RESUMO
BACKGROUND: After a traumatic brain injury, post-concussion symptoms are commonly reported by patients. Although common, these symptoms are difficult to diagnose and recognize. To date, no instruments evaluating post-concussion symptoms have been culturally translated or adapted to the Brazilian context. OBJECTIVE: To culturally adapt the Rivermead Post-Concussion Symptoms Questionnaire for use in Brazilian Portuguese. METHODS: Cross-cultural adaptation was done in five steps: translation, synthesis of translations, back-translation, evaluation by two expert committees and two pretests among adults in a target population. RESULTS: The semantic, idiomatic, cultural and experimental aspects of the adaptation were considered adequate. The content validity coefficient of the items regarding language clarity, pratical pertinence, relevance and dimensionality were considered adequate for evaluating the desired latent variable. Both pretests demonstrated that the instrument had satisfactory acceptability. CONCLUSION: The Brazilian version, named Questionário Rivermead de Sintomas pós Concussionais (RPQ-Br), has been adapted, and is ready for use in the Brazilian context.
Assuntos
Síndrome Pós-Concussão , Adulto , Brasil , Comparação Transcultural , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , TraduçõesRESUMO
Studies have suggested that neuronal loss in Parkinson's disease (PD) could be related to the pacemaker activity of the substantia nigra pars compacta generated by L-type Ca(v) 1.3 calcium channels, which progressively substitute voltage-dependent sodium channels in this region during aging. Besides this mechanism, which leads to increases in intracellular calcium, other factors are also known to play a role in dopaminergic cell death due to overproduction of reactive oxygen species. Thus, dihydropyridines, a class of calcium channel blockers, and resveratrol, a polyphenol that presents antioxidant properties, may represent therapeutic alternatives for the prevention of PD. In the present study, we tested the effects of the dihydropyridines, isradipine, nifedipine, and nimodipine and of resveratrol upon locomotor behavior in Drosophila melanogaster. As previously described, paraquat induced parkinsonian-like motor deficits. Moreover, none of the drugs tested were able to prevent the motor deficits produced by paraquat. Additionally, isradipine, nifedipine, resveratrol, and ethanol (vehicle), when used in isolation, induced motor deficits in flies. This study is the first demonstration that dyhidropyridines and resveratrol are unable to reverse the locomotor impairments induced by paraquat in Drosophila melanogaster.
Assuntos
Antioxidantes , Bloqueadores dos Canais de Cálcio/administração & dosagem , Di-Hidropiridinas , Degeneração Neural/induzido quimicamente , Estilbenos , Animais , Antioxidantes/administração & dosagem , Antioxidantes/metabolismo , Antioxidantes/uso terapêutico , Bloqueadores dos Canais de Cálcio/metabolismo , Bloqueadores dos Canais de Cálcio/uso terapêutico , Canais de Cálcio/efeitos dos fármacos , Canais de Cálcio/metabolismo , Di-Hidropiridinas/administração & dosagem , Di-Hidropiridinas/metabolismo , Di-Hidropiridinas/uso terapêutico , Modelos Animais de Doenças , Dopamina/metabolismo , Drosophila melanogaster/metabolismo , Degeneração Neural/metabolismo , Paraquat , Transtornos Parkinsonianos/induzido quimicamente , Transtornos Parkinsonianos/metabolismo , Resveratrol , Estilbenos/administração & dosagem , Estilbenos/metabolismo , Estilbenos/uso terapêutico , Substância Negra/citologia , Substância Negra/efeitos dos fármacos , Substância Negra/metabolismoRESUMO
Introdução: O Diagnóstico de Enfermagem Confusão Crônica (DCC) foi criado em 1994 e até o momento nenhum estudo realizou sua validação clínicopatológica. Como as principais causas de DCC são as demências, a única forma de validação, com base no diagnóstico definitivo, é a autópsia encefálica que é considerada padrão-ouro. Objetivo: Realizar a validação clínicopatológica do DCC. Método: Por meio de um estudo transversal, foram analisados 548 casos completos de indivíduos falecidos pertencentes à casuística do Banco de Encéfalos Humanos da Faculdade de Medicina da Universidade de São Paulo, no qual foram extraídos dados clínicopatológicos. O DCC foi definido em cada caso por meio de consenso diagnóstico. Para a validade de critério do DCC foram utilizados os testes de correlação, regressão logística e curva Receiver Operating Characteristic (ROC). Resultados: Dos 548 indivíduos, 26,3% tinham DCC, em relação à validade de critério, o DCC correlacionou-se com o Clinical Dementia Rating (CDR) (r = 0,68; p < 0,0001), com o Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) (r = 0,47; p < 0,0001) e obteve uma associação significativa estatisticamente com o diagnóstico neuropatológico (p < 0,0001). Os principais preditores neuropatológicos de DCC foram: Demência Vascular (OR = 18,00; p < 0,0001), Demência Mista (OR = 9,58; p < 0,0001), Degeneração Lobar Frontotemporal (OR = 9,58; p = 0,004) e Doença de Alzheimer (OR = 9,00; p < 0,0001). A melhor capacidade preditiva foi para o diagnóstico de Demência Vascular (AUC = 0,717; IC 95% 0,629-0,806). Ter DCC presente aumenta em 7,16 vezes a chance de apresentar alteração neuropatológica compatível com doença neurodegenerativa. Conclusão: De um modo geral, o DCC apresenta boas evidências de validade de critério em relação ao diagnóstico padrão-ouro das principais doenças neurodegenerativas. No entanto, ainda carece de refinamento e melhor exploração de suas características definidoras de modo a ampliar sua capacidade diagnóstica em relação a outras condições neurodegenerativas. Os fatores relacionados apresentados no DCC aprovado pela NANDA Internacional, Inc. (NANDA-I) necessitam de revisão, a partir dos resultados do presente estudo.
Introduction: The Nursing Diagnosis Chronic Confusion (NDCC) was first introduced in 1994 and, to date, no study has performed its clinical-pathological validation. As the main cause of NDCC is dementia, the only way to validate it, based on their definitive diagnosis is by brain autopsy that is considered the gold standard. Objective: This studys objective was to perform the clinical-pathological validation of NDCC. Method: Through a cross-sectional study, 548 complete cases of deceased individuals that belongs to the Human Brain Bank of the Brazilian Aging Brain Study Group, Medicine School of the University of São Paulo were analyzed, in which clinical and pathological data were extracted. The NDCC was defined to each case by a consensus diagnostic. For criteriom validity of the NDCC, correlation, logistic regression and ROC curve tests were used. Results: Of the 548 subjects, 26.3% had NDCC. Regarding the criterion validity, NDCC correlated with CDR (r = 0.68, p < 0.0001), with IQCODE (r = 0.47; p < 0.0001) and had a statistically significant association with the neuropathological diagnosis (p < 0.0001). The main neuropathological predictors of NDCC were: Vascular Dementia (OR = 18.00; p < 0.0001), Mixed Dementia (OR = 9.58; p < 0.0001), Frontotemporal Lobar Degeneration (OR = 9.58; p = 0.004) and Alzheimer's Disease (OR = 9.00; p < 0.0001). The best predictive capacity was for the diagnosis of Vascular Dementia (AUC = 0.717, 95% CI 0.629-0.806). NDCC increases the chance to have neuropathological lesions by 7,16. Conclusion: In general, the NDCC presented good evidence of criterion validity in relation to the gold standard diagnosis of the main neurodegenerative diseases. However, it still lacks refinement and a better exploration of its defining characteristics in order to increase its diagnostic capacity in relation to others neurodegenerative conditions. The related factors presented in the NDCC approved by NANDA-I is in need of a revision, based on the results of the present study.