Anamnesis Questionnaire Research Articles

P-490 ‘Your Fertility @ Home’, a clinical pilot study on a new diagnostic smartphone app for treatment naive fertility patients

Abstract Study question What are patients’ experiences with a newly developed diagnostic smartphone app? Summary answer The first patients’ experiences with the content of the app are positive. Also, participants made positive changes in their lifestyle after advice from the app. What is known already Previous studies on digital healthcare for fertility patients are promising. However, many e-Health initiatives are not thoroughly evaluated, which hampers implementation. During a fertility trajectory patients often feel a lack of control, we therefore developed a new smartphone app with a dual purpose. First, to give new fertility patients more control and empowerment over their situation by providing reliable information and personalized advice. Second, to support healthcare professionals in choosing the right diagnostic tests and interpretation of the results. This app was first validated on a historical cohort of patient data, before testing the app in a prospective patient group. Study design, size, duration This is an ongoing, prospective pilot study of 70 heterosexual patient couples. Patients were followed up from the start of the fertility workup until the work-up finished. This abstract covers the preliminary results of the first 19 participants. Follow up is expected to be complete at time of the ESHRE annual meeting. Participants/materials, setting, methods The study population consists of treatment naïve infertile couples, who were referred to a fertility-clinic. Before the first appointment, patients used the smartphone app, which consisted of a medical anamnesis questionnaire for both women and partners. Based on the anamnesis the app provided recommendations about lifestyle and diagnostic tests, which were in line with current Dutch guidelines. Patients were given advice on the results of the tests and filled in a questionnaire about their experiences. Main results and the role of chance The experience questionnaire for patients included three parts. The questions in the first part were based on the validated Patient-Centered Questionnaire Infertility. This covered questions about the use of the app, for example the ease of installation and if they felt involved with use of the app. Sixteen out of nineteen patients (84%) felt taken seriously, eleven patients (58%) experienced enough attention to their emotions and fourteen patients (74%) would advise their friends to use the app. The second part included questions about the results of the diagnostic tests. Ten patients (52%) found the explanation of the results clear, three patients (15%) wanted additional information. Eleven patients (58%) thought the results and information matched their personal situation. The third part of the questionnaire asked about the lifestyle advice patients received in the app. Twelve patients (63%) found this advice useful. The other patients found the advice not matching their situation. After using the app, ten patients (52%) said they made a change in their lifestyle to optimize their fertility situation. On a ten point Likert scale, 16 patients (84%) scored the app an eight or higher. Limitations, reasons for caution These are results of a pilot study and thus must be interpreted with caution. Secondly, this is the first version of the app that has been tested with patients, so next the app needs further optimization before it can be fully implemented. Wider implications of the findings Considering the positive reception, this app holds potential for a beneficial change in fertility care. It may increase the accessibility to reliable personal information and advice for new fertility patients in a safe and private environment. This might lead to patient empowerment and positive lifestyle changes enhancing their fertility potential. Trial registration number 2022.09.05.01

INTEGRATIVE NUTRITIONAL ASSESSMENT EPIGENETICS TRANSGENERATIONAL EFFECTS AND LIFE HISTORY THEORY

This review describes how nutritional assessment and anamnesis questionnaires can be helped by information from research that addresses transgenerational epigenetic effects and life history theory (LHT) in the prevention and treatments of chronic non-communicable diseases (NCDs). The connection between these fields of biological studies allows for better preventive clarification of individual needs through interaction: environment, epigenetics, life strategy pathways and their impacts on the organism’s functions, such as growth, maintenance, reproduction and immunological defense, associated with risks that predispose to chronic diseases.

Impact of occupational noise on the postural control of older adults

Introduction: The studies on the consequences of noise to the auditory system are well documented, particularly in workers’ health. Nevertheless, few studies in the field yet have related postural control to occupational noise exposure. Objective: To investigate the association between the history of occupational noise and the postural control in older adults. Materials and Methods: Cross-sectional study that included individuals of both sexes older than 60 years. All of them had their postural control assessed on a force platform. The occupational noise was assessed with an audiological anamnesis questionnaire. The hearing loss was assessed using the pure-tone threshold audiometry. The Tinnitus Handicap Inventory questionnaire was used to quantify the impact of tinnitus on daily life of the older adults. Results: 90 older adults (87.8% women, 70[64-75] years old) were analyzed. The history of occupational noise exposure was associated with a worse postural control in older adults, regardless of the person’s age (ANCOVA; P < 0.05). Moreover, the greater the hearing loss, the greater the body instability of the older adults (r≤0.36 for all). Finally, postural control was related to tinnitus presenting correlations with catastrophic Tinnitus Handicap Inventory (r = 0.314; P = 0.038) and functional Tinnitus Handicap Inventory (r = 0.430; P = 0.010). Conclusion: Postural control of older adults is related to the history of occupational noise exposure, hearing loss and tinnitus impact on older adult’s daily life.

O-202 Online fertility workup with video consultation for infertile patients; a randomized controlled trial

Study questionIs an online consultation for fertility work-up as effective as regular consultation in terms of patient centeredness and shared decision making?Summary answerThis study shows no significant differences in level of patient-centeredness and shared decision making for an online fertility work-up compared to a regular appointment.What is known alreadyCouples who suffer from involuntarily childlessness can experience a high psychological burden and treatment for their infertility has a high impact on their daily life. Most optimally, patients receive personalized information and undergo diagnostic testing for fertility work-up, with as little as possible interference in their personal life. Two recent studies already evaluated the use of video-consulting to further modernize current fertility care, with positive results. However, more well-designed research is needed to expand and carefully evaluate the idea of an online fertility work-up for patients with an unfulfilled child wish.Study design, size, durationThis is a single-center non-blinded randomized controlled trial of 84 heterosexual patient couples. Patients were followed up from the start of the fertility work-up until three months after completion of the work-up.After the work-up, a questionnaire was send through an online research program consisting of a modified version of the Patient-Centered Questionnaire-Infertility (PCQ-I) to measure patient-centeredness and the CollaboRATE questionnaire to evaluate the level of shared decision making.Participants/materials, setting, methodsThe study population consisted of infertile couples, who were referred to a fertility clinic for the first time. Couples were randomized between a regular fertility work-up, consisting of two face-to-face appointments of in total 45 minutes, and an online fertility work-up. The latter consisted of online recommendations and diagnostic tests, based on patient specific characteristics from an anamnesis questionnaire, followed by a 30 minute video consultation with a fertilitydoctor to discuss results and treatment advice.Main results and the role of chanceOf the 84 included patients, 75 questionnaires were returned for this abstract (89%). The mean score on the total PCQ-I was 2.66 (SD 0.20), on a scale of 0-3, for the online fertility work-up versus 2.57 (SD 0.29) for the control group. This was not statistically significant (p = 0.147). Also the different subscales of the PCQ-I did not show statistically differences between the two groups, but there was a positive trend for the online fertility work-up on the subscale ‘Information and Communication’ (2.85 (SD 0.21) vs 2.72 (SD 0.31); p = 0.055).On the CollaboRATE questionnaire, no significant differences in experienced level of shared decision making were found between the two groups (means between 7.52 – 7.91 on a ten point Likert scale).During seven video consultations (17%) some technical difficulties were experienced, for example the video worked but there was no sound. For 62% of the couples in the intervention group the time for preparation for the online fertility workup was less than five minutes, while the majority of the patients in the control group (52%) spend at least 60-90 minutes on their appointment in the fertility clinic.Limitations, reasons for cautionThis study was performed during the COVID-19 pandemic, when patients were more used to online meetings. The preferences of patient post pandemic might be different. At this point we have not yet evaluated whether online fertility consultation leads to different conclusions and treatment advices than regular fertility care.Wider implications of the findingsIn our study online fertility work-up with video consultation is perceived as good as a regular work-up, therefore future patients should be offered a choice between the two methods. Considering the rapid development of online technology, online fertilitycare may develop further. It is important that developments undergo thorough scientific evaluation.Trial registration numberNL8554

Most subjectively affected joints in patients with haemophilia - what has changed after 20 years in Germany?

In patients with haemophilia (PwH), most frequently affected joints are the ankle, knee and elbow. Due to improved factor therapy in the last decades, these previous findings have to be verified in Germany. The aim of this study is to detect the most affected joint, evaluate the significance of the source of pain and determine the point prevalence of back pain in Germany today. In a retrospective study, data of n=300 patients with severe moderate and mild haemophilia were evaluated regarding the most affected joint, the most common source of pain, and the point prevalence of back pain. An anamnesis questionnaire and the German Pain Questionnaire were used for this assessment. The most affected joint in German PwH is still the ankle (41%), followed by the knee (27%) and the elbow (11%). The most common source of pain is also the ankle joint (32%). Back pain was also identified as one of the most common sources of pain, which is comparable to the elbow (elbow:15%; back:13%). The point prevalence in PwH for back pain was significantly higher compared to the general German population (P=.031). Our data showed that the ankle is still the most affected joint and the most common source of pain in Germany. These results also showed the relevance of back pain as a pain source. The evaluations also demonstrated the high point prevalence of back pain in PwH. Future therapies should also focus on the spine because joint changes affect posture.

Perceptions of Doctors' Empathy and Patients' Subjective Health Status at an Online Clinic: Development of an Empathic Anamnesis Questionnaire.

ABSTRACTObjectiveMedical doctors’ empathy is known to support patients’ health status after face-to-face clinical visits. However, the role of doctors’ empathy in chat-based encounters is not yet well understood. This study investigates whether patients’ evaluations of doctors’ empathy are associated with their health perceptions after a meeting at an online clinic and whether experiences of empathy could be enhanced by augmenting an automated anamnesis questionnaire completed before the visit.MethodsA total of 209 adult patients agreed to participate in the study. First 103 patients filled out the regular version of the questionnaire (June–August 2019) and then 106 filled out the augmented version of the online anamnesis questionnaire (August–November 2019). Patients’ perceptions of doctors’ empathy were measured with the Consultation and Relational Empathy questionnaire. Patients’ self-perceived health status, potential confounders, and demographic background information were measured via questionnaires.ResultsPatients’ perceptions of doctors’ empathy during a chat-based encounter were associated with patients being less concerned about their symptoms (estimated odds ratios varied between 0.45 and 0.55 depending on the model, p values < .003) and considering their symptoms as less severe (estimated odds ratios = 0.54–0.61, p values < .007), as well as a higher probability of alleviation of symptoms as rated by the patients (estimated odds ratios = 2.16–2.24, p values < .001). Augmenting the anamnesis questionnaire did not affect patient reports on doctors’ overall empathy, but it did have positive effects on specific areas of doctors’ empathy covered by the questionnaire.ConclusionsThese results show that patients’ experience of doctors’ empathy not only is important during face-to-face encounters but also supports patients’ perceptions of health when the interaction is text based. The results also encourage further development of means to support patients’ experiences of empathy during online interaction with medical doctors.

Prevalence of signs and symptoms of temporomandibular disorders (TMD) in a sample of medical students in Erbil city

Objectives: The aim of the present study was to find the prevalence of temporomandibular disorder by Helkimo anamnesis and clinical dysfunction index and to determine the degree of associations present between temporomandibular disorder and each of age, gender and anxiety.Methods: 230 students were randomly selected with the age group of 18-25 years, from all colleges of Hawler medical university, from March 2019 to June 2019. Data was collected through Helkimo anamnesis dysfunction index1, Helkimo clinical dysfunction index1and generalized anxiety disorder 7-item scale2. The data were statistically analyzed by Descriptive statistics and chi square test.Results: The most encountered symptoms reported by the students were joint sounds (27.4%) and joint fatigue (27.4%). (50%) of the students had some grade of temporomandibular disorder according to Helkimo anamnesis questionnaire (subjective temporomandibular disorder symptoms) and (57.4%) had some grade of temporomandibular disorder According to Helkimo clinical dysfunction index (objective temporomandibular disorder symptoms). The associations between temporomandibular disorder and each of age (P-value= 0.900), Gender (P -value= 0.221), and anxiety (P-value= 0.288) were statistically not significant by using Helkimo anamnesis questionnaire. Significant association was found between temporomandibular disorder and each of gender (P-value &lt;0.001) and anxiety (P-value &lt;0.001) by using Helkimo clinical dysfunction index.Conclusion: In conclusion, the prevalence of temporomandibular disorder was high. The most common symptom reported by students were joint sounds and joint fatigue. According to Helkimo clinical dysfunction index temporomandibular disorder was more prevalent among females and those who had a degree of anxiety.

Temporomandibular Disorder and Oral Health-Related Quality of Life in Brazilian Adults: A Population-Based Survey

OBJECTIVE: Evaluate the association between TMD symptoms and physical and psychosocial oral health impact among adults of a small Brazilian municipality. &#x0D; &#x0D; METHODS: A population-based epidemiological study with a probabilistic sample of adults (30-49 years) was carried out. Data was collected in the participant&amp;rsquo;s residence using a structured questionnaire, and a clinical examination was conducted by calibrated examiners (Kappa &amp;gt;0.7). The presence of TMD symptoms was evaluated using the Fonseca&amp;rsquo;s Anamnesis Questionnaire (1994). Physical and psychosocial impact was considered if at least one oral functions item was reported as being experienced fairly often or very often, assessed by the Oral Health Impact Profile (OHIP-14), an instrument of Oral Health Related Quality of Life (OHRQoL). The association between TMD symptoms and presence of impact was adjusted for oral health condition, sociodemographic and socioeconomic profiles, and health behaviors. Associations were investigated using the crude and multivariate Poisson regression. &#x0D; &#x0D; RESULTS: Of the 197 participants, 114 (59.30%) had physical and psychosocial impact of oral health and 135 (68.19%) had at least one TMD symptom. After adjusting for covariates, individuals who reported TMD symptoms had a 1.75 times higher prevalence of impact (95%CI 1.18 - 2.57) than those who did not report symptoms, with psychological discomfort (60.46%), physical pain (40.19%), and psychological disability (35.71%) being the most affected dimensions (p &amp;lt;0.01). &#x0D; &#x0D; CONCLUSION: TMD is a common condition and the presence of symptoms is associated with impact in different dimensions of OHRQoL. These results demonstrate the importance of early identification of TMD symptoms to reduce the impact on OHRQoL.

Effect of visual condition and physical activity on the plantar pressure distribution in adult and older women

Abstract The aging process causes changes in the physical and functional conditions, as well as in the foot structure and function. This study aimed to analyze the plantar pressure variation with respect to visual information and physical activity in adult and older women. This was a cross-sectional study that included 142 women (mean age of 67.8 years). Participants responded the anamnesis questionnaire, Mini Mental State Examination, and International Physical Activity Questionnaire. Plantar pressure was assessed using computerized baropodometry. Weight distribution was observed in semitandem positions for the right foot forward and then the left foot forward . Data analysis showed that foot type had no correlation with age (p = 0.37 right foot; p = 0.93 left foot) or level of physical activity (p = 0.28 right foot; p = 0.96 left foot). Moreover, plantar pressure variation showed no significant relationship with age (R2 = 0.2; p = 0.6). In conclusion, plantar pressure variation is not associated with the morphological foot type in women analyzed, as the visual condition did not generate plantar pressure variations when compared to its effect on the classification of plantar arches. Furthermore, level of physical activity was not associated with plantar pressure variation .

Association between constitution, axiography, analysis of dental casts, and postural control in women aged between 41 and 50\xa0years

ObjectivesThe aim of this study was to investigate the relationship between anamnestic, axiographic and occlusal parameters and postural control in healthy women aged between 41 and 50 years.Materials and methodsA total of 100 female participants aged between 41 and 50 (45.12 ± 2.96) years participated in the study. In addition to completing a general anamnesis questionnaire, lower jaw movements were measured axiographically, dental occlusion parameters were determined using a model analysis and postural parameters were recorded using a pressure measurement platform. The significance level was 5%.ResultsAn increasing weight and a rising BMI lead to a weight shifted from the rearfoot (p ≤ 0.01/0.04) to the forefoot (p ≤ 0.01/0.02). A limited laterotrusion on the right resulted in a lower forefoot load and an increased rearfoot load (p ≤ 0.01). Laterotrusion to the left (extended above the standard) showed a lower frontal sway (p ≤ 0.02) and a reduced elliptical area, height and width (p ≤ 0.01, 0.02, 0.03). Thus, the extent of deviation correlated with reduced right forefoot loading (p ≤ 0.03) and the extent of deflection correlated with increased left foot loading (p ≤ 0.01). The higher the extent of angle class II malocclusion, the larger the ellipse area (p ≤ 0.04) and the ellipse height (p ≤ 0.02) resulted.ConclusionsThere is a connection between weight, BMI and laterotrusion, as well as between angle class II malocclusion and postural control in women aged between 41 and 50 years. Interdisciplinary functional examinations of mandibular movements treating possible limitations can be conducive for an improvement of postural control.Clinical relevanceAngle class II malocclusion has a negative influence on postural control.

Estímulos domiciliares e características ao nascimento de crianças com síndrome de Down

Este é um estudo quantitativo e descritivo realizado entre 2018 a 2019, que tem como objetivo descrever as características de nascimento e estímulos domiciliares de crianças com síndrome de Down. O questionário utilizado para coletar informações sobre o ambiente domiciliar da criança foi o Affordances in the Home Environment for Motor Development Self-Report (18 aos 36 meses), através de entrevista, e um questionário de anamnese. Participaram cinco mães e suas crianças com síndrome de Down. As crianças tinham média de 31 meses (±3,78) e, todas realizaram cirurgias. Verificou-se que todas as crianças apresentaram médias e altas oportunidades. O espaço interior e a variedade de estímulos foram os únicos itens em que todas as crianças receberam pontuação muito boa. A motricidade fina e grossa das crianças foi classificada como fraca. O ambiente domiciliar possuía estímulos importantes para o desenvolvimento das crianças. O ambiente é importante para o crescimento e desenvolvimento da criança com Down, assim como a participação na estimulação pelos pais e outros adultos ao redor.

Percepção da qualidade de vida dos trabalhadores da indústria metalúrgica na cidade de Sertãozinho, SP

Na indústria metalúrgica existe um alto índice de patologias e acidentes que vêm afetando os trabalhadores. Assim, este estudo objetivou analisar e compreender a correlação dos sintomas de dores relacionadas ao trabalho e do nível de atividade física com a percepção de qualidade de vida de trabalhadores de uma indústria metalúrgica. Foram avaliados 20 funcionários da indústria, por meio do questionário de anamnese e do SF-36, que avalia a percepção da qualidade de vida. Os resultados mostram que quanto maior a intensidade da dor, menor a qualidade de vida nos aspectos físico e emocional.. Quanto ao tempo de prática de exercícios por semana, encontrou-se que aqueles que realizavam maiores quantidades de minutos por semana apresentavam uma maior percepção da qualidade de vida para capacidade funcional. Os resultados indicam que o investimento das empresas em atividades físicas para os trabalhadores pode melhorar sua capacidade funcional e consequentemente o rendimento do funcionário no trabalho.

AB1147 SCREENED – HIGH REMISSION RATES UNDERLINE THE BENEFIT OF SCREENING CONSULTATION MODELS FOR EARLY RECOGNITION AND TREATMENT OF RHEUMATIC AND MUSCULOSKELETAL DISEASES

Background:Early recognition and treatment of rheumatic and musculoskeletal diseases (RMDs) is of critical importance for the individual outcome. However, nationwide health care structures in Germany do not facilitate early access to initial rheumatologic evaluation. Furthermore, waiting times of several months due to substantial capacity constrains in regional rheumatology care services compromise the prognostically relevant “window of opportunity” for subsequent sustained remission. To promote early detection of RMDs, the Division of Rheumatology at the University hospital Heidelberg, Germany has launched a unique screening consultation model that offers early access to rheumatologic evaluation on regional level.Objectives:The registry-based study SCREENED (“Screen for early diagnosis”) has been initiated to monitor the outcome of patients that were diagnosed with an RMD at the screening clinic and to assess the costs and benefits of this consultation model for the regional quality of care.Methods:The screening consultation model has been launched in two phases: in the first phase (02/2016 - 01/2018), a screening clinic open to all patients without previous rheumatologic evaluation with appointments according to the registration order has been established through rearrangement of available capacities. In contrast to regular appointments, the screening clinic took place in shorter consultation time frames and without additional diagnostic procedures. In the second phase (02/2018 - 01/2020), in order to manage and prioritize access to rheumatologic care at our division more efficiently, prior to appointment allocation (not only) to the screening clinic all new patient registrations became subject to a preselection procedure based on the evaluation of an anamnesis questionnaire, medical reports and laboratory findings by an experienced rheumatologist. Furthermore, SCREENED project has been launched for scientific evaluation of both phases of the consultation model.Results:The screening consultation model achieved a significant reduction in waiting times to few weeks compared to six months for a regular appointment. In the first phase, the screening clinic had a high sensitivity of 94.3% and an improvable specificity of 31.1%. In the retrospective cohort, high remission rates have been observed over all RMD entities (120/206 = 58.3% patients based on physicians’ assessment in the follow-up after screening clinic) and in rheumatoid arthritis (RA) in particular (38/61 = 62.3% and 33/55 = 60% patients with DAS28 score &lt; 2,6 after 12 and 24 months respectively). Remission was usually reached within a year after the first appointment (9.5 ± 6.7 months), however, a trend to higher remission rates in patients with shorter illness duration was obvious. In RA patients, csDMARDs have been initiated in a third of patients immediately at diagnosis in the screening clinic and in another third within six months after the first appointment. After 12 months, &gt; 80% have received csDMARDs, while only 14.2% needed b/tsDMARDs in the follow-up over 24 months.Conclusion:High sensitivity and significant reduction in waiting times for initial rheumatologic evaluation in the screening clinic pave the way for early recognition and treatment of RMDs. Subsequently, high remission rates in the follow-up were reached. In RA, a high proportion of patients only required csDMARDs to achieve sustained remission. A correspondingly small proportion of patients necessitating b/tsDMARD in the follow-up points towards a significant health economic benefit of the early rheumatologic intervention in the screening consultation model.Disclosure of Interests:Karolina Benesova Grant/research support from: Study grants for SCREENED study by Abbvie, Novartis and Rheumaliga Baden-Württemberg, Consultant of: One-time participation in Novartis advisory board., Vivienne Lion Grant/research support from: Grant/research support from: Study grants for SCREENED study by Abbvie, Novartis and Rheumaliga Baden-Württemberg, Oliver Hansen Grant/research support from: Grant/research support from: Study grants for SCREENED study by Abbvie, Novartis and Rheumaliga Baden-Württemberg, Hanns-Martin Lorenz Grant/research support from: Consultancy and/or speaker fees and/or travel reimbursements: Abbvie, MSD, BMS, Pfizer, Celgene, Medac, GSK, Roche, Chugai, Novartis, UCB, Janssen-Cilag, Astra-Zeneca, Lilly. Scientific support and/or educational seminars and/or clinical studies: Abbvie, MSD, BMS, Pfizer, Celgene, Medac, GSK, Roche, Chugai, Novartis, UCB, Janssen-Cilag, Astra-Zeneca, Lilly, Baxter, SOBI, Biogen, Actelion, Bayer Vital, Shire, Octapharm, Sanofi, Hexal, Mundipharm, Thermo Fisher., Consultant of: see above

“As professoras falam que eu sou lenta”: o autoconceito na interface educação e saúde

Durante a infância a escola constitui o principal espaço social onde as habilidades e limitações individuais ficam publicamente expostas. O estigma do “déficit escolar” leva a sentimentos de fracasso, incapacidade, e a um autoconceito empobrecido. Considerando a importância dos colegas e dos educadores nesse processo de co-construção, o estudo visou indagar o papel dessas relações interpessoais em crianças com queixa escolar no contexto de um atendimento clínico. Foram analisados, qualitativamente, registros de rodas de conversa e questionários de anamnese. Os resultados evidenciaram que para as crianças resultam significativas as provocações e zoações dos pares referentes a características físicas ou da personalidade. O olhar dos educadores expressou-se em atributos e elogios sobre o desempenho acadêmico. Ambos os olhares apresentaram tonalizações de gênero. Verificou-se, ademais, a fecundidade das rodas de conversa como um dispositivo metodológico e de intervenção favorável à tomada de consciência do autoconceito e dos sentimentos atrelados à autopercepção.

Audiological profile of indoor cycling teachers

ABSTRACT Purpose: to describe the audiological profile and auditory complaints of indoor cycling teachers, as well as to relate the findings with time of noise exposure and presence of tinnitus. Methods: participants were eight teachers of both genders, age ranging from 24 to 36 years, with professional experience in the area for at least one year. Sound pressure level was measured during the class, which lasted from 45 to 50 minutes and an adapted anamnesis questionnaire composed of ten items was applied to each individual to research the auditory symptoms and factors related to noise exposure and the audiological assessment performed. Inferential statistical tests were applied. The level of statistical significance was 0.05. Results: all of them had pure tone audiometry, tympanometry testing and brainstem auditory evoked potential within normal limits. There were alterations in the high frequency audiometry and otoacoustic emissions without a statistical correlation with the time of professional experience. Conclusion: the audiological profile obtained was pure tone audiometry, tympanometry and brainstem auditory evoked potential within normal limits; altered transient otoacoustic and distortion product emissions and high frequency audiometry. The complaints reported were: tinnitus, dizziness, the need to listen at a high volume and being exposed to excessive noise.

Úlceras vulvares agudas en adolescentes, reporte de una serie de casos clínicos

Introduction: genital ulcers are characterized by great clinical and etiological heterogeneity. They may correspond to infectious or non-infectious skin or systemic pathologies. Lipschutz ulcer and Behcet disease stand out among non-infectious conditions. Objective: to describe four clinical cases of adolescents with non-infectious severe vulvar ulcers hospitalized in two institutions of the national integrated health system in Montevideo, with the purpose of providing professionals with tools for the adequate diagnostic and therapeutic approach. Discussion: a detailed anamnesis questionnaire and a thorough physical examination are of the essence for an adequate diagnostic and therapeutic approach. The clinical analysis should include considering the patient’s age, initiation of sexual intercourse, the number, topography and characteristics of the ulcers including finding out whether there is pain or not, as well as the association of systemic manifestations. It is important to learn about this rather unusual condition in girls and adolescents, whose diagnostic and therapeutic approach depends on the etiological orientation based on well-defined epidemiological and clinical criteria. This will contribute to improving the quality of assistance and minimizing biological and psychological effects.

Formation of individual and group profilaktic programs using automated monitoring and evaluation of risk factors of development of non-infectious diseases

The goal is to develop a system for monitoring and assessing individual risk factors for the development of NCDs by implementing an advanced anamnesis questionnaire into the Unified Medical Information System of the healthcare institution.Materias and methods. The results of the anamnestic survey of 854 patients undergoing a planned prophylactic examination (male patients - 44%, women - 56%, average age of the respondents - 48.0 ± 10.3 rubles) testify to the expediency of introducing into the practice of the primary care physician. The subject of the study was anamnestic questionnaire on advanced questionnaires to determine the necessary diagnostic interventions in order to conduct an annual preventive medical examination, that is, the development of an individual prophylactic program.Results and discussion. Among the respondents, the proportion of those who adhere to the basic principles of a healthy lifestyle - spend on walking at a moderate pace more than 30 minutes a day (69.68% of respondents), daily 4-5 servings of vegetables and fruits (57.4%) or / or 100 grams of fish (62.96%) twice a week and pay attention to the content of fat and / or cholesterol in products when purchased (43.51% respectively) - was quite high - only 4.63% 0.8%, with 19.44% of those polled noted that their habit was to smoke more than one cigarette on the day of the respondents. Among patients, on the basis of anamnestic survey, on average, 13.84% confirmed the presence of illnesses in their close relatives (mother, father, brother, sister) that can provoke the development of NCDs in patients. In particular, 18.29% of the respondents answered the affirmative response to myocardial infarction in mother or sister up to 65 years old and father or brother up to 55 years old. It is the presence of certain risk factors for the development of NCDs, automatic processing of questionnaires and automated analysis of results allowing the formation of an individual prophylactic program of the patient.Conclusion. Thus, an approach to the formation of individual prophylactic programs with the use of monitoring and evaluation of risk factors for the development of NCDs, allows to determine the list of diagnostic examinations for the development of an individual program of passing an annual preventive medical examination, taking into account the results of anamnestic questionnaire, implemented to the Unified Medical Information System of the Health Care Institute.

Self-Anamnesis with a Conversational User Interface: Concept and Usability Study.

Self-anamnesis is a procedure in which a patient answers questions about the personal medical history without interacting directly with a doctor or medical assistant. If collected digitally, the anamnesis data can be shared among the health care team. In this article, we introduce a concept for digital anamnesis collection and assess the applicability of a conversational user interface (CUI) for realizing a mobile self-anamnesis application. We implemented our concept for self-anamnesis for the concrete field of music therapy. We collected requirements with respect to the application from music therapists and by reviewing the literature. A rule-based approach was chosen for realizing the anamnesis conversation between the system and the user. The Artificial Intelligence Markup Language was exploited for encapsulating the questions and responses of the system. For studying the quality of the system and analyzing performance, humanity, effect, and accessibility of the system, we performed a usability test with 22 persons. The current version of the self-anamnesis application is equipped with 63 questions on the music biography of a patient that are asked subsequently to the user by means of a chatbot conversation. The usability study showed that a CUI is a practical way for collecting anamnesis data. Users felt engaged of answering the questions and liked the human characteristics of the chatbot. They suggested to extend the conversation capabilities of the chatbot so that the system can react appropriately, in particular when the user is not feeling well. We could demonstrate the applicability of a CUI for collecting anamnesis data. In contrast to digital anamnesis questionnaires, the application of a CUI provides several benefits: the user can be encouraged to complete all queries and can ask clarifying questions in case something is unclear.

Relação entre vínculo de apego e desenvolvimento cognitivo, linguístico e motor

O estabelecimento de uma relação de apego segura é importante, pois fornece à criança segurança para que ela possa explorar o ambiente, atividade essencial para o desenvolvimento infantil. Este estudo tem como objetivo investigar se crianças com padrão de apego seguro e inseguro diferem quanto ao desempenho cognitivo, linguístico e motor. Participaram do estudo 50 crianças, com idades entre 12 e 25 meses. Foram utilizados um questionário de anamnese, a Situação Estranha de Ainsworth, as Escalas Bayley de Desenvolvimento Infantil – 3ª ed. e o questionário Estilo Materno como instrumentos de avaliação. Os resultados apontam diferença entre os grupos no desempenho cognitivo e de linguagem. Crianças com padrões inseguros de apego obtiveram menores escores nos testes que avaliam o desenvolvimento dos dois domínios. Estes resultados demonstram a importância da relação entre mãe e filho como um fator de proteção do desenvolvimento.

Association between alcohol dependence and both periodontal disease and tooth loss: a cross-sectional study.

The impact of alcohol consumption on periodontal disease and tooth loss is still under debate. The aim of this cross-sectional study was to evaluate the association between alcohol dependence and both periodontal diseases and tooth loss in Brazilian native Indians. Full mouth periodontal examination was performed and tooth loss was clinically evaluated in a representative sample of 225 Indians (≥ 19years). Sociodemographic, oral health-related data, and alcohol dependence were evaluated using structured questionnaires. The subjects were categorized as either alcohol-dependent or non-dependent according to the Alcohol Use Disorders Identification Test results. Severe periodontal disease was defined in individuals with ≥ 2 proximal sites with a clinical attachment level ≥ 6mm, not on the same tooth, and ≥ 1 proximal site with a probing depth ≥ 5mm. Tooth loss was categorized as one or more missing teeth, or no missing teeth. Bivariate models followed by logistic regression were used to assess the association between alcohol dependence and both periodontal disease and tooth loss. Prevalence ratio (PR) was calculated using Mantel-Haenszel analysis. Alcohol dependence increased 2.5 times the risk for tooth loss (prevalence ratio [PR] =2.49, 95% confidence interval [CI] = 1.01-9.04, p = 0.05). Severe periodontal disease was not associated with alcohol dependence (OR = 0.54, 95% CI = 0.22-1.31, p = 0.23). In conclusion, alcohol dependence was associated with tooth loss in the present population, but severe periodontal disease was not. Questions on alcohol dependence should be included in dental anamnesis questionnaires, and patients diagnosed with alcohol dependence should be referred for dental evaluation.