Subject(s)
Humans , Female , Pregnancy , Placenta Accreta/surgery , Placenta Accreta/psychology , Stress Disorders, Post-TraumaticABSTRACT
ABSTRACT Objective Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries. Methods This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS. Results Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case. Conclusion Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
Resumo Objetivo O espectro da placenta acreta (do inglês placenta accreta spectrum - PAS) é causa de hemorragia obstétrica maciça e mortalidade materna. A aplicação de técnicas de parto centrado na família (do inglês family-centered delivery techniques - FCDTs) durante a cirurgia para tratar esta doença é pouco frequente. Avaliamos a implementação das FCDTs durante as cirurgias do PAS. Métodos Estudo prospectivo e descritivo que incluiu pacientes com PAS submetidos a tratamento cirúrgico durante um período de 12 meses. Os pacientes foram divididos de acordo com a aplicação de FCDTs (grupo 1) ou não (grupo 2), e os resultados clínicos foram medidos. Além disso, anestesiologistas hospitalares foram entrevistados para avaliar suas opiniões sobre a implementação das FCDTs durante o manejo cirúrgico do PAS. Resultados Foram incluídos 13 pacientes com PAS. A implementação de FCDTs durante o parto foi possível em 53,8% das pacientes. A presença do acompanhante durante a cirurgia e o contato pele a pele não prejudicou o manejo interdisciplinar em nenhum caso. Conclusão A implementação de FCDTs durante o atendimento do PAS é possível em pacientes selecionados em centros com experiência no manejo dessa doença.
Subject(s)
Humans , Female , Pregnancy , Placenta Accreta , Birthing Centers , Patient-Centered Care , Humanization of AssistanceSubject(s)
Humans , Dermatologic Agents/therapeutic use , Skin Diseases/drug therapy , Bacitracin/therapeutic use , Betamethasone/therapeutic use , Skin Diseases/surgery , Steroids/therapeutic use , Lentigo/drug therapy , Lichen Planus, Oral/drug therapy , Methotrexate/therapeutic use , Onychomycosis/drug therapy , Psoriasis/drug therapy , Tetracyclines/therapeutic useABSTRACT
El presente estudio tiene como propósito establecer el efecto del tubérculo y hoja de yacón (smallantus sonchifolius) sobre los niveles de glucosa sérica y hemoglobina glicosilada con el consumo de una dieta ad libitum. Se realizó durante 90 días un ensayo experimental simple ciego controlado a nivel de campo en 30 sujetos entre los 26 y 90 años, con diagnóstico de diabetes mellitus tipo 2 no controlada a pesar del tratamiento farmacológico, dividiéndolos en tres grupos: al primer grupo se administró 500g/día de fruto fresco de yacón, al segundo grupo liofilizado de yacón equivalente a 500g/día del fruto fresco y al tercer grupo se le proporcionó bolsitas filtrantes de hoja de yacón (cada bolsita filtrante equivalente a 1g de hoja), tomando tres infusiones al día. Con respecto a la hemoglobina glicosilada, la administración de fruto, filtrante y liofilizado disminuyó en promedio de 1.98 por ciento, 1.84 por ciento y 1.14 por ciento, respectivamente, para cada grupo. En la glucosa sérica se apreció una baja considerable de la misma a la cuarta semana en los tres grupos teniendo mayor disminución con yacón filtrante y la menor disminución el grupo con fruto fresco. Podemos concluir que el yacón, en sus diferentes presentaciones produce disminución de la glucosa sérica sin llegar a valores normales, observando que los cambios en la concentración de glucosa sérica no evidenciaron diferencia significativa entre grupos etáreos ni en medidas repetidas de glucosa sérica entre semanas ni en género. También se evidenció una disminución significativa de la hemoglobina glicosilada final con respecto a la basal en todos los grupos, encontrándose disminución marcada en el grupo al que se le administró tubérculo fresco de yacón.
The purpose of the present study is to establish the effect of the yacon tuber and leaf (Smallantus Sonchifolius) on the levels of the seric glucose and glycosylated hemoglobin with the consumption of an adlibitum diet. A blind, simple and experimental field-controlled trial was carried out for a period of 90 days in 30 subjects, in an age range from 26 to 90, who were diagnosed with Type 2 Diabetes Mellitus with no control despite the pharmacological treatment. The subjects were divided into 3 groups; the first group received 500g per day of fresh yacon fruit; the second group received freeze-dried yacon equivalent to 500 g per day of the fresh fruit, and the third group received yacon leaves tea bags (each tea bag containing the equivalent to 1 g of yacon leaves), which were taken three times a day. Regarding the glycosylated hemoglobin, the administration of the fruit, the tea bags and the freeze-dried yacon reduced an average of 1.98%, 1.84% and .14%, correspondingly, in each group. In the seric glucose we could observe a considerable drop in the fourth week in the three groups. The largest drop happened in the group that received the yacon tea bags and the lowest drop in the group that received the yacon fruit. We can conclude that the yacon, in its different presentations, produce a decrease of the seric glucose without reaching the normal values. It was also noticed that the changes in the concentration of the seric glucose did not show a significant difference among the age groups nor in repeated measures of seric glucose among weeks nor in gender. A significant decrease of the final glycosylated hemoglobin regarding the basal was also shown in all the groups, finding a marked decrease in the group that received fresh yacon fruit.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aged, 80 and over , Asteraceae/classification , /therapy , Phytotherapy , Plants, Medicinal , Plant Tubers , Prospective Studies , Single-Blind MethodSubject(s)
Humans , Female , Adult , Lenses/adverse effects , Skin Neoplasms/diagnosis , Head , Skin Neoplasms/etiologyABSTRACT
En este artículo de revisión se analiza las distintas variedades clínicas de Psoriasis Pustular. La psoriasis pustular se subdivide de acuerdo a la extensión del compromiso y a su localización. Se discuten las características clínicas e histopatológicas de este tipo de psoriasis, con especial atención al diagnóstico diferencial y tratamiento