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Objetivo: Este estudio tuvo como objetivo principal validar el Voice Handicap Index (VHI) y su versión abreviada (VHI-10) adaptados al español rioplatense de Argentina, con objetivos específicos centrados en evaluar su fiabilidad y validez. Metodología: La adaptación cultural incluyó técnicas de traducción directa, síntesis y retrotraducción, evaluación de la equivalencia semántica y aplicación a un grupo piloto. Para la validación se evaluó la fiabilidad de ambos índices adaptados mediante la consistencia interna (coeficiente alfa de Cronbach) y la estabilidad test-retest (prueba de Bland-Altman, CCI y r de Spearman). Además, se examinó la validez de criterio y de constructo. 213 sujetos participaron en la validación del índice adaptado de 30 ítems (123 disfónicos; 90 de control); 113, en la del índice abreviado (63 disfónicos; 50 de control). Resultados: Se constituyó el Índice de Desventaja Vocal (IDV) como la versión adaptada del VHI al español rioplatense de Argentina. Ambos índices demostraron excelente consistencia interna (IDV-30 α = 0,96; IDV-10 α = 0,92) y estabilidad y concordancia (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Se halló alta correlación entre los puntajes de ambos índices y la autoevaluación de la severidad de la disfonía de los participantes (r = 0,85). Ambos índices demostraron capacidad de diferenciar entre individuos con disfonía y sujetos sanos (p< 0,001). El análisis factorial reveló tres factores para el IDV-30 y un factor para el IDV-10. Conclusiones: El IDV-30 e IDV-10 presentan grados adecuados de fiabilidad y validez. Ambos pueden ser incluidos en protocolos de valoración de la función vocal por profesionales de Argentina.
Aim: This study aimed to validate the Voice Handicap Index (VHI) and its abbreviated version (VHI-10) adapted into Rioplatense Spanish from Argentina, with specific goals centered on assessing their reliability and validity. Methods: Cultural adaptation involved direct translation, synthesis and back-translation techniques, followed by an assessment of semantic equivalence and application to a pilot group. For the validation process, the reliability of both adapted indices was assessed through measures of internal consistency (Cronbach's alpha coefficient) and test-retest stability (Bland-Altman test, ICC and Spearman's correlation coefficient). Additionally, we conducted analyses to asses criterion and construct validity. 213 subjects participated in the validation of the adapted 30-items index, (123 with dysphonia; 90 from control group); 113, in the abbreviated version (63 with dysphonia; 50 from control group). Results: The "Índice de Desventaja Vocal" (IDV) was established as the adapted version of the VHI into Rioplatense Spanish from Argentina. Both indeces exhibited excellent internal consistency (IDV-30 α = 0,96; IDV-10 α = 0,92) and satisfactory stability and agreement (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Regarding validity, a strong correlation was observed between the scores of both indeces and the participant's self-assessment of dysphonia degree (r = 0,85). Both indices effectively differentiated between individuals with dysphonia and healthy subjects (p< 0,001). Factor analysis revealed three factors for the IDV-30 and one factor for the IDV-10. Conclusion: The IDV-30 and IDV-10 demonstrate satisfactory levels of reliability and validity. Both indices can be incorporated into the assessment protocols for evaluating the vocal function by professionals in Argentina.
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Resumen La participación en programas de evaluación externa de la calidad (PEEC) dirigidos al diagnóstico de enfermedades genéticas permite obtener una medida objetiva del desempeño técnico y analítico de los laboratorios y es un requisito para la acreditación de los laboratorios clínicos bajo la norma ISO 15189. El objetivo de este estudio fue evaluar retrospectivamente el desempeño en los esquemas EMQN (European Molecular Genetics Quality Network) y CF Network (Cystic Fibrosis European Network) en el período 2014-2022. Se participó en un total de 88 esquemas. Se recolectó la información de nuestros puntajes y las medias de los laboratorios participantes en las categorías genotipificación, interpretación y exactitud de la información del paciente/informe. Se informó en forma completa el 90,9% (n=80) de los esquemas. El desempeño en genotipificación mostró puntajes superiores a la media en el 89,3% de los esquemas; 0,8% de los informes correspondieron a falsos negativos. En interpretación, el 66,7% de los esquemas evidenció un desempeño superior a la media y el 33,3% debajo de la media. La exactitud de la información del paciente/informe presentó puntajes superiores a la media en el 97,6% de los esquemas. Se observó una diferencia estadísticamente significativa en el porcentaje de esquemas con puntaje por encima de la media en el año 2022 (10/12 esquemas) respecto al año 2014 (1/6 esquemas) en la categoría interpretación (p=0,0128). En conclusión, la participación regular en PEEC tuvo impacto positivo en la calidad de los estudios y permite realizar mejoras continuas a partir de las recomendaciones sugeridas por estos programas.
Abstract Participation in external quality assessment programmes focused on rare genetic diseases makes it possible to assess the laboratory technical and analytical performance and it is a prerequisite for accreditation according to ISO 15189. The objective of this study was to perform a retrospective evaluation of our performance in the EMQN (European Molecular Genetics Quality Network) and the CF Network (Cystic Fibrosis European Network) programmes in the 2014-2022 period. The laboratory performance on genotyping, interpretation and clerical accuracy and patient identifiers in a total of 88 schemes were assessed. The information of our scores and the mean scores of all participating laboratories in the three categories were collected. A total of 90.9% of the schemes were fully completed. The performance in genotyping showed scores above the mean scores in 89.3% of the schemes; 0.8% of the reports correspond to false negative results. Regarding interpretation category, 66.7% of the schemes presented scores above the mean scores and 33.3% below the mean scores. The clerical accuracy and patient identifiers were above the mean scores in 97.6% of the schemes. A statistically significant difference in the percentage of schemes with a score above the mean for the interpretation category in the year 2022 (10/12 schemes) was observed compared to the year 2014 (1/6 schemes) (p=0.0128). In conclusion, regular participation in external quality assessment programmes had a positive impact on the quality of the studies and allows for continuous improvements based on the recommendations suggested by these programmes.
Resumo A participação em programas de avaliação externa da qualidade (PEECs) voltados para o diagnóstico de doenças genéticas permite obter uma mensuração objetiva do desempenho técnico e analítico dos laboratórios e é requisito para a acreditação dos laboratórios clínicos sob a norma ISO 15189. O objetivo desse estudo foi avaliar retrospectivamente o desempenho nos esquemas EMQN (European Molecular Genetics Quality Network) e CF Network (Cystic Fibrosis European Network) no período 2014-2022. Participou-se em um total de 88 esquemas. Foram coletadas informações de nossos escores e das médias dos laboratórios participantes nas categorias genotipagem, interpretação e precisão da informação do paciente/laudo. 90,9% (n=80) dos esquemas foram informados em sua totalidade. O desempenho na genotipagem apresentou escores acima da média em 89,3% dos esquemas; 0,8% dos laudos corresponderam a falsos negativos. Na interpretação, 66,7% dos esquemas apresentaram desempenho acima da média e 33,3% abaixo da média. A precisão das informações do paciente/laudo apresentou escores acima da média em 97,6% dos esquemas. Observou-se diferença estatisticamente significativa no percentual de esquemas com pontuação acima da média no ano de 2022 (10/12 esquemas) em relação ao ano de 2014 (1/6 esquemas) na categoria interpretação (p=0,0128). Em conclusão, a participação regular em PEECs teve um impacto positivo na qualidade dos estudos e permite fazer melhorias contínuas com base nas recomendações sugeridas por esses programas.
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BACKGROUND@#The thoracic small biopsy sampling procedure including transbronchial forceps lung biopsy (TBLB) and endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) can be accompanied by rapid on-site evaluation (ROSE) of sample material to provide immediate feedback for the proceduralist. The present study aims to investigate the supplemental effect of ROSE smear samples for lung cancer molecular test.@*METHODS@#In a retrospective study, 308 patients admitted to our hospital from August 2020 to December 2022 undergoing diagnostic TBLB and EBUS-TBNA with ROSE and subsequently diagnosed as non-small cell lung cancer (NSCLC) were analyzed. The matched formalin-fixed paraffin-embedding (FFPE) tissue section and ROSE smears for tumor cellularity were compared. DNA yields of smears were determined. Real-time polymerase chain reaction (PCR) and next-generation sequencing (NGS) were performed on adequate smear samples.@*RESULTS@#ROSE smear samples were enriched in tumor cells. Among 308 biopsy samples, 78 cases (25.3%) exhibited inadequate FFPE tissue sections, whereas 44 cases (14.3%) yielded adequate smear samples. Somatic mutations detected in the FFPE tissue section samples were also detected in the matching adequate smear sample.@*CONCLUSIONS@#ROSE smear samples of the thoracic small biopsies are beneficial supplemental materials for ancillary testing of lung cancer. Combined use of cytology smear samples with traditional FFPE section samples can enhance the detection rate of informative mutations in patients with advanced NSCLC. We recommend that the laboratory could further evaluate the ROSE cell smears of the patient when FFPE tissue sections are inadequate, and that adequate cell smears can be used as a supplemental source for the molecular testing of NSCLC.
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Humanos , Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/patología , Evaluación in Situ Rápida , Estudios Retrospectivos , Técnicas de Diagnóstico Molecular , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodosRESUMEN
This article reports a case with the chief complaint of “hepatosplenomegaly to be investigated” and a confirmed diagnosis of Niemann-Pick disease type B after various tests， and a literature review was conducted to summarize the heterogeneous manifestations of liver involvement in type B Niemann-Pick disease， in order to improve the clinical management of difficult and rare liver diseases.
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Objective To analyze the clinicopathological characteristics and prognosis of oligodendroglioma with IDH mutation and 1p/19q codeletion. Methods We collected the data of 54 oligodendroglioma patients with IDH mutation and 1p/19q codeletion.The patients'clinicopathological data, including age, histological grade, and tumor site, were analyzed for the effects on progression-free and overall survival. Results Among the 54 patients, 46 cases were with tumor sites in one lobe, and eight cases involved tumor sites in more than two lobes.A total of 12 and 42 cases had WHO grades 2 and 3 oligodendroglioma, respectively.Detection by fluorescence in situ hybridization showed 1p/19q co-deletion in all cases.Immunohistochemical tests revealed diffuse and strong positive results for Olig2.All glial fibrillary acidic proteins were positive.p53 was strongly positive in six cases.ATRX was expressed in all 48 cases.Ki-67 proliferation index ranged from 5% to 60%.Sanger sequencing showed that all 54 cases had IDH gene mutations (40 cases were IDH1 mutations, and 14 were IDH2 mutations), and 33 cases had telomerase reverse transcriptase promoter mutations.Relapse and metastasis occurred in 16 patients during treatment.Univariate analysis indicated that the postoperative recurrence and metastasis interval of more than two years can prolong the progression-free and overall survival of patients.All 54 patients had a mean progression-free survival of 33.5 months and the mean overall survival of 40.7 months. Conclusion For oligodendroglioma with IDH mutation and 1p/19q codeletion, precision chemoradiotherapy after surgery can reduce the risk of progression, and the postoperative recurrence and metastasis interval is associated with the prognosis.
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Objective To summarize the diagnosis and treatment experience of adenine phosphoribosyltransferase deficiency after kidney transplantation. Methods Clinical data of 1 patient with adenine phosphoribosyltransferase deficiency after kidney transplantation were retrospectively analyzed. Clinical characteristics, diagnosis, treatment and prognosis of adenine phosphoribosyltransferase deficiency were summarized by literature review. Results Renal biopsy showed that salt crystallization was found in most renal tubule lumen and positive results were observed under polarized light microscopy. After allopurinol, hemodialysis and anti-crystallization treatment, the graft function was gradually recovered. After postoperative 1-year follow-up, the patient's renal function was properly recovered. Conclusions Adenine phosphoribosyltransferase deficiency after kidney transplantation may lead to delayed graft function or graft dysfunction. Early detection, diagnosis and treatment may delay disease progression and improve renal function.
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@#One of the most frequent complaints of individuals with hearing impairment is listening comfort in noisy environments. In order to improve listening comforts in background noise, digital noise reduction (DNR) systems are incorporated into hearing aids (HAs). Each hearing aid manufacturer has its proprietary algorithm for the DNR system. The amount of attenuation (dB) provided by the DNR system can be quantified using the hearing aid analyser. However, the standard test signals in the hearing aid analyser could not quantify the attenuation of DNR for speech mixed with noise signals. Therefore, this study aimed to (i) develop speech-plus-noise test signals that incorporate Malay sentences and (ii) quantify the efficacy of DNR systems in commercial hearing aids using the newly developed test signals. Six different brands of hearing aids with identical technology but from different manufacturers were subjected to electroacoustic testing utilising newly created Malay speech-in-noise test signals with and without DNR enabled. The total root-meansquare (RMS) gain reduction for each HA was calculated. The results show that the types of noise, the signal-to-noise ratio and the gender of the speaker have a significant effect (p<0.05) on the amount of gain reduction in the HA output as a result of the DNR system in each HA . In conclusion, the newly developed Malay speech-in-noise test signals can be used to verify the efficacy of DNR system in commercial hearing aids.
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Originating but free from chromosomal DNA, extrachromosomal circular DNAs (eccDNAs) are organized in circular form and have long been found in unicellular and multicellular eukaryotes. Their biogenesis and function are poorly understood as they are characterized by sequence homology with linear DNA, for which few detection methods are available. Recent advances in high-throughput sequencing technologies have revealed that eccDNAs play crucial roles in tumor formation, evolution, and drug resistance as well as aging, genomic diversity, and other biological processes, bringing it back to the research hotspot. Several mechanisms of eccDNA formation have been proposed, including the breakage-fusion-bridge (BFB) and translocation-deletion-amplification models. Gynecologic tumors and disorders of embryonic and fetal development are major threats to human reproductive health. The roles of eccDNAs in these pathological processes have been partially elucidated since the first discovery of eccDNA in pig sperm and the double minutes in ovarian cancer ascites. The present review summarized the research history, biogenesis, and currently available detection and analytical methods for eccDNAs and clarified their functions in gynecologic tumors and reproduction. We also proposed the application of eccDNAs as drug targets and liquid biopsy markers for prenatal diagnosis and the early detection, prognosis, and treatment of gynecologic tumors. This review lays theoretical foundations for future investigations into the complex regulatory networks of eccDNAs in vital physiological and pathological processes.
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Masculino , Femenino , Animales , Humanos , Porcinos , ADN Circular/genética , Neoplasias de los Genitales Femeninos , Semen , ADN , ReproducciónRESUMEN
Abstract: The HIV/AIDS epidemic remains a persistent and real issue, especially in key populations such as men who have sex with men (MSM), travestis and transgender persons. Projects for expanding rapid HIV testing are strategic initiatives aimed at the earliest possible identification of individuals' serological status and thus early treatment, screening of sex partners, and upscaling of preventive actions to interrupt the transmission chain. This study thus maps, describes, and systematizes the projects for expanding rapid HIV testing implemented from 2004 to 2021 in Brazil, highlighting the on-going contribution of civil society organizations and discussing the interoperability and cooperation resulting from public governance processes. We selected 67 documents for analysis, including 30 scientific publications retrieved from electronic databases and 37 documents produced by government institutions and nongovernmental organizations (NGOs). Find Out (Fique Sabendo), I Want to Get Tested (Quero Fazer), The Time is Now (A Hora É Agora), Live Better Knowing (Viva Melhor Sabendo), and Live Better Knowing Young (Viva Melhor Sabendo Jovem) were the projects mapped. Results show that the projects have used strategies adapted to the key population, such as mobile testing units, peer education, and innovative community engagement approaches. Such actions were enabled by effective cooperation and interoperability between participating stakeholders, especially NGOs.
Resumo: A epidemia de HIV/aids está longe de terminar. Ainda é muito real, especialmente em populações-chave, como homens que fazem sexo com homens (HSH), travestis e pessoas transgênero. Projetos de ampliação da testagem rápida anti-HIV são iniciativas estratégicas que visam à identificação mais precoce possível do status sorológico dos indivíduos e, consequentemente, ao tratamento precoce, à triagem de parceiros sexuais e à ampliação das ações preventivas para interrupção da cadeia de transmissão. Assim, este estudo se propõe a mapear, descrever e sistematizar os projetos de expansão da testagem rápida para HIV realizados de 2004 a 2021 no Brasil, destacando a contribuição em curso das organizações da sociedade civil e discutindo a interoperabilidade e a cooperação resultantes dos processos de governança pública. Foram selecionados 67 documentos para análise, incluindo 30 publicações científicas recuperadas de bases de dados eletrônicas e 37 documentos produzidos por instituições governamentais e organizações não governamentais (ONGs). Os projetos mapeados foram: Fique Sabendo, Quero Fazer, A Hora É Agora, Viva Melhor Sabendo e Viva Melhor Sabendo Jovem. Os resultados mostram que os projetos utilizaram estratégias adaptadas à população-chave, como unidades móveis de testagem, educação entre pares e abordagens inovadoras de engajamento comunitário. Tais ações foram possíveis graças à cooperação e interoperabilidade efetivas entre as partes interessadas participantes, especialmente as ONGs.
Resumen: La epidemia de VIH/SIDS está lejos de terminar. Sigue siendo muy real, sobre todo en poblaciones clave, como hombres que tienen sexo con hombres (HSH), travestís y personas transgénero. Proyectos para ampliar las pruebas rápidas anti-VIH son iniciativas estratégicas que tienen el objetivo de identificar el estado serológico de las personas lo antes posible y, consiguientemente, hacer el tratamiento precoz, el triaje de las parejas sexuales y ampliar las acciones preventivas para interrumpir la cadena de transmisión. Así, este estudio tiene el objetivo de mapear, describir y sistematizar los proyectos de expansión de las pruebas rápidas del VIH realizados entre 2004 y 2021 en Brasil, resaltando la contribución en curso de los organismos de la sociedad civil y discutiendo la interoperabilidad y la cooperación que resultan de los procesos de gobernanza pública. Se seleccionaron 67 documentos para el análisis, entre ellos 30 publicaciones científicas recuperadas de bases de datos electrónicas y 37 documentos producidos por instituciones gubernamentales y organizaciones no gubernamentales (ONGs). Los proyectos mapeados fueron: Para que Sepas (Fique Sabendo), Quiero Hacer (Quero Fazer), La Hora Es Ahora (A Hora É Agora), Viva Mejor Sabiendo (Viva Melhor Sabendo) y Viva Mejor Sabiendo Joven (Viva Melhor Sabendo Jovem). Los resultados demuestran que los proyectos utilizaron estrategias adaptadas a la población clave, como las unidades móviles de prueba, educación entre pares y enfoques innovadores de participación comunitaria. Estas acciones fueron posibles gracias a la cooperación e interoperabilidad efectivas entre las partes interesadas participantes, sobre todo las ONGs.
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RESUMO Objetivo Traduzir e adaptar transculturalmente o Voice-related Experiences of Nonbinary Individuals - VENI para o português brasileiro. Método Os procedimentos de adaptação transcultural foram baseados na combinação das recomendações e diretrizes da World Health Organization (WHO) Guidelines on Translation com o COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Foram realizadas cinco etapas: a) tradução do instrumento para o Português Brasileiro (PB) por um tradutor especialista no construto e um não-especialista, nativos do PB e fluentes em inglês; b) elaboração da síntese das duas traduções por consenso; c) retrotradução por um tradutor especialista no construto e um não-especialista, nativos do inglês e fluentes em PB; d) análise de um comitê formado por cinco fonoaudiólogos especialistas em voz e elaboração da versão final; e) pré-teste com 21 pessoas da população-alvo, aplicado virtualmente. Resultados Na tradução houve discordância no título, instruções, chave de resposta e em 15 itens. Na retrotradução, houve discordância quanto à forma em 12 itens e ao conteúdo em 4 itens. A análise do comitê de especialistas indicou mudanças no título, instruções de resposta, uma opção da chave de resposta, e em oito itens, para atender aos critérios de equivalência. No pré-teste houve proporção significativamente maior de respostas habituais do instrumento quando comparadas com a opção não-aplicável, usada regularmente nas adaptações de instrumentos. Conclusão A adaptação transcultural para o português brasileiro do VENI foi bem sucedida e resultou na versão denominada "Experiências relacionadas a Voz de Pessoas Não Binárias - VENI-Br".
ABSTRACT Purpose This study aimed to translate and cross-culturally adapt the "Voice-related Experiences of Nonbinary Individuals" (VENI) to Brazilian Portuguese (BP). Methods Cross-cultural adaptation was performed based on the combined guidelines of the World Health Organization's (WHO) Translation Recommendations and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The process included five stages: a) Translation of the instrument into BP by a translator specialized in the construct and a non-specialist, both native BP speakers and fluent in English; b) Synthesis of the two translations by consensus; c) Back-translation by a translator specialized in the construct and a non-specialist, both native English speakers and fluent in BP; d) Analysis by a committee of five speech-language pathologists voice specialist and the creation of the final version; e) Pre-testing with 21 individuals from the target population, conducted virtually. Results During the translation stage, there were disagreements regarding the title, instructions, response key, and 15 items. In the back-translation stage, there were discrepancies in the format of 12 items and the content of four items. The expert committee's analysis led to changes in the title, instructions, one option in the response key, and eight items to meet the equivalence criteria. In the pre-test, a significantly higher proportion of usual responses to the instrument was observed when compared to the non-applicable option; this is frequently observed in instrument adaptations. Conclusion The cross-cultural adaptation of VENI into Brazilian Portuguese was successful, resulting in the "Experiências relacionadas à Voz de Pessoas Não Binárias - VENI-Br" version.
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Resumo Objetivo Apresentar as evidências de validade baseadas no conteúdo e nos processos de resposta da Escala de Coping para a Fala em Público (ECOFAP). Método Estudo metodológico de elaboração e validação de instrumento. Seguiu-se o modelo de elaboração de instrumentos com procedimentos teóricos, empíricos e analíticos, baseados nos critérios de validade do Standards for Educational and Psychological Testing (SEPT). O processo de obtenção das evidências de validade baseadas no conteúdo foi realizado em duas etapas: 1) definição conceitual do construto, elaborado com base nos preceitos teóricos da fala em público e da Teoria Motivacional do Coping (TMC); 2) elaboração dos itens e chave de respostas, estruturação do instrumento, avaliação por comitê de dez especialistas, reestruturação dos itens da escala, realizada em três momentos, até a elaboração da versão piloto da ECOFAP. O processo de resposta foi realizado com amostra de conveniência de 30 indivíduos, com e sem dificuldades de fala em público, no campus de uma universidade brasileira, pertencentes a diferentes extratos sociais e profissões. Nesse processo, foram analisadas qualitativamente as reações verbais e não verbais dos respondentes. Resultados A primeira versão da ECOFAP, composta por 46 itens, foi avaliada pelos juízes e posteriormente reformulada, resultando em uma segunda versão com 60 itens. Essa segunda versão foi novamente submetida à análise de especialistas e calculado o índice de validade de conteúdo por item. Foram excluídos 18 itens, originando uma terceira versão de 42 itens. As evidências de validade com base nos processos de resposta da versão de 42 itens foram aplicadas em uma amostra de 30 indivíduos, resultando na reescrita de um item e inclusão de mais seis itens, originando a versão piloto da ECOFAP de 48 itens. Conclusão A versão piloto da ECOFAP apresenta itens bem estruturados semântica e sintaticamente que representam estratégias de enfrentamento para a fala em público.
Abstract Purpose To present the content and response process validity evidence of the Speaking in Public Coping of Scale (ECOFAP). Methods A methodological study to develop and validate the instrument. It followed the instrument development method with theoretical, empirical, and analytical procedures, based on the validity criteria of the Standards for Educational and Psychological Testing (SEPT). The process of obtaining content validity evidence had two stages: 1) conceptual definition of the construct, based on theoretical precepts of speaking in public and the Motivational Theory of Coping (MTC); 2) developing items and response keys, structuring the instrument, assessment by a committee with 10 specialists, restructuring scale items, and developing the ECOFAP pilot version. Item representativity was analyzed through the item content validity index. The response process was conducted in a single stage with a convenience sample of 30 people with and without difficulties speaking in public, from the campus of a Brazilian university, belonging to various social and professional strata. In this process, the respondents' verbal and nonverbal reactions were qualitatively analyzed. Results The initial version of ECOFAP, consisting of 46 items, was evaluated by judges and later reformulated, resulting in a second version with 60 items. This second version was again submitted for expert analysis, and the content validity index per item was calculated. 18 items were excluded, resulting in a third version of 42 items. The validity evidence based on the response processes of the 42-item version was applied to a sample of 30 individuals, resulting in the rewriting of one item and the inclusion of six more items, resulting in the pilot version of ECOFAP with 48 items. Conclusion ECOFAP pilot version has items with well-structured semantics and syntactic, representing strategies to cope with speaking in public.
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RESUMO Objetivo Mapear o risco vocal em cantores eruditos profissionais, analisando sua autoavaliação vocal e autopercepção de desvantagem vocal no canto e fadiga vocal. Método Participaram deste estudo 52 cantores eruditos de coros profissionais, entre 31 e 72 anos, que preencheram online (Formulários Google) um questionário de caracterização, autoavaliação vocal, bem como os instrumentos Índice de Desvantagem Vocal 10 - IDV-10, Índice de Desvantagem para o Canto Clássico - IDCC e Índice de Fadiga Vocal - IFV. Resultados A média da autoavaliação vocal ficou entre "Boa" e "Muito boa" (1,2). A média do escore total do IDV-10 foi 1,35, abaixo da nota de corte. A média do escore total do IDCC foi 10,04. A média do escore total do IFV foi de 10,83, próxima da nota de corte. Cantores eruditos que, em suas aulas, dão exemplos aos alunos com a própria voz apresentam maiores escores nos instrumentos IDV-10 (p=0,013), IFV restrição vocal (p=0,011) e IFV escore total (p=0,015). Cantores eruditos que já procuraram fonoaudiólogo devido a problemas de voz apresentam maiores escores no IFV fator restrição vocal (p=0,040) e no IFV fator recuperação com repouso vocal (p=0,019), além de terem correlações entre os escores dos instrumentos. Conclusão Cantores eruditos profissionais não apresentam desvantagem vocal. Porém, questões relacionadas à autopercepção de fadiga vocal se mostram mais presentes quando relacionadas às atividades de uso da voz cantada, como dar exemplos em aulas com a própria voz. Ter tido problema vocal e procurado fonoaudiólogo no passado proporciona maior percepção de recuperação vocal com repouso.
ABSTRACT Purpose To map the vocal risk in professional classical singers, analyzing their self-assessment of voice and self-perception of singing voice handicap and vocal fatigue. Methods The study sample comprised of 52 professional classical choir singers, aged 31 to 72 years. They answered an online questionnaire in Google Forms, addressing their characterization, self-assessment of voice, the Voice Handicap Index-10 (VHI-10), Classical Singing Handicap Index (CSHI), and Vocal Fatigue Index (VFI). Results The mean self-assessment of voice was between "Good" and "Very good" (1.2). The mean total VHI-10 score was 1.35, which is below the cutoff. The mean total CSHI score was 10.04. The mean total VFI score was 10.83, near the cutoff value. Classical singers who use their voice to give examples to students in their classes had higher scores in VHI-10 (p = 0.013), VFI voice restriction (p = 0.011), and VFI total score (p = 0.015). Besides, classical singers who already visited a Speech-Language Pathologist for voice problems had higher scores in VFI voice restriction (p = 0.040) and VFI recovery with voice rest (p = 0.019), in addition to correlations between instrument scores. Conclusion Professional classical singers did not have voice handicaps. However, their self-perception of vocal fatigue was more present when the singing voice was used, such as giving examples with their own voice in class. Having had voice problems and visited a Speech-Language Pathologist in the past led to a greater perception of vocal recovery with rest.
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Abstract This study aimed to examine the relative age effect on muscle power in a large sample of Brazilian children and adolescents. The sample consisted of 87,766 girls and boys aged 7-16 years, data collected in repeated cross-sectional surveillance carried out since 1999. The participants were grouped into four age subgroups within each chronological age based on birthdates. Upper and lower limbs muscle power were assessed using the 2-Kg medicine ball throw and horizontal jump tests, respectively. The normative distribution of physical fitness components was used for classification. The results showed a significant association between relative age and normative classification of muscle power. Among boys, there was a sequential increase in the frequency of individuals classified as "very good/excellent" as the relative age increased. A similar trend was observed among girls. The findings provided evidence of a relative age effect on muscle power in Brazilian children and adolescents. These findings have implications for the organization of structured physical activities and sports, as early-born individuals may have an advantage in performance. Further research is needed to explore the underlying mechanisms and potential interventions to mitigate the relative age effect and promote equal opportunities for all youth in physical activities and sports.
Resumo Este estudo teve como objetivo examinar o efeito da idade relativa na potência muscular em crianças e adolescentes brasileiros. A amostra foi composta por 87.766 meninas e meninos com idades entre 7 e 16 anos. Os participantes foram agrupados em quatro subgrupos etários dentro de cada idade cronológica tendo como base as datas de nascimento e da coleta dos dados. A potência muscular dos membros superiores e inferiores foi avaliada por meio dos testes de arremesso de medicine ball de 2 kg, e salto horizontal, respectivamente. A distribuição normativa (fraco; razoável; bom; muito bom; excelente) dos dois testes de potência foi utilizada para a classificação. Os resultados mostraram associação significativa entre os subgrupos etários e a classificação normativa da potência muscular. Entre os meninos, houve aumento na frequência de indivíduos classificados como "muito bom/excelente" à medida que a idade relativa aumentava. Uma tendência semelhante foi observada entre as meninas. Os achados forneceram evidências do efeito de idade relativa na potência muscular de crianças e adolescentes brasileiros. Esses resultados têm implicações práticas na organização de atividades físicas estruturadas e esportes em diferentes contextos, pois indivíduos nascidos mais cedo podem ter vantagem no desempenho em tarefas que exijam potência muscular. Mais pesquisas são necessárias para explorar os mecanismos subjacentes e intervenções que possam mitigar o efeito de idade relativa e promover oportunidades iguais para todas as crianças e adolescentes nas atividades físicas e esportes.
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Abstract Resin composites containing surface pre-reacted glass (S-PRG) have been introduced to reduce demineralization and improve remineralization of the tooth structure. However, water diffusion within the material is necessary for its action, which can impair its overall physicomechanical properties over time, including color stability. This study aimed to evaluate the color stability and related degree of conversion (DC) of four resin composites. Discs (6 x 4 mm, n = 5/group) of microhybrid (MH), nanofilled (NF), nanohybrid (NH), and S-PRG-based nanohybrid (S-PRG-NH) composites with two opacities (A2/A2E and A2O/A2D) were prepared. Color (CIELab and CIEDE2000) was evaluated with a spectrophotometer after aging in grape juice (2 x 10 min/10mL/7days). The DC was analyzed by using Fourier transform infrared spectroscopy before and after light-curing. Data were statistically analyzed by using two-way analysis of variance and post-hoc least significant difference tests (p<0.05). In the color stability analysis, the interaction between filler type and opacity was significant (CIELab, p = 0.0015; CIEDE2000, p = 0.0026). NH presented the highest color stability, which did not differ from that of MH. The greatest color alteration was observed for S-PRG-NH. S-PRG fillers also influenced DC (p < 0.05). The nanohybrid resin composite presented favorable overall performance, which is likely related to its more stable organic content. Notwithstanding the benefits of using S-PRG-based nanohybrid resins, mostly in aesthetic procedures, professionals should consider the susceptibility of such resins to color alteration, probably due to the water-based bioactive mechanism of action.
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A interface implante pilar (IAI) por se constituir de duas peças inevitavelmente apresentam micro lacuna (GAP), na qual pode ocorrer infiltração bacteriana, permitindo a penetração de microorganismos que colonizam na parte interna do implante levando ao acúmulo de biofilme e, podendo levar ao desenvolvimento da periimplantite. O desgaste da conexão interna do implante é algo que ocorre com frequência, muitas vezes pela fratura do parafuso e/ou, pela perda da rosca interna do implante. A ausência de informações prévias também pode gerar a necessidade da remoção do implante, devido a estas intercorrências, surge a possibilidade da criação de um novo componente para implantes para possibilitar a reabilitação protética, sem ter que passar por uma nova cirurgia de remoção e instalação do implante. O objetivo do trabalho foi mensurar o nível de afrouxamento do parafuso do pilar protético e do minipilar comparando com novo componente protéticos, na tentativa de simular o comportamento do conjunto implante/pilar/prótese. Foram utilizados vinte implantes de plataforma cone morse (CM) da DSP® com seus respectivos mini pilares, na qual foram distribuídos em 2 grupos(n=10): Grupo 1 - implante CM + mini pilar FlexCone® DSP + coroa simplificada pirâmide invertida carga aplicada 3 mm do centro da coroa. E Grupo 2 - implante CM + mini pilar novo + coroa simplificada pirâmide invertida carga aplicada 3 mm do centro da coroa. Foram realizados ciclagem mecânica com carga 133 N, durante 2x106 ciclos, com frequência 2 Hz e temperatura de 37ºC em ambos grupos. Um torquímetro digital foi usado para medir os valores de torque reverso do parafuso protético da coroa e também do pilar protético, antes e após o carregamento. Os resultados do modelo de regressão demonstraram diferenças estatisticamente significativas em função do envelhecimento comparando os grupos da coroa sobre o pilar protético (p = 0.020) e entre os grupos do pilar sobre o implante (p = 0.048), indicando que após o envelhecimento de 2.000.000 de ciclos ao longo do tempo está associado de maneira significativa a essas variáveis no contexto deste estudo. O segundo objetivo deste estudo foi avaliar in vitro a taxa de infiltração bacteriana através da IAI, entre o novo componente protético e a superfície interna do implante, juntamente foi analisado a permeabilidade do IAI para colonização bacteriana. Um total de oitenta implantes foram testados. As estruturas montadas para grupo 1 foi torqueado com 20 N/cm e do G2 foram torqueados com 45 N, ambos imersos em microtubos contendo 200 µl de saliva humana. Após 14 dias de incubação da amostra de bactéria nos implantes, foi realizada uma análise qPCR (reação da cadeia da polimerase em tempo real). O teste revelou que não houve diferenças estatisticamente significativas no crescimento bacteriana entre os grupos em qualquer um dos pontos temporais analisados. Conclui-se que o novo componente testado apresentou um destoque menor do que comparado ao mini pilar FlexCone DSP® e apresentou infiltração bacteriana no GAP da conexão implante-pilar semelhante comparado ao mini pilar original da empresa (AU)
The abutment implant interface (IAI), as it consists of two pieces, inevitably presents a micro gap (GAP), in which bacterial infiltration can occur, allowing the penetration of microorganisms that colonize in the internal part of the implant, leading to the accumulation of biofilm and, which can lead to development of peri-implantitis. Wear of the implant's internal connection is something that occurs frequently, often due to screw fracture and/or loss of the implant's internal thread. The lack of prior information can also generate the need to remove the implant, due to these complications, the possibility arises of creating a new component for implants to enable prosthetic rehabilitation, without having to undergo a new surgery to remove and install the implant. implant. The objective of the work was to measure the level of screw loosening of the prosthetic abutment and the mini-abutment compared with the new prosthetic component, in an attempt to simulate the behavior of the implant/ abutment/prosthesis set. Twenty DSP® morse cone (CM) platform implants were used with their respective mini pillars, which were distributed into 2 groups (n=10): Group 1 - CM implant + FlexCone® DSP mini pillar + simplified crown inverted pyramid load applied 3 mm from the center of the crown. And Group 2 - CM implant + new mini abutment + simplified crown inverted pyramid load applied 3 mm from the center of the crown. Mechanical cycling was carried out with a load of 133 N, for 2x106 cycles, with a frequency of 2 Hz and a temperature of 37ºC in both groups. A digital torque wrench was used to measure the reverse torque values of the prosthetic crown screw and also the prosthetic abutment, before and after loading. The results of the regression model demonstrated statistically significant differences as a function of aging comparing the crown-on-prosthetic abutment groups (p =0.020) and between the abutment-on-implant groups (p = 0.048), indicating that after aging 2,000 ,000 cycles over time is significantly associated with these variables in the context of this study. The second objective of this study was to evaluate in vitro the rate of bacterial infiltration through the IAI, between the new prosthetic component and the internal surface of the implant, together with the permeability of the IAI for bacterial colonization. A total of eighty implants were tested. The assembled structures for group 1 were torqued with 20 N/cm and G2 were torqued with 45 N, both immersed in microtubes containing 200 µl of human saliva. After 14 days of incubation of the bacteria sample in the implants, a qPCR (real-time polymerase chain reaction) analysis was performed. The test revealed that there were no statistically significant differences in bacterial growth between groups at any of the time points analyzed. It is concluded that the new component tested presented a lower impact compared to the FlexCone DSP® mini abutment and presented bacterial infiltration in the GAP of the implant-abutment connection similar to the company's original mini abutment.(AU)
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Streptococcus mutans , Implantes Dentales , PeriimplantitisRESUMEN
Resumo Objetivo Construir e validar um instrumento para autoavaliação de soft skills em liderança autêntica de enfermagem. Métodos Pesquisa metodológica desenvolvida em três etapas: revisão de literatura, elaboração do instrumento intitulado "LEADERSKILLS" e validação de conteúdo do instrumento com experts, usando a Técnica Delphi Online. A primeira etapa foi composta por duas revisões narrativas. A segunda etapa incluiu um teste piloto ao desenvolvimento do instrumento contendo a descrição narrativa das soft skills mais relevantes (relacionadas ao exercício da liderança autêntica do enfermeiro) que foram apresentadas pela revisão narrativa da literatura. A terceira e última etapa incluiu a alteração do instrumento após as considerações realizadas pelos experts. Resultados O painel de experts da primeira rodada foi composto por 13 participantes. Das 17 questões de múltipla escolha avaliadas na primeira rodada, só duas (pertencentes aos componentes conteúdo e linguagem) não obtiveram Índice de Validade de Conteúdo (IVC) ≥0,85. A primeira questão era sobre a compreensão inadequada do que seriam os títulos e subtítulos do "LEADERSKILLS" e a segunda era sobre clareza e objetividade do instrumento. As principais sugestões dos juízes estavam concentradas nos componentes conteúdo, linguagem e layout. A segunda rodada foi composta pela resposta de cinco experts, sendo possível alcançar o consenso das questões obtendo IVC ≥0,80. Conclusão O instrumento construído para desenvolver soft skills em enfermagem foi considerado válido quanto ao conteúdo, layout, linguagem, motivação e cultura, alcançando avaliação coerente e aplicabilidade ao público-alvo.
Resumen Objetivo Elaborar y validar un instrumento para la autoevaluación de soft skills en liderazgo auténtico de enfermería. Métodos Investigación metodológica llevada a cabo en tres etapas: revisión de la literatura, elaboración del instrumento llamado "LEADERSKILLS" y validación del contenido del instrumento con expertos mediante el método Delphi vía internet. La primera etapa estuvo compuesta por dos revisiones narrativas. La segunda etapa incluyó una prueba piloto del desarrollo del instrumento, que contenía la descripción narrativa de las soft skills más relevantes (relacionadas con el ejercicio del liderazgo auténtico del enfermero) y que fueron introducidas por la revisión narrativa de la literatura. La tercera y última etapa incluyó la modificación del instrumento después de las reflexiones realizadas por los expertos. Resultados El panel de expertos de la primera ronda estuvo compuesto por 13 participantes. De las 17 preguntas de selección múltiple evaluadas en la primera ronda, solo dos (pertenecientes a los componentes contenido y lenguaje) no obtuvieron Índice de Validez de Contenido (IVC) ≥0,85. La primera pregunta era sobre la comprensión inadecuada de lo que serían los títulos y subtítulos del "LEADERSKILLS" y la segunda era sobre la clareza y objetividad del instrumento. Las principales sugerencias de los jueces estaban centradas en los componentes contenido, lenguaje y diseño. La segunda ronda estuvo compuesta por la respuesta de cinco expertos y fue posible llegar al consenso de las preguntas con un IVC de ≥0,80. Conclusión El instrumento elaborado para desarrollar soft skills en enfermería fue considerado válido respecto al contenido, diseño, lenguaje, motivación y cultura, y logró una evaluación coherente y aplicabilidad en el público destinatario.
Abstract Objective To build and validate an instrument for self-assessment of soft skills in authentic nursing leadership. Methods This methodological research was developed in three stages: literature review, development of the instrument entitled "LEADERSKILLS", and validation of the instrument's content by experts using the Delphi Online Technique. The first stage consisted of two narrative reviews. The second stage included a pilot test for the development of the instrument containing a narrative description of the most relevant soft skills (related to the exercise of authentic leadership by nurses) that were presented by the narrative literature review. The third and final stage included changes to the instrument after considerations made by the experts. Results In the first round, the panel of experts was composed of 13 participants. Of the 17 multiple-choice questions evaluated in the first round, only two (belonging to the content and language components) did not obtain the Content Validity Index (CVI) ≥0.85. The first question was about the inadequate understanding of what the titles and subtitles of "LEADERSKILLS" were, and the second was about the instrument's clarity and objectivity. The judges' main suggestions were concentrated on the content, language, and layout components. The second round consisted of responses from five experts, and reaching a consensus on the questions was possible by obtaining CVI≥0.80. Conclusion The instrument constructed to develop soft skills in nursing was considered valid in terms of content, layout, language, motivation, and culture, achieving coherent assessment and applicability to the target audience.
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ABSTRACT Background: Lactose tolerant test (LTT) is the most broadly used diagnostic test for lactose intolerance in Brazil, is an indirect, minimally invasive and a low-cost test that is widely available in primary care and useful in clinical practice. The C/T-13910 polymorphism in lactase persistence has been well characterized in Caucasian populations, but there are no studies evaluating the concordance between C/T-13910 polymorphism genotyping results and LTT results in Brazil, where the population is highly mixed. Objective: We aimed to evaluate agreement between presence of C/T-13910 polymorphism genotyping and malabsorption in LTT results. Methods: This is a retrospective analysis of a Brazilian population whose data were collected from a single laboratory database present in several Brazilian states. Results of individuals who underwent both genetic testing for lactose intolerance (C/T-13910 polymorphism genotyping) and an LTT from April 2016 until February 2019 were analysed to evaluate agreement between tests. Groups were classified according to age (<10-year-old (yo), 10-17 yo, ≥18 yo groups) and state of residence (São Paulo or Rio Grande do Sul). Results: Among the 404 patients evaluated, there was agreement between the genotyping and LTT results in 325 (80.4%) patients and discordance in 79 (19.6%) patients (k=0.42 -moderate agreement). Regarding the genotype, 47 patients with genotype C/C (lactase nonpersistence) had normal LTT results, and 32 with genotype C/T or T/T (indicating lactase persistence) had abnormal LTT results. Neither age nor state of residence (Rio Grande do Sul or São Paulo) affected the agreement between test results. Conclusion: Considering the moderate agreement between C/T-13910 polymorphism genotyping and LTT results (κ=0.42) in the Brazilian population, we hypothesize that an analysis of other polymorphisms could be a strategy to improve the agreement between genotyping and established tests and suggest that additional studies should focus on exploring this approach.
RESUMO Contexto: O teste de tolerancia à lactose (TTL) é ampliamente utilizado por ser minimamente invasivo e de baixo custo, disponível na atenção primária e muito útil na prática clínica. Está bem estabelecido o polimorfismo C/T-13910 na persistência da lactase em populações caucasianas, mas não há estudos avaliando a concordância entre os resultados da genotipagem do polimorfismo C/T-13910 e do TTL no Brasil, onde a população é altamente miscigenada. Objetivo: Avaliar a concordância entre a presença do polimorfismo C/T-13910 e a má absorção nos resultados do TTL. Métodos: Análise retrospectiva de dados coletados de um laboratorio presente em vários estados brasileiros. Os resultados dos pacientes que realizaram um teste genético para intolerância à lactose (genotipagem do polimorfismo C/T-13910) e um TTL de abril de 2016 a fevereiro de 2019 foram analisados para avaliar a concordância entre os testes. Os grupos foram classificados de acordo com a idade (<10 anos; 10-17 anos, ≥18 anos) e estado de residência (São Paulo ou Rio Grande do Sul). Resultados: Entre os 404 pacientes avaliados, houve concordância entre os resultados de genotipagem e TTL em 325 (80,4%) pacientes e discordância em 79 (19,6%) pacientes (K=0,42 - concordância moderada). Em relação ao genótipo, 47 pacientes com genótipo C/C (não persistência de lactase) apresentaram TTL normal e 32 com genótipo C/T ou T/T (indicando persistência da lactase) apresentaram TTL anormal. A idade e o estado de residência (Rio Grande do Sul ou São Paulo) não afetaram a concordância entre os resultados dos exames. Conclusão: Considerando a concordância moderada entre a genotipagem do polimorfismo C/T-13910 e os resultados de TTL (κ=0,42) na população brasileira, sugerimos que a análise de outros polimorfismos poderia ser uma estratégia para melhorar a concordância entre os testes.
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Introducción: El traumatismo craneoencefálico (TCE) puede generar vértigo, mareo e inestabilidad. Posibles causas otorrinolaringológicas son el vértigo postural paroxístico benigno (VPPB) que constituye el diagnóstico más frecuente, y la hipofunción vestibular. Objetivo: Describir la prevalencia de hipofunción vestibular en un grupo de pacientes con VPPB asociado a TCE. Material y Método: Estudio retrospectivo de pacientes con VPPB asociado a TCE que requirieron maniobra de reposición (MRP) entre los años 2017 y 2021. La información clínica, características clínico-demográficas, hallazgos en pruebas de función vestibular y número de MRP fueron evaluados. Resultados: Se incluyeron 48 pacientes con una edad promedio de 60,8 ± 16,5 años, siendo un 52% mujeres. La prevalencia de pacientes con paresia vestibular concomitante correspondió al 35,4%. Al comparar al grupo con y sin paresia se observó: (1) en el grupo con paresia fue, significativamente, más frecuente presentar contusión cerebral asociada, 47,1% vs 12,9%; (2) el sexo masculino fue, significativamente, más frecuente en el grupo con paresia, 70,59% vs 35,5%; (3) en ambos grupos, la mediana de MRP fue 1. Conclusión: La presencia de paresia vestibular en pacientes con VPPB secundario a TCE, no es un hallazgo infrecuente, en nuestro estudio, correspondió a un 35,4%, siendo este más frecuente en hombres. Adicionalmente, la contusión cerebral asociada es más frecuente en el grupo con paresia.
Introduction: Head trauma can generate vertigo, dizziness and instability. Possible otorhinolaryngologic causes are benign paroxysmal postural vertigo (BPPV), which is the most frequent diagnosis, and vestibular hypofunction. Aim: To describe the prevalence of vestibular hypofunction in a group of patients with BPPV associated with head trauma. We studied the clinical characteristics, vestibular function test findings and the number of (PRM). Material and Method: Retrospective study of patients with BPPV associated with head trauma who underwent particle repositioning maneuvers (PRM) during the years 2017 to 2021. Clinical characteristics, vestibular function test findings and the number of PRM were evaluated. Results: 48 patents were included. The mean age was 60.8 ± 16.5 years old, 52% were women. The prevalence of patients with concomitant vestibular paresis was 35.4%. When comparing the groups with and without paresis the following was observed: (1) associated brain contusions were significatively more frequent in the paresis group, 47.1% vs 12.9%; (2) male sex was significatively more frequent in the paresis group, 70.59% vs 35.5%; (3) in both groups, the median of needed PRM was 1. Conclusion: The presence of vestibular paresis in patients with BPPV secondary to head trauma is not an infrequent finding. In our study, its prevalence was 35.4%, being significatively more frequent in men. Also, associated brain contusions were significatively more frequent in the paresis group.
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INTRODUCCIÓN: los adolescentes experimentan varios cambios que pudieran determinar la presencia de conductas de riesgo, uno de los aspectos es la sexualidad responsable principalmente ante la prevención de VIH/SIDA. OBJETIVO: Determinar la relación entre el conocimiento sobre VIH/SIDA y la disposición a realizarse la prueba del VIH en adolescentes escolarizados de Ciudad del Carmen, Campeche, México. MATERIALES Y MÉTODOS: estudio descriptivo-correlacional llevado a cabo en 241 adolescentes que decidieron participar de manera voluntaria en la investigación, se utilizó la escala de Conocimientos hacia el VIH/SIDA y la Escala de Pros y Contras hacia la prueba de VIH, los datos fueron capturados y analizados en el programa estadístico SPSS V23. RESULTADOS: 18,7% de los adolescentes manifestó una vida sexualmente activa, 1,7% señalo haberse realizado la prueba de VIH anteriormente. Se obtuvieron diferencias significativas (p= <0,05) por sexo, donde los conocimientos hacia el VIH/SIDA y pros hacia la prueba de VIH fueron mayores en las mujeres, además se identificó una relación positiva y significativa de los conocimientos de los adolescentes hacia el VIH/SIDA y los pros hacia la prueba de VIH (rs= 0,213, p= 0,001). CONCLUSIÓN: durante la adolescencia se conciben los conocimientos, pros y contras ante la detección del VIH/SIDA, lo que pudiera ser un punto de partida para una sexualidad responsable este grupo etario.
INTRODUCTION: Adolescents experience various changes that could determine the presence of risk behaviors, one of the aspects is sexuality responsible mainly for the prevention of HIV/AIDS. OBJECTIVE: To determine the relationship between knowledge about HIV/AIDS and the willingness to undergo an HIV test in school adolescents from Ciudad del Carmen, Campeche, Mexico. MATERIALS AND METHODS: Descriptive correlational study carried out in 241 adolescents who decided to voluntarily participate in the research, the Knowledge scale towards HIV/AIDS and the Scale of Pros and Cons towards the HIV test were used, the data were captured and analyzed in the statistical program SPSS V23. RESULTS: 18.7% of students manifested to have a sexually active life, whereas 1.7% of students indicated having previously an HIV test. Significant differences were obtained (p=<0.05) by sex where knowledge towards HIV and pros towards HIV testing were higher in women, furthermore, a positive and meaningful relationship of knowledge of adolescents towards HIV/AIDS and pros towards HIV testing were identified (rs=0.213, p=0.001). CONCLUSION: During adolescence, the knowledge, pros and cons of detecting HIV/AIDS are conceived, which could be a starting point for responsible sexuality in this age group.
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Objetivo: Desenvolver uma análise de custo-utilidade da implementação do teste farmacogenético como uma ferramenta adicional para orientar a escolha do melhor tratamento medicamentoso para indivíduos com depressão. Métodos: Para a realização desta análise, criou-se um modelo analítico de decisão baseado em um modelo de Markov. A avaliação foi realizada sob a perspectiva do Sistema de Saúde Suplementar brasileiro, com horizonte temporal de 10 anos, incluindo custos médicos diretos e custos da tecnologia utilizada, além de ter como comparador o tratamento empírico tradicional para a depressão. As probabilidades de transição foram obtidas por meio de análise da literatura disponível. Também foram realizadas análises de sensibilidade probabilística e univariada. Adicionalmente, foi realizada uma avaliação sob a perspectiva da sociedade, incluindo os custos de tratamento medicamentoso realizados pelos pacientes. Resultados: De acordo com a análise realizada, o emprego do teste farmacogenético como guia do tratamento para depressão mostrou-se favorável, proporcionando economia de -R$ 3.439,97 por paciente e aumento de 0,39 QALY ao longo do horizonte temporal. Assim, evidencia-se uma economia significativa a favor do teste farmacogenético, correspondendo a -R$ 8.776,78 por QALY salvo. Além disso, a robustez do modelo foi comprovada por meio das análises de sensibilidade. No cenário sob perspectiva da sociedade, o resultado foi ainda mais favorável, proporcionando economia de -R$ 9.381,49 por paciente e aumento de 0,39 QALY, correspondendo a -R$ 23.936,05 por QALY salvo. Conclusão: Os resultados encontrados neste estudo demonstraram que o uso de testes farmacogenéticos no tratamento da depressão é economicamente vantajoso, com aumento no valor de QALY e redução nos custos médicos diretos, em comparação ao tratamento empírico tradicional. Essa descoberta alinha-se à tendência atual de personalização no cuidado da saúde mental, sugerindo implicações práticas na reavaliação de protocolos, com potencial incorporação dos testes farmacogenéticos como padrão de cuidado.
Objective: To evaluate the cost-utility of pharmacogenetic testing incorporation as an additional tool in guiding the selection of optimal drug treatments for individuals with depression. Methods: A decision analytical model was created based on the Markov model for this analysis. The evaluation was conducted from the perspective of the Brazilian Supplementary Health System, with a time horizon of 10 years. The study included direct medical and technology costs and a comparison with traditional empirical treatment for depression was performed. Transition probabilities were derived from an analysis of available literature. Probabilistic and univariate sensitivity analyses were also carried out. Additionally, an evaluation was conducted from the perspective of Society, including the costs of drug treatment carried out by patients. Results: The application of pharmacogenetic testing as a guide for depression treatment demonstrated favorable outcomes, yielding savings of -R$ 3,439.97 per patient and an increase of 0.39 QALY over the specified time frame. Thus, significant savings were evident, corresponding to -R$ 8,776.78 per QALY saved. The sensitivity analyses confirmed the model's robustness. In the Society's perspective scenario, the outcome was even more favorable, resulting in savings of -R$ 9,381.49 per patient and a 0.39 increase in QALYs, equivalent to -R$ 23,936.05 per QALY saved. Conclusion: The study findings reveal that incorporating harmacogenetic tests in depression treatment offers economic benefits, evidenced by an increase in QALY value and a decrease in direct medical costs compared to conventional empirical treatment. This aligns with the ongoing trend towards personalized mental health care, implying practical considerations for protocol reassessment and the possible integration of pharmacogenetic tests as a standard of care.