O Uso das Imagens Mentais na Terapia Cognitivo-Comportamental do Transtorno de Estresse P��s-Traum��tico: uma Revis��o Sistem��tica

No transtorno de estresse p��s-traum��tico (TEPT) �� comum a ocorr��ncia de sintomas associados a imagens mentais que remetem ao evento traum��tico.��Estas imagens tem um impacto emocional bastante intenso,��uma vez que podem se manifestar de maneira intrusiva e gerar sensação de reviv��ncia do trauma.��Assim, tem sido estudadas t��cnicas de terapia cognitivo-comportamental (TCC) que utilizam as imagens mentais como interven����o terap��utica.��O objetivo deste estudo foi revisar de forma sistem��tica os efeitos do uso de imagens mentais como um recurso da TCC para o TEPT. Foram identificados 8 artigos publicados entre os anos de 2001 a 2012 por meio das bases de dados PubMed, PsycNet e Web of Science. As interven����es dos grupos experimentais apresentaram diferen��a estat��stica significativa em cinco dos oito estudos selecionados.��Contudo,��ainda se faz necess��rio a realiza����o de mais pesquisas sobre seus efeitos em virtude do restrito n��mero de estudos encontrados nesta revis��o.

Family Characterization of Young Experimental Consumers of Psychoactive Substances Seen in the Toxicology Department at Colsubsidio

This investigation characterized families of adolescents experimenting with psychoactive substances (PAS) consumption. Materials and methods: For this purpose, a qualitative study with a hermeneutical emphasis was conducted among a population of adolescents between the ages of 12 and 17 who have experimented with PAS. Semi-structured interviews were conducted with patients and their families employing a flexible protocol of 14 categories. Results: The findings showed low levels of family cohesion and sense of family identity, inconsistency between educational patterns followed by the parents, as well as deficient parental support. Similarly, the findings indicate significant peer influence during the first stages of consumption of illegal substances. In this regard, the findings suggest that more than providing physical satisfaction, consumption represents a form of acquiring prestige and social position while granting a sensation of psychological, emotional and social well-being. Conclusions: Parental influence was also found considerable in regarding the consumption of legal PAS, like alcohol and tobacco. The study identified as a high-priority need to promote and incorporate communication and conflict resolution skills within the family dynamics by means of prevention and monitoring programs. Those skills and programs would be aimed at providing parents of adolescents experimenting with PAS consumption with new educational tools to orientate new raising guidelines so as to respond appropriately to the problems identified in this study.

Transcutaneous electrical nerve stimulation and primary dysmenorrhea: a case report

Primary dysmenorrhea is pelvic pain during the menstrual cycle. The A delta and C fibers aresensitized by the increased release of prostaglandins and leukotrienes, thus causing pain. TransElectric Nerve Stimulation (TENS) is a physiotherapeutic strategy that mitigatespain sensation. Objective: The aim of this paper is to present six cases of women in childbearingage who were diagnosed with primary dysmenorrhea and received transcutaneous electricnerve stimulation. Materials and methods: A type of study, case report, was conducted with sixwomen between 15 and 25 years of age with medical diagnosis of primary dysmenorrhea. Weassessed pain intensity utilizing the visual analogue pain scale and located the pain by usinga pain test map. Results: Pain intensity decreased in all treated women. Conclusion: Transcutaneouselectric nerve stimulation (TENS) is a physiotherapeutic strategy that mitigates painsensation. We conclude that high frequency TENSis a safe noninvasive modality to achievereduction of pain in primary dysmenorrhea.

Mediastinitis post revascularizaci��n mioc��rdica: impacto del cambio de profilaxis antibi��tica en la fundaci��n Cardioinfantil 2012 - 2013

INTRODUCCI��N. La mediastinitis posterior a cirug��a de revascularizaci��n mioc��rdica es una infecci��n infrecuente, pero potencialmente fatal. En la Fundaci��n Cardioinfantil se ha observado una tendencia al incremento de la misma en los ��ltimos a��os, obligando a un cambio en las medidas de profilaxis antimicrobiana, pasando de cefalosporinas a vancomicina ��� gentamicina, sin embargo no se conoce a��n el impacto de estas medidas. OBJETIVO: Determinar si el cambio de la profilaxis antibi��tica en pacientes sometidos a revascularizaci��n mioc��rdica influye en una disminuci��n de la incidencia de mediastinitis durante los a��os 2012 ��� 2013. METODOLOG��A: Estudio de cohortes retrospectivo, evaluando la incidencia de mediastinitis post revascularizaci��n mioc��rdica, en pacientes expuestos a 2 diferentes tipos de profilaxis antimicrobiana (cefalosporinas vs vancomicina-gentamicina). Se describieron los patrones de susceptibilidad y resistencia de los pat��genos encontrados en mediastinitis y la mortalidad de esta patolog��a. RESULTADOS: Los pat��genos m��s frecuentemente aislados en la mediastinitis fueron Staphylococcus aureus y Klebsiella pneumoniae, en la mayor��a monomicrobiano. Se encontraron pat��genos con perfiles de resistencia como betalactamasas de espectro extendido en Gram negativos y resistencia a la meticilina en cocos Gram positivos. El RR de mediastinitis del grupo expuesto a vancomicina-gentamicina respecto al grupo de cefalosporinas fue de 0,9 con IC 95% 0,28 ��� 3,28. CONCLUSI��N: la epidemiologia microbiana de la mediastinitis no difiere de la reportada en otras series. La profilaxis antimicrobiana con vancomicina - gentamicina en pacientes sometidos a revascularizaci��n mioc��rdica, no redujo la incidencia de mediastinitis. Se propone regresar a la terapia de profilaxis con cefalosporinas.

Apoyo social e ideaci��n suicida en pacientes con c��ncer

El diagn��stico de c��ncer ha sido asociado con un alto riesgo de presentar ideaci��n suicida en comparaci��n con la poblaci��n no oncol��gica, sin embargo se ha considerado al apoyo social como un factor protector para la ocurrencia de esta conducta. La presente investigaci��n tuvo como objetivo identificar la relaci��n entre el apoyo social percibido y la ideaci��n suicida en 90 pacientes oncol��gicos adultos en Bogot��, bajo la hip��tesis de que a mayor apoyo social percibido, menor presencia de ideaci��n suicida. Se midi�� la variable de apoyo social a trav��s del cuestionario Duke UNC y la ideaci��n suicida a trav��s de cuatro instrumentos: Escala de Ideaci��n Suicida (SSI), Escala de Desesperanza de Beck (BHS), el ��tem 9 del Inventario de Depresi��n de Beck (BDI-IA) y una entrevista semiestructurada. Los resultados mostraron que no existe relaci��n entre el apoyo social percibido y la ideaci��n suicida. Por otro lado se identific�� una prevalencia de suicidio entre 5,6% y 22,77%, confirmando que el paciente con c��ncer considera el suicidio y es fundamental evaluar esta variable en esta poblaci��n. Se considera importante continuar con la realizaci��n de investigaciones que permitan generalizar los resultados a la poblaci��n oncol��gica colombiana.