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Maeda A.K.,Pontifical Catholic University of Parana | Aguiar L.R.,Pontifical Catholic University of Parana | Martins C.,Institute Medicina Integral Professor Fernando Figueira IMIP | Bichinho G.L.,Pontifical Catholic University of Parana | Gariba M.A.,Pontifical Catholic University of Parana
Arquivos de Neuro-Psiquiatria

Objective: To compare two different methods for measuring intracerebral hemorrhage (ICH) volume: the ellipse volume (called ABC/2), and the software-aided planimetric. Methods: Four observers evaluated 20 brain computed tomography (CT) scans with spontaneous ICH. Each professional measured the volume using the ABC/2 and the planimetric methods. The average volumes were obtained, and the intra- and inter-rater variability was determined. Results: There is an absolute 2.24 cm3 average difference between both methodologies. Volumes yielded by the ABC/2 method were as much as 14.9% smaller than by the planimetric one. An intra-observer variability rate of 0.46% was found for the planimetric method and 0.18% for the ABC/2. The inter-observer rates were 1.69 and 1.11% respectively. Conclusions: Both methods are reproducible. The ABC/2 yielded hemorrhage volumes as much as 14.9% smaller than those measured using the planimetric methodology. Source

de Carvalho C.C.M.,Institute Medicina Integral Professor Fernando Figueira IMIP | Souza A.S.R.,Residencia Medica em Medicina Fetal | Filho O.B.M.,University of Pernambuco
Revista da Associacao Medica Brasileira

Objective. To determine the prevalence and factors associated with episiotomy in a reference center of Pernambuco. Methods. A retrospective cross-sectional study was carried out from January to December 2006 with 495 women who had a normal delivery at the Maternity Center Monteiro de Moraes Integrated Health Amaury de Medeiros (CISAM) University of Pernambuco. Assciated factors were issues preceeding birth, characteristics of labor and perinatal outcome. To verify the association between predictors and performance of episio-tomy the Chi square, Fisher's exact and Student's t tests were used as appropriate, with a a significance level of 5%. The prevalence ratio and confidence intervals were calculated at 95%, in addition to logistic regression analysis. Results. Prevalence of performing episiotomy was 29.1% (n = 144). After bivariate analysis, we found a significant association of episiotomy with adolescence (PR 1.74. 95% CI I. 33-2.28), age over 35 years (PR 0.35. 95% CI 0.14-0.90), primiparity (PR 4.73, 95% CI 3.33-6.71), absence of previous vaginal delivery (PR 5.44, 95% CI 3.67-8.06) and related diseases at the time of delivery (RP 1.71, 95% CI 1.30-2.25). There was no significant relation with gestational age at delivery, duration of labor over 6h and expulsion period of more than 30 minutes, use of misoprostol or oxytocin, abnormal fetal heart rate, presence of meconium, shift of completion of delivery (night or day), rate of Apgar score in 1 and 5 minutes and weight of the newborn. Presence of perineal lacerations was higher in the group not subject to episiotomy, however only 1 st and 2 nd degree lacerations were described. After logistic regression, the analyzed remaining factors associated with episiotomies were maternal diseases (RA 1.99, 95% CI 1.20-3.28) and absence of previous vaginal delivery (9.85 RA, 95% CI 6.04-16.06). Conclusion. Prevalence of episiotomies in the institution was 29%. Variables that remained related to episiotomy were maternal diseases and absence of previous vaginal delivery. Source

de Oliveira M.G.O.A.,Federal University of Pernambuco | Lira P.I.C.,Federal University of Pernambuco | Batista Filho M.,Institute Medicina Integral Professor Fernando Figueira IMIP | Lima M.C.,Federal University of Pernambuco
Revista Brasileira de Epidemiologia

Objective: To determine the duration of breastfeeding and to identify factors associated with exclusive / predominant breastfeeding in children under two years old. Methods: This is a cross-sectional study conducted from March to June 2005 in the municipalities of Gameleira and São João do Tigre, located in the interior of Pernambuco and Paraiba States. The sample comprised 504 children under two years (280 residents in Gameleira and 224 in São João do Tigre). Survival analysis was used to estimate the median duration of survival time of breastfeeding and the associations with socioeconomic conditions, factors related to mothers and children and health care. Results: The duration of exclusive and exclusive/predominant breastfeeding and breastfeeding were of 19, 79 and 179 days in Gameleira and 23, 91 and 169 days in São João do Tigre, respectively. Mothers with better socioeconomic conditions, as represented by education, sanitation, and possession of consumer goods, had a higher median duration of exclusive/ predominant breastfeeding in both towns. Prenatal care represented by higher number of attendance, earlier onset and feeding and breastfeeding advice had a positive influence on breastfeeding duration. Conclusions: Breastfeeding duration was lower than the recommendation. Despite the families precarious living conditions, a better socioeconomic status and prenatal care were protective factors for exclusive/ predominant breastfeeding duration in these areas. Source

McNamara P.S.,University of Liverpool | Fonceca A.M.,University of Liverpool | Howarth D.,University of Liverpool | Correia J.B.,Institute Medicina Integral Professor Fernando Figueira IMIP | And 5 more authors.

Background: The mechanisms regulating antibody expression within the human lung during airway infection are largely unknown. In this study, our objectives were to determine if infection with respiratory syncytial virus (RSV) upregulates expression of the B cell differentiation factors A proliferation inducing ligand (APRIL) and B cell activating factor of the TNF family (BAFF), if this is a common feature of viral airway infection, and how this is regulated in human airway epithelial cells. Methods: We measured BAFF and APRIL protein expression in bronchoalveolar lavage (BAL) fluid from infants with severe RSV disease, and healthy control children, and in nasopharyngeal aspirates from preschool children with other single respiratory viral infections. We also measured mRNA expression in bronchial brushings from RSV-infected infants, and in RSV-infected paediatric primary airway epithelial cell cultures ( pAEC). Beas-2B cell cultures were used to examine mechanisms regulating BAFF expression. Results: BAFF protein and mRNA were elevated (in marked contrast with APRIL) in BAL and bronchial brushings, respectively, from RSV-infected infants. BAFF protein was also found in upper airway secretions from children with human metapneumovirus, H1N1, bocavirus, rhinovirus, RSV and Mycoplasma pneumoniae infection. BAFF mRNA and protein were expressed following in vitro RSV infection of both pAEC and Beas- 2B cultures, with mRNA expression peaking 12-h postinfection. BAFF induction was blocked by addition of a neutralising anti-interferon-β antibody or palivizumab. Conclusions: BAFF, produced through an interferon-β- dependant process, is a consistent feature of airway infection, and suggests a role for the airway epithelia in supporting protective antibody and B cell responses in the lung. Source

da Silva Nunes F.L.,Institute Medicina Integral Professor Fernando Figueira IMIP | Gadelha P.C.F.P.,Federal University of Pernambuco | de Souza Costa M.D.,University of Pernambuco | de Amorim A.C.R.,Institute Medicina Integral Professor Fernando Figueira IMIP | da Silva M.G.B.,Maternal and Child health and Nutritionist IMIP
Nutricion Hospitalaria

Introduction: The nutritional state is the independent factor that most influences the post-operational results in elective surgeries.Objective: to evaluate the influence of the nutritional state on the hospitalization period and on the post-operative complications of patients submitted to abdominal surgery.Methods: prospective study with 99 surgical patients over 18 years of age, submitted to abdominal surgeries in the period from April to October of 2013, in the Instituto de Medicina Integral Professor Fernando Figueira (IMIP). All patients were submitted to anthropometric nutritional evaluations through the body mass Index (BMI), arm circumference (AC) and triceps skinfold thickness (TEST). The biochemical evaluation was carried out from the leukogram and serum albumin results. The identification of candidate patients to nutritional therapy (NT) was carried out through the nutritional risk (NR) evaluation by using the BMI, loss of weight and hypoalbuminemia. The information about post-operational complications, hospitalization period and clinical diagnosis was collected from the medical records. Program SPSS version 13.0 and significance level of 5% were used for the statistical analysis.Results: The malnutrition diagnosed by the AC showed significant positive association with the presence of post-operative complications (p=0.02) and with hospitalization period (p=0.02). The presence of NR was greater when evaluated by hypoalbuminemia (28.9%), however, only 4% of the sample carried out the NT in the pre-operational period. The hospitalization period was greater for patients with malignant neoplasia (p<0.01).Conclusion: The malnutrition diagnosis of patients submitted to abdominal surgeries is associated to greater risk of post-operational complications and longer hospitalization permanence. © 2014, Grupo Aula Medica S.A. All rights reserved. Source

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