Anesthesia for EXIT procedure (ex utero intrapartum treatment) in congenital cervical malformation - a challenge to the anesthesiologist / Anestesia para procedimento EXIT (tratamento extraútero intraparto) em malformação congênita cervical - um desafio para o anestesiologista

The ex utero intrapartum treatment (EXIT) procedure consists of partial externalization of the fetus from the uterine cavity during delivery, allowing the maintenance of placental circulation. It is indicated in the presence of congenital malformation when difficulty in fetal airway access is anticipated, allowing it to be ensured by direct laryngoscopy, bronchoscopy, tracheostomy, or surgical intervention. Anesthesia for EXIT procedure has several special features, such as the appropriate uterine relaxation, maintenance of maternal blood pressure, fetal airway establishment, and maintenance of postpartum uterine contraction. The anesthesiologist should be prepared for the anesthetic particularities of this procedure in order to contribute to a favorable outcome for the mother and particularly the fetus.

O procedimento EXIT (tratamento extraútero intraparto) consiste na exteriorização parcial do feto da cavidade uterina durante o parto para permitir a manutenção da circulação fetoplacentária. Está indicado na presença de malformações congênitas em que se antecipa a dificuldade no acesso da via aérea fetal e permite que essa seja assegurada por laringoscopia direta, broncoscopia, traqueostomia ou intervenção cirúrgica. A anestesia para procedimento EXIT apresenta várias particularidades. O relaxamento uterino adequado, a manutenção da pressão arterial materna, o estabelecimento de via aérea fetal e a manutenção da contração uterina pós-parto são alguns exemplos. O anestesiologista deve estar preparado para as particularidades anestésicas desse procedimento, de modo a contribuir para um desfecho favorável para a mãe e particularmente para o feto.

Quality of Life and its Associated Factors among Some Elderly Residents Using a Hall for the Aged in a Community / 예방의학회지

OBJECTIVES: This study was performed to investigate the level of quality of life (QOL) and to identify its related factors among the elderly using a hall for the aged. METHODS: The study subjects were 350 elderly people living in Nam Gu, Gwangju City. They were interviewed by questionnaire to collect information on social-demographic characteristics, health behaviors, health-related characteristics and QOL. We used statistical analysis methods such as T-test, ANOVA and multiple regression analysis to find which factors affected QOL. RESULTS: The characteristics relating to physical functions were as follows: presence of spouse, education, alcohol drinking, teeth condition, arthritis, frequency of visiting the hall for the aged, and depression. Age, arthritis and depression were significantly related to role limitation due to physical problems. General health was related to gender, age, and depression, and vitality was related to education, frequency of visiting the hall, and depression. Role limitation due to emotional problems was related to age and depression, and mental health was related to age, hypertension, arthritis and depression. CONCLUSIONS: This study showed QOL of the elderly was significantly influenced by socio-demographic factors, and physical or emotional conditions. To improve QOL of the elderly, we need to develop programs to promote health and to manage chronic diseases of the elderly.

Hospital-dia (HD) para transtornos alimentares: revisão da literatura e primeiras impressões do HD do ambulatório de bulimia e transtornos alimentares do IPqHCFMUSP(AMBULIM) / Day hospital care for eating disorders: review of the literature and preliminary findings at AMBULIM, Institute of psychiatry, University of São Paulo

Os autores revisaram a literatura a respeito de tratamento em hospital-dia (HD) para transtornos psiquiátricos em geral e mais especificamente para transtornos alimentares, apontando aspectos históricos, indicações e contra-indicações para essa forma de tratamento, eficácia clínica e vantagens financeiras. Também foram descritos programas de HD em atividade no mundo, incluindo o HD do AMBULIM-IPqHCFMUSP.