ABSTRACT
Antecedentes. se encuentran algunos vacíos en las diferentes revisiones científicas respecto al análisis de diversas variables en el trastorno obsesivo compulsivo en niños y adolescentes. Objetivo. describir respuestas a preguntas planteadas por los autores en relación a factores sociodemográficos, interferencias, comorbilidades, curso, seguimiento y tratamiento. Material y métodos. Estudio Descriptivo observacional y retrospectivo; realizado en el servicio de la psiquiatría infantil de consulta externa de la Fundación Hospital la Misericordia, a menores de 18 años que presentaron diagnóstico de trastorno obsesivo compulsivo entre enero del 2006 a diciembre del 2010, con revisión de 88 historias clínicas. Resultados. Los factores sociodemográficos presentaron predominio en género masculino, promedio de edad once años, Comorbilidades se presentaron tanto médicas en un 52%, como psiquiátricas 92%. Interferencias: Se presentó mayor interferencia asociada en colegio y vida social en un 28%, además de mayor dificultad en tener amigos en un 65%. Seguimiento, curso y tratamiento: seguimiento en lapso mayor de un año se presentó en el 34% de los sujetos; con reporte de mejoría en la última consulta realizada del 53%; cuyo principal síntoma en mejorar fue la ansiedad en la totalidad de pacientes en un 69%; con tratamiento farmacológico en el 86% de los 88 sujetos evaluados. Conclusión. Es llamativo en el curso de la enfermedad la presencia como uno de los ejes cardinales de comorbilidades tanto como causa de solicitud de atención médica, como en su curso y pronóstico, seguido por la presencia de interferencia en el paciente que en la mayoría de ocasiones no es evidenciado por los padres razón que probablemente explicaría la demora en el diagnóstico de esta patología.
Background. The present study describes gaps in scientific reviews regarding obsessive compulsive disorder (OCD) in children and adolescents concerning. questions raised about sociodemographic factors, interference, comorbidity, ongoing monitoring and treatment. Methods. This retrospective, observationaldescriptive study was carried out in the Misericordia Hospital's child psychiatry service's outpatient clinic; it involved reviewing 88 medical records for children aged less than 18 who had been diagnosed as suffering from OCD between January 2006 and December 2010. Results. The sociodemographic factors revealed male predominance, average age being eleven years old. There was 52% medical and 92% psychiatric comorbidity. Greater emotional interference occurred regarding school and social life (28%) and greater difficulty in having/keeping friends (65%). The study revealed that 34% of the subjects had been followedup for longer than one year, improvement in 53% of the cases having been reported by the time of the last consultation. Anxiety was the main symptom reported to have become improved in all patients (69%), 86% of the 88 subjects' records evaluated having shown that they had received pharmacological management. Conclusion. The presence of comorbidity was striking in the course of the disease; it was the cause of medical care having been sought (during its course and prognosis) and patients' emotional interference which was usually not noted by their parents. This would probably explain the delay in diagnosing this disorder.
ABSTRACT
There is little information about which laboratory and imaging study and when should be taken to assess patients after nephrectomy of renal cell carcinoma. Commonly ordered tests during the postoperative followup include serum liver function studies, chest X-ray, and abdominal pelvic computerized tomography, Less commonly used test include bone scans and chest computerized tomography. To define better which patients require more intensive followup, we retrospectively reviewed 52 patients who underwent radical nephrectomy with a final pathological diagnosis of renal cell carcinoma. Of the patients 8 were excluded for node positive or extension to an adjacent organ. Among the remaining 44 patients, localized disease 15 cases with stage TlN0M0 recurred null, 16 cases with stage T2N0M0 recurred in 12.5%, 9 cases with T3aN0M0 and 4 cases with T3bN0M0 recurred in 55.6% and 100% respectively. The average interval to recur was 22 months for patients with stage T2 tumor and 16.8 months with stage T3a, and 5.7 months for those with stage T3b disease. Based on our data, followup studies should be done appropriately and cost effectively according to the pathological stage of disease.