Trabalhos Acadêmicos
URI permanente desta comunidadehttps://repositorio.cmmg.edu.br/handle/123456789/5
Navegar
20 resultados
Resultados da Pesquisa
Item Caracterização funcional de idosos comunitários durante a pandemia por Covid-19 em uma capital brasileira(Faculdade Ciências Médicas de Minas Gerais, 2023-10-05) Vieira, Maria Carolina Santos; Barbosa, Maira Tonidandel; Leopoldino, Amanda Aparecida de OliveiraObjective: to compare functional behavior in elderly people aged over and under 85 years, considering a sample of community-dwelling older adults in a Brazilian capital during the COVID-19 pandemic. Methods: a cross-sectional study was carried out with self-administered questionnaires available through digital means, consisting of questions to assess the risk of functional decline, frailty, perception of the impact of social isolation on health and participation of the family member or caregiver in the daily activities of the participants. Results: 373 elderly people with a mean age of 76.8 9,4 years participated in this study. Most of the sample reported that health problems do not limit the performance of activities (63.5%), that their health problems do not force them to stay at home (77.7%) and that they do not regularly depend on walking devices (88.6%). There was a significant difference in the risk of functional decline: 22.5% in individuals aged 60-84 years old and 40.1% in individuals aged 85 years or older needed more care and support from their family members or caregivers to carry out their daily tasks. Conclusions: aging itself does not imply functional dependence, but is an important risk factor for that. In the present study, the group of elderly aged 85 years and older had a higher risk of functional decline, need for support and care from family members, use of walking aids and activity limitations. The data suggest that this group must be considered a priority in interventions to mitigate the impacts of social isolation during pandemic periods and in similar epidemiological, clinical and psychosocial circumstances.Item Validação do questionário Duke Activity Status Index (DASI) para avaliação da capacidade funcional, por meio de contato telefônico, em indivíduos com Doença de Parkinson(Faculdade Ciências Médicas de Minas Gerais, 2023-09-20) Thomazi, Maria Clara Bellavinha; Campelo, Raquel de Carvalho Lana; Leopoldino, Amanda Aparecida de OliveiraIntroduction: Parkinson's Disease (PD) is a chronic-degenerative and progressive disorder of the central nervous system, more prevalent in the elderly, characterized by both motor and non-motor changes. Given the decline in physical abilities and in carrying out activities of daily living, it is crucial to establish a suitable method for assessing functional capacity for this population. The Duke Activity Status Index (DASI) is an easily administered and low-cost questionnaire, capable of measuring the functional capacity of individuals. Currently, there are no studies validating the DASI in the PD population, especially through telephone calls. With the COVID-19 pandemic, there was a need to validate new ways of administering questionnaires, particularly remotely. Objective: To validate the DASI questionnaire for assessing the functional capacity of individuals with PD through telephone contact. Objective: To validate the DASI questionnaire for assessing the functional capacity of individuals with PD through telephone contact. Materials and Methods: This is a methodological study in which individuals diagnosed with PD were included. Sociodemographic and clinical data were initially obtained, and subsequently, the patients underwent the DASI on two occasions: face-to-face and by telephone, both conducted by the same examiner. To compare the mean differences in the total scores of the questionnaires administered face-to-face and by telephone, the Student's T-test was used, with a 95% confidence interval, to investigate the concurrent validity between the modes of application. The values obtained in each of the questionnaire items, administered face-to-face and by telephone, were compared using the Kappa coefficient. Results: Fifty-one PD patients were included in the study, with an average age of 66.9 (±8.5) years and an average diagnosis time of 106.7 (±65.0) months. No significant difference was observed between the averages of the scores obtained in both the face-to-face DASI application and via telephone contact (40.3±14.0 versus 40.7±13.5, respectively). Most of the questions showed substantial agreement (items 3, 5, 8, 10, and 12, 0.638 ≥ k ≤ 0.790) or almost perfect agreement (items 6, 7, and 9, 0.812 ≥ k ≤ 0.940) between the two DASI application routes, except for a single question which showed moderate agreement (item 11, k=0.497). Conclusions: The application of the DASI via telephone proved to be valid for assessing the functional capacity of individuals with PD.Item Achados ecocardiográficos em crianças de pacientes com diagnóstico de síndrome do PRKAG2(Faculdade Ciências Médicas de Minas Gerais, 2023-08-25) Santos Neto, Dinamar Amador; Pena, José Luiz BarrosBackground: PRKAG2 syndrome typically manifests in adolescence and early adulthood along with left ventricular hypertrophy, arrhythmias, and increased risk of sudden death. Echocardiographic marker findings before clinical manifestation in children of PRKAG2 parents can facilitate prevention strategies and therapeutic planning. Objective: Identify the existence of early echocardiographic findings in asymptomatic children of PRKAG2 parents. Methods: Cross-sectional observational study of seven children, aged between 9 months and 12 years, of PRKAG2 parents was compared to a control group matched by sex and age with no cardiovascular disease. All children underwent conventional and advanced echocardiographic techniques. Results: Conventional echocardiography showed higher values with statistical significance in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness. Global longitudinal strain obtained from the two-dimensional examination showed no statistical significance between the groups. None of the parameters on the three dimensional echocardiogram showed statistical significance between the groups. Conclusion: Children diagnosed with PRKAG2 presented echocardiographic findings suggestive of a tendency to cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of these patients before the onset of clinical manifestations.Item Comportamento alimentar, qualidade de vida e risco cardiovascular em crianças e adolescentes com obesidade e sobrepeso(Faculdade Ciências Médicas de Minas Gerais, 2024-03-28) Santos, Fernanda Gabriela Colombo Drumond; Machado, Maria da Glória Rodrigues; Rezende, Bruno AlmeidaINTRODUCTION: Eating habits are closely relate to the development of chronic diseases throughout life, such as obesity, diabetes, high blood pressure, dyslipidemia, among others. Adequate eating education and behavior contribute to good health and quality of life. Epidemiological studies show the increased occurrence of arterial hypertension during childhood and adolescence, probably due to the association of being overweight, obesity and lack of physical activity. OBJECTIVE: Evaluate the relationships between eating behaviors and their impact in body composition of children and teenagers, as well as possible association with quality of life (QoL) and early indicators of cardiovascular risk. METHODS: This is a transversal and observational that study which evaluated anthropometric, cardiovascular, QoL, and eating behavior parameters of 181 healthy children and teenagers, of both genders, and between the ages of 5 to 13, who are enrolled in the public education system in Belo Horizonte city, Minas Gerais, Brazil. They were fitted in three groups regarding body composition: Normal Weight, Overweight, and Obese. To determine these groups, the z-score for age-based body mass index (IMC/I) was used, and the children were classified according to the cutoff scores proposed by the World Health Organization (WHO). Anthropometry included weight, height, waist and hip circumferences, waist-hip ratio, and waist-height ratio. QoL was assessed using the Peds-QL 4.0 questionnaire, and eating behavior was assessed using the Children’s Eating Behaviour Questionnaire (CEBQ). Cardiovascular parameters were assessed using the Mobil-O-Graph® device, which measures the pulse wave velocity (PWV) and augmentation index (AIx@75) to estimate arterial stiffness (AS), which is considered an early marker of cardiovascular disease. RESULTS: In addition to the increase in anthropometric measurements (p < 0.001), the Obesity group exhibited behaviour related to food intake (p < 0.05). When analyzing QoL, a worsening in the social domain was also observed in the Obesity group (p < 0.05). However, PWV and AIx@75 did not differ between groups. CONCLUSION: Eating behaviour is related to the development of childhood obesity. However, early markers of cardiovascular risk related to AS did not change as a function of body composition in the children evaluated.Item Características epidemiológicas e clínicas de pacientes jovens com câncer de mama segundo o perfil mutacional(Faculdade Ciências Médicas de Minas Gerais, 2024-06-13) Corrêa, Daniela Beggiato; Rodrigues, Angélica NogueiraIntroduction: Breast cancer is the most common cancer in women and an important cause of death. Advanced age is directly proportional to the risk of developing the disease, but young women are more likely to develop breast cancer with worse clinicopathological charac teristics and more aggressive subtypes. It is essential to get to know the epidemiological pro file of young breast cancer (YBC) patients to better organize strategies to improve its control. Data from Brazilian YBC patients are scarce, especially regarding its association with a germline mutations with pathogenic potential. Objective: To compare epidemiological and clinical outcome data from non-mutated YBC patients to mutated ones. Material and meth ods: It is a cross-sectional retrospective study that included the analysis of medical records from two institutions in Minas Gerais/Brazil, focusing on YBC patients diagnosed between January 2012 to December 2020. The following variables were collected: sociodemographic profile of patients, tumor and patient-related characteristics, presence or absence of genetic mutation and variants of uncertain significance, follow-up time, and death. Binary logistic regression models were built to assess the association between traits and the occurrence of the mutation. This study was approved by the ethics committee of Hospital Felício Rocho before data collection began (4.553.583 / 2021). Results: 377 patients were included, 99.5% of them were women, mean age was 36 years, 63.7% were married at diagnosis, 62.5% with a com plete college education, and 89% had a private health insurance. Most of the sample (54.6%) underwent mastectomy, and 35.6% had sentinel lymph node involvement. Genetic testing was performed in 137 patients, and 29.9% of them presented a pathogenic or likely pathogenic mutation, predominantly in the BRCA1 gene (36.6%). Patients with a positive family history of cancer were more likely to be mutated (OR 1.92, IC 95% 0.90-4.16). Mutated patients un derwent more frequent mastectomies (OR 2.74, IC 95% 1.24-6.45) and contralateral prophy lactic surgery (OR 7.39, IC 95% 3.22-17.72). 36.3% of the tumors were luminal B and 43% stage II. Stage IV was scored in 6.7% of cases, locoregional recurrences in 11.9%, distant metastasis in 20.4%, and 10.9% deaths. 96,7% dos pacientes não mutantes e 100% dos mutantes estavam vivos em um acompanhamento médio de três anos (p 0,36). Conclusion: In this cohort of YBC has an un-favorable prognosis, with greater luminal subtype B, inter mediate histological grade, tumors larger than 2 cm with anatomical stage II, and 20,4% of patients, more than a fifth of the sample, progressing with distant metastases. We observed high rates of genetic mutation in this population and an increase in genetic testing over the years; patients with a genetic mutation with pathogenic potential were submitted more radical surgical procedures.Item A intensidade da dor e a incapacidade afetam a qualidade de vida relacionada à saúde da pessoa idosa com dor lombar? Análise multinível entre Brasil e Holanda: estudo cross sectional do consórcio BACE(Faculdade Ciências Médicas de Minas Gerais, 2023-03-27) Grigorini, Adriana Estela de Oliveira; Pereira, Leani Souza Máximo; Leopoldino, Amanda Aparecida de OliveiraIntroduction: The prognosis of back pain (BP) in the elderly is less favorable than in adults and progress to adverse outcomes such as disability, falls, comorbidities, sleep disorders, psychosocial distress, and consequent worsening of health-related quality of life (HRQoL). Objective: To verify the association between the acute BP intensity, disability, and quality of life in elderly residents in Brazil and Netherlands. Methods: Data were collected from 602 Brazilian and 675 Dutch participants with a new episode of BP from the Back Complaints in Elders (BACE) consortium. For the present study, a cross section was used. Pain intensity and disability were assessed using the Numerical Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ), respectively. HRQoL was assessed using the Short Form Health Survey (SF-36) quality of life questionnaire. Age, sex, and education were descriptive variables. Pain intensity (NPS score) and country were the independent variables and quality of life assessed by each SF domain - 36 was the dependent variable. Analysis of models at the individual level was performed to verify the association between pain and disability, also HRQoL in Netherlands and Brazil in the total sample. The multilevel model was used to verify whether the elderly person's country of residence influenced this relationship. Results: The evaluated sample consisted of 1270 participants who were divided into two groups: Brazilians (n = 602, 67.7 ± 7.0 years) and Dutch (n = 668, 66.4 ± 7.57 years). As for sociodemographic characteristics, 908 (71.5%) of all participants were female and 362 (28.5%) were male, with a mean age of 67 (± 7.33 years). Brazilian elderly had lower educational levels and worse scores for disability (RMDQ) and pain intensity (NPS) compared to Dutch elderly. In the total sample, linear regression analysis adjusted for sex and age showed a significant association between BP intensity scores and HRQoL, for all domains, observing that Dutch elderly people had a greater impact of pain on quality of life as assessed by the SF-36. There was no association between disability and HRQoL. In the multilevel analysis, there was an association between BP intensity and HRQoL in all domains and an association between the country of residence and HRQoL, influencing the effect of pain, in all domains, except for the physical functioning. Conclusion: Socioeconomic and cultural aspects of Brazil and Netherlands can impact the perception of the elderly about their quality of life in the presence of BP. Pain and disability in Brazilian and Dutch elderly ones are experienced differently in relation to their quality of life.Item Fatores preditores de delirium e cognição em idoso com fratura de fêmur: pontos de corte para triagem cognitiva de 10 pontos (CS-10) e Mini-Cog que discriminam idosos com fratura de fêmur(Faculdade Ciências Médicas de Minas Gerais, 2023-12-05) Gusmão, Vanessa Patrícia do Valle; Avelar, Núbia Carelli Pereira; Leopoldino, Amanda Aparecida de OliveiraSummary: Delirium is a common complication in elderly people undergoing femoral fracture surgery. It is related to greater morbidity, mortality and functional and cognitive decline. Despite its relevance from a clinical, economic and social point of view, interventions to reduce its occurrence and severity remain neglected. Objectives: This study sought to establish cutoff points for the 10-point Cognitive Screening (CS-10) and Mini-Cog in elderly people after femoral fracture surgery and verify the association between cognitive decline and delirium, considering the points established cutoffs. Methods: 51 patients were evaluated in a prospective cohort study, with CS-10 and Mini-Cog tests performed before and after surgery. Delirium was assessed on admission and prospectively by the Confusion Assessment Method (CAM). Results: Analysis of the Receiver operator characteristic curve (ROC) determined cutoff points for CS-10 and Mini-Cog, which could discriminate delirium. Logistic regression reveals that elderly people with Cs-10 ≤5 points and Mini-Cog≤ 2 points were more likely to develop delirium, even after adjusting for sex, age and education. Conclusion: Patient with perioperative Cs-10 ≤5 and Cs-10 ≤5 was more likely to develop delirium. Stratification based on cognitive assessment can guide the implementation of cost effective prophylactic interventions in surgical patients with femoral fractures, aiming to improve clinical results and reduce costs in the healthcare system.Item Prevalência e fatores associados com sarcopenia em idosos brasileiros: uma revisão sistemática e metanálise(Faculdade Ciências Médicas de Minas Gerais, 2023-03-13) Cardoso Júnior, José Milton; Pereira, Leani Souza Máximo; Leopoldino, Amanda Aparecida de OliveiraIntroduction: Sarcopenia is a muscular disease that influences several homeostatic and functional mechanisms in the geriatric population. Despite being rooted in adverse muscular changes, it affects several organic systems. It can be divided into primary and secondary, the former originating in the aging of the individual and the latter due to associated comorbidities, where the prevalence in the elderly population is widely variable, as it ranges from 5% to 50% depending on sex, age, pathological conditions and mainly the diagnostic criteria. There is a pressing need for advances in the study of this pathology and to offer better diagnostic methods, prevention, and individualized health care. Physical activity and nutrition are the main ways studied to prevent, treat, and even reverse sarcopenia and to date, they offer better results in their approach. Objectives: To estimate the prevalence and cumulative incidence of sarcopenia in Brazilian elderly people living in the community and identify factors associated with this condition. Methods: Systematic review and meta-analysis. Searches were carried out in the LILACS, EMBASE, SciELO, AMED, CINAHL and MEDLINE/PubMed databases, with descriptors Brazil and sarcopenia, from 2005 to 2023. Observational studies were included, and assessments of risk of bias and quality of evidence were using the Joanna Briggs tool. All diagnostic recommendations were used to identify sarcopenia in studies according to publication date. The combined prevalence was estimated by the proportion of individuals with sarcopenia in the total sample of each included study. The pooled associated factors were calculated or obtained using odds ratios (OR) from the data reported in the included studies. The meta-analysis was performed using a random effects model. Results: A total of 53 studies were included grouping 17,555 participants. The overall prevalence of sarcopenia was 18% (95%CI=13.5–22.7%). The cumulative incidence of sarcopenia, considering a projection of the Brazilian elderly population in the period 2012-2023 (n=~26,723,827), was 0.13 (95%CI=0.13– 0.14) per 1,000 elderly people. The factors significantly associated with sarcopenia were: female sex (OR=0.67, 95%CI=0.45–0.99); advanced age 70–79 years: OR=1.50; 95%CI=1.13–1.99 and ≥80 years: OR=4.01; 95%CI=2.12–7.58); higher education level (OR=0.73, 95%CI=0.56–0.96); osteoporosis (OR=2.02, 95% CI=1.28– 3.18); depression (OR=1.17; 95CI%=1.07–1.27); falls (OR=1.30, 95%CI=1.13–1.51); and hospitalization (OR=2.24, 95%CI=1.35–3.71). Conclusion: The overall prevalence of sarcopenia was 18%. The factors that provide greater risks of developing the disease were advanced age, osteoporosis, depression, falls and hospitalization, while the factor that proved to be the lowest risk was higher education. These findings provide evidence for early identification of individuals at high risk for sarcopenia who may benefit from appropriate interventions to prevent, treat, and even reverse this condition and its complications.Item Relação entre transtorno do déficit de atenção e hiperatividade e transtorno por uso de substância em adultos internados em comunidade terapêutica: estudo caso-controle(Faculdade Ciências Médicas de Minas Gerais, 2023-07-07) Calazans, Sigrid Terezinha Campomizzi; Souza, Alessandra Hubner deAttention deficit hyperactivity disorder (ADHD) is a neuropsychiatric condition that affects people in all age groups. It is currently considered a neurodevelopmental disorder and is underdiagnosed in adults can cause negative outcomes if left untreated. This study was conducted to evaluate the frequency of ADHD in adults admitted for treatment of severe chemical dependency in the Rios de Água Viva Therapeutic Community (CTRAV) in Coronel Fabriciano, Minas Gerais. We did a case-control study in men over 18 years old, compared to age-matched men with no history of chemical dependence, in a 1:1 ratio. Data collection was done by applying the DSM-5 questionnaire for diagnosis of ADHD, adding information about demographic profile, smoking, and age of onset of substance use. The control group was made up of men with no history of chemical dependence, living in the same region as the patients, randomly selected, matched by age. The great majority of patients had a high school degree (72.7%), were unmarried (93.2%), and smoked (86.4%). Of the 44 patients with Substance Use Disorder (SUD) tested for ADHD symptoms, 10 (22.7%) met DSM-5 criteria for the diagnosis of the disorder (p<0.001), while only one man in the control group received this diagnosis (2.3%). The most commonly used drug was alcohol (100%), followed by crack-cocaine (47%), with cannabis appearing in third place (4.5%). The high frequency of ADHD was found among patients with severe chemical dependence hospitalized in a Therapeutic Community (TC), which leads us to think that ADHD may be one of the modifiable factors to act on for prevention measures of severe chemical dependence.Item Eventos adversos do uso dos inibidores de SGLT2 em pacientes com insuficiência cardíaca com fração de ejeção reduzida e preservada: revisão sistemática e meta-análise(Faculdade Ciências Médicas de Minas Gerais, 2023-12-14) Britto, Mariana Feldner de; Polese, Janaine Cunha; Souza, Alessandra Hubner dentroduction: Heart failure (HF) is a growing public health problem, with around 64 million people affected by the disease worldwide. In recent years, a new class of drugs has emerged for the treatment of this disease with the aim of preventing the development or worsening of HF, in addition to improving quality of life. Sodium-glucose cotransporter 2 (iSGLT2) inhibitors are a class of drugs that work by decreasing glucose reabsorption, helping patients with type 2 diabetes mellitus (T2DM), but also have other beneficial effects on the body such as kidneys and heart. Despite the positive effects, there are concerns and inconsistencies in the literature about the repercussion of the use of iSGLT2 in relation to its adverse events. Objective: The present systematic review and meta-analysis aims to evaluate the occurrence of adverse events (hypotension, volume depletion, and acute kidney injury) in patients with HF with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) using iSGLT2. Method: This is a review with systematic search and meta-analysis, registered in PROSPERO (CRD42022365684) and developed according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the following databases: PubMed, EBSCO and LILACS, with no restriction of language or publication date until 2023. The following descriptors were used (Mesh): sglt2 inhibitors, heart failure, reduced ejection fraction, preserved ejection fraction, hypotension, volume depletion, acute kidney injury ("sglt2" AND "heart failure"), ("acute kidney injury AND safety"), ("hypotension AND safety"), ("volume depletion AND safety"). The selection by titles was performed by two independent examiners using Rayyan software, and then the abstracts and full titles were evaluated. The articles were included considering the acronym PICOS: (1) (P) population (adult individuals diagnosed with HFpEF or HFpEF); (2) (I) type of intervention (use of iSGLT2); (3) (C) standard therapies; (4) (O) occurrence of hypotension, volume depletion, or acute kidney injury, and (5) (S) randomized controlled trials. Two evaluators independently analyzed the risk of bias using RoB 2. The meta-analysis was performed using RevMan 3.4.1 in order to verify the effects on XIII hypotension, volume depletion, and acute kidney injury. Results: A total of 9474 records were identified, of which ten articles were included in the systematic review and meta analysis. The outcomes of hypotension, volume depletion, and acute kidney injury were assessed in isolation. In the outcome of hypotension, a statistically significant increase in risk was observed through the meta-analysis of four studies, with no heterogeneity (RR: 1.15; 95% CI 1.01 – 1.30; P=0.03; I2= 0%). Regarding volume depletion, the meta analysis including five studies showed that there was no statistically significant difference and no heterogeneity (RR: 1.12; 95% CI 1.95 – 1.33; P=0.17; I2= 0%). For acute kidney injury, based on the meta-analysis carried out with seven studies, it was observed that it was not statistically significant, presenting low heterogeneity (RR: 0.85; 95% CI 0.69 – 1.06; P=0.14; I2 = 16%). Conclusion: The present systematic review and meta-analysis showed that iSGLT2 therapy leads to a higher risk of adverse events of hypotension. No increased risk of volume depletion and acute kidney injury was observed in association with iSGLT2. Despite the 15% reduction in relative risk (not significant) in the outcome of acute kidney injury, the results suggest a renal benefit. This analysis shows us that, despite a growing number of publications in recent years involving adverse events related to the use of iSGLT2, there is still divergence of results, leading to the need for future studies with the class.