RESUMO
Introducción: El síndrome de Ogilvie es una patología rara que se puede encontrar en pacientes que han sido sometidos a cirugías extensas dando un cuadro clínico de obstrucción intestinal, llegando a ser letal de no ser diagnosticada a tiempo. Existen varios tratamientos tanto farmacológicos, endoscópicos y quirúrgicos para descomprimir el colon. Caso clínico: Se presenta el caso de un paciente de 35 años intervenido quirúrgicamente de un meningioma que sufre de un cuadro de obstrucción intestinal posterior a la intervención catalogándose como un Síndrome de Ogilvie.
Introduction: Ogilvie syndrome is a rare condition that can be found in patients who have undergone extensive surgery giving a clinical picture of intestinal obstruction, becoming lethal if not diagnosed in time. There are several pharmacological, endoscopic and surgical treatments to decompress the colon. Clinical case: We present the case of a 35 year-old patient surgically operated on a meningioma suffering from a picture of intestinal obstruction following the intervention, being classified as an Ogilvie Syndrome. The case is presented by the low incidence of the same.
Assuntos
Humanos , Cirurgia Geral , Pseudo-Obstrução do Colo , Meningioma , Dor Abdominal , Colo , Medidas de Resultados Relatados pelo PacienteRESUMO
INTRODUCTION: The application of the Lean methodology in health institutions is an effective tool to improve the capacity and workflow, as well as to increase the level of satisfaction of patients and employees. OBJECTIVE: To optimise the time of outpatient care in a clinical laboratory, by implementing a methodology based on the organisation of operational procedures to improve user satisfaction and reduce the number of complaints for delays in care. MATERIAL AND METHODS: A quasi-experimental before and after study was conducted between October 2011 to September 2012. XBar and S charts were used to observe the mean service times and standard deviation. The user satisfaction was assessed using service questionnaires. RESULTS: A reduction of 17 minutes was observed in the time of patient care from arrival to leaving the laboratory, and a decrease of 60% in complaints of delay in care. Despite the high staff turnover and 38% increase in the number of patients seen, a culture of empowerment and continuous improvement was acquired, as well as greater efficiency and productivity in the care process, which was reflected by maintaining standards 12 months after implementation. CONCLUSION: Lean is a viable methodology for clinical laboratory procedures, improving their efficiency and effectiveness.
Assuntos
Serviços de Laboratório Clínico , Laboratórios/organização & administração , Satisfação do Paciente , Gestão da Qualidade Total , Assistência Ambulatorial , Colômbia , Eficiência , Eficiência Organizacional , Humanos , Laboratórios/normas , Melhoria de Qualidade , Design de Software , Fatores de TempoRESUMO
En el mundo existen más de 500 millones de personas con una u otra forma de discapacidad[1]; la Organización Mundial de la Salud (OMS) sostiene que la proporción oscila entre el 10% y el 12%, del total de la población; la Organización Internacional del Trabajo (OIT) señala que de estos, 400 millones se encuentran en países en desarrollo. El Departamento Administrativo Nacional de Estadísticas (DANE) reconoce que de cada cien colombianos, seis presentan algún tipo de discapacidad permanente y que se presenta una tendencia creciente, de esta situación como consecuencia del conflicto armado. El uso de minas antipersona se constituye en una de las situaciones que además de un gran número de víctimas, genera una amplia gama de problemática social, que evidencia la necesidad de plantear estrategias para el abordaje de una situación de salud que afecta un amplio grupo poblacional, en el que los militares y sus familias son los más afectados, en respuesta a esta situación se plantea la investigación que da origen a este articulo y responde al interrogante asociado a la identificación de necesidades de cuidado de enfermería, vivenciadas por los soldados amputados por minas antipersona durante el proceso de rehabilitación. Se reconoció que en el grupo de necesidades que cobran mayor relevancia son las asociadas a la vinculación de la familia y las redes de apoyo a los procesos de rehabilitación y las que se relacionan con la importancia de incentivar la reconstrucción del proyecto de vida del soldado, que posterior a la amputación manifiesta temores, expectativas e incertidumbre frente al desempeño de los roles previos y a la necesidad de reconstruir o redimensionar, en el marco del proceso de rehabilitación, una nueva forma de relación con el entorno.
Assuntos
Amputados , Cuidados de Enfermagem , Ajuda a Veteranos de Guerra com Deficiência , Enfermagem Primária , Avaliação da Deficiência , Reabilitação , ColômbiaRESUMO
The tackiness of aqueous chitosan film coatings and effects of anti-sticking agents on sticking tendency, were evaluated. A novel rapid method exploiting minimum fluidization velocity to determine tackiness was introduced and tested. The pressure difference over the miniaturized fluidized-bed was precisely recorded as a function of velocity of fluidization air. High molecular weight chitosan plasticized with glycerol was used as a film-forming agent. Magnesium stearate, titanium dioxide, colloidal silicon dioxide and glyceryl-1-monostearate (GMS) were studied as anti-sticking agents. Film coatings were performed in a miniaturized top-spray coater. The incorporation of anti-sticking agents led to a clear decrease in tackiness of the chitosan films, and magnesium stearate and GMS were shown the most effective. Film-coated pellets containing magnesium stearate and GMS as an anti-sticking agent were very easily fluidized (showing very low values of minimum fluidization velocity) and were thus classified as the best flowing and the least sticking samples. Both these additives were found anti-sticking agents of choice for aqueous chitosan film coatings. Determination of the experimental minimum fluidization velocity in a fluidized bed, is a useful and sensitive method of measuring the tackiness tendency of film-coated pellets.
Assuntos
Adesividade , Química Farmacêutica/métodos , Quitosana/química , Preparações de Ação Retardada , Celulose/análogos & derivados , Celulose/química , Cristalização/métodos , Avaliação Pré-Clínica de Medicamentos/métodos , Glicerídeos/química , Glicerol/química , Dióxido de Silício/química , Ácidos Esteáricos/química , Titânio/químicaRESUMO
Reportamos el caso de un paciente con cirrosis hepática de etiología viral con HbsAg y Anti VHC positivos, que se diagnostica por ecografía y por TC de un carcinoma hepatocelular (CHC) y la punción aspirativa con aguja fina (PAAF) reporta: material hemorrágico con escasas células epiteliales y con cambios degenerativos. El paciente fue sometido a tratamiento médico mediante inyecciones intratumorales de etanol (HE). Dado que el CHC acostumbra asentar sobre una cirrosis, sus manifestaciones clínicas son en gran parte superponibles a las de esta enfermedad y en el momento del diagnóstico dependerán tanto del grado de reserva funcional de la cirrosis hepática de base como del estadío evolutivo del tumor. En este sentido debe remarcarse que más del 50 por ciento de los nódulos menores de 3cm de diámetro detectados mediante ecografía en pacientes cirróticos corresponden a un CHC. No obstante sólo se establece el diagnóstico por PAAF en el 75 por ciento de los casos y en estos casos debe basar la presunción diagnóstica en la coincidencia de dos técnicas por imagen.
Assuntos
Humanos , Masculino , Idoso , Carcinoma Hepatocelular/terapia , Cirrose HepáticaRESUMO
Reportamos una paciente con diagnóstico de neoplasia gástrica, cuyas características morfológicas son: lesión polipoidea, triloculada, irregular, ulcerada, localizada a nivel de fornix y región sub-cardial; dicha lesión fue biopsiada por 3 ocasiones, siendo la Anatomía Patológica negativa para células neoplásticas. Los tumores del cardias y del estómago proximal representan alrededor del 10xciento de todas las neoplasias en las series más antiguas pero en fecha más reciente se observó una mayor incidencia de cáncer gástrico proximal. No se sabe con certeza si este incremento refleja un verdadero aumento de la incidencia de las neoplasias en esa ubicación o una disminución de la incidencia del cáncer gástrico distal...
Assuntos
Humanos , Gastroscopia , Pólipos , Neoplasias Gástricas/diagnósticoRESUMO
In the early gastrula of Bufo arenarum the prospective mesoderm was previously identified as a marginal belt of grey cells. To analyze their differentiation capacity explants of these cells were cultured within ectodermal vesicles, in isolation and in combination with vegetal components. When cultured in isolation, dorsal and ventral fragments from the deep marginal zone behaved differently. Whilst ventral explants produced blood cells, dorsal explants failed to differentiate, remaining as masses of yolk-laden cells. On the other hand, both cultures were drastically modified when associated with superficial cells from the blastoporal zone, which caused the following effects: a) Promotion of differentiation in dorsal marginal explants, able now to produce notochordal and somitic structures, in addition to mesenchymatic cells. b) Promotion of dorsalization in ventral marginal explants, which changed their expected destiny developing axial components, similar to those furnished by "activated" dorso marginal explants. On the contrary, combined cultures of animal and vegetal pieces were unable to generate mesodermal structures. These studies suggest that the axial mesoderm, identified as the "organizer", develops from a marginal substrate of genuine mesodermal cells through a dorsalizing inductive stimulus originated in superficial periblastoporal cells.
Assuntos
Bufo arenarum/embriologia , Diferenciação Celular , Indução Embrionária , Mesoderma/fisiologia , Animais , Ectoderma/fisiologia , Gástrula/fisiologia , Gástrula/ultraestrutura , Mesoderma/ultraestrutura , Técnicas de Cultura de ÓrgãosRESUMO
In the early gastrula of Bufo arenarum the prospective mesoderm was previously identified as a marginal belt of grey cells. To analyze their differentiation capacity explants of these cells were cultured within ectodermal vesicles, in isolation and in combination with vegetal components. When cultured in isolation, dorsal and ventral fragments from the deep marginal zone behaved differently. Whilst ventral explants produced blood cells, dorsal explants failed to differentiate, remaining as masses of yolk-laden cells. On the other hand, both cultures were drastically modified when associated with superficial cells from the blastoporal zone, which caused the following effects: a) Promotion of differentiation in dorsal marginal explants, able now to produce notochordal and somitic structures, in addition to mesenchymatic cells. b) Promotion of dorsalization in ventral marginal explants, which changed their expected destiny developing axial components, similar to those furnished by [quot ]activated[quot ] dorso marginal explants. On the contrary, combined cultures of animal and vegetal pieces were unable to generate mesodermal structures. These studies suggest that the axial mesoderm, identified as the [quot ]organizer[quot ], develops from a marginal substrate of genuine mesodermal cells through a dorsalizing inductive stimulus originated in superficial periblastoporal cells.