RESUMO
Aim: To evaluate the biochemical and hematological markers associated with the risk of death due to COVID-19 in a clinical cohort with a severe clinical profile. Methods: A retrospective study was conducted among 215 anonymized inpatient records from the Hospital Nacional Almanzor Aguinaga Asenjo, Peru, between April and June 2020. The association between biomarkers and death due to COVID-19 was assessed using Cox regression, with a multivariable modeling of 1) biochemical and 2) hematological markers. Kaplan-Meier analyses and time-dependent receiver operating characteristic curves were calculated for each associated biomarker (p < 0.05). Results: Data analysis of 215 inpatient records revealed an overall mortality rate of 51.30% (95% CI 44.70-58.50), a mean age of 63.90 ± 14.10 years, and a median oxygen saturation of 88% (interquartile range 82-92%). The best-fitted biochemical model included higher levels of C-reactive protein (CRP), D-dimer, fibrinogen, urea, and lactate dehydrogenase. Similarly, the best-fitted hematological model included higher absolute neutrophil and prothrombin time, and lower absolute platelet counts. The best area under the curve values in both models were found to be CRP and D-dimer values (>0.74) and the absolute neutrophil count (0.63). Conclusions: Some specific biochemical markers outperformed hematological markers. Evaluated hematological counts analyzed in multivariable models proved to be better markers and could be useful to discriminate COVID-19 patients at high risk of death.
RESUMO
Introducción: El derrame pleural paraneumónico resulta la complicación más frecuente de la neumonía bacteriana, de manejo complejo y muchas veces quirúrgico. No existen publicaciones en Cuba provenientes de ensayos clínicos controlados y aleatorizados ni del uso de la estreptoquinasa recombinante (Heberkinasa®) en el derrame pleural. Objetivo: Evaluar la eficacia y la seguridad de la Heberkinasa® en el tratamiento del derrame pleural paraneumónico complicado complejo y el empiema en niños. Métodos: Ensayo clínico fase III, abierto, aleatorizado (2:1), en grupos paralelos y controlado. Se concluyó la inclusión prevista de 48 niños (1-18 años de edad), que cumplieron los criterios de selección. Los progenitores otorgaron el consentimiento informado. Los pacientes se distribuyeron en dos grupos: I- experimental: terapia estándar y administración intrapleural diaria de 200 000 UI de Heberkinasa® durante 3-5 días y II-control: tratamiento estándar. Las variables principales: necesidad de cirugía y la estadía hospitalaria. Se evaluaron los eventos adversos. Resultados: Ningún paciente del grupo I-experimental requirió cirugía, a diferencia del grupo II-control en el que 37,5 por ciento necesitó cirugía video-toracoscópica, con diferencia altamente significativa. Se redujo la estadía hospitalaria (en cuatro días), las complicaciones intratorácicas y las infecciones asociadas a la asistencia sanitaria en el grupo que recibió Heberkinasa®. No se presentaron eventos adversos graves atribuibles al producto. Conclusiones: La Heberkinasa® en el derrame pleural paraneumónico complicado complejo y empiema resultó eficaz y segura para la evacuación del foco séptico, con reducción de la necesidad de tratamiento quirúrgico, de la estadía hospitalaria y de las complicaciones, sin eventos adversos relacionados con su administración(AU)
Introduction: Paraneumonic pleural effusion is the most frequent complication of bacterial pneumonia, with complex and often surgical management. There are no publications in Cuba from randomized controlled clinical trials or the use of recombinant streptokinase (Heberkinase®) in pleural effusion. Objective: To evaluate the efficacy and safety of Heberkinase® in the treatment of complex complicated parapneumonic pleural effusion and empyema in children. Methods: Phase III, open-label, randomized (2:1), parallel-group, controlled clinical trial. The planned inclusion of 48 children (1-18 years of age), who met the selection criteria, was completed. Parents gave informed consent. The patients were divided into two groups: I-experimental: standard therapy and daily intrapleural administration of 200,000 IU of Heberkinase® for 3-5 days; and II-control: standard treatment. The main variables: need for surgery and hospital stay. Adverse events were evaluated. Results: No patient in group I-experimental required surgery, unlike group II-control in which 37.5 percent required video-assisted thoracoscopic surgery, with a highly significant difference. Hospital stay (to 4 days), intrathoracic complications and infections associated to healthcare in the group that received Heberkinase® was reduced. No serious adverse events attributable to the product occurred. Conclusions: Heberkinase® in complex complicated parapneumonic pleural effusion and empyema was effective and safe for the draining of the septic focus, with reduction of the need for surgical treatment, hospital stay and complications, with no adverse events related to its administration(AU)
Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Derrame Pleural/complicações , Pneumonia/complicações , Estreptoquinase/uso terapêutico , Resultado do Tratamento , Empiema Pleural/tratamento farmacológico , Pneumonia Bacteriana/etiologia , Unidades de Terapia Intensiva Pediátrica , Ensaio Clínico Controlado Aleatório , Ensaio Clínico Fase IIIRESUMO
Las escuelas latinoamericanas enfrentan demandas desde los entornos en los que operan, que definen escenarios caracterizados por las brechas entre aquello que las escuelas están capacitadas para ofrecer (representado principalmente por los docentes en el aula) y las necesidades emergentes de estudiantes que responden a entornos sociales concretos y muy diversos. Cerrar esta brecha es una prioridad y se estima que para ello es necesario fortalecer las capacidades de los docentes en aspectos como la contextualización de sus prácticas. Para ello se ejecutaron diversas intervenciones empleando distintos formatos de capacitación y metodologías de trabajo. Se presenta un estudio observacional realizado sobre una experiencia de desarrollo profesional docente que incorporó un componente de investigación-acción, con 21 docentes en servicio. El propósito del estudio fue establecer cómo y cuánto se fortalecieron las habilidades y expectativas que componen la competencia de investigación docente en el grupo mencionado. Se emplearon distintas herramientas para juntar información como pruebas, grupos focales, análisis de testimonios y de textos. Asimismo, se utilizaron complementariamente análisis cuantitativo y cualitativo, con énfasis en este último. Los resultados dan cuenta de mejoras significativas en las habilidades de problematización, empleo de evidencias y herramientas metodológicas, formulación de hipótesis y estrategias de intervención y redacción científica; así como de mejoras igualmente significativas en la competencia de investigación en general. Los mismos no reportan cambios o mejoras en las expectativas de empleo de la investigación en la enseñanza.
Currently many schools in Latin America face strong demands from their environments, these demands are marked by an increasing and more complex economic poverty, a deeper social inclusion and a lack of social cohesion, which are reflected in an escalated individualism. In addition to these demands, there are other expectations imposed by the academic and political world. In the academic world, contextualized learning and quality education services are expected, while in the political world, the demands are constituted by more levels of inclusion and of student permanence in schools. Together, these demands define a scenario for education characterized by several gaps: the ones between the performances of students from public and private schools, urban and rural schools, considering if they are male or female students, amongst others. It is important to highlight one of the most substantial disparity, which is the breach that exists from what the school is able to offer, greatly represented by the teacher in the classroom, and the emerging needs of the students,these needs correspond to particular and very diverse social environments, where every specific demand must be satisfied. To Close this gap, and the others previously mentioned, which are of no less importance, a priority in the political agenda of the governments must be given. To accomplish this major point, it is necessary to strengthen teachers' abilities to use and manage technologies and tools that will allow them to cater to the diversity of students in each of the schools attended, as well as contextualize teaching practices, and adapt them to reach the needs of these specific groups. In order to address these points many interventions, which used various training modes and work methodologies, were executed. However the actions taken, they have not have the desired outcome until now. Moreover the evidence resulting from international research specify that to strengthen the skills of the teachers accordingly, it is necessary that the training of in-service teachers should allow the promotion of spaces for reflection and dialog, as well as the opportunity to question common knowledge and practices. Data obtained from the field report that training given to teachers only generates real changes in teaching practices when these teachers have previously changed their understanding and beliefs of what teaching is to them, aligning them with the new approaches. This same data also reports that one of the most effective methodologies to generate these positive changes is the use of action research. The following observational investigation composed a study group of 21 in-service teachers attending a professional development that incorporated an action-research component. The purpose of this study is to establish how, and to what extent, the capacities for competitive research were strengthened in the group previously mentioned. To achieve this, different information collection tools were used for the observation of teaching performance: Tools such as tests, focus groups, analysis of testimonies and products. Complementary methodologies were also used for the quantitative and qualitative analysis, giving an emphasis on the latter. The results obtained from the quantitative analysis account for a significant improvement in each one of the seven skills that were part of this research, which are presented in the study as a whole. The results of the qualitative analysis report improvements in areas such as the formulation of problems, the use of evidences and methodological tools, hypothesis formulation and intervention, and scientific writing strategies, as well as important improvement in the capacity to research generally speaking. However, the outcome of this investigation has not created and impact in teachers so that will pursue them to implement and evaluate the use of research in their teaching practices.
RESUMO
Introducción: La mordida abierta anterior se ha descrito clásicamente como una deformidad de etiología multifactorial. La mordida abierta dental en el sector anterior, y cruzada posterior son dos tipos de mordidas más frecuentes que pueden encontrarse principalmente en niños. Objetivo: Conocer la frecuencia de mordida abierta en alumnos de la escuela Gregoria. M. de Saldívar y sus factores asociados. Material y Método: Estudio observacional descriptivo cuyos datos fueron recolectados a través de un cuestionario precodificado, participaron del estudio 52 alumnos del primero al noveno grado de la Escuela Gregoria M. de Saldívar. Las variables del estudio consideradas fueron: la presencia o no de mordida abierta, su frecuencia según los hábitos y su asociación con hábitos. Resultados: Del total de 52 alumnos, 28 son del sexo masculino y 24 del sexo femenino, el 15,4% de la muestra presenta mordida abierta anterior. De los 15,4% de la muestra que presentó mordida abierta anterior el 87,5 % de ellos correspondió al sexo femenino. Teniendo en cuenta la presencia o ausencia de hábitos de acuerdo al sexo, se encontró que un 62,5% del sexo femenino con mordida abierta anterior presentó el hábito de succión del dedo pulgar o uso prolongado del chupete. Conclusión: La etiología de esta maloclusión es debida principalmente al uso prolongado del chupete y el hábito de succión del dedo pulgar. Según los resultados de este estudio, la cifra obtenida guarda relación con la práctica de estos hábitos, pero no hubo predominancia en alguno de ellos .
Introduction: Anterior open bite has classically been described as a deformity of multifactorial etiology. Open bite in the anterior sector and posterior crossbite are two of the most commonly found bite disorders, especially in boys. Objective: To determine the prevalence of open bite and associated factors in students of the Gregoria. M. de Saldívar school. Material and Methods: We conducted a descriptive observational study including 52 students of the Gregoria M. de Saldívar school using a pre-coded questionnaire. Study variables included were the presence or absence of open bite, and the prevalence and association found with certain personal habits. Results: Of the 52 students, 28 were male and 24 female, with 15.4% presenting anterior open bite Of the 15.4 % of the sample with anterior open bite, 87.5% were girls; and in relation to the habits named, we found that 62.5% of the girls with anterior open bite had either the habit of thumb sucking or prolonged pacifier use.. Conclusion: The etiology of this type of malocclusion is primarily due to habits of prolonged use of pacifiers or thumbsucking. According to the results of our study, the data obtained is related to these habits, with neither habit predominating compared to the other in those with anterior open bite
Assuntos
Pré-Escolar , Má Oclusão , Mordida Aberta , Pré-EscolarRESUMO
Four methods (chromogenic, acidimetric, inhibition, and iodometric) for demonstration of the beta-lactamase production by 70 isolates of Neisseria gonorrhoeae, were evaluated in Cuba. There was 100 percent correlation between all beta-lactamase methods and the standardized penicillin dilution susceptibility test for penicillinase-non-producing N. gonorrhoeae. For penicillinase-producing N. gonorrhoeae strains, there was a perfect correlation between the chromogenic method and penicillin susceptibility testing, but one and two strains failed to give a positive result for beta-lactamase with the inhibition/acidimetric and the iodometric methods, respectively. There was a high concordance between the chromogenic method, considered as gold standard and the rest of penicillinase tests evaluated: Kappa Index (KI) = 0.98 for inhibition/acidimetric methods and KI = 0.97 for the iodometric method. The four methods evaluated were accurate, reproducible, easily readable, economical, and ease to use for screening primary isolates of N. gonorrhoeae in Cuba. We recommended the use of the inhibition method, when testing the penicillinase activity in gonococcal isolates in provincial and municipal reference laboratories.
Assuntos
Feminino , Humanos , Masculino , Técnicas Bacteriológicas , beta-Lactamases , Neisseria gonorrhoeae , Cuba , Resistência a Medicamentos , Testes de Sensibilidade Microbiana , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: In many regions the susceptibility of Neisseria gonorrhoeae isolates to antimicrobial agents is rarely tested. The Gonococcal Antimicrobial Surveillance Program (GASP) in Cuba was established as part of a larger regional GASP program to facilitate the collection and reporting of antimicrobial susceptibility data for N gonorrhoeae isolates. GOAL: The goal was to retrospectively determine the antimicrobial susceptibility and molecular epidemiology of 91 isolates of N gonorrhoeae isolated from 11 centers in Cuba. STUDY DESIGN: Isolates of N gonorrhoeae were collected and presumptively identified from 11 Cuban provincial health centers. They were then forwarded to the National Laboratory of Pathogenic Neisseria Havana for confirmatory identification and were subsequently analyzed at the Center for GASP in Ottawa. Isolates were tested for susceptibility to penicillin, tetracycline, spectinomycin, ceftriaxone, ciprofloxacin, and azithromycin by the agar dilution method. To establish baseline data for molecular epidemiologic profiles, the auxotype (A), serovar (S), plasmid content (P), and TetM type of the isolates were determined. Certain A/S/P classes were further analyzed by pulsed field gel electrophoresis (PFGE). RESULTS: High percentages of the 91 N gonorrhoeae isolates were resistant to penicillin (68%) and tetracycline (83.5%), with 56% being penicillinase-producing (PPNG) and 64% carrying plasmid-mediated tetracycline resistance (TRNG; 50% were PP/TRNG). An additional 14% of the isolates carried chromosomal resistance (CMRNG) to either tetracycline or penicillin or both antibiotics. All isolates were susceptible to spectinomycin, ceftriaxone, and ciprofloxacin. However, nine isolates were resistant to azithromycin (MIC, > or = 1.0 microgram/ml), and 43 other isolates displayed reduced susceptibility to this antibiotic (MIC, 0.25-0.5 microgram/ml). Although a total of 21 different A/S classes were identified, most of the isolates (61) belonged to three A/S classes: NR/IA-6 (35 isolates), NR/IB-1 (15 isolates), and P/IA-6 (11 isolates). Thirty-two of 45 PP/TRNG were A/S class NR/IA-6, and nine of the P/IA-6 isolates were TRNG. By contrast, most of A/S class NR/IB-1 (8) were CMRNG. PFGE analysis following digestion with NheI or SpeI further clustered the isolates into separate groups. CONCLUSIONS: This study demonstrates high percentages of N gonorrhoeae isolates with penicillin and tetracycline resistance in Cuba. As has been noted in other studies in the Caribbean region and Latin America, resistance and reduced susceptibility to azithromycin are developing as emerging problems. Since penicillin and tetracycline continue to be widely used for the treatment of gonococcal infections in Cuba, this study indicates the importance of antimicrobial susceptibility surveillance so that effective antibiotics may be recommended for treatment of gonococcal infections.
Assuntos
Antibacterianos/farmacologia , Azitromicina/farmacologia , Gonorreia/microbiologia , Neisseria gonorrhoeae/efeitos dos fármacos , Resistência às Penicilinas , Penicilinas/farmacologia , Resistência a Tetraciclina , Tetraciclina/farmacologia , Ceftriaxona/farmacologia , Ciprofloxacina/farmacologia , Cuba/epidemiologia , Feminino , Genótipo , Gonorreia/epidemiologia , Humanos , Incidência , Masculino , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/isolamento & purificação , Resistência às Penicilinas/genética , Estudos Retrospectivos , Sorotipagem , Espectinomicina/farmacologia , Resistência a Tetraciclina/genética , População UrbanaRESUMO
Se evaluaron 5 métodos de utilización de azúcares en 25 cepas identificadas previamente como Neisseria gonorrhoeae: agar CTA, agar CTA modificado, agar gelatina almidón, agar Mueller Hinton más azul de bromotimol y método rápido. Por los métodos de CTA y rápido fueron identificadas 100 por ciento de las cepas de N. gonorrhoeae, mientras que por los métodos de CTA modificado y agar gelatina almidón fue 96 por ciento. Ninguna cepa de gonococo fue identificada por el método de agar Mueller Hinton más azul de bromotimol. El medio de agar cistina tripticasa (CTA), constituye el método de elección para confirmar los aislamientos de Neisseria gonorrhoeae; es elaborado fundamentalmente por compañías norteamericanas, por lo que su adquisición en Cuba resulta difícil. Los métodos de agar gelatina almidón y rápido constituyen alternativas útiles del medio CTA, por lo que su uso se propone en este trabajo
Assuntos
Ágar , Carboidratos , Neisseria gonorrhoeae , Meios de CulturaRESUMO
BACKGROUND: Antibiotic-resistant strains of Neisseria gonorrhoeae, especially those resistant to penicillin and tetracycline, have spread with remarkable rapidity in many Caribbean countries. GOAL: The goal of the study was to survey the antibiotic susceptibilities of N gonorrhoeae strains isolated from 1995 to 1999 in Cuba and to discuss the impact of antimicrobial resistance on the management of gonorrhea in the country. STUDY DESIGN: Susceptibility of the strains to penicillin, tetracycline, cefuroxime, ceftriaxone, ciprofloxacin, spectinomycin, and azithromycin were determined by an agar dilution method. RESULTS: Penicillin and tetracycline resistance was noted in 60.8% and 54.2%, respectively, of the N gonorrhoeae strains tested. A total of 63.35 (76/120) of the N gonorrhoeae strains exhibited plasmid-mediated resistance to penicillin, tetracycline, or both. Strains with chromosomally mediated resistance to these antibiotics accounted for 10% (12/120) of the strains. The strains were susceptible to ceftriaxone, cefuroxime, spectinomycin, and ciprofloxacin. One strain's ciprofloxacin MIC was 0.125 mircog/ml. Of the 52 strains tested, 23.1% displayed intermediate resistance to azithromycin. CONCLUSIONS: N gonorrhoeae strains exhibited a high frequency of resistance and multiresistance to penicillin and tetracycline. Therefore, these antibiotics should no longer be used to treat gonococcal infections in Cuba and should be substituted with effective drugs such as third-generation cephalosporins, spectinomycin, and fluoroquinolones. The detection of intermediate resistance to azithromycin and ciprofloxacin underlines the importance of periodic surveillance for susceptibility of N gonorrhoeae strains to antimicrobials agents used as primary therapy for gonorrhea.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Gonorreia/epidemiologia , Gonorreia/microbiologia , Neisseria gonorrhoeae/efeitos dos fármacos , Cuba/epidemiologia , Feminino , Gonorreia/prevenção & controle , Humanos , Masculino , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeae/isolamento & purificação , Resistência às Penicilinas , Penicilinas/farmacologia , Tetraciclina/farmacologia , Resistência a TetraciclinaRESUMO
Four methods (chromogenic, acidimetric, inhibition, and iodometric) for demonstration of the beta-lactamase production by 70 isolates of Neisseria gonorrhoeae, were evaluated in Cuba. There was 100% correlation between all beta-lactamase methods and the standardized penicillin dilution susceptibility test for penicillinase-non-producing N. gonorrhoeae. For penicillinase-producing N. gonorrhoeae strains, there was a perfect correlation between the chromogenic method and penicillin susceptibility testing, but one and two strains failed to give a positive result for beta-lactamase with the inhibition/acidimetric and the iodometric methods, respectively. There was a high concordance between the chromogenic method, considered as gold standard and the rest of penicillinase tests evaluated: Kappa Index (KI) = 0.98 for inhibition/acidimetric methods and KI = 0.97 for the iodometric method. The four methods evaluated were accurate, reproducible, easily readable, economical, and ease to use for screening primary isolates of N. gonorrhoeae in Cuba. We recommended the use of the inhibition method, when testing the penicillinase activity in gonococcal isolates in provincial and municipal reference laboratories.
Assuntos
Técnicas Bacteriológicas/métodos , Neisseria gonorrhoeae/enzimologia , beta-Lactamases/biossíntese , Cuba , Farmacorresistência Bacteriana , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Sensibilidade e EspecificidadeRESUMO
5 methods of utilization of sugars were evaluated in 25 strains previously identified as N. gonorrhoeae: CTA agar, modified CTA agar, gelatin starch agar, Mueller Hinton agar plus bromotimol blue and rapid method. 100% of the strains of N. gonorrhoeae were identified by the CTA and rapid methods, whereas 96% were identified by the modified CTA and gelatin starch agar methods. No strain of gonoccocus was identified by the Mueller Hinton agar method plus bromotimol blue. The cystine tripticase agar medium (CTA) is the elective method to confirm the isolates of Neisseria gonorrhoeae. As it is mainly made by U.S. companies, it is difficult for Cuba to acquire it. The gelatin-starch agar method and the rapid method are useful alternative of the CTA medium, so their use is proposed in this paper.
Assuntos
Metabolismo dos Carboidratos , Meios de Cultura , Neisseria gonorrhoeae/crescimento & desenvolvimento , Neisseria gonorrhoeae/metabolismoRESUMO
The susceptibility to penicillin of 111 Neisseria meningitidis strains was assessed by the agar-dilution procedure and serosubtypes were determined by a whole-cell enzyme-linked immunoassay using monoclonal antibodies reagents. Thirty-five isolates showed reduced sensitivity to penicillin (MIC > or = 0.1 mg/l and <= 1 mg/l) and no resistant strains were detected. The most common phenotype was B:4:P1.15 (77.5 percent) and a rising trend of non-typeable and non-subtypeable strains was detected. The increase in levels of minimal inhibitory concentrations of meningococci to penicillin gives cause for concern and the increase in non-typeable and non-subtypeable isolation demand the use of molecular biology techniques for their typing
Assuntos
Humanos , Neisseria meningitidis/efeitos dos fármacos , Penicilinas/farmacologia , Anticorpos Monoclonais/isolamento & purificação , Cuba , Resistência Microbiana a Medicamentos , Neisseria meningitidis/classificação , Neisseria meningitidis/genética , Neisseria meningitidis/imunologia , Fenótipo , SorotipagemRESUMO
The conjunctivitis produced by Neisseria gonorrhoeae is the less frequently reported clinical form of gonococcal infection. We aim to phenotypically characterize N. gonorrhoeae isolated from conjunctivae sites. A total of six cases of this disease were notified in the Camagüey province, Cuba. All the strains isolated were penicillin-producing, showed the serogroup WI and exhibited the same antimicrobial susceptibility pattern and plasmid profile (2.6-3.2-24.5). The results contribute to the characterization of N. gonorrhoeae strains circulating in our environment
Assuntos
Humanos , Pré-Escolar , Adulto , Conjuntivite Bacteriana/microbiologia , Neisseria gonorrhoeae/isolamento & purificação , Gonorreia/tratamento farmacológico , Gonorreia/microbiologia , Neisseria gonorrhoeae/efeitos dos fármacos , Resistência às Penicilinas , Penicilinas/biossíntese , Penicilinas/farmacologia , Penicilinas/uso terapêutico , Tetraciclinas/farmacologia , Tetraciclinas/uso terapêutico , Tetraciclina/farmacologia , Tetraciclina/uso terapêuticoRESUMO
Este estudio clínico controlado, aleatorizado y cegado se realizó para determinar la eficacia del manejo del catéter vesical transuretral por un día en comparación por tres días, valorando la restauración temprana de la función vesical normal, la infección de vías urinarias y los días de estancia hospitalaria. Se incluyeron 50 pacientes que fueron intervenidas quirúrgicamente para cirugía reconstructiva de la pared vaginal anterior y asignadas a dos grupos para el manejo del catéter, grupo A: 25 pacientes por un día, y grupo B: 25 pacientes por tres días. En 23 (92 por ciento) pacientes de ambos gupos hubo restauración temprana de la función vesical normal. El promedio de días requeridos de cateterización en el grupo de un día fue de 1.4 y en el grupo de tres días fue de 3.2, de las 25 pacientes cateterizadas por un día fue diagnosticada infección de vías urinarias en una (4 por ciento) y de las 25 de tres días en cinco (20 por ciento), y el promedio de días de estancia hospitalaria fue de dos en el grupo A y de tres en el grupo B. Las diferencias fueron estadísticamente significativas (P<0.05), por lo tanto el tiempo de la permanencia del catéter puede reducirse con seguridad a un día. Esto puede asociarse a una reducción de la infección urinaria y menor tiempo de estancia hospitalaria
Assuntos
Feminino , Adulto , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Fatores de Tempo , Cateterismo Urinário , Cateterismo Urinário/instrumentação , Infecções Urinárias , Infecções Urinárias/etiologiaRESUMO
Estudio de cohortes concurrentes de causa efecto, de dos técnicas quirúrgicas para corregir la incontinencia urinaria de esfuerzo anatómica. El objetivo fue determinar los porcentajes de éxitos obtenidos a largo plazo. Se incluyeron 65 mujeres quienes fueron sometidas a procedimientos quirúrgicos tales como la colposuspensión de Burch-Tanagho en 20 pacientes y la Pereyra modificada en 45 pacientes, todas fueron evaluadas clínicamente antes y después anualmente durante cinco años postquirúrgicamente. Ambas técnicas quirúrgicas tuvieron excelentes porcentajes de curación de 90 por ciento y 86.6 por ciento respectivamente, no teniendo significancia estadística. La función vesical normal se restauró mas tempranamente 80 por ciento contra 71 por ciento y hubo menor incidencia de infección de tracto urinario 5 por ciento contra 20 por ciento, en la colposuspensión de Buch al compararla con la Pereyra, ambas teniendo significancia estadística (P<0.05). No hubo diferencia significativa en el sangrado transoperatorio y los días de estancia hospirtalaria entre ambos grupos. El tiempo del acto quirúrgico fue significativamente menor en la Pereyra modificada (P<0.05). Se concluye que cada técnica quirúrgica tiene su indicación precisa y en ambas los resultados son excelentes a largo plazo
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Incontinência Urinária por Estresse/cirurgia , UrologiaRESUMO
Es nuestro interés en este trabajo presentar un nuevo enfoque del tratamiento de la agenesia vaginal en el sindrome de rokitansky-meyer-kuztner. La tecnica actualizada de davidow pretende reemplazar a las cirugias convencionales hasta hoy dia realizadas en nuestro servicio de ginecologia, Hospital de Clinicas de Asunción-Paraguay Concluimos que los resultados obtenidos con el empleo de esta técnica son muy favorables en muchos aspectos para el paciente y por otro lado resaltar el uso del peritoneo perinatal abdominal para realizar el revestimiento interno de la nueva vagina
Assuntos
Doenças Vaginais , Síndrome de DiGeorge/enfermagemRESUMO
Se estudió la prevención de mastopatía fibroquística en una población de pacientes con endometriosis. Estudio realizado en la clínica de Biología de la Reproducción de referencia en un centro de atención médica de tercer nivel. Se incluyeron 43 pacientes con el diagnóstico laparoscópico de endometriosis en quienes se efectuó la búsqueda intencionada de datos clínicos y ultrasonográficos de mastopatía fibroquística en su período de control. La edad promedio de las pacientes fue 28 años, con un rango de 18 a 36 años. De las 43 pacientes con endometriosis, en 37.2 por ciento se efectuó el diagnóstico de mastopatía fibroquística. De estas pacientes por grupo de edad fue de 37.5 por ciento entre las de 30-34 años, y de 31.2 por ciento entre los 20-24 años. El 43.7 por ciento de las pacientes que tenían ambas patologías tenían el antecedente de un embarazo y 25 por ciento tenían alteraciones menstruales. La prevalencia de mastopatía fibroquística en pacientes con endometriosis fue de 37 por ciento se observó fuerte evidencia de asociación entre ambas patologías
Assuntos
Humanos , Feminino , Adolescente , Adulto , Endometriose/diagnóstico , PrevalênciaRESUMO
Se realizó un estudio de cohortes concurrentes aleatorio entre dos métodos de drenaje vesical transuretral posoperatorio: con la técnica cerrada y la abierta con el objetivo de determinar cuál de los dos métodos es más eficiente. Se incluyeron 50 pacientes posoperadas por relajación del piso pélvico o incontinencia urinaria de esfuerzo, que fueron asignadas en forma aleatoria a dos grupos de 25 pacientes cada uno. En el grupo con técnicas cerrada se estableció más tempranamente la función vesical normal en comparación con las de la técnica abierta (P< 0.05), así como la reducción significativa de la incidencia de infección del tracto urinario (P< 0.05). Se concluye que el denaje vesical transuretral con la técnica cerrada es más eficiente que la técnica abierta, después de cirugía por relajación del piso pélvico o incontinencia urinaria de esfuerzo
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Cateteres de Demora , Estudos de Coortes , Doenças da Bexiga Urinária/cirurgia , Cateterismo Urinário , Incontinência Urinária por Estresse/cirurgia , Prolapso Uterino/cirurgiaRESUMO
El Bloqueo Epidural es un procedimiento muy frecuente en la práctica anestésica. Una de las complicaciones de esta técnica es la cefalea postpunción dural, por lo que es de importancia conocer las alternativas de manejo de este problema, en base a un conocimiento de la fisiopatología y el diagnóstico del mismo. Se realizó un estudio prospectivo, para determinar el volumen mínimo de sangre autóloga en el parche hamático para el tratamiento de la cefalea postpunción de duramadre. Se formaron 3 grupos de 10 pacientes cada uno, a quienes se les había practicado Bloqueo Epidural para procedimientos gineco-obstétricos, las cuales presentaron como complicación punción accidental de duramadre. Integraron los grupos estudiados aquellas pacientes que presentaban cefalea de moderada a severa intensidad y que no habían respondido a un manejo conservador previo. Se utilizaron volúmenes de 7,6 y 5 mL de sangre, obteniendo resultados satisfactorios con volúmenes hasta de 6 mL.