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1.
Med. clín (Ed. impr.) ; 156(11): 535-540, junio 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-213571

RESUMO

Introducción: Analizar las características clínico-patológicas de los pacientes operados por nódulo pulmonar solitario (NPS) y 18F-FDG PET-TC integrado tras su resección quirúrgica.Material y métodosEstudio retrospectivo sobre una base de datos prospectiva de pacientes operados entre enero-2007 y octubre-2017 por NPS sin diagnóstico preoperatorio. La variable dependiente fue el resultado anatomopatológico (benigno vs. maligno) del NPS. Las variables del estudio fueron: edad, sexo, captación en PET-TC, SUVmáx, tabaquismo, EPOC, antecedente de tumoración maligna previa, localización del tumor y tamaño en la TC.ResultadosUn total de 305 pacientes fueron incluidos en el estudio, 225 (73,8%) varones, 80 (26,2%) mujeres, edad media = 63,9 (rango 29-86 años), tamaño medio NPS = 1,68 (d.t. 0,65 cm), benignos = 46 (15,1%), malignos = 258 (84,6%), tipo de resección: cuña = 151 (49,5%), lobectomía = 141 (46,2%), segmentectomía = 12 (3,9%), exploradora = 1 (0,3%). La mortalidad postoperatoria fue del 1,9%. EPOC = 50,8% casos, cáncer previo = 172 casos (56,4%), tabaquismo = 250 casos (82%), PET positiva = 280 casos (91,8%), NPS en campos superiores = 204 casos (66,9%), SUVmáx mediana = 3,4 (rango 0-20,7). El modelo de regresión logística binaria por pasos hacia atrás mostró que la edad, SUVmáx, enfermedad maligna previa y sexo femenino fueron factores de riesgo independientes con significación estadística (p < 0,05).La sensibilidad, especificidad, el valor predictivo positivo, el valor predictivo negativo y la seguridad diagnóstica fueron 94,6%, 23,4%, 87,1%, 44% y 83,6%, respectivamente. Hubo un total de 14 casos falsos negativos (4,6%) y 36 casos falsos positivos (11,8%). (AU)


Introduction: To analyse clinicopathological characteristics of patients operated for pulmonary solitary nodule (PSN) and 18F-FDG integrated PET-CT scan after surgical resection.MethodologyRetrospective study on a prospective database of patients operated from January 2007 to October 2017 for PSN without preoperative diagnosis. Dependent variable was anatomopathological result (benign vs malignant) of PSN. Variables of the study were: age, sex, PET-CT uptake, SUVmax, smoking history, COPD, previous history of malignant disease, tumoral location, and tumour size on CT-scan.ResultsA total of 305 patients were included in this study, 225 (73.8%) men, 80 (26.2%) women, mean age = 63.9 (range 29-86 years), mean size PSN = 1.68 (s.d. .65 cm), benign = 46 (15.1%), malignant = 258 (84.6%), type of resection: pulmonary wedge = 151 (49.5%), lobectomy = 141 (46.2%), segmentectomy = 12 (3.9%), exploratory intervention = 1 (0.3%). Postoperative mortality was 1.9%. COPD = 50.8% cases, previous cancer disease = 172 cases (56.4%), smoking history = 250 cases (82.0%), positive PET = 280 cases (91.8%), PSN in upper pulmonary fields = 204 cases (66.9%), median SUVmax = 3.4 (range 0-20.7). Backward stepwise binary logistic regression model showed that age, SUVmax, previous malignant disease and female sex were independent risk factors with statistical significance (p < .05). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 94.6%, 23.4%, 87.1%, 44.0%, and 83.6% respectively. There were 14 false negative cases (4.6%) and 36 false positive cases (11.8%). (AU)


Assuntos
Humanos , Fluordesoxiglucose F18 , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Compostos Radiofarmacêuticos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/cirurgia , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Estudos Retrospectivos
2.
Med Clin (Barc) ; 156(11): 535-540, 2021 06 11.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32859401

RESUMO

INTRODUCTION: To analyse clinicopathological characteristics of patients operated for pulmonary solitary nodule (PSN) and 18F-FDG integrated PET-CT scan after surgical resection. METHODOLOGY: Retrospective study on a prospective database of patients operated from January 2007 to October 2017 for PSN without preoperative diagnosis. Dependent variable was anatomopathological result (benign vs malignant) of PSN. Variables of the study were: age, sex, PET-CT uptake, SUVmax, smoking history, COPD, previous history of malignant disease, tumoral location, and tumour size on CT-scan. RESULTS: A total of 305 patients were included in this study, 225 (73.8%) men, 80 (26.2%) women, mean age = 63.9 (range 29-86 years), mean size PSN = 1.68 (s.d. .65 cm), benign = 46 (15.1%), malignant = 258 (84.6%), type of resection: pulmonary wedge = 151 (49.5%), lobectomy = 141 (46.2%), segmentectomy = 12 (3.9%), exploratory intervention = 1 (0.3%). Postoperative mortality was 1.9%. COPD = 50.8% cases, previous cancer disease = 172 cases (56.4%), smoking history = 250 cases (82.0%), positive PET = 280 cases (91.8%), PSN in upper pulmonary fields = 204 cases (66.9%), median SUVmax = 3.4 (range 0-20.7). Backward stepwise binary logistic regression model showed that age, SUVmax, previous malignant disease and female sex were independent risk factors with statistical significance (p < .05). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 94.6%, 23.4%, 87.1%, 44.0%, and 83.6% respectively. There were 14 false negative cases (4.6%) and 36 false positive cases (11.8%). CONCLUSIONS: Age, SUVmax, previous malignant disease, and female sex were independent risk factors in our study. Each case should be individually evaluated in a multidisciplinary committee, and the patient's preferences or concerns should be kept in mind in decision-making. Surgical resection of PSN is not exempt from morbidity and mortality, even in sublobar or pulmonary wedge resection.


Assuntos
Neoplasias Pulmonares , Nódulo Pulmonar Solitário , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Nódulo Pulmonar Solitário/cirurgia , Tomografia Computadorizada por Raios X
3.
Enferm. glob ; 16(46): 315-335, abr. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-161735

RESUMO

Este proyecto de investigación pretende analizar las condiciones de trabajo, las variables individuales y de salud que están relacionadas con el desarrollo del síndrome de burnout, así como el potencial efecto de la «entereza» o «personalidad resistente», presente en nuestro ámbito de trabajo, todo esto en el contexto de crisis económica en la que nos encontramos en la actualidad. Partiendo de este análisis, se podrían plantear estrategias de cambio con el fin de mejorar la satisfacción laboral y disminuir los niveles de desgaste laboral, actuando sobre los factores que más incidan sobre el mismo. Se trata de un estudio observacional, descriptivo, transversal, realizado en una muestra de 377 profesionales de enfermería y auxiliares de enfermería, de Atención Especializada y Atención Sociosanitaria del Sistema Sanitario Público de la ciudad de Albacete. Los sujetos se seleccionarán de forma no aleatoria según disponibilidad en servicio/unidad de trabajo. La prevalencia del síndrome de burnout es superior al periodo precrisis siendo el cansancio emocional la dimensión más influyente en su aparición. Existen ciertos factores que predisponen al aumento del burnout y otros que son factores de riesgo para su desarrollo. A su vez la personalidad resistente actúa como factor protector en la aparición del síndrome. Futuras líneas de investigación podrían estar encaminadas al estudio de intervenciones para el fomento de la resilencia (AU)


This research project aims to analyze the conditions of work, the individual variables and health are related to the development of burnout syndrome, as well as the potential effect of «hardness» or «resistant personality», present in our field of work, all this in the context of economic crisis in which we find ourselves today. Based on this analysis, strategies for change in order to improve job satisfaction and lower levels of work wear, acting on the factors that most influence on it could pose. It is an observational, descriptive, transversal, study in a sample of 377 nursing professionals and auxiliary nurses specialized care and attention health public system socio-health of the city of Albacete. Subjects will be selected randomly according to availability in service/work unit. The prevalence of burnout syndrome is superior to its pre-crisis being the emotional exhaustion the more influential in his appearance dimension. There are certain factors that predispose to the increase of burnout and others that are risk factors for its development. At the same time the resistant personality acts as a protective factor in the emergence of the syndrome. Future lines of research could be aimed at the study of interventions for the promotion of resilience (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Recessão Econômica/estatística & dados numéricos , Esgotamento Profissional/enfermagem , Esgotamento Profissional/psicologia , Recursos Humanos de Enfermagem/psicologia , Resiliência Psicológica , Assistentes de Enfermagem/psicologia , Avaliação do Impacto na Saúde/métodos , 16360 , Satisfação no Emprego , Estudos Transversais/métodos
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