Medicina

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Análise da associação dos índices compostos de atividade da doença e questionários de capacidade funcional e qualidade de vida relacionada à saúde em pacientes com artrite reumatoide
(2017) Althoff, Bárbara Ferreira
Introduction: Rheumatoid arthritis, when not properly treated, may determine progressive joint destruction, functional limitation and impairment in physical and mental quality of life of the patients. Compound scores for assessing disease activity (ICADs) are used for follow-up and to guide treatment. The correlation analysis of these ICADs with questionnaires of functional evaluation and quality of life is essential, since it is the outcomes that matter to the patients. Objective: To evaluate the correlations between ICADs with questionnaires of functional capacity (HAQ) and health-related life quality (SF12). Methods: Cross-sectional study with 100 out-patients of Santa Catarina, participants of a multicenter cohort, followed between August 2015/January 2016. Evaluated ICADs were: DAS-28 VHS, DAS-28 PCR, SDAI, CDAI, RADAI. The questionnaires were: HAQ and SF12. Tests Qui Square, test t Student, prevalence ratio and Pearson’s correlation were used, with reliability interval 95%. Approved by Ethics Committee in Research of UNISUL. Results: Female sex (86%), in working activity (53%), average age (54), average illness duration (15 years), positive rheumatoid fator (65%). Averages found: DAS-28 VHS (3,65), DAS-28 PCR (3,02), SDAI (13,46), CDAI (12,52), RADAI (3,59), HAQ (1,05), SF-12 (físico 35,87 e mental 41,1). Moderate correlation between ICADs and HAQ (variation r 0,52 – 0,65). Weak correlation between ICADs and SF12 (Physical: variation r 0,15 – 0,24 and Mental: variation r 0,40 – 0,45). Conclusion: ICADs correlate poorly with quality of life, assessed by SF12, but moderately with functional limitation, assessed by HAQ.
Análise da influência do genótipo na carga viral dos pacientes infectados com o vírus da Hepatite C em um estado do Sul do Brasil
(2017) Borges, Kleiton Rosa
Introduction: Hepatitis C is a transmissible infectious viral disease, which manifests itself acutely, chronic and fulminant. Studies have shown that viral load decreases in 99% of patients in the fourth week of treatment, however, there are genotypes that are more resistant to treatment. These may be associated with a higher viral load. Based on the above, the present study aimed to analyze the influence of genotype on the viral load of patients infected with hepatitis C virus (HCV) in the State of Santa Catarina. Method: A cross-sectional study consisting of laboratory data from 856 patients infected with HCV, attended at the Central Public Health Laboratory of Santa Catarina, in the year 2015. Data were analyzed by the SPSS program. The qualitative data were presented in absolute and relative frequency and the quantitative as mean and standard deviation. The association between variables was calculated using the Chi-square test or Fisher's Exact Test or Kruskal-Wallis test and Dunn's post hoc test, as appropriate. p <0.05 was considered statistically significant. Results: A total of 856 patients were evaluated, of which 64.4% were male. The mean age was 50.74 ± 11.41 years and the mean HCV viral load was 5.69 x106 ± 0.89x106 log/mL. The Health region where it was evidenced more prevalence was Greater Florianópolis (22.3%). The most prevalent genotype was 1. However, when the analysis is made considering the subtypes, the most prevalent was the 3 in 38.8% of the patients, followed by 1/1a in 36.9%. There was a statistically significant association between age and genotypes 1, 2 and 3 (p< 0.05). When comparing HCV RNA quantification results in relation to genotypes, we observed that the mean viral load is higher in genotype 2 when compared to genotypes 1 and 3 (p<0.05). Conclusions: HCV in chronic patients predominated in males, in the Greater Florianópolis Region. The most prevalent genotype in the State was 1. However, when the result is expanded considering each of the subtypes, the predominant genotype was 3. There was an association between the age group and genotypes 1, 2 and 3. Genotype 2 presented a higher and statistically significant viral load when compared to genotype 1 and 3.
A associação entre a gravidade da doença arterial coronariana e o sinal de Frank em pacientes com infarto agudo do miocárdio
(2017) Weissheimer, Stephanie Scuiciato
Introduction: The diagonal earlobe crease, described in 1973 by Frank, is controversial in the literature when associated with coronary disease and its severity. If this relationship is proven, it will help in the early diagnosis, reducing the incidence of heart attack in the population. Objective: To correlate the severity of coronary artery disease and Frank’s signal. Methods: This cross-sectional study was carried out in a sample of 134 patients from the Catarina Heart Study, a prospective cohort performed at the Cardiology Institute of Santa Catarina between August 2016 and January 2017. Hospitalized patients were interviewed through a questionnaire after their first heart attack. The statistical analysis was done through the Chi-square test and Student Test, considering of significance values of p < 0.05, with a 95% confidence interval. Results: Of the patients analyzed, 56,7% had the Frank’s sign. The mean age was 59,13±11,54, body mass index 27,51±5,1, hypertension 61,9%, diabetes 23,1%, dyslipidemia 36,6%, family history 44,0% and most of them were male (66,4%). The resuts of Syntax score, FEVE e TIMI frame count were, respectively, 12,34±8,98, 50,29±14,56 e 34,49±32,07. The patients that had the sign, most of them were male (55,7% vs 44,3%, p=0,634), had hypertension (55,4% vs 44,6%, p=0,605) and less than half were diabetic (48,4% vs 51,6%, p=0,261). Dyslipdemic were just over half (51,0% vs 49,0%, p=0,276), similar to whom had family history (52,5% vs 47,5%, p=0,338). Body mass index and age were, respectively, 27,00±4 vs 28,22±5,97, p=0,198 e 61,25±9,56 vs 55,99±13,08, p=0,012. O The Syntax Score was 13,22±9,31 vs 10,96±8,43 p=0,161, FEVE 52,24±13,88 vs 47,84±15,40, p=0,162 and TIMI Frame Count 33,03±31,38 vs 35,47±34,48, p=0,808. Conclusion: There was no demonstrated association between severity of coronary disease and Frank's sign. However, had we a bigger sample of patients, likely we would have had more conclusive results.
Associação entre a indicação de procedimento de endoscopia digestiva alta e o resultado obtido, em um hospital terciário da Grande Florianópolis
(2017) Machado, Matheus Camilo Martins
Introduction: The esophagogastroduodenoscopy (EGD) is a procedure used for diagnostic and therapeutical purposes in the upper gastrointestinal tract. In Brazil, it has a low financial cost and a high cost-benefit, being thus increasingly used. Therefore, it’s important to analyse if the EGDs are being referred in a rational, cohesive and logical manner, or if changes are necessary. Objective: To investigate the association between indication of EGD and outcome. Methods: This cross-sectional study was conducted in the Endoscopic Unit of the Hospital Governador Celso Ramos in Florianópolis. 1080 EGDs were evaluated in the period between January and June of 2016. The data were collected through the patients’ electronic records. Statistical analysis was done using the chi-squared test, and a value of p < 0.05 was considered statistically significant, having a risk ratio with a 95% confidence interval. Results: Of the EGDs analysed, 57,5% were performed in women, and 48,1% in patients between the ages of 46-65. Of the indications, 43,6% were gastric complaints. 4,7% had no identifiable indication. The gastric and duodenal outcomes were observed in 46,7% of EGDs; neoplasms, in 1,4%. A normal outcome was seen in 9,5%. Gastric complaints had a correspondence with gastric and duodenal diseases of 59,2%. Conclusion: Most indications were due to gastric complaints and the commonest outcomes were gastric and duodenal diseases, and those two had the biggest correspondence with each other. Indication and outcome corresponded with each other in 47,5% of the EGDs.
Associação entre sintomas depressivos e capacidade cognitiva em pessoas com 50 anos ou mais atendidas em um ambulatório da memória
(2017) Tavares, Sarah Karolina Lima
Introduction: Depression is a modifiable risk factor for cognitive decline and dementia, depressed people improve their cognitive ability after successful treatment. Objective: To identify the association between depressive symptoms evaluated by the Geriatric Depression Scale version 15 (GDS 15) in relation to the cognitive status measured by the Montreal Cognitive Assessment (MoCA) Test in patients with 50 years or more of an outpatient memory clinic. Method: An exploratory cohort study, with 154 patients followed at the outpatient memory clinic of the Medical Specialties Ambulatory (AME / UNISUL). The main predictor was the GDS variation between the first (entrance) and second interview in the outpatient clinic and the main outcome was the MoCA variation in the same period. The analysis was univariate, bivariate using the Chi-square test and Student's T test for independent and paired samples; the final multivariate model was obtained by linear regression. Results: white color (90.9%); female gender (85.1%); Diabetes (74.0%); Hypothyroidism (84.4%); Depression (47.4%). The diagnosis of hypothyroidism was associated with the variation of the MoCA test (p = 0.025). Conclusion: In relation to the total sample, the presence of hypothyroidism was associated with the variation in the outcome studied. There was a significant reduction in the number of participants in a major depressive episode and an increase in the number of people with a remission of a depressive episode according to GDS. The variation (improvement) in GDS scores between the first and second interviews was significantly associated with variation (improvement) in MoCA only among those who had previously diagnosed depression.Among non-depressed individuals, there was no association between depressive symptoms and cognitive ability.
Associação entre via de parto e resultados perinatais em gestantes de alto risco
(2017) Puel, Ana Gabriela de Olivera
Introdução: A gestação de alto risco é aquela em que se verificam condições ou complicações que aumentam os riscos de desfecho materno e perinatal desfavoráveis, se comparadas à população geral. Tais condições estão mais associadas à indicação de cesariana – via de parto que geralmente apresenta piores resultados para o binômio mãe-filho. A correta indicação pode sim trazer benefícios. Porém, observa-se uma epidemia de indicações de parto operatório, principalmente no sistema privado. Objetivos: Avaliar a associação entre via de parto e resultados maternos e perinatais nas gestantes consideradas de alto risco obstétrico. Método: Estudo transversal que avaliou todas as gestantes classificadas como alto risco, que tiveram seus partos realizados na maternidade do Hospital Universitário Polydoro Ernani de São Thiago, e seus recém-nascidos, entre janeiro de 2010 e dezembro de 2014. A coleta foi realizada a partir de uma base de dados, e a diferença da prevalência nas variáveis independentes foram investigadas e testadas utilizando o teste do “Qui-quadrado”. Foram calculadas as Odds Ratios de acordo com as variáveis independentes associadas à via de parto. Resultados: A cesariana se apresentou como fator de risco para as seguintes variáveis: baixo peso ao nascer [OR=1,75 IC95%(1,37-2,21)], prematuridade [OR=1,73 IC95%(1,38-2,17)] e Ápgar de 1º minuto <7 [OR=1,35 IC95%(1,01-1,81)]. As complicações maternas não apresentaram relevância estatística no estudo utilizado. Conclusão: Os piores desfechos neonatais estiveram mais associados à cesariana, se comparados ao parto normal. Sendo assim, o uso exaustivo das tecnologias obstétricas pode trazer repercussões imediatas e futuras aos recém-nascidos.
Avaliação da gravidade das lesões coronarianas e do comprometimento do miocárdio pós Infarto Agudo do Miocárdio (IAM) relacionadas com a atividade física
(2017) Sartor, Evelim de Medeiros
Introduction: The regular practice of physical exercise offers a relevant protective effect, especially if combined with the prevention of other Risk Factors Objective: Evaluate the severity of coronary lesions and myocardial compromise after AMI related to physical activity. Methods: This cross-sectional study included 134 patients who were admitted with a first infarction at the Santa Catarina Institute of Cardiology (ICSC). Data were collected through interview and analysis of medical records. Approved in Ethical Committee in Research of UNISUL and ICSC. Results: The mean age was 58.39 ± 10.68 years, male predominance (63.6%), Hypertension (61.9%), smoking (29.9%) and total Baecke score 4.86 ± 1.34. Patients who consumed alcohol presented a higher Baecke score (5.28 ± 1.32) when compared to those who did not drink (4.70 ± 1.31). Conclusion: There was no correlation between the severity of the lesions and myocardial involvement related to physical activity.
Comparação da prevalência de comorbidades em pacientes com Arterite de Takayasu e Arterite de células gigantes
(2017) Ferreira, Cristiane Janson
Introduction: Vasculitis are associated with high morbi-mortality caused by cardiovascular disease, through accelerated atherosclerosis. This process has a multifactorial risk factors, which could be related to aspects of the inflammatory disease itself, to the use of steroids and to the presence of traditional risk factors of cardiovascular diseases. Objective: Analyze if patients with large vessels vasculitis (LVV) have higher frequency of comorbidities and compare the prevalence between Takayasu arteritis (TAA) and giant cell arteritis (GCA). Method: 45 medical records of patients who had LVV were analyzed in a retrospective study in Florianopolis, Brazil. Demographic data were collected, as well as related to clinical tidings. These data were compared between the vasculitis groups (TAA and GCA) through analysis on SPSS 18.0, t-student test and chi-squared test or Fisher’s exact test, p ≤ 0,05. Project was approved by Human Research Ethics Committee of the related institutions. Results: Among the 45 patients, 22 had TAA and 23 had GCA. 84,4% of the patients were women. The percentage of systemic arterial hypertension, diabetes mellitus and dyslipidemia on TAA were 77,3%, 9,1% and 95,5%, respectively. In the same order these comorbidities were found in GCA patients in 87%, 39,1% and 100%. The control of dyslipidemia was not satisfactory in both groups. Lipid profile did not have a significant difference between TAA and GCA. Conclusion: Patients with GCA have higher prevalence of diabetes mellitus when compared to general population and to TAA. The higher prevalence of systemic arterial hypertension and dyslipidemia found in LVV combined with endothelial inflammation due to vasculitis can contribute to accelerate atherosclerosis and should be evaluated and well treated.
Comparação de estratégias de associação de DMARDs no tratamento da artrite reumatoide
(2017) Schaefer, Bernardo Oliveira
Introduction: Rheumatoid arthritis (RA) is a systemic disease of chronic progression characterized by the progressive destruction of the peripheral joints. Several classes of drugs are employed in its treatment, with several possible combinations between them. There is no consensus in literature on the best treatment regimen with DMARDs. Objective: To analyze which association strategy of DMARDS provides better results in the treatment of Rheumatoid Arthritis. Methods: A retrospective study was carried out at two rheumatology clinics in Florianópolis, SC, from 1997 to 2017, with data from patients who used a triple scheme (Metotrexate + Sufassalazine + Hydroxichloroquine) or double scheme (Metotrexate + Leflunomide), collected and tabulated in Excel and exported to SPSS 20.0 software and described as relative and absolute frequency. The chi-square and ANOVA tests were used to test the homogeneity of proportions, with a significance level of p <0.05. Project approved by CEP UNISUL. Results: The triple scheme was used by 41 patients and the double scheme by 62 patients, totalizing 103 patients. The mean age of the patients was 57 years and the mean age at diagnosis was 49 years, with 67.96% of female patients, with a positive rheumatoid factor of 80.39%. The double scheme was associated with higher progression to the use of anti-TNF alpha (RP 1.97) compared to the triple scheme. The mean time to progression to anti-TNF alpha of the two schemes were similar. Conclusion: The triple scheme was associated with a lower rate of progression to anti-TNF alpha compared to the double regimen, although both schemes have a similar mean time to progression to the use of anti-TNF alpha. Key words: Rheumatoid arthritis, DMARDs, anti-TNF alpha.
Correlação da perfusão coronariana pós-angioplastia primária com a função ventricular pós-infarto
(2017) Bald, Ana Paula
Background: Acute Myocardial Infarction (AMI) stands out for its high prevalence. Primary angioplasty is the most effective treatment, in addition to allowing the analysis of coronary perfusion by TIMI frame count (TFC). The severity of AMI is related to worse prognosis and development of left ventricular dysfunction. Objectives: To correlate coronary perfusion after primary angioplasty with post-infarction ventricular function; to describe the demographic characteristics, comorbidities, life habits and family history of the study population; to correlate perfusion after primary angioplasty, post-infarction ventricular function and SYNTAX score (SXs) with each other and with symptom-to-door time, door-to-reperfusion therapy time and total ischemic time; to associate comorbidities, life habits, family history and involvement of the anterior wall with coronary perfusion after primary angioplasty. Method: A cross-sectional study including 55 patients admitted in Santa Catarina’s Institute of Cardiology with diagnosis of AMI with ST-segment elevation, from August to November, 2016. Data collection from interview and consultation in medical records. Analysis by SPSS 13.0, Chi-square test, Student t and p≤0.05. Results: 63.3% were males, mean age 58.39 years. Arterial hypertension (63.3%), family history (47.3%) and dyslipidemia (36.4%) were the most prevalent clinical variables. There was no significant correlation between TFC and left ventricular ejection fraction (LVEF). There was a correlation between TFC and SXs (r=0.31, p=0.041), in addition to a non-significant correlation between SXs and LVEF (r=0.31, p=0.051) and between symptom-to-door time and LVEF (r=0.31, p=0.058). Conclusion: Coronary perfusion is not correlated with post-infarction ventricular function, but SXs is positively correlated with coronary perfusion and has a non-significant correlation with post-AMI ventricular function and symptom-to-door time.
Estudo da prevalência e dos fatores associados à hipovitaminose D na população portadora de HIV na região metropolitana de Florianópolis
(2017) Schirmbeck, Aline Riffel
Introduction: HIV infection has a high incidence in the metropolitan region of Florianópolis and, currently, studies have shown it to be a chronic inflammatory disease with potential association with hypovitaminosis D. Objective: To identify the prevalence and factors associated with hypovitaminosis D in the population with HIV. Methods: A cross-sectional study conducted in the Hospital Regional de São José with 160 HIV patients from January 1, 2015 to December 31, 2016, based on information obtained in medical records. Results: In the studied population, there was a predominance of women (53.1%), aged less than 50 years (70.6%) and Caucasians (87.3%). The prevalence of hypovitaminosis D was 56.3%, 20.6% with deficiency and 35.6% with insufficiency. A statistical association was observed between hypovitaminosis D and renal insufficiency (p = 0.04). It was also observed a protective relationship with tenofovir (p = 0.03) and associative tendency with zidovudine use (p = 0.06).Conclusion: This is one of the first studies on the subject conducted in the southern region of the country, with a prevalence rate of 56%. The results reinforce the importance of monitoring vitamin D levels in patients with HIV, especially those with renal impairment and history of use of zidovudine.
Fatores associados à adesão ao tratamento dos pacientes com fenilcetonúria atendidos no Hospital Infantil Joana de Gusmão
(2017) Mariosa, Nayara Ferreira
Introduction: Phenylketonuria (PKU) is a disease of autosomal genetic inheritance which promotes a change in the metabolism of amino acids with increased phenylalanine (phe) in the blood and impairment in cellular communication. Adherence to treatment linked to the maintenance of a restricted diet in phenylalanine and control of metabolic levels, is a great challenge with high impact on family quality of life. Objectives: To analyze the factors associated with adherence to the treatment of patients with Phenylketonuria treated at the Hospital Joana de Gusmão - Florianópolis - SC, in the period between August 2015 and November 2016. Method: Cross-sectional observational study with case-control type analysis. Data from patients between 0 and 41 years of age were collected and analyzed from 50 charts, and interviews were conducted with those who were responsible for the patients. Approved in CEP Unisul. Results: The prevalence of adherence to treatment was 52.2% in patients younger than 13 years of age, 92.3% of patients adhering to treatment started treatment in childhood, 41.7% of those responsible for the patients, adhering to treatment, have more than 8 years of schooling and 75% reported on government failure to provide the formula. Conclusion: The treatment adherence depends on demographic factors like the age of the patients, as well the early beginning of treatment, well known about phenylketonuria and the adequate supply of the metabolic formula, that can contribute for the maintenance of phenylalanine levels.
Fatores associados à gravidez e aos desfechos perinatais em casais adolescentes no estado de Santa Catarina
(2017) Cabral, Thalyta Indja Dittert
Introduction: Adolescence is a critical period of human development. The occurrence of pregnancy at this stage is related to risks to the mother and her newborn. Numerous studies are focused on the adolescent mother and her newborn, neglecting the importance of paternal age. This study addresses the risk factors for teenage pregnancy with a focus on the "adolescent father and mother" binomial. Objective: To investigate factors associated with pregnancy in adolescent couples and the perinatal outcomes. Method: A cross-sectional study with SINASC/SC data, totaling 17,156 deliveries of primiparous women with single pregnancy. Prevalence ratios adjusted according to hierarchical model and Percentage Attributable Risk (RAP) were calculated to obtain the excess in the chances of the outcomes among the adolescent couples. Results: Findings show that in the 16.6% of deliveries among adolescent mothers, more than 1/3 of these occurred among live births of adolescent parents. This group had a less privileged profile regarding socio-demographic factors, prenatal care and an excess in the relative risk and attributable risk for practically all the variables of interest when compared to pairs of adolescent mother and adult father. Conclusion: When strategies are designed directed at the issue of adolescent pregnancy, it is essential to look at the adolescent couple as a special group, and the adolescent father as an independent factor, with an important role in the final definition of risk in this group.
Fatores associados à neoplasia não invasiva de alto grau em pólipos adenomatosos de pacientes que realizaram colonoscopia por indicação de rastreamento de carcinoma colorretal
(2017) Souza, Julia Koerich de
Introduction: Intestinal adenomatous polyps are precursor lesions of colorectal carcinoma (CRC), one of the most common types of cancer among men and women. Screening and appropriate treatment of polyps is able to reduce incidence and mortality by CRC. Objective: To identify the factors associated with high-grade neoplasia in adenomatous polyps of patients 50 years of age or older who underwent colonoscopy for CRC screening. Methods: Case-control study with 216 individuals with adenomatous polyps who underwent colonoscopy in private practice in Florianópolis, separated in two groups according to the presence or absence of high grade neoplasia. Data obtained from electronic medical records. Statistical analysis SPSS 18.0, Chi-square test, and p≤0.05. Oddis Ratio (OR) with 95% CI. Approved by CEP UNISUL. Results: There was no statistically significant relationship between sex; Age; Genre; Family history; Previous polypectomies; Number of polyps; And high-grade neoplasia. Weak association with non-polypoid morphology (OR=2,875 and p=0,051) and statistical significance with polyp size ≥1cm (OR=26.147 and p<0.01), villous or tubulo-villous histology (OR=7 and p <0.01) and location of the polyp in the left colon (OR=37.766 and p<0.01). Conclusion: The factors associated with high-grade neoplasia in colon adenomas include polyp size greater than or equal to 1 cm, villous or tubulo-villous histology, the location of the polyp in the left colon, and non-polypoid morphology.
Fatores associados ao óbito em pacientes submetidos à laparotomia pós trauma abdominal no Hospital Regional de São José
(2017) Schmitz, José Ricardo Grams
Introduction: Abdominal trauma is an important cause of morbidity and mortality, and knowledge of the epidemiological and clinical context is necessary to assist in the initial evaluation of the patient. The standardization of criteria for surgical intervention or the choice of conservative treatment are extremely important to avoid complications or mortality due to abdominal trauma. Objective: To identify the factors associated with death in patients submitted to laparotomy after abdominal trauma at the Regional Hospital of São José. Methods: A case-control study analyzing 202 patient charts of abdominal trauma victims submitted to an exploratory laparotomy using an instrument for collecting data. Data Analysis in SPSS 18.0, chi-square test and p<0.05. Prevalence ratio with 95% CI. The study was approved by REC. Results: Prevalence of mortality in male patients (91%), younger than 55 years (82.4%), blunt trauma (58.8%), automobilistic accident (52.9%), Glasgow ≤8 (59.1%), SBP≥90mmHg, FC ≥100bpm (52.4%), Hb <10g/dL (52%), multiple lesions (61.8%), spleen and liver injuries (38.2% each), extra abdominal injuries (76.5%), associated thoracic trauma (64.7%), presence of complications (94.1%), hypovolemic shock (61.8%) and damage control surgery (51.5%). Conclusion: The factors associated with mortality with statistical significance (p <0.05) were advanced age, blunt trauma, altered GCS, SBP <90mmGh, Hb <10g/dL, multiple lesions, solid viscera (spleen, kidney and pancreas), associated traumas (thoracic and cranioencephalic), postoperative complications (hypovolemic / hemorrhagic shock, CRP, acute renal failure, acute respiratory insufficiency) and the need for damage control surgery.
FFatores associados ao padrão de prescrição de estatinas para pacientes ambulatoriais em prevenção secundária cardiovascular do Instituto de Cardiologia de Santa Catarina antes e após 2013
(2017) Schmitt, Camila Bussolo
Introduction: Cardiovascular diseases are the main cause of morbidity and mortality in the world. Among them, atherosclerosis is the most prevalent and has a great impact on public health. Objectives: To analyze the factors that influenced the choice of statin potency for patients in secondary prevention. Method: It was a cross-sectional study performed at the cardiology outpatient ambulatory of the Instituto de Cardiologia de Santa Catarina, with 511 patients from the database “Assessing the Impact of New Guidelines on the Use of Statins”, evaluated before and after 2013, thus configuring groups A and B. Analysis in SPSS 18.0, Chi-square test or Fisher's exact test, and p≤0.05. Ratio of Prevalence with 95% CI. Approved by CEP UNISUL. Results: There was prevalence of males (63%), 82.8% with less than 75 years; White color (96.7%); 76.1% hypertensive, 31.1% diabetic, 28.6% smokers, 77.3% previously used statin; LDL value between 70 and 100 (38.6%); 73.2% AMI and 30.9% UA. In group A 9.2% and in B, 22.2% had been using high potency statin. The majority, in both groups, received moderate potency statin. There was association with statistical significance in group A with SAH, DM, smoking, age, AI, previous use of statin, and in B with age, AMI, previous use of statin. Conclusion: Majority of males, age less than 75 years, white color. Most patients received statin with less intensity than recommended, being the predictors for that the previous use of statins and the SAH.
Perfil epidemiológico dos óbitos por COVID-19 segundo faixa etária em Santa Catarina, 2020-2021.
(2022-12) da Costa, Ícaro; Dias, Leandro
Introdução: A mortalidade por COVID-19 ocorre com maior frequência em idosos e presença de comorbidades. O sexo masculino e a cor da pele não branca apresentam maior risco de óbito. A evolução do quadro clínico com dispneia e febre, e suporte ventilatório invasivo estão relacionados a maior probabilidade de óbito. Objetivo: Analisar o perfil epidemiológico dos óbitos por COVID-19 segundo faixa etária em Santa Catarina no período de 2020 a 2021. Métodos: Estudo transversal com análise de óbitos por COVID-19 do banco de dados do Sistema de Informação de Mortalidade disponibilizados pela Diretoria de Vigilância Epidemiológica do Estado de Santa Catarina. Análise descritiva dos dados segundo distribuição das variáveis em duas faixas etárias, abaixo de 60 e a partir de 60 anos, expressa na forma de frequências. Resultados: Analisados 20.000 óbitos com maior prevalência a partir de 60 anos de idade (69,1%). Nas duas faixas etárias, foram mais frequentes óbitos no sexo masculino, cor branca e baixa escolaridade. As causas imediatas dos óbitos foram septicemia não especificada, insuficiência respiratória aguda e não especificada. As causas intermediárias foram pneumonia por organismo não identificado, septicemia não especificada, COVID-19 vírus identificado/síndrome respiratória aguda grave e insuficiência respiratória aguda. A obesidade foi o estado patológico que mais contribuiu para o óbito abaixo de 60 anos e a HAS e a diabetes a partir de 60 anos. Conclusão: Maiores prevalências nas duas faixas etárias de sexo masculino, cor de pele branca, baixa escolaridade. As causas imediatas e intermediárias foram similares.
Perfil epidemiológico e fatores associados ao desfecho da sífilis congênita no estado de Santa Catarina no período de 2013 a 2015
(2017) Freschi, Leonardo Demartini
Introduction: Syphilis is a serious public health problem and is now considered a reemerging disease. Failure to diagnose and treatment during pregnancy often results in negative outcomes for the child. Objective: To analyze associated factors with congenital syphilis in the state of Santa Catarina, Brazil, from 2013 to 2015. Methods: A cross-sectional study was carried out through data collected from Notification Data Sheets that fed the Brazilian Notification of Injury Information System - SINAN. Sociodemographic and clinical data on 1110 children diagnosed with congenital syphilis and their respective mothers was collected and analyzed by the SPSS 18.0 program, under the approval of Ethics and Research Committee - UNISUL. Results: 50.9% of the mothers were aged 20-29 years; 33.2% between 4th and 8th grade; 36.3% lived in Grande Florianópolis region. About the children, 89.7% survived, 88.7% were asymptomatic; 87.7% did not perform the non-treponemal test and 48.9% did not perform a CSF test. Noticed statistical significance between outcome being alive and antenatal care; diagnosis of syphilis during antenatal care; appropriate treatment; non-treponemal test and CSF test. Conclusion: The quality of antenatal care and adequate treatment for pregnant women is still insufficient to promote the maintenance of the life of children exposed to syphilis in Santa Catarina. In addition, when vertical transmission occurs, there are failures to perform examinations necessary for the clinical follow-up of these children.
Prevalência de cetoacidose diabética na apresentação inicial de diabetes mellitus tipo 1 em crianças e adolescentes entre 2018 e 2012 em um serviço de emergência pediátrica: Cetoacidose no diagnóstico de diabetes tipo 1
(2022-11-30) Amabile Rodrigues Alves, Amabile; Fernando Molon Braz, Fernando
Objetivo: Analisar a prevalência de cetoacidose diabética (CAD) e fatores associados na apresentação inicial de diabetes mellitus tipo 1 (DM1) em crianças e adolescentes entre 2018 e 2021 em um serviço de emergência pediátrica. Método: Estudo transversal, com análise casocontrole, que incluiu 124 pacientes menores de 18 anos com diagnóstico de DM1. Os dados coletados em prontuários eletrônicos incluíram: presença e gravidade da CAD, sexo, idade, origem, etnia, sintomas pré-diagnóstico de DM1, tempo de evolução dos sintomas, número de consultas médicas e diagnósticos diferenciais realizados, histórico familiar de DM1, glicemia, bicarbonato, hemoglobina glicada, cetonúria, glicosúria, autoanticorpos, necessidade de cuidados intensivos e doenças autoimunes associadas. Como medida de associação, utilizou-se razão de chances, com intervalo de confiança de 95%. Resultados: Dos 124 pacientes analisados, verificou-se que 58,9% foram diagnosticados com DM1 durante um episódio de CAD, com média de idade de 8 anos. História familiar presente se mostrou um fator de proteção (RC 0,332; IC 0,114-0,970) para CAD. Os sintomas associados à CAD foram náusea e vômito, dor abdominal e outros. Apenas os pacientes com CAD apresentaram taquidispneia, alteração do nível de consciência, prostração e febre. Houve associação com tempo de evolução dos sintomas. Conclusão: A CAD foi frequente no momento do diagnóstico de DM1. Os principais fatores associados foram história familiar de DM1, tempo de evolução dos sintomas e presença de sintomas gastrointestinais. Observa-se a importância da implementação de campanhas de conscientização, com o propósito de diagnóstico precoce do DM1, prevenção e tratamento adequado da CAD.
Prevalência de hepatite B e fatores associados no município de Águas Mornas em Santa Catarina
(2017) Machado, Jéssica Fretta
Introduction: According to the World Health Organization, around 2 billion of individuals have already been in contact with the hepatitis B virus and around 400 million are considered chronic carriers. In Brazil, the North region is considered of high endemicity with a prevalence of 8%.In Santa Catarina, the west of the state is considered an endemic region. By the chronification of the disease, the hepatitis B virus can evolve into cirrhosis and hepatocellular carcinoma. Objective: To evaluate the prevalence in adults and other associated factors to hepatitis B in the city of Águas Mornas, SC. Method: Cross-sectional study, with 334 individuals over 18 years old, interviewed by a sociodemographic and life habits questionnaire and a rapid format test for the HBV. Analysis in SPSS 18.0, using the Qui-square test and p≤0,05. Prevalence ratio with CI of 95%. Approved by the Ethics Committee of UNISUL. Results: The prevalence of the HBV was 2,4%, 1,2 times higher in men and the age group more affected was 46-59 years old. The presence of tattoos showed a 1,5 times higher risk to contract the infection, just as sexual practice (2,6 times higher) and the no condom use. The vaccination coverage was 38,1% and only 0,8% of the vaccinated had hepatitis B. Conclusion: Águas Mornas can be considered an intermediary endemicity region. Sexual practice, tattos and the no condom use were the associated factors found. Immunization of the population is still deficient and prevention of infection needs to be better disseminated and implemented in the city.

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