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1.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1535342

RESUMO

Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.


Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.

2.
Cir Cir ; 92(2): 174-180, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38782390

RESUMO

INTRODUCTION: Transversus abdominis plane (TAP) block is a widely used anesthetic technique of the abdominal wall, where ultrasound guidance is considered the gold standard. In this study, we aimed to compare the effectiveness of laparoscopic-assisted TAP (LTAP) block with ultrasound-assisted TAP (UTAP) block for post-operative pain, nausea, vomiting, duration of the block, and bowel function. MATERIALS AND METHODS: This study included 60 patients who were randomly assigned to two groups to undergo either the LTAP or UTAP block technique after laparoscopic cholecystectomy. The time taken for administering the block, post-operative nausea and vomiting, post-operative pain, respiratory rate, bowel movements, and analgesia requirements were reported. RESULTS: The time taken for the LTAP block was shorter (p < 0.001). Post-operative mean tramadol consumption, paracetamol consumption, and analgesic requirement were comparable between the two groups (p = 0.76, p = 0.513, and p = 0.26, respectively). The visual analog scale at 6, 24, and 48 h was statistically not significant (p = 0.632, p = 0.802, and p = 0.173, respectively). Nausea with vomiting and the necessity of an antiemetic medication was lower in the UTAP group (p = 0.004 and p = 0.009, respectively). CONCLUSION: The LTAP block is an easy and fast technique to perform in patients as an alternative method where ultrasound guidance or an anesthesiologist is not available.


ANTECEDENTES: El bloqueo del plano transverso del abdomen (TAP) es una técnica anestésica de la pared abdominal ampliamente utilizada, en la cual la guía ecográfica se considera el método de referencia. OBJETIVO: Comparar la efectividad del bloqueo TAP asistido por laparoscopia (LTAP) con el bloqueo TAP asistido por ultrasonido (UTAP) para el dolor posoperatorio, las náuseas y los vómitos, y la función intestinal. MÉTODO: El estudio incluyó 60 pacientes que fueron asignados aleatoriamente a dos grupos para someterse a la técnica de bloqueo LTAP o UTAP después de una colecistectomía laparoscópica. Se informaron el tiempo de administración del bloqueo, las náuseas y los vómitos posoperatorios, el dolor posoperatorio, la frecuencia respiratoria, las evacuaciones y los requerimientos de analgesia. RESULTADOS: El tiempo de bloqueo LTAP fue menor (p < 0.001). El consumo medio de tramadol, el consumo de paracetamol y el requerimiento de analgésicos posoperatorios fueron comparables entre los dos grupos (p = 0.76, p = 0.513 y p = 0.26, respectivamente). El dolor en la escala analógica visual a las 6, 24 y 48 horas no fue estadísticamente significativo (p = 0.632, p = 0.802 y p = 0.173, respectivamente). CONCLUSIONES: El bloqueo PATL es una técnica fácil y rápida de realizar en pacientes como método alternativo cuando no se dispone de guía ecográfica o anestesióloga.


Assuntos
Colecistectomia Laparoscópica , Bloqueio Nervoso , Dor Pós-Operatória , Náusea e Vômito Pós-Operatórios , Ultrassonografia de Intervenção , Humanos , Colecistectomia Laparoscópica/métodos , Feminino , Masculino , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Pessoa de Meia-Idade , Ultrassonografia de Intervenção/métodos , Bloqueio Nervoso/métodos , Adulto , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Náusea e Vômito Pós-Operatórios/etiologia , Músculos Abdominais/inervação , Músculos Abdominais/diagnóstico por imagem , Estudos Prospectivos
3.
Cir Cir ; 92(2): 219-227, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38782393

RESUMO

BACKGROUND: Acute appendicitis remains as a differential diagnosis in older patients with abdominal pain. The Alvarado scale may assist to guide the diagnosis and treatment of this entity. The operative characteristics of the scale are little known in this population. METHOD: We conducted a systematic review of original studies published between 1986 and 2022 evaluating the diagnostic performance of the Alvarado scale in older adults with suspected acute appendicitis. The review was conducted according to the PRISMA statement. The evaluation of the methodological quality of the studies was performed according to the ROBINS-I criteria. RESULTS: Four original studies of retrospective design including 480 patients were identified. The heterogeneity and poor methodological quality limited an aggregate statistical analysis (meta-analysis). The value of the ROC curve of the scale varies between 0.799 and 0.969. From the available studies, the value of the ROC curve is lower in comparison to the RIPASA scale and comparable to the Lintula scale. CONCLUSIONS: The evidence on the diagnostic performance of the Alvarado scale in older adults is limited. The poor methodological quality of the available studies calls for a prudent use of this tool in this population. Our findings offer opportunities for future research.


ANTECEDENTES: La apendicitis aguda es un diagnóstico diferencial en el adulto mayor con dolor abdominal. La escala de Alvarado se utiliza para orientar el diagnóstico y el tratamiento. Las características operativas de la escala son poco conocidas en este grupo de pacientes. MÉTODO: Revisión sistemática de estudios originales publicados entre 1986 y 2022 que evaluaron el rendimiento diagnóstico de la escala de Alvarado en adultos mayores con sospecha de apendicitis aguda, con base en la declaración PRISMA. La evaluación de la calidad metodológica de los estudios se realizó con los criterios ROBINS-I. RESULTADOS: Se identificaron cuatro estudios originales de diseño retrospectivo que incluyen 480 pacientes. La heterogeneidad y la baja calidad metodológica limitaron un análisis estadístico agregado (metaanálisis). El valor de la curva ROC de la escala varía entre 0.799 y 0.969. En los estudios disponibles, el valor de la curva ROC es inferior al de la escala RIPASA y similar al de la escala de Lintula. CONCLUSIONES: La evidencia que sustenta el rendimiento diagnóstico de la escala de Alvarado en los adultos mayores es limitada. La pobre calidad de los estudios disponibles advierte sobre el uso prudente de esta herramienta en este grupo poblacional. Los hallazgos identificados ofrecen oportunidades de investigación futura.


Assuntos
Dor Abdominal , Apendicite , Apendicite/diagnóstico , Humanos , Idoso , Dor Abdominal/etiologia , Doença Aguda , Curva ROC , Diagnóstico Diferencial , Estudos Retrospectivos , Idoso de 80 Anos ou mais
4.
Gac Sanit ; 38: 102395, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38781777

RESUMO

OBJECTIVE: To construct and validate a questionnaire about the attitude of university students toward health promotion. METHOD: A cross-sectional study. A questionnaire of 14 questions was designed and administered to 1486 first-year undergraduates. The principal axes factoring method with oblique rotation was applied and a confirmatory factor analysis was carried out. Reliability was calculated through internal consistency with Cronbach's alpha and item-total correlation for the global scale and its subscales. RESULTS: A 14-item scale was constructed, with two dimensions. Its Cronbach's alpha was 0.872, and 0.852, and 0.718 for its subscales. The adjustment values of the confirmatory factor analysis were adequate. CONCLUSIONS: The attitude towards health promotion scale has shown to have adequate psychometric properties. It is an instrument that will help to detect referents and health assets for future interventions.

5.
Artigo em Inglês | MEDLINE | ID: mdl-38657706

RESUMO

OBJECTIVE: The study aimed to reveal the approaches to coping with stress of women with breast cancer and the factors predicting these approaches, to determine the prevalence and characteristics of Complementary and Alternative Medicine (CAM), and to examine the relationship between use of CAM and approaches to coping with stress. METHODS: A descriptive and cross-sectional study was conducted among 328 women with breast cancer at a training and research hospital in Türkiye. Data were collected with the "Descriptive Information Form" and the "Stress Coping Styles Scale (SCSS)". RESULTS: Women's SCSS score was 47.26±6.39 (effective) and 37.76±6.33 (ineffective). The SCSS score were not significantly different between CAM users and non-CAM users (p>0.05). The prevalence of CAM use was 36%, the most common types of CAM were herbal products (55.1%) and prayer (33.8%) and the reasons for using CAM were for relaxation (symptomatic) (43.2%). As a result of multivariate logistic regression analysis, level of income, working, number of living children, receiving chemotherapy, receiving surgery, having a family history of cancer, and the interest of their partner after the disease were associated with effective coping with stress (p<0.05, adjusted R2=0.08, 0.05, and 0.33 respectively). Working, receiving chemotherapy, receiving surgery, stage of cancer, and having a history of cancer in a social environment were associated with ineffective coping with stress (p<0.05, adjusted R2=0.14 and 0.11 respectively). CONCLUSIONS: One-third of women were using CAM and had a good level of approaches to coping with stress. Healthcare providers, especially gynecology-oncology nurses, should provide counseling on CAMs and develop strategies for coping with stress for women with breast cancer.

6.
Emergencias ; 36(2): 116-122, 2024 Apr.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-38597618

RESUMO

OBJECTIVES: To identify predictors for developing delayed neurological syndrome (DNS) after an initial episode of carbon monoxide (CO) poisoning in the interest of detecting patients most likely to develop DNS so that they can be followed. MATERIAL AND METHODS: Retrospective review of cases of CO poisoning treated in the past 10 years in the emergency departments of 4 hospitals in the AMICO study (Spanish acronym for the multicenter analysis of CO poisoning). We analyzed demographic characteristics of the patients and the clinical characteristics of the initial episode. The records of the cohort of patients with available follow-up information were reviewed to find cases of DNS. Data were analyzed by multivariant analysis to determine the relationship to characteristics of the initial exposure to CO. RESULTS: A total of 240 cases were identified. The median (interquartile range) age of the patients was 36.2 years (17.6-49.6 years); 108 patients (45.0%) were men, and the poisoning was accidental in 223 cases (92.9%). The median carboxyhemoglobin concentration on presentation was 12.7% (6.2%-18.7%). Follow-up details were available for 44 patients (18.3%). Eleven of those patients (25%) developed DNS. A low initial Glasgow Coma Scale score predicted the development of DNS with an odds ratio (OR) of 0.61 (95% CI, 0.41-0.92) and an area under the receiver operating characteristic curve of 0.876 (95% CI, 0.761-0.990) (P .001). CONCLUSION: The initial Glasgow Coma Scale score seems to be a clinical predictor of DNS after CO poisoning. We consider it important to establish follow-up protocols for patients with CO poisoning treated in hospital EDs.


OBJETIVO: Identificar factores pronósticos de desarrollo de síndrome neurológico tardío (SNT) después de un episodio inicial de intoxicación por monóxido de carbono (ICO), con el fin detectar precozmente a la población más susceptible y facilitar su acceso a un seguimiento específico. METODO: Revisión retrospectiva de todos los casos de ICO que acudieron a los servicios de urgencias (SU) de 4 hospitales durante los últimos 10 años. Se analizaron datos demográficos y características clínicas en el momento del episodio. En la cohorte de pacientes con datos de seguimiento disponibles, se evaluó la aparición de SNT y su relación con diferentes variables en la exposición inicial al CO a través de técnicas de análisis multivariante. RESULTADOS: Se identificaron 240 pacientes. La mediana de edad fue de 36,2 años (17,6-49,6). De ellos 108 (45,0%) eran hombres y 223 casos (92,9%) fueron accidentales. El nivel medio de COHb fue del 12,7% (6,2-18,7). En 44 (18,3%) episodios se disponía de datos de un seguimiento específico. En esta cohorte, 11 (25%) pacientes desarrollaron SNT. Una puntuación inicial más baja en la Escala Coma de Glasgow (GCS) (OR: 0,61, IC 95%: 0,41-0,92) fue predictor independiente del desarrollo del SNT, con un ABC en la curva COR de 0,876 (IC 95%: 0,761-0,990, p 0,001). CONCLUSIONES: Una puntuación inicial baja en la GCS parece ser un predictor clínico de desarrollo de SNT en la ICO. Dada la incidencia de SNT, consideramos fundamental establecer protocolos de seguimiento específico de estos pacientes tras su asistencia inicial en los SU.


Assuntos
Intoxicação por Monóxido de Carbono , Oxigenoterapia Hiperbárica , Adulto , Feminino , Humanos , Masculino , Intoxicação por Monóxido de Carbono/complicações , Intoxicação por Monóxido de Carbono/diagnóstico , Intoxicação por Monóxido de Carbono/terapia , Oxigenoterapia Hiperbárica/métodos , Estudos Retrospectivos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade
7.
Actas Dermosifiliogr ; 2024 Feb 19.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38382749

RESUMO

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

8.
Bragança; s.n; 20240000. il., tab..
Tese em Português | BDENF - Enfermagem | ID: biblio-1527170

RESUMO

Os enfermeiros são um grupo profissional particularmente suscetível de experienciar com o stresse, pela natureza das suas funções. A exposição permanente ao contacto humano com doentes e familiares, a gestão de situações de emergência, em que um pequeno erro pode comprometer a sobrevivência ou o prognóstico do doente, a interação com outros profissionais de saúde, o trabalho por turnos e a disrupção de ritmos circadianos, a morte de doentes, de entre outros fatores, criam uma conjuntura em que o enfermeiro experiencie níveis elevados de stresse no seu dia-a-dia. Objetivos: Caracterizar o perfil sociodemográfico e profissional dos enfermeiros do Serviço de Urgência de um Centro Hospitalar da região norte de Portugal; Identificar os principais fatores indutores de stresse nos enfermeiros do Serviço de Urgência de um Centro Hospitalar da região norte de Portugal; Avaliar a relação entre os fatores indutores de stresse e as variáveis sociodemográficas e profissionais. Métodos: Foi realizado um estudo descritivo, transversal correlacional, avaliando os níveis de stresse numa amostra de 54 enfermeiros de um serviço de urgência de um hospital da região do norte de Portugal através da aplicação da Escala de Stresse Profissional dos Enfermeiros e de um questionário para fazer o levantamento de aspetos sociodemográficos e profissionais. Resultados: Os participantes no estudo (n=54) eram maioritariamente do sexo feminino (68,5%). A classe etária dominante (63%) foi a dos 31-40 anos. O estado civil dos enfermeiros dividiu-se quase equitativamente entre os que estão sozinhos e aqueles casados ou união de facto. Quarenta enfermeiros (74,1%) eram licenciados, e os restantes 25,9% mestres. Trinta e três eram enfermeiros (61.1%), os restantes eram especialistas (38,9%). O tempo de serviço mais frequente (46,3%) foi 11 a 20 anos, e 2 a 10 anos no Serviço de Urgência. O contrato sem termo foi a modalidade de vínculo mais frequente (74,1%). Só 35,2% dos enfermeiros indicou acumular funções noutra instituição. O valor médio observado para o conjunto de profissionais que constituíram a amostra foi de 80,94±11,95. Considerando que o ponto médio da escala é de 85 pontos, pode considerar-se que os enfermeiros do SU apresentam, em média, níveis medianos de stresse. Das várias componentes da escala, a "carga de trabalho" integrada na componente "ambiente físico" foi um domínio onde foram registados níveis de stresse elevados. Na componente de "ambiente psicológico" a morte do doente e a incerteza quanto aos tratamentos representaram maior stresse para os enfermeiros. No "ambiente social" a relação com os médicos mostrou-se como um fator importante na perceção de stresse pelos enfermeiros. Atendendo aos resultados da relação das variáveis sociodemográficas na perceção do stresse percecionado pelos enfermeiros, avaliado com a ESPE, os enfermeiros do sexo masculino e aqueles que têm a habilitação de mestre apontam para níveis mais elevados de perceção de stresse. Também ao nível do estado civil verifica-se que os enfermeiros casados percecionarem níveis mais elevados de stresse. Pelo contrário, a idade dos enfermeiros, avaliada em classes de 10 anos, não evidenciou ter influência na perceção de stresse. Não se observou uma relação entre as variáveis profissionais e a perceção do stresse pelos enfermeiros, avaliado pela pontuação total da ESPE. Há, porém, diferenças pontuais em fatores da escala que apontam para os enfermeiros que trabalham há pouco tempo no SU e aqueles que aí trabalham entre 11 e 20 anos percecionarem mais stresse associado ao conflito com outros profissionais, assim como uma tendência para os profissionais com contrato a termo certo sentirem percecionarem mais stresse Conclusão: O enfermeiro que trabalha num serviço de urgência está sujeito a inúmeros stressores. Há aspetos técnicos, relacionais e emocionais que potencial o agravamento do stresse nos enfermeiros. Tratando-se de um serviço que lida permanentemente com a vida ou morte do doente, particularmente na área do doente crítico, o stresse do enfermeiro deve ser olhado com atenção, pois as implicações cognitivas do stresse crónico podem fazer o profissional ter uma prestação de menor qualidade. Particularmente na área dedicada a doentes críticos, todas as capacidades cognitivas do enfermeiro são valiosas, pelo que é determinante que se consiga criar um ambiente de reduzido stresse para que os cuidados prestados sejam de elevada qualidade, como se espera e exige que aconteça.


Nurses are a professional group particularly susceptible to experiencing stress due to the nature of their work. The constant exposure to human contact with patients and their families, the management of emergency situations where a small error can compromise the patient's survival or prognosis, interaction with other healthcare professionals, shift work and disruption of circadian rhythms, and the death of patients, among other factors, create a situation in which nurses experience high levels of stress in their daily lives. Objectives: Characterize the sociodemographic and professional profile of nurses in the Emergency Service of a Hospital Center in the north of Portugal; Identify the main factors that induce stress in nurses in the Emergency Department of a Hospital Center in the north of Portugal; Assess the relationship between stress-inducing factors and sociodemographic and professional variables. Methods: A descriptive, cross-sectional correlational study was conducted, evaluating stress levels in a sample of 54 nurses from an emergency department in a hospital in the northern region of Portugal. This was done through the application of the Nurses' Professional Stress Scale and a questionnaire to collect sociodemographic and professional information. Results: The study participants (n=54) were predominantly female (68.5%). The dominant age group (63%) was between 31 and 40 years old. The marital status of the nurses was almost equally divided between those who are single and those who are married or in a domestic partnership. Forty nurses (74.1%) had a bachelor's degree, and the remaining 25.9% had a master's degree. Thirty-three were general nurses (61.1%), while the remaining were specialists (38.9%). The most frequent length of service was 11 to 20 years (46.3%), both overall and in the Emergency Department. Permanent contracts were the most common employment type (74.1%). Only 35.2% of nurses indicated that they held additional positions in another institution. The average observed value for the professionals in the sample was 80.94±11.95. Considering that the midpoint of the scale is 85 points, it can be considered that nurses in the Emergency Department have, on average, moderate to high levels of stress. Among the various components of the scale, "workload" within the "physical environment" domain was an area where high levels of stress were reported. In the "psychological environment" component, the death of patients and uncertainty about treatments were identified as major sources of stress for nurses. In the "social environment," the relationship with doctors was found to be an important factor in nurses' perception of stress. Regarding the relationship between sociodemographic variables and the perceived stress reported by nurses, as evaluated by the Nurses' Professional Stress Scale, male nurses and those with a master's degree reported higher levels of perceived stress. Additionally, married nurses indicated higher levels of stress. On the other hand, the age of nurses, assessed in 10-year intervals, did not show any influence on the perception of stress. There was no significant relationship between professional variables and nurses' perception of stress, as measured by the total score of the Nurses' Professional Stress Scale. However, there were some isolated differences in scale factors indicating that nurses who had recently started working in the Emergency Department and those who had been working there for 11 to 20 years perceived more stress related to conflicts with other professionals. There was also a tendency for professionals with fixed-term contracts to report higher levels of perceived stress. Conclusion: Nurses working in an emergency department are exposed to numerous stressors. Technical, relational, and emotional aspects contribute to the exacerbation of stress in nurses. Considering that this department deals constantly with life or death situations, particularly in critical care, nurses' stress should be closely monitored, as the cognitive implications of chronic stress can impair their performance. In the field dedicated to critical patients, all cognitive abilities of the nurse are valuable, so it is crucial to create a low-stress environment to ensure the provision of high-quality care, as expected and demanded.


Assuntos
Humanos , Feminino , Adulto , Angústia Psicológica , Enfermeiros
9.
Gastroenterol Hepatol ; 47(2): 130-139, 2024 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36870478

RESUMO

AIMS: Patients' perception of their cleansing quality can guide strategies to improve cleansing during colonoscopy. There are no studies assessing the agreement between the quality of cleansing perceived by patients and cleansing quality assessed during colonoscopy using validated bowel preparation scales. The main aim of this study was to compare the cleansing quality reported by patients with the quality during colonoscopy using the Boston Bowel Preparation Scale (BBPS). PATIENTS AND METHODS: Consecutive patients referred to an outpatient colonoscopy were included. Four drawings representing different degrees of cleansing were designed. Patients chose the drawing that most resembled the last stool. The predictive ability of the patient's perception and agreement between the patient's perception and the BBPS were calculated. A BBPS score of <2 points in any segment was considered inadequate. RESULTS: Six hundred and thirty-three patients were included (age: 62.8±13.7 years, male: 53.4%). Overall, 107 patients (16.9%) had inadequate cleansing during colonoscopy, and in 12.2% of cases, the patient's perception was poor. The patient's perception compared to the quality of cleanliness during colonoscopy presented a positive and negative predictive value of 54.6% and 88.3%, respectively. The agreement between patient perception and the BBPS was significant (P<0.001), although fair (k=0.37). The results were similar in a validation cohort of 378 patients (k=0.41). CONCLUSIONS: The cleanliness perceived by the patient and the quality of cleanliness using a validated scale were correlated, although fair. However, this measure satisfactorily identified patients with adequate preparation. Cleansing rescue strategies may target patients who self-report improper cleaning. Registration number of the trial: NCT03830489.


Assuntos
Catárticos , Colonoscopia , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Colonoscopia/métodos , Valor Preditivo dos Testes , Colo , Percepção , Polietilenoglicóis
10.
Rev Esp Cir Ortop Traumatol ; 68(2): T108-T120, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37992860

RESUMO

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4 months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2 years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative haemoglobin decrease of 3.08±1.08g/dl, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4 months). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

11.
Artigo em Inglês | MEDLINE | ID: mdl-37295495

RESUMO

INTRODUCTION: Multiple scales have been designed to stratify the severity and predict the prognosis in the initial evaluation of patients with aneurysmal subarachnoid hemorrhage (aSAH). Our study aimed to validate the most commonly used prognostic scales for aSAH in our population: Hunt-Hess, modified Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), Prognosis on Admission of Aneurysmal Subarachnoid Hemorrhage (PAASH), and Barrow Aneurysm Institute (BAI) scales. METHODS: This study includes all aSAH cases treated at our institution between June 2019 and December 2020. We developed a retrospective cohort by reviewing medical records and radiologic images performed during hospitalization. The outcome was evaluated using the modified Rankin scale (mRS). It was defined as a poor outcome (mRS 4-5) and mortality (mRS 6). The ROC curves and the area under the curve (AUC) of each of the prognostic scales were calculated to evaluate their prognostic prediction capacity. RESULTS: A total of 142 patients were diagnosed with aSAH. A poor outcome occurred in 52.1% of the patients, whereas mortality was 27.5%. The AUC of the scales studied was similar and no significant difference was found between them for predicting a poor outcome (P = .709) or mortality (P = .715). CONCLUSION: We determined that the prognostic scales for aSAH had a similar predictive value for poor clinical outcomes and mortality in our institution, with no significant difference. Thus, we recommend the most simple and well-known scale used institutionally.


Assuntos
Hemorragia Subaracnóidea , Humanos , Prognóstico , Hemorragia Subaracnóidea/diagnóstico por imagem , Resultado do Tratamento , Estudos Retrospectivos , Peru
12.
Rev Esp Cir Ortop Traumatol ; 68(2): 108-120, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37245634

RESUMO

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4month). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

13.
Conserv Biol ; 38(2): e14192, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37768193

RESUMO

The Kunming-Montreal Global Biodiversity Framework was adopted by parties to the Convention on Biological Diversity in December 2022. The aftermath of these negotiations provides an opportunity to draw lessons as to how ecological and evolutionary science can more effectively inform policy. We examined key challenges that limit effective engagement by scientists in the biodiversity policy process, drawing parallels with analogous challenges within global climate negotiations. Biodiversity is multifaceted, yet represents only one framing for nature's contributions to people, complicating the nexus between evidence and values in development of the framework's targets. Processes generating biodiversity and driving its loss are multiscalar, challenging development of an evidence base for globally standardized targets. We illustrated these challenges by contrasting development of 2 key elements of the framework. The genetic diversity element of the framework's target 4 is directly related to the framework's primary goals, but its complexity required development of novel engagement skills. The target for protected areas was easily communicated but more indirectly related to biodiversity outcomes; evidence from ecological and social science was essential to communicating the context and limitations of this relationship. Scientists can strengthen the effectiveness of global agreements and address challenges arising from complexity, scaling, capacity limitations, and the interplay of science and values, if they can prioritize communication, consensus-building, and networking skills and engage throughout the process, from development of an evidence base to implementation.


Lecciones de la COP15 sobre la participación científica efectiva en los procesos políticos de biodiversidad Resumen El Marco Global de la Biodiversidad de Kunming­Montreal lo adoptaron los participantes de la Convención sobre la Diversidad Biológica en diciembre 2022. Las consecuencias de estas negociaciones proporcionan una oportunidad para tomar lecciones de cómo la ciencia evolutiva y ecológica puede orientar de mejor manera a las políticas. Examinamos los retos clave que limitan la participación efectiva de los científicos en el proceso de políticas de la biodiversidad, estableciendo paralelismos con los retos análogos en las negociaciones climáticas mundiales. La biodiversidad es multifacética y aun así representa sólo un marco para las contribuciones que tiene la naturaleza para las personas, lo que complica el nexo entre la evidencia y los valores en el desarrollo de los objetivos del marco. Los procesos que generan la biodiversidad y causan su pérdida son multiescalares, lo que representa un reto para el desarrollo de una base de evidencias para tener objetivos mundiales estandarizados. Ilustramos estos retos con el contraste del desarrollo de dos elementos clave del marco. El elemento de la diversidad genética en el objetivo 4 del marco está relacionado directamente con los objetivos principales del marco, pero su complejidad requiere el desarrollo de habilidades novedosas de participación. El objetivo para las áreas protegidas se comunicó con facilidad, pero estuvo relacionado de forma más indirecta con los resultados de biodiversidad; la evidencia de las ciencias sociales y ecológicas fue esencial para comunicar el contexto y las limitaciones de esta relación. Los científicos pueden fortalecer la efectividad de los acuerdos globales y abordar los retos que surgen de la complejidad, el escalamiento, las limitaciones en la capacidad y la interacción de la ciencia y los valores, si pueden priorizar la comunicación, la llegada a consensos y el conocimiento de redes y participan durante el proceso, a partir del desarrollo de una evidencia base hasta la implementación.


Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Humanos , Políticas , Comunicação , Evolução Biológica , Ecossistema
14.
Conserv Biol ; 38(1): e14160, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37551779

RESUMO

The establishment of protected areas is a cornerstone of conservation, but permanent protection could be inefficient or even impossible in some situations. We synthesized the literature on temporarily conserved areas (TCAs) across Canada, the United States, and Mexico. We used a comprehensive search string to retrieve peer-reviewed articles published from 2000 to 2021 from the Web of Science. We identified 27 relevant peer-reviewed articles that examined the potential benefits of TCAs in the study area, indicating TCA is a relatively understudied area of research in the peer-reviewed literature. The TCA studies were highly clustered; 77% of studies focused on protecting a single life stage of migratory species and 61% of studies related to temporary conservation of breeding or staging habitats for migratory birds. Ninety-three percent of studies focused on preventing human-driven threats, mainly on public lands of coastal areas, the Great Plains, and the Mississippi Valley in the central United States. Short-term and experimental studies were the dominant study types. TCAs have the potential to complement permanently protected areas and provide protection when permanent protection is difficult. Some included studies examined their conservation value, but the ecological, social, and economic outcomes of TCAs are unclear. More TCA research is needed to determine the role they could play in conservation worldwide. Embracing the concept of TCAs as conservation tool could lead to more comprehensive and consistent reporting of the outcomes of temporary area-based conservation measures. However, a global review and analysis of effectiveness of TCAs will be required if they are to play a formal role in meeting international targets for biodiversity conservation.


Revisión de áreas terrestres conservadas temporalmente en Canadá, Estados Unidos y México Resumen La creación de áreas protegidas es una piedra angular de la conservación, aunque en algunos casos la protección permanente podría ser ineficiente o incluso imposible. Condensamos la literatura sobre las áreas de conservación temporal (ACT) en Canadá, Estados Unidos y México. Usamos una cadena completa de búsqueda para obtener artículos revisados por pares publicados del 2000 al 2021 en Web of Science. Identificamos 27 artículos relevantes que analizaban el potencial de las ACT en el área de estudio, lo que indica que las ACT es un área poco estudiada en la literatura revisada por pares. Los estudios sobre ACT estaban muy agrupados: el 77% se enfocaban en la protección de un solo estadio de vida de las especies migratorias y el 61% se relacionaban con la conservación temporal de los hábitats de reproducción o de descanso de las aves migratorias. El 93% de los estudios se enfocó en la prevención de amenazas causadas por humanos, principalmente en los terrenos públicos de las áreas costeras, las Grandes Llanuras y el valle del Mississippi en el centro de los Estados Unidos. Los estudios experimentales y a corto plazo fueron el tipo de estudio dominante. Las áreas de conservación temporal tienen el potencial para complementar las áreas de protección permanente y proporcionar protección cuando es complicado proporcionarla permanentemente. Algunos de los estudios incluidos analizaron el valor para la conservación de las ACT, pero aún no están claros sus resultados ecológicos, sociales y económicos. Se necesita más investigación sobre las ACT para determinar el papel que podrían tener en la conservación mundial. Si se acepta el concepto de ACT como una herramienta de conservación, se podrían reportar los resultados de las medidas de conservación basadas en las ACT de forma más completa y consistente. Sin embargo, se requerirá una revisión y análisis global de la eficiencia de las ACT si se espera que tengan un papel formal en el cumplimiento de los objetivos internacionales de la conservación de la biodiversidad.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Estados Unidos , Humanos , México , Biodiversidade , Canadá
15.
Actas Urol Esp (Engl Ed) ; 48(2): 162-169, 2024 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37832847

RESUMO

OBJECTIVE: To analyze the level of agreement of the Post-Ureteroscopy Lesion Scale (PULS) and the consequences on its application in clinical practice with more reliable statistical data than the one used in the original work. METHODS: 14 URS and 14 micro-URS were performed in 14 female porcine model. All the procedures were video recorded and an anatomopathological analysis was performed in each ureter. Sixteen urologists (9 endourologists and 7 general urologists) and 4 residents evaluated the ureteral lesions according to the PULS, with degrees 0, 1 and ≥2. The agreement was calculated with percentages, Kendall's W coefficient and the indicators Fleiss' Kappa and Krippendorff's Alpha, while the inter-rater agreement was calculated with Spearman's correlation and Cohen's Kappa. RESULTS: The percent of agreement was 11.1%. The coefficients were likewise classified as low or very low, with the greatest agreement found among the inexperienced. Also, 50% of the raters did not agree with the rest. CONCLUSIONS: The low inter-rater agreement, the specificity of the PULS and the clinical-pathological correlation suggests that this scale is not simple, and probably has a long learning curve.


Assuntos
Ureter , Feminino , Suínos , Animais , Ureteroscopia/métodos , Reprodutibilidade dos Testes
16.
Nutr Hosp ; 41(1): 152-162, 2024 Feb 15.
Artigo em Espanhol | MEDLINE | ID: mdl-38047428

RESUMO

Introduction: Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essential to confirm health-related habits and orientate behaviors of risk for health. Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age. Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72. This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained a variance of 8.67 % of the total scale (66.87 %) and a Cronbach's alpha of 0.794 for a total alpha of 0.894. Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson's 2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferential data (Student's t-tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that have an unhealthy level of nutrition in their lifestyle.


Introducción: Introducción: los hábitos de alimentación constituyen uno de los factores predictores de salud principales dentro de los estilos de vida adquiridos. La evaluación de dichos hábitos va a ser fundamental para poder reafirmar las conductas saludables y reorientar aquellos hábitos que supongan un riesgo. Objetivos: evaluar el hábito de alimentación dentro del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad. Métodos: a una muestra de 788 sujetos de edades comprendidas entre los 22 y los 72 años de edad se aplicó la Escala de Valoración del Estilo de Vida Saludable Adquirido (E-VEVSA), formada por 52 ítems y estructurada en siete dimensiones, entre las cuales se evaluó el hábito de alimentación saludable, que explicó una varianza de 8,67 % sobre el total de la escala (66,87 %) y un alfa de Cronbach de 0,794 para un alfa total de 0,894. Resultados: el 16 % de los adultos encuestados posee hábitos de alimentación saludables; el 68,3 %, tendente hacia la salud; y el 15,7 %, poco saludables. Las pruebas de 2 de Pearson muestran una asociación positiva y significativa de las mujeres con hábitos saludables de alimentación y una mejora significativa con el transcurso de la edad. Los datos inferenciales (pruebas t de Student y ANOVA de un factor) confirman estas diferencias en función del sexo y la edad. Conclusiones: es necesario promover programas preventivos para la mejora de los hábitos de alimentación en la población adulta, sobre todo, en el 15,7 % que posee un nivel poco saludable de la alimentación en su estilo de vida.


Assuntos
Nível de Saúde , Estilo de Vida , Adulto , Humanos , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Dieta Saudável , Comportamento Alimentar , Hábitos
17.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 42: e2023089, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1529500

RESUMO

ABSTRACT Objective: To evaluate the focus of pediatricians' gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians' pain perception: absent/mild (score: 0-5) and moderate/intense (score: 6-10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5-8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face.


RESUMO Objetivo: Avaliar o foco do olhar do pediatra durante a punção do calcanhar de neonatos. Métodos: Estudo prospectivo no qual pediatras, utilizando óculos de rastreamento visual, avaliaram a dor neonatal antes/depois de uma punção de calcanhar. Os pediatras pontuaram a dor de acordo com a sua percepção por meio de uma escala analógica verbal (0=sem dor; 10=dor máxima). Os desfechos analisados foram o número e o tempo das fixações visuais na face superior, face inferior e mãos, em dois períodos de 10 segundos, antes (PRÉ) e depois da punção (PÓS). Os resultados foram comparados entre os períodos e segundo a percepção da dor do pediatra: ausente/leve (escore: 0-5) e moderada/grave (escore: 6-10). Resultados: Vinte e quatro pediatras (31 anos, 92% sexo feminino) avaliaram 24 neonatos. A mediana do escore atribuído à dor do recém-nascido durante a punção do calcanhar foi 7,0 (intervalo interquartil: 5-8). Comparado ao período PRÉ, no período PÓS, o maior número de pediatras fixou o olhar na face inferior (63 vs. 92%; p=0,036) e o número de fixações visuais foi maior na face inferior (2,0 vs. 5,0; p=0,018). Não houve diferença no número e no tempo das fixações visuais de acordo com a intensidade da dor. Conclusões: À beira do leito, os pediatras mudam seu foco de atenção visual na face do recém-nascido após um procedimento doloroso, focando o olhar principalmente na parte inferior da face.

18.
Arq. bras. oftalmol ; 87(4): e2021, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1520236

RESUMO

ABSTRACT Purpose: Stargardt-like phenotype has been described as associated with pathogenic variants besides the ABCA4 gene. This study aimed to describe four cases with retinal appearance of Stargardt disease phenotypes and unexpected molecular findings. Methods: This report reviewed medical records of four patients with macular dystrophy and clinical features of Stargardt disease. Ophthalmic examination, fundus imaging, and next-generation sequencing were performed to evaluate pathogenic variants related to the phenotypes. Results: Patients presented macular atrophy and pigmentary changes suggesting Stargardt disease. The phenotypes of the two patients were associated with autosomal dominant inheritance pattern genes (RIMS1 and CRX) and in the other two patients were associated with recessive dominant inheritance pattern genes (CRB1 and RDH12) with variants predicted to be pathogenic. Conclusion: Macular dystrophies may have phenotypic similarities to Stargardt-like phenotype associated with other genes besides the classic ones.


RESUMO Objetivo: Fenótipos Stargardt-like já foram asso-ciados a variantes patogênicas no gene ABCA4. O propósito desse estudo é descrever quatro pacientes com achados retinianos semelhantes a doença de Stargardt com resultados moleculares diferentes do esperado. Métodos: Esse relato fez a revisão de prontuários médicos de quatro pacientes com distrofia macular e achados clínicos sugestivos de doença de Stargardt. Foram realizados avaliação oftalmológica, exames de imagens e testes usando next generation sequencing para avaliar variantes patogênicas associadas aos fenótipos dos pacientes. Resultados: Os pacientes apresentavam atrofia macular e alterações pigmentares sugerindo achados clínicos de doença de Stargardt. Dois pacientes foram associados a genes com herança autossômica dominante (RIMS1 e CRX) e dois pacientes foram associados a genes com herança autossômica recessiva (CRB1 e RDH12) com variantes preditoras de serem patogênicas. Conclusão: Distrofias maculares podem ter similaridades fenotípicas com fenótipo de Stargardt-like associados a outros genes além dos classicamente já descritos.

19.
Dental press j. orthod. (Impr.) ; 29(1): e2423133, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1550224

RESUMO

ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.


RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.

20.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1551009

RESUMO

Se describen, en la literatura médica, predictores radiográficos que constituyen herramientas diagnósticas útiles para la retención de los caninos maxilares. Sin embargo, en la especialidad de ortodoncia las investigaciones sobre las herramientas predictivas de riesgo son escasas. Por ello se decide realizar una revisión bibliográfica con el objetivo de recopilar información acerca de la utilidad de las herramientas predictivas de riesgo en el diagnóstico de la retención de los caninos maxilares. Se realizó una búsqueda de información de artículos en idioma español e inglés, utilizándose las bases de datos SciELO, PubMed, Cochrane y Scopus. Para lograr un tratamiento óptimo de la anomalía debe priorizarse un buen diagnóstico, basado en métodos clínicos y radiográficos, pero se hace notoria la ausencia de herramientas que identifiquen individuos con alto riesgo en la comunidad. Los modelos o escalas de riesgo pueden ser útiles en este aspecto, para detectar precozmente el trastorno eruptivo y priorizar así intervenciones preventivas, que eviten el uso excesivo de medios auxiliares de diagnóstico y la sobrecarga de los sistemas de salud. Las herramientas predictivas de riesgo constituyen una alternativa para la clasificación adecuada de la población con alto riesgo de retención de caninos maxilares. Un instrumento de tal magnitud es de gran utilidad tanto en los servicios de Estomatología General como en los de Ortodoncia.


Radiographic predictors that are useful diagnostic tools for the retention of maxillary canines are described in the literature. However, in the specialty of orthodontics, research on risk predictive tools is scarce. Therefore, it was decided to carry out a bibliographic review with the objective of collecting information about the usefulness of risk predictive tools in the diagnosis of retention of maxillary canines. A search for information on articles in Spanish and English was carried out, using the SciELO, PubMed, Cochrane and Scopus databases. To achieve optimal treatment of the anomaly, a good diagnosis should be prioritized, based on clinical and radiographic methods, but the absence of tools that identify individuals at high risk in the community is notorious. Models or risk scales can be useful in this aspect, to detect the eruptive disorder early and thus prioritize preventive interventions that avoid the excessive use of diagnostic aids and the overload of health systems. Predictive risk tools are an alternative for the adequate classification of the population with high risk of retention of maxillary canines. An instrument of this magnitude is very useful both in General Dentistry and Orthodontics services.

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