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1.
Rev. Nac. (Itauguá) ; 16(3): 120-133, sep-dec 2024.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1572563

RESUMO

RESUMEN Introducción: el cáncer cervical representa un grave problema de salud pública a pesar de ser altamente prevenible. Objetivo: determinar las características clínicas y epidemiológicas de la participación de las mujeres del área de influencia de un Hospital Público en la prevención del cáncer de cuello uterino entre los meses de enero a diciembre de los años 2020 al 2021. Metodología: diseño no experimental de corte transversal tipo descriptivo, con enfoque cuantitativo. Se incluyó el total de mujeres participantes de la prevención de cáncer cervical en el área de influencia del Hospital Público. Se utilizaron datos secundarios que fueron cargados en una planilla elaborada previamente. Resultados: el 61 % de las mujeres estaban en edad de riesgo, 83 % no estaban embarazadas y 17 % si, 53 % tiene antecedente de PAP y 47 %, no, 86 % tuvo resultado negativo para lesión, 9 % inflamatorio y 4 % positivo. Entre los resultados positivos el preponderante fue el de ASCUS con un 47 %. Se concluye que la mayoría de las mujeres tuvieron un resultado de PAP negativo. Entre las mujeres con resultados positivos se tuvo preponderancia de diagnósticos de ASCUS y en segundo lugar CIN I LSIL. Conclusión: las características que se encontraron significativamente asociadas al resultado de PAP fueron: formar parte del grupo de edad de riesgo y presencia de embarazo. Se sugiere seguir haciendo hincapié en la prevención y seguimiento, indagar en las edades de riesgo e incluir otras variables de interés en futuros estudios.


ABSTRACT Introduction: cervical cancer represents a serious public health problem despite being highly preventable. Objective: to determine the clinical and epidemiological characteristics of the participation of women in the area of influence of a Public Hospital in the prevention of cervical cancer between the months of January to December of the years 2020 to 2021. Methodology: non-experimental cross-sectional descriptive design, with a quantitative approach. The total number of women participating in the prevention of cervical cancer in the area of influence of the Public Hospital was included. Secondary data were used that were loaded into a previously prepared form. Results: 61 % of the women were of 13 years old at risk, 83 % were not pregnant and 17 % were pregnant, 53 % had a history of PAP and 47 % did not, 86 % had a negative result for lesion, 9 % inflammatory and 4 % positive. Among the positive results, the predominant one was ASCUS with 47 %. The majority women had a negative PAP result. As a conclusion among women with positive results, there was a predominance of ASCUS diagnoses and in second place CIN I LSIL. Conclusion: the features that were found to be significantly associated with the PAP result were: being part of the age group at risk and presence of pregnancy. It is suggested to continue emphasizing prevention and follow-up, to investigate the ages at risk and to include other variables of interest in future studies.

2.
PLoS One ; 19(4): e0299954, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38635514

RESUMO

For migratory birds, events happening during any period of their annual cycle can have strong carry-over effects on the subsequent periods. The strength of carry-over effects between non-breeding and breeding grounds can be shaped by the degree of migratory connectivity: whether or not individuals that breed together also migrate and/or spend the non-breeding season together. We assessed the annual cycle of the White-crested Elaenia (Elaenia albiceps chilensis), the longest-distance migrant flycatcher within South America, which breeds in Patagonia and spends the non-breeding season as far north as Amazonia. Using light-level geolocators, we tracked the annual movements of elaenias breeding on southern Patagonia and compared it with movements of elaenias breeding in northern Patagonia (1,365 km north) using Movebank Repository data. We found that elaenias breeding in southern Patagonia successively used two separate non-breeding regions while in their Brazilian non-breeding grounds, as already found for elaenias breeding in the northern Patagonia site. Elaenias breeding in both northern and southern Patagonia also showed high spread in their non-breeding grounds, high non-breeding overlap among individuals from both breeding sites, and similar migration phenology, all of which suggests weak migratory connectivity for this species. Elucidating the annual cycle of this species, with particular emphasis on females and juveniles, still requires further research across a wide expanse of South America. This information will be critical to understanding and possibly predicting this species' response to climate change and rapid land-use changes.


Assuntos
Passeriformes , Aves Canoras , Humanos , Animais , Feminino , Migração Animal/fisiologia , Brasil , Cruzamento , Estações do Ano
3.
Aesthetic Plast Surg ; 47(5): 1896-1904, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36542093

RESUMO

OBJECTIVES: To describe characteristics of women with aesthetically ideal buttocks and differentiate them from women with normal buttocks. METHODS: Case-control study comparing anatomy of women with ideal buttocks (buttocks models) to women with normal buttocks using magnetic resonance images, anthropometric measurements and photography. RESULTS: Comparing to normal women, buttocks models have a narrower waist, narrower iliac crest, wider C point, wider hips and bigger and thicker gluteus maximus muscle (GMM). A bigger GMM adds more projection to the C point, point of maximum projection in the lateral view is 2.7 cm higher than the pubic bone. The amount of subcutaneous fat was equal in models and controls. CONCLUSIONS: Our study provides new knowledge regarding the tridimensional aspects of the beauty of the buttocks area. A beautiful buttock is a conjunction of adequate bony shape, muscle development, subcutaneous fat layer, and tight skin. Comparing to normal women, buttocks models have a narrower waist, narrower iliac crest, wider C point, wider hips and bigger and thicker Gluteus Maximus Muscle. Accurate understanding of the aesthetic goals in a given patient can guide surgical technique. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Imageamento por Ressonância Magnética , Humanos , Feminino , Nádegas/diagnóstico por imagem , Nádegas/cirurgia , Estudos de Casos e Controles , Antropometria , Estética
4.
Rev. cir. (Impr.) ; 73(2): 158-165, abr. 2021.
Artigo em Espanhol | LILACS | ID: biblio-1388809

RESUMO

Resumen Introducción: La incorporación de tecnologías en la práctica quirúrgica, ha cambiado la forma de enfrentar el proceso quirúrgico. Objetivo: Describir la experiencia de los últimos 9 años, en cirugía ortognática, con la incorporación de la cefalometría 3D. Materiales y Método: Se realizó una revisión retrospectiva de pacientes operados de cirugía ortognática durante el período enero de 2011 a agosto de 2018. Se registraron datos demográficos, quirúrgicos, tipo de planificación quirúrgica, complicaciones y resultados a largo plazo. Resultados: 21 pacientes requirieron cirugías ortognáticas. Se realizaron 16 cirugías bimaxilares (76%), 3 cirugías de avance maxilar superior (14%) y 2 cirugías de osteotomía sagital de rama (10%). Las principales etiologías fueron: 67% maloclusión clase III (n = 14), 28% maloclusión clase II (n = 6) y 5% desviación mandibular (n = 1). La planificación prequirúrgica virtual fue utilizada en 11 pacientes (52%). La tasa de complicaciones Clavien-Dindo > III fue 4,8% (n = 1). Conclusiones: En nuestra experiencia, las técnicas de cirugía ortognática son seguras. Las complicaciones de la serie fueron escasas y bien toleradas por los pacientes. Durante los últimos años y, de acuerdo a los avances tecnológicos, la incorporación de la planificación quirúrgica virtual 3D favoreció el desarrollo de la cirugía ortognática en nuestro centro.


Introduction: Technological advances have been incorporated into cranio-maxillo-facial surgery changing the clinical practice of surgeons. Aim: The aim of this article is to describe our experience in orthognatic surgery in the last 9-years, with the incorporation of 3D cephalometry. Materials and Method: A retrospective chart review was performed from January 2011 to August 2018 on patients undergoing Orthognatic Surgery. Demographic and surgical data, type of surgical planning, complications and long-term results were recorded. Results: A total of 21 patients underwent orthognatic surgery. Average age was 28 years (DE 8.1), 11 men (52.3%) and 10 women (47.61%). The principal surgeries performed were: 16 (76%) bimaxillary, 3 maxillary advancement surgery 3 (14%) and bilateral sagital split osteotomy 2 (10%). Ethiologies were: 14 patients (this 67%) with malocclusion class III, 6 patients (28%) with malocussion class II, and 1 patient (5%) with mandibular deviation. Virtual 3D presurgical planning was used in 11 patients (52%). The total of complications Clavien-Dindo > III was 4.8% (n = 1). None patient required reoperation. Satisfaction rate with the procedure was high. Conclusions: Based on our experience, orthognatic surgery techniques are safe. The complication rate was lower and well tolerated by patients. The introduction of virtual planning provided a better scenario to develop maxillo-facial surgery.


Assuntos
Humanos , Imageamento Tridimensional/métodos , Cirurgia Ortognática/métodos , Cirurgia Ortognática/tendências , Resultado do Tratamento , Imageamento Tridimensional/tendências , Procedimentos Cirúrgicos Ortognáticos/métodos , Mandíbula/cirurgia
5.
Facial Plast Surg Aesthet Med ; 23(4): 278-282, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32898440

RESUMO

Purpose: The purpose of this study is to evaluate surgical outcomes of facial fractures after the introduction of intraoperative radiology. Methods: An historic cohort of patients without intraoperative fluoroscopy (IOF) was compared with a prospective cohort of patients with IOF. Main outcomes were postoperative complications and reoperation rate. Results: There were 51 in the non-IOF group and 49 in the IOF group. In the group with IOF 10 patients required intraoperative revisions (20.46%). Overall postoperative complication rate was higher in the non-IOF group (25.49% vs. 6.12%) due to the significantly higher bone-related complication rate (15.69% vs. 2.04%). Reoperation rate was also higher in the non-IOF group (11.76% vs. 0%). Conclusion: This study demonstrates that IOF reduces bone-related complication and reoperation rate by allowing correction of surgical errors immediately during surgery.


Assuntos
Traumatismos Faciais/cirurgia , Fluoroscopia , Fixação de Fratura , Cuidados Intraoperatórios/métodos , Complicações Pós-Operatórias/prevenção & controle , Reoperação/estatística & dados numéricos , Fraturas Cranianas/cirurgia , Adulto , Idoso , Traumatismos Faciais/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Erros Médicos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Fraturas Cranianas/diagnóstico por imagem , Resultado do Tratamento
6.
Rev Chilena Infectol ; 37(2): 175-178, 2020 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-32730485

RESUMO

Acute compartment syndrome (ACS) is the increase of pressure in a closed osteofascial space. This reduces capillary perfusion below the level necessary for tissue viability. Injury could be irreversible if proper treatment is not performed. Hand ACS secondary to cutaneous loxoscelism with edematous predominance is extremely infrequent. We present a clinical case of a 22-year-old patient who started a hand compartment syndrome secondary to cutaneous loxoscelism (CL), requiring emergency surgical treatment with dorsal and palmar fasciotomy.


Assuntos
Síndromes Compartimentais , Edema , Fasciotomia , Mãos , Humanos , Adulto Jovem
9.
Rev. chil. infectol ; Rev. chil. infectol;37(2): 175-178, abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1126105

RESUMO

Resumen El síndrome compartimental agudo (SCA) es el aumento de la presión en un espacio osteofascial cerrado. Esto reduce la presión capilar bajo el nivel necesario para la viabilidad de los tejidos del compartimento. El SCA de mano como complicación de un loxoscelismo cutáneo (LC) de predominio edematoso es muy poco frecuente. Presentamos el caso de una mujer de 22 años que presentó un SCA de la mano secundario a un LC y que requirió tratamiento quirúrgico de urgencia mediante una fasciotomía dorsal y palmar.


Abstract Acute compartment syndrome (ACS) is the increase of pressure in a closed osteofascial space. This reduces capillary perfusion below the level necessary for tissue viability. Injury could be irreversible if proper treatment is not performed. Hand ACS secondary to cutaneous loxoscelism with edematous predominance is extremely infrequent. We present a clinical case of a 22-year-old patient who started a hand compartment syndrome secondary to cutaneous loxoscelism (CL), requiring emergency surgical treatment with dorsal and palmar fasciotomy.


Assuntos
Humanos , Adulto Jovem , Síndromes Compartimentais , Edema , Fasciotomia , Mãos
10.
Aesthet Surg J ; 40(7): 721-731, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-31761953

RESUMO

BACKGROUND: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emergent disease that threatens patients with texturized breast implants. Major concerns about the safety of these implants are leading to global changes to restrict the utilization of this product. The principal alternative is to perform breast augmentation utilizing smooth implants, given the lack of association with BIA-ALCL. The implications and costs of this intervention are unknown. OBJECTIVES: The authors of this study determined the cost-effectiveness of smooth implants compared with texturized implants for breast augmentation surgery. METHODS: A tree decision model was utilized to analyze the cost-effectiveness. Model input parameters were derived from published sources. The capsular contracture (CC) rate was calculated from a meta-analysis. Effectiveness measures were life years, avoided BIA-ALCL, avoided deaths, and avoided reoperations. A sensitivity analysis was performed to test the robustness of the model. RESULTS: For avoided BIA-ALCL, the incremental cost was $18,562,003 for smooth implants over texturized implants. The incremental cost-effectiveness ratio was negative for life years, and avoided death and avoided reoperations were negative. The sensitivity analysis revealed that to avoid 1 case of BIA-ALCL, the utilization of smooth implants would be cost-effective for a risk of developing BIA-ALCL equal to or greater than 1:196, and there is a probability of CC with smooth implants equal to or less than 0.096. CONCLUSIONS: The utilization of smooth implants to prevent BIA-ALCL is not cost-effective. Banning texturized implants to prevent BIA-ALCL may involve additional consequences, which should be considered in light of higher CC rates and more reoperations associated with smooth implants than with texturized implants.


Assuntos
Implante Mamário , Implantes de Mama , Neoplasias da Mama , Linfoma Anaplásico de Células Grandes , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/cirurgia , Análise Custo-Benefício , Humanos , Linfoma Anaplásico de Células Grandes/etiologia , Linfoma Anaplásico de Células Grandes/prevenção & controle , Mastectomia
11.
Aesthetic Plast Surg ; 44(2): 411-418, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31432229

RESUMO

BACKGROUND: High-definition liposculpture is a novel surgical technique widely accepted among plastic surgeons. The aim of this article is to describe surgical outcomes with a special emphasis on complications in high-definition liposculpture patients. METHODS: An historical cohort of patients who underwent high-definition liposculpture from two senior surgeons was reviewed. Technique, patient selection criteria, preoperative marks and surgical outcomes are described. Postoperative complications are discussed. RESULTS: A total of 417 patients underwent high-definition liposculpture between 2015 and 2018. Primary liposuction and secondary liposuction were performed in 308 (74%) and 109 (26%), respectively. Combined surgeries were performed in 121 cases (29%). There were no systemic complications. Local complications included hyperpigmentation (n = 276), seroma (n = 125), nodular fibrosis (n = 83), unsatisfactory definition in superficial liposuction areas (n = 16), unnatural appearance of body contour (n = 17), VASER-related burns (n = 3) and Mondor's syndrome (n = 2). Most patients (94%) were satisfied with the results. CONCLUSION: High-definition liposculpture is a body contouring technique that has shown excellent results. Despite non-serious complications were frequent, most complications were local and safely treated without affecting surgical outcome. To know these complications will help to recognize them earlier and to adjust patient expectation about the postoperative period. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.


Assuntos
Contorno Corporal , Lipectomia , Contorno Corporal/efeitos adversos , Estética , Humanos , Lipectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento
12.
Aesthetic Plast Surg ; 43(4): 899-904, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31087117

RESUMO

Chest wall shape is an important aspect to consider when planning a breast augmentation. Minor chest wall deformities are usually underestimated by the patient and surgeon and may compromise postoperative outcomes. Lower costal cartilage dysmorphia or winged rib is one of these minor underestimated chest wall deformities characterized by a visible and palpable cartilaginous prominence under the inframammary fold and causes discomfort in patients decreasing the satisfaction with the breast augmentation surgery. For these patients, the author utilized an innovative surgical technique that allows resection of the protruding cartilages and placement of breast implants through the same surgical incision. Six patients with winged ribs underwent breast augmentation and costal cartilage resection via this method and there were no intraoperative or early postoperative complications, and all patients were satisfied with the aesthetical result after 6 months of follow-up. The presented surgical technique has a short learning curve with excellent postoperative results. Cases are presented to demonstrate the improved postoperative chest wall contour combined with breast augmentation outcome.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Implante Mamário/métodos , Mamoplastia/métodos , Costelas/anormalidades , Costelas/cirurgia , Adulto , Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Estudos de Coortes , Estética , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Estudos Retrospectivos , Caixa Torácica/anormalidades , Caixa Torácica/cirurgia , Fatores de Tempo , Resultado do Tratamento
13.
Artigo em Espanhol | LILACS | ID: biblio-1122257

RESUMO

La motivación es un elemento de gran importancia para obtener mayor rendimiento en las actividades que realiza el personal de enfermería; el presente estudio tuvo como objetivo identificar el nivel de motivación laboral extrínseca de los profesionales de enfermería de las unidades de cuidados intensivos de los hospitales públicos de Corrientes Capital 2018. Materiales y métodos: estudio cuantitativo, descriptivo de corte transversal, observacional y prospectivo constituido por una muestra de 50 profesionales, donde fueron seleccionados diez enfermeros de cada institución que cumplieron con los criterios de selección; el muestreo fue probabilístico utilizando la técnica por conglomerados y aleatorio simple. Se aplicó un cuestionario tipo Likert que comprende 20 ítems y las variables estudiadas fueron edad, sexo, remuneración, decisiones laborales, progreso laboral, condiciones físicas, equipamiento, seguridad laboral, relaciones grupales y comunicación. Resultados: El 4% de la población estudiada presentó nivel bajo de motivación laboral, mientras que en el nivel medio se obtuvo el 52% y finalmente el nivel alto el 44%. Con respecto al sexo, el femenino fue el mas frecuente con el 62% y el masculino 38%. Discusión: en su mayoría, se encontraron semejanzas con la presente investigación en los siguientes aspectos edad, sexo y nivel de motivación con los datos obtenidos en diversos estudios realizados en la región latinoamericana sobre motivación laboral. Conclusiones: la motivación laboral es una herramienta sumamente importante que puede afectar de manera positiva y negativamente en el correcto desempeño de los profesionales de enfermería en dichos servicios


Summary: Motivation is an element of great importance to obtain greater performance in the activities carried out by the nursing staff; the objective of this study was to identify the level of extrinsic job motivation of nursing professionals in the intensive care units of the public hospitals of Corrientes Capital 2018. Materials and methods: quantitative, descriptive, cross-sectional, observational and prospective study consisting of a sample of 50 professionals, where ten nurses from each institution who met the selection criteria were selected; sampling was probabilistic using the conglomerate technique and simple randomization. A Likert questionnaire was applied, comprising 20 items and the variables studied were age, sex, remuneration, labor decisions, work progress, physical conditions, equipment, job security, group relations and communication. Results: 4% of the studied population had a low level of work motivation, while in the middle level 52% was obtained and finally the high level 44%. With respect to sex, the female was the most frequent with 62% and the masculine 38%. Discussion: in its majority, similarities with the present investigation were found in the following aspects: age, sex and level of motivation with the data obtained in several studies carried out in the Latin American region on work motivation. Conclusions: Work motivation is an extremely important tool that can positively and negatively affect the correct performance of nursing professionals in these services


Resumo: A motivação é um elemento de grande importância para obter maior desempenho nas atividades realizadas pela equipe de enfermagem; Este estudo teve por objetivo identificar o nível de motivação extrínseca trabalho dos enfermeiros em unidades de terapia intensiva de hospitais públicos em Corrientes Capital 2018. Materiais e Métodos: estudo quantitativo, descritivo, transversal, observacional e prospectivo, constituído por uma amostra de 50 profissionais, onde foram selecionados dez enfermeiros de cada instituição que atendiam aos critérios de seleção; A amostragem foi probabilística utilizando a técnica de conglomerado e randomização simples. Aplicou-se um questionário do tipo Likert, composto por 20 itens, e as variáveis estudadas foram idade, sexo, remuneração, decisões trabalhistas, andamento do trabalho, condições físicas, equipamentos, segurança no trabalho, relações grupais e comunicação. Resultados: 4% da população estudada apresentaram baixo nível de motivação no trabalho, enquanto no nível médio 52% foi obtido e, finalmente, o nível alto foi de 44%. Com relação ao sexo, a fêmea foi a mais frequente com 62% e a masculina com 38%. Discussão: em sua maioria, as semelhanças com a presente investigação foram encontradas nos seguintes aspectos: idade, sexo e nível de motivação com os dadoConclusões: A motivação para o trabalho é uma ferramenta extremamente importante que pode afetar positiva e negativamente o desempenho correto dos profissionais de enfermagem nesses serviçoss obtidos em diversos estudos realizados na região latino-americana sobre motivação no trabalho


Assuntos
Humanos , Masculino , Feminino , Hospitais Públicos , Unidades de Terapia Intensiva , Recursos Humanos de Enfermagem , Pesquisa/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Saúde Ocupacional , Motivação
14.
Rev Med Chil ; 146(5): 660-664, 2018 May.
Artigo em Espanhol | MEDLINE | ID: mdl-30148930

RESUMO

Garengeot's hernia corresponds to the presence of the appendix within a femoral hernia, associated or not with acute appendicitis. The diagnosis of this uncommon situation is usually done during surgery. Furthermore, the clinical presentation as necrotizing fasciitis is a rare condition. We report a 54 years old obese hypertensive woman with rheumatoid arthritis of 40 years of evolution treated with methotrexate and prednisone. She consulted for pain and erythema in the right inguinal region. Laboratory revealed leukocytosis and an elevated C-reactive Protein. Suspecting a cellulitis, the patient was admitted for antimicrobial therapy. A pelvic magnetic resonance imaging showed a perforated acute appendicitis in an inguinal hernia with extensive pelvic cellulitis associated with signs of fasciitis. At surgery, an extensive groin and pubic fasciitis was evident, with a necrotic and perforated appendix within a femoral hernia. Surgical debridement, open appendectomy, and femoral hernioplasty without mesh were carried out. Vacuum-assisted closure was installed in the coverage defect. Three surgical debridement procedures were required for the closure of the wound. Two weeks after the first surgical procedure, the patient was discharged in good condition. During the follow-up, she evolved with a surgical wound dehiscence, which was managed with wound dressings until closure.


Assuntos
Apendicite/diagnóstico , Fasciite Necrosante/diagnóstico , Hérnia Femoral/diagnóstico , Hérnia Inguinal/diagnóstico , Doença Aguda , Apendicectomia , Apendicite/complicações , Apendicite/cirurgia , Fasciite Necrosante/complicações , Fasciite Necrosante/cirurgia , Feminino , Hérnia Femoral/complicações , Hérnia Femoral/cirurgia , Hérnia Inguinal/complicações , Hérnia Inguinal/cirurgia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Obesidade/complicações
15.
Rev. méd. Chile ; 146(5): 660-664, mayo 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-961443

RESUMO

Garengeot's hernia corresponds to the presence of the appendix within a femoral hernia, associated or not with acute appendicitis. The diagnosis of this uncommon situation is usually done during surgery. Furthermore, the clinical presentation as necrotizing fasciitis is a rare condition. We report a 54 years old obese hypertensive woman with rheumatoid arthritis of 40 years of evolution treated with methotrexate and prednisone. She consulted for pain and erythema in the right inguinal region. Laboratory revealed leukocytosis and an elevated C-reactive Protein. Suspecting a cellulitis, the patient was admitted for antimicrobial therapy. A pelvic magnetic resonance imaging showed a perforated acute appendicitis in an inguinal hernia with extensive pelvic cellulitis associated with signs of fasciitis. At surgery, an extensive groin and pubic fasciitis was evident, with a necrotic and perforated appendix within a femoral hernia. Surgical debridement, open appendectomy, and femoral hernioplasty without mesh were carried out. Vacuum-assisted closure was installed in the coverage defect. Three surgical debridement procedures were required for the closure of the wound. Two weeks after the first surgical procedure, the patient was discharged in good condition. During the follow-up, she evolved with a surgical wound dehiscence, which was managed with wound dressings until closure.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Apendicite/diagnóstico , Fasciite Necrosante/diagnóstico , Hérnia Femoral/diagnóstico , Hérnia Inguinal/diagnóstico , Apendicectomia , Apendicite/cirurgia , Apendicite/complicações , Imageamento por Ressonância Magnética , Doença Aguda , Fasciite Necrosante/cirurgia , Fasciite Necrosante/complicações , Hérnia Femoral/cirurgia , Hérnia Femoral/complicações , Hérnia Inguinal/cirurgia , Hérnia Inguinal/complicações , Obesidade/complicações
16.
Rev. chil. cir ; 68(4): 289-294, jul. 2016. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: lil-788896

RESUMO

Objetivo Determinar los cambios en calidad de vida en mujeres sometidas a mamoplastia de aumento o mastopexia con prótesis, usando el instrumento validado Breast-Q®. Materiales y métodos Estudio de cohortes prospectivo. Se incluyeron todas las pacientes operadas de mamoplastia de aumento o mastopexia de aumento en el Hospital Clínico de la Universidad de Chile entre octubre de 2013 y mayo de 2014. La calidad de vida (CdV) se midió con el instrumento validado Breast-Q®. Se realizó estadística descriptiva y analítica para evaluar el cambio global en CdV y por dominios considerando estadísticamente significativo un valor p < 0,05. Resultados En el periodo estudiado se operaron 58 pacientes, 33 (56,9%) completaron el instrumento Breast-Q® en el preoperatorio y 25 (75,7%) de ellas en el postoperatorio. La CdV subió de un 49,7% a un 82,5% (p < 0,001); analizando por dominio hubo mejoría en autoestima (52% a 88%, p < 0,001), autoimagen (22% a 80%, p < 0,001) y vida sexual (31% a 86%, p < 0,001). Los síntomas físicos empeoraron desde un 94% a 75% (p < 0,001). Conclusiones El aumento mamario mejora la CdV, específicamente la autoestima, la autoimagen y la vida sexual, pero las molestias físicas aumentan. La satisfacción global fue alta.


Objective To determine the changes in the quality of life of women subjected to augmentation mammoplasty or a prosthesis mastopexy, using the validated tool Breast-Q®. Materials and methods A prospective cohorts study was conducted that included operated on for augmentation mammoplasty or augmentation mastopexy in the Hospital Clínico de la Universidad de Chile (HCUCH) between October 2013 and May 2014. The quality of life (QoL) was measured using the Breast-Q® validated tool. Descriptive and analytic statistics were performed to evaluate the overall change in QoL and by domains, considering a p<.05 as statistically significant. Results A total of 58 patients were operated on, of whom 33 (56.9%) completed the Breast-Q® questionnaire before surgery, and 25 (75.7%) of them in the post-operative period. The quality of life increased from 49.7% to 82.5% (p<.001). When analysed by domain, there was an improvement in Self-esteem (52% to 88%, p<.001), Self-image (22% to 80%, p<.001) and Sex Life (31% to 86%, p<.001). The physical symptoms increased from 75% to 94% (p<.001). Conclusions Breast augmentation improves the quality of life, in particular, self-esteem, self-image, and sex life, but physical discomforts increased. The overall satisfaction was high.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Qualidade de Vida , Implantes de Mama/psicologia , Implante Mamário/psicologia , Autoimagem , Atividades Cotidianas/psicologia , Estudos Prospectivos , Inquéritos e Questionários , Seguimentos , Satisfação do Paciente
17.
Aesthetic Plast Surg ; 40(1): 19-29, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26578194

RESUMO

OBJECTIVE: To develop a new patient-reported outcome instrument (PRO) to measure body-related satisfaction quality of life (QoL). METHODS: Standard 3-phase PRO design was followed; in the first phase, a qualitative design was used in 45 patients to develop a conceptual framework and to create preliminary scale domains and items. In phase 2, large-scale population testing on 1340 subjects was performed to reduce items and domains. In phase 3, final testing of the developed instrument on 34 patients was performed. Statistics used include Factor, RASCH, and multivariate regression analysis. Psychometric properties measured were internal reliability, item-rest, item-test, and test-retest correlations. RESULTS: The PRO-developed instrument is composed of four domains (satisfaction with the abdomen, sex life, self-esteem and social life, and physical symptoms) and 20 items in total. The score can range from 20 (worst) to 100 (best). Responsiveness was 100 %, internal reliability 93.3 %, and test-retest concordance 97.7 %. Body image-related QoL was superior in men than women (p < 0.001) and decreased with increasing age (p = 0.004) and BMI (p < 0.001). Post-bariatric body contouring patients score lower than cosmetic patients in all domains of the Body-QoL instrument (p < 0.001). After surgery, the score improves by on average 21.9 ± 16.9 (effect size 1.8, p < 0.001). CONCLUSIONS: Body satisfaction-related QoL can be measured reliably with the Body-QoL instrument. It can be used to quantify the improvement in cosmetic and post-bariatric patients including non- or minimally invasive procedures, suction assisted lipectomy, abdominoplasty, lipoabdominoplasty, and lower body lift and to give an evidence-based approach to standard practice. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.


Assuntos
Abdominoplastia , Lipectomia , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Qualidade de Vida , Adolescente , Adulto , Idoso , Beleza , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Vet Parasitol ; 175(1-2): 60-5, 2011 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-20965660

RESUMO

American mink (Neovison vison) is a widely distributed invasive species in southern Chile. Thirty four feral minks were trapped at two distinct sites (rural and peri-urban), diet analyzed and Toxoplasma gondii exposure compared using PCR and specific antibodies. Serum samples were evaluated using a commercial latex agglutination test where a titer ≥ 1:32 was considered positive. Of 30 mink analyzed, 21 (70%) were positive to T. gondii antibodies, with titers ranging from 1:32 to 1:2048. As expected, adult mink showed higher seroprevalence of exposure to T. gondii (18/21) than young mink (3/9) (P=0.008). There was not statistically significant difference between sex groups (P=0.687). Differences in seroprevalence were observed between the two sample sites with a higher proportion of positive individuals in the peri-urban area, and therefore, closer to human settlements (35.7% vs. 100%, P=0.0001). Individuals positive to T. gondii using PCR and/or serology showed similar differences by site with higher infected individuals in peri-urban areas (58.8% vs. 100%, P=0.007). Diet of American mink based in fecal composition analyses was mainly based on crustaceans (frequency of occurrence: crustaceans=100%, birds and rodents<7%), suggesting that the high observed prevalence of T. gondii infection might be more associated with its aquatic behavior (e.g. ingestion of oocysts in contaminated fresh water) than with their trophic behavior (e.g. preying over species that can have T. gondii cysts in their tissues). As an invasive species potentially subject to routine culling to maintain population sizes under control, minks could be used as a sentinel species to monitor pathogens of public and wildlife health importance, such as T. gondii, in aquatic environments.


Assuntos
Vison , Toxoplasmose Animal/parasitologia , Animais , Chile , Demografia , Fezes/parasitologia , Feminino , Espécies Introduzidas , Masculino , Estudos Soroepidemiológicos , Toxoplasmose Animal/epidemiologia
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