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BACKGROUND: The aim of this study was whether the Food Intake Visual Scale (FIVS) can be used in clinical practice to measure food intake in patients with decompensated cirrhosis. METHODS: A cross-sectional study was performed with patients with cirrhosis between April 2017 and July 2019. The food intake was assessed through the 1-day diet record (DR) and according to FIVS, which consists of pictures of four plates of food at different levels of consumption: "about all," "half," "a quarter," or "nothing." The analysis of variance test with Bonferroni multiple comparison analysis was used to compare the mean energy intake through the DR according to the FIVS categories. RESULTS: This study included 94 patients with a mean age of 60.29 ± 9.33 years. Patients with lower food intake according to the FIVS categories also had lower mean energy and macronutrient intake according to the DR: patients eating "about all" (n = 49, 52.1%) consumed a mean of 1526.58 ± 428.27 kcal/day, patients eating "half" (n = 16, 17%) consumed a mean of 1282.08 ± 302.83 kcal/day, patients eating "a quarter" (n = 25, 26.6%) consumed a mean of 978.96 ± 468.81 kcal/day, and patients eating "nothing" (n = 4, 4.3%) consumed a mean of 353.59 ± 113.16 kcal/day (P < .001). CONCLUSION: The results of this study demonstrate that FIVS can be implemented in clinical practice to measure food intake in patients with decompensated cirrhosis as a substitute for the DR because it is a noninvasive, low-cost, quick, reliable, and easy bedside method for obtaining data.

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The white matter hyperintensities (WMH, leucoaraiosis) represent the most common kind of ischemic vascular lesion of the white matter due to small vessel diseases, and occurs frequently in the elderly. Consequent to the neuroimaging identification arouse the need for their assessment. The group of Fazekas proposed a systematized semi-quantitative visual scale to score such lesions where two parameters were considered, extent and localization. The original scale was further modified, to a simplified version. Although other more complex scales have appeared, researchers remarked that the relatively simple Fazekas scale, in comparison to the complex ones and to volumetric measures, appeared to be sufficient when analyzing relationships between clinical parameters and WMH load in a clinical setting.

As hiperintensidades da substância branca (HSB, leucoaraiose) representam o tipo de lesão isquêmica mais comum da substância branca decorrente de doenças de pequenos vasos e ocorre frequentemente em idosos. Consequente à identificação por neuroimagem surgiu a necessidade de sua avaliação. O grupo de Fazekas propos uma escala visual semiquantitativa sistematizada para pontuar tais lesões, onde foram considerados dois parâmetros, extensão e localização. A escala original foi modificada para constituir uma versão mais simplificada. Embora outras escalas mais complexas tenham aparecido, pesquisadores comentaram que a relativamente simples escala de Fazekas, em comparação às mais complexas e a método volumétrico, mostrou-se suficiente quando é analisada a relação entre parâmetros clínicos e a carga de HSB em um cenário clínico.

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A Raghavendra, Madhuri, Sujata Pictorial Scale (RMS-PS) é uma escala que foi criada para mensurar a ansiedade odontológica em crianças e adolescentes indianos. Esta escala é composta por fotografias de crianças reais. Nela são consideradas expressões diferentes que representam sentimentos que variam de nenhuma/pouca até muita ansiedade odontológica. Para sua confecção, foram consideradas fotografias de crianças reais de ambos os sexos em diferentes expressões. Portanto, a RMS-PS original possui uma escala para o sexo feminino com cinco expressões e uma para o sexo masculino com cinco expressões. Na literatura, a mensuração da ansiedade odontológica em crianças e adolescentes pode ser realizada aplicando inúmeras escalas, sejam elas compostas por desenhos simples, desenhos mais elaborados com cores e acompanhadas ou não de uma sequência de perguntas. É importante considerar que falar sobre sentimentos não é algo comumente ensinado a crianças e adolescentes, sendo que muitos na vida adulta podem ainda apresentar dificuldades em verbalizar suas emoções. Sendo assim, lançar estratégias com o intuito de facilitar esta verbalização da ansiedade odontologica é de grande relevância. Conhecer o grau de ansiedade odontológica antes de um tratamento poderá trazer maior confiança ao clínico, uma vez que as estratégias no manejo, a elaboração do plano de tratamento, e as orientações aos responsáveis serão aplicadas de uma forma personalizada e assertiva, pois serão consideradas as particularidades apresentadas por cada criança ou adolescente. Este trabalho consiste em uma adaptação transcultural da RMS-PS para ser aplicável à população brasileira. Em seu processo de adaptação transcultural, todos os itens da escala original foram mantidos, e decidiu-se por incluir também as variações de cor da pele. No processo de adaptação transcultural, inicialmente, foi realizado a confecção das versões brasileiras da RMS-PS, com fotografias de crianças brasileiras: menina negra, menina branca, menino negro, menino branco. Versões com cinco expressões (escala cinco), e outras mais curtas, com três expressões (escala três) foram desenvolvidas. Em seguida, reuniu-se o Comitê de Especialistas que avaliaram as fotografias. As alterações propostas foram realizadas e as novas fotografias foram aplicadas no pré- teste com 25 crianças e adolescentes de Carmópolis de Minas, Brasil, estratificadas por faixa etária: 10 a 14 anos, 7 a 9 anos e 4 a 6 anos. Os participantes foram selecionados por conveniência em clínicas odontológicas particulares. O pré-teste foi realizado de forma virtual ou presencial, utilizando-se as versões da escala de cinco faces e da escala de três faces. Os participantes foram questionados quanto a escala de preferência, e qual expressão representaria sua ansiedade durante a consulta odontológica. O Comitê de Especialistas foi novamente reunido após o pré-teste. Resultados: A expressão neutra foi a mais frequente (44,0%) para escala três, e a expressão feliz (36,0%), para escala cinco. A maioria dos adolescentes preferiu a escala cinco (66,6%), e 75% das crianças preferiu a escala três. Como conclusão, o presente estudo disponibiliza a versão brasileira da escala RMS-PS, contando com quatro variações considerando o sexo e a cor de pele. A preferência por uma escala de três ou cinco expressões variou conforme a idade.

The Raghavendra, Madhuri, Sujata Pictorial Scale (RMS-PS) is a scale that was created to measure dental anxiety in Indian children and adolescents. This scale is composed of photographs of real children. It considers different expressions that represent feelings ranging from no/low to high dental anxiety. For its confection, photographs of real children of both sexes in different expressions were considered. Therefore, the original RMS-PS has a scale for females with five expressions and one for males with five expressions. In the literature, the measurement of dental anxiety in children and adolescents can be performed by applying numerous scales, whether they consist of simple drawings, more elaborate drawings with colors, and whether they are accompanied or not by a sequence of questions. It is important to consider that talking about feelings is not something commonly taught to children and adolescents, and many in adulthood may still have difficulties verbalizing their emotions. Thus, launching strategies to facilitate this verbalization of dental anxiety is of great importance. Knowing the degree of dental anxiety before a treatment may bring more confidence to the clinician, since the strategies in the management, development of treatment plan, and guidelines to those responsible will be applied in a personalized and assertive way, because the particularities presented by each child or adolescent will be considered. This consists of a cross-cultural adaptation of the RMS-PS to be applicable to the Brazilian population. In its cross-cultural adaptation process, all items of the original scale were kept, and it was decided to include also the skin color variations. In the cross-cultural adaptation process, we initially made the Brazilian versions of the RMS-PS, with photographs of Brazilian children: black girl, white girl, black boy, white boy. Versions with five expressions (scale five), and shorter ones, with three expressions (scale three) were developed. Next, the Committee of Experts met to evaluate the photographs. The proposed changes were made and the new photographs were applied in the pre-test with 25 children and adolescents from Carmópolis de Minas, Brazil, stratified by age group: 10 to 14 years, 7 to 9 years, and 4 to 6 years. The participants were selected by convenience in private dental clinics. The pre-test was performed virtually or face-to-face, using the five-sided scale and the three-sided scale versions. Participants were asked which scale they preferred, and which expression represented their anxiety during a dental appointment. The Expert Committee was reconvened after the pre-test. Results: The neutral expression was the most frequent (44.0%) for scale three, and the happy expression (36.0%), for scale five. Most adolescents preferred scale five (66.6%), and 75% of children preferred scale three. As a conclusion, the present study provides the Brazilian version of the RMS-PS scale, counting on four variations considering sex and skin color. The preference for a scale of three or five expressions varied according to age

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Resumen: Objetivo: Determinar la asociación entre las características clínicas y estudios de laboratorio con el tipo de microorganismo aislado en hemocultivos de pacientes con espondilodiscitis piógena. Material y métodos: Es un estudio transversal analítico, se revisaron expedientes clínicos de pacientes con espondilodiscitis piógena desde Enero de 2013 hasta Enero de 2017. Se realizó análisis descriptivo univariado usando frecuencias y porcentajes para variables cualitativas, medidas de tendencia central y dispersión para las cuantitativas. Análisis bivariado mediante prueba de χ2 o test exacto de Fisher. Análisis de variables cuantitativas mediante t Student o U de Mann-Whitney. Se usó coeficiente de correlación de Spearman. Considerando significancia estadística p < 0.05. Resultados: Se obtuvo una muestra de 34 pacientes, 20 (58%) fueron mujeres, mediana (Me) de edad 60 años (52-66). Se aisló en hemocultivos, bacterias Gram positivas 11 (32.4%) y Gram negativas 23 (67.6%). El microorganismo aislado más frecuente fue Escherichia coli 12 (35.3%). Los pacientes con espondilodiscitis por Gram negativas presentaron dolor leve y velocidad de sedimentación globular (VSG) Me 26 mm/hra P (18-36), los pacientes con espondilodiscitis por Gram positivas presentaron dolor severo y VSG Me 38 mm/h P (34-40) (p = 0.000 y 0.028, respectivamente). La VSG y dolor en el grupo de pacientes con espondilodiscitis por bacterias Gram negativas tuvo un coeficiente de correlación de Spearman moderado 0.418, (p = 0.047); en el grupo de Gram positivas, un coeficiente de correlación de Spearman bajo 0.228, (p = 0.507). Conclusión: Existe una asociación clínica y estadística de manera significativa entre los tipos de microorganismo aislado en hemocultivo, la intensidad del dolor valorado en escala visual análoga (EVA) y los niveles de VSG.

Abstract: Objective: Determine the association between clinical characteristics and laboratory studies with the type of isolated microorganism in blood cultures of patients with Pyogenic Spondylodiscitis. Material and methods: It is a cross-analytical study, clinical records of patients with Pyogenic Spondylodiscitis were reviewed from January 2013 to January 2017. Univariate descriptive analysis was performed using frequencies and percentages for qualitative variables, central trend measures and dispersion for quantitative ones. Bivariate analysis by testing of χ2 or Fisher's exact test. Analysis of quantitative variables using T Student or Mann-Whitney U. Spearman's correlation coefficient was used. Considering statistical significance p < 0.05. Results: A sample of 34 patients was obtained, 20 (58%) were women, median (Me) of age 60 years (52-66). Was isolated into blood cultures, Gram-positive bacteria 11 (32.4%) gram negatives 23 (67.6%). The microorganism most common isolate was Escherichia coli 12 (35.3%). Patients with Gram-negative spondylodiscitis had mild pain and globular sedimentation rate (VSG) Me 26 mm/hra P (18-36), patients with Gram-positive spondylodyscitis had severe pain and VSG Me 38 mm/h P (34-40) (p= 0.000 and 0.028, respectively). VSG and pain in the group of patients with gram-negative bacteria spondylodiscitis had a moderate Spearman correlation coefficient of 0.418, (p = 0.047); in the Gram positives group, a low correlation coefficient of Spearman 0.228, (p = 0.507). Conclusion: There is a clinical and statistical association significant between types of isolated microorganism in blood culture, pain intensity valued on analog visual scale (EVA) and VSG levels.

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OBJECTIVE: Determine the association between clinical characteristics and laboratory studies with the type of isolated microorganism in blood cultures of patients with Pyogenic Spondylodiscitis. MATERIAL AND METHODS: It is a cross-analytical study, clinical records of patients with Pyogenic Spondylodiscitis were reviewed from January 2013 to January 2017. Univariate descriptive analysis was performed using frequencies and percentages for qualitative variables, central trend measures and dispersion for quantitative ones. Bivariate analysis by testing of 2 or Fishers exact test. Analysis of quantitative variables using T Student or Mann-Whitney U. Spearmans correlation coefficient was used. Considering statistical significance p 0.05. RESULTS: A sample of 34 patients was obtained, 20 (58%) were women, median (Me) of age 60 years (52-66). Was isolated into blood cultures, Gram-positive bacteria 11 (32.4%) gram negatives 23 (67.6%). The microorganism most common isolate was Escherichia coli 12 (35.3%). Patients with Gram-negative spondylodiscitis had mild pain and globular sedimentation rate (VSG) Me 26 mm/hra P (18-36), patients with Gram-positive spondylodyscitis had severe pain and VSG Me 38 mm/h P (34-40) (p= 0.000 and 0.028, respectively). VSG and pain in the group of patients with gram-negative bacteria spondylodiscitis had a moderate Spearman correlation coefficient of 0.418, (p = 0.047); in the Gram positives group, a low correlation coefficient of Spearman 0.228, (p = 0.507). CONCLUSION: There is a clinical and statistical association significant between types of isolated microorganism in blood culture, pain intensity valued on analog visual scale (EVA) and VSG levels.

OBJETIVO: Determinar la asociación entre las características clínicas y estudios de laboratorio con el tipo de microorganismo aislado en hemocultivos de pacientes con espondilodiscitis piógena. MATERIAL Y MÉTODOS: Es un estudio transversal analítico, se revisaron expedientes clínicos de pacientes con espondilodiscitis piógena desde Enero de 2013 hasta Enero de 2017. Se realizó análisis descriptivo univariado usando frecuencias y porcentajes para variables cualitativas, medidas de tendencia central y dispersión para las cuantitativas. Análisis bivariado mediante prueba de 2 o test exacto de Fisher. Análisis de variables cuantitativas mediante t Student o U de Mann-Whitney. Se usó coeficiente de correlación de Spearman. Considerando significancia estadística p 0.05. RESULTADOS: Se obtuvo una muestra de 34 pacientes, 20 (58%) fueron mujeres, mediana (Me) de edad 60 años (52-66). Se aisló en hemocultivos, bacterias Gram positivas 11 (32.4%) y Gram negativas 23 (67.6%). El microorganismo aislado más frecuente fue Escherichia coli 12 (35.3%). Los pacientes con espondilodiscitis por Gram negativas presentaron dolor leve y velocidad de sedimentación globular (VSG) Me 26 mm/hra P (18-36), los pacientes con espondilodiscitis por Gram positivas presentaron dolor severo y VSG Me 38 mm/h P (34-40) (p = 0.000 y 0.028, respectivamente). La VSG y dolor en el grupo de pacientes con espondilodiscitis por bacterias Gram negativas tuvo un coeficiente de correlación de Spearman moderado 0.418, (p = 0.047); en el grupo de Gram positivas, un coeficiente de correlación de Spearman bajo 0.228, (p = 0.507). ­. CONCLUSIÓN: Existe una asociación clínica y estadística de manera significativa entre los tipos de microorganismo aislado en hemocultivo, la intensidad del dolor valorado en escala visual análoga (EVA) y los niveles de VSG.

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Introducción. Muchos padres de familia tienen una percepción inadecuada del tamano de su hijo; en general, subestiman el sobrepeso y la obesidad. Objetivo. Identificar la diferencia entre la percepción de los padres del estado nutricional del niño y el índice de masa corporal medido. Población y métodos. Se realizó un estudio analítico, descriptivo y transversal entre padres de niños de 2 a 6 años de edad. Se determinó el índice de masa corporal de los niños y se evaluó la percepción de los padres mediante una escala visual de imágenes corporales en forma de pictogramas (dibujos de siluetas equivalentes a percentiles del índice de masa corporal). Resultados. Fueron evaluados 605 niños y sus padres. Se encontró sobrepeso en 74 casos (12,2%) y obesidad en 87 casos (14,3%). De 161 niños con sobrepeso u obesidad, 98,8% (159) de los padres subestimaron el estado nutricional de sus hijos. Tener una imagen paterna de la figura del cuerpo infravalorada presentó un OR= 2,1 ± 0,5, p= 0,002 (IC 95%: 1,32-3,32) para obesidad y un OR= 4,42 ± 1,2, p < 0,001 (IC 95%: 2,631-7,439) para sobrepeso. Conclusiones. El 98,8% (159) de los padres de niños con sobrepeso u obesidad subestimaron el peso de sus hijos. Esta subestimación por parte de los padres puede considerarse un factor de riesgo significativo para el desarrollo y/o mantenimiento del sobrepeso y la obesidad en sus hijos.

Introduction. Many parents have a misperception of their children's body size; in general, they underestimate overweight and obesity. Objective. To identify the difference between parents' perception of their children's nutritional status and measured body mass index. Population and methods. An analytical, descriptive and cross-sectional study was conducted among parents of children aged 2 to 6 years old. Children's body mass index was measured, and parents' perception was assessed using a visual scale of body size pictograms (drawings of body figures equivalent to body mass index percentiles). Results. A total of 605 children and their parents were assessed. Seventy-four (12.2%) were overweight and 87 were obese (14.3%). There were 161 overweight or obese children, but 98.8% (159) of parents underestimated their children's nutritional status. Parents' underperception of their children's body size accounted for an OR= 2.1 ± 0.5, p= 0.002 (95% confidence interval [CI]: 1.32-3.32) for obesity and an OR = 4.42 ± 1.2, p < 0.001 (95% CI: 2.631-7.439) for overweight. Conclusions. Among parents of overweight and obese children, 98.8% (159) underestimated their children's weight status. Such underestimation by parents may be a significant risk factor for the development and/or persistence of overweight and obesity in their children.

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INTRODUCTION: Many parents have a misperception of their children's body size; in general, they underestimate overweight and obesity. OBJECTIVE: To identify the difference between parents' perception of their children's nutritional status and measured body mass index. POPULATION AND METHODS: To identify the difference between parents' perception of their children's nutritional status and measured body mass index. RESULTS: A total of 605 children and their parents were assessed. Seventy-four (12.2%) were overweight and 87 were obese (14.3%). There were 161 overweight or obese children, but 98.8% (159) of parents underestimated their children's nutritional status. Parents' underperception of their children's body size accounted for an OR= 2.1 ± 0.5, p= 0.002 (95% confidence interval [CI]: 1.32-3.32) for obesity and an OR = 4.42 ± 1.2, p < 0.001 (95% CI: 2.631-7.439) for overweight. CONCLUSIONS: Among parents of overweight and obese children, 98.8% (159) underestimated their children's weight status. Such underestimation by parents may be a significant risk factor for the development and/or persistence of overweight and obesity in their children.

INTRODUCCIÓN: Muchos padres de familia tienen una percepción inadecuada del tamano de su hijo; en general, subestiman el sobrepeso y la obesidad. OBJETIVO: Identificar la diferencia entre la percepción de los padres del estado nutricional del niño y el índice de masa corporal medido. POBLACIÓN Y MÉTODOS: Se realizó un estudio analítico, descriptivo y transversal entre padres de niños de 2 a 6 anos de edad. Se determinó el índice de masa corporal de los niños y se evaluó la percepción de los padres mediante una escala visual de imágenes corporales en forma de pictogramas (dibujos de siluetas equivalentes a percentiles del índice de masa corporal). RESULTADOS: Fueron evaluados 605 niños y sus padres. Se encontró sobrepeso en 74 casos (12,2%) y obesidad en 87 casos (14,3%). De 161 niños con sobrepeso u obesidad, 98,8% (159) de los padres subestimaron el estado nutricional de sus hijos. Tener una imagen paterna de la figura del cuerpo infravalorada presentó un OR= 2,1 ± 0,5, p= 0,002 (IC 95%: 1,32-3,32) para obesidad y un OR= 4,42 ± 1,2, p < 0,001 (IC 95%: 2,631-7,439) para sobrepeso. CONCLUSIONES: El 98,8% (159) de los padres de niños con sobrepeso u obesidad subestimaron el peso de sus hijos. Esta subestimación por parte de los padres puede considerarse un factor de riesgo significativo para el desarrollo y/o mantenimiento del sobrepeso y la obesidad en sus hijos.

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Se efectuó un estudio longitudinal y controlado de 100 pacientes con osteoartrosis generalizada, atendidos en el Servicio de Medicina Natural y Tradicional del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero hasta diciembre del 2010, a fin de evaluar la eficacia de los imanes permanentes multipolares en el tratamiento del dolor crónico en los afectados. Estos imanes se ubicaron y fijaron en diferentes puntos de acupunturas para aliviar la dolencia. Los niveles de dolor se cuantificaron mediante la Escala Visual Análoga, por sexo y rango de edades; se evaluaron a los 0, 30, 60 y 90 días durante la terapia. Se demostró la factibilidad del uso de los imanes permanentes multipolares en el alivio del dolor de los pacientes con osteoartrosis generalizada por ser simples, seguros, eficaces y no inducir efectos adversos en el organismo.

A longitudinal and controlled study of 100 patients with generalized osteoarthrosis, assisted in the Service of Natural and Traditional Medicine of "Saturnino Lora Torres" Clinical Surgical Teaching Provincial Hospital in Santiago de Cuba was carried out from January to December, 2010, in order to evaluate the effectiveness of the multipolar permanent magnets in the treatment of the chronic pain in those affected. These magnets were placed and fixed in different acupuncture points to reduce pain. The pain levels were quantified by means of the Analogue Visual Scale, by sex and age range; they were evaluated at the 0, 30, 60 and 90 days during the therapy. The feasibility of the use of the multipolar permanent magnets was demonstrated in the relief of pain of the patients with generalized osteoarthrosis as they are simple, sure, effective and induce no adverse effects in the organism.

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Introducción: el pectus excavatum es una deformidad congénita de la pared anterior del tórax. Al nacer es poco evidente su existencia, pero durante la infancia y la adolescencia se desarrolla plenamente y puede llegar a constituir un problema funcional, psicosocial y estético relevante para el paciente. La fisiopatogenia se atribuye al crecimiento anormal de los cartílagos costales. En nuestro país, su incidencia no es despreciable, un pequeño número de pacientes pediátricos se han operado; sin embargo, existen escasas referencias publicadas. Objetivo: presentar el proceder anestésico multimodal utilizado en un paciente con pectus excavatum. Caso clínico: varón de 15 años de edad, con trastornos respiratorios restrictivos clínicos y espirométricos que dificultaban su actividad física. La deformidad fue corregida mediante tratamiento quirúrgico convencional, con anestesia multimodal. Presentó un transoperatorio estable lo cual permitió ser extubado a su llegada a la Unidad de Cuidados Intensivos (UCI). Durante el período posoperatorio recibió analgesia por catéter epidural, cuando la Escala Visual Análoga del dolor posoperatorio (EVA) fue superior a 5. Conclusiones: el uso de anestesia multimodal en un paciente pediátrico, hizo posible la corrección de forma satisfactoria de un niño con pectus excavatum, por lo que se puede generalizar esta técnica para la corrección quirúrgica de ésta enfermedad en instalaciones de salud especializadas en Cuba.

Introduction: Pectus excavatum is a congenital deformity of the anterior chest wall. Not evident at birth, it fully develops during childhood and adolescence, and may constitute a relevant functional, psychosocial and aesthetic problem for the sufferer. Its physiopathogeny is attributed to the abnormal growth of the costal cartilages. The incidence of pectus excavatum in our country is not negligible. A small number of patients have been operated on, but there are few published references on the topic. Objective: describe the multimodal anesthetic procedure used in a patient with pectus excavatum. Clinical case: 15-year-old male patient with clinical and spirometric restrictive respiratory disorders hindering his physical activity. The deformity was corrected by conventional surgical treatment under multimodal anesthesia. The patient had a stable transoperative period and was extubated upon arrival at the Intensive Care Unit (ICU). During the postoperative period he received analgesia through an epidural catheter when Analog Visual Scale (AVS) values for postoperative pain were greater than 5. Conclusions: the use of multimodal anesthesia in a pediatric patient enabled the satisfactory correction of a pectus excavatum. This technique for the surgical correction of this condition may be generalized in specialized health facilities in the country.