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Item Implantação de uma Unidade Sentinela Centro de Referência em Medicina Internacional e de Viagem no Hospital das Clínicas da Universidade Federal de Goiás (HC / UFG)(Universidade Federal de Goiás, 2010-12-03) AIRES, Leticia Mara Conceição; GARCÍA-ZAPATA, Marco Túlio Antonio; http://lattes.cnpq.br/3672512339058369Introduction: The number of domestic and international travel has increased in past years. This way, Travel Medicine, has become an important subject, with the emergence of services that provide health care to travelers. Objective: To evaluate strategies used in deploying Sentinel Unit Reference Center for International and Travel Medicine at the HC / UFG. Methods: First approach: Systematic Review of Literature using the keywords: "Travel and medicine", "Travel and prevention", "Travel and Disease and Medicine" and "Traveler and medicine . Then were selected articles in English, Spanish and Portuguese, from 2004 to 2008. Second approach: a descriptive, qualitative and quantitative, with evaluation of actions taken during the period preceding the implementation of the Unit. Results: In the literature review were found 1,301 articles, and 72 included for analysis, we observed that malaria is the most studied disease, the main preventive measures discussed are chemoprophylaxis for malaria and vaccination. Health professionals working in Travel Medicine are general practitioners, pharmacists and nurses in various parts of the world, and among the obstacles we stress the lack of information in travelers, the lack of professional preparation and last-minute travelers. In a qualitative and quantitative research was performed a retrospective study in which differences were observed between physicians at the General Hospital and the tropical Diseases Hospital, where 1% of primary and 12.1% of the latter, asked about previous trips during office visits, and future study outlined profiles of health workers and travelers in their Knowledge, Attitudes and Practices in Travel Medicine, and noticed that 38% of professionals and travelers refer or seek treatment, although 91% of respondents consider it important to receive pre-departure orientation. Courses were held, symposium, lectures in education activities proposed. Travel Medicine now has code of regulation for public patients receive, and in 2009 and 2010 the Unit attended eight international travelers. Conclusions: The Travel Medicine faces many obstacles in Goiânia, as elsewhere in the world, being the main one the lack of information. We need a massive USCREMIVI disclosure to reach the objective of service to the traveler, in order of doing a situational diagnosis and to establish an educational facet.Item Perfil epidemiologico das neoplasias do colo uterino (in situ e invasoras) diagnosticadas na cidade de goiânia: análise de 17 anos (1988-2004)(Universidade Federal de Goiás, 2010-10-28) ALMEIDA, Fábio Marques de; MOREIRA, Marise Amaral Rebouças; http://lattes.cnpq.br/6390358577348486Determine the epidemiological profile of in situ and invasive neoplasias of the uterus cervix in Goiânia during the period from 1988 to 2004. Methodology: The cases were identified in the Population Base Register of Cancer database of Goiânia. The studied variables were: age, histological type, extension of the disease and mortality. Analysis was done by central tendency in which the incidence rates were calculated by age, extension of the disease using Census population data and the standard population of Segi; for the mortality analysis the data were extracted from Mortality Information System. Results: We identified 4446 cases of in situ and invasive neoplasias of the uterus from the period of 1988 to 2004. Histopathology was used in 91,9% of the cases; average age was 40 years old for the in situ neoplasias and 52 years for the invasive ones (DP ± 13 and 14 years old, respectively). There were 2213 (58,28%) in situ cases, 1603 invasives (41,8%) and, in 633 cases (14,2%), it was not possible to verify their extension. The annual rate of percentage change (AAPC) for the in situ incidence was 13.08% (IC 95% 9.75 16.50; p<0.0000) per year and1.27% (IC95% -1.74 4.37; p<0.3862) for the invasive cases. The standard mortality rate was 12.2 and 8.2 per 100,000 in 1988 and 2004 respectively, with an AAPC of -3.02 (IC95% -5,36 -0,62; p<0,0172). Squamous cell carcinoma was found to be the predominant histologic type. A reduction of the Adenocarcinoma incidence in situ was not found nor was found a significant change of the Adenocarcinoma invasive; the squamous invasive cancer did present a considerable reduction of 2,85 per year. Conclusion: It was observed that the most frequent invasive tumors were the squamous cell carcinomas and Adenocarcinomas. Data did not demonstrate a rise in the diagnosis of invasive neoplasia, although there occurred an increase of diagnoses of in situ neoplasias. Mortality has demonstrated a tendency of reduction, suggesting that improvements of the tracking programs have changed the incidence or uterine cancer, though it has not yet accomplished all its objectives. Keywords: cervical cancer, uterus, epidemiology, frequency, extension, incidence, Goiânia, Brazil.Item Capacidade funcional de idosos com vertigem posicional parxística benigna(Universidade Federal de Goiás, 2010-10-18) ALVARENGA, Gabriella Assumpção; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225; PORTO, Celmo Celeno; http://lattes.cnpq.br/9673684282497548Dissertation built modality scientific article. In the first article submitted to "Journal of Otolaryngology" with the title benign paroxysmal positional vertigo without nystagmus: diagnosis and treatment, there was a literature review, using the following keywords: "dizziness / vertigo, diagnosis / diagnosis, therapeutic / therapeutical approaches. " Scientific publications are included in the period 2001-2009 in Portuguese, English and German. We found nine papers dealt with BPPV without nystagmus, whose diagnosis was based exclusively on clinical history and physical examination. The treatment of BPPV without nystagmus was made by Epley maneuvers, Semont, discharge modified for posterior semicircular canal and Brandt-Daroff exercises. All show that 50% to 97.1% of patients with BPPV without nystagmus, had remission of symptoms, while patients with BPPV nystagmus with remission of symptoms ranged from 76% to 100%. Hence one can conclude that the differences may not be significant, which demonstrates the need for further studies on BPPV without nystagmus. In the second paper, Functional Capacity of Elderly with benign paroxysmal positional vertigo, compared the functional capacity among elderly patients with BPPV and elderly without clinical diagnosis of BPPV and that / or dizziness or vertigo, identifying the physical activities of daily living and instrumental activities of daily living in elderly people in both the Group of Elderly with BPPV (EBPPVG) and Control Group (CG). This is a cross-sectional study, case-control study in Hospital Geral de Goiânia (HGG), with the participation of 14 elderly patients with a diagnosis of BPPV and the Programa de Gerontologia Social / Universidade Aberta à Terceira Idade (UNATI) from the Pontificia Universidade Católica de Goiás (PUC-GO), with the participation of 13 subjects without dizziness or vertigo and / or clinical diagnosis was of BPPV. Functional capacity was assessed by the subscale of the Functional Assessment Questionnaire Brazilian Multidimensional Functional Capacity / Operating Older American Resources and Services Multidimensional Functional Assessment Questionnaire (BOMFAQ/OARS), verifying that the difficulty in performing 15 activities of daily living (ADL), eight physical activities of daily living (AFVD): throw / out of bed, eating, combing hair, walk on the plane, bathing, dressing, going to the bathroom in time and trimming toenails, and seven instrumental activities of living daily living (IADL): climbing stairs (one flight), doctor-on time, walk close to home, shopping, preparing meals, driving out and do house cleaning. Arrived at the following conclusions: a) elderly people with BPPV showed a statistically significant lower functional capacity than subjects without this diagnosis, b) in EBPPVG, the average number of daily activities (physical and instrumental), those with difficulty was 6.53 with a maximum of 11 activities committed while in the CG, the average impairment was 0.86 with a maximum of 4 activities referred with difficulty in performing c) EBPPVG affected performance in 13 activities of daily living, including physical seventh floor in the plan, bathing, dressing, combing hair, going to the bathroom in time, bedtime and getting up from bed or chair and cut nails feet, and 6 which are instrumental, climbing stairs, walking around the house, shopping, preparing meals, driving out and do house cleaning in the comparison between groups, d) Activities that were cited as the most difficult among the elderly were similar in both groups. However, the degree of impairment, characterized in: without commitment (when the elderly did not report any difficulty in any of the 15 evaluated ADL), mild (1 to 3 activities impaired), moderate (4-6 impaired activities) and severe (for seven or more impaired activities) was significantly higher in EBPPVG, where 7 (50%) showed severe impairment in ADL performance.Item Avaliação da inicialização da marcha na gestante de baixo risco nos três trimestres gestacionais(Universidade Federal de Goiás, 2012-02-17) ANDRADE, Sara Rosa de Sousa; VIEIRA, Marcus Fraga; http://lattes.cnpq.br/4153462617460766; AMARAL, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579Introduction: The pregnant woman's body promotes many changes, including their biomechanics. The hormonal action which increases the laxity causes structural changes in the static and dynamic skeleton. Other factors, such as weight gain, growth of the uterus and the breasts, will help changing the gravitational forces of the pregnant woman and cause large static and dynamic postural adjustments in pregnant women. The startup of gait position is the transition from quasi-static to the first step. It is a task that challenges the postural control, because the demands on the neuromuscular system are increased at the beginning of the march, since it is required a complex integration of neural mechanisms, muscle activity and biomechanical forces. Objective: describe the oscillation amplitude and mean velocity of center of pressure during startup of gait, to compare the behavior of the center of pressure between the three groups at different gestational periods, verify that the changes in the behavior of the center of pressure along the pregnancy is at risk dynamic stability for pregnant women. Methods: A total of oscillation amplitude and velocity of displacement of center of pressure during startup of gait in 57 low-risk pregnancies in three trimesters. Results: Significant differences were found when comparing the groups 1º trimester and 3º trimester for the variable amplitude of oscillation mediolateral and mediolateral displacement speed. Discussion: Pregnant women tend to decrease the amplitude of oscillation mediolateral and mediolateral displacement speed during gestation. Conclusions: The amplitude of oscillation anteroposterior and mediolateral displacement speeds and respective of the first quarter from the third there was, on average, a gradual decrease to a platform and to the platform 2. There were significant differences in the oscillation amplitude variables mediolateral and mediolateral displacement speed when comparing the groups 1° trimester and 3° trimester, being higher in 1º trimester for both variables. The variables analyzed showed minor differences and do not constitute an imminent risk to the dynamic stability of the pregnant woman.Item Análise da atenção básica à saúde do idoso na estratégia saúde da família(Universidade Federal de Goiás, 2009-12-15) ARAÚJO, Maria Aparecida da Silva; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225The study focused on the health care of the elderly, more specifically in Family health strategy as a way of thinking about alternatives that allow the reorganization of elderly care to adscritas areas. Processorsthe General was discussing the basic attention actions offered to the elderly in context family health strategy. Search descriptive exploratory in nature,- qualitative basic performed with professionals that comprise health team family doctors, nurses, technicians, nurses and community agents health in the municipality of Aparecida de Goiânia, goaiz. For data collection were the focal group technique and the data were analysed in categories as Bardin. The results suggest that prospects strengthen the professional aspects in family health care to the elderly, while showing some limitations of the elderly in the team. The team's contribution family health was significant health care of the elderly be reconsidered by professionals and managers for the operationalization of education These professional standing. It was concluded that the multidisciplinary actions are present in health promotion, both in the basic unit in address through talks, walks, assistance activities Prevention and control of diseases, although realize difficulties operacionalizá them. The insertion of the elderly in some family health teams occurs through attractive activities forming your social network participation activities outside of the health unit, such as concerts and tours and provide suggestions for activities. However, for other teams actions intersectoral health promotion is not present. The results of this study may offer subsidies to family health professionals for Organization of care to the elderly, to assistance the oldest coherent national policy guidelines of care.Item Avaliação dos resultados dos exames citopatológicos do colo do útero dos laboratórios credenciados pelo Sistema Único de Saúde de acordo com o diagnóstico da Unidade de Monitoramento Externo da Qualidade(Universidade Federal de Goiás, 2010-03-03) ÁZARA, Cinara Zago Silveira; GUIMARÃES, Janaína Valadares; http://lattes.cnpq.br/0986934969522024; AMARAL, Rita Goreti; http://lattes.cnpq.br/3665611660713029Introduction: The External Quality Monitoring (MEQ) was developed from recommendations of the National Cancer Institute, in order to evaluate the performance of cytopathology diagnostic of the cervix and provide subsidies for continuing education to professionals in laboratories that provide services to public health. Objectives: To evaluate the results of Pap cervical smear between the laboratories accredited by the Single Health System (SUS) according to the diagnostic of the Unit of External Quality Monitoring (UMEQ), checking the frequency of the results of Pap cervical smear, the discordant cases, false positives (FP), false negative (FN) and diagnostic agreement. Methods: A total of 14 laboratories accredited by the SUS indicated by the Municipal Secretary of Health in Goiânia-GO participated in this study. It was reviewed the period from January 2007 to December 2008, Pap cervical smear tests selected by the Information System of Cancer of the cervix including all positive cases, all unsatisfactory ones and at least 5% of negative test results which should achieve at least 10% of the monthly routine of each laboratory, totaling 10,053 tests. These were reviewed by professionals from UMEQ / Faculty of Pharmacy from Federal University of Goiás. It was considered discordant cases in which there was a change in clinical management in accordance with the criteria established by the Ministry of Health. To place the cytological cervical results the Bethesda System was used. The magnitude of agreement was evaluated between the diagnoses using the kappa coefficient. The level of agreement considering its respective confidence intervals of 95% depending on the need to assign different weights to the disagreements were classified as follows: less than 0 - very bad agreement, 0 to 0.2, bad agreement; from 0.2 to 0.4 - reasonable agreement, from 0.4 to 0.6 - good agreement, from 0.6 to 0.8 - very good agreement and from 0.8 to 1.0 excellent. Results: There was disagreement between the UMEQ and laboratories of origin in 763 (7,59%) cases, of these 110 (1,1%) were FN distributed in: 37 (0,37%) atypical squamous cells of undetermined significance (ASC-US), 22 (0,22%) intraepithelial low-grade squamous lesions (LSIL), 30 (0,30%) atypical squamous cells cannot exclude a high-grade lesion (ASC-H), 12 (0,13%) squamous intraepithelial lesions of high grade (HSIL), an (0,01%) intraepithelial lesion of high-grade with suspicious features for invasion, six (0,07%) atypical glandular cells and two (0,02%) adenocarcinomas in situ. There was a delay in clinical management in 245 (2,44%) cases, of these 85 (0,84%) were initially classified as ASC-US and 160 (1,50%) as LSIL.The cases of ASC-US were distributed in: 53 (0,53%) ASC-H, 31 (0,31%) HSIL and an (0,01%) atypical glandular. The cases of LSIL were distributed in: 19 (0,19%) ASC-H, 139 (1,38%) HSIL and two (0,02%) atypical glandular cells. It was considered 283 (2,82%) FP cases and 125 (1,24%) initially negative cases that were reclassified as unsatisfactory. The agreement between the laboratories of origin and the UMEQ was excellent (Kappa = 0.81). It was found that for the evaluation of agreement of each laboratory, the majority showed very good agreement. The agreement of the sample adequacy was considered reasonable (Kappa = 0.30). Conclusion: Most laboratories showed very good agreement, however, it is worth mentioning that MEQ is an exercise of improvement needed to establish the standardization of diagnostic criteria and improve the accuracy of cervical smear.Item Prevalência do Transtorno de Déficit de Atenção e Hiperatividade (TDAH) em uma População de Crianças e Adolescentes Índias da Etnia Karajá.(Universidade Federal de Goiás, 2009-02-04) AZEVÊDO, Paulo Verlaine Borges e; CAIXETA, Leonardo Ferreira; http://lattes.cnpq.br/9536747113677509Few studies have been carried out worldwide about ADHD among indigenous children and no study has been conducted in Brazil so far. This study aims to evaluate the estimated prevalence of ADHD among the indigenous populations of Karajá children and adolescents aged 7 to 14 years old. Three of the largest settlements pertaining to this ethnic group were investigated and a sample of 144 subjects of a total population of 350 individuals was collected. The sample was randomly collected and stratified according to the age bands and gender (male and female) proportionally to the size of each participating settlement. Both the CBCL/6-18 (Child Behavior Checklist for ages 6 18) and the TRF (Teacher s Report Form 6-18) were used as instruments of epidemiological tracking of behavioral and emotional problems. Of these instruments, the data used were those compatible with the DSM-IV and ADHD diagnoses as well as Affective Disorder, Anxiety Disorders, Oppositional Defiant Disorders and Conduct Disorders comorbidities. The results indicate a prevalence of 10.4% (95% CI 6.6 14.2) when the respondents are either the parents or the guardians and 2.8% (95% CI 0.7 4.8) when the respondents are the teachers. Of the 144 interviewed participants, 30 had ADHD and comorbidities were 86.7% (95% CI 74.5 98.8) for conduct disorders, 86.7% (95% CI 74.5 98.8) for oppositional defiant disorders, 83.3% Abstract xxviii (95% CI 70.0 96.7) for anxiety disorders and 60% (95% CI 42.5 77.5) for affective disorders. ADHD is then concluded to exist in a population so culturally diverse from that of the east white and to have a high prevalence rate and the comorbidities routinely found in all populations of children from a number of diverse cultures around the globe.Item Qualidade de vida de mulheres com dor pélvica crônica(Universidade Federal de Goiás, 2010-06-16) BARCELOS, Priscilla Rodrigues; CONDE, Délio Marques; http://lattes.cnpq.br/8628571386803692OBJECTIVES: to compare the quality of life (QOL) of women who have or do not have chronic pelvic pain (CPP) and to investigate the factors associated with QOL in women with CPP. METHODS: a cross-sectional study was performed, in which 30 women with CPP and 20 women without CPP were included. They were premenopausal women aged 18 to 50 years attending the gynecologic outpatient department of a tertiary care university hospital (Hospital das Clínicas, Universidade Federal de Goiás, Brazil). A CPP case was considered when presenting with recurrent or constant pelvic pain of at least six months` duration, unrelated to periods. Women who had been pregnant in the previous year or who had a history of malignant disease were excluded. Sociodemographic and clinical features were assessed. The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire was used to investigate QOL. It provides an eight-scale profile of scores: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional and mental health. These eight domains can be summed up in two summary measures: physical component summary (PCS) and mental component summary (MCS). Pain intensity was evaluated using a mechanical visual analogue scale (VAS). Multiple regression analyses was used to compare QOL scores between women with and without CPP and to identify the factors associated with QOL in women with CPP. RESULTS: the mean age of women with and without CPP was 35.2±7.5 and 36±9.3 years, respectively (p=0.77). Women with CPP had a lower monthly family income (p=0.04) and a higher prevalence of dysmenorrhea (87% versus 40%; p<0.01) and depression (30% versus 5%; p=0.04) compared to those without CPP. After adjusting the analyses using potential confounding variables, women with CPP had lower QOL scores in two domains: bodily pain (31 versus 72; p<0.01) and social functioning (56.3 versus 100; p<0.01). Depression was negatively associated with the role-emotional domain (coefficient: -65.185; CI 95% -130.25 to -0.12; p=0.05) and the MCS (coefficient: -23.271; CI 95% -43.8 to -2.74; p=0.03), whereas pain intensity was negatively associated with the bodily pain domain (coefficient: -8.826; CI 95% -13.98 to -3.66; p<0.01) of the QOL of women with CPP. CONCLUSIONS: women with CPP had poorer QOL compared to those without CPP. Depression in women with CPP was associated with lower QOL. Greater pain intensity, as assessed by the mechanical VAS, was also associated with lower QOL among women with CPP. These factors should be considered when managing CPP patients in an attempt to minimize the negative effects they may exert on QOL.Item Monitoração terapêutica das concentrações plásmaticas da digoxina em pacientes com insuficiência cardíaca(Universidade Federal de Goiás, 2008-10-27) BARROS, Isabel Cristina Medeiros; RASSI, Salvador; http://lattes.cnpq.br/7236834842677715; CUNHA, Luiz Carlos da; http://lattes.cnpq.br/6349547031976679It was investigated the clinical, lab and plasma digoxin concentration profiles in 15 cardiac heart failure (CHF) outpatients of the Cardiac Heart Service of the Goias Federal University Clinical Hospital. It was aimed to know plasma digoxin concentration profile in 15 cardiac heart failure (CHF) outpatients by two analytical methods, taking account clinical, laboratorial, habits, anthropometric data and drug usage. Digoxin dosage was developed by LC/MS/MS and immunoassay methods; questionnaire and consults handbooks were performed. Results and Conclusions: 87% of the patients who over 46 years of age (33% above 61), the masculine majority; the IC of Chagas disease origin presented greater occurrence, followed of the hipertensive and idiopatic (59%); IC functional classroom II (53.33%); hypertension and diabetes had been distinguished as co-morbidities (26.67% and 20%); tobaccoism, overweight and obesity degree I had presented low occurrence. No patients presented relevant clinical data suggestive of digitalis intoxication. No observed changes in biochemical and hematological exams. The ejection fractions were good by means 41.7 ± 9%. Some drugs with interaction potential had been associated to the treatment, apparently without alterations. Statistical significative difference between both methods was observed (P < 0.05, ANOVA, Tukey Test). In the immunoassay method, all the patients were inside of the therapeutical range (0, 5-2, 0 ng/mL), whereas for the LC-MS/MS method, 8 patients they would be in subtherapeutical concentrations. However, no patient presented signals or symptoms of poisoning or inefficacy of the digoxin, demonstrating biological variability. The two methods are useful, since that it has a correlation with the clinical and laboratorial state of the patients.Item Força muscular do assoalho pélvico em mulheres submetidas ao parto vaginal, à cesárea e nulíparas(Universidade Federal de Goiás, 2010-11-17) BATISTA, Elicéia Marcia; AMARAL, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579; CONDE, Délio Marques; http://lattes.cnpq.br/8628571386803692Childbirth may determine pelvic floor modifications that may cause dysfunctions such as urinary/fecal incontinence and pelvic organ prolapse. Furthermore, delivery may be associated with a decrease in pelvic floor muscle (PFM) strength. Objectives: to compare PFM strength in women who delivered vaginally or by cesarean section and nulliparae, investigate the factors associated with PFM strength and demonstrate a correlation between measurements of PFM strength obtained by vaginal digital examination and by perineometer. Methods: a cross-sectional study was conducted, including 31 women following vaginal delivery, 30 following cesarean section and 30 nulliparae. PFM strength was investigated by vaginal digital examination (modified Oxford grading system) and by perineometer. Multiple linear regression analysis with adjustment for covariables was used to compare the mean PFM strength and identify factors associated with PFM strength. The Kendall test was applied to investigate the correlation between vaginal digital examination and a perineometer. Results: the mean age of the participants who delivered vaginally, underwent cesarean section and those who were nulliparous was 32.3±5.8 years, 30.5±5.4 years and 27.2±5.9 years (p<0.01), respectively. The mean PFM strength of women undergoing vaginal delivery and cesarean section was 25.6±14.5cmH2O and 39.6±22.0cmH2O (p<0.01, adjusted for covariables), respectively. A correlation between measurements of PFM strength obtained by vaginal digital examination and perineometer device was observed (tau=0.82; p<0.01). Non-white race/ethnicity was negatively associated with PFM strength (coefficient: -10.2424; p=0.02). Conclusions: women with a history of vaginal delivery had a lower PFM strength than those delivering by cesarean section. Non-white race/ethnicity negatively affected PFM strength. Our data suggest that vaginal digital examination may be applied in clinical practice because of its expressive correlation with a perineometer.Item Ingestão de nutrientes e anemia em crianças de creches municipais em Goiânia(Universidade Federal de Goiás, 2008-02-14) BERALDO, Fernanda Carneiro; HADLER, Maria Claret Costa Monteiro; http://lattes.cnpq.br/6754793957094104; FORNÉS, Nélida Schmid; http://lattes.cnpq.br/0630711826568302Introduction: The high prevalence of anemia, which is a serious public health problem, together with an early and in appropriate introduction of food for children, shows a close relationship between feeding practices and the presence of anemia. Objectives: To compare anemia among anemic and non-anemic children enrolled in municipal day nurseries of Goiânia, the socioeconomic and demographic characteristics, nutritional status, distribution of the consumption of macronutrients and the intake of micronutrients (calcium, iron and vitamin C), for Dietary Reference Intakes; evaluate and compare the ingestion of total iron, heme and non-heme iron and the bioavailable iron in the diets of anemic and non-anemic children from 12 to 24 months and compare the bioavailable iron according to algorithms developed by Monsen et al. and FAO / WHO. Methods: Observational study of cross-sectional analysis with children from 6 to 24 months in Goiânia-Goiás, in the years of 2005 and 2006. Investigations of socioeconomic, demographic and food (direct food weighing and 24 hour dietary recall) were applied for 2 days and the anthropometric evaluation and the dosage of hemoglobin were done. The diagnosis of anemia was determined by the level of hemoglobin less than 11 g / dL. Results: 89 children were studied. The prevalence of anemia was 53.9%. It was observed an statistically significant difference between anemic and non-anemic children as for per capita income. The proportion of macronutrients in the diets of the evaluated groups was appropriate and there was no difference statistically significant. Among the anemic children (n = 47), the prevalence of inadequacy was 12.8% for iron and 8.5% for vitamin C, whereas in the non-anemic ones (n = 41), the prevalence of inadequacy for iron and vitamin C was: 14.6% and 7.3%, respectively. The average intake of calcium was 50% above the recommendations in both groups. By the criterion of the World Health Organization, it was realized an anthropometric evaluation in three moments and the anemic had greater z-score according to the weight / length than non-anemic in the 2 and 3 moments (p = 0.015 p = 0.006) respectively . The average consumption of total iron, non-heme and bioavailable iron were low in the groups studied, showing no statistically significant difference. There was an intense positive correlation between the methodologies used to evaluate the iron bioavailable (r = 0.91 r = 0.84) for nonanemic and anemic children, respectively. Conclusion: There was a statistically difference between per capita income and anemia. It was observed a greater z-score for the index weight / length in the anemic children. There was no statistically difference between the two groups in relation to the consumption of calcium, iron and vitamin C, however there was a significant prevalence of inadequacy of iron and vitamin C, besides a high intake of calcium in the diet. There was a low total consumption of iron, heme and non-heme and bioavailable iron that reinforces the importance of the knowledge of food consumption of children, as well as the adoption of measures that ensure the supply of food sources of iron and food promoters of bioavailability of this micronutrient.Item Avaliação da eficácia e segurança do uso de radioterapia intraocular com estrôncio 90 e bevacizumabe no tratamento de pacientes portadores de degeneração macular relacionada à idade, forma exsudativa(Universidade Federal de Goiás, 2012-03-27) BIANCHI, Lívia Carla de Souza Nassar; ISAAC, David Leonardo Cruvinel; http://lattes.cnpq.br/5474072354473614; ÁVILA, Marcos; http://lattes.cnpq.br/3335187297522447Purpose: To evaluate the efficacy and safety of strontium-90 epimacular brachytherapy combined with intravitreal bevacizumab for treating subfoveal choroidal neovascularization secondary to exudative age-related macular degeneration. Its effects on visual acuity and macular thickness at 36 months of follow up were also studied. Methods: Sixteen patients with predominantly classic, minimally classic and occult choroidal neovascularization were treated with a single 24 Gy dose of radiation during pars plana vitrectomy, associated to two injections of bevacizumab at baseline and one injection at the one-month visit. The patients underwent a complete ophthalmologic examination, which included fluorescein angiography and optical coherence tomography, at the initial visit, every three months during the first year, and every six months during the second and third years of follow up. Results: Of the 16 cases, 2 patients (12.5%) lost more than 15 letters at the end of 36 months, and 3 (18.75%) lost fewer than 15 letters. Among the patients with improved visual acuity, 3 (18.75%) gained less than 15 letters and 8 (50%) gained more than 15 letters at the end of treatment. The mean best corrected visual acuity showed a gain of 16.0 letters at 12 months. After 36 months (n = 16), the mean best corrected visual acuity showed a gain of 10.4 letters. Of the 16 eyes included in the study, six required further therapy. The evaluation of macular thickness showed decreased thickness in 10, among the 16 patients (62.5%). Three eyes (18.75%) had similar values at the beginning and the end of 36 months, and 3 eyes (18.75%) showed increased macular thickness. Conclusion: Epimacular brachytherapy combined with bevacizumab may be considered a possible therapeutic option for choroidal neovascularization in age-related macular degeneration. The procedure was thought to be safe and was well tolerated by the patients. The treatment resulted in anatomical and functional improvements, compatible with currently available therapies.Item EFEITOS DO MÉTODO PILATES E DO TREINAMENTO COM PESOS NA MARCHA, NO PESO CORPORAL, NA CAPACIDADE FÍSICA FUNCIONAL E NA QUALIDADE DE VIDA DE MULHERES OBESAS(Universidade Federal de Goiás, 2008-09-29) CARNEIRO, Juliana Alves; VIEIRA, Marcus Fraga; http://lattes.cnpq.br/4153462617460766; SILVA, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496The physical exercise is, currently, a means to intervene in the epidemics of obesity, helping with the weight loss, enhancing the capacity to perform daily activities and decrease the factors of risk of chronicle diseases. Objective: Assess the effectiveness of two programs of physical exercises (Pilates and weight training) and nutritional orientation, in the body weight, in the biomechanics gait, in the functional physical capacity and in the quality of life of obese women. Methodology: For twelve weeks, a group of fifteen obese women participated in a program of aerobic exercises and Pilates method and another group of fourteen obese women participated in a program of aerobic exercises and weight training. The groups participated of nutritional orientation. The exercise training lasted sixty minutes, three times a week. Were evaluated: the body weight, the body mass index (BMI), the six-minute walk test, the stand-up test, the sit-and-reach test, the SF-36(The Medical Outcomes Study 36 item) and the kinematics of the gait through recorded images and digitalized using specific software (Kwon 3D). Results: There was significant reduction of the body weight and the BMI, development in the rates of all tests of functional physical capacity and in the variables of the angular movement of the knee after twelve weeks of intervention in the two groups. The Pilates group showed significant improvement in five domains of SF-36, after twelve weeks and in the domain functional capacity between the two groups. The group trained with weights showed meaningful development in most of the space-time variables of the gait after twelve weeks. Conclusion: Both programs were effective to promote weight loss and enhance the functional physical capacity after twelve weeks. The Pilates method was more effective providing obese women with a better quality of life, mainly in the aspect of physical health. The weight training program was more effective to alter positively the kinematics variable which increased the dynamic stability of the gait of obese women after twelve weeks of intervention.Item A saúde mental em cursos de graduação na área da saúde em Goiânia/GO interfaces com a Reforma Psiquiátrica e as Diretrizes Curriculares Nacionais(Universidade Federal de Goiás, 2010-06-15) CARNEIRO, Larissa Arbués; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225; PORTO, Celmo Celeno; http://lattes.cnpq.br/9673684282497548Dissertation Thesis consisting of two steps each article format. The first, a bibliographic search, sought to understand the scientific literature in national periodicals on the teaching of mental health in undergraduate in health courses. The consultation was held in the Virtual Health Library (VHL) for publications between April 2001 to December 2009, twenty-six articles were the corpus of the study and their data were identified through a protocol. The results indicate that were more frequent papers published in 2005, authorship of nursing and studies of reporting experience type. The reports have revealed a trend of changes in educational practices. Despite the strong influence of biomedical model focusing psychopathologic, currently converge the theoretical framework of Collective Health and Psychiatric Reform, as well as the diversification of practice scenarios and development of communication and relationship skills in students, themes been underwritten by axis of interdisciplinarity and by humanizing, de-institutionalisation and subjectivity and rights of citizenship. Before this movement for change, the second step of the search sought to describe the insertion of the theme in local context, for both were investigated mental health disciplines in Nursing, Medicine, Psychology and Occupational Therapy courses in two universities of Goiânia/GO/Brazil. The data sources were: curricular matrix, programs of nine disciplines/thematic areas and questionnaires applied to teachers. Survey data shows characteristics of disciplines in relation to the matrix curricular, practice scenarios, methods and contents adopted. The results indicated that in the general context of disciplines there is a nascent but important rapprochement with Psychiatric Reform and National Curriculum Guidelines principles. Shows the coexistence of messages from biomedical and biopsychossocial models, with greater emphasis on the first model. It is expected that the results of this dissertation can bring subsidies for understanding the mental health teaching-learning process, extending discussions on the theme that forward-looking building knowledge and practice in the context of mental health education. Some of these paths have already been flagged as factors that drive changes the magnification of theoretical, intra and interpersonal skills learning, diversification of scenarios and teaching-learning practices and the strengthening of integration education-service. Suggested further studies in mental health education with the goal of better understanding of local and national realities and investigate how undergraduate come operationalizing making changes from National Curriculum Guidelines and Psychiatric Reform.Item Prevalência de sinais e sintomas do transtorno de déficit de atenção e hiperatividade em crianças e adolescentes da cidade de Cavalcante-GO que se identificam como Kalunga(Universidade Federal de Goiás, 2011-03-16) CARVALHO, Karla Cristina Naves de; CAIXETA, Leonardo Ferreira; http://lattes.cnpq.br/9536747113677509Few studies have been conducted worldwide on Attention Deficit Disorder and Hyperactivity Disorder (ADHD) in rural communities and none in Brazil so far. This is the first prevalence research on the signs and symptoms of ADHD in children and adolescents who identify themselves as Kalunga, as well as one of the pioneers on this field specifically with African descendants in Brazil. Its overall objective was the investigation of the presence of signs and symptoms of ADHD in children and adolescents (from 6 to 18 years) who identify themselves as Kalunga, in Cavalcante- GO, Brazil. A total of 204 children and adolescents were assessed through the responses provided by their parents or guardians and their teacher during interviews using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and the Teacher s Report Form for Ages 6-18 (TRF/6-18), respectively. Using the CBCL/6-18 and TRF/6-18, the signs and symptoms of ADHD were detected in 5.9% and 5,4% of the individuals assessed, whereas those of ADD were observed in 16.2% and 15.2% of them, respectively. Also, we detected that the prevalence of ADD in this study was higher than the national average, while the ADHD presented median prevalence compared with that of the world population. According to the evaluations of parents or guardians and teachers, the following estimated prevalences of comorbidities with signs and symptoms of ADHD were observed, respectively: 83% and 90% with oppositional defiant disorder; 41.6% and 45.4% with conduct disorder; 58.3% and 63.6% with anxiety disorders; 33.3% and 36.3% with affective disorders. In accordance with the evaluations of parents or guardians and teachers, the following estimated prevalences of comorbidities with signs and symptoms of ADHD were registered, respectively: 60.6% and 64% with oppositional defiant disorder; 54.5% and 58% with conduct disorder; 75.7% and 80.6% with anxiety disorders; 57.5% and 61.2% with affective disorders. We concluded that ADD exists in a culturally diverse population, the children and adolescents who identify themselves as Kalunga and who live in Cavalcante-GO, Brazil, presenting a high prevalence rate, with comorbidities commonly found in other populations of children from various cultures around the world. On the other hand, the signs and symptoms of ADHD in the present sample presented a prevalence that can be compared with that of the world population, also with comorbidities commonly found in studies performed in several parts of the world and some carried out in Brazil.Item Efeito da idade da mulher na dosagem sérica do FSH basal e na contagem dos folículos antrais Ovarianos(Universidade Federal de Goiás, 2011-12-06) CASTRO, Eduardo Camelo de; AMARAL, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579OBJECTIVES: To establish the correlation between the curves of the AFC and serum basal FSH as well as to construct a nomogram correlating age with different values of antral follicles counts percentiles in infertile patients. METHODS: A cross-sectional study of patients treated at Fêmina Reprodução Humana was made from March 2010 to October 2011. The patients were submitted to transvaginal ultrasonography and basal FSH dosage from days 2 to 4 of their menstrual period. The patients included were the ones who were 21 to 45 years old, with regular menses, two healthy ovaries, without any evidence of endocrinopathies and that signed the consent. Patients excluded: smokers, with galactosemia or ovarian cysts, with antecedents of hepatopathies, ovarian surgeries or treated with chemotherapy or radiotherapy. Pearson s correlations coefficient was used to analyze the parametric data and Spearman`s test to the non parametric data. To evaluate the evolution of the AFC in relation to age of patients the percentiles 5th, 25th, 50th, 75th and 95th were used. A linear regression was made to understand the effect of age on the AFC. RESULTS: One hundred and seventy-two patients were included in the trial with a mean age of 32.7 years old. There was a weak correlation between the dose of basal FSH and the AFC (r = - 0,269). The age-related normogram for the 5rd, 25th, 50th, 75th and 95th percentile of antral follicle count revealed that changes were best fitted by a linear function. The percentiles that showed the highest correlations were 25 (r = - 0,960; p < 0,001), 50 (r = - 0,948; p < 0,001) and 75 (r = - 0,917; p < 0,001). All were statistically significant. CONCLUSIONS: The correlation between serum levels of FSH and AFC was negative and weak. A nomogram was constructed correlating age with different values of the percentiles of the antral follicle count in infertile women without endocrinopathies. There was a linear, strong and negative correlation in all percentiles.Item Encontro do Paciente surdo que usa língua de sinais com os profissionais da saúde(Universidade Federal de Goiás, 2007-09-12) CHAVEIRO, Neuma; BARBOSA, Maria Alves; http://lattes.cnpq.br/5025797873585225; PORTO, Celmo Celeno; http://lattes.cnpq.br/9673684282497548This dissertation was built in the modality scientific article and it has three articles: the first and second ones of systematic revision of literature about the theme of the study and the third article consist of the experimental part of the dissertation. The first article, accepted in Revista da Escola de Enfermagem da USP, has as title Literature Revision about the attendance of the deaf patient by health professionals, with emphasis on the communication between deaf patient and health professional. In the second one, accepted to publish in Revista Brasileira de Otorrinolaringologia and entitled Relation between deaf patient and the doctor, the legal and sociocultural aspects of the relation between deaf patient and the doctor were presented. The third article, submitted to Revista de Saúde Pública, with the title Meeting of deaf patient who uses sign language with health professionals, has as content the object of this dissertation and has as purpose to evaluate the meeting of the deaf patient who use sign language with health. It was developed in a qualitative approach, of descriptive-analytical nature. Eleven deaf people, who use the Brazilian Sign Language to communicate, including 8 males and 3 females, with ages between 19 and 36 years old, had participated of the research. For data collection a half-structured interview was used and it had questions that approach the expectations of the death person about the meeting with health professionals, the means of communication used, the presence of a Brazilian Sign Language interpreter as a mediator and what the person judges necessary to favor a good relation. The data were organized using the content analysis, proposed by Bardin, that allowed to identify three categories: Established Communication, Interpreter Presence and Lack of Autonomy. In the first category, two sub-categories had been distinguished: facilities and difficulties. As facilitator the visual resources stood out and as difficulties inefficiency in the communication, even reaching the extreme of feeling hindered to search assistance. Other difficulties were the written language and non capable professionals to attend. The category Interpreter Presence presents as eminence the complexity of this mediator. In some moments his presence is valued, while in others it turned to a barrier. In Lack of Autonomy, it was verified that their rights haven t been respected and they stay apart from the decisions taken mainly by the family. It followed that deaf patients face a lot of barriers in the meeting with health professional, since the appointment, the moment of the meeting, until the decurrent unfoldings. And in many stories it was verified that they can t solve their problems and they can t comprehend the reason of the attitudes taken by professionals, so they feel excluded and not respected in their autonomy. So an effective participation of the deaf patient in clinical meetings requires special attention from the health professionals.Item Subclassificação por imunoistoquímica de carcinomas ductais de mama do Hospital das Clínicas da Universidade Federal de Goiás no período de 2003 a 2007(Universidade Federal de Goiás, 2011-11-18) CIRQUEIRA, Magno Belém; FREITAS JÚNIOR, Ruffo de; http://lattes.cnpq.br/7343840830786566; MOREIRA, Marise Amaral Rebouças; http://lattes.cnpq.br/6390358577348486This dissertation aimed to study the breast cancer with emphasis on the molecular subtypes. In the theoretical context, important aspects on the subject were reviewed, including prognostic aspects, predictive factors and molecular markers used in the classification by immunohistochemistry. In the practical context, the prevalence of the molecular subtypes was evaluated in a series of patients with invasive ductal breast carcinoma, using two different panels of classification by immunohistochemistry, with and without the use of proliferation marker Ki-67. We evaluated the agreement between the results obtained by the two classification models, correlating the subtypes found with the clinicopathological characteristics of tumors. Two papers were prepared, a review article, from the MEDLINE/ PubMed, LILACS and SciELO database with relevant topics about the molecular subtypes of the breast cancer and their classification by immunohistochemistry; and an original article, in which a study with 234 cases of invasive ductal carcinoma of the breast was conducted, according to the objectives previously mentioned. A significant change in the percentage of luminal tumors was observed with the use of the Ki-67, and a significant correlation with the histological grade.Item Repercussões dos fatores socioeconômicos, de estilo de vida e nutricionais no ganho ponderal excessivo no ciclo gravídico-puerperal(Universidade Federal de Goiás, 2010-02-12) COSTA, Bárbara Miranda Ferreira; PAULINELLI, Régis Resende; http://lattes.cnpq.br/8580274630880562The excessive gestational weight gain can cause harmful consequences for both the mother and for the fetus. Nutritional, lifestyle, economic and social factors can affect the weight gain above recommendations. Objectives: To evaluate the nutritional (caloric intake, macro and micronutrients), lifestyle (smoking, physical activity, reproductive behavior) and economic (income) factors associated with the excessive weight gain in eutrophic pregnant women. Methods: This case-control study included 200 low-risk pregnant women in 2 public obstetric hospitals in Goiás, Brazil. The women that agreed to this study were divided in 2 groups: cases with excessive weight gain (> 16Kg) and controls within the recommended weight gain for eutrophic pregnant (11.50 < a < 16Kg), matched on age. The women were inquired about their food intake during the gestational period, by means of a quantitative and qualitative food-frequency questionnaire validated and adapted to the low income regional people. The women were inquired about their economic and lifestyle conditions, too. The software for statistical analyze were the SPSS version 17.0. Were used the folowing tests: Kolmogorov-Smirnov, Fisher, Student´s t, chi-square (x²), odds ratio (CI 95%), Mann-Whitney, Spearman´s correlation coefficient and multivariate linear regression. Results: The median age was 25.00 (22.00-29.00) years-old for cases and 24.00 (22.00-28.00) years-old for controls (p=0.52). The median per capita income was R$ 303.75 (225.60-500.00) for cases and R$ 333.33 (175.00-480.00) for controls (p=0.41). The median education level was 10.50 (9.00-12.00) years for cases and 11.00 (9.00-12.00) years for controls (p=0.77). There was 13.00 (13%) smokers among cases and 8.00 (8%) among controls (p=0.25). The frequency of regular physical activity was 28.00 (28%) pregnant women among cases and 31.00 (31%) among controls (p=0.65). About the reproductive behavior, there were no differences between groups for the parity (p=0.45) and abortion (p=0.90). The birth interval was 27.00 (0.00-60.75) months in cases and 22.50 (0.00-47.75) in controls (p=0.34). The following variables showed in the univariate analysis a significant correlation coefficient (ρ) to the weight gain: calories = 0.15 (p=0.04), protein = 0.16 (p=0.03), total cholesterol = 0.21 (p<0.01), retinol = 0.21 (p<0.01), iron = 0.18 (p=0.01), zinc = 0.15 (p=0.04), selenium = 0.19 (p<0.01) and phosphorus = 0.16 (p=0.03). The median of the satured fat intake was 36.57 grams (23.37 51.06) in the case group and 28.21 grams (19.92 41.90) in the control group (p=0.04). In the multivariate analysis the protein intake was the only independente variable associated with excessive pregnant weight gain. Conclusion: The factors associated with the excessive weight gain in the group of cases were total caloric intake, proteins, satured fat, cholesterol, retinol, iron, zinc, selenium and phosphorus, and in special, the protein intake. Lifestyle and economic factors didn t affect weight gain.Item Comportamento subagudo da pressão arterial de idosas hipertensas após sessão de exercícios resistidos(Universidade Federal de Goiás, 2010-11-08) CUNHA, Raphael Martins da; JARDIM, Paulo César Brandão Veiga; http://lattes.cnpq.br/2292209583823133Introduction: Studies have demonstrated the positive effect of resistance exercise on blood pressure (BP) in the post-exercise period. However, studies involving medicated, older hypertensive patients are scarce in the literature. Objective: To evaluate the subacute blood pressure behavior of pharmacologically-treated older hypertensive women after a session of resistance exercises. Methodology: Controlled clinical trial, carried out with 30 older hypertensive women. The procedures of the study was carried out over three days with the same patients, with an interval of 48 hours, and consisted of a 10RM test session, an experimental protocol (EP) and a control protocol (CP). A 10 RM test was carried out to determine the load for the EP, which consisted of machine leg press, knee extensions, pull-ups, biceps curl and machine bench press. In the EP, three series with 8 to 10 repetitions were carried out at 2- minute intervals. In the CP the exercises were not done but BP was measured at the same moments. The BP measurements were taken before, immediately after and every ten minutes until 60 minutes after the exercise (EP) or control (CP). Results: In neither the EP nor the CP was there any significant increase in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the immediate post-exercise period. As time went on, there was a significant difference in BP with a decrease in both SBP and DBP in both EP and CP. Conclusion: The data from the present study offer a good indication that the prescription of resistance exercises may be carried out safely with this group of patients. The BP reduction seems to be influenced by rest post protocols and not by exercise. These data need to be confirmed with a greater number of individuals, controlled sessions and also medium- and long-term studies.