RESUMO
INTRODUCTION: Vascular anomalies of the large bowel, commonly referred to as vascular malformations of the colon (VMC) constitute a rare but important condition, potentially causing significant morbidity and mortality. Our aim is to provide an up-to-date, practical summary evaluating this disease entity, focussing on pathogenesis, as well as diagnostic and therapeutic modalities. MATERIALS AND METHODS: We reviewed available data in the literature, and discussed it in the form of a narrative, readily applicable review. RESULTS: Most VMC (over 70%) are detected in the caecum and ascending colon, and affect people aged over 50 years. VMC are almost always symptomatic, presenting with lower bleeding. Endoscopy is crucial to identify and locate VMC, and to treat the lesions. In patients who fail or do not fit endoscopic treatment, aggressive approaches (interventional angiology or surgery) are mandatory. Up to 40% of patients may have relapse in the long term. CONCLUSIONS: VMC are rare but potentially life-threatening. Advances in endoscopic imaging and therapy have improved the results of treatment. Long-term follow-up after treatment is recommended.
RESUMO
Vascular anomalies of the large bowel, commonly known as vascular malformations of the colon (VMC), constitute a rare but important condition, potentially causing significant morbidity and mortality. Our aim is to provide an up-to-date, practical summary evaluating this disease entity, focussing on pathogenesis, as well as diagnostic and therapeutic modalities. We reviewed available data in the literature, and discussed it in the form of a narrative, readily applicable review. Most VMC (over 70%) are detected in the caecum and ascending colon, and affect people aged over 50 years. VMC are almost always symptomatic, presenting with lower bleeding. Endoscopy is crucial to identify and locate VMC, and to treat the lesions. In patients who fail or do not fit endoscopic treatment, aggressive approaches (interventional angiology or surgery) are mandatory. Up to 40% of patients may have relapse in the long term. VMC are rare but potentially life-threatening. Advances in endoscopic imaging and therapy have improved the results of treatment. Long-term follow-up after treatment is recommended.
Assuntos
Doenças do Colo/terapia , Malformações Vasculares/terapia , Ceco/patologia , Colo Ascendente/patologia , Doenças do Colo/diagnóstico , Endoscopia , Humanos , Malformações Vasculares/diagnósticoRESUMO
In recent years psychology has defined for itself an expanding role in health care. Although more and more psychologists have gained entry into medical settings, evaluation efforts directed at assessing progress and obstacles have been extremely limited. The purpose of this study was to gather information from physicians regarding their level of knowledge, acceptance, and utilization of psychologists in hospital settings. Survey responses from 397 physicians to a 15 item paper and pencil questionnaire were analyzed according to medical specialty, type of practice, sex of physician, and number of years in practice. Overall, the findings were quite favorable toward psychologists though differences associated with physicians' age, sex, and specialty did emerge. Discussion of the findings included suggestions underlying the importance of evaluation efforts and methods of improving the future integration of health psychologists into health care organizations.
Assuntos
Atitude do Pessoal de Saúde , Médicos/psicologia , Psicologia Médica , Adulto , Idoso , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-IdadeRESUMO
Reports have appeared recently describing the successful reduction of nocturnal bruxism through nocturnal biofeedback. These claims of effective treatments rest mainly on the use of a single index of integrated masseter EMG levels as a measure of bruxism and are based only on short-term effects. The present study was conducted to provide a more rigorous evaluation of the effectiveness of nocturnal biofeedback for nocturnal bruxism through the use of all-night polysomnographic recordings. The results from multiple indices of bruxism are internally consistent and indicate that simple nocturnal biofeedback does not appear to be effective in reducing nocturnal bruxing. Recommendations are made for a more comprehensive approach to the treatment of nocturnal bruxism.
Assuntos
Biorretroalimentação Psicológica , Bruxismo/terapia , Transtornos do Sono-Vigília/terapia , Adulto , Eletromiografia , Feminino , Humanos , Pessoa de Meia-Idade , Fases do SonoRESUMO
Antibodies (ICA and other organ-specific and non-organ-specific antibodies), HLA histocompatibility antigens and serum IgE levels were analysed in 27 diabetic children aged 2 to 14 years. The results obtained are as follows : 59% of examined subjects had ICA; the HLA-B8 incidence in our diabetic patients was significantly higher (p less than 0.0005) than in normal population; serum IgE levels were higher than +1 SD in 67% of patients; this percentage reaches 76% in diabetics with ICA and 86% in diabetics with ICA and HLA-B8. Enhancement of IgE production could be the consequence of a reduction in the number and/or function of suppressor T lymphocytes.
Assuntos
Diabetes Mellitus Tipo 1/imunologia , Imunoglobulina E/biossíntese , Adolescente , Autoanticorpos/análise , Criança , Pré-Escolar , Antígenos HLA/análise , Antígeno HLA-B8 , Antígenos de Histocompatibilidade/análise , Humanos , Ilhotas Pancreáticas/imunologiaRESUMO
Dehydroepiandrosterone sulphate plasma levels were measured in patients with benign breast disease and in healthy women. In addition the adrenal secretion of dehydroepiandrosterone sulphate was assessed by means of an ACTH stimulation test in some patients and control subjects. The results obtained demonstrate that dehydroepiandrosterone sulphate plasma levels of patients with benign breast disease overlap those found in controls and that the adrenal response to ACTH of patients with breast pathology does not differ from that of healthy women.