Isoniazid use, effectiveness, and safety for treatment of latent tuberculosis infection: a systematic review

ABSTRACT Background: The treatment strategy for latent tuberculosis infection is to reduce the number of tuberculosis cases and consequently reduce the transmission of pathogenic bacteria. This study aimed to determine the safety, effectiveness, and adherence of isoniazid use for latent tuberculosis infection treatment. Methods: To identify studies on isoniazid use for latent tuberculosis infection, five electronic databases were searched. The methods and results are presented in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Most studies (53) used isoniazid for 9 months. The prevalence of use and adherence to treatment varied considerably (18% to 100%), and were evaluated by participant completion of isoniazid treatment for latent tuberculosis infection. The adverse events most frequently reported were hepatotoxicity, gastric intolerance, and neuropathy; the rates of occurrence ranged from < 1% to 48%. In the studies that evaluated the effectiveness of isoniazid for latent tuberculosis infection, the rate varied from 0 to 19.7% for patients who did not have active tuberculosis after the follow-up period. Conclusions: The importance of maintaining follow up for patients using isoniazid should be emphasized due to the risk of developing adverse events. Despite the treatment challenges, the rates of patients who used isoniazid and developed active tuberculosis during the follow-up period were low. We believe that isoniazid continues to contribute to tuberculosis control worldwide, and better care strategies are required.

Alternative therapies for viral infections caused by SARS-Cov-2 / Terapias alternativas para infecções virais causadas pelo SARS-Cov-2

Abstract Introduction The relevance of the studied topic lies in the complexity of the treatment of infection caused by SARS-CoV-2. Objective To discuss the potential advantages and disadvantages of alternative treatments compared to conventional medical approaches, and to highlight the importance of collaborative communication between patients and healthcare providers in making informed decisions about alternative treatments of the SARS-CoV-2 virus. Methods The research methodology employed literature analysis methods, including bibliographic and bibliosemantic approaches. The study used theoretical, systematic, and statistical methods, including analysis, synthesis, generalization, interpretation, classification, and meta-analysis to explore alternative treatments for SARS-CoV-2 infections, their interrelationships, and statistical trends in incidence. Results The study identifies diverse alternative therapies for treating SARS-CoV-2 infections, highlighting herbal medicine, acupuncture, reflexology, biohacking, homoeopathy, and magnetotherapy. It underscores the potential benefits of herbal remedies like garlic, ginger, chamomile, and honeysuckle, as well as vitamins (C, D, B12) and minerals (zinc, selenium) in managing COVID-19 symptoms. Conclusion While of-fering holistic benefits, these therapies warrant cautious consideration due to limited scientific backing and potential interactions. Cultural understanding, patient-provider dialogue, and informed choices are key in harnessing the potential of alternative medicine along-side conventional approaches for managing COVID-19 challenges.

Resumo Introdução A relevância do tema estudado reside na comple-xidade do tratamento da infeção causada pelo SARS-CoV-2. Objetivo Discutir as potenciais vantagens e desvantagens dos tratamentos alternativos em comparação com as abordagens médicas convencionais e realçar a importância da comunicação colaborativa entre os doentes e os prestadores de cuidados de saúde na tomada de decisões informadas sobre os tratamentos alternativos do vírus SARS-CoV-2. Métodos A metodologia de investigação utilizou métodos de análise da literatura, incluindo abordagens bibliográficas e bibliosemânticas. O estudo utilizou métodos teóricos, sistemáticos e estatísticos, incluindo análise, síntese, generalização, interpretação, classificação e meta-aná-lise para explorar tratamentos alternativos para as infecções por SARS-CoV-2, suas inter-relações e tendências estatísticas da incidência. Resultados O estudo identifica diversas terapias alternativas para o tratamento das infecções por SARS-CoV-2, destacando a fitoterapia, a acupunctura, a reflexologia, o biohacking, a homeopatia e a magnetoterapia. Sublinha os potenciais benefícios dos remédios à base de plantas como o alho, o gengibre, a camomila e a madressilva, bem como das vitaminas (C, D, B12) e dos minerais (zinco, selénio) na gestão dos sintomas da COVID-19. Conclusão Embora ofereçam benefícios holísticos, estas terapias devem ser consideradas com cautela devido ao apoio científico limitado e às potenciais interações. A compreensão cultural, o diálogo paciente-prove-dor e as escolhas informadas são fundamentais para aproveitar o potencial da medicina alternativa juntamente às abordagens convencionais para gerir os desafios da COVID-19.

Complicaciones y re intervenciones de las cintas transobturadoras y retropúbicas en el Hospital Militar Central, Bogotá 2015-2020

la incontinencia urinaria (IU), se define por la Sociedad Internacional de Continencia, como la perdida involuntaria de orina, una condición potencialmente tratable con disminución de la calidad de vida de las mujeres en diferentes aspectos, entre ellos la salud sexual con su pareja y su bienestar social. Se han descrito que solo el 44,9 % de las mujeres consultan, teniendo mayores tasas de depresión y ansiedad. El objetivo de esta investigación fue determinar la aparición de complicaciones intraoperatorias y posoperatorias con la realización de cintas transobturadora y retropúbica en el Hospital Militar Central en Bogotá durante el periodo 2015 al 2020. Se realizó un estudio observacional, descriptivo, retrospectivo de corte longitudinal, en el Hospital Militar Central en Bogotá; se incluyeron todas las pacientes con diagnósticos de incontinencia urinaria, tanto de esfuerzo, como de urgencias y/o mixtas, intervenidas con cintas medios uretrales libres de tensión por vía retropúbica o transobturadora. Las complicaciones posteriores al procedimiento quirúrgico la más prevalente fue el dolor con un 96,8 %, seguida de infección urinaria o expulsión de la banda con un 8,6 %; entre otras complicaciones menos frecuentes como hematomas, dispareunia y abscesos. La mayoría de las pacientes obtuvieron una adecuada respuesta clínica en el postoperatorio, el 77 % no requirió ningún manejo adicional. Las cintas mediouretrales, proporcionan un buen resultado con una baja incidencia de complicaciones quirúrgicas y recidiva, con mejoría de la calidad de vida de la paciente frente a su patología de incontinencia urinaria.

The International Continence Society defines urinary incontinence (UI) as the involuntary loss of urine, a potentially treatable condition with a decrease in the quality of life of women in different aspects, including sexual health with their partner and their social well-being. It has been described that only 44.9% of women consult, having higher rates of depression and anxiety. The objective of this research was to determine the occurrence of intraoperative and postoperative complications with the performance of transobturator and retropubic taping at the Central Military Hospital in Bogota during the period 2015 to 2020. An observational, descriptive, retrospective, retrospective. All patients with diagnoses of urinary incontinence, both stress, emergency, and/or mixed, operated with tension-free mid-urethral tapes by retropubic or transobturator route were included. The most prevalent complications after the surgical procedure were pain (96.8 %), followed by urinary tract infection or expulsion of the band (8.6 %), among other less frequent complications such as hematomas, dyspareunia, and abscesses. Most patients obtained an adequate clinical response in the postoperative period, 77 % did not require additional management. Mediourethral tapes provide a good result with a low incidence of surgical complications and recurrence, improving the patient's quality of life concerning her urinary incontinence pathology.

a incontinência urinária (IU) é definida pela Sociedade Internacional de Continência como a perda involuntária de urina, uma condição potencialmente tratável com uma diminuição na qualidade de vida das mulheres em diferentes aspectos, incluindo a saúde sexual com seu parceiro e seu bem-estar social. Foi relatado que apenas 44,9% das mulheres consultam, apresentando taxas mais altas de depressão e ansiedade. O objetivo desta pesquisa foi determinar a ocorrência de complicações intraoperatórias e pós-operatórias com fita transobturatória e retropúbica no Hospital Militar Central de Bogotá, Colômbia, durante o período de 2015 a 2020. Foi realizado um estudo observacional, descritivo, retrospectivo de corte longitudinal no Hospital Militar Central de Bogotá, incluindo todos os pacientes diagnosticados com incontinência urinária, tanto de esforço, de emergência e/ou mista, operados com slings mediouretrais sem tensão via retropúbica ou transobturatória. As complicações mais prevalentes após o procedimento cirúrgico foram dor (96,8%), seguida de infecção do trato urinário ou expulsão da faixa (8,6%), entre outras complicações menos frequentes, como hematomas, dispareunia e abscessos. A maioria dos pacientes teve uma resposta clínica adequada no pós-operatório e 77% não precisaram de nenhum tratamento adicional. Os slings mediouretrais proporcionam um bom resultado com baixa incidência de complicações cirúrgicas e recorrência, com melhora na qualidade de vida da paciente com relação à sua patologia de incontinência urinária.

Palliative care consultation team: symptom relief in first 48 hours of hospitalization / Equipo interconsultor en cuidados paliativos: alivio de síntomas en las primeras 48 horas de hospitalización / Equipe interconsultora em cuidados paliativos: alívio de sintomas nas primeiras 48 horas de hospitalização

ABSTRACT Objective: To compare the relief of symptoms provided by palliative care consultation team (PCCT) compared to the traditional care team (TC), in patients with advanced cancer in the first 48 hours of hospitalization. Method: Allocated to PCCT Group and TC Group, this study assessed 290 patients according to the Edmonton Symptom Assessment System (ESAS) within the first 48 hours of hospitalization. The main outcome was a minimum 2-point reduction in symptom intensity. Results: At 48 hours, the PCCT Group had a 2-point reduction in the mean differences (p <0.001) in pain, nausea, dyspnea, and depression; and TC Group, on nausea and sleep impairment (p <0.001). Multiple Logistic Regression found for the PCCT Group a greater chance of pain relief (OR 2.34; CI 1.01-5.43; p = 0.049). Conclusion: There was superiority of the PCCT Group for pain relief, dyspnea and depression. There is a need for more studies that broaden the understanding of team modalities.

RESUMEN Objetivo: Comparar el alivio de síntomas obtenido por equipo interconsultor en cuidados paliativos (ICP) al obtenido por equipo de cuidado tradicional (CT), en enfermos con cáncer avanzado en las primeras 48 horas de hospitalización. Método: Alocados en los Equipos ICP y Equipo CT, 290 pacientes han sido evaluados por la Escala de Síntomas de Edmonton (ESAS) en las primeras 48 horas de la hospitalización. El desenlace principal ha sido la reducción mínima de 2 puntos en la intensidad de síntomas. Resultados: En 48 horas, el Equipo ICP tuvo reducción de 2 puntos en las medias de las diferencias (p < 0,001) del dolor, náusea, disnea y depresión; y el Equipo CT, en la náusea y perjuicio del sueño (p < 0,001). Regresión Logística Múltiple mostró para el Equipo ICP mayor oportunidad de alivio del dolor (RC 2,34; CI 1,01-5,43; p = 0,049). Conclusión: Hubo superioridad del Equipo ICP para alivio del dolor, disnea y depresión. Estudios que amplíen la comprensión acerca de las modalidades de equipo son necesarios.

RESUMO Objetivo: Comparar o alívio de sintomas obtido por equipe interconsultora em cuidados paliativos (ICP) ao obtido por equipe de cuidado tradicional (CT), em doentes com câncer avançado nas primeiras 48 horas de hospitalização. Método: Alocados nos Grupos ICP e Grupo CT, 290 pacientes foram avaliados pela Escala de Sintomas de Edmonton (ESAS) nas primeiras 48 horas da hospitalização. O desfecho principal foi a redução mínima de 2 pontos na intensidade de sintomas. Resultados: Em 48 horas, o Grupo ICP teve redução de 2 pontos nas médias das diferenças (p < 0,001) da dor, náusea, dispneia e depressão; e o Grupo CT, na náusea e prejuízo do sono (p < 0,001). Regressão Logística Múltipla mostrou para o Grupo ICP maior chance de alívio da dor (RC 2,34; CI 1,01-5,43; p = 0,049). Conclusão: Houve superioridade do Grupo ICP para alívio da dor, dispneia e depressão. Estudos que ampliem a compreensão sobre modalidades de equipe são necessários.

Factores que Afectan la Duración de los Tratamientos de Ortodoncia en un Servicio Público de Salud / Factors that Affect the Duration of Orthodontic Treatment in Public Health Services

RESUMEN: La duración de los tratamientos de ortodoncia siempre ha sido una de las mayores preocupaciones, tanto en los pacientes como en los Ortodoncistas. El proposito de esta investigacion fue determinar la magnitud de las inasistencias a los controles por parte de los pacientes y como estas y otras variables, influyen en la duración de los tratamientos de Ortodoncia en el Centro de Salud Familiar (CESFAM) Dr. Victor Manuel Fernandez, Servicio de Salud de Concepcion, Chile. Se realizo un estudio descriptivo, de tipo transversal, retrospectivo, en el que se utilizaron las fichas clínicas de todos los pacientes que fueron dados de alta por los Ortodoncistas del CESFAM Dr. V. M. F. durante el año 2017. La tabulación se realizó en Microsoft Excel y el análisis estadístico se hizo en InfoStat 17. Se incluyeron 246 pacientes, con una edad de ingreso promedio de 13,6 años. La maloclusion predominante fue la Clase I de Angle (71 %). Estos pacientes tuvieron una duracion de tratamiento promedio de 33,9 meses. Se concluyó que a mayor cantidad de inasistencias, el tratamiento de ortodoncia tuvo una duración mayor.

ABSTRACT: The duration of orthodontic treatments has always been one of the biggest concerns, both in patients and for orthodontists. The purpose of this investigation was to determine the magnitude of the absences to the controls of the patients and how they influence the duration of the orthodontic treatments in the CESFAM Dr. Victor Manuel Fernandez, Concepcion, Chile. A descriptive, cross-sectional, retrospective study was carried out, in which the clinical records of all patients discharged by the Orthodontists of CESFAM Dr. V.M.F. during the year 2017 were analyzed. The tabulation was performed in Microsoft Excel and the statistical analysis was carried out in InfoStat 17. In total, 246 patients were included, with an average age of admission of 13.6 years. The predominant malocclusion was Class I of Angle (71 %). These patients had an average treatment duration of 33.9 months. It was further concluded that the length of orthodontic treatment, was also affected by the increased number of times patients failed to show for treatment.

Overview of artemisinin effectiveness during outset years of its implementation in the western Brazilian Amazon

BACKGROUND The elimination of malaria depends on the blocking of transmission and of an effective treatment. In Brazil, artemisinin therapy was introduced in 1991, and here we present a performance overview during implementation outset years. METHODS It is a retrospective cohort (1991 to 2002) of patients treated in a tertiary centre of Manaus, with positive microscopic diagnosis of Plasmodium falciparum malaria, under treatment with using injectable or rectal artemisinin derivatives, and followed over 35-days to evaluate parasite clearance, death and recurrence. FINDINGS This cohort outcome resulted 97.6% (1554/1593) of patients who completed the 35-day follow-up, 0.6% (10/1593) of death and 1.8% (29/1593) of follow-up loss. All patients that died and those that presented parasitaemia recurrence had pure P. falciparum infections and received monotherapy. Considering patients who completed 35-day treatment, 98.2% (1527/1554) presented asexual parasitaemia clearance until D4 and 1.8% (27/1554) between D5-D10. It is important to highlight that had no correlation between the five treatment schemes and the sexual parasite clearance. Finally, it is noteworthy that we were able to observe also gametocytes carriage during all follow-up (D0-D35). MAIN CONCLUSIONS Artemisinin derivatives remained effective in the treatment of falciparum malaria during first 12-years of use in north area of Brazil.

Curative effect analysis of different clinical characteristics and treatment modalities for primary esophageal small cell carcinoma / 国际肿瘤学杂志

Objective To analyze the efficacy of different clinical characteristics and treatment modalities for patients with primary esophageal small cell carcinoma (PESC),and to find out the prognostic factors,and provide reference for clinical treatment decision.Methods Patients with PESC who were treated at Shandong Cancer Hospital Affiliated to Shandong University from January 2008 to May 2017 were retrospectively enrolled.The clinical features were collected.Their disease progression time and survival status were determined by follow-up,and the follow-up ended in October 2017.Data analysis was performed using SPSS 25.0 software,and GraphPad Prism 7.0 was used for mapping.Survival analysis was performed by Kaplan-Meier method,and log-rank test was used to compare the differences in survival curves of each group.Factors with significant differences in univariate analysis were included in the Cox multivariate survival analysis.ROC curve was used to verify the sensitivity and specificity of the model.Results A total of 83 PESC patients with a complete follow-up were included in the study,including 68 males and 15 females.The average age was 61.93 years old (41-82 years old).The median progression-free survival (PFS) was 9.1 months (1.0-60.0 months) and the median overall survival (OS) was 26.1 months (1.8-60.0 months).Cox multivariate survival analysis showed radiotherapy or not (HR=0.321,95％ C I:0.184-0.559,P ＜0.001) and chemotherapy cycles (HR =0.841,95％CI:0.737-0.960,P =0.010) were independent prognostic factors for PFS.The Veterans Administration Lung Study Group (VALSG) staging (HR =3.050,95 ％ CI:1.606-5.794,P =0.001),radiotherapy or not (HR =0.312,95％CI:0.174-0.560,P ＜0.001),and chemotherapy cycle (HR =0.711,95％ CI:0.601-0.842,P ＜0.001) were independent predictors of OS.The ROC curve showed that the sensitivity and specificity of the PFS prediction model were 78.26％ and 73.33％,and the sensitivity and the specificity of the OS prediction model were 80.00％ and 58.49％.Conclusion VALSG staging is an independent predictor of PESC survival.Comprehensive therapy based on radiotherapy and chemotherapy can improve disease control,reduce metastasis,and improve survival.

Un análisis sobre intervenciones eficaces en la protección del menor / An Analysis of Child Welfare Effective Interventions

Resumen El propósito de este artículo es contribuir a la discusión del tipo de intervenciones que podrían ser más eficaces para la protección de los menores. Para lograrlo, se analizan las características de algunos de los programas mejor valorados en las clasificaciones de las intervenciones basadas en la evidencia: los tipos de intervenciones realizadas, sus formatos de ejecución y su efectividad. En la discusión, se plantean tres posibles factores que podrían estar relacionados con la eficacia de estos programas: la interacción entre la utilización de técnicas basadas en la evidencia y la adaptación de la intervención a las necesidades de cada familia, los efectos sobre la motivación y las expectativas de autoeficacia de los participantes y las características de los profesionales. Palabra clave: protección al menor; intervenciones basadas en la evidencia; evaluación de la eficacia.

Abstract The purpose of this article is to contribute to the discussion of the kind of interventions that could be most effective for child protection. To achieve this, the characteristics of some of the most highly valued programmes for evidence-based practice are analysed: the type of intervention used, their implementation formats and their effectiveness results. In the discussion, three possible factors that could be related to the effectiveness of these programmes are considered: the interaction between the use of evidence-based techniques and adaptation of the intervention to the needs of each family, the effects on motivation and the expectations of self-efficacy by the participants and the characteristics of the practitioners.

Efficacy indicators of four methods in outpatient addiction treatment

Abstract Background In Portugal, as far as we know, there are no recent studies that evaluated the comparative efficacy of therapeutic modalities in addiction problems by reference to a holistic and psychosocial model of effectiveness. Objectives Using a sample of Portuguese patients in outpatient treatment for drug and alcohol abuse, this study aimed to examine if a combined treatment modality (group therapy with individual intervention) had greater overall efficacy when compared to other three types of treatment without group therapy. Methods This is a correlational and cross-sectional study using a convenience sample of patients (N = 254) from an outpatient treatment in the Intervention Service on Addictive Behaviors and Substance Dependence. At the time of data collection, the patients were attending four types of treatment, such as receiving intervention based on individual psychological counseling (n = 66); receiving individual psychiatric counseling (n = 68); receiving both individual psychological and psychiatric counseling (n = 102); and receiving not only individual counseling (i.e., psychology or psychiatry), but also attending group therapy (n = 18). Results Using MANOVA and Wilks's multivariate test criterion, there was a significant effect of treatment modality on the global efficacy, Λ = 0.88, F(9, 603) = 3.75, p < 0.0001. Examination of mean estimates indicated that patients in a combined therapeutic modality revealed more treatment involvement compared to patients in other therapeutic modalities without group therapy. Discussion The results obtained in this study highlight the importance of integrating interventions in a collaborative way. A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual's probability to remain abstinent.

The curative effect in patients with systemic lupus erythematosus complicated by moderate or severe thrombocytopenia / 实用医学杂志

Objective To observe the curative effect in patients with systemic lupus erythematosus(SLE) complicated by moderate or severe thrombocytopenia with a blood platelet count(BPC) of under 50 × 109/L and analyze its related factors. Methods We retrospectively analyzed the clinical data on 109 SLE patients with mod-erate or severe thrombocytopenia. Results Of the 109 patients,82(75.2%)had complete response(CR),15 (13.8%)had partial response(PR),and 12(11.0%)had no response(NR),respectively. As compared with the CR+PR group,the NR group had a higher incidence rate of decreased bone marrow megakaryocyte(P 0.05 for all comparisons). The total effectiveness rate did not differ signifi-cantly between MP pulse therapy and high-dose corticosteroid therapy. Conclusions A decrease in bone marrow megakaryocytes can be an adverse factorfor affecting the efficacy in patients with SLE complicated by moderate or severe thrombocytopenia.

The Clinical Observation of Pelvic lymphadenoetomy and Vaginal Radical Trachelectomy Procedure in both the Effect and Reproductive Outcome for 16 Cases of Early-stage Cervical Cancer / 实用妇产科杂志

Objective:To investigate the clinical effectiveness and reproductive outcome of fertility-preserving surgery(pelvic lymphadenoetomy +Vaginal radical trachelectomy(VRT)in women with early stage cervical cancer.Methods:A perspective observation of 16 patients who had undergone pelvic lymphadenoetomy + VRT with early stage cervical cancer(study group) since Jan 2011 to Dec 2015 was carried out.30 patients who undergone laparoscopic radical hysterectomy(LRH) + pelvic lymphadenoetomy with early stage cervical cancer were set as the control group.The clinical efficiency were compared between the two groups,and the cumulative pregnancy rate and pregnancy outcome were followed up in study group.Results:There was no statistic difference in age,clinical staging,pathologicalgrade,LVSI,SCC expression,operating-time,pastoper ationfever,operative complications,tumor recurrence between the two groups(P＞0.05).Compare to control group,the index of amount of bleeding was fewer and the average hospital stay was shorter in study group(P ＜ 0.05),12 patients got pregnant and cumulative pregnancy 15 times within one year after operation,there were 4 mature delivery(33.3％) and 11 fetal loss(73.3％).Conclusions:For the young patients with early stage cervical cancer,pelvic lymphadenoetomy + VRT is the treatment procedure with the same clinical effectiveness with radical hysterectomy + pelvic lymphadenoetomy and has the advantage of fertility preserving,but the pregnancy and reproductive outcome need to be improved.

Renal transplantation in patients with diabetes mellitus-induced end-stage nephropathy / 中华器官移植杂志

Objective To explore the clinical characteristics of renal transplantation in patients with diabetes mellitus (DM)-induced end-stage nephropathy.Methods The clinical data of 408 cases who underwent renal transplantation in our center from 2009 to 2013 were retrospectively analyzed.The patients were divided into DM group (n =82) and non-DM group (n =326).The postoperative infection,delayed graft function (DGF),adverse events,and the survival rate of patients/kidneys were comparatively analyzed.Results The incidence of postoperative infection,DGF and adverse events was significantly higher in DM group than in non-DM group (23.2％ vs.15.6％,P =0.04;17.1％ vs.8.6 ％,P =0.04;13.4％ vs.8.3 ％,P =0.03).No significant difference was found in the 1-,2-,and 3-year survival rate of patients and kidneys between the two groups after operation (P＞ 0.05).Conclusion The incidence of postoperative infection,DGF and adverse events is higher in DM patients.The DM does not affect the survival rate of patients/kidneys through appropriate treatment.It is important to prevent complications in DM patients after renal transplantation.

Estresse pós-traumático: novidades, tratamento e Psicodrama / Post traumatic stress disorder: news, treatment and Psychodrama / Trastorno de estrés postraumático: noticias, tratamiento y Psicodrama

O estudo das reações humanas ao trauma tem crescido substancialmente nos últimos anos englobando, não apenas as Histéricas de Freud, mas também os combatentes de guerras, sobreviventes de tragédias naturais e as vítimas de abuso infantil e violência doméstica. Surgiram, pela ampliação do campo de trabalho, inúmeras terapias novas, cada uma reclamando maior eficiência e rapidez que a outra, fazendo com que os terapeutas das velhas escolas psicodinâmicas pareçam dinossauros antiquados e sem recursos úteis no tratamento destas questões. Este artigo visa mostrar as contribuições contemporâneas de colegas psicodramatistas internacionais para lidar com situações de Estresse pós-traumático, bem como estimular o desenvolvimento de estudos controlados estatisticamente que possam mostrar a riqueza do nosso instrumental teórico e prático.

The study of Trauma has grown substantially in recent years covering not only Freud and his hysterics but also for combatants of war, survivors of natural disasters, and victims of child abuse and domestic violence. Inumerous new therapies have emerged, each more efficient and faster than the other, making the old school psychodynamic therapists appear like antiquated dinosaurs with no useful resources to deal with these issues. This article aims to show the contemporary contributions of international psychodramatists to deal with post-traumatic stress disorder, and encourage the development of controlled studies to show statistically the richness of our theoretical and practical body of knowledge.

El estudio de las reacciones humanas a un trauma ha crecido considerablemente en los últimos años, incluyendo no sólo las pacientes histéricas de Freud, sino también los combatientes de la guerra, los sobrevivientes de desastres naturales y las víctimas de abuso infantil y violencia doméstica. La ampliación del campo de trabajo ha estimulado numerosas terapias nuevas, cada una reclamando ser más eficiente y más rápida que la otra, de forma que las viejas escuelas psicodinámicas se parezcan dinosaurios anticuados, sin recursos útiles en el tratamiento de estos temas. Este artículo tiene como objetivo mostrar las contribuciones contemporáneas del Psicodrama para trabajar con situaciones de estrés postraumático, y fomentar el desarrollo de los estudios controlados para mostrar estadísticamente la riqueza de nuestras herramientas teóricas y prácticas.

Efficacy and economic evaluation of sublingual immunotherapy with Dermatophagoides farinae drops in patients with allergic rhinitis and allergic asthma / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the efficacy and economics of sublingual immunotherapy (SLIT) with Dermatophagoides farinae drops in patients with allergic rhinitis and allergic asthma. Method:Two hundred and three patients (aged 4-60 yr) with allergic rhinitis and allergic asthma induced by house dust mites were retrospectively analyzed. Eighty-six patients were treated by SLIT with standardized Dermatophagoides farina drops and pharmacotherapy (SLIT group), while 117 patients were treated by standardized pharmacotherapy (drug group). Patients were followed up for 2 years with one visit in every 3 months. Total nasal syptom score (TNSS), total rhinitis medicine score (TRMS), daytime asthma syptom score (DASS), nighttime asthma syptom score (NASS), total asthma medicine score (TAMS) and treatment charge were recorded at each visit. Result:There was no significant difference between two groups in TNSS, TRMS, DASS, NASS, TAMS before treatment (all P>0.05). After 1-year or 2-year duration, there were significant differences between the SLIT group and drug group in TNSS, TMSS, DASS, NASS, TAMS (all P<0.01). After 1-year or 2-year duration, the symptom scores and medication scores of SLIT group significantly decreased compared with those before treatment (all P<0.01). In terms of treatment charge, although direct cost of SLIT group was a little higher than that of drug group, the indirect cost of SLIT group was remarkably lower than that of drug group, showing significant difference (P<0.01). Conclusion:SLIT with Dermatophagoides farinae drops is effective in patients with allergic rhinitis and allergic asthma, which may also reduce indirect cost.

Effect of traditional Chinese medicine sputum discharge liquid on preventing and treating ventilator-associated pneumonia / 中国感染控制杂志

Objective To evaluate the effect of traditional Chinese medicine sputum discharge liquid on preventing ventilator-associated pneumonia(VAP).Methods A randomized double-blind,placebo-controlled study was con-ducted,according to the inclusion and exclusion criteria,patients with respiratory failure and mechanical ventilation in the intensive care unit (ICU)of a hospital in 2011 -2014 were selected and divided into treatment group and con-trol group.Treatment group received sputum discharge liquid in addition to conventional treatment,control group adopted simulation agent based on conventional treatment.The incidence,treatment effectiveness,occurrence time, and prognosis of VAP between two groups of patients were compared.Results A total of 139 patients were monitored,70 cases in treatment group and 69 in control group.The incidence of VAP in treatment group and con-trol group were 37.14% (n =26)and 57.97%(n =40)respectively;the average onset time of VAP in treatment group and control group were (76±3.2)hours and (45±8.9)hours after admission to ICU respectively;treatment effectiveness rates in treatment and control group were 88.46% and 55.00% respectively;the incidence,occurrence time,and treatment effectiveness rates of VAP between two groups of patients were both significantly different (all P 0.05 ).Conclusion Intervention in patients with mechanical ventilation by sputum discharge liquid can reduce the incidence of VAP,and has a positive effect on the prognosis of disease and pulmonary infection in patients.

A Double-Blind, Randomized, Crossover Study to Compare the Effectiveness of Montelukast on Atopic Dermatitis in Korean Children

PURPOSE: Some studies report a role of leukotrienes in the pathogenesis of atopic dermatitis and suggest a rationale for the use of leukotriene receptor antagonist (LTRA) in the treatment of atopic dermatitis. This study aimed to evaluate the treatment effectiveness of montelukast in children with atopic dermatitis. METHODS: Fifty-four children between the ages of 2 and 6 years with moderate to severe atopic dermatitis were enrolled. Group A received montelukast for 8 weeks, followed by a crossover to 8 weeks of placebo after a 2-week washout period. Group B reversed the administration according to a randomized, double-blind, placebo-controlled, crossover design. The SCORing atopic dermatitis (SCORAD) index, urinary leukotriene E4 (LTE4), and eosinophil-derived neurotoxin (EDN) were assessed at every visit. RESULTS: Forty-three patients (21 males) completed the study. Although the SCORAD index was decreased in both groups, there was no statistically significant difference between montelukast and placebo (-3.0±11.2 vs -5.7±11.3, P=0.43). The level of urinary LTE4 was decreased after taking montelukast when compared to placebo, but there was no statistically significant difference (-65.9±556.2 vs 87.7±618.3, P=0.26). The changes in urinary EDN after taking montelukast and placebo had no significant difference (37.0±1,008.6 vs -195.8±916.7, P=0.10). When analyzing SCORAD indices, urinary LTE4, and EDN, we could not prove the effectiveness of montelukast in the atopic, non-atopic or high ECP (ECP ≥15 µg/L) subgroups. CONCLUSIONS: There was no statistically significant difference in clinical improvement or biomarkers between montelukast and placebo treatment. Therefore, conventional treatments with skin care and infection control might be more important strategies in the treatment of atopic dermatitis.

The effectiveness of substance abuse treatment: development of a brief questionnaire

Practitioners need brief instruments to monitor outcomes in both treatment of drugs and alcohol addiction because they are useful to guide decision making in a short time. Objectives: This study aims to develop a brief questionnaire, based on Client Evaluation of Self and Treatment, to evaluate the treatment effectiveness in drug and alcohol addiction treatment settings. Methods: A cross-sectional study using a convenience sample (N = 608) recruited from Division for Intervention on Addictive Behaviours and Dependencies (DICAD – ARS North). Results: The results show a new four-factor solution that accounted for 54.4% of the total variance and that provides the best fit to the data (c2/df = 1.72, CFI = .94, GFI = .91, RMSEA = .048 [.040-.057]; prmsea = .623). It also revealed a high internal consistency (a = .82). It was found a significant negative correlation (r = - .52, p < .01) between the final version of the instrument and a self report measure of psychopathology symptoms. Discussion: This brief questionnaire, with good psychometric properties, can be useful to provide a viable and rapid feedback of treatment outcomes. Further studies should be performed to continue the evaluation of the reliability of this measure...

Psicoterapia pela Internet: viável ou inviável? / Online therapy: viable or unviable? / Psicoterapia a través de Internet: ¿viable o inviable?

A psicoterapia pela internet é uma prática que, no Brasil, só é permitida aos psicólogos na forma de pesquisa. O objetivo do presente artigo foi realizar uma revisão dos estudos em psicoterapia pela internet, discorrendo sobre os recursos e os limites desse atendimento psicológico e suas implicações para a relação terapêutica e para a efetividade do tratamento. São apresentadas questões legais e éticas concernentes à prática. Os resultados apontaram similaridades entre a relação terapêutica online e a presencial, mostrando-se a psicoterapia pela internet efetiva nas mais distintas modalidades, embora a maioria dos estudos seja sobre intervenções cognitivo-comportamentais. As questões legais e éticas podem ser parcialmente solucionadas com diretrizes claras das organizações profissionais e com o treino de terapeutas na modalidade online. Concluímos que a psicoterapia pela internet, embora requeira maiores estudos, anuncia-se como uma prática viável e promissora...

The practice of online therapy is only allowed to psychologists in Brazil for research. The aim of this paper was to review studies on online therapy, discussing the features and limits of this type of psychological treatment and its implications for the therapeutic relationship and treatment effectiveness. Legal and ethical issues concerning the practice are presented. The results pointed to similarities between the therapeutic relationship online and face-to-face therapy, showing that online therapy is effective in its different modalities, although most studies deal with cognitive-behavioral interventions. Legal and ethical issues can be partially solved with clear guidelines of professional organizations and training of therapists in online mode. We conclude that online therapy requires more study, but already presents itself as a viable and promising practice...

La psicoterapia a través de Internet en Brasil sólo está permitida a los psicólogos en la forma de investigación. El objetivo de este trabajo fue revisar los estudios de la psicoterapia a través de Internet, hablando de las características y los límites de esto tratamiento psicológico y sus implicaciones para la relación terapéutica y la efectividad del tratamiento. Se muestran problemas legales y éticos relacionados con la práctica. Los resultados apuntaron a las similitudes entre la relación terapéutica online y cara a cara, muestrando que la psicoterapia a través de Internet es efectiva en sus más distintas modalidades, aunque la mayoría de los estudios se trata de intervenciones cognitivo-conductuales. Las cuestiones jurídicas y éticas pueden ser parcialmente resueltas con claras diretrices de las organizaciones profesionales y formación de los terapeutas en la modalidade online. Concluimos que la psicoterapia a través de Internet, aunque requiere más estudio, se anuncia como una práctica viable y prometedora...

Cognitive behavioral intervention in the nursing care for chronic obstructive pulmonary disease / 中华医院管理杂志

Objective To explore the application effect of cognitive behavioral intervention on chronic obstructive pulmonary disease nursing care.Methods 80 patients with chronic obstructive pulmonary disease were randomly divided into an experimental group and a control group(n=40).Both groups were given medical treatment and conventional nursing care,and the control group was given the cognitive behavioral intervention nursing care additionally.The average days of stay,the ratio of readmission,the treatment adherence,and smoking cessation rate in one year were recorded.Moreover,the life quality of the two groups was analyzed with a CAT assessment test.Results Compared with the control group,the experimental group achieved shorter average days of stay,higher medication adherence and smoking cessation rate,lower readmission rate and admission rate.The experimental group achieved better life quality with lower CAT value than the control group.Conclusion Cognitive behavioral intervention can obviously improve the treatment effectiveness of patients with chronic obstructive pulmonarv disease.

Uso de medidas quantitativas de eficácia em reabilitação neuropsicológica / Use of effectiveness quantitative measures to neuropsychological rehabilitation

O objetivo deste estudo foi oferecer orientações quanto ao uso de medidas quantitativas para verificar a eficácia da reabilitação neuropsicológica, apresentando os pressupostos para emprego de medidas de magnitude de efeito. O método utilizado foi a revisão bibliográfica, baseada na escolha arbitrária de artigos em periódicos científicos e livros que tratem do tema. A partir desta revisão, recomendamos o uso de medidas de magnitude de efeito na mensuração da eficácia de intervenções em reabilitação neuropsicológica, com especial atenção para o uso do d de Cohen e delta de Cliff, bem como a descrição do poder estatístico dos testes utilizados e seus respectivos intervalos de confiança.

The aim of this study was to offer guidelines on the use of quantitative measures to verify the neuropsychological rehabilitation effectiveness, presenting the assumptions for the use of effect size measures. The method was literature review, based on the arbitrary choice of articles in scientific journals and books that addressed the topic. From this review, we recommend the use of effect size measures in the mensuration of the treatment effectiveness in neuropsychological rehabilitation, with special attention to Cohen's d and Cliff's delta usage, as well as the description of the statistical power of the applied tests and their respective confidence intervals.