Pesquisa | SciELO

Resumo O objetivo deste estudo é identificar o efeito da polarização ideológica na geração de ódio e na intenção de compra (IC) em relação a uma marca. Por meio de um survey, no qual 206 participantes foram estimulados(as) a pensar que uma marca relevante para suas vidas estaria financiando um candidato político totalmente antagônico a suas crenças pessoais, identificamos a ideologia política declarada e mensuramos o ódio decorrente dessa situação, além do perfil regulatório (preventivo versus promocional) e a IC em relação à marca alvo. Os resultados evidenciaram a relação entre a polarização ideológica do participante (direita ou esquerda) e a IC. Identificamos, ainda, que o envolvimento e o ódio à marca - gerado por um posicionamento ideológico incongruente entre a marca e o respondente - medeiam a relação entre a autocongruência e a IC. Além disso, o perfil regulatório moderou o efeito das relações entre o envolvimento e ódio e a IC.

Abstract In this study, the main objective is to identify the effect of ideological polarization on the generation of both hate and purchase intent (PI), in relation to a brand. A survey encouraged 206 participants to think that a significant brand would support a political candidate antagonistic to their personal beliefs. We identified the political ideology declared and then measured the hatred generated in this situation, in addition to the regulatory focus (preventive versus promotional), and PI in relation to the brand. The results showed the relationship between the participant’s ideological polarization (right-wing or left-wing) and the PI. We also identified that involvement and brand hate - as generated by a non-congruent positioning between the brand and the ideological respondent - mediated the relationship between self-congruence and PI. Additionally, regulatory focus moderated the effects of the relationships among involvement and brand hate and the PI.

https://doi.org/10.15728/bbr.2022.19.5.6.en

Correlation between the Severity of the Lumbar Degenerative Disease and Sagittal Spinopelvic Alignment
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Pratali, Raphael de Rezende

; Battisti, Raphael

; Oliveira, Carlos Eduardo Algaves Soares de

; Maranho, Daniel Augusto Carvalho

; Herrero, Carlos Fernando P. S

Revista Brasileira de Ortopedia

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Jan 2022, Volume 57 Nº 1 Páginas 41 - 46

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivo Avaliar o impacto da graduação da doença degenerativa lombar (DDL) sobre o alinhamento sagital espinopélvico. Métodos Ao todo, 130 pacientes (dade média: 57 anos; 75% do sexo feminino) com dor lombar associada a DDL foram prospectivamente incluídos. A gravidade da DDL foi definida pelos seguintes achados nas radiografias anteroposterior e de perfil da coluna lombar: osteofitose; perda de altura do disco intervertebral; esclerose na placa vertebral terminal; número de segmentos afetados; deformidades; e instabilidade objetiva. Os pacientes foram graduados segundo a DDL da seguinte maneira: grau 0-ausência de sinais de DDL na coluna lombar; grau I - sinais de DDL em até dois segmentos; grau II - envolvimento em três ou mais segmentos; grau III - quando associada a escoliose, espondilolistese ou laterolistese. Parâmetros radiográficos espinopélvicos, como incidência pélvica (IP), lordose lombar (LL), discrepância entre a IP e a LL (IP-LL), versão pélvica (VP), e eixo vertical sagital (EVS) foram analisados de acordo com os graus de DDL. Resultados Houve diferença nos parâmetros radiográficos comparando-se os graus de DDL, com os pacientes de grau III apresentando maiores valores de EVS (p= 0,001) e VP (p= 0,0005), o que denota maior inclinação anterior do tronco e maior retroversão pélvica do que os pacientes de graus 0 e I. Pacientes de grau III também apresentaram maiores valores de IP-LL, o que denota perda da lordose relativa ao valor da IP, do que pacientes grau I (p= 0,04). Conclusão Pacientes com DDL mais grave demonstraram uma tendência a maior desalinhamento sagital espinopélvico comparados com pacientes com graus mais leves.

Abstract Objective To evaluate the impact of the severity of lumbar degenerative disease (LDD) on sagittal spinopelvic alignment. Methods In total, 130 patients (mean age: 57 years; 75% female) with LDD-associated low-back pain were prospectively included. The severity of the LDD was defined by the following findings on anteroposterior and lateral lumbar spine radiographs: osteophytosis; loss of of height of the intervertebral disc; terminal vertebral plate sclerosis; number of affected segments; deformities; and objective instability. The disease was classified as follows: grade 0-absence of signs of LDD in the lumbar spine; grade I - signs of LDD in up to two segments; grade II - three or more segments involved; grade III - association with scoliosis, spondylolisthesis, or laterolisthesis. Spinopelvic radiographic parameters, including pelvic incidence (PI), lumbar lordosis (LL), discrepancy between the PI and LL (PI-LL), pelvic tilt (PT), and sagittal vertical axis (SVA), were analyzed according to the LDD grades. Results The radiographic parameters differed according to the LDD grades; grade-III patients presented higher SVA (p= 0.001) and PT (p= 0.0005) values, denoting greater anterior inclination of the trunk and pelvic retroversion when compared to grade-0 andgrade-I subjects. In addition, grade-III patients had higher PI-LL values, which indicates loss of PI-related lordosis, than grade-I subjects (p= 0.04). Conclusion Patients with more severe LDD tend to present greater spinopelvic sagittal misalignment compared to patients with a milder disease.

https://doi.org/10.1055/s-0041-1729579

Quality Indicators of Transanal Total Mesorectal Excision (TaTME) for Rectal Cancer
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Martínez, María Labalde

; Lopez, Alfredo Vivas

; Jimenez, Juan Ocaña

; García, Cristina Nevado

; Villar, Oscar García

; Gonzalez, Eduardo Rubio

; Borda, Francisco Javier García

; Vigo, Felipe Cruz

; Herrero, Eduardo Ferrero

Journal of Coloproctology (Rio de Janeiro)

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Dez 2021, Volume 41 Nº 4 Páginas 411 - 418

Resumo: En | Texto: En | PDF: En

Abstract Introduction Transanal total mesorectal excision (TaTME) has revolutionized the surgical techniques for lower-third rectal cancer. The aim of the present study was to analyze the outcomes of quality indicators of TaTME for rectal cancer compared with laparoscopic TME (LaTME). Methods A cohort prospective study with 50 (14 female and 36male) patients, with a mean age of 67 (range: 55.75 to 75.25) years, who underwent surgery for rectal cancer. In total, 20 patients underwent TaTME, and 30, LaTME. Every TaTME procedure was performed by experienced colorectal surgeons. The sample was divided into two groups (TaTME and LaTME), and the quality indicators of the surgery for rectal cancer were analyzed. Results There were no statistically significant differences regarding the patients and the main characteristics of the tumor (age, gender, American Society of Anesthesiologists [ASA] score, body mass index [BMI], tumoral stage, neoadjuvant therapy, and distance from the tumor to the external anal margin) between the two groups. The rates of: postoperativemorbidity (TaTME: 35%; LaTME: 30%; p=0.763);mortality (0%); anastomotic leak (TaTME: 10%; LaTME: 13%; p=0.722); wound infection (TaTME: 0%; LaTME: 3.3%; p=0.409); reoperation (TaTME: 5%; LaTME: 6.6%; p=0.808); and readmission (TaTME: 5%; LaTME: 0%; p=0.400), as well as the length of the hospital stay (TaTME: 13.5 days; LaTME: 11 days; p=0.538), were similar in both groups. There were no statistically significant differences in the rates of positive circumferential resection margin (TaTME: 5%; LaTME: 3.3%; p=0.989) and positive distal resection margin (TaTME: 0%; LaTME: 3.3%; p=0.400), the completeness of the TME (TaTME: 100%; LaTME: 100%), and the number of lymph nodes harvested (TaTME: 15; LaTME: 15.5; p=0.882) between two groups. Conclusion Transanal total mesorectal excision is a safe and feasible surgical procedure for middle/lower-third rectal cancer.

https://doi.org/10.1055/s-0041-1736640

Impact of the Covid-19 Pandemic on Colorectal Cancer Surgery in Madrid
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Martínez, Maria Labalde

; Borda, Francisco Javier García

; Chavez, Cristina Narvaez

; Lopez, Alfredo Vivas

; Villar, Oscar García

; Gomez, Ramón

; Martinez, Rafael Ramos

; Vigo, Felipe de La Cruz

; Herrero, Eduardo Ferrero

Journal of Coloproctology (Rio de Janeiro)

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Jul 2021, Volume 41 Nº 3 Páginas 257 - 264

Resumo: En | Texto: En | PDF: En

Abstract Introduction The Covid-19 pandemic has had an important impact on colorectal cancer surgery, for hospital resources had to be redistributed in favour of Covid-19 patients. The aim of the present study is to analyze our results in colorectal oncologic surgery during the Covid-19 pandemic in patients with and without perioperative SARSCoV- 2 infection. Methods In total, 32 patients (19 male and 13 female patients), with a mean age of 64 years (range: 57.2 to 69.5 years) with colorectal cancer underwent surgery under the recommendations of surgical societies included in a protocol. Data collection included clinical characteristics (gender, age, body mass index, American Society of Anesthesiologists score, tumor location, preoperative staging, lymphopenia), data related to SARS-CoV-2 infection (postoperative symptoms, diagnostic tests), operative details (surgical procedure, approach, duration, stoma), pathological outcomes (tumor stage, number of lymph nodes harvested, distal and circumferential radial margins, quality of the total mesorectal excision), and surgical outcomes (morbidity, mortality, hospital stay, and the rates of reoperation and readmission). Results A total of 3 (9.4%) patients who underwent colorectal surgery during the Covid-19 pandemic were infected by SARS-CoV-2 in the postoperative period. Chronic obstructive pulmonary disease was associated with Covid-19 (6.2% versus 33.3%; p=0.042), and surgical morbidity was higher among Covid-19 patients (100% versus 37.9%; p=0.039). There were not significant differences between COVID-19 patients and non-COVID-19 patients in relation to the rest of the analyzed outcomes. Conclusion During the Covid-19 pandemic, colorectal cancer surgery should be performed according to the recommendations of surgical societies. However, Covid- 19 patients could present a higher morbidity rate.

https://doi.org/10.1055/s-0041-1730017 22 downloads

Desarrollo de una aplicación para configurar el teléfono inteligente como fonendoscopio para profesionales sanitarios con deficiencias auditivas
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Vallejo-Valdezate, Luis A

; Santamaria-Vázquez, Eduardo

; Hornero, Roberto

; Gil-Carcedo Sañudo, Elisa

; Herrero-Calvo, David

Revista ORL

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Dez 2020, Volume 11 Nº 4 Páginas 401 - 411

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction and objectives: The hearing loss supposes a severe handicap for any professional whose activity is based on the recognition of sounds. In the case of health professionals, auscultation is a routine activity and the condition of hearing loss limits it to a variable degree depending on the severity of the same. Those health professionals who, due to the severity of their hearing loss, need the use of hearing aids, find routines based on the use of the stethoscope difficult. The objective of this work is to describe the process to develop a smartphone application that allows real-time reproduction, recording and analysis of sounds to facilitate the work of health professionals with hearing loss. Methods. We have collected cardiac, pulmonary and abdominal somatosounds from healthy and pathological subjects in order to characterize them spectrographically. Then, the application has been designed in order to facilitate the diagnostic work of the hypoacoustic healthcare professional, considering the previous characterization to optimize listening and analysis of cardiac, pulmonary and abdominal sounds. Moreover, in order to maximize the number of compatible devices, it has been developed for the Android operating system, the most widespread in the market. Results: An App for Android-based smartphones has been developed (called STETHOSCOPE) that configures the phone as a stethoscope, picking up the somatosounds through its microphone (being possible to use only the internal microphone of the Smartphone as external microphones of high quality to through its JACK connector), processing the signal until finally sending it via Bluetooth to the hearing aid of the hearing impaired professional. This application allows you to record and graphically represent heart sounds, lungs and abdominals in Android devices and store them in WAV format without compression with a 32-bit FLOAT IEEE coding, allowing your file, comparison or sharing with other professionals. Conclusion: In this study, we present a novel application designed to use the smartphone as a stethoscope, sending the captured sound to the hearing aid (wirelessly) of the physician with hearing loss.

RESUMEN Introducción y objetivos: La hipoacusia supone un severo hándicap para cualquier profesional cuya actividad se base en el reconocimiento de sonidos. En el caso de profesionales sanitarios, la auscultación constituye una actividad rutinaria y el padecimiento de hipoacusia la limita en grado variable en función de la severidad de la misma. Aquellos profesionales sanitarios que por la severidad de su hipoacusia necesitan del uso de audífonos ven dificultadas las rutinas basadas en el uso del fonendoscopio. El objetivo del presente trabajo es describir el proceso llevado a cabo para desarrollar una aplicación para smartphones, que permita la reproducción en tiempo real, el registro y el análisis de sonidos para facilitar la labor de profesionales sanitarios con hipoacusia. Métodos. Hemos recogido somatosonidos cardiacos, pulmonares y abdominales de sujetos sanos y patológicos a fin de caracterizarles frecuencialmente. Posteriormente, la aplicación ha sido diseñada con el objetivo de facilitar la labor diagnóstica del profesional sanitario hipoacúsico, teniendo en cuenta la caracterización anterior para optimizar la escucha y el análisis de sonidos cardiacos, pulmonares y abdominales. Además, con el objetivo de maximizar el número de dispositivos compatibles, ha sido desarrollada para el sistema operativo Android, el más extendido del mercado. Resultados: Hemos desarrollado una App para smartphones (a la que hemos llamado STETHOSCOPE) basados en Android que configura el teléfono como un fonendoscopio recogiendo el somatosonido a través de su micrófono (siendo posible utilizar exclusivamente el micrófono interno del smartphone o bien micrófonos externos de alta calidad a través de su conector JACK), procesando la señal hasta enviarla finalmente por Bluetooth a los audífonos del profesional hipoacúsico. Esta aplicación permite grabar y representar gráficamente sonidos cardiacos, pulmonares y abdominales en dispositivos Android y almacenarlos en formato WAV, según las recomendaciones del Instituto de Ingeniería Eléctrica y Electrónica (Institute of Electrical and Electronics Engineers, IEEE), utilizando una codificación FLOAT de 32 bits sin compresión posibilitando su archivo, comparación o compartición con otros profesionales. Conclusiones: En este estudio presentamos una aplicación destinada a utilizar el smartphone como fonendoscopio, haciendo llegar el sonido captado a la ayuda auditiva (por vía inalámbrica) del profesional sanitario hipoacúsico que lo precise.

Clinical and Epidemiological Characteristics of Patients Diagnosed with COVID-19 in a Tertiary Care Center in Mexico City: A Prospective Cohort Study
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Ortiz-Brizuela, Edgar

; Villanueva-Reza, Marco

; González-Lara, María F.

; Tamez-Torres, Karla M.

; Román-Montes, Carla M.

; Díaz-Mejía, Bruno A.

; Pérez-García, Esteban

; Olivas-Martínez, Antonio

; Rajme-López, Sandra

; Martinez-Guerra, Bernardo A.

; León-Cividanes, Nereyda A. de

; Fernández-García, Oscar A.

; Guerrero-Torres, Lorena

; Torres-González, Lorena

; Carrera-Patiño, Fabián A.

; Corral-Herrera, Ever A.

; Hernández-Alemón, Aldo N.

; Tovar-Vargas, Maria de los Ángeles

; Serrano-Pinto, Yamile G.

; Espejo-Ortiz, Cristian E.

; Morales-Ortega, María de la L.

; Lozano-Cruz, Óscar A.

; Cárdenas-Fragoso, José L.

; Vidal-Mayo, José de J.

; Hernández-Gilsoul, Thierry

; Rivero-Sigarroa, Eduardo

; Domínguez-Cherit, Guillermo

; Cervantes-Villar, Luz E.

; Ramos-Cervantes, Maria del P.

; Ibarra-González, Violeta

; Calva-Mercado, Juan J.

; Sierra-Madero, Juan G.

; López-Íñiguez, Álvaro

; Ochoa-Hein, Eric

; Crabtree-Ramírez, Brenda E.

; Galindo-Fraga, Arturo

; Guerrero-Almeida, María de L.

; Ruiz-Palacios, Guillermo M.

; Gulías-Herrero, Alfonso

; Sifuentes-Osornio, José

; Kershenobich-Stalnikowitz, David

; Ponce-de-León, Alfredo

Revista de investigación clínica

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Jun 2020, Volume 72 Nº 3 Páginas 165 - 177

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.

https://doi.org/10.24875/ric.20000211 533 downloads

Percepción estudiantil sobre una innovación evaluativa utilizando la plataforma Moodle
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Pomares Bory, Eduardo de Jesús

; Barrios Herrero, Liliam

; Vázquez Naranjo, Odalys

; Arencibia Flores, Lourdes Guadalupe

; Lastayo Bourbon, Lourdes

; Pérez Yero, Carlos Manuel

EDUMECENTRO

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Jun 2020, Volume 12 Nº 2 Páginas 92 - 109

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Background: the introduction of educational innovations in response to the social demand to integrate electronic technology in the teaching-learning process needs to implement the assessment of new educational offerings. Objective: to analyze the student's perception of an evaluative innovation using Moodle, introduced in the Nervous, Endocrine and Reproductive Systems subject, in the "Salvador Allende" School of Medical Sciences during the 2018-2019 academic year. Methods: a descriptive investigation with a mixed approach was carried out. Theoretical methods were used: analysis-synthesis and inductive-deductive; empirical ones: pedagogical test to students, participatory observation and the survey in the form of a questionnaire, and the forum; and mathematical-statistic for data processing. Educational innovation was valued by criteria of specialists. Results: the application of the pedagogical test led to homogeneity in the evaluation instruments and the implementation of the formative evaluation, the participatory observation evidenced the interest of the students in the development of the evaluations and the need to advise the work with the Moodle platform. The data obtained with the surveys showed a satisfactory student perception of innovation, although the graphic design of the activities was considered as a weakness. Conclusions: the evaluative innovation was a satisfactory student experience in responding to some of their expectations as centered participants in the teaching-learning process; Teachers of experience in the subject valued it as a feasible didactic alternative to be used to achieve a more relevant approach in the apprehension of knowledge.

RESUMEN Fundamento: la introducción de innovaciones educativas en respuesta a la demanda social de integrar la tecnología digital en el proceso docente educativo precisa instrumentar la valoración de las nuevas ofertas educativas. Objetivo: analizar la percepción estudiantil sobre una innovación evaluativa utilizando Moodle, introducida en la asignatura Sistemas Nervioso, Endocrino y Reproductor, en la Facultad de Ciencias Médicas “Salvador Allende” durante el curso 2018-2019. Métodos: se realizó una investigación descriptiva con enfoque mixto. Se utilizaron métodos teóricos: análisis-síntesis e inductivo-deductivo; empíricos: prueba pedagógica a estudiantes, observación participativa y la encuesta en forma de cuestionario, y el foro; y matemático-estadísticos para el procesamiento de los datos. La innovación educativa fue valorada por criterios de especialistas. Resultados: la aplicación de la prueba pedagógica propició homogeneidad en los instrumentos evaluativos y la implementación de la evaluación formativa, la observación participativa evidenció el interés de los estudiantes en el desarrollo de las evaluaciones y la necesidad de asesorar el trabajo con la plataforma Moodle. Los datos obtenidos en las encuestas mostraron una percepción estudiantil satisfactoria sobre la innovación, aunque el diseño gráfico de las actividades fue apreciado como una debilidad. Conclusiones: la innovación evaluativa fue una experiencia estudiantil satisfactoria al dar respuestas a algunas de sus expectativas como participantes centrales del proceso enseñanza aprendizaje; los docentes de experiencia en la asignatura la valoraron como una alternativa didáctica factible de ser utilizada para lograr un enfoque más pertinente en la aprehensión del conocimiento.

SPINOPELVIC VARIABILITY ACCORDING TO THE ROUSSOULY CLASSIFICATON CURVE TYPE
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PRATALI, RAPHAEL DE REZENDE

; PASSOS, LUIZ EDUARDO MOREIRA

; OLIVEIRA, CARLOS EDUARDO ALGAVES SOARES DE

; HERRERO, CARLOS FERNANDO P. S.

Coluna/Columna

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Jun 2020, Volume 19 Nº 2 Páginas 112 - 115

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo Avaliar a variabilidade dos parâmetros sagitais espinopélvicos em uma amostra de pacientes, assim como a distribuição de lordose no segmento lombar da coluna vertebral. Métodos Trata-se de um estudo transversal, considerando radiografias da coluna total de uma amostra de pacientes. Os pacientes foram avaliados de acordo com a classificação de Roussouly e foram considerados os parâmetros radiográficos do alinhamento sagital espinopélvico, além da medida da lordose de cada segmento da coluna lombar. Os parâmetros radiográficos foram correlacionados com o tipo da classificação de Roussouly. Resultados Noventa pacientes foram incluídos no estudo. Houve correlação significativa entre a incidência pélvica (IP) e a lordose lombar (LL) L1-S1 (R=0,89; p<0,0001). O valor da IP foi significativamente maior nos tipos 3 e 4 de Roussouly do que nos tipos 1 e 2 (p<0,001), assim como o valor da LL L1-S1 (p<0,001). Considerando o total da amostra, 67% da LL L1-S1 estava localizada entre L4-S1, porém com variação conforme o tipo de curva pela classificação de Roussouly. Conclusões O presente estudo demonstrou grande correlação entre os valores da IP e da LL, assim como a importância do segmento lombar distal (L4-S1) no valor global da LL L1-S1, ainda maior nos pacientes com menor valor de IP (tipos 1 e 2 de Roussouly). Nível de evidência II; Análise retrospectiva de banco de dados prospectivo (coorte); Estudo diagnóstico.

ABSTRACT Objective To evaluate the variability of spinopelvic sagittal parameters and the distribution of lordosis in the lumbar spine in a sample of patients. Methods This is a cross-sectional study considering full-spine radiographs of a patient sample. The patients were classified according to the Roussouly classification and both radiographic spinopelvic alignment parameters and the lordosis measurement of each lumbar spinal segment were considered. The radiographic parameters were correlated with the Roussouly classification type. Results Ninety patients were included in the study. There was significant correlation between pelvic incidence (PI) and lumbar lordosis (LL) (R=0.89; p<0.0001). The values of PI were significantly higher in Roussouly types 3 and 4 than in types 1 and 2 (p<0.001), as were the values of LL L1-S1(p<0.001). Considering the total sample, 67% of LL L1-S1 was located between L4-S1, but with variations by the Roussouly classification curve types. Conclusion This study demonstrated a high correlation between the values of PI and LL, as well as the importance of the distal lumbar segment (L4-S1) in the overall value of LL L1-S1, which was even higher in patients with a lower PI value (Roussouly types 1 and 2). Level of evidence II; Retrospective analysis of a prospective database (Cohort); Diagnostic study.

RESUMEN Objetivo Evaluar la variabilidad de los parámetros sagitales espinopélvicos en una muestra de pacientes, así como la distribución de lordosis en el segmento lumbar de la columna vertebral. Métodos Se trata de un estudio transversal, considerando radiografías de la columna total de una muestra de pacientes. Los pacientes fueron evaluados de acuerdo con la clasificación de Roussouly y fueron considerados los parámetros radiográficos de la alineación sagital espinopélvica, además de la medida de la lordosis de cada segmento de la columna lumbar. Los parámetros radiográficos fueron correlacionados con el tipo de la clasificación de Roussouly. Resultados Fueron incluidos 90 pacientes en el estudio. Hubo correlación significativa entre la incidencia pélvica (IP) y la lordosis lumbar (LL) L1-S1 (R=0,89; p <0,0001).). El valor de la IP fue significativamente mayor en los tipos 3 y 4 de Roussouly que en los tipos 1 y 2 (p <0,001), así como el valor de la LL L1-S1 (p <0,001). Considerando el total de la muestra, 67% de la LL L1-S1 estaba localizada entre L4-S1, aunque con variación conforme al tipo de curva por la clasificación de Roussouly. Conclusiones El presente estudio demostró gran correlación entre los valores de la IP y de la LL, así como la importancia del segmento lumbar distal (L4-S1) en el valor global de la LL L1-S1, aún mayor en los pacientes con menor valor de IP (tipos 1 y 2 de Roussouly). Nivel de evidencia II; Análisis retrospectivo de banco de datos prospectivo (cohorte), Estudio diagnóstico.

https://doi.org/10.1590/s1808-185120201902224176 842 downloads

Usefulness of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of severity on Fournier fasciitis of the Hospital General de México "Dr. Eduardo Liceaga"
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Guemes-Quinto, Agustín

; Godínez-Vidal, Ansony R.

; Villanueva-Herrero, Juan A.

; Jimenez-Bobadilla, Billy

; Perez Escobedo, Sergio U.

; Bandeh-Moghaddam, Hamzeh

; Gracida-Mancilla, Noé I.

Revista médica del Hospital General de México

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Dez 2019, Volume 82 Nº 4 Páginas 175 - 178

Resumo: En | Texto: En | PDF: En

Background: Fournier fasciitis (FF) severity is traditionally assessed by the Fournier gangrene severity index (FGSI), as it is an internationally accredited index, which consists of some clinical and laboratory parameters. However, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have shown to be useful as predictors of severity in different septic and ischemic processes, and a full blood count is sufficient for its application. Objectives: The objectives of this study were to determine if there is a correlation between FF severity measured by NLR and PLR, and the severity measured by the FGSI scale. Materials and methods: We conducted a retrospective, observational, and analytical study to evaluate the usefulness of the NLR and PLR as indicators of severity on Fournier fasciitis. Results: We included 45 cases treated at Hospital General de México "Dr. Eduardo Liceaga", from 2010 to 2016. Forty cases were of anorectal origin and five of them of urological origin. The severity assessment scale was set for FGSI at 9 points, NLR at 7 points, and PLR at 140 points. About 60% of cases deemed severe by NLR, resulted in an FGSI score lower than 9, p = 0.547, without statistical significance. About 72% of cases diagnosed as severe by PLR, yielded an FGSI score lower than 9, p = 0.613, without statistical significance. Conclusions: Additional studies would be required to confirm or rule out these results.

https://doi.org/10.24875/hgmx.m19000027 27 downloads

10.

IMPACT OF THE APPENDICEAL POSITION ON THE DIAGNOSIS AND TREATMENT OF PEDIATRIC APPENDICITIS
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Castro, Belén Aneiros

; Novillo, Indalecio Cano

; Vázquez, Araceli García

; Garcia, Pedro Yuste

; Herrero, Eduardo Ferrero

; Fraile, Andrés Gómez

Revista Paulista de Pediatria

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Abr 2019, Volume 37 Nº 2 Páginas 161 - 165

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Investigar como os sintomas variam de acordo com a posição do apêndice em pacientes pediátricos e demonstrar que a laparoscopia é segura e eficaz em qualquer posição do apêndice, comparando-as. Métodos: Os prontuários de 1.736 pacientes pediátricos com idade ≤14 anos submetidos à apendicectomia laparoscópica em um período de 14 anos foram analisados retrospectivamente. Os pacientes foram divididos de acordo com a posição do apêndice: anterior, pélvica, retrocecal e sub-hepático. Os testes de Kruskal-Wallis e do qui-quadrado foram usados com a correção de Bonferroni, sendo significante p<0,05. Resultados: A posição do apêndice era anterior em 1.366 casos, retrocecal em 248 casos, pélvica em 66 casos e sub-hepática em 56 casos. Não houve diferenças significativas entre os grupos quanto às variáveis idade e sexo. A dor abdominal foi a única variável com diferenças estatisticamente significantes entre os grupos. A taxa de apêndice perfurado foi superior nas posições sub-hepática e pélvica. As complicações intraoperatórias e a taxa de conversão não foram estatisticamente significativas. As dificuldades técnicas e o tempo cirúrgico foram superiores em posição sub-hepática. A taxa de complicações pós-operatórias foi semelhante entre as diferentes posições, exceto a obstrução intestinal, que foi superior em posição pélvica. Conclusões: Os sintomas da apendicite dificilmente variam com a posição do apêndice. A laparoscopia é segura e eficaz, independentemente da posição do apêndice.

ABSTRACT Objective: To investigate how symptoms vary according to the appendiceal position in pediatric patients and to demonstrate that the laparoscopic approach is safe and effective in any appendiceal location by comparing each location to another. Methods: The medical records of 1,736 children aged 14 or younger who underwent laparoscopic appendectomy over a period of 14 years were analyzed retrospectively. Patients were divided according to the position of the appendiceal tip into four groups: anterior, pelvic, retrocecal and subhepatic. The Kruskal-Wallis and chi-square tests were used with the Bonferroni correction, with a significant p<0.05. Results: The appendiceal location was anterior in 1,366 cases, retrocecal in 248 cases, pelvic in 66 cases and subhepatic in 56 cases. There were no significant differences between the groups in terms of patient age and gender. Abdominal pain was the only symptom with statistically significant differences between the groups. The rate of perforated appendicitis was higher in the subhepatic and pelvic positions. Intraoperative complications and conversions were not statistically significant. Technical difficulties and operative time were higher in subhepatic position. The rate of postoperative complications was similar between the different locations, except for bowel obstruction, which was higher in pelvic appendicitis. Conclusions: The clinical symptoms of appendicitis hardly ever change with the position of the appendix. The laparoscopic approach is safe and effective, regardless the appendiceal location.

https://doi.org/10.1590/1984-0462/;2019;37;2;00012 3926 downloads

11.

Application of the predictive abdominal reoperation index for abdominal infection in patients with diagnosis of sepsis of the General Hospital of Mexico “Dr. Eduardo Liceaga”
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Godinez-Vidal, Ansony R.

; Chaga-Torres, Jose F.

; Cruz-Romero, Christian I.

; Villanueva-Herrero, Juan A.

; Jimenez-Bobadilla, Billy

; Alarcón-Bernés, Lisbeth

; Gracida-Mancilla, Noe I.

Revista médica del Hospital General de México

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Mar 2019, Volume 82 Nº 1 Páginas 11 - 14

Resumo: En | Texto: En | PDF: En

Background: Despite the improvement in care, recognition and management of multiple organ failure, availability of new antibiotics, advances in diagnostic techniques, and the decision to reintervention in a critically ill patient ultimately depend on a medical judgment. The use of the Abdominal Reoperation Predictive Index (ARPI) among patients with a possibility of reintervention allows the estimation of mortality being susceptible to be abated, reducing the time elapsed between the first operation and the relaparotomy, as well as a shorter stay in intensive care units. Objective: The objectives of this study were to determine the degree of certainty of the ARPI to diagnose the need for reoperation in patients with abdominal sepsis. Materials and Methods: An observational, descriptive, cross-sectional, retrospective study of patients from the General Hospital of Mexico “Eduardo Liceaga” belonging to the clinic of integral care of abdominal sepsis, from January to June 2016, with diagnosis of abdominal sepsis operated urgently by secondary peritonitis. Results: A total of 94 patients were included, 58.5% of male (n = 55) and 41.5% of female (n = 39), with an average age of 48.1 years (Standard mean [SD] ± 17.4). The most frequently injured organ in the initial surgery was the cecal appendix in 39 cases (41.5%) followed by the small intestine in 21 cases (22.3%). Those cases with ARPI scores > 21 were operated on 6 of 8, corresponding to 75% with a score > 21, while of the cases with ARPI score < 20 points reoperated 23 of 86, corresponding to 26.7% with a score < 20 points. Fisher’s exact test, p = 0.01, statistically significant. Conclusions: The ARPI may be helpful in guiding the decision-making of laparotomy in patients diagnosed with secondary peritonitis.

https://doi.org/10.24875/hgmx.m19000007 50 downloads

12.

GRADING SCALE OF LUMBAR DEGENERATIVE DISEASE IN FULL SPINE X-RAY
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Vasconcelos, Iúri Tomaz de

; Sant’Anna, Daniel Arnoni

; Oliveira, Carlos Eduardo Algaves Soares de

; Herrero, Carlos Fernando P. S.

; Pratali, Raphael de Rezende

Coluna/Columna

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Mar 2019, Volume 18 Nº 1 Páginas 32 - 36

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: Apresentar uma nova escala de graduação da doença degenerativa lombar observada em exames de radiografia panorâmica da coluna vertebral e avaliar sua reprodutibilidade inter e intraobservador. Métodos: Foram avaliados 132 exames de radiografia total da coluna vertebral (panorâmica) nas incidências frente e perfil. Os casos foram graduados de maneira independente por dois examinadores. Os parâmetros radiográficos observados foram osteofitose, perda da altura discal, esclerose e cistos subcondrais, número de segmentos acometidos, deformidades e sinais de instabilidade. A escala de graduação foi proposta da seguinte maneira: Grau zero como ausência de sinais de doença degenerativa na coluna lombar; Grau I apresentando sinais de doença degenerativa até 2 segmentos; Grau II apresentando acometimento de três segmentos ou mais; Grau III quando associado com deformidade ou instabilidade. A reprodutibilidade intra e interobservador foi determinada pelo coeficiente Kappa (κ) de forma geral e conforme a faixa etária. Resultados: O Coeficiente Kappa obtido para a análise interobservador e intraobservador, mostrou excelente correlação geral (0,855 e 0,902, respectivamente). Quando analisados conforme a faixa etária, os resultados obtidos na correlação intraobservador mantiveram-se como excelente (κ > 0,8) em todas as faixas etárias. Na correlação interobservador, os resultados mantiveram-se excelentes, exceto na faixa etária de 40-59 anos (κ = 0,773), mas mantendo uma reprodutibilidade substancial. Conclusão: A escala de graduação da doença degenerativa lombar observada em exames de radiografia total (panorâmica) da coluna vertebral apresentou excelente reprodutibilidade tanto inter quanto intraobservador. Nível de Evidência I; Estudo diagnóstico.

ABSTRACT Objective: To present a new lumbar degenerative disease grading scale considering full spine radiography and to evaluate its inter- and intraobserver reproducibility. Methods: A total of 132 full spine radiographies in the anterior and lateral views were analyzed. The cases were independently graded by two examiners. The radiographic parameters observed were osteophytosis, loss of disc height, sclerosis and subchondral cysts, number of affected segments, deformities, and signs of instability. The grading scale was proposed as follows: Degree zero corresponded to the absence of signs of degenerative disease in the lumbar spine; Grade I – presence of signs of degenerative disease up to two segments; Grade II – involvement of three or more segments; Grade III – associated deformity or signs of instability. The intra- and interobserver reproducibility was determined by the Kappa coefficient (κ) in general and according to the age group. Results: Kappa coefficient obtained for interobserver and intraobserver analysis showed excellent overall correlation (0.855 and 0.902, respectively). When analyzed according to age, results obtained in intraobserver correlation remained excellent (κ >0.8) in all age groups. The interobserver correlation remained excellent, except in the age range of 40-59 years (κ = 0.773), although maintaining a substantial reproducibility. Conclusion: The grading scale of lumbar degenerative disease observed in full spine x-rays showed excellent inter- and intraobserver reproducibility. Level of Evidence I; Diagnostic study.

RESUMEN Objetivo: Presentar una escala de graduación de la enfermedad degenerativa lumbar en radiografías panorámicas de columna vertebral y evaluar su reproducibilidad inter e intraobservador. Métodos: Se evaluaron 132 radiografías panorámicas anteriores y laterales de columna vertebral. Los casos fueron graduados de manera independiente por dos examinadores. Los parámetros radiográficos observados fueron osteofitosis, pérdida de la altura discal, esclerosis y quistes subcondrales, número de segmentos afectados, deformidades y signos de inestabilidad. La escala de graduación que se propuso fue la siguiente: Grado cero – ausencia de signos de enfermedad degenerativa en la columna lumbar; Grado I – signos de enfermedad degenerativa hasta 2 segmentos; Grado II - compromiso de tres segmentos o más; Grado II I - deformidad asociada o signos de inestabilidad. La reproducibilidad intra e inter-observador fue determinada por el coeficiente Kappa (κ) de forma general y conforme al grupo de edad. Resultados: El coeficiente Kappa obtenido en los análisis interobservador e intraobservador mostró excelente correlación general (0,855 y 0,902, respectivamente). Cuando se analizaron según el grupo de edad, los resultados de la correlación intraobservadores se mantuve excelente (κ > 0,8) en todas las edades. En la correlación interobservadores, los resultados se mantuvieron excelentes, excepto en el edad de 40-59 años (κ = 0,773), pero manteniendo reproducibilidad sustancial. Conclusión: La escala de graduación de la enfermedad degenerativa lumbar observada en exámenes de radiografía total (panorámica) de la columna vertebral presentó excelente reproducibilidad tanto inter como intraobservador. Nivel de evidencia I; Estudio diagnóstico.

https://doi.org/10.1590/s1808-185120191801196326 2066 downloads

13.

Pertinencia de la evaluación formativa en la clase taller: un estudio de caso
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Pomares Bory, Eduardo de Jesús

; Barrrios Herrero, Liliam

; Vázquez Naranjo, Odalys

; Iglesias Ramírez, Belén

; Arencibia Flores, Lourdes

; Galvizu Díaz, Katiana

EDUMECENTRO

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Set 2018, Volume 10 Nº 3 Páginas 56 - 70

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: the formative evaluation contributes to the self-management of knowledge from a comprehensive conception of learning assessment. Objective: to assess the relevance of the use of formative assessment in the workshop classes of the subject Cells, Tissues and integumentary System. Methods: the research was developed in the "Salvador Allende" Medical Sciences Faculty, of Havana during the 2017-2018 academic year. The qualitative case study method was applied, applying the grounded theory procedure. Analysis-synthesis, induction-deduction and historical-logical were used as theoretical methods. Among the empirical ones, documentary analysis and scientific observation were applied. Results: the superficial learning approach based on the memorization of data and information was specified as the essential emerging category of the data obtained, from which the formative evaluation was applied and the feedback was developed based on the use of conceptual maps and schemes for information processing; This procedure was gradually incorporated by some students, although resistance to the change of method in independent work prevailed. Conclusions: the formative evaluation constituted a didactic alternative coherent with the learning needs that the students showed, so its use is recommended in the subjects that make up the Biological Bases of Medicine discipline.

Fundamento: la evaluación formativa contribuye a la autogestión del conocimiento a partir de una concepción integral de la evaluación del aprendizaje. Objetivo: valorar la pertinencia del uso de la evaluación formativa en las clases taller de la asignatura Células, Tejidos y Sistema Tegumentario. Métodos: la investigación se desarrolló en la Facultad de Ciencias Médicas "Salvador Allende", de La Habana durante el curso 2017-2018. Se aplicó el método de estudio de caso cualitativo, aplicando el procedimiento de la teoría fundamentada. Fueron utilizados como métodos teóricos el análisis-síntesis, la inducción-deducción y el histórico-lógico. Entre los empíricos se aplicaron el análisis documental y la observación científica. Resultados: el enfoque de aprendizaje superficial basado en la memorización de datos e información fue precisado como la categoría esencial emergente de los datos obtenidos, a partir de lo cual se aplicó la evaluación formativa y se desarrolló la retroalimentación basada en el uso de mapas conceptuales y esquemas para el procesamiento de la información; procedimiento que fue paulatinamente incorporado por algunos estudiantes, aunque prevaleció la resistencia al cambio de método en el trabajo independiente. Conclusiones: la evaluación formativa constituyó una alternativa didáctica coherente con las necesidades de aprendizaje que mostraron los estudiantes por lo que se recomienda su utilización en las asignaturas que conforman la disciplina Bases Biológicas de la Medicina.

14.

Actualización en el manejo respiratorio de pacientes con enfermedades neuromusculares
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Pinchak, Catalina

; Salinas, Pamela

; Prado, Francisco

; Herrero, María

; Giménez, Gloria

; García, Carolina

; Vito, Eduardo De

; Bach, John

Archivos de Pediatría del Uruguay

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Fev 2018, Volume 89 Nº 1 Páginas 40 - 51

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen: Los días 24 y 25 de noviembre del 2016, en Montevideo, Uruguay, tuvo lugar un encuentro de capacitación en cuidados respiratorios no invasivos con más de 200 profesionales médicos, kinesiólogos y licenciadas de enfermería. El encuentro fue presidido por el Dr. John Bach, Director Médico del Centro de Ventilación Mecánica No Invasiva en la Escuela de Medicina de Rutgers, New Jersey en Newark, New Jersey, quien es reconocido a nivel mundial por su amplia trayectoria en estudios y trabajos publicados sobre ventilación no invasiva y enfermedades neuromusculares Los cuidados respiratorios no invasivos, combinando la asistencia ventilatoria, inicialmente nocturna y luego durante las 24 horas del día, incluso en pacientes con capacidad vital mínima, y la implementación de estrategias para asistencia de la tos y respiración glosofaríngea, han contribuido a una mejor calidad de vida y sobrevida de los pacientes con enfermedades neuromusculares. Los avances tecnológicos, la capacitación de los pacientes y sus cuidadores facilitan su estadía en el hogar sin depender de instituciones o cuidados de enfermería permanentes promoviendo su autonomía e integración. Resulta esencial que los profesionales de la salud, conozcan todas las opciones terapéuticas posibles para ofrecer a sus pacientes y sus familias, de modo que, conforme avanza la enfermedad, ellos puedan expresar sus voluntades en forma anticipada y sin apremios derivados de eventos “inesperados”. Es necesario impulsar un cambio de paradigma en la forma en que los profesionales de la salud ven a estos individuos. Las recomendaciones claves de ese encuentro están resumidas en este artículo.

Summary: A November 2016 Noninvasive Ventilatory Support workshop and meeting with more than 200 medical professionals, physiotherapists, respiratory therapists and nurses took place in the city of Montevideo, Uruguay. It was conducted by Dr. John Robert Bach, Medical Director of the Center for Non-Invasive Mechanical Ventilation at Rutgers New Jersey School of Medicine in Newark, New Jersey, who is recognized worldwide for his extensive background in studies and publications on noninvasive ventilation and neuromuscular diseases. Non-invasive respiratory care which combines ventilatory support initially at night and then support continuously 24 hours per day, even in patients with minimal vital capacity combined with the implementation of specifics techniques for assisted coughing and glossopharyngeal breathing have contributed to a better quality of life and survival of patients with neuromuscular diseases. Technological advances and proper training for patients and caregivers facilitates the patient’s ability to stay at home and also promotes their autonomy and integration, without them having to depend on hospice or permanent nursing care. It is essential for health care professionals to know all the therapeutic possibilities available for their patients and share with both the patients and the patient’s family, so as the disease progresses it will help everyone clearly understand all options during conscious decision-making. It is necessary to promote a paradigm shift in the way health professionals approach individuals with neuromuscular diseases. The key recommendations from that meeting are summarized in this article.

https://doi.org/10.31134/ap.89.1.8 9792 downloads

15.

Obstrucción intestinal por peritonitis esclerosante encapsulada en un adulto con derivación ventriculoperitoneal
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Tirapo, Julia Bernal

; García Borda, Javier

; Ferrero Herrero, Eduardo

Revista chilena de cirugía

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2018, Volume 70 Nº 3 Páginas 273 - 276

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Introduction Sclerosing encapsulating peritonitis is a chronic inflammation of the peritoneum characterized by the progressive accumulation of collagen. This leads to a thickening of the peritoneum, encapsulating loops of small bowel and causing intestinal obstruction. Case report 83 year old male, carrying a ventriculoperitoneal low pressure shunt for 8 years. The patient was admitted for emergency surgery after presentation for possible intestinal obstruction with radiological findings consistent with small bowel obstruction, probably related to the catheter of the ventriculoperitoneal shunt. Surgery confirmed bowel obstruction and a change of gauge of the terminal ileum. The small bowel was dilated into a ball, encased by a small fibrous capsule. Adhesiolysis and right hemicolectomy was performed with resection of the affected bowel segment. The pathology was consistent with sclerosing encapsulating peritonitis. Conclusions Sclerosing encapsulating peritonitis is a rare and potentially serious cause of bowel obstruction and its secondary form is usually associated with chronic peritoneal dialysis. The radiological diagnosis is difficult and the treatment of choice is surgical. We must consider it in cases of intestinal obstruction in patients with ventriculoperitoneal shunt.

Resumen Introducción La peritonitis esclerosante encapsulada es una inflamación crónica del peritoneo caracterizada por la formación progresiva de colágeno que produce un engrosamiento peritoneal que encapsula las asas del intestino delgado, produciendo una obstrucción intestinal. Caso clínico Varón de 83 años portador de catéter de derivación ventriculoperitoneal de baja presión desde hacía 8 años. Acude a Urgencias por clínica de obstrucción intestinal, con hallazgos radiológicos en relación con obstrucción de intestino delgado en probable relación con catéter de derivación ventriculoperitoneal, por lo que se decide realizar intervención quirúrgica urgente. Se confirmó la obstrucción intestinal y un cambio de calibre del íleon terminal. El intestino delgado estaba dilatado formando un ovillo, englobado por una pequeña cápsula fibrosa. Se realizó adhesiólisis y hemicolectomía derecha con resección del segmento intestinal afectado. La anatomía patológica fue compatible con peritonitis esclerosante encapsulada. Conclusiones La peritonitis esclerosante encapsulada es una causa poco frecuente y potencialmente grave de obstrucción intestinal y su forma secundaria está habitualmente asociada a la diálisis peritoneal crónica. Su diagnóstico radiológico es difícil y el tratamiento de elección es quirúrgico. Debemos considerarla en casos de obstrucción intestinal en pacientes portadores de derivación ventriculoperitoneal.

https://doi.org/10.1016/j.rchic.2017.03.001 1487 downloads

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Glossário e ajuda para busca

Você pode enriquecer sua busca de uma forma muito simples. Use os índices de pesquisa combinados com os conectores (AND ou OR) e especifique cada vez mais sua busca.

Por exemplo, se você deseja buscar artigos sobre
casos de dengue no Brasil em 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

Veja abaixo a lista completa de índices de pesquisa que podem ser usados:

Cód. do Índice	Elemento
ti	título do artigo
au	autor
kw	palavras-chave do artigo
subject	assunto (palavras do título, resumo e palavras-chave)
ab	resumo
ta	título abreviado da revista (ex. Cad. Saúde Pública)
journal_title	título completo da revista (ex. Cadernos de Saúde Pública)
la	código do idioma da publicação (ex. pt - Português, es - Espanhol)
type	tipo do documento
pid	identificador da publicação
publication_year	ano de publicação do artigo
sponsor	financiador
aff_country	código do país de afiliação do autor
aff_institution	instituição de afiliação do autor
volume	volume do artigo
issue	número do artigo
elocation	elocation
doi	número DOI
issn	ISSN da revista
in	código da coleção SciELO (ex. scl - Brasil, col - Colômbia)
use_license	código da licença de uso do artigo

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