Celiac disease (CD) is a permanent condition of gluten intolerance and a number of autoimmune diseases have been associated with it. In the past few years, a relation between CD and dilated cardiomyopathy (CM) was described in Europe and United States. The aim of this study was to evaluate the prevalence of CD among south Brazilian precardiac transplant patients with advanced CM. A total of 74 patients on a list for heart transplantation were evaluated for the presence CD. The presence of anti-endomisial antibody (IgA-EmA) was determined by indirect immunofluorescence and for the anti-transglutaminase antibody (IgA anti-h-tTG) by ELISA. Serologically positive patients were submitted to upper endoscopy with intestinal biopsy. Two individuals (2.63%) were positive for IgA-EmA and 5 (6.75%) for IgA anti-h-tTG; 1 (1.35%) had both tests positive. Histologic confirmation of CD occurred only in the IgA-EmA positive patients. In conclusion, data from the present study allows recommend the screening for CD in patients with CM using IgA-EmA test as the method of choice.

Objective: To determine the prevalence of smoking and the frequency of smoking cessation counseling among patients at a university hospital, as well as to compare smokers and former smokers in terms of smoking history. Methods:A cross-sectional study involving 629 patients at the Federal University of Paraná Hospital de Clínicas, located in the city of Curitiba, Brazil. Results: Of the 629 patients, 206 (32.7%) were male, 76 (12.1%) were smokers, 179 (28.5%) were former smokers, and 374 (59.5%) were nonsmokers. The mean age of the patients was 49.9 ± 15.0 years (range, 18-84 years). Of the 76 smokers and 179 former smokers, 72 (94.7%) and 166 (92.7%), respectively, were questioned about tobacco use. Smoking history and degree of nicotine dependence were higher among the former smokers (p = 0.0292 and p = 0.0125, respectively). Gender, age at smoking initiation, physician inquiry about tobacco use, and smoking cessation counseling were comparable between the two groups. The smoking cessation rate was 0.70. The prevalence of heavy smoking varied by gender and by age bracket, being higher in males and in the 41-70 year age bracket. Conclusions: The smoking prevalence in this group of patients was lower than that reported for patients at another university hospital, for adults in Curitiba, and for adults in Brazil. The smoking cessation rate was higher in these patients than in the general population of Curitiba. Smokers and former smokers differed regarding age, smoking history, and degree of nicotine dependence. Heavy smoking and a moderate or high degree of nicotine dependence were not obstacles to smoking cessation. ResumoObjetivo: Determinar a prevalência de tabagismo e do aconselhamento para a cessação do tabagismo em um grupo de pacientes de um hospital universitário, assim como comparar a carga tabágica entre fumantes e ex-fumantes. Métodos: Estudo transversal com 629 pacientes do Hospital de Clínicas da Universidade Federal do Paraná, localizado em Curitiba. Resultados: Dos 629 pacientes, 206 (32,7%) eram do sexo masculino, 76 (12,1%) eram fumantes, 179 (28,5%) eram ex-fumantes, e 374 (59,5%) eram não fumantes. A média de idade dos pacientes foi de 49,9 ± 15,0 anos (variação: 18-84 anos). Dos 76 fumantes e 179 ex-fumantes, 72 (94,7%) e 166 (92,7%), respectivamente, foram indagados sobre o hábito de fumar. A carga tabágica e o grau de dependência de nicotina foram maiores entre os ex-fumantes (p = 0,0292 e p = 0,0125, respectivamente). Gênero, idade ao início do tabagismo, questionamento médico sobre hábito de fumar e orientação para cessação do fumo foram semelhantes entre os dois grupos. O índice de cessação de tabagismo foi de 0,70. A prevalência de fumo pesado variou entre os gêneros e as faixas etárias -maior entre os homens e na faixa etária de 41-70 anos. Conclusões: A prevalência de tabagismo neste grupo de pacientes foi menor do que a observada em pacientes de outro hospital universitário e na população adulta de Curitiba e do Brasil. O índice de cessação do tabagismo foi maior do que o da ...

Several factors are implicated in the increased vulnerability of multiple trauma victims to infection, especially in intensive care-units (ICU). This cohort study was designed to report the incidence, the topography, the etiology and to identify the risk factors for infection in trauma patients admitted in an ICU. From January 2000 to December 2001, 416 trauma patients were admitted to the ICU for more than 24 hours, the mean length of stay was 9.3 days (range 2-65) and 188 (45%) patients developed a total of 290 NI. The most prevailing infections were pneumonia (49%), bloodstream (19%) and urinary tract infections (12%). The variables studied were: the demographic data, diagnosis on admission, site and mechanism of injury, type and number of surgeries, use of invasive devices, days under mechanical ventilation (MV) and site and number of NI. These variables were analyzed with a univariable and multivariable regression analysis. The NI was associated with injury in more than 1 anatomic segment (OR=1.6; CI 95% 1.06-2.40); mechanical ventilation for more than 3 days (OR=12; CI 95% 6.87-24.02); more than 1 surgery (OR=3.13;CI 95% 1.75-5.65) and more than 2 invasive devices (OR=4.7; CI 95% 2.99-7.37). Deaths over the first 5 days had high association (RR=3.18) with NI. Three significant variables were identified in the logistic regression, which are: more than 3 days under MV, number of invasive devices and number of surgeries. Key-Words: Trauma, nosocomial infection, intensive care.The growing complexity of intensive care during recent decades has been accompanied by increased risk of nosocomial infection (NI) [1][2][3][4][5][6][7][8][9]. Patients with multiple traumas have increased survival, and several factors increased risk of NI too [10][11][12]. The interaction between victims of trauma and intensive care unit (ICU) is considered additive for morbidity, mortality, hospital days, and economic burden for both patient and hospital [13][14][15][16][17][18][19][20][21][22]. The objective of this study was to identify risk factors for NI in ICU. Materials and MethodsHospital do Trabalhador is a trauma referral center in Curitiba (Parana-Brazil).The UCI is a 10-bed unit with singlepatient rooms. Retrospective data was analysed (historical cohort study) from January 2000 tO December 2001. All 416 trauma patients who stayed for more than 24 hours at the ICU were included. Demographic data (age and gender), diagnosis on admission, sites and mechanism of injuries (blunt or penetrating injury), type and number of surgeries, use of invasive devices, days under mechanical ventilation, site and number of NI were recorded. Centers for Disease Control and Prevention's (CDC) [23,24] definitions of nosocomial infection (NI) were utilized. The data was analyzed using Mann-Whitney U Test. Categorical data was assessed using Chi-Square and Mantel-Haenszel Test and Comparison of 2 Proportions. Odds Ratio (OR) with 95% confidence interval was employed to measure the magnitude of association between the studied variables and NI. Logi...

Myocardial strain measurements are useful for the early diagnosis of LVSD in DMD patients. Older age, use of corticosteroids, and mutations within the "hot-spot" region of the DMD gene are associated with early LVSD. Muscle Nerve, 2018.