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1.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38971564

RESUMO

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To compare early (<24h) versus late (>24h) spinal cord decompression on neurological recovery in patients with acute spinal cord injury. METHODS: A systematic review was performed according to the PRISMA protocol to identify studies published up to December 2022. Prospective cohort studies and controlled trials comparing early versus delayed decompression on neurological recovery were included. Variables included number of patients, level of injury, treatment time, ASIA grade, neurological recovery, use of corticosteroids, and complications. For the meta-analysis, the "forest plot" graph was developed. The risk of bias of the included studies was assessed using the ROBINS-I22 and Rob223 tools. RESULTS: Six of the seven studies selected for our review were included in the meta-analysis, with a total of 1188 patients (592 patients in the early decompression group and 596 in the delayed decompression group), the mean follow-up was 8 months, in 5 studies used methylprednisolone, the most reported complications were thromboembolic cardiopulmonary events. Five studies showed significant differences in favour of early decompression (risk difference 0.10, 95% confidence interval 0.07-0.14, heterogeneity 46%). The benefit was greatest in cervical and incomplete injuries. CONCLUSION: There is scientific evidence to recommend early decompression in the first 24h after traumatic spinal cord injury, as it improves final neurological recovery, and it should be recommended whenever the patient and hospital conditions allow it to be safely done.

2.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1535342

RESUMO

Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.


Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.

3.
An Pediatr (Engl Ed) ; 100(6): 420-427, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38834435

RESUMO

INTRODUCTION: Up to 60% of hospitalised neonates may develop incontinence-associated dermatitis (IAD). Our aim was to adapt the Clinical Evaluation Scale for Characterization of the Severity of Diaper Dermatitis to the Spanish population and to find out the nationwide frequency of IAD in hospitalized neonates. METHODS: Cross-cultural adaptation and assessment of content validity of the scale. We carried out a prospective, multicentre observational study of the incidence of nappy rash in postnatal wards and neonatal intensive care units in 6 Spanish hospitals. RESULTS: We obtained a content validity index of 0.869 for the total scale (95% CI, 0.742-0.939). The sample included 196 neonates. The cumulative incidence of IAD was 32.1% (9.1% mild-moderate, 8% moderate and 1.6% severe). The incidence rate was 2.2 IAD cases per 100 patient days. A stool pH of less than 5.5, a greater number of bowel movements a day, a greater daily urine output and the use of oral drugs were among the factors associated with the development of IAD. CONCLUSION: The Spanish version of the Clinical Evaluation Scale for Characterization of the Severity of Diaper Dermatitis had an adequate content validity for the assessment of DAI in the hospitalised neonatal population. Mixed feeding, treatment with oral drugs and the use of medical devices in the perianal area were associated with an increased risk of nappy dermatitis in infants.


Assuntos
Dermatite das Fraldas , Incontinência Fecal , Índice de Gravidade de Doença , Incontinência Urinária , Humanos , Recém-Nascido , Estudos Prospectivos , Incidência , Incontinência Fecal/epidemiologia , Incontinência Fecal/diagnóstico , Incontinência Fecal/complicações , Masculino , Feminino , Dermatite das Fraldas/epidemiologia , Dermatite das Fraldas/diagnóstico , Espanha/epidemiologia , Incontinência Urinária/epidemiologia , Incontinência Urinária/diagnóstico , Hospitalização
4.
Artigo em Inglês | MEDLINE | ID: mdl-38880712

RESUMO

OBJECTIVE: 1) To evaluate the ability of baseline and on 24 h serum calprotectin, in comparison to canonical biomarkers (lactate and procalcitonin), for prognosis of 28-day mortality in critically ill septic patients; and 2) To develop a predictive model combining the three biomarkers. DESIGN: A single-center, retrospective study. SETTING: Intensive Care Unit of a university hospital. PATIENTS OR PARTICIPANTS: One hundred and seventy three septic pacientes were included. INTERVENTIONS: Measurement of baseline lactate, procalcitonin and calprotectin level and procalcitonin and calprotectin levels on 24 h. MAIN VARIABLES OF INTEREST: Demographics and comorbidities, SOFA score on ICU admission, baseline lactate, procalcitonin and calprotectin on admission and on 24 h and 28-day mortality. RESULTS: 1) On ICU admission, lactate was the only biomarker achieving a significant accuracy (AUC: 0.698); 2) On 24 h, no differences were found on procalcitonin and calprotectin levels. Procalcitonin and calprotectin clearances were significantly lower in non-survivors and both achieved a moderate performance (AUCs: 0.668 and 0.664, respectively); 3) A biomarker based-model achieved a significant accuracy (AUC: 0.766), trending to increase (AUC: 0.829) to SOFA score alone; y 4) Baseline lactate levels and procalcitonin and calprotectin clearance were independent predictors for the outcome. CONCLUSIONS: 1) Baseline and on 24 h calprotectina and procalcitonin levels lacked ability in predicting 28-day mortality; 2) Accuracy of clearance of both biomarkers was moderate; and 3) Combination of SOFA score and the predictive biomarker based-model showed a high prognostic accuracy.

5.
Cir Cir ; 92(2): 219-227, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38782393

RESUMO

BACKGROUND: Acute appendicitis remains as a differential diagnosis in older patients with abdominal pain. The Alvarado scale may assist to guide the diagnosis and treatment of this entity. The operative characteristics of the scale are little known in this population. METHOD: We conducted a systematic review of original studies published between 1986 and 2022 evaluating the diagnostic performance of the Alvarado scale in older adults with suspected acute appendicitis. The review was conducted according to the PRISMA statement. The evaluation of the methodological quality of the studies was performed according to the ROBINS-I criteria. RESULTS: Four original studies of retrospective design including 480 patients were identified. The heterogeneity and poor methodological quality limited an aggregate statistical analysis (meta-analysis). The value of the ROC curve of the scale varies between 0.799 and 0.969. From the available studies, the value of the ROC curve is lower in comparison to the RIPASA scale and comparable to the Lintula scale. CONCLUSIONS: The evidence on the diagnostic performance of the Alvarado scale in older adults is limited. The poor methodological quality of the available studies calls for a prudent use of this tool in this population. Our findings offer opportunities for future research.


ANTECEDENTES: La apendicitis aguda es un diagnóstico diferencial en el adulto mayor con dolor abdominal. La escala de Alvarado se utiliza para orientar el diagnóstico y el tratamiento. Las características operativas de la escala son poco conocidas en este grupo de pacientes. MÉTODO: Revisión sistemática de estudios originales publicados entre 1986 y 2022 que evaluaron el rendimiento diagnóstico de la escala de Alvarado en adultos mayores con sospecha de apendicitis aguda, con base en la declaración PRISMA. La evaluación de la calidad metodológica de los estudios se realizó con los criterios ROBINS-I. RESULTADOS: Se identificaron cuatro estudios originales de diseño retrospectivo que incluyen 480 pacientes. La heterogeneidad y la baja calidad metodológica limitaron un análisis estadístico agregado (metaanálisis). El valor de la curva ROC de la escala varía entre 0.799 y 0.969. En los estudios disponibles, el valor de la curva ROC es inferior al de la escala RIPASA y similar al de la escala de Lintula. CONCLUSIONES: La evidencia que sustenta el rendimiento diagnóstico de la escala de Alvarado en los adultos mayores es limitada. La pobre calidad de los estudios disponibles advierte sobre el uso prudente de esta herramienta en este grupo poblacional. Los hallazgos identificados ofrecen oportunidades de investigación futura.


Assuntos
Dor Abdominal , Apendicite , Idoso , Idoso de 80 Anos ou mais , Humanos , Dor Abdominal/etiologia , Doença Aguda , Apendicite/diagnóstico , Diagnóstico Diferencial , Estudos Retrospectivos , Curva ROC
6.
Emergencias ; 36(3): 197-203, 2024 Jun.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-38818985

RESUMO

OBJECTIVES: Status epilepticus (SE) is a serious event associated with high mortality. This study aims to validate the recently developed ADAN (Abnormal speech, ocular Deviation, Automatisms, and Number of motor epileptic seizures) scale for detecting high risk for SE. MATERIAL AND METHODS: Prospective, multicenter, observational study in adults with suspected epileptic seizures. Consecutive recruitment took place over a 27-month period in 4 hospital emergency departments (EDs). The main endpoint was the proportion of patients with criteria for SE based on the collection and analysis of clinical characteristics and the ADAN scale criteria on arrival at the ED. RESULTS: Of the 527 patients recruited, 203 (38.5%) fulfilled the criteria that predicted SE. Multiple regression analysis demonstrated that the 4 ADAN criteria were the only variables independently associated with a final diagnosis of SE (P .001). The predictive power of the scale was 90.9% (95% CI, 88.4%-93.4%) for a final SE diagnosis. We established 3 risk groups based on ADAN scores: low (score, 0-1: 8.7%), moderate (2, 46.6%), and high (> 2, 92.6%). A cut point of more than 1 had a sensitivity of 88.2% for predicting SE, specificity of 77.8%, positive predictive value of 71.3%, and negative predictive value of 91.3%. CONCLUSION: The ADAN scale is a prospectively validated, simple clinical tool for identifying patients in the ED who are at high risk for SE.


OBJETIVO: El estado epiléptico (EE) es una enfermedad grave con elevada mortalidad. Este estudio tiene como objetivo validar la escala ADAN, propuesta recientemente para identificar pacientes con alto riesgo de desarrollar un EE. METODO: Se realizó un estudio prospectivo, multicéntrico y observacional que incluyó a pacientes adultos con sospecha de crisis epilépticas. Se llevó a cabo un reclutamiento consecutivo durante 27 meses en los servicios de urgencias (SU) de cuatro hospitales. La variable principal fue la proporción de pacientes que cumplían criterios para EE. Se han recopilado y analizado las características clínicas y la puntuación en la escala ADAN a su llegada al SU. RESULTADOS: Se reclutaron 527 pacientes, de los cuales 203 (38,5%) cumplieron criterios de EE. En el análisis de regresión múltiple, se demostró que el habla anormal, la desviación ocular, los automatismos y el número de crisis epilépticas motoras fueron las únicas variables independientemente asociadas con un diagnóstico final de EE (p 0,001). La capacidad predictiva de la escala fue del 90,9% (intervalo de confianza del 95%, 88,4-93,4) para identificar el EE como diagnóstico final. Se establecieron tres grupos de riesgo: bajo (0 1 puntos: 8,7%), moderado (2: 46,6%) y alto (> 2: 92,6%). Una puntuación de corte > 1 punto proporcionó una sensibilidad del 88,2%, especificidad del 77,8%, valor predictivo positivo del 71,3% y valor predictivo negativo del 91,3% para predecir el EE. CONCLUSIONES: La escala ADAN es una herramienta clínica simple y validada de manera prospectiva para identificar, en los SU, a los pacientes con elevado riesgo de EE.


Assuntos
Serviço Hospitalar de Emergência , Estado Epiléptico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco/métodos , Estado Epiléptico/diagnóstico
7.
Cir Cir ; 92(2): 174-180, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38782390

RESUMO

INTRODUCTION: Transversus abdominis plane (TAP) block is a widely used anesthetic technique of the abdominal wall, where ultrasound guidance is considered the gold standard. In this study, we aimed to compare the effectiveness of laparoscopic-assisted TAP (LTAP) block with ultrasound-assisted TAP (UTAP) block for post-operative pain, nausea, vomiting, duration of the block, and bowel function. MATERIALS AND METHODS: This study included 60 patients who were randomly assigned to two groups to undergo either the LTAP or UTAP block technique after laparoscopic cholecystectomy. The time taken for administering the block, post-operative nausea and vomiting, post-operative pain, respiratory rate, bowel movements, and analgesia requirements were reported. RESULTS: The time taken for the LTAP block was shorter (p < 0.001). Post-operative mean tramadol consumption, paracetamol consumption, and analgesic requirement were comparable between the two groups (p = 0.76, p = 0.513, and p = 0.26, respectively). The visual analog scale at 6, 24, and 48 h was statistically not significant (p = 0.632, p = 0.802, and p = 0.173, respectively). Nausea with vomiting and the necessity of an antiemetic medication was lower in the UTAP group (p = 0.004 and p = 0.009, respectively). CONCLUSION: The LTAP block is an easy and fast technique to perform in patients as an alternative method where ultrasound guidance or an anesthesiologist is not available.


ANTECEDENTES: El bloqueo del plano transverso del abdomen (TAP) es una técnica anestésica de la pared abdominal ampliamente utilizada, en la cual la guía ecográfica se considera el método de referencia. OBJETIVO: Comparar la efectividad del bloqueo TAP asistido por laparoscopia (LTAP) con el bloqueo TAP asistido por ultrasonido (UTAP) para el dolor posoperatorio, las náuseas y los vómitos, y la función intestinal. MÉTODO: El estudio incluyó 60 pacientes que fueron asignados aleatoriamente a dos grupos para someterse a la técnica de bloqueo LTAP o UTAP después de una colecistectomía laparoscópica. Se informaron el tiempo de administración del bloqueo, las náuseas y los vómitos posoperatorios, el dolor posoperatorio, la frecuencia respiratoria, las evacuaciones y los requerimientos de analgesia. RESULTADOS: El tiempo de bloqueo LTAP fue menor (p < 0.001). El consumo medio de tramadol, el consumo de paracetamol y el requerimiento de analgésicos posoperatorios fueron comparables entre los dos grupos (p = 0.76, p = 0.513 y p = 0.26, respectivamente). El dolor en la escala analógica visual a las 6, 24 y 48 horas no fue estadísticamente significativo (p = 0.632, p = 0.802 y p = 0.173, respectivamente). CONCLUSIONES: El bloqueo PATL es una técnica fácil y rápida de realizar en pacientes como método alternativo cuando no se dispone de guía ecográfica o anestesióloga.


Assuntos
Colecistectomia Laparoscópica , Bloqueio Nervoso , Dor Pós-Operatória , Náusea e Vômito Pós-Operatórios , Ultrassonografia de Intervenção , Humanos , Colecistectomia Laparoscópica/métodos , Feminino , Masculino , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Pessoa de Meia-Idade , Ultrassonografia de Intervenção/métodos , Bloqueio Nervoso/métodos , Adulto , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Náusea e Vômito Pós-Operatórios/etiologia , Músculos Abdominais/inervação , Músculos Abdominais/diagnóstico por imagem , Estudos Prospectivos
8.
Gac Sanit ; 38: 102395, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38781777

RESUMO

OBJECTIVE: To construct and validate a questionnaire about the attitude of university students toward health promotion. METHOD: A cross-sectional study. A questionnaire of 14 questions was designed and administered to 1486 first-year undergraduates. The principal axes factoring method with oblique rotation was applied and a confirmatory factor analysis was carried out. Reliability was calculated through internal consistency with Cronbach's alpha and item-total correlation for the global scale and its subscales. RESULTS: A 14-item scale was constructed, with two dimensions. Its Cronbach's alpha was 0.872, and 0.852, and 0.718 for its subscales. The adjustment values of the confirmatory factor analysis were adequate. CONCLUSIONS: The attitude towards health promotion scale has shown to have adequate psychometric properties. It is an instrument that will help to detect referents and health assets for future interventions.

9.
Revista Digital de Postgrado ; 13(1): 385, abr. 2024. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1554959

RESUMO

Objetivo: Relacionar las complicaciones y el riesgo de muerte en pacientes neurocríticos admitidos en la unidad de cuidados intensivos (UCI) del Hospital Universitario de Caracas durante un período de 5 meses. Métodos: investigación observacional, prospectiva, descriptiva. La muestra estuvo conformada por 65 pacientes neurocríticos, ≥ 18 años, con patologías médicas o quirúrgicas, ingresados en la UCI. El análisis estadístico incluyó la determinación de frecuencias, promedios, porcentajes y medias para descripción de variables y el T de Student. Resultados: La edad promedio fue 50,98 ± 16,66 años; la población masculinarepresentó el 50,76%. Entre las complicaciones, la mayor incidencia correspondió a las no infecciosas (70,77 %) y los trastornos ácido-básicos de tipo metabólico, la anemia y las alteraciones electrolíticas fueron las más frecuentes; el 29,23% de los pacientes presentaron complicaciones infecciosas, y la neumonía asociada a ventilación mecánica fue la más frecuente (73,91 %). La comorbilidad con mayor incidencia fue hipertensión arterial sistémica (53,84%). El 90.70% requirió ventilación mecánica y el tiempo en VM fue 4.29 ± 6.43 días. La estancia en UCI fue 5.96 ± 7.72 días. El 29,23% presentó un puntaje en la escala APACHE II entre 5-9; el SAPS II presentó mayor incidencia entre los 6-21 y 22-37 puntos con (66,70%); el SOFA al ingreso se reportó < 15 puntos en 98,46% y > 15 en 1,53%. La mortalidad del grupo fue 23,08 % (n=15). Conclusiones: Las complicaciones no infecciosas predominaron sobre las infecciosas las primeras íntimamente relacionadas con la mortalida(AU)


Objective: To relate complications and the risk of death in neurocritical patients admitted to the intensive care unit (ICU) of the University Hospital of Caracas during a period of 5 months. Methods: observational, prospective, descriptive research. The sample was made up of 65 neurocritical patients, ≥ 18 years old, with medical or surgical pathologies, admitted to the ICU.The statistical analysis included the determination of frequencies, averages, percentages and meansfor description of variables and Student's T.Results: The average age was 50.98 ± 16.66 years; the male population represented 50.76%. Among the complications, the highest incidence corresponded to non-infectious complications (70.77%) and metabolic acid-base disorders, anemia and electrolyte alterations were the most frequent; 29.23% of patients presented infectious complications, and pneumonia associated with mechanical ventilation was the most frequent (73.91%). The comorbidity with the highest incidence was systemic arterial hypertension (53.84%), 90.70% required mechanical ventilation and the time on MV was 4.29 ± 6.43 days. The ICU stay was 5.96 ± 7.72 days. 29.23% had a score on the APACHE II scale between 5-9; SAPS II presented the highest incidence between 6-21 and 22-37 points with (66.70%); The SOFA upon admission was reported to be < 15 points in 98.46% and > 15 in 1.53%. The mortality of the group was 23.08% (n=15). Conclusions: Non-infectious complications predominated over infectious complications, the former being closely related to mortalit(AU)


Assuntos
Humanos , Masculino , Feminino , Mortalidade , Cuidados Críticos , Anemia
10.
Vive (El Alto) ; 7(19): 50-62, abr. 2024.
Artigo em Espanhol | LILACS | ID: biblio-1560623

RESUMO

Introducción: La diabetes mellitus 2 es una enfermedad frecuente en adultos mayores, con múltiples complicaciones que pueden llegar a afectar el equilibrio y la marcha e incrementar el riesgo de caída. Objetivo: Determinar el riesgo de caídas en dos grupos de adultos mayores, uno con padecimiento de DM2 y otro sin este padecimiento. Metodología: Estudio de enfoque cuantitativo, alcance descriptivo, diseño observacional, y de cohorte transversal; muestra poblacional de 120 adultos mayores en la ciudad de Guayaquil divididos en dos grupos: grupo A con 60 adultos mayores que no padecían DM2 y grupo B con 60 adultos mayores con DM2; que cumplen con los criterios de inclusión y a quienes se evalúan mediante las técnicas: observación, evaluación y entrevista; y los instrumentos: Escala de Berg, Mini-BESTest y formulario estándar. Se utilizó la prueba estadística Chi cuadrado para la comparación de los resultados obtenidos. Resultados: Los resultados indican que, en la determinación del riesgo de caídas, se encontraron diferencias estadísticamente significativas (p0.05). El estudio además encontró que los resultados obtenidos, en las dos pruebas de riesgo de caídas, difieren entre sí. Conclusiones: Los adultos mayores diabéticos presentan un mayor riesgo de caída a comparación de adultos mayores no diabéticos.


Introduction: Diabetes mellitus 2 is a common disease in older adults, with multiple complications that can affect balance and gait and increase the risk of falling. Objective: To determine the risk of falls in two groups of older adults, one with and the other without DM2. Methodology: Quantitative approach study, descriptive scope, observational design, and cross-sectional cohort; population sample of 120 older adults in the city of Guayaquil divided into two groups: group A with 60 older adults who did not suffer from DM2 and group B with 60 older adults with DM2; who meet the inclusion criteria and who are evaluated by means of the techniques: observation, evaluation and interview; and the instruments: Berg scale, Mini-BESTestest and standard form. The Chi-square statistical test was used to compare the results obtained. Results: The results indicate that, in the determination of the risk of falls, statistically significant differences (p0.05) were found. The study further found that the results obtained, in the two fall risk tests, differed from each other. Conclusions: Diabetic older adults present a higher risk of falling compared to non-diabetic older adults.


Introdução: O diabetes mellitus tipo 2 é uma doença comum em idosos, com múltiplas complicações que podem afetar o equilíbrio e a marcha e aumentar o risco de quedas. Objetivo: Determinar o risco de quedas em dois grupos de idosos, um com DM2 e outro sem essa condição. Metodologia: Estudo com abordagem quantitativa, escopo descritivo, desenho observacional e coorte transversal; amostra populacional de 120 idosos da cidade de Guayaquil dividida em dois grupos: grupo A com 60 idosos que não sofriam de DM2 e grupo B com 60 idosos com DM2; que atendam aos critérios de inclusão e que sejam avaliados pelas técnicas: observação, avaliação e entrevista; e os instrumentos: Escala de Berg, Mini-BESTest e formulário padrão. O teste estatístico Qui-quadrado foi utilizado para comparação dos resultados obtidos. Resultados: Os resultados indicam que, na determinação do risco de quedas, foram encontradas diferenças estatisticamente significativas (p0,05). O estudo também constatou que os resultados obtidos nos dois testes de risco de queda diferem entre si. Conclusões: Idosos diabéticos apresentam maior risco de queda em comparação aos idosos não diabéticos.


Assuntos
Humanos
11.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1561426

RESUMO

La diabetes mellitus tipo 2 (DM2) es una amenaza para la salud por las complicaciones derivadas de un diagnóstico tardío, donde la identificación oportuna es primordial. Con el objetivo de establecer la relación entre índice cintura talla (ICT), índice cintura cadera (ICC) y puntaje de la escala FINDRISC (Finnish Diabetes Risk Score) como determinantes del riesgo de padecer DM2 a largo plazo, se realizó este estudio predictivo transversal con adultos de 18 y 60 años atendidos en el Centro de Salud Primero de Julio del municipio de Mixco, Guatemala. Participaron 80 adultos, seleccionados por un muestreo aleatorio simple. El instrumento de recolección de datos estuvo conformado por tres secciones: información general de la persona, parámetros antropométricos y la encuesta de FINDRISC. Se generaron modelos lineales generalizados para identificar relaciones entre índice cintura talla (ICT), índice cintura cadera (ICC) y puntaje de la escala FINDRISC (Finnish Diabetes Risk Score). El 36.2% presentó riesgo de desarrollar DM2 a largo plazo; encontrándose un 21.2% en el nivel de riesgo alto y muy alto. Se comprobó que únicamente existe relación significativa entre el ICT y el puntaje de la escala de FINDRISC como determinante del riesgo de padecer DM2 a largo plazo. Se concluye que la implementación de la medición del ICT constituye una herramienta útil para identificar personas con riesgo de desarrollar DM2, siendo su aplicación sencilla, no invasiva, económica y de fácil acceso en los servicios de salud.


Type 2 diabetes mellitus (T2DM) is a health threat due to the complications derived from a late diagnosis, where timely identification is essential. This study aimed to establish the relationship between waist-height index (WHR), waist-hip index (WHR) and the FINDRISC (Finnish Diabetes Risk Score)scale as determinants of the risk of suffering from T2DM in the long term. A cross-sectional predictive study was carried out with a simple random sample of 80 adults between 18 and 60 years old treated at the Primero de Julio Health Center in Mixco, Guatemala. The data collection instrument was structured into three sections: general information, anthropometric parameters and the FINDRISC survey. Generalized linear models were generated to identify relationships between waist-height ratio (WHR), waist-hip ratio (WHR) and the FINDRISC scale score (Finish Diabetes Risk Score). The results shows that 36.2% of the participants were at risk of developing T2DM in the long term; 21.2% being at the high and very high risk level. It was found that there is only a significant relationship between the WHR and the FINDRISC scale score as a determinant of the risk of suffering from T2DM in the long term. The implementation of the waist height index measurement constitutes a useful tool to identify people at risk of developing T2DM, its application being simple, non-invasive, economical and easily accessible in health services.

12.
Artigo em Inglês | MEDLINE | ID: mdl-38657706

RESUMO

OBJECTIVE: The study aimed to reveal the approaches to coping with stress of women with breast cancer and the factors predicting these approaches, to determine the prevalence and characteristics of Complementary and Alternative Medicine (CAM), and to examine the relationship between use of CAM and approaches to coping with stress. METHODS: A descriptive and cross-sectional study was conducted among 328 women with breast cancer at a training and research hospital in Türkiye. Data were collected with the "Descriptive Information Form" and the "Stress Coping Styles Scale (SCSS)". RESULTS: Women's SCSS score was 47.26±6.39 (effective) and 37.76±6.33 (ineffective). The SCSS score were not significantly different between CAM users and non-CAM users (p>0.05). The prevalence of CAM use was 36%, the most common types of CAM were herbal products (55.1%) and prayer (33.8%) and the reasons for using CAM were for relaxation (symptomatic) (43.2%). As a result of multivariate logistic regression analysis, level of income, working, number of living children, receiving chemotherapy, receiving surgery, having a family history of cancer, and the interest of their partner after the disease were associated with effective coping with stress (p<0.05, adjusted R2=0.08, 0.05, and 0.33 respectively). Working, receiving chemotherapy, receiving surgery, stage of cancer, and having a history of cancer in a social environment were associated with ineffective coping with stress (p<0.05, adjusted R2=0.14 and 0.11 respectively). CONCLUSIONS: One-third of women were using CAM and had a good level of approaches to coping with stress. Healthcare providers, especially gynecology-oncology nurses, should provide counseling on CAMs and develop strategies for coping with stress for women with breast cancer.

13.
Emergencias ; 36(2): 116-122, 2024 Apr.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-38597618

RESUMO

OBJECTIVES: To identify predictors for developing delayed neurological syndrome (DNS) after an initial episode of carbon monoxide (CO) poisoning in the interest of detecting patients most likely to develop DNS so that they can be followed. MATERIAL AND METHODS: Retrospective review of cases of CO poisoning treated in the past 10 years in the emergency departments of 4 hospitals in the AMICO study (Spanish acronym for the multicenter analysis of CO poisoning). We analyzed demographic characteristics of the patients and the clinical characteristics of the initial episode. The records of the cohort of patients with available follow-up information were reviewed to find cases of DNS. Data were analyzed by multivariant analysis to determine the relationship to characteristics of the initial exposure to CO. RESULTS: A total of 240 cases were identified. The median (interquartile range) age of the patients was 36.2 years (17.6-49.6 years); 108 patients (45.0%) were men, and the poisoning was accidental in 223 cases (92.9%). The median carboxyhemoglobin concentration on presentation was 12.7% (6.2%-18.7%). Follow-up details were available for 44 patients (18.3%). Eleven of those patients (25%) developed DNS. A low initial Glasgow Coma Scale score predicted the development of DNS with an odds ratio (OR) of 0.61 (95% CI, 0.41-0.92) and an area under the receiver operating characteristic curve of 0.876 (95% CI, 0.761-0.990) (P .001). CONCLUSION: The initial Glasgow Coma Scale score seems to be a clinical predictor of DNS after CO poisoning. We consider it important to establish follow-up protocols for patients with CO poisoning treated in hospital EDs.


OBJETIVO: Identificar factores pronósticos de desarrollo de síndrome neurológico tardío (SNT) después de un episodio inicial de intoxicación por monóxido de carbono (ICO), con el fin detectar precozmente a la población más susceptible y facilitar su acceso a un seguimiento específico. METODO: Revisión retrospectiva de todos los casos de ICO que acudieron a los servicios de urgencias (SU) de 4 hospitales durante los últimos 10 años. Se analizaron datos demográficos y características clínicas en el momento del episodio. En la cohorte de pacientes con datos de seguimiento disponibles, se evaluó la aparición de SNT y su relación con diferentes variables en la exposición inicial al CO a través de técnicas de análisis multivariante. RESULTADOS: Se identificaron 240 pacientes. La mediana de edad fue de 36,2 años (17,6-49,6). De ellos 108 (45,0%) eran hombres y 223 casos (92,9%) fueron accidentales. El nivel medio de COHb fue del 12,7% (6,2-18,7). En 44 (18,3%) episodios se disponía de datos de un seguimiento específico. En esta cohorte, 11 (25%) pacientes desarrollaron SNT. Una puntuación inicial más baja en la Escala Coma de Glasgow (GCS) (OR: 0,61, IC 95%: 0,41-0,92) fue predictor independiente del desarrollo del SNT, con un ABC en la curva COR de 0,876 (IC 95%: 0,761-0,990, p 0,001). CONCLUSIONES: Una puntuación inicial baja en la GCS parece ser un predictor clínico de desarrollo de SNT en la ICO. Dada la incidencia de SNT, consideramos fundamental establecer protocolos de seguimiento específico de estos pacientes tras su asistencia inicial en los SU.


Assuntos
Intoxicação por Monóxido de Carbono , Oxigenoterapia Hiperbárica , Adulto , Feminino , Humanos , Masculino , Intoxicação por Monóxido de Carbono/complicações , Intoxicação por Monóxido de Carbono/diagnóstico , Intoxicação por Monóxido de Carbono/terapia , Oxigenoterapia Hiperbárica/métodos , Estudos Retrospectivos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade
14.
Actas Dermosifiliogr ; 2024 Feb 19.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38382749

RESUMO

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

15.
Bragança; s.n; 20240000. il., tab..
Tese em Português | BDENF - Enfermagem | ID: biblio-1527170

RESUMO

Os enfermeiros são um grupo profissional particularmente suscetível de experienciar com o stresse, pela natureza das suas funções. A exposição permanente ao contacto humano com doentes e familiares, a gestão de situações de emergência, em que um pequeno erro pode comprometer a sobrevivência ou o prognóstico do doente, a interação com outros profissionais de saúde, o trabalho por turnos e a disrupção de ritmos circadianos, a morte de doentes, de entre outros fatores, criam uma conjuntura em que o enfermeiro experiencie níveis elevados de stresse no seu dia-a-dia. Objetivos: Caracterizar o perfil sociodemográfico e profissional dos enfermeiros do Serviço de Urgência de um Centro Hospitalar da região norte de Portugal; Identificar os principais fatores indutores de stresse nos enfermeiros do Serviço de Urgência de um Centro Hospitalar da região norte de Portugal; Avaliar a relação entre os fatores indutores de stresse e as variáveis sociodemográficas e profissionais. Métodos: Foi realizado um estudo descritivo, transversal correlacional, avaliando os níveis de stresse numa amostra de 54 enfermeiros de um serviço de urgência de um hospital da região do norte de Portugal através da aplicação da Escala de Stresse Profissional dos Enfermeiros e de um questionário para fazer o levantamento de aspetos sociodemográficos e profissionais. Resultados: Os participantes no estudo (n=54) eram maioritariamente do sexo feminino (68,5%). A classe etária dominante (63%) foi a dos 31-40 anos. O estado civil dos enfermeiros dividiu-se quase equitativamente entre os que estão sozinhos e aqueles casados ou união de facto. Quarenta enfermeiros (74,1%) eram licenciados, e os restantes 25,9% mestres. Trinta e três eram enfermeiros (61.1%), os restantes eram especialistas (38,9%). O tempo de serviço mais frequente (46,3%) foi 11 a 20 anos, e 2 a 10 anos no Serviço de Urgência. O contrato sem termo foi a modalidade de vínculo mais frequente (74,1%). Só 35,2% dos enfermeiros indicou acumular funções noutra instituição. O valor médio observado para o conjunto de profissionais que constituíram a amostra foi de 80,94±11,95. Considerando que o ponto médio da escala é de 85 pontos, pode considerar-se que os enfermeiros do SU apresentam, em média, níveis medianos de stresse. Das várias componentes da escala, a "carga de trabalho" integrada na componente "ambiente físico" foi um domínio onde foram registados níveis de stresse elevados. Na componente de "ambiente psicológico" a morte do doente e a incerteza quanto aos tratamentos representaram maior stresse para os enfermeiros. No "ambiente social" a relação com os médicos mostrou-se como um fator importante na perceção de stresse pelos enfermeiros. Atendendo aos resultados da relação das variáveis sociodemográficas na perceção do stresse percecionado pelos enfermeiros, avaliado com a ESPE, os enfermeiros do sexo masculino e aqueles que têm a habilitação de mestre apontam para níveis mais elevados de perceção de stresse. Também ao nível do estado civil verifica-se que os enfermeiros casados percecionarem níveis mais elevados de stresse. Pelo contrário, a idade dos enfermeiros, avaliada em classes de 10 anos, não evidenciou ter influência na perceção de stresse. Não se observou uma relação entre as variáveis profissionais e a perceção do stresse pelos enfermeiros, avaliado pela pontuação total da ESPE. Há, porém, diferenças pontuais em fatores da escala que apontam para os enfermeiros que trabalham há pouco tempo no SU e aqueles que aí trabalham entre 11 e 20 anos percecionarem mais stresse associado ao conflito com outros profissionais, assim como uma tendência para os profissionais com contrato a termo certo sentirem percecionarem mais stresse Conclusão: O enfermeiro que trabalha num serviço de urgência está sujeito a inúmeros stressores. Há aspetos técnicos, relacionais e emocionais que potencial o agravamento do stresse nos enfermeiros. Tratando-se de um serviço que lida permanentemente com a vida ou morte do doente, particularmente na área do doente crítico, o stresse do enfermeiro deve ser olhado com atenção, pois as implicações cognitivas do stresse crónico podem fazer o profissional ter uma prestação de menor qualidade. Particularmente na área dedicada a doentes críticos, todas as capacidades cognitivas do enfermeiro são valiosas, pelo que é determinante que se consiga criar um ambiente de reduzido stresse para que os cuidados prestados sejam de elevada qualidade, como se espera e exige que aconteça.


Nurses are a professional group particularly susceptible to experiencing stress due to the nature of their work. The constant exposure to human contact with patients and their families, the management of emergency situations where a small error can compromise the patient's survival or prognosis, interaction with other healthcare professionals, shift work and disruption of circadian rhythms, and the death of patients, among other factors, create a situation in which nurses experience high levels of stress in their daily lives. Objectives: Characterize the sociodemographic and professional profile of nurses in the Emergency Service of a Hospital Center in the north of Portugal; Identify the main factors that induce stress in nurses in the Emergency Department of a Hospital Center in the north of Portugal; Assess the relationship between stress-inducing factors and sociodemographic and professional variables. Methods: A descriptive, cross-sectional correlational study was conducted, evaluating stress levels in a sample of 54 nurses from an emergency department in a hospital in the northern region of Portugal. This was done through the application of the Nurses' Professional Stress Scale and a questionnaire to collect sociodemographic and professional information. Results: The study participants (n=54) were predominantly female (68.5%). The dominant age group (63%) was between 31 and 40 years old. The marital status of the nurses was almost equally divided between those who are single and those who are married or in a domestic partnership. Forty nurses (74.1%) had a bachelor's degree, and the remaining 25.9% had a master's degree. Thirty-three were general nurses (61.1%), while the remaining were specialists (38.9%). The most frequent length of service was 11 to 20 years (46.3%), both overall and in the Emergency Department. Permanent contracts were the most common employment type (74.1%). Only 35.2% of nurses indicated that they held additional positions in another institution. The average observed value for the professionals in the sample was 80.94±11.95. Considering that the midpoint of the scale is 85 points, it can be considered that nurses in the Emergency Department have, on average, moderate to high levels of stress. Among the various components of the scale, "workload" within the "physical environment" domain was an area where high levels of stress were reported. In the "psychological environment" component, the death of patients and uncertainty about treatments were identified as major sources of stress for nurses. In the "social environment," the relationship with doctors was found to be an important factor in nurses' perception of stress. Regarding the relationship between sociodemographic variables and the perceived stress reported by nurses, as evaluated by the Nurses' Professional Stress Scale, male nurses and those with a master's degree reported higher levels of perceived stress. Additionally, married nurses indicated higher levels of stress. On the other hand, the age of nurses, assessed in 10-year intervals, did not show any influence on the perception of stress. There was no significant relationship between professional variables and nurses' perception of stress, as measured by the total score of the Nurses' Professional Stress Scale. However, there were some isolated differences in scale factors indicating that nurses who had recently started working in the Emergency Department and those who had been working there for 11 to 20 years perceived more stress related to conflicts with other professionals. There was also a tendency for professionals with fixed-term contracts to report higher levels of perceived stress. Conclusion: Nurses working in an emergency department are exposed to numerous stressors. Technical, relational, and emotional aspects contribute to the exacerbation of stress in nurses. Considering that this department deals constantly with life or death situations, particularly in critical care, nurses' stress should be closely monitored, as the cognitive implications of chronic stress can impair their performance. In the field dedicated to critical patients, all cognitive abilities of the nurse are valuable, so it is crucial to create a low-stress environment to ensure the provision of high-quality care, as expected and demanded.


Assuntos
Humanos , Feminino , Adulto , Angústia Psicológica , Enfermeiros
16.
Gastroenterol Hepatol ; 47(2): 130-139, 2024 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36870478

RESUMO

AIMS: Patients' perception of their cleansing quality can guide strategies to improve cleansing during colonoscopy. There are no studies assessing the agreement between the quality of cleansing perceived by patients and cleansing quality assessed during colonoscopy using validated bowel preparation scales. The main aim of this study was to compare the cleansing quality reported by patients with the quality during colonoscopy using the Boston Bowel Preparation Scale (BBPS). PATIENTS AND METHODS: Consecutive patients referred to an outpatient colonoscopy were included. Four drawings representing different degrees of cleansing were designed. Patients chose the drawing that most resembled the last stool. The predictive ability of the patient's perception and agreement between the patient's perception and the BBPS were calculated. A BBPS score of <2 points in any segment was considered inadequate. RESULTS: Six hundred and thirty-three patients were included (age: 62.8±13.7 years, male: 53.4%). Overall, 107 patients (16.9%) had inadequate cleansing during colonoscopy, and in 12.2% of cases, the patient's perception was poor. The patient's perception compared to the quality of cleanliness during colonoscopy presented a positive and negative predictive value of 54.6% and 88.3%, respectively. The agreement between patient perception and the BBPS was significant (P<0.001), although fair (k=0.37). The results were similar in a validation cohort of 378 patients (k=0.41). CONCLUSIONS: The cleanliness perceived by the patient and the quality of cleanliness using a validated scale were correlated, although fair. However, this measure satisfactorily identified patients with adequate preparation. Cleansing rescue strategies may target patients who self-report improper cleaning. Registration number of the trial: NCT03830489.


Assuntos
Catárticos , Colonoscopia , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Colonoscopia/métodos , Valor Preditivo dos Testes , Colo , Percepção , Polietilenoglicóis
17.
Conserv Biol ; 38(1): e14160, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37551779

RESUMO

The establishment of protected areas is a cornerstone of conservation, but permanent protection could be inefficient or even impossible in some situations. We synthesized the literature on temporarily conserved areas (TCAs) across Canada, the United States, and Mexico. We used a comprehensive search string to retrieve peer-reviewed articles published from 2000 to 2021 from the Web of Science. We identified 27 relevant peer-reviewed articles that examined the potential benefits of TCAs in the study area, indicating TCA is a relatively understudied area of research in the peer-reviewed literature. The TCA studies were highly clustered; 77% of studies focused on protecting a single life stage of migratory species and 61% of studies related to temporary conservation of breeding or staging habitats for migratory birds. Ninety-three percent of studies focused on preventing human-driven threats, mainly on public lands of coastal areas, the Great Plains, and the Mississippi Valley in the central United States. Short-term and experimental studies were the dominant study types. TCAs have the potential to complement permanently protected areas and provide protection when permanent protection is difficult. Some included studies examined their conservation value, but the ecological, social, and economic outcomes of TCAs are unclear. More TCA research is needed to determine the role they could play in conservation worldwide. Embracing the concept of TCAs as conservation tool could lead to more comprehensive and consistent reporting of the outcomes of temporary area-based conservation measures. However, a global review and analysis of effectiveness of TCAs will be required if they are to play a formal role in meeting international targets for biodiversity conservation.


Revisión de áreas terrestres conservadas temporalmente en Canadá, Estados Unidos y México Resumen La creación de áreas protegidas es una piedra angular de la conservación, aunque en algunos casos la protección permanente podría ser ineficiente o incluso imposible. Condensamos la literatura sobre las áreas de conservación temporal (ACT) en Canadá, Estados Unidos y México. Usamos una cadena completa de búsqueda para obtener artículos revisados por pares publicados del 2000 al 2021 en Web of Science. Identificamos 27 artículos relevantes que analizaban el potencial de las ACT en el área de estudio, lo que indica que las ACT es un área poco estudiada en la literatura revisada por pares. Los estudios sobre ACT estaban muy agrupados: el 77% se enfocaban en la protección de un solo estadio de vida de las especies migratorias y el 61% se relacionaban con la conservación temporal de los hábitats de reproducción o de descanso de las aves migratorias. El 93% de los estudios se enfocó en la prevención de amenazas causadas por humanos, principalmente en los terrenos públicos de las áreas costeras, las Grandes Llanuras y el valle del Mississippi en el centro de los Estados Unidos. Los estudios experimentales y a corto plazo fueron el tipo de estudio dominante. Las áreas de conservación temporal tienen el potencial para complementar las áreas de protección permanente y proporcionar protección cuando es complicado proporcionarla permanentemente. Algunos de los estudios incluidos analizaron el valor para la conservación de las ACT, pero aún no están claros sus resultados ecológicos, sociales y económicos. Se necesita más investigación sobre las ACT para determinar el papel que podrían tener en la conservación mundial. Si se acepta el concepto de ACT como una herramienta de conservación, se podrían reportar los resultados de las medidas de conservación basadas en las ACT de forma más completa y consistente. Sin embargo, se requerirá una revisión y análisis global de la eficiencia de las ACT si se espera que tengan un papel formal en el cumplimiento de los objetivos internacionales de la conservación de la biodiversidad.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Estados Unidos , Humanos , México , Biodiversidade , Canadá
18.
Artigo em Inglês | MEDLINE | ID: mdl-37295495

RESUMO

INTRODUCTION: Multiple scales have been designed to stratify the severity and predict the prognosis in the initial evaluation of patients with aneurysmal subarachnoid hemorrhage (aSAH). Our study aimed to validate the most commonly used prognostic scales for aSAH in our population: Hunt-Hess, modified Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), Prognosis on Admission of Aneurysmal Subarachnoid Hemorrhage (PAASH), and Barrow Aneurysm Institute (BAI) scales. METHODS: This study includes all aSAH cases treated at our institution between June 2019 and December 2020. We developed a retrospective cohort by reviewing medical records and radiologic images performed during hospitalization. The outcome was evaluated using the modified Rankin scale (mRS). It was defined as a poor outcome (mRS 4-5) and mortality (mRS 6). The ROC curves and the area under the curve (AUC) of each of the prognostic scales were calculated to evaluate their prognostic prediction capacity. RESULTS: A total of 142 patients were diagnosed with aSAH. A poor outcome occurred in 52.1% of the patients, whereas mortality was 27.5%. The AUC of the scales studied was similar and no significant difference was found between them for predicting a poor outcome (P = .709) or mortality (P = .715). CONCLUSION: We determined that the prognostic scales for aSAH had a similar predictive value for poor clinical outcomes and mortality in our institution, with no significant difference. Thus, we recommend the most simple and well-known scale used institutionally.


Assuntos
Hemorragia Subaracnóidea , Humanos , Prognóstico , Hemorragia Subaracnóidea/diagnóstico por imagem , Resultado do Tratamento , Estudos Retrospectivos , Peru
19.
Rev Esp Cir Ortop Traumatol ; 68(2): 108-120, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37245634

RESUMO

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated. RESULTS: Average age was 67.2years (min 47, max 88), being 56% male population sample. 88% involves primary coxarthrosis, 4% post-traumatic coxarthrosis, 4% secondary avascular necrosis and 4% secondary femoroacetabular impingement. Average surgery time was 116.9min (min 92, max 150). The average time of the first five surgeries was 122.6min, and, regarding the last five interventions, it was 108.2min. Found medical intraoperative complications were four intraoperative markers loss. Average admission time was 4.4days (min 3, max 7), with an average postoperative hemoglobin decrease of 3.08±1.08g/dL, requiring a transfusion in 12% of the cases. Three medical complications have been registered in the meantime of the admission, with a relevant case of a confusional syndrome and a fall, which resulted in a non-displaced AG1 periprosthetic fracture. The analysis of the positioning of registered implants with Mako® system shows 40.55±1.53 acetabular inclination degrees and 12.2±3.6 acetabular anteversion degrees. The postoperative image study carried out on patients, are consistent with Mako® s results, as it shows an acetabular inclination of 41.2±1.7 in Rx, as well as acetabular anteversion of 16±4.6 in CT. Hip length variance ranges depending on preoperative values of 3.91mm (SD: 3.9; min -12, max 3) to 1.29mm (SD: 1.96) after surgery registered with Mako®, with an increase of an average hip length of 5.64mm (SD: 3.35). Rx simple study results show a postoperative difference between both hips of 0.5±3.08mm, which is consistent with Mako® results. Native femoral offset was stable after surgery with a showing difference both pre and post operative of the intervened hip of 0.1mm (SD: 3.7), registered with Mako®. Preoperatory modified Harris punctuation was 41.6±13.3, improving to postoperative values of 74.6±9.7 after four months since the surgery. No complications were registered in immediate postoperative (4month). CONCLUSIONS: Total hip arthroplasty robot-assisted achieves an adequate precision and repeatability of the implant positioning and the postoperative hip dysmetry without showing an increase of associated complications to the technique applied. Surgery time, complications and functional results in a short-time period are similar to conventional techniques applied to great series previously published.

20.
Nutr Hosp ; 41(1): 152-162, 2024 Feb 15.
Artigo em Espanhol | MEDLINE | ID: mdl-38047428

RESUMO

Introduction: Introduction: eating habits are one of the main predictors of health within a person lifestyle. The assessment of these habits will be essential to confirm health-related habits and orientate behaviors of risk for health. Objectives: to assess the eating habits within the health-related lifestyle among Spanish adults from 22 to 72 years of age. Methods: the Health-Related Lifestyle Assessment Scale (E-VEVSA) was applied to a sample of 788 subjects between the ages of 22 and 72. This scale is made up of 52 items and structured in seven dimensions, among which the healthy eating habit was evaluated, which explained a variance of 8.67 % of the total scale (66.87 %) and a Cronbach's alpha of 0.794 for a total alpha of 0.894. Results: sixteen percent of the adults surveyed have healthy eating habits, 68.3 % tend towards health and 15.7 % are unhealthy. Pearson's 2 tests show a positive and significant association of women with healthy eating habits and a significant improvement with age. The inferential data (Student's t-tests and one-factor ANOVA) confirm these differences according to gender and age. Conclusions: it is necessary to promote preventive programs to improve eating habits in the adult population, especially in the 15.7 % that have an unhealthy level of nutrition in their lifestyle.


Introducción: Introducción: los hábitos de alimentación constituyen uno de los factores predictores de salud principales dentro de los estilos de vida adquiridos. La evaluación de dichos hábitos va a ser fundamental para poder reafirmar las conductas saludables y reorientar aquellos hábitos que supongan un riesgo. Objetivos: evaluar el hábito de alimentación dentro del estilo de vida saludable adquirido en adultos españoles de 22 a 72 años de edad. Métodos: a una muestra de 788 sujetos de edades comprendidas entre los 22 y los 72 años de edad se aplicó la Escala de Valoración del Estilo de Vida Saludable Adquirido (E-VEVSA), formada por 52 ítems y estructurada en siete dimensiones, entre las cuales se evaluó el hábito de alimentación saludable, que explicó una varianza de 8,67 % sobre el total de la escala (66,87 %) y un alfa de Cronbach de 0,794 para un alfa total de 0,894. Resultados: el 16 % de los adultos encuestados posee hábitos de alimentación saludables; el 68,3 %, tendente hacia la salud; y el 15,7 %, poco saludables. Las pruebas de 2 de Pearson muestran una asociación positiva y significativa de las mujeres con hábitos saludables de alimentación y una mejora significativa con el transcurso de la edad. Los datos inferenciales (pruebas t de Student y ANOVA de un factor) confirman estas diferencias en función del sexo y la edad. Conclusiones: es necesario promover programas preventivos para la mejora de los hábitos de alimentación en la población adulta, sobre todo, en el 15,7 % que posee un nivel poco saludable de la alimentación en su estilo de vida.


Assuntos
Nível de Saúde , Estilo de Vida , Adulto , Humanos , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Dieta Saudável , Comportamento Alimentar , Hábitos
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