ABSTRACT
Resumen Introducción: La incorporación de tecnologías en la práctica quirúrgica, ha cambiado la forma de enfrentar el proceso quirúrgico. Objetivo: Describir la experiencia de los últimos 9 años, en cirugía ortognática, con la incorporación de la cefalometría 3D. Materiales y Método: Se realizó una revisión retrospectiva de pacientes operados de cirugía ortognática durante el período enero de 2011 a agosto de 2018. Se registraron datos demográficos, quirúrgicos, tipo de planificación quirúrgica, complicaciones y resultados a largo plazo. Resultados: 21 pacientes requirieron cirugías ortognáticas. Se realizaron 16 cirugías bimaxilares (76%), 3 cirugías de avance maxilar superior (14%) y 2 cirugías de osteotomía sagital de rama (10%). Las principales etiologías fueron: 67% maloclusión clase III (n = 14), 28% maloclusión clase II (n = 6) y 5% desviación mandibular (n = 1). La planificación prequirúrgica virtual fue utilizada en 11 pacientes (52%). La tasa de complicaciones Clavien-Dindo > III fue 4,8% (n = 1). Conclusiones: En nuestra experiencia, las técnicas de cirugía ortognática son seguras. Las complicaciones de la serie fueron escasas y bien toleradas por los pacientes. Durante los últimos años y, de acuerdo a los avances tecnológicos, la incorporación de la planificación quirúrgica virtual 3D favoreció el desarrollo de la cirugía ortognática en nuestro centro.
Introduction: Technological advances have been incorporated into cranio-maxillo-facial surgery changing the clinical practice of surgeons. Aim: The aim of this article is to describe our experience in orthognatic surgery in the last 9-years, with the incorporation of 3D cephalometry. Materials and Method: A retrospective chart review was performed from January 2011 to August 2018 on patients undergoing Orthognatic Surgery. Demographic and surgical data, type of surgical planning, complications and long-term results were recorded. Results: A total of 21 patients underwent orthognatic surgery. Average age was 28 years (DE 8.1), 11 men (52.3%) and 10 women (47.61%). The principal surgeries performed were: 16 (76%) bimaxillary, 3 maxillary advancement surgery 3 (14%) and bilateral sagital split osteotomy 2 (10%). Ethiologies were: 14 patients (this 67%) with malocclusion class III, 6 patients (28%) with malocussion class II, and 1 patient (5%) with mandibular deviation. Virtual 3D presurgical planning was used in 11 patients (52%). The total of complications Clavien-Dindo > III was 4.8% (n = 1). None patient required reoperation. Satisfaction rate with the procedure was high. Conclusions: Based on our experience, orthognatic surgery techniques are safe. The complication rate was lower and well tolerated by patients. The introduction of virtual planning provided a better scenario to develop maxillo-facial surgery.
Subject(s)
Humans , Imaging, Three-Dimensional/methods , Orthognathic Surgery/methods , Orthognathic Surgery/trends , Treatment Outcome , Imaging, Three-Dimensional/trends , Orthognathic Surgical Procedures/methods , Mandible/surgeryABSTRACT
Resumen El síndrome compartimental agudo (SCA) es el aumento de la presión en un espacio osteofascial cerrado. Esto reduce la presión capilar bajo el nivel necesario para la viabilidad de los tejidos del compartimento. El SCA de mano como complicación de un loxoscelismo cutáneo (LC) de predominio edematoso es muy poco frecuente. Presentamos el caso de una mujer de 22 años que presentó un SCA de la mano secundario a un LC y que requirió tratamiento quirúrgico de urgencia mediante una fasciotomía dorsal y palmar.
Abstract Acute compartment syndrome (ACS) is the increase of pressure in a closed osteofascial space. This reduces capillary perfusion below the level necessary for tissue viability. Injury could be irreversible if proper treatment is not performed. Hand ACS secondary to cutaneous loxoscelism with edematous predominance is extremely infrequent. We present a clinical case of a 22-year-old patient who started a hand compartment syndrome secondary to cutaneous loxoscelism (CL), requiring emergency surgical treatment with dorsal and palmar fasciotomy.
Subject(s)
Humans , Young Adult , Compartment Syndromes , Edema , Fasciotomy , HandABSTRACT
La motivación es un elemento de gran importancia para obtener mayor rendimiento en las actividades que realiza el personal de enfermería; el presente estudio tuvo como objetivo identificar el nivel de motivación laboral extrínseca de los profesionales de enfermería de las unidades de cuidados intensivos de los hospitales públicos de Corrientes Capital 2018. Materiales y métodos: estudio cuantitativo, descriptivo de corte transversal, observacional y prospectivo constituido por una muestra de 50 profesionales, donde fueron seleccionados diez enfermeros de cada institución que cumplieron con los criterios de selección; el muestreo fue probabilístico utilizando la técnica por conglomerados y aleatorio simple. Se aplicó un cuestionario tipo Likert que comprende 20 ítems y las variables estudiadas fueron edad, sexo, remuneración, decisiones laborales, progreso laboral, condiciones físicas, equipamiento, seguridad laboral, relaciones grupales y comunicación. Resultados: El 4% de la población estudiada presentó nivel bajo de motivación laboral, mientras que en el nivel medio se obtuvo el 52% y finalmente el nivel alto el 44%. Con respecto al sexo, el femenino fue el mas frecuente con el 62% y el masculino 38%. Discusión: en su mayoría, se encontraron semejanzas con la presente investigación en los siguientes aspectos edad, sexo y nivel de motivación con los datos obtenidos en diversos estudios realizados en la región latinoamericana sobre motivación laboral. Conclusiones: la motivación laboral es una herramienta sumamente importante que puede afectar de manera positiva y negativamente en el correcto desempeño de los profesionales de enfermería en dichos servicios
Summary: Motivation is an element of great importance to obtain greater performance in the activities carried out by the nursing staff; the objective of this study was to identify the level of extrinsic job motivation of nursing professionals in the intensive care units of the public hospitals of Corrientes Capital 2018. Materials and methods: quantitative, descriptive, cross-sectional, observational and prospective study consisting of a sample of 50 professionals, where ten nurses from each institution who met the selection criteria were selected; sampling was probabilistic using the conglomerate technique and simple randomization. A Likert questionnaire was applied, comprising 20 items and the variables studied were age, sex, remuneration, labor decisions, work progress, physical conditions, equipment, job security, group relations and communication. Results: 4% of the studied population had a low level of work motivation, while in the middle level 52% was obtained and finally the high level 44%. With respect to sex, the female was the most frequent with 62% and the masculine 38%. Discussion: in its majority, similarities with the present investigation were found in the following aspects: age, sex and level of motivation with the data obtained in several studies carried out in the Latin American region on work motivation. Conclusions: Work motivation is an extremely important tool that can positively and negatively affect the correct performance of nursing professionals in these services
Resumo: A motivação é um elemento de grande importância para obter maior desempenho nas atividades realizadas pela equipe de enfermagem; Este estudo teve por objetivo identificar o nível de motivação extrínseca trabalho dos enfermeiros em unidades de terapia intensiva de hospitais públicos em Corrientes Capital 2018. Materiais e Métodos: estudo quantitativo, descritivo, transversal, observacional e prospectivo, constituído por uma amostra de 50 profissionais, onde foram selecionados dez enfermeiros de cada instituição que atendiam aos critérios de seleção; A amostragem foi probabilística utilizando a técnica de conglomerado e randomização simples. Aplicou-se um questionário do tipo Likert, composto por 20 itens, e as variáveis estudadas foram idade, sexo, remuneração, decisões trabalhistas, andamento do trabalho, condições físicas, equipamentos, segurança no trabalho, relações grupais e comunicação. Resultados: 4% da população estudada apresentaram baixo nível de motivação no trabalho, enquanto no nível médio 52% foi obtido e, finalmente, o nível alto foi de 44%. Com relação ao sexo, a fêmea foi a mais frequente com 62% e a masculina com 38%. Discussão: em sua maioria, as semelhanças com a presente investigação foram encontradas nos seguintes aspectos: idade, sexo e nível de motivação com os dadoConclusões: A motivação para o trabalho é uma ferramenta extremamente importante que pode afetar positiva e negativamente o desempenho correto dos profissionais de enfermagem nesses serviçoss obtidos em diversos estudos realizados na região latino-americana sobre motivação no trabalho
Subject(s)
Humans , Male , Female , Hospitals, Public , Intensive Care Units , Nursing Staff , Research/statistics & numerical data , Surveys and Questionnaires/statistics & numerical data , Occupational Health , MotivationABSTRACT
Garengeot's hernia corresponds to the presence of the appendix within a femoral hernia, associated or not with acute appendicitis. The diagnosis of this uncommon situation is usually done during surgery. Furthermore, the clinical presentation as necrotizing fasciitis is a rare condition. We report a 54 years old obese hypertensive woman with rheumatoid arthritis of 40 years of evolution treated with methotrexate and prednisone. She consulted for pain and erythema in the right inguinal region. Laboratory revealed leukocytosis and an elevated C-reactive Protein. Suspecting a cellulitis, the patient was admitted for antimicrobial therapy. A pelvic magnetic resonance imaging showed a perforated acute appendicitis in an inguinal hernia with extensive pelvic cellulitis associated with signs of fasciitis. At surgery, an extensive groin and pubic fasciitis was evident, with a necrotic and perforated appendix within a femoral hernia. Surgical debridement, open appendectomy, and femoral hernioplasty without mesh were carried out. Vacuum-assisted closure was installed in the coverage defect. Three surgical debridement procedures were required for the closure of the wound. Two weeks after the first surgical procedure, the patient was discharged in good condition. During the follow-up, she evolved with a surgical wound dehiscence, which was managed with wound dressings until closure.
Subject(s)
Humans , Female , Middle Aged , Appendicitis/diagnosis , Fasciitis, Necrotizing/diagnosis , Hernia, Femoral/diagnosis , Hernia, Inguinal/diagnosis , Appendectomy , Appendicitis/surgery , Appendicitis/complications , Magnetic Resonance Imaging , Acute Disease , Fasciitis, Necrotizing/surgery , Fasciitis, Necrotizing/complications , Hernia, Femoral/surgery , Hernia, Femoral/complications , Hernia, Inguinal/surgery , Hernia, Inguinal/complications , Obesity/complicationsABSTRACT
Objetivo Determinar los cambios en calidad de vida en mujeres sometidas a mamoplastia de aumento o mastopexia con prótesis, usando el instrumento validado Breast-Q®. Materiales y métodos Estudio de cohortes prospectivo. Se incluyeron todas las pacientes operadas de mamoplastia de aumento o mastopexia de aumento en el Hospital Clínico de la Universidad de Chile entre octubre de 2013 y mayo de 2014. La calidad de vida (CdV) se midió con el instrumento validado Breast-Q®. Se realizó estadística descriptiva y analítica para evaluar el cambio global en CdV y por dominios considerando estadísticamente significativo un valor p < 0,05. Resultados En el periodo estudiado se operaron 58 pacientes, 33 (56,9%) completaron el instrumento Breast-Q® en el preoperatorio y 25 (75,7%) de ellas en el postoperatorio. La CdV subió de un 49,7% a un 82,5% (p < 0,001); analizando por dominio hubo mejoría en autoestima (52% a 88%, p < 0,001), autoimagen (22% a 80%, p < 0,001) y vida sexual (31% a 86%, p < 0,001). Los síntomas físicos empeoraron desde un 94% a 75% (p < 0,001). Conclusiones El aumento mamario mejora la CdV, específicamente la autoestima, la autoimagen y la vida sexual, pero las molestias físicas aumentan. La satisfacción global fue alta.
Objective To determine the changes in the quality of life of women subjected to augmentation mammoplasty or a prosthesis mastopexy, using the validated tool Breast-Q®. Materials and methods A prospective cohorts study was conducted that included operated on for augmentation mammoplasty or augmentation mastopexy in the Hospital Clínico de la Universidad de Chile (HCUCH) between October 2013 and May 2014. The quality of life (QoL) was measured using the Breast-Q® validated tool. Descriptive and analytic statistics were performed to evaluate the overall change in QoL and by domains, considering a p<.05 as statistically significant. Results A total of 58 patients were operated on, of whom 33 (56.9%) completed the Breast-Q® questionnaire before surgery, and 25 (75.7%) of them in the post-operative period. The quality of life increased from 49.7% to 82.5% (p<.001). When analysed by domain, there was an improvement in Self-esteem (52% to 88%, p<.001), Self-image (22% to 80%, p<.001) and Sex Life (31% to 86%, p<.001). The physical symptoms increased from 75% to 94% (p<.001). Conclusions Breast augmentation improves the quality of life, in particular, self-esteem, self-image, and sex life, but physical discomforts increased. The overall satisfaction was high.