Accuracy of the mid-trimester ultrasound scan in the detection of fetal congenital anomalies in a reference center in Northeastern Brazil.

OBJECTIVE: To assess the performance of a basic mid-trimester fetal ultrasound scan protocol for the diagnosis of congenital anomalies by calculating its accuracy, sensitivity, and specificity. METHODS: This longitudinal cohort study involved singleton pregnant women recruited at the mid-trimester fetal ultrasound scan through the postnatal evaluation of congenital anomalies. Pregnant women who underwent a routine mid-trimester ultrasound scan for fetal abnormalities at 20-24 weeks of gestation were enrolled in this study. After childbirth, we searched their medical records on gestational outcomes and neonatal examination records, as well as complementary medical examinations, to assess the ultrasound performance in diagnosing congenital malformations. RESULTS: We included 967 pregnant women in the study population, and prenatal ultrasound scans detected congenital abnormalities in 67 fetuses (6.9%). Among newborns, 54 (5.6%) were postnatally diagnosed with malformations. The overall sensitivity and specificity of the mid-trimester ultrasound scan for congenital malformation detection were 61.1% and 96.3%, respectively, with an accuracy of 94.3% (p < .05). CONCLUSION: The mid-trimester ultrasound scan had good accuracy in the detection of congenital malformations, although the overall sensitivity does not support it as the only screening test for anomalies throughout pregnancy.

Evaluation of the quality of life of patients with chronic rhinosinusitis by means of the SNOT-22 questionnaire.

UNLABELLED: SNOT-22 is a questionnaire used to assess the quality of life of patients with chronic rhinosinusitis (CRS). It is broadly utilized to assess the surgical treatment of patients with CRS. In Brazil there are no studies utilizing the SNOT-22 in non-surgical patients. OBJECTIVE: To use the SNOT-22 questionnaire to assess the quality of life of individuals with chronic rhinosinusitis without previous surgery and with indication for clinical treatment. METHOD: Prospective and analytical cohort and cross-sectional controlled clinical trial. We had 2 groups, one made up of patients with CRS and another one with adult individuals without the sinonasal disease, consecutively seen in an otorhinolaryngology clinic in Salvador, Bahia, between August of 2011 and June of 2012. They all filled out the Consent Form, a registration form and the SNOT-22. RESULTS: 176 patients, 78 with CRS and 98 without the disease, the groups matched as far as gender, medication and respiratory allergies were concerned. Age was 40.7 + 13.5 years in the study group and 37.8 + 12.9 in controls (p = 0.26). The SNOT-22 median value in the study group was 53, compared to 8 in the control group (p = 0.001). CONCLUSION: Chronic rhinosinusitis reduces the quality of life of patients, according to the SNOT-22 questionnaire.

Avaliação da qualidade de vida de pacientes com rinossinusite crônica por meio de questionário SNOT-22 / Evaluation of the quality of life of patients with chronic rhinosinusitis by means of the SNOT-22 questionnaire

O SNOT-22 é um questionário para avaliação da qualidade de vida dos pacientes com rinossinusite crônica (RSC). Ele é largamente utilizado para avaliação do tratamento cirúrgico na RSC. No Brasil, não existem estudos utilizando o SNOT-22 em pacientes não cirúrgicos. OBJETIVO: Avaliar por meio do questionário SNOT-22 a qualidade de indivíduos com rinossinusite crônica sem cirurgia prévia e com indicação de tratamento clínico. MÉTODO: Estudo clínico prospectivo e analítico, tipo corte transversal com controle. Foram dois grupos, sendo um constituído de pacientes com RSC e outro por indivíduos sem doença nasossinusal, adultos, atendidos consecutivamente num serviço de otorrinolaringologia em Salvador, Bahia, de agosto de 2011 a junho de 2012. Todos preencheram o termo de consentimento, um cadastro e o SNOT-22. RESULTADOS: Cento e setenta e seis pacientes, sendo 78 com RSC, e 98 sem a doença. Os grupos foram homogêneos quanto ao gênero, alergias medicamentosas e respiratórias. A idade foi de 40,7 + 13,5 anos no grupo caso e 37,8 + 12,9 no controle (p = 0,26). A mediana do SNOT-22 no grupo caso foi 53 contra 8 do controle (p = 0,001). CONCLUSÃO: A rinossinusite crônica reduz a qualidade de vida do paciente de acordo com o questionário SNOT-22.

SNOT-22 is a questionnaire used to assess the quality of life of patients with chronic rhinosinusitis (CRS). It is broadly utilized to assess the surgical treatment of patients with CRS. In Brazil there are no studies utilizing the SNOT-22 in non-surgical patients. OBJECTIVE: To use the SNOT-22 questionnaire to assess the quality of life of individuals with chronic rhinosinusitis without previous surgery and with indication for clinical treatment. METHOD: Prospective and analytical cohort and cross-sectional controlled clinical trial. We had 2 groups, one made up of patients with CRS and another one with adult individuals without the sinonasal disease, consecutively seen in an otorhinolaryngology clinic in Salvador, Bahia, between August of 2011 and June of 2012. They all filled out the Consent Form, a registration form and the SNOT-22. RESULTS: 176 patients, 78 with CRS and 98 without the disease, the groups matched as far as gender, medication and respiratory allergies were concerned. Age was 40.7 + 13.5 years in the study group and 37.8 + 12.9 in controls (p = 0.26). The SNOT-22 median value in the study group was 53, compared to 8 in the control group (p = 0.001). CONCLUSION: Chronic rhinosinusitis reduces the quality of life of patients, according to the SNOT-22 questionnaire.

Sedação com sufentanil e clonidina em pacientes submetidos a cateterismo cardíaco / Sedation with sufentanil and clonidine in patients undergoing heart catheterization / Sedación con sufentanil y clonidina en pacientes sometidos a cateterismo cardíaco

FUNDAMENTO: A sedação para a realização de cateterismo cardíaco tem sido alvo de preocupação. Benzodiazepínicos, agonistas alfa-2 adrenérgicos e opioides são utilizados para esse fim, entretanto, cada um destes medicamentos possui vantagens e desvantagens. OBJETIVO: Avaliar a eficácia do sufentanil e da clonidina como sedativos em pacientes submetidos a cateterismo cardíaco, observando o impacto dos mesmos sobre os parâmetros hemodinâmicos e respiratórios, a presença de efeitos colaterais, além da satisfação do paciente e do hemodinamicista com o exame. MÉTODOS: Trata-se de um ensaio clínico prospectivo, duplo-cego, randomizado e controlado, que envolveu 60 pacientes que receberam 0,1 µg/kg de sufentanil ou 0,5 µg/kg de clonidina antes da realização do cateterismo cardíaco. O escore de sedação segundo a escala de Ramsay, a necessidade de utilização de midazolam, os efeitos colaterais, os parâmetros hemodinâmicos e respiratórios foram registrados, sendo os dados analisados em 06 diferentes momentos. RESULTADOS: O comportamento da pressão arterial, da frequência cardíaca e da frequência respiratória foi semelhante nos dois grupos, entretanto, no momento 2, os pacientes do grupo sufentanil (Grupo S) apresentaram menor escore de sedação segundo a escala de Ramsay, e a saturação periférica da oxihemoglobina foi menor que o grupo clonidina (Grupo C) no momento 6. Os pacientes do Grupo S apresentaram maior incidência de náusea e vômito pós-operatório que os pacientes do Grupo C. A satisfação dos pacientes foi maior no grupo clonidina. Os hemodinamicistas mostraram-se satisfeitos nos dois grupos. CONCLUSÃO: O sufentanil e a clonidina foram efetivos como sedativos em pacientes submetidos a cateterismo cardíaco.

BACKGROUND: Sedation for heart catheterization has been a cause for concern. Benzodiazepines, alpha-2 adrenergic agonists and opioids are used for this purpose. However, each drug has advantages and disadvantages. OBJECTIVE: To evaluate the efficacy of sufentanil and clonidine as sedative in patients undergoing heart catheterization, observing their impact on hemodynamic and respiratory parameters, the presence of side effects and satisfaction of the patient and interventional cardiologist with the examination. METHODS: This is a prospective, double-blind, randomized and controlled clinical trial involving 60 patients who received 0.1 µg/kg of sufentanil or 0.5 µg/kg of clonidine before heart catheterization. The score of sedation according to the Ramsay scale, the need for use of midazolam, side effects and hemodynamic and respiratory parameters were recorded, with the data being analyzed at 06 different moments. RESULTS: The behavior of blood pressure, heart rate and respiratory rate was similar in both groups, but, at moment 2, the patients in the sufentanil group (Group S) had a lower sedation score on the Ramsay scale, and the peripheral oxyhemoglobin saturation was lower than in the clonidine group (Group C) at time 6. Patients in Group S had higher incidence of nausea and vomiting after surgery than patients in Group C. Patient satisfaction was higher in the clonidine group. The interventional cardiologists were satisfied in both groups. CONCLUSION: Sufentanil and clonidine were effective as sedative in patients undergoing heart catheterization.

FUNDAMENTO: La sedación para la realización de cateterismo cardíaco ha sido blanco de preocupación. Benzodiazepínicos, agonistas alfa-2 adrenérgicos y opioides son utilizados para ese fin, entre tanto, cada uno de estos medicamentos posee ventajas y desventajas. OBJETIVO: Evaluar la eficacia del sufentanil y de la clonidina como sedativos en pacientes sometidos a cateterismo cardíaco, observando el impacto de los mismos sobre los parámetros hemodinámicos y respiratorios, la presencia de efectos colaterales, además de la satisfacción del paciente y del hemodinamista con el examen. MÉTODOS: Se trata de un ensayo clínico prospectivo, doble ciego, randomizado y controlado, que incluyó 60 pacientes que recibieron 0,1 µg/kg de sufentanil o 0,5 µg/kg de clonidina antes de la realización del cateterismo cardíaco. El escore de sedación según la escala de Ramsay, la necesidad de utilización de midazolam, los efectos colaterales, los parámetros hemodinámicos y respiratorios fueron registrados, siendo los datos analizados en 6 diferentes momentos. RESULTADOS: El comportamiento de la presión arterial, de la frecuencia cardíaca y de la frecuencia respiratoria fue semejante en los dos grupos, entre tanto, en el momento 2, los pacientes del grupo sufentanil (Grupo S) presentaron menor escore de sedación según la escala de Ramsay, y la saturación periférica de la oxihemoglobina fue menor que el grupo clonidina (Grupo C) en el momento 6. Los pacientes del Grupo S presentaron mayor incidencia de náusea y vomito post operatorio que los pacientes del Grupo C. La satisfacción de los pacientes fue mayor en el grupo clonidina. Los hemodinamistas se mostraron satisfechos en los dos grupos. CONCLUSIÓN: El sufentanil y la clonidina fueron efectivos como sedativos en pacientes sometidos a cateterismo cardíaco.

Sedation with sufentanil and clonidine in patients undergoing heart catheterization.

BACKGROUND: Sedation for heart catheterization has been a cause for concern. Benzodiazepines, alpha-2 adrenergic agonists and opioids are used for this purpose. However, each drug has advantages and disadvantages. OBJECTIVE: To evaluate the efficacy of sufentanil and clonidine as sedative in patients undergoing heart catheterization, observing their impact on hemodynamic and respiratory parameters, the presence of side effects and satisfaction of the patient and interventional cardiologist with the examination. METHODS: This is a prospective, double-blind, randomized and controlled clinical trial involving 60 patients who received 0.1 µg/kg of sufentanil or 0.5 µg/kg of clonidine before heart catheterization. The score of sedation according to the Ramsay scale, the need for use of midazolam, side effects and hemodynamic and respiratory parameters were recorded, with the data being analyzed at 06 different moments. RESULTS: The behavior of blood pressure, heart rate and respiratory rate was similar in both groups, but, at moment 2, the patients in the sufentanil group (Group S) had a lower sedation score on the Ramsay scale, and the peripheral oxyhemoglobin saturation was lower than in the clonidine group (Group C) at time 6. Patients in Group S had higher incidence of nausea and vomiting after surgery than patients in Group C. Patient satisfaction was higher in the clonidine group. The interventional cardiologists were satisfied in both groups. CONCLUSION: Sufentanil and clonidine were effective as sedative in patients undergoing heart catheterization.

Bacterial contamination in milk kitchens in pediatric hospitals in Salvador, Brazil.

Milk may represent an important source of infectious agents to hospitalized pediatric patients. To describe the bacterial microflora isolated from the hands, stools, pharynx of all workers at milk kitchens in pediatric hospitals in the city of Salvador, Brazil, as well as in the formulas prepared by them, we carried out this cross-sectional study with all 91 workers from the 20 milk kitchens of all the public and private hospitals in Salvador, Brazil. Hand and pharynx swabs and stool samples were collected from all workers, as well as samples of the milk and formulas delivered by the kitchens. All samples were cultured for the detection of pathogenic and non-pathogenic bacteria. Pathogenic bacteria were isolated from 20 (22.0%) and 8 (8.8%) cultures of the hands and pharynx of the workers, respectively. No pathogenic bacteria were isolated from stool samples. Pathogenic bacteria were isolated from 17 (18.7%) milk samples. The prevalence of pathogenic bacteria in hand swabs was significantly higher in workers from public (37.8%) than from private (6.5%) hospitals (prevalence ratio [PR]=5.8; p<0.01). Pathogenic bacteria were isolated from two (4.4%) workers from public hospitals and six (13.0%) workers from private hospitals (PR=0.38; p=0.27). Pathogenic bacteria were isolated from 11 (24.4%) milk samples from public hospitals and 6 (13.0%) from private hospitals (PR=1.9; p=0.16). A high prevalence of contamination was found, mainly on the hands of workers on units for manipulation of milk. Preventive efforts should be intensified and focus primarily on effective hand washing and continuous work supervision.

Bacterial contamination in milk kitchens in pediatric hospitals in Salvador, Brazil

Milk may represent an important source of infectious agents to hospitalized pediatric patients. To describe the bacterial microflora isolated from the hands, stools, pharynx of all workers at milk kitchens in pediatric hospitals in the city of Salvador, Brazil, as well as in the formulas prepared by them, we carried out this cross-sectional study with all 91 workers from the 20 milk kitchens of all the public and private hospitals in Salvador, Brazil. Hand and pharynx swabs and stool samples were collected from all workers, as well as samples of the milk and formulas delivered by the kitchens. All samples were cultured for the detection of pathogenic and non-pathogenic bacteria. Pathogenic bacteria were isolated from 20 (22.0 percent) and 8 (8.8 percent) cultures of the hands and pharynx of the workers, respectively. No pathogenic bacteria were isolated from stool samples. Pathogenic bacteria were isolated from 17 (18.7 percent) milk samples. The prevalence of pathogenic bacteria in hand swabs was significantly higher in workers from public (37.8 percent) than from private (6.5 percent) hospitals (prevalence ratio [PR]=5.8; p<0.01). Pathogenic bacteria were isolated from two (4.4 percent) workers from public hospitals and six (13.0 percent) workers from private hospitals (PR=0.38; p=0.27). Pathogenic bacteria were isolated from 11 (24.4 percent) milk samples from public hospitals and 6 (13.0 percent) from private hospitals (PR=1.9; p=0.16). A high prevalence of contamination was found, mainly on the hands of workers on units for manipulation of milk. Preventive efforts should be intensified and focus primarily on effective hand washing and continuous work supervision.

Prevenção da transmissão vertical do HIV: atitude dos obstetras em Salvador, Brasil / Prevention of HIV vertical transmission: obstetricians'atitude in Salvador, Brasil

OBJETIVO: avaliar as atitudes e conhecimento dos obstetras das maternidades públicas da cidade de Salvador (MPS) sobre as recomendações do Ministério da Saúde para a profilaxia da transmissão vertical do vírus humano da imunodeficiência (HIV) e terapia antiretroviral em gestantes. Avaliou-se também a influência das condições de trabalho, disponibilidade da testagem rápida e da terapia antiretroviral em relação à aplicação destas recomendações. MÉTODOS: realizou-se um estudo de corte transversal entre agosto e novembro de 2005, envolvendo 129/152 (85 por cento) dos obstetras de todas as MPS. Utilizou-se como instrumento um questionário anônimo, estruturado e auto-explicativo, com questões sobre as características da população, condições de trabalho e disponibilidade de insumos, conhecimento e atitudes relacionadas ao aconselhamento e testagem para o HIV e condutas com as pacientes (uso da zidovudina (AZT), reconhecimento de fatores de risco, escolha e manejo da via de parto e cuidados no puerpério). RESULTADOS: dos obstetras, 69 por cento referiram conhecer integralmente as recomendações do Ministério da Saúde; 90,7 por cento concordaram com a solicitação compulsória da testagem rápida para o HIV; 63,6 por cento escolheram a cesariana para via de parto; 38 por cento contra-indicaram o parto por via vaginal; 37,5 por cento recomendaram isolamento das pacientes soropositivas e 58,1 por cento indicaram laqueadura tubária. A maioria (90 por cento) dos sujeitos referiram a existência de fatores prejudiciais à aplicabilidade das recomendações, sendo que os mais apontados foram a realização inadequada e a indisponibilidade das informações do pré-natal na admissão. Embora a testagem rápida estivesse disponível, apenas um terço dos entrevistados afirmou que o resultado estava sempre disponível em tempo hábil. CONCLUSÕES: algumas atitudes relacionadas à assistência à gestante com HIV foram discordantes das recomendações do Ministério da Saúde. Na...

PURPOSE: to evaluate the attitudes and knowledge of obstetricians from public maternities in Salvador city (PMS) about the recommendations from the Health Ministry (HM) for the prophylaxis of vertical transmission of HIV (VTH) and antiretroviral therapy in pregnant women. The influence of working conditions, availability for quick testing and antiretroviral therapy has also been evaluated concerning the application of these recommendations. METHODOLOGY: a transversal study from August to November 2005, involving 129/152 (85 percent) of the obstetricians from all the PMS. The instrument used was a structured and self-explanatory anonymous questionnaire, with questions on the population characteristics, working conditions and availability of material, knowledge and attitudes related to HIV counseling and testing, and proceedings with the patients (use of AZT, recognition of risk factors, choice and management of type of delivery and puerperal care). RESULTS: 69 percent of the obstetricians stated they knew integrally the HM recommendations, 90.7 percent agreed with the compulsory request of quick testing for HIV; 63.6 percent chose the caesarean section as the type of delivery; 38 percent were against normal delivery; 37.5 percent recommended isolation of positive serum patients and 58.1 percent indicated tubal ligation. Most of them (90 percent) mentioned the existence of factors unfavorable to the recommendations applicability, and among those factors, the most pointed were the inadequate way the pre-natal admission was done and the lack of information at that occasion. Even though the quick testing was available, only one third of the interviewees stated that the result was always available in due time. CONCLUSIONS: some attitudes related to the assistance to the pregnant women with HIV were incompatible with the HM recommendations. According to the interviewees, the inadequacy of the pre-natal plus the non-availability of quick...

[Prevention of HIV vertical transmission: obstetricians' attitude in Salvador, Brazil]. / Prevenção da transmissão vertical do HIV: atitude dos obstetras em Salvador, Brasil.

PURPOSE: to evaluate the attitudes and knowledge of obstetricians from public maternities in Salvador city (PMS) about the recommendations from the Health Ministry (HM) for the prophylaxis of vertical transmission of HIV (VTH) and antiretroviral therapy in pregnant women. The influence of working conditions, availability for quick testing and antiretroviral therapy has also been evaluated concerning the application of these recommendations. METHODOLOGY: a transversal study from August to November 2005, involving 129/152 (85%) of the obstetricians from all the PMS. The instrument used was a structured and self-explanatory anonymous questionnaire, with questions on the population characteristics, working conditions and availability of material, knowledge and attitudes related to HIV counseling and testing, and proceedings with the patients (use of AZT, recognition of risk factors, choice and management of type of delivery and puerperal care). RESULTS: 69% of the obstetricians stated they knew integrally the HM recommendations, 90.7% agreed with the compulsory request of quick testing for HIV; 63.6% chose the caesarean section as the type of delivery; 38% were against normal delivery; 37.5% recommended isolation of positive serum patients and 58.1% indicated tubal ligation. Most of them (90%) mentioned the existence of factors unfavorable to the recommendations applicability, and among those factors, the most pointed were the inadequate way the pre-natal admission was done and the lack of information at that occasion. Even though the quick testing was available, only one third of the interviewees stated that the result was always available in due time. CONCLUSIONS: some attitudes related to the assistance to the pregnant women with HIV were incompatible with the HM recommendations. According to the interviewees, the inadequacy of the pre-natal plus the non-availability of quick testing, influence negatively the applicability of VTH prophylaxis recommendations.

Sedative and cardiovascular effects of midazolam and diazepam alone or combined with clonidine in patients undergoing hemodynamic studies for suspected coronary artery disease / Efeitos sedativos e cardiovasculares do midazolam e do diazepam, associados ou não a clonidina, em pacientes submetidos a estudos hemodinâmicos por suspeita de doença arterial coronariana

FUNDAMENTO: A sedação durante a cineangiocoronariografia tem sido pouco estudada e saber qual é a melhor droga para sedar esses pacientes é um questionamento importante. OBJETIVO: Avaliar a qualidade da sedação e os efeitos sobre a freqüência cardíaca (FC) e a pressão arterial (PA) do midazolam e do diazepam, associados ou não a clonidina, em pacientes com suspeita de doença coronariana. MÉTODOS: Foi desenvolvido ensaio clínico prospectivo, duplo-cego, randomizado, controlado, com 160 pacientes divididos em cinco grupos de 32 pacientes cada, de acordo com o fármaco utilizado: grupo C (clonidina 0,5 µg/kg); grupo M (midazolam 40 µg/kg); grupo MC (associação de midazolam 40 µg/kg e clonidina 0,5 µg/kg); grupo D (diazepam 40 µg.kg); e grupo DC (associação de diazepam 40 µg/kg e clonidina 0,5 µg/kg). A sedação foi avaliada com base na escala de Ramsay e no consumo de meperidina 0,04 mg.kg-1. A PA invasiva, a FC e o escore de sedação foram analisados a cada cinco minutos em quatro diferentes momentos. RESULTADOS: Os pacientes que utilizaram midazolam apresentaram maiores escores de sedação e variação da FC e da PA (p < 0,05). Os que utilizaram diazepam ou clonidina tiveram menores escores de sedação e mais satisfatórios para a realização do exame e apresentaram menor variação da PA e da FC (p > 0,05). CONCLUSÃO: O midazolam foi associado a maior efeito sedativo e cardiovascular enquanto o diazepam causou menor efeito sedativo e cardiovascular. A clonidina e o diazepam tiveram efeitos semelhantes na PA, na FC e na sedação.

BACKGROUND: Sedation during coronary angiography has been rarely studied, and it is important to know which drug is the best to sedate these patients. OBJECTIVE: To evaluate the quality of sedation and the effects of midazolam and diazepam alone or combined with clonidine on the heart rate (HR) and blood pressure (BP) of patients with suspected coronary artery disease. METHODS: This is a controlled, randomized, double-blind, prospective clinical study of 160 patients divided into five groups of 32 patients each, according to the drug used: group C (clonidine 0.5 µg/kg); group M (midazolam 40 µg/kg); group MC (combination of midazolam 40 µg/kg and clonidine 0.5 µg/kg); group D (diazepam 40 µg/kg); and group DC (combination of diazepam 40 µg/kg and clonidine 0.5 µg/kg). Sedation was evaluated based on the Ramsay scale and on the use of meperidine 0.04 mg.kg-1. Invasive BP monitoring, HR and the sedation score were analyzed every five minutes at four different time points. RESULTS: Patients who received midazolam presented higher sedation scores as well as HR and BP variation (p < 0.05). Those who received diazepam or clonidine had lower sedation scores, which were more satisfactory for the performance of the procedure, and presented a lower BP and HR variation (p > 0.05). CONCLUSION: Midazolam was associated with a greater sedative and cardiovascular effect, whereas for diazepam these effects were less intense. Clonidine and diazepam had similar effects on BP, HR and sedation.

Sedative and cardiovascular effects of midazolam and diazepam alone or combined with clonidine in patients undergoing hemodynamic studies for suspected coronary artery disease.

BACKGROUND: Sedation during coronary angiography has been rarely studied, and it is important to know which drug is the best to sedate these patients. OBJECTIVE: To evaluate the quality of sedation and the effects of midazolam and diazepam alone or combined with clonidine on the heart rate (HR) and blood pressure (BP) of patients with suspected coronary artery disease. METHODS: This is a controlled, randomized, double-blind, prospective clinical study of 160 patients divided into five groups of 32 patients each, according to the drug used: group C (clonidine 0.5 microg/kg); group M (midazolam 40 microg/kg); group MC (combination of midazolam 40 microg/kg and clonidine 0.5 microg/kg); group D (diazepam 40 microg/kg); and group DC (combination of diazepam 40 microg/kg and clonidine 0.5 microg/kg). Sedation was evaluated based on the Ramsay scale and on the use of meperidine 0.04 mg.kg-1. Invasive BP monitoring, HR and the sedation score were analyzed every five minutes at four different time points. RESULTS: Patients who received midazolam presented higher sedation scores as well as HR and BP variation (p < 0.05). Those who received diazepam or clonidine had lower sedation scores, which were more satisfactory for the performance of the procedure, and presented a lower BP and HR variation (p > 0.05). CONCLUSION: Midazolam was associated with a greater sedative and cardiovascular effect, whereas for diazepam these effects were less intense. Clonidine and diazepam had similar effects on BP, HR and sedation.

Clonidina na cineangiocoronariografia: efeitos sedativos sobre a pressão arterial e freqüência cardíaca / Clonidine in cineangiocardiography: sedative effects on blood pressure and heart rate

OBJETIVO: Avaliar os efeitos da clonidina sobre a freqüência cardíaca (FC), pressão arterial (PA) e sedação de pacientes submetidos à cineangiocoronariografia. MÉTODOS: Um ensaio clínico prospectivo, duplo cego, randomizado, controlado, foi realizado com 62 pacientes submetidos a cineangiocoronariografias eletivas, divididos em dois grupos: grupo clonidina que utilizou 0,8 æg/kg desta droga, e o grupo controle que utilizou solução fisiológica a 0,9 por cento. A sedação foi avaliada com base na escala de Ramsay e o consumo de meperidina 0,04 mg/kg que foi utilizada nos pacientes que apresentaram agitação ou ansiedade durante o procedimento. A PA invasiva, a FC e o escore de sedação, de acordo com a escala de Ramsay, foram analisados a cada 5 minutos e quatro diferentes momentos foram considerados para avaliação: M1- inicio do exame; M2- 5 minutos após o início do exame; M3- mediana do tempo do exame e M4 - final do exame. RESULTADOS: O grupo clonidina apresentou maior estabilidade da PA e FC e eficácia na sedação, enquanto o grupo controle apresentou um maior consumo de meperidina (p<0,05). Na análise estatística, para inferência das variáveis contínuas foi utilizado o teste T ou Mann-Whitney e chi2 ou Teste Exato de Fisher para as variáveis categóricas. CONCLUSÃO: Este trabalho mostrou que, nos pacientes submetidos à cineangiocoronariografia, a utilização da clonidina foi eficaz tanto no controle da PA e FC quanto em proporcionar uma sedação consciente.

OBJECTIVE: To evaluate the effects of clonidine on heart rate (HR), and blood pressure (BP) as well as its sedative effect on patients submitted to a cineangiocardiography. METHODS: A randomized, controlled, double blind, prospective clinical trial was conducted on 62 patients submitted to an elective cineangiocardiography. The patients were divided in two groups: the clonidine group, that were administered a 0.8 æg/kg dose of this drug and the control group, that were administered a 0.9 percent saline solution. Sedation was evaluated based on the Ramsay Scale and the administration of a 0.04 mg/kg dose of meperidine that was given to the patients who were agitated or anxious during the procedure. The invasive BP, HR and sedation score based on the Ramsay Scale were analyzed every 5 minutes and four different intervals were considered for the assessment: I1- start of the test; I2- 5 minutes after the start of the test; I3- median time of the test and I4- end of the test. RESULTS: The clonidine group presented better BP and HR stability and sedation efficacy while the control group presented a higher intake of meperidine (p<0.05). In the statistical analysis, the inference of the continuous variables was calculated using the Student's t-test or Mann-Whitney test and the chi2 or Fisher Exact Probability test was used for the categorical variables. CONCLUSION: This study demonstrated that clonidine was an efficient means to control BP and HR and provided a conscious sedation for patients submitted to a cineangiocardiography.

Clonidine in cineangiocardiography: sedative effects on blood pressure and heart rate.

OBJECTIVE: To evaluate the effects of clonidine on heart rate (HR), and blood pressure (BP) as well as its sedative effect on patients submitted to a cineangiocardiography. METHODS: A randomized, controlled, double blind, prospective clinical trial was conducted on 62 patients submitted to an elective cineangiocardiography. The patients were divided in two groups: the clonidine group, that were administered a 0.8 microg/kg dose of this drug and the control group, that were administered a 0.9% saline solution. Sedation was evaluated based on the Ramsay Scale and the administration of a 0.04 mg/kg dose of meperidine that was given to the patients who were agitated or anxious during the procedure. The invasive BP, HR and sedation score based on the Ramsay Scale were analyzed every 5 minutes and four different intervals were considered for the assessment: I1- start of the test; I2- 5 minutes after the start of the test; I3- median time of the test and I4- end of the test. RESULTS: The clonidine group presented better BP and HR stability and sedation efficacy while the control group presented a higher intake of meperidine (p<0.05). In the statistical analysis, the inference of the continuous variables was calculated using the Student's t-test or Mann-Whitney test and the chi2 or Fisher Exact Probability test was used for the categorical variables. CONCLUSION: This study demonstrated that clonidine was an efficient means to control BP and HR and provided a conscious sedation for patients submitted to a cineangiocardiography.

Sobrenome de conotaçäo religiosa e tipo histológico de glomerulonefrites em pacientes provenientes do Estado da Bahia / Association between surname with relligious connotation and histologic type of glomerulonephritis in patients from the state of Bahia

Objetivo: avaliar se sobrenome de conotaçäo religiosa (SCR), um indicador de ancestralidade africana, está associado com tipo de glomerulonefrite (esclerose glomerular focal(EGF) versus glomerulonefrite membranoproliferativa (GNMP), em paciente do Estado da Bahia.Métodos:pacientes do Seriço de Nefrologia da Universidade Federal da Bahia, 80 com esclerose glomerular focal (EGF) e 50 com glomerulonefrite membranoproliferativa (GNMP), foram comparados quanto à distribuiçäo de tipo de sobrenome: SCR (último nome representando santos, invocaçöes a Nossa Senhora, símbolos religiosose cerimônias da Igreja Católica) versus outros. Utilizou-se modelos de regressäo logística para as comparaçöes ajustadas para a idade. Pacientes com formas secundárias de glomerulonefrites näo foram incluídos na presente análise. Resultados: SCR foi associado com EGF entre pessoas do sexo masculino; odds ratio (OR) näo ajustado = 3,35 (IC 95porcento = 1,16-11,75;p=0,021) e OR ajustado para idade = 2,89 (IC 95porcento = 0,84-8,81;p=0,064). Contrariamente, no sexo feminino e se manteve estatisticamente näo significante após o ajuste para os potenciais efeitos da idade (OR=0,34,95porcento CI=0,06-2,05;p=0,24). Conclusäo: os resultados do presente estudo säo consistentes com a possibilidade de que indivíduos do sexo masculino com SRC apresentam, independente da idade, maior predisposiçäo para EGF (comparado com GNMP). Os dados apóoam o uso do tipo de sobrenome com um indicador de doenças relacionadas com ancestralidade africana, particularmente no sexo masculino