RESUMO

OBJECTIVE: The aim of this retrospective study was to determine the prevalence and patterns of impacted third molars in a Trinidadian population. METHODS: A total of 1500 orthopantomograms (OPG) taken at the School of Dentistry, University of the West Indies, from 2008 to 2019 in patients between 15 and 67 years old were evaluated. From the data collected, the prevalence of third molar impaction, the parameters of gender, angulation, level of impaction, and associated pathologies were evaluated. Other types of impacted teeth were also recorded. RESULTS: Of the 1500 OPG viewed, 408 (27.2%) of the study sample presented with at least one impacted third molar. 161 (39.5%) were males and 247 (60.5%) were females, with a male-to-female ratio of 1:1.5. There was a greater incidence of mandibular third molars versus maxillary third molars, which had a frequency of 77.9% and 22.1%, respectively. The most common type of impaction (Winter's classification) was horizontal in the mandible and distoangular in the maxilla. The most common level of impaction in the mandible (Pell and Gregory classification) was level 1A. The total number of impacted teeth was 775, and of these, 75 (9.7%) showed other impacted teeth besides the third molars. Canines and second premolars were the most prevalent with 7.6% and 1.5%, respectively. Caries on the second molar (49.3%) and third molars (40%) were the most frequently associated pathologies identified. CONCLUSION: The prevalence of impacted wisdom teeth in this study was 27%. These results raise awareness and provide insight among dental professionals in Trinidad as to the prevalence of impacted third molars, their patterns, as well as commonly associated pathologies, and the need for screening within the population.

Assuntos

Dente Serotino , Radiografia Panorâmica , Dente Impactado , Humanos , Feminino , Masculino , Trinidad e Tobago/epidemiologia , Prevalência , Dente Impactado/epidemiologia , Dente Impactado/diagnóstico por imagem , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Adolescente , Dente Serotino/diagnóstico por imagem , Idoso , Adulto Jovem , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem

RESUMO

BACKGROUND: The relationship between marijuana use and cardiovascular health remains uncertain, with several observational studies suggesting a potential association with increased adverse atherosclerotic cardiovascular disease (ASCVD) outcomes. This study examined the relationship between marijuana use, ASCVD risk factors, and cardiometabolic risk profiles. METHODS: US adults (18-59 years) without cardiovascular disease were identified from the National Health And Nutrition Examination Survey (2005-2018) based on self-reported marijuana use. Current users (used within the past month) and never users were compared with assess the burden and control of traditional ASCVD risk factors and biomarkers, using inverse probability of treatment weighting to adjust for sociodemographic and lifestyle factors, including tobacco use. RESULTS: Of the 13 965 participants identified (mean age, 37.5; 51.2% female; 13% non-Hispanic Black), 26.6% were current users. Current users were predominantly male, low-income, and more likely to be concurrent tobacco users. Inverse probability of treatment weighting analysis showed no significant differences in the burden and control of hypertension (19.3% versus 18.8%, P=0.76; 79.8% versus 77.8%, P=0.75), dyslipidemia (24.0% versus 19.9%, P=0.13; 82% versus 75%, P=0.95), diabetes (4.8% versus 6.4%, P=0.19; 52.9% versus 50.6%, P=0.84), obesity (35.8% versus 41.3%, P=0.13), and physical activity levels (71.9% versus 69.3%, P=0.37) between current and never users. Likewise, mean 10-year ASCVD risk scores (2.8% versus 3.0%, P=0.49), 30-year Framingham risk scores (22.7% versus 24.2%, P=0.25), and cardiometabolic profiles including high-sensitivity C-reactive protein (3.5 mg/L versus 3.7 mg/L, P=0.65), neutrophil-lymphocyte ratio (2.1 versus 2.1, P=0.89), low-density lipoprotein (114.3 mg/dL versus 112.2 mg/dL, P=0.53), total cholesterol (191.2 mg/dL versus 181.7 mg/dL, P=0.58), and hemoglobin A1C (5.4% versus 5.5%, P=0.25) were similar between current and never users. CONCLUSIONS: This cross-sectional study found no association between self-reported marijuana use and increased burden of traditional ASCVD risk factors, estimated long-term ASCVD risk, or cardiometabolic profiles. Further studies are needed to explore potential pathways between adverse cardiovascular disease outcomes and marijuana use.

Assuntos

Aterosclerose , Cannabis , Doenças Cardiovasculares , Adulto , Humanos , Masculino , Feminino , Fatores de Risco , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Inquéritos Nutricionais , Estudos Transversais , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Fatores de Risco de Doenças Cardíacas

RESUMO

OBJECTIVE: To study the association between discontinuing predischarge car seat tolerance screening (CSTS) with 30-day postdischarge adverse outcomes in infants born preterm. STUDY DESIGN: Retrospective cohort study involving all infants born preterm from 2010 through 2021 who survived to discharge to home in a 14-hospital integrated health care system. The exposure was discontinuation of CSTS. The primary outcome was a composite rate of death, 911 call-triggered transports, or readmissions associated with diagnostic codes of respiratory disorders, apnea, apparent life-threatening event, or brief resolved unexplained events within 30 days of discharge. Outcomes of infants born in the periods of CSTS and after discontinuation were compared. RESULTS: Twelve of 14 hospitals initially utilized CSTS and contributed patients to the CSTS period; 71.4% of neonatal intensive care unit (NICU) patients and 26.9% of non-NICU infants were screened. All hospitals participated in the discontinuation period; 0.1% was screened. Rates of the unadjusted primary outcome were 1.02% in infants in the CSTS period (n = 21 122) and 1.06% after discontinuation (n = 20 142) (P = .76). The aOR (95% CI) was 0.95 (0.75, 1.19). Statistically insignificant differences between periods were observed in components of the primary outcome, gestational age strata, NICU admission status groups, and other secondary analyses. CONCLUSIONS: Discontinuation of CSTS in a large integrated health care network was not associated with a change in 30-day postdischarge adverse outcomes. CSTS's value as a standard predischarge assessment deserves further evaluation.

Assuntos

Sistemas de Proteção para Crianças , Recém-Nascido Prematuro , Recém-Nascido , Humanos , Lactente , Sistemas de Proteção para Crianças/efeitos adversos , Alta do Paciente , Estudos Retrospectivos , Assistência ao Convalescente , Unidades de Terapia Intensiva Neonatal

RESUMO

INTRODUCTION: Despite UN recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for The Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the remote island nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation and its food system. This article aims to examine the validity of the FIES for use in The Bahamas, the prevalence of moderate and severe food insecurity, and the sociodemographic factors that contribute to increased food insecurity. METHODS: The FIES survey was administered by randomized and weighted landline telephone survey in Nassau in The Bahamas to 1000 participants in June and July 2017. The Rasch modelling procedure was applied to examine tool validity and prevalence of food insecurity. Equating procedures calibrated this study's results to the global FIES reference scale and computed internationally comparable prevalence rates of both moderate and severe food insecurity. A regression analysis assessed the relationship between household variables and food security. RESULTS: The FIES met benchmarks for fit statistics for all eight items and the overall Rasch reliability is 0.7. As of 2017, Bahamians' prevalence of moderate and severe food insecurity was 21%, and the prevalence of severe food insecurity was 10%. Statistically significant variables that contribute to food insecurity included education, age, gender, and presence of diabetes, high blood pressure, or heart disease. Results also indicated that Bahamians experience food insecurity differently than populations across the globe, likely due in large part to the workings of an isolated food system heavily dependent on foreign imports. Responses showed that by the time a Bahamian worries they will not have enough food to eat, they have already restricted their meals to a few kinds of foods and begun to limit their intake of vegetables and fruits. CONCLUSION: This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in small island developing states. Further, this study provides a benchmark for future research, which may seek to understand the impacts of Hurricane Dorian and COVID-19, disasters further isolating the remote island nation. Post-disaster food security data are needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following catastrophic events.

Assuntos

Insegurança Alimentar , Abastecimento de Alimentos/estatística & dados numéricos , Fome , Inquéritos e Questionários/normas , Bahamas , Humanos , Prevalência , Reprodutibilidade dos Testes , Fatores Socioeconômicos

RESUMO

Multiple sclerosis (MS) management presently aims to reach a state of no (or minimal) evidence of disease activity. The development and commercialization of new drugs has led to a renewed interest in family planning, since patients with MS may face a future with reduced (or no) disease-related neurological disability. The advice of neurologists is often sought by patients who want to have children and need to know more about disease control at conception and during pregnancy and the puerperium. When MS is well controlled, the simple withdrawal of drugs for patients who intend to conceive is not an option. On the other hand, not all treatments presently recommended for MS are considered safe during conception, pregnancy and/or breastfeeding. The objective of the present study was to summarize the practical and evidence-based recommendations for family planning when our patients (women and men) have MS.Funding TEVA Pharmaceutical Brazil.

RESUMO

BACKGROUND: Both internal and external distraction devices have been used successfully in correcting midface hypoplasia. Although the indication for surgery and the osteotomy techniques may be similar, deciding when to use internal versus external devices has not been studied. The authors studied patient-reported outcomes with FACE-Q and functional surveys for internal and external devices for midface distraction patients. METHODS: Patients who underwent distraction advancement after Le Fort I and Le Fort III were surveyed using the FACE-Q survey and a functional survey. Equal groups of internal and external device patients were compared (n = 64). Data recorded included: sex, age, follow-up, diagnosis, operating room time, expected blood loss, length of stay, distraction length, consolidation time, and complications. RESULTS: Internal and external device groups were similar with regards to patient diagnosis, operative time, expected blood loss, distraction length but consolidation times differed (internal = 3.6 versus external = 1.1 months). For FACE-Q appearance appraisal, there were similarities in domain and scale. For the functional survey (airway/breathing, ocular/vision, occlusion/eating, speech/articulation), there was also similar scoring. However, internal device patients had superior FACE-Q scores for Quality of Life: Social Function (80.9 versus 68.9), Early Life Impact (92.9 versus 62.4), Dental Anxiety (70.2 versus 48.3), Psychological Well-being (87.8 versus 68.6); and Decision Satisfaction (81.2 versus 56.9) and Outcome Satisfaction (91.0 versus 84.7). CONCLUSIONS: Internal and external midface distraction patients had similar patient-reported outcomes for appearance and functional improvement; however, internal device patients were more satisfied with their quality of life and their decision to undergo the procedure.

Assuntos

Disostose Craniofacial , Ossos Faciais/cirurgia , Osteogênese por Distração , Osteotomia de Le Fort , Qualidade de Vida , Dispositivos de Fixação Cirúrgica , Adolescente , Pesquisa Comparativa da Efetividade , Disostose Craniofacial/psicologia , Disostose Craniofacial/cirurgia , Feminino , Humanos , Masculino , Osteogênese por Distração/instrumentação , Osteogênese por Distração/métodos , Osteogênese por Distração/psicologia , Osteotomia de Le Fort/instrumentação , Osteotomia de Le Fort/métodos , Osteotomia de Le Fort/psicologia , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Período Pós-Operatório

RESUMO

Peace processes are complex, protracted, and contentious involving significant bargaining and compromising among various societal and political stakeholders. In civil war terminations, it is pertinent to measure the pulse of the nation to ensure that the peace process is responsive to citizens' concerns. Social media yields tremendous power as a tool for dialogue, debate, organization, and mobilization, thereby adding more complexity to the peace process. Using Colombia's final peace agreement and national referendum as a case study, we investigate the influence of two important indicators: intergroup polarization and public sentiment toward the peace process. We present a detailed linguistic analysis to detect intergroup polarization and a predictive model that leverages Tweet structure, content, and user-based features to predict public sentiment toward the Colombian peace process. We demonstrate that had proaccord stakeholders leveraged public opinion from social media, the outcome of the Colombian referendum could have been different.

Assuntos

Condições Sociais , Mídias Sociais , Colômbia , Humanos , Negociação , Política , Opinião Pública , Guerra

RESUMO

OBJECTIVE: Sleep apnea (SA) has been linked with various forms of cardiovascular disease, but little is known about its association with peripheral artery disease (PAD) measured using the ankle-brachial index. This relationship was evaluated in the Hispanic Community Health Study/Study of Latinos. APPROACH AND RESULTS: We studied 8367 Hispanic Community Health Study/Study of Latinos participants who were 45 to 74 years of age. Sleep symptoms were examined with the self-reported Sleep Health Questionnaire. SA was assessed using an in-home sleep study. Systolic blood pressure was measured in all extremities to compute the ankle-brachial index. PAD was defined as ankle-brachial index <0.90 in either leg. Multivariable logistic regression was used to investigate the association between moderate-to-severe SA, defined as apnea-hypopnea index ≥15, and the presence of PAD. Analyses were adjusted for covariates. The prevalence of PAD was 4.7% (n=390). The mean apnea-hypopnea index was significantly higher among adults with PAD compared with those without (11.1 versus 8.6 events/h; P=0.046). After adjusting for covariates, moderate-to-severe SA was associated with a 70% increase in the odds of PAD (odds ratio, 1.7; 95% confidence interval, 1.1-2.5; P=0.0152). This association was not modified by sex (P=0.8739). However, there was evidence that the association between moderate-to-severe SA and PAD varied by Hispanic/Latino background (P<0.01). Specifically, the odds were stronger in Mexican (adjusted odds ratio, 2.9; 95% confidence interval, 1.3-6.2) and in Puerto Rican Americans (adjusted odds ratio, 2.0; 95% confidence interval, 0.97-4.2) than in other backgrounds. CONCLUSIONS: Moderate-to-severe SA is associated with higher odds of PAD in Hispanic/Latino adults.

Assuntos

Hispânico ou Latino , Doença Arterial Periférica/etnologia , Síndromes da Apneia do Sono/etnologia , Idoso , Índice Tornozelo-Braço , Distribuição de Qui-Quadrado , Comorbidade , Feminino , Humanos , Modelos Logísticos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Doença Arterial Periférica/diagnóstico , Porto Rico/etnologia , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Síndromes da Apneia do Sono/diagnóstico , Inquéritos e Questionários , Estados Unidos/epidemiologia

RESUMO

BACKGROUND: Co-morbid allergic rhinitis (AR) and asthma has not been studied in Caribbean countries where there is a high prevalence of childhood asthma. METHODS: Using the International Primary Care Airways Group (IPAG) guidelines to determine AR, care-givers of 393 (response rate=100%) children attending asthma clinics in selected public sector health facilities in Trinidad, West Indies, were interviewed. RESULTS: Children (393) were between 2-17 years and included 239 (60.8%) boys and 154 (39.2%) girls. As many as 53.9% of children sampled (95% CI 45.9-55.8) suffered from AR. Children exposed to household smoking were nearly twice as likely to have AR (p<0.0041, OR=1.9, CI 1.22-2.88). Significantly (p<0.01) more asthmatics with AR (154, 58.6%) visited Accident and Emergency (A&E) in the past 12 months. The odds of visiting A&E at least once in the past 12 months for asthmatics with AR were 1.75 (95% CI 1.15-2.68). The average frequency of A&E visits was higher in children who also suffered from AR (1.75 vs 1.36, p<0.04). Age was negatively correlated (-0.21, p<0.005) with exacerbation frequency for asthmatics without AR suggesting A&E visits are independent of age in co-morbid disease. More children with AR (>60%) suffer day and night symptoms (p<0.001), and miss school (59.8%) (p<0.03) at least once a week (p<0.002) than asthmatics without AR (OR=1.5, 95% CI=1.03-2.30). CONCLUSIONS: AR is prevalent in 53.9% of Trinidadian children with asthma. The burden of co-morbid disease in asthmatic children is associated with increased likelihood of asthma-related A&E visits, day and night symptoms and absence from school.

Assuntos

Asma/epidemiologia , Rinite Alérgica Perene/epidemiologia , Rinite Alérgica Sazonal/epidemiologia , Adolescente , Fatores Etários , Asma/fisiopatologia , Criança , Pré-Escolar , Comorbidade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Prevalência , Rinite Alérgica Perene/fisiopatologia , Rinite Alérgica Sazonal/fisiopatologia , Fatores de Risco , Instituições Acadêmicas , Inquéritos e Questionários , Poluição por Fumaça de Tabaco , Índias Ocidentais

RESUMO

Introdução: O alongamento ósseo gradual da mandíbula foi inicialmente descrito por McCarthy et al., que utilizaram conceitos previamente desenvolvidos por Illizarov para a aplicação clínica em pacientes com microssomia hemifacial. Molina e Monastério comprovaram em número consistente de pacientes portadores de micrognatia a aplicabilidade clínica da distração osteogênica (DOG) para a região mandibular. O tratamento das craniofaciossinostoses por via intracraniana foi proposto por Tessier na década de 60. Na década de 70, Ortiz-Monastério et al. descreveram o avanço frontofacial em monobloco para tratamento das craniossinostoses sindrômicas. Em 1994, Raposo do Amaral et al. inciaram o tratamento das craniofaciossinostoses com a cirurgia de avanço frontofacial em monobloco utilizando a distração osteogênica do terço médio da face. Bradley et al. comprovaram que a distração osteogênica para os pacientes portadores de craniofaciossinostoses diminui a recidiva da face e a morbidade da cirurgia intracraniana. Subseqüente aos trabalhos pioneiros, inúmeros autores publicaram modificações pessoais da técnica inicial, bem como a evolução do distratores ósseos. Lima et al., em 2008 demostraram sua experiência no tratamento das craniofaciossinostoses com o distrator RED (rig external device). O grupo da Universidade de São Paulo, assim como o grupo da NYU (New York University), acredita que a distração osteogênica externa oferece adequada estabilidade óssea no processo de alongamento facial. Cirurgiões plásticos que trabalham na área craniofacial apresentam contraponto sobre qual o aparelho de distração osteogênica pode oferecer maior estabilidade óssea no processo de alongamento gradual do esqueleto facial. Kawamoto et al. desenvolveram o aparelho de distração interna de Kawamoto, que além de ser bastante conveniente ao paciente, apresenta grande estabilidade óssea no processo de distração e consolidação de oito semanas...

Assuntos

Humanos , Alongamento Ósseo/efeitos adversos , Dor Facial/cirurgia , Hemiatrofia Facial/cirurgia , Osteogênese por Distração

RESUMO

O tratamentodas deformidades craniofaciais foi revolucionado com o advento da técnica do alongamento ósseo gradual denominada distração osteogênica. Oito pacientes com diagnóstico de craniofaciossinostose foram submetidos a avanço fronto facial em monobloco com distração osteogência. Os pacientes foram divididos em 2 grupos de 4 pacientes. No grupo 1 (n=4), o avanço fronto facial foi realizado utilizado os distratores externos fabricados na SOBRAPAR. A idade média do grupo 1 foi de 10,5 anos. O tempo de seguimento do grupo 1 foi de 11 anos. No grupo 2 (n=4), o avanço fronto facial foi realizado utilizando os distratores internos fabricados nos USA pela KLS Martin - USA. A idade média do grupo 2 foi de 8,7 anos. O tempo de seguimento do grupo 2 foi de 1,5 anos. Traçados cefalométricos utilizando o padrão Ricketts foram utilizados para comparação de resultados. O índice de avanço médio do grupo foi 18,3 mm. As variações cefalométricas do grupo 1 foram: SNA: 7º, SNB: -3º. O índice de avanço médio do grupo 2 foi 10,7 mm. As variações cefalométricas do grupo 2 foram: SNA: 8.1º, SNB: -3,4º. Em ambos os grupos, os pacientes ficaram com enoftalmia temporária e com oclusão classe 2. No caso do grupo 1, a classe 2 envoluiu para classe 1 com o passar do tempo. No grupo 2, os pacientes permanecem em classe 2. Os pacientes dos 2 grupos tiveram boa evolução. A retrusão do terço médio, o exorbitismo, bem como o déficit respirat´roio foi tratado satisfatoriamente em ambos os grupos. Maior avanço ósseo do terço médio foi necessário no grupo 1, provavelmente decorrente de uma menor estabilidade óssea durante o processo de alongamento ósseo gradual.

Assuntos

Humanos , Criança , Acrocefalossindactilia , Alongamento Ósseo , Anormalidades Craniofaciais , Craniossinostoses , Osteogênese por Distração/instrumentação

RESUMO

OBJECTIVE: To describe ameloblastoma of the jawbone in young Jamaicans, with special emphasis on radiological findings, and to introduce a radiological classification which could assist in the categorization of these cases according to their biological behaviour and hence their subsequent surgical and medical management. SUBJECTS AND METHODS: The series comprised all the 18 cases of ameloblastoma of the jaw seen in patients under the age of 20 years in the two major hospitals in Jamaica with an oral and maxillofacial surgery department from 1980 to 1995. Radiological and histological diagnosis was confirmed in all. A case of maxillary ameloblastoma in a 13-year old girl seen in the year 2000 was also included in this study. This last case had special attributes. RESULTS: All 19 patients had primary lesions of ameloblastoma. The mean age was 16.1 years with a mode of 18 years and a range of 13 to 19 years. The male to female ratio was 1.1:1. Eighteen cases were seen in the mandible and one case in the maxilla. Of these, 42were unilocular and 58were multilocular radiologically. Thirty-two per cent of cases had unerupted teeth associated with the lesions and 32had root resorption. Based on our new radiological classification, the most predominant radiological type was IIb2 with root resorption (42). There was no radiological type classically simulating dentigerous cyst (Ia2). CONCLUSION: Ameloblastoma in young Jamaicans presented more in the adolescent period and are predominantly unicystic and rare in the maxilla. A new classification for ameloblastoma based solely on radiological presentation is adopted.

Assuntos

Humanos , Masculino , Feminino , Adolescente , Adulto , Ameloblastoma , Ameloblastoma/classificação , Ameloblastoma/epidemiologia , Fatores Etários , Jamaica/epidemiologia , Projetos Piloto

RESUMO

OBJECTIVE: To describe ameloblastoma of the jawbone in young Jamaicans, with special emphasis on radiological findings, and to introduce a radiological classification which could assist in the categorization of these cases according to their biological behaviour and hence their subsequent surgical and medical management. SUBJECTS AND METHODS: The series comprised all the 18 cases of ameloblastoma of the jaw seen in patients under the age of 20 years in the two major hospitals in Jamaica with an oral and maxillofacial surgery department from 1980 to 1995. Radiological and histological diagnosis was confirmed in all. A case of maxillary ameloblastoma in a 13-year old girl seen in the year 2000 was also included in this study. This last case had special attributes. RESULTS: All 19 patients had primary lesions of ameloblastoma. The mean age was 16.1 years with a mode of 18 years and a range of 13 to 19 years. The male to female ratio was 1.1:1. Eighteen cases were seen in the mandible and one case in the maxilla. Of these, 42% were unilocular and 58% were multilocular radiologically. Thirty-two per cent of cases had unerupted teeth associated with the lesions and 32% had root resorption. Based on our new radiological classification, the most predominant radiological type was IIb2 with root resorption (42%). There was no radiological type classically simulating dentigerous cyst (Ia2). CONCLUSION: Ameloblastoma in young Jamaicans presented more in the adolescent period and are predominantly unicystic and rare in the maxilla. A new classification for ameloblastoma based solely on radiological presentation is adopted.

Assuntos

Ameloblastoma/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Ameloblastoma/classificação , Ameloblastoma/epidemiologia , Feminino , Humanos , Jamaica/epidemiologia , Masculino , Projetos Piloto , Radiografia

RESUMO

Introduçäo: O tratamento dos carcinomas glóticos iniciais invasivos e ainda muito discutido. A opçäo pela abordagem cirúrgica apresenta vantagens, mas muitos preferem a radioterapia, por oferecer melhor qualidade vocal. Material e métodos: Os autores apresentam a análise retrospectiva dos resultados cirúrgicos de 31 pacientes com diagnóstico de carcinoma glótico invasivo inicial submetidos a diferentes técnicas cirúrgicas, na Divisäo de Clínica Otorrinolaringológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo, com pelo menos dois anos de seguimento. Resultados: A maioria dos pacientes apresentava mais de 60 anos (52 por cento), e apenas dois eram do sexo feminino. O tabagismo foi relatado por 59 por cento dos casos, muitas vezes associado ao etilismo (26 por cento). Doze (39 por cento) pacientes foram classificados como Tla, sendo submetidos à cordectomia (oito por laringofissura e quatro por endoscopia com laser de CO2). Doze classificados como Tlb, submetidos à laringectomia frontolateral, e sete como T2, submetidos a hemilaringectomia. No seguimento pós-operatório todos referiram piora da qualidade vocal. No período pós-operatório, três apresentaram aspiraçäo transitória e três evoluíram com granuloma e dois com sinéquia de comissura anterior. Houve um caso (T2) de recidiva local tratado com radioterapia. Conclusäo: O tratamento cirúrgico empregado teve relaçäo direta com o estadiamento do tumor, näo sendo observadas complicaçöes maiores. Os autores acreditam que a classificaçäo TNM pode ser um guia para escolha do tipo de cirurgia a ser utilizada nos casos de tumores glóticos iniciais

Assuntos

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias Laríngeas/cirurgia , Alcoolismo , Seguimentos , Glote/cirurgia , Laringectomia , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Resultado do Tratamento , Prega Vocal/fisiologia

RESUMO

The purpose of this study was to examine the influence of self-care education on illness behaviors and health locus of control of Mexican American women. Participants were randomly assigned to a control (n = 60) or experimental group (n = 60). Subjects completed the Multidimensional Health Locus of Control questionnaire and an Illness Behavior Assessment at pretest and 6-months. The experimental group received a self-care manual and participated in two 2-hour seminars on how to effectively use the textbook. The experimental group demonstrated a significant increase in self-care behaviors, and significant changes in Internal Health Locus of Control and Powerful Others Health Locus of Control. Chance Health Locus of Control was found to have a low, direct correlation with age, and a low, indirect correlation with education. The conclusion of this investigation is that self-care education can positively influence illness behaviors and Health Locus of Control in Mexican American women.

Assuntos

Comportamentos Relacionados com a Saúde , Educação em Saúde , Americanos Mexicanos , Autocuidado , Saúde da Mulher , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Feminino , Humanos , Controle Interno-Externo , Manuais como Assunto , México/etnologia , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos

RESUMO

PIP: Over the past decade, studies in Jamaica revealed widespread acceptance of sex outside of marriage or other stable relationships and a common perception that sexually transmitted diseases (STDs) are a natural and easily curable outcome of sexual activity. However, recent surveys suggest that these attitudes and behaviors are beginning to change. Jamaican men who once readily had 5 or more sex partners per year are choosing their partners more carefully and staying in relationships longer. Men and women report having fewer sex partners, while young male adolescents are waiting until they are older to begin having sex. This attitudinal and behavioral change may be attributed to the Ministry of Health's HIV/STD control program launched in 1987. The program is comprehensive, systematic, and sometimes uses an unorthodox approach to HIV/AIDS prevention. HIV/AIDS and STDs were linked in the integrated approach.^ieng

Assuntos

Síndrome da Imunodeficiência Adquirida , Atitude , Infecções por HIV , Comportamentos Relacionados com a Saúde , Educação em Saúde , Planejamento em Saúde , Pesquisa , Assunção de Riscos , Comportamento Sexual , Infecções Sexualmente Transmissíveis , América , Comportamento , Região do Caribe , Países em Desenvolvimento , Doença , Educação , Infecções , Jamaica , América do Norte , Organização e Administração , Psicologia , Viroses

RESUMO

A pregnant woman with acquired immunodeficiency syndrome had nonprimary cytomegalovirus (CMV) viremia and died of complications from Pneumocystis carinii pneumonia and CMV sinusitis and pneumonitis. A boy was delivered by cesarean section at 34 weeks of gestation as the mother's health deteriorated and fetal distress developed. The infant died soon after delivery of interstitial pneumonitis and hyaline membrane disease with invasive CMV disease that affected the kidneys, adrenal glands, and placenta; the CMV strains from the mother and neonate were identical.

Assuntos

Infecções Oportunistas Relacionadas com a AIDS/patologia , Infecções por Citomegalovirus/congênito , Infecções por Citomegalovirus/patologia , Doenças Fetais/patologia , Complicações Infecciosas na Gravidez/patologia , Viremia/patologia , Infecções Oportunistas Relacionadas com a AIDS/virologia , Adulto , Infecções por Citomegalovirus/virologia , Evolução Fatal , Feminino , Doenças Fetais/virologia , Humanos , Doença da Membrana Hialina/patologia , Doença da Membrana Hialina/virologia , Recém-Nascido , Recém-Nascido Prematuro , Doenças Pulmonares Intersticiais/patologia , Doenças Pulmonares Intersticiais/virologia , Masculino , Pneumonia por Pneumocystis/patologia , Pneumonia por Pneumocystis/virologia , Gravidez , Complicações Infecciosas na Gravidez/virologia , Viremia/virologia

RESUMO

PIP: The threat of sexually transmitted diseases (STD) and other sexual challenges facing young people are depicted with humor and creativity in Vibes in a World of Sexuality, a musical revue by the ASHE Caribbean Arts Ensemble, a Jamaican performing arts group of young people 8-19 years old. The Little People and Teen Players, another youth drama group, and ASHE have performed Vibes more than 100 times in 5 countries, reaching over 50,000 people. In the revue's allegorical world, strong sexual urges, jealousy, ignorance, disease, and guilt struggle to overcome the super safer sexual skills of self control, trust, knowledge, and communication. A series of skits and catchy songs show how these skills can influence the choices made by teenagers. The music is a mixture of pop, blues, and Afro-Caribbean rhythms. Catherine Brokenshire, the resident advisor for the AIDSCAP Project in Jamaica and the US Agency for International Development Mission in Jamaica, decided to support 60 Vibes performances in Jamaican schools, youth clubs, communities, and churches. 20 audience members were asked to fill out a questionnaire about STDs and their transmission before and after each performance to assess whether it had changed their knowledge or attitudes about sex and STDs. An analysis of 100 sets of the forms found a 20% increase in correct answers to these questions. Each performance is followed by a 15-minute question-and-answer period. The most common questions are about handling peer pressure, talking to parents about sex and dating, and obtaining condoms. AIDSCAP is supporting the development of a manual to help teachers lead discussions with students after they see Vibes. Educational materials are available at every performance with addresses and phone numbers for Jamaica AIDS Support, The Family Center, and the Ministry of Health's Helpline, where people can request more information or assistance.^ieng

Assuntos

Síndrome da Imunodeficiência Adquirida , Planejamento em Saúde , Serviços de Informação , Meios de Comunicação de Massa , População , Infecções Sexualmente Transmissíveis , América , Região do Caribe , Comunicação , Demografia , Países em Desenvolvimento , Doença , Infecções por HIV , Infecções , Jamaica , América do Norte , Características da População , Viroses

Assuntos

Farmacologia , Efeito Placebo , Método Duplo-Cego , Medidas em Epidemiologia , Estudo de Avaliação , Pesquisa sobre Serviços de Saúde , Qualidade da Assistência à Saúde , Distribuição Aleatória

Assuntos

Farmacologia , Efeito Placebo , Método Duplo-Cego , Medidas em Epidemiologia , Estudo de Avaliação , Pesquisa sobre Serviços de Saúde , Qualidade da Assistência à Saúde , Distribuição Aleatória