OBJETIVO: determinar a prevalência de depressão e ansiedade em mulheres climatéricas e os prováveis fatores responsáveis por sua ocorrência. MÉTODOS: em estudo transversal, foram selecionadas 93 mulheres que frequentaram um ambulatório de climatério no período de maio de 2006 a agosto de 2007. Como critério de inclusão foram consideradas mulheres na faixa etária de 40 a 65 anos e que concordaram em participar do projeto. Os critérios de exclusão foram: pacientes em uso de terapia hormonal, hormonioterapia por implantes, DIUs e injetáveis de depósito nos últimos seis meses, endocrinopatias que levassem a irregularidades menstruais, hepatopatias, coagulopatias, uso de drogas que interferissem no ciclo menstrual, ansiolíticos e antidepressivos (pois o uso dessas drogas era indicativo de diagnóstico prévio de alterações do humor), histerectomizadas, ooforectomizadas, portadoras de câncer e de enfermidades psiquiátricas, pacientes que tivessem sido submetidas à radioterapia ou quimioterapia. Foram aplicados quatro questionários durante a entrevista: Anamnese, contendo dados sociodemográficos, clínicos e hábitos de vida; Índice Menopausal de Blatt-Kupperman, com o objetivo de diagnosticar as pacientes portadoras de síndrome climatérica; a subescala para Ansiedade, derivada da escala Hospitalar para Ansiedade e Depressão (HADS-A), com a finalidade de diagnosticar os casos de Ansiedade e o Inventário de Depressão de Beck, com o intuito de diagnosticar as mulheres portadoras de depressão. Foram realizadas as análises descritivas e de correlação entre as variáveis; o teste do χ 2 e de Hosmer-Lemeshow, usando o programa Software Statistica versão 6. RESULTADOS: a média de prevalência de depressão entre as pacientes avaliadas foi de 36,8% enquanto que da ansiedade foi de 53,7%. Não houve diferença significativa entre a prevalência de depressão e ansiedade e as três fases do climatério. Observou-se relação significativa entre a presença de sintomas climatéricos de intensidade moderada e o aparecimento dessas alterações do humor (p<0,001). A depressão foi mais frequente em mulheres portadoras de ansiedade (OR=4,2) e insônia (OR=4,9) sendo a atividade remunerada considerada fator de proteção (OR=0,2). Os fatores de risco relacionados à ansiedade foram a presença de depressão (OR=6,1) e os antecedentes de tensão pré-menstrual (OR=7,0). CONCLUSÕES: a prevalência de depressão e ansiedade é elevada no climatério, sendo possível detectar fatores de risco relacionados à sua ocorrência.Abstract PURPOSE: to determine the prevalence of depression and anxiety in climacteric women and the probable factors responsible for its occurrence. METHODS: a transversal study that has selected 93 women attended at a climacteric outpatient

the prevalence of depression and anxiety is high in climacterium, being possible to detect risk factors related to their occurrence.

Introduction: Adequate sedation is one of the cornerstones of good quality gastrointestinal endoscopy (GIE). Propofol sedation has increased significantly but there has been much debate over whether it can be administered by endoscopists. The aim of this prospective trial was to compare nonanesthesiologist-administered propofol (NAAP) and monitored anesthesia care (MAC). Methods: A total of 2000 outpatients undergoing GIE at Hospital Albert Einstein (São Paulo, Brazil), a tertiary-care private hospital, were divided into two matched groups: NAAP (n = 1000) and MAC (n = 1000). In NAAP, propofol doses were determined by the endoscopist. A second physician stayed in the room during the entire procedure, according to local regulations. In MAC, the anesthesiologist administered propofol. Results: In total, 1427 patients (71.3 %) were ASA (American Society of Anesthesiologists) class I and 573 were ASA class II. In NAAP, patients received more propofol + fentanyl (61.1 % vs. 50.5 %; P < 0.05) and there were fewer cases of deep sedation (44.7 % vs. 66.1 %; P < 0.05). Hypoxemia rates were similar (12.8 % for NAAP and 11.2 % for MAC; P = 0.3) but these reverted more rapidly in MAC (4.22 seconds vs. 7.26 seconds; P < 0.05). Agitation was more frequent in MAC (14.0 % vs. 5.6 %; P < 0.05). No later complications were observed. Patient satisfaction was very high and similar in both groups. Conclusion: In this setting, NAAP was as safe and effective as MAC for healthy patients undergoing GIE.Clinical trial ref. no.: U1111-1134-4430

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Background: Various functional asymmetries detected by different neurophysiological and neuroimaging methods have been reported in the literature on the Attention Deficit Hyperactivity Disorder (ADHD), some of them pointing to the right hemisphere activity. In our attempt to discriminate the ADHD patients from normal subjects by hierarchical clustering of behavioural, psychological and event related potential (ERP) variables, the late P3 component of potentials from the right central region (C4) proved to be one of the most informative parameters (in preparation for publication). Here, we have studied the differences in ERPs between the left (C3) and right (C4) central leads and relation of this asymmetry to ADHD diagnosed using DSM. Methods: 16 typically developing (TD) boys and 16 boys diagnosed with ADHD according to DSM-IV-TR, aged 10-13 years, were examined by the Attentional Network Test (ANT), with simultaneous recording of the respective ERPs. The intergroup differences in the ERP amplitude parameters in the left (C3) and right (C4)central channels and in the difference in these parameters between the two channels ('C3 minus C4') were accessed. These characteristics were compared to the subjects' DSM scores and ANT performance. Results:The target-related potentials' late characteristics from the C4 showed significant difference between the groups, while no difference was observed for the C3. Only in the ADHD patients, both the left and right late target ERP characteristics correlated with the reaction time, while the DSM scores did not show any correlations in both groups. The difference between ERPs of the C3 and C4 channels inside the interval of 40-290 ms after target onset was positive in the ADHD group and negative in the control group. This asymmetry correlated with DSM scores, mainly to hyperactive and impulsive criteria. Conclusion:In ADHD patients, the results suggest ERP pattern of right-side functional predominance in the motor control, which correlates to DSM scores, mainly to hyperactive and impulsive criteria.