ABSTRACT
INTRODUCCIÓN. La evaluación preoperatoria determina el estado de salud del paciente que será sometido a una intervención quirúrgica, minimiza su riesgo y optimiza los recursos humanos y materiales del escenario perioperatorio. OBJETIVO. Determinar el proceso de evaluación preoperatorio y su capacidad para prevenir eventos clínicos adversos durante el postoperatorio inmediato de pacientes adultos sometidos a un procedimiento quirúrgico no cardiaco. MATERIALES Y MÉTODOS. Estudio retrospectivo de corte transversal. Población de 6 250 adultos y muestra de 912 Historias Clínicas electrónicas de pacientes atendidos en el Hospital de Especialidades Carlos Andrade Marín, en el año 2017. Criterios de inclusión: pacientes mayores de 18 años, que se sometieron a una evaluación preoperatoria de manera ambulatoria y fueron operados de intervenciones no cardiacas hasta el mes de enero del 2019, o suspensión de cirugía por contraindicaciones determinadas en la cita médica. Criterios de exclusión: pacientes menores a 18 años, no intervenidos quirúrgicamente, hospitalizados por cualquier motivo entre la revisión y la cirugía, embarazadas e individuos con consulta preoperatoria fuera del hospital. Los programas informáticos utilizados para el registro de datos y su análisis fueron Microsoft Excel e International Business Machines Statistical Package for the Social Sciences. RESULTADOS. El 82,68% (754; 912) presentó un antecedente clínico y el 82,13% (749; 912) uno de tipo quirúrgico. Se reportó un 2,00% (18; 912) de complicaciones postoperatorias, y un caso de muerte pasadas las 72 horas postquirúrgicas. No se encontró correlación estadísticamente significativa p>0,05 entre las conclusiones clínicas del control preoperatorio y la ocurrencia de complicaciones en el postoperatorio. CONCLUSIÓN. Se evidenció que el proceso de evaluación preoperatoria fue realizado de manera sistemática a pacientes con características sociodemográficas y clínicas heterogéneas y no existió correlación estadística entre sus resultados y la presencia de complicaciones perioperatorias.
INTRODUCTION. The preoperative evaluation determines the health status of a patient that will undergo a surgical intervention, minimizes its risk, and optimizes the human and material resources of the perioperative scenario. OBJECTIVE. To determine the preoperative evaluation process and its ability to prevent adverse clinical events during the immediate postoperative period in adult patients undergoing a noncardiac surgical procedure. MATERIALS AND METHODS. This is a retrospective cross-sectional study. The sample of 912 medical records was calculated upon a population of 6 250 adults treated at the Carlos Andrade Marín Specialties Hospital in 2017. Inclusion criteria: patients over 18 years of age, who underwent a preoperative evaluation on an outpatient basis, and were operated on for non-cardiac interventions until January 2019, or suspension of surgery due to contraindications determined in the medical appointment. Exclusion criteria: patients under 18 years of age, not undergoing surgery, hospitalized for any reason between revision and surgery, pregnant women, and individuals with preoperative consultation outside the hospital. The computer programs used for data collection and analysis were Microsoft Excel and the International Business Machines Statistical Package for the Social Sciences. RESULTS. 82,68% (754; 912) had a previous clinical condition and 82,13% (749; 912) had a previous surgical intervention. 2,00% (18; 912) of postoperative complications were reported, and one case of death after 72 postoperative hours. No statistically significant correlation p>0,05 was found between the clinical conclusions of the preoperative control and the occurrence of postoperative complications. CONCLUSION. It was evidenced that the preoperative evaluation process was carried out systematically to patients with heterogeneous sociodemographic and clinical characteristics and there was no statistical correlation between its results and the presence of perioperative complications.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Postoperative Complications/prevention & control , Preoperative Period , Surgical Clearance , Cross-Sectional Studies , Retrospective Studies , Risk AssessmentABSTRACT
Introduction: Planetary health (PH) has emerged as a leading field for raising awareness, debating, and finding solutions for the health impacts of human-caused disruptions to Earth's natural systems. PH education addresses essential questions of how humanity inhabits Earth, and how humans affect, and are affected by, natural systems. A pilot massive open online course (MOOC) in PH was created in Brazil in 2020. This MOOC capitalized on the global online pivot, to make the course accessible to a broader audience. This study describes the process of course creation and development and assesses the impact evaluation data and student outcomes of the PH MOOC. Methods: The PH MOOC pilot was launched in Brazilian Portuguese, using the TelessaúdeRS-UFRGS platform on 4/27/2020 and concluded on 7/19/2020 with a total load of 80 h. It was composed of 8 content modules, pre and post-test, 10 topics in a forum discussion, and an optional action plan. This study analyzes the course database, profile of participants, answers to questionnaires, forum interaction, and action plans submitted. Results: Two thousand seven hundred seventy-seven participants enrolled in the course, of which 1,237 (44.54%) gave informed consent for this study. Of the 1,237 participants who agreed to participate in the research, 614 (49.8%) completed the course, and 569 (92.67%) were accredited by TelessaúdeRS-UFRGS. The majority of the participants were concerned with climate change, trained in the health area, and worked in primary health care in places that lacked ongoing sustainability programs. Two hundred forty-one action plans were submitted, major topics identified were food and nutrition, infectious diseases, and garbage and recycling. Discussion: The use of the PH lens and open perspective of the course centered the need to communicate planetary health topics to individuals. The local plans reflected the motto of "think global and act local." Brazil presents a context of an unprecedented social, political, and environmental crisis, with massive deforestation, extensive fires, and biomass burning altering the biomes, on top of an ongoing necropolitical infodemic and COVID-19 pandemic. In the face of these multiple challenges, this MOOC offers a timely resource for health professionals and communities, encouraging them to address planetary challenges as fundamental health determinants.
Subject(s)
COVID-19 , Education, Distance , Brazil , Health Education , Humans , Infodemic , Pandemics , Primary Health Care , SARS-CoV-2ABSTRACT
Phylogenetic analysis of hepatitis C virus isolates from Argentina that were previously nontypeable by restriction fragment length polymorphism (RFLP) analysis revealed that they belong to genotype 1a. A substitution at position 107 (G-->A), which is the landmark of these strains, was shown to be distributed among isolates worldwide. The RFLP patterns obtained for these isolates should be added to the ones reported for genotype 1 isolates.
Subject(s)
Hepacivirus/classification , Hepatitis C, Chronic/virology , Phylogeny , Polymorphism, Restriction Fragment Length , 5' Untranslated Regions/genetics , Adult , Argentina/epidemiology , Child , Child, Preschool , Female , Genotype , Hepacivirus/genetics , Hepacivirus/isolation & purification , Hepatitis C, Chronic/epidemiology , Humans , Infant, Newborn , Molecular Sequence Data , Sequence Analysis, DNAABSTRACT
Hepatitis C virus isolates which disclosed a novel genotype 1-associated restriction pattern by restriction fragment length polymorphism analysis were characterized. Except for a mother and child pair, the patients were unrelated. Sequence analysis showed a G-->A substitution leading to a new RsaI recognition site. Phylogenetic analysis revealed that these isolates constitute a novel genetic lineage within the main cluster of genotype 1 strains.
Subject(s)
5' Untranslated Regions/genetics , Hepacivirus/isolation & purification , 5' Untranslated Regions/chemistry , Argentina , Base Sequence , Geography , Hepacivirus/classification , Hepacivirus/genetics , Hepatitis C/virology , Humans , Molecular Sequence Data , Phenotype , Polymorphism, Restriction Fragment Length , Restriction MappingABSTRACT
Los bacilos curvos Gram negativos anaeróbicos, frecuentemente son detectados en la flora vaginal de mujeres con cuadros de vaginosis bacteriana. Existen dificultades para su aislamiento por su naturaleza anaeróbica y la competencia de la abundante flora acompañante. El presente trabajo trató de determinar por exámenes directos y cultivos la presencia de estos microorganismos en 100 mujeres con cuadros compatibles clínicamente con vaginosis y en 30 mujeres sin sintomatología clínica. Asimismo tratamos de definir la utilidad comparativa de las técnicas de diagnóstico disponibles y determinar el grupo etario más proclive a esta patología. Obtuvimos un 41% de detección para las técnicas directas y un 37% para los cultivos. Con la combinación de ambas alcanzamos el 46% de positividad, siendo el grupo testígo negativo para ambos métodos. Teniendo en cuenta la edad promedio del grupo de estudio vemos que esta patología se detecta en la etapa fértil de las mujeres estudiadas
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Female , Bacteriological Techniques , Gram-Negative Anaerobic Bacteria/isolation & purification , Vaginitis/microbiology , Vaginitis/diagnosisABSTRACT
Los bacilos curvos Gram negativos anaeróbicos, frecuentemente son detectados en la flora vaginal de mujeres con cuadros de vaginosis bacteriana. Existen dificultades para su aislamiento por su naturaleza anaeróbica y la competencia de la abundante flora acompañante. El presente trabajo trató de determinar por exámenes directos y cultivos la presencia de estos microorganismos en 100 mujeres con cuadros compatibles clínicamente con vaginosis y en 30 mujeres sin sintomatología clínica. Asimismo tratamos de definir la utilidad comparativa de las técnicas de diagnóstico disponibles y determinar el grupo etario más proclive a esta patología. Obtuvimos un 41% de detección para las técnicas directas y un 37% para los cultivos. Con la combinación de ambas alcanzamos el 46% de positividad, siendo el grupo testígo negativo para ambos métodos. Teniendo en cuenta la edad promedio del grupo de estudio vemos que esta patología se detecta en la etapa fértil de las mujeres estudiadas (AU)