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1.
Rev. bras. cir. cardiovasc ; 37(5): 694-701, Sept.-Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1407306

ABSTRACT

Abstract Introduction: Halting ventilation during cardiopulmonary bypass (CPB) is implemented to operate in a less bleeding setting. It sustains a better visualization of the operation area and helps to perform the operation much more comfortably. On the other hand, it may lead to a series of postoperative lung complications such as atelectasis and pleural effusion. In this study, we investigated the effects of low tidal volume ventilation on inflammatory cytokines during CPB. Methods: Twenty-eight patients undergoing cardiovascular surgery were included in the study. Operation standards and ventilation protocols were determined and patients were divided into two groups: patients ventilated with low tidal volume and non-ventilated patients. Plasma samples were taken from patients preoperatively, perioperatively from the coronary sinus and postoperatively after CPB. IL-6, IL-8, TNF-α and C5a levels in serum samples were studied with enzyme-linked immunosorbent assay (ELISA) kits. Results: C5a, IL-6, IL-8 and TNF-α were similar when compared to the low tidal volume ventilated and non-ventilated groups (P>0.05) Comparing the groups by variables, IL-6 levels were increased during CPB in both groups (P=0.021 and P=0.001), and IL-8 levels decreased in the ventilation group during CPB (P=0.018). Conclusion: Our findings suggest that low tidal volume ventilation may reduce the inflammatory response during CPB. Although the benefit of low tidal volume ventilation in CPB has been shown to decrease postoperative lung complications such as pleural effusion, atelectasis and pneumonia, we still lack more definitive and clear proofs of inflammatory cytokines encountered during CPB.

2.
Serv. soc. soc ; (144): 193-212, maio-set. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1377369

ABSTRACT

Resumo: O artigo analisa os impactos socioterritoriais provocados por desastres com barragens à luz da Vigilância Socioassistencial. Adotou-se o método qualitativo, por meio de análise documental e técnica, de cidades impactadas por desastres com barragens de mineradoras em Minas Gerais (Brasil). Concluiu-se que as condições objetivas de respostas no campo da Assistência Social estão aquém dos preceitos internacionais de Gestão Integral de Riscos e de Desastres (GIRD), destacando foco para o aprimoramento específico para uma gestão planejada e compartilhada de Redução de Riscos de Desastres (RRD).


Abstract: The article analyzes the socio-territorial impacts caused by disasters with dams in the light of Social Assistance Surveillance. We adopted the qualitative method based on documental and technical analysis of cities impacted by disasters with mining dams in Minas Gerais/BR. We concluded that the objective conditions of answers in the field of Social Assistance fall short of the international precepts of Disaster Risk Management (DRM), highlighting a focus for specific improvement for a planned and shared management of Disaster Risk Reduction (DRR).

3.
Rev. cir. traumatol. buco-maxilo-fac ; 22(3): 27-31, jul.-set. 2022. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1399758

ABSTRACT

As fraturas nasais são de grande incidência dentre as fraturas faciais, podendo envolver também outras estruturas da face. O diagnóstico é baseado no exame físico, o qual muitas vezes é dificultado devido ao edema formado na região. A palpação dos contornos ósseos, verificação de presença de crepitação nasal, alterações de permeabilidade e assimetrias locais são algumas das alterações sugestivas de fraturas nasais. Além disso, a inserção do ligamento cantal medial pode ser perdida devido ao trauma ou devido ao deslocamento ósseo em que ele se encontra inserido. Exames de imagem, como radiografias e Tomografias Computadorizadas, são utilizados para a visualização das fraturas ósseas e planejamento cirúrgico. A redução aberta dos ossos nasais é indicada para fraturas de maior complexidade e cominuição, tendo em vista o adequado reposicionamento dos ossos, cartilagens e ligamentos deslocados. Assim, o objetivo deste estudo é relatar a redução aberta de uma fratura dos ossos nasais com perda de inserção do ligamento cantal medial direito, sob anestesia geral... (AU)


Nasal fractures are of great incidence among facial fractures, and may also involve other facial structures. The diagnosis is based on physical examination, which is often hampered due to the edema formed in the region. Palpation of bone contours, checking for the presence of nasal crackling, changes in permeability and local asymmetries are some of the changes suggestive of nasal fractures. In addition, the insertion of the medial canthal ligament may be lost due to trauma or due to the bone displacement in which it is inserted. Imaging exams, such as radiographs and CT scans, are used for visualizing bone fractures and surgical planning. The open reduction of the nasal bones is indicated for fractures of greater complexity and comminution, in view of the appropriate repositioning of the bones, cartilage and dislocated ligaments. Thus, the aim of this study is to report the open reduction of a fracture of the nasal bones with loss of insertion of the right medial canthal ligament, under general anestesia... (AU)


Las fracturas nasales son de gran incidencia entre las fracturas faciales, y también pueden involucrar otras estructuras faciales. El diagnóstico se basa en el examen físico, que a menudo se ve obstaculizado por la inflamación que se forma en la región. La palpación de los contornos óseos, confirmación de la presencia de crepitantes nasales, alteraciones de la permeabilidad y asimetrías locales son algunas de las alteraciones sugestivas de fracturas nasales. Además, la inserción del ligamento cantal medial puede perderse debido a un traumatismo o al desplazamiento del hueso en el que se inserta. Las pruebas de imagen, como las radiografías y las tomografías computadorizadas, se utilizan para visualizar las fracturas óseas y planificar la cirugía. La reducción abierta de los huesos nasales está indicada para las fracturas de mayor complejidad y conminución, en vista del reposicionamiento adecuado de los huesos, cartílagos y ligamentos dislocados. Así, el objetivo de este estudio es relatar la reducción abierta de una fractura de los huesos nasales con pérdida de inserción del ligamento cantal medial derecho, bajo anestesia general... (AU)


Subject(s)
Humans , Female , Adult , Nose/injuries , Open Fracture Reduction , Fracture Fixation , Nasal Bone/injuries , Accidents, Traffic , Face
4.
Rev. Finlay ; 12(2): 221-227, abr.-jun. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1406843

ABSTRACT

RESUMEN Fundamento: en estadios avanzados del cáncer de pulmón de células no pequeñas el tratamiento se basa fundamentalmente en la poliquimioterapia. Estudios previos relacionan el desarrollo de resistencia al cisplatino con el aumento de los niveles del glutatión celular, mientras que, la depleción de este tripéptido se ha asociado con una mayor sensibilidad a este fármaco. Objetivo: evaluar el efecto de la poliquimioterapia con cisplatino y vinblastina en los niveles intracelulares de glutatión y en el estado redox celular en pacientes con cáncer de pulmón de células no pequeñas en estadios avanzados. Métodos: se realizó un estudio de casos y controles en el que se incluyeron 38 pacientes con cáncer de pulmón de células no pequeñas en estadios IIIb-IV, que concluyeron el esquema de tratamiento con cisplatino y vinblastina y 25 individuos aparentemente sanos como grupo control en el período correspondiente al período de mayo del 2016 a mayo del 2018 en el Hospital Neumológico Benéfico Jurídico de la Habana. Las concentraciones intraeritrocitarias del glutatión reducido y oxidado fueron determinadas mediante un método de HPLC-UV. El estado redox celular se calculó mediante la ecuación de Nerst. Los resultados se expresaron como medias y desviación estándar. Se utilizó la prueba no paramétrica U-Mann Whitney para la comparación de las medias aritméticas de las variables de respuesta. Resultados: después del tratamiento se apreció una disminución de las concentraciones de glutatión reducido (920 µM vs. 1252 µM; p=0,036) así como, cambios en el estado redox celular (-338,4 mV vs. -353,2 mV; p=0,029) en contraste con los controles. Conclusiones: la quimioterapia combinada con cisplatino induce una disminución de los niveles glutatión reducido y cambios en el estado redox celular. Estos efectos pueden contribuir a una mayor supervivencia en los pacientes que responden al tratamiento.


ABSTRACT Background: in advanced stages of non-small cell lung cancer, treatment is fundamentally based on polychemotherapy. Previous studies relate the development of resistance to cisplatin with increased levels of cellular glutathione, while depletion of this tripeptide has been associated with greater sensitivity to this drug. Objective: to evaluate the effect of polychemotherapy with cisplatin and vinblastine on intracellular glutathione levels and cellular redox status in patients with non-small cell lung cancer in advanced stages. Methods: a case-control study was carried out that included 38 patients with non-small cell lung cancer in stages IIIb-IV, who completed the treatment scheme with cisplatin and vinblastine, and 25 apparently healthy individuals as a control group from May 2016 to May 2018 at the Benéfico Jurídico Pneumological Hospital in Havana. The intraerythrocyte concentrations of reduced and oxidized glutathione were determined by an HPLC-UV method. The cellular redox state was calculated using the Nerst equation. The results were expressed as means and standard deviation. The non-parametric U-Mann Whitney test was used to compare the arithmetic means of the response variables. Results: after treatment, a decrease in reduced glutathione concentrations (920 µM vs. 1252 µM; p=0.036) was observed, as well as changes in the cellular redox state (-338.4 mV vs.-53.2 mV; p=0.029) in contrast to controls. Conclusions: chemotherapy combined with cisplatin induces a decrease in reduced glutathione levels and changes in the cellular redox state. These effects may contribute to increased survival in patients who respond to treatment.

5.
Rev. cuba. salud pública ; 48(2): e3342, abr.-jun. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409289

ABSTRACT

RESUMEN Introducción: La salud humana, animal y el medio ambiente muestran un complejo escenario que reta a los paradigmas tradicionales del manejo de desastres. El equipo básico de salud debe asumir un óptimo desempeño en el enfoque "Una Salud" dentro del proceso de reducción de riesgo de desastres. Objetivo: Determinar el desempeño profesional del equipo básico de salud en la atención primaria para la reducción de riesgo de desastres desde el enfoque de "Una Salud" en el Policlínico Docente "Reina". Métodos: Se realizó una investigación de desarrollo a partir del enfoque "Una Salud" en el desempeño profesional de los 28 equipos básicos de salud que componen el Policlínico Docente "Reina", ubicado en el Consejo Popular Los Sitios, Municipio Centro Habana. Se realizó la revisión del plan de reducción de desastres y el programa de estudio de la residencia de Medicina General Integral y se aplicó una encuesta a los profesionales médicos y de enfermería. Se valoraron tres dimensiones y once indicadores. Resultados: Los principales problemas se detectaron en los planes y los modos de actuación profesional, la actividad práctica profesional y personal, el desarrollo de materiales de apoyo, escasa participación en cursos de superación, en eventos científicos y en proyectos de investigación. La dimensión "superación" fue la más afectada. Conclusiones: Perfeccionar el trabajo del equipo básico de salud desde el enfoque "Una Salud" permite un buen desempeño profesional y el cumplimiento de las normativas vigentes para mejorar la planificación y organización del proceso de reducción de riesgo de desastres en el policlínico.


ABSTRACT Introduction: Human, animal and environmental health show a complex scenario that challenges traditional paradigms of disaster management. The basic health team must assume optimal performance in the "One Health" approach within the disaster risk reduction process. Objective: To determine the professional performance of the basic health team in primary care for disaster´s risk reduction from the "One Health" approach at "Reina" Teaching Polyclinic. Methods: A development research was carried out based on the "One Health" approach in the professional performance of the 28 basic health teams that make up "Reina" Teaching Polyclinic, located in Los Sitios Popular Council, Centro Habana Municipality. The review of the disaster reduction plan and the study program of the Comprehensive General Medicine residency was carried out and a survey was applied to medical and nursing professionals. Three dimensions and eleven indicators were assessed. Results: The main problems were detected in the plans and modes of professional performance, professional and personal practical activity, the development of support materials, and low participation in training courses, scientific events and research projects. The dimensión called "improvement" was the most affected. Conclusions: Perfecting the work of the basic health team from the "One Health" approach allows a good professional performance and compliance with current regulations to improve the planning and organization of the disaster risk reduction process in the polyclinic.

6.
Cogit. Enferm. (Online) ; 27: e80768, Curitiba: UFPR, 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1384633

ABSTRACT

RESUMO Objetivo: sintetizar evidências sobre efeitos das intervenções breves na redução do consumo de bebidas alcóolicas entre adultos. Método: estudo de revisão sistemática, cadastrado protocolo na International Prospective Register of Systematic Reviews, registro nº CRD42020153034. A busca foi realizada em 2020, em bases de dados eletrônicas e foram incluídos ensaios clínicos randomizados que avaliavam os efeitos de Intervenções Breve em adultos bebedores de álcool. Resultados: foram avaliados 11 artigos. Todos os estudos realizaram, nos grupos controle e experimental, teste de identificação do padrão de consumo de álcool, com oferta de feedback para o usuário em seguida. As intervenções utilizam metodologias que incitam o usuário à tomada de decisão, bem como manter a decisão tomada e evitar recaídas. Conclusão: esta pesquisa contribui para o ensino e assistência em saúde, por meio de reflexões sobre a identificação do abuso de álcool e compilado sobre a aplicação e impacto das Intervenções Breves.


ABSTRACT Objective: to synthesize evidence on the effects of brief interventions on reducing alcohol consumption among adults. Method: systematic review study, protocol registered in the International Prospective Register of Systematic Reviews, registration no. CRD42020153034. The search was conducted in 2020, in electronic databases and randomized clinical trials that evaluated the effects of Brief Interventions in adult alcohol drinkers were included. Results: 11 articles were evaluated. All studies performed, in the control and experimental groups, a test to identify the pattern of alcohol consumption, with feedback offered to the user afterwards. The interventions use methodologies that encourage the user to make a decision, as well as maintain the decision made and avoid relapse. Conclusion: this research contributes to health care teaching and assistance, through reflections on the identification of alcohol abuse and compiled on the application and impact of Brief Interventions.


RESUMEN Objetivo: sintetizar las pruebas sobre los efectos de las intervenciones breves para reducir el consumo de alcohol entre los adultos. Método: estudio de revisión sistemática, protocolo registrado en el Registro Internacional Prospectivo de Revisiones Sistemáticas, número de registro CRD42020153034. La búsqueda se realizó en 2020, en bases de datos electrónicas y se incluyeron ensayos clínicos aleatorios que evaluaron los efectos de las Intervenciones Breves en bebedores de alcohol adultos. Resultados: Se evaluaron 11 artículos. Todos los estudios realizaron, en los grupos de control y experimental, una prueba para identificar el patrón de consumo de alcohol, con una retroalimentación ofrecida al usuario después. Las intervenciones utilizan metodologías que incitan al usuario a tomar una decisión, así como a mantener la decisión tomada y evitar recaídas. Conclusión: esta investigación contribuye a la docencia y a la atención sanitaria, a través de reflexiones sobre la identificación del abuso de alcohol y recopiladas sobre la aplicación y el impacto de las Intervenciones Breves.

7.
Int. j. morphol ; 40(3): 781-788, jun. 2022. ilus
Article in English | LILACS-Express | LILACS | ID: biblio-1385681

ABSTRACT

SUMMARY: High-intensity physical exercises can cause oxidative stress and muscle damage. Several medicinal plants have been used as antioxidant and anti-inflammatory agents. The present study evaluated high-intensity resistance exercise (HIRE) associated with Schinus Terebentifholius ethanolic extract (EE) on oxidative parameters and muscle damage in Wistar rats. Animals were divided into 04 groups (n=10/group): 1. Control (CG) - animals that did not undergo HIRE and were treated with vehicle (distilled water, orally); 2. Acute exercise (AE) - animals submitted to acute exercise session; 3. Exercise + vehicle (EV) - animals that underwent HIRE and were treated with vehicle and 4. Exercise + extract (EX) animals administered with Schinus terebenthifolius EE (100mg/Kg, orally) and submitted to the exercise session. Schinus terebenthifolius EE showed high in vitro antioxidant activity (13.88 ± 0.36 mg/mL). Before the experimental period, lactate was measured at pre and post moments of AE (p<0.0001) and EX (p<0.0001) groups. After the acute session, the following were evaluated: oxidative stress {malondialdehyde (MDA), sulfhydryl groups (SH) and ferric reducing antioxidant power (FRAP)}, muscle damage (creatine kinase (CK) and lactate dehydrogenase (LDH)), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). In the in vivo analyses of the EX group compared to AE and EV groups, respectively: hepatic (MDA: p<0.0001 and SH: p=0.0033, in both; FRAP: p=0.0011 and p=0.0047), muscle (MDA, SH and FRAP: p<0.0001, in both; CK: p=0.0001 and p<0.0001; LDH: p<0.0001, in both), serum levels (MDA: p=0.0003, p=0.0012, SH: p=0.0056, p=0.0200, FRAP: p=0.0017 and p=0.0165) were significant. There was no significant difference in ALT and AST markers. It could be concluded that Schinus terebenthifolius EE associated with HIRE attenuated oxidative stress and muscle damage in rats.


RESUMEN: Los ejercicios físicos de alta intensidad pueden causar estrés oxidativo y daño muscular. Varias plantas medicinales se han utilizado como agentes antioxidantes y antiinflamatorios. El presente estudio evaluó el ejercicio de resistencia de alta intensidad (HIRE) asociado con el extracto etanólico (EE) de Schinus terebentifholius sobre los parámetros oxidativos y el daño muscular en ratas Wistar. Los animales se dividieron en 4 grupos (n=10/grupo): 1. Control (GC) - animales que no se sometieron a HIRE y fueron tratados con vehículo (agua destilada, por vía oral); 2. Ejercicio agudo (AE) - animales sometidos a sesión de ejercicio agudo; 3. Ejercicio + vehículo (EV) - animales que se sometieron a HIRE y fueron tratados con vehículo y 4. Ejercicio + extracto (EX) animales administrados con Schinus terebenthifolius EE (100 mg/kg, por vía oral) y sometidos a la sesión de ejercicio. Schinus terebenthifolius EE mostró una alta actividad antioxidante in vitro (13,88 ± 0,36 mg/mL). Antes del período experimental, se midió el lactato en los momentos pre y post de los grupos AE (p<0,0001) y EX (p<0,0001). Tras la sesión aguda, se evaluaron: el estrés oxidativo malondialdehído (MDA), grupos sulfhidrilo (SH) y poder antioxidante reductor férrico (FRAP), daño muscular (creatina quinasa (CK) y lactato deshidrogenasa (LDH)), alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST). En los análisis in vivo del grupo EX frente a los grupos AE y EV, respectivamente: hepático (MDA: p<0,0001 y SH: p=0,0033, en ambos; FRAP: p=0,0011 y p=0,0047), muscular (MDA, SH y FRAP: p<0,0001, en ambos; CK: p=0,0001 y p<0,0001; LDH: p<0,0001, en ambos), niveles séricos (MDA: p=0,0003, p=0,0012, SH: p=0,0056, p=0,0200, FRAP: p=0,0017 y p=0,0165) fueron significativas. No hubo diferencia significativa en los marcadores ALT y AST. Se podría concluir que Schinus terebenthifolius EE asociado con HIRE atenuó el estrés oxidativo y el daño muscular en ratas.


Subject(s)
Animals , Rats , Plant Extracts/administration & dosage , Exercise , Anacardiaceae , Antioxidants/administration & dosage , Physical Endurance , Plants, Medicinal , Plant Extracts/pharmacology , Biomarkers , Rats, Wistar , Oxidative Stress , Dietary Supplements , Antioxidants/pharmacology
8.
Salud ment ; 45(2): 71-80, Mar.-Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1377301

ABSTRACT

Abstract Introduction There is little information in Mexico about the transition to injecting drugs among drug users in cities other than Tijuana. Objective We compare characteristics of the onset of drug use and first injection among people who inject drugs (PWID) from Ciudad Juárez and Hermosillo, two cities of Northern Mexico and identify factors associated with faster rates of transition from first drug use to the first injection. Method 841 PWID were interviewed in 2012 in Ciudad Juárez (n = 445) and Hermosillo (n = 396). Using lifetables, we describe timing at the onset of drug use and first injection. Cox regression analysis was used to determine factors associated with the transition hazard to first injection. Results Median age at onset of drug use was 15.5 years old (standard deviation [SD] = 5.73). The median age at first injection was 21.30 (SD = 7.22). The median duration-time between first drug use and transition to injection was 4.8 years (SD = 5.6). Controlling for sociodemographics, factors that increase the hazard of transitioning to injection are age at onset of drug use (adjusted-hazard-rate [AHR] = 1.04, 95% confidence-interval CI [1.03, 1.05], p<.01) having used cocaine, heroin, or methamphetamine at the onset of drug use (AHR = 1.14, 95% CI [1.03, 1.27], p = .01), and having received assistance at first injection (AHR = 1.25, 95% CI [1.17, 1.33], p<.01). Discussion and conclusion Results show the need to enhance harm reduction programs among non-injecting drug users so as to prevent the spread of injecting drugs in Mexico.


Resumen Introducción Existe poca información en México sobre los calendarios al uso inyectado de drogas en ciudades distintas a Tijuana. Objetivo Comparamos las características del inicio del consumo de drogas y la primera inyección entre las personas que se inyectan drogas (PID) de Hermosillo y Ciudad Juárez e identificamos factores asociados con la transición a la primera inyección. Método En 2012 encuestamos a 841 PID en Ciudad Juárez (n = 445) y Hermosillo (n = 396). Utilizando tablas de vida analizamos las edades al primer uso de sustancias ilícitas y de la primera inyección. Ajustamos un modelo de regresión Cox para determinar los factores asociados con el riesgo de transición a la primera inyección. Resultados La edad mediana al primer consumo de drogas fue 15.5 años (desviación estándar [DE] = 5.73). La edad mediana a la primera inyección fue 21.30 (DE = 7.22). La duración mediana entre el primer uso de drogas ilícitas y la primera inyección fue de 4.8 años (DE = 5.6). Controlando los factores sociodemográficos, los factores que aumentan el riesgo de transición a la inyección son la edad al inicio de uso de drogas ([AHR] = 1.04, intervalo de confianza [IC] del 95% [1.03, 1.05], p<.01) uso de cocaína, heroína o metanfetamina como droga de inicio (AHR = 1.14, IC 95% [1.03, 1.27], p = .01) y haber recibido asistencia en la primera inyección (AHR = 1.25, IC 95% [1.17, 1.33], p<.01). Discusión y conclusión Es necesario mejorar los programas de reducción de daños entre los consumidores de drogas no inyectables para prevenir la propagación del uso inyectado de sustancias en el norte de México.

9.
Braz. j. otorhinolaryngol. (Impr.) ; 88(1): 89-100, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364571

ABSTRACT

Abstract Introduction Multi-canal benign paroxysmal positional vertigo is considered to be a rare and controversial type in the new diagnostic guidelines of Bárány because the nystagmus is more complicated or atypical, which is worthy of further study. Objective Based on the diagnostic criteria for multi-canal benign paroxysmal positional vertigo proposed by International Bárány Society, the study aimed to investigate the clinical characteristics, diagnosis and treatment of multi-canal benign paroxysmal positional vertigo. Methods A total of 41 patients with multi-canal benign paroxysmal positional vertigo were included and diagnosed by Roll, Dix-Hallpike and straight head hanging tests. Manual reduction was performed according to the involvement of semicircular canals. Results Among the 41 cases, 19 (46.3%) patients showed vertical up-beating nystagmus with or without torsional component and geotropic, apogeotropic horizontal nystagmus, and were diagnosed with posterior-horizontal canal. 11 (26.8%) patients showed vertical up-beating nystagmus with torsional component on one side and vertical down-beating nystagmus with or without torsional component on the other side during Dix-Hallpike test or straight head hanging test and were diagnosed with posterior-anterior canal benign paroxysmal positional vertigo 9 (26.8%) patients showed vertical down-beating nystagmus with or without torsional component and geotropic, apogeotropic horizontal nystagmus, and were diagnosed with anterior-horizontal canal 2 (4.9%) patients showed vertical geotropic torsional up-beating nystagmus on both sides and were diagnosed with bilateral posterior canal benign paroxysmal positional vertigo. High correlation between the sides with reduced vestibular function or hearing loss and the side affected by Multi-canal benign paroxysmal positional vertigo was revealed (contingency coefficient = 0.602, p = 0.010). During one-week follow up, nystagmus/vertigo has been significantly alleviated or disappeared in 87.8% (36/41) patients. Conclusion Posterior-horizontal canal benign paroxysmal positional vertigo was the most common type. Multi-canal benign paroxysmal positional vertigo involving anterior canal was also not uncommon. Caloric tests and pure tone audiometry may help in the determination of the affected side. Manual reduction was effective in most of Multi-canal benign paroxysmal positional vertigo patients.


Resumo Introdução A vertigem posicional paroxística benigna multicanal é considerada um tipo raro e controverso nas novas diretrizes de diagnóstico da Bárány Society, porque o nistagmo é mais complicado ou atípico, o que é digno de mais estudos. Objetivo Com base nos critérios diagnósticos para a vertigem posicional paroxística benigna multicanal proposta pela International Bárány Society, o estudo teve como objetivo investigar as características clínicas, o diagnóstico e o tratamento da vertigem posicional paroxística benigna multicanal. Método Foram incluídos 41 pacientes com vertigem posicional paroxística benigna multicanal e diagnosticados pelo teste de Dix-Hallpike, roll test ou e teste straight head hanging A redução manual foi feita de acordo com o envolvimento dos canais semicirculares. Resultados Entre os 41 casos, 19 (46,3%) pacientes apresentaram nistagmo de batimento ascendente vertical com ou sem componente de torção e nistagmo horizontal apogeotrópico e geotrópico e foram diagnosticados com vertigem posicional paroxística benigna de canal horizontal-posterior. Onze (26,8%) pacientes apresentaram nistagmo vertical de batimento ascendente com componente de torção de um lado e nistagmo vertical de batimento descendente com ou sem componente de torção do outro lado durante o teste de Dix-Hallpike ou teste straight head hanging e foram diagnosticados com vertigem posicional paroxística benigna do canal posterior-anterior. Nove (26,8%) pacientes apresentaram nistagmo vertical com batimento descendente com ou sem componente de torção e nistagmo horizontal apogeotrópico e geotrópico e foram diagnosticados com vertigem posicional paroxística benigna de canal anterior-horizontal. Dois (4,9%) pacientes apresentaram nistagmo de torção geotrópico vertical de batimento ascendente em ambos os lados e foram diagnosticados com vertigem posicional paroxística benigna de canal posterior bilateral. Foi revelada alta correlação entre os lados com função vestibular reduzida ou perda auditiva e o lado afetado pela vertigem posicional paroxística benigna multicanal (coeficiente de contingência = 0,602, p = 0,010). Durante o seguimento de uma semana, o nistagmo/vertigem foi significativamente aliviado ou desapareceu em 87,8% (36/41) dos pacientes. Conclusões A vertigem posicional paroxística benigna de canal horizontal e posterior foi o tipo mais comum. A vertigem posicional paroxística benigna multicanal que envolveu canal anterior também não foi incomum. Testes calóricos e audiometria tonal pura podem ajudar na determinação do lado afetado. A redução manual foi eficaz na maioria dos pacientes com vertigem posicional paroxística benigna multicanal.

10.
Ciênc. Saúde Colet. (Impr.) ; 27(1): 123-132, jan. 2022.
Article in English, Portuguese | LILACS | ID: biblio-1356038

ABSTRACT

Resumo Mediante o processo de estigmatização existente sobre a População em Situação de Rua que faz uso de drogas e a reprodução de violências nos serviços de saúde, refletiu-se neste artigo sobre esse público e o espaço da rua para além da visão de decrepitude com que costumeiramente são vistos. Nesse sentido, a pesquisa tomou contornos a partir do objetivo de conhecer práticas e saberes construídos nos processos de cuidado entre a População em Situação de Rua usuária de drogas. Para isso, delineou-se um estudo qualitativo, utilizando-se da triangulação das técnicas de observação participante, a partir da inserção de uma das pesquisadoras em um Consultório na Rua, em uma cidade no interior de Pernambuco, e duas modalidades de entrevistas individuais em profundidade: a entrevista episódica e a entrevista narrativa. A partir dos dados obtidos, delineou-se três categorias temáticas: "Sujeitos, territorialidades e contextos", "Drogas, medicalização de problemas sociais e controle" e "Redução de danos, singularidades e produção de cuidado no território". Construíram-se, assim, compreensões sobre as normativas e dicotômicas que atravessam a visão sobre a População em Situação de Rua, pretendendo contribuir para a consolidação da oferta de cuidado orientada pela perspectiva da Redução de Danos.


Abstract Through the stigmatization of drug-using People Living on the Streets (PLS) and the reproduction of violence in health services, this paper reflected on this community and the street space beyond the view of decrepitude with which they are usually seen. In this sense, the research contours were shaped from the objective of knowing practice and knowledge constructed in the care processes among the drug-using PLS. A qualitative study was designed, using the triangulation of participant observation techniques, from the inclusion of one of the researchers in a "Street Clinic" (Consultório na Rua), in an inland city of the state of Pernambuco, Brazil, and two types of in-depth individual interviews: the episodic interview and the narrative interview. Three thematic categories were outlined from the data retrieved, as follows: "subjects, territorialities and contexts", "drugs, social problem medicalization, and control", and "harm reduction, singularities and care production in the territory". Thus, understandings about the norms and dichotomies that cross the view of PLS were constructed to consolidate the care offer guided by the perspective of harm reduction.


Subject(s)
Humans , Homeless Persons , Pharmaceutical Preparations , Substance-Related Disorders/epidemiology , Harm Reduction , Qualitative Research
11.
Article in Chinese | WPRIM | ID: wpr-928915

ABSTRACT

Lung volume reduction loop uses bronchoscopic lung volume reduction(BLVR) technology to compress and collapse the necrotic emphysema tissue and exhaust the internal gas to achieve the purpose of lung volume reduction to treat emphysema. After the lung volume reduction loop is implanted into the human body, the compressed part of the lung tissue tends to expand with breathing, which makes the lung volume reduction loop expand into a linear trend periodically. Fatigue resistance is one of the most important performance indexes of the lung volume reduction loop. In the paper, Z-direction vibration fatigue machine was used to simulate the changes of human respiratory cycle movement to test the fatigue performance of lung volume reduction loop, which can provide some reference for the test method of in vitro fatigue performance of lung volume reduction related products in the future.


Subject(s)
Bronchoscopy/methods , Emphysema/surgery , Humans , Lung , Pneumonectomy/methods , Pulmonary Emphysema/surgery , Treatment Outcome
12.
Article in English | WPRIM | ID: wpr-913197

ABSTRACT

Objectives: This study aims to investigate the effects of mindful meditation and yoga on reducing burnout and stress in care workers who assist elderly individuals. Knowing how to reduce burnout is important because that of care workers is associated with the quality of client care, worker productivity, and job turnover.Patients and Methods: The participants included 44 care workers who worked for elderly care facilities in rural Fukuoka. They were randomly assigned to one of three intervention groups: control, yoga, or mindfulness. In the yoga intervention group, a certified yoga instructor taught a 60-minute yoga session each week for six weeks. In the mindfulness group, an experienced medical doctor instructed a mindful meditation program for the same length. Participants were asked to complete the Japanese Burnout Scale (JBS), and the research team collected the level of α-amylase in saliva using NIPRO: T-110-N pre- and post-interventions.Results: MANOVA was performed with each intervention (control, yoga, mindfulness) as the independent variable on the three subscales of the JBS (emotional exhaustion, depersonalization, and personal achievement) and a biomarker of stress level (α-amylase). The results indicated a significant main effect of interventions, and a follow-up ANOVA showed a significant effect of interventions on emotional exhaustion and personal achievement.Conclusion: The results indicate that practicing mindful meditation or yoga for 60 minutes once a week for six weeks can reduce care workers’ burnout. This study was notable because the biomarker of stress also improved. It is strongly recommended and encouraged that institutions caring for the elderly population provide mindful meditation or yoga intervention to reduce burnout, which benefits not only care workers but also their clients.

13.
Article in Chinese | WPRIM | ID: wpr-934499

ABSTRACT

Objective:To explore the efficacy of the oncoplastic round block technique in surgical management of idiopathic granulomatous mastitis (IGM).Methods:From January 2014 to December 2019, a total of 18 patients (24 to 38 years old, 32.2 years in average) with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, the postoperative clinical efficacy was summarized and analyzed.Results:All 18 patients with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, among them 2 patients underwent round-block reduction surgery of contralateral breast at the same time. The median follow-up duration was 16.1 months (from 6 to 36 months). Incision poor healing occurred in two cases which was cured after dressing change. Recurrence occurred in one case at 6 months after operation, and then cured with conservative measures. No other severe complications occurred. All patients were satisfacted with the results.Conclusions:Application of oncoplastic round block technique in surgical management of IGM may remove more tissue in order to reduce the recurrent rate, and get a better cosmetic results.

14.
Article in Chinese | WPRIM | ID: wpr-934493

ABSTRACT

Objective:To explore an optimal surgical approach for different types of labia minora hypertrophy and to design a better personalized surgical treatment plan for patients.Methods:From October 2017 to October 2020, 71 patients with labia minora hypertrophy were treated in the plastic surgery department of Sichuan Provincial People's Hospital, aged 18-38 years, with an average of 26 years. According to the type and degree of hypertrophy, the appropriate surgical method was selected. The wound healing and complications were observed after operation, and the shape of labia minora was followed up.Results:Among the 71 patients, 1 patient had postoperative hematoma and no flap necrosis after active treatment. 1 patient had poor healing of distal labia minora incision and improved after dressing change. The other patients had good blood supply of labia minora, no necrosis, no postoperative infection, hematoma and other complications. The patients were followed up for 1-6 months. The appearance of labia minora was natural, bilateral symmetry, and the incision scar was hidden. The improvement was significant compared with that before operation. The patients were satisfied with the shape and function.Conclusions:According to the degree of hypertrophy of the labia minora, the specific shape and the psychological expectation of patients, we can choose the appropriate operation method, which can achieve the aesthetic standard of symmetry and beautiful shape of the labia minora, and meet the normal physiological function and aesthetic requirements of patients.

15.
Article in Chinese | WPRIM | ID: wpr-933972

ABSTRACT

Objective:To observe the curative effect of exercise training combined with posture control among patients with displacement of the anterior disc of the temporomandibular joint (TMJ) without reduction.Methods:Forty-four patients with anterior TMJ disc displacement without reduction who had successfully been treated with manual repositioning were randomly divided into a control group and a treatment group, each of 22. Both groups underwent routine exercise training, while the experimental group was additionally provided with posture training five times a week for 4 weeks. After the 4th week of training both groups were evaluated using a visual analogue scale (VAS) and their maximum active mouth opening was compared. Six months later, MRI was performed to observe the disc-condyle relationship of the temporomandibular joint and its position.Results:①After 4 weeks of training, the average VAS scores of both groups were significantly lower than those before the training. The improvement in the treatment group′s average was significantly greater than among the control group. ②After the 4 weeks of training the average maximum active mouth opening of both groups had increased, with the improvement in the treatment group significantly greater. ③Six months later, 19 persons in the treatment group had a normal disc-condyle relationship, significantly more than the 13 in the control group.Conclusions:Posture control training can improve the effectiveness of sports training in maintaining manual repositioning of the TMJ after anterior disc displacement without reduction.

16.
Article in Chinese | WPRIM | ID: wpr-932804

ABSTRACT

Objective:To investigate the clinical effect and safety of reduction and fixation for the anterior glenoid fracture through an axillary approach.Methods:Two autopsy specimens (a total of 4 shoulder joints) were used to simulate the surgery of open reduction and internal fixation to treat anterior glenoid fracture through an axillary approach. Specimens were placed in the lateral decubitus position. An incision was made in the posterior axillary line to expose the lateral side of the scapula through the interval ahead of the latissimus dorsi muscle. Attended to the separation and protection of the axillary nerve, posterior humerus artery, thoracic dorsal nerve, and scapular artery. The surgical area of the axillary approach was divided into the upper "quadrilateral area" and the lower "trilateral area", which exposed the anteroinferior glenoid, neck, and the full length of lateral border of the scapula. Thirteen cases (7 males and 6 females) were involved in this study, all patients were diagnosed with anterior glenoid fracture and treated by open reduction and internal fixation through the axillary approach between April 2018 and December 2020. Constant-Murley score and Disabilities of the Arm, Shoulder and Hand (DASH) were used to evaluate the clinical efficacy.Results:Thirteen patients were enrolled for final analysis, which included 12 right cases and 1 left case. The average age was 50.38±13.74 years (range 24-67 years). All 13 patients were classified as Ideberg type Ia fracture. Anatomical buttress plates were used in 5 cases, cannulated screws combined with metacarpal plates in 7 cases, and distal radius plate in 1 case. The average length of follow-up was 13.00±5.97 months (range 6-26 months). No delayed union or malunion in all cases at the last follow-up visits. The average of Constant-Murley score was 62.46±10.26 points (range 45-83) and the DASH score was 27.56±9.76 points (range 14.14-43.33) at the three months follow up visits. At 6 months postoperatively, the Constant-Murley score was 80.85±8.32 points (range 65 to 90) and the DASH score was 11.47±8.56 points (range 0 to 35.00). Constant-Murley score at the final patient's follow-up visit was 84.54±8.95 points (range 70-95), and the DASH score was 10.94±8.67 points (range 1.67 to 33.33 points). The joint function gradually recovered with time. The functional scores at 3 months, 6 months after surgery, and final follow-up visit had significant differences ( P<0.05). Conclusion:The axillary approach is a safe and feasible approach for the treatment of the anterior glenoid fracture. This approach exposes the anteroinferior glenoid and the lateral border of the scapula, which reduces rotator-cuff injury and achieves anatomic reduction and strong fixation of the fracture. The axillary approach surgery also allows early functional physiotherapy after surgery.

17.
Article in Chinese | WPRIM | ID: wpr-932610

ABSTRACT

Objective:To investigate the method of simulating low-dose CT (LDCT) images using routine dose level scanning mode to generate LDCT images with correspondence to the routine dose CT (RDCT) images in the training sets for deep learning model, which would be used for LDCT noise reduction.Methods:The CT images reconstructed by different algorithms in Philips CT Big Core had different noise levels, where the noise was larger with iDose 4 algorithm and lower with IMR(knowledge-based iterative model reconstruction)algorithm. A new method of replacing LDCT image with noise equivalent reconstructed image was proposed. The uniform module of CTP712 was scanned with the exposure of 250 mAs for RDCT, 35 mAs for LDCT. The images were reconstructed using IMR algorithm for LDCT images and iDose 4 algorithm at multiple noise reduction levels for RDCT images, respectively. The noise distribution of each image set was analyzed to find the noise equivalent images of LDCT. Then, RDCT images, those selected images were used for training cycle-consistent adversarial networks (CycleGAN)model, and the noise reduction ability of the proposed method on real LDCT images of phantom was tested. Results:The RDCT images generated with iDose 4 level 1 could substitute the LDCT images reconstructed with IMR algorithm. The radiation dose was reduced by 86% in low dose scanning. Using CycleGAN model, the noise reduction degree was 45% for uniform module, and 50%, 13%, 7% for CIRS-SBRT 038 phantom in the specific regions of brain, spinal cord, bone, respectively. Conclusions:Equivalent noise level reconstructed images could potentially serve as the alternative of LDCT images for deep learning network training to avoid additional radiation dose. The generated CT images had substantially reduced noise relative to that of LDCT.

18.
Article in Chinese | WPRIM | ID: wpr-932343

ABSTRACT

Objective:To compare the clinical efficacy between a bidirectional-traction reduction device and a traction table in the treatment of femoral neck fracture with femoral neck system (FNS).Methods:A retrospective study was conducted in the 46 patients with femoral neck fracture who had been treated at Department of Orthopedics, The First Central Hospital of Baoding from January 2020 to January 2021. There were 19 males and 27 females, aged from 30 to 64 years (average, 47.1 years). According to the Garden classification, 29 cases were type Ⅲ and 17 type Ⅳ. By the reduction method, the patients were assigned into an observation group ( n=24) in which the reduction was assisted by a bidirectional-traction reduction device and a control group ( n=22) in which the reduction was assisted by a traction table. FNS fixation was conducted in both groups. The 2 groups were compared in terms of operation time, reduction time, fluoroscopy frequency, intraoperative blood loss, femoral neck shortening at immediate postoperation and 12 months postoperation, Harris scores of the affected hip at 3, 6, and 12 months postoperation, and incidence of lower extremity venous thrombosis. Results:There were no significant differences in age, gender or fracture type between the 2 groups, showing they were comparable ( P>0.05). The observation group needed significantly less operation time [57.5 (54.0, 64.5) min], reduction time [(16.3±3.0) min] and fluoroscopy frequency [(20.5±4.6) times] than the control group did [85.0 (71.3, 92.0) min, (21.0±6.0) min and (29.7±4.7) times, respectively] (all P<0.05). There was no significant difference in intraoperative blood loss between 2 groups ( P>0.05). All patients were followed up for 12 to 22 months (average, 15.5 months). There was no significant difference in femoral neck shortening between the 2 groups at immediate postoperation or 12 months postoperation ( P>0.05). The Harris score of the affected hip in the observation group was significantly better than that in the control group at 3 months after surgery ( P<0.05), but such a significant difference was not observed at 6 or 12 months postoperation ( P>0.05). The incidence of thrombotic complications in the observation group (12.5%, 3/24) was significantly lower than that in the control group (40.9%, 9/22) ( P<0.05). Conclusions:In the FNS treatment of femoral neck fracture, compared with a traction table, reduction assisted by a bidirectional-traction reduction device is more advantageous because it is simpler and less time-consuming, incurs less fluoroscopy and leads to better early functional recovery of the affected hip and lower incidence of thrombotic complications.

19.
Article in Chinese | WPRIM | ID: wpr-932341

ABSTRACT

Objective:To evaluate a self-designed intelligent robot-assisted minimally invasive reduction system in the reduction of unstable pelvic fractures by a cadaveric anatomic study.Methods:Ten unembalmed cadavers (7 male and 3 female ones) were used in this study. In each cadaveric specimen an unstable pelvic fracture was created in accordance with clinical case models (3 cases of type B1, 4 cases of type B2 and 3 cases of type C1 by the Tile classification). A self-designed intelligent robot-assisted minimally invasive reduction system was used to assist the reduction in the cadaveric models. Intraoperative registration and navigation time, autonomous reduction time, total operation time and reduction error were measured.Results:Effective reduction was completed in 10 bone models with the assistance of our self-designed intelligent robot-assisted minimally invasive reduction system. The time for intraoperative registration and navigation averaged 47.4 min (from 32 to 74 min), the autonomous reduction time 73.9 min (from 48 to 96 min), and the total operation time 121.3 min (from 83 to 170 min). The reduction error averaged 2.02 mm (from 1.67 to 2.62 mm), and the reduction results met the clinical requirements.Conclusion:Our self-designed intelligent robot-assisted minimally invasive reduction system is a new clinical solution for unstable pelvic fractures, showing advantages of agreement with clinical operative procedures, high reduction accuracy and operational feasibility, and reduced radiation exposure compared to a conventional operation.

20.
Article in Chinese | WPRIM | ID: wpr-932319

ABSTRACT

Objective:To revise the 2017 classification of irreducible intertrochanteric fractures and summarize reduction techniques of 2021 classification.Methods:A retrospective analysis was conducted of the 17 patients with irreducible intertrochanteric fracture who had been treated at Department of Orthopaedic Surgery, The Ninth People's Hospital of Shanghai, Shanghai Jiaotong University School of Medicine from January 2015 to December 2019. They were 7 males and 10 females, with an age of (73.2 ± 16.1) years. On the basis of 2017 classification, the irreducible intertrochanteric fractures were classified into 2 types in the present 2021 classification. Type Ⅰ were interlocking fractures which were further classified into 3 subtypes: type ⅠA were sagittal interlocking ones (7 cases), type ⅠB greater trochanter interlocking ones (one case) and type ⅠC lesser trochanter interlocking ones (one case). Type Ⅱ were separating fractures which were further classified into 4 subtypes: type ⅡA were sagittal separating ones (4 cases), type ⅡB coronal separating ones (one case), type ⅡC rotational separating ones(one case) and type ⅡD complete separating ones (2 cases). All patients were treated by closed reduction and intramedullary nailing with different reduction strategies corresponding to their fracture types (application of ejector rods, clamps or prying techniques, etc.). A total of 132 patients with reducible femoral intertrochanteric fracture who had been admitted during the same period were selected as the control group. The fracture reduction time, intraoperative blood loss and Harris hip score at the last follow-up were compared between the 2 groups.Results:The 2 groups were comparable because there was no significant difference in their preoperative general data ( P>0.05). Type ⅠA accounted for the highest proportion of irreducible intertrochanteric fractures [41.3% (7/17)], followed by type ⅡA [23.6% (4/17)]. The fracture reduction time [(44.6 ± 6.7) min] in the irreducible group was significantly longer than that in the control group [(39.2 ± 9.6) min] ( P<0.05). There was no significant difference in intraoperative blood loss or Harris hip score at the last follow-up between the 2 groups ( P>0.05). Conclusions:Compared with the "2017 classification" , the "2021 classification" is more concise and easy to remember, and can directly prompt the corresponding proper fracture reduction techniques. The patients with irreducible intertrochanteric fracture using proper reduction techniques can obtain functional recovery similar to that in the patients with reducible intertrochanteric fracture after reduction and fixation.

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