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1.
Acta Paul. Enferm. (Online) ; 32(4): 470-476, Jul.-Ago. 2019. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-1010818

RESUMO

Resumo Objetivo Avaliar as evidências científicas disponíveis na literatura sobre a associação entre Síndrome de Burnout e Síndrome Metabólica. Métodos Revisão integrativa da literatura, com buscas nas bases de dados do Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online e Springer Link. Os artigos selecionados foram analisados de acordo com a Agency for Healthcare Research and Quality. Resultados A maioria (80%) dos 5 artigos que atenderam aos critérios de seleção estava na língua inglesa e indexada nas bases de dados Web of Science e Scopus. Dentre os trabalhos, 80% tinham médicos como autores principais. O continente asiático (Israel, Japão e China) concentrou a maior parte de produção. Não ocorreu predominância de desenho de estudo. A área financeira correspondeu a 60% do público pesquisado. Conclusão As evidências disponíveis na literatura são incipientes, apenas 20% dos artigos elegíveis apresentou associação entre as síndromes estudadas e os demais, indicam associação entre Burnout e componentes da SM separadamente.


Resumen Objetivo evaluar las evidencias científicas disponibles en la literatura sobre la asociación entre el síndrome de burnout y el síndrome metabólico. Métodos revisión integradora de la literatura, con búsquedas en las bases de datos del Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online y Springer Link. Los artículos seleccionados fueron analizados de acuerdo con la Agency for Healthcare Research and Quality. Resultados la mayoría (80%) de los cinco artículos que cumplieron los criterios de selección estaba en inglés e indexada en las bases de datos Web of Science y Scopus. Entre los trabajos, 80% tenía médicos como autores principales. El continente asiático (Israel, Japón y China) concentró la mayor parte de la producción. No ocurrió predominio de diseño de estudio. El área financiera correspondió al 60% del público investigado. Conclusión las evidencias disponibles en la literatura son incipientes, solo el 20% de los artículos elegibles presentó asociación entre los síndromes estudiados y los demás indican asociación entre burnout y componentes del SM separadamente.


Abstract Objective To evaluate the scientific evidence available in the literature on the association between Burnout Syndrome and Metabolic Syndrome. Methods Integrative literature review, searching the databases of the Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine, National Institutes of Health, Web of Science, Scopus, Cochrane Library, Latin American and Caribbean Center on Health Sciences Information, Scientific Eletronic Library Online and Springer Link. The selected articles were analyzed according to the Agency for Healthcare Research and Quality. Results Most (80%) of the 5 studies that met the selection criteria were in English language and indexed in the Web of Science and Scopus databases. Among the studies, 80% had physicians as the main authors. The Asian continent (Israel, Japan and China) concentrated the majority of production. There was no predominance of study design. The financial area corresponded to 60% of the study participants. Conclusion The available evidence in the literature is incipient, only 20% of the eligible articles showed association between the syndromes studied and the others, indicate association between Burnout and MS components separately.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31357596

RESUMO

This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.

3.
Ann Hepatol ; 18(5): 751-756, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31153910

RESUMO

INTRODUCTION AND OBJECTIVES: Viral hepatitis is an endemic and epidemic disease of relevance in public health. This study estimated the frequency of viral hepatitis by occupational and non-occupational infections and analyzed the factors associated with case notifications in Brazil from 2007 to 2014. MATERIAL AND METHODS: This was an exploratory epidemiological study using the Notifiable Diseases Information System database. Descriptive and multivariate analyses were performed. RESULTS: The frequency of viral hepatitis by occupational infections was 0.7%, of which 1.3% were due to hepatitis A virus (HAV), 45.1% hepatitis B virus (HBV), and 45.3% hepatitis C virus (HCV). There was a significant association of the disease with female sex [AOR=1.31; P=0.048], schooling [AOR=1.71; P<0.001], occupation [AOR=2.74; P<0.001], previous contact with an HBV or HCV-infected patient [AOR=5.77; P<0.001], exposure to accidents with biological materials [AOR=99.82; P<0.001], and hepatitis B vaccination [AOR=0.73; P=0.033]. CONCLUSION: While there was a low frequency of viral hepatitis by occupational infections in Brazil from 2007 to 2014, these findings might be underreported and have been associated with individual and occupational characteristics. This reinforces the need for the adoption of prevention strategies in the workplace and for completeness of case notifications.

4.
Rev Bras Epidemiol ; 21: e180006, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30088586

RESUMO

OBJECTIVE: To assess the completeness and consistency of reports describing viral hepatitis caused by work-related accidents in Brazil between 2007 and 2014. METHODS: This is an analytical, epidemiological study evaluating the quality of data from the Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação). Data were analyzed using absolute and relative frequencies, proportional percentage variation, and a linear χ2 test. RESULTS: The majority of mandatory and essential variables were classified with good completeness, despite growth during the study period. The occupation and clinical form variables were classified as normal when they had less than 25.1% incomplete data. Inconsistency was considered high among different variables above 15.0%, including, for example, serologic markers with the types of viral hepatitis and age with occupation and date of birth. CONCLUSIONS: We need to evaluate data quality periodically, in addition to train health professionals on the adequate way to completely fill out reports, because this contributes to the establishment of an efficient surveillance of communicable diseases and improves the population's quality of life.

5.
Rev. bras. epidemiol ; 21: e180006, 2018. tab
Artigo em Português | LILACS-Express | ID: biblio-958821

RESUMO

RESUMO: Objetivo: Avaliar a completitude e a consistência das notificações de hepatites virais por acidentes de trabalho no Brasil entre 2007 e 2014. Métodos: Trata-se de um estudo epidemiológico analítico de avaliação da qualidade dos dados do Sistema de Informação de Agravos de Notificação. Os dados foram analisados pelas frequências absoluta e relativa, variação percentual proporcional e pelo teste do χ2 linear. Resultados: A maior parte das variáveis obrigatórias e essenciais foi classificada em boa completitude, apesar de crescimento no período em estudo. A ocupação e a forma clínica foram classificadas como regular, com mais de 25,1% dos dados incompletos. A inconsistência foi considerada alta entre diferentes variáveis, superior a 15,0%, como por exemplo os marcadores sorológicos com os tipos de hepatites virais; e a idade com a ocupação e data de nascimento. Conclusões: Conclui-se que se faz necessária a avaliação da qualidade dos dados periodicamente, assim como a capacitação dos profissionais de saúde quanto ao preenchimento adequado e completo das notificações, o que contribui para atuação eficiente da vigilância das doenças transmissíveis e melhoria da qualidade de vida da população.


ABSTRACT: Objective: To assess the completeness and consistency of reports describing viral hepatitis caused by work-related accidents in Brazil between 2007 and 2014. Methods: This is an analytical, epidemiological study evaluating the quality of data from the Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificação). Data were analyzed using absolute and relative frequencies, proportional percentage variation, and a linear χ2 test. Results: The majority of mandatory and essential variables were classified with good completeness, despite growth during the study period. The occupation and clinical form variables were classified as normal when they had less than 25.1% incomplete data. Inconsistency was considered high among different variables above 15.0%, including, for example, serologic markers with the types of viral hepatitis and age with occupation and date of birth. Conclusions: We need to evaluate data quality periodically, in addition to train health professionals on the adequate way to completely fill out reports, because this contributes to the establishment of an efficient surveillance of communicable diseases and improves the population's quality of life.

6.
Rev. pesqui. cuid. fundam. (Online) ; 9(1): 208-214, jan.-mar. 2017. tab
Artigo em Inglês, Português | LILACS | ID: biblio-836328

RESUMO

Objective: to estimate the prevalence of Burnout Syndrome among the Primary Health Care nurses in a city of Bahia Southwest. Methods: Cross-sectional study, conducted with 60 nursing professionals of primary care. We used a sociodemographic and occupational questionnaire, and the Maslach Burnout Inventory. Data were tabulated using SPSS, version 22.0, and analyzed using descriptive statistics. Results: The prevalence of burnout syndrome was 58.3% according to the criteria of Grunfeld et al, and 16.7% according to Ramirez et al., they have found high levels in the dimension depersonalization (48.3%) and low job satisfaction (56.6%). The prevalence of burnout syndrome in the study population was high, as was the high rate predisposition to develop this syndrome. Conclusions: The study pointed out the need to implement preventive and interventional measures to ensure a beneficial and promising health work environment.


Objetivo: estimar a prevalência da Síndrome de Burnout entre profissionais de enfermagem da Atenção Básica à Saúde de um município do sudoeste baiano. Método: Estudo de corte transversal, realizado com 60 profissionais de enfermagem da Atenção Básica. Utilizou-se um questionário sociodemográfico e laboral, e o Maslach Burnout Inventory. Os dados foram tabulados no SPSS versão 22.0 e analisados segundo estatística descritiva. Resultados: A prevalência de Síndrome de Burnout foi de 58,3%, de acordo os critérios de Grunfeld et al., e de 16,7% segundo Ramirez et al. Encontraram-se altos níveis na dimensão despersonalização (48,3%) e baixa realização profissional (56,6%). A prevalência da Síndrome de Burnout na população estudada foi alta, assim como foi alto o índice de predisposição para desenvolver esta síndrome. Conclusões: O estudo apontou a necessidade de implementação de medidas preventivas e interventivas para garantir um ambiente de trabalho benéfico e promissor de saúde.


Objetivo: estimar la prevalencia del Síndrome de Burnout entre las enfermeras de Atención Primaria de la Salud en la ciudad de Bahía Suroeste. Métodos: Estudio transversal, realizado con 60 profesionales de atención primaria. Se utilizó un cuestionario sociodemográfico ocupacional y el Maslach Burnout Inventory. Los datos fueron tabulados mediante el programa SPSS, versión 22.0, y analizados mediante estadística descriptiva. Resultados: La prevalencia del Síndrome de Burnout fue del 58,3%, según los criterios de Grunfeld et al., y el 16,7%, de acuerdo a los altos niveles de Ramírez et al. Ellos han encontrado en la despersonalización dimensión (48,3%) y la satisfacción laboral bajo (56,6%). La prevalencia del síndrome en la población de estudio fue alta, al igual que la predisposición tasa alta de desarrollar este síndrome. Conclusiones: El estudio señala la necesidad de implementar medidas de prevención y de intervención para garantizar un ambiente de trabajo de salud beneficioso prometedor.


Assuntos
Humanos , Esgotamento Profissional , Equipe de Enfermagem/estatística & dados numéricos , Atenção Primária à Saúde , Brasil
7.
Rev. pesqui. cuid. fundam. (Online) ; 9(1): 208-214, jan.-mar. 2017. tab
Artigo em Inglês, Português | BDENF - Enfermagem | ID: bde-30423

RESUMO

Objective: To estimate the prevalence of Burnout Syndrome among the Primary Health Care nurses in a city of Bahia Southwest. Methods: Cross-sectional study, conducted with 60 nursing professionals of primary care. We used a sociodemographic and occupational questionnaire, and the Maslach Burnout Inventory. Data were tabulated using SPSS, version 22.0, and analyzed using descriptive statistics. Results: The prevalence of burnout syndrome was 58.3% according to the criteria of Grunfeld et al, and 16.7% according to Ramirez et al., they have found high levels in the dimension depersonalization (48.3%) and low job satisfaction (56.6%). The prevalence of burnout syndrome in the study population was high, as was the high rate predisposition to develop this syndrome. Conclusions: The study pointed out the need to implement preventive and interventional measures to ensure a beneficial and promising health work environment.(AU)


Objetivo: Estimar a prevalência da Síndrome de Burnout entre profissionais de enfermagem da Atenção Básica à Saúde de um município do sudoeste baiano. Método: Estudo de corte transversal, realizado com 60 profissionais de enfermagem da Atenção Básica. Utilizou-se um questionário sociodemográfico e laboral, e o Maslach Burnout Inventory. Os dados foram tabulados no SPSS versão 22.0 e analisados segundo estatística descritiva. Resultados: A prevalência de Síndrome de Burnout foi de 58,3%, de acordo os critérios de Grunfeld et al., e de 16,7% segundo Ramirez et al. Encontraram-se altos níveis na dimensão despersonalização (48,3%) e baixa realização profissional (56,6%). A prevalência da Síndrome de Burnout na população estudada foi alta, assim como foi alto o índice de predisposição para desenvolver esta síndrome. Conclusões: O estudo apontou a necessidade de implementação de medidas preventivas e interventivas para garantir um ambiente de trabalho benéfico e promissor de saúde.(AU)


Objetivo: Estimar la prevalencia del Síndrome de Burnout entre las enfermeras de Atención Primaria de la Salud en la ciudad de Bahía Suroeste. Métodos: Estudio transversal, realizado con 60 profesionales de atención primaria. Se utilizó un cuestionario sociodemográfico ocupacional y el Maslach Burnout Inventory. Los datos fueron tabulados mediante el programa SPSS, versión 22.0, y analizados mediante estadística descriptiva. Resultados: La prevalencia del Síndrome de Burnout fue del 58,3%, según los criterios de Grunfeld et al., y el 16,7%, de acuerdo a los altos niveles de Ramírez et al. Ellos han encontrado en la despersonalización dimensión (48,3%) y la satisfacción laboral bajo (56,6%). La prevalencia del síndrome en la población de estudio fue alta, al igual que la predisposición tasa alta de desarrollar este síndrome. Conclusiones: El estudio señala la necesidad de implementar medidas de prevención y de intervención para garantizar un ambiente de trabajo de salud beneficioso prometedor.(AU)


Assuntos
Humanos , Esgotamento Profissional , Equipe de Enfermagem/estatística & dados numéricos , Atenção Primária à Saúde , Brasil
8.
J. bras. pneumol ; 42(6): 423-428, Nov.-Dec. 2016. tab, graf
Artigo em Inglês | LILACS | ID: biblio-841249

RESUMO

ABSTRACT Objective: To describe orofacial muscle function in patients with severe asthma. Methods: This was a descriptive study comparing patients with severe controlled asthma (SCA) and severe uncontrolled asthma (SUA). We selected 160 patients, who completed a sociodemographic questionnaire and the 6-item Asthma Control Questionnaire (ACQ-6), as well as undergoing evaluation of orofacial muscle function. Results: Of the 160 patients evaluated, 126 (78.8%) and 34 (21.2%) presented with SCA and SUA, respectively, as defined by the Global Initiative for Asthma criteria. Regardless of the level of asthma control, the most frequent changes found after evaluation of muscle function were difficulty in chewing, oronasal breathing pattern, below-average or poor dental arch condition, and difficulty in swallowing. When the sample was stratified by FEV1 (% of predicted), was significantly higher proportions of SUA group patients, compared with SCA group patients, showed habitual open-mouth chewing (24.8% vs. 7.7%; p < 0.02), difficulty in swallowing water (33.7% vs. 17.3%; p < 0.04), and voice problems (81.2% vs. 51.9%; p < 0.01). When the sample was stratified by ACQ-6 score, the proportion of patients showing difficulty in swallowing bread was significantly higher in the SUA group than in the SCA group (66.6% vs. 26.6%; p < 0.01). Conclusions: The prevalence of changes in the stomatognathic system appears to be high among adults with severe asthma, regardless of the level of asthma control. We found that some such changes were significantly more common in patients with SUA than in those with SCA.


RESUMO Objetivo: Descrever os achados da avaliação miofuncional orofacial em pacientes com asma grave. Métodos: Estudo descritivo comparando pacientes com asma grave controlada (AGC) e asma grave não controlada (AGNC). Foram selecionados 160 participantes, que responderam a um questionário sociodemográfico e o Asthma Control Questionnaire com seis questões (ACQ-6) e realizaram avaliação miofuncional orofacial. Resultados: Na amostra estudada, 126 (78,8%) e 34 (21,2%) pacientes, respectivamente, apresentavam AGC e AGNC segundo os critérios da Global Initiative for Asthma. Independentemente do nível de controle da asma grave, as alterações mais frequentes observadas na avaliação miofuncional foram problemas de mastigação, padrão de respiração oronasal, estado de conservação da arcada dentária médio ou ruim e problemas na deglutição. Quando a amostra foi estratificada pelo VEF1 (% do previsto), os resultados foram significativamente maiores no grupo AGNC que no grupo AGC quanto a mastigação habitual com boca aberta (24,8% vs. 7,7%; p < 0,02), deglutição de água com dificuldade (33,7% vs. 17,3%; p < 0,04) e problemas de voz (81,2% vs. 51,9%; p < 0,01). Quando estratificada pelo ACQ-6, os resultados do grupo AGNC foram significativamente maiores que no grupo AGC quanto à deglutição de pão com dificuldade (66,6% vs. 26,6%; p < 0,01). Conclusões: A prevalência de alterações do sistema estomatognático parece ser alta em adultos com asma grave independentemente do nível de controle da doença. No grupo AGNC, algumas dessas alterações foram significativamente mais frequentes que no grupo AGC.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Asma/fisiopatologia , Sistema Estomatognático/fisiopatologia , Asma/tratamento farmacológico , Broncodilatadores/uso terapêutico , Estudos Transversais , Mastigação/fisiologia , Músculos da Mastigação/fisiologia , Índice de Gravidade de Doença , Fatores Socioeconômicos , Espirometria , Inquéritos e Questionários
9.
Psicol. reflex. crit ; 29: 44, 2016. tab, ilus
Artigo em Inglês | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-910185

RESUMO

Background: Accumulation of abdominal adiposity (AA) constitutes a risk factor for heart and coronary diseases and for metabolic complications. Research suggests that stress is related to adipogenesis. The burnout syndrome (BS) is linked to stress due to the chronicity of work stress. The objective of this study is to estimate the association between BS and AA in Primary Health Care (PHC) nursing practitioners. Methods: This is confirmatory cross-sectional study with 189 workers from nine municipalities in Bahia, Brazil. The dependent variable was AA, measured by waist circumference. The independent variable was the BS, diagnosed by the Maslach Burnout Inventory (MBI). Sociodemographic and job characteristics, lifestyle, and human biology were taken as covariates and were evaluated as modifiers or confounders by the homogeneity tests and by comparison with the adjusted Mantel-Haenszel test, respectively. Logistic regression was employed to evaluate the association between BS and AA, adjusted for covariates. The adequacy of the final regression model was evaluated by the model's goodness of fit test and the area under the ROC curve. Results: BS prevalence was 10.6% and AA 54%. The variables age, education, hypertension, diabetes, working time, and high emotional exhaustion were associated with AA. An association was found between BS and AA (1.63 adjusted prevalence ratios; 95% CI, 1.29 to 2.06) even after age and working time adjustment. Conclusion: The results suggest an association between BS and AA in the analyzed professionals. A significant prevalence of burnout and AA is highlighted. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Enfermeiros/psicologia , Obesidade Abdominal/psicologia , Estresse Ocupacional , Estudos Transversais , Atenção Primária à Saúde
10.
Am J Mens Health ; 8(6): 503-9, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24626602

RESUMO

Men generally have a lower life expectancy and higher mortality than women in nearly all age groups. Military police, whose main activity in Brazil is the maintenance of public order and the prevention of crimes and transgressions of the laws, is mostly composed of men; it is also a risky and stressful profession generally related to poor quality of life. Considering that risk factors for disease and death from cardiovascular causes--including the multiple risk factor metabolic syndrome-are mostly related to lifestyle and associated with impaired quality of life, this study aims to provide a theoretical basis for other studies about the prevalence of metabolic syndrome among police officers. In a theoretical study, the authors present an interdisciplinary review based on studies on the health and quality of life of men in general and policemen in their specificity; published studies were selected according to the key words: men, health, quality of life, police, metabolic syndrome; they should also have been published in the past 15 years and available in the Scientific Electronic Library Online--SciELO--and in the Public Medline--PubMed. In conclusion, military policemen have a risky profession, whose conditions may contribute to low quality of life, illness, and mortality from cardiovascular causes; these conditions indicate a need for the characterization of metabolic syndrome in this population as an important element for promotion of health. Studying these conditions may contribute to the adoption of comprehensive and continuing care for military policemen's integral health.


Assuntos
Expectativa de Vida , Síndrome Metabólica/epidemiologia , Militares/estatística & dados numéricos , Polícia/estatística & dados numéricos , Qualidade de Vida , Adulto , Brasil/epidemiologia , Humanos , Incidência , Comunicação Interdisciplinar , Masculino , Saúde do Homem , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Militares/psicologia , Medição de Risco , Índice de Gravidade de Doença , Fatores Socioeconômicos , Taxa de Sobrevida
11.
J Bras Pneumol ; 39(3): 296-305, 2013 May-Jun.
Artigo em Inglês, Português | MEDLINE | ID: mdl-23857681

RESUMO

OBJECTIVE: To determine the prevalence of atopy and to evaluate clinical, laboratory, and radiological profiles in patients with COPD. METHODS: This was a cross-sectional study involving outpatients with stable COPD (defined by the clinical history and a post-bronchodilator FEV1/FVC < 70% of the predicted value). The patients completed a questionnaire regarding clinical characteristics and atopy, after which they underwent nasal lavage cytology, skin prick testing, chest X-rays, arterial blood gas analyses, and determination of total serum IgE. RESULTS: Of the 149 subjects studied, 53 (35.6%), 49 (32.8%), and 88 (59.1%) presented with nasal eosinophilia, a positive skin prick test result, and symptoms of allergic rhinitis, respectively. Correspondence analysis confirmed these findings, showing two distinct patterns of disease expression: atopy in patients with COPD that was less severe; and no evidence of atopy in those with COPD that was more severe (reduced FEV1 and hyperinflation). There was a statistically significant association between nasal eosinophilia and a positive bronchodilator response. CONCLUSIONS: Using simple and reproducible methods, we were able to show that there is a high frequency of atopy in patients with COPD. Monitoring inflammation in the upper airways can be a useful tool for evaluating respiratory diseases in the elderly and in those with concomitant asthma and COPD, a clinical entity not yet fully understood.


Assuntos
Hipersensibilidade Imediata/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Idoso , Asma/terapia , Bronquite Crônica/diagnóstico , Estudos Transversais , Eosinofilia/diagnóstico , Feminino , Humanos , Hipersensibilidade Imediata/terapia , Masculino , Pessoa de Meia-Idade , Líquido da Lavagem Nasal/citologia , Doença Pulmonar Obstrutiva Crônica/terapia , Rinite/diagnóstico , Fatores de Risco , Testes Cutâneos/métodos , Inquéritos e Questionários
12.
Environ Sci Pollut Res Int ; 18(3): 416-27, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20798993

RESUMO

PURPOSE: The aims of this paper were to quantify the heavy metals (HM) in the air of different sites in Rio de Janeiro (RJ) and Salvador (SA) using Tillandsia usneoides (Bromeliaceae) as a biomonitor, and to study the morphology and elemental composition of the air particulate matter (PM) retained on the Tillandsia surface. METHODS: Tillandsia samples were collected in a noncontaminated area and exposed to the air of five sites in RJ State and seven in SA for 45 days, in two seasons. Samples were prepared to HM quantification by flame atomic absorption spectrophotometry, while morphological and elemental characterizations were studied by using scanning electron microscopy. RESULTS: HM concentrations were significantly higher when compared to control sites. We found an increasing metal concentration as follows: Cd < Cr < Pb < Cu < Zn. PM exhibited a morphology varying from amorphous- to polygonal-shaped particles. Size measurements indicated that more than 80% of particles were less than 10 µm. PM contained aluminosilicates iron-rich particles, but Zn, Cu, Cr, and Ba were also detected. CONCLUSION: HM input in the atmosphere was mainly associated with anthropogenic sources such as vehicle exhaust. Elemental analysis detected HM in the inhalable particles, indicating that those HMs may intensify the toxic effects of PM on human health. Our results indicated T. usneoides as an adequate biomonitor of HM in the PM belonging to the inhalable fraction.


Assuntos
Poluentes Atmosféricos/metabolismo , Monitoramento Ambiental/métodos , Metais Pesados/metabolismo , Material Particulado/metabolismo , Tillandsia/metabolismo , Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Brasil , Cidades , Metais Pesados/análise , Microscopia Eletrônica de Varredura , Tamanho da Partícula , Material Particulado/análise , Tillandsia/ultraestrutura
13.
J Bras Pneumol ; 36(2): 159-66, 2010 Mar-Apr.
Artigo em Português | MEDLINE | ID: mdl-20485935

RESUMO

OBJECTIVE: To develop and validate a Portuguese-language version of the Asthma Control Test (ACT) for use in Brazil. METHODS: The study comprised 290 asthma outpatients over 12 years of age. The patients completed the ACT questionnaire and had an appointment with a pulmonologist in order to assess asthma control in two visits. In the first visit, the patients also underwent spirometry. The second visit took place at least four weeks later. RESULTS: We found that a cut-off score of 18 points-to differentiate between subjects with controlled asthma and those with uncontrolled asthma-had a sensitivity of 93%, a specificity of 74%, a negative predictive value of 86% and a positive predictive value of 85%. The positive and negative likelihood ratios were 3.58 and 0.09, respectively. The questionnaire has an outstanding capacity to differentiate uncontrolled asthma from controlled asthma, with an area under the ROC curve of 0.904. The patients whose symptoms remained stable between the two visits had similar scores, demonstrating good test-retest reproducibility, with an intraclass correlation coefficient of 0.93. The patients whose symptoms improved in the second visit had significantly higher scores, demonstrating good responsiveness of the questionnaire in the identification of changes in disease control. CONCLUSIONS: The Portuguese-language version of the ACT showed good test-retest reproducibility and was capable of discriminating the levels of asthma control and detecting changes in asthma control in a population of patients with a low level of education and low family income at a public health facility in Brazil.


Assuntos
Asma/prevenção & controle , Inquéritos e Questionários/normas , Adulto , Asma/diagnóstico , Asma/terapia , Brasil , Métodos Epidemiológicos , Feminino , Humanos , Linguagem , Masculino , Pessoa de Meia-Idade , Prática de Saúde Pública , Tradução
14.
J. bras. pneumol ; 36(2): 159-166, mar.-abr. 2010. ilus, tab
Artigo em Português | LILACS | ID: lil-546369

RESUMO

OBJETIVO: Desenvolver e validar uma versão do Asthma Control Test (ACT, Teste de Controle da Asma) em português para uso no Brasil. MÉTODOS: Foram estudados 290 pacientes ambulatoriais com asma maiores que 12 anos. Os pacientes responderam ao ACT e foram examinados por um pneumologista para avaliar o controle da asma em duas visitas. Na primeira visita, também realizaram prova de função pulmonar. A segunda visita foi realizada ao menos quatro semanas depois da primeira. RESULTADOS: Utilizando-se como ponto de corte um escore de 18 para diferenciar asma controlada de asma não controlada, foram encontradas sensibilidade de 93 por cento, especificidade de 74 por cento, valor preditivo negativo de 86 por cento e valor preditivo positivo de 85 por cento. As razões de verossimilhança positiva e negativa foram, respectivamente, 3,58 e 0,09. O questionário tem grande capacidade de discriminar asma controlada de asma não controlada, com uma área sob a curva ROC de 0,904. Os pacientes que mantiveram os sintomas estáveis na segunda avaliação tiveram pontuação semelhante no questionário, indicando uma boa reprodutibilidade teste-reteste, com um coeficiente de correlação intraclasse de 0,93. Os pacientes que melhoraram os sintomas na segunda avaliação tiveram pontuação do questionário significativamente melhor, indicando uma boa responsividade do questionário para identificar mudanças no controle da doença. CONCLUSÕES: A versão em português do ACT apresentou boa reprodutibilidade teste-reteste e foi capaz de discriminar o nível de controle da asma, assim como detectar mudanças no controle da asma em uma população de baixa escolaridade e renda familiar em um serviço público de saúde no Brasil.


OBJECTIVE: To develop and validate a Portuguese-language version of the Asthma Control Test (ACT) for use in Brazil. METHODS: The study comprised 290 asthma outpatients over 12 years of age. The patients completed the ACT questionnaire and had an appointment with a pulmonologist in order to assess asthma control in two visits. In the first visit, the patients also underwent spirometry. The second visit took place at least four weeks later. RESULTS: We found that a cut-off score of 18 points-to differentiate between subjects with controlled asthma and those with uncontrolled asthma-had a sensitivity of 93 percent, a specificity of 74 percent, a negative predictive value of 86 percent and a positive predictive value of 85 percent. The positive and negative likelihood ratios were 3.58 and 0.09, respectively. The questionnaire has an outstanding capacity to differentiate uncontrolled asthma from controlled asthma, with an area under the ROC curve of 0.904. The patients whose symptoms remained stable between the two visits had similar scores, demonstrating good test-retest reproducibility, with an intraclass correlation coefficient of 0.93. The patients whose symptoms improved in the second visit had significantly higher scores, demonstrating good responsiveness of the questionnaire in the identification of changes in disease control. CONCLUSIONS: The Portuguese-language version of the ACT showed good test-retest reproducibility and was capable of discriminating the levels of asthma control and detecting changes in asthma control in a population of patients with a low level of education and low family income at a public health facility in Brazil.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Asma/prevenção & controle , Inquéritos e Questionários/normas , Asma/diagnóstico , Asma/terapia , Brasil , Métodos Epidemiológicos , Linguagem , Prática de Saúde Pública , Tradução
15.
Cardiovasc Ultrasound ; 7: 24, 2009 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-19480653

RESUMO

BACKGROUND: Coronary artery disease (CAD) is the leading cause of death in diabetic patients. Although exercise echocardiography (EE) is established as a useful method for diagnosis and stratification of risk for CAD in the general population, there are few studies on its value as a prognostic tool in diabetic patients. The purpose of this investigation was to evaluate the value of EE in predicting cardiac events in diabetics. METHODS: 193 diabetic patients, 97 males, 59.8 +/- 9.3 yrs (mean +/- SD) were submitted to EE between 2001 and 2006 and followed from 7 to 65 months with median of 29 months by phone calls and personal interviews with patients and their primary physician, and reviewing medical records and death certificates. The end points were cardiac events, defined as non-fatal myocardial infarction, late myocardial revascularization and cardiac death. Sudden death without another explanation was considered cardiac death. Survival free of end points was estimated by the Kaplan-Meier method. RESULTS: Twenty-six cardiac events were registered in 24 individuals during the follow-up. The rates of cardiac events were 20.6 and 7% in patients with positive and negative EE, respectively (p < 0.001). Predictors of cardiac events included sedentary lifestyle, with RR of 2.57 95%CI [1.09 to 6.02] (P = 0.03) and positive EE, with RR 3.63, 95%CI [1.44 to 9.16] (P = 0.01). Patients with positive EE presented higher rates of cardiac events at 12 months (6.8% vs. 2.2%), p = 0.004. CONCLUSION: EE is a useful method to predict cardiac events in diabetic patients with suspected or known CAD.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico por imagem , Diabetes Mellitus Tipo 2/epidemiologia , Ecocardiografia/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Comorbidade , Feminino , Humanos , Incidência , Masculino , Prognóstico , Reprodutibilidade dos Testes , Medição de Risco/métodos , Fatores de Risco , Sensibilidade e Especificidade
16.
J. bras. pneumol ; 34(12): 995-1002, dez. 2008. tab
Artigo em Inglês, Português | LILACS | ID: lil-503811

RESUMO

OBJETIVO: Determinar a taxa de adesão ao tratamento padrão com corticóide inalatório em pacientes com asma grave, identificar seus fatores preditores e avaliar a relação entre adesão ao tratamento e os parâmetros de resposta clínica e funcional. MÉTODOS: Coorte prospectiva de pacientes atendidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia, Brasil. O estudo incluiu 160 pacientes com asma grave, acompanhados por um período de 180 dias para medida da adesão (variável dependente) ao corticóide inalatório prescrito. As variáveis independentes foram determinadas na avaliação inicial e durante seis meses através de entrevistas e aplicação de questionário estruturado. Os pacientes registraram em um diário as doses não utilizadas. RESULTADOS: Do total de 160 pacientes, 158 completaram o estudo. A taxa de adesão ao tratamento foi de 83,8 por cento. Dos 158 pacientes, 112 (70,9 por cento) foram considerados aderentes ao tratamento (ponto de corte: 80 por cento de todas as doses administradas). Houve associação significante entre o controle da asma e adesão ao tratamento. Os fatores relacionados a uma baixa adesão foram efeitos adversos, local de residência distante do centro de referência, dificuldade de pagar pelo transporte e regime posológico. Outros fatores, como sintomas depressivos, religião e classe econômica, não tiveram relação com a adesão. CONCLUSÕES: A adesão ao tratamento foi considerada elevada, havendo relação com a resposta clínica ao tratamento em uma amostra de pacientes com asma grave atendidos em um programa público com fornecimento gratuito de medicamentos e atendimento multidisciplinar em unidade de referência.


OBJECTIVE: To determine the rate of adherence to treatment with inhaled corticosteroids in patients with severe asthma, to identify predictive factors for adherence and to evaluate the relationship between adherence to treatment and parameters of clinical and functional response. METHODS: Prospective cohort study of patients enrolled in the Program for the Control of Asthma and Allergic Rhinitis in the state of Bahia, Brazil. The study comprised 160 patients with severe asthma, monitored for 180 days in order to evaluate adherence (dependent variable) to the prescribed inhaled corticosteroid. Independent variables were assessed at baseline and for a six-month follow-up period by means of interviews and the completion of a standardized questionnaire.Patients recorded the missed doses in a diary. RESULTS: Of the 160 patients. 158 completed the study. Adherence rate was 83.8 percent. Of the 158 patients, 112 (70.9 percent) were considered adherent (cut-off point: 80 percent of prescribed doses administered). There was a significant association between asthma control and adherence to treatment.Predictors of poor adherence were adverse effects, living far from the referral center, limited resources to pay for transportation and dose schedule. Other factors, such as depressive symptoms, religion and economic status, were not associated with poor adherence. CONCLUSIONS: Adherence to asthma treatment was high and was associated with the clinical response to treatment, in a sample of patients with severe asthma enrolled in a public program that provides free medication and the assistance of a multiprofessional specialized team in a referral center


Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Doença Aguda , Administração por Inalação , Corticosteroides/efeitos adversos , Antiasmáticos/efeitos adversos , Asma/fisiopatologia , Brasil , Esquema de Medicação , Métodos Epidemiológicos , Adesão à Medicação/psicologia , Fatores Socioeconômicos , Espirometria
17.
J Bras Pneumol ; 34(10): 756-63, 2008 Oct.
Artigo em Inglês, Português | MEDLINE | ID: mdl-19009207

RESUMO

OBJECTIVE: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. METHODS: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician in order to characterize the control of the disease in the first visit. The questionnaire was evaluated in three versions, with 5, 6 and 7 questions, respectively, and scores of 0.75 and 1.50 were used as cut-off points. RESULTS: Of the 278 patients, 77 (27.7%) had intermittent asthma, 39 (14.0%) had mild persistent asthma, 40 (14.4%) had moderate persistent asthma and 122 (43.9%) had severe persistent asthma. The sensitivity of ACQ to identify uncontrolled asthma ranged from 77% to 99%, and the specificity ranged from 36% to 84%. The positive predictive value ranged from 73% to 90%, and the negative predictive value ranged from 67% to 95%. The positive likelihood ratio ranged from 1.55 to 4.81, and the negative likelihood ratio ranged from 0.03 to 0.27. In the 5- and 6-question versions of the ACQ, the intraclass correlation coefficient was 0.92. These two versions were both responsive to clinical changes in the patients. CONCLUSIONS: All three versions of the ACQ satisfactorily discriminated between patients with uncontrolled asthma and those with controlled asthma. The 5- and 6-question versions also presented good reliability and responsiveness. Therefore, the ACQ is a valid tool for evaluating asthma control in adult outpatients in Brazil.


Assuntos
Asma/prevenção & controle , Linguagem , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Espirometria , Adulto Jovem
18.
J. bras. pneumol ; 34(10): 756-763, out. 2008. ilus, tab
Artigo em Inglês, Português | LILACS | ID: lil-496610

RESUMO

OBJETIVO: Avaliar se a versão em língua portuguesa do Asthma Control Questionnaire (ACQ, Questionário de Controle da Asma) é um instrumento válido para medir o controle da asma em pacientes adultos ambulatoriais no Brasil. MÉTODOS: Foram avaliados 278 pacientes ambulatoriais com diagnóstico de asma. Todos os pacientes, durante a primeira visita, responderam ao questionário, foram submetidos à espirometria e avaliados clinicamente por um médico para a caracterização do controle da doença. Foram analisadas as versões do questionário com 5, 6 e 7 questões, utilizando dois escores distintos (0,75 e 1,50) como pontos de corte. RESULTADOS: Dos 278 pacientes, 77 (27,7 por cento) tinham asma intermitente, 39 (14,0 por cento) asma persistente leve, 40 (14,4 por cento) asma persistente moderada e 122 (43,9 por cento) asma persistente grave. A sensibilidade do questionário para identificar asma não-controlada variou de 77 por cento a 99 por cento e a especificidade variou de 36 por cento a 84 por cento. O valor preditivo positivo variou de 73 por cento a 90 por cento, e o valor preditivo negativo variou de 67 por cento a 95 por cento. A razão de verossimilhança positiva variou de 1,55 a 4,81, e a razão de verossimilhança negativa variou de 0,03 a 0,27. Nas versões do ACQ com 5 e 6 questões, o coeficiente de correlação intraclasse foi de 0,92, e estas versões foram responsivas a mudanças no quadro clínico dos pacientes. CONCLUSÕES: O ACQ, nas suas três versões, teve boa capacidade de discriminar indivíduos com asma não-controlada daqueles com asma controlada. As versões com 5 e 6 questões apresentaram também boa reprodutibilidade e responsividade. Trata-se, portanto, de um instrumento válido para avaliação do controle da asma em pacientes adultos ambulatoriais no Brasil.


OBJECTIVE: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. METHODS: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician in order to characterize the control of the disease in the first visit. The questionnaire was evaluated in three versions, with 5, 6 and 7 questions, respectively, and scores of 0.75 and 1.50 were used as cut-off points. RESULTS: Of the 278 patients, 77 (27.7 percent) had intermittent asthma, 39 (14.0 percent) had mild persistent asthma, 40 (14.4 percent) had moderate persistent asthma and 122 (43.9 percent) had severe persistent asthma. The sensitivity of ACQ to identify uncontrolled asthma ranged from 77 percent to 99 percent, and the specificity ranged from 36 percent to 84 percent. The positive predictive value ranged from 73 percent to 90 percent, and the negative predictive value ranged from 67 percent to 95 percent. The positive likelihood ratio ranged from 1.55 to 4.81, and the negative likelihood ratio ranged from 0.03 to 0.27. In the 5- and 6-question versions of the ACQ, the intraclass correlation coefficient was 0.92. These two versions were both responsive to clinical changes in the patients. CONCLUSIONS: All three versions of the ACQ satisfactorily discriminated between patients with uncontrolled asthma and those with controlled asthma. The 5- and 6-question versions also presented good reliability and responsiveness. Therefore, the ACQ is a valid tool for evaluating asthma control in adult outpatients in Brazil.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Asma/prevenção & controle , Linguagem , Inquéritos e Questionários/normas , Brasil , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Curva ROC , Índice de Gravidade de Doença , Espirometria , Adulto Jovem
19.
Arq. bras. cardiol ; 89(2): 111-118, ago. 2007. graf, tab
Artigo em Português | LILACS | ID: lil-460775

RESUMO

FUNDAMENTO: A incompetência cronotrópica (ICT) é freqüente em pacientes idosos e pode limitar o papel do teste ergométrico na identificação da doença arterial coronariana (DAC) nessa população. OBJETIVO: Avaliar o valor da ICT, em uma população idosa, no diagnóstico da DAC. MÉTODOS: Foram estudados 3.308 pacientes, desses, 804 eram idosos (idade >65 anos) que se submeteram a ecocardiografia sob estresse pelo esforço físico (EEEF). Com base na freqüência cardíaca (FC) alcançada durante o teste ergométrico, subdivididos em dois grupos: G1 - 150 pacientes que não atingiram 85 por cento da FC preconizada para a idade e G2 - 654 pacientes que conseguiram atingir. Os grupos foram comparados quanto a características clínicas, índice de contratilidade segmentar do ventrículo esquerdo (IMVE) e cineangiocoronariografia (CACG). RESULTADOS: As características clínicas foram similares entre os grupos. O IMVE foi maior em G1 do que em G2, tanto no repouso (1.09 ± 0.21 versus 1.04 ± 0,15) quanto após esforço (1.15 ± 0.29 versus 1.08 ± 0.2) (p < 0,001). As anormalidades na contratilidade das paredes foram mais freqüentes em G1 do que em G2 (55 por cento versus 37 por cento; p < 0,05), sugerindo que pacientes idosos com ICT apresentam maior freqüência de DAC. Realizou-se CACG em 69 por cento das EEEF positiva para isquemia miocárdica. No G1, 91 por cento dos pacientes com EEEF positivo para isquemia realmente eram portadores doença obstrutiva arterial coronariana (>50 por cento) versus 84,5 por cento em G2. CONCLUSÃO: A ICT está associada à maior freqüência de alterações contráteis em população idosa e adiciona valor preditivo positivo à EEEF ao identificar pacientes com DAC obstrutiva.


BACKGROUND: Chronotropic incompetence (CTI) is frequent in elderly patients and may limit the role of the exercise test in the identification of coronary artery disease (CAD) in this population. OBJECTIVE: To assess the value of CTI in an elderly population in the diagnosis of CAD. METHODS: A total of 3,308 patients were studied, 804 were elderly individuals (age > 65 years) who underwent exercise stress echocardiography (ESE). Based on the heart rate (HR) reached during the exercise test, were divided into two groups: G1 150 patients who did not reach 85 percent of the age-predicted HR, and G2 654 patients who did. The groups were compared to clinical characteristics, segmental left ventricular contractility rate (WMSI) and coronary angiography (CAG). RESULTS: Clinical characteristics were similar between the groups. WMSI was higher in G1 than in G2, both at rest (1.09 ± 0.21 versus 1.04 ± 0.15) and after exercise (1.15 ± 0.29 versus 1.08 ± 0.2) (p < 0.001). Abnormalities in wall contractility were more frequent in G1 than in G2 (55 percent versus 37 percent; p < 0.05), thus suggesting that elderly with CTI have a higher frequency of CAD. CAG was performed in 69 percent ESE positive for myocardial ischemia. In the G1 group, 91 percent of the ESE were true positive versus 84.5 percent in G2, that is, presence of obstructive coronary artery disease (> 50 percent). CONCLUSION: CTI is associated with a higher frequency of contractile alterations in the elderly population and adds a positive predictive value to ESE in the identification of patients with obstructive CAD.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Doença da Artéria Coronariana , Ecocardiografia sob Estresse , Frequência Cardíaca/fisiologia , Distribuição de Qui-Quadrado , Angiografia Coronária , Doença da Artéria Coronariana/fisiopatologia , Doença da Artéria Coronariana , Teste de Esforço , Isquemia Miocárdica/fisiopatologia , Isquemia Miocárdica , Isquemia Miocárdica , Razão de Chances , Valor Preditivo dos Testes , Valores de Referência , Descanso , Função Ventricular Esquerda/fisiologia
20.
Clin Chim Acta ; 375(1-2): 124-8, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16916502

RESUMO

BACKGROUND: C-reactive protein (CRP) measured at hospital arrival of patients with non-ST elevation acute coronary syndromes (ACS) may add prognostic information to the TIMI-Risk Score. METHODS: Eighty-six consecutive patients admitted with unstable angina or non-ST-elevation acute myocardial infarction and symptoms onset within the prior 48 h were included. Recurrent cardiovascular events during hospitalization were defined as non-fatal myocardial infarction or death. Serum CRP was measured immediately at hospital arrival and its prognostic value in relation to in-hospital cardiovascular events was tested by the area under the ROC curve and adjusted for TIMI risk predictors by logistic regression analysis. In addition, a CRP modified TIMI-Risk score was created by adding 2 points if CRP greater than the cut-off proposed by the ROC curve analysis. The accuracy of this new score was compared with the usual TIMI-Risk Score. RESULTS: A significant predictive value of CRP in relation to in-hospital cardiovascular events was indicated by an area under the ROC curve of 0.80 (95% CI=0.66 to 0.93, p=0.009). C-reactive protein cut-off point of best prognostic performance was 7.2 mg/l. In the multivariate analysis, increased CRP (>7.2 mg/l) remained a significant predictor of events after adjustment for TIMI risk predictors (OR=14; 95% CI=1.6-121; p=0.018). The area under the ROC curve for the TIMI-Risk Score was 0.87 (95% CI=0.76-0.99, p=0.001). The addition of CRP to the TIMI-Risk Score improved its prognostic value (area under the ROC curve=0.93; 95% CI=0.87-0.99, p<0.001). The additional value of the new score is demonstrated by a higher specificity (86% vs. 63%, p<0.001) and positive predictive value (39% vs. 19%) in relation to the TIMI-Risk Score. CONCLUSIONS: CRP measured at admission of patients with non-ST-elevation acute coronary syndromes adds prognostic information to the TIMI-Risk Score. Additionally, the incorporation of this variable into the TIMI-Risk Score calculation is an effective manner to utilize CRP for risk stratification.


Assuntos
Angina Instável/diagnóstico , Proteína C-Reativa/metabolismo , Infarto do Miocárdio/diagnóstico , Idoso , Angina Instável/sangue , Biomarcadores/sangue , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco
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