RESUMO
La enteritis por radiación o enteritis actínica es una complicación secundaria al uso de radioterapia para tratamiento de tumores pélvicos, que puede afectar con mayor frecuencia al intestino delgado (principalmente íleon) y al colon. La cirugía en pacientes con enteritis por radiación crónica debe reservarse ante la presencia de complicaciones, ya que está relacionada con una alta morbilidad y estancia hospitalaria prolongadas, así como posibilidad de re operación. Exponemos el caso de una paciente con oclusión intestinal secundaria a enteritis por radiación que desarrolló años después de la conclusión de su tratamiento por cáncer de cuello uterino, con el objetivo de que esta enfermedad sea sospechada en pacientes con antecedentes de radiación.
Radiation enteritis or actinic enteritis is a complication secondary to the use of radiotherapy to treat pelvic tumors, which can more frequently affect the small intestine (mainly ileum) and the colon. Surgery in patients with chronic radiation enteritis should be reserved in the presence of complications, since it is related to high morbidity and prolonged hospital stay, as well as the possibility of reoperation. We present the case of a patient with intestinal occlusion secondary to radiation enteritis who developed years after the conclusion of her treatment due to cervical cancer, with the objective that this disease has to be suspected in patients with history of radiation.
Assuntos
Trato Gastrointestinal/efeitos da radiação , Enterite , Radiação , Radioterapia/efeitos adversosRESUMO
BACKGROUND: Training of basic laparoscopic psychomotor skills improves the acquisition of more advanced laparoscopic tasks, such as laparoscopic intra-corporeal knot tying (LICK). This randomized controlled trial was designed to evaluate whether pre-training of basic skills, as laparoscopic camera navigation (LCN), hand-eye coordination (HEC), and bimanual coordination (BMC), and the combination of the three of them, has any beneficial effect upon the learning curve of LICK. The study was carried out in a private center in Asunción, Paraguay, by 80 medical students without any experience in surgery. Four laparoscopic tasks were performed in the ENCILAP model (LCN, HEC, BMC, and LICK). Participants were allocated to 5 groups (G1-G5). The study was structured in 5 phases. In phase 1, they underwent a base-line test (T1) for all tasks (1 repetition of each task in consecutive order). In phase 2, participants underwent different training programs (30 consecutive repetitions) for basic tasks according to the group they belong to (G1: none; G2: LCN; G3: HEC; G4: BMC; and G5: LCN, HEC, and BMC). In phase 3, they were tested again (T2) in the same manner than at T1. In phase 4, they underwent a standardized training program for LICK (30 consecutive repetitions). In phase 5, they were tested again (T3) in the same manner than at T1 and T2. At each repetition, scoring was based on the time taken for task completion system. RESULTS: The scores were plotted and non-linear regression models were used to fit the learning curves to one- and two-phase exponential decay models for each participant (individual curves) and for each group (group curves). The LICK group learning curves fitted better to the two-phase exponential decay model. From these curves, the starting points (Y0), the point after HEC training/before LICK training (Y1), the Plateau, and the rate constants (K) were calculated. All groups, except for G4, started from a similar point (Y0). At Y1, G5 scored already better than the others (G1 p = .004; G2 p = .04; G3 p < .0001; G4 NS). Although all groups reached a similar Plateau, G5 has a quicker learning than the others, demonstrated by a higher K (G1 p < 0.0001; G2 p < 0.0001; G3 p < 0.0001; and G4 p < 0.0001). CONCLUSIONS: Our data confirms that training improves laparoscopic skills and demonstrates that pre-training of all basic skills (i.e., LCN, HEC, and BMC) shortens the LICK learning curve.
RESUMO
Presenta trabajo cientifico sobre el climaterio y menopausia presentado en el 1er Congreso Parguayo de Climaterio y Menopausia
Assuntos
Climatério , Menopausa , ParaguaiAssuntos
Humanos , Adolescente , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/enfermagem , Endometriose/diagnóstico , Endometriose/enfermagem , Endometriose/prevenção & controle , Endométrio , Endométrio/cirurgia , Aborto , Ginecologia/educação , Infertilidade Feminina , Infertilidade Feminina/diagnóstico , Educação Sexual , Fertilização in vitro/métodos , Síndrome da Imunodeficiência AdquiridaAssuntos
Climatério , Ginecologia , Menopausa , Hemorragia Uterina , Prolapso Uterino , Neoplasias Vulvares , Mioma/diagnósticoRESUMO
Presenta en forma clara y amena conocimientos de ginecología y además una serie de anécdotas extraídas de la experiencia del autor en hospitales, sanatorios y de casos atendidos en su consultorio, el libro se convierte en una introducción informal, para la educación sexual para adultos, ya que atrae y motiva este campo tan importante en los seres humanos. Incluye: introducción ; quistes de ovarios ; la mestruación ; mestruaciones dolorosas ; las hemorragias acíclicas ; el dolor de vientre ; el flujo vaginal ; enfermedades de transmisión sexual ; miomas uterinos ; cáncer de ovarios ; embarazo extrauterino ; el aborto ; los desgarros perineales ; el himen ; propapso genital ; la incontinencia de orina de esfuerzo ; la infertilidad y otros