RESUMO
INTRODUCCIÓN Es necesario profundizar el conocimiento sobre las prácticas en relación con la nueva ley de infancia, puesta al servicio de un cambio de paradigma que considera al niño como sujeto de derechos. OBJETIVOS Explorar y describir las prácticas y opiniones sobre niñez de los trabajadores del Centro de Acción Familiar (CAF) N° 25 de Santa Fe y analizar desde qué paradigma y qué nociones de infancia se realiza el abordaje institucional. Métodos Se realizó un estudio exploratorio cualitativo, con una muestra no probabilística de carácter intencional. Los datos se recabaron a partir de entrevistas semiestructuradas y revisión de legislación, documentos oficiales e institucionales. RESULTADOS Subyace la idea del niño como sujeto de derechos. En cuanto a las prácticas realizadas a diario en el CAF, consisten en actividades lúdicas orientadas a promover el desarrollo integral de los niños y proporcionarles un ambiente de protección, confianza y seguridad. Por otro lado, aún falta profundizar el trabajo en red y con la comunidad. En relación con la implementación de la Ley Provincial 12697 en el CAF, hay en general una necesidad de participar de espacios de capacitación y de formación respecto al nuevo paradigma de protección de derechos. DISCUSIÓN Existe en los trabajadores una concepción de niñez acorde a los postulados de la Ley de Protección de Derechos, donde se piensa a los niños como sujetos de derechos. Asimismo, dentro de la institución se encuentra arraigado el espíritu de la ley y las prácticas con niños se encuentran orientadas a promover su desarrollo integral. Existen diferencias significativas con las prácticas que se realizaban en años anteriores; sin embargo, el equipo se encuentra en un proceso de cambio, donde se debe profundizar el trabajo comunitario y en red. Para afianzar una estrategia de abordaje integral de la infancia, es necesario implementar espacios de capacitación con los lineamientos de la Ley y de reflexión sobre la práctica.
Assuntos
Política Pública , Defesa da Criança e do Adolescente , Integralidade em SaúdeRESUMO
OBJECTIVES: To study the impact of obesity, age and varicocele on sexual hormones of adult and elderly men. MATERIALS AND METHODS: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. RESULTS: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. CONCLUSIONS: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.
Assuntos
Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Obesidade/sangue , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue , Varicocele/sangue , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Valores de Referência , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Varicocele/fisiopatologiaRESUMO
ABSTRACT Objectives: To study the impact of obesity, age and varicocele on sexual hormones fof adult and elderly men. Materials and Methods: 875 men who were screened for prostate cancer were enrolled in this study. Data recorded comprised age, body mass index (BMI), serum levels of total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicular stimulating hormone (FSH). Patients were divided in groups according to their BMI in underweight, normal weight, overweight and obese grades 1, 2 or 3. First, it was studied the association between age, BMI, and hormone profile. Then, clinical varicocele was evaluated in 298 patients to assess its correlation to the others parameters. Results: Obese patients had lower levels of TT, FT and SHBG (p<0.001) compared to underweight or normal weight patients. There were no differences in age (p=0.113), FSH serum levels (p=0.863) and LH serum levels (p=0.218) between obese and non-obese patients. Obese grade 3 had lower levels of TT and FT compared to obese grade 1 and 2 (p<0.05). There was no difference in the SHBG levels (p=0.120) among obese patients. There was no association between varicocele and BMI; and varicocele did not impact on testosterone or SHBG levels. Conclusions: Men with higher BMI have a lower serum level of TT, FT and SHBG. The presence of clinical varicocele as well as its grade has no impact on hormone profile in elderly men.
Assuntos
Humanos , Masculino , Idoso , Idoso de 80 Anos ou mais , Testosterona/sangue , Varicocele/sangue , Globulina de Ligação a Hormônio Sexual/análise , Hormônio Luteinizante/sangue , Hormônio Foliculoestimulante/sangue , Obesidade/sangue , Valores de Referência , Varicocele/fisiopatologia , Índice de Gravidade de Doença , Índice de Massa Corporal , Estudos Transversais , Fatores Etários , Estatísticas não Paramétricas , Pessoa de Meia-Idade , Obesidade/fisiopatologiaRESUMO
PURPOSE: To report a single center experience with elective surgical patients as living kidney donors. METHODS: We retrospectively analyzed a prospective database of 458 living kidney donors from September 2005 to May 2011. Fifteen (3.2%) of them were elective surgical patients simultaneously undergoing living donor nephrectomy. We reviewed age, gender, operative time, intraoperative blood transfusion, intra- and postoperative complications, as well as length of hospital stay. Recipients were evaluated for delayed graft function. Four hundred forty-three patients undergoing living donor nephrectomy alone composed the control group. RESULTS: Among the elective surgical patients group, the mean (range) operative time was 155 (90 to 310) minutes and mean (range) length of hospital stay was 3 (2 to 9) days. One (6.7%) recipient displayed delayed graft function. Among the regular living kidney donors group, the mean (range) operative time was 100 (70 to 150) minutes, mean (range) length of hospital stay was 3 (2 to 5) days, and delayed graft function was observed in 5.6% of recipients. Only operative time (P = .03) was significantly different between the groups. CONCLUSIONS: Elective surgical patients are potential donors who may be treated at the same time as the living donor nephrectomy.
Assuntos
Adrenalectomia , Colecistectomia , Herniorrafia , Transplante de Rim/métodos , Doadores Vivos , Nefrectomia , Coleta de Tecidos e Órgãos/métodos , Adrenalectomia/efeitos adversos , Adulto , Idoso , Brasil , Distribuição de Qui-Quadrado , Colecistectomia/efeitos adversos , Função Retardada do Enxerto/etiologia , Procedimentos Cirúrgicos Eletivos , Feminino , Herniorrafia/efeitos adversos , Humanos , Transplante de Rim/efeitos adversos , Longevidade , Masculino , Pessoa de Meia-Idade , Nefrectomia/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Coleta de Tecidos e Órgãos/efeitos adversos , Resultado do TratamentoRESUMO
The objective of this paper was to evaluate our initial experience with pancreas retransplantation. From January 26, 1996 to February 2005, 285 pancreas transplantations were performed, including 20 (7%) retransplants. The causes of primary graft loss were graft thrombosis in 11 (55%, 7 venous and 4 arterial); 4 (20%) chronic rejections; 2 (10%) ischemia/reperfusion injury; 1 severe graft pancreatitis; 1 primary nonfunction; and 1 sepsis. Venous drainage was placed in the iliac vessels in 14 (70%), vena cava in 5 (25%), and portal drainage in 1. The exocrine drainage was vesical in 16 (80%) and enteric in 4 (20%). In 14 cases (70%), the primary graft was removed before and in 6 (30%) at the time of retransplantation. Immunosuppression was based on antilymphocyte induction, tacrolimus, mycophenolate mofetil, and steroids in all patients. One-year patient and graft survivals were 95% and 85%. In conclusion, pancreas retransplants were feasible with results comparable to a primary pancreas transplantation.
Assuntos
Transplante de Pâncreas/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Diabetes Mellitus Tipo 1/cirurgia , Nefropatias Diabéticas/cirurgia , Humanos , Transplante de Rim/estatística & dados numéricos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: Despite the highest importance of studying the inferential process in psychotherapy, few systematic studies deal with the ways in which psychotherapists work with the material offered by their patients and construct clinical hypotheses about it. The purpose of this study is to present empirical findings about similarities and differences in the way psychoanalysts from different theorethical orientations and level of clinical experience produce their clinical inferences. METHODOLOGY: The sample includes 20 psychoanalysts selected according to their theoretical orientation (Freudian and Lacanian psychoanalysts) and their level of clinical experience (less than ten years and more than twenty years of clinical practice). They listened to the same tape-recorded first session of psychotherapy and were asked to report their clinical hypotheses, clues, and hunches about the material. They also answered a questionnaire about their inferential work. RESULTS: Freudian psychoanalysts produced more single hypothesis and the same number of combined hypothesis than lacanian psychoanalysts. The level of experience was a factor when it came to producing combined hypothesis, no matter their theoretical framework. 90 per cent of the interviewed made their first clinical inference before the first 9 minutes of the session (regardless of their experience and framework), and agreed on the core themes of the clinical case. CONCLUSIONS: there are similarities and differences in the inferential work according to the theoretical orientation and clinical experience of the psychoanalysts. Their level of experience has a positive matching with their capacity to produce more combined inferences. Most of the clinical inferences are psychological and relational, and they are produced at the very beginning of the session.
Assuntos
Psicanálise/métodos , Adulto , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: Despite the highest importance of studying the inferential process in psychotherapy, few systematic studies deal with the ways in which psychotherapists work with the material offered by their patients and construct clinical hypotheses about it. The purpose of this study is to present empirical findings about similarities and differences in the way psychoanalysts from different theorethical orientations and level of clinical experience produce their clinical inferences. METHODOLOGY: The sample includes 20 psychoanalysts selected according to their theoretical orientation (Freudian and Lacanian psychoanalysts) and their level of clinical experience (less than ten years and more than twenty years of clinical practice). They listened to the same tape-recorded first session of psychotherapy and were asked to report their clinical hypotheses, clues, and hunches about the material. They also answered a questionnaire about their inferential work. RESULTS: Freudian psychoanalysts produced more single hypothesis and the same number of combined hypothesis than lacanian psychoanalysts. The level of experience was a factor when it came to producing combined hypothesis, no matter their theoretical framework. 90 per cent of the interviewed made their first clinical inference before the first 9 minutes of the session (regardless of their experience and framework), and agreed on the core themes of the clinical case. CONCLUSIONS: there are similarities and differences in the inferential work according to the theoretical orientation and clinical experience of the psychoanalysts. Their level of experience has a positive matching with their capacity to produce more combined inferences. Most of the clinical inferences are psychological and relational, and they are produced at the very beginning of the session.
RESUMO
OBJECTIVE: Despite the highest importance of studying the inferential process in psychotherapy, few systematic studies deal with the ways in which psychotherapists work with the material offered by their patients and construct clinical hypotheses about it. The purpose of this study is to present empirical findings about similarities and differences in the way psychoanalysts from different theorethical orientations and level of clinical experience produce their clinical inferences. METHODOLOGY: The sample includes 20 psychoanalysts selected according to their theoretical orientation (Freudian and Lacanian psychoanalysts) and their level of clinical experience (less than ten years and more than twenty years of clinical practice). They listened to the same tape-recorded first session of psychotherapy and were asked to report their clinical hypotheses, clues, and hunches about the material. They also answered a questionnaire about their inferential work. RESULTS: Freudian psychoanalysts produced more single hypothesis and the same number of combined hypothesis than lacanian psychoanalysts. The level of experience was a factor when it came to producing combined hypothesis, no matter their theoretical framework. 90 per cent of the interviewed made their first clinical inference before the first 9 minutes of the session (regardless of their experience and framework), and agreed on the core themes of the clinical case. CONCLUSIONS: there are similarities and differences in the inferential work according to the theoretical orientation and clinical experience of the psychoanalysts. Their level of experience has a positive matching with their capacity to produce more combined inferences. Most of the clinical inferences are psychological and relational, and they are produced at the very beginning of the session.