Avaliação das condições ao nascer e complicações em recém-nascidos gemelares segundo a ordem de nascimento.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina. Curso de Medicina. Departamento de Pediatria

Asma, índice de massa corporal e sintomas respiratórios: um estudo de base populacional

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências Médicas, Florianópolis, 2019.Introdução: Asma e obesidade são doenças comuns, predominam em mulheres e podem coexistir. Nos últimos anos acumulou-se um número considerável de estudos que dão suporte à noção de que obesidade está ligada à asma. Nesse sentido, a obesidade tem sido relatada como fator de risco para asma em diversos grupos demográficos. Fatores que podem contribuir para a patogênese da asma nos obesos incluem alterações mecânicas, inflamatórias e imunes decorrentes da obesidade. Objetivo: Estimar a prevalência de sintomas respiratórios e asma, e relacioná-los ao IMC em indivíduos com idade = 40 anos bem como avaliar os fatores associados ao diagnóstico prévio de asma.Métodos: Estudo transversal, de base populacional, probabilístico, fundamentado na metodologia do estudo PLATINO. Foram selecionados adultos com idade = 40 anos e coletadas informações demográficas, relato de diagnóstico médico prévio de asma, sintomas respiratórios, medicações em uso e comorbidades. Também foram realizadas medidas antropométricas e espirometria pré e pós-broncodilatador. O IMC foi subdivido em normal (IMC=24,9 kg/m2), sobrepeso (IMC=25 kg/m2 e =29,9 kg/m2) e obesidade (IMC=30 kg/m2). Resultados: Foram avaliados 1026 indivíduos com IMC normal [n=274 (26,7%)], sobrepeso [n=436 (42,5%)] ou obesos [n=316 (30,8%)]. A prevalência de diagnóstico prévio de asma foi 11,0%. A prevalência de obesidade foi maior em mulheres (p=0,03) e em entrevistados com escolaridade Abstract : Introduction: Asthma and obesity are common conditions, predominate in women and can coexist. In recent years a considerable number of studies have been accumulated that support the notion that obesity is linked to asthma. In this sense, obesity has been reported as a risk factor for asthma in several demographic groups. Factors that may contribute to the pathogenesis of asthma in the obese include mechanical alterations, inflammation and immune responses due to obesity. Objective: To estimate the prevalence of asthma and respiratory symptoms according to BMI in individuals aged =40 years as well as to evaluate the factors associated with the previous diagnosis of asthma.Methods: A cross-sectional, population-based, probabilistic study based on the PLATINO study methodology. Adults aged =40 years were selected. Demographic information, previous medical diagnosis of asthma, respiratory symptoms, medications and comorbidities were collected. Anthropometric measurements and pre-and post-bronchodilator spirometry were also assessed. The BMI was categorized as normal (BMI =24,9 kg /m2), overweight (BMI =25 kg /m2 and =29,9 kg/m2) and obesity (BMI =30 kg/m2). Results: A total of 1.026 individuals with normal BMI [n=274 (26.7%)], overweight [n=436 (42.5%)] or obese [n=316 (30.8%)] were evaluated. The prevalence of previous diagnosis of asthma was 11.0%. The prevalence of obesity was higher in women (p=0.03) and in those with schooling <4 years (p <0.001) or with family income between 3-10 minimum wages. Obese patients reported more frequently diagnosis of asthma (7.5 vs. 9.9 vs. 16.1%, p=0.002), dyspnea (17.3 vs. 22.5 vs. 35.8%, p <0.001) and wheezing in the last year (14.7 vs. 11.9, vs. 25.6%, p <0.001) than overweight or individuals with normal BMI, respectively. These results were independent of the smoking status. In addition, obese patients had a 3.0 (1.2-3.1) fold higher odds ratio (p=0.005) for medical diagnosis of asthma than non-obese. Conclusion: There was a significant association between medical diagnosis of asthma and BMI =30 kg/m2. Being obese tripled the chance of prior medical diagnosis of asthma

Evaluation of an Internal Review Process for Grants And Manuscripts in the Canadian Critical Care Trials Group

RATIONALE AND OBJECTIVES: All grants and manuscripts bearing the Canadian Critical Care Trials Group name are submitted for internal peer review before submission. The authors sought to formally evaluate authors’ and reviewers’ perceptions of this process

Evaluation of an Internal Review Process for Grants And Manuscripts in the Canadian Critical Care Trials Group

RATIONALE AND OBJECTIVES: All grants and manuscripts bearing the Canadian Critical Care Trials Group name are submitted for internal peer review before submission. The authors sought to formally evaluate authors’ and reviewers’ perceptions of this process.METHODS: The authors developed, tested and administered two electronic nine-item questionnaires for authors and two electronic 13-item questionnaires for reviewers. Likert scale, multiple choice and free-text responses were used.RESULTS: Twenty-one of 29 (72%) grant authors and 16 of 22 (73%) manuscript authors responded. Most author respondents were somewhat or very satisfied with the turnaround time, quality of the review and the review process. Two-thirds of grant (13 of 20 [65%]) and manuscript authors (11 of 16 [69%]) reported one or more successful submissions after review. Changes made to grants based on reviews were predominantly editorial and involved the background, rationale, significance/relevance and the methods/protocol sections. Twenty-one of 47 (45%) grant reviewers and 32 of 44 (73%) manuscript reviewers responded. Most reviewer respondents reported a good to excellent overall impression of the review process, good fit between their expertise and interests and the grants reviewed, and ample time to review. Although most respondents agreed with the current nonblinded review process, more grant than manuscript reviewers preferred a structured review format.CONCLUSIONS: The authors report a highly favourable evaluation of an existing internal review process. The present evaluation has assisted in understanding and improving the current internal review process.Peer Reviewe

Mielopatia torácica por calcificação do ligamento amarelo cursando com hiperproteinorraquia e resposta à corticoterapia: relato de caso Thoracic myelopathy due to calcification of the ligamentum flavum with hyperproteinorachia and responsive to steroid therapy: case report

Calcificação e ossificação do ligamento amarelo ou do ligamento longitudinal posterior são causas de mielopatia compressiva, mais frequentes nos níveis torácicos inferiores e bastante raras em populações ocidentais. A descompressão cirúrgica é a única terapia proposta, mas a doença costuma ser progressiva e sua recorrência após a cirurgia não é incomum. Mediadores inflamatórios podem ter algum papel na progressão da mielopatia compressiva, mas não se tem notícia de qualquer proposta de abordagem terapêutica envolvendo agentes anti-inflamatórios. Neste contexto, relatamos um caso de mielopatia compressiva por calcificação do ligamento amarelo em que se observou hiperproteinorraquia e resposta à corticoterapia. Tais informações são inéditas e podem fornecer novas ideias para a compreensão da doença.<br>Calcification and ossification of the ligamentum flavum or of the posterior longitudinal ligament are causes of compressive myelopathy, more frequent in the lower thoracic levels, and extremely rare in Western populations. Surgical decompression is the only therapy, but the disease is usually progressive, and its recurrence after surgery is common. Inflammatory mediators might play a role in the progression of compressive myelopathy, but, to our knowledge, the therapeutic approach involving anti-inflammatory agents has never been tried before. We report a case of compressive myelopathy due to calcification of the ligamentum flavum, in which hyperproteinorachia and response to steroid therapy have been observed. Those data have not been published before and might provide new ideas for the disease understanding