Participación de enfermeros(as) de la Región de las Américas en una capacitación virtual sobre liderazgo / Participation of nurses from the Region of the Americas in a leadership virtual training / Participação de enfermeiros(as) da Região das Américas em uma capacitação virtual sobre liderança

Resumen Objetivo Analizar la participación de los enfermeros(as) de la Región de las Américas en la iniciativa para desarrollar el liderazgo de enfermería en la Región, a través de un curso virtual de autoaprendizaje. Método Estudio descriptivo, cuantitativo con descripciones cualitativas de datos obtenidos del Campus Virtual de Salud Pública de la OPS/OMS por medio de la Encuesta de calidad del CVSP - cursos de autoaprendizaje del Curso Virtual de Liderazgo en Enfermería: Empoderamiento de los (las) enfermeros(as) líderes en Latinoamérica. Se calcularon medidas de estadística descriptiva. Resultados Participaron en este curso de agosto de 2015 a julio del 2018, tres mil 348 enfermeros. Del total, Ecuador, México y Colombia representan juntos el 83.1% de la participación. Solamente, 8.7% de los participantes en el curso reportaron específicamente que tienen cargos de liderazgo. El curso fue útil para las personas que tienen barreras relacionadas con el acceso a la educación permanente. Discusión La mayor participación en algunos países puede deberse a mayor difusión de estos cursos o del acceso a la plataforma virtual. El entorno virtual tiene beneficios y puede colaborar con el entrenamiento del recurso humano en salud, ya que muchos de ellos tienen barreras físicas para desarrollar sus habilidades profesionales. Conclusiones El entorno virtual colaboró, de forma significativa en la práctica de estos profesionales. Además, fue una iniciativa de fortalecimiento de la enfermería con enfoque en la formación de líderes y puede ser aprovechado para la formulación de futuros programas de educación.

Abstract Objective To analyze the participation of nurses from the Region of the Americas in a nursing leadership development initiative which uses a self-learning virtual training. Method This is a descriptive and quantitative study with qualitative descriptions on data obtained from the Virtual Campus for Public Health PAHO/WHO (VCPH) with the VCPH quality survey - self-learning courses of the Virtual Training of Nursing Leadership: empowerment of nurse leaders in Latin-America. Descriptive statistics were calculated. Results 3348 nurses participated in this course from august 2015 to july 2018. The nurses from Ecuador, Mexico, and Colombia represented 83.1% of the total participation. Only 8.7% reported having a leadership position specifically. The course was found useful among those persons with barriers related to the access to a permanent education. Discussion The larger participation in some countries could be the result of the broader diffusion and access to virtual platforms. The advantages of using a virtual environment include the possibility to further strengthen the training of health human resources, particularly of those with physical barriers related to the development of professional skills. Conclusions The training in a virtual environment strengthened the practice skills of the professionals enrolled in the course. Further education programs can take advantage of this kind of platforms to better prepare the future nursing leaders.

Resumo Objetivo Analisar a participação dos enfermeiros(as) da Região das Américas na iniciativa de desenvolver a liderança de enfermagem na Região, através de um curso virtual de autoaprendizagem. Método Estudo descritivo, quantitativo com descrições qualitativas de dados obtidos do Campus Virtual de Saúde Pública da OPS/OMS por meio da Enquete de qualidade do CVSP - cursos de autoaprendizagem do Curso Virtual de Liderança em Enfermagem: Empoderamento dos(as) enfermeiros(as) líderes na América Latina. Calcularam-se medidas de estatística descritiva. Resultados Participaram neste curso de agosto de 2015 a julho de 2018, três mil 348 enfermeiros. Do total, o Equador, o México e a Colômbia representam juntos o 83.1% da participação. Somente, 8.7% dos participantes no curso reportaram especificamente que têm cargos de liderança. O curso foi útil para as pessoas que têm barreiras relacionadas com o acesso à educação permanente. Discussão A maior participação em alguns países pode se dever a maior difusão destes cursos ou do acesso à plataforma virtual. O entorno virtual tem benefícios e pode colaborar com o treinamento do recurso humano em saúde, já que muitos deles têm barreiras físicas para desenvolver suas habilidades profissionais. Conclusões O entorno virtual colaborou, de forma significativa na prática destes profissionais. Aliás, foi uma iniciativa de fortalecimento da enfermagem com enfoque na formação de líderes e pode ser aproveitado para a formulação de futuros programas de educação.

The prevalence of BRCA1 and BRCA2 mutations among young Mexican women with triple-negative breast cancer.

Various guidelines recommend that women with triple-negative breast cancer should be tested for BRCA1 mutations, but the prevalence of mutations may vary with ethnic group and with geographic region, and the optimal cutoff age for testing has not been established. We estimated the frequencies of BRCA1 and BRCA2 (BRCA) mutations among 190 women with triple-negative breast cancer, unselected for family history, diagnosed at age 50 or less at a single hospital in Mexico City. Patients were screened for 115 recurrent BRCA mutations, which have been reported previously in women of Hispanic origin, including a common large rearrangement Mexican founder mutation (BRCA1 ex9-12del). A BRCA mutation was detected in 44 of 190 patients with triple-negative breast cancer (23 %). Forty-three mutations were found in BRCA1 and one mutation was found in BRCA2. Seven different mutations accounted for 39 patients (89 % of the total mutations). The Mexican founder mutation (BRCA1 ex9-12del) was found 18 times and accounted for 41 % of all mutations detected. There is a high prevalence of BRCA1 mutations among young triple-negative breast cancer patients in Mexico. Women with triple-negative breast cancer in Mexico should be screened for mutations in BRCA1.

[Incidence of nutritional support complications in critical patients: multicenter study]. / Incidencia de complicaciones del soporte nutricional en pacientes críticos: estudio multicéntrico.

INTRODUCTION: Nutritional support (NS) leads complications that must be detected and prompt treated. OBJECTIVE: To estimate the incidence of some complications of nutritional support in critically ill patients. MATERIALS AND METHODS: A multicenter, descriptive, prospective study in patients with NS in intensive care units. Studied variables included medical diagnosis, nutritional status, length of NS, path, type of formula and ten complications. RESULTS: 419 patients evaluated, 380 received enteral nutrition (EN) and 39 parenteral nutrition (PN). The high gastric residue was the most incident complication in the ENS (24.2%), followed by diarrhea (14%) and withdrawal tube (6.6%). The high gastric residue and diarrhea were associated with the duration of the NS (p < 0.05). For the PNS the complication most incidents were hypophosphatemia (38.5%), followed by catheter sepsis (15.4%). The duration of the NS was associated with cholestasis, sepsis and hypophosphatemia (p < 0.05). CONCLUSIONS: complications of highest incidence were the high gastric residue for EN and hypophosphatemia for the PN; the withdrawal of the tube is a complication that claims further monitoring. The duration of the NS was the variable that showed greater association with the complications studied. Is a must to get consensus on complications definitions for comparisons establishment and best international standards target, furthermore propose protocols in order to decrease complications incidence of NS to fulfill the critical ill patient requirements.

Pseudoaneurisma arteria renal postnefrectomía parcial: Tratamiento exitoso con embolización selectiva / Renal artery pseudo aneurism after partial nephrectomy: Report of one case successfully treated with selective embolization

La cirugía renal conservadora ha llegado a ser el estándar en el tratamiento de lesiones tumorales renales de menos de 4 cm. El pseudoaneurisma de la arteria renal es una complicación rara de la nefrectomía parcial, sin embargo puede ser un cuadro grave y de difícil diagnóstico si no se tiene un alto índice de sospecha. El manejo dependerá de las condiciones del paciente, pudiendo llegar incluso a la nefrectomía de necesidad. A continuación presentamos un caso clínico de pseudoaneurisma post nefrectomía parcial manejado en forma exitosa con embolización selectiva.

Renal artery pseudo aneurism is an uncommon, severe and difficult to diagnose complication of partial nephrectomy. We report a 72 years old male subjected to a partial left nephrectomy to excise a 6 cm. diameter tumor. The patient was discharged four days after surgery, but was admitted again due to persistent hematuria. An ultrasound showed a cystic lesion in the kidney and clots in the ureter. A selective renal angiography showed a 4 cm diameter pseudo aneurism of the renal artery and a high flow arteriovenous fistula. Afferent branches were embolized and the fistula was completely occluded. A double catheter was installed in the ureter to resolve a hydronephrosis and the patient was discharged without symptoms, four days after admission.

[Esophagogastric acute injury caused by a chemical agent]. / Lesão aguda esôfago--gástrica causada por agente químico.

UNLABELLED: Treatment of chemical agent ingestion remain controversial. The incidence of these episodes has increased over the several last decades due to a variety reasons. PURPOSE: To analyze the occurrence, complications and results of the treatment of chemically induced esophagogastric injury. METHODS: Twenty-one adult patients with chemically induced esophagogastric injury were retrospectively studied. The patients were admitted up to 23 days after ingestion of a chemical agent to the Emergency Department of Santa Casa of Sao Paulo University Hospital from August, in a 12-year period. The mean age was 32.1 years. Eleven patients were of the female gender, which attempted suicide. Soda was the most ingested agent (76.2%), muriatic acid was present in three cases (14.3%) followed by one case of sulfur acid and another one of ammonia (4.8% each). RESULTS: Injuries of the Larynx and Pharynx were frequently associated with those of the esophagus, accounting for 18 cases (85.7%). Esophageal, gastric and duodenal injuries were assessed and classified according to endoscopic features. Five cases each of severe esophageal or gastric lesions were present. CONCLUSION: Treatment and outcome varied and suggested placement of esophageal tube to be harmful. Global mortality rate was 28.6% with the highest rate related to esophageal injuries of the third degree.

Preanestesia educativa sistematizada / Pre-anesthesia automation

Este trabajo consiste en un desarrollo de un software el cual permite apoyar al anestesiólogo en los siguientes aspectos: historia clinica con enfasis en las valoraciones de la via aerea, sistema cardiovascular, pulmonar, neurologico; valoración de factores de riesgo asociados más frecuentes; resumenes con los hallazgos positivos en cada paciente; base de datos; archivos de consulta academica con conceptos básicos de anestesia para el médico; información al paciente. Este desarrollo está apoyado en la tecnologia de la informática actual con características de sistema experto, multimedia, interactividad. pretendiendo sea una herramienta más en nuestro quehacer post-moderno

Lesäo aguda esôfago-gástrica causada por agente químico / Chemically induced esophagogastric acute injury

O tratamento da ingestão de agentes químicos corrosivos continua controverso. A incidência desses episódios tem aumentado nas últimas décadas por várias razões. OBJETIVO: Analisar a ocorrência, as complicações e os resultados do tratamento da lesão esôfago - gástrica causada por agentes químicos. MÉTODOS: Foram estudados retrospectivamente 21 pacientes adultos com lesão esôfago-gástrica, causada por ingestão de substância química, admitidos até 23 dias após o episódio, no Serviço de Emergência da Santa Casa de Misericórdia de São Paulo num período de 12 anos. A média de idade foi 32,1 anos e 11 doentes pertenciam ao sexo feminino, as quais mais freqüentemente tinham intenções suicidas. A soda cáustica foi o produto mais ingerido (76,2 por cento), ingestão de ácido muriático ocorreu em três casos (14,3 por cento), amoníaco e ácido sulfúrico em um caso (4,8 por cento) cada. RESULTADOS: As lesões faríngeas e laríngeas estiveram freqüentemente associadas às lesões de esôfago, presentes em 18 casos (85,7 por cento). As lesões esofágicas, gástricas e duodenais foram avaliadas e classificadas por endoscopia. Lesões graves esofágicas ou gástricas estiveram presentes em cinco casos cada. CONCLUSÃO: O tratamento e os resultados foram variados, mas sugeriram que a sondagem esofágica foi prejudicial. A mortalidade global foi 28,6 por cento, mais elevada na lesão esofágica grau 3.

Headaches in persons attending polyclinics in Barbados.

Headache is a very common problem in the community, but only a small proportion of people who have it presents to the health services. In the Caribbean little is known of its prevalence, the resulting morbidity or the nature of self care used. This paper reports on a survey of 679 adults who attended three polyclinics as patients, or accompanying young, elderly or acutely ill relatives. 68.9% reported having experienced a headache in the previous month. Headaches were more prevalent among respondents aged 25-44 years (78.6%) than among those in other age groups; in women (73%) than in men; in those living in households of four or more people (72%) than in those living in smaller households; in those whose family members were reported as using alcohol, tobacco or marijuana singly or in combination (70-72.5%) compared to those whose families did not use any of these substances (55%); and in those whose family members were reported as having allergy, asthma and migraine (72.5 to 77.1%). No significant association was shown in relation to employment. 18.4% of the respondents visited the doctor for their headache. In the clinical evaluation of these patient, the number of costly investigations may be reduced by attention to the epidemiological variables such as age and gender, domestic factors such as stress, and family diseases such as migraine, asthma and allergy.

Headaches in persons attending polyclinics in Barbados

Headache is a very common problem in the community, but only a small proportion of people who have it presents to the health services. In the Caribbean little is known of its prevalence, the resulting morbidity or the nature of self care used. This paper reports on a survey of 679 adults who attended three polyclinics as patients, or accompanying young, elderly or acutely ill relatives. 68.9reported having experienced a headache in the previous month. Headaches were more prevalent among respondents aged 25-44 years (78.6) than among those in other age groups; in women (73) than in men; in those living in households of four or more people (72) than in those living in smaller households; in those whose family members were reported as using alcohol, tobacco or marijuana singly or in combination (70-72.5) compared to those whose families did not use any of these substances (55); and in those whose family members were reported as having allergy, asthma and migraine (72.5 to 77.1). No significant association was shown in relation to employment. 18.4of the respondents visited the doctor for their headache. In the clinical evaluation of these patient, the number of costly investigations may be reduced by attention to the epidemiological variables such as age and gender, domestic factors such as stress, and family diseases such as migraine, asthma and allergy.

Ergotism and photosensitization in swine produced by the combined ingestion of Claviceps purpurea sclerotia and Ammi majus seeds.

Poisoning of domestic animals happens frequently in the southeast of Buenos Aires Province (Argentina). Intoxications are produced mainly by the ingestion of plants and mycotoxins, but animals are rarely affected simultaneously by both types of agents. One herd of pigs suffered simultaneous intoxications by ergot alkaloids from Claviceps purpurea sclerotia and furocoumarins from Ammi majus seeds. Pigs were fed a diet composed of wheat (poor quality) or corn and protein and vitamin supplements. This diet was completed with forage sorghum. Nervous signs were first observed 5-7 days after the initiation of feeding the suspect ration. These signs were followed by cutaneous irritation. Snout ulcers, eyelid edema, and conjunctivitis were observed in several piglets. Ten days after the start of feeding the incriminated ration, 8 abortions were observed. Many of the sows that were nursing piglets developed udder edema and teat cracking. Dermal lesions were observed in most of the animals with unpigmented areas in the skin but not in a Duroc-Jersey boar. Removal of the incriminated diet and feeding of another diet prepared with good-quality wheat allowed all the animals to recover in 15 days. The herd experienced normal pregnancies and parturitions, litter sizes, and piglet weights when fed a cleaned portion of the poor-quality wheat. No photosensitization lesions were observed. Examination of impurities in the suspected wheat indicated the presence of 2.2% of A. majus seeds and 0.14% of C. purpurea sclerotia. The quantitative analysis indicated the presence of 3.2 g xanthotoxin and 0.65 g bergaptene/100 g A. majus seeds and 0.73 g ergot alkaloids (expressed as ergonovine) per 100 g of C. purpurea sclerotia. Qualitative analysis demonstrated the presence of ergotamine, ergocristine, and ergonovine. These results indicate that clinical signs and lesions were caused by the ingestion of large quantities of these biologically active compounds.

Nomenclatura de los anticuerpos monoclonales que se utilizan para marcar linfocitos, granulocitos y macrofagos / Monoclonal antibodies nomenclature that is used for marking, lynphocytes, monocytes and macrophages

El estudio histopatologico con hematoxilina y eosina se la principal fuente de informacion para el medico. Pero sumados al estudio morfologico, una serie de analisis inmunologicos, citogenicos y moleculares puede ayudar a un diagnostico certero. Las poblaciones celulares pueden identeificarse de acuerdo a las expresion de diferentes antigenos de superficie (marcadores). El empleo actual de AC monoclonales contra estos Ag colabora en la inmunotipificacion y por lo tanto con la individualizacion de las poblaciones celulares. El uso anarquico de diferentes nombres o acronimos pa Ac que estaban dirigidos contra el mismo Ag confundia la interpretacion de los resultados. Nuestra intencion fue elaborar un cuadro donde el medico encuentre la nomenclatura actualizada hasta el workshop de 1993-29, los sinonimos y las celulas o grupos de celulas que poseen el el Ag que puede detectar cada Ac. La deteccion de marcadores linfocitarios medieante un amplio panel de Ac complementa pero no sustituye la valoracion de la microscopia convencional. Si se emplea un grupo restringido de Ac puede confundirse el diagnostico. Se recomienda como minimo utilizar los siguientes Ac.Celulas T: CD1, CD2, CD3, CD4, CD5, CD7, CD8. Celulas B: CD19, CD20, CD21, CD22. ig superficie (A,G,M yD), cadena kappa y lambda. Serie mielomonocitica: CD!ú; CD! $; CDúú; CD&$; CD& (.Celulas progenitoras:CD38. Marcadores de proliferacion:CD38,CD71.(AU)

[Forms of population mobility in Bogota and its impact on metropolitan area dynamics: methodology of a survey system]. / Las formas de movilidad de la poblacion de Bogota y su impacto sobre la dinamica del area metropolitana: metodologia de un sistema de encuestas.

PIP: The authors discuss the methodology of a project that aimed to improve knowledge of the dynamics of the population of Bogota, Colombia, and particularly of the spatial mobility of the population and changes in different areas of the metropolitan region.^ieng

Nomenclatura de los anticuerpos monoclonales que se utilizan para marcar linfocitos, granulocitos y macrofagos / Monoclonal antibodies nomenclature that is used for marking, lynphocytes, monocytes and macrophages

El estudio histopatologico con hematoxilina y eosina se la principal fuente de informacion para el medico. Pero sumados al estudio morfologico, una serie de analisis inmunologicos, citogenicos y moleculares puede ayudar a un diagnostico certero. Las poblaciones celulares pueden identeificarse de acuerdo a las expresion de diferentes antigenos de superficie (marcadores). El empleo actual de AC monoclonales contra estos Ag colabora en la inmunotipificacion y por lo tanto con la individualizacion de las poblaciones celulares. El uso anarquico de diferentes nombres o acronimos pa Ac que estaban dirigidos contra el mismo Ag confundia la interpretacion de los resultados. Nuestra intencion fue elaborar un cuadro donde el medico encuentre la nomenclatura actualizada hasta el workshop de 1993-29, los sinonimos y las celulas o grupos de celulas que poseen el el Ag que puede detectar cada Ac. La deteccion de marcadores linfocitarios medieante un amplio panel de Ac complementa pero no sustituye la valoracion de la microscopia convencional. Si se emplea un grupo restringido de Ac puede confundirse el diagnostico. Se recomienda como minimo utilizar los siguientes Ac.Celulas T: CD1, CD2, CD3, CD4, CD5, CD7, CD8. Celulas B: CD19, CD20, CD21, CD22. ig superficie (A,G,M yD), cadena kappa y lambda. Serie mielomonocitica: CD!ú; CD! $; CDúú; CD&$; CD& (.Celulas progenitoras:CD38. Marcadores de proliferacion:CD38,CD71.

Hypertension, diabetes, and obesity in Barbados: findings from a recent population-based survey.

A stratified random sample of 464 persons aged 40 to 79 years, drawn from enumeration registers in the Bridgetown area of Barbados, participated in this survey. The prevalence of hypertension (defined as systolic blood pressure of at least 160 mm Hg, diastolic blood pressure of at least 95 mm Hg, or use of antihypertensive medication) was 47% and 43% for women and men, respectively. Diabetes was present in 17% of all subjects (18% of women and 15% of men). Of the 209 hypertensive subjects, 82% were aware of their blood pressure status. The proportion of previously diagnosed hypertensive subjects on medication was 72% for men and 68% for women. Fifty-three percent of men and 42% of women were overweight (body mass indices [weight in kilograms divided by height in meters squared] between 25 and 30). However, 30% of women and 10% of men were obese (body mass indices over 30), supporting the growing recognition of the marked gender disparity in obesity among persons of African origin in the Caribbean. Body mass index was positively associated with hypertension (OR = 1.33; 95% CI: 1.1-1.6). Obese persons experienced a 2.6 times greater risk of hypertension compared to those with body mass indices below 25. Similar statistically significant associations were observed between diabetes and body mass index: OR comparing body mass index over 30 with body mass index under 25 was 2.5 (95% CI: 1.3-5.1) for all subjects, 1.0 (0.3-4.1) for men only, and 5.2 (1.9-14) for women only. Preventing obesity in this population could reduce the incidence of hypertension and diabetes by approximately 30% and 33% among men and women, respectively.

An AIDS-related knowledge, attitudes, beliefs, and practices survey among schoolchildren in Barbados.

A knowledge, attitudes, beliefs, and practices (KABP) survey was performed among Barbadian secondary schoolchildren 11-16 years old in January 1990. The survey sought to assess the children's knowledge of AIDS and human immunodeficiency virus (HIV) transmission; their attitudes toward people with HIV/AIDS; their sexual practices; and changes needed in education programs seeking to reduce childhood HIV transmission. A pretested self-administered questionnaire was used. The survey sample was derived by selecting every eleventh student on the rosters of all the secondary schools in Barbados. All of the survey respondents completed the questionnaire on the same day, having been assembled examination-style for that purpose. The results showed high levels of correct knowledge about the principal routes of HIV transmission. However, a considerable proportion of the respondents harbored incorrect beliefs regarding mosquito transmission and dangers to blood donors, and many showed uncertainty or incorrect knowledge regarding possible HIV transmission by biting, spitting, or use of public toilets. About a third of the children (51.4% of the boys and 18.7% of the girls) said they had experienced sexual intercourse, though only 20% reported being sexually active in the year preceding the survey. Three-quarters of the sexually experienced group said they knew how to use condoms, but only a third said there was any time when they had used protection during sexual intercourse. Overall, the results indicate that education efforts prior to the survey had been effective, but that reinforcement of such efforts as well as their extension into the primary schools is warranted. Further research directed at helping these efforts to encourage more meaningful changes in sexual behavior is also needed.

PIP: A knowledge, attitude, beliefs, and practices (KABP) survey was performed among Barbadian secondary schoolchildren ages 11-16 in January 1990. The survey sought to assess the children's knowledge of AIDS and human immunodeficiency virus (HIV) transmission; their attitudes towards people with HIV/AIDS; their sexual practices; and changes needed in education programs seeking to reduce childhood HIV transmissions. A pretested self-administered questionnaire was used. The survey sample was derived by selecting every 11th student on the rosters of all secondary school in Barbados. All of the survey respondents completed the questionnaire on the same day, having been assembled examination- style for that purpose. Results showed high levels of correct knowledge concerning the principle routes of HIV transmission; however, a considerable portion of the respondents maintained incorrect beliefs with regard to mosquito transmission and dangers to blood donors, and many demonstrated uncertainty or incorrect knowledge concerning possible HIV transmission by biting, spitting, or use of public toilets. About 1/3 of the children (51.4% of the boys and 18.7% of the girls) said they had experienced sexual intercourse, although only 20% said they were sexually active in the year preceding the survey. 3/4 of the sexually experienced group said they knew how to use condoms, but only 1/3 said there was any time when they had used protection during sexual intercourse. Overall, results indicate that education efforts prior to the survey had been effective, but that reinforcement of such efforts as well as their extension into the primary schools is warranted. Further research directed at aiding in this effort to encourage more meaningful changes in sexual behavior is also necessary.

Colecistitis aguda y crónica momento quirúrgico. Hospital General de Medellín Septiembre 1 de 1990 – Abril 15 de 1991 / Chronic and acute cholecystitis. Surgical timing. Medellín General Hospital. September 1, 1990 – April 15, 1991

En el Hospital General de Medellín (Colombia) se realizó un estudio descriptivo prospectivo en 129 pacientes con enfermedad Inflamatoria vesicular a quienes se les practicó Colecistectomía en un período de 8 meses, de las cuales 66 fueron realizadas en pacientes con Colecistitis aguda y 63 electivamente. El 89.9 por ciento de los pacientes fueron de sexo femenino, 52.7 por ciento de ellas eran menores de 40 años y 61.6 por ciento tuvieron menos de 3 partos. No hubo diferencias de edad, sexo, paridad, antecedentes personales y técnica quirúrgica entre los dos grupos. La morbilidad en los pacientes agudos fue: Infección de herida 9 por ciento, dehiscencia y colección Intraabdominal 1.5 por ciento c/u y iatrogenia en 0 por ciento y, en pacientes electivos: Infección de herida 3.1 por ciento, iatrogenia 1.6 por ciento, y no se presentaron casos de dehiscencia ni colección Intraabdominal. No hubo mortalidad en los pacientes electivos, y en agudos fue 1.5x100. Las colecistectomías urgentes fueron un procedimiento seguro con una morbilidad similar a las colecistectomías programadas, lo cual sugiere que pueden surgir siendo de elección de Colecistitis Aguda y se deben realizaren pacientes con Colecistitis aguda, con lo cual sé podría disminuir sufrimiento, costo hospitalario e Incapacidad a los pacientes...

Concepts of obesity in family practice

In this study, 502 adults (409 women, 93 men) attending a Group Teaching Family Practice were weighed, their heights were measured and they were then interviewed on their concepts and beliefs about obesity. The results conformed other reports that the prevalence of obesity is high; 46% of women and 17% of men were found to have body mass indices greater than 27.0 and 27.4 respectively. Of the 198 obese responts, only 94 (47%) considered themselves to be fat, whilw self-image in the nom-obese was more realistic with 176 (59%) thinking that they were right size; 18.7% of respondents thought that obesity was associated with good health, 29.9% associated obesity with wealth and 36.3% associated obesity with happiness. Two hundred and four respondents (40.6) believed that men preferred their women to be fat, female respondents being more often of this view. Concepts as to the cause of obesity were found to differ from medical teaching with 195 (39%) respondents believing obesity to be hereditary and only 215 (42.8%) associating obesity with overeating. These views should be appreciated by health-care provuders, who should try to change them, if necessary, before making efforts to prevent and treat obsity