Universidade Federal do Cearà / ESPI e HemodiÃlise. O estudo compreendeu duas fases, transversal em uma primeira fase e prospectivamente durante os dois anos seguintes (2007-2009) para avaliar as alteraÃÃes do sono, sintomas depressivos e a mortalidade em pacientes em hemodiÃlise (HD). Dos 400 pacientes estudados 59% eram homens, idade=51,6Â15,5, em HD hà 5,9Â5,5 anos. SÃndrome de pernas inquietas (SPI) presente em 21,5% predominou em mulheres (p< 0,005); 55,8% apresentavam SPI moderada/grave (International Restless Legs Syndrome (IRLS)>15),e 44,2% sintomas leves. Pacientes com SPI apresentavam reduÃÃo da hemoglobina (p < 0,005) e tendÃncia a hipoalbuminemia (p=0,06). Mà qualidade do sono (Ãndice de Qualidade do Sono de Pittsburgh, IQSP>5) foi mais comum nos indivÃduos com SPI tinham quando comparados aos que nÃo tinham SPI (69,8% vs 56,8%, p=0,002). O risco de SAOS foi maior nos casos com SPI (todos os casos p = 0,01 e casos com SPI moderada/grave, p=0,007, respectivamente). Os casos com SPI moderada/grave associaram-se com hipertensÃo arterial (p=0,01) que permaneceu apÃs o controle para o risco de SAOS (p=0,02). Os turnos de diÃlise nÃo se relacionaram com transtornos do sono nem com sintomas depressivos e outras variÃveis clÃnicas e laboratoriais. AlteraÃÃes do sono e sintomas depressivos na HD. Foram utilizados os questionÃrios IQSP, a Escala de SonolÃncia de Epworth (ESE), o questionÃrio de Berlin, o IDB-II e o Ãndice de Comorbidades de Charlson (ICC). Os fatores de risco independentes associados com a mà qualidade do sono (56,8%) foram insuficiÃncia cardÃaca (OR=1,99, p=0,006), envelhecimento (OR=1,01, p=0,009). Os fatores de risco independentes para depressÃo (BDI-II>16, 19,3%) foram diabetes (OR=2,96, p=0,001], gÃnero feminino (OR=1,96, p=0,007), e hipoalbuminemia (OR=1,86, p=0,024). Mortalidade. O teste mÃltiplo de regressÃo mostrou que, em ambos os gÃneros, o aumento das comorbidades (p<0,005) e idade avanÃada (p<0,005) associaram-se com a mortalidade. Nas mulheres, o Ãndice de comorbidades determinou a mortalidade (p<0,005). Em homens, hipoalbuminemia (p=0,007), idade mais avanÃada(p<0,005), paratormÃnio reduzido (p=0,001) e sonolÃncia excessiva (p=0,03) diurna constituem fatores de risco para mortalidade. ConclusÃes. A prevalÃncia de depressÃo nos pacientes em HD à maior que na populaÃÃo geral. GÃnero feminino, diabetes, insuficiÃncia cardÃaca, hipoalbuminemia e idade sÃo condiÃÃes importantes associadas com depressÃo nos pacientes de HD e constituem caracterÃsticas Ãteis para identificar com prioridade os pacientes que podem se beneficiar com o tratamento da depressÃo apÃs o seu rastreamento. As mulheres e indivÃduos com anemia tÃm risco maior de SPI e SPI revelou-se importante nesse estudo pela sua associaÃÃo nas formas moderada/grave com hipertensÃo arterial, alÃm de depressÃo e mà qualidade do sono. BenefÃcios do tratamento adequado com possÃvel impacto nesses parÃmetros devem ser avaliados. SonolÃncia excessiva diurna associada com doenÃa cerebrovascular e anemia instiga a possibilidade de que a correÃÃo da anemia pode melhorar a sonolÃncia um conhecido fator de risco para DCV e mortalidade. A influÃncia de fatores distintos na mortalidade de homens e mulheres nesses pacientes merece ser explorada. . / SPI and Hemodialysis. The study comprised two phases, first phase in a cross-sectional and prospectively over the next two years (2007-2009) to evaluate sleep disturbances, depressive symptoms and mortality in patients on hemodialysis (HD). Of the 400 patients studied 59% were men, mean age = 51.6  15.5 in HD for 5.9  5.5 years. Restless Leg Syndrome (RLS) present in 21.5% predominated in women (p <0.005), 55.8% had RLS impairment (International Restless Legs Syndrome (IRLS)> 15) and 44.2% mild symptoms. RLS patients had a reduction in hemoglobin (p <0.005) and tendency to hypoalbuminemia (p = 0.06). Poor quality of sleep (Sleep Quality Index in Pittsburgh, PSQI> 5) was more common in individuals with RLS were compared to those without RLS (69.8% vs 56.8%, p = 0.002). The risk of OSA was higher in patients with RLS (all cases p = 0.01 and RLS cases with moderate / severe, p = 0.007, respectively). Cases with SPI moderate / severe were associated with hypertension (p = 0.01) that remained after controlling for risk of OSA (p = 0.02). The shifts of dialysis were not related to sleep disorders or depression symptoms and other clinical and laboratory findings. Sleep disturbances and depressive symptoms in HD. We used the PSQI questionnaire, the Epworth Sleepiness Scale (ESS), the Berlin questionnaire, the BDI-II and Charlson Comorbidity Index (CCI). The independent risk factors associated with poor sleep quality (56.8%) were heart failure (OR = 1.99, p = 0.006), age (OR = 1.01, p = 0.009). The independent risk factors for depression (BDI-II> 16, 19.3%) were diabetes (OR = 2.96, p = 0.001), female gender (OR = 1.96, p = 0.007), and hypoalbuminemia (OR = 1.86, p = 0.024). Mortality. The multiple regression test showed that in both genders, increasing age and comorbidities were associated with mortality. In women, the comorbidity rates determined mortality (p<005). In men, hypoalbuminemia ((p=0.007), older age (p<005), parathyroid hormone (p=0.001) and reduced excessive daytime sleepiness (p=0.03) were associated with mortality. Conclusion. The prevalence of depression in HD patients is higher than the general population. Female gender, diabetes, heart failure, hypoalbuminemia and age are important conditions associated with depression in HD patients and are useful features to identify priority patients who may benefit from the treatment of depression after his screening. Women and individuals with anemia are at greater risk of SPI and SPI has proved important in this study by its association forms moderate / severe arterial hypertension, and depression and poor sleep quality. Benefits of treatment and a possible impact on these parameters must be evaluated. Somnolence excessive daytime sleepiness associated with cerebrovascular disease and anemia instigates the possibility that correction of anemia may improve sleepiness a known risk factor for CVD and mortality. The influence of different factors on mortality in men and women in these patients deserves to be explored.

RLS är ett neurologiskt tillstånd. Karakteristiska symtom är känselförnimmelser framförallt lokaliserade till de nedre extremiteterna. Besvären upplevs sitta djupt inne i benen och framkalla ett oemotståndligt behov att röra på sig. Beskrivningen av symtomen, dess intensitet och förekomst varierar och är mycket individuell. RLS delas in i primär och sekundär form, beroende på symtomens ursprungliga orsak. Med tanke på att orsaken till RLS ännu är oklar finns inte någon kurativ behandling, men däremot goda möjligheter att lindra symtom och obehag. Syftet med denna systematiska litteraturstudie var att kartlägga hur livskvalitén påverkas hos personer med Restless legs syndrom (RLS). Granskning och kvalitetsbedömning av artiklarna gjordes med hjälp av triangulering utefter ett modifierat granskningsprotokoll. Totalt inkluderades 10 vetenskapliga artiklar av varierande kvalité i litteraturstudien efter litteratursökning i databaserna CINAHL, PubMed, PsycINFO samt via Cochrane Library. Samtliga studier visade signifikant resultat avseende sänkt livskvalité hos personer med RLS. Resultatet påvisar att personer med RLS har en sänkt livskvalité på grund av begränsningar i fysiska och psykiska funktioner. Personer med RLS upplever låg vitalitet, försämrad psykisk hälsa, lågt emotionellt välbefinnande, upplevelser av depressiva symtom samt begränsningar i sociala funktioner. Vidare faktorer som bidrar till sänkt livskvalité hos personer med RLS är sömnproblem, besvärande symtom, nedsatt fysisk funktion, försämrad fysisk rollfunktion, samt en upplevd sämre generell hälsa och daglig funktion. / RLS is a neurological condition. Characteristic symptoms are tactile sensations especially localized to the lower extremities. The disorder is perceived deep in the legs and provokes an irresistible need to move. Description of symptoms, its intensity and incidence vary and are highly individual. RLS is divided into primary and secondary form depending on the symptom’s original cause. Given that the cause of the RLS still is unclear, there is no curative treatment but good opportunities to alleviate symptoms and discomfort. The aim of this systematic literature review was to identify how the quality of life in people with Restless legs syndrome (RLS) is affected. Review and quality assessment of the articles was made with triangulation along a modified audit protocol. There were totally 10 scientific articles of varying quality included in the literature survey, after literature search in the databases PubMed, CINAHL, PsycINFO and the Cochrane Library. All studies showed significant results for lower quality of life in people with RLS. The result showed that people with RLS had a reduced quality of life because of limitations in the physical and mental functions. People with RLS were experiencing low vitality, deterioration of mental health, low emotional well-being, experiences of depressive symptoms and restrictions in social functions. Moreover factors affecting the low quality of life in people with RLS were sleeping problems, bothersome symptoms, impaired physical function, loss of physical role functioning and a perceived poor general health and daily function.

No description available.

Background: Symptoms of anxiety and depression in patients with restless legs syndrome (RLS) have been observed. However, it is unclear whether rates of threshold depression and anxiety disorders according to DSM-IV criteria in such patients are also elevated. Methods: 238 RLS patients were assessed with a standardized diagnostic interview (Munich- Composite International Diagnostic Interview for DSM-IV) validated for subjects aged 18–65 years. Rates of anxiety and depressive disorders were compared between 130 RLS patients within this age range and 2265 community respondents from a nationally representative sample with somatic morbidity of other types. Results: RLS patients revealed an increased risk of having 12-month anxiety and depressive disorders with particularly strong associations with panic disorder (OR=4.7; 95% CI=2.1–10.1), generalized anxiety disorder (OR=3.5; 95% CI= 1.7–7.1), and major depression (OR=2.6; 95% CI=1.5–4.4). In addition, lifetime rates of panic disorder and most depressive disorders as well as comorbid depression and anxiety disorders were considerably increased among RLS patients compared with controls. Conclusions: The results suggest that RLS patients are at increased risk of having specific anxiety and depressive disorders. Causal attributions of patients suggest that a considerable proportion of the excess morbidity for depression and panic disorder might be due to RLS symptomatology.

No description available.

Introduction: The Restless Legs Syndrome (RLS) is a frequent neurological disorder with a prevalence ranging from 5 - 10%. RLS is characterized by an urge to move the lower extremities during the night, thus RLS causes sleep disturbance. It presents as both idiopathic and secondary form. Idiopathic RLS is associated with common genetic variants in MEIS1, BTBD9, PTPRD and MAP2K5/SCOR1. Recently, multiple sclerosis (MS) was identified as a common cause for secondary RLS, the prevalence of RLS in patients with MS ranges from 13.3 to 37.5%. The aim of our study was to analyse the clinical and genetic aspects of this disorder, especially in patients with multiple sclerosis. In the clinical part, we evaluated the prevalence of RLS among Czech patients with MS and we compared the extent of brain damage between patients with and without RLS using magnetic resonance imaging (MRI). In the genetic part, we further analysed the impact of known genetic variants (MEIS1, BTBD9, MAP2K5/SCOR1, PTPRD) for RLS in other European populations and in patients with MS. Methods: Clinical part: Each patient with MS underwent a semi-structured interview. A patient was considered to be affected by RLS if he/she met all four standard criteria at life- long interval. Lesion load (LL - T2), brain atrophy - T1 and brain...

Introduction: The Restless Legs Syndrome (RLS) is a frequent neurological disorder with a prevalence ranging from 5 - 10%. RLS is characterized by an urge to move the lower extremities during the night, thus RLS causes sleep disturbance. It presents as both idiopathic and secondary form. Idiopathic RLS is associated with common genetic variants in MEIS1, BTBD9, PTPRD and MAP2K5/SCOR1. Recently, multiple sclerosis (MS) was identified as a common cause for secondary RLS, the prevalence of RLS in patients with MS ranges from 13.3 to 37.5%. The aim of our study was to analyse the clinical and genetic aspects of this disorder, especially in patients with multiple sclerosis. In the clinical part, we evaluated the prevalence of RLS among Czech patients with MS and we compared the extent of brain damage between patients with and without RLS using magnetic resonance imaging (MRI). In the genetic part, we further analysed the impact of known genetic variants (MEIS1, BTBD9, MAP2K5/SCOR1, PTPRD) for RLS in other European populations and in patients with MS. Methods: Clinical part: Each patient with MS underwent a semi-structured interview. A patient was considered to be affected by RLS if he/she met all four standard criteria at life- long interval. Lesion load (LL - T2), brain atrophy - T1 and brain...

Bakgrund: Restless legs syndrome (RLS) är en vanligt förekommande, underdiagnostiserad neurologisk sjukdom som orsakar lidande hos individen. Distriktssköterskor i telefonrådgivning utgör ofta första patiententkontakten med primärvården. Studier gällande distriktssköterskors erfarenhet av individer med RLS-associerade symtom och behandlingsbehov saknas varvid stort behov sågs av studien för ökad identifiering av dessa individer.  Syfte: Syftet var att beskriva hur distriktssköterskor erfar symtombild och behandlingsbehov hos individer med RLS-associerade besvär vid telefonrådgivning inom primärvården med fokus på möjligheter och hinder utifrån 4-habits kommunikationsmodell.  Metod: En kvalitativ intervjustudie med innehållsanalys genomfördes med 16 sjuksköterskor och distriktssköterskor yrkesverksamma i sex svenska regioner inom primärvården. En deduktiv ansats utifrån 4-habits kommunikationsmodell genomfördes.  Resultat: Resultatet presenteras utifrån kommunikationsmodellens delar; Investera i början innefattar; Patientmötets påverkansfaktorer, Försöka förstå patientens RLS-associerade symtom och Erfarenhet av RLS-associerade symtom. Ta reda på patientens perspektiv; Patientens symtombeskrivning som utgångspunkt och Symtomens inverkan på patientens livssituation. Visa empati; Förhålla sig till patientens situation och Tillitens betydelse i patientmötet. Investera i slutet; Triagering av patienter med RLS-associerade symtom, Egenvårdsrådgivning vid RLS-associerade symtom och Samsyn i slutet av samtalet. Slutsats: 4-habits kommunikationsmodell utgjorde struktur i distriktssköterskornas telefonrådgivningsarbete. Distriktssköterskorna lyssnade och ville förstå patienter med RLS-associerade symtom men begränsad kunskap avseende symtom och behandlingsbehov samt tidspress var hindrande faktorer. / Background: Restless legs syndrome (RLS) is a common, underdiagnosed neurological disease that causes great suffering. Primary healthcare nurses in telephone counseling are often patient's first contact with primary care. Studies regarding primary healthcare nurses experiences of individuals with RLS-associated symptoms and treatment needs are lacking. This study could contribute to increased awareness.  Purpose: The purpose was to describe how primary healthcare nurses experience symptoms and treatment needs of individuals with RLS-associated symptoms during telephone counseling in primary care with focus on opportunities and obstacles based on the 4-habits model. Method: A qualitative interview study with content analysis was conducted with 16 nurses working in six Swedish regions within primary healthcare. A deductive approach based on the 4-habits communication model was carried out. Results: Opportunities and obstacles in the primary healthcare nurses telephone counseling work, were identified based on the different parts of the 4-habits model; Invest in the beginning, elicit the patient's perspective, demonstrate empathy and invest in the end.  Conclusion: The 4-habits model contribute to primary healthcare nurses telephone counseling. The nurses listened and wanted to understand patients with RLS-associated symptoms, but limited knowledge regarding symptoms and treatment needs as well as time pressure were hindering factors.

Fidgeting and otherwise constant movements in individuals can be beneficial in those who suffer from Attention Deficit/Hyperactivity Disorder or Generalized Anxiety Disorder as well as others. However this constant movement can also be a distraction to others as well as protrude an air of no self confidence. It is the drawbacks from these actions that we wish to address. By developing an intelligent system that can detect these motions and alert the user, it will allow the wearer of the device to self correct. It is in this self control that one may exhibit more confidence or simply reduce the level of irritation experienced by those in the immediate vicinity. We have designed and built a low cost, mobile, lightweight, untethered, wearable prototype device. It will detect these actions and deliver user selectable biofeedback through a light emitting diode, buzzer, vibromotor or an electric shock to allow for self control. / by Scott A. Barnard. / Thesis (M.S.C.S.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

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Added 1 bitstream(s) on 2015-08-11T03:26:20Z : No. of bitstreams: 5 Publico-165a.pdf: 463473 bytes, checksum: cae240c8ee591f50351d96ca3258bfba (MD5) Publico-165b.pdf: 155628 bytes, checksum: 1115706461101400dcec7e30309c015b (MD5) Publico-165c.pdf: 1838976 bytes, checksum: 98bc6262f927468869ae5e34cde1918a (MD5) Publico-165d.pdf: 1269518 bytes, checksum: f1bbb32c8edea554dfa6517033d47653 (MD5) Publico-165e.pdf: 1520227 bytes, checksum: 275186328f675001df3bba84180ce117 (MD5) / Contexto: A síndrome das pernas inquietas (SPI) é uma desordem caracterizada por uma angustiante necessidade de movê-las e, às vezes, mover também outras partes do corpo, geralmente acompanhada de desconforto ou dor. O tratamento desta síndrome com agonistas dopaminérgicos tem sido reconhecido como terapêutica de primeira linha, porque parece eficaz com base em princípios fisiopatológicos; vários grupos farmacológicos compreendem seu tratamento. Objetivos: Avaliar se intervenções farmacológicas são eficazes e seguras para o tratamento da SPI. Método: Revisão Sistemática Cochrane de estudos randomizados ou quasirandomizados sobre agentes farmacológicos utilizados no tratamento da SPI. Foram avaliados os seguintes desfechos para cada fármaco: alívio dos sintomas medido pela escala de gravidade para a síndrome das pernas inquietas (IRLSSG Rating Scale), eventos adversos, parâmetros polissonográficos, melhora subjetiva, qualidade de vida, impressão clínica global, impressão global do paciente, escala de sonolência de Epworth MSLT: Múltiplos Testes de Latência do Sono; PLMI: índice dos Movimentos Periódicos dos Membros. A autora desta tese avaliou os estudos recuperados nas buscas, utilizando critérios que envolviam os métodos randômicos, de cegamento e sigilo de alocação. As divergências foram resolvidas em reunião de consenso. Resultados: As buscas manual e eletrônica encontraram 1.026 estudos. Foram incluídos 94 ensaios clínicos que atendiam aos critérios de inclusão (estudos randomizados ou quasi-randomizados). A análise dos dados considerados em conjunto permitiu concluir que as intervenções farmacológicas foram efetivas para os agonistas dopaminérgicos. Dentre as drogas de segunda linha, apenas a clonidina mostrou-se efetiva. A qualidade dos estudos foi adequada para os ensaios clínicos envolvendo os agonistas dopaminérgicos, parcialmente adequada para levodopa e anticonvulsivantes e pouco adequada para os demais fármacos estudados. Conclusões: Há evidências de que os agonistas dopaminérgicos são eficazes e seguros para o tratamento da SPI a curto prazo, mas não há evidência científica de que os demais fármacos são efetivos nesta doença. / Background: The restless legs syndrome (RLS) is a disorder characterized by a distressing need to move the legs and sometimes other parts of the body. Usually accompanied by a marked sense of discomfort or pain in the leg or other body part affected. The treatment of restless legs syndrome with dopamine agonists has been recognized as the main first-line treatment because it seems to be effective based on pathophysiologic principles. Although, several pharmacological drugs are envolved in the treatment of RLS. Objectives: To assess whether pharmacological interventions are effective and safe for the treatment of RLS. Methods: Systematic Cochrane Review of randomized studies or quasi-randomized on pharmacological agents used to treat RLS. The following outcomes were assessed for each drug: relief of symptoms measured by the restless legs syndrome ranting scale (IRLSSG Rating Scale), adverse events, polysomnographic parameters, subjective improvement, quality of life and clinical global impression, overall impression of the patient , the scale of Epiworth MSLT: Multiple Sleep Latency Test; PLM periodic limb movments and others. The authors evaluated the studies retrieved in searches using criteria involving the method of randomization, blinding and the method of allocation concelment. Disagreements were resolved by consensus. Results: The electronic and manual search found 1,026 studies. Were included 94 studies that met the clinical criteria for inclusion (randomized studies or quasi-randomized). The analysis of data, taken together, indicated that the pharmacological interventions were effective for dopamine agonists. Among the second-line drugs, only clonidine was shown to be effective. The quality of studies was suitable for clinical trials involving the dopamine agonists, partially adequated to levodopa and anticonvulsants, and unsuited for the other drugs studied. Conclusions: There is evidence that dopamine agonists are effective and safe for the treatment of RLS in the short term, there is no scientific evidence that all drugs are effective in this disease. / TEDE / BV UNIFESP: Teses e dissertações