RESUMO
AIM: To determine the agreement rates between clinical and autopsy diagnoses in a neonatal intensive care unit (NICU), distinguishing between the main diagnosis and cause of death. METHODS: Clinical and autopsy records of 75 infants who died in two consecutive years in the NICU (autopsy rate 42.6%) of a pediatric hospital in Mexico City were reviewed. RESULTS: Ninety-two percent of main clinical diagnoses were confirmed by autopsy. Four conditions (congenital cardiopathy, prematurity, specific congenital syndromes and hyaline membrane disease) accounted for more than two-thirds of diagnoses. However, for cause of death, the global agreement was only 50%. The most common conditions considered by clinicians (77%) and pathologists (56%) to be the causes of death were cardiogenic, septic or mixed shocks. Additionally, clinicians omitted 34 relevant conditions in 30 (40.0%) patients, and 21 of these conditions possibly played a role in the deaths of 17 (22.7%) patients. The most frequently omitted diagnosis was pneumonia, in 9 (26.5%) patients. Omissions were not related to gestational age, age at death, days as an inpatient, or gender. CONCLUSION: Despite a high agreement rate in the main diagnoses, notable imprecisions were present regarding cause of death and antemortem overlooking of potentially fatal conditions, confirming the useful role of autopsy to verify clinical diagnoses and suggesting that differentiation between the main diagnosis and cause of death should be carried out in future studies.
Assuntos
Autopsia/normas , Causas de Morte , Mortalidade Hospitalar , Mortalidade Infantil , Patologia/normas , Diagnóstico Diferencial , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , México/epidemiologia , Estudos RetrospectivosRESUMO
The relationship between gender-related personality traits, on one hand and drinking, permissiveness towards drinking, and social as well as personal problems associated to drinking on the other, was studied in a general population sample from the City of Morelia, Mexico. Four gender-related traits scales were used for measuring assertive and aggressive masculinity and affective and submissive feminity, in addition to a standardized questionnaire for assessing drinking and other associated behavior. Some of the main results showed that people with high scores in affective feminity were less willing to allow drinking. Men who adopted a submissive feminine role and women with high masculine aggressive scores were more permissive as regards drinking. Among men, assertive masculine and affective feminine traits were more characteristic among those who drank than among abtainers. Drinking among women was related to liberal attitudes towards drinking and to aggressive masculinity. As regards the number of drinks consumed per month, assertive masculinity and liberal attitudes among men and affective feminity and liberal attitudes among women predicted the number of drinks. Affective feminity was negatively related to drinking. Regarding drinking-associated problems, frequency of drunkenness and submissive feminity among males predicted greater personal and social problems. Among women, drunkenness frequency and number of drinks were the most significant predictors. Contrary to what has been found in other countries, gender was a better drinking predictor than gender-related personality traits.
Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Comparação Transcultural , Identidade de Gênero , Comportamento Social , Valores Sociais , Adolescente , Adulto , Intoxicação Alcoólica/psicologia , Alcoolismo/psicologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Problemas Sociais , EstereotipagemRESUMO
Separate factor analyses of a Spanish version of the Bem Sex Role Inventory and of New Sex Role Scales (Positive and Negative Masculinity and Femininity), for 82 Mexican workers, yielded four interpretable factors for the BSRI, two related to feminine aspects and two to masculine ones. For the New Scales, three factors could be interpreted: a negative masculine, a negative feminine and a positive masculine-feminine. These results provide evidence which gives substantial support to the construct validity of both instruments. The present results are further compared with previous findings related to Mexican, and foreign samples as well, and discussed in relation to the concepts of masculinity and femininity.
Assuntos
Identidade de Gênero , Identificação Psicológica , Inventário de Personalidade , Escalas de Graduação Psiquiátrica , Desejabilidade Social , Comércio , Feminino , Humanos , Indústrias , Masculino , MéxicoRESUMO
Separate factor analyses of a Spanish version of the Bem Sex Role Inventory and of New Sex Role Scales (Positive and Negative Masculinity and Femininity), for 82 Mexican workers, yielded four interpretable factors for the BSRI, two related to feminine aspects and two to masculine ones. For the New Scales, three factors could be interpreted: a negative masculine, a negative feminine and a positive masculine-feminine. These results provide evidence which gives substantial support to the construct validity of both instruments. The present results are further compared with previous findings related to Mexican, and foreign samples as well, and discussed in relation to the concepts of masculinity and femininity.
RESUMO
Clinical data were collected in 194 cases of jaundiced patients treated at the "Adolfo Lopez Mateos" ISSSTE Hospital in Mexico City from July 1985 to July 1986. A copy of the clinical history of each patient was given to each of four physicians--one recently graduated from medical school, another in his first year of gastroenterology, and two others who were experienced gastroenterologists. The same clinical data were processed by a computer set up to use a modified Danish COMIC algorithm. All physicians and the computer technician were blinded to the "gold standard" pathologic diagnoses, with which their diagnoses were compared. Accuracy rates of the physicians in distinguishing intrahepatic (medical) from extrahepatic (surgical) jaundice were 78%, 86%, 86%, and 91%, and the accuracy of computer-assisted diagnoses was 96%. Chi-squared analysis of the diagnoses of three of the physicians and those of the computer showed significant differences (p between 0.1 and 0.01). For the diagnoses of the remaining physician, however, no significant difference was found after chi-squared continuity correction.
Assuntos
Algoritmos , Colestase Extra-Hepática/diagnóstico , Colestase Intra-Hepática/diagnóstico , Diagnóstico por Computador , Adulto , Idoso , Idoso de 80 Anos ou mais , Colestase Extra-Hepática/etiologia , Colestase Extra-Hepática/patologia , Colestase Intra-Hepática/etiologia , Colestase Intra-Hepática/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This investigation presents the results of a multimodal therapeutic programme for the cessation of smoking. The programme included the following elements: self-control techniques, education on a variety of issues on tobacco effects, group dynamic techniques, medical check up and pharmacological support. There were two treatment conditions, one included twelve sessions, and the other eight sessions. All groups received four follow-up sessions in a six month period. Ninety four subjects initiated treatment and 69 (73.4%) completed it. Twenty one subjects (22.3%) stopped smoking and remained abstinent after six months, eleven (11.7%) stopped smoking and relapsed and fourteen (14.7%) stopped smoking but did not attend the last follow-up sessions. Twenty three subjects (24.5%) did not stop smoking but reduced their smoking rate in 50% from initial report. These results were considered as satisfactory when compared with others obtained in similar studies.
Assuntos
Terapia Comportamental , Educação em Saúde , Psicoterapia de Grupo , Prevenção do Hábito de Fumar , Adulto , Idoso , Terapia Combinada , Feminino , Seguimentos , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Reforço Psicológico , Terapia de RelaxamentoRESUMO
Se presentan los resultados de un programa terapeutico multimodal para el control del tabaquismo. El programa incluyo tecnicas de autocontrol, educacion sobre diversos aspectos del tabaquismo, manejo de la dinamica del grupo, estudios medicos y apoyo farmacologico. Se impartieron 12 sesiones a unos grupos y 8 a otros y se llevaron a cabo cuatro seguimientos en un periodo de seis meses. Noventa y cuatro personas iniciaron el tratamiento, de las cuales 69 (73.4%) lo completaron. Veintiuna personas (22.3%) dejaron de fumar y siguieron sin fumar a los seis meses, once (11.7%) dejaron de fumar y reincidieron, catorce (14.5%) dejaron de fumar pero no completaron los ultimos seguimientos y vientitres (24.5%) no dejaron de fumar pero redujeron su tabaquismo un 50%. Estos resultados se consideraron satisfactorios al ser comparados con los de estudios similares
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Terapia Comportamental , Educação em Saúde , Psicoterapia de Grupo , NicotianaRESUMO
This investigation presents the results of a multimodal therapeutic programme for the cessation of smoking. The programme included the following elements: self-control techniques, education on a variety of issues on tobacco effects, group dynamic techniques, medical check up and pharmacological support. There were two treatment conditions, one included twelve sessions, and the other eight sessions. All groups received four follow-up sessions in a six month period. Ninety four subjects initiated treatment and 69 (73.4
) completed it. Twenty one subjects (22.3
) stopped smoking and remained abstinent after six months, eleven (11.7
) stopped smoking and relapsed and fourteen (14.7
) stopped smoking but did not attend the last follow-up sessions. Twenty three subjects (24.5
) did not stop smoking but reduced their smoking rate in 50
from initial report. These results were considered as satisfactory when compared with others obtained in similar studies.
RESUMO
Se presentan los resultados de un programa terapeutico multimodal para el control del tabaquismo. El programa incluyo tecnicas de autocontrol, educacion sobre diversos aspectos del tabaquismo, manejo de la dinamica del grupo, estudios medicos y apoyo farmacologico. Se impartieron 12 sesiones a unos grupos y 8 a otros y se llevaron a cabo cuatro seguimientos en un periodo de seis meses. Noventa y cuatro personas iniciaron el tratamiento, de las cuales 69 (73.4%) lo completaron. Veintiuna personas (22.3%) dejaron de fumar y siguieron sin fumar a los seis meses, once (11.7%) dejaron de fumar y reincidieron, catorce (14.5%) dejaron de fumar pero no completaron los ultimos seguimientos y vientitres (24.5%) no dejaron de fumar pero redujeron su tabaquismo un 50%. Estos resultados se consideraron satisfactorios al ser comparados con los de estudios similares
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Feminino , Educação em Saúde , Nicotiana , Psicoterapia de Grupo , Terapia ComportamentalRESUMO
A clinical case of this disease in a newborn is reported. The clinical signs and laboratory results were typical and were confirmed by pathological studies. The modern literature stresses the high frequency of this disease, specially in the U.S.A. and England, where reports reach 4% in pregnant women and 1% of newborns with cytomegalic inclusion disease. We do not know its frequency in Mexico.
Assuntos
Infecções por Citomegalovirus/patologia , Doenças do Recém-Nascido/patologia , Autopsia , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/epidemiologia , Infecções por Citomegalovirus/microbiologia , Inglaterra , Humanos , Recém-Nascido , Doenças do Recém-Nascido/epidemiologia , Masculino , Estados UnidosRESUMO
The present work includes six cases of congenital syphilis that were diagnosed radiologically before birth in patients with positive syphilitic reactions who had not been given treatment during gestation. The x-ray diagnosis was mainly based on lesions of diaphyses and metaphyses of the long bones of the fetal skeleton that were identified in lateral projection of x-ray plates of the maternal abdomen. In all cases reported, x-ray plates were taken in the immediate post-partum period with confirmation of the bony lesions and at the same time, of the laboratory tests including blood picture and liver function test in 5 cases. Autopsy was practiced in one case.
Assuntos
Doenças Fetais/diagnóstico por imagem , Sífilis Congênita/diagnóstico por imagem , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Gravidez , Diagnóstico Pré-Natal , RadiografiaRESUMO
Fourteen cases of multicystic kidney were identified out of 153,825 births through five and a half years at the "Dr. Ignacio Morones Prieto" hospital in Monterrey, Nuevo León. The etiopathogenesis and heredity in this disease are not clear. An early diagnosis is possible following a careful abdominal examination. The left kidney is the one most frequently involved. The excretory urography only shows renal exclusion of the affected side; when the disease is of only one side there is good excretion of the opaque medium by the contralateral kidney. The kidney is substituted by an irregular mass made up of multiple cysts losing the aspects of a normal kidney. Microscopically, its architecture is completely lost and there is replacement by cysts and some occasional hypoplastic glomeruli. If the opposite kidney is not affected, the prognosis is good. Nephrectomy must be done. Differential diagnosis must be made with hydronephrosis, nephroblastoma and thrombosis of the renal vein.