Investor Presentaiton
IJMS
INTERNATIONAL JOURNAL of
MEDICAL STUDENTS
XXI COMAPI
Abstracts
Abstracts
Methods: It's a cross-sectional, retrospective, descriptive and quan-
titative study based on secondary data, accounted and available by
Datasus about deaths due to CSD, IHD and their categories, according
to CID-10, in Piauí, from 2001 to 2011. Were been considered the
variables: age, scholarity, gender, and place of occurrence of death
(POD). Results: In the years 2001 and 2011 were accounted for 173
635 deaths in Piauí, of which 31.36% were from CSD and 23.77% of
the IHD, being 60.75% in men. The main conditions, according to CID-
10 category, include angina pectoris (0.54%); AMI (90.35%); Recurrent
myocardial infarct (0.11%), chronic ischemic heart diseases (5.49%)
and Other acute ischemic heart diseases (3.51%). Of the total, 73.21%
of the deaths reported occur in people having 60 years or more and
62.14% do not have any or only up to 3 years of schooling. Regar-
ding the POD, 47.12% occur in hospitals and 44.51% at home. The
Pearson correlation was positive (p = 0.9693) among the variables
"year" and "mortality". Improperly filled death certificates are re-
cognized limitations. Conclusion: This study revealed, as the deaths
for ischemic heart disease: higher prevalence in men, a phenomenon
well described; higher mortality for AMI; less prevalence in higher
education levels and few differences in the POD. Furthermore, the
study confirmed the increasing trend of deaths from IHD observed in
the Northeast region, which may be due, among other factors, the
increasing improvement in diagnostics, forecasting the maintenance
of the situation for the years 2012 to 2014.
22
Epidemiological Study Of Tuberculosis In The City Of Teresina-
Pi, In The Period 2007- 2012
Vanessa Gonçalves Costa; Brunna De Sousa Silva; Juliane
Brígida Silva Do Nascimento; Raissa Lua Rodrigues Carvalho
Araújo; Joycce Huanna De Souza Silva; Augusto César Evelin
Rodrigues.
Introduction: Tuberculosis (TB) is a infectious, chronic and trans-
mitted disease caused by Mycobacterium tuberculosis or Bacillus of
Koch (BK), in despite of to be one of the oldest diseases reported,
still causes great social impact, and is responsible currently for the
largest number of deaths for a single infectious agent around the
world. The possibility of the occurrence of coinfection of TB/HIV in-
creases the importance of this condition in public health. Objective:
To characterize the epidemiology of TB cases registered in the city
of Teresina (PI), between 2007 and 2012. Methodology: The present
study is an epidemiological, cross-sectional, quantitative and retros-
pective. The data were collected from an active search on databases
of Sistema de Informação de Agravos de Notificação (SINAN) e Rede
Interagencial de Informações para a Saúde (RIPSA). All cases were
analyzed according sex, age group, scholarity, treatment outcome,
coinfection with HIV and lethality in the period from 2007 to 2012 in
Teresina-Pl. Next, the data were tabulated and statistically analyzed
through Excel spreadsheet and PrismaⓇ. Results: The number of
cases in 2012 decreased by 20% compared to 2007, the year that
had the highest number of cases (375), being notified of a total of
1982 cases during the period. TB is most prevalent in young adults
(20-39 years) with 732 cases (37%) and in males in the ratio of 2:3.
With regard to education, there is a higher frequency in patients of
incomplete primary education (1st to 4th incomplete) in all years.
The move towards healing and treatment dropout outcome were 50%
and 4.7% of cases, respectively, with death the evolution of 2.8% (56
cases) of the notifications. The HIV test was not performed in 390
cases (19.7%). Conclusion: It was found that in Teresina TB is more
common in males, in adults aged 20 to 39 years and people with
low education. Testing for HIV has oscillated since 2007 and does
not cover 100% of TB cases, which is recommended by the Ministry
of Health. Information on treatment outcome is poor, because 24.8%
are without information. It follows that cure rate in Teresina is well
below the goal adopted in Brazil, which is 85%. In contrast, the
dropout rate and the lethality remained at acceptable levels during
the period.
23
Evaluation By Genogram: Prevention Of Familial Breast Can-
cer In Female Relatives Of Women Who Died From Breast
Cancer
Walber Emanuel Da Cruz Fontes; Almir Jose Guimarães Gou-
veia; Vicktor Bruno Pereira Pinto; Carlos Alberto Rosado Da
Silva Filho; Renato Barboza Da Silva Neto; Maria Hilda Araújo
Ribeiro.
Introduction: The familial cancer includes some types of cancer
without a well-defined pattern of heritage genetic. The genetics of
cancer is an essential component in clinical oncology practice, es-
pecially in Brazil, where breast cancer is the leading cause of death
in women. Objectives: Evaluate the familial breast cancer, based on
family history of women who died from breast cancer, aimed at buil-
ding genograms to identify families with hereditary predisposition,
which is an aspect of relevance in the early diagnosis of tumors.
Methodology: Descriptive and observational study of a sample of
convenience from 54 medical records of women who died from
breast cancer of Instituto Maranhense de Oncologia Aldenora Bello -
IMOAB, in the period from 2000 to 2007 in São Luís - MA. This study
was approved by Ethics Committee for Research of the University
Hospital of the Federal University of Maranhao. Data were analyzed
in Epi Info 2007. Results and Discussion: We investigated 54 medical
records of women who died of breast cancer under the age of 60
years and their relatives of first and second degree. Genograms were
built and were identified 18 families with case reports of cancer.
The average age of patients at diagnosis was 39.55 and at death
41.98 years. The overall survival ranged from 1 to 240 months. It was
observed only 1 case of affected relative in 13 families and 2 cases
in 3 families. 11 patients had cases in first-degree relatives and 4
of second-degree relatives. 11 patients with a family history were
diagnosed under the age of 39 years and 4 were 50 years or more. 10
families had 2 or more cases over two generations, 3 had 2 or more
cases in a generation and a reported 3 cases in three generations. 10
families reported that only first-degree relatives were affected, three
families reported that only second-degree relatives were affected
and one family reported cases in the first and second degree relati-
ves Conclusion: It was found that 33.33% of the studied patients had
family history of cancer. Of these, more than half were diagnosed
aged less than 39 years, suggesting a possible relationship between
early age at diagnosis and increased frequency of cases in the fa-
mily, which justifies the study of hereditary câncer.
24
Hemophagocytic Lymphohistiocytosis In Child With Visceral
Leishmaniasis: Case Report
Joana Mayra Teixeira Lima; Sérgio Clementino Benvindo; Lívia
Araújo Vale Castelo Branco Torres; Maria Aline Ferreira De
Cerqueira; Gildene Alves Da Costa; Catarina Fernandes Pires.
Introduction: Hemophagocytic lymphohistiocytosis (HLH) or he-
mophagocytic syndrome is a disorder of the mononuclear phagocytic
system, characterized by an exacerbated inflammatory response in
which activated macrophages exhibit uncontrolled phagocytosis of
red blood cells, white blood cells, platelets and precursors. For diag-
nosis, the Histiocytosis Society proposed the presence of > 5 out
of 8 criteria: fever, splenomegaly, bicytopenia, hypertriglyceridemia
and/or hypofibrinogenemia, hemophagocytosis, low or absent NK
cell activity, high serum ferritin levels, and elevated soluble CD25
levels. We report a case of HLH secondary to Visceral Leishmaniasis
(VL). Case report: Female patient, aged 2 years and 3 months, na-
tive of Parnarama-MA, previously treated for pneumonia. Few days
after respiratory symptoms, progressed with recrudescence of fever,
associated with abdominal distention, lower limb edema, jaundice,
hepatosplenomegaly, hyporexia and irritability. She was referred to
a specialized center in Teresina-PI, initiating treatment with liposo-
mal amphotericin B after confirmation of VL. The child progressed
with anasarca, persistent jaundice and visceromegaly. On review of
bone marrow slides, hemophagocytosis complexes were visualized.
The patient was then transferred to the Children's Hospital for com-
plementary diagnostic investigation of HLH. On hospital admission,
the child was irritable, presenting with anasarca, jaundice (3+/4+),
no alterations in cardiac and pulmonary auscultation, low-grade fe-
ver (37.96C). Laboratory tests revealed pancytopenia (Hemoglobin:
7.3g/dL; White Blood Cells: 3560/mL; Platelets: 74.000/mm), hy-
pertriglyceridemia (790mg/dl), hyperbilirubinemia (25.45mg/dl), hy-
poalbuminemia (1.0g/dl), high serum ferritin levels (>2000ng/mL),
ALT (216U/L) and AST (115U/L), Gamma GT (292U/L), PTA without
formation of fibrin, negative sorology for cytomegalovirus, hepatitis
B, HIV, german measles, measles and toxoplasmosis. The child was
managed with pulse therapy (methylprednisolone for three conse-
cutive days), obtaining good clinical and laboratory response. Final
considerations: The association between HLH and VL is very rare,
with approximately 56 cases described in the English literature. We
draw atention to the importance of early recognition and success
obtained with the institution of pulse therapy, when adoption of the
recommended therapeutic regimen (dexamethasone, etoposide and
cyclosporine) is impossible.
25
Hospital Morbidity And Mortality In The Elderly In Piauí
Brenda Paula Brito Lobão; Leonardo De Melo Rodrigues;
Alessandra Maria Cerqueira De Sousa; Mirna Karine De Britto
Melo Escórcio; Leonardo Fortes Gomes; Luciana Tolstenko
Nogueira.
Introduction: The aging population is a reality found in many na-
tions, such as Brazil. This growth in the number of seniors and their
implications when building a new epidemiological profile of health
care are reflected in changes in the structure of hospital care and
attention in the demand for medical and social services. Objective:
To describe the pattern of hospital mortality in the elderly population
in the state of Piaui. Methods: This was a retrospective, and descrip-
tive epidemiological study of hospitalizations of elderly patients (60
years or more) in the state of Piauí in the period from 2010 to May
2014. There were analyzed data from the Hospital Information Sys-
tem (SIH-SUS) available in DATASUS. Considered the causes of hospi-
tal admissions according to the International Classification of Disea-
ses (ICD10). Results: There were 207 072 hospital admissions of the
elderly over this period, with a slight female predominance (51.5%).
The most common causes, the second chapter of the ICD were: car-
diovascular diseases (25.11%), respiratory diseases (15.34%) and
infectious and parasitic diseases (14.33%). Once specified the cau-
se, pneumonia (16 739), heart failure (16,723), intestinal infectious
diseases (11,315) and diabetes mellitus (10,697) figure as the most
incidents and together account for 26.79% of hospitalizations of el-
derly people. 12,282 deaths were recorded, and the hospital morta-
lity rate was 5.93%. Neoplasms correspond to the group of diseases
with the highest mortality rate (8.89%), followed by diseases of the
nervous system (7.80%), respiratory (7.66%) and circulatory (7.04%).
Conclusion: The pattern of hospital morbidity and mortality in the el-
derly population presents important differences with the equivalent
standard for younger adults and their characterization is of funda-
mental importance for the development of strategies to improve the
effectiveness of hospital care.
Keywords: Morbidity, elderly, Hospitalization
26
Hospitalizations Due To External Causes In The State Of Piauí
2008-2013
Mirna Karine De Britto Melo Escórcio; Leonardo De Melo
Rodrigues; Brenda Paula Brito Lobão; Alessandra Maria Cer-
queira De Sousa; Leonardo Fortes Gomes; Luciana Tolstenko
Nogueira.
Introduction: External causes conceptualized by the World Health Or-
ganization (WHO), like intentional injuries (assaults, homicides, sui-
cides, privation or neglect) and unintentional injuries (motor vehicle
accidents, drownings, falls, burns, among others) play an prominent
among the causes of morbidity and mortality in the country. Such
injuries are responsible for a significant portion of the health and
social problems, acquiring epidemic character and becoming one of
the most serious public health problems in the world. Objective: To
describe the morbidity of hospital admissions in the state of Piaui.
Methods: This is a retrospective, descriptive and an epidemiological
study of hospital admissions due to external causes in Piauí 2008-
2013, based on the data collection (SIH-SUS) Hospital Information
System. We considered the external causes of hospital admissions
according to the twentieth chapter of the International Classifica-
tion of Diseases (ICD10). Results: During the period under review, 89
655 hospital admissions were recorded by external causes. Falls and
traffic accidents correspond, respectively, the first (42.01%) and se-
cond (26.74%) because in both sexes and in all age groups. The age
group 15-39 years is responsible for 65.74% of hospitalizations due
to traffic accidents. Motorcyclists are the main victims and represent
64.74%. The males constitute 80.67% of hospitalizations due to tra-
ffic accidents. Importantly, the attacks are consistent only 3.52% of
admissions. As for the drops, the majority are male (77.06%) and the
age distribution extends from 20 to 39 years (33.76%); 73.25% were
classified as unspecified falls. The mortality rate (TM) recorded was
2.11%; TM from traffic accidents was 2.86%, while the TM for falls
was 1.11%. Conclusion: The profile of hospital mortality from external
causes found confirmed falls and traffic accidents as the predomi-
nant causes. Given the limited information about falls, difficult to
be a better analysis of admissions for such a cause. Motorcyclists
young males are the primary victims of accidents. Thus, based on
the profile of demand met, such information helps to support the
adoption of preventive measures, as well as the appropriateness of
hospital services.
Keywords: Morbidity, External Causes, Accidents, Falls
27
Incidence of Staphylococcus Aureus In Stethoscopes Of Me-
dical Students After Hospital Care
Mariélia Barbosa Leal De Freitas; Teresa Maria Barbosa Leal
De Freitas, Raíssa Maritan Silva Sousa; Dra Maria Do Rosário
Conceição Moura Nunes.
Introduction: the stethoscope is a very useful instrument to health
care professionals. As it is used directly on the patient, it becomes a
potential vector for pathogenic or tolerable micro-organisms. Among
the germs carried out by the stethoscope, there is Staphylococcus
aureus bacteria, which may cause infections such as: impetigo, folli-
culitis, puerperal mastitis, pneumonia, endocarditis and sepsis. The
use of an unhygienic stethoscope leads to microbe dissemination
and indiscriminate use of antimicrobial agents to treat hospital in-
fections. Objectives: To assess the presence of S. aureus in medical
student's stethoscopes; To identify bacterias of S. aureus specie and
its antibiotics resistance profile. To assess the frequency, stethosco-
pe sanitization method and the standard antiseptic chosen by the
students. Methods: Quantitative study analyzing 43 samples collec-
ted in non-sanitized stethoscopes from medical students. This re-
search was approved by Ethics Committee of FACID, according to the
resolution 466/2012 of Ministério da Saúde. Participants signed an in-
formed consent. Questionnaires regarding to the frequency, method
of sanitizing the stethoscope, sharing this instrument and which an-
tiseptics are most used were performed. The sample collecting and
culture were obtained from stethoscopes, following the assessment
of an antibiotics resistance profile through agar diffusion test. The
outcomes were analyzed through Origin and Microsoft Excel pro-
grams. Results: From 43 samples, 5 suggested presence of S. aureus
(12%). Most of the samples with S. aureus (80%) showed resistance
to the following antimicrobial agents: Penicillin G, Ampicillin, Strep-
tomycin, Tetracycline. Data obtained from the questionnaire are the
following: 60% of students sanitize the stethoscope only once a day;
72% share stethoscope; 88% use antiseptic to sanitize the stethos-
cope; 96% use alcohol 70% as antiseptic; during sanitizing process,
65% completely disinfect the stethoscope. Conclusion: In the present
study, most of the samples did not have S. aureus in its content,
however the resistance was analyzed in positive samples. There was
prevalence of students that shared and did not sanitize the stethos-
cope after hospital care, which increases potential risk of pathogenic
germs dissemination and the amount of hospital infections.
28
Incidence of Visceral Leishman's Disease In The State Of
Piauí In The Period Of 2008 At 2012
Ananda Sousa Silva; Amanda Moita Carneiro; Flaylson Moura
Barros; João Pedro Pinheiro Do Nascimento Vieira; Ânderson
Batista Rodrigues; Cíntia Maria De Melo Mendes.
Introduction: The visceral leishman's disease or calazar is a chronic
infected disease with long periods of fever, weight loss, hepatospe-
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