Hospital Materno Infantil HMI

La Paz, Bolivia

Hospital Materno Infantil HMI

La Paz, Bolivia

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Conde D.M.,Hospital Materno Infantil HMI | Costa-Paiva L.,University of Campinas | Martinez E.Z.,University of Sao Paulo | Pinto-Neto A.M.,University of Campinas
Revista da Associacao Medica Brasileira | Year: 2012

Objective: The values of bone mineral density (BMD) were compared in postmenopausal women with and without breast cancer. Methods: A cross-sectional study was conducted, including 51 breast cancer survivors (BCS) and 71 women without breast cancer, who were non-users of hormone therapy, tamoxifen, or aromatase inhibitors. BMD T-scores and measurements in grams per centimeter squared (g/cm2) were obtained at the femoral neck, trochanter, Ward's triangle, and lumbar spine. Osteopenia and osteoporosis were grouped and categorized as abnormal BMD. Unconditional logistic regression analysis was used to estimate the odds ratios (OR) of abnormal BMD values as measures of association, with 95% confidence intervals (CIs), adjusting for age, years since menopause, parity, and body mass index (BMI). Results: The mean age of the women with and without breast cancer was 54.7 ± 5.8 years and 58.2 ± 4.8 years (p < 0.01), respectively. After adjusting for age, parity and BMI, abnormal BMD at the femoral neck (adjusted OR: 4.8; 95% CI: 1.5-15.4), trochanter (adjusted OR: 4.6; 95% CI: 1.4-15.5), and Ward's triangle (adjusted OR: 4.5; 95% CI: 1.5-12.9) were significantly more frequent in postmenopausal BCS than in women without breast cancer. Postmenopausal BCS had a significantly lower mean BMD at the trochanter (0.719 vs. 0.809 g/cm2, p < 0.01) and at the Ward's triangle (0.751 vs. 0.805 g/cm2, p = 0.03). Conclusion: The prevalence of abnormal BMD was higher in postmenopausal BCS than in postmenopausal women without breast cancer. Bone health requires special vigilance and the adoption of interventions should be instituted early to minimize bone loss in BCS. © 2012 Elsevier Editora Ltda. All rights reserved.


Freitas-Silva R.,Federal University of Goais | Conde D.M.,Hospital Materno Infantil HMI | de Freitas-Junior R.,Federal University of Goais | Martinez E.Z.,University of Sao Paulo
Clinics | Year: 2010

OBJECTIVES: This study was designed to compare the prevalence of shoulder-arm morbidity, patient satisfaction with surgery and the quality of life of women submitted to breast-conserving therapy or modified radical mastectomy and immediate breast reconstruction. METHODS: This study was a cross-sectional study of women who underwent breast-conserving therapy (n = 44) or modified radical mastectomy and immediate breast reconstruction (n = 26). Quality of life was evaluated with the SF-36 Health Survey Questionnaire. RESULTS: No differences were found in the prevalence of lymphedema. The movements that were most commonly affected by these procedures were abduction, flexion and external rotation. When the two groups were compared, however, we only found a statistically significant difference for the prevalence of restricted internal rotation, which occurred in 32% of women in the breast-conserving therapy group and 12% of those in the modified radical mastectomy and immediate breast reconstruction group (OR: 7.23; p = 0.03 following adjustment for potential confounding factors). No difference in quality of life or satisfaction with surgery was found between the two groups. CONCLUSIONS: These data suggest that the type of surgery did not affect the occurrence of lymphedema. Breastconserving therapy, however, increased the risk of shoulder movement limitation. No differences were found between the two surgical techniques with respect to quality of life or satisfaction with surgery. © 2010 CLINICS.


Mazzi E.,Hospital del Nino HN Dr Ovidio Aliaga Uria | Mazzi E.,Higher University of San Andrés | Bartos A.E.,Higher University of San Andrés | Bartos A.E.,Hospital Materno Infantil HMI | And 4 more authors.
Journal of Tropical Pediatrics | Year: 2010

Identification of simple signs and symptoms that predict severe illness needing referral for admission of young infants is critical for reducing mortality in developing countries. Infants <2 months of age presenting to two hospitals in La Paz, Bolivia (n=1082) were evaluated by nurses for signs and symptoms, and independently by physicians for the need for admission. In young neonates, sensitivity of individual clinical signs was >35% for measured temperature ≥37.5°C (65%); all signs had specificity >85%. Odds ratios (ORs) for association of individual clinical signs with need for urgent hospital management were highest (>5) for history of difficulty feeding, not feeding well and fever. Clinical signs or symptoms are useful for primary healthcare workers to identify young infants with serious illness needing admission, and have been incorporated into the Integrated Management of Childhood Illness algorithm for use in Bolivia and elsewhere in Latin America. © The Author [2010]. Published by Oxford University Press. All rights reserved.

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