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Introducción: el 1 de enero de 1899 inició la ocupación militar de Cuba por Estados Unidos, cuyo objetivo fundamental fue sentar las bases de la futura República neocolonial. Objetivo: describir el comportamiento de la salud pública matancera durante el período de ocupación militar norteamericana 1899-1902. Materiales y métodos: se utilizó el método histórico descriptivo para estudiar el comportamiento de la salud pública matancera en el período de ocupación militar, y se realizó la revisión bibliográfica y documental. Resultados: no obstante los logros sociales -en especial en el ámbito de la salud pública-, las medidas y posiciones antinacionales que adoptó el gobierno interventor encontraron el rechazo de las clases y sectores interesados en lograr la absoluta soberanía de Cuba. Conclusiones: los matanceros realizaron notables esfuerzos para enfrentar la difícil situación sanitaria a través de la apertura de hospitales e instituciones, que brindaban servicios, sobre todo, a los sectores pobres de la población, y de la campaña de higienización para evitar la propagación de enfermedades y epidemias.
Introduction: the period of U.S. military occupation in Cuba officially began on January 1, 1899. Its main objective was to lay the foundation of the future neocolonial republic. Objective: to describe the behavior of Matanzas public health during the period of the US military occupation 1899-1902. Materials and methods: the historical descriptive method was used to study the behavior of Matanzas public health in the period of military occupation, and a bibliographic and documental review was conducted. Results: despite the social achievements- especially in the field of public health-, antinational measures and positions adopted by the intervening government found the rejection of the classes and sectors interested in achieving the absolute sovereignty of Cuba. Conclusions: the people of Matanzas made notable efforts to face the difficult sanitary situation opening hospitals and institutions which provided services, above all, to the poor sectors of the population, and to carry out a sanitation campaign to prevent the spread of diseases and epidemics.
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OBJECTIVE: To evaluate at-home opioid and benzodiazepine use, the degrees of pain and anxiety, and the incidence of probable withdrawal in post-discharge Trauma Intensive Care Unit (TICU) survivors. METHODS: This was an exploratory study of post-TICU survivors who had participated in a previous study of opioid and benzodiazepine withdrawal. We surveyed survivors by telephone asking for retrospective information (during their first 4-months postdischarge- Time 1) and current information (around 2-years post-discharge- Time 2). RESULTS: A mostly male (82%), young (median 38 years [IQR, 28-52]) sample of 27 TICU survivors reported using opioids (56%) at Time 1 for a median of 30 (IQR,14-90) days. Twelve percent of 26 survivors were still using opioids at Time 2. Sixty percent of the survivors had pain during Time 1, a median pain score of 6 (IQR, 5-8) on a 0-10 numeric rating scale (NRS).; 57% had pain at Time 2, median NRS score=6 (IQR, 4-7). Sixty-five percent of survivors had anxiety during Time 1, NRS median=7 (IQR, 5-9); 50% had anxiety at Time 2, NRS median= 6 (IQR, 3-7). At Time 1, 26% used prescribed benzodiazepines, and 12% used benzodiazepines at Time 2. Five and one of the 27 patients reported symptoms of opioid or benzodiazepine withdrawal, respectively, upon discontinuation or weaning. CONCLUSION: Many TICU survivors had discontinued opioid/benzodiazepine prescriptions by 4-months post discharge while half reporting pain/anxiety for up to 2-years. Investigating the effects of acute-to-chronic pain in ICU survivors and gaining a better understanding of the mechanisms of prolonged opioid use are warranted.
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Analgésicos Opioides , Benzodiazepinas , Assistência ao Convalescente , Ansiedade , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Dor , Alta do Paciente , Estudos Retrospectivos , SobreviventesRESUMO
Introducción: En muchas investigaciones científicas de las Ciencias Sociales, es usual la aplicación del método de consulta a expertos con el fin de validar escalas, enfoques, proyecciones, políticas y otros temas para la adopción de decisiones fundamentadas, aunque se constata su empleo parcial, indiscriminado e incorrecto. Objetivo: Fundamentar la necesidad de aplicar el método de consulta a expertos en tres niveles para determinar: la competencia de los expertos; la fiabilidad del instrumento empleado y el consenso entre los expertos sobre el tema abordado. Material y Métodos: Se realizó una sistematización de documentos relacionados con el empleo del método de consulta de expertos en la investigación científica, tesis de doctorado y maestría, artículos, monografías y otras publicaciones. Se aplicaron pruebas estadísticas no paramétricas. Resultados: Se constata que la aplicación del método de consulta a expertos siguiendo los procedimientos adecuados, permite elevar el rigor metodológico y su contribución en la investigación científica. Conclusiones: El método de consulta a expertos constituye una herramienta eficaz en la investigación científica siempre que se aplique con el rigor requerido(AU)
Introduction: The method for expert consultation is commonly applied to scientific research conducted in the Social Sciences to validate scales, approaches, planning, politics, and other matters in decision making; however, its incorrect, indiscriminate, and partial use is confirmed. Objective: To validate the need to apply the method for expert consultation at three levels in order to determine: the competence of experts; the reliability of the instrument used; and the consensus among experts on the topic approached. Material and Methods: Systematization of documents related to the use of the method for expert consultation in scientific research, master´s and doctoral theses, articles, monographs, and other publications. Non-parametric statistical tests were applied. Results: It is confirmed that the application of the method for expert consultation following the appropriate procedures allows for an increase in the methodological rigor and a contribution to scientific research. Conclusions: The method for expert consultation is an effective tool in scientific research provided that it is rigorously applied(AU)
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HumanosRESUMO
Trauma ICU patients may require high and/or prolonged doses of opioids and/or benzodiazepines as part of their treatment. These medications may contribute to drug physical dependence, a response manifested by withdrawal syndrome. We aimed to identify risk factors, symptoms, and clinical variables associated with probable withdrawal syndrome. DESIGN: Prospective exploratory observational study. SETTING: Trauma ICU in large medical center in Puerto Rico. PARTICIPANTS: Fifty patients who received opioids and/or benzodiazepines for greater than or equal to 5 days. MEASUREMENTS AND MAIN RESULTS: Using an opioid/benzodiazepine withdrawal syndrome checklist developed from research in adult ICU patients, the Diagnostic and Statistical Manual of Mental Disorders-5, and the International Classification of Diseases, 10th Edition, we evaluated patients at baseline and for 72 hours after drug weaning was initiated. Patients received opioid/benzodiazepine (88%), opioid (10%), or benzodiazepine (2%). Probable withdrawal syndrome occurred in 44%, questionable withdrawal syndrome in 20%, and no withdrawal syndrome in 18 (36%). Signs that were more frequent in the probable withdrawal syndrome group were agitation, diarrhea, fever, tachypnea, lacrimation, and hyperactive delirium. Patients who developed probable withdrawal syndrome spent almost double the amount of time receiving mechanical ventilation, and length of stay was higher in both ICU and hospital when compared with patients in the other two groups. Age, cumulative opioid dose amounts, and previous drug (opioid/benzodiazepine, cannabis, cocaine, or heroin) use were associated with odds of developing withdrawal syndrome. With the addition of Richmond Agitation-Sedation Scale and delirium to the multilevel analysis, older age no longer had its protective effect, whereas increase in Richmond Agitation-Sedation Scale scores, delirium presence, and increased duration of mechanical ventilation were associated with higher odds of withdrawal syndrome. CONCLUSIONS: We identified probable withdrawal syndrome in a sample of trauma ICU patients through observation of several associated symptoms. Significant factors associated with withdrawal syndrome found in this study should be considered when caring for patients being weaned from opioids and/or benzodiazepines. Further validation of the opioid/benzodiazepine withdrawal syndrome checklist is recommended.
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OBJECTIVE: Our study described the occurrence, assessment, prevention, and management practices of pain, agitation, and delirium (PAD) in four intensive care units (ICUs) from the Puerto Rico Medical Center and compared findings with the 2013 PAD guidelines. METHODS: A descriptive study, with repeated bedside measures (two times a day/two times a week) of PAD and review of patient clinical records. RESULTS: Eighty ICU patients (20 per ICU) were evaluated, (median 3 times [IQR, 2-7]). At least once during the assessment period, 57% percent of patients had significant pain and 34% had delirium. Moreover, 46% were deeply sedated, 17.5% had agitation, and 52.5% of patients were within the recommended Richmond Agitation-Sedation Scale (RASS) scores. The Numeric Rating Scale and RASS were the most common tools used by clinicians to evaluate pain and agitation/sedation levels, respectively. Clinicians did not assess pain in patients unable to self-report with any guideline-recommended tools, as was the case for delirium. Fentanyl and morphine were the most commonly used analgesics, while benzodiazepines were used for sedation. CONCLUSION: Although pain, agitation, and delirium occurrence were similar to other studies, patients continue to suffer. A gap exists between clinical practices in these ICUs and current guidelines. Strategies that contribute to integrating guidelines into these ICUs should be developed, studied, and implemented.
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Delírio/epidemiologia , Unidades de Terapia Intensiva , Dor/epidemiologia , Agitação Psicomotora/epidemiologia , Adulto , Idoso , Cuidados Críticos/métodos , Cuidados Críticos/normas , Delírio/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/prevenção & controle , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Agitação Psicomotora/prevenção & controleRESUMO
Metallic nanorods are promising agents for a wide range of biomedical applications. We report an optical hyperthermia method capable of inducing slowdown tumor progression of an experimental in vivo CT-2A glioblastoma tumor. The tumor model used in this research is based on the transplantation of mouse astrocytoma CT-2A cells in the striatum of mice by intracranial stereotaxic surgery. Two weeks after cell implant, the resulting tumor is treated by irradiating intratumoral injected gold nanorods, biofunctionalized with CD133 antibody (B-GNRs), using a continuous wave laser. Nanoparticles convert the absorbed light into localized heat (reaching up to 44 °C) due to the effect of surface plasmon resonance. A significant slowdown in CT-2A tumor progression is evident, by histology and magnetic resonance imaging, at one (p = 0.03) and two weeks (p = 0.008) after irradiation treatment. A notable deceleration in tumor size (15%-75%) as compared to the control untreated groups, it is observed. Thus, laser irradiation of B-GNRs is found to be effective for the treatment of CT-2A tumor progression. Similarities between the pre-clinical CT-2A tumor model and the human astrocytoma disease, in terms of anatomy, metastatic behavior and histopathology, suggest that hyperthermic treatment by laser irradiation of B-GNRs administered into high-grade human astrocytoma might constitute a promising alternative treatment to limit the progression of this deadly disease.
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Astrocitoma/terapia , Neoplasias Encefálicas/terapia , Ouro/farmacologia , Hipertermia Induzida/métodos , Terapia a Laser/métodos , Nanotubos/química , Antígeno AC133/antagonistas & inibidores , Antígeno AC133/imunologia , Animais , Anticorpos Neutralizantes/farmacologia , Astrocitoma/imunologia , Astrocitoma/patologia , Neoplasias Encefálicas/imunologia , Neoplasias Encefálicas/patologia , Linhagem Celular Tumoral , Modelos Animais de Doenças , Progressão da Doença , Ouro/administração & dosagem , Ouro/química , Humanos , Injeções Intralesionais , Lasers , Camundongos , Camundongos Endogâmicos C57BL , Nanotubos/ultraestrutura , Transplante de Neoplasias , Técnicas Estereotáxicas , Ressonância de Plasmônio de Superfície , Carga Tumoral/efeitos da radiaçãoRESUMO
Como características demográficas esenciales, el decrecimiento de la fecundidad y la mortalidad, junto al aumento de la esperanza de vida y las migraciones a expensas de las poblaciones más jóvenes, traen como consecuencia el crecimiento de la población mayor de 60 años. En Cuba, si bien contar con una esperanza de vida al nacer de 78,45 años, una clara muestra de los logros alcanzados por el Sistema Nacional de Salud, y el incremento sostenido de su población anciana, expone al país como un escenario complejo, toda vez que los recursos son limitados. Al cierre de 2017, los datos referidos en el Anuario Estadístico de Salud) indicaban que una quinta parte (20,1 por ciento) de la población cubana tenía o sobrepasaba los 60 años de edad, mientras que se contaba solamente con la existencia de 150 hogares de ancianos y 287 Casas de Abuelos para todo el país, lo cual obviamente no es suficiente para la demanda que pudiera existir.....
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Humanos , Idoso , Idoso de 80 Anos ou mais , Nível de Saúde , Cuidadores/psicologia , Indicadores de Produção CientíficaRESUMO
Introducción: La ventilación mecánica es un proceder para la sustitución de la ventilación, que salva la vida de pacientes con insuficiencia respiratoria aguda, al mismo tiempo es una de las primeras causas de complicaciones y de mortalidad. Objetivo: Identificar las características clínico-epidemiológicas en pacientes fallecidos con ventilación mecánica, ingresados en la UCI del hospital Joaquín Albarrán Domínguez en el trienio 2013-2015. Material y Métodos: Se realizó un estudio descriptivo, transversal, con las historias clínicas de dichos pacientes, recopilando la información en una matriz de datos y posteriormente fue analizada con el software SPSS 21.0, a través de frecuencias absolutas y relativas y con la utilización de la prueba de chi2 para las correlaciones bi-variadas, tomando como valor de significación estadística p< 0,05. Resultados: De los 166 pacientes, el 49,4 por ciento superaba los 70 años. La EPOC fue el motivo de ventilación más frecuente. Las mayores complicaciones de la ventilación fueron: fallo multiorgánico 25,3 por ciento, fallo al destete 21,6 por ciento, y distrés respiratorio 20,4 por ciento. Conclusiones: El fallo multiorgánico, las bronconeumonías bacterianas bilaterales y la neumonía asociada a la ventilación mecánica, fueron las principales complicaciones y causas de muerte más frecuentes en los pacientes ventilados(AU)
Introduction: Mechanical ventilation is a procedure used for the replacement of ventilation, which saves the life of patients with acute respiratory failure; but at the same time, it is one of the first causes of complications and mortality. Objective: To identify the clinical and epidemiological characteristics of patients who died while receiving mechanical ventilation, admitted to the Intensive Care Unit (ICU) of the Joaquín Albarrán Dominguez Clinical Surgical Hospital during the triennium 2013-2015. Material and methods: A descriptive, cross-sectional study was carried out with the clinical histories of these patients. The information was collected in a data matrix that was subsequently analyzed with the SPSS 21.0 software, on the basis of absolute and relative frequencies and the use of the chi2 test for the bi-varied correlations; the statistical significance value was p <0.05. Results: Of the 166 patients selected for the study, the 49.4 percent were over 70 years of age. COPD was the most frequent reason for ventilation. The main complications of ventilation were: multiple organ failure (25.3 percent), weaning failure (21.6 percent), and respiratory distress (20.4 percent). Conclusions: Multiple organ failure, bilateral bacterial bronchopneumonia, and pneumonia associated with mechanical ventilation were the most frequent complications and causes of death in ventilated patients(AU)
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Humanos , Masculino , Feminino , Respiração Artificial/mortalidade , Cuidados Críticos , Epidemiologia Descritiva , Estudos TransversaisRESUMO
Introducción: El envejecimiento es parte integrante y natural de la vida, y aunque todos aspiran a ser miembros de este proceso, alrededor del mismo se tejen representaciones diversas, en tanto diferentes sean los perceptores. Objetivo: Comprender los significados que le atribuye un grupo de ancianos al envejecimiento. Material y Métodos: Investigación cualitativa realizada a través de seis grupos focales, con personas de 60 años y más, de ambos sexos, residentes en el área del Policlínico Ana Betancourt del municipio Playa. Resultados: Los participantes hicieron notar que el envejecer no es necesariamente sinónimo de padecer. Desde sus perspectivas, el envejecimiento les brinda la posibilidad de repasar sus vidas día a día, y junto a ello disfrutar de sus familiares, de su tiempo libre; y aun de que se hagan presentes algunas enfermedades, el control de estas les puede hacer sentir bien. Conclusiones: Si bien los testimonios de los participantes (ancianos y ancianas) podrían mostrarse divergentes en los significados que ellos le atribuyen al envejecimiento, tal variación se argumenta en el hecho de que envejecer es un proceso complejo que difiere de persona a persona, y se encuentra influenciado por todos los factores que giran alrededor de su cotidianeidad; encontrándose como más relevantes lo económico y lo afectivo(AU)
Introduction: Aging is a natural and integral part of life, and although all persons aim to be members of this process, different representations merge into it, whether the preceptors are different. Objective: To understand the meaning that a group of elderly people give to the process of aging. Material and methods: Qualitative research conducted in six focus groups, in people aged 60 years or older, from both sexes, and residents in the area of Ana Betancourt Polyclinic in Playa Municipality. Results: The participants expressed that aging is not necessarily considered to be a synonym of suffering. From their perspectives, aging gives them the possibility to reorganize their lives daily, and beside this, to enjoy their family, their free time, and although suffering from some diseases which can be controlled, to feel well. Conclusions: Even though the testimonies of the participants (elderly women and men) could be different in the meaning that they give to aging, such change is argued on the fact that aging is a complex process that differs from person to person, and is also influenced by all the factors that exist in their daily lives, being the economic and the affective ones the most relevant(AU)
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Humanos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento Saudável/psicologia , Saúde do Idoso , Epidemiologia Descritiva , Grupos Focais/métodos , Pesquisa QualitativaRESUMO
Introducción: diversos han sido los estudios pedagógicos en diferentes especialidades, disciplinas y esferas del conocimiento para determinar las necesidades de aprendizaje. La capacitación del personal de la salud en temas económicos constituye un reclamo permanente de sus directivos y trabajadores en diferentes escenarios. Objetivo: determinar las necesidades de aprendizaje y el impacto educativo del módulo de Preparación Económica en los Directivos de la provincia La Habana, quienes cursan el Diplomado de Dirección en Salud. Material y Métodos: se aplicó una encuesta -al inicio y al final del módulo- a los 43 diplomantes que asistieron a este. La información se analizó con el software SPSS, utilizando la estadística descriptiva, y el Test de McNemar para evaluar el impacto del módulo. Resultados: el promedio de la edad fue de 45,0±5,4 años, y trabajando en el sector fue de 20,1±6,9 años. En el cargo de dirección promediaban en 2,7±2,1 años. Fueron estadísticamente significativas las diferencias en las respuestas (antes y después) sobre la eficiencia económica (16,3 vs. 81,4), y su aplicación en la Atención Primaria (46,5 vs. 81,4). Las respuestas sobre el control interno fueron altas en ambos momentos. Conclusiones: se constatan (al inicio) carencias cognoscitivas en relación con los temas económicos. Luego de impartido el módulo, la mayoría de los cursistas elevaron sus conocimientos sobre estos temas. Lo relacionado al Control Interno, fue bien respondido tanto al inicio como al final, lo que pudo estar determinado por el uso que de este se viene realizando desde hace tiempo en el sector.
Introduction: various pedagogic studies in different specialties, disciplines and branch of knowledge have determined learning needs. The training of the health´s professional in economic themes constitutes a permanent need for them, at different scenarios. Objective: to determine the learning needs and the educational impact of the module about economic themes, in the Havana's professionals of health, who take a course in the Directing Graduate in Health. Material and Methods: a surveys was applied, to the start and at the end of the module, to 43 students that assisted the first day. Data were analyzed by SPSS software, and were used descriptive statistics, and McNemar's test to evaluate the impact of module. Results: mean of age was 45,0±5,4 years old, working at the sector was 20,1±6,9 years old, and as executives of health sector were 2,7±2,1 years old. It was statistically significant the answers (before and after) on the economic efficiency (16,3 vs. 81,4 ), and his application in the first attention level of health (46,5 vs. 81,4). The answers on the internal control were high in both moments. Conclusions: knowledge lacks in relation to the economic themes was verified at the beginning. After the economy module was given, the majority of the students raised their knowledge on these themes. The answers about aspects of internal control were good in both moments (before and after).
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Introducción: el envejecimiento poblacional es un logro de la humanidad, pero las consecuencias que provoca a la sociedad lo hacen tributario de grandes y complejas decisiones. Objetivo: mostrar evidencias sobre la necesidad de aplicar la intersectorialidad para mejorar el bienestar del adulto mayor. Métodos: investigación documental mediante la recopilación de resultados de investigaciones realizadas sobre necesidades de atención en salud al adulto mayor. Resultados: la fragilidad en el adulto mayor aumenta con la edad y compromete su desempeño en la vida cotidiana, esto se vincula con un deterioro físico, mental y situación socioeconómica. Estos hechos traen como consecuencia falta de autonomía en lo económico, afectivo y físico, que hace que los ancianos requieran ayuda para el acceso a los medicamentos, disponibilidad de alimentos, lavado de ropa, asistencia social a domicilio, recreación, entre otros. La intersectorialidad es una de las herramientas del trabajo social y comunitario en salud, que aunque muy conocida, es poco utilizada por directivos y prestadores de servicios de salud. En Cuba, las exigencias que impone el envejecimiento poblacional requiere identificar las necesidades que hay, así como las potencialidades existentes que pudieran ayudar a satisfacerlas mediante alianzas entre diferentes sectores, donde la intersectorialidad constituye una vía esencial para mejorar la calidad de vida del anciano. Conclusiones: las tendencias demográficas muestran que Cuba se encuentra ante una situación inédita que impactará de forma considerable el sector de la salud, lo que impone plantear estrategias como la intersectorialidad, que permitan enfrentar este fenómeno en ascenso
Introduction: The population aging is an achievement of the Cuban populations, but the consequences for the society turns it into the subject of big complex decisions. Objective: To present evidence supporting the needs for intersectoriality, in order to improve the older adult wellbeing. Methods: Documentary research study based on the collection of results from research works on the health care requirements of the elderly. Results: The frailty of the older adult increases with the age and hinders her/his daily life performance. This situation is linked to physical, mental deterioration and to economic difficulties. These events bring about lack of autonomy in the economic, affectionate and physical aspects of life and make the older people require assistance to access medications, available food, laundry service, social assistance at home, recreational activities, among other things. Intersectoriality is one of the tools of the social and community work in health. It is widely known but poorly used by the health managers and service providers. The demands imposed by the population aging in Cuba comprise the detection of real needs as well as the existing potentialities that could help in meeting them through the alliances of different sectors, where intersectoriality represents an essential path to improve the quality of life of the older adult. Conclusions: The population trends show that Cuba is facing an unprecedented situation that will have a considerable impact on the health sector, therefore; it is necessary to put forward new strategies like intersectoriality, with a view to facing this rising phenomenon
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Humanos , Envelhecimento , Colaboração Intersetorial , Saúde do IdosoRESUMO
OBJECTIVES: To determine the feasibility of conducting a sedation wake-up trial (SWT) plus a spontaneous breathing trial (SBT) in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients' physiological responses; and to maintain patient safety. METHODS: A secondary analysis of the intervention group from a trial of 20 mechanically ventilated patients receiving SWT plus SBT in a trauma-intensive care unit. RESULTS: Patients passed 67% of the 39 SWTs performed; those who failed presented RASS scores of +1 and +2 (70%), tachycardia (15%) or ventilator asynchrony (15%). Eighteen patients tolerated their first SBT, and after the second SBT, more than half of the patients were discontinued from the mechanical ventilator. A significant increase from the beginning to the end of the SWT was found in heart rate (p=.021), respiratory rate (p=.043) and systolic blood pressure (p=.04). Although these measures increased significantly, their overall mean did not increase by 20%. CONCLUSION: SWT plus SBT was well tolerated and successfully implemented. Our data showed that it is not necessary to withhold continuous-infusion analgesia during the SWT.
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Cuidados Críticos/métodos , Desmame do Respirador/métodos , Ferimentos e Lesões/terapia , Pressão Sanguínea , Enfermagem de Cuidados Críticos , Delírio/prevenção & controle , Estudos de Viabilidade , Frequência Cardíaca , Humanos , Hipnóticos e Sedativos/administração & dosagem , Unidades de Terapia Intensiva , Tempo de Internação , Taxa Respiratória , Ferimentos e Lesões/enfermagemRESUMO
Introducción: El envejecimiento de la población es una realidad del presente, lo cual obliga al sistema de salud, a adoptar estrategias dirigidas a cubrir la calidad de la atención a los adultos mayores. Entre las demandas de esta población se ubican los servicios estomatológicos. Objetivo: Determinar las opiniones de los usuarios de 60 años y más, en relación con las principales dificultades que ellos le atribuyen a los servicios estomatológicos del municipio Playa. Métodos: Se realizó un estudio descriptivo y exploratorio. Se aplicó un cuestionario a 116 usuarios de los servicios estomatológicos del municipio Playa, quienes asistieron a consulta el día en que fue visitado dicho centro. La información se analizó con el software SPSS 11.5, y como estadígrafos se utilizaron los propios de la estadística descriptiva. Resultados: De los 116 usuarios entrevistados (mayores de 60 años), el 54,3 porciento eran mujeres. El motivo de consulta más frecuente se relacionó con el área de prótesis (32,8 porciento). Los entrevistados plantean como principales deficiencias, el déficit de personal técnico y asistencial (85,3 porciento); solo el 5,7 porciento refirió escasez de recursos materiales. Conclusiones: La escasez de recursos humanos, se convierte en una necesidad que atenta contra la calidad de la atención estomatológica, a las personas de 60 y más años, del municipio Playa
Introduction: People aging is a current reality, which oblige health service to adopt strategies aimed to cover the quality of life of elderly. Among the requests of this population are located in the stomatology services. Objective: To determine the criteria of elderly aged over 60, in relation to the major difficulties attributable to stomatology services in the Playa municipality. Methods: An exploratory and descriptive study. A questionnaire was applied in 116 users of stomatology services of the Playa municipality who came to consultation the visit day to this center. Information was analyzed using the SPSS 11.5 software and as statistical process we used the own of descriptive statistics. Results: From the 116 users interviewed (aged over 60), the 54.3 percent were women. The more frequent consultation reason was related to prosthesis area (32.8 percent). The interviewed users propose as main deficiencies the lack of technical and assistance staff (85.3 percent); only the 5.7 percent referred a lack of material resources. Conclusions: The lack of human resources becomes a need attempt against the quality of Stomatology care for persons aged 60 and more from the Playa municipality
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Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Pesquisa sobre Serviços de Saúde , Pesquisa sobre Serviços de Saúde/métodos , Satisfação do Paciente , Opinião Pública , Serviços de Saúde Bucal/ética , Epidemiologia Descritiva , Mão de Obra em Saúde , Estatísticas de Serviços de Saúde , Estatísticas de Assistência MédicaRESUMO
OBJECTIVE: The purpose of this study was to evaluate differences in pain intensity, pain quality, physiological measures, and adverse effects when patients received morphine with saline (MS) compared with morphine and a small dose of ketamine (MK) before an open wound care procedure (WCP). METHODS: A randomized, cross-over design was used to determine whether the addition of a small dose of ketamine would potentiate morphine's analgesic effects and decrease WCP pain intensity. Patients were randomized to receive either 0.1 mg/kg of morphine (8 mg maximum) plus saline intravenously (IV) or 0.05 mg/kg of morphine (4 mg maximum) plus ketamine 0.25 mg/kg IV before the WCP. Patients were crossed-over to receive the alternate treatment during the next WCP. RESULTS: Eleven male patients participated in the study. Mean rank of pain intensity during WCP-MK was significantly less than during WCP-MS (P=0.005). Mean±standard error of mean pain intensity during the WCP-MK was 3.09±0.99, whereas it was 6.82±0.92 during the WCP-MS. However, 91% of the patients had adverse effects (eg, strange sensations, hallucinations, blurred vision) with MK versus 0% with MS. Diastolic blood pressure was significantly higher during the WCP-MK. DISCUSSION: Ketamine with morphine significantly reduced procedural wound pain intensity during WCP. Adverse effects and higher diastolic BP occurred with MK. Further research is warranted to determine the optimal analgesic dose of ketamine or if the addition of a benzodiazepine would mitigate the psychotomimetic effects of ketamine.