ABSTRACT
Introdução: as fissuras labiopalatais pertencem ao grupo de anomalias orofaciais, caracterizadas por uma fenda labial e/ou palatal na parte superior da boca, uni ou bilateral. Na literatura, as fissuras apresentam alta prevalência e podem interferir negativamente na vida dos pacientes e familiares, causando alterações estéticas, funcionais e psicossociais. Objetivo: pretendeu-se realizar um levantamento sobre quais aspectos psicológicos têm sido pesquisados neste tema, nos últimos cinco anos. Método: foi realizado um levantamento nas bases de dados SCIELO, LILACS e Periódicos CAPES para subsidiar uma revisão de literatura. Os descritores foram "Fissura labiopalatal", "Fissura labiopalatina", "Fissura labial", "Lábio leporino", "Fenda palatina", "Cleft Palate" e "Cleft Lip", todas associadas com os descritores "Psicologia" e "Psychology". Resultados e Discussão: houve predomínio de estudos com enfoque em aspectos psicológicos identitários, da família (ansiedade, stress, depressão e enfrentamento), desempenho escolar e qualidade de vida. Identificou-se carência de estudos brasileiros, pouco conhecimento sobre a doença e necessidade de maior inserção do psicólogo nas equipes multidisciplinares. Conclusão: conclui-se a relevância da participação dos cuidadores na recuperação deste indivíduo e suporte de enfrentamento diante às adversidades.
Introduction: the cleft cracks are within the group of orofacial anomalies being characterized by cleft lip and / or palate of the mouth at the top and can be unilateral or bilateral, having high prevalence. Studies show that cracks may negatively impact lives of patients and families, especially in relation to the aesthetic, functional and psychological changes. Objective: the aim was to conduct a survey on what aspects have been researched on people with cleft lip and palate in the last five years. Method: a survey was carried out in the SCIELO, LILACS and CAPES Periodic databases to support a literature review. The descriptors were "Cleft Palate", "Cleft Lip", "Cleft Lip", "Cleft Lip", "Cleft Palate", "Cleft Palate" and "Cleft Lip", all associated with the descriptors "Psychology" and "Psychology". Results and Discussion: the results showed a prevalence of studies focusing on psychological aspects of family (anxiety, stress, depression and coping), identity of patients, school performance and quality of life. It identified lack of Brazilian studies, little knowledge about the disease and the need for greater inclusion of psychologist in multidisciplinary teams. Conclusion: a multidisciplinary team is as important as the participation of caregivers to a satisfactory recovery and coping support.
Subject(s)
Psychological Phenomena , Cleft Lip , Craniofacial AbnormalitiesABSTRACT
El diagnóstico y tratamiento de los pacientes con cáncer de recto ha cambiado notoriamente en los últimos decenios. A fin de evaluar la conducta al respecto en nuestro medio, llevamos a cabo un estudio multicéntrico retrospectivo en 18 servicios asistenciales de la Ciudad de Buenos Aires, considerando los pacientes operados entre junio de 2004 y mayo de 2007. En 397 pacientes (mediana de edad: 63.5 años) se registraron y analizaron los datos de demografía, diagnóstico, cirugía, morbimortalidad, patología, radioterapia y quimioterapia consignados en la historia clínica. Constaba el "TNM" en 253 (estadio I: 23.7%, II: 32.8%, III: 39.5%). Se realizó resonancia nuclear magnética de pelvis en 44 (11.1%). Recibieron neoadyuvancia 115 (29%). Se efectuó resección anterior en 170 (42.8%), resección ultrabaja en 95 (23.9%), amputación abdominoperineal en 76 (19.1%). Faltaron datos sobre la escisión del mesorrecto en 135 (34.0%). La mediana de ganglios linfáticos resecados fue de 13; con metástasis: 3. El margen circunferencial de resección se informó en 219 (55.2%). Se empleó quimioterapia en 123 (31%). Se presentaron en Comité de Tumores 98 (24.7% del total). La confrontación de estos resultados con los estándares internacionales muestra una morbimortalidad quirúrgica adecuada a esos estándares, al tiempo que demuestra que fue insuficiente la discusión interdisciplinaria, reducido el empleo de resonancia nuclear magnética para la estadificación, baja la utilización de neoadyuvancia y escasa la mención del tipo de resección mesorrectal efectuada. Este estudio sugiere la conveniencia de una adopción más generalizada de las pautas internacionales y la necesidad de una acción educativa en tal sentido.
Diagnosis and treatment of patients with rectal cancer has changed dramatically in recent decades. In order to assess the approach in this regard in Argentina we conducted a multicenter retrospective study in 18 health care services in Buenos Aires City, including patients operated on between June 2004 and May 2007. Data on demographics, diagnosis, surgery, pathology, radiotherapy and chemotherapy, contained in medical records, were analyzed in 397 patients (median age: 63.5 years).TNM stage was recorded in 253 (I: 23.7%, II: 32.8% and III: 39.5%). Pelvic magnetic resonance imaging (MRI) was performed in 44 patients (11.1%); 115 (29%) received neo-adjuvant therapy. Anterior resection was performed in 170 (42.8%), ultra-low resection in 95 (23.9%) and abdomino-perineal resection in 76 (19.1%) cases. There were no data regarding mesorectal excision in 135 (34.0%). The median number of lymph nodes removed was 13 and the median of nodal metastasis, 3. The circumferential resection margin was reported in 219 (55.2%) cases. Chemotherapy was used in 123 (31%) patients; the modality was postoperative in 40.6%, preoperative in 29.3% and pre plus postoperative in 30.1%. Comparing these data with international standards we observed appropriate results regarding surgical morbidity and mortality, while we found insufficient interdisciplinary discussion, low use of MRI for staging, low use of neo-adjuvant therapy, and scant mention of the type of mesorectal resection performed. This study suggests the desirability of a more widespread adoption of international standards and the need for educational action in this regard.