Comparaison de deux équations de référence pour le diagnostic des anomalies spirométriques à Cotonou / NA

Introduction : L'interprétation de la spirométrie se base sur des équations de référence, prenant en compte l'âge, le sexe, la taille et la race. Au CNHU-PPC, deux équations ont été utilisées ces dernières années : celles de l'American Thoracic Society/European Respiratory Society "ATS/ERS" (publiées en 1983, actualisées en 1993), et celles du Global Lung Initiative (GLI) 2012, désormais recommandées par plusieurs sociétés savantes. Notre étude visait à comparer les interprétations de spirométries basées sur ces équations. Matériel et méthodes : Nous avons mené une étude rétrospective descriptive, avec recrutement exhaustif des spirométries réalisées au CNHU-PPC du 1er Janvier 2018 au 31 Mars 2020. Les données recueillies furent analysées avec le logiciel R. Le coefficient Kappa a été calculé pour apprécier la performance des équations ATS/ERS par rapport au GLI 2012. Pour tous les tests statistiques, la différence était statistiquement significative pour une p-value inférieure à 0,05. Résultats : Les 955 spirométries recensées concernaient une population majoritairement féminine (sex-ratio=0,7) et jeune (âge moyen=44±20 ans). Il y avait plus de spirométries normales selon les équations ATS/ERS (53,6%, versus 53,0% selon GLI 2012 ; Kappa=0,71). Un TVO était objectivé dans 18,6% des cas selon l'ATS/ERS (versus 18,0% selon GLI 2012, Kappa=0,90). Il y avait moins de TVR selon l'ATS/ERS (21,3%, versus 29 % selon GLI 2012 ; Kappa=0,72), et moins de TVM selon l'ATS/ERS (5,3%, versus 6,6% selon GLI 2012 ; Kappa=0,79). Les proportions d'asthmatiques étaient identiques (12,3%). Les équations ATS/ERS ont objectivé moins de BPCO et de maladies restrictives (respectivement 4,6% et 21,3%) que le GLI 2012 (respectivement 5,8% avec Kappa=0,74, et 29% avec Kappa =0,72). Conclusion : Les équations ATS/ERS objectivent moins d'anomalies spirométriques que celles du GLI 2012 au CNHU-PPC. Des études ultérieures s'imposent pour intégrer les valeurs de référence béninoises au GLI 2012, actuellement récommandées pour l'interprétation de la spirométrie

Introduction: Spirometry's interpretation is based on reference equations, taking into account age, sex, height and race. At the CNHU-PPC, two equations have been used in recent years: those of the American Thoracic Society / European Respiratory Society "ATS/ERS"(published in 1983, updated in 1993), and more recently, those of the Global Lung Initiative (GLI) 2012, now recommended by several learned societies. Objectives: Our study aimed to compare interpretations of spirometry based on these equations. Material and methods: We carried out a descriptive retrospective study, with exhaustive recruitment of the spirometry done at the CNHU-PPC from January 1, 2018, to March 31, 2020. The data collected were analyzed with the software R. The Kappa coefficient was calculated to assess the performance of the ATS/ERS equations compared to GLI 2012. Results: The 955 spirometries recorded concerned a predominantly female (sex ratio=0.7) and young (mean age=44±20 years) population. There was more normal spirometry according to the ATS/ERS (53.6%, vs 53.0% according to GLI 2012; Kappa=0.71). An obstructive ventilatory disorder was objectified in 18.6% of cases according to ATS/ERS (vs 18.0% for GLI 2012, Kappa=0.90). There was less restrictive ventilation disorder according to ATS/ERS (21.3%, vs 29% for GLI 2012; Kappa=0.72), and less mixed ventilatory disorder according to ATS/ERS (5.3%, vs 6.6% for GLI 2012; Kappa=0.79). The proportions of asthma patients were identical (12.3%). ATS/ERS objectified less COPD and restrictive diseases (respectively 4.6% and 21.3%) than GLI 2012 (respectively 5.8% with Kappa=0.74, and 29% with Kappa=0.72).

Can preoperative serum lactate dehydrogenase levels predict postoperative pulmonary complication following an emergency abdominal surgery? An observational study

Background: Postoperative pulmonary complications (PPC) are one of the commonest complications following gastrointestinal surgery. They lead to increase in morbidity and mortality. Lactate dehydrogenase (LDH) is an enzyme present in essentially all major organ systems. Studies have shown measurement of its activity levels and its isoenzyme pattern may provide additional information about lung and pulmonary endothelial cell injury. The objectives of the present study were to study the levels of serum LDH in patients with and without post-operative pulmonary complications following emergency abdominal surgery.Methods: The study was designed as an observational study. All patients ≥18 years of age undergoing gastrointestinal surgery, excluding those with prior lung pathology were included in the study. The demographic parameters, clinical parameters and laboratory parameters along with details of pulmonary complications were recorded. Serum LDH level were assessed on admission. Levels of serum LDH were compared between patients with and without post-operative pulmonary infections and were assessed for significance.Results: Incidence of PPC was 28% in our study. There was significant difference in the mean age in the group with and without PPC (p=<0.001). Smoking habit, serum albumin total protein and upper abdomen incision surgery were associated with increased incidence of PPC. Pleural effusion was the commonest PPC seen in patients. Serum LDH was not significantly associated with the incidence of PPC.Conclusions: Pre-operative serum LDH level is not a predictive factor for occurrence of postoperative pulmonary complication. Age, smoking, total protein, serum albumin, upper abdomen incision were found to associated with increased risk of PPCs.

Enfrentamento à LGBTIfobia, afirmação ético-política e regulamentação profissional: 20 anos da Resolução CFP nº 01/1999 / Coping with LGBTIphobia, ethical-political affirmation and professional regulation: 20 Years of CFP Resolution 01/1999 / Enfrentamiento a la LGBTIfobia, declaración ético-política y regulación profesional: 20 Años de la Resolución CFP 01/1999

O presente artigo analisa, de maneira crítica, os 20 anos da Resolução nº 01/1999 do Conselho Federal de Psicologia. Tal documento regulamenta o exercício profissional sobre orientação sexual; mais exatamente, veta práticas de patologização e discriminação, e incentiva o enfrentamento ao preconceito e à violência. Primeiramente, discutimos como a Resolução foi objeto de debate legislativo e esteve cerceada pelo judiciário, apesar de sua imensa visibilidade, força política e capacidade de garantia de direitos humanos ­ ou, talvez, justamente por isso. Em seguida, analisamos o objetivo de tais ações ­ autorizar práticas que tentam reverter a homossexualidade: elas não têm fundamentos no atual conhecimento psicológico, configuram exercício de tortura e produzem efeitos de intenso sofrimento e adoecimento. Posteriormente, debatemos desafios e possibilidades para posicionamento ético do exercício profissional da Psicologia com homossexualidades em diferentes campos de atuação (educação, justiça e política de saúde) de forma a enfrentar as patologizações. Por fim, interrogamos a votação do Supremo Tribunal Federal sobre a criminalização da LGBTIfobia a partir da criminologia crítica, em dialogo com os efeitos da Resolução no 01/1999. Concluímos que este documento, ainda que insuficiente para eliminar as práticas de LGBTIfobia, segue um instrumento relevante para uma Psicologia de garantia dos direitos humanos...(AU)

This article critically analyzes the 20 years of Resolution nº 01/1999 of the Federal Council of Psychology. This document regulates the professional exercise on sexual orientation; more precisely, it prohibits pathologization and discrimination practices, and also encourages confronting prejudice and violence. Firstly, we discuss how the resolution has been subject of legislative and judiciary actions, despite its immense visibility, political power and capacity to guarantee human rights - or, perhaps, precisely because of them. Then, we analyze the purpose of such actions ­ to authorize practices trying to reverse homosexuality: they do have not basis in current psychological knowledge, configuring a torture exercise and producing intense suffering and illness. Subsequently, we discuss challenges and possibilities for ethical psychological practices with homosexualities in different fields (education, justice and health policy) confronting pathologizations. Finally, we use the critical criminology to question the Federal Supreme Court decision on the LGBTIphobia criminalization, in dialogue with the Resolution's effects. We conclude that even if this document did not eliminate LGBTIphobia practices, is a relevant strategy for psychology to ensure human rights...(AU)

Este artículo analiza críticamente el vigésimo aniversario de la Resolución No. 01/1999 del Consejo Federal de Psicología. Este documento regula el ejercicio profesional sobre orientación sexual; más precisamente, veta las prácticas de patologización y discriminación, y alienta la confrontación de prejuicios y violencia. Primero, discutimos cómo la Resolución fue objeto de debate legislativo y estuvo rodeada por el poder judicial, a pesar de su inmensa visibilidad, fortaleza política y capacidad para garantizar los derechos humanos, o quizás, precisamente por eso. Luego analizamos el propósito de tales acciones: autorizar prácticas que intentan revertir la homosexualidad: no tienen base en el conocimiento psicológico actual, configuran ejercicio de tortura y producen efectos de sufrimiento y enfermedad intensos. Posteriormente, discutimos los desafíos y las posibilidades para el posicionamiento ético de la práctica profesional de la psicología con las homosexualidades en diferentes campos (educación, justicia y política de salud) para enfrentar patologías. Finalmente, cuestionamos el voto de la Corte Suprema sobre la criminalización de la fobia LGBTI por la criminología crítica, en diálogo con los efectos de la Resolución 01/1999.Concluimos que este documento, aunque insuficiente para eliminar las prácticas de LGBTIfobia, sigue una herramienta relevante para una psicología que garantice los derechos humanos...(AU)

Enfrentamento à LGBTIfobia, afirmação ético-política e regulamentação profissional: 20 anos da Resolução CFP nº 01/1999 / Coping with LGBTIphobia, ethical-political affirmation and professional regulation: 20 years of CFP Resolution 01/1999 / Enfrentamiento a la LGBTIfobia, declaración ético-política y regulación profesional: 20 años de la Resolución CFP 01/1999

O presente artigo analisa, de maneira crítica, os 20 anos da Resolução nº 01/1999 do Conselho Federal de Psicologia. Tal documento regulamenta o exercício profissional sobre orientação sexual; mais exatamente, veta práticas de patologização e discriminação, e incentiva o enfrentamento ao preconceito e à violência. Primeiramente, discutimos como a Resolução foi objeto de debate legislativo e esteve cerceada pelo judiciário, apesar de sua imensa visibilidade, força política e capacidade de garantia de direitos humanos - ou, talvez, justamente por isso. Em seguida, analisamos o objetivo de tais ações - autorizar práticas que tentam reverter a homossexualidade: elas não têm fundamentos no atual conhecimento psicológico, configuram exercício de tortura e produzem efeitos de intenso sofrimento e adoecimento. Posteriormente, debatemos desafios e possibilidades para posicionamento ético do exercício profissional da Psicologia com homossexualidades em diferentes campos de atuação (educação, justiça e política de saúde) de forma a enfrentar as patologizações. Por fim, interrogamos a votação do Supremo Tribunal Federal sobre a criminalização da LGBTIfobia a partir da criminologia crítica, em dialogo com os efeitos da Resolução no 01/1999. Concluímos que este documento, ainda que insuficiente para eliminar as práticas de LGBTIfobia, segue um instrumento relevante para uma Psicologia de garantia dos direitos humanos.(AU)

This article critically analyzes the 20 years of Resolution nº 01/1999 of the Federal Council of Psychology. This document regulates the professional exercise on sexual orientation; more precisely, it prohibits pathologization and discrimination practices, and also encourages confronting prejudice and violence. Firstly, we discuss how the resolution has been subject of legislative and judiciary actions, despite its immense visibility, political power and capacity to guarantee human rights - or, perhaps, precisely because of them. Then, we analyze the purpose of such actions - to authorize practices trying to reverse homosexuality: they do have not basis in current psychological knowledge, configuring a torture exercise and producing intense suffering and illness. Subsequently, we discuss challenges and possibilities for ethical psychological practices with homosexualities in different fields (education, justice and health policy) confronting pathologizations. Finally, we use the critical criminology to question the Federal Supreme Court decision on the LGBTIphobia criminalization, in dialogue with the Resolution's effects. We conclude that even if this document did not eliminate LGBTIphobia practices, is a relevant strategy for psychology to ensure human rights.(AU)

Este artículo analiza críticamente el vigésimo aniversario de la Resolución No. 01/1999 del Consejo Federal de Psicología. Este documento regula el ejercicio profesional sobre orientación sexual; más precisamente, veta las prácticas de patologización y discriminación, y alienta la confrontación de prejuicios y violencia. Primero, discutimos cómo la Resolución fue objeto de debate legislativo y estuvo rodeada por el poder judicial, a pesar de su inmensa visibilidad, fortaleza política y capacidad para garantizar los derechos humanos, o quizás, precisamente por eso. Luego analizamos el propósito de tales acciones: autorizar prácticas que intentan revertir la homosexualidad: no tienen base en el conocimiento psicológico actual, configuran ejercicio de tortura y producen efectos de sufrimiento y enfermedad intensos. Posteriormente, discutimos los desafíos y las posibilidades para el posicionamiento ético de la práctica profesional de la psicología con las homosexualidades en diferentes campos (educación, justicia y política de salud) para enfrentar patologías. Finalmente, cuestionamos el voto de la Corte Suprema sobre la criminalización de la fobia LGBTI por la criminología crítica, en diálogo con los efectos de la Resolución 01/1999.Concluimos que este documento, aunque insuficiente para eliminar las prácticas de LGBTIfobia, sigue una herramienta relevante para una psicología que garantice los derechos humanos.(AU)

Transnacionalização do Ensino Superior: Impactos nos Processos Formativos em Psicologia no Brasil / The Transnationalization of Higher Education: the Impacts in the Formative Process in Psychology in Brazil / Transnacionalización de la Enseñanza Superior: Impactos en los Procesos Formativos en Psicología en Brasil

A expansão da educação superior nos últimos anos aprofundou a hegemonia do setor privado que passou a concentrar significativas fatias do mercado, inclusive com a presença de grupos internacionais operando no Brasil. Trata-se de um fenômeno resultante do alargamento da atuação de grupos financeiros em direção à esfera transnacional com a aquisição e fusão de instituições de ensino superior em todo o mundo. O presente trabalho traça um panorama histórico quanto à formação desses grupos no Brasil acompanhado da análise do impacto desse processo na formação em Psicologia e na organização dos cursos em termos do perfil do egresso, objetivos e estrutura curricular. Utilizou-se de um estudo documental, com base nas informações oficiais da educação superior e dos cursos de Psicologia no Brasil, incluindo os projetos pedagógicos de curso (fontes primárias), além de relatórios financeiros e de gestão dos grupos educacionais e consultorias especializadas em fundos de investimentos (fontes secundárias). Os resultados indicam a movimentação de pelo menos três grandes players transnacionais operando no Brasil: Laureate International Universities, DeVry University e Whitney International University System. Juntos detêm 26 instituições de ensino superior, concentrando-se nas regiões Nordeste (58%), Sudeste (25%) e Norte (12,5%). A Psicologia aparece como curso presente na maioria das IES adquiridas pelos grupos investigados (n = 21). Conclui-se que o processo em curso, ao padronizar conteúdos/currículo e homogeneizar determinados processos formativos, pode desvalorizar experiências educacionais locais e aprofundar o descompasso entre os saberes psicológicos e as necessidades sociais do país....(AU)

The spreading of higher education has enhanced the hegemony on the private sector that has concentrated significant slices of the market, including International groups in Brazil. It is a phenomenon resulting of the expansion of the actions of financial groups towards the transnational sphere with the acquisition and fusion of higher education institutions (HEI) around the world. The present work traces a historical panorama about the formation of these groups in Brazil; it is followed by the analysis of the impact of this process in the formation in Psychology and the organization of the courses in terms of alumni profile, objectives and curricular structure. This is a documental study, based on some official information on higher education and psychology courses in Brazil, including pedagogical projects of the course (Primary sources), as well as financial reports and management of educational groups and specialized consulting in funds (Secondary sources). The results indicate the movement of at least three major transnational players operating in Brazil: Laureate International Universities, DeVry University and Whitney International University System. Together they have 26 higher education institutions, concentrated in the Northeast (58%), Southeast (25%) and North (12.5%). Psychology appears as a course present in most HEI acquired by the analyzed groups (n = 21). It is concluded that the current process, by standardizing contents / curriculum and homogenizing certain formative processes, may devalue local educational experiences and deepen the gap between the psychological knowledge and the social necessities of the country....(AU)

La expansión de la educación superior en los últimos años profundizó la hegemonía del sector privado que pasó a concentrar significativas rebanadas del mercado, incluso con la presencia de grupos internacionales operando en Brasil. Este fenómeno resulta de la ampliación de la actuación de grupos financieros hacia la esfera transnacional con la adquisición y fusión de instituciones de enseñanza superior (IES) en todo el mundo. Este trabajo presenta un panorama histórico de la formación de estos grupos en Brasil, un análisis del impacto de ese proceso en la formación en Psicología y en la organización de los cursos en términos del perfil del egresado, objetivo y estructuras curriculares. Se utilizó un estudio documental, basado en las informaciones oficiales de la educación superior y de los cursos de Psicología en Brasil, incluyendo los proyectos pedagógicos (fuentes primarias), informes financieros y de gestión de los grupos educativos y consultorías especializadas en fondos de inversiones (fuentes secundarias). Los resultados indican el movimiento de por lo menos tres grandes players transnacionales operando en Brasil: Laureate International Universities, DeVry University y Whitney International University System. Estos detienen 26 instituciones de enseñanza superior, sobretodo en el Nordeste (58%), el Sudeste (25%) y el Norte (12,5%). El curso de Psicología aparece en la mayoría de las IES de los grupos investigados (n = 21). Se concluye que el proceso en curso, al estandarizar contenidos / currículos y homogeneizar determinados procesos formativos, puede devaluar experiencias educativas locales y profundizar el descompás entre los saberes psicológicos y las necesidades sociales del país....(AU)

Treatment of Paradoxical Puborectalis Contraction (PPC) Using Botulinum Toxin-A

PURPOSE: Paradoxical puborectalis contraction (PPC) or Anismus is known to have a pathogenesis of abnormal contraction of puborectalis at defecation and its managements are not satisfactory. Recently, therapy of PPC and its associated symptoms using Botulinum toxin-A (BTX-A) has been introduced. we evaluate the effect of BTX-A injection to the puborectalis for the patients with PPC. METHODS: Fourteen patients were diagnosed as paradoxical puborectalis contraction on defecography and/or anorectal manometry and electromyography (EMG) during September 1998 to January 2001 in Daegu Catholic Medical Centre, Catholic University of Daegu. All patients were underwent 30 (15 15) units of BTX-A injection on each side of puborectalis guided by EMG. Among them, five patients needed further injection of 20 (10 10) units because the expected results were not satisfied. Follow-up were conducted on one month and one year after BTX-A injection and the patients were assessed for the constipation score and anorectal manometry. RESULTS: After injection of BTX-A, constipation score was significantly decreased from 15.5 +/- 3.5 (mean SD) to 5.7 +/- 4.3. Maximal resting and squeezing pressure also decreased from 48.4 +/- 22 mmHg, 96.9 +/- 39.8 to 41.2 +/- 17, 68.3 +/- 38.2, respectively. Twelve patients who were followed up more than one year after injection, the constipation score (n=12) increased up to 7.7 +/- 2.9 (mean SD). Among them, three patients have had stool softeners or laxatives to evacuate and the remained nine patients did not have any kinds of drug or food for defecation. There was no complication for the injection BTX-A. CONCLUSIONS: BTX-A injection seems to be effective for the treatment of PPC and the long term therapeutic effect can be defined through double blind placebo-controlled trials.