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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-4, 01/jan./2022.
Article in English | LILACS | ID: biblio-1369163

ABSTRACT

Introduction: One of the challenges of maxillofacial surgery is the rehabilitation of patients with severe bone loss, using implant-supported prostheses. This challenge is based on the small remaining bone structure, and on the need to reconstruct the structure for the rehabilitation with autogenous or exogenous grafts. Case report: We report the case of a patient with severe maxillary atrophy, where a skullcap graft was performed associated with implant placement and prosthetic completion 14 months after the start of treatment. Final considerations: We demonstrate clinical safety for the use of extraoral grafts without complications, representing a good alternative treatment for this group of patients.


Introdução: um dos desafios da cirurgia bucomaxilofacial é a reabilitação de pacientes com perda óssea severa, utilizando próteses implantossuportadas. Este desafio baseia-se na pequena estrutura óssea remanescente e na necessidade de reconstrução da estrutura para a reabilitação com enxertos autógenos ou exógenos. Relato de caso: Relatamos o caso de um paciente com atrofia maxilar grave, onde foi realizado enxerto de calota craniana associado à instalação de implante, com finalização protética 14 meses após o início do tratamento. Consideracoes finais: Demonstramos segurança clínica para o uso de enxertos extrabucais sem complicações, representando uma boa alternativa de tratamento para este grupo de pacientes.


Subject(s)
Mandible , Patients , Prostheses and Implants , Atrophy , Skull , Surgery, Oral , Jaw, Edentulous
2.
Braz. j. otorhinolaryngol. (Impr.) ; 88(2): 187-193, Mar.-Apr. 2022. graf
Article in English | LILACS | ID: biblio-1374725

ABSTRACT

Abstract Introduction: Individuals with cleft palate can present with velopharyngeal dysfunction after primary palatoplasty and require a secondary treatment due to insufficiency. In these cases, the pharyngeal bulb prosthesis can be used temporarily while awaiting secondary surgery. Objective: This study aimed to investigate the outcome of treatment of hypernasality with pharyngeal bulb prosthesis in patients with history of cleft palate presenting with velopharyngeal insufficiency after primary palatal surgery. We hypothesized that the use of the pharyngeal bulb prosthesis is an effective approach to eliminate hypernasality related to velopharyngeal insufficiency in patients with cleft palate. Methods: Thirty speakers of Brazilian Portuguese (15 males and 15 females) with operated cleft palate, ages ranging from 6 to 14 years (mean: 9 years; SD = 1.87 years), participated in the study. All patients were fitted with a pharyngeal bulb prosthesis to manage velopharyngeal insufficiency while they were awaiting corrective surgery to be scheduled. Auditory-perceptual analysis of speech recorded in the conditions with and without pharyngeal bulb prosthesis were obtained from three listeners who rated the presence or absence of hypernasality for this study. Results: Seventy percent of the patients eliminated hypernasality while employing the pharyngeal bulb prosthesis, while 30% still presented with hypernasality. The comparison was statistically significant (p < 0.001). Conclusion: The use of the pharyngeal bulb prosthesis is an effective approach to eliminate hypernasality related to velopharyngeal insufficiency.


Resumo Introdução: Indivíduos com fissura palatina podem apresentar disfunção velofaríngea após a palatoplastia primária e necessitam de um secundário devido à insuficiência velofaríngea. Nesses casos, o obturador faríngeo pode ser usado temporariamente enquanto se aguarda uma cirurgia secundária. Objetivo: Investigar o resultado do tratamento da hipernasalidade com o uso de obturador faríngeo em pacientes com histórico de fissura palatina que apresentam insuficiência velofaríngea após a palatoplastia primária. Nossa hipótese é que o uso do obturador faríngeo seja uma abordagem eficaz para eliminar a hipernasalidade relacionada à insuficiência velofaríngea em pacientes com fissura palatina Método: Participaram do estudo 30 indivíduos falantes do Português Brasileiro (15 homens e 15 mulheres) com fissura palatina operada, de 6 a 14 anos de idade (média: 9 anos; DP = 1,87 anos). Todos os pacientes receberam obturador faríngeo para o tratamento da insuficiência velofaríngea, enquanto aguardavam vaga para a cirurgia secundária. A análise perceptivo-auditiva da fala, realizada nas condições com e sem obturador faríngeo, foi realizada por três ouvintes, quanto à presença e ausência da hipernasalidade. Resultados: 70% dos pacientes eliminaram a hipernasalidade de fala com o uso do obturador faríngeo, enquanto 30% não eliminaram. A comparação foi estatisticamente significante (p < 0,001). Conclusão: O uso temporário do obturador faríngeo é uma abordagem efetiva para eliminar a hipernasalidade decorrente da insuficiência velofaríngea.


Subject(s)
Velopharyngeal Insufficiency/surgery , Velopharyngeal Insufficiency/etiology , Voice Disorders , Nose Diseases , Cleft Palate/surgery , Cleft Palate/complications , Prostheses and Implants , Speech , Treatment Outcome
3.
Rev. argent. cir. plást ; 28(1): 29-33, 20220000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1392329

ABSTRACT

Los grandes defectos torácicos requieren generalmente procedimientos complejos para su reparación; en la mayoría de los casos es necesaria la combinación de tejidos autólogos y materiales protésicos, por lo que constituye un desafío para el cirujano plástico. En nuestra experiencia se presenta una herida compleja de la pared torácica secundaria a exéresis tumoral. En general se dispone de varias opciones reconstructivas para cubrir los defectos resultantes de las amplias escisiones y poder aportar colgajos vascularizados, amplios y voluminosos. A pesar de no disponer en nuestro caso con los tejidos regionales más comúnmente usados, hemos podido dar cobertura a todo el defecto y se ha garantizado una adecuada estabilidad de la pared torácica. Se tuvo como objetivo mostrar la forma en que se realizó la reconstrucción inmediata con la combinación de colgajo de rotación y material protésico. En este artículo se revisa el hemicolgajo dermograso abdominal, la técnica de elevación y sus ventajas e inconvenientes. Se trata de una técnica de gran seguridad, versátil, con pocas secuelas en la zona donante, de tiempo quirúrgico relativamente corto.


Large thoracic defects require complex procedures for repair, in most cases it requires the combination of autologous tissues and prosthetic materials. A complex wound secondary to tumor exeresis was presented in our service. Among the multiple reconstructive options, a rotation and advancement abdominal dermofat hemicolgajo was chosen. Resulting in a technique of great safety, versatile, with little sequel in the donor area, and short surgical time


Subject(s)
Humans , Female , Middle Aged , Prostheses and Implants , Breast Neoplasms/surgery , Thoracic Wall/surgery , Abdominal Fat/transplantation , Myocutaneous Flap/transplantation , Mastectomy/methods
4.
Rev. bras. oftalmol ; 81: e0052, 2022.
Article in Portuguese | LILACS | ID: biblio-1387965

ABSTRACT

RESUMO A manufatura aditiva, mais popularmente conhecida como impressão tridimensional, baseia-se no desenvolvimento de um objeto com a ajuda de um software de desenho assistido por computador seguido de sua impressão por meio da deposição de uma matéria-prima, camada por camada, para a construção do produto desejado. Existem vários tipos de técnicas de impressão tridimensional, e o tipo de processo de impressão escolhido depende da aplicação específica do objeto a ser desenvolvido, dos materiais a serem utilizados e da resolução necessária à impressão do produto final. A impressão tridimensional abriu perspectivas na pesquisa e revolucionou o campo das ciências da saúde, com a possibilidade de criação e de desenvolvimento de produtos personalizados de maneira rápida, econômica e de forma mais centralizada do que no processo de manufatura tradicional. As tecnologias de manufatura aditiva remodelaram os diagnósticos médicos; as medidas preventivas e pré-operatórias; o tratamento e a reabilitação, assim como os processos de engenharia de tecidos nos últimos anos. Na oftalmologia, as aplicações da impressão tridimensional são extensas. Modelos anatômicos para aplicação na área da educação e planejamentos cirúrgicos, desenvolvimento de implantes, lentes, equipamentos para diagnósticos, novas aplicações terapêuticas e desenvolvimento de tecidos oculares já estão em desenvolvimento. Por possuir um campo amplo e ser alvo de pesquisa constante, a área oftalmológica permite que a manufatura aditiva ainda seja amplamente utilizada a favor dos médicos e dos pacientes.


ABSTRACT Additive manufacturing, more popularly known as three-dimensional (3D) printing, is based on the development of an object with the help of computer-aided design software followed by its printing through the deposition of a material, layer by layer, to create the desired product. There are several types of 3D printing techniques and the type of printing process chosen depends on the specific application of the object to be developed, the materials to be used, and the resolution required to print the final product. 3D printing has brought new perspectives to research and revolutionized the field of health sciences, with the possibility of creating and developing customized products in a faster, more economical, and more centralized way than in the traditional manufacturing process. Additive manufacturing technologies have reformulated medical diagnostics, preventive, preoperative, treatment, and rehabilitation, as well as tissue engineering processes in recent years. In ophthalmology, the applications of 3D printing are extensive. Anatomical models for application in education and surgical planning, development of implants, lenses, diagnostic equipment, new therapeutic applications, and development of ocular tissues (3D bioprinting) are already under development. As it has a wide field and is the subject of constant research, the ophthalmic area allows additive manufacturing to still be widely used in favor of doctors and patients.


Subject(s)
Humans , Ophthalmology , Imaging, Three-Dimensional , Printing, Three-Dimensional , Polymers , Prostheses and Implants , Biosensing Techniques , Computer-Aided Design , Recycling , Bioprinting , Stereolithography , Models, Anatomic
5.
Article in English | WPRIM | ID: wpr-928997

ABSTRACT

Peri-implantitis, characterized by inflammation of tissues around implants and gradual loss of supporting bone tissue, has become one of the main causes for implant failure. Thoroughly removing the plaque biofilm on the implant surface is the first principle in the treatment of peri-implantitis. For this reason, various decontamination methods have been proposed, which can be divided into 2 categories: Removing biofilm and killing microorganisms according to the effect of plaque biofilm on the implant surface. However, at present, there is no decontamination method that can completely remove the plaque biofilm on the implant surface, and it lacks of clinical recommended guidelines. To understand the advantages and disadvantages, effectiveness and safety for different implant surface decontamination methods is of great significance to guide the clinical selection for peri-implantitis treatment.


Subject(s)
Bone and Bones , Decontamination , Dental Implants , Humans , Inflammation , Peri-Implantitis/therapy , Prostheses and Implants
6.
Article in Chinese | WPRIM | ID: wpr-928911

ABSTRACT

Stainless steel has been widely used in non-active surgical implantable medical device of cardiovascular, orthopedics, dental and ophthalmology. In this paper, we mainly focused on development of stainless steel, as well as the material-related standard evolution. We further summarized the recent advancement of stainless steel use in surgical implantable medical device. Insight and regulatory perspective has been further demonstrated.


Subject(s)
Prostheses and Implants , Stainless Steel
7.
Article in Chinese | WPRIM | ID: wpr-928896

ABSTRACT

The unipolar/bipolar pacing mode of pacemaker is related to its circuit impedance, which affects the battery life. In this study, the in vitro experiment scheme of pacemaker circuit impedance test was constructed. The human blood environment was simulated by NaCl solution, and the experimental environment temperature was controlled by water bath. The results of in vitro experiments showed that under the experimental conditions similar to clinical human parameters, the difference between the circuit impedance of bipolar mode and unipolar mode is 120~200 Ω. The results of the in vitro experiment confirmed that the circuit impedance of bipolar circuit was larger than that of unipolar mode, which was found in clinical practice. The results of this study have reference value to the optimization of pacing mode and the reduction of pacemaker power consumption.


Subject(s)
Cardiac Pacing, Artificial/methods , Electric Impedance , Humans , Pacemaker, Artificial , Prostheses and Implants
8.
Article in Chinese | WPRIM | ID: wpr-928870

ABSTRACT

OBJECTIVE@#To discuss how to implement and promote the lean management of medical devices life cycle through establishing medical device UDI.@*METHODS@#Discuss the application of UDI on medical consumables lean management by relying on the construction of medical device UDI system in our country, and summarize the pilot experience of implanted medical devices in Shanghai.@*RESULTS@#Improve the application value of UDI in medical device Internet of Things through analyzing the present situation of implanted medical device and further strengthen the UDI application standardization.@*CONCLUSIONS@#Form the interconnection and mutual recognition during medical device life cycle and reduce the input of product cost and resource consumption in our country through establishing a more standardized and effective UDI circulation system.


Subject(s)
China , Internet , Internet of Things , Prostheses and Implants
9.
Article in Chinese | WPRIM | ID: wpr-928868

ABSTRACT

To find an effective method of minimally invasive treatment combining prevention and assistance in the middle zone of conservative treatment and fusion surgery for lumbar degenerative diseases, through the clinical effect observation and the advantage and disadvantage comparison of several commonly used lumbar interspinous dynamic stabilization systems, by analyzing the physiological structure, biomechanics and relevant data of lumbar interspinous processes, based on fully understanding of memory alloy materials, a new dynamic lumbar interspinous fixation device with a memory alloy material has been independently designed and researched, which can not only reconstruct the normal biomechanical characteristics of the lumbar spine and satisfy the normal activities of the human spine, but also avoid damage to the original structure and reduce the incidence of postoperative complications. In addition, the device can be used to optimize the current therapeutic methods. According to our research, the dynamic lumbar interspinous process stabilization device with a memory alloy has theoretically achieved satisfactory results, which can be used to overcome the shortcomings of the existing technology and is superior to the current several dynamic lumbar interspinous process stabilization systems.


Subject(s)
Alloys , Biomechanical Phenomena , Humans , Lumbar Vertebrae/surgery , Postoperative Complications , Prostheses and Implants , Spinal Fusion
10.
Article in Chinese | WPRIM | ID: wpr-928850

ABSTRACT

In order to solve the problem of communication interference and communication distance caused by the rapid pacing system when establishing the rapid atrial fibrillation model, a low-power implantable pacing system based on 433 MHz communication frequency to form a star network is designed. The system includes an implantable pacemaker, a programmer head, and programmer software. The pacemaker is composed of a wireless communication module, a pacing module, an ECG monitoring module, and a power management module. The programmer head acts as an intermediate node in the star network and is controlled by PC programmer software to program each pacemaker. This article introduces the hardware design and software flow of each part of the system, and describes the results of in vivo simulation and in vivo animal models of the system. The results show that the designed system and application method are effective and feasible for the rapid atrial pacing atrial fibrillation model. 433 MHz wireless communication, implantable, pacemaker system, low-power, ECG monitoring.


Subject(s)
Animals , Atrial Fibrillation/therapy , Electrocardiography , Equipment Design , Pacemaker, Artificial , Prostheses and Implants , Wireless Technology
12.
Saúde Soc ; 31(1): e200398, 2022. tab, graf
Article in Portuguese | LILACS | ID: biblio-1352217

ABSTRACT

Resumo Obsolescência programada é um conjunto de ações empreendidas por parte do produtor com o objetivo de estabelecer o decaimento gradativo de algum atributo de uma mercadoria para, assim, estimular artificialmente a demanda pelo consumo. A literatura sobre o fenômeno tem apontado como vítimas somente indivíduos e, como forma de manifestação do fenômeno, objetos. Este trabalho aponta a ocorrência do fenômeno de obsolescência programada em serviços públicos de saúde. Para isso, é empreendido um estudo exploratório-interpretativo de abordagem qualitativa e utilizado como estratégia de pesquisa o estudo de caso. A unidade de análise foi a nomeada Máfia das Próteses e, para coleta de dados, foram empregadas as técnicas de pesquisa bibliográfica e documental. Como resultado, foram selecionados e expostos três casos da ocorrência do fenômeno em cirurgias. Foi também realizado um esforço interpretativo dos condicionantes, da dinâmica e dos efeitos da prática de sabote cirúrgico com objetivo de estimular a demanda por serviços médicos e equipamentos médico-hospitalares. Como contribuição, este estudo realiza o delineamento dos elementos que caracterizam a ocorrência deste fenômeno em serviços médicos. Além disso, inaugura uma agenda de futuros estudos que abordam tanto o Estado sendo vitimado pela prática, quanto a ocorrência do fenômeno no setor de serviços.


Abstract Planned obsolescence is a set of actions undertaken by the producer to establish the gradual decay of some attribute of a commodity, artificially stimulating the demand for consumption. The literature on the phenomenon has identified only individuals as victims and objects as forms of expression. This study reports the occurrence of planned obsolescence in public health services. To this end, it consists of an exploratory-interpretative study with a qualitative approach, using the case study of the so-called Prosthetic Mafia. Data were collected by means of bibliographic and documentary research, resulting in three cases that expose the phenomenon occurrence in surgeries. The results were analyzed through an attempt to interpret the conditions, dynamics, and effects of the practice of surgical sabotage to stimulate the demand for medical services and medical-hospital equipment. This study outlines the elements that characterize planned obsolescence occurrence in medical services, inaugurating an agenda of future studies that address both the State being victimized by the practice and the phenomenon in the service sector.


Subject(s)
Humans , Male , Female , Orthotic Devices , Prostheses and Implants , Science, Technology and Society , Hospital Administration , Materials Management, Hospital
13.
Rev. colomb. cir ; 37(2): 318-323, 20220316. fig
Article in Spanish | LILACS | ID: biblio-1362982

ABSTRACT

Introducción. Por ser un procedimiento de mínima invasión, la colangiopancreatografía retrógrada endoscópica (CPRE) es el procedimiento más utilizado para el manejo de la patología litiásica biliar. Sin embargo, puede presentar complicaciones que comprometen la vida del paciente. Caso clínico. Paciente masculino de 63 años es llevado a CPRE por una coledocolitiasis recidivante gigante. Durante el procedimiento presentó una disección aérea masiva con neumotórax bilateral a tensión, secundarios a una perforación duodenal, que derivó en una fístula bilio-retroperitoneal. Se trató de forma conservadora con una adecuada evolución. Discusión. Se han descrito pocos casos de neumotórax como complicación de la CPRE. Se considera que este es el primer caso publicado de neumotórax a tensión manejado exitosamente de forma conservadora. Conclusión. El diagnóstico temprano de las disecciones aéreas es el único predictor independiente que podría cambiar el curso clínico de esta patología y su manejo dependerá de la experticia del cirujano y del estado clínico del paciente.


Introduction. Because it is a minimally invasive procedure, endoscopic retrograde cholangiopancreatography (ERCP) is the most widely used procedure for the management of biliary lithiasic pathology. However, it can present complications that compromise the life of the patient. Clinical case. A 63-year-old male patient is taken to ERCP for a giant recurrent choledocholithiasis. During the procedure presented a massive air dissection with bilateral tension pneumothorax, secondary to a duodenal perforation, which led to a bilio-retroperitoneal fistula. It was treated conservatively with adequate evolution.Discussion. Few cases of pneumothorax have been described as a complication of ERCP. This is considered to be the first published case of tension pneumothorax successfully managed conservatively. Conclusion. Early diagnosis of air dissections is the only independent predictor that could change the clinical course of this pathology, and its management will depend on the expertise of the surgeon and the clinical status of the patient.


Subject(s)
Humans , Biliary Fistula , Cholangiopancreatography, Endoscopic Retrograde , Pneumothorax , Prostheses and Implants , General Surgery
14.
Pesqui. bras. odontopediatria clín. integr ; 22: e210047, 2022. tab, graf
Article in English | LILACS, BBO | ID: biblio-1365229

ABSTRACT

Abstract Objective: To determine the patients' management pattern for restorative treatment procedures at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital (LASUTH). Material and Methods: A descriptive and retrospective study design was employed to determine patients' management patterns for the restorative treatment procedures at the Restorative Dentistry Clinic at LASUTH. Treatment records of patients who attended the Restorative Clinic at the Lagos State University Hospital, Ikeja, Lagos, Nigeria, from 2011 to 2014 were reviewed; the effective treatments during the period under review were recorded as treatment procedures and were recorded as operative, endodontic, fixed prosthodontics, and removable procedures. Results: A total of 14,437 (75%) operative; 1,353 (7.0%) endodontic; and 559 (2.9%) fixed prosthodontics and 2,852 (14.9%) removable prosthodontic procedures were carried out during the period under review. This study showed that operative procedures were the most performed restorative procedures, whereas removable prosthodontics and endodontic procedures ranked second and third, respectively, to operative procedures. Fixed prosthodontics procedures were the least performed restorative procedures. Conclusion: This study showed that more efforts were being expended by dentists on operative services compared to endodontic, removable, and fixed prosthodontics services combined. Comprehensive studies, embracing all disciplines of dentistry, should be carried out to determine the level of demand and clinical relevance of procedures in clinical dental practice and hence to set specific and general objectives of dental education for the populace. Access to dental health Insurance services should also be increased in the country.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Prostheses and Implants , Surgical Procedures, Operative , Costs and Cost Analysis , Dentistry, Operative , Regenerative Endodontics , Nigeria , Root Canal Therapy , Medical Records , Epidemiology, Descriptive , Retrospective Studies , Denture, Partial, Fixed , Denture, Partial, Removable , Electronic Health Records , Hospitals, Teaching
15.
Article in Spanish | LILACS, BINACIS | ID: biblio-1367132

ABSTRACT

Introducción: Se dispone de una amplia variedad de opciones terapéuticas para la reconstrucción de defectos óseos segmentarios causados por fracturas, tumores o infecciones, pero aún es un desafío en la cirugía ortopédica. materiales y métodos:Se presentan seis casos de pacientes con pérdida ósea masiva tratados mediante lo que denominamos "combinación sinérgica" de una membrana inducida para aportar beneficios biológicos, más un andamiaje (scaffold) de titanio trabecular desarrollado especialmente, según cada paciente, para el aporte de estabilidad y estructura. Resultados: Cinco hombres y una mujer (edad promedio 30 años) fueron operados con esta técnica. El seguimiento promedio fue de 24 meses. En el posoperatorio inmediato, se logró el restablecimiento del eje, la longitud y la estabilidad mecánica suficiente para iniciar la carga parcial. La carga total, según las condiciones del paciente (dolor, fuerza muscular), demandó un promedio de 25 a 30 días. Conclusiones: Proponemos una opción de tratamiento poco frecuente en nuestro medio que brinda estabilidad biomecánica suficiente para tolerar la carga precoz recuperando la longitud total del defecto en un solo acto, con excelentes resultados funcionales, entendiendo estas como ventajas frente a las opciones terapéuticas de uso tradicional, como transporte o técnica de Masquelet. Nivel de Evidencia: IV


Introduction: There is a wide variety of therapeutic options for the reconstruction of segmental bone defects caused by fractures, tumors, or infections, but it continues to be a challenge in orthopedic surgery. materials and methods: The present work presents six (6) cases of patients with massive bone loss treated by means of what we call a "synergistic combina-tion" of an induced membrane, to provide biological benefits, plus a trabecular titanium scaffold designed for each patient to provide stability and structure. Results: Five men and one woman with an average age of 30 years were operated on by this technique. The average follow-up was 24 months. In the immediate postoperative period, the axis, length, and sufficient mechanical stability to initiate partial weight-bearing were reestablished. Full weight-bearing according to the patients' conditions (pain, muscle strength) required an average of 25 to 30 days. Conclusion: We propose a rare treatment option in our field with sufficient biomechanical stability to tolerate early weight-bearing, recovering the entire length of the defect in a single stage with excellent functional outcomes, understanding these as an advantage over traditional therapeutic options such as bone transport or the Masquelet technique. Level of Evidence: IV


Subject(s)
Prostheses and Implants , Titanium , Bone and Bones , Bone Transplantation , Reconstructive Surgical Procedures
16.
South African Family Practice ; 64(3): 1-6, 19 May 2022. Tables
Article in English | AIM | ID: biblio-1380569

ABSTRACT

The etonogestrel subcutaneous contraceptive implant offers efficacy for three years, but some women remove it earlier than prescribed. This study discusses factors associated with the early removal of these implants at a Pretoria community health centre between 01January 2020 to 30 June 2020.Methods: A cross-sectional study using a piloted and researcher assistant-administered questionnaire.Results: Of the 124 participants who removed their etonogestrel subcutaneous contraceptive implant earlier than prescribed, most were single, unemployed, in the age group 30­39 years, Christian, with secondary level education and with parity one or more. Etonogestrel subcutaneous contraceptive implant pre-insertion counselling was given to all participants, most of whom had not previously used contraceptives. Those participants with previous contraceptive use had used injectables. Long-term contraception was the main reason for getting the etonogestrel subcutaneous contraceptive implant. Most participants did not attend post-insertion counselling. Heavy bleeding was the most common side effect and reason for early removal. Fifty-one participants kept the etonogestrel subcutaneous contraceptive implant in for a longer period of 12­23 months. From participants' responses, it seems that Etonogestrel implants may be offered from as early as 15­20 years of age. Conclusion: Women having etonogestrel subcutaneous contraceptive implants removed early at a Pretoria community health centre tended to be young, single, unemployed, Christian, with a secondary level education and with parity one or more. All participants attended the etonogestrel subcutaneous contraceptive implant pre-insertion counselling services but not the post-counselling services. Heavy bleeding was the main reason for the early removal of the etonogestrel subcutaneous contraceptive implant.Keywords: early removal; etonogestrel; subcutaneous contraceptive; implant; Pretoria; community health centre; weight gain; vaginal bleeding.


Subject(s)
Contraception , Device Removal , Early Diagnosis , Gestational Weight Gain , Prostheses and Implants , Uterine Hemorrhage
17.
Int. braz. j. urol ; 47(6): 1219-1227, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340041

ABSTRACT

ABSTRACT Purpose: The aim of this paper is to propose a modified surgical technique for immediate intravaginal prosthesis implantation in patients undergoing orchiectomy due to testicular torsion, and to evaluate the wound healing process and patient's satisfaction. Material and methods: We prospectively analyzed 137 patients with testicular torsion admitted to our facility between April 2018 and May 2020. Twenty-five patients who underwent orchiectomy were included in this study. Fifteen had a testicular prosthesis implanted at the same time as orchiectomy using a modified intravaginal technique (summary figure) and 10 received implants 6 to 12 months after orchiectomy. Wound healing was evaluated at a minimum of four checkpoints (on days 15, 45, 90 and 180 after surgery). At the end of the study, a questionnaire was administered to measure patients' satisfaction rate. Student's t test was used for comparison of quantitative data between negative vs. positive cultures (p <0.05). The chi-square test was used to verify associations between categorical variables and immediate vs. late prosthesis implantation (p <0.05). Results: Patient's ages ranged from 13 to 23 years (mean 16.44 years). Overall time lapse from symptoms to orchiectomy ranged from 10 hours to 25 days (mean 7.92 days). Only one extrusion occurred and it happened in the late implant group. All wounds were healed in 72%, 88%, 95.8% and 100% of the cases on the 15th, 45th, 90th and 180th days after implant, respectively. At the end of the study, all patients stated they would recommend it to a friend or relative. The only patient that had prothesis extrusion asked to have it implanted again. Conclusion: There was no prosthesis extrusion using the modified intravaginal surgical technique for immediate testicular prosthesis implantation, which proved to be an easily performed and safe procedure that can avoid further reconstructive surgery in patients whose testicle was removed due to testicular torsion.


Subject(s)
Humans , Male , Adolescent , Adult , Young Adult , Spermatic Cord Torsion/surgery , Prostheses and Implants , Testis/surgery , Orchiectomy , Retrospective Studies , Prosthesis Implantation
18.
Rev. SOBECC (Online) ; v26(n4): 199-204, 31-12-2021.
Article in Portuguese | LILACS, BDENF | ID: biblio-1367529

ABSTRACT

Objetivo: Estimar os intervalos de tempo envolvidos no reprocessamento de materiais consignados temporários de prótese total de quadril em um centro de material e esterilização de um hospital privado de São Paulo (SP). Método: Estudo exploratório-descritivo, de campo, com abordagem quantitativa. A amostra foi composta de 41 processamentos de materiais consignados. Os intervalos de tempo foram registrados com auxílio de cronômetro digital, hora inicial e final de cada atividade. O cálculo amostral foi estimado com intervalo de confiança de 95%. Resultados: O tempo total do processamento teve mediana de 10 horas, o tempo efe-tivo total foi de 4,9 horas e o intervalo de tempo entre o fim do reprocessamento e o horário da cirurgia foi de 4,7 horas de antecedência. Houve cancelamento de uma cirurgia em virtude do atraso na entrega do material. Conclusão: Nesta pesquisa foram mensurados os tempos de reprocessamento de materiais consignados, sendo mantido o rigor metodológico em todas as etapas, com estimativas que respeitaram o intervalo de confiança, o que faz deste estudo passível de reprodução. Sugere-se que profissionais de outras instituições realizem tais mensurações, de modo que permitam a construção de indicadores, auxiliando enfermeiros na tomada de decisão.


Objective: To estimate the time intervals necessary to reprocess loaner items for total hip replacement in a sterile processing department of a private hospital in São Paulo (SP). Method: This is an exploratory, descriptive field study with a quantitative approach. The sample consisted of 41 processing cycles for loaner items. Intervals were recorded using a digital stopwatch, including the start and end times of each activity. Sample calculation was estimated with a 95% confidence interval. Results: Median total processing time was 10 hours, total effective time was 4.9 hours, and the interval between the end of reprocessing and the time of surgery was 4.7 hours in advance. One surgery was canceled due to delayed delivery of the item. Conclusions: This study measured the reprocessing times of loaner items, maintaining the methodological rigor at all stages, with estimates that respected the confidence interval, making this investigation reproduci-ble. We suggest that professionals from other facilities perform these measurements to allow the construction of indicators that can help nurses in decision-making.


Objetivo: Estimar los intervalos de tiempo involucrados en el reprocesamiento de materiales consignados temporalmente para reemplazo total de cadera en un Centro de Material y Esterilización de un hospital privado de São Paulo. Método: Estudio de campo exploratorio-descriptivo con enfoque cuantita-tivo. La muestra consistió en 41 procesamientos de materiales consignados. Los intervalos de tiempo se registraron con la ayuda de un cronómetro digital, hora de inicio y finalización de cada actividad. El cálculo del tamaño de la muestra se estimó con un intervalo de confianza del 95%. Resultados: El tiempo total de procesamiento tuvo una mediana de 10 horas; el tiempo efectivo total fue de 4,9 horas y el intervalo de tiempo entre el final del reprocesamiento y el momento de la cirugía fue de 4,7 horas antes. Se canceló una cirugía debido al retraso en la entrega del material. Conclusión: En esta investigación se midieron los tiem-pos de reprocesamiento de los materiales consignados, manteniendo el rigor metodológico en todas las etapas, con estimaciones que respetaron el intervalo de confianza, haciendo este estudio susceptible de reproducción. Se sugiere que profesionales de otras instituciones realicen dichas mediciones, de manera que per-mitan la construcción de indicadores, ayudando a las enfermeras en la toma de decisiones.


Subject(s)
Humans , Prostheses and Implants , Arthroplasty, Replacement, Hip , Denture, Complete , Sterilization , Hospitals, Private , Hip
19.
Medicina UPB ; 40(2): 33-40, 13 oct. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1342178

ABSTRACT

Objetivo: caracterizar desde el punto de vista microbiológico las infecciones periprotesicas (IP) de los pacientes sometidos a remplazo articular de rodilla o cadera, en la IPS universitaria Clínica León XIII, y evidenciar los patrones más comunes de resistencia a los antibióticos, en el periodo 2015-2018. Metodología: se recolectó información de 25 pacientes llevados a remplazo articular de rodilla o cadera en la IPS universitaria, sede Clínica León XIII, durante el periodo de 2015-2018, que desarrollaron IP. Se obtuvo información sobre características demográfica, clínicas y patrones de resistencia (según antibiograma), y sobre los criterios usados para diagnosticarla. Los datos se registraron, según la naturaleza y distribución de la variable, en medias o medianas para las variables cuantitativas, y en frecuencias para las cualitativas. Resultados: entre 2015 y 2018 se realizaron 541 remplazos articulares, la incidencia de infección periprotésica fue de 4.6% (25 pacientes), 22 casos (88%) con crecimiento microbiológico. El germen más frecuente fue el S. aureus, con patrón alto de resistencia para meticilina (SAMR), en el 44%. Seguido por K. pneumoniae, con un patrón de resistencia por producción de betalactamasas de espectro extendido (BLEE) de 83%. Ninguno tuvo resistencia a los carbapenémicos. Conclusiones: los resultados son similares a los reportados en la literatura internacional. Sigue siendo el S. aureus el principal causante de la infección periprotésica, seguido de los gérmenes gram negativos.


Objective: to microbiologically characterize the periprosthetic infections (PI) of patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIIIin the period 2015-2018, and to demonstrate the most common antibiotic resistance patterns. Methodology: the information was collected from 25 patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIII during the period 2015-2018 who developed PI. Data was obtained on demographic, clinical characteristics, and antibiotic resistance patterns (according to antibiograms), as well as on the diagnostic criteria used to diagnose it. The data was recorded, according to the nature and distribution of the variable, in means or medians for the quantitative variables, and in frequencies for the qualitative variables.Results:between 2015-2018, 541 joint replacements were performed. There was an incidence of periprosthetic infection in 25 patients (4.6%), 22 of whom (88%) had micro-biological growth. The most frequent germ was S. aureus, which had a high resistance pattern for methicillin-resistant S. aureus (MRSA) in 44%, followed by K. pneumoniaewith a positive extended spectrum beta-lactamase (ESBL) in 83%. None of them showed resistance to carbapenems.Conclusions: the results found are similar to those reported in the international lite-rature. This investigation evidenced that S. aureus continues to be the main cause of periprosthetic infection, followed by gram-negative germs.


Objetivo: caracterizar do ponto de vista microbiológico as infecções periprotéticas (IP) dos pacientes submetidos à artroplastia articular do joelho ou do quadril, na IPS universitário, Clínica León XIII, e demonstrar os padrões mais comuns de resistência aos antibióticos, em o período 2015-2018.Metodologia: foram coletadas informações de 25 pacientes encaminhados para prótese de joelho ou quadril no IPS universitário, sede da Clínica León XIII, no período 2015-2018, que desenvolveram IP. Foram obtidas informações sobre as características demográfi-cas, clínicas e padrões de resistência (de acordo com antibiograma) e sobre os critérios usados para diagnosticá-la. Os dados foram registrados, de acordo com a natureza e distribuição da variável, em médias ou medianas para as variáveis quantitativas e em frequências para as qualitativas.Resultados: entre 2015 e 2018, foram realizadas 541 substituições articulares, a incidência de infecção periprotética foi de 4,6% (25 pacientes), 22 casos (88%) com crescimento microbiológico. O germe mais frequente foi S. aureus, com alto padrão de resistência à meticilina (MRSA), em 44%. Seguido por K. pneumoniae, com padrão de resistência devido à produção de beta-lactamase de espectro estendido (ESBL) de 83%. Nenhum apresentou resistência aos carbapenêmicos.Conclusões: os resultados são semelhantes aos relatados na literatura internacional. S. aureus continua a ser a principal causa de infecção periprotética, seguido por germes gram-negativos.


Subject(s)
Humans , Prostheses and Implants , Drug Resistance, Microbial , Methicillin-Resistant Staphylococcus aureus , Hip Joint , Infections , Joints , Knee , Anti-Bacterial Agents
20.
Rehabil. integral (Impr.) ; 15(1): 20-29, ago. 2021. tab
Article in Spanish | LILACS | ID: biblio-1283456

ABSTRACT

INTRODUCCIÓN: Las deficiencias congénitas y adquiridas de extremidades superiores son una condición importante en la población pediátrica, existe poca información respecto de sus características clínicas, sociodemográficas y las asociadas al uso de prótesis. OBJETIVO: Describir las características clínicas y sociodemográficas de la población infantojuvenil entre 2 y 17 años con diagnóstico de deficiencia de extremidades superiores adquirida y/o congénita, pertenecientes al Instituto Teletón Santiago (IT-S). METODOLOGÍA: Estudio transversal, en población infantojuvenil entre 2 y 17 años, con diagnóstico de deficiencia de extremidades superiores, adquirida y congénita, que se atienden en el IT-S. Se realizó una revisión de fichas clínicas y encuesta para la obtención de datos de características sociodemográficas, clínicas y asociadas al uso de prótesis. RESULTADOS: Se incluyeron 215 pacientes, 93,9% de etiología congénita y 6,1% adquirida. El nivel de la deficiencia más frecuente fue parcial de mano con 51,6%, seguido del transradial con 33,1%. El 33% de los 215 pacientes estudiados tuvieron prescripción de prótesis. De los pacientes con prescripción de prótesis, 78,9% correspondía a mecánica y 18,3% a prótesis 3D. El 53,5% usaba su prótesis y el 46,4% no la usaba. Respecto a las prótesis 3D, el 84,6% no la usaban. En el nivel parcial de mano, el 83,3% no usaban su prótesis. CONCLUSIONES: Este estudio aporta datos de importancia clínica, destacando, una prescripción protésica de inicio temprano y asociada a las características clínicas de los pacientes. Así mismo, existe una alta tasa de no uso de las prótesis 3D, en el nivel parcial de mano.


INTRODUCTION: Congenital and acquired deficiencies of the upper extremities are an important condition in the pediatric population, however, there is almost no information regarding the clinical and sociodemographic characteristics and those associated with the use of prostheses. OBJECTIVE: Describe the clinical and sociodemographic characteristics of the child and adolescent population between 2 and 17 years old with a diagnosis of acquired and/or congenital upper limb deficiency, belonging to the Instituto Teletón Santiago (IT-S). METHODS: A cross-sectional study was conducted in child and adolescent population between 2 and 17 years old, with a diagnosis of acquired and/ or congenital upper limb deficiency treated in the IT-S. A review of clinical records and a survey were carried out to obtain data on sociodemographic and clinical characteristics and characteristics associated with the use of prostheses. RESULTS: 215 patients were included, 93.9% of congenital and 6.1% of acquired etiology. The most common level of deficiency was partial hand with 51.6%, followed by transradial with 33.1%. 33% of the 215 patients included had a prescription for a prosthesis. 78.9% of the patients with a prosthesis prescription had a mechanical prosthesis and 18.3% had a 3D prosthesis. 53.5% used their prosthesis and 46.4% did not use it. 84.6% of the patients with 3D prostheses did not use them and an 83.3% of the patients with a partial hand level deficiency did not use their prosthesis. CONCLUSION: This study provides data of clinical importance, highlighting an early-onset prosthetic prescription associated with the clinical characteristics of the patients. Likewise, there is a high rate of non-use of 3D prostheses at the partial hand level.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Upper Extremity/pathology , Upper Extremity Deformities, Congenital/epidemiology , Prostheses and Implants , Socioeconomic Factors , Chile , Cross-Sectional Studies , Surveys and Questionnaires , Retrospective Studies , Upper Extremity Deformities, Congenital/rehabilitation , Amputation
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