ABSTRACT
Introducción: la disección arterial cérvico-cefálica (DACC) es una causa importante de accidente cerebrovascular (ACV) en pediatría. Dentro de los factores de riesgo más relevantes están los traumas cervicales y cefálicos, presentes en el 50% de los casos. El pronóstico es variable y depende de la magnitud de oclusión de la arteria afectada. Es importante la detección precoz de esta patología, que muchas veces se presenta con pocos síntomas en pediatría, lo que genera retraso en el diagnóstico y tratamiento. Objetivo:presentar la evidencia disponible sobre DACC incluyendo DACC post trauma para familiarizar a los médicos generales y especialistas sobre la sospecha diagnóstica, diagnóstico enfocado en neuroimágenes y posibles manejos de esta patología. Métodos: se llevó a cabo una revisión bibliográfica de la literatura científica sobre esta condición. Dentro de los criterios de selección de los estudios se consideró la fecha de publicación, el diseño y la relevancia.Conclusiones: la DACC post trauma es una causa frecuente de ACV en pediatría. Se puede presentar con escasa sintomatología, por lo que es importante mantener una alta sospecha en contexto de trauma cervical o cefálico, implementando un diagnóstico y tratamiento precoces para mejorar el pronóstico de los pacientes.
Introduction:Craniocervical arterial dissection (CCAD) is a major cause of arterial ischemic stroke (AIS) in children. The most important risk factors are cervical and cephalic traumas, present in 50% of all cases.The prognosis changes depending on the magnitude of the artery affected. Early detection of this pathology is important. It many times presents itself with few symptoms, which generates a de-lay in its diagnosis and treatment. Objective: To present the evidence available on CCAD, including CCAD post-trauma,to familiarize general physicians and specialists with this diagnosis, neuroimages required, and possible treatments.Methods: Extensive revision of bibliographic scientific literature about this condition. The criteria selection to include studies in this review were the date of publication, the design of the study, and their relevance.Conclusions: the CCAD post-trauma is asignificant cause of AIS in children. It can present itself with mild symptomatology, which is why it is relevant to suspect it in the context of cervical or cephalic trauma, aiming for an early diagnosis and treatment to improve the outcome of patients.
Subject(s)
Pediatrics , Review , Stroke , Dissection, Blood Vessel , Carotid Artery, Internal, Dissection , LiteratureABSTRACT
OBJECTIVE: This manuscript explores the characteristics of individuals diagnosed with an eating disorder who dropped out of treatment, compared with those who completed it. METHOD: The participants were 196 patients diagnosed with eating disorders (according to DSM-IV-TR criteria) who consecutively began treatment for the first time in an eating disorders unit. They were assessed at baseline with a set of questionnaires evaluating eating habits, temperament, and general psychopathology. During the follow-up period, patients who dropped out were re-assessed via a telephone interview. RESULTS: In the course of a 2-year follow-up, a total of 80 (40.8%) patients were labeled as dropouts, and 116 (59.2%) remaining subjects were considered completers. High TCI scores in the character dimensions of Disorderliness (NS4) (p < .01) and total Novelty Seeking (NST), along with low scores in Dependency (RD4), were significantly associated with dropout in the course of 2 years. Once the results were submitted to logistic regression analysis, dropout only remained associated with high scores in Disorderliness (NS4) and, inversely, with an initial Anorexia Nervosa (AN) diagnosis (p < .05). Reasons for dropout stated by the patients included logistic difficulties, subjective improvement of their condition, and lack of motivation. DISCUSSION: Clinicians should handle the first therapeutic intervention with particular care in order to enhance their understanding of clients and their ability to rapidly identify those who are at risk of dropping out of treatment. LEVEL OF EVIDENCE: Level III: Cohort Study.
Subject(s)
Feeding Behavior/psychology , Feeding and Eating Disorders/therapy , Patient Dropouts/psychology , Personality/physiology , Adolescent , Adult , Anxiety/psychology , Feeding and Eating Disorders/psychology , Female , Follow-Up Studies , Humans , Male , Surveys and Questionnaires , Temperament , Young AdultABSTRACT
La amenorrea es un criterio para el diagnostico de la anorexia nerviosa (AN) según el DSM-IV-TR. Sin embargo, al comparar grupos de pacientes que cumplen todos los criterios de este manual para la AN con grupos de mujeres que los presentan todos salvo la amenorrea, algunos estudios no han encontrado diferencias significativas en la psicopatología típicamente asociadas con la AN. El propósito de nuestro estudio ha sido comparar variables demográficas, antropométricas, psicológicas y psicopatológicas, en ambos grupos. No se observaron diferencias estadísticamente significativas entre ambos grupos en las variables evaluadas, pero el grupo con amenorrea tenía un índice de masa corporal significativamente más bajo. Nuestros datos apoyan la hipótesis de que la amenorrea podría no ser un criterio diagnóstico útil para la AN.
Amenorrhea is a current criterion for the diagnosis of anorexia nervosa (AN) according to the DSM-IV-TR. Nevertheless, when comparing groups of patients who fulfill all the criteria of this manual for AN and groups of women who show them all but amenorrhea, some studies did not find significant differences in the psychopathology typically associated with AN. The purpose of our study was to compare both groups in demographic, anthropometric, psychological and psychopathological variables. There were no statistically significant differences between both groups in the analyzed variables, but the group with amenorrhea had a significantly lower body mass index. Our data support the hypothesis that amenorrhea could not be a useful criterion for AN.
Subject(s)
Anorexia Nervosa , Diagnostic and Statistical Manual of Mental Disorders , AmenorrheaABSTRACT
La anorexia nerviosa, como trastorno de la conducta alimentaria, está asociada a una elevada preocupación por el peso, a ideas sobrevaloradas respecto a la delgadez, a una alteración de la imagen corporal y a un miedo excesivo a engordar. En este trabajo estudiamos las diferencias en la distorsión de la percepción corporal en pacientes con anorexia nerviosa de inicio temprano vs. tardío mediante el Cuestionario de la forma corporal (Body Shape Questionnaire) de Cooper, Taylor, Cooper y Fairburn (1987). La muestra clínica estaba compuesta por un total 176 pacientes diagnosticadas de anorexia nerviosa (47.1%) y anorexia nerviosa atípica (52.9%). En el 21.4% de la muestra los síntomas aparecieron antes de los 14 años. El grupo de anorexia nerviosa de inicio temprano presenta una mayor distorsión de su imagen corporal que el grupo de anorexia nerviosa de inicio tardío (AU)
Anorexia nervosa as an eating disorder is associated with high weight concern, overvalued ideas about thinness, body image disturbance and excessive fear of gaining weight. In this paper, we study the differences in the distortion of body perception in patients with anorexia nervosa, comparing early and late onset patients, using the Body Shape Questionnaire (BSQ) by Cooper, Taylor, Cooper and Fairburn (1987).The clinical sample composed of a total of 187 patients diagnosed with anorexia nervosa (47.1%) and atypical anorexia nervosa (52.9%). Of this sample, 21.4% had shown symptoms before age 14. The group of early-onset anorexia nervosa patients has a greater distortion of body image than the group of late-onset anorexia nervosa patients (AU)
