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[PMID]:28747158
[Au] Autor:Iwaya T; Doi T; Seichi A; Hoshino Y; Ogata T; Akai M
[Ad] Endereço:Nagano University of Health and Medicine, 11-1 Imaihara Kawanajima-chou Nagano-shi, Nagano, 381-2227, Japan.
[Ti] Título:Characteristics of disability in activity of daily living in elderly people associated with locomotive disorders.
[So] Source:BMC Geriatr;17(1):165, 2017 Jul 26.
[Is] ISSN:1471-2318
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ageing is associated with a decline of motor function and ability to perform daily activities. Locomotive disorders are one of the major disorders resulting in adverse health condition in elderly people. Concept of Locomotive syndrome (LoS) was proposed to tackle the problems and prolong healthy life expectancy of people with locomotive disorders. To develop intervention strategy for LoS it is mandatory to investigate impairments, functional disabilities which people with locomotive disorder experience and to examine relationships among these parameters. For this purpose we have developed Geriatric Locomotive Function Scale-25 (GLFS-25). Though several physical performance tests were reported for identification or monitoring the severity of LoS, there are few studies reported on characteristics of disability which people with locomotive disorders experience. The aim of this study was to report the characteristics of ADL disabilities in elderly people with locomotive disorders in terms of numbers and degree of activity limitations. METHODS: We organized a cohort study and recruited 314 participants aged 65 years and over from five orthopedic clinics or nursing care facilities. This was a cross-sectional study to use the baseline data of such cohort. ADL disabilities were assessed using GLFS-25 scale arranging the GLFS-25 scores in ordinal levels using "R language" program. Numbers and degrees of activity limitations were determined and compared among the levels. Frequency of limitation in activities regarding social activity, housework, locomotion, mobility and self-care was compared among across the disability level. RESULTS: The GLFS-25 score was mathematically categorized into 7 levels. The number of activity limitations and the degrees of each activity limitation were significantly greater in high GLFS-25 levels than in low levels. Difficulties in mobility appeared in less severe level, difficulties in domestic and social life appeared in moderately severe level, and difficulties in self-care appeared in advanced level. CONCLUSIONS: High GLFS-25 score represented high degree of disability on ADLs. Concordant increase of numbers of activity limitation and severity progression in activity limitation may contribute to progression of disability. Activity limitation may occur in the following order: sports activity, walking, transferring, and self-care.
[Mh] Termos MeSH primário: Atividades Cotidianas
Avaliação da Deficiência
Avaliação Geriátrica
Locomoção
Limitação da Mobilidade
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida
Autocuidado
Síndrome
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1186/s12877-017-0543-z


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[PMID]:29229614
[Au] Autor:McMinn D; Fergusson SJ; Daly M
[Ad] Endereço:Rowett Institute of Nutrition and Health, University of Aberdeen, Aberdeen AB25 2ZD, UK.
[Ti] Título:Does pride really come before a fall? Longitudinal analysis of older English adults.
[So] Source:BMJ;359:j5451, 2017 12 11.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To test whether high levels of reported pride are associated with subsequent falls. DESIGN: Secondary analysis of the English Longitudinal Study of Ageing (ELSA) dataset. SETTING: Multi-wave longitudinal sample of non-institutionalised older English adults. PARTICIPANTS: ELSA cohort of 6415 participants at wave 5 (baseline, 2010/11), of whom 4964 were available for follow-up at wave 7 (follow-up, 2014/15). MAIN OUTCOME MEASURES: Self reported pride at baseline (low/moderate/high) and whether the participant had reported having fallen during the two years before follow-up. RESULTS: The findings did not support the contention that "pride comes before a fall." Unadjusted estimates indicate that the odds of reported falls were significantly lower for people with high pride levels compared with those who had low pride (odds ratio 0.69, 95% confidence interval 0.58 to 0.81, P<0.001). This association remained after adjustment for age, sex, household wealth, and history of falls (odds ratio 0.81, 0.68 to 0.97, P<0.05). It was partially attenuated after further adjustment for mobility problems, eyesight problems, the presence of a limiting long term illness, a diagnosis of arthritis or osteoporosis, medication use, cognitive function, and pain and depression (odds ratio 0.86, 0.72 to 1.03, P<0.1). Because the confidence interval exceeded 1 in the final model, it remains possible that pride may not be an independent predictor of falls when known risk factors are considered. People with moderate pride did not have lower odds of having fallen than those with low pride in adjusted models. Participants lost to follow-up did not differ from those retained in terms of key variables, and weighting the analyses to account for selective attrition did not produce different results. CONCLUSIONS: Contrary to the well known saying "pride comes before a fall," these findings suggest that pride may actually be a protective factor against falling in older adults. Future studies may seek to investigate the mechanisms underpinning this relation.
[Mh] Termos MeSH primário: Acidentes por Quedas/estatística & dados numéricos
Atividades Cotidianas/psicologia
Comorbidade/tendências
Satisfação Pessoal
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cognição/fisiologia
Inglaterra/epidemiologia
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Limitação da Mobilidade
Fatores de Risco
Autorrelato
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5451


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[PMID]:29419697
[Au] Autor:Petit N; Enel P; Ravaux I; Darque A; Baumstarck K; Bregigeon S; Retornaz F; Visage group
[Ad] Endereço:Department of Internal, Geriatric and Therapeutic Medicine, University Hospital Center AP-HM.
[Ti] Título:Frail and pre-frail phenotype is associated with pain in older HIV-infected patients.
[So] Source:Medicine (Baltimore);97(6):e9852, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:As HIV-infected patients grow older, some accumulate multiple health problems earlier than the noninfected ones in particular frailty phenotypes. Patients with frailty phenotype are at higher risk of adverse outcomes (worsening mobility, disability, hospitalization, and death within three years).Our study aimed to evaluate prevalence of frailty in elderly HIV-infected patients and to assess whether frailty is associated with HIV and geriatric factors, comorbidities, and precariousness in a French cohort of older HIV infected.This 18-month cross-sectional multicenter study carried in 2013 to 2014 had involved 502 HIV-infected patients aged 50 years and older, cared in 18 HIV-dedicated hospital medical units, located in South of France.Prevalence of frailty was 6.3% and of pre-frailty 57.2%. Low physical activity and weakness were the main frailty markers, respectively 49.4% and 19.9%. In univariate models, precariousness, duration of HIV antiretroviral treatment >15 years, 2 comorbidities or more, risk of depression, activities of daily living disability, and presence of pain were significantly associated with frail and pre-frail phenotype. Multivariate logistic regression analyses showed that only pain was significantly different between frail and pre frail phenotype versus non frail phenotype (odds ratio = 1.2; P = .002).Our study is the first showing a significant association between pain and frailty phenotype in older patients infected by HIV. As frailty phenotype could be potentially reversible, a better understanding of the underlying determinant is warranted. Further studies are needed to confirm these first findings.
[Mh] Termos MeSH primário: Idoso Fragilizado/estatística & dados numéricos
Fragilidade
Infecções por HIV
Dor
[Mh] Termos MeSH secundário: Idoso
Antirretrovirais/uso terapêutico
Comorbidade
Avaliação da Deficiência
Feminino
Fragilidade/diagnóstico
Fragilidade/epidemiologia
Fragilidade/etiologia
França/epidemiologia
Avaliação Geriátrica/métodos
Infecções por HIV/tratamento farmacológico
Infecções por HIV/epidemiologia
Infecções por HIV/fisiopatologia
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Limitação da Mobilidade
Dor/diagnóstico
Dor/epidemiologia
Fenótipo
Prevalência
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Retroviral Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009852


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[PMID]:29350895
[Au] Autor:Durovic A; Sovilj S; Dokic I; Brdareski Z; Vukomanovic A; Ilic N; Milavic-Vujkovic M
[Ti] Título:Pastoral care and religious support as a part of treatment of religious patient with the severe form of osteoarthritis.
[So] Source:Vojnosanit Pregl;74(1):69-77, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Religious needs of patients are consistently being neglected in the clinical medicine. Pastoral care is a religious support which a religious patient receives from priests, chaplains, imams, rabbis or other religious authorities. Religious support, in terms of clinical medicine, is a spiritual support which religious patients obtain from religious and trained medical workers. The aim of this report was to present the effects of pastoral care and religious support in hospital treatment of a 73-year-old patient with the severe form of osteoarthritis. Case report: The 73- year-old, highly religious patient with severe form of osteoarthritis was admitted at the Clinic for Physical Medicine and Rehabilitation, Military Medical Academy in Belgrade, due to heterogeneous problems in the activities of daily living. The patient walked with difficulty using a stick, suffered pain, and was anxious and depressive. In order to objectively demonstrate effects of both pastoral care and religious support in this patient we performed multiple treatment with reversal design, in which the basic treatment consisting of hospital care, pharmacotherapy and physical therapy (the treatment A) was alternatively changed with the treatment that included combination of the basic treatment and religious support provided by religious physiatrist and physiotherapist (the treatment B) or combination of the basic treatment and pastoral care provided by military priest (the treatment C). The treatment A was applied three times and lasted two weeks, every time. Treatments B and C were applied once and lasted three weeks, each. The order of the treatments was: A→B→A→C→A. During the whole treatment period the patient's condition was assessed by several measuring scale: the level of depression by The Hamilton Rang Scale for Depression and The Zung Self Rating Depression Scale; the level of anxiety by The Zung Self Rating Anxiety Scale; the functional capability of patient by The Barthel Index and The Functional Independent Measure. Measuring was carried out on a daily basis. In statistical analysis two nonparametric statistic were used: the percentage of non-overlapping data (PND) and the percentage of data points exceeding the median (PEM). PND and PEM values below 0.7 reflect questionable effectiveness of the treatment. The values between 0.7 and 0.9 reflect moderate effects. The values above 0.9 are considered as a highly effective treatment. The anxiety of the patient was moderately to significantly reduced after introducing religious support (treatment B: mean and mean deviation = 50.1 ± 10.89; variability = 4.598653; mean shift = 0.219626; PND = 0.6; PEM = 0.9) and pastoral care (treatment C: mean and mean deviation = 53.5 ± 5.90; variability = 9.062591; mean shift = 0.207407; PND = 0.9; PEM = 0.9). The patient's depression was reduced after introducing pastoral care (treatment C: mean and mean deviation = 51.3 ± 4.66; variability = 10.99005; mean shift = 0.08881; PND = 0; PEM = 0.9). On the contrary, the patient's functional capability was not significantly improved. Conclusion: In the highly religious patient with severe osteoarthritis pastoral care and religious support, applied along with the standard medical treatment of this condition, produced some beneficial effects on anxiety and depressive mood, but with no significant effect on patient's functional capability.
[Mh] Termos MeSH primário: Ansiedade/terapia
Depressão/terapia
Osteoartrite/terapia
Assistência Religiosa
Religião e Medicina
[Mh] Termos MeSH secundário: Atividades Cotidianas
Afeto
Idoso
Ansiedade/diagnóstico
Ansiedade/psicologia
Terapia Combinada
Efeitos Psicossociais da Doença
Depressão/diagnóstico
Depressão/psicologia
Feminino
Nível de Saúde
Seres Humanos
Limitação da Mobilidade
Osteoartrite/diagnóstico
Osteoartrite/fisiopatologia
Osteoartrite/psicologia
Equipe de Assistência ao Paciente
Qualidade de Vida
Recuperação de Função Fisiológica
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP1508025059D


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[PMID]:29280811
[Au] Autor:Powell-Cope G; Thomason S; Bulat T; Pippins KM; Young HM
[Ad] Endereço:Gail Powell-Cope is codirector of the Health Services Research and Development Center of Innovation on Disability and Rehabilitation Research at the James A. Haley Veterans' Hospital in Tampa, FL, where Susan Thomason is a research associate, Tatjana Bulat is director of the Tampa Patient Safety Center of Inquiry, and Karla M. Pippins is a neurologic clinical specialist, faculty of PT Neurologic Residency. Heather M. Young is dean of the Betty Irene Moore School of Nursing at the University of California, Davis, and associate vice chancellor for nursing at UC Davis Health. Contact author: Gail Powell-Cope, gail.powell-cope@va.gov. The authors have disclosed no potential conflicts of interest, financial or otherwise.
[Ti] Título:Preventing Falls and Fall-Related Injuries at Home.
[So] Source:Am J Nurs;118(1):58-61, 2018 Jan.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:: This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series explain principles for promoting safe mobility that nurses should reinforce with family caregivers. Each article also includes an informational tear sheet-Information for Family Caregivers-that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage the caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.
[Mh] Termos MeSH primário: Acidentes por Quedas/prevenção & controle
[Mh] Termos MeSH secundário: Cuidadores
Seres Humanos
Limitação da Mobilidade
Guias de Prática Clínica como Assunto
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; PATIENT EDUCATION HANDOUT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000529720.67793.60


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[PMID]:29241381
[Au] Autor:Barrois B; Colin D; Allaert FA
[Ad] Endereço:a Département Qualité , Centre Hospitalier de Gonesse , Gonesse , France.
[Ti] Título:Prevalence, characteristics and risk factors of pressure ulcers in public and private hospitals care units and nursing homes in France.
[So] Source:Hosp Pract (1995);46(1):30-36, 2018 Feb.
[Is] ISSN:2154-8331
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study conducted in 2014 was to describe the prevalence of pressure ulcers in different types of French hospital unit at the national level to compare them with data from the 1994 and 2004 study. METHODS: This cross-sectional study was conducted over a single day. All care units were invited to participate by drawing lots stratified by region in successive waves until 1,200 agreements were obtained. Lots were drawn for towns with more than 10,000 inhabitants. All public- and private-sector hospital facilities in each town drawn by lot were invited to participate in the survey. RESULTS: 776 hospital services throughout France took part and accommodated 21,538 patients: 12,752 women (59.2%) and 8,786 men (40.8%). Of these patients, 1,753 (8.1%; IC95% = 7.7; 8.5) had pressure ulcers. The pressure-ulcer rate was 7.8% (IC95% = [7.3; 8.3] (n = 997)) for hospitalized women and 8.6% (IC95% = [8.0; 9.2] (n = 756)) for men (p = 0.0381). The 8.1% level reported in 2014 therefore points to a reduction in pressure-ulcer prevalence; 8.6% in 1994 and 8.9% in 2004. CONCLUSIONS: The actions performed daily by healthcare professionals to prevent pressure ulcers, supported by research and training programs, including those by PERSE, are having a real impact over time.
[Mh] Termos MeSH primário: Instituição de Longa Permanência para Idosos/estatística & dados numéricos
Hospitais Privados/estatística & dados numéricos
Hospitais Públicos/estatística & dados numéricos
Casas de Saúde/estatística & dados numéricos
Lesão por Pressão/epidemiologia
Lesão por Pressão/prevenção & controle
[Mh] Termos MeSH secundário: Distribuição por Idade
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
França
Seres Humanos
Masculino
Desnutrição/epidemiologia
Meia-Idade
Limitação da Mobilidade
Prevalência
Medição de Risco
Fatores de Risco
Índice de Gravidade de Doença
Distribuição por Sexo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1080/21548331.2018.1418139


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[PMID]:27773531
[Au] Autor:Iezzoni LI; Wint AJ; Smeltzer SC; Ecker JL
[Ad] Endereço:Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts. Electronic address: liezzoni@mgh.harvard.edu.
[Ti] Título:Recommendations about Pregnancy from Women with Mobility Disability to Their Peers.
[So] Source:Womens Health Issues;27(1):75-82, 2017 Jan - Feb.
[Is] ISSN:1878-4321
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although growing numbers of women with mobility disability are becoming pregnant and desiring motherhood, relatively little is known about their pregnancy experiences or what they might recommend to other women with mobility disability contemplating pregnancy. METHODS: Using a semistructured, open-ended interview protocol, we conducted 2-hour telephone interviews with 22 women who had a significant mobility disability before becoming pregnant and had delivered babies within the prior 10 years. We recruited most interviewees through online social networks. We used NVivo software to sort interview transcript texts and performed conventional content analyses to identify major themes. RESULTS: Participants' mean ± standard deviation age was 34.8 ± 5.3 years; most were White, well-educated, and middle income and 18 used wheeled mobility aids. Recommendations for other women with mobility disability coalesced around five themes: recognizing the possibility of giving birth, advocacy and support, being informed, approaches toward obstetrical practitioners, and managing fears about losing custody of their child. Lacking information about what to expect during their pregnancy was a significant problem. Women got information about pregnancy from diverse sources, but questions arose about accuracy and relevance of this information to individual circumstances. Women urged their peers to advocate for their preferences and needs with obstetrical practitioners. CONCLUSIONS: Women with mobility disability who had delivered babies offered constructive advice for their peers who desire pregnancy. Increasing availability of accurate and relevant information about pregnancy among women with mobility disability is critically important, as is training obstetrical practitioners to provide patient-centered care to these women during pregnancy.
[Mh] Termos MeSH primário: Pessoas com Deficiência/psicologia
Limitação da Mobilidade
Parto/psicologia
Complicações na Gravidez/psicologia
Gravidez/psicologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Entrevistas como Assunto
Meia-Idade
Obstetrícia
Grupo Associado
Resultado da Gravidez
Pesquisa Qualitativa
Apoio Social
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:25815678
[Au] Autor:Mattie JL; Borisoff JF; Wong AS; Miller WC
[Ad] Endereço:a MAKE+, British Columbia Institute of Technology , Burnaby , British Columbia , Canada .
[Ti] Título:User perceptions of existing home access solutions and a novel home access device.
[So] Source:Disabil Rehabil Assist Technol;11(8):668-77, 2016 11.
[Is] ISSN:1748-3115
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: This study aimed to evaluate end user perspectives of four existing home access solutions (HAS) and a newly designed experimental device (the ARISE). METHOD: A cross-sectional design was used to evaluate the ARISE prototype against other HAS. Specifically, participants trialed stairs, a ramp, a platform lift (PL), a stair glide and the ARISE, after which they completed questionnaires aimed at soliciting their perspectives of these solutions. The time taken by participants to use each HAS was also collected. RESULTS: Five HAS design features were deemed as important by 90% of participants: ease of use, ability to use independently, reliability, safety and security. Time taken to use each HAS from fastest to slowest was: stairs, the ARISE, ramp, PL and stair glide. The ARISE prototype was rated as the first or second most preferred device by the most number of participants, followed by the PL, then the ramp. CONCLUSIONS: Results from this study provide greater understanding of user perspectives of HAS. End user feedback on a novel prototype device has provided valuable insight into its usability and function, which should not only guide future development of this device, but also provide direction for other innovations around home access. Implications for Rehabilitation It is anticipated that gaining a better understanding of strengths and weaknesses of home access solutions will: assist clinicians and end users in finding solutions that meet the individuals' needs. lead to the development of new or improved solutions that more closely address user needs. encourage further innovation in the area.
[Mh] Termos MeSH primário: Estruturas de Acesso/instrumentação
Pessoas com Deficiência/psicologia
Desenho de Equipamento/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Limitação da Mobilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.3109/17483107.2015.1027302


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Registro de Ensaios Clínicos
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[PMID]:28460889
[Au] Autor:Bertini E; Dessaud E; Mercuri E; Muntoni F; Kirschner J; Reid C; Lusakowska A; Comi GP; Cuisset JM; Abitbol JL; Scherrer B; Ducray PS; Buchbjerg J; Vianna E; van der Pol WL; Vuillerot C; Blaettler T; Fontoura P; Olesoxime SMA Phase 2 Study Investigators
[Ad] Endereço:Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Research Hospital IRCCS, Rome, Italy. Electronic address: enricosilvio.bertini@opbg.net.
[Ti] Título:Safety and efficacy of olesoxime in patients with type 2 or non-ambulatory type 3 spinal muscular atrophy: a randomised, double-blind, placebo-controlled phase 2 trial.
[So] Source:Lancet Neurol;16(7):513-522, 2017 Jul.
[Is] ISSN:1474-4465
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Spinal muscular atrophy (SMA) is a progressive motor neuron disease causing loss of motor function and reduced life expectancy, for which limited treatment is available. We investigated the safety and efficacy of olesoxime in patients with type 2 or non-ambulatory type 3 SMA. METHODS: This randomised, double-blind, placebo-controlled, phase 2 study was done in 22 neuromuscular care centres in Belgium, France, Germany, Italy, Netherlands, Poland, and the UK. Safety and efficacy of olesoxime were assessed in patients aged 3-25 years with genetically confirmed type 2 or non-ambulatory type 3 SMA. A centralised, computerised randomisation process allocated patients (2:1 with stratification by SMA type and centre) to receive olesoxime (10 mg/kg per day) in an oral liquid suspension or placebo for 24 months. Patients, investigators assessing outcomes, and sponsor study personnel were masked to treatment assignment. The primary outcome measure was change from baseline compared with 24 months between the two treatment groups in functional domains 1 and 2 of the Motor Function Measure (MFM D1 + D2) assessed in the full analysis population. A shorter, 20-item version of the MFM, which was specifically adapted for young children, was used to assess patients younger than 6 years. Safety was assessed in all patients who received one or more doses of the study drug. The trial is registered with ClinicalTrials.gov, number NCT01302600. FINDINGS: The trial was done between Nov 18, 2010, and Oct 9, 2013. Of 198 patients screened, 165 were randomly assigned to olesoxime (n=108) or placebo (n=57). Five patients in the olesoxime group were not included in the primary outcome analysis because of an absence of post-baseline assessments. The change from baseline to month 24 on the primary outcome measure was 0·18 for olesoxime and -1·82 for placebo (treatment difference 2·00 points, 96% CI -0·25 to 4·25, p=0·0676). Olesoxime seemed to be safe and generally well tolerated, with an adverse event profile similar to placebo. The most frequent adverse events in the olesoxime group were pyrexia (n=34), cough (n=32), nasopharyngitis (n=25), and vomiting (n=25). There were two patient deaths (one in each group), but these were not deemed to be related to the study treatment. INTERPRETATION: Olesoxime was safe at the doses studied, for the duration of the trial. Although the primary endpoint was not met, secondary endpoints and sensitivity analyses suggest that olesoxime might maintain motor function in patients with type 2 or type 3 SMA over a period of 24 months. Based on these results, olesoxime might provide meaningful clinical benefits for patients with SMA and, given its mode of action, might be used in combination with other drugs targeting other mechanisms of disease, although additional evidence is needed. FUNDING: AFM Téléthon and Trophos SA.
[Mh] Termos MeSH primário: Colestenonas/farmacologia
Fármacos Neuroprotetores/farmacologia
Avaliação de Resultados (Cuidados de Saúde)
Atrofias Musculares Espinais da Infância/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Colestenonas/administração & dosagem
Colestenonas/efeitos adversos
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Limitação da Mobilidade
Fármacos Neuroprotetores/administração & dosagem
Fármacos Neuroprotetores/efeitos adversos
Atrofias Musculares Espinais da Infância/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Cholestenones); 0 (Neuroprotective Agents); A6778U5IFY (olesoxime)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180121
[Lr] Data última revisão:
180121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:29239590
[Au] Autor:Chan CS; Slaughter SE; Jones CA; Wagg AS
[Ti] Título:Measuring Activity Performance of Continuing Care Residents Using the activPAL: An Exploratory Study.
[So] Source:J Frailty Aging;5(3):158-161, 2016.
[Is] ISSN:2260-1341
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Few studies have measured the activity patterns of continuing care residents using objective, uniaxial, accelerometers such as the activPAL. This exploratory study described the activity performance of continuing care residents and explored the correlation of activity performance with grip strength, falls and mobility. Data were gathered from 24 continuing care residents. Participants (82.3 ± 5.8 years of age), wore the activPAL an average of 12.60 hours per day (SD = 0.96) and were stepping for a median of 0.47 hours (25th and 75th percentiles = 0.31, 0.81) with a median step count of 1906 steps (25th and 75th percentiles = 1216, 3420). Participants were inactive (sitting/lying/standing) for a mean 11.99 hours (SD = 1.03). No statistically significant correlations were identified between activity performance (active time, inactive time or step count) and grip strength, falls or mobility. Ambulatory older adults in continuing care centres were more sedentary compared to community-dwelling older adults or older adults with cancer.
[Mh] Termos MeSH primário: Avaliação Geriátrica
Assistência de Longa Duração
Monitorização Ambulatorial/instrumentação
Movimento
[Mh] Termos MeSH secundário: Acidentes por Quedas/estatística & dados numéricos
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Força da Mão/fisiologia
Seres Humanos
Masculino
Limitação da Mobilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE



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