Philosophiae Doctor - PhD / In the decade since first identified, the Acquired Immunodeficiency syndrome (AIDS) has become a serious global disease. The nature of the Human Immunodeficiency Virus (HIV) that causes AIDS, whereby a carrier may be asymptomatic yet remain infectious, has enabled its dramatic spread. The number of AIDS cases is increasing exponentially, averaging a doubling time of between 8-15 months in different countries. Of the millions of HIV carriers, it is now estimated that all will eventually go on to develop full-blown AIDS and probably die within 15 years. Unlike other infectiqus diseases, there is currently no known vaccine or cure. Further, HIV is now virtually completely dependent on volitional sexual behaviours for transmission to occur. It is therefore an entirely preventable disease. However, since the behaviours that contribute to HIV-transmission are influenced by biological, psychological, and social factors, their alteration in line with safer sexual practices has been shown to be considerably complex and difficult. Intervention strategies that have relied on imparting knowledge about the disease have achieved limited success in influencing behaviour change. Unsafe sexual practices, and the risk of HIV-infection, often continue even when knowledge regarding prevention is adequate. It has therefore become apparent that other variables intrude which may mediate between knowledge acquisition, attitude formation, and consequent sexual behaviours. There appear to be no models which adequately explain the complexities in this area, and which enable adequate intervention strategies to be developed. The present study was undertaken to redress this problem, and to explore those variables that mediate in the area. Various psychological and social factors appear to be implicated in influencing sexual attitudes and behaviours. In order to adequately test the impact of psychosocial variables that were found to have significant associations in an exploratory study, a measuring instrument was developed. The AIDS Psychosocial Scale was statistically validated using content, frequency, factor, and reliability analyses and included psychological factors of self concept, defenses of denial, repression, and rationalisation, perceived empowerment in the form of locus of control and selfefficacy, and the social factor of peer pressure susceptibility. The impact of these psychosocial variables on indices of knowledge, condom attitude, and sexual practices, and on other epidemiological variables was tested using a sample of students at the University of the Western Cape (n=308). Results indicated a number of correlational and causal links between variables, confirming the mediational role psychosocial factors have in influencing knowledge acquisition, attitude formation, and behaviour outcome. A profile of lower self concept, higher defenses, lower self-efficacy, more external locus of control, and higher peer pressure susceptibility emerged which was associated with poorer knowledge, more negative attitudes, and higher unsafe sex. Based on this study, a model of psychosocial mediation is developed and its implications for intervention strategies discussed.

No description available.

I takt med att andelen äldre ökar i samhället rapporteras om stigande läkemedelsanvändning. Normala åldersförändringar, ökad risk för multisjuklighet och kroniska sjukdomar i kombination med polyfarmaci och bristande följsamhet medför en ökad risk för läkemedelsrelaterad ohälsa hos äldre. Bristande följsamhet till läkemedelsbehandling är en stor och problematik hos äldre vilket kan medföra negativa konsekvenser för både patienten och samhället. Syftet med studien är att beskriva kunskapsläget avseende associerade faktorer till den äldres upplevelse av följsamhet och bristande följsamhet till läkemedelsbehandling. Studien är en integrativ litteraturstudie med sammanställning av totalt 11 vetenskapliga artiklar både kvalitativa och kvantitativa från databaserna CINHAL, PubMed, Web of Science och Nursing and Allied Health database. Efter granskning av artiklarna framträdde tre huvudteman; Kunskap och förståelse, Minne och vardagliga hinder, Stöd och strategier, utifrån dessa formades tio subteman. I resultatet framkom det att äldres upplevelse av bristande följsamhet till läkemedelsbehandling var associerade till flertal faktorer. Bakomliggande orsaker till äldres upplevelse av bristande följsamhet var således relaterade till bristande kunskap om sin läkemedelsbehandling, kognitiv svikt samt otillräckligt stöd och brist på strategier. Faktorer som hade positiv effekt på följsamhet till läkemedelsbehandling var kunskap och information om sina läkemedel, stöd från anhöriga, stöd och god relation med sin vårdgivare samt hitta rätt strategier. Studiens slutsats är att med hjälp av patientens egna strategier samt vårdgivarens stöd, information och undervisning kan äldres följsamhet till läkemedel främjas och osäker läkemedelsbehandling reduceras. / With the growing number of older people in society there is a report of increasing drug use. Normal age changes, increased risk of multiple morbidity and chronic diseases in combination with polypharmacy and lack of medication adherence entail an increased risk of drug-related illness in the elderly. Lack of medication adherence is a major problem in the elderly, which could have negative consequences for both the patient and society. The purpose of the study is therefore to describe the state of knowledge regarding factors associated with the elderly's experience of medication adherence and lack of medication adherence. The study is an integrative literature study with a compilation of a total of 11 peer reviewed articles both qualitative and quantitative from the databases CINHAL, PubMed, Web of Science and Nursing and Allied Health database. Through review of the articles, three main themes emerged; Knowledge and understanding, Memory and everyday obstacles, Support and strategies, based on these, ten sub-themes were formed. The result showed that the elderly's experience of lack of medication adherence was associated with several factors. The underlying causes of the elderly´s experience of lack of medication adherence were related to lack of knowledge about their drug treatment, cognitive impairment and insufficient support and lack of strategies. Factors that had a positive effect on medication adherence were knowledge and information about their drug treatment, support from relatives, support and a good relationship with their healthcare providers and finding the right strategies. The study concludes that with the help of the patient's own strategies and the support from the healthcare provider, information and education, the elderly's medication adherence can be promoted and unsafe medication treatment can be reduced

Introduction : Afin de minimiser la morbidité postopératoire et les échecs du traitement dentaire, plusieurs schémas thérapeutiques antibiotiques ont été proposés. Cependant, l’utilisation intensive des antibiotiques dans les soins de santé a été débattue en raison des effets indésirables et la résistance bactérienne. De plus, l’impact des antibiotiques préopératoires sur le niveau osseux péri-implantaire n’est toujours pas clairement établi. Objectifs : L’objectif primaire de cette étude était d’évaluer si l’administration d’un antibiotique préopératoire (azithromycine 500 mg) avant la pose d’implant avait un impact sur les niveaux d’os crestal péri-implantaire après quatre mois chez les patients en bonne santé subissant une pose d’implant simple de type « platform-switching ». Les objectifs secondaires étaient d’évaluer la sévérité de la douleur postopératoire, la morbidité postopératoire associée à la chirurgie implantaire et le taux de survie des implants à quatre mois. Méthodes : Dix-neuf participants ont été recrutés dans un essai clinique randomisé à double insu en groupes parallèles. Les participants du groupe d’intervention ont reçu 500 mg d’azithromycine une heure avant la pose d’implant. Les participants du groupe contrôle ont reçu un placebo identique une heure avant la chirurgie implantaire. Les changements du niveau de l’os crestal péri-implantaire (résultat primaire) ont été mesurés quatre mois plus tard à l’aide de radiographies standardisées. La sévérité de la douleur et la morbidité postopératoire associées à la chirurgie (résultats secondaires) ont été évaluées par des examens cliniques et des questionnaires autoadministrés à une semaine et quatre mois postopératoires. Le taux de survie des implants et la santé péri-implantaire ont été évalués quatre mois après la pose d’implant, avant la mise en charge prothétique. Des analyses descriptives et bivariées ont été utilisées pour analyser les données. Une valeur de P ≤ 0,05 était considérée statistiquement significative. Résultats : Dix-huit participants ont complété l’étude (âge moyen : 52,8 ± 13,9ans). Les changements moyens du niveau osseux péri-implantaire pour le groupe intervention et le groupe contrôle étaient respectivement de -0,79 ± 0,57mm et de -0,35 ± 0,37mm. Il n’y avait pas de différences statistiquement significatives entre les deux groupes en ce qui concerne le remodelage osseux moyen péri-implantaire (-0,44mm (IC 95% : -0,94, +0,55)) et la sévérité de la douleur (P>0,05). Les interférences avec les activités quotidiennes, plus précisément, l’interférence de la chirurgie à ouvrir grand la bouche étaient significativement plus importante chez le groupe antibiotique comparativement au groupe intervention au cinquième jour postopératoire (P<0,05). Le taux de survie des implants était de 100% dans les deux groupes et la santé des tissus péri-implantaires était similaire entre les deux groupes quatre mois après la chirurgie. Conclusion : Les résultats préliminaires de cette étude clinique suggèrent qu’une dose préopératoire d’antibiotique chez les patients en bonne santé ayant une pose d’implant simple de type « platform-switching » n’apporte pas de bénéfice clinique. Des investigations additionnelles de plus grande envergure sont nécessaires afin de confirmer les résultats de cette étude. / Introduction: In order to minimise postoperative morbidity and failures of dental implant therapy, several antibiotic regimens have been proposed. However, the extensive use of antibiotics in health care has been debated due to the adverse effects and bacterial resistance. Furthermore, the impact of preoperative antibiotics on peri-implant bone level remains unclear. Objectives: The primary objective of this study was to assess whether giving a preoperative antibiotic (azithromycin 500mg) before implant placement would influence peri-implant crestal bone levels after four months in healthy patients undergoing straightforward platform-switched implant placement. The secondary objectives were to evaluate postoperative pain severity, surgery-associated morbidities, and four-month implant survival rate. Methods: Nineteen individuals were recruited in a double-masked two-arm randomised clinical trial. Participants in the intervention group received 500mg of azithromycin one hour before implant placement. Participants in the control group took one identical placebo one hour preoperatively. The changes in mesial and distal crestal bone level (primary outcome) were measured at baseline and four-month follow-up using standardised periapical radiographs. Pain severity and surgery-associated morbidities (secondary outcomes) were evaluated by clinical examinations and self-administered questionnaires at one-week and four-month follow-ups. Implant survival rate was assessed at the four-month follow-up. Descriptive and bivariate analyses were used to analyse the data. A P value ≤ 0.05 was considered statistically significant. Results: Eighteen participants completed the study (mean age: 52,8 ±13,9 years). The mean changes in peri-implant bone level for the intervention group and the control group were 0,79 ±0,57 mm and -0,35 ±0,37mm, respectively. There were no statistically significant differences between the two groups in mean change in peri-implant bone level (-0,44mm (95% CI: -0,94, +0,55)) and pain severity (P>0.05). Interferences with daily activities, more specifically the interference of surgery with opening the mouth larger was significantly higher in the antibiotic group compared to the control group (P<0.05) on the fifth postoperative day. The implant survival rate was 100% in both groups and peri-implant tissue health was similar between groups four months after surgery. Conclusion: The preliminary results of this clinical study demonstrates that giving one preoperative dose of antibiotic in healthy patients undergoing straightforward “platform-switching” implant placement does not provide any clinical benefit. Further larger controlled studies are needed to confirm the results of this study.

My dissertation is composed of an introductory chapter followed by three independent chapters focusing on two themes: health and retirement. The last chapter concludes. After the introductory chapter, the second chapter investigates whether self reported general stress is a mediator in the relationship between socio-economic status (SES) and health. I use a six-year long panel of the Canadian Survey of Labour and Income Dynamics and employ dynamic econometric modelling techniques to study men and women who are major income earners in their families. I find little evidence that general stress is a pathway from SES to health. While the results suggest a strong negative association between stress and health for both men and women, they provide little support to the hypothesis of a significant effect of income on stress, consistent with the direction of the SES-health gradient. The third chapter studies whether self-assessed health status (SAH) contains information about future mortality and morbidity, beyond the information that is contained in standard "observable" characteristics of individuals (including pre-existing diagnosed medical conditions). Using a ten-year span of the Canadian National Population Health Survey, we find evidence that SAH does contain private information for future mortality and morbidity. Moreover, the extra information in SAH is greater at older ages. Our results suggest that a shift from defined benefit to defined contribution pension arrangements may carry with it the cost of exacerbated adverse selection in the market for annuities, especially at older ages. That would make it more difficult for older individuals to insure longevity risk. The fourth chapter looks at whether differences in early retirement pathways are associated with differences in post-retirement outcomes of health, stress and dwelling tenure. I use a 5 ample of men from the Canadian Survey of Labour and Income Dynamics, years 1996 to 2004. I find that differences in pre-retirement health indicators (such as self-assessed health and disability), as pathways to early retirement, are likely to be associated with differences in post-retirement health and stress. In addition, the results suggest that "involuntary" retirees (men who may have retired because of health and/or health related coniitions) are more likely to experience worse post-retirement outcomes (in terms of health and stress) than men who retire "voluntarily". Retirement circumstances are found to have no statistically significant effect on dwelling tenure. / Thesis / Doctor of Philosophy (PhD)

Background: Long-term health sequelae of the Coronavirus Disease 2019 (COVID-19) are a major public health concern. However, evidence on post-acute COVID-19 syndrome (post-COVID-19) is still limited, particularly for children and adolescents. Utilizing comprehensive healthcare data on approximately 46% of the German population, we investigated post-COVID-19-associated morbidity in children/adolescents and adults. Methods and findings: We used routine data from German statutory health insurance organizations covering the period between January 1, 2019 and December 31, 2020. The base population included all individuals insured for at least 1 day in 2020. Based on documented diagnoses, we identified individuals with polymerase chain reaction (PCR)-confirmed COVID-19 through June 30, 2020. A control cohort was assigned using 1:5 exact matching on age and sex, and propensity score matching on preexisting medical conditions. The date of COVID-19 diagnosis was used as index date for both cohorts, which were followed for incident morbidity outcomes documented in the second quarter after index date or later.Overall, 96 prespecified outcomes were aggregated into 13 diagnosis/symptom complexes and 3 domains (physical health, mental health, and physical/mental overlap domain). We used Poisson regression to estimate incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs). The study population included 11,950 children/adolescents (48.1% female, 67.2% aged between 0 and 11 years) and 145,184 adults (60.2% female, 51.1% aged between 18 and 49 years). The mean follow-up time was 236 days (standard deviation (SD) = 44 days, range = 121 to 339 days) in children/adolescents and 254 days (SD = 36 days, range = 93 to 340 days) in adults. COVID-19 and control cohort were well balanced regarding covariates. The specific outcomes with the highest IRR and an incidence rate (IR) of at least 1/100 person-years in the COVID-19 cohort in children and adolescents were malaise/fatigue/exhaustion (IRR: 2.28, 95% CI: 1.71 to 3.06, p < 0.01, IR COVID-19: 12.58, IR Control: 5.51), cough (IRR: 1.74, 95% CI: 1.48 to 2.04, p < 0.01, IR COVID-19: 36.56, IR Control: 21.06), and throat/chest pain (IRR: 1.72, 95% CI: 1.39 to 2.12, p < 0.01, IR COVID-19: 20.01, IR Control: 11.66). In adults, these included disturbances of smell and taste (IRR: 6.69, 95% CI: 5.88 to 7.60, p < 0.01, IR COVID-19: 12.42, IR Control: 1.86), fever (IRR: 3.33, 95% CI: 3.01 to 3.68, p < 0.01, IR COVID-19: 11.53, IR Control: 3.46), and dyspnea (IRR: 2.88, 95% CI: 2.74 to 3.02, p < 0.01, IR COVID-19: 43.91, IR Control: 15.27). For all health outcomes combined, IRs per 1,000 person-years in the COVID-19 cohort were significantly higher than those in the control cohort in both children/adolescents (IRR: 1.30, 95% CI: 1.25 to 1.35, p < 0.01, IR COVID-19: 436.91, IR Control: 335.98) and adults (IRR: 1.33, 95% CI: 1.31 to 1.34, p < 0.01, IR COVID-19: 615.82, IR Control: 464.15). The relative magnitude of increased documented morbidity was similar for the physical, mental, and physical/mental overlap domain. In the COVID-19 cohort, IRs were significantly higher in all 13 diagnosis/symptom complexes in adults and in 10 diagnosis/symptom complexes in children/adolescents. IRR estimates were similar for age groups 0 to 11 and 12 to 17. IRs in children/adolescents were consistently lower than those in adults. Limitations of our study include potentially unmeasured confounding and detection bias. Conclusions: In this retrospective matched cohort study, we observed significant new onset morbidity in children, adolescents, and adults across 13 prespecified diagnosis/symptom complexes, following COVID-19 infection. These findings expand the existing available evidence on post-COVID-19 conditions in younger age groups and confirm previous findings in adults

No description available.

<p>Nonsteroidal anti-inflammatory drugs are among the most commonly used prescription and over-the-counter medications, but they often produce significant gastrointestinal ulceration and bleeding, particularly in elderly patients and patients with certain co-morbidities. Novel anti-inflammatory drugs are seldom tested in animal models that mimic the high-risk human users, leading to an underestimate of the true toxicity of these drugs. In the present study we examined the effects of two novel NSAIDs and two commonly used NSAIDs in models in which mucosal defence was expected to be impaired. Naproxen, celecoxib, ATB-346 (a hydrogen sulfide- and naproxen-releasing compound) and NCX 429 (a nitric oxide- and naproxen-releasing compound) were evaluated in healthy, arthritic, obese, hypertensive rats, and in rats of advanced age (19 months) and rats co-administered low-dose aspirin and/or omeprazole. In all models except hypertension, greater gastric and/or intestinal damage was observed when naproxen was administered in these models than in healthy rats. Celecoxib-induced damage was significantly increased when co-administered with low-dose aspirin and/or omeprazole. In contrast, ATB-346 and NCX 429, when tested at doses that were as effective as naproxen and celecoxib in reducing inflammation and inhibiting cyclooxygenase activity, did not produce significant gastric or intestinal damage in any of the models. These results demonstrate that animal models of human co-morbidities display the same increased susceptibility to NSAID-induced gastrointestinal damage as observed in humans. Moreover, two novel NSAIDs that release mediators of mucosal defence (hydrogen sulfide and nitric oxide) do not induce significant gastrointestinal damage in these models of impaired mucosal defence.</p> / Master of Science (MSc)

Background The number of liver resections is constantly rising over the last decades. Despite the reduction of overall mortality and morbidity in liver surgery, biliary leakage is still a relevant postoperative complication that can lead to a fatal postoperative course. Aim of this analysis is the identification of specific risk factors for postoperative biliary complications after liver resections and the development of a predictive biliary leakage risk score. Methods A single-center, retrospective analysis of 844 liver resections performed in the Department of Visceral, Thoracic and Vascular Surgery, Technische Universität Dresden, between 1/2013 and 12/2019 is conducted to identify risk factors for postoperative biliary leakage and a risk score for biliary leakage after hepatectomy is established based on multivariate regression. The score has been validated by an independent validation cohort consisting of 142 patients. Results Overall morbidity is 43.1% with 36% surgical complications and an overall mortality of 4.3%. Biliary leakage occurred in 15.8% of patients. A predictive score for postoperative biliary leakage based on age, major resection, pretreatment with FOLFOX/cetuximab and operating time is created. Patients are stratified to low (< 15%) and high (> 15%) risk with a sensitivity of 67.4% and a specificity of 70.7% in development cohort and a specificity of 68.2% and sensitivity of 75.8% in validation cohort. Conclusions The presented score is robust and has been validated in an independent patient cohort. Depending on the calculated risk, prevention or early treatment can be initiated to avoid bile leakage and to improve postoperative course.

Made available in DSpace on 2016-01-26T12:51:38Z (GMT). No. of bitstreams: 1 susilenemariatnardi_tese.pdf: 1061867 bytes, checksum: 8dce282b5fe788e66ffab06d00c915cd (MD5) Previous issue date: 2012-11-09 / Introduction: Leprosy is a chronic infectious, contagious, insidious, but treatable disease that causes dermatoneurologic disorders. The complications resulting from neurological involvement cause sequelae that often affect the eyes, nose, hands and feet and if not treated early, evolve to physical disabilities that are sometimes irreversible and disastrous for the functionally of the individual. In Brazil, the coefficient of severe and visible physical disabilities (Grade 2) at diagnosis is considered high (&#8805; 10) by the Ministry of health. The drug treatment that eliminates the bacillus does not guarantee the end of the progression of the disability. Thus, ex-patients with severe or mild physical disabilities should remain under the care of a rehabilitation team. Aim: To assess physical disabilities, social participation and activity limitations of individuals affected by leprosy after completing multidrug therapy, describing their relationship with the socio-demographic characteristics of these individuals and estimate the distances between their homes and rehabilitation services. Patients and methods: A cross-sectional descriptive study was carried out of all leprosy patients from 1998 to 2006 who were residents and treated in São José do Rio Preto, SP, Brazil. A specific questionnaire was applied to obtain general and clinical data. The physical disabilities were assessed using the Degree of Disability score of the WHO and the Eyes-Hand-Feet score. The Screening of Activity Limitation and Safety Awareness scale (SALSA) and the scale of participation (version 4.6) were applied to measure social participation. Results: Of the 335 people treated in the period, 223 (66.6%) were contacted and evaluated. Of these, 51.6% were women, the mean age was 54 years (SD 15.7), 66.4% had up to 6 years of schooling, 43.5% worked and 26.9% were retired, and the dimorphous form of the disease predominated (39.9%). The mental and physical healths were considered good in the previous month by 50.2% and 59.2% of the participants, respectively. Pain was reported by 54.7% of respondents; 54.3% suffered from some disease. Disabilities occurred in 32% and limitations of activities as evaluated by the SALSA scale affected 57.8% the participants. Restrictions in social participation occurred in 35.4% of the ex-patients. The presence of disabilities was higher with increasing age, in cases of multibacilar disaease and when individuals considered their physical health was bad. Those who needed preventive measures/rehabilitation travelled a mean distance of 5.5 km to the rehabilitation service. There were significant associations of social restriction with family income of less than 3 minimum wages, associated diseases, hospitalization within the previous year and physical disabilities. There were also associations of activity limitations with being female, household income &#8804; 3 minimum wages, reports of significant injury, pain, associated diseases and physical disability. Conclusions: Disabilities are common and were associateed with increasing age, the multibacilar form of the disease and the feeling that the physical health was bad. Social restriction was also common and influenced by the presence of deficiencies, associated diseases, recent hospitalization and low income. The limitation of activities was more common than physical disabilities, and was associated to low incomes, being female, presence of injury, disability, disease and pain. Rehabilitation services are far from patients residences. / Introdução: A hanseníase é uma doença crônica, infecto-contagiosa, insidiosa, tratável e crônica que provoca afecções dermatoneurológicas. As complicações decorrentes do comprometimento neurológico provocam seqüelas que freqüentemente atingem olhos, nariz, mãos e pés e se não tratados precocemente, evolui para deficiências físicas, por vezes irreversíveis e funcionalmente desastrosas para o indivíduo. No Brasil, o coeficiente de deficiências físicas graves e visíveis (Grau 2) no diagnóstico é considerado alto (&#8805; 10%) pelo Ministério da Saúde. O tratamento medicamentoso que elimina o bacilo, não garante o fim da progressão das deficiências. Assim, ex-pacientes com deficiências físicas graves ou leves devem permanecer sob os cuidados da equipe de reabilitação. Objetivo: Avaliar deficiências físicas, participação social e limitação de atividades em indivíduos afetados pela hanseníase após o término do tratamento medicamentoso com a poliquimioterapia, descrever sua relação com as características sociodemográficas desses indivíduos e estimar as distâncias entre suas residências e serviços de reabilitação do município. Casuística e Métodos: Estudo descritivo transversal que incluiu todas as pessoas acometidas pela hanseníase, residentes e tratadas em São José do Rio Preto-SP no período de 1998 a 2006. Aplicou-se protocolo próprio para obtenção de dados gerais e clínicos. As deficiências físicas foram medidas pelo Grau de Incapacidades da OMS (GI) e pelo Eyes-Hand-Feet (EHF). Aplicou-se a escala Screening of Activity Limitation and Safety Awareness (SALSA) e a escala de Participação (EP) versão 4.6, para medir a participação social. Resultados: Das 335 pessoas tratadas no período, foram localizadas e avaliadas 223 (66,6%). Destes, 51,6% eram do gênero feminino, com idade média de 54 anos (dp15,7), 66,4% tinham até 6 anos de estudo, 43,5% trabalhavam e 26,9% estavam aposentados, a forma dimorfa (39,9%) predominou. A saúde física e mental foi considerada boa no último mês por 50,2% e 59,2%, respectivamente. Dores foram relatadas por 54,7% dos entrevistados; 54,3% sofrem de alguma doença. As deficiências físicas ocorreram em 32% e a limitação de atividades avaliada pela escala SALSA em 57,8% dos participantes. A restrição social ocorreu em 35,4% dos ex-pacientes. A presença de deficiências físicas foi maior com aumento da idade, em casos multibacilares e com julgamento ruim sobre sua saúde física. Os que necessitam de prevenção/reabilitação percorreram distancia média de 5,5 km até o serviço de reabilitação. Houve associação significante da restrição social com renda familiar menor que 3 salários mínimos; doenças associadas; hospitalização no último ano e presença de deficiência física. Houve associação entre limitação de atividades e gênero feminino, renda familiar &#8804; que 3 salários mínimos, relato de lesão significante, dores, doenças associadas e presença de deficiência física. Conclusões: As deficiências foram frequentes e associaram-se a aumento da idade, formas multibacilares e julgamento ruim sobre sua própria saúde física. A restrição social foi frequente e influencida pela presença de deficiências, outras doenças associadas, hospitalização recente e baixa renda. A limitação de atividades foi mais frequente que as deficiências físicas, associou-se aos fatores de baixa renda, gênero feminino, presença de lesão, deficiência física, doenças e dores. Os serviços de reabilitação no município estão distantes das residências dos pacientes.