1,720,967 research outputs found
Estudo descritivo de uma população de pacientes com transtornos do sono em ambulatório privado no Distrito Federal com ênfase na prevalência das queixas de sonolência e fadiga
Get PDFDissertação (mestrado)—Universidade de Brasília, Programa de Pós-Graduação em Ciências Médicas, 2011.OBJETIVO: Estudar população de pacientes ambulatoriais com transtornos de sono com relação à frequência das queixas de sonolência e fadiga, verificando a existência de possível diferença dessas queixas entre as doenças estudadas e entre gêneros, avaliando a existência de fatores que possam promover essas queixas nesta população. METODOLOGIA: foram estudados 980 prontuários eletrônicos de pacientes de ambos os sexos, em um ambulatório privado de Medicina do Sono em Brasília-DF, entre janeiro de 2008 e maio de 2010. Foram considerados elegíveis os pacientes com os seguintes diagnósticos: narcolepsia, síndrome da apnéia obstrutiva do sono (SAOS), insônia e síndrome das pernas inquietas (SPI). Para tal foram utilizados: Escala de Sonolência de Epworth (ESE), Escala de Pichot (EP), Escala de Mallampati (EMa), Índice de Apnéia-hipopnéia (IAH) e Índice de Massa Corpórea (IMC). RESULTADOS: 214 pacientes foram incluídos sendo 114 (53,3%) do sexo masculino e 100 (46,7%) do sexo feminino, com média de idade de 49 anos (variando de 17 a 85 anos) sendo que 69 (32,2%) apresentaram fadiga associada à sonolência; 46 (21,5%) apresentaram apenas sonolência sem fadiga; 39 (18,2%) só fadiga sem sonolência e 60 (28,0%) não apresentaram nenhum dos sintomas. A ESE teve média de 11,2±5,9 e a EP de 16,2±8,7. A EMa teve como moda estatística o tipo III (29,9%). O IAH apresentou valor médio de 30,8±22,8 (variando de 0 a 105). O IMC, com média de 29,0±4,4, variou de 19,1 a 41,8. A distribuição por doenças mostrou insônia com 76 pacientes (35,5%); SPI com 27 (12,6%); narcolepsia com 4 (1,9%) e SAOS com 107 (50,0%). Todas as doenças apresentaram níveis de sonolência e fadiga distintos entre si (p<0,01 e p=0,02, respectivamente). A análise de correlação de Pearson entre a ESE e EP foi positiva (R=14% p=0,02). As mulheres apresentaram mais fadiga que os homens (p<0,01), mas não existiram diferenças na sonolência (p=0,82). Pacientes com mais de 49 anos foram mais sonolentos que os mais jovens (p<0,05). As mulheres com insônia foram mais fadigadas do que os homens do mesmo grupo (p=0,02). CONCLUSÃO: As queixas de sonolência e fadiga foram muito frequentes na população com transtornos do sono, apresentando-se como sintomas importantes e diretamente proporcionais a serem avaliados rotineiramente na prática clínica. A fadiga foi mais prevalente no sexo feminino, mas não houve diferenças significativas da sonolência entre gêneros. A presença de SPI mostrou-se um fator agravante da fadiga nos pacientes com transtornos do sono. Considerando os achados deste trabalho fica evidente a necessidade de otimizar o tratamento medicamentoso, biomédico e psicossocial da fadiga nos transtornos do sono. ______________________________________________________________________________ ABSTRACTOBJECTIVE: To evaluate a population of patients with sleep disorders in relation to the frequency of sleepiness and fatigue, checking for possible differences in complaints between the diseases studied and genders. The existence of factors that could lead to these complaints in this population was also investigated. METHODS: We studied 980 electronic records of patients of both genders in a private clinic of sleep medicine in Brasilia (Federal District) between January 2008 and May 2010. Patients with the following diagnosis were considered eligible: narcolepsy, obstructive sleep apnea syndrome (OSAS), insomnia and restless legs syndrome (RLS). To this purpose, the following were used: Epworth Sleepiness Scale (ESS), Pichot's Scale (PS), Mallampati Scale (MSca), apnea-hypopnea index (AHI) and body mass index (BMI). RESULTS: 214 patients were included in the study, of which 114 (53.3%) were male and 100 (46.7%), female. The mean age was 49 years (ranging from 17 to 85 years); 69 patients (32.2%) presented fatigue associated with sleepiness, 46 (21.5%) showed only sleepiness and 39 (18.2%), only fatigue. Sixty (60) patients (28.0%) showed no symptoms. ESS and PS had a mean of 11.2 ± 5.9 and 16.2 ± 8.7, respectively. Mallampati class III was the most common (29.9%). AHI showed a mean value of 30.8 ± 22.8 (ranging from 0 to 105). BMI had a mean of 29.0 ± 4.4 and ranged from 19.1 to 41.8. Distribution by disease showed 76 patients with insomnia (35.5%), 27 patients with RLS (12.6%), 4 patients with narcolepsy (1.9%) and 107 patients with OSAS (50.0%). All the diseases had distinct levels of sleepiness and fatigue (p <0.01 and p = 0.02, respectively). The analysis of Pearson's correlation between ESS and PS was positive (R = 14% p = 0.02). Women showed more fatigue than men (p <0.01), but there were no gender-related differences in sleepiness (p = 0.82). Patients over 49 years old were sleepier than younger patients (p <0.05). Women with insomnia were more fatigued than men in the same group (p = 0.02). CONCLUSION: Complaints of sleepiness and fatigue were very common in the population with sleep disorders. The great importance of these symptoms indicated the need for a routine assessment in clinical practice. Fatigue was more prevalent in women, but there were no significant gender-related differences in sleepiness. The presence of RLS was shown to be an aggravating factor of fatigue in patients with sleep disorders. The findings of this study indicate the need to optimize the biomedical, psychosocial and drug treatment of fatigue in sleep disorders.Faculdade de Medicina (FM)Programa de Pós-Graduação em Ciências Médica
Custo benefício do tratamento da síndrome da apnéia obstrutiva do sono (SAOS) com dispositivo de pressão positiva contínua nas vias aéreas (CPAP)
Get PDFDissertação (mestrado)—Universidade de Brasília, Faculdade de Medicina, 2010.Introdução: O aumento da prevalência da síndrome da apnéia obstrutiva do sono
(SAOS) é um grave problema de saúde pública. Para o tratamento da SAOS, usa-se a
Pressão Positiva Contínua nas Vias Aéreas (CPAP), administrado durante o sono com
máscara nasal para prevenir fechamento e estreitamento das vias aéreas. Entretanto, há
pouca informação acerca da relação do custo-benefício desse tratamento.
Objetivos: Comparar gastos com saúde (medicamentos, consultas médicas e
internações hospitalares) dos portadores de SAOS um ano antes e um ano após o início do
tratamento da SAOS com CPAP e avaliar a adesão dos pacientes ao tratamento.
Materiais e métodos: Realizou-se um estudo de coorte retrospectivo, no período
do 1º semestre de 2008 até o 1º semestre de 2010. Foram estudados 70 pacientes com
diagnóstico de SAOS. Os entrevistados foram questionados acerca da adesão ao tratamento
e dos gastos com consultas médicas, internações hospitalares e medicamentos por meio de um questionário. Os dados foram analisados com a utilização do software SAS 9.1 (Statistical Analysis System).
Resultados: Foram entrevistados 33 mulheres e 37 homens. Dos 70 pacientes estudados, 81,43% aderiram ao tratamento. As mulheres iniciaram o tratamento 8 anos mais novas que os homens um ano após o tratamento; 85,7% dos pacientes tiveram redução dos gastos com consultas e, 78,6% deles apresentaram redução dos gastos com medicamentos. Todavia, não houve correlação estatística entre a redução dos gastos com
medicamentos, consultas e internações hospitalares com a adesão ao tratamento por pressão positiva.
Conclusão: Verificou-se que houve redução dos gastos com saúde dos portadores
de SAOS um ano após o início do tratamento com CPAP, porém não foi observado a
redução desses gastos ao relacioná-los à boa adesão dos pacientes ao tratamento com
CPAP. _________________________________________________________________________________ ABSTRACTIntroduction: The increasing prevalence of the syndrome of obstructive sleep
apnea (OSA) is a serious public health problem. For the treatment of OSAS, we use the Pressure Continuous Positive Airway (CPAP) administered during sleep with nasal mask to prevent closure and airway narrowing. However, there is little information about the costbenefit
ratio of such treatment.
Objectives: To compare health expenditures (drugs, medical consultations and
hospital admissions) of patients with OSA one year before and one year after beginning
treatment of OSA with CPAP and to evaluate patient’s adherence to treatment.
Methods: It’s a retrospective cohort study, started in 1st semester of 2008 and
finished in 1 st semester of 2010. We studied 70 patients diagnosed with OSA. Patients were asked about adherence to treatment and the cost of medical consultations, hospitalizations and medications through a questionnaire. Data were analyzed using the software SAS 9.1 (Statistical Analysis System).
Results: We interviewed 33 women and 37 men. Of the 70 patients studied, 81,43% adhered to treatment. The women started treatment eight years younger than men, one year after treatment; 85,7% of patients spending less on consultations, 78,6% had reduced their spending on drugs. However, no statistical correlation between the reductions of drug costs, consultations and hospitalizations to the adherence to treatment by positive pressure.
Conclusion: It was found that there was a reduction in spending on health of patients with OSA one year after starting treatment with CPAP, but no reduction of these expenditures were related to the good adherence to the CPAP treatment.Faculdade de Medicina (FM)Programa de Pós-Graduação em Ciências Médica
Neurocysticercosis associated to hypoparathyroidism and Fahr's disease (?) : a case report
No full textRelata-se um caso de neurocisticercose associada a hipoparatireoidismo. Discute-se a relação destes com a "doença de Fahr", após breve revisão crítica da literatura. ____________________________________________________________________________________________________________ ABSTRACTThe author reports a case of neurocysticercosis and hypoparathyroidism in a 28 year-old female with bilateral symmetric basal ganglia calcification demonstrable by C.A.T.-Scan. A brief review of the literature is made in order to show why the eponym "Fahr's disease" should not be applied to this case.Faculdade de Medicina (FM
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
- …
