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[PMID]:28453783
[Au] Autor:Ferré Á; Poca MA; de la Calzada MD; Moncho D; Romero O; Sampol G; Sahuquillo J
[Ad] Endereço:Clinical Neurophysiology Department, Barcelona, Spain.
[Ti] Título:Sleep-Related Breathing Disorders in Chiari Malformation Type 1: A Prospective Study of 90 Patients.
[So] Source:Sleep;40(6), 2017 Jun 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Study objective: The aim of the present study is to describe the prevalence of sleep disorders in a large group of patients with Chiari malformation type 1 (CM-1) and determine the presence of risk factors associated with these abnormalities. Methods: Prospective study with consecutive patient selection. We included 90 adult patients with CM-1, defined by the presence of a cerebellar tonsillar descent (TD) ≥3 mm. Clinical, neuroradiological studies, and nocturnal polysomnography (PSG) was carried out. In addition, patients were also subclassified into 2 CM subtypes: CM-1, with the obex above the foramen magnum (FM) and CM-1.5, in which along with a TD ≥3 mm, the obex was located below the FM. Results: We observed a high prevalence (50%) of sleep-related breathing disorders (SRBDs) with predominant hypopnea. Only six patients showed a central apnea index of ≥5. Hypoventilation was observed in only three patients. SRBD severity was associated with male sex, older age, excess weight, and the presence of hydrocephalus. No differences in clinical or PSG parameters were found when comparing CM subtypes (CM-1 and CM-1.5). Sleep architecture study showed decreased sleep efficiency with an increase in arousal and waking after sleep onset. The presence of SRBDs was found to be associated with poorer sleep architecture parameters. Conclusions: This study confirms a high prevalence of SRBDs in patients with CM-1 and CM-1.5, with a predominant obstructive component. Nocturnal PSG recordings should be systematically conducted in these patients, especially those who are male, older, or overweight or those who present hydrocephalus.
[Mh] Termos MeSH primário: Malformação de Arnold-Chiari/epidemiologia
Dissonias/epidemiologia
Dissonias/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Malformação de Arnold-Chiari/classificação
Nível de Alerta
Feminino
Seres Humanos
Hidrocefalia/epidemiologia
Hipoventilação/epidemiologia
Masculino
Sobrepeso/epidemiologia
Polissonografia
Prevalência
Estudos Prospectivos
Fatores de Risco
Caracteres Sexuais
Síndromes da Apneia do Sono/epidemiologia
Síndromes da Apneia do Sono/fisiopatologia
Vigília
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx069


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[PMID]:29308828
[Au] Autor:Lewis SR; Schofield-Robinson OJ; Alderson P; Smith AF
[Ad] Endereço:Patient Safety Research Department, Royal Lancaster Infirmary, Pointer Court 1, Ashton Road, Lancaster, UK, LA1 4RP.
[Ti] Título:Propofol for the promotion of sleep in adults in the intensive care unit.
[So] Source:Cochrane Database Syst Rev;1:CD012454, 2018 Jan 08.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: People in the intensive care unit (ICU) experience sleep deprivation caused by environmental disruption, such as high noise levels and 24-hour lighting, as well as increased patient care activities and invasive monitoring as part of their care. Sleep deprivation affects physical and psychological health, and people perceive the quality of their sleep to be poor whilst in the ICU. Propofol is an anaesthetic agent which can be used in the ICU to maintain patient sedation and some studies suggest it may be a suitable agent to replicate normal sleep. OBJECTIVES: To assess whether the quantity and quality of sleep may be improved by administration of propofol to adults in the ICU and to assess whether propofol given for sleep promotion improves both physical and psychological patient outcomes. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 10), MEDLINE (1946 to October 2017), Embase (1974 to October 2017), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1937 to October 2017) and PsycINFO (1806 to October 2017). We searched clinical trials registers for ongoing studies, and conducted backward and forward citation searching of relevant articles. SELECTION CRITERIA: We included randomized and quasi-randomized controlled trials with adults, over the age of 16 years, admitted to the ICU with any diagnoses, given propofol versus a comparator to promote overnight sleep. We included participants who were and were not mechanically ventilated. We included studies that compared the use of propofol, given at an appropriate clinical dose with the intention of promoting night-time sleep, against: no agent; propofol at a different rate or dose; or another agent, administered specifically to promote sleep. We included only studies in which propofol was given during 'normal' sleeping hours (i.e. between 10 pm and 7 am) to promote a sleep-like state with a diurnal rhythm. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, extracted data, assessed risk of bias and synthesized findings. MAIN RESULTS: We included four studies with 149 randomized participants. We identified two studies awaiting classification for which we were unable to assess eligibility and one ongoing study.Participants differed in severity of illness as assessed by APACHE II scores in three studies and further differences existed between comparisons and methods. One study compared propofol versus no agent, one study compared different doses of propofol and two studies compared propofol versus a benzodiazepine (flunitrazepam, one study; midazolam, one study). All studies reported randomization and allocation concealment inadequately. We judged all studies to have high risk of performance bias from personnel who were unblinded. We noted that some study authors had blinded study outcome assessors and participants for relevant outcomes.It was not appropriate to combine data owing to high levels of methodological heterogeneity.One study comparing propofol with no agent (13 participants) measured quantity and quality of sleep using polysomnography; study authors reported no evidence of a difference in duration of sleep or sleep efficiency, and reported disruption to usual REM (rapid eye movement sleep) with propofol.One study comparing different doses of propofol (30 participants) measured quantity and quality of sleep by personnel using the Ramsay Sedation Scale; study authors reported that more participants who were given a higher dose of propofol had a successful diurnal rhythm, and achieved a greater sedation rhythmicity.Two studies comparing propofol with a different agent (106 participants) measured quantity and quality of sleep using the Pittsburgh Sleep Diary and the Hospital Anxiety and Depression Scale; one study reported fewer awakenings of reduced duration with propofol, and similar total sleep time between groups, and one study reported no evidence of a difference in sleep quality. One study comparing propofol with another agent (66 participants) measured quantity and quality of sleep with the Bispectral Index and reported longer time in deep sleep, with fewer arousals. One study comparing propofol with another agent (40 participants) reported higher levels of anxiety and depression in both groups, and no evidence of a difference when participants were given propofol.No studies reported adverse events.We used the GRADE approach to downgrade the certainty of the evidence for each outcome to very low. We identified sparse data with few participants, and methodological differences in study designs and comparative agents introduced inconsistency, and we noted that measurement tools were imprecise or not valid for purpose. AUTHORS' CONCLUSIONS: We found insufficient evidence to determine whether administration of propofol would improve the quality and quantity of sleep in adults in the ICU. We noted differences in study designs, methodology, comparative agents and illness severity amongst study participants. We did not pool data and we used the GRADE approach to downgrade the certainty of our evidence to very low.
[Mh] Termos MeSH primário: Dissonias/tratamento farmacológico
Hipnóticos e Sedativos/uso terapêutico
Unidades de Terapia Intensiva
Propofol/uso terapêutico
Sono/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Flunitrazepam/uso terapêutico
Seres Humanos
Midazolam/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 620X0222FQ (Flunitrazepam); R60L0SM5BC (Midazolam); YI7VU623SF (Propofol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012454.pub2


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[PMID]:27779314
[Au] Autor:Jacquier D; Newman CJ
[Ad] Endereço:Paediatric Neurology and Neurorehabilitation Unit, Department of Paediatrics, University Hospital of Lausanne, Lausanne, Switzerland.
[Ti] Título:Co-sleeping in school-aged children with a motor disability: a comparative population-based study.
[So] Source:Dev Med Child Neurol;59(4):420-426, 2017 04.
[Is] ISSN:1469-8749
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To determine the prevalence and determinants of co-sleeping in school-aged children with a motor disability compared with the school-aged general population. METHOD: A questionnaire on demographic characteristics and co-sleeping habits, along with the Sleep Disturbance Scale for Children (SDSC), was sent to parents of children aged between 4 years and 18 years followed in our tertiary paediatric neurorehabilitation clinic, and to school-aged children in a representative sample of state schools. RESULT: We analysed responses for 245 children with motor disability (142 males, 103 females; mean age 10y 6mo, standard deviation [SD] 3y 10mo, range 4-18y) and 2891 of the general population (1484 males, 1497 females; mean age [SD] 9y 6mo [3y 5mo], range 4-18y) (response rates 37% and 26% respectively). Cerebral palsy was the most common diagnosis among children with motor disability. Weekly co-sleeping was significantly more common in children with motor disability than in the general population (11.8% vs 7.9% respectively, p=0.032). Special care of the child with motor disability at night, mainly addressing epilepsy, was reported as a cause of co-sleeping by two-thirds of parents. Factors associated with co-sleeping in the motor disability group were age, housing crowding, severe visual impairment, and pathological sleep according to the SDSC. INTERPRETATION: Co-sleeping is common among children with motor disability. It is influenced by personal and medical factors, as well as the requirements for special care at night. Therefore, health professionals should explore sleeping arrangements in families of children with motor disability.
[Mh] Termos MeSH primário: Dissonias/epidemiologia
Hábitos
Transtornos dos Movimentos/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Distribuição por Idade
Criança
Pré-Escolar
Planejamento em Saúde Comunitária
Estudos Transversais
Dissonias/psicologia
Feminino
Seres Humanos
Masculino
Pais/psicologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171209
[Lr] Data última revisão:
171209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1111/dmcn.13300


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[PMID]:28457053
[Au] Autor:Katz I; Katz D; Shoenfeld Y; Porat-Katz BS
[Ad] Endereço:Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel.
[Ti] Título:Clinical Evidence for Utilizing Cannabinoids in the Elderly.
[So] Source:Isr Med Assoc J;19(2):71-75, 2017 Feb.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Canabinoides/farmacologia
Cognição/efeitos dos fármacos
Dissonias/tratamento farmacológico
Doença de Parkinson/tratamento farmacológico
Desempenho Psicomotor/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Agonistas de Receptores de Canabinoides/farmacologia
Demência/tratamento farmacológico
Demência/metabolismo
Demência/psicologia
Dissonias/metabolismo
Endocanabinoides/metabolismo
Geriatria/métodos
Seres Humanos
Doença de Parkinson/metabolismo
Doença de Parkinson/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cannabinoid Receptor Agonists); 0 (Cannabinoids); 0 (Endocannabinoids)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


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[PMID]:28481382
[Au] Autor:Skrzypek M; Kowalska M; Czech EM; Niewiadomska E; Zejda JE
[Ad] Endereço:Medical University of Silesia, Katowice, Poland (School of Public Health in Bytom, Department of Biostatistics). mskrzypek@sum.edu.pl.
[Ti] Título:Impact of road traffic noise on sleep disturbances and attention disorders amongst school children living in Upper Silesian Industrial Zone, Poland.
[So] Source:Int J Occup Med Environ Health;30(3):511-520, 2017 May 08.
[Is] ISSN:1896-494X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Published reports suggest that some adverse health impact may be related to noise exposure, and motor vehicle traffic is considered to be the main source of environmental hazard of noise. The aim of this study has been to assess an association between occurrence of sleep and attention disorders with exposure to the noise generated by motor vehicle traffic in the case of a large group of children living in an urban environment. MATERIAL AND METHODS: The data was obtained using a cross sectional study design in Bytom (Silesia, Poland) from 2003-2007 for a selected group of 7-14 year olds (N = 5136). The geographic information system was used for assessing the exposure to noise generated by the motor vehicle traffic. The association between occurrences of sleep disturbances or attention disorders and exposure to the traffic noise was examined by means of multivariable logistic regression. RESULTS: Sleep disturbances and attention disorders were found to be statistically significantly associated with exposure to the traffic noise. The multivariable logistic regression results suggest that sleep disturbances and attention disorders were more likely to occur in the case of children living in the area with higher traffic density, the odds ratio (OR) = 1.44 (95% confidence interval (CI): 1.05-1.97) and 1.38 (95% CI: 1.03-1.86), respectively. CONCLUSIONS: The results of the study have confirmed that the exposure to the traffic noise could be a significant risk factor for sleep disturbances and attention disorders among children. Int J Occup Med Environ Health 2017;30(3):511-520.
[Mh] Termos MeSH primário: Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia
Dissonias/epidemiologia
Exposição Ambiental/efeitos adversos
Ruído dos Transportes/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Criança
Estudos Transversais
Feminino
Seres Humanos
Masculino
Polônia/epidemiologia
Distribuição Espacial da População
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


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[PMID]:28362644
[Au] Autor:Litton E; Elliott R; Thompson K; Watts N; Seppelt I; Webb SAR; ANZICS Clinical Trials Group and The George Institute for Global Health
[Ad] Endereço:1Intensive Care Unit, St John of God Hospital, Subiaco, Perth, Western Australia, Australia. 2School of Medicine and Pharmacology, University of Western Australia, Crawley, Perth, Western Australia, Australia. 3Intensive Care Unit, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, Australia. 4Critical Care and Trauma Division, The George Institute for Global Health, Sydney, New South Wales, Australia. 5Sydney Medical School-Nepean, University of Sydney, Sydney, New South Wales, Australia. 6St John of God Hospital, Subiaco, Perth, Western Australia, Australia. 7Monash University, Melbourne, Victoria, Australia.
[Ti] Título:Using Clinically Accessible Tools to Measure Sound Levels and Sleep Disruption in the ICU: A Prospective Multicenter Observational Study.
[So] Source:Crit Care Med;45(6):966-971, 2017 Jun.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To use clinically accessible tools to determine unit-level and individual patient factors associated with sound levels and sleep disruption in a range of representative ICUs. DESIGN: A cross-sectional, observational study. SETTING: Australian and New Zealand ICUs. PATIENTS: All patients 16 years or over occupying an ICU bed on one of two Point Prevalence study days in 2015. INTERVENTIONS: Ambient sound was measured for 1 minute using an application downloaded to a personal mobile device. Bedside nurses also recorded the total time and number of awakening for each patient overnight. MEASUREMENTS AND MAIN RESULTS: The study included 539 participants with sound level recorded using an application downloaded to a personal mobile device from 39 ICUs. Maximum and mean sound levels were 78 dB (SD, 9) and 62 dB (SD, 8), respectively. Maximum sound levels were higher in ICUs with a sleep policy or protocol compared with those without maximum sound levels 81 dB (95% CI, 79-83) versus 77 dB (95% CI, 77-78), mean difference 4 dB (95% CI, 0-2), p < 0.001. There was no significant difference in sound levels regardless of single room occupancy, mechanical ventilation status, or illness severity. Clinical nursing staff in all 39 ICUs were able to record sleep assessment in 15-minute intervals. The median time awake and number of prolonged disruptions were 3 hours (interquartile range, 1-4) and three (interquartile range, 2-5), respectively. CONCLUSIONS: Across a large number of ICUs, patients were exposed to high sound levels and substantial sleep disruption irrespective of factors including previous implementation of a sleep policy. Sound and sleep measurement using simple and accessible tools can facilitate future studies and could feasibly be implemented into clinical practice.
[Mh] Termos MeSH primário: Dissonias/etiologia
Unidades de Terapia Intensiva/estatística & dados numéricos
Aplicativos Móveis
Ruído/efeitos adversos
Sono
[Mh] Termos MeSH secundário: Idoso
Austrália/epidemiologia
Estudos Transversais
Feminino
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Nova Zelândia/epidemiologia
Políticas
Estudos Prospectivos
Respiração Artificial/estatística & dados numéricos
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002405


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[PMID]:28216568
[Au] Autor:Han B; Zhu FX; Shi C; Wu HL; Gu XH
[Ad] Endereço:Department of nephrology, First Affiliated Hospital of Jiaxing University, Jiaxing 314000, China. wmuhanbin@163.com.
[Ti] Título:Association between Serum Vitamin D Levels and Sleep Disturbance in Hemodialysis Patients.
[So] Source:Nutrients;9(2), 2017 Feb 14.
[Is] ISSN:2072-6643
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Sleep disturbance is a frequent and serious complication of hemodialysis (HD). Low serum vitamin D levels have been associated with sleep quality in non-HD subjects. Our aim was to examine the possible association between serum vitamin D levels and the presence of sleep disturbance in HD patients. We recruited 141 HD patients at the HD center of the First Affiliated Hospital of Jiaxing University during 2014-2015. Serum levels of 25-hydroxyvitamin D (25(OH)D) were determined by the competitive protein-binding assay. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Demographic, clinical and laboratory data were recorded. Meanwhile, 117 healthy control subjects were also recruited and underwent measurement of 25(OH)D. Eighty-eight patients (62.4%) had sleep disturbance (PSQI scores ≥ 5). Patients with sleep disturbance showed lower levels of 25(OH)D as compared to those without sleep disturbance (85.6 ± 37.4 vs. 39.1 ± 29.1 nmol/L, < 0.001). In multivariate analyses, serum levels of 25(OH)D (≤48.0 nmol/L) were independently associated with sleep disturbance in HD patients (OR 9.897, 95% CI 3.356-29.187, < 0.001) after adjustment for possible variables. Our study demonstrates that low serum levels of vitamin D are independently associated with sleep disturbance in HD patients, but the finding needs to be confirmed in future experimental and clinical studies.
[Mh] Termos MeSH primário: Dissonias/sangue
Diálise Renal
Sono
Vitamina D/sangue
[Mh] Termos MeSH secundário: Idoso
Glicemia/metabolismo
Índice de Massa Corporal
Colesterol/sangue
Escolaridade
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Diálise Renal/efeitos adversos
Triglicerídeos/sangue
Deficiência de Vitamina D/sangue
Deficiência de Vitamina D/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Triglycerides); 1406-16-2 (Vitamin D); 97C5T2UQ7J (Cholesterol)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170221
[St] Status:MEDLINE


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[PMID]:27995318
[Au] Autor:Peoples AR; Roscoe JA; Block RC; Heckler CE; Ryan JL; Mustian KM; Janelsins MC; Peppone LJ; Moore DF; Coles C; Hoelzer KL; Morrow GR; Dozier AM
[Ad] Endereço:Department of Surgery, University of Rochester Medical Center, 265 Crittenden Blvd., CU 420658, Rochester, NY, 14642, USA. Anita_Peoples@urmc.rochester.edu.
[Ti] Título:Nausea and disturbed sleep as predictors of cancer-related fatigue in breast cancer patients: a multicenter NCORP study.
[So] Source:Support Care Cancer;25(4):1271-1278, 2017 Apr.
[Is] ISSN:1433-7339
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Cancer-related fatigue (CRF) is a prevalent and distressing side effect of cancer and its treatment that remains inadequately understood and poorly managed. A better understanding of the factors contributing to CRF could result in more effective strategies for the prevention and treatment of CRF. The objectives of this study were to examine the prevalence, severity, and potential predictors for the early onset of CRF after chemotherapy cycle 1 in breast cancer patients. METHODS: We report on a secondary data analysis of 548 female breast cancer patients from a phase III multi-center randomized controlled trial examining antiemetic efficacy. CRF was assessed by the Brief Fatigue Inventory at pre- and post-chemotherapy cycle 1 as well as by the four-day diary. RESULTS: The prevalence of clinically relevant post-CRF was 75%. Linear regression showed that pre-treatment CRF, greater nausea, disturbed sleep, and younger age were significant risk factors for post-CRF (adjusted R = 0.39; P < 0.0001). Path modeling showed that nausea severity influenced post-CRF both directly and indirectly by influencing disturbed sleep. Similarly, pre-treatment CRF influenced post-CRF directly as well as indirectly through both nausea severity and disturbed sleep. Pearson correlations showed that changes in CRF over time were significantly correlated with concurrent changes in nausea severity (r = 0.41; P < 0.0001) and in disturbed sleep (r = 0.20; P < 0.0001). CONCLUSION: This study showed a high prevalence (75%) of clinically relevant CRF in breast cancer patients following their initial chemotherapy, and that nausea severity, disturbed sleep, pre-treatment CRF, and age were significant predictors of symptom.
[Mh] Termos MeSH primário: Neoplasias da Mama/complicações
Dissonias/etiologia
Fadiga/etiologia
Náusea/induzido quimicamente
[Mh] Termos MeSH secundário: Neoplasias da Mama/tratamento farmacológico
Feminino
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161221
[St] Status:MEDLINE
[do] DOI:10.1007/s00520-016-3520-8


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[PMID]:27629558
[Au] Autor:Allampati S; Lopez R; Thota PN; Ray M; Birgisson S; Gabbard SL
[Ad] Endereço:Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
[Ti] Título:Use of a positional therapy device significantly improves nocturnal gastroesophageal reflux symptoms.
[So] Source:Dis Esophagus;30(3):1-7, 2017 Feb 01.
[Is] ISSN:1442-2050
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to measure the efficacy of a positional therapy device (PTD) at reducing proton pump inhibitor (PPI) refractory nocturnal GERD symptoms. Among patients with GERD, nocturnal symptoms are very common. A recent study demonstrated a decrease in nocturnal acid exposure and reflux episodes in healthy volunteers who slept using a PTD. This is a single-center prospective trial involving patients on anti-secretory medications with continued nocturnal heartburn and regurgitation. Patients completed the Nocturnal GERD Symptom Severity and Impact Questionnaire (N-GSSIQ) and GERD health-related quality of life questionnaire (GERD-HRQL) at enrollment. Patients were instructed to sleep on the PTD for at least 6 hours a night during the two week study period; subjects continued their baseline anti-secretory medication dose. After 2 weeks, the questionnaires were repeated. A total of 27 patients (16 females and 11 males; age 57.8 ± 15.1) were recruited. After 2 weeks of PTD use, N-GSSIQ scores significantly improved from baseline, with a mean total score improvement of 39.5 (mean 57.7 [pre] vs. 18.2 [post], P < 0.001). Significant improvement from baseline was also observed for the GERD-HRQL questionnaire (29.8 vs. 16.7, P < 0.001). No adverse events were reported. At 3 months after the trial period, 91% of the subjects continued to use the PTD on a nightly basis. Use of the PTD significantly decreased nocturnal GERD symptoms and improved GERD-HRQL. The PTD was well tolerated during the study period and for 3 months after enrollment.
[Mh] Termos MeSH primário: Leitos
Dissonias/terapia
Refluxo Gastroesofágico/terapia
Posicionamento do Paciente/instrumentação
Postura
[Mh] Termos MeSH secundário: Adulto
Idoso
Dissonias/etiologia
Dissonias/fisiopatologia
Feminino
Refluxo Gastroesofágico/complicações
Refluxo Gastroesofágico/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Inibidores da Bomba de Prótons/uso terapêutico
Qualidade de Vida
Índice de Gravidade de Doença
Sono/fisiologia
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160916
[St] Status:MEDLINE
[do] DOI:10.1111/dote.12495


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[PMID]:27479519
[Au] Autor:Wilson C; Whiteman K; Stephens K; Swanson-Biearman B; LaBarba J
[Ad] Endereço:Cleveland Clinic Akron General Hospital, Akron, Ohio (Dr Wilson and Ms LaBarba); Waynesburg University, Waynesburg, Pennsylvania (Drs Whiteman and Stephens); and Department of Physician Assistant Studies, John G. Rangos Sr. School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania (Dr Swanson-Biearman).
[Ti] Título:Improving the Patient's Experience With a Multimodal Quiet-at-Night Initiative.
[So] Source:J Nurs Care Qual;32(2):134-140, 2017 Apr/Jun.
[Is] ISSN:1550-5065
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This project describes a multifaceted noise reduction program on 2 hospital units designed to ensure a quiet hospital environment, with the goal of improving the patient experience. The noise committee in an urban city hospital developed a plan to control noise including scripted leadership rounding, staff education, a nighttime sleep promotion cart, and visual aids to remind staff to be quiet. Postintervention improvement in patient satisfaction scores was noted.
[Mh] Termos MeSH primário: Ambiente de Instituições de Saúde/normas
Assistência Noturna/métodos
Ruído/prevenção & controle
Satisfação do Paciente
Melhoria de Qualidade
[Mh] Termos MeSH secundário: Dissonias/etiologia
Dissonias/enfermagem
Ambiente de Instituições de Saúde/estatística & dados numéricos
Hospitalização/estatística & dados numéricos
Seres Humanos
Assistência Noturna/normas
Assistência Noturna/estatística & dados numéricos
Ruído/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:160802
[St] Status:MEDLINE
[do] DOI:10.1097/NCQ.0000000000000219



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