Depressive symptoms and self-rated health among Brazilian older adults: baseline data from the ELSI-Brazil study

Objective: To investigate whether having a higher number of depressive symptoms is associated with negative self-rated health (SRH) even in the absence of illness. Methods: This is a secondary analysis of baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015-2016, using a national sample of 9,412 people aged 50 or over. SRH was dichotomized into poor or very poor and very good or excellent, good, or average. Depressive symptoms were assessed through the eight-item Center for Epidemiologic Studies Depression Scale (CES-D8). Sociodemographic variables, information about unhealthy behaviors, and the number of chronic conditions were also analyzed. Results: Having depressive symptoms was strongly associated with poor or very poor SRH both in the unadjusted and adjusted analyses. The magnitude of the association was reduced when the number of chronic illnesses was included in the multivariate analysis, along with the other sociodemographic variables and unhealthy behaviors (OR 1.35, 95%CI 1.31-1.39). Conclusion: Having depressive symptoms may contribute towards having a poorer perception of health, even in the absence of health conditions. SRH is a multidimensional construct that can accurately reflect a person's state of general mental health.

Protocolo de avaliação para apraxia de fala adquirida / Assessment protocol for acquired apraxia of speech

RESUMO Objetivo Elaborar um protocolo de avaliação do planejamento motor da fala com estímulos fonologicamente balanceados para o português brasileiro e que contemple todas as variáveis necessárias para este diagnóstico. Método Foram realizadas três etapas: Na primeira, construíram-se listas de palavras cujo critério principal foram os padrões silábicos e acentuais. Do levantamento realizado na Etapa 1, procedeu-se à seleção dos vocábulos que compuseram a primeira versão do protocolo na Etapa 2, reunidas em duas tarefas: de repetição e de Leitura em Voz Alta (LVA). Em seguida, investigou-se a ocorrência das palavras usando a base de dados do Corpus Brasileiro (PUC-SP) - Linguateca. Na etapa 3 realizou-se a análise estatística para verificar se as listas de repetição e de LVA estavam equilibradas quanto à ocorrência das palavras. Assim, as listas foram distribuídas em quartis e foram analisadas de forma descritiva e bivariada. O nível de significância utilizado foi de 5%. Resultados Após a realização de todas as etapas, foi possível obter as palavras que compuseram as listas das tarefas de repetição e de LVA. Finalmente, foram então acrescidas ao protocolo as demais tarefas consideradas essenciais para a avaliação da apraxia como as taxas diadococinéticas e a prancha para a emissão oral espontânea. Conclusão O protocolo desenvolvido contém as tarefas consideradas padrão para a avaliação da apraxia de fala pela literatura internacional, o que torna esse instrumento importante para o diagnóstico desse distúrbio em falantes do português brasileiro.

ABSTRACT Purpose To develop an assessment protocol for speech motor planning with phonologically balanced stimuli for Brazilian Portuguese, including all necessary variables for this diagnosis. Methods Three stages were carried out: In the first, word lists were built with the main criterion being syllabic and accentual patterns. From the survey conducted in Stage 1, the words that composed the first version of the protocol lists in Stage 2 were selected, and grouped into two fundamental tasks for diagnosing acquired apraxia of speech (AOS): repetition and Reading Aloud (RA). In Stage 3, the occurrence of words was investigated using the Brazilian Corpus (PUC-SP) - Linguateca database, and a statistical analysis was performed to verify if the repetition and RA lists were balanced in terms of the occurrences. Thus, the lists were distributed in quartiles and submitted to both descriptive and bivariate analyses. A significance level of 5% (p<0.05) was adopted. Results After completion of all stages, the words that composed the lists of the repetition and RA tasks were obtained. Finally, other tasks considered essential for the assessment of AOS, such as diadochokinetic rates and the board for spontaneous oral emission, were then added to the protocol. Conclusion The developed protocol contains the tasks considered standard for the assessment of AOS according to the international literature, which makes this instrument important for diagnosing this disorder in speakers of Brazilian Portuguese.

Assessment and indicators of kinematic behavior and perceived fatigability

SUMMARY OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure.

Lecturas sobre la anorexia desde el psicoanálisis: una revisión sistemática / Readings on anorexia from psychoanalysis: a systematic review

Resumen Este trabajo propone realizar una revisión sistemática sobre las diferentes lecturas sobre la anorexia para describir las propuestas de abordaje en el psicoanálisis y sus perspectivas metodológicas. La revisión sistemática, según la Declaración PRISMA, se lleva a cabo en julio de 2022 y se seleccionan quince artículos científicos provenientes de siete bases de datos (REDIB, SCIELO, Dialnet, REDALYC, DOAJ, SNRD y Portal Regional en Salud Organización Panamericana de la Salud) que refieren a publicaciones en español entre 2022-2012 tomando como referencias las propuestas de la clínica psicoanalítica sobre la anorexia, en donde se concluye sobre las similitudes y diferencias en los abordajes de la temática desde el psicoanálisis sobre la consideración de la anorexia tanto a nivel teórico como clínico-terapéutico. Se podría pensar a la anorexia de hoy en día como la respuesta de algunos jóvenes histéricos a este imperativo: el sujeto insiste en afirmar su división subjetiva, rechazando al objeto que pretende colmarla. Se afana en albergar la nada, espacio del deseo puro.

Abstract This work proposes to carry out a systematic review on the different readings on anorexia to describe the proposals of approach in psychoanalysis and its methodological perspectives. The systematic review, according to the PRISMA Declaration, will be carried out in July 2022 and fifteen scientific articles will be selected from seven databases (REDIB, SCIELO, Dialnet, REDALYC, DOAJ, SNRD and Portal Regional en Salud Organización Panamericana de la Salud) that refer to publications in Spanish between 2022-2012 taking as references the proposals of the psychoanalytic clinic on anorexia, where it is concluded about the similarities and differences in the approaches to the subject from psychoanalysis on the consideration of anorexia both at a theoretical and clinical-therapeutic level. Today's anorexia could be thought of as the response of some hysterical young people to this imperative: the subject insists on affirming his subjective division, rejecting the object that tries to fill it. It strives to house nothingness, the space of pure desire.

Percepción temporal de síntomas de disfagia en una cohorte de pacientes con disfagia orofaríngea neurogénica

Introducción: La disfagia resulta de varios mecanismos fisiopatológicos donde sus síntomas no son estáticos ni homogéneos en las personas, especialmente cuando existe disfagia orofaríngea neurogénica. Objetivo: Conocer la percepción y comportamiento en el tiempo de síntomas de disfagia mediante el instrumento Eating Assessment Tool-10 (EAT-10) en pacientes con disfagia orofaríngea neurogénica, con el fin de visualizar la dinámica clínica de esta forma de disfagia. Metodología: Estudio observacional tipo cohorte en pacientes con disfagia orofaríngea neurogénica de causas neurológicas y neuromusculares, con seguimiento a tres y seis meses y diligenciamiento del EAT-10 al momento basal, tercer y sexto mes. Resultados: Un total de 90 personas con evaluación basal, de las cuales el 56,7 % (51/90) lograron seguimiento al tercer mes y 25,6 % (23/90) al sexto mes. Los síntomas de disfagia con mayor autopercepción en los tres momentos fueron la dificultad para tragar sólidos, sensación de comida pegada en garganta y tos al comer. La odinofagia no fue un síntoma habitualmente percibido. La puntuación total del EAT-10 estuvo entre 16,61 ± 9 y 18,1 ± 9,5 puntos en general. En pacientes con seguimiento completo se observó variación en la autopercepción para tragar líquidos y pastillas. Se observó variación del puntaje al ajustarlo por recepción de terapias. Discusión: Las enfermedades neurológicas y neuromusculares impactan directamente la deglución con gravedad entre leve a profunda, donde la autopercepción de síntomas deglutorios es dinámica, pero con síntomas cardinales de disfagia orofaríngea en el tiempo. Conclusiones: El reconocimiento y seguimiento de síntomas de disfagia deben ser aspectos usuales en la atención de pacientes con enfermedades neurológicas y neuromusculares.

Introduction: Dysphagia results from several pathophysiological mechanisms where its symptoms are not static or homogeneous in people, especially when there is neurogenic oropharyngeal dysphagia. Objective: To know the perception and behavior over time of symptoms of dysphagia using the Eating Assessment Tool-10 (EAT-10) in patients with neurogenic oropharyngeal dysphagia to visualize the clinical dynamics of this form of dysphagia. Methodology: Observational cohort study in patients with neurogenic oropharyngeal dysphagia of neurological and neuromuscular causes with, follow-up at three and six months, and completion of the EAT-10 at baseline, third and sixth month. Results: A total of 90 people with baseline evaluation were included, of whom 56.7% (51/90) achieved follow-up at the third month and 25.6% (23/90) at the sixth month. Symptoms of dysphagia with greater self-perception at all three moments were difficulty swallowing solids, sensation of food stuck in the throat and coughing when eating. Odynophagia was not a commonly perceived symptom. The total score of the EAT-10 was between 16.61±9 and 18.1±9.5 points in general. In patients with complete follow-up, variation in self-perception of swallowing liquids and pills was observed. Variation of the score when adjusting for the reception of therapies. Discussion: Neurological and neuromuscular diseases directly impact swallowing with mild to profound severity, where self-perception of swallowing symptoms is dynamic, but with cardinal symptoms of oropharyngeal dysphagia over time. Conclusions: The recognition and monitoring of dysphagia symptoms should be usual aspects in the care of patients with neurological and neuromuscular diseases.

Resultados de una evaluación y seguimiento online de problemas de salud mental en universitarios chilenos / Results of an online mental health problems screening and follow-up with Chilean university students

Resumen Este estudio examina la detección y posterior seguimiento online de problemas de salud mental en estudiantes universitarios y expone los resultados de ambos procesos. Para ello, se aplicó a través de la plataforma de la universidad a 1 707 estudiantes una batería de cuestionarios destinados a detectar desesperanza y riesgo de suicidio, síntomas depresivos y ansiosos, estrés, trastornos de la conducta alimentaria y apoyo social percibido. Una vez aplicados los instrumentos, los estudiantes recibían una retroalimentación acerca de sus niveles de síntomas e información acerca de redes y establecimientos para buscar ayuda y recibir atención en los casos requeridos. A mediados del año siguiente, se realizó una encuesta de seguimiento a 577 de los estudiantes que previamente habían respondido todos los cuestionarios. Los resultados de la batería de cuestionarios aplicados indican altos índices de problemas de salud mental, con diferencias estadísticamente significativas según sexo, siendo las mujeres quienes presentan mayor prevalencia. Estos resultados concuerdan con diversos estudios que muestran altos porcentajes de síntomas de problemas de salud mental en los universitarios. A su vez, el posterior seguimiento permitió evidenciar que el feedback entregado activó la búsqueda de ayuda, y se obtuvieron correlaciones positivas entre sentirse mejor y haber buscado un tratamiento de salud mental o haber pedido ayuda a los amigos o a la familia. El uso de tecnologías de la información en la detección y prevención de salud mental tendría un alcance positivo y resultó ser una herramienta útil, accesible y cercana para los jóvenes.

Abstract The exponential increase in higher education students and the new university profile that incorporates more vulnerable social groups are associated with an increase in mental health problems in this population. Likewise, the complex stage of the life cycle in which these young people find themselves and the stress of the transition between adolescence and adulthood are other risk factors for the development of mental health problems. The emergence of mental health problems in this group could then be due to a confluence of factors, also facilitating risk behaviors. National and international researches have reported the worrying rates of mental health disorders in university students, mainly in relation to the presence of depression, anxiety, stress, alcohol or drug use, eating disorders, and suicidal ideation. These disorders tend to be aggravated, because the university population is prone not to seek help. The stigma of presenting mental health problems, skepticism about treatments, not wanting to worry the closest family and the few economic resources or not having a health plan, lead to not seeking help or do this late. Studies have found that more than half of students who need mental health and support services are not receiving them. On the other hand, a high percentage seeks help late, which implies that the disorders are accentuated or become chronic, which makes subsequent treatment and improvement difficult, even becoming a public health problem due to the high economic and professional demand that these treatments require.

Esboços para uma teoria do sujeito: com Badiou e a psicanálise / Outlines for a theory of the subject: with Badiou and psychoanalysis / Essais pour une théorie du sujet: avec Badiou et la psychanalyse

Partindo-se do pressuposto de que, com Descartes, a questão que subjaz na constituição da modernidade é o que seria o sujeito, este texto se propõe a explorar desdobramentos sobre essa questão tendo como referência teorizações de Alain Badiou e algumas concepções básicas que aprendemos a ler na psicanálise. Ele procura demonstrar os impasses que encontramos ao tentarmos estabelecer formalizações sobre o sujeito, impasses esses que estariam na constituição do homem moderno. Trabalha também interseções e implicações dessas formalizações paradoxais com conceitos igualmente caros à psicanálise, como os de sintoma, corpo e verdade, assim como ressonâncias que poderíamos desdobrar entre a tipologia formal do sujeito proposta por Badiou e formalizações sobre esse tema que poderíamos depreender da leitura das obras de Freud e Lacan.

Based on the assumption that with Descartes the question that underlies the constitution of modernity is what the subject would be, this text proposes to explore developments on this issue with Alain Badiou's theorizations as a reference and some basic concepts that we learn to read in psychoanalysis. He tries to demonstrate the impasses that we find when we try to establish formalizations about the subject, impasses that would be in the constitution of modern humans. It also works on the intersections and implications of these paradoxical formalizations with concepts equally dear to psychoanalysis such as symptom, body, and truth, as well as resonances that we could unfold between the formal typology of the subject proposed by Badiou and formalizations on this theme that we could infer from reading the works by Freud and Lacan.

Sur la base de l'hypothèse que, avec Descartes, la question qui sous-tend la constitution de la modernité est ce qui serait le sujet, ce texte propose d'explorer les développements sur cette question ayant pour référence des théorisations d'Alain Badiou et quelques concepts de base que nous apprenons à lire en psychanalyse. Il essaie de démontrer les impasses que nous trouvons lorsque nous essayons d'établir des formalisations sur le sujet, des impasses qui seraient dans la constitution de l'homme moderne. Il travaille également sur les intersections et implications de ces formalisations paradoxales avec des concepts tout aussi chers à la psychanalyse, tels que les symptômes, le corps et la vérité, ainsi que les résonances que nous pourrions déployer entre la typologie formelle du sujet proposée par Badiou et les formalisations sur ce thème que nous pourrions déduire de la lecture des travaux de Freud et de Lacan.

Assessment of the efficacy of olopatadine 0.1% in the treatment of vernal keratoconjunctivitis in terms of clinical improvement based on total ocular symptom score and ocular surface disease index

Purpose: The main objective of this study is to explore the efficacy of olopatadine 0.1% treatment in the resolution of symptoms of vernal keratoconjunctivitis (VKC) among the Indian population. Methods: This single?center, prospective cohort study involved 234 patients with VKC. Patients were treated with olopatadine 0.1%, twice daily for a period of 12 weeks and then followed up in 1st week, 4th week, 3rd month, and 6th month. The extent of relief in the symptoms of VKC was measured using total ocular symptom score (TOSS) and ocular surface disease index (OSDI). Results: In the present study, the dropout rate was 5.6%. Total of 136 males and 85 females with a mean age of 37.68 ± 11.35 years completed the study. TOSS score reduced from 58.85 to 5.06 and the OSDI score reduced from 75.41 to 11.2 with statistical significance (P < 0.01) from 1st week to 6th week after olopatadine 0.1% treatment. The data showed relief in subjective symptoms of itching, tearing, and redness, and relief in discomfort in functions related to ocular grittiness, visuals like reading, and environmental like tolerability in dry conditions. Further, olopatadine 0.1% was effective in both males and females, and patients across ages 18–70 years. Conclusion: Based on TOSS and OSDI scores, the findings of this study validate safety and tolerability as revealed by low adverse effects and moderate efficacy of olopatadine 0.1% in reducing VKC symptoms in a broader age group (18–70 years) of both genders.

Efficacy and Safety of Stomatab Capsules® in Improving Oral Health in Recurrent Aphthous Stomatitis: An Open-labeled Clinical Study

Background: Recurrent aphthous stomatitis (RAS) is a common ulcerative disease of the oral mucosa, which is difficult to treat. In Ayurveda, several medicinal plants have been evaluated for their anti-inflammatory and antioxidant effects in many oral diseases as an alternative for modern medicines. Method: A study with open-label, non-comparative single-arm design was conducted to evaluate the efficacy of “Stomatab” capsules in improving oral health in 30 subjects with RAS. The secondary objectives were to assess the improvement in oral health and tolerability of the herbal formulation. Subjects were instructed to take one capsule thrice daily after meals for 14 days. Patients were evaluated at three assessment points: screening and baseline (Visit 1, Day 0) with follow-ups done at Visit 2 (Day 5 ± 2) and Visit 3 at the end of the study (Day 14 ± 2). Results: There was a significant reduction in the mean ulcer size from 3.66 ± 1.27 mm (V1) to 0.64 ± 0.78 (V3). The mean number of ulcers reduced from 1.97 ± 0.72 (V1) to 0.90 ± 0.66 (V3). Significant improvement in ulcer-related symptoms of pain (Ruja), burning sensation (Daha) and redness (Raktavarnata) was noted. The total ulcer symptom scores decreased from 7.67 ± 2.38 (V1) to 0.63 ± 0.56 (V3). No side effects were reported by the study participants. Conclusion: These results show that the polyherbal formulation “Stomatab” capsule is safe and effective for the treatment of RAS.

O sintoma da criança: a criança como sintoma dos pais / Le symptôme de l'enfant: l'enfant comme symptôme des parents / The symptom of the child: the child as a symptom of the parents

A questão que introduz este artigo diz respeito à constituição do sintoma da criança e como este é atravessado pelo discurso dos pais. Na bagagem adquirida na clínica foi possível observar como as manifestações do inconsciente aparecem nos detalhes no discurso do indivíduo. Tem-se como intuito marcar a importância das funções paterna e materna na constituição da criança e, quando essas não operam, a desordem que podem causar no psiquismo infantil. Busca-se sensibilizar a noção de que a desorganização psíquica dos pais tem repercussão no processo de subjetivação dos filhos. Nota-se a impossibilidade de separar a criança dos pais no processo analítico, uma vez que ela ainda não se diferenciou enquanto sujeito. Convém não desconsiderar a resposta da criança. Há algo que é dela, que diz respeito à sua singularidade e que não podemos deixar de lado. A função parental tem como responsabilidade a imposição de limites, a orientação para a lógica da hierarquia, e não do igualitarismo, em que pai e filho têm os mesmos direitos e deveres. Entretanto, lidamos hoje com uma sociedade que desacredita da potência desse aparelho regulador e, por consequência, podemos observar um excesso de gozo. O que se colhe disso são crianças que têm que lidar com a falta da falta que a castração impõe a todos

La question qui introduit cet article concerrne la constitution du symptôme de l'enfant et comme elle est traversée par le discours des parents. Avec l'expérience acquise en clinique, cela a été possible d'observer comment les manifestations de l'inconscient apparaissent dans les détails du discours de l'individu. Il a l'intention de souligner l'importance des fonctions paternelle et maternelle dans la constitution de l'enfant et quand celles-ci n'opèrent pas, elles peuvent causer le désordre dans le psychisme infantile. Nous cherchons à sensibiliser la notion que la désorganisation psychique des parents a une répercussion dans le procès de subjectivation des fils. On peut noter l'impossibilité de séparer l'enfant des parents dans le procès analytique, une fois qu'il ne s'est pas différencié en tant que sujet. Il convient de déconsidérer que la réponse de l'enfant. Il y a quelque chose qui est à lui, qui concerne sa singularité et que nous pouvons laisser de côté. Cependant, nous faisons face aujourd'hui à une société qui ne croit pas à la puissance de cet appareil régulateur et, par conséquence, nous pouvons observer un excès de jouissance. Ce que nous en recueillons ce sont des enfants qui doivent gérer avec le manque du manque que la castration impose à tous.

The question that introduces this article concerns the constitution of the child's symptom and how it is traversed by the discourse of the parents. In the baggage acquired through clinical practice, it was possible to observe how manifestations of the unconscious appear in the details of the individual's speech. The aim is to emphasize the importance of both paternal and maternal functions in the constitution of the child, and when these functions do not operate, the disorder they can cause in the child's psyche. The intention is to raise awareness of the notion that the psychic disorganization of the parents has repercussions on the process of subjectivation of the children. It is noted the impossibility to separate the child from the parents in the analytic process, as the child has not yet differentiated itself as a subject. It is worth not disregarding the child's response. There is something that belongs to the child, related to their uniqueness, that we cannot overlook. The parental function bears the responsibility of imposing limits, guiding towards the logic of hierarchy, rather than egalitarianism, where the parent and the child have the same rights and duties. However, today we deal with a society that disbelieves in the potency of this regulatory apparatus, and consequently, we can observe an excess of jouissance. What is gathered from this is that we have children who must cope with the lack of absence that castration imposeson everyone

An Open-label Prospective Noncomparative Clinical Study to Evaluate the Efficacy and Safety of Beliv: An Ayurvedic Medicine in Improving Liver Function

An open-label prospective noncomparative study was conducted to examine the efficacy and safety of Beliv tablet, a polyherbal Ayurvedic medicine, in 30 adult patients suffering from liver disorders. Two tablets were administered daily for 56 days. Patients were evaluated at Day 0, Day 21, Day 42 and at Day 56. The primary end point of the study was a change in liver function test parameters measured by the levels of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and total bilirubin at all assessment points. Results showed a significant reduction in the serum levels of SGOT, SGPT and total bilirubin from baseline to 21 days, 42 days and 56 days. The total icterus symptom score was also significantly reduced from 5.17 ± 2.26 (baseline) to 2.6 ± 1.48, 1.37 ± 1.13 and 0.77 ± 0.73 at Days 21, 42 and 56, respectively. The Subjective Global Assessment (SGA) decreased significantly from 3.33 ± 1.16 (Day 21) to 2.33 ± 1.16 and 1.80 ± 0.76 at Days 42 and 56, respectively. The Physician Global Assessment (PGA) score was also significantly reduced from 3.0 ± 1.02 (Day 21) to 2.07 ± 0.83 and 1.70 ± 0.79 at Days 42 and 56, respectively. A significant reduction in serum creatinine level was observed at Day 56. No adverse effects or serious adverse effects were observed during the study period. The study concluded that Beliv tablet was highly effective for the treatment of liver disorders, as evidenced by the reduction in serum levels of SGOT, SGPT, total bilirubin, icterus symptoms and PGA and SGA scores. No treatment-related side effects were reported by any of the study participants suggesting that it was safe for clinical use in humans for the treatment of liver disorders.

Avaliação de sintomas da pessoa com câncer avançado / Assessment of symptoms in people with advanced cancer

Resumo: Trata-se de um estudo de natureza quantitativa, observacional, descritivo com delineamento longitudinal, com o objetivo de avaliar os sintomas apresentados pela pessoa com câncer avançado, assistida em um serviço de oncologia. Aprovado pelo Comitê de Ética em Pesquisa com seres humanos do Complexo Hospital de Clínicas da Universidade Federal do Paraná. O local do estudo foi um hospital de referência em atendimento a pacientes oncológicos na cidade de Curitiba, Paraná. Participaram do estudo 23 adultos portadores de câncer em estadiamento III e IV. A coleta de dados ocorreu de fevereiro a julho de 2022. A etapa inicial foi presencial, houve a identificação dos participantes quanto ao perfil sociodemográfico e clínico, bem como, a avaliação dos sintomas com a Escala de Avaliação de Sintomas de Edmonton (ESAS). O seguimento do estudo se deu majoritariamente por telefone, uma vez por semana, com a ESAS. Foram avaliados os sintomas dor, cansaço, sonolência, náusea, apetite, falta de ar, depressão, ansiedade e bem-estar. Os participantes atribuíram valores de 0 a 10 de acordo com a intensidade que cada sintoma apresentava no momento da avaliação. Os dados obtidos foram analisados por meio do software GraphPad Prism 5.0. Para a análise descritiva de dados dos sintomas foi usado a análise de variância (ANOVA) de duas vias, considerando p<0,05 como estatisticamente significativo. A ANOVA de 2 vias é baseada em dois fatores. O fator linha equivale às diferenças entre as respostas dos itens, e o fator coluna, equivale às variações das respostas em um mesmo item. Quanto ao perfil sociodemográfico, os participantes tinham média de idade de 53,3 anos, 78,3% do sexo feminino, e 82,6% procedentes de Curitiba. Acerca do perfil clínico, as neoplasias de mama representaram 30,8% dos diagnósticos, seguido por adenocarcinoma de cólon e reto 17,4% e carcinoma espinocelular de colo uterino 13%. Entre os sintomas avaliados, o de maior intensidade média foi o cansaço (5,53) e, a náusea, apresentou a menor média (1,76). Referente à décima questão da ESAS (Outro problema?), a constipação intestinal foi a mais presente, relatada em 13,8% das 247 avaliações. Constatou-se que os sintomas em pessoas com câncer avançado se manifestam de maneira concomitante, e que existe um processo de inter-relação importante entre sintomas físicos e psicológicos. O instrumento ESAS foi eficiente para as avaliações de sintomas, sendo facilmente compreendido pelos participantes, de aplicação rápida, e ainda, forneceu dados objetivos. Espera-se que este estudo contribua para o aprimoramento da avaliação e manejo dos sintomas, proporcionando melhora da qualidade de vida aos pacientes com câncer avançado e seus familiares.

Abstract: This is a quantitative, observational, descriptive study with a longitudinal design, with the objective of evaluating the symptoms presented by people with advanced cancer assisted in an oncology service. Approved by the Ethics Committee for Research with Human Subjects of the Clinics Hospital Complex of the Federal University of Paraná. The study location was a hospital that is a reference in treating cancer patients in the city of Curitiba, Paraná. Twenty-three adults with stage III and IV cancer participated in the study. Data was collected from February to July 2022. The first stage was faceto- face, where participants were identified according to their sociodemographic and clinical profile, and their symptoms were assessed using the Edmonton Symptom Assessment Scale (ESAS). The follow-up of the study took place mostly by phone, once a week, with ESAS. The symptoms pain, fatigue, drowsiness, nausea, appetite, shortness of breath, depression, anxiety, and well-being were assessed. Participants assigned values from 0 to 10 according to how intense each symptom was at the time of the assessment. The data obtained were analyzed using GraphPad Prism 5.0 software. For the descriptive analysis of symptom data, two-way analysis of variance (ANOVA) was used, considering p<0.05 as statistically significant. The 2-way ANOVA is based on two factors. The row factor equals the differences between item responses, and the column factor, equals the variations in responses within the same item. As for the sociodemographic profile, the participants had a mean age of 53.3 years, 78.3% were female, and 82.6% were from Curitiba. About the clinical profile, breast neoplasms accounted for 30.8% of the diagnoses, followed by colon and rectal adenocarcinoma 17.4% and cervical squamous cell carcinoma 13%. Among the symptoms evaluated, the one with the highest average intensity was tiredness (5.53), and nausea had the lowest average (1.76). Regarding the tenth question of the ESAS (Other problem?), constipation was the most present, reported in 13.8% of the 247 evaluations. It has been found that symptoms in people with advanced cancer occur concomitantly, and that there is an important interrelationship process between physical and psychological symptoms. The ESAS instrument was efficient for symptom assessments, being easily understood by the participants, quick to apply, and also providing objective data. It is hoped that this study will contribute to the improvement of symptom assessment and management, providing improved quality of life for patients with advanced cancer and their families.

A prospective study to evaluate the efficacy and adverse effects of alpha-blockers in the management of benign prostatic hyperplasia

Background: Benign prostatic hyperplasia (BPH) is the most common cause for the lower urinary tract symptoms in men. The conservative management of BPH comprises of alpha blockers, especially selective alpha 1 adrenergic blockers for symptomatic relief. Aims and Objectives: We aimed to evaluate the efficacy and adverse effects of alpha blockers in managing BPH. Materials and Methods: After getting approval from the Institutional Human Ethics Committee and consent from subjects, this prospective, randomized, and controlled trial was conducted. In this study, patients under inclusion criteria were divided into two groups. Group I received silodosin 8 mg once daily for 8 weeks. Group II received tamsulosin 0.4 mg once daily for 8 weeks. Primary outcome measure was reduction in international prostate symptom score (IPSS). Adverse events during study period were recorded. Results: A total of 90 patients were enrolled in this study. Ten patients were excluded and remaining 80 patients were divided as 40 in Group I (Silodosin) and 40 in Group II (Tamsulosin), patients were followed up for 8 weeks. As primary outcome, the IPSS at 8th week was significantly <0 week, that is, baseline in both the groups. The comparison of IPSS within Group I and Group II at 0 week and 8th week was significant (P < 0.05). The quality of life comparison within Group I and Group II at 0 week and 8th week was significant (P < 0.05). Both the drugs were well tolerated. Retrograde ejaculation and diarrhea were noted with silodosin (Group I), dizziness and orthostatic hypotension were noted with Tamsulosin (Group II). Conclusion: The obtained results showed that both silodosin and tamsulosin produced significant improvement in IPSS and quality of Life in BPH patients. In silodosin group, retrograde ejaculation and diarrhea were notable adverse effects and in tamsulosin group, dizziness and orthostatic hypotension were noted.

Epidemiological characteristics of pertussis in Yiwu City / 预防医学

Objective @#To investigate the epidemiological and clinical characteristics of cases with pertussis in Yiwu City, Zhejiang Province, so as to provide insights into pertussis diagnosis and control.@*Methods@#A total of 186 patients with definitive diagnosis of pertussis in medical institutions in Yiwu City from November 1, 2020 to August 31, 2022 were recruited, and subjects' demographic, clinical symptoms and history of pertussis vaccination were collected using questionnaire surveys. The temporal, population, and spatial distribution and clinical symptoms of pertussis were analyzed using a descriptive epidemiological method, and the clinical characteristics of pertussis patients with different doses of pertussis vaccination were compared.@*Results@#Pertussis was found to predominantly occur during the period between July and November (101 cases, 54.30%), and the three highest-incidence regions included Jiangdong Street, Beiyuan Street and Choujiang Street (87 cases, 46.77%). The 186 pertussis cases included 105 males (56.45%) and 81 females (43.55%), and included 144 cases with age of onset under 7 year (77.42%). Preschool and diaspora children were predominant among all pertussis cases, and the main clinical symptoms included spasmodic cough (97 cases, 52.15%), post-tussive vomiting (82 cases, 44.09%) and aggravated cough at night (77 cases, 41.40%). Routine blood tests measured 119 cases with abnormal white blood cell counts (63.98%), 137 cases with abnormal lymphocyte counts (73.66%), 39 cases with abnormal neutrophil counts (20.97%), 21 cases with abnormal platelet counts (11.29%) and 111 cases with abnormal hemoglobin concentrations (59.68%). There were 55 cases that were unvaccinated (29.57%), 23 cases that were not fully vaccinated (12.37%), and 108 cases that were fully vaccinated (58.06%). There were significant differences among pertussis cases with different doses of vaccination in terms of age, incidence of post-tussive vomiting, percentage of abnormal platelet counts and percentage of hemoglobin concentrations (all P<0.05).@*Conclusions@#The majority of pertussis cases are preschool and diaspora children in Yiwu City from November 1, 2020 to August 31, 2022, and the clinical symptoms mainly include spasmodic cough, post-tussive vomiting and aggravated cough at night, with atypical symptoms. The capability for differential diagnosis of pertussis is required to be improved in medical institutions.

Acupoint selection rules of staging, syndrome types, and symptoms of acupuncture for peripheral facial paralysis based on data mining / 中国针灸

OBJECTIVES@#To analyze and explore the acupoint selection rules of different staging, syndrome types, and symptoms of acupuncture for peripheral facial paralysis based on data mining.@*METHODS@#Literature regarding acupuncture for peripheral facial paralysis was retrieved in CNKI, VIP, Wanfang, SinoMed, and PubMed from January 1, 2012, to December 31, 2021. The Traditional Chinese Medicine Inheritance Assistant Platform (V 3.0), SPSS Modeler 18.0, and Cytoscape software were used to analyze the selection of acupoints based on staging, meridian distribution of acupoints, the selection of acupoints based on syndrome types, syndrome types based on staging, and symptom-based acupoint selection. Association rule analysis was performed for each stage and major syndrome types, and co-occurrence network diagrams were generated.@*RESULTS@#A total of 1 695 articles were included, involving 124 acupoints with a total frequency of 5 456 times. Among 1 080 articles related to staging-based acupoint selection, the acute stage had the highest acupoint use frequency (2 224 times) and number (88 acupoints). Among all stages, the acupoints of the stomach meridian of foot-yangming were most frequently used, with Dicang (ST 4)-Yangbai (GB 14) and Dicang (ST 4)-Jiache (ST 6) being the high-frequency acupoint pairs in each stage. The top four syndrome types in terms of acupoint usage frequency were wind-cold syndrome, wind-heat syndrome, qi-blood deficiency syndrome, and liver-gallbladder damp-heat syndrome. Among 521 articles combining staging with symptoms or syndrome types with symptoms for acupoint selection, the symptom "nasolabial groove becoming shallow or disappearing" had the highest frequency of occurrence. The symptoms with the highest acupoint usage frequency and number were "forehead wrinkles becoming shallow or disappearing" and "pain behind the ear" respectively.@*CONCLUSIONS@#Acupoint selection for peripheral facial paralysis primarily focuses on the yang meridians in each stage, supplemented by local acupoints and based on the pathological characteristics. Syndrome differentiation and treatment should be prioritized, combined with local acupoint selection. Clinical acupoint selection can be based on a combination of staging, syndrome types, and symptoms.

Consideration of Definition of Solitary Death, and Changes before and after Coronavirus Pandemic: A Survey of Post-mortem Examination Cases in Shizuoka City / 日本プライマリ・ケア連合学会誌

Introduction: The aim of this study was to consider the definition of solitary death by examining characteristics of cases, and to explore the impact of the coronavirus pandemic.Methods: Subjects were individuals with post-mortem examination and autopsy imaging data recorded between 2017 and 2022. Subjects were classified by whether they passed away at home (solitary). We investigated differences between groups in their causes of death, time elapsed between death and discovery, presence or absence of housemates, and prior symptoms.Results: There were 129 cases (79.9%) of solitary death and 41 cases (24.1%) of death outside the home. Solitary death cases were significantly younger. Among these, less than half were discovered more than a day after death, lived alone, or were older adults. Older adults and those discovered more than a day after death were more likely to have trauma as their official cause of death. The frequency and characteristics of solitary death did not change before or after the coronavirus pandemic.Conclusion: Preventive measures for solitary death should not be limited to older adults or those living alone. In particular, deaths from diseases other than sudden death, trauma in older adults, and cases where symptoms were present or medical attention was sought before death are potentially preventable. Countermeasures for solitary death are important in the post-coronavirus pandemic period.

Analysis of the clinical efficacy and safety of laparoscopic radical prostatectomy in prostate cancer patients aged 80 years or older / 现代泌尿外科杂志

【Objective】 To investigate the clinical efficacy and safety of laparoscopic radical prostatectomy in elderly prostate cancer patients aged ≥80 years in good health. 【Methods】 A total of 18 octogenarian patients who underwent laparoscopic radical prostatectomy during Aug.2016 and Mar.2020 at our hospital were selected for retrospective analysis. 【Results】 The patients were 80 to 86 years old. The preoperative serum PSA was 5.25-101.00 ng/mL. There were 2 cases in stage cT1N0M0,12 in stagec T2N0M0 and 4 in stage cT3N0M. The Gleason score was ≤6 in 4 cases,=7 in 9 cases,and ≥8 in 5 cases. During the follow-up of 22 to 65 months,the rates of urinary incontinence at 1 month,3 months,6 months,and 1 year were 50.00% (9/18),33.33% (6/18),16.67% (3/18) and 5.56 %(1/18),respectively. The postoperative urinary control recovery time was 1 to 220 days. Positive incision margin developed in 3 cases and biochemical recurrence occurred in 3 cases. The IPSS score at 3, 6 months and 1 year after surgery were lower than these before surgery (P<0.05). The overall health score of the FACD-P scale at 6 months after surgery was higher than that before surgery (P<0.05). 【Conclusion】 For well selected octogenarian prostate cancer patients in good condition,laparoscopic radical prostatectomy is a feasible,safe and effective treatment option,but long-term follow-up and prospective clinical studies with large sample size are still needed to confirm its efficacy.

Efficacy of pelvic floor magnetic and electrical stimulation combined with Kegel exercise training in the treatment of stress urinary incontinence after minimally invasive surgery for benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To explore the clinical efficacy and safety of pelvic floor magnetic and electrical stimulation combined with Kegel exercise training in the treatment of stress urinary incontinence (SUI) after minimally invasive surgery for benign prostatic hyperplasia (BPH). 【Methods】 A total of 52 patients with SUI after minimally invasive surgery for BPH treated during Jan.2016 and Feb.2022 were randomly divided into test group (n=26) and control group (n=26). The test group received pelvic floor magnetic and electrical stimulation and Kegel exercise training, while the control group received Kegel exercise training only. The treatment lasted for 3 months. The scores of International Consultation on Incontinence Modular Questionnaire Short Form (ICIQ-SF), 1 h pad test, International Prostate Symptom Score (IPSS) and Incontinence Quality of Life Questionnaire (I-QoL) were recorded and compared between the two groups before and after treatment. The adverse reactions were observed. 【Results】 The scores of ICIQ-SF, IPSS and I-QoL and 1 h pad test significantly decreased in both groups after treatment (P0.05), but after treatment, the scores of ICIQ-SF,IPSS,I-QoL and 1 h pad test were significantly lower in the test group than in the control group (P<0.05). No severe adverse reactions were observed. 【Conclusion】 Pelvic floor magnetic stimulation combined with Kegel exercise training is safe and effective for SUI after minimally invasive surgery for BPH.

Measurement of environmental sensitivity in adolescents: Chinese version of the Highly Sensitive Child Scale and its moderation role / 西安交通大学学报(医学版)

【Objective】 To revise the Highly Sensitive Child (HSC) Scale for Chinese Adolescents and investigate the role of adolescents’ sensitivity to environmental influences. 【Methods】 The HSC Scale was translated into Chinese. A total of 2166 adolescents in Xi’an were selected for exploratory factor, confirmatory factor analyses and reliability analysis. The participants were 609 healthy adolescents and 105 depressive adolescents aged 14-17 years, who were evaluated with the HSC scale and PHQ-9 scale as well as sleep duration and academic achievement questions. 【Results】 First, the factor structure (CFI=0.989, GFI=0.977, AGFI=0.958, TLI=0.983, RMSEA=0.042, RMR=0.050) indicated that HSC scale was a reliable measure of environmental sensitivity. The results supported a bifactor model with a general sensitivity factor and three group factors. Second, the Cronbach α was 0.892, and the test-retest reliability coefficient was 0.743. Third, depressive adolescents had a significantly higher HSC score, compared with the healthy ones (F=15.1, P<0.01). Fourth, the relationship between BMI and adolescent adjustment was moderated by environmental sensitivity. Simple slope analysis showed that when the level of environmental sensitivity was higher, weight gain could predict adolescents’ emotional, sleep and academic problems. 【Conclusion】 The Chinese version of HSC has good psychometric characteristics and may be applied in Chinese adolescents. Environmental sensitivity may be a personality factor that influences depressive symptoms in adolescents.

Association between depressive symptoms and risk of coronary heart disease in middle-aged and elderly Chinese community: An empirical analysis based on CHARLS database / 西安交通大学学报(医学版)

【Objective】 To investigate the association of depressive symptoms with the predicted risk of coronary heart disease in middle-aged and elderly Chinese based on a large community study. 【Methods】 A total of 2532 cases in the group without depression and 2758 cases in the group with depression were included. We compared the two groups in general demographics, information related to coronary heart disease risk, and physical function and ability to perform daily living. We also analyzed the factors associated with coronary heart disease risk by linear regression. 【Results】 ① Demographic information: The group with depression had a higher mean age, a higher proportion of women, more people with poor marital status, and a higher number of comorbid chronic diseases compared with the group without depression (all P<0.05). ② Risk indicators related to coronary heart disease: The group with depression had more people with diabetes and a significantly higher systolic blood pressure compared with the group without depression (P<0.05). The two groups did not significantly differ in the proportion of smokers, diastolic blood pressure, LDL-C, or HDL-C (all P>0.05). The risk of coronary heart disease was significantly higher in the group with depression than in the group without depression (P<0.05). ③ Physical function and ability of daily living: The physical function score, physical self-care score, and instrumental daily living ability were significantly higher in the group with depression than in the group without depression (all P<0.001). ④ Linear regression showed that except for gender, age, marital status, comorbid diabetes, smoking, systolic and diastolic blood pressure, HDL-C and LDL-C were associated with risk of coronary heart disease (P<0.05); CESD was the only factor associated with the risk of coronary heart disease [B=0.019, 95% CI: (0.015, 0.032), P=0.032]. 【Conclusion】 The risk of coronary heart disease is higher in middle-aged and elderly people with depressive symptoms than in those without depressive symptoms. Having depressive symptoms is one of the risk factors for coronary heart disease in middle-aged and elderly people.