ABSTRACT
ABSTRACT CONTEXT AND OBJECTIVE: Many researchers have suggested that aspirin prevents migraines. However, the evidence is unclear. The aim of this study was to analyze the available evidence on the effect of aspirin as a migraine prophylactic. DESIGN AND SETTING: Systematic review, conducted at the Pontifícia Universidade Católica do Paraná, Brazil, and at the University of São Paulo, Brazil. METHODS: We performed electronic searches in the databases of MEDLINE/PubMed, Embase, WEB OF SCIENCE, the World Health Organization, CENTRAL and OpenGrey, and we also searched manually for interventional studies published before April 2016 that compared the effects of aspirin with a control, in adults. Two authors independently extracted data on the publication, population recruited, intervention (aspirin dosage, follow-up and combined treatment) and main outcomes (frequency, severity and duration of migraine). We evaluated the quality of the studies using the Cochrane risk-of-bias tool. RESULTS: Our search retrieved 1,098 references, of which 8 met the selection criteria for this systematic review. The total population was 28,326 participants (18-64 years old); most (96%) were men. The dosage varied from 50 to 650 mg/day across the studies. The risk of bias was generally low or unclear. The only outcome for which most of the studies included (6/8) reported a significant reduction was frequency of migraine, which was reduced at an aspirin dosage of at least 325 mg/day. CONCLUSION: Aspirin can reduce the frequency of migraines. However, the optimal dosage is unclear.
RESUMO CONTEXTO E OBJETIVO: Muitos pesquisadores têm sugerido que a aspirina previne enxaquecas. No entanto, a evidência não é clara. O objetivo deste estudo foi analisar as evidências disponíveis para os efeitos da aspirina como um profilático da enxaqueca. DESENHO E LOCAL: Revisão sistemática, realizada na Pontifícia Universidade Católica do Paraná, Brasil, bem como na Universidade de São Paulo, Brasil. MÉTODOS: Foram realizadas buscas eletrônicas nas bases de dados MEDLINE/PubMed, Embase, WEB OF SCIENCE, Organização Mundial de Saúde, CENTRAL e OpenGrey. Nós buscamos manualmente estudos de intervenção publicados antes de abril de 2016, comparando efeitos da aspirina com um controle em adultos. Dois autores extraíram independentemente os dados de publicação, população recrutada, intervenção (dose de aspirina, acompanhamento e tratamento combinado) e os resultados principais (frequência, gravidade e duração da enxaqueca). Foi avaliada a qualidade dos estudos com a ferramenta da Cochrane para risco de viés. RESULTADOS: A nossa busca recuperou 1.098 referências, das quais 8 preencheram os critérios de seleção para esta revisão sistemática. A população total foi de 28,326 participantes (18-64 anos); a maioria (96%) de homens. A dosagem variou entre 50 a 650 mg/dia em todos os estudos. O risco de viés foi geralmente baixo ou pouco claro. O único desfecho para o qual a maioria dos estudos incluídos (6/8) relatou redução significativa foi a frequência de enxaqueca, que foi reduzida com uma dose de aspirina de pelo menos 325 mg/dia. CONCLUSÃO: A aspirina pode reduzir a frequência das enxaquecas; no entanto, a dosagem ideal não é clara.
Subject(s)
Humans , Male , Female , Platelet Aggregation Inhibitors/administration & dosage , Aspirin/administration & dosage , Migraine Disorders/prevention & controlABSTRACT
Abstract: Background: Psoriasis is a chronic inflammatory skin disease that often progresses with nail alterations. It is suspected that there is a correlation between nail psoriasis and enthesitis of the distal interphalangeal joint, seeming to serve as a predictor. Objectives: To analyze the profile of patients with nail psoriasis and correlate the presence of nail alterations with psoriatic arthritis, quality of life, extent of psoriasis and the histopathology of the nail. Methods: An observational cross-sectional study with 40 patients with a diagnosis of psoriasis and without systemic treatment. The patient profile was researched, including quality of life and evaluated for the presence of psoriatic arthritis. The severity of the skin psoriasis and the presence of nail lesions were evaluated. Nail fragments were collected and analyzed through clipping. It obtained 100% of positivity for psoriasis in the histopathology exam of the nail plate. Results: Of the 40 patients, 65% were diagnosed with nail psoriasis. Suggestive findings of psoriatic arthritis in hands were present in 33%, being more frequent in those with nail alteration (p = 0.01). In 92.3% of patients diagnosed with psoriatic arthritis in the hands there was some nail injury. The most frequent injuries were pitting and onycholysis. Conclusions: Patients with nail psoriasis are usually men, with worse quality of life and higher chance of psoriatic arthritis. The correlation between the nail involvement of psoriasis and psoriatic arthritis in hands confirms the association between these two forms. The clinical diagnosis of nail psoriasis did not correlate with the histological diagnosis.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psoriasis/epidemiology , Nail Diseases/epidemiology , Parakeratosis/pathology , Psoriasis/pathology , Quality of Life , Severity of Illness Index , Brazil/epidemiology , Arthritis, Psoriatic/complications , Arthritis, Psoriatic/epidemiology , Incidence , Cross-Sectional Studies , Sex Distribution , Onycholysis/epidemiology , Hospitals, University/statistics & numerical data , Nail Diseases/pathologyABSTRACT
Avaliar a qualidade de vida de pacientes em até um ano após episódio de IAM. Estudo retrospectivo por meio de pesquisa de campo e coleta de dados dos prontuários de pacientes que deram entrada no pronto atendimento do Hospital Vita Batel de Curitiba com diagnóstico de IAM, no período de julho a dezembro de 2011. A avaliação da qualidade de vida foi feita por meio do questionário Mac New QLMI. Os dados foram descritos por variáveis qualitativas e quantitativas. Foi considerado como significância estatística valores de p<0,05. Foram avaliados 25 pacientes, com média de idade de 54 ± 13 anos, 68% do gênero masculino e 68% hipertensos. Considerando o escore de qualidade de vida (QV) global, a média foi de 5,4 ± 1,1 pontos. Pacientes hipertensos têm QV global significativamente pior do que pacientes normotensos (p=0,043). Na avaliação da QV separada categoricamente, a presença hipertensão também mostrou-se associada a piores escores de QV psicológica e física, com valores de p = 0,019 e 0,037, respectivamente. Da mesma forma, foi observado escores de QV social significativamente menores em mulheres (p=0,049), embora essa diferença não tenha sido detectada para as demais esferas da QV. Não houve impacto na QV dependente da idade, presença de dislipidemia ou tipo de tratamento realizado para o IAM. Conclui-se que a piora da QV de pacientes pós-IAM pode estar relacionada à presença de hipertensão arterial. Também é importante ressaltar que as mulheres apresentam maior prejuízo quanto à QV social. Mais estudos devem ser realizados, em busca de outros fatores que possam modificar a QV desses pacientes
The aim of this study is to evaluate the quality of life of patients within one year after an episode of AMI. Retrospective study through field research and data collection from medical records of patients admitted in the emergency room of the Hospital VitaBatel in Curitiba with AMI in the period July-December 2011. The assessment of quality of life was made through the questionnaire Mac New QLMI. The data were described by qualitative and quantitative variables. It was considered statistically significant p values <0.05.We evaluated 25 patients with a mean age of 54 ± 13 years, 68% male and 68% were hypertensive. Considering the overal score of quality of life (QoL) l, the average was 5.4 ± 1.1 points. Hypertensive patients have significantly worse overall QOL than normotensive patients (p = 0.043). QOL evaluation categorically separeted, also showed the presence of hypertension was associated with worse QoL scores psychological and physical, with values of p = 0.019 and 0.037, respectively. Likewise, it was observed social QoL scores significantly lower in women (p = 0.049), although this difference was not detected for the other spheres of QOL. There was no impact on QoL dependent on age, dyslipidemia, or type of treatment for AMI. It is concluded that the worsening of QoL of patients after AMI may be related to the presence of hypertension. It is also important to note that women have more social prejudice regarding QOL. More studies should be performed in search of other factors that will influence the QoL of these patients