[show abstract][hide abstract] ABSTRACT: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers.
We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies.
Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization.
The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization.
Clinics (São Paulo, Brazil) 01/2012; 67(3):261-4. · 1.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: Studies have suggested that the thalamus is a key structure in the pathophysiology of juvenile myoclonic epilepsy. The objective of the present investigation was to examine the thalami of patients with juvenile myoclonic epilepsy using a combination of multiple structural neuroimaging modalities. The association between these techniques may reveal the mechanisms underlying juvenile myoclonic epilepsy and help to identify the neuroanatomical structures involved. Twenty-one patients with juvenile myoclonic epilepsy (13 women, mean age=30±9 years) and a control group of 20 healthy individuals (10 women, mean age=31±8 years) underwent MRI in a 2-T scanner. The volumetric three-dimensional sequence was used for structural investigation. Evaluation of the thalamus comprised voxel-based morphometry, automatic volumetry, and shape analysis. Comparisons were performed between patient and control groups. Voxel-based morphometry analysis identified areas of atrophy located in the anterior portion of the thalamus. Post hoc analysis of automatic volumetry did not reveal significant differences between the groups. Shape analysis disclosed differences between patients and controls in the anterior and inferior portions of the right thalamus and in the anterior portion of the left thalamus. The present investigation confirms that thalami of patients with juvenile myoclonic epilepsy are structurally abnormal with impairments located mainly in the anterior and inferior sections.
[show abstract][hide abstract] ABSTRACT: Inflammation and dysfunction of the hypothalamus are common features of experimental obesity. However, it is unknown whether obesity and massive loss of body mass can modify the immunologic status or the functional activity of the human brain. Therefore, the aim of this study was to determine the effect of body mass reduction on brain functionality.
In humans, changes in hypothalamic activity after a meal or glucose intake can be detected by functional magnetic resonance imaging (fMRI). Distinct fMRI analytic methods have been developed to explore changes in the brain's activity in several physiologic and pathologic conditions. We used two analytic methods of fMRI to explore the changes in the brain activity after body mass reduction.
Obese patients present distinct functional activity patterns in selected brain regions compared with lean subjects. On massive loss of body mass, after bariatric surgery, increases in the cerebrospinal fluid (CSF) concentrations of interleukin (IL)-10 and IL-6 are accompanied by changes in fMRI patterns, particularly in the hypothalamus.
Massive reduction of body mass promotes a partial reversal of hypothalamic dysfunction and increases anti-inflammatory activity in the CSF.
[show abstract][hide abstract] ABSTRACT: Stigma is a major issue for people who develop epilepsy. Reducing stigma is a major focus of activity for the epilepsy patient support groups globally. In this paper, we introduce some key ideas and debates about the nature of and drivers for the stigma of epilepsy, including recent arguments about the need to frame analyses of the nature of epilepsy stigma within sociological debates about conflict and power. We then consider the role of the legislative process for redressing power imbalances that promote or maintain epilepsy stigma; and the value of tailored educational campaigns and programmes directed at stigma reduction. Finally, we consider the nature of 'difference' as experienced by people with epilepsy and how that difference translates into stigma; and provide evidence from a specific targeted intervention to combat epilepsy stigma that its reduction is an achievable goal.
[show abstract][hide abstract] ABSTRACT: Patients with deficit schizophrenia have worse cognition and poorer social functioning compared to the nondeficit ones. Insight is another domain in which these two groups might differ, but data on insight impairment in deficit versus nondeficit schizophrenia are still scarce. We compared 29 patients with deficit schizophrenia to 44 nondeficit patients and found a tendency to poorer insight in the deficit group. However such tendency disappeared when analysis was controlled for cognition, a domain in which both groups differed significantly. This finding reinforces the pressing need for simultaneous assessment of the several dimensions or domains of schizophrenic psychopathology.
Schizophrenia Research 02/2011; 128(1-3):124-6. · 4.59 Impact Factor
[show abstract][hide abstract] ABSTRACT: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy.
A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without.
The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4).
The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy.
Arquivos de neuro-psiquiatria 01/2011; 69(2B):342-8. · 0.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: Objective: To estimate the frequency of depression/anxiety and to establish the social, epilepsy and psychiatric characteristics in individuals with epilepsy. Method: A cross-sectional study was employed to evaluate 153 subjects with epilepsy who were identified in a previous community-based survey. First, a structured interview was conducted, followed by a psychiatric evaluation. Subjects with depression were compared to those without, and subjects with anxiety were compared to those without. Results: The prevalence of anxiety and depression was 39.4 and 24.4%, respectively. Both were associated with low schooling (OR 3.8, 95% CI 1.6 to 9.0 and OR 2.8, 95% CI 1.2 to 6.5 for depression and anxiety, respectively), lifetime suicidal thoughts (OR 4.4, 95% CI 1.9 to 10.3 and OR 3.6, 95% CI 1.7 to 7.7) and lifetime suicide attempts (OR 9.3, 95% CI 2.6 to 32.8 and OR 6.9, 95% CI 1.8 to 26.4). Conclusion: The high rates of depression and anxiety reinforced the need for recognition and treatment of mental disorders in epilepsy. Depressão e ansiedade na epilepsia: uma amostra da comunidade no Brasil RESUMO Objetivo: Estimar a frequência de depressão/ansiedade em pessoas com epilepsia e estabelecer as características sociais, da epilepsia e psiquiátricas associadas. Método: Foi feito um estudo transversal para avaliar 153 sujeitos com epilepsia identificados em um levantamento prévio feito na comunidade. Primeiramente foi realizada uma entrevista estruturada, seguida de uma avaliação psiquiátrica. Os sujeitos deprimidos foram comparados com aqueles sem depressão e os sujeitos com ansiedade foram comparados com aqueles sem ela. Resultados: A prevalência de ansiedade e depressão foi de 39,4% e 24,4%, respectivamente. Ambas foram associadas a baixa escolaridade (OR 3,8; IC95% 1,6-9,0 e OR 2,8, IC95% 1,2-6,5 para depressão e ansiedade, respectivamente), ideação suicida (OR 4,4; IC95% 1,9-10,3 e OR 3,6; IC95% 1,7-7,7) e tentativa de suicídio (OR 9,3; IC95% 2,6-32,8 e OR 6,9; IC95% 1,8-26,4). Conclusão: As altas taxas de depressão e ansiedade reforçam a necessidade de reconhecimento e tratamento dos transtornos mentais na epilepsia. Palavras-chave: transtornos do humor, ansiedade, depressão, epilepsia, epidemiologia, tentativa de suicídio.
[show abstract][hide abstract] ABSTRACT: Epilepsy has been associated with increased risk of suicide; however, few studies have examined the relationship between epilepsy and suicidal behavior. The aims of this study were to evaluate the frequency of suicidal behavior in people with epilepsy and to identify characteristics that are associated with suicidal ideation in epilepsy. Of 171 people with epilepsy identified in a previous survey, 139 were included. A structured interview was conducted, and a second psychiatric evaluation was scheduled for those who agreed. The frequencies of suicidal thoughts, plans, and attempts during lifetime were 36.7, 18.2, and 12.1%, respectively. The following conditions were strongly associated with suicidal thoughts: anxiety (OR=3.3, 95% CI=1.4-7.5, P=0.001), depression (OR=4.8, 95% CI=1.9-12.5, P=0.001), and two or more standardized psychiatric diagnoses (OR=21.6, 95% CI=4.4-105.9, P<0.0001). Although specific characteristics of epilepsy were found to be related to suicidal thoughts, psychiatric diseases also play an essential role.
[show abstract][hide abstract] ABSTRACT: To provide information about psychiatric comorbidity and suicidal behavior in people with epilepsy compared to those without epilepsy from a community sample in Brazil.
An attempt was made to evaluate all 174 subjects with epilepsy (cases) identified in a previous survey. For every case identified, an individual without epilepsy (control) matched by sex and age was selected in the same neighborhood. A structured interview with validated psychiatric scales was performed. One hundred and fifty-three cases and 154 controls were enrolled in the study.
People with epilepsy had anxiety more frequently [39.4% vs. 23.8%, odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.5; p = 0.006], depression (24.4% vs. 14.7%, OR 1.9, 95% CI 1.01-3.5; p = 0.04), and anger (55.6% vs. 39.7%, OR 1.9, 95% CI 1.2-3.1; p = 0.008). They also reported more suicidal thoughts [36.7% vs. 23.8%, OR 1.8, 95% CI 1.1-3.1; p = 0.02), plans (18.2% vs. 3.3%, OR 2.0, 95% CI 1.0-4.0; p = 0.04), and attempts (12.1% vs. 5.3%, OR 2.4, 95% CI 1.1-3.2, p = 0.04) during life than controls.
These findings call attention to psychiatric comorbidity and suicidal behavior associated with epilepsy. Suicide risk assessment, mental evaluation, and treatment may improve quality of life in epilepsy and ultimately prevent suicide.
[show abstract][hide abstract] ABSTRACT: Computed tomography (CT) images are routinely used to assess ischemic brain stroke in the acute phase. They can provide important clues about whether to treat the patient by thrombolysis with tissue plasminogen activator. However, in the acute phase, the lesions may be difficult to detect in the images using standard visual analysis. The objective of the present study was to determine if texture analysis techniques applied to CT images of stroke patients could differentiate between normal tissue and affected areas that usually go unperceived under visual analysis. We performed a pilot study in which texture analysis, based on the gray level co-occurrence matrix, was applied to the CT brain images of 5 patients and of 5 control subjects and the results were compared by discriminant analysis. Thirteen regions of interest, regarding areas that may be potentially affected by ischemic stroke, were selected for calculation of texture parameters. All regions of interest for all subjects were classified as lesional or non-lesional tissue by an expert neuroradiologist. Visual assessment of the discriminant analysis graphs showed differences in the values of texture parameters between patients and controls, and also between texture parameters for lesional and non-lesional tissue of the patients. This suggests that texture analysis can indeed be a useful tool to help neurologists in the early assessment of ischemic stroke and quantification of the extent of the affected areas.
Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade Brasileira de Biofisica ... [et al.] 10/2009; 42(11):1076-9. · 1.08 Impact Factor
[show abstract][hide abstract] ABSTRACT: Experimental animal studies have shown that physical exercise, associated with planning and execution of complex movements, are related to changes in brain structure. In humans, changes in cortical tissue density in relation to physical activity are yet to be fully determined and quantified. We investigated differences on gray matter volume in judo players by using voxel-based morphometry. Comparison between a group of eight internationally competitive judo players and a group of 18 healthy controls showed a significantly higher gray matter tissue density in brain areas of judo players.
Journal of science and medicine in sport / Sports Medicine Australia. 02/2009; 12(6):688-90.
[show abstract][hide abstract] ABSTRACT: Stroke awareness by lay people in general is poor. It has been estimated that only as much as one third of patients with acute stroke reach emergency medical services within two hours of onset of their symptoms. We aimed to assess perception of and attitude towards a person with an acute stroke by professionals working in mobile unit of emergency medical service in the city of Campinas, Brazil.
The study was conducted during VII Stroke Workshop of Campinas in November 2007. We used an anonymous self-report questionnaire with a clinical case of an acute stroke with duration of 50 minutes. We asked two open-ended questions to gauge perception and attitude.
One-hundred forty-nine of 205 (73%) participants answered the questionnaire; 49% were women, average age of 37 years (range 21-59). Ninety (60%) were professionals allied to medicine (nurses, health auxiliary, dentists), six (4%) were physicians, and 53 (36%) were other professionals (secretary, driver). In regard to perception, 142 of 149 (95%) had a correct perception of stroke. In regard to attitude, in general, the basic support measures have been pointed out, but only one (0.5%) mentioned an issue of time less than 3 hours for thrombolysis, four (2%) mentioned the possibility of thrombolysis, and 12 (8%) requested computed tomographic examination.
It appears that professionals allied to medicine can diagnosis stroke of anterior circulation; however, they do not have thrombolytic therapy in mind, and this should be considered the default treatment for all patients with stroke within the "therapeutic window."
Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association 01/2009; 18(3):195-7.
[show abstract][hide abstract] ABSTRACT: This study aimed to validate two instruments that evaluate pre-surgery expectations and post-surgery life changes of people with epilepsy. The expectations questionnaire comprises 18 yes/no questions and the life changes questionnaire 25 yes/no questions, which includes the 18 questions of the expectations questionnaire plus seven negative questions, considering that the surgery could have a negative effect on the patient quality of life. There were also questions asking the patients to state if they consider the surgery to be a success or a failure, and about the frequency of seizures and their intensity. Patients were interviewed in three different phases: pre-surgery, post-surgery 1 (six months after surgery) and post-surgery 2 (12 months after surgery). The internal consistency of the instruments showed a general Kuder-Richardson coefficient of 0.855 (pre-surgery), 0.833 (post-surgery 1), 0.756 (post-surgery 2), showing that both instruments have a satisfactory content validity and high internal consistency. In this context, the answers obtained in this study are important because they represent the development of a complete set of categorical instruments to evaluate pre-surgery epilepsy expectations and post-surgery life changes.
Epileptic disorders: international epilepsy journal with videotape 01/2009; 10(4):290-6. · 1.17 Impact Factor
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to evaluate the impact upon attitude and perceived stigma of using different terms for referring to persons with epilepsy among teenagers. High school students received one of two versions of a brief questionnaire and of the Stigma Scale of Epilepsy (SSE). The versions differed only in the term used: "people with epilepsy" (PWE) in the group-1 (N = 109) and "epileptics" in group-2 (N = 105). Group-1 responded that 62% of PWE and group-2, that 93% of epileptics have more difficulty finding employment. Group-1 responded that 37% of PWE and group-2, that 70% of epileptics have more difficulties at school. Group-1 responded that 41% of PWE and group-2, that 87% of epileptics are rejected by the society. None of individuals in group-1 indicated that they were prejudiced toward PWE, whereas 3% of group-2 indicated that they were prejudiced toward epileptics. The SSE score (range from 0 to 100, higher the score, higher the degree of perceived stigma) was 49 [confidence interval (CI) = 46.9-52.0] for group-2 and 45 (CI = 42.4-48.2) for group-1 (p = 0.03). In conclusion, the words we use can influence our perceptions and have consequences in terms of social stigma associated with epilepsy. We should refrain from using the term "epileptic" to refer to a person with epilepsy, and consider the importance of our choice of words as part of the effort to bring epilepsy out of the shadows.
[show abstract][hide abstract] ABSTRACT: To assess the perception of epilepsy stigma in different regions of Brazil.
The Stigma Scale of Epilepsy (SSE) questionnaire was applied to people in different Brazilian urban settings. The survey was performed on individual basis; an interviewer read the questions to the subjects and wrote down the answers. The same procedure was applied to all the subjects and took around 10 minutes.
266 questionnaires were completed in four different towns of Brazil (Curitiba=83; São Paulo=47; Vila Velha=79; Ipatinga=57). The overall stigma score was 49.7 (median). Different scores were obtained in each locality. Vila Velha=42; Curitiba=49; São Paulo=52; Ipatinga=54 (ANOVA [2.262]=3.82; p=0.01).
This study showed differences in the perception of stigma, which may depend on cultural and regional aspects. The concept of stigma has cultural perspectives, depending on the region and the context where each person lives. The understanding of this aspect of epilepsy is important to promote better de-stigmatization campaigns, considering the cultural and social differences.
Arquivos de Neuro-Psiquiatria 10/2008; 66(3A):471-6. · 0.83 Impact Factor