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Gueldini de Moraes AV, Costa-Paiva L, da Costa Machado H, Maciel TF, Mariano FV, Pedro AO. Comparison of the effect of noninvasive radiofrequency with vaginal estrogen and vaginal moisturizer in the treatment of vulvovaginal atrophy in postmenopausal women: a randomized clinical trial. Menopause 2024; 31:288-302. [PMID: 38412393 DOI: 10.1097/gme.0000000000002326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To compare the effect of noninvasive radiofrequency (RF) with vaginal estrogen (E), and vaginal moisturizer (M) on improving vulvovaginal atrophy (VVA) in women with genitourinary syndrome of menopause. METHODS A total of 32 postmenopausal women who met the inclusion criteria were randomized into three intervention arms to receive one of the following treatments: three sessions of noninvasive RF therapy (RF arm); intravaginal estriol cream 1 mg applied daily for 2 weeks, followed by 1 mg applied two times weekly or 1 mg of estradiol vaginal fast-dissolving film applied daily for 2 weeks, followed by 1 mg applied two times weekly (E arm); and intravaginal moisturizer two times a week (M arm). Assessments at baseline and after 4 months were conducted using Vaginal Health Index score, Vaginal Maturation, visual analog scale for VVA symptoms (dyspareunia, dryness, and burning), and Menopause Rating Scale (MRS) for urogenital symptoms. Vaginal wall biopsies were administered to participants who consented, pretreatment and posttreatment (at baseline and after 4 months of follow-up). RESULTS After 4 months, the Vaginal Health Index showed an increase of 6.6 points in mean total score in the RF arm, also in the E arm (+7.3 points), with no significant improvement in the M arm (+1.5 points) (interaction effect: RF, E ≠ M, P < 0.001). Regarding vaginal maturation, there was a significant increase in superficial cells in the E arm (+31.3), with no significant changes in the RF (+9.3) and M (-0.5) arms (interaction effect: E ≠ M, P < 0.001). Vaginal pH decreased significantly in the E arm (-1.25), with a similar response in the RF arm (-1.7), with no significant improvement in the M arm (-0.25) (interaction effect: RF, E ≠ M, P < 0.001).There was a significant improvement in the MRS score for VVA symptoms in the three intervention arms, with no predominance of any arm, whereas the improvement in the total MRS score for urogenital symptoms showed a predominance of the RF arm (ΔRF: -7.8; ΔE: -3.5; ΔM: -2.3; RF ≠ E, M). According to histopathologic analysis, there was no statistically significant increase in glycogenation ( P = 0.691) or epithelial cone height ( P = 0.935), despite an increase in the median delta (difference between pretreatment and posttreatment) in the three intervention arms (glycogenation: RF arm Δ = +118.4%; E arm Δ = +130.9%; M arm Δ = +24.9%; epithelial cone height: RF arm Δ = +33.5%; E arm Δ = +18.6%; M arm Δ = +22.3%). CONCLUSION The effect of noninvasive RF on the treatment of vulvovaginal symptoms of genitourinary syndrome of menopause was similar to vaginal estrogen, except for hormonal cytology, and superior to vaginal moisturizer, with improvement in some histomorphometric parameters. These findings are promising, especially for the population that cannot or prefers not to use vaginal estrogen therapy.
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Affiliation(s)
- Anna Valéria Gueldini de Moraes
- From the Department of Obstetrics and Gynecology of Faculty of Medical Sciences, State University of Campinas (FCM-UNICAMP), Campinas, São Paulo, Brazil
| | - Lucia Costa-Paiva
- From the Department of Obstetrics and Gynecology of Faculty of Medical Sciences, State University of Campinas (FCM-UNICAMP), Campinas, São Paulo, Brazil
| | | | - Tayná Figueiredo Maciel
- Department of Pathological Anatomy of Faculty of Medical Sciences, State University of Campinas (FCM-UNICAMP), Campinas, São Paulo, Brazil
| | - Fernanda Viviane Mariano
- Department of Pathological Anatomy of Faculty of Medical Sciences, State University of Campinas (FCM-UNICAMP), Campinas, São Paulo, Brazil
| | - Adriana Orcesi Pedro
- From the Department of Obstetrics and Gynecology of Faculty of Medical Sciences, State University of Campinas (FCM-UNICAMP), Campinas, São Paulo, Brazil
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Williams CR, Valeria Bahamondes M, Gómez Ponce de León R, da Costa Machado H, Bahamondes L, Caffe S, Serruya SJ. Analysing the context and characteristics of legal abortion and comprehensive post-abortion care among adolescents aged 10-14 in a network of sentinel centres in Latin America: a retrospective cross-sectional study, 2016-2020. Sex Reprod Health Matters 2023; 31:2175442. [PMID: 36919908 PMCID: PMC10026806 DOI: 10.1080/26410397.2023.2175442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Pregnancy-related complications are a substantial source of morbidity and mortality among adolescents in low- and middle-income countries. While the youngest adolescents (those aged 10-14) are considered to be at particularly high risk of adverse outcomes, there is little empirical data available on their sexual and reproductive health. Using a unique dataset of clinical records drawn from a regional network of sentinel centres providing legal abortion and comprehensive post-abortion care in 12 Latin American and Caribbean countries, we described the population of adolescents aged 10-14 seeking legal abortion and post-abortion care and calculated institutional rates of complications, using older adolescents (aged 15-19) and young adults (aged 20-24) as comparator groups. We also assessed the quality of care provided as compared to WHO recommendations. Nearly 17% (89 out of 533) of young adolescents sought care when they were already at 15 or more weeks' gestation. Young adolescents were at higher risk of pre-procedure and intra-operative complications than older adolescents and young adults, though the trend is less clear for the most severe complications. In general, the quality of care provided by centres in the network was aligned with WHO recommendations for safe abortion and comprehensive post-abortion care. Taken together, these findings provide insight into the challenges facing the global health community in assuring the sexual and reproductive health and rights of the youngest adolescents, and outline avenues for future research, advocacy, and evidence-based policymaking.
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Affiliation(s)
- Caitlin R Williams
- PhD Candidate, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Valeria Bahamondes
- International Consultant, Latin American Center for Perinatology/Women's Health and Reproductive Health of the Pan American Health Organization (CLAP/WR-PAHO/WHO), Montevideo, Uruguay
| | - Rodolfo Gómez Ponce de León
- Regional Reproductive Health Advisor, Latin American Center for Perinatology/Women's Health and Reproductive Health Pan American Health Organization (CLAP/WR-PAHO/WHO), Montevideo, Uruguay
| | - Helymar da Costa Machado
- Statistician, Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas - UNICAMP, Cidade Universitária, Rua Alexander Fleming 101, Campinas, SP 13083-881, Brazil
| | - Luis Bahamondes
- Professor of Gynaecology, Human Reproduction Unit, Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil
| | - Sonja Caffe
- Regional Adolescent Health Advisor, Pan American Health Organization/World Health Organization, Washington, DC, USA
| | - Suzanne Jacob Serruya
- Director, Latin American Center for Perinatology/Women's Health and Reproductive Health of the Pan American Health Organization (CLAP/WR-PAHO/WHO), Montevideo, Uruguay
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Fachini AMD, Zuliani AC, Sarian LO, Teixeira JC, Esteves SCB, da Costa Machado H, Zeferino LC. Long-term outcomes of concomitant cisplatin plus radiotherapy versus radiotherapy alone in patients with stage IIIB squamous cervical cancer: A randomized controlled trial. Gynecol Oncol 2020; 160:379-383. [PMID: 33341239 DOI: 10.1016/j.ygyno.2020.11.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/26/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The present analysis determined the disease free survival (DFS) and overall survival (OS) at up to 14 years of follow-up in women who participated in our previous phase 3 randomized controlled clinical trial, in which women with stage IIIB squamous cervical cancer received either cisplatin plus RT or RT alone for treatment. The first study showed that the addition of cisplatin to RT offered a significant benefit in DFS, but not in OS. METHODS The present analysis examined DFS and OS in 146 women from the original cohort (72 patients in the CRT arm and 74 patients in the RT-only arm) with follow-up of up to 14 years. RESULTS Longer term follow-up showed that treatment with CRT offers a significant benefit in DFS and OS compared with treatment with RT only. Patients who received RT alone had significantly worse OS (HR, 1.88; 95% CI, 1.09-3.24) and DFS (HR, 1.82; 95% CI, 1.07-3.08) compared with patients who received CRT. The multivariate analyses also showed that the patients with baseline Karnofsky performance status (KPS) <90% showed significantly worse OS (HR, 3.11; 95% CI, 1.78-5.43), as did those with hemoglobin <10 mg/dL (HR, 4.32; 95% CI, 2.23-8.36). Patients with baseline KPS < 90% showed significantly worse DFS (HR, 2.83; 95% CI, 1.60-5.01), as did those with hemoglobin <10 mg/dL (HR, 4.16; 95% CI, 2.17-7.95). CONCLUSIONS For stage IIIB cervical cancer, treatment with CRT offers a significant benefit in DFS and OS compared with treatment with RT only.
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Affiliation(s)
- Ana Maria Dias Fachini
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Antonio Carlos Zuliani
- Department of Radiotherapy, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Luís Otávio Sarian
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Júlio César Teixeira
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Sérgio Carlos Barros Esteves
- Department of Radiotherapy, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Helymar da Costa Machado
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Luiz Carlos Zeferino
- Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
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Teixeira JC, Maestri CA, Machado HDC, Zeferino LC, de Carvalho NS. Incidence rates and temporal trends of cervical cancer relating to opportunistic screening in two developed metropolitan regions of Brazil: a population-based cohort study. SAO PAULO MED J 2019; 137:322-328. [PMID: 31691764 PMCID: PMC9744015 DOI: 10.1590/1516-3180.2018.0306220719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 07/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Brazilian opportunistic screening programs for cervical cancer have limited impact. In the regions of two cities (Campinas and Curitiba) with high human development indices, consistent information from 96-97% of all cervical cancer cases managed within the public healthcare system is available. OBJECTIVE To estimate the incidence rate (IR) and temporal trends in these regions, covering 2001-2012. DESIGN AND SETTING A population-based cohort study was conducted under the assumption that all cervical cancer cases were managed in cancer referral center hospitals. METHODS 3,364 records (1,646 from Campinas; 1,718 from Curitiba) were analyzed to provide estimates of IR, age-standardized IR (ASR) and cervical cancer trends (shown per 100,000 women/year). Longitudinal patterns were analyzed using linear regression and shown as annual percentage change (APC); P < 0.05 for significance. RESULTS Annual IR and ASR estimates for cervical cancer ranged from 3.8 to 8.0 over 2001-2012, decreasing over more recent years, and were similar for the two regions. The age-specific IR was about 50% lower among women aged 45 years or older (IR-2001/IR-2012: Campinas = 14.8/8.0; Curitiba = 18.7/8.3; P < 0.001). There was an increasing APC trend in Campinas among women aged 15-24 years, and a decreasing IR trend for squamous-cell histology in both regions (P < 0.05). CONCLUSION Cervical cancer incidence estimates showed slowly decreasing trends in both regions, most evidently for women aged 45 years or older and for squamous-cell histology. These findings reflect the opportunistic nature of the population screening program, despite the comparatively high economic development level in the two regions.
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Affiliation(s)
- Júlio César Teixeira
- MD, PhD. Physician and Assistant Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Carlos Afonso Maestri
- MD, MSc. Physician and Doctoral Student, Lower Genital Tract Disease Service, Hospital Erasto Gaertner, Curitiba (PR), Brazil.
| | - Helymar da Costa Machado
- MSc. Statistician, Department of Statistics, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Luiz Carlos Zeferino
- MD, PhD. Physician and Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Newton Sérgio de Carvalho
- MD, PhD. Physician and Professor, Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade Federal do Paraná (UFPR), Curitiba (PR), Brazil.
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Bacha AM, Grassiotto ODR, Gonçalves SP, Higa R, Fonsechi-Carvasan GA, Machado HDC, Cacique DB. Job satisfaction of nursing staff in a university hospital. Rev Bras Enferm 2017; 68:1130-8. [PMID: 26676437 DOI: 10.1590/0034-7167.2015680619i] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.
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Affiliation(s)
- Angela Maria Bacha
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | | | - Simone Pollini Gonçalves
- Centro de Atenção Integral à Saúde da Mulher, Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Rosângela Higa
- Centro de Atenção Integral à Saúde da Mulher, Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Gislaine Aparecida Fonsechi-Carvasan
- Centro de Atenção Integral à Saúde da Mulher, Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Helymar da Costa Machado
- Centro de Atenção Integral à Saúde da Mulher, Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Universidade Estadual de Campinas, Campinas, SP, Brasil
| | - Denis Barbosa Cacique
- Centro de Atenção Integral à Saúde da Mulher, Hospital da Mulher Professor Doutor José Aristodemo Pinotti, Universidade Estadual de Campinas, Campinas, SP, Brasil
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Bacha AM, Grassiotto ODR, Cacique DB, Carvasan GAF, Machado HDC. Job satisfaction in a hospital context: an analysis according to gender. Escola Anna Nery - Revista de Enfermagem 2015. [DOI: 10.5935/1414-8145.20150073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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de Pádua Cintra I, Zanetti Passos MA, dos Santos LC, da Costa Machado H, Fisberg M. Waist-to-height ratio percentiles and cutoffs for obesity: a cross-sectional study in brazilian adolescents. J Health Popul Nutr 2014; 32:411-419. [PMID: 25395904 PMCID: PMC4221447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study aimed to describe the distribution of waist-to-height ratio (WHtR) percentiles and cutoffs for obesity in Brazilian adolescents. A cross-sectional study including adolescents aged 10 to 15 years was conducted in the city of São Paulo, Brazil; anthropometric measurements (weight, height, and waist-circumference) were taken, and WHtRs were calculated and then divided into percentiles derived by using Least Median of Squares (LMS) regression. The receiver operating characteristic (ROC) curve was used in determining cutoffs for obesity (BMI ≥ 97th percentile) and Mann-Whitney and Kruskal-Wallis tests were used for comparing variables. The study included 8,019 adolescents from 43 schools, of whom 54.5% were female, and 74.8% attended public schools. Boys had higher mean WHtR than girls (0.45 ± 0.06 vs 0.44 ± 0.05; p=0.002) and higher WHtR at the 95th percentile (0.56 vs 0.54; p<0.05). The WHtR cutoffs according to the WHO criteria ranged from 0.467 to 0.506 and 0.463 to 0.496 among girls and boys respectively, with high sensitivity (82.8-95%) and specificity (84-95.5%). The WHtR was significantly associated with body adiposity measured by BMI. Its age-specific percentiles and cutoffs may be used as additional surrogate markers of central obesity and its co-morbidities.
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Affiliation(s)
- Isa de Pádua Cintra
- Adolescent Sector, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Luana Caroline dos Santos
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Mauro Fisberg
- Adolescent Sector, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Quintino-Moro A, Zantut-Wittmann DE, Tambascia M, Machado HDC, Fernandes A. High Prevalence of Infertility among Women with Graves' Disease and Hashimoto's Thyroiditis. Int J Endocrinol 2014; 2014:982705. [PMID: 24678319 PMCID: PMC3942334 DOI: 10.1155/2014/982705] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 12/27/2013] [Indexed: 12/12/2022] Open
Abstract
Objectives. To evaluate the prevalence of infertility in women with Graves' disease (GD) or Hashimoto's thyroiditis (HT) and associated factors. Material and Methods. This cross-sectional study was conducted at the Endocrinology Clinic for Thyroid Autoimmune Diseases, with 193 women aged 18-50 years with GD and 66 women aged 18-60 years with HT. The women were interviewed to obtain data on their gynecological and obstetric history and family history of autoimmune diseases. Their medical records were reviewed to determine the characteristics of the disease and to confirm association with other autoimmune diseases. Infertility was defined as 12 months of unprotected sexual intercourse without conception. Results. The prevalence of infertility was 52.3% in GD and 47.0% in HT. Mean age at diagnosis was 36.5 years and 39.2 years, in GD and HT, respectively. The mean number of pregnancies was lower in women who were 35 years old or younger at diagnosis and was always lower following diagnosis of the disease, irrespective of age. The only variable associated with infertility was a shorter time of the disease in HT. Conclusions. The prevalence of infertility was high in women with GD and HT and affected the number of pregnancies in young women.
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Affiliation(s)
- Alessandra Quintino-Moro
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Rua Alexander Fleming, 101, Cidade Universitária, 13083-881 Campinas, SP, Brazil
| | - Denise E. Zantut-Wittmann
- Endocrinology Division of Department of Clinical Medicine, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária, 13083-887 Campinas, SP, Brazil
| | - Marcos Tambascia
- Endocrinology Division of Department of Clinical Medicine, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária, 13083-887 Campinas, SP, Brazil
| | - Helymar da Costa Machado
- Statistical Office, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária, 13083-887 Campinas, SP, Brazil
| | - Arlete Fernandes
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Rua Alexander Fleming, 101, Cidade Universitária, 13083-881 Campinas, SP, Brazil
- *Arlete Fernandes:
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Marangoni AB, Machado HDC, Passos MAZ, Fisberg M, Cintra IDP. Validade de medidas antropométricas autorreferidas em adolescentes: sua relação com percepção e satisfação corporal. J bras psiquiatr 2011. [DOI: 10.1590/s0047-20852011000300008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Verificar a validade da classificação do estado nutricional e da estatura para idade quando utilizadas massa corporal e estatura autorreferidas por adolescentes, bem como relacionar essa validade com percepção e com satisfação corporal. MÉTODOS: 304 adolescentes antes de terem suas medidas de massa e estatura aferidas autorreferiram essas medidas, foram questionados sobre a percepção de seu corpo e a classificação da imagem corporal foi obtida com o uso de uma escala de silhuetas corporais. Também foram aplicados testes específicos para avaliar a satisfação corporal e o comportamento alimentar. RESULTADOS: As classificações feitas com base nos dados autorreferidos e aferidos tiveram concordância alta (K = 1,00) para a classificação da estatura por idade e moderada (K < 0,75) para a classificação de índice de massa corporal. No entanto, adolescentes que se consideravam "abaixo do peso" subestimaram o índice de massa corporal autorrelatado e, os que se percebiam como "gordos", o superestimaram. As meninas e os que se classificaram como obesos tenderam a subestimar o índice de massa corporal, e os meninos, a superestimá-lo. CONCLUSÃO: Os adolescentes autorrelataram suas medidas de massa e estatura de maneira adequada. No entanto, o sexo, a percepção e a classificação da imagem corporal foram variáveis que influenciaram na obtenção de respostas não válidas.
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Carvalho FL, Mezzacappa MA, Calil R, Machado HDC. Incidence and risk factors of accidental extubation in a neonatal intensive care unit. J Pediatr (Rio J) 2010; 86:189-95. [PMID: 20401427 DOI: 10.2223/jped.1999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Accepted: 02/22/2010] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To determine the incidence and risk factors of accidental extubation (AE) in a tertiary neonatal intensive care unit. METHODS A prospective cohort study was conducted to determine AE incidence density per 100 patient-days, during a 23-month period, in 222 newborns receiving assisted ventilation (AV). Logistic regression analysis was used to determine risk factors for AE. The presence of a cyclical pattern in extubation rates, according to the variables of interest, was investigated by Cosinor analysis. RESULTS The mean AE rate was 5.34/100 patient-days ventilated. AE-associated predictive variables were: subsequent use of the oral and nasal routes during AV [relative risk (RR) = 4.73; 95% confidence interval (95%CI) 1.92-11.60], AV duration (per day, RR = 1.03; 95%CI 1.02-1.04), and number of patient-days ventilated (RR = 1.01; 95%CI 1.01-1.02). According to the adjusted multiple regression analysis, total AV time was the only independent predictor of AE in this sample (RR = 1.02; 95%CI 1.01-1.03). AV time of 10.5 days showed an accuracy of 0.79 (95%CI 0.71-0.87) for the occurrence of AE. Cosinor analysis showed significant periodicity in overall AE rate and in the number of patient-days ventilated. There was a significant correlation between the number of patient-days ventilated and AE frequency. CONCLUSION Mean AE density was 5.34/100 patient-days ventilated. AV duration was the only independent predictor of AE. The best accuracy for AE occurrence was achieved at 10.5 days of AV duration.
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Affiliation(s)
- Fabiana L Carvalho
- Department of Pediatrics, School of Medicine, Universidade Estadual de Campinas (FCM/UNICAMP), Campinas, SP, Brazil.
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Passos MAZ, Cintra IDP, Branco LM, Machado HDC, Fisberg M. Body mass index percentiles in adolescents of the city of São Paulo, Brazil, and their comparison with international parameters. ACTA ACUST UNITED AC 2010; 54:295-302. [PMID: 20520960 DOI: 10.1590/s0004-27302010000300008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 11/08/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE: To describe the percentile distribution of body mass index (BMI) in school adolescents, by gender and age, comparing them with international parameters. SUBJECTS AND METHODS: The study included 8,020 adolescents aged 10-15 years from 43 schools in the city of São Paulo, southeastern Brazil. BMI values of the study sample were distributed in percentiles and compared to international parameters (CDC, Must and cols. and Cole and cols.). RESULTS: Both male and female adolescents aged 10 to 14 years showed BMI cut-offs over the international parameters, especially in the P50-P85 percentile range. At the age of 15, the observed values were very similar to reference data; however, BMI values in the 95th percentile were much higher than international parameters. CONCLUSIONS: The study results show how important it is to use adequate BMI values for Brazilian adolescents aged 10-15 since international parameters may not reflect the actual nutritional status of this group.
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Ogido R, Costa EAD, Machado HDC. [Prevalence of auditory and vestibular symptoms among workers exposed to occupational noise]. Rev Saude Publica 2009; 43:377-80. [PMID: 19287878 DOI: 10.1590/s0034-89102009000200021] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 11/04/2008] [Indexed: 11/22/2022] Open
Abstract
The purpose of the study was to assess the prevalence of auditory and vestibular symptoms in workers exposed to occupational noise. There were examined medical records of 175 workers with noise-induced hearing loss who attended an occupational health reference center in the city Campinas, Southeastern Brazil, from 1997 to 2003. The variables studied were frequency of symptoms of hypoacusis, tinnitus, and vertigo. Association with age, noise exposure time, and auditory thresholds were analyzed using the chi-square test and Fisher's exact test. Hypoacusis was reported in 74% of cases, tinnitus in 81%, and vertigo in 13.2%. There was found an association between hypoacusis and age, noise exposure time, and auditory thresholds and between vertigo and noise exposure time. No other significant associations were found.
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Affiliation(s)
- Rosalina Ogido
- Departamento de Medicina Preventiva e Social, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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