EXERCISES WITH AND WITHOUT VIRTUAL REALITY ON PAIN IN PATIENTS WITH PARKINSON DISEASE: A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL

Introduction: Pain in individuals with Parkinson's Disease (PD) may result from factors such as progressive changes of the disease, originating from the Central Nervous System (CNS), until coming from classic symptoms such as stiffness, dyskinesia and dystonia, having possible correlations with important functional markers such as balance and gait. There is no consensus with regard to the treatment of pain in this condition, and exercises associated with virtual reality (VR) may be an effective intervention. Objective: To evaluate the influence of an exercise program associated with virtual reality (VR) on pain intensity, correlating changes in this symptom with the functional performance of elders with Parkinson Disease (PD). Design: randomized comparative clinical trial. Setting: clinical facility from a school of physiotherapy in Brazil. Participants: 29 elders with PD. Interventions: exercises with VR and exercises without VR. Main Outcome Measures: pain, balance and gait, evaluated before and after 10 sessions, by Visual Analog Scale (VAS), Berg Balance Scale and 10 Meter Walk Test. Results: Reduction in pain intensity in the VR Group, and groups improved their balance and gait performance. Significant correlation was between the improvement in pain intensity and reduction in gait timing in the non VR Group (r = 0.713; p < 0.005). Conclusion: VR in elders with PD may be a tool for reducing pain intensity, and independently of the type, physical exercises had positive impact on their functional performance.

SYSTEMIC ARTERIAL HYPERTENSION: SOCIAL REPRESENTATIONS OF PATIENTS ATTENDED AT PRIMARY CARE ABOUT THE DISEASE AND ITS TREATMENT

Introdução: Hipertensão Arterial Sistêmica (SAH) é considerado um problema de saúde pública muito relevante, devido à sua alta freqüência na população em todo o mundo. As Representações Sociais (SR) foram abordadas em estudos com o objetivo de compreender a relação do aspecto cultural e psicossocial com os meios de lidar com pessoas com SAH, justificando e orientando suas atitudes e expectativas em relação à sua condição. Objetivo: o objetivo era compreender SR de pacientes com Hipertensão Arterial Sistêmica em relação ao tratamento, adesão terapêutica e fatores de risco para complicações. Estratégia metodológica:Uma abordagem qualitativa foi utilizada de acordo com a perspectiva Minayo e entrevistas guiadas por um roteiro semi-estruturado como técnica de pesquisa em uma Unidade de Saúde da Família em Salvador-BA. Resultados: um total de 18 informantes-chave com idade variando de 32 a 72 anos participaram do estudo. Em geral, os usuários eram principalmente sedentários (83,4%) e tinham sobrepeso ou obesidade (44,5%). Os dados foram organizados em três fases para análise: ordenação, classificação e análise final, permitindo a determinação do priori e do emic. Os indivíduos relataram dificuldades quanto à necessidade de ingestão diária de medicamentos e à adoção de hábitos de vida saudáveis, sugerindo diferenças entre senso comum e conhecimento técnico. Considerações finais:Múltiplas influências foram percebidas sobre as crenças individuais e as redes sociais na adesão ao tratamento. A SR dos hipertensos interfere diretamente com sua percepção sobre a doença, orientando-os em seus comportamentos de saúde.

Does histopathological examination still have value in detecting and preventing cancer?

Introduction: Cancer is a very dangerous disease causing a high mortality rate every year. The prevention or reduction of malignant disease required early detection, mainly depending on histological examination as the first step in the diagnosis.Methods: This study was designed to gauge the value of the numbers of histological specimen as an indicator for the level of education to prevent cancer development. Histological specimens of 14670 suspected cases of cancer diseases were histopathologically examined during seven years. Findings: Histopathological examination revealed that 960 patients had a positive result of 38 cancer types, while 13710 patients were clear of any type of cancer. More specimens were received from females, especially in 2014 and the most important organs for diagnosis of cancer, included the gastrointestinal tract (gastro-esophagus, gallbladder, and appendix), skin, lymphoid, and breast.Discussion: Increase the education level about the importance of histopathological examination of any suspected specimens is considered the first step in preventing and controlling the distribution of cancer disease. Some cancer types should receive greater attention in the diagnosis by increased use of the histopathological laboratories.

EPIDEMIOLOGICAL STUDY OF CLEFT PALATE IN THE STATE OF BAHIA, BRAZIL

The non-syndromic cleft palate (NSCP) is a common congenital defect in humans. This work has aimed to perform a descriptive epidemiological study of patients with NSCP in the State of Bahia, Brazil. A questionnaire was applied to patients and/or parents at three reference centres for treatment of craniofacial anomalies. Of the 135 patients with NSCP, 60% were female and 40% male. Blacks and mulattos were predominant. The most common systemic disorder was otologic findings. The average age of the surgery was 5 years and 2 months with a percentage of 74.8% operated. With regard to the mothers, 16.3 % consumed alcoholic beverages and 12.6 % smoked. The most cited vitamin supplementation was folic acid. Contact with chemicals involved 20.7 % of the fathers and 14.9 % of the mothers. The most frequent mother’s age gestational ranged between 15 and 25 years old. The results showed that the frequency of children with NSCP in the State of Bahia is related to the location of the reference centres. Younger mothers gave birth to cleft palate children even despite using vitamin supplementation. Although no surgical procedure has been performed at an ideal age, the majority of the children with cleft palate were submitted to surgical repair.

TREND OF ACUTE HEPATITIS A IN THE STATE OF BAHIA, BRAZIL OVER A 5-YEAR PERIOD

ABSTRACT INTRODUCTION: Hepatitis A virus (HAV) has a universal distribution. The prevalence of HAV infection varies greatly according to hygiene and sanitary conditions.OBJECTIVE: To determine the proportion of acute infection of HAV in the state of Bahia during a 5-year period. METHODS: This study was conducted at Central Public Health Laboratory of Bahia (LACEN-BA). All individuals referred for anti-HAV IgM serology from 417 municipalities from January, 2009 to December, 2013 were included. Percentages of HAV positive cases were presented according to age range for each year of the 5-year study and for each of the nine health districts (RHC) of Bahia.RESULTS: 21,175 samples were analyzed. Proportion of HAV infection was 7.2% (1,535 / 21,175) throughout the study period. The highest proportion was in 2009 (17.4%) and the lowest in 2012 (3.8%), demonstrating a decreasing trend (r = 0.7). The highest infection rates was found in children up to 10 years old. HAV infection was more frequent among males among all age groups. 52.4% (184/351) of the municipalities had acute HAV cases diagnosed. The North and West regions had the highest number of cases. CONCLUSION: There was a progressive decrease of approximately 70% in the proportion of acute HAV infection in the state of Bahia during a five-year assessment period. However, children up to 10 years old remain at higher risk, therefore the vaccine should be expanded to reach this age range.

BLUE LIGTH EMITTING DIODE IN TREATMENT OF RECURRING VULVOVAGINAL CANDIDIASIS: A CASE REPORT

Introduction: Recurring vulvovaginal candidiasis (RVVC) is an infectious disease of the lower genitourinary tract, that occurs at least 4 times per year. Drug treatment can last months and favor the appearance of adverse effects and increase the chances of recurrence. Blue Light Diode (LED) is an electromagnetic spectrum light, with antimicrobial functions. Case Report: A case report was made of a patient with RVVC whose treatment consisted of three sessions of 60-minutes each, of application of blue LED in intervals of 15 days. Evaluation was carried out before, at the end of third application and three months after the last session by means of fungal culture, cervical cytology; analysis of patient´s clinical condition; and measurement of vaginal pH. After the third session, there was a reduction in fungal load and vaginal pH; absence of symptoms (pruritus, burning and dyspareunia) and vulvovaginal edema, but there were no alterations in the cytology and microflora, which remained with inflammatory markers. Three months after the end of the treatment, there was no Candida in vaginal secretion, neither signs nor symptoms of candidiasis, and vaginal pH was normal. As for cytology and microflora, cellular alterations associated with cytolysis and presence of lactobacilli was observed. Conclusion: The blue LED 401 nm may be a promising alternative to treat RVVC by eliminating signs and symptoms in women.

PREGNANT AWARENESS ABOUT ZIKA VIRUS INFECTION DURING PREGNANCY

Introduction: The infection by Zika virus (ZIKV) on pregnancy has been related to several birth defects such as congenital microcephaly and fetal deaths. According to what is currently known about this infection, the only way to avoid it is prevention. Objective: Evaluate the pregnant women awareness about usual ZIKV infection risks. Methods and materials: This is a quantitative descriptive observational report developed at a outpatient clinic in Salvador/BA. The analysis group was composed by 60 pregnant subjects of usual risk from September to October of 2016. The data acquisition was done by structured instruments such as questions regarding sociodemographic data and ZIKV infection risks. Results: Approximately 97% of the subjects affirmed to known how the disease spread occurs, and all of them have mentioned the Aedes aegypti mosquito. The most commonly reported indications and symptoms were maculopapular rash (77.8%), headache (66.7%) and pruritus (61.1%). The most frequent complication was microcephaly (98.3%). About ways of prevention from the disease, 93.3% affirmed that they are aware of the virus. The use of the repellent lotion was the most mentioned (96.5%). Just 51.8% claimed to always do some prevention measures in their daily basis. And 88.6% of the subjects who had unplanned pregnancy allege that they would not wish to become pregnant with real chances of being infected by the virus. Conclusion: the studied group is aware of the infection risks by ZIKV, but there is a lack of prevention acts.

Using a new tool to evaluate the functional capacity of patients with HTLV-1 associated myelopathy/Tropical spastic paraparesis (HAM/TSP)

HAM/TSP patients experience impaired functional capacity. The use of categorical scales to accurately describe motor ability in these patients has been questioned.Aim: To evaluate the functional capacity of HAM/TSP patients by using the individual tests comprising the GDLAM protocol.Methods: Cross sectional study carried out in the CHTLV, Salvador, Brazil. Functional capacity was evaluated using the tests of the GDLAM protocol (timed 10-minute walk, getting up from a sitting position, rising from a prone position, getting up from a chair, and moving around the house). Functional classifications were made by comparing patient performance to that of uninfected control individuals.Results: Twenty-four HAM/TSP and 25 healthy individuals were enrolled. Only 75% HAM/TSP patients completed the GDLAM protocol. Six patients failed to perform the RPP test. Timed measurements were significantly higher in the HAM/TSP patients in comparison to uninfected controls.Conclusion: The use of alternative methods, such as the individual tests comprising the GDLAM protocol, may more accurately assess motor function in HAM/TSP patients.