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Introducción. Padecer una enfermedad crónica genera un impacto psicosocial significativo y con ello cambios en el estilo de vida, que se convierten en desafíos para aprender a vivir como es la Diabetes Mellitus tipo 2, generando una experiencia singular ante el autocuidado y manejo de la enfermedad. Siendo importante la experiencia del paciente generada a partir del diagnóstico porque permite identificar aspectos significativos que influyen directa e indirectamente en la enfermedad. Objetivo. Interpretar las experiencias psicológicas y sociales del paciente con Diabetes tipo 2 a partir del diagnóstico. Metodología. Investigación cualitativa con enfoque fenomenológico social interpretativa desde Alfred Schütz. La selección de los participantes fue por típico ideal con diagnostico mayor de 5 años. La recolección de los datos fue mediante entrevista a profundidad, observación participante y notas de campo. El análisis de los datos fue a través de lo propuesto por Amedeo Giorgi. Los criterios de rigor se consideró lo propuesto por Castillo y Vázquez, así como el consentimiento informado. Hallazgos. Cuatro temas derivados de la experiencia de padecer Diabetes Mellitus tipo 2: el primer tema correspondiendo a la experiencia psicológica que experimento el paciente, el segundo tema hace referencia a la experiencia social que surgió entre sus círculos sociales y el profesional de salud como nueva relación social, el tercer tema habla sobre la cotidianidad del paciente con DM2, y finalmente el cuarto tema habla de la vida sexual del paciente que surgió como descubrimiento. Conclusiones. El profesional de salud, en particularmente Enfermería debe abordar al paciente con DM2 desde un enfoque biopsicosocial para dar un cuidado integral a partir del reconocimiento del discurso del paciente a través de sus experiencias, con la finalidad de obtener resultados favorables en el autocuidado y manejo de la enfermedad.
Introduction. Having a chronic illness generates a significant psychosocial impact and thereby changes in lifestyle, which become challenges to learn to live, as it is diabetes mellitus type 2, generating a unique experience at the self-care and management of the disease. The patient's experience generated from diagnosis being important because it allows identifying significant aspects that directly influence and indirectly in the disease. Objective. Interpret the psychological and social experiences of the patient with type 2 diabetes from diagnosis. Methodology. Qualitative research with interpretative social phenomenological approach from Alfred Schütz. The selection of the participants was by typical ideal with diagnosis greater than 5 years. The collection of the data was through a depth interview, participant observation and field notes. The analysis of the data was through what is proposed by Amedeo Giorgi. The criteria of rigor was considered the proposed by castle and Vázquez, as well as informed consent. Findings. Four themes derived from the experience of suffering Diabetes Mellitus Type 2: The first topic corresponding to the psychological experience that the patient experienced, the second topic refers to the social experience that emerged between his social circles and the health professional as a new social relationship. The third topic talks about the daily life of the patient with DM2, and finally the fourth issue speaks of the sex life of the patient that emerged as a discovery. Conclusions. The health professional, in particular nursing must address the patient with DM2 from a biopsychosocial approach to take comprehensive care from the recognition of patient's discourse through his experiences, in order to obtain favorable results in self-care and management of the illness.
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Humanos , Adulto , Diabetes Mellitus Tipo 2 , Enfermería , Acontecimientos que Cambian la Vida , MéxicoRESUMEN
As interest in the use of copper-based nanomaterials in agriculture continue to increase, research into their exposure effects must expand from short-term, high exposure studies to long-term studies at realistic concentrations. Long-term studies can better elucidate the implications of copper nanomaterial exposure by allowing plants to mature and adapt to higher copper concentrations. In this study, sugarcane plants were grown to maturity in large nursery pots using soils amended with one of the following treatments: Kocide 3000 (Cu(OH)2), a nano-sized CuO (nCuO), a bulk-sized CuO (bCuO), copper metal nanoparticles (Cu NP), or CuCl2 at 20, 40, and 60 mg kg-1. After tissue harvesting, copper content in plant tissues, including pressed cane juice, were determined. Chlorophyll content and the activity of reactive oxygen species (ROS) related enzymes, in root tissues, were measured as an indicator of plant health. Elemental analysis revealed significant changes in root copper concentrations only upon application of the highest levels of Kocide 3000, nCuO, and Cu NP. However, translocation of copper to leaf tissues displayed consistent increases with added copper over controls. Plants treated with Kocide 3000 at 60 mg kg-1 experienced a significant 31% decrease in cane juice yield; copper concentrations in the pressed juice of plants treated with: Kocide 3000 at 20 and 60 mg kg-1, nCuO at 20 and 60 mg kg-1, bCuO at 20 mg kg-1, CuCl2 at 40 mg kg-1, and Cu NP increased by at least 58%. Chlorophyll content remained comparable to controls, and there was a significant 50 to 68% decrease in superoxide dismutase (SOD) activity in plants treated with nCuO, bCuO, Cu NP, and CuCl2. The results indicate that sugarcane plants exposed to the selected copper-based treatments were not adversely affected.
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Saccharum , Clorofila , Cobre , Nanopartículas del Metal , SueloRESUMEN
BACKGROUND/OBJECTIVES: Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample. SUBJECTS/METHODS: We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20-64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions. RESULTS: Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained. CONCLUSIONS: This study presents first reference values of WC and WHtR for Colombians aged 20-64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications.
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Obesidad/epidemiología , Circunferencia de la Cintura , Relación Cintura-Estatura , Adolescente , Adulto , Distribución por Edad , Área Bajo la Curva , Colombia/epidemiología , Estudios Transversales , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Valores de Referencia , Distribución por Sexo , Estadística como Asunto , Adulto JovenRESUMEN
Objetivo: El cuestionario desarrollado en EE. UU. por Jette et al. se emplea como herramienta para estimar las actitudes, las creencias, los conocimientos y los comportamientos hacia la práctica basada en la evidencia (PBE). Este instrumento fue adaptado y validado en lengua española por Guerra et al., pero carece de estudios de validez en población hispana. El objetivo de esta investigación fue estimar las propiedades psicométricas, como forma de obtener evidencias de validez del instrumento para el uso propuesto. Método: La muestra se compone de 1.064 fisioterapeutas de Colombia y que completaron la versión on-line del cuestionario. La fiabilidad y la reproducibilidad fueron estimadas mediante el procedimiento alfa de Cronbach, prueba-reprueba con el coeficiente de correlación intra-clase de Lin y el índice de kappa de Cohen, respectivamente. Se aplicó un análisis factorial exploratorio para analizar la estructura factorial. Resultados: El cuestionario ha mostrado a nivel global alta consistencia interna, moderada estabilidad temporal, aceptable reproducibilidad, apropiada validez de constructo y adecuada bondad de ajuste a una estructura unidimensional. El análisis factorial exploratorio identificó 2 factores que explican el 37,953% de la varianza. Conclusiones: Los resultados obtenidos en este cuestionario avalan la utilización de este instrumento con este tipo de muestra, desde el punto de vista de la fiabilidad y la estructura factorial. No obstante, es necesario realizar nuevos estudios que aporten evidencias de validez basadas en la relación con otras variables, para determinar su utilidad como instrumento de prueba que evalúe la PBE
Objective: The questionnaire developed in the U.S by Jette et al. is used as a screening to olto estimate the attitudes, beliefs, knowledge and behaviors toward evidence-based practice(EBP). This instrument was adapted and validated in the Spanish language by Guerra et al., but lacking validity studies in the Hispanic population. This research has aimed to estimate the psychometric properties as a way to obtain evidence on the validity of the instruments for the use proposed. Method: The sample was made up of 1,064 Physiotherapists in Colombia who completed the on-line version of the questionnaire. Its reliability and reproducibility were estimated with Cronbachs alpha procedure, the test-retest with Lin correlation coefficient and Cohens kappaindex, respectively. An exploratory factor analysis was used to analyze the factorial structure. Results: The questionnaire has shown global high internal consistency, moderate temporal stability, acceptable reproducibility, and construct validity appropriate. Exploratory factorial analysis identified two factors that account for 37.953% of the variance. Conclusions: The results obtained in this study support the use of this questionnaire for this type of sample from the viewpoint of reliability and factor structure. However, further studies are needed to provide evidence of validity based on the relationship with other variables to determine its usefulness as a questionnaire to evaluate the EBP
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Humanos , Psicometría/instrumentación , Modalidades de Fisioterapia , Práctica Clínica Basada en la Evidencia , Reproducibilidad de los Resultados , Reproducibilidad de los Resultados , Conocimientos, Actitudes y Práctica en SaludRESUMEN
Introducción La práctica basada en la evidencia científica (PBE) se define como un proceso cuyo objetivo es la selección de los mejores argumentos científicos para la resolución de los problemas que se plantean en la práctica clínica. El propósito de este estudio fue evaluar el estado actual de la investigación y las principales barreras para la incorporación del uso de la PBE en fisioterapeutas colombianos. Materiales y métodos Estudio transversal, multicéntrico y descriptivo en 221 fisioterapeutas colombianos sin formación previa en PBE. Se aplicó una encuesta de 18 ítems divida en 3 apartados diferenciados: a) información de la titulación; b) aplicación de PBE, y c) áreas y líneas de desempeño profesional e investigativo. Adicionalmente, se reunieron datos de información sociodemográfica. Resultados El promedio de edad fue 26,6 ± 6,1 años; el 76% de los encuestados tenían titulación profesional y solo el 3,2% nivel de maestría. Un 43,4% de los encuestados buscan información en fuentes primarias y secundarias, mientras que el 28,5% respondió nunca hacerlo. El 55,7% usaban búsquedas mediante Altavista, Google, Hotbot y Lycos, y solo un 13% usaba Tesauros. El 48,9% respondía haber realizado estudios de tipo descriptivo, el 10,4% experimentales y el 3,2% de casos y controles. Un 10,9% de los encuestados desarrollaba proyectos en cuidado crítico, el 7,2% en enfermedad articular y el 4,5% en enfermedad neurológica. Conclusión El estudio confirma la escasa actividad científica y las barreras que limitan la inclusión de la PBE en profesionales de fisioterapia de Colombia. Múltiples estrategias de cambio serán necesarias para facilitar la inclusión de actividades encaminadas a la mejora de la competencia profesional en esta materia (AU)
Introduction Scientific evidence based practice (SEBP) is defined as a process whose objective is the selection of the best scientific arguments to solve the problems occurring in the clinical practice. This study has aimed to evaluate the current status of the investigation and the principal barriers existing for the Columbian physiotherapists to incorporate SEBP. Material and methods A cross-sectional, multicenter and descriptive study was performed in 221 Colombian physiotherapists with no previous training in SEBP. An 18-item survey divided into 3 differentiated sections was applied. These sections were: 1) degree information, 2) application of SEBP and 3) areas and lines of professional and investigational work. In addition, sociodemographic information data were collected. Results Average age was 26.6 ± 6.1 years; 76% of those surveyed had a professional degree and only 3.2% a master's degree. A total of 43.4% of those surveyed looked for information in primary and secondary sources while 28.5% stated they never did so. Searcy was performed in Altavista, Google, Hotbot, Lycos by 55.7% and only 13% used Tesauros. 48.9% stated they had carried out descriptive type studies, 10.4% experimental and 3.2% case-controls. Of those surveyed, 10.9% developed projected in critical care, 7.2% in articular disease and 4.5% in neurological disorder. Conclusion This study confirms the scarce scientific activity and barriers that limit including SEPB in physiotherapy professionals in Colombia. Multiple strategies of change will be necessary to facilitate the inclusion of activities aimed at the improvement of professional expertise in this material(AU)
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Humanos , Práctica Clínica Basada en la Evidencia/organización & administración , Especialidad de Fisioterapia/tendencias , Investigación sobre Servicios de Salud , Colombia/epidemiología , Fisioterapeutas/educaciónRESUMEN
AIMS: This retrospective observational study examined the association between International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)-coded outpatient hypoglycaemic events and fall-related fractures in Medicare-covered patients with type 2 diabetes. METHODS: Data were derived from healthcare claims for individuals with employer-sponsored Medicare supplemental insurance. The study period consisted of two consecutive 1-year periods; the baseline period (1 April 2008 to 31 March 2009) and the evaluation period (1 April 2009 to 31 March 2010). Patients selected for study were at least 65 years of age with evidence of type 2 diabetes during the baseline period, as identified using a Healthcare Effectiveness Data and Information Set algorithm or by at least two prescription claims for oral antidiabetic drugs. The baseline period was used to collect information on the patients' demographics and clinical characteristics. The evaluation period was used to identify the presence of hypoglycaemic events and fall-related fractures. Logistic regression was employed to examine the association between hypoglycaemic events and fall-related fractures occurring during the evaluation period, adjusting for patients' demographics and clinical characteristics. RESULTS: Of 361 210 included patients, 16 936 had hypoglycaemic events during the evaluation period. Patients with hypoglycaemic events had 70% higher regression-adjusted odds (hypoglycaemic events odds ratio = 1.70; 95% confidence interval = 1.58-1.83) of fall-related fractures than patients without hypoglycaemic events. Multiple sensitivity analyses also yielded results suggesting increased odds of fall-related fractures in patients with hypoglycaemic events. CONCLUSIONS: ICD-9-CM-coded outpatient hypoglycaemic events were independently associated with an increased risk of fall-related fractures. Further studies of the relationship between hypoglycaemia and the risk of fall-related fractures are warranted.
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Accidentes por Caídas , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Fracturas Óseas/economía , Hipoglucemia/inducido químicamente , Hipoglucemia/complicaciones , Hipoglucemiantes/efectos adversos , Pacientes Ambulatorios , Inconsciencia/complicaciones , Administración Oral , Factores de Edad , Anciano , Anciano de 80 o más Años , Algoritmos , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/etiología , Prescripciones de Medicamentos/economía , Femenino , Fracturas Óseas/etiología , Humanos , Hipoglucemiantes/administración & dosificación , Revisión de Utilización de Seguros , Modelos Logísticos , Masculino , Medicare , Estudios Retrospectivos , Factores de Riesgo , Inconsciencia/etiología , Estados Unidos/epidemiologíaRESUMEN
This study investigated the effect of bone marrow-derived cells associated with guided bone regeneration in the treatment of dehiscence bone defects around dental implants. Iliac-derived bone marrow cells were harvested from dogs and phenotypically characterized with regard to their osteogenic properties. After teeth extraction, three implant sites were drilled, dehiscences created and implants placed. Dehiscences were randomly assigned to: bone marrow-derived cells, bone marrow-derived cells+guided bone regeneration, and control (no treatment). After 3 months, implants with adjacent tissues were processed histologically, bone-to-implant contact, bone fill within the threads, new bone area in a zone lateral to the implant, new bone height, and new bone weight at the bottom of the defect were determined. Phenotypic characterization demonstrated that bone marrow-derived cells presented osteogenic potential. Statistically higher bone fill within the threads was observed in both bone marrow-derived cells+guided bone regeneration bone marrow-derived cell groups compared with the control group (P<0.05), with no difference between the groups treated with cells (P>0.05). For the other parameters (new bone area, bone-to-implant contact, new bone height and new bone weight), only the bone marrow-derived cells+guided bone regeneration group presented higher values compared with the non-treated control (P<0.05). Bone marrow-derived cells provided promising results for peri-implantar bone regeneration, although the combined approach seems to be relevant, especially to bone formation out of the implant threads.
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Pérdida de Hueso Alveolar/cirugía , Trasplante de Médula Ósea/métodos , Regeneración Ósea/fisiología , Implantes Dentales , Regeneración Tisular Guiada Periodontal/métodos , Fosfatasa Alcalina/análisis , Pérdida de Hueso Alveolar/patología , Proceso Alveolar/patología , Animales , Adhesión Celular/fisiología , Movimiento Celular/fisiología , Forma de la Célula , Colágeno Tipo I/análisis , Perros , Sialoproteína de Unión a Integrina/análisis , Membranas Artificiales , Microscopía Electrónica de Rastreo , Oseointegración/fisiología , Osteogénesis/fisiología , Fenotipo , Politetrafluoroetileno , Distribución Aleatoria , Factores de Tiempo , Andamios del Tejido , Titanio , Alveolo Dental/patología , Alveolo Dental/cirugía , Trasplante Autólogo , Resultado del TratamientoRESUMEN
During March of 2008, bibb lettuce (Lactuca sativa L.) plants with severe wilting and root rot were observed in a commercial liquid-hydroponic greenhouse in Guanajuato, Mexico. By July of that year, the disease affected most plants in the facility. A Phytophthora sp. was consistently isolated from diseased roots on potato carrot agar. Several Phytophthora isolates were morphologically characterized. Sporulation was achieved by placing colonized disks of clarified V8 juice agar (V8A) into nonautoclaved soil extract (10 g avocado soil/1,000 ml distilled water, stirred for 3 h, and filtered). Sporangia were persistent, nonpapillate, and 40 to 58 µm long × 30 to 40 µm wide. External and internal proliferation was observed. Hyphal swellings were predominantly rounded. Oospores were not observed. The isolates grew on V8A at 35°C. Pathogenicity tests were conducted twice by utilizing a representative isolate (AC1) on bibb lettuce seedlings (10 replicates per experiment). Seeds were placed on sterile, water-soaked paper in petri dishes. After 10 days, each lettuce seedling was placed into a tube containing approximately 2 ml of sterile distilled water and 2,000 zoospores. Control plants were placed in tubes with water only. Plants were incubated for 7 days in a moist chamber at 25°C. Symptoms of wilting and root necrosis were observed 2 to 3 days after inoculation. All plants were dead 5 to 7 days after inoculation. A Phytophthora sp. was always isolated from the roots of inoculated plants. Control plants remained healthy. The pathogen was identified as Phytophthora drechsleri Tucker according to morphological characteristics. To confirm the identity of the pathogen, sequences of the internal transcribed spacers (ITS) were obtained from three representative isolates. The ITS sequences that were obtained shared 100% homology to several strains of P. dreschleri, including isolates from cucurbits (GenBank Accession No. AF228097). The ITS sequence was deposited in NCBI as Accession No. FJ790770. P. cryptogea and P. dreschleri have been reported as causing root rot on lettuce grown hydroponically in the United States and Korea (1,2). To our knowledge, this is the first report of P. drechsleri causing root rot on lettuce in Mexico. References: (1) H. J. Jee et al. Plant Pathol. J. 17:311, 2001. (2) A. R. Linde et al. Plant Dis. 74:1037, 1990.
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The final concentration of 6-pentyl-a-pyrone (6PP) produced in cultures of Trichoderma spp. is limited by the fact that inhibition of biomass growth occurs at 6PP concentrations as low as 100 mg/l. The aim of this work was to evaluate liquid-liquid extractive fermentation systems as an alternative to overcome the toxicity problems and to increase the production of 6PP by this fungus. Two alkanes (n-decane and n-hexadecane) and two dicarboxylic esters (dibutyl phthalate and dioctyl phthalate) were evaluated in shake flask cultures. The highest 6PP production (173 ppm) was achieved when n-hexadecane was used, being 3.5-fold the maximum 6PP concentration of a culture without the solvent. Cultivation of Trichoderma harzianum in a 10-1 bioreactor with n-hexadecane yielded 6PP production ninefold higher than that from control cultures. However, 6PP production in the bioreactor (83 ppm) was lower than in shake flasks. Differences in the power drawn to the fluid at each scale could account for such behavior. Even in the presence of the solvent, 6PP content decreased after reaching its maximal concentration.
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Pironas/química , Pironas/metabolismo , Trichoderma/crecimiento & desarrollo , Trichoderma/metabolismo , Reactores Biológicos , Medios de Cultivo , Fermentación , Pironas/aislamiento & purificación , Solventes/químicaRESUMEN
Experience is presented of the treatment of 100 patients for routine dentistry in general dental practice under propofol (Diprivan) sedation, delivered by continuous infusion. The infusion rates were set manually according to patients' responses. There were no differences in dental treatment or propofol requirements according to gender. Propofol requirements in some cases exceeded the upper limit of the recommended dose ranges and reasons why this may have occurred are discussed. A most useful feature of propofol sedation was the associated rapid recovery, with no patients needing to remain in the surgery for the purposes of recovery. The technique met with patients' approval, as all responses returned indicated a willingness to undergo the same type of sedation in future. Propofol sedation is not appropriate for the single operator/sedationist.
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Anestesia Dental , Anestésicos Intravenosos/administración & dosificación , Sedación Consciente , Propofol/administración & dosificación , Adolescente , Adulto , Anciano , Periodo de Recuperación de la Anestesia , Anestesia Dental/economía , Anestesiología , Anestésicos Intravenosos/economía , Niño , Sedación Consciente/economía , Ansiedad al Tratamiento Odontológico/prevención & control , Femenino , Odontología General , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Grupo de Atención al Paciente , Satisfacción del Paciente , Selección de Paciente , Propofol/economía , Estadísticas no Paramétricas , Encuestas y CuestionariosRESUMEN
OBJECTIVE: This study was carried out to examine the effectiveness of topically applied bupivacaine 0.25% with adrenaline 1:200,000, for post-operative analgesia in children undergoing dental extractions under general anaesthesia. DESIGN: Randomised double blind study in a single centre. SETTING: An outpatient dental clinic in a district general hospital, in England, in 1997. SUBJECTS AND METHODS: Subjects were selected from children of age 7-15 years having six or less extractions, and randomised using the closed envelope technique. INTERVENTIONS: The local anaesthetic used was bupivacaine 0.25% with adrenaline 1:200,000. MAIN OUTCOME MEASURES: Children were asked on waking from the anaesthetic whether they had pain or not. Pain was reassessed five and ten minutes post application of swabs to determine any changes in pain. RESULTS: Forty-eight children were recruited, of these 18 had no pain post-operatively and 6 were withdrawn due to a lack of cooperation. Twelve children were randomised to each group. There were 6 boys and 6 girls in the bupivacaine group (age 7-15 years), and 4 boys and 8 girls in the saline group. Bupivacaine 0.25% with adrenaline soaked swabs resulted in a significant reduction in pain in 10 children at 10 minutes (P = 0.01). CONCLUSION: Bupivacaine 0.25% with adrenaline 1:200,000, on application to exposed sockets is a simple technique that may provide useful post-operative analgesia.
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Analgésicos/uso terapéutico , Anestésicos Locales/uso terapéutico , Bupivacaína/uso terapéutico , Dolor Postoperatorio/prevención & control , Extracción Dental , Administración Tópica , Adolescente , Procedimientos Quirúrgicos Ambulatorios , Analgésicos/administración & dosificación , Anestesia Dental , Anestesia General , Anestésicos Locales/administración & dosificación , Bupivacaína/administración & dosificación , Niño , Método Doble Ciego , Epinefrina/administración & dosificación , Femenino , Humanos , Masculino , Cloruro de Sodio , Vasoconstrictores/administración & dosificaciónRESUMEN
This study compared the quality of anaesthesia and surgical access afforded by two techniques for the administration of anaesthesia during paediatric chair dental procedures. A total of 50 ASA 1 paediatric day case patients were randomly assigned to receive anaesthesia through either the traditional Goldman nasal mask or through a nasopharyngeal airway. Patients in the nasal mask group were judged to have significantly worse airway patency (p = 0.0001) and significantly more episodes of airway obstruction (14 vs. 4; p = 0.0032) than those in the nasopharyngeal airway group. Anaesthetic, surgical and oxygen saturation data did not differ significantly between the two groups. Operating conditions were universally graded as excellent in the nasopharyngeal airway group, while those in the nasal mask group were graded as excellent/good in only 79% of cases (p < 0.0001). These results suggest that better quality anaesthesia and operating conditions can be achieved by using a nasopharyngeal airway rather than the traditional nasal mask for the administration of anaesthesia to paediatric chair dental patients.
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Anestesia Dental/métodos , Anestesia General/métodos , Intubación/métodos , Máscaras , Nasofaringe , Adolescente , Obstrucción de las Vías Aéreas/etiología , Procedimientos Quirúrgicos Ambulatorios , Niño , Preescolar , Femenino , Humanos , Complicaciones Intraoperatorias , Intubación/efectos adversos , Masculino , Máscaras/efectos adversos , Oxígeno/sangre , Extracción DentalRESUMEN
A patient undergoing coronary artery bypass was found to have a giant epicardial lipoma weighing 1.36 kg which was excised uneventfully. The radiological and pathophysiological features are considered, and the options for management discussed.
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Neoplasias Cardíacas/cirugía , Lipoma/cirugía , Taponamiento Cardíaco/patología , Taponamiento Cardíaco/cirugía , Puente de Arteria Coronaria , Neoplasias Cardíacas/patología , Ventrículos Cardíacos/patología , Humanos , Lipoma/patología , Masculino , Persona de Mediana EdadRESUMEN
This retrospective study found that the long-term (greater than 6 months) postoperative survival in ASA 4E and 5E patients was 41% and 21% respectively, in 1986. This supports the Confidential Enquiry into Peri-operative Deaths' recommendation that life-saving surgery should not be withheld from patients who present in so serious a condition that they are unlikely to survive surgery.