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1.
Rev. cuba. hematol. inmunol. hemoter ; 37(3): e1455, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1341398

ABSTRACT

Introducción: La leucemia mieloide aguda es una enfermedad clonal, reconocida como una de las hemopatías malignas más heterogénea en la que determinados biomarcadores clínicos, inmunológicos, citogenéticos y moleculares influyen en la respuesta de los pacientes al tratamiento. Objetivo: Describir la influencia pronóstico de biomarcadores inmunológicos, citogenéticos y moleculares en la respuesta terapéutica en los pacientes adultos menores de 60 años con leucemia mieloide aguda. Métodos: Se realizó una revisión exhaustiva del tema en bases de datos como: Pubmed, Scielo, ScienceDirect, Medline y el motor de búsqueda Google académico; se utilizaron como referencia artículos actualizados publicados principalmente en los últimos cinco años. Análisis y síntesis de la información: La heterogeneidad inmunológica, citogenética y molecular de los pacientes adultos menores de 60 años con leucemia mieloide aguda se relaciona con la variabilidad en la respuesta al tratamiento que tienen los enfermos y repercute en la supervivencia global y libre de enfermedad. Conclusión: Sobre la base a características inmunológicas, citogenéticas y moleculares es posible establecer el pronóstico de los pacientes con leucemia mieloide aguda, lo cual permite seleccionar la terapéutica adecuada para disminuir en lo posible las complicaciones, las recaídas y aumentar la supervivencia global(AU)


Introduction: Acute myeloid leukemia is a clonal disease, recognized as one of the most heterogeneous malignant hemopathy in which certain clinical, immunological, cytogenetic and molecular biomarkers influence the response of patients to treatment. Objective: Describe the prognostic influence of immunological, cytogenetic and molecular biomarkers on the therapeutic response in adult patients under 60 years of age with acute myeloid leukemia. Methods: An exhaustive review was conducted about the topic in the databases as Pubmed, Scielo, ScienceDirect, Medline and Scholar Google, for which papers mainly published in the last five years were used as reference. Analysis and synthesis of the information: The immunological, cytogenetic and molecular heterogeneity of adult patients under 60 years of age with acute myeloid leukemia is related to the variability in the response to treatment that patients have and affects their overall and disease-free survival. Conclusions: Based on the immunological, cytogenetic and molecular characteristics, it is possible to establish the prognosis of patients with acute myeloid leukemia, which allows selecting the appropriate therapy to reduce complications, relapses as much as possible and increase overall survival(AU)


Subject(s)
Humans , Adult , Biomarkers/analysis , Leukemia, Myeloid, Acute , Disease-Free Survival , Cytogenetics , Prognosis
2.
Rev. ecuat. pediatr ; 22(2): 1-8, 31 de agosto del 2021.
Article in Spanish | LILACS | ID: biblio-1284503

ABSTRACT

Introducción: El objetivo del presente estudio fue realizar un estudio de pruebas diagnósticas entre la escala PRISM III vs la escala PELOD para predecir mortalidad en pacientes que ingresan a la Unidad de Cuidados Intensivos (UCIP) del Hospital Pediátrico Baca Ortiz en el periodo de junio-diciembre 2019. Métodos: En el presente estudio observacional, retrospectivo, se registró la mortalidad y las variables que conforman cada una de las escalas predictivas. Se aplicó estadística descriptiva e inferencial, cálculo del área bajo la curva de ROC. La calibración, se calculó usando el chi2 de Hosmer Lemeshow y la tasa de mortalidad estandarizada mediante le paquete estadístico STATA v16. Resultados: Ingresaron al estudio 150 pacientes. 99 pacientes (66%) fueron hombres, tuvieron una media de edad de 3 años (P25 a P75) de 1 mes a 14 años. La patología de ingreso más frecuente fue la enfermedad posquirúrgica en 43 pacientes (28.6%), y la insuficiencia respiratoria en 31 pacientes (21.6%). La mortalidad fue 12.7%, con una media de estancia hospitalaria de 5 días (1 a 60). La escala de PRIMS III con área bajo la curva de 0.80 (IC 95% de 0.70 a 0.90), sensibilidad 79 % y especificidad 63 % con un puntaje PRISM III de 13 puntos. La escala de PELOD con área bajo la curva de 0.7 (IC 95% de 0.5 a 0.80), sensibilidad de 79 % y especificidad de 60 % con un puntaje PELOD de 21 puntos. Conclusiones: La escala de PRISM III predice la mortalidad mejor que la escala PELOD en este grupo de pacientes pediátricos en las primeras 24 horas.


Introduction: The aim of the present study was a study of diagnostic tests between the PRISM III scale vs the PELOD scale to predict mortality in patients admitted to the Intensive Care Unit (PICU) of the Baca Ortiz Pediatric Hospital in the period of June-December 2019. Methods: In this retrospective, observational study, mortality and the variables that make up each of the predictive scales were recorded. Descriptive and inferential statistics were ap-plied, calculation of the area under the ROC curve. The calibration was calculated using the Hosmer Lemeshow chi2 and the mortality rate standardized using the statistical package STATA v16. Results: 150 patients entered the study. 99 patients (66%) were men, had a mean age of 3 years (P25 to P75) from 1 month to 14 years. The most frequent admission pathology was postoperative disease in 43 patients (28.6%), and respiratory failure in 31 patients (21.6%). Mortality was 12.7%, with a mean hospital stay of 5 days (1 to 60). The PRIMS III scale with area under the curve of 0.80 (95% CI from 0.70 to 0.90), sensitivity 79% and specificity 63% with a PRISM III score of 13 points. The PELOD scale with area under the curve of 0.7 (95% CI from 0.5 to 0.80), sensitivity of 79% and specificity of 60% with a PELOD score of 21 points. Conclusions: the PRISM III scale predicts mortality better than the PELOD scale in this group of pediatric patients in the first 24 hours.


introdução: O objetivo do presente estudo foi realizar um estudo de testes diagnósticos entre a escala PRISM III vs a escala PELOD para predizer mortalidade em pacientes internados na Unidade de Terapia Intensiva (UTIP) do Hospital Pediátrico Baca Ortiz no período de junho a dezembro 2019. Métodos: Nesse estudo retrospectivo e observacional, foram registradas a mortalidade e as variáveis ​​que compõem cada uma das escalas preditivas. Foi aplicada estatística descritiva e inferencial, cálculo da área sob a curva ROC. A calibração foi calculada usando o Hosmer Lemeshow chi2 e a taxa de mortalidade padronizada usando o pacote estatístico STATA v16. Resultados: 150 pacientes entraram no estudo. 99 pacientes (66%) eram homens, com idade média de 3 anos (P25 a P75) de 1 mês a 14 anos. A patologia de admissão mais frequente foi doença pós-operatória em 43 pacientes (28,6%) e insuficiência respiratória em 31 pacientes (21,6%). A mortalidade foi de 12,7%, com tempo médio de internação de 5 dias (1 a 60). Escala PRIMS III com área sob a curva de 0,80 (IC 95% de 0,70 a 0,90), sensibilidade 79% e especificidade 63% com escore PRISM III de 13 pontos. A escala PELOD com área sob a curva de 0,7 (IC 95% de 0,5 a 0,80), sensibilidade de 79% e especificidade de 60% com escore PELOD de 21 pontos. Conclusões: A escala PRISM III prediz mortalidade melhor do que a escala PELOD neste grupo de pacientes pediátricos nas primeiras 24 horas.


Subject(s)
Humans , Child, Preschool , Child , Prognosis , Cause of Death , Critical Care , Child Mortality , Child
3.
Rev. ecuat. pediatr ; 22(2): 1-7, 31 de agosto del 2021.
Article in Spanish | LILACS | ID: biblio-1284504

ABSTRACT

Introducción: El trasplante renal en pediatría constituye el tratamiento de elección para la enfermedad renal crónica terminal (ERCT) con ventajas ampliamente comprobadas sobre los tratamientos dialíticos. El objetivo del presente estudio fue determinar los factores de riesgo relacionados con la sobrevida global y del injerto en un grupo de pacientes pediátricos con trasplante renal atendidos en un hospital de referencia nacional con observación de factores asociados al hiperparatiroidismo secundario. Métodos: En el presente estudio observacional, retrospectivo, se realizó en el Hospital Metropolitano de Quito - Ecuador desde el primero de enero del 2010 al treinta de junio del 2013. Se registró la mortalidad y la supervivencia del injerto, presencia de hiperparatiroidismo pre trasplante, variables demográficas, clínicas (compatibilidad). Se usa el método de Kaplan Meier para el análisis y se presentan riesgos relativos. Resultados: Ingresaron al estudio 33 pacientes, de edad 12±3.8 años. Donante cadavérico 21 casos (63.6%), donante vivo 12 pacientes 36.4%. 18 hombres (54.5%). La etiología de la ERCT fue indeterminada en 63.6%; nefropatías en 24.2% y uropatías en 12.1%. Rechazo agudo 1 paciente, rechazo tardío 10 pacientes. Las variables con significancia en la sobrevida del injerto fueron: hiperparatiroidismo RR= 6.0 (IC95%= 1.078-45.902) P=0.032. No recibir inmunosupresión completa RR=14.5 (IC95%= 3.807-55.225) P<0.001. La necesidad de diálisis pos trasplante la primera semana y biopsia temprana tuvieron RR=15 (IC95%= 3.9-57.2). Conclusiones: Este estudio demostró que el hiperparatiroidismo secundario es un factor de riesgo negativo para la sobrevida del injerto renal en pacientes pediátricos trasplantados


Introduction: Kidney transplantation in pediatrics is the treatment of choice for end-stage renal disease (ESRD) with widely proven advantages over dialysis treatments. The aim of the present study was to determine the risk factors related to global and graft survival in a group of pediatric kidney transplant patients treated at a national referral hospital with observation of factors associated with secondary hyperparathyroidism. Methods: In the present observational, retrospective study, it was carried out in the Hospital Metropolitano de Quito - Ecuador from January 1, 2010 to June 30, 2013. Mortality and graft survival, presence of hyperparathyroidism pre transplantation, demographic and clinical variables (compatibility). The Kaplan Meier method is used for analysis and relative risks are presented. Results: 33 patients, aged 12 ± 3.8 years, entered the study. Cadaveric donor 21 cases (63.6%), living donor 12 patients 36.4%. 18 men (54.5%). The etiology of ESRD was indeterminate in 63.6%; nephropathies in 24.2% and uropathies in 12.1%. Acute rejection 1 patient, late rejection 10 patients. Variables with significance in graft survival were: hyperparathyroidism RR = 6.0 (95% CI = 1.078-45.902) P = 0.032. Not receiving complete immunosuppression RR = 14.5 (95% CI = 3.807-55.225) P <0.001. The need for post-transplant dialysis the first week and early biopsy had RR = 15 (95% CI = 3.9-57.2). Conclusions: This study demonstrated that secondary hyperparathyroidism is a negative risk factor for kidney graft survival in pediatric transplant patients.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Parathyroid Diseases , Prognosis , Kidney Transplantation , Child , Cause of Death , Critical Care
4.
Rev. ADM ; 78(3): 149-154, mayo-jun. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1254699

ABSTRACT

Introducción: Las alternativas de tratamiento de órganos dentales con gran destrucción en su estructura varían, no sólo por el material de restauración, sino también por el valor económico y estético. Dentro de las alternativas existe: corona convencional, endocorona cuyo objetivo principal es la elaboración de una restauradora que evita la colocación de postes intraconducto y endocorona con ausencia de una pared axial (EPA) que se realiza cuando una pared, mesial, distal, vestibular o palatina está ausente. Objetivo: Verificar si la endocorona EPA se comporta de igual manera que las coronas convencionales y endocoronas al medir su resistencia ante fuerzas de tracción. Material y métodos: Treinta premolares fueron tratados endodóncicamente, 10 fueron preparados para recibir una corona convencional (grupo A), 10 para endocorona (grupo B) y 10 para endocorona EPA (grupo C). Se realizaron fuerzas de tracción para obtener el valor máximo en el cual las coronas fallaron. Se realizó una prueba ANOVA para comparar los resultados. Resultados: Al someter a los tres tipos de coronas a fuerzas de tracción los resultados obtenidos fueron: 3.04 ± 0.55 MPa para la corona, 7.08 ± 1.6 MPa para la endocorona y 6.17 ± 1.12 MPa para la endocorona EPA. Conclusiones: No existió diferencia significativa entre la endocorona (7.08 MPa) y la EPA (6.17 MPa), convirtiéndose en una alternativa de tratamiento con buen pronóstico en la práctica diaria (AU)


Introduction: The alternatives of treatment of tooth with excessive wear vary not only by the restoration material but also by the economic and aesthetic value. Among the alternatives there is: conventional crown, endocrown whose main objective is the elaboration of a restorative that avoids the placement of intraconducting posts and endocrown without one axial wall (EPA) that is done when a wall; mesial, distal, vestibular or palatal is absent. Objective: To verify if the (EPA) behaves in the same way as the conventional crown and endocrown when measuring its resistance to tensile strength. Material and methods: 30 premolars were treated endodontically, ten were prepared to receive a conventional crown, 10 for endocrown and 10 for EPA. Tensile strength were performed to obtain the maximum value at which the crowns failed, an ANOVA test was performed to compare the results. Results: When the three types of crowns were subjected to tensile strength, the results obtained were; 3.04 ± 0.55 MPa for the crown, 7.08 ± 1.6 MPa for the endocrown and 6.17 ± 1.12 MPa for the EPA endocrown. Conclusions: There was no significant difference between the endocrown (7.08 MPa) and EPA endocrown (6.17 MPa) becoming an alternative treatment with good prognosis in daily practice (AU)


Subject(s)
Humans , Tensile Strength , Tooth, Nonvital/therapy , Crowns , Prognosis , Bicuspid , Ceramics , Statistical Analysis , Analysis of Variance , Cementation/methods
5.
Rev. ADM ; 78(3): 176-180, mayo-jun. 2021.
Article in Spanish | LILACS | ID: biblio-1255021

ABSTRACT

La microendodoncia involucra la visualización a través de un microscopio operatorio de todas las fases del tratamiento de conductos y procedimientos de cirugía apical y correctiva por parte del endodoncista. Existe sobrada evidencia acerca de las mejoras que puede aportar la magnificación al tratamiento; la literatura demuestra que la capacidad del operador mejora si su visión del campo gana claridad y precisión, ambos recursos pueden ser proporcionados por el microscopio operatorio, aunado a que posibilita diagnósticos más certeros junto con mejoras en el pronóstico, lo que permite evitar posibles complicaciones. La calidad de los tratamientos endodóncicos involucra infinidad de factores, cada uno relevante en sí mismo pero, en determinados casos, el microscopio puede significar la diferencia entre un tratamiento exitoso o un fracaso clínico. En la actualidad, se ha convertido en un tema de lo más relevante, por lo que el objetivo del presente trabajo es revisar la literatura con el fin de ayudar al entendimiento basado en evidencia científica de los criterios que determinan la relevancia del uso del microscopio en el ámbito endodóncico (AU)


Microendodontics involves the visualization through an operating microscope of all phases of root canal treatment and apical and corrective surgery procedures by the endodontist. There is plenty of evidence about the improvements that magnification can provide, the literature shows that the operator's ability improves if his vision of the field gains clarity and precision, both resources can be provided by the operating microscope, added to the fact that it enables more accurate diagnoses together with improvements in the prognosis allowing to avoid possible complications. The quality of endodontic treatments involves countless factors, each relevant in itself, but in certain cases the microscope can mean the difference between a successful treatment or a clinical failure. At present, it has become a very relevant topic, so the objective of this work is to review the literature in order to help understand the criteria that determine the relevance of the use of the microscope in the endodontic field based on scientific evidence (AU)


Subject(s)
Humans , Root Canal Therapy/trends , Image Enhancement/instrumentation , Microscopy/methods , Periapical Diseases/diagnosis , Prognosis , Treatment Outcome , Dental Instruments , Dental Pulp Diseases/diagnosis
6.
Int. braz. j. urol ; 47(3): 566-573, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1154486

ABSTRACT

ABSTRACT Background: Tyrosine kinase inhibitors (TKI) and immunotherapy improved survival in metastatic renal cell carcinoma (mRCC). Disparities in treatment access are present in healthcare systems globally. The aim of this study was to analyze survival outcomes of mRCC patients treated with first-line TKIs in the public (PHS) and private (PrS) health system in a Brazilian Cancer Center. Materials and Methods: Records from all mRCC patients treated with first-line TKIs from 2007-2018 were reviewed retrospectively. Categorial variables were compared by Fisher's exact test. Survival was estimated by Kaplan-Maier method and survival curves were compared using the log-rank test. Prognostic factors were adjusted by Cox regression model. Results: Of the 171 eligible patients, 37 (21.6%) were PHS patients and 134 (78.4%) were PrS patients. There were no difference in age, gender, or sites of metastasis. PHS patients had worse performance status (ECOG ≥2, 35.1% vs. 13.5%, p=0.007), poorer risk score (IMDC poor risk, 32.4% vs. 16.4%, p=0.09), and less nephrectomies (73% vs. 92.5%, p=0.003) than PrS patients. Median lines of therapy was one for PHS versus two for PrS patients (p=0.03). Median overall survival (OS) was 16.5 versus 26.5 months (p=0.002) and progression-free survival (PFS), 8.4 versus 11 months (p=0.01) for PHS and PrS patients, respectively. After adjusting for known prognostic factors on multivariate analysis, PHS patients still had a higher risk of death (HR: 1.61, 95% CI: 1.01-2.56, p=0.047). Conclusion: Patients with mRCC treated via the PHS had worse overall survival, possibly due to poorer prognosis at presentation and less drug access.


Subject(s)
Humans , Carcinoma, Renal Cell/drug therapy , Kidney Neoplasms/drug therapy , Prognosis , Brazil , Retrospective Studies , Treatment Outcome , Disease-Free Survival , Sunitinib
7.
Arch. argent. pediatr ; 119(5): e526-e530, oct. 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1292776

ABSTRACT

La hidrocefalia es una condición clínica que consiste en un cúmulo de líquido cefalorraquídeo a nivel encefálico. Una de las causas, poco frecuente, es el síndrome de Dandy-Walker. Se presenta el caso de un recién nacido con diagnóstico prenatal de hidrocefalia secundaria a una malformación de Dandy-Walker y sospecha de genitales ambiguos. Tras el nacimiento, se confirma el diagnóstico prenatal de malformación de Dandy-Walker asociado a manifestaciones extracraneales poco frecuentes como hipospadias interescrotal y dilatación del seno coronario secundario a persistencia de la vena cava superior izquierda. Con este caso clínico queremos exponer la complejidad del síndrome de Dandy-Walker debido a sus múltiples asociaciones, que marcarán el pronóstico del paciente y la necesidad de tratamiento multidisciplinar.


Hydrocephalus is a clinical condition that consists of an accumulation of cerebrospinal fluid around the brain; Dandy-Walker syndrome is a rare cause of it. We present the case of a newborn with prenatal diagnose of hydrocephalus due to a Dandy-Walker malformation, as well as ambiguous genitalia. After birth, diagnosis of Dandy-Walker malformation associated with uncommon extracranial manifestations is confirmed. Specifically, the baby presents interscrotal hypospadias and coronary sinus dilatation due to the persistence of the left superior vena cava. With the exposition of this case, we bring out the complexity of the Dandy-Walker syndrome due to the malformations associated with it; the ones that will determine the prognosis and the need of a multidisciplinary treatment


Subject(s)
Humans , Male , Pregnancy , Infant, Newborn , Dandy-Walker Syndrome/complications , Dandy-Walker Syndrome/diagnosis , Hydrocephalus/diagnosis , Hydrocephalus/etiology , Prognosis , Vena Cava, Superior , Brain
8.
Rev. cuba. anestesiol. reanim ; 20(1): e663, ene.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156366

ABSTRACT

Introducción: El pronóstico de morir por sangrado digestivo permite individualizar el tratamiento y disminuir la letalidad. Objetivos: Identificar los factores pronósticos de mortalidad por sangramiento digestivo no variceal en pacientes graves. Métodos: Se estudiaron casos y controles en pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Docente Clínico Quirúrgico Joaquín Albarrán Domínguez entre el 1ro de enero 2018 al 31 de diciembre de 2019. El universo estuvo constituido por 1060 pacientes, se seleccionaron 154 pacientes (137 controles y 17 casos). Se aplicó el Chi cuadrado y el Odds ratio (IC= 95 por ciento). Resultados: Del total de pacientes estudiados, 11,3 por ciento fallecieron, la edad promedio fue 69 ± 11,58 (grupo control) y 75± 11,42 (grupo casos). Las alteraciones del equilibrio ácido-base tuvieron 7,4 riesgo de morir con (IC 95 por ciento 2,5-21,9), la hipoxia 1,1 (IC 95 por ciento 0,41-3,2), las variaciones del potasio 4,9 (IC 95 por ciento 1,54-16,1), hiperlactemia 16,9 (IC 95 por ciento 5,3-52,0), las desviaciones del sodio 6,5 (IC 95 % 0,8-51,4). Con ventilación mecánica 2,17 (IC 95 por ciento 0,6-7,0), el apoyo de aminas vasoactivas 16,9 (IC 95 por ciento5,30-52,0), la trasfusión de glóbulos rojos, 11,7 (IC 95 por ciento 3,1-4,3) y con tratamiento dialítico 47,5 (IC 95 por ciento 8,6-258.0), las complicaciones 3,4 (IC 95 por ciento 1,15-10,4). El tratamiento endoscópico fue 93,5 por ciento de grupo control y 41,3 por ciento del grupo de casos, con OR en 0,04 (IC 95 por ciento 0,01-0,15). Conclusiones: Los factores pronósticos identificados fueron: alteraciones del pH, del sodio, el potasio, elevación del lactato, la ventilación mecánica, transfusiones más de 250 mL de glóbulos rojos, apoyo de aminas vasoactivas, tratamiento dialítico, y complicaciones relacionadas con el sangrado. El tratamiento endoscópico fue un factor de protección(AU)


Introduction: The prognosis of dying from digestive bleeding allows individualizing treatment and reducing mortality. Objectives: To identify the prognostic factors of mortality due to nonvariceal gastrointestinal bleeding in seriously-ill patients. Methods: Cases and controls were studied in patients admitted to the intensive care unit of Joaquín Albarrán Domínguez Clinical-Surgical Teaching Hospital, between January 1, 2018 and December 31, 2019. The universe consisted of 1060 patients, 154 of which were selected to make up the sample (137 controls and 17 cases). Chi-square and odds ratio (CI: 95 percent) were applied. Results: Of the total of patients studied, 11.3 percent died, the average age was 69±11.58 (control group) and 75±11.42 (case group). Alterations in acid-base balance accounted for 7.4 as risk of dying (CI: 95 percent; 2.5-21.9), hypoxia accounted for 1.1 (CI: 95 percent; 0.41-3.2), variations in potassium accounted for 4.9 (CI: 95 percent; 1.54-16.1), hyperlacthemia accounted for 16.9 (CI: 95 percent; 5.3-52.0), and sodium deviations accounted for 6.5 (CI: 95 percent; 0.8-51, 4), mechanical ventilation accounted for 2.17 (CI: 95 percent; 0.6-7.0), vasoactive amines support accounted for 16.9 (CI: 95 percent; 5.30-52.0), red blood cell transfusion accounted for 11.7 (CI: 95 percent; 3.1-4.3), dialysis treatment accounted for 47.5 (CI: 95 percent; 8.6-258.0), and complications accounted for 3.4 (CI: 95 percent; 1.15-10.4). Endoscopic treatment was 93.5 percent in the control group and 41.3 percent in the case group, with odds ratio at 0.04 (CI: 95 percent; 0.01-0.15). Conclusions: The prognostic factors identified were alterations in pH, sodium, potassium, elevated lactate, mechanical ventilation, transfusions of more than 250 mL of red blood cells, vasoactive amine support, dialysis treatment, and complications related to bleeding. Endoscopic treatment was a protective factor(AU)


Subject(s)
Humans , Digestive System Diseases/mortality , Digestive System Diseases/blood , Hemorrhage/complications , Prognosis , Case-Control Studies
9.
Rev. colomb. cardiol ; 28(2): 119-127, mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1341273

ABSTRACT

Resumen Introducción:: El índice leucoglucémico es un factor pronóstico, poco conocido y utilizado, que relaciona la glucemia y los leucocitos registrados al ingreso hospitalario. Su importancia radica en la determinación del riesgo de complicaciones y la mortalidad en pacientes con infarto agudo de miocardio. Objetivo: Establecer al índice leucoglucémico como factor predictor de complicaciones durante la evolución intrahospitalaria en los pacientes con infarto agudo de miocardio. Método: Estudio de tipo epidemiológico, analítico, observacional y de corte transversal, en una cohorte de pacientes que ingresaron con infarto agudo de miocardio durante un período de un año y tres meses. Resultados: Se incluyó en el estudio a 205 pacientes con infarto agudo de miocardio, cuyo promedio de edad fue de 62.99 ± 12.2 años, con predominio en varones con 69.3%. El infarto agudo de miocardio con elevación del segmento ST predominó en frecuencia con 63.9% y mayor tasa de complicaciones (p < 0.001). El promedio del índice leucoglucémico fue de 1,578.41 ± 1,208.1 y el punto de corte establecido fue de 656.8, de acuerdo con la curva ROC, con sensibilidad del 95.8% y especificidad del 73% para la predicción de complicaciones intrahospitalarias, con OR de 7.89. Conclusión: Un índice leucoglucémico > 656.8 representa un riesgo de 7.89 veces de desarrollar complicaciones en la población estudiada.


Abstract Introduction: Leukoglycemic index is a poorly known and used prognostic factor that correlates blood glucose and leukocytes which are taken at hospital admission. Its importance lies in determining complications and mortality risks in patients with acute myocardial infarction. Objective: To establish the leukoglycemic index as a predictor of complications during the in-hospital evolution in patients with acute myocardial infarction. Methods: Epidemiological, observational, cross-sectional, crosssectional study on a cohort of patients admitted with acute myocardial infarction during a period of 1 year 3 months. Results: 205 patients with acute myocardial infarction were included in this study. The mean age was 62.99 ± 12.2 years old, more frequently in males by 69.3%. It was determined that acute myocardial infarction with ST elevation predominated both in frequency with 63.9%, as well as with a higher rate of complications (p < 0.001). The average of leukoglycemic index was 1578.41 ± 1208.1 and the cut-off point was 656.8, according to ROC curve, with sensitivity of 95.8% and specificity of 73% for the prediction of inhospital complications, OR 7.89. Conclusions: A leukoglycemic index greater than 656.8 represents a 7.89-fold risk of developing complications in the study population.


Subject(s)
Humans , Male , Female , Middle Aged , Myocardial Infarction , Prognosis , Mortality , Sensitivity and Specificity , Glycemic Index
11.
Rev. ADM ; 78(2): 100-105, mar.-abr. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1247906

ABSTRACT

Trastorno neurológico enmarcado dentro de los trastornos de espectro autista (TEA) cuyas manifestaciones se reflejan en los ámbitos de la comunicación, interacción e imaginación social. Se clasifica en el manual diagnóstico y estadístico de trastornos mentales (DSM IV), se caracteriza por un mayor o menor grado de deterioro en las habilidades de lenguaje y comunicación, así como patrones repetitivos o restrictivos de pensamiento y comportamiento. El síntoma más distintivo es el interés obsesivo en un solo objeto o tema y la exclusión de cualquier otro pero siempre conservando habilidades de lenguaje. El pronóstico es bueno, debido a la compensación cognitiva, el enfoque repetitivo y restrictivo a actividades humanas productivas o generadoras de deferencias particulares, aunque no hay tratamiento específico, sino más bien interdisciplinario e individualizado, éste consiste en manejar los síntomas conductuales y la comorbilidad de forma independiente ya sea farmacológica o intervencionista. Paciente masculino de cinco años de edad, con un peso de 26 kg, cuadro de inmunizaciones completas, previamente diagnosticado con trastorno de Asperger (2015); caries dental de diversos grados, manejo estomatológico para su rehabilitación. El objetivo de este reporte es dar a conocer los cuidados para el tratamiento dental en pacientes con este trastorno (AU)


Neurological disorder known as autism spectrum disorders (ASD) whose main manifestations are reflected in the areas of communication, interaction and social imagination. It was first classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM lV), characterized by a greater or lesser degree of deterioration in language and communication skills, as well as repetitive patterns or restrictive of thought and behavior. The most distinctive symptom is obsessive interest in a single object or topic and the exclusion of any other, but always retaining language skills. The prognosis is good in most of the cases, due to the cognitive compensation, the repetitive and restrictive approach to productive or deferential human activities, although there is no specific treatment, but rather interdisciplinary and individualized, this consists of managing behavioral symptoms and comorbidity independently either pharmacologically or interventionally. Male patient with five years old and weight of 26 kg, complete immunization chart, previously diagnosed with Asperger's disorder (2015); with dental caries of various degrees implementing dental management. The objective of this report is to make aware of the care and behavior management for dental treatment in patients with this Disorder (AU)


Subject(s)
Humans , Male , Child, Preschool , Dental Care for Disabled , Dental Care for Children , Asperger Syndrome , Autism Spectrum Disorder , Patient Care Team , Prognosis , Signs and Symptoms , Behavioral Symptoms , Rett Syndrome , Dental Caries/therapy , Diagnostic and Statistical Manual of Mental Disorders , Diagnosis, Differential , Mouth Diseases/therapy , Mouth Rehabilitation/methods
12.
Rev. argent. mastología ; 40(145): 52-64, mar. 2021. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1284046

ABSTRACT

La 8° edición del Sistema de Estadificación del American Joint Committee on Cancer (AJCC) para el cáncer de mama ha incorporado el grado tumoral, el receptor de estrógenos, el receptor de progesterona y el estado del receptor 2 del factor de crecimiento epidémico humano como factores biológicos de estadificación que reflejan el pronóstico. El propósito de este estudio fue comparar el impacto pronóstico de la 7° y 8° edición del Sistema de Estadificación AJCC. Se revisaron las historias clínicas de 365 pacientes con cáncer de mama primario diagnosticados entre enero de 2011 y diciembre de 2015 en la Ciudad de Rosario. Se estimó la sobrevida específica del cáncer de mama (SE) y la sobrevida global (SG) entre los estadios. Se identificaron 83 pacientes que no pudieron clasificarse según el 8° Sistema de Estadificación Pronóstica del AJCC, dejando a 282 pacientes incluidos para los análisis finales. Un total de 172 (61%) de los pacientes fueron reasignados a un estadio diferente en la 8° edición del AJCC; el estadio IIIA en la 7° edición AJCC migró al estadio IB con peor pronóstico que el IIA y el IIB en la 8° edición AJCC, aunque en los estudios comparativos se pueden observar diferencias sutiles entre los dos sistemas.


The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for breast cancer has incorporated tumor grade, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status as staging biologic factors reflecting prognosis. The purpose of this study was to compare the 7th and 8th edition of AJCC staging system for prognostic impact. The medical records of 365 patients with primary breast cancer diagnosed between january 2011 and december 2015 in Rosario city were reviewed. Breast cancer specific survival (SE) and overal survival (OS) between stages were estimated 83 (22.7%) patients could not be categorized according to 8th AJCC prognostic staging system leaving 282 patients included for final analysis. A total of 172 (61%) of the patients were restaged to a different stage group in the 8th AJCC; stage IIIA in the 7th AJCC migrated to stage IB with worse prognosis than IIA and IIB in the 8th AJCC. Nevertheless, the 8th AJCC had a better AIC than the 7th staging system. The prognostic accuracy of the 8th AJCC staging system was generally superior to the 7th AJCC, although subtle differences between the two systems should be noted in comparative studies


Subject(s)
Humans , Breast Neoplasms , Prognosis , Neoplasm Staging
13.
Femina ; 49(3): 187-192, 20210331. ilus
Article in Portuguese | LILACS | ID: biblio-1224085

ABSTRACT

A ocorrência de úlceras genitais em adolescentes e mulheres jovens tem impacto emocional para as pacientes e seus familiares, pela frequente associação com uma possível etiologia de transmissão sexual. Porém, úlcera de Lipschütz e síndrome de Behçet não têm etiologia infecciosa e devem ser lembradas como possíveis diagnósticos diferenciais. O diagnóstico dessas duas patologias é clínico e pode ser desafiador. Dessa forma, foi realizada uma revisão na literatura com o objetivo de comparar as duas entidades. A úlcera de Lipschütz é causada por uma vasculite local e caracteriza-se pelo surgimento súbito de úlceras na vulva ou vagina inferior. Já a doença de Behçet é causada por vasculite sistêmica, com episódios de remissão e exacerbação, que pode envolver quase todos os sistemas orgânicos. Em ambos os casos, é essencial o referenciamento para reumatologia. O tratamento objetiva suprimir exacerbações, controlar a dor e prevenir infecção secundária.(AU)


The occurrence of genital ulcers in adolescents and young women have an emotional impact for the patient and their families, due to the frequent association of its etiology with a sexually transmitted disease. However, Lipschütz ulcer and Behçet's syndrome do not have an infectious etiology and should be remembered as a possible differential diagnoses. As the diagnosis of these two pathologies is clinical and can be challenging, a review of literature was carried out. The objective of this review of literature was to compare both diseases. Lipschütz ulcer is caused by local vasculitis and is characterized by the sudden appearance of ulcers in the vulva or lower vagina. Behçet's syndrome is caused by systemic vasculitis, with episodes of remission and exacerbation, which can affect almost all organ systems. In both cases, referral to rheumatology is essential. Treatment aims to suppress exacerbations, control pain and prevent secondary infection.(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/drug therapy , Oral Ulcer , Systemic Vasculitis/complications , Systemic Vasculitis/diagnosis , Systemic Vasculitis/drug therapy , Prognosis , Uveitis , Vulvar Diseases , Epstein-Barr Virus Infections
15.
Rev. bras. ortop ; 56(1): 83-90, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1288654

ABSTRACT

Abstract Objective To describe a new presentation of tears and retears of the rotator cuff, which we denominate captured rotator cuff (CRC). We also aim to evaluate it clinically and through images. Methods We assessed retrospectively 16 patients with intraoperative diagnosis of CRC between March 2005 and September 2017; by means of imaging (radiography and magnetic resonance imaging [MRI]) and functional scores (UCLA and Constant & Murley). In images we analyzed the evolution for rotator cuff arthropathy and presence of retears. Functionally, we compared the affected side with the contralateral side and extensive lesions with nonextensive. Results Five (31.25%) patients presented with rotator cuff arthropathy, and 10 (62.5%) with retears. Three (75%) patients with nonextensive lesions had good/excellent UCLA and Constant & Murley scores. In patients with extensive lesions, when the Constant & Murley score was evaluated, 6 (50%) presented good/excellent results, and in the UCLA score, 7 (58.3%). Comparing the affected side (Constant 74.72 points; UCLA 20 points) with the contralateral side (Constant 96.96 points; UCLA 25.63 points), there were worse functional results with statistical significance. Conclusion The diagnosis of CRC is suspected by characteristic findings on MRI and confirmed in arthroscopy. The affected shoulders present worse functional postoperative scores.


Resumo Objetivo Descrever uma nova apresentação de ruptura e rerruptura do manguito rotador (MR), a qual denominamos manguito capturado (MC). Objetivamos também avaliá-la clinicamente e por meio de imagens. Métodos Foram avaliados retrospectivamente 16 pacientes com diagnóstico intraoperatório de MC no período de março de 2005 a setembro de 2017; por meio de exames de imagem (radiografia e ressonância magnética [RM]) e escores funcionais (UCLA e Constant & Murley). Nas imagens, analisamos a evolução para artropatia do manguito rotador e presença de rerrupturas. Funcionalmente, comparamos o lado afetado com o contralateral e as lesões extensas com nãoextensas. Resultados Cinco (31,25%) pacientes evoluíram com artropatia do manguito rotador e 10 (62,5%) tiveram rerrupturas. Três (75%) pacientes com lesões não extensas tiveram UCLA e Constant & Murley bons/excelentes. Nos pacientes com lesões extensas, quando avaliado Constant & Murley, 6 (50%) apresentaram resultados bons/excelentes, e no escore UCLA, 7 (58,3%). Comparando o lado acometido (Constant 74,72 pontos; UCLA 20 pontos) com o contralateral (Constant 96,96 pontos; UCLA 25,63 pontos), houve pior resultado funcional com significância estatística. Conclusão O diagnóstico de MC é suspeitado por achados característicos na RM e confirmado na artroscopia. Os ombros acometidos apresentam piores escores funcionais pós-operatórios.


Subject(s)
Prognosis , Rupture , Shoulder , Magnetic Resonance Spectroscopy , Rotator Cuff , Shoulder Impingement Syndrome , Joint Diseases
16.
Säo Paulo med. j ; 139(1): 10-17, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156965

ABSTRACT

ABSTRACT BACKGROUND: Diabetic ketoacidosis is the most frequent hyperglycemic complication in the evolution of diabetes mellitus. Common precipitating factors include newly diagnosed diabetes mellitus, noncompliance with therapy and infections. However, few studies have been conducted in Brazil and none were prospective in design. OBJECTIVE: To describe the incidence, clinical and laboratory characteristics and precipitating factors of diabetic ketoacidosis among emergency department patients in a tertiary-level teaching hospital in Brazil. We also aimed to identify immediate and long-term mortality within two years. DESIGN AND SETTING: Prospective prognosis cohort study conduct at a tertiary-level teaching hospital in São Paulo, Brazil. METHODS: All patients > 12 years old presenting diabetic ketoacidosis who were admitted to the emergency department from June 2015 to May 2016 were invited to participate. RESULTS: The incidence of diabetic ketoacidosis per 1,000 admissions was 8.7. Treatment noncompliance and infection were the most common causes of diabetic ketoacidosis. The immediate mortality rate was 5.8%, while the six-month, one-year and two-year mortality rates were 9.6%, 13.5% and 19.2%, respectively. Death occurring within two years was associated with age, type 2 diabetes, hypoalbuminemia, infection at presentation and higher sequential organ failure assessment (SOFA) score at admission. CONCLUSIONS: Diabetic ketoacidosis among patients presenting to the emergency department was relatively frequent in our hospital. Treatment noncompliance and infection were major precipitating factors and presence of diabetic ketoacidosis was associated with immediate and long-term risk of death.


Subject(s)
Humans , Child , Diabetic Ketoacidosis/complications , Diabetic Ketoacidosis/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Prognosis , Brazil/epidemiology , Incidence , Prospective Studies , Retrospective Studies , Cohort Studies , Emergency Service, Hospital
17.
Rev. bras. oftalmol ; 80(1): 33-41, jan.-fev. 2021. graf
Article in Portuguese | LILACS | ID: biblio-1251314

ABSTRACT

RESUMO A Leucemia Linfocitica Aguda (LLA) é uma doença caracterizada por uma alta taxa de sobrevida, porém o número absoluto de crianças que morrem por ela representa uma grande parcela dos casos de óbitos infantis por câncer. A morbidade decorrente de seu tratamento pode deixar sequelas em pessoas com grande expectativa de vida, tornando-se extremamente necessário o entendimento da patogênese desta doença, possibilitando o desenvolvimento de novos tratamentos e diminuição de sequelas provocadas pela doença. O diagnóstico precoce é importante para se evitar complicações oculares que possam levar a baixa de acuidade visual em longo prazo e para avaliação de recaídas de tratamento sendo determinante no direcionamento de condutas.


ABSTRACT The Acute Lymphocytic Leukemia (ALL) is a disease characterized by a high survival rate, but the absolute number of children who die from it represents a large proportion of cases of infant deaths from cancer. The morbidity resulting from its treatment can leave sequelae in people with high life expectancy, making it extremely necessary to understand the pathogenesis of this disease, enabling the development of new treatments and reduction of sequelae caused by the disease. This early diagnosis is important to avoid ocular complications that may lead to low long-term visual acuity and to evaluate treatment relapses and determine the conducts.


Subject(s)
Humans , Male , Child , Prognosis , Retina/pathology , Leukemic Infiltration , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
18.
Int. braz. j. urol ; 47(1): 159-168, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1134329

ABSTRACT

ABSTRACT Purpose: Epidemiological studies reported conflicting results about preoperative hydronephrosis in upper tract urothelial carcinoma (UTUC). This study aimed to investigate the association between preoperative hydronephrosis and pathologic features and oncologic outcomes in patients with UTUC treated by radical nephroureterectomy (RNU). Materials and Methods: This was a retrospective, single-center cohort study of 377 patients treated by RNU without perioperative chemotherapy between January 2001 and December 2014. Logistic regression, Cox regression, and survival analyses were performed. Results: Among the 226 patients with high-grade UTUC, 132 (58%) had preoperative hydronephrosis. Multivariable logistic regression revealed that hydronephrosis was independently associated with advanced pT stage (P=0.017) and lymph node or lymphovascular invasion (P=0.002). Median follow-up was 36 months (interquartile range: 20-48 months). The 3- and 5-year overall survival (OS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P <0.001). The 3- and 5-year cancer-specific survival (CSS) rates in patients with hydronephrosis were significantly lower than in those without hydronephrosis (both P=0.001). Hydronephrosis was independently associated with OS and CSS (P=0.001 and P=0.004, respectively). Among the 151 patients with low-grade UTUC, hydronephrosis was not associated with pathologic features and postoperative survival. Conclusions: Preoperative hydronephrosis was significantly associated with adverse pathologic features and postoperative survival in patients with high-grade UTUC.


Subject(s)
Humans , Carcinoma, Transitional Cell/surgery , Carcinoma, Transitional Cell/complications , Urologic Neoplasms/surgery , Urologic Neoplasms/complications , Hydronephrosis , Prognosis , Retrospective Studies , Cohort Studies
19.
Rev. inf. cient ; 100(1): 1-11, ene.-feb. 2021. tab
Article in Spanish | LILACS | ID: biblio-1156704

ABSTRACT

RESUMEN Introducción: La cardiopatía isquémica, a pesar de que la mortalidad ha disminuido en casi todas las regiones del mundo, continúa siendo un problema de salud. Objetivo: Identificar los factores pronósticos de mortalidad intrahospitalaria en pacientes con infarto agudo del miocardio con elevación del segmento ST. Método: Se realizó un estudio analítico, de casos y controles, de 347 pacientes diagnosticados con infarto agudo del miocardio con elevación del segmento ST tipo I, desde enero de 2018 a diciembre de 2019 en el Hospital Clínico Quirúrgico Docente "Celia Sánchez Manduley", de Manzanillo, Granma. El grupo de estudio lo integraron 46 fallecidos y por cada paciente de este grupo se escogieron, aleatoriamente, 2 egresados vivos, constituyendo los controles. Se utilizó la prueba de la Chi cuadrado para variables cualitativas y la de la t de Student para las cuantitativas. Para determinar los factores pronósticos de mortalidad se utilizó un modelo de regresión logística. Resultados: Se determinó una media de edad de 73,7 años (DE ±8,0). Prevalecieron los antecedentes de tabaquismo, diabetes mellitus e hipertensión arterial. Resultaron factores de riesgos de mortalidad el antecedente de insuficiencia cardiaca (OR: 5,4 IC 95 % 1,226-23,97), presentarse con insuficiencia cardiaca mayor que I según Killip-Kimball (OR: 12,6 IC 95 % 3,245-49,30), valores de glucemia mayores de 10 mmol/L (OR: 4,7 IC 95 % 1,149-19,79) y de creatinfosfoquinasa MB mayores de 160 UI (OR: 17,7 IC 95 % 3,992-79,07). Conclusiones: Existen variables epidemiológicas, clínicas y analíticas capaces de predecir mortalidad en pacientes con infarto agudo del miocardio.


ABSTRACT Introduction: Despite the fact that the mortality has decreased in almost all regions of the world, ischemic heart disease continues to be a health problem. Objective: To identify prognostic factors for in-hospital mortality in patients with ST-segment elevation myocardial infarction. Method: An analytical study of cases and controls was carried out, out of 347 patients diagnosed with acute myocardial infarction with ST segment elevation type I, from January 2018 to December 2019 at the Hospital Clínico Quirúrgico Docente "Celia Sánchez Manduley" in Manzanillo, Granma. The study group was made up of 46 deceased, and for each deceased patient in this group, 2 living discharged patients were randomly chosen, constituting the control group. The Chi-square test was used for qualitative variables and the Student's T-test for quantitative variables. To determine the prognostic factors of mortality, a logistic regression model was used. Results: A mean age of 73.7 years (SD ± 8.0) was determined. History of smoking, diabetes mellitus and arterial hypertension prevailed. The mortality risk factors were: history of heart failure (OR: 5.4 95% CI 1,226-23.97); heart failure higher than I according to Killip-Kimball (OR: 12.6 95% CI 3,245-49 , 30); blood glucose values higher than 10 mmol / L (OR: 4.7 95% CI 1.149-19.79) and creatine phosphokinase MB higher than 160 IU (OR: 17.7 95% CI 3.992-79.07). Conclusions: There are epidemiological, clinical and analytical variables capable of predicting mortality in patients with acute myocardial infarction.


RESUMO Introdução: A doença isquêmica do coração, apesar de a mortalidade ter diminuído em quase todas as regiões do mundo, continua sendo um problema de saúde. Objetivo: Identificar fatores prognósticos para mortalidade intra-hospitalar em pacientes com infarto do miocárdio com elevação do segmento ST. Método: Foi realizado um estudo analítico, de casos e controles, de 347 pacientes com diagnóstico de infarto agudo do miocárdio com elevação do segmento ST tipo I, de janeiro de 2018 a dezembro de 2019, no Hospital Clínico Quirúrgico Docente "Celia Sánchez Manduley", Manzanillo, Granma. O grupo de estudo foi composto por 46 falecidos e para cada paciente deste grupo foram escolhidos aleatoriamente 2 que receberam alta vivos, constituindo os controles. O teste Qui-quadrado foi usado para variáveis qualitativas e o teste t de Student para variáveis quantitativas. Para determinar os fatores prognósticos de mortalidade, foi utilizado um modelo de regressão logística. Resultados: Foi determinada uma média de idade de 73,7 anos (DP ± 8,0). Prevaleceu história de tabagismo, diabetes mellitus e hipertensão arterial. Fatores de risco de mortalidade foram história de insuficiência cardíaca (OR: 5,4 IC 95% 1,226-23,97), apresentando-se com insuficiência cardíaca maior que I de acordo com Killip-Kimball (OR: 12,6 IC 95% 3,245-49,30), valores de glicose no sangue maior que 10 mmol/L (OR: 4,7 95% CI 1,149-19,79) e creatina fosfoquinase MB maior que 160 UI (OR: 17,7 95% CI 3,992-79,07). Conclusões: Existem variáveis epidemiológicas, clínicas e analíticas capazes de predizer mortalidade em pacientes com infarto agudo do miocárdio.


Subject(s)
Humans , Prognosis , Hospital Mortality , ST Elevation Myocardial Infarction/diagnosis , Case-Control Studies
20.
Rev. medica electron ; 43(1): 2771-2783, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156774

ABSTRACT

RESUMEN Introducción: diversos son los factores mancomunados a un mayor riesgo de recién nacidos con bajo peso al nacer en gestantes. Objetivos: aplicar y validar un índice pronóstico para la estratificación de riesgo de recién nacidos con bajo peso al nacer. Material y métodos: se realizó un estudio observacional de corte longitudinal, prospectivo o de cohortes en gestantes atendidas en el área de salud del municipio de Guanabacoa, en el período comprendido desde el 1º de enero de 2016 hasta el 31 de diciembre del 2019, para aplicar un índice pronóstico de bajo peso al nacer, con elementos clínicos. Mediante la función de regresión logística apreciada se calcularon las probabilidades de bajo peso al nacer en la muestra de estimación, y esa distribución empírica fue fragmentada en terciles para escrutar zonas que permitieran clasificar a las gestantes como de bajo, mediano y alto riesgo de bajo peso. Resultados: el (85,7 %) de las gestantes poseían baja probabilidad de bajo peso al nacer. El 60,4 % de las gestantes estuvieron clasificadas como pacientes con una alta probabilidad de bajo peso al nacer, y la mayoría de los pacientes clasificados de riesgo medio con bajo peso al nacer; 11 pacientes no fueron clasificados adecuadamente por el Índice pronostico. Conclusiones: el índice construido mostró eficacia y robustez adecuadas, siendo útil para realizar pronóstico de bajo peso al nacer en gestantes del área de salud (AU).


SUMMARY Introduction: there are many factors associated to a bigger risk for newborns with low weight at birth. Objective: to apply and to validate a prognostic index for the risk stratification in newborns with low weight at birth. Materials and methods: a cohort or prospective, longitudinal, observational study was carried out in pregnant women attending the health area of Guanabacoa municipality in the period from January 1st 2016 until December 31st 2019 to apply a prognostic index of low weight at birth, with clinical elements. Through the appreciated logistic regression function the possibilities of low weight at birth were calculated in the estimation sample, and that empiric distribution was fragmented in tertils to scrutinize zones allowing classifying pregnant women as low, medium and high risk of low weight births. Results: 85.7% of the pregnant women showed low probability of low birth weight. 60.4% of them was classified as patient with a high probability of low birth weight, and most of the patients classified as of medium risk of low birth weight; 11 patients were not adequately classified by the prognostic index. Conclusions: the conformed index showed suitable efficacy and reliability, being useful to carry out prognosis of low weight at birth in pregnant women of the health area (AU).


Subject(s)
Humans , Prognosis , Severity of Illness Index , Infant, Low Birth Weight , Risk Factors , Risk Index , Longitudinal Studies , Observational Study
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