick to apply and its interpretation is indicative of people with and without phonotraumatic injury.

RESUMO

OBJECTIVE: To identify the first symptoms and signs of patients with suspected infection or sepsis and their association with the composite outcome of admission to the Intensive Care Unit (ICU) or mortality. DESIGN: Prospective cohort study between June 2019 and March 2020. SETTING: Hospital Universitario San Vicente Fundación, Colombia. PATIENTS: Over 18 years of age with suspicion or confirmation of sepsis, which required hospitalization. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Symptoms and signs associated with infection, with their time of evolution, specified in the study. RESULTS: From 1005 eligible patients, 261 were included. After multivariable adjustment with a logistic regression model, the main factors for ICU admission or mortality were heart rate (OR 1.04 with 95% CI 1.04-3.7), respiratory rate (OR 1.19 with 95% CI 1.0-1.4) and capillary refill time (OR 3.4 with 95% CI 1.9-6.1). CONCLUSIONS: Heart rate, respiratory rate, and capillary refill may behave as early predictors of ICU admission and mortality in cases of sepsis.

Assuntos

RESUMO

Human T-lymphotropic virus type 1 (HTLV-1) is classically associated with the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), although the mechanisms of this neurological disorder remain unclear. In addition, some patients who develop "minor" neurological signs that do not meet diagnostic criteria for HAM/TSP are classified as asymptomatic carriers. This study aims to demonstrate the neurological symptoms of Brazilian patients living with HTLV-1 classified as not-HAM.TSP. This observational study evaluated patients treated in an HTLV reference center in Bahia, Brazil, between February 2022 and July 2023. The data were obtained through the analysis of medical records and neurological consultation. Those individuals classified as HAM/ TSP were excluded from this study. 74 patients were submitted to a careful neurological evaluation: 23 HAM/TSP, 22 were classified with intermediate syndrome (IS), and 29 were oligosymptomatic. Self-reported symptoms were significantly more common in the IS group, including urinary symptoms such as nocturia, urgency, incontinence, dysuria, weakness, paresthesia, lumbar pain, xerostomia, and xerophthalmia. Physical examination findings consistent with reduced vibratory and tactile sensitivity were more common in the IS group (p = 0.017 and p = 0.013). Alterations in the V and VIII cranial nerves were present in both groups. HTLV-1 can lead to the development of important neurological signs and symptoms in apparently asymptomatic individuals. This data highlights the need for more research into the neurological aspects of HTLV-1 infection and emphasizes the importance of early diagnosis, treatment, and support for individuals living with this virus.

Assuntos

RESUMO

Resumen: Introducción: La COVID-19 se acompaña de síntomas que suelen ser más evidentes cuando la enfermedad es severa. Objetivo: Evaluar los síntomas de pacientes hospitalizados por COVID-19 a través del cuestionario Evaluación de Síntomas de Edmonton ESAS-r(es) y comparar su intensidad de acuerdo con la gravedad. Material y métodos: Se realizó un estudio transversal, prospectivo y observacional, que consistió en la evaluación de la intensidad de síntomas en pacientes con COVID-19 hospitalizados y se comparó de acuerdo con la gravedad. Resultados: Se incluyeron 110 evaluaciones, la mayoría de síntomas se presentaron con mayor intensidad en el grupo gravedad severa: agotamiento (p ≤ 0.001), pérdida de apetito (p = 0.006), dificultad para respirar (p = 0.001), desánimo (p = 0.009) y nerviosismo/ansiedad (p = 0.041). Conclusión: Los síntomas se presentaron con mayor frecuencia e intensidad en enfermedad severa.

Abstract: Introduction: COVID-19 is accompanied by symptoms that are usually more evident when the disease is severe. Objective: To evaluate the symptoms of patients hospitalized for COVID-19 through the ESAS-r(es) questionnaire and compare their intensity according to severity. Material and methods: A cross-sectional, prospective and observational study was carried out, which consisted of the evaluation of the intensity of symptoms in hospitalized patients with COVID-19 and was compared according to severity. Results: 110 evaluations were included, most of the symptoms presented with greater intensity in the severe severity group: exhaustion (p ≤ 0.001), loss of appetite (p = 0.006), shortness of breath (p = 0.001), discouragement (p = 0.009) and nervousness/anxiety (p = 0.041). Conclusion: The symptoms occurred with greater frequency and intensity in severe disease.

RESUMO

Resumen Introducción: Un espectro de enfermedad hemorrágica intracraneal se puede presentar con síntomas neurológicos focales transitorios; aunque las enfermedades congénitas del fibrinógeno son inusuales y rara vez se manifiestan de esta manera, a continuación se presenta un caso de microsangrados cerebrales por hipofibrinogenemia congénita con síntomas neurológicos focales transitorios. Presentación del caso: Paciente masculino de 29 años de edad con microsangrados cerebrales por hipofibrinogenemia congénita con síntomas neurológicos focales transitorios. Discusión: La hemorragia intracerebral de vasos pequeños es una causa de síntomas neurológicos focales transitorios. La prevalencia de microhemorragias cerebrales en la población adulta mayor es un problema altamente reconocido, sin embargo, la incidencia de estos microsangrados en personas más jóvenes es baja y desconocida. Las discrasias sanguíneas, como el trastorno hereditario del fibrinógeno, son una causa de anomalías hereditarias de la coagulación sanguínea, donde este tiene una función importante en el control del sangrado por agregación plaquetaria y en la cascada de coagulación. La ausencia de fibrinógeno normal conduce a una altercación en la hemostasia y, por tanto, a complicaciones hemorrágicas. Conclusiones: Los síntomas neurológicos focales transitorios pueden ser causados por una enfermedad vascular cerebral hemorrágica de vasos pequeños, donde las discrasias sanguíneas congénitas son una causa rara de este tipo de enfermedad cerebrovascular.

Abstract Introduction: Intracranial hemorrhagic disease can present with transient focal neurological symptoms. Congenital fibrinogen diseases are unusual and can rarely manifest in this way. Below we present a case of cerebral microbleeds due to congenital hypofibrinogenemia with transient focal neurological symptoms. Case presentation: This is a 29-year-old man with cerebral microbleeds due to congenital hypofibrino-genemia with transient focal neurological symptoms. Discussion: Cerebral microbleed and intracerebral hemorrhage is a cause of transient focal neurological symptoms. The prevalence of cerebral microbleeds in the elderly population is a highly recognized problem. However, the incidence of these microbleeds in younger people is low and unknown. Blood dyscrasias, such as inherited fibrinogen disorder, are a cause of inherited abnormalities of blood clotting. Fibrinogen has an important role in the control of bleeding due to platelet aggregation and is part of the coagulation cascade. The absence of normal fibrinogen induces alteration in platelet and coagolation hemostasis and, therefore, causes hemorrhagic complications. Conclusions: Transient focal neurological symptoms may be caused by small vessel hemorrhagic cere-brovascular disease. Congenital blood dyscrasias are a rare cause of this type of cerebrovascular disease.

RESUMO

BACKGROUND: Fatigue is significant in the context of Parkinson's disease (PD), considering that one-third of patients classify it as the most restricting symptom in their daily life activities (DLAs). The objective was to verify the relationship (association) between fatigue and non-motor and motor symptoms of PD. METHODS: A cross-sectional study which included 100 individuals with PD. Initially, demographic and clinical data (modified Hoehn and Yahr scale-HY, anxiety, and depression) were collected. To assess the non-motor and motor symptoms of PD, the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) was applied. Fatigue was evaluated using the Parkinson Fatigue Scale. RESULTS: A higher HY score, greater severity of non-motor aspects of DLAs and motor aspects of DLAs, more motor complications, and higher levels of anxiety as well as depression were observed in the "fatigue" group. Fatigue was associated with a lower daily equivalent levodopa dose (LEDD), a higher body mass index (BMI), anxiety, depression, and the presence of non-motor symptoms. CONCLUSION: Non-motor symptoms are more determining factors for fatigue than the motor condition itself, with an association between fatigue and higher BMI scores, increased anxiety and depression, lower LEDD, and greater severity of non-motor aspects of DLAs. Individuals in the "fatigue" group had higher HY scores, anxiety, and depression, worse non-motor and motor symptoms related to experiences of daily life, as well as motor complications.

Assuntos

RESUMO

Introducción: La enfermedad cerebrovascular isquémica tiene una alta frecuencia debida, fundamentalmente, al envejecimiento poblacional. Objetivo: Comparar las características clínicas de pacientes con enfermedad cerebrovascular isquémica de dos grupos etarios. Métodos: Se realizó un estudio descriptivo, transversal y retrospectivo en 36 pacientes con enfermedad cerebrovascular isquémica correspondientes a dos grupos etarios (65 y menos años y mayores de 65), quienes fueron atendidos en el Instituto de Neurología y Neurocirugía, La Habana, de enero a diciembre del 2017. Al respecto, se analizaron variables demográficas y clínicas y se aplicaron diferentes pruebas estadísticas para comparar. Resultados: Se obtuvo un aumento significativo de pacientes hipertensos (88,9 %) en el grupo etario mayor de 65 años. La mediana de la escala de ictus del National Institute of Health fue superior en estos pacientes (mediana [10-90 percentil]: 9,5 (4-19]). Hubo incremento estadístico de los mayores de 65 años con parálisis parcial de la mirada y ataxia; en tanto, la monoparesia y la extinción visual predominaron en los de 65 y menos años. Dicha escala mostró un aumento estadístico en el ictus aterotrombótico y cardioembólico en comparación con otras causas en ambos grupos. Los pacientes mayores de 65 años con solo un factor de riesgo o ninguno y los que eran hipertensos tuvieron mayor puntuación de la escala. Conclusiones: El grado de afectación neurológica fue superior en los mayores de 65 años que tenían un factor de riesgo y en aquellos con hipertensión arterial. Puede sugerirse que los mecanismos moleculares y fisiopatológicos de estos pacientes varían según la edad.

Introduction: The ischemic cerebrovascular disease has a high frequency due to the population aging mainly. Objective: To compare clinical characteristics of patients with ischemic cerebrovascular of two age groups. Methods: A descriptive, cross-sectional, retrospective study was carried out in the Neurology and Neurosurgery Institute in Havana, from January to December, 2017 in patients with ischemic cerebrovascular disease; 36 individuals of both age groups. In this regard, demographic variables, risk factors, clinical manifestations, coma scale and neurological deficiency, etiology and localization of the ischemic ictus were analyzed. Results: The 65 years group had a significant increase of hypertensive patients (88.9%). The average of the National Institute of Health stroke scale was superior in these patients (median [10-90 percentile]: 9.5 [4-19]). There was statistical increment of over 65 years patients with partial paralysis of the look and ataxia, but monoparesis and visual extinction in the age under 65 years. Such a scale had a statistical increase in the atherothrombotic and cardioembolic ictus in comparison with other etiologies in both patient groups. The over 65 years patients with just one risk factor or and those with hypertension had a higher punctuation of the scale. Conclusions: The degree of neurological affectation was higher in over 65 years patients that had a risk factor and in those with hypertension. As a result it could be suggested that the molecular and pathophysiolologic mechanisms of these patients vary with the age.

RESUMO

PURPOSE: To identify the prevalence of the nursing diagnosis of compromised end-of-life syndrome in patients in end-of-life care. METHODS: This is a clinical validation based on a cross-sectional epidemiological clinical study conducted at the National Cancer Institute in Rio de Janeiro, Brazil. The defining characteristics of a syndrome diagnosis were identified, defined as a "subset of nursing diagnoses," using sensitivity and specificity measures through the application of latent class statistical methods. FINDINGS: The statistical results revealed seven nursing diagnoses characterizing the syndrome: imbalanced nutrition: less than body requirements, nausea, anxiety, ineffective breathing pattern, disturbed sleep pattern, ineffective thermoregulation, and fatigue. Compromised end-of-life syndrome was present in 76% of the sample. CONCLUSION: The study demonstrated the presence of compromised end-of-life syndrome in most end-of-life patients from the sample. IMPLICATIONS FOR NURSING PRACTICE: Recognizing the presence of the syndrome diagnosis enables nurses to have efficient and effective clinical reasoning for implementing the nursing process in palliative care. CAAE Number: 85415618.0.3001.5274.

OBJETIVO: Identificar a prevalência do diagnóstico de enfermagem Síndrome de fim de vida comprometido em pacientes em cuidados de fim de vida. MÉTODO: Trata-se de uma validação clínica baseada em um estudo clínico epidemiológico transversal, desenvolvido no Instituto Nacional do Câncer no Rio de Janeiro, Brasil. Foram identificadas as características definidoras de um diagnóstico de síndrome, definido como um "subconjunto de diagnósticos de enfermagem" utilizando-se medidas de sensibilidade e especificidade a partir da aplicação do método estatístico de classe latente. RESULTADOS: Os resultados estatísticos identificaram sete diagnósticos de enfermagem caracterizadores da síndrome: nutrição desequilibrada: menor que as necessidades corporais, náusea, ansiedade, padrão respiratório ineficaz, padrão de sono perturbado, termorregulação ineficaz e fadiga. O diagnóstico Síndrome de fim de vida comprometido esteve presente em 76% da amostra. CONCLUSÃO: O estudo demonstrou a presença da Síndrome de fim de vida comprometido na maioria dos pacientes em cuidados de fim de vida da amostra. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: O reconhecimento da presença do diagnóstico de síndrome permite ao enfermeiro um raciocínio clínico eficaz e eficiente para a implantação do processo de enfermagem em cuidados paliativos. Número CAAE: 85415618.0.3001.5274.

RESUMO

O número de casos de dengue no continente americano, no primeiro semestre de 2023, superou o total de casos de 2022 e o Brasil lidera com 2,3 milhões de ocorrências da doença e 769 mortes. A dengue se expande no mundo e já é considerada endêmica em mais de 100 países. Este estudo objetiva caracterizar o perfil dos óbitos por dengue, no período de 2015 a 2023, em uma cidade do interior do estado de São Paulo. Este é um estudo transversal, retrospectivo e descritivo, com análise de dados secundários do Sistema Nacional de Notificação (Sinan), Sistema de Mortalidade (SIM) e banco de dados dos óbitos por dengue, do comitê de mortalidade da vigilância epidemiológica municipal. A capacidade das equipes de saúde em identificar os sinais e sintomas ocorreu em apenas 42,9% dos casos antes da internação e do óbito, seguida por no dia do óbito (11,7%) e após o óbito (8,8%). A mortalidade por dengue predominou em indivíduos do sexo masculino (51,4%), com idade mediana de 74 anos. A análise dos dados demonstrou que o manejo clínico da dengue ainda é desafiador para a equipe de saúde, que precisa se manter permanentemente capacitada para o reconhecimento dos sintomas, sinais de alarme e gravidade, para a correta condução de cada caso, visando a redução da mortalidade.

In the first half of 2023, the number of dengue cases in the Americas surpassed the total for 2022, with Brazil leading the list with 2.3 million disease occurrences and 769 deaths. Dengue is expanding globally and is already considered endemic in more than 100 countries. This study characterizes the profile of dengue deaths from 2015 to 2023 in a municipality of São Paulo. A cross-sectional, retrospective, and descriptive study was conducted with secondary data obtained from the National Notification System (SINAN), Mortality System (SIM), and dengue death database of the municipal epidemiological surveillance mortality committee. Only in 42.9% of cases were the health teams able to identify the signs and symptoms before hospitalization and death, followed by after death (8.8%) and on the day of death (11.7%). Dengue mortality predominated among male individuals (51.4%) with a median age of 74 years. Data analysis showed that the clinical management of dengue remains challenging for health teams, who needs continuous training to recognize the signs and symptoms, warning signs, and severity for correct management of each case, aiming to reduce mortality.

Los casos de dengue en las Américas superaron en el primer semestre de 2023 al total de casos de 2022, en el cual lidera Brasil con 2,3 millones de notificaciones de la enfermedad y 769 muertes. El dengue se expande por el mundo, y más de 100 países ya lo consideran una endemia. Este estudio tiene como objetivo caracterizar el perfil de las muertes por dengue en el período de 2015 a 2023, en una ciudad del interior del estado de São Paulo. Se trata de un estudio transversal, retrospectivo y descriptivo con análisis de datos secundarios del Sistema Nacional de Notificación (SINAN), del Sistema de Mortalidad (SIM) y de la Base de Datos de Muertes por Dengue del Comité de Mortalidad de la Vigilancia Epidemiológica Municipal. Los equipos de salud fueron capaces de identificar los signos y síntomas en solo el 42,9% de los casos antes de la hospitalización y de la muerte, seguida del día de la muerte (11,7%) y tras la muerte (8,8%). La mortalidad por dengue predominó en individuos del sexo masculino (51,4%) con una edad media de 74 años. El análisis de datos demostró que el manejo clínico del dengue sigue siendo un desafío para el equipo de salud, quien necesita mantenerse capacitado continuamente para detectar los signos y síntomas, señales de alarma y gravedad, para la correcta conducción de cada caso, con el objetivo de reducir la mortalidad.

RESUMO

Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment.

Assuntos

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions. METHODS: This was a case-control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS. FINDINGS: This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS. CONCLUSIONS: A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS. IMPLICATIONS FOR NURSING PRACTICE: The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy.

Assuntos