Clínica

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    Sexual health and sexual quality of life among individuals with spinal cord injury in Latin America
    (American Spinal Injury Association (ASIA), 2023) Longoni, Melina Noemi ; Ertl, Melissa E. ; Ramos-Usuga, Daniela Lucía ; Carballea, Denise ; Degano, Mariela ; Perrin, Paul P ; Arango-Lasprilla, Juan Carlos
    Background: Sexual changes are an area of primary concern for individuals with spinal cord injury (SCI) and their partners, but the topic has gone largely unexplored in the research literature. Objectives: This study examined how individuals with SCI in Latin America experience their sexuality and what issues they and their partners face in this area. Methods: A total of 248 individuals with SCI from Latin America completed an online 60-item survey regarding sexuality. Results: The majority of participants (87.7%) reported that they had noticed changes in sexuality after the injury, mainly physical problems (50.7%), emotional problems (38.7%), and changes in relationships with partners (27.5%). Regarding sexual desire, 47.2% indicated that desire remained the same after SCI. The majority of participants (81.9%) indicated not having received any information about sexuality after SCI during their hospital stay but reported that they would have liked to have received information (98.1%). Of all participants, 66.1% reported never having been asked about problems or difficulties in their sexual life after SCI by any health professional. Conclusion: Interventions designed to educate individuals with SCI regarding the effect of injury on their sexual functioning, responsiveness, and expression, as well as to support them in maintaining and enhancing their sexual well-being, may be extremely beneficial, particularly in Latin America. Findings highlight the distinct need for professionals to introduce the topic of sexuality by discussing it in a straightforward, nonjudgmental manner and to integrate discussions about sex and related issues into assessment, planning, and ongoing treatment.
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    Which thyroid nodules should be treated with surgery?
    (Jaypee Brothers Medical Publishers, 2021) Batallés, Stella Maris ; Novelli, Jorge Luis ; Brunàs, Oscar L. ; Brunás, Melisa E. ; Brunás, Anabela V.
    Aim: The objective of this work was to review the different conditions and characteristics of thyroid nodules that suggest surgical treatment. Background: A systematic literature searching was carried out in main databases (Medline, PubMed, EMBASE, LILACS, Google Academic, SciELO, and The Cochrane Library). The search was restricted to scientific papers published after 2005; only previous works that were inexcusable, specific references were included. The quality and consistency of the recommendations of treatment of thyroid nodules were systematically reviewed and assessed with the AGREE and AGREE-II guidelines. The different conditions and characteristics of thyroid nodules that suggest surgical treatment must be defined by valid, reliable, independent, and easily applied clinical-therapeutic guidelines. Several prestigious organizations from America, Europe, and Asia have developed guidelines containing recommendations for the surgical management of thyroid nodules. However, these recommendations may differ, and that could lead to confusion in many cases. Homogeneous guidelines are required to decide in which cases a thyroid nodule should be treated with a surgical intervention. Review results: Currently, fine needle aspiration under ultrasound guidance (FNA) has allowed cytological evaluation of non-palpable thyroid nodules from 2 mm in diameter. Nowadays, both ultrasound and FNA define–in most cases–whether or not a nodule requires surgery. Conclusion: Not all thyroid nodules require surgery. Surgical treatment is indicated in nodules with confirmed diagnosis or suspected malignancy, when the cytology of an FNA is undetermined, when goiter produces compressive symptoms, in cases of cervicothoracic goiters, recurrent cysts, or when the nodule grows during the follow-up. Clinical significance: To identify clinical and cytological characteristics in thyroid nodules to decide in which cases a thyroid nodule should be treated with surgery.