65 resultados para confounding variable
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Introduction: Body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) have several similarities and are included among the obsessive-compulsive spectrum of disorders. However, the content of preoccupations and level of insight of BDD patients differ from OCD patients. Objective: To compare the level of insight regarding obsessive-compulsive symptoms (OCS) and other clinical features in OCD patients with and without comorbid BDD. Methods: We evaluated 103 OCD patients (n=25, comorbid BDD), according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria using the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, the Beck Depression and Anxiety Inventories, and the Brown Assessment of Beliefs Scale. Resylts: The study groups differed significantly on several clinical features, including level of insight. A worse level of insight regarding OCS was independently associated with the presence of comorbid BDD. Lower educational level, more psychiatric comorbidities, presence of somatic and hoarding obsessions, and presence of intrusive images were associated with BDD comorbidity, even after adjusting for possible confounders. Conclusion: The presence of BDD in OCD patients is associated with poorer insight into obsessional beliefs and higher morbidity, reflected by lower educational levels and higher number of psychiatric comorbid disorders in general.
American visceral leishmaniasis: Factors associated with lethality in the state of São Paulo, Brazil
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Objectives. To identify factors associated with death in visceral leishmaniasis (VL) cases. Patients and Methodology. We evaluated prognostic factors for death from VL in São Paulo state, Brazil, from 1999 to 2005. A prognostic study nested in a clinical cohort was carried out by data analysis of 376 medical files. A comparison between VL fatal cases and survivors was performed for clinical, laboratory, and biological features. Association between variables and death was assessed by univariate analysis, and the multiple logistic regression model was used to determine adjusted odds ratio for death, controlling confounding factors. Results. Data analysis identified 53 fatal cases out of 376 patients, between 1999 and 2005 in São Paulo state. Lethality was 14.1 (53/376), being higher in patients older than fifty years. The main causes of death were sepsis, bleeding, liver failure, and cardiotoxicity due to treatment. Variables significantly associated with death were severe anemia, bleeding, heart failure, jaundice, diarrhea, fever for more than sixty days, age older than fifty years, and antibiotic use. Conclusion. Educational health measures are needed for the general population and continuing education programs for health professionals working in the affected areas with the purpose of identifying and treating early cases, thus preventing the disease evolution towards death. © 2012 Geraldine Madalosso et al.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Organisms are constantly subjected to stressful stimuli that affect numerous physiological processes and activate the hypothalamo-pituitary-adrenal (HPA) axis, increasing the release of glucocorticoids. Exposure to chronic stress is known to alter basic mechanisms of the stress response. The purpose of the present study was to compare the effect of two different stress paradigms (chronic restraint or variable stress) on behavioral and corticosterone release to a subsequent exposure to stressors. Considering that the HPA axis might respond differently when it is challenged with a novel or a familiar stressor we investigated the changes in the corticosterone levels following the exposure to two stressors: restraint (familiar stress) or forced novelty (novel stress). The changes in the behavioral response were evaluated by measuring the locomotor response to a novel environment. In addition, we examined changes in body, adrenals, and thymus weights in response to the chronic paradigms. Our results showed that exposure to chronic variable stress increased basal plasma corticosterone levels and that both, chronic restraint and variable stresses, promote higher corticosterone levels in response to a novel environment, but not to a challenge restraint stress, as compared to the control (non-stressed) group. Exposure to chronic restraint leads to increased novelty-induced locomotor activity. Furthermore, only the exposure to variable stress reduced body weights. In conclusion, the present results provide additional evidence on how chronic stress affects the organism physiology and point to the importance of the chronic paradigm and challenge stress on the behavioral and hormonal adaptations induced by chronic stress. (c) 2006 Elsevier B.V. All rights reserved.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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It is shown that, in the two brane time variation model framework, if the hidden brane tension varies according to the phenomenological Eotvos law, the visible brane tension behavior is such that its time derivative is negative in the past and positive after a specific time of cosmological evolution. This behavior is interpreted in terms of a useful mechanical system analog and its relation with the variation of the Newtonian (effective) gravitational constant is explored.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The general assumption under which the (X) over bar chart is designed is that the process mean has a constant in-control value. However, there are situations in which the process mean wanders. When it wanders according to a first-order autoregressive (AR (1)) model, a complex approach involving Markov chains and integral equation methods is used to evaluate the properties of the (X) over bar chart. In this paper, we propose the use of a pure Markov chain approach to study the performance of the (X) over bar chart. The performance of the chat (X) over bar with variable parameters and the (X) over bar with double sampling are compared. (C) 2011 Elsevier B.V. All rights reserved.
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A novel single-phase voltage source rectifier capable to achieve High-Power-Factor (HPF) for variable speed refrigeration system application, is proposed in this paper. The proposed system is composed by a single-phase high-power-factor boost rectifier, with two cells in interleave connection, operating in critical conduction mode, and employing a soft-switching technique, controlled by a Field Programmable Gate Array (FPGA), associated with a conventional three-phase IGBT bridge inverter (VSI - Voltage Source Inverter), controlled by a Digital Signal Processor (DSP). The soft-switching technique for the input stage is based on zero-current-switching (ZCS) cells. The rectifier's features include the reduction in the input current ripple, the reduction in the output voltage ripple, the use of low stress devices, low volume for the EMI input filter, high input power factor (PF), and low total harmonic distortion (THD) in the input current, in compliance with the EEC61000-3-2 standards. The digital controller for the output stage has been developed using a conventional voltage-frequency control (scalar V/f control), and a simplified stator oriented Vector control, in order to verify the feasibility and performance of the proposed digital controls for continuous temperature control applied at a refrigerator prototype.
Variable-Structure Control Design of Switched Systems With an Application to a DC-DC Power Converter
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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INTRODUÇÃO: Pacientes com doença renal crônica (DRC) apresentam menor tolerância ao exercício e baixa capacidade funcional, o que os torna, via de regra, sedentários. Outra alteração importante encontrada na DRC é a disfunção cognitiva. O sedentarismo tem sido associado à disfunção cognitiva na população geral, porém, poucos estudos avaliaram essa associação na DRC. OBJETIVOS: Verificar associação entre o nível de atividade física e a função cognitiva de pacientes com DRC que realizam hemodiálise (HD). MÉTODOS: Foram avaliados 102 pacientes que realizam HD. Os participantes responderam o Questionário Internacional de Atividade Física, que avalia o nível de atividade física e o Mini Exame do Estado Mental, utilizado para o rastreamento cognitivo. Os pacientes foram divididos em três grupos conforme a classificação do nível de atividade física (GI: ativos/GII: irregularmente ativos/GIII: sedentários). Foi aplicada análise de regressão logística adotando-se como variável desfecho a presença de disfunção cognitiva e preservando como variáveis independentes aquelas com probabilidade estatística de diferença entre os grupos inferior a 0,1. Foi considerado estatisticamente significante o valor de p inferior a 0,05. RESULTADOS: Os grupos foram semelhantes quanto à idade, tempo de HD, escolaridade e tabagismo. Apresentaram diferença estatisticamente significante quanto à raça, índice de massa corporal, presença de diabetes mellitus, doença de base e grau de déficit cognitivo. Quanto aos dados laboratoriais, os grupos diferiram quanto à creatinina, glicemia, hemoglobina e hematócrito. Houve associação entre o nível de atividade física e função cognitiva, mesmo ajustando-se para as variáveis de confusão. CONCLUSÃO: O maior nível de atividade física associou-se a melhor função cognitiva em renais crônicos em HD, independentemente das variáveis de confusão avaliadas.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)