Subject(s)
Commerce , Ethnicity , Race Relations , Racial Groups , Social Problems , Africa/ethnology , Anthropology, Cultural/education , Anthropology, Cultural/history , Archives/history , Central America/ethnology , Commerce/economics , Commerce/education , Commerce/history , Commerce/legislation & jurisprudence , Ethnicity/education , Ethnicity/ethnology , Ethnicity/history , Ethnicity/legislation & jurisprudence , Ethnicity/psychology , History, 17th Century , History, 18th Century , History, 19th Century , Humans , Race Relations/history , Race Relations/legislation & jurisprudence , Race Relations/psychology , Racial Groups/education , Racial Groups/ethnology , Racial Groups/history , Racial Groups/legislation & jurisprudence , Racial Groups/psychology , Social Problems/economics , Social Problems/ethnology , Social Problems/history , Social Problems/legislation & jurisprudence , Social Problems/psychologyABSTRACT
Objetivos: Comparar la eficacia de las nebulizaciones contínuas de sabutamol versus nebulizaciones intermintentes en el paciente pediátrico con crisis asmática aguda. Diseño: Estudio prospectivo, randomizado, abierto. Sitio: Servicio de Emergencias Médicas, Hospital Nacional Niños "Dr Carlos Saénz Herrera" en San José, Costa Rica. Pacientes: 50 pacientes con crisis asmática aguda fueron randomizados en dos grupos. Grupo I: recibieron nebulizaciones contínuas con salbutamol y dexametasona intravenosa. Grupo II: salbutamol nebulizado en forma intermitente y dexametasoan intravenosa. Se valoraron los siguientes parámetros durante las primeras 12 horas: frecuencia cardiaca y respiratoria, saturación de oxígeno arterial, flujo espiratorio pico, puntaje clínico de asma, niveles de postasio sérico. Resultados: Se evaluaron 50 pacientes. No se encontró ninguna diferencia estadisticamente significativa en los parámetros valorados, excepto que la frecuenca cardiaca fue más alta durante las primeras 4 horas del estudio en el grupo de pacientes con nebulizaciones contínuas (p=0.03). Conclusiones: El salbutamol nebulizado en forma contínua es igualmente eficaz que nebulizado en forma intermintente para el tratamiento de la crisis asmática aguda en el paciente pediátrico. Palabras clave: asma, flujo espiratorio pico, salbutamol, nebulizaciones, dexametasona
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Albuterol/analysis , Albuterol/therapeutic use , Asthma/therapy , Dexamethasone , Status Asthmaticus/therapy , Pulmonary Ventilation , Costa RicaABSTRACT
OBJECTIVE: To investigate whether doctors know users' beliefs about health and to investigate some of these beliefs. DESIGN: A crossover study. SETTING: The Cartuja and Almanjayar Health Centres in Granada. PATIENTS AND OTHER PARTICIPANTS: These were 204 users of the two centres, chosen at random and who attended for on-demand attention for whatever reason. Eleven patients refused the questionnaire. INTERVENTIONS: A 23-question questionnaire was administered during november and december 1993. MEASUREMENTS AND MAIN RESULTS: 64% were women and 36% men. Distribution by age and gender in both centres was similar. Coincidence (defined as 50% of replies totally in agreement and/or in agreement with the item in the questionnaire) between users' beliefs and doctors' opinions of those beliefs was slight (30%). Doctors' opinions concerning their patients' beliefs coincided with the beliefs shown by people with a lower educational level (F = 11.21, p < 0.00001) and over 45 years old (Sp = 0.25, p < 0.001). 70% thought that "illnesses are seen better on the screen"; and 57% that "if analysis and x-rays are not done, they don't feel satisfied". CONCLUSIONS: Doctors do not know their patients' health beliefs, attributing to the whole population the health beliefs of those who most consult the doctor. Users place great hopes in technology, with no relation to age, gender or educational level.
Subject(s)
Attitude to Health , Adult , Age Factors , Attitude of Health Personnel , Cross-Over Studies , Education , Female , Health Services , Humans , Male , Middle Aged , Physicians , Random Allocation , Spain , Surveys and QuestionnairesABSTRACT
Intelligent organizations (IO) represent a valuable tool to organize and guide dengue fever surveillance, prevention and control interventions. IO entail state of the art technology in managerial science to generate behavioral frameworks of organizational structures and policies. They present a systematic description of problems and construct computerized models to develop systemic thinking; they produce a shared vision and build progressive mental learning and advancement models. Also, IO promote team building and personal control skills. Scientific-technological advances have produced a wealth of information in medicine, with the corresponding growth of organizations and difficulty of responses because of sudden and incessant change. This new environment calls for the application of IO know-how. This article is oriented to prove the usefulness of the IO technology in the ordering and systematization of the reports about the medical sciences facts. Dengue was chosen to exemplify the use of IO technology as it represents an increasing health problem in America, as well as in Mexico; it is so complex that it can evolve to a more serious problem, besides it can be analyzed within a systemic method.
Subject(s)
Decision Making, Organizational , Decision Support Techniques , Dengue/prevention & control , Aedes , Animals , Computer Simulation , Dengue/epidemiology , Dengue/transmission , Humans , Insect Vectors , Mexico , Models, Biological , Mosquito Control , Risk Factors , SoftwareABSTRACT
Como culminación de un largo proceso de negociaciones entre la Comunidad Económica Europea y los Programas de Cooperación Técnica del Organismo Internacional de Energía Atómica (OIEA), se realiza en Costa Rica el Programa ARCAL VIII "Arreglos Regionales Cooperativos para la Promoción de la Ciencia y la Tecnología Nuclear en América Latina". El proyecto está coordinado por el Laboratorio de Inmunoanálisis de INCIENSA y participan cuatro laboratorios del sistema hospitalario nacional. Con el fin determinar la confiabilidad de los procedimientos utilizados, se evaluó la variabilidad intra e inter laboratorio de las determinaciones del país, utilizando reactivos NETRIA (Nort East Thames Region Inmunoassay Unit). La variabilidad interlaboratorio osciló entre el 9-20 por ciento para T4, del 12-22 por ciento para TSH y del 22-36 por ciento para T3. El estudio permitió evaluar la calidad del trazador (T3-I125, T4-I125) producido localmente conrelación a productos comerciales. Al correlacionar los resultados obtenidos con 63 sueros seleccionados al azar y procesados paralelamente con reactivos mixtos (anticuerpo y estándares de NETRIA y trazador propio) con reactivos de Diagnostic Products Corporation (DPC) la variabilidad intralaboratorio resultó ser de 8,4 por ciento para T3 y de 6,8 por ciento para T4. Se concluye que los ensayos de T4 y TSH son estadísticasmente válidos y confiables, no así los T3. Nuestros datos indican que el trazador preparado en INCIENSA puede usarse hasta 6 semanas después de la marcación con I125. (Rev. Cost. Cienc. Méd. 1988; 9(4):31-6)