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1.
Einstein (Säo Paulo) ; 18: eAO5269, 2020. tab
Article in English | LILACS | ID: biblio-1133742

ABSTRACT

ABSTRACT Objective To evaluate aspects of eating behavior, presence of non-food substance consumption and negative urgency in women from an on-line support group for eating disorders. Methods Participants (n=147) completed questionnaires for binge eating assessment, Intuitive Eating, negative urgency, cognitive restraint and a question of non-food substance consumption. Participants were separated according to criteria for bulimic symptoms and compulsive symptoms. Results The consumption of non-food substances was 4.8% (n=7). The Bulimic Group (n=61) showed higher values for binge eating (p=0.01), cognitive restraint (p=0.01) and negative urgency (p=0.01) compared with the Compulsive Group (n=86). Only the Compulsive Group showed an inverse correlation between scores for binge eating and Intuitive Eating (p=0.01). In both groups, binge eating was inversely correlated with the subscale of body-food choice congruence of Intuitive Eating scale. As expected, the Bulimic Group reached higher values for measures of disordered behaviors such as cognitive restraint and binge eating, and lower scores for Intuitive Eating. Conclusion The aspects of Intuitive Eating are inversely associated with compulsive and bulimic symptoms and the correlation analyses for binge eating and negative urgency agreed with models reported in published literature about negative urgency.


RESUMO Objetivo Avaliar aspectos do comportamento alimentar, presença do consumo de substâncias não alimentares e urgência negativa em mulheres de um grupo de apoio para transtornos alimentares. Métodos As participantes (n=147) preencheram instrumentos para avaliação de compulsão alimentar, Comer Intuitivo, urgência negativa, restrição cognitiva e uma questão para consumo de substâncias não alimentares. Elas foram divididas de acordo com critérios para sintomas bulímicos e sintomas compulsivos. Resultados O consumo de substâncias não alimentares foi de 4,8% (n=7). O Grupo Bulímico (n=61) apresentou maiores valores para compulsão alimentar (p=0,01), restrição cognitiva (p=0,01), e urgência negativa (p=0,01) em relação ao Grupo Compulsivo (n=86). Apenas o Grupo Compulsivo demonstrou correlação inversa entre escores para compulsão alimentar e Comer Intuitivo (p=0,01). Para ambos os grupos, a compulsão alimentar foi inversamente correlacionada com a subescala de escolhas alimentares realizadas em congruência com o estado do corpo do Comer Intuitivo. Como esperado, o Grupo Bulímico apresentou maiores valores para medidas de comportamentos disfuncionais como restrição e compulsão alimentar, e menores escores para Comer Intuitivo. Conclusão Os aspectos do Comer Intuitivo estiveram inversamente associados com os sintomas compulsivos e bulímicos, e os resultados das análises de correlação para Escala de Compulsão Alimentar e urgência negativa concordam com modelos da literatura sobre o envolvimento da urgência negativa.


Subject(s)
Humans , Female , Bulimia , Pica/psychology , Feeding Behavior/psychology , Binge-Eating Disorder/psychology , Feeding and Eating Disorders , Surveys and Questionnaires , Impulsive Behavior
2.
Int. j. odontostomatol. (Print) ; 13(2): 195-197, jun. 2019. graf
Article in English | LILACS | ID: biblio-1002305

ABSTRACT

ABSTRACT: Pica is a condition associated with the chronic, compulsive consumption of a particular substance or material that is not considered food. Culturally it is not accepted by society and its nutritional value is non-existent. When this behavior is repeated consistently for more than one month, it is considered to be Pica. This eating disorder does not have a clear etiology, but is associated with; orality in children, psychotic disorders, nutritional deficiencies, psychosocial problems, autism, family problems, OCD, stress, abuse, family separations and other traumatic events. In order to detect it, it is necessary to perform a correct anamnesis, clinical examination, radiographic examination, complementary examinations such as blood count, as well as a relationship of trust between the dentist and the patient are necessary. All of them will be able to guide us and make us come out of suspicion that this harmful behavior exists, since patients often hide it.


RESUMEN: Pica es una condición asociada al consumo compulsivo y crónico de alguna sustancia o material en particular, que no es considerada alimento. Culturalmente no es aceptado por la sociedad y su valor nutricional es inexistente. Cuando esta conducta se repite consiste-ntemente durante más de un mes, se considera como Pica. Este desorden de comportamiento alimenticio no tiene una etiología clara, pero se asocia a la oralidad en niños, trastornos psicóticos, deficiencias nutricionales, problemas psicosociales, autismo, problemas familiares, TOC, estrés, abuso, separaciones familiares y otros eventos traumáticos. Para detectarla, es necesaria una correcta anamnesis, examen clínico, radiográfico, exámenes complementarios como hemograma, además de una relación de confianza rapport odontólogo- paciente. El conjunto de ellos nos podrán guiar y salir de sospecha que esta conducta dañina existe, ya que los pacientes muchas veces lo esconden.


Subject(s)
Humans , Female , Aged , Pica/complications , Pica/etiology , Tooth Attrition/diagnosis , Radiography, Dental , Feeding and Eating Disorders , Chile , Foreign Bodies , Anemia
3.
Article in English | WPRIM | ID: wpr-760851

ABSTRACT

Rapunzel syndrome is caused by gastric trichobezoar with extended tail and small bowel obstruction. Patients with gastric trichobezoar can be asymptomatic until the bezoar increases in size. We report a case of a girl who visited the emergency department with abdominal pain. She was finally diagnosed with Rapunzel syndrome that causes multiple small bowel intussusceptions associated with trichophagia. Surgery was needed to reduce the multiple intussusceptions, and to remove the large trichobezoar. This case highlights to consider the possibility of Rapunzel syndrome when diagnosing the main cause of intussusceptions.


Subject(s)
Abdominal Pain , Bezoars , Emergency Service, Hospital , Female , Humans , Intestinal Obstruction , Intussusception , Pica , Tail , Trichotillomania
4.
Article in English | WPRIM | ID: wpr-759989

ABSTRACT

Vertebral artery injuries associated with C1 lateral mass screw insertion rarely occur during C1-2 fusion. The posterior inferior cerebellar artery (PICA) is uncommonly located at the C1 lateral mass insertion position. A 71-year-old woman with atlanto-axial subluxation and cord compression underwent C1-2 fusion. Sixth nerve palsy and diplopia were detected postoperatively, and decreased consciousness occurred on postoperative day 4. Brain magnetic resonance image (MRI) and computed tomography (CT) revealed PICA infarction. In the preoperative CT angiography, the PICA originated between the C1 and C2 level. In the postoperative CT scan, the PICA was not visible. The patient was treated conservatively for two weeks and recovered. PICA originating between the C1 and C2 level comprises 1.1–1.3% of cases. Therefore, vertebral artery anomalies should be evaluated prior to C1-2 fusion to prevent vessel injuries.


Subject(s)
Abducens Nerve Diseases , Aged , Angiography , Arteries , Brain , Brain Infarction , Consciousness , Diplopia , Female , Humans , Infarction , Pica , Tomography, X-Ray Computed , Vertebral Artery
5.
Article in English | WPRIM | ID: wpr-788711

ABSTRACT

OBJECTIVE: Surgical obliteration of ruptured aneurysm of the proximal posterior inferior cerebellar artery (PICA) is challenging because of limited surgical accessibility. In recent years, coil embolization is the first-choice treatment for these lesions. However, coil embolization is not always easy in ruptured PICA aneurysm owing to the variable anatomical diversity of its shapes, its relationship to the parent artery, its low incidence, and accordingly, lesser neurointerventionist experience.METHODS: The parent artery and microcatheter for easier navigation and the embolization technique for stable coiling were identified.RESULTS: This study aimed to identify the more appropriate approach route, microcatheter, and strategies for an easier and safer, and more durable coil embolization in the treatment of lesions in the proximal PICA.CONCLUSION: Coil embolization for aneurysmal subarachnoid hemorrhage due to a ruptured proximal PICA remains a challenge, but with the appropriate coiling plan, it can be treated successfully.


Subject(s)
Aneurysm , Aneurysm, Ruptured , Arteries , Embolization, Therapeutic , Humans , Incidence , Parents , Pica , Subarachnoid Hemorrhage
6.
Article in English | WPRIM | ID: wpr-788674

ABSTRACT

OBJECTIVE: Sometimes a vertebral artery (VA) enters the spinal canal via the C1–2 intervertebral space, a variation regarded as a C2 segmental-type VA. This paper describes the anatomy of the C2 segmental-type VA and reviews its clinical importance.METHODS: Between March 2014 and November 2015, 3386 patients underwent computed tomographic angiography. I identified C2 segmental-type VAs, associated vascular variation, the origin of ipsilateral posterior inferior cerebellar arteries (PICAs), and the clinical symptoms associated with C2 segmental-type VAs. The origin of an ipsilateral PICA is divided into 5 types. A type 1 PICA originates from ipsilateral VAs coursing suboccipitally (IVASO), a type 2 originates from ipsilateral proximal C2 segmental-type VAs, a type 3 originates from ipsilateral distal C2 segmental-type VAs. For type 4, the PICA does not originate from an ipsilateral VA. For type 5, the PICA is the terminal end of an ipsilateral C2 segmental-type VA.RESULTS: One hundred thirteen patients had 121 C2 segmental-type VAs; 47 were associated with an IVASO, and 74 were not. Four type 1, 13 type 2, 60 type 3, 42 type 4, and two type 5 PICAs were identified. Only one patient showed symptoms associated with a C2 segmental-type VA, being a 71-year-old man presenting with a C2 segmental-type VA infarction.CONCLUSION: For C2 segmental-type VAs, the ipsilateral IVASO and origin of the PICA are important for predicting the outcome of this type of VA infarction.


Subject(s)
Aged , Angiography , Arteries , Congenital Abnormalities , Humans , Infarction , Pica , Spinal Canal , Vertebral Artery
7.
Article in English | WPRIM | ID: wpr-765281

ABSTRACT

OBJECTIVE: Surgical obliteration of ruptured aneurysm of the proximal posterior inferior cerebellar artery (PICA) is challenging because of limited surgical accessibility. In recent years, coil embolization is the first-choice treatment for these lesions. However, coil embolization is not always easy in ruptured PICA aneurysm owing to the variable anatomical diversity of its shapes, its relationship to the parent artery, its low incidence, and accordingly, lesser neurointerventionist experience. METHODS: The parent artery and microcatheter for easier navigation and the embolization technique for stable coiling were identified. RESULTS: This study aimed to identify the more appropriate approach route, microcatheter, and strategies for an easier and safer, and more durable coil embolization in the treatment of lesions in the proximal PICA. CONCLUSION: Coil embolization for aneurysmal subarachnoid hemorrhage due to a ruptured proximal PICA remains a challenge, but with the appropriate coiling plan, it can be treated successfully.


Subject(s)
Aneurysm , Aneurysm, Ruptured , Arteries , Embolization, Therapeutic , Humans , Incidence , Parents , Pica , Subarachnoid Hemorrhage
8.
Article in English | WPRIM | ID: wpr-765244

ABSTRACT

OBJECTIVE: Sometimes a vertebral artery (VA) enters the spinal canal via the C1–2 intervertebral space, a variation regarded as a C2 segmental-type VA. This paper describes the anatomy of the C2 segmental-type VA and reviews its clinical importance. METHODS: Between March 2014 and November 2015, 3386 patients underwent computed tomographic angiography. I identified C2 segmental-type VAs, associated vascular variation, the origin of ipsilateral posterior inferior cerebellar arteries (PICAs), and the clinical symptoms associated with C2 segmental-type VAs. The origin of an ipsilateral PICA is divided into 5 types. A type 1 PICA originates from ipsilateral VAs coursing suboccipitally (IVASO), a type 2 originates from ipsilateral proximal C2 segmental-type VAs, a type 3 originates from ipsilateral distal C2 segmental-type VAs. For type 4, the PICA does not originate from an ipsilateral VA. For type 5, the PICA is the terminal end of an ipsilateral C2 segmental-type VA. RESULTS: One hundred thirteen patients had 121 C2 segmental-type VAs; 47 were associated with an IVASO, and 74 were not. Four type 1, 13 type 2, 60 type 3, 42 type 4, and two type 5 PICAs were identified. Only one patient showed symptoms associated with a C2 segmental-type VA, being a 71-year-old man presenting with a C2 segmental-type VA infarction. CONCLUSION: For C2 segmental-type VAs, the ipsilateral IVASO and origin of the PICA are important for predicting the outcome of this type of VA infarction.


Subject(s)
Aged , Angiography , Arteries , Congenital Abnormalities , Humans , Infarction , Pica , Spinal Canal , Vertebral Artery
9.
Article in English | WPRIM | ID: wpr-717706

ABSTRACT

We describe the case of a patient who had infarction of the posterior inferior cerebellar artery (PICA) after a chiropractic cervical manipulation. A 39-year-old man visited the emergency room with signs of cerebellar dysfunction, presenting with a 6-hour history of vertigo and imbalance. Two weeks ago, he was treated by a chiropractor for intermittent neck pain. At the time of admission, brain computed tomography, magnetic resonance imaging, and angiography revealed an acute infarction in the left PICA territory and occlusion of the extracranial vertebral artery (VA; V1/2 junction) as a result of the dissection of the VA. Angiography revealed complete occlusion of the left PICA and arterial dissection was shown in the extracranial portion of the VA. He was treated with antiplatelet therapy. Three weeks later, he was discharged without any sequelae. The possibility of VA dissection should be considered at least once in patients presenting with cerebellar dysfunctions with a recent history of chiropractic cervical manipulation.


Subject(s)
Adult , Angiography , Arteries , Brain , Cerebellar Diseases , Cerebral Infarction , Chiropractic , Emergency Service, Hospital , Humans , Infarction , Lateral Medullary Syndrome , Magnetic Resonance Imaging , Manipulation, Chiropractic , Manipulation, Spinal , Neck Pain , Pica , Vertebral Artery , Vertigo
10.
Neurointervention ; : 129-132, 2018.
Article in English | WPRIM | ID: wpr-730253

ABSTRACT

A 64-year-old female presented with an incidentally-discovered right posterior inferior cerebral artery (PICA) aneurysm, initially treated in 2015 by simple coiling. Follow-up demonstrated significant coil compaction that required retreatment. Retreatment was done uneventfully using a Pipeline embolization device (PED) shield deployed starting from the basilar artery and ending at the V4 segment of the vertebral artery. Eight-weeks post-deployment, a follow-up digital subtraction imaging (DSA) and intravascular imaging with optical coherence tomography were obtained. The intravascular imaging demonstrated that the flow diverter had good wall apposition and concentric neointimal growth over the braid with exception to the areas that the PED was not in contact with the endothelial wall, such as at the right PICA ostium and at the vertebrobasilar junction. The entire procedure was safe, and the patient had no complications. In this article, we describe for the first time the assessment of the status of endothelial “healing” of the PED shield at 8-weeks.


Subject(s)
Aneurysm , Basilar Artery , Cerebral Arteries , Female , Follow-Up Studies , Humans , Middle Aged , Pica , Retreatment , Tomography, Optical Coherence , Vertebral Artery
11.
Med. Afr. noire (En ligne) ; 65(02): 121-126, 2018. ilus
Article in French | AIM, AIM | ID: biblio-1266289

ABSTRACT

Le pica est un trouble du comportement alimentaire fréquemment rencontré chez les femmes et les enfants. Il se caractérise par l'ingestion d'objets ou de substances non-comestibles comme la craie, le charbon, le savon, le métal, le sable etc... Nous rapportons une observation d'une patiente de 20 ans avec notion d'autisme depuis l'enfance et d'addiction à la géophagie (Kaolin appelé "kéw" au Sénégal) depuis plusieurs années qui a eu à consulter pour des douleurs abdominales associées à des ballonnements abdominaux, une hématémèse et un arrêt complet des matières et des gaz. Son examen clinique avait objectivé un abdomen légèrement sensible sans défense ni cris de l'ombilic et le toucher rectal avait objectivé un fécalome de consistance dure. Le bilan biologique était normal en dehors d'une légère hypokaliémie, le test de Wide était négatif. La radiographie de l'abdomen sans préparation avait objectivé des micro calcifications en amas au niveau du rectum confortée par la tomodensitométrie abdomino-pelvienne qui avait en plus infirmé l'existence d'une perforation d'organe et de souffrance viscérale. Un traitement évacuateur mécanique consistant en la mise en place d'une sonde d'intubation orotrachéale charnière n°6 au niveau du rectum avec ballonnet gonflé et irrigation par 500 ml de sérum savonneux stérile suivi d'une évacuation au doigt avait permis d'évacuer la quasi-totalité des corps étrangers endorectaux confirmée par la radiographie de contrôle. Devant la constatation d'une ré-ingestion au bout d'une semaine avec une radiographie de l'abdomen sans préparation qui avait montré des images quasi-superposable, la patiente a été adressée en consultation psychiatrique pour un suivi


Subject(s)
Abdominal Pain , Case Reports , Eating , Intestinal Obstruction , Kaolin , Pica/diagnosis , Pica/etiology , Senegal
12.
The Korean Journal of Pain ; : 191-198, 2018.
Article in English | WPRIM | ID: wpr-742188

ABSTRACT

BACKGROUND: Patient-controlled epidural analgesia (PCEA) is known to provide good postoperative analgesia in many types of surgery including laparoscopic surgery. However, no study has compared PCEA with patient-controlled intravascular analgesia (PCIA) in laparoscopic radical prostatectomy (LARP). In this study, the efficacy and side effects of PCEA and PCIA after LARP were compared. METHODS: Forty patients undergoing LARP were randomly divided into two groups: 1) a PCEA group, treated with 0.2% ropivacaine 3 ml and 0.1 mg morphine in the bolus; and 2) a PCIA group, treated with oxycodone 1 mg and nefopam 1 mg in the bolus. After the operation, a blinded observer assessed estimated blood loss (EBL), added a dose of rocuronium, performed transfusion, and added analgesics. The numeric rating scale (NRS), infused PCA dose, and side effects were assessed at 1, 6, 24, and 48 h. RESULTS: EBL, added rocuronium, and added analgesics in the PCEA group were less than those in the PCIA group. There were no significant differences in side-effects after the operation between the two groups. Patients were more satisfied with PCEA than with PCIA. The NRS and accumulated PCA count were lower in PCEA group. CONCLUSIONS: Combined thoracic epidural anesthesia could induce less blood loss during operations. PCEA showed better postoperative analgesia and greater patient satisfaction than PCIA. Thus, PCEA may be a more useful analgesic method than PICA after LARP.


Subject(s)
Administration, Intravenous , Analgesia , Analgesia, Epidural , Analgesia, Patient-Controlled , Analgesics , Anesthesia, Epidural , Humans , Injections, Epidural , Laparoscopes , Laparoscopy , Methods , Morphine , Nefopam , Oxycodone , Pain Measurement , Pain, Postoperative , Passive Cutaneous Anaphylaxis , Patient Satisfaction , Pica , Prostatectomy , Thoracic Vertebrae
13.
Article in English | WPRIM | ID: wpr-764317

ABSTRACT

The safety and feasibility of simple coil embolization and stent deployment for the treatment of posterior inferior cerebellar artery (PICA) aneurysms, as well as their radiologic and clinical results, have not been adequately understood. Especially, if dissecting aneurysm of proximal PICA is associated with small caliber PICA and stenosis of ipsilateral vertebral artery orifice (VAO), endovascular coiling with saving of PICA is not always easy. This 64-year-old man presented with subarachnoid hemorrhage due to a ruptured dissecting aneurysm of left proximal PICA. The aneurysm was irregularly fusiform in nature with a shallow PICA orifice (1.4 mm) and narrow caliber (0.9–1.5 mm). Moreover, the ipsilateral VAO showed severe stenosis (1.8 mm). We performed bifemoral puncture and chose additional route from right vertebral artery to left vertebrobasilar junction for retrograde approach and deployment of LVIS Jr. intraluminal support at proximal PICA. And then, the antegrade approach and coiling of aneurysm was done. Despite of transient thrombus of PICA, the aneurysm was successfully secured with preservation of whole PICA course. For preservation of narrow PICA with ipsilateral VAO stenosis, the contralateral approach and deployment of LVIS Jr. intraluminal support may be considered.


Subject(s)
Aneurysm , Aneurysm, Dissecting , Arteries , Constriction, Pathologic , Embolization, Therapeutic , Humans , Middle Aged , Pica , Punctures , Stents , Subarachnoid Hemorrhage , Thrombosis , Vertebral Artery
14.
Article in Korean | WPRIM | ID: wpr-47047

ABSTRACT

Ischemic stroke caused by spontaneous thrombosis of posterior inferior cerebellar artery (PICA) aneurysm has been rarely reported. A 52-year-old man presented with sudden headache, dizziness, and gait disturbance. Diffusion-weighted MRI showed acute infarction in left PICA territory. A saccular aneurysm with internal thrombus at the distal PICA was detected by CT angiography and conventional angiography. The thrombus resolved spontaneously at 2 months after stroke onset with aspirin medication. At that time, endovascular coiling was underwent successfully to prevent aneurysmal rupture.


Subject(s)
Aneurysm , Angiography , Arteries , Aspirin , Cerebral Infarction , Dizziness , Gait , Headache , Humans , Infarction , Magnetic Resonance Imaging , Middle Aged , Pica , Rupture , Stroke , Thrombosis
15.
Article in Spanish | LILACS | ID: biblio-1348585

ABSTRACT

La Pica es un síndrome caracterizado por la ingestión persistente de más de un mes de sustancias no nutritivas, se presenta en pacientes con alteración de la salud mental de cualquier causa con padecimientos de orden metabólico, enfermedad celíaca, drepanocitosis, déficit de nutrientes y embarazadas, entre otros. Las complicaciones asociadas a la Pica varían según el tipo de sustancia consumida, manifestándose como obstrucción intestinal -siendo esta la más frecuente- infecciones y desnutrición. Asimismo, observamos que el 75% de los pacientes atendidos necesita cirugía, el 30% sufre complicaciones y hasta el 11% fallece a consecuencia de la Pica o complicaciones postoperatorias. Por ser un síndrome de etiología no bien clarificada, multifactorial y recidivante, los pacientes debe ser evaluados y tratados por un equipo de salud multidisciplinario. En el presente estudio se presentan tres casos de pacientes pediátricos autóctonos de la provincia de Corrientes y una breve revisión y actualización clínica del tema.


Subject(s)
Humans , Child , Adolescent , Syndrome , Pica , Abdomen, Acute/pathology , Intestinal Obstruction/diagnosis , Pediatrics , Postoperative Complications , Malnutrition , Anatomy , Infections
16.
Article in Korean | WPRIM | ID: wpr-65867

ABSTRACT

Arterial dissection is an important cause of stroke. We report two cases of isolated posterior inferior cerebellar artery (PICA) dissection diagnosed by high-resolution vessel-wall MRI (HRVW-MRI). One subject complained of abrupt-onset vertigo and headache, and the other subject had headache, vertigo, and Horner syndrome. Conventional MRA showed only focal dilatation of the PICA, but HRVW-MRI revealed intramural hematoma and double-lumen contour in the PICA, suggesting arterial dissection. We suggest that the use of HRVW-MRI should be considered when diagnosing isolated PICA dissection in a PICA infarct with an unknown cause.


Subject(s)
Arteries , Dilatation , Headache , Hematoma , Horner Syndrome , Magnetic Resonance Imaging , Pica , Stroke , Vertigo
17.
Rev. bras. ginecol. obstet ; 37(12): 571-577, dez. 2015.
Article in Portuguese | LILACS | ID: lil-767796

ABSTRACT

Resumo OBJETIVO: Avaliar fatores nutricionais e psicológicos associados com a ocorrência da prática da picamalácia em gestantes atendidas em maternidade pública do Rio de Janeiro, Brasil. MÉTODOS: Estudo descritivo, de caráter exploratório, realizado com 13 gestantes (idades entre 16 e 40 anos) com diagnóstico de picamalácia na gestação atual identificada em entrevista padronizada na consulta com nutricionista que abordava questões sobre ocorrência e frequência do transtorno, além dos tipos de substâncias ingeridas. Após assinarem o Termo de Consentimento Livre e Esclarecido (TCLE), todas as gestantes passaram por avaliação nutricional e, posteriormente, sete foram submetidas à avaliação psicológica com instrumentos padronizados para medida de ansiedade e estresse, além da avaliação de estratégias de enfrentamento (coping ) diante de estressores. RESULTADOS: As práticas de picamalácia mais referidas foram pagofagia (30,8%) e fruta com sal (30,8%). Observou-se ocorrência de algum grau de estresse e ansiedade em todas as gestantes com picamalácia, assim como alguma comorbidade (69,2%) e sintomatologia digestiva (84,6%). As estratégias decoping mais prevalentes foram "focada em práticas religiosas/pensamento fantasioso" e "busca de suporte social", ambas com 42%. CONCLUSÃO: Considerando que a picamalácia pode associar-se com maior risco perinatal, é fundamental que essa prática seja investigada durante o atendimento pré-natal e que ocorra a adoção de práticas preventivas obstétricas, psicológicas e nutricionais para reduzir complicações para a mãe e o concepto.


Abstract PURPOSE: To evaluate the nutritional and psychological factors associated with the occurrence of the practice of pica in pregnant women attending a public hospital in Rio de Janeiro, Brazil. METHODS: The study was based on a descriptive design with exploratory features, and conducted on 13 adult and adolescent pregnant women aged 16 to 40 years with a diagnosis of pica in the current pregnancy. Pica was diagnosed by a nutritionist in a standardized interview situation, when questions about the occurrence and frequency of pica, and types of substance ingestion were investigated. After signing the Informed Consent Form (ICF), all participants were evaluated by a nutritionist and seven of them were submitted to psychological assessment with standardized instruments to evaluate stress and anxiety, and to assess coping strategies. RESULTS: The type of pica most frequently reported was pagophagia (30.8%) and the consumption of fruit with salt (30.8%). The most prevalent coping strategies were "religious practice-focused" and "seeking social support", both presented by 42% of the pregnant women. We observed the occurrence of some degree of stress and anxiety in all pregnant women, as well as comorbidities (69.2%) and gastrointestinal symptoms (84.6%). CONCLUSION: Considering that pica may be associated with increased perinatal risk, it is very important to investigate this disorder during prenatal care, and to dopt obstetric, psychological and nutritional preventive practices to reduce the complications for mother and fetus.


Subject(s)
Humans , Female , Pregnancy , Adult , Adaptation, Psychological , Pica/psychology , Pregnancy Complications , Prenatal Care , Brazil , Pica/prevention & control , Prevalence , Social Support , Stress, Psychological
18.
Article in English | WPRIM | ID: wpr-19662

ABSTRACT

OBJECTIVE: Intracranial ruptured vertebral artery dissecting aneurysms (VADAns) are associated with high morbidity and mortality when left untreated due to the high likelihood of rebleeding. The present study aimed to establish an endovascular therapeutic strategy that focuses specifically on the angioarchitecture of ruptured VADAns. METHODS: Twenty-three patients with ruptured VADAn received endovascular treatment (EVT) over 7 years. The patient group included 14 women (60.9%) and 9 men (39.1%) between the ages of 39 and 72 years (mean age 54.2 years). Clinical data and radiologic findings were retrospectively analyzed. RESULTS: Four patients had aneurysms on the dominant vertebral artery. Fourteen (61%) aneurysms were located distal to the posterior inferior cerebellar artery (PICA). Six (26%) patients had an extracranial origin of the PICA on the ruptured VA, and 2 patients (9%) had bilateral VADAns. Eighteen patients (78%) were treated with internal coil trapping. Two patients (9%) required an adjunctive bypass procedure. Seven patients (30%) required stent-supported endovascular procedures. Two patients experienced intra-procedural rupture during EVT, one of which was associated with a focal medullary infarction. Two patients (9%) exhibited recanalization of the VADAn during follow-up, which required additional coiling. No recurrent hemorrhage was observed during the follow-up period. CONCLUSION: EVT of ruptured VADAns based on angioarchitecture is a feasible and effective armamentarium to prevent fatal hemorrhage recurrence with an acceptable low risk of procedural complications. Clinical outcomes depend mainly on the pre-procedural clinical state of the patient. Radiologic follow-up is necessary to prevent hemorrhage recurrence after EVT.


Subject(s)
Aneurysm , Aneurysm, Dissecting , Arteries , Endovascular Procedures , Female , Follow-Up Studies , Hemorrhage , Humans , Infarction , Male , Mortality , Pica , Recurrence , Retrospective Studies , Rupture , Subarachnoid Hemorrhage , Vertebral Artery
19.
Article in English | WPRIM | ID: wpr-189967

ABSTRACT

A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.


Subject(s)
Aged , Aneurysm , Aneurysm, Dissecting , Arteries , Cerebral Revascularization , Humans , Pica , Subarachnoid Hemorrhage
20.
Article in English | WPRIM | ID: wpr-28124

ABSTRACT

Treatment of complex aneurysms usually entails not only direct clipping but also alternative treatment modality. We recently experienced a case of vertebral artery dissecting aneurysm and obtained good treatment outcomes. Our case suggests that the endovascular segmental occlusion with posterior inferior cerebellar artery (PICA) to PICA side anastomosis might be a good treatment option in patients with complex vertebral artery dissecting aneurysms. A 45-year-old woman has a left vertebral dissecting aneurysm with dizziness. Based on the aneurysmal morphology and the involvement of PICA, the patient underwent side to side anastomosis of the PICA. This was followed by the endovascular segmental coil occlusion. The aneurysmal sac was completely obliterated. At a 2-year follow-up, the patient achieved a good patency of both PICA. In conclusion our case suggests that the endovascular segmental occlusion of the parent artery followed by PICA to PICA bypass surgery through a midline suboccipital approach is a reasonable multimodal treatment option in patients with complex vertebral artery dissecting aneurysms.


Subject(s)
Aneurysm , Aneurysm, Dissecting , Arteries , Combined Modality Therapy , Dizziness , Female , Follow-Up Studies , Humans , Middle Aged , Parents , Pica , Vertebral Artery
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