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Search Results: 1 - 10 of 131992 matches for " Bloch Katia V. "
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Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study
Evandro SF Coutinho, Astrid Fletcher, Katia V Bloch, Laura C Rodrigues
BMC Geriatrics , 2008, DOI: 10.1186/1471-2318-8-21
Abstract: A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002–2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture.Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk.Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs.About one third of the population aged 65 or more suffers at least one fall a year, of which 5 to 10% result in severe injuries [1-4]. More than 90% of hip fractures are the result of a fall [5,6]. Falling and the frequency of falls increases exponentially with age [1,3-5,7]. Injuries resulting from falls incur costs for health providers, social services, patients and their families [6-8].An active research agenda exists with a focus on prevention [2]. Cognitive impairment, low body mass index and certain medications such as benzodiazepines have been consistently associated with severe injuries from falls [5,9-12]. Data on the proportion of fall-related injuries attributable to each of these factors is sparse and it is likely that their relative contribution varies from one setting to another.Most studies of risk factors for fractures due to falls have been carried out in developed countries, althoug
Qualidade de vida de crian?as e adolescentes portadores de febre reumática
Carvalho, Márcia F. C.;Bloch, Katia V.;Oliveira, Sheila K. F.;
Jornal de Pediatria , 2009, DOI: 10.1590/S0021-75572009000500012
Abstract: objective: to assess the quality of life of patients with rheumatic fever receiving outpatient treatment at two hospitals. methods: cross-sectional study using the child health questionnaire (chq) administered to the parents of 133 patients with rheumatic fever aged between 5 and 18 years. the scores of the several dimensions of the questionnaire were calculated and compared within the categories of clinical and sociodemographic variables using a nonparametric test. results: patients' age ranged from 5 to 18 years old, with a mean age of 12 years and standard deviation of 2.8 years. the most common manifestation of the disease was articular symptoms associated with cardiac problems, present in 74 cases (56.1%). most patients belonged to low-income families. subjects had higher scores on the following concepts of the questionnaire: physical functioning, role/social-physical; role/social-emotional/behavioral; bodily pain; and family activities. the items with the lowest scores were: family cohesion; general health; global behavior; and parental impact-emotional. girls had higher scores on: self-esteem; role/social-emotional/behavioral; and general health. patients belonging to middle-income families had higher scores on: mental health; physical functioning; role/social-physical; and family activities. children from the lowest social class had higher scores on bodily pain and psychosocial aspects. conclusions: the quality of life of patients with rheumatic fever is similar to that of patients with other chronic diseases, showing intermediate scores on the several concepts included both in the physical and the psychosocial domains. social class was the variable most frequently associated with the chq concepts.
Hipertens o arterial na Ilha do Governador, Brasil: II. Prevalência
Klein Carlos Henrique,Silva Nelson A. de Souza e,Nogueira Armando da R.,Bloch Katia V.
Cadernos de Saúde Pública , 1995,
Abstract: Este segundo artigo (de uma série de dois) tem como finalidade apresentar apenas os resultados básicos de um estudo, em amostra representativa de popula o, sobre Hipertens o Arterial na Ilha do Governador (regi o administrativa do município do Rio de Janeiro), em três estratos de acordo com a renda média domiciliar (baixa, média e alta) de setores censitários. No conjunto da Ilha do Governador a prevalência de hipertens o n o controlada foi de 16,1 % (I.C. de 95%: 13,4 a 18,9%), e incluindo-se os hipertensos controlados, este índice subiu para 24,9% (I.C. de 95%: 21,7 a 28,1 %). Por ambos os critérios (incluindo ou n o os hipertensos controlados), as prevalências mais elevadas foram as do estrato de renda baixa e as menores do estrato de renda alta. Porém, só foi possível rejeitar a homogeneidade de prevalências de hipertens o (incluindo os controlados) entre os estratos, e ainda assim para uma significancia de 10%, quando se ajustou o efeito de confus o da idade. As mulheres hipertensas parecem controlar em maior propor o seus níveis de press o arterial em qualquer faixa etária dos adultos, do que os homens.
Hipertens o arterial na Ilha do Governador, Rio de Janeiro, Brasil: I. Metodologia
Klein Carlos Henrique,Silva Nelson A. de S. e,Nogueira Armando da R.,Bloch Katia V.
Cadernos de Saúde Pública , 1995,
Abstract: Este primeiro artigo (de uma série de dois) tem como finalidade apresentar os principais aspectos da metodologia empregada em um estudo de popula o para determinar a prevalência de Hipertens o Arterial na Ilha do Governador (regi o administrativa do município do Rio de Janeiro), e estudar sua rela o com outros fatores de risco, inclusive para doen as cardiovasculares, assim como conhecer o seu estado de controle. S o descritos com detalhes o delineamento amostral (amostragem de aglomerados em estratos, segundo renda média domiciliar) e os instrumentos de coleta de dados. S o apresentados, ainda, indicadores de desempenho no trabalho de campo e do controle de qualidade.
Hipertens?o arterial na Ilha do Governador, Rio de Janeiro, Brasil: I. Metodologia
Klein, Carlos Henrique;Silva, Nelson A. de S. e;Nogueira, Armando da R.;Bloch, Katia V.;Campos, Lúcia Helena S.;
Cadernos de Saúde Pública , 1995, DOI: 10.1590/S0102-311X1995000200003
Abstract: the aim of this paper (first of a series of two) is to present the main methodological aspects used in a cross-sectional study whose proposals were to establish the prevalence of arterial hypertension in adults in ilha do governador (a district of the city of rio de janeiro, brazil), and to examine its relationship to other risk factors, including those for cardiovascular diseases, so as to establish its control status. sampling design (of clusters in strata, according to mean household income) is described in detail, in addition to measurement methods, and training of observers. indicators of performance in field work and quality control are also presented as results of the application of the metodology of study.
Press?o arterial, glicemia capilar e medidas antropométricas em uma popula??o Yanomámi
Bloch, Katia V.;Coutinho, Evandro da S. F.;L?bo, Maria Stella de C.;Oliveira, José Egídio P. de;Milech, Adolfo;
Cadernos de Saúde Pública , 1993, DOI: 10.1590/S0102-311X1993000400003
Abstract: seventy-two yanomámi indians from surucucus, roraima, brazil, were examined to evaluate the correlation between capillary glucose level (cgl), systolic and diastolic blood pressure (sbp and dbp), and anthropometrical features. blood pressure was higher among men than women: sbp=109.8 and 100.2 mm hg; dbp=71.2 and 63.5 mmhg, respectively. levels compatible with hypertension were not found. sbp was correlated negatively with age and positively with height, weight, body mass index (bmi), and waist and hip circumferences. controlling for bmi did not change the negative correlation between sbp and age. when weight was controlled, correlation between sbp and height changed to a negative value, but when height was controlled, positive correlation between weight and pas was mantained. dbp was positively correlated with weight and height. capillary glucose level was significantly higher among women than men: 114.1 and 98.4 mg/dl, respectively. when weight was controlled, waist circumference correlated positively with cgl. when waist circumference was controlled, weight and bmi correlated negatively with cgl. the results suggest that while blood pressure is correlated especially with body mass, capillary glucose level is more correlated with abdominal fat distribution.
Hipertens?o arterial na Ilha do Governador, Brasil: II. Prevalência
Klein, Carlos Henrique;Silva, Nelson A. de Souza e;Nogueira, Armando da R.;Bloch, Katia V.;Campos, Lúcia Helena S.;
Cadernos de Saúde Pública , 1995, DOI: 10.1590/S0102-311X1995000300015
Abstract: the aim of this paper (the second of two) is to present the basic results of a cross?sectional study on arterial hypertension in adults in ilha do governador (a district of the city of rio de janeiro, brazil), with a representative sample of the population, stratified by the census tracts' mean household incorre (low, median, and high). overall, prevalence of uncontrolled hypertension in ilha do governador was 16.1% (c.i. of 95%: 13.4 to 18.9%), and with the inclusion of controlled hypertensive individuals this figure rose to 24.9% (c i. of 95%: 21.7 to 28.7%). under both criteria (whether including controlled hypertensive individuais or not), higher prevalences were from low?incorre strata, while lower ones were from the high?incorre strata. however, it was only possible to reject the hypothesis of strata homogeneity of prevalences (including controlled hypertensives), and even then at a 10% level of significance, when the confounding effect of age was adjusted. proportionally, women with hypertension appear to control their blood pressure levels better than men in all age brackets.
One-year mortality among elderly people after hospitalization due to fall-related fractures: comparison with a control group of matched elderly
Coutinho, Evandro Silva Freire;Bloch, Katia Vergetti;Coeli, Claudia Medina;
Cadernos de Saúde Pública , 2012, DOI: 10.1590/S0102-311X2012000400019
Abstract: fall-related fractures among the elderly represent an important public health problem. severe fractures have been related to increased risk of death. in order to investigate the mortality profile of elderly individuals with severe fractures, 250 patients aged 60 years and over, hospitalized due to fall-related fractures and 250 elderly without fractures living in the local community were followed-up for one year. they were matched according to sex, age, time of hospitalization and neighborhood. deaths were identified using probabilistic linkage of the research dataset and the local mortality registry. the one-year cumulative mortality was 25.2% in the case of individuals with severe fractures and 4% for those individuals without. the mortality distribution was not homogeneous across the follow-up period. two-thirds of deaths among the elderly individuals hospitalized due to fracture occurred within the first 3 months, whereas mortality among those individuals without fractures took place later. heart disease, pneumonia, gi bleeding, sepsis, and pulmonary embolism, diabetes and stroke were important causes of one-year mortality.
Prevalência da ades?o ao tratamento anti-hipertensivo em hipertensos resistentes e valida??o de três métodos indiretos de avalia??o da ades?o
Bloch, Katia Vergetti;Melo, André Nascimento de;Nogueira, Armando R.;
Cadernos de Saúde Pública , 2008, DOI: 10.1590/S0102-311X2008001200030
Abstract: this study estimated adherence to anti-hypertensive medication using three indirect methods and their combinations in a cohort of patients with resistant hypertension in rio de janeiro, brazil, 2005. the methods used were: self-reported adherence; physicians' adherence evaluation; and the morisky-green test (mgt) translated into portuguese. the predictive validation was performed comparing office blood pressure and ambulatory blood pressure monitoring, measured on two different occasions, from patients classified as adherent or not. the means were compared using non-parametric tests. two hundred patients were interviewed. mean age was 63 years (sd = 10.3), and 73.5% were female. adherence prevalence was 51% using mgt, 52% according to the physician, and 80.5% according to the patient. adherent patients showed a reduction in both office blood pressure and ambulatory blood pressure, while non-adherent patients did not. the use of more than one method to evaluate adherence showed that non-adherent individuals according to the three methods (11.9%) had the worst evolution in blood pressure levels. this finding suggests that resistant hypertension cannot be attributed exclusively to low adherence.
Ensaios clínicos pragmáticos: uma op??o na constru??o de evidências em saúde
Coutinho, Evandro da Silva Freire;Huf, Gisele;Bloch, Katia Vergetti;
Cadernos de Saúde Pública , 2003, DOI: 10.1590/S0102-311X2003000400039
Abstract: the authors present and discuss the potential of pragmatic clinical trials as an alternative to both explanatory trials and observational studies to support the use of therapeutic interventions with good evidence. they argue that this strategy, when properly applied, can be a powerful tool to obtain unbiased measures of effectiveness, with simpler logistics and lower costs than in current clinical trials.
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