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Acta Neurochir Suppl ; 127: 179-183, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407082


From 2013 to 2017, at the Burdenko Institute of Neurosurgery, intra-arterial verapamil for treatment of cerebral vasospasm following intracranial hemorrhage after aneurysm rupture was administered to 35 patients (total 75 procedures). The age is from 8 to 77 years. All ruptured aneurysms were treated: in 26 cases with open approach-clipping-and in 9 cases with endovascular occlusion. The procedure was carried out from 0 to 11 days after the operation. Severity of spasm was assessed by angiography and TCDU. Efficacy of the administration was assessed by TCDU 1 h after the procedure and by clinical evaluation of the patient's condition. The dose of verapamil was 15-50 mg (on average 40 mg) per procedure/per carotid pool and depended on the data of TCDU and clinical and radiological picture. The procedure was performed repeatedly (1-5 times) according to the indications and depending on the patient's condition, with an interval of 24 h. The procedure was effective as a preventive measure for care of patients in the initial stage of cerebral ischemia and was ineffective with a formed focus of ischemia. Endovascular administration of verapamil for treatment of cerebral vasospasm is a safe technique which positively affects the overall recovery of such patients.

Aneurisma Roto , Hemorragia Subaracnóidea , Vasodilatadores , Vasoespasmo Intracraniano , Verapamil , Adolescente , Adulto , Idoso , Criança , Humanos , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/tratamento farmacológico , Hemorragia Subaracnóidea/prevenção & controle , Resultado do Tratamento , Vasodilatadores/uso terapêutico , Vasoespasmo Intracraniano/tratamento farmacológico , Verapamil/uso terapêutico , Adulto Jovem
Food Chem ; 302: 125326, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31416003


Ruminant meat is considered an excellent source of proteins, dietary fatty acids and essential minerals. Grilling is a popular cooking method; however, the high temperatures employ could modify the grilled meat quality and safety. In this study, the effects of novel beer-based marinades infused with herbs and spices on the quality, safety, and sensory perception of grilled beef and moose meat is examined. Unmarinated meat showed high content of volatile lipid oxidation and Maillard reaction products compared to the marinated samples, which contained higher number and abundance of terpenes and sulfur based compounds. Strong relationships between Maillard products and heterocyclic amines formation, as well as between volatile terpenes and the lipophilic antioxidant activity, were observed in the grilled meats. The findings suggest the unfiltered beer-based marinades were effective in reducing lipid oxidation and Maillard reaction compounds formation, while improving the nutritional quality, safety and sensory preference of grilled ruminant meats.

Cerveja , Culinária/métodos , Carne , Ruminantes , Adolescente , Adulto , Aminas/análise , Aminas/química , Animais , Bovinos , Qualidade dos Alimentos , Cromatografia Gasosa-Espectrometria de Massas , Compostos Heterocíclicos/análise , Temperatura Alta , Humanos , Reação de Maillard , Carne/análise , Pessoa de Meia-Idade , Valor Nutritivo , Carne Vermelha , Especiarias , Paladar , Compostos Orgânicos Voláteis/análise
Orthop Clin North Am ; 51(1): 55-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739879


The increasing incidence of anterior cruciate ligament injuries in skeletally immature children demands careful attention by orthopedic surgeons. Assessing skeletal age is essential to selecting the appropriate reconstruction technique. Males with a bone age of 15 years or older and females of 13 years and older are ideal candidates for a transphyseal anterior cruciate ligament reconstruction because there is minimal risk of growth disturbance. Children with substantial growth remaining (skeletal age males ≤12 years and females ≤10 years) seem to be at risk for more significant growth disturbance, so we generally recommend physeal-sparing techniques for these younger patients.

Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/transplante , Traumatismos do Joelho/cirurgia , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Ligamento Cruzado Anterior/anatomia & histologia , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/reabilitação , Criança , Feminino , Humanos , Traumatismos do Joelho/epidemiologia , Masculino , Procedimentos Cirúrgicos Reconstrutivos/métodos , Resultado do Tratamento
Orthop Clin North Am ; 51(1): 97-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739884


Osteochondritis dissecans (OCD) of the capitellum is a relatively rare condition, with a higher incidence in adolescents who participate in repetitive overhead sports. The surgical treatment approach for this uncommon problem has varied from microfracture, loose body removal, abrasion chrondroplasty, lesion fixation, osteochondral allograft transplantation surgery, and osteochondral autologous transplantation surgery. The purpose of this study is to present the authors' preferred surgical technique for the treatment of unstable OCD lesions of the capitellum with osteochondral autologous transplantation surgery using autograft from the ipsilateral knee.

Cartilagem Articular/cirurgia , Articulação do Cotovelo/cirurgia , Úmero/cirurgia , Osteocondrite Dissecante/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adolescente , Criança , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/patologia , Feminino , Fraturas de Estresse , Humanos , Úmero/diagnóstico por imagem , Úmero/patologia , Úmero/transplante , Incidência , Articulação do Joelho/cirurgia , Imagem por Ressonância Magnética , Masculino , Osteocondrite Dissecante/diagnóstico por imagem , Osteocondrite Dissecante/epidemiologia , Osteocondrite Dissecante/patologia , Radiografia , Esportes , Transplante Autólogo/métodos , Resultado do Tratamento
Einstein (Sao Paulo) ; 18: eAO4739, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553355


OBJECTIVE: To use magnetic resonance imaging to assess the prevalence of foot and ankle ligament injuries and fractures associated with ankle sprain and not diagnosed by x-ray. METHODS: We included 180 consecutive patients with a history of ankle sprain, assessed at a primary care service in a 12-month period. Magnetic resonance imaging findings were recorded and described. RESULTS: Approximately 92% of patients had some type of injury shown on the magnetic resonance imaging. We found 379 ligament injuries, 9 osteochondral injuries, 19 tendinous injuries and 51 fractures. Only 14 magnetic resonance imaging tests (7.8%) did not show any sort of injury. We observed a positive relation between injuries of the lateral complex, syndesmosis and medial ligaments. However, there was a negative correlation between ankle ligament injuries and midfoot injuries. CONCLUSION: There was a high rate of injuries secondary to ankle sprains. We found correlation between lateral ligament injuries and syndesmosis and deltoid injuries. We did not observe a relation between deltoid and syndesmosis injuries or between lateral ligamentous and subtalar injuries. Similarly, no relation was found between ankle and midfoot injuries.

Traumatismos do Tornozelo/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Traumatismos do Tornozelo/diagnóstico por imagem , Brasil/epidemiologia , Cartilagem Articular/lesões , Criança , Feminino , Humanos , Ligamentos Laterais do Tornozelo/lesões , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
Gene ; 724: 144153, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31610221


As heroin and morphine produce reactive oxygen species and down-regulate several genes involved in cellular detoxification and DNA repair pathways, neurons experience DNA damage. Xeroderma pigmentosum complementation group C (XPC, OMIM: 613208) gene, which is expressed in the brain, is one of the central genes in the nucleotide excision repair pathway. Three common XPC polymorphisms (Lys939Gln, Ala499Val and PAT) are associated with reduced DNA repair capacity. In this study, the relationship between these polymorphisms and the risk of heroin dependency (HD), as well as, age of first use (AFU) for illegal drugs was investigated on 795 healthy individuals and 442 heroin dependent patients. Statistical analyses indicated that there was no significant association between the XPC polymorphisms and the risk of HD. The haplotypic frequencies of the polymorphisms showed significant difference between HD patients and healthy controls (χ2 = 16.38, df = 6, P = 0.012). Analysis indicated that the "Ala + Gln" haplotype increased the HD risk more than the "Ala + Lys" haplotype (OR = 4.21, 95% CI = 1.29-13.7, P = 0.017). In Cox proportional model, there was significant association between AFU and the Ala499Val polymorphism (Hazard ratio = 1.53, 95% CI: 1.02-2.92, P = 0.036). To investigate the effect of the linkage between the polymorphic sites, we compared the AFU among two common diplotypes ("Ala - Lys/Ala - Lys" and "Val - Lys/Val - Lys"). Statistical analysis indicated that AFU was significantly lower in "Val - Lys/Val - Lys" diplotype (t = 2.63, df = 49, P = 0.011). The present findings suggest that the XPC is a candidate polymorphic locus for AFU.

Proteínas de Ligação a DNA/genética , Dependência de Heroína/genética , Polimorfismo Genético , Adolescente , Adulto , Fatores Etários , Estudos de Casos e Controles , Feminino , Haplótipos , Humanos , Irã (Geográfico) , Estimativa de Kaplan-Meier , Desequilíbrio de Ligação , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único
Toxicol Lett ; 318: 92-98, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31678399


Sulfur mustard (SM) is a vesicant chemical warfare agent. Recent studies reported alleged use of SM by non-state actors in Syria and Iraq. It has been shown that SM induced immunological and hematological complications. The aim of this study was to determine acute toxic effects of SM exposure on hematological parameters. Blood samples from a group of Syrian exposed to SM in 2016 were taken daily during the follow-up of the patients in intensive care unit. Initial leukocytosis was observed in all patients (100%) on the first 48 h after exposure. Following leukocytosis, isolated lymphopenia was observed in all patients (100%) between 2nd and 4th days. A decrease in hemoglobin level was noted in five patients (62.5%) between 4th and 5th days. Thrombocytopenia was observed in 75% of patients between 4th and 6th days for mild cases and between 9th and 11th days for severe cases. Three patients (37.5%) developed distinct leucopenia/neutropenia on 11th and 12th days. It was observed that human exposure to high dose of SM has direct toxic effect on hematological cells and bone marrow. New strategies on treatment of SM-induced myelosuppression could reduce the effects of hematological complications and could increase the survival rate in these patients.

Medula Óssea/efeitos dos fármacos , Terrorismo Químico , Substâncias para a Guerra Química/envenenamento , Leucocitose/induzido quimicamente , Leucopenia/induzido quimicamente , Linfopenia/induzido quimicamente , Gás de Mostarda/envenenamento , Trombocitopenia/induzido quimicamente , Adolescente , Adulto , Biomarcadores/sangue , Medula Óssea/patologia , Feminino , Hemoglobinas/metabolismo , Humanos , Leucocitose/sangue , Leucocitose/patologia , Leucopenia/sangue , Leucopenia/patologia , Linfopenia/sangue , Linfopenia/patologia , Masculino , Síria , Trombocitopenia/sangue , Trombocitopenia/patologia , Adulto Jovem
Gene ; 723: 144133, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589956


BACKGROUND AND AIM: Autism spectrum disorder (ASD) is one of the neurodevelopmental and cognitive conditions that involves 1 in 160 children around the world. Several studies showed that there is a relationship between vitamin D receptor (VDR) gene polymorphisms with the neurodevelopmental behavioral disorders. In the current study, we aimed to highlight the association of VDR gene polymorphisms (FokI and TaqI) with the risk of autism in Birjand population. MATERIAL AND METHODS: In this case-control study eighty-one patients recognized with ASD and one hundred-eight healthy controls were recruited to the study from 2017 to 2018. Genotyping was carried out by polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) technique for all subjects. RESULTS: Calculated odds ratio and P-value for the alleles of VDR gene FokI and TaqI variants between autistic patients and controls did not show a significant difference (P > 0.05). However, calculated homozygous recessive (tt) for TaqI polymorphism was statistically significant (P = 0.015) in control group and there was also statistically meaningful difference in both case and control groups in ft haplotype (P = 0.04). CONCLUSION: These results provide preliminary evidence that genetic variants of the VDR gene (FokI and TaqI) might have a possible reduced risk of ASD occurrence in children. The additional examination is needed to acquire more decisive and precise results in this area.

Transtorno do Espectro Autista/genética , Polimorfismo de Fragmento de Restrição , Receptores de Calcitriol/genética , Adolescente , Transtorno do Espectro Autista/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Colecalciferol/sangue , Feminino , Estudos de Associação Genética , Testes Genéticos , Humanos , Irã (Geográfico) , Masculino
Rev. Esc. Enferm. USP ; 53: e03491, Jan.-Dez. 2019. graf
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020389


RESUMO Objetivo Relatar as experiências educativas das mães ou cuidadoras de crianças com microcefalia, desenvolvidas por equipe acadêmica na temática da promoção da saúde dessas crianças. Método Trata-se de relato de experiência vivenciado por alunos do curso de graduação em enfermagem, discentes e docentes do programa de Pós-Graduação em Saúde e Ambiente da Universidade Tiradentes sobre intervenções educativas realizadas em três unidades de referência no atendimento à criança com microcefalia no estado de Sergipe. A amostra do estudo foi de conveniência. Resultados Participaram da pesquisa 70 mães ou cuidadoras principais de crianças com diagnóstico confirmado de microcefalia, durante os meses de setembro a dezembro. Os eixos temáticos-teóricos selecionados para descrever as atividades foram promoção da alimentação saudável, importância do vínculo mãe e filho e estimulação precoce de crianças com microcefalia. Conclusão A experiência relatada demostrou a importância das estratégias educativas na promoção da saúde de crianças com microcefalia, proporcionando capacitação adicional às mães/cuidadoras para que estas ofereçam um cuidado holístico e humanizado a essas crianças.

RESUMEN Objetivo Relatar las experiencias educativas de las madres o cuidadoras de niños con microcefalia, desarrolladas por equipo académico en la temática de la promoción de la salud de esos niños. Método Se trata de relato de experiencia vivida por alumnos de la carrera universitaria de enfermería, discentes y docentes del programa de Posgrado en Salud y Ambiente de la Universidad Tiradentes acerca de intervenciones educativas realizadas en tres unidades de referencia en la atención al niño con microcefalia en el Estado de Sergipe. La muestra del estudio fue de conveniencia. Resultados Participaron en la investigación 70 madres o cuidadoras principales de niños con diagnóstico de microcefalia, durante los meses de septiembre a diciembre. Los ejes temáticos-teóricos seleccionados para describir las actividades fueron promoción de la alimentación sana, importancia del vínculo madre e hijo y estimulación precoz de niños con microcefalia. Conclusión La experiencia relatada demostró la importancia de las estrategias educativas en la promoción de la salud de niños con microcefalia, proporcionando capacitación adicional a las madres/cuidadoras a fin de que estas proporcionen un cuidado holístico y humanizado a esos niños.

ABSTRACT Objective To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. Method This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. Results A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. Conclusion The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.

Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Educação em Saúde , Cuidadores , Promoção da Saúde , Microcefalia/terapia , Mães , Entrevista , Enfermagem Familiar , Pesquisa Qualitativa
Rev. Esc. Enferm. USP ; 53: e03464, Jan.-Dez. 2019.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1020376


RESUMEN Objetivo Explorar la construcción social que sobre violencia obstétrica han elaborado mujeres Tének y Náhuatl de México. Método Estudio cualitativo-sociocrítico, mediante gupos focales se profundizó en las experiencias de parto de quienes vivieron un parto en el periodo 2015-2016. Resultados Participaron 57 mujeres. Mediante análisis de discurso se identificó que las participantes no poseen suficiente información sobre violencia obstétrica y/o derechos sexuales y reproductivos, lo que las imposibilita para asociar sus experiencias negativas al término legal "violencia obstétrica". Sus discursos corresponden en su mayoría a lo que desde el marco legal se ha denominado "violencia obstétrica", sin embargo, experiencias como el ayuno prolongado o el uso de tecnologías para la invasión de su intimidad fueron narradas como algo que conciben violento y que no se ha incorporado dentro del término legal. Conclusión Múltiples acciones que atentan contra los derechos humanos de las mujeres tienen lugar dentro de las salas de parto, la mayor parte no son identificadas por las usuarias, puesto que no han construido socialmente la imagen de la violencia obstétrica, ello no las hace menos susceptibles sin embargo, a sentirse agredidas y denigradas en sus partos.

RESUMO Objetivo Explorar a construção social que as mulheres Tének e Náhuatl do México elaboraram sobre a violência obstétrica. Método Estudo qualitativo-sociocrítico; por meio de grupos focais, houve um aprofundamento nas experiências de parto daquelas que passaram por um parto no período de 2015 a 2016. Resultados Participaram 57 mulheres. Mediante análise do discurso, foi identificado que as participantes não possuem informação suficiente sobre violência obstétrica e/ou direitos sexuais e reprodutivos, o que as impossibilita de associar suas experiências negativas ao termo legal "violência obstétrica". Seus discursos correspondem na sua maioria ao que, a partir do marco legal, foi denominado "violência obstétrica"; entretanto, experiências como jejum prolongado ou uso de tecnologias para a invasão da sua intimidade foram narradas como algo que concebem ser violento e que não foi incorporado ao termo legal. Conclusão Múltiplas ações que atentam contra os direitos humanos das mulheres têm lugar dentro das salas de parto, a maior parte não é identificada pelas usuárias, visto que não construíram socialmente a imagem da violência obstétrica, mas isso não as faz menos suscetíveis de sentir-se agredidas e denegridas nos seus partos.

ABSTRACT Objective To explore the social construction of obstetric violence developed by Tenek and Nahuatl women in Mexico. Method Qualitative, socio-critical study conducted through focal groups in which were deepened the childbirth experiences lived in the period 2015-2016. Results Participation of 57 women. Through discourse analysis, it was identified that participants do not have enough information about obstetric violence and/or sexual and reproductive rights. This makes the association of their negative experiences with the legal term "obstetric violence" impossible. Most of their speeches correspond to the legal denomination of "obstetric violence". Experiences like prolonged fasting or the use of technologies for invading their privacy were narrated like situations they perceive as violent, but have not been incorporated within the legal term. Conclusion Multiple actions against women's human rights take place within delivery rooms. Most remain unidentified by users, since they have not socially constructed the image of obstetric violence. However, that fact does not make them less susceptible to feel attacked and denigrated during their childbirth experiences.

Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Salas de Parto , Parto , População Indígena , Violência contra a Mulher , México , Grupos Focais , Pesquisa Qualitativa , Enfermagem Obstétrica
Acta colomb. psicol ; 22(2): 178-193, July-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019281


Abstract Developing programs to prevent alcohol consumption whose impact goes beyond cultural borders represents a challenge since it is necessary to recognize cultural differences that determine consumption. This cross-cultural comparative study was aimed to find the differences in beliefs related to alcohol consumption in a non-randomized stratified sample of 1602 educated teenage men and women and youth (870 Chileans and 732 Colombians) with ages between 14 and 25 years. The instruments used were the Belief Questionnaire Regarding Alcohol Consumption and the Audit Consumption Test. The ANOVA statistic was used to compare the means between countries. Results indicated that Colombians have higher consumption triggers, higher perception of risk and vulnerability, and the highest perception of perceived benefits of consumption. On the other hand, Chileans present significantly greater beliefs regarding the consumption barriers with lower averages in all factors. However, in both populations the averages found indicate moderate and high risk.

Resumo O desenvolvimento de programas de prevenção do consumo de álcool cujo impacto sobrepasse fronteiras culturais representa um desafio importante devido ao fato de que é preciso reconhecer as diferenças culturais determinantes do consumo. O presente estudo comparativo transcultural teve como objetivo conhecer as diferenças nas crenças relacionadas com o consumo de álcool em uma amostra estratificada não aleatorizada de 1602 adolescentes e jovens (870 chilenos e 732 colombianos), homens e mulheres escolarizados com idades entre 14 e 25 anos. Para isso, fez-se uso do Cuestionario de Creencias Referidas al Consumo de Alcohol e o teste AUDIT de consumo. Para comparar as médias entre países, utilizou-se o estatístico ANOVA. Os resultados indicaram que os colombianos têm mais altos gatilhos de consumo, maior percepção de risco e vulnerabilidade, e percepção mais alta de benefícios percebidos com o consumo. Por sua vez, os chilenos apresentaram crenças significativamente maiores com respeito às barreiras de consumo, com menores médias em todos os fatores. Em ambas as populações, as médias reportadas indicaram um risco moderado e alto para o consumo de álcool.

Resumen El desarrollo de programas de prevención del consumo de alcohol cuyo impacto sobrepase fronteras culturales representa un reto importante debido a que se hace necesario reconocer las diferencias culturales determinantes del consumo. El presente estudio comparativo transcultural tuvo como objetivo conocer las diferencias en las creencias relacionadas con el consumo de alcohol en una muestra estratificada no aleatorizada de 1602 adolescentes y jóvenes (870 chilenos y 732 colombianos), hombres y mujeres escolarizados con edades entre los 14 y los 25 años. Para esto, se hizo uso del Cuestionario de Creencias Referidas al Consumo de Alcohol y el test AUDIT de consumo. Para comparar las medias entre países se utilizó el estadístico ANOVA. Los resultados indicaron que los colombianos tienen más altas claves disparadoras de consumo, mayor percepción de riesgo y vulnerabilidad, y percepción más alta de beneficios percibidos con el consumo. Por su parte, los chilenos presentaron creencias significativamente mayores respecto a las barreras de consumo, con menores promedios en todos los factores. En ambas poblaciones las medias reportadas indicaron un riesgo moderado y alto para el consumo de alcohol.

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adolescente , Alcoolismo , Adulto Jovem
Acta colomb. psicol ; 22(2): 292-318, July-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1019286


Abstract Resilience implies a process of positive adjustment to adverse conditions. The growing interest in their study demands the need for valid and reliable measurement instruments that allow assessments with scientific rigor in different types of populations. The aim of the present research was to analyze the psychometric properties of the Resilience Questionnaire for Children and Adolescents. 512 students from a high school of the University of Guadalajara, Mexico, participated. Exploratory factor analysis yielded a four-dimensional composition with 18 items than explain 61.18% of the variance, with an excellent level of reliability (a = .90). Through confirmatory factor analysis, the model was corroborated, presenting adequate levels of adjustment. Convergent validity was assessed using Rosenberg's Self-esteem Scale, obtaining significant positive correlations with the dimensions of resilience. The divergent validity was assessed through the Depression Scale of the Epidemiological Studies Center - Revised, showing significant negative correlations. Results and practical implications are discussed.

Resumo O estudo da resiliência, capacidade que implica um processo de adaptação positiva às condições de adversidade, passou por um crescente interesse nos últimos anos que demanda a necessidade de contar com instrumentos de medição válidos e confiáveis que permitam realizar avaliações com rigor científico em diferentes tipos de população. Por esse motivo, a presente pesquisa teve como objetivo analisar as propriedades psicométricas do Questionário de Resiliência para Crianças e Adolescentes com uma amostra de 512 estudantes do Ensino Médio preparatório da Universidade de Guadalajara, no México. Inicialmente, realizou-se uma análise fatorial exploratória que resultou em uma composição de quatro dimensões com 18 itens que explicam 61,18% da variância, com um nível de confiabilidade alto (a = .90), e uma análise fatorial confirmatória com a qual se corroborou o modelo, com níveis adequados de ajuste. Posteriormente, avaliou-se a validade convergente do instrumento com a Escala de Autoestima de Rosenberg, com a qual foram obtidas correlações positivas significativas com as dimensões da resiliência. E, por último, aplicou-se a validade divergente com a Escala de Depressão do Centro de Estudos Epidemiológicos (Revisada), com a qual foram encontradas correlações negativas significativas. Por fim, discutem-se os resultados e as implicações práticas.

Resumen El estudio de la resiliencia, capacidad que implica un proceso de adaptación positiva a condiciones de adversidad, ha tenido un creciente interés en los últimos años que demanda la necesidad de contar con instrumentos de medición válidos y confiables que permitan hacer evaluaciones con rigor científico en diferentes tipos de poblaciones. Por esta razón, la presente investigación tuvo como objetivo analizar las propiedades psicométricas del Cuestionario de Resiliencia para Niños y Adolescentes con una muestra de 512 estudiantes de una preparatoria de la Universidad de Guadalajara, México. Inicialmente, se realizó un análisis factorial exploratorio que arrojó una composición de cuatro dimensiones con 18 ítems que explican 61.18% de la varianza, con un nivel de confiabilidad alto (a = .90); y un análisis factorial confirmatorio con el que se corroboró el modelo, con niveles adecuados de ajuste. Posteriormente, se evaluó la validez convergente del instrumento con la Escala de Autoestima de Rosenberg, donde se obtuvieron correlaciones positivas significativas con las dimensiones de la resiliencia. Y, por último, se valoró la validez divergente con la Escala de Depresión del Centro de Estudios Epidemiológicos (Revisada), donde se encontraron correlaciones significativas negativas. Al final se discuten los resultados y las implicaciones prácticas.

Humanos , Masculino , Feminino , Adolescente , Análise Fatorial , Adolescente , Resiliência Psicológica
Autops. Case Rep ; 9(4): e2019094, Oct.-Dec. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1024293


Neurofibrosarcoma is a rare malignant neoplasm of the head and neck region and accounts for 8% to 16% of all cases. Its origin is varied and may stem from cells of the peripheral nerves, develop de novo, or result from malignant transformation of preexisting neurofibromas. Because the features of neurofibrosarcomas are heterogeneous, the data retrieved during clinical examinations are of great aid for diagnosis. In this case, owing to clinical features and the fact that the patient had neurofibromatosis type 1, the hypothesis of neurofibrosarcoma was promptly established. The final diagnosis was confirmed by associating clinical, imaging, and pathological data. After the treatment, the patient has been followed up for 10 years, with no evidence of recurrence.

Humanos , Feminino , Adolescente , Neoplasias Bucais/etiologia , Neurofibromatose 1/complicações , Neurofibrossarcoma/diagnóstico , Reconstrução Mandibular , Neurilemoma
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 440-444, Out.-Dez. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1024425


Introduction: Middle ear surgeries, including myringoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Objectives: The objective of the present study was to evaluate the graft uptake rate and to evaluate the hearing results. Methods: This is a prospective study. We have analyzed 139 patients who underwent surgery for chronic otitis media (COM) of the mucosal type. All of the surgeries were performed exclusively under total endoscopic transcanal approach using tragal cartilage as graft, underlay technique. We have evaluated the postoperative graft uptake and performed a hearing evaluation at 6 weeks, at 12 weeks, and at 6 months. Results: During the study period, 139 patients were included, out of which 13 were lost to follow-up; therefore, only 126 patients were assessed. All of the cases were performed under total endoscopic approach. As for the surgical outcome at the postoperative otoscopy, 3 cases had initial uptake at 3 months and failed later; therefore, complete closure of the perforation was observed in 97.6% ( n = 123) of the patients 6 months after the intervention. Four patients presented with preoperative anacusis; therefore, only 122 patients were included for hearing evaluation. The preoperative air conduction threshold (ACT) and airbone gap (ABG) were 43.34 ± 11.53 and 24.73 ± 7.89, respectively. Postoperatively, the ACT and ABG closure were 28.73 ± 15.75 and 11.91 ± 8.41, respectively. This difference was statistically significant ( p < 0.001). Conclusion: The endoscopic approach for myringoplasty offers excellent visualization; avoids postaural approach, enables a faster recovery, requires less hospital stay, with excellent graft closure rate and improved functional outcomes (AU)

Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Cartilagem da Orelha/transplante , Cirurgia Endoscópica por Orifício Natural/métodos , Miringoplastia/métodos , Otite Média , Doença Crônica , Estudos Prospectivos , Resultado do Tratamento , Testes Auditivos
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 403-407, Out.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1024212


Introduction: Tonsillectomy is one of the most common otolaryngology procedures performed worldwide. It is also one of the first procedures learnt by residents during their training period. Although tonsillectomy is viewed relatively as a low-risk procedure, it can be potentially harmful because of the chance of posttonsillectomy hemorrhage. Objective: The objective of the present study is to analyze the effects of peroperative factors and experience of the surgeon on the incidence and pattern of posttonsillectomy reactionary hemorrhage. Methods: A retrospective review of medical charts was performed from 2014 to 2017 in a tertiary care hospital. A total of 1,284 patients who underwent tonsillectomy and adenoidectomy were included in the study. The parameters assessed were experience of the surgeon, operating time, intraoperative blood loss, difference in mean arterial pressure (MAP) and pulse rate. Results: A total of 23 (1.79%) out of the 1,284 patients had reactionary hemorrhage. Out of those 23, 16 (69.5%) patients had been operated on by trainees, while 7 (30.5%) had been operated on by consultants (p = 0.033, odds ratio [OR] = 0.04). Operating time, intraoperative blood loss, difference in MAP and pulse rate were significantly higher in the reactionary hemorrhage group, and showed a positive association with risk of hemorrhage (p < 0.05; OR >1). Re-exploration to control the bleeding was required in 10 (76.9%) out of the 23 cases. Conclusion: The experience of the surgeon experience and peroperative factors have an association with posttonsillectomy hemorrhage. Close surveillance and monitoring of the aforementioned peroperative factors will help in the identification of patients at risk of hemorrhage (AU)

Humanos , Masculino , Feminino , Adolescente , Adulto , Tonsilectomia/efeitos adversos , Hemorragia Pós-Operatória/etiologia , Pulso Arterial , Estudos Retrospectivos , Fatores de Risco , Perda Sanguínea Cirúrgica , Hemorragia Pós-Operatória/terapia , Duração da Cirurgia , Pressão Arterial , Hospitais Universitários , Período Intraoperatório
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 408-414, Out.-Dez. 2019. ilus, tab
Artigo em Inglês | LILACS | ID: biblio-1024235


Introduction: Acute acoustic trauma, which is a kind of sensorineural hearing loss, is caused by acoustic overstimulation. Hyperbaric oxygen therapy (HBOT) is reported to be effective against acute acoustic trauma. Objective: We aimed to evaluate the efficacy of HBOT against acoustic hearing loss based on our 20 years of experience with such cases. Methods: Patients who were treated with HBOT for acute acoustic trauma between April 1997 and August 2017 were evaluated in this study. Thirty-five patients with a mean age of 25.7 ± 9.2 (range: 16­48) years were included. Thirty-nine out of 70 ears (35 patients) were damaged. We investigated the initial level of hearing loss; the extent to which hearing recovered; subjective symptoms, such as tinnitus and aural fullness; and the treatment administered. Results: The planned HBOT was completed in 37 of 39 ears. Twenty-six of the 37 ears (70.2%) displayed improved hearing, and 31 of the 37 ears (83.9%) exhibited symptom improvement. Twenty-three (76.7%) and 26 (86.7%) of the 30 ears treated with steroids demonstrated improvements in hearing and subjective symptoms, respectively. Conclusion: A combination of HBOT and steroids should be considered as a treatment for acute acoustic trauma in cases involving symptoms such as tinnitus and aural fullness (AU)

Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Perda Auditiva Provocada por Ruído/terapia , Oxigenação Hiperbárica , Esteroides/uso terapêutico , Zumbido/terapia , Resultado do Tratamento , Perda Auditiva Neurossensorial/terapia , Testes Auditivos , Hospitais Militares , Japão
Int. arch. otorhinolaryngol. (Impr.) ; 23(4): 415-421, Out.-Dez. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1024301


Introduction: Upper airway obstruction at multiple sites, including the velum, the oropharynx, the tongue base, the lingual tonsils, or the supraglottis, has been resulting in residual obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy (TA). The role of combined lingual tonsillectomy and tongue base volume reduction for treatment of OSA has not been studied in nonsyndromic children with residual OSA after TA. Objective: To evaluate the outcomes of tongue base volume reduction and lingual tonsillectomy in children with residual OSA after TA. Methods: A retrospective chart review was conducted to obtain information on history and physical examination, past medical history, findings of drug-induced sleep endoscopy (DISE), of polysomnography (PSG), and surgical management. Pre- and postoperative PSGs were evaluated to assess the resolution of OSA and to determine the improvement in the obstructive apnea-hypopnea index (oAHI) before and after the surgery. Results: A total of 10 children (5 male, 5 female, age range: 10­17 years old, mean age: 14.5 ± 2.6 years old) underwent tongue base reduction and lingual tonsillectomy. Drug-induced sleep endoscopy (DISE) revealed airway obstruction due to posterior displacement of the tongue and to the hypertrophy of the lingual tonsils. All of the patients reported subjective improvement in the OSA symptoms. All of the patients had improvement in the oAHI. The postoperative oAHI was lower than the preoperative oAHI ( p < 0.002). The postoperative apnea-hypopnea index during rapid eye movement sleep (REM-AHI) was lower than the preoperative REM-AHI ( p = 0.004). Obstructive sleep apnea was resolved in children with normal weight. Overweight and obese children had residual OSA. Nonsyndromic children had resolution of OSA or mild OSA after the surgery. Conclusions: Tongue base reduction and lingual tonsillectomy resulted in subjective and objective improvement of OSA in children with airway obstruction due to posterior displacement of the tongue and to hypertrophy of the lingual tonsils (AU)

Humanos , Masculino , Feminino , Criança , Adolescente , Tonsilectomia , Adenoidectomia , Apneia Obstrutiva do Sono/cirurgia , Língua/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Registros Eletrônicos de Saúde
Rev. méd. Urug ; 35(4): 325-331, dic. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1026238


Introducción: las úlceras genitales se caracterizan por su gran heterogeneidad clínica y etiológica. Pueden corresponder a entidades patológicas cutáneas o sistémicas de naturaleza infecciosa o no infecciosa. Dentro de estas últimas, se destacan las úlceras de Lipschütz y la enfermedad de Behcet. Objetivo: describir cuatro casos clínicos de adolescentes con úlceras vulvares agudas de causa no infecciosa hospitalizadas en dos prestadores del Sistema Nacional Integrado de Salud de Montevideo con el objetivo de brindar herramientas a profesionales para el correcto abordaje diagnóstico y terapéutico. Discusión: la realización de una anamnesis detallada y un examen físico minucioso son esenciales para realizar un adecuado abordaje diagnóstico y terapéutico. En el análisis clínico es importante considerar la edad de la paciente, el inicio de relaciones sexuales, el número, topografía y características de las úlceras incluyendo la presencia o no de dolor, así como la asociación de manifestaciones sistémicas. Resulta necesario el conocimiento de esta patología poco frecuente en niñas y adolescentes cuyo abordaje diagnóstico y terapéutico depende de la orientación etiológica basada en criterios epidemiológicos y clínicos bien definidos. Ello contribuirá a mejorar la calidad de la asistencia y a minimizar las repercu¬siones biológicas y psicológicas.

Introduction: genital ulcers are characterized by great clinical and etiological heterogeneity. They may correspond to infectious or non-infectious skin or systemic pathologies. Lipschütz ulcer and Behcet disease stand out among non-infectious conditions. Objective: to describe four clinical cases of adolescents with non-infectious severe vulvar ulcers hospitalized in two institutions of the national integrated health system in Montevideo, with the purpose of providing professionals with tools for the adequate diagnostic and therapeutic approach. Discussion: a detailed anamnesis questionnaire and a thorough physical examination are of the essence for an adequate diagnostic and therapeutic approach. The clinical analysis should include considering the patient's age, initiation of sexual intercourse, the number, topography and characteristics of the ulcers including finding out whether there is pain or not, as well as the association of systemic manifestations. It is important to learn about this rather unusual condition in girls and adolescents, whose diagnostic and therapeutic approach depends on the etiological orientation based on well-defined epidemiological and clinical criteria. This will contribute to improving the quality of assistance and minimizing biological and psychological effects.

Introdução: as úlceras genitais se caracterizam por uma grande heterogeneidade clínica e etiológica. Podem ser causadas por patologias cutâneas ou sistémicas tanto infecciosas como não infecciosas. Entre as últimas, destacam-se as úlceras de Lipschütz e a doença de Behçet. Objetivo: descrever quatro casos clínicos de adolescentes com úlceras vulvares agudas de causa não infecciosa hospitalizadas em duas unidades de saúde do sistema nacional integrado de saúde de Montevidéu buscando oferecer ferramentas para uma correta abordagem diagnóstica e terapêutica. Discussão: é fundamental realizar uma anamnese detalhada e um exame físico minucioso para uma abordagem diagnóstica e terapêutica adequada. O exame clínico deve incluir a idade da paciente, o inicio das relações sexuais, o número, topografia e características das úlceras incluindo a presencia ou não de dor, bem como a associação com manifestações sistémicas. É necessário conhecer esta patologia pouco frequente em meninas e adolescentes cuja abordagem diagnóstica e terapêutica depende da orientação etiológica baseada em critérios epidemiológicos e clínicos bem definidos. Isso contribuirá para melhorar a qualidade da assistência e a minimizar as repercussões biológicas e psicológicas.

Humanos , Feminino , Criança , Adolescente , Doenças da Vulva/diagnóstico , Doenças da Vulva/etiologia , Úlcera/diagnóstico
Eur. j. psychol. appl. legal context (Internet) ; 11(2): 93-97, jul.-dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-183603


Intimate partner violence (IPV) perpetrators were categorized based on whether they were generally violent (GV) or family only violent (FO) using self-report or arrest records. Classification criteria to assess recidivism in perpetrators of IPV were evaluated herein to determine the incremental validity of using a perpetrator's criminal history in addition to their self-report information for categorization purposes. The concordance rates for categorizing subtypes of male perpetrators were compared for two methods, namely, self-report versus criminal history data. Categorizations were made based on self-reported history of violence and federal criminal records separately. Between measures consistency was defined as whether or not the self-report categorizations matched federal criminal record categorizations. It was hypothesized that self-report would not be sufficient as the sole method of categorizing male perpetrators, and the use of criminal history data would add to the validity of the categorization system. Self-reports of aggression were higher than criminal records of aggression. Using data sources together may yield the best outcomes for offenders and society. Implications are discussed

Se clasificaron los varones que ejercen violencia en las relaciones de pareja (VP) en función de si eran violentos en general (VG) o solo en el entorno familiar (VF), empleando registros de autoinformes o de arrestos. Se analizaron los criterios de clasificación para evaluar la reincidencia de los infractores de VP con el fin de determinar la validez incremental del uso de los antecedentes penales del infractor, además de la información procedente de su autoinforme para la clasificación. Se compararon los índices de concordancia para categorizar los subtipos de infractores masculinos para dos métodos: los datos procedentes de autoinforme y los de antecedentes penales. La categorización se basó en la historia de violencia autoinformada y en los antecedentes penales por separado. La congruencia entre medidas se definió como la coincidencia o discrepancia de la categorización de autoinforme con la categorización de antecedentes penales. Se planteó la hipótesis de que el autoinforme no bastaba como único método para clasificar a los infractores masculinos y que el uso de datos procedentes de antecedentes penales aumentaba la validez del sistema de categorización. Hubo más autoinformes sobre agresión que antecedentes penales de agresión. El uso conjunto de ambos podría tener mejores resultados, tanto para los delincuentes como para la sociedad. Se discuten las implicaciones de estos resultados

Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Violência de Gênero/classificação , Criminosos/psicologia , Agressão/classificação , Comportamento Perigoso , Violência contra a Mulher , Autorrelato/estatística & dados numéricos
Rev. latinoam. cienc. soc. niñez juv ; 17(2): 240-261, jul.-dic. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1043051


Resumen (analítico) Analizamos los factores que promueven la incursión de menores de edad a mercados laborales ilícitos en la frontera norte de México. Se analiza el caso de los niños, niñas y adolescentes de circuito. Llevamos a cabo una revisión bibliográfica, hemerográfica, así como desarrollamos y aplicamos indicadores de desarrollo social en una de las regiones de mayor incidencia del fenómeno y realizamos entrevistas a actores clave en la atención institucional a esta población. Concluimos que este fenómeno tiene un origen multifactorial, pero con un trasfondo geográfico y de deficiencias en desarrollo social con una visión incluyente de la niñez y la adolescencia.

Abstract (analytical) In this study the authors explore the factors that promote the involvement of children and adolescences in illicit labor markets in Mexico's northern border region. The study analyses cases from the population known as circuit children and adolescents. The research includes bibliographic, hemerographic, and statistical analyses, as well as the application of social development indicators in one of the regions that has the highest concentration of cases. The study also included interviews with key informants who provide institutional assistance to this population. The authors conclude that there are multiple factors that contribute to the insertion of minors in illicit labor markets. These can be traced to geographic conditions and a lack of social development that has an inclusive vision for children and adolescents.

Resumo (analítico) Este artigo analisa a relação entre as condições de desenvolvimento social e a incursão de menores de idade em mercados de trabalho ilícitos na fronteira norte do México. Analisa-se o caso de meninos, meninas e adolescentes de circuito. Realizou-se uma revisão bibliográfica, hemerográfica, desenvolveram-se e aplicaram-se indicadores de desenvolvimento social em uma das regiões com maior incidência do fenômeno, e realizaram-se entrevistas com atores-chave no atendimento institucional dessa população. Concluiu-se que esse fenômeno tem origem geográfica e multifatorial, mas com um pano de fundo de deficiências no desenvolvimento social com visão inclusiva da infância e adolescência.

Humanos , Mudança Social , Adolescente , Emigração e Imigração