Navegando por Palavras-chave "Técnicas de diagnóstico e procedimentos"
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- ItemAcesso aberto (Open Access)Avaliação da maturidade pulmonar fetal pela contagem dos corpos lamelares no líquido amniótico(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2010-03-01) Gil, Beatriz Maykot Kuerten; Souza, Eduardo de [UNIFESP]; Silva, Carlos Alberto Justo da; Figueiredo, Cláudia Pinto; Universidade Federal de Santa Catarina Hospital Universitário; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Santa Catarina; Universidade Federal de Santa Catarina Centro de Ciências BiológicasPURPOSE: to compare the lamellar body number density (LBND) count in amniotic fluid using the fluorescent polarization (FP) test as a diagnostic parameter for the assessment of fetal pulmonary maturity. METHOD: this was an analytical, controlled cross-sectional study conducted on 60 pregnant women from March 2002 to December 2007. Amniotic fluid specimens were obtained by amniocentesis or at the time of caesarean section, and submitted to the LBND and FP tests (TDxFLM®, Abbott Laboratories), the latter considered to be a reference test, and compared in terms of the presence or absence of respiratory distress syndrome (RDS). Cut-off values for maturity were established at 30,000 lamellar bodies/µL for the LBND test and 55 mg/g albumin for the FP test. Maternal and perinatal characteristics and neonatal evolution were evaluated, and the performance of the diagnostic tests regarding fetal pulmonary maturity was determined. In the statistical analysis, descriptive measures were used and the sensitivity, specificity and positive and predictive values of the tests were determined with the level of significance set at p<0.05. RESULTS: maternal age ranged from 15 to 34 years (mean: 26.6 years) and gestational age ranged from 24.3 to 41.6 weeks (mean: 35.1 weeks). RDS was diagnosed in 35.1% of neonates. Perinatal characteristics such as weight, Apgar score, and RDS incidence were compared to the results of the LBND and FP tests and a significant correspondence (p<0.05) was observed between the groups of neonates clinically classified as mature and immature in both tests. The tests were concordant in 68.3% of the cases. Comparison of the PF and LBND tests revealed 100% specificity for both and a higher specificity for the LBND test (73.1% as opposed to 51.9% for the PF test). The gold standard for the determination of fetal maturity is the occurrence of RDS. The positive predictive value of the LBND test was higher (36.4%) than that of the FP test (24.2%) (p<0.05) and the negative predictive value was 100% for both tests. CONCLUSIONS: the present study demonstrated that the LBND test has 100% sensitivity and higher specificity than the reference test (FP). In addition, the LBND test is considered to be rapid, accessible, inexpensive and feasible for the Brazilian reality, and it can be used as a reliable test for the prediction of fetal pulmonary maturity.
- ItemAcesso aberto (Open Access)Avaliação de duas classificações para excesso de peso em adolescentes brasileiros(Faculdade de Saúde Pública da Universidade de São Paulo, 2007-08-01) Vítolo, Márcia Regina [UNIFESP]; Campagnolo, Paula Dal Bó; Barros, Maria Elisa; Gama, Cintia Mendes [UNIFESP]; Ancona Lopez, Fábio [UNIFESP]; Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Departamento de Saúde Coletiva; Universidade Estadual do Rio de Janeiro Departamento de Nutrição; Universidade Federal de São Paulo (UNIFESP)A cross-sectional study carried out among 418 adolescents between ten and 19 years old at a private school in the city of São Paulo in 1998. The objective of the study was to evaluate the proposed thresholds for diagnosing overweight among Brazilian adolescents. The percentage body fat was measured by dual energy X-ray absorptiometry. The cutoff points used for excess body fat were 25% for boys and 30% for girls. The body mass index was classified in accordance with Cole et al and with Conde & Monteiro. The Brazilian reference (Conde & Monteiro) presented higher sensitivity among younger girls (44.2% vs. 32.6%), older girls (18.9% vs. 17%) and older boys (83.3% vs. 50%). The Conde & Monteiro proposal presented higher positive and negative predictive values and provided higher-sensitivity predictions of excess body fat among the study population.
- ItemAcesso aberto (Open Access)Versão brasileira da escala London Chest Activity of Daily Living para uso em pacientes com doença pulmonar obstrutiva crônica(Sociedade Brasileira de Pneumologia e Tisiologia, 2008-03-01) Carpes, Marta Fioravante; Mayer, Anamaria Fleig; Simon, Karen Muriel; Jardim, José Roberto [UNIFESP]; Garrod, Rachel; Universidade do Vale do Itajaí; Centro Universitário do Triângulo Programa de Mestrado em Fisioterapia; Universidade Federal de São Paulo (UNIFESP); St George's, University of London Faculty of Health and Social Care Sciences School of PhysiotherapyOBJECTIVE: To translate the London Chest Activity of Daily Living (LCADL) scale into Portuguese and to determine whether this version is reproducible in Brazilian patients with severe chronic obstructive pulmonary disease (COPD). METHODS: The LCADL scale was translated into Portuguese and then back-translated into English. This pilot Brazilian Portuguese version was administered to 8 patients with COPD, and possible text-related problems were investigated. The principal problems were discussed with the authors of the original scale, and a final translated version was arrived at. At the study outset, two observers administered this final version (twice in one day) to 31 patients with COPD. One of those observers again administered the scale to the same patients 15-20 days later. At baseline, the patients were submitted to pulmonary function testing and to the six-minute walk test (6MWT). RESULTS: The Brazilian Portuguese version of the LCADL scale demonstrated excellent reproducibility in the total score and in most of the questions, with an inter-rater Cronbach's alpha coefficient of 0.97 (95% CI: 0.89-0.97; p < 0.01) and an intra-rater Cronbach's alpha coefficient of 0.96 (95% CI: 0.83-0.96; p < 0.01). The total score presented a negative correlation with forced expiratory volume in one second in liters (r = -0.49; p < 0.05) and with distance covered on the 6MWT (r = -0.56; p < 0.05). CONCLUSION: The Brazilian Portuguese version of the LCADL scale is a reliable, reproducible, and valid instrument for evaluating dyspnea during activities of daily living in patients with severe COPD.