Prevalence of depressive and anxiety symptoms in medical students in the city of Santos

ABSTRACT Objective Ascertain the prevalence of depressive and anxiety symptoms in medical students, considering data in the literature that indicate higher vulnerability to emotional disorders in this population. Methods A descriptive cross-sectional study with a sample of 657 (98%) students. The instruments used were: questionnaire of socioeconomic-demographic characteristics, Beck Depression Inventory and Beck Anxiety Inventory. Results Predominance of the female gender (61%), aged between 17 and 30 years (98%), Catholic religion (64.2%) from the city of São Paulo (40.7%) and other cities in the state (35.7%); 30% presented depressive symptoms and 21% anxiety symptoms. Female students had higher scores both for depression (34.8%) and for anxiety (26.8%). As regards the course year, the highest rates were found in the 5th year (40.7%) for depression and in the 2nd year for anxiety (28.8%). Conclusion The data obtained in this study (30%) agreed with the literature regarding the prevalence of depressive symptoms in medical students, but this index was higher compared to the population in general (15.1% to 16.8%), and related to people in São Paulo city (18.5%). Concerning anxiety the rates found were slightly lower than those in specific literature but higher than those in literature for the population in general (8% to 18%) and in city São Paulo (16.8%). These indices indicate that the school of medicine may play a role as a predisposing and/or triggering factor in some students. The results suggest that more attention should be directed to 5th year students, who are beginning the internship period.

Right ventricular structure and function as possible determinants of surgical outcome 30 years after repair of tetralogy of Fallot

OBJECTIVE: To identify the variables that may be involved in the persistence of symptoms (functional class II, III, or IV vs. I) in patients being followed up for 30 years after surgical repair of tetralogy of Fallot. METHODS: Fifty-three patients (27 women), who underwent corrective surgery for tetralogy of Fallot between 1960 and 1970, were studied. Their ages ranged from 7 months to 26 years. At the end of follow-up, 13 patients were asymptomatic and the remaining were in functional class II (N=24), III (N=15), and IV (N=1). To differentiate asymptomatic from symptomatic patients, the following variables were analyzed: age at surgery, need for widening the pulmonary ring and trunk, need for a second (2nd OP) or 3rd operation, residual defect of the interventricular septum, residual regurgitation of the pulmonary valve, systolic gradient through the right ventricular outflow tract, right ventricular dilation or hypertrophy (RVH), cardiothoracic index (CTI), right and left ventricular ejection fraction (RVEF/LVEF), and arrhythmias. RESULTS: The univariate analysis showed an association between the presence of symptoms and the 2nd OP (P=0.03), an increase in the CTI (P=0.0001), moderate to severe RVH (P=0.002), and dilation (P=0.0003). In the logistic regression model, the combination of the 2nd OP (P=0.008), the RVH (P=0.002), and the reduction in RVEF (P=0.01) determined the presence of symptoms. CONCLUSION: Despite the surgical treatment, right ventricular remodeling and performance were the major determinants in the late follow-up of tetralogy of Fallot.

Education to a Healthy Lifestyle Improves Symptoms and Cardiovascular Risk Factors – AsuRiesgo Study

Background: Cardiovascular diseases are the current leading causes of death and disability globally. Objective: To assess the effects of a basic educational program for cardiovascular prevention in an unselected outpatient population. Methods: All participants received an educational program to change to a healthy lifestyle. Assessments were conducted at study enrollment and during follow-up. Symptoms, habits, ATP III parameters for metabolic syndrome, and American Heart Association’s 2020 parameters of cardiovascular health were assessed. Results: A total of 15,073 participants aged ≥ 18 years entered the study. Data analysis was conducted in 3,009 patients who completed a second assessment. An improvement in weight (from 76.6 ± 15.3 to 76.4 ± 15.3 kg, p = 0.002), dyspnea on exertion NYHA grade II (from 23.4% to 21.0%) and grade III (from 15.8% to 14.0%) and a decrease in the proportion of current active smokers (from 3.6% to 2.9%, p = 0.002) could be documented. The proportion of patients with levels of triglycerides > 150 mg/dL (from 46.3% to 42.4%, p < 0.001) and LDL cholesterol > 100 mg/dL (from 69.3% to 65.5%, p < 0.001) improved. A ≥ 20% improvement of AHA 2020 metrics at the level graded as poor was found for smoking (-21.1%), diet (-29.8%), and cholesterol level (-23.6%). A large dropout as a surrogate indicator for low patient adherence was documented throughout the first 5 visits, 80% between the first and second assessments, 55.6% between the second and third assessments, 43.6% between the third and fourth assessments, and 38% between the fourth and fifth assessments. Conclusion: A simple, basic educational program may improve symptoms and modifiable cardiovascular risk factors, but shows low patient adherence.

Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

AbstractBackground:Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined.Objective:To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group.Methods:This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05.Results:Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043).Conclusion:The occurrence of major cardiac events in 8 years was small. Patients with fibrosis at MS had more major events, whereas patients with normal MS result had fewer major cardiac events, with higher survival.

A estimação do efeito residual de fertilizantes por meio da Lei de Mitscherlich

This paper deals with the estimation of the residual effect of fertilizers through the use of Mitscherlich's law. The formulas and reasonings now presented are a further development of those introduced previously by PIMENTEL GOMES (2). The new formulas allow the estimation of the residual effect h in cases where the experiments are carried out in the same plots for two or three subsequent years (or crops). In an experiment analysed as an example, the residual effect of calcium hydroxide was estimated to be h = 0.423, that is, about 42%, so that one should advise the use of frequent application of small amounts of lime instead of heavy quantities used at long intervals.

Efeito residual de superfosfato, fosfato precipitado e fosforita de Olinda em cana-de-açúcar

Este trabalho apresenta os resultados de um estudo dos efeitos residuais de fertilizantes fosfatados realizado com auxílio de fósforo radioativo, do método de Neubauer e do método do A. niger. Conclui-se, de um modo geral, que, dos adubos estudados, o menos solúvel, isto é, a Fosforita de Olinda é o que apresenta maior ação residual. O superfosfato e o Fertifos, um fosfato precipitado, praticamente não diferiram entre si. Os resultados obtidos em laboratório estão de acordo com aqueles conseguidos sob condição de campo.

Influência da embalagem e do período de armazenamento no teor residual de SO2 em banana passa

No presente trabalho foram determinados os teores residuais de SO2 em passas elaboradas com bananas tratadas com solução de metabisulfito de potássio a 2%, acondicionadas em alumínio,, celofane, polietileno e alumínio+polietileno ("combinado") e armazenadas de 15 a 105 dias à temperatura ambiente. A determinação de SO2 foi realizada com medida potenciométrica em eletrodo com separação de ar (em sistema de fluxo contínuo). Constatou-se que: a) o produto perde SO2 após processamento; b) o celofane proporciona, relativamente aos demais materiais testados, uma maior retenção de anidrido sulfuroso nas passas; c) os teores de SO2 encontrados nas passas de banana desde os 15 dias até os 105 dias de armazenamento não ultrapassam o limite estabelecido pela Comissão Nacional de Normas e Padrões para Alimentos.

Eficiência de vários adubos fosfatados II. Efeito residual

Estudou-se efeito residual de oito fontes de fósforo em dois solos de baixo teor em fósforo, na cultura de milho (Zea mays L.). Os experimentos foram realizados na casa de vegetação. Pela avaliação do peso de matéria seca e quantidade de nitrogênio, fósforo e potássio absorvidos, constatou-se que os fertilizantes com melhor efeito residual foram metafosfato de cálcio e metafosfato de potássio, seguidos por termofosfato e fosforita de Olinda, no regosol. No latosol não se observou diferenças estatisticamente significativas para peso de materia seca, mas de uma maneira geral o metafosfato de cálcio, fosforita de Olinda e metafosfato de potássio foram os melhores. Os fertilizantes com menor efeito residual foram os que contem alto teor em fósforo solúvel em água: superfosfato triplo, superfosfato simples, fosfato diamonico e polifosfato de amonio.

Efeito residual de alguns adubos nitrogenados na cultura do milho (Zea mays L.) avaliados pela produção de matéria seca

Foi feito um ensaio em vasos, com 4 repetições, usando terra ácida e de baixa fertilidade para testar os valores fertilizantes de uréia (com e sem enxofre). nitrato de amônio e sulfato de amônio. Fez-se, a princípio, correção do pH para 6,0 e apiicação de adubo fosfatado e potássio nas doses de 90 e 120 kg/ha de P2O5 e K2O, respectivamente. As doses de N foram de 0, 120 e 240 kg/ha. A planta teste foi o milho. No ano seguinte o ensaio foi repetido, mas sem calagem e sem adição dos fertilizantes nitrogenados. No ano subsequente repetiu-se o ensaio anterior fazendo-se, porém, calagem em duas repetições de cada tratamento. Após a colheita do milho estudaram-se os efeitos residuais dos adubos nitrogenados em competição tomando-se como parâmetros de avaliação a produção de massa de matéria seca de partes aéreas e de plantas inteiras e conteúdos de nitrogênio das mesmas As principais conclusões gerais são: a. No que concerne à produção de matéria seca de partes aéreas e de plantas inteiras não houve efeito residual de N, exceto nos tratamentos correspondentes às partes aéreas de plantas que não receberam calagem. b. Não houve efeito residual das fontes nitrogenadas quando se tomou como parâmetro de avaliação o conteúdo de N das plantas.

Efeito residual de alguns adubos nitrogenados sobre algumas características químicas de um solo

Foi feito um ensaio em vasos, com 4 repetições, usando terra ácida e de baixa fertilidade para testar os valores fertilizantes de uréia (com e sem enxofre), nitrato de amônio e sulfato de amônio. Fez-se, a princípio, correção do pH para 6,0 e aplicação de adubo fosfatado e potássio nas doses de 90 e 120 kg/ha de P(2)0(5) e K(2)0, respectivamente. As doses de N foram de 0, 120 e 240 kg/ha. A planta teste foi o milho. No ano seguinte o ensaio foi repetido, mas sem calagem e sem adição dos fertilizantes nitrogenados. No ano subsequente repetiu-se o ensaio anterior fazendo-se, porém, calagem em duas repetições de cada tratamento. Após a colheita do milho estudaram-se os efeitos residuais dos adubos nitrogenados em competição tomando-se como parâmetros de avaliação a produção de massa de matéria seca de partes aéreas e de plantas inteiras e conteúdos de nitrogênio das mesmas, os teores de alumínio trocável do solo, de hidrogênio potencial, hidrogênio trocável, indices pH e porcentagens de nitrogênio das terras. As principais conclusões gerais são: a. Relativamente ao Al3+ trocável, nos tratamentos que receberam calagem não houve efeito residual dos adubos nitrogenados, mas na ausência do corretivo o sulfato de amônio apresentou efeito considerável. Os demais apresentaram efeitos menos pronunciados. b. De um modo global, no que se refere ao H+ potencial e trocável não houve efeito residual dos fertilizantes nitrogenados nos tratamentos que sofreram correção da acidez, mas, naqueles que não receberam CaCO3 houve algum efeito residual, sobretudo do sulfato de amônio. c. Quando se tomou o valor pH como índice de avaliação do efeito residual, apenas o sulfato de amônio baixou o pH das terras, tanto nos tratamentos que receberam calagem como nos que não a receberam. d. Não houve efeito residual dos fertilizantes nitrogenados quando ele foi avaliado pelo teor de N do solo. e. Quando se emprega fertilizantes amoniacais com frequência, sobretudo o sulfato de amônio, deve-se atentar para a correção da acidez do solo.

Suporte sólido capilar para fertilizantes fluídos: I. Ensaio de efeito residual

Procurou-se avaliar o comportamento agronômico do Suporte Solido Capilar para Fertilizantes Fluídos (SC), que é um produto fertilizante experimental desenvolvido pela ULTRAFÉRTIL com comportamento potencial de Fertilizante de Solubilização Lenta. Procurou-se avaliar seu efeito sobre as plantas e sobre os solos além de compará-lo com fertilizantes convencionais, através de um ensaio de efeito residual. O SC não se comportou como Fertilizante de Solubilizaçao Lenta, igualando-se aos outros tratamentos. O K quando aplicado via SC é melhor aproveitado pelas plantas e a presença do SC no solo provoca variações nos teores de P, Ca e S - SO4-2 no solo.

The influence of building materials on the residual action of BHC

Residual insecticide activity of BHC vapors from various building materials in controlled humidity chambers in the laboratory were significantly different. Laboratory-reared, first instar nymphs of Dipetalogaster maximus were exposed to vapors of BHC which were being released from the treated surfaces of building materials taken from Mambaí, Goiás.

Residual effect of lambdacyhalothrin on Triatoma infestans

Insecticidal residual effect and triatomine infestation rates in houses of a community fumigated with lambdcyhalothrin (Icon) are reported. No mortality was observed in 5th-instar Triatoma infestans nymphs in 72-hr exposure test on three different surfaces, one month after fumigation for a dose of 31.5 mg am/m2. However, during post-exposure observation a mortality of 60% was recorded for those insect exposed on sprayed woodboard. The results observed with mud-containing treated walls, were markedly poorer (0% of mortality). Twelve month after spraying 40% of mortality was observed on first-instar T. infestans nymphs in 72-hr exposure test on woodboard, but lower mortality rates were observed in mud-containing materials. When the effect of deltamethrin (109 mg ai/m2) and lambdcyhalothrin (94 mg ai/m2) was compared, the former did not appear to be superior at similar loads. Both have showed a mortality rate of 30% on 5th-instar T. infestans nymphs three months post-fumigation. The dose utilized in the field fumigation was enough to get a significant (p < 0.0001) control of triatomine domestic infestation, since it was sufficient to keep 95% of the houses uninfested throughout 21 months following treatment, when compared with baseline situation. A remarkable knock-down effect on adult and nymphs forms of the insect and a high in situ mortality were observed as a result of its application, even at very low doses.