Incidencia y tratamiento de las cardiopatías congénitas en San Miguel del Padrón / Incidence and treatment of congenital heart disease in San Miguel del Padrón

Introducción: los defectos congénitos cardiovasculares son en la actualidad con frecuencia, la causa de muerte en los primeros años de vida, y la detección de estos en la etapa fetal, les proporciona a los futuros padres, los conocimientos que les permite tomar una decisión, con respecto a continuar o no con el embarazo. Objetivo: analizar la incidencia y tratamiento de las cardiopatías congénitas, en el municipio San Miguel del Padrón, en el periodo entre enero de 2007 y diciembre de 2010. Métodos: se realizó un estudio descriptivo acerca del diagnóstico prenatal y postnatal de las cardiopatías congénitas, en el municipio San Miguel del Padrón, entre el 1ro de enero de 2007 y el 31 de diciembre de 2010. ..

Introduction: Nowadays, cardiovascular birth defects are often the cause of death in the first years of life, and the detection of these in the fetal stage, provides prospective parents, the knowledge that enables them to make a decision, regarding whether to continue pregnancy. Objective: To analyze incidence and treatment of congenital heart disease in the municipality of San Miguel del Padrón, from January 2007 to December 2010. Methods: We carried out a descriptive study on the prenatal and postnatal diagnosis of congenital heart disease in the municipality of San Miguel del Padrón, from 1st January 2007 to December 31st, 2010. ..

Self-management and biomedical outcomes of a cooking, and exercise program for patients with chronic kidney disease.

BACKGROUND: Limited research has been done on integrating cooking and exercise classes into the routine care of chronic kidney disease (CKD) patients. The main purpose of the research was to determine whether the addition of these services would slow the progression of certain CKD parameters. METHODS: The study evaluated 5 endpoints, at baseline, 6 months, and 12 months: urinary protein, blood pressure, urinary sodium, glomerular filtration rate, and total cholesterol between 2 groups (control group receiving CKD standard care and experimental group receiving standard care plus cooking and exercise classes). Eighty percent of the experimental group was hypothesized to improve in 4 out of the 5 endpoints versus ≤50% in the control group with a P-value of 0.05. An overall difference of 30% was anticipated between the 2 groups. The research also compared self-efficacy and health status outcomes using a self-management questionnaire. RESULTS: Forty randomly assigned patients participated in the study (17 controls and 23 experimental). In the control group, 2 of 17 people improved in at least 4 of the 5 endpoints. In the experimental group, 14 of 23 people improved in at least 4 of the 5 endpoints. CONCLUSIONS: Sixty-one percent of experimental subjects showed improvements in 4 of 5 endpoints, showing a significant difference overall when compared with the control group (12% improved in 4 out of 5 endpoints). In looking at the trend in qualitative measures from the comparison of the self-management questionnaire, the overall trend showed more improved answers with the experimental group versus the control group.

Assessing the metabolic and clinical consequences of early enteral feeding in the malnourished patient.

BACKGROUND: It is often thought that enteral feeding should be initiated slowly in those who are severely malnourished. This descriptive study examined the effect of an enteral feeding protocol on the typical metabolic consequences seen in refeeding syndrome. METHODS: A retrospective chart review was conducted on 51 patients who had been placed on hospital-wide enteral feeding and electrolyte replacement protocols over a 9-month period to determine whether there were any negative clinical consequences to early feeding. RESULTS: Goal feeding rate was achieved within 17.6 +/- 8.7 hours. Forty patients (80%) developed depletions in phosphate, magnesium, or potassium after initiation of enteral feeding, including 93% of those deemed "at risk" and 74% of those "not at risk." All patients received electrolyte replacement according to protocols, and no patients showed any negative clinical effect. CONCLUSIONS: This study showed that malnourished patients at risk for refeeding syndrome can be fed early without observed negative clinical consequences. An electrolyte replacement protocol may be an effective means of minimizing the electrolyte imbalances associated with early feeding. It also demonstrated the significance of applying such protocols to all patients requiring enteral support, as current methods of assessing "risk"for refeeding syndrome may be inadequate.