Therapeutic Attitude Research Articles

Juvenile Giant Fibroadenoma Vs. Phyllodes Tumor: Know the Difference in a 14-Years-Old Woman: Case Report

Fibroadenoma is the most common benign fibroepithelial lesion of the breast in young women, accounting for around 90% of solid lesions of the gland in adolescence. However, juvenile giant fibroadenoma is a rare breast condition that occurs in women under 18 years of age. Due to the similarity of the characteristics of juvenile giant fibroadenoma and phyllodes tumor, both lesions characterized by rapid growth, it is important to establish the differential diagnosis of both pathologies when one of them is suspected, in order to guarantee the most appropriate therapeutic attitude to follow. A 14-year-old woman with no family or personal history of interest, who consulted due to a clinical picture characterized by breast asymmetry secondary to progressive growth of the left breast of 5 months of evolution. An ultrasound-guided core needle biopsy was performed that reported giant juvenile fibroadenoma. Lumpectomy was performed. Histopathological diagnosis compatible with juvenile giant fibroadenoma of the left breast. Based on our case and on the reviewed bibliography, we recommend an early differential diagnosis, as well as an accurate one, and surgical treatment of cases of juvenile giant fibroadenoma. The surgical tactics and technique depend on the age at the time of diagnosis, the clinical and imaging characteristics of the mammary gland and the tumor, as well as the wishes of the patient in question.

Development of a measure quantifying helpful psychotherapy interventions: The Helpful Therapeutic Attitudes and Interventions Scale.

Despite the number of empirical studies identifying the helpful factors correlated with beneficial psychotherapy outcomes, there is no validated scale that measures helpful therapeutic attitudes and interventions applied by therapists within the actual therapy process in China. In the current study, we developed the Helpful Therapeutic Attitudes and Interventions Scale (HTAIS) as an accessible client-rated instrument to measure useful interventions applied by the therapist during psychotherapy sessions. Based on the results of previous literature and our prior psychotherapy process studies, a 40-item measure was initially designed. Two studies with a total of 2,780 Chinese participants who received psychotherapy were carried out to evaluate the structure, reliability, and validity of the developed scale. Principal component analysis yielded a three-component HTAIS containing 26 items. The scale included dimensions labeled "Empathy, respect and neutrality," "Using techniques to solve practical issues," and "In-depth exploration and expansion." Confirmatory factor analysis showed the construct validity of the derived three components model. And the developed scale had high internal consistency and test-retest reliability. The scale scores of the HTAIS were positively correlated with those of the Working Alliance Scale and Session Rating Scale, as well as clients' perceived therapy satisfaction, thus supporting its concurrent validity. The HTAIS allows an immediate examination, as experienced by the client, of the extent to which certain useful therapeutics interventions have been conducted during therapy and could help to improve the clinician's subsequent therapy strategies. Future research is suggested to further validate the scale, especially to assess its psychometric properties in various populations with different clinical complaints.

Emphysematous Pyelonephritis: Radiologic Diagnosis

Emphysematous pyelonephritis (EPP) is a severe and necrotizing form of acute bacterial pyelonephritis with a life-threatening outcome. It is a rare condition, occurring preferentially in diabetic patients and linked to the development of anaerobic germs. There is a predominance of women (2/1). The CT scan is the best technique, which allows the positive diagnosis by the presence of gases in the renal parenchyma, in the collecting system or in the peri- renal spaces. The evolution of the disease is the basis of its radiological classification in 4 stages. The therapeutic attitudes diverge between surgical treatment, percutaneous drainage and conservative treatment.

Neonatal Microcolon Occlusion: About A Case and Review of the Literature

Microcolon is a rare radiological feature encountered during neonatal lower gastro intestinal obstruction. It results from a defect in the passage of digestive contents from the small intestines to the colon during fetal life. The etiologies involved are meconium ileus, ileojejunal atresia, and total colonic agonglion. The unprepared abdomen (UAP) and colonic opacification help to orient the diagnosis and the therapeutic attitude. We report the case of a neonate with a micro-colon occlusion by reviewing the data in the literature.

COVID-19 Infection in Heart Transplants in Pre- and Postvaccination Periods

Heart transplant (HTx) recipients constitute a group vulnerable to COVID-19 infection. Vaccination has been a turning point in the evolution of the pandemic. The objective was to analyze a series of HTx recipients with COVID-19 prior to vaccination and post vaccination. Inclusion: All HTx recipients diagnosed with COVID-19 (February 2020 to April 2022). HTx younger than 16 years. They were subdivided into prevaccination period (February 2020 to February 2021) and postvaccination period (March 2021 to April 2022). They were classified into 3 groups according to severity. Group 1: mild symptoms without admission. Group 2: admission for nonsevere pneumonia. Group 3: severe pneumonia according to American Thoracic Society/Infectious Diseases Society of America criteria. The general therapeutic attitude before and after vaccination was similar in both groups. A total of 65 HTx recipients have had COVID-19 to date (10.7% of the 374 HTx recipients alive). In the prevaccination period, 22 HTx recipients presented the disease (Fig 1A): 27% in group 1; 59% were admitted for nonsevere pneumonia (group 2), with favorable evolution and a mean stay of 16 days; and 14% in group 3 (criteria for severe pneumonia), with 2 HTx recipients dying in this group. In the postvaccination period, 43 HTx recipients have presented COVID-19 (Fig 1B), 49% in group 1, 42% in group 2, and 9% in group 3. The hospital stay is slightly reduced to 15 days and 3 of the 4 patients in group 3 have died (mortality rate 7%). A significant number of HTx recipients have been affected by COVID-19, associating high mortality in severe forms both in the pre- and postvaccination period. In our series of patients, vaccination has reduced the percentage of hospitalization for nonsevere pneumonia slightly below the average hospitalization and mortality.

Experience and Utility of the Protocol Kidney Biopsy in the First Year of Kidney Transplantation

Protocol kidney biopsy (PKB) in kidney transplant is a useful tool for graft monitoring because the subclinical detection of histologic lesions helps to modulate immunosuppression. We analyze our experience. We performed a descriptive study that analyzed the PKB results at the fourth to sixth month and the first year post transplant of patients with kidney transplant followed in our hospital between January 2015 and June 2021. A total of 100 patients and 134 biopsy results were included, of which 71 were obtained between the fourth and sixth month and 63 at the first year. The mean age was 57.8 years, and 66% were men. Unknown etiology was the most common underlying kidney disease (31%), followed by diabetes mellitus (15%) and polycystic kidney disease (14%). A total of 80% had panel-reactive antibody < 50%. Induction therapy consisted of thymoglobulin (51%) and basiliximab (49%), and maintenance therapy consisted of corticosteroids and tacrolimus (100%), mycophenolate mofetil (82%), and mammalian target of rapamycin inhibitor (18%). Of the total of the PKB results (n=134), 19 episodes of subclinical rejection (14%) and 10 with borderline changes (7.4%) were observed. Regarding other findings, there were cases of nephrocalcinosis (4.4%), immunoglobulin A nephropathy (2.2%), and BK nephropathy (1.5%). The PKB brought about a change in the therapeutic attitude in 45 cases (33%) of the total number of biopsies, the most frequent change being the administration of boluses of methylprednisolone (12.6%) and the change to mammalian target of rapamycin inhibitor (8.9%). In our experience, PKB is a useful tool for monitoring and evaluating histologic changes without clinical expression in the kidney graft, allowing us to adapt the treatment during the first year of kidney transplant.

Perceived Aetiology and Therapeutic Attitudes: Mediating Role of Stigmatizing Attitudes in Substance Use Disorders

Introduction: Substance Use Disorders (SUDs) are among the most stigmatized mental health condition in Pakistan’s health care system. Stigma serves as a chief barrier to successful treatment engagement including seeking, sustaining participation or receiving quality care by health care professionals. Purpose: The present study aimed to investigate the mediating role of stigmatizing attitudes in explaining the relationship between perceived aetiology and therapeutic attitudes. Method: Correlational research design and purposive sampling strategy were used to collect a sample of 100 MHP’s (N= 100) consisting of n= 36 (M=33.64, SD=8.34) psychiatrists and n= 64 (M=30.38, SD=7.30) psychologist from hospitals, addiction centers and universities. Results: Results indicated that bio-medical causal attributions predicted stigmatizing attitudes (i.e., permissiveness, non-stereotype treatment optimism and treatment intervention); however, only treatment intervention mediated the relationship between bio- medical causal attributions and therapeutic preparedness among MHPs. Similarly, psychosocial causal attributions predicted stigmatizing attitudes (i.e., non-stereotype and non-moralism), however neither of them mediated the relationship between psycho- social causal attributions and therapeutic preparedness among MHPs. Conclusion: The study highlights the importance of combined aetiological information in anti-stigma interventions, advance training, and informed curriculum to reduce stigma and increase therapeutic preparedness. Keywords: Perceived Aetiology, Therapeutic Attitudes, Stigmatizing Attitudes, Substance Use Disorders

Diagnostic and Therapeutic Characteristics in Patients with Pneumotorax Associated with COVID-19 versus Non-COVID-19 Pneumotorax.

Introduction: Pneumothorax is a condition that usually occurs in thin, young people, especially in smokers. It is an unusual complication of COVID-19 disease that can be associated with worse results. This disease can occur without pre-existing lung disease or without mechanical ventilation. Materials and Methods: We present a monocentric comparative retrospective study of diagnostic and treatment analysis of two groups of patients diagnosed with COVID-19 and non-COVID-19 pneumothorax. All patients included in this study underwent surgery in a thoracic surgery department. The study was conducted over a period of 18 months. It included 34 patients with COVID-19 pneumothorax and 42 patients with non-COVID-19 pneumothorax. Results: The clinical symptoms were more intense in patients with COVID-19 pneumothorax. We found that the patients with COVID-19 had significantly more respiratory comorbidities. Diagnostic procedures include chest CT exam for both groups. Laboratory findings showed that increasing values for the analyzed data were consistent with the deterioration of the general condition and the appearance of pneumothorax in the COVID-19 group. The therapeutic attitude regarding the non-COVID-19 group was to eliminate the air from the pleural cavity and surgical approach to the lesion that determined the occurrence of pneumothorax. The group of patients with COVID-19 pneumothorax received systemic treatment, and only minimal pleurotomy was performed. The surgical approach did not alter patients’ survival. Conclusions: Careful monitoring of the patient’s clinic and laboratory tests evaluating the degradation of the lung parenchyma, correlated with the imaging examination (chest CT) is mandatory and reduces COVID-19 complications. Early imaging examination starts an effective diagnosis and treatment management. In severe COVID-19 pneumothorax cases, the pneumothorax did not influence the evolution of COVID-19 disease. When we found that the general condition worsened with the rapid progression of dyspnea and the deterioration of the general condition, and we found that it represented the progression or recurrence of pneumothorax.

Drama Therapy for Children and Adolescents with Psychosocial Problems: A Systemic Review on Effects, Means, Therapeutic Attitude, and Supposed Mechanisms of Change.

Drama therapy is applied to children and adolescents with psychosocial problems. Drama therapy is an experimental form of treatment which methodologically uses drama and theatre processes to achieve psychological growth. Although in clinical practice, drama therapy has been applied successfully, little is known about how and why drama therapy contributes to a decrease in psychosocial problems. A systematic narrative review was performed to obtain more insight into this issue. Eight databases were systematically searched. Ten out of 3742 studies were included, of which there were four random controlled trails, three non-controlled trials, and three pre-and post-test design studies. We identified the results, drama therapeutic means, attitude, and mechanism of change. Positive effects were found on overall psychosocial problems, internalizing and externalizing problems, social functioning, coping and regulation processes, social identity, and cognitive development. An adaptive approach was mentioned as the therapeutic attitude. The means established contribute to a dramatic reality, which triggers the mechanisms of change. These are processes that arise during treatment and which facilitate therapeutic change. We found ten supposed mechanisms of change to be frequently used in all studies. No direct relations were found between the results, drama therapeutic attitude, means, and mechanisms of change.

Risk factors of reintervention after endovascular treatment of type B acute and subacute aortic dissections

The treatment of type B aortic dissections is not driven by well defined guidelines. At the time of diagnosis these dissections can be complicated by rupture or organ or limb malperfusion, which require an emergency surgical treatment, or not complicated. In these cases, optimal medical care only was recommended in first intention. The ADSORB and INSTEAD-XL studies recently led us to change our therapeutic attitude by showing the superiority of TEVAR associated with the optimal medical care compared to medical care only in terms of aortic remodeling, healing of the false lumen, and mortality related to the pathology aortic. Studies highlighted several risk factors for a poor prognosis at the time of the diagnosis, including the maximum aortic diameter, the laminated aspect of the true lumen, the principal main entry tear size, or the patency of the false lumen, which contributed to define the population needing TEVAR in association with the best medical care. These risk factors were measured at the time of the diagnosis, i.e. before the medical or surgical treatment. The literature also reported 25% - 50% reintervention rates for the patients who survived the acute phase. The aim of our study was to determine the risk factors of survival without secondary aortic intervention of the patients presenting with a type B aortic dissection, complicated or not, and treated in the 90 days of the diagnosis by TEVAR with coverage of the principal main entry tear.

Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

Early maximal surgical resection is the first treatment in diffuse low-grade glioma (DLGG), because the reduction of tumor volume delays malignant transformation and extends survival. Awake surgery with intraoperative mapping and behavioral monitoring enables to preserve quality of life (QoL). However, because of the infiltrative nature of DLGG, relapse is unavoidable, even after (supra)total resection. Therefore, besides chemotherapy and radiotherapy, the question of reoperation(s) is increasingly raised, especially because patients with DLGG usually enjoy a normal life with long-lasting projects. Here, the purpose is to review the literature in the emerging field of iterative surgeries in DLGG. First, long-term follow-up results showed that patients with DLGG who underwent multiple surgeries had an increased survival (above 17 years) with preservation of QoL. Second, the criteria guiding the decision to reoperate and defining the optimal timing are discussed, mainly based on the dynamic intercommunication between the glioma relapse (including its kinetics and pattern of regrowth) and the reactional cerebral reorganization—i.e., mechanisms underpinning reconfiguration within and across neural networks to enable functional compensation. Third, how to adapt medico-surgical strategy to this individual spatiotemporal brain tumor interplay is detailed, by considering the perpetual changes in connectome. These data support early reoperation in recurrent DLGG, before the onset of symptoms and before malignant transformation. Repeat awake resection(s) should be integrated in a global management including (neo)adjuvant medical treatments, to enhance long-lasting functional and oncological outcomes. The prediction of potential and limitation of neuroplasticity at each step of the disease must be improved to anticipate personalized multistage therapeutic attitudes.

Intrahepatic Portal Vein Aneurysm: A Case Report of an Uncanny Late Complication of Liver Transplantation

Whereas chronic rejection, opportunistic infections, post-transplant lymphoproliferative disorder, hemophagocytic lymphohistiocytosis, biliary tract issues, and cardiovascular side effects of immunosuppressive drugs are frequently reported as late complications in liver transplanted patients, intrahepatic portal venous aneurysm following liver transplantation remains exceptional and unusual. We report the case of a 25-year-old man who underwent a liver transplantation in 1997 because he had glycogen storage disease type 4. The patient developed a late postoperative complication, an intrahepatic portal aneurysm, and 2 episodes of acute cholangitis. By reviewing and scoping the literature, we tried to spotlight the best therapeutic attitude concerning the management of this rare complication.

Congenital Hydrocephalus Secondary To Parvovirus Infection (About One Case)

In pregnancy, even if the risk of fetal complications is extremely low in case of parvovirus infection, a preventive or therapeutic attitude must be implemented as quickly as possible in the event of contagion because the risk of foetoplacental hydrops exists as well as the risk of death fetal in utero and malformative. We report the case of parvovirus seroconversion during pregnancy discovered in the etiological assessment of hydrocephalus associated with hydramnios.

Un langage en devenir : exemple clinique d’une structuration autistique

ObjectivesThe representations of the autistic subject who is mute or has great difficulty with language no longer coincide with the clinical and non-clinical documents collected over the last decades. MethodThe story of Eric's care, from his childhood diagnosis until his reaching legal adulthood, is used as a clinical illustration of the various attitudes that an autistic subject can have with language. ResultsIf the erasure of the voice signals a defense against primordial difficulties, the development of special interests favors the elaboration of an edge which, by becoming more complex, allows an increasingly significant insertion in certain social environments. Some stages of this developing language are identified here, including leaning on a double, the factual language of ordered signs, and accessing the realm of metaphor. DiscussionHowever, this sequence remains marked by an idiosyncratic trajectory where the opposition of “good” and “evil” covers the difficulty of integrating a father figure judged to be deficient. ConclusionsAlthough it involves surprising interactions, a treatment through “verbose” speech, even within public mental health units, proves to be relevant for the accompaniment of the autistic subject in his evolution, provided that a therapeutic attitude informed by the principles governing autistic structuring is deployed.

Initial clinical and treatment patterns of advanced differentiated thyroid cancer: ERUDIT study.

BackgroundUp to 30% of differentiated thyroid cancer (DTC) will develop advanced-stage disease (aDTC) with reduced overall survival (OS).ObjectiveThe aim of this study is to characterize initial diagnosis of aDTC, its therapeutic management, and prognosis in Spain and Portugal.MethodsA multicentre, longitudinal, retrospective study of adult patients diagnosed with aDTC in the Iberian Peninsula was conducted between January 2007 and December 2012. Analyses of baseline characteristics and results of initial treatments, relapse- or progression-free survival ((RP)FS) from first DTC diagnosis, OS, and prognostic factors impacting the evolution of advanced disease were evaluated.ResultsTwo hundred and thirteen patients (median age: 63 years; 57% female) were eligible from 23 hospitals. Advanced disease presented at first diagnosis (de novo aDTC) included 54% of patients, while 46% had relapsed from early disease (recurrent/progressive eDTC). At initial stage, most patients received surgery (98%) and/or radioiodine (RAI) (89%), with no differences seen between median OS (95% CI) (10.4 (7.3–15.3) years) and median disease-specific-survival (95% CI) (11.1 (8.7–16.2) years; log-rank test P = 0.4737). Age at diagnosis being <55 years was associated with a lower risk of death (Wald chi-square (Wc-s) P < 0.0001), while a poor response to RAI to a higher risk of death ((Wc-s) P < 0.05). In the eDTC cohort, median (RP)FS (95% CI) was of 1.7 (1.0–2.0) years after RAI, with R0/R1 surgeries being the only common significant favourable factor for longer (RP)FS and time to aDTC ((Wc-s) P < 0.05).ConclusionIdentification of early treatment-dependent prognostic factors for an unfavourable course of advanced disease is possible. An intensified therapeutic attitude may reverse this trend and should be considered in poor-performing patients. Prospective studies are required to confirm these findings.

Diagnostic Therapeutic Attitude in Patello Femoral Instability

Diagnostic Therapeutic Attitude in Patello Femoral Instability

Relational factors predict telepsychotherapy acceptance in patients: The role of therapeutic relationship and attachment

IntroductionDuring the early months of the COVID-19 pandemic, patients receiving individual psychotherapy needed to transition to telepsychotherapy (TP). Since telemental health appears to be here to stay after the pandemic ends, it is crucial to understand factors that determine whether telemental health is a good fit for patients.ObjectivesThe aim of the present study was to (1) explore patients’ perception of the therapeutic relationship and attitudes towards TP, and (2) identify predictors of patients’ TP acceptance.MethodsWe used a longitudinal design, where patients (N = 719) receiving individual TP during the pandemic participated in an online survey, in which they responded to demographic questions and completed measures of symptom severity, Covid-related distress, attachment style (avoidant/anxious), perceived quality of the therapeutic relationship (working alliance and real relationship), and TP acceptance.ResultsWe found that (1) patients perceived the quality of the therapeutic relationship as reasonably good, and patients’ TP acceptance was moderately high. (2) patients’ TP acceptance was predicted by their attachment avoidance and their perception of the real relationship, whereas attachment anxiety, working alliance, as well as demographic variables, symptom severity, and Covid-related distress were unrelated to TP acceptance. The final model showed that perceived strength of the real relationship mediated the relationship between attachment avoidance and TP acceptance.ConclusionsBoth general (attachment) and situational (therapeutic relationship) relational variables are important predictors of patient’s acceptance of TP, and should be considered during decision making about suitability of TP to patients.DisclosureNo significant relationships.

Examination of Factors Affecting Therapeutic Attitude and Empowerment of Perianesthesia Nurses Who Care for Patients With Opioid Use Disorder

Patients with opioid use disorder (OUD) and associated complexities are presenting to hospitals in increasing numbers. Preparation of perianesthesia nurses caring for this patient population has lagged, with noted deficits in continuing education, resources, and role support. Previous research found education without considering therapeutic attitude (TA), empowerment and factors that influence nursing practice does not translate into feelings of competence in nursing care. The purpose of this study was to identify correlates and predictors that affect TA and empowerment among perianesthesia nurses caring for patients with OUD. A cross-sectional, correlation design was used to identify correlates and predictors of TA and empowerment in a national sample of perianesthesia nurses (N=215) METHODS: A national survey collected data from perianesthesia nurses. The Perianesthesia Nurse Empowerment and Therapeutic Attitude Model was the guiding framework. Pearson product-moment correlation and hierarchical multiple regression analyses were used to examine relationships between personal factors, the professional practice environment and societal factors of perianesthesia nurses. The standardized regression coefficients indicated the professional practice environment (β=-0.28), drug user stigma (β=0.27), access to a pain specialist (β=0.25), and exposure to drug users (β=0.25) were the strongest predictors of TA. Access to a pain specialist (β=-0.15) and the professional practice environment (β=0.72) were the strongest predictors of empowerment. The professional practice environment directly influenced the degree of empowerment and TA reported by perianesthesia nurses. Exposure to persons with OUD and personal stigmatization of persons who misuse drugs decreased TA but had no association with empowerment. Access to a pain specialist was moderately predictive of empowerment and negatively associated with TA suggesting a lack of role legitimacy and the need for further research into perianesthesia nurses' perceptions of their role when caring for this population.

Improving Medication Adherence in Community-Dwelling Patients with Schizophrenia Through Therapeutic Alliance and Medication Attitude: A Serial Multiple Mediation Model.

BackgroundIncreased medication adherence improves patient outcomes and lowers the overall cost of care by preventing disease relapse and hospital readmission. Several systematic reviews have identified that insight, therapeutic alliance, and attitude towards medication affect medication adherence in patients with schizophrenia; however, no study has examined all the aforementioned variables together nor has discussed the chains of these mediators.PurposeTo examine the insight–medication adherence relationship among community-dwelling schizophrenia patients through a serial multiple mediation model of therapeutic alliance and medication attitude.Patients and MethodsThis study with a cross-sectional correlational design included a convenience sample of community-dwelling schizophrenia patients from Taiwan (n = 229). From January 2017 to January 2018, data were collected by trained nurses using questionnaires. The PROCESS tool was used to analyse fine-grained chains.ResultsIn serial multiple mediation, the indirect effect of insight on medication adherence through therapeutic alliance and, subsequently, alteration of medication attitude was significant. However, the direct effect changed from significant to non-significant, indicating a complete mediating effect.ConclusionIn community-dwelling schizophrenia patients, the effects of therapeutic alliance and medication attitude on medication adherence are greater than that of insight. We recommend revising the strategy of community home visits by different psychiatrists or nurses in alternating shifts. Therapeutic alliance is the first step required to promote medication adherence. Based on this alliance, altering the patients’ medication attitude may be more effective in improving medication adherence than merely enhancing insight.

Pathological and Evolutive Correlations in Steroid Resistant Nephrotic Syndrome in Children

BackgroundNephrotic syndrome (NS) is the term used for the association of edema and massive proteinuria. From a therapeutic point of view, it is important to distinguish between primitive and secondary kidney damage. The clinical evolution, prognosis and therapeutic response in the NS in children are directly determined by the anatomopathological aspect. Steroid resistant nephrotic syndrome was diagnosed in patients with idiopathic NS based on lack of complete remission despite treatment with steroids.PurposeTo analyse the anatomopathological aspects of steroid resistant nephrotic syndrome (SRNS) and their correlation with evolution.Materials and MethodsWe made a retrospective study with the aim to analyze the anatomo-pathological aspects and their correlations with evolution in 68 cases of steroid resistant nephrotic syndrome (SRNS) hospitalized in the Pediatric Nephrology Department in Iaşi, Romania. We defined SRNS in all cases without response to corticosteroids after the first month of therapy. For all the cases selected, the period of follow-up was the minimal 6 months.Results and DiscussionsA 36% case of nephrotic syndrome was corticoresistant, with the mean age at onset of patients with SRNS being 9.18 years, compared to KDIGO studies in which the corticosteroid resistance is 10–20%. Renal biopsy was performed in 80.88% children with SRNS and was allowed the evaluation of the activity and chronicity index. Total remission was obtained in 44.01% children with SRNS. The correlation of the anatomopathological aspects with the evolution is not statistically significant (p = 0.76), observing different therapeutic responses to all the analyzed histological types.ConclusionAlmost half of NS in children are cortico resistant. Remission was obtained in 44% of cases of SRNS. Predicting the response to long-term treatment in SRNS is difficult using only renal biopsy; it is necessary to introduce genetic molecular analyses to establish a judicious therapeutic attitude.