RESUMO
BACKGROUND: the perinatal mortality (PM) represents a partial expression of a developing country and its health programs. The aim was to determine the rate of PM in a second level hospital that lacks the support of a perinatal care unit, and to help with some epidemiological elements to plan strategies to give a better care in the perinatal stage. METHODS: we collected all records of deaths within the parameters of perinatal death. DATA INCLUDED: maternal age, prenatal history, cause of the perinatal death and birth control information. RESULTS: out of 117 deaths, 59.8 % were in the late fetal death stage, and the rest in the first week of life. The PM rate calculated for each year from 2004 to 2007 was the following: 11.3, 12.8, 12.53, and 15.46: The birth control was good in 73 % of the cases, the most frequent cause of death was the interruption of maternal-fetal circulation in 80 % of the cases, and the early neonatal death was due to perinatal asphyxia in 20 %. The incidence of major malformations was 26.5 %. CONCLUSIONS: the undeniable increase in the PM rate forced us to encourage our staff to improve the availability of adequate material for the neonatal care.
Assuntos
Mortalidade Perinatal/tendências , Adolescente , Adulto , Criança , Hospitais Gerais , Humanos , Recém-Nascido , Estudos Longitudinais , México , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Adulto JovemRESUMO
BACKGROUND: Chest x-ray (Rx) is the standard test to assess correct placement of a central venous catheter (CVC). Our objective was to validate the use of four clinical measures (CMs) to assess the proper placement of the line. METHODS: During a period of eight month, at the Intensive Care Unit a prospective study was done. A chest Rx was always obtained to assess the position of the catheter. The CMs were: venous return; waveform of the central venous pressure (CVP); arrhythmias while advancing the guide wire and the difference between planned length in cm to be introduced and the length of the catheter introduced. RESULTS: For each parameter alone the sensitivity and specificity found were: for venous return 97% and 22%, for CVP waveform changes 86% and 40%, for arrhythmias 97% and 60%, for difference between planned and real length introduced into the patient 97% and 50% respectively. According to chest x-ray, 78% of the catheters were located at a central position. Using the four CMs, we obtained 86% sensitivity and 90% specificity of the placement of the CVC. CONCLUSIONS: The use of each parameter alone is highly sensitive but poorly specific.
Assuntos
Cateterismo Venoso Central/métodos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: to evaluate the validity (sensitivity, specificity, and accuracy) of three screening methods used in the early detection of the cervical carcinoma versus the histopathology diagnosis. METHODS: a selected sample of 107 women attended in the Opportune Detection of Cervicouterine Cancer Program in the Hospital de Zona 46, Instituto Mexicano del Seguro Social in Durango, during the 2003 was included. The application of Papa-nicolaou, acetic acid test, and molecular detection of human papillomavirus, and histopatholgy diagnosis were performed in all the patients at the time of the gynecological exam. The detection and tipification of the human papillomavirus was performed by polymerase chain reaction (PCR) and analysis of polymorphisms of length of restriction fragments (RFLP). Histopathology diagnosis was considered the gold standard. The evaluation of the validity was carried out by the Bayesian method for diagnosis test. RESULTS: the positive cases for acetic acid test, Papanicolaou, and PCR were 47, 22, and 19. The accuracy values were 0.70, 0.80 and 0.99, respectively. CONCLUSION: since the molecular method showed a greater validity in the early detection of the cervical carcinoma we considered of vital importance its implementation in suitable programs of Opportune Detection of Cervicouterino Cancer Program in Mexico. However, in order to validate this conclusion, cross-sectional studies in different region of country must be carried out.
Assuntos
Neoplasias do Colo do Útero/diagnóstico , Adulto , Detecção Precoce de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
In Mexico, more of 36% of malignant tumors in the women are cervical cancer, representing an important public health problem. Although cytologic screening for cervical cancer was introduced in 1974, the mortality rate for this disease has been increasing. The state of Durango represents the second national place in mortality by CaCu (3.4/100,000). Since there are few the studies of DOC program evaluation in Mexico were considered important to evaluated the cervical screening program (coverage, assiduity, diagnoses and pursuit) in the state of Durango. Of 40,000 active sexually women attended in the IMSS; we received 11,185 slides during May of 1999 to April of 2000 for cytologic screening. The coverage in this population was 27.96% (11,185/40,000), 8,187 women (73.2%) had cytologic control at least previous two years, 652 (5.83%) had more of four years without control and 2,346 (21%) assisted for first time. The cytological diagnostic showed 189 abnormal Pap (1.68%), and only 40 of them (21.16%) had cytohistopatholgic pursuit and clinic treatment. According to these results we concluded that DOC program in Gomez Palacio, Durango has a deficiency of coverage (72.04%) and pursuit (78.84%). These results indicated the need for development institutional activities of prevention for increase efficiency of preventive services.
Assuntos
Carcinoma in Situ/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Feminino , Humanos , México , Proteínas Associadas a Pancreatite , Avaliação de Programas e Projetos de Saúde , Fatores de TempoRESUMO
In Mexico, more of 36 of malignant tumors in the women are cervical cancer, representing an important public health problem. Although cytologic screening for cervical cancer was introduced in 1974, the mortality rate for this disease has been increasing. The state of Durango represents the second national place in mortality by CaCu (3.4/100,000). Since there are few the studies of DOC program evaluation in Mexico were considered important to evaluated the cervical screening program (coverage, assiduity, diagnoses and pursuit) in the state of Durango. Of 40,000 active sexually women attended in the IMSS; we received 11,185 slides during May of 1999 to April of 2000 for cytologic screening. The coverage in this population was 27.96 (11,185/40,000), 8,187 women (73.2) had cytologic control at least previous two years, 652 (5.83) had more of four years without control and 2,346 (21) assisted for first time. The cytological diagnostic showed 189 abnormal Pap (1.68), and only 40 of them (21.16) had cytohistopatholgic pursuit and clinic treatment. According to these results we concluded that DOC program in Gomez Palacio, Durango has a deficiency of coverage (72.04) and pursuit (78.84). These results indicated the need for development institutional activities of prevention for increase efficiency of preventive services.