<p>A Síndrome de Burnout é definida como uma desordem mental, caracterizada por esgotamento de energia, falta de realização profissional, desgaste emocional, e sentimento de incompetência, que acomete principalmente profissionais que estão em constante contato com pessoas, como acadêmicos da área de saúde. O objetivo do estudo é analisar a presença da Síndrome de Burnout relacionado a variáveis sociodemográficas, acadêmicas e psicossociais em universitários da área da saúde. Utilizou-se o Inventário de Burnout de Maslach – versão estudantes – que foi aplicado a 540 acadêmicos de 5 cursos da área da saúde. Realizou-se análise descritiva com média e desvio padrão. Para averiguar a comparação entre as variáveis qualitativas e a síndrome de Burnout foi usado teste T de student. Sendo considerado como nível de significância, o valor de (p<0,05), estabelecido pelo pacote SPSS versão 14.0. Entre os participantes 66,5% eram do sexo feminino e 33,1% do sexo masculino, a maioria, 59,3%, vive com a família, 73,9% declararam renda familiar superior a 3 salários, 71.3% não consomem bebidas alcoólicas, 96,3% negaram tabagismo e 64,9% negaram o uso de medicação devido aos estudos. Dos estudantes, 14,44% apresentaram a Síndrome de Burnout. Observou-se significância estatística entre a síndrome e desempenho do estudante no curso, ano que o estudante cursava, condições de materiais, uso de medicações devido aos estudos e pensamento de desistência em relação ao curso. Os resultados apontam para associação entre dimensões de burnout e variáveis sóciodemográficas, acadêmicas e psicossociais. Assim, torna-se necessário a implantação de estratégias para amenizar essa problemática.</p>
Objetivo: Avaliar a qualidade de sono e o grau de sonolência excessiva diurna em acadêmicos do curso deMedicina de um centro universitário no Estado do Pará. Métodos: Trata-se de estudo transversal descritivo,conduzido com 192 acadêmicos de medicina entre o primeiro e o quarto ano da graduação, investigadosatravés de questionários: índice de Qualidade do Sono de Pittsburgh (PSQI), Escala de Sonolência deEpworth (ESE) e sociodemográfico. A estatística analítica foi realizada através dos Testes G e QuiQuadrado no programa BioEstat 5.5. Resultados: Houve predominância de baixa qualidade do sono, com29,7% de portadores de distúrbios do sono. Ao longo dos anos, a proporção de sono ruim aumenta. A ESEindicou ausência de sonolência na maioria dos estudantes, com um aumento na proporção de ausência desonolência ao longo dos anos. Ressalta-se que essa discrepância pode estar relacionada ao aumento doconsumo de substâncias estimulantes avaliado pelo estudo. Não houve significância em relação àsdiferenças de gênero e estado civil. Conclusão: Observou-se incidência significante de estudantes comqualidade ruim do sono, incluindo portadores de distúrbios do sono. Em contraste, o estudo demonstrousonolência excessiva diurna na minoria dos estudantes.
Introduction: Chorea is a movement disorder characterized by involuntary, random and irregular movements. In the emergency department, the most common causes of chorea are cerebrovascular disorders, but other conditions may also play an important role. The aim is to present a rare case of acquired hemichorea secondary to hyponatremia by reviewing the patient’s records. Case report: A 73-year-old female patient with a history of arterial hypertension, dyslipidemia, active smoking, and heart failure, taking enalapril, hydrochlorothiazide, furosemide and simvastatin, was admitted to the emergency department after falling from standing height and hitting her head, also presenting choreic movements in the right side of her body. The patient started amitriptyline for chronic low back pain in the last month and had been experiencing apathy and weight loss since; the choreic movements had started a week before admission and had progressively worsened. On admission, the patient presented with fluctuating level of consciousness and hemichorea. Complementary evaluation showed leukocytosis and hyponatremia (117 mg/ dL); magnetic resonance imaging of the brain showed diffuse brain atrophy without any other findings compatible with hemichorea and the lumbar puncture did not reveal any additional findings; a pulmonary infection was detected by the chest computed tomography. The patient was treated for pulmonary infection and hyponatremia. Haloperidol was started, but the chorea was fully solved after hyponatremia correction over the next few days and did not return after haloperidol weaning. Discussion: We presented the case of a 73-year-old woman with acquired hemichorea secondary to hyponatremia, which resolved completely after the metabolic disorder was corrected. Although this condition has been described, its incidence remains unclear, as few cases have been reported.
Introduction: Stroke is characterized by the acute onset of one or more neurologic deficits that persist for at least 24 hours, and is the result of a vascular disorder in a defined territory, being the leading cause of disability. Late complications, such as sexual dysfunction, have a direct impact on psychological and emotional aspects and directly affect the quality of life of these patients. Objectives and methods: Cross-sectional study that aimed to determine the prevalence of sexual dysfunction in patients with ischemic stroke followed in the neurovascular outpatient clinic of a tertiary hospital in São Paulo, Brazil, using the Female Sexual Quotient (FSQ) questionnaire. The FSQ can range from 0-100 points. Higher values indicate better sexual performance/satisfaction and a score of 60 points or less was considered as having sexual dysfunction. Casuistics and results: Sixty-five questionnaires were analyzed and classified according to the FSQ score. Mean age was 52 years and median FSQ score was 54 points. Of the interviewees, 30.7% had their sexual performance classified as poor-null, 13.85% of patients had poor-unfavorable sexual performance, 15.38% as unfavorable-regular. Regular-good and good-great sexual performance were found in 21.54% and 18.46%, respectively. Discussion: In this study, only 40% of post-stroke women have regular-good and good-great sexual performance. The impact of the stroke on the sexual life of these patients is high, because most of the interviewees had sexual dysfunction according to FSQ. Conclusion: The health professional must be aware of the non-motor sequelae caused by the stroke and be prepared to help these patients in coping with sexual dysfunctions.
Introduction: Stroke is the leading cause of disability worldwide. Late complications, such as sexual dysfunction, have a direct impact on psychological and emotional aspects and directly affect the quality of life of these patients. Objectives and methods: We present a cross-sectional study that aimed to determine the prevalence of sexual dysfunction in patients with ischemic stroke followed in the neurovascular outpatient clinic of a tertiary hospital in São Paulo, Brazil, using the Male Sexual Quotient (MSQ) questionnaire. The MSQ can range from 0-100 points. Higher values indicate better sexual performance/satisfaction and a score of 60 points or less was considered as having sexual dysfunction. Casuistics and results: Fifty eight questionnaires were analyzed and classified according to the MSQ score. Mean age was 60 years and median MSQ score was 64 points. Of the interviewees, 24.14% had their sexual performance classified as poor-null, 17.24% of patients had poorunfavorable sexual performance, 6.90% as unfavorable-regular; regulargood and good-great sexual performance were equally found in 25.86% of the subjects. Discussion and conclusion: In this study, almost half of post-stroke men have sexual dysfunction according to MSQ, indicating a high impact of such a condition in the quality of life of our patients due to its prevalence. Thus, the health professional dealing with post-stroke patients must be aware and prepared to help patients in coping with sexual dysfunctions.
Introduction: Acute stroke is the second most prevalent cause of death in the world and an important cause of disability in adults. Urinary incontinence (UI) is a complication present in the acute and chronic phases of stroke and is a strong predictor of mortality and need for institutional care. Objectives and methods: Cross-sectional study that aimed to evaluate the presence of UI through the International Consultation Questionnaire on Incontinence - Short Form (ICIQ-UI SF) in patients with ischemic stroke followed in the neurovascular outpatient clinic of a tertiary hospital in São Paulo, Brazil. The ICIQ-SF assesses the impact of UI on quality of life and qualifies degrees of urinary loss. The final score ranges from 0 to 21, with higher values representing greater impact. Casuistics and results: A total of 141 patients adequately answered the questionnaire, among which 75 were female and 66 were male. As for symptoms, 36.87% reported some degree of UI, 40.00% among women and 33.33% among men. The mean ICIQ-UI SF score across all patients was 9.90. For males the mean score was 10.36 and for females it was 9.56. Among symptomatic patients, only 9.21% reported urinary symptoms before the stroke. Discussion: Almost 40% of the patients in the study acquired UI after stroke. This condition prevailed in women, but with less impact compared to men. Urinary incontinence can affect the quality of life of patients, causing psychological, social, physical, economic, personal and sexual relationships. Conclusion: New studies are needed to evaluate prevention and treatment strategies for incontinence in these patients.
Introduction: Stroke is the second most prevalent cause of death in the world and an important cause of disability in adults. Obstructive sleep apnea (OSA) is an independent risk factor for stroke and is associated with poor poststroke functional outcome if left untreated. Objectives and methods: In this cross-sectional study, we aimed to determine the prevalence of OSA in ambulatory stroke patients using the STOPBang (snoring, tiredness, observed apnea, blood pressure, body mass index, age, neck size, gender) questionnaire. Casuistic and results: A total of 149 patients completed the clinical assessment. Mean age was 57.47 years, 75 (50.34%) were men and 74 (49.66%) were female. Among the patients, 56.37% were smokers or former smokers, and mean body mass index was 27.01 kg/m2 . The median STOP-Bang score was 3 (interquartile range: 2–4). 69.12% were considered moderate to severe risk for OSA (STOP-Bang score ≥3). For the identification of OSA, the questionnaire demonstrated sensitivity of 83.5%, accuracy of 75.2% and specificity of 45.5%. Among the 84 patients who answered the question about the presence of previous OSA symptoms, 59.53% had a negative answer. Discussion: Approximately two out of three stroke patients were classified as moderate to high risk for OSA, reinforcing the need for screening for the disease in this population. In addition, almost 60% reported no symptoms prior to cerebrovascular disease. Finally, the high sensitivity in this study confirms the usefulness of the tool in screening patients for diagnosis and therapeutic intervention. Conclusion: New studies are needed to evaluate OSA prevention and treatment strategies, as this measure will help in the global clinical recovery of the patient after the stroke.
Objetivo: Analisar a experiência de acadêmicos de medicina como representantes de turma de uma Faculdade de Medicina em Belém – Pará. Detalhamento do Caso/Relato de experiência: A construção do relato foi analisando o período de 2 anos de vários representantes de turma durante diversos períodos (semestres) do curso de Medicina de um Centro Universitário em Belém – Pará. A experiência de representação de turma desenvolve o currículo oculto, aprende sobre planejamento e execução de ações, liderança de equipe e mediação de conflitos. O papel de representante é negligenciado pelos discentes sendo pouco procurado como atividade extracurricular e por isso, desenvolvem-se poucas pesquisas na área. Contudo, o discente com tal cargo desenvolve o currículo óculo (currículo paralelo), tornando-se uma figura representativa para a coordenação do curso e desenvolvendo habilidades necessárias e importantes para futura gestão profissional. Considerações finais: A participação como representante de turma durante a graduação médica desenvolve habilidades de liderança, senso de organização e gerência de grupo, sendo necessário o desenvolvimento de pesquisas futuras na área a fim de melhorar a qualidade da educação proporcionada e a gestão de pessoas.
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