Leptospira spp. and Rickettsia spp. as pathogens with zoonotic potential causing acute undifferentiated febrile illness in a central-eastern region of Peru.

OBJETIVE: this study was to determine the relationship between acute febrile illness and bacterial pathogens with zoonotic potential that cause emerging and re-emerging diseases in a central-eastern region of Peru. RESULTS: Out of the 279 samples analyzed, 23 (8.2%) tested positive for infection by Rickettsia spp., while a total of 15 (5.4%) tested positive for Leptospira spp. Women had a higher frequency of infection by Rickettsia spp., with 13 cases (53.3%), while men had a higher frequency of infection by Leptospira spp., with 10 cases (66.7%). The most frequently reported general symptom was headache, with 100.0% (n = 23) of patients with Rickettsia (+) and 86.7% (n = 13) of patients with Leptospira (+) experiencing it. Arthralgia was the second most frequent symptom, reported by 95.6% (n = 22) and 60% (n = 9) of patients with Rickettsia (+) and Leptospira (+), respectively. Myalgia was reported by 91.3% (n = 21) and 66.7% (n = 10) of patients with Rickettsia (+) and Leptospira (+), respectively. Retroocular pain, low back pain, and skin rash were also present, but less frequently. Among the positives, no manifestation of bleeding was recorded, although only one positive case for Leptospira spp. presented a decrease in the number of platelets.

Prevalence and associated factors of myofascial pain in orthognathic patients with skeletal class II malocclusion.

Orthognathic patients with skeletal class II malocclusion frequently suffer from myofascial pain (MP). PURPOSE: This study aimed to evaluate the prevalence and associated factors of MP in these patients. METHODS: This cross-sectional study was performed in adult patients with skeletal Class II malocclusion requiring orthognathic surgery. They were divided according to the presence or absence of MP. The predictor variables were craniofacial morphology, sex, temporomandibular disorders, chronic pain, depression, and polymorphisms of dopamine receptors DRD2 (rs6275 and rs6276) and ANKK1 (rs1800497) genes. Data were submitted to statistical analyses using the linear regression model and Poisson regression with a significance level of 0.05. RESULTS: Sixty-five individuals were selected, of which 50 (76.92%) were females. A total of 21 (32.3%) patients had MP. Individuals with MP showed a decrease in the mandible gonial angle (p = 0.042) and an increased risk of having temporomandibular joint (TMJ) disc displacement (p = 0.003), TMJ pain (p = 0.030), chronic pain (p = 0.001), and severe depression (p = 0.015). Additionally, individuals carrying AA and AG genotypes in rs6275, and CC genotype in rs6276, were more likely to have MP (p < 0.05). CONCLUSION: In this study, 32.3% of skeletal class II orthognathic patients had MP, which was associated with a decreased gonial angle, TMJ disc displacement, TMJ pain, chronic pain, depression, and polymorphisms in the DRD2 gene.

SARS-CoV-2 infection in children and adolescents: a Brazilian experience.

OBJECTIVE: To describe clinical and epidemiological aspects of children and adolescents infected with the SARS-CoV-2 in the Municipality of Taubaté, SP, from March to November 2020. METHODS: Cross-sectional study with secondary data obtained from the Epidemiological Surveillance System about confirmed cases in city residents and from medical records of patients who were treated in hospitals in Taubaté, aged between 0 and 19 years. Chi-square and Student's t tests were used for comparisons. RESULTS: 677 cases in the studied age range were reported during the study period, corresponding to 10.1% of cases reported in the municipality. The rapid antibody test was the most used to confirm infection, followed by RT-PCR and serology. Symptoms were described in 57.7% of the cases, mainly fever and cough. Diarrhea was associated with age below 4 years, while fever, cough, headache, odynophagia, ageusia, anosmia, myalgia, and dyspnea were associated with an age ranging from 10 to 19 years. In the study period, there were no deaths from COVID-19 of residents of the municipality in the age group from 0 to 19 years. CONCLUSIONS: The study was able to identify the proportion of involvement of COVID-19 in children and adolescents in the city, and the disease had a mild evolution. The main symptoms were fever and cough, but mainly diarrhea in younger children, and headache, odynophagia, anosmia, ageusia, and myalgia in adolescents.

Clinical Signs and Symptoms Associated with COVID-19: A Cross Sectional Study / Signos y Síntomas Clínicos Asociados a COVID-19: Un Estudio Transversal

ABSTRACT: Covid-19 is a viral disease that has spread throughout the world, becoming a pandemic. Dysgeusia and anosmia are some of its most frequent symptoms. The aim of the study was to determine the frequent signs and symptoms associated with COVID-19 patients. A cross-secional study from 370 patients with acute respiratory illness admitted by emergenc y services of a hospital in Acapulco. An institutional survey was applied to all patients as a data collection instrument, and a SARS-CoV-2 test, by RT-PCR processed by a certified laboratory. Statistical analysis was performed using the STATA V13 program. The numerical variables without normality were reported in medians, 25th and 75th percentiles, and the Mann W ithney U test was performed for differences between groups. The categorical variables were presented in percentages and differences between groups with Chi-square test. A generalized linear models (GLM) analysis was carried out to determine the most frequent symptoms and signs associated with COVID-19. Clinical signs and symptoms associated to COVID-19 in the bivariate análysis were dysgeusia, odynophagia, anosmia, arthralgia, myalgia, conjunctivitis, and age older than 40 years. In the final multivariate model only age older than 40 years (OR) 2.2; CI 95 % 1.3,3.8) and dysgeusia (OR 2.1; CI95 % 1.2,3.6) kept significance. Dysgeusia, odynophagia, anosmia, arthralgia, myalgia and conjunctivitis are clinical signs and symptoms that can appear in the early stages of the disease, so they could be important for an early diagnosis.

RESUMEN: El Covid-19 es una enfermedad viral que se ha extendido por todo el mundo, convirtiéndose en una pandemia. La disgeusia y la anosmia son algunos de sus síntomas más frecuentes. El objetivo del estudio fue determinar los signos y síntomas frecuentes asociados con los pacientes con COVID-19. Estudio transversal de 370 pacientes con enfermedad respiratoria aguda ingresados por los servicios de emergencia de un hospital de Acapulco. A todos los pacientes se les aplicó una encuesta institucional como instrumento de recolección de datos, y una prueba de SARS-CoV-2, por RT-PCR procesada por un laboratorio certificado. El análisis estadístico se realizó utilizando el programa STATA V13. Las variables numéricas sin normalidad se reportaron en medianas, percentiles 25 y 75, y se realizó la prueba U de Mann Withney para diferencias entre grupos. Las variables categóricas se presentaron en porcentajes y diferencias entre grupos con la prueba de Chi-cuadrado. Se realizó un análisis de modelos lineales generalizados (GLM) para determinar los síntomas y signos más frecuentes asociados a la COVID-19. Los signos y síntomas clínicos asociados a COVID-19 en el análisis bivariado fueron disgeusia, odinofagia, anosmia, artralgia, mialgia, conjuntivitis y edad mayor de 40 años. En el modelo multivariado final solo la edad mayor de 40 años (OR) 2,2; IC 95 % 1,3,3,8) y la disgeusia (OR 2,1; IC95 % 1,2,3,6) mantuvieron significanca estadística. Disgeusia, odinofagia, anosmia, artralgias, mialgias y conjuntivitis son signos y síntomas clínicos que pueden aparecer en etapas tempranas de la enfermedad, por lo que podrían ser importantes para un diagnóstico precoz.

Seroprevalence of chikungunya virus infection among HIV-infected adults in French Caribbean Islands of Martinique and Guadeloupe in 2015: A cross-sectional study.

BACKGROUND: In 2014, a first outbreak of chikungunya hit the Caribbean area where chikungunya virus (CHIKV) had never circulated before. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cross-sectional study to measure the seroprevalence of CHIKV immediately after the end of the 2014 outbreak in HIV-infected people followed up in two clinical cohorts at the University hospitals of Guadeloupe and Martinique. Study patients were identified during the first months of 2015 and randomly selected to match the age and sex distribution of the general population in the two islands. They were invited to complete a survey that explored the symptoms consistent with chikungunya they could have developed during 2014 and to have a blood sample drawn for CHIKV serology. The study population consisted of 377 patients (198 in Martinique and 179 in Guadeloupe, 178 men and 199 women), 182 of whom reported they had developed symptoms consistent with chikungunya. CHIKV serology was positive in 230 patients, which accounted for an overall seroprevalence rate of 61% [95%CI 56-66], with only 153 patients who reported symptoms consistent with chikungunya. Most frequent symptoms included arthralgia (94.1%), fever (73.2%), myalgia (53.6%), headache (45.8%), and skin rash (26.1%). CONCLUSIONS/SIGNIFICANCE: This study showed that the seroprevalence of CHIKV infection was 61% after the 2014 outbreak, with one third of asymptomatic infections. TRIAL REGISTRATION: ClinicalTrials.gov NCT02553369.

Safety of Chronic Simvastatin Treatment in Patients with Decompensated Cirrhosis: Many Adverse Events but No Liver Injury.

BACKGROUND: The high mortality rate of decompensated cirrhosis underlines the need for new treatments. Experimental models of cirrhosis and its reported relationship with atherosclerotic cardiovascular disease have provided data supporting the rational use of statins in these patients. However, little is known about the safety of statins in this setting. AIM: We evaluate the safety of chronic simvastatin treatment in patients with decompensated cirrhosis. METHODS: We conducted a prospective, open, uncontrolled, phase 2a trial in 30 patients with Child-Pugh class A (n = 6), B (n = 22), and C (n = 2) decompensated cirrhosis. The patients received standard treatment throughout the trial plus simvastatin 20 mg/day for 2 weeks and thereafter simvastatin 40 mg/day up to 1 year. RESULTS: Sixteen out of 30 patients (53.3%) showed adverse events, including gastrointestinal toxicity (36.7%), muscle injury (MI) (36.7%), and headache (13.3%). No liver injury was registered. Due to MI alone, simvastatin dosage was reduced in 23.4% of cases and transiently interrupted in 13.3%. Once these adverse events were overcome, simvastatin was resumed until the end of the trial. MI was associated with baseline MELD score > 12 (p = 0.035) and with baseline Child-Pugh class C. No MI was associated with final Child-Pugh score ≤ 6 (p = 0.030) or final Child-Pugh class A (p = 0.020). CONCLUSIONS: Chronic treatment with simvastatin 40 mg/day in patients with decompensated cirrhosis was associated with several adverse events, being MI the only clinically significant one, which appears to be related to the simvastatin dosage and the degree of cirrhosis severity. Noticeably, no liver injury was recorded.

Echovirus 30 detection in an outbreak of acute myalgia and rhabdomyolysis, Brazil 2016-2017.

OBJECTIVES: To describe an outbreak of acute myalgia accompanied by elevated levels of muscle enzymes that occurred in the northeast region of Brazil from December 2016 through to May 2017. METHODS: Clinical data were analysed and laboratory tests were performed in 86 specimens obtained from 52 individuals with suspected acute myalgia. A broader reactive enterovirus real-time RT-PCR followed by a semi-nested PCR amplification of partial VP1 gene were performed to identify the causative agent. RESULTS: Eighty-six clinical samples were received in our laboratory during the myalgia outbreak. Median age of individuals was 39 years. Sudden acute myalgia and dark urine were the most common symptoms. Creatine phosphokinase levels were elevated with mean value ∼16 893 U/L. Human enterovirus was detected in 67% (58/86) of the patient's specimens (urine, serum, faeces and rectal swab). The enterovirus positivity per patient was 82.7% (43/52). Echovirus 30 (E-30) (82% of the typed specimens, 18/22; 76.4% (13/17) of the typed specimens per patient) was the main enterovirus identified. In addition to E-30, CV-A16 (1/22) and E-6 (3/22) were detected in 4% and 14% of the typed specimens, respectively. No deaths occurred. CONCLUSION: The 2016-2017 outbreak of acute myalgia that occurred in the northeast region of Brazil can be associated with E-30. Despite the clinical manifestations, a favourable outcome was observed for all patients.

Reemerging arboviruses: clinical-epidemiological profile of hospitalized elderly patients. / Arboviroses reemergentes: perfil clínico-epidemiológico de idosos hospitalizados.

OBJECTIVE: Describe the clinical-epidemiological profile of hospitalized elderly patients with arbovirus. METHOD: A documentary retrospective population-based descriptive study that used a quantitative approach with hospitalized elderly patients diagnosed with arbovirus was conducted in a teaching hospital. Data were collected from medical records and investigation forms. RESULTS: Thirty-three elderly patients participated in this study. A prevalence of dengue was observed, with fever, myalgia, and arthralgia. Arterial hypertension and diabetes were the comorbidities. Statistically significant correlations were obtained between arbovirus and schooling, employment situation, marital status, test results, and use of analgesics; and between the site of arthralgia and Chikungunya. CONCLUSION: The results support nursing care to hospitalized elderly patients with arbovirus, allowing the development of a proper and humanized care plan.

Análise da qualidade de vida e prevalência de dores musculares em trabalhadores de postos de combustível / Analysis of the quality of life and prevalence of muscle pain in workers at gas stations

Introdução: O campo do conhecimento que trata da saúde do trabalhador tem por finalidade promover, proteger a saúde e prevenir doenças e acidentes, como também estudar a qualidade de vida no trabalho (QVT). Os frentistas são profissionais expostos a intensidades sonoras elevadas e solventes, trabalham em turnos e com posturas inadequadas. Objetivo: Descrever a prevalência dos sintomas osteomusculares que acometem os frentistas e avaliar a qualidade de vida no trabalho destes profissionais, correlacionando-os com avaliação audiológica. Método: Estudo transversal, constituído por dois grupos, um grupo controle, com 15 participantes sem exposição a intensidades sonoras elevadas ou agentes químicos; e um grupo experimental com 20 frentistas. Para avaliação de dor foi utilizado o Questionário Nórdico de Sintomas Osteomusculares, foram também realizados Testes de Equilíbrio Dinâmico e exames audiológicos como, Audiometria Tonal Liminar, Medidas de Imitância Acústica e Potencial Evocado Auditivo do Tronco Encefálico, para análise da QVT foi utilizado o Questionário da Qualidade de Vida no Trabalho (QWQL-bref). Resultados: Os sintomas mais prevalentes nos frentistas foram dores em pescoço/coluna cervical e quadril/MMII (55%), seguidas da região lombar (50%). Foram verificadas alterações auditivas nos frentistas, sugerindo ação tóxica da exposição a combustíveis. Houve correlação entre idade e QVT (p=0,027). Conclusão: Acredita-se que os sintomas osteomusculares encontrados nos frentistas possa ser consequência da postura em pé prolongada e também da falta de atividade física. Sintomas que poderiam ser minimizados pela adoção dos postos de combustíveis de medidas ergonômicas. No entanto, apesar de alguns exames audiológicos e de equilíbrio apresentarem alterações nos frentistas, estes não foram suficientes para interferirem na qualidade de vida do trabalho que foi satisfatória para ambos os grupos. Salienta-se a importância da vigilância na saúde dos frentistas devido aos níveis de exposição e no desenvolvimento de medidas preventivas para promoção de saúde.(AU)

Introduction: The field of knowledge that deals with workers' health aims to promote, protect health and prevent diseases and accidents, as well as study quality of life at work (QWL). The professionals are professionals exposed to high sound intensities and solvents, work in shifts and with inappropriate postures. Objective: To describe the prevalence of musculoskeletal symptoms affecting the pediatricians and to evaluate the quality of life of these professionals, correlating them with audiological evaluation. Method: A cross-sectional study, consisting of two groups, a control group, with 15 participants without exposure to high sound intensities or chemical agents; and an experimental group with 20 participants. In order to evaluate pain, the Nordic Questionnaire of Musculoskeletal Symptoms was used, Dynamic Equilibrium Tests and audiological tests were also performed, such as Tone Limit Audiometry, Acoustic Immitance Measurements and Brainstem Auditory Evoked Potential. Quality of Life at Work (QWQL-bref). Results: The most prevalent symptoms in the gas station attendants were pain in neck / cervical spine and hip / MMII (55%), followed by lumbar region (50%). Auditory alterations were observed in the ventilators, suggesting toxic action of exposure to fuels. There was a correlation between age and QWL (p = 0.027). Conclusion: It is believed that the musculoskeletal symptoms found in the chairs can be a consequence of prolonged standing posture and also the lack of physical activity. Symptoms that could be minimized by the adoption of ergonomically designed fuel stations. However, although some audiological and balance exams presented changes in the individuals, these were not enough to interfere in the quality of life of the work that was satisfactory for both groups, emphasizing the importance of surveillance in the health of the gas station attendant due to the exposure levels and in the development of preventive measures for health promotion.(AU)

Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015.

We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease.

Prophylactic use of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia: a randomized, double-blinded, placebo-controlled study / Uso profilático de pregabalina para prevenção de mialgia e fasciculação induzidas por succinilcolina: estudo randômico, duplo-cego e controlado por placebo

ABSTRACT BACKGROUND: Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. OBJECTIVE: The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. DESIGN: Prospective, randomized, placebo controlled, double blinded study. MATERIALS AND METHODS: Patients of both genders undergoing elective spine surgery were randomly assigned to two groups. Patients in Group P (pregabalin group) received 150 mg of pregabalin orally 1 h prior to induction of anesthesia with sips of water and patients in Group C (control group) received placebo. Anesthesia was induced with fentanyl 1.5 mcg/kg, propofol 1.5-2.0 mg/kg followed by succinylcholine 1.5 mg/kg. The intensity of fasciculations was assessed by an observer blinded to the group allotment of the patient on a 4-point scale. A blinded observer recorded postoperative myalgia grade after 24 h of surgery. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief. RESULTS: Demographic data of both groups were comparable (p > 0.05). The incidence of muscle fasciculation's was not significant between two groups (p = 0.707), while more patients in group C had moderate to severe fasciculation's compared to group P (p = 0.028). The incidence and severity of myalgia were significantly lower in group P (p < 0.05). CONCLUSION: Pregabalin 150 mg prevents succinylcholine-induced fasciculations and myalgia and also decreases the fentanyl consumption in elective sine surgery.

RESUMO JUSTIFICATIVA: A succinilcolina é comumente usada para atingir um bloqueio neuromuscular profundo, de início rápido e de curta duração. OBJETIVO: Comparar a eficácia de pregabalina na prevenção de mialgia e fasciculação induzidas por succinilcolina. DESENHO: Estudo prospectivo, randômico, duplo-cego e controlado por placebo. MATERIAIS E MÉTODOS: Pacientes de ambos os sexos submetidos a cirurgia eletiva de coluna foram aleatoriamente divididos em dois grupos. Os pacientes do Grupo P (pregabalina) receberam 150 mg de pregabalina oral uma hora antes da indução da anestesia e os pacientes do Grupo C (controle) receberam placebo. A anestesia foi induzida com fentanil (1,5 mcg/kg) e propofol (1,5-2,0 mg/kg), seguidos de succinilcolina 1,5 mg/kg. A intensidade da fasciculação foi avaliada por um observador, cego para a alocação dos grupos, com uma escala de 4 pontos. Um observador cego registrou o grau pós-operatório de mialgia após 24 horas de cirurgia. Para o alívio da dor no pós-operatório, fentanil foi usado em sistema de analgesia controlada pelo paciente. RESULTADOS: Os dados demográficos de ambos os grupos eram comparáveis (p > 0,05). A incidência de fasciculação muscular não foi significativa entre os dois grupos (p = 0,707), enquanto mais pacientes do Grupo C apresentaram fasciculação de moderada a grave em relação ao Grupo P (p = 0,028). A incidência e a gravidade da mialgia foram significativamente menores no grupo P (p < 0,05). CONCLUSÃO: Pregabalina (150 mg) previne mialgia e fasciculação induzidas por succinilcolina, além de diminur o consumo de fentanil em cirurgia eletiva de coluna.

Prophylactic use of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia: a randomized, double-blinded, placebo-controlled study.

BACKGROUND: Succinylcholine is commonly used to achieve profound neuromuscular blockade of rapid onset and short duration. OBJECTIVE: The present study compared the efficacy of pregabalin for prevention of succinylcholine-induced fasciculation and myalgia. DESIGN: Prospective, randomized, placebo controlled, double blinded study. MATERIALS AND METHODS: Patients of both genders undergoing elective spine surgery were randomly assigned to two groups. Patients in Group P (pregabalin group) received 150mg of pregabalin orally 1h prior to induction of anesthesia with sips of water and patients in Group C (control group) received placebo. Anesthesia was induced with fentanyl 1.5mcg/kg, propofol 1.5-2.0mg/kg followed by succinylcholine 1.5mg/kg. The intensity of fasciculations was assessed by an observer blinded to the group allotment of the patient on a 4-point scale. A blinded observer recorded postoperative myalgia grade after 24h of surgery. Patients were provided patient-controlled analgesia with fentanyl for postoperative pain relief. RESULTS: Demographic data of both groups were comparable (p>0.05). The incidence of muscle fasciculation's was not significant between two groups (p=0.707), while more patients in group C had moderate to severe fasciculation's compared to group P (p=0.028). The incidence and severity of myalgia were significantly lower in group P (p<0.05). CONCLUSION: Pregabalin 150mg prevents succinylcholine-induced fasciculations and myalgia and also decreases the fentanyl consumption in elective sine surgery.

Cutaneous Application of Silicone Wafers Containing Carbon Microcoils: Efficacy in Relieving Chronic Muscle Tension and Pain.

BACKGROUND: Chronic musculoskeletal pain is highly prevalent worldwide. PRIMARY STUDY OBJECTIVE: The aim of this study was to evaluate the efficacy of Helical(®) microcoils, a new, noninvasive treatment for chronic musculoskeletal pain. DESIGN: This was a prospective, observational study. SETTING: The study was conducted at the main author's private clinic, in São Paulo, Brazil. PARTICIPANTS: We evaluated 20 physicians, from 2 different hospitals, who suffered from chronic musculoskeletal pain and volunteered to participate in the study. INTERVENTION: The Helical(®) microcoils were applied to the skin over the affected areas. Before and after the intervention, the physician-patients completed questionnaires and a visual analog scale. PRIMARY OUTCOME MEASURES: We quantified postintervention improvement or worsening of pain and muscle tension. RESULTS: Significant improvements in pain and muscle tension were observed in 95% of the physician-patients evaluated. The only side effect reported was mild pruritus at the application site, which occurred in 5 of the 20 cases. CONCLUSION: The use of Helical microcoils was found to be safe and efficacious in relieving muscle tension and pain.

Application of the 10-item Cervantes Scale among mid-aged Ecuadorian women for the assessment of menopausal symptoms.

BACKGROUND: The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture. OBJECTIVE: To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10). METHOD: This was a cross sectional study in which a total of 451 Ecuadorian women (40-59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data. RESULTS: Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores. CONCLUSION: In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.

Prevalencia de trastornos temporomandibulares en el adulto mayor institucionalizado / Prevalence of temporomandibular disorders in institutionalized older people

Los trastornos temporomandibulares (TTM) son una serie de signos y síntomas buco faciales de etiología multifactorial. En Cuba existen varias investigaciones que tratan sobre los TTM sobre todo en jóvenes dentados no conociéndose amplias referencias de este tipo de estudio en el adulto mayor. Objetivo: identificar la prevalencia de TTM en los adultos mayores institucionalizados, los signos y síntomas más frecuentes según edad y sexo. Métodos: se realizó un estudio descriptivo transversal en 113 adultos mayores de ambos sexos, institucionalizados en dos hogares de ancianos de la Habana, de marzo a abril de 2012. Se aplicó una encuesta donde se recogió sexo, edad, signos y síntomas. Las manifestaciones clínicas evaluadas fueron: la presencia de dolor muscular, dificultad al movimiento de abertura y cierre, dolor articular, dolor muscular articular, ruidos articulares, limitación de la abertura bucal, limitación de los movimientos de lateralidad y propulsión, desviación de la mandíbula. Resultados: el 40,70 por ciento de los adultos mayores estudiados, presentaron afectación en la articulación temporomandibular. Los ruidos articulares fue el síntoma con mayor predominio en todos los grupos etarios (76,08 por ciento), afectando al 82,35 por ciento de los hombres y al 72,41 por ciento de las mujeres. Seguido por el dolor muscular que se manifestó en el 52,17 por ciento de los afectados, con mayor porcentaje en mujeres (58,62 por ciento) que en hombres (41,17 por ciento). La dificultad para realizar los movimientos de abertura y cierre se detectó en el 28,26 por ciento de los afectados con mayor prevalencia en el sexo femenino (34,48 por ciento) que en el masculino (17,14 por ciento). Conclusiones. se observó una elevada prevalencia de TTM en los adultos mayores estudiados. Los signos y síntomas más frecuentes por edad y sexo fueron los ruidos articulares y el dolor muscular y la dificultad para realizar los movimientos de abertura y cierre(AU)

The Temporomandibular Disorders (TMD) are a series of signs and symptoms of multifactoral etiology in the mouth-face area. In Cuba, there exist several research studies about TMD, mainly in young people with natural dentition, but no extensive references of this kind are known in the older adult. Objective: to identify the prevalence of temporomandibular disorders in the institutionalized older adults in two homes for the elderly located in Havana from March to April 2012. A survey was administered in which sex, age, sign and symptoms data were collected. The evaluated clinical manifestations were muscular pain, difficult opening and closure movement, joint pain, articular and muscular pain, articulary noises, limited mouth opening, limited laterality and propulsion movements, jaw deviation. Methods: a descriptive and cross-sectional study of 113 institutionalized older adults of both sexes was carried out from March to April of 2012 in two homes for elderly in Havana. A survey was administered in which sex, age, sign and symptoms data were collected. The evaluated clinical manifestations were muscular pain, difficult opening and closure movement, articular pain, articular and muscular pain, articular noises, limited mouth opening, limited laterality and propulsion movements, jaw deviation. Results: in the studied older adults, 40.70 percent were affected in their temporomandibular articulation. The articular noises were the most prevalent sign in all age groups (76.08 ), affecting 82.35 percent of men and 72.41 percent of women, followed by muscular pain in 52.17 percent of those affected, with higher percentage found in women (58.62 percent) than in men (41.17 percent). Difficulties in opening and closing the mouth were detected in 28.26 percent of the affected people, being more prevalent in females (34.48 percent) than in males (17.14 percent). Conclusions: a high prevalence of TMD was observed in the studied older people. The most frequent symptoms and sings by age and sex were articular noises and the muscular pain, and the difficulty in making the opening and closing movements of the mouth(AU)

Queixas musculoesqueléticas em uma Unidade Básica de Saúde: implicações para o planejamento das ações em saúde e fisioterapia / Musculoskeletal complaints in a health unit: implications for health planning and physical therapy / Quejas musculoesqueléticas en una Unidad Básica de Salud: implicaciones para el planeamiento de las acciones en salud y fisioterapia

OBJETIVO: O objetivo deste estudo foi analisar a prevalência de queixas musculoesqueléticas em adultos em uma Unidade Básica de Saúde. MÉTODO: Foram avaliados os usuários atendidos na recepção espontânea no período de março de 2010 a maio de 2011. Ao todo, foram estudados 1.023 indivíduos. A caracterização das queixas foi realizada por meio de questionário com dados sociodemográficos e motivo da procura por atendimento. RESULTADOS: Os dados mostraram que a maioria dos usuários pertence ao sexo feminino (71,2%), está na faixa etária de 31 a 60 anos (50,0%), é solteira (31,6%), aposentada (14,2%) e apresenta queixas em vários sistemas (77,1%). O sistema musculoesquelético é o mais acometido (14,4%), representando o segundo motivo de procura por atendimento (31,0%). Analisando as razões de chance de ocorrência de queixas musculoesqueléticas com relação às variáveis estudadas, verificou-se que pessoas com idade entre 40 e 59 anos apresentaram 3,49 (IC95% 2,17-5,57) vezes mais chances de associação com essas dores do que as demais. Não houve associação entre outros sistemas e variáveis. CONCLUSÃO: A alta prevalência de queixas musculoesqueléticas requer um novo olhar de gestores em saúde para o atendimento destas demandas, pensando em incluir o fisioterapeuta na atenção básica para tratamento de dores de menor complexidade...

OBJECTIVE: The aim of this study was to analyze the prevalence musculoskeletal complaints in adults in a Health Center. METHODS: There were evaluated users seen in spontaneous reception in the period of 2010 March to 2011 May. Altogether there were studied 1.023 individuals. The characterization of the complaints was conducted through a questionnaire with socio demographic data and the reason for the demand for care. RESULTS: Data from this study showed that most users were women (71.2%), aged 31 to 60 years (50.0%), single (31.6%), retired (14.2%) and had complaints in various systems (77.1%). The musculoskeletal system was the most affected (14.4%), representing the second reason for seeking treatment (31.0%). Analyzing the odds ratios of occurrence of musculoskeletal complaints in relation to the variables studied, we found that people aged 40 to 59 years were 3.49 (95%CI 2.17-5.57) times more likely to occur in association with these pains than older and younger persons. There was no association between other systems and the variables studied. CONCLUSION: The high prevalence of musculoskeletal complaints requires a new look from health managers to meet these demands, thinking about the possibility of including the physiotherapist in primary health care unit to treat less complex pains...

OBJETIVO: El objetivo de este estudio fue analizar la prevalencia de quejas musculoesqueléticas en adultos en una Unidad Básica de Salud. MÉTODO: Fueron evaluados los usuarios atendidos en la recepción espontánea en el período de marzo de 2010 a mayo de 2011. En total, fueron estudiados 1.023 individuos. La caracterización de las quejas fue realizada por medio de cuestionario con datos sociodemográficos y motivo de la búsqueda de atención. RESULTADOS: Los datos mostraron que la mayoría de los usuarios pertenece al sexo femenino (71,2%), está en la franja etárea de 31 a 60 años (50,0%), es soltera (31,6%), jubilada (14,2%) y presenta quejas en varios sistemas (77,1%). El sistema musculoesquelético es el más afectado (14,4%), representando el segundo motivo de búsqueda de atención (31,0%). Analizando las razones de posibilidad de ocurrencia de quejas musculoesqueléticas con relación a las variables estudiadas, se verificó que personas con edad entre 40 y 59 años presentaron 3,49 (IC95% 2,17-5,57) veces más posibilidades de asociación con esos dolores que las demás. No hubo asociación entre otros sistemas y variables. CONCLUSIÓN: La alta prevalencia de quejas musculoesqueléticas requiere una nueva mirada de gestores en salud para la atención de estas demandas, pensando en incluir el fisioterapeuta en la atención básica para tratamiento de dolores de menor complejidad...