Correlação entre velocidade da percepção visual e mini-exame do estado mental / Correlation between speed of visual perception and mini mental state examination

Introdução: O Critical Flicker Fusioné um método não invasivo que pode ser utilizado para rastreio de distúrbio cognitivo (DC), contribuindo para o diagnóstico mais objetivo das demências. Objetivos: Comparar a velocidade de percepção visual e valores do Mini-Exame do Estado Mental (MEEM) de indivíduos com e sem DC. Metodologia: Estudo observacional analítico realizado de agosto de 2017 a julho de 2018. A amostra foi formada por pacientes atendidos num serviço de geriatria local. Procedeu-se aferição de CFF cujos resultados foram comparados com valores recentes de MEEM. Utilizou-se o qui-quadrado para comparar proporções e o t de Student para comparar médias. As correlações lineares foram avaliadas pelo r de Pearson ou rho de Spearman. Definiu-se significância estatística p<0,05. Resultados: A amostra final foi composta por 63 indivíduos, cujos valores de CFF demonstraram estar correlacionados à idade (p<0,001) e aos valores de MEEM (p<0,05). Ainda, o CFF foi capaz de discriminar os pacientes por presença de DC, não sendo influenciado pela escolaridade. Conclusão: O CFF se mostrou capaz de diagnosticar a presença de DC, além de ser um teste mais objetivo que o MEEM. Contudo, novos estudos são necessários para definir seu ponto de corte ideal, bem como sua real acurácia.

Introduction: Critical Flicker Fusion is a non-invasive method that can be used to screen for cognitive deficit (CD), contributing to the more objective diagnosis of dementias. Objectives: To compare the speed of visual perception and values of the Mini Mental State Examination (MMSE) of individuals with and without CD. Methodology: Analytical study carried out from August 2017 to July 2018. The sample consisted of patients from a local geriatric service. CFF measurement was performed, and the results were compared with recent MMSE values. Chi-square was used to compare proportions and Student's t to compare means. Linear correlations were assessed using Pearson's r or Spearman's rho. Statistical significance was set at p<0,05. Results: The final sample consisted of 63 individuals, whose CFF values were correlated with age (p<0,001) and MMSE values (p<0,05). Still, the CFF was able to discriminate patients or the presence of CD, not being influenced by education level. Conclusion: The CFF proved to be capable of diagnosing the presence of CD, in addition to being a more objective test than the MMSE. However, further studies are needed to define its ideal cutoff point, as well as itsreal accuracy.

Effectiveness of first-wave protease inhibitors in hepatitis C virus genotype 1 infection: a multicenter study in Brazil.

INTRODUCTION: In 2013, combination therapy using peginterferon, ribavirin, and boceprevir or telaprevir was introduced to treat hepatitis C virus genotype 1 infection in Brazil. The effectiveness of this therapy in four Brazilian regions was evaluated. METHODS: Clinical and virological data were obtained from patients of public health institutions in five cities, including sustained virological response (SVR) and side effects. Patients with advanced fibrosis (F3/4), moderate fibrosis (F2) for > 3 years, or extra-hepatic manifestations were treated according to Ministry of Health protocol. Treatment effectiveness was verified by using bivariate and multivariate analysis; p-values of < 0.05 were considered significant. RESULTS: Of 275 patients (64.7% men; average age, 57 years old), most (61.8%) were treatment-experienced; 53.9% had subgenotype 1a infection, 85.1% had advanced fibrosis, and 85.5% were treated with telaprevir. SVR was observed in 54.2%. Rapid virological response (RVR) was observed in 54.6% of patients (data available for 251 patients). Overall, 87.5% reported side effects and 42.5% did not complete treatment. Skin rash, severe infection, and death occurred in 17.8%, 2.5%, and death in 1.4% of cases, respectively. SVR was associated with treatment completion, RVR, and anemia. CONCLUSIONS: The effectiveness of hepatitis C virus triple therapy was lower than that reported in phase III clinical trials, possibly owing to the prioritized treatment of patients with advanced liver fibrosis. The high frequency of side effects and treatment interruptions observed supported the decision of the Brazilian authorities to suspend its use when safer and more effective drugs became available in 2015.

Effectiveness of first-wave protease inhibitors in hepatitis C virus genotype 1 infection: a multicenter study in Brazil

Abstract INTRODUCTION: In 2013, combination therapy using peginterferon, ribavirin, and boceprevir or telaprevir was introduced to treat hepatitis C virus genotype 1 infection in Brazil. The effectiveness of this therapy in four Brazilian regions was evaluated. METHODS: Clinical and virological data were obtained from patients of public health institutions in five cities, including sustained virological response (SVR) and side effects. Patients with advanced fibrosis (F3/4), moderate fibrosis (F2) for > 3 years, or extra-hepatic manifestations were treated according to Ministry of Health protocol. Treatment effectiveness was verified by using bivariate and multivariate analysis; p-values of < 0.05 were considered significant. RESULTS: Of 275 patients (64.7% men; average age, 57 years old), most (61.8%) were treatment-experienced; 53.9% had subgenotype 1a infection, 85.1% had advanced fibrosis, and 85.5% were treated with telaprevir. SVR was observed in 54.2%. Rapid virological response (RVR) was observed in 54.6% of patients (data available for 251 patients). Overall, 87.5% reported side effects and 42.5% did not complete treatment. Skin rash, severe infection, and death occurred in 17.8%, 2.5%, and death in 1.4% of cases, respectively. SVR was associated with treatment completion, RVR, and anemia. CONCLUSIONS: The effectiveness of hepatitis C virus triple therapy was lower than that reported in phase III clinical trials, possibly owing to the prioritized treatment of patients with advanced liver fibrosis. The high frequency of side effects and treatment interruptions observed supported the decision of the Brazilian authorities to suspend its use when safer and more effective drugs became available in 2015.