Navegando por Palavras-chave "Prevalencia"
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- ItemAcesso aberto (Open Access)Estudo sobre prevalência e impacto prognóstico da sarcopenia em portadores de cirrose hepática.(Universidade Federal de São Paulo (UNIFESP), 2018-12-05) Souza, Gabriela Morais De [UNIFESP]; Carvalho Filho, Roberto Jose de [UNIFESP]; http://lattes.cnpq.br/4303806669248065; http://lattes.cnpq.br/1105170025844543; Universidade Federal de São Paulo (UNIFESP)Introduction: Sarcopenia is a common nutritional complication common in cirrhotic patients. It adversely affects functional status, disease progression, survival, quality of life, stress response and outcomes after hepatic transplantation, being associated with poor prognosis and occurrence of complications in these patients. The diversity and complexity of the methods currently used for the diagnosis of sarcopenia is evident. Objectives: 1) to evaluate the prevalence of functional sarcopenia; 2) to identify epidemiological, clinical and nutritional factors associated with the presence of functional sarcopenia; 3) to evaluate the concordance between functional and objective sarcopenia; and 4) to assess the impact of sarcopenia on the incidence of hepatic decompensation and on the overall survival. Methodology: a crosssectional study, carried out through clinical and nutritional evaluation of outpatients with liver cirrhosis, including measurement of handgrip strength (HGS) with dynamometry and L3 skeletal muscle mass index (SMIL3) obtained by CT for the diagnosis of functional and objective sarcopenia, respectively. Results: 69 patients were evaluated, with 87% of men. The mean age was 58.8 ± 10.1 years. Alcoholic liver disease was the most prevalent cause or cirrhosis (61%), followed by chronic infection with hepatitis C or B viruses (20%). The ChildPughTurcotte (CPT) classification defined 58% of the patients as CPTA, 32% CPTB and 9% CPTC, and the mean MELD (Model for EndStage Liver Disease) score was 11.8 ± 3.8. Diabetes mellitus was present in 38% of the patients, as well as systemic arterial hypertension (SAH) in 36%, ascites in 33% and peripheral edema in 20%. Laboratory evaluation revealed serum albumin lower than 3.5 g/dL in 33% of cases and anemia in 35% of the subjects. Nutritional status through body mass index evaluation considered 45% of the patients as eutrophic, 10% malnourished and 45% overweight and through the midarm circumference (MAC) 43% were eutrophic, 49% undernourished and 8% overweight. The mean HGS was 31.9 ± 9.5 kgf and the mean SMIL3 was 50.5 ± 8.6 cm2/m2. The mean caloric intake was 21.5 ± 8.6 kcal/kg/day and the mean protein intake was 0.9 ± 0.5 g/kg/day. Of the patients evaluated, 90% did not reach the ideal goal for daily caloric intake and 71% did not reach the protein goal. By the HGS, 52% of the patients exhibited functional sarcopenia, which was associated with absence of SAH (p = 0.011), presence of ascites (p = 0.011), low serum levels of albumin (p = 0.040) and sodium (p = 0.001), and lower values of MAC (p = 0.003) and corrected arm muscle area (CAMA; p = 0.001). Through IMML3, 39% of the patients showed objective sarcopenia. There was low concordance between HGS with dynamometry and SMIL3 by CT (kappa coefficient = 0.064). There was no significant association between the presence of functional sarcopenia and the incidence of hepatic decompensation and death during followup. Conclusions: the prevalence of sarcopenia was 52% using dynamometry and 39% using CT. Factors associated with the presence of sarcopenia by HGS include absence of SAH, presence of ascites, low serum levels of albumin and sodium, and lower values of MAC and CAMA. There was low concordance between the two criteria used for the diagnosis of sarcopenia, HGS and SMIL3. Functional sarcopenia had no significant impact on the incidence of hepatic decompensation or survival.
- ItemAcesso aberto (Open Access)Prevalence of simple liver cysts and hemangiomas in cirrhotic and non-cirrhotic patients submitted to magnetic resonance imaging(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2013-07-01) Galvao, Breno Victor Tomaz; Torres, Lucas Rios; Cardia, Patricia Prando; Nunes, Thiago Franchi; Salvadori, Priscila Silveira; D'Ippolito, Giuseppe [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective To determine the prevalence of liver cysts and hemangiomas in the general population and in cirrhotic patients. Materials and Methods Retrospective, observational, and cross-sectional study selecting consecutive magnetic resonance imaging studies performed in the period from February to July 2011. A total of 303 patients (187 women and 116 men) with mean age of 53.3 years were included in the present study. Patients with previously known liver lesions were excluded. The images were consensually analyzed by two observers in the search for simple liver cysts and typical liver hemangiomas, according to universally accepted imaging criteria. Lesions prevalence, diameters and location were determined in both cirrhotic and non-cirrhotic individuals. Results The authors observed prevalence of 8.6% for hemangiomas and 14.5% for simple cysts. No statistically significant difference was observed in relation to prevalence of hemangiomas and cysts among cirrhotic and non-cirrhotic patients (p = 0.954; p = 0.472). Conclusion In the present study, the prevalence of cysts and hemangiomas was higher than the prevalence reported by autopsy series. No influence of cirrhosis was observed on the prevalence and appearance of such incidental lesions.
- ItemEmbargoPrevalência e fatores de risco associados à sibilância em lactentes no primeiro ano de vida em Belém - Pará - Brasil(Universidade Federal de São Paulo (UNIFESP), 2011-01-26) Prestes, Elaine Xavier [UNIFESP]; Solé, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: determinar a prevalência e fatores de risco para sibilância, sibilância recorrente e asma em lactentes de Belém, Pará, Brasil. Métodos: estudo transversal que utilizou o questionário escrito do Estudio Internacional de Sibilancias en Lactentes (EISL) para pais de lactentes de 12 a 15 meses, nas Unidades Básicas de Saúde de Belém, por ocasião de vacinação, entre maio e agosto de 2006. Utilizou-se o Teste t de Student ou Mann-Whitney para variáveis contínuas e teste Qui-quadrado para as categóricas, estimação da razão de chances (RC), com intervalo de confiança de 95%, e ajuste de modelo de regressão logística para avaliar fatores de risco com nível de significância de 5%. Resultados: participaram do estudo 3.024 crianças. A prevalência de sibilância foi 46,1%, de sibilância recorrente 21,9% e asma 10,1%. Os fatores de risco para sibilância no primeiro ano de vida foram: ter infecções de vias aéreas; ser exposto ao fumo na gestação; ser do gênero masculino; ter história familiar de asma, rinite e dermatite atópica; ter tido o primeiro resfriado antes dos cinco meses de idade; ter dermatite atópica; morar em local com poluição atmosférica. Ter o esquema de vacinação atualizado e maior número de pessoas em casa foi identificado como fator de proteção. Os fatores de risco para sibilância recorrente foram: gênero masculino, infecção de vias aéreas, infecção de vias aéreas antes dos cinco meses de idade, ser da raça negra, exposição à poluição atmosférica, história familiar de asma e rinite, dermatite atópica pessoal. Ter o calendário vacinal atualizado e ter seis meses de idade ou mais na primeira infecção foram fatores de proteção. Os fatores de risco para asma foram: ter mais de três episódios de infecções de vias aéreas; ser exposto ao fumo na gestação; ter história familiar de asma; morar em local com poluição atmosférica. Conclusão: a prevalência de sibilância, sibilância recorrente e asma em lactentes de Belém são elevadas e os fatores de risco associados a elas apontam para fatores genéticos, exposição a infecções de vias aéreas, fumo e poluição do ar. A educação dos pais em relação à sibilância e a capacitação de pediatras poderão diminuir a morbidade da doença sibilante e os custos com serviços de saúde.