RESUMO
Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos das Habilidades Motoras , Destreza Motora , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/diagnóstico , Criança , Masculino , Feminino , Estudos Transversais , Destreza Motora/fisiologia , Desempenho Psicomotor/fisiologiaRESUMO
Clinical guidelines recommend the development of ST-elevation myocardial infarction (STEMI) networks at community, regional and/or national level to ideally offer primary coronary angioplasty, or at least the best available STEMI care to all patients. However, there is a discrepancy between this clinical recommendation and daily practice, with no coordinated care for STEMI patients in many regions of the world. While this can be a consequence of lack of resources, in reality it is more frequently a lack of organisational power. In this paper, the Stent - Save a Life! Initiative (www.stentsavealife.com) proposes a practical methodology to set up a STEMI network effectively in any region of the world with existing resources, and to develop the STEMI network continuously once it has been established.
Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , StentsRESUMO
The Editors' Network of the European Society of Cardiology (ESC) provides a dynamic forum for editorial discussions and endorses the recommendations of the International Committee of Medical Journal Editors (ICMJE) to improve the scientific quality of biomedical journals. Authorship confers credit and important academic rewards. Recently, however, the ICMJE emphasized that authorship also requires responsibility and accountability. These issues are now covered by the new -(fourth) criterion for authorship. Authors should agree to be accountable and ensure that questions regarding the accuracy and integrity of the entire work will be appropriately addressed. This review discusses the implications of this paradigm shift on authorship requirements with the aim of increasing awareness on good scientific and editorial practices.
La Red de Editores de la Sociedad Europea de Cardiología (SEC) proporciona un foro dinámico para debates editoriales y respalda las recomendaciones del Comité Internacional de Editores de Revistas Médicas (ICMJE) para mejorar la calidad científica de las revistas biomédicas. La autoría confiere crédito e importantes recompensas académicas. Recientemente, sin embargo, el ICMJE enfatizó que la autoría también requiere responsabilidad y compromiso. Estos problemas ahora están cubiertos por el nuevo (cuarto) criterio de autoría. Los autores deben aceptar ser responsables y garantizar que las preguntas sobre la precisión y la integridad de todo el trabajo será abordado adecuadamente. Esta revisión discute las implicaciones de este cambio de paradigma en requisitos de autoría con el objetivo de aumentar la conciencia sobre las buenas prácticas científicas y editoriales.
Assuntos
Autoria , Políticas Editoriais , Editoração/ética , Responsabilidade SocialRESUMO
Resumen: La Red de Editores de la Sociedad Europea de Cardiología (ESC, por su sigla en inglés) constituye un foro dinámico dedicado a discusiones editoriales y respalda las recomendaciones del Comité Internacional de Editores de Revistas Médicas (ICMJE, por su sigla en inglés) destinadas a mejorar la calidad científica de las revistas biomédicas. La paternidad literaria confiere crédito, además de importantes recompensas académicas. Recientemente, sin embargo, el ICMJE ha destacado que la autoría también exige que los autores sean responsables y se hagan cargo de lo que publican. Estas cuestiones ahora están cubiertas por el nuevo (cuarto) criterio para la autoría. Los autores deben aceptar hacerse responsables de lo que escriben y garantizar un adecuado enfoque de las cuestiones concernientes a la precisión e integridad de todo el trabajo. Esta revisión analiza las implicancias de este cambio de paradigma en los requisitos de autoría con el objetivo de aumentar la conciencia sobre las buenas prácticas científicas y editoriales.
Summary: The Editors´ Network of the European Society of Cardiology provides a dynamic forum for editorial discussions and endorses the recommendations of the International Committee of Medical Journal Editors to improve the scientific quality of biomedical journals. Authorship confers credit and important academic rewards. Recently, however, the International Committee of Medical Journal Editors emphasized that authorship also requires responsibility and accountability. These issues are now covered by the new (fourth) criterion for authorship. Authors should agree to be accountable and ensure that questions regarding the accuracy and integrity of the entire work will be appropriately addressed. This review discusses the implications of this paradigm shift on authorship requirements with the aim of increasing awareness on good scientific and editorial practices.
Resumo: A Rede de Editores da Sociedade Europeia de Cardiologia é um fórum dinâmico para discussões editoriais e apoia as recomendações do Comitê Internacional de Editores de Revistas Médicas, visando melhorar a qualidade científica das revistas biomédicas. A autoria confere crédito, além de importantes recompensas acadêmicas. Recentemente, no entanto, o Comitê Internacional de Editores de Revistas Médicas enfatizou que a autoria também requer que os autores sejam responsáveis do que escrevem e se encarreguem do que publicam. Essas questões agora estão cobertas pelo novo (quarto) critério de autoria. Os autores devem concordar em ser responsáveis e garantir que as questões relativas à precisão e integridade de todo o trabalho sejam abordadas de maneira apropriada. Esta revisão discute as implicações dessa mudança de paradigma nos requisitos de autoria, com o objetivo de aumentar a conscientização sobre as boas práticas científicas e editoriais.
Assuntos
Humanos , Autoria , Responsabilidade Social , Turquia , Cardiologia , Políticas Editoriais , Europa (Continente)RESUMO
The Editors' Network of the European Society of Cardiology (ESC) provides a dynamic forum for editorial discussions and endorses the recommendations of the International Committee of Medical Journal Editors (ICMJE) to improve the scientific quality of biomedical journals. Authorship confers credit and important academic rewards. Recently, however, the ICMJE emphasized that authorship also requires responsibility and accountability. These issues are now covered by the new -(fourth) criterion for authorship. Authors should agree to be accountable and ensure that questions regarding the accuracy and integrity of the entire work will be appropriately addressed. This review discusses the implications of this paradigm shift on authorship requirements with the aim of increasing awareness on good scientific and editorial practices.
RESUMO
Abstract The Editors Network of the European Society of Cardiology (ESC) provides a dynamic forum for editorial discussions and endorses the recommendations of the International Committee of Medical Journal Editors (ICMJE) to improve the scientific quality of biomedical journals. Authorship confers credit and important academic rewards. Recently, however, the ICMJE emphasized that authorship also requires responsibility and accountability. These issues are now covered by the new (fourth) criterion for authorship. Authors should agree to be accountable and ensure that questions regarding the accuracy and integrity of the entire work will be appropriately addressed. This review discusses the implications of this paradigm shift on authorship requirements with the aim of increasing awareness on good scientific and editorial practices.
Assuntos
Editoração/ética , Autoria , Responsabilidade Social , Políticas EditoriaisRESUMO
AIMS: The aim of this study was to compare clinical outcomes of patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) with balloon-expandable (BE) valves vs. self-expandable (SE) valves. Transcatheter aortic valve implantation is a minimally invasive and lifesaving treatment in patients with aortic valve stenosis. Even though BE-valves and SE-valves are both commonly used on a large scale, adequately sized trials comparing clinical outcomes in patients with severe aortic valve stenosis treated with BE-valves compared with SE-valves are lacking. METHODS AND RESULTS: In this CENTER-collaboration, data from 10 registries or clinical trials, selected through a systematic search, were pooled and analyzed. Propensity score methodology was used to reduce treatment selection bias and potential confounding. The primary endpoints were mortality and stroke at 30 days follow-up in patients treated with BE-valves compared with SE-valves. Secondary endpoints included clinical outcomes, e.g. bleeding during hospital admission. All outcomes were split for early-generation BE-valves compared with early-generation SE-valves and new-generation BE-valves with new-generation SE-valves. The overall patient population (N = 12 381) included 6239 patients undergoing TAVI with BE-valves and 6142 patients with SE-valves. The propensity matched population had a mean age of 81 ± 7 years and a median STS-PROM score or 6.5% [interquartile range (IQR) 4.0-13.0%]. At 30-day follow-up, the mortality rate was not statistically different in patients undergoing TAVI with BE-valves compared with SE-valves [BE: 5.3% vs. SE: 6.2%, relative risk (RR) 0.9; 95% confidence interval (CI) 0.7-1.0, P = 0.10]. Stroke occurred less frequently in patients treated with BE-valves (BE: 1.9% vs. SE: 2.6%, RR 0.7; 95% CI 0.5-1.0, P = 0.03). Also, patients treated with BE-valves had a three-fold lower risk of requiring pacemaker implantation (BE: 7.8% vs. SE: 20.3%, RR 0.4; 95% CI 0.3-0.4, P < 0.001). In contrast, patients treated with new-generation BE-valves more frequently experienced major and life-threatening bleedings compared with new-generation SE-valves (BE: 4.8% vs. SE: 2.1%, RR 2.3; 95% CI 1.6-3.3, P < 0.001). CONCLUSION: In this study, which is the largest study to compare valve types in TAVI, we demonstrated that the incidence of stroke and pacemaker implantation was lower in patients undergoing transfemoral TAVI with BE-valves compared with SE-valves. In contrast, patients treated with new-generation BE-valves more often suffered from major or life-threatening bleedings than patients with new-generation SE-valves. Mortality at 30-days was not statistically different in patients treated with BE-valves compared with SE-valves. This study was a propensity-matched analysis generated from observational data, accordingly current outcomes will have to be confirmed in a large scale randomized controlled trial. (AU)
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Angioplastia com Balão , Substituição da Valva Aórtica TranscateterRESUMO
OBJECTIVE: This study investigated the relationship between motor performance; attentional, hyperactive, and impulsive symptoms; and social problems. Correlations between parents' versus teachers' ratings of social problems and ADHD symptomatology were also examined. METHOD: A total of 129 children aged 9 to 12 years were included. ADHD symptoms and social problems were identified based on Conners' Rating Scales-Revised: L, and the McCarron Assessment of Neuromuscular Development was used to assess motor skills. RESULTS: After controlling for ADHD symptomatology, motor skills remained a significant predictor of social problems in the teacher model but not in the parent model. After controlling for motor skills, inattentive (not hyperactive-impulsive) symptoms were a significant predictor of social problems in the parent model, whereas hyperactive-impulsive (not inattentive) symptoms were a significant predictor of social problems in the teacher model. CONCLUSION: The findings suggested that intervention strategies should consider the interaction between symptoms and environmental contexts.
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Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Destreza Motora/fisiologia , Habilidades Sociais , Atenção/fisiologia , Criança , Feminino , Humanos , Comportamento Impulsivo/fisiologia , Masculino , Pais , Problemas Sociais/psicologiaRESUMO
The pressure wire has revolutionised cardiology by moving the focus of revascularisation from anatomy to physiology. This review provides a comprehensive viewpoint on the foundations of the field of intracoronary physiology, with emphasis on the development and clinical evidence of fractional flow reserve (FFR). Additionally, we critically appraise clinical decision making based on the evolving area of resting coronary physiology. The emerging role of coronary flow reserve and its complementariness with FFR is also discussed, and the importance of the invasive assessment of the coronary microcirculation in outlining prognosis is put into perspective. Overall, this review summarises the capacity of invasive coronary physiology indices to guide revascularisation and to discriminate patients at high risk of an adverse cardiovascular outcome.
Assuntos
Angiografia Coronária , Estenose Coronária/fisiopatologia , Vasos Coronários/fisiopatologia , Reserva Fracionada de Fluxo Miocárdico/fisiologia , Cateterismo Cardíaco/métodos , Angiografia Coronária/métodos , Circulação Coronária/fisiologia , Estenose Coronária/diagnóstico por imagem , HumanosRESUMO
BACKGROUND: Research has suggested an important association between motor proficiency and overweight/obesity. Many children with motor difficulties experience ADHD symptoms which have also been linked with overweight/obesity. Previous research has not considered both ADHD and motor performance when investigating their relationship with overweight/obesity. AIMS: To investigate the relationships between motor performance, ADHD symptoms, and overweight/obesity in children. METHODS AND PROCEDURES: A cross-sectional study was conducted involving189 children aged six to 10 years. Symptoms of ADHD were identified using the SNAP-IV rating scale. Motor impairment (MI) was identified using the Movement Battery Assessment for Children-2. Body composition was estimated from the Body Mass Index (BMI) based on World Health Organization child growth standards. OUTCOMES AND RESULTS: Balance was the only motor skill associated with BMI even after controlling for gender and ADHD. Group comparisons revealed that the proportion of overweight ADHD children was significantly less than the proportion of overweight control children and overweight MI children; the proportion of underweight ADHD children was significantly greater than the proportion of underweight MI children. CONCLUSIONS AND IMPLICATIONS: The results highlight the importance of taking into consideration both ADHD symptoms and motor difficulties in the assessment and intervention of physical health outcomes in children with ADHD and/or movement problems.
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Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos das Habilidades Motoras/epidemiologia , Destreza Motora , Obesidade/epidemiologia , Equilíbrio Postural , Magreza/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Índice de Massa Corporal , Peso Corporal , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos das Habilidades Motoras/fisiopatologia , Sobrepeso/epidemiologiaRESUMO
OBJECTIVE: To compare both global and specific domains of motor development of children with attention deficit hyperactivity disorder (ADHD) with that of typically developing children. METHODS: Two hundred children (50 children with clinical diagnoses of ADHD, according to the DSM-IV-TR and 150 typically developing controls), aged 5 to 10 years, participated in this cross-sectional study. The Motor Development Scale was used to assess fine and global motricity, balance, body schema, and spatial and temporal organization. RESULTS: Between-group testing revealed statistically significant differences between the ADHD and control groups for all domains. The results also revealed a deficit of nearly two years in the motor development of children with ADHD compared with the normative sample. CONCLUSION: The current study shows that ADHD is associated with a delay in motor development when compared to typically developing children. The results also suggested difficulties in certain motor areas for those with ADHD. These results may point to plausible mechanisms underlying the relationship between ADHD and motor difficulties.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Desenvolvimento Infantil/fisiologia , Destreza Motora/fisiologia , Fatores Etários , Imagem Corporal , Estudos de Casos e Controles , Criança , Estudos Transversais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Equilíbrio Postural/fisiologia , Escalas de Graduação Psiquiátrica , Comportamento Espacial/fisiologia , Estatísticas não ParamétricasRESUMO
Objective:To compare both global and specific domains of motor development of children with attention deficit hyperactivity disorder (ADHD) with that of typically developing children.Methods:Two hundred children (50 children with clinical diagnoses of ADHD, according to the DSM-IV-TR and 150 typically developing controls), aged 5 to 10 years, participated in this cross-sectional study. The Motor Development Scale was used to assess fine and global motricity, balance, body schema, and spatial and temporal organization.Results:Between-group testing revealed statistically significant differences between the ADHD and control groups for all domains. The results also revealed a deficit of nearly two years in the motor development of children with ADHD compared with the normative sample.Conclusion:The current study shows that ADHD is associated with a delay in motor development when compared to typically developing children. The results also suggested difficulties in certain motor areas for those with ADHD. These results may point to plausible mechanisms underlying the relationship between ADHD and motor difficulties.