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1.
Rev. cient. (Guatem.) ; 29(1)20191126. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1046008

RESUMO

Las largas jornadas laborales a las que se someten los médicos en el contexto hospitalario, ejercen un efecto negativo sobre su estado físico y emocional, abarcando hasta 16 a 24 h al día y hasta 32 a 36 h continuas sin descanso. A nivel de pruebas de laboratorio y signos clínicos, se han descrito alteraciones en los niveles de glicemia, catecolaminas, cortisol, frecuencia cardiaca, entre otros. El objetivo fue comparar el perfil metabólico en los estudiantes externos e internos de la Facultad de Ciencias Médicas de la Universidad de San Carlos de Guatemala, antes y después del turno hospitalario. Este estudio apareado, se realizó en los hospitales Roosevelt, San Juan, Regional de Cuilapa, Regional de Escuintla y Nacional de Antigua, evaluándose la glicemia, el perfil lipídico y el cortisol; signos vitales y estilos de vida antes y después de turno en 80 estudiantes. Se observó variación significativa en los valores de cortisol (p = .023), glicemia (p = .002) y triglicéridos (p = .050) antes y después del turno. Se concluyó que después del turno el estudiante experimentó aumento en los valores de cortisol y disminución en los niveles de glicemia y triglicéridos; estos cambios no se asociaron al grado académico, al sexo, ni al servicio hospitalario, pero sí al hospital


The long work shifts of 16 to 24 hours and up to 32 to 36 hours that doctors have in the hospitals, exert a negative effect on their physical and emotional health. Alterations have been described in the levels of glycaemia, catecholamines, cortisol, heart rate, among others. This research aimed to compare the metabolic profile of internal and external medical students of the Faculty of Medical Sciences of the University of San Carlos of Guatemala, before and after their hospital shifts. This paired study was carried out in many national hospitals, such as: Hospital Nacional Roosevelt, Hospital General San Juan de Dios, Hospital Regional de Cuilapa, Hospital Regional de Escuintla, and Hospital Nacional de Antigua. Glycaemia, lipid profile and cortisol, vital signs and lifestyles before and after each shift were evaluated in 80 students. Significant variation was observed in cortisol values (p = .023), glycemia (p = .002) and triglycerides (p = .050) before and after the work shift. After the work shift the students experienced an increase in cortisol values and a decrease in glycaemia and triglyceride levels. These changes were associated to the different hospitals

2.
Rev. cient. (Guatem.) ; 29(1)20191126.
Artigo em Espanhol, Inglês | LILACS-Express | LILACS | ID: biblio-1046009

RESUMO

El trastorno de la coagulación más frecuente en la unidad de cuidados intensivos es la trombocitopenia. Teniendo en cuenta el papel fundamental de las plaquetas en la hemostasia y como marcadores de la coagulación intravascular diseminada, una disminución significativa en el recuento de plaquetas es alarmante en el contexto de pacientes sépticos, y se sabe que es un predictor de muerte. El objetivo fue comparar la capacidad del recuento de plaquetas con la puntuación Sequential Organ Failure Assessment (SOFA) para predecir la muerte en pacientes con sepsis grave o choque séptico. Se realizó un estudio longitudinal con una muestra de 29 casos consecutivos evaluados durante enero a diciembre de 2015 en la Unidad de Cuidado Intensivo del Hospital General de Enfermedades (HGE) del Instituto Guatemalteco de Seguridad Social. Se realizó recuento de plaquetas y SOFA al primero y al quinto día de hospitalización, documentando el desenlace de los pacientes. El 51.7 % de los pacientes eran hombres y 48.3 % mujeres, con edad promedio (desviación estándar) de 62.0 (16.9) años, mediana de SOFA al ingreso de 10 unidades (Q1=4, Q3=14) y mediana de plaquetas al ingreso de 196,000 (Q1=100,000, Q3=250,000). La asociación univariante entre trombocitopenia y muerte fue significativa (p = .021; RR = 2.45, IC95% [1.21, 4.99]). Según una prueba Bootstrap, no existe diferencia significativa entre la capacidad predictiva de SOFA y recuento plaquetario (p = .965). Se concluyó que la presencia de trombocitopenia es un predictor sencillo de muerte en pacientes con sepsis grave o choque séptico, con capacidad similar a SOFA


The most common coagulation disorder in the intensive care unit is thrombocytopenia. Considering the fundamental role of platelets in hemostasis and as markers of disseminated intravascular coagulation, a significant decrease in platelet count is alarming in the context of septic patients, and it is known to be a predictor of death. The objective was to compare the ability of the platelet count with the Sequential Organ Failure Assessment (SOFA) to predict death in patients with severe sepsis or septic shock. A longitudinal study was conducted with a sample of 29 consecutive cases evaluated during January to December 2015 in the Intensive Care Unit of the General Hospital of Diseases (HGE) of the Guatemalan Social Security Institute. Platelet and SOFA counts were performed at the first and the fifth day of hospitalization, documenting the outcome of the patients. Of the total, 51.7% of the patients were men and 48.3% were women, with an average age of 62.0 (16.9) years, median SOFA on admission of 10 units (Q1=4, Q3=14), and platelet median on admission of 196000 (Q1=100000, Q3=250000). The univariate association between thrombocytopenia and death was significant (p = .021, RR = 2.45, CI 95% [1.21, 4.99]). According to a Bootstrap test, there is no significant difference between the predictive capacity of SOFA and platelet count (p = .965). It was concluded that the presence of thrombocytopenia is a simple predictor of death in patients with severe sepsis or septic shock, with similar capacity to SOFA

3.
Rev. cient. (Guatem.) ; 28(1)20181107.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-963798

RESUMO

El Síndrome Burnout se caracteriza por agotamiento emocional, despersonalización y baja realización personal, que suele producirse en entornos de estrés laboral continuo, afectando gradualmente a trabajadores cuya labor les exige implicación emocional con personas. La calidad de vida profesional es la calidad que uno siente con relación a su trabajo. Este trabajo, transversal analítico, tuvo como objetivo determinar la frecuencia del Síndrome Burnout y de deficiencias en la calidad de vida laboral del personal de enfermería de los servicios de hospitalización de Medicina Interna del Hospital Roosevelt. Asimismo, se determinó qué relación presentaban las subescalas del inventario Maslach de Síndrome de Burnout y las subescalas de calidad de vida profesional del instrumento ProQOL. Se incluyó a 55 trabajadores de enfermería de los servicios de Medicina Interna del Hospital Roosevelt, durante 2016. Se observó una frecuencia de Síndrome de Burnout de 3.6 %, agotamiento emocional alto de 20 %, despersonalización de 24.5 % y baja satisfacción laboral de 30 %. No se encontró ningún caso de calidad de vida laboral deficiente. Se observó asociación significativa entre satisfacción laboral y realización personal (Tau = .36; p = .014), burnout con realización personal (Tau = -.31; p = .040) y estrés traumático con despersonalización (Tau = .36; p = .014). Se concluyó que algunos dominios de la escala de calidad de vida laboral poseen alguna relación de débil a moderada con los dominios de la escala de Burnout


Burnout Syndrome is characterized by emotional exhaustion, depersonalization and low personal fulfillment, which usually occurs in environments of continuous work stress, gradually affecting workers whose work requires emotional involvement with people. The quality of professional life is the quality one feels in relation to their work. This work, cross-sectional analysis, aimed to determine the frequency of Burnout Syndrome and deficiencies in the quality of working life of the nursing staff of the Internal Medicine hospitalization services of the Roosevelt Hospital. Likewise, it was determined what relation the subscales of the Maslach inventory of Burnout Syndrome and the subscales of quality of professional life of the ProQOL instrument presented. Fifty-five nursing workers from the Internal Medicine departments of Roosevelt Hospital were included during 2016. A frequency of Burnout Syndrome of 3.6%, high emotional exhaustion of 20%, depersonalization of 24.5% and low job satisfaction of 30% was observed. No case of poor quality of working life was found. There was a significant association between job satisfaction and personal fulfillment (Tau = .36; p = .014), burnout with personal fulfillment (Tau = -.31; p = .040) and traumatic stress with depersonalization (Tau = .36; p = .014). It was concluded that some domains of the quality of work life scale have some weak to moderate relationship with the domains of the Burnout scale

4.
Rev. cient. (Guatem.) ; 28(1): 44-56, 20181107.
Artigo em Espanhol | LILACS | ID: biblio-963807

RESUMO

La mortalidad fetal intrauterina, la prematurez, las complicaciones del parto, la mortalidad perinatal e infantil, así como el bajo peso al nacer son afectados por el estado nutricional de la madre antes y durante el embarazo. El objetivo del estudio fue determinar la asociación entre complicaciones obstétricas y neonatales, y el estado nutricional de la madre. Este estudio transversal analítico consistió en una muestra de 711 mujeres comprendidas en las edades de 18 a 35 años, atendidas consecutivamente en el Departamento de Ginecoobstetricia, Hospital Roosevelt, durante enero a diciembre de 2015 que presentaron una o varias complicaciones maternas y/o fetales. La edad materna presentaba una mediana de 26 años (Q1 = 22, Q3 = 31), con una edad gestacional más frecuente de 27 semanas o más (59.3%), seguido de 13 a 26 semanas (28.6%); mujeres con bajo peso (10.8%), con sobrepeso (30.8%) y con obesidad (33.6%). bajo peso y restricción del crecimiento intrauterino (OR = 7.08, IC95% [3.82 a 13.11]; p < .001), sobrepeso y diabetes gestacional (OR = 4.20, IC95% [1.93 a 9.10]; p < .001), sobrepeso y óbito fetal (OR = 6.79, IC95% [1.79 a 25.72]; p < .001), obesidad y diabetes gestacional (OR = 5.02, IC95% [2.36 a 10.69]; p < .001), obesidad y óbito fetal (OR = 8.30, IC95% [2.23 a 30.88]; p < .001), sobrepeso y hemorragia posparto (OR = 9.69, IC95% [5.03 a 18.66]; p < .001), sobrepeso e hipoglucemia del neonato (OR = 4.58, IC95% [1.64 a 12.83]; p = .005), obesidad y hemorragia postparto (OR = 13.58, IC95% [7.09 a 25.98]; p < .001), obesidad e hipoglicemia del neonato (OR = 4.16, IC95% [1.49 a 11.63]; p = .005) así como asociación entre bajo peso y anemia durante el embarazo, anemia en el postparto y anemia neonatal. Se concluyó que las complicaciones obstétricas y neonatales durante el embarazo, el parto y postparto, en mujeres con edades apropiadas para el embarazo, están asociadas a su estado nutricional (AU)


Intrauterine fetal mortality, prematurity, birth complications, perinatal and infant mortality, as well as low birth weight are affected by the nutritional status of the mother before and during pregnancy. The objective of the study was to determine the association between obstetric and neonatal complications, and the nutritional status of the mother. This cross-sectional analytical study consisted of a sample of 711 women aged between 18 and 35 years, consecutively attended in the Department of Gynecology and Obstetrics, Roosevelt Hospital, during January to December 2015, who presented one or several maternal and / or fetal complications. Maternal age presented a median of 26 years (Q1 = 22, Q3 = 31), with a gestational age more frequent of 27 weeks or more (59.3%), followed by 13 to 26 weeks (28.6%); women with low weight (10.8%), overweight (30.8%) and with obesity (33.6%). low weight and intrauterine growth restriction (OR = 7.08, 95% IC [3.82 to 13.11], p <.001), overweight and gestational diabetes (OR = 4.20, 95% IC [1.93 to 9.10]; p <.001), overweight and death fetal (OR = 6.79, 95% IC [1.79 to 25.72]; p <.001), obesity and gestational diabetes (OR = 5.02, 95% IC [2.36 to 10.69]; p <.001), obesity and fetal death (OR = 8.30, 95% IC [2.23 to 30.88]), overweight and postpartum hemorrhage (OR = 9.69, 95% IC [5.03 to 18.66], p <. 001), overweight and hypoglycemia of the newborn (OR = 4.58, 95% IC [1.64 to 12.83], p = .005), obesity and postpartum hemorrhage (OR = 13.58, 95% IC [7.09 to 25.98], p <.001), obesity and hypoglycemia of the neonate (OR = 4.16, 95% IC [1.49 to 11.63], p = .005) as well as association between low weight and anemia during pregnancy, anemia in the postpartum and neonatal anemia. It was concluded that obstetric and neonatal complications during pregnancy, delivery and postpartum, in women of appropriate ages for pregnancy, are associated with their nutritional status (AU)


Assuntos
Humanos , Feminino , Nutrição Pré-Natal , Complicações do Trabalho de Parto/mortalidade , Estado Nutricional , Estudos Transversais , Anemia
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