Revista da Associa??o Médica Brasileira (English Edition)最新文献

{"title":"Commitment in the completion of the medical death certification. Evaluation in Belém, Pará, Brazil in 2010","authors":"José Antônio Cordero da Silva ,&nbsp;Vitor Nagai Yamaki ,&nbsp;João Paulo Santiago de Oliveira ,&nbsp;Renan Kleber Costa Teixeira ,&nbsp;Felipe Augusto Folha Santos ,&nbsp;Victor Seiji Nascimento Hosoume","doi":"10.1016/S2255-4823(13)70484-3","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70484-3","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the completion of medical death certifications in Belém, state of Pará, Brazil in 2010.</p></div><div><h3>Methods</h3><p>In the present study, 800 medical certifications of non-violent death, randomly chosen, and produced in 2010 were analyzed. Regarding correct completion, all fields of the document were evaluated, except for fields I (reserved for civil registries), V (stillbirth or death under age of 1 year), and VIII (external causes/violent death). Each field was analyzed regarding the following parameters: incomplete fields, fields left blank, illegibility, and incorrect completions.</p></div><div><h3>Results</h3><p>Based on the data collected, very high rates of errors in completion were observed; 98.7% of the certifications had at least one mistake. The most remarkable and important mistakes were found in field VI, intended for the cause of death, with a frequency of error of 71.5%, especially due to vagueness.</p></div><div><h3>Conclusion</h3><p>The very high rates of poorly completed medical death certifications highlights a significant failure in the medical schools’ curriculum, as well as a lack of continuing medical education programs addressing such topic of paramount importance. The results demonstrated neglect or lack of knowledge on the pathophysiology of diseases by physicians.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 4","pages":"Pages 335-340"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70484-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137438543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung age in women with morbid obesity","authors":"Fabiana Sobral Peixoto-Souza ,&nbsp;Camila Piconi-Mendes ,&nbsp;Letícia Baltieri ,&nbsp;Irineu Rasera-Junior ,&nbsp;Marcela Cangussu Barbalho-Moulim ,&nbsp;Maria Imaculada de Lima Montebelo ,&nbsp;Dirceu Costa ,&nbsp;Eli Maria Pazzianotto-Forti","doi":"10.1016/S2255-4823(13)70467-3","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70467-3","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the influence of morbid obesity on the lung age in women and to correlate with body mass, body mass index (BMI), and ventilatory variables.</p></div><div><h3>Methods</h3><p>This was a cross-sectional study with 72 morbidly obese women and a control group consistingof 37 normal weightwomen. The subjects performed apulmonary function test to determine lung age, and the results were correlated to anthropometric variables and lung volumes.</p></div><div><h3>Results</h3><p>The morbidly obese group had significantly higher lung age (50.1<!--> <!-->±<!--> <!-->6.8 years) than the control group (38.8<!--> <!-->±<!--> <!-->11.4 years). There was no difference in chronological age between groups. There was a significant positive correlation among chronological age, body mass, BMI, and lung age (r<!--> <!-->=<!--> <!-->0.3647, 0.4182, and 0.3743, respectively). There was a negative correlation among forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, expiratory reserve volume (ERV), and lungage (r<!--> <!-->=<!--> <!-->-0.7565, -0.8769, —0.2723, and —0.2417, respectively).</p></div><div><h3>Conclusion</h3><p>Lung age is increased in morbidly obese women and is associated with increased body mass and BMI.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 3","pages":"Pages 265-269"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70467-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137161964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on cervical herniated disc","authors":"Wanderley M. Bernardo,&nbsp;Carlos Fernando Pereira da Silva Herrero,&nbsp;Fabiano Ricardo de Tavares Canto,&nbsp;Fernando Antonio Façanha Filho,&nbsp;Helton Delfino,&nbsp;Marcelo Luis Mudo,&nbsp;Mario Augusto Taricco,&nbsp;Osmar J.S. Moraes,&nbsp;Ricardo dos Santos Simões,&nbsp;Ricardo Vieira Botelho,&nbsp;Robert Neves,&nbsp;Sérgio Zylbersztein","doi":"10.1016/S2255-4823(13)70423-5","DOIUrl":"10.1016/S2255-4823(13)70423-5","url":null,"abstract":"","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 1","pages":"Page 14"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70423-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82806040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of cardiovascular risk factors before and 6 and 12 months after bariatric surgery","authors":"Maria Alayde Mendonça da Silva,&nbsp;Ivan Romero Rivera,&nbsp;Emília Maria Wanderley de Gusmão Barbosa,&nbsp;Maria Angélica Correia Crispim,&nbsp;Guilherme Costa Farias,&nbsp;Alberto Jorge Albuquerque Fontan,&nbsp;Rodrigo Azavedo Bezerra,&nbsp;Larissa Gabriella de Souza Sá","doi":"10.1016/S2255-4823(13)70491-0","DOIUrl":"10.1016/S2255-4823(13)70491-0","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the frequency of cardiovascular risk factors (CVRFs) in obese patients of the Brazilian Unified Health System (Sistema Único de Saúde – SUS) with indication of bariatric surgery during the preoperative period and after the sixth month and the first year of the procedure.</p></div><div><h3>Methods</h3><p>An observational, longitudinal, prospective, and analytical study was performed, with consecutive selection of obese patients with indication for surgery referred to preoperative cardiac evaluation. The protocol consisted of: medical history, physical examination, electrocardiogram, echocardiogram, and biochemical analysis. This study analyzed the following variables: weight, body mass index (BMI), waist circumference (WC), systemic arterial hypertension (SAH), diabetes mellitus type 2(DM), dyslipidemia (high LDL cholesterol; low HDL cholesterol; hypertriglyceridemia), and metabolic syndrome (MS). The chi-squared test and the Tukey-Kramer method were used for statistical analysis.</p></div><div><h3>Results</h3><p>The sample was composed of 96 obese people, among which 86 were women, aged between 18 and 58 years old (median 35 years old). At the end of six months, significant reductions of 88%, 95%, 71%, 89%, and 80% in the frequency of SAH, high LDL cholesterol, hypertriglyceridemia, DM, and MS could already be observed. A significant and small reduction in the frequency of low HDL cholesterol (24%) and abnormal WC (31%) was observed only at the end of 12 months. After six months and one year, weight and BMI experienced reductions of 33.4<!--> <!-->kg and 44.3<!--> <!-->kg, and 13.1<!--> <!-->kg/m² and 17.2<!--> <!-->kg/m², respectively.</p></div><div><h3>Conclusion</h3><p>The positive impact on weight loss and the reduction in BMI, WC, and in the frequency of CVRFs are already extremely significant after six months and remain so one year after bariatric surgery.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 4","pages":"Pages 381-386"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70491-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89909660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-cultural adaptation of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) into Portuguese","authors":"Carla Silveira ,&nbsp;Mary Angela Parpinelli ,&nbsp;Rodolfo Carvalho Pacagnella ,&nbsp;Rodrigo Soares de Camargo ,&nbsp;Maria Laura Costa ,&nbsp;Dulce Maria Zanardi ,&nbsp;Elton Carlos Ferreira ,&nbsp;Juliana Paula Santos ,&nbsp;Lesley Hanson ,&nbsp;José Guilherme Cecatti ,&nbsp;Carla Betina Andreucci","doi":"10.1016/S2255-4823(13)70462-4","DOIUrl":"10.1016/S2255-4823(13)70462-4","url":null,"abstract":"<div><h3>Objective</h3><p>The World Health Organization Disability Assessment Schedule (WHODAS 2.0) was designed to assess the functioning level in six life domains (cognition, mobility, self-care, getting along, life activities, and participation in community activities). There are different versions, from the simplest to the most complete, various presentations (either interviews or self-administered), comprehending the domains of the International Classification of Functioning, Disability and Health (ICF). This study aimed to make a cross-cultural adaptation of the complete version into Portuguese.</p></div><div><h3>Methods</h3><p>The proceeding was developed over six stages: translation, back-translation, semantic equivalence, evaluation of previous stages by experts, tool pretest, and final version.</p></div><div><h3>Results</h3><p>After the pretest, an adjustment to a more colloquial Portuguese was made. The versions were shown to be similar regarding general and referential meaning.</p></div><div><h3>Conclusion</h3><p>WHODAS 2.0 was shown to be easily applied and understood by women in the pregnancy-postpartum cycle.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 3","pages":"Pages 234-240"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70462-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84445005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of patients, physicians, and medical students on physicians’ appearance*","authors":"Cláudia Leiko Yonekura ,&nbsp;Lucas Certain ,&nbsp;Suen Ka Kee Karen ,&nbsp;Guilherme Augusto Sousa Alcântara ,&nbsp;Lucas Gaspar Ribeiro ,&nbsp;Antonio Luiz Rodrigues-Júnior ,&nbsp;José Baddini-Martinez","doi":"10.1016/S2255-4823(13)70504-6","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70504-6","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the impressions made by different styles of dress and appearance adopted by physicians on patients, medical students, and other physicians in Brazil.</p></div><div><h3>Methods</h3><p>Two hundred fifty nine patients, 119 students, and 99 physicians answered questions related to a panel of male and female physicians’ pictures covering the following styles: white clothing; white coat; formal coat; formal, informal, and casual garments; and surgical scrubs. They also reported their level of discomfort with a list of 20 items for professional appearance of both genders.</p></div><div><h3>Results</h3><p>Most of the answers of the volunteers involved using white clothes or white coat, and in many situations the percentages of preference referred for these styles were close. Physicians and students preferred physicians wearing surgical scrubs for emergency visits, and doctors with informal style for discussing psychological problems with male professionals. Patients most often chose white clothing in response to questions. Regarding male professionals, all three groups reported a high degree of discomfort for the use of shorts and bermuda shorts, multiple rings, facial piercings, sandals, extravagant hair color, long hair, and earrings. For females, high levels of discomfort were reported for shorts, blouses exposing the belly, facial piercings, multiple rings, extravagant hair color, and heavy makeup.</p></div><div><h3>Conclusion</h3><p>Brazilian patients, physicians, and medical students form a better initial impression of physicians using clothing traditionally associated with the profession and exhibiting a more conventional appearance. The use of entirely white garments appears to be a satisfactory option in this country.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 5","pages":"Pages 452-459"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70504-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72283422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular carcinoma: epidemiology, biology, diagnosis, and therapies","authors":"Marcos António Gomes ,&nbsp;Denise Gonçalves Priolli ,&nbsp;José Guilherme Tralhão ,&nbsp;Maria Filomena Botelho","doi":"10.1016/S2255-4823(13)70511-3","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70511-3","url":null,"abstract":"","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 5","pages":"514-524"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70511-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72283426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homocysteine: cardiovascular risk factor in children and adolescents?","authors":"Adriana Amorim De Farias Leal ,&nbsp;Ástrid Camêlo Palmeira ,&nbsp;Gabriella Menezes Almeida De Castro ,&nbsp;Mônica Oliveira Da Silva Simões ,&nbsp;Alessandra Teixeira Ramos ,&nbsp;Carla Campos Muniz Medeiros","doi":"10.1016/S2255-4823(13)70529-0","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70529-0","url":null,"abstract":"<div><p>The aim of this study was to identify publications in literature that investigated Homocys-teine (He) as a risk factor for CVD among children and adolescents. An active search for information in LILACS, IBECS, Science Direct, Medline and Cochrane Library databases was conducted using the following combination of keywords “homocysteine”, “cardiovascular diseases”, “child” and “adolescent”. Fifteen articles were analyzed showing direct relationship with increasing age (8 studies) and male gender (10 studies), and an inverse relationship with serum vitamins B6, B12 and folate levels. Thus, the results suggest that more research must be carried through in order to determine in a more coherent way the causes of the hiperhomocisteinemia in the pediatric population, guiding for an adequate diet, rich in nutrients necessary to favor the metabolism of the He.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 6","pages":"Pages 622-628"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70529-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72282203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status in the oldest elderly and associated factors","authors":"Elaine Caroline Boscatto ,&nbsp;Maria de Fátima da Silva Duarte ,&nbsp;Raildo da Silva Coqueiro ,&nbsp;Aline Rodrigues Barbosa","doi":"10.1016/S2255-4823(13)70428-4","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70428-4","url":null,"abstract":"<div><h3>Objective</h3><p>To verify factors associated with nutritional status in an oldest elderly community-dwelling population in Southern Brazil.</p></div><div><h3>Methods</h3><p>This cross-sectional epidemiological and household-based study involved all subjects (n<!--> <!-->=<!--> <!-->134) aged ≥ 80 years who were living in Antônio Carlos (Santa Catarina state, Brazil). Nutritional status was assessed by body mass index (BMI &lt; 22.0<!--> <!-->kg/m², underweight; BMI &gt; 27.0<!--> <!-->kg/m², overweight). Explanatory variables in the study were: gender (women/men), literacy (knows how to write and read – yes/no), living conditions (lives alone/with company), cognitive function (normal/altered), eating difficulty (yes/no), medication use (none to two/three or more), morbidity (none to two/three or more diseases), alimentary pattern (adequate/inadequate), alcohol consumption (none to one day a week, two or more days a week), cigarette smoking (never/current or former smoker), physical activity level (&lt; 150<!--> <!-->min/week; ≥ 150<!--> <!-->min/week), and sitting time (&lt; 4 hours/day; ≥ 4<!--> <!-->hours but &lt; 6<!--> <!-->hours/day; ≥ 6<!--> <!-->hours/day).</p></div><div><h3>Results</h3><p>Prevalence of underweight was 27.3% in men and 12.8% in women (p &lt; 0.01), and was positively associated with altered cognitive function (OR: 3.52) and inversely related with greater medication use (OR: 0.34). Overweight affected 25.5% of men and 53.8% of women. It was negatively associated with illiteracy (OR: 0.12) and positively associated with female gender (OR: 2.58).</p></div><div><h3>Conclusion</h3><p>There are differences between men and women regarding nutritional status. The factors associated to nutritional status of the oldest elderly from Antônio Carlos are specific to the vulnerability condition (underweight and overweight).</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 1","pages":"Pages 40-47"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70428-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91689664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D: non-skeletal actions and rational use","authors":"Arnaldo Lichtenstein ,&nbsp;Mario Ferreira-Júnior ,&nbsp;Maria Mirtes Sales ,&nbsp;Francisco Bueno de Aguiar ,&nbsp;Luiz Augusto M. Fonseca ,&nbsp;Nairo M. Sumita ,&nbsp;Alberto J.S. Duarte ,&nbsp;Grupo de Estudos para o Uso Racional do Laboratório Clínico do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo","doi":"10.1016/S2255-4823(13)70509-5","DOIUrl":"10.1016/S2255-4823(13)70509-5","url":null,"abstract":"<div><p>Recent years have witnessed a substantial increase in the number of seric determinations of vitamin D, in a worldwide basis. At Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo that increase reached 700% over the last four years. Nevertheless there are many controversies on the literature about the role of vitamin D in conditions unrelated to the musculoskeletal system. In this study the metabolism, sources and actions of vitamin D on the body are reviewed. Observational studies, clinical trials, systematic reviews and metanalysis which focused on the relationship between the vitamin and conditions such as cancer, cardiovascular disease, diabetes and falls were searched on the literature, analyzed and discussed. Results are presented as quiz and answer, tables and a figure. The role of vitamin D on the above-mentioned conditions is discussed, and the controversial issues stressed.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 5","pages":"Pages 495-506"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70509-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78900515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}