RESUMO
INTRODUCTION: The SARS-CoV-2 (COVID-19) pandemic warranted expanded care via telemedicine across a breath of medical specialties. The aim of the study is to analyze the preferences of caregivers of patients with dementia on the use of telemedicine in monitoring these patients. SUBJECTS AND METHODS: Caregivers and family members responsible for patients with dementia completed an online self-applicable questionnaire, which was distributed in Facebook and WhatsApp groups between April and October 2020. RESULTS: 130 responses were obtained; most caregivers were women (83.8%), of whom 60% were daughters of patients. Most patients were also women (75.3%). Alzheimer's disease caused dementia in 73% of cases. The Internet was accessible to 98% of respondents, yet less than half (33.8%) had used telemedicine at least once. Although 66.9% of caregivers would be willing to use telemedicine if the doctor offered it, 63% believed that the cost of video consultations should be lower than those face-to-face. During the COVID-19 pandemic, 85.3% of caregivers needed to contact the physician: just over half of these consultations were face-to-face (52.2%), but telemedicine was preferred (62.3%) if possible. CONCLUSION: Caregivers accepted and were interested in telemedicine as a tool for monitoring patients with dementia, especially those with walking difficulties.
TITLE: Telemedicina en la monitorización de pacientes con demencia: una perspectiva de cuidadores brasileños.Introducción. La pandemia de SARS-CoV-2 (COVID-19) requirió una atención ampliada a través de la telemedicina en una variedad de especialidades médicas. El objetivo del estudio es analizar las preferencias de los cuidadores de pacientes con demencia sobre el uso de la telemedicina en el seguimiento de estos pacientes. Sujetos y métodos. Los cuidadores y familiares a cargo de pacientes con demencia completaron un cuestionario autoaplicable en línea, que se distribuyó en grupos de Facebook y WhatsApp entre abril y octubre de 2020. Resultados. Se obtuvieron 130 respuestas; la mayoría de los cuidadores eran mujeres (83,8%), de las cuales el 60% eran hijas de pacientes. La mayoría de los pacientes también eran mujeres (75,3%). La enfermedad de Alzheimer causó demencia en el 73% de los casos. Internet era accesible para el 98% de los encuestados, pero menos de la mitad (33,8%) había utilizado la telemedicina al menos una vez. Aunque el 66,9% de los cuidadores estaría dispuesto a utilizar la telemedicina si el médico se la ofreciera, el 63% cree que el coste de las videoconsultas debería ser inferior al de las presenciales. Durante la pandemia de COVID-19, el 85,3% de los cuidadores necesitó contactar con el médico: poco más de la mitad de estas consultas fueron presenciales (52,2%), pero se prefirió la telemedicina (62,3%) si era posible. Conclusión. Los cuidadores aceptaron y se interesaron por la telemedicina como herramienta para el seguimiento de los pacientes con demencia, especialmente los que tenían dificultad para caminar.
Assuntos
COVID-19 , Demência , Telemedicina , Brasil , Cuidadores , Feminino , Humanos , Masculino , Pandemias , SARS-CoV-2RESUMO
The aim of this paper is to compare the fluoride-releasing and mechanical properties of an experimental luting glass ionomer cement, which has a modified composition and a commercial luting cement. The experimental powder was obtained by sol-gel process and then, it was used to prepare the experimental cements. The properties of cement pastes, such as setting time and working time, microhardness and diametral tensile strength were determined. Fluoride release from GICs was evaluated at time intervals of 1, 7, 14, 21 and 28 days in deionized water. Atomic force microscopy (AFM) analyses showed that the surface of the experimental cements is more homogeneous than commercial GICs. The mechanical properties and the measure of liberation of fluoride of the two cements were influenced by ratio powder:liquid and chemical composition of the precursor powders. Experimental cements released less fluoride than commercial cements. However, this liberation was more constant during the analyzed period. Thus, the results obtained in this study indicated that the composition of the experimental powder modified by the niobium can lead the formation of the polysalt matrix with good mechanical properties. In other words, we can say that experimental powder offered considerable promise for exploitation in dental field.
Assuntos
Cimentos Dentários/química , Cimentos de Ionômeros de Vidro/química , Força Compressiva , Odontologia/métodos , Desenho de Equipamento , Dureza , Teste de Materiais , Microscopia de Força Atômica/métodos , Nióbio/química , Pós , Estresse Mecânico , Temperatura , Resistência à Tração , Fatores de Tempo , Difração de Raios XRESUMO
The Authors report one case of amniotic band syndrome identified in the second trimester of pregnancy. Amniotic band syndrome appears to be sufficiently common. The spectrum of possible malformations suggests caution in the evaluation of such findings.
Assuntos
Síndrome de Bandas Amnióticas/diagnóstico , Diagnóstico Pré-Natal , Ultrassonografia , Adulto , Feminino , Humanos , Recém-Nascido , GravidezRESUMO
Two cases of cystic microglandular hyperplasia of the cervix, one with exocervical and the other with endocervical site are reported. These clinical cases were presented because of the rarity of this type of lesion and because of the difficulty of differentiating them from a well-differentiated cervical adenocarcinoma; noteworthy is the lack of a progestinic climate in the two patients, a situation that is considered highly predisposing.
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Cistos/patologia , Hiperplasia Endometrial/patologia , Doenças do Colo do Útero/patologia , Adulto , Feminino , HumanosRESUMO
Osteonecrosis is a disease characterized by the death of marrow and bone tissues. All bones may be affected, most commonly those of the hip, knee, shoulder, ankle as well as the small bones of the hands and feet. When the disease involves a weight-bearing joint there is a significant risk that subarticular fracture may develop leading to disabling arthrosis and requiring, therefore, arthroplasty surgery. Osteonecrosis typically affects patients in their third, fourth and fifth decades of life and is associated with many factors including other diseases and co-morbidities. Multifocal osteonecrosis is defined according to the involvement of at least three separated anatomic sites. We describe the case of a young man with osteonecrosis of the shoulder and hip joints which required total arthroplasty. Among biochemical investigations, an increase in the plasminogen activator inhibitor type 1 (PAI-1) levels associated with mild hyperhomocysteinemia was present. Another finding was the HLA B27, without signs of spondyloarthropathies. In patients with osteonecrosis, especially if multifocal, a careful medical history, a complete physical examination and some biochemical investigations, particularly those related to thrombophilia and hypofibrinolysis, should be performed.
Assuntos
Necrose da Cabeça do Fêmur/etiologia , Fibrinólise , Antígeno HLA-B27/genética , Úmero/patologia , Hiper-Homocisteinemia/complicações , Osteonecrose/etiologia , Inibidor 1 de Ativador de Plasminogênio/sangue , Trombofilia/complicações , Adulto , Artroplastia de Substituição , Artroplastia de Quadril , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/genética , Necrose da Cabeça do Fêmur/cirurgia , Humanos , Úmero/diagnóstico por imagem , Úmero/cirurgia , Imageamento por Ressonância Magnética , Masculino , Osteonecrose/diagnóstico por imagem , Osteonecrose/genética , Osteonecrose/cirurgia , Cintilografia , Trombofilia/sangueRESUMO
Neurogenous arthropatHy is a rare disease. Nonetheless, every orthopaedist will sooner or later be faced with the arthropathy before the neurologic disease has been diagnosed. The authors report their study on two cases of syringomyelic arthropathy, repropose its anatomopathological, clinical and radiographic features, and discuss the etiopathogenesis, differential diagnosis and treatment of the disease.
Assuntos
Artropatia Neurogênica/etiologia , Siringomielia/complicações , Adulto , Artropatia Neurogênica/diagnóstico , Artropatia Neurogênica/patologia , Biópsia por Agulha , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Radiografia , Cintilografia , Ombro/patologia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/patologia , Siringomielia/diagnóstico , Siringomielia/patologiaRESUMO
The authors discuss 18 cases of acute capsuloligamentous lesions of the external compartment of the knee submitted to surgical treatment. The results obtained by separately studying the progression of the various types of anatomical lesions revealed a relationship between the entity of the lesion and the results. Positive results were as follows: 100% in isolated lesions of the EC, 70% in lesions of the EC and ACL, 40% in lesions of the EC + ACL + PCL. In grade I distorsion trauma surgery is not indicated; in grade II lesions treatment is based on an objective examination in narcosis, and surgery should be performed when dynamic tests are positive; in grade III lesions surgery is always indicated. An objective examination in narcosis (rarely arthroscopy) is thus of essential importance to therapeutic indications.
Assuntos
Traumatismos do Joelho/cirurgia , Ligamentos Articulares/lesões , Doença Aguda , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/etiologia , Ligamentos Articulares/cirurgia , Masculino , Pessoa de Meia-IdadeRESUMO
We evaluated the cord blood level of specific IgE in newborn having first grade relatives affected by allergic disease. We aimed: a) to look for a significant threshold (if any) of sp. IgE predictive of atopy; b) to verify the clinical reliability of the CAP System by Pharmacia. 9 out of 60 patients with positive family history had sp. IgE > 0.35 KU/L; 7 out of these 9 children were symptomatic to a clinical follow-up at 18 months. Moreover 65% of children with positive history but no sp. IgE and 100% of patients with both a negative history and no sp. IgE were completely free of allergic symptoms in the same period. We conclude that a careful history and cord blood sp. IgE measurement might be of value in early diagnosis of atopy.
Assuntos
Especificidade de Anticorpos , Sangue Fetal/imunologia , Hipersensibilidade/diagnóstico , Imunoglobulina E/sangue , Estudos de Avaliação como Assunto , Feminino , Fluorimunoensaio , Seguimentos , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/genética , Técnicas Imunoenzimáticas , Recém-Nascido , Itália/epidemiologia , MasculinoAssuntos
Síndrome da Sela Vazia/fisiopatologia , Síndrome da Sela Vazia/complicações , Síndrome da Sela Vazia/diagnóstico por imagem , Feminino , Humanos , Hiperprolactinemia/etiologia , Hipoglicemia/etiologia , Hipotireoidismo/etiologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XAssuntos
Doenças Ósseas/congênito , Ossos do Tarso , Tíbia , Doenças Ósseas/cirurgia , Criança , Humanos , MasculinoAssuntos
Neurilemoma/cirurgia , Nervo Isquiático , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/patologiaAssuntos
Osteotomia , Tíbia/cirurgia , Humanos , Tíbia/anormalidades , Tíbia/patologia , Anormalidade TorcionalRESUMO
Eleven cases of breakage of the Grosse-Kempf nail were observed in a series of 297 operations performed at the Rizzoli Orthopaedic Institute in Bologna. Seven of the 9 femoral nails were not the latest available model, which is capable of supporting more stress because areas of less resistance have been eliminated. However, breakage is still a possibility as a result of errors of technique and incorrect planning of weightbearing.
Assuntos
Pinos Ortopédicos/normas , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/instrumentação , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Idoso , Peso Corporal , Deambulação Precoce , Falha de Equipamento , Fraturas do Fêmur/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Estresse Mecânico , Fraturas da Tíbia/diagnóstico por imagemRESUMO
The hallmark of SAPHO Syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is osteitis of the anterior chest wall, which can be so pronounced as to cause thoracic outlet syndrome, thrombosis of the subclavian vein, and compression of the superior vena cava. Suggestive skin manifestations, namely palmoplantar pustulosis and severe acne, generally antedate the bone and joint lesions. We report a case of SAPHO syndrome that went unrecognized for many years and eventually caused compression and thrombosis of the right subclavian vein requiring cleidectomy. SAPHO syndrome should be considered in every patients with anterior chest wall inflammation, particularly when skin lesions are also present.