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Objective: The present study analyzed the Virtual-PRO program's efficacy in preventing peer sexual harassment by promoting the bystanders' active intervention and incorporating a virtual reality (VR) component. The impact of the program on sexist attitudes, moral disengagement, the intention to intervene as bystanders, and the involvement in sexual aggression and victimization was tested. Method: Virtual-PRO is a VR-enhanced sexual harassment curricular prevention program of six one-hour sessions. The evaluation comprised a pre-test, a post-test after the intervention, and a follow-up measure at three months. In the study, 579 Spanish adolescent students aged between 12 and 17 years (M = 14.76, SD = 0.88; 47.1% boys) were randomly grouped into experimental (n = 286) and control (n = 293) conditions. Results: The Virtual-PRO program effectively controlled participants' levels of sexism and reduced moral disengagement in the experimental group compared to the control group three months after the intervention. The program also showed positive results in changing bystander behavior, increasing the intention to intervene when the victim was not a friend. Finally, visual/verbal and online victimization decreased in the experimental group and increased in the control group. No differences were found for physical sexual victimization and sexual aggression. Conclusions: The first trial of the Virtual-PRO program is promising and highlights the use of VR as a sexual harassment prevention tool. Follow-up measures are essential to determine the impact of interventions accurately.
Objetivo: El presente estudio analiza la eficacia del programa Virtual-PRO en la prevención del acoso sexual entre iguales promoviendo la intervención activa de los espectadores mediante el uso de la realidad virtual (RV). Se comprobó el impacto del programa en las actitudes sexistas, la desconexión moral, la intención de intervenir como espectadores y la implicación en agresión y victimización sexual. Método: Virtual-PRO es un programa curricular compuesto por seis unidades que incorpora la RV para mejorar la prevención del acoso sexual. La evaluación incluyó una medida pre-test, un post-test después de la intervención y una medida de seguimiento a los tres meses. En el estudio participaron 579 estudiantes españoles de entre 12 y 17 años (M = 14.76, DT = 0.88, 47.1% chicos), agrupados aleatoriamente en grupo experimental (n = 286) y control (n = 293). Resultados: El programa Virtual-PRO controló eficazmente los niveles de sexismo y redujo la desconexión moral en el grupo experimental en comparación con el grupo de control tres meses después de la intervención. También mostró resultados positivos en el cambio del comportamiento de los espectadores, mejorando la intención de intervenir cuando la víctima no era amigo o amiga. Por último, la victimización visual/verbal y online disminuyó en el grupo experimental y aumentó en el grupo control. No se encontraron diferencias en victimización sexual física y agresión sexual. Conclusiones: El primer ensayo del programa Virtual-PRO es prometedor y pone de relieve el uso de la RV como herramienta eficaz para la prevención del acoso sexual. Las medidas de seguimiento son esenciales para determinar con precisión el efecto de las intervenciones.
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Assédio Sexual , Realidade Virtual , Adolescente , Criança , Feminino , Humanos , Masculino , Agressão , Homens , Sexismo , Assédio Sexual/prevenção & controleRESUMO
LGBTQ+ bullying is a specific type of stigma-based bullying with a high prevalence among LGBTQ+ people. However, instruments to assess this phenomenon are scarce and focus on homophobic aggressions, and the motivations therefor, mainly in relation to gay and lesbian youths. In this study, we introduce and validate an instrument to assess LGBTQ+ bullying. The instrument covers general and specific aggressions, as well as dimensions of sexuality besides sexual orientation such as gender identity and expression, as a more comprehensive approach to understand the phenomenon. The study included 2,552 adolescents (MAge = 14.54, SD = 1.76) from 13 Andalusian public secondary schools. Regarding gender identity, 43.9% of participants were cisgender boys, 53.5% were cisgender girls, and 2.6% were trans-binary and non-binary gender youths. In terms of sexual orientation, 81.1% of participants were heterosexual students, 2.4% lesbian/gay, 11.2% bisexual/pansexual, 4.4% questioning, and 0.9% asexual. Second-order models for bullying and cyberbullying had a good fit. Moreover, invariance was seen for bullying [ΔCFI = -.003] and cyberbullying [ΔCFI = .003] victimization measures. Furthermore, there was a sexual diversity bias: cisgender heterosexual students were more likely to perpetrate LGBTQ+ aggressions, and LGBTQ+ students were more likely to be targets of general and specific aggressions.
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OBJECTIVE: The general objective of this study is to analyze the change in mental health and post-traumatic symptoms over 6 months during the COVID-19 pandemic in a Spanish community sample, with a particular focus on individual differences in longitudinal change in symptoms and its predictors. METHOD: This longitudinal prospective study surveyed a Spanish community sample three times (T1: during the initial outbreak, T2: after 4 weeks and T3: after 6 months). Four thousand one hundred and thirty-nine participants from all the Spanish regions completed the questionnaires. However, the longitudinal analysis was performed only with participants which responded at least two times (1,423 participants). Mental health assessments included depression, anxiety, and stress (measured by the Depression, Anxiety and Stress Scale (DASS-21) and post-traumatic symptoms were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: All the mental health variables achieved worse results at T2. Depression, stress, and posttraumatic symptoms did not recover at T3 when compared with the initial measure, while anxiety was practically stable across the timeline. Women, younger age, having a previous mental health diagnosis and contact with individuals with COVID-19 were linked to worse psychological evolution during the 6-months period. A good perception of one's physical health may be a protective factor. CONCLUSIONS: After 6 months of the pandemic, the general population's mental health was still worse than at the initial outbreak for most of the variables analyzed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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There is a paucity of studies on dating violence profiles that incorporate the forms of cyber and sexual dating violence. Moreover, the results on the predictive role of peer violence on dating violence are inconsistent. Our aim was to identify dating violence profiles and to study the predictive value of peer violence profiles on dating violence profiles using a short-term longitudinal design. The sample consisted of 498 adolescents with current or past romantic relationship (42.8% boys), aged 12-18 years (M = 14.22; SD = 1.39). Four dating violence profiles were identified with an overlap between traditional and cyberdating violence. Peer violence profiles were associated with dating violence profiles 4 months later. The results suggest the need to prevent all forms of dating violence at an early age, starting with the improvement of interpersonal relationships between peers.
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Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Masculino , Humanos , Adolescente , Feminino , Prevalência , Violência , Grupo AssociadoRESUMO
This study investigated adolescents' understanding of cyber dating aggression in terms of frequency and aggressiveness: how prevalent they perceived cyber dating aggression among adolescents and how aggressive they perceived such behaviors to be. To do so, different WhatsApp scenarios were presented to adolescents, controlling for the typology of cyber dating aggression (verbal/emotional, controlling, or sexual) and its publicity (public or private cyber dating aggression). The moderating effect of gender and moral disengagement (MD) was also analyzed. A total of 262 adolescents (56.5% girls; mean age of 14.46 years) participated in the study and answered a computer-based questionnaire. General linear models revealed that adolescents consider cyber dating aggression to be present in most adolescent romantic relationships. Controlling online behavior was perceived as the most frequent and the least aggressive behavior. Adolescents rated private cyber aggression as more frequent and less aggressive than public cyber aggressions. Controlling for gender, girls reported that cyber dating aggression was more common and more severe than boys. Moreover, participants with high levels of MD perceived cyber dating aggressions to be less aggressive than participants with medium-low MD. This study reveals the significance of the type of cyber dating aggression, the public/private dimension, gender, and MD as variables that influence adolescent understanding of cyber dating aggression. These results have implications not only for the design of cyber dating aggression prevention programs but also for future research on cyber dating aggression.
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Comportamento do Adolescente , Agressão , Adolescente , Agressão/psicologia , Feminino , Humanos , Masculino , Percepção , Comportamento Sexual , Inquéritos e QuestionáriosRESUMO
The global outbreak of COVID-19 has brought changes in adolescents' daily routines, restrictions to in-person interactions, and serious concerns about the situation. The purpose of this study was to explore COVID-19-related concerns, daily routines, and online peer activities during the confinement period according to sex and age groups. Additionally, the relationship of these factors and optimism along with adolescents' frustration was examined. Participants included 1246 Spanish students aged 16-25 years old (M = 19.57; SD = 2.53; 70.8% girls). The results indicated that the top concern was their studies. COVID-19-related concerns, daily routines, and online peer activities varied by sex and age. Findings also revealed moderate to high levels of frustration, which were associated with adolescents' main concerns, online peer activities, maintaining routines, and optimism. The results are discussed in light of their implications in designing support programs and resources to reduce the psychological impact of COVID-19 on adolescent mental health.
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This research aimed to explore the interplay of sexism and moral disengagement (MD) in the explanation of psychological and physical dating aggression. The sample comprised 1113 Spanish adolescents (49.2% girls, n = 552) between the ages of 12 to 17 (M = 14.44). A latent profile analysis conducted with sub-sample of 432 adolescents with sentimental experience identified four configurations: (1) benevolent; (2) less disengaged and sexist; (3) highly disengaged and sexist; and (4) moderately disengaged and sexist. Regarding gender and age, boys were more present than girls in the moderately disengaged and sexist group, as well as in the highly disengaged and sexist profile. The highly disengaged and sexist and benevolent groups were the youngest. Regarding dating aggression, the highly disengaged and sexist group had the highest engagement in physical and psychological aggression. However, the others three profiles showed a similar engagement in aggression. These findings confirmed the moderating role of MD on the relationship between sexism and dating aggression and suggested that the association between MD, sexism, and dating aggression was exponential; that is, the risk appeared when adolescents were extremely hostile and disengaged. The results have implications for the design of tailored dating aggression prevention programmes.
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Agressão , Princípios Morais , Adolescente , Atitude , Criança , Feminino , Hostilidade , Humanos , Masculino , Fatores de Risco , SexismoRESUMO
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a clinical entity with specific features that impacts significantly on patient quality of life (QoL). CRSwNP is often associated with asthma and is difficult to control and manage despite pharmacological and/or surgical treatment. Omalizumab, a monoclonal anti-IgE antibody, has emerged as a putative therapeutic option. OBJECTIVE: To evaluate the effects of omalizumab on nasal polyp (NP) size and QoL assessed by Sino-Nasal Outcome Test-22 (SNOT-22) in patients with recalcitrant CRSwNP and mild asthma. METHODS: A multicenter retrospective analysis of patient data from the Community of Valencia (Spain) was performed. Adult patients with recalcitrant CRSwNP and comorbid mild asthma receiving compassionate use of omalizumab were included. NP size measured by total nasal endoscopic polyp score (TPS) and QoL evaluated through the SNOT-22 questionnaire were assessed at baseline and monthly over 12 months. An ordinal regression model was built to analyze the results. RESULTS: A total of 23 CRSwNP patients with a mean age (± SD) of 54.78 ± 9.46 years were included. Nineteen suffered from aspirin-exacerbated respiratory disease (AERD). In all patients, a significant and sustained reduction in TPS was observed over time, accompanied by improvements in QoL reflected in lower SNOT-22 scores. In the ordinal regression model, time but not total IgE, age or tissue eosinophilia impacted on NP size and SNOT-22 outcomes. Additionally, improvements in QoL were not explained by reductions in the size of polyps. CONCLUSION: Omalizumab was effective for the treatment of patients with recalcitrant CRSwNP and mild asthma, even when AERD was present, by reducing NP size and improving QoL; treatment time was a key factor. SNOT-22 improvements were not explained by decreases in TPS, indicating that omalizumab may be effective in all patients, regardless of polyp size.
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Asma , Pólipos Nasais , Rinite , Adulto , Asma/complicações , Asma/tratamento farmacológico , Asma/epidemiologia , Doença Crônica , Humanos , Pólipos Nasais/tratamento farmacológico , Omalizumab/uso terapêutico , Qualidade de Vida , Estudos Retrospectivos , Rinite/tratamento farmacológico , Resultado do TratamentoRESUMO
Background: The aim of this study was to assess the efficacy of the school-based "Dat-e Adolescence" prevention program in the reduction of dating aggression and victimization and bullying in adolescents. Method: a RCT design with three waves (pre-test, post-test and follow-up six months apart) and two groups (an experimental group and a control group) were used. One thousand four hundred and twenty three (1423) adolescents, mean age 14.98 (557 in the experimental group) participated in the study. Results: Efficacy evaluation was analyzed using Multiple-group latent growth models and showed that the Dat-e Adolescence program was effective in reducing sexual and severe physical dating violence and bullying victimization. Conclusions: The results suggest that dating violence prevention programs could be an effective approach for tackling different behavioral problems in adolescence given the protective and risk factors shared between dating violence and bullying.
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Comportamento do Adolescente , Bullying/prevenção & controle , Violência por Parceiro Íntimo/prevenção & controle , Serviços Preventivos de Saúde/normas , Adolescente , Agressão , Vítimas de Crime , Feminino , Humanos , Relações Interpessoais , Masculino , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Comportamento Sexual , Adulto JovemRESUMO
This study presents the first evaluation of Dat-e Adolescence, a dating violence prevention program aimed at adolescents in Spain. A cluster randomized control trial was used involving two groups (a control group and experimental group) and two waves (pre-test and post-test six months apart). 1,764 students from across seven state high schools in Andalucía (southern Spain) participated in the study (856 in the control group and 908 in the experimental group); 52.3% were boys (n = 918), with ages ranging from 11 to 19 years (average age = 14.73; SD = 1.34). Efficacy evaluation was analyzed using Latent Change Score Models and showed that the program did not impact on physical, psychological or online aggression and victimization, nor did it modify couple quality. It was, however, effective at modifying myths about romantic love, improving self-esteem, and improving anger regulation, as a trend. These initial results are promising and represent one of the first prevention programs evaluated in this country. Future follow-up will allow us to verify whether these results remain stable in the medium term.
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Violência por Parceiro Íntimo/prevenção & controle , Adolescente , Ira , Criança , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Masculino , Avaliação de Programas e Projetos de Saúde , Testes Psicológicos , Autoimagem , Espanha , Inquéritos e Questionários , Adulto JovemRESUMO
Recent studies suggest that the online and offline behaviors young people display in romantic relationships are closely related. However, the differential effects of the dimensions of couple quality in the online context have not yet been explored in depth. The aim of this study was to explore online couple quality in young-adult relationships, and its association with romantic relationship satisfaction, also looking at effects of gender, age, and length of the relationship. 431 university students currently in a romantic relationship (68.2% females; mean age = 21.57) participated in this study. They completed different self-report measures to tap the online quality of their romantic relationships (online intimacy, control, jealousy, intrusiveness, cyberdating practices, and communication strategies) and level of satisfaction with those relationships. Results showed that participants more often reported online intimacy (M men = 2.49; M women = 2.38) than the negative scales of online quality (mean ranged from .43 to 1.50), and all the online quality scales decreased with age (correlations ranged from -.12 to -.30) and relationship length (correlations ranged from -.02 to -.20). Linear regression analyses indicated that online intimacy (b = .32, p = .001) and intrusiveness (b = .11, p = .035) were positively related to relationship satisfaction, while cyberdating practices (b = -.20, p = .001) and communication strategies (b = -.34, p = .001) were negatively correlated with relationship satisfaction. Moreover, gender and relationship length moderated some of these associations. Results indicate that while online quality and relationship satisfaction are related, the impact of different online quality dimensions on relationship satisfaction differs depending on a participant's sex, age, and relationship length.
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Comunicação , Características da Família , Internet , Relações Interpessoais , Satisfação Pessoal , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Ciúme , Modelos Lineares , Masculino , Fatores Sexuais , Comportamento Sexual , Fatores de Tempo , Adulto JovemRESUMO
Background/Objective: The study of sexual cyberbehaviour in adolescence has received much attention in recent years, because of the risks associated with exposure to pornography, unwanted sexual solicitations, and gender-based sexual harassment. The prevalence of this phenomenon varies from study to study due to a lack of consensus around how to define and measure peer sexual cybervictimization. This study aims to contribute to this research topic by developing and validating a measure of peer sexual cybervictimization among adolescents. Method: 601 adolescents (mean age 14.06) from two Spanish cities participated in this study. Cross-validation was performed using EFA and CFA. In a second step, a multi-group analysis was conducted to compare the equivalence of the measure by gender. Results: The results confirmed a second-order model comprising two first-order factors: Ambiguous sexual Cybervictimization and Personal sexual Cybervictimization. The model was invariant by gender. Descriptive analyses showed significant differences in Ambiguous sexual aybervictimization, this being more frequent in boys than in girls. Prevalence rates varied from 17 to 26%, with less involvement observed in the Personal dimension. Conclusions: This work proposes a valid and gender invariant measure to analyze peer sexual cybervictimization in adolescence.
Antecedentes/Objetivo: El estudio de la ciberconducta sexual en la adolescencia ha recibido mucha atención en los últimos años, especialmente la referida a los riesgos que suponen la exposición a la pornografía, las solicitudes sexuales indeseadas y el hostigamiento sexual basado en el género. La prevalencia del fenómeno varía entre los diferentes estudios debido a una falta de consenso en la definición y medida del constructo cibervictimización sexual. Este trabajo pretende contribuir en esta área, desarrollando y validando una escala para medir victimización sexual online. Método: Una muestra de 601 adolescentes de dos ciudades españolas (edad media 14,06) participaron en el estudio. Se realizó una validación cruzada empleando AFE y AFC, así como un análisis multigrupo para comparar la equivalencia de la medida por sexo. Resultados: se confirmó un modelo de segundo orden compuesto por dos factores (Cibervictimización sexual ambigua y Cibervictimización sexual personal) invariante por sexo. Los análisis indicaron diferencias significativas en la dimensión ambigua, siendo más frecuente en ellos. Los datos revelaron una prevalencia entre el 17 y 26%, siendo menor la implicación en la forma personal. Conclusiones: Se propone una medida válida e invariante en ambos sexos de la cibervictimización sexual por parte de los iguales en la adolescencia.
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INTRODUCTION AND OBJECTIVES: Prevalence of congenital sensorineural hearing loss (SNHL) is approximately 1.5-6 in every 1,000 newborns. Dysfunction of the auditory nerve (auditory neuropathy) may be involved in up to 1%-10% of cases; hearing losses because of vestibulocochlear nerve (VCN) aplasia are less frequent. The objectives of this study were to describe clinical manifestations, hearing thresholds and aetiology of children with SNHL and VCN aplasia. METHODOLOGY: We present 34 children (mean age 20 months) with auditory nerve malformation and profound HL taken from a sample of 385 children implanted in a 10-year period. We studied demographic characteristics, hearing, genetics, risk factors and associated malformations (Casselman's and Sennaroglu's classifications). Data were processed using a bivariate descriptive statistical analysis (P<.05). RESULTS: Of all the cases, 58.8% were bilateral (IIa/IIa and I/I were the most common). Of the unilateral cases, IIb was the most frequent. Auditory screening showed a sensitivity of 77.4%. A relationship among bilateral cases and systemic pathology was observed. We found a statistically significant difference when comparing hearing loss impairment and patients with different types of aplasia as defined by Casselman's classification. Computed tomography (CT) scan yielded a sensitivity of 46.3% and a specificity of 85.7%. However, magnetic resonance imaging (MRI) was the most sensitive imaging test. CONCLUSIONS: Ten percent of the children in a cochlear implant study had aplasia or hypoplasia of the auditory nerve. The degree of auditory loss was directly related to the different types of aplasia (Casselman's classification) Although CT scan and MRI are complementary, the MRI is the test of choice for detecting auditory nerve malformation.
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Perda Auditiva Neurossensorial/congênito , Nervo Vestibulococlear/anormalidades , Anormalidades Múltiplas , Audiometria de Tons Puros , Limiar Auditivo , Pré-Escolar , Feminino , Perda Auditiva Bilateral/congênito , Perda Auditiva Bilateral/diagnóstico por imagem , Perda Auditiva Bilateral/epidemiologia , Perda Auditiva Bilateral/fisiopatologia , Perda Auditiva Neurossensorial/diagnóstico por imagem , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Unilateral/congênito , Perda Auditiva Unilateral/diagnóstico por imagem , Perda Auditiva Unilateral/epidemiologia , Perda Auditiva Unilateral/fisiopatologia , Testes Auditivos , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Prevalência , Sensibilidade e Especificidade , Síndrome , Tomografia Computadorizada por Raios X , Nervo Vestibulococlear/diagnóstico por imagem , Nervo Vestibulococlear/embriologiaRESUMO
INTRODUCTION: Otosclerosis is an osteodystrophy of the labyrinthine capsule producing conductive hearing loss. If the process invades the cochlea, a sensorineural hearing loss usually takes place. The cochlear implant is a good alternative in these patients. OBJECTIVE: To ascertain the behaviour of cochlear implantation in otosclerosis. MATERIAL AND METHODS: We reviewed a database of 250 patients that underwent cochlear implantation, performing a retrospective study of 13 patients with clinical, audiological and/or imaging findings of bilateral otosclerosis. The 26 ears were studied as to their natural history, previous surgeries, evolution to profound hearing loss, computed tomography images, complications and functional results. RESULTS: Of the cases studied, 46% were female and 54% were men, with a mean age of 26 years at the onset of conductive hearing loss. Stapes surgery was performed in 19 ears (73%), with a mean patient age of 29 years, and 53% of them underwent cochlear implantation. Computed tomography results showed that there were signs of different degrees of radiological affectation in 54% of the ears. A total of 3 complications took place (23%): implant failure, overstimulation of the facial nerve and bilateral tinnitus were found. One year after implantation, the average percentages of correct 2-syllable words were 80% and 85% in open sentences. CONCLUSIONS: Patients having profound bilateral sensorineural hearing loss secondary to otosclerosis obtain great benefit from cochlear implantation.
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Implantes Cocleares , Otosclerose/cirurgia , Idoso , Progressão da Doença , Nervo Facial/fisiopatologia , Feminino , Perda Auditiva Bilateral/etiologia , Perda Auditiva Bilateral/cirurgia , Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva/cirurgia , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Otosclerose/diagnóstico por imagem , Estudos Retrospectivos , Cirurgia do Estribo , Zumbido/etiologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We present five cases of tonsillitis secondary to Yersinia enterocolitica. No response to commonly-used antibiotics and continuous professional contact with pigs were common. The definitive diagnosis was established by bacteriological isolation on tonsil tissue samples.
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Tonsilite/microbiologia , Yersiniose , Yersinia enterocolitica , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tonsilite/diagnóstico , Yersiniose/diagnóstico , Adulto JovemRESUMO
Second branchial cleft anomalies are the most common of this type of neck masses. They can be classified in four types (Bailey/Proctor classification) according to their location. Type II is the most common, and related to vital neck structures such as the carotid artery and jugular vein. Cysts are the most frequent among them. Management consists of surgical excision of the cyst and tract by cervicotomy to avoid recurrence. We present an extremely rare case of a 32-year-old male who presented a sudden appearance of a right lateral neck mass that was identified by an image study as a double branchial cleft cyst. A review of simultaneous branchial cleft cyst in the literature is also made.
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Branquioma/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Adulto , Humanos , MasculinoRESUMO
OBJECTIVE: To evaluate tolerance and efficiency of two nasal blocking systems for posterior refractory epistaxis. PATIENTS AND METHODS: A five year comparative and longitudinal prospective study was developed in patients with epistaxis who attended our Emergency Unit and who required posterior nasal packing. Two groups were considered: one group was treated with a bi-chamber pneumatic inflation system (n=105). In other one, posterior occlusion was carried out with gauze, accessing through the mouth and using nasal reinforcement (n=47). The tolerance was measured by means of an analogue scale of pain intensity during the placement and maintenance of the packing, as well as for the need of analgesia. The efficiency was evaluated by episodes of re-bleeding, need for other concomitant measures, blood transfusion and side effects. RESULTS: In patients with inflatable nasal packing its placement was significantly faster (36+/-19s vs. 228+/-102 s; p<0.001) and less painful (6.7+/-1.7 vs. 8.3+/-1.5; p<0.001), requiring less analgesia until its removal. Patients with pack of gauze showed a lower average incidence of re-bleeding (17% vs. 26 %; p<0.001), fewer cases of blood transfusion (15% vs. 18%; p<0.001) or of other procedures (4% vs. 11 %; p<0.001). The sanitary cost of the latter was also lower (1327+/-202 euro vs. 1648+/-318 euro; p<0.001) and it generated less short and long-term complications CONCLUSIONS: The classical posterior packing with gauze is less rapid and comfortable to adapt, but it ensures a higher success rate in the control of epistaxis, produces fewer local injuries and reduces sanitary costs in comparison with inflatable balloon packing.
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Tratamento de Emergência/métodos , Epistaxe/terapia , Técnicas Hemostáticas , Tampões Cirúrgicos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVE: To evaluate the characteristics of hearing loss (HL) in patients with rheumatoid arthritis (RA). MATERIAL AND METHOD: A comparative case-control study was performed with 194 patients and 107 healthy subjects. All of them were submitted to pure-tone audiometry and detection of inflammatory parameters and Western blot for anticochlear antibodies. RESULTS: HL was detected in 42.7 % of patients with RA (15.9 % in controls; P.001). This was sensorineural in 38.6 %. Three or more altered blood parameters appeared in 28.9 % of patients with RA (17.6 % in controls; P<.01). We observed positive Western blot in 12 % of patients with RA and HL and none among healthy controls. CONCLUSIONS: There is a predisposition to HL, mainly sensorineural, in RA. In view of this prevalence, audiologic reviews must be performed to try to determine if this disorder shows an immunomediated aspect so that a therapeutic alternative could modify the course of HL.