São Paulo medical journal = Revista paulista de medicina
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Comparative Study
Assessing glomerular filtration rate in patients with severe heart failure: comparison between creatinine-based formulas.
Severe heart failure is highly associated with chronic kidney disease (CKD). Serum creatinine is a poor indicator of renal function and glomerular filtration rate (GFR) estimation is an accessible method for assessing renal function. The most popular formulas for GFR estimation are the Cockcroft-Gault (CG), the four-variable Simplified Modification of Diet in Renal Disease (sMDRD) and the recently introduced CKD-Epidemiology Collaboration (CKD-EPI). The objective of the study was to analyze the correlation between these three equations for estimating GFR in patients with severe heart failure. ⋯ Despite the good correlation and agreement between the three methods, the sMDRD formula classified more patients as presenting GFR less than 60 ml/min.
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Burnout syndrome (BS) is characterized by three dimensions: emotional exhaustion, depersonalization and reduced personal fulfillment. The objectives of this study were to evaluate a possible association between BS and weekly workload, and to describe the prevalence of BS and the sociodemographic and occupational profile of on-call physicians in Maceió. ⋯ Despite the high prevalence of BS, especially among physicians who did not practice regular physical activity, our data did not indicate any significant correlation between weekly workload and any of the three dimensions of BS in this sample. The high prevalence of BS draws attention to the importance of investigating other possible causes, in order to prevent and adequately treat it.
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Compromised maternal mental health (MMH) is considered to be a risk factor for child malnutrition in low income areas. Psychosocial variables associated with MMH are potentially different between urban and rural environments. The aim here was to investigate whether associations existed between MMH and selected sociodemographic risk factors and whether specific to urban or rural settings. ⋯ The prevalence of CMD is high among mothers of children aged up to two years in the semiarid region of Alagoas. This seems to be associated with lower educational level in urban settings and lack of partner in rural settings.
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Large loop excision of the transformation zone (LLETZ) is a nontraumatic cut and coagulation method with several advantages, but it induces thermal artifacts in the cut region. The aim here was to assess the correlations of age, number of fragments, lesion grade and degree of thermal artifacts with margin quality in conized specimens from LLETZ for cervical intraepithelial neoplasia (CIN). ⋯ CIN III in women aged 30 or over, when removed in two or more fragments during LLETZ, presented a greater number of compromised margins and greater severity of thermal artifacts.
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Epidemiology may help educators to face the challenge of establishing content guidelines for the curricula in medical schools. The aim was to develop learning objectives for a medical curriculum from an epidemiology database. ⋯ The frequencies of the health conditions and their statistical treatment made it possible to identify topics that should be fully developed within medical education. The classification also suggested limits between topics that should be developed in depth, including knowledge and development of skills and attitudes, regarding topics that can be concisely presented at the level of knowledge.