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De Mello M.T.,University of Sao Paulo | Narciso F.V.,Associacao Fundo de Incentivo a Pesquisa | Tufik S.,University of Sao Paulo | Paiva T.,Institute of Molecular Medicine | And 6 more authors.
International Journal of Preventive Medicine | Year: 2013

Studies have shown that a large proportion of traffic accidents around the world are related to inadequate or disordered sleep. Recent surveys have linked driver fatigue to 16% to 20% of serious highway accidents in the UK, Australia, and Brazil. Fatigue as a result of sleep disorders (especially obstructive sleep apnea), excessive workload and lack of physical and mental rest, have been shown to be major contributing factors in motor vehicle accidents. A number of behavioral, physiological, and psychometric tests are being used increasingly to evaluate the impact of fatigue on driver performance. These include the oculography, polysomnography, actigraphy, the maintenance of wakefulness test, and others. Various strategies have been proposed for preventing or reducing the impact of fatigue on motor vehicle accidents. These have included: Educational programs emphasizing the importance of restorative sleep and the need for drivers to recognize the presence of fatigue symptoms, and to determine when to stop to sleep; The use of exercise to increase alertness and to promote restorative sleep; The use of substances or drugs to promote sleep or alertness (i.e. caffeine, modafinil, melatonin and others), as well as specific sleep disorders treatment; The use of CPAP therapy for reducing excessive sleepiness among drivers who have been diagnosed with obstructive sleep apnea. The evidence cited in this review justifies the call for all efforts to be undertaken that may increase awareness of inadequate sleep as a cause of traffic accidents. It is strongly recommended that, for the purpose of promoting highway safety and saving lives, all disorders that cause excessive sleepiness should be investigated and monitored.


Narciso F.V.,University of Sao Paulo | Barela J.A.,Southern Cross University of Brazil | Aguiar S.A.,Southern Cross University of Brazil | Carvalho A.N.S.,Associacao Fundo de Incentivo A Pesquisa | And 3 more authors.
PLoS ONE | Year: 2016

The purpose of the study was to investigate the effects of shift work on the psychomotor and postural performance of night workers. The study included 20 polysomnography technicians working schedule of 12-h night shift by 36-h off. On the first day of protocol, the body mass and height were measured, and an actigraph was placed on the wrist of each participant. On the second day of protocol, sleepiness by Karolinska Sleepiness Scale, postural control by force platform (30 seconds) and psychomotor performance by Psychomotor Vigilance Task (10 minutes) were measured before and after 12-h night work. Results showed that after 12-h night work, sleepiness increased by 59% (p<0.001), postural control variables increased by 9% (p = 0.048), and 14% (p = 0.006). Mean reaction time, and the number of lapses of attention increased by 13% (p = 0.006) and 425% (p = 0.015), respectively, but the mean reciprocal reaction time decreased by 7%. In addition, there were correlations between sleepiness and postural control variables with opened eyes (r = 0.616, 95% confidence interval [CI] = 0.361-0.815; r = 0.538; 95% CI = 0.280-0.748) and closed eyes (r = 0.557; 95% CI = 0.304-0.764, r = 0497; 95% CI = 0.325-0.715) and a pronounced effect of sleepiness on postural sway (R2 = 0.393; 95% CI = 0.001-0.03). Therefore, 12-h night work system and sleepiness showed a negative impact in postural and psychomotor vigilance performance of night workers. As unexpected, the force platform was feasibility to detect sleepiness in this population, underscoring the possibility of using this method in the workplace to prevent occupational injuries and accidents. © 2016 Narciso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Abboud C.S.,Dante Pazzanese Institute of Cardiology | de Souza E.E.,Dante Pazzanese Institute of Cardiology | Zandonadi E.C.,Dante Pazzanese Institute of Cardiology | Borges L.S.,Dante Pazzanese Institute of Cardiology | And 7 more authors.
Journal of Hospital Infection | Year: 2016

Background: Carbapenem-resistant Enterobacteriaceae (CRE) cause surgical site infections (SSIs) in intensive care units (ICUs). This study aimed to evaluate the impact of intervention and control measures to reduce CRE colonization and infection rates among patients in the ICU of a cardiac surgery hospital following a CRE outbreak. Methods: An observational study of the pre- and postintervention status of a cohort of colonized or infected patients in the postoperative adult cardiac surgery ICU was performed between April 2013 and December 2014. As well as the usual measures of screening and cohort nursing, the control measures were enhanced during the intervention period by providing alcohol gel at the bedside, daily bathing with no-rinse 2% chlorhexidine-impregnated wash cloths, and disinfection of surfaces around the patient three times per day. Results: The rates of CRE colonization (P<0.001), and primary central-line-associated bloodstream infections (P<0.002) and SSIs (P< 0.003) decreased significantly during the postintervention period. Conclusion: The implemented measures were effective in controlling colonization and infection with CRE in the cardiac surgery ICU. © 2016.


Guarnieri R.V.,University of Sao Paulo | Ribeiro R.L.,University of Sao Paulo | de Souza A.A.L.,Associacao Fundo de Incentivo a Pesquisa | Galduroz J.C.F.,University of Sao Paulo | And 2 more authors.
Frontiers in Psychiatry | Year: 2016

Episodic memory, working memory, emotional memory, and attention are subject to dopaminergic modulation. However, the potential role of dopamine on the generation of false memories is unknown. This study defined the role of the dopamine D2receptor on true and false recognition memories. Twenty-four young, healthy volunteers ingested a single dose of placebo or 400 mg oral sulpiride, a dopamine D2-receptor antagonist, just before starting the recognition memory task in a randomized, double-blind, and placebo-controlled trial. The sulpiride group presented more false recognitions during visual and verbal processing than the placebo group, although both groups had the same indices of true memory. These findings demonstrate that dopamine D2receptors blockade in healthy volunteers can specifically increase the rate of false recognitions. The findings fit well the two-process view of causes of false memories, the activation/monitoring failures model. © 2016 Guarnieri, Ribeiro, de Souza, Galduróz, Covolan and Bueno.


Feres M.C.,University of Sao Paulo | Fonseca F.A.H.,University of Sao Paulo | Cintra F.D.,University of Sao Paulo | Mello-Fujita L.,University of Sao Paulo | And 7 more authors.
Atherosclerosis | Year: 2015

Objective: Obstructive sleep apnea (OSA) has been linked to increased oxidative stress, lipid peroxidation and worsening atherosclerosis. This study investigated oxidized low-density lipoprotein (oxLDL) as a marker of lipid peroxidation, and total LDL cholesterol (direct LDL-C), as a marker of the lipid profile among individuals with OSA, and its association with hypertension (HYP) and dyslipidemia (DYS). The impact of one year of continuous positive airway pressure (CPAP) was also assessed. Methods: Blood was collected after 12h of fasting from 99 consecutive patients who were diagnosed with OSA via polysomnography, and were also diagnosed with both HYP and DYS via clinical and laboratory studies. The patients were classified into the following three groups: GI [OSA with comorbidities (HYP or DYS)], GII [OSA without comorbidities], and GIII [control]. Thirty-five patients with an apnea/hypopnea index >20 per hour of sleep were randomized to groups that received either Sham-CPAP or CPAP treatments over 12 months. Results: In a binary regression controlled for sex, age, body mass index, and glycemia, model 1 which analyzed direct LDL-C, demonstrated significant levels of risk in the setting of DYS but not in the settings of HYP and OSA. In model 2, which analyzed oxLDL, DYS (p=0.01), HYP (p=0.032), and OSA (p=0.039) were statistically significant. Significant alterations were observed in only the sleep parameters following one year of CPAP. Conclusions: Based on the statistical regression model, only the presence of DYS (p=0.001) was associated with the levels of direct LDL-C. The remaining comorbidities (OSA and HYP) were not significantly related to the levels of direct LDL-C. Regarding oxLDL, OSA, HYP and DYS each added significant score values to the levels of oxLDL.These findings are suggestive of the importance of assessing oxLDL among patients presenting with OSA, both with and without comorbidities. © 2015 Elsevier Ireland Ltd.


Monteiro J.,Associacao Fundo de Incentivo a Pesquisa | Inoue F.M.,Associacao Fundo de Incentivo a Pesquisa | Lobo A.P.T.,Associacao Fundo de Incentivo a Pesquisa | Sugawara E.K.,Associacao Fundo de Incentivo a Pesquisa | And 2 more authors.
Journal of Microbiological Methods | Year: 2015

A simple and reliable protocol using 0.1% trifluoroacetic acid (TFA) was developed to identify bacteria directly from blood cultures on the Vitek® MS system. Results presented a correlation of 99% for Gram-negative bacteria at species level, and 86.3% and 82.3% of Gram-positive bacteria at the genus and species levels, respectively. © 2014 Elsevier B.V.


PubMed | Southern Cross University of Brazil, Associacao Fundo de Incentivo a Pesquisa and University of Sao Paulo
Type: Journal Article | Journal: PloS one | Year: 2016

The purpose of the study was to investigate the effects of shift work on the psychomotor and postural performance of night workers. The study included 20 polysomnography technicians working schedule of 12-h night shift by 36-h off. On the first day of protocol, the body mass and height were measured, and an actigraph was placed on the wrist of each participant. On the second day of protocol, sleepiness by Karolinska Sleepiness Scale, postural control by force platform (30 seconds) and psychomotor performance by Psychomotor Vigilance Task (10 minutes) were measured before and after 12-h night work. Results showed that after 12-h night work, sleepiness increased by 59% (p<0.001), postural control variables increased by 9% (p = 0.048), and 14% (p = 0.006). Mean reaction time, and the number of lapses of attention increased by 13% (p = 0.006) and 425% (p = 0.015), respectively, but the mean reciprocal reaction time decreased by 7%. In addition, there were correlations between sleepiness and postural control variables with opened eyes (r = 0.616, 95% confidence interval [CI] = 0.361-0.815; r = 0.538; 95% CI = 0.280-0.748) and closed eyes (r = 0.557; 95% CI = 0.304-0.764, r = 0497; 95% CI = 0.325-0.715) and a pronounced effect of sleepiness on postural sway (R2 = 0.393; 95% CI = 0.001-0.03). Therefore, 12-h night work system and sleepiness showed a negative impact in postural and psychomotor vigilance performance of night workers. As unexpected, the force platform was feasibility to detect sleepiness in this population, underscoring the possibility of using this method in the workplace to prevent occupational injuries and accidents.

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