Objective: To describe the frequency of domestic violence against Brazilian children and adolescents due to episodes of enuresis, as well as associated risk factors. Methods:A cross-sectional study was carried out with 149 patients aged between 6 and 18 years who received the diagnosis of primary monosymptomatic nocturnal enuresis. A semi-structured interview was done with the patients and their guardians to collect information about the characteristics of domestic violence and abusers. In addition, a playful activity was performed by the patients. Abuse was characterized as verbal aggression, physical aggression without physical contact, and physical aggression with physical contact.Results: Eighty-nine percent (n = 132) of the patients suffered abuse due to episodes of urine leakage. All cases were characterized by verbal punishment associated or not with other types of aggression. Physical punishment without physical contact occurred in 50.8% of the cases, while physical punishment with physical contact accounted for 48.5% of the cases. The main abuser was the mother (87.9%). One patient suffered an intentional severe genital injury, and reconstructive surgery was necessary. There was a significant correlation (p = 0.043, r = -0.768) between the abuser's educational level and punishment severity. Conclusions:Punishment rates due to episodes of urine leakage are alarming. Children and adolescents with enuresis who live with low-educated people can be considered a population at risk of suffering domestic violence. J Pediatr (Rio J). 2009;85(5):433-437:Childhood, adolescence, enuresis, aggression, punishment. ResumoObjetivo: Descrever a frequência da violência doméstica praticada contra crianças e adolescentes brasileiros devido ao episódio enurético e os fatores de risco associados a ela.Métodos: Foi realizado um estudo transversal envolvendo 149 pacientes com idades de entre 6 e 18 anos, diagnosticados com enurese noturna monossintomática primária. Durante uma entrevista semiestruturada com o paciente e seu responsável legal, foram obtidas informações sobre as características da violência doméstica e o agressor, sendo adicionada uma atividade lúdica para o paciente. A agressão foi classificada em verbal, física sem contato, ou física com contato.Resultados: Dos pacientes entrevistados, 89% (n = 132) sofreram algum tipo de agressão devido ao episódio enurético. Todos os casos apresentaram punição verbal associada ou não a outro tipo de agressão. Punição física sem contato ocorreu em 50,8% dos casos, e com contato, em 48,5%. O principal agressor foi a mãe (87,9%). Em um caso, houve lesão genital grave que necessitou de cirurgia reconstrutora. Houve uma correlação significativa (p = 0,043, r = -0,768) entre os anos de estudo dos responsáveis e a gravidade da punição. Conclusões:Os índices de punição em pacientes com enurese noturna monossintomática primária são alarmantes. Crianças e adolescentes enuréticos que convivem no âmbito doméstico com pessoas com poucos anos de estudo podem ser considerados popul...
Objetivo: Classicamente, o pênis tem duas funções: permitir a fertilização interna e direcionar o jato miccional. Entretanto, alterações objetivas do tamanho peniano podem levar ao diagnóstico de doenças. Além disso, é motivo comum de consulta médica a busca por parâmetros de normalidade do tamanho do pênis. Contudo, a antropometria do pênis da criança e do adolescente brasileiros ainda não foi devidamente estudada. O objetivo do estudo é realizar a antropometria do pênis de crianças e adolescentes brasileiros, estabelecendo referências para aplicação clínica.Métodos: Foi realizado um estudo transversal, envolvendo 2.010 pacientes com idades variando entre 0 e 18 anos. Foram obtidas cinco medidas penianas: diâmetro da haste peniana; comprimento aparente e real do pênis flácido; comprimento aparente e real (CRT max ) do pênis flácido sob tração máxima. O desenvolvimento puberal foi caracterizado pelos critérios de Tanner.Resultados: De todas as medidas penianas, o CRT max foi a única que não apresentou variação significativa interpesquisador em todas as faixas etárias analisadas (p = 0,255). Os resultados foram distribuídos em tabelas com a média do CRT max e os valores do que se considera micropênis (média -2,5 desvio padrão) de acordo com as diferentes faixas etárias e com os diferentes graus de maturação sexual de Tanner. Foi desenvolvido um gráfico com a distribuição dos valores do CRT max distribuído por percentis 10, 25, 50, 75 e 90 por faixa etária.Conclusões: De todas as medidas antropométricas penianas, o CRT max é a única clinicamente útil. Recomendamos nossos resultados como referência de antropometria peniana para crianças e adolescentes brasileiros.
Objective: Classically, the penis has two functions: to make internal fertilization possible and to direct the urine stream. However, objective abnormalities in penis size can lead to diseases being diagnosed. Furthermore, many medical consultations are the result of patients seeking parameters for normal penis size. Additionally, the penile anthropometry of Brazilian children and adolescents has not yet been properly studied. The objective of this study is to carry out penile anthropometry of Brazilian children and adolescents, establishing references for clinical use. Methods:A cross-sectional study was carried out of 2,010 patients with ages varying from 0 to 18 years. Five penile measurements were taken: diameter of penile shaft; apparent and real length of flaccid penis; apparent and real (RSL max ) length of flaccid penis fully stretched. Pubertal development was defined according to Tanner's criteria. Results:Only RSLmax, out of all of the penile measurements, did not exhibit significant interobserver variation at all ages analyzed (p = 0.255). Results were tabulated with mean RSLmax and the values that define micropenis (mean -2.5 standard deviations) by age and by Tanner sexual maturity stages. A graph was plotted of the distribution of RSLmax results by the 10th, 25th, 50th, 75th and 90th percentiles and by age. Conclusions:Out of all of the penile anthropometric measurements, only RSL max is clinically useful. We recommend our results as a reference standard for penile anthropometry of Brazilian children and adolescents.J Pediatr (Rio J). 2007;83(5):441-446: Anthropometry, penis, child development, adolescent development, growth.
Abstract. Anti-tumor antibodies act as biomarkers for the early diagnosis of prostate cancer (PCa). Osteopontin (OPN) is overexpressed in PCa cells and contributes to the progression of the disease. This study aimed to evaluate whether OPN evokes a humoral immune response in PCa patients and whether the reactivity levels of anti-OPN antibodies may be used to better differentiate PCa from benign and healthy donor plasma samples. Plasma samples from biopsy-proven PCa patients (29), benign prostate hyperplasia (BPH) (18) and control healthy donors (HD) (30) were tested by immunoblots using the recombinant human OPN. The frequency of anti-OPN antibodies was significantly higher in PCa (66%) plasma samples as compared to BPH (33%) and HD controls (10%). Anti-OPN antibodies were detected in a high proportion of plasma samples from patients with a Gleason score of less than 6 (57%), prostate-specific antigen levels lower than 10 ng/ml (67%) and pT2 organ-confined disease (70%), suggesting that anti-OPN antibodies may be used as an early serum marker for PCa. To the best of our knowledge, this is the first description of OPN as a tumor autoantigen and one of the most reactive individual autoantigens described thus far. These data support the inclusion of OPN in a multiplex of tumor antigens in order to perform antibody profiling in PCa as well as in other malignancies overexpressing OPN.
Lipomas and their variants are benign soft-tissue tumors that occur at any age and most frequently on the upper back and neck, shoulder, and abdomen. The foot is a relatively uncommon site for soft-tissue neoplasia and the etiology is not usually related to trauma. We describe a case of a pedunculated fibrolipoma of the forefoot that originated from a cut wound at the Atlantic Ocean. A brief review of the literature is also given.
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