Toxoplasmose em parturientes de um Hospital do Sul de Santa Catarina, Brasil / Toxoplasmosis in parturients in a hospital in South Santa Catarina

Introdução: Atualmente, ainda existe uma alta incidência de infecção pelo Toxoplasma gondii durante o período gestacional, comparada com as demais doenças infecciosas que atingem as parturientes. Assim, este estudo visou identificar a presença de infecção aguda ou tardia pelo Toxoplasma gondii em gestantes e correlacioná-la à soropositividade para o Vírus da Imunodeficiência Humana (HIV). Métodos: Estudo transversal realizado com gestantes atendidas em um hospital do Sul de Santa Catarina, de agosto de 2015 a janeiro de 2016. Os dados foram coletados a partir de uma cópia do cartão das gestantes vinculado ao prontuário. Resultados: O estudo avaliou dados de 676 gestantes. A idade variou de 14 a 44 anos, sendo o grupo de 20 a 29 anos o mais prevalente (51,6%). Os resultados positivos para IgG, acompanhados de resultado negativo para IgM, corresponderam a um total de 175 (25,8%) gestantes. 420 (62,1%) pacientes possuíram resultados IgG negativos. 16 (2,3%) pacientes tiveram anticorpos IgM positivos. Destas, 04 pacientes possuíam IgG negativos e 12 IgG positivos. 2 (0,3%) pacientes tiveram resultado positivo para infecção pelo HIV. Não houve associação estatisticamente significativa entre IgM positivo e infecção pelo HIV, pesos alterados dos recém-nascidos e prematuridade. Conclusão: Verifica-se que há um elevado número de pacientes susceptíveis à infecção pelo T. gondii durante a gestação e, consequentemente, ao risco elevado de transmissão intraútero. Para o melhor conhecimento sobre as consequências desta infecção em parturientes, seria necessário o acompanhamento dos recém-nascidos por um longo período (AU)

Introduction: Currently, there is still a high incidence of Toxoplasma gondii infection during the gestational period, compared to other infectious diseases that affect parturients. This study was designed to identify the presence of acute or late infection by Toxoplasma gondii in pregnant women and to correlate it with seropositivity for Human Immunodeficiency Virus (HIV). Methods: A cross-sectional study was carried out with pregnant women seen at a hospital in southern Santa Catarina from August 2015 to January 2016. Data were collected from a copy of the pregnant women's card attached to the chart. Results: The study evaluated data from 676 pregnant women. Their age ranged from 14 to 44 years, with the group of 20-29 years old being the most prevalent (51.6%). The positive results for IgG accompanied by a negative result for IgM, amounted to a total of 175 (25.8%) women. 420 (62.1%) patients had negative IgG results. 16 (2.3%) patients had positive IgM antibodies. Of these, 4 patients had negative IgG and 12 positive IgG. Two (0.3%) patients tested positive for HIV infection. There was no statistically significant association between positive IgM and HIV infection, altered weights of the newborns, and prematurity. Conclusion: There is a high number of patients susceptible to infection by T. gondii during pregnancy and, thus, to a high risk of intrauterine transmission. For better knowledge about the consequences of this infection in parturients, it would be necessary to monitor the newborns for a long period (AU)

Critérios diagnósticos e prevalência de Diabetes Mellitus Gestacional em um hospital do sul de Santa Catarina / Diagnostic criteria and prevalence of gestational diabetes mellitus in a hospital in south Santa Catarina, Brazil

Introdução: Não há consenso na literatura com relação ao método de diagnóstico ideal para Diabetes Mellitus Gestacional (DMG). O objetivo foi estabelecer a prevalência de DMG nas parturientes atendidas em Tubarão/SC, conforme critérios diagnósticos utilizados pelo serviço de referência: classifi cação da Organização Mundial da Saúde ou The International Association of the Diabetes and Pregnancy Study Groups (IADPSG). Métodos: Estudo transversal realizado com gestantes atendidas em um hospital do Sul de Santa Catarina, de agosto de 2013 a abril de 2014. Os dados foram coletados a partir de uma cópia do cartão das gestantes vinculado ao prontuário. Resultados: O estudo avaliou 506 gestantes. O rastreamento por glicemia de jejum foi positivo em 153 (30,2%) mulheres, mas apenas 96 (62,7%) realizaram TOTG 75g. Três pacientes (0,6%) foram diagnosticadas de acordo com os critérios da OMS, os quais exigem a realização de TTGO para confirmação. Segundo critérios do consenso da Associação Internacional de Diabetes e Grupos de Estudos da Gravidez (IADSPG), o DMG foi confirmado em 73 pacientes (14,4%). Essa confirmação foi mais frequente em mulheres que tiveram rastreamento de glicemia positivo (p4000g) foi verificada em 11 (3,3%) bebês. A frequência de cesáreas foi de 70% nas mulheres com DMG e de 58,5% entre as sem o diagnóstico (p=0,09). Foram registrados dois abortos. Conclusão: A prevalência de DMG, conforme o consenso da IADSPG, foi de 14,4%, superior ao verificado pelo critério da OMS. Este último possivelmente subestimou a real frequência de DMG pela não complementação diagnóstica.

Introduction: There is no consensus in the literature regarding the ideal method for diagnosis of gestational diabetes mellitus (GDM). The aim was to establish the prevalence of GDM in pregnant women cared for in Tubarão, SC, according to the diagnostic criteria used by the reference service: the classifi cation of the World Health Organization or the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Methods: Cross-sectional study of pregnant women at a hospital in southern Santa Catarina, from August 2013 to April 2014. Data were collected from a copy of the card of the women linked to the medical record. Results: The study evaluated 506 pregnant women. The fasting glucose screening was positive in 153 (30.2%) women, but only 96 (62.7%) underwent 75g OGTT. Three patients (0.6%) were diagnosed according to the WHO criteria, which requires performing OGTT for confi rmation. According to IADSPG consensual criteria, GDM was confi rmed in 73 patients (14.4%). This confi rmation was more frequent in women who tested positive for blood glucose (p 4000g) was observed in 11 (3.3%) babies. The frequency of cesarean sections was 70% in women with GDM and 58.5% among those without the diagnosis (p = 0.09). Two abortions were recorded. Conclusion: The prevalence of GDM, according to the IADSPG consensus, was 14.4%, higher than the one reported by the WHO criteria. The latter possibly underestimated the actual frequency of DMG owing to the lack of complementary testing.

Nutritional repercussions in patients submitted to bariatric surgery.

BACKGROUND: Few studies evaluated the association between nutritional disorders, quality of life and weight loss in patients undergoing bariatric surgery. AIM: To identify nutritional changes in patients undergoing bariatric surgery and correlate them with weight loss, control of comorbidities and quality of life. METHOD: A prospective cohort, analytical and descriptive study involving 59 patients undergoing bariatric surgery was done. Data were collected preoperatively at three and six months postoperatively, evaluating nutritional aspects and outcomes using BAROS questionnaire. The data had a confidence interval of 95%. RESULTS: The majority of patients was composed of women, 47 (79.7%), with 55.9% of the series with BMI between 40 to 49.9 kg/m(²). In the sixth month after surgery scores of quality of life were significantly higher than preoperatively (p<0.05) and 27 (67.5 %) patients had comorbidities resolved, 48 (81.3 %) presented BAROS scores of very good or excellent. After three and six months of surgery 16 and 23 presented some nutritional disorder, respectively. There was no relationship between the loss of excess weight and quality of life among patients with or without nutritional disorders. CONCLUSION: Nutritional disorders are uncommon in the early postoperative period and, when present, have little or no influence on quality of life and loss of excess weight.

Nutritional repercussions in patients submitted to bariatric surgery / Repercussões nutricionais em pacientes submetidos à cirurgia bariátrica

BACKGROUND: Few studies evaluated the association between nutritional disorders, quality of life and weight loss in patients undergoing bariatric surgery. AIM: To identify nutritional changes in patients undergoing bariatric surgery and correlate them with weight loss, control of comorbidities and quality of life. METHOD: A prospective cohort, analytical and descriptive study involving 59 patients undergoing bariatric surgery was done. Data were collected preoperatively at three and six months postoperatively, evaluating nutritional aspects and outcomes using BAROS questionnaire. The data had a confidence interval of 95%. RESULTS: The majority of patients was composed of women, 47 (79.7%), with 55.9% of the series with BMI between 40 to 49.9 kg/m². In the sixth month after surgery scores of quality of life were significantly higher than preoperatively (p<0.05) and 27 (67.5 %) patients had comorbidities resolved, 48 (81.3 %) presented BAROS scores of very good or excellent. After three and six months of surgery 16 and 23 presented some nutritional disorder, respectively. There was no relationship between the loss of excess weight and quality of life among patients with or without nutritional disorders. CONCLUSION: Nutritional disorders are uncommon in the early postoperative period and, when present, have little or no influence on quality of life and loss of excess weight. .

RACIONAL: Poucos estudos avaliam a associação entre distúrbios nutricionais, qualidade de vida e perda de peso em pacientes submetidos à cirurgia bariátrica. OBJETIVO: Identificar alterações nutricionais em pacientes submetidos à cirurgia bariátrica e correlacioná-las com perda de peso, controle de comorbidades e qualidade de vida. MÉTODO: Estudo de coorte, prospectivo, analítico e descritivo envolvendo 59 pacientes submetidos à cirurgia bariátrica. Os dados foram coletados no pré-operatório e aos três e seis meses pós- operatórios, quantificando aspectos nutricionais e utilizando o Bariatric Analysis and Reporting Outcomes System (BAROS) como ferramenta de sucesso. Os dados usaram intervalo de confiança de 95%. RESULTADOS: O total de mulheres foi 47 (79,7%), sendo 55,9% com IMC entre 40-49,9 kg/m². No sexto mês depois da operação os escores de qualidade de vida foram significativamente maiores do que no pré-operatório (p<0,05) e 27 (67,5%) pacientes tinham todas comorbidades resolvidas, 48 (81,3%) apresentaram conceito BAROS muito bom ou excelente. Após três e seis meses 16 e 23 pacientes apresentaram algum distúrbio nutricional, respectivamente. Não houve relação entre a perda do excesso de peso e qualidade de vida entre pacientes com ou sem distúrbio nutricional. CONCLUSÃO: os distúrbios nutricionais são pouco frequentes no pós-operatório precoce e, quando presentes, têm pouca ou nenhuma influência na qualidade de vida e na perda do excesso de peso. .