Could Mycobacterium leprae Infection Be an Occupational Disease? A Survey in Healthcare Workers From an Endemic Area in the Amazonian Region.

A serologic survey was conducted to evaluate the prevalence of Mycobacterium leprae infection among healthcare workers and associated factors. Of 280 workers, 26 (9.3%) were positive using immunoglobulin M serology for PGL-I M. leprae antigen. Exposure to leprosy patients in the workplace was significantly associated with seropositivity (P=.044).

Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial / Otimização da Adesão Terapêutica Pós-alta Hospitalar de Pacientes com DCV: Ensaio Clínico Randomizado - Estudo Piloto

Background: Effective interventions to improve medication adherence are usually complex and expensive. Objective: To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD. Method: A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates. Results: 61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups. Conclusion: The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes. .

Fundamento: Intervenções eficazes para melhorar a adesão à terapia medicamentosa são geralmente complexas e caras. Objetivo: Avaliar o impacto de uma intervenção de baixo custo delineada para melhorar a adesão à medicação e desfechos clínicos em pacientes no pós-alta com DCV. Método: Um ECR - estudo piloto foi realizado em um hospital-escola. A intervenção foi baseada na escala de adesão terapêutica de Morisky de quatro itens - MMAS-4. O desfecho primário medido foi a avaliação da adesão à medicação utilizando a MMAS de oito itens no momento da alta, 1 mês após a alta hospitalar, e a reavaliação 1 ano depois da alta. Outros resultados incluíram reinternação e as taxas de mortalidade. Resultados: Foram randomizados 61 pacientes para grupos de intervenção (n = 30) e controle (n = 31). A idade média dos pacientes foi de 61 anos (DP 12,73), 52,5% eram do sexo masculino e 57,4% eram casados ou moravam com parceiro (a). O número médio de medicamentos prescritos por paciente foi de 4,5 (DP 3,3). A adesão à medicação foi correlacionada à intervenção (p = 0,04) e após 1 mês, 48,4% dos pacientes do grupo controle e 83,3% no grupo de intervenção foram considerados aderentes. No entanto, essa diferença diminuiu depois de 1 ano, quando a adesão foi de 34,8% e 60,9%, respectivamente. As taxas de readmissão e de mortalidade foram relacionadas à baixa adesão nos dois grupos. Conclusão: A intervenção com base em um instrumento validado de auto-relato do paciente para avaliar a adesão é um método potencialmente eficaz para melhorar o comportamento aderente e pode ser usado com sucesso como uma ferramenta para orientar o aconselhamento da adesão na visita ...

Improving post-discharge medication adherence in patients with CVD: a pilot randomized trial.

BACKGROUND: Effective interventions to improve medication adherence are usually complex and expensive. OBJECTIVE: To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD. METHOD: A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates. RESULTS: 61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups. CONCLUSION: The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.

Comportamiento de los accidentes en menores de 15 años / Behavior of Accidents in Children Under 15 Years

Se realizó un estudio observacional analítico longitudinal y retrospectivo en el Policlínico Universitario Marta Martínez Figuera del municipio Güines, provincia La Habana. La población objeto de estudio estuvo integrada por 878 niños menores de 15 años que sufrieron accidentes en el transcurso de un año. La incidencia global de accidentes fue de 21,5 por ciento. El sexo masculino fue el más afectado con un 57,6 por ciento. Los grupos etáreos menores de 1 año y de 1 a 4 años presentaron Incidencias específicas iguales, significativamente superiores al grupo de 5 a 14 años. Los factores lesionantes que predominaron fueron los traumatismos y estuvieron presentes en todos los grupos etáreos con un 86,4 por ciento presentando un incremento en los aportes proporcionales a medida que se incrementa la edad y la mayoría de los accidentes ocurrieron en el hogar (AU)

It was conducted a longitudinal, observational and retrospective study, in Marta Martínez Figuera University Polyclinic in Güines Municipality, Havana province. The study population consisted of 878 children under 15 years who suffered accidents in the course of a year. The overall incidence of accidents was 21,5 per cent. The masculine sex was the most affected with 57,6 per cent. The age groups under 1 year and 1-4 years had equal specific incidences, significantly higher than the group of 5-14 years. Injurious factors that predominated were traumatisms and were present in all age groups with 86,4 per cent showing an increase in the proportional contributions as age increases and most accidents occurred at home (AU)

Lugares y síntomas justo antes del accidente en pacientes con fibromialgia primaria / Places and symptoms just before the accident in patients with primary fibromyalgia

Se realizó un estudio observacional analítico retrospectivo longitudinal con grupo control en ambos sexos y más de 15 años de edad a través de una tabla de números aleatorios a los pacientes diagnosticados de fibromialgia primaria en las consultas de reumatología de los Policlínicos Docentes Luis Li Tregent y Martha Martínez Figueras del Municipio Güines en el período comprendido desde el 1ero de septiembre del 2006 al 31 de mayo del 2007. La edad osciló entre los 35 y 44 años, la frecuencia de accidentes en pacientes con fibromialgia primaria fue mayor que en el grupo control y aumentó a medida que pasó el tiempo de aparición de los síntomas. El sueño no reparador y no alcanzar el sueño hasta pasado una hora y más de haberse acostado se relacionó significativamente con una mayor frecuencia de accidentes. La aparición de los síntomas cuatro años atrás, se relacionó significativamente con el número de accidentes en el último año. No existió relación significativa entre los síntomas justo antes del accidente y el lugar donde ocurrió. Fue significativa la relación de la aparición de los síntomas desde hace cuatro años y más con la afectación laboral en el último año (AU)

It was carried out a retrospective longitudinal, analytical and observational study with control group in both sexes and more than 15 years of age through a table of random numbers to patients diagnosed with primary fibromyalgia in rheumatology consultations of Luis Li Tregent and Martha Martinez Figueras teaching polyclinics in Güines Municipality in the period from September 1st 2006 to May 31st, 2007. The age ranged between 35 and 44 years, the frequency of accidents in primary fibromyalgia patients was higher than in the control group and it increased as time passed from the onset of symptoms. The non-restful sleep and not getting asleep after more than an hour of lying in bed it was significantly associated with greater frequency of accidents in the past year. There was no significant relationship between symptoms just before the accident and the place. It was significant the relationship between the onset of symptoms since four years and more with the work affectation in the past year

Efecto del cinc sobre el desarrollo y el crecimiento en ratas con crecimiento intrauterino retardado / Effect of zinc on the development and growth in rats with intrauterine growth retardation

Se realizó un estudio experimental para determinar el efecto del sulfato de cinc sobre el crecimiento postnatal del encéfalo en crías de ratas con Crecimiento Intrauterino Retardado. En esta investigación se utilizaron 20 ratas hembras de la línea Sprague Dawley, a las que se les realizó la ligadura de las arterias de ambos cuernos uterinos el día 16 de la gestación (modelo experimental de crecimiento intrauterino retardado). Cien crías se obtuvieron por vía vaginal el día 21 de la preñez y se asignaron aleatoriamente a dos grupos: 50 experimental y 50 control. A las crías del grupo experimental se les administró por vía oral con cánula esofágica una solución de sulfato de cinc al 1 por ciento (5 mg/ kg de peso corporal, equivalente a dos gotas dos veces al día) al nacer, a los 3 y a los 7 días. Por su parte, a las crías del grupo control se les suministró una solución de cloruro de sodio 0,9 por ciento, utilizando iguales vía y momentos de administración que en el grupo experimental. Entre los principales resultados se determinó el efecto positivo del sulfato de cinc sobre el peso, talla y diámetro anteroposterior y biparietal de los cráneos a los 7 y 14 días de nacidas con diferencias estadísticamente significativas (p<0,005)(AU)

An experimental study was carried out to determine the effect of zinc sulfate on the postnatal encephalo growth in a rat litter with intrauterine growth retardation (IUGR). Twenty female rats of the line Sprague Dawley were used in these investigation, which underwent artery ligation of both uterine horns on the 16th day of gestation (experimental model of intrauterine growth retardation). A hundred rat's young were obtained via vagina on the 21st day of pregnancy and they were randomly assigned to two groups: 50 experimental and 50 control. A 1per cent zinc sulfate solution was orally administered with esophagic cannula to the litter of the experimental group (5 mg/ kg of body weight, equivalent to two drops twice a day) at 3 and 7 days of birth. A 0,9 per cent sodium chloride solution was administered to the the litter of the control group using the same via, and moments of administration than in the experimental group. Among the main results it was determined the positive effect of zinc sulfate on the weight, size and antero-posterior and biparietal diameter of the craniums at 7 and 14 days of birth with significant statistical differences (p<0,005)(AU)