RESUMO
Colombia is a country with major problems, mainly a high degree of inequality and an unacceptably high level of violence (both armed military conflict and crime related). There are unacceptably high variations in health and health provision. Despite these difficulties, there are important steps being taken by both the government and independent organisations to try and improve child health and to achieve the Millennium Development Goals in relation to poverty, hunger and health issues. The participation of different sectors and stakeholders (including government, non-governmental organisations and other organisations of civil society) is essential to overcome Colombian history and to promote a better place for children.
Assuntos
Proteção da Criança , Acessibilidade aos Serviços de Saúde , Adolescente , Causas de Morte , Criança , Defesa da Criança e do Adolescente , Mortalidade da Criança , Pré-Escolar , Colômbia , Atenção à Saúde/organização & administração , Etnicidade , Humanos , Lactente , Recém-Nascido , Pobreza , Fatores Socioeconômicos , Nações Unidas , Violência , Adulto JovemRESUMO
This study is based on skeletons and mummies belonging to 582 individuals excavated at sites of Pueblo Viejo, Cahuachi, Estaqueria and Atarco in the Nasca valley, South Coast of Peru. Archaeological evidence distinguishes three cultural phases: Nasca (400 BC-550 AD), Wari (600-1100 AD) and Chincha (1100-1412 AD). Since the Chincha human remains were too exiguous (27 individuals), only Nasca and Wari were considered. For the Nasca population, sex ratio was 113 men to 100 women (53% of males); for the Wari population, sex ratio was 117 men to 100 women (54% of males). The palaeodemographic data show that the infant mortality rate was 33@1000 for Nasca and 105@1000 for Wari. Life expectancy was 38-43 years for Nasca and 31-36 years for Wari. Death percentages in all the age groups increased from Nasca to Wari phase. ANOVA and t-test for paired comparison were applied in order to examine if dental and bone ages were statistically different. Long bones and teeth showed an allometric development, and the age estimated from the tooth formation and eruption was generally higher than the age estimated from the maximum lengths of long bones. The anthropological study of the Nasca valley skeletal populations confirmed the archaeological hypothesis of worse conditions of the Wari population in comparison with the previous Nasca people.
Assuntos
Nível de Saúde , Indígenas Norte-Americanos , Expectativa de Vida , Adulto , Determinação da Idade pelo Esqueleto , Determinação da Idade pelos Dentes , Antropometria , Osso e Ossos/anatomia & histologia , Demografia , Feminino , Humanos , Masculino , Mortalidade , Múmias , Peru , Dinâmica Populacional , Razão de MasculinidadeRESUMO
A collaborative effort to assess factors affecting newborn survival at neonatal intensive care units (NICUs) was made by studying 1948 newborns admitted to nine NICUs in the city of São Paulo between 1 June and 30 November 1991. Data on the study subjects were obtained using a standardized form. This was the first activity undertaken by a network of neonatologists (the Paulista Collaborative Group on Neonatal Care) dedicated to jointly evaluating and improving neonatal care in that city. The study results showed an overall mortality of 59 deaths per 1,000 neonates, with survival improving as gestational age and birthweight rose. Other variables significantly affecting survival were a poor maternal obstetric history (a previous stillbirth or neonatal death, or two or more spontaneous abortions); birth asphyxia (Apgar at 5 minutes < 7); respiratory distress syndrome; severe infections; and major malformations. However, multiple logistic regression analysis showed that the rates of neonatal survival in the nine NICUs differed even when these factors were considered. Potential sources of this variability included undetermined population differences in neonatal disease severity and medical care. These results suggest a need for greater efforts to identify and reduce risk factors associated with neonatal mortality, and to adequately evaluate the medical care provided in NICUs. Within this context, the collaborative network of neonatologists established in São Paulo provides a sound organizational structure for evaluating and improving the effectiveness of neonatal care.
Assuntos
Asfixia Neonatal/terapia , Unidades de Terapia Intensiva Neonatal , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Índice de Apgar , Asfixia Neonatal/mortalidade , Brasil/epidemiologia , Feminino , Humanos , Recém-Nascido , Infecções/mortalidade , Infecções/terapia , Masculino , Análise de Regressão , Síndrome do Desconforto Respiratório do Recém-Nascido/mortalidade , Fatores de Risco , Taxa de SobrevidaRESUMO
Evaluar los resultados de la Colposacropexia transabdominal en el prolapso de la cúpula vaginal. Ventisiete pacientes con prolapso de la cúpula vaginal, tratados quirúrgicamente por colposacropexia, entre Julio de 1992 a Agosto de 1996.Se analizan los resultados del procedimiento quirúrgico,las complicaciones intra y postoperatorias y la funcionalidad vaginal. El tiempo de seguimiento para las colposacropexias fue de 14,9 meses (3-52 meses). La tasa de curación fue de 92,6 por ciento. Las principales complicaciones intraoperatorias fueron dos lesiones de intestino delgado, no relacionadas directamente con el procedimiento operatorio y de las postoperatorias, dos ileos paralíticos.No hubo mortalidad. De las 12 pacientes con actividad sexual, ella es normal en el 90,9 por ciento. La colposacropexia es una operación de técnica simple, con baja morbilidad intra y postoperatoria, que asegura una alta tasa de curación del prolapso de la cúpula vaginal y constituye la intervención de elección en esta unidad de ginecología
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Histerectomia Vaginal , Prolapso Uterino/cirurgia , Fatores Etários , Hipertensão , Histerectomia Vaginal/efeitos adversos , Complicações Intraoperatórias , Obesidade , Complicações Pós-Operatórias , Resultado do Tratamento , Incontinência Urinária , Prolapso Uterino/complicações , Vagina/fisiologiaAssuntos
Mortalidade Infantil , Recém-Nascido de Baixo Peso , Brasil , Idade Gestacional , Humanos , Recém-Nascido , PrognósticoRESUMO
Se presentan dos casos clínicos de colecciones pelvianas de diferente etiología, ingresados a la Unidad de Aislamiento del Servicio de Ginecología y Obstetricia del Hospital del Salvador, resueltos ambos por punción bajo visión ecográfica transabdominal; el primero un absceso tuboovárico, en el cual se dejó drenaje percutáneo y el segundo un quíste lúteo residual (post embarazo ectópico operado) puncionado. En el primer caso (absceso tuboovárico) la paciente se embaraza a los dos meses post punción con evolución fisiológica actual. En el segundo caso la paciente está clínicamente asintomática a la fecha, post procedimiento