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1.
Demetra (Rio J.) ; 15(1): e39815, jan.- mar.2020. tab
Article in English, Portuguese | LILACS (Americas) | ID: biblio-1096034

ABSTRACT

A obesidade é um grave e crescente problema de saúde pública, e está associada ao aumento de comorbidades e diminuição da qualidade de vida. Este trabalho tem como objetivo avaliar a percepção sobre a qualidade de vida de usuários do Centro de Referência em Obesidade (CRO) da unidade de Acari, Rio de Janeiro, em dois momentos: antes e durante o tratamento para obesidade grave. O protocolo de acompanhamento dos usuários do CRO inclui a avaliação da qualidade de vida, usando o questionário SF-36. Foram selecionados 58 prontuários de usuários com obesidade grau III, de ambos os sexos, que entraram no serviço entre agosto de 2012 e dezembro de 2016, e que possuíam dois questionários SF-36 preenchidos. Descreveram-se a média e o desvio padrão para as variáveis contínuas, e as frequências de variáveis categóricas. Para comparar a evolução dos escores de qualidade de vida, para as variáveis com distribuição paramétrica foi realizado o teste T pareado, e para as variáveis com distribuição não paramétrica, o teste de Wilcoxon. Utilizou-se para a análise dos dados o programa Statistical Package for the Social Science (SPSS), versão 19. Os resultados dos dois questionários foram analisados e comparados. Os oito domínios (aspectos físicos, capacidade funcional, estado geral de saúde, dor, vitalidade, aspectos sociais, aspectos emocionais e saúde mental) apresentaram escores maiores na segunda aplicação do SF-36 (p<0,05), ou seja, houve melhoria da percepção da qualidade de vida em todos os domínios avaliados pelo instrumento, o que parece apontar o impacto positivo do modelo de cuidado multidisciplinar experimentado pelo serviço. (AU)


Obesity is a serious public health problem that has grown in recent years and is associated with increased comorbidities and decreased quality of life. This study aims to evaluate the perception about the quality of life of users of the Reference Center for Obesity of Acari, in the municipality of Rio de Janeiro, at two different times: before and during the treatment. The follow-up protocol of the users of the Reference Center for Obesity includes a quality of life assessment using the SF-36 questionnaire. A total of 58 medical records were selected for male and female patients with morbid obesity who started using the service from August 2012 to December 2016 and who had completed two SF-36 questionnaires. The mean and standard deviation for the continuous variables and the frequencies of categorical variables were described. To compare the evolution of the quality of life scores, the paired T-test and the Wilcoxon test were used for the variables with parametric distribution and the variables with non-parametric distribution, respectively. The Statistical Package for Social Science (SPSS), version 19, was used for data analysis. The results were analyzed statistically and compared between the first and second questionnaire. The eight domains had a higher score in the second application of the SF-36 (role-physical, physical functioning, general health perception, bodily pain, vitality, social functioning, role-emotional and mental health) (p <0.05). The study showed the importance of multidisciplinary health care and its positive impact on the quality of life of individuals with obesity. (AU)


Subject(s)
Humans , Male , Female , Primary Health Care , Obesity , Quality of Life , Statistics, Nonparametric , Obesity Management
2.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 68-71, Jan.-Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055368

ABSTRACT

Objective: Circadian dysregulation plays an important role in the etiology of mood disorders. Evening chronotype is frequent in these patients. However, prospective studies about the influence of chronotype on mood symptoms have reached unclear conclusions in patients with bipolar disorder (BD). The objective of this study was to investigate relationship between chronotype and prognostic factors for BD. Methods: At the baseline, 80 euthymic BD patients answered a demographic questionnaire and clinical scales to evaluate anxiety, functioning and chronotype. Circadian preference was measured using the Morningness-Eveningness Questionnaire, in which lower scores indicate eveningness. Mood episodes and hospitalizations were evaluated monthly for 18 months. Results: Among the BD patients, 14 (17.5%) were definitely morning type, 35 (43.8%), moderately morning, 27 (33.7%) intermediate (neither) and 4 (5%) moderately evening. Eveningness was associated with obesity or overweight (p = 0.03), greater anxiety (p = 0.002) and better functioning (p = 0.01), as well as with mood episodes (p = 0.04), but not with psychiatric hospitalizations (p = 0.82). This group tended toward depressive episodes (p = 0.06), but not (hypo)mania (p = 0.56). Conclusion: This study indicated that evening chronotype predicts a poor prognostic for BD. It reinforces the relevance of treating rhythm disruptions even during euthymia to improve patient quality of life and prevent mood episodes.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Anxiety/physiopathology , Bipolar Disorder/physiopathology , Circadian Rhythm/physiology , Prognosis , Psychiatric Status Rating Scales , Quality of Life , Time Factors , Logistic Models , Prospective Studies , Surveys and Questionnaires , Statistics, Nonparametric , Chronobiology Disorders/physiopathology , Hospitalization/statistics & numerical data , Middle Aged
3.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 54-62, Jan.-Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055351

ABSTRACT

Objective: Although studies have shown an association between poor sleep and chronotype with psychiatric problems in young adults, few have focused on identifying multiple concomitant risk factors. Methods: We assessed depressive symptoms (Beck Depression Inventory [BDI]), circadian typology (Morningness-Eveningness Questionnaire [MEQ]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), perceived stress (Perceived Stress Scale [PSS]), social rhythm (Social Rhythm Metrics [SRM]), and salivary cortisol (morning, evening and night, n=37) in 236 men (all 18 years old). Separate analyses were conducted to understand how each PSQI domain was associated with depressive symptoms. Results: Depressive symptoms were more prevalent in individuals with higher perceived stress (prevalence ratio [PR] = 6.429, p < 0.001), evening types (PR = 2.58, p < 0.001) and poor sleepers (PR = 1.808, p = 0.046). Multivariate modeling showed that these three variables were independently associated with depressive symptoms (all p < 0.05). The PSQI items subjective sleep quality and sleep disturbances were significantly more prevalent in individuals with depressive symptoms (PR = 2.210, p = 0.009 and PR = 2.198, p = 0.008). Lower levels of morning cortisol were significantly associated with higher depressive scores (r = -0.335; p = 0.043). Conclusion: It is important to evaluate multiple factors related to sleep and chronotype in youth depression studies, since this can provide important tools for comprehending and managing mental health problems.


Subject(s)
Humans , Male , Adolescent , Sleep Wake Disorders/psychology , Stress, Psychological/psychology , Hydrocortisone/analysis , Chronobiology Disorders/psychology , Depression/etiology , Military Personnel/psychology , Psychiatric Status Rating Scales , Reference Values , Saliva/metabolism , Sleep/physiology , Time Factors , Multivariate Analysis , Risk Factors , Analysis of Variance , Statistics, Nonparametric , Depression/metabolism , Self Report
4.
Arch. Clin. Psychiatry (Impr.) ; 47(1): 1-6, Jan.-Feb. 2020. tab
Article in English | LILACS (Americas) | ID: biblio-1088742

ABSTRACT

Abstract Background Obsessive-compulsive disorder is a challenging disease in terms of remission rates and treatment approaches. All theoretical approaches are needed for a better understanding. Compared to other theories, it has not been examined sufficiently from the perspective of gestalt theory in the literature. Objective To examine and compare the Gestalt Contact Styles of patients with obsessive-compulsive disorder (OCD) and the Control Group and to examine the relationship between Gestalt Contact Styles and OCD symptoms. Methods 50 OCD patients were compared with the healthy control group. All patients were evaluated with the Yale Brown Obsessive-Compulsive Scale (Y-BOCS), the Padua Inventory (PI), and the Gestalt Contact Styles Scale-Revised Form (GCSS-RF). For the control group, GCSS-RF was applied. Results The scores of the OCD patients for GCSS-RF "Retroflection" and "Deflection" subscales were significantly higher than the Control Group. Statistically significant high scores were found between the subscales of Padua Inventory "contamination obsessions and washing compulsions", "obsessional thoughts", "obsessional impulses" and "checking compulsions" subtypes and Gestalt contact styles in the Patient Group in a symptomatological examined manner. With these findings, in terms of Gestalt Contact Styles, it is seen that the difference between Patient and Control Groups is significantly different. There was no significant relationship between the Yale-Brown total score of the Patient Group and the GCSS-RF subscales. Discussion In conclusion, the findings of the study showed significant differences in terms of Gestalt Contact Styles (Retroflection, Contact, Deflection, Desensitization, Confluence) in Patient and Control Groups and OCD symptoms. These results are important to Gestalt Therapists in terms of shedding light on the therapeutic intervention to be done for an OCD patient and contributing to the literature.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gestalt Therapy/methods , Obsessive-Compulsive Disorder/therapy , Personality Inventory , Projection , Psychiatric Status Rating Scales , Psychometrics/methods , Data Interpretation, Statistical , Statistics, Nonparametric , Feedback, Psychological , Defense Mechanisms , Desensitization, Psychologic/methods , Introversion, Psychological
5.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 33-39, Jan.-Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055365

ABSTRACT

Objective: To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma. Methods: Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients' dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms. Results: The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients. Conclusion: Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.


Subject(s)
Humans , Female , Adult , Young Adult , Pituitary Neoplasms/psychology , Hyperprolactinemia/psychology , Prolactinoma/psychology , Body Dysmorphic Disorders/psychology , Pituitary Neoplasms/blood , Prolactin/blood , Psychiatric Status Rating Scales , Reference Values , Body Image/psychology , Hyperprolactinemia/drug therapy , Hyperprolactinemia/blood , Prolactinoma/blood , Body Mass Index , Surveys and Questionnaires , Statistics, Nonparametric , Dopamine Agonists/therapeutic use , Middle Aged
6.
Rev. Col. Bras. Cir ; 47: e20202374, 2020. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1091926

ABSTRACT

RESUMO Objetivo: A pneumonia necrosante (PNS) é uma grave e rara complicação da pneumonia adquirida na comunidade, acometendo principalmente crianças, sendo assim, objetivamos analisar prontuários de crianças submetidas ao tratamento cirúrgico de PNS e comparação dos resultados obtidos com os presentes na literatura médica. Métodos: Análise retrospectiva dos prontuários de crianças submetidas ao tratamento cirúrgico por PNS entre julho de 2006 a julho de 2016 em dois hospitais do sul de Santa Catarina, Brasil. Resultados: Do total de 26 crianças, com mediana de idade 2,70 anos, maioria mulheres (61,5%). Os principais sintomas foram febre (88,5%) e tosse (65,4%). Houve média de 4,31 antibióticos utilizados por paciente. O principal agente etiológico foi o Staphylococcus aureus (23,1%) mas as culturas foram negativas em 69% dos pacientes. Em 23 pacientes realizou-se decorticação e desbridamento das áreas necróticas (88,5%). A média de drenagem pleural pós-operatória foi 8,12 dias. Fístula broncopleural ocorreu em 50,0% no pré-operatório e 46,2% após a cirurgia. O tempo total de internação hospitalar foi, em média, de 27,52 dias e tempo pós-operatório com média de 12,60 dias. Complicações pós-operatórias ocorreram em 13 crianças e não houve mortalidade. Conclusões: Propõe-se abordagem cirúrgica nos pacientes sem resposta ao tratamento clínico, pois o atraso na intervenção cirúrgica associa-se a infecção progressiva no parênquima pulmonar e taxas maiores de complicações. A cirurgia pode conduzir a melhor evolução clínica e recuperação mais precoce.


ABSTRACT Objective: Necrotizing pneumonia (PNZ) is a severe and rare complication of a community-acquired pneumonia, affecting mainly children. We aimed to analyze medical records of children undergoing surgical treatment for PNZ and compare our results with those found in the medical literature. Methods: Retrospective analysis of children's medical charts who underwent an operation for PNZ, between July 2006 and July 2016, in two hospitals in southern Santa Catarina, Brazil. Results: A total of 26 children with a median age of 2.70 years and mostly females (61.5%) were included in the current study. The main symptoms were fever (88.5%) and cough (65.4%). There was an average use of 4.31 antibiotics per patient. The primary etiological agent was Staphylococcus aureus (23.1%), but cultures were negative in 69% of the patients. Decortication and debridement of necrotic areas were performed in 23 patients (88.5%). The mean postoperative pleural drainage was 8.12 days. The presence of bronchopleural fistula occurred in 50.0% in the preoperative period and 46.2% in the postoperative. The total length of hospital stay was, on average, 27.52 days and the postoperative length of stay was 12.60 days (mean). Postoperative complications occurred in 13 children and there was no mortality. Conclusion: The surgical approach is indicated to patients with no response to clinical treatment. Late surgical intervention is associated with progressive parenchyma infection and higher rates of complications. Surgery can lead to better clinical outcomes and earlier recovery.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Postoperative Complications , Oxacillin/therapeutic use , Time Factors , Ceftriaxone/therapeutic use , Vancomycin/therapeutic use , Drainage/methods , Medical Records , Cross-Sectional Studies , Retrospective Studies , Treatment Outcome , Community-Acquired Infections/surgery , Statistics, Nonparametric , Pneumonia, Necrotizing/surgery , Length of Stay , Anti-Bacterial Agents/therapeutic use
7.
Rev. Ciênc. Plur ; 6(2): 101-112, 2020. tab
Article in Portuguese | LILACS (Americas), BBO | ID: biblio-1100314

ABSTRACT

Introdução:Oclareamento dental é o procedimento estético mais realizado nos consultórios odontológicos. O uso de fontes luminosas tem sido recomendado para acelerar a ação do gel clareador, entretanto evidências científicas são controversas no que se diz respeito a essas fontes.Objetivo:Avaliar protocolos de clareamento dentário modificados por fontes luminosas, objetivando verificar, qual a influência dessas fontes no procedimento de clareamento dentário.Metodologia:Sendo essa, uma pesquisa que utilizou material biológico, a mesma foi submetida e aprovada pelo Comitê de Ética em Pesquisa da UEPB. Realizou-se a obtenção de dentes(n = 20)por meio de parceria com o Banco de Dentes Humanos do curso de Odontologia da UEPB Campus VIII. Posteriormente realizou-se identificação dos dentes, em seguida registro inicial da cor do dente(escala VITA), o preparo dos blocos dentários e seleção dos grupos. Os dentes foram submetidos a dois protocolos de clareamentos distintos, com luz halógena e com LED, com ou sem troca do gel. Por fim, realizada a análise estatística. Resultados:A modificação do protocolo, seja quanto o tempo de aplicação do agente clareador, seja quanto à fonte de luz utilizada, alcança resultados satisfatórios. Houve diferença estatisticamente significativa entre os gruposda luz halógena (p = 0.041)Conclusões:Tendo em vista os resultados e a discussão encontrados na pesquisa, podemos verificar que as evidências científicas nos levam a observar que não há bases suficientes que comprovem a eficácia e benefícios a curto prazo da modificação dos protocolos de clareamento dental pelas fontes luminosas (AU).


Introduction:Tooth whitening is the most common cosmetic procedure performed in dental offices. The use of light sources has been recommended to accelerate the action of the whitening gel;however scientific evidence is controversial regardingthese sources.Objective:Evaluate tooth whitening protocols modified by light sources, aiming to verify, what is the influence of these sources in the tooth whitening procedure. Methodology:This being a research that used biological material, it was submitted and approved by theResearch Ethics Committee of UEPB. Teeth (n = 20) were obtained through a partnership with the Human Teeth Bank of the Dentistry course at UEPB Campus VIII. Subsequently, teeth identification was performed, followed by initial registration of tooth color(VITA scale), preparation of dental blocks and selection of groups. The teeth were submitted to two different whitening protocols, with halogen light and with LED, with or without changing the gel. Finally, statistical analysis was performed. Results:Themodification of the protocol, both in terms of the application time of the bleaching agent and in terms of the light source used, achieves satisfactory results. There was statistically significant difference between groupswith halogen light (p = 0.041). Conclusions:In view of the results and the discussion found in the research, we can see that the scientific evidence leads us to observe that there are not enough bases to prove the effectiveness and short-term benefits of modifying the teeth whitening protocols by light sources (AU).


Introducción: El blanqueamiento dental es el procedimiento cosmético más común que se realiza en consultorios dentales. Se ha recomendado el uso de fuentesde luz para acelerar la acción del gel blanqueador, sin embargo, la evidencia científica es controvertida con respecto a estas fuentes.Objetivo: Evaluar los protocolos de blanqueamiento dental modificados por fuentes de luz, con el objetivo de verificar cuál es la influencia de estas fuentes en el procedimiento de blanqueamiento dental. Metodología: Al tratarse de una investigación que utilizó material biológico, fue presentada y aprobada por el Comité de Ética en Investigación de la UEPB. Los dientes (n = 20) se obtuvieron a través de una asociación con el Banco de Dientes Humanos del curso de Odontología en el Campus VIII de la UEPB. Posteriormente, se realizó la identificación de los dientes, seguida del registro inicial del color del diente(escala VITA), la preparación de los bloques dentales y la selección de grupos. Los dientes fueron sometidos a dos protocolos diferentes de blanqueamiento, con luz halógena y con LED, con o sin cambiar el gel. Finalmente, se realizó un análisis estadístico. Resultados: La modificación del protocolo, tanto en términos del tiempo de aplicación del agente blanqueador como en términos de la fuente de luz utilizada, logra resultados satisfactorios. Hubo diferencias estadísticamente significativas entre los gruposcom luz halógena (p =0.041).Conclusiones: En vista de los resultados y la discusión encontrada en la investigación, podemos ver que la evidencia científica nos lleva a observar que no hay suficientes bases para probar la efectividad y los beneficios a corto plazo de modificar los protocolos de blanqueamiento dental por fuentes de luz (AU).


Subject(s)
Humans , Tooth Bleaching/methods , Clinical Protocols , Hydrogen Peroxide , Lasers , Light , Brazil , Statistics, Nonparametric , Molar
8.
Prensa méd. argent ; 105(11): 842-848, dic2019.
Article in English | LILACS (Americas), BINACIS | ID: biblio-1050053

ABSTRACT

To improve the comorbid families behavior, knowledge, and attitudes about evidencebased options, we undertook an educational intervention. In current study, we evaluated the knowledge and attitude of the comorbid families about family planning option s pre and post informing program. the knowledge and attitudes of the comorbid families about family planning options pre and post educational intervention, from Feb -2015 to April-2016. This is a pre-post intervention survey analysis of seventy-six monogamous married couples. Couples were sequentially enrolled if they met inclusion criteria of harboring comorbidities when seeking family planning services. we evaluated the participants by using a questionnaire based on health belief model prior to and fo llowing the educational intervention. Education sessions incloude an educational video programme and a question and answer parts. For analyzing our data was used c hi-square, paired t-test, Spearma n and Pearson's correlation coefficient. Directed family planning education to couples with comorbidities significantly altered their attitude and knowledge. Counseling led to more informed choice behavior about family planning methods,by prioritizing permanent methods of vasectomy versus tubal ligation, especially after the education intervention (P<0.005). Family planning education and counseling directed to couples with multiple comorbidit ies should be a priority in health centers as because the appropriate contraceptive choice will improve their health literacy and outcomes


Subject(s)
Humans , Male , Female , Comorbidity , Surveys and Questionnaires , Contraception/methods , Educational Measurement , Family Planning (Public Health) , Statistics, Nonparametric
9.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(6): 479-484, Nov.-Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055343

ABSTRACT

Objective: The relationship between biomarkers of amyloid-beta aggregation (Aβ1-42) and/or neurodegeneration (Tau protein) in cerebrospinal fluid (CSF) and cognitive decline is still unclear. We aimed to ascertain whether CSF biomarkers correlate with cognitive performance in healthy and cognitively impaired subjects, starting from clinical diagnoses. Methods: We tested for correlation between CSF biomarkers and Mini-Mental State Examination (MMSE) scores in 208 subjects: 54 healthy controls, 82 with mild cognitive impairment (MCI), 46 with Alzheimer's disease (AD), and 26 with other dementias (OD). Results: MMSE correlated weakly with all CSF biomarkers in the overall sample (r = 0.242, p < 0.0006). Aβ1-42 and MMSE correlated weakly in MCI (r = 0.247, p = 0.030), and moderately in OD (r = 0.440, p = 0.027). t-Tau showed a weak inverse correlation with MMSE in controls (r = -0.284, p = 0.043) and MCI (r = -0.241, p = 0.036), and a moderate/strong correlation in OD (r = 0.665), p = 0.0003). p-Tau correlated weakly with MMSE in AD (r = -0.343, p = 0.026) and moderately in OD (r = -0.540, p = 0.0005). The Aβ1-42/p-Tau ratio had a moderate/strong correlation with MMSE in OD (r = 0.597, p = 0.001). Conclusion: CSF biomarkers correlated best with cognitive performance in OD. t-Tau correlated weakly with cognition in controls and patients with MCI. In AD, only p-Tau levels correlated with cognitive performance. This pattern, which has been reported previously, seems to indicate that CSF biomarkers might not be reliable as indicators of disease severity.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Peptide Fragments/cerebrospinal fluid , Amyloid beta-Peptides/cerebrospinal fluid , tau Proteins/cerebrospinal fluid , Alzheimer Disease/cerebrospinal fluid , Cognitive Dysfunction/cerebrospinal fluid , Reference Values , Biomarkers/cerebrospinal fluid , Case-Control Studies , Analysis of Variance , Cohort Studies , Statistics, Nonparametric , Alzheimer Disease/psychology , Mental Status and Dementia Tests , Middle Aged
10.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(6): 485-493, Nov.-Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1055347

ABSTRACT

Objective: Cocaine use disorders (CUDs) represent a major public health problem in many countries. To better understand the interaction between the environmental modulations and phenotype, the aim of the present study was to investigate the DNA methylation pattern of CUD patients, who had concomitant cocaine and crack dependence, and healthy controls. Methods: We studied DNA methylation profiles in the peripheral blood of 23 CUD patients and 24 healthy control subjects using the Illumina Infinium HumanMethylation450 BeadChip arrays. Results: Comparison between CUD patients and controls revealed 186 differentially methylated positions (DMPs; adjusted p-value [adjP] < 10-5) related to 152 genes, with a subset of CpGs confirmed by pyrosequencing. DNA methylation patterns discriminated CUD patients and control groups. A gene network approach showed that the EHMT1, EHMT2, MAPK1, MAPK3, MAP2K1, and HDAC5 genes, which are involved in transcription and chromatin regulation cellular signaling pathways, were also associated with cocaine dependence. Conclusion: The investigation of DNA methylation patterns may contribute to a better understanding of the biological mechanisms involved in CUD.


Subject(s)
Humans , Male , Adult , Young Adult , Crack Cocaine , DNA Methylation , Cocaine-Related Disorders/genetics , Cocaine-Related Disorders/blood , Genome-Wide Association Study/methods , Case-Control Studies , Linear Models , Histone-Lysine N-Methyltransferase/genetics , Statistics, Nonparametric , Mitogen-Activated Protein Kinase 1/genetics , MAP Kinase Kinase 1/genetics , Mitogen-Activated Protein Kinase 3/genetics , Gene Regulatory Networks , High-Throughput Nucleotide Sequencing , Histocompatibility Antigens/genetics , Histone Deacetylases/genetics
11.
J. pediatr. (Rio J.) ; 95(6): 674-681, Nov.-Dec. 2019. graf
Article in English | LILACS (Americas) | ID: biblio-1056656

ABSTRACT

ABSTRACT Objective: The objective of this study was to develop and validate a computational tool to assist radiological decisions on necrotizing enterocolitis. Methodology: Patients that exhibited clinical signs and radiographic evidence of Bell's stage 2 or higher were included in the study, resulting in 64 exams. The tool was used to classify localized bowel wall thickening and intestinal pneumatosis using full-width at half-maximum measurements and texture analyses based on wavelet energy decomposition. Radiological findings of suspicious bowel wall thickening and intestinal pneumatosis loops were confirmed by both patient surgery and histopathological analysis. Two experienced radiologists selected an involved bowel and a normal bowel in the same radiography. The full-width at half-maximum and wavelet-based texture feature were then calculated and compared using the Mann-Whitney U test. Specificity, sensibility, positive and negative predictive values were calculated. Results: The full-width at half-maximum results were significantly different between normal and distended loops (median of 10.30 and 15.13, respectively). Horizontal, vertical, and diagonal wavelet energy measurements were evaluated at eight levels of decomposition. Levels 7 and 8 in the horizontal direction presented significant differences. For level 7, median was 0.034 and 0.088 for normal and intestinal pneumatosis groups, respectively, and for level 8 median was 0.19 and 0.34, respectively. Conclusions: The developed tool could detect differences in radiographic findings of bowel wall thickening and IP that are difficult to diagnose, demonstrating the its potential in clinical routine. The tool that was developed in the present study may help physicians to investigate suspicious bowel loops, thereby considerably improving diagnosis and clinical decisions.


RESUMO Objetivo: O objetivo deste estudo foi desenvolver e validar uma ferramenta computacional para auxiliar as decisões radiológicas na enterocolite necrotizante. Metodologia: Pacientes que exibiam sinais clínicos e evidências radiográficas do estágio 2 ou superior de Bell foram incluídos no estudo, que resultou em 64 exames. A ferramenta foi usada para classificar o aumento localizado da espessura da parede intestinal e a pneumatose intestinal com medidas de largura total a meia altura e análises de textura baseadas na decomposição da energia wavelet. Os achados radiológicos de aumento suspeito da espessura da parede intestinal e das alças na pneumatose intestinal foram confirmados pela cirurgia e análise histopatológica do paciente. Dois radiologistas experientes selecionaram um intestino afetado e um intestino normal na mesma radiografia. A largura total a meia altura e a característica da textura baseada em wavelet foram então calculadas e comparadas com o uso do teste U de Mann-Whitney. Foram calculados a especificidade, sensibilidade, valores preditivos positivos e negativos. Resultados: Os resultados da largura total a meia altura foram significativamente diferentes entre a alça normal e a distendida (mediana de 10,30 e 15,13, respectivamente). Medidas de energia wavelet horizontal, vertical e diagonal foram avaliadas em oito níveis de decomposição. Os níveis 7 e 8 na direção horizontal apresentaram diferenças significativas. Para o nível 7, as medianas foram 0,034 e 0,088 para os grupos normal e com pneumatose intestinal, respectivamente, e para o nível 8, as medianas foram 0,19 e 0,34, respectivamente. Conclusões: A ferramenta desenvolvida pode detectar diferenças nos achados radiográficos do aumento da espessura da parede intestinal e PI de difícil diagnóstico, demonstra seu potencial na rotina clínica. A ferramenta desenvolvida no presente estudo pode ajudar os médicos a investigar alças intestinais suspeitas e melhorar consideravelmente o diagnóstico e as decisões clínicas.


Subject(s)
Humans , Infant, Newborn , Enterocolitis, Necrotizing/diagnostic imaging , Infant, Newborn, Diseases/diagnostic imaging , Severity of Illness Index , Image Processing, Computer-Assisted , Software Validation , Radiography, Abdominal , Retrospective Studies , Sensitivity and Specificity , Statistics, Nonparametric , Wavelet Analysis , Intestines/physiopathology
12.
An. bras. dermatol ; 94(6): 658-663, Nov.-Dec. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054887

ABSTRACT

Abstract Background: Palmoplantar pustulosis is considered to be a localized pustular psoriasis confined to the palms and soles. Mutation of the IL36RN gene, encoding interleukin-36 receptor antagonist (IL-36Ra), is associated with generalized pustular psoriasis, but IL36RN mutations in Chinese palmoplantar pustulosis patients have not previously been investigated. Objective: The aim of this study was to evaluate the mutation of IL36RN in Chinese patients with palmoplantar pustulosis. Methods: Fifty-one Han Chinese patients with palmoplantar pustulosis were recruited. All exons and exon-intron boundary sequences of IL36RN were amplified in polymerase chain reactions, and Sanger sequencing of the amplicons was performed. Results: Among the 51 palmoplantar pustulosis patients, four different single-base substitutions were identified in nine patients. The mutations were c.140A>G/p.Asn47Ser in five patients, c.258G>A/p.Met86IIe in two patients, and c.115+6T>C and c.169G>A/p.Val57IIe in one patient each. All mutations were heterozygous. Comparison with the human genome database and reported literature suggested that these variants may not be pathogenic mutations causing palmoplantar pustulosis. Furthermore, there was no difference in disease severity, onset age, or disease duration between patients with these heterozygous IL36RN variants and those without (p > 0.1). Study limitation: Lack of the further evaluation of IL36Ra protein in palmoplantar pustulosis lesions. Conclusions: The four variants of IL36RN identified did not appear to be associated with the specific phenotypes of palmoplantar pustulosis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psoriasis/genetics , Interleukins/genetics , Mutation , Phenotype , Psoriasis/pathology , China , Sequence Analysis, DNA , Statistics, Nonparametric , Asian Continental Ancestry Group/genetics , Amplified Fragment Length Polymorphism Analysis , Genetic Association Studies , Foot Dermatoses/genetics , Foot Dermatoses/pathology , Hand Dermatoses/genetics , Hand Dermatoses/pathology , Heterozygote
13.
Prensa méd. argent ; 105(9 especial): 538-545, oct 2019. graf, fig
Article in English | LILACS (Americas), BINACIS | ID: biblio-1046465

ABSTRACT

The incisive canal and its contents are often subject to intervention in maxillofacial surgery, otorhinolaryngology, and various areas of dentistry. The purpose of this paper is to study the variability of the dimensional and topographic characteristics of the incisive and nasal foramina of the incisive canal depending on the gender, shape, and parameters of the craniofacial complex in the first adult age. The authors have studied the parameters of the craniofacial complex, such as the morphological facial height, the upper morphological facial height, and the morphological facial breadth. They also have determined the Garson facial index and the upper face index. Cone-beam computerized tomography has been used in order to determine the number of foramina of Stensen and incisive foramina, their mesiodistal and vestibulo-lingual diameters, the shape of the incisive foramen; the distance from the incisive foramen to the labial inferior and palatal inferior points of the alveolar process; the distance from the incisive foramen to the central incisors, lateral incisors, canines of the maxilla; the bone density around the incisive canal; the length, shape, and type of incisive canal. Quantitative data were processed by variational statistical methods using the Statistica software package for Windows v 10.0. The significance of differences between groups was assessed using the Kolmogorov- Smirnov criterion at a significance level of p<0.05. It has been discovered that the incisive canal, the nasal and incisive foramina had a pronounced individual variability in size, shape, and topography depending on the gender, shape, the Garson facial index and upper face index, as well as the presence of correlations between the diameters and the number of nasal and incisive foramina. The authors have determined the values of bone tissue density in the area of the nasal and incisive foramina.


Subject(s)
Humans , Adult , Bone Density , Topography , Cephalometry , Statistics, Nonparametric , Cone-Beam Computed Tomography , Incisor/anatomy & histology
14.
An. bras. dermatol ; 94(5): 542-548, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054874

ABSTRACT

Abstract Background There is an obvious need for more prompt and specific biomarkers of bacterial infections in generalized pustular psoriasis patients. Objective The aim of this study was to evaluate the diagnostic properties and define appropriate cut-off values of procalcitonin and C-reactive protein in predicting bacterial infection in generalized pustular psoriasis patients. Methods Sixty-four generalized pustular psoriasis patients hospitalized from June 2014 to May 2017 were included in this retrospective study. The values of procalcitonin, C-reactive protein, details of infection, and other clinical parameters were analyzed. Results Receiver operating characteristic curve analysis generated similar areas (p = 0.051) under the curve for procalcitonin 0.896 (95% CI 0.782-1.000) and C-reactive protein 0.748 (95% CI 0.613-0.883). A cut-off value of 1.50 ng/mL for procalcitonin and 46.75 mg/dL for C-reactive protein gave the best combination of sensitivity (75.0% for procalcitonin, 91.7% for C-reactive protein) and specificity (100% for procalcitonin, 53.8% for C-reactive protein). Procalcitonin was significantly positively correlated with C-reactive protein levels both in the infected (r = 0.843, p = 0.040) and non-infected group (r = 0.799, p = 0.000). Study limitations The sample size and the retrospective design are limitations. Conclusions The serum levels of procalcitonin and C-reactive protein performed equally well to differentiate bacterial infection from non-infection in generalized pustular psoriasis patients. The reference value of procalcitonin and C-reactive protein applied to predicting bacterial infection in most clinical cases may not be suitable for generalized pustular psoriasis patients. C-reactive protein had better diagnostic sensitivity than procalcitonin; however, the specificity of procalcitonin was superior to that of C-reactive protein.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Psoriasis/microbiology , Psoriasis/blood , Bacterial Infections/blood , C-Reactive Protein/analysis , Procalcitonin/blood , Reference Values , Body Temperature , Biomarkers/blood , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Statistics, Nonparametric , Leukocyte Count , Neutrophils
15.
An. bras. dermatol ; 94(5): 553-560, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054873

ABSTRACT

Abstract Background Skin picking disorder is a prevalent disorder frequently comorbid with depression and anxiety, which is underdiagnosed mainly by dermatologists. Assessment of skin picking disorder is based on instruments influenced by the awareness about skin picking disorder and comorbid symptoms. To date, there is no validated instrument for Brazilian individuals nor an instrument to evaluate the severity of skin lesions in an objective way. Objectives Validate the Skin Picking Impact Scale for Brazilian Portuguese and create a photographic measurement to assess skin lesions. Methods The sample was assessed through the Skin Picking Impact Scale translated into Brazilian Portuguese, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Clinical Global Impression Scale. The patients' skin lesions were photographed. Photos were evaluated regarding active excoriation, crust/bleeding, exulceration, and linear lesions. Results There were 63 patients included. The Skin Picking Impact Scale translated into Brazilian Portuguese had good internal consistency (Cronbach's alpha = 0.88), which tests of goodness-of-fit, showing a suitable model. The reliability of photographic measurement was 0.66, with a high internal consistency (Cronbach's alpha = 0.87). Photographic measurement was not correlated with the Skin Picking Impact Scale, the Clinical Global Impression Scale, or comorbid symptoms. Study limitations Lack of a previously validated instrument to evaluate dermatillomania in the Brazilian population for comparison. Conclusion The Skin Picking Impact Scale validated in Brazilian Portuguese is a good instrument to evaluate skin picking disorder. Photographic measurement is a consistent way of assessing skin lesions, but it does not reflect the impact of skin picking disorder on the individual's life.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Skin/injuries , Photography/trends , Self-Injurious Behavior/diagnosis , Self-Injurious Behavior/psychology , Sickness Impact Profile , Psychiatric Status Rating Scales/standards , Socioeconomic Factors , Translations , Severity of Illness Index , Brazil , Reproducibility of Results , Statistics, Nonparametric , Obsessive-Compulsive Disorder
16.
An. bras. dermatol ; 94(5): 532-541, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054868

ABSTRACT

Abstract Background The knowledge of general practitioners about photoprotection is unknown. Objectives To develop and validate an instrument to evaluate the knowledge of general practitioners and pediatricians about photoprotection, gauging the knowledge of these professionals. Methods The study followed the steps: (1) Literature identification and item elaboration related to the theme; (2) Content validation; (3) Apparent validation; (4) Construct validation: internal consistency analysis and discriminatory analysis; (5) Reliability analysis. In Step 4, the instrument was applied to 217 general practitioners and pediatricians who worked in the host city of the study; the scores were compared with dermatologists scores. Results The final instrument had 41 items and showed satisfactory internal consistency (Cronbach's alpha = 0.780), satisfactory reproducibility and good test-retest reliability (good-to-excellent kappa statistic in more than 60% of items). The discriminatory analysis registered a mean score of 54.1 points for dermatologists and 31.1 points for generalists and pediatricians, from a total of 82 possible points, representing a statistically significant difference (p < 0.001). Generalists and pediatricians demonstrated an understanding of the relationship between excessive sun exposure and skin cancer, but they revealed lack of technical information necessary for their professional practice. Study limitations The instrument evaluates only knowledge, without evaluating the conduct of the participants. Conclusion The results show that the instrument has good internal consistency and good reproducibility. It could be useful in the identification of general practitioners and pediatricians knowledge gaps on the subject, for the subsequent development of training and educational strategies.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Radiation Protection/methods , Solar Energy , Ultraviolet Rays/adverse effects , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires/standards , General Practitioners/statistics & numerical data , Pediatricians/statistics & numerical data , Skin Neoplasms/prevention & control , Sunscreening Agents/therapeutic use , Brazil , Reproducibility of Results , Statistics, Nonparametric , Radiation Exposure/prevention & control
17.
An. bras. dermatol ; 94(5): 561-566, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1054858

ABSTRACT

Abstract Background Rubeosis faciei diabeticorum is a persistent facial erythema in patients with diabetes mellitus. The actual pathogenesis has not been studied. However, it is speculated to be a cutaneous diabetic microangiopathy. Objective Examine the correlation between the severity of facial erythema and the possible causes of microvascular diabetic complications, namely oxidative stress, hyperglycemia, and cutaneous accumulation of advanced glycation end-products . Methods Patients diagnosed with Type 2 diabetes mellitus (n = 32) were enrolled in the study. The facial erythema index was measured using the Mexameter MX18; cutaneous accumulation of advanced glycation end-products was estimated by measuring skin auto fluorescence with the AGE Reader (DiagnOptics Technologies B.V. - Groningen, Netherlands). Glycated haemoglobin, total antioxidant status, and malondialdehyde were measured in blood by TBARS assay. The correlation between the selected variables was assessed by Spearman's rank test; p ≤ 0.05 was considered statistically significant. Results There was a statistically significant correlation between total antioxidant status and the facial erythema index (ρ = 0.398, p = 0.024). Malondialdehyde, skin autofluorescence, glycated haemoglobin, body mass index, duration of diabetes, and age did not demonstrate statistically significant correlation with the facial erythema index. Study limitations This is an observational study. Elevation of total antioxidant status could have been caused by several factors that might have also influenced the development of rubeosis faciei, including hyperbilirubinemia and hyperuricemia. Conclusions The results contradicted expectations. Total antioxidant status correlated positively with facial erythema index; however, there was no correlation with oxidative stress and skin autofluorescence. Further investigations should be conducted to reveal the cause of total antioxidant status elevation in patients with rubeosis faciei.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Oxidative Stress , Diabetic Angiopathies/metabolism , Erythema/metabolism , Facial Dermatoses/metabolism , Reference Values , Spectrophotometry , Glycated Hemoglobin A/analysis , Body Mass Index , Statistics, Nonparametric , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/metabolism , Diabetic Angiopathies/complications , Erythema/etiology , Facial Dermatoses/etiology , Fluorescence , Malondialdehyde/blood , Antioxidants/analysis
18.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 428-432, Sept.-Oct. 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039099

ABSTRACT

Objective: Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings. Methods: This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student's t-tests. Correlations among parameters were performed. Results: This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores. Conclusion: This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.


Subject(s)
Humans , Male , Female , Adult , Anxiety Disorders/psychology , Temperament , Fibromyalgia/psychology , Mood Disorders/psychology , Depressive Disorder/psychology , Personality Inventory , Psychiatric Status Rating Scales , Severity of Illness Index , Case-Control Studies , Pilot Projects , Cross-Sectional Studies , Surveys and Questionnaires , Statistics, Nonparametric , Affective Symptoms/psychology , Middle Aged
19.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 389-395, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1039101

ABSTRACT

Objective: To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. Methods: Generalized estimating equation models were used to assess the impact of socioeconomic factors - including social inequality and unemployment rates - on adolescent suicide rates. Results: The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (β = 10.68; 95%CI = 2.32-19.05; p ≤ 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (β = 9.63; 95%CI = 2.31-16.96; p ≤ 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. Conclusion: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence.


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Suicide/trends , Suicide/statistics & numerical data , Socioeconomic Factors , Time Factors , Unemployment/statistics & numerical data , Brazil/epidemiology , Sex Factors , Retrospective Studies , Risk Factors , Sex Distribution , Statistics, Nonparametric
20.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(5): 403-410, Sept.-Oct. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1039114

ABSTRACT

Objective: To investigate quality of life (QoL) and QoL predictors among caregivers of individuals in first-episode psychosis (FEP). Methods: This longitudinal study investigated predictors of QoL in caregivers of 80 individuals in FEP over a 1-year follow-up period, measured using a single component extracted from the 36-item Short-Form Health Survey (SF-36). Results: Mediation analysis demonstrated that, at 1 year, high scores in the Self-Report Questionnaire (SRQ-20) were associated with high scores on the negative sub-scale of the Experience of Caregiving Inventory (ECI), which was also associated with low scores in the Essential Quality of Life (Essential QoL) component extracted from the SEF-36. Clinically, the resulting association indicates that depression and anxiety symptoms in caregivers at baseline are predictors of their 1-year quality of life, based on self-assessment of the caregiving experience. Conclusion: Supporting an individual in FEP can have a negative impact on QoL. Maintaining caregivers' mental health and subjective evaluation of the caregiving experience must be primary goals of FEP services. Complementary studies of FEP caregivers' QoL can support the design of personalized interventions in the near future.


Subject(s)
Humans , Male , Female , Adult , Psychotic Disorders/psychology , Quality of Life/psychology , Caregivers/psychology , Anxiety/psychology , Psychiatric Status Rating Scales , Psychometrics , Reference Values , Socioeconomic Factors , Time Factors , Brazil , Follow-Up Studies , Longitudinal Studies , Statistics, Nonparametric , Depression/psychology , Self Report , Life Change Events , Middle Aged
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