Promoting mental health in the workplace: web software development and validation.

OBJECTIVE: to develop and validate the content and technical aspects of a web software program for promoting mental health in the workplace. METHOD: applied methodological study and technological development, carried out in three stages: 1) Umbrella review development; 2) Web software development; 3) Content and technical validation carried out by 14 judges. The data was submitted to descriptive statistical analysis and calculation of the content validity index. RESULTS: based on the guidelines' recommendations, information was defined and extracted in order to develop the web software consisting of the following dimensions: mental health education, support among coworkers, promotion strategies and mental health self-assessment. For the technical development, the objectives, general functions and technological infrastructure were defined. After development and functional testing, the version was made available for content and technical validation by judges. The overall content validity index was 0.98 and for the technical aspects it was 0.97. CONCLUSION: the agreement between the judges in relation to the content and technical aspects, as well as the suggestions incorporated, demonstrated the potential for using web software to promote mental health in the workplace.

University Student Depression Inventory, Brazilian Version, Construct Assessment.

OBJECTIVES: to assess the University Student Depression Inventory, Brazilian version (USDI-BR), construct. METHODS: a methodological study carried out with a snowball probabilistic sample, consisting of 334 undergraduate and graduate students. Confirmatory factor analysis, reliability using McDonald's omega coefficient and Cronbach's alpha were performed. Principal component analysis was performed using the varimax rotation and oblimin rotation, using the Kaiser-Meyer-Olkin criteria, Bartlett's test of sphericity and scree plot. RESULTS: the USDI-BR presented an internal consistency of items of ω = 0.95 and remained with 30 items, with the addition of 1 factor (Death wish and social withdrawal), totaling 4 factors. CONCLUSIONS: the USDI-BR has evidence that points to its validity and also its internal consistency, deserving that new studies be carried out to expand the evidence of its psychometric properties.

A descriptive analysis of hospitalized adolescents facing chronic illnesses with different durations of disease.

OBJECTIVES: To assess characteristics of hospitalized adolescents facing chronic diseases, correlating the perceptions of their illness, quality of life and the prevalence of risk behaviors, considering gender and the diseases' durations. METHODS: The sample consisted of 61 adolescents, aged between 10 and 19 years, with chronic diseases, hospitalized at the University Hospital of the State University of Londrina. They answered a questionnaire and the scales World Health Organization Quality of Life (WHOQOL-BREF) and Illness Perception Questionnaire (IPQ). They were divided in groups, according to the durations of the disease: group 1 (up to 4 years) and group 2 (5 years or more). RESULTS: Group 2 demonstrated higher leisure activity (p = 0.02) and more painful symptoms (p = 0.02). In WHOQOL-BREF, group 2 had a higher quality of life in the domain on environment (p = 0.02) and a higher total score (p = 0.04). Lower scores on the IPQ were associated with higher scores on the WHOQOL-BREF. Positive correlation was found between WHOQOL-BREF total score and years of disease, in which male presented higher scores. CONCLUSIONS: These findings may alert to the need for more knowledge about the diseases and the importance of encouraging ways to improve quality of life and care to reduce risky behaviors.

C and N content in density fractions of whole soil and soil size fraction under cacao agroforestry systems and natural forest in Bahia, Brazil.

Agroforestry systems (AFSs) have an important role in capturing above and below ground soil carbon and play a dominant role in mitigation of atmospheric CO(2). Attempts has been made here to identify soil organic matter fractions in the cacao-AFSs that have different susceptibility to microbial decomposition and further represent the basis of understanding soil C dynamics. The objective of this study was to characterize the organic matter density fractions and soil size fractions in soils of two types of cacao agroforestry systems and to compare with an adjacent natural forest in Bahia, Brazil. The land-use systems studied were: (1) a 30-year-old stand of natural forest with cacao (cacao cabruca), (2) a 30-year-old stand of cacao with Erythrina glauca as shade trees (cacao + erythrina), and (3) an adjacent natural forest without cacao. Soil samples were collected from 0-10 cm depth layer in reddish-yellow Oxisols. Soil samples was separated by wet sieving into five fraction-size classes (>2000 µm, 1000-2000 µm, 250-1000 µm, 53-250 µm, and <53 µm). C and N accumulated in to the light (free- and intra-aggregate density fractions) and heavy fractions of whole soil and soil size fraction were determined. Soil size fraction obtained in cacao AFS soils consisted mainly (65 %) of mega-aggregates (>2000 µm) mixed with macroaggregates (32-34%), and microaggregates (1-1.3%). Soil organic carbon (SOC) and total N content increased with increasing soil size fraction in all land-use systems. Organic C-to-total N ratio was higher in the macroaggregate than in the microaggregate. In general, in natural forest and cacao cabruca the contribution of C and N in the light and heavy fractions was similar. However, in cacao + erythrina the heavy fraction was the most common and contributed 67% of C and 63% of N. Finding of this study shows that the majority of C and N in all three systems studied are found in macroaggregates, particularly in the 250-1000 µm size aggregate class. The heavy fraction was the most common organic matter fraction in these soils. Thus, in mature cacao AFS on highly weathered soils the main mechanisms of C stabilization could be the physical protection within macroaggregate structures thereby minimizing the impact of conversion of forest to cacao AFS.

Carbon storage in soil size fractions under two cacao agroforestry systems in Bahia, Brazil.

Shaded perennial agroforestry systems contain relatively high quantities of soil carbon (C) resulting from continuous deposition of plant residues; however, the extent to which the C is sequestered in soil will depend on the extent of physical protection of soil organic C (SOC). The main objective of this study was to characterize SOC storage in relation to soil fraction-size classes in cacao (Theobroma cacao L.) agroforestry systems (AFSs). Two shaded cacao systems and an adjacent natural forest in reddish-yellow Oxisols in Bahia, Brazil were selected. Soil samples were collected from four depth classes to 1 m depth and separated by wet-sieving into three fraction-size classes (>250 microm, 250-53 microm, and <53 microm)-corresponding to macroaggregate, microaggregate, and silt-and-clay size fractions-and analyzed for C content. The total SOC stock did not vary among systems (mean: 302 Mg/ha). On average, 72% of SOC was in macroaggregate-size, 20% in microaggregate-size, and 8% in silt-and-clay size fractions in soil. Sonication of aggregates showed that occlusion of C in soil aggregates could be a major mechanism of C protection in these soils. Considering the low level of soil disturbances in cacao AFSs, the C contained in the macroaggregate fraction might become stabilized in the soil. The study shows the role of cacao AFSs in mitigating greenhouse gas (GHG) emission through accumulation and retention of high amounts of organic C in the soils and suggests the potential benefit of this environmental service to the nearly 6 million cacao farmers worldwide.

N-acetylcysteine as an adjunctive treatment for smoking cessation: a randomized clinical trial.

OBJECTIVE: This randomized controlled trial examined the efficacy and safety of N-acetylcysteine as an adjunctive treatment for smoking cessation. METHODS: Heavy smokers were recruited from smoking cessation treatment for this 12- week randomized controlled trial. Eligible tobacco use disorder outpatients (n=34) were randomized to N-acetylcysteine or placebo plus first-line treatment. Abstinence was verified by exhaled carbon monoxide (COexh). The assessment scales included the Fagerström Test for Nicotine Dependence, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Minnesota Nicotine Withdrawal Scale, and the Medication Adherence Rating Scale. We also assessed anthropometrics, blood pressure, lipid profile, and soluble tumor necrosis factor receptor (sTNF-R) levels 1 and 2. RESULTS: First-line treatment for smoking cessation plus adjunctive N-acetylcysteine or placebo significantly reduced COexh (p < 0.01). In the N-acetylcysteine group, no significant changes were found in nicotine withdrawal symptoms, depressive and anxiety symptoms, anthropometric measures, blood pressure, or glucose compared to placebo. However, there was a significant reduction in sTNF-R2 levels between baseline and week 12 in the N-acetylcysteine group. CONCLUSIONS: These findings highlight the need to associate N-acetylcysteine with first-line treatment for smoking cessation, since combined treatment may affect inflammation and metabolism components. CLINICAL TRIAL REGISTRATION: NCT02420418.

University Student Depression Inventory, Brazilian Version, Construct Assessment / Evaluación del Constructo del University Student Depression Inventory, Versión Brasileña / Avaliação do Construto do University Student Depression Inventory, Versão Brasileira

ABSTRACT Objectives: to assess the University Student Depression Inventory, Brazilian version (USDI-BR), construct. Methods: a methodological study carried out with a snowball probabilistic sample, consisting of 334 undergraduate and graduate students. Confirmatory factor analysis, reliability using McDonald's omega coefficient and Cronbach's alpha were performed. Principal component analysis was performed using the varimax rotation and oblimin rotation, using the Kaiser-Meyer-Olkin criteria, Bartlett's test of sphericity and scree plot. Results: the USDI-BR presented an internal consistency of items of ω = 0.95 and remained with 30 items, with the addition of 1 factor (Death wish and social withdrawal), totaling 4 factors. Conclusions: the USDI-BR has evidence that points to its validity and also its internal consistency, deserving that new studies be carried out to expand the evidence of its psychometric properties.

RESUMEN Objetivos: evaluar el constructo del University Student Depression Inventory, versión brasileña (USDI-BR). Métodos: estudio metodológico, realizado con una muestra probabilística en bola de nieve compuesta por 334 estudiantes de pregrado y posgrado. Se realizaron análisis factoriales confirmatorios, confiabilidad mediante el coeficiente omega de McDonald y alfa de Cronbach. El análisis de componentes principales se realizó mediante rotación ortogonal varimax y rotación oblicua oblimin, utilizando los criterios de Kaiser-Meyer-Olkin, la prueba de esfericidad de Bartlett y scree plot. Resultados: el USDI-BR presentó una consistencia interna de ítems de ω = 0,95 y quedó con 30 ítems, con la adición de 1 factor (Deseo de muerte y alejamiento social), totalizando 4 factores. Conclusiones: el USDI-BR tiene evidencias que apuntan a su validez y también a su consistencia interna, ameritando que se realicen nuevos estudios para ampliar la evidencia de sus propiedades psicométricas.

RESUMO Objetivos: avaliar o construto do University Student Depression Inventory, versão brasileira (USDI-BR). Métodos: estudo metodológico, realizado com uma amostra probabilística bola de neve constituída de 334 estudantes de graduação e pós-graduação. Foram realizadas a análise fatorial confirmatória, a confiabilidade pelo coeficiente de ômega de McDonald e o alfa de Cronbach. A análise por componentes principais foi realizada utilizando a rotação ortogonal varimax e a rotação oblíqua oblimin, por meio dos critérios de Kaiser-Meyer-Olkin, teste de esfericidade de Bartlett e scree plot. Resultados: o USDI-BR apresentou consistência interna dos itens de ω = 0,95 e permaneceu com 30 itens, com acréscimo de 1 fator (Desejo de morrer e retraimento social), totalizando 4 fatores. Conclusões: o USDI-BR possui evidências que remetem à sua validade e também à sua consistência interna, merecendo que novos estudos sejam realizados visando ampliar as evidências de suas propriedades psicométricas.

Towards the understanding of the cocoa transcriptome: Production and analysis of an exhaustive dataset of ESTs of Theobroma cacao L. generated from various tissues and under various conditions.

BACKGROUND: Theobroma cacao L., is a tree originated from the tropical rainforest of South America. It is one of the major cash crops for many tropical countries. T. cacao is mainly produced on smallholdings, providing resources for 14 million farmers. Disease resistance and T. cacao quality improvement are two important challenges for all actors of cocoa and chocolate production. T. cacao is seriously affected by pests and fungal diseases, responsible for more than 40% yield losses and quality improvement, nutritional and organoleptic, is also important for consumers. An international collaboration was formed to develop an EST genomic resource database for cacao. RESULTS: Fifty-six cDNA libraries were constructed from different organs, different genotypes and different environmental conditions. A total of 149,650 valid EST sequences were generated corresponding to 48,594 unigenes, 12,692 contigs and 35,902 singletons. A total of 29,849 unigenes shared significant homology with public sequences from other species.Gene Ontology (GO) annotation was applied to distribute the ESTs among the main GO categories.A specific information system (ESTtik) was constructed to process, store and manage this EST collection allowing the user to query a database.To check the representativeness of our EST collection, we looked for the genes known to be involved in two different metabolic pathways extensively studied in other plant species and important for T. cacao qualities: the flavonoid and the terpene pathways. Most of the enzymes described in other crops for these two metabolic pathways were found in our EST collection.A large collection of new genetic markers was provided by this ESTs collection. CONCLUSION: This EST collection displays a good representation of the T. cacao transcriptome, suitable for analysis of biochemical pathways based on oligonucleotide microarrays derived from these ESTs. It will provide numerous genetic markers that will allow the construction of a high density gene map of T. cacao. This EST collection represents a unique and important molecular resource for T. cacao study and improvement, facilitating the discovery of candidate genes for important T. cacao trait variation.

Effects of adjunctive N-acetylcysteine on depressive symptoms: Modulation by baseline high-sensitivity C-reactive protein.

Outcomes in a RCTs of 12 weeks of theclinical efficacy of N-acetylcysteine (NAC) as an adjunctive treatment on depression and anxiety symptoms and its effects on high-sensitivity C-reactive protein (hs-CRP) levels. A wide array of measures were made. The 17-item version of the Hamilton Depression Rating Scale (HDRS17); the Hamilton Anxiety Rating Scale (HAM-A); Sheehan Disability Scale; Quality of Life; Clinical Global Impression (CGI); anthropometrics measures; and vital signs and biochemical laboratory. There were no significant differences among the groups regarding demographic, clinical features, use of medication, metabolic syndrome and comorbidities. From baseline to week 12, individuals receiving NAC, versus placebo, had a statistically significant reduction in depressive symptoms on HDRS17 (p < 0.01) and anxiety symptoms on HAM-A (p = 0.04), but only for individuals with levels of hs-CRP > 3 mg/L at baseline. Individuals receiving NAC with baseline levels of hs-CRP > 3 mg/L, had more significant reduction in uric acid levels compared to individuals with baseline levels of hs-CRP ≤ 3 mg/L on week 12. Participants receiving placebogained significantly more weight during the 12 weeks for baseline levels of hs-CRP ≤ 3 mg/L and hs-CRP > 3 mg/L, and individuals receiving NAC in both groups did not have significant weight change during the 12 weeks. No individuals were withdrawn from the study because of adverse event. NAC group exhibited significantly greater reduction on hs-CRP levels than placebo group from baseline to week 12. TRIAL REGISTRATION: clinicaltrials.gov Identifier; NCT02252341.

Depressed female smokers have higher levels of soluble tumor necrosis factor receptor 1.

AIM: To examine clinical and biomarkers in depressed female smokers, in order to better clarify the process that link mood disorders, childhood trauma and smoking in women. METHODS: The clinical sample comprised women with unipolar or bipolar depression, divided into subgroups of smokers and never-smoker. The control groups comprised two subgroups non-depressed women, separated into smokers and never-smokers. A structured questionnaire was used to assess socio-demographic and clinical data. The following scales were used: 17-item version Hamilton Depression Rating Scale, Hamilton Anxiety Rating scale (HAM-A), Sheehan disability scale, the Child Trauma Questionnaire. The following biomarkers were investigated: lipid profile, including total cholesterol, high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol, triglycerides the Castelli's Risk indexes I and II; and cytokines, including interleukins (IL)-1ß, IL-6, IL-10, IL-12, soluble tumor necrosis factor receptor 1 (sTNF-R1). RESULTS: Depressed female smokers showed a number of significant positive correlations: emotional neglect and sTNF-R1 (p = 0.02); waist circumference and sTNF-R1 (p = 0.001); body mass index and sTNF-R1 (p < 0.01); HAM-A and sTNF-R1 (p = 0.03); IL-1ß and sTNF-R1 (p < 0.01); IL-10 and sTNF-R1 (p = 0.001); IL-12 and sTNF-R1 (p < 0.01);Castelli index I and sTNF-R1 (p < 0.01); Castelli index II and sTNF-R1 (p < 0.01); and a significantly negative correlation between HDLc and sTNF-R1(p = 0.014). CONCLUSION: This study suggests that depressed female smokers who experienced more childhood trauma and had more anxiety symptoms are associated with the activation of inflammatory processes and alterations in components of lipid profile.

Protein extraction for proteome analysis from cacao leaves and meristems, organs infected by Moniliophthora perniciosa, the causal agent of the witches' broom disease.

Preparation of high-quality proteins from cacao vegetative organs is difficult due to very high endogenous levels of polysaccharides and polyphenols. In order to establish a routine procedure for the application of proteomic and biochemical analysis to cacao tissues, three new protocols were developed; one for apoplastic washing fluid (AWF) extraction, and two for protein extraction--under denaturing and nondenaturing conditions. The first described method allows a quick and easy collection of AWF--using infiltration-centrifugation procedure--that is representative of its composition in intact leaves according to the smaller symplastic contamination detected by the use of the hexose phosphate isomerase marker. Protein extraction under denaturing conditions for 2-DE was remarkably improved by the combination of chemically and physically modified processes including phenol, SDS dense buffer and sonication steps. With this protocol, high-quality proteins from cacao leaves and meristems were isolated, and for the first time well-resolved 1-DE and 2-DE protein patterns of cacao vegetative organs are shown. It also appears that sonication associated with polysaccharide precipitation using tert-butanol was a crucial step for the nondenaturing protein extraction and subsequent enzymatic activity detection. It is expected that the protocols described here could help to develop high-level proteomic and biochemical studies in cacao also being applicable to other recalcitrant plant tissues.

Cessação do tabagismo em pacientes assistidos em um ambulatório de tratamento de dependência do tabaco / Tobacco cessation on patients assisted in an ambulatory of tobacco dependence treatment / Cesación del tabaquismo en pacientes asistidos en un ambulatorio de tratamiento de dependencia del tabaco

O presente estudo, de caráter descritivo, procurou identificar o perfil socioeconômico e clínico dos pacientes assistidos no Centro de Controle do Tabagismo da Universidade Estadual de Londrina. A população do estudo foi constituída por doze tabagistas em tratamento da dependência do tabaco, no período de fevereiro a agosto de 2008. Os dados foram coletados a partir da aplicação de um questionário com variáveis socioeconômicas, história tabagística e comorbidades clínicas. Também se utilizou a escala Hamilton para avaliação da depressão e o teste de Fagerström para determinação do grau de dependência da nicotina. Foi realizada análise descritiva das variáveis e dos escores das escalas utilizadas. A maior parte da população foi constituída de adultos jovens, com baixa escolaridade e baixa renda mensal que iniciaram o tabagismo na adolescência apresentavam alto grau de dependência da nicotina e sintomas de ansiedade e depressão. Neste grupo, oito pessoas (66,6%) obtiveram sucesso na cessação do tabagismo, dos quais quatro pessoas necessitaram de apoio medicamentoso para abandonar o vício. Encontramos, ainda, a presença de comorbidades clínicas prevalentes no grupo de pessoas que não conseguiu parar de fumar. Para a cessação do tabagismo é preciso uma intervenção multidisciplinar e acompanhamento integral do tabagista.

This is a descriptive study which identified the clinical and socioeconomic profile of patients in the Center for Tobacco Control at Londrina State University. The studied population consisted of twelve smokers in treatment between February and August 2008. Data were collected from the application of an instrument containing a questionnaire with socioeconomic variables, smoking history, medical comorbidity. The Hamilton scale in order to evaluate the depression, and the Fagerström test to determine the nicotine dependence degree were used. A descriptive statistical analysis of the variables and the scores of the used scales were studied. Most of the population consisted of young adults with low education level, low income, who started smoking during adolescence, with a high degree of nicotine dependence and symptoms of anxiety and depression. In this group, eight individuals (66.6%) succeeded in their efforts to stopping smoking; four of them needed medical assistance to fight the addiction. The presence of clinical comorbidity in the group that could not to stop smoking was found. It is believed that for tobacco cessation is required a multidisciplinary intervention and an integral follow-up of smokers.

El presente estudio, de carácter descriptivo, buscó identificar el perfil clínico y socioeconómico de los pacientes asistidos en el Centro de Control del Tabaquismo de la Universidad Estatal de Londrina. El grupo de estudio fue constituido por doce tabaquistas en tratamiento de la dependencia del tabaco, en el período de febrero a agosto de 2008. Los datos fueron recogidos a partir de la aplicación de un cuestionario con variables socioeconómicas, historia tabaquística y comorbidades clínicas. También se utilizó la escala de Hamilton para evaluación de la depresión y el test de Fagerström para la determinación del grado de dependencia de la nicotina. Se realizó un análisis descriptivo de las variables y de las puntuaciones de las escalas utilizadas. La mayor parte de los pacientes fue constituida por adultos jóvenes, con bajo nivel de educación y de baja renta mensual que comenzaron a fumar durante la adolescencia, con un alto grado de dependencia de la nicotina y con síntomas de ansiedad y depresión. En este grupo, ocho personas (66,6%) obtuvieron éxito en la cesación del tabaquismo, de los cuales cuatro personas necesitaron de apoyo con medicamentos para abandonar el vicio. Encontramos, aun, la presencia de comorbidades clínicas predominante en el grupo de personas que no consiguió parar de fumar. Para la cesación del tabaquismo es necesario una intervención multidisciplinaria y acompañamiento integral del tabaquista.

Risco cardiovascular na síndrome metabólica: estimativa por diferentes escores / Cardiovascular risk in metabolic syndrome: estimating by different criteria

JUSTIFICATIVA E OBJETIVOS: A síndrome metabólica (SM) constitui importante indicador de risco cardiovascular, estando associada a elevadas taxas de mortalidade por doença arterial coronariana (DAC). O objetivo deste estudo foi comparar três diferentes escores de avaliação de DAC em portadores de SM. MÉTODO: Trinta e nove pacientes não diabéticos, portadores de SM foram avaliados pelo Escore de Risco de Framingham (ERF), pelo ERF modificado pela IV Diretriz Brasileira sobre Dislipidemias e Aterosclerose (ERF-mod) e pelo escore do Prospective Cardiovascular Münster Study (PROCAM). RESULTADOS: O risco estimado de DAC pelo ERF foi baixo em 35 (90%) indivíduos e médio, em quatro (10%), não sendo detectado alto risco em nenhum caso. Pelo PROCAM, 29 (74%) indivíduos continuaram na faixa de baixo risco, sete (18%) apresentaram médio risco e três (8%); alto risco. Por outro lado, o ERF-mod detectou cinco casos (13%) de baixo risco, 30 (77%) casos de médio risco e quatro (10%) de alto risco. CONCLUSÃO: Comparado com o ERF-mod, o ERF subestimou o cálculo do risco de DAC em pacientes com SM, enquanto o PROCAM apresentou eficácia ligeiramente superior ao ERF.

BACKGROUND AND OBJECTIVES: Metabolic syndrome (MS) is an indicator of cardiovascular risk associated with high rates of coronary heart disease (CHD) mortality. The aim of this study was to assess the CHD risk in patients with metabolic syndrome (MS) using three different scores. METHOD: Thirty nine non-diabetic patients with MS were evaluated by the Framingham Risk Score (FRS), FRS modified by IV Diretriz Brasileira sobre Dislipidemias e Aterosclerose (mod-FRS) and by Prospective Cardiovascular Münster Study score (PROCAM). RESULTS: Based in the FRS the CHD risk in 10 years was considered low in 35 (90%) individuals and intermediate in 4 (10%), with no patient in high risk group. According to PROCAM 29 (74%) individuals were in low risk group, 7 (18%) in the intermediate risk and 3 (8%) in high risk group. On the other hand, the mod-FRS detected 5 (13%) subjects in low risk, 30 (77%) in the intermediate and 4 (10%) individuals in the high risk group.CONCLUSION: Framingham Risk Score was less accurate than the FRS-mod for the assessment of CHD risk in subjects with MS while the PROCAM score was slightly better than FRS for this purpose.

Concentrações das drogas em técnicas histológicas. 2. Estudo sobre Verhoeff para fibras elásticas / Drug concentrations in histological techniques. 2. Study on Verhoeff for elastic fibers

Uma excelente coloração das fibras elásticas em preto azulado é obtida quando a solução de Verhoeff é usada com concentrações mais baixas de Hematoxilina- 0,7 g em 66 ml de álcool etílico absoluto - do que as usualmente empregadas. A camada muscular cora-se como sempre em verde amarelado e as fibras de colágeno, em rosa. O método foi aplicado a cortes de órgãos provindos de necropsias (rim, pulmão, aorta) (AU).

Raríssimo caso de carcinoma epidermóide de esôfago, adenocarcinoma gástrico e adenocarcinoma duodenal, sincrônicos / Very rare case of synchronous squamous cell carcinoma of the esophagus, gastric adenocarcinoma and duodenal adenocarcinoma

Os autores relatam caso raro de sincronismo entre carcinoma epidermóide de esôfago, adenocarcinoma gástrico e adenocarcinoma duodenal, o que, por si só, já é extremamente infrequente. O prognóstico nesse caso não foi bom, evoluindo para óbito 40 dias após o diagnóstico

Apoio psicológico do paciente cardíaco cirurgiado / Psychological support of surgical cardiac patients

Este trabalho é um estudo retrospectivo feito em 105 pacientes portadores de cardiopatias cirúrgicas, no período de 1982 à 1986, evidenciando suas manifestaçöes psicossomáticas. Após um breve resumo dos casos, säo feitas consideraçöes pertinentes às ponderaçöes dos pacientes, seu acompanhamento profissional e elementos de terapêutica psicológica. No momento, há considerável interesse na eficácia e nos efeitos seletivos do recente apoio psicológico ao paciente cardíaco cirurgiado

Metodologia doutrinária em psiquiatria / Doctrinaire methodology in psychiatry

Nosso presente trabalho resulta de uma reflexäo dos dados levantados quanto ao desempenho de forma generalizada da realidade que existe no universo da enfermaria na Unidade Integrada de Saúde Mental-HFA. Nota-se que existe um elevado índice de reinternaçöes, com percentuais de 36,48% para o sexo masculino e 30,33% quanto ao sexo feminino; associado à alta rotatividade e conseqüente curto período de permanência hospitalar. É um campo amplo para novos estudos pela riqueza de variáveis e aspectos que podem ser abordados, a saber: padräo de qualidade técnica de atendimento, ocorre psiquiátrica mais evidente com seus efeitos e benefícios e índice elevado de reinternaçöes, dentre outros

O uso de clebopride na doença funcional do aparelho digestivo: estudo duplo-cego / The use of clebopride in functional disease of digestive system: double-blind study

Quarenta pacientes com queixas dispépticas, sem patologia orgânica demonstrada aos exames laboratoriais e complementares, foram avaliados durante um mês. Os pacientes foram divididos aleatoriamente em dois grupos de vinte: um grupo recebeu clebopride como droga única e outro placebo, ambos na posologia de um comprimido três vezes ao dia. Os pacientes que tomaram clebopride obtiveram melhora da plenitude gástrica pós-prandial e da regurgitaçäo ácida; a incidência de efeitos colaterais mostrou-se pouco significativa. Observou-se ainda efeito do palcebo sobre a dor epigástrica e a sensaçäo de boca amarga, cuja interpretaçäo näo está definida. O presente trabalho demonstra que o emprego de clebopride tem seu lugar no tratamento dos quadros dispépticos de natureza funcional do tubo digestivo alto

Validaçäo do Indice de Qualidade de Vida de Ferrans e Powers para a populaçao geral do município de Londrina / Validation of the Ferrans and Powers Quality of life Index for the general population of Londrina city- Brazil

Trata-se de um estudo que teve por objetivo a validaçäo do Indice de Qualidade de Vida (IQV) de Ferrans e Powers para uma populaçäo geral do município de Londrina. O IQV é um instrumento genérico de avaliaçäo de qualidade de vida, composto por duas partes distintas, com 34 ítens cada uma, correspondentes a quatro domínios: 1. Saúde/Funcionamento (14 ítens), 2. Socioeconômico (9 ítens), 3. Psicológico/Espiritual (7 ítens) e 4. Família (4 ítens). A primeira parte avalia o grau de satisfaçäo quanto aos ítens do instrumento, e a segunda, mede o grau de importância atribuída a eles. O instrumento foi administrado por meio de auto-aplicaçäo (93 porcento), aplicaçäo assistida (4,7porcento) e por entrevista (2,3 porcento), a uma amostra de 300 pessoas da populaçäo geral de Londrina. O tempo médio para administraçäo do instrumento foi de 16,5 minutos (DP=8,5). A avaliaçäo de sua confiabilidade foi realizada pela análise da consistência interna dos ítens, através do coeficiente Alfa de Cronbach, aplicado a cada dimensäo do IQV e à escala completa (IQV Total). A análise obteve um Alfa com índices de consistência interna satisfatórios, com os seguintes valores de Alfa: 0,82 = IQV Total; 0,76 = Saúde/Funcionamento; 0,67 = Socioeconômico; 0,82 = Psicológico/Espiritual; 0,54 = Família. Na análise discriminativa, observou-se a diferença estatisticamente significante dos ítens e domínios do instrumento em relaçäo a indivíduos com melhor e pior qualidade de vida. Em relaçäo à validade de critério, obteve-se uma correlaçäo positiva e estatisticamente significante (r=0,69; p,0,0001) entre o escore total do IQV e o ítem 32 - "Satisfaçao com sua vida em geral". Os resultados desta pesquisa evidenciaram coeficientes de confiabilidade satisfatórios bem como validade discriminante de critério do instrumento analisado, permitindo sua utilizaçao para avaliar a qualidade de vida da populaçäo geral do município de Londrina

Validação do Índice de Qualidade de Vida de Ferrans e Powers para a população geral do município de Londrina / Validation of the Ferrans and Powers Quality of Life Index for the general population of Londrina city Brazil

Trata-se de um estudo que teve por objetivo a validação do Índice de Qualidade de Vida (IQV) de Ferrans e Powers para uma população geral do município de Londrina. O IQV é um instrumento genérico de avaliação de qualidade de vida, composto por duas partes distintas, com 34 ítens cada uma, correspondentes a quatro domínios: 1. Saúde/Funcionamento (14 ítens), 2. Socioeconômico (9 ítens), 3. Psicológico/Espiritual (7 ítens) e 4. Família (4 ítens). A primeira parte avalia o grau de satisfação quanto aos ítens do instrumento, e a segunda, mede o grau de importância atribuída a eles. O instrumento foi administrado por meio de auto-aplicação (93%), aplicação assistida (4,7%) e por entrevista (2,3%), a uma amostra de 300 pessoas da população geral de Londrina. O tempo médio para administração do instrumento foi de 16,5 minutos (DP=8,5). A avaliação de sua confiabilidade foi realizada pela análise da consistência interna dos ítens, através do coeficiente Alfa de Cronbach, aplicado a cada dimensão do IQV e à escala completa (IQV Total). A análise obteve um Alfa com índices de consistência interna satisfatórios, com os seguintes valores de Alfa: 0,82 = IQV Total; 0,76 = Saúde/Funcionamento; 0,67 =Socioeconômico; 0,82 = Psicológico/Espiritual; 0,54 = Família. Na análise discriminativa, observou-se a diferença estatisticamente significante dos ítens e domínios do instrumento em relação a indivíduos com melhor e pior qualidade de vida. Em relação à validade de critério, obteve-se uma correlação positiva e estatisticamente significante (r=0,69; p,0,0001) entre o escore total do IQV e o ítem 32 - "Satisfação com sua vida em geral". Os resultados desta pesquisa evidenciaram coeficientes de confiabilidade satisfatórios bem como validade discriminante de critério do instrumento analisado, permitindo sua utilização para avaliar a qualidade de vida da população geral do município de Londrina

The present study aimed to validate the Ferrans and Powers Quality of Life Index for the general population of Londrina city - Brazil. The Quality of Life Index (QLI) is a generic instrument to evaluate quality of life, divided into two distinct parts, with 34 items each, corresponding to four domains: 1. Health/Functioning (14 items), 2. Socioeconomical (9 items), 3. Psychological/Spiritual (7 items) and 4. Family (4 items). The first part evaluates the level of satisfaction related to the items of the instrument and the second measures the level of importance of each item to the subject. The instrument was administered to a sample of 300 people of the general population of Londrina, using the following strategies: self answering (93%), assisted answering (4,7%) and interviewing (2,3%). Mean time for managing the instrument was 16,5 minutes (SD=8,5). Internal consistency reliability was estimated through Cronbach's alpha applied to each of the dimensions of the QLI and to the total scale (Total QLI). The analysis demonstrated a satisfactory level of internal consistency, with the following Alpha coeficients: 0,82 = Total QLI; 0,76 = Health/Functioning; 0,67 = Socioeconomical; 0,82 =Psychological/Spiritual; 0,54 = Family. Discriminant analysis showed a statistically significant difference between items and domains of the instrument in relation to individuals with higher and lower quality of life. The correlation between scores from QLI and overall satisfaction with life question - item 32 - was 0,69 (p<0,0001), thus supporting the criterion-related validity. The results of this study indicate that Quality of Life Index shows a satisfactory level of internal consistency as well as discriminant and criterion-related validity, thus allowing its utilization to evaluate quality of life of the general population of Londrina city