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1.
Arq Neuropsiquiatr ; 81(5): 460-468, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37257466

RESUMEN

BACKGROUND: Levodopa-induced dyskinesia (LID) is a common motor complication of levodopa therapy in patients with Parkinson's disease (PD). Doxycycline is a widely used and inexpensive tetracycline with anti-inflammatory properties. OBJECTIVE: To evaluate the efficacy and safety of doxycycline in patients with PD and LID. METHODS: This was an open-label, uncontrolled, single-arm, single-center, phase 2 proof-of-concept study in patients with PD with functional impact of dyskinesia, which used levodopa three times daily, in a movement disorders clinic in Brazil. Participants were treated with doxycycline 200 mg/day for 12 weeks, with evaluations at baseline, week 4, and week 12 of treatment. The primary outcome measure was the change from baseline in the Unified Dyskinesia Rating Scale (UDysRS) total score at week 12, evaluated by two blinded raters. Key secondary outcomes measures were OFF time and ON time with troublesome dyskinesia in the PD home diary. RESULTS: Eight patients with PD were treated and evaluated. Doxycycline 200 mg/day reduced the UDysRS total score at week 12, compared with baseline (Friedman χ2 = 9.6; p = 0.008). Further, doxycycline reduced the ON time with troublesome dyskinesia (Friedman χ2 = 10.8; p = 0.004) without worsening parkinsonism. There were no severe adverse events, and dyspepsia was the commonest event. CONCLUSION: In this preliminary, open-label and uncontrolled trial, doxycycline was effective in reducing LID and safe after a 12-week treatment. Further well-designed placebo-controlled clinical trials with a longer duration and a larger number of participants are needed. CLINICAL TRIAL REGISTRATION: https://ensaiosclinicos.gov.br, identifier: RBR-1047fwbf.


ANTECEDENTES: A discinesia induzida por levodopa (DIL) é uma complicação motora comum da terapia com levodopa em pacientes com doença de Parkinson (DP). A doxiciclina é uma tetraciclina amplamente usada e barata, com propriedade anti-inflamatória. OBJETIVO: Avaliar a eficácia e segurança da doxiciclina em pacientes com DP e DIL. MéTODOS: Este foi um estudo aberto, não-controlado, de braço único, monocêntrico, fase 2 e de prova de conceito, em pacientes com DP e impacto funcional das discinesias, que usavam levodopa três vezes ao dia, em um ambulatório de distúrbios de movimento no Brasil. Os participantes foram tratados com doxiciclina 200 mg/dia por 12 semanas, com avaliações na base, na semana 4 e na semana 12 do tratamento. A medida de desfecho primário foi a mudança no escore total da Unified Dyskinesia Rating Scale (UDysRS) da base à semana 12, avaliada por dois avaliadores cegos. As medidas-chave de desfecho secundário fora o tempo em OFF e tempo em ON com discinesia problemática. RESULTADOS: Oito pacientes com DP foram tratados e avaliados. A doxiciclina 200 mg/dia reduziu o escore total da UDysRS na semana 12, comparado com a avaliação inicial (χ2 de Friedman = 9.6; p = 0.008). Além disso, a doxiciclina reduziu o tempo em ON com discinesia problemática (χ2 de Friedman = 10.8; p = 0.004) sem piorar o parkinsonismo. Não houve eventos adversos graves, e dispepsia foi o evento mais comum. CONCLUSãO: No presente estudo preliminar, aberto e não-controlado, a doxiciclina foi eficaz em reduzir as DIL e segura após tratamento por 12 semanas. Estudos clínicos bem-desenhados e placebo-controlados adicionais, com duração mais longa e maior número de participantes, são necessários.


Asunto(s)
Discinesia Inducida por Medicamentos , Discinesias , Enfermedad de Parkinson , Humanos , Levodopa/efectos adversos , Antiparkinsonianos/efectos adversos , Doxiciclina/uso terapéutico , Discinesia Inducida por Medicamentos/etiología , Discinesia Inducida por Medicamentos/complicaciones , Método Doble Ciego , Discinesias/complicaciones , Discinesias/tratamiento farmacológico
2.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;81(5): 460-468, May 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1447412

RESUMEN

Abstract Background Levodopa-induced dyskinesia (LID) is a common motor complication of levodopa therapy in patients with Parkinson's disease (PD). Doxycycline is a widely used and inexpensive tetracycline with anti-inflammatory properties. Objective To evaluate the efficacy and safety of doxycycline in patients with PD and LID. Methods This was an open-label, uncontrolled, single-arm, single-center, phase 2 proof-of-concept study in patients with PD with functional impact of dyskinesia, which used levodopa three times daily, in a movement disorders clinic in Brazil. Participants were treated with doxycycline 200 mg/day for 12 weeks, with evaluations at baseline, week4, and week 12 of treatment. The primary outcome measure was the change from baseline in the Unified Dyskinesia Rating Scale (UDysRS) total score at week 12, evaluated by two blinded raters. Key secondary outcomes measures were OFF time and ON time with troublesome dyskinesia in the PD home diary. Results Eight patients with PD were treated and evaluated. Doxycycline 200 mg/day reduced the UDysRS total score at week 12, compared with baseline (Friedman χ2 = 9.6; p = 0.008). Further, doxycycline reduced the ON time with troublesome dyskinesia (Friedman χ2 = 10.8; p = 0.004) without worsening parkinsonism. There were no severe adverse events, and dyspepsia was the commonest event. Conclusion In this preliminary, open-label and uncontrolled trial, doxycycline was effective in reducing LID and safe after a 12-week treatment. Further well-designed placebo-controlled clinical trials with a longer duration and a larger number of participants are needed. Clinical trial registration https://ensaiosclinicos.gov.br, identifier: RBR-1047fwbf


Resumo Antecedentes A discinesia induzida por levodopa (DIL) é uma complicação motora comum da terapia com levodopa em pacientes com doença de Parkinson (DP). A doxiciclina é uma tetraciclina amplamente usada e barata, com propriedade anti-inflamatória. Objetivo Avaliar a eficácia e segurança da doxiciclina em pacientes com DP e DIL. Métodos Este foi um estudo aberto, não-controlado, de braço único, monocêntrico, fase 2 e de prova de conceito, em pacientes com DP e impacto funcional das discinesias, que usavam levodopa três vezes ao dia, em um ambulatório de distúrbios de movimento no Brasil. Os participantes foram tratados com doxiciclina 200 mg/dia por 12 semanas, com avaliações na base, na semana 4 e na semana 12 do tratamento. A medida de desfecho primário foi a mudança no escore total da Unified Dyskinesia Rating Scale (UDysRS) da base à semana 12, avaliada por dois avaliadores cegos. As medidas-chave de desfecho secundário fora o tempo em OFF e tempo em ON com discinesia problemática. Resultados Oito pacientes com DP foram tratados e avaliados. A doxiciclina 200 mg/dia reduziu o escore total da UDysRS na semana 12, comparado com a avaliação inicial (χ2 de Friedman = 9.6; p = 0.008). Além disso, a doxiciclina reduziu o tempo em ON com discinesia problemática (χ2 de Friedman = 10.8; p = 0.004) sem piorar o parkinsonismo. Não houve eventos adversos graves, e dispepsia foi o evento mais comum. Conclusão No presente estudo preliminar, aberto e não-controlado, a doxiciclina foi eficaz em reduzir as DIL e segura após tratamento por 12 semanas. Estudos clínicos bem-desenhados e placebo-controlados adicionais, com duração mais longa e maior número de participantes, são necessários.

3.
Cannabis Cannabinoid Res ; 8(2): 374-378, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-35749710

RESUMEN

Background: Cannabidiol (CBD) is one of the main nonpsychoactive components of Cannabis sativa and may represent an alternative treatment for Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) in patients with Parkinson's disease (PD) and REM (Rapid Eye Movement) sleep behavior disorder (RBD). Objective: Our purpose was a post hoc exploratory analysis to evaluate the CBD's efficacy to improve the severity of RLS/WED symptoms in patients with PD and RBD. Methods: A post hoc exploratory analysis of a phase II/III, a parallel, double-blind, placebo-controlled clinical trial was conducted in 18 patients with RLS/WED and PD plus RBD associated. Six patients were randomized to the CBD group in doses of 75-300 mg, and twelve received placebo capsules. They were followed up for 14 weeks. The primary outcome was the severity of RLS/WED by Restless Legs Syndrome Rating Scale of the International Restless Legs Syndrome Study Group (IRLSSG). Results: CBD showed no difference in relationship to placebo for primary and secondary outcomes. Conclusion: CBD showed no reduction in the severity of RLS/WED manifestation in patients with PD and RBD.


Asunto(s)
Cannabidiol , Cannabis , Enfermedad de Parkinson , Trastorno de la Conducta del Sueño REM , Síndrome de las Piernas Inquietas , Humanos , Síndrome de las Piernas Inquietas/tratamiento farmacológico , Síndrome de las Piernas Inquietas/complicaciones , Síndrome de las Piernas Inquietas/diagnóstico , Cannabidiol/farmacología , Cannabidiol/uso terapéutico , Trastorno de la Conducta del Sueño REM/tratamiento farmacológico , Trastorno de la Conducta del Sueño REM/complicaciones , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/tratamiento farmacológico
4.
J Huntingtons Dis ; 11(1): 91-95, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35124656

RESUMEN

Huntington's disease (HD) is an inherited neurodegenerative disease characterized by motor, cognitive and behavioral deficits. Some evidence suggests that the endocannabinoid system participates in the pathophysiology of HD. We conducted a cross-sectional study comparing plasma levels of anandamide and 2-arachidonoylglycerol in manifest HD gene-expansion carriers (HDGEC) and healthy controls, finding no difference in endocannabinoid levels between the groups. Correlations between endocannabinoid levels and clinical scales (Mini-Mental State Examination, Hospital Anxiety and Depression Scale, Unified Huntington Disease Rating Scale) were non-significant. We found a significant association between body mass index and anandamide levels in healthy controls but not in HDGEC.


Asunto(s)
Enfermedad de Huntington , Enfermedades Neurodegenerativas , Estudios Transversales , Endocannabinoides , Heterocigoto , Humanos
5.
J Neural Transm (Vienna) ; 129(1): 55-63, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34940921

RESUMEN

Levodopa-induced dyskinesia (LID) is a common complication of Parkinson's disease (PD) therapy. Nitric oxide in the central nervous system may have a role in its pathophysiology. The present work investigates plasma and CSF levels of nitric oxide metabolites nitrite and nitrate in patients with PD, LID, and healthy control. We measured plasma and CSF nitrite and nitrate levels in patients with PD with and without LID and in healthy controls. The levels of plasma and CSF nitrite and nitrate were measured by ozone-based chemiluminescence. Sixty-seven participants were enrolled. CSF nitrite levels in patients with PD and LID were higher than in patients with PD without LID and healthy controls. CSF/plasma ratio of nitrite was higher in patients with PD and LID than in patients with PD without LID. The CSF/plasma ratio of nitrite in patients with PD and LID was higher than 1, indicating an intrathecal production of NO in patients with this motor complication. There was an increase in nitrate levels of CSF and CSF/plasma ratio of nitrate in patients with PD and LID compared to the healthy controls. Sex, age at evaluation, disease duration, and levodopa equivalent daily doses, as well as processing and storage time, did not critically influence these results. The present study demonstrated an increase in nitrite and nitrate levels in the central nervous system of patients with PD and LID. This finding strengthens the role of NO on LID pathophysiology.


Asunto(s)
Discinesias , Enfermedad de Parkinson , Antiparkinsonianos/efectos adversos , Humanos , Levodopa/efectos adversos , Óxido Nítrico
6.
Mol Neurobiol ; 59(2): 1140-1150, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34855116

RESUMEN

The existence of few biomarkers and the lack of a better understanding of the pathophysiology of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD) require new approaches, as the metabolomic analysis, for discoveries. We aimed to identify a metabolic profile associated with LID in patients with PD in an original cohort and to confirm the results in an external cohort (BioFIND). In the original cohort, plasma and CSF were collected from 20 healthy controls, 23 patients with PD without LID, and 24 patients with PD with LID. LC-MS/MS and metabolomics data analysis were used to perform untargeted metabolomics. Untargeted metabolomics data from the BioFIND cohort were analyzed. We identified a metabolic profile associated with LID in PD, composed of multiple metabolic pathways. In particular, the dysregulation of the glycosphingolipid metabolic pathway was more related to LID and was strongly associated with the severity of dyskinetic movements. Furthermore, bile acid biosynthesis metabolites simultaneously found in plasma and CSF have distinguished patients with LID from other participants. Data from the BioFIND cohort confirmed dysregulation in plasma metabolites from the bile acid biosynthesis pathway. There is a distinct metabolic profile associated with LID in PD, both in plasma and CSF, which may be associated with the dysregulation of lipid metabolism and neuroinflammation.


Asunto(s)
Discinesia Inducida por Medicamentos , Enfermedad de Parkinson , Antiparkinsonianos/efectos adversos , Cromatografía Liquida , Discinesia Inducida por Medicamentos/metabolismo , Humanos , Levodopa/efectos adversos , Metaboloma , Enfermedades Neuroinflamatorias , Enfermedad de Parkinson/tratamiento farmacológico , Espectrometría de Masas en Tándem
7.
Mov Disord ; 36(7): 1711-1715, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-33754375

RESUMEN

BACKGROUND: REM sleep behaviour disorder (RBD) is a common non-motor feature of Parkinson's disease (PD). Cannabidiol (CBD) is one of the main non-psychoactive components of Cannabis sativa and may represent an alternative route for treating RBD. OBJECTIVE: This study assessed the efficacy and safety of CBD for RBD in PD. METHODS: We conducted a phase II/III, double-blind, placebo-controlled clinical trial in 33 patients with RBD and PD. Patients were randomized 1:1 to CBD in doses of 75 to 300mg or matched capsules placebo and were followed up for 14 weeks. The primary outcomes were the frequency of nights with RBD, CGI-I, and CGI-S. RESULTS: CBD showed no difference to placebo for primary outcomes. Regarding secondary outcomes, we observed a significant improvement in average sleep satisfaction from the 4th to 8th week in the CBD versus placebo group with P = 0.049 and P = 0.038, respectively. CONCLUSION: CBD, as an adjunct therapy, showed no reduction in RBD manifestations in PD patients. A transient improvement in sleep satisfaction with a dose of 300mg has been noted. © 2021 International Parkinson and Movement Disorder Society.


Asunto(s)
Cannabidiol , Enfermedad de Parkinson , Trastorno de la Conducta del Sueño REM , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/tratamiento farmacológico , Trastorno de la Conducta del Sueño REM/tratamiento farmacológico , Trastorno de la Conducta del Sueño REM/etiología
8.
Artículo en Inglés | MEDLINE | ID: mdl-30783550

RESUMEN

Background: Idiopathic focal dystonia is a motor syndrome associated with dysfunction of basal ganglia circuits. Observations have suggested that many other non-motor symptoms may also be part of the clinical picture. The aim was to assess the prevalence and correlation of non-motor symptoms in patients with common idiopathic focal or segmental dystonia. Methods: In a single-center cross-sectional case-control study, we evaluated the presence of pain, neuropsychiatric symptoms, and sleep alterations in 28 patients with blepharospasm, 28 patients with cervical dystonia, 24 patients with writer's cramp, and 80 control subjects matched for sex, age, and schooling. We obtained clinical and demographic data, and evaluated patients using the Fahn-Marsden Dystonia Rating Scale and other specific scales for dystonia. All subjects completed the following questionnaires: Beck Depression Inventory, Beck Anxiety Inventory, Social Phobia Inventory, Apathy Scale, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Brief Pain Scale, and the World Health Organization Quality of Life brief scale. Results: The patients presented more symptoms of depression, anxiety, and apathy than the control subjects. They also reported worse quality of sleep and more pain complaints. Patients with blepharospasm were the most symptomatic subgroup. The patients had worse quality of life, and the presence of pain and symptoms of apathy and depression were the main influences for these findings, but not the severity of motor symptoms. Discussion: Patients with dystonia, especially those with blepharospasm, showed higher prevalence of symptoms of depression, anxiety, apathy, worse quality of sleep, and pain. These symptoms had a negative impact on their quality of life.


Asunto(s)
Blefaroespasmo/epidemiología , Trastornos Distónicos/epidemiología , Tortícolis/epidemiología , Anciano , Ansiedad/epidemiología , Apatía , Blefaroespasmo/psicología , Estudios de Casos y Controles , Estudios Transversales , Depresión/epidemiología , Trastornos Distónicos/psicología , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Dolor/epidemiología , Prevalencia , Trastornos del Sueño-Vigilia/epidemiología , Tortícolis/psicología
9.
RGO (Porto Alegre) ; 67: e2019009, 2019. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1002963

RESUMEN

ABSTRACT Objective: To evaluate the association between the presence of tooth decay and the eating habits, oral hygiene habits, and socioeconomic profile of children in the fifth grade at the state secondary and elementary school Pedro Simão in Alegre, ES. Methods: Questionnaires were used to evaluate the socioeconomic profile, eating habits, and oral hygiene habits of the fifth-grade students. Then an epidemiological survey on dental caries and on the presence of dental plaque was conducted. After the first clinical examination, the students completed educational and preventive activities about nutritional and oral hygiene education. One week after the performance of the educational actions, the dental plate index was evaluated. Results: The variables "family income" and "number of members" in the family were statistically significant (p≤0.20) with caries association using a bivariate regression analysis. However, variables related to diet did not present a significant association with caries (p>0.20). The initial and final IHOS were 1.85 and 0.92, respectively, which was significantly lower after the intervention (p<0.05). The DMFT was 1.81, which is higher than the average for the Southeast Brazil, obtained in 2010 by the Brazilian National Oral Health Survey (SB Brazil). Conclusion The caries prevalence was high in the sample studied, and the intervention was important to reduce the students' dental plaque levels and improve their oral hygiene condition. Thus, it is necessary to develop continuous educational programs so that oral health is maintained.


RESUMO Objetivo: Avaliar a associação entre a presença de cárie dentária com a dieta alimentar, hábitos de higiene oral e o perfil socioeconômico de crianças do 5° ano da Escola Estadual Ensino Fundamental e Médio Pedro Simão do Município de Alegre, Espírito Santos, Brasil. Métodos: Foram aplicados questionários para avaliar o perfil socioeconômico, os hábitos alimentares e hábitos de higiene oral de 26 escolares do 5° ano; em seguida, foram realizados levantamento epidemiológico em relação à cárie dentária e a presença de placa bacteriana. Após o primeiro exame clínico, foram realizadas atividades educativas e preventivas em educação nutricional e de higiene oral. Uma semana após a aplicação das ações educacionais, o índice de placa foi reavaliado. Resultados: As variáveis 'renda familiar' e 'número de membros na família' foram estatisticamente significativas (p≤0.20) pela análise de regressão bivariada, tendo associação com a cárie, porém, as variáveis relacionadas à dieta não apresentaram associação significativa (p>0.20) com a cárie. O IHOS inicial foi 1.85, e o final 0.92, sendo significativamente menor (p<0.05) após a intervenção realizada. O CPO-D foi de 1.81, resultado acima da média da região Sudeste do Brasil, obtida em 2010 pela Pesquisa Nacional de Saúde Bucal (SB Brasil). Conclusão: A prevalência de cárie foi elevada na amostra estudada e a intervenção realizada foi de suma importância para reduzir os níveis de placa bacteriana dental dos escolares e melhorar a condição da higiene oral, afirmando que é necessário desenvolver ações educativas continuadas para que a saúde seja mantida.

10.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;76(12): 821-826, Dec. 2018. tab
Artículo en Inglés | LILACS | ID: biblio-983863

RESUMEN

ABSTRACT Dystonia is a relatively common movement disorder but some of its epidemiological and clinical aspects have not been well characterized in Brazilian patients. Also, a new clinical classification for the disorder has been proposed and its impact on clinical practice is unclear. We aimed to describe the clinical and demographic characteristics of a Brazilian series of patients with primary dystonia, to estimate its local prevalence, and to explore the impact of using a new classification for dystonia. We identified 289 patients with primary dystonia over a 12-month period, of whom235 underwent a detailed evaluation. Patients with primary dystoniamade up one-sixth of all patients evaluated at the service where the study was conducted, with an estimated local prevalence of 19.8/100,000 inhabitants. The clinical and demographic characteristics of the patients were similar to those described elsewhere, with blepharospasm as the most common focal dystonia and most patients using sensory tricks that they judged useful on a day-to-day basis. The application of the new classification was easy and simple, and the systematic approach allowed for a better clinical characterization of our patients. We recognized two dystonic syndromes that were not described in the original article that proposed the classification, and suspected that the arbitrary distinction between generalized and multifocal dystonia seems not to be useful for patients with primary dystonia. In conclusion, the prevalence and clinical characteristics of our patients were not distinct from other studies and the new classification was shown to be practical and useful to characterize patients with dystonia.


RESUMO A distonia é um distúrbio de movimento relativamente comum e alguns de seus aspectos epidemiológicos e clínicos ainda não foram bem caracterizados em pacientes brasileiros. Além disso, uma nova classificação clínica para o transtorno foi proposta e seu impacto na prática clínica não é claro. Nosso objetivo é descrever as características clínicas e demográficas de uma série brasileira de pacientes com distonia primária, estimar sua prevalência local e explorar o impacto do uso de uma nova classificação para distonia. Foram identificados 289 pacientes com distonia primária (PDYS) durante um período de 12 meses, dos quais 235 foram submetidos a uma avaliação detalhada. Os pacientes com PDYS corresponderam a um sexto de todos os pacientes avaliados no serviço em que o estudo foi realizado, com uma prevalência local estimada de 19,8/100.000 habitantes. As características clínicas e demográficas dos pacientes foram semelhantes àquelas descritas em outros locais, com o blefaroespasmo como distonia focal mais comum e a maioria dos pacientes apresentando truques sensoriais que julgaram úteis no dia-a-dia. A aplicação da nova classificação foi fácil e simples, e a abordagem sistemática permitiu uma melhor caracterização clínica de nossos pacientes. Reconhecemos duas síndromes distônicas que não foram descritas no artigo original que propôs a classificação e suspeitamos que a distinção arbitrária entre distonia generalizada e multifocal parece não ser útil para pacientes com PDYS. Em conclusão, a prevalência e as características clínicas de nossos pacientes não foram distintas de outras amostras e a nova classificação mostrou-se prática e útil para caracterizar pacientes com distonia.


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Trastornos Distónicos/clasificación , Trastornos Distónicos/epidemiología , Blefaroespasmo/epidemiología , Brasil/epidemiología , Prevalencia , Estudios Transversales , Trastornos Distónicos/diagnóstico
11.
Arq Neuropsiquiatr ; 76(12): 821-826, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30698205

RESUMEN

Dystonia is a relatively common movement disorder but some of its epidemiological and clinical aspects have not been well characterized in Brazilian patients. Also, a new clinical classification for the disorder has been proposed and its impact on clinical practice is unclear. We aimed to describe the clinical and demographic characteristics of a Brazilian series of patients with primary dystonia, to estimate its local prevalence, and to explore the impact of using a new classification for dystonia. We identified 289 patients with primary dystonia over a 12-month period, of whom235 underwent a detailed evaluation. Patients with primary dystoniamade up one-sixth of all patients evaluated at the service where the study was conducted, with an estimated local prevalence of 19.8/100,000 inhabitants. The clinical and demographic characteristics of the patients were similar to those described elsewhere, with blepharospasm as the most common focal dystonia and most patients using sensory tricks that they judged useful on a day-to-day basis. The application of the new classification was easy and simple, and the systematic approach allowed for a better clinical characterization of our patients. We recognized two dystonic syndromes that were not described in the original article that proposed the classification, and suspected that the arbitrary distinction between generalized and multifocal dystonia seems not to be useful for patients with primary dystonia. In conclusion, the prevalence and clinical characteristics of our patients were not distinct from other studies and the new classification was shown to be practical and useful to characterize patients with dystonia.


Asunto(s)
Trastornos Distónicos/clasificación , Trastornos Distónicos/epidemiología , Adolescente , Adulto , Anciano , Blefaroespasmo/epidemiología , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Trastornos Distónicos/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
12.
Texto & contexto enferm ; 20(2): 255-262, abr.-jun. 2011.
Artículo en Portugués | BDENF - Enfermería, LILACS | ID: lil-594019

RESUMEN

Estudo descritivo, de abordagem qualitativa, que objetivou compreender a percepção da vulnerabilidade à doença, entre mulheres com diagnóstico avançado do câncer do colo do útero, tendo como referencial, a vulnerabilidade. Participaram doze mulheres que estavam em atendimento ambulatorial hospitalar, para tratamento do câncer cérvico-uterino avançado. Os dados foram coletados por entrevistas e analisados por Análise de Conteúdo. Dos resultados emergiram duas categorias temáticas: Percebendo-se vulnerável na descoberta da doença e Percebendo-se vulnerável na realização do tratamento. Fatores relacionados à cliente, profissionais, serviços, entre outros, tornaram a mulher suscetível aos problemas e danos de saúde, relativos ao câncer cérvico-uterino, exacerbando sua vulnerabilidade à doença. É necessário superar deficiências no modelo de assistência e humanização do atendimento, no grau de compromisso e qualidade das instituições, dos recursos, gerenciamento e monitoramento dos programas de prevenção e detecção do câncer do colo do útero, nos diferentes níveis de atenção.


This descriptive qualitative study aimed to comprehend perceptions of vulnerability to disease among women diagnosed with advanced cervical cancer. Twelve women who were receiving outpatient hospital care in treating advanced cervical cancer participated in the study. Data was collected through interviews and analyzed via content analysis. The results highlight two themes: Perceiving oneself as vulnerable in discovering the disease; and Perceiving oneself vulnerable in carrying out treatment. Factors related to the client, health care professionals, and services rendered, among others have made women susceptible to health problems and damage relating to cervical cancer, exacerbating their vulnerability to the disease. It is necessary to overcome deficiencies in care model and the humanization of treatment, the degree of commitment, as well as the quality of institutions, resources, management and monitoring programs towards preventing and detecting cervical cancer within different levels of care.


Este estudio descriptivo y cualitativo tuvo como objetivo comprender la percepción de la vulnerabilidad a la enfermedad, entre las mujeres diagnosticadas con cáncer cervical avanzado, tomando como referencia la vulnerabilidad. Participaron doce mujeres que recibían atención ambulatoria hospitalaria para el tratamiento del cáncer cervico uterino avanzado. La recolección de los datos se hizo a través de entrevistas y se analizaron mediante el análisis de contenido. Los resultados destacan dos temas: Percepción de su vulnerabilidad al descubrir la enfermedad, y percepción de su vulnerabilidad al realizar el tratamiento. Factores relacionados con el cliente, los servicios, los profesionales, entre otros, han hecho que las mujeres sean susceptibles a los problemas de salud y daños relacionados con el cáncer cervico uterino, lo que agrava su vulnerabilidad a las enfermedades. Es necesario superar las deficiencias en el modelo de tratamiento para el cuidado y la integridad personal, el grado de compromiso y calidad de las instituciones, recursos, programas de gestión y control para prevenir y detectar el cáncer del cuello uterino, en los diferentes niveles de atención.


Asunto(s)
Humanos , Neoplasias del Cuello Uterino , Enfermería , Vulnerabilidad ante Desastres , Prevención de Enfermedades , Diagnóstico Tardío
13.
Ciênc. cuid. saúde ; 9(2): 220-227, abr.-jun. 2010.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: lil-647344

RESUMEN

O objetivo deste estudo foi conhecer como os profissionais de saúde e agentes comunitários de saúde de duasunidades da Estratégia de Saúde da Família de um município de Minas Gerais atuam na prevenção e controle docâncer de colo de útero. Para isso foram realizadas, com dezesseis membros das equipes, entrevistasorientadas por um questionário. Procedeu-se à análise dos dados, que foram apresentados por meio da análisetemática. Os resultados mostraram divergências entre as orientações às mulheres prestadas pelos profissionaise agentes comunitários de saúde das duas equipes quanto à prevenção e controle do câncer de colo de útero.Não obstante, ficou evidenciado o interesse dos membros das equipes na atuação junto às mulheres, os quaisas alertaram sobre a importância dos cuidados no sentido de evitar e/ou controlar uma doença que apresentaalta taxa de incidência e de mortalidade entre as brasileiras. A educação permanente dos profissionais e agentescomunitários de saúde e a adoção de novas estratégias no atendimento à população poderão ajudar napadronização de atendimentos, contribuindo para uma assistência de melhor qualidade.


This study aimed to know how health professionals and community agents involved in two Family HealthStrategy Units, in a city of the state of Minas Gerais, act in the prevention and control of uterine cervical cancer.Interviews guided by a questionnaire were carried out with sixteen team members. Thematic analysis was usedfor data analysis. Results showed differences between orientations given to women by health professionals andhealth team community agents, for the prevention and control of uterine cervical cancer. However, the interest inacting with women was evidenced, in order to show them the importance of care, to avoid and/or control adisease with high incidence and mortality rates among Brazilians. Permanent education of professionals andcommunity health agents and the adoption of new strategies will help in the standardization of assistance,contributing for a better quality of care given to population.


Este estudio tuvo como objetivo conocer cómo los profesionales de salud y agentes comunitarios de salud dedos unidades de la Estrategia de Salud de la Familia de un municipio del estado de Minas Gerais, Brasil, actúanen la prevención y control del cáncer de cuello uterino. Para ello fueron realizadas, con dieciséis miembros del equipo, entrevistas guiadas por preguntas. Se utilizó el análisis de los datos, que fueron presentados por mediodel análisis temático. Los resultados mostraron divergencias entre las orientaciones de los profesionales y de losagentes comunitarios de salud de los dos equipos de salud que fueron dadas a las mujeres para prevención ycontrol del cáncer de cuello uterino. Sin embargo, se evidencia el interés de los miembros de los equipos en laactuación junto a las mujeres, alertándolas acerca de la importancia de los cuidados para evitar y/o controlar unaenfermedad que tiene alta tasa de incidencia y mortalidad entre las brasileñas. La educación permanente de losprofesionales y agentes comunitarios de salud y la adopción de nuevas estrategias en la atención a la poblaciónpodrán ayudar en la estandarización de atenciones, contribuyendo para una atención de mejor calidad.


Asunto(s)
Humanos , Masculino , Femenino , Neoplasias del Cuello Uterino , Estrategias de Salud Nacionales , Salud de la Mujer , Salud de la Familia
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