Consecutive use of the 52 mg levonorgestrel-releasing intrauterine system: variations in bleeding patterns / Uso consecutivo do sistema intrauterino de levonorgestrel 52 mg: variações no padrão de sangramento

Abstract Objective Changes in bleeding patterns could influence the decisions of healthcare professionals to change the levonorgestrel-releasing intrauterine system (LNG-IUS) before 7 years of use, the recommended period of extended use. We evaluated changes in the bleeding patterns of users of the 52 mg LNG-IUS at the end of use of the first (IUS-1) and during the second device (IUS-2) use. Methods We performed an audit of the medical records of all women who used two consecutive LNG-IUSs at the Family Planning clinic. We evaluated the sociodemographic/gynecological variables, the length of use, and the bleeding patterns reported in the reference periods of 90 days before removal of the IUS-1 and at the last return in use of IUS-2. We used the McNemar test to compare bleeding patterns. Statistical significance was established at p < 0.05. Results We evaluated 301 women aged (mean ± SD) 32 (±6.1) years, with lengths of use of 68.9 (±16.8) and 20.3 (±16.7) months for the IUS-1 and IUS-2, respectively. No pregnancies were reported. Bleeding patterns varied significantly among women who used the IUS-2 for ≥ 7 months to 6 years when compared the bleeding patterns reported in IUS-1 use. Eighty-nine out of 221 (40%) women maintained amenorrhea and infrequent bleeding; 66 (30%) evolved to bleeding patterns with light flow, and 66 (30%) maintained or evolved to heavy flow patterns (p = 0.012). No differences were observed among the 80 women with ≤ 6 months of use. Conclusion Changes in bleeding patterns occur during the use of LNG-IUS and should not be decisive for the early replacement of the device.

Resumo Objetivo Variações no padrão de sangramento podem afetar a decisão de troca do sistema intrauterino de levonorgestrel (SIU-LNG) antes do período de uso estendido recomendado de 7 anos. Nós avaliamos mudanças no padrão de sangramento de usuárias ao final do uso do primeiro SIU-LNG 52 mg (SIU-1) e durante o uso do segundo dispositivo (SIU-2). Métodos Revisamos os prontuários de todas as mulheres que inseriram consecutivamente o SIU-LNG no ambulatório de Planejamento Familiar. Foram avaliadas as variáveis sociodemográficas/ginecológicas, o tempo de uso, e os padrões de sangramento relatados nos períodos de referência de 90 dias antes da remoção do SIU-1 e no último retorno em uso do SIU-2. Usamos o teste de McNemar para comparar os padrões de sangramento. A significância estatística foi estabelecida em p < 0,05. Resultados Analisamos os dados de 301 mulheres com idade (média ± desvio padrão [DP]) de 32 (±6,1) anos e tempo de uso de 68,9 (±16,8) e 20,3 (±16,7) meses para o SIU-1 e SIU-2, respectivamente. Nenhuma gravidez foi relatada. Os padrões de sangramento variaram significativamente durante o uso do SIU-2 (≥ 7 meses a 6 anos) em relação ao padrão relatado no SIU-1. Oitenta e nove das 221 (40%) mulheres mantiveram amenorreia e sangramento infrequente; 66 (30%) evoluíram para padrões de sangramento com fluxo leve e 66 (30%) mantiveram ou evoluíram para padrões de fluxo intenso (p = 0,012). Não foram observadas diferenças entre as 80 mulheres que utilizavam o SIU-2 há ≤ 6 meses. Conclusão Mudanças nos padrões de sangramento ocorrem durante o uso do LNG-IUS e não devem ser decisivas para a troca precoce do dispositivo.

Emotional repercussions and quality of life in children and adolescents undergoing hemodialysis or after kidney transplantation / Repercussões emocionais e qualidade de vida das crianças e adolescentes em hemodiálise ou após transplante renal

ABSTRACT Objective: To investigate the emotional repercussions and quality of life (QOL) associated with end-stage kidney disease (ESKD) in children and adolescents undergoing hemodialysis or a kidney transplant (TX). Methods: We conducted a quantitative-qualitative study. 48 children and adolescents with ESKD were interviewed; half of them underwent hemodialysis treatment, and the other half had a kidney transplantation. Their respective 48 caregivers also participated in the study. The questionnaire involved both the Pediatric Quality of Life Inventory and a thematic story-drawing tool. An analysis of the QOL questionnaire's results was done by comparing the sum of points between groups and the theme-based story-drawing consisted of interpreting the data contained in the material using Freudian and Lacanian theories. Results: In the QOL questionnaires, the total score was higher in the transplanted patients and in their caregivers, suggesting a perception of better QOL after kidney transplantation. In the specific aspects of the questionnaire, physical capacity was considered superior by children who underwent transplants and their caregivers. There were no differences between the groups in the emotional, social and school aspects. However, the caregivers of the patients who had a transplant perceived a significant difference in QOL in the school aspect. In the thematic story-drawings, emotional suffering in the two analyzed groups was evidenced regardless of the treatment. Conclusions: Despite the questionnaire results suggesting that transplantation does improve some aspects of QOL, there were no differences observed between kidney replacement therapies regarding the emotional repercussion of chronic kidney disease.

RESUMO Objetivo: Investigar as repercussões emocionais e a qualidade de vida (QV) associadas à doença renal crônica em crianças e adolescentes submetidos à hemodiálise ou ao transplante renal. Métodos: Foram entrevistadas 48 crianças e adolescentes com doença renal crônica, metade dos quais submetidos ao tratamento hemodialítico, e a outra metade, ao transplante renal. Os 48 respectivos cuidadores também participaram da pesquisa. Utilizou-se o questionário de QV Pediatric Quality of Life Inventory e o instrumento de desenho-estória com tema. A análise dos resultados do questionário de QV foi feita pela somatória dos pontos e a dos desenhos-estórias com tema consistiu na interpretação dos dados do material, utilizando as teorias freudiana e lacaniana. Resultados: Nos questionários de QV, a pontuação total foi superior na opinião dos pacientes transplantados e seus cuidadores, indicando percepção de melhor QV após o transplante renal. Nos aspectos específicos, a capacidade física também foi considerada superior por esse grupo. Não houve diferenças entre os grupos de pacientes nos aspectos emocional, social e escolar, porém os cuidadores dos pacientes transplantados notaram diferença na QV no aspecto escolar. Nos desenhos-estórias com tema, observou-se que o sofrimento emocional foi evidenciado nos dois grupos estudados. Conclusões: Não foram percebidas diferenças entre as terapêuticas renais substitutivas quanto às repercussões emocionais da doença renal crônica. Por outro lado, verificou-se que o transplante melhora a QV no aspecto geral.

Emotional and behavioral problems: a school-based study in southern Brazil / Problemas emocionais e comportamentais: um estudo de base escolar no sul do Brasil

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.

Funcionamiento psicosocial en pacientes agudos y crónicos no psiquiátricos en régimen hospitalario: depresión, alexitimia y falta de asertividad / Psychosocial functioning in non-psychiatric acute and chronic inpatients: depression, alexithymia and lack of assertiveness

Background: Depression, alexithymia, and lack of assertiveness interfere with individual psychosocial functioning and may result in longer hospitalization stay and poorer therapeutic results. Aim: To analyze the psychosocial functioning in acute and chronic patients and its association with psychological, clinical and sociodemographic variables. Material and Methods: We performed a cross-sectional study that included 80 inpatients of both sexes with organic pathology, aged between 18 to 70 years old, without any current psychiatric disorder. Clinical and sociodemographic data were collected from a semi-structured interview and hospital records. Beck Depression Inventory-IA, Toronto Alexithymia Scale-20 and Rathus Assertiveness Scale were administered. Results: Fifty five percent of patients had some degree of depression, 33% alexithymia and 34% lack of assertiveness. The levels of depression, alexithymia and lack of assertiveness in chronic patients were significantly higher than those observed in acute patients. Women and participants older than 60 years exhibited the highest degrees of depression. Alexithymia and lack of assertiveness were associated with a lower educational level. A negative significant correlation between alexithymia and assertiveness scores was observed among acute patients. Conclusions: Participants with chronic diseases had a lower psychosocial functioning. Less educated patients showed more alexithymic and less assertive features. We emphasized the need of a better management of these aspects by the health team, since social functioning might interfere with the outcome of physical illnesses.

Effects of programmed physical activity on body composition in post-pubertal schoolchildren / Efeito da atividade física programada sobre a composição corporal em escolares pós-púberes

OBJECTIVE: To assess body composition modifications in post-pubertal schoolchildren after practice of a physical activity program during one school year. METHODS: The sample consisted of 386 students aged between 15 and 17 years and divided into two groups: the study group (SG) comprised 195 students and the control group (CG), 191. The SG was submitted to a physical activity program and the CG attended conventional physical education classes. Body composition was assessed using body mass index (BMI), percentage of body fat (%BF), fat mass (FM), and lean mass (LM). RESULTS: A positive effect of the physical activity program on body composition in the SG (p < 0.001) was observed, as well as on the interaction time x group in all the variables analyzed in both genders. A reduction in %BF (mean of differences = -5.58%) and waist circumference (-2.33 cm), as well as an increase in LM (+2.05 kg) were observed in the SG for both genders, whereas the opposite was observed in the CG. CONCLUSION: The practice of programmed physical activity promotes significant reduction of body fat in post-pubertal schoolchildren. .

OBJETIVO: Verificar as modificações da composição corporal de escolares pós-púberes após a prática da atividade física programada durante um ano letivo. MÉTODO: Amostra composta de 386 alunos, divididos em dois grupos: estudo 195 e controle 191, entre 15 e 17 anos. O grupo estudo (GE) foi submetido a atividade física programada e o grupo controle (GC) a aulas convencionais de educação física. A composição corporal foi avaliada pelo índice de massa corporal (IMC), percentual de gordura (%G) e massa gorda (MG) e magra (MM). RESULTADOS: Foi possível observar um efeito positivo do programa de atividade física sobre a composição corporal no GE (p < 0,001) do grupo e da interação tempo x grupo em todas as variáveis analisadas em ambos os sexos. Foram observados reduções na %G (média das diferenças = -5,58%) e no perímetro da cintura (-2,33 cm) e aumento da MM (+2,05 kg) no GE em ambos os sexos. O contrário foi observado no GC. CONCLUSÃO: A prática de atividade física programada promove redução significativa de gordura corporal em escolares pós-púberes. .

Behavioral and emotional impact of sickle cell disease in young children with repeated hospitalization

Background: Chronic disease such as Sickle Cell Disease [SCD] in children with a history of repeated hospitalization is distressing for children as well as parents or guardians, leading to anxiety and has bad effects on the psychological slate of children and their families

Objective: The aim of the study was to determine the overall effect of SCD on the behavior of young children age 1[1/2] -5 years old with repeated hospitalization [as an indicator for severe symptoms] compared to a control group of healthy children routine vaccination vaccination

Patients and Methods: Thirty five child with SCD and repeated /hospitalization [group I] were recruited from pediatric clinic and the same number of age and gender matched healthy children [group II] as a control group came for vaccination. Socio-demographic data, child behavior checklist [CBCL] 1[1/2] - 5 years and diagnostic and statistical manual [DSM] oriented scale were collected through a personal interview with parents/legal guardians of children in the two study groups using a structured questionnaire

Results: The children with SCD had significantly higher behavioral changes on CBCL, anxiety/depression. somatic complaint, withdrawn and aggressive behavior and internalizing symptoms [65.2 +/- 14.2. 66.7 +/- 12.6, 63.4 +/- 11.6, 60.4 +/- 10.4 and 64.7 +/- 14.7 respectively] compared to healthy control group [55.1 +/- 4.6, 54.4 +/- 3.1, 53.2 +/- 2.6, 56 +/- 6. 9 and 51.5 +/- 4.4 respectively,], DSM oriented scale showed that children with SCD scored higher in pervasive developmental and oppositional defiant problems [60.90.2 and 60.6 +/- 10.4 respectively, compared to control group [53. 9 +/- 5.4 and 56.7 +/- 2.7 respectively]

Conclusion: Young pediatric patients with SCD and history of repeated hospitalization put kids at risk for behavioral and emotional abnormalities. Good pain control, psychiatric management and support and avoidance of unpleasant experiences can ameliorate these bad effects

Alexithymia and Type “A” Behavior Pattern (TABP) in Coronary Heart Diseases: A preliminary study.

Background: The number of patients with CHD is increasing and psychosocial factors are now recognized as playing a significant and independent role in the development of CHD and its complications. Aims: The present study aimed at examining the association between alexithymia and Type A Behavior Pattern (TABP) in Coronary Heart Disease (CHD) patients. Methodology: The sample consisted of 150 participants, comprising 50 in the study group (drawn from the outpatient clinical services) and 50 in the control group (from the general population) from Kashmir. Further 50 controls from the general population of Haryana were included to study alexithymia in broader context. The tools used included Jenkins Activity Survey (JAS-C) and Toronto Alexithymia Scale (TAS-20). Statistical analysis was done using SPSS-12.0 and various descriptive and inferential statistics were applied. Results: The results revealed a high prevalence (40%) of alexithymia in our study group. However the association of alexithymia with CHD was not clearly indicated as the comparison of alexithymia between our study group and control group did not reveal any significant difference and paradoxically the prevalence in the control group was even higher. Further a comparison of the control group from Kashmir with that of Haryana revealed a highly significant difference. Thus, our study suggests that perpetual trauma and unending stress due to present prevailing condition in Kashmir together with the presence of some kind of mental disorders in a significant segment of Kashmiri population has rendered the whole population more vulnerable to developing alexithymia. Further, our findings did not reveal any association between Type A Behavior Pattern and CHD. Conclusion: This indicates a need for further clarification of the precise role of personality types in producing and preventing CHD.

Prevalência da alexitimia na anorexia nervosa e sua associação com variáveis clínicas e sociodemográficas / Prevalence of alexithymia in anorexia nervosa and its association with clinical and sociodemographic variables

OBJETIVO: Analisar a prevalência da alexitimia numa amostra de pacientes com anorexia nervosa e sua relação com variáveis do foro clínico e sociodemográfico, em concreto, índice de massa corporal, duração da doença, idade, escolaridade e nível socioeconômico. MÉTODOS: Foram avaliados 2 grupos de participantes do sexo feminino, com idades compreendidas entre os 13 e os 34 anos. Um grupo foi composto por 80 participantes com anorexia nervosa (Grupo AN) e o outro por 80 participantes saudáveis (Grupo Controle). A versão portuguesa da Toronto Alexithymia Scale - 20 items - foi aplicada a ambos os grupos. RESULTADOS: A prevalência da alexitimia no Grupo AN foi 62,5 por cento e no Grupo Controle, 12,5 por cento. Os valores médios de alexitimia não diferiram significativamente entre os dois subtipos de AN, e ambos apresentaram valores estatisticamente superiores aos do Grupo Controle. A alexitimia não se correlacionou às variáveis clínicas e sociodemográficas consideradas, à exceção da escolaridade, cuja associação com a alexitimia foi positiva e baixa. CONCLUSÃO: Os pacientes com anorexia nervosa apresentaram, com elevada frequência, dificuldades na regulação dos afetos, independentemente de seu peso, tempo de evolução da doença, idade e nível socioeconômico. O tratamento deve privilegiar uma intervenção sistematizada no domínio das emoções.

OBJECTIVE: To analyze the prevalence of alexithymia in anorexia nervosa and its relationship with clinical and sociodemographic variables, such as, body mass index, anorexia nervosa duration, age, years of education and socioeconomic status. METHODS: Two groups of female participants, between the ages of 13 and 34 years, were recruited. One group was composed of 80 participants with anorexia nervosa (AN Group) and the other consisted of 80 healthy participants (Control Group). The Portuguese version of the Toronto Alexithymia Scale - 20 items - was applied to both groups. RESULTS: The prevalence of alexithymia in the AN Group was 62.5 percent and 12.5 percent in the Control Group. The mean values of alexithymia (total score and factors) did not significantly differ between the two AN subtypes, and both subtypes presented higher statistical values when compared to the Control Group. Alexithymia did not correlate with clinical and sociodemographic variables, with the exception of years of education, which had a positive and low association with alexithymia. CONCLUSION: Patients with anorexia nervosa revealed a high prevalence of affect regulation deficits regardless of their weight, duration of the disease, age and socioeconomic status. Therapy should focus on a systematic intervention in the domain of emotional regulation.

Effect of emotional stress on sperm quality.

BACKGROUND & OBJECTIVE: Emotional stress plays a detrimental role on fertility. In this study male patients with idiopathic infertility were selected after evaluation of psychological stress to evaluate a positive effect of a stress therapy on their semen quality. METHODS: A total of 20 patients with infertility were enrolled in the study and randomly divided in two groups. Ejaculates were examined by light and transmission electron microscopy (TEM). Meiotic segregation was also investigated by fluorescence in situ hybridization (FISH). Ten patients were treated with Conveyer of Modulating Radiance (CRM) therapy and sperm characteristics and meiotic segregation were evaluated again three months at the end of treatment. RESULTS: TEM data showed that, among sperm pathologies, necrosis and apoptosis were higher and the number of "healthy" sperm was significantly reduced in both groups of stressed men compared to reference values. The number of "healthy" sperm was significantly higher in the treated group after therapy, indicating a recovery of sperm quality, although no significant decrease in sperm pathologies was observed. FISH analysis showed that the mean frequencies of sex chromosomes disomies and diploidies significantly decreased after stress therapy. INTERPRETATION & CONCLUSION: The effects induced by stress also seem to include meiotic and structural alterations in sperm cells. The spermatogenic process was improved after a cycle of CRM therapy indicating that stress is an additional risk factor for idiopathic infertility.

Prevalência de transtornos emocionais e comportamentais em adolescentes com asma / Prevalence of emotional and behavioral disorders in adolescents with asthma

OBJETIVO: Determinar a prevalência de transtornos emocionais e comportamentais em adolescentes com asma e compará-la com a prevalência em adolescentes sem asma. MÉTODOS: Estudo transversal através de um questionário de transtornos psicológicos (Strengths and Difficulties Questionnaire) aplicado a adolescentes de 14 a 16 anos, com e sem asma, selecionados aleatoriamente em escolas municipais de Belo Horizonte (MG) Brasil. RESULTADOS: A prevalência de transtornos emocionais e comportamentais em adolescentes com e sem asma foi 20,4 por cento (IC95 por cento: 14,5-27,8 por cento) e 9 por cento (IC95 por cento: 6,1-12,8 por cento), respectivamente. Entre os adolescentes com asma, 56,6 por cento (IC95 por cento: 48,3-64,5 por cento) apresentavam escores dentro da faixa de normalidade e 23 por cento (IC95 por cento: 16,8-30,7 por cento), valores limítrofes. Entre os que não tinham asma, 75 por cento (IC95 por cento: 69,7-79,6 por cento) apresentavam escores normais e 16 por cento (IC95 por cento: 12,2-20,7 por cento), limítrofes. A mediana no escore total do questionário foi 14 nos portadores de asma e 12 nos sem asma (p < 0,01). Na análise multivariada (regressão logística), controlado para variáveis socioeconômicas, permaneceram significativas as associações entre transtornos emocionais e comportamentais e as seguintes variáveis: sexo feminino (OR = 1,98; IC95 por cento: 1,10-3,56, p = 0,02), e ter asma (OR = 2,66; IC95 por cento: 1,52-4,64, p = 0,001). CONCLUSÕES: A prevalência de transtornos emocionais e comportamentais em adolescentes portadores de asma é significativamente maior do que naqueles que não tem asma, reforçando a necessidade de uma abordagem interdisciplinar e sistêmica.

OBJECTIVE: To determine the prevalence of emotional and behavioral disorders in adolescents with asthma and to compare it with that of adolescents without asthma. METHODS: A transversal study using the Strengths and Difficulties Questionnaire, administered to adolescents with or without asthma, ranging from 14 to 16 years of age and randomly selected from schools in the city of Belo Horizonte, Brazil. RESULTS: The prevalence of emotional and behavioral disorders in adolescents with and without asthma was 20.4 percent (95 percent CI: 14.5-27.8 percent) and 9.0 percent (95 percent CI: 6.1-12.8 percent), respectively. Among adolescents with asthma, 56.6 percent (95 percent CI: 48.3-64.5 percent) presented normal scores, and 23.0 percent (95 percent CI 16.8-30.7 percent) presented borderline scores. Among adolescents without asthma, 75.0 percent (95 percent CI: 69.7-79.6 percent) presented normal scores, and 16.0 percent (95 percent CI: 12.2-20.7 percent) presented borderline scores. The median total score on the questionnaire was 14 and 12 among subjects with and without asthma, respectively (p < 0.01). In the final logistic regression model, adjusted for socioeconomic variables, the association between emotional/behavioral disorders and the following variables remained significant: being female (OR = 1.98; 95 percent CI: 1.10-3.56; p = 0.02) and having asthma (OR = 2.66; 95 percent CI: 1.52-4.64; p = 0.001). CONCLUSIONS: The prevalence of emotional and behavioral disorders is higher in adolescents with asthma than in those without asthma, underscoring the need for a holistic, interdisciplinary approach.

Influencia de la familia como factor protector de conductas de riesgo en escolares chilenos / Family influence as a protective factor against risk behaviors in Chilean adolescents

Background: Family is an important protective factor in the prevention of risk behaviors in Chilean adolescents. Aim To determine the prevalence of risk and protective factors and behaviors in Chilean students, and to study the association between family functioning and adolescent risk behaviors. Material and methods: Descriptive cross sectional study of 815 adolescents aged 15 ± 2 years (51 percent male), studying 7th to 12th grade in three educational facilities in Santiago, Chile. They answered the Adolescent Risk Behavior Score, adapted from the Adolescent Health Survey and the "How is your family" survey of the Pan American Health Organization. Results: Tobacco, alcohol and marihuana consumption was reported by 31 percent, 27 percent and 24 percent of students, respectively. Twelve percent reported being sad all the time, 23 percent being desperate and 13 percent being anxious. Forty four percent have had a sexual intercourse. The risk to have these behaviors was greater in adolescents who perceive their families as dysfunctional. Conclusions: In this sample, there was a high prevalence of risk behaviors, emotional symptoms and premature sexual intercourse. The risk of having these behaviors is higher among students who perceive their families as dysfunctional. The study emphasizes the protective function of family in the prevention of risk behaviors in Chilean students.

Estudio oncativo: factores de riesgo psicopatológicos de enfermedad arterial (prevalencia, superposición o vínculo con otros factores) / Psycho-pathological risk factor of arterial disease (prevalence, superposition or vinculation with other factors)

Entidades psicopatológicas como alexitimia y depresión, pueden coexistir o no con factores de riesgo de enfermedad arterial o ser entidades independientes. Tienen frecuentemente relación con aspectos socio-económico-culturales y con la etnia; a veces son determinantes del proceso ateroesclerótico por alterar la reactividad vascular (Alexitimai) o agravadores del proceso evolutivo (depresión). Materiales y métodos: Existe escasa información sobre esta tematica en nuestro país: la existente se refiere a los mismos en muestras seleccionadas, no de poblaciones generales (urbanas o rurales). Resultados: se exponen los resultados obtenidos de lainvestigación de esos factores en una población de la Provincia de Córdoba (RA), donde simultáneamente se estudiaron factores de orden fisico y conductual. Conclusiones: La prevalencia de la depresión es más elevada que en otras poblaciones

Alexitimia and depression may or not coexist with others risk factors (comportment o physical). Frecuently they have relation with socio-echonomic status and with ethnia. Sometimes are determinants of the atherosclerotic process by increasing the vascular reactivity by the alteration of the evolution. There is no information in our country about this problem in general population. The present study result of the investigation of these aspects and the comportamental and physical factors of arterial disease, in a population of Cordoba province (Argentina Republic).

Desgaste emocional en docentes oficiales de Medellín, Colombia, 2005 / Emotional burn-out in official teachers, Medellín, Colombia, 2005

Objetivo: Explorar manifestaciones de desgaste emocional y físico o, síndrome de Burnout, en docentes oficiales de Medellín, Colombia, 2005. Métodos: Estudio cuantitativo transversal en una muestra aleatoria bietápica de 239 sujetos a quienes se aplicó cuestionario autodiligenciado para explorar variables demográficas, sociolaborales y las dimensiones del síndrome Burnout según el Maslach Burnout Inventary-MBI. Resultados: El 23,4 por ciento presentó manifestaciones de Burnout y un 23,4 por ciento adicional tuvo riesgo de manifestarlo; en ambos subgrupos prevaleció el agotamiento emocional y la despersonalización. Conclusiones: Se encontró relación de manifestaciones del Burnout con algunas variables estudiadas. Se sugiere profundizar en la exploración de variables personales, familiares y sociales que potencialmente responden por las manifestaciones del síndrome.

Objetive: Exploring signs of emotional and physical weakness or Burnout syndrome in qualified teachers in Medellín, Colombia, 2005. Methods: A cross-sectional study was applied to a random bi-stage sample of 239 teachers who filled in a questionnaire by themselves to explore demographic, work and social variables and dimensions of the Burnout syndrome, according to the Maslach Burnout Inventary (MBI). Results: The findings showed that 23,4 percent of the sample presented signs of Burnout and a further 23,4 percent were at risk of suffering it; emotional weakness and depersonalisation were present in both subgroups. Conclusions: A relationship between Burnout signs and some of the variables studied was found. It is suggested that personal, family and social variables potentially associated with the syndrome should be explored more deeply.

The Relationship of Anger Expression and Alexithymia with Coronary Artery Stenosis in Patients with Coronary Artery Diseases

This study examined the relationship between anger expression or alexithymia and coronary artery stenosis in patients with coronary artery diseases. 143 patients with coronary artery diseases (104 males and 39 females) were enrolled in this study. The severity of their coronary artery stenosis was measured by angiography. The Anger Expression Scale and the Toronto Alexithymia Scale were used to assess the level of anger expression and alexithymia. The more stenotic group (occluded by 75% or more) exhibited a significantly higher level of alexithymia than the less stenotic group (occluded by less than 25%). Multiple regression anaylsis on the extent of stenosis also revealed that regardless of gender and age, the coronary artery disease patients with higher alexithymia were likely to show a greater level of stenosis. However, no significant differences were found on either the anger-in or anger-out subscale scores between the two groups. These results suggest that alexithymia is associated with the severity of coronary artery stenosis in patients with coronary artery disease. However, both anger expression and anger suppression were not shown to be associated with the severity of coronary artery stenosis.

Impact of disability on quality of life of rural disabled people in Bangladesh.

This study examined the impact of disability on the quality of life of disabled people in rural Bangladesh. A primary healthcare specialist conducted a door-to-door survey in two villages in Bangladesh to collect socioeconomic and demographic information on the villagers and for identification of disabled people. Information on disability and how it affected their life was also obtained either from the disabled people or from their caregivers by interviewing them. The study revealed that disability had a devastating effect on the quality of life of the disabled people with a particularly negative effect on their marriage, educational attainment, employment, and emotional state. Disability also jeopardized their personal, family and social life. More than half of the disabled people were looked at negatively by society. Disabled women and girl children suffered more from negative attitudes than their male counterparts, resulting in critical adverse effects on their psychological and social health. A combination of educational, economic and intensive rehabilitative measures should be implemented urgently to make them self-reliant. Collaborative communication between professionals and parents, behavioural counselling, formation of a self-help group, and comprehensive support to families will reduce their suffering.

Halitosis en pacientes con problemas periodontales / Halitosis in patients with periodontal problems

La halitosis es una condición frecuente, que todas las personas en algún momento de su vida padecen, el odontólogo es el profesional más ligado con este problema. El objetivo de este estudio fue determinar la asociación entre la halitosis y la severidad de la enfermedad periodontal. Se realizó un estudio transversal descriptivo en donde se evaluaron 200 pacientes cuyo motivo de consulta fue la halitosis. Se utilizó un alímetro para medir los compuestos volátiles de sulfuro (CVS) y se determinó la asociación con enfermedad periodontal. El 19.3 por ciento de los pacientes con halitosis presentan enfermedad periodontal, el 43.2 por ciento problemas sistémicos asociados, y el 6 por ciento problemas emocionales. En el 31.5 por ciento, la cantidad de CVS fue menor a 300 partes por billón (ppb)

Migracao, insercao produtiva e saude mental na modernidade tardia: novas evidencias do estudo multicentrico de morbidade psiquiatrica em areas metropolitanas brasileiras / Migration, economic position and mental health in late modernity: a new evidence from the Brazilian multicentric study of psyquiatric morbidity in metropolitan areas

O presente texto busca contribuir para o debate sobre a correlacao entre migracao e a ocorrencia de disturbios emocionais no contexto dos avancos metodologicos da pesquisa em psiquiatria social na America Latina...