Résumé
Introducción: El carcinoma verrugoso es una variante inusual bien diferenciada del carcinoma epidermoide que tiende a aparecer en adultos de mediana edad o mayores. Se considera una neoplasia maligna de grado bajo con cuatro subtipos principales. Objetivo: Referir la infrecuente presentación del carcinoma verrugoso en un adolescente. Presentación de caso: Escolar masculino de 12 años de edad, de raza mestiza, que acude a Consulta Especializada de Dermatología en el Hospital Clínico Quirúrgico Docente Celia Sánchez Manduley con lesión vegetante localizada en planta de pie derecho; se realizan complementarios, biopsia excisional más injerto y se concluye el caso como epitelioma curriculatum. Conclusiones: A nivel clínico, los carcinomas verrugosos se presentan en forma de tumores exofíticos con una superficie papilomatosa o verrugosa. Se asocian con frecuencia a la infección por el virus del papiloma humano, y puede ser difícil distinguir entre un carcinoma verrugoso y una verruga. Es importante el reconocimiento temprano para guiar un diagnóstico preciso y tratamiento oportuno(AU)
Introduction: Verrucous carcinoma is a well differentiated unusual variant of squamous cell carcinoma that tends to occur in middle-aged or older adults. It is considered a low-grade malignant tumour with four main subtypes. Objective: To explain the uncommon presentation of the verrucous carcinoma in a teenager and the importance of early recognition to guide an accurate diagnosis and a timely treatment. Case presentation: 12 years old, school age male, mixed race who attends to specialized consultation of Dermatology in Celia Sánchez Manduley Surgical Clinical Hospital presenting a vegetating lesion located in the right foot´s sole; there were made complementary blood tests, an excisional biopsy plus graft and the case was finally diagnoses as curriculatum epithelioma. Conclusions: At the clinical level, the verrucous carcinomas are presented in the form of exophytic tumors with a papillomatous or verrucous surface. They are often associated with the human papilloma virus infection, and it may be difficult to distinguish between a verrucous carcinoma and a wart(AU)
Sujets)
Humains , Mâle , Enfant , Carcinome épidermoïde/diagnostic , Carcinome verruqueux/anatomopathologie , Carcinome verruqueux/épidémiologieRésumé
Se realizó un estudio observacional, descriptivo y longitudinal, desde septiembre de 2007 hasta junio de 2009, de 33 escolares con ambliopía, pertenecientes a la escuela especial "Josué País García" de Santiago de Cuba, para describir los resultados del tratamiento rehabilitador. Estos niños fueron clasificados según el grado de la agudeza visual con corrección y la causa de la enfermedad. Se les realizó visuscopia antes y después del tratamiento, además de potencial evocado visual cortical. En la casuística prevalecieron el grupo etario de 4-6 años, el sexo femenino y la ambliopía estrábica. La agudeza visual mejoró significativamente después del tratamiento rehabilitador y hubo 9,0 % de pacientes irrecuperados. Se recomienda diseñar un programa de salud dirigido al personal médico de la atención primaria acerca de la prevención y tratamiento de estos pacientes, así como realizar acciones educativas con los padres sobre tan importante tema de salud.
An observational, descriptive and longitudinal study was carried out from September 2007 to June 2009 in 33 schoolchildren with amblyopia, belonging to "Josué País García" special school of Santiago de Cuba, in order to describe the results of the rehabilitation treatment. These children were classified according to the degree of corrected visual acuity and cause of the disease. Visuscopy was performed in them before and after treatment, besides cortical visual evoked potential. Age group of 4-6 years, the female sex and strabic amblyopia prevailed in the case material. Visual acuity improved significantly after rehabilitation treatment and 9.0% of patients did not recover. It is recommended to design a health program aimed at medical staff of primary care for prevention and treatment of these patients, and to conduct educational activities with parents on this important health issue.
Résumé
Se realizó una intervención educativa cuasiexperimental en 60 estudiantes de séptimo grado de la Secundaria Básica Urbana "Francisco Maceo Osorio" de Santiago de Cuba, desde noviembre de 2010 hasta febrero de 2011, con vistas a modificar sus conocimientos sobre las enfermedades diarreicas agudas. Se aplicó un cuestionario que incluía determinados aspectos sobre la afección, cuyas respuestas fueron evaluadas en ese momento y 3 meses después de varias sesiones de trabajo, donde se utilizaron técnicas participativas para intercambiar informaciones y amenizar la actividad. Se utilizaron la frecuencia absoluta y el porcentaje como medidas de resumen para variables cualitativas y se aplicó la prueba de McNemar, con nivel de significación de 95 %. Antes del estudio 85,0 % tenían conocimientos inadecuados sobre el tema, lo cual estuvo relacionado con las insuficientes actividades de promoción y prevención que se efectuaban en el centro; comportamiento que fue variado satisfactoriamente después de este (93,3 %). La acción educativa demostró ser eficaz, de manera que esta experiencia podría extenderse a otros centros escolares del territorio.
A quasi-experimental educational intervention was performed in 60 seventh graders of "Francisco Maceo Osorio" Urban Junior High School in Santiago de Cuba, from November 2010 to February 2011, with the purpose of modifying their knowledge of acute diarrheal diseases. A questionnaire was used, which included some aspects on the disease, and their answers were evaluated at that moment and 3 months after several working sessions, where participative techniques were used to exchange information and to make the activity more enjoyable. Absolute frequency and percentage were used as summary measures for qualitative variates and the McNemar test was applied with 95 % significance. Before the study 85.0 % of them had inadequate knowledge of the topic, which was related to the insufficient promotion and prevention activities, but this behavior was successfully changed after that (93.3 %). The educational action proved to be effective, so that this experience could be extended to other schools in the territory.
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Objective:To understand the related factors of tic disorders(TD) and early intervention among schoolchildren.Methods:Using stratified-cluster random sampling techniques,4,020 children were selected from 61,836 schoolchildren in Daxing district of Beijing.Totally 4,020 children and their parents were asked to fill in a self-designed questionnaire covering both motor and vocal tics and general information.A three-stage procedure was used:screening,interview and clinical investigation.A total of 3,813 children were investigated successfully.The children who were reported with tic symptoms as well as those who were reported by their teachers or classmates were surveyed according to the TD criteria in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition(DSM-Ⅳ).Eighty-six TD children were investigated respectively about the related factors of TD,and 86 healthy children matched in age,sex and grade were selected as controls.Telephone interview was carried out to find the doubtful TD cases in family members.Those people identified as having tics underwent a semistructured interview to determine whether they had TD according to DSM-Ⅳ criteria.Related risk factors of TD were investigated according to self-designed formulary medical history sheet. Results:Positive TD inheritance family history(7.0%),abdominal delivery style(36.0%),carbonate drink(10.5%),obesity(14.0%) and psychological stress were risk factors of TD(P<0.05).The multivariate analysis of variance indicated that inheritance family history,delivery style,dwelling environment,carbonate drink,parent-child relation,hobby,underachieve,self-care ability were closely related to the high incidence of TD (P<0.05).Conclusion:The occurrence of tic disorders may be related to multiple interacted factors.Early intervention is most important.
Résumé
This study is designed to understand the meaning and nature of raising children with cerebral palsy. It researches the experience of mothers of schoolchildren with cerebral palsy by the research method of hermeneutic phenomenology. The study was conducted from November 10, 1999 to December 20, 2000. When children with cerebral palsy usually show symptoms in the early stage of cerebral palsy, mothers do not take children to a doctor for diagnosis. And, most of mothers have a difficult time to accept the reality; they usually respond to the initial diagnosis with shock, reproach, and deny. When mothers start recognizing the reality, they consider that their children have cerebral palsy due to the their mismanagement during pregnancy, delivery, nursing, and initial treatment. They shelter their children from view and feel guilty that they cannot afford to try folk remedies for their children. As time passes, mothers face conflicts between families in diverse ways. Families put the blame on genetic effects. Mothers-in-law give their daughters-in-law a hard time, husbands shift the responsibility of raising children onto their wives, and trouble arises between families-in-law and mothers native families. When children grow up, it is physically difficult for mothers to take care their children. In addition, they suffer from all the troubles in family due to childrens handicap. Mothers try the diverse methods of bringing up children. However, they start getting tired of raising children as they experience failures and financial difficulties. Mothers feel collapsed recalling the ways of raising children. They feel anxiety, miserable, lonely, and worrying when they think how children would attend school, make friends, and live in the future. In this stage, mothers do their best to raise their children with hope. They tend to compare their children with others without handicap and spend money and time in attempting all the treatments. When mothers and children join the society at school, they find that the society does not understand disabled people, teachers show inconsiderate attitude, friends avoid them, and children hardly follow classes. Such experiences make mothers feel angry and frustrated. However, when children adapt to school, mothers see the possibility that children could accomplish schoolwork. They appreciate teachers help and others consideration. Mothers place appropriate expectations on their children and help them to prepare for the future. I would make following suggestions based on the results. 1. As a primary basic course of rehabilitation nursing intervention, solution-centered nursing intervention system should be developed. The intervention needs to be based on the understanding of mothers, who raise children with cerebral palsy, through in-depth interview. 2. Advance researches on the development of individual nursing intervention should be conducted. Individual nursing intervention needs to prevent and release actual pain focusing on mothers raising children with cerebral palsy. 3.Integrated curriculum that help children with cerebral palsy lead a normal school life with ordinary children should be developed. 4.Basic research on using of facilities and effective application of service volunteer to help children with cerebral palsy in school needs to be conducted.