São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial
Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy.
Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. ⋯ ClinicalTrials.gov NCT02839538.
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Comparative Study
Comparison of machine-learning algorithms to build a predictive model for detecting undiagnosed diabetes - ELSA-Brasil: accuracy study.
Type 2 diabetes is a chronic disease associated with a wide range of serious health complications that have a major impact on overall health. The aims here were to develop and validate predictive models for detecting undiagnosed diabetes using data from the Longitudinal Study of Adult Health (ELSA-Brasil) and to compare the performance of different machine-learning algorithms in this task. ⋯ Most of the predictive models produced similar results, and demonstrated the feasibility of identifying individuals with highest probability of having undiagnosed diabetes, through easily-obtained clinical data.
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It has been reported that earlier age at first childbirth may increase the risk of adult-onset diabetes among postmenopausal women, a novel finding with important public health implications. To date, however, no known studies have attempted to replicate this finding. We aimed to test the hypothesis that age at first childbirth is associated with the risk of adult-onset diabetes among postmenopausal women. ⋯ Our current analysis does not support the existence of an association between age at first childbirth and adult-onset diabetes among postmenopausal women, which had been reported previously.
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One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. ⋯ Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
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Aging causes changes in men and women. Studies have shown that women have worse postural balance and greater functional dependence than men, but there is no consensus regarding this. The aim of this study was to compare the balance and functional independence of elderly people according to sex and age, and to evaluate the association between postural balance and the number of drugs taken. ⋯ There was no sexual difference in relation to postural balance. However, people who were more elderly presented a high risk of falling. Functional dependence was worse among females. There was an association between the number of medication drugs and risk of falling.