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Master's Dissertation
DOI
10.11606/D.6.2007.tde-06112007-205024
Document
Author
Full name
Mônica Tilli Reis Pessôa Conde
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2007
Supervisor
Committee
Waldman, Eliseu Alves (President)
Luna, Expedito José de Albuquerque
Oliveira, Acary Souza Bulle
Title in Portuguese
Síndrome pós-poliomielite: aspectos epidemiológicos e prognósticos
Keywords in Portuguese
Epidemiologia
Poliomielite
Síndrome pós-poliomielite
Abstract in Portuguese
Objetivos: Descrever aspectos clínicos e epidemiológicos da síndrome pós-poliomielite (SPP) e fatores associados, bem como suas repercussões na capacidade funcional e à sua gravidade. Métodos: Estudo descritivo de série de casos e fatores prognósticos da SPP, em população de pacientes com diagnóstico de SPP acompanhados no Ambulatório de Doenças Neuromusculares da Universidade Federal de São Paulo. A definição de caso utilizada foi história prévia de poliomielite, período de estabilidade funcional maior ou igual a 15 anos, presença de nova fraqueza muscular por período maior de 1 ano e a exclusão de outras enfermidades que pudessem afetar a força muscular. A descrição da doença foi efetuada segundo aspectos relativos ao tempo, espaço e pessoa. A associação entre formas graves e exposições de interesse foi investigada pelas estimativas não ajustadas e ajustadas da odds ratio, com os respectivos intervalos de confiança de 95%, usando regressão logística não condicional. Resultados: Dos 132 casos de SPP estudados, 63,6% eram do sexo feminino; a mediana da idade foi de 45,5 anos. A mediana da idade da poliomielite aguda foi de 17 meses, do período de recuperação funcional foi de 3,0 anos e do período de estabilidade funcional 33,7 anos; 50,4% foram considerados graves. Mostraram-se independentemente associados à gravidade: período de recuperação neurológica e funcional máximo menor e igual a 4 anos (OR= 2,8;IC95%:1,2-6,7), seqüela crônica de dois membros (OR=3,6;IC95%:1,5-8,7) e ter residido na época da poliomielite aguda em município com acesso a assistência médica de maior complexidade (OR=2,5;IC95%:1,15,6).Conclusões: A alta proporção de casos graves e as perdas funcionais dos pacientes com SPP no Brasil indicam a necessidade de políticas públicas focalizando o problema.
Title in English
Post-polio syndrome: epidemiological and prognostic aspects
Keywords in English
Epidemiology
Poliomyelitis
post-poliomyelitis syndrome
Abstract in English
Objectives: To describe the clinical and epidemiological aspects of post-poliomyelitis syndrome (PPS) and associated factors, and repercussions on functional capacity and severity. Methods: A descriptive study of cases series and prognostic factors was undertaken, including PPS patients from Neuromuscular Diseases Outpatients Clinic of the Federal University of São Paulo. The case definition used was a previous history of poliomyelitis with a period of functional stability more than or equal 15 years and presence of new muscle weakness lasting greater than 1 year, after ruling out other diseases that affect the muscle strength. The disease was described in terms of time, space and personal characteristics. Associations between severe forms and exposures of interest were investigated by calculating unadjusted and adjusted odds ratios, with respective 95% confidence intervals, using unconditional logistic regression. Results: The median age of the 132 PPS cases studied was 45.5 years and 63.6% were women. The median age when poliomyelitis was contracted was 17 months, median time taken to achieve maximum functional recovery was 3.0 years and median length of time with functional stability was 33.7 years; 50.4% were considered severe. Factors independently associated with severity: neurological and maximum functional recovery period less than or equal 4 years (OR= 2.8; 95%CI:1.26.7), permanent sequelae in two limbs (OR=3,6;95%CI:1,5-8,7) and having lived at the time of acute poliomyelitis in a municipality with access to higher-complexity medical care (OR=2,5;95%CI:1,15,6). Conclusions: The high proportion of severe cases and losses of functional capacity among PPS patients in Brazil indicate the need for public policies focusing on this problem.
 
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Publishing Date
2007-11-09
 
WARNING: The material described below relates to works resulting from this thesis or dissertation. The contents of these works are the author's responsibility.
  • CONDE, M. T. R. P., et al. Post-polio syndrome: epidemiologic and prognostic aspects in Brazil [doi:10.1111/j.1600-0404.2008.01142.x]. Acta Neurologica Scandinavica [online], 2009, vol. 120, p. 190-197.
  • CONDE, Monica TRP, et al. Post-polio syndrome: epidemiologic and prognostic aspects in Brazil. Acta Neurologica Scandinavica, 2009, vol. 120, p. 191-197.
  • CONDE, M. T. R. P., et al. Aspectos prognósticos da Síndrome Pós-Poliomielite no Brasil. In XVIII Congresso Mundial de Epidemiologia e VII Congresso Brasileiro de Epidemiologia, Porto Alegre - RGS, 2008. Revista Brasileira de Epidemiologia.São Paulo : ABRASCO, 2008. Resumo.
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