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1.
Int J Psychiatry Clin Pract ; : 1-9, 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32787650

RESUMO

OBJECTIVES: The aim of this study was to identify independent predictors of satisfaction with antipsychotics in patients with schizophrenia spectrum disorders treated in a mental health catchment area. METHODS: Observational analytical study of patients (n = 150) recruited through a convenience sampling method from five mental health units. Satisfaction with the antipsychotic as a medication was evaluated using the Treatment Satisfaction Questionnaire for Medication (TSQM). Therapeutic alliance was assessed by the Working Alliance Inventory Short Form (WAI-S). Patient-perceived participation in decision-making was assessed using COMRADE (Combined Outcome Measure for Risk communication And treatment Decision making Effectiveness). A multiple linear regression analysis was performed to identify variables independently associated with the TSQM 'Global Satisfaction' total score. RESULTS: Two variables - age and higher level of self-perceived participation in treatment decision-making - were directly, significantly, and independently associated (ß coefficient values: 0.209 and 0.432, respectively) with a higher TSQM Global satisfaction score. In addition, the severity of psychotic symptoms was inversely associated with satisfaction (ß coefficient value: -0.205) (R 2 = 0.355; R 2 adj. = 0.291; F(13) = 5.554; p < 0.01). CONCLUSIONS: These findings suggest that involving the patient in treatment decision-making and optimising the treatment to reduce symptoms, especially in younger patients, could increase satisfaction with antipsychotic treatment. Key Points Patient involvement in shared decision-making is relevant for treatment satisfaction. Current evidence suggests that improving the doctor-patient relationship optimises antipsychotics outcomes. Self-perceived participation in decision-making predicts satisfaction with antipsychotic medication. Types of antipsychotics do not determine consistent differences in satisfaction.

2.
PLoS One ; 15(7): e0236071, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730261

RESUMO

High myopia and the subsequent degenerative changes of the retina, choroid, and sclera, known as myopic maculopathy (MM), are a serious visual problem in many Asian countries, and are beginning to be so in the south of Europe, especially in the Mediterranean. It is therefore necessary to carry out genetic and environmental studies to determine the possible causes of this disease. This study aims to verify if the genetic factors that have been most related to Asian populations are also associated in two Spanish cohorts. Eight SNPs from six genes (PAX6, SCO2, CCDC102B, BLID, chromosome 15q14, and COL8A1) along with demographic, ophthalmic and environmental factors were analysed in two cohorts from a total of 365 highly myopic subjects and 177 control subjects. The genetic analysis showed that COL8A1 SNP rs13095226 was associated with the development of choroidal neovascularization (CNV) and also seems to play an important role in the increase of axial length. The SNP rs634990 of chromosome 15q14 also showed a significant association with MM, although this was lost after the Bonferroni correction. Additional demographic and environmental factors, namely age, sex, smoking status, and pregnancy history, were also found to be associated with MM and CNV in this population.

3.
Semin Oncol ; 47(2-3): 148-154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32513423

RESUMO

Brain tumors comprise a heterogeneous group of diseases, featuring different biology, prognosis, and treatment. The most known forms are malignant gliomas and metastases. Brain biopsy is a recognized technique in the management of intracranial space-occupying lesions and tumors in particular. Tumor heterogeneity of malignant brain lesions has been described and can lead to significant sampling errors in stereotactic biopsy. Different methods have been used to perform biopsies, including biopsy guided by CT or RMI, echoguided or stereotactic. The choice of the target with the help of PET and MRI with spectroscopy allows one to identify metabolically more active areas of the tumor, and in this way reduce the rate of negative results.

4.
Nanoscale ; 12(29): 15577-15587, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32510095

RESUMO

Pair distribution function, PDF, analyses are emerging as a powerful tool to characterize non-ideal metal-organic framework (MOF) materials with compromised ordering. Although originally envisaged as crystalline porous architectures, MOFs can incorporate defects in their structures through either chemistry or mechanical stress, resulting in materials with unpredicted novel properties. Indeed, a wide variety of current non-ideal MOFs have disorder in their structures to some extent, thereby often lacking crystals. Typically, PDF experiments are performed using high-energy synchrotron X-rays or neutrons to achieve a superior high atomic resolution in short times. The PDF technique analyses both Bragg and diffuse scattering signals simultaneously, without being restricted to crystalline materials. This characteristic makes PDF analyses a powerful probe to address the structural characterization of non-ideal MOF materials both at the local and intermediate range scales, including under in situ conditions relevant to MOF synthesis, activation and catalysis.

5.
Int Ophthalmol ; 40(9): 2247-2255, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32388672

RESUMO

PURPOSE: To compare in vivo swept-source optical coherence tomography (SS-OCT) measurements of the ciliary muscle (CM) in patients with primary open-angle glaucoma (POAG) and healthy subjects, and examine correlations between CM dimensions and several covariates. METHODS: This was a cross-sectional study of the right eyes of 181 subjects: 89 POAG patients and 92 healthy subjects. Using the Triton SS-OCT device (Topcon, Tokyo, Japan), CM length (CML), area (CMA) and thickness measured 1000 µm (CMT1), 2000 µm (CMT2) and 3000 µm (CMT3) from the scleral spur were determined in the temporal and nasal quadrants. POAG patients were subjected to visual field (VF) and peripapillary retinal nerve fiber layer (RNFL) assessment. CM dimensions were then assessed for correlation with VF mean defect (MD), mean RNFL thickness and intraocular pressure (IOP). RESULTS: Mean CMLs were 4325 ± 340 µm and 4195 ± 843 µm for the healthy subjects and POAG patients, respectively (p = 0.17). Mean CM thicknesses were CMT1 = 546 ± 56 µm, CMT2 = 326 ± 44 µm and CMT3 = 174 ± 16 µm in the healthy eyes versus CMT1 = 534 ± 108, CMT2 = 332 ± 99 and CMT3 = 183 ± 74 in the POAG eyes, with no significant differences detected (all p ≥ 0.25). In the temporal quadrant, mean CMA was 1.12 ± 0.29 mm2 and 1.15 ± 0.24 mm2 for the healthy and POAG subjects, respectively (p = 0.45). No correlations were observed between CM measurements and RNFL thickness (p ≥ 0.15), IOP or VF MD (p ≥ 0.14) in POAG subjects irrespective of glaucoma severity (p ≥ 0.19). CONCLUSIONS: While SS-OCT proved useful to measure CM dimensions in vivo, these dimensions did not differ between healthy individuals and POAG subjects. In the patients with POAG, no correlations were detected between CM dimensions and VF, RNFL or IOP.

6.
J Neurointerv Surg ; 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32277038

RESUMO

BACKGROUND: The clinical consequences and factors related to the progression from a carotid near-occlusion (CNO) to a complete occlusion are not well established. Our aim is to describe the rate, predictive factors and clinical implications of the progression to complete carotid occlusion (PCCO) in a population of patients with symptomatic CNO. METHODS: We conducted a multicenter, nationwide, prospective study from January 2010 to May 2016. Patients with angiography-confirmed CNO were included. We collected information on demographic data, clinical manifestations, radiological and hemodynamic findings, and treatment modalities. A 24 month carotid-imaging follow-up of the CNO was performed. RESULTS: 141 patients were included in the study, and carotid-imaging follow-up was performed in 122 patients. PCCO occurred in 40 patients (32.8%), and was more frequent in medically-treated patients (34 out of 61; 55.7%) compared with patients treated with revascularization (6 out of 61; 9.8%) (p<0.001). 7 of the 40 patients with PCCO (17.5%) suffered ipsilateral symptoms. Factors independently related with PCCO in the multivariate analysis were: age ≥75 years (OR 2.93, 95% CI 1.05 to 8.13), revascularization (OR 0.07, 95% CI 0.02 to 0.20), and collateral circulation through the ipsilateral ophthalmic artery (OR 3.25, 95% CI 1.01 to 10.48). CONCLUSIONS: PCCO occurred within 24 months in more than half of the patients under medical treatment. Most episodes of PCCO were not associated with ipsilateral symptoms. Revascularization reduces the risk of PCCO.

7.
Clin Nucl Med ; 45(5): 394-397, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32209884

RESUMO

Gliomas are characterized by intratumoral histological heterogeneity, coexisting foci of low and high grade. First, in low-grade gliomas, neoangiogenesis has not yet developed and cellularity is low, so alterations on perfusion MRI may not be present. Second, a non-negligible number of high-grade gliomas show none, patchy, or weak contrast enhancement on MRI, so they can be misdiagnosed as low-grade glioma, preventing their correct management. We present 4 cases of patients in which F-fluorocholine PET defined the anaplastic tumor component and therefore the tumor aggressiveness, solving the limitations of MRI.


Assuntos
Colina/análogos & derivados , Glioma/diagnóstico por imagem , Glioma/patologia , Tomografia por Emissão de Pósitrons , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Humanos , Imagem por Ressonância Magnética , Gradação de Tumores , Neovascularização Patológica
8.
Curr Eye Res ; : 1-8, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32188270

RESUMO

Purpose: To provide a normative data set of swept-source optical coherence tomography angiography (SS-OCTA) peripapillary vessel density (VD) measurements and assess correlations with age, gender, disc area and axial length (AL).Material and Methods: This was an observational cross-sectional study conducted on 346 right eyes of healthy subjects. Peripapillary SS-OCTA VD measurements were obtained in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) in all four quadrants using the Triton device (Topcon, Nagoya, Japan). AL measurements were made by optical biometry.Results: Mean participant age was 37.7 ± 19.8 years (range 5- 83), AL was 23.9 ± 1.3 mm (21-27), and 59% were women. Mean VDs for all quadrants were 57.2 ± 5.7% for SCP (52.4 ± 4.0% - 62.1 ± 4.2%), 46.3 ± 6.5% for DCP (41.9 ± 5.8% - 49.7 ± 4.8%) and 60.8 ± 7.4% for CC (53.4 ± 5.8% - 65.7 ± 5.5%). Negative correlation was detected between SCP VD and age (R = -0.264; P < .001), while correlation between DCP densities and age was positive (R = 0.202; P = .002). No associations were detected between peripapillary VD and gender (P ≥ 0.087) and negative correlation was found with AL and disc area only in the CC (P ≤ 0.004). In a subgroup analysis of 33 individuals, we noted no differences in VD between fellow eyes (P ≥ 0.139).Conclusion: Peripapillary VD showed wide individual variation when measured with the Triton SS-OCTA in the different retinal plexuses and CC. While correlations were observed with age, no relationships emerged with gender and only CC showed negative correlation with AL and disc area.

9.
Pharmacoecon Open ; 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32100249

RESUMO

BACKGROUND: The clinical and economic management of retinal diseases has become more complex following the introduction of new intravitreal treatments. Multicriteria decision analysis (MCDA) offers the potential to overcome the challenges associated with traditional decision-making tools. OBJECTIVES: A MCDA to determine the most relevant criteria to decision-making in the management of diabetic macular edema (DME) based on the perspectives of multiple stakeholders in Spain was developed. This MCDA was termed the MULTIDEX-EMD study. METHODS: Nineteen stakeholders (7 physicians, 4 pharmacists, 5 health authorities and health management experts, 1 psychologist, and 2 patient representatives) participated in this three-phase project. In phase A, an advisory board defined all of the criteria that could influence DME treatment decision-making. These criteria were then screened using a discrete choice experiment (DCE) (phase B). Next, a multinomial logit model was fitted by applying the backward elimination algorithm (relevant criteria: p value < 0.05). Finally, the results were discussed in a deliberative process (phase C). RESULTS: Thirty-one criteria were initially defined (phase A) and grouped into 5 categories: efficacy/effectiveness, safety, organizational and economic impact, patient-reported outcomes, and other therapeutic features. The DCE results (phase B) showed that 10 criteria were relevant to the decision-making process for a 50- to 65-year-old DME patient: mean change in best corrected visual acuity (p value < 0.001), percentage of patients with an improvement of ≥ 15 letters (p value < 0.001), effect duration per administration (p value = 0.008), retinal detachment (p value < 0.001), endophthalmitis (p value = 0.012), myocardial infarction (p value < 0.001), intravitreal hemorrhage (p value = 0.021), annual treatment cost per patient (p value = 0.001), health-related quality of life (HRQoL) (p value = 0.004), and disability level (p value = 0.021). CONCLUSIONS: From a multi-stakeholder perspective, the selection of an appropriate treatment for DME patients should guarantee patient safety and maximize the visual acuity improvement and treatment effect duration. It should also contribute to system sustainability by being affordable, it should have a positive impact on HRQoL, and it should prevent disability.

11.
J Sports Sci ; 37(22): 2596-2603, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31354059

RESUMO

This study aimed to compare the goodness of fit and the reliability of different regression models for fitting the force-velocity relationship (FV) of bench press (BP) and squat (SQ). Additionally, the reliability of the position on FV of the velocity (V1RM) and the force performed with the 1RM (F1RM) was explored. Nine rugby players and 12 judokas participated in this study. The FV of BP and SQ were obtained twice by a protocol performed until the 1RM. Individual FV were fitted by linear (LM), quadratic polynomial (PM), and exponential models (EM). Adjusted coefficients of determination of LM and PM (medians higher than 0.919) were higher than for EM. The reliability was higher for LM in comparison with PM. The reliability of V1RM was not acceptable (CV% = 19 and 18% for BP and SQ). High reliability was observed for F1RM (CV% = 3 and 2% for BP and SQ) and for the ratio between F1RM and the force-axis intercept of FV (CV% = 2 and 4% for BP and SQ). The reliability of the relative values of F1RM around 92 and 87% of F0 for BP and SQ suggests the use of these values for monitoring resistance training programmes.


Assuntos
Modelos Lineares , Modelos Estatísticos , Treinamento de Resistência/métodos , Treinamento de Resistência/estatística & dados numéricos , Levantamento de Peso/fisiologia , Levantamento de Peso/estatística & dados numéricos , Adulto , Fenômenos Biomecânicos , Estudos Transversais , Feminino , Futebol Americano/fisiologia , Humanos , Masculino , Artes Marciais/fisiologia , Reprodutibilidade dos Testes , Adulto Jovem
12.
Eur J Ophthalmol ; : 1120672119861623, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291782

RESUMO

OBJECTIVE: The aim of this study is to develop guidance on the use of intravitreal dexamethasone implants in the treatment of diabetic macular edema. METHOD: The study was performed using the modified Delphi method to obtain a consensus among a panel of experts on management of patients with diabetic macular edema and use of intravitreal dexamethasone implants in clinical practice. Thirty-seven panel members, experts on retina, from different Spanish centers were invited to participate. Individual and anonymous opinions were asked by answering a 76-item questionnaire across 11 topic areas (two rounds were done). Level of agreement was assessed using a Likert-type scale of 9 points. RESULTS: Agreement on "consensus" was reached during the first round in 63 items. The 13 remaining items underwent a second round of voting. After the second round, agreement on "consensus" was reached on five items. Finally, eight items remained without consensus. CONCLUSION: Intravitreal dexamethasone implants are useful in the treatment of patients with diabetic macular edema with different profiles, for example, pseudophakic, poor-adherents, vitrectomized, candidates for cataract surgery, patients with high inflammatory component, and with a history of cardiovascular events. The use of intravitreal dexamethasone reduces the number of visits and facilitates compliance. Experts thought that the switch from anti-vascular endothelial growth factor therapy to intravitreal dexamethasone implants should be done preferably after three injections. Also, pro re nata treatment provides better results in diabetic macular edema patients as it helps to prevent undertreatment. Finally, experts concluded that clinical guidelines and treatment protocols for diabetic macular edema need to be updated.

13.
Clin Nucl Med ; 44(10): e548-e558, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31306196

RESUMO

AIM: To study the association of metabolic features of F-fluorocholine in gliomas with histopathological and molecular parameters, progression-free survival (PFS) and overall survival (OS). METHODS: Prospective multicenter and nonrandomized study (Functional and Metabolic Glioma Analysis). Patients underwent a basal F-fluorocholine PET/CT and were included after histological confirmation of glioma. Histological and molecular profile was assessed: grade, Ki-67, isocitrate dehydrogenase status and 1p/19q codeletion. Patients underwent standard treatment after surgery or biopsy, depending on their clinical situation. Overall survival and PFS were obtained after follow-up. After tumor segmentation of PET images, SUV and volume-based variables, sphericity, surface, coefficient of variation, and multilesionality were obtained. Relations of metabolic variables with histological, molecular profile and prognosis were evaluated using Pearson χ and t test. Receiver operator caracteristic curves were used to obtain the cutoff of PET variables. Survival analysis was performed using Kaplan-Meier and Cox regression analysis. RESULTS: Forty-five patients were assessed; 38 were diagnosed as having high-grade gliomas. Significant differences of SUV-based variables with isocitrate dehydrogenase status, tumor grade, and Ki-67 were found. Tumor grade, Ki-67, SUVmax, and SUVmean were related to progression. Kaplan-Meier analysis revealed significant associations of SUVmax, SUVmean, and multilesionaly with OS and PFS. SUVmean, sphericity, and multilesionality were independent predictors of OS and PFS in Cox regression analysis. CONCLUSIONS: Metabolic information obtained from F-fluorocholine PET of patients with glioma may be useful in the prediction of tumor biology and patient prognosis.


Assuntos
Colina/análogos & derivados , Glioma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Deleção Cromossômica , Progressão da Doença , Feminino , Glioma/genética , Glioma/metabolismo , Glioma/patologia , Humanos , Isocitrato Desidrogenase/metabolismo , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Intervalo Livre de Progressão , Estudos Prospectivos
14.
Clin Nucl Med ; 44(8): e472-e476, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274626

RESUMO

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that causes CNS tumors in around 20% of patients, being pilocytic astrocytomas (PA), and particularly optic pathway gliomas (OPG), the most common. We present three cases of NF1 patients referred for F-fluorocholine PET/CT because of suspected glioma in the setting of ongoing FUMEGA (Functional and Metabolic Glioma Analysis) trial. One case turned out to be a WHO grade I ganglioglioma; the second was a high grade glioma; and the last one (negative in PET) a probable low-grade glioma.


Assuntos
Neoplasias Encefálicas/diagnóstico por imagem , Colina/análogos & derivados , Neurofibromatose 1/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Adulto , Neoplasias Encefálicas/patologia , Humanos , Masculino , Gradação de Tumores , Neurofibromatose 1/patologia
15.
Materials (Basel) ; 12(12)2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31213003

RESUMO

Different metalorganic lamellar hybrid materials based on associated nanoribbons were synthesized by the use of alkyl-benzyl monocarboxylate spacers, containing alkyl tails with variable lengths, which acted like structural growing inhibitors. These molecular agents were perpendicularly located and coordinated to aluminium nodes in the interlayer space, controlling the separation between individual structure sub-units. The hybrid materials were studied by X-ray diffraction (XRD), chemical and thermogravimetrical analysis (TGA), nuclear magnetic resonance (NMR) and infrared spectroscopy (IR), and field emission scanning electron microscopy (FESEM)/transmission electron microscopy (TEM), showing their physicochemical properties. The specific capacity of the metalorganic materials to be exfoliated through post-synthesis treatments, using several solvents due to the presence of 1D structure sub-units and a marked hydrophobic nature, was also evidenced.

16.
Clin Nucl Med ; 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31219845

RESUMO

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder that causes CNS tumors in around 20% of patients, being pilocytic astrocytomas (PA), and particularly optic pathway gliomas (OPG), the most common. We present three cases of NF1 patients referred for F-fluorocholine PET/CT because of suspected glioma in the setting of ongoing FUMEGA (Functional and Metabolic Glioma Analysis) trial. One case turned out to be a WHO grade I ganglioglioma; the second was a high grade glioma; and the last one (negative in PET) a probable low-grade glioma.

17.
Chem Sci ; 10(7): 2053-2066, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30842863

RESUMO

Novel MOF-type materials with different morphologies based on assembled 1D organic-inorganic sub-domains were prepared using specific monodentate benzylcarboxylate spacers with functional substituents in the para-position as structure modulating agents. The combination of electron-withdrawing or electron-donating functions in the organic spacers with suitable solvothermal synthesis conditions allowed modulating the structuration level (2D or 3D), vacancies, physico-chemical properties and Lewis acidity strength of the metal-organic structures. Furthermore, bimetallic (Al/Fe) MOF-type materials were synthesized by a one-pot direct process without modification of the structural framework. The activity of these hybrid materials as Lewis acid catalysts was evaluated to prepare cyanohydrins as precursors for the synthesis of biologically active compounds, and for aerobic oxidation of thiols to disulfides. The catalytic results showed that the derived MOFs exhibited modulatable Lewis acid capacities which are a function of the morphology, functionality of monodentate substituents present in the networks and a cooperative effect between metallic nodes of different nature.

18.
Mater Sci Eng C Mater Biol Appl ; 97: 438-450, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30678930

RESUMO

ZnO materials with spherical morphology, core-shell and solid, disperse or interconnected, were obtained by a completely green synthesis via a carbohydrate-template route. Morphology, structure and optical properties, as well as antimicrobial potential and cytocompatibility were investigated. The antimicrobial efficiency of the obtained materials was screened against a large spectrum of reference and clinical microbial strains, both susceptible and exhibiting resistance phenotypes of clinical and epidemiological interest, in planktonic and biofilm state. Their biocidal activity is strongly dependent of material's characteristics and target microorganism. One of the most valuable findings of our study is the good antibiofilm activity of the obtained nanostructures, which in some cases was superior to that noted against planktonic cells, despite the well-known high tolerance of biofilm-embedded cells to different stressor agents. Another important finding is the excellent efficiency against three Gram-negative, respectively Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae and two Gram-positive species, i.e. Staphylococcus aureus and Enteroccus faecium included in the ESKAPE list of the most dangerous resistant pathogens, requiring global surveillance and urgent need for the development of novel antimicrobial agents. Our study offers the first insight regarding the high therapeutic potential of ZnO nanoparticles against the fearful nosocomial pathogen A. baumannii. The cytocompatibility of the developed materials in terms of cell morphology, viability and proliferation, revealed a comparable dose-dependent cellular response, at the active antimicrobial concentrations, only a low effect on cell viability is evidenced. Overall, our data demonstrated the potential of the materials for antimicrobial applications and also that their biotoxicity can be modulated directly through their morpho-structural characteristics.


Assuntos
Anti-Infecciosos/síntese química , Nanopartículas Metálicas/química , Óxido de Zinco/química , Anti-Infecciosos/química , Anti-Infecciosos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Nanopartículas Metálicas/toxicidade , Testes de Sensibilidade Microbiana , Microscopia de Fluorescência , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X
19.
Psychiatry Res ; 272: 284-289, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30594761

RESUMO

The Coercion Experience Scale (CES) is a questionnaire that evaluates the subjective experience of coercion during psychiatric hospitalization. This study aimed to assess a short version of the Coercion Experience Scale (CES-18) in a Spanish Sample (N = 114). Two authors independently selected the items, choosing those that could also be applied to the experience of coercion after the use of forced medication. Reliability was estimated using internal consistency coefficients. Internal validity was assessed by means of a factorial analysis based on the method of extraction of main components and using orthogonal rotation VARIMAX. Convergent and discriminatory validity was evaluated by correlation between the total score of the CES-18 with the original CES and a Visual Analogue Scale, The Davidson Trauma Scale and the Client Assessment of Treatment Scale. The CES-18 showed adequate internal consistency (Cronbach α = 0.940). Factor analysis resulted in a two-factor solution (Coercion and Humiliation and Fear) explaining 64.2% of the total variance. The correlation between the original CES and CES-18 was adequate (r = 0.968). The scores suggested good divergent and convergent validity. The Spanish language CES-18 demonstrated adequate psychometric proprieties in order to assess perceived coercion during psychiatric hospitalization.


Assuntos
Coerção , Hospitais Psiquiátricos , Transtornos Mentais/terapia , Psicometria/instrumentação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/normas , Reprodutibilidade dos Testes , Espanha
20.
Age Ageing ; 48(1): 74-80, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30307470

RESUMO

Background: the association between pain characteristics and frailty risk is uncertain. Objective: to investigate the separate impact of the frequency, intensity and location of pain on frailty risk and its possible mechanisms. Methods: prospective cohort of 1505 individuals ≥63 years followed between 2012 and 2015 in Spain. In 2012, pain was classified into: lowest pain (Score 0), middle pain (Score 1-4) and highest pain (Score 5-6). Incident frailty was assessed in 2015 as having ≥3 Fried criteria or a Frailty Index (FI) ≥0.30. Results: in multivariate analyses, the risk of frailty (measured with the Fried criteria or the FI) increased progressively with the frequency of pain, its intensity and the number of pain locations. Compared with those having the lowest pain score, the odds ratio (95% confidence interval) of Fried-based frailty was 1.24 (0.56-2.75) in the middle score and 2.39 (1.34-4.27; P-trend <0.01) in the highest score. Corresponding values for frailty as FI ≥0.30 were 1.39 (0.80-2.42) and 2.77 (1.81-4.24; P-trend <0.01). Odds ratios did not change after adjustment for alcohol intake, Mediterranean diet adherence or sedentary time, but were reduced with adjustment for pain-associated chronic diseases (cardiovascular disease, diabetes, chronic lung disease, osteomuscular disease and depression). A higher pain score was linked to higher risk of exhaustion and low physical activity (two out of five Fried criteria) and to a worse score in all FI domains. Conclusion: frequency, intensity and location of pain were associated with higher risk of frailty. Study associations were partly explained by pain-associated morbidity.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Fragilidade/etiologia , Dor/complicações , Fatores Etários , Idoso , Feminino , Fragilidade/epidemiologia , Avaliação Geriátrica , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Análise Multivariada , Dor/epidemiologia , Medição da Dor , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia
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