The prevalence of symptoms of attention-deficit/hyperactivity disorder in parents of children with autism spectrum disorder.

This study aims to estimate the prevalence of symptoms of attention-deficit/hyperactivity disorder (ADHD) in parents of children with autism spectrum disorder (ASD). This is a cross-sectional study conducted with the parents of 89 children previously diagnosed with ASD. The research instrument used was the 18-item Adult ADHD Self-Report Scale (ASRS). Symptoms of ADHD were present in 10.4% of the mothers of children with a diagnosis of ASD and in 11.3% of the fathers. These results suggest that the prevalence of symptoms of ADHD in the parents of children with autism is higher than that found in the general adult population.

Occurrence rate and clinical predictors of hypertensive pseudocrisis in emergency room care.

OBJECTIVES: To describe the prevalence of hypertensive pseudocrisis in patients treated in emergency rooms with substantially elevated blood pressure levels. To compare this prevalence in private and public hospitals. To describe the frequency of wrong treatment for this condition. To identify, during triage, independent predictors of pseudocrisis. To evaluate the prognosis of patients with pseudocrisis. METHODS: Patients above the age of 18, admitted to the Emergency Rooms of two hospitals (private and public) during a 6 month timeframe, with diastolic blood pressure > or = 120 mmHg were included in the study. Hypertensive pseudocrisis was determined when none of the criteria for hypertensive crisis were present (Guidelines of the Brazilian Society of Cardiology(1)). RESULTS: In the 110 patients studied, the prevalence of hypertensive pseudocrisis was 48% (95% CI = 39%-58%) and prevailed in the private hospital (59% vs 37%, p=0.02). The frequency of wrong treatment was similar between the two hospitals (94% vs 95%, p=0.87). After multivariate analysis, the presence of headache upon admission (Odds Ratio=5.4; 95% CI = 5.1-13; p< 0.001) and diastolic BP levels (Odds Ratio=0.93; 95% CI = 0.89-0.97; p=0.002) were independent predictors of pseudocrisis. The 5 month mortality rate was lower in the pseudocrisis group than the hypertensive crisis group (0% vs 21%, p=0.0004). CONCLUSIONS: There is a high prevalence of hypertensive pseudocrisis in patients when hypertensive crisis is suspected, particularly in the private hospital. The frequency of wrong treatment was similar for both the private and public hospitals. Headaches and diastolic BP levels are independent predictors for this clinical condition. Hypertensive pseudocrisis has a low rate of lethality.

Ocorrência e preditores clínicos de pseudocrise hipertensiva no atendimento de emergência / Occurrence rate and clinical predictors of hypertensive pseudocrisis in emergency room care

OBJETIVOS: Descrever a prevalência de pseudocrise hipertensiva em pacientes atendidos em unidade de emergência com níveis de pressão arterial substancialmente elevados, comparando-a entre serviços privado e público; descrever a freqüência de tratamento indevido para essa condição; identificar, no momento da triagem, preditores independentes de pseudocrise; e avaliar o prognóstico dos pacientes com pseudocrise. MÉTODOS: Durante seis meses, foram incluídos pacientes com idade > 18 anos, atendidos nas Emergências de dois hospitais (privado e público), com pressão arterial diastólica > 120 mmHg. Pseudocrise hipertensiva foi definida na ausência de critérios para crise hipertensiva, segundo as Diretrizes da Sociedade Brasileira de Cardiologia. RESULTADOS: Em 110 pacientes estudados, a prevalência de pseudocrise hipertensiva foi de 48 por cento (intervalo de confiança de 95 por cento [IC 95 por cento] = 39 por cento-58 por cento), predominando no serviço privado (59 por cento vs 37 por cento; p = 0,02). A freqüência de tratamento indevido foi semelhante nos dois serviços (94 por cento vs 95 por cento; p = 0,87). Após análise multivariada, a presença de cefaléia na admissão (odds ratio = 5,4; IC 95 por cento = 5,1-13; p < 0,001) e o nível da pressão arterial diastólica (odds ratio = 0,93; IC 95 por cento = 0,89-0,97; p = 0,002) foram preditores independentes de pseudocrise. A mortalidade em cinco meses foi menor no grupo pseudocrise em relação à crise hipertensiva (0 por cento vs 21 por cento; p = 0,0004). CONCLUSÕES: A prevalência de pseudocrise hipertensiva é elevada em pacientes com suspeita de crise hipertensiva, especialmente em serviço privado. A freqüência de tratamento indevido é semelhante nos serviços privado e público. A presença de cefaléia e o nível da PA diastólica são preditores independentes dessa condição clínica. A pseudocrise hipertensiva é uma situação clínica de baixa letalidade.

OBJECTIVES: To describe the prevalence of hypertensive pseudocrisis in patients treated in emergency rooms with substantially elevated blood pressure levels. To compare this prevalence in private and public hospitals. To describe the frequency of wrong treatment for this condition. To identify, during triage, independent predictors of pseudocrisis. To evaluate the prognosis of patients with pseudocrisis. METHODS: Patients above the age of 18, admitted to the Emergency Rooms of two hospitals (private and public) during a 6 month timeframe, with diastolic blood pressure > 120 mmHg were included in the study. Hypertensive pseudocrisis was determined when none of the criteria for hypertensive crisis were present (Guidelines of the Brazilian Society of Cardiology¹). RESULTS: In the 110 patients studied, the prevalence of hypertensive pseudocrisis was 48 percent (95 percent CI = 39 percent-58 percent) and prevailed in the private hospital (59 percent vs 37 percent, p=0.02). The frequency of wrong treatment was similar between the two hospitals (94 percent vs 95 percent, p=0.87). After multivariate analysis, the presence of headache upon admission (Odds Ratio=5.4; 95 percent CI = 5.1-13; p< 0.001) and diastolic BP levels (Odds Ratio=0.93; 95 percent CI = 0.89-0.97; p=0.002) were independent predictors of pseudocrisis. The 5 month mortality rate was lower in the pseudocrisis group than the hypertensive crisis group (0 percent vs 21 percent, p=0.0004). CONCLUSIONS: There is a high prevalence of hypertensive pseudocrisis in patients when hypertensive crisis is suspected, particularly in the private hospital. The frequency of wrong treatment was similar for both the private and public hospitals. Headaches and diastolic BP levels are independent predictors for this clinical condition. Hypertensive pseudocrisis has a low rate of lethality.