Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70462-4
Carla Silveira , Mary Angela Parpinelli , Rodolfo Carvalho Pacagnella , Rodrigo Soares de Camargo , Maria Laura Costa , Dulce Maria Zanardi , Elton Carlos Ferreira , Juliana Paula Santos , Lesley Hanson , José Guilherme Cecatti , Carla Betina Andreucci
Objective
The World Health Organization Disability Assessment Schedule (WHODAS 2.0) was designed to assess the functioning level in six life domains (cognition, mobility, self-care, getting along, life activities, and participation in community activities). There are different versions, from the simplest to the most complete, various presentations (either interviews or self-administered), comprehending the domains of the International Classification of Functioning, Disability and Health (ICF). This study aimed to make a cross-cultural adaptation of the complete version into Portuguese.
Methods
The proceeding was developed over six stages: translation, back-translation, semantic equivalence, evaluation of previous stages by experts, tool pretest, and final version.
Results
After the pretest, an adjustment to a more colloquial Portuguese was made. The versions were shown to be similar regarding general and referential meaning.
Conclusion
WHODAS 2.0 was shown to be easily applied and understood by women in the pregnancy-postpartum cycle.
{"title":"Cross-cultural adaptation of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) into Portuguese","authors":"Carla Silveira , Mary Angela Parpinelli , Rodolfo Carvalho Pacagnella , Rodrigo Soares de Camargo , Maria Laura Costa , Dulce Maria Zanardi , Elton Carlos Ferreira , Juliana Paula Santos , Lesley Hanson , José Guilherme Cecatti , Carla Betina Andreucci","doi":"10.1016/S2255-4823(13)70462-4","DOIUrl":"10.1016/S2255-4823(13)70462-4","url":null,"abstract":"<div><h3>Objective</h3><p>The World Health Organization Disability Assessment Schedule (WHODAS 2.0) was designed to assess the functioning level in six life domains (cognition, mobility, self-care, getting along, life activities, and participation in community activities). There are different versions, from the simplest to the most complete, various presentations (either interviews or self-administered), comprehending the domains of the International Classification of Functioning, Disability and Health (ICF). This study aimed to make a cross-cultural adaptation of the complete version into Portuguese.</p></div><div><h3>Methods</h3><p>The proceeding was developed over six stages: translation, back-translation, semantic equivalence, evaluation of previous stages by experts, tool pretest, and final version.</p></div><div><h3>Results</h3><p>After the pretest, an adjustment to a more colloquial Portuguese was made. The versions were shown to be similar regarding general and referential meaning.</p></div><div><h3>Conclusion</h3><p>WHODAS 2.0 was shown to be easily applied and understood by women in the pregnancy-postpartum cycle.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 3","pages":"Pages 234-240"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70462-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84445005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70437-5
Shailendra Kapoor
{"title":"Psychiatric co-morbidities in Crohn's disease: an often overlooked aspect","authors":"Shailendra Kapoor","doi":"10.1016/S2255-4823(13)70437-5","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70437-5","url":null,"abstract":"","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 2","pages":"Page 100"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70437-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136496682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70483-1
Fausto Aloísio Pedrosa Pimenta , Maria Aparecida Camargos Bicalho , Marco Aurélio Romano-Silva , Edgar Nunes de Moraes , Nilton Alves de Rezende
Objective
To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction.
Methods
A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia.
Results
After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index.
Conclusion
These comorbidities were associated with the functional decline in elderly people with dementia.
{"title":"Chronic diseases, cognition, functional decline, and the Charlson index in elderly people with dementia","authors":"Fausto Aloísio Pedrosa Pimenta , Maria Aparecida Camargos Bicalho , Marco Aurélio Romano-Silva , Edgar Nunes de Moraes , Nilton Alves de Rezende","doi":"10.1016/S2255-4823(13)70483-1","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70483-1","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia.</p></div><div><h3>Results</h3><p>After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index.</p></div><div><h3>Conclusion</h3><p>These comorbidities were associated with the functional decline in elderly people with dementia.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 4","pages":"Pages 326-334"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70483-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137438544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70420-X
Eduardo Mekitarian Filho
{"title":"Alternative for pre-anesthetic sedation and for surgical procedures in children: use of intranasal midazolam","authors":"Eduardo Mekitarian Filho","doi":"10.1016/S2255-4823(13)70420-X","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70420-X","url":null,"abstract":"","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 1","pages":"Pages 3-4"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70420-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91689670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70444-2
Rita Maria Rodrigues-Bastos, Estela Márcia Saraiva Campos, Luiz Cláudio Ribeiro, Róberti Uili Rodrigues Firmino, Maria Teresa Bustamante-Teixeira
Objective
To study the most frequent causes of hospitalizations for primary care-sensitive conditions (HPCSC) in the city of Juiz de Fora, Brazil, by age group and gender, over the periods of 2002 to 2005 and of 2006 to 2009.
Methods
This was a descriptive study, with data collected from the Hospital Information System of the Unified Health System (Sistema de Informação Hospitalar do Sistema Único de Saúde - SIH-SUS) and from population projections by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística – IBGE). HPCSC rates were calculated for 1,000 inhabitants, and the most frequent causes were studied by gender and age group, comparing both periods.
Results
HPCSP showed rates of 7.74/1,000 between 2002 and 2005 and 8.81/1,000 between 2006 and 2009. The main causes were heart failure, cerebrovascular diseases, angina pectoris, pulmonary diseases, and kidney and urinary tract infections, which together represented 4.9/1,000 in the first period and 5.6/1,000 in the second period. The evolution of the rates between both periods occurred differently by age group and gender.
Conclusion
The study did not exhibit any remarkable differences in HPCSC rates between the periods. Regarding the most frequent causes, reduced hospitalization rates for gastroenteritis, asthma, high blood pressure, and cerebrovascular diseases were observed, as well as increased hospitalizations for heart failure, pulmonary diseases, epilepsies, and kidney and urinary tract infections; these hospitalizations occurred differently by gender and age group. The results showed that a deep reflection regarding the determinants of hospitalizations for avoidable causes is needed.
目的研究2002年至2005年和2006年至2009年期间巴西Juiz de Fora市按年龄组和性别划分的初级保健敏感疾病(HPCSC)住院的最常见原因。方法这是一项描述性研究，数据收集自统一卫生系统医院信息系统(Sistema de informa o Hospitalar do Sistema Único de Saúde - SIH-SUS)和巴西地理与统计研究所(Instituto Brasileiro de Geografia e Estatística - IBGE)的人口预测。计算了1,000名居民的HPCSC发病率，并按性别和年龄组研究了最常见的原因，比较了两个时期。结果2002 - 2005年shpcsp患病率为7.74/ 1000,2006 - 2009年为8.81/ 1000。主要原因是心力衰竭、脑血管疾病、心绞痛、肺部疾病、肾脏和尿路感染，在第一期占4.9/ 1000，在第二期占5.6/ 1000。这两个时期的发病率变化因年龄组和性别而异。结论不同时期间HPCSC发生率无显著差异。对于最常见的原因，观察到胃肠炎、哮喘、高血压和脑血管疾病的住院率下降，以及心力衰竭、肺病、癫痫、肾脏和尿路感染的住院率增加;这些住院情况因性别和年龄组而异。结果表明，需要对可避免原因住院的决定因素进行深刻反思。
{"title":"Hospitalizations for primary care-sensitive conditions in a Southern Brazilian municipality","authors":"Rita Maria Rodrigues-Bastos, Estela Márcia Saraiva Campos, Luiz Cláudio Ribeiro, Róberti Uili Rodrigues Firmino, Maria Teresa Bustamante-Teixeira","doi":"10.1016/S2255-4823(13)70444-2","DOIUrl":"10.1016/S2255-4823(13)70444-2","url":null,"abstract":"<div><h3>Objective</h3><p>To study the most frequent causes of hospitalizations for primary care-sensitive conditions (HPCSC) in the city of Juiz de Fora, Brazil, by age group and gender, over the periods of 2002 to 2005 and of 2006 to 2009.</p></div><div><h3>Methods</h3><p>This was a descriptive study, with data collected from the Hospital Information System of the Unified Health System (Sistema de Informação Hospitalar do Sistema Único de Saúde - SIH-SUS) and from population projections by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística – IBGE). HPCSC rates were calculated for 1,000 inhabitants, and the most frequent causes were studied by gender and age group, comparing both periods.</p></div><div><h3>Results</h3><p>HPCSP showed rates of 7.74/1,000 between 2002 and 2005 and 8.81/1,000 between 2006 and 2009. The main causes were heart failure, cerebrovascular diseases, angina pectoris, pulmonary diseases, and kidney and urinary tract infections, which together represented 4.9/1,000 in the first period and 5.6/1,000 in the second period. The evolution of the rates between both periods occurred differently by age group and gender.</p></div><div><h3>Conclusion</h3><p>The study did not exhibit any remarkable differences in HPCSC rates between the periods. Regarding the most frequent causes, reduced hospitalization rates for gastroenteritis, asthma, high blood pressure, and cerebrovascular diseases were observed, as well as increased hospitalizations for heart failure, pulmonary diseases, epilepsies, and kidney and urinary tract infections; these hospitalizations occurred differently by gender and age group. The results showed that a deep reflection regarding the determinants of hospitalizations for avoidable causes is needed.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 2","pages":"Pages 120-127"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70444-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76372642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70503-4
Allex Jardim da Fonseca , Luiz Carlos de Lima Ferreira , Giacomo Balbinotto Neto
Objective
To assess the cost-utility of the human papillomavirus (HPV) vaccination on the prevention of cervical cancer in the Brazilian Amazon region.
Methods
A Markov cohort model was developed to simulate the natural evolution of HPV and its progress to cervical cancer, considering the current preventive programs and treatment costs. The one-year transition probabilities were mainly based on empirical data of local and national studies. The model evaluated the addition of the vaccine to three cervical cancer-screening scenarios (0, 3 or 10 exams throughout life).
Results
The scenario of three Pap tests resulted in satisfactory calibration (base case). The addition of HPV vaccination would reduce by 35% the incidence of cervical cancer (70% vaccination coverage). The incremental cost-effectiveness ratio was US$ 825 for each quality-adjusted life year gained. The sensitivity analysis confirms the robustness of this result, and duration of immunity was the parameter with greater variation in incremental cost-effectiveness ratio.
Conclusion
Vaccination has a favorable profile in terms of cost-utility, and its inclusion in the immunization schedule would result in a substantial reduction in incidence and mortality of invasive cervical cancer in the Brazilian Amazon region.
{"title":"Cost-effectiveness of the vaccine against human papillomavirus in the Brazilian Amazon region","authors":"Allex Jardim da Fonseca , Luiz Carlos de Lima Ferreira , Giacomo Balbinotto Neto","doi":"10.1016/S2255-4823(13)70503-4","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70503-4","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the cost-utility of the human papillomavirus (HPV) vaccination on the prevention of cervical cancer in the Brazilian Amazon region.</p></div><div><h3>Methods</h3><p>A Markov cohort model was developed to simulate the natural evolution of HPV and its progress to cervical cancer, considering the current preventive programs and treatment costs. The one-year transition probabilities were mainly based on empirical data of local and national studies. The model evaluated the addition of the vaccine to three cervical cancer-screening scenarios (0, 3 or 10 exams throughout life).</p></div><div><h3>Results</h3><p>The scenario of three Pap tests resulted in satisfactory calibration (base case). The addition of HPV vaccination would reduce by 35% the incidence of cervical cancer (70% vaccination coverage). The incremental cost-effectiveness ratio was US$ 825 for each quality-adjusted life year gained. The sensitivity analysis confirms the robustness of this result, and duration of immunity was the parameter with greater variation in incremental cost-effectiveness ratio.</p></div><div><h3>Conclusion</h3><p>Vaccination has a favorable profile in terms of cost-utility, and its inclusion in the immunization schedule would result in a substantial reduction in incidence and mortality of invasive cervical cancer in the Brazilian Amazon region.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 5","pages":"Pages 442-451"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70503-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72283495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-01-01DOI: 10.1016/S2255-4823(13)70429-6
Fabiana Lucena Rocha, Tarciana Nobre de Menezes, Rômulo Lustosa Pimenteira de Melo, Dixis Figueroa Pedraza
Objective
To verify the correlation between anthropometric indicators of abdominal obesity and serum lipids in the elderly.
Methods
Cross-sectional, descriptive, and analytical study conducted with elderly individuals of both genders enrolled in the Family Health Strategy Program of Campina Grande/PB. Abdominal obesity was assessed by waist circumference (WC), abdominal circumference (AC), and waist/hip ratio (WHR). Lipid profile was verified by levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and non-high density lipoprotein (non-HDL).
Results
A total of 321 elderly patients were evaluated (67.6% women). There were significant correlations between abdominal obesity indicators and lipid levels only in the group of women. WC, AC, and WHR correlated with TG and HDL. Only WHR showed correlation with non-HDL. The highest correlations were observed between WHR and TG (r = 0.292, p < 0.01) and between WC and HDL (r = -0.281, p < 0.01). WC was a predictor of 9.2% of the variation in HDL, and WHR was a predictor of 7.3% of the variation in TG.
Conclusion
The indicators of abdominal obesity that best correlated with serum lipids in elderly women were WC and WHR. They were predictors of alterations in HDL and TG levels in women, respectively
目的验证老年人腹部肥胖人体测量指标与血脂的相关性。方法采用横断面、描述性和分析性研究方法，对参加格兰皮纳/PB家庭健康战略计划的男女老年人进行研究。通过腰围(WC)、腹围(AC)和腰臀比(WHR)评估腹部肥胖。脂质谱通过甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和非高密度脂蛋白(non-HDL)的水平来验证。结果共评估老年患者321例(67.6%为女性)。腹部肥胖指标与脂质水平仅在女性组中存在显著相关性。WC、AC、WHR与TG、HDL相关。只有WHR与non-HDL相关。WHR与TG相关性最高(r = 0.292, p <0.01)， WC与HDL之间存在差异(r = -0.281, p <0.01)。WC是9.2% HDL变异的预测因子，WHR是7.3% TG变异的预测因子。结论老年妇女腹部肥胖与血脂相关性最好的指标是腰围和腰宽比。它们分别是女性HDL和TG水平变化的预测因子
{"title":"Correlation between indicators of abdominal obesity and serum lipids in the elderly","authors":"Fabiana Lucena Rocha, Tarciana Nobre de Menezes, Rômulo Lustosa Pimenteira de Melo, Dixis Figueroa Pedraza","doi":"10.1016/S2255-4823(13)70429-6","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70429-6","url":null,"abstract":"<div><h3>Objective</h3><p>To verify the correlation between anthropometric indicators of abdominal obesity and serum lipids in the elderly.</p></div><div><h3>Methods</h3><p>Cross-sectional, descriptive, and analytical study conducted with elderly individuals of both genders enrolled in the Family Health Strategy Program of Campina Grande/PB. Abdominal obesity was assessed by waist circumference (WC), abdominal circumference (AC), and waist/hip ratio (WHR). Lipid profile was verified by levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and non-high density lipoprotein (non-HDL).</p></div><div><h3>Results</h3><p>A total of 321 elderly patients were evaluated (67.6% women). There were significant correlations between abdominal obesity indicators and lipid levels only in the group of women. WC, AC, and WHR correlated with TG and HDL. Only WHR showed correlation with non-HDL. The highest correlations were observed between WHR and TG (r<!--> <!-->=<!--> <!-->0.292, p<!--> <!--><<!--> <!-->0.01) and between WC and HDL (r<!--> <!-->=<!--> <!-->-0.281, p<!--> <!--><<!--> <!-->0.01). WC was a predictor of 9.2% of the variation in HDL, and WHR was a predictor of 7.3% of the variation in TG.</p></div><div><h3>Conclusion</h3><p>The indicators of abdominal obesity that best correlated with serum lipids in elderly women were WC and WHR. They were predictors of alterations in HDL and TG levels in women, respectively</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 1","pages":"Pages 48-55"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70429-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91637544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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