Estudio CURIE-2017: Nociones de los estudiantes del internado rotativo de medicina del Hospital Carlos Andrade Marín (Quito) con respecto al uso y aplicación de estudios imagenológicos / CURIE-2017 Study: Notions of the students of the rotating medical internship of the Carlos Andrade Marín Hospital (Quito) regarding the use and application of general imaging studies

La solicitud inadecuada de estudios médicos basados en imágenes es un problema en Ecuador y otros países. El estudio se realizó con el objetivo de establecer el nivel de conocimientos de 125 internos rotativos de un hospital de Quito, procedentes de varias universidades locales, en el uso de estudios imagenológicos. Ellos tuvieron en general un bajo desempeño en la prueba de conocimientos, por lo que se recomienda instaurar el uso de criterios más apropiados en la enseñanza de radiología en las universidades.

Wrong application of medical image studies is an issue in Ecuador and other countries. This study was done to stablish the level of knowledge on image studies of 125 fellows from several local universities working at a hospital in Quito. The results show low performance in the knowledge test, therefore recomendation is to establish better teaching criteria on radiology subject at Universities.

Concordancia en la codificación clínica del Informe Estadístico en Hospitales Públicos en Tucumán, 2014-2015 / Agreement in Clinical Coding of Medical Records from Public Hospitals in Tucumán, 2014-2015

La información de morbilidad y epidemiología del informe estadístico de hospitalización (IEH) repercute en las estadísticas y en la toma de decisiones en salud. En 2013, el 71,8% (61 002) de los IEH fueron codificados inicialmente en seis servicios estadísticos hospitalarios públicos y controlados o recodificados posteriormente en un nivel central: el Departamento de Estadísticas de Salud de los Servicios (DESS) de la provincia de Tucumán. OBJETIVOS: Evaluar el grado de acuerdo alcanzado en codificación clínica de enfermedades y procedimientos quirúrgicos del IEH entre los codificadores hospitalarios y los del DESS entre septiembre de 2014 y junio de 2015. MÉTODOS: Se realizó un estudio de concordancia en codificación con muestreo aleatorio estratificado y afijación proporcional según producción hospitalaria. Se estimó el grado de acuerdo con el estadístico Kappa (K). RESULTADOS: Se evaluaron 2255 IEH. El 60,39% (1362) contenía codificado un segundo diagnóstico, y el 54,01% (1218), un procedimiento quirúrgico. El grado de acuerdo en la codificación entre el DESS y los hospitales fue: K=0,74 en el diagnóstico principal; K=0,61 en el segundo diagnóstico; y K=0,75 en procedimientos quirúrgicos. CONCLUSIONES: El grado de acuerdo en la codificación clínica del IEH fue bueno

A eficácia de diferentes tratamentos em pacientes com transtorno de humor: um estudo comparativo / The efficacy of different treatments in patients with mood disorder: a comparative study

A principal contribuição deste trabalho consiste em apresentar a evolução clínica de usuários de um Centro de Atenção Psicossocial na cidade de Brasília, com o diagnóstico de transtorno de humor, que utilizam antidepressivos como uma das modalidades terapêuticas, e correlacionar, com as variáveis: idade, sexo e outras formas de tratamento. Este estudo epidemiológico, descritivo, exploratório, retrospectivo e documental foi realizado com prontuários de pacientes em tratamento no CAPS-II da região administrativa de Samambaia-DF, no período de junho de 2013 a julho de 2014. Os dados foram avaliados através do Software SPSS e executadas análises descritivas e inferenciais, com o teste qui-quadrado, para verificar a associação entre as variáveis, com nível de significância de 5%. Não se obteve diferença significativa na eficácia quanto ao fármaco utilizado, no entanto, quando submetidos a outras modalidades terapêuticas, como, por exemplo, psicoterapia, os pacientes obtiveram melhora independentemente do fármaco utilizado. Conclui-se que as evoluções não dependem da escolha da classe de antidepressivos, pois as melhores respostas terapêuticas são alcançadas quando associadas a outras modalidades terapêuticas

The main contribution of this work is to present the clinical evolution of the users of one Psychosocial Care Center in Brasília with a diagnosis of mood disorder, using antidepressants as one of therapeutic modalities, and correlate with the variables: age, sex and other forms of treatment. This epidemiological, descriptive,exploratory, retrospective and documentary study was conducted with medical records of treatment in patients at CAPS-II administrative region of Samambaia-DF, from June 2013 to July 2014. Descriptive and inferential analyzes were evaluated by SPSS Software using chi-square test to verify the association between variables, withsignificance level of 5%. It has not obtained a significant difference in efficacy on the drug used, however, when undergoing other therapies, such as psychotherapy, patients had improvements regardless of the drug used. Concluding that developments do not depend of the choice of antidepressant class, as the best therapeutic responses are achieved when combined with other therapeutic modalities

Associação entre predição para lesão por pressão e marcadores bioquímicos / Association between pressure injury prediction and biochemical markers

Verificar a associação da predição de lesão por pressão com os níveis de albumina, hematócrito ehemoglobina. Métodos: estudo documental, desenvolvido em uma Unidade de Terapia Intensiva para Adultoscom prontuários de pacientes elegíveis (n=255). Foram extraídas variáveis de caracterização sociodemográficae clínica, desenvolvimento de lesão por pressão e região; escore da escala de Braden e resultados dosmarcadores bioquímicos. Fez-se análise estatística descritiva e inferencial, adotando-se nível de significânciade 5,0%. Resultados: houve prevalência do sexo masculino (64,7%) e de pacientes cirúrgicos (69,8%). Nãohouve associação estatística significativa entre os marcadores de hematócrito e hemoglobina com a prediçãode lesão por pressão, diferentemente dos níveis de albumina (p=0,023). Conclusão: há associação de prediçãode lesão por pressão no que se refere à albumina. O aporte proteico do paciente deve ser visto com maior rigorpela equipe de saúde.

Objective: to verify the association of pressure injury prediction with albumin, hematocrit and hemoglobin levels. Methods: documentary study, developed in an Intensive Care Unit for Adults with records of eligible patients (n=255). Sociodemographic and clinical characterizations lesion, development of pressure injury and region; a score of the Braden scale and results of biochemical markers were extracted. There was a descriptive and inferential statistical analysis, adopting a significance level of 5.0%. Results: there was a prevalence of males (64.7%) and surgical patients (69.8%). There was no significant association between hematocrit and hemoglobin markers with the pressure injury prediction, unlike albumin levels (p=0.023). Conclusion: there is an injury pressure prediction association in the albumin. The protein intake of the patient should be seen in greater detail by the health team.

Avaliação do perfil periodontal dos pacientes atendidos na Faculdade de Odontologia da Unievangélica / Periodontal assessment profile of patients treated in the College of Dentistry UniEVANGÉLICA / Periodontal assessment profile of patients treated in the College of Dentistry UniEVANGÉLICA

INTRODUÇÃO: A Doença Periodontal é caracterizada por uma doença infecciosa resultante da inflamação dos tecidos de suporte e do tecido de revestimento dos dentes. Esta pode ser classificada em: gengivite quando compromete o periodonto de proteção e periodontite que acomete os tecidos de inserção. OBJETIVO: Este estudo teve como objetivo verificar o perfil periodontal dos pacientes atendidos na Faculdade de Odontologia da UniEVANGÉLICA, Anápolis- GO. MATERIAL E MÉTODO: Esta pesquisa documental descritiva retrospectiva avaliou prontuários de pacientes atendidos na clínica da Faculdade de Odontologia da UniEVANGÉLICA no período de 2009 a 2014. Nos prontuários foram analisados principalmente o Registro Periodontal Simplificado (PSR), a classificação da doença periodontal e o periograma dos pacientes que apresentaram periodontite. RESULTADOS: Dentre os 233 prontuários, 68% (n = 158) eram mulheres, 33,05% (n = 77) tinham entre 40 e 50 anos e 21% (n = 51) eram fumantes. Destes, 55 % (n = 129) possuíam gengivite e 45% (n=104) periodontite. Dos pacientes com periodontite, a Crônica Localizada foi constatada em 48% (n = 50), a Crônica Generalizada em 40% (n = 42), enquanto as Agressivas Localizada e Generalizada foram encontradas em 7% (n = 7) e 5% (n = 5) respectivamente. Pelos dados do PSR, pode-se observar que 49% (n = 114) apresentaram o código asterisco. CONCLUSÃO: De acordo com os resultados obtidos nesta pesquisa, pode-se notar uma prevalência de pacientes do gênero feminino e a gengivite foi a doença periodontal mais prevalente seguida pela periodontite crônica localizada.

INTRODUCTION: The Periodontal Disease is characterized by an infectious disease resulted from the inflammation of covering tissues (gingivitis) and/or of the support tissue (periodontitis) of teeth. OBJECTIVE: The objective of this study was to verify the periodontal profile of the patients attended at UniEVANGÉLICA’S Dental School. MATERIAL AND METHOD: This is a descriptive documental and retrospective research that evaluated the records of the patients that were attended at UniEvangélica’s Dental School clinic from 2009 to 2014. The Periodontal Screening and Record (PSR), the periodontal disease’s classification and the periodontal chart of the patients that presented periodontitis were the main analysis performed from the records. RESULTS: Among the 233 records, 68% (n=158) were women, 33,05% (n=77) among 40 to 50 years old and 21% (n=51) were smokers. Among these, 55% (n=129) presented gingivitis, from the patients with periodontitis, 48% (n=50) were diagnosed with the Localized Chronic periodontitis, 40% (n=42) with the Generalized Chronic, while 7% (n=7) and 5% (n=5) had the Aggressive Localized and the Generalized Periodontitis, respectively. Through the PSR data, it was noticed that 49% (n=114) presented the asterisk code. CONCLUSION: According to the results of this research, a female prevalence could be noticed and the gingivitis was the most prevalent periodontal disease, followed by the Localized Chronic Periodontitis

Integridad de la información del subsistema estadístico de urgencias en el Hospital Provincial Manuel Ascunce Domenech, de Camagüey / Information integrity in the emergency statistics subsystem of Manuel Ascunce Domenech Provincial Hospital in Camagüey

Objetivo: se realizó un estudio de evaluación en el Departamento de Registros Médicos y Estadísticas del Hospital Provincial Manuel Ascunce Domenech, de Camagüey, durante el año 2012, con el objetivo de evaluar la integridad de la información del subsistema de urgencias. Métodos: para determinar el nivel de eficacia se aplicó una encuesta a los médicos que atienden el Cuerpo de Guardia. Se utilizó la matriz BAFI como instrumento gerencial. Resultados: los resultados obtenidos permiten calificar la integridad de la información estadística del Servicio de Urgencias como deficiente. La elevada pérdida económica ocasionada por la omisión del diagnóstico manifiesta la ineficiencia estadística del subsistema. Se evidencia un predominio de las debilidades sobre las fortalezas, la vulnerabilidad ante las amenazas y el poco aprovechamiento de las oportunidades. Recomendaciones: se recomienda la aplicación de la propuesta de acciones elaborada, con el propósito de revertir dicha situación

Objective: an evaluation study was conducted in the Department of Medical Records and Statistics of Manuel Ascunce Domenech Provincial Hospital in Camagüey during the year 2012, with the purpose of evaluating the integrity of the information stored in the emergency subsystem. Methods: determination of the level of efficacy was based on a survey given to doctors from the emergency service. The Innovative Power Balance Matrix was used as a management instrument. Results: integrity of the statistical information in the Emergency Service was evaluated as deficient, based on the results of the study. The considerable economic loss caused by the omission of diagnoses is evidence of the statistical inefficiency of the subsystem. It was found that weaknesses predominate over strengths, there is vulnerability to threats, and opportunities are hardly taken advantage of. Recommendations: it is recommended that the actions proposed are implemented, with a view to overcoming the present deficiencies

Compendio estadístico de egresos hospitalarios 2012. Resumen ejecutivo / Statistical Compendium 2012 hospital discharge. executive Summary

En el periodo 2002 al 2012, los egresos hospitalarios se incrementaron en 307 mil 683 pacientes egresados, equivalente aproximadamente a 30 mil 768 egresos hospitalarios por año, es decir, un incremento de 56% respecto a los egresos hospitalarios del 2002 que fue de 547 mil 733 pacientes egresados

Compendio estadístico de egresos hospitalarios Perú: 2011 / Statistical Compendium of hospital discharges Peru: 2011

El compendio estadístico, brinda información de la producción de los servicios hospitalarios del año 2011. Asimismo, se basa en las tablas básicas recomendadas por la Clasificación Internacional de Enfermedades y Problemas Relacionados con la Salud, décima revisión, CIE 10, que se viene utilizando desde 1999

[Assessment of hospital information system efficiency [SHAFA] in IMAM REZA hospital]

Mechanized hospital software [HIS: Hospital Information System], is a replacing way for manual activities in hospital. This system leads to mechanize hospital activities from admission to patient discharge, effective relation between wards and being more quick and exact extraction of managing and statistical report. Nowadays, use of HIS will help improve level of recognizing problems, improving management, increasing efficiency of hospital managers, improvement in render services, increasing in level of hospital services, specialized medical services and more technical hospital structure. This study is a descriptive- analytical assessment. In this research all of users and hospital information technicians in IMAM REZA hospital took part in the study. Questioners checklist, library and web research were used together literature review, reliable and valid data were analyzed with SPSS statistical software. After concluding the row information, from statistical program named SPSS, we analyze them and the conclusion is:- 56% of users were women and 44% were men.- All HIS users are between 25-45 years old.- 44% of HIS users had BA degree and only 6% of them had master degree.- 42% of HIS users are in the range of [0-5] years old and 6% in the range of [16-20] years old had maximum to minimum level of occupational experiments.- Only 8% of users had passed ICDL courses in army association, So efficiency of 8% users had maximum level. This study emphasized on education of HIS users with different methods, make effective relation between HIS users and program technicians, repairing structure of the reporting system, improving the hardware structure and defining the level of special accessibility to software program. Finding express 64% of 52 system users are satisfied with HIS. In assessment of working system users believe that 55% of needed capabilities existed in software and on the other hand deficiency of 45% of necessary capabilities can be considered as a major problem and is being asked to be removed and increased the efficiency. Ultimately results show 70% of users assumed the speed of system is proper and 76% are satisfied with the net connection of HIS and confirmed it. Incidentally 39% of users expressed the back of system is suitable and provides the hospital necessities

[Adequacy of data on injuries' external causes for coding based on ICD-10 in inpatient medical records and emergency wards of Shahid Beheshti Hospital In Kashan]

Background and Aim: Knowledge about the external causes of accidents is vital for their prevention, and insufficient data on external causes can reduce their usefulness. That is why, the adequacy of the sources of data is of great importance. The aim of this research is to study the adequacy of data regarding the injuries' external causes for coding based on ICD-10 in inpatient medical records and emergency wards of Kashan Shahid Beheshti Hospital

Materials and Methods: This prospective descriptive cross-sectional research was done on 1000 patients in Kashan Shahid Beheshti Hospital in 1386 [2007]. The data needed for coding were chosen from medical records based on ICD-10 rules and for the following groups: transportation accidents, poisoning, burns, lightning, assaults, respiratory threats, intentional self harm, contact with venomous animals, and exposure to animate and inanimate mechanical forces. Then, the data were put in a checklist and analyzed with SPSS and descriptive statistics

Results: The data required for the three main characters of the external causes of injuries were adequate in 740 files [47%]; the figure for the fourth character of the external causes of transportation accidents was found to be 430 [88.7%]. Figures for the place of occurrence and the type of subjects' activities at the time of accidents were found to be sufficient in 109 cases [21.16%] and 50 cases [5%], respectively

Conclusion: Data on the eternal causes of injuries do not have the required adequacy. More evaluations are essential to enhance the adequacy of such data

[ role of medical records in the implementation of the EFQM model in hospital]

Background and Aim: Information is a factor for organizations success and organizations try to stay in this competitive world. In each organization, there are sections that have special role in information aspect; in hospitals and healthcare centers, this role is for medical record section which organizes all of the patients' health care information. Paying attention to function quality in this section[medical record] is very important. Since health ministry introduce[EFQM] as an Excellence Model for hospitals, there fore, the role and importance of medical record section in implementation of this model and its criteria is determined

Materials and Methods: All of the information databases was collected and those which were appropriate were selected. Then according to the article's goal, proper keywords were selected and documented through comparing with MESH. Finally related articles in credible journals were used in two Persian and English languages

Results: After determining all the concepts and criteria of EFQM and matching them to the medical record section's goals, task's and functions, feasibility study of EFQM implementation in medical record section, is approved. With this comparism, importance of this section's role in signification model scores hospitals quality of performance is determined

An audit of non-urgent general adult referrals to Stikland State Psychiatric Facility

Objectives. The national Department of Health strongly advocates the strengthening of primary health care systems; and recommendations for appropriate level of care referrals exist. Very few published data on the scope of current ambulatory specialised psychiatric hospital services in South Africa are currently available; making it difficult to assess whether these recommendations are being followed. As a starting point; an audit was conducted to obtain a profile of new non-urgent general adult patients seen at Stikland Hospital with a view to evaluating system needs and demands. Methods. The folders of 103 consecutively seen patients were selected for retrospective review. Patient demographic; referral and assessment information was entered into a single database. Descriptive statistics were compiled with reference to the above variables using SPSS. Results. Overall 58.3 of referrals were from the private sector. More than a third (36.7) of referral letters stated no clear reason for referral and 41.7 no psychiatric diagnosis; and 29.1 of patients were referred without psychotropic medication being started. On assessment 62.1 of patients were found to have a single Axis I diagnosis. Despite virtually no referral letters making any mention of them; substance use disorders (30.1); personality traits/disorders (35.9) and co-morbid medical illness (36.7) were commonly found on assessment. Conclusions. A significant portion of the patients in our sample could have been managed at primary care level and were referred prematurely. The overall quality of referral letters was poor; and they lacked vital information required for appropriate preassessment decision making. Undergraduate training focusing on these skills should be intensified; and consideration should be given to incorporating aspects of our findings into primary health care updates

Evaluación del Sistema de Radiocomunicación Implementado en el Área de Salud Nº3, del Cantón Salcedo de la Provincia del Cotopaxi / Evaluation of the System of Implemented Radio communication in the Area of Health Nº3, of the Canton Salcedo of the County of the Cotopaxi

Los procesos, trámites, actividades, tanto adminsitrativas como técnicas de salud; desde años atrás se los ejecuta de manera lenta, a destiempo, y en algunos casos sin considerar fuentes de información adecuadas y reales. esta situación pone en serio peligro la vida humana individual y colectiva sobre todo de grupos vulnerables, quienes por su ubicación geográfica, condiciones socio-económicas, políticas, religiosas, culturales, de género, medio ambiente, tienen dificultades para el acceso a las unidades de salud con el consiguiente riesgo para su vida. El servicio de salud podría operar eficientemente a través de una red de comunicación que conecte el centro urbano con el rural, de esa manera se podría resolver algunos de los problemas que enfrentan estas unidades tales como déficit de profesionales y funcionarios de salud, reducido presupuesto

Ergonomics disorders in the personnel of medical records department at training hospitals of Shiraz University of medical sciences

The current study was designed to focus on the status of work-related musculoskeletal disorders in the personnel of Medical Records Departments of training hospital affiliated to Shiraz University of Medical Sciences. Since occupational safety has a direct impact on efficiency, assessment of personnel health is of great importance. This cross-sectional descriptive survey included 75 personnel of medical records departments. The required data were collected in Noredic and a demographic questionnaire. It was shown that 92% of the subjects in this study suffered from musculoskeletal disorders. In 2005 they had 177 days off work. Also they were visited by a doctor because of musculoskeletal disorders 26 times in a year and they had 37 days off work. They reported that MSD or pain were present in lumbar 9.3%, neck 9.3%, shoulders 6.7% and wrist 10.7%. There was an insignificant relationship between demographic variables and work related injuries. In 69.3% of the cases, pain quality of MSD was observed at working and in 37.3% cases pain severity was with 3 degrees. Researchers propose use ergonomic factors in workplace to prevent musculoskeletal disorders for medical records staff

[Total quality management princples and concepts; implementation in medical records departments [Iran University of Medical Sciences; teaching hospitals, 2004]]

It is very important to use fundamental of total quality management in medical record department as a part of hospitals which their action has a tremendous affect on performance, evaluation, and upgrading the quality and quantity of health care activities in hospitals. The research were done with the idea of measurement of the rate of applying fundamental of total quality management in medical record departments of Iran University of Medical Sciences' teaching hospitals to report suggestions for upgrading the department performance. This is a descriptive cross- sectional study were done in 2004. The study population is all personnel of medical record departments of Iran University of Medical Sciences' teaching hospitals and data were collected by a questionnaire and were analyzed by SPSS. Our findings showed that in medical record departments of Iran University of Medical Sciences' teaching hospitals only the concept of" raise and reward "was worst between the nine sections of total quality management. According to the out coming results, it is clear that some activities must been arranged to improve group and personal participation, training workshops periodically, collection, analyzed, and evaluation of customers' point of view and redesign different medical record department

Valoración y registro de signos primarios de infección en sitio de salida de catéter peritoneal / Assessment and recording of primary infection symptoms in the peritoneal catheter's insertion site

Introducción: La infección del sitio de salida del catéter de diálisis peritoneal es una complicación frecuente, la causa de peritonitis y pérdida del mismo. El cuidado de enfermería, incluye la valoración y registro de datos que sugieren evolución satisfactoria o detección oportuna de complicaciones, mismas que deben documentarse de forma objetiva, precisa, completa y oportuna. Objetivo: Identificar en qué proporción el personal de enfermería realiza la valoración y registro de signos primarios de infección en el sitio de salida del catéter peritoneal de pacientes pediátricos. Metodología: En una muestra convencional de 100 enfermeras que atendieron pacientes pediátricos con terapéutica de diálisis peritoneal, se evaluaron los procedimientos de valoración y registro de signos primarios de infección en sitio de salida del catéter dialítico. Los datos se recolectaron de la hoja de Registros Clínicos, Tratamientos y Observaciones de Enfermería. El análisis fue con estadística descriptiva. Resultados: Solo 6% del personal de enfermería valora y registra signos primarios de infección del sitio de salida del catéter de diálisis peritoneal, dicha proporción corresponde a enfermeras generales. Los datos textualmente referidos y registrados con mayor frecuencia son, infección y salida de secreción. Conclusiones: Una adecuada valoración y registro por parte del personal de enfermería de los signos primarios de infección, radica en la oportunidad de la detección, prevención de peritonitis y de la consecuente pérdida del catéter peritoneal.

Assessment and recording of primary infection symptoms in the peritoneal catheter's insertion site Introduction: Infection in the peritoneal catheter's insertion site is a frequent complication, the origin of peritonitis and lost of the catheter. Nursing care include assessment and recording of data that suggest a satisfactory evolution or an opportune detection of complications, which should be documented in an concrete, concise, complete and suitable way. Objective: Identify the percentage of nursing staff that assess and record the primary signs of infection in the peritoneal catheter's insertion site in pediatric patients. Methodology: With a conventional sample of 100 nurses that assisted pediatric patients with treatment of peritoneal dialysis, it was evaluated the procedures of assessment and recording of primary signs of infection in the peritoneal catheter's insertion site. The data was collected in the form called Clinic Recording, Treatments, and Nursing Observations (4-30-61/86). The analysis was done with descriptive statistic. Results: Only 6% from the nursing staff assess and record the peritoneal catheter's insertion site; that proportion corresponds to registered nurses. The data registered with major frequency are: infection and secretion discharge, literally referred them. Conclusions: An appropriate assessment and data recording from nursing staff about primary signs of infection, provides an opportunity to detect, prevent peritonitis, and the consequent lost of the peritoneal catheter.

Studying the staffs job satisfaction in admission unit of training hospitals affiliated with Shiraz University of Medical Sciences

Job satisfaction is one of the key factors affecting professional success which, in turn, allows an organization to achieve its objectives. And ultimately it can result in individual and social health. Thus, managers are highly concerned with factors affecting job satisfaction. In this study, it was decided to investigate factors determining the staffs job satisfaction. It was a descriptive analytic study in which data were collected by a standard questionnaire in nine training hospitals affiliated with Shiraz University of Medical Sciences in 1380. The questionnaire was given to fifty people working in admission unit. The data were analyzed by t-test, kruskal-wallis, pearson correlation and one way ANOVA. Findings of the study revealed that there was a significant relationship between sex and job satisfaction on the one hand and promotion and salary on the other. There was also statistically meaningful relationship between organizational position and job satisfaction. In order to increase the productivity in admission units, the staffs job satisfaction must be fulfilled. In addition, by reducing the gap between different social classes and achieving a logical distinction in exploiting economic and social rights, we can make organizational objectives closer to staffs expected tasks