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1.
Drugs ; 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38652355

RESUMO

Dry eye disease (DED) can arise from a variety of factors, including inflammation, meibomian gland dysfunction (MGD), and neurosensory abnormalities. Individuals with DED may exhibit a range of clinical signs, including tear instability, reduced tear production, and epithelial disruption, that are driven by different pathophysiological contributors. Those affected often report a spectrum of pain and visual symptoms that can impact physical and mental aspects of health, placing an overall burden on an individual's well-being. This cumulative impact of DED on an individual's activities and on society underscores the importance of finding diverse and effective management strategies. Such management strategies necessitate an understanding of the underlying pathophysiological mechanisms that contribute to DED in the individual patient. Presently, the majority of approved therapies for DED address T cell-mediated inflammation, with their tolerability and effectiveness varying across different studies. However, there is an emergence of treatments that target additional aspects of the disease, including novel inflammatory pathways, abnormalities of the eyelid margin, and neuronal function. These developments may allow for a more nuanced and precise management strategy for DED. This review highlights the recent pharmacological advancements in DED therapy in the United States. It discusses the mechanisms of action of these new treatments, presents key findings from clinical trials, discusses their current stage of development, and explores their potential applicability to different sub-types of DED. By providing a comprehensive overview of products in development, this review aims to contribute valuable insights to the ongoing efforts in enhancing the therapeutic options available to individuals suffering from DED.

2.
Res Sq ; 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38352587

RESUMO

Background: Negative dysphotopsias (ND) are visual aberrations associated with in-the-bag optic intraocular lens (IOL) placement, causing arc-shaped or linear shadows. Reverse optic capture (ROC) is employed to prevent ND, yet it poses the risk of posterior capsular opacification (PCO) which usually develops within 2-5 years post-surgery due to the lens epithelial cells (LECs) proliferation and migration onto the posterior capsule. This can lead to a cloudy or hazy appearance in the visual field. Early identification of posterior capsular opacities is crucial to ensure timely intervention and minimize visual impairment. Cases Presentations: Two cases of acute and rapidly progressive PCO following cataract extraction (CE) and IOL placement using the ROC technique to prevent ND are reported at the Bascom Palmer Eye Institute. At the two-week postoperative follow-up, both patients reported a significant progressive decrease in vision in the treated eye, and severe posterior capsular opacities were observed. A diagnosis of PCO was confirmed, and successful visual rehabilitation was achieved through the performance of ND:YAG laser capsulotomy without complications. This case series represents the first reported instances of patients developing PCO within two weeks of CE and IOL placement using the ROC technique. Conclusions: This case series sheds light on the occurrence of posterior capsular opacities shortly after CE and IOL placement using the ROC technique. It highlights the importance of preoperative patient education, postoperative monitoring, and prompt management of potential complications in cataract surgery.

3.
Cornea ; 43(2): 265-268, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37603688

RESUMO

PURPOSE: The aim of this study was to describe a combined surgical approach for ocular surface and visual rehabilitation in patients with limbal stem cell deficiency, corneal scarring, and cataract. We aimed to introduce this combined approach as an alternative to a staged approach and to describe the intraoperative use of a diamond ophthalmic burr (DOB) and optical coherence tomography (OCT) to achieve and confirm a smooth graft-host interface during the anterior lamellar keratoplasty (ALK) portion of the procedure. METHODS: The quintuple procedure described herein consists of a modified ALK, cataract extraction, intraocular lens implantation, simple limbal epithelial transplantation, and temporal tarsorrhaphy. Intraoperative OCT and DOB were used to guide the creation of the stromal bed during the ALK. The procedure was performed in a patient with limbal stem cell deficiency and corneal scarring after a chemical ocular burn. RESULTS: The tarsorrhaphy was removed at 3 months postoperatively once complete corneal epithelialization was observed. The best-corrected visual acuity improved from light perception preoperatively to 20/30 at 16 months postoperatively with the use of scleral contact lenses. At this postoperative time point, the cornea was clear and compact, and the ocular surface was stable. CONCLUSIONS: The quintuple procedure allowed for visual and ocular surface rehabilitation in cases in which follow-up for a staged approach was not possible. Intraoperative OCT allowed for real-time visualization and dissection of the stromal bed, whereas the use of the DOB helped achieve a smooth stromal surface for an optimal graft-host interface.


Assuntos
Doenças da Córnea , Lesões da Córnea , Transplante de Córnea , Deficiência Límbica de Células-Tronco , Humanos , Cicatriz/cirurgia , Acuidade Visual , Córnea/cirurgia , Lesões da Córnea/cirurgia , Receptores Proteína Tirosina Quinases , Transplante de Córnea/métodos , Doenças da Córnea/cirurgia
4.
J Aerosol Med Pulm Drug Deliv ; 35(6): 313-320, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36318820

RESUMO

Background: Greater patient satisfaction with his or her inhalation device is associated with better adherence to pharmacological therapy and better clinical outcomes, such as improved quality of life, greater asthma control, and fewer exacerbations. The objective of this study was to determine the satisfaction level of a group of patients diagnosed with bronchial asthma concerning their devices for inhalation of bronchodilators and glucocorticoids. Methods: This was a cross-sectional study of patients treated in the Colombian health system. Satisfaction with inhalation devices was evaluated with the Feeling of Satisfaction with Inhaler (FSI)-10 questionnaire. A score of ≥44 points indicated high satisfaction. Results: In total, 362 patients from 59 cities were identified, their median age was 55 years, and 74.6% were women. The FSI-10 average score was 44.6; 68.5% of patients showed high satisfaction, especially with pressurized metered-dose inhalers (pMDIs), and 63.4% did not use them with an inhalation chamber. Users of pMDIs (odds ratio [OR]: 1.80; 95% confidence interval [CI]: 1.05-3.10) and those who received training by medical specialists (OR: 2.29; 95% CI: 1.33-3.97) had high satisfaction, while patients who were older (40-64 vs. <40 years: OR: 0.38; 95% CI: 0.19-0.78 and ≥65 vs. <40 years: OR: 0.35; 95% CI: 0.15-0.81), resided in the Caribbean region (OR: 0.48; 95% CI: 0.29-0.81), and had a university education (OR: 0.54; 95% CI: 0.32-0.90) had lower satisfaction. Conclusions: The majority of patients with asthma used pMDIs without an inhalation chamber, and their overall satisfaction was higher than that of patients using other inhalation devices. Patients who received special training from medical specialists showed better satisfaction.


Assuntos
Asma , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Administração por Inalação , Estudos Transversais , Satisfação do Paciente , Asma/tratamento farmacológico , Inaladores Dosimetrados , Nebulizadores e Vaporizadores , Broncodilatadores , Satisfação Pessoal
5.
Rev. estomat. salud ; 24(2): 14-25, 20160000.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-878640

RESUMO

Objetivo: El propósito de este ensayo clínico controlado aleatorizado simple ciego fue determinar el efecto del raspaje y alisado radicular en una sesión adjunto a azitromicina oral, sobre los niveles de proteína C reactiva ultra sensible y otros biomarcadores sanguíneos, parámetros clínicos y microbiológicos periodontales en pacientes con periodontitis crónica tres meses después del tratamiento. Materiales y Métodos: 49 sujetos con periodontitis crónica participaron en el estudio y fueron asignados aleatoriamente en dos grupos de 27 pacientes, el grupo intervención recibió raspaje y alisado ra- dicular adjunto a azitromicina (RAR+Azi) 500 mg/día por cinco días, y el grupo con- trol recibió raspaje y alisado radicular más placebo (RAR+Pb), ambos tratamiento en sesión única. Los grupos de periodontitis recibieron un examen periodontal a boca completa, análisis de sangre y cultivos microbiológicos al inicio del estudio y tres meses después del tratamiento. Se incluyó un grupo referencia de 25 pacientes perio- dontalmente sanos tomando muestras sólo al inicio. La variable principal de desenlace fue la variación de la proteína C reactiva ultra sensible. Las variables de resultado secundarias fueron la variación de triglice - ridos, colesterol de alta densidad (HDL), colesterol de baja densidad (LDL), glucosa en ayunas, profundidad al sondaje (PS) y composición microbiana. Resultados: La terapia RAR+Azi no redujo significativamente los niveles plas - máticos de hsPCR, sin embargo, se observó una tendencia positiva (4,33 a 2,99 mg/L). Este grupo obtuvo también una mayor re- ducción en PS, índice arterial y frecuencia de detección de Porphyromonas gingivalis y Prevotela intermedia en comparación con el grupo RAR+Pb (p<0.05). Los otros pa- rámetros sanguíneos no cambiaron signifi - cativamente. En contraste, el grupo control aumentó los niveles de hsPCR después de la terapia y en algunos casos se detectó un aumento de PS. Conclusiones: La terapia de RAR+Azi ofrece a corto plazo beneficios clínicos y microbiológicos comparado a RAR solo. No se encontraron diferencias significati - vas en los niveles de hsPCR. Es necesario realizar estudios con mayor tiempo de seguimiento para confirmar o rechazar la hipótesis que el tratamiento periodontal solo o con antibióticos generan efectos en los niveles de hsPCR y otros marcadores de riesgo cardiovascular...(AU)


Objective: This single blind randomized clinical trial (RCT) determined the effect of scaling and root planning plus azithromycin (SRP+Azi) in serum C reactive protein levels and other blood biomarkers, clinical periodontal parameters and subgingival microbial composition three months after periodontal therapy. Materials and Methods: Forty-nine chronic periodontitis patients participated in the study and were randomly assigned Recibido para publicación: Octubre 09 de 2016 Aceptado para publicación: Diciembre 07 de 2016 Correspondencia: JE, Soto, Universidad del Valle jesotofranco@gmail.com R E V I S T A ESTOMATOLOGIA Artículo original La Revista Estomatología usa la licencia Creative Commons de Atribución ­ No comercial ­ Sin Derivar 4.0 Internacional; de tal forma que los textos de la revista pueden ser descargados en ver - sión PDF siempre que sea reconocida la autoría y el texto no tenga modificaciones de ningún tipo. Volumen 24 Nº 2 2016 15 to a test group of 27 patients received one session of scaling and root planning plus oral azithromycin 500 mg daily for five days (SRP+Azi) while, 27 patients in the control group received the same single session of scaling and root planning plus placebo (SRP+Pb). A group of 25 subjects presenting periodontal health-gingivitis were included as a comparison group and in them was determined clinical periodontal parameters, blood parameters and micro - biota at baseline. Periodontitis groups recei - ved a full mouth periodontal examination, blood test and microbiological cultures at baseline, and three months after therapy. Primary outcome variable was the variation in serum high sensitive C- reactive protein (hs-CRP). Secondary outcome variables were variation of triglycerides, High density Cholesterol (HDL), low density Cholesterol (LDL), fasting glucose, pocket depth and microbial composition. Results: Therapy with SRP+Azi do not significantly reduce the plasmatic levels of hs-CRP however, a positive trend was noti - ce (4,33 to 2,99 mg/l). This group obtained also greater reduction of pocket depth (PD), artery index and P. gingivalis and P inter - media detection frequency when compared to the SRP-placebo group (p<0.05). Other blood biochemistry parameters did not changed significantly in the test group. In contrast, the control group increased the hs- CRP levels after therapy and in some cases a increase of pocket depth was detected. Conclusions: Combined SRP+Azi therapy in chronic periodontitis did not reduced hs- CRP serum level significantly after three months. However, this group reduced signi - ficantly their probing pocket depth, reduced P. gingivalis and P intermedia frequency and increased clinical attachment gain.


Assuntos
Humanos , Albuminas , Proteína C-Reativa , Periodontite Crônica , Ensaio Clínico , Odontologia , Bolsa Periodontal , Periodontia , Periodontia/instrumentação , Curetagem Subgengival , Azitromicina , Periodontite
6.
Nutr Rev ; 71(10): 682-91, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24117791

RESUMO

The present article articulates principles for effective public-private partnerships (PPPs) in scientific research. Recognizing that PPPs represent one approach for creating research collaborations and that there are other methods outside the scope of this article, PPPs can be useful in leveraging diverse expertise among government, academic, and industry researchers to address public health needs and questions concerned with nutrition, health, food science, and food and ingredient safety. A three-step process was used to identify the principles proposed herein: step 1) review of existing PPP guidelines, both in the peer-reviewed literature and at 16 disparate non-industry organizations; step 2) analysis of relevant successful or promising PPPs; and step 3) formal background interviews of 27 experienced, senior-level individuals from academia, government, industry, foundations, and non-governmental organizations. This process resulted in the articulation of 12 potential principles for establishing and managing successful research PPPs. The review of existing guidelines showed that guidelines for research partnerships currently reside largely within institutions rather than in the peer-reviewed literature. This article aims to introduce these principles into the literature to serve as a framework for dialogue and for future PPPs.


Assuntos
Inocuidade dos Alimentos , Política Nutricional , Saúde Pública , Parcerias Público-Privadas , Comportamento Cooperativo , Tecnologia de Alimentos , Guias como Assunto , Humanos , Estado Nutricional , Pesquisa
9.
Crit Rev Food Sci Nutr ; 50 Suppl 1: 1-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21132578

RESUMO

The interpretation and integration of epidemiological studies detecting weak associations (RR <2) with data from other study designs (e.g., animal models and human intervention trials) is both challenging and vital for making science-based dietary recommendations in the nutrition and food safety communities. The 2008 ILSI North America "Decision-Making for Recommendations and Communication Based on Totality of Food-Related Research" workshop provided an overview of epidemiological methods, and case-study examples of how weak associations have been incorporated into decision making for nutritional recommendations. Based on the workshop presentations and dialogue among the participants, three clear strategies were provided for the use of weak associations in informing nutritional recommendations for optimal health. First, enable more effective integration of data from all sources through the use of genetic and nutritional biomarkers; second, minimize the risk of bias and confounding through the adoption of rigorous quality-control standards, greater emphasis on the replication of study results, and better integration of results from independent studies, perhaps using adaptive study designs and Bayesian meta-analysis methods; and third, emphasize more effective and truthful communication to the public about the evolving understanding of the often complex relationship between nutrition, lifestyle, and optimal health.


Assuntos
Tecnologia de Alimentos , Ciências da Nutrição , Saúde Pública , Tomada de Decisões , Dieta , Inocuidade dos Alimentos , Humanos
11.
Appetite ; 51(1): 111-9, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18342398

RESUMO

L-Phenylalanine (Phe), is a potent releaser of the satiety hormone, cholecystokinin (CCK) and previous studies, conducted primarily in men, show that ingestion of Phe reduces energy intake. The objective of the current study was to test the effects of Phe on energy intake in overweight and obese women. Subjects (n=32) received three treatments (high-dose (10 g Phe), low-dose (5 g Phe and 5 g glucose) or control (10 g glucose)) 20 min before an ad libitum lunch and dinner meal in a within-subjects', counterbalanced, double-blind study. No effect of Phe was found, however, interactions with dietary restraint status were detected in post-hoc analyses. Energy intake over the day was 11% lower following high-dose Phe versus control for women classified in the lower tertile of rigid restraint, a subscale of the dietary restraint scale, whereas no effects were noted for women in the middle and upper tertiles. High-dose Phe increased ratings of nausea, however, reduced energy intake in the high-dose condition was noted only for subjects with low nausea ratings. These results suggest that the satiety response to Phe is modulated by rigid restraint status and that reductions in food intake occur independently of Phe's effects on nausea.


Assuntos
Ingestão de Energia/efeitos dos fármacos , Obesidade/tratamento farmacológico , Sobrepeso/tratamento farmacológico , Fenilalanina/farmacologia , Saciação/efeitos dos fármacos , Adulto , Restrição Calórica/métodos , Colecistocinina/metabolismo , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Ingestão de Alimentos/efeitos dos fármacos , Ingestão de Energia/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Fenilalanina/efeitos adversos , Saciação/fisiologia
12.
Am J Clin Nutr ; 86(6): 1595-602, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18065575

RESUMO

BACKGROUND: Foods containing strong-gelling fibers may provide a safe and efficacious strategy for reducing food intake by stimulating endogenous satiety signaling. OBJECTIVE: A novel, 2-part beverage, consisting of alginate-pectin and calcium components, that forms a stable, fibrous gel in the stomach was tested to determine its effects on subjective satiety and food intake in overweight and obese women. DESIGN: The investigation was a within-subjects, double-blind, placebo-controlled study. Subjects (n = 29) ingested a 2-part beverage twice per day (once before breakfast and once midafternoon) for 7 d. Three alginate-pectin formulations were tested: 1.0 g, 2.8 g, and control (no fiber). Subjective satiety and ad libitum food intake were measured on days 1 and 7 of each 1-wk treatment period with a 1-wk washout between testings. RESULTS: A significant reduction in food intake was observed at dinner for both formulations compared with the control formulation. The effects of the gel beverage differed as a function of rigid dietary restraint status. Women in the lower 50th percentile of rigid restraint consumed 12% less energy during the day and 22% less for the evening snack in the 2.8-g condition compared with the control condition. No effect was found for women in the upper 50th percentile of rigid restraint. CONCLUSIONS: Consumption of a postingestion, calcium-gelled fiber beverage twice daily reduced energy intake in overweight and obese women with low rigid restraint scores. Use of foods designed to enhance satiety may be an effective adjunctive therapy for weight loss; however, more research is needed to determine how dietary restraint alters this response.


Assuntos
Alginatos/administração & dosagem , Cálcio/administração & dosagem , Restrição Calórica/métodos , Géis/administração & dosagem , Obesidade/dietoterapia , Pectinas/administração & dosagem , Resposta de Saciedade/efeitos dos fármacos , Adulto , Bebidas , Método Duplo-Cego , Ingestão de Energia , Comportamento Alimentar/efeitos dos fármacos , Feminino , Humanos
13.
Rev. colomb. cardiol ; 14(4): 198-206, jul.-ago. 2007. tab, graf
Artigo em Espanhol | LILACS | ID: lil-469039

RESUMO

Antecedentes: el entrenamiento de la fuerza muscular en pacientes con eventos cardiovasculares, estaba totalmente contraindicado por el riesgo de incrementar las cifras de tensión arterial sistólica y diastólica, así como someter al miocardio a una sobrecarga. Objetivo: valorar la respuesta hemodinámica (frecuencia cardiaca, tensión arterial) durante el entrenamiento de resistencia a la fuerza muscular en los pacientes que asisten a un programa de rehabilitación cardiaca.Diseño: cuasi experimental prospectivo.Excenario: se realizó un entrenamiento de resistencia a la fuerza muscular en miembros superiores a pacientes durante la fase II de rehabilitación cardiaca.Sujetos: se incluyeron 175 pacientes, 135 hombres y 40 mujeres con un promedio de edad de 58,79 años, los cuales presentaron enfermedad coronaria con y sin procedimientos de revascularización, cirugía de cambios valvulares, síncope y corrección quirúrgica de anomalías congénitas...


Background: training of muscular strength in patients with cardiovascular events was totally contraindicated because of the risk of incrementing the systolic and diastolic arterial pressure values, as well as the submission to a myocardial overload. Objective: evaluate the hemodynamic response (heart rate, arterial pressure) during the resistance to muscular strength training in patients assisting to a heart rehabilitation program. Design: quasi experimental prospective study. Setting: resistance training to muscular strength in upper limbs to patients during stage II of cardiac rehabilitation was realized. Subjects: 175 patients were included. 135 men and 40 women with mean age 58.79 years with coronary disease, with or without revascularization procedures, valvular surgery, syncope and surgical correction of congenital heart disease. Procedure: previous aerobic training (treadmill or static bicycle), muscular strength evaluation was realized through maximal repetition and the strength training was initiated at 30%-50% of this, in a three different exercise circuit in upper limbs, 10 repetitions in three series with a twice a week frequency. Besides, monitoring of heart frequency, electrocardiogram by telemetry (V5), arterial pressure recording before, during and after the session, and subjective perception of the effort by the Borg scale were made, and signs and symptoms of intolerance to the activity or decompensation were observed. For the statistical analysis, measures of central tendency with the cardiovascular changes were used and in order to compare the change in muscular strength, a paired t test with significance level 0.05 was utilized. Results: mean muscular strength with maximal repetition evidenced a significant increase of 1.92 ± 2.49 lb (p<0.001) in the general population, with an increment of 2.03 ± 2.57 lb (p<0.001) in men and of 1.46 ± 2.1 lb...


Assuntos
Pressão Sanguínea , Doença das Coronárias , Resistência Física , Reabilitação
14.
J Cardiothorac Vasc Anesth ; 20(5): 648-51, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17023281

RESUMO

OBJECTIVE: There is increasing interest in the use of the thoracic paravertebral block (TPVB) in association with general anesthesia for lung-resection surgery. The aim of the study was to evaluate the hemodynamic effects of a 5-mg/kg lidocaine bolus injected in the thoracic paravertebral space during one-lung ventilation (OLV) in noncardiac patients undergoing thoracic surgery. DESIGN: Prospective, observational study. SETTING: Tertiary care university hospital. PARTICIPANT: Twenty patients undergoing thoracotomy for lung resection. INTERVENTIONS: In addition to standard monitoring, cardiac output, preload parameters (global diastolic volume, total intrathoracic blood volume, and systolic volume variation), and myocardial contractility (dP(max) and cardiac function index) were measured with an aortic transpulmonary thermodilution technique. MEASUREMENTS AND MAIN RESULTS: After OLV initiation, a paravertebral lidocaine bolus of 5 mg/kg (2%) caused decreases in the dP(max) and cardiac function index that lasted up to 30 minutes. Accompanying minor reductions in heart rate and systolic blood pressure required no vasoactive drugs and were self-limiting. None of the other hemodynamic parameters studied was significantly altered. CONCLUSIONS: In noncardiac patients, TPVB is associated with good hemodynamic stability, despite a small and transient decrease in myocardial contractility that could be related to the drug's systemic effects after its absorption.


Assuntos
Anestesia Local/métodos , Anestésicos Locais/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Débito Cardíaco/efeitos dos fármacos , Lidocaína/administração & dosagem , Respiração Artificial/métodos , Toracotomia/métodos , Pressão Sanguínea/fisiologia , Débito Cardíaco/fisiologia , Seguimentos , Humanos , Injeções , Pneumonectomia/métodos , Estudos Prospectivos , Vértebras Torácicas , Resultado do Tratamento
16.
Med Clin (Barc) ; 124 Suppl 1: 13-5, 2005 Mar 01.
Artigo em Espanhol | MEDLINE | ID: mdl-15771835

RESUMO

The present study describes the impact on the Department of Anesthesiology, Resuscitation and Critical Care of treating the victims of the 11 March terrorist attack, both on the day of the attack and on subsequent days. Of the 182 victims who were hospitalized, 61 had a poor prognosis, 24 had a very poor prognosis, 2 were already dead, and a further 2 died that day. Twenty-seven patients were admitted to the critical care unit. Patients with suspected severe injuries were sent to postanesthesia recovery units, where a second level of triage was performed, allowing patients to be appropriately transferred according to their severity and the necessary interventions to be performed.


Assuntos
Serviço Hospitalar de Anestesia/organização & administração , Cuidados Críticos/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Hospitais Universitários/organização & administração , Unidades de Terapia Intensiva/organização & administração , Incidentes com Feridos em Massa/estatística & dados numéricos , Ressuscitação , Traumatismos por Explosões/epidemiologia , Recursos em Saúde/provisão & distribuição , Humanos , Incidentes com Feridos em Massa/mortalidade , Espanha/epidemiologia , Triagem/organização & administração
17.
Med. clín (Ed. impr.) ; 124(supl.1): 13-15, mar. 2005. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-144166

RESUMO

El presente trabajo tiene como objetivo dar a conocer el impacto que supuso para el Departamento de Anestesia, Reanimación y Cuidados Intensivos la asistencia el 11 de marzo a las víctimas del atentado, tanto ese día como en los sucesivos. De los 182 pacientes procedentes del atentado que ingresaron, 61 fueron calificados con pronóstico grave, 24 como muy grave, 2 ingresos eran cadáveres y 2 pacientes murieron a lo largo del día. Un total de 27 pacientes ingresaron en las Unidades de Cuidados Críticos. A los pacientes con sospecha de gravedad se les trasladó a las Unidades de Recuperación Postanestésica, donde se estableció otro segundo paso de triage, lo que permitió ubicar de forma adecuada a los pacientes en función de su gravedad y realizar de forma progresiva cuantas intervenciones fueron necesarias (AU)


The present study describes the impact on the Department of Anesthesiology, Resuscitation and Critical Care of treating the victims of the 11 March terrorist attack, both on the day of the attack and on subsequent days. Of the 182 victims who were hospitalized, 61 had a poor prognosis, 24 had a very poor prognosis, 2 were already dead, and a further 2 died that day. Twenty-seven patients were admitted to the critical care unit. Patients with suspected severe injuries were sent to postanesthesia recovery units, where a second level of triage was performed, allowing patients to be appropriately transferred according to their severity and the necessary interventions to be performed (AU)


Assuntos
Feminino , Humanos , Masculino , Cuidados Críticos/métodos , Cuidados Críticos/organização & administração , Cuidados Críticos/normas , Anestesia/métodos , Anestesia/normas , Vítimas de Crime/história , Vítimas de Crime/legislação & jurisprudência , Vítimas de Crime/reabilitação , Identificação de Vítimas , Triagem/organização & administração , Cuidado Periódico , Padrão de Cuidado/organização & administração , Padrão de Cuidado/normas
18.
Rev. colomb. cardiol ; 11(5): 237-245, sept.-oct. 2004. tab, graf
Artigo em Espanhol | LILACS | ID: lil-438385

RESUMO

Se realizó un estudio observacional descriptivo de corte longitudinal prospectivo, con el fin de describir la disminución en la prevalencia de nuevos eventos coronarios en 344 pacientes que asistieron de enero de 2001 a enero de 2003, a un programa de rehabilitación cardiaca y con una consulta y al menos un control en la clínica de factores de riesgo, donde se hace seguimiento de la modificación de hábitos nutricionales, promoción y realización de actividad física, cese del tabaquismo y cumplimiento del tratamiento farmacológico.Resultados: se observaron cambios significativos en todos los componentes de prevención, en el grupo de pacientes que asistieron a mayor número de controles en factores de riesgo. Más del 75.85 porciento de la población continuaba con tratamiento farmacológico betabloqueador, 91.97 porciento con ácido acetilsalicílico (AAS), 87.9 porciento con estatinas y 55.67 porciento con terapia antihipertensiva. Se evidenciaron valores de LDL entre 98.9 y 122 mg porciento, y HDL entre 38.3 y 41.1 porciento. Los rangos de presión arterial registrados fueron de 117.0 a 132.2 mm Hg y de 76.5 a 82.7 mm Hg para la presión arterial sistólica y diastólica respectivamente. Más del 80 porcient de los pacientes que permanecieron en control, realizaban una actividad fìsica mayor a tres veces por semana. Se evidenció que más del 75 porciento de los pacientes que ingresaron al programa y asistieron a los controles programados, manifestaron no haber vuelto a fumar.No se registraron nuevos eventos coronarios en el grupo de pacientes que asistió a más de dos controles en factores de riesgo.Conclusiones: el seguimiento de factores de riesgo mostró modificación en los hábitos de vida, como incremento en la actividad física, continuidad en el tratamiento farmacológico, cese del tabaquismo y disminución en el riesgo para nuevos eventos coronarios. La prevención para enfermedad cardiovascular, debe iniciarse lo más temprano posible en todo paciente con riesgo y/o sín...


Assuntos
Prevenção Primária , Fatores de Risco
19.
Rev. colomb. cardiol ; 11(4): 205-212, jul.-ago. 2004. tab, graf
Artigo em Espanhol | LILACS | ID: lil-438406

RESUMO

Se trata de un estudio descriptivo de corte longitudinal, prospectivo, en donde se realizó un entrenamiento supervisado de tipo intervalado, manteniendo la frecuencia cardiaca en límites de seguridad mediante caminata y/o trote en 21 hombres con rango de edad de 30 a 73 años, con previo evento cardiaco, que se encontraban en fase III de un programa de rehabilitación cardiaca, con el fin de participar en un evento atlético competitivo. Además, se describieron y compararon los cambios en las variables cardiovasculares en reposo (frecuencia cardiaca y presión arterial) y los cambios en la composición corporal antes y después del entrenamiento.Cada semana, el programa de entrenamiento intervalado tenía una intensidad diferente, oscilando entre 70 porciento y 75 porciento de la frecuencia cardiaca máxima teórica calculada, durante 35 a 45 minutos.Al comparar las variables cardiovasculares, de peso y composición corporal analizadas mediante la prueba t de student, se evidenció una disminución en el peso corporal, el índice de masa corporal, el porcentaje de grasa y el perímetro de cintura, lo cual estadísticamente significativo (p< 0.005). Al analizar el comportamiento de la frecuencia cardiaca durante el ejercicio con la prueba ANOVA de una vía, se evidenció que los promedios de porcentaje de frecuencia cardiaca máxima oscilaron entre 61.7 porciento y 75.47 porciento. Es de destacar que el 76 porciento de estos pacientes tomaban betabloqueadores.


Assuntos
Composição Corporal , Reabilitação , Esportes
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