106 research outputs found

    Gastro oesophageal reflux disease (GORD)-related symptoms and its association with mood and anxiety disorders and psychological symptomology: a population-based study in women

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    Background: Psychopathology seems to play a role in reflux pathogenesis and vice versa, yet few population based studies have systematically investigated the association between gastro-oesophageal reflux disease (GORD) and psychopathology. We thus aimed to investigate the relationship between GORD-related symptoms and psychological symptomatology, as well as clinically diagnosed mood and anxiety disorders in a randomly selected, population-based sample of adult women.&nbsp;Methods:&nbsp;This study examined data collected from 1084 women aged 20-93 yr participating in the Geelong&nbsp;Osteoporosis Study. Mood and anxiety disorders were identified using the Structured Clinical Interview for DSM-IVTR Research Version, Non-patient edition (SCID-I/NP), and psychological symptomatology was assessed using the&nbsp;General Health Questionnaire (GHQ-12). GORD-related symptoms were self-reported and confirmed by medication&nbsp;use where possible and lifestyle factors were documented.Results: Current psychological symptomatology and mood disorder were associated with increased odds of&nbsp;concurrent GORD-related symptoms (adjusted OR 2.1, 95% CI 1.3-3.5, and OR 3.0, 95% CI 1.7-5.6, respectively). Current&nbsp;anxiety disorder also tended to be associated with increased odds of current GORD-related symptoms (p=0.1).&nbsp;Lifetime mood disorder was associated with a 1.6-fold increased odds of lifetime GORD-related symptoms (adjusted OR&nbsp;1.6, 95% CI 1.1-2.4) and lifetime anxiety disorder was associated with a 4-fold increased odds of lifetime GORD- related&nbsp;symptoms in obese but not non-obese participants (obese, age-adjusted OR 4.0, 95% CI 1.8-9.0).Conclusions: These results indicate that psychological symptomatology, mood and anxiety disorders are positively&nbsp;associated with GORD-related symptoms. Acknowledging this common comorbidity may facilitate recognition and&nbsp;treatment, and opens new questions as to the pathways and mechanisms of the association.</div

    Analysis of the epidemiological profile of patients actively registered in the ostomy care service in Juiz de Fora / Análise do perfil epidemiológico dos pacientes cadastrados ativamente no serviço de ostomias de Juiz de Fora

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    AIM: Population-based study on the profile of ostomized patients attended by a specialized service in the city of Juiz de Fora, Brazil. METHOD: This retrospective, cross-sectional study was based on a descriptive epidemiological model. A total of 2,406 medical records of patients registered between 1988 and 2016 were analyzed and only the records of active patients (alive, not having undergone reconstruction) were selected (507 cases). The analyzed variables were gender, age, type of stoma, and the disease that led to the need for a stoma. Statistical analyzes were performed using SPSS software, version 20.0. RESULTS: Stomata were observed in 265 male patients (52.3% of the cases). The age varied from a range of 0 to 98 years. The colostomy corresponded to 63.7% of the cases. Ileostomy was the second most common type of stoma (27%) and then the urostomy (6.5%) was the third. The main causes for stoma creation were colorectal cancer (CRC) with 59.8% of cases, bladder cancer (5.9%) and others less prevalent, such as intestinal obstruction, diverticular disease, volvulus, peritonitis, colorectal injury, and inflammatory bowel disease. CONCLUSION: Colostomy was the most frequent type and the highest prevalence of stomata that was observed in males. The age group of the most ostomized patients was between the fourth and eight decade. CRC was the main cause of a diverting stoma creation. The services of ostomized care with competent and efficient multidisciplinary teams play an important rolefor the user can overcome the possible limitations of an intestinal or urinary stoma.

    Diabetes insipidus como manifestação inicial de leucemia mieloide aguda em paciente com monossomia do cromossomo 7

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    O diabetes insipidus (DI) central é uma síndrome caracterizada pela incapacidade de concentração urinária devido à deficiência do hormônio antidiurético. O envolvimento do sistema nervoso central é frequente nas leucemias, mas a ocorrência de DI é rara e confere pior prognóstico. A patogênese do DI na leucemia não é totalmente conhecida, mas a infiltração do eixo hipotálamo-hipofisário por células leucêmicas parece ser um fator responsável. O presente relato descreve o caso de um paciente que apresentou DI como primeira manifestação de leucemia mieloide aguda e que evoluiu com dificuldades de ajustes do sódio sérico, da poliúria e da reposição volêmica, necessitando de permanência prolongada em unidade de cuidados intensivos. Palavras-chave: diabetes insipidus; leucemia mieloide aguda; monossomia; cromossomo 7

    Diabetes insipidus como manifestação inicial de leucemia mieloide aguda em paciente com monossomia do cromossomo 7

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    O diabetes insipidus (DI) central é uma síndrome caracterizada pela incapacidade de concentração urinária devido à deficiência do hormônio antidiurético. O envolvimento do sistema nervoso central é frequente nas leucemias, mas a ocorrência de DI é rara e confere pior prognóstico. A patogênese do DI na leucemia não é totalmente conhecida, mas a infiltração do eixo hipotálamo-hipofisário por células leucêmicas parece ser um fator responsável. O presente relato descreve o caso de um paciente que apresentou DI como primeira manifestação de leucemia mieloide aguda e que evoluiu com dificuldades de ajustes do sódio sérico, da poliúria e da reposição volêmica, necessitando de permanência prolongada em unidade de cuidados intensivos.Palavras-chave: diabetes insipidus; leucemia mieloide aguda; monossomia; cromossomo 7

    Upper limb revascularization with reversed vein graft and microvascular anastomoses after brachial artery aneurysm resection in a child with tuberous sclerosis

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    The authors present an unusual case of a 3-year-old girl who was diagnosed with a fast-growing brachial aneurysm due to tuberous sclerosis. The patient underwent aneurysm resection and microsurgical reconstruction with reversed greater saphenous vein graft at the same time. She had a favorable outcome, without neuromuscular deficits. Doppler ultrasonography was performed for diagnosis, vein graft selection, and postoperative follow-up. The authors believe that such combined approach may be the routine for pediatric vascular reconstructions. Finally, this reconstruction has been rarely reported in tuberous sclerosis patients

    PROCEDIMENTOS CIRÚRGICOS ROBÓTICOS EM OBSTETRÍCIA: HISTERECTOMIA, MIOMECTOMIA E CERCLAGEM

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    Evaluating the efficacy and safety of robotic surgical procedures in obstetrics requires a comprehensive approach that considers both the benefits and potential risks associated with these technologies. Detailed analysis of the surgical techniques and outcomes is essential to ensure that robotic-assisted procedures provide adequate treatment while minimizing any potential adverse effects. The efficacy of robotic surgeries in obstetrics is measured by their ability to improve surgical precision, reduce recovery times, and lower complication rates. Procedures such as robotic hysterectomy, myomectomy, and cervical cerclage are constantly being refined to enhance surgical outcomes. Clinical and laboratory studies are fundamental in testing these aspects, ensuring that the new techniques deliver the promised benefits. The safety of robotic-assisted surgical procedures is a constant concern. The technology involved, including the robotic systems and instruments, is subject to rigorous evaluation to determine its potential for causing complications, including surgical errors, equipment failures, or adverse reactions. Continuous research and regulatory review are crucial to ensure that these procedures remain safe for long-term use, especially considering their increasing application in various obstetric surgeries. In addition to the efficacy and safety for patients, the training and proficiency of surgeons using robotic systems are gaining importance. Mastering robotic surgery requires a significant investment in education and ongoing training to ensure that healthcare professionals are well-equipped to utilize these advanced technologies effectively. The standardization of operational protocols and adequate technical support are essential for the successful implementation of robotic surgery on a large scale. Furthermore, the economic implications of robotic surgeries cannot be overlooked. The costs associated with acquiring, maintaining, and operating robotic systems are considerable, and these factors must be balanced against the potential benefits in terms of patient outcomes and healthcare efficiency. In summary, evaluating the efficacy and safety of robotic surgical procedures in obstetrics is a complex process that involves multiple facets, from surgical precision and patient recovery to surgeon training and economic considerations. An integrated and continuous approach to research and development is essential to ensure that robotic surgeries offer effective and safe treatment options, contributing to advancements in obstetric care.A avaliação da eficácia e segurança dos procedimentos cirúrgicos robóticos em obstetrícia exige uma abordagem abrangente que considere tanto os benefícios quanto os possíveis riscos associados a essas tecnologias. A análise detalhada das técnicas cirúrgicas e dos resultados é essencial para garantir que os procedimentos assistidos por robôs proporcionem um tratamento adequado, minimizando quaisquer efeitos adversos potenciais. A eficácia das cirurgias robóticas em obstetrícia é medida pela capacidade de melhorar a precisão cirúrgica, reduzir os tempos de recuperação e diminuir as taxas de complicações. Procedimentos como a histerectomia robótica, miomectomia e cerclagem cervical estão constantemente sendo aprimorados para melhorar os resultados cirúrgicos. Estudos clínicos e laboratoriais são fundamentais para testar esses aspectos, garantindo que as novas técnicas ofereçam os benefícios prometidos. A segurança dos procedimentos cirúrgicos assistidos por robôs é uma preocupação constante. A tecnologia envolvida, incluindo os sistemas robóticos e os instrumentos, é submetida a uma rigorosa avaliação para determinar seu potencial de causar complicações, incluindo erros cirúrgicos, falhas de equipamentos ou reações adversas. A pesquisa contínua e a revisão regulatória são cruciais para assegurar que esses procedimentos permaneçam seguros para uso a longo prazo, especialmente considerando sua aplicação crescente em diversas cirurgias obstétricas. Além da eficácia e segurança para as pacientes, o treinamento e a proficiência dos cirurgiões no uso de sistemas robóticos estão ganhando importância. Dominar a cirurgia robótica requer um investimento significativo em educação e treinamento contínuo para garantir que os profissionais de saúde estejam bem preparados para utilizar essas tecnologias avançadas de forma eficaz. A padronização dos protocolos operacionais e o suporte técnico adequado são essenciais para o sucesso da implementação da cirurgia robótica em larga escala. Além disso, as implicações econômicas das cirurgias robóticas não podem ser negligenciadas. Os custos associados à aquisição, manutenção e operação dos sistemas robóticos são consideráveis, e esses fatores devem ser equilibrados com os potenciais benefícios em termos de resultados dos pacientes e eficiência do sistema de saúde. Em suma, a avaliação da eficácia e segurança dos procedimentos cirúrgicos robóticos em obstetrícia é um processo complexo que envolve múltiplos aspectos, desde a precisão cirúrgica e recuperação das pacientes até o treinamento dos cirurgiões e considerações econômicas. Uma abordagem integrada e contínua de pesquisa e desenvolvimento é essencial para garantir que as cirurgias robóticas ofereçam opções de tratamento eficazes e seguras, contribuindo para os avanços no cuidado obstétrico
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