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Av. enferm ; 38(2): 202-215, May-Aug. 2020. tab, graf
Artigo em Espanhol | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1114690


Resumen Objetivo: comparar los efectos de la implementación de un programa de ejercicio continuo de mediana intensidad vs. un programa de ejercicio interválico de alta intensidad sobre los parámetros antropométricos y de condición física en mujeres hipertensas. Materiales y método: estudio experimental con pre y post prueba, realizado en 62 mujeres hipertensas divididas en 3 grupos: el primer grupo realizó ejercicio interválico de alta intensidad, el segundo hizo ejercicio continuo de mediana intensidad y el tercero es el grupo control. La intervención se realizó durante 12 semanas con una frecuencia semanal de 3 repeticiones. En todas las mujeres hipertensas se evaluó su condición física y características antropométricas. Resultados: posterior a la intervención, se encontraron diferencias estadísticamente significativas entre el grupo HiiT (high intensity interval training) y el grupo control en cuanto a las variables porcentaje de grasa (p = 0,014), densidad corporal (p = 0,014) e índice de conicidad [IC] (p = 0,003). Adicionalmente, se identificaron diferencias entre los dos grupos de ejercicio y el grupo control en las variables distancia recorrida (p = 0,04), flexibilidad en miembro superior derecho (p = 0,00) y fuerza en miembros inferiores (p = 0,01). Conclusiones: el estudio demostró que el ejercicio es una herramienta efectiva para mejorar la aptitud física de mujeres hipertensas. Sin embargo, no se encontraron diferencias en la efectividad entre el entrenamiento interválico de alta intensidad y el entrenamiento continuo.

Resumo Objetivo: comparar os efeitos da implementação de um programa de exercício contínuo de média intensidade versus um programa de exercício interválico de alta intensidade nos parâmetros antropométricos e de condição física em mulheres hipertensas. Materiais e método: estudo experimental com pré e pós-teste, realizado em 62 mulheres hipertensas divididas em 3 grupos: um primeiro grupo fez exercício interválico de alta intensidade, o segundo grupo fez exercício contínuo de média intensidade e um grupo controle. A intervenção foi realizada durante 12 semanas com uma frequência semanal de 3 vezes por semana; todas as mulheres hipertensivas foram avaliadas quanto à sua condição física e características antropométricas. Resultados: foram encontradas diferenças estatisticamente significativas pós-intervenção entre o grupo HiiT (high intensity interval training) e o grupo controle nas variáveis porcentagem de gordura (p = 0,014), densidade corporal (p=0,014) e índice de conicidade (IC) (p = 0,003). Adicionalmente, foram encontradas diferenças entre os dois grupos de exercícios e o grupo controle nas variáveis distância percorrida (p=0,04), flexibilidade no membro superior direito (p=0,00) e força nos membros inferiores (p=0,01). Conclusões: este estudo mostrou que o exercício físico é uma ferramenta eficaz para melhorar a aptidão física das mulheres hipertensivas. No entanto, não foi encontrada diferença na eficácia entre o treinamento em intervalos de alta intensidade e o treinamento contínuo.

Abstract Objective: To compare the effects of medium intensity continuous exercise implementation vs. a program with high intensity interval exercise on the anthropometric parameters and physical condition of hypertensive women. Materials and method: Experimental study with a pre and post-test, conducted in 62 hypertensive women who were divided into 3 groups: the first group performed high-intensity interval exercise, the second group did continuous-medium intensity exercise, and the third acted as the control group. It was a 12-week intervention, with a 3-times-per-week frequency. All hypertensive women were evaluated for physical condition and anthropo-metric characteristics. Results: After the intervention, statistically significant differences were found between the HiiT (high intensity interval training) group and the control group regarding the variables body fat percentage (p = 0.014), body density (p = 0.014), and conicity index [CI] (p = 0.003). Additionally, differences between the two exercise groups and the control group were identified for the variables distance traveled (p = 0.04), flexibility in the upper right limb (p = 0.00), and strength in lower limbs (p = 0.01). Conclusions: This study showed that exercise is an effective tool to improve the physical fitness of hypertensive women. However, no differences in terms of effectiveness were found between high intensity interval training and continuous training.

Feminino , Exercício Físico , Antropometria , Aptidão Física , Treinamento Intervalado de Alta Intensidade , Hipertensão , Grupos Controle
PLoS One ; 15(8): e0237739, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817629


OBJECTIVE: To assess the effect of HIV infection and combined antiretroviral therapy (c-ART) on various proatherogenic biomarkers and lipids and to investigate their relationship with subclinical atherosclerosis in a cohort of treatment-naive HIV-infected patients. METHODS: We performed a prospective, comparative, multicenter study of 2 groups of treatment-naive HIV-infected patients (group A, CD4>500 cells/µL, not starting c-ART; and group B, CD4<500 cells/µL, starting c-ART at baseline) and a healthy control group. Laboratory analyses and carotid ultrasound were performed at baseline and at months 12 and 24. The parameters measured were low-density lipoprotein (LDL) particle phenotype, lipoprotein-associated phospholipase A2 (Lp-PLA2), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), sCD14, sCD163, monocyte chemoattractant protein-1(MCP-1), and asymmetric dimethylarginine (ADMA). A linear mixed model based on patient clusters was used to assess differences in biomarkers between the study groups and over time. RESULTS: The study population comprised 62 HIV-infected patients (group A, n = 31; group B, n = 31) and 22 controls. Age was 37 (30-43) years, and 81% were men. At baseline, the HIV-infected patients had a worse LDL particle phenotype and higher plasma concentration of sCD14, sCD163, hs-CRP, and LDL-Lp-PLA2 than the controls. At month 12, there was an increase in total cholesterol (p = 0.002), HDL-c (p = 0.003), and Apo A-I (p = 0.049) and a decrease in sCD14 (p = <0.001) and sCD163 (p<0.001), although only in group B. LDL particle size increased in group B at month 24 (p = 0.038). No changes were observed in group A or in the healthy controls. Common carotid intima-media thickness increased in HIV-infected patients at month 24 (Group A p = 0.053; group B p = 0.048). Plasma levels of sCD14, sCD163, and hs-CRP correlated with lipid values. CONCLUSIONS: In treatment-naive HIV-infected patients, initiation of c-ART was associated with an improvement in LDL particle phenotype and inflammatory/immune biomarkers, reaching values similar to those of the controls. HIV infection was associated with progression of carotid intima-media thickness.

Aterosclerose/sangue , Biomarcadores/sangue , Infecções por HIV/sangue , Lipídeos/sangue , Adulto , Antirretrovirais/administração & dosagem , Antirretrovirais/sangue , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Aterosclerose/tratamento farmacológico , Aterosclerose/virologia , Proteína C-Reativa/metabolismo , Espessura Intima-Media Carotídea , Colesterol/sangue , Grupos Controle , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Inflamação/sangue , Inflamação/tratamento farmacológico , Inflamação/virologia , Lipoproteínas LDL/sangue , Masculino , Estudos Prospectivos
Epidemiology ; 31(6): 836-843, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32841988


Testing of symptomatic persons for infection with severe acute respiratory syndrome coronavirus-2 is occurring worldwide. We propose two types of case-control studies that can be carried out jointly in test settings for symptomatic persons. The first, the test-negative case-control design (TND) is the easiest to implement; it only requires collecting information about potential risk factors for Coronavirus Disease 2019 (COVID-19) from the tested symptomatic persons. The second, standard case-control studies with population controls, requires the collection of data on one or more population controls for each person who is tested in the test facilities, so that test-positives and test-negatives can each be compared with population controls. The TND will detect differences in risk factors between symptomatic persons who have COVID-19 (test-positives) and those who have other respiratory infections (test-negatives). However, risk factors with effect sizes of equal magnitude for both COVID-19 and other respiratory infections will not be identified by the TND. Therefore, we discuss how to add population controls to compare with the test-positives and the test-negatives, yielding two additional case-control studies. We describe two options for population control groups: one composed of accompanying persons to the test facilities, the other drawn from existing country-wide healthcare databases. We also describe other possibilities for population controls. Combining the TND with population controls yields a triangulation approach that distinguishes between exposures that are risk factors for both COVID-19 and other respiratory infections, and exposures that are risk factors for just COVID-19. This combined design can be applied to future epidemics, but also to study causes of nonepidemic disease.

Estudos de Casos e Controles , Grupos Controle , Infecções por Coronavirus/epidemiologia , Projetos de Pesquisa Epidemiológica , Pneumonia Viral/epidemiologia , Betacoronavirus , Causalidade , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Infecções Respiratórias/epidemiologia , Fatores de Risco
PLoS One ; 15(8): e0237096, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756603


Careful design of experiments using living organisms (e.g. mice) is of critical importance from both an ethical and a scientific standpoint. Randomization should, whenever possible, be an integral part of such experimental design to reduce bias thereby increasing its reliability and reproducibility. To keep the sample size as low as possible, one might take randomization one step further by controlling for baseline variations in the dependent variable(s) and/or certain known covariates. To give an example, in animal experiments aimed to study atherosclerosis development, one would want to control for baseline characteristics such as plasma triglyceride and total cholesterol levels and body weight. This can be done by first defining blocks to create balance among groups in terms of group size and baseline characteristics, followed by random assignment of the blocks to the various control and intervention groups. In the current study we developed a novel, user-friendly tool that allows users to easily randomize animals into blocks and identify random block divisions that are well-balanced based on given baseline characteristics, making randomization time-efficient and easy-to-use. Here, we present the resulting software tool that we have named RandoMice.

Experimentação Animal , Bioestatística/métodos , Software , Animais , Grupos Controle , Camundongos , Distribuição Aleatória
Artigo em Inglês | MEDLINE | ID: mdl-32664643


The purpose of this study was to compare the effects of 6 weeks direct instruction and teaching games for understanding (TGfU) programs on the decision-making and execution (post-interventions), as well, as on the physical activity (PA) levels during sessions. Thirty under-12 football players participated in this study (age: 10.3 ± 0.45 years) and were randomly assigned to TGfU (n = 15) or direct instruction (n = 15) group. Two sessions/week were implemented. Results revealed that TGfU promoted higher levels (p = 0.043; d = 2.99) of light PA (28.96%) compared with direct instruction (27.55%). Non-significant higher sedentary PA levels (p = 0.073; d = 2.62) were found in the control group (35.48%). In terms of tactical principles, conservation of the ball increased the percentage of moderate to vigorous physical activity in TGfU (43.60%) compared with direct instruction (38.05%). According to the Game Performance Evaluation Tool (GPET), significant improvements (p = 0.018, d = 3.78) of the attacking player with the ball in the percentage of change between groups in the unsuccessful execution in TGfU (% = -62.2) were observed compared with direct instruction (% = 14.2). TGfU seems to be more appropriate than direct instruction to increase the light PA levels during sessions while no significant differences were found between programs in moderate and vigorous intensities. Regarding the effects of programs in decisions, greater improvements in decisions with the ball were found in TGFU compared to DI.

Exercício Físico , Futebol , Grupos Controle , Feminino , Humanos , Masculino
Invest. educ. enferm ; 38(2): [e07], junio 30 2020. Table 1, Table 2, Table 3, Table 4, Table 5
Artigo em Inglês | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1103577


Objective. The purpose of this study was to provide appropriate preoperative supportive conditions to improve anxiety and vital signs for patients undergoing Coronary Artery Bypass Grafting -CABG- surgery. Methods. This clinical trial study was performed on 90 patients undergoing CABG surgery in Farshchian Hospital of Hamadan, Iran in 2019. Sample was selected by convenience and were randomly divided into three groups: control (n=30), intervention1 (n=30), and intervention2 (n=30). The control group received only the routine preoperative counseling of ward and admitted to the operating room as usual; the intervention1 and intervention2 groups in addition received another two counseling sessions, then the intervention1 group was admitted in the operating room as usual, but the intervention2 group was admitted by the counselor in the operating room. Data were collected using a three-part questionnaire including demographic characteristics, vital signs chart, and the Spielberger's State-Trait Anxiety Inventory. Results. The results showed that there was a significant difference in the mean anxiety of the three groups after admission in the operating room (intervention2 was lower than intervention1 and control groups, p<0.001; and intervention 1 group was lower than control group, p<0.001) and also there was a significant difference between the mean systolic blood pressure, heart rate and respiratory rate of the three groups (p<0.001) but the mean of the variables of temperature and diastolic blood pressure in the three groups were not significantly different (p=0.59 and p=0.225, respectively). Conclusion. Our results revealed preoperative consultation and admission in the operating room by the consultant can reduce the level of anxiety and stability of vital signs of patients undergoing CABG

Objetivo. Evaluar si las condiciones de apoyo preoperatorias mejoran la ansiedad y los signos vitales para los pacientes sometidos a cirugía de bypass de arterias coronarias (CABG por sus siglas en inglés). Métodos. Este estudio clínico se realizó en 90 pacientes sometidos a cirugía de revascularización coronaria -CABG- en el Hospital Farshchian de Hamadan en Irán. La muestra se seleccionó por conveniencia y se dividió aleatoriamente en tres grupos: control (n=30), intervención1 (n=30) e intervención2 (n=30). El grupo de control recibió solamente la consejería preoperatoria de rutina cuando ingresó a hospitalización y en el momento de admisión en la sala de cirugía; los grupos de intervención1 e intervención2 además de la consejería rutina recibieron otra sesión adicional; y cuando se admitió el grupo de intervención2 en la sala de operaciones, lo acompañó la misma persona que hizo la consejería. Los datos se recopilaron mediante un cuestionario de tres partes que incluyó características demográficas, un cuadro de signos vitales y los puntajes del State-Trait Anxiety Inventory de Spielberger. Resultados. Los hallazgos mostraron que hubo diferencia significativa en el puntaje de ansiedad de los tres grupos después de la admisión en la sala cirugía (en intervención2 fue menor que en los grupos intervención1 y control, p<0.001; y en el grupo de intervención1 fue menor que en el grupo de control, p<0.001). También se encontraron diferencias estadísticamente significantes para las diferencias en la presión arterial sistólica, la frecuencia cardíaca y la frecuencia respiratoria de los tres grupos, pero no para las variables de temperatura y presión arterial diastólica (p=0.59 y p=0.225, respectivamente). Conclusión. Nuestros resultados revelaron que la consulta preoperatoria y la admisión en el quirófano por parte del consultor pueden reducir el nivel de ansiedad y la estabilidad de los signos vitales de los pacientes sometidos a CABG.

Objetivo. O propósito deste estudo foi avaliar se as condições de apoio pré-operatórias melhoram a ansiedade e os signos vitais para os pacientes submetidos a cirurgia de bypass de artérias coronárias (CABG por suas siglas em inglês). Métodos. Este estudo clínico se realizou em 90 pacientes submetidos a cirurgia de revascularização coronária -CABG- no Hospital Farshchian de Hamadan no Irão. A mostra se selecionou por de conveniência e se dividiu aleatoriamente em três grupos: controle (n=30), intervenção1 (n=30) e intervenção2 (n=30). O grupo de controle recebeu somente o aconselhamento pré-operatória de rotina quando ingressou a hospitalização e no momento de admissão na sala de cirurgia; os grupos de intervenção1 e intervenção2 ademais do aconselhamento de rotina receberam outra sessão adicional; e quando o grupo de intervenção2 foi admitido na sala de operações foi acompanhado pela mesma pessoa que fez o aconselhamento. Os dados se recopilaram mediante um questionário de três partes que incluiu características demográficas, um quadro de signos vitais e as pontuações do State-Trait Anxiety Inventory de Spielberger. Resultados. As descobertas mostraram que houve diferença significativa na pontuação de ansiedade dos três grupos depois da admissão na sala cirurgia (em intervenção2 foi menor do que nos grupos intervenção1 e controle, p<0.001; e no grupo de intervenção1 foi menor do que no grupo de controle, p<0.001). Também se encontrou diferenças estatisticamente significantes para as diferenças na pressão arterial sistólica, a frequência cardíaca e a frequência respiratória dos três grupos, mas não para as variáveis de temperatura e pressão arterial diastólica (p=0.59 e p=0.225, respectivamente). Conclusão. Nossos resultados revelaram que a consulta pré-operatória e a admissão na sala de cirurgia por parte do consultor podem reduzir o nível de ansiedade e a estabilidade dos signos vitais dos pacientes submetidos a CABG.

Humanos , Salas Cirúrgicas , Ansiedade , Temperatura , Pressão Sanguínea , Ponte de Artéria Coronária , Grupos Controle , Taxa Respiratória , Conselheiros , Frequência Cardíaca
Ann Parasitol ; 66(2): 183-192, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32592457


Schizophrenia and bipolar disorder are serious neuropsychiatric disorders. Studies have found a high seroprevalence of Toxoplasma gondii in psychiatric patients. This study aimed to estimate the seroprevalence of T. gondii infection among schizophrenia and bipolar disorder patients. A case-control study was conducted in Assiut University Hospitals on 53 patients with schizophrenia, 57 patients with bipolar disorder, and 50 healthy volunteers. The psychiatric patients were recruited from the psychiatry department and the controls from their relatives. Both groups were subjected to socio-demographic assessment. Neither of them was immunodeficient nor with any other psychiatric disorders. Anti-Toxoplasma IgG antibodies were detected by indirect-ELISA to find the relationship between T. gondii infection and psychiatric disorders. Data were analysed using Chi-square test. The seropositivity rate, among patients with schizophrenia (50.9%) and patients with bipolar disorders (52.6%), was significantly higher than control group (30%) (P = 0.031 and 0.018 respectively). We found no statistically significant difference among all groups regarding environmental risk factors associated with T. gondii infection, except cat contact which was higher in schizophrenia and bipolar disorder patients (P = 0.011 and 0.007 respectively). The results of our study confirm that T. gondii infection is significantly correlated with schizophrenia and bipolar disorder and significantly associated with cat contact rather than beef consumption.

Anticorpos Antiprotozoários , Transtorno Bipolar , Esquizofrenia , Toxoplasma , Toxoplasmose , Animais , Anticorpos Antiprotozoários/sangue , Transtorno Bipolar/complicações , Estudos de Casos e Controles , Gatos , Grupos Controle , Egito/epidemiologia , Humanos , Fatores de Risco , Esquizofrenia/complicações , Estudos Soroepidemiológicos , Toxoplasmose/sangue , Toxoplasmose/complicações , Toxoplasmose/epidemiologia
Rev. bras. ciênc. mov ; 28(1): 102-115, jan.-mar., 2020. tab
Artigo em Português | LILACS | ID: biblio-1102721


O objetivo do estudo é analisar os efeitos de um programa de intervenção interdisciplinar no perfil de risco cardiometabólico de adolescentes com diagnóstico de sobrepeso/ obesidade. Estudo de intervenção, realizado com adolescentes com excesso de peso, constituído por grupo controle e grupo intervenção, o qual participou de um programa interdisciplinar com duração de seis meses. O grupo experimental final é composto por 23 adolescentes (12 sexo feminino e 11 sexo masculino). No início do programa, quatro adolescentes apresentavam sobrepeso e 19 obesidade. O grupo controle é composto pelo mesmo número de sujeitos, uma vez que este foi composto pelos pares dos escolares do grupo experimental. A intervenção contou com sessões de exercícios físicos, em três dias da semana e orientações nutricionais e psicológicas, uma vez por semana. Uma avaliação foi realizada antes do inicio do programa e logo após seu término. As avaliações consistiram em variáveis antropométricas - índice de massa corporal, circunferência da cintura, razão cintura-estatura e razão cintura -quadril, avaliação da pressão arterial, da aptidão cardiorrespiratória e coleta sanguínea para avaliação do perfil lipídico. Para a comparação das variáveis no período pré e pós-intervenção foi utilizado o teste t para amostras pareadas, para as variáveis de distribuição normal e, para as variáveis não paramétricas, foi aplicado o t este de Wilcoxon, considerando o nível de significância de p<0,05. O programa de intervenção foi eficaz n a redução de todos os indicadores antropométricos, na melhora dos níveis de aptidão cardiorrespiratória e na redução dos níveis de colesterol LDL. Entretanto, não modificou de forma significativa o s níveis de pressão arterial e demais parâmetros do perfil lipídico (colesterol total, HDL e triglicerídeos)...(AU)

: The objective of the study is to analyze the effects of an interdisciplinary in terven tion program on the cardiometabolic risk profile of adolescents diagnosed as overweight / obese. Intervention study with overweight adolescents, consisting of a control group and an intervention group, which participated in an interdisciplinary program lasting six months. The final experimental group co nsists o f 23 adolescents (12 females and 11 males). At the beginning of the program, four adolescents were overweight and 19 were obese. The control group is composed of the number of subject s, sin ce it was composed by the pairs of students in the experimental group. The intervention coun ted o n sessio n s o f physical exercises, in three days of the week and nutritional and psychological orientations, once a week . An evaluation was carried out before the start of the program and soon after its completion. The evaluations consisted of anthropometric variable - body mass index, waist circumference, waist-to-waist ratio, and waist-to-hip ratio, arterial pressure, cardiorespiratory fitness evaluation and blood collection t o evaluate the lipid profile. For the comparison of the variables in the pre- and post-intervention period, t he t-test for paired samples was used for the variables of normal distribution and fo r th e n on-parametric variables the Wilcoxon test was used, considering the level of significance of p < 0.05. The intervention program was effective in reducing all anthropometric indicators, improving cardiorespiratory fitness levels and reducing LDL cholesterol levels. However, it did not significantly modify the blood pressure levels and other parameters of the lipid profile (total cholesterol, HDL and triglycerides)...(AU)

Humanos , Masculino , Feminino , Educação Física e Treinamento , Estudantes , Índice de Massa Corporal , Grupos Controle , Fatores de Risco , Adolescente , Sobrepeso , Controle , Obesidade , Orientação , Triglicerídeos , Pressão Sanguínea , Colesterol , Risco , Parâmetros , Circunferência da Cintura , Pressão Arterial , Aptidão Cardiorrespiratória , HDL-Colesterol
BMC Infect Dis ; 20(1): 368, 2020 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-32448132


BACKGROUND: Hepatitis E virus (HEV) infection is an important cause of acute hepatitis worldwide. In pregnant women, HEV can cause more severe symptoms, with high rates of fatal hepatic failure in endemic countries. However, HEV prevalence and circulation among pregnant women from South America is almost unknown. We aimed to investigate HEV infection in pregnant women for the first time in Argentina. METHODS: IgG and IgM anti-HEV antibodies and RNA-HEV were investigated (by ELISA assays and RT-Nested-PCR, respectively) in 202 serum samples from pregnant women collected in the central region of Argentina between 2015 and 2017. A control group of 155 non-pregnant women was included (year 2018). RESULTS: The IgG anti-HEV positivity rate was 8.4% (17/202), higher than the 2.6% (4/155) obtained for the non-pregnant women control group, and showing association between pregnancy and HEV infection (p = 0.023, OR = 3.5, CI95% = 1.1-10.5). Women younger than 25 years old presented higher levels of antibodies, and there were no differences in the prevalences between trimesters of pregnancy. Two samples were reactive for IgM anti-HEV, showing recent infections, although no symptoms were registered in these patients. All samples were negative for RNA-HEV amplification. CONCLUSIONS: HEV produces infections in pregnant women from Argentina, alerting health teams to consider it as a possible cause of liver disease.

Vírus da Hepatite E/genética , Vírus da Hepatite E/imunologia , Hepatite E/diagnóstico , Hepatite E/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Adolescente , Adulto , Argentina/epidemiologia , Grupos Controle , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite E/virologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Reação em Cadeia da Polimerase , Gravidez , Prevalência , RNA Viral/genética , RNA Viral/imunologia , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
Am J Psychiatry ; 177(6): 506-517, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32375539


OBJECTIVE: Observational studies of prenatal antidepressant safety are hindered by methodological concerns, including susceptibility to surveillance bias. Some studies address potential bias by using alternative strategies to operationalize study comparison groups. In a meta-analysis of the association between prenatal antidepressant exposure and autism risk, the authors examined the utility of comparison group operationalization in reducing surveillance bias. METHODS: A systematic search of multiple databases through August 2017 was conducted, selecting controlled observational studies of the association of prenatal antidepressant exposure with autism. Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analysis produced summary effect measures with 95% confidence intervals stratified by comparator group composition, antidepressant class, and trimester of exposure. RESULTS: Fourteen studies were included, with 13 reporting results using a population-based comparison group, five using a psychiatric control group, and four using a discordant-sibling control group. Eight of the 14 studies were rated poor because of inadequate control for prenatal depression and maternal ethnicity. Autism risk estimates after prenatal exposure to any antidepressant were decidedly different for population-based designs (hazard ratio=1.42, 95% CI=1.18, 1.70; odds ratio=1.58, 95% CI=1.25, 1.99) compared with psychiatric control (hazard ratio=1.14, 95% CI=0.84, 1.53; odds ratio=1.24, 95% CI=0.93, 1.66) and discordant-sibling (hazard ratio=0.97, 95% CI=0.68, 1.37; odds ratio=0.85, 95% CI=0.54, 1.35) designs. Findings for prenatal exposure to selective serotonin reuptake inhibitors were similar. Meta-regression of population-based studies demonstrated that despite statistical adjustment, ethnicity differences remained a significant source of study heterogeneity. CONCLUSIONS: In this meta-analysis, neither psychiatric control nor discordant-sibling designs supported an association between prenatal antidepressant exposure and autism. Discordant-sibling designs effectively addressed surveillance bias in pharmacovigilance reports derived from national registries and other large databases.

Antidepressivos/uso terapêutico , Transtorno Autístico/epidemiologia , Grupos Controle , Transtorno Depressivo/tratamento farmacológico , Complicações na Gravidez/tratamento farmacológico , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Feminino , Humanos , Farmacovigilância , Gravidez , Modelos de Riscos Proporcionais , Projetos de Pesquisa , Fatores de Risco , Irmãos
Artigo em Inglês | MEDLINE | ID: mdl-32349401


The promotion of communicative competence in students play a key role in schools for the purpose of improving social, emotional and coexistence relationships in Secondary Education students. The development of said competence can represent a great strategy to improve conflicts in the classroom, notably bullying. We used a quasi-experimental pre-test and post-test control group design with a sample of 55 students from the city of Salamanca (Spain) to analyse the level of conflict and their perceptions about bullying during the 2017-2018 academic year. The anti-bullying programme called the Improvement of Coexistence and Communicative Competence (ICCC) programme used is. The behaviour of students based on their level of coexistence with the group of classmates was measured by the INSEBULL instrument (Bullying Assessment Instrument), which added one more dimension of own elaboration. The results showed that, even though the significant levels of conflict, they decreased substantially once the ICCC programme was applied. Furthermore, we found differences between the control and experimental groups which underlined the effectiveness of the program. Regarding gender, no differences were found in the experimental group. This study shows that the development of communicative competence in students has a significant impact on their level of coexistence with other classmates, although the results suggested the need for longitudinal implementation of the programme in order to improve school coexistence and social skills of students from the early stages of education.

Bullying , Comunicação , Estudantes , Adolescente , Bullying/prevenção & controle , Criança , Grupos Controle , Feminino , Humanos , Relações Interpessoais , Masculino , Negociação , Instituições Acadêmicas , Espanha
Medicine (Baltimore) ; 99(10): e19366, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150082


BACKGROUND: Perimenopause is a period that every woman must go through, most people are more or less affected by perimenopausal symptoms, it to affect women's health, work, life, and economy. As acupuncture treatment is more and more increasing in perimenopausal symptoms, there have also been many clinical trials about it. But the results of the trials are inconsistent. Therefore, we will conduct a systematic review and meta-analysis of the safety and efficacy of perimenopausal symptoms treated with acupuncture. METHODS: The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. RCT study on different acupuncture interventions for perimenopausal symptoms will be searched in 8 databases (PubMed, EMBASE, the Cochrane Library, the web of science, CBM, CNKI, WAN FANG, and VIP). Besides, the search will also be performed on the clinical trial research platform if necessary. The primary outcome that will be extracted: the Flushes per 24 hours, the Frequency of hot flashes, the severity of hot flashes, the menopause-related symptom score, the treatment efficacy, the adverse event. Endnote software X8 will be used for study selection, STATA 13.0 and Review Manager software 5.3 will be used for analysis and synthesis. These studies selection, data extraction, and risk of bias assessment will be conducted by 2 independent reviewers. RESULTS: This study will provide the results: 1. the primary and secondary outcome indicators of different acupuncture intervention measures (traditional hand acupuncture, moxibustion, ear acupuncture, laser, acupressure points) for perimenopausal symptoms. 2. The effects of different control groups (medicine control, routine care, waiting, and sham acupuncture control) on the analysis results will be reported, especially the effects of different sham acupuncture control (invasive/noninvasive) on the analysis results. CONCLUSION: This systematic review and meta-analysis study hopes to provide useful evidence for better use of different types of acupuncture in treat perimenopausal symptoms and better design of control groups in related clinical trials. In addition, the research conclusion will be published in peer journals.OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/VZCKU Ethics and dissemination This conclusion of the study will be published in peer journals. The ethical approval is not required because there is no direct involvement of human.

Terapia por Acupuntura/normas , Perimenopausa/psicologia , Terapia por Acupuntura/métodos , Idoso , Protocolos Clínicos , Grupos Controle , Feminino , Humanos , Metanálise como Assunto , Pessoa de Meia-Idade , Revisões Sistemáticas como Assunto , Resultado do Tratamento
Arthroscopy ; 36(2): 613-614, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32014189


The results of anterior cruciate ligament repair are not satisfactory. While some cohort studies reported optimistic outcomes, even using augmentation and modern rehabilitation procedures, repair of anterior cruciate ligament ruptures should not be done outside well-designed studies as the overwhelming literature is quite negative on short-term results. The steps from basic science through animal surgery to clinical studies have still not resulted in techniques for daily use.

Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Animais , Ligamento Cruzado Anterior/cirurgia , Grupos Controle
Invest. educ. enferm ; 38(1): [E02], febrero 15 2020. Tab 1, Tab 2, Tab 3, Diagram 1
Artigo em Inglês | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1051482


Objective. This work sought to determine the effect of an educational intervention based on the stages of change in promoting physical activity in employees in the Mashhad airport in Iran. Methods. This was a quasi-experimental study conducted with the participation of 60 volunteers (30 in the intervention group and 30 in the control group) who were in the stages of contemplating or preparing for change in physical activity. The intervention consisted in educational activities provided during home visits, telephone calls, group training sessions, and delivery of printed material. To gather the information, the study used five questions on the stage in which they were for behavioral change in physical activity, according to the Theoretical Model by Marcus et al., (1. pre-contemplation, 2. contemplation, 3. preparation, 4. action, and 5. maintenance), and the International Questionnaire on Physical Activity. Changes in the stages were evaluated during three moments: upon entering the study, at the end of the intervention (8th month), and two months after the second evaluation (10th month). Results. During the 10th month evaluation, it was noted that 26.7% of the subjects from the intervention group versus 3.3% from the control group improved their physical activity and were in the action stage (p<0.01). Conclusion. The educational intervention based on stages of change is effective in promoting physical activity in the participants and may be used in educational programs that seek to improve physical activity in the employees studied.

Objetivo. Determinar o efeito de uma intervenção educacional baseada nos estágios de mudança na promoção da atividade física nos funcionários do aeroporto de Mashhad, no Irã. Métodos Estudo quase experimental realizado com a participação de 60 voluntários (30 no grupo intervenção e 30 no grupo controle) que estavam nos estágios de contemplação ou preparação para a mudança na atividade física. A intervenção consistiu em atividades educativas realizadas durante visitas domiciliares, telefonemas, sessões de treinamento em grupo e entrega de material impresso. Para a coleta de informações, foram utilizadas 5 questões no estágio em que se destinava à mudança de comportamento na atividade física, conforme o Modelo Transteórico de Marcus et al. (1. pré-contemplação, 2. Contemplação, 3. Preparação, 4. Ação e 5. Manutenção) e o Questionário Internacional de Atividade Física. As alterações nas etapas foram avaliadas em três momentos: na admissão ao estudo, ao final da intervenção (mês 8) e dois meses após a segunda avaliação (mês 10). Resultados. Na avaliação de 10 meses, observou-se que 26.7% dos indivíduos no grupo intervenção versus 3.3% no grupo controle melhoraram a atividade física e estavam no estágio de ação (p<0.01). Conclusão A intervenção educacional baseada nos estágios de mudança é eficaz na promoção da atividade física dos participantes e pode ser usada em programas educacionais que visam melhorar a atividade física dos funcionários.

Objetivo. Determinar el efecto de una intervención educativa basada en las etapas de cambio en la promoción de la actividad física en los empleados del aeropuerto de Mashhad en Irán. Métodos. Estudio cuasiexperimental realizado con la participación de 60 voluntarios (30 en el grupo de intervención y 30 en el grupo control) quienes se encontraban en las etapas de contemplación o preparación para el cambio en la actividad física. La intervención consistió en actividades educativas proporcionadas durante visitas domiciliarias, llamadas telefónicas, sesiones de capacitación en grupo y entrega de material impreso. Para la recolección de información se utilizaron 5 preguntas sobre la etapa en la que se encontraba para el cambio de comportamiento en la actividad física, según el Modelo Transteórico de Marcus et al. (1. pre-contemplación, 2. contemplación, 3. preparación, 4. acción y 5. mantenimiento), y el Cuestionario Internacional de Actividad Física. Los cambios en las etapas se evaluaron en 3 momentos: al ingreso al estudio, al finalizar la intervención (mes 8) y dos meses después de la segunda evaluación (mes 10). Resultados. En la evaluación de los 10 meses se apreció que el 26.7% de los sujetos del grupo de intervención versus el 3.3% del grupo control mejoraron su actividad física y se encontraban en la etapa de acción (p<0.01). Conclusión. La intervención educativa basada en las etapas de cambio es efectiva en la promoción de la actividad física en los participantes por lo que puede ser empleada en programas educativos que tengan como objetivo mejorar la actividad física de los empleados

Humanos , Educação em Saúde , Exercício Físico , Grupos Controle , Inquéritos e Questionários , Aeroportos , Modelos Teóricos
Handb Exp Pharmacol ; 257: 101-117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31595416


Control groups are expected to show what happens in the absence of the intervention of interest (negative control) or the effect of an intervention expected to have an effect (positive control). Although they usually give results we can anticipate, they are an essential component of all experiments, both in vitro and in vivo, and fulfil a number of important roles in any experimental design. Perhaps most importantly they help you understand the influence of variables that you cannot fully eliminate from your experiment and thus include them in your analysis of treatment effects. Because of this it is essential that they are treated as any other experimental group in terms of subjects, randomisation, blinding, etc. It also means that in almost all cases, contemporaneous control groups are required. Historical and baseline control groups serve a slightly different role and cannot fully replace control groups run as an integral part of the experiment. When used correctly, a good control group not only validates your experiment; it provides the basis for evaluating the effect of your treatments.

Análise de Variância , Grupos Controle , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
Psychiatr Hung ; 35(1): 20-29, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31854319


BACKGROUND: The measure of health-related quality of life (HRQoL) among children with mental disorders is still in early ages, even though the worldwide-pooled prevalence of psychiatric diagnoses among children and adolescents is around 13%. Several studies confirmed that these children have impaired social and school functioning and low HRQoL. Mental disorders among children often remain undiagnosed or diagnosed too late, in that case additional negative effects could be expected. The aim of the current study was to identify psychiatric disorders in children who participated in a clinical study as a "healthy" control group and measure its effects on HRQoL. METHODS: The inclusion criteria for control participated children were not having ongoing or previous psychiatric or psychological treatment. In the second step control children (n=79, age range 6-15) were divided into two subgroups according to achieved diagnostic criteria. Measures were Mini International Neuropsychiatric Interview Kid and Inventory for the Assessment of the Quality of Life in Children and Adolescents. For data analyzing due to unequal sample sizes robust Welch t-test with omega squared, Spearman's rank correlation coefficients and logistic regression were applied. RESULTS: According to the children and parents control group with diagnoses have lower HRQoL in school, peer relationships and mental health dimensions than control group without diagnoses. Furthermore, by the children's report this difference exists in the domain of time spent alone, by the parent proxy report exist in the somatic health and general dimensions. An increasing number of diagnoses decreased HRQoL in most areas. The presence of psychiatric diagnoses by children increase 8 times more likely to have low HRQoL in the domain of school and 4 times in the domain of time spent alone. CONCLUSIONS: These results draw attention to the relative high ratio of undiagnosed mental disorders in the control group and for the low HRQoL of these children. Screening of psychiatric disorders in schools should be crucial and the earliest recourse of treatment in the identified children. The findings of this study also underline the importance of assessing HRQoL from different perspectives.

Grupos Controle , Nível de Saúde , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Qualidade de Vida/psicologia , Adolescente , Criança , Humanos , Pais
Anesth Analg ; 130(4): 857-868, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31880627


BACKGROUND: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. While volumetric and gravimetric blood loss measurement techniques have been shown to increase PPH detection compared to visual estimation of blood loss (vBL), a combination of these methods has not been evaluated. The primary aim of this study was to compare the change in odds of PPH detection after vaginal delivery (VD; the intervention series) versus cesarean delivery (CD; the control series) before versus after implementation of a device (Triton L&D, Gauss Surgical, Inc, Los Altos, CA) that combines gravimetric and volumetric estimation of blood loss (tBL). METHODS: After institutional review board (IRB) approval, patients were identified who had a VD or CD at our institution 3 months before and 3 months after the implementation of a tBL device for VD. The levels and trends in odds of PPH detection (the primary outcome, defined as blood loss ≥500 mL for VD and ≥1000 mL for CD) were compared within and between delivery methods before and after implementation of the device. Secondary outcomes were blood loss ≥1000 mL, total blood loss, secondary uterotonic use, and a composite outcome related to PPH management (transfusion, vasopressor administration, and/or surgical procedures). A post hoc subgroup analysis compared nadir hematocrit, hematocrit reduction ≥10%, and difference between vBL or tBL and calculated blood loss (cBL) between VDs before and after introduction of the device. All outcome comparisons were performed using segmented regression with inverse probability of treatment weighting. RESULTS: The weighted odds ratio (wOR) of PPH detection post- versus preimplementation of the device was 2.74 (95% confidence interval [CI], 1.39-5.41; P = .004) for VDs versus 1.43 (95% CI, 0.72-2.85; P = .304) for CDs (P for interaction .190). No difference was detected in the secondary outcomes for VDs between time periods. In the subgroup of VD patients who had postdelivery hematocrits measured, the mean difference between vBL or tBL and cBL was smaller in the tBL (mean ± standard deviation [SD]: -237 ± 522 mL) versus vBL group (-600 ± 596 mL; weighted difference in means [95% CI]: 349 mL [13-684]; P = .042). CONCLUSIONS: In this interrupted time series analysis, the odds of PPH detection after VD increased after implementation of the tBL device. However, a statistical difference was not detected between the increase in PPH detection post- versus preimplementation of the device in VDs versus CDs.

Perda Sanguínea Cirúrgica/prevenção & controle , Parto Obstétrico/métodos , Hemorragia Pós-Parto/prevenção & controle , Adulto , Cesárea/estatística & dados numéricos , Grupos Controle , Feminino , Hematócrito , Humanos , Recém-Nascido , Análise de Séries Temporais Interrompida , Mortalidade Materna , Hemorragia Pós-Parto/epidemiologia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Resultado do Tratamento
Revista Digital de Postgrado ; 9(1): e189, 2020. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1095033


Evaluar el impacto educativo en pacientes con Diabetes Mellitus tipo 2 (DMT2) e Hipertensión arterial (HTA), y su efecto en la calidad de vida. Métodos: Se realizó un estudio intervención en comunidad, en pacientes con diagnóstico de DMT2 e HTA, en la consulta de Medicina Interna. Resultados: Participaron 314 pacientes, distribuidos en un grupo estudio (n = 160) y grupo control (n = 154). Sin diferencias en edad (p = 0,491) y sexo (p = 0,747). En la calidad de vida de pacientes DM entre pre y post charla, en cada grupo, sin diferencias entre grupos en pre-charla (p = 0,869), pero sí en post-charla (p = 0,001), siendo calidad de vida más alta en el grupo estudio (98,2%) que en grupo control (76,9%). Al evaluar los cambios entre pre y post charla, se observó que pre charla en el grupo estudio tuvo 86% de alta calidad de vida, posterior aumentó a 98,2%, cambio estadístico (p = 0,008), en grupo control en cambio, la calidad de vida pre charla fue 87% pasó a 76,9% posterior a ésta, aun así, fue un cambio significativo (p = 0,025) La calidad de vida en HTA, sin diferencias en pre y post charla. La comparación entre pre charla y post charla, en el grupo estudio, no tuvo cambios (p = 0,157) como igualmente en el grupo control (p = 0,317). Conclusiones: Se demostró el impacto positivo de un plan educativo en calidad de vida de los pacientes con diabetes, mas no en pacientes hipertensos(AU)

To evaluate the educational impact in patients with Type 2 Diabetes Mellitus (T2DM) and arterial hypertension (AHT), and its effect on quality of life. Methods: A community intervention study was carried out in patients diagnosed with T2DM and HBP in the Internal Medicine department. Results: 314 patients participated, distributed in a study group (n = 160) and control group (n = 154). No differences in age (p = 0.491) and sex (p = 0.747). In the quality of life of DM patients between pre and post talk, in each group, without differences between groups in pre-talk (p = 0.869), but in post-talk (p = 0.001), with higher quality of life in the study group (98.2%) than in the control group (76.9%). When evaluating the changes between pre and post talk, it was observed that pre-talk in the study group had 86% of high quality of life, later it increased to 98.2%, statistical change (p = 0.008), in control group instead, Pre-chat quality of life was 87%, after 76.9%, it was still a significant change (p = 0.025) Quality of life in HTA, without differences in pre and post talk. The comparison between pre-talk and post-talk, in the study group, did not change (p = 0.157) as well as in the control group (p = 0.317). Conclusions: The positive impact of an educational plan on the quality of life of diabetic patients was demonstrated, but not in hypertensive patients(AU)

Qualidade de Vida , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/prevenção & controle , Planos e Programas de Saúde , Educação de Pacientes como Assunto , Grupos Controle , Inquéritos e Questionários/estatística & dados numéricos , Progressão da Doença
Int. j. odontostomatol. (Print) ; 14(3): 442-447, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1114919


Dietary supplements are being consumed with an increasingly high frequency among sports practitioners, whether at professional and/or amateur level. The supplements contain some nutritional properties in their composition, so they can dissolute the hydroxyapatite crystals of the enamel and favor the process of dental corrosion. The objective was to measure the corrosive power of protein-based supplementation (Whey Protein), under conditions that resemble the use of the supplement by the athletes, increasing the ecological validity of the study. The teeth of the test group (TG) were placed in contact with the Whey protein solution and then exposed to artificial saliva. And the teeth of the control group (CG) were exposed only to artificial saliva. The analysis occurred in natural healthy molar teeth, so that each tooth of the TG was immersed in 50 mL of supplement for 1.5 minutes and then placed in contact with the artificial saliva for 30 seconds. The same procedure was performed 5 times a day for 30, 60, 90, 120, 150 and 180 days. Each group, in its time (TG0 to TG180), underwent analysis of superficial roughness with the aid of optical profilometer (Talysurf CCI®, 3D model). The control group (CG) did not change its superficial roughness. Half of the teeth of the test group (TG) suffered loss of enamel surface. The values, in micrometers, of surface loss of the TG samples were 1.21; 2.1; 2.0; 1.04; 0.97; 0.8; 0.53; 1.14; 1.9; 2.0; 1.66; 1.80. The dietary supplement (Whey protein®) may be a potential cause of the dental corrosion process, considering the demineralization of hydroxyapatite that occurs along with the surface enamel loss.

Los suplementos dietéticos se consumen con una frecuencia cada vez más alta entre los practicantes de deportes, sea a nivel profesional y / o aficionado. Los suplementos contienen algunas propiedades nutricionales en su composición, por lo que pueden disolver los cristales de hidroxiapatita del esmalte y favorecer el proceso de corrosión dental. El objetivo fue medir el poder corrosivo de la suplementación a base de proteínas (proteína de suero), en condiciones que se asemejan al uso del suplemento por parte de los atletas, aumentando la validez ecológica del estudio. Los dientes del grupo de prueba (TG) se pusieron en contacto con la solución de proteína de suero y luego se expusieron a saliva artificial. Y los dientes del grupo de control (CG) estuvieron expuestos solo a saliva artificial. El análisis se realizó en dientes molares sanos naturales, cada diente del TG se sumergió en 50 ml de suplemento durante 1,5 minutos y luego se puso en contacto con la saliva artificial durante 30 segundos. El mismo procedimiento se realizó 5 veces al día durante 30, 60, 90, 120, 150 y 180 días. Cada grupo, en su momento (TG0 a TG180), se sometió a un análisis de rugosidad superficial con la ayuda de un perfilómetro óptico (Talysurf CCI®, modelo 3D). El grupo de control (CG) no cambió su rugosidad superficial. La mitad de los dientes del grupo de prueba (TG) sufrieron pérdida de la superficie del esmalte. Los valores, en micrómetros, de pérdida de superficie de las muestras de TG fueron 1.21; 2.1; 2,0; 1.04; 0,97; 0.8; 0,53; 1.14; 1.9; 2,0; 1,66; 1.80. El suplemento dietético (Whey protein®) puede ser una causa potencial del proceso de corrosión dental, considerando la desmineralización de la hidroxiapatita que ocurre junto con la pérdida de esmalte superficial.

Humanos , Esportes , Proteínas na Dieta/efeitos adversos , Desmineralização do Dente/induzido quimicamente , Suplementos Nutricionais/efeitos adversos , Saliva/química , Técnicas In Vitro , Projetos Piloto , Grupos Controle , Durapatita , Corrosão , Corrosão Dentária , Concentração de Íons de Hidrogênio