São Paulo medical journal = Revista paulista de medicina
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Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. ⋯ We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined caffeine plus naps to decrease sleepiness or to increase alertness.
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Observational Study
Follow-up of women with inadequate Pap smears: a prospective cohort study.
Inadequate Pap smears do not provide satisfactory cell samples for evaluation, thus making it more difficult to detect cervical cytological abnormalities. The objective of this study was to determine the cytological and histological follow-up results from women with inadequate smear reports in primary healthcare centers in Santiago, Chile 2010-2011. ⋯ The large proportion of normal results justifies revision of the current clinical guidelines. The results showed that it is not necessary to repeat the Pap test early on, with the exception of inadequate hemorrhagic and inflammatory cytological results.
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Central diabetes insipidus (CDI) is a rare cause of hypernatremia during the neonatal period. The diagnosis is particularly difficult in very low birth weight (VLBW) newborns. ⋯ The diagnosis of CDI is rarely made during the neonatal period, especially in VLBW newborns, because of the difficulty in detecting elevated diuresis. Persistent hypernatremia, usually accompanied by hyperthermia despite abundant fluid supply, weight loss and low urine osmolality are important signs of alert.
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Rheumatoid arthritis is a chronic systemic disease that causes joint damage. A variety of methods have been used to evaluate the general health status of these patients but few have specifically evaluated the hands. The objective of this study was to translate, perform cultural adaptation and assess the validity of the Michigan Hand Outcomes Questionnaire for Brazil. ⋯ The Brazilian Portuguese version of the Michigan Hand Outcomes Questionnaire was translated and culturally adapted successfully, and it showed excellent internal consistency, reproducibility and construct validity.