Introdução: O Hospital Universitário é referência na cidade de Rio Grande, no Rio Grande do Sul, para pneumopatas crônicos, sendo importante a existência de um programa para cessação do fumo. Objetivos: Analisar a utilização do Questionário de Tolerância de Fagerström como instrumento de medida da magnitude da dependência nicotínica do paciente tabagista e obter subsídios para planejar a conduta terapêutica mais adequada. Material e método: Aplicação do Questionário de Tolerância de Fagerström em pacientes adultos fumantes regulares, dos setores de Clínica Médica e Pneumologia do Hospital Universitário e Santa Casa de Rio Grande durante o período de 12 meses. Foram preenchidos 301 questionários válidos, sendo 40,5% dos entrevistados do sexo feminino e 59,5% do masculino. A média de idade dos participantes foi de 48,6 anos. Conforme a pontuação obtida com o questionário, os pacientes foram classificados segundo sua dependência nicotínica em cinco graus: muito baixa, baixa, média, elevada e muito elevada. Resultados: 54,9% dos fumantes pertenciam ao Grupo de Elevada Dependência Nicotínica (<FONT FACE=Symbol>³</FONT> 6 pontos). Foi encontrada associação entre elevada dependência nicotínica e consumo diário de cigarros ou tempo até o fumar o primeiro cigarro do dia (p < 0,001). Conclusão: A utilização do Questionário de Tolerância de Fagerström mostrou ser de aplicação simples, rápida e de baixo custo, e permitiu identificar mais de 50% dos pacientes com um grau de dependência nicotínica que faz prever desconforto ao deixar de fumar e necessidade de tratamento para controle da síndrome de abstinência.
Objective: In view of the relevance of co-infection with tuberculosis and human immunodeficiency virus, this study was designed to determine tuberculosis prevalence and identify factors related to tuberculosis in patients residing in a region in which both infections are highly prevalent. Methods: All patients treated during 1999 at the HIV/AIDS Clinic of the Universidade Federal do Rio Grande (Rio Grande Federal University) University Hospital were evaluated retrospectively, from the time of human immunodeficiency virus diagnosis, in terms of the incidence of tuberculosis and its relationship to sociodemographic, behavioral and immunological factors. Results: The sample included 204 patients, and tuberculosis prevalence was found to be 27%. The multivariate analysis showed a significant correlation between the development of tuberculosis and being of African descent (odds ratio: 4.76; 95% confidence interval: 1.93-11.72) and an inverse correlation between the development of tuberculosis and the TCD4+ lymphocyte count at the time of human immunodeficiency virus diagnosis (odds ratio: 0.995; 95% confidence interval: 0.993-0.997). When analyzed separately, other variables were found to be potential risk factors: being of the male gender (odds ratio: 2.49; 95% confidence interval: 1.15-5.39); and using illicit drugs (odds ratio: 2.1; 95% confidence interval: 1.02-4.31). Conclusion: The factors responsible for the development of tuberculosis among patients who are human immunodeficiency virus seropositive include immunological, socioeconomic and demographic factors. The high rate of tuberculosis prevalence among the seropositive patients underscores the urgent need to implement strategies that combine rapid identification and prompt treatment of individuals with active or latent infection, as well as of those with whom they have been in contact.
Tuberculosis is an increasingly important public health problem in developing countries. We studied 111 tuberculosis patients confirmed by mycobacteria isolation between 1998 and 2000 in Rio Grande, in south Brazil. One-hundred-thirteen pulmonary and extrapulmonary clinical materials were examined through culture by the Ogawa-Kudoh method and through smear examination by the Ziehl-Nielsen or Kinyoun methods. The identification of Mycobacterium tuberculosis was done through the usual phenotypical methods. The proportion method (indirect technique) was used to determine the resistance of isolates. The man/woman ratio was 2.6:1, 75% were white, and the group had a mean age of 39.7±12.7. Risk factors were present in 38.7% (34 men and 9 women, p=0.2), with a mean age of 35 (p=0.002); infection by HIV was the most frequent (28.8%), followed by alcoholism (16.2%) and injected drug use (15.3%). The frequency of M. tuberculosis isolates was 99.1%. Pulmonary disease occurred in 88.3% of the cases, extrapulmonary in 9.9% and 1.8% in both. There was an association between extrapulmonary tuberculosis and the presence of risk factors (p=0.0001). Resistance to isoniazid was found in 4% of the isolates and to isoniazid and rifampin in 2%, all being patients with some risk factors. The profile of tuberculosis in the population of this study followed the pattern described for developing regions of the world.
Prevalência de enteroparasitas em crianças atendidas em unidades básicas de saúde em uma cidade do sul do BrasilPrevalence of enteroparasites in children attended at basic health unities in a Brazilian southern city RESUMOAs helmintoses e protozooses intestinais constituem sério problema de saúde pública nos países em desenvolvimento. Este estudo analisou a prevalência de parasitas intestinais em crianças pré-escolares atendidas em Unidades Básicas de Saúde (UBS) na cidade do Rio Grande, Rio Grande do Sul, Brasil. Foram examinadas amostras de fezes de 144 crianças, no período de outubro de 2009 a março de 2010. A prevalência de parasitas patogênicos foi de 17,4 %, em que foram detectados ovos dos nematoides Ascaris lumbricoides (11,1 %) e Trichuris trichiura (6,3 %), e cistos do protozoário Giardia lamblia (4,9 %). Foram também identificados cistos de protozoários considerados não patogênicos, como Entamoeba coli, Endolimax nana e Enteromonas hominis, em 28,5 % das crianças. Em relação às prevalências nas UBS, as positividades foram de 36,4 % na UBS-1, 11,1 % na UBS-3, 14,8 % na UBS-4, 8 % na UBS-5 e 19,2 % na UBS-6. Na UBS-2 não foi detectada positividade nas amostras de fezes analisadas. A prevalência de parasitas patogênicos registrada na população estudada sugere a ocorrência de prováveis condições de reinfecção e a necessidade de implementar medidas de saneamento básico e de programas que possibilitem a melhoria da condição de vida dessas crianças. Palavras-chave. parasitas intestinais, pré-escolar, saúde pública. ABSTRACTHelminthes and enteric protozoa are serious problem of public health in developing countries. This study analyzed the prevalence of intestinal parasites in preschool children attend at basic health unities (BHS) in the city of Rio Grande, Rio Grande do Sul, Brazil. Stool samples collected from 144 children were analyzed, from October 2009 to March 2010. The observed prevalence rate for enteroparasites was 17.4 %, including eggs of nematodes Ascaris lumbricoides (11.1 %) and Trichuris trichiura (6.3 %), and cysts of protozoan Giardia lamblia (4.9 %). Also, cysts of protozoa considered as non-pathogenic, such as Entamoeba coli, Endolimax nana and Enteromonas hominis were found in 28.5 % of children. Regarding to the BHSs prevalence, in BHS-1 was detected a positivity of 36.4 %, 11.1 % in BHS-3, 14.8 % in BHS-4, 8 % in BHS-5 and 19.2 % in BHS-6. No positivity was detected in the stool samples from BHS-2. The prevalence of intestinal parasites registered in the studied population suggests the occurrence of probable conditions for re-infection, and the need to implement the basic sanitation procedures and programs which will provide an improvement in the life quality of these children.
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