Current management of patients with cutaneous melanoma with a positive sentinel lymph node / Tratamiento actual de pacientes con melanoma cutáneo y ganglio centinela positivo

Abstract Introduction : Immediate completion lymph node dissection (CLND) performed in patients with a positive sentinel lymph node biopsy (SLNB) cutaneous melanoma is not associated with improved melanoma specific survival versus active surveillance (AS) using nodal ul trasound. Clinical practice experience and outcomes of AS and adjuvant therapy is now starting to be published in literature. Methods : Retrospective analysis of patients with a positive-SLNB between June/2017-February/2022. Impact of management on any-site recurrence free survival (RFS), isolated nodal recurrence (INR), distant metasta sis-free survival (DMFS) and melanoma-specific survival (MSS) was evaluated. Results : From 126 SLNB, 31 (24.6%) were positive: 24 received AS and 7 CLND. Twenty-one (68%) received ad juvant therapy (AS, 67% and CLND, 71%). With a median follow-up of 18 months, 10 patients developed recur rent disease with an estimated 2-yr RFS of 73% (CI95%, 0.55-0.86) (30% in AS group vs. 43% in dissection group; P = 0.65). Four died of melanoma with an estimated 2-yr MSS of 82% (CI 95%, 0.63-0.92) and no differences between AS and CLND groups (P = 0.21). Estimated 2-yr DMFS of the whole cohort was 76% (CI 95%, 0.57-0.88) with no differences between groups (P = 0.33). Conclusion : Active surveillance strategy has been adopted for most positive-SLNB cutaneous melanoma patients. Adjuvant therapy without immediate CLND was delivered in nearly 70% of patients. Our results align with outcomes of randomized control trials and previous real-world data.

Resumen Introducción : La linfadenectomía inmediata (LI) re alizada en pacientes con biopsia de ganglio centinela (BGC) positivo por melanoma cutáneo no está asociada a mejoría en la supervivencia libre de enfermedad vs. vigilancia activa (VA). Resultados oncológicos y experi encia en la práctica clínica con dicha conducta asociados a tratamiento adyuvante comienzan a ser publicados en la literatura. Métodos : Análisis retrospectivo incluyendo paci entes con BGC-positiva por melanoma cutáneo entre junio/2017-febrero/2022. Se evaluó impacto del manejo en: supervivencia libre de recurrencia (SLR), recurren cia ganglionar aislada (RGA), supervivencia libre de metástasis a distancia (SLMD) y supervivencia libre de enfermedad (SLE). Resultados : De 126 pacientes, 31 (24.6%) fueron positi vos: en 24 se realizó VA y en 7 LI. Veintiún pacientes (68%) recibieron tratamiento adyuvante (VA, 67% y LI, 71%). Con una media de seguimiento de 18 meses, 10 pacientes presentaron recurrencia de la enfermedad con una SLR estimada a 2 años del 73% (CI95%, 0.55-0.86) (30% en VA vs. 43% en LI; P = 0.65). Cuatro murieron de melanoma con una SLE a 2 años del 82% (CI 95%, 0.63-0.92); sin diferencia entre ambos grupos (P = 0.21). La SLMD a 2 años de toda la cohorte fue de 76% (CI 95%, 0.57-0.88; P = 0.33). Conclusión : La vigilancia activa se ha adoptado como conducta para la mayoría de los pacientes con BGC-positivo. El tratamiento adyuvante sin linfadenectomía inmediata se realizó en cerca del 70% de nuestra serie. Los resultados de nuestra serie son similares a los re portados en la literatura.

Rare Incidental Foreign Body in the Maxillary Sinus on Routine Radiographic Examination

Accidental entry of any foreign body into the paranasal sinus could be due to known causes or unknown causes with the patient being either symptomatic or sometimes asymptomatic. Such asymptomatic conditions make it difficult to detect the foreign body for an indefinite period which on a longer duration may lead to various complications later. Routine radiographic examination during dental checkup reports to serve a good purpose in these kinds of cases by accidental detection of such foreign bodies in the maxillofacial region leading to early diagnosis and timely management. The present paper highlights the importance of routine radiographs in detecting a rare type of foreign body (nasal stud) in the maxillary sinus in the asymptomatic patient.

Adolescent mothers, self-care and childcare: content validation of an Event History Calendar / Madres adolescentes, autocuidado y cuidado de los hijos: validación del contenido de un calendario histórico de acontecimientos / Mães adolescentes, autocuidado e cuidado infantil: validação de conteúdo de um calendário histórico de eventos

ABSTRACT Objective: To validate the content of the tool Event History Calendar Adolescent Mother: strengthening self-care and child care. Method: Methodological study using the Delphi technique, conducted in two rounds, involving 37 nursing specialists. In data collection, from December/2019 to August/2020, a semi-structured questionnaire composed of 47 items related to the two dimensions of the tool: Self-care and Child Care was used. The Content Validity Index ≥ 0.80 was used to assess agreement among the experts. Qualitative elements were analyzed for clarity and comprehensiveness of content. Results: In the first round, 46 items showed Content Validity Index ≥ 0.80. The qualitative elements pointed out more clarity for the adolescent audience. After the changes, the tool presented 30 items. In the second round, the 30 items evaluated achieved Content Validity Index ≥ 0.80. The qualitative considerations were translated into modifications in the content and sequence in the final version of the tool. Conclusion: The validated tool obtained adequate evaluation of the items of each dimension, related to adolescent mother self-care and child care, with a high degree of comprehensibility.

RESUMEN Objetivo: Validar el contenido de la herramienta Event History Calendar Madre Adolescente: fortaleciendo el autocuidado y el cuidado de los hijos. Método: Estudio metodológico mediante la técnica Delphi, realizado en dos rondas, en el que participaron 37 expertos en enfermería. En la recopilación de datos, de diciembre de 2019 a agosto de 2020, se utilizó un cuestionario semiestructurado compuesto por 47 ítems relacionados con dos dimensiones de la herramienta: Autocuidado y Cuidado del niño. Se utilizó el Índice de Validez del Contenido ≥ 0,80 para evaluar el acuerdo entre los expertos. Se analizaron los elementos cualitativos para comprobar la claridad y exhaustividad del contenido. Resultados: En la primera ronda, 46 ítems presentaron Índice de Validez de Contenido ≥ 0,80. Los elementos cualitativos apuntan a la necesidad de una mayor claridad para el público adolescente. Tras los cambios, la herramienta presentaba 30 ítems. En la segunda ronda, los 30 ítems evaluados alcanzaron un Índice de Validez de Contenido ≥ 0,80. Las consideraciones cualitativas se tradujeron en modificaciones del contenido y la secuencia en la versión final de la herramienta. Conclusión: El instrumento validado obtuvo evaluación adecuada de los ítems de cada dimensión, relacionados al autocuidado de la madre adolescente y al cuidado del niño, con alto grado de comprensibilidad.

RESUMO Objetivo: Validar o conteúdo da ferramenta Event History Calendar Mãe Adolescente: fortalecendo o autocuidado e o cuidado da criança. Método: Estudo metodológico com a técnica Delphi, realizado em duas rodadas, envolvendo 37 especialistas de enfermagem. Na coleta de dados, de dezembro/2019 a agosto/2020, foi utilizado um questionário semiestruturado composto por 47 itens relacionados às duas dimensões da ferramenta: Autocuidado e Cuidado da criança. O Índice de Validade de Conteúdo ≥ 0,80 foi utilizado para avaliar a concordância entre os especialistas. Elementos qualitativos foram analisados quanto à clareza e abrangência do conteúdo. Resultados: Na primeira rodada, 46 itens apresentaram Índice de Validade de Conteúdo ≥ 0,80. Os elementos qualitativos apontaram necessidade de maior clareza para o público adolescente. Após as alterações, a ferramenta apresentou 30 itens. Na segunda rodada, os 30 itens avaliados alcançaram Índice de Validade de Conteúdo ≥ 0,80. As considerações qualitativas foram traduzidas em modificações no conteúdo e sequência na versão final da ferramenta. Conclusão: A ferramenta validada obteve avaliação adequada dos itens de cada dimensão, relacionados ao autocuidado da mãe adolescente e cuidado da criança, com alto grau de compreensibilidade.

Structure internal of the dimension Human Person of the Questionnaire of Health Vulnerability in Heart Failure / Estructura interna de la dimensión Persona Humana del Cuestionario de Vulnerabilidad Sanitaria en la Insuficiencia Cardíaca / Estrutura interna da dimensão Pessoa Humana do Questionário de Vulnerabilidade em Saúde na Insuficiência Cardíaca

ABSTRACT Objective: to analyze the evidence of validity of the internal structure of the dimension Human Person of the Questionnaire of Health Vulnerability in Heart Failure. Method: psychometric study with 1,008 people with heart failure, in a tertiary healthcare institution located in Northeastern Brazil. The internal structure was assessed by exploratory factor analysis with a polychoric correlation matrix, followed by confirmatory factor analysis to verify the quality of the model fit. Internal consistency was measured by composite reliability (CR) and McDonald's omega (ω). Results: psychometric parameters revealed 22-item model, distributed in five factors, total explained variance of 64.9%, factor loadings (0.38 to 0.97) and adequate communalities (0.20 ≤ h2 ≤ 0.98) and acceptable indicators of precision (0.79 ≤ ORION ≤ 0.98), representativeness (0.89 ≤ FDI ≤ 0.99), sensitivity (1.92 ≤ SR ≤ 7.07), factor expectancy (88.3% ≤ EPTD ≤ 97.9%), replicability (0.82 ≤ H-latent ≤ 0.97; 0.81 ≤ H-observed ≤ 0.87) and reliability (CR = 0.92 and ω = 0.83). Adequate adjustment quality was achieved (TLI = 0.99; CFI = 0.99; GFI = 0.99; RMSEA = 0.04 and RMSR = 0.04). Conclusion: We obtained an instrument with good evidence of internal structure validity for construct measurement.

RESUMEN Objetivo: analizar las evidencias de validez de la estructura interna de la dimensión Persona Humana del Cuestionario de Vulnerabilidad Sanitaria en la Insuficiencia Cardíaca. Material y método: estudio psicométrico con 1.008 personas con insuficiencia cardíaca, en una institución de salud terciaria ubicada en el Nordeste de Brasil. La estructura interna fue evaluada por análisis factorial exploratorio con matriz de correlación policórica, seguido de análisis factorial confirmatorio para verificar la calidad del ajuste del modelo. La consistencia interna se midió mediante la fiabilidad compuesta (FC) y el omega de McDonald (ω). Resultados: los parámetros psicométricos revelaron un modelo de 22 ítems, distribuidos en cinco factores, una varianza total explicada del 64,9%, cargas factoriales (0,38 a 0,97) y comunalidades adecuadas (0,20 ≤ h2 ≤ 0,98) e indicadores de precisión aceptables (0. 79 ≤ ORION ≤ 0,98), representatividad (0,89 ≤ FDI ≤ 0,99), sensibilidad (1,92 ≤ SR ≤ 7,07), expectativa de factor (88,3% ≤ EPTD ≤ 97,9%), replicabilidad (0,82 ≤ H-latente ≤ 0,97; 0,81 ≤ H-observado ≤ 0,87) y fiabilidad (CR = 0,92 y ω = 0,83). Se alcanzó una calidad de ajuste adecuada (TLI = 0,99; CFI = 0,99; GFI = 0,99; RMSEA = 0,04 y RMSR = 0,04). Conclusión: Se obtuvo un instrumento con buena evidencia de validez de estructura interna para la medición del constructo.

RESUMO Objetivo: analisar as evidências de validade de estrutura interna da dimensão Pessoa humana do Questionário de Vulnerabilidade em Saúde na Insuficiência Cardíaca. Método: estudo psicométrico com 1.008 pessoas com insuficiência cardíaca, em instituição de saúde terciária situada no Nordeste brasileiro. A estrutura interna foi avaliada por meio de análise fatorial exploratória com matriz de correlação policórica, seguida da confirmatória, para atestar a qualidade do ajuste do modelo. A consistência interna foi medida pela fidedignidade composta (FC) e ômega de McDonald (ω). Resultados: os parâmetros psicométricos revelaram modelo de 22 itens, distribuídos em cinco fatores, variância total explicada de 64,9%, cargas fatoriais (0,38 a 0,97) e comunalidades (0,20 ≤ h2 ≤ 0,98) adequadas, e indicadores aceitáveis de precisão (0,79 ≤ ORION ≤ 0,98), representatividade (0,89 ≤ FDI ≤ 0,99), sensibilidade (1,92 ≤ SR ≤ 7,07), espera do fator (88,3% ≤ EPTD ≤ 97,9%), replicabilidade (0,82 ≤ H-latente ≤ 0,97; 0,81 ≤ H-observado ≤ 0,87) e confiabilidade (FC = 0,92 e ω = 0,83). Alcançou-se qualidade de ajustamento adequada (TLI = 0,99; CFI = 0,99; GFI = 0,99; RMSEA = 0,04 e RMSR = 0,04). Conclusão obteve-se um instrumento com boas evidências de validade de estrutura interna para mensuração do constructo.

Clinical validation of the nursing diagnosis "Risk for delayed child development" / Validación clínica del diagnóstico de enfermería "Riesgo de retraso en el desarrollo infantil" / Validação clínica do diagnóstico de enfermagem "Risco de atraso no desenvolvimento infantil"

ABSTRACT Objective: To validate clinically the risk factors of the nursing diagnosis "Risk for delayed child development". Method: Cross-sectional quantitative study carried out in a specialty outpatient clinic and in family health units with 124 children. The data was collected through interviews with the children's guardians to investigate the risk factors for delay in child development. Results: The tested risk factors affected 108 of the evaluated children (87.1%). In the accuracy tests, most specificity values were above 80% and sensitivity values were lower than 30%. Most risk factors had odds ratio >1, three of which were noteworthy: genetic disorder (OR = 38, p < 0.05) and congenital disorder (OR = 4.4, p < 0.05), among child-related aspects, and impaired cognitive development in parents (OR = 27, p < 0.05), among caregiver-related aspects. Conclusion: The study contributed to a refined diagnostic accuracy, identifying potential associated factors of the evaluated diagnosis.

RESUMEN Objetivo: Realizar la validación clínica de los factores de riesgo del diagnóstico de enfermería "Riesgo de retraso en el desarrollo infantil". Método: Estudio transversal, cuantitativo, realizado en un ambulatorio de especialidades y en unidades de salud de la familia, con 124 niños. Los datos se recogieron a través de entrevistas con los tutores de los niños y se investigaron los factores de riesgo para el retraso en el desarrollo infantil. Resultados: Los factores de riesgo sometidos a prueba estuvieron presentes en 108 de los niños evaluados (87,1%). En las pruebas de precisión, la mayoría de los valores de especificidad fueron superiores al 80% y los valores de sensibilidad fueron inferiores al 30%. La mayoría de los factores de riesgo tenían odds ratio >1, con énfasis en tres: el trastorno genético (OR = 38, p < 0,05) y el trastorno congénito (OR = 4,4, p < 0,05), entre los aspectos relacionados con el niño, y el desarrollo cognitivo deficiente de los padres (OR = 27, p < 0,05), entre los aspectos de los cuidadores. Conclusión: El estudio contribuyó para el refinamiento de la precisión diagnóstica, identificando factores potencialmente asociados con el diagnóstico evaluado.

RESUMO Objetivo: Realizar a validação clínica dos fatores de risco do diagnóstico de Enfermagem "Risco de atraso no desenvolvimento infantil". Método: Estudo transversal, de abordagem quantitativa, realizado em um ambulatório de especialidades e em unidades de saúde da família, com 124 crianças. A coleta de dados ocorreu por meio de entrevistas com os responsáveis pelas crianças e investigou os fatores de risco para atraso no desenvolvimento infantil. Resultados: Os fatores de risco sob teste estiveram presentes em 108 crianças avaliadas (87,1%). Nos testes de acurácia, a maioria dos valores de especificidade foi acima de 80%, e os de sensibilidade, inferiores a 30%. A maioria dos fatores de risco teve odds ratio >1, com destaque para três: distúrbio genético (OR = 38, p < 0,05) e distúrbio congênito (OR = 4,4, p < 0,05), entre os aspectos relativos à criança, e o desenvolvimento cognitivo dos pais prejudicado (OR = 27, p < 0,05), entre os aspectos dos cuidadores. Conclusão O estudo contribuiu para o refinamento da acurácia diagnóstica, identificando fatores potencialmente associados ao diagnóstico avaliado.

Secondary prevention in coronary artery disease: development and content validity of educational messages for mobile phones / Prevenção secundária na doença arterial coronariana: desenvolvimento e validade de conteúdo de mensagens educativas para celulares / Prevención secundaria en la enfermedad de las arterias coronarias: desarrollo y validez de contenido de mensajes educativos para teléfonos móviles

ABSTRACT Objective: To identify information needs of patients with coronary artery disease and develop and validate the content of educational messages for mobile phones for these patients. Method: The study was carried out in three phases: 1) Identification of information needs in relation to coronary artery disease of patients hospitalized for an acute coronary event; 2) Development of templates containing text and pictures about the disease and treatment; 3) Content validity analysis of template evidence through the assessment of 10 experts. Templates were considered validated when the Content Validity Ratio (CVR) was equal to or greater than 0.80. Results: A total of 67 patients were included, and all the information that emerged about the disease was classified as important to very important. Thirty templates were developed (heart function, recommendations on nutrition and exercise, treatments and medications, and clinical signs related to the disease and risk factor control), and the CVR obtained was greater than 0.80. Conclusion: All information needs were categorized by patients as important or very important. The templates were developed and validated considering content and design.

RESUMO Objetivo: Identificar as informações sobre necessidades de pacientes com doença arterial coronariana e desenvolver e validar o conteúdo de mensagens educativas para celulares para esses pacientes. Método: O estudo foi realizado em três fases: 1) Identificação das informações sobre necessidades em relação à doença arterial coronariana de pacientes internados por evento coronariano agudo; 2) Desenvolvimento de templates contendo textos e imagens sobre a doença e tratamento; 3) Análise da validade de conteúdo das evidências do template por meio da avaliação de 10 especialistas. Os templates foram considerados validados quando a Razão de Validade de Conteúdo (RVC) foi igual ou superior a 0,80. Resultados: Foram incluídos 67 pacientes, e todas as informações que surgiram sobre a doença foram classificadas como importantes a muito importantes. Foram desenvolvidos 30 templates (função cardíaca, recomendações de nutrição e exercícios, tratamentos e medicamentos, sinais clínicos relacionados à doença e controle de fatores de risco), e a RVC obtida foi superior a 0,80. Conclusão Todas as necessidades de informação foram categorizadas pelos pacientes como importantes ou muito importantes. Os templates foram desenvolvidos e validados considerando conteúdo e design.

RESUMEN Objetivo: Identificar las necesidades de información de los pacientes con enfermedad de las arterias coronarias y desarrollar y validar el contenido de mensajes educativos para teléfonos celulares para estos pacientes. Método: El estudio se realizó en tres fases: 1) Identificación de necesidades de información sobre enfermedad de las arterias coronarias en pacientes hospitalizados por evento coronario agudo; 2) Desarrollo de templates que contienen textos e imágenes sobre la enfermedad y el tratamiento; 3) Análisis de la validez de contenido de la evidencia del template a través de la evaluación de 10 expertos. Los templates se consideraron validadas cuando el Razón de Validez de Contenido (RVC) fue igual o superior a 0,80. Resultados: Se incluyeron 67 pacientes y toda la información que surgió sobre la enfermedad se clasificó como importante a muy importante. Se desarrollaron 30 templates (función cardiaca, recomendaciones de nutrición y ejercicio, tratamientos y medicamentos, signos clínicos relacionados con la enfermedad y control de factores de riesgo), y la RVC obtenida fue superior a 0,80. Conclusión: Todas las necesidades de información fueron categorizadas por los pacientes como importantes o muy importantes. Los templates fueron desarrollados y validados considerando contenido y diseño.

Effects of total shoulder arthroscopy versus small-incision rotator cuff repair for rotator cuff injury / 中国基层医药

Objective:To investigate the effects of total shoulder arthroscopy versus small-incision rotator cuff repair on shoulder range of motion, postoperative pain, and complications in patients with rotator cuff injury. Methods:The clinical data of 106 patients with rotator cuff injuries treated in Yiwu Central Hospital between June 2018 and July 2021 were retrospectively analyzed. These patients were divided into an observation group and a control group according to different treatment regimens, with 53 patients in each group. The control group underwent arthroscopic small-incision rotator cuff repair. The observation group underwent total shoulder arthroscopy. Perioperative indicators, pain (Visual Analogue Scale score) before surgery and 1, 3, and 6 months after surgery, shoulder range of motion and shoulder-elbow function before surgery, and 3 and 6 months after surgery and postoperative complications were compared between the two groups.Results:Operative time in the observation group was significantly longer than that in the control group [(98.67 ± 12.31) minutes vs. (85.72 ± 10.53) minutes, t = 5.82, P < 0.01). Intraoperative blood loss, postoperative passive shoulder expansion time, and hospital stay in the observation group were (28.66 ± 3.12) mL, (5.61 ± 1.03) days, and (14.17 ± 2.26) days, which were significantly shorter than (37.68 ± 3.59) mL, (7.22 ± 1.41) days and (17.21 ± 3.04) days in the control group ( t = 13.81, 6.71, 5.86, all P < 0.01). After surgery, the Visual Analogue Scale score in each group significantly decreased compared with that before surgery (both P < 0.05). At 1, 3, and 6 months after surgery, the Visual Analogue Scale score in the observation group was (2.46 ± 0.63) points, (1.53 ± 0.42) points, and (1.03 ± 0.26) points, respectively, which were significantly lower than (3.04 ± 0.74) points, (1.84 ± 0.51) points, and (1.21 ± 0.34) points in the control group ( t = 4.35, 3.42, 3.06, all P < 0.01). At 3 and 6 months after surgery, the ranges of motion of shoulder abduction, external rotation, and internal rotation in each group significantly increased compared with those before surgery (all P < 0.05). The scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles in each group were significantly increased compared with those before surgery (both P < 0.05). After treatment, there were no significant differences in the scores of American Shoulder and Elbow Surgeons and the University of California Los Angeles between the two groups (both P < 0.05). By 6 months after surgery, the incidence of complications in the control group was 3.77%. No obvious complications were observed in the observation group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.51, P > 0.05). Conclusion:Compared with small-incision rotator cuff repair, total arthroscopic rotator cuff repair has less invasive trauma and mild pain and is more conducive to postoperative shoulder function recovery.

Study on the relation between the common diseases and the constitution of Traditional Chinese Medicine of plateau-related soldiers / 国际中医中药杂志

Objective:To investigate the common diseases and the Constitution of Traditional Chinese Medicine of plateau-related soldiers, and explore the correlation between them.Methods:A total of 271 plateau-related soldiers in our sanatorium from January 1, 2020 to December 31, 2020 were selected as the subjects. All of them were assessed by the TCM constitution scale and the self-designed disease questionnaire and Sociodemographic information.Results:Eighty two percent of 271 plateau-related soldiers were regarded as paranoid constitution and 17.7% were gentleness type. There 73.1% of plateau-related soldiers had one or more diseases, and 90.9% of them were paranoid constitution. There were 47 cases of respiratory diseases, including 2 cases of gentleness type (4.3%) and 45 cases of paranoid constitution (95.7%); 53 cases of digestive system diseases, including 1 case of gentleness type (1.9%) and 52 cases of paranoid constitution (98.1%); 27 cases of skin diseases, including 1 case of gentleness type (3.7%) and 26 cases of paranoid constitution (96.3%); 148 cases of musculoskeletal diseases, including 15 cases of gentleness type (10.1%) and 133 cases of paranoid constitution (89.9%). The digestive system diseases with the highest proportion of paranoid constitution were selected for TCM Constitution correlation analysis, suggesting that there was a correlation between them( χ2=11.32, P<0.01). People including Qi deficiency and phlegm-dampness were more prone to digestive system diseases ( P<0.01). There was a significant negative correlation between gentleness type and digestive system diseases [ OR=0.17, 95% CI(0.040-0.726); P=0.017], as well as Qi deficiency [ OR=4.98, 95% CI(2.717-9.120)] and phlegm-dampness [ OR=12.00, 95% CI(5.269-27.332)]were risk factors for them ( P<0.01). Conclusions:The overall health level of plateau-related soldiers was not optimistic. The digestive system diseases of them were positively correlated with Qi deficiency and phlegm-dampness.

Characterization of Boar Studs in Brazil / Caracterização das centrais de coleta e processamento de sêmen no Brasil

ABSTRACT: Understanding the flow of processes in swine production systems and how they work is fundamental to improving reproductive performance. We surveyed 32 boar studs in Brazil, representing 61.53% of the total in the country. Commercial lines were the most common breed (59.38%) used in the studs. Individual pens and stalls were the most commonly used as housing system (71.9%), and 81.25% of the studs reported having some form of thermal control system. For most of the studs (62.51%), average weekly sperm concentration was higher than 200 million cells per mL. Also, for most studs (71.88%) average weekly ejaculate volume was more than 250 mL. In 46.88% of the studs each ejaculate yielded 26 to 40 semen doses. In 6.25% of the studs, 3.5 billion sperm cells per dose were used for artificial, intracervical insemination. Sperm concentration in 46.88% of the studs was determined using a computer-assisted system analysis. The assessment of sperm quality was conducted using morphology, concentration, and microbiological testing. Employees working on semen collection had formal education of elementary/middle school (34.38%) and high school (37.5%). Most of the laboratory technicians had frequented high school (75%). The most time-consuming task was semen processing, taking 16 to 25 h a week (46.8%) and 6 to 10 h was allotted for the cleaning of stud facilities (46.8%). The data collected in the present study allow greater knowledge of this important part in the pig production chain in Brazil.

RESUMO: O entendimento dos processos na suinocultura e como estes funcionam é fundamental para o incremento da performance reprodutiva. Por via eletrônica, foi realizada uma investigação com 32 centrais de coleta e processamento de sêmen no Brasil, representando 61,53% do total no país. O número médio de reprodutores por central foi de 122. Reprodutores da linhagem comercial foram os mais frequentemente (59,38%) utilizados nas centrais. As baias para alojamento individual dos reprodutores foram as mais comuns (71,9%) e 81,25% das centrais relataram possuir algum sistema de climatização. Na maioria das centrais (62,51%), a média da concentração espermática foi maior que 200 milhões de espermatozoides/mL. Da mesma forma, a maioria das centrais (71,88%) apresentaram um volume do ejaculado superior a 250 mL. Em 46,88% das centrais um ejaculado produziu de 26 a 40 doses inseminantes. Em 6,25% das centrais eram utilizadas uma concentração de 3,5 bilhões de espermatozoides por dose inseminante na inseminação intracervical. A concentração espermática em 46,88% das centrais era determinada através do sistema CASA. A avaliação da qualidade espermática era realizada através da análise de morfologia, concentração e exame microbiológico das doses inseminantes. Os colaboradores envolvidos com a coleta de sêmen tinham nível de instrução fundamental (43,38%) e médio (37,5%). A maioria dos técnicos no laboratório das centrais tinham ensino médio (75%). A atividade que mais consumia tempo foi o processamento do sêmen, com 16 a 25 horas/semana (46,8%) e 6 a 10 horas era utilizada na limpeza das instalações (46,8%). Os dados coletados no presente estudo permitem um maior conhecimento desse elo da cadeia produtiva da suinocultura no Brasil.

A Study To Compare The Level Of Stigma In Psychiatric And Tuberculosis Patients

INTRODUCTION The study was planned to compare self-stigma experienced by psychiatric patients with tuberculosis patients and its relation to patient‘s age, gender, marital status, employment status and education level. MATERIAL AND METHODS A cross-sectional study was conducted in tertiary care hospital during March- October 2017 comprising patients from psychiatric and tuberculosis groups. We collected data on Socio-demographic Pro forma and the stigma scale & the statistical analysis by SPSS version 16.0. RESULTS Patients attending psychiatry OPD consistently gave responses showing a greater degree of self -stigma than those attending general medicine OPD for tuberculosis. The impact of demographic factors and psychiatric diagnosis on the perception of stigma was not statistically significant. CONCLUSION The findings of this study suggest high self-stigma among patients attending the Psychiatric Clinic in comparison with tuberculosis patients in the same setting. There was no significant correlation between stigma scores, patient‘s diagnosis, and demographic factors.

Development characteristics of empathy and its relationship with aggression in adolescents / 中国心理卫生杂志

Objective:To explore the development characteristics of empathy in adolescents and the relations with aggression.Methods:With multistage stratified random sampling method,15 738 middle school students were selected from 5 provinces across China.The Buss-Warren Aggression Questionnaire Revised in China (BWAQ-RC) and Interactional Reactivity Index (IRI-C)was used to measure adolescents'aggression and empathy.Results:Girls had higher level of empathy than boys (P <0.001).Age and gender were interacted in predicting empathetic con-cern (P <0.001).Perspective taking was significant negative predictor of indirect aggression,physical aggression, hostile and angry (P <0.001),while empathetic concern was significant positive predictor of indirect aggression, verbal aggression,hostile and angry (P <0.001).Empathy was divided into 4 class used the K-Means clustering a-nalysis,namely,low empathy class,high perspective taking class,high empathetic concern class,high perspective taking and empathetic concern class.In contrast to other classes,individuals in low empathy class were more likely to involve in physical aggression (P <0.05),and individuals in high level of perspective taking and empathetic con-cern class were related with less physical aggression and elevated verbal aggression (P <0.05).Individuals in high empathetic concern class exhibited more indirect aggression,hostile and anger than other subgroups (P <0.05). Conclusion:The unbalance development of the two components of empathy may be closely correlated with different conduction of aggressive behaviors.

A cross-sectional study of 4 mental disorders in Chifeng City of Inner Mongolia Autonomous Region / 中国心理卫生杂志

Objective:To describe the epidemiological characteristics of mental disorders in community resi-dents aged 18 years and over in the Chifeng City of Inner Mongolia Autonomous Region.Methods:Six thousand three hundred and seventy six individuals aged 18 years and over were sampled using stratified Probability-Propor-tional-to-Size Sampling in Chifeng City in 2010.All respondents were investigated by face-to-face interview.The Composite International Diagnostic Interview-3.0 Computer Assisted Personal Interview (CIDI-3.0-CAPI)was used to make diagnoses based on the definition and criteria of the Diagnostic and Statistical Manual of Mental Dis-orders,Fourth Edition (DMS-IV).Results:A total of 4528 subjects completed the CIDI-3.0-CAPI.Regarding anxi-ety disorder,mood disorder,substance use disorder,and impulse control disorder,the 30-day adjusted prevalence rates (95%CI)were 2.5%(2.08% -2.99%,0.9%(0.67% -1.23%),0.5%(0.34% -0.76%),and 0.6%(0.41% -0.86%)respectively,and the 12 -month prevalence rates were 4.5% (3.93% -5.15%),2.4%(2.0% -2.90%),1.1% (0.84% -1.45%),and 1.0% (0.74% -1.32%)respectively.The lifetime adjusted prevalence rates were 6.6% (5.92% -7.36%),6.5% (5.81% -7.24%),2.7% (2.26% -3.21%),and 1.4%(1.23% -1.95%)respectively.Conclusion:According to morbidity,anxiety disorders,mood disorder,substance use disorders and impulse control disorders are common in Chifeng City of Inner Mongolia Autonomous Region se-quencely,being a prominent public health problem.

Prevalence rates of depression and anxiety in HIV-infected men who have sex with men / 中国心理卫生杂志

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Stud male-originating chemosignals: A luteotrophic agent.

The chemosignals from mating male are found to be responsible for protecting his coital partner against pregnancy failure induced by strange male or food-deprivation. The stud male pheromone not only provides luteotrophic support in female of vulnerable condition but also exerts luteotrophic effect in pregnancy-blocked females by inducing pseudopregnancy. The luteotrophic stimulus rendered by stud male to prevent pregnancy failure is mediated through the main olfactory system, and not through the accessory olfactory system, since the accessory olfactory system is primarily involved in perceiving the luteolytic stimulus produced from strange male for causing pregnancy failure. It has been shown that pericopulatory period seems to be crucial in females in the formation of stud male chemosignals, and the olfactory luteotrophic memory of stud male is further proved to be a short-term one. The precise mechanism involved in accessing and retaining the stud male chemical cues is unclear. In this brief review an attempt has been made to bring out the luteotrophic process of stud male chemosignals, the olfactory pathway and critical period to access the signals. The possible neural mechanism and neural chemistry underlying the formation and recognition of mating male chemical cues are also highlighted.

The Relationship between Stud Morphology and 5th Metatarsal Proximal Stress Fractures on Soccer Players / 대한스포츠의학회지

This research sets out to define the relationship between stud morphology of soccer shoes and 5th metatarsal proximal stress fractures on soccer players by comparison and analysis. After the pre-survey of 132 soccer players in Gwangju, 107 players who seem to have a 5th metatarsal fracture were selected. We investigated the shape of the studs and asked whether they had ever had a 5th metatarsal proximal stress fracture. We also asked them some questions on factors, which cause stress fracture, such as what position they play, how long they have been playing soccer as athletes and average playing time. And we analyzed correlation between these several factors and whether they had ever had stress fracture using chi-square (x2) test and Logistic regression analysis. We concluded that soccer players who wore bar type studs shoes had a much greater possibility of stress fracture than soccer players who wore the round type. Also we learned that soccer players who play mid-fielder have a much greater possibility of stress fracture than soccer players who play other positions. And the result of logistic regression analysis of relevance between soccer shoes stud morphology and stress fracture shows a statistically significant odd ratio, 6.840. It has been suggested that the morphology of the soccer shoes stud has relevance to the occurrence of stress fracture. Therefore, according to the result of this study, soccer shoes with the round shape are more helpful in preventing 5th metatarsal proximal stress fracture than soccer shoes with the bar shape.

Significance of detection of anti-SmD1 antibody in systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the significance of anti-SmD1 antibody and other auto-antibod- ies in systemic lupus erythematosus(SLE).Methods Forty-four SLE patients and 136 other rheumatic dis- eases patients were studied.The later group included Sj(?)gren's syndrome,undifferentiated connective tissue disease,ankylosing spondylitis,and rheumatoid arthritis.Immunoblotting was used to measure,the anti-SmD1 antibody,ANuA and anti-SSA60 000 antibody.ANA and anti-dsDNA were detected by indirect immunofluo- rescence,immunodotting was used to measure the anti-Sin antibody.Results The seropositive rate of anti- StuD1 was 47.7% in SLE patients.It was much higher than that of anti-Sm(P

Compression fixation with small incision steel plate and stud bolt for calcaneal fractures / 中华创伤骨科杂志

Objective To explore a new surgical procedure of open reduction and internal fixation for intraarticular fractures of calcaneus and its clinic outcome. Methods Between August 2004 and August 2005, 54 feet in 44 patients with calcaneal fracture were treated in our department. Based on the results of X-ray and coronal CT scan before and after treatment, small incision (2-3 cm) at lateral sides of calcaneus, self-made calcaneal anatomical plate and stud bolt were used. According to Sanders classification system, there were 12 cases of type Ⅱ, 32 cases of type Ⅲand 10 cases of type Ⅳ. Results The internal fixation with the calcaneal anatomical plate almost restored the height, length, width, Blher's and Gissane's angles of the calcaneus for the 44 patients. No infection of incision happened. The results were evaluated using Maryland Foot Score. 54 fractures were followed up for 2 to 12 months (averaging 8.3 months) after treatment. Excellent results were noted in 26 fractures,good in 24,fair in 4, and the excellent and good rates were 92.6%. Conclusion The open-reduction and internal fixation with self-made calcaneal anatomical plate and stud bolt is one of the best ways for treatment of fracture of calcaneus.

Surgical treatment of congenital blepharophimosis syndrome and long-term follow-up / 中华医学美学美容杂志

ObjectiveTo summarize long-term effects of different op eration methods to cure congenital blepharophimosis syndrome in the past twenty years. MethodsIn the past twenty years, according to the clini cal features of 74 cases of congenital blepharophimosis syndrome,we adopted one -stage or two-stage technique to do the medial and lateral canthoplasty and/or to correct blepharoptosis. 24 patients accepted post-operative follow-up as l ong as 9 years. ResultsGenerally, Mustrarde technique was adop ted to correct inverse epicanthus for 54 cases, but for 20 patients with mild ep icanthus we adopted other methods. When enlarging the medial canthus, we selecti vely shortened the medial canthal ligament for 36 patients. When transverse tens ion on the upper eyelids was not increased, 33 cases selected one-stage techniq ue to correct this syndrome and obtained the same effects as two-stage techniqu e did for the other 41 cases. Other combined deformations of the patients should be treated in adolescence according to the patients' requirements. ConclusionBy adopting one-stage or two-stage technique to perform the medial and lateral canthoplasty and/or to correct blepharophimosis for con genital blepharophimosis syndrome can reach the satisfactory results if a correc t indication is selected.

Fatigue test of retention force of magnetic attachment and stud-type attachment / 实用口腔医学杂志

Objective:To study retention force durability of root-type attachments.Methods:Five magnetic attachments(Magfit EX-600),semi-precise stud-type attachments(Bedent) and precise stud-type attachments(Dalbo-classic) were fixed on a thermal-cycling and mechanical-loading machine respectively.The retention force of each attachment was measured at the baseline and after every 1,000 cycles of seating-removing.Results:The average retention force of magnetic attachments was(3.85?0.107) N at the baseline which attenuated for 3.38% after 10,000 cycles;The retention force of semi-precise group was(14.10?0.144) N originally and decreased 90.06% of the original force after 10,000 cycles.The primary force of the precise group was 33.14 N and was adjusted to(11.95?0.082) N as baseline attenuating for 74.56%.Conclusion: The retention force of magnetic attachments is lower than the stud attachments but is stable for 10 years.The retention force of stud-type attachments is larger at the baseline but reduced rapidly.

Small renal cell carcinoma: CT and pathologic correlation / 中华放射学杂志

Objective To analyze the correlation of CT and pathological manifestation of small renal cell carcinoma (SRCC). Methods Thirty six SRCC were all diagnosed by surgical pathology. On CT, attenuation value and the amount of enhancement were observed; on pathology, tumor cell characteristics, cell arrangement, the stage and grade of the tumor et al were observed. Results 31 tumors were iso or hypoattenuation on CT and clear cell tumors were dominant in 28 cases; 5 cases were hyperattenuation and 2 of them were granular cell carcinoma. After the contrast enhancement, 31 tumors were enhanced more than 40 HU. 27 of them were solid which had abundant sinusoid vessels; Enhancement in 29 cases was heterogeneous, and on pathology, hemorrhage and necrosis were found in 27 of them. Conclusion The CT findings of SRCC were correlated with tumor cell characteristic and architecture.