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1.
Rev. SPAGESP ; 22(1): 83-97, ene.-jun. 2021.
Article in Portuguese | LILACS, Index Psychology - Scientific journals | ID: biblio-1155516

ABSTRACT

Partimos do trabalho em uma instituição de acolhimento para crianças e adolescentes propondo uma escuta orientada pela psicanálise. Considerando as tensões entre instituição e psicanálise, a questão que nos orienta é de que forma a transferência pode contribuir para uma instauração de escuta, que permitirá a elaboração da situação de vulnerabilidade desses sujeitos. Utilizamos como método de pesquisa a revisão bibliográfica associada à psicanálise aplicada e recorremos aos fragmentos de recordação das situações vividas no cotidiano institucional. Concluiu-se que há um lugar de escuta sob transferência a ser considerada na instituição e que o Plano Individual de Atendimento (PIA) necessita ser efetivado sob transferência, para que seja implementado como instrumento que valorize o surgimento das singularidades dos acolhidos.


We started from work at a host institution for children and adolescents, proposing a listening guided by psychoanalysis. Considering the tensions between institution and psychoanalysis, the question that guides us is how the transfer can contribute to establishing a listening that will allow the elaboration of the situation of vulnerability of these subjects. We used as a research method the bibliographic review associated with applied psychoanalysis and we also used fragments of remembrance of the situations experienced in the institutional daily life. It was concluded that there is a place of listening under the transfer to be considered in the institution and that the Individual Assistance Plan needs to be carried out under the transfer in order to be implemented as an instrument that values the emergence of the singularities of the sheltered.


Partimos desde el trabajo en una institución de acogida para niños y adolescentes proponiendo una escucha orientada por el psicoanálisis. Considerando las tensiones entre institución y psicoanálisis, la cuestión que nos orienta es de qué forma la transferencia puede contribuir al establecimiento de un escuchar que permitirá la elaboración de la situación de vulnerabilidad de esos sujetos. Utilizamos como método de investigación la revisión bibliográfica asociada al psicoanálisis aplicado y recurrimos a los fragmentos de recuerdos de las situaciones de la vida cotidiana institucional. Concluimos que hay un lugar de escucha bajo transferencia a ser considerado en la institución y que el Plan Individual de Atención necesita ser efectivado bajo transferencia para que sea implementado como un instrumento que valore el surgimiento de las singularidades de los acogidos.


Subject(s)
Humans , Male , Female , Child , Adolescent , Psychoanalysis , Attention , Orphanages , Disaster Vulnerability , Lodged , User Embracement , Child, Foster , Health Services Needs and Demand
2.
Barbarói ; (58)jan.-jun. 2021.
Article in Portuguese | LILACS, Index Psychology - Scientific journals | ID: biblio-1150692

ABSTRACT

Este artigo analisa os sentidos atribuídos ao jovem configurado pela atual política pública brasileira de aprendizagem profissional e como operam as tecnologias de governo do indivíduo na produção da noção de risco social. Trata-se de um estudo documental com base na teoria de leitura de Mikhail Bakhtin, na qual se analisam os enunciados objetivando a sua desnaturalização. Um conjunto de normativas atinentes a essa política foi selecionado, lido e analisado enquanto textos e intertextos a produzir uma rede dialógica complexa que evidencia o posicionamento do Estado em relação ao significado de ser aprendiz, o qual envolve a noção de proteção social, portanto direcionado ao público alvo da política de assistência social. O sentido da identidade do jovem considerado de risco é o principal alvo da política, que regulamenta o trabalho antes dos 18 anos identificando-o como aprendiz. O estudo evidencia o caráter normativo e regulador desse processo, embora a esfera social seja complexa e requeira uma revisão constante. Diante da naturalização do conceito de juventude constatado, as políticas públicas voltadas para o jovem apresentam-se contraditórias e distantes das demandas específicas desta população. Este estudo aponta para a necessidade de problematizar os sentidos da proteção social para o jovem e para a sociedade, bem como os seus efeitos, especialmente na política de aprendizagem profissional, a qual não afeta somente o seu destinatário, mas a toda a sociedade, uma vez que atua na fabricação de um modelo identitário e gesta a existência dos indivíduos objetivando sua conformação.(AU)


This article analyses the meanings attributed to the young person as seen by Brazilian public policy of professional apprenticeship and how the government technologies of the individual work on the production of the concept social risk. It is a documental study based on Mikhail Bakhtin's reading theory, in which utterances are analysed aiming at their denaturalisation. A set of norms regarding this policy has been selected, read and analysed as texts and intertexts, producing a complex dialogic web and casting light on the positioning of the state government concerning the meaning of apprentice and social protection, therefore directed to the target audience of this social care policy. The meaning of the identity of the youth seen as at risk is the main target of this policy, which regulates work before the age of 18, identifying the young person as an apprentice. This study evinces the characteristics of this process as normative and regulatory, although the social sphere is complex, requiring constant revision. Considering the naturalisation of the meaning of youth, the public policies for the young person are presented as contradictory and distant from the specific needs of this population. This study shows the necessity to problematize the meanings of social care for youth and for society, and its effects, particularly regarding the policy for professional apprenticeship, which affects not only its receiver, but also the whole society, since it acts on the fabrication of an identity model and manages the existence of the individuals, aiming at their conformity.(AU)


Este articulo analiza los sentidos atribuidos al joven configurado por la actual política pública brasilera de aprendizaje profesional y cómo operan las tecnologias de gobierno del individuo en la producción de la noción de riesgo social. Es un estudio documental basado en la teoría de lectura Bajtiniana, que analiza los enunciados buscando su desnaturalización. Un conjunto de normativas referidas a esa política fueron analizados como textos e intertextos que producen una red dialógica compleja que evidencia el posicionamiento del Estado en relación al significado de ser aprendiz, el cual involucra la noción de protección social, por lo tanto direccionado al público objeto de la política de asistencia social. El sentido de la identidad del joven considerado en riesgo es el principal objetivo de la política, que reglamenta el trabajo antes de los 18 años identificándolo como aprendiz. El estudio evidencia el caracter normativo y regulador de ese proceso aunque la esfera social sea compleja y requiera una revisión constante. Delante de la naturalización del concepto de juventud constatado, las políticas públicas volcadas hacia el joven se presentan contradictorias y distantes de las demandas específicas de ésta población. Este estudio apunta la necesidad de problematizar los sentidos de la protección social para el joven y la sociedad, también como sus efectos, especialmente en la política de aprendizaje profesional, la cual no afecta solamente su destinatario, sino a toda la sociedad, una vez que actua en la fabricación de un modelo identitario y gesta la existencia de los indivíduos buscando su conformación.(AU)


Subject(s)
Humans , Adolescent , Public Policy , Adolescent , Education, Professional , Learning , Social Work , Risk
3.
Barbarói ; (58): 47-64, jan.-jun. 2021. ilus
Article in Portuguese | LILACS, Index Psychology - Scientific journals | ID: biblio-1150688

ABSTRACT

Este estudo buscou investigar as perspectivas de adolescentes sobre a prática de cuidado dos irmãos. A amostra foi composta por seis adolescentes de ambos os sexos, com idades entre 11 e 19 anos. Os dados foram coletados por meio de entrevistas semiestruturadas e as informações foram submetidas à análise de conteúdo. Ressalta-se a importância das atividades desempenhadas pelos adolescentes no contexto familiar para o sustento financeiro da família. A percepção do cuidador sobre o cuidado dispensado aos irmãos abarcou aspectos positivos e negativos, sendo também considerada uma prática normal e rotineira. Dentre os pontos positivos, constatou-se transmitir algo de bom aos irmãos, os desafios e facilidades na realização de atividades de cuidado com os irmãos menores. A prática do cuidado pode contribuir para o sentimento de importância no contexto familiar, como também ser percebida como uma falha das mães no cumprimento de suas responsabilidades. As percepções negativas referiram-se à limitação dos tempos de lazer, à rotina estressante e à mediação de brigas entre os irmãos menores. Evidencia-se a importância de analisar o que essa prática representa para os adolescentes cuidadores, já que esta pode estar associada a sentimentos de desconforto, influenciar o bem-estar, bem como limitar a realização de atividades de lazer.(AU)


This study sought to investigate the perspectives of adolescents about their sibling caretaking. The sample consisted of six adolescents of both sexes, aged between 11 and 19 years old. The data were collected through semi-structured interviews and were submitted to content analysis. The importance of the activities performed by adolescents in the family context for the financial support of the family is emphasized. The caregiver's perception of the care given to siblings contained positive and negative aspects, and was also considered to be routine practice. Among the positives factors, it was found to transmit something good to the siblings, the challenges and facilities in carrying out care activities to younger siblings. The sibling caretaking practice can contribute to the feeling of importance in the family context, as well as being perceived as a failure of mothers in carrying out their responsibilities. Negative perceptions referred to the limitation of leisure time, the stressful routine and the mediation of fights between younger siblings. The importance of analyzing what this practice represents for young caregivers is evident, as it can be associated with uncomfortable feelings, influence well-being, as well as limit the performance of leisure activities.(AU)


Este estudio buscó investigar las perspectivas de los adolescentes sobre la práctica del cuidado de los hermanos. La muestra estuvo formada por seis adolescentes de ambos sexos, con edades comprendidas entre los 11 y los 19 años. La información se recopiló a través de entrevistas semiestructuradas y la información se sometió a análisis de contenido. Se enfatiza la importancia de las actividades que realizan los adolescentes en el contexto familiar para el apoyo financiero de la familia. La percepción del cuidador sobre el cuidado brindado a los hermanos contenía aspectos tanto positivos como negativos, y también se considera una práctica normal y rutinaria. Entre los puntos positivos, se encontró transmitir algo bueno a los hermanos, los desafíos y facilidades para realizar actividades de cuidado con los hermanos menores. La práctica del cuidado puede contribuir al sentimiento de importancia en el contexto familiar, además de ser percibida como un fracaso de las madres en el cumplimiento de sus responsabilidades. Las percepciones negativas se referían a la limitación del tiempo libre, la rutina estresante y la mediación de peleas entre hermanos menores. Es evidente la importancia de analizar lo que representa esta práctica para los cuidadores adolescentes, ya que puede asociarse a sentimientos de malestar, influir en el bienestar, así como limitar la realización de actividades de ocio.(AU)


Subject(s)
Humans , Adolescent , Adolescent , Caregivers , Siblings , Family
4.
Barbarói ; (58): 30-46, jan.-jun. 2021.
Article in Portuguese | LILACS, Index Psychology - Scientific journals | ID: biblio-1150661

ABSTRACT

O autoconceito pode ser concebido como uma construção teórica que o indivíduo realiza sobre si a partir de sua interação com o meio social, que assume importante papel na compreensão do processo de desenvolvimento humano. Variáveis como desempenho escolar e práticas educativas parentais tem sido relatadas como relevantes para o estabelecimento do autoconceito. Tendo em vista a relevância do tema na adolescência o presente artigo objetivou investigar as possíveis relações entre o autoconceito, desempenho escolar e práticas educativas dos pais, em adolescentes escolares. Fizeram parte desta pesquisa 57 adolescentes de ambos os sexos, com idades entre 12 e 16 anos (M= 13,44; DP=1,13) do 6º ao 9º ano de uma escola pública de Ensino Fundamental. Para isso, foram utilizados a Escala de Autoconceito Infanto ­Juvenil (EAC-IJ), a Escala de Responsividade e Exigência Parental e análise documental na escola para o desempenho escolar. Os resultados demonstraram que houve correlação significativa entre as variáveis do estudo, destacando-se as correlações estabelecidas entre autoconceito e desempenho escolar, desempenho escolar e exigência da mãe, assim como do autoconceito com a responsividade do pai. Discute-se sobre a importância da qualidade da relação familiar e do grupo de amigos no estabelecimento do autoconceito dos adolescentes.(AU)


Self-concept may be conceived as a theoretical construction that the individual has about himself from his interaction with society that assumes an important role in the comprehension of the human development process. Variables such as school performance and parental educational practices have been reported as relevant for the establishment of self-concept. Since this theme can be relevant in adolescence the present article sought to investigate the possible relations between self-concept, school performance and educational practices from parents in school-aged teens. Were part of this research 57 teenagers, from both sexes, with ages between 12 and 16 years old (M= 13,44; DP=1,13) from 6th to9th years of an public elementary school. For that we used the "Escala de Autoconceito Infanto-Juvenil (EAC-IJ)", the "Escala de Responsividade e Exigencia Parental" and analysis of school papers for the school performance. The results showed that there's a significant relation between the variables of study, featuring the relations established between self-concept and school performance, school performance and mother exigency, as for self-concept and father responsiveness. We argue about the importance of a quality family relationship and group of friends in the establishment of self-concept of teenagers.(AU)


El autoconcepto puede ser determinado como una construcción teórica que el individuo realiza sobre sí por medio de su interacción con el medio social, que adquiere importante papel en la comprensión del proceso de desarrollo humano. Variables como el desempeño escolar y las prácticas educativas parentales han sido relatadas como relevantes para la determinación del autoconcepto. Teniendo en cuenta la relevancia del tema en la adolescencia el presente artículo tuvo como objetivo investigar las posibles relaciones entre el autoconcepto, desempeño escolar y prácticas educativas de los padres, en adolescentes escolares. Participaron de esta investigación 57 adolescentes de ambos sexos, con edades comprendidas entre 12 y 16 años (M = 13,44, SD = 1,13) del 6 al 9 de grado de una escuela pública de enseñanza primaria. Para eso, fueron utilizadas la Escala de Autoconcepto Infantil Juvenil (EAC-IJ), la Escala de Responsividad y Exigencia Parental y análisis documental en escuela para el desempeño escolar. Los resultados demostraron que hubo correlación significativa entre las variables del estudio, resaltándose las correlaciones establecidas entre autoconcepto y desempeño escolar, desempeño escolar y exigencia de la madre, asi como del autoconcepto con la responsividad del padre. Se discute sobre la importancia de la calidad de la relación familiar y del grupo de amigos en la determinación del autoconcepto de los adolescentes.(AU)


Subject(s)
Humans , Adolescent , Parents , Self Concept , Adolescent , Family Relations , Academic Performance , Friends , Human Development
5.
Barbarói ; (58): 8-29, jan.-jun. 2021.
Article in Portuguese | LILACS, Index Psychology - Scientific journals | ID: biblio-1150659

ABSTRACT

O presente artigo resulta de uma pesquisa intervenção de cunho qualitativo, realizada com quinze adolescentes de uma instituição localizada litoral norte de Santa Catarina. Para coleta de dados foram realizadas oficinas musicais, nas quais os participantes escolheram letras de músicas para abordar questões a respeito de sua condição de vida, discorrendo sobre o território onde vivem, a percepção que têm de si e do tempo e sobre as suas redes sociais de apoio. Em um corte temático para efeitos deste artigo, as redes sociais de apoio foram eleitas como a temática a ser analisada e discutida por meio da análise temático-categorial. Os resultados apontaram para um espaço escolar com uma função indefinida, pautado na contestação das regras e normas que são impostas, onde ocorrem brincadeiras e intrigas. Quanto à rede de amigos, observou-se que essa relação é baseada nos sentimentos de confiança e de lealdade, se configurando como uma rede essencial nesse ciclo da vida, assim como a família que se apresenta como um fator de proteção, mesmo perpassando situações conflituosas, de violência, mortes e separações.(AU)


The proposal of this paper is a result from a qualitative intervention research conducted with fifteen teenagers from an institution located north coast of Santa Catarina. For data collection, music workshops were made and the participants chose music lyrics that address questions about their life condition, talking about the place where they live, their perception of themselves, their perception of the time and of the social support networks. In a cutting theme for the proposes of this article, the social support networks were chosen as the theme to be analyzed and discussed by thematic-categorical analysis. The results pointed to a school area with an undefined function, based on the contestation of the rules and regulations that are imposed, where the games and intrigues happen. Referring to the friends network, observed that this relation is based on feelings of trust and loyalty, setting up as a essential network in the life cycle, as well as the family that presents itself as a protective factor, even through conflict situations , violence, deaths an separations.(AU)


El presente artículo es el resultado de una investigación de intervención con enfoque cualitativo, realizada con quince adolescentes de una institución localizada en litoral norte de Santa Catarina. Para la coleta de dados fueron realizados talleres musicales, en los cuales los miembros preferirán letras de canciones que enfoquen cuestiones con respecto a su condición de vida, disertando sobre los lugares donde viven, la percepción que tienen de sí propio, del tiempo y sus redes de apoyo social. En un tema de corte para los efectos de este artículo, se eligieron las redes de apoyo social como el tema para ser analizado y debatido por el análisis de temáticas-categóricas. Los resultados apuntaron para un espacio escolar con una función indefinida, pautado en la contestación de las reglas y normas que son impuestas, donde hay juegos y chismes. Cuanto a la rede de amistades, se ha observado que esta relación se basa en los sentimientos de confianza y de lealtad, se perfila como una red esencial en el ciclo de vida, así como la familia es presentada como un factor de protección, incluso impregna situaciones contradictorias, con violencia, muertes y separaciones.(AU)


Subject(s)
Humans , Adolescent , Social Support , Adolescent , Social Networking , Music , Protective Factors , Interpersonal Relations , Life Cycle Stages
6.
BMC Infect Dis ; 21(1): 405, 2021 May 01.
Article in English | MEDLINE | ID: mdl-33933008

ABSTRACT

BACKGROUND: Aseptic meningitis is most often caused by enteroviruses (EVs), but EVs associated with aseptic meningitis have not yet been reported in Liaocheng. The aim of this study was to determine the prevalence and genetic characteristics of EVs causing aseptic meningitis in children in Liaocheng. METHODS: We reviewed the epidemiological and clinical characteristics of 504 paediatric cases of aseptic meningitis in Liaocheng from 2018 to 2019 and analysed the phylogeny of the predominant EV types causing this disease. RESULTS: A total of 107 children were positive for EV in cerebrospinal fluid samples by nested PCR. Most of the positive patients were children 13 years old or younger and had symptoms such as fever, headache and vomiting (P < 0.05). The seasons with the highest prevalence of EV-positive cases were summer and autumn. The 107 EV sequences belonged to 8 serotypes, and echovirus types 18, 6 and 11 were the three dominant serotypes in Liaocheng during the 2-year study period. Phylogenetic analyses demonstrated that the E18 and E6 isolates belonged to subgenotype C2, while the E11 isolates belonged to subgenotype D5. VP1 analysis suggested that only one lineage of these three types was cocirculating in the Liaocheng region. CONCLUSIONS: This study demonstrated the diverse EV genotypes contributing to a large outbreak of aseptic meningitis in Liaocheng. Therefore, large-scale surveillance is required to assess the epidemiology of EVs associated with aseptic meningitis and is important for the diagnosis and treatment of aseptic meningitis in Liaocheng.


Subject(s)
Enterovirus Infections/virology , Enterovirus/genetics , Meningitis, Aseptic/cerebrospinal fluid , Meningitis, Aseptic/epidemiology , Meningitis, Viral/cerebrospinal fluid , Adolescent , Child , Child, Preschool , China/epidemiology , Disease Outbreaks , Enterovirus/isolation & purification , Enterovirus Infections/cerebrospinal fluid , Enterovirus Infections/epidemiology , Enterovirus Infections/etiology , Female , Genotype , Humans , Infant , Male , Meningitis, Aseptic/etiology , Meningitis, Aseptic/virology , Meningitis, Viral/epidemiology , Meningitis, Viral/virology , Phylogeny , Seasons
7.
J Clin Pediatr Dent ; 45(2): 117-122, 2021 Apr 01.
Article in English | MEDLINE | ID: mdl-33951171

ABSTRACT

OBJECTIVE: To identify the association of occlusal disorders in patients with sickle cell disease (SCD). STUDY DESIGN: A literature review was conducted, and articles published between 2010 and 2019 were searched on Bireme and PubMed websites and in MEDLINE and LILACS databases, in English, Portuguese, and Spanish, using the keywords "malocclusion," "sickle cell disease," and "cephalometry," combined by Boolean operators AND and OR. One of the criteria for the selection of articles was the presence of adolescents in the sample. This methodology followed the PRISMA recommendations. Seventy-nine articles were found, seven of which were included in the review as they met the inclusion criteria and the study goals. RESULTS: The prevalence of malocclusion in SCD patients ranged from 62.9% to 100%, which was considered very severe in 30.1% to 80.6%. The most common occlusal changes were Angle's class II malocclusion, increased maxillary overjet, and anterior open bite. In addition, class II skeletal pattern was the most prevalent due to mandibular retrusion. CONCLUSION: Malocclusion prevalence in SCD patients is high and considered to be a risk factor, with a significant rate of very severe malocclusion when compared to healthy patients.


Subject(s)
Anemia, Sickle Cell , Malocclusion, Angle Class II , Malocclusion , Open Bite , Overbite , Adolescent , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/epidemiology , Cephalometry , Humans , Malocclusion/epidemiology
8.
JMIR Mhealth Uhealth ; 9(5): e25895, 2021 05 06.
Article in English | MEDLINE | ID: mdl-33955844

ABSTRACT

BACKGROUND: Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions. OBJECTIVE: This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection. METHODS: Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage. RESULTS: Patients' median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting. CONCLUSIONS: In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise. TRIAL REGISTRATION: ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796.


Subject(s)
Sunburn , Adolescent , Adult , Health Behavior , Humans , Pandemics , Prospective Studies , Sunburn/drug therapy , Sunburn/epidemiology , Sunburn/prevention & control , Sunscreening Agents/therapeutic use , Ultraviolet Rays/adverse effects , United States , Young Adult
9.
Urologiia ; (2): 14-20, 2021 May.
Article in Russian | MEDLINE | ID: mdl-33960151

ABSTRACT

AIM: To present the technical features and results of intestinal and appendicular ureteral replacement. MATERIAL AND METHODS: From 1998 to 2020, a total of 196 patients aged 18 to 77 years (mean age 49.5 +/- 1.2 years) were undergone to intestinal and appendicular ureteral reconstruction in our clinic. There were 123 women (62.8%). The most frequent indications for surgery were complications of open and endoscopic ureteral procedures, radiation-induced ureteral stricture, and iatrogenic injuries of the ureters during gynecological and surgical interventions (81.6%). In 165 (84.2%) patients, for ureteral replacement the ileal segment was used, while in 4 (2.0%) and 27 (13.8%) cases the colon segment and the appendix were chosen, respectively. Unilateral ileal ureteral replacement was performed in 131 (79.4%) cases, while in 34 (26.6%) patients a bilateral procedure was done. Partial and complete ureteral replacement was performed in 107 (81.7%) and 24 (18.3%) cases, respectively. Laparoscopic intestinal and appendicular ureteral replacement was performed in 44 (22.4%) patients, while two patients were undergone to robot-assisted procedure (1.0%). RESULTS: Early postoperative complications were noted in 17 (8.7%) cases. The most severe included acute bowel obstruction, leakage of entero-ureteral anastomoses, necrosis of the ileal graft and bleeding in 10 (5.1%) patients. In all cases, repeat intervention was performed. There were no lethal complications. Late postoperative complications developed in 24 (14.3%) patients. CONCLUSION: Today our clinic has the worlds largest experience in intestinal and appendicular ureteral reconstruction, including original procedures, confirmed by 5 patents for inventions. The minimum number of postoperative complications, the absence of deaths and good long-term results provide the basis for the introduction of ileal and appendicular ureteral replacement into clinical practice.


Subject(s)
Appendix , Reconstructive Surgical Procedures , Ureter , Ureteral Obstruction , Adolescent , Adult , Aged , Appendix/surgery , Female , Humans , Ileum/surgery , Male , Middle Aged , Ureter/surgery , Ureteral Obstruction/etiology , Ureteral Obstruction/surgery , Young Adult
10.
Acta Chir Orthop Traumatol Cech ; 88(2): 101-106, 2021.
Article in Czech | MEDLINE | ID: mdl-33960922

ABSTRACT

PURPOSE OF THE STUDY Diagnosis and treatment of fractures of the facial skeleton in children can be difficult due to the skeletal growth. MATERIAL AND METHODS The 9-year retrospective study included patients admitted with the orbital fracture diagnosis to the University Hospital Brno, Children s Hospital, Department of Paediatric ENT, Department of Paediatric Anaesthesiology and Resuscitation, and Department of Paediatric Surgery, Orthopaedics and Traumatology. We looked into the number of patients admitted to the hospital with the orbital fracture diagnosis and the cause of the injury, the age of patients, and the used treatment method - surgical or non-operative treatment were analysed. The following assumptions were applied: 1. Incidence of the injury (orbital fracture) increases with the age of the patient, 2. Incidence of the injury in individual years is constant. RESULTS In the followed-up period, between 2010 and 2018, a total of 47 patients, of whom 8 girls and 39 boys, with the orbital fracture diagnosis were treated. 12 patients underwent surgery, 35 patients were treated non-operatively. The study group included 47 patients with the age range of 1 to 18 years, with the median age 12 years. When the results were processed, a trend was revealed showing an increase in the number of injuries as well as an in the age of patients at the time of injury. The number of injuries increases with age and year. Both the correlations, however, are statistically insignificant and the trend can be considered statistically insignificant. DISCUSSION Both the non-operative and surgical treatment of patients lead to excellent results, even in the long-term follow-up. In paediatric patients, the surgical approach should be opted for only in cases when the non-operative approach is impossible due to the extent and characteristics of fracture and damage to soft tissues. CONCLUSIONS The surgical treatment aims at the best possible anatomical reconstruction of the orbit with no subsequent functional or cosmetic defects. If surgical treatment is necessary, then the transconjunctival approach is most appropriate in children, namely because of the good overview over the operating field, simple procedure as well as the cosmetic outcome. In most cases it is enough to reposition the orbital soft tissues. In complicated cases, with an orbital floor defect, it needs to be covered with a suitable material. Also, the non-operative approach has its place in therapy and the case-by-case approach must be applied. Orbital fractures should always be treated by experienced specialists (ENT, dental surgeon, traumatologist) specialising in paediatric patients. Key words: fracture, orbit, childhood, surgical, non-operative treatment.


Subject(s)
Orbital Fractures , Orthopedic Procedures , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Orbital Fractures/diagnosis , Orbital Fractures/epidemiology , Orbital Fractures/surgery , Postoperative Complications , Retrospective Studies , Treatment Outcome
11.
Acta Chir Orthop Traumatol Cech ; 88(2): 131-136, 2021.
Article in English | MEDLINE | ID: mdl-33960926

ABSTRACT

PURPOSE OF THE STUDY The aim of this study was to investigate the culture results of children undergoing debridement for suspected septic arthritis or acute osteomyelitis and to compare the laboratory parameters and clinical characteristics of culture-positive and culture-negative patients. MATERIAL AND METHODS Patients who underwent surgery in our hospital for septic arthritis and acute osteomyelitis between 2011 and 2019 were retrospectively analyzed. Seventy-two of 96 patients were included in the study. The patients had documented joint swelling, redness, pain with joint movement and weight-bearing failure. Fever was assessed preoperatively. Sedimentation rate, C-reactive protein level, white blood cell count and the leukocyte count in aspiration material as well as complications were evaluated preoperatively and 3 months postoperatively. RESULTS Twenty patients underwent surgery of the hip; 39 of the knee; 7 of the foot, ankle and distal tibia; 1 of the elbow; and 1 of the distal radius. Additionally, 4 patients had septic arthritis and acute osteomyelitis of the femur. The mean age of the patients was 7.8 years (1-16). The mean follow-up period was 16.2 months (3-42). Preoperative aspiration was performed in 44 of 72 patients. Thirty of 72 patients had positive cultures. No statistically significant difference in age, preoperative duration, C-reactive protein, sedimentation, white blood cell count, preoperative fever or complications was found when compared between patients with culture growth and those without reproduction (p > 0.05). There was a significant difference between the leukocyte count in the aspiration material (p < 0.05). CONCLUSIONS Prediagnosis of septic arthritis or acute osteomyelitis in pediatric patients is important in terms of future joint health and sepsis. According to our findings an inability to obtain bacteria does not exclude septic arthritis as a diagnosis. Empirical antibiotic therapy with a wide postoperative spectrum is important for joint health in these patients. Preoperative serum parameters cannot predict the agent needed for treatment. Key words: septic arthritis, osteomyelitis, pediatric septic arthritis, pediatric joint infection, pediatric infection.


Subject(s)
Arthritis, Infectious , Osteomyelitis , Adolescent , Arthritis, Infectious/diagnosis , Blood Sedimentation , Child , Child, Preschool , Humans , Infant , Leukocyte Count , Osteomyelitis/diagnosis , Retrospective Studies
12.
Acta Chir Orthop Traumatol Cech ; 88(2): 137-143, 2021.
Article in Czech | MEDLINE | ID: mdl-33960927

ABSTRACT

PURPOSE OF THE STUDY The Minimally Invasive Chevron Akin (MICA) is a percutaneous technique used to correct hallux valgus deformity. The combination of distal osteotomy of the first metatarsal and the proximal phalanx of the big toe stabilized with internal fixation was used over the last decade. The retrospective study presents the results of measurements performed on preoperative and postoperative X-rays and offers a comparison with conventional osteotomies. MATERIAL AND METHODS The study population consists of 76 patients who underwent 93 operations between 2015 and 2018 at the Department of Orthopaedics, 1st Faculty of Medicine, Charles University in Prague. The mean age of patients was 50.2 years (range 18-74 years). The study evaluates and measures the parameters and the attributes of interest on weight-bearing X-rays of the foot before and after the operation at 6-week or 3-month follow-ups. The first intermetatarsal angle was measured according to the mechanical and the anatomic axis of the first metatarsal bone. Apart from that, the displacement of the first metatarsal head in the osteotomy, hallux valgus angle and distal metatarsal articular angle were analysed. The position of the medial sesamoid bone and the congruency of the first metatarsophalangeal joint were evaluated as well. RESULTS The mean hallux valgus angle was 33.2° ± 7.3° and 10.2° ± 5.8° postoperatively. The mean value of the first mechanical intermetatarsal angle decreased from 12.4° ± 2.8° to 7.4° ± 2.5° postoperatively. The mean value of the first anatomic intermetatarsal angle increased from 13.7° ± 3.6° to 17.4° ± 4.6°. The used technique restored the congruency of the first metatarsophalangeal joint in 85 cases (91%). The mean lateral displacement of the metatarsal head fragment was 50% of its width (range 18% to 84%). The mean X-ray exposure during the operation was 0.58 mGy and the personnel were exposed to radiation for 79 seconds on average. DISCUSSION One of many questions raised with regard to hallux valgus surgery is the choice of the right technique in order to achieve proper position of the big toe. The surgeon should have the opportunity to use a technique that provides the possibility to change orientation of the metatarsal head articular surface in three anatomic planes. Our study found out that the displacement of the metatarsal head using the MICA technique in transversal plane is from 4 mm to 18 mm (in 20 mm diameter of the head). The method thus offers a possibility to correct mild, moderate and partially severe deformities as well. The main disadvantage of the method is the necessity to use a C-arm at the operating theatre. CONCLUSIONS The Minimally Invasive Chevron Akin (MICA) is a percutaneous technique to correct hallux valgus deformity based on two extraarticular osteotomies of the proximal phalanx of the big toe and the distal part of the first metatarsal bone. The method using stable internal fixation with two screws offers a possibility to change the orientation of the articular surface of the metatarsal head in sagittal, transversal, and even in frontal plane, and is useful to correct mild and moderate deformities. Key words: hallux valgus, minimally invasive technique, percutaneous technique, chevron osteotomy, Akin osteotomy.


Subject(s)
Bunion , Hallux Valgus , Metatarsal Bones , Metatarsophalangeal Joint , Adolescent , Adult , Aged , Hallux Valgus/diagnostic imaging , Hallux Valgus/surgery , Humans , Metatarsal Bones/diagnostic imaging , Metatarsal Bones/surgery , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
13.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(4): 536-542, 2021 Apr 20.
Article in Chinese | MEDLINE | ID: mdl-33963712

ABSTRACT

OBJECTIVE: To explore the clinical phenotype and changes in joint structure and function in adolescent patients with severe hemophilia A under different doses of FVIII. OBJECTIVE: Forty- three adolescents with severe hemophilia A aged 4-18 years were divided into on-demand group (n=7), low-dose group (FVIII dose of 10-15 U/kg, 2-3 times a week, and ≤30 U/kg a week; n=17), and intermediate-dose group (FVIII dose of 15-20 U/kg, 2-3 times a week, and 45-60 U/kg a week (n=19). The 3 groups were compared for their clinical bleeding phenotype, annual bleeding rate (ABR), annual joint bleeding rate (AJBR), annual the most severe joint bleeding rate, joint imaging scores (ultrasound HEAD-US score and IPSG MRI score), Hemophilia Joint Health Score (HJHS) and Functional Independence Score in Hemophilia (FISH) within 24 months. OBJECTIVE: Compared with that in on-demand group, the ABR was significantly reduced in the low- and intermediate-dose groups (P=0.004 and 0.000, respectively), and was reduced by 32.87% in the intermediate-dose group as compared with the low-dose group. The AJBR (P < 0.01) and annual the most severe joint bleeding rate (P < 0.05) also differed significantly among the 3 groups. The number of bleeding episodes increased progressively with time in the on-demand group, remained stable in the low- dose group, and tended to decrease in the intermediate-dose group. The imaging scores of the most severe joints showed lesion progression in all the 3 groups. The ultrasound scores, which increased steadily in the on-demand group, showed significantly lowered increment rates in the low- and intermediate-dose groups (P=0.002 and 0.000, respectively). The MRI scores showed also delayed increment in the low- and intermediate-dose groups as compared with the on-demand group (P=0.041 and 0.000, respectively), and the increment was accelerated in the on-demand and low-dose group but remained stable in the intermediate-dose group. The increment of the HJHS scores was significantly higher in the on-demand group than in the lowand intermediate-dose groups (P=0.003 and 0.000, respectively), and the scores increased at a steady rate in the on-demand group but tended to decrease in the latter two groups. The FISH score was decreased by 0.29±3.09 in the on-demand group but was increased significantly in the low- and intermediate-dose groups compared with the on-demand group (P=0.000). OBJECTIVE: In Chinese adolescents with severe hemophilia A, low- and intermediate-dose FVIII prophylaxis, especially at the intermediate dose, is better than on- demand treatment for protecting joint structure and function.


Subject(s)
Hemophilia A , Adolescent , Child , Child, Preschool , Factor VIII , Hemarthrosis , Hemophilia A/drug therapy , Hemorrhage , Humans , Prospective Studies
14.
Georgian Med News ; (312): 42-46, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33964824

ABSTRACT

In recent years, according to the WHO, more than 1,9 billion people over the age of 18 are overweight, of whom more than 650 million are obese, with an annual trend. Studies in recent decades have shown that obese young people with generalized periodontitis have abnormalities in protein, fat and carbohydrate metabolism, which contributes to the early destruction of the periodontal tissue complex and rapid tooth loss. The aim of our study was to examine changes in serum leptin and adiponectin in patients with generalized periodontitis on the background of obesity. The study involved 94 people aged 19 to 35 years. Patients were divided into 3 groups: 32 patients with generalized periodontitis on the background of overweight, 40 patients with generalized periodontitis and obesity, and the control group - 22 healthy individuals of the same age category. The content of leptin and adiponectin in the serum was determined by enzyme-linked immunosorbent assay (ELISA) ELISA. The study was performed by analyzing venous blood (2 ml) in a BD Vacutainer tube and then centrifuging on LDN and Mediagnost GmbH analyzers and test systems (Germany). Studies allow us to conclude that in the serum of patients with generalized periodontitis on the background of overweight and obesity there is an imbalance of adipokines leptin and adiponectin. The obtained data are consistent with the literature, according to which, an increase in BMI is accompanied by an increase in leptin production and a decrease in adiponectin levels. These disorders were more pronounced in patients with generalized periodontitis on the background of obesity. Such an imbalance in adipose tissue may stimulate the production of pro-inflammatory cytokines and contribute to the progression of periodontal disease in such patients.


Subject(s)
Leptin , Periodontitis , Adipokines , Adiponectin , Adolescent , Adult , Germany , Humans , Middle Aged , Obesity/complications , Periodontitis/complications , Young Adult
15.
Georgian Med News ; (312): 78-82, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33964832

ABSTRACT

In this study was to investigate the сoexistence of diabetes mellitus type 1 with other chronic pathology in children and adolescents and their impact on the course of diabetes mellitus type 1 (DM1). The 88 children from 3 to 17 years who had DM1 were observed. The study was conducted by survey with the aim of finding risk factors and associated comorbidties with a questionnaire-based, objective-subjective study. All patients had severe form of T1DM, with suboptimal and poor glycemic control. Comorbid pathologies observed in 71,6±4,8% of childrn included: thyroid pathology - 62,5±5,1%, disorders of the autonomic nervous system - 20,5±4,3%, gastro-pathology - 7,9±2,8%, atopic dermatitis - 6,8±2,6%, arthritis - 6,8±2,6%, bronchial asthma - 4,5±2,2%, allergic rhinitis - 3,4±1,9%, immune-deficient disorder - 2,3±1,5%. Conclusions. 1. The detected comorbid pathology in children with DM1 makes it necessary to collect an anamnesis and examination of children for the purpose of early finding a coexistence of chronic pathology. 2. The risk of development of the thyroid pathology enhances is 7,5 times, allergic pathology is 6,9 times in patients with DM1. 3. Coexistence of type 1 diabetes and other chronic diseases impairs glucose metabolism, impedes effective insulin therapy, and deteriorates diabetes control. 4. This accent the need for the improvement of the monitoring of patient with diabetes mellitus and comorbid pathology for the prognosis of the course and optimization of treatment and rehabilitation measures.


Subject(s)
Asthma , Diabetes Mellitus, Type 1 , Rhinitis, Allergic , Adolescent , Asthma/complications , Asthma/epidemiology , Child , Comorbidity , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Humans , Insulin
16.
Georgian Med News ; (312): 82-87, 2021 Mar.
Article in Russian | MEDLINE | ID: mdl-33964833

ABSTRACT

The purpose of this review is study of literature for the development of biological effect of Kalcipherol (D vitamin group) on children population. Different factors seem, that D- vitamin deficiency disbalance elevated, children specifically negative effect, which have a major impact on health, growth and development of infants, children and adolescents. Vitamin D and calcium deficiencies are preventable global public health problems in pediatric medicine. The laboratory assessment of vitamin D (calcidiol-25(OH)D), epidemiological studies assessing the prevalence of vitamin D deficiency, are performed to analyze the relationships between neuropsychological function and mechanisms of toxic effects in the setting of vitamin D.


Subject(s)
Vitamin D Deficiency , Adolescent , Adult , Child , Humans , Infant , Prevalence , Vitamin D , Vitamin D Deficiency/epidemiology , Vitamins
17.
Rinsho Ketsueki ; 62(4): 257-261, 2021.
Article in Japanese | MEDLINE | ID: mdl-33967149

ABSTRACT

Herein, we describe a 13-year-old male adolescent who had chronic thrombocytopenia since infancy. In this case, X-linked thrombocytopenia (XLT) was suspected owing to a family history of chronic thrombocytopenia and small-sized platelets. Moreover, the patient was refractory to immunoglobulin therapy. The Wiskott-Aldrich syndrome protein (WASP) expression analysis revealed a decreased expression. Results showed a missense mutation [c.296A>G (p.Gln99Arg)] in exon 3 of the WASP-interacting protein region. Therefore, a diagnosis of XLT was made. To lift exercise restrictions, we initiated treatment with eltrombopag at a dose of 12.5 µg/day. The platelet count of the patient increased to approximately 50×103/µl after the treatment dose was escalated to 25 µg/day, and bleeding symptoms decreased after the patient resumed exercise. Ultrastructural platelet abnormalities and abnormal platelet aggregation were observed on transmission electron microscopy after the administration of eltrombopag. Therefore, eltrombopag treatment can increase platelet count and reduce bleeding symptoms in patients with XLT.


Subject(s)
Thrombocytopenia , Adolescent , Benzoates , Genetic Diseases, X-Linked , Humans , Hydrazines/therapeutic use , Male , Platelet Count , Pyrazoles , Thrombocytopenia/drug therapy
18.
Endocr Pract ; 27(5): 419-425, 2021 May.
Article in English | MEDLINE | ID: mdl-33934752

ABSTRACT

OBJECTIVE: To explore the body composition of pediatric patients referred for endocrine evaluation. METHODS: This real-life observational study conducted between January 2018 and January 2020 included 10 001 clinic visits of 3500 children and adolescents; first visits of 5 to 18-year-old patients were included. Anthropometric data, blood pressure levels, pubertal status, and bioelectrical impedance analysis (BIA, Tanita MC-780 MA) were extracted from medical files. Excluded from the analysis were patients participating in other studies. RESULTS: A total of 1001 patients (48% boys, mean age 11.3 ± 3.4 years, 33.5% prepubertal) were included. Mean anthropometric z-scores were normal and similar for boys and girls. Sex differences in body composition were as follows: boys had lower fat percentage, lower truncal fat percentage, higher appendicular skeletal muscle mass, and a higher muscle-to-fat ratio (MFR) than girls (P < .001 for all). MFR correlated with body mass index-standard deviation scores (BMI-SDS) in overweight/obese patients (r = -0.558, P < .001), although not in underweight patients. Systolic blood pressure (SBP) correlated with BMI-SDS in overweight/obese patients (r = 0.262, P < .001), although not in underweight patients. Diastolic blood pressure (DBP) did not correlate with BMI-SDS in either group of extreme weight status. MFR correlated with SBP and DBP in overweight/obese patients (r = -0.230, P < .001 and r = -0.141, P = .018, respectively) as well as in underweight patients (r = 0.331, P < .001 and r = 0.264, P = .005, respectively). CONCLUSIONS: Our findings support BIA for a more refined characterization of patients referred for endocrine evaluation than BMI-SDS. MFR may be a better surrogate marker of blood pressure levels than BMI-SDS in both underweight and overweight/obese pediatric patients.


Subject(s)
Body Composition , Obesity , Adolescent , Anthropometry , Body Mass Index , Body Weight , Child , Child, Preschool , Electric Impedance , Female , Humans , Male , Obesity/epidemiology
19.
Ideggyogy Sz ; 74(3-4): 135-138, 2021 Mar 30.
Article in English | MEDLINE | ID: mdl-33938664

ABSTRACT

Carnitine palmitoyltransferase II (CPT II) deficiency is an autosomal inherited metabolic disorder in which the ß-oxidation of the long chain fatty acids is defective. The clinical presentation may be in various forms; it presents itself in the severe form during neonatal and infantile periods and as the less severe myopathic form in the school age and adolescence. While the severity of the rhabdomyolysis attacks varies, occasionally the clinical course may be complicated with acute renal failure. Acylcarnitine analysis may help in the diagnosis of CPT II, but its normality does not indicate the absence of the disease. If there is strong suspicion, genetic analysis should be performed on the cases. In this article, we present a 15-year-old male patient who had two rhabdomyolysis attacks triggered by infection and starvation. Acylcarnitine analysis of the case was normal, CPT II deficiency was considered when the history was evaluated, and CPT II gene c.137A>G (p.Gln46Arg) homozygous novel pathogenic mutation was detected. CPT II deficiency is one of the most common causes of metabolic rhabdomyolysis in patients with recurrent episodes of rhabdomyolysis.


Subject(s)
Metabolism, Inborn Errors , Rhabdomyolysis , Adolescent , Carnitine O-Palmitoyltransferase/deficiency , Carnitine O-Palmitoyltransferase/genetics , Humans , Male , Metabolism, Inborn Errors/complications , Metabolism, Inborn Errors/genetics , Mutation , Rhabdomyolysis/genetics
20.
Am J Dent ; 34(2): 101-104, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33940668

ABSTRACT

PURPOSE: To evaluate and describe the most frequent TMJ degenerative bone alterations on MRI and CT and to determine the accuracy, sensitivity, and specificity of MRI. METHODS: Images of 80 subjects were selected and evaluated from a database and 57 were selected. The subjects were submitted to CT and MRI exams (each subject on the same day). The joints were evaluated in the sagittal and coronal planes under closed mouth position. Each individual parameter was scored as absent or present. Absolute and relative frequencies were obtained and the Kappa concordance index test and equality of two proportions were used. To correlate the presence of bone alterations, the Chi-Square test was performed. A significance level of 0.05 (5%) was defined, with 95% of statistical confidence interval. RESULTS: Of the 57 subjects, (47 female, 10 male), the ages ranged from 18-83 years (mean 43 years). The intra and inter-rater agreement tests demonstrated reliability among the examiners for all variables analyzed on MRI and CT. CLINICAL SIGNIFICANCE: MRI is a reliable and valid method for observing bone changes in the TMJ, with the advantage of non-exposure to radiation and cost-effectiveness due to the use of only one exam.


Subject(s)
Magnetic Resonance Imaging , Temporomandibular Joint , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Reproducibility of Results , Temporomandibular Joint/diagnostic imaging , Young Adult
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