Abstract Historically, phenol/croton oil deep chemical peeling has been very effective and has generated excellent results compared to other formulas used in dermatological clinics. However, it can cause serious side effects in patients sensitive to phenol. Therefore, this study aimed to develop a liquid crystalline structure containing croton oil (without phenol) as well as to evaluate the physical characteristics and cytotoxicity of this new system. Rational proportions of the croton oil, purified water, and polyethylene glycol hexadecyl ether were designed through a partial phase diagram to obtain 26 formulations. After macroscopic analysis and polarized light microscopy evaluation, formulations with lamellar liquid crystalline phase (4 samples) were identified and chosen to determine pH, size, polydispersion index (PDI), zeta potential, and rheological behavior. After 48 hours, three samples presented phase separation. Formulation 8 remained stable, but hydroxyethyl cellulose (HEC, 0.5%, w/w) was added to the aqueous phase, to prevent coalescence. Sample 8A exhibited a pH compatible with the skin, nanometric size, narrow PDI, negative zeta potential, and stability throughout the study period. The addition of HEC improved the organization of the system, making the formulation more stable. The oil, fractions of the oil, and the sample exhibited increasing cytotoxicity, respectively. This result could be attributed to the fractionation process of the vegetal matrix, and the surfactant present in the formulation increased the cell membrane permeability. The proposed approach successfully achieved a physically stable liquid crystal system containing croton oil.

RESUMO Objetivo Verificar como a qualidade de vida de crianças com implante coclear foi avaliada em estudos publicados e analisar criticamente quais foram as variáveis influenciadoras. Estratégia de pesquisa Pesquisa norteada pelas recomendações do PRISMA. A pergunta norteadora foi elaborada com base na estratégia PICO, sendo: “Quais variáveis são consideradas como influenciadoras sobre a qualidade de vida de crianças com implante coclear?”. Os descritores selecionados foram: implante coclear, implantes cocleares, qualidade de vida, criança e seus sinônimos, nos idiomas português, inglês e espanhol. Foram identificados estudos indexados nas bases de dados: Pubmed/MEDLINE, LILACS, Scopus, SciELO, Embase, EBSCO/CINAHL e Web of Science. Critérios de seleção Foram selecionados estudos direcionados ao tema, com níveis de evidência científica de 1 a 4, publicados nos idiomas português, inglês e espanhol, no período de 2009 a 2018. Análise dos dados: inicialmente analisou-se os títulos de todos os estudos encontrados, seguido dos resumos e da leitura na íntegra dos textos mais relevantes. Resultados Após a análise rigorosa dos 1062 artigos, oito foram classificados como contendo as respostas necessárias à pergunta norteadora de pesquisa. Os estudos selecionados foram publicados entre os anos de 2009 a 2016, classificados em nível de evidência 2a e 4, com casuística entre dez a 259 crianças e com idades entre 18 meses a 18 anos incompletos. Conclusão Os fatores influenciadores que se correlacionaram com a qualidade de vida das crianças com implante coclear foram: a implantação precoce, o uso do dispositivo eletrônico, as habilidades auditivas e as habilidades de linguagem.

ABSTRACT Purpose To verify how the quality of life of children with cochlear implant was evaluated in published studies and to critically analyze which were the influencing variables. Research Strategy Research guided by PRISMA recommendations. The guiding question was elaborated based on the PICO strategy, being: “Which variables are considered as influencers on the quality of life of children with cochlear implants?” The selected descriptors were cochlear implants, cochlear implants, quality of life, child and their synonyms, in the Portuguese, English and Spanish languages. We have identified indexed studies in the databases: Pubmed / MEDLINE, LILACS, Scopus, SciELO, Embase, EBSCO / CINAHL and Web of Science. Selection Criteria Selected studies were selected, with levels of scientific evidence from 1 to 4, published in the Portuguese, English and Spanish languages, from 2009 to 2018. Data analysis: initially the titles of all the studies, followed by summaries and full reading of the most relevant texts. Results After the rigorous analysis of the 1062 articles, eight were classified as containing the necessary answers to the guiding question of research. The selected studies were published between 2009 and 2016, classified as evidence level 2a and 4, with a sample of between 10 and 259 children and between the ages of 18 months and 18 years. Conclusion The influencing factors that correlated with the quality of life of children with cochlear implants were early implantation, use of the electronic device, hearing skills and language skills.

The classical approaches of traditional organizations also called emphasize formal models and work through the application of rules and written procedures. In this perspective the managers of the companies assume a leading role for being the ones who unilaterally set goals and meet other workers as if the organization were a single man, which often generates the closure of the same. The purpose of this article is to take a brief tour of the most relevant theoretical trajectories in the field of administration and to describe the Gung-Ho technique which shows some difficulties in its application because there is a business culture and a culture acquired by the Society, which determines ethical values, behavior, ways of doing things, expressing and acting of people through honesty, respect, sincerity and humility. This creates an atmosphere of trust in workers avoiding unfair acts. By applying this technique, it is recommended as a first step to change the mentality of employees in general, which suggests reprogramming their minds and make them understand the importance of their work and generate a change of attitude in the staff generating an increase in productivity, Efficiency and competitiveness and contribute to the achievement of the previously established goals.

Los enfoques clásicos de las organizaciones también denominadas tradicionales hacen énfasis en modelos formales y funcionan mediante la aplicación de reglas y procedimientos escritos mediante los cuales los directivos asumen un rol protagónico por ser ellos quienes fijan objetivos de manera unilateral y el resto de los trabajadores cumple como si la organización fuera un solo hombre, ocasionando con ello el cierre de estas. El propósito de este articulo consiste, en realizar un breve recorrido por las trayectorias teóricas más relevantes del campo de la administración y describir la técnica Gung Ho la cual visualiza algunas dificultades su aplicación en virtud de que existe una cultura empresarial y una cultura adquirida por la sociedad, la cual determina los valores éticos, el comportamiento, la forma de hacer las cosas, de expresarse y actuar de las personas mediante la honradez, el respeto, la sinceridad y humildad. Esto genera un ambiente de confianza en los trabajadores evitando actos desleales. Mediante la aplicación de esta técnica se recomienda como primer paso modificar la mentalidad de los empleados en general, lo que sugiere reprogramar sus mentes y hacerles comprender la importancia de su trabajo y generar un cambio de actitud en el personal generando un incremento en la productividad, eficiencia y competitividad y contribuir al logro de las metas previamente establecidas.

Technological progress has allowed women to change their natural hair configuration according to their will. This type of treatment is very popular around the world, even involving the use of prohibited chemicals, such as formaldehyde. Studies of hair characterization, straighteners and toxic evaluation are available in the literature, although few studies have evaluated the consumer profile or the current legislation of Brazil and the European Union (EU) and its influence on the consumption of hair straighteners. Previous studies from our research group have shown that hair care is essential for the quality of life and well-being of women. Within this context, the present study aimed to evaluate the profile of Brazilian hair straightener consumers, as well as the legislation of Brazil and the EU and its influence on the use of these products. The consumer profile was evaluated by applying questionnaires and the legislation was examined using documental and bibliographic exploratory research. The results provided a full understanding of the current legislation of Brazil and its similarities to EU legislation. It was observed that over 50% of Brazilians currently use or have previously used hair straightener products, even persons who do not have curly hair, suggesting that straight hair is more attractive for today’s society. Although the study participants consider the current legislation to be important, over 40% do not know the active ingredients present in the hair straightener they use. Finally, the legislation is not considered in terms of the daily hair treatment routine, with the esthetic result being more important to the consumer.

Objetivo Avaliar os resultados do “Teste Prático de Habilidade de manuseio do aparelho de amplificação sonora individual AASI (PHAST)” em novos usuários deste dispositivo. Verificar a confiabilidade interavaliadores para o teste PHAST. Análise descritiva, longitudinal de dados de um estudo clínico randomizado controlado. O PHAST foi aplicado em 60 novos usuários de AASI retroauriculares e intra-aurais, imediatamente e cerca de dez dias após a concessão do dispositivo. As avaliações foram filmadas e, posteriormente, analisadas e pontuadas por um ou dois juízes independentes. Aproximadamente 55% dos participantes obtiveram desempenho variando de razoável a ruim. A troca da pilha e inserção do AASI foram as tarefas de maior dificuldade. A pontuação total e das tarefas de “abertura do compartimento de pilha” e “inserção do AASI” aumentaram significativamente entre as aplicações do PHAST, indicando melhora do manuseio ao longo do tempo. O desempenho no PHAST foi correlacionado com a idade dos participantes. A confiabilidade entre avaliadores foi alta e significativa para a pontuação total e para seis tarefas individuais do PHAST. Conclusão Novos usuários exibem diferentes dificuldades no manuseio do AASI, que são maiores nos períodos iniciais de uso. O PHAST pode ser utilizado na clínica audiológica a fim de propiciar um registro mais sistemático de tais habilidades.

Purpose To evaluate the results of the “Practical Hearing Aid Skills Test (PHAST)” in new HA users. To assess the inter-rater reliability of the PHAST. Methods Descriptive, longitudinal analysis of data from a randomized controlled trial. The PHAST was administered to 60 new users of behind-the-ear and in-the-ear instruments, immediately and 10 days after the hearing aid fitting. The assessments were recorded and later analyzed and scored by one or two independent evaluators. Results About 55% of the participants showed fair and poor performance on the PHAST. Battery replacement and hearing aid insertion tasks were the most difficult to complete. Total scores as well as “opening battery compartment” and “hearing aid insertion” tasks scores, improved significantly between the first and second administration of the PHAST. The PHAST performance was correlated with the participant’s age. Inter-rater reliability was high and significant concerning the total score and for six PHAST individual tasks. Conclusion New hearing aid users have different hearing aid handling skills that increase in the initial periods of HA use. The PHAST can be used in the audiology clinic, allowing for a more systematic record of such skills.

Objetivo identificar junto aos alunos dos Cursos de Fonoaudiologia: fatores que levaram a esta escolha de carreira e informações que gostariam de ter recebido sobre esta profissão antes do exame vestibular. Métodos estudo exploratório, descritivo, transversal. Discentes dos cursos de graduação em Fonoaudiologia oferecidos pela Universidade de São Paulo nos campi de Bauru, São Paulo e Ribeirão Preto e egressos do campus de Bauru foram convidados a preencher anonimamente, um questionário online composto por 10 questões a respeito de suas opções de carreira universitária e sobre as fontes e suficiência de informação a respeito da profissão Fonoaudiologia quando da inscrição no exame vestibular. Resultados responderam ao questionário 201 sujeitos (144 graduandos e 57 egressos). A Fonoaudiologia foi a primeira opção de carreira para 119 (59,2%) dos participantes. O interesse pela profissão foi o motivador de escolha para 42% dos participantes e o status da universidade, a relação candidato/vaga e a influencia de familiares, dentre outros, para 58% dos respondentes. Os guias de profissões foram as principais fontes de informação sobre a carreira. Cerca de 80% dos sujeitos não estavam satisfeitos com as informações que receberam antes do vestibular, a maioria indicando que gostariam de saber mais sobre o campo de atuação do fonoaudiólogo. Conclusão fatores não relacionados à afinidade ou pendor pela profissão levam à opção pela carreira Fonoaudiologia para a maioria dos participantes. Há necessidade de intensificar a veiculação de informações sobre a profissão, sobretudo o seu campo de atuação para candidatos ao exame vestibular.

Purpose to identify factors that led Speech and Language Pathology and Audiology students to choose the career as well as the information they would have liked to receive before entering College. Methods exploratory, descriptive, cross-sectional study. SLP-Audiology students of undergraduate courses in the University of São Paulo (Bauru, São Paulo and Ribeirão Preto campus) and graduate students (Bauru campus) were asked to complete, anonymously, an online questionnaire consisting of 10 questions about their career choices and about the sources and adequacy of information regarding the SLP-Audiology profession before college entrance examination. Results the questionnaire was answered 201 individuals (144 undergraduates and 57 graduates). SLP-Audiology was the first career option for 119 (59.2%) of the participants. Interest in the profession was the motivator of choice for 42% of the participants. For 58% of respondents, the University status, the candidate/vacancy ratio and the influence of family members, among others, led to the SLP-Audiology career choice. Profession guides were the main sources of information and 80% of respondents were not satisfied with the information received before entering College, most indicating they would like to learn more about the areas where SLP-Audiologists can work. Conclusion factors unrelated to career affinity where the motivator for the choice of SLP-Audiology profession for most participants. There is need to intensify the information process about this career especially among high school students.

La presente investigación tuvo como finalidad central la comprensión profunda de la realidad humana en un contexto educativo, la forma cómo crecen humana y profesionalmente los docentes en formación que aspiran a ser maestros de secundaria

The first peruvian pediatric case of Neuro-Behcet, who had seizures, hemiparesis and a magneic nuclear resonance with a pseudotumoral imagine is here presented (Rev Med Hered 1996; 7: 178-181).

Objective: To determine the most frequent causes of cerebral palsy. Material and methods: A descriptive study of etiology in cerebral palsy (CP) is reported. We studied 102 cases of CP between November 1990 and May 1992 in two outpatient Neuropediatric Clinics associated to the Universidad Peruana Cayetano Heredia, Lima - Perú (Hospital Nacional Cayetano Heredia y Hogar Clínica San Juan de Dios). Results: The distribution of gestational age of our patients was 14.7% preterm, 67% fullterm and only one premature baby. The birth weight was more than 2,500 g in 54.9%, 1,500 g in 16.7% and less than 1500 in 6.9% of 97 cases. The cause was identified in 70% of patients, the more frequent etiology group was the perinatal one, with 59.3%, then the prenatal group with 29.1% and finally the postnatal 11.6%. In the prenatal group, almost 50% were congenital cerebral malformations; in the perinatal group the most frequent cause was perinatal asphyxia with or without other metabolic factor. We had 4 patients with severe hypoglycemia and two with dyskinetic PC related to kernicterus. Among the postnatal causes the most frequent was meningoencephalitis sequelae. We found, that in preterm newborns with low or very low birth weight the most comun type of CP was spastic diplegia and all of them with an hipoxic background. Conclusions: The high frequency of perinatal hypoxic cases and the low frequency of spastic diplegia are explained as a consequence of deficient conditions and poor technological resources for attention of mothers and newborns in our Public Healt System. (Rev Med Hered 1996; 7: 114-118).

Objetivo: Determinar las causas mas frecuentes de parálisis cerebral (PC). Material y métodos: Estudio descriptivo realizado en Hospital Nacional Cayetano Heredia y el Hogar Clínica San Juan de Dios (Lima-Perú), entre noviembre 1990 y mayo de 1992. Se revisaron las historias clínicas de 102 pacientes con diagnósticos de PC y se revisó las etiologías. Resultados: En relación a edad gestacional hubieron 15 casos de prematuros (14.7%), 67(65%) a término y un postmaduro, en 19 no se tuvo la edad gestacional. El peso al nacer fue adecuado en 56(54.9%), bajo en 17(16.7%) y muy bajo en 7(6.9%). Se identificó la causa de PC en 73/102 casos (70%), siendo las causas más frecuentes las perinatales (59.3%), seguidas de las prenatales con 29.1% y las postnatales con 11.6%. En el grupo de causas prenatales, la mitad fueron malformaciones cerebrales congénitas entre las que destaca el quiste porencefálico, presente en la mitad de estos casos. En el grupo perinatal, la más frecuente fue asfixia (83%) asociada o no a otro factor metabólico. Hubieron además en este grupo 4 casos de hipoglicemia severa y 2 con encefalopatía hiperbilirrubinémica y PC distónica. Las causas postnatal más frecuente fue la meningoencefalitis bacteriana, en menores de un año de edad. Al correlacionar etiología y momento del daño, peso al nacer y tipo de PC se observa que, en los recién nacidos PT de bajo o muy bajo peso al nacer es mas frecuente la PC de tipo dipléjica y en todos el antecedente fue asfixia perinatal. Conclusiones: La baja frecuencia de PC dipléjica y la elevada frecuencia de causas perinatales (asfixia), marca nuestra diferencia con otras series y obedece en nuestra opinión, a los escasos recursos tecnológicos y las deficiencias en la atención a las gestantes y recién nacidos de nuestro sistema nacional de salud. (Rev Med Hered 1996; 7: 114-118).

Case report of a 12 years old female child who developed in the last seven months focal neurological signs and progressive intracranial hypertension. CT scan showed a giant cystic tumor, and cerebral hydatidosis has been diagnosed. The hydatic cyst was surgically removed without complications. Cerebral hydatidosis is rare, its diagnosis is clinical and tomographic, and the treatment is always surgical.

Se presenta el caso de una niña de 12 años de edad con siete meses de evolución de signos focales e hipertensión endocraneana progressiva. Con ayuda de la TAC se diagnosticó tumoración quística gigante compatible a hidatidosis cerebral. Se realizó craneotomía y extirpación del quiste sin complicaciones. La hidatidosis cerebral es rara, su diagnóstico es clínico-tomográfico y el tratamiento siempre es quirúrgico.

We present the study of 23 pediatric cases with infantile epileptic encephalopathies at the ambulatory neuropediatric facility of the Hospital Base Cayetano Heredia and ambulatory neurologic facility of Hospital IPPS Guillermo Almenara (Lima, Perú) between January 1984 and October 1988 with 6 to 54 months follow-up. There was one patient with Ohtahara syndrome, 9 with West síndrome and 13 with Lennox-Gastaut syndrome. The clinical and electroencephalographic characteristics were reviewed and related with the outcome. Despite the general characteristics of Ohtahara syndrome our patient had a good prognosis; only two West evolve into Lennox-Gastaut and none of these was West. Although the common features in these syndrome include frequent and intractable seizures and grave prognosis most of our patients had a good control of seizures.

Se presenta una serie de 23 casos de encefalopatías epilepticas de la infancia, vistos en los consultorios externos de Neuropediatría del Hospital General Cayetano Heredia y Neurología del Hospital IPSS. Guillermo Almenara (Lima, Perú) entre Enero-1984 y Octubre-1988, con un seguimiento entre 6 meses y 4 años 6 meses para cada paciente. Del total, uno correspondió al sindrome de Ohtahara, 9 fueron West y 13 Lennox-Gastaut. Se revisan las características clínico electroencefalográficas de cada uno de los grupos y su evolución. Con relación al sindrome de Ohtaharta llama la atención el buen pronóstico encontrado en este paciente; de los 9 West únicamente 2 evolucionaron para Lennox-Gastaut y de estos últimos ninguno tuvo antecedente de West y contrariamente a lo esperado y teniendo en cuenta los factores de riesgo para mal pronóstico, la mayor parte de nuestros pacientes tuvieron un buen control de crisis.

Se presentan 159 casos de procesos expansivos de los cuales se revisan 111 catalogados como no neoplásicos vistos durante los años 1984-1988 en el HGBCH, llamando la atención fundamentalmente sobre 3 aspectos: (1) la importancia de establecer organicidad en la epilepsia parcial y la epilepsia tardía; (2) la incidencia aada vez mayor de procesos infecciosos e inflamatorios intracraneanos en países en desarrollo; (3) la existencia de dos procesos parasitarios que deben encontrarse en el diagnóstico diferencial de procesos expansivos no tumorales: amebiasis de vida libre, y toxoplasmosis (especialmente en pacientes con SIDA).

Presentation of clinical-tomographic correlation in 111 cases of non tumoral intracranial expansive processes seen between 1984-1988 in the Hospital Cayetano Heredia (Lima, Peru). Emphasis is given fundamentally to: (1) the importance of stablishing the or-ganicity of partial and late epilepsy; (2) the high incidence rate of inflammatory infectious processes with CNS compromise in underdeveloping countries; (3) the necessity of making public the importance of two parisitic diseases in the differential diagnosis of non tumoral intracranial expansive processes: free living amebiasis, and toxoplasmosis (especially in association with AIDS).

Twenty seven cases of Pott's disease in children between 6 months and 14 years of age are reported. They were observed during a two years period, with a follow-up time till 18 months. In report to their ages 67% were lower than 6 years old and two of them lower than one year old. There was a male sex predominance. The 'hump' sign was the most frequently observed. The most frequent damage localization was at dorsal level. All patients received treatment with four drugs, 14 of them needed orthopedic methods, and only 6 were submitted to surgical correction. In more than 50% of the patients there was good outcome toward cure or improvement with sequelae.

Se presentan 27 casos de mal de Pott en niños entre 6 meses y 14 años de edad vistos durante un período de 2 años con tiempo de seguimiento hasta de 18 meses, 67% menores de 6 años y de ellos 2 pacientes menores de 1 año. Hubo predominio de pacientes de sexo masculino. El síntoma "jiba" fue el mas frecuente. La localización mas frecuente de la lesión fue el nivel dorsal. Todos recibieron tratamiento médico con 4 drogas, 14 de ellos necesitaron de métodos ortopédicos y solo 6 fueron sometidos a corrección quirúrgica. En mas del 50% hubo una evolución favorable hacia la curación o la mejoría con secuelas.