RESUMO
OBJECTIVE: There are limited studies on urogenital symptoms in women who experience menopause before the age of 40 years due to primary ovarian insufficiency (POI) or bilateral oophorectomy (surgical POI). This study aimed to compare the urogenital symptoms, including sexuality, of women with POI to those without the condition. METHODS: This cross-sectional study conducted was in seven Latin American countries, in which postmenopausal women (with POI and non-POI) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS) and the six-item Female Sexual Function Index (FSFI-6). The association of premature menopause with more urogenital symptoms and lower sexual function was evaluated with logistic regression analysis. RESULTS: Women with POI experience more urogenital symptoms (MRS urogenital score: 3.54 ± 3.16 vs. 3.15 ± 2.89, p < 0.05) and have lower sexual function (total FSFI-6 score: 13.71 ± 7.55 vs. 14.77 ± 7.57 p < 0.05) than women who experience menopause at a normal age range. There were no significant differences in symptoms when comparing women based on the type of POI (idiopathic or surgical). After adjusting for covariates, our logistic regression model determined that POI is associated with more urogenital symptoms (odds ratio [OR]: 1.38, 95% confidence interval [CI] 1.06-1.80) and lower sexual function (OR: 1.67, 95% CI 1.25-2.25). CONCLUSION: POI, whether idiopathic or secondary to bilateral oophorectomy, is associated with symptoms that affect vaginal and sexual health.
Assuntos
Menopausa Precoce , Insuficiência Ovariana Primária , Disfunções Sexuais Fisiológicas , Humanos , Feminino , Estudos Transversais , Insuficiência Ovariana Primária/complicações , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/etiologia , Adulto , Inquéritos e Questionários , Ovariectomia/efeitos adversos , Doenças Urogenitais Femininas , América Latina , Modelos Logísticos , Menopausa/fisiologiaRESUMO
This paper focuses on the fabrication of three-dimensional porous PLGA-biomimetic carbonated apatite composite scaffolds by freeze-casting and using dimethyl carbonate as a solvent. Several charge/polymer ratios were tested in order to finely understand the influence of the filler rate on the scaffold porosity and mechanical and degradation properties using complementary characterization techniques (SEM, mercury porosimetry and X-ray microtomography). It was demonstrated that the apatite ratio within the composite scaffold has a strong influence in terms of architecture, material cohesion, mechanical properties and in vitro degradation properties. An optimum biomimetic apatite ratio was reached to combine good mechanical properties (higher rigidity) and material cohesion. In vitro degradation studies showed that higher apatite filler rates limited PLGA degradation and enhanced the hydrophilicity of the scaffolds which is expected to improve the biological properties of the scaffolds in addition to the bioactivity related to the presence of the apatite analogous to bone mineral.
Assuntos
Ácido Láctico/química , Ácido Poliglicólico/química , Apatitas , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Porosidade , Engenharia Tecidual , Alicerces TeciduaisRESUMO
Self-esteem is an attitude formed by self-evaluation based on positive and negative aspects of oneself. Low self-esteem is a risk factor for psychiatric disorders and is especially associated with social difficulties. Recently, behavioral economics has allowed the quantitative study of social interactions. We investigated the association between self-esteem and interpersonal problems and whether self-esteem modulates behavior and emotions during an economic task, the Ultimatum Game (UG). In this task participants accept or reject fair/unfair monetary offers from others. Low (LSE, n=40) and high (HSE, n=45) self-esteem participants were assessed in their interpersonal problems and psychiatric symptoms using self-reported questionnaires, and were compared on their decision making and emotional response during the UG. LSE was associated with depression and anxiety symptoms. In addition, LSE was associated with interpersonal problems, especially in the domains of socially inhibited, nonassertive, overly accommodating, self-sacrificing and cold/distant. During the UG, LSE women reported more anger towards unfair offers than HSE women. Our findings suggest that low self-esteem individuals experience high distress by interpersonal problems in several domains. Importantly, low self-esteem in women seems to be associated with an accentuated emotional response to unfair social exchanges. These results may contribute to treat social difficulties in this population.
Assuntos
Jogos Experimentais , Relações Interpessoais , Autoimagem , Adolescente , Adulto , Ira/fisiologia , Ansiedade/psicologia , Tomada de Decisões/fisiologia , Depressão/psicologia , Autoavaliação Diagnóstica , Emoções/fisiologia , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Demands on primary health care services in Chile are increasing. The staff perception of specific sources of tension at work is not known. This knowledge is necessary to avoid preventable health problems caused by distress. AIM: To identify specific work stressors in primary health care facilities and to examine individual characteristics that could mediate their effects on health. MATERIAL AND METHODS: We evaluated organizational stressors (Perceived Work Characteristics for Health Services Survey), personal characteristics (Work Locus of Control Scale, Ways of Coping Check List) and distress (Goldberg General Health Questionnaire, Cooper Stress Symptoms Checklist) in a representative sample of 129 workers of 5 public Primary Health Care Centers of a borough in Santiago. RESULTS: Women and non-professional personnel reported more psychological and physical stress symptoms. Regression analysis showed that work stressors significantly explained the variance of psychological (26%) and physical (28%) distress symptoms. Perception of more role conflicts, less support of peers and superiors and less workload were predictors significantly associated with higher stress outcomes. Avoidance coping strategies were associated with more distress and mediated the effect of organizational stressors on health. CONCLUSIONS: We identified the groups at risk of stress in Primary Health Care Centers and specific sources of tension in the organization, as well as individual risk factors. Both should be addressed in interventions to reduce distress and prevent consequences on health.
Assuntos
Adaptação Psicológica , Pessoal de Saúde/psicologia , Doenças Profissionais/diagnóstico , Atenção Primária à Saúde , Estresse Psicológico/diagnóstico , Feminino , Humanos , Masculino , Doenças Profissionais/psicologia , Escalas de Graduação Psiquiátrica , Fatores Sexuais , Inquéritos e Questionários , Tolerância ao Trabalho Programado/psicologia , Carga de Trabalho/psicologiaRESUMO
Background: Demands on primary health care services in Chile are increasing. The staff perception of specific sources of tension at work is not known. This knowledge is necessary to avoid preventable health problems caused by distress. Aim: To identify specific work stressors in primary health care facilities and to examine individual characteristics that could mediate their effects on health. Material and Methods: We evaluated organizational stressors (Perceived Work Characteristics for Health Services Survey), personal characteristics (Work Locus of Control Scale, Ways of Coping Check List) and distress (Goldberg General Health Questionnaire, Cooper Stress Symptoms Checklist) in a representative sample of 129 workers of 5 public Primary Health Care Centers of a borough in Santiago. Results: Women and non-professional personnel reported more psychological and physical stress symptoms. Regression analysis showed that work stressors significantly explained the variance of psychological (26%) and physical (28%) distress symptoms. Perception of more role conflicts, less support of peers and superiors and less workload were predictors significantly associated with higher stress outcomes. Avoidance coping strategies were associated with more distress and mediated the effect of organizational stressors on health. Conclusions: We identified the groups at risk of stress in Primary Health Care Centers and specific sources of tension in the organization, as well as individual risk factors. Both should be addressed in interventions to reduce distress and prevent consequences on health.
Assuntos
Feminino , Humanos , Masculino , Adaptação Psicológica , Pessoal de Saúde/psicologia , Doenças Profissionais/diagnóstico , Atenção Primária à Saúde , Estresse Psicológico/diagnóstico , Doenças Profissionais/psicologia , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Fatores Sexuais , Tolerância ao Trabalho Programado/psicologia , Carga de Trabalho/psicologiaAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Isoantígenos , Sistema do Grupo Sanguíneo Kidd/genética , Sistema do Grupo Sanguíneo Kidd/história , Sistema do Grupo Sanguíneo Kidd/imunologia , Tipagem e Reações Cruzadas Sanguíneas , Etnicidade/genética , Isoanticorpos , Fenótipo , Testes Sorológicos , Transfusão de Sangue/efeitos adversosAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Sistema do Grupo Sanguíneo Kidd/genética , Sistema do Grupo Sanguíneo Kidd/história , Sistema do Grupo Sanguíneo Kidd/imunologia , Isoantígenos , Isoanticorpos , Fenótipo , Tipagem e Reações Cruzadas Sanguíneas , Testes Sorológicos , Transfusão de Sangue/efeitos adversos , Etnicidade/genéticaRESUMO
El objetivo de esta investigación fue realizar tamizaje neonatal para detectar neonatos con Hipotiroidismo Congénito en el área de influencia de la Universidad el Bosque, confirmar el diagnóstico, iniciar tratamiento temprano y realizar seguimiento, previniendo las respectivas consecuencias. Se recolectaron datos de las historias clínicas y muestras de TSH en sangre total de talón en 2400 recién nacidos vivos, después de 24 horas de vida, desde noviembre de 1999 hasta junio de 2001 en neonatos de bajo riesgo y desde febrero de 2001 hasta febrero de 2002 en neonatos de alto riesgo. Se tomó con criterio de alto riesgo todo neonato que ingresara al área de recién nacidos. Se informó a los padres mediante visita y folleto de difusión. La muestra se procesó en el laboratorio de biología Molecular empleando la técnica microELISA tipo sándwich para TSH y RIA para T4 en los casos a confirmar y con punto de corte de 20 mUI/ml. Para el análisis estadístico de los resultados se utilizó SPSS versión 8.0 para Windows. Entre los resultados más sobresalientes está la prevalencia, de 2 en 2400 recién nacidos vivos, dato similar al descrito por la literatura. Se encontró dependencia estadísticamente significativa entre el tiempo de toma de la muestra y los valores de TSH en talón. No se encontró dependencia de los casos positivos de hipotiroidismo congénito primario y las poblaciones de alto y bajo riesgo neonatal. Como conclusión, es necesario implementar y ejecutar programas de tamizaje neonatal, teniendo en cuenta sus invaluables beneficios.
Assuntos
Ensaio de Imunoadsorção Enzimática , Hipotireoidismo , Triagem Neonatal , Radioimunodetecção , TireotropinaAssuntos
Anaplasmose/imunologia , Doenças dos Bovinos/imunologia , Anaplasmose/tratamento farmacológico , Animais , Anticorpos Antibacterianos/sangue , Formação de Anticorpos , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Ensaio de Imunoadsorção Enzimática , Geografia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Tetraciclinas/uso terapêutico , Fatores de Tempo , VenezuelaAssuntos
Humanos , Bancos de Sangue/provisão & distribuição , Controle de Qualidade , Transfusão de Componentes Sanguíneos/normas , Transfusão de Eritrócitos , Fator VIII , Estudos Multicêntricos como Assunto/estatística & dados numéricos , Plasma , Transfusão de Plaquetas , Transfusão de Componentes Sanguíneos/tendênciasAssuntos
Humanos , Controle de Qualidade , Bancos de Sangue/provisão & distribuição , Transfusão de Componentes Sanguíneos/normas , Transfusão de Plaquetas , Transfusão de Eritrócitos , Plasma , Fator VIII , Transfusão de Componentes Sanguíneos/tendências , Estudos Multicêntricos como Assunto/estatística & dados numéricosAssuntos
Humanos , Derrame Pericárdico/diagnóstico , Pericardite Constritiva/diagnóstico , Pericardite/diagnóstico , Tamponamento Cardíaco/diagnóstico , Derrame Pericárdico/fisiopatologia , Pericardite Constritiva/fisiopatologia , Pericardite Constritiva/terapia , Pericardite/etiologia , Pericardite/terapia , Tamponamento Cardíaco/fisiopatologia , Tamponamento Cardíaco/terapiaRESUMO
Las lesiones del canal anal y del tercio inferior, presentaron una recurrencia significativamente mayor que las del tercio medio y superior, del 38 por ciento vs el 25 por ciento, p<0.0001. Se observó el doble de recurrencias locales con suturas mecanicas en comparacion con las manuales, del 28 por ciento vs el 13 por ciento, sin ser significativamente diferentes. Los principales factores pronosticos que afectaron la sobrevida fueron, el compromiso ganglionar y la penetracion a la pared rectal, valorados en la clasificacion de Astler Collery TNM, p<0.001. La sobrevida a 5 años fue similar en la reseccion anterior y en la reseccion abdominoperineal (63 por ciento y 58 por ciento, respectivamente) (p.=0.3 5). Variables comparables incluyeron unicamente adenocarcinomas y se tomo la distancia entre el borde inferior del tumor y el borde anal como medida para localizarlos: en el canal anal, de 0 a 3 cm; en el tercio inferior del recto, de 4 a 7 cm; en el tercio medio, de 8 a 12 cm. y en el tercio superior, de 12 a 15 cm; se analizaron variables en relacion con estas localizaciones. En conclusion, la preservacion del mecanismo esfinteriano mediante una reseccion anterior, no aumento la recurrencia local ni disminuyó la sobrevida a 5 años, y si logro una mejor calidad de vida
Assuntos
Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios , Neoplasias Retais , Recidiva , Análise de SobrevidaRESUMO
Se presentan los resultados obtenidos en 33 pacientes adultos con diagnostico de carcinoma esofágico o gastroesofagico, sometidos a tratamiento quirurgico mediante la tecnica de esofagectomia transhiatal y ascenso gastrico al cuello, tratados en el Instituto Nacional de Cancerologia de Santafe de Bogota, en un periodo de 5 años. La edad promedio fue de 59 años; 24 casos (73 por ciento) pertenecian al sexo masculino y 9 casos (27 por ciento) al femenino.Treinta y un casos fueron llevados a cirugia en forma electiva y en 2 casos la cirugia fue efectuada de urgencia por perforacion esofágica durante dilataciones de la estenosis tumoral. La mayoria de los tumores (79 por ciento) se localizaban en el tercio inferior del esofago, y los restantes (21 por ciento) en el tercio media. Hubo complicaciones postoperatorias mayores en 14 casos y la mortalidad operatoria fue del 18 por ciento. Se efectuó seguimiento de 20 meses en promedio, con una sobrevida general de 29 meses para los pacientes con neoplasias del tercio medio, y de 19 para las lesiones del tercio inferior, cifras que guardan correlacion con la sobrevida segun el tipo histologico: 27 meses para el carcinoma escamocelular y 16 para el adenocarcinoma.
Assuntos
Esofagectomia , Complicações Pós-Operatórias , Análise de SobrevidaRESUMO
Long-term prognosis in acute myocardial infarction (AMI) can be related to a number of risk factors, including the electrocardiographic stress test (ECG Test). This study analyzes its contribution to the prognosis and management of such patients. 60 individuals discharged from a coronary care unit, without or with persisting complications underwent an ECG test 4-6 weeks following AMI, and were followed for a period of 12-39 months. 40 cases had a negative ECG test. During follow-up they continued to be generally asymptomatic and their survival was 100%. Coronary angiography in patients younger than 45 years revealed mainly single vessel disease. 20 cases (33%) had a positive ECG test. During follow-up 50% of these had anginal manifestations, and coronary angiograms revealed mainly 2-3 vessel disease. 6 patients underwent surgical revascularization. One patient died awaiting surgery. Overall survival in this group was 95%. It is concluded that stress testing performed during the convalescence period of patients with an AMI allows recognition of patients with a potentially poorer prognosis, which can be modified by appropriate study and revascularization in selected cases, bringing survival expectations to the same level of more benign cases.
Assuntos
Eletrocardiografia/métodos , Infarto do Miocárdio/fisiopatologia , Adulto , Idoso , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores de Risco , Fatores de TempoRESUMO
Se analiza un caso de poliposis familiar del colon y su tratamiento quirurgico mediante un nuevo procedimiento alternativo, estudiado y tratado en el Instituto Nacional de Cancerologia en septiembre de 1989. Una vez hecho el diagnostico endoscopico y radiologico de poliposis multiple del colon, se propone el tratamiento quirurgico siguiendo la tecnica descrita por el doctor Utsunomiya y col, en 1980. El motivo de esta presentacion es hacer conocer una alternativa quirurgica para el tratamiento de la poliposis del colon que conlleve seguridad, poca morbilidad, buena continencia y, lo más importante, la curacion para el paciente. Se describe e ilustra la tecnica de la colectomia total más mucosectomia rectal, construccion del reservorio ileal en J y la anastomosis ileoanal. Se revisa la literatura sobre el tema.
Assuntos
Pólipos do Colo/cirurgia , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
The case of a 58-year-old male with severe anemia after hemicolectomy is described. The patient proved to be Kp(b-), and the serum contained anti-Kpb. Because no Kp(b-) donors were available, two incompatible units are administered after intravenous gammaglobulin (400 mg/kg/day) and hydrocortisone (500 mg). The tolerance was good, without signs of increased red cell destruction. Pending the arrival of compatible blood from the American Red Cross, the hematocrit reached 18%, and the direct antiglobulin test remained negative.