nÃo hà / Para analisar a histÃria natural da Esclerose MÃltipla (EM) no estado do CearÃ, Brasil, o autor estuda retrospectivamente 146 pacientes diagnosticados por critÃrios de Poser e / ou McDonald-2010. CasuÃstica e mÃtodos: dados biogrÃficos, clÃnicos e para-clÃnicos obtidos em visitas ambulatoriais e nos surtos. Considera como desfechos de incapacidade os marcos EDSS 4, 6 e 7. Com software estatÃstico R ( RKWard 0.5.3 ) faz anÃlise descritiva, teste exato de Fisher (p < 0,05) e curvas de anÃlise de tempo atà o evento ( Kaplan-Meier). Mais de 75 % dos pacientes sÃo acompanhados durante atà 15 anos. Resultados: EM predomina no sexo feminino (80,82 %); tem inÃcio antes dos 30 anos de idade em 47,9 % dos casos. Pacientes com educaÃÃo de nÃvel superior (33,5 %) representam mais do dobro do esperado na populaÃÃo em geral. Nas avaliaÃÃes inicial e evolutiva predominam os sintomas sensitivos, motores e esfincterianos. Pacientes mais jovens e com evoluÃÃo recorrente â remitente atingem EDSS 4 apÃs maior intervalo de tempo. A proporÃÃo de casos de EM benigna à de 4,7 %. A taxa anualizada de surtos à 0,6. Os dois primeiros surtos da maioria dos pacientes ocorreram nos primeiros 3 anos. O tempo entre 1 e 2 surtos tem relaÃÃo positiva com o tempo para atingir EDSS 4, 6 e 7. A duraÃÃo da doenÃa atà o Ãbito (8 casos, 5,4 %) foi em mÃdia de 14,4 anos. PrevalÃncia de EM no estado do Cearà à estimada em 2,9 / 100.000 habitantes. ConclusÃo: As caracterÃsticas clÃnicas e evolutivas da EM, no estado do Cearà (latitude sul entre 2o 46â e 7o 52â), sÃo semelhantes Ãs observadas mundialmente. / In order to study the natural history of Multiple Sclerosis (MS) in the state of CearÃ, Brazil, the author retrospectively analyzes 146 patients diagnosed according to Poser and/or McDonald-2010 criteria. Cases and methods: biographical, clinical and para-clinical data collected on outpatient visits and at relapses. EDSS scores 4, 6 and 7 used as disability outcomes. Statistical software R (RKWard 0.5.3) used to perform descriptive analysis, Fisher exact test (p< 0,05) and time-to-the-event curves (Kaplan-Meier). Results: over 75 % of the patients followed for as long as 15 years; disease onset before 30 years of age in 47,9 %, with female sex preponderance (80.82 %). Patients with university education (33,5 %) are in high proportion when compared to the general population. Sensory, motor and sphincter complaints are the most common, in both initial and final examinations. Younger patients with relapsing-remitting MS took a longer time to reach EDSS 4. The proportion of benign MS cases was 4, 7 %. Annualized relapse rate was 0,6 . For most patients, the first two relapses took place in the initial three years of illness.Time between 1st. and 2nd relapses bears a positive relationship with time to reach EDSS 4, 6 and 7. Disease duration until death (8 cases , 5,4 %) was an average of 14,4 years. The prevalence of MS in the state of CearÃ, Brazil, is estimated as 2,9 / 100.000 inhabitants. Conclusion: Clinical course of MS in the state of CearÃ, Brazil (south latitudes between 2o 46â and 7o 52â ) is similar to that observed worldwide.

O objetivo do estudo foi determinar a prevalÃncia de sobrepeso e obesidade em adolescentes matriculados em escolas pÃblicas e privadas do MunicÃpio de Fortaleza. A prevalÃncia do excesso de peso foi analisada, levando-se em consideraÃÃo o sexo e a faixa etÃria dos adolescentes, bem como o nÃvel socioeconÃmico das famÃlias. Um estudo transversal de base populacional foi realizado de marÃo a maio de 2003, com uma amostra de 1.158 adolescentes entre 10 a 19 anos, alunos do ensino fundamental da 5 a 8  sÃrie e do ensino mÃdio. As variÃveis do estudo incluÃram: sexo, faixa etÃria (adolescÃncia precoce, 10 a 14 anos; e adolescÃncia tardia, 15 a 19 anos) situaÃÃo escolar (privada ou pÃblica), nÃvel socioeconÃmico e dados antropomÃtricos. Na avaliaÃÃo nutricional, foi utilizado o Ãndice de massa corpÃrea. Foi considerado como ponto de corte para sobrepeso percentil igual ou maior que 85 e menor que 95 e para obesidade o percentil igual ou maior que 95. A referÃncia para as medidas antropomÃtricas foi baseada nas tabelas de Must et al.(1991). Na determinaÃÃo do nÃvel socioeconÃmico das famÃlias, foram utilizados os âCritÃrios de ClassificaÃÃo EconÃmica do Brasilâ (IBOPE). A prevalÃncia de sobrepeso/obesidade foi de 19,5%, sendo maior nas escolas privadas do que nas pÃblicas (23,9 e 18,0%, respectivamente). Em relaÃÃo ao sexo, o excesso de peso foi distribuÃdo igualmente nos dois grupos de colÃgios, contudo, nas escolas particulares foi mais frequente no sexo masculino, nÃo sendo observada diferenÃa nos colÃgios pÃblicos. Foi encontrada maior prevalÃncia de sobrepeso/obesidade na adolescÃncia precoce do que na adolescÃncia tardia. Nos estratos sociais mais elevados, a prevalÃncia de sobrepeso/obesidade foi maior, sendo os rapazes e os adolescentes entre 10 a 14 anos os que mais contribuÃram para esta diferenÃa. Conclui-se que à elevada a prevalÃncia de adolescentes com sobrepeso/obesidade no MunicÃpio de Fortaleza, sendo maior nas escolas da rede privada, na adolescÃncia precoce e nas classes de maior nÃvel socioeconÃmico, nÃo se encontrando diferenÃa entre os sexos. / The aim of this study was to determine the prevalence of the overweight and obesity in adolescents from public and private schools in the city of Fortaleza, Brazil. The overweight and obesity prevalence was analyzed considering gender and age, as well as the familyâs socioeconomic background. A population-based cross-sectional study was conducted between March and May of 2003, including a sample of 1,158 adolescents (10 to 19 years old) enrolled in elementary education (between the fifth and eight grades) and in high school. The variables included in this study were: gender, age group (early adolescence- 10 to14 years old and late adolescence-15 to 19 years old), type of school (public or private), socioeconomic level, and anthropometric measures. The Body Mass Index (BMI) was used in the nutritional assessment. Overweight was defined as the BMI equal or above to the 85 percentile and below to the 95 percentile while obesity was defined as BMI equal or above to the 95 percentile. The reference of the anthropometric measures was based on the tables provided by Must et al. (1991). The economic classification of Brazil (IBOPE) was used to determine the socioeconomic level. The overall prevalence of overweight/obesity was 19.5%; the proportion in private schools was higher than in public schools (23.9 e 18.0%, respectively). Regarding gender, the overweight incidence was similar in both types of schools; however, its prevalence among males was higher in private schools while no difference among males and females was found in public schools. Overweight/obesity prevalence among adolescents aged 10 to 14 years old was higher than among adolescents aged 15 to 19 years old. The highest rates were found in the highest SES stratum, being males and adolescents aged 10 to14 years old responsible for this difference. It was concluded that the prevalence of overweight/obesity among adolescents in the city of Fortaleza is considerably elevated, being higher in private schools, in the early adolescence, and in the highest SES level. No difference was found in this rate among males and females.

A tuberculose continua sendo um grave problema de saÃde pÃblica. A morbidade e mortalidade por todas as formas de apresentaÃÃo da doenÃa tem aumentado nos Ãltimos anos. Os SintomÃticos RespiratÃrios (SRâS) tÃm papel importante como indicadores de programaÃÃo das aÃÃes de controle. No presente trabalho, foi efetuado um estudo transversal, com o objetivo de conhecer o percentual de SR na populaÃÃo maior de 14 anos, que demanda os ServiÃos de SaÃde em Fortaleza. Os resultados mostram que, do total de 1200 consultantes, 23,58% sÃo SRâs com qualquer tempo de duraÃÃo dos sintomas e 6,50% com o tempo de 3 semanas e mais. O percentual de SRâs variou de 4,5% a 9,5% nas diferentes regiÃes de Fortaleza, bem como variou de 5,1% a 20,5% em diferentes grupos etÃrios. Dos SRâs, detectados com sintomas de 3 semanas e mais, 70,5% procuraram o Centro de SaÃde por outras razÃes que nÃo os sintomas respiratÃrios. / The Tuberculosis is still a serious Public Health problem. The Morbidity and Mortality for all the forms of the diseases has been increasing in the last years. The Respiratory Symptomatic (RS) have an important role as indicators of the programmatic control actions. In the present work a transversal study was carried out. study, aiming to determine the percentage of SR in the population older than 14 years old that seek the Public Health Services in Fortaleza. The results demonstrate that a total of 1200 patients, 23,58% were RS with any time of duration of the symptoms and 6.50% with the time of 3 weeks or more. The percentage of RS ranged from 4,5% to 9,5% in the different regions of the Fortaleza City, as well as from 5,1% to 20,5% in different age groups. From the detected RS with symptoms of 3 weeks of duration time or more, 70.5% went to the Health Center for reasons other than respiratory symptoms.

O presente estudo teve como objetivo verificar a prevalência de anemia em crianças de 3 a 12 meses de idade, associada às variáveis maternas, neonatais e de aleitamento materno, atendidas num serviço de saúde de Ribeirão Preto, SP. Neste estudo, que foi um recorte de um projeto multicêntrico, utilizou-se parte dos dados coletados na UBDS Vila Virginia, em Ribeirão Preto-SP, a fim de se atingirem os objetivos propostos. Estudo transversal, observacional, descritivo e quantitativo, do qual participaram 121 mães e seus respectivos filhos, de 3 a 12 meses de idade, atendidos no serviço de puericultura da UBDS Vila Virgínia, turno da tarde, no período de 01 de setembro/2005 a 31 de julho/2006. No seu desenvolvimento, realizaram-se entrevistas com as mães, para preenchimento do formulário, e também colheu-se amostra de sangue da região do calcâneo da criança, para dosagem da hemoglobina (Hb). Adotaram-se três critérios internacionais, como parâmetros de anemia, usando-se para as crianças de 3 a 5 meses de idade completos dois critérios, de Hb < 10,0 g/dL segundo padrão Brault-Dubuc e Hb< 10,3 g/dL, padrão Saarinen; para as crianças e 6 a 12 meses de idade incompletos, critério de Hb < 11,0 g/dL, adotado pela OMS. Na análise dos dados, utilizaram-se distribuição de freqüências, médias, desvios padrões e medianas, teste de associação e regressão logística. Do total de 69 crianças de 3 a 5 meses de idade completos, a prevalência de anemia foi de 17,4 e 20,2%, segundo padrões Brault-Dubuc e Saarinen, respectivamente. Nas crianças de 6 a 12 meses de idade incompletos, a prevalência de anemia foi de 48,0%, segundo critério da OMS. No total de 121 crianças de 3 a 12 meses de idade, a prevalência de anemia foi de 30,6 e 32,2%, respectivamente, segundo combinação dos três critérios. Não encontrou-se associação entre anemia e variáveis maternas e formas de morar e viver das famílias; porém, com relação às variáveis infantis, encontrou-se forte associação entre anemia e idade da criança; não se identificou associação entre anemia e sexo, peso ao nascer, idade gestacional e consumo de ferro medicamentoso. Quanto à anemia e aleitamento não se encontrou associação estatisticamente significativa entre os diferentes tipos e duração do aleitamento materno. O consumo de água e chá aumentou 1,8 vez o risco de adquirir anemia mas, o resultado não foi estatisticamente significativo. O uso de leite de vaca fluido apresentou-se associado à anemia, aumentando em 1,7 vez o risco de adquiri-la. / This study aimed to verify the prevalence of anemia in children 3 to 12 months old associated to maternal, neonatal and breastfeed variables, assisted in a health service in Ribeirão Preto, SP. Part of the data collected for a multicenter project in the UBDS (Basic and District Health Unit) Vila Virginia was used. This is a cross-sectional, observational, descriptive and quantitative study. A total of 121 mothers and their respective children, 3 to 12 moths old, assisted in the child care service of the UBDS Vila Virginia in the afternoon shift in the period between September 1st, 2005 to July 31st, 2006 participated in the study. Mothers were interviewed in order to fill in the form and blood samples were collected from the children\'s calcaneus region to determine the hemoglobin (Hb) dosage. Three international criteria were adopted as parameters of anemia. For children 3 to 5 months old, two criteria were used, the standard Brault-Dubuc, Hb<10.0 g/dl and the standard Saarinen, Hb<10.3 g/dl and for children 6 to under 12 months old, the criterion adopted by WHO, Hb < 11,0 g/dl, was used. In the data analysis, frequency distribution, mean, standard deviation and median, association test and logistic regression were used. From the 69 children, 3 to 5 months old, the prevalence of anemia was 17.4 and 20.2%, according to Brault-Dubuc and Saarinen standards, respectively. For children 6 to under 12 months old, the prevalence of anemia was 48.0% according to the WHO criterion. In the total, for 121 children 3 to 12 months old, the prevalence of anemia was 30.6 and 32.2% respectively, according to the three combined standards. There was no association between anemia and maternal variables and families\' living conditions. However, there was strong association between anemia and children\'s age; no association between anemia and gender, weight at birth, gestational age and consumption of medicamentous iron were found. There was also no statistically significant association between anemia and breastfeeding in terms of types and duration of breastfeeding. The consumption of water and tea increased 1.8 times the risk of acquiring anemia though the results was not statistically significant. The consumption of liquid cow milk was associated to anemia and increased 1.7 times the risk of acquiring it.

Abstract The aims of this study were to estimate the prevalence of autism in Northern Finland and to assess retrospectively the associations of autistic disorder with identified medical conditions and additional disabilities in this defined population of children and adolescents with autistic disorder. In order to find out the factors influencing the outcome, the methods of treatment/habilitation and the interventions used were studied in detail. The last aim was to elicit reliable information for decision-makers as well as ideas for giving support and, because of the presumed better outcome, saving resources in the long run. The data were collected from hospital records and the records of the central institutions for the intellectually disabled in the Provinces of Oulu and Lapland in 1996–1997. The age-specific prevalences obtained in this study showed the prevalence to be lowest, i.e. 6.1 per 10 000, in the oldest age group of 15- to 18-year-old adolescents and highest, i.e. 20.7 per 10 000, in the age group of 5- to 7-year-old children, when the criteria of ICD-10 and DSM-IV were used. In this study, almost 50% of the autistic cases had a tested IQ above 70. Associated medical disorders or associated disorders of known or suspected genetic origin were diagnosed in 12.3%. Other associated medical disorders were epilepsy, hydrocephalus, fetal alcohol syndrome and cerebral palsy. Severe impairment of vision was evident in 3.7%. The most common therapies were physiotherapy and speech, occupational and music therapy. 43.9% of the children and adolescents with autism received specific training according to the TEACCH (Treatment and Education of Autistic and related Communication-Handicapped Children), 10.2% according to the Lovaas and 30.5% according to the Portage program. Antiepileptic medication had been prescribed to 23.9% and psychopharmacals to 14.9% of the individuals with autistic disorder (AD). About three- to fourfold prevalence of AD in Northern Finland was found when compared to 16 years ago. Early, effective and regular interventions in autism have a good impact and should be provided as early as possible to children with autism. Based on the poorer prognosis of those without any early intervention, it can be anticipated that these methods will save resources in the long run.

Introduction: Proportion of seniors in the world population is growing and substantial attention is given to population aging worldwide. Geriatric patients present very heterogenous group of patients with high interindividual differences. With increasing age number of chronic and degenerative disorders increases, drug consumption raises and consequently also polypharmacy. The more medications a senior consume, the higher probability of prescription of high-risk medications he/she has. With the aim to rationalize drug prescribing in geriatric patients, significant number of explicit criteria of medications/medication procedures potentially inappropriate in older age has been published. The aim of this diploma thesis was to evaluate prevalence of potentially inappropriate prescribing in geriatric population in studies published between 1991 and 2015 years and to further evaluate the most frequently prescribed potentially inappropriate medications (PIMs) in these studies. Methods: Detailed literature search has been conducted with the use of PubMed and Web of Science databases. Studies dealing with potentially inappropriate prescribing that have been published from 1st January 1991 to 31st December 2015 were included. Data from scientific articles were summarized in the first part of the diploma...

Read abstract on the attached document. / Dissertation (MSc)--University of Pretoria, 2014. / lk2014 / School of Health Systems and Public Health (SHSPH) / MSc / Unrestricted

Introduction Three cases of M. ozzardi infection from 2 suburban communities in Iquitos, Peru, led to a suspicion of local transmission. The objective of the study was to determine the prevalence of filariasis by M. ozzardi and its associated factors among these communities. Materials and methods A cross-sectional study was performed, as well as an epidemiological survey and a thick smear blood test. Larvae and mosquitoes were collected. The adjusted OR (aOR) using multiple logistic regression was calculated. Results A total of 433 participants were enrolled; 58% were women. The prevalence of M. ozzardi was 1.4% and the associated factors included being a fisherman (aOR: 8.7; 95%CI: 1.1–76.0) and being on the Alto Nanay river (aOR: 11.2; 95%CI: 1.2–112.5). No significant evidence of simulidos or culicoides was found. Conclusion The low prevalence of M. ozzardi found suggests a foreign infection, probably derived from the Alto Nanay river. / narrospide@ins.gob.pe / Introducción Tres casos de infección por Mansonella ozzardi (M. ozzardi) en muestras de malaria que provenían de 2 comunidades periurbanas de Iquitos (Perú) dieron la sospecha de transmisión local. El objetivo del estudio fue determinar la prevalencia y factores asociados con la filariosis por M. ozzardi en estas comunidades. Materiales y métodos Se realizó un estudio transversal en las comunidades de Laguna Azul y La Unión en Iquitos. A todos los pobladores se les tomó una gota gruesa para la detección de M. ozzardi y se les realizó una encuesta epidemiológica. Se realizó colecta de larvas y mosquitos para identificación de potenciales vectores. Se calcularon los OR ajustados (ORa) usando regresión logística múltiple. Resultados Se evaluaron a 433 personas; 58% fueron mujeres; la mediana de edad fue de 20 años; 58,2% fueron migrantes, 3,7% pescadores y 12,9% habían viajado por las cuencas del Alto Nanay. La prevalencia de M. ozzardi fue de 1,4% (6/433) y el más joven de los casos tuvo 31 años; se encontró asociación con ser pescador (ORa: 8,7; IC 95: 1,1-76,0) y con haber realizado viajes por la cuenca del Alto Nanay (ORa: 11,2; IC 95: 1,2-112,5). No se evidenció densidad significativa de vectores simúlidos o culicoides. Conclusión Las comunidades estudiadas tuvieron una baja prevalencia de M. ozzardi y por la edad de los casos y los factores asociados encontrados se sospecha infección foránea a la zona de estudio, en especial en la cuenca del Alto Nanay.

Class of 2014 Abstract / Specific Aims: To determine the prevalence of metabolic syndrome (MetS) in patients treated in an outpatient clinic that were taking atypical antipsychotics. Methods: This retrospective chart review included 822 adults diagnosed with various personality/mood disorders. Age, gender, ethnicity, blood pressure, height, weight, lipid panels, fasting blood glucose, and second-generation antipsychotic (SGA) used and treatment length were obtained. Patients were separated into two groups: those who were not taking an SGA in/for the past three months (group 1), and those taking at least one SGA for a minimum of three months (group 2). MetS was determined using NCEP ATP III guidelines. The primary outcome measured was the difference in the prevalence of MetS between each group. Main Results: At baseline, 753 patients were in group 1 and 69 patients were in group 2, there was a higher percentage of females in group 1 (p<0.0001), and a higher percentage of males in group 2 (p<0.0001). No difference was seen with age, and weight, (p=0.294, p=0.625, respectively). There were more patients reported as Caucasian in group 2 (p=0.0001) and more reported as Caucasian/Hispanic in group 1 (p=0.0001). The rate of MetS between group 1 (54.45%) and group 2 (59.42%) was not statistically different (p = 0.427). Conclusion: No statistical difference was found in the rate of MetS between the two groups. Removing confounding drugs known to cause weight gain did not change these results.

Magister Chirurgiae Dentium - MChD / Aim: To determine the prevalence of peri-implant mucositis and the association between systemic and local risk factors