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[PMID]:29431927
[Au] Autor:Katulskiy YN
[Ti] Título:[About unification of indices of the possibility of disease occurrence in risk assessment methodology and the determination of the probability of non-carcinogenic effects in toxicological-hygienic, clinical and epidemiological studies and according to data about health-seeking behavior].
[So] Source:Gig Sanit;95(10):998-1002, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:In the methodology for the assessment of the risk the possibility of the disease occurrence under the impact of carcinogenic and non-carcinogenic substances is measured by different indices. This leads to the fact that within the single methodology there are used various scores for such similar index as the risk of the disease occurrence, as a result carcinogens and systemic toxicants happen to be inconsistent from this point of view. At the same time, unlike carcinogens risk indices for systemic toxicants do not allow to evaluate the number of possible diseases in the population during the corresponding period of time, because they contain no information about their probability. Obviously, from this point of view, the characteristics of carcinogenic risk have certain advantages. Therefore, noncarcinogenic risk should be assessed by the similar indices as carcinogenic ones. However, an obstacle to this is the fact that in toxicological-hygienic, clinical and epidemiological studies, according to the results of which there is determined the risk for systemic toxicants, the impact of non-lethal levels of the exposure is established not in separate individuals, as for carcinogens, but according to mean-group values of indices of the state of the body as the identification of the nonspecific effect under relatively non high doses (concentrations) in the single person is fairly difficult. Such data do not allow to estimate the probability of the break of the effect. Also the data concerning seeking for the medical help, considering repeated medical resource utilization due to protract diseases or afflictions occurring repeatedly in a person several times for the considered period of time fail to be the estimation of the probability for the disease occurrence. For the obtaining of the possibility of unification of the carcinogenic and non-carcinogenic indices of risk in the paper there are presented methods for the determination of the probability of non-carcinogenic effects in toxicological-hygienic, clinical and epidemiological studies, as well as according to statistical data on the seeking for the medical help, taking into account the repeated appeals of the protract or re-emerging diseases.
[Mh] Termos MeSH primário: Doença Ambiental/epidemiologia
Substâncias Perigosas
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
Medição de Risco
[Mh] Termos MeSH secundário: Rotas de Resultados Adversos/estatística & dados numéricos
Viés
Estudos Epidemiológicos
Substâncias Perigosas/efeitos adversos
Substâncias Perigosas/análise
Seres Humanos
Medição de Risco/métodos
Medição de Risco/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hazardous Substances)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


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[PMID]:28461067
[Au] Autor:Dunn AG; Surian D; Leask J; Dey A; Mandl KD; Coiera E
[Ad] Endereço:Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109, Australia. Electronic address: adam.dunn@mq.edu.au.
[Ti] Título:Mapping information exposure on social media to explain differences in HPV vaccine coverage in the United States.
[So] Source:Vaccine;35(23):3033-3040, 2017 05 25.
[Is] ISSN:1873-2518
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Together with access, acceptance of vaccines affects human papillomavirus (HPV) vaccine coverage, yet little is known about media's role. Our aim was to determine whether measures of information exposure derived from Twitter could be used to explain differences in coverage in the United States. METHODS: We conducted an analysis of exposure to information about HPV vaccines on Twitter, derived from 273.8 million exposures to 258,418 tweets posted between 1 October 2013 and 30 October 2015. Tweets were classified by topic using machine learning methods. Proportional exposure to each topic was used to construct multivariable models for predicting state-level HPV vaccine coverage, and compared to multivariable models constructed using socioeconomic factors: poverty, education, and insurance. Outcome measures included correlations between coverage and the individual topics and socioeconomic factors; and differences in the predictive performance of the multivariable models. RESULTS: Topics corresponding to media controversies were most closely correlated with coverage (both positively and negatively); education and insurance were highest among socioeconomic indicators. Measures of information exposure explained 68% of the variance in one dose 2015 HPV vaccine coverage in females (males: 63%). In comparison, models based on socioeconomic factors explained 42% of the variance in females (males: 40%). CONCLUSIONS: Measures of information exposure derived from Twitter explained differences in coverage that were not explained by socioeconomic factors. Vaccine coverage was lower in states where safety concerns, misinformation, and conspiracies made up higher proportions of exposures, suggesting that negative representations of vaccines in the media may reflect or influence vaccine acceptance.
[Mh] Termos MeSH primário: Infecções por Papillomavirus/prevenção & controle
Vacinas contra Papillomavirus/administração & dosagem
Mídias Sociais
Cobertura Vacinal
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Aprendizado de Máquina
Masculino
Aceitação pelo Paciente de Cuidados de Saúde
Fatores Socioeconômicos
Estados Unidos
Recusa de Vacinação
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Papillomavirus Vaccines)
[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:170503
[St] Status:MEDLINE


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[PMID]:28449049
[Au] Autor:Banerjee S; Califano R; Corral J; de Azambuja E; De Mattos-Arruda L; Guarneri V; Hutka M; Jordan K; Martinelli E; Mountzios G; Ozturk MA; Petrova M; Postel-Vinay S; Preusser M; Qvortrup C; Volkov MNM; Tabernero J; Olmos D; Strijbos MH
[Ad] Endereço:Gynaecology Unit Royal Marsden Hospital NHS Foundation Trust, Institute of Cancer Research, London.
[Ti] Título:Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey.
[So] Source:Ann Oncol;28(7):1590-1596, 2017 Jul 01.
[Is] ISSN:1569-8041
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). Methods: A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Results: Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05). Conclusions: This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.
[Mh] Termos MeSH primário: Esgotamento Profissional/epidemiologia
Saúde do Trabalhador
Oncologistas
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Atitude do Pessoal de Saúde
Esgotamento Profissional/diagnóstico
Esgotamento Profissional/psicologia
Esgotamento Profissional/terapia
Distribuição de Qui-Quadrado
Despersonalização
Emoções
Europa (Continente)/epidemiologia
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Inquéritos Epidemiológicos
Seres Humanos
Satisfação no Emprego
Modelos Lineares
Modelos Logísticos
Masculino
Análise Multivariada
Oncologistas/psicologia
Aceitação pelo Paciente de Cuidados de Saúde
Qualidade de Vida
Fatores de Risco
Fatores Sexuais
Equilíbrio Trabalho-Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1093/annonc/mdx196


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[PMID]:29251433
[Au] Autor:Sabapathy K; Mubekapi-Musadaidzwa C; Mulubwa C; Schaap A; Hoddinott G; Stangl A; Floyd S; Ayles H; Fidler S; Hayes R; HPTN 071 (PopART) study team
[Ad] Endereço:London School of Hygiene and Tropical Medicine, London, United Kingdom.
[Ti] Título:Predictors of timely linkage-to-ART within universal test and treat in the HPTN 071 (PopART) trial in Zambia and South Africa: findings from a nested case-control study.
[So] Source:J Int AIDS Soc;20(4), 2017 Dec.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: HPTN 071 (PopART) is a three-arm community randomized trial in Zambia and South Africa evaluating the impact of a combination HIV prevention package, including universal test and treat (UTT), on HIV incidence. This nested study examined factors associated with timely linkage-to-care and ART initiation (TLA) (i.e. within six-months of referral) in the context of UTT within the intervention communities of the HPTN 071 (PopART) trial. METHODS: Of the 7572 individuals identified as persons living with HIV (PLWH) (and not on antiretroviral treatment (ART)) during the first year of the PopART intervention provided by Community HIV-care Providers (CHiPs) through door-to-door household visits, individuals who achieved TLA (controls) and those who did not (cases), stratified by gender and community, were randomly selected to be re-contacted for interview. Standardized questionnaires were administered to explore factors potentially associated with TLA, including demographic and behavioural characteristics, and participants' opinions on HIV and related services. Odds ratios comparing cases and controls were estimated using a multi-variable logistic regression. RESULTS: Data from 705 participants (333 cases/372 controls) were analysed. There were negligible differences between cases and controls by demographic characteristics including age, marital or socio-economic position. Prior familiarity with the CHiPs encouraged TLA (aOR of being a case: 0.58, 95% CI: 0.39 to 0.86, p = 0.006). Participants who found clinics overcrowded (aOR: 1.51, 95% CI: 1.08 to 2.12, p = 0.006) or opening hours inconvenient (aOR: 1.63, 95% CI: 1.06 to 2.51, p = 0.02) were less likely to achieve TLA, as were those expressing stronger feelings of shame about having HIV (p  = 0.007). Expressing "not feeling ready" (aOR: 2.75, 95% CI: 1.89 to 4.01, p < 0.001) and preferring to wait until they felt sick (aOR: 2.00, 95% CI: 1.27 to 3.14, p = 0.02) were similarly indicative of being a case. Worrying about being seen in the clinic or about how staff treated patients was not associated with TLA. While the association was not strong, we found that the greater the number of self-reported lifetime sexual partners the more likely participants were to achieve TLA (p  = 0.06). There was some evidence that participants with HIV-positive partners on ART were less likely to be cases (aOR: 0.75, 95% CI: 0.53 to 1.06, p = 0.07). DISCUSSION: The lack of socio-demographic differences between cases and controls is encouraging for a "universal" intervention that seeks to ensure high coverage across whole communities. Making clinics more "patient-friendly" could enhance treatment uptake further. The finding that those with higher risk behaviour are more actively engaging with UTT holds promise for treatment-as-prevention.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Intervenção Médica Precoce
Infecções por HIV/prevenção & controle
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Adulto
Fármacos Anti-HIV/administração & dosagem
Estudos de Casos e Controles
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Encaminhamento e Consulta
Parceiros Sexuais
África do Sul
Zâmbia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25037


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[PMID]:29206357
[Au] Autor:Semitala FC; Camlin CS; Wallenta J; Kampiire L; Katuramu R; Amanyire G; Namusobya J; Chang W; Kahn JG; Charlebois ED; Havlir DV; Kamya MR; Geng EH
[Ad] Endereço:Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
[Ti] Título:Understanding uptake of an intervention to accelerate antiretroviral therapy initiation in Uganda via qualitative inquiry.
[So] Source:J Int AIDS Soc;20(4), 2017 Dec.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The Streamlined Antiretroviral Therapy Initiation Strategy (START-ART) study found that a theory-based intervention using opinion leaders to inform and coach health care providers about the risks of treatment delay, provision of point of care (POC) CD4 testing machines (PIMA) and reputational incentives, led to rapid rise in ART initiation. We used qualitative research methods to explore mechanisms of provider behaviour change. METHODS: We conducted in-depth interviews (IDIs) with 24 health care providers and nine study staff to understand perceptions, attitudes and the context of changes in ART initiation practices. Analyses were informed by the Theoretical Domains Framework. RESULTS: Rapid dissemination of new practices was enabled in the environmental context of an existing relationship based on communication, implementation and accountability between Makerere University Joint AIDS Program (MJAP), a Ugandan University-affiliated organization that provided technical oversight for HIV service delivery at the health facilities where the intervention was implemented, and a network of health facilities operated by the Uganda Ministry of Health. Coaching carried out by field coordinators from MJAP strengthened influence and informal accountability for carrying out the intervention. Frontline health workers held a pre-existing strong sense of professional identity. They were proud of attainment of new knowledge and skills and gratified by providing what they perceived to be higher quality care. Peer counsellors, who were not explicitly targeted in the intervention design, effectively substituted some functions of health care providers; as role models for successful ART uptake, they played a crucial role in creating demand for rapid ART initiation through interactions with patients. Point of care (POC) CD4 testing enabled immediate action and relieved providers from frustrations of lost or delayed laboratory results, and led to higher patient satisfaction (due to reduced costs because of ability to initiate ART right away, requiring fewer return trips to clinic). CONCLUSIONS: Qualitative data revealed that a multicomponent intervention to change provider behaviour succeeded in the context of strong institutional and individual relationships between a University-affiliated organization, government facilities, and peer health workers (who acted as a crucial link between stakeholders) and the community. Fostering stable institutional relationships between institutional actors (non-governmental organization (NGOs) and ministry-operated facilities) as well as between facilities and the community (through peer health workers) can enhance uptake of innovations targeting the HIV cascade in similar clinical settings.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Infecções por HIV/tratamento farmacológico
Pessoal de Saúde
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Instituições de Assistência Ambulatorial
Feminino
Pessoal de Saúde/psicologia
Seres Humanos
Masculino
Motivação
Grupo Associado
Sistemas Automatizados de Assistência Junto ao Leito
Pesquisa Qualitativa
Uganda
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25033


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[PMID]:29178197
[Au] Autor:MacKenzie RK; van Lettow M; Gondwe C; Nyirongo J; Singano V; Banda V; Thaulo E; Beyene T; Agarwal M; McKenney A; Hrapcak S; Garone D; Sodhi SK; Chan AK
[Ad] Endereço:Dignitas International, Zomba, Malawi.
[Ti] Título:Greater retention in care among adolescents on antiretroviral treatment accessing "Teen Club" an adolescent-centred differentiated care model compared with standard of care: a nested case-control study at a tertiary referral hospital in Malawi.
[So] Source:J Int AIDS Soc;20(3), 2017 Nov.
[Is] ISSN:1758-2652
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: There are numerous barriers to the care and support of adolescents living with HIV (ALHIV) that makes this population particularly vulnerable to attrition from care, poor adherence and virological failure. In 2010, a Teen Club was established in Zomba Central Hospital (ZCH), Malawi, a tertiary referral HIV clinic. Teen Club provides ALHIV on antiretroviral treatment (ART) with dedicated clinic time, sexual and reproductive health education, peer mentorship, ART refill and support for positive living and treatment adherence. The purpose of this study was to evaluate whether attending Teen Club improves retention in ART care. METHODS: We conducted a nested case-control study with stratified selection, using programmatic data from 2004 to 2015. Cases (ALHIV not retained in care) and controls (ALHIV retained in care) were matched by ART initiation age group. Patient records were reviewed retrospectively and subjects were followed starting in March 2010, the month in which Teen Club was opened. Follow-up ended at the time patients were no longer considered retained in care or on 31 December 2015. Cases and controls were drawn from a study population of 617 ALHIV. Of those, 302 (48.9%) participated in at least two Teen Club sessions. From the study population, 135 (non-retained) cases and 405 (retained) controls were selected. RESULTS: In multivariable analyses, Teen Club exposure, age at the time of selection and year of ART initiation were independently associated with attrition. ALHIV with no Teen Club exposure were less likely to be retained than those with Teen Club exposure (adjusted odds ratio (aOR) 0.27; 95% CI 0.16, 0.45) when adjusted for sex, ART initiation age, current age, reason for ART initiation and year of ART initiation. ALHIV in the age group 15 to 19 were more likely to have attrition from care than ALHIV in the age group 10 to 14 years of age (aOR 2.14; 95% CI 1.12, 4.11). CONCLUSIONS: This study contributes to the limited evidence evaluating the effectiveness of service delivery interventions to support ALHIV within healthcare settings. Prospective evaluation of the Teen Club package with higher methodological quality is required for programmes and governments in low- and middle-income settings to prioritize interventions for ALHIV and determine their cost-effectiveness.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Infecções por HIV/tratamento farmacológico
Aceitação pelo Paciente de Cuidados de Saúde
Padrão de Cuidado
[Mh] Termos MeSH secundário: Adolescente
Instituições de Assistência Ambulatorial
Estudos de Casos e Controles
Feminino
Seres Humanos
Malaui
Masculino
Estudos Prospectivos
Estudos Retrospectivos
Grupos de Autoajuda
Centros de Atenção Terciária
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/jia2.25028


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[PMID]:28463455
[Au] Autor:Gros CP; Parr C; Wright DK; Montreuil M; Frechette J
[Ad] Endereço:Catherine Pugnaire Gros, RN, MSc(A), is Assistant Professor, Ingram School of Nursing, McGill University and Clinical Nurse Specialist, Douglas Mental Health University Institute, Montreal, Quebec, Canada.
[Ti] Título:Hospital rules and regulations: The perspectives of youth receiving psychiatric care.
[So] Source:J Child Adolesc Psychiatr Nurs;30(1):18-24, 2017 Feb.
[Is] ISSN:1744-6171
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rules and regulations represent an aspect of psychiatric hospitalization about which little is known. STUDY PURPOSE: To explore the perceptions of rules from the perspective of youth receiving hospital-based psychiatric services. DESIGN: Qualitative descriptive. METHODS: Perceptions of rules were elicited through semi-structured interviews with a convenience sample of six youth. RESULTS: Rules were perceived as governing virtually all aspects of everyday living in the hospital environment. Rules were used to structure daily activities, routines, and social interactions, and were embedded within clinical protocols and treatment plans. For each participant, "making sense" or "not making sense" were central themes through which rules were interpreted as being either therapeutic or oppressive. Rules that made "no sense" negatively affected youth mood, behavior, treatment adherence, and engagement in a collaborative relationship. CONCLUSION: Working in partnership with youth in psychiatric care to establish, implement, and evaluate rules that "make sense" can promote positive health outcomes and prevent negative, unintended consequences.
[Mh] Termos MeSH primário: Adolescente Hospitalizado
Hospital Dia/organização & administração
Pacientes Internados
Serviços de Saúde Mental/organização & administração
Aceitação pelo Paciente de Cuidados de Saúde
Unidade Hospitalar de Psiquiatria/organização & administração
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/jcap.12166


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[PMID]:28452905
[Au] Autor:Regidor I; Benita V; Del Álamo de Pedro M; Ley L; Martinez Castrillo JC
[Ad] Endereço:*Unit of Functional Neurosurgery, †Service of Neurophysiology, ‡Service of Gastroenterology, §Service of Neurosurgery, and ∥Service of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
[Ti] Título:Duodenal Levodopa Infusion for Long-Term Deep Brain Stimulation-Refractory Symptoms in Advanced Parkinson Disease.
[So] Source:Clin Neuropharmacol;40(3):103-107, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study assesses the effect of levodopa/carbidopa intestinal infusion gel (LCIIG) as an additional treatment in patients with advanced idiopathic Parkinson disease (PD) previously treated with deep brain stimulation (DBS). METHODS: Prospective study of advanced PD patients, satisfactorily treated with bilateral DBS of the subthalamic nucleus, who had developed refractory symptoms and LCIIG was added. Controls were advanced PD patients treated with LCIIG. Measurements included the Unified Parkinson Disease Rating Scale (UPDRS)-III and the UPDRS axial compound. RESULTS: There were 19 patients in the DBS-LCIIG therapy group and 21 in the control group. The DBS-LCIIG patients were younger and had disease duration longer than controls. The median time from DBS to gastrostomy was 7.8 years (range, 2-12 years). In both study groups, the mean scores of the UPDRS-III and UPDRS axial subscales improved significantly after LCIIG treatment (DBS-LCIIG group: UPDRS-III, 62.0 [15.7] vs 30.9 [12.1]; UPDRS axial, 24.7 [4.9] vs 10.2 [2.7]; P < 0.0005 for all comparisons). There were no differences in adverse events between the groups. In the follow-up of the DBS-LCIIG group. 5 patients discontinued DBS-LCIIG therapy and returned to DBS, 5 discontinued DBS and were maintained with LCIIG, and the remaining 9 continued with DBS-LCIIG therapy. Mean time until discontinuation in the double DBS-LCIIG group was 891 days. The main risk factors for discontinuation were age at the beginning of LCIIG and severity of the UPDRS axial subscale. CONCLUSIONS: Levodopa/carbidopa intestinal infusion gel therapy may be a valuable option in selected patients with advanced PD who develop refractory symptoms after long-term subthalamic nucleus-DBS.
[Mh] Termos MeSH primário: Antiparkinsonianos/administração & dosagem
Carbidopa/administração & dosagem
Estimulação Encefálica Profunda
Gastrostomia
Levodopa/administração & dosagem
Doença de Parkinson/tratamento farmacológico
Doença de Parkinson/terapia
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Antiparkinsonianos/efeitos adversos
Antiparkinsonianos/uso terapêutico
Carbidopa/efeitos adversos
Carbidopa/uso terapêutico
Terapia Combinada/efeitos adversos
Estimulação Encefálica Profunda/efeitos adversos
Combinação de Medicamentos
Duodeno
Feminino
Seguimentos
Gastrostomia/efeitos adversos
Géis
Seres Humanos
Intubação Gastrointestinal
Levodopa/efeitos adversos
Levodopa/uso terapêutico
Masculino
Meia-Idade
Doença de Parkinson/fisiopatologia
Pacientes Desistentes do Tratamento
Estudos Prospectivos
Índice de Gravidade de Doença
Espanha
Núcleo Subtalâmico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Drug Combinations); 0 (Gels); 0 (carbidopa, levodopa drug combination); 46627O600J (Levodopa); MNX7R8C5VO (Carbidopa)
[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:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000216


  9 / 37709 MEDLINE  
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[PMID]:28471315
[Au] Autor:Tung WC; Lu M; Granner M; Sohn J
[Ad] Endereço:a Orvis School of Nursing, University of Nevada , Reno , Nevada , USA.
[Ti] Título:Assessing perceived benefits/barriers and self-efficacy for cervical cancer screening among Korean American women.
[So] Source:Health Care Women Int;38(9):945-955, 2017 09.
[Is] ISSN:1096-4665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A large proportion of Korean American women (KAW) do not receive regular cervical cancer screening. Self-report data from 102 KAW were analyzed by multiple linear regressions. As compared to women in action/maintenance, women in precontemplation/relapse stages were less likely to agree that a Pap test is important for health and were more likely to endorse barriers to testing (cost, not having a female doctor, preference for Korean medicine). Women in precontemplation/relapse stages also reported lower scores on self-efficacy items (travel large distances, pain perceptions, financial costs, and time). Differences in specific aspects may be informative for interventions to improve screening rates among KAW.
[Mh] Termos MeSH primário: Americanos Asiáticos/psicologia
Conhecimentos, Atitudes e Prática em Saúde/etnologia
Aceitação pelo Paciente de Cuidados de Saúde/etnologia
Autoeficácia
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Americanos Asiáticos/estatística & dados numéricos
Estudos Transversais
Detecção Precoce de Câncer
Feminino
Seres Humanos
Programas de Rastreamento
Meia-Idade
Teste de Papanicolaou
Aceitação pelo Paciente de Cuidados de Saúde/psicologia
Percepção
República da Coreia/etnologia
Neoplasias do Colo do Útero/prevenção & controle
Neoplasias do Colo do Útero/psicologia
Esfregaço Vaginal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180304
[Lr] Data última revisão:
180304
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1080/07399332.2017.1326495


  10 / 37709 MEDLINE  
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[PMID]:29341067
[Au] Autor:Soares-Weiser K; Maayan N; Bergman H
[Ad] Endereço:Cochrane Editorial Unit, Cochrane, St Albans House, 57 - 59 Haymarket, London, UK, SW1Y 4QX.
[Ti] Título:Vitamin E for antipsychotic-induced tardive dyskinesia.
[So] Source:Cochrane Database Syst Rev;1:CD000209, 2018 01 17.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Antipsychotic (neuroleptic) medication is used extensively to treat people with chronic mental illnesses. Its use, however, is associated with adverse effects, including movement disorders such as tardive dyskinesia (TD) - a problem often seen as repetitive involuntary movements around the mouth and face. Vitamin E has been proposed as a treatment to prevent or decrease TD. OBJECTIVES: The primary objective was to determine the clinical effects of vitamin E in people with schizophrenia or other chronic mental illness who had developed antipsychotic-induced TD.The secondary objectives were:1. to examine whether the effect of vitamin E was maintained as duration of follow-up increased;2. to test the hypothesis that the use of vitamin E is most effective for those with early onset TD (less than five years) SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (July 2015 and April 2017), inspected references of all identified studies for further trials and contacted authors of trials for additional information. SELECTION CRITERIA: We included reports if they were controlled trials dealing with people with antipsychotic-induced TD and schizophrenia who remained on their antipsychotic medication and had been randomly allocated to either vitamin E or to a placebo, no intervention, or any other intervention. DATA COLLECTION AND ANALYSIS: We independently extracted data from these trials and we estimated risk ratios (RR) or mean differences (MD), with 95% confidence intervals (CI). We assumed that people who left early had no improvement. We assessed risk of bias and created a 'Summary of findings' table using GRADE. MAIN RESULTS: The review now includes 13 poorly reported randomised trials (total 478 people), all participants were adults with chronic psychiatric disorders, mostly schizophrenia, and antipsychotic-induced TD. There was no clear difference between vitamin E and placebo for the outcome of TD: not improved to a clinically important extent (6 RCTs, N = 264, RR 0.95, 95% CI 0.89 to 1.01, low-quality evidence). However, people allocated to placebo may show more deterioration of their symptoms compared with those given vitamin E (5 RCTs, N = 85, RR 0.23, 95% CI 0.07 to 0.76, low-quality evidence). There was no evidence of a difference in the incidence of any adverse effects (9 RCTs, N = 205, RR 1.21, 95% CI 0.35 to 4.15, very low-quality evidence), extrapyramidal adverse effects (1 RCT, N = 104, MD 1.10, 95% CI -1.02 to 3.22, very low-quality evidence), or acceptability of treatment (measured by participants leaving the study early) (medium term, 8 RCTs, N = 232, RR 1.07, 95% CI 0.64 to 1.80, very low-quality evidence). No trials reported on social confidence, social inclusion, social networks, or personalised quality of life, outcomes designated important to patients. There is no trial-based information regarding the effect of vitamin E for those with early onset of TD. AUTHORS' CONCLUSIONS: Small trials of limited quality suggest that vitamin E may protect against deterioration of TD. There is no evidence that vitamin E improves symptoms of this problematic and disfiguring condition once established. New and better trials are indicated in this under-researched area, and, of the many adjunctive treatments that have been given for TD, vitamin E would be a good choice for further evaluation.
[Mh] Termos MeSH primário: Antipsicóticos/efeitos adversos
Discinesia Induzida por Medicamentos/tratamento farmacológico
Vitamina E/uso terapêutico
Vitaminas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Progressão da Doença
Discinesia Induzida por Medicamentos/etiologia
Seres Humanos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
Transtornos Psicóticos/tratamento farmacológico
Ensaios Clínicos Controlados Aleatórios como Assunto
Esquizofrenia/tratamento farmacológico
Vitamina E/efeitos adversos
Vitaminas/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Vitamins); 1406-18-4 (Vitamin E)
[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:180118
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000209.pub3



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