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Search Results: 1 - 10 of 217402 matches for " Carlos Maurício de Figueiredo; "
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Fatores associados à soropositividade do teste ML Flow em pacientes e contatos de pacientes com hanseníase menores de 18 anos
Ferreira, Maria Aparecida Alves;Antunes, Carlos Maurício de Figueiredo;
Revista da Sociedade Brasileira de Medicina Tropical , 2008, DOI: 10.1590/S0037-86822008000700013
Abstract: this article presents the results of a cross-sectional study involving 115 newly-diagnosed leprosy patients and 1,011 household contacts, all under the age of 18. seropositivity ratios and factors associated with a positive ml flow were determined. the test was positive in 21.7% of patients and in 19.7% of contacts. among patients, logistic regression indicated the association of seropositivity with positive slit skin smear and having more than five skin lesions. the tree method analysis indicated associations with skin smear, madrid classification, number of nerves affected and age. in the contact group, index case classification, age and type of health service were associated with seropositivity in both analyses. the variables that best explained seropositivity are those associated with higher bacterial load. therefore, the ml flow test could be used in children to aid correct classification of patients for treatment and to identify contacts at greater risk of developing leprosy.
Febre amarela: estudo de um surto
Ribeiro, Mirtes;Antunes, Carlos Maurício de Figueiredo;
Revista da Sociedade Brasileira de Medicina Tropical , 2009, DOI: 10.1590/S0037-86822009000500009
Abstract: this study had the aim of describing an outbreak of yellow fever that occurred in the municipalities under the jurisdiction of the regional healthcare administration of diamantina, minas gerais, between 2002 and 2003, in which 36 cases were notified. this was an autochthonous outbreak of wild-type yellow fever. failure of vaccinal coverage and low levels of detection of mild cases were found. among the cases, 33 (91.7%) were male and the age range was from 16 to 67 years. nineteen (52.8%) of the cases were classified as severe and 12 men (33.3%) died of the disease. all of the cases came from rural areas and presented fever, headache, vomiting, jaundice, myalgia, oliguria and signs of hemorrhage. surveillance through laboratory tests was the determining factor in diagnosing the outbreak. by describing the epidemiological and clinic findings, this study contributes towards diagnosing and classifying this disease. it was deduced that there is a relationship between deforestation, and outbreaks, and that there is a potential regional risk of yellow fever because of the local development of tourism.
The management of multidisciplinary care or patients with chronic disease O gerenciamento do cuidado multidisciplinar no acompanhamento de pacientes portadores de doen as cr nicas
Regina Torres Costa,Carlos Maurício de Figueiredo Antunes
Revista Brasileira de Medicina de Família e Comunidade , 2010, DOI: 10.5712/rbmfc4(13)210
Abstract: This study presents a health care program based on systemized multidisciplinary follow-up of 92 patients, carriers of chronic disease, with repeated hospital admissions and medical appointments and analyzes its results in terms of cost reduction for the health plan operator. The investigation covered a period of 12 months before introducing the program (10/01/2002 to 31/12/2002) and the same period after introducing the program (01/01/2003 to 31/12/2003). The results show a statistically significant reduction of appointments (from a mean of 15,39 to 9,58), hospital admissions (from 2,11 to 0,85), costs (from R$ 8.029,32 to R$ 3.054,03), as well as a decrease in hospital admissions due to the main disease (from 54 to 26) and to complications (from 55 to 38). Consequently, an equation establishing a mathematical model could be developed with the purpose of calculating the expenditure with the multidisciplinary care of a patient, allowing the health plan operator to conduct a strategic financial analysis for cost reduction. The established mathematical model is represented by the following equation: Y = 962 + 286 marital status - 1184 HA + 1070 admissions after + 84,3 appointments after - 621 caretaker before. The program improves the health of the patient and resultsin a significant reduction of the medical and hospital costs for the health plan operator. O estudo apresenta um modelo de assistência à saúde com base no acompanhamento sistematizado de equipe multidisciplinar a 92 pacientes portadores de doen a cr nica, com repetidas interna es e consultas médicas no período de 12 meses anteriores ao programa, e, em seguida, com a implanta o da metodologia por igual tempo, a análise dos resultados obtidos na redu o dos custos assistenciais para a operadora do plano de saúde. A investiga o foi realizada no período de 01 de janeiro de 2002 a 31 de dezembro de 2002 (sem aplica o do programa) e de 01 de janeiro de 2003 a 31 de dezembro de 2003 (com aplica o do programa). O trabalho mostra a redu o estatisticamente significativa das consultas (média de 15,39 para 9,58), das interna es (de 2,11 para 0,85), dos custos (de R$8.029,32 para R$3.054,03), das interna es por motivo de doen a principal (54 para 26) e, também, a diminui o das interna es devido a complica es da doen a (55 para 38). Como conseqüência, uma equa o que estabelece um modelo matemático p de ser desenvolvida, com a finalidade de se obter valor capaz de or ar uma despesa com assistência multidisciplinar daquele paciente, possibilitando um estudo estratégico financeiro para a operadora
Risk Factors for tuberculosis among human immunodeficiency virus-infected persons. A case-control study in Belo Horizonte, Minas Gerais, Brazil (1985-1996)
Toledo Jr., Antonio Carlos de Castro;Greco, Dirceu Bartolomeu;Antunes, Carlos Maurício Figueiredo;
Memórias do Instituto Oswaldo Cruz , 2000, DOI: 10.1590/S0074-02762000000400001
Abstract: the objective of this study was to identify tuberculosis risk factors and possible surrogate markers among human immunodeficiency virus (hiv)-infected persons. a retrospective case-control study was carried out at the hiv outpatient clinic of the universidade federal de minas gerais in belo horizonte. we reviewed the demographic, social-economical and medical data of 477 hiv-infected individuals evaluated from 1985 to 1996. the variables were submitted to an univariate and stratified analysis. aids related complex (arc), past history of pneumonia, past history of hospitalization, cd4 count and no antiretroviral use were identified as possible effect modifiers and confounding variables, and were submitted to logistic regression analysis by the stepwise method. arc had an odds ratio (or) of 3.5 (ci 95% - 1.2-10.8) for tuberculosis development. past history of pneumonia (or 1.7 - ci 95% 0.6-5.2) and the cd4 count (or 0.4 - ci 0.2-1.2) had no statistical significance. these results show that arc is an important clinical surrogate for tuberculosis in hiv-infected patients. despite the need of confirmation in future studies, these results suggest that the ideal moment for tuberculosis chemoprophylaxis could be previous to the introduction of antiretroviral treatment or even just after the diagnosis of hiv infection.
Risk Factors for tuberculosis among human immunodeficiency virus-infected persons. A case-control study in Belo Horizonte, Minas Gerais, Brazil (1985-1996)
Toledo Jr. Antonio Carlos de Castro,Greco Dirceu Bartolomeu,Antunes Carlos Maurício Figueiredo
Memórias do Instituto Oswaldo Cruz , 2000,
Abstract: The objective of this study was to identify tuberculosis risk factors and possible surrogate markers among human immunodeficiency virus (HIV)-infected persons. A retrospective case-control study was carried out at the HIV outpatient clinic of the Universidade Federal de Minas Gerais in Belo Horizonte. We reviewed the demographic, social-economical and medical data of 477 HIV-infected individuals evaluated from 1985 to 1996. The variables were submitted to an univariate and stratified analysis. Aids related complex (ARC), past history of pneumonia, past history of hospitalization, CD4 count and no antiretroviral use were identified as possible effect modifiers and confounding variables, and were submitted to logistic regression analysis by the stepwise method. ARC had an odds ratio (OR) of 3.5 (CI 95% - 1.2-10.8) for tuberculosis development. Past history of pneumonia (OR 1.7 - CI 95% 0.6-5.2) and the CD4 count (OR 0.4 - CI 0.2-1.2) had no statistical significance. These results show that ARC is an important clinical surrogate for tuberculosis in HIV-infected patients. Despite the need of confirmation in future studies, these results suggest that the ideal moment for tuberculosis chemoprophylaxis could be previous to the introduction of antiretroviral treatment or even just after the diagnosis of HIV infection.
Perfil de sensibilidade e fatores de risco associados à resistência do Mycobacterium tuberculosis, em centro de referência de doen?as infecto-contagiosas de Minas Gerais
Souza, Márcia Beatriz de;Antunes, Carlos Maurício de Figueiredo;Garcia, Guilherme Freire;
Jornal Brasileiro de Pneumologia , 2006, DOI: 10.1590/S1806-37132006000500010
Abstract: objective: to assess the determining factors for mycobacterium tuberculosis multidrug resistance at a referral center for infectious diseases in the state of minas gerais, brazil. methods: a retrospective case-control study was conducted using data collected from september of 2000 to january of 2004. during this period, 473 cultures presenting growth of m. tuberculosis, corresponding to 313 patients, were submitted to susceptibility tests at the central laboratory of minas gerais. cases presenting resistance to at least rifampin and isoniazid were classified as cases of multidrug resistance and were selected for study. these cases were paired to control group cases of drug-susceptible tuberculosis at a ratio of 1:3. clinical and demographic data were analyzed using univariate and multivariate analyses. results: during the study period, 12 (3.83%) cases of multidrug-resistant tuberculosis were identified. in the univariate analysis, multidrug-resistant tuberculosis was found to be more common among male patients, as well as among those testing positive in the sputum smear microscopy, those with cavitations larger than 4 cm in diameter and those having been previously treated for tuberculosis (p = 0.10 for all). after the multivariate analysis, only previous treatment for tuberculosis remained statistically significant (p = 0.0374), with an odds ratio of 14.36 (1.96-176.46). conclusion: in the present study, previous treatment for tuberculosis was found to be an independent risk factor for multidrug-resistant tuberculosis.
Fatores preditivos de incapacidades em pacientes com hanseníase
Gon?alves,Soraya Diniz; Sampaio,Rosana Ferreira; Antunes,Carlos Maurício de Figueiredo;
Revista de Saúde Pública , 2009, DOI: 10.1590/S0034-89102009000200007
Abstract: objective:to analyze predictive factors in the progression of the disability grade in patients with leprosy. methods: a retrospective cohort study followed up 595 patients with disability registered at a healthcare unit in the city of belo horizonte (southeastern brazil) from 1993 to 2003. patients' sociodemographic and clinical information was collected from the respective medical records. comparisons were made between the disability grade upon admission and at the end of treatment using a marginal homogeneity test. to determine factors associated with progression in the disability grade, univariate analysis (linear trend chi-square test) was employed, as well as multivariate analysis by means of the algorithm chi-square automatic interaction detector. results:among the cases in which the disability grade was recorded upon admission and upon discharge, 43.2% of the patients who had grade 1 in the first assessment progressed to grade 0. among those who began with grade 2, 21.3% progressed to grade 0 and 20% progressed to grade 1. in the univariate analysis, the variables that proved to be statistically associated with progression in the disability grade were: neuritis, time elapsed until the occurrence of neuritis, number of damaged nerves, type of physiotherapy treatment and higher dose of prednisone. in the multivariate analysis, the main factor associated with the progression of disability was the disability grade upon admission. conclusions: the results showed the importance of an early diagnosis of neuropathy as well as the efficient association of pharmacological and non-pharmacological treatment, through disability prevention techniques and adequate doses of steroid.
Ocorrência de neurite em pacientes com hanseníase: análise de sobrevida e fatores preditivos
Gon?alves, Soraya Diniz;Sampaio, Rosana Ferreira;Antunes, Carlos Maurício de Figueiredo;
Revista da Sociedade Brasileira de Medicina Tropical , 2008, DOI: 10.1590/S0037-86822008000500006
Abstract: neuritis in leprosy cases is responsible for deformities and disability. the objective of this historical cohort study was to investigate the risk factors associated with the time taken for neuritis to occur. this study followed up 595 patients from 1993 to 2003. the life table technique and the kaplan-meier method for survival curves were used. the log-rank test was used to test differences between groups regarding the time take for neuritis to occur, and the cox regression model was used to estimate the hazard ratios. just over half (54%) of the sample had neuritis, which had mostly taken 0 to 11.9 months to appear. the degree of disability at admission and the bacillary index were strongly associated with the occurrence of neuritis, thus confirming the need for early diagnosis of leprosy, as well as regular neurological follow-up and appropriate interventions.
Risk factors for physical disability at diagnosis of 19,283 new cases of leprosy
Moschioni, Cristiane;Antunes, Carlos Maurício de Figueiredo;Grossi, Maria Aparecida Faria;Lambertucci, José Roberto;
Revista da Sociedade Brasileira de Medicina Tropical , 2010, DOI: 10.1590/S0037-86822010000100005
Abstract: introduction: the purpose of this study was to evaluate risk factors for physical disability at the moment of leprosy diagnosis. methods: this is a retrospective, descriptive and exploratory investigation of 19,283 patients with leprosy, registered in the state of minas gerais, brazil, between 2000 and 2005. results: the risk of grade 2 disability was 16.5-fold higher in patients with lepromatous leprosy, and 12.8-fold higher in patients presenting the borderline form, compared to patients presenting indeterminate leprosy. the occurrence of more than one thickened nerve increased the odds of a patient developing grade 2 disability, 8.4-fold. age <15 years, multibacillary leprosy and no formal education presented 7.0, 5.7 and 5.6 odds of developing physical disability, respectively. conclusions: these factors should be considered as strong prognostic indicators in the development of physical disability at diagnosis.
Paraparesia espástica tropical nos trópicos e Brasil: análise histórica
Castro-Costa, Carlos Maurício de;Carton, Herwig;Goubau, Patrick;Figueiredo, Eberval Gadelha de;Giffoni, Silvyo David A.;
Arquivos de Neuro-Psiquiatria , 1994, DOI: 10.1590/S0004-282X1994000100022
Abstract: the tropical spastic paraparesis (tsp) is a chronic myelopathy, predominant in the tropics, recently known to be of retroviral origin (htlv-i). this paper aims at delineating the clinico-etiological evolution of this entity. the historical analysis of it showed that the tsp has had, along decades, many different denominations and the discovery of the retroviral origin for some of them has stimulated new paths of research and epidemiological interest in the tropics and brazil.
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