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Navegando FM - Faculdade de Medicina por Por Área do CNPQ "CIENCIAS DA SAUDE::MEDICINA::ANATOMIA PATOLOGICA E PATOLOGIA CLINICA"
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Item Qualidade de vida relacionada à saúde em pacientes com glomerulopatias primárias(Universidade Federal de Goiás, 2023-08-31) Borges, Marcela Oliveira Faria Braga; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Fernandes, Marcos Rassi; http://lattes.cnpq.br/3918453247388300; Fernandes, Marcos Rassi; Naghettini, Alessandra Vitorino; Veloso, Valéria Soares PigozziIntroduction Primary Glomerulopathies (PG) represent around 20% of prevalent cases of Chronic Kidney Disease (CKD) in the world and can be a cause of irreversible kidney damage, a source of personal suffering, and also a socioeconomic problem. This study aims to evaluate Health-Related Quality of Life (HRQoL) using Patient Reported Outcome Measures (PROM), and identify predictive factors associated with worse HRQoL in patients with GP. Methods A PROMIS (Patient-Reported Outcome Measurement Information System) instrument was completed by 46 patients with GP to assess HRQoL. Five domains were assessed: global health, fatigue, anxiety, depression and sleep impairment. Exploratory univariate statistical analyzes were performed followed by multiple linear regression analysis. Results Forty-six patients participated in the study. The mean age was 38.5 ± 16.4 years (ranging from 18 to 76 years). Female patients had worse scores for anxiety (p=0.044), depression (p=0.040) and sleep disorders (p=0.007). Patients younger than 60 years had worse anxiety scores (p=0.041). Better educational level was related to lower depression score (p=0.010). Obesity determined a worse physical health score (43.95 versus 40.14, p=0.022). The presence of pain, swelling, diagnosis time ≥9 months and Diabetes Mellitus (DM) were predictors of worse HRQoL in more than one evaluated domain. Conclusion The predictive variables of worse HRQoL in patients with PG were female gender, age younger than 60 years, lower educational level, overweight and obesity, need for emergency care, DM, diagnosis time ≥9 months and the presence of pain and edema at the time of the study. The study concludes that the assessment of HRQoL domains using MRRP makes it possible to identify factors that worsen HRQoL, allowing early intervention and improving patient care.Item Vaginose bacteriana e tricomoníase: prevalência, fatores associados e desempenho de testes diagnósticos em mulheres atendidas em ambulatório de ginecologia preventiva(Universidade Federal de Goiás, 2022-02-21) Camargo, Kélvia Cristina de; Saddi, Vera Aparecida; http://lattes.cnpq.br/7496804650895441; Alves, Rosane Ribeiro Figueiredo; http://lattes.cnpq.br/8335736301768972; Alves, Rosane Ribeiro Figueiredo; Santos, Silvia Helena Rabelo dos; Matos, Marcos André de; Barbosa, Maria Alves; Ribeiro, Andrea AlvesINTRODUCTION. Bacterial vaginosis BV and genital infections have a great impact on women's health and are the main causes of demand for health services. GOALS. To investigate the prevalence, associated factors and performance of diagnostic methods for BV and Trichomonas vaginalis TV. METHODS. The thesis is presented in articles, in an original cross-sectional article and a systematic review. The Crosssectional study, conducted with women seen at a preventive gynecology clinic, in the public network of Goiânia, referred to a gynecological consultation. Gynecological examination with evaluation of the characteristics of the vaginal secretion, and the collection of cervicovaginal material for cytological study, fresh examination, vaginal pH, Whiff test, Gram-stained bacterioscopy and the polymerase chain reaction (PCR) for the detection of TV . The samples were analyzed at the Genetic Diversity Laboratory of the Pontifical Catholic University of Goiás (PUC GO) and at the Rômulo Rocha Clinical Analysis Center of the Faculty of Pharmacy of the Federal University of Goiás (FF/UFG). Sociodemographic and behavioral characteristics were analyzed using descriptive statistics. Logistic regression analysis was performed to identify factors associated with BV. The degree of agreement between the clinical characteristics of the vaginal secretion and the different diagnostic methods was evaluated by the Kappa index. The systematic review study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and performed according to the methodological guidelines of the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA). The search was performed on PubMed and Scopus databases in September 2021, with no language restriction. Articles were considered eligible if they investigated the prevalence of BV in Brazil; used Amsel's clinical diagnostic criteria or Gram-stained bacterioscopy in women of reproductive age and without comorbidities. Studies were evaluated by two investigators to establish reliability. The risk of bias and the quality of the selected studies were assessed using the Joana Briggs Institute (JBI) tool. RESULTS. The cross-sectional study showed a prevalence of BV, according to the Nugent criteria, of 33.7% and of trichomoniasis by PCR, of 0.5%. The complaint of abnormal vaginal secretion was significantly associated with the diagnosis of BV (OR = 2.2; 95%CI: 1.0- 4.5); The diagnostic accuracy for BV, by the methods of Amsel, Ison & Hay and cytological examination, compared to the Nugent criteria was 35.6%, 97.0% and 84.2%, respectively. The sensitivity and degree of agreement for the diagnosis of TV, by the fresh test was 0.0% and 0.0% and by the cytological test, 100% and 1, respectively. Systematic review included ten articles. The mean prevalence of BV in the included studies was 25.4% (95%CI: 24.0-26.8), ranging from 15.3% (95%CI: 11.8- 19.4) to 51. 0% (95%CI: 43.1-58.7). In three population-based studies, the prevalence ranged from 15.3% (95%CI:11.8-19.4) to 20% (95%CI:16.9-23.6), with a mean of 18,1% (CI:16.0-20.5). In seven clinical-based studies, the prevalence ranged from 18.6% (95%CI: 13.6-25.0) to 51% (95%CI: 43.1-58.7), with an average of 27.2% (95%CI: 24.6-29.9). Factors associated with BV were use of sexual accessories (OR: 2.4; 95%CI: 1.1-4.9), single marital status (OR: 1.4; 95%CI: 1.1-1.8), partner infidelity (OR: 1.5; 95%CI: 1.2-1.9), abnormal vaginal discharge (OR: 1.5; 95%CI:1.2-2.0), presence of trichomoniasis (OR: : 4.1 (95% CI: 1.5-11.5).CONCLUSION. The crosssectional study showed a high prevalence of BV and a low prevalence of TV; The report of abnormal vaginal secretion as the only factor associated with BV; the methods with the best diagnostic performance for BV, compared to the Nugent method, were those Abstract xix of Ison and Hay and cytological examination and cytological examination considered to be easily accessible in the daily clinic. The systematic carried out in this study showed a high prevalence of BV and associated factors linked to sexual behavior, although it is not considered a sexually transmitted infection.