Reference Hospital In Brazil Research Articles

Content and tissue expression of Collagen I, Collagen IV, and Laminin in the Extracellular Matrix in Prostate Adenocarcinoma.

Prostate cancer is one of the most common neoplasm in the male population. It is not known why some tumors become more aggressive than others. Although most studies show changes in the expression of cell adhesion molecules and the extracellular matrix correlated with the Gleason score, no study has objectively measured the tissue content of these molecules. This study aims to measure the content and tissue expression of collagen type I and IV and laminin in the extracellular matrix of patients with prostate adenocarcinoma and correlate these findings with the Gleason score and clinical characteristics. Forty-one patients who underwent radical prostate surgery at the Urology Department of a reference Hospital in Brazil between January 2015 and December 2020 were studied. The tissue protein content was estimated under light microscopy at a final magnification of 200 × . The mean collagen I score in prostate adenocarcinoma tissue samples was 7.16 ± 1.03 pixels/field. The mean type IV collagen score was 3.44 ± 0.61 pixels/field. The mean laminin score was 5.19 ± 0.79 pixels/field. The total Gleason score was correlated with both collagen and laminin. All the correlations were negative, which shows that the higher the collagen/laminin expression was, the lower the total Gleason score (p-value < 0,05). According to the Pearson correlation analysis, age has no statistical relationship with collagen and laminin content. PSA, in turn, showed a correlation only with laminin, but r = -0.378 (p = 0.015). Among the associated diseases and lifestyle habits, there is only statistical significance in the comparison of alcoholism for collagen I. For collagen IV and laminin, no statistical significance was obtained with the clinical variables analyzed.

Brazilian Version of the Yale Food Addiction Scale for Individuals with Severe Obesity.

Adapting and validating the Portuguese version of Br-YFAS 2.0-Obes to allow it to be used by the Brazilian candidates for bariatric surgery. This study included 329 individuals with body mass indexes (BMI) ≥ 30kg/m2, candidates for bariatric surgery at a reference hospital in Brazil. They were given a questionnaire that identified sociodemographic data, and the YFAS 2.0 scale, Portuguese version (BR-YFAS2.0-Obes), was applied to assess their food dependence levels. The Food Craving Questionnaire - Trait: The FCQ-T-reduced was subsequently used for a correlation analysis. The patients' average BMI was 41.6 ± 8.8kg/m2. Br-YFAS2.0-Obes presented an average of 4.9 ± 3.1 for the FA diagnostic criteria. The resulting values of the Comparative Fit Index, Tucker Lewis Index, and Standardized Root Mean Square Residual were 0.990, 0.986, and 0.074, respectively. The internal consistency analysis of the 11 domains presented a Kuder-Richardson α of 0.82. The convergent validity, obtained through an analysis of the Pearson correlation coefficient, was r = 0.43 (p < 0.001). It was found that an increase in the number of Br-YFAS 2.0-Obes symptoms is associated with an increase in the FCQ-T-r mean. Much like the YFAS 2.0 in other languages, the BR-YFAS 2.0-Obes presented adequate convergent validity, reliability, and one-factor structure results, which makes it suitable for Brazilian candidates for bariatric surgery or any individual who is within BMI > = 30kg/m2.

Analysis of Childhood Pneumonia: A Comparison Between the Pre- and During the COVID-19 Pandemic in a Reference Hospital in Brazil.

Community-acquired pneumonia (CAP) is one of the most common causes of childhood morbidity and mortality, causing about two million deaths per year worldwide. The complicated CAP (CCAP) results from the worsening of CAP. Their incidence has reduced in the last 30 years due to vaccination. However, the coronavirus disease (COVID-19) pandemic reduced vaccination coverage, resulting in increased incidence of CCAP in 2021 and 2022. To analyze the clinical and epidemiological profile of CAP in children under five years of age in two periods: pre- (2018 to 2019) and during the COVID-19 pandemic (2020 to 2022). This cross-sectional retrospective study was conducted at the Professor Fernando Figueira Institute of Integral Medicine (IMIP). We analyzed the sociodemographic and clinical variables of children with CAP aged below five years who were admitted to IMIP from 2018 to 2022. Analysis encompassed the Pearson's Chi-square test, Fischer's exact test, and Student's T tests. A total of 468 children were analyzed: 382 in the pre-pandemic period and 86 during the COVID-19 pandemic. Concerning the antibiotic therapy, the most prescribed was Ampicillin (45.00%) in both periods. The combination of Oxacillin and Ceftriaxone was prescribed in 6.86% of cases in the pre-pandemic period; this value increased to 20.90% during the COVID-19 pandemic. Pleural effusion represented 12.10% of cases in the pre-pandemic period and 24.40% during the COVID-19 pandemic. The presence of pleural empyema went from 1.60% to 8.20%, and necrotizing pneumonia from 1.30% to 5.90% in the respective periods. Regarding ICU admission, 5.30% were admitted during the pre-pandemic period and 34.10% during the COVID-19 pandemic. Clinical suspicion of influenza presented a positivity rate of 17.60%. Children with CAP presented a higher frequency of complications during the COVID-19 pandemic. Further research is needed to find the cause of increased CAP complications in this period.

Epidemiological indicators and predictors of lethality associated with fungal infections in a NICU: an historical series

ObjectivesFungal infections (FI) pose a public health concern and significantly increase mortality rates, especially within Neonatal Intensive Care Units (NICU). Thus, this study aimed to investigate epidemiological indicators, risk factors, and lethality predictors associated with FI in a NICU. MethodsThis study included 1,510 neonates admitted to the NICU of a reference hospital in Brazil between 2015 and 2022. Demographic data, such as sex, birth weight, gestational age, and use of invasive devices were analyzed. ResultsThirty neonates developed invasive FI, totaling 33 episodes and an incidence of 1.2 per 1,000 patient days. Candida albicans was the most frequent species (52.9 %), the bloodstream was the most affected site (78.9 %), and 72.7 % of infections occurred between 2015 and 2018. The lethality rate associated with FI was 33.3 %, and 90 % of deaths occurred within 30 days of diagnosis of infection. Weight < 750 g, prolonged hospital stay, use of parenteral nutrition, and broad-spectrum antimicrobials were independent risk factors for infection occurrence, especially glycopeptides and 4th generation cephalosporins, having a considerable role in the increase in fungal infections. Weight < 750 g was considered a significant predictor of lethality, and C. albicans had the highest lethality rate (40 %). ConclusionThese findings highlight the elevated lethality rate associated with these infections, reinforcing the importance of developing strategies to control FI within NICU.

Main Pathogens Causing Infections and Antibiotic Resistance Profile in Major Burns in Brazil Comparing Two Periods: 2015/2016 and 2019/2020.

Sepsis is the main cause of death in major burns. In this retrospective study conducted in a reference hospital in Brazil, the main agents causing infection and the resistance profile to antibiotics were identified. In addition, the epidemiological profile, length of hospital stay, type of burn, and total body surface area (TBSA) in major burns were collected from medical records, comparing the years 2015/2016 and 2019/2020. In both time periods, there was a predominance of males with a mean age of 43 years. Burns with less than 30% of TBSA predominated. There was a significant increase in positive cultures (P = .00026), from 58.7% to 80%, and an increase in skin punch culture collection from 25.6% to 43.9% in the years 2019/2020. The predominant etiological agent was Pseudomonas aeruginosa, followed by Acinetobacter baumannii resistant to carbapenems, and Staphylococcus aureus in both evaluated periods. The percentage of deaths was higher in 2019/2020 (26.2% vs. 14.6%; P = .026). The length of hospital stay was shorter in the latter period (P = .0081). Sepsis was the cause of death in 81.2% of cases in 2015/2020 and 78.3% in 2019/2020. Among the deaths, P. aeruginosa was the main agent identified. There was no change in the main pathogens and bacterial antibiotic resistance between the 2 time periods.

Genomic analysis of RAS and BRAF mutation in an oncology reference hospital in Brazil.

e15545 Background: Colorectal cancer (CRC) is a common malignancy worldwide and a leading cause of cancer-related deaths. The molecular basis of CRC can guide patient prognosis and therapy. Unfortunately, knowledge on the CRC mutation landscape is limited. In this study, we investigated the mutation profile of related genes by next-generation sequencing and associated with microsatellite instability (MSI) in a series of 43 Brazilian CRC patients from 2016 to 2022, of a Public Oncology Hospital. This study aimed to analyze the frequency of mutation covariates of the KRAS and BRAF genes and their correlation with survival data in patients diagnosed with metastatic RCC. Methods: We conducted a retrospective, observational and descriptive study in 43 patients diagnosed with CRC treated at an Oncology Reference Hospital in Brazil. DNA was extracted from formalin-fixed, paraffin-embedded (FFPE) tumor tissues. Targeted sequencing was performed using a customized panel for CRC-related genes. The mutation data was analyzed in relation to clinicopathological features, MSI status and survival, using the Kaplan-Meier method and log-rank test. Results: RAS mutations were found in 37.2% of patients and BRAF mutations in 9.3%. The analysis of most secondary clinicopathological features did not show statistical prognostic impact. In general analysis, the age and presence of BRAF mutation were related to the increased risk of death HR-0.31 (0.11-0.82). However, among patients with BRAF mutations exclusively, the age did not represent an increased risk of death. Concerning our RAS mutations, as we already knew from previous literature data, the variety is diverse. We noticed nine different RAS alterations, in which the most prevalent was the G12D (33%), followed by G13D, Q61K and G12A. The distribution of our RAS alteration and prevalence is summarized in the table below: Conclusions: Our findings are consistent with previous studies concerning frequency and patterns of RAS and BRAF mutations in CRC. The identification of MSI and the evaluation of genetic ancestry may help to guide treatment decisions in CRC patients. At present, it is already known that some of RAS mutations are targets for selective RAS drugs and may have better outcomes the pan-RAS drugs. Our study provides important insights into the mutation profile of related genes in Brazilian CRC patients and these findings have implications in clinical management of CRC. Further studies with larger cohorts are needed to validate our findings. [Table: see text]

Radioiodine therapy during the COVID-19 pandemic in a public reference hospital in Brazil: an experience report.

COVID-2019 has resulted in an emerging respiratory infection that has spread as a pandemic since January 2020. Nuclear Medicine Services and its workers experienced a dramatic change in their clinical routine. They were required to adjust protocols for this new health condition. Regarding radioiodine therapy (RIT), initial orientations were to postpone treatments. In Brazil, National Nuclear Energy Commission prepared guidelines. It authorized RIT to employ activities over 1850MBq in an outpatient setting on an exceptional basis. This study reports the RIT experience of a Brazilian hospital during the COVID-19 pandemic, intending to evaluate the applicability of outpatient treatment employing over 1850MBq of I-131 on a large scale. During referred period, 106 patients at our service had an indication for RIT, of which 58 agreed to participate in the research and provided informed consent. Majority of patients did not meet the minimum requirements for outpatient treatment using doses>1850MBq.

Prevalence of SARS-CoV-2 infection among health care workers in a reference hospital in Brazil.

Health care workers (HCW) are the frontline workforce for COVID-19 patient care and, consequently, are exposed to SARS-CoV-2 infection due to close contact to infected patients. Here, we evaluate the prevalence of SARS-CoV-2 infection among HCW from an infectious disease hospital, reference center for COVID-19 care in the metropolitan area of Sao Paulo city, Brazil. Among 2,204 HCW, 1,417 (64.29%) were subjected to detection of anti-SARS-CoV-2 antibodies by chemiluminescent immunoassay. Out of the total, 271 (19.12%) presented anti-SARS-CoV-2 antibodies. Prevalence varied according to HCW categories. The highest prevalence was observed in workers from outsourced companies, cooks and kitchen assistants, hospital cleaning workers, and maintenance workers. On the other hand, resident physicians and HCW from the institution itself presented lower prevalence (nurses, nursing assistants, physicians, laboratory technicians). Social and environmental factors are important determinants, associated with exposure in the hospital environment, which can determine the greater or lesser risk of infection by pathogens that spread rapidly by air.

Retrospective Evaluation of Characteristics of Patients with Burn Injuries Treated at the Largest Reference Hospital in Brazil.

Burn injuries are a significant cause of morbidity and mortality in the Brazilian population. We conducted this study in a tertiary hospital in Brazil to discover the epidemiological characteristics of patients with burn injuries. We conducted a cohort review of patients admitted to the burn unit of our institute during a 5-year period. For each patient, we collected data that included age, gender, total percentage of burned body surface area, burn location, burn mode, and burn cause. We analyzed the data using the R programming language. We included a total of 496 patients in our study. The mean age of the patients was 28 ± 14.7 years. The median length of hospital stay was 2 weeks. We found a significant correlation between the total percentage of burned body surface area and the length of hospitalization (p < .001) and the length of hospitalization in the intensive care unit (p < .001). A total of 427 patients (86%) were discharged from the hospital after successful treatment. In contrast, 43 patients (8.67%) died. The mortality rate was highest in patients who had more than 70% of their total body surface area burned. The average length of hospitalization aligned with global and national statistics presented in the literature. The main causes of the burn injuries were thermal (e.g., fire, hot liquids). We found inhalation injuries present in more than one third of the patients who were hospitalized in the intensive care unit with thermal burns.

Characterization of Candida spp. isolated from the bloodstream in a reference hospital in Brazil: using MALDI-TOF/MS to identify unusual species of Candida

Candidemia is a health problem with a high mortality rate. The aims of this study were to compare the identification of Candida spp. via traditional methodologies and mass spectrometry (MALDI-TOF/MS) in order to verify the antifungal susceptibility profile of these isolates and analyze the clinical evolution of patients. This was a two-year prospective cohort conducted at the Hospital de Clínicas de Uberlândia (HCU-UFU). Candida spp. were identified via VITEK®-2 and MALDI-TOF/MS. Antifungal susceptibility tests were conducted via VITEK®-2. Clinical-demographic data were assessed from medical records and variables were described as mean, standard deviation, frequency and percentage, and risk factors were evaluated using univariate and multivariate analysis. A total of 113 patients and 126 Candida spp. isolates were studied. C. albicans was most frequent (30%); MALDI-TOF/MS identified unusual species, including misidentification of C. famata. Most of the isolates (95%) were susceptible to the tested antifungals. Most patients were men (65%) and older than 60 years of age (45%); 85% of patients were treated with fluconazole. The 30-day mortality rate was 56%; patients who did not receive treatment and those who started later had a lower survival rate (p &lt;0.0001). MALDI-TOF/MS was able to identify unusual Candida spp. Candidemia presented a high mortality rate; the correct identification of Candida spp. and the introduction of appropriate and timely therapy are essential for increasing patient survival.

Evaluation of Clinical Course of Gamma (P.1) Variant of Concern versus Lineages in Hospitalized Patients with COVID-19 in a Reference Center in Brazil.

ABSTRACT.The SARS-CoV-2 variant of concern (VOC) gamma (P.1) has increased transmissibility and resulted in elevated hospitalization and mortality rates in Brazil. We investigated the clinical course of COVID-19 caused by gamma and non-VOCs at a reference hospital in Brazil in a retrospective cohort study with nonelderly hospitalized patients from two periods, before and after the emergence of gamma. Cohort 1 included patients from both periods whose samples would be eligible for whole-genome sequencing (WGS). Cohort 2 was composed of randomly selected patients from Cohort 1 whose samples were submitted to WGS. A total of 433 patients composed Cohort 1: 259 from the first and 174 from the second period. Baseline characteristics were similar, except for a higher incidence of severe distress respiratory syndrome at admission in patients from the second period. Patients from the second period had significantly higher incidence rates of advanced respiratory support (adjusted hazard ratio [aHR]: 2.04; 95% confidence interval [CI], 1.60–2.59), invasive ventilatory support (aHR: 2.72; 95% CI: 2.05–3.62), and 28-day mortality from the onset of symptoms (aHR: 2.62; 95% CI: 1.46–4.72). A total of 86 (43 gamma and 43 non-gamma) patients composed Cohort 2. Patients with confirmed gamma VOC infections had higher advanced ventilatory support and mortality rates than non–gamma-infected patients. Our study suggests that non-elderly patients hospitalized for COVID-19 in the second period (used as a proxy of gamma infection) had a more severe clinical course. This might have contributed to higher hospitalization and death rates observed in the second wave in Brazil.

Prevalence of the special needs of patients served in a type III CEO of a reference hospital in Brazil

The aim of this study was to determine the prevalence of Patients with Special Needs seen at the pediatric outpatient clinic of a type III CEO.Method: Descriptive cross-sectional study carried out by surveying 1,384 clinical records of patients from 0 to 19 years of age, with confirmed diagnoses of some special need and attended from June to September 2018. Information collected from medical records such as: the registration number, sex, age, origin, the type of special needs and the history of caries experience. Then, the classification was applied according to the diagnosed pathology, elaborated by Santos &amp; Haddad. Results: Most patients were male (58.2%) and lived in the Metropolitan Region of Recife (51.4%). Regarding special needs, it was found that the highest percentages correspond to patients with Congenital Defects (27.4%), Chronic Systemic Diseases (21.1%), Special Physiological States (15.2%), Physical Defects (14, 7%), Sensory and Audio-communication Defects (8.5%), Behavioral Deviations (4.8%), Intelligence Deviations (4.3%), Endocrine-Metabolic Diseases (3.6%) and Deviations Psychic (0.2%).

The Practice of Hospital Dentistry in a Reference Hospital in Brazil

The Practice of Hospital Dentistry in a Reference Hospital in Brazil

Hematopoietic stem cell transplantation and quality of life during the first year of treatment.

ABSTRACTObjective:to evaluate the quality of life of adult patients with hematological cancer comparing Hematopoietic Stem Cell Transplantation modalities during the first year of treatment. Method:this is an observational and longitudinal research with 55 participants. Data collection was performed in six steps: before transplantation, pancytopenia, before hospital discharge, after 100, 180 and 360 days, in a reference hospital in Brazil for this treatment. The international instruments Quality of Life Questionnaire - Core 30 and Functional Assessment Cancer Therapy - Bone Marrow Transplantation were validated and translated into Portuguese (Brazil). Results:the mean age of participants was 36 years, 65% (n = 36) had leukemia diagnosis and 71% (n = 39) had undergone allogenic transplantation. In the Quality of Life Questionnarie - Core30 instrument, the pain symptom was significant between the first and second stages, and loss of appetite between the third and fourth stages, both in the allogenic group. In the Functional Assessment Cancer Therapy - Bone Marrow Transplantation, the functional well-being domain was significant between the third and fourth stages, also in the allogenic group. Conclusions:although the aggressiveness of treatment affects quality of life, patients consider it satisfactory after the first year. There are few significant differences between autologous and allogenic patients, and both groups have recovered in the course of the process.

Predictive factors for disseminated histoplasmosis in AIDS patients with fever admitted to a reference hospital in Brazil.

In many settings, the lack of sensitive biomarkers of disseminated histoplasmosis (DH) leads to a clinical reliance on older diagnostic methods and delayed treatment initiation. The early recognition of DH is critical for survival, especially in patients with human immunodeficiency virus (HIV). This study aimed to identify clinical and laboratory findings associated with the definitive diagnosis of DH in low-income HIV patients in endemic areas. Febrile AIDS patients with suspected DH who were admitted to a reference hospital in northeastern Brazil from January 2006 to January 2007 were evaluated for clinical and laboratory findings associated with DH diagnosis. One hundred seventeen patients with fever were included, and 48 (41%) cases of DH were determined by Histoplasma capsulatum identification. A higher fever (≥38.5ºC), maculopapular/papular rash, splenomegaly, hepatomegaly, wheezing, hemoglobin ≤9.5g/dL, platelets ≤80,000/µL, CD4 count ≤75/µL, aspartate aminotransferase (AST) level ≥2.5 times the upper limit of normal (ULN), lactate dehydrogenase (LDH) ≥5times the ULN; and international normalized ratio (INR) >2 times the ULN were significantly associated with DH. A multivariable analysis identified hepatomegaly [adjusted (a) prevalence ratio (PR)= 1.96; 95% confidence interval (CI): 1.21-3.16), CD4 count ≤75/µL (aPR = 2.02; 95% CI: 1.06-3.83), LDH ≥5 times the ULN (aPR = 2.23; 95% CI: 1.44-3.48), and maculopapular/papular rash (aPR = 1.70; 95% CI: 1.02-2.83) were independent risk factors for DH. These easily assessed parameters can facilitate clinical decision-making for febrile AIDS patients with suspected DH in low socioeconomic and Histoplasma-endemic regions.

Association between pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit: a retrospective study.

ObjectiveTo evaluate the association between acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score and mortality in a pediatric intensive care unit.MethodsThis retrospective cohort study assessed all children admitted to the pediatric intensive care unit of a reference hospital in Brazil from January to December 2016. Patients were screened for the presence of acute kidney injury through the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score. Patients were subdivided into the stages of Risk, Injury and Kidney Failure.ResultsThe sample comprised 192 children, of whom 45.8% developed acute kidney injury, with 79.5% of the cases identified up to 72 hours after admission. Patients with acute kidney injury showed a 3.74 increase risk of death (p = 0.01) than the control group. Patients with kidney failure had a mortality rate that was 8.56 times greater than that of the remaining sample (p < 0.001). The variables that were associated with the stages of acute kidney injury were nephrotoxic drugs (p = 0.025), renal replacement therapy (p < 0.001), vasoactive drugs (p < 0.001), pediatric risk of mortality 2 score (p = 0.023), fluid overload (p = 0.005), pediatric intensive care unit length of stay (p = 0.001) and death (p < 0.001).ConclusionIn this study, the pediatric Risk, Injury, Failure, Loss and End Stage Renal Disease score proved to be a useful tool for the early identification of severely ill children with acute kidney injury, showing an association with mortality. We thus suggest its use for pediatric intensive care unit patient admission.

Clinical and microbiological profile of chronic Burkholderia cepacia complex infections in a cystic fibrosis reference hospital in Brazil.

Burkholderia sp. infections are extremely complex in cystic fibrosis (CF) patients, especially considering the lack of knowledge regarding its behavior, its relationship with prognosis, as well as its transmissibility and multidrug resistance features. This study evaluated the frequency of chronic infection by Burkholderia, using microbiological and clinical data. Ninety-eight patients with CF attended from July 2011 to April 2014 in a Brazilian reference hospital were included. Antimicrobial activity, molecular epidemiology, Shwachman score, body mass index, exacerbations, and lung function were analyzed. Nine patients had chronic colonization, and all of them showed preserved pulmonary function levels, body mass index, and Shwachman score. Meropenem was the most effective antibiotic; however, divergent results were shown by other studies. Cross-contamination may have occurred in only two unrelated patients of different ages, who were colonized by B. vietnamiensis, which does not occur frequently. Twelve new sequence types (STs) were identified and three STs have presented intercontinental distribution. None of the patients presented known epidemic strains. In conclusion, a relatively low number of patients with chronic colonization and suspected cross-infection were identified. Different from other studies that have found CF patients chronically colonized with Burkholderia sp. having a greater deterioration of lung function, more frequent antibiotic therapy, and increased mortality, in the current study, the patients showed good clinical outcomes and favorable options for antibiotics therapy. This study also updated the epidemiological database, which facilitates the multicentric collaborative analysis and assists in the control of global infection by these pathogens.

Patients with Chagas Disease and Cardiac Arrest Treated at the Emergency Department of a Reference Hospital in Brazil

: People with Chagas disease are at a higher risk of death due to cardiac arrest (CA). Considering that Chagas disease remains a serious health problem in Latin America, studies in this regard are still needed. The aim of this study was to present 2 patients with Chagas that developed CA and were treated at the emergency department of a reference hospital in Brazil (Sao Paulo city). Case one: Male (73 years old and Caucasian) with a history of systemic arterial hypertension, diabetes mellitus, liver cirrhosis, and Chagas disease associated with megacolon and megaesophagus. After cardiac collapse and 30 minutes of cardiopulmonary resuscitation (CPR), unfortunately the patient died. Case two: A female patient (64 years old and Caucasian), with a history of systemic arterial hypertension, obesity, and Chagas disease. After 23 days of hospitalization, pharmacological therapy, and implantation of a cardioverter defibrillator, the patient was discharged. People with Chagas disease are at a higher risk of CA. The researchers believe that a prompt and efficient treatment (advanced life support) allied with educational programs on CA recognition targeted at health professionals and caregivers (basic life support knowledge) could improve the prognoses of these patients.

Profile Of Elderly Diagnosed With Tuberculosis In A Reference Hospital In Brazil

Introduction: The increase in life expectancy shall be related to the higher number of tuberculosis cases, which, in spite of its curableness, still stand as a major challenge for public healthcare in several countries. Objective: We sought to characterize the profile of elderly with the referred disease diagnosed in a reference hospital, residents of the city of Joao Pessoa-Paraiba-Brazil. Method: It was a documental, descriptive, retrospective study with a quantitative approach which utilized the Epiinfo software, version 3.3.1 so as to systematize the data. Results: The sample includes 169 diagnosis records of elderly with pulmonic tuberculosis, between the years of 2011 and 2013, of whom 6,5% are residents of the city of Bayeux, 12,4% Santa Rita, 3,6% Cabedelo, and 77,5% Joao Pessoa; The majority were male (65,1%), married (54,5%), with low education background (32,5%), non-institutionalized (79,9%), and actives (47,9%); of those, 32,5% were directed to reference service by another hospital unit. Among the associated comorbidities, we highlight alcoholism (25,5) and smoking (27,3%). Diabetes had higher rates in females (39,0%). The relevant symptom was coughing (66,1%); As for the closure, only 55,0% of the elderly were discharged from hospitals after cured, 10,7% died, and 11,2% abandoned treatment. Conclusion: Describing the profile of elderly diagnosed with tuberculosis is relevant for public health. The results obtained are used to propose improvements in the care of the health service, allowing a treatment geared to the peculiarities of elderly people suffering from tuberculosis and actions to reduce cases of the disease in this population.

Health-related quality of life in adolescents with congenital heart disease

This study aims to evaluate the health-related quality of life of adolescents with congenital heart disease, describing health-related quality of life according to the diagnosis and severity of congenital heart disease, identified by variables such as the presence of symptoms, surgical interventions, use of medication, and residual lesion. A cross-sectional study was conducted on 203 adolescents with congenital heart disease attended at the Pediatric Cardiology ambulatory of a reference hospital in Brazil. The Brazilian version of the questionnaire KIDSCREEN-27 was used for the assessment of health-related quality of life. Information related to the congenital heart disease diagnosis and clinical variables were collected from the medical records of the patients. There was no statistically significant difference between acyanotic and cyanotic groups, as well as for the different diagnosis of congenital heart disease. A trend for better health-related quality of life in the dimension of Psychological Well-Being (p=0.054) was found in the groups with surgical intervention and use of medication. Adolescents that referred a good general health presented significantly better results in all dimensions of health-related quality of life, except for Autonomy and Parent Relation, than those who presented clinical symptoms (p<0.05). Type of congenital heart disease and initial diagnosis did not seem to affect the perception of health-related quality of life, corroborating findings of several studies. Surgical interventions and the use of medication can improve previous clinical status, and therefore it seems to be beneficial in terms of Psychological Well-Being. The presence of clinical symptoms was the variable that caused the largest impact on the perception of health-related quality of life, possibly because of the impairment they bring to the daily lives of these patients.