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1.
Medicentro (Villa Clara) ; 28(1)mar. 2024.
Article in Spanish | LILACS | ID: biblio-1550548

ABSTRACT

Introducción: La capacitación es, sin duda, uno de los temas actuales más importantes cuando se habla de competitividad, innovación y mejora continua de una empresa. Este proceso implica: detección de necesidades, planeación, implementación, evaluación, retroalimentación y seguimiento de resultados. El eje fundamental de este proceso es el Diagnóstico de Necesidades de Capacitación, pues señala de manera precisa los aspectos sobre los cuales ha de trabajar el capacitador. Objetivo: Realizar un diagnóstico de las necesidades de capacitación de los asistentes de farmacia del Municipio Santa Clara. Métodos: Para elaborar el Diagnóstico de Necesidades de Capacitación se utilizó el método comparativo. Este método se basa en la identificación de las discrepancias entre lo que es y lo debe ser, lo que posibilita constatar los requisitos que son necesarios cubrir. Se utilizaron como técnicas la entrevista y la encuesta. Resultados: Finalmente, después del análisis de todos los datos obtenidos de las matrices y preguntas abiertas, se elaboró el Diagnóstico de Necesidades de Capacitación final que se entregó a la Empresa Farmacias y Ópticas. Conclusiones: Estos resultados mostraron que esta empresa necesita de manera inmediata implementar actividades de capacitación a sus asistentes de farmacia en lo referente a conocimientos.


Introduction: training is, undoubtedly one of the most important current issues when talking about competitiveness, innovation and continuous improvement of a company. This process involves: detection of needs, planning, implementation, evaluation, feedback and monitoring of results. The fundamental axis of this process is the Diagnosis of Training Needs, since it indicates precisely the aspects on which the trainer must work. Objective: to carry out a diagnosis of the training needs in pharmacy assistants from Santa Clara municipality. Methods: the comparative method was use to prepare the Training Needs Diagnosis. This method is based on the identification of discrepancies between what is and what should be; it made possible to verify the necessary requirements to be met. Interviews and surveys were used as techniques. Results: Finally, after analyzing all the data obtained from the matrices and the open questions, a final Diagnosis of Training Needs was prepared and delivered to the Pharmacy and Optics Company. Conclusions: these results showed that this company needs to immediately implement training activities for their pharmacy assistants in terms of knowledge.


Subject(s)
Diagnosis , Pharmacy Technicians , Inservice Training
2.
Rev. colomb. cir ; 39(2): 231-244, 20240220. fig, tab
Article in Spanish | LILACS | ID: biblio-1532579

ABSTRACT

Introducción. Los datos epidemiológicos de la diverticulitis en Colombia son limitados. El objetivo de este artículo fue caracterizar una población que ingresó con diverticulitis aguda al Hospital Universitario San Vicente Fundación, un centro de referencia de la ciudad de Medellín, Colombia, para analizar la presentación y comportamiento de la enfermedad en la población local, con estadísticas propias y desenlaces de la enfermedad en los últimos años. Métodos. Estudio observacional retrospectivo, descriptivo, entre enero de 2015 y diciembre de 2019. Se hizo un estudio exploratorio uni-, bi- y multivariado de factores de riesgo para fallo en el tratamiento y la mortalidad. Resultados. Se incluyeron 103 pacientes. Se presentó principalmente en mujeres y la edad promedio fue de 65 años. La diverticulitis Hinchey Ia fue la más frecuente (41,7 %) y el manejo médico fue exitoso en todos los casos, mientras que en las tipo III y IV, todos se manejaron de forma quirúrgica, con tasas de éxito entre el 50 y el 64 %. La presencia de signos de irritación peritoneal al examen físico, el recuento de leucocitos y la PCR, el ingreso a la Unidad de Cuidados Intensivos y la mortalidad aumentaron de forma directamente proporcional con el estadio de Hinchey. Conclusiones. Existe una relación directamente proporcional entre la clasificación de Hinchey y los signos de respuesta inflamatoria clínicos y paraclínicos, la necesidad de manejo quirúrgico, la estancia en la Unidad de Cuidados Intensivos y la mortalidad.


Introduction. Epidemiological data on diverticulitis in Colombia are limited. The objective of this article was to characterize a population that was admitted with acute diverticulitis to the San Vicente Fundación University Hospital, a reference center in the city of Medellín, Colombia, to analyze the presentation and behavior of the disease in the local population, with its own statistics, and outcomes of the disease in recent years. Methods. Retrospective descriptive observational study between January 2015 and December 2019. An exploratory uni-, bi- and multivariate study of risk factors for treatment failure and mortality was performed. Results. A total of 103 patients were included. The most frequent Hinchey classification was Ia (41.7%). It occurs mainly in women, mean age 65 years. Hinchey Ia diverticulitis is the most frequent and medical management is successful in 100% of cases; while in III and IV, 100% were managed surgically with success rates between 50 and 64%. The presence of peritoneal signs on physical examination, leukocyte count and CRP, ICU admission and mortality increased directly proportional with Hinchey stage. Conclusions. There is a directly proportional relationship between Hinchey staging with clinical and paraclinical signs of inflammatory response, need for surgical management, ICU stay and mortality.


Subject(s)
Humans , Diverticulitis , Diverticulum, Colon , Diverticular Diseases , Diverticulosis, Colonic , Diagnosis , Conservative Treatment
4.
Health sci. dis ; 25(2 suppl 1): 48-52, 2024. tables, figures
Article in French | AIM | ID: biblio-1526746

ABSTRACT

Introduction. La tuberculose est dite multifocale (TMF) lorsqu ́il y a l ́atteinte d ́au moins deux sites extra pulmonaires non contigus associée ou non à une atteinte pulmonaire. Cette étude avait pour but d'étudier les aspects épidémiologiques, diagnostics et évolutifs de la TMF au service de pneumo-phtisiologie du CHU-RN de N'Djamena. Matériels et méthode. Il s'agissait d'une étude rétrospective à visée descriptive de 5 ans allant de janvier 2018 à décembre 2022. Les variables étudiées étaient, épidémiologiques, cliniques et évolutives. Résultats. Au total, 185 patients étaient inclus sur 2001 cas de tuberculose, soit une fréquence de 9,24%. L'âge moyen était de 34,1 ans avec des extrêmes de 16 ans et 75 ans. Le sex-ratio était de 1,28. Les patients sans-emploi étaient majoritaire soit 47% des cas. La notion de contage tuberculeux représentait 13,5% des cas, et 66,5% des patients étaient vaccinés au BCG avec une séroprévalence VIH de 54,6%. Tous les signes habituels de la tuberculose étaient présents. La localisation pulmonaire était la plus représentée (66,2%) suivie de la localisation ganglionnaire (48,6%). Dans 80% des cas, la localisationétait bifocale. La mortalité était de 21,6% pour un séjour moyen d'hospitalisation de 20,26 jours. Conclusion. La tuberculose multifocale est une forme rare et grave, qui survient généralement chez les patients infectés par le VIH, mais le sujet immunocompétent peut être aussi touché. Un traitement antituberculeux doit être instauré le plus rapidement possible afind'éviter les complications


Introduction. Tuberculosisis called multifocal (TMF) when there is involvement of at least two non-contiguous extrapulmonary sites, whether or notassociated with pulmonary involvement. This study aimed to study the epidemiological, diagnostic and evolutionary aspects of FMT in the pneumo-phthisiology department of the CHU-RN of N'Djamena. Materials and method. This was a 5-year retrospective study with a descriptive aim from January 2018 to December 2022. The variables studied were epidemiological, clinical and progressive. Results. In total, 185 patients were included out of 2001 cases of tuberculosis, i.e. a frequency of 9.24%. The average age was 34.1 years with extremes of 16 and 75 years. The sex ratio was 1.28. Unemployed patients were the majority, i.e. 47% of cases. The notion of tuberculosis contagion represented 13.5% of cases, and 66.5% of patients were vaccinated with BCG with an HIV seroprevalence of 54.6%. All the usual signs of tuberculosis were present. The pulmonary location was the most represented (66.2%) followed by the lymph node location (48.6%). In 80% of cases, bifocal localization. Mortality was 21.6% for an average hospital stay of 20.26 days. Conclusion.Multifocal tuberculosis is a rare and serious form, which generally occurs in patients infected with HIV, but immunocompetent subjects can also be affected. Anti-tuberculosis treatment must be started as quickly as possible to avoid complications.


Subject(s)
Tuberculosis , Disease Progression , Tuberculosis, Extrapulmonary , Epidemiology , Diagnosis
5.
Health sci. dis ; 25(2 suppl 1): 42-47, 2024. tables, figures
Article in French | AIM | ID: biblio-1526872

ABSTRACT

Introduction. La fréquence, la présentation et le devenir de cardiomyopathie du peripartum (CMPP) varient considérablement dans le monde. Au Niger, les données sont inexistantes d'où le but de notre étude qui était de préciser les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de la cardiomyopathie du peripartum (CMPP). Méthodologie. Il s'agit d'une étude rétrospective concernant les patientes hospitalisées pour CMPPau pôle de Cardiologie de l'Hôpital National de Niamey du 01/01/2019 au 31/12/2019. Les facteurs de risque et les aspects épidémiologiques, cliniques, paracliniques, diagnostiques, thérapeutiques et évolutifs ont été étudiés. Résultats. La prévalence hospitalière de la CMPP était de 3,83%. L'âge moyen était de 27,4 ans (extrêmes de 16 et 45 ans). La multiparité a été rapportée chez 79 % des patientes contre 21% qui étaient primipares. La dyspnée était le signe le signe fonctionnel rapporté chez toutes les patientes. Les anomalies échocardiographiques les plus fréquentes étaient l'HVG (75%) et L'HAG (45,83%). L'hypocinésie était diffuse dans 100% des cas. L'altération de la fraction d'éjection du ventricule du ventricule gauche (FEVG) était moyenne dans 50%. Toutes les patientes ont ont eu comme traitement des bétabloquants, des diurétiques et des IEC. L'évolution a été favorable dans 87,5 % des cas. Les principaux facteurs pronostiques péjoratifs étaient la multiparité (79%) une fraction d'éjection du ventricule inférieure à (FEVG)


Introduction. The frequency, presentation and outcome of peripartum cardiomyopathy (PCM) vary considerably throughout the world. In Niger, data are non-existent, hence the aim of our study, which was to clarify the epidemiological, diagnostic, therapeutic and evolutionary aspects of peripartum cardiomyopathy (PPCM). Methodology. This is a retrospective study concerning patients hospitalized for CMPPat the Cardiology pole of the National Hospital of Niamey from 01/01/2019 to 31/12/2019. Risk factors and epidemiological, clinical, paraclinical, diagnostic, therapeutic and evolutionary aspects were studied. Results. The hospital prevalence of CMPP was 3.83%. The mean age was 27.4 years (extremes 16 and 45 years). Multiparity was reported in 79% of patients versus 21% who were primiparous. Dyspnea was the functional sign reported in all patients. The most frequent echocardiographic abnormalities were LVH (75%) and GAH (45.83%). Hypokinesia was diffuse in 100% of cases. Impaired left ventricular ejection fraction (LVEF) was moderate in 50%. All patients were treated with beta-blockers, diuretics and ACE inhibitors. Progression was favorable in 87.5% of cases. The main pejorative prognostic factors were multiparity (79%) lower ventricular ejection fraction (LVEF)


Subject(s)
Humans , Female , Peripartum Period , Cardiomyopathies , Epidemiology , Diagnosis
6.
Ibom Medical Journal ; 17(1): 56-61, 2024.
Article in English | AIM | ID: biblio-1552049

ABSTRACT

Background:Methicillin resistant S. aureus(MRSA) has become a major public health predicament worldwide. This is owing to its involvement in the evolution of MDR strains and difficulty in therapeutic management of infected patients. This study was conducted to investigate the prevalence of methicillin resistance Staphylococcus aureusamong patients in two health facilities in Akwa Ibom State, Nigeria.Materials and Methods:Clinical isolates of patients from University of Uyo Teaching Hospital (UUTH), Uyo and General Hospital, Ikot Abasi (GHIA) were investigated based on the strategic location of the hospitals. The study design was a descriptive cross-sectional study. Three hundred clinical samples were collected from male and female in and out-patients of all ages and processed using standard bacteriological methods. Detection of Staphylococcus aureusand MRSAstrains were done according to standard protocols while antibiotic susceptibility testing of MRSAisolates was conducted using Kirby-Bauer disc diffusion method and interpreted following the CLSI 2021 guidelines. Results:The prevalence of MRSAstrains in this study was 42.9%. Majority of patients with MRSAwere from UUTH (44%) closely followed by patients from GHIA(40%). High antibiotics resistant rates of MRSAwere recorded for ampicillin (96.6%), ciprofloxacin (73.3%), erythromycin (63.3%) and cotrimoxazole (60%). Gentamicin and ceftriaxone sensitivity rates were 53.3% and 63.4%, respectively. Conclusion:Health facilities in the state should institute effective antimicrobial stewardship, intensify surveillance and screening of Staphylococcus aureusfor MRSAstrains to guard against dissemination of multidrug resistant strains in both hospital and community settings because of the clinical implications.


Subject(s)
Staphylococcus aureus , Prevalence , Methicillin-Resistant Staphylococcus aureus , Therapeutics , Clindamycin , Diagnosis , Health Facilities
7.
AlQalam Journal of Medical and Applied Sciences ; 7(2): 213-221, 2024. figures, tables
Article in English | AIM | ID: biblio-1552710

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by a novel strain of coronavirus belonging to the genus Beta coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as a major pandemic worldwide. This contagious virus had spread in many different forms, and patients have demonstrated a wide range of symptoms, ranging from moderate to severe illness. This study aims to highlight the important associations between SARS-CoV-2 infection, vaccination, and possible complications at the Libyan International Medical University, Benghazi. This crosssectional survey was conducted among students and their families at Libyan International Medical University in Benghazi, Libya. Among the 100 participants, 72% were between the ages of 18 and 39. Up to (59%) of participants were men. As for the infection with COVID-19, 77% of participants were infected. Most of the participants had no chronic diseases (69%); however, the most common chronic disease was diabetes mellitus (13%). 82% of participants were vaccinated; the most common types of vaccines administered were Sinopharm and Sputnik V (24%). Following vaccination, 71% of participants had no COVID-19 infection, while 29% did get the infection. Regarding this study, after COVID-19 infection, 66% of participants had no complications; however, 17% had pulmonary complications, which was the most common complication among the participants. As for the complications following the vaccination, 81% of participants had none, while there were pulmonary and neurological complications in 7­6%. The results of the study showed that the most frequent complications noticed among the participants following the COVID-19 infection and vaccination were pulmonary and neurological complications.


Subject(s)
Humans , Male , Female , Polymerase Chain Reaction , Vaccination , Drug-Related Side Effects and Adverse Reactions , COVID-19 Vaccines , COVID-19 , Comorbidity , Diagnosis , Pandemics
8.
AlQalam Journal of Medical and Applied Sciences ; 7(1): 74-81, 2024. figures, tables
Article in English | AIM | ID: biblio-1553175

ABSTRACT

Polycystic ovarian syndrome (PCOS) is the most common heterogenic endocrine illness in women of reproductive age, caused mostly by an excess of androgen and ovarian dysfunction. The present study was carried out to estimate the prevalence of PCOS among Libyan women who attended infertility center Tripoli, Libya, from 2020-2022, evaluate hormonal profile, Body Mass Index, weight and west circumferential before and after treatment and diet management. A longitudinal cross-sectional study conducted in the Tripoli Fertility Center in Tripoli, Libya, the study population targeting output Libyan female patients who presented to the gynecology and obstetrics (OPD) department and therapeutic nutrition department. Data Retrospectively collected from 2020 until 2022 and diagnosed using Rotterdam's criteria. A total of 603 patients visited the gynecology and obstetrics department and the therapeutic nutrition department between January 2020 and December 2022. Out of which 174 women in the PCOS group and 429 in the non-PCOS group. The prevalence of PCOS was 29.56% in 2020, 37.5% in 2021, and 20.27% in 2022. The mean age of PCOS was 34.90 ± 5.5 SD, and all of the PCOS group were married. Worth to mention that all of PCOS cases was insulin resistance type. In terms of weight in the PCOS group, 19.54% were obese BMI >29, 68.96% were morbid obese with BMI >35, and approximately 68.39% of waist circumference measurements were more than 88cm. Hirsutism and oligomenorrhea were the major clinical features, morbid obese seems to be more prevalent in Libyan PCOS patients, low carbohydrate diet and physical activities may play an important role in PCOS management


Subject(s)
Humans , Female , Polycystic Ovary Syndrome , Obstetrics and Gynecology Department, Hospital , Disease Management , Diagnosis
9.
Afr J Pharm Res Dev (AJOPRED) ; 16(1): 39-49, 2024. figures, tables
Article in English | AIM | ID: biblio-1553329

ABSTRACT

The burden of epilepsy in developing countries made medicinal plants like Xylopia aethiopica fruit; Khaya grandifoliola, Alstonia boonei etc an alternative source in epilepsy management in the south-western part of Nigeria. The aim of the study was to provide pharmacological rationale for the ethnomedicinal use of the plants in epilepsy management. The oral medial lethal dose of methanol stem bark extracts of Alstonia boonei (MEAB) and Khaya grandifoliola (MEKG) and methanol fruit extract of Xylopia aethiopica (MEXAF) were done in accordance with the Organization for Economic Cooperation Development guideline. Quantitative and qualitative phytochemical profiling of the extracts was done. Anticonvulsant screening was carried out on the extracts (doses: 75, 150 and 300 mg/kg) using the pentylenetetrazole (PTZ)-induced seizure and maximum electroshock tests (MEST). Results showed that the MEXAF has the highest amount of phytochemicals except for saponins in MEKG; and MEAB with the least amount (but higher alkaloid) than MEKG. The TLC showed different bands of spots of the extracts. In the PTZ test, MEXAF showed 100 % protection against mortality at 300 mg/kg; MEAB with 66.67 % protection at 75 mg/kg and MEKG 0 % protection. MEAB, MEKG and MEXAF nonsignificantly increased the onset of seizure and latency to death. In the MEST, MEXAF, MEKG and MEAB at 75 mg/kg protected 50, 33.3 and 16.67% of the animals against tonic hind limb extension respectively and nonsignificantly (p˃0.05) decreased the recovery time at a dose of 75 mg/kg. It was concluded that the extracts possess anticonvulsant activities hence, the pharmacological credence for the ethnomedicinal use of these plants in treating epilepsy.


Subject(s)
Seizures , Plant Extracts , Alstonia , Diagnosis , Epilepsy , Xylopia , Anticonvulsants , Plants, Medicinal , Prevalence , Meliaceae , Phytochemicals
10.
Acta neurol. colomb ; 39(4)dic. 2023.
Article in Spanish | LILACS | ID: biblio-1533515

ABSTRACT

Propósito: La neuropatía periférica tiene un espectro clínico inespecífico y multifactorial, con frecuente subdiagnóstico y terapéutica de eficacia variable. Existe una heterogénea prescripción de vitaminas B, las cuales pueden desempeñar un rol importante en el manejo de diferentes neuropatías; sin embargo, en Colombia no existen guías clínicas al respecto. El propósito de este trabajo es orientar en el reconocimiento temprano de las neuropatías periféricas y generar recomendaciones sobre el uso adecuado de vitaminas B neurotrópicas. Descripción de la metodología: Acuerdo de expertos sobre la neuropatía periférica y el rol terapéutico de las vitaminas B con énfasis en la epidemiología en Colombia, diagnóstico y tratamiento. Contenidos: En Colombia, la prevalencia de neuropatía periférica se estima cercana al 10 %, sin embargo, no hay datos recientes. Dentro de las etiologías más frecuentes se encuentran la neuropatía diabética, infecciosa, inflamatoria, carenciales, toxica y farmacológica. Se recomiendan las siguientes herramientas de tamizaje en población de riesgo: DN4, MNSI, test de monofilamento, test de vibración y valoración de reflejos. Las vitaminas B1, B6 y B12 son seguras, accesibles y pueden ser eficaces en neuropatía periférica, incluso cuando el déficit no ha sido demostrado, pero con requerimientos particulares en su administración conjunta. Conclusiones: Las neuropatías periféricas son un reto diagnóstico y terapéutico que requiere la identificación oportuna para el tratamiento de la etiología subyacente y el control de síntomas. El uso de vitaminas B neurotrópicas es efectivo y seguro en neuropatía periférica carencial, y también parece ser eficaz en el manejo de neuropatías periféricas de diferentes etiologías.


Purpose: Peripheral neuropathy has a nonspecific and multifactorial clinical spectrum, with frequent underdiagnosis and therapeutics of variable efficacy. There is a high but heterogeneous prescription of B vitamins, which can play an important role in the management of different neuropathies; however, in Colombia there are no clinical guidelines in this regard. The purpose of this article is to guide the early recognition of peripheral neuropathy and generate recommendations on the proper use of neurotropic B vitamins. Description of the methodology: Expert agreement on peripheral neuropathy and the therapeutic role of B vitamins with emphasis on epidemiology in Colombia, diagnosis and treatment. Contents: In Colombia, there are no recent data to estimate the prevalence of peripheral neuropathy; the main etiologies are: diabetes mellitus, nutritional deficiencies, herpes zoster and neuropathies due to chemotherapy. Given risk factors in the anamnesis, the use of DN4, MNSI, monofilament test, vibration test and assessment of reflexes is recommended. Vitamins B1, B6, and B12 are safe and can be effective in peripheral neuropathy, even when the deficit has not been demonstrated, but with special requirements in their joint administration. Conclusions: peripheral neuropathies are a diagnostic and therapeutic challenge, and require timely identification, for the treatment of the underlying etiology and symptom control. The use of neurotropic B vitamins is effective and safe in deficient peripheral neuropathy, and also appears to be effective in the management of peripheral neuropathies of different etiologies.


Subject(s)
Vitamin B 12 , Peripheral Nervous System Diseases , Diabetic Neuropathies , Diagnosis , Pyridoxine , Pain Management
11.
Ludovica pediátr ; 26(2): 39-45, dic.2023. ilus
Article in Spanish | LILACS | ID: biblio-1531137

ABSTRACT

La palabra "miasis" proviene del griego, "myia" que significa mosca. La enfermedad corresponde a los daños causados por la invasión de larvas de moscas a tejidos del hombre u otros vertebrados


The term 'Myiasis' originates from the ancient Greek word 'myia', meaning 'fly'. This disease refers to tissue damage caused by the infestation of fly larvae in humans or other vertebrates


Subject(s)
Screw Worm Infection , Myiasis , Child , Diagnosis
12.
Acta neurol. colomb ; 39(3)sept. 2023.
Article in Spanish | LILACS | ID: biblio-1533498

ABSTRACT

Introducción: La epilepsia del lóbulo temporal mesial se considera la más frecuente de las epilepsias focales, con signos y síntomas característicos que ayudan a definir su diagnóstico. Contenidos: Dentro de su historia natural, las crisis pueden iniciar en los primeros años de vida, usualmente como episodios febriles con un periodo de remisión, para reaparecer en la adolescencia o en el adulto joven. La presentación electroencefalográfica tiene un patrón característico, con aparición de puntas y ondas agudas interictales en la región temporal anterior, por lo general unilaterales, y con actividad ictal generalmente theta en la misma localización. La causa más frecuente es la esclerosis del hipocampo. El tratamiento con medicamentos anticrisis puede controlar la epilepsia, aunque algunos casos pueden evolucionar a la farmacorresistencia, en la cual la cirugía de epilepsia está indicada, y tiene buenos resultados. Conclusiones: Esta revisión se centra en la descripción de las características electroclínicas de la epilepsia temporal mesial, para hacer un diagnóstico temprano e iniciar un tratamiento adecuado, a efectos de lograr un mejor pronóstico y una mejor calidad de vida para los pacientes con epilepsia y sus familiares.


Introduction: Mesial temporal lobe epilepsy is considered the most common of the focal epilepsies, with characteristic signs and symptoms that help define its diagnosis. Contents: In the natural history of the disease, seizures can begin in the first years of life, usually as febrile seizures with a period of remission, to reappear in adolescence or in the young adult. The electroencephalographic presentation has a characteristic pattern with the appearance of interictal sharp waves and spikes in the anterior temporal region, usually unilateral, and with generally theta ictal activity in the same location. The most common cause is hippocampal sclerosis. Treatment with antiseizure medication can control epilepsy. However, in some cases evolution of drug resistance can occur, leading to epilepsy surgery as the most appropriate treatment, based on its good results. Conclusions: This review focuses on the description of the electroclinical characteristics of temporal mesial epilepsy, in order to make an early diagnosis and adequate treatment, thus providing a better prognosis and quality of life for patients with epilepsy and their families.


Subject(s)
Quality of Life , Seizures, Febrile , Diagnosis , Epilepsy, Temporal Lobe , Patients , Prognosis , Sclerosis , Review , Natural History
13.
Rev. Ciênc. Saúde ; 13(3): 3-9, 20230921.
Article in English, Portuguese | LILACS | ID: biblio-1510411

ABSTRACT

A fibromialgia é uma condição crônica de etiologia desconhecida e desvinculada de marcadores laboratoriais específicos para diagnóstico, devido à pobre caracterização da etiopatogenia. Em geral, as alterações comuns à fibromialgia também são observadas em outras condições de dor crônica, tornando a patogênese controversa entre diferentes condições patológicas. A etiologia desconhecida dificulta o diagnóstico e, consequentemente, repercute em um tratamento não tão eficaz de pacientes com fibromialgia. A restauração de desordens sistêmicas confere amplo espectro de possibilidades terapêuticas com potencial de orientar profissionais a estabelecer metas e métodos de avaliação. Diante disso, essa revisão narrativa se volta para debater hipóteses etiológicas e fisiopatológicas no desenvolvimento da fibromialgia.


Fibromyalgia is a chronic condition of unknown etiology unrelated to specific laboratory markers for diagnosis because of poor etiopathogenesis. In general, the changes common to fibromyalgia are also seen in other chronic pain conditions, making the pathogenesis controversial among different pathological conditions. The unknown etiology makes the diagnosis difficult and consequently has repercussions on a not so effective treatment of patients with fibromyalgia. The restoration of systemic disorders provides a wide spectrum of therapeutic possibilities with the potential to guide professionals in establishing goals and evaluation methods. Therefore, this narrative review discusses the etiological and pathophysiological hypotheses involved in the development of fibromyalgia.


Subject(s)
Humans , Female , Signs and Symptoms , Diagnosis
14.
Biomédica (Bogotá) ; 43(Supl. 1): 20-31, ago. 2023. graf
Article in Spanish | LILACS | ID: biblio-1533887

ABSTRACT

La histoplasmosis es una micosis endémica en Colombia. Se presentan dos casos del departamento del Cauca, para mostrar el impacto clínico que conlleva un retraso en su diagnóstico y tratamiento. Se obtuvo el consentimiento informado para revisar las historias clínicas de los pacientes y publicar los casos. El primer caso se trata de un paciente con infección por el virus de inmunodeficiencia humana (Human Immunodeficiency Virus, HIV), quien presentaba lesiones cutáneas generalizadas atribuidas inicialmente al virus del herpes; post mortem y mediante el cultivo para hongos de muestras de las lesiones dérmicas, se confirmó el diagnóstico de histoplasmosis. El segundo caso es un paciente inmunocompetente con sintomatología pulmonar, a quien se le diagnosticó tuberculosis clínicamente y se le instauró tratamiento; sin embargo, ante la nula mejoría y teniendo en cuenta el antecedente de ingreso a una cueva de murciélagos, se enfocó como una posible histoplasmosis pulmonar y se obtuvo mejoría con el tratamiento. Se revisó la literatura sobre las pruebas de laboratorio y los datos epidemiológicos de histoplasmosis que deben considerar los profesionales de la salud. Se concluyó que las instituciones de salud deben disponer de pruebas rápidas (por ejemplo, antigénicas) para el diagnóstico y tratamiento adecuado de esta micosis, además de adoptar los correctivos necesarios para minimizar la exposición a Histoplasma.


Histoplasmosis is an endemic mycosis in Colombia. Here we present two cases in the Cauca department, to indicate the clinical impact of histoplasmosis delayed diagnosis and treatment when its epidemiology is unknown. Informed consent was requested to review patients' medical records and case report publication. The first case was a patient diagnosed with human immunodeficiency virus and generalized presence of skin lesions. Initially, these lesions were diagnosed as herpes, but a postmortem diagnosis confirmed histoplasmosis through fungal cultures of tissues from the skin lesions. The second case is an immunocompetent patient with pulmonary symptoms diagnosed and treated for tuberculosis. However, given the lack of improvement and considering the bat cave entrance history, the patient was treated for possible pulmonary histoplasmosis with an adequate response. We made a review of laboratory tests and histoplasmosis epidemiological data relevant to health professionals. We concluded that health institutions must provide rapid tests, such as antigen ones, to adequately diagnose and treat this mycosis; and also take corrective measures to minimize exposure to Histoplasma.


Subject(s)
Histoplasmosis , Public Health , Acquired Immunodeficiency Syndrome , HIV , Diagnosis
15.
Rev. bras. ortop ; 58(4): 580-585, July-Aug. 2023. tab, graf
Article in English | LILACS | ID: biblio-1521795

ABSTRACT

Abstract Objective The study aimed to compare whether the diagnoses of orthopedic diseases at telemedicine (TM) consultations are the same as those established at face-to-face visits. Method Primary, observational, prospective, analytical study, with subjects from the local municipal network who were referred to the orthopedics outpatient clinic from May to June 2021. Subjects underwent two assessments: a telemedicine (TM) consultation and a face-to-face (FF) visit. Two different physicians attended to the patients and established a diagnosis. The physician performing the FF visit was not aware of the previous diagnoses. We compared the diagnoses obtained at both modalities to assess the degree of similarity. In addition, we determined the time required for consultations and the degree of satisfaction of the physicians. Results We evaluated 43 patients and seven physicians, totaling 44 TM and 43 FF visits. The diagnostic similarity index was 81.4%. TM consultations were shorter (mean time, 4.8 minutes) than FF visits. Physicians were less satisfied with TM in the four criteria evaluated (respective scores of 79.1, 23.3, 46.6, and 37.2). Conclusion TM consultations have a diagnoses agreement higher than 80% compared with FF visits. On the other hand, TM consultations were faster, and physicians were less satisfied with them in comparison with FF visits.


Resumo Objetivo O objetivo do estudo foi comparar se os diagnósticos das doenças ortopédicas realizados por teleconsulta (TC) são os mesmos dos atendimentos presenciais. Método Estudo primário, observacional, prospectivo, analítico, com dados colhidos de maio a junho de 2021, com participantes provenientes da rede municipal local que foram encaminhados ao ambulatório de ortopedia de referência e oferecida participação no estudo com duas avaliações: a primeira por teleatendimento e a segunda de forma presencial. Cada participante foi atendido por dois diferentes profissionais, e cada um emitiu um diagnóstico. Os profissionais do atendimento presencial não conheciam os diagnósticos prévios. Os diagnósticos emitidos foram comparados para avaliar o grau de semelhança. Ainda, foi aferido o tempo para realização dos atendimentos e o grau de satisfação do profissional participante. Resultados Foram avaliados 43 pacientes e 07 profissionais participaram, totalizando 44 TC e 43 atendimentos presenciais. O índice de semelhança do diagnóstico foi de 81,4%. A TC teve um tempo menor para realização (média de 4,8 minutos), que o presencial. A satisfação dos profissionais foi menor na TC nos quatro critérios avaliados, sendo, respectivamente, 79,1, 23,3, 46,6 e 37,2. Conclusão A TC tem concordância no diagnóstico superior a 80% em comparação ao atendimento presencial. Já a realização do teleatendimento teve menor tempo de duração e os profissionais se consideraram menos satisfeitos em relação ao atendimento presencial.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Orthopedics/trends , Remote Consultation , Diagnosis , Treatment Adherence and Compliance
16.
RECIIS (Online) ; 17(2): 372-386, abr.-jun.,2023.
Article in Portuguese | LILACS | ID: biblio-1438490

ABSTRACT

A idade avançada é um dos fatores de risco para o desenvolvimento do câncer de mama. O objetivo deste estudo é apresentar a situação epidemiológica e o acesso ao diagnóstico do câncer de mama entre idosas nas regiões do Brasil. O estudo é descritivo e compreende o período entre 2000 a 2019. Analisam-se indicadores de mortalidade, morbidade e acesso ao diagnóstico. A qualidade da informação da mortalidade foi analisada pelo indicador 'óbitos com causa básica mal definida'. Segundo os resultados, a maioria dos óbitos foi prematura. As regiões Sul e Sudeste tiveram as maiores taxas de mortalidade por câncer de mama. Nas regiões Norte e Nordeste, há maior subnotificação de óbitos devido à qualidade das informações sobre mortalidade. Conclui-se que as idosas devem ser consideradas nas ações e nos programas sobre câncer de mama e que se deve aumentar o acesso ao diagnóstico das idosas


Advanced age is one of the risk factors for developing breast cancer. The aim of this study is to present the epidemiological situation and the access to breast cancer diagnosis among older people in the regions of Brazil. The study is descriptive and covers the period between 2000 and 2019. Indicators of mortality, morbidity and access to diagnosis are analyzed. The quality of information on mortality was assessed using the indicator 'deaths with an ill-defined underlying cause'. According to the results, most deaths were pre-mature. The South and Southeast regions had the highest mortality rates from breast cancer. In the North and Northeast regions, there is a greater underreporting of deaths due to the quality of information on mortality. It is concluded that the elderly should be considered in actions and programs on breast cancer and that access to diagnosis for the elderly should be expanded


La edad avanzada es uno de los factores de riesgo para desarrollar cáncer de mama. El objetivo de este estudio es presentar la situación epidemiológica y el acceso al diagnóstico de cáncer de mama entre mujeres ancianas en las regiones de Brasil. El estudio es descriptivo y abarca el período comprendido entre 2000 y 2019. Se analizan indicadores de mortalidad, morbilidad y acceso al diagnóstico. La calidad de la infor-mación sobre mortalidad se evaluó mediante el indicador 'muertes con causa subyacente mal definida'. Según los resultados, la mayoría de las muertes fue prematura. Las regiones Sur y Sudeste presentaron las mayores tasas de mortalidad por cáncer de mama. En las regiones Norte y Nordeste, existe un mayor sub-registro de muertes debido a la calidad de la información sobre mortalidad. Se concluye que los ancianos deben ser considerados en las acciones y programas sobre el cáncer de mama y que debe ampliarse el acceso al diagnóstico de los ancianos


Subject(s)
Humans , Women , Breast Neoplasms , Comprehensive Health Care , Aged , Morbidity , Mortality , Diagnosis
17.
San Salvador; MINSAL; mayo, 05, 2023. 106 p. ilus, graf.
Non-conventional in Spanish | BISSAL, LILACS | ID: biblio-1435420

ABSTRACT

El trabajo desarrollado en los laboratorios, es importante no solo por su rol en el diagnóstico de las enfermedades transmisibles como la tuberculosis, sino también en el control de la evolución del tratamiento de los pacientes, así como la evaluación epidemiológica y operacional. Tiene como función principal, la detección de fuentes de infección tuberculosa a través de métodos como pruebas moleculares, cultivo, baciloscopia y prueba de flujo lateral para lipoarabinomanano (LF-LAM). La elección de la técnica más conveniente y su estandarización permite la obtención de resultados comparables a lo largo de todo el país, además de facilitar la capacitación, así como la ampliación de la cobertura. El propósito de los presentes lineamientos, es proporcionar al personal de laboratorio clínico del Sistema Nacional Integrado de Salud (SNIS) y de otras instituciones prestadoras de servicios de salud, información sobre los procedimientos técnicos aplicables para el diagnóstico bacteriológico de la tuberculosis


The work carried out in the laboratories is important not only for its role in the diagnosis of communicable diseases such as tuberculosis, but also in the control of the evolution of the treatment of patients, as well as the epidemiological and operational evaluation. Its main function is to detect sources of tuberculosis infection through methods such as molecular tests, culture, bacilloscopy and lateral flow test for lipoarabinomanan (LF-LAM). The choice of the most appropriate technique and its standardization allows for comparable results throughout the country, in addition to facilitating training, as well as expanding coverage. The purpose of these guidelines is to provide clinical laboratory staff with


Subject(s)
Humans , Tuberculosis , Diagnosis , Laboratories, Clinical , Patients , Communicable Diseases , El Salvador , Infections , Laboratories
18.
Rev. méd. hered ; 34(2): 83-91, abr. 2023. graf, tab
Article in Spanish | LILACS, LIPECS | ID: biblio-1515441

ABSTRACT

Objetivo: Determinar la frecuencia y describir las características de referencias injustificadas, en base a diagnósticos no pertinentes, enviadas al servicio de consulta externa adultos de un hospital de tercer nivel. Material y métodos: Estudio transversal, observacional y descriptivo, realizado en el Hospital Cayetano Heredia (HCH) en el periodo abril a diciembre del 2019. Se utilizaron los datos del aplicativo "REFCON" con una población de 99 891 referencias. Para la variable "justificación de la referencia", se utilizó un listado de diagnósticos que no deberían derivarse a hospitales de la DIRIS Lima Norte. Adicionalmente, se estudiaron las variables de edad, sexo, grupo etario, especialidad de destino, categoría del EESS de origen, distrito de origen, y diagnóstico del grupo de referencias injustificadas. Se utilizó estadística descriptiva. Resultados: La frecuencia de referencias injustificadas fue de 8,4 %. El 34,2 % fue de pacientes adultos; el 65,8 %, de adultos mayores; y el 67 %, de pacientes mujeres Las especialidades con más referencias injustificadas fueron cardiología, geriatría, medicina interna, medicina familiar y neurología. Los diagnósticos injustificados más frecuentes fueron hipertensión esencial, lumbago no especificado y cefalea. Conclusiones: La frecuencia de referencias injustificadas al HCH por diagnósticos no pertinentes fue 8,4 %, tasa similar a otros dos estudios, pese a la emisión de una lista de diagnósticos que no deberían derivarse a hospitales de la DIRIS Lima Norte.


SUMMARY Objective: To determine the frequency and to describe the characteristics of unjustified ambulatory referrals bases on no pertinent diagnosis done at an adult outpatient clinic of a third level Peruvian hospital. Methods: A cross-sectional study was carried-out from April to December 2019 at Hospital Cayetano Heredia. Data were extracted from REFCON with a population of 99 891 referrals. To justify the reference, a list of diagnosis that does not require referral was used. In addition, variables such as age, sex, specialty of destination, category of EESS, district of origin and diagnosis of the unjustified referral. Descriptive statistics was used. Results: the frequency of unjustified referrals was 8.4%; 34.2% comprised the adult population; 65.8% were elder and 67% were female. Specialties with more unjustified referrals were geriatrics, internal medicine, family medicine and neurology. The most common unjustified diagnosis was essential hypertension, nonspecific low back pain and headache. Conclusions: Despite of socializing a list of unjustified referral diagnosis a frequency of 8,4% remain in this category, which is like results from two previous studies.


Subject(s)
Humans , Primary Health Care , Referral and Consultation , Diagnosis , Tertiary Care Centers
19.
Arq, bras psicol ; ;75(esp)30/03/2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1527385

ABSTRACT

O exame foi uma tecnologia disciplinar destacada por Michel Foucault desde os estudos realizados acerca do sistema carcerário. O exame se apresentou como um ponto de desvio nas reformas penais do século XVIII, conforme nos mostra Foucault, em que a lógica punitiva se afasta das propostas dos reformadores para voltar-se à correção dos infratores e ao controle das virtualidades. No Brasil, o denominado exame criminológico, instrumento de inserção do trabalho da psicologia no âmbito prisional, apresenta-se como a peça-chave dessa tecnologia de poder. Inserido na legislação nacional desde a Lei de Execuções Penais, datada de 1984, o exame criminológico se mantém resistente nas práticas penais e nas discussões legislativas, mesmo que tenha sido questionado em sua credibilidade e atestada, por pesquisas, a arbitrariedade das orientações presentes na prática dos laudos. Assim é que o presente artigo pretende fazer uma análise histórica e social da inserção do exame criminológico na legislação brasileira, assim como nas práticas judiciais, levando em consideração a permanência do instituto, mesmo após a retirada da previsão legal em 2003. A metodologia utilizada foi a análise do discurso com um viés pragmático e dialético, assim como utilizamos a pesquisa documental e qualitativa de leis e projetos de lei, além de pesquisa bibliográfica e análise comparativa.


Subject(s)
Psychoanalysis , Criminal Law , Diagnosis , Jurisprudence
20.
Rev. colomb. reumatol ; 30(1)mar. 2023.
Article in English | LILACS | ID: biblio-1536224

ABSTRACT

Introduction: Ultrasound is very useful in the management of rheumatological pathology today. Despite this, in Colombia, progress towards its implementation is limited and entails great difficulties. This deficit is also related to the difficulties in training new human talent. In Colombia, there is no study that identifies the current status of ultrasound among rheumatologists in the country. Methods: This is a descriptive cross-sectional study where medical specialists in Rheumatology practising in Colombia were surveyed through an online form. They were asked about general aspects and for their opinion regarding ultrasound in rheumatology and, if they practiced it, they were asked about specific aspects of its application in clinical practice. Additionally, questions were asked of the rheumatologists who are part of the specialist training processes in the country. Closed multiple-choice or Likert scale assessment questions were presented as required. The main objective was to describe the current use and opinion of musculoskeletal ultrasound in Colombian rheumatologists, as well as the limitations for its implementation. Frequency measurements were performed of the categorical variables of nominal type and ordinal type. The intention was to survey all rheumatologists in the country, who according to Colombian Society of Rheumatology data for the end of 2019 totalled 186. Results: Taking into account the number of rheumatologists of the Colombian Association of Rheumatology (Asoreuma) for 2019 totalling 186, a participation of 139 specialists (74.7%) was obtained, of which 22 of the respondents performed ultrasound in their daily practice (15.8%) the majority in this group being trained in Colombian territory (80.6%). Of the 139 respondents, 64.7% have received some type of training in ultrasound, generally pre-congress courses (22.5%), EULAR courses (16.7%) and training included in their residency curriculum outside the rheumatology service (9.8%). The acceptance of ultrasound is high among rheumatologists practicing in Colombia, 75.5% consider it important or very important and 84.9% indicated that for a comprehensive rheumatology service it is important or very important to have ultrasound. From the responses, however, they consider that its use could change their behaviour frequently, and very frequently in less than half of the cases at 46.7%. Regarding the opinion on the use of ultrasound in specific pathologies, rheumatoid arthritis (77.7%) and crystal arthropathies (72.7%) were considered the highest and most important, as well as in the performance of procedures at 87%. For decision-making in the inflammatory pathology study, 60.4% would consider performing ultrasound compared to 28.8% who responded MRI. Regarding the limitations for implementation, the lack of training in the country (25.6%), followed by the lack of resources to procure equipment (17.9%) and ignorance and lack of interest on the part of the health entities (17.1%) were the most recognized. Conclusion: Musculoskeletal ultrasound is only practiced by a minority of rheumatologists practicing in Colombia, even though the majority consider it important. Its importance lies in its use to treat patients with rheumatoid arthritis, crystal arthropathies and psoriatic arthropathy, as well as for the performance of procedures. More than half of the rheumatologists have received some type of training in ultrasound, usually very few hours' education and without practical or informal training, this being the main problem for its implementation.


Introducción: En la actualidad, la ecografía es de gran utilidad en el manejo de la patología reumatológica. A pesar de esto, en Colombia, los avances para su implementación son escasos y han enfrentado grandes dificultades. Este déficit también se encuentra relacionado con las complicaciones para la formación del nuevo talento humano. En Colombia no se dispone de ningún estudio en el que se identifique el estado actual de la ecografía entre los reumatólogos del país. Métodos: Se trata de un estudio descriptivo de carácter transversal en el cual se encuestó, por medio de un formulario on-line, a médicos especialistas en reumatología que hacen su práctica en el territorio colombiano. Se les preguntó acerca de los aspectos generales y su opinión sobre la ecografía en la reumatología, si la practicaban, como también en torno a los aspectos específicos de su aplicación en la práctica clínica. De manera adicional, se formularon preguntas dirigidas a aquellos reumatólogos que hacen parte de los procesos de capacitación de especialistas en el país; se presentaron preguntas cerradas de opción múltiple o de valoración por escala de Likert según se requirió. El objetivo principal fue describir el uso y la opinión actual sobre la ecografía musculoesquelética en reumatólogos colombianos, así como las limitantes para su implementación. A las variables categóricas de tipo nominal y de tipo ordinal se les hicieron medidas de frecuencia. Se pretendía encuestar a la totalidad de los reumatólogos en el país, los cuales, según información de la Asociación Colombiana de Reumatología (Asoreuma) de finales del 2019, eran 186. Resultados: De acuerdo con el número de reumatólogos proporcionado por la Asoreuma, de 186 especialistas en el año 2019, se obtuvo una participación de 139 de estos (74,7%), de los cuales 22 realizaban ecografía en su práctica diaria (15,8%), siendo este grupo en su mayoría formado en Colombia (80,6%). De los 139 encuestados, el 64,7% había recibido algún tipo de estudios en ecografía, generalmente cursos precongreso (22,5%), cursos de la Liga Europea Contra el Reumatismo (EULAR) (16,7%) y formación incluida en el pensum de su residencia fuera del servicio de reumatología (9,8%). La aceptación de la ecografía es alta entre los reumatólogos que ejercen en Colombia, el 75,5% la consideraron importante o muy importante. Asimismo, el 84,9% indicó que para un servicio de reumatología integral es importante o muy importante contar con ecografía. Sin embargo, los encuestados consideraron que su uso podría llegar a cambiar su conducta de manera frecuente, y muy frecuentemente en menos de la mitad de los casos (46,7%). Con respecto a la opinión sobre el uso de la ecografía en patologías específicas, se consideró con importancia y mucha importancia en artritis reumatoide (77,7%) y artropatías por cristales (72,7%), que fueron las más altas, así como para la realizaron de procedimientos (87%). Para la toma de decisiones en estudio de patología inflamatoria, el 60,4% consideraría realizar ecografía, comparado con 28,8% que se inclina por la resonancia. En relación con las limitaciones para la implementación, la falta de entrenamiento en el país (25,6%), seguida de la carencia de recursos para la consecución del equipo (17,9%) y el desconocimiento y la falta de interés por parte de los entes de salud (17,1%) fueron las más reconocidas. Conclusiones: La ecografía musculoesquelética solamente es practicada por una minoría de los reumatólogos que ejercen en Colombia, a pesar de que la mayoría la considera importante. Su relevancia radica en su uso para tratar a los pacientes con artritis reumatoide, artropatías por cristales y por artropatía psoriásica, así como para la realización de procedimientos. Más de la mitad de los reumatólogos ha recibido algún tipo de formación en ecografía, la mayoría de las veces educación de muy pocas horas o sin entrenamiento práctico, o no formal, lo cual constituye el principal problema para su implementación.


Subject(s)
Humans , Rheumatology , Ultrasonography , Diagnostic Techniques and Procedures , Diagnosis , Health Occupations , Medicine
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