Tuberculin skin testing in inflammatory bowel disease patients from an endemic area of Brazil

Objective: Inflammatory bowel disease (IBD) is a chronic disorder involving the gastrointestinal tract. Immunosuppressive drugs are usually prescribed to treat IBD patients, and this treatment can lead to tuberculosis reactivation. This paper aimed to analyze tuberculin skin test (TST) results in IBD patients at a reference center in Brazil. Methods: We evaluated TST results in IBD patients using a cross-sectional study. We also analyzed the medical records of patients treated at a reference IBD outpatient unit where TST is routinely performed. Results: We reviewed 119 medical records of 57 (47.9%) Crohn's disease (CD), 57 (47.9%) ulcerative colitis (UC) and 5 (4.2%) indeterminate colitis (IC) patients. The mean (SD) age was 43.5 (13.7) years old. TST was positive in 24 (20.2%) of the patients. TST was positive in 16/57 (28.1%) UC and 6/57 (10.5%) CD patients (prevalence ratio [PR] 2.7). Forty-one patients (34.5%) were taking immunosuppressive drugs (azathioprine or prednisone) at the time of the TST, and six of these patients (14.6%) had positive test results. Two patients using infliximab had negative TST results. Thirty-five of the 41 patients (85.4%) on immunosuppressive treatment were anergic compared with 73.1% (57/78) of the untreated patients (PR 1.2). Conclusions: Patients with IBD have TST results similar to the general Brazilian population. Within the IBD population, CD patients have a lower frequency of TST positivity than UC patients. .

Impact of psychiatric disorders on the quality of life of brazilian HCV-infected patients

The aim of our study was to determine the impact of psychiatric comorbidities on the health-related quality of life of HCV-infected patients. Assessment of clinical, socio-demographic and quality of life data of the patients followed up at a Hepatology unit was performed by using a standard questionnaire and the SF-36 instrument. Psychiatric diagnoses were confirmed by using the Mini International Neuropsychiatric Interview, Brazilian version 5.0.0 (MINI Plus). Evaluation using the MINI plus demonstrated that 46 (51 percent) patients did not have any psychiatric diagnosis, while 44 (49 percent) had at least one psychiatric diagnosis. Among patients with a psychiatric comorbidity, 26 (59.1 percent) had a current mental disorder, out of which 22 (84.6 percent) had not been previously diagnosed. Patients with psychiatric disorders had lower scores in all dimensions of the SF-36 when compared to those who had no psychiatric diagnosis. Scores of physical functioning and bodily pain domains were lower for those suffering from a current psychiatric disorder when compared to those who had had a psychiatric disorder in the past. Females had lower scores of bodily pain and mental health dimensions when compared to males. Scores for mental health dimension were also lower for patients with advanced fibrosis. The presence of a psychiatric comorbidity was the variable that was most associated with the different scores in the SF-36, compared to other variables such as age, gender, aminotransferase levels, and degree of fibrosis.

Avaliação prospectiva do sistema cardiovascular em adolescentes jogadores de futebol / Prospective assessment of the cardiovascular system among teenage soccer players

Avaliar o efeito cardiovascular do treinamento físico em adolescentes jogadores de futebol da categoria infantil de um time profissional da cidade de Salvador. Métodos: Estudo prospectivo realizado durante o período de maio de 2004 a outubro de 2005 em 27 atletas do sexo masculino com a idade variando de 13 a 16 anos e um grupo de 11 adolescentes com prática esportiva a nível escolar. O grupo de atletas foi submetido em duas oportunidades e o grupo controle em uma, á avaliação clínica e a exames complementares como o ECG, Teste ergométrico, Ecocardiograma e a Espirometria. Estatística: a diferença entre as médias foi avaliada com o T de Teste Student para amostra pareadas. Resultados: Quando comparadas as duas avaliações funcionais (Anos 2004 a 2005 dos atletas, detectou-se um aumento significativo do V02 (p<0,009). A comparação entre os dois grupos mostrou um V02 superior nos jogadores (p<0,004). a comparação com os dois ecocardiogramas de 2004 e 2005 feitos nos atletas mostrou um aumento nos diâmetros das câmaras cardíacas (p<0,002), como também na massa ventricular (p<0,007). Já as espessuras musculares das paredes do ventrículo esquerdo não mostram uma diferença significativa (p<0,06). a comparação dos achados ecocardiográficos entre os dois grupos não demonstrou diferença em nenhuma das variáveis estudadas (p<0,4). Conclusão: A comparação das duas avaliações dos atletas mostrou um aumento significativo da superfície corporal, do V02, das câmaras cardíacas e massa ventricular. O estudo realizado com esta amostra sugere que o treinamento físico realizado nos atletas de futebol não causa um aumento significativo da massa ventricular ou das câmaras cardíacas quando comparado com outros esportes.

To evaluate the cardiovascular effect of regular physical training in adolescent football players of infantile category of professional teams of Salvador city. Methods: Prospective study carried from May 2004 to October 2005, in 27 men athletes, age ranging from 13 to 16 years, matched to 11 adolescents with exercise training by school level. The athlete group was evaluated twice and the control once clinical evaluation and the complementary examination as ECG, Ergometric Test, Echocardiogram and Spirometry. Statistics: The difference between averages was a significant of V02 (p<0,009). The comparison between group showed higher V02 in athletes (p<0,004). The comparasion of the two echocardiograms (Years 2004, 2005) in athletes showed an increase in the cardiac chambers diameters (p<0,002), as well as in the ventricular mass (p<0,007). Muscular thicknesses of the left ventricle walls did not show difference (p<0,6). The comparison of echocardiographic findings between groups did not demonstrate difference in none of the studied variables (p<0,4). Conclusion: The comparison of the two evaluations of the thçetes showed a significant increase of the corporal surface, V02, cardiac chambers and ventricular mass. the study suggests that physical training in the soccer athletes do not lead to significant of the ventricular mass or cardiac chambers when compared with other sports.