Paciente de 26 años afecto de ataxia de Friederich con una miocardiopatía hipertrófica no obstructiva sometido a una tiroidectomía total por una tirotoxicosis secundaria a amiodarona persistente (a pesar de elevadas dosis de antitiroideos y corticoides), que intraoperatoriamente presentó un episodio sugestivo de tormenta tiroidea.La tormenta tiroidea es una urgencia endocrinológica que asocia una elevada morbimortalidad. Para mejorar la supervivencia es de vital importancia un diagnóstico temprano y un tratamiento precoz que incluya: un tratamiento sintomático, el tratamiento de las manifestaciones cardiovasculares, neurológicas y/o hepáticas y de la tirotoxicosis, así como suprimir o evitar estímulos desencadenantes y practicar un tratamiento definitivo.(AU)
A 26-year-old patient with Friederich's ataxia with hypertrophic obstructive cardiomyopathy undergoing a total thyroidectomy due to persistent amiodarone-induced thyrotoxicosis (despite high doses of antithyroid drugs and corticosteroids), presented an intraoperative episode suggestive of thyroid storm.Thyroid storm is an endocrine emergency that is associated with high morbimortality. Early diagnosis and treatment, which is of vital importance to improve survival. Treatment includes: symptomatic treatment, treatment of cardiovascular, neurological, and/or hepatic manifestations and thyrotoxicosis, measures to suppress or avoid triggering stimuli, and definitive treatment.(AU)
Humans , Male , Adult , Friedreich Ataxia/complications , Friedreich Ataxia/drug therapy , Thyroid Crisis/complications , Thyroid Crisis/drug therapy , Cardiomyopathy, Hypertrophic , Thyrotoxicosis , Amiodarone , Anesthesia , Anesthesiology , Treatment Outcome , Inpatients , Physical Examination , Symptom Assessment
A 26-year-old patient with Friederich's ataxia with hypertrophic obstructive cardiomyopathy undergoing total thyroidectomy due to persistent amiodarone-induced thyrotoxicosis (despite high doses of antithyroid drugs and corticosteroids), presented an intraoperative episode suggestive of thyroid storm. Thyroid storm is an endocrine emergency that is associated with high morbidity and mortality. Early diagnosis and treatment, which is of vital importance to improve survival, includes symptomatic treatment, treatment of cardiovascular, neurological, and/or hepatic manifestations and thyrotoxicosis, measures to suppress or avoid triggering stimuli, and definitive treatment.
Anesthetics , Thyroid Crisis , Thyrotoxicosis , Humans , Adult , Thyroid Crisis/complications , Thyroid Crisis/diagnosis , Thyroid Crisis/drug therapy , Thyrotoxicosis/complications , Thyrotoxicosis/surgery , Thyrotoxicosis/chemically induced , Ataxia/complications , Ataxia/drug therapy , Antithyroid Agents/adverse effects , Anesthetics/adverse effects
Antecedentes y objetivo: La concepción actual de la discapacidad, donde las características físicas de una persona son contempladas en su interacción con el entorno, requiere de estudios actitudinales de la población que faciliten la identificación de las barreras que limitan el ejercicio de los derechos en igualdad de oportunidades para las personas con discapacidad en contextos profesionales. El objetivo principal del estudio ha sido el diseño, construcción y validación de un instrumento de evaluación de las actitudes hacia la discapacidad en personal militar.Método:En el estudio han participado 204 militares de diferentes empleos y escalas, donde un 11,76 % fueron mujeres y un 88,24 % hombres. El desarrollo del trabajo estuvo dividido en dos fases. En la primera fase, se construye la escala y se somete a juicio de expertos analizando la concordancia entre los mismos con el fin de valorar la validez de contenido del cuestionario. En la segunda fase, se valoran las cualidades psicométricas de fiabilidad y validez (constructo y concurrente) de la escala.Resultados:Los resultados obtenidos reflejan propiedades psicométricas adecuadas y ajustadas del instrumento. En el análisis de la fiabilidad se observa que, tanto la escala en su conjunto (.87), como las dos subescalas que la conforman (.88 y .89), presentan una adecuada consistencia interna. En los análisis exploratorio y confirmatorio realizados, se obtiene un modelo con una solución de dos factores cuyos datos de bondad de ajuste (NFI = 0.94, GFI = 0.94, CFI = .97, RMSEA = .06 (IC 90 % = .048 - .070), RMR estandarizado = .091) garantizan una adecuada validez de constructo. Asimismo, se observa una adecuada validez concurrente (.76; p< .01).Conclusiones:Se concluye el uso justificado y óptimo del instrumento para la evaluación de las actitudes hacia la discapacidad en personal militar. (AU)
Background and objective: Currently, the conception of disability considers the physical characteristics of the person in their interaction with the environment. This understanding makes it necessary for the development of attitudinal studies of the population that facilitate the identification of barriers that limit the exercise of people with disabilities rights in equal opportunities in the professional field. The main objective of the study was the design, construction, and validation of an instrument to assess attitudes towards disability in the Armed Forces.Method:204 soldiers of different positions and scales participated in the study, where 11.76 % were women and 88.24 % were men. The study was divided into two phases. In the first phase, the scale was constructed and evaluated by a group of experts. The concordance between them was also analyzed in order to evaluate the validity of the content of the questionnaire. In a second phase, the psychometric qualities of reliability and validity (construct and concurrent) of the scale were evaluated.Results:The results obtained reflect appropriate psychometric properties adjusted to the instrument. The reliability analysis, shows that both, the scale as a whole (.87), and the two subscales that make it up(.88 and .89), present adequate internal consistency. In the exploratory and confirmatory analyses performed, it is obtained a model with a two-factor solution. Its goodness-of-fit data (NFI = 0.94, GFI = 0.94, CFI = .97, RMSEA = .06 (90 % CI = .048 - .070), standardized RMR = .091) guarantee adequate construct validity. Likewise, an appropriate concurrent validity is observed (.76; p<.01).Conclusions:In conclusion, the use of the instrument for the evaluation of attitudes towards disability in the Armed Forces is justified and optimal. (AU)
Humans , Disability Studies , Veterans , 51708
