Investigating the Impact of Community Volunteerism on the Mental Health of Medical Students.

OBJECTIVE: This study aimed to analyze the impact of community service on the mental health of medical students through their perception of stress. METHODS: The 10-item Perceived Stress Scale was used to measure the stress levels of 82 medical students over a 3-month period. Additional survey questions gauged students' weekly volunteer experiences in clinical and nonclinical settings and their perceived effects on stress and quality of life. RESULTS: Results found an inverse relationship between the number of clinical volunteer hours and perceived stress (P = .0497). Nonclinical and total volunteer hours were correlated with both reduced perceived stress levels (nonclinical P = .0095, total P = .0052) and better quality of life (nonclinical P = .0301, total P = .0136). All individual perceived stress scores fell into the low or moderate stress ranges of the Perceived Stress Scale per the week-to-week analysis. CONCLUSION: The preliminary results raised important research questions about the impact of volunteering on medical student perceived stress. As medical students face higher levels of stress in comparison to the general population, it is exceedingly important to determine methods to decrease their risk of compromising their mental health. This study may aid in decision-making and research in favor of or against offering community service opportunities as part of the core medical education curriculum.

Effects of Aerobic Exercise in the Intensive Care Unit on Patient-Reported Physical Function and Mental Health Outcomes in Severely Burned Children-A Multicenter Prospective Randomized Trial.

Severe burns are life-altering and can have lasting effects on patients' physical and mental health. Alterations in physical function, changes in appearance, and psychological disturbances resulting from severe burns are especially concerning in children, as they are still in the early stages of identity formation. Exercise in the nonburn population has been shown to improve quality of life and result in better physical and mental status. However, the effect of early exercise on the quality of life in pediatric burn patients requires more research. METHODS: Forty-eight children between the ages of seven and seventeen with ≥30% total body surface area (TBSA) burn were randomized in a 1:2 fashion to receive treatment with standard-of-care (SOC) or standard-of-care plus exercise (SOC+Ex). Surveys administered at admission and discharge collected patient-reported information regarding physical and mental health outcomes. The results are given as means +/- standard deviation. Significance was set at p < 0.05. RESULTS: The average age of the SOC and SOC+Ex groups were 12 ± 3 and 13 ± 4 years, respectively. The average %TBSA burned in the SOC and SOC+Ex groups were 54 ± 17 and 48 ± 14, respectively. The SOC+Ex group averaged 10 ± 9 exercise sessions (range of 1 to 38 sessions) with an attendance rate of 25% (10 sessions out of 40 BICU days). Both groups demonstrated significant improvement in patient-reported physical and mental outcomes during hospital admission (p < 0.05) However, additional exercise did not exhibit any additional benefits for measured levels. CONCLUSIONS: Our recommendation is for all pediatric patients in the BICU to continue with the SOC and consult with their physician over the benefits of additional aerobic exercise. This study suggests that perhaps there is potential for increasing the amount of exercise that can be administered to pediatric burn survivors beyond SOC as we did not find aerobic exercise to be of any harm to any patients if it is performed properly and under supervision.

Fatores associados à gravidade da apneia obstrutiva do sono: Obesidade e sonolência diurna excessiva / Factures associated with obstructive sleep apnea severity: Obesity and excessive daytime sleepiness

Fundamentos: A apneia obstrutiva do sono (AOS) é uma doença crônica, subdiagnosticada, com alta taxa de morbimortalidade, associada à obesidade. Justifica-se este estudo pela elevada prevalência de obesidade e sua associação com a AOS. Objetivo: Avaliar fatores nutricionais, polissonográficos e de sonolência diurna excessiva (SDE) associados à gravidade da AOS. Métodos: Estudo transversal que compara alterações antropométricas e polissonográficas em indivíduos com e sem AOS. Avaliados índice de massa corpórea, escala de sonolência de Epworth e parâmetros polissonográficos. A síndrome de AOS foi classificada em: leve/moderada e grave, baseada no índice apneia/hipopneia. Resultados: Incluídos 288 pacientes, com média de idade 43,9±12,3 anos e índice de massa corpórea 29,4±6,38 kg/m2. Entre os pacientes com AOS grave, 92,0 % apresentaram excesso de peso. Mais da metade apresentava sonolência diurna (55,6 %). A presença de obesidade, sonolência diurna excessiva, roncos e de fragmentação do sono foi 3, 2, 11 e 23 vezes maior na AOS grave do que na leve/moderada. Conclusão: Indivíduos com apneia grave apresentaram maior IMC, mais sonolência diurna, mais fragmentação do sono e mais roncos do que aqueles com forma leve a moderada de AOS.

Background: Obstructive sleep apnea (OSA) is an underdiagnosed chronic disease associated with obesity and high morbidity and mortality rates. This study is justified by the high prevalence of obesity and its association with obstructive sleep apnea. Objective: To evaluate nutritional, polysomnographic and daytime sleepiness factors associated with OSA severity. Methods: Cross-sectional study comparing anthropometric and polysomnographic alterations in patients with and without OSA, assessing body mass index, subjective Epworth sleepiness scale (ESS) and polysomnography parameters. The OSA syndrome was classified as mild/moderate or severe, based on the apnea/hypopnea rates. Results: A total of 288 patients were included, with a mean age of 43.9±12.3 years and a body mass index of 29.4±6.38kg/m2. Among patients with severe OSA, almost 92.0% were overweight and more than half (55.6%) presented excessive daytime sleepiness. Obesity, excessive daytime sleepiness, snoring and sleep fragmentation were respectively 3, 2, 11 and 23 times greater with severe OSA than for mild/ moderate OSA. Conclusion: People with severe OSA presented higher BMIs, more frequent daytime sleepiness, greater sleep fragmentation and more frequent snoring than those with mild/moderate OSA.

Tuberculose e AIDS: revisäo atualizada / Tuberculosis and AIDS: current revision

Os autores apresentam aspectos epidemiológicos e os principais tópicos a serem considerados no diagnóstico e tratamento da tuberculose, quando incidente nos pacientes com Aids. Däo ênfase à importância de se estadiar a Aids, pois, como se verá adiante, as apresentaçöes podem diferir, francamente, de acordo com o grau de imunodepressäo em que se encontra o paciente. Ilustram o trabalho com cinco casos selecionados entre os pacientes por eles acompanhados.