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[PMID]:29377930
[Au] Autor:Eghdam A; Hamidi U; Bartfai A; Koch S
[Ad] Endereço:Health Informatics Centre (HIC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:Facebook as communication support for persons with potential mild acquired cognitive impairment: A content and social network analysis study.
[So] Source:PLoS One;13(1):e0191878, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Social media has the potential to increase social participation and support for the well-being of individuals with chronic medical conditions. To date, Facebook is the most popular social medium for different types of communication. However, there is a lack of knowledge about the potential use of Facebook as a means of communication for persons with potential Mild Acquired Cognitive Impairment (MACI), a non-progressive mild cognitive impairment after an acquired brain injury. The aim of this study was to explore how persons with potential MACI, specifically persons with perceived brain fatigue after brain injury, communicate through Facebook, to classify the content of the communication and to visualize the frequency and types of interactions. METHODS AND MATERIALS: A social network analysis of the interactions between members' and a qualitative content analysis of a whole year's communication of a public Facebook group for Swedish speaking persons (1310 members) with perceived brain fatigue after an illness or injury to the brain were performed. RESULTS: The results showed how members use social media technology and Facebook as a means for communication and support for their condition. Individual group members showed very different patterns of communication and interactions. However, for the group as a whole, the most frequent topics in their communication were related to informational support and banter in posts, and socialization in comments. The findings also showed that the majority of members only communicated with few other members and had few direct communications. The most used communication feature of Facebook was likes in form of "thumbs-up". CONCLUSIONS: This study indicated that social media and in this case Facebook is used for communication and social support by persons with potential MACI, and revealed that their communication behavior is similar to the healthy population. Further studies relating specific cognitive problems of the participants to the use of social media would provide more reliable results for this specific group.
[Mh] Termos MeSH primário: Transtornos Cognitivos/psicologia
Comunicação
Mídias Sociais
Apoio Social
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Defesa do Paciente
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[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:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191878


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[PMID]:29278027
[Au] Autor:Madhavadas S; Subramanian S; Kutty BM
[Ad] Endereço:1 Department of Neurochemistry, National Institute of Mental Health and Neurosciences , Bangalore, India.
[Ti] Título:Environmental enrichment improved cognitive deficits more in peri-adolescent than in adult rats after postnatal monosodium glutamate treatment.
[So] Source:Physiol Int;104(4):271-290, 2017 Dec 01.
[Is] ISSN:2498-602X
[Cp] País de publicação:Hungary
[La] Idioma:eng
[Ab] Resumo:Exposure to enriched environment (EE) is known to promote sensory, cognitive, and motor stimulation with intensified levels of novelty and complexity. In this study, we investigated the positive regulatory effect of short-term exposure to EE on establishing functional recovery in monosodium glutamate (MSG)-induced obese rats. Unless treated, MSG rats exhibited peripheral insulin resistance, cognitive deficits, and a reduction in the total hippocampal volume with decreased neuron count in the DG, CA3, and CA1 subfields. These MSG rats were exposed to short-term EE for 15 days for a period of 6 h/day, beginning either at 45 or at 75 days of age. EE exposure has improved insulin sensitivity, yielded a significant increase in total hippocampal volume along with increase in neuron number in the CA1 subfield of the hippocampus in both age groups. However, as assessed by radial arm maze task, which relies upon the positive reinforcement to test spatial memory, and the Barnes maze task, which utilizes an aversive learning strategy, a complete recovery of cognitive function could be achieved in 2-month-old rats only and not among 3-month-old rats, thus highlighting the importance of critical window period for EE interventions in restoring the memory functions. These results suggest the therapeutic potential of EE paradigm in prevention of cognitive disorders.
[Mh] Termos MeSH primário: Transtornos Cognitivos/prevenção & controle
Transtornos Cognitivos/fisiopatologia
Cognição
Meio Ambiente
Hipocampo/fisiopatologia
Estimulação Física/métodos
Glutamato de Sódio
[Mh] Termos MeSH secundário: Animais
Transtornos Cognitivos/induzido quimicamente
Hipocampo/efeitos dos fármacos
Hipocampo/patologia
Masculino
Ratos
Ratos Sprague-Dawley
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
W81N5U6R6U (Sodium Glutamate)
[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:171227
[St] Status:MEDLINE
[do] DOI:10.1556/2060.104.2017.4.7


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[PMID]:29297082
[Au] Autor:Prescott HC; Angus DC
[Ad] Endereço:Department of Internal Medicine and Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor.
[Ti] Título:Enhancing Recovery From Sepsis: A Review.
[So] Source:JAMA;319(1):62-75, 2018 01 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments. Impairments include development of an average of 1 to 2 new functional limitations (eg, inability to bathe or dress independently), a 3-fold increase in prevalence of moderate to severe cognitive impairment (from 6.1% before hospitalization to 16.7% after hospitalization), and a high prevalence of mental health problems, including anxiety (32% of patients who survive), depression (29%), or posttraumatic stress disorder (44%). About 40% of patients are rehospitalized within 90 days of discharge, often for conditions that are potentially treatable in the outpatient setting, such as infection (11.9%) and exacerbation of heart failure (5.5%). Compared with patients hospitalized for other diagnoses, those who survive sepsis (11.9%) are at increased risk of recurrent infection than matched patients (8.0%) matched patients (P < .001), acute renal failure (3.3% vs 1.2%, P < .001), and new cardiovascular events (adjusted hazard ratio [HR] range, 1.1-1.4). Reasons for deterioration of health after sepsis are multifactorial and include accelerated progression of preexisting chronic conditions, residual organ damage, and impaired immune function. Characteristics associated with complications after hospital discharge for sepsis treatment are not fully understood but include both poorer presepsis health status, characteristics of the acute septic episode (eg, severity of infection, host response to infection), and quality of hospital treatment (eg, timeliness of initial sepsis care, avoidance of treatment-related harms). Although there is a paucity of clinical trial evidence to support specific postdischarge rehabilitation treatment, experts recommend referral to physical therapy to improve exercise capacity, strength, and independent completion of activities of daily living. This recommendation is supported by an observational study involving 30 000 sepsis survivors that found that referral to rehabilitation within 90 days was associated with lower risk of 10-year mortality compared with propensity-matched controls (adjusted HR, 0.94; 95% CI, 0.92-0.97, P < .001). Conclusions and Relevance: In the months after hospital discharge for sepsis, management should focus on (1) identifying new physical, mental, and cognitive problems and referring for appropriate treatment, (2) reviewing and adjusting long-term medications, and (3) evaluating for treatable conditions that commonly result in hospitalization, such as infection, heart failure, renal failure, and aspiration. For patients with poor or declining health prior to sepsis who experience further deterioration after sepsis, it may be appropriate to focus on palliation of symptoms.
[Mh] Termos MeSH primário: Sepse/complicações
Sepse/reabilitação
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Transtornos Cognitivos/etiologia
Hospitalização/estatística & dados numéricos
Seres Humanos
Transtornos Mentais/etiologia
Sepse/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17687


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[PMID]:29287106
[Au] Autor:Díaz-Venegas C; Schneider DC; Myrskylä M; Mehta NK
[Ad] Endereço:Max Planck Institute for Demographic Research, Rostock, Germany.
[Ti] Título:Life expectancy with and without cognitive impairment by diabetes status among older Americans.
[So] Source:PLoS One;12(12):e0190488, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Diabetes affects mortality and cognitive functioning. It is not known how diabetes influences life expectancy (LE) with and without cognitive impairment. We seek to examine age at onset of cognitive impairment and life expectancy (LE) with and without cognitive impairment by diabetes status among middle- and older-aged Americans. Data come from the U.S. Health and Retirement Study 2000-2012 linked to the National Death Index (N = 13,687). We use multinomial regression models stratified by gender and controlling for age, education and race/ethnicity to estimate diabetes-status specific transition probabilities, then use a Markov chain matrix population model to calculate age at onset of cognitive impairment and LE with and without cognitive impairment by diabetes status at age 50. LE at age 50 was 27.6 (men) and 32.1 (women). From age 50, those with diabetes had a first incidence of cognitive impairment 3 (men) and 4 (women) years earlier than those without. Diabetes reduced total LE by 5-7 years and cognitively healthy LE by 4-6 years. Those with diabetes lived one year less in a cognitively impaired state than those without. Over 80% of the lower LE associated with diabetes is attributable to the loss of cognitively-healthy years. Those with diabetes have a shorter LE with cognitive impairment because of higher mortality. In analyses by educational attainment, education was strongly protective of cognitive health, yet diabetes was associated with lower age of cognitive impairment onset and fewer cognitive healthy years lived in all educational groups. The excess mortality because of diabetes may be decreasing. If the mortality decline is not coupled with a comparable decline in the risk of cognitive impairment, the population level burden of impaired cognition may grow larger.
[Mh] Termos MeSH primário: Transtornos Cognitivos
Diabetes Mellitus/fisiopatologia
Expectativa de Vida
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190488


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[PMID]:28463847
[Au] Autor:Benítez-Burraco A; Di Pietro L; Barba M; Lattanzi W
[Ad] Endereço:Department of Philology, Faculty of Humanities, University of Huelva, Huelva, Spain.
[Ti] Título:Schizophrenia and Human Self-Domestication: An Evolutionary Linguistics Approach.
[So] Source:Brain Behav Evol;89(3):162-184, 2017.
[Is] ISSN:1421-9743
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Schizophrenia (SZ) is a pervasive neurodevelopmental disorder that entails social and cognitive deficits, including marked language problems. Its complex multifactorial etiopathogenesis, including genetic and environmental factors, is still widely uncertain. SZ incidence has always been high and quite stable in human populations, across time and regardless of cultural implications, for unclear reasons. It has been hypothesized that SZ pathophysiology may involve the biological components that changed during the recent human evolutionary history, and led to our distinctive mode of cognition, which includes language skills. In this paper we explore this hypothesis, focusing on the self-domestication of the human species. This has been claimed to account for many human-specific distinctive traits, including aspects of our behavior and cognition, and to favor the emergence of complex languages through cultural evolution. The "domestication syndrome" in mammals comprises the constellation of traits exhibited by domesticated strains, seemingly resulting from the hypofunction of the neural crest. It is our intention to show that people with SZ exhibit more marked domesticated traits at the morphological, physiological, and behavioral levels. We also show that genes involved in domestication and neural crest development and function comprise nearly 20% of SZ candidates, most of which exhibit altered expression profiles in the brain of SZ patients, specifically in areas involved in language processing. Based on these observations, we conclude that SZ may represent an abnormal ontogenetic itinerary for the human faculty of language, resulting, at least in part, from changes in genes important for the domestication syndrome and primarily involving the neural crest.
[Mh] Termos MeSH primário: Esquizofrenia/genética
Esquizofrenia/fisiopatologia
[Mh] Termos MeSH secundário: Evolução Biológica
Encéfalo/patologia
Cognição/fisiologia
Transtornos Cognitivos/fisiopatologia
Bases de Dados Genéticas
Regulação da Expressão Gênica no Desenvolvimento/genética
Seres Humanos
Linguagem
Linguística/métodos
Crista Neural/fisiologia
Psicologia do Esquizofrênico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1159/000468506


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[PMID]:29341066
[Au] Autor:Yu Y; Zhang K; Zhang L; Zong H; Meng L; Han R
[Ad] Endereço:Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantan Xili, Beijing, China, 100050.
[Ti] Título:Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
[So] Source:Cochrane Database Syst Rev;1:CD010947, 2018 Jan 17.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay). SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 12), Embase (1974 to 20 December 2016) and MEDLINE (PubMed) (1975 to 20 December 2016). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing studies on 20 December 2016. We updated this search in November 2017, but these results have not yet been incorporated in the review. We imposed no language restriction. SELECTION CRITERIA: We included all relevant randomized controlled trials (RCTs) dealing with the use of cerebral NIRS in the perioperative setting (during the operation and within 72 hours after the operation), including the operating room, the postanaesthesia care unit and the intensive care unit. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies, assessed risk of bias and extracted data. For binary outcomes, we calculated the risk ratio (RR) and its 95% confidence interval (CI). For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. As we expected clinical and methodological heterogeneity between studies, we employed a random-effects model for analyses and we examined the data for heterogeneity (I statistic). We created a 'Summary of findings' table using GRADEpro. MAIN RESULTS: We included 15 studies in the review, comprising a total of 1822 adult participants. There are 12 studies awaiting classification, and eight ongoing studies.None of the 15 included studies considered the paediatric population. Four studies were conducted in the abdominal and orthopaedic surgery setting (lumbar spine, or knee and hip replacement), one study in the carotid endarterectomy setting, and the remaining 10 studies in the aortic or cardiac surgery setting. The main sources of bias in the included studies related to potential conflict of interest from industry sponsorship, unclear blinding status or missing participant data.Two studies with 312 participants considered postoperative neurological injury, however no pooled effect estimate could be calculated due to discordant direction of effect between studies (low-quality evidence). One study (N = 126) in participants undergoing major abdominal surgery reported that 4/66 participants experienced neurological injury with blinded monitoring versus 0/56 in the active monitoring group. A second study (N = 195) in participants having coronary artery bypass surgery reported that 1/96 participants experienced neurological injury in the blinded monitoring group compared with 4/94 participants in the active monitoring group.We are uncertain whether active cerebral NIRS monitoring has an important effect on the risk of postoperative stroke because of the low number of events and wide confidence interval (RR 0.25, 95% CI 0.03 to 2.20; 2 studies, 240 participants; low-quality evidence).We are uncertain whether active cerebral NIRS monitoring has an important effect on postoperative delirium because of the wide confidence interval (RR 0.63, 95% CI 0.27 to 1.45; 1 study, 190 participants; low-quality evidence).Two studies with 126 participants showed that active cerebral NIRS monitoring may reduce the incidence of mild postoperative cognitive dysfunction (POCD) as defined by the original studies at one week after surgery (RR 0.53, 95% CI 0.30 to 0.95, I = 49%, low-quality evidence).Based on six studies with 962 participants, there was moderate-quality evidence that active cerebral oxygenation monitoring probably does not decrease the occurrence of POCD (decline in cognitive function) at one week after surgery (RR 0.62, 95% CI 0.37 to 1.04, I = 80%). The different type of monitoring equipment in one study could potentially be the cause of the heterogeneity.We are uncertain whether active cerebral NIRS monitoring has an important effect on intraoperative mortality or postoperative mortality because of the low number of events and wide confidence interval (RR 0.63, 95% CI 0.08 to 5.03, I = 0%; 3 studies, 390 participants; low-quality evidence). There was no evidence to determine whether routine use of NIRS-based cerebral oxygenation monitoring causes adverse effects. AUTHORS' CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients undergoing non-cardiac surgery (e.g. neurosurgery, carotid endarterectomy and other surgery) are needed.
[Mh] Termos MeSH primário: Encéfalo/metabolismo
Hipóxia-Isquemia Encefálica/diagnóstico
Consumo de Oxigênio/fisiologia
Espectroscopia de Luz Próxima ao Infravermelho
[Mh] Termos MeSH secundário: Abdome/cirurgia
Adulto
Artroplastia de Quadril
Artroplastia do Joelho
Criança
Transtornos Cognitivos/prevenção & controle
Seres Humanos
Vértebras Lombares/cirurgia
Monitorização Intraoperatória
Complicações Pós-Operatórias/prevenção & controle
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[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.CD010947.pub2


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[PMID]:29253878
[Au] Autor:Asam K; Staniszewski A; Zhang H; Melideo SL; Mazzeo A; Voronkov M; Huber KL; Pérez E; Stock M; Stock JB; Arancio O; Nicholls RE
[Ad] Endereço:Department of Pathology and Cell Biology, Columbia University, New York, NY, United States of America.
[Ti] Título:Eicosanoyl-5-hydroxytryptamide (EHT) prevents Alzheimer's disease-related cognitive and electrophysiological impairments in mice exposed to elevated concentrations of oligomeric beta-amyloid.
[So] Source:PLoS One;12(12):e0189413, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Soluble forms of oligomeric beta-amyloid (Aß) are thought to play a central role in Alzheimer's disease (AD). Transgenic manipulation of methylation of the serine/threonine protein phosphatase, PP2A, was recently shown to alter the sensitivity of mice to AD-related impairments resulting from acute exposure to elevated levels of Aß. In addition, eicosanoyl-5-hydroxytryptamide (EHT), a naturally occurring component from coffee beans that modulates PP2A methylation, was shown to confer therapeutic benefits in rodent models of AD and Parkinson's disease. Here, we tested the hypothesis that EHT protects animals from the pathological effects of exposure to elevated levels of soluble oligomeric Aß. We treated mice with EHT-containing food at two different doses and assessed the sensitivity of these animals to Aß-induced behavioral and electrophysiological impairments. We found that EHT administration protected animals from Aß-induced cognitive impairments in both a radial-arm water maze and contextual fear conditioning task. We also found that both chronic and acute EHT administration prevented Aß-induced impairments in long-term potentiation. These data add to the accumulating evidence suggesting that interventions with pharmacological agents, such as EHT, that target PP2A activity may be therapeutically beneficial for AD and other neurological conditions.
[Mh] Termos MeSH primário: Doença de Alzheimer/tratamento farmacológico
Peptídeos beta-Amiloides/química
Transtornos Cognitivos/prevenção & controle
Serotonina/análogos & derivados
[Mh] Termos MeSH secundário: Doença de Alzheimer/patologia
Animais
Café
Cognição/efeitos dos fármacos
Condicionamento (Psicologia)
Modelos Animais de Doenças
Eletrofisiologia
Medo
Feminino
Potenciação de Longa Duração
Masculino
Aprendizagem em Labirinto
Metilação
Camundongos
Camundongos Endogâmicos C57BL
Doenças do Sistema Nervoso/tratamento farmacológico
Doenças do Sistema Nervoso/patologia
Plasticidade Neuronal
Fosforilação
Serotonina/farmacologia
Solubilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amyloid beta-Peptides); 0 (Coffee); 0 (eicosanoyl-5-hydroxytryptamide); 333DO1RDJY (Serotonin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189413


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Registro de Ensaios Clínicos
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[PMID]:29320647
[Au] Autor:Bassler D; Shinwell ES; Hallman M; Jarreau PH; Plavka R; Carnielli V; Meisner C; Engel C; Koch A; Kreutzer K; van den Anker JN; Schwab M; Halliday HL; Poets CF; Neonatal European Study of Inhaled Steroids Trial Group
[Ad] Endereço:From the Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich (D.B.), and the Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel (J.N.A.) - both in Switzerland; Ziv Medical Center, Faculty of Medicine in the Galilee,
[Ti] Título:Long-Term Effects of Inhaled Budesonide for Bronchopulmonary Dysplasia.
[So] Source:N Engl J Med;378(2):148-157, 2018 01 11.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The long-term effects on neurodevelopment of the use of inhaled glucocorticoids in extremely preterm infants for the prevention or treatment of bronchopulmonary dysplasia are uncertain. METHODS: We randomly assigned 863 infants (gestational age, 23 weeks 0 days to 27 weeks 6 days) to receive early (within 24 hours after birth) inhaled budesonide or placebo. The prespecified secondary long-term outcome was neurodevelopmental disability among survivors, defined as a composite of cerebral palsy, cognitive delay (a Mental Development Index score of <85 [1 SD below the mean of 100] on the Bayley Scales of Infant Development, Second Edition, with higher scores on the scale indicating better performance), deafness, or blindness at a corrected age of 18 to 22 months. RESULTS: Adequate data on the prespecified composite long-term outcome were available for 629 infants. Of these infants, 148 (48.1%) of 308 infants assigned to budesonide had neurodevelopmental disability, as compared with 165 (51.4%) of 321 infants assigned to placebo (relative risk, adjusted for gestational age, 0.93; 95% confidence interval [CI], 0.80 to 1.09; P=0.40). There was no significant difference in any of the individual components of the prespecified outcome. There were more deaths in the budesonide group than in the placebo group (82 [19.9%] of 413 infants vs. 58 [14.5%] of 400 infants for whom vital status was available; relative risk, 1.37; 95% CI, 1.01 to 1.86; P=0.04). CONCLUSIONS: Among surviving extremely preterm infants, the rate of neurodevelopmental disability at 2 years did not differ significantly between infants who received early inhaled budesonide for the prevention of bronchopulmonary dysplasia and those who received placebo, but the mortality rate was higher among those who received budesonide. (Funded by the European Union and Chiesi Farmaceutici; ClinicalTrials.gov number, NCT01035190 .).
[Mh] Termos MeSH primário: Displasia Broncopulmonar/prevenção & controle
Budesonida/administração & dosagem
Deficiências do Desenvolvimento/epidemiologia
Glucocorticoides/administração & dosagem
Lactente Extremamente Prematuro
[Mh] Termos MeSH secundário: Administração por Inalação
Cegueira/epidemiologia
Paralisia Cerebral/epidemiologia
Transtornos Cognitivos/epidemiologia
Feminino
Seguimentos
Idade Gestacional
Perda Auditiva/epidemiologia
Seres Humanos
Recém-Nascido
Doenças do Prematuro/mortalidade
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Glucocorticoids); 51333-22-3 (Budesonide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1708831


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[PMID]:29206951
[Au] Autor:Hong M; Harrington D
[Ad] Endereço:School of Social Work, Indiana University, 902 West New York Street, Education/SW Building ES 4109, Indianapolis, IN 46202-5156; School of Social Work, University of Maryland, Baltimore.
[Ti] Título:The Effects of Caregiving Resources on Perceived Health among Caregivers.
[So] Source:Health Soc Work;41(3):155-163, 2016 Aug 01.
[Is] ISSN:0360-7283
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study examined how various types of resources influence perceived health of caregivers. Guided by the conservation of resources theory, a caregiver health model was built and tested using structural equation modeling. The caregiver health model consisted of caregiving situations (functional limitations and cognitive impairments of older adults and caregiving time), resources (financial resources, mastery, social support, family harmony, and service utilization), caregiver burden, and perceived health of caregivers. The sample included 1,837 unpaid informal caregivers drawn from the 2004 National Long-Term Caregiver Survey. The model fit indices indicated that the first structural model did not fit well; however, the revised model yielded an excellent model fit. More stressful caregiving situations were associated with fewer resources and higher burden, whereas greater resources were associated with lower burden and better perceived health of caregivers. The results suggest explicit implications for social work research and practice on how to protect the health of caregivers.
[Mh] Termos MeSH primário: Cuidadores/psicologia
Transtornos Cognitivos/enfermagem
Pessoas com Deficiência
Relações Familiares
Recursos em Saúde
Autoeficácia
Apoio Social
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Inquéritos e Questionários
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1093/hsw/hlw025


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[PMID]:29214732
[Au] Autor:Van Rheenen TE
[Ad] Endereço:Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia.
[Ti] Título:Commentary on "Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force".
[So] Source:Bipolar Disord;20(1):72-73, 2018 02.
[Is] ISSN:1399-5618
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Mh] Termos MeSH primário: Comitês Consultivos
Transtorno Bipolar
[Mh] Termos MeSH secundário: Cognição
Transtornos Cognitivos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1111/bdi.12577



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