ABSTRACT
Objetivo: El objetivo de este estudio fue valorar el nivel de acierto del personal de salud en la identificación de hipocolia/acolia en un escenario simulado. Con respecto a esto afirmamos que la hipocolia/acolia son signos clínicos que indican obstrucción biliar, relacionándose con enfermedades colestásicas obstructivas, siendo la atresia de vías biliares una de las principales causas en los primeros meses de vida; en esta, el pronóstico del manejo quirúrgico depende del diagnóstico temprano. Métodos: Estudio descriptivo/ prospectivo basado en la realización de una prueba virtual al personal de salud de Medellín, dividiéndose según sitio de trabajo, edad, sexo y profesión. Fueron utilizadas cinco imágenes de la tabla de colores de materia fecal, utilizada en Taiwán, previa autorización de sus autores. Se consideró reconocimiento adecuado cuando el participante identificaba como anormales las tres imágenes que representaban la acolia/hipocolia. Resultados: Se obtuvo respuesta de 442 participantes (se excluyeron 53) y solo 253 (65 %) lograron reconocimiento adecuado. En el análisis por subgrupos se encontró que hubo un mayor acierto en los participantes del Hospital Pablo Tobón Uribe con respecto a otras instituciones (69 y 54.6 %, respectivamente - p. 0.005). Los participantes con menor porcentaje de acierto fueron los médicos generales en un (45 %). Conclusión: Durante la valoración simulada sobre la identificación adecuada de acolia/hipocolia se encontró que solo el 65 % de la población participante acertó en la identificación correcta de este signo clínico, lo que sugiere una mayor atención en cuanto al entrenamiento para la identificación de acolia/hipocolia.
Objetive: The objective of this study was to assess the level of success of healthcare worker in the identification of hypocholia / acholia in a simulated scenario. With respect to this, we affirm that hypocholia/acholia are clinical signs indicative of biliary obstruction, related to obstructive cholestatic diseases, being bile duct atresia one of the main causes in the first months of life. In this, the prognosis of surgical management depends on the early diagnosis. Methods: Descriptive and prospective study, based on the analysis of a virtual survey to Medellín's healthcare workers, subgroup analysis was done according to workplace, age, sex and profession. Five images were used from the Taiwan Stool Color Card, with the authorization from their authors. Adequate recognition was considered when the participant identified the three images representing acholia / hypocholia as abnormal. Results: a response was obtained from 442 participants (53 were excluded), and only 253 (65 %) achieved adequate recognition. In the analysis by subgroups, it was found that there was a greater success in the Pablo Tobón Uribe Hospital participants with respect to other institutions (69 % and 54.6 %, respectively - p. 0.005). The participants with the lowest percentage of correct answers were general practitioners (45%). Conclusion: During the simulated assessment on the adequate identification of acholia / hypocolia, it was found that only 65% of the participating population was correct in the right identification of this clinical sign, which suggests greater attention in training for the identification of acholia / hypocolia.
ABSTRACT
It is generally accepted that Kasai operation is the best treatment for biliary atresia (BA). The implementation of early screen plan improves the age threshold at the suitable time point of Kasai operation. This is the key issue to improve the survival rate of autologous liver in biliary atresia. The monitoring of stool color card, B-ultrasonography and serum con?jugated bilirubin can be used for preliminary seeming biliary atresia. It is very important to improve the ability of basic unit medical staff for major improvements to the understanding of the significance of biliary atresia. In some country and district, the local government has put the screen list for BA into healthcare booklet for children. Thus, it has a significant impact of early screen plan on the diagnosis and treatment of BA, and it can improve the BA autologous liver survival time. So far, there is still no BA early screen plan in the nationwide. We should pay attention to BA, and establish early screen system in different local health unit quickly.
ABSTRACT
Biliary atresia(BA) is a common reason for obstructive jaundice in children.Pathogenesis of BA is unclear,and the prognosis is poor.Over the last 2 years,gene mutation,viral infection and autoimmune are considered to be the most possible reason for BA;Stool co-lor card has shown favourable perspective in early screening;Kasai is also the first choice for treatment of BA,which progressed in laparoscopic operation and robot surgery.Corticosteroids after surgery is still disputing.Now,liver transplantation is the only way for BA and cirrhosis.This article gave a review on the pathogenesis,diagnosis and treatment of BA.