Revista da Associa??o Médica Brasileira (English Edition)最新文献_第6页

Urinary incontinence in pregnant women and its relation with socio-demographic variables and quality of life 孕妇尿失禁及其与社会人口学变量和生活质量的关系

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70505-8

Claudia de Oliveira , Maura Seleme , Paula F. Cansi , Renata F.D.C. Consentino , Fernanda Y. Kumakura , Gizelle A. Moreira , Bary Berghmans

{"title":"Urinary incontinence in pregnant women and its relation with socio-demographic variables and quality of life","authors":"Claudia de Oliveira , Maura Seleme , Paula F. Cansi , Renata F.D.C. Consentino , Fernanda Y. Kumakura , Gizelle A. Moreira , Bary Berghmans","doi":"10.1016/S2255-4823(13)70505-8","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70505-8","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the occurrence of urinary incontinency (UI) in pregnant women and its relationship with socio-demographic variables and quality of life.</p></div><div><h3>Methods</h3><p>A descriptive cross-sectional multicenter study was conducted to investigate 495 women using the International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF). The survey was conducted on the same day of delivery, with the volunteers still in the maternity ward. Statistical analysis of the comparison between groups 1 (incontinence) and 2 (continent) was done using chi-square test for comparison of proportions of women with and without urinary incontinency and logistic regression analysis.</p></div><div><h3>Results</h3><p>From the total of 495 women studied, 352 (71%) reported having had UI during the last four weeks of pregnancy. Group 1 presented the ICIQ-SF median score of 11 (range 3– 21), considered as severe impact in quality of life. Logistic regression analysis showed that there was a closer relation between the self-report of UI with the following variables: level of education below 8 years (OR: 2.99; p<0.001), black women (OR: 2.32; p=0.005), women with more than 3 children (OR: 4.93; p<0.001), obese (OR: 4.22; p<0.001) and normal vaginal delivery (OR: 2.59; p<0.001).</p></div><div><h3>Conclusion</h3><p>The majority of pregnant women have UI, negatively affecting the quality of their lives.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 5","pages":"Pages 460-466"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70505-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72283421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethics for physicians and surgeons: consent 医生和外科医生的伦理:同意

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70478-8

Ivan D. Miziara

引用次数: 0

Supplemental care from a bioethical perspective 从生物伦理角度看补充护理

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70526-5

Regina Ribeiro Parizi Carvalho , Paulo Antônio de Carvalho Fortes , Volnei Garrafa

{"title":"Supplemental care from a bioethical perspective","authors":"Regina Ribeiro Parizi Carvalho , Paulo Antônio de Carvalho Fortes , Volnei Garrafa","doi":"10.1016/S2255-4823(13)70526-5","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70526-5","url":null,"abstract":"<div><h3>Objective</h3><p>To describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010.</p></div><div><h3>Methods</h3><p>Qualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board.</p></div><div><h3>Results</h3><p>There was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care.</p></div><div><h3>Discussion</h3><p>Private participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model.</p></div><div><h3>Conclusion</h3><p>It is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS).</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 6","pages":"Pages 600-606"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70526-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72282159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rebound effects of modern drugs: serious adverse events unknown by health professionals 现代药物的反弹效应：卫生专业人员未知的严重不良事件

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70530-7

Marcus Zulian Teixeira

引用次数: 13

Validity of the methods to assess body fat in children and adolescents using multi-compartment models as the reference method: a systematic review 使用多室模型作为参考方法评估儿童和青少年体脂的有效性:系统综述

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70507-1

Danilo R.P. Silva , Alex S. Ribeiro , Fernando H. Pavão , Enio R.V. Ronque , Ademar Avelar , Analiza M. Silva , Edilson S. Cyrino

{"title":"Validity of the methods to assess body fat in children and adolescents using multi-compartment models as the reference method: a systematic review","authors":"Danilo R.P. Silva , Alex S. Ribeiro , Fernando H. Pavão , Enio R.V. Ronque , Ademar Avelar , Analiza M. Silva , Edilson S. Cyrino","doi":"10.1016/S2255-4823(13)70507-1","DOIUrl":"10.1016/S2255-4823(13)70507-1","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the validity of methods to assess body fat in children and adolescents using a systematic review.</p></div><div><h3>Methods</h3><p>The search was performed by two independent researchers using the MEDLINE, BioMed Central, SciELO, and LILACS electronic databases. For inclusion, the articles should have been written in English or Portuguese, and must have used multi-compartment models as the criterion measure of the model, with body fat measurement of the whole body in non-athlete children and adolescents.</p></div><div><h3>Results</h3><p>A preliminary search resulted in 832 studies. After all selection steps were performed, 12 articles were included. The selected studies were published between 1997 and 2010, whose samples consisted of children and adolescents with levels of relative body fat ranging from 20.7% to 41.4%. The methods used were: dual energy X-ray absorptiometry (58.3%), isotope dilution (41.6%), skinfold thickness (33.3%), hydrostatic weighing (25%), bioelectrical impedance analysis (25%), air displacement plethysmography (16.6%), and total body electrical conductivity (8.3%).</p></div><div><h3>Conclusions</h3><p>Based on the analysis of the studies, isotope dilution and air displacement plethysmography methods were the most reliable, despite the limited number of studies. As for clinical use or for population-based studies, the equation of Slaughter et al. (1988), which uses the triceps and subscapular skinfold thickness, showed the best results for assessment of body fat in this population.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 5","pages":"Pages 475-486"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70507-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73965783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Cystatin C, kidney function, and cardiovascular risk factors in primary hypertension 原发性高血压的胱抑素C、肾功能和心血管危险因素

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2013-10-23 DOI: 10.1016/S2255-4823(13)70425-9

João Victor Salgado , Ana Karina França , Nayra Anielly Cabral , Joyce Lages , Valdinar Sousa Ribeiro , Alcione Miranda Santos , Bernardete Jorge Salgado

{"title":"Cystatin C, kidney function, and cardiovascular risk factors in primary hypertension","authors":"João Victor Salgado , Ana Karina França , Nayra Anielly Cabral , Joyce Lages , Valdinar Sousa Ribeiro , Alcione Miranda Santos , Bernardete Jorge Salgado","doi":"10.1016/S2255-4823(13)70425-9","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70425-9","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the clinical usefulness of serum cystatin C (Scys) and cystatin C-based equations for the screening of chronic kidney disease in primary hypertensive patients, and correlate these markers with risk factors for cardiovascular disease.</p></div><div><h3>Methods</h3><p>A cross-sectional study was performed in 199 middle-aged adults at a basic health unit. Kidney function assessment included measurements of serum creatinine (Scr) and Scys levels, 24-hour microalbuminuria (MA), as well as glomerular filtration rate (GFR) through Larsson and Modification of Diet in Renal Disease (MDRD) study equations. Bland-Altman plot analysis was used to calculate the agreement between equations.</p></div><div><h3>Results</h3><p>High levels of Scys were found in 22% of the patients, even with normal values of GFR estimated by MDRD study equation. Systolic blood pressure and MA correlated better with Scys than Scr, but there was no correlation between Scys and diastolic blood pressure. Gender, age ≥ 60 years, MA, and uric acid were significantly associated with high Scys levels. After multivariate analysis, only age ≥ 60 yrs (RR=6.4; p<0.001) and male gender (RR=3.0; p=0.006) remained associated with high Scys levels.</p></div><div><h3>Conclusion</h3><p>Cystatin C can be used as a screening marker both for detecting mild declines of renal function and for preventing the risk of cardiovascular events in hypertensive subjects with presumably normal renal function.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 1","pages":"Pages 21-27"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70425-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137441029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The tragedy of medical education in Brazil 巴西医学教育的悲剧

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70474-0

Paulo Kassab , Laércio Gomes Lourenço , Elias Jirjoss Ilias , Carlos Alberto Malheiros

引用次数: 0

Does impact factor influence the ethics of the instructions provided to journal authors?* 影响因子是否影响向期刊作者提供指导的伦理?*

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70470-3

Renan Kleber Costa Teixeira , Vitor Nagai Yamaki , Thiago Barbosa Gonçalves , Nara Macedo Botelho , José Antonio Cordero da Silva

{"title":"Does impact factor influence the ethics of the instructions provided to journal authors?*","authors":"Renan Kleber Costa Teixeira , Vitor Nagai Yamaki , Thiago Barbosa Gonçalves , Nara Macedo Botelho , José Antonio Cordero da Silva","doi":"10.1016/S2255-4823(13)70470-3","DOIUrl":"10.1016/S2255-4823(13)70470-3","url":null,"abstract":"<div><h3>Objective</h3><p>Verify whether a journal's impact factor is a mechanism that modifies the ethical requirements described in the instructions provided to authors of articles published in Brazilian medical journals.</p></div><div><h3>Methods</h3><p>48 selected journals were divided into two groups: impact-factor (n=24), and no-impact-factor (n=24). The number of ethical requirements was compared between both groups based on a specific research protocol, ranging from zero to six points, analyzing the presence of an approval by a research ethics committee; reference to the fact that the research follows the precepts of the Declaration of Helsinki and the rules of Resolution 196/96; use of an informed consent; information about the authors’ conflicts of interest; and a request for registration of clinical trials in the Brazilian Clinical Trials Registry.</p></div><div><h3>Results</h3><p>The average score of the impact-factor group was significantly higher than that of the no-impact-factor group (3.12±1.03 vs. 2.08±1.64, p=0.0121). When each ethical requirement was compared between the groups, there was significant difference only between the requirement of an informed consent and the disclosure of conflicts of interest (p<0.05).</p></div><div><h3>Conclusion</h3><p>The impact factor is a determinant factor on the ethics included in the instructions to authors of articles in scientific journals, showing that higher-quality journals seek better-designed articles that are conscientious at the beginning of the research.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 3","pages":"Pages 280-284"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70470-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88818708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Proposal for a unified selection to medical residency programs 建议对住院医师项目进行统一选择

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2014-03-14 DOI: 10.1016/S2255-4823(13)70523-X

Sônia Ferreira Lopes Toffoli , Olavo Franco Ferreira Filho , Dalton Francisco de Andrade

{"title":"Proposal for a unified selection to medical residency programs","authors":"Sônia Ferreira Lopes Toffoli , Olavo Franco Ferreira Filho , Dalton Francisco de Andrade","doi":"10.1016/S2255-4823(13)70523-X","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70523-X","url":null,"abstract":"<div><h3>Objective</h3><p>This paper proposes the unification of entrance exams to medical residency programs (MRP) in Brazil. Problems related to MRP and its interface with public health problems in Brazil are highlighted and how this proposal is able to help solving these problems.</p></div><div><h3>Methods</h3><p>The proposal is to create a database to be applied in MRP unified exams. Some advantages of using the Item Response Theory (IRT) in this database are highlighted.</p></div><div><h3>Results</h3><p>The MRP entrance exams are developed and applied decentralized where each school is responsible for its examination. These exams quality are questionable. Reviews about items quality, validity and reliability of appliances are not common disclosed.</p></div><div><h3>Conclusion</h3><p>Evaluation is important in every education system bringing on required changes and control of teaching and learning. The proposal of MRP entrance exams unification, besides offering high quality exams to institutions participants, could be as an extra source to rate medical school and cause improvements, provide studies with a database and allow a regional mobility.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 6","pages":"Pages 583-588"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70523-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137408204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in prostate cancer incidence and mortality in a mid-sized Northeastern Brazilian city 巴西东北部一个中等城市前列腺癌发病率和死亡率的趋势

Revista da Associa??o Médica Brasileira (English Edition) Pub Date : 2013-01-01 Epub Date: 2013-10-23 DOI: 10.1016/S2255-4823(13)70424-7

Carlos Anselmo Lima , Angela Maria da Silva , André Yoichi Kuwano , Margareth Rose Uchôa Rangel , Matheus Macedo-Lima

{"title":"Trends in prostate cancer incidence and mortality in a mid-sized Northeastern Brazilian city","authors":"Carlos Anselmo Lima , Angela Maria da Silva , André Yoichi Kuwano , Margareth Rose Uchôa Rangel , Matheus Macedo-Lima","doi":"10.1016/S2255-4823(13)70424-7","DOIUrl":"https://doi.org/10.1016/S2255-4823(13)70424-7","url":null,"abstract":"<div><h3>Objective</h3><p>International data have reported prostate cancer as the most frequent among men, and the third highest in mortality. A rise in incidence has been observed in the course of recent decades, probably influenced by early detection, mainly in asymptomatic men, through regular screening with prostate-specific antigen (PSA) testing. The purpose of this study was to contribute to information on trends in prostate cancer incidence and mortality using population-based data.</p></div><div><h3>Methods</h3><p>This was an exploratory ecological study of time trends, aiming at describing changes in prostate cancer incidence and mortality in Aracaju, Sergipe, Brazil, from 1996 to 2006. Rates were calculated from data of the Registro de Câncer de Base Populacional de Aracaju. Trends were calculated using the Joinpoint Regression Program.</p></div><div><h3>Results</h3><p>For the study period, 1,490 incident cases and 334 deaths were included. Incident cases were more common after 50 years of age, and deaths after 55 years. Age-standardized incidence rates of 46.6 and 50.0/100,000 were observed in the early years of the series, and then progressively increased, with rates higher than 100.0/100,000 in later years. For mortality, age-standardized rates varied from 21.6 and 16.6/100,000 to 24.1 and 28.9/100,000 in later years. Joinpoint analysis identified one joinpoint for the incidence series, resulting in two trends, the first with annual percent change of 34% and the second with 5.8%; for the mortality series no joinpoint was identified, and the annual percent change was 2.1%.</p></div><div><h3>Conclusion</h3><p>There was a sharp increase in incidence rates during the study period, probably due to screening. Mortality rates had a small upward trend, and did not show major changes during the study period.</p></div>","PeriodicalId":101100,"journal":{"name":"Revista da Associa??o Médica Brasileira (English Edition)","volume":"59 1","pages":"Pages 15-20"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S2255-4823(13)70424-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91689669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0