Non-pharmacological interventions for sleep and quality of life: a randomized pilot study

Objetivo: estimar los efectos de intervenciones no farmacológicas para mejoría de la calidad de sueño y de vida de pacientes con insuficiencia cardíaca. Método: estudio piloto de un ensayo controlado aleatorizado con 32 individuos asignados a cuatro grupos. El sueño fue evaluado por el Pittsburgh Sleep Quality Inventory y la calidad de vida relacionada a la salud fue evaluada por el Minnessota Living with Heart Failure Questionnaire, en el inicio y en las semanas 12 y 24 del estudio. Las medias de los resultados por grupo de intervención fueron comparadas con análisis de covariancia y los tamaños de los efectos fueron calculados para cada grupo. Resultados: todos los grupos presentaron mejoría en la calidad de sueño y de vida relacionada a la salud al final del período de intervención (12 semanas) y en el seguimiento de 24 semanas; sin embargo, las diferencias no fueron estadísticamente significativas (p entre 0,22 y 0,40). En 12 semanas, los efectos de las intervenciones variaron entre -2,1 y -3,8 en la calidad de sueño y de -0,8 a -1,7 en la calidad de vida, con valores similares en 24 semanas. Conclusión: los efectos obtenidos en este estudio pueden servir de base para calcular el tamaño de la muestra y del poder estadístico en estudios confirmatorios. Registro Brasileño de Ensayos Clínicos - RBR 7jd2mm.Objective: to estimate the effects of non-pharmacological interventions to improve the quality of sleep and quality of life of patients with heart failure. Method: pilot study of a randomized controlled trial with 32 individuals assigned to four groups. Sleep was assessed using the Pittsburgh Sleep Quality Inventory, while health-related quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire, at the baseline and at the 12th and 24th weeks. The means of the outcomes according to intervention groups were compared using analysis of covariance; effect sizes were calculated per group. Results: all groups experienced improved quality of sleep and health-related quality of life at the end of the intervention (week 12) and at follow-up (week 24), though differences were not statistically significant (p between 0.22 and 0.40). The effects of the interventions at the 12th week ranged between -2.1 and -3.8 for the quality of sleep and between -0.8 and -1.7 for quality of life, with similar values at the 24th week. Conclusion: the effects found in this study provide information for sample size calculations and statistical power for confirmatory studies. Brazilian Clinical Trials Registry - RBR 7jd2mmObjetivo: estimar os efeitos de intervenções não farmacológicas para melhora da qualidade de sono e de vida de pacientes com insuficiência cardíaca. Método: estudo piloto de um ensaio controlado aleatorizado com 32 indivíduos alocados em quatro grupos. Sono foi avaliado pelo Pittsburgh Sleep Quality Inventory e qualidade de vida relacionada à saúde avaliada pelo Minnessota Living with Heart Failure Questionnaire, no início e nas semanas 12 e 24 do estudo. As médias dos desfechos por grupo de intervenção foram comparadas por análise de covariância, e os tamanhos dos efeitos calculados para cada grupo. Resultados: todos os grupos apresentaram melhora na qualidade de sono e de vida relacionada à saúde no final do período de intervenção (12 semanas) e no seguimento de 24 semanas, mas as diferenças não foram estatisticamente significantes (p entre 0,22 e 0,40). Em 12 semanas, os efeitos das intervenções variaram entre -2,1 e -3,8 na qualidade de sono e de -0,8 e -1,7 na qualidade de vida, com valores similares em 24 semanas. Conclusão: os efeitos obtidos neste estudo podem servir de base para cálculos de tamanho amostral e poder estatístico em estudos confirmatórios. Registro Brasileiro de Ensaios Clínicos - RBR 7jd2m

Shiga Toxin–Producing \u3ci\u3eEscherichia coli\u3c/i\u3e in Montana: Bacterial Genotypes and Clinical Profiles

The diseases and virulence genes associated with Shiga toxin–producing Escherichia coli (STEC) are characterized incompletely. We analyzed, by polymerase chain reaction, 82 STEC isolates collected prospectively in Montana and profiled associated illnesses by patient chart review. All E. coli O157:H7 contained stx2-group genes, as well as eae, iha, espA, and ehxA; 84% contained stx1. Non-O157:H7 STEC less frequently contained stx1( P = .046 ), stx2 (P \u3c .001), iha (P \u3c .001), eae, and espA (P = .039 for both), were isolated less often from patients treated in emergency departments (P = .022), and tended to be associated less frequently with bloody diarrhea (P = .061). There were no significant associations between stx genotype and bloody diarrhea, but isolates containing stx2c or stx2d-activatable were recovered more often from patients who underwent diagnostic or therapeutic procedures (P = .033). Non-O157:H7 STEC are more heterogeneous and cause bloody diarrhea less frequently than do E. coli O157:H7. Bloody diarrhea cannot be attributed simply to the stx genotype of the infecting organism

Chamomile gel versus urea cream to prevent acute radiation dermatitis in head and neck cancer patients : results from a preliminary clinical trial

We assessed safety and potential efficacy of a chamomile gel compared with urea cream to prevent acute radiation dermatitis in head and neck cancer patients. We assessed safety and potential efficacy of the chamomile gel in escalating concentrations of 2.50%, 5.00% and 8.35% of chamomile. Concentration of 8.35% was chosen for a randomized trial comparing chamomile gel (8.35%) with urea cream (n=24per group), for potential efficacy to delay or prevent radiation dermatitis in these patients. Preliminary results demonstrate a delayed onset of dermatitis, with onset of Grade 2 dermatitis at 5.1 (1.3) weeks in the chamomile group and 4.5 (1.3) weeks in the urea group (effect size of 0.46). Itching, burning and hyperpigmentation were more frequently reported in the urea group. Results indicates a potential efficacy of the chamomile gel. Further studies are needed to confirm the effect of the chamomile gel in reducing or delaying the occurrence of radiation dermatitis

ESTADO DE SAÚDE PERCEBIDO E ADESÃO FARMACOLÓGICA EM PACIENTES SUBMETIDOS À INTERVENÇÃO CORONÁRIA PERCUTÂNEA

Os objetivos foram avaliar o estado de saúde percebido e a adesão farmacológica, e verificar a correlação entre essasmedidas em pacientes submetidos à intervenção coronária percutânea, após alta hospitalar. Trata-se de estudotransversal realizado no período de maio de 2011 a julho de 2012. Utilizaram-se os instrumentos SF-36 e Medidade Adesão aos Tratamentos, com 101 pacientes. Destes, 54 (53,5%) eram homens, a idade média era 59,5±10,3 e32 (32,7%) haviam passado por tratamento cardíaco prévio. Todos utilizavam medicamentos anti-hipertensivos;99 (98%) utilizavam antiagregantes plaquetários; 98 (97%), redutores de colesterol e 59 (58,4%), vasodilatadorescoronarianos. A média do número de medicamentos utilizados foi 6,8±2,1. A adesão farmacológica foi verificada em 98 (97%) pacientes. Os participantes apresentaram melhor estado de saúde nos componentes “Aspectos sociais” e “Capacidade funcional”. Constataram-se correlações positivas e de moderada magnitude entre as medidas de adesão e “Capacidade funcional”, “Estado geral de saúde” e “Aspectos sociais”. Houve correlação entre adesão farmacológica e estado de saúde percebido

Pelvic tenderness is not limited to the prostate in chronic prostatitis/chronic pelvic pain syndrome (CPPS) type IIIA and IIIB: comparison of men with and without CP/CPPS

Background: We wished to determine if there were differences in pelvic and non-pelvic tenderness between men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) Type III and men without pelvic pain. Methods: We performed the Manual Tender Point Survey (MTPS) as described by the American College of Rheumatology on 62 men with CP/CPPS Type IIIA and IIIB and 98 men without pelvic pain. We also assessed tenderness of 10 external pelvic tender points (EPTP) and of 7 internal pelvic tender points (IPTP). All study participants completed the National Institutes of Health Chronic Prostatitis Symptom Inventory (NIH CPSI). Results: We found that men with CPPS were significantly more tender in the MTPS, the EPTPS and the IPTPS. CPSI scores correlated with EPTP scale but not with IPTP scale or prostate tenderness. Prostatic tenderness was present in 75% of men with CPPS and in 50% of men without CPPS. Expressed prostatic fluid leukocytosis was not associated with prostatic tenderness. Conclusion: Men with CP/CPPS have more tenderness compared to men without CPPS. Tenderness in men with CPPS is distributed throughout the pelvis and not specific to the prostate

Somatic and cognitive-affective depressive symptoms among patients with heart disease: differences by sex and age

OBJECTIVE: this study investigated the association of somatic and cognitive-affective symptoms with sex and age, among patients hospitalized with heart disease. METHOD: this study was a secondary analysis of two previous observational studies totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two public hospitals in Ribeirão Preto, state of São Paulo, Brazil. Somatic and cognitive-affective symptoms were assessed using the subscales of the Beck Depression Inventory - I (BDI-I). RESULTS: of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0) for males and 56.2 years (SD= 12.1) for females. Analyses of variance showed an effect of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms), but no effect of age. Women presented with higher mean values than men in both BDI-I subscales: 7.1 (4.5) vs. 5.4 (4.3) for somatic, and 8.3 (7.9) vs. 6.7 (7.2) for cognitive-affective symptoms. There were no differences by age for somatic (p=0.84) or cognitive-affective symptoms (p=0.84). CONCLUSION: women hospitalized with heart disease had more somatic and cognitive-affective symptoms than men. We found no association of somatic and cognitive-affective symptoms with age. Future research for these patients could reveal whether these differences according to sex continue throughout the rehabilitation process

Metodos de estimação de componentes de variança em modelos mistos

Orientador: Jose Ferreira de CarvalhoDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Matematica, Estatistica e Ciencia da ComputaçãoResumo: Modelos lineares compostos de fatores fixos e aleatórios são chamados mistos. Nestes casos surge a necessidade da estimação dos componentes de variância, isto é, das variâncias dos fatores aleatórios do modelo. Compilamos neste trabalho os seguintes métodos de estimação de componentes de variância: momentos ou análise de variância, MINQUE, MIVQUE, máxima verossimilhança e máxima verossimilhança restrita, acompanhados de algoritmos para a resolução nu­mérica do problema de estimação. Apresentamos, ainda, dois exemplos reais da aplicação desses métodos de estimaçãoAbstract: We consider mixed linear models, that is, those composed of fixed and random components. The estimation of the variances of random components is the major problem in this setting. Several methods of estimation are considered and studied in great detail: MINQUE, MIVQUE, maximum likelihood and restricted maximum likelihood. Algorithms for actual computing of estimators are also presented. Two short examples are presented in order to show some possible differences in actual problemsMestradoMestre em Estatístic