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INTRODUCTION: During the COVID-19 pandemic, the literature highlighted an increased risk of child abuse and the use of negative parenting practices. Furthermore, pregnancy during this time may have been challenging and generated different feelings regarding the pandemic and motherhood. Many pregnant women had other young children, underscoring the need to understand this scenario better. Therefore, the present study examined the predictive effect of indicators of mental health disorders, emotional discomfort with motherhood, and negative perceptions of COVID-19 on negative parenting practices. METHODS: The study used a cross-sectional design. Pregnant women (n = 303) who had other children younger than six years answered an online questionnaire during the physical distancing period due to COVID-19 in Fortaleza. A partially latent structural equation model (SEM) was used to test direct and indirect relations between the variables. RESULTS: The results revealed a direct positive relation between maternal mental health and the variables COVID-19 feelings, emotional discomfort with motherhood, and negative parenting practices. The stronger relationship was between maternal mental health and emotional discomfort with motherhood. The COVID-19 negative feelings also showed a direct positive relation to emotional discomfort with motherhood. Additionally, older mothers and those with fewer children tended to have less mental health disorders. Furthermore, being in a later trimester of pregnancy was linked to more negative feelings about motherhood. DISCUSSION: The study suggests that mothers experiencing mental health challenges are more likely to feel discomfort with motherhood and use negative parenting practices, highlighting a need for intervention.
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COVID-19 , Gestantes , Criança , Gravidez , Feminino , Humanos , Pré-Escolar , Gestantes/psicologia , Saúde Mental , Poder Familiar/psicologia , Estudos Transversais , Pandemias , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/psicologia , Mães/psicologiaRESUMO
BACKGROUND: In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status. AIMS: This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures. METHODS: Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains. RESULTS: The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices. CONCLUSIONS: Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.
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COVID-19 , Criança , Feminino , Pré-Escolar , Humanos , COVID-19/epidemiologia , Pandemias , Saúde Mental , Surtos de Doenças , MãesRESUMO
BACKGROUND: Intimate partner violence (IPV) is a pervasive public health issue that affects millions of women worldwide. Women living below the poverty line experience higher rates of violence and fewer resources to escape or cope with the abuse, and the COVID-19 pandemic has significantly impacted women's economic well-being worldwide. We conducted a cross-sectional study in Ceará, Brazil, on women in families with children living below the poverty line at the peak of the second wave of COVID to assess the prevalence of IPV and its association with common mental disorders(CMD). METHODS: The study population comprised families with children up to six years of age who participated in the cash transfer program "Mais Infância". The families selected to participate in this program must meet a poverty criterion: families must live in rural areas, in addition to a monthly per capita income of less than US$16.50 per month. We applied specific instruments to evaluate IPV and CMD. To access IPV, we used the Partner Violence Screen (PVS). The Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. To verify the association between IPV and the other evaluated factors with CMD, simple and hierarchical multiple logistic models were used. RESULTS: Of the 479 participant women, 22% were positively screened for IPV (95% CI 18.2-26.2). After multivariate adjustment, the chances of CMD are 2.32 higher in women exposed to IPV than in those not exposed to IPV ((95%CI 1.30-4.13), p value = 0.004). CMD was also associated with job loss during the COVID-19 pandemic (ORa 2.13 (95% CI 1.09-4.35), p-value 0.029). In addition to these, separate or single marital status, as well as non-presence of the father at home and food insecurity were associated with CMD. CONCLUSION: We conclude that the prevalence of intimate partner violence in families with children up to six years of age living below the poverty line in Ceará is high and is associated with greater chances of common mental disorders in mothers. Also, job loss and reduced access to food caused by the Covid 19 pandemic exacerbated both phenomena, constituting a double burden generator factor on mothers.
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COVID-19 , Violência por Parceiro Íntimo , Transtornos Mentais , Humanos , Feminino , Criança , Estudos Transversais , Brasil/epidemiologia , Pandemias , COVID-19/epidemiologia , Transtornos Mentais/epidemiologia , Pobreza , Fatores de Risco , PrevalênciaRESUMO
INTRODUCTION: Management strategies and hemostatic treatments to achieve control of bleeding are relevant across many disease areas. Identification of primary outcomes for studies assessing hemostatic intervention was the objective of a National Heart, Lung and Blood Institute (NHLBI) sponsored multidisciplinary initiative. The aim of this report is to summarize the evidence reviewed, and the outcomes identified by the subgroup tasked to assess outcomes for inherited bleeding disorders. METHODS: The subgroup decided to focus on haemophilia, the prototypal congenital bleeding disorder and the one with the largest available body of evidence. MEDLINE, EMBASE and PsycINFO, The Cochrane Review, CINAHL, and Web of Science were searched for systematic and narrative reviews on outcomes used in haemophilia clinical trials. Three different clinical goals were identified as typical objectives of future research. RESULTS: Out of 1322 unique citations, 24 reviews published in the period 2002-2019 were included. We identified 113 outcome measures, categorized in 6 domains: health-related quality of life (HRQoL), comorbidities and mortality, overall physical functioning and participation, bleeding and hemostasis, joint health, and costs and resource use. Three different clinical goals were identified as typical objectives of future research: Episodic 'on demand' replacement therapy, prevention of bleeding (Prophylaxis), and long-term and overall impact of bleeding. For each of these scenarios, specific outcomes were recommended. CONCLUSIONS: Primary outcomes for clinical trials assessing the efficacy of hemostatic treatment in achieving control, prevention and limiting long-term consequences of bleeding in inherited bleeding disorders are suggested, and their strength and limitations discussed.
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Hemofilia A , Hemostáticos , Hemofilia A/tratamento farmacológico , Hemorragia/prevenção & controle , Hemostasia , Hemostáticos/uso terapêutico , Humanos , Qualidade de VidaRESUMO
PURPOSE: Clinicians are not confident in diagnosing deep gluteal syndrome (DGS) because of the ambiguity of the DGS disease definition and DGS diagnostic pathway. The purpose of this systematic review was to identify the DGS disease definition, and also to define a general DGS diagnostic pathway. METHODS: A systematic search was performed using four electronic databases: PubMed, MEDLINE, EMBASE, and Google Scholar. In eligibility criteria, studies in which cases were explicitly diagnosed with DGS were included, whereas review articles and commentary papers were excluded. Data are presented descriptively. RESULTS: The initial literature search yielded 359 articles, of which 14 studies met the eligibility criteria, pooling 853 patients with clinically diagnosed with DGS. In this review, it was discovered that the DGS disease definition was composed of three parts: (1) non-discogenic, (2) sciatic nerve disorder, and (3) nerve entrapment in the deep gluteal space. In the diagnosis of DGS, we found five diagnostic procedures: (1) history taking, (2) physical examination, (3) imaging tests, (4) response-to-injection, and (5) nerve-specific tests (electromyography). History taking (e.g. posterior hip pain, radicular pain, and difficulty sitting for 30 min), physical examination (e.g. tenderness in deep gluteal space, pertinent positive results with seated piriformis test, and positive Pace sign), and imaging tests (e.g. pelvic radiographs, spine and pelvic magnetic resonance imaging (MRI)) were generally performed in cases clinically diagnosed with DGS. CONCLUSION: Existing literature suggests the DGS disease definition as being a non-discogenic sciatic nerve disorder with entrapment in the deep gluteal space. Also, the general diagnostic pathway for DGS was composed of history taking (posterior hip pain, radicular pain, and difficulty sitting for 30 min), physical examination (tenderness in deep gluteal space, positive seated piriformis test, and positive Pace sign), and imaging tests (pelvic radiographs, pelvic MRI, and spine MRI). This review helps clinicians diagnose DGS with more confidence. LEVEL OF EVIDENCE: IV.
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Síndromes de Compressão Nervosa/diagnóstico , Síndrome do Músculo Piriforme/diagnóstico , Ciática/diagnóstico , Eletromiografia , Humanos , Imageamento por Ressonância Magnética , Anamnese , Síndromes de Compressão Nervosa/diagnóstico por imagem , Exame Físico , Síndrome do Músculo Piriforme/diagnóstico por imagem , Ciática/diagnóstico por imagemRESUMO
BACKGROUND: In patients with Parkinson's disease, stimulation above the subthalamic nucleus (STN) may engage the pallidofugal fibers and directly suppress dyskinesia. OBJECTIVES: The objective of this study was to evaluate the effect of interleaving stimulation through a dorsal deep brain stimulation contact above the STN in a cohort of PD patients and to define the volume of tissue activated with antidyskinesia effects. METHODS: We analyzed the Core Assessment Program for Surgical Interventional Therapies dyskinesia scale, Unified Parkinson's Disease Rating Scale parts III and IV, and other endpoints in 20 patients with interleaving stimulation for management of dyskinesia. Individual models of volume of tissue activated and heat maps were used to identify stimulation sites with antidyskinesia effects. RESULTS: The Core Assessment Program for Surgical Interventional Therapies dyskinesia score in the on medication phase improved 70.9 ± 20.6% from baseline with noninterleaved settings (P < 0.003). With interleaved settings, dyskinesia improved 82.0 ± 27.3% from baseline (P < 0.001) and 61.6 ± 39.3% from the noninterleaved phase (P = 0.006). The heat map showed a concentration of volume of tissue activated dorsally to the STN during the interleaved setting with an antidyskinesia effect. CONCLUSION: Interleaved deep brain stimulation using the dorsal contacts can directly suppress dyskinesia, probably because of the involvement of the pallidofugal tract, allowing more conservative medication reduction. © 2019 International Parkinson and Movement Disorder Society.
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Estimulação Encefálica Profunda , Discinesias/terapia , Doença de Parkinson/terapia , Núcleo Subtalâmico/cirurgia , Estimulação Encefálica Profunda/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Silica-based nanoparticles have been developed as powerful platforms for drug delivery and might also prevent undesired side effects of drugs. Here, a fast method to synthesize positively charged mesoporous silica nanoparticles (ζ = 20 ± 0.5 mV, surface area = 678 m2 g-1, and 2.3 nm of porous size) was reported. This nanomaterial was employed to anchor sodium nitroprusside (SNP), a vasodilator drug with undesired cyanide release. A remarkable incorporation of 323.9 ± 7.55 µmol of SNP per gram of nanoparticle was achieved, and a series of studies of NO release were conducted, showing efficient release of NO along with major cyanide retention (ca. 64% bound to nanoparticle). Biological assays with mammalian cells showed only a slight drop in cell viability (13%) at the highest concentration (1000 µM), while SNP exhibited an LC50 of 228 µM. Moreover, pharmacological studies demonstrated similar efficacy for vasodilation and sGC-PKG-VASP pathway activation when compared to SNP alone. Altogether, this new SNP silica nanoparticle has great potential as an alternative for wider and safer use of SNP in medicine with lower cyanide toxicity.
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Sistemas de Liberação de Medicamentos/métodos , Nanopartículas/química , Doadores de Óxido Nítrico/efeitos adversos , Doadores de Óxido Nítrico/química , Nitroprussiato/efeitos adversos , Nitroprussiato/química , Dióxido de Silício/química , Animais , Aorta Torácica/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Chlorocebus aethiops , Liberação Controlada de Fármacos , Cobaias , Masculino , Óxido Nítrico/metabolismo , Porosidade , Artéria Pulmonar/efeitos dos fármacos , Ratos , Ratos Wistar , Propriedades de Superfície , Células VeroRESUMO
INTRODUCTION: Hearing loss (HL) affects people worldwide, many of whom are children. Especially in developing countries, epidemiological data on the prevalence of HL are insufficient to implement effective health promotion programs. In this preliminary study with young adults, we describe and validate a tablet-based hearing screening test developed for interactive remote hearing screening and compare the performance of an audiometry screening tablet application with conventional audiometry. In addition, the sensitivity, specificity, and predictive values of the tablet-based method and the concordance between the two methods were analyzed. METHODS: Thirty volunteers participated in a double-blind study assessing two auditory threshold screening methods: tablet-based hearing screening and sweep audiometry. For both methods, a correct response to a minimum of two tones out of three emitted at 20 dBHL for the frequencies of 1, 2, and 4 kHz and 30 dBHL for 0.5 kHz in both ears, was considered a negative screening result (normal hearing), whereas hearing impairment was considered a positive screening result. RESULTS: According to both methods, 26 participants had normal hearing and four had HL. The Kappa coefficient indicated perfect concordance between methods. The tablet-based hearing screening method had a sensitivity of 100% (confidence interval [CI]: 30.5-100.0), a specificity of 100% (CI: 87.1-100.0), a positive predictive value of 100% (CI: 30.5-100.0), and a negative predictive value of 100% (CI: 87.1-100.0). CONCLUSIONS: The tablet-based hearing screening test was shown to be a reliable and an accurate method for hearing screening that can be used effectively in places with Internet access and where local audiologists are not available.
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Computadores de Mão , Testes Auditivos/métodos , Programas de Rastreamento/métodos , Aplicativos Móveis , Telemedicina/métodos , Adolescente , Adulto , Limiar Auditivo , Método Duplo-Cego , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Adulto JovemRESUMO
The first years of Parkinson disease (PD) treatment are marked by good and sustained responses to dopaminergic therapy. With disease progression and longer exposure to levodopa (l-dopa), patients develop a range of l-dopa-induced complications that include motor and non-motor symptoms. Motor complications include motor fluctuations, characterized by periods of reduced benefit from the medication, and l-dopa-induced dyskinesia, characterized by emergence of hyperkinetic involuntary movements. Dyskinesia can occur at peak effect of l-dopa, at the beginning and end of dose, or between doses. These motor complications are often associated with fluctuations in non-motor symptoms, particularly fluctuations in neuropsychiatric, autonomic, and sensory symptoms. Recognizing such complications and understanding their relationship with the timing of l-dopa doses is essential for adequate diagnosis and management. Society.
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Antiparkinsonianos/efeitos adversos , Discinesia Induzida por Medicamentos/etiologia , Levodopa/efeitos adversos , Doença de Parkinson/tratamento farmacológico , Animais , HumanosRESUMO
The field of neuromodulation has evolved significantly over the past decade. Developments include novel indications and innovations of hardware, software, and stimulation techniques leading to an expansion in scope and role of these techniques as powerful therapeutic interventions. In this review, which is the second part of an effort to document and integrate the basic fundamentals and recent successful developments in the field, we will focus on classic paradigms for electrode placement as well as new exploratory targets, mechanisms of neuromodulation using this technique and new developments, including focused ultrasound driven ablative procedures.
O campo da neuromodulação evoluiu significativamente na última década. Esse progresso inclui novas indicações e inovações de hardware, software e técnicas de estimulação, levando a uma expansão das áreas clínicas cobertas e no papel dessas técnicas como intervenções terapêuticas eficazes. Nesta revisão, que é a segunda parte de um esforço para documentar e integrar os fundamentos básicos e os desenvolvimentos recentes e bem-sucedidos no campo, vamos nos concentrar em paradigmas clássicos para colocação de eletrodos, bem como em novos alvos exploratórios, mecanismos de neuromodulação usados por esta técnica e novos desenvolvimentos, incluindo procedimentos ablativos orientados por ultrassom focalizado.
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Estimulação Encefálica Profunda , Doença de Parkinson , Estimulação Encefálica Profunda/métodos , Humanos , Doença de Parkinson/terapia , Eletrodos ImplantadosRESUMO
Deep brain stimulation (DBS) is recognized as an established therapy for Parkinson's disease (PD) and other movement disorders in the light of the developments seen over the past three decades. Long-term efficacy is established for PD with documented improvement in the cardinal motor symptoms of PD and levodopa-induced complications, such as motor fluctuations and dyskinesias. Timing of patient selection is crucial to obtain optimal benefits from DBS therapy, before PD complications become irreversible. The objective of this first part review is to examine the fundamental concepts of DBS for PD in clinical practice, discussing the historical aspects, patient selection, potential effects of DBS on motor and non-motor symptoms, and the practical management of patients after surgery.
Nas últimas três décadas, a estimulação cerebral profunda (ECP) se tornou um tratamento bem estabelecido para doença de Parkinson (DP) e outros transtornos do movimento. A eficácia a longo prazo na DP foi bem documentada para a melhora dos sintomas motores cardinais da DP e das complicações induzidas pelo uso do levodopa, como as flutuações motoras e as discinesias. O momento da seleção do paciente é crucial para se obter os benefícios ideais da ECP, antes que as complicações da DP se tornem irreversíveis. O objetivo desta primeira parte da revisão é examinar os conceitos fundamentais da ECP na prática clínica, discutindo os aspectos históricos, a seleção de pacientes, os potenciais efeitos da ECP nos sintomas motores e não motores da doença e o manejo prático dos pacientes após a cirurgia.
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Estimulação Encefálica Profunda , Doença de Parkinson , Humanos , Estimulação Encefálica Profunda/métodos , Doença de Parkinson/terapia , Seleção de Pacientes , Resultado do TratamentoRESUMO
We report a 37-year-old Caucasian male with history of developmental delay, childhood onset Intellectual Disability (ID) and attention deficit hyperactivity disorder (ADHD) who presented at the age of 34 with tremor-dominant parkinsonism. Next Generation Sequencing (NGS) revealed pathogenic hemizygous sequence variant, c.200G > T, in the RAB39B gene. This report expands the number of described individuals with young onset PD associated with RAB39B mutation.
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Deficiência Intelectual , Doença de Parkinson , Transtornos Parkinsonianos , Adulto , Criança , Humanos , Masculino , Deficiência Intelectual/genética , Levodopa , Mutação/genética , Doença de Parkinson/genética , Transtornos Parkinsonianos/tratamento farmacológico , Transtornos Parkinsonianos/genéticaRESUMO
PURPOSE: To assess the prevalence of food insecurity (FI) among families with infants born during the COVID-19 pandemic and its associated factors in Fortaleza, the fifth largest city in Brazil. METHODS: Data from two survey rounds of the Iracema-COVID cohort study collected at 12 (n = 325) and 18 months (n = 331) after birth. FI was measured using the Brazilian Household Food Insecurity Scale. FI levels were described according to potential predictors. Crude and adjusted logistic regressions with robust variance were used to assess factors associated with FI. RESULTS: In the 12- and 18-month follow-ups interviews, there was a 66.5% and 57.1% prevalence of FI, respectively. Over the study period, 3.5% of the families persisted in severe FI and 27.4% in mild/moderate FI. Households headed by mothers, with more children, low education and income, sustained maternal common mental disorders, and that were beneficiaries of cash transfer programs were the most affected by persistent FI. CONCLUSIONS: Although the prevalence of FI decreased in our sample, almost 60% of families in Fortaleza still have no regular access to enough and/or nutritionally appropriate food. We have identified the groups at higher FI risk, which can guide governmental policies.
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COVID-19 , Criança , Feminino , Humanos , Lactente , Brasil , Estudos de Coortes , Pandemias , MãesRESUMO
OBJECTIVE: To evaluate the association of conditional cash transfer policies to mitigate the food insecurity (FI) among families living in poverty during the COVID-19 pandemic in Ceará, Brazil. METHODS: An analytical cross-sectional study was carried out through telephone contact during the period of May-July 2021, during the second wave of the COVID-19 pandemic in Ceará. Families in a situation of high social and economic vulnerability participated in this study (monthly per capita income of less than US$16.50). FI was assessed using the EBIA, a Brazilian validated questionnaire. The participation of families in government programs and public policies was also investigated. Logistic regression models were used to assess the association of the several factors assessed with food insecurity. RESULTS: The prevalence of any food insecurity in this sample was 89.1% (95% Confidence interval (95% CI: 86.2 - 92.1) and of severe food insecurity, 30.3% (95% CI: 26.0 - 34.6). The Mais Infância card program, adopted as a cash transfer supplement in the state of Ceará, was significantly associated with food insecurity (OR 4.2 (95% CI: 1.7 - 10.2), with a p-value of 0.002. In addition, families affected by job losses due to the COVID-19 pandemic presented higher odds of FI. CONCLUSIONS: In this study, 89% of evaluated families presented food insecurity. Conditional cash transfer programs were associated with FI. We highlight the need for policies and interventions to reduce the impact of the COVID-19 pandemic on food insecurity. Such policies can adopt appropriate criteria for defining the participants, as well as connect the participants to an appropriate set of broader social protection measures.
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COVID-19 , Pandemias , Humanos , Brasil/epidemiologia , Estudos Transversais , Abastecimento de Alimentos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Insegurança Alimentar , Política PúblicaRESUMO
Maternal educational attainment has been identified as relevant to several child health and development outcomes. This study aimed to evaluate the association of sociodemographic and maternal education factors with child development in families living below the poverty line. A cross-sectional study was conducted through telephone contact from May to July 2021 in Ceará, a state in Northeastern Brazil. The study population comprised families with children up to six years of age participating in the cash transfer program "Mais infância". The families selected to participate in this program must have a monthly per capita income of less than US$16.50. The Ages and Stages Questionnaire version 3 was applied to assess the children's development status. The mothers reported maternal educational attainment as the highest grade and or degree obtained. The final weighted and adjusted model showed that maternal schooling was associated with the risk of delay in all domains except for the fine motor domain. The risk of delay in at least one domain was 2.5-fold higher in mothers with a lower level of schooling (95% CI: 1.6-3.9). The findings of this study suggest that mothers with higher educational attainment have children with better child development outcomes.
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Background: Postural abnormalities involving the trunk are referred to as axial postural abnormalities and can be observed in over 20% of patients with Parkinson's disease (PD) and in atypical parkinsonism. These symptoms are highly disabling and frequently associated with back pain and a worse quality of life in PD. Despite their frequency, little is known about the pathophysiology of these symptoms and scant data are reported about their clinical predictors, making it difficult to prompt prevention strategies. Objectives: We conducted a scoping literature review of clinical predictors and pathophysiology of axial postural abnormalities in patients with parkinsonism to identify key concepts, theories and evidence on this topic. Methods: We applied a systematic approach to identify studies, appraise quality of evidence, summarize main findings, and highlight knowledge gaps. Results: Ninety-two articles were reviewed: 25% reported on clinical predictors and 75% on pathophysiology. Most studies identified advanced disease stage and greater motor symptoms severity as independent clinical predictors in both PD and multiple system atrophy. Discrepant pathophysiology data suggested different potential central and peripheral pathogenic mechanisms. Conclusions: The recognition of clinical predictors and pathophysiology of axial postural abnormalities in parkinsonism is far from being elucidated due to literature bias, encompassing different inclusion criteria and measurement tools and heterogeneity of patient samples. Most studies identified advanced disease stage and higher burden of motor symptoms as possible clinical predictors. Pathophysiology data point toward many different (possibly non-mutually exclusive) mechanisms, including dystonia, rigidity, proprioceptive and vestibular impairment, and higher cognitive deficits.
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INTRODUCTION: Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD), but its efficacy is tied to DBS programming, which is often time consuming and burdensome for patients, caregivers, and clinicians. Our aim is to test whether the Mobile Application for PD DBS (MAP DBS), a clinical decision support system, can improve programming. METHODS: We conducted an open-label, 1:1 randomized, controlled, multicenter clinical trial comparing six months of SOC standard of care (SOC) to six months of MAP DBS-aided programming. We enrolled patients between 30 and 80 years old who received DBS to treat idiopathic PD at six expert centers across the United States. The primary outcome was time spent DBS programming and secondary outcomes measured changes in motor symptoms, caregiver strain and medication requirements. RESULTS: We found a significant reduction in initial visit time (SOC: 43.8 ± 28.9 min n = 37, MAP DBS: 27.4 ± 13.0 min n = 35, p = 0.001). We did not find a significant difference in total programming time between the groups over the 6-month study duration. MAP DBS-aided patients experienced a significantly larger reduction in UPDRS III on-medication scores (-7.0 ± 7.9) compared to SOC (-2.7 ± 6.9, p = 0.01) at six months. CONCLUSION: MAP DBS was well tolerated and improves key aspects of DBS programming time and clinical efficacy.
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Estimulação Encefálica Profunda , Aplicativos Móveis , Doença de Parkinson , Núcleo Subtalâmico , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Parkinson/complicações , Resultado do TratamentoRESUMO
Introduction: Chronic noncommunicable diseases (NCDs) account for leading causes of death in Argentina and early identification of their risk factors (RF) is key to prevention.Objective: The objective of this study was to describe the frequency of RF for NCDs among students from Universidad Nacional de la Matanza. Methods: A cross-sectional study was performed, using a self-reported survey adapted from the "National survey of risk factors", to describe risk factors and their association with sociodemographic characteristics. Results: A total of 130 students participated; 6.9% identified their health as "fair" and 48.5% referred some degree of anxiety or depression, 26.2% reported a low level of physical activity and almost all respondents ate less than 5 fruits or vegetables per day, 6.2% were smokers and 38.5% were exposed to tobacco smoke. The prevalence of overweight and obesity was 23.2% and 6.4% respectively. Occasional high cholesterol and blood pressure were reported by 20.4% and 16.8% of respondents, respectively. Conclusion: The university is an ideal setting for activities aimed at the promotion and prevention of these RF.
INTRODUCCIÓN: Las Enfermedades Crónicas No Transmisibles (ECNT) representan las principales causas de muerte en Argentina y la identificación temprana de sus factores de riesgo (FR) es clave para su prevención. El objetivo de este estudio fue describir la frecuencia de FR y ECNT en estudiantes de la Universidad Nacional de La Matanza. MÉTODOS: Se realizó un estudio de corte transversal, utilizando un cuestionario adaptado de la Encuesta Nacional de Factores de Riesgo por autorreporte, para describir los FR y su asociación con características sociodemográficas. RESULTADOS: Se encuestaron 130 estudiantes de ambos sexos. El 6,9% identificó su salud como "regular" y un 48,5% algún grado de ansiedad o depresión. El 26,2% reportó bajo nivel de actividad física y casi todos los encuestados consumieron menos de 5 porciones de frutas y verduras al día. Un 6,2% reportó ser fumador y un 38,5% estar expuesto al humo del tabaco. La prevalencia de sobrepeso fue de 23,2% y de obesidad de 6,4%. El 20,4% y el 16,8% de los estudiantes informaron respectivamente colesterol y presión arterial elevados "alguna vez". CONCLUSIÓN: El ámbito universitario es un espacio ideal para el abordaje de actividades de promoción y prevención de estos FR.