961 resultados para Nightingale, Florence


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In this paper we discuss the existence of compact attractor for the abstract semilinear evolution equation u = Au + f (t, u); the results are applied to damped partial differential equations of hyperbolic type. Our approach is a combination of Liapunov method with the theory of alpha-contractions.

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Cytogenetic studies carried out on nine species belonging to five genera of the subfamily Hypoptopomatinae showed that this group has a relatively constant diploid number, 2n = 54, with only one species having 2n = 72 chromosomes. Nevertheless, the karyotypic formulae, NOR position and C-band pattern are very different among species and sometimes among local populations, with species having undifferentiated sex chromosomes and species having the XX/XY or the ZZ/ZW mechanisms. The population structure of species belonging to the subfamily Hypoptopomatinae suggests that many chromosome rearrangements have been fixed in the different species and populations due to their geographic isolation and these karyotypic differences may be very important today for species definition.

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Cytogenetic studies involving conventional Giemsa staining, C-banding analysis and silver staining of NORs were performed on nine species belonging to six genera of the family Callichthyidae. The diploid number ranged from 2n = 44 to 2n = 100, the number of chromosomal pairs with NORs ranged from 1 to 4 and constitutive heterochromatin was mainly distributed in the centromeric and/or pericentromeric position of the chromosomes. The DNA content of erythrocytes from six species studied ranged from 1.18 +/- 0.07 to 2.77 +/- 0.22 pg/nucleus. The extensive variability in karyotypes and in nuclear DNA content detected are in accordance with the initial hypothesis that chromosome rearrangements and polyploidy have played a significant role in the evolutionary history of Callichthyidae.

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Objective. To investigate the proxy-reported health-related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA).Methods. In this multinational, multicenter, cross-sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate.Results. A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 +/- 10.6 versus 54.6 +/- 4.0, P < 0.0001; psychosocial: 47.6 +/- 8.7 versus 51.9 +/- 7.59 P < 0.0001), with the physical well-being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score > 1 and a pain intensity rating > 3.4 cm on a 10-cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively.Conclusion. We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well-being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health.

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Swallowing function may be impaired by a number of conditions involving primary or associated emotional distress. When psychogenic dysphagia is suspected, routine investigation using radiological and manometric examination is inappropriate. These cases demand an evaluation of the individual as a whole, interesting the disease as well as the patient's personal problems and concerns. Five cases of patients complaining of swallowing difficulty and showing concurrent emotional distress were studied. Four individuals were anxious and one was depressed. Because of our approach, a close medical-patient-relationship was established. Afterwards, an explanation about the normal swallowing mechanisms and the role of the emotions on it was provided. All patients showed improvement of the symptom in the following 24 hours. Dysphagia can be found in anxiety, depression and conversion hysteria, with high incidence in the urban population of the third world countries. However, several professionals are unaware of these disorders. Our results suggest that this plain approach is an useful tool in managing dysphagic patients and it has validity even in individuals bearing dysphagia due to comproved organic disease. The results also emphasize the importance of the medical patient relationship and the utility of a hollistic evaluation of the disease.

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The aim of this paper was to assess the Projeto UNI (Kellogg Foundation) in one of the Mental Health Centers (ARE) of Botucatu, SP, Brazil. We analysed 20% of the charts and the number of patients seen by psychiatrists and other mental health professionals before and after. Our results showed that: 1) the service users were mainly of neurotic patients (anxious, dysthymiacs, ICD-9 V code), followed by psychotics (schizophrenics, affectives) and organics (epileptics, mental deficients, demented patients); 2) there were more treatment options after the Projeto UNI implementation and over 2,495 group consultations were made in one year (as opposed to 90 in the year prior the project); 3) medical and nurse students are evaluating the program favourably; 4) there is a clear necessity of reassessing and changing some prescription practices: 43% of the patients were taking drug associations, there was an excessive use of benzodiazepines (54%) and low use of mood stabilizers (5%). There is also a need for more availability of depot neuroleptics, other antidepressants and better quality psychotropic drugs, and 5) there is a necessity of improving quality and quantity of charts information.

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The purpose of this study was to compare the efficacy and tolerability of venlafaxine and amitriptyline in outpatients with major depression with or without melancholia. This was an 8-week, multicentre, randomized, double-blind, parallel-group comparison of venlafaxine and amitriptyline. Outpatients with DSM-IV major depression, a minimum score of 20 on the 21-item Hamilton Depression Rating Scale (HAM-D), and depressive symptoms for at least 1 month were eligible. Patients were randomly assigned to venlafaxine or amitriptyline, both drugs titrated to a maximum of 150 mg/day until study day 15. The primary efficacy variables were the final on-therapy scores on the HAM-D, Montgomery-Asberg Depression Rating Scale and Clinical Global Impression severity scales. Data were evaluated on an intent-to-treat basis using the LOCF method. One hundred and 16 patients were randomized, and 115 were evaluated for efficacy. Both drugs showed efficacy in the treatment of depression with or without melancholia. No significant differences were noted between treatments for any efficacy parameter. However, significantly (p < 0.05) more patients in the amitriptyline group had at least one adverse event. These results should support the efficacy and tolerability of venlafaxine in comparison with amitriptyline for treating major depression with or without melancholia.

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The objective of this study is to translate to Brazilian Portuguese, and validate (criterion) it to the Brazilian population, the Women's Health Questionnaire (WHQ), questionnaire was developed by Hunter (1992) in order to evaluate physical and mental symptoms, which were experienced by women, along their climacteric transition. A sample of 63 women, from 45 to 65 years old, was selected from the HC-UNESP staff and HC-Community Health School Center users. The WHQ and the General Health Questionnaire - GHQ (Goldberg-1972 - 60 items) were answered by all of them. The GHQ was used as reference. Pearson correlation coefficient, sensitivity and specificity were calculated for assessing the validity of the questionnaire. Cut-off points were determined in the WHQ by linear regressions (the reference was GHQ's cut-off points - higher than 2). Outcomes highlighted a general index of sensitivity of 0.83, specificity of 0.87, and correlation of - 0.82 and reliability of 0.89. The study sample does not portray the general population because the persons interviewed had high level of education. As the WHQ is easy to be applied and analyzed, it could be used in general, gynecologic, oncology and psychiatric practice.