Introduction: Depressive disorders can be defined as episodes of depressed mood or loss of interest and pleasure in nearly all activities. Depression is considered a major mental disorder in the elderly, and may be related to quality of sleep and living habits as well as being influenced by sociodemographic factors. Objective: To determine the prevalence of depression among the elderly in the north-east of Brazil, and the relationship between the condition and socio-demographic profile, quality of sleep and living habits. Method: An epidemiological cross-sectional study was performed of the elderly population of the urban area of Campina Grande, Paraiba. The dependent variable presence of depression and the independent variables sociodemographic aspects, sleep quality, and living habits were investigated. Estimates of the prevalence of the variables were obtained and association measured using Poisson Regression. A 5% significance level was adopted for the estimates. Results: The study included 168 elderly patients with a mean age of 72.3 (±7.8) years, most of whom, 122 (72.6%), were women. Depression was identified in 72 elderly persons (42.9%). Elderly women were twice as associated with depression (PR=2.26) as men. A subjective quality of sleep of very good (PR=0.34), medium/high risk of sleep disturbance (PR = 4.08), taking sleeping medications once or twice (PR=5.21) and three times or more (PR=8.69) a week, daytime dysfunction once or twice (PR=14.40) and three times or more (PR=27) a week and poor quality of sleep on the Pittsburgh index were associated with depression in bivariate analysis, although there was no relationship following multivariable adjustment. Conclusion: The prevalence of depression was high in the studied population, being noticeably more frequent among elderly woman. However, it was not possible to detect an association between depression and living habits and sleep quality.
Isolated and painless infraspinatus atrophy and weakness are described in two top-level volleyball players. EMG revealed isolated denervation of the infraspinatus muscle. One athlete continued playing and his clinical features have not changed. The other recovered her muscle bulk and strength after stopping playing. These findings were attributed to intense activity of the shoulder joint, without any direct trauma. On clinical grounds, we did not consider these cases as true examples of entrapment neuropathy. Pathogenesis was related to traction of the distal branch of the suprascapular nerve during the act of reception of the ball ("Manchete").
It was found that obesity for women, and depression and cardiovascular dysfunction risking for men were associated with EDS in the elderly. The variable sex is a confusion condition for the association with sleepiness.
SUMMARYThis cross-sectional study assessed the grade of physical impairments in 61 individuals with leprosy receiving multidrug therapy (MDT) under the Brazilian Unified Health System (SUS), and residing in Campina Grande, Paraíba State, Brazil. Impairments were assessed using the disability grade (DG) standardized by the WHO, and the EHF score (Eye-Hand-Foot sum of impairment scores). Impairments were detected in 25 (41%) of the subjects. A total of 14 (23%) patients scored DG 1, while 11 (18%) were assigned DG 2. The EHF score ranged from 1 to 10 points in the group of patients with physical impairments, with a mean score of 3.6 points. The majority of individuals with impairments were affected in at least two sites. We conclude that the EHF score showed overlapping impairments in the segments examined and may be more appropriate than the DG classification system for describing the degree of physical impairment of leprosy patients.
Introdução: Acidente vascular encefálico isquêmico (AVCI) é o comprometimento neurológico mais comum na população geral. Seu estudo permite conhecer sua dinâmica epidemiológica objetivando tomada de decisões em saúde pública. Objetivos: Traçar perfil temporal da ocorrência de AVCI e sua taxa de mortalidade hospitalar. Métodos: Utilizou-se um delineamento ecológico de série temporal nas Unidades Federativas do Nordeste brasileiro. Os dados foram coletados no Sistema de Informação Hospitalar sobre os episódios de AVCI, entre os anos de 1998 e 2010. Resultados: Observou-se grande redução na incidência de AVCI no período analisado, com redução de 31,33 casos/105 habitantes em média até 2002, para 11,4 casos/105, após esse período. A incidência de AVCI aumenta com a idade e não há diferença entre os sexos. A mortalidade hospitalar não mostrou alteração considerável no período. Conclusão: A incidência de AVCI no Nordeste do Brasil declinou a partir do ano de 2002, mantendo um novo paradigma.
-Restless legs syndrome (RLS) is characterized by disturbing leg sensations associated to sleep complaints and excessive daytime somnolence. In the elderly, it affects 10 to 35%. Our objective was to determine the prevalence of RLS in institutionalized elderly, analyzing its relationship with clinical, laboratorial and neurophysiological features. We conducted a cross-sectional study of all the subjects under treatment on a chronic-care geriatric service by using face-to-face interviews, which include sleep complaints, the Epworth Sleepiness Scale and standardized questions addressing the four minimal criteria for RLS. The patients with RLS diagnosis received neurological examination, laboratorial tests and three of them, neurophysiological evaluation. The prevalence of RLS was 15.6%. Women were more affected and sleep complaints were frequent. There was no significance on other clinical, laboratorial or neurophysiological findings. We conclude that RLS is a prevalent condition in elderly, may lead to sleep complaints and is often underdiagnosed.KEY WORDS: restless legs syndrome, prevalence, elderly. Síndrome de pernas inquietas em idosos institucionalizadosResumo -Síndrome de pernas inquietas (SPI) é um distúrbio caracterizado por sensações parestésicas nos membros, aliviadas à sua movimentação ativa. A patologia se associa freqüentemente a distúrbios do sono, sendo especialmente prevalente em idosos (10 a 35%), e pode estar associada a outras condições clínicas. Nosso objetivo foi determinar a prevalência da SPI em idosos institucionalizados, analisando queixas do sono e outras condições clínicas, bioquímicas e neurofisiológicas. Nós entrevistamos os idosos em regime de internato no Instituto São Vicente de Paula (Campina Grande, PB), utilizando questionários específicos para o sono, escala de sonolência de Epworth e um questionário para critérios mínimos para o diagnóstico de SPI. Os pacientes com o diagnóstico de SPI submeteram-se a exame neurológico, laboratoriais, e três deles, a exame neurofisiológico. A prevalência de SPI foi 15,62%, afetando especialmente o sexo feminino. Queixas de sono e patologias associadas foram freqüentes, embora os testes laboratoriais e neurofisiológicos não tenham acrescentado dados significativos. Nós concluímos que SPI é prevalente em idosos, relaciona-se a alterações do sono e é freqüentemente subdiagnosticada. PALAVRAS-CHAVE: síndrome de pernas inquietas, prevalência, idosos.
RESUMO -Objetivo:Avaliar o conhecimento do diagnóstico e conduta de médicos não-neurologistas quanto às cefaléias primárias. Método: 91 médicos foram solicitados a diagnosticar e estabelecer condutas em três histórias de pacientes com características clínicas de migrânea sem aura (MSA), cefaléia do tipo tensional crônica (CTTC) e migrânea com aura (MCA), elaboradas de acordo com a Classificação Internacional das Cefaléias -2ª Edição (CIC-II). Resultados: MSA: dois profissionais (2,2%) fizeram o diagnóstico correto, 54 (59,3%) diagnosticaram migrânea sem especificar o subtipo. CTTC: 15 médicos (16,5%) diagnosticaram cefaléia de tensão sem especificar o subtipo. MCA: 26 (28,6%) fizeram o diagnóstico de migrânea e apenas um médico (1,1%) fez o diagnóstico correto do subtipo. Dezesseis médicos (17,6%) afirmaram conhecer a CIC-II. Conclusão: A maioria dos médicos não-neurologistas desconhece os critérios utilizados para diagnóstico e classificação das formas mais freqüentes de cefaléias primárias.PALAVRAS-CHAVE: diagnóstico, classificação internacional das cefaléias, cefaléias primárias, migrânea com aura, migrânea sem aura, cefaléia do tipo tensional crônica.primary headaches: a diagnostic approach by non-neurologist doctors ABSTRACT -Objective: To evaluate the knowledge of diagnostic and posture of non-neurologist doctors concerning primary headaches. Method: 91 doctors were asked to diagnose and establish procedures on three patient histories presenting clinic characteristics of migraine without aura (MA), chronic tensiontype headache (CTTH) and migraine with aura (MO), according to the International Classification of Headaches -2 nd Edition (CIC-II). Results: MSA: Two professionals (2.2%) were accurate in their diagnostic, 54 (59.3%) said it was migraine but did not specify the subtype. CTTC: 15 doctors (16.5%) diagnosed tensiontype headache but did not specify the subtype. MCA: 26 (28.6%) said it was migraine, and only one doctor (1.1%) was right about the subtype. Sixteen doctors (17.6%) said to be aware of CIC-II. Conclusion: Most of non-neurologist doctors do not know the diagnostic criteria used to diagnose and to classify the most frequent forms of primary headaches.KEY WORDS: diagnostic, international classification of headaches, primary headaches, migraine with aura, migraine without aura, chronic tension-type headache. Neste estudo procuramos avaliar o conhecimento diagnóstico e conduta, por médicos não-neurologistas, frente a quadros clínicos sugestivos de cefaléias primárias.
RESUMOIntrodução: O EEG tem sido usado, desde sua descoberta, como um importante método diagnóstico auxiliar, especialmente para a epilepsia. Objetivo: Avaliar o papel do EEG no diagnóstico de epilepsia, em uma clínica na cidade de Campina Grande (PB). Método: Foram analisados 1015 formulários de admissão pré-exame, selecionando-se aqueles cujos motivos de solicitação referiam-se a pacientes portadores ou com suspeita de epilepsia. Resultados: Foram analisados 259 laudos que se enquadravam na metodologia. Destes, 113 (43,6%) foram anormais, com a ocorrência de descargas em 78 (30,1%), sendo generalizadas em 30 (11,6%), focais em 44 (17%) e multifocais em 4 (1,5%). Alentecimentos anormais ocorreram em 19 (7,3%), sendo focais em 11 (4,2%) e generalizados em 8 (3,1%). Assimetria dos ritmos de base ocorreu em 16 (6,2%). Conclusão: O papel do EEG para o diagnóstico da epilepsia é importante na população estudada, sendo o seu índice de positividade semelhante a outros observados na literatura.Unitermos: epilepsia, EEG, diagnóstico. ABSTRACTValue of EEG in suspected or diagnosis of epilepsy Introduction: Since it was discovered, EEG has been used as an important auxiliary diagnostic method in neurology, especially in epilepsy. Objective: To verify the value of EEG for supporting the diagnosis of epilepsy. Method: We retrospectively analyzed 1015 pre-admission reports from an outpatient clinic of Campina Grande (PB) selecting the ones with suspected or confirmed epilepsy diagnosis. Results: Analyzing 259 EEG reports, which were in accordance with the methodology, we found abnormalities in 113 (43.6%). Generalized discharges occurred in 30 (11.6%), focal discharges in 44 (17%) and multifocal discharges in 4 (1.5%). Abnormal slow waves occurred in 19 (7.3%), being focal in 11 (4.2%) and diffuse in 8 (3.1%). Background asymmetry occurred in 16 (6.2%). Conclusion: EEG is important for supporting the diagnosis of epilepsy and our results were similar to other reports in the literature. INTRODUÇÃOO Eletrencefalograma (EEG) foi introduzido no iní-cio do século passado, por Hans Berger. Desde então, as técnicas eletrencefalográficas têm evoluído, e o exame vem sendo utilizado como coadjuvante para o diagnóstico de diversas patologias. Dentre estas, a epilepsia ocupa uma posição privilegiada, uma vez que esta afecção neurológica está freqüentemente associada com alterações neuronais, que resultam em potenciais eletromagnéti-cos detectáveis por eletrodos de escalpo (descargas epileptiformes). Por ser um exame de execução relativamente fácil e de baixo custo, o EEG se constitui num dos mais importantes auxílios diagnósticos para a epilepsia, especialmente quando se consideram as condições socioeconômicas representadas pela população assistida pelo Sistema Único de Saúde (SUS). Muitas vezes, o EEG pode
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