Indiana University-Purdue University Indianapolis (IUPUI) / Current evidence shows that sleep-wake disturbances are a persistent problem in women surviving breast cancer. The purpose of this study was to refine the knowledge regarding the incidence, prevalence, and predictive factors of sleep-wake disturbances in breast cancer survivors (BCS) compared to age-matched women without breast cancer (WWBC). The cross-sectional, convenience-sample consisted of secondary data from BCS and WWBC who were recruited by two parent quality of life studies. Subjects were matched within +/- 5 years of age. The sample consisted of 246 BCS and 246 WWBC who were a mean age of 48 years old (SD=8.50), Caucasian (70%), employed (69%), married or partnered (76%), postmenopausal (59%), with a college education (56%), and with at least one concurrent medical problem (95%). Results showed that BCS had more prevalent sleep-wake disturbances (65%) compared to WWBC (55%). The poorest sleepers were BCS, women with hot flashes, poor physical functioning, depressive symptoms, or with moderate or high levels of distress related to a life event. BCS had higher PSQI scores indicating poorer sleep quality and higher sleep disturbances compared to WWBC. Predictors of the severity of poor sleep quality and sleep disturbances were BCS, women with higher number of co-morbidities, women with hot flashes, lower levels of physical functioning, higher depressive symptoms, and greater impact of a life event. Disease and treatment related factors did not predict poor sleep or sleep quality in BCS. Sleep disturbances are a problem in long-term BCS. Knowledge of contributing factors provides useful information during clinical evaluations and treatment of BCS reporting poor sleep. Additional research is needed to determine the impact of poor sleep on quality of life and develop/test effective interventions for long-term BCS.

Orientador: Regina Maria Barretto Cicarelli / Banca: Marcia Graminha / Banca: Alberto José Cavalheiro / Resumo: Trypanosoma brucei é o agente etiológico da tripanossomíase africana ou doença do sono, transmitida por dípteros do gênero Glossina, conhecidos como moscas tsé-tsé. O diagnóstico e tratamento da doença não são satisfatórios, uma vez que para o tratamento está disponível um número de drogas altamente tóxicas e com um efeito limitado, pois dependem da fase da doença, das condições fisiológicas do hospedeiro, da suscetibilidade e variabilidade genética da cepa. Além do alto custo, o tratamento é potencialmente perigoso e está limitado ao surgimento de resistência generalizada aos fármacos utilizados. O diagnóstico é limitado à associação dos sintomas com a doença, muitas vezes é confundido com outras doenças pelo que o paciente não recebe o tratamento adequado. Por isso, tem-se a necessidade de buscar novos fármacos com melhor atividade tripanocida. Neste trabalho, avaliou-se a atividade tripanocida de 38 compostos diferentes e inéditos, como N1,N2-dibenziletano-1,2-diamina (cloridratos de benzil diaminas), N1-benzil,N2-metilferroceniletano-1,2-diamina (cloridratos de diaminas de ferroceno), 2-metoxi/hidroxi-3-(1-alquenil)-1,4-naftoquinonas e seus derivados 2-amina-1,4-naftoquinonas contra as cepas 427 e 29-13 de T. brucei. A eficácia dos compostos foi avaliada pelo método colorimétrico do MTT [brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazoliom]. Os resultados encontrados foram similares aos das atividades metabólicas das células (parasitas e/ou células HepG2 - linhagem de células de hepatoma, usada como modelo para simular funções hepáticas humanas in vitro), sendo o IC50 (metade da concentração inibitória máxima) calculado por regressão linear para cada composto. Da série anterior, o composto cloridrato de... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Trypanosoma brucei is the etiologic agent of sleeping sickness (Human African Trypanosomiasis [HAT]), transmitted by flies of Glossina genus, known as tsetse flies. The diagnostic and treatment of this disease are not satisfactory, since the treatment uses many toxicity drugs with limited effects, because depend on the stage of the disease, morphological diversity, heterogeneous biological behaviour, different clinical courses and the virulence appears to be an intrinsic property of each strain and high genetic variability. Besides the high cost, the treatment is potentially dangerous and limited the emergence of widespread drug resistance. The diagnosis is limited to the association of symptoms with the disease, is often confused with other diseases so the patient does not receive adequate treatment. Thus, the development of new research is necessary in order to generate new drugs with trypanocidal activity. In this work, we evaluated the trypanocidal activity of 38 inedited compounds of N1,N2-dibenzylethane-1,2-diamine hydrochlorides, N1-benzyl,N2-methyferrocenylethane-1,2-diamine hydrochlorides, 2-metoxy/hydroxy-3-(1-alquenyl)-1,4-naphtoquinones and amine derivatives of this compounds (2-amine-1,4-naphtoquinones) against 427 and 29-13 T. brucei parasite strains. The efficacy of these compounds was also measured using the reduction of MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. The results were similar to the metabolic activity of cells (parasites and/or HepG2 - hepatoma cell line used as a model to simulate human hepatic functions in vitro), being the IC50 (half of the maximum inhibitory concentration) calculated by linear regression for each sample. The compounds N-(ferrocenylmetyl)-N'-(4-metoxybenzyl)ethane-1,2-diamine) hydrochlorides and 2-metoxy-3-(2-phenylethenyl)-1,4-naphtoquinone... (Complete abstract click electronic access below) / Mestre

The purpose of this study was to evaluate masticatory muscle (MM) and temporomandibular joint (TMJ) pain patients regarding the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, and evaluate the level of psychological dysfunction and its relationship to PTSD symptoms in these patients. This study included 445 adult patients (male = 42, female = 403). Psychological questionnaires included the Symptom Check List-90-Revised (SCL-90-R), the Multidimensional Pain Inventory, the Pittsburgh Sleep Quality Index and the PTSD Check List Civilian. The total sample of patients was divided into two major groups: The MM group (n=242) and TMJ group (n=203). Each group was divided into three subgroups according to the presence of a stressor and severity of PTSD symptoms. Thirty six patients (14.9%) in the MM group and 20 patients (9.9%) in the TMJ group presented symptomatology of PTSD. MM and TMJ pain patients in the positive PTSD subgroups scored higher on all scales of the SCL-90-R (p = .000) than the other two subgroups and reached levels of distress that were indicative of psychological dysfunction. MM and TMJ pain patients in the positive PTSD subgroups were more often classified as dysfunctional than as adaptive copers and presented with more sleep disturbances than patients in the no stressor and negative PTSD subgroups. A somewhat elevated prevalence rate for PTSD symptomatology was found in the MM than in the TMJ group. Significant levels of psychological dysfunction appear limited to temporomandibular disorder patients with symptoms of PTSD.

Thesis (Ph.D.)--Indiana University, 2008. / Title from screen (viewed on June 1, 2009). School of Nursing, Indiana University-Purdue University Indianapolis (IUPUI). ADVISOR(S): Janet S. Carpenter. Includes vita. Includes bibliographical references (leaves 227-243).

Made available in DSpace on 2014-06-11T19:27:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-02-25Bitstream added on 2014-06-13T19:36:14Z : No. of bitstreams: 1 arenasvelasquez_am_me_araiq.pdf: 997352 bytes, checksum: 9599053b27f7ec5bce201d3d5079009a (MD5) / Trypanosoma brucei é o agente etiológico da tripanossomíase africana ou doença do sono, transmitida por dípteros do gênero Glossina, conhecidos como moscas tsé-tsé. O diagnóstico e tratamento da doença não são satisfatórios, uma vez que para o tratamento está disponível um número de drogas altamente tóxicas e com um efeito limitado, pois dependem da fase da doença, das condições fisiológicas do hospedeiro, da suscetibilidade e variabilidade genética da cepa. Além do alto custo, o tratamento é potencialmente perigoso e está limitado ao surgimento de resistência generalizada aos fármacos utilizados. O diagnóstico é limitado à associação dos sintomas com a doença, muitas vezes é confundido com outras doenças pelo que o paciente não recebe o tratamento adequado. Por isso, tem-se a necessidade de buscar novos fármacos com melhor atividade tripanocida. Neste trabalho, avaliou-se a atividade tripanocida de 38 compostos diferentes e inéditos, como N1,N2-dibenziletano-1,2-diamina (cloridratos de benzil diaminas), N1-benzil,N2-metilferroceniletano-1,2-diamina (cloridratos de diaminas de ferroceno), 2-metoxi/hidroxi-3-(1-alquenil)-1,4-naftoquinonas e seus derivados 2-amina-1,4-naftoquinonas contra as cepas 427 e 29-13 de T. brucei. A eficácia dos compostos foi avaliada pelo método colorimétrico do MTT [brometo de 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazoliom]. Os resultados encontrados foram similares aos das atividades metabólicas das células (parasitas e/ou células HepG2 - linhagem de células de hepatoma, usada como modelo para simular funções hepáticas humanas in vitro), sendo o IC50 (metade da concentração inibitória máxima) calculado por regressão linear para cada composto. Da série anterior, o composto cloridrato de... / Trypanosoma brucei is the etiologic agent of sleeping sickness (Human African Trypanosomiasis [HAT]), transmitted by flies of Glossina genus, known as tsetse flies. The diagnostic and treatment of this disease are not satisfactory, since the treatment uses many toxicity drugs with limited effects, because depend on the stage of the disease, morphological diversity, heterogeneous biological behaviour, different clinical courses and the virulence appears to be an intrinsic property of each strain and high genetic variability. Besides the high cost, the treatment is potentially dangerous and limited the emergence of widespread drug resistance. The diagnosis is limited to the association of symptoms with the disease, is often confused with other diseases so the patient does not receive adequate treatment. Thus, the development of new research is necessary in order to generate new drugs with trypanocidal activity. In this work, we evaluated the trypanocidal activity of 38 inedited compounds of N1,N2-dibenzylethane-1,2-diamine hydrochlorides, N1-benzyl,N2-methyferrocenylethane-1,2-diamine hydrochlorides, 2-metoxy/hydroxy-3-(1-alquenyl)-1,4-naphtoquinones and amine derivatives of this compounds (2-amine-1,4-naphtoquinones) against 427 and 29-13 T. brucei parasite strains. The efficacy of these compounds was also measured using the reduction of MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. The results were similar to the metabolic activity of cells (parasites and/or HepG2 - hepatoma cell line used as a model to simulate human hepatic functions in vitro), being the IC50 (half of the maximum inhibitory concentration) calculated by linear regression for each sample. The compounds N-(ferrocenylmetyl)-N’-(4-metoxybenzyl)ethane-1,2-diamine) hydrochlorides and 2-metoxy-3-(2-phenylethenyl)-1,4-naphtoquinone... (Complete abstract click electronic access below)

The present study aimed to investigate sleep disturbances and negative emotions as predictors of posttraumatic stress disorder (PTSD) symptom trajectories in a publicly available longitudinal dataset of patients (N = 1127; mean age = 36.53; SD = 13.29; 65.5% women) who presented to a U.S. emergency department (ED) in the early aftermath of a trauma exposure. Latent growth curve models were fitted iteratively to characterize PTSD symptom trajectories over 1-year. Models then examined the simultaneous influence of sleep disturbances (i.e., insomnia symptoms, nightmares, and sleep duration) and negative emotions (i.e., feelings of anxiety and depression) on PTSD symptom trajectories, as well as whether negative emotions mediate the link between sleep disturbances and PTSD symptom trajectories. Results indicated that (a) PTSD symptom trajectories reflected a quadratic trend across time, although there was variability between individuals, (b) both sleep disturbances and negative emotions were uniquely associated with PTSD symptom trajectories, and (c) negative emotions partially explained associations between sleep disturbances and PTSD symptom trajectories. The results from this study can potentially aid detection of modifiable risk factors during the early course of PTSD and inform cognitive-behavioral intervention efforts.

Orientador: Rubens Nelson Amaral de Assis Reimão / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T18:35:50Z (GMT). No. of bitstreams: 1 Rocha_CeliaReginadaSilva_D.pdf: 6590104 bytes, checksum: 914a9ba91c4cc093a989c25c30387121 (MD5) Previous issue date: 2010 / Resumo: A adolescência é tida como um período de transição, marcado por significativas transformações nos aspectos bioquímicos, fisiológico e psicossocial, acarretando ansiedade e muita angústia, configurando-se como fatores de risco para o surgimento de algum tipo de distúrbio. Neste estudo, verificamos a ocorrência de sintomas de depressão, compulsão alimentar e distúrbios do sono em estudantes do terceiro ano do ensino médio e de curso pré-vestibular. Foi realizado um estudo transversal, descritivo. A amostra de 529 estudantes (M=241; F=288) de sete escolas públicas e privadas e dois cursos pré-vestibulares, de um bairro de classe média, da cidade de São Paulo, na faixa etária entre 16 e 19 anos. Os instrumentos utilizados foram: Inventário Beck de Depressão (BDI), Questionário sobre Padrões Alimentares e Peso - Revisado (QEWP-R) e o Índice de Qualidade do Sono de Pittsburgh (IQSP). A análise dos dados indica maior percentual de sintomatologia depressiva no grupo feminino e entre estudantes dos cursinhos. Verificou-se a presença de indícios de compulsão alimentar com maior percentual nos estudantes das escolas particulares. Em relação aos distúrbios do sono mostram diferenças significativas no período de estudo, problemas para ficar acordado, qualidade subjetiva do sono, latência, duração do sono, uso de medicação, eficiência habitual do sono, sonolência diurna e distúrbios do sono e número de pessoas na casa. Houve Associação entre distúrbios do sono e indícios de compulsão alimentar, distúrbios do sono e sintomatologia depressiva. Concluímos que na população estudada existe a ocorrência de sintomatologia depressiva, indícios de episódios de compulsão alimentar e distúrbios do sono / Abstract: Adolescence is a period of transition marked by significant transformations in biochemical, physiological and psychosocial aspects, leading to anxiety and anguish, which consist in risk factors for the appearance of some type of disturbance. In this study, we verified the occurrence of symptoms of depression, eating compulsion and sleep disturbances in third-year intermediate students and students enrolled in courses for university entrance examination. This was a transversal and descriptive study comprising 529 students (241 males; 288 females) from seven public and private schools and two courses for university entrance examination located in a middle-class district in the city of São Paulo, in the age group of 16-19 years. The instruments used were: Beck Depression Inventory (BDI), Questionnaire on Eating and Weight Patterns - Revised (QEWP-R) and the Pittsburgh Sleep Quality Index (PSQI). The data analysis indicated a major percentage of depressive symptomatology in the group of females and among students of the courses. It was verified a major percentage of eating compulsion signs in students of private schools. Concerning sleep disturbances, they showed significant differences regarding the period of study, difficulty staying awake, subjective quality of sleep, latency, sleep duration, medication use, habitual sleep efficiency, daytime sleepiness, and number of people at home. There was an association between sleep disturbances and eating compulsion signs, as well as sleep disturbances and depressive symptomatology. We could conclude that there was an occurrence of depressive symptomatology, signs of eating compulsion and sleep disturbances / Doutorado / Saude da Criança e do Adolescente / Doutor em Saude da Criança e do Adolescente

Breast cancer is the second most common cancer in women worldwide and the second leading cause of all-cancer mortality. Breast cancer is a multifactorial disease with several elements that contribute to its development. Several lines of evidence suggest that disruptions in circadian rhythm may increase the risk of breast cancer, primarily through decreasing the body’s production of melatonin, a molecule that combats tumorigenesis through antioxidant, anti-angiogenic, and anti-aromatase properties. Sleep characteristics like insomnia, sleep duration, chronotype, and participating in night shift work have all been studied to determine their impact on breast cancer risk. While there is research both in support of and against each of the previously mentioned sleep characteristics’ role in breast cancer development, the majority of studies that have been carried out are supportive of some form of causal association between sleep disturbances and breast cancer incidence and progression. The variability in various studies suggests that sleep disturbance may need to be particularly severe or persist for many years in order to have tumorigenic effects. This connection between sleep and breast cancer suggests that maintaining healthy sleep habits may reduce the risk of breast cancer over time. Taking melatonin supplements, participating in cognitive behavioral therapy, exercising regularly, and limiting exposure to blue light have all been shown to be useful practices for improving sleep quality; thus, these techniques may be useful for reducing breast cancer risk in women who experience sleep disturbances.

Background: Epidemiologic evidence supports the association between shiftwork and the development of cardiovascular disease. Sleep disturbances are associated with a variety of adverse cardiometabolic outcomes and they may lie on the causal pathway between the exposure to shiftwork and cardiovascular disease. Objectives: 1) To describe sleep quality in a group of shift-working and day-working female hospital employees; 2) To determine the association between shiftwork status and sleep disturbances in this group and to determine the effect of lifetime exposure to shiftwork on current sleep disturbances; and 3) To explore whether sleep disturbances mediate the relationship between shiftwork and cardiometabolic risk. Methods: A cross-sectional study was conducted among female hospital employees: participants were 132 women working only during the day, and 98 women who worked a shift schedule of two 12-hour days, followed by two 12-hour nights and five days off. Sleep quality was assessed with the Pittsburgh Sleep Quality Index questionnaire. The primary outcome of interest was the metabolic syndrome defined in accordance with the 2009 Joint Interim Studies consensus statement. Results: Shiftwork was associated with poor sleep latency (odds ratio (OR)= 2.08 95% CI: 1.11-3.92), poor sleep efficiency (OR=2.35 95% CI: 1.21- 4.54), and poor global sleep quality (OR=1.88 95% CI: 1.02-3.49), while the impact of past shiftwork history was inconclusive. The OR for the association of shiftwork with the metabolic syndrome was 2.00 (95% CI: 0.89-4.51), and there was no evidence of mediation by sleep disturbances in the relationship of shiftwork and the metabolic syndrome. Conclusion: In this study, a rapid forward rotating 2-shift system is associated with self-reported poor sleep quality, while the long-term effects of sleep disturbances on cardiometabolic risk requires further study. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-09-24 21:16:38.768

Distúrbios no padrão do sono são sintomas comuns em pacientes com câncer e a literatura pertinente é escassa. Sabe-se que suas conseqüências são fortemente relacionadas à qualidade de vida dos sobreviventes do câncer. Objetivo: avaliar o padrão do sono em pacientes cirúrgicos oncológicos após a alta hospitalar e relacioná-lo com as dimensões da qualidade de vida. Método: estudo de pesquisa exploratória com delineamento observacional-transversal, realizado em 46 pacientes com diagnóstico de câncer, submetidos a procedimento cirúrgico nas especialidades de cabeça e pescoço e de urologia, no período de um até o sexto mês de pósoperatório. As entrevistas foram realizadas no ambulatório da Associação de Combate ao Câncer do Brasil Central, localizada na cidade de Uberaba MG, após assinatura do termo de consentimento. Para obtenção dos dados foram utilizados três questionários: instrumento A, para obter características sociais e clínicas dos pacientes; Índice de Qualidade do Sono de Pittsburg PSQI, utilizado na mensuração da qualidade subjetiva do sono e para a ocorrência de seus distúrbios; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 itens (EORTC-QLQ-C30), para abordar os aspectos relacionados com a qualidade de vida no câncer. A consistência interna das escalas do PSQI e do EORTC foi verificada por meio do Coeficiente Alfa de Cronbach. Para este estudo, adotou-se p value inferior a 0,05 como estatisticamente significante. Resultados e Discussão: os procedimentos cirúrgicos na área de Cabeça e Pescoço corresponderam a 30,4% (14) dos pacientes e os da Urologia, a 69,6% (32). A confiabilidade alfa de Cronbach da escala do PSQI e do EORTC foi 0,794 e 0,8139, respectivamente. A correlação de Pearson entre o Estado Geral de Saúde (EGS) do EORTC e o escore global do PSQI foi r=-0,339 e entre o escore global do PSQI e o domínio de insônia do EORTC, de r= 0,710. Em relação às respostas fornecidas pelos entrevistados, observou-se: 73,9% possuem comprometimento da qualidade subjetiva do sono; os itens estatisticamente significantes para os dados sociodemográficos e clínicos, em relação ao escore global do PSQI, foram a renda, a escolaridade e o local do câncer; para os domínios do EORTC, em relação ao escore global do PSQI, foram o EGS, desempenho de papel, função social, dispnéia, fadiga, insônia e dificuldade financeira. Considerações: distúrbios no padrão do sono são freqüentes em sobreviventes do câncer e aceita-se que geralmente levam a problemas crônicos, que interferem diretamente na qualidade de vida. Espera-se que este estudo sensibilize a equipe de enfermagem, quanto à necessidade de investigar possíveis causas para distúrbios no padrão do sono em sobreviventes e conseguir implementar cuidados necessários para garantir melhor qualidade de vida. / sleep pattern disturbances are common in patients with cancer and pertinent references are scarce. It is known that their consequences are closely related to quality of life of cancer survivors. Objective: to evaluate the sleep pattern of surgical oncology patients after hospital discharge and to relate it with quality of life dimensions. Method: exploratory research with transversal-observational design, in 46 postoperative head & neck and urology cancer patients, one to six months after the operation. Outpatient interviews were made in the Associação de Combate ao Câncer do Brasil Central, located in the city of Uberaba MG, after obtention of signed consent form. Data were collected by use of three questionnaires: instrument A, to obtain social characteristics and patients\' clinical information; Pittsburgh Sleep Quality Index PSQI, for evaluation of subjective quality of sleep and for occurrence of sleep disturbances; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 itens (EORTC-QLQ-C30), to register aspects related to cancer quality of life. The internal consistency of the scales of PSQI and of EORTC was verified by means of Cronbach\'s Alpha Coefficient. For this study, p values lower than 0.05 were considered statistically significant. Results and Discussion: surgical procedures of Head and Neck corresponded to 30.4% (14) of the patients, compared to 69.6% (32) for Urology. Cronbach\'s alpha reliability of the scales of PSQI and EORTC were 0.794 and 0.8139, respectively. Pearson\'s Correlation between General Health Condition (EGS) of EORTC and global PSQI score was r=-0.339, and between global PSQI score and the insomnia domain of EORTC was r= 0.710. Regarding the answers supplied by the interviewees, it was observed: 73,9% have impairment of the subjective quality of sleep; the statistically significant items for social and clinical data, relative to global PSQI score, were the income, the level of schooling and the location of the cancer; for the domains of EORTC, relative to global PSQI score, were EGS, daily activity performance, social function, dyspnea, fatigue, insomnia and financial difficulty. Considerations: sleep pattern disturbances are frequent in cancer survivors and it is accepted that they usually lead to chronic problems, which interfere directly with quality of life. It is expected that this study sensitizes the nursing team, regarding the need to investigate possible causes for sleep pattern disturbances in survivors and to get implemented necessary cares to guarantee better quality of life.