Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital

BACKGROUND: The objective of this study was to estimate the prevalence of depression and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in Sao Paulo, Brazil. OBJECTIVE: To assess the prevalence of mood and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in Sao Paulo. METHOD: A total of 75 patients, men and women, aged between 18 and 76 years, took part in the research. The study employed a descriptive, cross sectional and correlational method. The data was collected by means of a social demographic questionnaire and the PRIME-MD. RESULTS: It was found that 45.3 percent of the subjects presented with depressive symptoms, and 52 percent presented with symptoms of anxiety and that this survey showed moderate and high significant correlations (p<0,01; r= 0,616) for depression and anxiety. CONCLUSION: These facts could evidence the relationship between physical and psyche, just as the literature presents.

Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation

Objective: this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings. Design: open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique. Setting: the study was carried out at a public university hospital in Brazil. Participants: 249 pregnant women who had received the diagnosis of a severe lethal fetal malformation. Findings: fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%). Key conclusions: the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated. (C) 2011 Elsevier Ltd. All rights reserved.

Effects of Matrix Metalloproteinase (MMP)-2 Polymorphisms on Responsiveness to Antihypertensive Therapy of Women with Hypertensive Disorders of Pregnancy

Imbalanced matrix metalloproteinase (MMP) expression, including MMP-2, has been demonstrated in pre-eclampsia. However, little is known about the effect of polymorphisms in MMP-2 gene on hypertensive disorders of pregnancy. We examined whether two functional MMP-2 polymorphisms (g.-1306C>T and g.-735C>T) are associated with pre-eclampsia and/or gestational hypertension and whether these polymorphisms affect therapeutic responses in women with these conditions. We studied 216 healthy pregnant women (HP), 185 patients with gestational hypertension (GH) and 216 patients with pre-eclampsia (PE). They were stratified as responsive or non-responsive to antihypertensive therapy according to clinical and laboratorial parameters of therapeutic responsiveness. Genomic DNA was extracted from whole blood and genotypes for g-1306C>T and g.-735C>T polymorphisms were determined by real-time PCR using Taqman allele discrimination assays. Haplotype frequencies were inferred using the PHASE 2.1 program. The distributions of MMP-2 genotypes and haplotypes were similar in HP, GH and PE patients (p > 0.05). In addition, we found no significant differences in MMP-2 genotype or haplotype frequencies when GH or PE patients were classified as responsive or non-responsive to antihypertensive therapy (p > 0.05). Our results suggest that MMP-2 polymorphisms do not affect the susceptibility to hypertensive disorders of pregnancy. In parallel, MMP-2 polymorphisms apparently do not affect the responsiveness to antihypertensive therapy of women with these hypertensive disorders of pregnancy.

The Gracilariaceae Germplasm Bank of the University of So Paulo, Brazil-a DNA barcoding approach

The University of So Paulo Gracilariaceae Germplasm Bank has 50 strains collected mostly in Brazil, but also elsewhere in the world. This bank has been used as a source of material for research developed locally and abroad. With over 200 species, some of which have high economic value, the family Gracilariaceae has been extensively studied. Nonetheless, taxonomic problems still persist by the existence of cryptic species, phenotypic plasticity, and broad geographic distribution. In the case of algae kept in culture for long periods of time, the identification is even more problematic as a consequence of considerable morphological modification. Thus, the use of molecular markers has been shown to be an efficient tool to elucidate taxonomic issues in the group. In this work, we sequenced the 5'-end of the cox1 gene for 41 strains and the universal plastid amplicon (UPA) plastid region for 45 strains, covering all 50 strains in the bank. In addition, the rbcL for representatives of the cox1/UPA clusters was sequenced for 14 strains. The original species identification based on morphology was compared with the molecular data obtained in this work, resulting in the identification of 13 different species. Our analyses indicate that cox1 and UPA are suitable markers for the delineation of species of Gracilariales in the germplasm bank. The addition of DNA barcode tags to the samples in the Gracilariaceae germplasm bank and the molecular identification of the species will make this bank even more useful for future research as the species can be easily traced and confirmed.

THE CARE NEEDS OF WOMEN INFECTED WITH THE HUMAN PAPILLOMA VIRUS: A COMPREHENSIVE APPROACH

This study is founded on the phenomenology of Martin Heidegger, with the objective to understand the care needs of women infected with the human papilloma virus. Participants were fourteen women who had been diagnosed with this infection. The guiding questions were: What is it like to have this diagnosis? Tell me your experience, from when you received your diagnosis until today. What has your health care been like? The questions revealed the theme - seeking care as solicitude - which showed the importance of the support of family and friends. The presence of the infection as the cause of marital conflicts and separation was another highlighted aspect. The statements showed that there was a sense of resignation after an unsuccessful attempt to find accurate and clear information in order to make assertive decisions. Health interventions for infected women must overcome the traditional models of care, including interventions for health promotion and prevention, with trained professionals who are sensitive to the subjective dimension.

Nutrient Intake of Women 3 Years After Roux-en-Y Gastric Bypass Surgery

Nutritional deficiencies, especially micronutrient deficiencies, can occur in obese individuals. Surgical treatment may aggravate or cause these deficiencies, depending on the type of procedure, food intake and the use of multivitamins, minerals or other supplements. The objective of the study was to evaluate the nutrient intake of women who had undergone Roux-en-Y gastric bypass (RYGB) surgery. A cross-sectional, controlled study was conducted among 44 women after RYGB (operated-group, OG; mean years post-operation = 3.4) and a control group of 38 healthy women (non-operated group, NOG) matched by age and economic condition. The women reported their dietary intake using a 4-day record. The Dietary Reference Intakes was used as a reference. The macronutrient contributions to dietary energy intake presented an acceptable distribution for proteins and carbohydrates. Lipid intake was high among women in the OG and the NOG (43.2 and 55.3 %, respectively). In the evaluation of micronutrients, a statistically significant difference was observed between the groups for iron, zinc and vitamins B1 and B12. Both groups were at high risk for inadequate calcium intake, and the OG was at risk for inadequate zinc, iron and vitamin B1 intake. The nutrient intake of women who had undergone RYGB is very similar to that of non-operated women, with the exception of a reduced intake of iron, zinc and vitamins B1 and B12, which may be due to the difficulty of consuming meat and a balanced diet. The findings of this study emphasize the importance of appropriate nutritional intervention and the regular use of multivitamin and mineral supplements for these patients.

Do the physical discomforts from breast cancer treatments affect the sexuality of women who underwent mastectomy?

The objective of this integrative review is to analyze the scientific production addressing the sexuality of women with breast cancer following mastectomy, focused on the effects that the physical discomfort due to cancer treatments have on their sex life. The search included articles published in the period between 2000 and 2009 on the MEDLINE, LILACS and PsycINFO databases, using the following descriptors: mastectomy, breast neoplasms, sexuality, sexual behavior, amputation, psychosexual development, and marital relations. Nine articles were selected, which addressed the effects of the physical discomfort from cancer treatments on the patients' sexuality. The findings revealed that, even when the patient's sex life is intense and fulfilling before the disease, factors such as stress, pain, fatigue, insult to body image, and low self-esteem due to the treatments may alter the sexual functioning of the affected woman. Healthcare professionals must be sensitized in order to welcome and include the topic in policies as well as in preventive, diagnostic, and therapeutic strategies.

The identities of the Brazilian female athlete: the "points of temporary attachment" of women in sports

The aim of this study is to analyze the formation of the Brazilian Olympic female athletes' identities and the construction of this social role both in the Olympic scene as in Brazilian social context. The results, when compared with previous researches and the theoretical approach allows to conclude that even after inclusion of the growing Brazilian women in several sports - including pointing out that this did not occur in the form of confrontation, just as in other countries - this does not represent a rethinking of the social roles of the female and male letting to the athletes maintain a separation between sports life and life as a woman.

Relationship Between Oral Health-Related Quality of Life and the Position of the Lower Third Molar: Postoperative Follow-Up

Purpose: The aim of this study was to verify possible associations between oral health-related quality of life (QoL) and the position of the lower third molar among patients undergoing lower third molar surgery during the first postoperative week. Materials and Methods: We performed an interventional prospective study of 86 patients for whom the preoperative treatment plan included the removal of 2 third molar teeth from the same side in a 1-time procedure. The patients were divided into 2 groups depending on the position of the lower third molar. QoL was evaluated before and after the surgical procedure (during the first 7 days) with the Oral Health Impact Profile (OHIP) 14 questionnaire. Data were treated according to Stata 10.0 (StataCorp, College Station, TX). Variables were evaluated by use of split-plot analysis of variance for the repeated-measures analysis to identify the association between QoL and the position of the lower third molar. Results: Patients can have deterioration in their QoL immediately after surgery, especially during the first and second postoperative days, and subsequently show rapid improvement. The variation in the total OHIP score during the days after surgery was significant, whereas a decrease in QoL was observed immediately after the procedure (P = .001), which returned to initial value (preoperative) levels after the sixth postoperative day. The OHIP domains with higher scores (ie, those that had an impact) were physical pain, psychological discomfort, and physical disability (domains 2, 3, and 4, respectively). Conclusions: Teeth considered to be associated with technical difficulties for extraction based on their position had a higher score on the OHIP-14 questionnaire and worse health-related QoL score. QoL outcomes may be as important as clinical signs in decisions regarding third molar extractions. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70:779-786, 2012

The occupational roles of women with anorexia nervosa

This study's objective was to understand how occupational roles of individuals with anorexia nervosa are configured. The sample was composed of a control group and 11 adult women with anorexia nervosa being cared for by the Eating Disorders Care Group in a hospital in Ribeirao Preto, SP, Brazil. Socio-demographic and anthropometric data were collected and the Role Checklist was applied. The results revealed a significant loss of roles for women with anorexia nervosa in relation to the performance of the roles worker, friend, and amateur/hobbyist, supporting the idea that psychosocial harm may arise from this eating disorder. The evaluation of occupational roles in the treatment of eating disorders is an important strategy for planning Occupational Therapy activities and supporting the creation of healthier spaces to enable individuals to resume occupational roles, and acquire independence and autonomy.

The profile of women who have experienced cesarean section and obstetric care at a public maternity hospital in Ribeirao Preto

The present paper presents the social and obstetric profile of women undergoing cesarean childbirth at a public maternity hospital in the interior of Sao Paulo state. This is a quantitative, retrospective, descriptive study performed using documental research. The collected data refer to the period between July and December 2005, and between January and June 2006. A total of 670 records were reviewed. A 23% rate of cesarean births was identified at the institution studied during the aforementioned period. The studied population was characterized as having a low level of education, living in a common-law relationship, and not having a paid occupation. The main indications for cesarean sections were iterativity and acute fetal distress. The findings revealed an emphasis on obstetric nursing in the low-risk normal childbirth scenario, considering the non-interventionist character inherent to their education and training.

Incidence of gastric extubation of users in a home care program of a university hospital

This quantitative, prospective study, aimed to characterize the profile of users and caregivers and to measure the incidence of gastric extubation, identifying the type and the reasons for the extubation of these users in a Home Care Program of a university hospital. The population consisted of 37 subjects and the date were collected from April to August 2010. For the analysis, descriptive statistics, test of significance of 5% and calculation of indicators were adopted. It was found that 51.4% of the users were female, 67.5% in the age group >= 60 years and 67.6% presented neurological diseases. Regarding the caregivers 89.2% were female and their mean age was 50.6 years. The incidence of extubation, considering 100 days of intubation, corresponded to 1.08, with 0.26 planned and 0.82 unplanned (p=0.009). These results allowed the rates to be calculated of the extubation of patients with gastric intubation for nutritional support in domicile care, providing support in establishing care and management goals for the continuous improvement of quality.

Chronic Pain and Depression in the Quality of Life of Women With Migraine - A Controlled Study

Background. Migraine is comorbid to depression and widespread chronic pain (WCP), but the influence of these conditions on the health-related quality of life (HRQoL) of individuals with episodic (EM) and chronic migraine (CM) is poorly understood. Objective.-To assess the prevalence of depressive symptoms and WCP in individuals with EM and CM, as well as to estimate the joint impact of these conditions on the HRQoL of these individuals. Methods.-All women aged 18 to 65 years with a first diagnosis of EM or CM from September of 2006 to September of 2008 seen in an outpatient headache service were invited to participate. They were asked to attend a separate appointment in the service, and to bring another woman of similar age that also agreed to participate. Depressive symptoms were assessed using the Beck Depression Inventory. Questions about WCP followed the protocol of the American College of Rheumatology. HRQoL was assessed using the Short-Form 36 (SF-36). Multivariate analysis modeled HRQoL as a function of headache status, depressive symptoms, and pain, using quantile regression. Results.-Sample consisted of 179 women, 53 in the EM group, 37 in the CM group and 89 in control group. Groups did not differ by demographics. Mean scores of SF-36 were 53.6 (standard deviation [SD] = 23.5) for EM, 44.2 (SD = 18.5) for CM and 61.8 (SD = 21.5) for controls. In multivariate analysis, SF-36 scores were predicted by a CM status (P =.02; -10.05 [95% CI -18.52; -1.58]) and by a Beck Depression Inventory score (P <.01; -1.27 [95% CI -1.55; -0.99]). The influence of WCP in the SF-36 scores approached significance (P =.08; -0.78 [95% CI -1.64; 0.88]). Age did not contribute to the model. Conclusion.-Women with migraine are at an increased chance of WCP, and the chance increases as a function of headache frequency. Both depressive symptoms and CM independently predict HRQoL status.

Psychosexual Perspectives of the Husbands of Women Treated With an Elective Hysterectomy

The purpose of this study was to explore the psychosexual perspectives of a group of Brazilian men whose wives underwent an elective hysterectomy. A qualitative design based on the narrative analysis method was used to interview 22 husbands. Results showed similarities and differences among husbands regarding the support provided to their wives, the notion of sexual absence in the postsurgical period, the notion of sexual pleasure after the hysterectomy, and feelings regarding the impossibility of having children. The authors conclude that personal care requirements should be identified and satisfied to provide comprehensive and meaningful care.

Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i. e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p = 0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.