Expectativas prévias ao implante coclear e avaliação pós implante em adolescentes

This work aimed to verify tendencies of relation between previous expectations (P.E.), anxieties and fears of patients applying to Cochlear Implant (C.I.) and their later evaluation concerning the gains obtained with the implant. The subjects were 6 patients of both sexes, between 13 and 19 years of age, with C.I. accomplished from 7 to 44 months. The data previous to the surgery were collected from the patients registers and compared with the ones collected through the semi-structured interview conducted during the later rehabilitation stage. The results indicated similarity between two kinds of P.E. and evaluation post C.I.. The aesthetic aspect revealed itself as an important factor among the patients concerns. The pre-surgery guidance made the P.E. more adequate as well as the evaluation of the gains post C.I.. The necessity of psychological attendance pre and post C.I. is indicated in order to minimize the difficulties of adaptation related to the self-image of adolescent patients and the development of proper expectations.O trabalho objetivou verificar tendências de relação entre expectativas prévias (E.P.), ansiedades e temores de pacientes candidatos a Implante Coclear (I.C.) e suas avaliações posteriores quanto a ganhos obtidos com o implante. Os sujeitos foram 6 pacientes, de ambos os sexos, entre 13 a 19 anos de idade com I.C. realizado de 7 a 44 meses. Dados anteriores à cirurgia foram coletados dos prontuários e comparados aos coletados via entrevista semi-estruturada na fase de reabilitação posterior. Resultados indicaram similaridade entre tipos de E.P. e avaliações subseqüentes ao I.C.. O aspecto estético mostrou-se importante fator de preocupação. A orientação pré-cirúrgica facilitou adequação de E.P. e avaliações de ganhos pós implante. Indica-se a necessidade de acompanhamento psicológico pré e pós I.C. para minimizar dificuldades de adaptação relacionadas à auto-imagem de pacientes adolescentes e adequação de expectativas.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)USP Hospital de Reabilitação de Anomalias Craniofaciais - HRACUniversidade Estadual PaulistaUSP HRACHospital Reabilitação de Anomalias CraniofaciaisUSP Fac. Odontologia de BauruUSP HRAC CPAPUC-SPUniversidade Estadual Paulist

Disseminated pilocytic astrocytoma involving brain stem and diencephalon: a history of atypical eating disorder and diagnostic delay.

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Findings concerning testis, vas deference, and epididymis in adult cases with nonpalpable testes

In this study, we aimed to state the relationship between testis, epididymis and vas deference, in adult cases with nonpalpable testis. Between January 1996 and December 2009, we evaluated 154 adult cases with nonpalpable testes. Mean age was 23 years (20-27 years). Explorations were performed by open inguinal incision, laparoscopy, and by inguinal incision and laparoscopy together on 22, 131 and 1 patient, respectively. Of all the unilateral cases, 32 were accepted as vanishing testis. In five of these cases, vas deference was ending inside the abdomen, and in the others, it was ending inside the scrotum. In the remaining 99 unilateral and 22 bilateral cases, 143 testes were found in total. Testes were found in the inguinal canal as atrophic in one case, at the right renal pedicle level with dysmorphic testis in one case, and anterior to the internal ring between the bladder and the common iliac vessels at a smaller than normal size in 119 cases. One (0.69%) case did not have epididymis. While epididymis was attached to the testis only at the head and tail locations in 88 (61.53%) cases, it was totally attached to the testis in 54 (37.76%) cases. There is an obviously high incidence rate of testis and vas deference anomalies, where epididymis is the most frequent one. In cases with abdominal testes, this rate is highest for high localised abdominal testes