Prevención de la reincidencia del embarazo en adolescentes

OBJECTIVE: to evaluate the effectiveness of an educational family planning program in preventing the recurrence of teen pregnancy. METHODS: this was a retrospective study conducted in the department of Family Planning of the Federal University of São Paulo. The sample consisted of 264 patients who had at least one pregnancy. RESULTS: participants reported an average age of menarche at 12.2 years old. Their first sexual intercourse occurred at 15 years old and their age at the first pregnancy was 16 years old. In addition, 73.5% of the participants reported more than one pregnancy. Following educational family planning program, use of condoms, and birth control pills were the most used contraceptives methods; 4.9% of teens had a recurrence of pregnancy. CONCLUSION: the findings of this study support the importance and effectiveness of an educational family planning program in preventing recurrence of teen pregnancy.OBJETIVO: evaluar los efectos de un programa educativo y asistencial frente a la reincidencia de embarazo en adolescentes. MÉTODOS: estudio descriptivo y retrospectivo, realizado en el sector de Planificación Familiar de la Universidad Federal de São Paulo a partir de datos recolectados en 264 historias clínicas de adolescentes que tenían como antecedente al menos un embarazo anterior a la matrícula. RESULTADOS: los datos revelan que la menarquia ocurrió, en promedio, a los 12,2 años, la primera relación a los 15 y el primer embarazo un año después. Al matricularse en el programa el 73,5% poseían una gestación y el 2% dos. El condón y las hormonas fueron los anticonceptivos más utilizados. La reincidencia de embarazo fue observada en el 4,9% de las adolescentes. CONCLUSIONES: los datos encontrados refuerzan la importancia del ofrecimiento de programas de planificación familiar que abarquen la educación y la asistencia con la oferta de métodos anticonceptivos volcados a las adolescentes.OBJETIVO: avaliar os efeitos de um programa educativo e assistencial frente a reincidência de gestação em adolescentes. MÉTODOS: estudo descritivo e retrospectivo, realizado no setor de Planejamento Familiar da Universidade Federal de São Paulo (UNIFESP) a partir de dados coletados em 264 prontuários de adolescentes que tinham como antecedente ao menos uma gravidez anterior a matrícula. RESULTADOS: os dados revelam que a menarca ocorreu, em média, aos 12,2 anos, a sexarca aos 15 e a primeira gravidez um ano após. Ao se matricularem no programa 73,5% possuíam uma gestação e 2% duas. O condom e os hormonais foram os contraceptivos mais utilizados. A reincidência de gravidez foi observada em 4,9% das adolescentes. CONCLUSÕES Os dados encontrados reforçam a importância do oferecimento de programas de planejamento familiar, que englobem a educação e a assistência com oferta do método contraceptivo, voltados a adolescentes.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Departamento de ObstetríciaUniversidade Federal de São Paulo (UNIFESP) Departamento de GinecologiaUNIFESP, Depto. de EnfermagemUNIFESP, Depto. de ObstetríciaUNIFESP, Depto. de GinecologiaSciEL

Comparação entre três técnicas regionais de analgesia pós-operatória em crianças com ropivacaína Comparación entre tres técnicas regionales de analgesia postoperatoria en niños con ropivacaina Comparison among three techniques of postoperative regional analgesia with ropivacaine in children

JUSTIFICATIVA E OBJETIVOS: A dor pós-operatória acarreta um aumento nos gastos e gera insatisfação dos pais com relação à prescrição analgésica para os seus filhos. A ropivacaína apresenta larga margem de segurança em anestesia regional em pediatria. O objetivo deste estudo foi comparar a anestesia peridural sacra (PS) com o bloqueio dos nervos ileoinguinal/ileohipogástrico (BIHII) e com a infiltração da ferida operatória (IFO) utilizando a ropivacaína para a analgesia pós-operatória em crianças. MÉTODO: Foram estudadas 87 crianças do sexo masculino, com idade entre 1 e 5 anos, submetidas a herniorrafias inguinais eletivas unilaterais. As crianças receberam de forma aleatória a PS, o BIHII ou a IFO. Pesquisou-se a necessidade de analgésico no pós-operatório, o tempo necessário para a sua 1ª dose, a intensidade da dor e o grau de bloqueio motor. RESULTADOS: No Grupo da IFO observou-se maior necessidade de analgésicos, e maior intensidade de dor nas primeiras duas horas, quando comparada com a PS e com o BIHII. Apenas crianças submetidas a PS apresentaram bloqueio motor de grau leve. O tempo médio da necessidade da 1ª dose de analgésico foi semelhante entre os grupos. CONCLUSÕES: O BIHII apresentou superioridade sobre a IFO, sobretudo nas primeiras duas horas de pós-operatório. As três técnicas anestésicas podem ser utilizadas com segurança e eficácia no controle da dor pós-operatória de herniorrafia inguinal em crianças.<br>JUSTIFICATIVA Y OBJETIVOS: El dolor postoperatorio acarrea un aumento en los gastos y genera una insatisfacción de los padres en relación a la prescripción analgésica para sus hijos. La ropivacaína presenta un amplio margen de seguridad en anestesia regional en pediatría. El objetivo de este estudio fue el de comparar la anestesia peridural sacra (PS) con el bloqueo de los nervios ileoinguinal/ileohipogástrico (BIHII) y con la infiltración de la herida operatoria (IFO) utilizando la ropivacaína para la analgesia postoperatoria en niños. MÉTODO: Se estudiaron 87 niños del sexo masculino, con edad entre 1 y 5 años, sometidos a herniorrafias inguinales electivas unilaterales. Los niños recibieron aleatoriamente la PS, el BIHII o la IFO. Se investigó la necesidad de analgésico en el postoperatorio, el tiempo necesario para su primera dosis, la intensidad de dolor y el grado de bloqueo motor. RESULTADOS: En el grupo de la IFO se observó una mayor necesidad de analgésicos, y una mayor intensidad de dolor en las 1ª y 2ª horas, cuando se comparó con la PS y el BIHII. Apenas niños sometidos a PS presentaron bloqueo motor de grado moderado. El tiempo promedio de la necesidad de la primera dosis de analgésico fue similar entre los grupos. CONCLUSIONES: El BIHII presentó una superioridad sobre la IFO, especialmente en las primeras dos horas del postoperatorio. As tres técnicas anestésicas pueden ser utilizadas con seguridad y eficacia en el control de dolor postoperatorio de herniorrafia inguinal en niños.<br>BACKGROUND AND OBJECTIVES: Postoperative pain increases cost and generates dissatisfaction among parents regarding to the analgesics prescribed to their children. Ropivacaine has a broad safety margin to be used for regional block in pediatric patients. The aim of this study was to compare caudal epidural block (CE) with ilioinguinal/iliohypogastric nerve block (IINB) and infiltration of surgical wound (ISW) with ropivacaine for postoperative analgesia in children. METHODS: Eighty-seven children, all males, ages 1 to 5, who underwent elective unilateral inguinal herniorrhaphy participated in this study. Children were randomly assigned to receive CE, IINB, or ISW. The need for postoperative analgesia, length of time until the first dose, severity of pain, and degree of the motor blockade were evaluated. RESULTS: The need for analgesia and pain severity in the first two hours were greater for the ISW Group when compared with the CE and IINB Groups. Only the children in the CE Group presented a mild motor blockade. The mean length of time until de 1st dose of analgesic was similar in all groups. CONCLUSIONS: Ilioinguinal/iliohypogastric nerve block was superior to ISW, especially in the first two hours after the surgery. The three anesthetic techniques can be safely and effectively used to control postoperative pain in inguinal herniorrhaphy in children

Reverse inference of memory retrieval processes underlying metacognitive monitoring of learning using multivariate pattern analysis

Monitoring of learning is only accurate at some time after learning. It is thought that immediate monitoring is based on working memory, whereas later monitoring requires re-activation of stored items, yielding accurate judgements. Such interpretations are difficult to test because they require reverse inference, which presupposes specificity of brain activity for the hidden cognitive processes. We investigated whether multivariate pattern classification can provide this specificity. We used a word recall task to create single trial examples of immediate and long term retrieval and trained a learning algorithm to discriminate them. Next, participants performed a similar task involving monitoring instead of recall. The recall-trained classifier recognized the retrieval patterns underlying immediate and long term monitoring and classified delayed monitoring examples as long-term retrieval. This result demonstrates the feasibility of decoding cognitive processes, instead of their content

Sex differences on emotional processing are modulated by subclinical levels of alexithymia and depression: a preliminary assessment using event-related potentials

Several studies have suggested that women are more sensitive than men to emotions in general. Event-related potential (ERP) studies have demonstrated N2 and P3b modulations, suggesting that women allocate more attentional resources to emotions than men do. However, the exact origin of this emotional modulation by sex is still a matter of debate. We wondered whether these sex differences might be due to some specific personality traits of women and men. Thirty participants (15 males and 15 females) were selected so that there were no sex differences on alexithymia, or depression and anxiety scales. The participants were asked to complete a \u201cmodified emotional\u201d oddball task, in which they had to detect deviant stimuli among frequent neutral ones as quickly as possible. Behavioral performance, N2 and P3b ERP data were analyzed. When personality factors were controlled for, the sex differences on N2 and P3b components of the ERPs disappeared. Moreover, linear regression analyses showed that alexithymia was much better than sex at predicting the N2 latencies, while depression was the best factor for predicting the P3b latency. These results suggest that personality factors should be taken into account when sex differences on emotional processing are investigated

Adverse effect of beta-tricalcium phosphate with zeta potential control in repairing critical defects in rats' calvaria

ABSTRACT OBJECTIVE: To evaluate whether a new biphasic cement composed of calcium sulfate and beta tricalcium phosphate with zeta potential control could induce or lead to bone neoformation in critical defects. METHODS: A critical defect of diameter 8 mm was made in the calvaria of forty male Wistar rats. In the Test Group (n = 20), the defects were filled with cement. In the Control Group (n = 20), the defect was not filled and only coagulum was present. The animals were sacrificed 7, 14, 21 and 42 days after the operation. Calvaria specimens were subjected to microtomography and were then prepared for histological analysis. The analyses included morphological assessment on the histopathology of the repair; comparative morphometric evaluation of the area of formation of bone trabeculae between the groups; and histochemical staining by means of tartrate-resistant phosphatase (TRAP) in order to identify osteoclasts. RESULTS: Microtomographic images of the defects filled by the cement did not show any decrease in area over the course of postoperative evolution. In the Test Group, the material continued to present a foreign-body response until the last observational periods. Histomorphological analysis showed that there were more significant groupings of giant cells in the Test Group and greater maturity of neoformed bone in the Control Group. Exogenous material was also present. Histomorphometric analysis showed that in the Control Group, the total area of bone neoformation was significantly greater (p = 0.009) and grew progressively. The giant cells presented a positive reaction to TRAP but no osteoclasts were observed. CONCLUSION: The ceramic cement did not induce or lead to bone neoformation from the microtomographic or histological point of view

Incidental thyroid carcinomas. A retrospective study

The aim of the present study is to report our series of incidental thyroid carcinomas in the last 15 years and their follow-up, discussing therapeutics indications and surgical choices