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1.
Recurso de Internet en Español | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47423

RESUMEN

Contribuimos a garantizar el derecho a la salud de la población a través de acciones de promoción, prevención, recuperación y rehabilitación en pacientes adultos, con énfasis en rehabilitación y cuidados paliativos, y nos especializamos en líneas de cuidado de la Enfermedad de Hansen —lepra—


Asunto(s)
Lepra , Hospitales Federales , Hospitales Especializados , Colonias de Leprosos
2.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47400

RESUMEN

O Instituto Lauro de Souza Lima foi criado em 1933 como Asilo-Colônia Aymores onde eram internados os portadores de hanseníase do estado de São Paulo e região. A partir de 1989, com o decreto nº 30.521 de 02/10/89 o hospital transforma-se num Instituto de Pesquisa, da Secretaria da Saúde do Estado de São Paulo passando a ser denominadoInstituto lauro de Souza Lima. Hoje é centro de referência na área de Dermatologia Geral e , em particular , da Hanseníase para a Secretaria de Saúde do Estado de São Paulo, Ministério da Saúde e da Organização Mundial da Saúde - OMS. Além dos serviços na área de dermatologia, o Instituto Lauro de Souza Lima também realiza atividades voltadas à pesquisa, ensino, reabilitação física, terapia ocupacional, fisioterapia e cirurgias plásticas corretivas.


Asunto(s)
Lepra , Hospitales Especializados , Hospitales Provinciales , Colonias de Leprosos
3.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47401

RESUMEN

A Fundação de Dermatologia Tropical e Venereologia Alfredo da Matta (FUAM), órgão da Administração Indireta do Poder Executivo do Amazonas, vinculada à Secretaria de Estado de Saúde (Susam) é um Centro de Referência estadual, nacional e internacional nas áreas de Hanseníase, Dermatologia Tropical e Infecções Sexualmente Transmissíveis (IST). Tem como finalidade realizar ações de prevenção e atendimento ambulatorial a pacientes de Hanseníase e à população em geral que busca assistência em dermatologia clínica, IST/HIV/Aids e cirurgias dermatológicas, com atendimento a pacientes com câncer de pele. Atua ainda nas áreas de ensino e pesquisa, com cursos e treinamentos, estágios, com o Programa de Residência Médica em Dermatologia, além do Curso de Mestrado Profissional em Ciências Aplicadas à Dermatologia (UEA/Fuam). Coordenadora das ações do controle de Hanseníase no Estado do Amazonas.


Asunto(s)
Lepra , Colonias de Leprosos , Hospitales Especializados , Hospitales Provinciales
4.
BMJ Open Qual ; 9(2)2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32439740

RESUMEN

BACKGROUND: The COVID-19 outbreak has placed the National Health Service under significant strain. Social distancing measures were introduced in the UK in March 2020 and virtual consultations (via telephone or video call) were identified as a potential alternative to face-to-face consultations at this time. LOCAL PROBLEM: The Royal National Orthopaedic Hospital (RNOH) sees on average 11 200 face-to-face consultations a month. On average 7% of these are delivered virtually via telephone. In response to the COVID-19 crisis, the RNOH set a target of reducing face-to-face consultations to 20% of all outpatient attendances. This report outlines a quality improvement initiative to rapidly implement virtual consultations at the RNOH. METHODS: The COVID-19 Action Team, a multidisciplinary group of healthcare professionals, was assembled to support the implementation of virtual clinics. The Institute for Healthcare Improvement approach to quality improvement was followed using the Plan-Do-Study-Act (PDSA) cycle. A process of enablement, process redesign, delivery support and evaluation were carried out, underpinned by Improvement principles. RESULTS: Following the target of 80% virtual consultations being set, 87% of consultations were delivered virtually during the first 6 weeks. Satisfaction scores were high for virtual consultations (90/100 for patients and 78/100 for clinicians); however, outside of the COVID-19 pandemic, video consultations would be preferred less than 50% of the time. Information to support the future redesign of outpatient services was collected. CONCLUSIONS: This report demonstrates that virtual consultations can be rapidly implemented in response to COVID-19 and that they are largely acceptable. Further initiatives are required to support clinically appropriate and acceptable virtual consultations beyond COVID-19. REGISTRATION: This project was submitted to the RNOH's Project Evaluation Panel and was classified as a service evaluation on 12 March 2020 (ref: SE20.09).


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Telemedicina/organización & administración , Hospitales Especializados , Humanos , Ortopedia , Pandemias , Mejoramiento de la Calidad , Medicina Estatal , Reino Unido/epidemiología
6.
Lancet ; 395(10232): 1305-1314, 2020 04 18.
Artículo en Inglés | MEDLINE | ID: mdl-32247320

RESUMEN

Fangcang shelter hospitals are a novel public health concept. They were implemented for the first time in China in February, 2020, to tackle the coronavirus disease 2019 (COVID-19) outbreak. The Fangcang shelter hospitals in China were large-scale, temporary hospitals, rapidly built by converting existing public venues, such as stadiums and exhibition centres, into health-care facilities. They served to isolate patients with mild to moderate COVID-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities. We document the development of Fangcang shelter hospitals during the COVID-19 outbreak in China and explain their three key characteristics (rapid construction, massive scale, and low cost) and five essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, and essential living and social engagement). Fangcang shelter hospitals could be powerful components of national responses to the COVID-19 pandemic, as well as future epidemics and public health emergencies.


Asunto(s)
Infecciones por Coronavirus , Urgencias Médicas , Arquitectura y Construcción de Instituciones de Salud , Hospitales Especializados , Unidades Móviles de Salud , Pandemias , Neumonía Viral , Betacoronavirus , China/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Control de Costos , Brotes de Enfermedades , Hospitales Especializados/organización & administración , Hospitales Especializados/estadística & datos numéricos , Humanos , Control de Infecciones , Unidades Móviles de Salud/organización & administración , Unidades Móviles de Salud/estadística & datos numéricos , Aislamiento de Pacientes , Neumonía Viral/epidemiología , Neumonía Viral/terapia
7.
Int J Gynaecol Obstet ; 149(3): 377-378, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32267531

RESUMEN

From February 24, 2020, a COVID-19 obstetric task force was structured to deliver management recommendations for obstetric care. From March 1, 2020, six COVID-19 hubs and their spokes were designated. An interim analysis of cases occurring in or transferred to these hubs was performed on March 20, 2020 and recommendations were released on March 24, 2020. The vision of this strict organization was to centralize patients in high-risk maternity centers in order to concentrate human resources and personal protective equipment (PPE), dedicate protected areas of these major hospitals, and centralize clinical multidisciplinary experience with this disease. All maternity hospitals were informed to provide a protected labor and delivery room for nontransferable patients in advanced labor. A pre-triage based on temperature and 14 other items was developed in order to screen suspected patients in all hospitals to be tested with nasopharyngeal swabs. Obstetric outpatient facilities were instructed to maintain scheduled pregnancy screening as per Italian guidelines, and to provide pre-triage screening and surgical masks for personnel and patients for pre-triage-negative patients. Forty-two cases were recorded in the first 20 days of hub and spoke organization. The clinical presentation was interstitial pneumonia in 20 women. Of these, seven required respiratory support and eventually recovered. Two premature labors occurred.


Asunto(s)
Instituciones de Atención Ambulatoria/normas , Infecciones por Coronavirus , Asignación de Recursos para la Atención de Salud , Maternidades/normas , Obstetricia/normas , Pandemias , Atención al Paciente/normas , Neumonía Viral , Instituciones de Atención Ambulatoria/organización & administración , Femenino , Asignación de Recursos para la Atención de Salud/organización & administración , Asignación de Recursos para la Atención de Salud/normas , Maternidades/organización & administración , Hospitales Especializados/organización & administración , Hospitales Especializados/normas , Humanos , Italia , Equipo de Protección Personal/provisión & distribución , Embarazo
9.
Medellín; Unidad de Evidencia y Deliberación para la Toma de Decisiones (UNED). Facultad de Medicina, Universidad de Antioquia; 20200000. 20 p.
Monografía en Español | PIE, LILACS | ID: biblio-1095460

RESUMEN

La búsqueda estructurada identificó 78 artículos únicos, sólo cuatro relevantes para responder la pregunta planteada, que se sumaron a otros ocho identificados en la literatura gris. Adicionalmente, buscamos información sobre la experiencia en planeación de los servicios de salud a escala organizacional, en los siete países que reportan el mayor número de casos de COVID-19 (Alemania, China, España, Estados Unidos, Italia, Francia, y Reino Unido) y en dos países interesantes en su experiencia de planeación de los servicios (Noruega y Singapur). Los resultados de esta síntesis se presentan en tres secciones: 1. Atención en salud basada en la comunidad 2. Atención en salud en instituciones de baja complejidad 3. Atención en salud en hospitales de alta complejidad


Asunto(s)
Humanos , Atención a la Salud , Infecciones por Coronavirus , Servicios de Salud Comunitaria , Planificación Sanitaria , Hospitales Generales , Hospitales Especializados
12.
West Afr J Med ; 37(2): 183-188, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32150638

RESUMEN

BACKGROUND: Laparoscopic surgery is a relatively new and expanding field of surgical therapy in Ondo state. This is a multi-centre study cataloguing the work of the authors in Ondo State, Nigeria. AIM: To determine the indications, operative findings, and interventions at Laparoscopy in our resource challenged settings. PATIENTS AND METHODS: Medical records of all patients who had laparoscopic procedure at the Federal Medical Centre, Owo, Ondo State Specialist hospital, Okitipupa, University of Medical Sciences Teaching Hospital, Ondo, George and Martins Medical Centre, Ore and Mishmael Hospitals and Clinics, Akure from December, 2009 to December, 2018 were reviewed. Data on patient's age, gender, indications for surgery, duration of hospital stay, outcome of surgery were analyzed. Challenges and adaptations were also noted. RESULTS: One hundred and eighty-one (181) laparoscopic procedures were done, but only 152 had complete records for review. The median age was 35.5 years (mean = 33.7±11.4years; age range of 8 month -72 years). There were more males 88(57.9%) than females, 64(42.1%). Laparoscopy was purely diagnostic (n=28,18.4%), therapeutic (n=118, 77.6%) or both (n=6, 3.9%). Cholecystectomy (n=76, 50%) and appendicectomy (n=37, 24.3%) were the two most common procedures done. In the paediatric patients, patent processus vaginalis (hernia), cryptorchidism and indeterminate sex (gender) were common indication. Challenges encountered were power failure (n=3, 2%), equipment failure (n=4, 2.6%) and difficult dissection (n=4, 2.6%). The mean duration of surgery was 96.96(±25) minutes (diagnostic), 150 (±57.6) minutes (therapeutic); while the mean duration of hospital stay was one day (diagnostic) and 2.3(±1.7) days for therapeutic interventions. CONCLUSION: Laparoscopic service is achievable with adequate motivation, males appear to benefit more in our setting, and the service transcends all aged groups.


Asunto(s)
Apendicectomía/métodos , Apendicitis/cirugía , Colecistectomía Laparoscópica/métodos , Enfermedades de la Vesícula Biliar/cirugía , Laparoscopía , Adolescente , Adulto , Anciano , Niño , Preescolar , Colecistectomía , Femenino , Hospitales Especializados , Hospitales de Enseñanza , Humanos , Lactante , Tiempo de Internación , Masculino , Persona de Mediana Edad , Nigeria , Complicaciones Posoperatorias , Adulto Joven
14.
BMC Infect Dis ; 20(1): 35, 2020 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-31931732

RESUMEN

BACKGROUND: Streptococcus agalctiae (Group B Streptococcus, GBS) is a perinatal pathogen and a leading cause of neonatal infections worldwide. Serotype, sequence type, clonality, antibiotic resistance genes and surface protein profiles of GBS are scarce in Ethiopia, a reason that this study was planned to investigate. . METHODS: Sixteen colonizing GBS isolates obtained from recto-vaginal swabs of pregnant women and body surfaces of newborns were further analyzed. Minimum inhibitory concentration (MIC) test, and whole genome sequence (WGS) methods were done for antibiotic susceptibility test, and molecular characterization of the isolates. RESULTS: All the GBS isolates analyzed were belonged to four capsular serotypes: II, 11/16(68.8%), V, 3/16(18.8%), Ia and VI each with 1/16(6.3%) and five sequence type (ST-2, ST-10, ST-14, ST-569 and ST-933). Sequence type-10 was the most predominant ST followed by ST-569. The five STs were grouped into the four clonal complexes (CC - 1, CC-10, CC-19, and CC-23). Different surface proteins and pili families such as ALP1, ALPHA, ALP23, PI-1 / PI-2A1, PI-1 / PI-2B, and Srr1 were detected from WGS data. All isolates were found to be susceptible to the tested antibiotics except for tetracycline in MIC and WGS test methods used. Tetracycline resistant determinant genes such as TETM and TETL / TETM combination were identified. CONCLUSION: Further studies on serotype and molecular epidemiology will provide a comprehensive data of the GBS capsular serotype and clones available in Ethiopia.


Asunto(s)
Epidemiología Molecular/métodos , Complicaciones Infecciosas del Embarazo/epidemiología , Infecciones Estreptocócicas/epidemiología , Streptococcus agalactiae/genética , Streptococcus agalactiae/aislamiento & purificación , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana/genética , Etiopía/epidemiología , Femenino , Hospitales Especializados , Hospitales Universitarios , Humanos , Recién Nacido , Pruebas de Sensibilidad Microbiana , Filogenia , Embarazo , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Prevalencia , Recto/microbiología , Serogrupo , Infecciones Estreptocócicas/tratamiento farmacológico , Tetraciclina/uso terapéutico , Vagina/microbiología , Secuenciación Completa del Genoma
15.
PLoS One ; 15(1): e0227473, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31978137

RESUMEN

INTRODUCTION: Loss to follow up after the initiation of antiretroviral therapy (ART) is common in Africa, particularly in Ethiopia and it is a considerable obstacle for the effectiveness of the ART program. Mortality is a competing risk of loss to follow up but it is often overlooked and there is limited evidence about the incidence and predictors of loss to follow up in the presence of competing events. OBJECTIVE: To assess the Incidence and predictors of loss to follow up among adult HIV patients on ART in University of Gondar Comprehensive Specialized Hospital between January 1, 2015, and December 31, 2018. METHODS: Institution based retrospective follow up study was conducted in University of Gondar Comprehensive Specialized Hospital. A Gray's test and cumulative incidence curve were used to compare the cumulative incidence function of loss to follow up. Bivariable and multivariable competing risk regression models were fitted to identify the predictors of lost to follow up and those variables with p-value <0.05 in the multivariable analysis was considered as significant predictors of lost to follow up. RESULT: A total of 531 adult HIV patients on ART were included in the analysis. The incidence rate of loss to follow up in this study was 10.90 (95% CI: 8.9-13.2) per 100 person years. Being age group 15-30 years (aSHR = 2.01; 95%CI;1.11-3.63), being daily laborer(aSHR = 2.60; 95%CI;1.45-4.66), not receiving cotrimoxazole preventive therapy (aSHR = 2.66; 95%CI;1.68-4.21), not receiving isoniazid preventive therapy(aSHR = 4.57; 95% CI;1.60-13.08), ambulatory functional status (aSHR = 1.61; 95% CI; 1.02-2.51) and taking AZT-3TC-NVP medication at start of ART(aSHR = 2.01; 95% CI; 1.16-3.78) were significant predictors of lost to follow up. CONCLUSION: In this study the incidence of lost to follow up was high. Young people, daily laborer, ambulatory patients and those taking AZT-3TC-NVP as well as those who did not take opportunistic prophylaxis were at higher risk of loss to follow up. Therefore, giving special attention to the high-risk groups for lost to follow up highlighted in this study could decrease the rate of LTFU.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Perdida de Seguimiento , Adolescente , Adulto , Atención Ambulatoria , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Hospitales Especializados , Humanos , Incidencia , Lamivudine/uso terapéutico , Masculino , Nevirapina/uso terapéutico , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven , Zidovudina/uso terapéutico
16.
Cir. Esp. (Ed. impr.) ; 98: 0-0, 2020. graf
Artículo en Español | IBECS | ID: ibc-187154

RESUMEN

INTRODUCCIÓN: La rápidaexpansión de la infección por SARS-CoV-2 ha supuesto una radical reorganización de los recursos sanitarios y la exposición de profesionales al contagio. Los servicios de Cirugía General y del Aparato Digestivo también necesitan adaptarse a este cambio. PACIENTES Y MÉTODOS: Se realiza un estudio observacional descriptivo prospectivo de los casos de COVID-19 en pacientes y cirujanos de un Servicio de Cirugía General en un área de alta incidencia de infección entre el 1 y el 31 de marzo de 2020. RESULTADOS: Pacientes: La incidencia de infección por SARS-CoV-2 en los pacientes programados con hospitalización en el postoperatorio inmediato fue del 7%. Su edad media fue de 59,5 años y todos evolucionaron satisfactoriamente en planta. De 36 pacientes intervenidos de urgencia, dos fueron SARS-CoV-2+ y uno altamente sospechoso de COVID-19 (11,1%). Los tres pacientes fallecieron por insuficiencia respiratoria, su edad media era de 81 años. Cirujanos: Hubo un total de 12 casos SARS-CoV-2 + confirmados (24,4%) (8 de 34 adjuntos y 4 de 15 residentes).Actividad asistencial: El número medio de intervenciones quirúrgicas urgentes diarias bajó de 3,6 en febrero a 1,16 en el mes de marzo. El 42% de los pacientes intervenidos a partir de la entrada en vigor de las primeras medidas de aislamiento a nivel regional, presentaban cuadros evolucionados. CONCLUSIONES: El aumento de casos en la población general de COVID-19 debe alertar a los Servicios de Cirugía General de la necesidad de tomar de medidas de forma precoz que garanticen la seguridad de los pacientes y de los cirujanos


INTRODUCTION: The rapid spread of SARS-CoV-2 infection has led to a radical reorganization of healthcare resources. Surgical Departments need to adapt to this change. PATIENTS AND METHODS:We performed a prospective descriptive observational study of the incidence of COVID-19 in patients and surgeons of a General Surgical Department in a high prevalence area, between the 1st and 31st of March 2020. RESULTS:Patients: The incidence of SARS-CoV-2 infection in elective surgery patients was 7% (mean age 59.5 years). All survived.Of 36 patients who underwent emergency surgery, two of them were SARS-CoV-2 positive and one was clinically highly suspicious of COVID-19 (11.1%). All three patients died of respiratory failure (mean age 81 years). Surgeons: There were a total of 12 confirmed SARS-CoV-2+ cases among the surgical department staff (24.4%) (8 out of 34 consultants and 4 out of 15 residents).Healthcare activity: The average number of daily emergency surgical interventions declined from 3.6 in February to 1.16 in March. 42% of the patients who underwent emergency surgery had peritonitis upon presentation. CONCLUSIONS: The fast pace of COVID-19 pandemia, should alert surgical departments of the need of adopting early measures to ensure the safety of patients and staff


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Servicio de Cirugía en Hospital/estadística & datos numéricos , Betacoronavirus/genética , Enfermedades Profesionales/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Servicios Médicos de Urgencia , Cuidados Preoperatorios , Estudios Prospectivos , Incidencia , España/epidemiología , Tomografía Computarizada por Rayos X , Reacción en Cadena en Tiempo Real de la Polimerasa , Hospitales Especializados
18.
Stroke ; 51(1): 240-246, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31847753

RESUMEN

Background and Purpose- The increasing demand and shortage of experts to evaluate and treat acute stroke patients has led to the development of remote communication tools to aid stroke management. We aimed to evaluate the JOIN App smartphone system-a low-cost tool for rapid clinical and neuroimaging data sharing to expedite decision-making in stroke. Methods- Consecutive acute ischemic stroke patients treated at a University Hospital in Brazil from December 2014 to December 2015 were evaluated. The analysis included all patients presenting with acute ischemic stroke who underwent initial evaluation by neurology residents followed by JOIN teleconsultation with a stroke neurologist on call for management decisions. An expert panel of stroke neurologists and neuroradiologists revised all cases using a standard Picture Archiving and Communication System imaging workstation within 24 hours and analyzed the decision made with remote assistance during the emergency setting. Results- A total of 720 stroke codes were evaluated with 442 acute ischemic stroke qualifying. Seventy-eight (18%) patients were treated with intravenous thrombolysis. The main reasons for tPA (tissue-type plasminogen activator) exclusion were symptom onset >4.5 hours (n=295; 67%) and hypodense middle cerebral artery territory area >1/3 (n=31; 7%). The agreement rates between Picture Archiving and Communication System versus JOIN-based thrombolysis decisions were 100% for the stroke (unblinded) and 99.3% for the neuroradiologist (blinded) experts. The use of the application resulted in a significant reduction in the door-to-needle times across the pre- versus postimplementation periods (median, 90 [interquartile range, 75-106] versus 63 [interquartile range, 61-117] minutes; P=0.03). The rates of 90-day excellent outcomes (modified Rankin Scale, 0-1) were 51.3%; 90-day mortality, 2.6%; and symptomatic intracranial hemorrhage, 3.8%. Conclusions- The JOIN smartphone system allows rapid sharing of clinical and imaging data to facilitate decisions for stroke treatment. The remote application-based decisions seem to be as accurate as the physical presence of stroke experts and might lead to faster times to treatment. This system represents an easily implementable low-cost telemedicine solution for centers that cannot afford the full-time presence of stroke specialists.


Asunto(s)
Aplicaciones Móviles , Neuroimagen , Teléfono Inteligente , Accidente Cerebrovascular , Telemedicina , Terapia Trombolítica , Activador de Tejido Plasminógeno/uso terapéutico , Enfermedad Aguda , Administración Intravenosa , Anciano , Femenino , Hospitales Especializados , Humanos , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/tratamiento farmacológico
19.
BMC Res Notes ; 12(1): 650, 2019 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-31590693

RESUMEN

OBJECTIVES: This study aimed to determine the unfavorable outcomes and to assess factors contribute to the unfavorable management outcomes after cesarean deliveries in Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017. RESULTS: The unfavorable maternal management outcomes were Adhesion 28 (8.3%), excessive blood loss and blood transfusion 19 (5.6%), cesarean hysterectomy 10 (3%), relaparotomy 5 (1.5%), wound infection and wound dehiscence 23 (6.8%). Unfavorable fetal outcomes were were stillbirth 9 (2.6%), early neonatal death 8 (2.4%), low birth weight 58 (17.2%). women who did not book for Antenatal Care and having a history of previous cesarean delivery were found to be associated with unfavorable maternal outcomes and indications of cesarean delivery as obstructed labor was associated with unfavorable fetal outcomes.


Asunto(s)
Cesárea/estadística & datos numéricos , Hospitales Especializados , Resultado del Embarazo , Atención Prenatal/estadística & datos numéricos , Adulto , Cesárea/métodos , Atención Integral de Salud/métodos , Atención Integral de Salud/estadística & datos numéricos , Etiopía , Femenino , Humanos , Histerectomía , Embarazo , Atención Prenatal/métodos , Estudios Retrospectivos , Factores de Riesgo , Mortinato
20.
Rinsho Shinkeigaku ; 59(11): 716-722, 2019 Nov 08.
Artículo en Japonés | MEDLINE | ID: mdl-31656262

RESUMEN

We analyzed the registration data of inpatients with facioscapulohumeral muscular dystrophy (FSHD) receiving care at 27 specialized institutions for muscular dystrophy in Japan from 1999 to 2013 using data from October 1 of each year. The number of inpatients of each year ranged from 63 to 72 (67.1 ± 3.3) throughout the study period. Those aged over 50 years gradually increased during the study period, while the oldest inpatient was 82.8 years old. Most could not walk. The rate of respirator dependency increased from 21.0% in 1999 to 71.0% in 2013, while the rate of patients receiving oral nutrition was 98.4% in 1999 and then reduced to 75.4% in 2013. There were 36 death cases reported in the database, including 15 patients with respiratory failure and 4 with heart failure. Our findings indicate that FSHD patients in a severe condition are impacted by respiratory and nutritional problems and their prognosis for survival is related to respiratory failure.


Asunto(s)
Hospitalización/estadística & datos numéricos , Hospitales Especializados/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Distrofia Muscular Facioescapulohumeral/mortalidad , Adulto , Factores de Edad , Anciano , Causas de Muerte , Femenino , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/etiología , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Limitación de la Movilidad , Distrofia Muscular Facioescapulohumeral/complicaciones , Distrofia Muscular Facioescapulohumeral/fisiopatología , Distrofia Muscular Facioescapulohumeral/terapia , Apoyo Nutricional , Insuficiencia Respiratoria/epidemiología , Insuficiencia Respiratoria/etiología , Índice de Severidad de la Enfermedad , Factores de Tiempo , Ventiladores Mecánicos/estadística & datos numéricos
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