Narrazioni affettive nella gestione del diabete di tipo 1. Studio pilota di una triade familiare

Il diabete mellito tipo 1 è una malattia cronica dovuta ad un disordine metabolico ad eziologia multipla. Definita da Bury (2005) come una “discordanza biografica”, il suo trattamento si basa sul coinvolgimento attivo delle famiglie e rende necessario una riorganizzare della vita quotidiana del paziente e della famiglia. Lo studio ha lo scopo di analizzare le interazioni di una triade familiare in termini di modalità enabling (facilitante) e constraining (ostacolante) e l’influenza sulla salute del ragazzo di queste modalità comunicative. Gli strumenti self report, come la Scala degli ambiti di discussione familiari (Gambini, 2008) per il tema scelto e il Sample Diabetes Questionnaire (SDQ) dello Stanford Patient Education Research Center (2007), per la salute del paziente, hanno affiancato lo strumento Constraining and Enabling Coding System (CECS; Hauser, et al.1991 adattato da Chiarolanza, et al. 2016) per le analisi dell’interazione videoregistrata di una triade familiare. Dall’analisi delle interazioni emerge che le forme comunicative nella triade si orientano verso modalità comunicative della dimensione cognitiva vincolante. Questo sembra interferire sul monitoraggio della glicemia e sul rapporto del figlio col medico. La modalità con cui i membri di una triade riescono a coordinarsi o non, dunque, durante un’interazione sembra avere effetti sulla salute dell’adolescente sia declinata come qualità delle relazioni familiari che di benessereThe type 1 diabetes mellitus is a chronic disease caused by a metabolic disorder with multiple etiologies. Defined by Bury (2005) as a "biographical disagreement ", its treatment is based on the active involvement of families and makes it necessary to reorganize both patient daily life and his/her family one. This paper aims to analyze the interactions of a family triad in terms of enabling and constraining style and how this type of communication has an impact on the child health. We utilized for this study self-report questionnaires and Constraining and Enabling Coding System (CECS; Hauser, et al.,1991 adapted by Chiarolanza, et al., 2016) for analysis of a family triad interaction. Results showed that interactive communication in the triad are oriented towards constraining cognitive dimension. This could interfere with blood glucose monitoring and the patient relationship with integrated team care. Members of a triad can coordinate or not during a family interaction and this could have effects on adolescent health in terms of quality of family relationships and well bein

Effect of Substrates and Thermal Treatments on Metalorganic Chemical Vapor Deposition-Grown Sb2Te3 Thin Films

Antimony telluride (Sb2Te3) thin films were obtained by metalorganic chemical vapor deposition (MOCVD). The films were grown on crystalline Si(100) and Al2O3(0001) and amorphous SiO2 and alpha-Al2O3 substrates. Their structural properties were compared with those of the Sb2Te3/Si(111) heterostructure. In addition to the effect of the substrate, the influence of pre- and post-growth thermal annealing is also presented. The quality of the films is discussed by comparing their morphological properties, such as roughness and granularity, and ascertaining their crystallinity and their in-plane and out-of-plane orientation

Diagnostic Delay in Oncology: A Case Report of Metastatic Seminoma

Germ cell tumours are the most common malignancy among young men; cryptorchidism is a possible risk factor for the development of testicular cancer. Psycho-oncology studies indicate that diagnostic delay can often be explained by different social conditions and that symptoms worsened under lack of appropriate treatment can lead to an urgent admission to the hospital. Nevertheless, germ cell tumours are considered curable malignancies even in advanced stages since the introduction of a chemotherapy regimen based on bleomycin, etoposide and cisplatin. Cell lines derived from germ cell tumours are sensitive to cisplatin-based treatment more than other solid cancers, which is reflected in the good clinical response. We report an unusual manifestation of malignancy in an adult man presenting with a metastatic seminoma of the left testicle. The large ulcerate and necrotic mass suggested a secondary infection from a tumour site. The patient reported surgical orchiopexy for left cryptorchidism in his childhood. Despite worsening of physical features, he had not sought help at the hospital for social reasons. The patient achieved complete clinical remission after receiving standard chemotherapy, and a good objective response of the primitive mass was clearly visible. Complete response was persistent at the 30-month clinical follow-up. The chemotherapy administration was later complicated by acute haemorrage in the site of the primitive tumour that needed urgent surgical management; in addition to this, the artificial graft material was rejected and the arterial prosthesis had to be removed

Retroperitoneal cellular schwannoma (CS): a potential pitfall of malignancy. Report of a case and review of the literature

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Looking for an objective parameter to identify early vocal dysfunctions in healthy prceived singers

The finding of minimal laryngeal dysfunctions in professional voice users is essential to prevent the onset of organic vocal pathologies. The purpose of this study is to identify an objective parameter that supports the phoniatric evaluation in detecting minimal laryngeal dysfunctions in singers. 54 professional and non-professional singers have been evaluated with laryngostroboscopy, Multi-Dimensional Voice Program (MDVP), Dysphonia Severity Index (DSI), maximum phonation time (TMF), minimum intensity of sound emission (I-min), maximum frequency (F-max), voice handicap index (VHI), singing voice handicap index (SVHI), manual phonogram and audiometric examination. The SVHI of all the “healthy” singers was on average 23.7 ± 22.5, while that of the “dysfunctional” 20.9 ± 18. No statistically significant difference was found between the SVHI scores of the total of healthy singers compared to the scores of the dysfunctional ones on the VSL (p = 0.6). The between-group comparison of the means of individual parameter values of DSI, TMF, F-max, Jitter, Shimmer, NHR, and SPI was not statistically significant (respectively p = 0.315, 0.2, 0.18, 0.09, 0.2, 0.08, 0.3). The only parameter analyzed that was statistically significant was the I-min (p < 0.05). SVHI is a valid instrument for the evaluation after a therapy but in our experience, it is not useful in distinguishing healthy from dysfunctional patients. The minimum intensity of sound emission measured with the sound level meter (I-low2) resulted a reliable parameter to identify minimal laryngeal dysfunctions and a useful tool in supporting the phoniatric diagnostic-therapeutic process in singers

Dye-sensitized solar cells: a successful combination of materials

Dye-sensitized TiO2 solar cells, DSSC, are a promising alternative for the development of a new generation of photovoltaic devices. DSSC are a successful combination of materials, consisting of a transparent electrode coated with a dye-sensitized mesoporous film of nanocrystalline particles of TiO2, an electrolyte containing a suitable redox-couple and a Pt coated counter-electrode. In general, Ru bipyridyl complexes are used as the dye sensitizers. The light-to-energy conversion performance of the cell depends on the relative energy levels of the semiconductor and dye and on the kinetics of the electron-transfer processes at the sensitized semiconductor | electrolyte interface. The rate of these processes depends on the properties of its components. This contribution presents a discussion on the influence of each of the materials which constitute the DSSC of the overall process for energy conversion. An overview of the results obtained for solid-state dye-sensitized TiO2 solar cells assembled with polymer electrolytes is also presented.As células solares de TiO2/corante são uma alternativa promissora para o desenvolvimento de uma nova geração de dispositivos fotovoltaicos. Estas células resultam de uma bem sucedida combinação de materiais: um eletrodo transparente revestido com um filme poroso de partículas nanocristalinas de TiO2 sensibilizadas com um corante, um eletrólito contendo um par redox adequado e um contra-eletrodo revestido com platina. Em geral, utilizam-se complexos bipiridínicos de Ru como corantes fotosensibilizadores. O desempenho da célula na conversão de luz em eletricidade depende dos níveis de energia do semicondutor e do corante, e da cinética dos processos de transferência de elétrons na interface semicondutor | eletrólito. Esta revisão apresenta uma discussão da influência de cada um dos materiais que constituem as células solares de TiO2/corante no processo de conversão de energia, com ênfase aos resultados obtidos para células solares de estado sólido, preparadas com um eletrólito polimérico.898901Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Diversidad y biomasa de macroinvertebrados asociados acuatro tipos de sustratos en la laguna La Virginia, páramo Sumapaz, Colombia

For macroinvertebrates inhabiting lentic systems, quantity and availability of various substrates are important for the establishment and development of different assemblages, also, the biome reflects macroinvertebrates system production. In this study, the diversity was estimated from the biomass present in the four substrates: macrophyte (Myriophyllum aquaticum), rock, sediments and organic matter, it was analyzed the seasonal variation of biomass and abundance considering three hydrological periods. It was collected 2.957 individuals grouped in 17 genera and 11 orders. Helobdella was the dominant taxon, it contributes to 90% of the total biomass of the community; Hyalella, Tanytarsus and Centrocorisa were important too. Electric conductivity, sulfates and the water temperature were determined for the biomass. The dominance of macroinvertebrates was higher in macrophyta (0,99). In the rest of the substrates, diversity was larger (ï = 1,5 nats.ind-1) and the evenness minor (ï = 0,24). There are significant differences in the registers of biomass among the substrates but not among the campaigns. In conclusion, macrophyte was the substrate and the habitat most used by macroinvertebrates and it contains more individuals; however, the macrophyte was not the most diversity substrates because, when it was compared with other three substrates the diversity is higher.mporal de la biomasa y la abundancia con base en tres períodos hidrológicos. Se colectaron 2.957 individuos (17 géneros, 11 órdenes). Helobdella fue el taxón dominante aportando 90 % a la biomasa total de la comunidad, seguido de Hyalella, Tanytarsus y Centrocorisa. La conductividad, los sulfatos y la temperatura hídrica fueron determinantes para la biomasa. En la macrófita se encontró menor diversidad de Hâ (0,03 nats.ind-1) y mayor dominancia (0,99); en el resto de sustratos la diversidad fue mayor (ï = 1,5) y la dominancia menor (ï = 0,24). Se encontraron diferencias significativas en los registros de biomasa entre sustratos más no entre campañas. En conclusión, el sustrato macrófita es el hábitat más utilizado por los macroinvertebrados pues alberga mayor cantidad de individuos; sin embargo, no presenta la mayor diversidad, a diferencia de los otros tres sustratos que evidencian mayor diversidad de taxones

Conformational analysis of protonated cyclo-[(S)-phenylalanyl-(S)-histidyl] and its complex with benzaldehyde within metal-organic frameworks (MOFs)

The conformational analysis of protonated cyclo-[(S)-phenylalanyl-(S)-histidyl], denoted as cyclo-[(S)-Phe-(S)-His-H+], within a cavity of a new IRMOFs-phen (isoreticular metal-organic frameworks with a 2,7-dicarboxylate phenanthrene substituted bridges) porous material was performed with the AM1 quantum chemical method. Two forms of cyclo-[(S)-Phe-(S)-His-H+] were considered: the bound-form, where the peptide is chemically linked to the phenanthrene moiety and the unbound-form where the peptide is free within the cavity. The most probable conformers of cyclo-[(S)-Phe-(S)-His-H+] within the cavity have been compared to the conformers in gas phase and in water, simulated by the implicit solvent SM5.4 model. The preferred conformations within the IRMOF-phen cavity are the (g-, g+) and (t, g+) in contrast to the gas and aqueous phases. The environment within the cavity is also relevant, since the substitution of a hydrogen atom by CH3 (IRMOF-phen-CH3) or Br (IRMOF-phen-Br) lead to new IRMOFs-phen that changes drastically the conformer populations, as well as the adsorption site of the dipeptide. These results have important implications in controlling the stereoselectivity of reactions in the presence of chiral inductors. Indeed, this is the first time that a folded conformation of cyclo-[(S)-Phe-(S)-His-H+] was found, as well as an stable cyclo-[(S)-Phe-(S)-His-H+]-benzaldehyde complex was obtained using the ONIOM(PBE1:AM1) method. This complex is compatible with the proposed structure for the transition state of the hydrocyanation of benzaldehyde that explains the observed enantioselectivity

Efeitos da cinesioterapia no assoalho pélvico durante a gravidez

OJETIVE: The objective of the present study was to evaluate the effect of pelvic floor muscle training in 46 nulliparous pregnant women. METHODS: The women were divided into 2 groups: an exercise group and a control group. Functional evaluation of the pelvic floor muscle was performed by digital vaginal palpation using the strength scale described by Ortiz and by a perineometer (with and without biofeedback). RESULTS: The functional evaluation of the pelvic floor muscles showed a significant increase in pelvic floor muscle strength during pregnancy in both groups (P < .001). However, the magnitude of the change was greater in the exercise group than in the control group (47.4% vs. 17.3%, P < .001). The study also showed a significant positive correlation (Spearman's test, r = 0.643; P < .001) between perineometry and digital assessment in the strength of pelvic floor muscles. CONCLUSIONS: Pelvic floor muscle training resulted in a significant increase in pelvic floor muscle pressure and strength during pregnancy. A significant positive correlation between functional evaluation of the pelvic floor muscle and perineometry was observed during pregnancy.INTRODUÇÃO: A gravidez traz importantes modificações hormonais e anatômicas que têm efeito sobre a musculatura do assoalho pélvico. A cinesioterapia aplicada à musculatura do assoalho pélvico na gestação pode ser grande aliada no controle das alterações músculo-esqueléticas. OBJETIVOS: Avaliar efeitos da cinesioterapia no assoalho pélvico durante a gravidez, por meio da perineometria com e sem "biofeedback" e da avaliação funcional do assoalho pélvico, e correlacionar os valores da avaliação funcional com as perineometrias. MÉTODOS: Estudamos 46 gestantes nulíparas em seguimento pré-natal no Departamento de Obstetrícia do Hospital das Clínicas da Universidade de São Paulo, entre novembro de 2003 e dezembro de 2004, com até 20 semanas de gestação, atendidas no Setor de Baixo-Risco, divididas em dois grupos: Grupo exercício (23 casos): pacientes submetidas à cinesioterapia para a musculatura do assoalho pélvico; e grupo controle (23 casos): sem a prática da cinesioterapia. Por 12 semanas, até a 36ª semana, seguiu-se um protocolo, com treinamento de 60 minutos semanais, executando-se quatro séries de 10 contrações destes músculos com seis segundos de manutenção e 12 segundos de relaxamento, em decúbitos distintos. Realizaram-se 2 avaliações: 1ª (até 20 semanas) e 2ª (36 semanas gestacionais), por meio da avaliação funcional do assoalho pélvico e da perineometria. RESULTADOS: Na avaliação funcional do assoalho pélvico, tanto o grupo exercício como o grupo controle apresentaram aumento significativo da 1ª avaliação para a 2ª avaliação. Para a perineometria sem "biofeedback", na 2ª avaliação, somente o grupo exercício obteve aumento significativo, com p < 0,001. Quanto à perineometria com "biofeedback", tanto o grupo exercício como o controle tiveram aumento significativo nos valores, porém o delta porcentual foi maior no grupo exercício. Houve correlação significativa e positiva entre a avaliação funcional do assoalho pélvico e as perineometrias sem e com "biofeedback" nas duas primeiras avaliações. CONCLUSÕES: Os efeitos da cinesioterapia nos músculos do assoalho pélvico revelaram aumento significativo na pressão e na força durante a gestação. Durante o período gestacional houve correlação positiva e significativa entre a avaliação funcional do assoalho pélvico e as perineometrias

A solitary pink lesion: dermoscopy and RCM features of lichen planus

We present an unusual onset of cutaneous lichen planus (LP) in a middle-aged patient. The initial presentation as solitary, indolent pink lesion required further investigations to rule out malignancy, especially amelanotic melanoma. Dermoscopy and reflectance confocal microscopy findings were found to be helpful in our case in addressing the correct diagnosis