RESUMO
Background: Diabetic retinopathy is a progressive disfunction of blood vessels of the retina secondary to chronic hyperglycemia. There are several treatments, out of which panretinal photocoagulation (PRP) stands out. Objective: To compare the level of pain in patients undergoing PRP with different impulse. Material and methods: Comparative, cross-sectional study that compared the level of pain in patients undergoing PRP with a 50-millisecond pulse (group A) versus conventional 200 milliseconds pulse (group B). Mann-Whitney U test was used. Results: There were 26 patients, 12 (46.16%) female and 14 (53.84%) males. The median age was 58.73 ± 7.31 (40-75) years. 40 eyes were studied, 18 (45%) right and 22 (55%) left. The mean level of glycated hemoglobin was 8.15 ± 1.08 (6.5-12) %. The mean laser power was 297 ± 53.61 (200-380) and 214.5 ± 41.73 (170-320) milliwatts; the mean fluence was 18.85 ± 5.28 (12-28) J/cm2 and 65.9 ± 12.87 (52-98) J/cm2; the mean level of pain was 3.1 ± 1.33 (1-5) and 7.5 ± 1.23 (6-10) points for group A and B, respectively, and there was statistically significant difference (p Ë 0.001) in the level of pain. There were no complications in any group. Conclusion: The application of retinal 50-millisecond pulse PRP causes less pain and side effects than 200-millisecond pulse PRP.
Introducción: la retinopatía diabética es una disfunción progresiva del sistema vascular de la retina que es secundaria a una hiperglucemia crónica. Hay varias opciones de tratamiento, entre las que destaca la panfotocoagulación. Objetivo: comparar el nivel de dolor en pacientes sometidos a panfotocoagulación retiniana con diferente impulso. Material y métodos: estudio comparativo, transversal, que comparó el nivel de dolor en pacientes sometidos a panfotocoagulación con impulso de 50 milisegundos (grupo A) frente a impulso convencional de 200 milisegundos (grupo B). Se utilizó U de Mann Whitney. Resultados: fueron 26 pacientes, 12 (46.16%) mujeres y 14 (53.84%) hombres. La edad mediana fue 58.73 ± 7.31 (40-75) años. Se estudiaron 40 ojos, 18 (45%) derechos y 22 (55%) izquierdos. El nivel medio de hemoglobina glucosilada fue 8.15 ± 1.08 (6.5-12)%. La potencia láser media fue 297 ± 53.61 (200-380) y 214.5 ± 41.73 (170-320) miliwatts, la fluencia media fue 18.85 ± 5.28 (12-28) J/cm2 y 65.9 ± 12.87 (52-98) J/cm2, el nivel medio de dolor fue 3.1 ± 1.33 (1-5) y 7.5 ± 1.23 (6-10) puntos para el grupo A y B, respectivamente y hubo diferencia estadísticamente significativa (p ≤ 0.001) en el nivel de dolor. En ningún grupo hubo complicaciones. Conclusión: la aplicación de panfotocoagulación retiniana con impulso de 50 milisegundos provoca menos dolor y efectos secundarios que la panfotocoagulación con impulso de 200 milisegundos.
Assuntos
Retinopatia Diabética , Retina , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Retina/cirurgia , Fotocoagulação a Laser/efeitos adversos , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Dor/etiologiaRESUMO
BACKGROUND: The testicular cancer prevails in the third decade of life, the care cost increases with higher staging of the disease. OBJECTIVE: Compare the direct costs of medical and surgical attention for testicular cancer in early and advanced stages in a Third Level Medical Facility. MATERIAL AND METHODS: Process study, direct costs of medical attention are evaluated. Number of laboratory studies, imaging studies, and medical and surgical treatment were analyzed. The patients were divided into 2 groups: group 1 early stages and group 2 advanced stages. Mann Whitney U test was used for the difference between groups. RESULTS: There were 10 patients in each group, Group 1: 8 (80%) seminomas and 2 (20%) non-seminoma, Group 2: 4 (40%) seminomas and 6 (60%) non-seminomas. The average cost of care in Group 2 is higher than in Group 1, $288,827.90 and $145,911.70 Mexican pesos respectively (p=0.00578). CONCLUSIONS: The direct cost of medical attention is higher in the advanced stages compared to the early stages.
Assuntos
Neoplasias Embrionárias de Células Germinativas , Neoplasias Testiculares , Custos e Análise de Custo , Humanos , Masculino , Previdência Social , Neoplasias Testiculares/cirurgiaRESUMO
Introducción: el síndrome de fragilidad se caracteriza por la disminución de la reserva fisiológica y una menor resistencia a los factores estresantes, como resultado del deterioro progresivo en los sistemas fisiológicos. Objetivo: determinar la relación de fragilidad y depresión en el adulto mayor hospitalizado. Metodología: estudio descriptivo, transversal y correlacional. Se incluyeron adultos mayores hospitalizados en una unidad médica de tercer nivel con edad mínima de 70 años. Se utilizó la escala FRAIL versión mexicana para la fragilidad y la escala de depresión geriátrica de Yesavage. Para la prueba de normalidad de las escalas se utilizó la prueba de Shapiro-Wilk, y para obtener la correspondencia de las variables el coeficiente de correlación de Pearson. Resultados: se incluyeron 31 adultos mayores con edad promedio de 75 años (± 3.4), 14 (45.2%) mujeres y 17 (54.8%) hombres. Para la escala de fragilidad y depresión se encontró: w = 0.053 y w = 0.059, respectivamente. Se obtuvo un coeficiente de correlación de Pearson de 0.709. Conclusión: se determinó que existe correlación entre la fragilidad y la depresión en el adulto mayor hospitalizado.
Introduction: The frailty syndrome is characterized by decreased physiological reserve and decreased resistance to stressors, as a result of progressive deterioration in physiological systems. Objective: To determine the relationship between frailty and depression in hospitalized older adults. Methods: Descriptive, cross-sectional, and correlational study. Were included older adults hospitalized in a third level care unit with a minimum age of 70 years. The FRAIL Mexican version Scale for frailty and the Yesavage Geriatric Depression Scale were used. For the normality test of the scales, the Shapiro-Wilk test was used, and the Pearson correlation coefficient was used to obtain the correspondence of the variables. Results: Thirty-one older adults with a mean age of 75 years (± 3.4) were included, 14 (45.2%) women and 17 (54.8%) men. For the Fraility and Depression scale were found a w = 0.053 and w = 0.059, respectively. A Pearson correlation coefficient of 0.709 was obtained. Conclusion: There is a correlation between frailty and depression in hospitalized older adults.