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No description available.

Pectus excavatum (PE) is a congenital deformity that is characterized by a sunken chest. Children with PE often experience embarrassment and shame over their physical appearance and can undergo the Nuss procedure, a minimally invasive surgery, to correct their deformities. Because a child's characteristics can affect the well-being and experiences of hisiher parents, one might expect that children with PE would impact the lives and behaviors of their parents. The present study employed phenomenology to investigate the experiences, perceptions, and recommendations of three fathers and six mothers whose children have undergone the Nuss procedure. Interviewers were conducted, transcribed verbatim, and thematically analyzed. Results indicate parents were most concerned about their child's well-being when hisher pectus became severe and symptomatic, and when helshe recovered fiom surgery. Moreover, many of the children's pediatricians were unaware of the Nuss procedure; as such, parents suggested that medical professionals are informed about this corrective procedure.

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Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-01-31Bitstream added on 2014-06-13T19:32:56Z : No. of bitstreams: 1 arruda_ka_me_botfm.pdf: 7832149 bytes, checksum: 25a2e29b369d61ab33b2c873f2f89db5 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As cirurgias abdominais supra-umbilicais e torácicas são procedimentos com grande chance de complicações cardiorrespiratórias no pós-operatório (CPO). Determinar se os testes utilizados no pré-operatório para avaliação das funções cardíaca e pulmonar são capazes de diferenciar os pacientes que teriam maiores chances de desenvolver complicações no pós-operatório, em dois grupos de pacientes, os submetidos à cirurgia abdominal supra-umbilical e os submetidos à cirurgia torácica por via não esternal, e quais os testes mais importantes em cada uma das intervenções. Foram avaliados os candidatos a laparotomia supra-umbilical (Grupo L) e à toracotomia (Grupo T), de fevereiro de 2010 a agosto de 2011. Foi realizado espirometria, ventilometria, manovacuometria, teste de caminhada de seis minutos (TC6) e teste de escada (TE). Foram anotadas as CPO desde o pós-operatório imediato até a alta hospitalar. Os pacientes foram divididos em dois subgrupos relacionado com a ausência (A) ou presença (B) de CPO (LA e LB, TA e TB). Foi realizado o teste de Shapiro-wilki para avaliar a distribuição das variáveis, quando normal foi utilizado o teste t de Student e não normal o teste de Mann-Whitney. Foram realizadas a regressão uni e multivariada para associação das variáveis com as CPO e o p<0,05 foi considerado significativo. Foram avaliados 78 pacientes (30 grupo L e 48 grupo T). As taxas de CPO foram 17% no grupo L e 10% no grupo T. No grupo L as variáveis da manovacuometria foram significativamente menores no subgrupo LB, enquanto no grupo T as variáveis espirométricas, e do TC6 e TE, foram significativamente menores no subgrupo TB. Na regressão univariada a única variável que manteve correlação com as CPO na laparotomia foi a PEmax%, sendo considerada fator protetor. Na toracotomia a ventilação voluntária máxima... / Upper abdominal and thoracic surgery are procedures that present a high risk of cardiorespiratory complications in postoperative (POC). Evaluating if the tests used in preoperative to provide cardiopulmonary evaluation are able to differentiate the patients that presented complications in postoperative period, patients submitted to upper abdominal or to thoracic surgeries well as the most important tests for each of the interventions. The candidates for upper abdominal surgery were evaluated (UAS Group) and for thoracic surgery (TS Group), from February, 2010 to August, 2011. Spirometry, respirometry, manovacuometry, 6- minute walk test (6MWT) and stairclimbing test (SCT) were performed. The POC from immediate postoperative to discharge from hospital were registered. The patients were divided into two subgroups (UAA and UAP, TA and TP) related to the absence (A) or presence (P) of POC. Shapiro-wilki Test was performed in order to evaluate the distribution of variables; Student t test was performed when normal, whereas Mann-Whitney test, when not normal. Univariate and multivariate regression were carried out for association of variables with POC and the p<0.05 was considered significant. 78 patients were evaluated (30 from UAS Group and 48 from TS Group). The POC rates were 17% in UAS Group and 10% in TS Group. In UAS Group, the variables of manovacuometry were significantly lower in UAP Subgroup, while in TS Group, the spirometric, 6MWT and SCT variables were significantly lower in TP Subgroup. Related to univariated regression, the only variable that kept the correlation with POC in the upper abdominal surgery was PEmax%, being considered as a protective factor. In thoracic surgery, the MVV%, 6MWT and tTE presented correlation with POC, and MVV% and 6MWT were considered protective factors... (Complete abstract click electronic access below)

Orientador: Daniele Cristina Cataneo / Coorientador: Antonio José maria Cataneo / Banca: alexandre Ricardo Pepe Ambrozin / Banca: Olavo Ribeiro Rodrigues / Resumo: As cirurgias abdominais supra-umbilicais e torácicas são procedimentos com grande chance de complicações cardiorrespiratórias no pós-operatório (CPO). Determinar se os testes utilizados no pré-operatório para avaliação das funções cardíaca e pulmonar são capazes de diferenciar os pacientes que teriam maiores chances de desenvolver complicações no pós-operatório, em dois grupos de pacientes, os submetidos à cirurgia abdominal supra-umbilical e os submetidos à cirurgia torácica por via não esternal, e quais os testes mais importantes em cada uma das intervenções. Foram avaliados os candidatos a laparotomia supra-umbilical (Grupo L) e à toracotomia (Grupo T), de fevereiro de 2010 a agosto de 2011. Foi realizado espirometria, ventilometria, manovacuometria, teste de caminhada de seis minutos (TC6) e teste de escada (TE). Foram anotadas as CPO desde o pós-operatório imediato até a alta hospitalar. Os pacientes foram divididos em dois subgrupos relacionado com a ausência (A) ou presença (B) de CPO (LA e LB, TA e TB). Foi realizado o teste de Shapiro-wilki para avaliar a distribuição das variáveis, quando normal foi utilizado o teste t de Student e não normal o teste de Mann-Whitney. Foram realizadas a regressão uni e multivariada para associação das variáveis com as CPO e o p<0,05 foi considerado significativo. Foram avaliados 78 pacientes (30 grupo L e 48 grupo T). As taxas de CPO foram 17% no grupo L e 10% no grupo T. No grupo L as variáveis da manovacuometria foram significativamente menores no subgrupo LB, enquanto no grupo T as variáveis espirométricas, e do TC6 e TE, foram significativamente menores no subgrupo TB. Na regressão univariada a única variável que manteve correlação com as CPO na laparotomia foi a PEmax%, sendo considerada fator protetor. Na toracotomia a ventilação voluntária máxima... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Upper abdominal and thoracic surgery are procedures that present a high risk of cardiorespiratory complications in postoperative (POC). Evaluating if the tests used in preoperative to provide cardiopulmonary evaluation are able to differentiate the patients that presented complications in postoperative period, patients submitted to upper abdominal or to thoracic surgeries well as the most important tests for each of the interventions. The candidates for upper abdominal surgery were evaluated (UAS Group) and for thoracic surgery (TS Group), from February, 2010 to August, 2011. Spirometry, respirometry, manovacuometry, 6- minute walk test (6MWT) and stairclimbing test (SCT) were performed. The POC from immediate postoperative to discharge from hospital were registered. The patients were divided into two subgroups (UAA and UAP, TA and TP) related to the absence (A) or presence (P) of POC. Shapiro-wilki Test was performed in order to evaluate the distribution of variables; Student t test was performed when normal, whereas Mann-Whitney test, when not normal. Univariate and multivariate regression were carried out for association of variables with POC and the p<0.05 was considered significant. 78 patients were evaluated (30 from UAS Group and 48 from TS Group). The POC rates were 17% in UAS Group and 10% in TS Group. In UAS Group, the variables of manovacuometry were significantly lower in UAP Subgroup, while in TS Group, the spirometric, 6MWT and SCT variables were significantly lower in TP Subgroup. Related to univariated regression, the only variable that kept the correlation with POC in the upper abdominal surgery was PEmax%, being considered as a protective factor. In thoracic surgery, the MVV%, 6MWT and tTE presented correlation with POC, and MVV% and 6MWT were considered protective factors... (Complete abstract click electronic access below) / Mestre

Made available in DSpace on 2016-06-07T17:12:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-02-24. Added 1 bitstream(s) on 2016-06-07T17:16:39Z : No. of bitstreams: 1 000864305.pdf: 161359 bytes, checksum: 2699ee457a3507f7146161534b6f279c (MD5) / Introdução: Pectus excavatum caracteriza-se como uma depressão da parede anterior do tórax (esterno e cartilagens costais inferiores) e é a deformidade mais frequente da parede torácica. A prevalência varia entre 6,28-12 casos por mil em todo o mundo. Geralmente pectus excavatum é identificado no nascimento ou após algumas semanas ou meses; no entanto, por vezes, torna-se evidente apenas na puberdade. Sua consequência na condição de vida do indivíduo é variável. Alguns vivem uma vida normal e os outros apresentam sintomas físicos e psicológicos, tais como dor precordial após exercícios, deficiências de função pulmonar e cardíaca, timidez e isolamento social. Por muitos anos, a ressecção subpericondral das cartilagens costais, com ou sem osteotomia transversal cuneiforme do esterno e colocação de um suporte subesternal, chamada cirurgia convencional, foi a opção mais aceita para correção cirúrgica desses pacientes. A partir da década de 80 um novo reparo cirúrgico, chamado cirurgia minimamente invasiva, se tornou disponível. Essa opção cirúrgica menos invasiva consiste na colocação de uma barra de metal curvado retrosternal, sem ressecção das cartilagens costais ou osteotomia do esterno e é realizada por videotoracoscopia. No entanto, muitos aspectos que se relacionam com os benefícios e malefícios de ambas as técnicas não têm sido definidos. Objetivo: avaliar a eficácia e a segurança da cirurgia convencional em comparação com a cirurgia minimamente invasiva para o tratamento de pessoas com pectus excavatum. Método: na busca foram utilizados apenas os termos relacionados à condição do indivíduo (pectus excavatum). Termos relacionados às intervenções, resultados e tipos de estudos não foram incluídos. A busca foi feita nas seguintes bases: Cochrane Central Register de Ensaios Controlados (CENTRAL), PubMed, Embase, LILACS, e ICTPR. Critérios de seleção: foram considerados ensaios... / Background: pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1980's a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objective :To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Method: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery...

Orientador: Antônio José Maria Cataneo / Coorientador: / Banca: Vania S. Nunes / Banca: Olavo R. Rodrigues / Banca: Altair Silva Costa Junior / Banca: Alcides Durigan Junior / Resumo: Introdução: Pectus excavatum caracteriza-se como uma depressão da parede anterior do tórax (esterno e cartilagens costais inferiores) e é a deformidade mais frequente da parede torácica. A prevalência varia entre 6,28-12 casos por mil em todo o mundo. Geralmente pectus excavatum é identificado no nascimento ou após algumas semanas ou meses; no entanto, por vezes, torna-se evidente apenas na puberdade. Sua consequência na condição de vida do indivíduo é variável. Alguns vivem uma vida normal e os outros apresentam sintomas físicos e psicológicos, tais como dor precordial após exercícios, deficiências de função pulmonar e cardíaca, timidez e isolamento social. Por muitos anos, a ressecção subpericondral das cartilagens costais, com ou sem osteotomia transversal cuneiforme do esterno e colocação de um suporte subesternal, chamada cirurgia convencional, foi a opção mais aceita para correção cirúrgica desses pacientes. A partir da década de 80 um novo reparo cirúrgico, chamado cirurgia minimamente invasiva, se tornou disponível. Essa opção cirúrgica menos invasiva consiste na colocação de uma barra de metal curvado retrosternal, sem ressecção das cartilagens costais ou osteotomia do esterno e é realizada por videotoracoscopia. No entanto, muitos aspectos que se relacionam com os benefícios e malefícios de ambas as técnicas não têm sido definidos. Objetivo: avaliar a eficácia e a segurança da cirurgia convencional em comparação com a cirurgia minimamente invasiva para o tratamento de pessoas com pectus excavatum. Método: na busca foram utilizados apenas os termos relacionados à condição do indivíduo (pectus excavatum). Termos relacionados às intervenções, resultados e tipos de estudos não foram incluídos. A busca foi feita nas seguintes bases: Cochrane Central Register de Ensaios Controlados (CENTRAL), PubMed, Embase, LILACS, e ICTPR. Critérios de seleção: foram considerados ensaios... / Abstract: Background: pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1980's a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objective :To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Method: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery... / Doutor

Currently, there is little research on self-perception and the psychological impact of concealable deformities such as pectus excavatum (PE). The current study addresses this gap by comparing self-perceived severity, actual physical severity, and depressive symptoms in youth with PE. Substantiating parents' and physicians' concerns, participants' scores on the Youth Self-Report depression subscales were significantly higher than non-clinical normative samples, indicating more depressive symptoms. Analyses of self-perceived severity, the Haller Index (HI; a medical measure of PE severity), and depressive symptoms substantiated the importance of subjective self-perception. There were no significant correlations between the HI of physical severity and depressive affect; however, youths' perceptions of severity correlated strongly and predicted depressive affect. The results suggest that youth with PE may be at risk for depressive disorders, and that self-perception, not actual physical severity, is the better predictor of the psychosocial impact of the deformity.