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2.
Rev Med Suisse ; 16(691): 784-788, 2020 Apr 22.
Artigo em Francês | MEDLINE | ID: mdl-32320154

RESUMO

Digital media are central in our modern society and, as such, have an impact not only on teenagers but on most of us. Adolescents are among the most observed and stigmatized in terms of screens use. The encounter between the crucial developmental phase they cross and the neurobiological changes in their brains can be relatively «â€…noisy ¼. Because of the pervasive nature of screens in our daily lives and the potential effect on adolescent health, it is essential for health professionals to offer a systematic assessment of media use when consulting with an adolescent. This article provides practical tools for screening the use of media in consultation with the -adolescent and illustrates with a clinical story what lies behind the screens.


Assuntos
Comportamento do Adolescente , Internet/estatística & dados numéricos , Anamnese/métodos , Encaminhamento e Consulta , Tempo de Tela , Adolescente , Saúde do Adolescente , Humanos
6.
Lancet ; 395(10217): 24-25, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31982047
8.
Monaldi Arch Chest Dis ; 89(3)2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31850694

RESUMO

The reason for this review based on the results of many meta- analyses is the great assessed difference in the methods of most studies in e-Health, telemedicine and tele-rehabilitation. It consists of different understanding of new terms, using different hard- and software, including criteria, different methodology of patient's treatment and its evaluation. This status suggests that first of all m-Health/e-Health requires a unique ontology of terms using and methodology of studies comparing. In this review we try to describe shortly the most significant points of modern e-Health field of medicine. The basic parts include methodology of review formation, tele-communication implementation results, tele-education, interactive questioning, tele-consultation, telemedicine diagnosis, tele-monitoring, rehabilitation and tele-rehabilitation, gamification, acceptability of mobile electronic devices and software in e-Health and planning studies. At the end of the review the new ontological structure of digital medicine is presented.


Assuntos
Pneumologia/métodos , Telemedicina/organização & administração , Tomada de Decisão Clínica/métodos , Computadores , Diagnóstico , Humanos , Anamnese/métodos , Monitorização Fisiológica/métodos , Educação de Pacientes como Assunto/métodos , Satisfação do Paciente , Encaminhamento e Consulta , Reabilitação/métodos , Software
9.
Med Clin North Am ; 103(6): 957-966, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582006

RESUMO

The collection of family history has always been a tool for genetic evaluation, but it remains an essential tool even in the age of genomic medicine. Patients may have a risk for a disease based on family history regardless of the results of genetic and genomic tests. How this information is collected is less important than that relevant information is collected in the first place. There are many tools for collecting medical and family history information both by hand and electronically. Genetic and genomic testing should always be interpreted in the context of the personal and family history.


Assuntos
Testes Genéticos/métodos , Anamnese/métodos , Medicina de Precisão , Humanos , Linhagem , Medição de Risco
11.
BMC Womens Health ; 19(1): 113, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481033

RESUMO

BACKGROUND: Accurately measuring stigmatized experiences is a challenge across reproductive health research. In this study, we tested a novel method - the list experiment - that aims to reduce underreporting of sensitive events by asking participants to report how many of a list of experiences they have had, not which ones. We applied the list experiment to measure "self-managed abortion" - any attempt by a person to end a pregnancy on one's own, outside of a clinical setting - a phenomenon that may be underreported in surveys due to a desire to avoid judgement. METHODS: We administered a double list experiment on self-managed abortion to a Texas-wide representative sample of 790 women of reproductive age in 2015. Participants were asked how many of a list of health experiences they had experienced; self-managed abortion was randomly added as an item to half of the lists. A difference in the average number of items reported by participants between lists with and without self-managed abortion provided a population level estimate of self-managed abortion. In 2017, we conducted cognitive interviews with women of reproductive age in four states to understand how women (1) interpreted the list experiment question format, and (2) interpreted the list item on prior experiences attempting to self-manage an abortion. RESULTS: Results from this list experiment estimated that 8% of women of reproductive age in Texas have ever self-managed an abortion. This number was higher than expected, thus, the researchers conducted cognitive interviews to better understand how people interpreted the list experiment on self-managed abortion. Some women interpreted "on your own" to mean "without the knowledge of friends or family", as opposed to "without medical assistance", as intended. CONCLUSION: The list experiment may have reduced under-reporting of self-managed abortion; however, the specific phrasing of the list item may also have unintentionally increased reporting of abortion experiences not considered "self-managed." High participation in and comprehension of the list experiment, however, suggests that this method is worthy of further exploration as tool for measuring stigmatized experiences.


Assuntos
Aborto Induzido/psicologia , Anamnese/métodos , Saúde da Mulher/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Feminino , Humanos , Gravidez , Pesquisa Qualitativa , Saúde Reprodutiva/estatística & dados numéricos , História Reprodutiva , Projetos de Pesquisa/normas , Estereotipagem , Texas
12.
Lancet ; 394(10198): 596-603, 2019 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-31395442

RESUMO

Family health history (FHH) is the most useful means of assessing risk for common chronic diseases. The odds ratio for risk of developing disease with a positive FHH is frequently greater than 2, and actions can be taken to mitigate risk by adhering to screening guidelines, genetic counselling, genetic risk testing, and other screening methods. Challenges to the routine acquisition of FHH include constraints on provider time to collect data and the difficulty in accessing risk calculators. Disease-specific and broader risk assessment software platforms have been developed, many with clinical decision support and informatics interoperability, but few access patient information directly. Software that allows integration of FHH with the electronic medical record and clinical decision support capabilities has provided solutions to many of these challenges. Patient facing, electronic medical record, and web-enabled FHH platforms have been developed, and can provide greater identification of risk compared with conventional FHH ascertainment in primary care. FHH, along with cascade screening, can be an important component of population health management approaches to overall reduction of risk.


Assuntos
Doença Crônica , Anamnese/métodos , Medição de Risco/métodos , Registros Eletrônicos de Saúde , Humanos , Razão de Chances , Software
13.
Isr Med Assoc J ; 21(6): 376-380, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31280504

RESUMO

BACKGROUND: Hypertrophy of the adenoids is common in children. However, the anatomical site makes the adenoids difficult to assess, and studies evaluating the subject are ambiguous, especially with regard to the use of X-ray as an evaluation tool. OBJECTIVES: To compare medical history with clinical, radiological, and endoscopic evaluations of the adenoids and compare obstructed and non-obstructed children relative to the assessment methods. METHODS: A prospective comparative study was conducted with children who were suspected of having enlarged adenoids. All parents completed a medical history questionnaire and patients underwent clinical evaluation based on Nasal Obstruction Index (NOI) scores, radiological assessment based on the lateral neck X-ray adenoid-nasopharynx (A/N( ratio, and endoscopic evaluation based on anatomical relations. Spearman correlations were used for comparison between methods. RESULTS: We evaluated 36 patients, median age 5.33 years. Correlation measurements for clinical assessment and questionnaire (r = 0.582, P < 0.0001), questionnaire and endoscopy (r = 0.462, P = 0.005), and clinical assessment and nasal endoscopy (r = 0.621, P < 0.0001) were statistically significant. None of the parameters correlated with the radiological findings. A statistically significant difference was found between the obstructed and non-obstructed groups in both questionnaire (P = 0.004) and clinical assessment (P < 0.0001). However, no difference was found in X-ray measurements. CONCLUSIONS: Lateral neck X-ray measurements were not correlated to symptoms, signs, or endoscopic findings. Therefore, medical professionals should use lateral neck radiography when considering adenoidectomy only on a highly selective basis.


Assuntos
Tonsila Faríngea/diagnóstico por imagem , Tonsila Faríngea/patologia , Endoscopia/métodos , Obstrução Nasal/diagnóstico , Obstrução Nasal/patologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Hipertrofia , Masculino , Anamnese/métodos , Obstrução Nasal/diagnóstico por imagem , Estudos Prospectivos , Radiografia
14.
Indian Pediatr ; 56(7): 556-559, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-31333208

RESUMO

OBJECTIVE: To study the histopathological characteristics and mutation spectrum of patients presenting with the Duchenne muscular dystrophy (DMD) phenotype. METHODS: This was a descriptive study conducted over a period of 8 years. Multiplex ligation-dependent probe amplification (MLPA) was done in patients presenting with the DMD phenotype. If MLPA was negative, patients were offered muscle biopsy for histopathological studies and/or next generation sequencing (NGS) based multigene panel testing for muscular dystrophies. RESULTS: Of the 510 patients included, mutation in the DMD gene was detected by MLPA in 372 (72.9%), of whom 342 (67.1%) had exonic deletions and 30 (5.9%) had exonic duplications. Exons 45-55 were most commonly involved in large deletions and exons 1-10 were the commonest exons involved in duplications. In the MLPA-negative cohort, 27 proceeded for muscle biopsy. NGS was done in 14 patients, 10 of whom had pathogenic mutations in the DMD gene, 3 were non dystrophinopathies and no pathogenic variant could be identified in one patient. CONCLUSIONS: For patients presenting with the DMD phenotype, MLPA of the DMD gene has a high diagnostic rate of about 73%, and non-dystrophinopathies may constitute a small but significant proportion.


Assuntos
Biópsia/métodos , Distrofina/genética , Testes Genéticos , Distrofia Muscular de Duchenne , Adolescente , Idade de Início , Criança , Pré-Escolar , Testes Genéticos/métodos , Testes Genéticos/estatística & dados numéricos , Humanos , Imuno-Histoquímica , Índia/epidemiologia , Masculino , Anamnese/métodos , Transtornos das Habilidades Motoras/diagnóstico , Transtornos das Habilidades Motoras/epidemiologia , Reação em Cadeia da Polimerase Multiplex/métodos , Distrofia Muscular de Duchenne/diagnóstico , Distrofia Muscular de Duchenne/epidemiologia , Distrofia Muscular de Duchenne/genética , Distrofia Muscular de Duchenne/fisiopatologia , Mutação , Avaliação de Sintomas/métodos , Centros de Atenção Terciária/estatística & dados numéricos
15.
Surg Clin North Am ; 99(4): 711-720, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31255201

RESUMO

Family history is an essential component of the workup of endocrine surgery patients. The family history can change the diagnosis, management, and follow-up of endocrine patients. Here we discuss the importance of family history, review familial endocrine disorders, and develop a list of pertinent questions to ask when taking a family history of patients with endocrine disorders.


Assuntos
Gerenciamento Clínico , Procedimentos Cirúrgicos Endócrinos/métodos , Doenças do Sistema Endócrino/diagnóstico , Anamnese/métodos , Doenças do Sistema Endócrino/genética , Doenças do Sistema Endócrino/cirurgia , Testes Genéticos , Humanos
16.
Rev. argent. salud publica ; 39(9): 19-24, Julio 2019. Tab
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1007688

RESUMO

INTRODUCCIÓN: Los cánceres de mama (CM) y colorrectal (CCR) presentan una elevada carga de enfermedad en Argentina, por lo que el estudio de la epidemiología de estos tumores constituye una prioridad en salud pública. El objetivo del presente trabajo fue describir la prevalencia de antecedentes familiares de CM y CCR, y estimar la incidencia de los tumores en adultos de 35 a 74 años de dos ciudades de Argentina: Bariloche y Marcos Paz. MÉTODOS: En el marco de la cohorte prospectiva de población general CESCAS I (Estudio de detección y seguimiento de enfermedad cardiovascular y factores de riesgo en el Cono Sur de Latinoamérica), se recolectó información individual sobre antecedentes familiares de CM y CCR en una muestra representativa de las ciudades de Bariloche y Marcos Paz. Los casos de cáncer fueron investigados mediante documentación médica respaldatoria. RESULTADOS: Durante 2016-2017 se obtuvo información de 3245 participantes. El 8,4% de la población reportó antecedente familiar de CCR, y el 15,2% de las mujeres, de CM. La incidencia anual para el período 2011-2017 fue de 55,2/100 000 mujeres de 35 a 74 años (IC95%: 22,8-133,7) para CM y 8,5/100 000 adultos de 35 a 74 años (IC95%: 15,3-96,8) para CCR. CONCLUSIONES: Además de garantizar el acceso universal a los programas de tamizaje, se debe tener en cuenta la importancia de indagar sobre los antecedentes familiares de cáncer para identificar pacientes con riesgo aumentado, que requieren algoritmos particulares de detección temprana y vigilancia.


INTRODUCTION: Breast cancer (BC) and colorectal cancer (CRC) both present a high burden of disease in Argentina. Hence, studying the epidemiology of these tumors constitutes a public health priority. The objective of this study was to describe the prevalence of family history of BC and CRC and to estimate the incidence of these tumors in adults aged between 35 and 74 years from two cities in Argentina: Bariloche and Marcos Paz. METHODS: As part of the prospective population-based cohort CESCAS I (Study of detection and monitoring of cardiovascular disease and risk factors in the Southern Cone of Latin America), individual information on family history of BC and CRC was collected from a representative sample of the cities of Bariloche and Marcos Paz. Cancer cases were investigated using supporting medical documentation. RESULTS: During 2016-2017, information from 3245 participants was obtained. Family history of CRC was reported by 8.4% of the population, and 15.2% of women reported a family history of BC. The annual incidence for the 2011-2017 period was 55.2/100 000 women aged 35 to 74 years (95%CI: 22.8-133.7) for BC and 38.5/100 000 adults aged 35 to 74 years (95%CI: 15.3-96.8) for CRC.CONCLUSIONS: Besides guaranteeing universal access to screening programs, it is important to evaluate family history of cancer to identify patients with increased risk, who require specific early detection and surveillance algorithms.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias Colorretais/epidemiologia , Argentina/epidemiologia , Coleta de Dados/métodos , Anamnese/métodos
17.
J Am Assoc Nurse Pract ; 31(6): 327-329, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31205282

RESUMO

Family history risk assessment can identify individuals at increased risk of colorectal cancer (CRC) who would benefit from earlier or more frequent CRC screening. Clinicians should evaluate the patient's family history as well as personal history to identify red flags and patterns that may suggest predisposition to CRC and then use that information to stratify risk into average, increased, and high risk categories to inform genetic counseling recommendations and personalized management.


Assuntos
Neoplasias Colorretais/diagnóstico , Anamnese/métodos , Adulto , Neoplasias Colorretais/genética , Detecção Precoce de Câncer , Feminino , Aconselhamento Genético/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos
18.
Int Braz J Urol ; 45(4): 798-806, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31184452

RESUMO

OBJECTIVES: To determine the differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VSDirected) to predict voiding dysfunction in women. MATERIALS AND METHODS: Retrospective study of women with prior anti-incontinence surgery evaluated during 5 years. In a standardized clinical history taking, each patient was asked to answer question number fi ve of the UDI-6 questionnaire ("Do you experience any difficulty emptying your bladder?"). If the answer was positive, the following voiding symptoms spontaneously described by the patient were documented: slow urine stream, straining to void, intermittent stream and feeling of incomplete bladder emptying, which were considered VS-Open. If the answer to this question was negative or if the patient had not reported the four voiding symptoms, she was asked in a directed manner about the presence of each of them, which were considered VS-Directed. Voiding dysfunction was considered the presence of a maximum fl ow ≤ 12 mL/s and/ or a postvoid residual > 100 mL. RESULTS: Ninety-one women are analyzed. Eighteen patients presented voiding dysfunction (19.8%), There was a statistical association between voiding dysfunction and the presence of any VS-Open (p = 0.037) and straining to void obtained by open anamnesis (p = 0.013). Sensitivity, specificity, PPV, NPV, positive likelihood ratio and negative likelihood ratio, respectively, were 44.4% and 27.8%, 80.8% and 94.5%, 36.3% and 55.6%, 85.5% and 84.1%, 2.324 and 5.129, and 0.686 and 0.764. There was no statistical association between voiding dysfunction and VS-Directed. CONCLUSIONS: VS-Open may predict better voiding dysfunction than VS-Directed in women.


Assuntos
Anamnese/métodos , Transtornos Urinários/diagnóstico , Transtornos Urinários/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Valores de Referência , Reprodutibilidade dos Testes , Estudos Retrospectivos , Inquéritos e Questionários , Bexiga Urinária/fisiopatologia , Incontinência Urinária/cirurgia , Urodinâmica
19.
J Perinat Med ; 47(6): 656-664, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31211690

RESUMO

Objective To identify socio-cultural and clinician determinants in the decision-making process in the choice for trial of labor after cesarean (TOLAC) or elective repeat cesarean section (ERCS) in delivering women. Methods A tailored questionnaire focused on epidemiological, socio-cultural and obstetric data was administered to 133 patients; of these, 95 were admitted for assistance at birth at Fondazione Policlinico Universitario "A. Gemelli" (FPG) IRCCS, Rome, and 38 at S. Chiara Hospital (SCH), Trento, Italy. Descriptive analysis and logistic regression modeling were performed. Results Vaginal birth after cesarean (VBAC) rates were higher at SCH than at FPG (68.4% vs. 23.2%; P < 0.05). Maternal age in the TOLAC/VBAC group was significantly higher at SCH than at FPG (37.1 vs. 34.9 years, P < 0.05). High levels of education and no-working condition corresponded to a lower rate of VBAC. Proposal on delivery mode after a previous CS was missed in the majority of cases. Participation in prenatal course was significantly less among women in the ERCS groups. Using logistic regression, the following determinants were found to be statistically significant in the decision-making process: maternal age [odds ratio (OR) = 0.968 (95% confidence interval [CI] 0.941-0.999); P = 0.019], education level [OR = 0.618 (95% CI 0.419-0.995); P = 0.043], information received after the previous CS [OR = 0.401 (95% CI 0.195-1.252); P = 0.029], participation in antenatal courses [OR = 0.534 (95% CI 0.407-1.223); P = 0.045] and self-determination in attempting TOLAC [OR = 0.756 (95% CI 0.522-1.077); P = 0.037]. Conclusion In the attempt to promote person-centered care, increases in TOLAC/VBAC rates could be achieved by focusing on individual maternal needs. An ad hoc strategy for making birth safer should begin from accurate information at the time of the previous CS.


Assuntos
Recesariana , Cesárea , Prova de Trabalho de Parto , Nascimento Vaginal Após Cesárea , Adulto , Cesárea/psicologia , Cesárea/estatística & dados numéricos , Recesariana/psicologia , Recesariana/estatística & dados numéricos , Cultura , Tomada de Decisões , Feminino , Humanos , Itália/epidemiologia , Idade Materna , Anamnese/métodos , Preferência do Paciente , Assistência Centrada no Paciente/métodos , Assistência Centrada no Paciente/normas , Gravidez , Pesquisa Qualitativa , História Reprodutiva , Fatores Sociológicos , Nascimento Vaginal Após Cesárea/psicologia , Nascimento Vaginal Após Cesárea/estatística & dados numéricos
20.
J Am Assoc Nurse Pract ; 31(6): 327-329, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31181053

RESUMO

Family history risk assessment can identify individuals at increased risk of colorectal cancer (CRC) who would benefit from earlier or more frequent CRC screening. Clinicians should evaluate the patient's family history as well as personal history to identify red flags and patterns that may suggest predisposition to CRC and then use that information to stratify risk into average, increased, and high risk categories to inform genetic counseling recommendations and personalized management.


Assuntos
Neoplasias Colorretais/diagnóstico , Anamnese/métodos , Adulto , Neoplasias Colorretais/genética , Detecção Precoce de Câncer , Feminino , Aconselhamento Genético/métodos , Humanos , Masculino , Pessoa de Meia-Idade
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