Prevalência da doença falciforme em adultos com diagnóstico tardio / Prevalencia de la anemia falciforme en adultos con diagnóstico tardío / Prevalence of sickle cell disease in adults with delayed diagnosis

Resumo Objetivo: Estimar a prevalência da doença falciforme em adultos com diagnóstico tardio, em tratamento nos ambulatórios de hematologia na rede de saúde do Estado do Mato Grosso do Sul de 2013 a 2017; descrever as características sociodemográficas; verificar associações entre os genótipos em relação a idade atual, os genótipos e a idade ao diagnóstico. Métodos: Estudo transversal, retrospectivo, com dados coletados em dois hospitais de ensino. As variáveis investigadas foram: ano do atendimento, genótipo, sexo, data de nascimento, idade ao diagnóstico, naturalidade e procedência. A prevalência foi estimada por ponto (%) e intervalo de confiança de 95%. Resultados: A prevalência foi 3,9%, com 103 adultos com doença falciforme, sendo 60 do sexo feminino e 43 do masculino. Predominou o genótipo HbSS, seguido pelo HbSC. A mediana de idade foi de 35 para os HbSS e 31 para os HbSC. A mediana de idade ao diagnóstico foi cinco anos para os HbSS e 21 para HbSC. Não houve associação entre idade (anos) dos pacientes e genótipo (teste Qui-quadrado p=0,601) e nem entre genótipo e faixa etária (teste Qui-quadrado p= 0,318). Conclusão: O genótipo mais frequente foi o HbSS, seguido pelo HbSC. O diagnóstico dos pacientes com SC foi mais tardio do que naqueles com genótipo SS. As variáveis sociodemográficas e o diagnóstico tardio alertam para a necessidade de fortalecimento de ações na rede de saúde, que interferem sensivelmente na morbimortalidade de adultos com Doença Falciforme.

Resumen Objetivo: Estimar la prevalencia de la anemia falciforme en adultos con diagnóstico tardío, en tratamiento ambulatorio de hematología de la red de salud del estado de Mato Grosso do Sul de 2013 a 2017; describir las características sociodemográficas; verificar asociaciones entre los genotipos con relación a la edad actual, los genotipos y la edad de diagnóstico. Métodos: Estudio transversal, retrospectivo, con datos recopilados en dos hospitales universitarios. Las variables investigadas fueron: año de atención, genotipo, sexo, fecha de nacimiento, edad de diagnóstico, naturalidad y procedencia. La prevalencia fue estimada por punto (%) e intervalo de confianza de 95%. Resultados: La prevalencia fue 3,9%, con 103 adultos con anemia falciforme, 60 de sexo femenino y 43 masculino. Predominó el genotipo HbSS, seguido de HbSC. La mediana de edad fue 35 años en los HbSS y 31 en los HbSC. La mediana de edad de diagnóstico fue 5 años en los HbSS y 21 en los HbSC. No hubo relación entre edad (años) de los pacientes y genotipo (prueba ⊠2 de Pearson p=0,601) y tampoco entre genotipo y grupo de edad (prueba ⊠2 de Pearson p=0,318). Conclusión: El genotipo más frecuente fue el HbSS, seguido del HbSC. El diagnóstico de los pacientes con SC fue más tardío que el de los de genotipo SS: Las variables sociodemográficas y el diagnóstico tardío advierten sobre la necesidad de fortalecer acciones en la red de salud, que interfieren sensiblemente en la morbimortalidad de adultos con anemia falciforme.

Abstract Objective: To estimate the prevalence of sickle cell disease in adults with delayed diagnosis, receiving treatment at hematology outpatient clinics in the health network of the state of Mato Grosso do Sul, between 2013 and 2017; to describe sociodemographic characteristics; to verify associations between genotypes in relation to current age, the genotypes, and age at diagnosis. Methods: A retrospective, cross-sectional study with data collected at two teaching hospitals. The variables investigated were: year of treatment, genotype, sex, date of birth, age at diagnosis, and city in which they lived. Prevalence was estimated per point, using a 95% confidence interval. Results: The prevalence was 3.9% in 103 adults with sickle cell disease: 60 female and 43 male. The HbSS genotype was predominant, followed by HbSC. The median age was 35 for HbSS, and 31 for HbSC. Median age at diagnosis was five years for HbSS, and 21 for HbSC. No association was found between age (years) of patients and genotype (chi-square test p=0.601), or between genotype and age group (chi-square test p= 0,318). Conclusion: The most frequent genotype was HbSS, followed by HbSC. The diagnosis of patients with hemoglobin SC occurred later in life than those with the hemoglobin SS genotype. Sociodemographic variables and delayed diagnosis warns for the need to strengthen actions in the health network, which interfere significantly in the morbidity and mortality of adults with sickle cell disease.

Prevalence of latent tuberculosis and treatment adherence among patients with chronic kidney disease in Campo Grande, State of Mato Grosso do Sul

Introduction The primary strategy for tuberculosis control involves identifying individuals with latent tuberculosis. This study aimed to estimate the prevalence of latent tuberculosis in chronic kidney disease (CKD) patients who were undergoing hemodialysis in Campo Grande, State of Mato Grosso do Sul, Brazil, to characterize the sociodemographic and clinical profiles of patients with latent tuberculosis, to verify the association between sociodemographic and clinical characteristics and the occurrence of latent tuberculosis, and to monitor patient adherence to latent tuberculosis treatment. Methods This epidemiological study involved 418 CKD patients who were undergoing hemodialysis and who underwent a tuberculin skin test. Results The prevalence of latent tuberculosis was 10.3%. The mean patient age was 53.43±14.97 years, and the patients were predominantly men (63.9%). The population was primarily Caucasian (58.6%); half (50%) were married, and 49.8% had incomplete primary educations. Previous contact with tuberculosis patients was reported by 80% of the participants. Treatment adherence was 97.7%. Conclusions We conclude that the prevalence of latent tuberculosis in our study population was low. Previous contact with patients with active tuberculosis increased the occurrence of latent infection. Although treatment adherence was high in this study, it is crucial to monitor tuberculosis treatment administered to patients in health services to maintain this high rate. .

Scope and efficiency of the newborn screening program in identifying hemoglobin S

Background: In 2001, the Brazilian Ministry of Health added hemoglobinopathies to the National Neonatal Screening Program to be implemented in three steps. In order to meet the proposed goals, it is crucial to establish periodic assessments of this program with the aim of monitoring its implementation. Objective: To assess the scope and the efficiency of the stages of the National Newborn Screening Program in identifying hemoglobin S. Methods: A cross-sectional study was developed with the results of the heel prick test using the high performance liquid chromatography method for babies born in Mato Grosso do Sul from 2006 to 2010. The following variables were investigated: year, number of live births, total screening, coverage ratio, prevalence, time between the child birth and the blood collection; age at diagnosis; age at the time of the first consultation; and time between the diagnosis and the first appointment. Results: Over the five years of the study, the mean coverage rate was 91.77%.The prevalences of hemoglobin FAS and hemoglobin FS were 1.65% and 0.011%, respectively. Blood samples from 43.48% of children were collected from the second to the seventh day. The age at diagnosis was within the first 28 days in 87.80% of the screened children. The lowest mean indices for the first consultation and the time between the diagnosis and the first appointment (58.8 and 46.4 days, respectively) occurred in 2010. Conclusions: The scope of the National Neonatal Screening Program for hemoglobinopathies is good, with a large number of individuals being tested. Efficiency is a suitable indicator to assess the program steps. Three points are recommended: the training of the individuals involved, studies to assess the assistance provided to the affected child, and genetic counseling to the mothers. .

Efeitos de um programa de caminhada sobre os níveis de fadiga em pacientes com câncer de mama / Effects of jogging program the fatigue level of breast cancer patients

O objetivo deste estudo foi verificar os efeitos de um programa exercícios físicos (caminhada) nos níveis de fadiga em pacientes portadoras de câncer de mama, sob tratamento quimioterápico. Materiais e métodos: Oito pacientes portadoras de câncer de mama, estádio II e III, que participaram de tratamento de quimioterapia adjuvante foram voluntárias dessa pesquisa. Para tanto, as referidas pacientes participaram de duas avaliações, uma antes de iniciar o programa de exercícios físicos (caminhada) e outra ao final de doze semanas após o início. As sessões ocorreram 3 vezes por semana, eram constituídas de 5 minutos de alongamento, 30 minutos de esteira ergométrica (60% FCmáx. nas primeiras duas semanas, e 40 minutos de esteira ergométrica 60% a 80% FCmáx. nas semanas seguintes) e 5 minutos de alongamento, ao final. Foi utilizada para avaliar os níveis de fadiga, a escala de fadiga de Piper et al (1989). Os dados foram tratados pelo Teste de Wilcoxon. Resultados: Diferenças significativas (p < 0.05) correspondente à diminuição da fadiga entre os resultados pré e pós- testes ocorreram para a variável fadiga geral, e também nas dimensões afetividade, comportamento, cognitivo e sensorial. Conclusão: Os dados encontrados demonstraram que o programa de exercícios físicos (caminhada) de 12 semanas foi eficiente para a redução de fadiga nas pacientes de câncer de mama em tratamento quimioterápico.

Aim: This study aimed at verifying the effects of a physical exercise program (jogging) in the fatigue levels of breast cancer patients undergoing a chemotherapy treatment. Materials and methods: eight breast cancer patients, stages II and III who participated in adjuvant chemotherapy treatment were volunteers in this research. These patients were submitted in two assessments, one before the beginning of the program of physical exercise (jogging) and another in the end of twelve weeks. The sessions occurred three times a week and were constituted of five minutes stretching, thirty minutes ergometric treadmill (60% HRmax during the two first weeks, and 40 minutes ergometric treadmill 60% to 80% HRmax in the subsequent weeks) and 5 minutes stretching in the end. In order to assess the fatigue levels, Piper et al (1989) fatigue scale was used. Data were treated by the Wilcoxon Test. Outcomes: Meaningful differences (p < 0.05) among the outcomes pre and post tests occurred in the general fatigue variables, and also in the affective, behavioral, cognitive and sensorial dimensions. Conclusion: Data demonstrated that the physical exercise program (jogging) of twelve weeks was efficient to reduce the fatigue levels in breast cancer patients undergoing a chemotherapy treatment.

Efeitos de um programa de caminhada sobre os níveis de fadiga em pacientes com câncer de mama / Effects of jogging program the fatigue level of breast cancer patients

Objetivo deste estudo foi verificar os efeitos de um programa exercícios físicos (caminhada) nos níveis de fadiga em pacientes portadoras de câncer de mama, sob tratamento quimioterápico. Materiais e métodos: Oito pacientes portadoras de câncer de mama, estádio II e III, que participaram de tratamento de quimioterapia adjuvante foram voluntárias dessa pesquisa. Para tanto, as referidas pacientes participaram de duas avaliações, uma antes de iniciar o programa de exercícios físicos (caminhada) e outra ao final de doze semanas após o início. As sessões ocorreram 3 vezes por semana, eram constituídas de 5 minutos de alongamento, 30 minutos de esteira ergométrica (60% FCmáx. nas primeiras duas semanas, e 40 minutos de esteira ergométrica 60% a 80% FCmáx. nas semanas seguintes) e 5 minutos de alongamento, ao final. Foi utilizada para avaliar os níveis de fadiga, a escala de fadiga de Piper et al (1989). Os dados foram tratados pelo Teste de Wilcoxon. Resultados: Diferenças significativas (p < 0.05) correspondente à diminuição da fadiga entre os resultados pré e pós- testes ocorreram para a variável fadiga geral, e também nas dimensões afetividade, comportamento, cognitivo e sensorial. Conclusão: Os dados encontrados demonstraram que o programa de exercícios físicos (caminhada) de 12 semanas foi eficiente para a redução de fadiga nas pacientes de câncer de mama em tratamento quimioterápico.

This study aimed at verifying the effects of a physical exercise program (jogging) in the fatigue levels of breast cancer patients undergoing a chemotherapy treatment. Materials and methods: eight breast cancer patients, stages II and III who participated in adjuvant chemotherapy treatment were volunteers in this research. These patients were submitted in two assessments, one before the beginning of the program of physical exercise (jogging) and another in the end of twelve weeks. The sessions occurred three times a week and were constituted of five minutes stretching, thirty minutes ergometric treadmill (60% HRmax during the two first weeks, and 40 minutes ergometric treadmill 60% to 80% HRmax in the subsequent weeks) and 5 minutes stretching in the end. In order to assess the fatigue levels, Piper et al (1989) fatigue scale was used. Data were treated by the Wilcoxon Test. Outcomes: Meaningful differences (p < 0.05) among the outcomes pre and post tests occurred in the general fatigue variables, and also in the affective, behavioral, cognitive and sensorial dimensions. Conclusion: Data demonstrated that the physical exercise program (jogging) of twelve weeks was efficient to reduce the fatigue levels in breast cancer patients undergoing a chemotherapy treatment.

Prevalência e aspectos epidemiológicos da leptospirose bovina em rebanho leiteiro na microrregiäo de Goiânia - GO / Prevalence and epidemiology aspects of bovine leptospirosis in dairy herd from Goiânia microregion, Goiás State, Brasil

Foram colhidas 426 amostras de hemossoro bovino, provenientes de vacas em lactaçäo na microrregiäo de Goiânia-GO, e testadas pelo método de soroaglutinaçäo microscópica (SAM) para detecçäo de aglutininas antileptospiras, para efetuar um estudo de prevalência. Paralelamente, foi realizado um questionário epidemiológico, contendo informaçöes que pudessem fornecer dados sobre a epidemiologia da leptospirose nessa regiäo. Os resultados obtidos revelaram uma prevalência de 81,90 por cento de animais reagentes. Os principais sorovares envolvidos foram: wolffi (36,10 por cento), icterohaemorrhagiae (20,50 por cento), hardjo (5,20 por cento) e tarassovi (4,90 por cento). A presença de ratos e suínos, a utilizaçäo de inseminaçäo artificial e o tipo de fonte de água näo interferiram no número de animais reagentes no teste de SAM. A leptospirose tem um comportamento enzoótico nessa regiäo.