RESUMO
This research paper delves into the effectiveness and impact of behavior change techniques fostered by information technologies, particularly wearables and Internet of Things (IoT) devices, within the realms of engineering and computer science. By conducting a comprehensive review of the relevant literature sourced from the Scopus database, this study aims to elucidate the mechanisms and strategies employed by these technologies to facilitate behavior change and their potential benefits to individuals and society. Through statistical measurements and related works, our work explores the trends over a span of two decades, from 2000 to 2023, to understand the evolving landscape of behavior change techniques in wearable and IoT technologies. A specific focus is placed on a case study examining the application of behavior change techniques (BCTs) for monitoring vital signs using wearables, underscoring the relevance and urgency of further investigation in this critical intersection of technology and human behavior. The findings shed light on the promising role of wearables and IoT devices for promoting positive behavior modifications and improving individuals' overall well-being and highlighting the need for continued research and development in this area to harness the full potential of technology for societal benefit.
Assuntos
Internet das Coisas , Dispositivos Eletrônicos Vestíveis , HumanosRESUMO
RESUMEN El Trastorno por Estrés Postraumático (TEPT) es una condición psiquiátrica que surge como respuesta a eventos traumáticos y puede afectar significativamente la funcionalidad del paciente. La sierra andina es una región cuya población ha estado expuesta a eventos altamente estresantes; sin embargo, existe escasa información sobre factores asociados a la ocurrencia de TEPT en la región. Objetivo: Determinar los factores sociodemográficos y clínicos (comorbilidad y funcionalidad) asociados al TEPT. Material y métodos: Se trata de un estudio secundario que utilizó la base de datos del adulto del Estudio Epidemiológico de Salud Mental en la Sierra - 2017. Instrumentos: Mini Entrevista Neuropsiquiátrica Internacional (MINI) en la versión en español de CIE-10, Cuestionario de Salud Mental de Colombia, Escala de Discapacidad y una ficha de datos demográficos e indicadores de pobreza. Resultados: Se encontraron asociaciones significativas entre TEPT y grupos de personas casadas y carentes de instrucción escolarizada. El episodio depresivo fue la comorbilidad más frecuente. Los principales estresores fueron la violencia política y los accidentes graves. Asimismo, hubo asociación de TEPT con pensamientos suicidas y dificultad para planificar, organizar y ejecutar diversas actividades. Conclusiones: Existe asociación relevante entre TEPT y algunos factores sociodemográficos, eventos traumáticos y trastornos clínicos. Los programas de intervención deben brindar atención inmediata a personas expuestas a eventos traumáticos y disminuir la presencia y el impacto de factores estresantes presentes en la región andina.
SUMMARY Post-traumatic stress disorder (PTSD) is a psychiatric condition that occurs in response to traumatic events and can significantly affect the patient's functional capacities. The Peruvian highlands is a region whose population has been exposed to highly stressful events; however, there is limited information on the factors associated with PTSD in the region. Objective: To determine sociodemographic and clinical factors (comorbidity and functionality) associated with PTSD. Material and methods: A secondary study was conducted using the adult database of the Epidemiological Study of Mental Health in the Peruvian Highlands - 2017. Instruments: Mini International Neuropsychiatric Interview (MINI) Spanish version ICD-10, Mental Health Questionnaire of Colombia, Disability Scale, and an intake form with demographic data and poverty indicators. Results: Significant associations were found between PTSD and groups of married people and those who had no school education. Depressive episode was the most frequent comorbidity. The main stressors were political violence and serious accidents. Likewise, there was an association of PTSD with suicidal thinking and difficulties in planning, organizing and executing a variety of activities. Conclusions: PTSD was associated with some sociodemographic factors, traumatic events and clinical disorders. Intervention programs should be aimed at providing immediate care to people exposed to traumatic events and at reducing the presence and impact of such stressors in the Andean region.
RESUMO
BACKGROUND: Pain is essential for survival, but it is also a major clinical, social, and economic problem that demands adequate management. The latter involves timely and accurate assessment, so several efforts have been made to develop accurate and reliable pain assessment tools. Advances in objective pain assessment include a large body of work focused on determining whether autonomic-mediated peripheral responses can be used to predict pain intensity. However, there is still no clinically validated autonomic marker for objective pain assessment. OBJECTIVES: In order to identify possible causes of this situation, the present study reviews the most recent advances examining peripheral autonomic markers' ability to describe pain intensity. STUDY DESIGN: Systematic literature review. METHODS: We conducted an online search on PubMed using terms such as "pain assessment," "experimental pain," "autonomic arousal," "heart rate," "heart rate variability," "electrodermal activity," "pupillary diameter," and "blood pressure." Articles published from 2010 through 2020 examining the abilities of peripheral autonomic markers to describe experimental pain intensity were collected and reviewed. From each of the included studies, we extracted information regarding autonomic parameters and stimulation modalities used by experimenters, as well as the sample size, gender, and health condition of the patients. RESULTS: Twenty-six articles were included for analysis, from which only 2 studies reported the use of multiple modalities. Half of the documents reported sample sizes ranging from 20 to 50 patients, and only 3 studies used formal power calculation to determine the sample size. Most of the articles included only healthy patients, so the influence of age, gender, and pre-existing health conditions on the autonomic peripheral parameters' capabilities to reflect the experience of pain remains unexplored. LIMITATIONS: It is possible that several documents were not retrieved due to a potential search engine bias or the use of very specific terms. Furthermore, only studies reporting pain intensity as a unique measure of its severity were included. CONCLUSION: The measurement of autonomic responses elicited by experimentally induced pain is one crucial step toward the development of reliable pain assessment tools. Still, several issues need to be addressed before continuing to explore the use of autonomic parameters for the assessment of pain. It is also recommended that future research endeavors in capturing the singularity of the pain experience involve the measurement of both peripheral (end organs) and central (brain) autonomic responses to pain.
Assuntos
Sistema Nervoso Autônomo , Dor , Encéfalo , Frequência Cardíaca/fisiologia , Humanos , Dor/etiologia , Medição da DorRESUMO
Mujer de 55 años que acudió por cefalea súbita intensa, ptosis palpebral izquierda asociada a disminución de la agudeza visual a predominio del ojo izquierdo; además, los exámenes de laboratorio evidenciaron hiponatremia más hipopituitarismo. La resonancia magnética cerebral mostró un adenoma pituitario con gran componente necrótico que posteriormente fue confirmado en el estudio anatomo patológico. Se concluyó en una apoplejía hipofisaria como forma de presentación de un adenoma hipofisario sin diagnóstico previo, con buena evolución de los síntomas visuales después de la cirugía.
RESUMO
PURPOSE: Glaucoma is the leading cause of irreversible blindness worldwide. It is estimated that over 60 million people around the world have this disease, with only part of them knowing they have it. Timely and early diagnosis is vital to delay/prevent patient blindness. Deep learning (DL) could be a tool for ophthalmologists to give a more informed and objective diagnosis. However, there is a lack of studies that apply DL for glaucoma detection to Latino population. Our contribution is to use transfer learning to retrain MobileNet and Inception V3 models with images of the retinal nerve fiber layer thickness map of Mexican patients, obtained with optical coherence tomography (OCT) from the Instituto de la Visión, a clinic in the northern part of Mexico. METHODS: The IBM Foundational Methodology for Data Science was used in this study. The MobileNet and Inception V3 topologies were chosen as the analytical approaches to classify OCT images in two classes, namely glaucomatous and non-glaucomatous. The OCT files were collected from a Zeiss OCT machine at the Instituto de la Visión, and classified by an expert into the two classes under study. These images conform a dataset of 333 files in total. Since this research work is focused on RNFL thickness map images, the OCT files were cropped to obtain only the RNFL thickness map images of the corresponding eye. This action was carried out for images in both classes, glaucomatous and non-glaucomatous. Since some images were damaged (with black spots in which data was missing), these images were cut-out and cut-off. After the preparation process, 50 images per class were used for training. Fifteen images per class, different than the ones used in the training stage, were used for running predictions. In total, 260 images were used in the experiments, 130 per eye. Four models were generated, two trained with MobileNet, one for the left eye and one for the right eye, and another two trained with Inception V3. TensorFlow was used for running transfer learning. RESULTS: The evaluation results of the MobileNet model for the left eye are, accuracy: 86%, precision: 87%, recall: 87%, and F1 score: 87%. The evaluation results of the MobileNet model for the right eye are, accuracy: 90%, precision: 90%, recall: 90%, and F1 score: 90%. The evaluation results of the Inception V3 model for the left eye are, accuracy: 90%, precision: 90%, recall: 90%, and F1 score: 90%. The evaluation results of the Inception V3 model for the right eye are, accuracy: 90%, precision: 90%, recall: 90%, and F1 score: 90%. CONCLUSION: In average, the evaluation results for right eye images were the same for both models. The Inception V3 model showed slight better average results than the MobileNet model in the case of classifying left eye images.
Assuntos
Glaucoma , Tomografia de Coerência Óptica , Glaucoma/diagnóstico , Hispânico ou Latino , Humanos , Pressão Intraocular , Aprendizado de Máquina , Fibras Nervosas , Células Ganglionares da Retina , Campos VisuaisRESUMO
This study aimed at examining the approval rate of the medical students' regarding active euthanasia, passive euthanasia, and physician-assisted-suicide over the last ten years. To do so, the arguments and variables affecting students' choices were examined and a systematic review was conducted, using PubMed and Web of Science databases, including articles from January 2009 to December 2018. From 135 identified articles, 13 met the inclusion criteria. The highest acceptance rates for euthanasia and physician-assisted suicide were from European countries. The most common arguments supporting euthanasia and physician-assisted suicide were the followings: (i) patient's autonomy (n = 6), (ii) relief of suffering (n = 4), and (ii) the thought that terminally-ill patients are additional burden (n = 2). The most common arguments against euthanasia were as follows: (i) religious and personal beliefs (n = 4), (ii) the "slippery slope" argument and the risk of abuse (n = 4), and (iii) the physician's role in preserving life (n = 2). Religion (n = 7), religiosity (n = 5), and the attributes of the medical school of origin (n = 3) were the most significant variables to influence the students' attitude. However, age, previous academic experience, family income, and place of residence had no significant impact. Medical students' opinions on euthanasia and physician-assisted suicide should be appropriately addressed and evaluated because their moral compass, under the influence of such opinions, will guide them in solving future ethical and therapeutic dilemmas in the medical field.
RESUMO
AIM: To assess patient and disease characteristics, treatment patterns and associated costs in patients with locally advanced or metastatic gastric cancer in Argentina, in the public and private sectors. METHODS: A historic cohort of patients who had received first-line chemotherapy treatment (platinum analog and/or a fluoropyrimidine) and were followed-up for at least three months after the last administration of a first-line cytotoxic agent were eligible. Case-report forms were prepared based on medical records from four Argentinian hospitals. Estimates of treatment costs were also calculated using the unit costs of the participating hospitals. RESULTS: Of 101 patients, more than three quarters (79.2%) were male, 41.6% were diagnosed with metastatic stage IV disease (mean age, 57.7years), and 27.7 % had a smoking history. Before locally advanced or metastatic gastric cancer diagnosis, 42.4% of the patients had received total gastrectomy. Ninety-seven percent of the patients received a doublet or triplet therapy, of which epirubicin in combination with oxaliplatin and capecitabine was the most common treatment (38%), followed by capecitabine plus oxaliplatin (29%). Around 36% of the patients responded to first-line treatment (complete and partial response). Out of the 76.2% of the patients who followed a second-line treatment, 37.7% were still administered a platinum analog and/or fluoropyrimidine. During the reported follow-up period, 50% of the patients progressed, and 32.8% had stable disease. The best supportive care consisted mostly of outpatient visits after last-line therapy (16.8%), palliative radiotherapy (16.8%), and surgery (30.7%). We observed significant differences between public and private hospital costs. CONCLUSIONS: Understanding treatment patterns in patients with locally advanced or metastatic gastric cancer may help address unmet medical needs for better patient management and improvement of their clinical outcome in Argentina.
OBJETIVO: Describir las características clínicas, los patrones de tratamiento y los costos asociados en pacientes con cáncer gástrico localmente avanzado o metastásico en Argentina, en los sectores público y privado. MÉTODOS: Una cohorte histórica de pacientes que recibieron tratamiento de quimioterapia de primera línea (análogo de platino y/o una fluoropirimidina) y fueron seguidos durante al menos tres meses después de la última administración de un agente citotóxico de primera línea fueron elegibles. Se extrajeron los datos a través de un cuestionario estructurado a partir de los registros médicos de cuatro hospitales argentinos. Las estimaciones de los costos de tratamiento también se calcularon utilizando los costos unitarios de los hospitales participantes. RESULTADOS: Entre los 101 pacientes, más de tres cuartas partes (79,2%) eran hombres, 41,6% fueron diagnosticados con enfermedad metastásica en estadio IV, la edad media fue de 57,7 años y el 27,7% tenían antecedentes de tabaquismo. Antes del diagnóstico de cáncer gástrico metastásico, el 42,4% de los pacientes habían recibido gastrectomía total. El 97% de los pacientes recibió una terapia doble o triplete, de los cuales el tratamiento más frecuente fue la epirubicina en combinación con oxaliplatino y capecitabina (38%), seguida de capecitabina + oxaliplatino (29%). Alrededor del 36% de los pacientes respondieron al tratamiento de primera línea (respuesta completa y parcial). Del 76,2% de los pacientes que siguieron un tratamiento de segunda línea, al 37,7% todavía se les administró un análogo de platino y/o fluoropirimidina. Durante el período de seguimiento, el 50% de los pacientes progresó y el 32,8% tenía enfermedad estable. La terapia de apoyo consistió principalmente en visitas ambulatorias después de la última línea de quimioterapia (16,8%), radioterapia paliativa (16,8%) y cirugía (30,7%). Se observaron diferencias significativas entre los costos de los hospitales públicos y privado. CONCLUSIONES: Comprender los patrones de tratamiento en pacientes con cáncer gástrico localmente avanzado o metastásico puede ayudar a abordar las necesidades médicas no satisfechas para un mejor manejo del paciente y la mejora de sus resultados clínicos en Argentina.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Gastrectomia/métodos , Neoplasias Gástricas/epidemiologia , Adulto , Idoso , Argentina , Estudos de Coortes , Feminino , Seguimentos , Custos Hospitalares/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapiaRESUMO
Abstract Introduction TBI is associated with alterations in cortico-subcortical connectivity. However, little attention has been paid to its clinical characteristics and functional connectivity in pediatric patients with chronic TBI. Objective To evaluate the cognitive performance and spectral coherence of a group of children with TBI in non-acute phase. Method Cross-sectional study of 15 children with chronic TBI and 17 healthy children. The Neuropsychological Assessment of Children (Evaluación Neuropsicológica Infantil, ENI) was used and the resting activity of the EEG with eyes-closed was recorded. Offline, two-second epochs of the EEG of each participant were chosen and the spectral coherence was estimated in a range of 1.6 to 30 Hz. The cognitive performance between groups was compared with T-test/Mann-Whitney U Test and MANOVA for the coherence values. Results The TBI group showed a lower performance (p ≤ 0.05) in metalinguistic, visuospatial skills, attention, memory, non-verbal flexibility, planning, and organization. Differences (p ≤ 0.000) were found both inter and intrahemispherically in the spectral coherence between the groups, particularly on F1-F3 (95% CI: 0.543 - 0.557) over the whole frequency range and F3-C3 (95% CI: 0.503 - 0.515) in delta, theta, alpha2, and beta frequencies. Discussion and conclusión Our findings suggest alterations of hypo and hyper functional connectivity, particularly on the frontal and parietal lobes of both hemispheres, even after several years of a TBI. It is possible that a subtle difference in the degree of connectivity is crucial in the genesis or successful development of attentional, mnesic, executive, and visuospatial processes.
Resumen Introducción El TCE se asocia con alteraciones en la conectividad cortico-subcortical. Sin embargo, se ha prestado poca atención a las características clínicas y de conectividad funcional en pacientes pediátricos con TCE crónico. Objetivo Evaluar el desempeño cognitivo y la coherencia espectral de un grupo de niños con TCE en fase no aguda. Método Estudio transversal de 15 niños con TCE y 17 niños controles. Se empleó la Evaluación Neuropsicológica Infantil (ENI) y se registró la actividad en reposo del EEG con ojos cerrados. Fuera de línea, se eligieron épocas de 2 s del trazo de cada participante y se estimó la coherencia espectral en un rango de 1.6 a 30 Hz. Se comparó el rendimiento cognitivo entre los grupos con la prueba T/U-Mann de Whitney y MANOVA para los valores de coherencia. Resultados El grupo con TCE mostró un menor rendimiento (p ≤ 0.05) en habilidades metalingüísticas, visuoespaciales, atención, memoria, flexibilidad no verbal, planeación y organización. Se encontraron diferencias (p ≤ 0.000) en la coherencia espectral tanto inter como intrahemisférica entre los grupos. Particularmente, en F1-F3 (95%IC: 0.543 - 0.557) en todo el rango de frecuencias y F3-C3 (95%IC: 0.503 - 0.515) en delta, theta, alfa2 y beta. Discusión y conclusión Los resultados sugieren que distintas redes en estado de reposo muestran alteraciones de hipo e hiperconectividad funcional aun después de varios años de un TCE. Es probable que una sutil diferencia en el grado de conectividad sea determinante en la génesis o desarrollo exitoso de procesos atencionales, mnésicos, ejecutivos y visoespaciales.
RESUMO
The emergence of modern technologies, such as Wireless Sensor Networks (WSNs), the Internet-of-Things (IoT), and Machine-to-Machine (M2M) communications, involves the use of batteries, which pose a serious environmental risk, with billions of batteries disposed of every year. However, the combination of sensors and wireless communication devices is extremely power-hungry. Energy Harvesting (EH) is fundamental in enabling the use of low-power electronic devices that derive their energy from external sources, such as Microbial Fuel Cells (MFC), solar power, thermal and kinetic energy, among others. Plant Microbial Fuel Cell (PMFC) is a prominent clean energy source and a step towards the development of self-powered systems in indoor and outdoor environments. One of the main challenges with PMFCs is the dynamic power supply, dynamic charging rates and low-energy supply. In this paper, a PMFC-based energy harvester system is proposed for the implementation of autonomous self-powered sensor nodes with IoT and cloud-based service communication protocols. The PMFC design is specifically adapted with the proposed EH circuit for the implementation of IoT-WSN based applications. The PMFC-EH system has a maximum power point at 0.71 V, a current density of 5 mA cm - 2 , and a power density of 3.5 mW cm - 2 with a single plant. Considering a sensor node with a current consumption of 0.35 mA, the PMFC-EH green energy system allows a power autonomy for real-time data processing of IoT-based low-power WSN systems.
RESUMO
Objetivo: Determinar factores sociodemográficos y clínicos asociados a la presencia de irritabilidad en adultos con episodio depresivo (ED) en Lima Metropolitana. Materiales y Métodos: Estudio observacional, correlacional, transversal, utilizando la base de datos de adultos desde los 18 años del Estudio Epidemiológico de Salud Mental de Lima Metropolitana y Callao del año 2012, en una muestra probabilística multietápica de 4445 adultos. Los instrumentos usados fueron una ficha de datos sociodemográficos, MINI (Entrevista Neuropsiquiátrica Internacional), Cuestionario de Salud Mental de Colombia (modificado), Índice de Calidad de Sueño de Pittsburgh, EMBU modificado y Cuestionario de Experiencias Tempranas Adversas. Se utilizó estadística descriptiva, regresión simple y multivariada para estimar la prevalencia de adultos con irritabilidad en episodio depresivo (IED) y determinar la asociación entre IED y variables independientes. Resultados: La prevalencia de IED fue de 34,9%. Se halló asociación estadísticamente significativa con: menor edad de inicio del ED, mayor severidad del ED, presencia de trastorno de ansiedad generalizada, abuso/dependencia de alcohol, algunos síntomas depresivos (autorreproches, problemas de concentración e indicadores suicidas), conductas violentas, menor calidad de sueño, estilos de crianza de sobreprotección y favoritismo, y presencia de eventos adversos antes de los 18 años. Conclusiones: Varias características y factores diferencian la depresión con irritabilidad de la que carece de este síntoma. La posibilidad de que la irritabilidad llegue a ser considerada como un especificador del episodio depresivo, contribuiría a desarrollar estrategias para su más precisa identificación y manejo clínico.
Objective: To determine factors associated to the presence of irritability in adults with depressive episode (DE) in Metropolitan Lima in 2012. Materials and methods: Database of the Epidemiological Study of Metropolitan Lima and Callao, carried out in 2012, was used to make an observational, correlational, cross-sectional study. A multistage probabilistic sample of 4445 adults of 18 years and older. The instruments were: MINI (International Neuropsychiatric Interview), Mental Health Questionnaire of Colombia (modified), modified brief EMBU, a questionnaire of adverse early experiences, Pittsburgh Sleep Quality Index and a sociodemographic data sheet. Descriptive statistics, simple and multivariate regression were used to estimate prevalence of adults with irritability in depressive episode (IDE) and to determine the association between IDE and independent variables. Results: The prevalence of IDE was 34.9%. A statistically significant association was found with: early age of onset of DE, greater severity of DE, presence of generalized anxiety disorder (GAD), abuse/dependence on alcohol, some depressive symptoms (such as self-reproach, concentration problems and suicidal indicators), violent behaviors, a lower quality of sleep, parenting styles of overprotection and favoritism, and the presence of adverse events before the age of 18. Conclusions: The possibility that irritability may be considered as a specifier of the depressive episode, would contribute to the development of strategies for its identification and clinical management.
RESUMO
BACKGROUND: The idea to accelerate the process of death in a terminally ill patient is an issue that has polarized societies since ancient times. The purpose of this study is to describe and analyze the opinion of medical students from Nuevo Leon, Mexico, about passive euthanasia, active euthanasia, and their personal posture on the topic. MATERIAL AND METHODS: Using a three-part questionnaire, 1,319 medical students of the first three years of medical school, from three of the four medical schools in the state, were interviewed. The questionnaire included questions on demographics, religion, and the personal posture of the student on active euthanasia, passive euthanasia, and their personal posture on the topic. RESULTS: Of those interviewed, 44.4% were in favor of active euthanasia, 52.1% of passive euthanasia, and 44.8% had a positive personal posture on the topic. Age and grade were not significant variables for the posture of the students, but the variable gender showed a predominantly positive posture in the male subgroup for active (p=0.001) and passive euthanasia (p=0.031). Religion and the importance of religion/spirituality in daily life were the most significant factors (p<0.005) for the interviewees to hold a negative posture in each of the three scenarios. The legal nature of the scenario (p=0.000) and respect for patient's autonomy (p=0.000) were the most important arguments that could change an original negative posture into a positive one.
RESUMO
La fisioterapia en pacientes con lesión neurológica degenerativa puede mejorar la capacidad funcional permitiéndole una participación social activa y una mejor calidad de vida mientras la evolución de la enfermedad lo permita. Se describe los efectos de la fisioterapia en un paciente con lesión medular secundaria a Neurofibromatosis tipo II. La intervención se basó en terapias cardiorrespiratoria, funcional y deportiva. Se obtuvo en el paciente mayor funcionalidad para caminar, mejor autoestima y capacidad física para trabajar. (AU)
Physiotherapy in patients with degenerative neurologic conditions may improve functional capacity allowing a better quality of life and active social participation, as long as the progression of disease allows it. We report the effects of physiotherapy in a patient with medullar involvement due to type II neurofibromatosis. Interventions were based on cardiorespiratory, functional and sport interventions. The intervention attained better functionality to walk, better self-confidence and physical capacity to work. (AU)
Assuntos
Humanos , Masculino , Adulto , Traumatismos da Medula Espinal , Neurofibromatoses , Especialidade de FisioterapiaRESUMO
BACKGROUND: Oscillations, action, and postsynaptic potentials in glial-neuronal ensembles integrate the spectral power (SP) of electroencephalographic (EEG). Our objective is to propose SP indicators of healthy brains (control groups) based on the default mode and their modifications by habituation and visual-motor association (VM-asso), to support diagnostic and rehabilitation processes. However, important differences seem to exist between men and women. Therefore, we aim to analyze EEG characteristics in a female sample. SUBJECTS AND METHODS: In the current study, EEG was recorded at rest with closed eyes before and during repeated photostimulations (RPh) and before (pre) and during association of RPh with switch pressing (VM-asso) in 70 female adults. EEG was analyzed using UAM/INR software, which removes artifacts, identifies corresponding signals, selects 20 samples (2-s) from each condition, applies Welch's periodogram to calculate and average the absolute power (AP; AAPs) of áµ¹, θ, α, and ß, before and during learning, and emits data to a spreadsheet. Differences in each condition were evaluated using non-parametric tests. RESULTS: The AAPs were different; in habituation, áµ¹ and θ increased significantly in fronto-frontal (FF) and frontocentral and decreased in the other leads. During association, they increased in FF and decreased in the other three regions. α AAP decreased in all leads except in FF during habituation, and the decrement was lower in the association. ß AAP increased in all leads during both learning conditions. CONCLUSION: The SP and the topographic distribution are descriptive parameters of habituation and VM-asso; we propose them as EEG indicators.
Assuntos
Encéfalo/fisiologia , Eletroencefalografia , Estimulação Luminosa , Potenciais Sinápticos/fisiologia , Feminino , Humanos , Estudantes , Universidades , Adulto JovemRESUMO
PURPOSE: To assess the optimal interval of preoperative intravitreal bevacizumab (IVB) administration in diabetic subjects undergoing pars plana vitrectomy (PPV) for severe manifestations of active proliferative diabetic retinopathy (PDR). DESIGN: Randomized clinical trial. METHODS: One hundred and fifty-six patients with PDR-related complications requiring PPV were prospectively randomized into 1 of 2 treatment groups: Group A received IVB (2.5 mg/0.1 mL) 1-3 days before PPV, while Group B received IVB (2.5 mg/0.1 mL) 5-10 days before PPV. The primary outcome was best-corrected visual acuity (BCVA) at 6 months follow-up. Secondary outcome measures were intraoperative surgery time, intraoperative complications, postoperative complications, and incidence of unplanned PPV at 6 months follow-up. RESULTS: One hundred and twenty-five subjects underwent PPV and completed the 6-month follow-up interval. Group B patients had better final BCVA (P = .033) and were less likely to have a postoperative complication (P = .018) when compared to Group A patients. The mean difference in final BCVA between groups was 0.22 logMAR (95% confidence interval: 0.02-0.43, P = .017). Group A was 3.90 (95% confidence interval: 1.08-17.31, P = .046) times more likely to have a loss of 1 or more logMAR lines of final BCVA when compared to Group B. There were no significant differences among the treatment groups with regard to baseline features, intraoperative surgery time, intraoperative complications, and incidence of unplanned PPV during the study interval. CONCLUSIONS: This randomized clinical trial demonstrated better postoperative outcomes at 6 months when subjects received preoperative IVB 5-10 days before PPV compared to 1-3 days for the treatment of PDR-related complications.
Assuntos
Bevacizumab/administração & dosagem , Retinopatia Diabética/tratamento farmacológico , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Vitrectomia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/administração & dosagem , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retina/patologia , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia de Coerência Óptica , Resultado do Tratamento , Adulto JovemRESUMO
The heterotopic pancreas (HP) is a rare condition in the pediatric population. HP cases involving an ileal intussusception are rare in children and very rarely reported, usually presenting with symptoms of intestinal obstruction. We report the case of a one year old male patient with a chronic history of anorexia, irritability, abdominal pain, accompanied by intermittent episodes of "currant jelly" stools that evolved to rectal bleeding. The patient presented a concomitant diagnosis of allergic colitis, which prolonged the effective surgical treatment at an external health center. In the abdominal CT scan, the classic "target" sign was found. In the exploratory laparotomy an ileoileal intussusception was confirmed, a mass was found that the histopathology laboratory confirmed as HP. To our knowledge, it is the first case of pediatric intussusception by HP reported in Peru.
Assuntos
Coristoma/complicações , Intussuscepção/etiologia , Pâncreas , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/etiologia , Lactente , Intussuscepção/diagnóstico , Masculino , PeruRESUMO
El páncreas heterotópico (PH) es una condición rara en la población pediátrica. Los casos de PH que conllevan a una invaginación ileal, son infrecuentes en niños y muy raramente reportados, usualmente mostrándose con síntomas de obstrucción intestinal. Se presenta el caso de un paciente varón de un año de edad, con una historia crónica de anorexia, irritabilidad, dolor abdominal, acompañado de episodios intermitentes de sangrado tipo ôjalea de grosellaõ que evoluciona a sangrado rectal rutilante. El paciente presenta un diagnóstico concomitante de colitis alérgica, lo cual prolonga el tratamiento quirúrgico efectivo en un centro asistencial externo. En la tomografía abdominal se encuentra el signo de la ôescarapelaõ clásico. En la laparotomía exploratoria se confirma invaginación ileoileal, se encuentra una masa que el laboratorio de histopatología confirma como PH. A nuestro conocimiento, es el primer caso de invaginación por PH pediátrico reportado en el Perú...
The heterotopic pancreas (HP) is a rare condition in the pediatric population. HP cases involving an ileal intussusception are rare in children and very rarely reported, usually presenting with symptoms of intestinal obstruction. We report the case of a one year old male patient with a chronic history of anorexia, irritability, abdominal pain, accompanied by intermittent episodes of ôcurrant jellyõ stools that evolved to rectal bleeding. The patient presented a concomitant diagnosis of allergic colitis, which prolonged the effective surgical treatment at an external health center. In the abdominal CT scan, the classic ôtargetõ sign was found. In the exploratory laparotomy an ileoileal intussusception was confirmed, a mass was found that the histopathology laboratory confirmed as HP. To our knowledge, it is the first case of pediatric intussusception by HP reported in Peru...
Assuntos
Humanos , Masculino , Lactente , Intussuscepção , Obstrução Intestinal , PâncreasRESUMO
OBJECTIVE: To present two cases of food allergy of uncommon presentation and discuss the diagnostic approach to give in these cases: Case N° 1: 11-year-old girl, afflicting pain in the right iliac fossa 3 months ago. BACKGROUND: Prematurity, atopy (dermatitis, rhinitis, cramping). Sister and mother are atopic too. The physical exam show exquisite pain on right iliac fossa at palpation. Laboratory: Urine normal, parasitological serial negative. EDN (neurotoxin derived from eosinophils) fecal >3210 ng/ml (V. N. < 360 ng/ml). Colonoscopy: lymphoid hyperplasia of ileum. Case N° 2: Child of 9 years of age. Right fossa iliac painful three months ago, predominantly nocturnal and with irradiation to right thigh. A child psychiatrist may prescribe antidepressants. Personal History: Breastfeeding and formula since newborn. Atopy: asthma, atopic dermatitis, infant colic. Family history: Mother allergic to food, father presents rhinitis. The physical examination: Pain on palpation in the right iliac fossa. Laboratory: Immunoglobulin E 160.5 IU/ml (V. N. < 90) Colonoscopy: lymphoid hyperplasia in the distal ileum. Both cases relieved by hypoallergenic diet. CONCLUSION: When both, ileal nodular lymphoid hyperplasia and atopy personal or familiar are present, we must be think in food allergy therapeutic.