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1.
Univ. salud ; 25(2): E19-E25, mayo-ago. 2023. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1510653

ABSTRACT

Introducción: La evaluación de los pacientes con tuberculosis pulmonar permite establecer metas de intervención en salud; el test de caminata de los 6 minutos, es ideal para observar la respuesta de todos los sistemas incluidos durante el ejercicio. Objetivo: Describir la respuesta fisiológica de algunas variables ventilatorias y cardiovasculares durante el test de caminata de los 6minutos en pacientes con secuelas de tuberculosis pulmonar, y sus posibles correlaciones de las variables fisiológicas con la distancia recorrida. Materiales y métodos: Estudio descriptivo de corte transversal en 21 pacientes con diagnóstico de secuelas de tuberculosis pulmonar, quienes asistieron a un programa de rehabilitación pulmonar, y realizaron test de caminata de los 6 minutos. Resultados: La edad media fue 49,33±18,82 años, en su mayoría hombres, la media de la distancia fue 348,35±127,833m. Hubo diferencia significativa durante los cuatro momentos analizados con un valor p<0,0001 en frecuencia cardiaca, frecuencia respiratoria y saturación de oxígeno. Hubo correlación fuerte para la edad, consumo de Oxígeno (VO2), número de detenciones, disnea modified Medical Research Council (mMRC), capacidad funcional medida en equivalentes Metabólicos (METS) y Saturación de Oxígeno (SpO2).Conclusión: Pacientes con secuelas de tuberculosis pulmonar en su mayoría hombres, evidencian cambios estadísticamente significativos durante la prueba.


Introduction:The assessment of patients with pulmonary tuberculosis is useful to establish health intervention goals. The 6-minute walk test is key to observing the response of all of the body systems involved in the exercise. Objective:To describe the physiological response of some ventilatory and cardiovascular variables during the 6-minute walk test in patients with pulmonary tuberculosis sequelae and possible correlations between physiological variables and the covered distance. Materials and methods:Descriptive cross-sectional study on 21 patients diagnosed with sequelae caused by pulmonary tuberculosis, who attended a pulmonary rehabilitation program and performed a 6-minute walk test. Results: The mean age of patients was 49.33±18.82 years, mostly men, and the mean distance was 348.35±127833 m. There was a significant difference in heart rate, respiratory rate andoxygen saturation during the four analyzed moments, with a pvalue < 0.0001. There was a strong correlation for age, oxygen consumption (VO2), number of stops, dyspnea modified Medical Research Council (mMRC), functional capacity measured as metabolic equivalents (METS) and oxygen saturation (SpO2). Conclusion:Most male patients with pulmonary tuberculosis sequelae show statistically significant changes during the test.


Introdução:A avaliação de pacientes com tuberculose pulmonar permite estabelecer metas de intervenção em saúde; O teste de caminhada de 6 minutos é ideal para observar a resposta de todos os sistemas incluídos durante o exercício. Objetivo: Descrever a resposta fisiológica de algumas variáveis ventilatórias e cardiovasculares durante o teste de caminhada de 6 minutos em pacientes com sequela de tuberculose pulmonar e suas possíveis correlações das variáveis fisiológicas com a distância percorrida. Materiais e métodos:Estudo transversal descritivo em 21 pacientes diagnosticados com sequelas de tuberculose pulmonar, que frequentavam um programa de reabilitação pulmonar, e realizaram o teste de caminhada de 6 minutos. Resultados:A média de idade foi de 49,33±18,82 anos, a maioria homens, a distância média foi de 348,35±127,833m. Houve diferença significativa nos quatro momentos analisados com valor de p< 0,0001 na frequência cardíaca, frequência respiratória e saturação de oxigênio. Houve uma forte correlação paraidade, consumo de oxigênio (VO2), número de paradas, dispneia modificada do Medical Research Council (mMRC), capacidade funcional medida em equivalentes metabólicos (METS) e saturação de oxigênio (SpO2). Conclusão:Pacientes com sequelas de tuberculose pulmonar, em sua maioria homens, apresentam alterações estatisticamente significativas durante o exame.


Subject(s)
Humans , Adult , Middle Aged , Medical Examination , Lung Diseases , Physical Examination , Anthropometry
3.
Esc. Anna Nery Rev. Enferm ; 27: e20230009, 2023. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1528600

ABSTRACT

Resumo Objetivo Identificar a prevalência da realização dos exames de pré-natal e seus fatores associados, durante a pandemia de COVID-19, em uma regional de saúde brasileira. Método Pesquisa transversal, descritiva, realizada em três maternidades públicas, com 408 puérperas, por meio de inquérito e consulta de prontuários e cartão da gestante. Utilizou-se o teste Qui-quadrado assumindo nível de significância de p<0,05. Resultados Houve baixa prevalência na realização dos exames de pré-natal, sendo 67% no primeiro trimestre, 59,2% no segundo e 48,98% no terceiro. A raça não branca e o início do pré-natal após a 14ª semana estão associados à baixa realização dos testes sorológicos/bioquímicos. Conclusão e implicações para a prática A realização dos exames do pré-natal não ocorreu de forma satisfatória durante o período pandêmico, possibilitando verificar a existência de lacunas na qualidade da assistência pré-natal. Em situações adversas, como ocorrido na pandemia de COVID-19, o enfermeiro pode utilizar de estratégias que garantam a continuidade e integralidade da assistência pré-natal, especialmente entre as populações de maior vulnerabilidade.


Resumen Objetivo Identificar la prevalencia de la realización de controles prenatales y sus factores asociados, durante la pandemia de COVID-19 en una regional de salud brasileña. Método Investigación transversal y descriptiva, realizada con 408 puérperas en las maternidades de la 9ª Regional de Salud, por medio de indagaciones y consultas en las historias clínicas y cartillas sanitarias de las embarazadas. Se utilizó la prueba de Chi-cuadrado con un nivel de significancia de p<0,05. Resultados Se registró baja prevalencia de controles prenatales: 67% en el primer trimestre, 59,2% en el segundo y 48,98% en el tercero. La raza no blanca y el inicio de la atención prenatal después de la semana 14 se asocian con una escasa realización de las pruebas serológicas/bioquímicas. Conclusión e implicaciones para la práctica Los controles prenatales no se realizaron satisfactoriamente durante el periodo pandémico, lo que permite comprobar la existencia de brechas en la calidad de la atención prenatal. En situaciones adversas, como ocurrió en la pandemia de COVID-19, los enfermeros pueden utilizar estrategias que garanticen la continuidad e integralidad de la atención prenatal, especialmente entre las poblaciones más vulnerables.


Abstract Objective To identify the prevalence of prenatal screening and its associated factors during the COVID-19 pandemic in a Brazilian health region. Method A cross-sectional and descriptive research study, carried out with 408 puerperal women in the maternity hospitals from the 9th Health Region, through survey and consultation of the pregnant women's medical records and cards. The Chi-square test was used, assuming a significance level of p<0.05. Results There was low prevalence of prenatal exams: 67% in the first trimester, 59.2% in the second and 48.98% in the third. Non-white race and prenatal care initiation after the 14th week are associated with low performance of serological/biochemical tests. Conclusion and implications for the practice The performance of prenatal tests was not satisfactory during the pandemic period, allowing us to verify the existence of gaps in prenatal care quality. In adverse situations, as was the case in the COVID-19 pandemic, nurses can use strategies that guarantee prenatal care continuity and comprehensiveness, especially among the most vulnerable populations.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Prenatal Care/statistics & numerical data , Medical Examination , Maternal and Child Health , Maternal-Child Health Services , COVID-19 , Postpartum Period
4.
Article in Portuguese | LILACS, CONASS, ColecionaSUS, SES-GO | ID: biblio-1511052

ABSTRACT

Esta pesquisa busca identificar as causas de interrupção da administração da nutrição enteral em pacientes internados em unidades de terapia intensiva do Hospital de Urgências da cidade de Goiânia. Objetivo: Chegar às causas de interrupção da administração da nutrição enteral em pacientes internados em Unidades de Terapia Intensiva (UTIs). Método: Estudo transversal, prospectivo, realizado com pacientes internados nas UTIs do Hospital de Urgências de Goiás, no período de maio e junho de 2022. Foram coletadas as seguintes variáveis: sexo, idade, peso, altura, IMC, diagnóstico de internação, data de internação, desfecho clínico do paciente, causas de interrupção da dieta enteral, volume prescrito e volume infundido no prontuário. Os dados foram coletados até o sétimo dia de internação e acompanhados até o desfecho clínico (alta, óbito ou transferência). Resultados: Foram obtidos dados de 45 pacientes. As principais causas de interrupção da NE foram instabilidade hemodinâmica (28,2%), jejum para exames (19%) e intolerância gastrointestinal (19%). A adequação de volume prescrito comparado com o infundido foi de 86,4%. Conclusão: Quando agrupadas as causas evitáveis representam 71,4%, enquanto a causa não evitável representa 28,6%. O tempo de retenção é controlável e, portanto, os esforços devem ser direcionados a estratégias eficientes com a equipe multiprofissional, como capacitações quanto às causas das interrupções e soluções para minimizar o tempo da retenção da dieta


This research seeks to identify the causes of interruption in the administration of enteral nutrition in patients hospitalized in intensive care units at Hospital de Urgências in the city of Goiânia. Objective: Get to the causes of interruption of the administration of enteral nutrition in patients hospitalized in Intensive Care Units (ICUs). Method: A cross-sectional, prospective study carried out with patients admitted to the ICUs of the Hospital de Urgências de Goiás, between May and June 2022. The following variables were collected: sex, age, weight, height, BMI, hospitalization diagnosis, date length of stay, clinical outcome of the patient, causes of enteral diet interruption, volume prescribed and volume infused in the medical record. Data were collected up to the seventh day of hospitalization and followed up until the clinical outcome (discharge, death or transfer). Results: Data from 45 patients were obtained. The main causes of EN interruption were hemodynamic instability (28.2%), fasting for exams (19%) and gastrointestinal intolerance (19%). The adequacy of prescribed volume compared to infused volume was 86.4%. Conclusion: The three main causes of diet interruption were hemodynamic instability, gastrointestinal intolerance due to emesis and fasting for exams. The retention time is controllable and, therefore, efforts should be directed towards efficient strategies with the multidisciplinary team, such as training on the causes of interruptions and solutions to minimize the time of diet retention


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Intensive Care Units , Medical Examination , Cross-Sectional Studies , Fasting , Inpatients
5.
Rev. cir. (Impr.) ; 74(1): 61-72, feb. 2022. tab, ilus
Article in Spanish | LILACS | ID: biblio-1388920

ABSTRACT

Resumen Introducción: Los aloinjerto cutáneos (AC) son excelentes sustitutos cutáneos temporales, sin embargo, la donación y procura de piel cadavérica, fuente habitual de AC, es baja. Objetivo: Evaluar la factibilidad de utilizar la piel proveniente de abdominoplastías como fuente de AC y su eficacia clínica. Materiales y Método: Entre el 17 de agosto de 2020 al 28 de febrero de 2021 se analizó una cohorte prospectiva de 14 pacientes femeninas sometidas a abdominoplastía por motivos estéticos, que aceptaron donar la piel del colgajo cutáneo abdominal redundante, la cual fue criopreservada. Se utilizaron los AC de piel total criopreservados (ACPTC) en 10 pacientes con diagnósticos de: pie diabético (4), laparostomía contenida (2) herida compleja extremidad inferior (2), sarcoma de cuero cabelludo recidivado (1) y melanoma (1). Resultados: Se obtuvieron 14 colgajos de piel total, los cuales fueron procesados obteniendo una superficie promedio de 302 cm2 y 8,3 láminas de distintos tamaños de utilidad clínica por paciente. En todos los pacientes en que se utilizó ACPTC hubo un prendimiento inicial del AC para posteriormente, en promedio 21 días, presentar una escara necrótica que al ser retirada presentaba un tejido vital adherido al receptor rico en fibroblastos, siendo algunos pacientes auto injertados y otros manejados con cicatrización por segunda intención como tratamiento definitivo. Discusión: Los ACPTC proporcionan una cobertura intermedia, pues una parte se integra en forma definitiva, actuando como un andamiaje biológico para la formación de una interfase sobre la cual se puede autoinjertar o dejar evolucionar con cicatrización por segunda intención y una parte es rechazada. Conclusión: La procura de piel de donante vivo, en pacientes sometidos a cirugías de contorno corporal es un proceso factible, fuente de ACPTC, los cuales permiten una nueva cobertura intermedia con múltiples aplicaciones clínicas.


Introduction: Skin allografts (SA) are outstanding temporary skin substitutes; however, cadaveric skin donation and procurement, a common source of SA, remains low. Aim: To evaluate the feasibility and clinical efficacy of using skin from abdominoplasties as a source of SA. Materials and Method: A prospective cohort was analyzed from August 17th, 2020 and February 28th, 2021, with 14 female patients submitted to abdominoplasty surgeries for aesthetic motives, who authorized skin donation from the redundant abdominal flap which was posteriorly cryopreserved. Cryopreserved total skin allografts (CTSA) was used in 10 patients with the following diagnoses: diabetic foot (4), contained laparostomy (2) complex wound of the lower limb (2), relapsing sarcoma of the scalp (1), and melanoma (1). Results: 14 CTSA were obtained, which were processed, obtaining an average area of 302 cm2 and 8.3 sheets of different sizes and clinical applications from each patient. In all patients who received CTSA, an initial attachment was observed, followed by the appearance of a necrotic scar in an average of21 days. The peeling of the latter revealed a vital tissue tightly adhered to the receptor and rich in fibroblasts. Some of the patients received autografts, and others were managed with secondary intention scarring as a definite treatment. Discussion: CTSA provide an intermediate coverage since one part is definitely adhered to, acting as a biologic scaffolding for the formation of an interface that can be autografted or left for a secondary intention scarring, and the host rejects the other portion. Conclusión: skin procurement from a living donor in patients submitted to body contour surgeries is a feasible process and significant source of CTSA, which permits a new intermediate coverage with multiple clinical uses.


Subject(s)
Humans , Female , Cryopreservation , Abdominoplasty/methods , Allografts/surgery , Skin , Medical Examination , Surveys and Questionnaires , Informed Consent
6.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 59: e192646, fev. 2022. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1380316

ABSTRACT

Chemotherapy agents have some undesirable and non-selective cytostatic effects. Considering that kidneys are vulnerable to drug-induced toxicity, this study evaluated renal injury caused by vincristine sulfate (VS) in 12 female dogs diagnosed with transmissible venereal tumor (TVT). The animals were treated with VS (0.025 mg/kg IV) every 7 days for 4 weeks. During treatment, the animals were subjected to clinical examination, blood count, serum measurement of symmetric dimethylarginine (SDMA), blood urea nitrogen (BUN), creatinine, alanine aminotransferase, and alkaline phosphatase. In addition, urinalysis and urinary gamma-glutamyl transferase (GGT) measurements were performed. All parameters were determined three times: before beginning the treatment (T0), after 14 days (T1), and after 28 days (T2). During the study period, there were no changes in serum urea or creatinine levels, urine specific gravity, or persistent proteinuria. Furthermore, urinary GGT measurement did not indicate tubular lesions, and consistent elevation of SDMA was found in only one patient above the reference range. The results showed that weekly therapy with VS as a single agent for 28 days does not induce renal injury in most cases.(AU)


Os agentes quimioterápicos possuem efeitos citostáticos indesejáveis e não seletivos. Considerando a vulnerabilidade renal à toxicidade induzida por drogas, este estudo avaliou a lesão renal causada pelo sulfato de vincristina (VS) em 12 cadelas com diagnóstico de tumor venéreo transmissível (TVT). Os animais foram tratados com VS (0,025 mg / kg IV) a cada sete dias, durante quatro semanas. No transcurso do tratamento, os animais foram submetidos a exame clínico, hemograma, dosagem sérica de dimetilarginina simétrica (SDMA), nitrogênio ureico sanguíneo (BUN), creatinina, alanina aminotransferase e fosfatase alcalina. Além disso, foram realizadas análises de urina e medições de gama-glutamil transferase (GGT) urinária. Todos os parâmetros foram mensurados em três tempos, antes do início do tratamento (T0), aos 14 dias (T1) e aos 28 dias (T2). Durante o período do estudo, não houve alterações nas concentrações de ureia ou creatinina séricas, na gravidade específica da urina ou proteinúria persistente. Além disso, a medição de GGT urinária não indicou lesões tubulares, e elevação consistente de SDMA foi encontrada em apenas um paciente acima do intervalo de referência. Os resultados mostraram que a terapia semanal com VS como agente único por 28 dias não induz lesão renal na maioria dos casos.(AU)


Subject(s)
Animals , Female , Dogs , Venereal Tumors, Veterinary/drug therapy , Vincristine/adverse effects , Renal Insufficiency, Chronic/veterinary , Medical Examination , Dogs/injuries
7.
Ciênc. cuid. saúde ; 21: e58689, 2022.
Article in Portuguese | LILACS, BDENF | ID: biblio-1421222

ABSTRACT

RESUMO Objetivo: conhecer o itinerário percorrido pela família para a obtenção do diagnóstico da criança com necessidades especiais de saúde. Método: realizou-se estudo qualitativo em uma unidade de internação pediátrica do sul do Brasil. Utilizou-se como referencial metodológico a Grounded Theory. Participaram 16 familiares cuidadores. Os dados foram coletados em 2019 por entrevistas e submetidos à codificação aberta e axial. Resultados: as famílias percorreram um longo itinerário até o recebimento do diagnóstico da criança: detectaram alterações no seu estado geral, realizaram diversos exames, desconfiaram o diagnóstico por já ter outros com o mesmo na família, receberam informações dos profissionais da saúde acerca dos cuidados necessários e dos serviços especializados para o seu tratamento, apresentaram medo, pânico, negação e valorizaram a fé em Deus na esperança da melhora da criança. Considerações finais: o enfermeiro necessita desenvolver um processo educativo junto à família para que ela se sinta preparada e capaz de cuidar dessas crianças.


RESUMEN Objetivo: conocer el itinerario recorrido por la familia para la obtención del diagnóstico del niño con necesidades especiales de salud. Método: se realizó estudio cualitativo en una unidad de hospitalización pediátrica del sur de Brasil. Se utilizó como referencial metodológico la GroundedTheory. Participaron 16 familiares cuidadores. Los datos fueron recolectados en 2019 por entrevistas y sometidos a la codificación abierta y axial. Resultados: las familias recorrieron un largo itinerario hasta la recepción del diagnóstico del niño: detectaron alteraciones en su estado general; realizaron diversos exámenes; desconfiaron del diagnóstico por tener ya otros con el mismo en la familia; recibieron informaciones de los profesionales de la salud acerca de los cuidados necesarios y de los servicios especializados para su tratamiento; presentaron miedo, pánico y negación; y valoraron la fe en Dios en la esperanza de la mejora del niño. Consideraciones finales: el enfermero necesita desarrollar un proceso educativo con la familia para que ella se sienta preparada y capaz de cuidar a esos niños.


ABSTRACT Objective: to know the itinerary taken by the family to obtain the diagnosis of the children with special health needs. Method: a qualitative study was carried out in a pediatric inpatient unit in southern Brazil. Grounded Theory was used as a methodological reference. Sixteen (16) family caregivers participated. Data were collected in 2019 through interviews and submitted to open and axial coding. Results: the families traveled a long route until receiving the children's diagnosis: they detected changes in their general condition; performed several exams; they were suspicious of the diagnosis because other members of the family had already been diagnosed with the same conditions; received information from health professionals about the necessary care and specialized services for the treatment; showed fear, panic and denial; and they valued faith in God in the hope of improving of the children. Final considerations: nurses need to develop an educational process with the family so that they feel prepared and capable of taking care of these children.


Subject(s)
Humans , Male , Female , Child , Medical Examination , Chronic Disease , Nursing , Diagnosis
8.
Ciênc. cuid. saúde ; 21: e61516, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1421217

ABSTRACT

RESUMO Objetivo: analisar o autorrelato da saúde de pacientes com tuberculose e com diabetes mellitus, por meio da procura por atendimento, identificação de sintomas e realização de exames diagnósticos pelos mesmos, visando contribuir com o manejo integrado das comorbidades. Métodos: estudo quantitativo, analítico, ocorrido em município de Minas Gerais, Brasil. Os dados foram coletados por meio de contato telefônico a pessoas com diabetes, já diagnosticadas, por meio de 10 equipes de saúde da família do município; e a pessoas com tuberculose, em tratamento, identificadas no Sistema de Informação de Agravos de Notificação. Resultados: Foram contactados 411 pacientes com diabetes, com 159 respondentes, e entre os 72 pacientes com tuberculose, 16 atenderam às ligações telefônicas. Por meio do autorrelato foram identificados 34% de pacientes com diabetes e tosse concomitantes, maioria mulheres, 72%; Entre os pacientes com tuberculose, 37% realizaram glicemia de jejum nos três últimos meses, 12% possuíam diabetes autodeclarada. Considerações finais: os resultados mostraram fragilidades no atendimento prestado nos serviços de saúde relacionadas com o manejo integrado tuberculose-diabetes. Conhecer a relação entre essas doenças faz-se necessário a fim de contribuir para o enfrentamento das mesmas como problema de saúde pública. A enfermagem tem função importante na propagação do conhecimento e de ações que vislumbrem o manejo integrado da tuberculose e diabetes na busca da especificidade do cuidado.


RESUMEN Objetivo: analizar el autoinforme de la salud de pacientes con tuberculosis y diabetes mellitus, con base en la demanda por atención, identificación de síntomas y realización de exámenes diagnósticos, con finalidad de contribuir para el manejo integrado de las comorbilidades. Métodos: estudio cuantitativo y analítico ocurrido en municipio de Minas Gerais, Brasil. Los datos fueron recolectados de personas con diabetes ya diagnosticadas, vía contacto telefónico por diez equipos del programa Salud de la Familia del municipio, y de pacientes con tuberculosis en tratamiento, identificados en el Sistema de Información de Agravios de Notificación. Resultados: fueron contactados 411 pacientes con diabetes, con devolución de 159 encuestados, y 72 pacientes con tuberculosis, con devolución de 16. El autoinforme permitió identificar que 34% de pacientes presentaban diabetes y tos concomitantes y que 72% eran mujeres, mientras que de los pacientes con tuberculosis 37% realizaron glucemia de ayuno en los tres últimos meses y 12% poseían diabetes autodeclarada. Consideraciones finales: los resultados mostraron fragilidades en la atención prestada en los servicios de salud relacionados con el manejo integrado tuberculosis-diabetes. Es necesario conocer la relación entre esas enfermedades si se pretende contribuir al enfrentamiento de esas enfermedades como problema de salud pública. La enfermería tiene la importante función de propagar el conocimiento y las acciones que tienen por objetivo el manejo integrado de la tuberculosis y diabetes en la búsqueda de la especificidad del cuidado.


ABSTRACT Objective: to analyze the self-report of the health of patients with tuberculosis and diabetes mellitus, through the search for care, identification of symptoms and diagnostic tests performed by them, in order to contribute to the integrated management of comorbidities. Methods: quantitative, analytical study, carried out in a municipality of Minas Gerais, Brazil. Data were collected through telephone contact with people with diabetes, already diagnosed, through 10 family health teams in the municipality; and people with tuberculosis, under treatment, identified in the Notifiable Diseases Information System. Results: 411 patients with diabetes were contacted, with 159 respondents, and among the 72 patients with tuberculosis, 16 answered the phone calls. Through self-report, 34% of patients with concomitant diabetes and cough were identified, most of them women, 72%; Among patients with tuberculosis, 37% had fasting blood glucose in the last three months, 12% had self-reported diabetes. Final considerations: the results showed weaknesses in the care provided in health services related to the integrated management of tuberculosis-and diabetes. Knowing the relationship between these diseases is necessary in order to contribute to facing them as a public health problem. Nursing plays an important role in the propagation of knowledge and actions that envision the integrated management of tuberculosis and diabetes in the search for the specificity of care.


Subject(s)
Humans , Male , Female , Primary Health Care , Prisoners , Medical Examination , Diagnosis , Nursing Care
9.
South African Family Practice ; 64(3): 1-8, 19 May 2022. Figures
Article in English | AIM | ID: biblio-1380584

ABSTRACT

The series, 'Mastering your Fellowship', provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP SA) examination. The series is aimed at helping family medicine registrars (and their supervisors) prepare for this examination.Keywords: family physicians; FCFP (SA) examination; family medicine registrars; postgraduate training; national exit examination; infectious diseases.


Subject(s)
Physicians, Family , Communicable Diseases , Education, Nursing, Graduate , Medical Examination , Educational Measurement
10.
Salud(i)ciencia (Impresa) ; 24(4): 169-177, nov. 2020. tab.
Article in English, Spanish | BINACIS, LILACS | ID: biblio-1254094

ABSTRACT

La comprensión de la frecuencia y el significado de diversos hallazgos médicos en niños sometidos a abuso sexual se modificaron con el tiempo. Antes de 1989, se pensaba que diversas variaciones en la apariencia de los tejidos genitales y anales se debían al abuso. Los estudios que describen en detalle la apariencia de los tejidos anales en niños seleccionados como no sometidos a abuso en 1989 y los hallazgos genitales en niñas no sometidas a abuso en 1990, mostraron que muchas de estas variaciones también se observaron en niños que no habían experimentado abuso. Las más comunes de estas variaciones se incluyeron en una lista de hallazgos anogenitales que también comprendían signos conocidos de lesiones agudas e infecciones de transmisión sexual, así como otros hallazgos físicos y de laboratorio cuya importancia con respecto al abuso se desconocía. Esta lista evolucionó a medida que se publicaban nuevos estudios y se procuraba llegar a un consenso entre los expertos en la evaluación del abuso sexual en niños en cuanto a la forma en que debían interpretarse los hallazgos de los exámenes médicos adicionales. La tabla de "interpretación de los resultados" evolucionó durante los 26 años siguientes, y la más reciente se publicó en 2018. Todavía hay hallazgos, en junio de 2020, respecto de los cuales no hay consenso entre los expertos en cuanto a cómo deben interpretarse en un niño evaluado por presunción de abuso sexual. Deberán revisarse los antecedentes de los cambios en la interpretación de los hallazgos genitales y perianales en niños con presunción de abuso sexual.


The understanding of the frequency and significance of various medical findings in sexually abused children has changed over time. Before 1989, several variations in the appearance of genital and anal tissues were thought to be due to abuse. Studies describing in detail the appearance of anal tissues in children selected for non-abuse in 1989, and genital findings in non-abused girls in 1990, showed that many of these variations were seen non-abused children as well. The most common of these variations were included in a listing of anogenital findings that also included known signs of acute injury and sexually transmitted infections, as well as other physical and laboratory findings for which the significance with respect to abuse was unknown. This listing evolved as new studies were published and efforts were made to reach consensus among experts in child sexual abuse evaluation as to how additional medical examination findings should be interpreted. The "Interpretation of Findings" table evolved over the next 26 years, with the most recent being published in 2018. There are still findings, as of June, 2020, for which no expert consensus exists as to how they should be interpreted in a child who is being evaluated for suspected sexual abuse. The history of the changes in the interpretation of genital and perianal findings in children with suspected sexual abuse will be reviewed.


Subject(s)
Physical Examination , Sex Offenses , Child Abuse, Sexual , Sexually Transmitted Diseases , Medical Examination
11.
Rev. Univ. Ind. Santander, Salud ; 52(3): 215-223, Julio 8, 2020. tab
Article in Spanish | LILACS | ID: biblio-1155622

ABSTRACT

Resumen Introducción: a partir de la Encuesta Nacional de Empleo, Desempleo y Subempleo (ENEMDU), realizada por el Instituto Nacional de Estadísticas y Censos de Ecuador (INEC) en junio 2018, que representa uno de los instrumentos estadísticos más importantes para conocer la situación laboral en el país, se realiza el presente estudio. Objetivo: describir y analizar la percepción de la seguridad y salud, asociadas a características socio-demográficas y laborales en Ecuador. Metodología: consistió en un estudio de tipo cuantitativo, descriptivo y transversal, se aplicó un muestreo probabilístico y se determinó que 28.636 personas cumplen con la condición de estar laborando actualmente; se utilizó el software SPSS para el desarrollo de frecuencias absolutas y relativas, y el cálculo de prueba chi-cuadrado. Resultados: el 3,7 % de los encuestados afirman que se les ha realizado un examen preocupacional y el 7,2 % afirman que se les ha realizado un examen periódico; a su vez, el 42 % ha sido informado sobre los riesgos en su trabajo y el 14 % ha sido capacitado sobre el riesgo al que está expuesto. Discusión: lo que indica un déficit de la gestión de seguridad y salud a nivel nacional. Conclusión: se pone en manifiesto la necesidad de identificar los factores de riesgos laborales y su impacto en la salud, que en conjunto a registros oficiales permitan conocer las realidades de las organizaciones para establecer nuevas políticas de seguridad y salud en el país.


Abstract Introduction: this study was carried out based on the National Survey of Employment, Unemployment and Underemployment (ENEMDU), conducted by the National Institute of Statistics and Censuses of Ecuador (INEC) in June 2018, which represents one of the most important statistical tools to know the labor situation in the country. Objective: To describe and analyze the perception of safety and health, associated with socio-demographic and work characteristics in Ecuador. Methodology: it consisted of a quantitative, descriptive and transversal research. A probabilistic sampling method was applied being 28.636 people who meet the condition of being working at this time. SPSS software was used for the development of absolute and relative frequencies and calculation of chi-square test. Results: the results show that 3.7 % of the respondents have had a pre-occupational exam and 7.2 % have been periodically examined; in turn, 42 % have been informed about the risks at work and 14% have been trained on the risk to which they are exposed. Discussion: these results indicate a deficit of Health and Safety Management at the national level, Conclusion: This work highlights the need to identify the factors of Occupational risks and their impact on health, which together with official records allow to know the realities of organizations to establish new health and safety policies in the country.


Subject(s)
Humans , Occupational Risks , Occupational Health , Working Conditions , Perception , Population Characteristics , Medical Examination , Surveys and Questionnaires , Statistics , Ecuador
13.
Ciênc. cuid. saúde ; 19: e50245, 20200000.
Article in Portuguese | LILACS, BDENF | ID: biblio-1120805

ABSTRACT

Objective:to understand the perceptions of nurses specializing in nephrology regarding the skills needed to care for people with acute kidney injury. Method:qualitative study carried out with six nephrology nurses, using the focus group as a technique and the guiding question "Talk about your perceptions regarding the skills needed by nurses who care for people with acute renal failure". Audios were recorded, transcribed verbatim, and submitted to content analysis. Results: three categories emerged: pathophysiological knowledge of Acute Kidney Injury as a prevention and care strategy in pre-dialysis; operationalization and management of machines during dialysis therapy and difficulties in operationalizing care with transference of the responsibility to provide care for nursing technicians.Conclusion: knowledge about pathophysiology of acute kidney injury, skill in handling machines, intervention in complications, accurate analysis of exams, care with nutritional aspects and handling of catheters are the main skills required for operational care. However, the fragility of the legislation to this public makes it difficult to operate care safely.


Objetivo: compreender as percepções de enfermeiros especialistas em nefrologia quanto às competências necessárias para o cuidado a pessoas com injúria renal aguda. Método: estudo qualitativo, realizado com seis enfermeiros especialistas em nefrologia, tendo como técnica o grupo focal,com a questão norteadora:fale sobre suas percepções quanto às competências necessárias ao enfermeiro que cuida de pessoas com insuficiência renal aguda. Os áudios foram gravados, transcritos na íntegra e submetidos à análise de conteúdo. Resultados: emergiram três categorias: conhecimento fisiopatológico da lesão renal aguda como estratégia de prevenção e cuidados na pré-diálise; operacionalização e gerenciamento de máquinas durante a terapia dialítica e dificuldades para operacionalização do cuidado com transferência de responsabilidade de cuidados aos técnicos em enfermagem. Conclusão: conhecimento fisiopatológico da injúria renal aguda, habilidade no manuseio de máquinas, intervenção nas intercorrências, atenção acurada aos exames, cuidados com aspectos nutricionais e manejo de cateteres são as principais competências necessárias para operacionalização do cuidado. No entanto, a fragilidade da legislação a este público dificulta a operacionalização do cuidado com segurança.


Subject(s)
Humans , Male , Female , Nursing , Acute Kidney Injury , Nephrology , Medical Examination , Renal Dialysis , Nutritional Sciences , Catheters , Intensive Care Units , Kidney Diseases
15.
Med. interna (Caracas) ; 35(1): 16-31, 2019. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1005803

ABSTRACT

Analizar la relación entre los planteamientos diagnósticos de ingreso y egreso, así como la utilidad de los exámenes paraclínicos solicitados para su eficacia diagnóstica. También se determinaron los tiempos de estancia en los servicios de emergencia y hospitalización como parte del sistema de control de calidad. Métodos: Estudio de casos, prospectivo y longitudinal. La muestra estuvo constituida por pacientes que consultaron al Servicio de Emergencia del Hospital General del Oeste y fueron hospitalizados en el servicio de Medicina Interna. Se trató de un muestreo no probabilístico, de selección intencional, de pacientes de cualquier género mayores de 18 años, que ingresaron en el período de Enero a Julio de 2018 con un total de 135. Los datos recolectados de los exámenes complementarios se clasificaron en útiles o no, según cada diagnóstico. Otra importante variable medida fue la identificación de estancia intrahospitalaria prolongada y su causa. Tratamiento estadístico: Se aplicó estadística descriptica a través de medidas de tendencia central y proporción según la naturaleza de las variables, con el fin de priorizar las principales fallas de calidad seguida de la estimación de los costos. Resultados: En el 45% de los casos la causante de estancia prolongada en la Emergencia fue la limitación en la infraestructura. En cuanto a la estancia hospitalaria y su costo, las seis principales fallas correspondieron a un total estimado de US$ 289.695 e incluyó al personal y al Sistema de Salud. Los exámenes diagnósticos de laboratorio e imágenes más solicitados representaron un porcentaje de no utilidad con un costo total estimado de US$ 7.224. Conclusión: En este primer trabajo venezolano sobre Atención Médica de Alto Valor se observaron múltiples causas por las cuales su práctica no fue completa(AU)


To analyze the relationship between the diagnostic approaches at admission and discharge of our hospital, as well as the utility of the tests requested in terms of their diagnostic efficacy and the determination of the length of stay in the emergency services and hospitalization as part of the evaluation of the health system´s quality. Methods: Case study, prospective and longitudinal. The sample were patients who consulted to the Emergency Service of the Hospital General del Oeste, Caracas, Venezuela, and were hospitalized in the Internal Medicine wards. It was a non-probabilistic sampling, of intentional selection, of patients of any gender over 18 years old, from January to July 2018, with a total sample of 135 subjects. The data collected of the tests and images ordered, were clasified as useful or not according to their iagnostic power; another important variable was to evaluate the prolonged hospital stay length and the causes for it. Statistics: Measures of central tendency and proportion, according to the nature of the variables, in order to prioritize the main quality faults, followed by the estimation of costs. Results: In 45% the cause of prolonged stay in the Emergency was the limitation of the infrastructure. In the context of the hospital stay and the six main failures corresponded to an estimated total cost of US$ 289.695 and ncluded health personnel and the Health System. The most frequently ordered laboratory tests and images showed a percentage of non-utility with an estimated total cost of US$ 7.224. Conclusion: In this first Venezuelan study on High-Value Medical Care, multiple causes were observed and explain why its practice is not complete(AU)


Subject(s)
Humans , Male , Patient Admission/standards , Admitting Department, Hospital/standards , Patient Outcome Assessment , Medical Examination , Emergency Medicine , Hospitalization
16.
Biociencias ; 14(1): [13-25], 2019. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1006759

ABSTRACT

Introducción: El síntoma osteomuscular se puedepresentar en cualquier momento de la vida ya que son algo inmanente al ser humano; sin embargo,estas molestias pueden aumentarse y permanecer pormás tiempo en el individuo debido a múltiples factores individuales. Objetivo: Determinar los síntomas osteomusculares y factores individuales presentes en los trabajadores de la bodega de unaempresa de industria textil en Barranquilla en el periodo comprendido de febrero a diciembre, 2017.Metodología: El método que se utilizo fue deductivo, con una población de 21 trabajadores en el año 2017. Se recolectaron datos socio-demográficos (sexo, edad y tiempo en el cargo) y factores individuales (IMC). Los síntomas osteomusculares fueron evaluados por mediode una encuestade síntomas y factores individuales. Resultados:Se observó que el 47,6% de la población presenta sobrepesoy el 19% restante se encuentra en obesidad tipo 1, Se destaca que el 66,66% de los trabajadores encuestados, tienen problemas con su peso. la población estudio se identificó que las edades prevalentes están 85,7% representa por edad adulta, mayores de 26 años y el 14,3% son jóvenes menores a 26 años. Conclusión: A partir de lo mencionado y evidenciado anteriormente escrito se encontróque la frecuencia de los síntomas es baja y prevalece la respuesta casi nunca o nunca. Síntomas específicos como Dolor de cabeza, cuello, muñeca izquierda, abdomen, lumbar y pierna derecha, son los que más variabilidad presentan en cuanto a su frecuencia.En general los trabajadores refieren que lleven un estilo de vida saludable, no fuman, ni consumen bebidas alcohólicas, duermen más de 6 horas diarias y no tienen antecedentes de cáncer. Se observó en particular que el 57,14% consume café diariamente, mientras que el 42,86% no consume café. El 19,05% manifiesta llevar hábitos de vida sedentarios


Introduction: Osteomuscularsymptoms can occur at any time in life since they are something immanent to the human being; however, these discomforts can be increased and remain longer in the individual due to multiple individual factors.Objective:To determine the osteomuscular symptoms and individual factors present in the workers of the winery of a textile industry company in Barranquilla in the period from February to December, 2017. Methodology:The method I used was deductive, with a population of 21 workers in 2017. Socio-demographic data (sex, age and time in office) and individual factors (BMI) were collected. Osteomuscular symptoms were evaluated by means of a survey of syphilis and individual factors.Results:It was observed that 47.6% of the population is overweight and the remaining 19% is in type 1 obesity. It is noted that 66.66% of the workers surveyed have problems with their weight. The study population identified that the prevailing ages are 85.7% represented by adult age, older than 26 years and 14.3% are younger than 26 years.Conclusions:From the aforementioned and evidenced previously written it was found that the frequency of symptoms is low and the answer prevails almost never or never. Specific symptoms such as headache, neck, left wrist, abdomen, lumbar and right leg are the most variable in their frequency. In general, workers report that they lead a healthy lifestyle, do not smoke, or consume alcoholic beverages, sleep more than 6 hours a day, and do not have a history of cancer. It was observed in particular that 57.14% consume coffee daily, while 42.86% do not consume coffee. 19.05% manifest sedentary lifestyle habits


Subject(s)
Humans , Animal Proteins, Dietary , Therapeutics , Medical Examination
17.
Rev. medica electron ; 40(6): 1765-1779, nov.-dic. 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-978702

ABSTRACT

RESUMEN Introducción: la necesidad de lograr una mayor satisfacción de los servicios de salud, y, así proporcionar un estado de bienestar en todos los que los reciben; obliga a contar con métodos transformadores que permitan identificar todo lo que influye, de forma positiva o negativa, sobre el rendimiento de las personas que trabajan en el sector de la salud pública. Objetivo: identificar el nivel de satisfacción de los prestadores que laboran en consultorios médicos en el municipio Colón, en el período 2015 - 2016. Materiales y métodos: se realizó un estudio de tipo descriptivo, de corte transversal. Universo y muestra estuvo constituido por los 123 médicos y enfermeras que se encontraban trabajando en los 62 consultorios médicos. Se estudiaron las siguientes variables: condiciones de los locales de atención, recursos necesarios para el trabajo, atención al capital humano y trato de la población. Resultados: el 92,6 y el 90,2 % de los prestadores estuvieron satisfechos con la preocupación, la superación y la limpieza de los consultorios. Predominaron los trabajadores no satisfechos (52,0 %) por los recursos que poseen para los exámenes clínicos. Conclusiones: Los prestadores que laboran en los consultorios médicos se encuentran insatisfechos. Las dimensiones estudiadas fueron evaluadas como no aceptables, solo las variables preocupación por la superación y existencia de agua para lavado de manos estuvieron por encima del estándar establecido (AU).


ABSTRACT Introduction: the necessity of reaching a higher satisfaction from the health services and, with that, providing welfare to everybody who receives them, makes it necessary to have transforming methods that allow to identify everything that having positive or negative influence on the performance of the people working in the public health field. Objective: to identify the satisfaction level of people working in the medical houses of the municipality of Colon, in the period 2015-2016. Materials and methods: a descriptive, cross sectional study was carried out, in a universe and sample composed by the 123 physician and nurses who were working at the 62 medical houses. The following variables were studied: conditions of the health care places, resources that are necessary for work, care to human capital and population handling. Results: 92,6 % and 90,2 % of the medical staff were satisfied with the concern, upgrading and cleaning of the consulting rooms. Predominated workers unsatisfied (52,0 %) with the resources they have for the clinical examination. Conclusions: the medical staff working at the medical houses is unsatisfied. The studied dimensions were evaluated as non-acceptable; only the variables concern for upgrading and existence of water for hand washing were above the established standard (AU).


Subject(s)
Humans , Quality of Health Care , Working Conditions , Physicians' Offices , Health Personnel , Financial Management , Work Performance , Job Satisfaction , Physicians , Water Supply , Medical Examination , Epidemiology, Descriptive , Cross-Sectional Studies , Surveys and Questionnaires , Education, Professional , Nurses
18.
ABC., imagem cardiovasc ; 31(3)jul.-set. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-909414

ABSTRACT

Fundamento: A hipertensão pulmonar é potencialmente fatal, com grande impacto na qualidade de vida do paciente. O tratamento pode alterar sua progressão, mas o aumento na sobrevida é relacionado ao diagnóstico e à terapêutica precoces. Objetivo: Analisar a relação entre alterações em exames usados de rotina (ecocardiografia, eletrocardiografia e tomografia computadorizada) e o aumento da pressão sistólica da artéria pulmonar. Métodos: Avaliamos fichas de pacientes portadores de hipertensão pulmonar, separando-os em dois grupos de acordo com a pressão sistólica da artéria pulmonar estimada à ecocardiografia. O Grupo 1 consistiu de pacientes com pressão sistólica da artéria pulmonar entre 35 e 65 mmHg, e o Grupo 2, de pacientes com pressão sistólica da artéria pulmonar > 65 mHg. Analisamos a prevalência de alterações sugestivas de hipertensão pulmonar em exames de ecocardiografia, eletrocardiografia e tomografia computadorizada. Foram realizadas análises descritiva dos dados e comparativa entre os grupos.Resultados: Foram analisados 101 pacientes (43 do Grupo 1 e 58 do Grupo 2). A maioria foram mulheres (82). Valores maiores de pressão sistólica da artéria pulmonar foram correlacionados com dilatação de câmaras direitas à ecocardiografia (p < 0,001). À eletrocardiografia, sinais de hipertrofia direita e presença de padrão strain ventricular foram mais prevalentes no Grupo 2 (p < 0,05). À tomografia computadorizada, observaram-se maiores diâmetros de tronco da artéria pulmonar em pacientes do Grupo 2 (p < 0,05). Houve correlação entre progressão clínica da doença pelo escore e aumento da pressão sistólica da artéria pulmonar (p < 0,05).Conclusão: É possível, em um primeiro momento, fazer uso do exame clínico e da eletrocardiografia para uma estimativa da gravidade do quadro de hipertensão pulmonar. Os achados, então, devem ser confirmados com análise secundária por tomografia computadorizada e ecocardiografia


Introduction: Pulmonary hypertension is potentially fatal and courses with important day-to-day limitation. While the treatment is capable of slowing the disease's progression, increase in life expectancy is directly linked to early diagnosis and treatment. Objectives:To analyze the relation between alterations detectable on routine exams performed on pulmonary hypertension patients (echocardiography, electrocardiography and computerized tomography) and increases on pulmonary artery systolic pressure. Methods: We analyzed the recordings of patients presented with pulmonary hypertension, and separated them in two groups based on their echocardiography-estimated pulmonary artery systolic pressure. Group 1 was composed of patients with pulmonary artery systolic pressure between 35 mmHg and 65 mmHg, and Group 2 of patients with pulmonary artery systolic pressure > 65 mmHg. We analyzed the prevalence of alterations suggestive of pulmonary hypertension on echocardiography, electrocardiography and computerized tomography. A descriptive analysis of the findings was conducted, followed by comparative analysis between the groups. Results: We analyzed 101 patients (43 from Group 1 and 58 from Group 2). Most were women (82). Higher pulmonary artery systolic pressure values were correlated with right-heart dilation on echocardiography (p < 0.001). Electrocardiography findings revealed that right-heart hypertrophy and ventricular strain pattern were more common on Group 2 (p < 0.05). Computerized tomography analysis showed Group 2 patients had superior pulmonary artery diameters (p < 0.05). There was correlation between high pulmonary artery systolic pressure and clinical progression of the disease measured via the NYHA score (p < 0.05). Conclusion: It is possible to make use of clinical examination and a simple electrocardiography to stratify the severity of a pulmonary artery patient. Computerized tomography and echocardiography should be used to confirm these findings


Subject(s)
Humans , Male , Female , Middle Aged , Echocardiography/methods , Electrocardiography/methods , Hypertension, Pulmonary/diagnosis , Medical Examination/methods , Blood Pressure , Diagnostic Imaging/methods , Heart Ventricles , Prevalence , Pulmonary Artery , Retrospective Studies , Sex Factors , Data Interpretation, Statistical , Stroke Volume , Tomography, X-Ray Computed/methods , Ventricular Septum
19.
Rev. pesqui. cuid. fundam. (Online) ; 10(3, n. esp): 310-312, jun. 2018.
Article in Portuguese | LILACS, BDENF | ID: biblio-906255

ABSTRACT

Resultado e Discussão: Anseia-se identificar os exames solicitados para a pessoa idosa e construir um aplicativo orientador para idosos, cuidadores e familiares da população idosa, trabalhadores da saúde com locais, preparos dos exames ofertados pelo SUS ­ JP


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged , Medical Examination , Mobile Applications , Family Health
20.
Rev. medica electron ; 40(3): 627-637, may.-jun. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-961245

ABSTRACT

Introducción: la concepción científica, dialécticamente interrelacionada de todos los elementos que componen del método clínico, debe contribuir sin dudas, a su rescate y con ello a una asistencia médica de calidad. Objetivo: constatar el desempeño en la aplicación del método clínico por estudiantes de sexto año de la Carrera de Medicina, en el examen práctico de Medicina General Integral, pertenecientes a la Filial de Ciencias Médicas "Dr. Eusebio Hernández Pérez", Colón. Materiales y métodos: se realizó un estudio descriptivo, transversal y prospectivo en los estudiantes de sexto año de la carrera de Medicina, perteneciente a la Filial de Ciencias Médicas "Dr. Eusebio Hernández Pérez", Colón, curso 2015- 2016, se utilizó la guía de observación del examen práctico de Medicina General Integral. El universo fue 45 estudiantes de la carrera de Medicina, que se presentaron al examen y coincidió con la muestra. La guía de observación empleada fue validada por profesores de años de experiencia, teniendo en cuenta las etapas del método científico establecidas en la aplicación del método clínico: entrevista médica, examen físico y el razonamiento clínico. Se tuvo en cuenta el consentimiento informado de los estudiantes. Resultados: de 45 estudiantes, 17 obtuvieron calificaciones con 5 puntos, 16 con 4, y 12 con 3. De ellos, 28 presentaron deficiencias en la aplicación de las diferentes etapas del método clínico. Conclusiones: predominaron las deficiencias en aspectos evaluados en el examen práctico de la entrevista médica, el razonamiento clínico y en menor cuantía el examen físico (AU).


Introduction: the dialectically interrelated scientific conception of all the elements composing the clinical method, should undoubtedly contribute to its rescue and to a qualitative medical care with it. Objective: to state the performance of the sixth year students of Medicine belonging to the University of Medical Sciences Branch ¨Dr. Eusebio Hernández Pérez¨, of Colon, in the application of the clinical method during the practical examination of General Comprehensive Medicine. Materials and methods: a descriptive, cross-sectional and prospective study was carried out in the sixth year students of Medicine belonging to the University of Medical Sciences Branch ¨Dr. Eusebio Hernández Pérez¨, of Colon, 2015-2016 academic years, using the observational guideline of the practical examination of General Comprehensive Medicine. The universe was formed by 45 sixth-year students of Medicine, belonging to the sixth year group, who entered for the examination; it coincided with the sample. The used guideline was validated by experienced teachers, taking into account the stages of the scientific method established in the application of the clinical method: medical interview, physical examination, and clinical reasoning. The students gave their informed consent. Results: from 45 students, 17 got qualifications of 5 points, 16 got 4 and 12 got 3. From them, 28 had deficiencies in applying the different stages of the clinical method. Conclusions: deficiencies predominated in aspects evaluated in the practical examination of the medical interview and the clinical reasoning; less deficiencies were in the physical examination (AU).


Subject(s)
Humans , Adult , Young Adult , Students, Medical , Task Performance and Analysis , Critical Pathways , Quality of Health Care , Students , Medical Examination , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies , Health Care Quality, Access, and Evaluation , Cuba , Educational Measurement , Learning
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