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Supplemental Material, sj-doc-1-jgp-10.1177_0891988720964250 for Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease by Diego Santos-García, E. Suárez Castro, T. de Deus Fonticoba, M. J. Feal Panceiras, J. G. Muñoz Enriquez, J. M. Paz González, C. Cores Bartolomé, L. L. Planellas, J. García Caldentey, N. Caballol, I. Legarda, I. Cabo López, L. López Manzanares, M. A. Ávila Rivera, M. J. Catalán, V. Nogueira, C. Borrué, M. Álvarez Sauco, L. Vela, E. Cubo, J. C. Martínez Castrillo, P. Sánchez Alonso, M. G. Alonso Losada, N. López Ariztegui, M. I. Gastón, J. Kulisevsky, J. Pagonabarraga, M. Seijo, J. Ruíz Martínez, C. Valero, M. Kurtis, J. González Ardura, C. Prieto, P. Mir, P. Martinez-Martin and on behalf of the COPPADIS Study Group in Journal of Geriatric Psychiatry and Neurology

Supplemental Material, sj-pdf-2-jgp-10.1177_0891988720964250 for Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease by Diego Santos-García, E. Suárez Castro, T. de Deus Fonticoba, M. J. Feal Panceiras, J. G. Muñoz Enriquez, J. M. Paz González, C. Cores Bartolomé, L. L. Planellas, J. García Caldentey, N. Caballol, I. Legarda, I. Cabo López, L. López Manzanares, M. A. Ávila Rivera, M. J. Catalán, V. Nogueira, C. Borrué, M. Álvarez Sauco, L. Vela, E. Cubo, J. C. Martínez Castrillo, P. Sánchez Alonso, M. G. Alonso Losada, N. López Ariztegui, M. I. Gastón, J. Kulisevsky, J. Pagonabarraga, M. Seijo, J. Ruíz Martínez, C. Valero, M. Kurtis, J. González Ardura, C. Prieto, P. Mir, P. Martinez-Martin and on behalf of the COPPADIS Study Group in Journal of Geriatric Psychiatry and Neurology

Supplemental Material, sj-pdf-1-jgp-10.1177_0891988720964250 for Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease by Diego Santos-García, E. Suárez Castro, T. de Deus Fonticoba, M. J. Feal Panceiras, J. G. Muñoz Enriquez, J. M. Paz González, C. Cores Bartolomé, L. L. Planellas, J. García Caldentey, N. Caballol, I. Legarda, I. Cabo López, L. López Manzanares, M. A. Ávila Rivera, M. J. Catalán, V. Nogueira, C. Borrué, M. Álvarez Sauco, L. Vela, E. Cubo, J. C. Martínez Castrillo, P. Sánchez Alonso, M. G. Alonso Losada, N. López Ariztegui, M. I. Gastón, J. Kulisevsky, J. Pagonabarraga, M. Seijo, J. Ruíz Martínez, C. Valero, M. Kurtis, J. González Ardura, C. Prieto, P. Mir, P. Martinez-Martin and on behalf of the COPPADIS Study Group in Journal of Geriatric Psychiatry and Neurology

Background: Constipation has been linked to cognitive impairment development in Parkinson's disease (PD). Objective: Our aim was to analyze cognitive changes observed in PD patients and controls from a Spanish cohort with regards to the presence or not of constipation. Methods: PD patients and controls recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were followed-up during 2 years. The change in cognitive status from baseline (V0) to 2-year follow-up was assessed with the PD-CRS (Parkinson's Disease Cognitive Rating Scale). Subjects with a score >= 1 on item 21 of the NMSS (Non-Motor Symptoms Scale) at baseline (V0) were considered as "with constipation". Regression analyses were applied for determining the contribution of constipation in cognitive changes. Results: At V0, 39.7% (198/499) of PD patients presented constipation compared to 11.4% of controls (14/123) (p < 0.0001). No change was observed in cognitive status (PD-CRS total score) neither in controls without constipation (from 100.24 +/- 13.72 to 100.27 +/- 13.68; p = 0.971) and with constipation (from 94.71 +/- 10.96 to 93.93 +/- 13.03; p = 0.615). The PD-CRS total score decreased significantly in PD patients with constipation (from 89.14 +/- 15.36 to 85.97 +/- 18.09; p

[Background and objective] Diplopia is relatively common in Parkinson’s disease (PD) but is still understudied. Our aim was to analyze the frequency of diplopia in PD patients from a multicenter Spanish cohort, to compare the frequency with a control group, and to identify factors associated with it., [Patients and Methods] PD patients who were recruited from January 2016 to November 2017 (baseline visit; V0) and evaluated again at a 2-year ± 30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort were included in this longitudinal prospective study. The patients and controls were classified as “with diplopia” or “without diplopia” according to item 15 of the Non-Motor Symptoms Scale (NMSS) at V0, V1 (1-year ± 15 days), and V2 for the patients and at V0 and V2 for the controls., [Results] The frequency of diplopia in the PD patients was 13.6% (94/691) at V0 (1.9% in controls [4/206]; p < 0.0001), 14.2% (86/604) at V1, and 17.1% (86/502) at V2 (0.8% in controls [1/124]; p < 0.0001), with a period prevalence of 24.9% (120/481). Visual hallucinations at any visit from V0 to V2 (OR = 2.264; 95%CI, 1.269–4.039; p = 0.006), a higher score on the NMSS at V0 (OR = 1.009; 95%CI, 1.012–1.024; p = 0.015), and a greater increase from V0 to V2 on the Unified Parkinson’s Disease Rating Scale–III (OR = 1.039; 95%CI, 1.023–1.083; p < 0.0001) and Neuropsychiatric Inventory (OR = 1.028; 95%CI, 1.001–1.057; p = 0.049) scores were independent factors associated with diplopia (R2 = 0.25; Hosmer and Lemeshow test, p = 0.716)., [Conclusions] Diplopia represents a frequent symptom in PD patients and is associated with motor and non-motor severity., Martínez-Martin P. has received honoraria from National School of Public Health (ISCIII), Editori-al Viguera and Takeda Pharmaceuticals for lecturing in courses, and from the International Parkinson and Movement Disorder Society (MDS) for management of the Program on Rating Scales. Mir P. has received honoraria from AbbVie, Abbott, Allergan, Bial, Merz, UCB, and Zambon and have received grants from the Spanish Ministry of Economy and Competitiveness [PI16/01575], co-founded by ISCIII (Subdirección General de Evaluación y Fomento de la Investigación) and by Fondo Europeo de Desarrollo Regional (FEDER), the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [ PI-0437-2012, PI-0471-2013], the Sociedad Andaluza de Neurología, the Jacques and Gloria Gossweiler Foundation, the Fundación Alicia Koplowitz, the Fundación Mutua Madrileña.

Quality of life (QOL) plays an important role in independent living in Parkinson's disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months +/- 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 >= 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 +/- 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 +/- 13 to 20.3 +/- 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829-0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422-12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053-1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027-1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer-Lemeshow test, p = 0.665; R-2 = 0.655). An increase in >= 5 and >= 10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663-17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975-22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

Quality of life (QOL) plays an important role in independent living in Parkinson's disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months +/- 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 >= 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients (N = 507; p = 0.686) or in the control group (N = 119; p = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 +/- 8.5 years old; 58.8% males; N = 500) by 21.6% (from 16.7 +/- 13 to 20.3 +/- 16.4; p < 0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829-0.968; p = 0.006), to be a female (OR = 4.181; 95% CI 1.422-12.290; p = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053-1.231; p = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027-1.113; p < 0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer-Lemeshow test, p = 0.665; R-2 = 0.655). An increase in >= 5 and >= 10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663-17.876; p = 0.005) and 8 (OR = 8.217; 95% CI, 2.975-22.696; p = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.

BACKGROUND: Although depression is known to be frequent in Parkinson's disease (PD), it is unclear how mood can change and/or impact on patient's quality of life (QoL) over time. Our aim was to analyze the frequency of depression, mood related factors and the contribution of mood to a patient's QoL perception in regard to disease duration. METHODS: PD patients recruited from the COPPADIS cohort from January 2016 to November 2017 were included in this cross-sectional study. Three groups were defined

Supplemental Material, Table.1.SM.Sleep.Problems.PD.COPPADIS for Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease by Diego Santos-García, E. Suárez Castro, T. de Deus Fonticoba, M. J. Feal Panceiras, J. G. Muñoz Enriquez, J. M. Paz González, C. Cores Bartolomé, L. L. Planellas, J. García Caldentey, N. Caballol, I. Legarda, I. Cabo López, L. López Manzanares, M. A. Ávila Rivera, M. J. Catalán, V. Nogueira, C. Borrué, M. Álvarez Sauco, L. Vela, E. Cubo, J. C. Martínez Castrillo, P. Sánchez Alonso, M. G. Alonso Losada, N. López Ariztegui, M. I. Gastón, J. Kulisevsky, J. Pagonabarraga, M. Seijo, J. Ruíz Martínez, C. Valero, M. Kurtis, J. González Ardura, C. Prieto, P. Mir, P. Martinez-Martin and on behalf of the COPPADIS Study Group in Journal of Geriatric Psychiatry and Neurology

Supplemental Material, Table.2.SM.Sleep.Problems.PD.COPPADIS for Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson’s Disease by Diego Santos-García, E. Suárez Castro, T. de Deus Fonticoba, M. J. Feal Panceiras, J. G. Muñoz Enriquez, J. M. Paz González, C. Cores Bartolomé, L. L. Planellas, J. García Caldentey, N. Caballol, I. Legarda, I. Cabo López, L. López Manzanares, M. A. Ávila Rivera, M. J. Catalán, V. Nogueira, C. Borrué, M. Álvarez Sauco, L. Vela, E. Cubo, J. C. Martínez Castrillo, P. Sánchez Alonso, M. G. Alonso Losada, N. López Ariztegui, M. I. Gastón, J. Kulisevsky, J. Pagonabarraga, M. Seijo, J. Ruíz Martínez, C. Valero, M. Kurtis, J. González Ardura, C. Prieto, P. Mir, P. Martinez-Martin and on behalf of the COPPADIS Study Group in Journal of Geriatric Psychiatry and Neurology

Introduction: The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients. Methods: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson's disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems. Results: The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 +/- 28.8 vs 132.8 +/- 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 +/- 14 vs 13 +/- 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 +/- 0.5 vs 3.9 +/- 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015-1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009-1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments. Conclusion: Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.

Made available in DSpace on 2020-12-12T02:01:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 Associação Brasileira de Saúde Coletiva Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Background and objective In the present study, we compared the effect of diabetic pregnancy on the rectus abdominis muscle (RAM) in humans and rats. We hypothesized that our animal model could provide valuable information about alterations in the RAM of women with Gestational Diabetes (GDM). Method Newborns female rats (n = 10/group) were administered streptozotocin (100 mg/kg body weight) subcutaneously and were mated on reaching adulthood, to develop the mild hyperglycemic pregnant (MHP) rat model. At the end of pregnancy, the mothers were sacrificed, and the RAM tissue was collected. Pregnant women without GDM (non-GDM group; n = 10) and those diagnosed with GDM (GDM group; n = 8) and undergoing treatment were recruited, and RAM samples were obtained at C-section. The RAM architecture and the distribution of the fast and slow fibers and collagen were studied by immunohistochemistry. Results No statistically significant differences in the maternal and fetal characters were observed between the groups in both rats and women. However, significant changes in RAM architecture were observed. Diabetes in pregnancy increased the abundance of slow fibers and decreased fast fiber number and area in both rats and women. A decrease in collagen distribution was observed in GDM women; however, a similar change was not observed in the MHP rats. Conclusion Our results indicated that pregnancy- associated diabetes- induced similar structural adaptations in the RAM of women and rats with slight alterations in fiber type number and area. These findings suggest that the MHP rat model can be used for studying the effects of pregnancy-associated diabetes on the fiber structure of RAM. Perinatal Diabetes Research Center University Hospital Botucatu Medical School Univ. Estadual Paulista-UNESP Department of Gynecology and Obstetrics São Paulo State University (UNESP) Botucatu Medical School Department of Physiotherapy and Occupational Therapy São Paulo State University (UNESP) School of Philosophy and Sciences Department of Health Sciences Universidade Sagrado Coração Department of Anatomy São Paulo State University (UNESP) Institute of Biosciences Department of Biostatistics São Paulo State University (UNESP) Bioscience Institute Universidade Estadual Paulista Case Western Reserve University Pontificia Universidad Catolica de Chile Imperial College London Universidade Federal de São Paulo Universidade Católica de Pernambuco Faculdade de Medicina de Marília Maastrich University Charité Universitätsmedizin Berlin Universidade do Sagrado Coração Faculdades Integradas de Bauru Perinatal Diabetes Research Center University Hospital Botucatu Medical School Univ. Estadual Paulista-UNESP Department of Gynecology and Obstetrics São Paulo State University (UNESP) Botucatu Medical School Department of Physiotherapy and Occupational Therapy São Paulo State University (UNESP) School of Philosophy and Sciences Department of Anatomy São Paulo State University (UNESP) Institute of Biosciences Department of Biostatistics São Paulo State University (UNESP) Bioscience Institute Universidade Estadual Paulista FAPESP: #2014/26852-6 FAPESP: #2016/01743-5 FAPESP: #2016/09710-9

C-reactive protein (CRP) is a biomarker of systemic inflammation that has been linked to accelerated decline in walking speed in older adults. The aim of the present study was to compare the CRP levels of PD patients with vs patients without freezing of gait (FOG). Patients and controls participating in the COPPADIS-2015 study that performed blood extraction for determining molecular serum biomarkers were included. Patients with FOG were identified as those with a score of 1 or greater on item-3 of the Freezing of Gait Questionnaire (FOG-Q). Immunoassay was used for determining ultrasensitive CRP (US-CRP) level (mg/dL). In the PD group (n = 225; 61.8 +/- 9.5 years old, 61.8% males), 32% of the patients presented FOG but none in the control group (n = 65; 60.3 +/- 6.1 years old, 56.9% males) (p < 0.0001). Differences in US-CRP level were significant in patients with FOG vs patients without FOG and vs controls (0.31 +/- 0.52 vs 0.16 +/- 0.21 vs 0.21 +/- 0.22; p = 0.04). Significant differences were also observed between patients with vs without FOG (p = 0.001) but not between patients and controls (p = 0.163). US-CRP level was related to FOG (OR = 4.369; 95% CI 1.105-17.275; p = 0.036) along with H&Y (OR = 2.974; 95% CI 1.113-7.943; p = 0.030) and non-motor symptoms burden (NMSS total score; OR = 1.017; 95% CI 1.005-1.029; p = 0.006) after adjusting for age, gender, disease duration, equivalent daily levodopa dose, number of non-antiparkinsonian drugs per day, motor fluctuations, cognition, motor phenotype, and chronic use of anti-inflammatory drugs. The present study suggests that serum US-CRP level is related to FOG in PD patients. Inflammation could be linked to FOG development.

Background and purpose In Parkinson's disease (PD), the course of the disorder is highly variable between patients. Well-designed, prospective studies for identifying PD progression biomarkers are necessary. Our aim was to show the results of baseline evaluations of an ongoing global PD project, COPPADIS-2015 (Cohort of Patients with PArkinson's DIsease in Spain, 2015). Methods This was an observational, descriptive, nationwide study (Spain). The recruitment period ended in October 2017. Baseline evaluation included more than 15 validated scales and complementary studies in a subgroup of participants. Results In total, 1174 subjects from 35 centres were considered valid for baseline analysis: 694 patients (62.6 +/- 8.9 years old, 60.3% males), 273 caregivers (58.5 +/- 11.9 years old, 31.8% males) and 207 controls (61 +/- 8.3 years old, 49.5% males). The mean disease duration was 5.5 +/- 4.4 years. Hoehn and Yahr stage was 1 or 2 in 90.7% of the patients whilst 33.9% and 18.1% of them presented motor fluctuations and dyskinesias, respectively. The mean Non-Motor Symptoms Scale total score was 45.4 +/- 38.1, and 30.4% of the patients presented cognitive impairment, 16.1% major depression, 12.7% impulse control disorder, 7.2% compulsive behaviour, 57.2% pain and 13.2% falls. Compared to the control group, PD patients presented a significantly higher burden of non-motor symptoms and a worse quality of life. More than 300 subjects conducted complementary studies (serum biomarkers, genetic and neuroimaging). Conclusions Parkinson's disease is a complex disorder and different non-motor symptoms are frequently present and are more prevalent than in controls. In real clinical practice it is important to ask for them.

Background and purpose In Parkinson's disease (PD), the course of the disorder is highly variable between patients. Well-designed, prospective studies for identifying PD progression biomarkers are necessary. Our aim was to show the results of baseline evaluations of an ongoing global PD project, COPPADIS-2015 (Cohort of Patients with PArkinson's DIsease in Spain, 2015). Methods This was an observational, descriptive, nationwide study (Spain). The recruitment period ended in October 2017. Baseline evaluation included more than 15 validated scales and complementary studies in a subgroup of participants. Results In total, 1174 subjects from 35 centres were considered valid for baseline analysis: 694 patients (62.6 +/- 8.9 years old, 60.3% males), 273 caregivers (58.5 +/- 11.9 years old, 31.8% males) and 207 controls (61 +/- 8.3 years old, 49.5% males). The mean disease duration was 5.5 +/- 4.4 years. Hoehn and Yahr stage was 1 or 2 in 90.7% of the patients whilst 33.9% and 18.1% of them presented motor fluctuations and dyskinesias, respectively. The mean Non-Motor Symptoms Scale total score was 45.4 +/- 38.1, and 30.4% of the patients presented cognitive impairment, 16.1% major depression, 12.7% impulse control disorder, 7.2% compulsive behaviour, 57.2% pain and 13.2% falls. Compared to the control group, PD patients presented a significantly higher burden of non-motor symptoms and a worse quality of life. More than 300 subjects conducted complementary studies (serum biomarkers, genetic and neuroimaging). Conclusions Parkinson's disease is a complex disorder and different non-motor symptoms are frequently present and are more prevalent than in controls. In real clinical practice it is important to ask for them.

Objective: To identify factors related to a poor health-related and global quality of life (QoL) in a cohort of nondemented Parkinson's disease (PD) patients and compare to a control group. Methods: The data correspond to the baseline evaluation of the COPPADIS-2015 Study, an observational, 5-year follow-up, multicenter, evaluation study. Three instruments were used to assess QoL: (1) the 39-item Parkinson's disease Questionnaire (PDQ-39), (2) a subjective rating of global QoL (PQ-10), and (3) the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Multiple linear regression methods were used to evaluate the direct impact of different variables on these QoL measures. Results: QoL was worse in PD patients (n = 692; 62.6 +/- 8.9 years old, 60.3% males) than controls (n = 206; 61 +/- 8.3 years old, 49.5% males): PDQ-39, 17.1 +/- 13.5 vs 4.4 +/- 6.3 (p < 0.0001); PQ-10, 7.3 +/- 1.6 vs 8.1 +/- 1.2 (p < 0.0001); EUROHIS-Q0L8, 3.8 +/- 0.6 vs 4.2 +/- 0.5 (p < 0.0001). A high correlation was observed between PDQ-39 and Non-Motor Symptoms Scale (NMSS) (r = 0.72; p < 0.0001), and PDQ-39 and Beck Depression Inventory-II (BDI-II) (r = 0.65; p < 0.0001). For health-related QoL (PDQ-39), non-motor symptoms burden (NMSS), mood (BDI-II), and gait problems (Freezing Of Gait Questionnaire [FOGQ]) provided the highest contribution to the model (beta = 0.32, 0.28, and 0.27, respectively; p < 0.0001); whereas mood and gait pro- blems contributed the most to global QoL (PQ-10, beta = -0.46 and -0.21, respectively; EUROHIS-QOL8, beta = - 0.44 and - 0.23, respectively). Conclusions: QoL is worse in PD patients than in controls. Mood, non-motor symptoms burden, and gait problems seem to be the most relevant factors affecting health-related and global perceived QoL in non-demented PD patients.

Technological development and the appearance of new medical specialties have led to increased division of labor in hospitals, with the resultant creation of subareas. Therefore, the redistribution of human resources in hospitals has become an important aim in order to achieve efficiency. On the basis of interviews conducted between May and October 1993 with the directors and superintendents of eight hospitals in Sao Paulo, Brazil, this study describes and analyzes the distribution of human resources in four broad areas: infrastructure, clinico-surgical inpatient care, the complementary area of diagnostics and therapeutics, and emergency and outpatient care. The study also analyzed the ratio of employees per bed, besides outlining a comparison of public and private hospitals. The results revealed that, on average, the ratio of employees to beds was 6.8. The proportional distribution of employees by broad areas was found to be 46.9% in infrastructure, 10.7% in diagnostics and therapeutics, 32.0% in inpatient care, and 10.3% in outpatient/emergency care.

Myocardial revascularization surgery (MRS) is the most common surgery in this country, with most being performed through the National Health System(SUS).To assess MRS results when not associated to other procedures.The information from the Hospital Information System (SIH/DATASUS) made available online was submitted to analysis. The data include information on gender, age, hospital stay period, hospital admission authorization (AIH) costs, number of surgeries at each hospital, and in-hospital mortality rate. Only MRS with no associated procedures were analyzed.A total of 63,529 surgeries were performed in the period between 2005 and 2007 at 191 hospitals. Sixteen hospitals reporting very low surgery volume were excluded. The remaining total number of surgeries came down to 63,272 for the final analysis. In-hospital mortality rate was 6.22%, with small surgery volume hospitals reporting higher rate than high volume hospitals (or=300 surgeries in the time period under study), 7.29% versus 5.77% (p0.001). Average hospital stay time length was 12 days, with no difference having been reported between low (12.08+/-5.52) and high volume (12.15+/-7.70) hospitals. Males reported lower mortality rate than females - 5.20% versus 8.25% (p0.001), similarly to younger individuals when compared to the elderly (or= 65 years of age), 4.21% versus 9.36% (p0.001). A slight variation was observed in AIH values between the Southern Region (R$ 7.214,63 - approximately US$ 3,600.00) and the Northeastern Region (R$ 6.572,03 - approximately US$ 3,280.00) (p0.01). Regional distribution of surgeries was not comparable in all regions in the country, with Southern and Southeastern Regions having reported 77% of them.MRS performed by SUS has reported high mortality rate in low volume hospitals, among women, and among the elderly. Future prospective studies are deemed to be necessary.

The process of organ donation and retreat is complex and involves a high cost for hospitals that do it.to survey the expenses with the process of donation and retreat of organs.retrospective study based on medical records of 32 donors, admitted in the Search Organs Organisation do Instituto Dante Pazzanese de Cardiologia, during the period from January to December of 1999.the process is complex and involves a special structure as well as 24 hours of activities, making it costly. Expenses were related with the following items: human resources, permanent material, public utilities, complementary examinations, depreciation of equipment and transportation. A comparison with the values reimbursed by the Single Health System (SUS) followed.the total cost was high than the reimbursement provided by SUS, showing the necessity of research about cost of procedures and the reinvestment margin.

Teaching hospitals can be defined as hospitals whose mission is both to provide health care to the population and to train qualified professionals. This represents high costs that need to be balanced by higher productivity and quality. The aim of the present study was to identify the level of productivity in five teaching hospitals in the state of Sao Paulo, Brazil. For that, we measured indicators such as patient length of stay, patient turnover rate, substitution interval, and number of employees per hospital bed. For a better understanding of the reality of these teaching hospitals, data regarding morbidity and geographic range of influence were also analyzed. Results were compared with the results from a previous study which analyzed private tertiary and secondary hospitals and public secondary hospitals. Productivity was defined as inversely proportional to length of stay, patient turnover rate, substitution interval, and number of employees per hospital bed. We observed that private hospitals have a higher productivity in terms of most indicators, which suggests that these hospitals make a more efficient use of their human, material, and financial resources. Teaching hospitals have a higher length of stay than the other hospitals (median = 7 days); lower turnover rate than private hospitals and similar to public hospitals (median = 3.70 days); higher employee per bed ratio than the private hospitals, and smaller than public hospitals (median = 7 employee/hospital bed). Substitution interval was different for each type of hospital; only public hospitals had a lower substitution interval than teaching hospitals (median = 1.70 days).

Objetivo: Estimular debate sobre as competências profissionais necessárias e/ou desejáveis para garantir ao setor saúde, seja público ou privado, gestão com qualidade, alta produtividade e qualidade e custos sustentáveis. Métodos. Apresentação sucinta das variáveis que influenciam o meio interno e externo dos sistemas e serviços de saúde e a sua evolução enquanto quantidade e complexidade de procedimentos ao longo da segunda metade do século XX. Resultado. A dinâmica das mudanças nos sistemas de saúde são acentuadas e rápidas, características que exigem interação entre o aparelho formador de recursos humanos, o gestor e o prestador, na promoção da atualização dos conteúdos das disciplinas de acordo com as necessidades de saúde da população, das atuais demandas do mercado (no que se refere ao setor privado), de doenças novas e negligenciadas e, de tecnologias emergentes. Conclusão. O setor saúde depende cada vez mais de tecnologia e capacitação de recursos humanos. Complicados, complexos, com custos e riscos elevados, necessitam de gestão diferenciada se comparado a outras empresas.

Instituições necessitam ter claros a missão, visão e valores que caracterizam sua existência. Isto feito estabelece-se objetivos, com valores e prazos para sua obtenção. Tem-se então uma meta que, com as medidas, formam as diretrizes. Assim começa a ser delineado o planejamento que é uma das funções da administração. Este exercício, de planejar, deve ser de curto, médio e longo prazos. O foco deste artigo é no planejamento de longo prazo. Não se pode conduzir uma instituição sem planejamento, mesmo dentro de situações transitórias como são as que circundam os serviços de saúde. Com o mesmo dinamismo que se elabora o planejamento, traduzido num documento que pode ser denominado “plano diretor”, devem ser realizadas as correções ao longo do tempo, decorrentes do acompanhamento e avaliações de cada ação planejada. A importância disto é relatada neste artigo.

Objective: The aim of the present study was to analyze the progression of non-motor symptoms (NMS) burden in Parkinson's disease (PD) patients regarding the development of motor fluctuations (MF). Methods: PD patients without MF at baseline, who were recruited from January 2016 to November 2017 (V0) and evaluated again at a 2-year follow-up (V2) from 35 centers of Spain from the COPPADIS cohort, were included in this analysis. MF development at V2 was defined as a score >= 1 in the item-39 of the UPDRS-Part IV, whereas NMS burden was defined according to the Non-motor Symptoms Scale (NMSS) total score. Results: Three hundred and thirty PD patients (62.67 +/- 8.7 years old; 58.8% males) were included. From V0 to V2, 27.6% of the patients developed MF. The mean NMSS total score at baseline was higher in those patients who developed MF after the 2-year follow-up (46.34 +/- 36.48 vs. 34.3 +/- 29.07; p = 0.001). A greater increase in the NMSS total score from V0 to V2 was observed in patients who developed MF (+16.07 +/- 37.37) compared to those who did not develop MF (+6.2 +/- 25.8) (p = 0.021). Development of MF after a 2-year follow-up was associated with an increase in the NMSS total score (beta = 0.128; p = 0.046) after adjustment to age, gender, years from symptoms onset, levodopa equivalent daily dose (LEDD) and the NMSS total score at baseline, and the change in LEDD from V0 to V2. Conclusions: In PD patients, the development of MF is associated with a greater increase in the NMS burden after a 2-year follow-up.

Made available in DSpace on 2020-12-10T16:29:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-07-01 The present work deals with the synthesis, spectroscopic investigation and electrochemical behaviour of the compounds [W(CO)(4)(bipy)] (1), [W(CO)(3)(bipy)(dppm)] (2) and [W(CO)(3)(bipy)(dppf)] (3), bipy = 2,2'-bipyridine; dppm = bis(diphenylphosphino)methane; dppf = I,1'-bis(diphenylphosphino)ferrocene. The IR and P-31{H-1} NMR spectroscopic data have shown an octahedral coordination geometry for the tungsten atom with the diphosphines acting as monodentate ligands. The electrochemical behaviour of the complexes was investigated by cyclic voltammetry and controlled potential coulometry. Cyclic voltammograms have indicated that the compounds containing diphosphines ligands are more stable towards oxidation than compound (1). Univ Estadual Paulista, Inst Quim Araraquara, BR-14801970 Araraquara, SP, Brazil Univ Estadual Paulista, Inst Quim Araraquara, BR-14801970 Araraquara, SP, Brazil

Made available in DSpace on 2018-08-23T21:59:51Z (GMT). No. of bitstreams: 1 tese_12006_Ruteléia C. S. Silva.pdf: 3422054 bytes, checksum: 9e19757622c7f14162badbc704f08bf3 (MD5) Previous issue date: 2018-04-06 O presente estudo tem como objetivo investigar e compreender as bases teóricas de interpretação da economia política da pobreza e sua relação com a atual trama conjuntural brasileira, considerando o período que se inicia no ano de 2003 e se estende a 2017. Consiste num esforço investigativo de apreensão de suas bases teóricas de interpretação da economia política da pobreza, situando essas bases teóricas nos marcos de teorias e ideologias distintas. Nesse sentido, o termo economia política da pobreza foi empregado no sentido de explicitar a forma aparente e ideopolítica como o fenômeno da pobreza e as expropriações capitalistas têm sido apropriados pelos agentes e representantes do pensamento burguês que, num reformismo conservador, fortalecem o projeto de dominação burguesa, ocultando a dinâmica que alimenta a lógica imanente do capital portador de juros, centrada na expropriação e na produção, extração acelerada e intensificada de mais-valor. A investigação, à luz do método materialista histórico e dialético, tem seu percurso metodológico delimitado a partir de categorias básicas constituídas e constituintes da e pela realidade, apropriadas sob um viés exploratório e que permitiram uma maior aproximação às categorias essenciais à consecução dos objetivos propostos para este estudo, como: trabalho, pobreza, formação social, Estado e lutas de classes. Além de recorrer a um acervo que permitiu a compreensão de condicionantes que determinam o modo de ser e viver de toda uma sociedade, a exemplo das ideias defendidas pelas teses da capacitação dos pobres, empoderamento e empreendedorismo. No percurso metodológico foram apropriados elementos da pesquisa bibliográfica, de modo a reunir e organizar as formulações contidas em fontes analíticas diversas e que versassem sobre a temática estudada. Quanto à técnica de análise de dados, foi empregada a análise de conteúdo para decodificar as informações e realizar inferências em liame com o método apropriado. Como resultado, a síntese dialética construída permitiu aferir que a economia política da pobreza cumpre o papel justamente de oferecer as condições favoráveis e necessárias para atender aos interesses de dominação e de acumulação burguesas e, portanto, imprescindíveis para manter a ordem e o equilíbrio social. Atua, dessa forma, tanto na esfera do consenso, como no campo do disciplinamento, valendo-se de aparelhos privados de hegemonia e dominação burguesa nacional e internacional. A partir dessas reflexões ficou claro que a economia política da pobreza tem papel preponderante nas expropriações materiais e sociais, contribuindo, por meio da manipulação, regressão e até mesmo repressão, para consagrar definitivamente a supremacia do capital e a ilusão de um mercado onipotente. Palavras-chave: Economia política da pobreza. Expropriações capitalistas. Mais-valor.