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1.
PeerJ ; 12: e17428, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38881861

RESUMO

Background: Patients in serious condition due to COVID-19 often require special care in intensive care units (ICUs). This disease has affected over 758 million people and resulted in 6.8 million deaths worldwide. Additionally, the progression of the disease may vary from individual to individual, that is, it is essential to identify the clinical parameters that indicate a good prognosis for the patient. Machine learning (ML) algorithms have been used for analyzing complex medical data and identifying prognostic indicators. However, there is still an urgent need for a model to elucidate the predictors related to patient outcomes. Therefore, this research aimed to verify, through ML, the variables involved in the discharge of patients admitted to the ICU due to COVID-19. Methods: In this study, 126 variables were collected with information on demography, hospital length stay and outcome, chronic diseases and tumors, comorbidities and risk factors, complications and adverse events, health care, and vital indicators of patients admitted to an ICU in southern Brazil. These variables were filtered and then selected by a ML algorithm known as decision trees to identify the optimal set of variables for predicting patient discharge using logistic regression. Finally, a confusion matrix was performed to evaluate the model's performance for the selected variables. Results: Of the 532 patients evaluated, 180 were discharged: female (16.92%), with a central venous catheter (23.68%), with a bladder catheter (26.13%), and with an average of 8.46- and 23.65-days using bladder catheter and submitted to mechanical ventilation, respectively. In addition, the chances of discharge increase by 14% for each additional day in the hospital, by 136% for female patients, 716% when there is no bladder catheter, and 737% when no central venous catheter is used. However, the chances of discharge decrease by 3% for each additional year of age and by 9% for each other day of mechanical ventilation. The performance of the training data presented a balanced accuracy of 0.81, sensitivity of 0.74, specificity of 0.88, and the kappa value was 0.64. The test performance had a balanced accuracy of 0.85, sensitivity 0.75, specificity 0.95, and kappa value of 0.73. The McNemar test found that there were no significant differences in the error rates in the training and test data, suggesting good classification. This work showed that female, the absence of a central venous catheter and bladder catheter, shorter mechanical ventilation, and bladder catheter duration were associated with a greater chance of hospital discharge. These results may help develop measures that lead to a good prognosis for the patient.


Assuntos
COVID-19 , Unidades de Terapia Intensiva , Aprendizado de Máquina , SARS-CoV-2 , Humanos , COVID-19/mortalidade , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Brasil/epidemiologia , Idoso , Fatores de Proteção , Adulto , Fatores de Risco , Prognóstico , Alta do Paciente/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos
2.
Healthcare (Basel) ; 11(14)2023 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-37510513

RESUMO

BACKGROUND: This study aimed to analyze maternal risk factors associated with negative outcomes of COVID-19 and association with socioeconomic indicators in Brazil. METHODS: A cross-sectional study, with data from the Influenza Epidemiological Surveillance Information System (SIVEP-Flu) of pregnant women with COVID-19 and cases of hospitalization and death. For the analysis of risk factors and outcomes, the multiple logistic regression method was used. RESULTS: Pregnant women who had some risk factor represented 47.04%. The chance of death was 2.48 times greater when there was a risk factor, 1.55 for ICU admission and 1.43 for use of ventilatory support. The percentage of cure was 79.64%, 15.46% without any negative outcome, 4.65% death and 0.26% death from other causes. Pregnant women who did not take the vaccine represented 30.08%, 16.74% took it and 53.18% were not specified. The variables HDI, illiteracy, per capita income and urbanization did not influence the cases of COVID-19. CONCLUSIONS: Factors such as age, obesity, asthma and pregnancy were responsible for the increase in hospitalizations, respiratory complications and death. Vaccination reduced the risk of negative outcomes by 50%. There were no correlations between socioeconomic indicators and the negative outcomes of COVID-19 in pregnant women.

3.
BMC Public Health ; 23(1): 3, 2023 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-36593472

RESUMO

Heavy truck drivers represent a social group of great importance to any country's economy. Their professional activity requires a high level of dedication. Due to the irregular hours in their work routine and adopted habits, they mostly predispose them to a diversity of health problems. The purpose of this study is to perform a systematic review and meta-analysis aiming to identify the prevalence of diabetes, hypertension, and obesity in Latin American Truck Drivers. We searched the PubMed, Web of Science, Scopus and LILACS databases, for scientific publications articles, as reported by The PRISMA Statement. From 1,382, 7 studies were included according to the established criteria. The hypertension prevalence found was 34.2%, diabetes was of 9.2% and the highest prevalence found was for overweight and obesity (56%). Meta-analysis presented that drivers have a higher prevalence of overweight or obesity when compared to eutrophic individuals and that drivers with diabetes and hyperglycemia have a lower prevalence. Due to their work activity, their access to the health system is compromised limiting any type of monitoring of their health. This study showed that there is, in Latin America, an investment and assistance gap, both in the health sector and in the research section, for this professional category, which is so important to the economy of these countries. These data should help to identify the difficulties faced by this professional in health assistance, road safety, public safety, leisure and social life. This research also highlighted that they are young and already have the first sign of non-transmissible chronic diseases, which is overweight and obesity.


Assuntos
Condução de Veículo , Diabetes Mellitus , Hipertensão , Humanos , Veículos Automotores , América Latina/epidemiologia , Sobrepeso , Obesidade/epidemiologia , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia
4.
Asian Pac J Cancer Prev ; 24(12): 4339-4348, 2023 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38402419

RESUMO

Objective: Compare the breast cancer mortality rate and the rate of mammograms with socioeconomic factors, in Brazilian´s Federative Units, during the period of 2015 to 2021. Methods: This is an ecological study, of a descriptive nature, which covers the 27 Brazilian federative units, using secondary data extracted from the DATASUS System. The information analyzed was mammography data, breast cancer mortality, demographic and economic data of the resident population and women over 20 years of age. Results: There is a direct relationship between mortality rate and mammograms rates in the Federative Units. The data obtained for Brazil presents a total of 133,048 deaths from breast cancer and 17,324,526 mammography exams in the period from 2015 to 2021. In other words, Brazil presents a standardized mortality rate value, 19.25 deaths per 100,000 women. Regarding the mammography rate, the value of the exam-specific mammography rate was 2,506.55 per 100,000 women. In relation to socioeconomic data by mortality rate group, higher mortality rates from breast cancer present higher rates in the variables: income rate by State (2,594.86), people with income (63.5), average percentage of women with more over 50 years old (29.5%), women with average years of education (6.64), white population (55.1%) and mammography exam rate (2873.20). When analysing the highest rates of mammography exam rates, higher rates are observed income rate by State (2,161.47), people with income (62.5%), average percentage of women over 50 years old (28.6%), women with an average number of years of education (5.8). Conclusion: Brazil has a high mortality rate due to breast cancer, when compared to other countries. The reasons are diverse, such as the modern, industrialized and populous lifestyle. The Federative Units with the highest mortality rate also have high rates of mammograms, that is, in the Federative Units with "better" sociodemographic conditions, the South and Southeast.


Assuntos
Neoplasias da Mama , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Brasil/epidemiologia , Mamografia , Fatores Socioeconômicos , Renda
5.
PLoS One ; 17(6): e0269091, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35704604

RESUMO

OBJECTIVE: To analyze the characteristics associated with vaccination against Covid-19 in pregnant and postpartum women with Severe Acute Respiratory Syndrome in Brazil and to investigate a possible association between vaccination and the clinical course and outcome of the disease. METHODS: Retrospective cohort study of hospitalized pregnant and postpartum women diagnosed with Severe Acute Respiratory Syndrome (SARS) by SARS-CoV-2, presenting onset of signs and symptoms between May and October 2021. Secondary data were used, available in the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe). Data were analyzed using the SPSS statistical program, medians were applied to present continuous variables and frequencies, and proportions were calculated for categorical variables, using logistic and multivariate regression analysis. RESULTS: The final study population included 3,585 pregnant and postpartum women, of whom 596 (16.6) were vaccinated: 443 (74.3%) received one dose and 153 (25.7%) received two doses. They were factors associated with non-vaccination against Covid-19 age ≤ 19 anos (OR: 2.57; IC95% 1.40;4.71), non-white women (OR: 1.34; IC95% 1.07;1.67) and those who required ventilatory support (OR: 1.51; IC95% 1.19;1.90) and invasive ventilation (OR: 2.05; IC95% 1.37;3.08). On the other hand, vaccination was associated with advanced maternal age (OR: 0.60; IC95% 0.48;0.76), presence of comorbidities (OR: 0.57; IC95% 0.45;0.72) and loss of taste (OR: 0.63; IC95% 0.48;0.82). CONCLUSIONS: Demographic, ethnic-racial and clinical characteristics were associated with the vaccination status of pregnant and postpartum women with SARS by SARS-CoV-2 in Brazil. Vaccination against Covid-19 in the obstetric population has already shown positive results in the evolution of severe cases, which reiterates its importance. It is essential that health services advance vaccination against Covid-19 in the obstetric population, especially adolescentes and non-white women.


Assuntos
COVID-19 , Complicações Infecciosas na Gravidez , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Gestantes , Estudos Retrospectivos , SARS-CoV-2 , Vacinação
6.
PLoS One ; 13(12): e0210174, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30596793

RESUMO

The study had the goal to study the relationship between resilience, stress and injuries in the sport context. Eight female athletes, part of the Rhythmic Gymnastics Brazilian Team along the Olympic Cycle 2015-2016 participated in the study, with a mean age of 20.4±2.5 years. The following instruments were used: RESTQ-76 Sport, CD-RISC 10, documental analysis of physical therapy records, and structured questionnaire. Data was analyzed by descriptive statistics (frequency, mean and standard deviation); Repeated Measured ANOVA with Bonferroni's post-hoc, Student's "t" test, Friedman test, Pearson Correlation Coefficient, Cohen's d, and inductive thematic analysis. We found relatively stable levels of stress and recovery across the season; total recovery levels were higher than stress at all four measured timepoints (p<0.05); All athletes had at least one injury, with a total of 14 injuries; No significant correlations were found between the quantitative scores of resilience, stress and recovery; Training and the sport's scoring system were the most relevant perceived stressors; athletes presented meta-cognition and a non-positive evaluation (neutral) of stressors; Social support was considered the main psychological factor for the resilience process; such process resulted in improved control and interpretation of emotions; Our hypothesized model proposes that, in the relationship between stress and injuries, resilience acts by optimizing the injury recovery process. It was concluded that resilience plays a role in the process of injury rehabilitation and stress control in elite rhythmic gymnastics' athletes.


Assuntos
Ginástica , Modelos Biológicos , Estresse Psicológico/epidemiologia , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Medicina Esportiva , Estresse Psicológico/fisiopatologia , Ferimentos e Lesões/fisiopatologia
7.
Rev. bras. cineantropom. desempenho hum ; 17(6): 635-649, Nov.-Dec. 2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-771183

RESUMO

Abstract The aim of this study was to test the psychometric properties of the Brazilian version of the Coach-Athlete Relationship Questionnaire (CART-Q) - Athlete Version. For this, three studies were performed. In the first, four translators and five experts in Sport Psychology adapted the CART-Q contents to the Brazilian context. In the second, 364 athletes of individual and collective sports answered the adapted version of CART-Q. In the third, an independent sample of 185 athletes answered the CART-Q and the Task and Ego Orientation in Sport Questionnaire (TEOSQ) to analyze the external validity of the instrument; and 50 athletes answered the CART-Q in two distinct moments for the analysis of the temporal stability. Study 1 showed that the Portuguese version contains clear and relevant questions (CVC> 0.80). Study 2 showed that the CART-Q presents satisfactory internal consistency (α> 0.70 / CC> 0.70). The confirmatory factor analysis showed that the model with 11 items showed good fit [X2/gl = 3.03; CFI = 0.96, GFI = 0.94; TLI = 0.94; RMSEA = 0.08] and also the existence of the second-order model. Study 3 showed the external (r> 0.40 with variable task orientation) and internal validity (CFA with an independent sample) and temporal stability (ICC> 0.70). It was concluded that the Brazilian version for of CART-Q proved to be valid to evaluate the perception of athletes about their relationship with the coach in the Brazilian sports context.


Resumo O objetivo deste estudo foi testar as propriedades psicométricas da versão brasileira do Coach-Athlete Relationship Questionnaire (CART-Q)-Versão Atleta. Para isso, foram realizados três estudos. No primeiro, quatro tradutores e cinco especialistas em Psicologia do Esporte adaptaram o conteúdo do CART-Q para o contexto brasileiro. No segundo, 364 atletas de modalidades esportivas individuais e coletivas responderam a versão adaptada do CART-Q. No terceiro, uma amostra independente de 185 atletas respondeu o CART-Q e o Task and Ego Orientation in Sport Questionnaire (TEOSQ) para a análise da validade externa do instrumento; e 50 atletas responderam o CART-Q em dois momentos para a análise da estabilidade temporal. O Estudo 1 evidenciou que a versão em português contém questões claras e relevantes (CVC > 0,80). O Estudo 2 revelou que o CART-Q apresenta consistência interna satisfatória ( α > 0,70/CC > 0,70). A análise fatorial confirmatória revelou que o modelo com 11 itens apresentou ajuste adequado [X2/gl = 3,03; CFI = 0,96, GFI = 0,94; TLI = 0,94; RMSEA = 0,08] e também a existência do modelo de segunda ordem. O Estudo 3 evidenciou a validade externa (r>0,40 com as variáveis de orientação à tarefa) e interna (AFC com uma amostra independente), além da estabilidade temporal (ICC > 0,70). Concluiu-se que a versão para a língua portuguesa do CART-Q se mostrou válida para avaliar a percepção do atleta sobre sua relação com o treinador no contexto esportivo brasileiro.

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