ABSTRACT
Objetivo: Avaliar o risco de suicídio e a existência de comportamento suicida entre acadêmicos nos estágios inicial, intermediário e final do curso de Medicina de uma universidade particular e analisar os fatores de risco possivelmente associados à ideação suicida nessa população. Materiais e métodos: Foram analisados, em estudo transversal, 376 estudantes. Todos os participantes responderam questionário autopreenchível, por meio da plataforma eletrônica Google Forms, composto por 3 seções: perguntas sobre questões pessoais, perguntas do Questionário de Comportamento Suicida Revisado (Suicide Behavior Questionnaire Revised: SBQ-R) e do Inventário de Ideação Suicida Positiva e Negativa (Positive and Negative Suicide Ideation: PANSI). Resultados: 34% dos alunos eram do 1º ano, outros 34% do 3º ano e 32%, do 6º ano. 71,8% da população do estudo é composta pelo sexo feminino e 39,6% possui idade entre 21 e 24 anos. Na classificação de risco de suicídio segundo o PANSI, 31,7% dos estudantes apresentaram médio risco e 5,3%, alto risco. Na análise por etapa do curso, o 3º ano apresentou-se com maior porcentagem em alto risco (70,0%). De acordo com o SBQ-R, 37,2% dos estudantes da população total apresentaram comportamento suicida. Dentre as variáveis analisadas, orientação sexual, história de bullying na infância, conflito com responsáveis, história familiar de transtorno mental, uso de drogas ilícitas, história de violência sexual e ansiedade autorreferida foram consideradas como fatores de risco para suicídio na população total e na subanálise feita por ano de faculdade. Conclusão: A população do estudo apresenta aumento das taxas de ideação e comportamento suicida em relação a população geral. Assim, é necessária a implantação de medidas dentro das universidades para promover a saúde mental e diminuir aspectos estressantes sobre os acadêmicos. [au]
Objective : The purpose of this study is to assess the risk of suicide and the existence of suicidal behavior among academics in the early, intermediate and final stages of a private medical school, and also to analyze risk factors possibly associated with suicidal ideation in this population. Methods: This is a cross-sectional study with 376 medical students. All the participants answered a self-fillable questionnaire through the electronic platform Google Forms composed of 3 sections: questions about personal issues; questions of the Suicide Behavior Questionnaire Revised (SBQ-R); and of the Positive and Negative Suicide Ideation (PANSI) Inventory. Results: 34% of the students were in the 1st year of graduation, 34% in the 3rd year, and 32%, in the 6thyear. 71.8% of the population is female and 39.6% are between 21 and 24 years old. In the suicide risk classification according to PANSI, 31.7% of the students were in the medium risk group and 5.3% in high risk group. In the analysis per year, the 3rd year showed a greater percentage of high risk (70.0%). According to the SBQ-R classification of suicide risk, 37.2% of students out of the total population revealed suicidal behavior. Among the analyzed variables, sexual orientation, history of childhood bullying, domestic conflict, presence of mental disorders in family, use of illicit drugs, history of sexual violence and self-reported anxiety were considered as risk factors for suicide. The highlighted results revealed the same pattern when analyzed per year of college. Conclusion: The survey population has increased rates of suicidal negative ideation and behavior compared to the general population. Therefore, it is necessary to implement programs in colleges to promote a greater state of well-being and reduce stressful aspects in academics. [au]
ABSTRACT
INTRODUCTION: Rotation thromboelastometry (ROTEM®) can be used for hypercoagulability evaluation. Cushing's syndrome (CS) is associated with hypercoagulability; however, ROTEM® has never been evaluated in this setting. OBJECTIVE: To evaluate hypercoagulability in CS using ROTEM® and to correlate these parameters with coagulation markers and with the presence of deep vein thrombosis. DESIGN AND METHODS: Thirty patients with active CS (26 women) and 30 controls matched for age, sex, body mass index, diabetes mellitus, arterial hypertension, ABO blood group and smoking were included. We measured levels of activated partial thromboplastin time (aPTT), platelets, fibrinogen, D-dimer, factor VIII (FVIII), von Willebrand factor (vWF) and C-reactive protein. ROTEM® was used to evaluate the intrinsic (INTEM), extrinsic (EXTEM) and fibrinogen (FIBTEM) pathways. Doppler ultrasonography was performed to search for lower limbs deep vein thrombosis. RESULTS: INTEM clotting time using ROTEM® was shorter in patients than in controls (P = 0·04). Other ROTEM® parameters were not different. Mean aPTT was shorter in patients than in controls (P = 0·001). The FVIII, vWF and D-dimer levels were higher in patients than in controls (P = 0·001, 0·001 and 0·02, respectively). Obese CS patients presented higher levels of platelets and alterations in maximum clot formation (MCF), alpha angle and maximum speed of clot formation of INTEM (P = 0·03, 0·02 and 0·02, respectively) and an increase in the MCF of FIBTEM (P = 0·02). No deep vein thrombosis was found. CONCLUSIONS: Although FVIII and vWF were abnormal in CS patients, only the initiation clot formation was different in the ROTEM® methodology and no deep vein thrombosis was found.
