Rhinoplasty—Do Patients and Surgeons See the Same? A Double-Blind Study with 100 Randomized Patients

2018 ◽  
Vol 34 (04) ◽  
pp. 356-362 ◽  
Author(s):  
Mariline Santos ◽  
Diogo Carmo ◽  
José Neves ◽  
Cecília Sousa ◽  
Frank Datema ◽  
...  
Keyword(s):  
Subjective Evaluation ◽  
Cross Sectional Study ◽  
Clear Understanding ◽  
Double Blind Study ◽  
Double Blind ◽  
Cross Sectional ◽  
The North ◽  
Key Points ◽  
South Portugal ◽  
Level Of Agreement

AbstractOne of the key points of a successful rhinoplasty is communication between the patient and surgeon. The surgeon needs to get a clear understanding of the patient's motivation for surgery and expectations of the procedure. This information is mandatory in formulating an optimal surgical plan and managing realistic expectations of the procedures. Ideally, surgeons and patients see, discuss, and quantify the same nasal defects. In reality, the subjective nature of perceiving aesthetics can cause variability of inter-rating nasal appearance. Therefore, one might question how well surgeons understand their patients. Do they see what patients see? The aim of this study is to assess the level of agreement on the evaluation of nasal appearance between patients, surgeons, and nonphysicians observers, and try to find predictive factors that cause high interobserver variability. This prospective, observational, and cross-sectional study was performed on a total of 100 randomized patients undergoing rhinoplasty. All patients were photographed before surgery and asked to rate the appearance of their nose on a 10 cm visual analogue scale (VAS) with 0 indicating very ugly and 10 indicating very nice. Subsequently, the photographs of each patient were, independently, rated by two panels: one constituted by two rhinoplasty surgeons and the other by four nonmedical raters. Both panels included European raters from the north (The Netherlands) and south (Portugal). Data regarding age, gender, skin type, and major nasal deformity were also collected. The authors found that there is no statistical agreement between the aesthetical evaluation of the nose between patients and surgeons or patients and nonmedical raters. Based exclusively on the VAS for subjective evaluation of nasal appearance, the authors' findings show that surgeons and patients do not “see the same” and generally, the score attributed by the surgeon is more favorable (almost 1 point higher) than the auto-assessment's score. This is important to realize when communicating about nasal appearance before rhinoplasty.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

scholarly journals Reproducibility and agreement between three positions for handgrip assessment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Olga-Cecilia Vargas-Pinilla ◽  
Eliana-Isabel Rodríguez-Grande
Keyword(s):  
Supine Position ◽  
Cross Sectional Study ◽  
Sitting Position ◽  
Average Difference ◽  
Cross Sectional ◽  
Hand Grip ◽  
Standardization Process ◽  
The One ◽  
Level Of Agreement ◽  
Apparently Healthy

AbstractThe protocol established for taking hand grip dynamometry measurements determines that the patient must be in a sitting position. This protocol cannot be applied due to the patient’s conditions in some cases, such as abdominal surgery, musculoskeletal spine or hip injuries. The purpose was to determine the reproducibility and level of agreement between the Handgrip dynamometry in supine position with the elbow flexed or extended, and the one measured in the sitting position, the design was a descriptive cross-sectional study. The population were young apparently healthy between 18 and 30 years of age (N = 201). Handgrip measurement was performed on both upper limbs in a sitting position with a flexed elbow, a supine position with a flexed elbow, and supine position with the elbow extended. Reproducibility was nearly perfect in all positions (ICC 0.95–0.97). Regarding the level of agreement for the comparison between sitting and supine positions with a flexed elbow, an average difference of − 0.406. For supine position with an extended elbow and supine position with a flexed elbow, the average difference was − 1.479. Considering the results, clinicians or researchers can choose any of the positions evaluated herein and obtain reliable results as long as the standardization process is followed.

Omega-3 Levels and Nicotine Dependence: A Cross-Sectional Study and Clinical Trial

2015 ◽  
Vol 22 (3) ◽  
pp. 153-162 ◽  
Author(s):  
Juçara X. Zaparoli ◽  
Eduardo K. Sugawara ◽  
Altay A.L. de Souza ◽  
Sérgio Tufik ◽  
José Carlos F. Galduróz
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Fish Oil ◽  
Nicotine Dependence ◽  
Cross Sectional Study ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Double Blind ◽  
Cross Sectional ◽  
Omega 3 Fatty Acid

Background: High oxidative stress, which is caused by smoking, can alter omega-3 fatty acid concentrations. Since omega-3 fatty acids play a role in dopaminergic neurotransmission related to dependence, it is important to understand their effects on nicotine dependence. Methods: This research comprised 2 studies. The first one consisted of a cross-sectional evaluation, in which the levels of the most important omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), were compared between smokers and non-smokers in a sample of 171 individuals; of them, 120 were smokers and 51 were non-smokers. The other study was a clinical, double-blind, randomized, placebo controlled, in which 63 smokers received daily treatment with capsules of fish oil (a source of omega-3/3 g/day) or mineral oil (used as placebo, also 3 g/day), taken 3 times a day for 90 days. Each fish oil capsules contained approximately 210.99 mg EPA and 129.84 mg of DHA. The outcome was evaluated by means of psychometric and biological measures as well as self-reports of tobacco use. The evaluations were carried out at the beginning of treatment and once a month thereafter (total of 4 times). Outcomes: The omega-3 fatty acid lipid profile showed that smokers present lower concentrations of DHA. After treatment, the omega-3 group showed a significant reduction in their levels of dependence. Interpretation: Smokers showed lower peripheral levels of omega-3, and treatment with the most important omega-3 fatty acids brought about a reduction in nicotine dependence.

MS prevalence in New Zealand, an ethnically and latitudinally diverse country

2010 ◽  
Vol 16 (12) ◽  
pp. 1422-1431 ◽  
Author(s):  
Bruce V Taylor ◽  
John F Pearson ◽  
Glynnis Clarke ◽  
Deborah F Mason ◽  
David A Abernethy ◽  
...  
Keyword(s):  
New Zealand ◽  
Environmental Factors ◽  
Latitudinal Gradient ◽  
Population Level ◽  
Cross Sectional Study ◽  
European Population ◽  
Multiple Sources ◽  
Cross Sectional ◽  
The North ◽  
Mcdonald Criteria

Background: The prevalence of multiple sclerosis (MS) is not uniform, with a latitudinal gradient of prevalence present in most studies. Understanding the drivers of this gradient may allow a better understanding of the environmental factors involved in MS pathogenesis. Method: The New Zealand national MS prevalence study (NZMSPS) is a cross-sectional study of people with definite MS (DMS) (McDonald criteria 2005) resident in New Zealand on census night, 7 March 2006, utilizing multiple sources of notification. Capture—recapture analysis (CRA) was used to estimate missing cases. Results: Of 2917 people with DMS identified, the crude prevalence was 72.4 per 100,000 population, and 73.1 per 100,000 when age-standardized to the European population. CRA estimated that 96.7% of cases were identified. A latitudinal gradient was seen with MS prevalence increasing three-fold from the North (35°S) to the South (48°S). The gradient was non-uniform; females with relapsing—remitting/secondary-progressive (RRMS/SPMS) disease have a gradient 11 times greater than males with primary-progressive MS ( p < 1 × 10-7). DMS was significantly less common among those of Māori ethnicity. Conclusions: This study confirms the presence of a robust latitudinal gradient of MS prevalence in New Zealand. This gradient is largely driven by European females with the RRMS/SPMS phenotype. These results indicate that the environmental factors that underlie the latitudinal gradient act differentially by gender, ethnicity and MS phenotype. A better understanding of these factors may allow more targeted MS therapies aimed at modifiable environmental triggers at the population level.

Sex Dependent Association of Vitamin D with Insulin Resistance

2021 ◽  
Author(s):  
Xin Chen ◽  
Chang Chu ◽  
Cornelia Doebis ◽  
Volker von Baehr ◽  
Berthold Hocher
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Animal Studies ◽  
Linear Regression Analysis ◽  
Cross Sectional Study ◽  
Multivariate Linear Regression Analysis ◽  
Double Blind ◽  
Cross Sectional ◽  
Entire Study

Abstract Background Animal studies suggested that vitamin D might decrease insulin resistance. Estrogen increased insulin sensitivity and glucose tolerance in rodents. However, sex-specific association of vitamin D with insulin resistance in humans remains unclear. Objectives To investigate the sex-dependency of the association of insulin resistance and 25(OH)D in a large Caucasian population. Methods Cross-sectional study from out-patients’ blood samples with measurements of 25(OH)D and HOMA-IR drawn at exactly the same day (N=1887). This cohort was divided into three groups: i) group with vitamin D deficiency (n=1190), ii) group with vitamin D sufficiency (N=686)), iii) vitamin D excess groups (n=11), the vitamin D excess group was excluded from further analysis due to the small size. Results Analysis of the entire study population showed that serum 25-hydroxyvitamin D was inversely associated with HOMA-IR (rs=-0.19, P&lt;0.0001). When considering the vitamin D status, this association was only seen in the vitamin D deficiency group, but not in the vitamin D sufficient group. The correlation was sex-dependent: HOMA-IR was inversely correlated with vitamin D in women with vitamin D deficiency (rs=-0.26, P&lt;0.0001) but not in men with vitamin D deficiency (rs=0.01, P=0.714). After multivariate linear regression analysis considering confounding factors, this relationship was again only seen in women. Conclusion Vitamin D was inversely and independently associated with insulin resistance only in women with vitamin D deficiency. Based on our data, we suggest that in particular vitamin D deficient women might benefit from vitamin D substitution by improving insulin resistance. This, however, needs to be proven in adequately designed double-blind placebo-controlled clinical studies.

scholarly journals Interprofessional collaboration among care professionals in obstetrical care: are perceptions aligned?

2017 ◽  
Vol 27 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Anita Romijn ◽  
Pim W Teunissen ◽  
Martine C de Bruijne ◽  
Cordula Wagner ◽  
Christianne J M de Groot
Keyword(s):  
Primary Care ◽  
The Netherlands ◽  
Interprofessional Collaboration ◽  
Cross Sectional Study ◽  
Measurement Scale ◽  
Cross Sectional ◽  
Communication Accommodation ◽  
Obstetrical Care ◽  
The North ◽  
Ensure Patient Safety

BackgroundIn an obstetrical team, obstetricians, midwives and nurses work together in a dynamic and complex care setting. Different professional cultures can be a barrier for effective interprofessional collaboration. Although the different professional cultures in obstetrical care are well known, little is understood about discrepancies in mutual perceptions of collaboration. Similar perceptions of collaboration are important to ensure patient safety. We aimed to understand how different care professionals in an obstetrical team assess interprofessional collaboration in order to gain insight into the extent to which their perceptions are aligned.MethodsThis cross-sectional study was performed in the north-western region of the Netherlands. Care professionals from five hospitals and surrounding primary-care midwifery practices were surveyed. The respondents consisted of four groups of care professionals: obstetricians (n=74), hospital-based midwives known as clinical midwives (n=42), nurses (n=154) and primary-care midwives (n=109). The overall response rate was 80.8%. We used the Interprofessional Collaboration Measurement Scale (IPCMS) to assess perceived interprofessional collaboration. The IPCMS distinguishes three subscales: communication, accommodation and isolation. Data were analysed using non-parametrical tests.ResultsOverall, ratings of interprofessional collaboration were good. Obstetricians rated their collaboration with clinical midwives, nurses and primary-care midwives more positively than these three groups rated the collaboration with obstetricians. Discrepancies in mutual perceptions were most apparent in the isolation subscale, which is about sharing opinions, discussing new practices and respecting each other.ConclusionWe found relevant discrepancies in mutual perceptions of collaboration in obstetrical care in the Netherlands. Obstetrical care is currently being reorganised to enable more integrated care, which will have consequences for interprofessional collaboration. The findings of this study indicate opportunities for improvement especially in terms of perceived isolation.

scholarly journals Perfil dos diagnósticos de enfermagem de fumicultores

2019 ◽  
Vol 13 ◽  
Author(s):  
Naise de Moura Dantas ◽  
Alexandre Wendell Araujo Moura ◽  
Andreivna Kharenine Serbim ◽  
Cristiane Araujo Nascimento ◽  
Ana Caroline Melo dos Santos ◽  
...  
Keyword(s):  
Elementary Education ◽  
Family Health ◽  
Cross Sectional Study ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Safety Standards ◽  
The North ◽  
Nursing Diagnosis ◽  
Quantitative Descriptive ◽  
Nursing Diagnoses

RESUMO Objetivo: descrever os diagnósticos de Enfermagem segundo a taxonomia da American Nursing Diagnosis Association II.  Método: trata-se de estudo quantitativo, descritivo, transversal, com 51 produtores de tabaco expostos a agroquímicos que viviam na comunidade rural. Coletaram-se os dados por meio das consultas de Enfermagem. Tabularam-se os dados n Programa Microsoft Excel 2010, posteriormente inseridos no banco de dados utilizando o programa SPSS, versão 22.0, for Windows, e submetidos à revisão e análise estatística. Apresentaram-se os resultados em tabelas. Resultados: verificou-se, por meio das consultas de Enfermagem, que a maioria era do sexo feminino, tinha ensino fundamental incompleto e não praticava nenhum tipo de exercício físico. Acrescenta-se, além disso, que eles desconheciam os riscos para a saúde colocados pelos pesticidas e negligenciaram os padrões de segurança recomendados para o manuseio desses produtos. Conclusão: pode-se observar, a partir deste estudo, que o enfermeiro tem um papel importante no cuidado e na educação, nos diversos espaços de promoção, prevenção e manutenção do cuidado em saúde. Descritores: Enfermagem; Diagnósticos de Enfermagem; Estratégia Saúde da Família; Área Rural; Saúde Pública; Saúde do Trabalhador.ABSTRACT Objective: to describe Nursing diagnoses according to the Taxonomy II proposed by the North American Nursing Diagnosis Association. Method: this is a quantitative, descriptive, cross-sectional study conducted with co plantations. The research was carried out with 51 tobacco growers exposed to agrochemicals living in the rural community. The data were collected through nursing consultations. The data collected were tabulated in the Microsoft Excel 2010 software and later entered into a database using the SPSS software version 22.0, for Windows, and subjected to statistical review and analysis. The results were presented in tables. Results: the Nursing consultations revealed that the majority of the farm workers were females, had incomplete elementary education, and did not practice any type of physical exercise. In addition, they were unaware of the health risks posed by pesticides and neglected the recommended safety standards for the handling of these products. Conclusion: it was observed in this study that nurses have an important role in care and education, in the various spaces of promotion, prevention and maintenance of health care. Descriptors: Nursing; Nursing Diagnoses; Family Health Strategy; Rural Area; Public Health; Occupational Health.RESUMEN Objetivo: se buscó describir los diagnósticos de Enfermería según la taxonomía de la American Nursing Diagnosis Association II. Método: se trata de un estudio cuantitativo, descriptivo, transversal, realizado con 51 productores de tabaco expuestos a agroquímicos que vivían en la comunidad rural. Se recogieron los datos por medio de las consultas de Enfermería. Se tabularon los datos recogidos en el programa Microsoft Excel 2010, posteriormente inseridos en el banco de datos utilizando el programa SPSS, versión 22.0, for Windows, y sometidos a la revisión y análisis estadística. Se presentaron los resultados en tablas. Resultados: se verificó, por medio de las consultas de Enfermería, que la mayoría era del sexo femenino, tenía enseñanza primaria incompleta y no praticaba ningún tipo de ejercicio físico. Además de eso, ellos desconocen los riesgos para la salud colocados por los pesticidas y negligenciaron los patrones de seguridad recomendados para el manoseo de esos productos. Conclusión: se puede observar, a partir de este estudio, que el enfermero tiene un papel importante en el cuidado y en la educación, en los diversos espacios de promoción, prevención y mantenimiento del cuidado en salud. Descriptores: Enfermería; Diagnósticos de Enfermería; Estrategia Salud de la Familia; Zona Rural; Salud Pública; Salud Laboral.

scholarly journals Analysis of the presence and location of mast cells in periapical cysts and periapical granulomas

2016 ◽  
Vol 64 (4) ◽  
pp. 376-381 ◽  
Author(s):  
Emerson Filipe de Carvalho NOGUEIRA ◽  
Elder Gyress Feitosa FARIAS ◽  
Luciano Barreto SILVA ◽  
Alexandrino Pereira dos SANTOS NETO ◽  
Emanuel Sávio de Souza ANDRADE ◽  
...  
Keyword(s):  
Mast Cells ◽  
Granulation Tissue ◽  
Blue Staining ◽  
Double Blind Study ◽  
Double Blind ◽  
Cross Sectional ◽  
Periapical Granuloma ◽  
Staining Methods ◽  
Periapical Cyst ◽  
Quantitative Descriptive

ABSTRACT Objective: The aim of the present study was to locate mast cells in chronic periapical lesions (granulomas and cysts) by using histochemical techniques and toluidine blue staining. Methods: A quantitative, descriptive, cross-sectional and retrospective research was performed. The sample was obtained from histopathological reports in the archives of the laboratory of surgical pathology of the University of Pernambuco between November 2014 and May 2015. Results: Sixteen cases of granuloma and 21 cases of periapical cysts were selected. The stained slides were analyzed by two examiners at different times, in a double-blind study. Mast cells were found in 13 (61.9%) of the periapical cyst cases, located in the capsule of the lesion. In the periapical granuloma cases, mast cells were found in eight cases (50%), located in the granulation tissue. Conclusion: Mast cells were detected in both cysts and periapical granuloma, located in the capsule and granulation tissue, respectively. Mast cells were more prevalent in periapical cysts than in periapical granuloma.

scholarly journals Predictors of cognitive, behavioural and academic difficulties in NF1

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S243-S243
Author(s):  
Kavitha Chinnappa Ramamurthy ◽  
Marie-Maude Geoffray ◽  
Louise Robinson ◽  
Lauren Manderson ◽  
Julieta O'Flaherty ◽  
...  
Keyword(s):  
Remedial Education ◽  
Clinical Sample ◽  
Risk Groups ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Academic Difficulties ◽  
The North ◽  
Cognitive Behavioural ◽  
The Uk

AimsThe aim of this study is to systematically investigate the demographic and disease predictors of cognitive and behavioural phenotype in the largest cohort of children with NF1 published to date. Based on previously published research, we examine the potential role of demographic predictors such as age, sex, SES, parental NF1 status as well as the neurological complications such as epilepsy and brain tumours in NF1 associated cognitive/ behavioural impairments.MethodIn this cross-sectional study design, participant data were drawn from two large databases which included (i) A clinical database of all patients with NF1 seen in a clinical psychological service from 2010 to 2019 and (ii) A research dataset from two previously published studies (2,8). The complex National NF1 service based within Manchester regional genetic services is set up for individuals with complex NF1 (https://www.mangen.co.uk/healthcare-professionals/clinical-genomic-services/nf1/) in the North of the UK. Children were referred to the psychological services by NF1 clinicians if psychological assessment was warranted based on parental reports. In order to reduce clinic referral bias, the clinical sample was supplemented by including participants that were seen solely for the purposes of research studies within our centre.ResultRelative to population norms, 90% of the NF1 sample demonstrated significantly lower scores in at least one cognitive or behavioral domain. Family history of NF1 and lower SES were independently associated with poorer cognitive, behavioral and academic outcomes. Neurological problems such as epilepsy and hydrocephalus were associated with lower IQ and academic skills.ConclusionCognitive and behavioural phenotypes commonly emerge via a complex interplay between genes and environmental factors, and this is true also of a monogenic condition such as NF1. Early interventions and remedial education may be targeted to risk groups such those with familial NF1, families with lower SES and those with associated neurological comorbidities.

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