Immune thrombocytopenia: clinical features and analysis of risk factors to response to the treatment

Introduction: Immune thrombocytopenia (ITP) is an acquired decrease of platelets, caused by autoantibodies against platelets, in the absence of an associated condition. ITP is associated to low morbidity and mortality, however there is reduced quality of life on the patients under treatment. This study has as objectives to describe the clinical features of the patients and the evaluation of risk factors related to the response to treatment. Methods: A retrospective analysis was achieved, regarding the medical records of 99 patients diagnosed with ITP and seen between May of 1992 and August of 2016 in a hospital.Results: 99 patients were analyzed, 71 female (71.7%). Mean age 39 years old to diagnosis (variation 2-84). 83.3% of the patients were chronic ITP and the mean follow up 49.2 months (0,1-289). 74.7% of patients presented bleeding to diagnosis. 76.7% of patients required treatment, and there was remission in 7 (30.4%) of the 23 patients who did not receive any treatment. 37 patients were submitted to splenectomy, 30 (81.1%) of those obtained partial or complete response and 18 (48.6%) presented loss of response. 30% of patients were submitted to posterior treatments. Only two patients had death related to ITP. In bivariate analysis of risk factors to response to the treatment, the only predictors of chronicity were initially the absence of corticosteroid dependence and absence of response to splenectomy, however in multivariate analysis those factors had their significance discarded. Conclusion: The presented results did not confirm a higher progression rate to chronicity in non corticosteroid-dependent patients and in those who did not present response to splenectomy. The clinical features, response pattern and survival of analyzed patients were similar to other studies reported.&nbsp

EXPLORAÇÃO E SOFRIMENTO MENTAL DE PROFESSORES: UM ESTUDO NA REDE ESTADUAL DE ENSINO DO PARANÁ

Resumo A reestruturação do mundo do trabalho tem exercido forte impacto sobre as condições de vida e saúde da classe trabalhadora. Os professores têm sofrido, assim como os demais trabalhadores, a precarização do trabalho, entre outras consequências da acumulação flexível, com o aumento das exigências sem o incremento suficiente dos recursos necessários para o desempenho do trabalho. A intensa elevação do sofrimento mental dos docentes parece estar ligada às novas condições de trabalho. Visando a fornecer subsídios para o enfrentamento dessa questão, realizou-se pesquisa buscando verificar a associação entre a elevação da exploração no trabalho dos docentes e o sofrimento mental. Efetuou-se estudo transversal por meio da plataforma Limesurvey, em que 1.201 professores da rede estadual responderam a dois questionários on-line: o Self-Reporting Questionnaire-20 e outro, elaborado pelos pesquisadores, sobre as condições de trabalho dos docentes. Carga horária semanal, número de alunos por turma e número de turmas por professor apresentaram associação com transtornos psíquicos menores. A associação de número de alunos por turma com a presença de transtorno psíquico menor foi estatisticamente significativa. Concluiu-se que a prevalência de casos indicativos de distúrbios psíquicos é muito elevada entre os professores, havendo indícios de associação com diversas formas de exploração no trabalho docente