ABSTRACT
@#BACKGROUND: Few studies have examined the association of layperson characteristics with cardiopulmonary resuscitation (CPR) provision. Previous studies suggested provider characteristics, including age and gender, were associated with CPR quality, particularly chest compression (CC) depth. We sought to determine the association of subject characteristics, including age and gender with layperson CPR quality during an unannounced simulated CPR event. We hypothesized shallower CC depth in females, and older-aged subjects. METHODS: As part of a larger multicenter randomized controlled trial of CPR training for cardiac patients' caregivers, CPR skills were assessed 6 months after training. We analyzed associations between subject characteristics and CC rate, CC depth and no-flow time. Each variable was analyzed independently; significant predictors determined via univariate analysis were assessed in a multivariate regression model. RESULTS: A total of 521 laypersons completed a 6-month CPR skills assessment and were included in the analysis. Mean age was 51.8±13.7 years, 75% were female, 57% were Caucasian. Overall, mean CC rate was 88.5±25.0 per minute, CC depth was 50.9±2.0 mm, and mean no-flow time was 15.9±2.7 sec/min. CC depth decreased significantly in subjects >62 years (P<0.001). Male subjects performed deeper CCs than female subjects (47.5±1.7 vs. 41.9±0.6, P<0.001). CONCLUSION: We found that layperson age >62 years and female gender are associated with shallower CC depth.
ABSTRACT
@#BACKGROUND: Survival from cardiac arrest is sensitive to the quality of delivered CPR. In 2010, updated international resuscitation guidelines emphasized deeper chest compressions and faster rates, yet it is unknown whether training laypersons using updated guidelines resulted in changed CPR performance. We hypothesized that laypersons taught CPR using the 2010 guidelines performed deeper and faster compressions than those taught using the 2005 materials. METHODS: This work represents a secondary analysis of a study conducted at eight hospitals where family members of hospitalized cardiac patients were trained in CPR. An initial cohort was trained using the 2005 guidelines, and a subsequent cohort was trained using the 2010 guideline materials. Post training, CPR skills were quantified using a recording manikin. RESULTS: Between May 2009 to August 2013, 338 subjects completed the assessment. Among the subjects, 176 received 2005 training and 162 underwent 2010 training. The mean compression rate in the 2005 cohort was 87 (95％CI 83–90) per minute, and in the 2010 cohort was 86 (95％CI 83–90) per minute (P=ns), while the mean compression depth was 34 (95％CI 32–35) mm in the 2005 cohort and 46 (95％CI 44–47) mm in the 2010 cohort (P<0.01). CONCLUSIONS: Training with the 2010 CPR guidelines resulted in a statistically significant increase in trainees' compression depth but there was no change in compression rate. Nevertheless, the majority of CPR performed by trainees in both cohorts was below the guideline recommendation, highlighting an important gap between training goals and trainee performance.
ABSTRACT
Introducción: El sangrado uterino anormal (SUA) afecta a un 19% de las mujeres. Su tratamiento definitivo consiste en la histerectomía, sin embargo la ablación endometrial histeroscópica surge como un tratamiento menos invasivo, menos riesgoso y más rápido. Objetivo: Evaluar la efectividad de la ablación endometrial histeroscópica como tratamiento definitivo para el SUA. Método: Estudio de cohorte retrospectivo obtenido de base de datos de protocolos operatorios específicos del total de histeroscopías quirúrgicas realizadas en el Servicio de Ginecología del Hospital Naval Almirante Nef de Viña del Mar, entre enero de 2002 y diciembre de 2010. Resultados: De las 507 histeroscopías quirúrgicas realizadas, 230 fueron por SUA. Del total de pacientes sometidas a ablación endometrial histeroscópica, 27 (11,7 por ciento) necesitaron un segundo procedimiento, de las cuales sólo 15 (6,5 por ciento) fueron por persistencia de SUA. No se encontró asociación entre la necesidad de un segundo procedimiento por SUA con características propias de la paciente ni del procedimiento quirúrgico. Conclusión: La ablación endometrial histeroscópica es una opción terapéutica efectiva y segura para el tratamiento del SUA, con baja necesidad de segundo procedimiento por persistencia de éste y bajo riesgo de complicaciones. La necesidad de un segundo procedimiento por SUA no se asocia con características propias de la paciente ni del procedimiento quirúrgico.
Introduction: Abnormal uterine bleeding (AUB) affects 19% of women. Definitive treatment is hysterectomy, however hysteroscopic endometrial ablation is emerging as a less invasive, less risky and faster treatment. Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation as definitive treatment for AUB. Method: Retrospective cohort study database obtained from specific surgical protocols of all surgical hysteroscopies performed in the Gynecology Department of Hospital Naval Almirante Nef de Vina del Mar, between January 2002 and December 2010. Results: Of the 507 surgical hysteroscopies performed, 230 were because of AUB. Of all patients undergoing hysteroscopic endometrial ablation, 27 (11.7 percent) required a second procedure, of which only 15 (6.5 percent) were due to persistence of AUB. No association was found between the need for a second procedure because of AUB with patient characteristics or the surgical procedure itself. Conclusion: Hysteroscopic endometrial ablation is a safe and effective therapeutic option for AUB treatment, with a low need for a second procedure due to its persistence and with low risk of complications. The need of a second procedure because of AUB is not associated with patient characteristics or the surgical procedure itself.
Subject(s)
Humans , Female , Endometrial Ablation Techniques , Hysteroscopy , Hysterectomy/methods , Metrorrhagia/surgery , Uterine Hemorrhage/surgery , Retrospective StudiesABSTRACT
El ofidismo es el accidente provocado por la mordedura de una serpiente. En Chile se encuentran 2 tipos de culebras capaces de provocar emponzoñamiento: Philodryas chamissonis y Tachymenis peruviana. Se presenta el caso de una mordedura por P. chamissonis,ocurrida durante una actividad veraniega en la comuna de San Antonio, V Región. La mordedura comprometió la zona del dorso de la mano entre los dedos pulgar e índice de la extremidad superior izquierda, inicialmente indolora. Evolucionó las primeras 24 horas con edema equimótico que abarcó hasta la zona del hombro y pectoral, con dolor intenso, cefalea, náuseas, fiebre y posterior aparición de bulas serohemorrágicas en el pliegue del codo. La paciente se trató con antihistamínicos, corticoides sistémicos, analgesia y antimicrobianos por 7 días. Se discuten los accidentes por mordedura de culebras publicados en la literatura nacional, así como su tratamiento y las medidas de prevención.
There are two species of snakes associated with snake bite poisoning in Chile: Philodryas chamissonis and Tachymenis peruviana. A case associated with a P. chamissonis bite occuring during a summer activity in San Antonio, V Region, is presented. The bite compromised the dorsum of the right hand between the thumb and the index finger and was initially painless. During the following 24 hours equimotic edema developed up to the shoulder and pectoral region, with intense pain, headache, nausea, fever and appearance of a serohematic bulla on the elbow fold. The patient was treated with antihistamins, systemic steroids, analgesia and antibiotics for 7 days. Other cases of snake bites published in Chile are reviewed and treatment and prevention strategies are proposed.
Subject(s)
Humans , Animals , Female , Adolescent , Colubridae , Edema/etiology , Snake Bites/drug therapy , Snake Venoms/adverse effects , Snake Bites/complicationsABSTRACT
Se denomina Hidatidosis a la zoonosis parasitaria que causa la infección de herbívoros o del hombre con el estado larval (hidátide) de parásitos del género Echinococcus. Objetivo: Revisión del tema y presentación del primer caso en Chile estudiado mediante técnicas de biología molecular. Caso Clínico: Preescolar de 3 años 9 meses procedente de Punta Arenas portadora de una hidatidosis múltiple de 6 quistes (4 pulmonares y 2 hepáticos), trasladada a la V Región para su tratamiento. Se realizó 3 cirugías y tratamiento médico asociado (Albendazol en dosis de 15 mg/kg/día vía oral) durante 73 días. Las hidátides extraídas fueron medidas, se efectuó estudio de fertilidad y vitalidad e identificación de cepa de Echinococcus granulosus mediante técnicas de biología molecular. La paciente mostró notable mejoría clínica e imagenológica, y mantuvo serología positiva. El tratamiento fue bien tolerado no presentando reacciones adversas. El tamaño de las hidátides fluctuó entre 6 y 11 cm de diámetro, todas fueron fértiles y vitales en diferente porcentaje y en todas se identificó cepa oveja de E. granulosus. De regreso en Punta Arenas, a los 4 meses se le detecta una nueva hidátide hepática que fue extirpada. El complejo manejo de este caso resultó exitoso.
Subject(s)
Humans , Female , Child, Preschool , Echinococcosis, Hepatic/diagnosis , Echinococcosis, Hepatic/therapy , Echinococcosis, Pulmonary/diagnosis , Echinococcosis, Pulmonary/therapy , Albendazole/therapeutic use , Chile , Enzyme-Linked Immunosorbent Assay , Echinococcus/isolation & purification , Echinococcosis, Hepatic/genetics , Echinococcosis, Pulmonary/genetics , Molecular Diagnostic Techniques , Polymerase Chain Reaction , Treatment Outcome , ZoonosesABSTRACT
We examined the supply and demand of medical doctors and dentists in Bahrain. Demand for physicians and dentists was based on the objective of having a physician-to-population ratio of 1:650, and a dentist-to-population ratio of 1:5000. Analysis of the current workforce and projected graduates in the period 1998-2005 indicated that the supply of Bahraini medical doctors and dentists until the year 2005 will not be sufficient to meet the projected demand in these categories. By the year 2005, Bahraini doctors and dentists will provide 82.5% and 75.9% of medical and dental demands respectively. The remaining 17.2% of physicians and 24.1% of dentists will have to be recruited from abroad. Thus, the prospect of oversupply of Bahrainis among these categories until the year 2005 is highly unlikely
Subject(s)
Humans , Medically Underserved Area , Physician's Role , Dentists , Physician Executives , Health Services Needs and DemandSubject(s)
Humans , Parasitic Diseases , Ectoparasitic Infestations , Intestinal Diseases, Parasitic , Opportunistic Infections/parasitology , Parasites/classification , Parasites/pathogenicity , Parasitic Diseases , Parasitic Diseases/classification , Parasitic Diseases/diagnosis , Parasitic Diseases/drug therapy , Host-Parasite InteractionsABSTRACT
La cryptosporidiosis es una infección parasitaría cuyo agente causal, el Cryptosporidium sp. provoca diarrea autolimitadas en pacientes inmunocompetentes. En la actualidad, es uno de los parásitos oportunistas de mayor relevancia debido a sus implicancias en pacientes inmunodeficientes, en los que puede determinar la muerte solo o asociado a otros agentes. La finalidad del presente artículo es proporcionar una revisión bibliográfica, con el objeto de dar antecedentes a los clínicos de la existencia de este parásito oportunista, causante de síndromes diarreicos, y por otra parte informar los avances obtenidos por nuestra Cátedra en las investigaciones pertinentes realizadas en al V Región
Subject(s)
Infant , Child, Preschool , Child , Adolescent , Adult , Animals , Humans , Female , Cryptosporidiosis/epidemiology , Cryptosporidium/isolation & purification , Respiratory Tract Infections , Opportunistic Infections , Clindamycin/therapeutic use , Spiramycin/therapeutic use , Cryptosporidiosis/drug therapy , Diarrhea/diagnosis , Diarrhea, Infantile/etiology , Nutrition Disorders , Acquired Immunodeficiency Syndrome/complicationsABSTRACT
Se comparan dos esquemas de tratamiento de sarna, utilizando suspensión de lindano al 1% efectuado a 87 pacientes, separados en dos grupos al azar. El grupo A (45 personas) recibió dos aplicaciones, de una hora de duración cada uno, separados por 7 días. El grupo B (42 personas) recibió 2 aplicaciones de 4 días de duración cada uno separados por 7 días. Se analiza la regresión de los síntomas y signos en controles a los 7 y 14 días post-tratamiento y se observa una reducción franca del prurigo, especialmente del prurigo mayor (p = 0,02), en los pacientes del grupo A. Puesto que el esquema acortado (A) es igualmente efectivo que el B y, considerando la disminución del riesgo de toxicidad, la rapidez y comodidad estética del tratamiento acortado, se sugiere su empleo sistemático en la terapia antisárnica