RESUMEN
We assessed the association between asthma and suicidality in a nationally representative sample of US high school students. Data came from the 2007, 2009, and 2011 Youth Risk Behavioral Surveys. Weighted prevalence estimates and adjusted odds ratios were calculated. Subjects with asthma are more likely to report 2-week sadness (35.2%) compared to those without asthma (26.7%). Teens with asthma are also more likely to report suicide ideation (20.1% vs. 15%), planning (15.7% vs. 12.1%), attempt (10.1% vs. 6.9%), and treatment for attempt (3.5% vs. 2%). Although the unadjusted association between lifetime asthma and suicide attempts is statistically significant (crude odds ratio 1.5 (95% CI 1.3-1.8)), after controlling for confounders, that association is no longer statistically significant (AOR 1.2 (1-1.6)). Thus, this increase in suicidality seems to be due to the increased prevalence of sadness among teens with asthma. Similar patterns were seen in the 2007 and 2009 surveys.
Asunto(s)
Asma/psicología , Depresión/etiología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adolescente , Asma/complicaciones , Depresión/epidemiología , Femenino , Humanos , Modelos Logísticos , Masculino , Prevalencia , Estudiantes/psicología , Intento de Suicidio/psicología , Encuestas y Cuestionarios , Estados Unidos/epidemiologíaRESUMEN
Neurological diseases are common in inflammatory bowel disease (IBD) patients, but their exact prevalence is unknown. Method We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD) and 70 with ulcerative colitis (UC)] and 50 controls (gastritis and dyspepsia) over 3 years. Results Our standard neurological evaluation (that included electrodiagnostic testing) revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045), 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001) and 5.1 times more likely to develop autonomic complaints (p = 0.027). UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027) and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015). Conclusion In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia.
Asunto(s)
Colitis Ulcerosa/complicaciones , Enfermedad de Crohn/complicaciones , Enfermedades del Sistema Nervioso Periférico/etiología , Adulto , Análisis de Varianza , Brasil/epidemiología , Estudios de Casos y Controles , Dispepsia/complicaciones , Femenino , Gastritis/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Periférico/epidemiología , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Estadísticas no ParamétricasRESUMEN
Neurological diseases are common in inflammatory bowel disease (IBD) patients, but their exact prevalence is unknown. Method We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD) and 70 with ulcerative colitis (UC)] and 50 controls (gastritis and dyspepsia) over 3 years. Results Our standard neurological evaluation (that included electrodiagnostic testing) revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045), 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001) and 5.1 times more likely to develop autonomic complaints (p = 0.027). UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027) and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015). Conclusion In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia. .
Doenças neurológicas são comuns em pacientes com doença inflamatória intestinal (DII), mas sua prevalência exata é desconhecida. Métodos Nós estudamos prospectivamente a presença de distúrbios neurológicos em 121 pacientes com DII [51 com doença de Crohn (DC) e 70 com colite ulcerativa (RCU)] e 50 controles (gastrite e dispepsia) ao longo de 3 anos. Resultados A avaliação neurológica padronizada (que incluiu testes eletrodiagnósticos) demonstrou que pacientes com DC foram 7,4 vezes mais propensos a desenvolver neuropatias de fibras grossas do que os controles (p = 0,045), 7,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,001) e 5,1 vezes mais propensos a desenvolver queixas autonômicas (p = 0,027). Pacientes com RCU foram 5 vezes mais propensos de desenvolver neuropatia de fibras grossas (p = 0,027) e 3,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,015). Conclusão Em resumo, este é o primeiro estudo prospectivo a estabelecer que os pacientes tanto com DC quanto de RCU são mais propensos a doenças neuromusculares do que os pacientes com gastrite e dispepsia. .
Asunto(s)
Animales , Femenino , Embarazo , Antiinflamatorios/farmacología , Dexametasona/farmacología , Microcirculación/efectos de los fármacos , Músculo Esquelético/irrigación sanguínea , Efectos Tardíos de la Exposición Prenatal , Acetilcolina/farmacología , Peso Corporal/efectos de los fármacos , Bradiquinina/farmacología , Endotelio Vascular/efectos de los fármacos , Inhibidores Enzimáticos/farmacología , Arteria Femoral/efectos de los fármacos , Arteria Femoral/embriología , Microcirculación/embriología , NG-Nitroarginina Metil Éster/farmacología , Nitroprusiato/farmacología , Ovinos , Resistencia Vascular/efectos de los fármacos , Vasoconstricción/efectos de los fármacos , Vasodilatación/efectos de los fármacos , Vasodilatadores/farmacologíaRESUMEN
Although the association of schizophrenia and winter birth has been replicated many times in the Northern hemisphere, studies in the Southern hemisphere have been less consistent in their findings. A study from NE Brazil indicated the period between May and July, 3 months after the peak in rainfall, as a risk period for schizophrenia birth. We report findings from a random selection of charts (N = 1789) from the only public inpatient psychiatric facility in Ceará, Brazil (2 degrees to 5 degrees S). We compared the seasonality of birth in the schizophrenia group (N = 406) to multiple control groups: (1) psychosis not otherwise specified (N = 868), (2) other psychiatric diagnoses (N = 515), and (3) the average monthly birth rate in the general population. Patients with schizophrenia had a significantly greater risk of being born in the risk period compared with any of the control groups. There is a significant association between rainfall in a month and schizophrenia births 3 (p = 0.03) and 4 months (p = 0.01) later. This study corroborates findings of a significant seasonality in schizophrenia births in northeast Brazil.
Asunto(s)
Lluvia , Esquizofrenia/epidemiología , Estaciones del Año , Tasa de Natalidad , Brasil/epidemiología , Clima , HumanosRESUMEN
OBJECTIVES: The link between income disparities and health has been studied mostly in developed nations. This study assesses the relationship between income disparities and life expectancy in Brazil and measures the impact of illiteracy rates on the association. METHODS: The units of analysis (n = 27) are all the Brazilian states and the federal capital. Simple and multiple linear regressions were performed to measure the association between income disparity, measured by the Gini coefficient, gross domestic product (GDP) per capita, and illiteracy rate. Data came from publicly available sources at the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics. RESULTS: Income disparities and illiteracy rates were negatively associated with life expectancy in Brazil. GDP per capita was positively associated with life expectancy. The inclusion of illiteracy rates in the regression model removed the effect of income disparities. CONCLUSIONS: Illiteracy rate is strongly associated with life expectancy in Brazil. This finding is in accord with reports from the United States and has implications for health policy and planning for both developed and developing countries.
Asunto(s)
Escolaridad , Renta/clasificación , Esperanza de Vida , Factores Socioeconómicos , Anciano , Brasil/epidemiología , Factores de Confusión Epidemiológicos , Economía , Humanos , Renta/estadística & datos numéricos , Modelos Lineales , Persona de Mediana EdadRESUMEN
A implementaçäo da figura do doador presumido e as recentes mudanças na regulamentaçäo do transplante no Brasil iräo aumentar a disponibilidade de órgäos no país. O avanço no cuidado de doentes portadores de insuficiência grave de órgäos, por sua vez, irá aumentar a demanda por esses mesmos órgäos. Há considerável literatura apoiando o envolvimento de psiquiatras no processo de seleçäo dos candidatos ao transplante. Pesquisas mostram que fatores psicossociais influenciam na adesäo ao tratamento e, conseqüentemente, no prognóstico destes pacientes. A partir de uma revisäo da literatura existente, articula-se os componentes e lógicas de uma avaliaçäo psicossocial abrangente, propondo sua inserçäo na avaliaçäo pré-operatória dos pacientes para o recebimento de órgäo
Asunto(s)
Humanos , Psiquiatría , Rol del Médico , Selección de Paciente , Trasplante de Órganos/psicología , Trastornos Mentales , Cooperación del Paciente , Entrevista Psicológica , Grupo de Atención al PacienteRESUMEN
A importância de vari veis demogr ficas, clínicas e contextuais na decisäo de hospitalizar feita em emergência psiqui trica foi avaliada neste trabalho. Os prontu rios de 481 pacientes atendidos na Emergência do Hospital de Saúde Mental de Messejana, em Fortaleza, durante um período de duas semanas, foram analisados retrospectivamente. Dos 481 pacientes examinados, 60 foram internados. A importância das vari veis relacionadas com a decisäo de internar foi examinada através da regressäo logística. Os resultados demonstram que cinco vari veis estäo mais associadas com a decisäo de internar: concordância do paciente com o internamento, escore baixo na escala de avaliaçäo funcional, concordância da família com o internamento, procedência do interior do Estado, violência demonstrada na ocasiäo da consulta de emergência. Ao contr rio de outros centros, esta pesquisa demonstra que o diagnóstico näo é uma das principais vari veis na decisäo de internar. Conclui-se que a decisäo de internar nesta amostra brasileira obedece a critérios diferentes de outros países
Asunto(s)
Humanos , Servicios Médicos de Urgencia , Servicios de Urgencia Psiquiátrica , Hospitalización , PsiquiatríaRESUMEN
A importancia de variaveis demograficas, clinicas e contextuais na decisao de hospitalizar feita em emergencia psiquiatrica foi avaliada neste trabalho. Os prontuarios de 481 pacientes atendidos na Emergencia do Hospital de Saude Mental de Messejana, em Fortaleza, durante um periodo de duas semanas, foram analisados retrospectivamente. Dos 481 pacientes examinados, 60 foram internados. A importancia das variaveis relacionadas com a decisao de internar foi examinada atraves de regressao logistica. Os resultados demonstram que cinco variaveis estao mais associadas com a decisao de internar: concordancia do paciente com o internamento, escore baixo na escala de avaliacao funcional, concordancia da familia com o internamento, procedencia do interior do Estado, violencia demonstrada na ocasiao da consulta na emergencia. Ao contrario de outros centros, esta pesquisa demonstra que o diagnostico nao e uma das principais variaveis na decisao de internar. Conclui-se que a decisao de internar nesta amostra brasileira obedece a criterios diferentes de outros paises.