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Abstract Background: Role stress is linked to reduced work performance, diminished organizational commitment, increased intention to leave a job, and negative physical and mental health effects. Given the significant implications of role stress, researchers have sought to understand and quantify the concept. The Role Conflict and Ambiguity (RCA) scales are widely utilized in job stress research as the predominant measurement tools. They were originally conceptualized as consisting of two independent dimensions: role conflict and role ambiguity. Objective: This study advances the validation research of the RCA scales by exploring its dimensionality through Mokken Scale Analysis (MSA) and Classical Test Theory (CTT). Method: South African school teachers responded to the RCA scales, Maslach Burnout Inventory, and Teaching Satisfaction Scale. Confirmatory Factor Analysis (CFA) and MSA were employed for data analysis. Results: The research determined that a second-order model provided the optimal fit, indicating that role ambiguity and role conflict are subordinate dimensions within the overarching construct of role stress. Conclusion: The findings from the CFA and supplementary bifactor indices reinforce the view that the instrument comprises 13 items, which assess a general dimension of role stress along with two sub-dimensions: role conflict and role ambiguity. Such specificity may lead to more effective strategies to mitigate role-related stress, thereby enhancing overall employee well-being, job satisfaction, and organizational productivity.
Resumen Antecedentes: El estrés de rol está relacionado con la reducción del rendimiento laboral, la disminución del compromiso organizativo, el aumento de la intención de abandonar el trabajo y los efectos negativos sobre la salud física y mental. Dadas las importantes implicaciones del estrés de rol, los investigadores han tratado de comprender y cuantificar este concepto. Las escalas de Conflicto y Ambigüedad de Roles (RCA) se utilizan ampliamente en la investigación del estrés laboral como herramientas de medición predominantes. Al principio, se conceptualizaron como dos dimensiones independientes: conflicto de rol y ambigüedad de rol. Objetivo: Este estudio avanza en la investigación de validación de las escalas RCA, explorando su dimensionalidad mediante el Análisis de Escalas de Mokken (MSA) y la Teoría Clásica de los Test (CTT). Método: Profesores sudafricanos respondieron a las escalas RCA, Maslach Burnout Inventory y Teaching Satisfaction Scale. Se emplearon el Análisis Factorial Confirmatorio (AFC) y el MSA para el análisis de los datos. Resultados: La investigación determinó que un modelo de segundo orden proporcionaba el ajuste óptimo, indicando que la ambigüedad de rol y el conflicto de rol son dimensiones subordinadas dentro del constructo global del estrés de rol. Conclusiones: Los resultados del AFC y los índices bifactoriales suplementarios refuerzan la opinión de que el instrumento consta de 13 ítems, que evalúan una dimensión general de estrés de rol junto con dos subdimensiones: conflicto de rol y ambigüedad de rol. Esta especificidad puede conducir a estrategias más eficaces para mitigar el estrés relacionado con el rol, mejorando así el bienestar general de los empleados, la satisfacción en el trabajo y la productividad de la organización.
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Abstract Objective: We aim to assess the quality of life of older individuals living in nursing homes. Methodology: A descriptive cross-sectional study was conducted on institutionalized elderly individuals for over three months. The sample size of the study was 260 and Non-randomized convenience sampling was used. The study excluded participants with cognitive impairment, severe medical conditions, physical limitations, communication barriers, severe pain, recent surgery, acute illness, or psychiatric disorders. Ethical approval was obtained, and participants were given informed consent. The study took place in various nursing homes in Lahore in June and July 2023, for the analysis of data Statistical Package for Social Sciences (SPSS version 22) was used, employing frequency distribution, mean, standard deviation, and correlation. Results: The Pearson Correlation coefficient of 0.459 suggests a significant positive correlation between these variables (p < 0.01). This correlation is evident in both directions: Quality of life (QoL) score to Mini Mental Scale and vice versa. Conclusion: While assessing the QoL in elderly inhabitants of nursing residences, cognitive impairment, and high Body mass index (BMI) appeared to influence the overall QoL.
Resumen Objetivo: Nuestro objetivo es evaluar la calidad de vida de las personas mayores que viven en residencias de ancianos. Metodología: Se realizó un estudio descriptivo transversal en ancianos institucionalizados durante más de tres meses. El tamaño de la muestra del estudio fue de 260 y se utilizó un muestreo de conveniencia no aleatorizado. El estudio excluyó a los participantes con deterioro cognitivo, afecciones médicas graves, limitaciones físicas, barreras de comunicación, dolor intenso, cirugía reciente, enfermedad aguda o trastornos psiquiátricos. Se obtuvo la aprobación ética y los participantes dieron su consentimiento informado. El estudio se llevó a cabo en varias residencias de ancianos de Lahore en junio y julio de 2023. Para el análisis de los datos se utilizó Statistical Package for Social Sciences (SPSS versión 22), empleando distribución de frecuencias, media, desviación estándar y correlación. Resultados: El coeficiente de correlación de Pearson de 0,459 sugiere una correlación positiva significativa entre estas variables (p < 0,01). Esta correlación es evidente en ambas direcciones: puntuación de calidad de vida a Escala Mini-Mental y viceversa. Conclusión: Al evaluar la calidad de vida de los ancianos que viven en residencias, el deterioro cognitivo y un índice de masa corporal (IMC) elevado parecen afectar la calidad de vida general.
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Resumen Introducción: una de las barreras al acceso a la vacunación contra las enfermedades infecciosas es la reticencia a la vacunación, la cual suele medirse o asociarse a una poca disposición para vacunarse, actitudes antivacunas o la probabilidad reportada de obtener una vacuna. Sin embargo, no existe un consenso en la forma en la cual este constructo es medido. Objetivo: el propósito de este artículo es identificar las propiedades psicométricas y la estructura factorial de la nueva Escala Dispvac en una muestra colombiana. Método: se realizó un diseño psicométrico para identificar las propiedades psicométricas de la escala con una muestra de 1131 participantes (masculino: 37.30%, femenino 61.90%, otro: 0.79%; media edad: 25.84, SD edad: 10.19), a través de un muestreo por conveniencia. Se realizó un análisis factorial exploratorio, un análisis factorial confirmatorio, un análisis de fiabilidad y la validez convergente. Resultados: se sugieren dos factores: actitudes cognitivas hacia la vacunación y legitimidad percibida de las autoridades al requerir la vacunación que comprende la prueba. La prueba Dispvac se correlaciona de manera negativa con la Escala VAX. Conclusiones: los dos factores que comprenden la Escala Dispvac sugieren que la intención a vacunarse implica también creencias sobre la autoridad/instituciones en vacunación.
Abstract Introduction: One of the main barriers to access to vaccination against infectious diseases is vaccine hesitancy, which is usually measured or associated to a low disposition to receive vaccination, anti-vaccine attitudes or the reported probability to receive a vaccine. However, there is no consensus in the way this construct is measured. Objective: The objective of this study it to identify the psychometric properties and the factorial structure of the Scale Dispvac in a Colombian sample. Method: To this goal, a psychometric design was made to identify the psychometric properties of the new scale making use of 1131 participants (male: 37.30%, female: 61.90%, other: 0.79%; age mean: 25.84, age SD: 10.19), through a convenience sampling. We conducted an exploratory factorial analysis, a confirmatory factorial analysis, a reliability analysis, and the convergent validity. Results: Two factors are suggested: Cognitive attitudes towards vaccination and perceived legitimacy of authorities to require vaccination. The Dispvac Scale is negatively correlated with the VAX Scale. Conclusions: The mentioned factors suggest that intention to vaccinate also implies beliefs on the authority in vaccination.
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Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.
Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.
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Resumen Introducción: La endarterectomía carotídea se emplea para el tratamiento de pacientes con estenosis severa (> 70 %) o síntomas cerebrovasculares por enfermedad de la carótida interna. La escala Eagle ha sido usada como predictor de eventos cardiacos luego de una cirugía mayor. Este estudio busca determinar el uso de la escala Eagle como predictor de eventos mayores luego de endarterectomía carotídea. Materiales y métodos: En este estudio observacional retrospectivo de corte transversal, se revisaron historias clínicas de pacientes sometidos a endarterectomía carótida entre los años 2017 y 2021, donde la escala Eagle se realizó durante la visita prequirúrgica, para evaluar el riesgo de complicaciones mayores luego de una endarterectomía carotídea hasta finalizar la hospitalización. Discusión: Un total de 19 pacientes fueron evaluados prequirúrgicamente con el puntaje de la escala de Eagle y fueron tratados con endarterectomía carotídea, con un promedio de edad de 77 años. El procedimiento quirúrgico se realizó con mayor frecuencia en pacientes sintomáticos (89,40 %), incluyendo 10 (59 %) con antecedentes de ataque isquémico transitorio (AIT) y 7 (41 %) con ataque cerebrovascular. Las imágenes diagnósticas indicaron estenosis severa de la arteria carótida en 18 pacientes (94,7 %) y la mayoría de los pacientes presentaron riesgo moderado (68,42 %) según la escala Eagle, además, 5 presentaron complicaciones menores y ninguno presentó complicaciones mayores. Conclusiones: Un puntaje moderado en la escala de Eagle indica riesgo de desarrollar complicaciones cardiovasculares menores luego de endarterectomía carotídea, pero se requieren estudios con mayor tamaño de muestra para dilucidar el papel del puntaje Eagle como predictor de complicaciones cardiovasculares mayores luego de una endarterectomía carotídea.
Abstract Introduction: Carotid endarterectomy is used for treating patients with severe stenosis (>70%) or cerebrovascular symptoms secondary to internal carotid disease. Eagle score has been used as a predictor of cardiovascular events after major surgery. This study aims to assess the use of Eagle Score as a predictor of major cardiovascular events after carotid endarterectomy. Materials and methods: A retrospective observational cross-sectional study was conducted. Medical records of patients who underwent carotid endarterectomy between 2017 and 2021 were reviewed. The EAGLE scale was performed pre-surgically to assess the risk of the risk of major complications after carotid endarterectomy from surgery to the last day of hospitalization. Discussion: A total of 19 patients were assessed pre-surgically using the Eagle scale score and subsequently underwent carotid endarterectomy (Mean age of 77 years-old). The surgical procedure was predominantly performed on symptomatic patients (89.4%), including 10 patients (59%) with a history of transient ischemic attack (TIA) and 7 patients (41%) with a cerebrovascular attack. Previous diagnostic imaging indicated severe carotid artery stenosis in 18 patients (94.7%). According to the EAGLE Scale, the majority presented a moderate risk (68.42%), among whom 5 patients experienced minor complications, and none experienced major complications. Conclusions: Patients with minor cardiovascular complications after carotid endarterectomy were most commonly adjudicated as moderate risk according to the Eagle score. Further studies with large sample sizes are required to elucidate the role of Eagle Score as predictor of major cardiovascular events after carotid endarterectomy.
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Resumen El bienestar psicológico es un importante factor protector de la salud mental, particularmente en población vulnerable como los adultos mayores. Por lo tanto, es necesario contar con instrumentos de medición válidos, confiables e invariantes para su adecuado uso, con fines de evaluación e intervención psicológica. Este estudio se propuso analizar las evidencias de validez, confiabilidad e invarianza factorial de la Escala de Bienestar Psicológico (BIEPS-A) en una muestra de adultos mayores peruanos. Participaron 522 adultos mayores, de 60 a 93 años (M = 70.81, DE = 7.62), quienes respondieron la Escala BIEPS-A. Se encontraron adecuados índices de ajuste para un modelo de tres factores correlacionados: x2/gl = 1.631, CFI = .988, TLI = .984, SRMR = .0470, y RMSEA = .0350. También se halló relación entre las puntuaciones de la BIESP-A y el WHO-5 (r = .504), lo que es evidencia de validez convergente. Así mismo, se halló evidencia de confiabilidad de las puntuaciones con los coeficientes alfa (α) y omega (ω) (> .80). Finalmente, se encontró evidencia parcial de invarianza factorial en función al sexo (ΔCFI < .010, ΔRMSEA < .015). Se concluyó que la escala BIEPS-A reúne evidencias de validez, confiabilidad e invarianza parcial respecto al sexo para su correcto uso en adultos mayores peruanos.
Abstract Psychological well-being is an important protective factor for mental health, particularly in vulnerable populations such as the elderly. Therefore, it is necessary to have valid, reliable, and invariant measurement instruments for their proper use for psychological assessment and intervention purposes. This study aimed to analyze the evidence of validity, reliability, and factor invariance of the Psychological Well-Being Scale (BIEPS-A) in a sample of older Peruvian adults. Participants were 522 older adults, from 60 to 93 years old (M = 70.81, SD = 7.62), who answered the BIEPS-A Scale. Adequate fit indices were found for a model of three correlated factors: x2/gl = 1.631, CFI = .988, TLI = .984, SRMR = .0470, and RMSEA = .0350. A relationship was also found between the scores of the BIESP-A and the WHO-5 (r = .504, r2 = .254), which is evidence of convergent validity. Likewise, evidence of reliability of the scores with the alpha (α) and omega (ω) coefficients (> .80) was found. Finally, partial evidence of factor invariance based on gender was found (ΔCFI < .010, ΔRMSEA < .015). It was concluded that the BIEPS-A scale gathers evidence of validity, reliability and partial invariance with respect to sex for its correct use in older Peruvian adults.
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Existe en la práctica diaria de los cirujanos plásticos una búsqueda continua de mejores alternativas técnicas para el tratamiento de las deformidades del contorno abdominal. La LADE (Lipoabdominoplastia con defi nición anatómica) da un paso más adelante de la técnica LAP tradicional. Esta técnica incorpora los principios de resaltar la defi nición de la musculatura abdominal, consiguiendo resultados más naturales y con menos estigmas de una intervención quirúrgica. Los resultados estéticos son mucho más armoniosos, con un verdadero aspecto abdominal rejuvenecido. Logramos reducir la morbilidad preservando los vasos sanguíneos perforantes y suspendiendo la fascia de Scarpa. Una correcta selección del paciente asociado a la estandarización de esta técnica hace que el procedimiento sea seguro y reproducible
There is a continuous search for better technical alternatives for the treatment of abdominal contour deformities in the practice of plastic surgeons. LADE Lipoabdominoplasty with Anatomical Defi nition is a step ahead of the traditional LAP technique. This technique incorporated the principles of highlighting the defi nition of the abdominal musculature, achieving more natural results with fewer reminders of a surgical intervention. The aesthetic results are much harmonious, with a true abdominal rejuvenated appearance. We can reduce morbidity by preservation of perforating blood vessels and suspension of Scarpa's fascia. The correct selection of the patient associated with the standardization of this technique makes the procedure safe and reproducible
Sujet(s)
Lipectomie/méthodes , Fascia , Remodelage corporel/méthodes , Lipoabdominoplastie/méthodesRÉSUMÉ
Objetivo: Relacionar las complicaciones y el riesgo de muerte en pacientes neurocríticos admitidos en la unidad de cuidados intensivos (UCI) del Hospital Universitario de Caracas durante un período de 5 meses. Métodos: investigación observacional, prospectiva, descriptiva. La muestra estuvo conformada por 65 pacientes neurocríticos, ≥ 18 años, con patologías médicas o quirúrgicas, ingresados en la UCI. El análisis estadístico incluyó la determinación de frecuencias, promedios, porcentajes y medias para descripción de variables y el T de Student. Resultados: La edad promedio fue 50,98 ± 16,66 años; la población masculinarepresentó el 50,76%. Entre las complicaciones, la mayor incidencia correspondió a las no infecciosas (70,77 %) y los trastornos ácido-básicos de tipo metabólico, la anemia y las alteraciones electrolíticas fueron las más frecuentes; el 29,23% de los pacientes presentaron complicaciones infecciosas, y la neumonía asociada a ventilación mecánica fue la más frecuente (73,91 %). La comorbilidad con mayor incidencia fue hipertensión arterial sistémica (53,84%). El 90.70% requirió ventilación mecánica y el tiempo en VM fue 4.29 ± 6.43 días. La estancia en UCI fue 5.96 ± 7.72 días. El 29,23% presentó un puntaje en la escala APACHE II entre 5-9; el SAPS II presentó mayor incidencia entre los 6-21 y 22-37 puntos con (66,70%); el SOFA al ingreso se reportó < 15 puntos en 98,46% y > 15 en 1,53%. La mortalidad del grupo fue 23,08 % (n=15). Conclusiones: Las complicaciones no infecciosas predominaron sobre las infecciosas las primeras íntimamente relacionadas con la mortalida(AU)
Objective: To relate complications and the risk of death in neurocritical patients admitted to the intensive care unit (ICU) of the University Hospital of Caracas during a period of 5 months. Methods: observational, prospective, descriptive research. The sample was made up of 65 neurocritical patients, ≥ 18 years old, with medical or surgical pathologies, admitted to the ICU.The statistical analysis included the determination of frequencies, averages, percentages and meansfor description of variables and Student's T.Results: The average age was 50.98 ± 16.66 years; the male population represented 50.76%. Among the complications, the highest incidence corresponded to non-infectious complications (70.77%) and metabolic acid-base disorders, anemia and electrolyte alterations were the most frequent; 29.23% of patients presented infectious complications, and pneumonia associated with mechanical ventilation was the most frequent (73.91%). The comorbidity with the highest incidence was systemic arterial hypertension (53.84%), 90.70% required mechanical ventilation and the time on MV was 4.29 ± 6.43 days. The ICU stay was 5.96 ± 7.72 days. 29.23% had a score on the APACHE II scale between 5-9; SAPS II presented the highest incidence between 6-21 and 22-37 points with (66.70%); The SOFA upon admission was reported to be < 15 points in 98.46% and > 15 in 1.53%. The mortality of the group was 23.08% (n=15). Conclusions: Non-infectious complications predominated over infectious complications, the former being closely related to mortalit(AU)
Sujet(s)
Humains , Mâle , Femelle , Mortalité , Soins de réanimation , AnémieRÉSUMÉ
Introducción: La diabetes mellitus 2 es una enfermedad frecuente en adultos mayores, con múltiples complicaciones que pueden llegar a afectar el equilibrio y la marcha e incrementar el riesgo de caída. Objetivo: Determinar el riesgo de caídas en dos grupos de adultos mayores, uno con padecimiento de DM2 y otro sin este padecimiento. Metodología: Estudio de enfoque cuantitativo, alcance descriptivo, diseño observacional, y de cohorte transversal; muestra poblacional de 120 adultos mayores en la ciudad de Guayaquil divididos en dos grupos: grupo A con 60 adultos mayores que no padecían DM2 y grupo B con 60 adultos mayores con DM2; que cumplen con los criterios de inclusión y a quienes se evalúan mediante las técnicas: observación, evaluación y entrevista; y los instrumentos: Escala de Berg, Mini-BESTest y formulario estándar. Se utilizó la prueba estadística Chi cuadrado para la comparación de los resultados obtenidos. Resultados: Los resultados indican que, en la determinación del riesgo de caídas, se encontraron diferencias estadísticamente significativas (p0.05). El estudio además encontró que los resultados obtenidos, en las dos pruebas de riesgo de caídas, difieren entre sí. Conclusiones: Los adultos mayores diabéticos presentan un mayor riesgo de caída a comparación de adultos mayores no diabéticos.
Introduction: Diabetes mellitus 2 is a common disease in older adults, with multiple complications that can affect balance and gait and increase the risk of falling. Objective: To determine the risk of falls in two groups of older adults, one with and the other without DM2. Methodology: Quantitative approach study, descriptive scope, observational design, and cross-sectional cohort; population sample of 120 older adults in the city of Guayaquil divided into two groups: group A with 60 older adults who did not suffer from DM2 and group B with 60 older adults with DM2; who meet the inclusion criteria and who are evaluated by means of the techniques: observation, evaluation and interview; and the instruments: Berg scale, Mini-BESTestest and standard form. The Chi-square statistical test was used to compare the results obtained. Results: The results indicate that, in the determination of the risk of falls, statistically significant differences (p0.05) were found. The study further found that the results obtained, in the two fall risk tests, differed from each other. Conclusions: Diabetic older adults present a higher risk of falling compared to non-diabetic older adults.
Introdução: O diabetes mellitus tipo 2 é uma doença comum em idosos, com múltiplas complicações que podem afetar o equilíbrio e a marcha e aumentar o risco de quedas. Objetivo: Determinar o risco de quedas em dois grupos de idosos, um com DM2 e outro sem essa condição. Metodologia: Estudo com abordagem quantitativa, escopo descritivo, desenho observacional e coorte transversal; amostra populacional de 120 idosos da cidade de Guayaquil dividida em dois grupos: grupo A com 60 idosos que não sofriam de DM2 e grupo B com 60 idosos com DM2; que atendam aos critérios de inclusão e que sejam avaliados pelas técnicas: observação, avaliação e entrevista; e os instrumentos: Escala de Berg, Mini-BESTest e formulário padrão. O teste estatístico Qui-quadrado foi utilizado para comparação dos resultados obtidos. Resultados: Os resultados indicam que, na determinação do risco de quedas, foram encontradas diferenças estatisticamente significativas (p0,05). O estudo também constatou que os resultados obtidos nos dois testes de risco de queda diferem entre si. Conclusões: Idosos diabéticos apresentam maior risco de queda em comparação aos idosos não diabéticos.
Sujet(s)
HumainsRÉSUMÉ
La diabetes mellitus tipo 2 (DM2) es una amenaza para la salud por las complicaciones derivadas de un diagnóstico tardío, donde la identificación oportuna es primordial. Con el objetivo de establecer la relación entre índice cintura talla (ICT), índice cintura cadera (ICC) y puntaje de la escala FINDRISC (Finnish Diabetes Risk Score) como determinantes del riesgo de padecer DM2 a largo plazo, se realizó este estudio predictivo transversal con adultos de 18 y 60 años atendidos en el Centro de Salud Primero de Julio del municipio de Mixco, Guatemala. Participaron 80 adultos, seleccionados por un muestreo aleatorio simple. El instrumento de recolección de datos estuvo conformado por tres secciones: información general de la persona, parámetros antropométricos y la encuesta de FINDRISC. Se generaron modelos lineales generalizados para identificar relaciones entre índice cintura talla (ICT), índice cintura cadera (ICC) y puntaje de la escala FINDRISC (Finnish Diabetes Risk Score). El 36.2% presentó riesgo de desarrollar DM2 a largo plazo; encontrándose un 21.2% en el nivel de riesgo alto y muy alto. Se comprobó que únicamente existe relación significativa entre el ICT y el puntaje de la escala de FINDRISC como determinante del riesgo de padecer DM2 a largo plazo. Se concluye que la implementación de la medición del ICT constituye una herramienta útil para identificar personas con riesgo de desarrollar DM2, siendo su aplicación sencilla, no invasiva, económica y de fácil acceso en los servicios de salud.
Type 2 diabetes mellitus (T2DM) is a health threat due to the complications derived from a late diagnosis, where timely identification is essential. This study aimed to establish the relationship between waist-height index (WHR), waist-hip index (WHR) and the FINDRISC (Finnish Diabetes Risk Score)scale as determinants of the risk of suffering from T2DM in the long term. A cross-sectional predictive study was carried out with a simple random sample of 80 adults between 18 and 60 years old treated at the Primero de Julio Health Center in Mixco, Guatemala. The data collection instrument was structured into three sections: general information, anthropometric parameters and the FINDRISC survey. Generalized linear models were generated to identify relationships between waist-height ratio (WHR), waist-hip ratio (WHR) and the FINDRISC scale score (Finish Diabetes Risk Score). The results shows that 36.2% of the participants were at risk of developing T2DM in the long term; 21.2% being at the high and very high risk level. It was found that there is only a significant relationship between the WHR and the FINDRISC scale score as a determinant of the risk of suffering from T2DM in the long term. The implementation of the waist height index measurement constitutes a useful tool to identify people at risk of developing T2DM, its application being simple, non-invasive, economical and easily accessible in health services.
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Abstract Objective: Colonoscopy is a handy tool in preventing and diagnosing colorectal cancer. Its optimal performance requires adequate preparation for good visualization of the mucosa. In our endoscopy unit, we use the Boston scale to evaluate the quality of bowel preparation. The present work intends to assess whether or not an additional intervention with an educational video on the Internet could improve the result of preparation using the Boston scale for colonoscopy to enhance the visualization and detection of adenomas. Methods: A double-masked, randomized clinical trial. One group of patients received printed instructions on colonoscopy preparation, and another group received the same preparation plus the form contained a link and instructions to access and view a colonoscopy video posted on YouTube. Results: A highly significant difference was observed between the means of the Boston preparation score for the group that watched the video versus the group that did not (8.16 vs. 6.75; p < 0.0001). A significant difference was also found in the Boston score by segments of the colon: right (2.6 vs. 1.9; p < 0.001), transverse (2.7 vs. 2.3; p < 0.0001), and left (2.8 vs. 2.5; p < 0.0001). Concerning the adenoma detection rate, it was higher in the group that watched the video (28%) than in the group that did not (21%); however, the difference was not significant (p = 0.33). Conclusion: Watching an educational video significantly improves the quality of colonoscopy preparation through the Boston scale and the detection of adenomas; however, this difference was not significant, possibly due to a lack of a larger sample.
Resumen Objetivo: La colonoscopia es una herramienta muy útil en la prevención y diagnóstico del cáncer colorrectal. Su óptimo desempeño requiere una adecuada preparación para una buena visualización de la mucosa. En nuestra unidad de endoscopia utilizamos la escala de Boston para evaluar la calidad de la preparación. El objetivo del presente trabajo fue evaluar si una intervención adicional con un video educativo en internet podría mejorar el resultado de la preparación usando la escala de Boston para colonoscopia, de modo que se mejore la visualización y la detección de adenomas. Métodos: Ensayo clínico aleatorizado doble ciego. Un grupo de pacientes recibió las instrucciones impresas sobre la preparación para la colonoscopia y otro grupo recibió la misma preparación y, además, en el formulario había un enlace e instrucciones para acceder y ver un video de colonoscopia publicado en YouTube. Resultados: Se observó una diferencia altamente significativa entre las medias de la puntuación del Boston de la preparación a favor del grupo que vio el video frente al grupo que no (8,16 frente a 6,75; p < 0,0001). También se encontró una diferencia significativa en el puntaje de Boston por segmentos del colon: Boston derecho (2,6 frente a 1,9; p < 0,001), transverso (2,7 frente a 2,3; p < 0,0001) e izquierdo (2,8 frente a 2,5; p < 0,0001). En relación con la tasa de detección de adenomas, en el grupo que vio el video fue mayor (28%) comparado con el grupo que no (21%); sin embargo, la diferencia no fue significativa (p = 0,33). Conclusión: La visualización de un video educativo mejora significativamente la calidad de la preparación de la colonoscopia a través de la escala de Boston, y también mejora la detección de adenomas; sin embargo, esta última diferencia no fue significativa, posiblemente debido a la falta de una muestra mayor.
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RESUMEN El dolor se define como una experiencia sensorial y emocional desagradable que se asocia con el daño. Es un fenómeno multifactorial y subjetivo que presenta una incidencia de hasta el 60 % en los pacientes críticos y que puede ocasionar consecuencias negativas a nivel cardiovascular, respiratorio, digestivo, muscular, hematológico y psicológico. El estándar de oro para la evaluación del dolor es el reporte del paciente, quien puede indicar la presencia de dolor respondiendo a la pregunta simple «¿Tenés/tiene dolor?¼ o expresar la intensidad mediante la escala numérica del dolor (NRS, por sus siglas en inglés). El paciente capaz de comunicarse puede brindar también información sobre otras características del dolor. En pacientes que no pueden comunicarse pero pueden manifestar respuesta a estímulos, es apropiado utilizar escalas conductuales, las cuales se basan en observar la presencia de comportamientos asociados al dolor. El objetivo del presente paso a paso es describir la evaluación del dolor en pacientes adultos críticos.
ABSTRACT Pain is defined as an unpleasant sensory and emotional experience associated with damage. It is a multifactorial and subjective phenomenon with an incidence of up to 60 % in critically ill patients, which may lead to negative consequences at cardiovascular, respiratory, digestive, muscular, hematological, and psychological levels. The gold standard for pain assessment is the patient's report, who can indicate the presence of pain by answering the simple question «Do you have pain?¼ or express its intensity using the numeric pain rating scale (NRS). Patients who can communicate may also provide information regarding other characteristics of pain. In patients unable to communicate but capable of responding to stimuli, it is appropriate to use behavioral scales, which are based on observing the presence of behaviors associated with pain. The objective of this study is to describe the pain assessment in critically ill adult patients.
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ABSTRACT Objective: To evaluate the correlation between blood alcohol levels and the severity of injuries assessed by the Injury Severity Score (ISS) in patients who were victims of traffic accidents admitted to the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP). Methods: Cross-sectional study carried out between July 2018 and June 2019, at the Central Emergency Room of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (PSC-HCFMUSP). A total of 172 hospitalized patients victims of traffic accidents were included in this study. Blood samples were analyzed by the FMUSP Toxicology Laboratory. Results: 36 patients (20.9%) had positive BAC (≥ 0.2 g/L) with a mean of 1.21 g/L. Overall, patients had a mean age of 37.2 years old, and 136 (79.1%) were men. The ISS of the total casuistry was 15.6; regarding the external cause, the motorcycle was ranked first with 100 cases (58.1%), and drivers were the majority with 57.4% of the sample. Conclusion: There was no correlation between the severity of the injuries and the blood alcohol levels of traffic accident victims admitted to a reference hospital. Level of Evidence II, Cross-Sectional Study.
RESUMO Objetivo: Avaliar a correlação entre a alcoolemia e a gravidade das lesões avaliadas pelo Índice de Gravidade da Lesão ( Injury Severity Score* - ISS) em vítimas de acidentes de trânsito internadas no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP).* Método: Estudo transversal realizado entre julho de 2018 e junho de 2019, no Pronto Socorro Central do HC-FMUSP. Foram incluídas 172 vítimas de acidentes de trânsito. Amostras de sangue foram analisadas pelo Laboratório de Toxicologia da FMUSP. Resultados: 36 pacientes (20,9%) apresentaram alcoolemia positiva (≥ 0,2 g/L), com valor médio de 1,21 g/L. No geral, os pacientes tinham uma idade média de 37,2 anos, e 136 (79,1%) eram homens. O ISS da casuística total foi 15,6; quanto à causa externa, a motocicleta ficou em primeiro lugar com 100 casos (58,1%); e os condutores foram prevalentes entre as vítimas (57,4%). Conclusão: Não houve correlação entre a gravidade das lesões e a alcoolemia das vítimas de acidente de trânsito internadas em um hospital de referência. Nível de Evidência II, Estudo de Corte Transversal.
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RESUMO Nas competições de fisiculturismo são analisados a proporção, a definição, a simetria e o volume muscular, o que faz da incansável busca pelo corpo perfeito pelos atletas, uma insatisfação com a imagem corporal. Por isso, este trabalho objetivou-se em elaborar e validar uma escala de silhuetas específica para atletas de fisiculturismo feminino e masculino (Escala Shape), que aconteceu em três fases. 1) Elaboração de onze desenhos de imagem corporal que representassem as categorias de competição; 2) Concordância (teste de Kappa) entre especialistas/profissionais de fisiculturismo nacionais e internacionais na ordenação dos desenhos em ordem crescente e progressiva de muscularidade; 3) Aplicação e validação da Escala Shape em atletas amadores e profissionais ativos e filiados à Federações Nacionais e Internacionais de Fisiculturismo em ambos os sexos. Participaram da pesquisa 180 atletas (50 mulheres e130 homens). A escala apresentou adequada confiabilidade de estabilidade temporal (Kappa teste-reteste≥0,95). O instrumento apresentou validade de critério ao mostrar que atletas de categorias de competição distintas escolheram silhuetas compatíveis com suas categorias (p<0,001). Conclusão: a Escala Shape feminina e masculina apresentou evidências de confiabilidade e validade para a amostra, podendo ser utilizada para avaliar a satisfação com a imagem corporal de fisiculturistas de diferentes categorias.
ABSTRACT In bodybuilding competitions, proportion, definition, symmetry and muscle volume are analyzed, which makes the tireless search for the perfect body by athletes, a dissatisfaction with body image. Therefore, this work aimed to develop and validate a specific silhouette scale for female and male bodybuilding athletes (Shape Scale), which took place in three phases. 1) Elaboration of eleven body image drawings that represented the competition categories; 2) Agreement (Kappa test) between national and international bodybuilding specialists/professionals in ordering the drawings in ascending and progressive order of muscularity; 3) Application and validation of the Shape Scale in active amateur and professional athletes affiliated to National and International Bodybuilding Federations in both sexes. 180 athletes (50 women and 130 men) participated in the research. The scale showed adequate temporal stability reliability (Kappa test-retest≥0.95). The instrument showed criterion validity by showing that athletes from different competition categories chose silhouettes compatible with their categories (p<0.001). Conclusion: the female and male Shape Scale showed evidence of reliability and validity for the sample, and can be used to assess satisfaction with the body image of bodybuilders from different categories.
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ABSTRACT Introduction: measuring the severity of traumatic injuries is crucial for predicting clinical outcomes. Whereas the Injury Severity Score (ISS) has limitations in assigning scores to injuries at the same site, the New Injury Severity Score (NISS) corrects for this problem by taking into account the three most severe injuries regardless of the region of the body. This study seeks to comprehend the clinical and epidemiological profile of trauma patients while comparing the effectiveness of scales for predicting mortality. Methods: a descriptive, observational and retrospective study using records of patients who underwent thoracotomy at the Hospital das Clínicas of the Federal University of Triângulo Mineiro between 2000 and 2019. Demographic data, mechanisms of injury, affected organs, length of stay and mortality were analyzed. Injury severity was assessed using the ISS and NISS, and statistical analyses were conducted using MedCalc and SigmaPlot. Results: 101 patients were assessed, on average 29.6 years old, 86.13% of whom were men. The average duration of hospitalization was 10.9 days and the mortality rate was 28.7%. The ROC curve analysis revealed a sensitivity of 68.97%, specificity of 80.56% and area under the curve of 0.837 for the ISS, and 58.62%, 94.44% and 0.855 for the NISS, respectively. The Youden index was 0.49 for the ISS and 0.53 for the NISS. Conclusion: the study demonstrated comparable efficacy of NISS and ISS in predicting mortality. These findings hold significance in the hospital setting. Professionals must be familiar with these scales to utilize them competently for each patient.
RESUMO Introdução: a medição da gravidade das lesões traumáticas é essencial para prever os desfechos clínicos. Enquanto o Injury Severity Score (ISS) tem limitações ao atribuir pontuações às lesões no mesmo local, o New Injury Severity Score (NISS) corrige esse problema ao considerar as três lesões mais graves independentemente da região corporal. Este estudo visa entender o perfil clínico-epidemiológico dos pacientes traumatizados, comparando a eficácia das escalas para prever mortalidade. Métodos: estudo descritivo, observacional e retrospectivo utilizando registros de pacientes submetidos à toracotomia no Hospital das Clínicas da Universidade Federal do Triângulo Mineiro entre 2000 e 2019. Dados demográficos, mecanismos de lesão, órgãos afetados, tempo de internação e mortalidade foram analisados. A gravidade das lesões foi avaliada usando o ISS e NISS, e as análises estatísticas foram conduzidas no MedCalc e SigmaPlot. Resultados: Foram avaliados 101 pacientes, em média com 29,6 anos, sendo 86,13% homens. A média da internação foi de 10,9 dias e a taxa de mortalidade foi de 28,7%. A análise da curva ROC revelou uma sensibilidade de 68,97%, especificidade de 80,56% e área sob a curva de 0,837 para o ISS, e 58,62%, 94,44% e 0,855 para o NISS, respectivamente. O índice de Youden indicou 0,49 para o ISS e 0,53 para o NISS. Conclusão: o estudo demonstrou semelhante eficácia entre o NISS e o ISS na previsão de mortalidade. Esses resultados geram implicações importantes na aplicação dessas escalas no ambiente hospitalar. É essencial que os profissionais conheçam tais escalas para aplica-las adequadamente no contexto de cada paciente.
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ABSTRACT Purpose: Stargardt-like phenotype has been described as associated with pathogenic variants besides the ABCA4 gene. This study aimed to describe four cases with retinal appearance of Stargardt disease phenotypes and unexpected molecular findings. Methods: This report reviewed medical records of four patients with macular dystrophy and clinical features of Stargardt disease. Ophthalmic examination, fundus imaging, and next-generation sequencing were performed to evaluate pathogenic variants related to the phenotypes. Results: Patients presented macular atrophy and pigmentary changes suggesting Stargardt disease. The phenotypes of the two patients were associated with autosomal dominant inheritance pattern genes (RIMS1 and CRX) and in the other two patients were associated with recessive dominant inheritance pattern genes (CRB1 and RDH12) with variants predicted to be pathogenic. Conclusion: Macular dystrophies may have phenotypic similarities to Stargardt-like phenotype associated with other genes besides the classic ones.
RESUMO Objetivo: Fenótipos Stargardt-like já foram asso-ciados a variantes patogênicas no gene ABCA4. O propósito desse estudo é descrever quatro pacientes com achados retinianos semelhantes a doença de Stargardt com resultados moleculares diferentes do esperado. Métodos: Esse relato fez a revisão de prontuários médicos de quatro pacientes com distrofia macular e achados clínicos sugestivos de doença de Stargardt. Foram realizados avaliação oftalmológica, exames de imagens e testes usando next generation sequencing para avaliar variantes patogênicas associadas aos fenótipos dos pacientes. Resultados: Os pacientes apresentavam atrofia macular e alterações pigmentares sugerindo achados clínicos de doença de Stargardt. Dois pacientes foram associados a genes com herança autossômica dominante (RIMS1 e CRX) e dois pacientes foram associados a genes com herança autossômica recessiva (CRB1 e RDH12) com variantes preditoras de serem patogênicas. Conclusão: Distrofias maculares podem ter similaridades fenotípicas com fenótipo de Stargardt-like associados a outros genes além dos classicamente já descritos.
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ABSTRACT Objective: This study aimed to assess the frequency with which orthodontic patients decided to shift to another type of orthodontic appliance, among conventional metal brackets, ceramic brackets, lingual brackets and clear aligner, based on their personal experiences of pain, ulcers, bad breath, hygiene issues and social difficulties. Material and Methods: This study comprises of patients seeking orthodontic treatment. The sample (n = 500; age group = 19-25 years) was divided equally into four groups based on the treatment modality: conventional metal brackets, ceramic brackets, lingual brackets and clear aligner. Patients rated the questionnaire using a visual analogue scale, to assess variables (such as pain, ulcer etc) that impact various treatment modalities. Subsequently, patients from all groups provided feedback regarding their treatment experiences, and expressed their preference for an alternative modality. Intergroup comparison among the four groups was done using one-way analysis of variance with Tukey's HSD post-hoc test (p ≤ 0.05). Results: Patients who received lingual brackets reported higher levels of pain and ulceration, as compared to those who received clear aligners. All four groups showed statistically significant differences for ulcers during treatment (p ≤ 0.05). Of the 125 patients who received conventional metal brackets, 28% expressed a preference for clear aligner therapy, while 20% preferred ceramic brackets. In the lingual group, 56% of 125 patients preferred clear aligner therapy, and 8% preferred ceramic brackets to complete their treatment. In the ceramic group, 83% did not want to switch, whereas 17% desired to switch to clear aligner, while in aligner group no patient desired to switch. Conclusions: A higher percentage of patients from lingual brackets group chose to shift to clear aligners, followed by conventional metal brackets group and by ceramic brackets group, in this descending order. The clear aligner group demonstrated fewer issues than the other treatment modalities.
RESUMO Objetivo: Este estudo teve como objetivo avaliar a frequência com que pacientes ortodônticos decidiram mudar para outro tipo de aparelho ortodôntico, entre braquetes convencionais de metal, braquetes cerâmicos, braquetes linguais e alinhadores transparentes, com base em suas experiências pessoais de dor, aftas, mau hálito, problemas de higiene e dificuldades sociais. Material e Métodos: Esse estudo foi composto por pacientes que procuram tratamento ortodôntico. A amostra (n = 500; faixa etária = 19-25 anos) foi dividida igualmente em quatro grupos, com base na modalidade de tratamento: braquetes metálicos convencionais, braquetes cerâmicos, braquetes linguais e alinhadores transparentes. Os pacientes responderam a um questionário, usando uma escala visual analógica, para avaliar variáveis como dor e aftas, que impactam diferentes modalidades de tratamento. Posteriormente, os pacientes de todos os grupos forneceram feedback sobre suas experiências de tratamento e expressaram sua preferência por uma modalidade alternativa. A comparação intergrupos entre os quatro grupos foi feita usando análise de variância unidirecional com teste post-hoc HSD de Tukey (p ≤ 0,05). Resultados: Os pacientes que usaram braquetes linguais relataram níveis mais elevados de dor e aftas, em comparação com aqueles que usaram alinhadores transparentes. Todos os quatro grupos apresentaram diferenças estatisticamente significativas para aftas durante o tratamento (p ≤ 0,05). Dos 125 pacientes que usaram braquetes metálicos convencionais, 28% expressaram preferência pelo tratamento com alinhadores transparentes, enquanto 20% preferiram braquetes cerâmicos. No grupo com braquetes linguais, 56% dos 125 pacientes preferiram o tratamento com alinhadores transparentes e 8% preferiram braquetes cerâmicos para completar o tratamento. No grupo com braquetes cerâmicos, 83% não queriam trocar de tratamento, enquanto 17% desejavam mudar para os alinhadores transparentes; enquanto no grupo de alinhadores nenhum paciente desejou mudar. Conclusões: Uma porcentagem maior de pacientes do grupo com braquetes linguais optou pela mudança para alinhadores transparentes, seguido pelo grupo com braquetes metálicos convencionais e pelo grupo com braquetes cerâmicos, em ordem decrescente. O grupo de alinhadores transparentes demonstrou menos problemas do que as outras modalidades de tratamento.
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Se describen, en la literatura médica, predictores radiográficos que constituyen herramientas diagnósticas útiles para la retención de los caninos maxilares. Sin embargo, en la especialidad de ortodoncia las investigaciones sobre las herramientas predictivas de riesgo son escasas. Por ello se decide realizar una revisión bibliográfica con el objetivo de recopilar información acerca de la utilidad de las herramientas predictivas de riesgo en el diagnóstico de la retención de los caninos maxilares. Se realizó una búsqueda de información de artículos en idioma español e inglés, utilizándose las bases de datos SciELO, PubMed, Cochrane y Scopus. Para lograr un tratamiento óptimo de la anomalía debe priorizarse un buen diagnóstico, basado en métodos clínicos y radiográficos, pero se hace notoria la ausencia de herramientas que identifiquen individuos con alto riesgo en la comunidad. Los modelos o escalas de riesgo pueden ser útiles en este aspecto, para detectar precozmente el trastorno eruptivo y priorizar así intervenciones preventivas, que eviten el uso excesivo de medios auxiliares de diagnóstico y la sobrecarga de los sistemas de salud. Las herramientas predictivas de riesgo constituyen una alternativa para la clasificación adecuada de la población con alto riesgo de retención de caninos maxilares. Un instrumento de tal magnitud es de gran utilidad tanto en los servicios de Estomatología General como en los de Ortodoncia.
Radiographic predictors that are useful diagnostic tools for the retention of maxillary canines are described in the literature. However, in the specialty of orthodontics, research on risk predictive tools is scarce. Therefore, it was decided to carry out a bibliographic review with the objective of collecting information about the usefulness of risk predictive tools in the diagnosis of retention of maxillary canines. A search for information on articles in Spanish and English was carried out, using the SciELO, PubMed, Cochrane and Scopus databases. To achieve optimal treatment of the anomaly, a good diagnosis should be prioritized, based on clinical and radiographic methods, but the absence of tools that identify individuals at high risk in the community is notorious. Models or risk scales can be useful in this aspect, to detect the eruptive disorder early and thus prioritize preventive interventions that avoid the excessive use of diagnostic aids and the overload of health systems. Predictive risk tools are an alternative for the adequate classification of the population with high risk of retention of maxillary canines. An instrument of this magnitude is very useful both in General Dentistry and Orthodontics services.
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La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica de la piel que afecta a las glándulas sudoríparas apocrinas y causa nódulos inflamatorios, abscesos y fistulas dolorosas en áreas como las axilas, la ingle y los glúteos. Su impacto en la calidad de vida de los pacientes es significativo. La HS afecta al 1- 4% de la población mundial y se asocia con factores como el sobrepeso, el tabaquismo y antecedentes familiares. Su patogenia es compleja, involucrando inflamación y disfunción inmunológica. Su diagnóstico y tratamiento son desafiantes, especialmente en casos graves. El diagnóstico se basa en la presentación clínica, que a menudo se confunde con otras afecciones cutáneas. Se clasifica en etapas de Hurley según la gravedad. El tratamiento se centra en controlar los síntomas y prevenir recurrencias. Incluye educación del paciente, tratamiento médico y cirugía. La elección de la terapia antibiótica depende de la severidad y las cepas bacterianas presentes. Para casos graves, se investigan terapias biológicas. La cirugía, como la escisión simple o con injertos de piel, es efectiva en el control de la enfermedad. Presentamos un caso clínico de un paciente con HS, revisamos la epidemiología, etiopatogenia y su diagnóstico acompañado de las opciones terapéuticas existentes
A hidradenite supurativa (HS) é uma doença inflamatoria crônica da pele que afeta as glândulas sudoríparas apócrinas e causa nódulos inflamatórios, abscessos e fístulas dolorosas em áreas como axilas, virilha e nádegas. Seu impacto naqualidade de vida dos pacientes é significativo. A EH afeta de 1 a 4% da população mundial e está associada a fatores como excesso de peso, tabagismo e histórico familiar. Suapatogênese é complexa, envolvendoinflamação e disfunçãoimunológica, sendoseu diagnóstico e tratamento desafiadores, principalmente nos casos graves. O diagnóstico é baseadonaapresentação clínica, que muitasvezes é confundida comoutrasdoenças da pele. É classificado em estágios de Hurley com base nagravidade. O tratamento se concentra no controle dos sintomas e naprevenção de recorrências. Incluieducação do paciente, tratamento médico e cirurgia. A escolha da antibioticoterapia depende da gravidade e das cepas bacterianas presentes. Para casos graves, terapias biológicas são investigadas. A cirurgia, como excisão simples ouenxertos de pele, é eficaz no controle da doença. Apresentamosum caso clínico de umdoentecom HS, revisamos a epidemiologia, a etiopatogenia e o seu diagnóstico acompanhado das opçõesterapêuticas existentes.
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects the apocrine sweat glands and causes inflammatory nodules, abscesses, and painful fistulas in areas such as the armpits, groin, and buttocks. Its impact on patients' quality of life is significant. HS affects 1-4% of the world's population and is associated with factors such as overweight, smoking, and family history. Its pathogenesis is complex, involving inflammation and immune dysfunction. Its diagnosis and treatment are challenging, especially in severe cases. Diagnosis is based on clinical presentation, which is often confused with other skin conditions. It is classified into Hurley stages based on severity. Treatment focuses on controlling symptoms and preventing recurrences. Includes patient education, medical treatment and surgery. The choice of antibiotic therapy depends on the severity and the bacterial strains present. For severe cases, biological therapies are investigated. Surgery, such as simple excision or skin grafts, is effective in controlling the disease. We present a clinical case of a patient with HS, we review the epidemiology, etiopathogenesis and its diagnosis accompanied by the existing therapeutic options.
Sujet(s)
Humains , Mâle , Adulte , Fesses/chirurgie , Glandes périanales/chirurgie , Hidrosadénite suppurée/chirurgie , Fesses/anatomopathologie , Glandes périanales/anatomopathologie , Maladie chronique , Hidrosadénite suppurée/thérapie , Procédures chirurgicales dermatologiques/méthodesRÉSUMÉ
ABSTRACT Objective: To evaluate the focus of pediatricians' gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians' pain perception: absent/mild (score: 0-5) and moderate/intense (score: 6-10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5-8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face.
RESUMO Objetivo: Avaliar o foco do olhar do pediatra durante a punção do calcanhar de neonatos. Métodos: Estudo prospectivo no qual pediatras, utilizando óculos de rastreamento visual, avaliaram a dor neonatal antes/depois de uma punção de calcanhar. Os pediatras pontuaram a dor de acordo com a sua percepção por meio de uma escala analógica verbal (0=sem dor; 10=dor máxima). Os desfechos analisados foram o número e o tempo das fixações visuais na face superior, face inferior e mãos, em dois períodos de 10 segundos, antes (PRÉ) e depois da punção (PÓS). Os resultados foram comparados entre os períodos e segundo a percepção da dor do pediatra: ausente/leve (escore: 0-5) e moderada/grave (escore: 6-10). Resultados: Vinte e quatro pediatras (31 anos, 92% sexo feminino) avaliaram 24 neonatos. A mediana do escore atribuído à dor do recém-nascido durante a punção do calcanhar foi 7,0 (intervalo interquartil: 5-8). Comparado ao período PRÉ, no período PÓS, o maior número de pediatras fixou o olhar na face inferior (63 vs. 92%; p=0,036) e o número de fixações visuais foi maior na face inferior (2,0 vs. 5,0; p=0,018). Não houve diferença no número e no tempo das fixações visuais de acordo com a intensidade da dor. Conclusões: À beira do leito, os pediatras mudam seu foco de atenção visual na face do recém-nascido após um procedimento doloroso, focando o olhar principalmente na parte inferior da face.