A prospective study was undertaken in 1,520 children less than 15 years of age in São José de Ribamar, Maranhão, Brazil, from June 1994 to January 1995, to evaluate the prevalence and characteristics (socioeconomic, environmental, and behavioral) associated with infection by Leishmania chagasi. Montenegro skin test (MST) and enzyme-linked immunosorbent assay (ELISA-rK39 and CRUDE) test were used to detect infection. The statistical analysis used the chi2 test with Yates correction and a p value less than 0.05 was considered statistically significant. Prevalence of infection was 61.7% as measured by MST, 19.4% according to ELISA (rK39), and 19.7% by ELISA (CRUDE). Association was detected between leishmaniasis in the family, water supply, application of insecticide, and infection by L. chagasi using MST. No association with infection by L. chagasi was detected using ELISA rK39 or CRUDE. More effective control measures are needed to reduce prevalence and to detect asymptomatic cases in this high percentage of infected children.

Background and objectives: Despite advances, inappropriate analgesic treatment for burn patients is still seen. The objective of this review was to collect data on pain management in burn patients. Content:We reviewed the mechanisms of pain, burn patient assessment, as well as pharmacological and non-pharmacological treatment. Conclusion: Pain management in burn patients is still a challenge for the multidisciplinary team. Frequent and continuous evaluation of the patient's response is very important due to the various stages that the hospitalized burn patient goes through, as well as a combination therapy with analgesic and non-pharmacological measures. Understanding the complexity of the pathophysiological, psychological, and biochemical changes a burn patient presents is the fi rst step to achieve success in analgesic management.

Background: Music can influence human behavior and may be used as a complementary therapy in health care. Objectives: To assess the effect of music interventions on symptoms, adverse events, and quality of life (QoL) of breast cancer patients undergoing chemotherapy (CT). Design: Nonblinded, randomized clinical trial. Women with breast cancer undergoing adjuvant CT were randomized into 2 groups—Group Music (GM) or Group Control (GC)—and followed during the first 3 cycles of treatment. Measurements: Sociodemographic data, WHOQOL-BREF, BDI-II, BAI, and Chemotherapy Toxicity Scale were assessed. Patients were evaluated after each session of the first 3 CT cycles. GM underwent a 30-minute musical intervention before CT. There was no intervention in the GC. Continuous data were analyzed by Student’s t test, and χ2 test was used to compare qualitative variables. Results: Higher QoL scores on functional scales were observed for the GM in comparison to the GC after the first and third sessions of CT. Depression ( P < .001) and anxiety scores ( P < .001) and vomiting ( P < .01) incidence were lower for the GM in the third session of CT. All the participants in the GM reported positive changes in life in the Subjective Impression of the Subject questionnaire, as well as improvement in fatigue and reduced stress levels. Conclusions: Improvements in QoL, anxiety, depression, and incidence of vomiting were associated with the music intervention, suggesting a positive effect of the music intervention on adverse events of cancer CT.

Observa-se atualmente um cenário onde há um progressivo envelhecimento populacional, associado a um predomínio de doenças crônico-degenerativas de evolução lenta. Dentro deste contexto, os Cuidados Paliativos se inserem como uma medida extremamente necessária, de promover qualidade de vida, prevenir e aliviar o sofrimento de indivíduos e de seus familiares. Com base nesta problemática, surge o interesse em avaliar a partir de um questionário, como os estudantes que irão se formar em medicina se sentem a respeito do conhecimento e tratamento da dor, e como se comunicam com seus pacientes. Registros da literatura apontam que o médico tem sua formação acadêmica toda voltada para o diagnóstico e tratamento de doenças, assim, quando defronte de um paciente necessitado de Cuidados Paliativos, o foco deixa de ser a doença e passa a ser a pessoa doente. De forma a garantir não só alívio de sintomas desconfortáveis, mas também a dignidade de vida até o fim. Trata-se de um estudo longitudinal, prospectivo, de caráter quantitativo, realizado na Universidade Ceuma, em São Luís- MA, com estudantes de medicina do primeiro ao décimo segundo período, aprovado pelo Comitê de Ética e registrado sob o número de parecer 2.101.716. Foram avaliados 232 acadêmicos a partir de um questionário com perguntas fechadas, analisadas de acordo com os seguintes aspectos: formação técnica, percepção dos conhecimentos fisiopatológicos, semiologia e terapêutica associadas a dor e cuidados paliativos. A idade dos participantes variou entre 17 e 32 anos com prevalência de 52,6% com a faixa etária de 21|---|24 anos, e quanto ao gênero, a ocorrência de 69,0% do sexo feminino. A maioria dos alunos não conhece a definição de Cuidados Paliativos da Organização Mundial de Saúde (61%), e não se sente à vontade para comunicar más notícias aos pacientes e familiares. Assim, acredita-se que a criação de uma disciplina específica para Cuidados Paliativos, poderia sanar as deficiências educacionais aqui levantadas nos graduandos e eventuais egressos. Palavras-Chave: Cuidados Paliativos. Dor. Educação Médica.

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