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Introduction: Lower urinary tract dysfunction (LUTD) are voiding dysfunctions without anatomical or neurological defects. The diagnosis is primarily clinical, with symptoms standardized by the International Children's Continence Society. Few studies relate quality of life of patients with cognitive and school performance., Objective: To evaluate milestones of bladder control, daily problems, quality of life (QoL), cognitive function and school performance of children with LUTD., Methods: Case series of patients followed in the Pediatric Nephrology tertiary hospital with assessment of QoL (Pediatric Quality of Life Inventory - PedsQoL version 4), School Performance Test (TDE) and Raven Progressive Matrices test., Results: Girls of lower social class were (90.9%) of eligible children. The mean age was 9.1 ± 4.8 years old. The most common symptoms were urge incontinence (81%), holding maneuvers (77.3%) and enuresis (59.1%) associated with the elimination disorder syndrome (63.6%). Caregivers considered volunteers urinary losses and/ or symptoms, and fought and/or beat the child. Children had been subjected to embarrassing situations such as warnings of teachers, they hid symptoms and/or the dirty clothes. Mean score of QoL was 71.0 ± 12.6 with the lowest mean score on the school dimension. In TDE 55% had lower performance and in Raven Matrices 60% were intellectually in the medium level. It was observed lower QoL scores in the medium and lower level of TDE and average intellectual capacity/below average in Raven matrices., Conclusion: LUTD may negatively affect family and social relationships, school performance and QoL of children with the dysfunction.

Objective: To determine the effectiveness of 20 twice-weekly sessions of parasacral transcutaneous electrical neural stimulation (TENS) for treatment of urinary urgency and urge-incontinence in children and adolescents., Methods: A Phase II clinical trial was carried out with patients with urinary urgency or urge-incontinence aged between 5 and 14 years. Twenty TENS sessions were conducted, twice weekly, using a Quark® Dualpex 961 apparatus. The variables analyzed were daily micturition, dynamics ultrasonography of the lower urinary tract pre-and post-treatment and responses to a questionnaire on urinary leakage applied during each session., Results: The mean age of the 25 children participating in the study was 7.80 ± 2.22 years, most were female (92%) and had urge-incontinence (92%). The difference in urinary leakage pre- and post-treatment was statistically significant ( p = 0.04); a decline in the symptom of urinary leakage was reported by all caregivers in children who completed the 20th session; the ultrasound parameters, although not statistically significant, showed a reduction in the percentage of children with detrusor contractions (from 62.5% to 43.5%); and a more adequate pre-micturition bladder volume of 4.2% post-treatment compared with 19.0% prior to treatment., Discussion: The electro-stimulation carried out during the twice weekly sessions appeared to be effective and urinary incontinence declined in half of the patients from the 12th session onwards. However, there is a need for a study involving a larger number of patients to confirm the results obtained.

Objective: to analyze the workloads, strain processes and sickness absenteeism among nursing workers from a teaching hospital in the Brazilian Central-West., Method: a descriptive and cross-sectional study was developed with a quantitative approach, based on the theoretical framework of the social determination of the health-disease process. Data were collected between January and December 2009, based on records of complaints related to occupational exposure among nursing professionals, filed in the software Monitoring System of Nursing Workers' Health. For the sake of statistical analysis, relative and absolute frequencies of the variables and the risk coefficient were considered., Results: 144 notifications of occupational exposure were registered across the analysis period, which represented 25% of the total nursing population at the hospital. The physiological and psychic workloads were the most representative, corresponding to 37% and 36%, respectively. These notifications culminated in 1567 days of absenteeism for disease treatment., Conclusions: the findings evidence the impact of occupational illnesses on the absenteeism of nursing workers, and can be used to demonstrate the importance of institutional investments in occupational health surveillance.

Background: Scientific publications focusing on the results of pancreatic resections in Brazil are scarce., Aim: To present the surgical results of pancreatic resections., Methods: Were analyzed prospectively 54 consecutive cases of patients undergoing consecutive pancreatectomy evaluating the occurrence of postoperative complications (pancreatic fistula, delayed gastric emptying and postoperative hemorrhage) based on the criteria of the International Study Group on Pancreatic Fistula Definition and International Study Group of Pancreatic Surgery., Results: Of the 54 pancreatectomy, 32 occurred in women (59,26%) and 22 in men (40,74%). The mean age of patients was 54,5 years. The most performed procedure was the Whipple operation, in 38 patients. In eight of those cases, mesenteric-portal confluence was ressected. The mean period of hospitalization was 20,7 days. The hospitalization in 51% of patients was up to 10 days. A pancreatic fistula was observed in 50% of the cases submitted to the Whipple surgery. The postoperative hemorrhage and delayed gastric emptying in patients undergoing the surgery occurred respectively in 13,15% and 18,41%. The overall morbidity and mortality was respectively 62.9% and 5.5%., Conclusion: There is a need for the national publications to assimilate the concepts and criteria presented by the ISGFP(2) and ISGPS(23,25) to enable comparison of the results obtained with surgical treatment of pancreatic disorders, in the Brazilian context. Who knows, therefore, whether the great advanced seen in the last 40 years in terms of the reduction in mortality rates associated with pancreatic resections may also occur with the persistently high levels of postoperative complications.

The study aims to understand the occupational risks as symbolic processes that shapes the daily activities of health professionals that manipulate sharps objects. Descriptive research was conducted at a university hospital, with information collected through the survey on the accidents at work in Intensive Care and hospital laundry, with the application of 105 questionnaires. The information was analyzed through an interdisciplinary perspective, and enabled the conciliation of quantitative and qualitative analysis. The results revealed that although the number of accidents is low, it is still necessary to improve the instruments such as the risk map, the use of safety equipment and staff training.

Objective: To describe alterations in spirometric variables and its disturbances and to study the existence of a relationship between extent of the residual lung lesion at the end of treatment for tuberculosis and alteration of the lung function measured by spirometry., Methods: Analyzed were 96 patients with diagnosis of pulmonary tuberculosis, treated in three health centers in the metropolitan area of Recife, from January, 2003 to November, 2005. Patients of both genders, 15 years of age or older were included, whose chest x-rays at end of the treatment were classified according to criteria of the National Tuberculosis Association (NTA) for extent of lung lesion. Patients replied to a questionnaire at the beginning of the survey, and were submitted to spirometry after conclusion of treatment., Results: Of the 96 patients, 89.6% presented with radiographic sequels. About 54% had moderate to severe sequels. These radiographic alterations correspond to 24.6% and 73.8% respectively of alterations in the pulmonary function., Conclusion: The large number of residual radiographic lesionss (89.6%) and breathing dysfunction (66,7%) identified in this survey call attention to the fact that treatment of a patient with pulmonary tuberculosis must not be restricted to bacteriological healing of the disease. Identification of the residual lung lesions and of the breathing dysfunction in patients who conclude treatment will promote early actions to treat these sequels, improving the quality of life of these patients.

In Brazil, research is scarce on multiple disabilities and hearing disability in particular. Researchers began a pioneering study in 1992, evaluating students from public special education programs, currently focused on hearing disability. The authors evaluated 232 students ranging from 1 to 39 years of age (mean 10.9 years), with male gender prevailing. Consanguinity was present in 7.6% and a family history of deafness in 19%. Gestational complications were recorded in 33% of cases. Normal labor occurred in 72%, and delivery at term in 75%. Neonatal complications were present in 35% of the sample. Environmental causes accounted for 56% of the sample, genetic causes 20.7%, and the remaining 20.7% were classified as idiopathic. The current findings corroborate those from the literature. We believe that this study can spark greater concern for the hearing-disabled and that through increased knowledge of this group's characteristics it may foster strategies to facilitate interaction with society as a whole.

Objective: To determine the clinical profile of CMV colitis in AIDS patients, comparing clinical, endoscopic parameters and survival time between 2 groups of AIDS patients having chronic diarrhea. Group A being CMV colitis and group B without CMV colitis., Methods: 48 patients with diarrhea that lasted more than 30 days, being 27 in Group A and 21 in Group B, were studied. Age, risk factors, interval time between the diagnosis of HIV infection and the beginning of diarrhea, hematochesia, the endoscopic findings and life table in both groups, were analysed. All of them were diagnosed by stool culture and stools for ovum and parasites, along colonoscopy with biopsies. The unpaired t test was used to assess statistical significance of differences observed in the means of continuous and the chi-square with Yates correction for non-parametric variables. The survival curves were assessed by the Kaplan-Meier and the Mantel-Haenszel's tests. A P value of less than 0,05 was considered to indicate statistical significance., Results: The mucosal lesions associated with the CMV infection are typically ulcerative on a background of hemorrhagic erythema 14 (51,8%) p < 0,01. The life table analysis disclosed shorter survival time in the CMV colitis group 0,005> P>0,001. The others studied data did not achieve statistical significance., Conclusions: AIDS patients with CMV colitis have a poorer long-term survival. Among the colonoscopic findings, ulcerations with hemorrhagic background were the most common lesions.

The factors leading to high postoperative mortality in active infectious endocarditis (IE) are poorly defined. We studied patients operated at an University Hospital between March 1978 and April 1992. We hypothesized that the summation of potential adverse factors would strongly increase mortality after surgery. We studied 39 patients (28 men), age range 13-70 years (mean +/- SD = 32 +/- 16) operated during active IE (time from onset 52 +/- 48 days). Predisposing factor: rheumatic valvar disease in 14 cases, intravenous drug use in 5. Affected valves: aortic in 14, mitral in 10, tricuspid in 8, multiple structures in 7. In most cases, S aureus (12) or Streptococcus sp (10) was isolated in blood cultures. Surgery was indicated in most patients because of heart failure (30), multiple embolic complications (17) or treatment failure (14). The possible adverse influence of specific demographic characteristics, clinical features and surgical variables was assessed by the Student t test or the chi 2 test. Also, multiple regression analysis was performed in order to identify independent adverse factors for increased mortality. Positive correlations were further investigated with the chi 2 test to assess whether an increasing number of adverse factors could identify a special subset of patients with markedly elevated death risk. Fourteen patients (36%) died after surgery. Emergency surgery (p = 0.001), the presence of coma 6 hours after surgery (p = 0.0015) and S. aureus infection (p = 0.023) were all associated with increased mortality. The presence of neurological complications was correlated with a high mortality (54% vs. 27%). However this increase was of dubious statistical significance (p = 0.097). Multiple regression analysis confirmed S. aureus and emergency surgery as independent adverse factors for increased mortality. When put together, an increasing number of adverse factors was highly predictive of a fatal outcome, even after exclusion of that evaluated after surgery (level of consciousness). Patients with two or three adverse factors had a very high mortality rate (> 76.9%). Mortality following surgery for active IE is increased in patients operated on an emergency basis especially if the infection is caused by S. aureus. The presence of neurological complications may also be associated with worse outcome. Early consideration of surgery should reduce the high mortality in patients with active IE.