Repositório Institucional FCMMG
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O Repositório Institucional da Faculdade de Ciências Médicas de Minas Gerais (FCMMG) centraliza e organiza produções científicas, técnicas, artísticas e culturais em conformidade com os princípios da Ciência Aberta. A plataforma oferece acesso a uma coleção rica e variada, incluindo livros, TCCs, dissertações, teses, artigos, relatórios, portfólios, recursos multimídia e outros documentos resultantes das atividades de pesquisa e inovação da FCMMG.
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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 Oliveira
Objective: 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.
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 Oliveira
Introduction: 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.
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 Barros
Background: 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.
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 Almeida
INTRODUCTION: 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.
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 Nogueira
Introduction: 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.