Página 3 dos resultados de 1440 itens digitais encontrados em 0.009 segundos

‣ Efeito da manobra de recrutamento alveolar em pacientes com síndrome da angústia respiratória aguda: revisão sistemática e metanálise; Effects of alveolar recruitment maneuvers in patients with acute respiratory distress syndrome: a systematic review and meta-analysis

Suzumura, Erica Aranha
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 02/04/2015 Português
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Objetivo: Avaliar o efeito das manobras de recrutamento alveolar em desfechos clínicos de pacientes com síndrome da angústia respiratória aguda (SARA). Métodos: Busca nas bases eletrônicas MEDLINE, EMBASE, LILACS, CINAHL, CENTRAL, Scopus, and Web of Science (até Julho de 2014), sem limite de idioma, por ensaios clínicos randomizados avaliando o efeito das manobras de recrutamento alveolar versus tratamento padrão sem manobras de recrutamento em pacientes adultos com SARA. Quatro duplas de revisores avaliaram de maneira independente a elegibilidade e o risco de viés dos estudos e extraíram os dados de interesse. Realizamos metanálise dos dados por meio de modelos de efeitos aleatórios. Foi utilizada análise sequencial de trials para estabelecer limiares de significância estatística para a metanálise cumulativa considerando nosso desfecho primário (mortalidade hospitalar) para limitar o erro tipo I global por análises múltiplas. Utilizamos sistema GRADE para avaliar a qualidade da evidência. Resultados: Foram incluídos 10 ensaios clínicos randomizados (1594 pacientes, 612 eventos). O risco relativo (RR) de óbito nos pacientes tratados com manobras de recrutamento em comparação ao controle foi de 0,84 (intervalo de 95% de confiança [IC95%] 0...

‣ Triagem nutricional em adultos hospitalizados; Nutritional screening in inpatients

Beghetto, Mariur Gomes; Manna, Bibiana Borges; Candal, Andréia; Mello, Elza Daniel de; Polanczyk, Carisi Anne
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
Português
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Em hospitais, o objetivo de um procedimento de triagem nutricional é identificar indivíduos desnutridos ou em risco de desnutrição, possibilitando intervenção nutricional precoce e melhor alocação de recursos. Diferentes métodos são apresentados na literatura para esta finalidade: Malnutrition Screening Tool, Short Nutritional Assessment Questionnaire, Nutritional Risk Index, Nutrition Risk Score, Nutritional Risk Screening, Mini Nutritional Assessment, Malnutrition Universal Screening Tool, Nutritional Screening Tool, Nutritional Screening Equation. No entanto, o emprego de muitos destes instrumentos está limitado pela inadequada metodologia empregada na derivação e/ou validação, pela seleção de grupos específicos de pacientes, pela pouca praticidade ou por necessidade de um especialista para seu emprego. Na ausência de um padrão de referência para emitir o diagnóstico nutricional, desfechos clínicos relevantes devem balizar a derivação e a validação de novos instrumentos. Este trabalho descreve os instrumentos de triagem nutricional acima referidos e apresenta considerações quanto ao seu emprego para adultos hospitalizados não selecionados.; In hospitals, the aim of a nutritional screening procedure is to identify malnourished individuals or those at risk of malnutrition...

‣ Epidemiology and genetics of endemic goiter. I. Epidemiological aspects

Freire-Maia, D. V.; Freire-Maia, A.; Schull, W. J.; Morton, N. E.; Quelce-Salgado, A.; Lobo, L. C.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 11-16
Português
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This study dealt with approximately 2,000 children and their parents living in a hyperendemic goiter area in Central Brazil, which is bounded by the jungle to the north and by a large plain to the south. The determination of goiter was made according to the methods and classification adopted by WHO. Conspicuous forms of goiter were found in 41% of the children examined. Multiple linear regression analysis showed an increase with age in the frequency of goiter in both sexes. Although data from the literature show that Mulattoes and Negroes have statistically higher frequencies of goiter than do Whites, our multiple linear regression analysis revealed no evidence for an effect of race on the endemism. There was no significant association with socioeconomic level. The presence of goiter in parents was shown to be statistically associated with its occurrence in the children.

‣ Influence of soil texture in the recovery of Toxocara canis eggs by a flotation method

Nunes, Cáris Maroni; Sinhorini, Idércio Luis; Ogassawara, Saemi
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 269-274
Português
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In epidemiological surveys, the evaluation of soil contamination by Toxocara canis eggs requires a quick and easy method for the isolation of parasite eggs from soil samples. The efficiency of flotation methods is influenced by sample size, soil texture, degree of soil contamination, pretreatment, flotation solutions and time of flotation. This investigation was designed to evaluate the influence of soil texture in the recovery of T. canis eggs with the centrifugal flotation technique of Dada (Dada, B.J.O., 1979. A new technique for the recovery of Toxocara eggs from soil. J. Helminthol., 53: 141-144). Four types of soil (clay silt, sandy, silty clay and sand) were artificially contaminated with T. canis eggs (200 eggs per gram). Zinc sulphate (specific gravity 1.20) and sodium dichromate (specific gravity 1.35) were used as flotation solutions. Twenty replicated examinations were performed for each type of soil and flotation solution. There was a statistically significant difference in the results depending on soil type. The highest recovery percentages were observed in soils rich in sand (62.5% for sand and 38.0% for sandy soil). Differences were also observed with different flotation solutions. Sodium dichromate solution was more efficient for recovering T. canis eggs...

‣ Mortalidade e prognóstico específico em pacientes com insuficiência renal aguda

Balbi, André Luis; Gabriel, Daniela Ponce; Barsante, Renata Cristina; Caramori, Jacqueline Teixeira; Martin, Luis Cuadrado; Barretti, Pasqual
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 318-322
Português
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A variety of systems of risk factor stratification have been studied to predict the outcome in acute renal failure (ARF). OBJECTIVES. Assess and compare mortality and the Acute Tubular Necrosis Individual Severity Score (ATN-ISS) in patients with AFR treated in a university hospital. METHODS. A prospective analysis was made of 103 patients with a diagnosis of intrinsic ARF admitted to the Hospital das Clinicas da Faculdade de Medicina de Botucatu, UNESP. Patients were followed up until recovery of renal function or death. The Score ATN-ISS was recorded during the first hours of the assessment by a nephrologist. Results were reported as median or mean ± SD, with statistical significance of p<0.05. RESULTS. Fifty-one percent of patients were male with a mean age of 58 ± 36 years. Forty-four percent died in the hospital. Mortality was higher in patients from the surgical wards (52.7%) and in patients who were treated with dialysis (63.8%). The score ATN-ISS showed a good confidence level, with high discriminatory power (area under the curve of 0.95) and good accuracy. CONCLUSIONS. Mortality in this study was comparable to that found in literature. The ATN-ISS was shown to be a prognostic index with a high confidence level that could be routinely applied by nephrologists to patients with AFR.

‣ Efficacy of ultrasonic, electric and manual toothbrushes in patients with fixed orthodontic appliances

Costa, Mauricio Ribeiro; Silva, Vanessa Camila; Miqui, Miriam Nakatani; Sakima, Tatsuko; Spolidorio, Denise Madalena Palomari; Cirelli, Joni Augusto
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 361-366
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Objective: This crossover study compared the efficacy of an ultrasonic toothbrush for the reduction of plaque, gingival inflammation, and levels of Streptococcus mutans, in relation to an electric and a manual toothbrush. Materials and Methods: Twenty-one patients with orthodontic appliances were divided into three groups. All patients were evaluated by a periodontist and samples of saliva were collected for quantification of S mutans. The patients received their first brushes with appropriate instructions. For each crossover leg, patients used each toothbrush for a period of 30 days. At the end of each washout period, participants received a periodontal evaluation and new samples of saliva were collected. After 15 days of using their own toothbrushes, patients received the next toothbrushes in the experimental sequence. Results: The ultrasonic brush group presented significant improvement in the reduction of visible plaque on the buccal surfaces (-6.36%, P = .007). The counts of S mutans decreased in the electric (2.04 × 105 to 1.36 × 105 colony-forming units [CFU]/mL) and ultrasonic (2.98 × 105 to 1.84 × 105 CFU/mL) groups. There were no statistical differences among the three brushes for the clinical and microbiological parameters evaluated. Conclusions: This study did not demonstrate that the ultrasonic toothbrush was better in reducing gingival inflammation in adolescent orthodontic patients...

‣ Clinical signs of pneumonia in children: association with and prediction of diagnosis by fuzzy sets theory

Pereira,J.C.R.; Tonelli,P.A.; Barros,L.C.; Ortega,N.R.S.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2004 Português
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The present study compares the performance of stochastic and fuzzy models for the analysis of the relationship between clinical signs and diagnosis. Data obtained for 153 children concerning diagnosis (pneumonia, other non-pneumonia diseases, absence of disease) and seven clinical signs were divided into two samples, one for analysis and other for validation. The former was used to derive relations by multi-discriminant analysis (MDA) and by fuzzy max-min compositions (fuzzy), and the latter was used to assess the predictions drawn from each type of relation. MDA and fuzzy were closely similar in terms of prediction, with correct allocation of 75.7 to 78.3% of patients in the validation sample, and displaying only a single instance of disagreement: a patient with low level of toxemia was mistaken as not diseased by MDA and correctly taken as somehow ill by fuzzy. Concerning relations, each method provided different information, each revealing different aspects of the relations between clinical signs and diagnoses. Both methods agreed on pointing X-ray, dyspnea, and auscultation as better related with pneumonia, but only fuzzy was able to detect relations of heart rate, body temperature, toxemia and respiratory rate with pneumonia. Moreover...

‣ Hierarchy of evidence relating to hand surgery in Brazilian orthopedic journals

Moraes,Vinícius Ynoe de; Belloti,João Carlos; Moraes,Fábio Ynoe de; Galbiatti,José Antonio; Palácio,Evandro Pereira; Santos,João Baptista Gomes dos; Faloppa,Flávio
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2011 Português
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CONTEXT AND OBJECTIVE: There is no systematic assessment of the quality of scientific production in the specialty of hand surgery in our setting. This study aimed to systematically assess the status of evidence generation relating to hand surgery and to evaluate the reproducibility of the classification method based on an evidence pyramid. DESIGN AND SETTING: Secondary study conducted at Universidade Federal de São Paulo (Unifesp) and Faculdade Estadual de Medicina de Marília (Famema). METHODS: Two researchers independently conducted an electronic database search for hand surgery studies published between 2000 and 2009 in the two main Brazilian orthopedic journals (Acta Ortopédica Brasileira and Revista Brasileira de Ortopedia). The studies identified were subsequently classified according to methodological design (systematic review of the literature, randomized clinical trial, cohort study, case-control study, case series and other studies) and evidence level (I to V). RESULTS: A total of 1,150 articles were evaluated, and 83 (7.2%) were included in the final analysis. Studies with evidence level IV (case series) accounted for 41 (49%) of the published papers. Studies with evidence level V (other studies) accounted for 12 (14.5%) of the papers. Only two studies (2.4%) were ranked as level I or II. The inter-rater reproducibility was excellent (k = 0.94). CONCLUSIONS: Hand surgery articles corresponded to less than one tenth of Brazilian orthopedic production. Studies with evidence level IV were the commonest type. The reproducibility of the classification stratified by evidence level was almost perfect.

‣ Predictors of dental pain and general anesthetic receipt for hospital dental procedures among New Zealand children

Jamieson, L.; Koopu, P.
Fonte: AAPHD National Office Publicador: AAPHD National Office
Tipo: Artigo de Revista Científica
Publicado em //2006 Português
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Objectives: To predict experience of dental pain and hospital dental general anesthetic receipt among Maori, Pacific and New Zealand European or Other (NZEO) children in New Zealand. Methods: Data were from the 2002 National Child Nutrition Survey. Models representing demographic, socio-economic status (SES), lifestyle, dietary, food security and oral health paradigms were tested using logistic regression. Results: Some 3275 children participated; 37.4 % Mäori, 32.3 % Pacific and 30.3% NZEO. Mäori children had higher odds of dental pain experience than NZEO children after adjusting for age, sex and length of time lived in New Zealand and with addition of household SES or physical factors. There were no differences in Pacific and NZEO child dental pain experience when the same factors were accounted for. The prevalence of dental general anesthetic receipt was similar among Maori, Pacific and NZEO children after adjusting for demographic, lifestyle, dietary, food security and dental factors in separate models. When such factors were investigated together, Pacific children were less likely to have received a dental general anesthetic than NZEO children. Conclusions: Maori children were more likely to experience dental pain and Pacific children were less likely to have received a dental general anesthetic than NZEO children after accounting for various behavioral and material factors. The latter may reflect issues pertaining to access and culturally insensitive services rather than demand for care per se.; Lisa M. Jamieson and Pauline I. Koopu; The definitive version is available at www.blackwell-synergy.com

‣ Periodontal disease among 45-54 year olds in Adelaide, South Australia

Brennan, D.; Spencer, A.; Roberts-Thomson, K.
Fonte: Australian Dental Assn Inc Publicador: Australian Dental Assn Inc
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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Background: The aims of this study were to describe the prevalence, extent and severity of periodontal disease among middle-aged adults, and to examine periodontitis by dental visit pattern, dental and health behaviour, socio-demographics and socio-economic status. Methods: A random sample of 45–54 year olds from metropolitan Adelaide, South Australia was surveyed by mailed self-complete questionnaire during 2004–2005 with up to four follow-up mailings of the questionnaire to non-respondents (n=879 responded, response rate=43.8 per cent). Oral examinations were performed on 709 people who responded to the questionnaire (completion rate=80.7 per cent), providing an assessment of periodontal status. Results: Prevalence of loss of attachment (LOA) of 6+ mm was 19.2 per cent, extent of sites with LOA of 6+ mm was 1.3 per cent, and severity of LOA of sites with LOA of 2+ mm was 2.4mm. Using a case definition for periodontitis of two or more sites with LOA of 5+ mm and one or more sites with PD of 4+ mm in a multivariate logistic regression showed higher odds of periodontitis for people who last visited for relief of pain (OR=1.93) and who smoked daily/occasionally (OR=3.84), while lower odds were observed for people who were born in Australia (OR=0.51) and spoke English as the main language at home (OR=0.34). Conclusions: While periodontal disease was related to visit pattern and health-related behaviours...

‣ Oral health of Indigenous adult public dental patients in Australia

Brennan, D.; Roberts-Thomson, K.; Spencer, A.
Fonte: Australian Dental Assn Inc Publicador: Australian Dental Assn Inc
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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Background: Indigenous Australians have been reported in a range of studies to have worse health than non-Indigenous Australians. Among health care card holders, a financially disadvantaged group eligible for public-funded dental care, oral health may also be worse among Indigenous persons. The aims of this study were to examine the oral health of Indigenous compared to non-Indigenous adult public dental patients in terms of caries experience and periodontal status, controlling for age and gender of patient, type of care and geographic location. Methods: Patients were sampled randomly by state/territory dental services in 2001–2002. Dentists recorded oral health status at the initial visit of a course of care using written instructions. The samples were weighted in proportion to the numbers of public-funded dental patients for each state/territory. Results: Multivariate logistic regression showed that the presence of periodontal pockets of 6+ mm was higher (P < 0.05) among Indigenous compared to non-Indigenous patients (OR=2.24, 1.34–3.76), after controlling for age and gender of patients, type of care and geographic location. Multivariate negative binomial regression analysis (RR: rate ratio) controlling for age and gender of patients...

‣ Gonioscopy findings and prevalence of occludable angles in a Burmese population: the Meiktila Eye Study

Casson, R.; Newland, H.; Muecke, J.; McGovern, S.; Abraham, L.; Shein, W.; Selva-Nayagam, D.; Aung, T.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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AIM: To determine the prevalence of preglaucomatous angle-closure disease in central Myanmar. METHODS: A population-based survey of inhabitants >or=40 years in the Meiktila District was carried out; 2481 subjects were identified, 2076 participated and 2060 underwent gonioscopy of at least one eye. Eyes with angles traditionally described as "occludable" were recorded as primary angle-closure suspects (PACS); eyes with PACS and peripheral anterior synechiae (PAS), or an increased intraocular pressure but without primary angle-closure glaucoma, were recorded as primary angle closure (PAC). RESULTS: The prevalence of PACS in at least one eye was 5.7% (95% CI 4.72 to 6.62); prevalence increased with age and was more common in women (p<0.001). The prevalence of PAC in at least one eye was 1.50% (95% CI 1.47 to 1.53). All participants with PAS had at least 90 degrees of closure (range 90-360 degrees). CONCLUSION: The prevalence of preglaucomatous angle-closure disease (PACS and PAC) in this population was 5.7% and 1.5%, respectively. PACS was more common in women, and its prevalence increased with age.; R J Casson, H S Newland, J Muecke, S McGovern, L M Abraham, W K Shein, D Selva, T Aung

‣ Comorbities of overweight/obesity in Australian preschoolers: a cross-sectional population study

Wake, M.; Hardy, P.; Sawyer, M.; Carlin, J.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
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Objective: To determine relationships between body mass index (BMI) status and indicators of health and morbidity in a nationally-representative population sample of preschool children. Methods: Data from the 4–5-year-old cohort in the first wave (2004) of the Longitudinal Study of Australian Children were studied. Main outcome measures were: measured child BMI, categorised as non-overweight, overweight and obese using International Obesity TaskForce cutpoints; parent-reported child global health, health-related quality of life, mental health problems, asthma, sleep problems, injuries, special health care needs, and level of parental concern about the child’s weight. Regression methods were used to assess associations with child’s BMI status, adjusted for sociodemographic factors. Results: BMI was available for 4934 (99%) children; 756 (15.3%) were overweight and 258 (5.2%) obese. Compared to non-overweight children, parents of overweight and obese children reported a higher prevalence of special health care needs (adj OR 1.72, 95% CI 1.20 to 2.46), but other health outcomes were similar. Parental concern about the child’s weight was low among the overweight (14.4%) and non-overweight (17.8%) children, but rose to 52.7% in the obese. However...

‣ Mortality and cancer incidence of Australian participants in the British nuclear tests in Australia

Gun, R.; Parsons, J.; Crouch, P.; Ryan, P.; Hiller, J.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
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Objectives: To investigate the mortality and cancer incidence of Australian nuclear test participants, and to identify any association with exposure to ionising radiation. Methods: A retrospective cohort study was carried out in which the mortality and cancer incidence rates of participants (n = 10 983) were compared with rates in the general male Australian population. Dose reconstructions were carried out by a panel of health physicists. Mortality and cancer rates were compared with the general population and between groups of subjects categorised by assessed radiation exposure. Results: All-cause mortality was not raised. Mortality and incidence were significantly raised for cancers of the head and neck, lung, colon and rectum, and prostate, and for all cancers combined. For oesophageal cancer, melanoma, all leukaemias and non-chronic lymphatic leukaemia (non-CLL leukaemia), incidence was significantly raised, but mortality was non-significantly raised. No association was found between radiation exposure and overall cancer incidence or mortality, or with any cancer or cancer deaths occurring in excess. Conclusions: There is no evidence that the excess cancers and cancer deaths were caused by radiation exposure at the test sites. Possible contributing factors are high smoking prevalence and demographic differences from the Australian population with whom rates were compared. Asbestos is a likely contributor to some cancers in naval personnel.; R T Gun...

‣ Gastrointestinal symptoms and glycemic control in diabetes mellitus: a longitudinal population study

Quan, C.; Talley, N.; Jones, M.; Howell, S.; Horowitz, M.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
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Background: The prevalence of gastrointestinal (GI) symptoms is increased in diabetes, but their natural history is understood poorly and any impact of glycemic control is controversial. We aimed to quantify changes in GI symptom status and glycemic control among a population sample of patients with diabetes. Methods: Data on 10 chronic GI symptom complexes were obtained from a validated questionnaire at baseline and after 12 months. Changes in acute and chronic glycemic control were classified as always adequate, variable (deteriorated or improved), or always inadequate; acute glycemic control was assessed by fasting plasma glucose and chronic glycemic control by a validated self-report 5-point graded scale. Results: Baseline and follow-up data were available in 136 individuals with diabetes (mean age 59 years; 66% males; 95% type 2). The most prevalent GI symptom complexes were abdominal bloating/distension (35%), ulcer-like dyspepsia (35%), and irritable bowel syndrome (27%). Overall, between 7 and 24% reported a change in GI symptoms with the largest change in irritable bowel syndrome (24%), bloating/distension (22%), and ulcer-like dyspepsia (21%). Those who had a change in abdominal bloating (either loss or gain) over 12 months were more likely to have increased their mean fasting plasma glucose (P<0.05). Contrary to expectations...

‣ Prevalence and determinants of age-related macular degeneration in central Sri Lanka: the Kandy Eye Study

Goold, L.; Edussuriya, K.; Sennanayake, S.; Senaratne, T.; Selva-Nayagam, D.; Sullivan, T.; Casson, R.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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Aims To determine the prevalence, associations and risk factors for age-related macular degeneration (ARMD) in central Sri Lanka. Methods The study was a population-based, cross-sectional survey of residents aged ≥40 years in rural Sri Lanka. ARMD was assessed on dilated fundoscopy using the International Age-Related Maculopathy Epidemiology Study Group classification system. Results Of the 1721 subjects identified, 1375 participated (79.9%). Of the participants, 1013 were aged ≥50 years (73.6%). The prevalence of any ARMD (adjusted for study design) was 4.72 (95% CI 2.22 to 7.20)% with 3.82 (95% CI 1.60 to 6.04)% early ARMD and 1.70 (95% CI 0.14 to 3.27)% late ARMD. Age (p<0.001) and Sinhalese ethnicity (p = 0.016) were significantly associated with ARMD. Men had a tendency toward a higher prevalence of ARMD than women, although this was not statistically significant (p = 0.081). Ocular risk factors such as cortical cataract (p = 0.024) and pseudophakia (p = 0.003) were associated with ARMD on the univariate but not multivariate analyses. Illiteracy and the identification of social supports were significantly associated with ARMD on univariate analyses. However, only social support was statistically significant after multivariate analysis (p = 0.024). Conclusions Although the prevalence of ARMD is slightly lower in Sri Lanka than surrounding regions...

‣ A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care

Chai-Coetzer, C.; Antic, N.; Rowland, L.; Catcheside, P.; Esterman, A.; Reed, R.; Williams, H.; Dunn, S.; McEvoy, R.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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Background: To address the growing burden of disease and long waiting lists for sleep services, a simplified two-stage model was developed and validated for identifying obstructive sleep apnoea (OSA) in primary care using a screening questionnaire followed by home sleep monitoring. Methods: 157 patients aged 25–70 years attending their primary care physician for any reason at six primary care clinics in rural and metropolitan regions of South Australia participated. The first 79 patients formed the development group and the next 78 patients the validation group. A screening questionnaire was developed from factors identified from sleep surveys, demographic and anthropometric data to be predictive of moderate to severe OSA. Receiver operating characteristic (ROC) curve analysis was used to validate the two-channel ApneaLink device against full polysomnography. The diagnostic accuracy of the overall two-stage model was then evaluated. Results: Snoring, waist circumference, witnessed apnoeas and age were predictive of OSA and incorporated into a screening questionnaire (ROC area under curve (AUC) 0.84, 95% CI 0.75 to 0.94, p<0.001). ApneaLink oximetry with a 3% dip rate was highly predictive of OSA (AUC 0.96, 95% CI 0.91 to 1.0, p<0.001). The two-stage diagnostic model showed a sensitivity of 0.97 (95% CI 0.81 to 1.00) and specificity of 0.87 (95% CI 0.74 to 0.95) in the development group...

‣ Congenital and neonatal varicella: impact of the national varicella vaccination programme in Australia

Khandaker, G.; Marshall, H.; Peadon, E.; Zurynski, Y.; Burgner, D.; Buttery, J.; Gold, M.; Nissen, M.; Elliott, E.; Burgess, M.; Booy, R.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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Objective: Routine varicella zoster vaccination for children aged 18 months began in Australia from November 2005. The aim of this study was to compare the current incidence and outcomes of congenital and neonatal varicella in Australia with similarly collected data from 1995 to 1997. Methods: Active national prospective surveillance was carried out for congenital and neonatal varicella using the Australian Paediatric Surveillance Unit (APSU) for 3.5 years from June 2006. Around 1300 clinicians reported monthly according to predefined case criteria. Results: During the study period the mean monthly return rate of APSU report cards was 93.7%. Two cases of congenital varicella (0.19 per 100 000 live births per annum) and 16 cases of neonatal varicella (2.0 per 100 000 live births per annum) were identified. During 2008 and 2009 no cases of congenital varicella were reported; neonatal varicella rates declined to 0.7 per 100 000 live births per annum, a significant trend (p=0.005) and a reduction of over 85% compared with rates during 1995–1997 (the prevaccination era) and the first year of the current surveillance study. Eleven of 16 neonatal cases followed prenatal maternal infection; seven of the 11 infections were acquired from children...

‣ A 13-nation population survey of upper gastrointestinal symptoms: Prevalence of symptoms and socioeconomic factors

Haag, S.; Andrews, J.; Gapasin, J.; Gerken, G.; Keller, A.; Holtmann, G.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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Background: Previous data collected in separate studies using various different survey instruments have suggested some variability in the prevalence of symptoms between nations. However, there is a lack of studies which assess and compare the prevalence of upper gastrointestinal symptoms contemporaneously in various countries using a uniform, standardised method. Aim: To determine the prevalence of upper gastrointestinal (UGI) symptoms in 13 European countries, and the association between socioeconomic factors and symptoms using a standardised method. Methods: A representative age- and gender-stratified sample of 23 163 subjects (aged 18–69 years) was surveyed. Results: The prevalence of UGI symptoms was 38%. UGI symptoms were most prevalent in Hungary [45%, 95% confidence interval (CI): 42.2–48.4] and lowest in the Netherlands (24%, 95% CI: 21.0–26.2). UGI symptoms were more prevalent in women (39%, 95% CI: 38.4–39.6) vs. men (37%, 95% CI: 36.4–37.6). Heartburn (24%, 95% CI: 23.4–24.6) and acidic reflux (14%, 95% CI: 13.6–14.4) were most common. With age, the prevalence of UGI symptoms decreased (e.g. 18–29 years: 43%, 95% CI: 41.4–44.3 vs. 50–69 years: 33%, 95% CI: 32.3–34.4); in contrast, the frequency of symptom episodes/year increased with age (e.g. 18–29 years: 11.3 episodes per years...

‣ Multi-state models and arthroplasty histories after unilateral total hip arthroplasties: Introducing the Summary Notation for Arthroplasty Histories

Gillam, M.; Ryan, P.; Salter, A.; Graves, S.
Fonte: Taylor & Francis Publicador: Taylor & Francis
Tipo: Artigo de Revista Científica
Publicado em //2012 Português
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Background and purpose: An increasing number of patients have several joint replacement procedures during their lifetime. We investigated the use and suitability of multi-state model techniques in providing a more comprehensive analysis and description of complex arthroplasty histories held in arthroplasty registries than are allowed for with traditional survival methods. Patients and methods: We obtained data from the Australian Orthopaedic Association National Joint Replacement Registry on patients (n = 84,759) who had undergone a total hip arthroplasty for osteoarthritis in the period 2002–2008. We set up a multi-state model where patients were followed from their first recorded arthroplasty to several possible states: revision of first arthroplasty, either a hip or knee as second arthroplasty, revision of the second arthroplasty, and death. The Summary Notation for Arthroplasty Histories (SNAH) was developed in order to help to manage and analyze this type of data. Results: At the end of the study period, 12% of the 84,759 patients had received a second hip, 3 times as many as had received a knee. The estimated probabilities of having received a second arthroplasty decreased with age. Males had a lower transition rate for receiving a second arthroplasty...