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- ItemAcesso aberto (Open Access)Abordagens diagnósticas na Síndrome da Apneia Obstrutiva do Sono(Universidade Federal de São Paulo (UNIFESP), 2009) Bittencourt, Lia Rita Azeredo [UNIFESP]; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4797424Y1; Universidade Federal de São Paulo (UNIFESP)The Obstructive Sleep Apnea Syndrome (OSAS) is high prevalent and has as consequences excessive daytime sleepiness, risk of labor and traffic accidents, cognitive impairment, mood alterations, metabolic and cardiovascular diseases that compromise the health, the quality of life and surveillance of the patients. Still, the syndrome is not always adequately diagnosed, due especially to physicians’ limited acquaintance, patients’ misperception of signs and symptoms and to the complexity of diagnostic methods. In this dissertation it will be presented and discussed the main publications of my line of research concerning limitations on OSAS diagnostic approaches. The polysomnography (PSG) is considered the gold standard method for evaluating the syndrome; nevertheless, the reproductibility of measured parameters during the exam had not been completed evaluated. On my doctorate thesis, I attested that there is an individual variability of the apnea and hypopnea index (AHI), the metric measure used in the PSG for OSAS’s diagnose and treatment follow-up. Thereafter we sought to develop a systematic evaluation model of the upper airway that could simply and practically contribute to a diagnostic approach. Such model demonstrated a significant relationship with the presence and severity of OSAS in a sample of patients presenting the syndrome. Later on, in other two studies, one comparing patients and controls, and other comparing obese with and without OSAS, the model was able to differentiate groups and to demonstrate relationship to OSAS independently of obesity. In addition to this line of research, we demonstrated the accuracy of portable devices for cardio-respiratory ambulatory register, in diagnosing patients with high clinical probability for OSAS. With these results we prove the validity of simplified clinical and register methods for OSAS.
- ItemAcesso aberto (Open Access)Análise da fluência de fala na Doença de Parkinson(Universidade Federal de São Paulo (UNIFESP), 2011-01-26) Brabo, Natália Casagrande [UNIFESP]; Ortiz, Karin Zazo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: to characterize the frequency of occurrence and typology of disfluencies in individuals with PD verifying their relationship with the dysarthria and praxis verbal and nonverbal. Methods: This was a transversal observational study in which were analyzed 60 subjects, over 60 years, paired by their age and gender. The group was composed by 30 normal controls patients and 30 with PD. In order to evaluate the speech fluency, it was requested to the patients to narrate a story based on a picture description with seven pictures and was realized a transcript of 200 fluent syllables for verification of disfluencies and speech rate. So it was able to evaluate the speech praxis by the Boston Diagnosis of Aphasia, a dysarthria protocol. The patient’s performance was compared with the control group. Results: there was no difference between groups regarding gender, age and education. The PDG presented a greater number of total and atypical disfluencies in speech and worst praxis verbal and nonverbal compared to CG. All subjects with PD presented hypokinetic dysarthria. Typical and atypical disfluencies of speech were highly related to the dysarthria frame than to the praxis verbal and non-verbal ones. Conclusion: the atypical disfluencies are present in the speech of PD patients and they are more related to the dysarthria.
- ItemAcesso aberto (Open Access)H1N1: pandemia e perspectiva atual(Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2011-12-01) Bellei, Nancy Cristina Junqueira [UNIFESP]; Melchior, Thaís Boim [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The swine origin influenza virus A/CALIFORNIA/04/2009 (H1N1) was first detected in Mexico and determined the 2009 influenza pandemic. In August 2010, World Health Organization (WHO) declared the beginning of the post-pandemic period. This last pandemic was distinctly different from previous ones. The virus emerged from genetic rearrangement in non-human mammalian host. Moreover, its inter-species transmission is fully reported. However, it affected human population differently from previous pandemic viruses (1918, 1957, 1968), with increased morbidity and mortality among children and young adults. Currently, the virus has a seasonal pattern in the same way as influenza A H3N2 and influenza B, maintaining the same pathogenicity profile, clinical spectrum and sensitivity to antiviral agents. The strain was included in the annual trivalent seasonal vaccine formulation, mainly for risk groups, which are more vulnerable to complications caused by different influenza strains.
- ItemAcesso aberto (Open Access)Testes de rastreamento x testes de diagnóstico: atualidades no contexto da atuação fonoaudiológica(Pró-Fono Produtos Especializados para Fonoaudiologia Ltda., 2007-06-01) Goulart, Bárbara Niegia Garcia de [UNIFESP]; Chiari, Brasilia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); FeevaleBACKGROND: evaluation instruments, properties, selection indicators, application and validation of screening and diagnostic tests. AIM: to present some concepts concerning screening and diagnostic tests and their application according to a specific purpose. To present a few practical examples of the application of these instruments related to human communication, as well as to present validation criteria of tests in the population and criteria used for the rational selection of screening or diagnostic instruments in health programs and health services based on epidemiological concepts indexed in Scielo, Lilacs or Medline up to January 2007. CONCLUSION: diagnostic instruments differ from screening instruments in their objectives and eligibility criteria. Sensibility and specificity are two important indicators to be considered when choosing an instrument for screening or diagnosis. Reproducibility, time required to complete the evaluation and previous preparation of patients, if needed, are also indicators to be considered when choosing an instrument. Publication and information exchange regarding the properties of evaluation instruments, used for diagnosis or screening, related to the Speech, Language and Hearing Sciences must be systematically stimulated. Besides that, improving the knowledge about methodologies and evaluation instruments under different perspectives contribute to the better use of human and financial resources. Furthermore, the elaboration of studies that promote the correct validation of screening and diagnostic instruments used in human communication disorders contributes to the increase in knowledge in the field of Speech, Language and Hearing Sciences and, indirectly, to the acknowledgement of this science, based on technical-scientific evidence, in health promotion.