EDUARDO MASSAD
Projetos de Pesquisa
Unidades Organizacionais
Departamento de MedicinaLegal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina - Docente
LIM/01 - Laboratório de Informática Médica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/01 - Laboratório de Informática Médica, Hospital das Clínicas, Faculdade de Medicina - Líder
12 resultados
Resultados de Busca
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- Attention performance among Brazilian truck drivers and its association with amphetamine use: pilot study(2013) OLIVEIRA, Lucio Garcia de; SANTOS, Bernardo dos; GONCALVES, Priscila Dib; CARVALHO, Heraclito de Barbosa; MASSAD, Eduardo; LEYTON, VilmaThe aim of this article was to describe the attention functioning of twenty-two truck drivers and its relationship with amphetamine use. Those drivers who reported using amphetamines in the twelve months previous to the interview had the best performance in a test evaluating sustained attention functioning. Although amphetamine use may initially seem advantageous to the drivers, it may actually impair safe driving. The findings suggest the importance of monitoring the laws regarding amphetamine use in this country.
- Brain activity and medical diagnosis: an EEG study(2013) RIBAS, Laila Massad; ROCHA, Fabio Theoto; ORTEGA, Neli Regina Siqueira; ROCHA, Armando Freitas da; MASSAD, EduardoBackground: Despite new brain imaging techniques that have improved the study of the underlying processes of human decision-making, to the best of our knowledge, there have been very few studies that have attempted to investigate brain activity during medical diagnostic processing. We investigated brain electroencephalography (EEG) activity associated with diagnostic decision-making in the realm of veterinary medicine using X-rays as a fundamental auxiliary test. EEG signals were analysed using Principal Components (PCA) and Logistic Regression Analysis Results: The principal component analysis revealed three patterns that accounted for 85% of the total variance in the EEG activity recorded while veterinary doctors read a clinical history, examined an X-ray image pertinent to a medical case, and selected among alternative diagnostic hypotheses. Two of these patterns are proposed to be associated with visual processing and the executive control of the task. The other two patterns are proposed to be related to the reasoning process that occurs during diagnostic decision-making. Conclusions: PCA analysis was successful in disclosing the different patterns of brain activity associated with hypothesis triggering and handling (pattern P-1); identification uncertainty and prevalence assessment (pattern P-3), and hypothesis plausibility calculation (pattern P-2); Logistic regression analysis was successful in disclosing the brain activity associated with clinical reasoning success, and together with regression analysis showed that clinical practice reorganizes the neural circuits supporting clinical reasoning.
- Fuzzy cognitive map in differential diagnosis of alterations in urinary elimination: A nursing approach(2013) LOPES, Maria Helena Baena de Moraes; ORTEGA, Neli Regina Siqueira; SILVEIRA, Paulo Sergio Panse; MASSAD, Eduardo; HIGA, Rosangela; MARIN, Heimar de FatimaPurpose: To develop a decision support system to discriminate the diagnoses of alterations in urinary elimination, according to the nursing terminology of NANDA International (NANDA-I). Methods: A fuzzy cognitive map (FCM) was structured considering six possible diagnoses: stress urinary incontinence, reflex urinary incontinence, urge urinary incontinence, functional urinary incontinence, total urinary incontinence and urinary retention; and 39 signals associated with them. The model was implemented in Microsoft Visual C++(R) Edition 2005 and applied in 195 real cases. Its performance was evaluated through the agreement test, comparing its results with the diagnoses determined by three experts (nurses). The sensitivity and specificity of the model were calculated considering the expert's opinion as a gold standard. In order to compute the Kappa's values we considered two situations, since more than one diagnosis was possible: the overestimation of the accordance in which the case was considered as concordant when at least one diagnoses was equal; and the underestimation of the accordance, in which the case was considered as discordant when at least one diagnosis was different. Results: The overestimation of the accordance showed an excellent agreement (kappa = 0.92, p < 0.0001); and the underestimation provided a moderate agreement (kappa = 0.42, p < 0.0001). In general the FCM model showed high sensitivity and specificity, of 0.95 and 0.92, respectively, but provided a low specificity value in determining the diagnosis of urge urinary incontinence (0.43) and a low sensitivity value to total urinary incontinence (0.42). Conclusions: The decision support system developed presented a good performance compared to other types of expert systems for differential diagnosis of alterations in urinary elimination. Since there are few similar studies in the literature, we are convinced of the importance of investing in this kind of modeling, both from the theoretical and from the health applied points of view. Limitations: In spite of the good results, the FCM should be improved to identify the diagnoses of urge urinary incontinence and total urinary incontinence.
- Dengue infections in non-immune travellers to Thailand(2013) MASSAD, E.; ROCKLOV, J.; WILDER-SMITH, A.Dengue is the most frequent arboviral disease and is expanding geographically. Dengue is also increasingly being reported in travellers, in particular in travellers to Thailand. However, data to quantify the risk of travellers acquiring dengue when travelling to Thailand are lacking. Using mathematical modelling, we set out to estimate the risk of non-immune persons acquiring dengue when travelling to Thailand. The model is deterministic with stochastic parameters and assumes a Poisson distribution for the mosquitoes' biting rate and a Gamma distribution for the probability of acquiring dengue from an infected mosquito. From the force of infection we calculated the risk of dengue acquisition for travellers to Thailand arriving in a typical year (averaged over a 17-year period) in the high season of transmission. A traveller arriving in the high season of transmission and remaining for 7 days has a risk of acquiring dengue of 0.2% (95% CI 0.16-0.23), whereas the risk for travel of 15 and 30 days' duration is 0.46% (95% CI 0.41-0.50) and 0.81% (95% CI 0.76-0.87), respectively. Our data highlight that the risk of non-immune travellers acquiring dengue in Thailand is substantial. The incidence of 0.81% after a 1-month stay is similar to that reported in prospective seroconversion studies in Israeli travellers to Thailand, highlighting that our models are consistent with actual data. Risk estimates based on mathematical modelling offer more detailed information depending on various travel scenarios, and will help the travel medicine provider give better evidence-based advice for travellers to dengue-endemic countries.
- Maximum Equilibrium Prevalence of Mosquito-Borne Microparasite Infections in Humans(2013) AMAKU, Marcos; BURATTINI, Marcelo Nascimento; COUTINHO, Francisco Antonio Bezerra; LOPEZ, Luis Fernandez; MASSAD, EduardoTo determine the maximum equilibrium prevalence of mosquito-borne microparasitic infections, this paper proposes a general model for vector-borne infections which is flexible enough to comprise the dynamics of a great number of the known diseases transmitted by arthropods. From equilibrium analysis, we determined the number of infected vectors as an explicit function of the model's parameters and the prevalence of infection in the hosts. From the analysis, it is also possible to derive the basic reproduction number and the equilibrium force of infection as a function of those parameters and variables. From the force of infection, we were able to conclude that, depending on the disease's structure and the model's parameters, there is a maximum value of equilibrium prevalence for each of the mosquito-borne microparasitic infections. The analysis is exemplified by the cases of malaria and dengue fever. With the values of the parameters chosen to illustrate those calculations, the maximum equilibrium prevalence found was 31% and 0.02% for malaria and dengue, respectively. The equilibrium analysis demonstrated that there is a maximum prevalence for the mosquito-borne microparasitic infections.
conferenceObject The dengue outbreak in Madeira 2012: exploring the origins(2013) WILDER-SMITH, A.; ROCKLOV, J.; SESSIONS, O.; MASSAD, E.; KHAN, K.conferenceObject QUANTIFYING THE RISK OF MOSQUITO-BORNE INFECTIONS BASING ON THE EQUILIBRIUM PREVALENCE IN HUMANS(2013) AMAKU, Marcos; COUTINHO, Francisco Antonio Bezerra; MASSAD, EduardoThis paper proposes a general model for vector-borne infections that is flexible enough to comprise the dynamics of some known diseases transmitted by arthropods. From equilibrium analysis, we determined the number of infected vectors as an explicit function of the model's parameters and the prevalence of infection in the hosts. From the analysis, it is also possible to derive the Basic Reproduction Number and the equilibrium force of infection as a function of those parameters and variables. From the force of infection, we were able to conclude that, depending on the disease's structure and the model's parameters, it is possible to estimate a risk quantifier for those diseases. The analysis is exemplified by the case of malaria.- Estimating the Optimal Control of Zoonotic Visceral Leishmaniasis by the Use of a Mathematical Model(2013) RIBAS, Laila Massad; ZAHER, Vera Lucia; SHIMOZAKO, Helio Junji; MASSAD, EduardoWe argue that the strategy of culling infected dogs is not the most efficient way to control zoonotic visceral leishmaniasis (ZVL) and that, in the presence of alternative control strategies with better potential results, official programs of compulsory culling adopted by some countries are inefficient and unethical. We base our arguments on a mathematical model for the study of control strategies against ZVL, which allows the comparison of the efficacies of 5, alternative strategies. We demonstrate that the culling program, previously questioned on both theoretical and practical grounds is the less effective control strategy. In addition, we show that vector control and the use of insecticide-impregnated dog collars are, by far, more efficient at reducing the prevalence of ZVL in humans.
conferenceObject Determining the main driver for the increase of epidemic dengue in Singapore(2013) MASSAD, E.; ROKLOV, J.; COUTINHO, F.; STRUCHINER, C.; WILDER-SMITH, A.- The Impact of Hepatitis A Virus Infection on Hepatitis C Virus Infection: A Competitive Exclusion Hypothesis(2013) AMAKU, Marcos; COUTINHO, Francisco Antonio Bezerra; CHAIB, Eleazar; MASSAD, EduardoWe address the observation that, in some cases, patients infected with the hepatitis C virus (HCV) are cleared of HCV when super-infected with the hepatitis A virus (HAV). We hypothesise that this phenomenon can be explained by the competitive exclusion principle, including the action of the immune system, and show that the inclusion of the immune system explains both the elimination of one virus and the co-existence of both infections for a certain range of parameters. We discuss the potential clinical implications of our findings.