ABSTRACT
Objetivo: evaluar la calidad de vida en pacientes que se encuentran en la primera fase de tratamiento de ortodoncia, ofrecido por un programa de docencia-servicio de educación superior en la ciudad de Medellín. Métodos: se realizó un estudio transversal analítico en los pacientes atendidos en el servicio de ortodoncia. La muestra estuvo compuesta por un total de 104 pacientes. Se empleó un cuestionario estructurado de 12 ítems para evaluar información sociodemográfca. Para estudiar la calidad de vida relacionada con la salud bucal (CVRSB), la cual fue medida con el OHIP-14 (Oral Health Impact Profle 14) validado en el idioma español y datos clínicos tomados en el momento de la consulta odontológica. Resultados: el promedio de edad de los participantes fue de 25,7 ± 12,1 años, edad mínima de 12 y máxima de 60. Se encontraron diferencias estadísticamente signifcativas en los mayores de 30 años y con estudios superiores, principalmente en la extensión y la severidad del impacto en la calidad de vida. Respecto al OHIP-14, el mayor impacto lo presentaron aquellos con apiñamiento severo (8,1 RIC=13), mordida borde a borde (8,0 RIC=6) y relación molar clase III (9,0 RIC=10), con diferencias estadísticamente signifcativas. Conclusiones: este estudio permitió evidenciar que, en general, el impacto en la calidad de vida del OHIP-14 en los pacientes fue bueno durante la primera fase del tratamiento y que las diferencias están relacionadas con la edad, nivel de escolaridad y características oclusales, tales como apiñamiento, overbite y relación molar.
Objective: To evaluate the quality of life in patients with orthodontic treatment in the frst phase of treatment who consult in a higher education teaching-service program in the city of Medellín. Methods: An analytical cross-sectional study was conducted in the patients treated in the orthodontic service. The sample consisted of a total of 104 patients. A 12-item structured questionnaire was used with sociodemographic information, regarding quality of life related to oral health (QOLHR), which was measured with the OHIP-14 (Oral Health Impact Profle 14) validated in the Spanish language and clinical data taken at the time of the dental consultation. Results: The average age of the participants was 25.7 ± 12.1 years, with a minimum age of 12 and a maximum of 60. Statistically signifcant diferences were found in those over 30 years of age and with higher education, mainly in the extension and severity of impact on quality of life. Regarding OHIP-14, the greatest impact was presented by those with severe crowding (8.1 IQR=13), edge-to-edge bite (8.0 IQR=6) and class III molar relationship (9.0 IQR=10), with Statistically signifcant diferences. Conclusions: This study made it possible to show that in general the impact of the quality of life of OHIP-14 in patients was good in the frst phase of treatment and that the diferences are related to age, level of education and its dimensions with occlusal characteristics such as such as crowding, overbite and molar relationship of the patients reported during orthodontic treatment.
Subject(s)
Humans , Adolescent , Adult , Orthodontics , Quality of Life , Patients , Oral HealthABSTRACT
Abstract Background: Several interventional cardiology procedures are required in neonates with congenital heart disease. Interventional cardiology procedures have a higher risk of cardiac arrest compared to other interventions. At present, there is great heterogeneity in the perioperative management of congenital heart disease neonates undergoing diagnostic cardiac catheterization or therapeutic cardiac catheterization. Study objectives: Primary aim: Provide a systematic review of the most effective and/or safe anesthetic and perioperative management in neonates with congenital heart disease who undergo diagnostic cardiac catheterization or therapeutic cardiac catheterization. Secondary aim: Identify the medications, monitoring parameters and airway management used in the same population. Design: Systematic literature review. Setting: Catheterization laboratory. Methods: Literature was searched (December 2017) in electronic databases Medline, EMBASE, ScienceDirect, BIREME-Lilacs-Biblioteca Virtual de la Salud, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Health Technology Assessment Database. Main results: From 130 records identified, four studies met inclusion criteria and quality assessment. None of the studies were relevant to the primary objective. Regarding the secondary objectives, one study compared the efficacy and adverse effects of racemic ketamine and its S(+) ketamine enantiomer, one study reported the efficacy of subarachnoid anesthesia for high-risk children undergoing diagnostic cardiac catheterization, one study identified the factors associated to high severity adverse events related to sedation, anesthesia and airway, and one study retrospectively analyzed cardiac catheterization procedures in neonates weighing less than 2.5 kg. Conclusion: There are no evidence-based recommendations available for congenital heart disease neonates undergoing cardiac catheterization. More studies are required to evaluate the ideal anesthetic and perioperative management in this population.
Resumo Introdução: Vários procedimentos de cardiologia intervencionista são necessários em neonatos com doença cardíaca congênita. Os procedimentos de cardiologia intervencionista têm um risco maior de parada cardíaca em comparação com outras intervenções. Atualmente, há grande heterogeneidade no manejo perioperatório de neonatos com doença cardíaca congênita submetidos a cateterismo cardíaco diagnóstico ou cateterismo cardíaco terapêutico. Objetivo: Objetivo principal: fornecer uma revisão sistemática do manejo anestésico e perioperatório mais efetivo e/ou seguro em neonatos com doença cardíaca congênita submetidos à cateterismo cardíaco diagnóstico ou cateterismo cardíaco terapêutico. Objetivo secundário: Identificar os medicamentos usados, parâmetros monitorizados e manejo das vias aéreas utilizado na população estudada. Desenho: Revisão sistemática da literatura. Local: Laboratório de hemodinâmica e cateterismo cardíaco. Método: Foi realizada busca na literatura (Dezembro de 2017) nos seguintes bancos de dados eletrônicos: Medline, EMBASE, ScienceDirect, BIREME-Lilacs-Biblioteca Virtual de la Salud, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects e Health Technology Assessment Database. Resultados principais: Dos 130 registros identificados, quatro estudos obedeceram aos critérios de inclusão e de avaliação de qualidade. Nenhum dos estudos foi relevante para o objetivo principal. Em relação aos objetivos secundários, um estudo comparou a eficácia e os efeitos adversos da cetamina racêmica e seu enantiômero S(+) cetamina, um estudo relatou a eficácia da anestesia subaracnóidea em crianças de alto risco submetidas ao cateterismo cardíaco diagnóstico, um estudo identificou os fatores associados à maior gravidade de eventos adversos relacionados à sedação, anestesia e vias aéreas, e um estudo analisou retrospectivamente os procedimentos de cateterismo cardíaco em neonatos com peso inferior a 2,5 kg. Conclusão: Não há recomendações com base em evidências disponíveis para neonatos com doença cardíaca congênita submetidos a cateterismo cardíaco. Mais estudos são necessários para avaliar o manejo anestésico e perioperatório ideal nessa população.
Subject(s)
Humans , Infant, Newborn , Cardiac Catheterization , Heart Defects, Congenital/surgery , Heart Defects, Congenital/diagnosis , Anesthesia/standardsABSTRACT
Objetivo: Describir las características clínicas, demográficas, frecuencia, tipo de aislamientos microbiológicos y resistencia a los antimicrobianos de pacientes con neoplasias hematológicas que presentaron como complicación neutropenia febril en el Hospital Universitario de San Ignacio Métodos: Estudio descriptivo observacional, se tomaron datos de historias clínicas de los pacientes adultos hospitalizados en la Unidad de Hematología y Trasplante de Médula Ósea, que cumplieron criterios de neutropenia febril entre enero de 2013 y diciembre de 2014 Resultados: se recolectaron 345 episodios de neutropenia febril, correspondientes a 193 pacientes. Se documentó foco infeccioso en el 68,1% de los episodios, con aislamiento microbiológico en el 62.9% de los episodios, con predominio de bacilos gram negativos, en 63,7% de los casos, seguido por los cocos gram positivos en 27,9% y hongos en 4,9%. En cuanto a los mecanismos de resistencia, en los aislamientos Escherichia coli y Klebsiella peumoniae se encontró producción de Beta Lactamasas de Espectro Extendido (BLEEs) en 17,5 y 13,8%; Carbapenemasas tipo KPC en 1,25 y 2,8% respectivamente. En cuanto a Staphylococcus aureus, se encontró resistencia a meticilina en 6,8% de los aislamientos. Mortalidad asociada a infección en 16,5% de los casos. Conclusión: En pacientes con Neoplasias Hematológicas con neutropenia febril post quimioterapia en el Hospital Universitario de San Ignacio encontramos alta probabilidad de documentación de foco infeccioso, con predominio de microorganismos gram negativos, especialmente enterobacterias; con comportamiento similar en pacientes post trasplante de precursores hematopoyéticos.
Objective: To describe the demographic and clinical characteristics, as well as frequency and type of bacterial isolate and resistance patterns in patients with hematological neoplasms complicated by febrile neutropenia at San Ignacio University Hospital Methods: This is a retrospective observational study. Data were collected from medical records of adult patients admitted in the Hemato-oncology and Bone Marrow Transplant Unit. Inclusion criteria was presence of febrile neutropenia in the setting of a hematological neoplasm from January 2013 to December 2014. Results: 345 episodes of febrile neutropenia from 193 patients were studied. An infectious focus was identified in 68.1% of episodes, and a bacterial isolate was obtained in 62.9% of episodes. The predominant microorganisms were gram-negative rods, gram-positive cocci, and fungi with a frequency of 63.7%, 27.9%, and 4.9% respectively. In term of resistance patterns, Escherichia coli and Klebsiella peumoniae isolates had a frequency of ESBL susceptibility pattern of 17.5% and 13.8% respectively; and a frequency of KPC susceptibility pattern of 1.25% and 2.8% respectively. The frequency of methicillin resistant Staphylococcus aureus was 6.8%. Death associated to infection ocurred in 16.5% of episodes. Conclusions: In patients with hematological neoplasms complicated by febrile neutropenia at San Ignacio University Hospital, we found a high rate of documentation of infectious focus, with a predominance of gram-negative rods, specially Enterobacteriacea; with a similar pattern in receptors of hematopoietic stem cell transplantation.
Subject(s)
Humans , Male , Female , Adult , Bone Marrow Transplantation , Febrile Neutropenia , Neoplasms , Staphylococcus , Drug Resistance, Microbial , Epidemiology, Descriptive , Sepsis , Drug Resistance, Neoplasm , Drug TherapyABSTRACT
Objective: To evaluate and compare sensitivity and specificity of ANB, Wits, APDI and AF-BF to diagnose sagittal skeletal malocclusions, in children between 6 to 12 years old, using ROC curves, a widely accepted method for the analysis and evaluation of diagnostic tests. Material and Methods: A descriptive-comparative study of diagnostic tests was conducted. From a population of 3,000 children, a non-probabilistic sample of 209 was selected. The clinical classification of the patients as class I, II or III, made by a group of experts based on the visual inspection of models and photographs, was chosen as the gold standard. After calibration (ICC>0.94) the variables were measured in cephalograms. Eight ROC curves were plotted (I vs II, and I vs III for each one of the variables). The area under the curve was measured and compared (Ji-square test). Cut points were established. Results: To discriminate Class I from II, ANB showed the largest area under the curve (AUC) (0.876) and the cut point (best sensitivity and specificity) was at 5.75°. To discriminate class I from III, Wits showed the largest AUC (0.874) with a cut point of -3.25 mm. There were no statistical differences between the AUC for the four variables (p=0.48 y p=0.38 for class I-II and I-III). Conclusion: ANB and Wits performed better for the diagnosis of class II and III, respectively. Cut points in children were different from those reported in adults.
Subject(s)
Cephalometry/methods , ROC Curve , Malocclusion/diagnosis , Malocclusion, Angle Class II/diagnosis , Malocclusion, Angle Class III/diagnosis , Chi-Square Distribution , Epidemiology, Descriptive , Analysis of Variance , ColombiaABSTRACT
Abstract Flexible bronchoscopy is a diagnostic or therapeutic procedure with a low incidence of complications (0.08-6.8%). Bleeding after transbronchial biopsy is a rare complication (0-2.8% of the cases), usually resulting in minor bleeding that resolves with local measures. There is no clear definition of massive hemoptysis and due to the low incidence of this condition, there are no practical guidelines for the treatment of this complication that may be catastrophic. This case discusses the occurrence of massive hemoptysis during a transbronchial biopsy under flexible bronchoscopy, including a literature review on perioperative management.
Resumen La broncoscopia flexible es un procedimiento diagnóstico o terapéutico con baja incidencia de complicaciones (0,08-6,8%). El sangrado por biopsia transbronquial es una complicación rara (0-2,8% de los casos), suele ser leve y resuelve con medidas locales. No existe una definición clara de hemoptisis masiva y, por su baja incidencia, no hay guías de práctica clínica para el tratamiento de esta complicación, que puede ser catastrófica. Presentamos un caso de hemoptisis masiva durante la realización de una broncoscopia flexible más biopsia transbronquial y revisamos la literatura acerca del manejo intraoperatorio.
Subject(s)
HumansABSTRACT
El carcinoma escamocelular bucal (CEB), es una neoplasia maligna frecuente en cavidad oral. Objetivo: determinar la incidencia y el comportamiento clínico e histológico de este tipo de cáncer en Antioquia, Colombia. Métodos: éste estudio provee información acerca de las características clínicas e histopatológicas del CEB, proveniente de historias clínicas de 197 personas 112 (56,9 por ciento) hombres y 85 (43,1 por ciento) mujeres atendidas en el hospital Universitario San Vicente de Paúl de Medellín, durante un periodo de 14 años. Resultados: 197 historias fueron estudiadas, el 61,9 por ciento (122) de la población, era mayor de 60 años al momento del diagnóstico, 78,7 por ciento (157) fueron procedentes de Antioquia, el 78,6 por ciento (155), tenían antecedente tabaquismo, el 17,8 por ciento (35) de las personas, reportaron en la historia antecedentes familiares de cáncer. La localización más frecuente del CEB, fue la lengua 45 por ciento (90), seguido de paladar duro 17,1 por ciento (34), paladar blando 9 por ciento (17) y piso de boca 8,5 por ciento (17); la mayoría de estos (74,9 por ciento), fueron diagnosticados en estadios tardíos (III y IV), en cuanto al grado de diferenciación predominaron los carcinomas bien y moderadamente diferenciado, 45,2 por ciento (89) y 42,6 por ciento (84) respectivamente(AU)
Buccal squamous cell carcinoma (SCC) is frequent malign neoplasm in oral cavity; however, there isn't information on its incidence and clinical and histological behavior of this type of cancer in Antioquia (Colombia). Methods: Present study supply information on the clinical and histological features of SCC from medical records of 197 persons (56.9 percent) (112 of male sex and 85 of female sex (43.1 percent) seen in "San Vicente de Paúl" University Hospital of Medellin for 13 years. Results: A total of 197 medical records were studied, the 61.9 percent (122) of population aged over 60 at diagnosis, 78.7 percent (157) from Antioquia, and the 78.6 percent (155) had smoking backgrounds, and the 17.8 percent (35) of persons had a family history of cancer. More frequent location of SCC was in tongue for a 45 percent (90), followed by hard palate for a 17.1 percent (17) and mouth floor for a 8.5 percent (17), most of them (7.9 percent) were diagnosed with late stages (III and IV) regards the differentiation degree the carcinoma were well and moderately differentiated, 45.2 percent (89) and 42.6 percent (84), respectively(AU)