Satisfacción de pacientes y profesionales con las nuevas tecnologías de imagen tridimensional aplicadas a la medicina / Patient and healthcare professional satisfaction with 3D imaging new technologies for medical purposes

ANTECEDENTES Y OBJETIVOS: Gracias a los avances en el campo del escaneado tridimensional (3D) existen instrumentos capaces de generar imágenes con utilidad en medicina. Por otra parte, los estudios de satisfacción ganan cada vez más importancia para evaluar la calidad en la asistencia. Nuestro objetivo es valorar la satisfacción de los pacientes con el uso de un escáner 3D aplicado a las malformaciones de la pared torácica, así como de los profesionales implicados en su uso. MATERIAL Y MÉTODOS: Se han desarrollado encuestas de satisfacción para pacientes y profesionales que han completado pacientes sometidos a escáner 3D en el contexto de un estudio para validar los resultados obtenidos con esta nueva tecnología. Se han obtenido los estadísticos descriptivos de los resultados obtenidos. RESULTADOS: Se han incluido 42 pacientes y 10 profesionales. Los pacientes evalúan de manera positiva la velocidad y la inocuidad. La media de satisfacción global es de 4,71 en una escala del 1 al 5. Entre los profesionales, la satisfacción es inferior, sobre todo en lo que respecta al tratamiento de la imagen. La media de satisfacción global es de 3,1. CONCLUSIONES: Los pacientes evaluados tienen una buena aceptación y satisfacción con la tecnología de escaneado 3D. No ocurre lo mismo con los profesionales, ya que debido a la dificultad de tratamiento de la imagen y a la falta de familiaridad con el sistema presentan una satisfacción menor. Son necesarios avances en la difusión y simplificación de esta tecnología para aprovechar al máximo su potencial

BACKGROUND AND OBJECTIVES: Advances in the field of three-dimensional scanning have enabled the development of instruments that can generate images that are useful in medicine. On the other hand, satisfaction studies are becoming increasingly important in the evaluation of quality in healthcare. We aimed to evaluate patients' and professionals' satisfaction with the use of a three-dimensional scanner applied to chest wall malformations. MATERIAL AND METHODS: In the framework of a study to validate the results of three-dimensional scanning technology, we developed questionnaires to measure satisfaction among patients and professionals. We analyzed the results with descriptive statistics. RESULTS: We included 42 patients and 10 professionals. Patients rated the speed and harmlessness positively; the mean overall level of satisfaction was 4.71 on a scale from 1 to 5. Among professionals, the level of satisfaction was lower, especially with regards to the treatment of the image; the mean overall level of satisfaction was 3.1. CONCLUSIONS: Patients rated 3D scanning technology highly, but professionals were less satisfied due to the difficulty of treating the images and lack of familiarity with the system. For this technology to reach its maximum potential, it must be simplified and more widely disseminated

Patient and healthcare professional satisfaction with 3D imaging new technologies for medical purposes. / Satisfacción de pacientes y profesionales con las nuevas tecnologías de imagen tridimensional aplicadas a la medicina.

BACKGROUND AND OBJECTIVES: Advances in the field of three-dimensional scanning have enabled the development of instruments that can generate images that are useful in medicine. On the other hand, satisfaction studies are becoming increasingly important in the evaluation of quality in healthcare. We aimed to evaluate patients' and professionals' satisfaction with the use of a three-dimensional scanner applied to chest wall malformations. MATERIAL AND METHODS: In the framework of a study to validate the results of three-dimensional scanning technology, we developed questionnaires to measure satisfaction among patients and professionals. We analyzed the results with descriptive statistics. RESULTS: We included 42 patients and 10 professionals. Patients rated the speed and harmlessness positively; the mean overall level of satisfaction was 4.71 on a scale from 1 to 5. Among professionals, the level of satisfaction was lower, especially with regards to the treatment of the image; the mean overall level of satisfaction was 3.1. CONCLUSIONS: Patients rated 3D scanning technology highly, but professionals were less satisfied due to the difficulty of treating the images and lack of familiarity with the system. For this technology to reach its maximum potential, it must be simplified and more widely disseminated.

Abordaje mínimamente invasivo del ureterocele en pacientes con duplicidad renoureteral / Endoscopic incision of intravesical ureteroceles in patients with duplex system

Objetivo. Evaluar la situación clínica y la función renal de pacientes con duplicidad renoureteral y ureterocele tras su drenaje mediante cistoscopia. Material y métodos. En 9 pacientes diagnosticados de duplicidad renoureteral se realizó drenaje del ureterocele por presentar infecciones urinarias de repetición (7 niños con episodios de pielonefritis y sepsis) u obstrucción del drenaje urinario. La media de edad fue de 33 meses (rango 8-108 meses). La punción del ureterocele se realizó con anestesia general, en quirófano mediante cistouretroscopia con electrodo en asa. El tiempo mínimo de seguimiento fue de 12 meses (rango 12-48 meses) e incluye ecografía renal, estudio isotópico renal MAG 3 confurosemida y, en los casos con reflujo vesicoureteral preoperatorio o infección urinaria postoperatoria, estudio con ecocistografía. Resultados. El tiempo medio operatorio fue de 60 minutos. La estancia media hospitalaria fue de 48 horas. No se presentaron complicaciones durante la técnica. En cinco pacientes desparecieron los episodios de infección urinaria. La ecografía demostró la disminución de la hidronefrosis y del megauréter. En dos pacientes mejoró la función renal diferencial (FRD). Un paciente con FRD preoperatoria del 14% precisó nefrectomía. Un paciente presentó reflujo vesicoureteral postoperatorio. Conclusiones. El drenaje del ureterocele en pacientes con duplicidad renoureteral reduce los episodios de infección urinaria y la dilatación de la vía urinaria

Purpose. To evaluate the clinical status and renal function of patients with duplex system and intravesical ureterocele after drainage by cystoscopy. Material and methods. In 9 patients with duplex system and intravesical ureterocele drainage was performed to present recurrent urinarytract infections (7 children with episodes of pyelonephritis and sepsis) or obstruction of the urinary drainage. The mean age was 33 months (range 8-108 months). The technique was done under general anesthesia in the operating room and puncture of the ureterocele was performed using cystourethroscopy with loop electrode. The minimum follow-up was 12 months (range 12-48 months) and includes renal ultrasound, renal isotopic study (Mag 3 with furosemide) and echocystography study in patients with preoperative vesicoureteral reflux or postoperative urinary tract infection. Results. The average operative time was 60 minutes. Mean hospital stay was 48 hours. There were no complications during the procedure. In five patients urinary infection episodes disappeared. Ultrasound demonstrated decreased hydronephrosis and megaureter. In two patients the differential renal function following the technique improved. One patient with preoperative split renal function of 14% required nephrectomy. One patient had postoperative vesicoureteral reflux. Conclusions. The drainage of intravesical ureterocele in patients with duplex system reduces episodes of urinary tract infection and urinary tract dilation

[Endoscopic incision of intravesical ureteroceles in patients with duplex system]. / Abordaje mínimamente invasivo del ureterocele en pacientes con duplicidad renoureteral.

PURPOSE: To evaluate the clinical status and renal function of pa- tients with duplex system and intravesical ureterocele after drainage by cystoscopy. MATERIAL AND METHODS: In 9 patients with duplex system and intravesical ureterocele drainage was performed to present recurrent urinary tract infections (7 children with episodes of pyelonephritis and sepsis) or obstruction of the urinary drainage. The mean age was 33 months (range 8-108 months). The thecnique was done under general anesthesia in the operating room and puncture of the ureterocele was performed using cystourethroscopy with loop electrode. The minimum follow-up was 12 months (range 12-48 months) and includes renal ultrasound, renal isotopic study (Mag3 with furosemide) and-echocystography study in patients with preoperative vesicoureteral reflux or postoperative urinary tract infection. RESULTS: The average operative time was 60 minutes. Mean hospital stay was 48 hours. There were no complications during the procedure. In five patients urinary infection episodes disappeared. Ultrasound demonstrated decreased hydronephrosis and megaureter. In two patients the differential renal function following the technique improved. One patient with preoperative split renal function of 14% required nephrectomy. One patient had postoperative vesicoureteral reflux. CONCLUSIONS: The drainage of intravesical ureterocele in patients with duplex system reduces episodes of urinary tract infection and urinary tract dilation.

Resultados preliminares en la corrección del pectus excavatum con técnica de Welch modificada por Acastello / Preliminary results in the correction of the pectus excavatum with the acastello modified welch technique

Introducción. Las malformaciones congénitas de la pared torácicason un grupo heterogéneo de patología que pueden afectar a los cartílagoscostales, las costillas, el esternón y las escápulas y clavículas. Dentro del tipo I se encuentra el pectus excavatum el cual se caracterizapor la depresión o desplazamiento en sentido posterior del esternón, produciendo una disminución de la distancia entre éste y la columna vertebral. Para su corrección hemos utilizado la técnica de Welch modificada por Acastello, la cual consiste en una resección parcial de losc artílagos costales y la colocación de par de barras o placas preesternales las cuales se fijan unilateralmente en cada hemitórax a nivel lateral y en forma conjunta a nivel esternal. Materia y métodos. Desde octubre del 2008 hasta marzo de 2011hemos valorado a 108 pacientes con malformaciones congénitas de la pared torácica. De los cuales 47 pacientes (el 44%) correspondieron alpectus excavatum. Se realizaron 12 toracoplastias de Welch modificadas por Acastello para la corrección de los mismos. Resultados. En todos los pacientes se han implantado barras preesternales. No se han presentado complicaciones intraoperatorias, la corrección de la deformidad fue muy satisfactorias tanto objetiva como subjetiva para los pacientes, con un seguimiento de 1 mes a 27 meses del periodo postoperatorio. Conclusiones. La toracoplastia de Welch modificada por Acastello es una muy buena opción para la corrección del pectus excavatum, desde el punto de vista estético da muy buenos resultados y presenta escasa morbilidad, la cual se limita a la pared (AU)

Background. Congenital malformations of the chest wall are a heterogeneous group of diseases affecting the costal cartilage, ribs, sternum, scapula and clavicle. The pectus excavatum is characterized by a posterior depression of the sternum. Acastello-Welch technique consists in a partial resection of the costal cartilages adding some bars or plates unilaterally fi xed to the sternum in each hemithorax Materials and methods. From October 2008 to March 2011 we evaluated 108 patients with congenital malformations of the chest wall. Forty-seven patients (44%) had a pectus excavatum and 12 were treated with Acastello-Welch technique. Results. There were no intraoperative complications. After a mean follow up of 27 months, correction of the deformity was very satisfactory both objective and subjective for patients. Conclusions. The Welch thoracoplasty modified by Acastello is a good option for the correction of the pectus excavatum associating little morbidity and good esthetic outcomes (AU)

[Preliminary results in the correction of the pectus excavatum with the Acastello modified Welch technique]. / Resultados preliminares en la corrección del pectus excavatum con técnica de Welch modificada por Acastello.

BACKGROUND: Congenital malformations of the chest wall are a heterogeneous group of diseases affecting the costal cartilage, ribs, sternum, scapula and clavicle. The pectus excavatum is characterized by a posterior depression of the sternum. Acastello-Welch technique consists in a partial resection of the costal cartilages adding some bars or plates unilaterally fixed to the sternum in each hemithorax. MATERIALS AND METHODS: From October 2008 to March 2011 we evaluated 108 patients with congenital malformations of the chest wall. Forty-seven patients (44%) had a pectus excavatum and 12 were treated with Acastello-Welch technique. RESULTS: There were no intraoperative complications. After a mean follow up of 27 months, correction of the deformity was very satisfactory both objective and subjective for patients. CONCLUSIONS: The Welch thoracoplasty modified by Acastello is a good option for the correction of the pectus excavatum associating little morbidity and good esthetic outcomes.