260 resultados para Karnofsky Performance Status
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Santhiago, V, da Silva, ASR, Papoti, M, and Gobatto, CA. Responses of hematological parameters and aerobic performance of elite men and women swimmers during a 14-week training program. J Strength Cond Res 23(4): 1097-1105, 2009-The main purpose of the present investigation was to verify the responses of hematological parameters in men and women competitive swimmers during a 14-week training program. Twenty-three Olympic and international athletes were evaluated 4 times during the experiment: at the beginning of the endurance training phase (T1), at the end of the endurance training phase (T2), at the end of the quality phases (T3), and at the end of the taper period (T4). On the first day at 8:00 AM, each swimmer had a blood sample taken for the determination of hematological parameters. At 3:00 PM, the athletes had their aerobic performance measured by anaerobic threshold. On the second day at 8: 00 AM, the swimmers had their aerobic performance measured by critical velocity. Hematocrit and mean corpuscular volume diminished (p <= 0.05) from T1 to T2 (men: 5.8 and 7.2%; women: 11.6 and 6.8%), and increased (p <= 0.05) from T2 to T3 (men: 7.2 and 6.0%; women: 7.4 and 5.2%). These results were related to the plasma volume changes of the athletes. However, these alterations do not seem to affect the swimmers` aerobic performance. For practical applications, time-trial performance is better than aerobic performance (i.e., anaerobic threshold and critical velocity) for monitoring training adaptations.
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Background: The accuracy of multidetector computed tomographic (CT) angiography involving 64 detectors has not been well established. Methods: We conducted a multicenter study to examine the accuracy of 64-row, 0.5-mm multidetector CT angiography as compared with conventional coronary angiography in patients with suspected coronary artery disease. Nine centers enrolled patients who underwent calcium scoring and multidetector CT angiography before conventional coronary angiography. In 291 patients with calcium scores of 600 or less, segments 1.5 mm or more in diameter were analyzed by means of CT and conventional angiography at independent core laboratories. Stenoses of 50% or more were considered obstructive. The area under the receiver-operating-characteristic curve (AUC) was used to evaluate diagnostic accuracy relative to that of conventional angiography and subsequent revascularization status, whereas disease severity was assessed with the use of the modified Duke Coronary Artery Disease Index. Results: A total of 56% of patients had obstructive coronary artery disease. The patient-based diagnostic accuracy of quantitative CT angiography for detecting or ruling out stenoses of 50% or more according to conventional angiography revealed an AUC of 0.93 (95% confidence interval [CI], 0.90 to 0.96), with a sensitivity of 85% (95% CI, 79 to 90), a specificity of 90% (95% CI, 83 to 94), a positive predictive value of 91% (95% CI, 86 to 95), and a negative predictive value of 83% (95% CI, 75 to 89). CT angiography was similar to conventional angiography in its ability to identify patients who subsequently underwent revascularization: the AUC was 0.84 (95% CI, 0.79 to 0.88) for multidetector CT angiography and 0.82 (95% CI, 0.77 to 0.86) for conventional angiography. A per-vessel analysis of 866 vessels yielded an AUC of 0.91 (95% CI, 0.88 to 0.93). Disease severity ascertained by CT and conventional angiography was well correlated (r=0.81; 95% CI, 0.76 to 0.84). Two patients had important reactions to contrast medium after CT angiography. Conclusions: Multidetector CT angiography accurately identifies the presence and severity of obstructive coronary artery disease and subsequent revascularization in symptomatic patients. The negative and positive predictive values indicate that multidetector CT angiography cannot replace conventional coronary angiography at present. (ClinicalTrials.gov number, NCT00738218.).
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Background: Neuropsychological deficits have been reported in association with first-episode psychosis (FEP). Reductions in grey matter (GM) volumes have been documented in FEP subjects compared to healthy controls. However, the possible inter-relationship between the findings of those two lines of research has been scarcely investigated. Objective: To investigate the relationship between neuropsychological deficits and GM volume abnormalities in a population-based sample of FEP patients compared to healthy controls from the same geographical area. Methods: FEP patients (n = 88) and control subjects (n = 86) were evaluated by neuropsychological assessment (Controlled Oral Word Association Test, forward and backward digit span tests) and magnetic resonance imaging using voxel-based morphometry. Results: Single-group analyses showed that prefrontal and temporo-parietal GM volumes correlated significantly (p < 0.05, corrected) with cognitive performance in FEP patients. A similar pattern of direct correlations between neocortical GM volumes and cognitive impairment was seen in the schizophrenia subgroup (n = 48). In the control group, cognitive performance was directly correlated with GM volume in the right dorsal anterior cingulate cortex and inversely correlated with parahippocampal gyral volumes bilaterally. Interaction analyses with ""group status"" as a predictor variable showed significantly greater positive correlation within the left inferior prefrontal cortex (BA46) in the FEP group relative to controls, and significantly greater negative correlation within the left parahippocampal gyrus in the control group relative to FEP patients. Conclusion: Our results indicate that cognitive deficits are directly related to brain volume abnormalities in frontal and temporo-parietal cortices in FEP subjects, most specifically in inferior portions of the dorsolateral prefrontal cortex. (C) 2009 Elsevier B.V. All rights reserved.
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Background: Dementia screening in elderly people with low education can be difficult to implement. For these subjects, informant reports using the long (L) (26 items) and short (C) (16 items) versions of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) can be useful. The objective of the present study was to investigate the performance of Brazilian versions of the IQCODE L, S and a new short version (SBr) (15 items) in comparison with the Mini-mental State Examination (MMSE) for dementia screening in elderly people with low education. Methods: Thirty-four patients with mild to moderate dementia, diagnosed according to ICD-10 criteria, and 57 controls were evaluated and divided into three groups based on their socioeconomic status and level of education. Patients were evaluated using the MMSE and the informants were interviewed using the IQCODE by interviewers blind to the clinical diagnosis. Results: Education was correlated with MMSE results (r = 0.280, p = 0.031), but not with the versions of the IQCODE. The performance of the instruments, evaluated by the ROC curves, was very similar, with good internal consistency (Cronbach`s alpha = 0.97). MMSE correctly classified 85.7% of the subjects while the three IQCODE versions (L, S and SBr) correctly classified 91.2% of the subjects. Conclusions: The long, short and the new short Brazilian IQCODE versions can be useful as a screening tool for mild and moderate patients with dementia in Brazil. The IQCODE is not biased by schooling, and it seems to be an adequate instrument for samples with low levels of education.
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Objective: To compare the performance of patients with obsessive-compulsive disorder (OCD) refractory to conventional treatments to healthy controls according to the Frontal Systems Behaviour Scale (FrSBe), comparing the scale scores within each group (Self or Family) and correlating FrSBe with Y-BOCS, DY-BOCS, tic disorder and age of first symptoms. Method: Twenty OCD patients and 20 healthy controls were assessed using the FrSBe, a scale designed to evaluate frontal syndromes. Results: The patients had higher scores when compared with the control group (p value .001) in terms of total score on the scale for both profile forms (Self and Family). In addition, there was a significant difference between the scores reported by the patients and their respective relatives. However, no correlation was observed between the scale and the other variables. Conclusions: The scale was able to clearly differentiate patients with OCD from healthy controls. This finding suggests that the FrSBe can be used not only in neurologic patients but also in psychiatric cases such as refractory OCD.
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Background: Previous studies have reported an association between executive dysfunction and the ability to perform activities of daily living (ADL)s among older adults. This study aims to examine the association between executive functions and functional status in a cross-section of older adults with varying degrees of cognitive impairment. Methods: 89 individuals (mean age 73.8 years) were recruited at a memory clinic in Sao Paulo, Brazil. Subjects underwent evaluation, and were allocated into three diagnostic groups according to cognitive status: normal controls (NC, n = 32), mild cognitive impairment (MCI, n = 3 1) and mild Alzheimer`s disease (AD, n=26). Executive functions were assessed with the 25-item Executive Interview (EXIT25), and functional status was measured with the Direct Assessment of Functional Status test (DAFS-R). Results: Significantly different total DAFS-R scores were observed across the three diagnostic groups. Patients with AD performed significantly worse in EXIT25 compared with subjects without dementia, and no significant differences were detected between NC and MCI patients. We found a robust negative correlation between the DAFS-R and the EXIT25 scores (r=-0.872, p < 0.001). Linear regression analyses suggested a significant influence of the EXIT-25 and the CAMCOG on the DAFS-R scores. Conclusion: Executive dysfunction and decline in general measures of cognitive functioning are associated with a lower ability to undertake instrumental ADLs. MCI patients showed worse functional status than NC subjects. MCI patients may show subtle changes in functional status that may only be captured by objective measures of ADLs.
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PURPOSE: This clinical study evaluated the periodontal status of patients with bonded retainers as compared to a non-treated control group. METHODS: Forty dental students were included in the sample and divided into the following two groups: 1) a test group of 20 subjects that, after orthodontic treatment, have been bonded retainer users for at least 2 years and 2) a control group of 20 patients that never experienced orthodontic treatment nor used any bonded retainer. The region associated with the retainer in the test group and the lower canine-to-canine region in the control group were examined according to the following clinical parameters: plaque index (PI), bleeding on probing (BOP), gingival recession (GR), clinical attachment level (CAL) and probing depth (PD). RESULTS: No differences were observed for GR or BOP (P>0.05). In contrast, the test group showed higher values of CAL and PD at proximal sites when compared to controls (P<0.05). In addition, IP was significantly increased at buccal and lingual sites (P<0.05). CONCLUSION: The placement of orthodontic bonded retainers negatively affected periodontal health, resulting in increased PI, PD and CAL.
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The objective of this study was to compare the completion rates and performance of the Brazilian version of the Oral Health Impact Profile (OHIP14) when applied as an interview or in its original self-reported form. A convenience sample of 74 adult patients was selected in a Dental Clinic (University of Araras, Brazil). One examiner administered the instrument in both formats to participants with an interval of 2 weeks between each administration. Data about dental health condition and socioeconomic status were collected and associated with total OHIP14 scores in both formats using linear regression analyses. No differences were found in the total scores and in each subscale of the OHIP14 according to the form of administration. Higher values of completion were found in the interview format. More severe impacts were recorded in the interview format than in the questionnaire format. Higher values of total OHIP-14 scores in both formats were related to the presence of dental caries. Total OHIP14 scores were not influenced by the method of administration. However, the use of the OHIP14 in the questionnaire format may result in lower completion rates and loss of data.
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Roofing provides the main protection against direct solar radiation in animal housing. Appropriate thermal properties of roofing materials tend to improve the thermal comfort in the inner ambient. Nonasbestos fiber-cement roofing components reinforced with cellulose pulp from sisal (Agave sisalana) were produced by slurry and dewatering techniques, with an optional addition of polypropylene fibers. Nonasbestos tiles were evaluated and compared with commercially available asbestos-cement sheets and ceramic tiles (frequently chosen as roofing materials for animal housing). Thermal conductivity and thermal diffusivity of tiles were determined by the parallel hot-wire method, along with the evaluation of the downside surface temperature. Cement-based components reinforced with sisal pulp presented better thermal performance at room temperature (25ºC), while those reinforced with sisal pulp added by polypropylene fibers presented better thermal performance at 60ºC. Non-asbestos cement tiles provided more efficient protection against radiation than asbestos corrugated sheets.
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Estudou-se efeito de quatro níveis de dietas catiônicas sobre os parâmetros ácido-base do sangue e o pH urinário de vacas em lactação. Para a manipulação dos níveis do balanço cátion-amônico da dieta (BCAD), foram adicionadas diferentes concentrações de bicarbonato de sódio às dietas, obtendo-se os seguintes tratamentos: +150, +250, +400 e +500mEq/kg de matéria seca. O experimento foi realizado durante o verão, por um período total de 72 dias, utilizando-se oito vacas da raça Holandesa após o pico de lactação, distribuídas em quadrado latino (4x4), replicado, em que cada período teve duração de 18 dias. O pH urinário e o bicarbonato, o pH, o CO2 total e a pCO2 do sangue aumentaram linearmente (P<0,01) com o aumento do BCAD. As concentrações de sódio e potássio do sangue não foram modificadas (P>0,05) pelo BCAD. A concentração de cloro no sangue diminuiu linearmente (P<0,01) com o aumento do BCAD. O aumento do BCAD afetou o equilíbrio ácido-base das vacas, promovendo efeito alcalinogênico, o que poderia levar a diferenças significativas no desempenho do animal.
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Este artigo analisa, pela primeira vez na literatura, o impacto dos sindicatos de trabalhadores em vários indicadores de desempenho econômico de firmas industriais brasileiras. Realizou-se uma pesquisa retrospectiva sobre a densidade sindical de 1000 estabelecimentos industriais brasileiros e seus resultados foram combinados aos indicadores de desempenho econômico da Pesquisa Industrial Anual (PIA) de 1990 a 2000. Os resultados indicam que a relação entre a densidade sindical na firma e seus salários, emprego e produtividade, é não-linear, ou seja, um aumento no grau de sindicalização leva a um melhor desempenho, porém a taxas decrescentes. Observou-se, também, uma relação negativa entre sindicalização e rentabilidade. Finalmente, estabelecimentos que introduziram mecanismos de 'participação nos lucros' aumentaram sua produtividade e rentabilidade no período e pagaram maiores salários nas firmas onde o grau de sindicalização era maior.
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INTRODUÇÃO: O arco e flecha é um esporte estático que requer força e resistência da parte superior do corpo, sendo que a habilidade do arqueiro é definida pela capacidade de atirar a flecha no alvo em um intervalo de tempo com precisão. A contração muscular gerada durante a execução do gesto esportivo propicia o aumento da temperatura corporal, da oxidação de glicose e da sudorese, podendo esta ser potencializada pelas condições climáticas às quais o atleta é exposto. Todos estes fatores alteram a percepção de esforço e a própria geração de força, impondo um estresse negativo à performance. OBJETIVOS: Avaliar e relacionar o estado de hidratação de atletas de arco e flecha com alterações fisiológicas e de força intervenientes no rendimento competitivo. MÉTODOS: Participaram 11 arqueiros em duas competições distintas (indoor e outdoor). Foram mensurados parâmetros relacionados ao estado de hidratação, glicemia, percepção de esforço subjetivo e alteração na força de preensão palmar. RESULTADOS: Os atletas analisados apresentaram alterações significativas nos parâmetros relacionados ao estado hídrico em diferentes dias, provavelmente relacionadas às condições climáticas adversas na competição outdoor (34ºC e 60% URA) em relação à competição indoor (22ºC e 90% URA). O mesmo não foi observado para a glicemia. CONCLUSÃO: Este trabalho é o primeiro a comprovar a relação direta entre fatores climáticos e de rendimento em arqueiros de alto nível durante evento competitivo, assim como a evidenciar quais métodos não invasivos seriam os mais indicados para a avaliação do impacto destas alterações.
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Standardized olfactory tests are now available to quantitatively assess disorders of olfaction. A Brazilian-Portuguese version of the University of Pennsylvania Smell Identification Test (UPSIT) is currently being developed specifically for the Brazilian population. The most recent Brazilian-Portuguese version of the UPSIT (UPSIT-Br2) was administered to 88 Brazilian subjects who had no history of neurological or otorhinolaryngological disease. UPSIT-Br2 scores decreased with age, were lower in men than in women, and were lower in subjects with lower income. The degree to which the poorer performance of subjects with lower socio-economic status reflects lack of familiarity with test items is not known. Although this version of the UPSIT provides a sensitive and useful test of smell function for the Brazilian population, a revision of some test items is needed to achieve comparable norms to those found using the North American UPSIT in the United States.
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Geographic Data Warehouses (GDW) are one of the main technologies used in decision-making processes and spatial analysis, and the literature proposes several conceptual and logical data models for GDW. However, little effort has been focused on studying how spatial data redundancy affects SOLAP (Spatial On-Line Analytical Processing) query performance over GDW. In this paper, we investigate this issue. Firstly, we compare redundant and non-redundant GDW schemas and conclude that redundancy is related to high performance losses. We also analyze the issue of indexing, aiming at improving SOLAP query performance on a redundant GDW. Comparisons of the SB-index approach, the star-join aided by R-tree and the star-join aided by GiST indicate that the SB-index significantly improves the elapsed time in query processing from 25% up to 99% with regard to SOLAP queries defined over the spatial predicates of intersection, enclosure and containment and applied to roll-up and drill-down operations. We also investigate the impact of the increase in data volume on the performance. The increase did not impair the performance of the SB-index, which highly improved the elapsed time in query processing. Performance tests also show that the SB-index is far more compact than the star-join, requiring only a small fraction of at most 0.20% of the volume. Moreover, we propose a specific enhancement of the SB-index to deal with spatial data redundancy. This enhancement improved performance from 80 to 91% for redundant GDW schemas.
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Due to the development of nanoscience, the interest in electrochromism has increased and new assemblies of electrochromic materials at nanoscale leading to higher efficiencies and chromatic contrasts, low switching times and the possibility of color tuning have been developed. These advantages are reached due to the extensive surface area found in nanomaterials and the large amount of organic electrochromic molecules that can be easily attached onto inorganic nanoparticles, as TiO2 or SiO2. Moreover, the direct contact between electrolyte and nanomaterials produces high ionic transfer rates, leading to fast charge compensation, which is essential for high performance electrochromic electrodes. Recently, the layer-by-layer technique was presented as an interesting way to produce different architectures by the combination of both electrochromic nanoparticles and polymers. The present paper shows some of the newest insights into nanochromic science.