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Objective: To evaluate the time of ureteral ejection of intravenous sodium fluorescein in the assessment of ureteral patency in patients undergoing total laparoscopic hysterectomy (TLH). Material and Methods: Fifty-four women undergoing TLH were studied in a public teaching hospital in Culiacan, Sinaloa, Mexico. They underwent cystoscopic evaluation of ureteral patency after intravenous administration of 100 mg of sodium fluorescein. The present study analyzed the time elapsed in minutes from the intravenous administration of fluorescein to the outflow of stained urine by one or both ureteral meatus, the degree of urine staining, and the impact of body mass index (BMI) (BMI; normal, overweight, and obesity) on ejection time. Results: The overall average time elapsed to visualize the ejection of fluorescein through at least one ureteral meatus was 7.5 minutes [95% confidence interval (CI): 6.3-8.7]. There were no significant differences in the time of ureteral ejection of fluorescein taking BMI into account (p=0.579), with a mean time for normal BMI of 8.1 minutes (95% CI: 5.1-11.2), for overweight of 7.0 minutes (95% CI: 5.5-8.5), and for obesity of 7.8 minutes (95% CI: 5.3-10.3). Conclusion: Intravenously administered 10% sodium fluorescein dye is rapidly eliminated and strongly stains urine, which makes it useful for identifying ureteral patency during cystoscopy after TLH. Fluorescein excretion is not affected by patient BMI.
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BACKGROUND & AIMS: No universally accepted diagnostic criteria for malnutrition are available to date. The aim was to assess the concordance for the diagnosis of hospital malnutrition between the bioelectrical impedance vector analysis (BIVA) and the new definition of malnutrition proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS: A total of 140 adult hospitalized patients were included. The malnutrition risk was assessed by the Nutritional Risk Screening. The ESPEN malnutrition criteria (body mass index (BMI) <18.5 kg/m2, weight loss (WL) + low BMI, and WL + low fat free mass index (FFMI) were applied to each patient. The bioelectrical impedance of each patient was measured, and malnutrition was diagnosed using the BIVA method. Diagnostic concordance between the BIVA and the new ESPEN definition was assessed with the Kappa coefficient. RESULTS: The malnutrition prevalence was higher with the BIVA vs ESPEN definition (22.1% vs 13.6%) in the global population and was similar (12.8% vs 12.1%) in the population at risk of malnutrition. The diagnostic performance of the BIVA was acceptable, with higher sensitivity in patients with fluid overload (FO) and more specificity in euvolemic patients. Diagnostic concordance between the BIVA and the ESPEN definition was poor for the global population (kappa = 0.56) and the population at risk of malnutrition (kappa = 0.67) but was acceptable in patients with FO (kappa = 0.78). However, the discordant BIVA+/ESPEN- patients classified as false positives for BIVA showed clinical and body composition data (low FFMI, low phase angle) consistent with malnutrition. CONCLUSIONS: According to the clinical and bioelectrical characteristics of the discordant BIVA+/ESPEN- patients, the BIVA could perform better that the new ESPEN definition for the diagnosis of hospital malnutrition, which should be confirmed with other studies.
Assuntos
Hospitalização , Desnutrição/diagnóstico , Avaliação Nutricional , Terminologia como Assunto , Idoso , Impedância Elétrica , Feminino , Humanos , Masculino , México , Estado Nutricional , Valor Preditivo dos Testes , PrevalênciaRESUMO
BACKGROUND: Preeclampsia is one of the most frequent and serious complication of pregnancy characterized by systemic perfusion reduction generated by vasospasm and activation of coagulation systems. OBJECTIVE: To evaluate the association between preeclampsia sociodemographics and obstetrics antecedents. MATERIAL AND METHOD: An unmatched case-control study was carried out in which all the clinical registries of patients with preeclampsia (cases: n = 196) assisted in the period 2003-2007 in the Hospital Civil of Culiacan, Sinaloa State of Mexico were analyzed. As controls the clinical registries of patients assisted during the same period were selected at random but that they didn't show up preeclampsia (n = 470). The association of preeclampsia with socioeconomic level, tobacco use, alcohol use, gynecologic and obstetric antecedents (sexual partners, pregnancies, deliveries and abortions number, prenatal control, contraceptive method) and previous pregnancy with preeclampsia were analyzed. RESULTS: There were not association between tobacco use (OR: 3.05; 95% CI: 0.81-11.48), beginning of sexual activity (p = 0.1509), number of sexual partners (OR: 1.23; 95% CI: 0.83-1.83; p = 0.3009) and sexual cohabitation less than 12 months (OR: 0.90; 95% CI: 0.63-1.27). The alcoholism (OR: 5.77; 95% CI: 1.48-22.53), socioeconomic level (p < 0.05), pregnancy previous with preeclampsia (RM:14.81; 95% CI: 1.77-123.85; p = 0.0006) were associated with preeclampsia. There were differences in the use of the contraceptive method between groups (p < 0.005). CONCLUSIONS: Preeclampsia was significantly associated with the alcoholism, low socioeconomic level and pregnancy previous with preeclampsia.