Anabolic androgenic steroid-induced hypogonadism, a reversible condition in male individuals? A systematic review.

The anabolic-androgenic steroids (AAS) are clinically used as an androgen replacement, in hypogonadism treatment, to induce puberty, and also in the treatment of chronic degenerative diseases. The AAS use out of clinical context is becoming massively, being used merely for aesthetic reasons. AAS abuse may cause severe disarrangement on the HPG axis and generate a significant decrease in testosterone synthesis and secretion by the testes. This review aims to evaluate whether the hypogonadism induced by AAS abuse is reversible and under what circumstances the reversibility is possible. For this, PRISMA guidelines and several databases are used between July and September 2020. Altogether, this systematic review identified and analysed 179 cases of AAS users. Of these, 168 cases had the hypogonadism clearly diagnosed and proven to be linked exclusively to AAS abuse. However, between these 168 cases, only 38 cases presented fully known outcomes and among these, merely in 4, the hypogonadism was completely reversible (2 based on drug therapy) with HPG axis recovery. In conclusion, this review presents evidences that AAS-induced hypogonadism is a seriously underestimated problem, and in the majority of cases, full recovery is very difficult to succeed.

Validation of an educational game to promote cardiovascular health in children.

OBJECTIVE: The aim of this study was to validate the content and appearance of an educational game for children aged 7 to 10 years, focusing mainly on cardiovascular health promotion. METHOD: The study used methodological research, with a quantitative approach. The validation process included the participation of 17 specialists in children and/or cardiovascular health. A concordance index of at least 0.80 was considered for content validation and 0.75 for the appearance of the proposed educational material. RESULTS: The proposal of the educational game was considered valid, through some suggestions, in view of the purpose of sensitizing children in relation to the promotion of cardiovascular health while still in childhood. FINAL CONSIDERATIONS: As a relevant factor in the use of games as strategies to improve health education, we emphasize that the participant is the active agent and the protagonist of the health-disease process.

Composition of kidney stone fragments obtained after extracorporeal shock wave lithotripsy.

BACKGROUND: The objective of this study was to determine the composition of kidney stone fragments obtained after extracorporeal shock wave lithotripsy (ESWL). METHODS: Kidney stone fragments from 25 patients with urolithiasis treated with ESWL were submitted for morphological analysis. The composition was determined for all the recovered fragments. RESULTS: Thirteen patients (52%) had pure stones. The most common type of pure stone was calcium oxalate (61.6%), of which half was the monohydrate type (COM) and half was the dihydrate type (COD). The other pure stones consisted of either uric acid (30.8%) or struvite (7.6%). For mixed stones, the most frequently observed component was COM or COD (50%), followed by a mixture of COD and carbapatite (25.1%). CONCLUSIONS: Our findings indicate that the composition of kidney stone fragments recovered after ESWL can be determined. Knowledge of stone composition is fundamental to understand the etiology of lithogenesis.

Determination of urinary stone composition based on stone morphology: a prospective study of 325 consecutive patients in an emerging country.

BACKGROUND: Urolithiasis is a common disease that is increasing throughout the world. This study aimed at determining the composition of urinary stones in patients with renal lithiasis in an emerging country. METHODS: A morphological analysis was performed on 340 urinary stones from 325 consecutive patients from Brazil with lithiasis. RESULTS AND CONCLUSIONS: Among the 340 stones analyzed, 34.7% were pure. The most frequent stone was calcium oxalate (CaOx) (59.3%), followed by uric acid (23.7%). CaOx was more frequently seen in women (p=0.024), while uric acid was more common in men (p<0.001). Among the mixed stones, CaOx (67.1%) was the most frequent major component, followed by carbapatite (11.2%) and struvite (7.9%). CaOx (p<0.001) and uric acid (p=0.014) were more frequently the major components in men, while carbapatite (p<0.001) and struvite (p=0.011) were more frequent in women. The major component of both pure and mixed stones was CaOx (65.1%), followed by uric acid (10.9%), carbapatite (10%), struvite (6.7%), ammonium urate (5.1%), cystine (1.8%) and protein (0.4%). These findings may be related to regional factors, such as weather and nutritional habits.

Perfil sociodemográfico familiar e clínico de crianças com cardiopatia congênitaatendidas em uma instituição hospitalar / Sociodemographic and clinical profile of children with congenital heart disease assisted at a hospital institution / Perfil sociodemográfico familiar y clínico de niños com cardiopatía congénita asistidos en una institución hospitalaria

Conhecer o perfil sociodemográfico familiar e clínico de crianças com cardiopatia congênita atendidas em uma instituição hospitalar. Métodos: Estudo descritivo, transversal, desenvolvido no ambulatório de cardiologia pediátrica de um hospital em Fortaleza-CE, durante o período de março a agosto de 2012. Contemplou uma amostra não aleatória por conveniência de 80 pais de crianças cardiopatas entre 5 e 12 anos. Obtiveram-se informações a partir de dados primários de prontuário e por questionários, abordando as características sociodemográficas dos pais, dados familiares e condições clínicas das crianças. Resultados: Quanto aos dados sociodemográficos dos pais, 77 (96,2%) dos acompanhantes eram do sexo feminino, 50 (62,5%) estavam casados ou em união estável, 39 (48,7%) tinham entre 10 e 12 anos de estudo, e 69 (82,6%) relataram renda familiar entre 1 e 2 salários mínimos. Na amostra de crianças estudada, 43 (53,8%) eram do sexo feminino. A mediana das idades das crianças foi de 8,4 anos, variando entre 5 e 13 anos. Quanto à idade do diagnóstico, 44 (55,0%) ocorreram em idade inferior a 6 meses, independentemente do tipo da cardiopatia. Detectou-se que 19 (23,75%) tinham parentesco com a cardiopatia. Conclusão: Os pais acompanhantes de crianças com cardiopatia eram predominantemente mães, de baixo nível econômico e com escolaridade satisfatória. Houve predominância do diagnóstico precoce, principalmente nas crianças com cardiopatia do tipo cianótica...

To characterize the sociodemographic and clinical profile of children with congenital heart disease assisted at a hospital institution. Methods: A descriptive, crosssectional study conducted in the pediatric cardiology outpatient clinic of a hospitalin Fortaleza, CE, Brazil, in the period from March to August 2012. It comprised a nonrandom convenience sample of 80 parents of children with heart disease aged 5 to 12 years. Information was obtained from primary data of medical records and through questionnaires covering the parentâ??s sociodemographic characteristics, family data and the childrenâ??s clinical aspects. Results: Regarding socioeconomic data, 77 (96.2%) caregivers were female, 50 (62.5%) were married or in a stable relationship, 39 (48.7%) had 10-12 years of formal education, and 69 (82.6%) reported a household income between 1 and 2 minimum wages. In the sample of children studied, 43 (53.8%) were female. The median age of the children was 8.4 years, ranging from 5-13 years. As to the age at the heart disease diagnosis, 44 (55%) occurred under the age of 6 months, regardless of the type of cardiopathy. It was detected that 19 (23.75%) were related to the disease. Conclusion: Childrenâ??s caregivers were predominantly their mothers, with low income and satisfactory schooling. Early diagnosis was predominant, mainly among the children with cyanotic cardiopathy...

Conocer el perfil socio demográfico familiar y clínico de niños con cardiopatía congénita asistidos en una institución hospitalaria. Métodos: Estudio descriptivo, transversal, desarrollado en el ambulatorio de cardiología pediátrica de un hospital de Fortaleza-CE, en el período entre marzo y agosto de 2012. Se incluyó una muestra no aleatoria por conveniencia de 80 padres de niños cardiópatas con edad entre los 5 y 12 años. Se obtuvo informaciones a partir de datos primarios del historialclínico y a través de cuestionarios incluyendo las características socio demográficas de los padres, datos familiares y condiciones clínicas de los niños. Resultados: Respecto a los datos sócio demográficos de los padres, 77 (96,2%) de ellos eran del sexo femenino, 50 (62,5%) eran casados o vivían en unión estable, 39 (48,7%) habían estudiado durante 10 y 12 años y 69 (82,6%) relataron una renta familiar entre 1 y 2 ingresos mínimos. En La muestra de niños estudiada, 43 (53,8%) eran del sexo femenino. La mediana de las edades de los niños fue de 8,4 anos, variando entre los 5 y 13 años. Respecto a la edad del diagnóstico, 44 (55,0%) se dieron en edad inferior a 6 meses, independiente Del tipo de cardiopatía. Se detecto que 19 (23,75%) tenían algún familiar con cardiopatía. Conclusión: Los padres que estaban con los niños cardiópatas eran en su mayoría madres con bajo nivel económico y escolaridad satisfactoria. Hubo predominio Del diagnostico precoz principalmente en los niños con cardiopatia del tipo cianótica...