La calidad de vida de las madres de niños trabajadores en las calles de São Paulo, Brasil

The present study evaluated the perceived quality of life of the mothers of street children and investigated the association with their history of childhood violence, the occurrence of current domestic violence, their current mental states and that of their children, and family functioning. the applied instruments were as follows: Strengths and Difficulties Questionnaire, WorldSAFECore Questionnaire, Instrument for the Assessment of Quality of Life of the WHO, Global Assessment of Relational Functioning Scale, Childhood Trauma Questionnaire and a socio-demographic questionnaire. the sample of convenience consisted of 79 low-income mothers who raised their children alone, and most of whom had a positive screening for mental illness. the multiple regression analysis showed that the perception of quality of life of these women was associated with the presence of psychopathology either in themselves or their children and family dysfunction. Thus any program aimed at improving the quality of life of such mothers should consider addressing their mental problems as well as those of their children, besides offering educational and psychotherapeutic approaches to these families to improve the social environment.Universidade Federal de São Paulo, Dept Psiquiatria, BR-04038020 São Paulo, SP, BrazilUniv São Paulo, Inst Matemat & Estat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psiquiatria, BR-04038020 São Paulo, SP, BrazilWeb of Scienc

Changes in attachment dimensions during the treatment of acute post-traumatic stress disorder in sexually assaulted Brazilian women

Introduction: Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Methods: Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. Results: At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Discussion: Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD

Validation of the Brazilian-Portuguese version of the Clinician Administered Post Traumatic Stress Disorder Scale-5

Objectives: The aim of this study was to validate CAPS-5 for the Brazilian-Portuguese language on a sample of 128 individuals from two centers (from the cities of São Paulo and Porto Alegre) who have been recently exposed to a traumatic event. Methods: We performed a reliability analysis between interviewers (with a subset of 32 individuals), an internal consistency analysis, and a confirmatory factorial analysis for the validation study. Results: The inter-rater reliability of the total PTSD symptom severity score was high [intraclass correlation coefficient =0.994, 95% CI (0.987–0.997), p < 0.001]. Cohen’s Kappa for individual items ranged between 0.759 and 1. Cronbach’s alpha coefficients indicated high internal consistency for the CAPS-5 full scale (α = 0.826) and an acceptable level of internal consistency for the four symptom clusters. The confirmatory factorial analysis for the 20-item original CAPS-5 did not fit the data well. A 15-item model with better results was then established by excluding the following CAPS-5 items: dissociative amnesia, recklessness, distorted cognitions, irritability, and hypervigilance. Conclusion: Despite the limitation of the predominance of female victims, and the high number of sexually assaulted women in our sample, the model with only 15 items provided a good fit to the data with high internal consistency (α = 0.835)

Tumor de Frantz em paciente do sexo feminino com diarreia: relato de caso de neoplasia pancreática rara

O tumor pseudopapilar sólido, também conhecido como tumor de Frantz, é um tumor raro do pâncreas. Relatamos o caso de uma paciente de 25 anos com dor abdominal, febre, diarréia e perda de peso.TC de abdome com contraste revelou pâncreas alargado com lesão hipodensa de aparência nodular e calcificações periféricas. Foi decidido realizar pancreatectomia subtotal com linfadenectomia e optou-se pela esplenectomia com biópsia hepática intra-operatória. O anatomopatológico da ressecção cirúrgica do tumor pancreático revelou tumor pseudopapilar sólido compatível com o tumor de Frantz. A imuno-histoquímica confirmou os achados histopatológicos. Ela evoluiu com fístula pancreática e pancreatite resolvida após 15 dias. Atualmente, está sendo acompanhada ambulatorialmente em nosso serviço com remissão completa dos sintomas.Solid pseudopapillary tumor, also known as frantz tumor, is a rare tumor of the pancreas. We report a case of 25-year-old female patient with abdominal pain, fever, diarrhea and weight loss. Contrast abdominal CT showed enlarged pancreas with a hypodense lesion of nodular appearance and peripheral calcifications.It was decided to perform subtotal pancreatectomy with lymphadenectomy, and opted for splenectomy and intraoperative liver biopsy. The pathology of surgical resection of the pancreatic tumor showed solid pseudopapillary tumor compatible with Frantz’s tumor. Immunohistochemistry confirmed histopathological findings. She evolved with pancreatic fistula and pancreatitis resolved after 15 days. Currently, it is being followed up in our service with complete remission of symptoms

Neuropatia pós artroplastia de quadril: uma abordagem terapêutica e reabilitacional

Hip arthroplasty is a common surgical procedure to treat debilitating hip conditions such as arthritis and fractures. Although effective, the surgery can lead to post hip arthroplasty neuropathy (PHAN), a complication that affects up to 3% of patients and results in neuropathic pain and muscle weakness. In this scenario, given the high morbidity associated with CQA, this study aims to assess the importance of early rehabilitation, with a multidisciplinary approach, in an attempt to minimize neuropathic damage related to surgical manipulation. To develop this study, a literature review was carried out by collecting original articles published in the last 20 years, in English and Portuguese, in the main reference databases such as SciELO and PubMed, in order to ensure greater reliability of the information presented. Analysis of the studies revealed that various modalities can be associated in an attempt to minimize the damage related to CCAE, including physiotherapy, pharmacotherapy and, in some cases, a surgical approach. Although they can be associated with the late postoperative period, there is a better prognosis when interventions are carried out preoperatively and intraoperatively, as well as in the immediate postoperative period. Thus, the earlier the rehabilitation process begins, especially if it is multimodal, the better the patient's recovery of mobility, which tends to lead to an earlier return to work and normal activities, the lower the endocrine-metabolic and immunological response to surgical trauma, which also reduces the pain associated with neuropathy, as well as undoubtedly improving the quality of life of individuals affected by the disease.A artroplastia de quadril é um procedimento cirúrgico comum para tratar condições debilitantes do quadril, como artrite e fraturas. Embora eficaz, a cirurgia pode levar à neuropatia pós-artroplastia de quadril (NCAQ), uma complicação que afeta até 3% dos pacientes e resulta em dor neuropática e fraqueza muscular. Nesse cenário, tendo em vista a alta morbidade associada à NCAQ, este estudo objetiva avaliar a importância da reabilitação precoce, com enfoque multidisciplinar, na tentativa de minimizar os danos neuropáticos relacionados à manipulação cirúrgica. Para o desenvolvimento do presente estudo, foi realizada uma revisão bibliográfica mediante a coleta de artigos originais, publicados nos últimos 20 anos, em língua inglesa e portuguesa, nas principais bases de referência de dados, como SciELO e PubMed, a fim de garantir maior confiabilidade às informações apresentadas. A partir da análise dos estudos, percebeu-se que diversas modalidades podem ser associadas na tentativa de minimizar os danos relacionados à NCAQ, dentre elas, tem-se&nbsp; a fisioterapia, farmacoterapia e, em alguns casos, uma reabordagem cirúrgica. Embora possam ser associadas ao pós-operatório tardio, observa-se um melhor prognóstico quando as intervenções são feitas de forma pré e intra-operatória, além do pós-operatório imediato. Assim, quanto mais precoce o início do processo de reabilitação, principalmente se multimodal, melhor a recuperação da mobilidade pelo paciente, que tende ao retorno mais precoce às atividades laborais e habituais, menor a resposta endócrino-metabólica e imunológica ao trauma cirúrgico, que reduz, também, os quadros álgicos associados à neuropatia, além de melhorar, indiscutivelmente, a qualidade de vida dos indivíduos acometidos pela doença

Implicações da radiação na saúde dos profissionais que utilizam a fluoroscopia na prática diária: Implications of radiation on the health of professionals who use the fluoroscopy in daily practice

O presente estudo tem como objetivo analisar as implicações da radiação na saúde dos profissionais que utilizam o arco cirúrgico na prática diária. Neste estudo foi realizada uma revisão sistemática da literatura. Para seleção das publicações foram considerados como critérios de inclusão estar disponível em formato completo, publicado nos últimos cinco anos (2018-2022), escritas em língua portuguesa e inglesa. E como critérios de exclusão foram considerados estar foram do tema de pesquisa, ser revisão de literatura e repetido na base de dados. Os critérios de inclusão e exclusão foram considerados como meio de validade metodológica. Concluiu-se a partir desse estudo que apesar de baixos níveis de radiação emitidos por arco cirúrgico, os riscos ainda são significativos, verificando-se a necessidade de conscientização dos profissionais de saúde sobre a proteção necessária para mitigação das implicações, principalmente, entre os menos experientes.&nbsp