Personal and Social Performance (PSP) scale for patients with schizophrenia: translation to Portuguese, cross-cultural adaptation and interrater reliability

INTRODUCTION: Schizophrenia is a chronic mental disorder associated with impairment in social functioning. The most widely used scale to measure social functioning is the GAF (Global Assessment of Functioning), but it has the disadvantage of measuring at the same time symptoms and functioning, as described in its anchors. OBJECTIVES:Translation and cultural adaptation of the PSP, proposing a final version in Portuguese for use in Brazil. METHODS: We performed five steps: 1) translation; 2) back translation; 3) formal assessment of semantic equivalence; 4) debriefing; 5) analysis by experts. Interrater reliability (Intraclass correlation, ICC) between two raters was also measured. RESULTS: The final version was applied by two independent investigators in 18 adults with schizophrenia (DSM-IV-TR). The interrater reliability (ICC) was 0.812 (p < 0.001). CONCLUSION: The translation and adaptation of the PSP had an adequate level of semantic equivalence between the Portuguese version and the original English version. There were no difficulties related to understanding the content expressed in the translated texts and terms. Its application was easy and it showed a good interrater reliability. The PSP is a valid instrument for the measurement of personal and social functioning in schizophrenia.

Effects of protein-calorie restriction on mechanical function of hypertrophied cardiac muscle

OBJECTIVE: To assess the effect of food restriction (FR) on hypertrophied cardiac muscle in spontaneously hypertensive rats (SHR). METHODS: Isolated papillary muscle preparations of the left ventricle (LV) of 60-day-old SHR and of normotensive Wistar-Kyoto (WKY) rats were studied. The rats were fed either an unrestricted diet or FR diet (50% of the intake of the control diet) for 30 days. The mechanical function of the muscles was evaluated through monitoring isometric and isotonic contractions. RESULTS: FR caused: 1) reduction in the body weight and LV weight of SHR and WKY rats; 2) increase in the time to peak shortening and the time to peak developed tension (DT) in the hypertrophied myocardium of the SHR; 3) diverging changes in the mechanical function of the normal cardiac muscles of WKY rats with reduction in maximum velocity of isotonic shortening and of the time for DT to decrease 50% of its maximum value, and increase of the resting tension and of the rate of tension decline. CONCLUSION: Short-term FR causes prolongation of the contraction time of hypertrophied muscles and paradoxal changes in mechanical performance of normal cardiac fibers, with worsening of the shortening indices and of the resting tension, and improvement of the isometric relaxation.

Prospective assessment of different indices of cardiac risk for patients undergoing noncardiac surgeries

OBJECTIVE: To compare the accuracy of 4 different indices of cardiac risk currently used for predicting perioperative cardiac complications. METHODS: We studied 119 patients at a university-affiliated hospital whose cardiac assessment had been required for noncardiac surgery. Predictive factors of high risk for perioperative cardiac complications were assessed through clinical history and physical examination, and the patients were followed up after surgery until the 4th postoperative day to assess the occurrence of cardiac events. All patients were classified according to 4 indices of cardiac risk: the Goldman risk-factor index, Detsky modified risk index, Larsen index, and the American Society of Anesthesiologists' physical status classification and their compared accuracies, examining the areas under their respective receiver operating characteristic (ROC) curves. RESULTS: Cardiac complications occurred in 16% of the patients. The areas under the ROC curves were equal for the Goldman risk-factor index, the Larsen index, and the American Society of Anesthesiologists' physical status classification: 0.48 (SEM ± 0.03). For the Detsky index, the value found was 0.38 (SEM ± 0.03). This difference in the values was not statistically significant. CONCLUSION: The cardiac risk indices currently used did not show a better accuracy than that obtained randomly. None of the indices proved to be significantly better than the others. Studies to improve our ability to predict such complications are still required.

Valor prognóstico do índice de performance miocárdica no pós-operatório de cirurgia de revascularização miocárdica

OBJETIVO: Avaliar o valor preditivo do índice de performance miocárdica (IPM) para complicações cardiovasculares em pacientes de baixo risco no pós-operatório (PO) de cirurgia de revascularização miocárdica (CRM) no período de internação hospitalar. MÉTODOS: Foram estudados 80 pacientes submetidos a CRM com função ventricular esquerda adequada no pré-operatório, nos quais o IPM foi medido nas primeiras horas de pós-operatório. Os pacientes foram acompanhados até a alta hospitalar. A análise estatística incluiu teste qui-quadrado de Pearson, teste t de Student e teste de Mann-Whitney, além do cálculo do risco relativo, com intervalos de confiança de 95%, e das propriedades de sensibilidade e especificidade do índice, com elaboração de curva ROC. RESULTADOS: Os dados foram avaliados por dois observadores independentes, cegos aos dados clínicos, com variabilidade intra e interobservador não significativa. Encontrou-se IPM=0,43 como ponto de corte, considerando-se acima de 0,43 os pacientes com maior probabilidade de eventos no pós-operatório. Os eventos relevantes para análise foram IAM (RR 0,87; IC 0,21 - 3,65); fibrilação atrial (RR 0,65; IC 0,24 - 1,76); outras arritmias (RR 1,51; IC 0,36 - 6,33) e disfunção VE (RR 1,74; IC 0,31 - 9,88), não havendo associação entre pacientes com IPM>0,43 e a ocorrência destes eventos. O tempo de internação hospitalar foi similar, entre os grupos (p=0,999). CONCLUSÃO: Não houve associação do IPM com complicações cardiovasculares e maior tempo de internação neste grupo de pacientes, podendo-se considerar esse índice inadequado como método preditivo isolado.

Performance of Surgical Risk Scores to Predict Mortality after Transcatheter Aortic Valve Implantation

AbstractBackground:Predicting mortality in patients undergoing transcatheter aortic valve implantation (TAVI) remains a challenge.Objectives:To evaluate the performance of 5 risk scores for cardiac surgery in predicting the 30-day mortality among patients of the Brazilian Registry of TAVI.Methods:The Brazilian Multicenter Registry prospectively enrolled 418 patients undergoing TAVI in 18 centers between 2008 and 2013. The 30-day mortality risk was calculated using the following surgical scores: the logistic EuroSCORE I (ESI), EuroSCORE II (ESII), Society of Thoracic Surgeons (STS) score, Ambler score (AS) and Guaragna score (GS). The performance of the risk scores was evaluated in terms of their calibration (Hosmer–Lemeshow test) and discrimination [area under the receiver–operating characteristic curve (AUC)].Results:The mean age was 81.5 ± 7.7 years. The CoreValve (Medtronic) was used in 86.1% of the cohort, and the transfemoral approach was used in 96.2%. The observed 30-day mortality was 9.1%. The 30-day mortality predicted by the scores was as follows: ESI, 20.2 ± 13.8%; ESII, 6.5 ± 13.8%; STS score, 14.7 ± 4.4%; AS, 7.0 ± 3.8%; GS, 17.3 ± 10.8%. Using AUC, none of the tested scores could accurately predict the 30-day mortality. AUC for the scores was as follows: 0.58 [95% confidence interval (CI): 0.49 to 0.68, p = 0.09] for ESI; 0.54 (95% CI: 0.44 to 0.64, p = 0.42) for ESII; 0.57 (95% CI: 0.47 to 0.67, p = 0.16) for AS; 0.48 (95% IC: 0.38 to 0.57, p = 0.68) for STS score; and 0.52 (95% CI: 0.42 to 0.62, p = 0.64) for GS. The Hosmer–Lemeshow test indicated acceptable calibration for all scores (p > 0.05).Conclusions:In this real world Brazilian registry, the surgical risk scores were inaccurate in predicting mortality after TAVI. Risk models specifically developed for TAVI are required.

Incidence and Predictors of Cardiovascular Complications and Death after Vascular Surgery

AbstractBackground:Patients undergoing arterial vascular surgery are considered at increased risk for post-operative complications.Objective:To assess the incidence and predictors of complications and death, as well as the performance of two models of risk stratification, in vascular surgery.Methods:This study determined the incidence of cardiovascular complications and deaths within 30 days from surgery in adults. Univariate comparison and logistic regression assessed the risk factors associated with the outcomes, and the receiver operating characteristic (ROC) curve assessed the discriminatory capacity of the revised cardiac risk index (RCRI) and vascular study group of New England cardiac risk index (VSG-CRI).Results:141 patients (mean age, 66 years; 65% men) underwent the following surgeries: carotid (15); lower limbs (65); abdominal aorta (56); and others (5). Cardiovascular complications and death occurred within 30 days in 28 (19.9%) and 20 (14.2%) patients, respectively. The risk predictors were: age, obesity, stroke, poor functional capacity, altered scintigraphy, surgery of the aorta, and troponin change. The scores RCRI and VSG-CRI had area under the curve of 0.635 and 0.639 for early cardiovascular complications, and 0.562 and 0.610 for death in 30 days.Conclusion:In this small and selected group of patients undergoing arterial vascular surgery, the incidence of adverse events was elevated. The risk assessment indices RCRI and VSG-CRI did not perform well for complications within 30 days.

Influence of quantities of brewer yeast on the performance of Anastrepha obliqua wild females (Diptera, Tephritidae)

Using artificial solid diets, experiments were performed with Anastrepha obliqua (Macquart, 1835) wild females in order to verify the influence of different quantities of brewer yeast on the performance and compensation behavior to unbalanced diets ingestion. The observed parameters were egg production, ingestion, diet efficiency and survival in the reproductive phase. Results indicated that there was no compensatory ingestion to different quantities of yeast and that the diet with 12.5g of yeast provided the best performance. The absence of compensatory ingestion is discussed based on the yeast phagostimulation and on the costs involved in solid diets ingestion. The relation between the analyzed parameters and the protein quantities in the diet were discussed.

Influência da idade da fêmea na performance reprodutiva e longevidade de Argyrotaenia sphaleropa (Lepidoptera, Tortricidae)

Argyrotaenia sphaleropa (Meyrick, 1909) é uma praga generalista de fruteiras na América do Sul. A influência da idade da fêmea na performance reprodutiva e longevidade foi investigada sob condições laboratoriais. Fêmeas virgens com 1, 3, 5 e 8 dias de idade foram pareadas com machos virgens com idade entre 0 e 3 dias. Longevidade, sucesso no acasalamento, padrão de oviposição, fecundidade e fertilidade, foram avaliados diariamente. O retardo na cópula não influenciou o período de oviposição e longevidade, entretanto, afetou o período de pré-oviposição, sucesso no acasalamento, fecundidade e fertilidade. A percentagem de acasalamento foi 25% inferior em fêmeas de 8 dias de idade, comparadas às fêmeas pareadas com 1 dia após a emergência. A maior fecundidade foi observada nas fêmeas de 1 dia de idade. Fêmeas pareadas com 3, 5 e 8 dias, apresentaram redução na fertilidade de 57, 82 e 99%, respectivamente. As implicações destes resultados em relação às estratégias de controle de A. sphaleropa, são discutidas.

Performance of Anastrepha obliqua (Diptera, Tephritidae) larvae fed on artificial diets

Moscas das frutas do gênero Anastrepha Schiner, 1868 são conhecidas por sua importância econômica devido aos danos que elas causam nos frutos comerciais. As exigências nutricionais dos estágios imaturo e adulto são diferentes e as larvas não se desenvolvem bem utilizando a mesma dieta do adulto. Embora as necessidades nutricionais básicas dos insetos sejam bem conhecidas, existe ainda o problema de elaborar dietas de criação adequadas para espécies com necessidades específicas. O objetivo deste trabalho foi verificar o efeito de diferentes tipos e quantidades de carboidratos na dieta sobre a performance larval de Anastrepha obliqua (Macquart, 1835). Larvas foram criadas individualmente em tubos de ensaio contendo uma das dietas artificiais a serem testadas onde elas foram mantidas até a pupação. A composição básica das dietas testadas incluia 2,5 g de agar, 3,25 g de levedo de cerveja e quantidades variadas de sacarose e farinha de trigo. A adequação do meio artificial para A. obliqua foi testada pela avaliação da sobrevivência larval e pupal (%) e o tempo de desenvolvimento larval, pupal e de larva-adulto. A dieta contendo farinha de trigo (2 g) e sacarose (2 g) e a dieta somente com sacarose (5,5 g) foram as que apresentaram melhor performance larval. Todas as dietas testadas apresentaram resultados similares ou superiores às dietas utilizadas em outros trabalhos. A importância da presença da farinha de trigo e seu valor nutricional para as larvas são discutidos.

Assessing the performance of macroinvertebrate metrics in the Challhuaco-Ñireco System (Northern Patagonia, Argentina)

ABSTRACT Seven sites were examined in the Challhuaco-Ñireco system, located in the reserve of the Nahuel Huapi National Park, however part of the catchment is urbanized, being San Carlos de Bariloche (150,000 inhabitants) placed in the lower part of the basin. Physico-chemical variables were measured and benthic macroinvertebrates were collected during three consecutive years at seven sites from the headwater to the river outlet. Sites near the source of the river were characterised by Plecoptera, Ephemeroptera, Trichoptera and Diptera, whereas sites close to the river mouth were dominated by Diptera, Oligochaeta and Mollusca. Regarding functional feeding groups, collector-gatherers were dominant at all sites and this pattern was consistent among years. Ordination Analysis (RDA) revealed that species assemblages distribution responded to the climatic and topographic gradient (temperature and elevation), but also were associated with variables related to human impact (conductivity, nitrate and phosphate contents). Species assemblages at headwaters were mostly represented by sensitive insects, whereas tolerant taxa such as Tubificidae, Lumbriculidae, Chironomidae and crustacean Aegla sp. were dominant at urbanised sites. Regarding macroinvertebrate metrics employed, total richness, EPT taxa, Shannon diversity index and Biotic Monitoring Patagonian Stream index resulted fairly consistent and evidenced different levels of disturbances at the stream, meaning that this measures are suitable for evaluation of the status of Patagonian mountain streams.

Ectoparasitos de roedores da região urbana de Belo Horizonte, MG: III. Indices pulicidianos, anoplurianos e acarianos em Rattus Norvegicus norvegicus

Indices pulicidianos, anoplurianos e acarianos, globais e específicos foram determinados para os ectoparasitos de Rattus norvegicus norvegicus capturados em zona urbana de Belo Horizonte, Minas Gerais, Brasil, no período de junho de 1980 a setembro de 1982. Tendo-se em vista os valores limites ou críticos atribuídos aos índices pulicidianos, sobretudo ao índice "cheopis" e propostos por diversos autores como medida complementar de vigilância epidemiológica para peste bubônica, a comunidade de Belo Horizonte poderia ter estado exposta a esta infecção, uma vez que os índices globais anuais de 0,3 a 2,4 e a pulga prevalente foi Xenopsylla cheopis (99,2%), com os maiores índices coincidindo com o final da estação seca-fria. Em duas ocasiões, a comunidade poderia ter permanecido altamente exposta à infecção, já que os índices-limites tolerados foram suplantados: 8,8 (outubro 1980) e 6,2 (setembro 1982). Sugere-se que medidas profiláticas como anti-ratização e desinsetização sejam eficazmente aplicadas ao final da estação seca-fria, ou anteriormente à chegada das chuvas, sendo sucedidas pela desratização. Informações sobre índices anoplurianos e acarianos são importantes para que se possa, no exclusivas de roedores

The Influence of Self-fertilization performance and Copulation Behaviour in Reproduction by Cross-fertilization in Groups of Biomphalaria tenagophila (Mollusca, Planorbidae)

The following hypotheses were tested for groups of simultaneous hermaphrodites Biomphalaria tenagophila: (a) snails that have low reproductive success during the process of self-fertilization do not increase their reproductive success after the end of grouping; (b) the copulation behaviour and the presence of one snail whose eggs have a low viability rate influence the partner's reproductive success by cross-fertilization. Groups were constituted by a homozygous pigmented snail and two albinos: one with a viability rate higher than 70% ("good reproducers") and the other less than 10% ("bad reproducers"). All pigmented snails had viability rates higher than 70%. The "good" and "bad" reproducer albino snails had similar copulation behaviour. However, after the end of grouping, the "bad reproducers" continued to have viability rates less than 10% over 30 days. In 100% of the cases that pigmented snails copulated (performing either a male role or simultaneously male and female roles) exclusively with "good" reproducer albinos, they presented high reproductive success (producing, on average of 8.4 pigmented embryos/egg-mass). However, in 100% of the cases that pigmented snails copulated with both partners, the "good" reproducer albino snails produced none or very few embryos (the highest average was 2.2 pigmented embryos/egg-mass). Therefore, the production of viable embryos by cross-fertilization was more influenced by self-fertilization performance than by copulation behaviour. The presence of a snail whose eggs have a low viability rate could decrease their partners reproductive success

Diagnostic performance characteristics of rapid dipstick test for Plasmodium vivax malaria

We compared the diagnostic performance characteristics of newly developed method, the rapid dipstick test, which provides colorimetric determination by developing antibody to the lactate dehydrogenase enzyme of parasites, with conventional standard thick-blood film examination. For the rapid test, OptiMAL commercial kits were used. The results were also evaluated with clinical findings from patients. The parasites were determined by microscopic examination of thick-blood films from 81 patients with vivax malaria from southeastern Anatolia, Turkey. The OptiMAL test results were found to be negative in five patients who were diagnosed clinically and through thick-film testing as having vivax malaria. There was no false positivity observed with the OptiMAL test. We concluded that this rapid malaria test has a lower level of sensitivity than the classical thick-blood-film test for malaria, but that these methods have equal specificity.