To the Editor; Orthosis expenditure and compliance are both extremely important issues that can a... more To the Editor; Orthosis expenditure and compliance are both extremely important issues that can affect clubfoot treatment. Poor results and relapses could be associated with noncompliance due to economic, clinical and psychosocial reasons. Therefore, the study presented by Mang’oli et al (1) is not only scientifically relevant but also very important to developing countries or even to local areas within industrialized countries that are affected by poverty. The mean age at enrollment of the patients was 24 months, and the mean duration of Steenbeek foot abduction brace (SFAB) wear was 18 months (range six to 28 months). Therefore, all of the patients used the SFAB for a period of at least six months and most for >18 months. The results of the study showed that the noncompliance rate was lower (15%) in the SFAB group compared with the traditional brace group (41%). Our group has recently published a meta-analysis demonstrating that noncompliance was the main cause of relapse in th...
Background. The objective of the treatment of open fracture is to prevent infection, stabilize th... more Background. The objective of the treatment of open fracture is to prevent infection, stabilize the bones, and restore function. However, infection is the most important step in achieving the latter aims. Objective. The objective of the current paper is to find risk factors associated with infection in a sample of tibial open fractures. Patients and Methods. A retrospective analysis was carried out. The study included all patients who underwent to tibial open fracture treatment in the Hospital Geral Roberto Santos-HGRS, Salvador, Bahia, Brasil, from March to October, 2009. Patients under the age of eight, with multiple fractures or suffering from systemic or bone disease were excluded. Clinical and demographic data were collected and Patient outcomes were divided into two groups: Group 1 comprises those without infection whereas group 2 comprises those with lesions which became infected. The two groups were evaluated in search for associated factors that could lead to infection. Resu...
To verify the impact of avascular necrosis of the femoral head on the quality of life of children... more To verify the impact of avascular necrosis of the femoral head on the quality of life of children and adolescents with Perthes disease and sickle cell disease. A comparative study including 24 children between eight and 18 years old with avascular necrosis of the femoral head secondary to Perthes disease and sickle cell disease (Group with Necrosis) and 24 children considered asymptomatic (Group without Necrosis). Clinical and sociodemographic data were collected and the PedsQL 4.0 and the Charnley score for hip dysfunction were applied. There was no difference in the overall score and in any domain when comparing the Perthes group (global = 73.1) and the sickle cell disease group (global = 65.9). When comparing the groups with necrosis and without necrosis, the Perthes group had a lower overall score only for the Physical Functioning domain (87.5 versus 68.5); sickle cell disease group had a lower overall score (64.9 versus 79.4) and in the Physical Functioning (68.5 versus 87.5) a...
The aim of this study is to analyze the accuracy of the two classification systems for open fract... more The aim of this study is to analyze the accuracy of the two classification systems for open fractures most commonly used in current medical practice, Gustilo and Tscherne, as predictors of infection. A retrospective observational study was performed, including 121 patients suffering from open fracture of the appendicular skeleton treated at an emergency hospital. The fractures were classified according to Gustilo and Tscherne systems during the initial treatment, and ratings were subsequently confirmed or rectified during hospitalization. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated according to each classification adopted. The results of this study demonstrated that both classifications of Gustilo and Tscherne are associated with the clinical outcome of infection in open fractures. The Gustilo classification achieved sensitivity of 76.7%, specificity of 53.8%, and accuracy of 59.5%. Tscherne's classification had a sensitivity o...
Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of ag... more Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of age. This was a descriptive study with data collected from standardized forms of the Poison Control Center and patient record charts. All the cases of acute poisoning in children aged 0 to 14 years during the period 2008 to 2012 were selected. The variables studied comprised characteristics of the events and toxic agents, clinical development, and outcome. A total of 657 cases of acute poisoning, with higher frequency in the age-group from 1 to 4 years (48.7%) and male sex (53.4%), were recorded. The occurrences were accidental in 92% of the cases, and 5.8% were due to suicide attempts. Among the toxic agents, medications (28.5%), venomous animals (19.3%), nonvenomous animals (10%), household cleaning products (9.0%), and raticide agents (8.7%) predominated. The majority of cases were characterized as light (73.5%) and around 18% required hospitalization, and there was low lethality (0.5%).
Brazilian Journal of Medicine and Human Health, 2013
Objectives: To describe the populational profile of adults affected by neck and upper limb pain (... more Objectives: To describe the populational profile of adults affected by neck and upper limb pain (NULP) and to relate the characteristics of this type of pain with the predominantly physical, psychic and mixed workloads. Methods: A cross-sectional study was conducted in a sample of 2,297 individuals of > 20 years old, in Salvador-Brazil. A standardized questionnaire was applied to collect data about socio-demographic characteristics. Workers were grouped according to predominantly physical, psychic and mixed workloads, and associations were verified against the characteristics of those affected in comparison to individuals without reports of pain in the neck and upper limbs. The prevalence of pain was estimated by the OR adjusted (95% CI). Univariate analyses and logistic regression were performed. Results: NULP was found in 222 individuals (9.47%), and predominated in women and widowers exposed to physical workloads; moderate alcohol consumption was the protector in this occup...
Brazilian Journal of Medicine and Human Health, 2014
Osteoporosis has been reported among Human T-cell Lymphotropic Virus type 1 (HTLV-1) infected age... more Osteoporosis has been reported among Human T-cell Lymphotropic Virus type 1 (HTLV-1) infected aged patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) diagnosis. However, the association between osteoporosis and HTLV-1 infection remains unclear. This study aimed to evaluate the presence of bone disorders in young HTLV-1 asymptomatic individuals. A cross sectional study was carried out at the HTLV Reference Center in Salvador, Brazil. Forty-seven HTLV-1 infected asymptomatic and 108 healthy subjects aged between 20 to 45 years were included. Biochemical markers of bone metabolism were measured and bone mineral density (BMD) was determined at the femoral neck and at the lumbar spine (L1 -L4). Significant low BMD (Z-score <-1 ) was found in HTLV-1 infected individuals (1.177 ± 0.103) compared to control subjects (1.225 ± 0.146). In logistics regression analysis HTLV-1 infected subjects were more likely to have low BMD (OR = 3.48; 95%CI 1.29- 9.43) adjus...
Objective To determine the prevalence of depressive symptoms among elderly and correlate the agre... more Objective To determine the prevalence of depressive symptoms among elderly and correlate the agreement between the screening methods used. Methods A cross-section study of 137 elderly attending the Programa Vivendo a Terceira Idade [Living for the Elderly Program]. Depressive symptoms were screened by the Patient Health Questionnaire-9 and the 15-item Geriatric Depression Scale, by Yesavage. Cohen´s kappa analyzed the degree of agreement of these scales. Results The prevalence of depressive symptoms screened by the Patient Health Questionnaire-9 was 62.8% and, by the Geriatric Depression Scale, 52.6%. The Spearman correlation between the results of scales obtained rho=0.387, p<0.000. The Kappa reliability coefficient was 0.41 and significance level of p<0.001. The screening methods showed sensitivity of 80% and specificity of 44%. Conclusion Both scales showed moderate agreement and were useful for detecting a relevant prevalence of the target outcome of depression among the e...
Recent reports support the hypothesis that thrombophilia plays an important role in the pathogene... more Recent reports support the hypothesis that thrombophilia plays an important role in the pathogenesis of Perthes disease (PD) and the objective of this report is to show evidence of the role of protein C deficiency in the etiology of PD, based on a meta-analysis of current scientific literature. Studies were selected in all languages over the last twenty years (1986 to 2006) in MEDLINE, LILACS and EMBASE data bases. The inclusion criteria involved controlled studies, those that presented protein C as a continuous variable, and studies conducted in children with Perthes disease. The fixed effect model for continuous data was used; differences between groups were assessed by the t-test, Z-test and Cochran Q test for independent data and the level of significance was p < 0.05. The selected studies involved 175 patients and 193 control subjects. The selected studies were shown to be heterogeneous, but there were no statistically significant differences in protein C levels between grou...
To the Editor; Orthosis expenditure and compliance are both extremely important issues that can a... more To the Editor; Orthosis expenditure and compliance are both extremely important issues that can affect clubfoot treatment. Poor results and relapses could be associated with noncompliance due to economic, clinical and psychosocial reasons. Therefore, the study presented by Mang’oli et al (1) is not only scientifically relevant but also very important to developing countries or even to local areas within industrialized countries that are affected by poverty. The mean age at enrollment of the patients was 24 months, and the mean duration of Steenbeek foot abduction brace (SFAB) wear was 18 months (range six to 28 months). Therefore, all of the patients used the SFAB for a period of at least six months and most for >18 months. The results of the study showed that the noncompliance rate was lower (15%) in the SFAB group compared with the traditional brace group (41%). Our group has recently published a meta-analysis demonstrating that noncompliance was the main cause of relapse in th...
Background. The objective of the treatment of open fracture is to prevent infection, stabilize th... more Background. The objective of the treatment of open fracture is to prevent infection, stabilize the bones, and restore function. However, infection is the most important step in achieving the latter aims. Objective. The objective of the current paper is to find risk factors associated with infection in a sample of tibial open fractures. Patients and Methods. A retrospective analysis was carried out. The study included all patients who underwent to tibial open fracture treatment in the Hospital Geral Roberto Santos-HGRS, Salvador, Bahia, Brasil, from March to October, 2009. Patients under the age of eight, with multiple fractures or suffering from systemic or bone disease were excluded. Clinical and demographic data were collected and Patient outcomes were divided into two groups: Group 1 comprises those without infection whereas group 2 comprises those with lesions which became infected. The two groups were evaluated in search for associated factors that could lead to infection. Resu...
To verify the impact of avascular necrosis of the femoral head on the quality of life of children... more To verify the impact of avascular necrosis of the femoral head on the quality of life of children and adolescents with Perthes disease and sickle cell disease. A comparative study including 24 children between eight and 18 years old with avascular necrosis of the femoral head secondary to Perthes disease and sickle cell disease (Group with Necrosis) and 24 children considered asymptomatic (Group without Necrosis). Clinical and sociodemographic data were collected and the PedsQL 4.0 and the Charnley score for hip dysfunction were applied. There was no difference in the overall score and in any domain when comparing the Perthes group (global = 73.1) and the sickle cell disease group (global = 65.9). When comparing the groups with necrosis and without necrosis, the Perthes group had a lower overall score only for the Physical Functioning domain (87.5 versus 68.5); sickle cell disease group had a lower overall score (64.9 versus 79.4) and in the Physical Functioning (68.5 versus 87.5) a...
The aim of this study is to analyze the accuracy of the two classification systems for open fract... more The aim of this study is to analyze the accuracy of the two classification systems for open fractures most commonly used in current medical practice, Gustilo and Tscherne, as predictors of infection. A retrospective observational study was performed, including 121 patients suffering from open fracture of the appendicular skeleton treated at an emergency hospital. The fractures were classified according to Gustilo and Tscherne systems during the initial treatment, and ratings were subsequently confirmed or rectified during hospitalization. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated according to each classification adopted. The results of this study demonstrated that both classifications of Gustilo and Tscherne are associated with the clinical outcome of infection in open fractures. The Gustilo classification achieved sensitivity of 76.7%, specificity of 53.8%, and accuracy of 59.5%. Tscherne's classification had a sensitivity o...
Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of ag... more Acute poisoning is a frequent accident in childhood, particularly in children under 4 years of age. This was a descriptive study with data collected from standardized forms of the Poison Control Center and patient record charts. All the cases of acute poisoning in children aged 0 to 14 years during the period 2008 to 2012 were selected. The variables studied comprised characteristics of the events and toxic agents, clinical development, and outcome. A total of 657 cases of acute poisoning, with higher frequency in the age-group from 1 to 4 years (48.7%) and male sex (53.4%), were recorded. The occurrences were accidental in 92% of the cases, and 5.8% were due to suicide attempts. Among the toxic agents, medications (28.5%), venomous animals (19.3%), nonvenomous animals (10%), household cleaning products (9.0%), and raticide agents (8.7%) predominated. The majority of cases were characterized as light (73.5%) and around 18% required hospitalization, and there was low lethality (0.5%).
Brazilian Journal of Medicine and Human Health, 2013
Objectives: To describe the populational profile of adults affected by neck and upper limb pain (... more Objectives: To describe the populational profile of adults affected by neck and upper limb pain (NULP) and to relate the characteristics of this type of pain with the predominantly physical, psychic and mixed workloads. Methods: A cross-sectional study was conducted in a sample of 2,297 individuals of > 20 years old, in Salvador-Brazil. A standardized questionnaire was applied to collect data about socio-demographic characteristics. Workers were grouped according to predominantly physical, psychic and mixed workloads, and associations were verified against the characteristics of those affected in comparison to individuals without reports of pain in the neck and upper limbs. The prevalence of pain was estimated by the OR adjusted (95% CI). Univariate analyses and logistic regression were performed. Results: NULP was found in 222 individuals (9.47%), and predominated in women and widowers exposed to physical workloads; moderate alcohol consumption was the protector in this occup...
Brazilian Journal of Medicine and Human Health, 2014
Osteoporosis has been reported among Human T-cell Lymphotropic Virus type 1 (HTLV-1) infected age... more Osteoporosis has been reported among Human T-cell Lymphotropic Virus type 1 (HTLV-1) infected aged patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) diagnosis. However, the association between osteoporosis and HTLV-1 infection remains unclear. This study aimed to evaluate the presence of bone disorders in young HTLV-1 asymptomatic individuals. A cross sectional study was carried out at the HTLV Reference Center in Salvador, Brazil. Forty-seven HTLV-1 infected asymptomatic and 108 healthy subjects aged between 20 to 45 years were included. Biochemical markers of bone metabolism were measured and bone mineral density (BMD) was determined at the femoral neck and at the lumbar spine (L1 -L4). Significant low BMD (Z-score <-1 ) was found in HTLV-1 infected individuals (1.177 ± 0.103) compared to control subjects (1.225 ± 0.146). In logistics regression analysis HTLV-1 infected subjects were more likely to have low BMD (OR = 3.48; 95%CI 1.29- 9.43) adjus...
Objective To determine the prevalence of depressive symptoms among elderly and correlate the agre... more Objective To determine the prevalence of depressive symptoms among elderly and correlate the agreement between the screening methods used. Methods A cross-section study of 137 elderly attending the Programa Vivendo a Terceira Idade [Living for the Elderly Program]. Depressive symptoms were screened by the Patient Health Questionnaire-9 and the 15-item Geriatric Depression Scale, by Yesavage. Cohen´s kappa analyzed the degree of agreement of these scales. Results The prevalence of depressive symptoms screened by the Patient Health Questionnaire-9 was 62.8% and, by the Geriatric Depression Scale, 52.6%. The Spearman correlation between the results of scales obtained rho=0.387, p<0.000. The Kappa reliability coefficient was 0.41 and significance level of p<0.001. The screening methods showed sensitivity of 80% and specificity of 44%. Conclusion Both scales showed moderate agreement and were useful for detecting a relevant prevalence of the target outcome of depression among the e...
Recent reports support the hypothesis that thrombophilia plays an important role in the pathogene... more Recent reports support the hypothesis that thrombophilia plays an important role in the pathogenesis of Perthes disease (PD) and the objective of this report is to show evidence of the role of protein C deficiency in the etiology of PD, based on a meta-analysis of current scientific literature. Studies were selected in all languages over the last twenty years (1986 to 2006) in MEDLINE, LILACS and EMBASE data bases. The inclusion criteria involved controlled studies, those that presented protein C as a continuous variable, and studies conducted in children with Perthes disease. The fixed effect model for continuous data was used; differences between groups were assessed by the t-test, Z-test and Cochran Q test for independent data and the level of significance was p < 0.05. The selected studies involved 175 patients and 193 control subjects. The selected studies were shown to be heterogeneous, but there were no statistically significant differences in protein C levels between grou...
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Papers by Marcos Matos