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Background: Magnesium sulfate reduces pain scores and analgesic consumption. Its use as an analgesic resource in opioid-free or opioid-sparing techniques have also been tested. The evaluation of the antinociceptive potency of drugs and doses indirectly, through hemodynamic oscillations has been questioned. A relatively new algorithm called the plethysmographic stress index has been considered sensitive and relatively specific as a parameter for assessing the need for intraoperative analgesia. Objectives: The aim of this trial was to assess the intraoperative analgesic capacity of magnesium sulfate compared to remifentanil. The secondary objectives were propofol consumption and its latency, the consumption of opioids, ephedrine, and cisatracurium. Patients and Methods. Forty patients scheduled for post-bariatric dermolipectomy were randomly assigned to two groups to receive total intravenous anesthesia with target-controlled hypnosis induced with propofol. Analgesia was obtained in the remifentanil group with remifentanil at an initial dose of 0.2 µg·kg-1·min-1 and in the magnesium sulfate group with magnesium sulfate 40 mg·kg-1 + 10 mg·kg-1·h-1. Results: There was no statistical hemodynamic difference between the groups before and after orotracheal intubation (p = 0.062) and before and after the surgical incision (p = 0.656). There was also no statistical difference in the variation of mean arterial pressure before and after intubation (p = 0.656) and before and after the surgical incision (p = 0.911). There was similar consumption of cisatracurium, ephedrine, and postoperative opioids between the groups. Some patients in the magnesium sulfate group needed more intraoperative fentanyl and propofol, although the latency of propofol was similar in both the groups. Conclusion: We conclude that using magnesium sulfate in intravenous general anesthesia for post-bariatric dermolipectomy is related to a significant reduction in opioid consumption without compromising hemodynamic stability. Overall, PSI monitoring was helpful in driving the analgesic strategy. The use of magnesium sulfate proved to be an important adjunct in the scenario presented, allowing the use of opioids to be avoided in certain cases. We found no statistical differences in the consumption of neuromuscular blocker and vasoconstrictor. Substituting opioids for magnesium sulfate leads to an increase in propofol consumption in the scenario presented. Studies with a larger sample are needed to corroborate the results presented and evaluate other potential advantages in reducing opioid consumption.
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Introducción: El colgajo pediculado realizado con músculo temporal es una opción terapéutica válida para la reconstrucción de defectos de la región facial posterior a una resección quirúrgica, es una alternativa aceptable a los colgajos libres cuando estos no pueden ser utilizados ya sea por el performance status o patología de base de los pacientes a tratar o por no contar con cirujano microvascular. Objetivo: Describir nuestra experiencia en el uso de este colgajo para la reconstrucción de 7 pacientes con defectos de órbita, paladar y mucosa yugal tras la cirugía ablativa de diversas patologías. Materiales y métodos: Revisión retrospectiva de los pacientes del Servicio de Cirugía General del Hospital José Ramon Vidal, Corrientes-Argentina operados en el periodo comprendido desde enero del 2019 hasta enero del 2021.En este lapso, 7 pacientes fueron sometidos a cirugía reconstructiva inmediata con colgajo de músculo temporal en defectos del tercio medio de la región facial. Resultados: Un total de siete pacientes, (4 masculino- 3 femenino), sometidos a cirugía ablativa por presentar patología maligna (6) y patología benigna (1), con una edad media de 60 años. Dos colgajos se utilizaron para defectos de región orbitaria y partes blandas, seis para defectos en la cavidadoral en un paciente se emplearon los 2 músculos temporales-. El colgajo fue exitoso en todos los casos, se presentaron complicaciones menores como: dolor postoperatorio, hematoma, trismus, depresión de la zona dadora. Se obtuvo márgenes libres en el total de los procedimientos. Discusión: La cirugía reconstructiva con colgajo pediculado de musculo temporal es una excelente alternativa de colgajo regional con buenos resultados, posee alta tasa de éxito justificada por su buena vascularización. Además, la proximidad del músculo temporal con la región maxilofacial y su inserción contribuyen a obtener un arco de rotación hasta 180° sin comprometersu vitalidad. Es útil para la reconstrucción en un acto quirúrgico, acortando el tiempo intraoperatorio y sin cambios posicionales. Conclusiones: El colgajo de músculo temporal resulta una opción válida a los colgajos libres osteo-mio-cutáneos para defectos mixtos (óseos y de partes blandas) del tercio medio facial luego de la cirugía ablativa, cuando estos últimos no pueden ser implementados teniendo en cuenta varios aspectos como performance estatus de los pacientes, patología de base y necesidad de contar con un cirujano microvascular
Introduction: temporalis muscle vascularized flaps is a valid therapeutic option for reconstruction of defects in facial region after surgical resections. It is an acceptable alternative to free transfer flaps when these cannot be used because of the patient's performance state and base pathologies. Or because of the lack of a microvascular surgeon. Objectives: To describe on experience applying this kind of flaps for the reconstruction or 7 patients, with defects in palate orbit and yugal mucose after resective surgeries for various pathologies. Materials and methods: retrospective revision of patients in the general department, of Jose R Vidal Hospital (Corrientes - Argentina) into underwent surgery during the period between January 2019 ad January 2021. A total of 7 patients underwent immediate reconstructive surgery using a temporalis muscle flap. Results: 7 patients (4 males y 3 female) underwent resective surgery for different malignant (6) and benign (1) with a median age of 60. Two flaps were used for defects of the orbitary region and soft tissue, six for defects of the oral cavity (in one patient both temporalis muscle were used. Te procedure was successful in all cases, and minor complication were present, (post operatory pain, hematoma, trismus, excavation of the donor region) all procedures resulted un surgical margins of lesion of malignancy. Discussion: reconstructive surgery using a vascularized flap of temporalis muscle is an excellent alternative for regional flaps with good results and a high success justified because of its a good irrigation. Besides the proximity between temporalis muscle and the maxillofacial region, possibilities a flap rotation of up to 180 grades without compromising its vitality it is also useful for reconstruction in a single surgery shortening intra-operatory time while avoiding repositioning of the patients during the procedure. Conclusions: Temporalis muscle flaps are valid option to free osteo- mayo- cutaneal flaps for mixed defects (involving bone and soft tissue) of the medium third of facial region after resective surgeries when the latter cannot be carried and because of various aspects little performance status base pathologies and lack of microvascular margin.
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Humanos , Adulto , Pessoa de Meia-Idade , Cirurgia Bucal/métodos , Estudos Retrospectivos , Procedimentos de Cirurgia Plástica/métodos , Retalhos de Tecido Biológico/cirurgia , Músculos da MastigaçãoRESUMO
Lachryphagous males of Phortica variegata (Fallén, 1823) are gaining increasing attention in Europe, as they act as vectors of the nematode Thelazia callipaeda Railliet & Henry, 1910, causal agent of thelaziosis, an emergent zoonotic disease. Currently, there are no effective control strategies against the vector, and surveillance and monitoring rely on time-consuming and nonselective sampling methods. Our aim was to improve the knowledge about the population dynamics and the chemical ecology of the species. A total of 5,726 P. variegata flies (96.4% males and 3.6% females, mostly gravid) were collected in field experiments during June-September of 2020 in an oak forest in northern Spain. Our results indicate that 1) by means of sweep netting a significantly higher number of captures were found both around the collector´s body and in the air than at ground level; 2) a positive relationship was detected between the abundance of Phortica flies and temperature, with two significant peaks of abundance at 24 and 33°C; 3) the blend of red wine and cider vinegar was the most attractive bait; 4) yellow traps captured fewer flies compared to black and transparent traps; and 5) a significant reduction toward vinegar and wine was detected in presence of the phenolic monoterpenoid carvacrol. In addition, all the males (n = 690) analyzed by both molecular detection and dissection resulted negative for the presence of T. callipaeda larvae. Overall, these findings provide a better understanding of the vector in terms of monitoring and management strategies.
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Drosophilidae , Dinâmica Populacional , Animais , Doenças do Cão/transmissão , Cães/parasitologia , Drosophilidae/parasitologia , Drosophilidae/fisiologia , Europa (Continente) , Humanos , Controle de Insetos/métodos , Insetos Vetores/parasitologia , Insetos Vetores/fisiologia , Thelazioidea , Infecções por Trematódeos/transmissão , Zoonoses/transmissãoRESUMO
INTRODUCCIÓN Y OBJETIVO: La incontinencia urinaria (IU) es una patología qué por sus características epidemiológicas y fisiopatológicas, afecta en gran medida a los adultos mayores (AM); en particular en Chile, se han reportado prevalencias que van desde el 12,2 al 30% para este grupo. El objetivo de esta investigación fue evaluar la prevalencia de la IU a nivel nacional en personas mayores que viven en comunidad; analizar y describir si aquellos que presentan IU perciben una disminución en su calidad de vida evaluado a través del cuestionario SF-36, en los aspectos físicos y mentales. MÉTODOS: Estudio transversal, analítico, realizado en una muestra de personas chilenas de 60 años y más, residentes en la comunidad; con representatividad nacional, regional y urbano-rural. El análisis se realizó con el software STATA 15.0 RESULTADOS: Este estudio fue realizado en 4186 adultos mayores chilenos, se encontró una prevalencia de IU de un 12,1% siendo más frecuente en mujeres que en hombres (15,2% v/s 7,1 % respectivamente, p<0,0001). Los análisis de asociación mostraron que la IU afecta de manera negativa la autopercepcion de calidad de vida tanto en el aspecto físico como mental. La Calidad de vida, medida por SF-36 reportó una disminución en sus puntajes en personas incontinentes y de los AM que refieren una calidad de vida regular, mala o muy mala, el 50% de ellos presenta IU. CONCLUSIÓN: La IU se asocia a una percepción de disminución en la calidad de vida en las personas mayores chilenas residentes en la comunidad.
INTRODUCTION AND OBJECTIVES: Due to its epidemiological and pathophysiological characteristics, urinary incontinence (UI) is a pathology which greatly affects older adults. The reported prevalence for this group in Chile, specifically, ranges from 12.2 to 30%. The objective of this study was to evaluate, at the national level, the prevalence of UI in older people living in the community; analyze and describe whether those who experience UI perceive diminished quality of life, using the physical and mental subscales of the SF-36 questionnaire to evaluate. METHODS: Cross-sectional, analytical study conducted on a nationally, regionally and urban-rural representative sample of Chilean people aged 60 and over, who residents of the community. The analysis was performed using STATA 15.0 software. RESULTS: This study of 4,186 older Chilean adults found the prevalence of UI to be 12.1%, with higher frequency in women than in men (15.2% v / s 7.1%, respectively, p <0, 0001). Association analysis showed that UI negatively affects perceptions of the subject's own physical and mental quality of life. Quality of life, measured using SF-36, showed lower scores for incontinent people and, of the older adults who report normal, bad or very bad quality of life, 50% present UI. CONCLUSION: UI is associated with a perception of diminished in the quality of life in older Chilean people living in the community.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Incontinência Urinária/psicologia , Incontinência Urinária/epidemiologia , Qualidade de Vida , Autoimagem , Chile/epidemiologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Instituição de Longa Permanência para IdososRESUMO
Praziquantel is a broad spectrum antihelmintic agent and represents the drug of choice for the treatment of schistosomiasis. However, its low aqueous solubility and strong bitter taste highly affect the bioavailability and compliance in pediatric patients. Thus, the purpose of this study was to develop a dry nanosuspension, by a combination of high-pressure homogenization and spray drying, intended for redispersion in a pleasant taste vehicle for extemporaneous use. Three formulations, varying stabilizers to drug ratio, were developed and characterized in terms of particle size distribution, crystallinity, morphology, in vitro dissolution, and sedimentation-redispersibility behavior. A significant reduction in particle size was achieved after the high-pressure homogenization process, and the nanoparticles were further microencapsulated by spray drying technique. The redispersed dried powders exhibited a conserved particle size distribution (in the nanometric range) and certain crystallinity extent, with satisfactory redispersion ability. Besides, the enhancement of the dissolution performance obtained after comminution was conserved, even after drying and redispersion of the extemporaneous powdered formulation. In conclusion, the developed nanoparticle-loaded powders comprise an interesting tool for the administration of praziquantel to preschool-age children.
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Anti-Helmínticos/administração & dosagem , Nanopartículas/administração & dosagem , Praziquantel/administração & dosagem , Esquistossomose/tratamento farmacológico , Criança , Composição de Medicamentos/métodos , Humanos , Tamanho da Partícula , Pós , Praziquantel/químicaRESUMO
In the past few decades great effort has been devoted to the study of water confined in hydrophobic geometries at the nanoscale (tubes and slit pores) due to the multiple technological applications of such systems, ranging from drug delivery to water desalination devices. To our knowledge, neither numerical/theoretical nor experimental approaches have so far reached a consensual understanding of structural and transport properties of water under these conditions. In this work, we present molecular dynamics simulations of TIP4P/2005 water under different nanoconfinements (slit pores or nanotubes, with two degrees of hydrophobicity) within a wide temperature range. It has been found that water is more structured near the less hydrophobic walls, independently of the confining geometries. Meanwhile, we observe an enhanced diffusion coefficient of water in both hydrophobic nanotubes. Finally, we propose a confined Stokes-Einstein relation to obtain the viscosity from diffusivity, whose result strongly differs from the Green-Kubo expression that has been used in previous works. While viscosity computed with the Green-Kubo formula (applied for anisotropic and confined systems) strongly differs from that of the bulk, viscosity computed with the confined Stokes-Einstein relation is not so much affected by the confinement, independently of its geometry. We discuss the shortcomings of both approaches, which could explain this discrepancy.
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BACKGROUND AND AIMS: Polyphenol-rich diets have been associated with reduced risk of cardiovascular disease (CVD). However, few prospective epidemiological studies have examined the relationship between classes of ingested polyphenols and risk of CVD. Our aim was to evaluate the association between polyphenol intake and risk of major cardiovascular events in a prospective Spanish cohort. METHODS AND RESULTS: We included 17,065 university graduates (60.7% women, mean age: 37.2 years, age range: 20-89) followed-up for a mean of 10.1 years. Polyphenol intake was assessed at baseline using a validated semi-quantitative 136-item food frequency questionnaire and matching food consumption data with the Phenol-Explorer database. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for incident cardiovascular events (myocardial infarction, stroke or cardiovascular death). Cherries, chocolate, coffee, apples, and olives were the major sources of variability in polyphenol intake. Participants with higher flavonoids intake (fifth quintile) had a 47% lower incidence of cardiovascular events compared to those in the lowest quintile (HR: 0.53, 95% CI: 0.29-0.98; P for trend = 0.09) after adjusting for potential confounders. The results were non-significant for other polyphenol types. CONCLUSION: The intake of flavonoids showed an inverse association with risk of cardiovascular events in a prospective cohort of Spanish middle-aged adult university graduates. REGISTRATION NUMBER FOR CLINICAL TRIALS: NCT02669602 in Clinical Trials.
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Doenças Cardiovasculares/prevenção & controle , Dieta , Polifenóis/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Inquéritos sobre Dietas , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polifenóis/classificação , Estudos Prospectivos , Fatores de Proteção , Fatores de Risco , Espanha/epidemiologia , Estudantes , Fatores de Tempo , Universidades , Adulto JovemRESUMO
The increasing industrial utilization of tellurium has resulted in an important environmental pollution with the soluble, extremely toxic oxyanion tellurite. In this context, the use of microorganisms for detoxifying tellurite or tellurium biorecovery has gained great interest. The ability of different Shewanella strains to reduce tellurite to elemental tellurium was assessed; the results showed that the reduction process is dependent on electron transport and the ∆pH gradient. While S. baltica OS155 showed the highest tellurite resistance, S. putrefaciens was the most efficient in reducing tellurite. Moreover, pH-dependent tellurite transformation was associated with tellurium precipitation as tellurium dioxide. In summary, this work highlights the high tellurite reduction/detoxification ability exhibited by a number of Shewanella species, which could represent the starting point to develop friendly methods for the recovery of elemental tellurium (or tellurium dioxide).
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Biodegradação Ambiental , Inativação Metabólica/fisiologia , Shewanella/metabolismo , Telúrio/metabolismo , Transporte de Elétrons , OxirreduçãoRESUMO
Objetivo: Identificar conocimientos y experiencias de estudiantes de Licenciatura en Enfermería, sobre la muerte de pacientes hospitalizados. Métodos: Estudio transversal, descriptivo, exploratorio, en el que participaron 188 alumnos de 500, pertenecientes a 4°, 6° y 8° semestre (quienes tienen experiencia clínica). Se consideraron tanto hombres como mujeres, sin distinción de edad o experiencia previa ante la muerte. Se diseñó un instrumento ex profeso para el levantamiento de datos, el cual fue validado por expertos mediante técnica Delphi. El proyecto fue avalado por un Comité de Investigación y Bioética. Los resultados se procesaron en SPSS v. 17. Resultados: El 85% de los alumnos ha experimentado un proceso de muerte de un familiar o amigo, y el 75% de un paciente (en la práctica hospitalaria). El 46% no se consideran preparados para vivir esta experiencia. El 37.7% considera que el personal de las instituciones no está preparado para "manejar" la muerte de los pacientes. Hay opiniones divididas sobre el temor hacia este fenómeno. Los alumnos comprenden qué es la tanatología y qué es el duelo, aunque no se sienten competentes en el tema. Conclusiones: Es importante sensibilizar al futuro profesional de enfermería en competencias que permitan dar un trato digno al paciente, esto fundamentado en sólidos conocimientos en tanatología.
Objective: To identify knowledge and experiences of baccalaureate nursing students about death of hospitalized patients. Methods: Basic, descriptive, and exploratory study on 188 students of 4th, 6th, and 8th semester with clinical practices. Both men and women, regardless of age and previous experience with death, were considered. A Delphi technique expert validated specific instrument was designed. The project was approved by the Research and Bioethics Committee. Results were processed in SPSS v. 17. Results: The 85% of students have experienced the death of a relative or a friend, and 75% of a patient (at the hospital practice), while 46% do not consider themselves prepared to live this experience, and 37.7% consider that the institution staff are not prepared to "handle" the death of patients. There are divided opinions about the fear to this process. Although students understand tanatology and duel, they do not feel competent in the topic. Conclusions: It is important to sensitize the future nursing professional in skills which allow them offer the corresponding appropriate patient treatment.
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Humanos , Masculino , Feminino , AdultoRESUMO
OBJECTIVE: To determine the prevalence of metabolic syndrome (MS) and its risk factors in patients with Acute Ischemic Coronary Syndrome (AICS) in a tertiary hospital. METHODS: A total of 65 patients admitted to Cardiac Intensive Care Unit with myocardial infarction or unstable angina participated. MS was diagnosed in accordance to the Adult Treatment Panel III (ATPIII) criteria. RESULTS: The total prevalence of MS was 84.6% (95% CI: 75.6 to 93.6). MS was more frequent in women, persons with obesity according to the body mass index (BMI), family background diabetes, and dyslipidemia. Phenotype predictors of MS were: BMI (OR=2.12, 95% CI: 1.24, 3.17) and familiar history of dyslipidemia (OR=0.026, 95% CI: 0.003, 0.587). CONCLUSIONS: The prevalence of MS with AICS is higher than that reported in other populations. This fact is alarming if this risk is maintained in the Mexican population.
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Síndrome Coronariana Aguda/etiologia , Hospitalização , Síndrome Metabólica/complicações , Síndrome Metabólica/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , México , Pessoa de Meia-Idade , PrevalênciaRESUMO
The generalized analytical quadrature filter from a set of interferograms with arbitrary phase shifts is obtained. Both symmetrical and non symmetrical algorithms for any order are reported. The analytic expression is obtained through the convolution of a set of two-frame algorithms and expressed in terms of the combinatorial theory. Finally, the solution is applied to obtain several generalized tunable quadrature filters.
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Peripartum cardiomyopathy (PPCM) is a condition that affects women during the reproductive years in the late pregnancy period and/or early postpartum period. Although it is associated with several risk factors and various hypotheses exist of its etiology the cause of this disorder is still unknown. Standard therapy for PPCM is the same as for heart failure. Studies examining new therapeutic approaches are adding to the armamentarium available to physicians treating patients with PPCM. Despite all the current knowledge the mortality rates associated with PPCM remain relatively high. This article is a review of the current knowledge of etiology, diagnosis, treatment and prognosis of PPCM and attempts to present areas of need of further research.
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Humanos , Feminino , Cardiomiopatias/etiologia , Complicações Cardiovasculares na Gravidez/etiologia , Período Pós-Parto , Fármacos Cardiovasculares/uso terapêutico , Cardiomiopatias/diagnóstico , Cardiomiopatias/tratamento farmacológico , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Gravidez , Fatores de RiscoRESUMO
Estudio prospectivo, longitudinal y descriptivo. Introducción: La asistencia de los recién nacidos de muy bajo peso (RNMBP) en las unidades de cuidado intensivo neonatal (UCIN) es condición indispensable para su sobrevida, sin embargo crea situaciones desfavorables para su desarrollo neurológico y afectivo, dado la exposición a diversos estímulos durante internaciones prolongadas y a la precoz separación de su grupo familiar. Por tal motivo es necesario implementar programas de intervención temprana que estimulen y protejan al RN y su familia. Objetivos: demostrar la factibilidad del Programa Contacto Piel a Piel (Copap) Madre/Hijo Prematuro en RNMBPN. Identificar factores facilitadores y de interferencia en el equipo de salud de las UCIN en implementar el programa. Evaluar el grado de satisfacción de los padres por el mismo e incluir fundamentos y normativa de esta intervención en el programa docente de la residencia médica y de enfermería. Material y métodos: Se aplicó una encuesta autoadministrada, individual y anónima, sobre el conocimiento existente, detección de factores facilitadores y de interferencia para la implementación de Copap a 56 integrantes del equipo de salud, 28 enfermeras y 26 médicos residentes que se desempeñan en UCIN. En el caso de enfermería, se incluyó al personal de distintos turnos y en el grupo de médicos, a los residentes de pediatría y a los residentes de especialidad post básica en neonatología. Para evaluar la opinión de los padres por el programa, previo al alta, se realizaron 4 grupos focales con 27 madres de RNMBPN, internados en UCIN que habían participado de la experiencia. Resultados: El 100 por ciento de los padres de RNMBPN invitados, aceptó participar de la experiencia. El 96 por ciento de los encuestados dice conocer la intervención considerándola beneficiosa. 52 por ciento refiere tenes dificultades para su implementación. Las interferencias se relacionaron con el trabajo diario de la unidad, con el recién nacido y...(AU)
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Humanos , Masculino , Feminino , Relações Mãe-Filho , Recém-Nascido Prematuro/fisiologia , Recém-Nascido Prematuro/psicologia , Cuidado do Lactente , Terapia Intensiva Neonatal/métodos , Terapia Intensiva Neonatal , Recém-Nascido de muito Baixo Peso , Estudos Prospectivos , Estudos Longitudinais , Epidemiologia DescritivaRESUMO
Estudio prospectivo, longitudinal y descriptivo. Introducción: La asistencia de los recién nacidos de muy bajo peso (RNMBP) en las unidades de cuidado intensivo neonatal (UCIN) es condición indispensable para su sobrevida, sin embargo crea situaciones desfavorables para su desarrollo neurológico y afectivo, dado la exposición a diversos estímulos durante internaciones prolongadas y a la precoz separación de su grupo familiar. Por tal motivo es necesario implementar programas de intervención temprana que estimulen y protejan al RN y su familia. Objetivos: demostrar la factibilidad del Programa Contacto Piel a Piel (Copap) Madre/Hijo Prematuro en RNMBPN. Identificar factores facilitadores y de interferencia en el equipo de salud de las UCIN en implementar el programa. Evaluar el grado de satisfacción de los padres por el mismo e incluir fundamentos y normativa de esta intervención en el programa docente de la residencia médica y de enfermería. Material y métodos: Se aplicó una encuesta autoadministrada, individual y anónima, sobre el conocimiento existente, detección de factores facilitadores y de interferencia para la implementación de Copap a 56 integrantes del equipo de salud, 28 enfermeras y 26 médicos residentes que se desempeñan en UCIN. En el caso de enfermería, se incluyó al personal de distintos turnos y en el grupo de médicos, a los residentes de pediatría y a los residentes de especialidad post básica en neonatología. Para evaluar la opinión de los padres por el programa, previo al alta, se realizaron 4 grupos focales con 27 madres de RNMBPN, internados en UCIN que habían participado de la experiencia. Resultados: El 100 por ciento de los padres de RNMBPN invitados, aceptó participar de la experiencia. El 96 por ciento de los encuestados dice conocer la intervención considerándola beneficiosa. 52 por ciento refiere tenes dificultades para su implementación. Las interferencias se relacionaron con el trabajo diario de la unidad, con el recién nacido y...(AU)
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Humanos , Masculino , Feminino , Relações Mãe-Filho , Recém-Nascido Prematuro/fisiologia , Recém-Nascido Prematuro/psicologia , Cuidado do Lactente , Terapia Intensiva Neonatal/métodos , Terapia Intensiva Neonatal , Recém-Nascido de muito Baixo Peso , Estudos Prospectivos , Estudos Longitudinais , Epidemiologia DescritivaRESUMO
Estudio prospectivo, longitudinal y descriptivo. Introducción: La asistencia de los recién nacidos de muy bajo peso (RNMBP) en las unidades de cuidado intensivo neonatal (UCIN) es condición indispensable para su sobrevida, sin embargo crea situaciones desfavorables para su desarrollo neurológico y afectivo, dado la exposición a diversos estímulos durante internaciones prolongadas y a la precoz separación de su grupo familiar. Por tal motivo es necesario implementar programas de intervención temprana que estimulen y protejan al RN y su familia. Objetivos: demostrar la factibilidad del Programa Contacto Piel a Piel (Copap) Madre/Hijo Prematuro en RNMBPN. Identificar factores facilitadores y de interferencia en el equipo de salud de las UCIN en implementar el programa. Evaluar el grado de satisfacción de los padres por el mismo e incluir fundamentos y normativa de esta intervención en el programa docente de la residencia médica y de enfermería. Material y métodos: Se aplicó una encuesta autoadministrada, individual y anónima, sobre el conocimiento existente, detección de factores facilitadores y de interferencia para la implementación de Copap a 56 integrantes del equipo de salud, 28 enfermeras y 26 médicos residentes que se desempeñan en UCIN. En el caso de enfermería, se incluyó al personal de distintos turnos y en el grupo de médicos, a los residentes de pediatría y a los residentes de especialidad post básica en neonatología. Para evaluar la opinión de los padres por el programa, previo al alta, se realizaron 4 grupos focales con 27 madres de RNMBPN, internados en UCIN que habían participado de la experiencia. Resultados: El 100 por ciento de los padres de RNMBPN invitados, aceptó participar de la experiencia. El 96 por ciento de los encuestados dice conocer la intervención considerándola beneficiosa. 52 por ciento refiere tenes dificultades para su implementación. Las interferencias se relacionaron con el trabajo diario de la unidad, con el recién nacido y...
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Humanos , Masculino , Feminino , Terapia Intensiva Neonatal/métodos , Terapia Intensiva Neonatal , Cuidado do Lactente , Relações Mãe-Filho , Recém-Nascido Prematuro/fisiologia , Recém-Nascido Prematuro/psicologia , Epidemiologia Descritiva , Recém-Nascido de muito Baixo Peso , Estudos Longitudinais , Estudos ProspectivosRESUMO
INTRODUCTION AND AIMS: Health-related quality of life (HRQL) is currently essential in the evaluation of stroke-related clinical trials. Existing stroke-specific scales were developed in English-speaking countries and most of them do not satisfy the necessary standards of validity. In consequence, the first Spanish-language scale for evaluating the quality of life (QL) of stroke survivors was developed (ECVI-38). In this work the psychometric properties of this summary measure were assessed. PATIENTS AND METHODS: A group of 63 stroke patients were studied, between 2 months and 2 years after the event, to evaluate the acceptability, reliability and validity of the ECVI-38, using standardised psychometric methods. RESULTS: The ECVI-38 proved to have an important degree of acceptability; only three elements showed a high percentage of data loss due to the age of the patients in the sample; the floor and ceiling effects were within the accepted limits. The scale displayed good internal consistency (Cronbach's alpha 0.79-0.97, correlations between elements 0.53-0.90) and good stability in the test-retest trial (intraclass correlation coefficients 0.89-0.98). As regards its construct validity (total correlations among correct domains, convergent r = 0.57-0.90, discriminating r = 0.19-0.39), the results were very good, as were the findings of the studies of validity vs. external criteria (difference between groups with a known neurological status, and convergence validity). CONCLUSIONS: The ECVI-38 is a measure that is acceptable, reliable and valid for evaluating QL in patients who have had a stroke. Further tests are needed to evaluate its sensitivity and to explore its value in both clinical and research practice.
Assuntos
Qualidade de Vida , Acidente Vascular Cerebral , Inquéritos e Questionários , Atividades Cotidianas , Adulto , Idoso , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Avaliação de Resultados em Cuidados de Saúde , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Estatística como Assunto , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , SobreviventesRESUMO
The aims of this study were to describe a female obese population according to their food intake and physical activity, and to compare two methods to estimate physical activity (PA). The study included a nutritional interview where a detailed dietary history was done, an initial clinical day in which measurements of body composition and basal metabolic rate (BMR) were carried out and an estimation of PA by means of a triaxial accelerometer and a PA questionnaire. The group of volunteers showed a mean BMI of 37.15 kg/m2, a waist/hip ratio of 0.82 and a mean body fat mass of 43.34%. The average of BMR was 1720 Kcal/d and the CRNP of 0.79. The total caloric intake was 3344 Kcal/d with a energy-distribution of 43.1% Carbohydrates, 16.4% Proteins, 40.3% Lipids. Weight and BMI showed a positive correlation (p < 0.05) with the sedentary index (SI). Also, weight presented a positive correlation with the heart rate (p < 0.05). The estimates of PA derived from the questionnaire showed a positive correlation with the triaxial accelerometer (p < 0.01); and this one, revealed a negative correlation with the SI (p < 0.01). Anthropometric, metabolic and food intake variables are comparable to the results found in obese women from similar socioeconomic background. The estimates of PA according to the questionnaire were significantly correlated to the results of the triaxial accelerometer, thus confirming the validity of the questionnaire to assess PA in an obese population.
Assuntos
Metabolismo Basal/fisiologia , Composição Corporal , Ingestão de Energia , Atividade Motora/fisiologia , Obesidade/metabolismo , Inquéritos e Questionários/normas , Aceleração , Adulto , Calorimetria Indireta , Exercício Físico , Feminino , Humanos , Atividades de Lazer , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Espanha , EsportesRESUMO
INTRODUCTION: The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments. AIMS: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors. SUBJECTS AND METHODS: We followed a methodology that had previously been standardised by other authors based on using the opinion given by patients and caregivers in the generation of the items to be included. This has several stages that include individual interviews with patients, caregivers and experts, focal groups with patients and experts, quantitative and qualitative analyses of these interviews, two panels of experts to actually draw up the instrument, and a pilot test carried out in a sample of 50 patients to reduce and group the items. This reducing and grouping process was performed taking into account the following: 1. The percentage of responses left unanswered; 2. A factorial analysis of the main components; 3. Cronbach's alpha coefficient. RESULTS: We interviewed 20 patients and 12 experts; these results were later used to classify the above mentioned aspects in order of priority according to the frequency with which they appeared in the surveys. Then, we elaborated the questionnaire with four areas or subscales by including the questions or items in these categories: I. Physical status (17 items); II. Emotional status (13 items); III. Activities of daily living (13 items); IV. Social and familial functions (13 items). After the pilot study 38 items were reorganised into eight domains, according to the factorial analysis: 1. Physical problems; 2. Communication; 3. Cognition; 4. Emotions; 5. Feelings; 6. Activities of daily living; 7. Familial functions; 8. Social functions. They displayed high coefficients of internal consistency. CONCLUSIONS: We developed a new scale for evaluating the quality of life for stroke patients and it is now ready to undergo its validation process.
Assuntos
Qualidade de Vida , Acidente Vascular Cerebral , Inquéritos e Questionários , Atividades Cotidianas , Pessoas com Deficiência , Humanos , Reprodutibilidade dos Testes , Perfil de Impacto da Doença , Acidente Vascular Cerebral/patologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , SobreviventesRESUMO
INTRODUCTION: The prevention of mental retardation due to congenital hypothyroidism by treating it at an early stage is one of the great achievements of contemporary preventive medicine. Nevertheless, the children suffering from this disease are affected by selective cognitive deficits whose origin remains a controversial issue. PATIENTS AND METHODS: We describe the results from a cohort of 100 children who have been diagnosed as suffering from congenital hypothyroidism in La Havana since 1989 and whose cognitive performance has since been periodically evaluated. The mean age at each evaluation was as follows: 1.1 years (mean and typical deviation: 0.3) and 8.2 years (mean and typical deviation: 1.2). RESULTS: During the first two years of life the developmental quotients are within the normal range of values, although fine oculomotor coordination is significantly diminished. The duration of fetal hypothyroidism is linked to postural control, and the initial biochemical severity of the disease is associated to language development. Oculomotor coordination is not linked to any variable concerning the severity of the disease or with the effectiveness of therapy. At school age, intelligence quotients (IQ) are also within the normal range of values. A multiple regression analysis indicated that the total IQ can be predicted from the scores in oculomotor coordination during the first two years of life and from the initial doses of levothyroxine. CONCLUSIONS: The relations between the variables capable of forecasting intellectual development in these children are analysed and we also discuss the hypothesis which suggests that some of the persisting neurocognitive deficits are probably due to genetic influences that exist regardless of the effectiveness of the therapy.