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1.
Medwave ; 19(6)31-07-2019.
Artigo em Inglês, Espanhol | LILACS-Express | ID: biblio-1008024

RESUMO

Resumen Las revisiones sistemáticas de literatura constituyen una de las principales metodologías utilizadas en la validación de las propiedades saludables de los alimentos, o factores alimentarios, que afectan la fisiología humana. Esta herramienta, basada en la evidencia obtenida a través de ensayos clínicos aleatorizados realizados con un diseño experimental adecuado, permite concluir si existe una relación causal entre el producto consumido y un efecto beneficioso para la salud, principio que sustenta el calificativo de los alimentos como "funcionales". Se presentan y analizan las características y la forma en la que las revisiones sistemáticas pueden contribuir a que las agencias regulatorias aprueben un mensaje saludable (health claim), dirigido al consumidor.


Abstract Systematic literature reviews are one of the main methodologies used to substantiate the health properties of foods and food constituents purported to affect human physiology. This tool is based on scientific evidence obtained from correctly performed randomized controlled trials. Systematic reviews make it possible to conclude whether there is a causal relationship between food consumed and health effects observed, thus supporting the use of the term "functional foods." We present and analyze the prinicpal characteristics of, and ways by which, systematic reviews can contribute to the regulatory approval of health claims directed to consumers.

2.
Medwave ; 19(4)30-05-2019.
Artigo em Inglês, Espanhol | LILACS-Express | ID: biblio-997879

RESUMO

Resumen MOMO es un acrónimo para los términos macrosomía, obesidad, macrocefalia y anomalías oculares. El síndrome fue descrito por primera vez en 1993, con un total de nueve pacientes publicados a la fecha. Todos los casos reportaron discapacidad intelectual y en un caso se describió a un paciente con autismo. Presentamos un nuevo caso de paciente con síndrome de MOMO que consultó por fenómenos alucinatorios. Se completó una evaluación neuropsicológica, clínica y cognitiva, en donde se demostró un cociente intelectual limítrofe y se corroboraron los criterios para trastorno del espectro autista. Ésta es la primera evaluación neurocognitiva de un paciente con MOMO, la que apoya el uso de escalas estandarizadas a fin de evaluar el autismo y otras comorbilidades psiquiátricas en pacientes con síndromes genéticos.


Abstract MOMO is an acronym for macrosomia, obesity, macrocephaly and ocular abnormalities. The syndrome was first described in 1993, with a total of nine patients published thus far. All the cases presented intellectual disability and in one case autism was described. We present a new case of a patient with MOMO syndrome, who consulted for hallucinatory phenomena. He completed a neuropsychological, clinical and cognitive evaluation, showing a borderline intelligence quotient and fulfilled the criteria for autism spectrum disorder. This is the first neurocognitive evaluation of a patient with MOMO, supporting the use of standardized scales in order to assess the autism and other psychiatric comorbidities in patients with genetics syndromes.

3.
Medwave ; 18(7): e7354, 30-11-2018.
Artigo em Inglês, Espanhol | LILACS-Express | ID: biblio-966428

RESUMO

Resumen: La divulgación de información biomédica se expande de manera exponencial, lo que representa un desafío para aquellos profesionales de la salud que deseen obtener información integrada de alta calidad y relevancia. Las revisiones, en sus distintos formatos, son herramientas que pueden abordar este problema. Este artículo describe los principales tipos de síntesis de información biomédica, sus estructuras, la utilidad de cada una de ellas, y presenta los últimos formatos desarrollados por las diferentes organizaciones que se dedican a la síntesis de información.


Abstract: Biomedical information dissemination has expanded exponentially, and this can represent a challenge for those health professionals who wish to obtain high quality and relevant integrated information. Reviews, in their different formats, are tools that can address this problem. This article describes the main types of syntheses of biomedical information, their structures, their usefulness, and presents the latest information synthesis formats that were developed by different organizations committed to this purpose.

4.
Medwave ; 18(6): https://www.medwave.cl/link.cgi/Medwave/Estudios/Investigacion/7314, 31-10-2018.
Artigo em Inglês, Espanhol | LILACS-Express | ID: biblio-948393

RESUMO

Resumen Introducción La facoéresis es el procedimiento en que se extrae quirúrgicamente el cristalino para tratar las cataratas. La pérdida endotelial corneal es una complicación reconocida. Si bien se han descrito diversos factores asociados a este daño, la experiencia del cirujano ha sido poco explorada. Objetivos Evaluar la asociación entre la experiencia del cirujano y otras variables asociadas a la pérdida celular endotelial en el contexto de la facoéresis. Métodos Se analizaron registros clínicos de 198 cirugías de cataratas, evaluando el efecto de la experiencia del cirujano y otras variables asociadas: energía disipada acumulada, tipo de viscoelástico empleado, uso de azul tripán, cantidad de fluídica, tiempo de ultrasonido, energía de facoemulsificación combinada y recuento celular endotelial pre y postoperatorio. Resultados No se observaron diferencias en el conteo postoperatorio de células endoteliales. Los oftalmólogos con más de cinco años de experiencia presentaron menor uso de azul tripán pero mayor cantidad de energía disipada acumulada en cada procedimiento, mientras que los oftalmólogos con menor experiencia utilizaron mayor cantidad de fluídica. Conclusiones Aunque hubo diferencias en el manejo de algunos factores influyentes sobre la pérdida endotelial cornal según la experiencia de los oftalmólogos, no se hallaron diferencias en relación a dicha pérdida como resultado final.


Abstract Introduction Phacoeresis is the procedure through which the lens is surgically removed to treat cataracts. A corneal endothelial loss is a recognized sequel. Although several factors associated with this harm have been described, the surgeon's prior experience has been scarcely evaluated. Objectives To assess the association between the surgeon's experience and other variables associated with a corneal endothelial cell loss in the context of phacoeresis. Methods Clinical records of 198 patients undergoing cataract operations were prospectively reviewed. The experience of the surgeon and other variables were recorded, including cumulative dissipated energy, viscoelastic type, the use of trypan blue, amount of fluidics, ultrasound time, combined phacoemulsification energy, and pre- and postoperative corneal endothelial cell counts. Results No differences were observed in the postoperative corneal endothelial cell count between surgeons with more or less than five years of experience. Nevertheless, ophthalmologists with more than five years' experience used less trypan blue, but more cumulative dissipated energy in each procedure, while less experienced ophthalmologists used less fluidics. Conclusions Although there were differences in the surgical management regarding the surgeons' experience in factors known to influence corneal endothelial cell loss, no differences in endothelial cell loss were observed as an outcome.

5.
Medwave ; 18(2): e7208, 30-04-2018.
Artigo em Inglês, Espanhol | LILACS-Express | ID: biblio-912094

RESUMO

A fines del año 2016 se publicó la nueva edición de las Pautas Éticas Internacionales para la Investigación Relacionada con la Salud con Seres Humanos del Consejo de Organizaciones Internacionales de las Ciencias Médicas (CIOMS, por sus siglas en inglés Council for International Organizations of Medical Sciences), estándares universalmente reconocidos en la investigación biomédica. En este artículo se realiza un análisis crítico de las potencialidades y falencias de las nuevas pautas del CIOMS 2016. Algunos avances alcanzados consideran la importancia asignada al valor social de la investigación y su repercusión en la toma de decisiones y la creación de políticas públicas, el desarrollo de investigación en escenarios de bajos recursos, la participación de las comunidades en el proceso investigativo, la determinación de la vulnerabilidad de los participantes de una investigación y los cambios en los procedimientos de consentimiento informado. Esta actualización es una gran herramienta para investigadores y miembros de los comités de ética científica. Asimismo, aunque constituye una adaptación a los rápidos cambios científicos, tecnológicos y sociales; permanecen aspectos no resueltos, principalmente en torno al manejo del riesgo mínimo de los participantes y de los conflictos de interés involucrados en una investigación, además del desarrollo de ésta en escenarios de bajos recursos. No obstante, se hace un positivo progreso en cuanto al contexto y las necesidades de las poblaciones en las que se desarrollarán las investigaciones y la participación comunitaria en las distintas fases del proyecto, accediendo a sus potenciales beneficios. El impacto de las pautas del CIOMS 2016, deberá evaluarse en el tiempo, en particular en escenarios de inequidades socio-sanitarias y de intereses comerciales de la industria en la investigación biomédica.


In 2016, the new edition of the Council for International Organizations of Medical Sciences (CIOMS) Ethical Guidelines was released, which are universally acknowledged as ethical standards in biomedical research. In this article, we critically analyze the improvements and shortcomings of the CIOMS Ethical Guidelines 2016. Among the improvements are the relevance assigned to the social value of research and its effects on decision-making and the creation of public policies; the research development in low-resources scenarios; the communities' involvement in the research process; the determination of participants' vulnerability and changes on informed consent related proceedings. Despite the improved harmonization with scientific, technologic and social changes, and that the guidelines provide a tool for researchers and members of research ethics committees alike, some topics remain unsolved, namely the management of participants' minimal risk and conflicts of interest involved in research, and the development of research in low-incomes scenarios. Nonetheless, we recognize that these new guidelines constitute a progress regarding the context and needs of populations in which research will be conducted, with greater community involvement in the different phases of the investigation project, thus allowing them to access the potential benefits. The impact of the CIOMS Ethical Guidelines 2016, should be appraised over time, particularly in socio-sanitary inequities scenarios and in the context of commercial interests of industry on biomedical research.

6.
NeuroRehabilitation ; 40(2): 243-249, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28222546

RESUMO

BACKGROUND: Population ageing and changes in the epidemiological profile of neurological pathologies has resulted in an increase in patients with disabilities. Rehabilitation strategies such as Modified Constraint-Induced Movement Therapy (CIMTm) play a key role in treating patients with neurologic deficiencies and motor impairments. This intervention is intended to mitigate disability, promote maximum functional independence, and optimize social and economic participation of patients with upper extremity weakness. Our goal was to assess the recovery of functional independence in patients after a stroke using to CIMTm. PATIENTS AND METHOD: Thirty-six subjects who had suffered stroke took part in a randomised clinical trial. The treatment was applied through either collective or individual modalities for three hours per day for a period of ten days. Participant's functional independence was assessed using the Functional Independence Measure (FIM) scale at the before and after of the intervention. RESULTS: An analysis of covariance carried out on the pre-test assessments indicates that the dependent variable presents significant differences (F1.31 = 42.78, p < 0.001, η2p = 0.72) in favour of the collective intervention modality. CONCLUSION: Both modalities of CIMTm intervention promote functional independence. However, the greatest improvements were observed in participants in the collective modality. Improvements in functional independence pursue a reduction in learned non-use behaviours through greater use of the paretic upper extremity in everyday activities.


Assuntos
Atividades Cotidianas , Técnicas de Exercício e de Movimento/métodos , Recuperação de Função Fisiológica/fisiologia , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/diagnóstico , Adulto , Idoso , Chile/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia , Método Simples-Cego , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/tendências
8.
Rev. chil. neuro-psiquiatr ; 54(2): 151-161, jun. 2016. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: lil-791039

RESUMO

Introducción: Los trastornos somatomorfos (TS) y conversivos (TC) han aumentado su incidencia durante las dos últimas décadas en niños y adolescentes, aunque ambos son habitualmente subdiagnosticados. Objetivo: Efectuar una puesta al día de la evidencia sobre TS y TC en niños y adolescentes. Método: Se realizó una búsqueda bibliográfica mediante las bases de datos Medline/PubMed, SciELO y textos especializados. Resultados: Existe una alta intercurrencia con trastornos afectivos y ansiosos y se han identificado algunos factores de riesgo, especialmente mayor vulnerabilidad al estrés, disfunción familiar, sobreprotección parental y limitada mentalización de los síntomas físicos (alexitimia), que también perpetuan la sintomatología. Desde la perspectiva etiopatogénica se han invocado hipótesis psicodinámicas, psicosomáticas, traumático-ambientales y biológicas. Los pacientes con TS y TC frecuentemente son mujeres, presentan rasgos más introvertidos de personalidad, más eventos vitales estresantes y défictis ejecutivos. Las convulsiones psicógenas no epilépticas se relacionan con más comorbilidades psiquiátricas y peor pronóstico. Las psicoterapias cognitivo-conductual y la hipnoterapia-psicodinámica combinadas con fármacos inhibidores de la recaptura de serotonina han demostrado ser eficaces en el tratamiento. Conclusiones: Los TS y TC en poblaciones infanto juveniles se observan en contextos médicos y psiquiátricos. Su reconocimiento es difícil debido a su etiología multifactorial, la falta de consenso diagnóstico yla escasa experiencia clínica, implicando un verdadero desafío terapéutico, por lo que es indispensable realizar futuras investigaciones en este tópico. Su manejo en la atención primaria parece apropiado, pero en casos más complejos es necesaria su derivación al especialista.


Background: Somatoform (SD) and conversion (CD) disorders have increased their incidence during the last two decades in children and adolescents, although both are currently underdiagnosed. Objective: To review the evidence on SD and CD in children and adolescents. Method: A review ofspecialised textbooks and the available literature in Medline/PubMed and SciELO was made. Results: There is a high intercurrence with affective and anxiety disorders and some riskfactors have been identified, especially higher vulnerability to stress, family disfunction, parental overprotection, and limited mentalization of physical symptoms (alexithymia), which at the same time, perpetuate the symptomatology. From an ethiopathogenicperspective, psychodynamic, psychosomatic, traumatic-environmental and biological hypothesis have been invoked. Patients with SD and CD are frequently females, show more introversive personality features, more stressful life events and executive deficits. Psychogenic non-epileptic seizures are related with more psychiatric co-morbidities and worse outcome. Cognitive-behavioural psychotherapy and psychodynamic-hypnotherapy combined with selective serotonin reuptake inhibitors have been effective. Conclusions: SD and CD in child and adolescent populations have been observed in medical and psychiatric contexts. Their recognition is difficult due to their multifactorial ethiology, the lack of diagnosis consensus and the scarce clinical experience, involving a true therapeutic challenge; therefore, it is imperative to carry out future researches on this issue. Their management in primary care seems suitable, but in more complex cases the referral to the specialist is necessary.

9.
Rev. chil. neuro-psiquiatr ; 53(2): 100-109, jun. 2015. tab
Artigo em Espanhol | LILACS | ID: lil-753503

RESUMO

Introduction: The psychiatric hospitalization of children and adolescents suffering from anorexia nervosa (AN) has important implications in their developmental stage, but its impact has been scarcely reported, particularly from the subjective individual experience. Objective: To describe the experiencing meanings constructed by anorectic children and adolescents about their hospitalization process. Method: A qualitative descriptive study based on the Grounded Theory was conducted. The sample was intentionally composed by6 patients (5 females and 1 male) with and without previous hospitalization background. A semi-structured in-depth interview was applied. The data were transcribed and analysed by using open coding and triangulation of specialists. Results: Four categories are described: (A) Impressions on mental health professionals and psychiatric hospitalization units before inpatient treatment: reported experiences were negative, influencing future interventions; (B) Impressions and experiences at admission: anguish, sadness and fear (symptomatology impairment, abuse and weight gain); (C) Therapeutic effects of hospitalization: emphasis in therapeutic alliance and symptoms remission and (D) Critical assessment concerning psychiatric hospitalizations during the adolescence: reinforcement of individual capabilities for the disorder management, benefits of the isolation from family issues, development illness awareness. Conclusion: Hospitalization in AN is a positive therapeutic resource in certain cases. Improvement process was facilitated by constructive dialogues throw the acknowledgement of the patient particular affective needs and the institutional plasticity in offering appropriate tools for their experiencing, emphasising the relevance of therapeutic alliance.


Introducción: La hospitalización psiquiátrica en anorexia nerviosa (AN) infanto-juvenil posee importantes implicancias en el vivenciar de su etapa del desarrollo, pero su impacto ha sido escasamente reportado, particularmente desde la experiencia individual subjetiva. Objetivo: Describir los significados experienciales construidos por niños y adolescentes anorécticos en torno a su proceso de hospitalización. Método: Estudio cualitativo descriptivo basado en la Grounded Theory. La muestra se constituyó intencionadamente por un total de 6 pacientes (5 mujeres y 1 hombre) con y sin antecedentes de hospitalización psiquiátrica. Se utilizó la entrevista en profundidad semi-estructurada, analizando los datos mediante triangulación de especialistas y codificación abierta. Resultados: Se describen cuatro categorías: (A) Impresiones sobre los profesionales de la salud mental y las unidades de hospitalización psiquiátrica previas a la internación: las vivencias informadas fueron negativas, influyendo en futuras intervenciones; (B) Impresiones y experiencias al momento del ingreso: angustia, tristeza y temor (empeoramiento sintomático, maltrato y aumento ponderal); (C) Efectos terapéuticos de la hospitalización: énfasis en la alianza terapéutica y en la remisión sintomática y (D) Apreciación crítica sobre las hospitalizaciones psiquiátricas durante la adolescencia: fortalecimiento de habilidades individuales para el manejo del trastorno, beneficio del distanciamiento de las problemáticas familiares, desarrollo de consciencia de enfermedad. Conclusión: La hospitalización en AN es un recurso terapéutico positivo en determinados casos. El proceso de mejoría se facilitó estableciendo diálogos constructivos mediante el reconocimiento de las necesidades afectivas particulares del paciente y la plasticidad de la institución para ofrecerle herramientas atingentes a su vivenciar, enfatizando la relevancia de la alianza terapéutica.


Assuntos
Humanos , Masculino , Adolescente , Feminino , Anorexia Nervosa/psicologia , Hospitalização , Análise Qualitativa
10.
Rev. chil. neuro-psiquiatr ; 53(2): 127-133, jun. 2015.
Artigo em Espanhol | LILACS | ID: lil-753506

RESUMO

Suicide is an important worldwide death cause. Although 90 percent or more of those who commit suicide suffer from a psychiatric disorder, an isolated pathology does not fully explain the complex phenomenon of suicide. Because of the multifactorial behavior suicidal pattern, biological, psychological and social factors are implicated. Given the above, a single pharmacological management of the underlying disease or some symptoms such as anxiety and impulsivity, should not be enough to address or prevent suicidal behavior in its entirety. Because of the complexity and the interrelationship of risk factors for suicide, it is very unlikely that a single medication controls all the aspects involved; thereby it is difficult to ascribe the actual antisuicidal effect of a particular drug with certainty. However, the current literature despite its limitations supports an antisuicidal effect of particular drugs such as lithium and clozapine.


El suicidio es una importante causa de muerte a nivel mundial. Si bien el 90 por ciento o más de quienes cometen suicidio presenta un trastorno psiquiátrico, el ser portador de una patología no explica del todo el complejo fenómeno relacionado con él. Al ser un patrón de conducta multifactorial, intervendrán factores biológicos, psicológicos y sociales. Dado lo anterior, un manejo farmacológico de la patología de base o de algunos síntomas como la ansiedad o la impulsividad, no es suficiente para abordar o prevenir las conductas suicidas en su globalidad. Por la complejidad e interrelación de los factores de riesgo de suicidio, es muy poco probable que la mera medicación logre modular todos los aspectos involucrados; por ello, sería muy difícil poder atribuir con certeza el real efecto antisuicida a un fármaco en particular. Sin embargo, la literatura disponible, pese a sus limitaciones, frecuentemente apoya el efecto antisuicida de algunos psicofármacos como el litio y la clozapina.


Assuntos
Humanos , Psiquiatria Preventiva , Psicofarmacologia , Suicídio/prevenção & controle
11.
Rev. chil. neuro-psiquiatr ; 53(1): 24-34, mar. 2015. tab
Artigo em Espanhol | LILACS-Express | ID: lil-745585

RESUMO

Background: Several researches have demonstrated the relationship between alexithymia and depression. Some authors support the hypothesis that alexithymia measured by TAS-20 and BVAQ may be a personality trait and others point out that it would be a confrontation mechanism against stressful life events. Objective: To describe the concept of alexithymia, the evidence on its relationship with depression and its correlates within the context of various biopsychosocial aspects. Method: Medline/Pubmed and SciELO databases were used to look for evidence on alexithymia and depression. Results: The higher level of alexithymia, the higher severity of anxiety and depressive symptoms and a worse response to antidepressant treatment. Alexithymia is a risk factor for the development of psychopathological disorders (panic, eating disorders, substance abuse). In the acute phase of a major depressive disorder, alexithymia rates reached 46% and its prevalence was eight times higher in depressive patients than in a general population. Obssesive personality traits were significant predictors of alexithymia and in turn, a triggering and/or perpetuating factor and a prognosis index of psychosomatic illness in the development and maintenance of pain, mainly within a context of a negative affective state like depression. Conclusions: Alexithymia is significantly associated to depression. Future longitudinal studies are required to determine if both conditions are different phenomena or affective and cognitive variants of a unique psychopathological disorder.


Antecedentes: Numerosas investigaciones han demostrado la relación entre alexitimia y depresión. Algunos autores apoyan la hipótesis de que la alexitimia, evaluada por la TAS-20 y el BVAQ, puede ser un rasgo de personalidad y otros señalan que sería un mecanismo de afrontamiento ante eventos vitales estresantes. Objetivo: Describir el concepto de alexitimia y la evidencia de su relación con la depresión y su correlación con diversos aspectos biopsicosociales. Método: Se realizó una búsqueda bibliográfica de evidencia sobre alexitimia y depresión mediante las bases de datos Medline/PubMed, SciELO y textos especializados. Resultados: A mayor nivel de alexitimia, mayor severidad de síntomas ansiosos y depresivos y peor respuesta a antidepresivos. La alexitimia es un factor de riesgo para el desarrollo de trastornos psicopatológicos (pánico, conducta alimentaria, abuso de sustancias). En la fase aguda de un trastorno depresivo mayor, la tasa de alexitimia alcanzó un 46%, siendo su prevalencia ocho veces superior entre depresivos que en la población general. Los rasgos obsesivos de personalidad fueron predictores significativos de alexitimia, siendo ésta además un factor desencadenante y/o perpetuante e índice pronóstico de enfermedades psicosomáticas, favoreciendo el desarrollo y mantención del dolor, principalmente en el contexto de un afecto negativo como la depresión. Conclusiones: La alexitimia se encuentra significativamente asociada a la depresión. Se requieren futuros estudios longitudinales para determinar si ambas condiciones corresponden a fenómenos distintos o a variantes afectivas y cognitivas de un mismo desorden psicopatológico.

13.
Rev. chil. pediatr ; 85(6): 731-739, dic. 2014.
Artigo em Espanhol | LILACS | ID: lil-734816

RESUMO

Background: There is conclusive evidence about the influence of mothers with eating disorders (ED) on their children. Objective: To describe different aspects about mothers with ED and its implications in the feeding, growing and development in their children. Method: A review of specialized textbooks and the available literature in PubMed was made. Results: Mothers with previous or present ED show restrictive eating patterns, a deficient affective bond with their own mothers, exhibit more psychiatric comorbidities, mainly depression and anxiety; in addition, feelings of guilt and shame, early cessation of breastfeeding, high control of food consumption of their children, and/or pressure them to eat, irregular mealtimes, unbalanced and monotonous meals, proneness to slimness, a critical attitude about the body shape of their daughters. Breastfeeding implies a critical period for the irruption or relapse of an ED due to the adjustment to the characteristic body shape changes during pregnancy. Conclusions: There is a particular relationship between a maternal ED and its occurrence in their children, and it can be considered a risk factor for its development.


Antecedentes: Existe concluyente evidencia de la influencia de madres con trastornos de la conducta alimentaria (TCA) en sus hijas (os). Objetivo: Analizar descriptivamente los diversos aspectos de madres con historia de TCA y sus implicancias en la nutrición, crecimiento y desarrollo de sus hijas (os). Método: Se efectuó una revisión de la literatura disponible en PubMed y textos de consulta especializados. Resultados: Las madres con TCA previo o actual muestran patrones alimentarios restrictivos, un vínculo afectivo deficitario con sus propias madres, exhiben más comorbilidades psiquiátricas, principalmente depresión y ansiedad; además sentimientos de culpa y vergüenza, cese precoz de la lactancia, elevado control del consumo de alimentos de sus hijas (os) y/o presión para comer, horarios irregulares de comidas, dieta desequilibrada y monótona, preferencia por la delgadez y actitud crítica sobre la silueta corporal de sus hijas (os). La lactancia representa un período crítico para la irrupción o recaída de un TCA por la adaptación que implican los cambios característicos de su figura corporal durante el embarazo. Conclusiones: Existe una particular relación entre la presencia de un TCA materno y su ocurrencia en hijas (os), considerándose un factor de riesgo para su desarrollo.


Assuntos
Feminino , Humanos , Gravidez , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Relações Mãe-Filho , Ansiedade/epidemiologia , Depressão/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Culpa , Comportamento Materno/psicologia , Mães/psicologia , Vergonha
14.
J Food Sci ; 79(9): E1722-31, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25155351

RESUMO

Four chitosan samples were prepared from shrimp shells without deproteination and decoloration steps, by a deacetylation process at 2 reaction times (2 and 4 h) and with/without using a reducing agent (R.A.). Variations in the physicochemical properties of the final products were analyzed. Viscosity average molecular weight (Mw) determinations demonstrated the protective action of the R.A. on the molecular oxidative degradation. Oppositely, an increase on the reaction time produced samples with low Mw. Deacetylation degrees (DDs) were chemically evaluated by the nitrogen content and by spectroscopic techniques as infrared and nuclear magnetic resonance. The existing differences in crystallinity were studied by X-ray diffraction. Differential scanning calorimetry and thermogravimetry were used to demonstrate the dehydration and thermal degradation processes of the different chitosans. A novel method from calorimetric profiles is presenting for DD determinations of chitosan, which achieved highly satisfactory results (linear fit and Pearson's correlation coefficient) and is proposed to be generally extended to complex curves application.


Assuntos
Quitosana/isolamento & purificação , Penaeidae/química , Acetilação , Animais , Varredura Diferencial de Calorimetria , Quitosana/química , Peso Molecular , Substâncias Redutoras/química , Termogravimetria , Viscosidade , Difração de Raios X
15.
Rev. chil. neuro-psiquiatr ; 52(2): 103-114, jun. 2014. tab
Artigo em Espanhol | LILACS-Express | ID: lil-715180

RESUMO

Background: There is an important relationship between perfectionism (P), body dissatisfaction (BD) and eating disorders (ED). Objective: To describe the evidence about P and/or BD within the clinical course of ED. Method: A review of specialized textbooks and the available literature in PubMed was made. Two descriptive case reports are analyzed. Results: Socially prescribed and self-oriented dimensions of P were related to ED attitudes and specially restrictive behaviors, mediating and moderating the association between BD and ED. BD and P are intrapersonal risk factors in the development of an ED. BD shares about 10% of genetic variability with P and both increase the appearance comparative assessment, mainly within a higher western acculturation, drive for thinness, a maladaptative stress response, a low self-esteem, the severity of the disorder, depressive symptomatology, sports that emphasize a slim body shape, comorbidities (personality, anxiety and/or affective disorders), alexithymia and lack of assertiveness. Conclusions: According to the evidence, BD and P, although unspecific, are core characteristics of ED as predisposing, triggering and/or perpetuating factors that significantly influence its treatment and outcome.


Antecedentes: Existe una importante relación entre el perfeccionismo (P), la insatisfacción corporal (IC) y los trastornos de la conducta alimentaria (TCA). Objetivo: Se analiza descriptivamente la evidencia sobre la relación entre P e IC en el curso clínico de los TCA. Método: Se efectuó una revisión de la literatura disponible en PubMed y textos de consulta especializados. Se analizan dos casos clínicos ilustrativos. Resultados: El Pen sus dimensiones socialmente prescrito y auto-orientado se asoció con actitudes y conductas de TCA, especialmente restrictivas, mediando y moderando la relación entre la IC y el TCA. La IC y el P son factores de riesgo intrapersonal para el desarrollo de TCA. La IC comparte alrededor del 10% de la variabilidad genética con el P y ambos favorecen la evaluación comparativa de la apariencia, principalmente con una mayor aculturación occidental, la motivación por la delgadez, la respuesta maladaptativa al estrés, la baja autoestima, la severidad del desorden, la sintomatología depresiva, los deportes que acentúan la silueta corporal esbelta, las comorbilidades (trastornos de personalidad, de ansiedad, afectivos), la alexitimia y la falta de asertividad. Conclusiones: De acuerdo a la evidencia, la IC y el P, aunque inespecíficas, son características nucleares de los TCA como factores predisponentes, desencadenantes y perpetuantes, que influyen significativamente en su tratamiento y desenlace.

16.
Rev Chil Pediatr ; 85(6): 731-9, 2014 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-25697621

RESUMO

BACKGROUND: There is conclusive evidence about the influence of mothers with eating disorders (ED) on their children. OBJECTIVE: To describe different aspects about mothers with ED and its implications in the feeding, growing and development in their children. METHOD: A review of specialized textbooks and the available literature in PubMed was made. RESULTS: Mothers with previous or present ED show restrictive eating patterns, a deficient affective bond with their own mothers, exhibit more psychiatric comorbidities, mainly depression and anxiety; in addition, feelings of guilt and shame, early cessation of breastfeeding, high control of food consumption of their children, and/or pressure them to eat, irregular mealtimes, unbalanced and monotonous meals, proneness to slimness, a critical attitude about the body shape of their daughters. Breastfeeding implies a critical period for the irruption or relapse of an ED due to the adjustment to the characteristic body shape changes during pregnancy. CONCLUSIONS: There is a particular relationship between a maternal ED and its occurrence in their children, and it can be considered a risk factor for its development.


Assuntos
Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Relações Mãe-Filho , Ansiedade/epidemiologia , Depressão/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Culpa , Humanos , Comportamento Materno/psicologia , Mães/psicologia , Gravidez , Vergonha
17.
Rev Chilena Infectol ; 30(1): 81-5, 2013 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-23450416

RESUMO

Pyomyositis (PM) is an uncommon pyogenic infection of skeletal muscle and, when not properly treated, it can progress to a high-risk clinical situation with high mortality. Because it usually has a subacute presentation, diagnosis is often delayed. We present two cases of PM of the paraspinal muscles in healthy children and discuss the current state of knowledge of this disease.


Assuntos
Piomiosite/diagnóstico , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus , Antibacterianos/uso terapêutico , Criança , Cloxacilina/uso terapêutico , Feminino , Humanos , Região Lombossacral , Masculino , Piomiosite/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico
18.
Rev. chil. infectol ; 30(1): 81-85, feb. 2013. ilus
Artigo em Espanhol | LILACS | ID: lil-665584

RESUMO

Pyomyositis (PM) is an uncommon pyogenic infection of skeletal muscle and, when not properly treated, it can progress to a high-risk clinical situation with high mortality. Because it usually has a subacute presentation, diagnosis is often delayed. We present two cases of PM of the paraspinal muscles in healthy children and discuss the current state of knowledge of this disease.


La piomiositis (PM) es una infección piógena infrecuente del músculo estriado y, cuando no es tratada adecuadamente, puede evolucionar hasta una situación clínica de alto riesgo vital. Debido a su presentación usualmente subaguda, el diagnóstico es a menudo tardío. Presentamos dos casos clínicos de PM de la musculatura paraespinal en escolares sanos y se describe el estado actual del conocimiento de esta enfermedad.


Assuntos
Criança , Feminino , Humanos , Masculino , Piomiosite/diagnóstico , Staphylococcus aureus , Infecções Estafilocócicas/diagnóstico , Antibacterianos/uso terapêutico , Cloxacilina/uso terapêutico , Região Lombossacral , Piomiosite/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico
19.
Rev. chil. obstet. ginecol ; 74(6): 339-344, 2009. tab
Artigo em Espanhol | LILACS | ID: lil-561847

RESUMO

Antecedentes: A diferencia de la conización cervical por cono frío, no se ha podido demostrar una clara asociación entre el procedimiento de escisión electro-quirúrgica por asa térmica (LEEP) y el riesgo de parto prematuro. Objetivo: Análisis crítico de la literatura científica, en relación al riesgo de presentar un parto prematuro en pacientes que han sido sometidas a LEEP, y los resultados materno-perinatales asociados. Búsqueda sistemática en múltiples bases de datos. Resultados: Se encontraron sólo tres artículos que cumplían los criterios de inclusión, los cuales son incluidos en esta revisión. De éstos, el primero muestra que el LEEP no aumenta el riesgo de parto prematuro ni de recién nacidos de bajo peso. El segundo evidencia un aumento del riesgo de rotura prematura de membranas y parto prematuro secundario a esto, pero no de parto prematuro espontáneo. Sin embargo, el tercero, señala que el LEEP se asocia en forma significativa a riesgo aumentado de parto prematuro, parto prematuro secundario a rotura prematura de membranas y recién nacidos de bajo peso. Los tres estudios son de cohortes retrospectivas, lo cual les otorga un nivel de evidencia de tipo 2b. Conclusión: La evidencia indica que la excisión de la zona de transformación a través del uso de LEEP está asociada a un pequeño, pero real incremento del riesgo de presentar un parto de pretérmino.


Background: Unlike cold-knife conization, studies have shown conflicting results on the outcome of pregnancy following loop electrosurgical excision procedure (LEEP). Objective: Critical analysis of the literature to establish if the LEEP treatments increase risk of preterm delivery and its influence in maternal-perinatal results. Results: Only three studies were filling the inclusion criteria. The first study does not show that LEEP treatment increase risk of preterm delivery and low birth weight. The second study shows increased risk of premature rupture of membranes and the subsequent preterm delivery, but not spontaneous preterm delivery. Nevertheless, the third study shows increased risk of premature rupture of membranes and the subsequent preterm delivery, spontaneous preterm delivery and low birth weight. The three studies are based in retrospective cohorts, which grant them a level of evidence of type 2b. Conclusion: The evidence indicates that loop excision of the transformation zone by LEEP is associated with a small but real increase the risk of preterm delivery.


Assuntos
Humanos , Feminino , Gravidez , Eletrocirurgia/efeitos adversos , Eletrocirurgia/métodos , Neoplasia Intraepitelial Cervical/cirurgia , Neoplasias do Colo do Útero/cirurgia , Trabalho de Parto Prematuro/etiologia , Complicações Neoplásicas na Gravidez/cirurgia , Conização/efeitos adversos , Resultado da Gravidez , Probabilidade , Medição de Risco , Ruptura Prematura de Membranas Fetais/etiologia
20.
Rev Chilena Infectol ; 24(6): 454-61, 2007 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-18180820

RESUMO

INTRODUCTION: Pleural empyema (PE) is a serious complication of community-acquired pneumonia (CAP). OBJECTIVES: To describe the clinical profile of hospitalized patients with PE in the pediatric ward of the Catholic University Hospital between 2000-2005. PATIENTS AND METHODS: Retrospectively, all pediatric admission due to CAP and pleural effusion (86 children) were identified. In 59 (70%) children > 1 thoracocentesis were performed. We considered PE as the presence in the pleural effusion of pus, and/or a positive gram strain and/ or positive culture, and/or a pH < 7.10. Children with effusions not meeting any criteria were used as controls. RESULTS: Twenty four PE and 25 controls were identified, with a global mean age of 2.9 years (range: 8 months to 14.3 years); 78% were < 5 years, with a significant difference between PE and controls [1.6 vs 3.3 years (p = 0.01)]. The mean duration of symptoms in PE patients before admission was 7 days (range: 2-21), and the most frequent symptoms were fever (100%) and cough (96%). In 15/24 cases a microorganism was identified being Streptococcus pneumoniae (n = 9) the most common. In 48 patients management was conservative and in 4 surgical procedures were required. The mean duration of hospitalization was significantly higher in the PE group vs controls group: 15 (range: 5-38) vs 9 days (range 3-16) (p < 0.01). A chest tube was inserted in 83% of children with EP compared with 36% in the control group (p = 0.002). There were no difference in number of days of oxygen use [6 vs 4.5 (p = 0.36)] or number of chest tubes per child [3 vs 2.5 (p = 0.29)]. No deaths were reported. CONCLUSION: PE in children represented an acute respiratory event associated with more prolonged hospitalization especially at younger ages; the majority of cases did not require surgical intervention.


Assuntos
Empiema Pleural/etiologia , Derrame Pleural/etiologia , Pneumonia Bacteriana/complicações , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Chile/epidemiologia , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/microbiologia , Empiema Pleural/diagnóstico , Empiema Pleural/epidemiologia , Empiema Pleural/terapia , Feminino , Hospitalização , Humanos , Lactente , Masculino , Derrame Pleural/diagnóstico , Derrame Pleural/epidemiologia , Derrame Pleural/terapia , Pneumonia Bacteriana/microbiologia , Estudos Retrospectivos
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