PERCEPÇÃO DOS CUIDADORES SOBRE A EFICÁCIA DE SUAS MEDIDAS DE PREVENÇÃO DE ACIDENTES DE CRIANÇAS NO DOMICÍLIO

Goal: To evaluate the perception of caregivers regarding the prevention of accidents to their children in the domestic environment. Methodology: Cross-sectional observational study. Sixty people in charge of students from a municipal public school in Salvador/Bahia were interviewed. The data collection took place from December 2014 to October 2015. The perceptions of safety and domestic risks were evaluated, as well as accidents and preventive measures adopted. Results: Most of those responsible people were highly concerned about the risks of domestic children's accidents and considered extra-community environments as more prone. Although measures were taken to create protection against accidents, all children had already suffered some kind of injury. Conclusion: those responsible people knew the risks of accidents with children at home and ways to prevent it. Despite the precautions taken, accidents still occurred.Objetivo: Avaliar a percepção dos cuidadores quanto à prevenção de acidentes com seus filhos no ambiente doméstico. Metodologia: Estudo observacional transversal. Foram entrevistados 60 responsáveis ​​por alunos de uma escola pública municipal de Salvador / Bahia. A coleta de dados ocorreu no período de dezembro de 2014 a outubro de 2015. Foram avaliadas as percepções de segurança e riscos domésticos, bem como acidentes e medidas preventivas adotadas. Resultados: A maioria dos responsáveis ​​mostrou-se bastante preocupada com os riscos de acidentes domésticos com crianças e considerou os ambientes extracomunitários os mais propensos. Embora medidas tenham sido tomadas para criar proteção contra acidentes, todas as crianças já haviam sofrido algum tipo de lesão. Conclusão: os responsáveis ​​conheciam os riscos de acidentes com crianças no domicílio e as formas de evitá-los. Apesar dos cuidados tomados, acidentes ainda ocorreram.Objetivo: Evaluar la percepción de los cuidadores sobre la prevención de accidentes a sus hijos en el ámbito doméstico. Metodología: Estudio observacional transversal. Se entrevistó a sesenta responsables de alumnos de una escuela pública municipal de Salvador / Bahía. La recolección de datos se llevó a cabo entre diciembre de 2014 y octubre de 2015. Se evaluaron las percepciones de seguridad y riesgos domésticos, así como los accidentes y las medidas preventivas adoptadas. Resultados: La mayoría de los responsables estaban muy preocupados por los riesgos de accidentes de los niños domésticos y consideraban que los entornos extracomunitarios eran más propensos. Aunque se tomaron medidas para crear protección contra accidentes, todos los niños ya habían sufrido algún tipo de lesión. Conclusión: los responsables conocían los riesgos de accidentes con niños en el hogar y las formas de prevenirlos. A pesar de las precauciones tomadas, aún se produjeron accidentes

PERCEPÇÃO DOS CUIDADORES SOBRE A EFICÁCIA DE SUAS MEDIDAS DE PREVENÇÃO DE ACIDENTES DE CRIANÇAS NO DOMICÍLIO

Goal: To evaluate the perception of caregivers regarding the prevention of accidents to their children in the domestic environment. Methodology: Cross-sectional observational study. Sixty people in charge of students from a municipal public school in Salvador/Bahia were interviewed. The data collection took place from December 2014 to October 2015. The perceptions of safety and domestic risks were evaluated, as well as accidents and preventive measures adopted. Results: Most of those responsible people were highly concerned about the risks of domestic children's accidents and considered extra-community environments as more prone. Although measures were taken to create protection against accidents, all children had already suffered some kind of injury. Conclusion: those responsible people knew the risks of accidents with children at home and ways to prevent it. Despite the precautions taken, accidents still occurred.Objetivo: Avaliar a percepção dos cuidadores quanto à prevenção de acidentes com seus filhos no ambiente doméstico. Metodologia: Estudo observacional transversal. Foram entrevistados 60 responsáveis ​​por alunos de uma escola pública municipal de Salvador / Bahia. A coleta de dados ocorreu no período de dezembro de 2014 a outubro de 2015. Foram avaliadas as percepções de segurança e riscos domésticos, bem como acidentes e medidas preventivas adotadas. Resultados: A maioria dos responsáveis ​​mostrou-se bastante preocupada com os riscos de acidentes domésticos com crianças e considerou os ambientes extracomunitários os mais propensos. Embora medidas tenham sido tomadas para criar proteção contra acidentes, todas as crianças já haviam sofrido algum tipo de lesão. Conclusão: os responsáveis ​​conheciam os riscos de acidentes com crianças no domicílio e as formas de evitá-los. Apesar dos cuidados tomados, acidentes ainda ocorreram.Objetivo: Evaluar la percepción de los cuidadores sobre la prevención de accidentes a sus hijos en el ámbito doméstico. Metodología: Estudio observacional transversal. Se entrevistó a sesenta responsables de alumnos de una escuela pública municipal de Salvador / Bahía. La recolección de datos se llevó a cabo entre diciembre de 2014 y octubre de 2015. Se evaluaron las percepciones de seguridad y riesgos domésticos, así como los accidentes y las medidas preventivas adoptadas. Resultados: La mayoría de los responsables estaban muy preocupados por los riesgos de accidentes de los niños domésticos y consideraban que los entornos extracomunitarios eran más propensos. Aunque se tomaron medidas para crear protección contra accidentes, todos los niños ya habían sufrido algún tipo de lesión. Conclusión: los responsables conocían los riesgos de accidentes con niños en el hogar y las formas de prevenirlos. A pesar de las precauciones tomadas, aún se produjeron accidentes

Percepção de cuidadores quanto aos riscos de acidentes na infância

Objetivo: compreender como cuidadores de crianças menores de dez anos percebem os riscos de acidentes no ambiente doméstico.Metodologia: estudo do tipo transversal. Foram entrevistados 60 (sessenta) responsáveis por alunos de uma escola pública municipal.A coleta de dados ocorreu em dezembro de 2014 e de julho a outubro de 2015. Resultados: quanto à amostra houve a prevalênciade mulheres entre 18 e 40 anos de idade, com companheiro e ensino médio. A maior parte relatou não trabalhar e possuir rendamédia familiar de até 1 salário mínimo. A percepção geral dos entrevistados foi a de que a queda é o acidente não letal mais comume o acidente automobilístico é o que causa mais mortes de crianças no país. Afirmaram ainda que os maiores riscos em casa são aqueda seguida da queimadura, mas apenas uma pequena parcela acreditava que os riscos são passíveis de prevenção. Conclusão:acidentes com crianças em casa ainda são subestimados e pouco valorizados pelos adultos. Assim é fundamental que esforços sejamempreendidos para conscientizar os cuidadores quanto ao tema e a necessidade do seu comprometimento para que haja uma efetivaredução desses índices no país

Prevalência de hipovitaminose D em obesos graves encaminhados à cirurgia bariátrica

Modelo do estudo: Estudo transversal. Objetivo: estimar a prevalência da hipovitaminose D em um grupo de obesos graves encaminhados à cirurgia bariátrica. Métodos: Foram estudados obesos atendidos por uma equipe especializada em cirurgia bariátrica, com 18 anos ou mais de ambos os sexos. Dados clínicos, antropométricos e laboratoriais foram obtidos dos prontuários dos pacientes. A 25 (OH) D plasmática foi determinada por quimioluminescência e valores ≤20 ng/mL foram considerados como hipovitaminose D. Os dados foram analisados ​​utilizando o Statistical Package for the Social Sciences® (SPSS) 20.0. Estatística descritiva foi utilizada para apresentação das variáveis e para comparação dos três grupos foram utilizados os testes: ANOVA, Kruskal-Wallis e qui-quadrado de Pearson. Foram considerados estatisticamente significantes valores de p<0,05. Resultados: Foram estudados 400 pacientes, 71% do sexo feminino, com média (DP) de idade e IMC 35,6 (9,1) anos e 41,4 (5,1) kg/m², respectivamente. A vitamina D variou de 4,5 a 62,4ng/mL com média (DP) de 24,7 (7,9) ng/mL. Na amostra, 117 (29.3%) dos pacientes apresentaram hipovitaminose D. Houve correlação negativa entre 25 (OH) D e IMC (r = -0,110; p = 0,028) e paratormônio (r = -0,152; p=0,006) e correlação positiva com cálcio sérico (r=0,132; p = 0,013) e fósforo (r=0,116; p=0,027). Conclusão: Os obesos graves apresentaram alta prevalência de hipovitaminose D, mesmo vivendo em um estado ensolarado.Study Design: Cross-sectional. Objective: Estimating the prevalence of hypovitaminosis D in a group of severely obese subjects referred to bariatric surgery. Methods: This study evaluated severely obese patients aged ≥18 years assisted by a specialized team in bariatric surgery. Clinical, anthropometric, and laboratory data were obtained from patient records. Plasma 25 (OH) D was determined by chemiluminescence and levels ≤ 20 ng/mL was considered as Hypovitaminosis D. The data were analyzed using the Statistical Package for Social Sciences® (SPSS) 20.0. Variables were described using descriptive statistics. For the comparison of the three groups, ANOVA, Kruskal-Wallis, and Pearson's chi-square tests were used. Spearman correlation test was performed to assess correlations between 25(OH)D and the other variables. P-values <0.05 were considered to be significant. Results: The study included 400 individuals, 71% were female with the mean age (SD) and BMI (SD) of 35.6 (9.1) years and 41.4 (5.1) kg/m², respectively. The vitamin D ranged from 4.5 to 62.4 ng/mL and the mean (SD) was 24.7 (7.9) ng/mL. In this sample, 117 (29.3%) individuals had hypovitaminosis D. There was a negative correlation between 25(OH)D and BMI (r= -0.110; p=0.028) and parathormone (r= -0.152; p=0.006) and positive correlation with serum calcium (r= 0.132; p=0.013) and phosphorus (r= 0.116; p=0.027). Conclusion: Severely obese subjects had a high prevalence of hypovitaminosis D even living in a sunny state

Most patients with severe obesity has liver fibrosis even without Metabolic Syndrome/ A maioria dos pacientes com obesidade grave apresenta fibrose Hepática mesmo sem Síndrome Metabólica

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a condition commonly associated with metabolic syndrome (MS). This association is frequently found in people with severe obesity, yet some who are diagnosed with NAFLD do not fulfill the criteria for MS. We aimed to compare the clinical and histological characteristics of NAFLD in patients with obesity with and without MS.METHODOLOGY: Cross-sectional study with patients with severe obesity (BMI ≥35kg/m2) diagnosed with NAFLD on liver biopsy during bariatric surgery between Sep/2014 and May/2015.  Patients with a history of chronic alcohol consumption and other liver diseases were excluded. MS diagnosis was based on the International Diabetes Federation criteria. Statistical analyses were performed using Chi-square and t tests. P<0.05 were considered significant. RESULTS: The simple included 170 patients with severe obesity with histological diagnosis of NAFLD. The mean BMI (body mass index) was 43.2±5.3 kg/m2; 60% were female and the mean age was 37.1±10.7 years. Dyslipidemia (81.7%) and arterial hypertension (48.2%) were the most frequent NAFLD risk factor associated with obesity in these patients. A total of 75 of them (44.1%) did not meet the criteria for MS. They were younger than those with MS [33.8 (9.9) vs 39.7 (10.8) years; p<0.001], and 68.0% (51) of them had nonalcoholic steatohepatitis (NASH) and fibrosis.  CONCLUSION: The results reinforce the relevance to evaluate NAFLD in people with severe obesity, even those without MS. Despite not presenting MS, these patients with severe obesity already had NASH with fibrosis and can potentially evolve to cirrhosis

PROFILE OF TYPE 2 DIABETICS INSULIN-APPLICANTS FOLLOWED IN A MULTI HEALTH CENTER, SALVADOR, BAHIA, BRAZIL

Objetivo: Descrever o perfil clínico e epidemiológico de pacientes com Diabetes Mellitus (DM) tipo 2 insulino-requerentes acompanhados por equipe multidisciplinar em um Multicentro de Saúde em Salvador-BA, Brasil. Método: Estudo epidemiológico, transversal, descritivo de pacientes atendidos em um Multicentro de Saúde no período de outubro/2017 a outubro/2019. As variáveis clínicas e sociodemográficas foram coletadas de prontuários e expressas em frequências absolutas e relativas, média e desvio padrão (DP), além de mediana e intervalo interquartílico (IIQ). Resultados: Foram avaliados 163 pacientes com média (DP) de idade de 61,2 (± 10,6) anos, com predomínio entre 51 e 60 anos (39,3%), sendo 66,3% do sexo feminino. A mediana de tempo de diagnóstico foi de 10 (3) anos e 78,8% usavam insulina há menos de 5 anos. Metade dos pacientes aceitava sua condição de diabético, 53,2% não corrigiam adequadamente os episódios hipoglicêmicos, 68,1% possuíam hemoglobina glicada acima das metas estipuladas pela Sociedade Brasileira de Diabetes e 59,9% tinham microalbuminúria. Além disso, 96,3% não praticavam exercícios físicos, 2,5% possuíam perfil alimentar apropriado, 71,0% tinham diagnóstico de Hipertensão Arterial Sistêmica, e 70,8% possuíam o valor da fração de colesterol Low Density Lipoprotein (LDL) acima da meta estabelecida pela Sociedade Brasileira de Cardiologia. Conclusão: Nesta amostra de pacientes diabéticos insulino-requerentes, a maioria dos pacientes era do sexo feminino, apresentava outras comorbidades associadas ao DM, baixa adesão às medidas higienodietéticas, elevação da hemoglobina glicada e indícios de nefropatia diabética.Objective: To describe the clinical and epidemiological profile of patients with insulin-inuming Type 2 Diabetes Mellitus followed by a multidisciplinary team in a Multicenter Health Unit in Salvador-BA, Brazil. Method: Epidemiological, cross-sectional, retrospective, descriptive study with patients treated in the Multicenter Health Unit from October/2017 to October/2019. The clinical and sociodemographic variables were collected from medical records and expressed in absolute and relative frequencies, mean and standard deviation (SD), in addition to median and interquartile range (IR). Results: We evaluated 163 patients with mean (SD) of age of 61.2 (± 10.6) years, with a predominance between 51 and 60 years (39.3%), 66.3% of which were female.The median time of diagnosis was 10 (3) years and 78.8% had been using insulin for less than 5 years. Half of the patients accepted their diabetic condition, 53.2% did not adequately correct hypoglycemic episodes, 68.1% glycated hemoglobin above the targets set by the Brazilian Diabetes Society and 59.9% had microalbuminuria. In addition, 96.3% did not exercise, 2.5% had an appropriate food profile, 71.0% were diagnosed with Systemic Arterial Hypertension, and 70.8% did not have the cholesterol fraction Low Density Lipoprotein (LDL) value in the goal established by the Brazilian Society of Cardiology. Conclusion: In this sample of insulin-applicant diabetic patients, most patients were female, had other comorbidities associated with DM, low adhering to hygienic dietary measures, elevation of glycated hemoglobin and signs of diabetic nephropathy

Arquivos de Neuro-Psiquiatria

p. 25-28BACKGROUND: Sleep disturbances and symptoms of anxiety and depression have been shown to be involved in the genesis and perpetuation of chronic pain. OBJECTIVE: To evaluate sleep patterns and the prevalence of symptoms of anxiety and depression in patients with chronic pain. METHOD: Four hundred consecutive patients referred to a chronic pain outpatient clinic were investigated using patient charts, the numerical Visual Analogue Scale for the evaluation of pain, the Hospital Anxiety and Depression scale and the Mini-Sleep Questionnaire. RESULTS: The mean age of patients was 45.6±11.4 years. The most frequent medical diagnosis was myofascial pain followed by neuropathic pain. The prevalence of symptoms of anxiety was 72.8%, depression 93% and altered sleep patterns 93%. CONCLUSION: This study revealed a high prevalence of symptoms of depression and anxiety and alterations in sleep patterns in patients with chronic pain, justifying investigation into these disturbances in this group of patients.São Paul

Arquivos de Neuro-Psiquiatria

p. 864-868Chronic pain causes functional incapacity and compromises an individual's affective, social, and economic life. OBJECTIVE: To study the cognitive behavioral therapy (CBT) effectiveness in a group of patients with chronic pain. METHODS: A randomized clinical trial with two parallel groups comprising 93 patients with chronic pain was carried out. Forty-eight patients were submitted to CBT and 45 continued the standard treatment. The visual analogue, hospital anxiety and depression, and quality of life SF-36 scales were applied. Patients were evaluated before and after ten weeks of treatment. RESULTS: When the Control Group and CBT were compared, the latter presented reduction of depressive symptoms (p=0.031) and improvement in the domains 'physical limitations' (p=0.012), 'general state of health' (p=0.045), and 'limitations by emotional aspects' (p=0.025). CONCLUSIONS: The CBT was effective and it has caused an improvement in more domains of quality of life when compared to the Control Group, after ten weeks of treatment