RESUMEN
SETTING: Few studies have investigated factors associated with defaulting from anti-tuberculosis (TB) therapy in hospital settings. OBJECTIVE: To identify the factors associated with defaulting from treatment among TB in-patients in Rio de Janeiro city, Brazil. DESIGN: Case-control study. METHODS: All study participants initiated anti-tuberculosis treatment in a teaching hospital. A defaulting case was defined as a person who did not return for anti-tuberculosis medications after 60 days. Cases and controls were interviewed by a trained health care worker using a standardized form. RESULTS: From 1 January to 31 December 1997, 228 TB cases were registered. After a review of the medical records, 39 were excluded. Household visits were performed in 189 patients; 46 subjects were identified as cases and 117 as controls. Defaulting from anti-tuberculosis treatment was observed in 66 cases (28.9%) before and in 46 (20.2%) after a home visit. After multivariate analysis, the strongest predictors of defaulting from treatment were: 1) returning card not provided (OR 0.099; 95%CI 0.008-1.2; P = 0.07), 2) not feeling comfortable with a doctor (OR 0.16; 95%CI 0.33-0.015; P = 0.001), and 3) blood pressure not measured (OR 0.072; 95%CI 0.036-0.79; P = 0.024). CONCLUSIONS: In this hospital, the factors associated with defaulting from anti-tuberculosis treatment highlight the necessity for a structured TB Control Program. It is expected that the implementation of such a program, pursuing specific approaches, should enhance completion of anti-tuberculosis treatment and cure.
Asunto(s)
Negativa del Paciente al Tratamiento , Tuberculosis/tratamiento farmacológico , Brasil , Estudios de Casos y Controles , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Servicio Ambulatorio en Hospital , Evaluación de Procesos, Atención de Salud , Factores de Riesgo , Factores SocioeconómicosRESUMEN
Foi analisando o efeito da aplicaçäo do ultra-som terapêutico em lesäo muscular aguda. Foi realizada uma lesäo por esmagamento no músculo reto da coxa direita e esquerda em 26 coelhos (52 músculos) da raça Nova Zelândia, com peso médio de 2,2 kg. Após 3dias da lesäo, os animais foram tratados em um lado com ultra-som terapêutico com tipo de onda pulsada, razäo 1:5, frequência de 1 MHz e intensidade de 0,5 W/cm2 por 5 minutos, durante 10 dias consecutivos. O músculo contralateral serviu como controle e sofreu apenas esmagamento. Após 3 dias do término da aplicaçäo, os animais foram sacrificados e os músculos submetidos a ensaios de traçäo na máquina universal de ensaio, com célula de carga de 2000 kgf e velocidade de 4,5 mm/minuto. Foram analisados os resultados dos ensaios de 36 músculos (18 animais), mostrando que os músculos tratados pelo ultra-som apresentaram diferença significativa na deformaçäo máxima, carga e deformaçäo no limite de proporcionalidade, e na energia na fase de deformaçäo elástica. Estes resultados sugerem que a aplicaçäo do ultra-som terapêutico possa melhorar a qualidade da reparaçäo da lesäo muscular aguda.
