Exploring healthcare barriers and satisfaction levels among deaf individuals in Ecuador: A video-based survey approach.

BACKGROUND: Approximately 80% of Deaf individuals live in low- and middle-income countries, where health systems often overlook their specific needs. This communication gap can result in misdiagnosis and inappropriate treatment, impacting their overall satisfaction with healthcare services. OBJECTIVES: This study aims to uncover barriers to healthcare access and preferences among the Deaf population in Ecuador, and the role of communication barriers in shaping satisfaction levels with healthcare services. METHODS: The study gathered data from 386 participants through online surveys, focusing on demographic characteristics, healthcare experiences, communication methods, and levels of satisfaction. Descriptive statistics and association analyses were employed to analyze the data. RESULTS: The study reveals that nearly all participants possessed an officially recognized disability (95.9%) and 53.9% reported hereditary deafness. Ecuadorian sign language was predominant (60.9%). Communication barriers were evident, with 65.0% having trouble understanding medical instructions, and 66.6% identifying a deficiency of tools for Deaf individuals in healthcare settings. Satisfaction levels were associated with the presence of interpreters during medical care, with 46.6% expressing a preference for interpreters over other communication methods. Additionally, private healthcare facilities were perceived as providing better services, despite being less frequently accessed (38.9%). Dissatisfaction was evident, particularly in aspects of communication and physician courtesy. CONCLUSIONS: This study underscores the importance of tailoring healthcare services to address the unique needs of the Deaf population. Communication barriers emerged as a central obstacle, necessitating the inclusion of sign language interpreters and improvement of resources. The study's implications extend to healthcare equity in developing nations, emphasizing the significance of patient-centered care and inclusive healthcare practices.

Cirugía endomedular retrógrada (con prototipo UHN) en fractura de húmero: experiencia de 13 casos / Retrograde endomedular Surgery (with protive UHN) in humeral fracture: experience to 13 cases

Trece pacientes con fractura de húmero (diafisiaria o pseudoartrosis) fueron tratados con el nuevo sistema endomedular UHN (unreamed humeral nail) entre los meses de enero de 1997 y abril de 1998. Todos los clavos fueron implantados en forma retrógada obteniéndose éxito terapéutico en 85 por ciento de casos. Sólo dos pacientes presentaron complicaciones leves, uno con diastasis de los fragmentos y otro con mala alineación rotacional. Los resultados obtenidos muestran que la aplicación de está técnica ortopédica a la fractura de húmero permite mayor estabilidad al hueso y evita complicaciones neurológicas, además de que brinda recuperación precoz y reincorporación rápida a las actividades habituales

Cáncer de cervix

En el periodo comprendido entre 1985-1990 en el servicio de Ginecología del Hospital General de las FF.AA. se han atendido 35 casos de cáncer de Cervix, siendo la paciente de menor edad de 23 años y la de mayor edad de 68 años. En cuanto a la pariedad 15 pacientes tuvieron entre 5 y 8 hijos y apenas una paciente sobre los 12 hijos. Todas las pacientes tuvieron Papanicolaou previos que inclinaban al diagnóstico definitivo. En el servicio de oncología durante el mismo período se atendieron 100 casos de Cáncer de Cérvix dentro de 457 casos oncológicos registrados. Se analizan algunos casos estadísticos, siendo la paciente de menor edad de 27 años y la de mayor edad de 88 años. En cuanto a la paridad 43 pacientes tuvieron de 4 a 8 hijos y 32 más de 8 hijos. Se registraron 40 casos en estado II, 22 casos en estado III, 19 casos en estado I Y IV. No se clasificaron 10 casos de control mensual promedio de 15 meses.

Atrioventricular responses of canine heart following chronic unilateral vagotomy.

The intrinsic cardiac nerves (ICN) have been shown to develop supersensitivity to nicotine (NIC) following complete extrinsic cardiac denervation. The present experiments were performed to delineate the pattern of ICN distribution in the heart by examining the pattern of NIC supersensitivity after unilateral vagotomy (VGX). Thirty-eight dogs were placed on cardiopulmonary bypass and inotropy evaluated by means of isovolumic pressures from fluid-filled balloons placed in the atria and ventricles. The animals were divided into three groups: group I, sham-operated controls; group II, animals studied 1-2 wk after VGX; and group III, animals studied 8-12 wk after VGX. Chronotropic and inotropic responses were evaluated in terms of NIC and acetylcholine (ACh) dose-response curves as well as frequency-response curves to stimulation of the intact vagus nerve (0.5-30 Hz). No change in NIC sensitivity was observed in group II, and vagal frequency-response curves were identical to group I. In group III dogs, both the right atrium and right ventricle showed significant increases in NIC sensitivity after left vagotomy. All group III animals showed right-shifted frequency-response curves. We conclude that nicotinic supersensitivity of the ICN and inotropic unresponsiveness to vagal stimulation occur but are slow in developing (70-130 days); and preganglionic sprouting does not appear to play a functional role in the adjustment of cardiac control mechanisms to unilateral vagotomy.

Diabetes gestacional / Gestacional diabetes

La diabetes gestacional y la diabetes mellitus constituyen trastornos metabólicos que afectan en forma importante al feto contribuyendo a un embarazo de alto riesgo; si no se lleva un control adecuado el embarazo puede terminar en aborto o mortinato; se debe establecer un tratamiento eficaz conjuntamente con el endocrinológo, a base de dieta e insulina, descartándose de antemano el uso de hipoglucemiantes orales por la teratogenicidad que producen los mismos.