Perfil sociodemográfico, clínico e funcional de idosos com Doença de Parkinson / Sociodemographic, clinical and functional profile of elderly people with Parkinson's disease

Objetivo: Descrever as características sociodemográficas, clínicas e funcinais de idosos com doença de Parkinson. Método:Trata-se de um Estudo descritivo transversal, que avaliou os pacientes idosos no estágio I a III da Doença de Parkinson. Aplicados a Escala (Unified Parkinson’s Disease Rating Scale – UPDRS-III), Hoehn & Yahr Scale, Mini Balance Evaluation Systems Test (MiniBESTest), Parkinson´s Disease Questionnaire-39 e questionário sociodemográfico. Resultado: 52% do sexo feminino, 44% relataram oito anos ou mais de escolaridade, média de idade foi de 72,90 anos (DP=7,0), 25 (50%) dos pacientes relataram ter a DP há mais de cinco anos e 33 (68%) apontaram que a doença se iniciou antes dos 59 até 75 anos, 22 (44%) dos pacientes  relataram quedas nos últimos seis meses, 68% dos pacientes apresentaram HY 2,5 e 3, média na UPDRS-III foi de 21,4 (DP=7,3), na MiniBESTest de 15,08 (DP=6,33); no TUGT pontuação média de 16,35 (DP=10,27) e 31,34 (DP=23,18) no TUGT COG e o escore médio no PDQ-39 foi de 41,96 (DP=17,30). Conclusão: Com base nos resultados deste estudo, constatou-se que o perfil sociodemográfico predominante é feminino, com alta escolaridade e presença de histórico de quedas em seis meses, com relação aos fatores clínicos metade dos idosos relataram ter a doença há mais de cinco anos e a maioria estavam na fase leve a moderada da doença, os fatores funcionais evidenciaram, declínio no equilíbrio, comprometimento motor, dificuldade para percepção de realização de AVD, com diminuição da velocidade de marcha e pior desempenho motor e cognitivo

Systematic Review and Critical Analysis of Cost Studies Associated with Parkinson's Disease

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease worldwide, affecting more than four million people. Typically, it affects individuals above 45, when they are still productive, compromising both aging and quality of life. Therefore, the cost of the disease must be identified, so that the use of resources can be rational and efficient. Additionally, in Brazil, there is a lack of research on the costs of neurodegenerative diseases, such as PD, a gap addressed in this study. This systematic review critically addresses the various methodologies used in original research around the world in the last decade on the subject, showing that costs are hardly comparable. Nonetheless, the economic and social impacts are implicit, and important information for public health agents is provided.Hosp Israelita Albert Einstein, Programa Posgrad, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Movement Disorders Dept Neurol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Sao Paulo, SP, BrazilHosp Israelita Albert Einstein, Neurol Program, Sao Paulo, SP, BrazilMovement Disorders Department in Neurology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, BrazilUniversidade Federal de São Paulo (UNIFESP), São Paulo, SP, BrazilWeb of Scienc

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Depression in Parkinson's disease: clinical-epidemiological correlates and comparison with a controlled group of non-parkinsonian geriatric patients Depressão na doença de Parkinson: análise clínico-epidemiológica e comparação com um grupo de pacientes geriátricos não parkinsonianos

OBJECTIVE: To evaluate and compare the frequency and severity of major depression in patients with Parkinson's disease and in individuals older than 60 years without neurological, rheumatological and/or oncological comorbidities. METHOD: We studied 50 patients with Parkinson's disease older than 60 years and 50 geriatric patients. Subjects with scores of Mini Mental State Examination indicating cognitive impairment were excluded. We used Diagnostic Statistical Manual of Mental Diseases-IV criteria to diagnose major depression and the Hamilton Depression Scale and the Beck Depression Inventory to rate it. The Unified Parkinson's Disease Rating Scale part 3 and the Hoehn and Yahr Scale were used to evaluate the motor severity of Parkinson's disease. RESULTS: Major depression was found in 42% of Parkinson's disease patients and in 10% of the geriatric patients (p RESUMO OBJETIVO: Avaliar e comparar a freqüência e intensidade de depressão em um grupo com doença de Parkinson e um grupo sem doença de Parkinson, sem doença neurológica, reumatológica e/ou oncológica acompanhados na Universidade Federal de São Paulo. MÉTODO: Avaliaram-se 50 indivíduos com doença de Parkinson (grupo Parkinson) e 50 indivíduos sem doença de Parkinson (grupo controle) acima de 60 anos. Excluíram-se indivíduos que demonstravam alterações cognitivas pelo Mini Exame Estado Mental. Todos foram submetidos à entrevista estruturada para depressão maior do Diagnostic Statistical Manual of Mental Diseases-IV, Escala de Depressão de Hamilton e Inventário de Depressão de Beck. O grupo Parkinson foi submetido à avaliação física por Unified Parkinson Disease Rating Scale 3 e Hoehn-Yahr. RESULTADOS: 42% do grupo Parkinson e 10% do grupo controle (p < 0,001) apresentaram depressão maior, segundo os critérios do Diagnostic Statistical Manual of Mental Diseases-IV. As médias de pontuação da Escala de Depressão de Hamilton e do Inventário de Depressão de Beck foram maiores no grupo Parkinson (p < 0,001). Em tempo de doença (p = 0,020), as médias dos escores de Hoehn-Yahr (p = 0,027) e Unified Parkinson Disease Rating Scale 3 (p = 0,029) foram maiores nos parkinsonianos com depressão. CONCLUSÕES: A freqüência (42%) e a intensidade de depressão maior foram maiores no grupo Parkinson. A depressão maior também esteve significativamente relacionada à pior função motora dos parkinsonianos

Núcleos de Ensino da Unesp: artigos 2007

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data