Resumo em Inglês:

INTRODUCTION: Acute respiratory diseases (ARDs) are a major cause of infant morbidity and mortality. OBJECTIVE: The present case-controlled study investigated the hospitalizations by ARDs in children under one year of age and the association with the respiratory syncytial virus (RSV) in za Pelotas, RS. METHODS: All children under one year of age hospitalized due to ARDs from August 1997 to July of 1998 were followed-up in the four hospitals of the city. A standardized questionnaire was applied to the children's mother regarding symptoms of the actual illness in addition to social and demographic variables, nutrition, and previous morbidity. The final diagnosis of ARDs was performed by an arbiter (a pediatrician) based on the hospital records of the children and the data on the questionnaire. Nasopharyngeal secretions were collected for RSV detection by direct immunofluorescence. RESULTS: The study included 650 children and the annual incidence rate of hospital admissions for ARDs was 13.9%. Admissions showed a seasonal pattern with most of the hospitalizations occurring from July to October. The main causes of admission were: pneumonia (43.7%), bronchiolitis (31.0%), asthma (20.3%), influenza (3.5%), otitis media (0.8%) and laryngitis (0.6%). The overall prevalence of RSV was 30.7%, with 40.2% in bronchiolitis, 28.6% in influenza, 27.4% in asthma, 26.3% in pneumonia, and 25% in otitis media. CONCLUSIONS: The results of the present study confirm the high morbidity of ARDs in childhood and the seasonal pattern of ARDs hospitalizations and their association with RSV infection.

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Patients with active tuberculosis (Tb) may be admitted to a hospital for different conditions, and not have Tb as their main diagnosis. In this study, 141 inpatient Tb cases are analyzed, which were notified to the São Paulo Hospital Central Control of Infectious Diseases from August, 1999, through April, 2001, with identification of causes, risk factors, and hospitalization time. Sixty-three percent of the patients were males, and 37% were females, with a mean age of 38.1 years. Twenty-eight percent of them were smokers, 23% were alcoholics, and 17% were drug addicts. Previous tuberculosis was reported by 23% of the patients. Forty-two of them were HIV-positive. Fifty-four point six percent had pulmonary Tb, 67.5% of which were sputum-positive. Twenty-two percent of the patients presented side effects to the Tb treatment during hospitalization, the most frequent of which were drug-induced hepatitis (65.7%), and gastric intolerance (25.7%). Eight point five percent of the patients required intensive care for an average of 11 days, and 54% stayed in a ward with respiratory isolation. Death occurred in 17.7% of cases, in 52% of them as a consequence of Tb. On the average, the patients stayed at the hospital for 29 days, and in isolation (when necessary) for 18 days. Drug addicted and smoking patients had longer hospitalization times. This was not the case of HIV-positive or sputum-positive patients.

Resumo em Inglês:

Streptococcus pneumoniae resistance to penicillin was studied in two hospitals in Caxias do Sul, Rio Grande do Sul, Brazil, between May 1998 and November 2001. From the 176 strains of invasive Streptococcus pneumoniae that were identified, 2.28% (CI 0.62-5.74) presented intermediate resistance, and 3.42% (CI 1.26-7.31) presented high-level resistance. The conclusion was that in Caxias do Sul the use of penicillin was still justified as treatment of pneumococcal pneumonia, differently from other centers where penicillin was replaced by other antibiotics. These results confirm the statement of IDSA (Infectious Diseases Society of America) guideline for the management of community-acquired pneumonia in adults, that the choice of antimicrobial drug to treat pneumococcal pneumonia should be guided by local or regional prevalence of resistance to penicillin.

Resumo em Inglês:

INTRODUCTION: Data on the relationship between personality profile and nicotine dependence may help health professionals to design and improve programs for the treatment and prevention of this dependence. OBJECTIVE: To investigate the relationship between personality profile and nicotine dependence in a group of smoking undergraduate students. METHODS: A total of 1,245 undergraduate students were randomly selected among 10,500 students enrolled at the Cuiabá campus of UFMT in 2001. A standard questionnaire was applied for social characterization and for the determination of the tobacco consumption pattern, comprising 80 students considered as smokers. These students were then submitted to the Fagerström Test (1978) for nicotine dependence and to the reduced version of the Comrey Personality Scale (CPS), that determines personality dimensions. RESULTS: Analysis of the mean scores (Student's t test) revealed an inversely proportional borderline association between dependence and the Order x Lack of Compulsion scale (p = 0.06), and a negative or inversely proportional association between the CPS Extroversion x Introversion (p = 0.002) and Control of Validity scales (p = 0.04). Linear regression analysis of the Fagerström Test points confirmed the inversely proportional borderline association between dependence and the Order x Lack of Compulsion (p = 0.06) and CPS Extroversion x Introversion scales (p = 0.02). However, when the interference of daily cigarette consumption was controlled, only the Extroversion x Introversion scale remained associated with dependence (p = 0.001). CONCLUSION: Students who are nicotine-dependent smokers are less extroverted than non-dependent smokers.

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INTRODUCTION: A great emphasis has been placed on health-related quality of life of COPD patients and specific questionnaires have been developed in order to measure it. OBJECTIVE: This study describes the language and cultural adaptation of a new (and short) disease-specific health status questionnaire developed for chronic obstructive pulmonary diseases: the Airways Questionnaire 20 (AQ20). METHODS: In order to validate this questionnaire in Brazil, it was initially translated into Portuguese. The cultural adaptation was taken into consideration and then a back translation to English was undertaken, in order to obtain a final Portuguese version. Correlations were made with FEV1, SpO2, BMI and another disease-specific health status questionnaire, the Saint George Respiratory Questionnaire (SGRQ), previously validated in Brazil. The interclass correlation ratio was done to test the reproducibility of AQ20. RESULTS: The interclass correlation ratio for the total score was alpha = 0.90 (intra-observer variability) and alpha = 0.93 (inter-observer variability) (p < 0.05 for both). The correlation with total SGRQ score was 0.76, with p < 0.001. The average time to answer the AQ20 was 4 min and 6 s. CONCLUSION: The Brazilian Portuguese version of AQ20 is reproducible, of fast application and with good a correlation with SGRQ total score, which makes it a valid questionnaire to measure health status in obstructive patients in Brazil.

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Asthma is the most frequent chronic inflammatory disease in childhood, and its prevalence has increased remarkably over the last decades. Therefore, the scientific community became interested in studying the growth of the affected children. The relationship between asthma and growth suffers the influence of the clinical picture, of therapeutics, but the different study methods make it difficult to distinguish the factors responsible for the growth retardation detected by some authors. This review has the purpose of providing an overall outlook on this matter.

Resumo em Inglês:

Sternal neoplasms are extremely rare. It is difficult to make prospective evaluations due to the lack of consistent reports in the literature. The authors report the case of a woman in her seventies, who presented a chondrosarcoma of the sternum, treated by them.

Resumo em Inglês:

A male farmer, 20 years old, from the countryside of the State of Piauí, developed acute respiratory infection. Despite adequate antimicrobial therapy, his conditions worsened, requiring mechanical ventilation. His X-rays showed diffuse pulmonary infiltrates. His PaO2/FiO2 ratio was 58. Direct microscopy and culture of tracheal aspirates showed the presence of Coccidioides immitis. Autochthonous cases of coccidioidomycosis have only recently been described in Brazil, most of them from the State of Piauí. C. immitis has been isolated from humans, dogs and armadillos (Dasypus novemcinctus), and also from soil samples of armadillo's burrows. Failure to respond to antimicrobial therapy and a patient's origin from recognized endemic areas should alert to the possibility of acute pulmonary coccidioidomycosis.