Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
Rev. cuba. endocrinol ; 32(2): e282, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347399

ABSTRACT

Introducción: La práctica de la cirugía genital es frecuente en infantes y adolescentes diagnosticados de intersexualidad. Una de sus principales consecuencias se refleja en la personalidad del paciente. Existen numerosos estudios en población adulta, pero son escasos en edades pediátricas. El dibujo constituye un instrumento valioso para la exploración psicológica en edades tempranas. Objetivo: Identificar las características psicológicas de infantes y adolescentes con tratamiento quirúrgico de los genitales, y de su desarrollo psicológico en el momento de la valoración. Métodos: Estudio transversal descriptivo y metodología cualitativa. La muestra la integraron 15 participantes entre 6 y 12 años, con hiperplasia adrenal congénita y cirugía genital. De ellos, 4 con asignación al sexo masculino y 11 con asignación femenina. Todos residentes en La Habana, Cuba y captados de las consultas de seguimiento de los servicios de Endocrinología del Instituto de Endocrinología y hospitales pediátricos. Se aplicaron las técnicas psicográficas (dibujo espontáneo, dibujo temático de la familia y dibujo temático "Así soy yo"). Resultados: El desarrollo psicológico se correspondió con la edad cronológica. El 100 por ciento presentó un pensamiento coherente y estructurado. El 50 por ciento presentó indicadores emocionales que aluden a insatisfacción con el propio yo, angustia (40 por ciento), y falta de aceptación del propio cuerpo (70 por ciento); además, expresaron dificultades en la comunicación familiar (60 por ciento). Conclusiones: Los indicadores globales relevantes de los dibujos denotaron daño emocional, dificultades en la aceptación, percepción y representación del esquema corporal y también en la comunicación social y familiar. Resulta impostergable intervenir en las causas del malestar y los problemas psicológicos de los sujetos estudiados para evitar que se desarrollen enfermedades psiquiátricas en la edad adulta(AU)


Introduction: The practice of genital surgery is frequent in infants and adolescents diagnosed with intersex. One of the main consequences is reflected in the patient´s personality. There are numerous studies in the adult population; however, they are rare in pediatric ages. Drawing is a valuable tool for psychological exploration in early ages. Objective: Identify the psychological characteristics of infants and adolescents with surgical treatment of the genitalia, and to characterize their psychological development. Method: Descriptive cross-sectional study and qualitative methodology. The sample was made up of 15 infants and adolescents between 6 and 12 years old with congenital adrenal hyperplasia and genital surgery. 4 of them with male sex assignment and 11 with female assignment, coming from the primary care level, residents in Havana, Cuba, recruited in the follow-up consultations of the endocrinology services of the Institute of Endocrinology and pediatric hospitals. The psychographic techniques (spontaneous drawing, thematic drawing of the family and thematic drawing called "I am like this" were applied). The study complied with the basic ethical aspects of scientific research. Results: Psychological development corresponded with chronological age. 100 percent of the patients presented a coherent and structured thinking. 50 percent presented emotional indicators that allude to dissatisfaction with one's own self, anguish (40 percent), and lack of acceptance of one's own body (70 percent); in addition, they expressed difficulties in family communication (60 percent). Conclusions: The relevant global indicators of the drawings denoted emotional damage, difficulties in the acceptance, perception and representation of the body scheme and also in social and family communication. It cannot be postponed an intervention in the discomfort causes and psychological problems of the patients studied, in order to avoid that psychiatric diseases can be developed in adults ages(AU)


Subject(s)
Humans , Male , Female , Child , Primary Health Care , Adrenal Hyperplasia, Congenital/psychology , Sex Reassignment Surgery/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Psychological Techniques
2.
Ciênc. Saúde Colet. (Impr.) ; 25(4): 1233-1240, abr. 2020.
Article in Spanish | LILACS | ID: biblio-1089501

ABSTRACT

Resumen En Medicina es clave "ofrecer el 100% de lo que se precisa y evitar el 100% de lo que no se precisa". Lamentablemente, es difícil cumplir con esta cuestión clave y generalmente se ofrece más de lo que se precisa y no se evita todo lo que no se precisa. Este texto es una revisión no sistemática con objetivo docente en que se revisa el problema general en atención primaria y se proponen formas de evitar los excesos y defectos respecto a intervenciones preventivas, diagnósticas, terapéuticas y de rehabilitación. Saber no hacer es ciencia y arte que se enseña poco y se practica menos. Los excesos que dañan son parte casi diaria de la práctica clínica, en prevención, diagnóstico, tratamiento y rehabilitación. Es imprescindible fomentar "el arte y la ciencia de no hacer".


Abstract In Medicine, it is critical "to offer 100% of what is needed and avoid 100% of what is not needed." Unfortunately, this primary issue is challenging, and generally, more than required is offered, and everything that is unnecessary is not avoided. This is a nonsystematic review with a teaching objective that reviews the general issue in primary care and suggests ways to avoid overuse and shortcomings concerning preventive, diagnostic, therapeutic, and rehabilitative interventions. Knowing not to do is science and art that is hardly taught and practiced less. The overuse that harm are an almost daily part of clinical practice in prevention, diagnosis, treatment, and rehabilitation. It is essential to promote "the art and science of not doing".


Subject(s)
Humans , Community Medicine , Family Practice , Health Services Misuse/prevention & control , Physician-Patient Relations , Primary Prevention/ethics , Rehabilitation , Therapeutics , Unnecessary Procedures , Diagnostic Techniques and Procedures
3.
Invest. educ. enferm ; 38(1): [E04], febrero 15 2020. Tab 1, Tab 2
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1051969

ABSTRACT

Objective. To evaluate the effect of interactive training conducted during pregnancy on choosing delivery method among primiparous women. Methods. Quasi-experimental study carried out in 2017 in two hospitals in the city of Bushehr (Iran), with the participation of 108 primiparous pregnant women in an educational program consisting of eight 2-hour sessions every two weeks in which interactive training activities were performed (group discussions, classroom sessions, and delivery of printed educational material) on themes related with physiological delivery, painless vaginal delivery methods, and complications of cesarean delivery without indication, among others. Before and after the intervention, the Knowledge and Preferred Method of Delivery Questionnaire by Moradabadi et al., was used to obtain information. Results. The results indicated that the level of knowledge in the group of mothers increased significantly between the pre-intervention and post-intervention assessment (13.2 versus 19.4, of 20 possible maximum points; p <0.001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p<0.001). Conclusion. Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery.


Objetivo. Evaluar el efecto de un entrenamiento interactivo realizado durante el embarazo sobre la elección del método de parto en mujeres primíparas. Métodos. Estudio cuasiexperimental realizado en 2017 en dos hospitales de la ciudad de Bushehr (Irán). 108 mujeres embarazadas primíparas participaron en un programa educativo consistente en ocho sesiones de dos horas de duración cada dos semanas, en las que se realizaron actividades de capacitación interactiva (discusiones grupales, clases magistrales y entrega de material educativo impreso) sobre temas relacionados con el parto fisiológico, los métodos de parto vaginal sin dolor, las complicaciones del parto por cesárea sin indicación, entre otros. Antes y después de la intervención se utilizó, para la toma de información, el Knowledge and Preferred Method of Delivery Questionnaire de Moradabadi et al. Resultados. Los resultados indicaron que el nivel de conocimiento en el grupo de madres aumentó significativamente entre la evaluación preintervención a la posintervención (13.2 versus 19.4, de 20 puntos máximos posibles; p<0.001). Además, se observó una diferencia significativa en la selección del método de parto vaginal antes y después de la intervención (74.1% versus 98.1%; p<0.001). Conclusión. La implementación de la capacitación interactiva aumentó el conocimiento de las embarazadas sobre el parto e indujo un efecto positivo para alentar a las madres primíparas a tener un parto vaginal.


Objetivo. Avaliar o efeito de um treinamento interativo realizado durante a gravidez na escolha do método de parto em mulheres primíparas. Métodos Estudo quase experimental realizado em 2017 em dois hospitais na cidade de Bushehr (Irã). 108 gestantes primíparas participaram de um programa educacional composto por oito sessões de duas horas a cada duas semanas, nas quais foram realizadas atividades de treinamento interativas (discussões em grupo, master classes e entrega de material educacional impresso) sobre questões relacionadas ao parto métodos fisiológicos, parto vaginal sem dor, complicações do parto cesáreo sem indicação, entre outros. Antes e após a intervenção, o Questionário de Conhecimento e Método Preferido de Entrega de Moradabadi et al. Resultados Os resultados indicaram que o nível de conhecimento no grupo de mães aumentou significativamente entre a avaliação pré-intervenção e a pós-intervenção (13.2 versus 19.4, de 20 possíveis pontos máximos; p<0.001). Além disso, foi observada diferença significativa na seleção do método de parto vaginal antes e após a intervenção (74.1% versus 98.1%; p<0.001). Conclusão A implementação do treinamento interativo aumentou o conhecimento das gestantes sobre o parto e induziu um efeito positivo para incentivar as primíparas a terem um parto vaginal.


Subject(s)
Humans , Parity , Pregnancy , Cesarean Section , Unnecessary Procedures , Delivery, Obstetric
4.
Arch. argent. pediatr ; 116(6): 426-429, dic. 2018.
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1038446

ABSTRACT

Pueden cometerse muchos errores en el momento de hacer un diagnóstico: subdiagnosticar, hacer un diagnóstico equivocado y sobrediagnosticar. Mientras que el subdiagnóstico y el diagnóstico equivocado son errores obvios, cuando se sobrediagnostica se descubre una anomalía real, pero la detección no beneficia al paciente. El daño ocurre cuando se continúa evaluando al paciente y se lo trata innecesariamente por una afección que, de no haberse diagnosticado, nunca lo habría afectado. Son varios los fenómenos que apuntan a un posible sobrediagnóstico: que la demora u omisión de un diagnóstico no ocasione daños; que aumente la detección de una enfermedad, pero no haya cambios en los resultados, y que los estudios aleatorizados no muestren ningún beneficio con el diagnóstico.Hay quienes dirían que el saber siempre reporta beneficios, pero los efectos adversos del sobrediagnóstico están bien documentados. Tendremos que adquirir más conocimientos sobre el daño que puede generar el sobrediagnóstico y transmitirlos a nuestros colegas, y deberemos aprender a encontrar el equilibrio entre el posible beneficio de un diagnóstico y el riesgo del sobrediagnóstico.


Many errors can be made in diagnosis: underdiagnosis, misdiagnosis, and overdiagnosis. While underdiagnosis and misdiagnosis are clear errors, in overdiagnosis, a true abnormality is discovered, but detection does not benefit the patient. Harm occurs when patients are further evaluated and treated unnecessarily as a result of making a diagnosis that would never have affected the patient if the diagnosis had not been made. Several phenomena point to potential overdiagnosis: when delayed or missed diagnoses do not result in harm; when there is increased detection of a disease, but no change in the outcome; and when randomized trials show no benefit from the diagnosis. Some might say that there is always benefit in knowing, but the adverse effects of overdiagnosis are well documented. We will need to educate ourselves and our colleagues about the potential for harm from overdiagnosis, and learn how to balance the potential benefit of a diagnosis against the risk of overdiagnosis.


Subject(s)
Humans , Therapeutics , Risk Assessment , Diagnostic Errors , Medical Overuse
5.
Article in English | WPRIM | ID: wpr-715818

ABSTRACT

OBJECTIVES: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. METHODS: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. RESULTS: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. CONCLUSIONS: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.


Subject(s)
Adult , Behavioral Risk Factor Surveillance System , Cross-Sectional Studies , Female , Hispanic or Latino , Humans , Hysterectomy , Insurance, Health , Marital Status , Mass Screening , Methods , Multivariate Analysis , Odds Ratio , Papanicolaou Test , Retrospective Studies , United States , Unnecessary Procedures , Uterine Cervical Neoplasms
6.
Rev. saúde pública (Online) ; 51: 116, 2017. graf
Article in English | LILACS | ID: biblio-903252

ABSTRACT

ABSTRACT Quaternary prevention consists in the identification of persons at risk of excessive medicalization and their protection against new unnecessary interventions, avoiding iatrogenic damages. Here, we argue about the importance of quaternary prevention in specific primary and secondary prevention. The recent great development of preventive medicine, biomedicalization of risks and their treatment as if they were diseases, and the powerful influence of the commercial interests of pharmaceutical industries on the production of medical-sanitary knowledge alter classifications, create diseases and pre-diseases, lower cutoff points, and erase the distinction between prevention and healing. This situation converts larger amounts of asymptomatic persons into sick individuals and diverts clinical attention and resources from sick persons to the healthy, from older adults to young persons, and from the poor to the rich. Quaternary prevention facilitates and induces the development and systematization of operational knowledge and guidelines to contain hypermedicalization and the damages of preventive actions in professional care, especially in primary health care.


RESUMO A prevenção quaternária consiste na identificação de pessoas em risco de medicalização excessiva e sua proteção contra novas intervenções desnecessárias, evitando danos iatrogênicos. Aqui, argumentamos sobre a importância da prevenção quaternária na prevenção primária específica e secundária. O grande desenvolvimento recente da medicina preventiva, da biomedicalização dos riscos e seu tratamento como se fossem doenças e a influência poderosa dos interesses comerciais das indústrias farmacêuticas sobre a produção de conhecimento médico-sanitário alteram classificações, criam doenças e pré-doenças, rebaixam pontos de corte e apagam a distinção entre prevenção e cura. Isso converte maiores proporções de pessoas assintomáticas em doentes e desvia a atenção clínica e os recursos dos mais doentes para os saudáveis, dos idosos para os jovens e dos pobres para os ricos. A prevenção quaternária facilita e induz o desenvolvimento e sistematização de saberes e diretrizes operacionais para a contenção da hipermedicalização e dos danos das ações preventivas no cuidado profissional, sobretudo na atenção primária à saúde.


Subject(s)
Humans , Preventive Health Services/standards , Unnecessary Procedures/standards , Asymptomatic Diseases , Medicalization/standards
7.
Belo Horizonte; s.n; 2016. 117 p. tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-870157

ABSTRACT

O Brasil é o líder mundial de cirurgias cesarianas com uma taxa de 56% do total de partos, enquanto o índice recomendado pela Organização Mundial de Saúde é de 15%. Esse alto índice, já considerado uma epidemia no país, traz sérios riscos para a saúde da mulher e do recém-nascido, apresentando relação direta com o aumento da morbi-mortalidade materna e neonatal. Estima-se que no Brasil quase um milhão de mulheres são submetidas a essa cirurgia sem indicação médica e obstétrica adequada, impactando no aumento das taxas de cesáreas desnecessárias e prematuridade. A região sudeste se destaca como a região com maior índice desse tipo de parto. Objetivo: Analisar as cesáreas desnecessárias em Belo Horizonte e a prematuridade relacionada. Método: Trata-se de um estudo de coorte, de base hospitalar, desenvolvido em maternidades públicas e privadas de Belo Horizonte, Minas Gerais, no período de novembro de 2011 a março de 2013. A amostra foi constituída por puérperas hospitalizadas por motivo de parto hospitalar e seus conceptos vivos, independente de peso e idade gestacional ou mortos com peso maior que 500 gramas e idade gestacional maior que 22 semanas. Os dados foram coletados por meio de entrevistas com as puérperas, nos prontuários da mãe e do recém-nascido e no cartão de pré-natal. Para estimativa da idade gestacional usou-se o algoritmo proposto por Pereira et al.,(2014) e a ultrassonografia precoce ( 7 a 20 semanas). As cesáreas desnecessárias foram analisadas utilizando-se a classificação dos 10 grupos de Robson e em relação às seguintes variáveis: tipo de hospital (público ou privado), procedência, idade, raça/cor da pele e classe econômica da puérpera, plano de saúde, acompanhante e justificativa para a realização da cesárea. Os dados foram analisados por técnicas de estatística descritiva e os resultados expressos em tabelas com ênfase nas taxas esperada, observada e desnecessária...


Brazil is the world´s leader in cesarean surgery, with a rate of 56% of total births, while the percentage recommended by the World Health Organization is 15%. This high rate is considered an epidemic in the country and is associated with increased morbidity as well as maternal and newborn mortality. In Brazil, it is estimated that almost a million women undergo this surgery without medical advice and adequate obstetric care, which affects the increase in rates of unnecessary cesarean sections and prematurity. The Southeast region stands out as the region with the highest rate of this type of birth. Objective: It is to analyze the unnecessary cesarean sections in Belo Horizonte and related prematurity. Method: This is a hospital-based study that was conducted in public and private maternity hospitals in Belo Horizonte, Minas Gerais, Brazil, from November 2011 to March 2013. The sample is comprised of hospitalized mothers for birth reasons as well as their living fetuses, regardless of the weight and gestational age, or dead fetuses that weigh more than 500 grams and obtain gestational age greater than 22 weeks. Data were collected through interviews with the mothers, based in their medical records as well as the newborn´s and prenatal card. An algorithm proposed by Pereira was used to estimate the gestational age et al (2014) and early pregnancy ultrasound (7 to 20 weeks). The unnecessary caesarean sections were analyzed through the use of Robson´s 10 groups classification, based on the following variables: Type of hospital (public or private), origin, age, race/skin color and postpartum women´s economic status, health plan, her company and justifications for conducting the caesarian. Data were analyzed by descriptive statistics and the results expressed on tables with emphasis on expected rates and unnecessary cesareans as well as the proportion of unnecessary cesareans. Prematurity was analyzed by different methods of...


Subject(s)
Humans , Female , Pregnancy , Cesarean Section/statistics & numerical data , Gestational Age , Infant, Premature , Unnecessary Procedures , Brazil , Cesarean Section/classification , Retrospective Studies , Cohort Studies , Socioeconomic Factors , Surveys and Questionnaires
8.
Rev. bras. anestesiol ; 63(2): 197-201, mar.-abr. 2013. ilus, tab
Article in Portuguese | LILACS | ID: lil-671561

ABSTRACT

JUSTIFICATIVA E OBJETIVOS: A avaliação pré-operatória tem como objetivos diminuir a morbimortalidade do paciente cirúrgico, o custo do atendimento perioperatório e a ansiedade pré-operatória. A partir da avaliação clínica deve-se definir a necessidade de exames complementares e estratégias para reduzir o risco anestésico-cirúrgico. O objetivo deste trabalho foi avaliar o benefício de exames de rotina pré-operatório de pacientes de baixo risco em cirurgias de pequeno e médio porte. MÉTODOS: Trata-se de um estudo descritivo, transversal, com 800 pacientes atendidos no consultório de avaliação pré-anestésica do Hospital Santo Antonio, Salvador, BA. Foram incluídos pacientes de 1 a 45 anos, estado físico ASA I, que seriam submetidos a cirurgias eletivas de pequeno e médio porte. Avaliaram-se alterações no hemograma, coagulograma, eletrocardiograma, RX de tórax, glicemia, função renal e dosagem de sódio e potássio e as eventuais mudanças de conduta que ocorreram decorrentes dessas alterações. RESULTADOS: Dos 800 pacientes avaliados, 97,5% fizeram hemograma, 89% coagulograma, 74,1% eletrocardiograma, 62% RX de tórax, 68% glicemia de jejum, 55,7% dosagens séricas de ureia e creatinina e 10,1% dosagens de sódio e potássio séricos. Desses 700 pacientes, 68 (9,71%) apresentaram alteração nos exames pré-operatórios de rotina e apenas 10 (14,7%) dos considerados alterados tiveram conduta pré-operatória modificada, ou seja, solicitação de novos exames, interconsulta ou adiamento do procedimento. Nenhuma das cirurgias foi suspensa. CONCLUSÃO: Observou-se que excessivos exames complementares são solicitados no pré-operatório, mesmo em pacientes jovens, de baixo risco cirúrgico, com pouca ou nenhuma interferência na conduta perioperatória. Exames aboratoriais padronizados não são bons instrumentos de screening de doenças, além de gerar gastos elevados e desnecessários.


BACKGROUND AND OBJECTIVES: Preoperative tests aim to reduce morbidity and mortality of surgical patients, cost of perioperative care, and preoperative anxiety. Clinical evaluation allows defining the need for additional tests and strategies to reduce the surgical-anesthetic risk. The aim of this study was to evaluate the benefit of routine preoperative testing of low-risk patients undergoing minor and medium surgical procedures. METHODS: A descriptive cross-sectional study of 800 patients seen at the preanesthetic assessment department of Hospital Santo Antonio, Salvador, BA. Patients with physical status ASA I, aged 1-45 years and scheduled to undergo elective minor and medium surgeries were include in the study. We evaluated changes in blood count, coagulation profile, electrocardiogram, chest X-ray, blood sugar, kidney function, sodium and potassium levels, and eventual change in clinical approach occurring due to these changes. RESULTS: Of 800 patients evaluated, a blood count was performed in 97.5%, coagulation in 89%t, electrocardiogram in 74.1%, chest X-ray in 62%, fasting glucose in 68%, serum urea and creatinine in 55.7%, and plasma levels of sodium and potassium in 10.1%. Of these 700 patients, 68 (9.71%) showed changes in preoperative routine tests and only 10 (14.7%) of the patients with abnormal tests had a preoperative modified approach (i.e., new tests ordered, referral to a specialist or surgery postponement). No surgery was suspended. CONCLUSION: We found that preoperative additional tests are excessively ordered, even for young patients with low surgical risk, with little or no interference in perioperative management. Laboratory tests, besides generating high and unnecessary costs, are not good standardized screening instruments for diseases.


OBJETIVOS Y JUSTIFICATIVA: La evaluación preoperatoria tiene el objetivo de disminuir la morbimortalidad del paciente quirúrgico, el coste de la atención perioperatoria y la ansiedad preoperatoria. A partir de la evaluación clínica debemos definir la necesidad de exámenes complementarios y de estrategias para reducir el riesgo anestésico-quirúrgico. El objetivo de este trabajo fue el de evaluar el beneficio de exámenes de rutina preoperatorio de pacientes de bajo riesgo en las cirugías menores. MÉTODOS: Se trata de un estudio descriptivo, transversal con 700 pacientes atendidos en la consulta de evaluación preanestésica del Hospital Santo Antonio, Salvador, BA. Fueron incluidos pacientes de 1 a 45 años, estado físico ASA I, que serían sometidos a cirugías electivas menores. Se evaluaron las alteraciones en el hemograma, el coagulograma, el electrocardiograma, RX de tórax, glucemia, función renal y dosificación de sodio y potasio, y los eventuales cambios de conducta que se suscitaron provenientes de esas alteraciones. RESULTADOS: De los 800 pacientes evaluados un 97,5% realizaron hemograma, 89% coagulograma, 74,1% electrocardiograma, 62% RX de tórax, 68% glucemia en ayunas, 55,7% dosificaciones séricas de urea y creatinina y un 10,1% dosificaciones de sodio y potasio séricos. De esos 800 pacientes, 68 (9,71%) tuvieron alteración en los exámenes preoperatorios de rutina y solo 10 (14,7%) de los considerados alterados tuvieron una conducta preoperatoria modificada, o sea, una solicitación de nuevos exámenes, interconsulta o la postergación del procedimiento. Ninguna de las cirugías se suspendió. CONCLUSIONES: Observamos que los excesivos exámenes complementarios se solicitaban en el preoperatorio, aunque fuese en los pacientes jóvenes y de bajo riesgo quirúrgico, con poca o ninguna interferencia en el conducta perioperatoria. Los exámenes laboratoriales estándares no son buenos instrumentos de screening de enfermedades y pueden generar gastos elevados e innecesarios.


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Diagnostic Tests, Routine , Elective Surgical Procedures , Minor Surgical Procedures , Preoperative Care , Cross-Sectional Studies , Prospective Studies , Risk Assessment
SELECTION OF CITATIONS
SEARCH DETAIL