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1.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1370822

ABSTRACT

O antígeno prostático específico (PSA) é o marcador mais importante para a detecção e monitoramento do câncer de próstata. Objetivo: O estudo objetivou analisar os dados laboratoriais e epidemiológicos do antígeno prostático específico de pacientes atendidos no Laboratório Clínico do Hospital do Policial Militar de Goiânia-GO (LC/HPM), considerando as medidas preventivas em relação ao câncer de próstata. Trata-se de um estudo retrospectivo baseado na análise de 1.249 prontuários de usuários do LC/HPM. O levantamento de dados laboratoriais e epidemiológicos, como idade, resultados do PSA total e PSA livre foi realizado por meio de um formulário padronizado pelos pesquisadores. Foram analisados 1.249 exames de PSA L/T, dos quais 58 (4,6%) apresentaram PSA total com resultados entre 4,0 e 10,0 ng/mL e 16 (1,3%) apresentaram concomitantemente valores de PSA total entre 4,0 e 10,0 ng/mL e relação PSA L/T < 25%. Os pacientes apresentaram faixa etária entre 34 e 93 anos, sendo a média 60 anos. Tornou-se evidente que tanto no ano de 2018 quanto em 2019, realizou-se um número maior de exames de PSA L/T, em comparação ao ano de 2020. O estudo revelou que 16 (1,3%) pacientes apresentaram risco aumentado para o desenvolvimento de neoplasia prostática, sendo observada uma diminuição do número de indivíduos que procuraram o LC/HPM para realização de exames de PSA livre e total no ano de 2020, quando comparado aos anos de 2019 e 2018, possivelmente em razão da pandemia de Covid-19, uma tendência global


Prostate-specific antigen (PSA) is the most important marker for the detection and monitoring of prostate cancer. This study aimed to analyse the epidemiological and laboratory data of prostate-specific antigen of patients treated at the Clinical Laboratory of the Military Police Hospital at Goiânia-GO (CL/MPH), considering preventive measures in relation to prostate cancer. Methods: This is a retrospective study with analysis of 1,249 medical records of CL/MPH users. The collection of epidemiological and laboratory data, such as age, total PSA and free PSA results, was performed using a form standardized by the researchers. We analyzed 1,249 PSA T/F tests, and of these, of which 58 (4.6%) total PSA sink with results between 4.0 and 10.0 ng/mL and 16 (1.3%) were concomitantly presenting total PSA values between 4.0 and 10.0 ng/mL and PSA T/F < 25%. The patients were aged between 34 and 93 years, with a mean age of 59 years. It became evident that both in 2018 and in 2019, there were a greater number of PSA T/F exams, compared to 2020. This study revealed that 16 (1.3%) patients were at increased risk for the development of prostate cancer, with a decrease in the number of individuals who sought the CL/MPH for free and total PSA tests in 2020, compared to 2019 and 2018, possibly due to Covid-19 pandemic, a global trend


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Prostatic Neoplasms/prevention & control , Prostate-Specific Antigen , Biomarkers, Tumor , Medical Records/statistics & numerical data , Retrospective Studies , Environmental Monitoring , Hospitals, Military
2.
Rev. Ciênc. Plur ; 7(2): 88-106, maio 2021. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1282971

ABSTRACT

Introdução:Estudos retrospectivos sobre trauma facial são importantes para quantificar sua demanda para os serviços de saúde, além de contribuir parao planejamento de ações de educação e prevenção. Objetivo:Este estudo teve por objetivo traçar o perfil epidemiológico do trauma facial em um hospital regional do interior da Bahia. Metodologia:Realizou-se um estudo descritivo, transversal, por meio de análise retrospectiva dos prontuários de pacientes vítimas de trauma facial, atendidos no Hospital Geral Prado Valadares, em Jequié-Bahia,Brasil,durante o período de janeiro de 2012 a dezembro de 2014.A análise estatística foi descritiva, sendo calculada em proporções e frequências absolutas e relativas.Para a comparação entre as variáveis foi realizado o teste do Qui-quadrado ou teste exato de Fisher.Resultados:Foram analisados 499 prontuários e observou-se que o sexo masculino (81,6%) e a etnia parda (50,3%) foram os mais acometidos pelo trauma facial. A faixa etária de maior prevalência foi de 25 a 34 anos (25,5%).O principal fator etiológico foi o acidente por motocicleta (30,1%) e houve elevada prevalência de traumatismo cranioencefálico (33,5%).Conclusões:No período estudado, verificou-se que indivíduos do sexo masculinoeadultos jovens foram os mais acometidos pelo trauma facial. Os traumas relacionados aos acidentes de motocicletae quedaforam os mais prevalentes (AU).


Introduction:Retrospective studies on facial trauma are important to quantify their demand for health services, in addition to contributing to the planning of education and prevention actions. Objective:This study aimed to trace the epidemiological profile of the facial trauma at a regional hospital in the interior of Bahia. Methodology:A descriptive, cross-sectional study was carried out through the retrospective analysis of medical records of patients who were victims of facial trauma, attended at the Prado Valadares General Hospital, Jequié-Bahia, Brazil, during the period from January 2012 to December 2014. The statistical analysis was descriptive, being calculated in absolute and relative proportionsand frequencies. The Chi-square test or Fisher's exact test were used to compare the variables.Results:499 medical records were analyzed and it was observed that males (81.6%) and mixed race (50.3%) were the most affected by facial trauma. The most prevalent age group was 25 to 34 years old (25.5%). The main etiological factor was the motorcycle accident (30.1%) and there was a high prevalence of traumatic brain injury (33.5%). Conclusions:During the study period, it was found that male individuals and young adults were the most affected by facial trauma. Traumas related to motorcycle accidents and falls were the most prevalent (AU).


Introducción: Los estudios retrospectivos sobre trauma facial son importantes para cuantificar su demanda de servicios de salud, además de contribuir a la planificación de acciones de educación y prevención. Objetivo: Este estudio tuvo como objetivo rastrear el perfil epidemiológico del trauma facial en un hospital regional del interior de Bahía. Metodología: Se realizó un estudio descriptivo, transversal, mediante un análisis retrospectivo de las historias clínicas de pacientes con trauma facial atendidos en el HospitalGeral Prado Valadares, en Jequié-Bahia, Brasil, desde enero de 2012 a diciembre de 2014. El análisis estadístico fue descriptivo, siendo calculado en proporciones y frecuencias absolutas y relativas. Para comparar las variables se utilizó la prueba de Chi-cuadrado o la prueba exacta de Fisher. Resultados:se analizaron 499 historias clínicas y se observó que los hombres (81,6%) y mestizos (50,3%) fueron los más afectados por el traumatismo facial. Elgrupo de edad más prevalente fue el de 25 a 34 años (25,5%). El principal factor etiológico fue el accidente de motocicleta (30,1%) y hubo una alta prevalencia de traumatismo craneoencefálico (33,5%). Conclusiones: Durante el período de estudio, se encontró que los hombres y los adultos jóvenes fueron los más afectados por el trauma facial. Los traumatismos relacionados con accidentes de motocicleta y caídas fueron los más prevalentes (AU).


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Violence/prevention & control , Accidental Falls/prevention & control , Brazil/epidemiology , Accidents, Traffic/prevention & control , Facial Injuries/diagnosis , Chi-Square Distribution , Medical Records/statistics & numerical data , Epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies/methods , Brain Injuries, Traumatic , Health Services
3.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1293311

ABSTRACT

Objetivo: Identificar as causas e consequências das quedas de pacientes idosos, ocorridas fora do âmbito hospitalar, antes da internação em uma Unidade de Pronto Atendimento (UPA) de Goianésia, no estado de Goiás. Métodos: Trata-se de uma pesquisa quantitativa, de natureza retrospectiva e descritiva, realizada em uma UPA. Foram coletadas informações de 55 prontuários de pacientes idosos que sofreram quedas. Resultados: Foram 55 pacientes idosos, que sofreram quedas fora da UPA, na cidade de Goianésia, no mês de janeiro de 2020. Desses pacientes, 23 eram mulheres e 32 homens; a faixa etária variou entre 60 e 92 anos. O local com maior incidência de quedas foi o domicílio dos pacientes, representando 76,36%; das quedas, 85,45% apresentaram como causa ambiente inadequado, no domicílio ou na rua. Cada paciente teve uma ou mais consequências, que ficaram entre leves, moderadas ou graves. Todos os 55 pacientes apresentaram algum tipo de algia. Considerações finais: A partir desse estudo, foi possível identificar as características das quedas sofridas pelos idosos, atendidos na UPA de Goianésia. Devido ao evento adverso, os pacientes tiveram algia, trauma, escoriações, edemas, traumatismo cranioencefálico, fraturas e hematomas. O único protocolo implantado no hospital é o protocolo de Manchester


Objective: Identify the causes and consequences of falls in elderly patients that occurred outside the hospital environment, before admission to an Emergency Care Unit (UPA) in Goianésia, in the State of Goiás. Identify the characteristics of falls that occurred outside the hospital environment of elderly patients, before admission to an Emergency Care Unit (UPA) in Goianésia, in the state of Goiás. Methods: This was a quantitative research of a nature retrospective and descriptive study carried out in an Emergency Care Unit. Information was collected from 55 medical records of elderly patients who suffered falls. Results: There were 55 patients over the age of 60 who suffered a fall outside the Emergency Care Unit in the city of Goianésia in January 2020. Of these 55 patients, 23 were women and 32 men, the age range of patients ranged from 60 and 92 years. The place with the highest incidence of falls was at the patients' homes, representing 76.36%, and 85.45% of the falls had an inappropriate environment at home or on the street as a cause. Each patient had one or more consequences, which were mild, moderate or severe. All 55 patients had some type of pain. Final considerations: From this study, it is possible to identify the characteristics of falls suffered by the elderly, seen at the UPA in Goianésia. Due to the adverse event, patients had pain, trauma, abrasions, edema, traumatic brain injury, fractures and bruises. The only protocol implanted in the hospital is the Manchester protocol


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Accidental Falls/prevention & control , Aged , Medical Records/statistics & numerical data , Accident Consequences , Ambulatory Care
4.
Esc. Anna Nery Rev. Enferm ; 25(1): e20200166, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1133825

ABSTRACT

Resumo Objetivo Avaliar registros dos cartões de pré-natal de puérperas atendidas em maternidades públicas e privadas. Método Estudo transversal que analisou fotos de 394 cartões de pré-natal de mulheres que participaram da pesquisa Nascer em Belo Horizonte. Os registros foram avaliados quanto ao preenchimento, legibilidade e completude das informações sociodemográficas, clínicas, obstétricas e exames laboratoriais. Resultados Evidenciou-se que 88,5% dos cartões não apresentaram registro do nome da unidade básica de referência, 76,9%, da maternidade de referência e 82,4%, da instituição de realização do pré-natal. A avaliação do edema, o uso de sulfato ferroso e ácido fólico não foram registrados em 55%, 91,1% e 92,6% dos cartões, respectivamente. A ausência de registros no gráfico de peso foi identificada em 86,8% dos cartões, e no de altura uterina, 79,7%. Conclusão e implicações para a prática Existem grandes lacunas no registro do processo de cuidado pré-natal nos cartões e cadernetas, o que pode comprometer a qualidade da assistência e o acompanhamento das gestantes. Os achados apontam para a necessidade da educação permanente em serviço direcionada aos profissionais de saúde, como os enfermeiros, quanto à importância da realização e registro das ações preconizadas no cuidado pré-natal.


Resumen Objetivo Analizar registros de las tarjetas de prenatal de puérperas atendidas en maternidades públicas y privadas. Métodos Estudio transversal, con fotos de 394 tarjetas de prenatal, provenientes de la investigación Nascer em Belo Horizonte (Nacer en Belo Horizonte), que analizó registros en cuanto al llenado, legibilidad y completitud de las informaciones sociodemográficas, clínicas, obstétricas y exámenes de laboratorio. Resultados El 88,5% de las tarjetas no tuvieron registro del nombre de la unidad básica de referencia, el 76,9%, de la maternidad de referencia y el 82,4%, de la institución de realización del prenatal. Evaluación del edema, uso de sulfato ferroso y ácido fólico no se registraron en el 55%, 91,1% y 92,6% de las tarjetas, respectivamente. La ausencia de registros en el gráfico de peso fue identificada en el 86,8% de las tarjetas, y en el 79,7% de altura uterina. Conclusión Existen grandes lagunas en el registro del proceso de asistencia prenatal, pudiendo comprometer la calidad de la asistencia y el acompañamiento de las gestantes. Implicaciones para la práctica Se necesita educación permanente dirigida a profesionales de la salud, como enfermeras, sobre la importancia de llevar a cabo y registrar las acciones recomendadas en la atención prenatal.


Abstract Objective To evaluate the antenatal care (ANC) home-based records of puerperal women attended in public and private maternity hospitals. Methods Cross-sectional study that analyzed photographs of 394 ANC home-based records of women who participated in the research Nascer em Belo Horizonte (Born in Belo Horizonte, in free translation). Records were assessed regarding completeness, legibility and completeness of sociodemographic, clinical, obstetric and laboratory data. Results 88.5% of the cards had no record of the name of the primary care unit of reference, 76.9% of the maternity of reference and 82.4% of the ANC institution. Evaluation of edema, use of ferrous sulfate and folic acid were not registered in 55%, 91.1% and 92.6% of the cards, respectively. The absence of records in the weight chart was identified in 86.8% of the cards, and in the uterine height chart, 79.7%. Conclusions and implications for practice There are large gaps in the registration of the ANC process in the home-based records, which may compromise the quality of care and follow-up of pregnant women. The findings point to the need for permanent education in service directed to health professionals, such as nurses, regarding the importance of carrying out and registering the actions recommended in ANC.


Subject(s)
Humans , Female , Pregnancy , Adult , Prenatal Care , Quality of Health Care , Medical Records/statistics & numerical data , Cross-Sectional Studies , Critical Pathways/statistics & numerical data
5.
Braz. J. Pharm. Sci. (Online) ; 57: e18064, 2021. tab, graf
Article in English | LILACS | ID: biblio-1339301

ABSTRACT

Medication discrepancies are of great concern in hospitals because they pose risks to patients and increase health care costs. The aim of this study was to estimate the prevalence of inconsistent medication prescriptions to adult patients admitted to a hospital in southern Santa Catarina, Brazil. This was a patient safety study on patients recruited between November 2015 and June 2016. The participants were interviewed and had their medical records reviewed. Discrepant medications were considered those that did not match between the list of medicines taken at home and the prescribed drugs for treatment in a hospital setting. Of the 394 patients included, 98.5% took continuous-use medications at home, with an average of 5.5 medications per patient. Discrepancies totaled 80.2%, The independent variables associated with the discrepancies were systemic arterial hypertension, hypercholesterolemia, vascular disease, number of medications taken at home, and poor documentation of the medications in the medical record. Findings from this study allowed us to conclude there was a high rate of prescription medication misuse. Medication reconciliation is crucial in reducing these errors. Pharmacists can help reduce these medication-related errors and the associated risks and complications.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Pharmacists/ethics , Drug Prescriptions/standards , Health Care Costs , Medication Reconciliation/ethics , Medication Errors/adverse effects , Patients/classification , Pharmaceutical Preparations , Medical Records/statistics & numerical data , Patient Safety , Drug Misuse/statistics & numerical data , Hospitals/supply & distribution
6.
Arq. bras. cardiol ; 114(6): 995-1003, Jun., 2020. tab, graf
Article in Portuguese | SES-SP, LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-1131247

ABSTRACT

Resumo Fundamento Existe carência de informações prospectivas sobre a evolução em um ano após uma síndrome coronária aguda (SCA) em uma grande amostra de pacientes brasileiros. Objetivos Avaliar a prescrição de terapias baseadas em evidência, a ocorrência de desfechos graves e os preditores para estes desfechos em um registro brasileiro multicêntrico de pacientes com SCA. Métodos O ACCEPT é um estudo observacional prospectivo que incluiu pacientes internados com diagnóstico de SCA em 47 hospitais brasileiros. Os pacientes foram seguidos por 1 ano e coletou-se dados sobre prescrição médica e ocorrência de eventos cardiovasculares maiores (mortalidade cardiovascular, reinfarto e acidente vascular encefálico - AVE). Valores de p < 0,05 foram considerados estatisticamente significantes. Resultados Um total de 5.047 pacientes foram incluídos neste registro, de agosto de 2010 até abril de 2014. Foi confirmado o diagnóstico de SCA em 4.782 pacientes (94,7%) e, dentre os 3 diagnósticos possíveis, o mais comum foi SCA com elevação do segmento ST (35,8%). A taxa de eventos cardiovasculares maiores foi de 13,6 % em 1 ano. A prescrição completa de terapias baseadas em evidência na admissão hospitalar foi de 62,1%. Idade, atendimento público, infarto agudo do miocárdio, AVE, insuficiência renal, diabetes e qualidade da terapia estiveram associados de forma independente à ocorrência de eventos cardiovasculares maiores. Conclusões No seguimento de 1 ano do registro ACCEPT, mais de 10% dos pacientes apresentaram eventos cardiovasculares maiores e esta taxa variou de acordo com a qualidade da terapia. Há necessidade da elaboração de estratégias para melhorar o uso de terapias baseadas em evidência no sentido de minimizar os eventos cardiovasculares na população brasileira. (Arq Bras Cardiol. 2020; 114(6):995-1003)


Abstract Background There is lack of prospective data on evolution within one year of acute coronary syndromes (ACS) in a representative population of Brazilian patients. Objectives To assess the prescription of evidence-based therapies, the incidence of severe outcomes and the predictors for these outcomes in a multicenter Brazilian registry of ACS patients. Methods The ACCEPT is a prospective observational study, which included patients hospitalized with a diagnostic of ACS in 47 Brazilian hospitals. The patients were followed for a 1 year and data were collected on the medical prescription and the occurrence of major cardiovascular events (cardiovascular mortality, reinfarction and cerebrovascular accident - CVA). Values of p < 0.05 were considered statistically significant. Results A total of 5,047 patients were included in this registry from August 2010 to April 2014. The diagnosis of ACS was confirmed in 4,782 patients (94.7%) and, among those, the most frequent diagnosis was ACS with ST segment elevation (35.8%). The rate of major cardiovascular events was 13.6 % within 1 year. Adherence to prescription of evidence-based therapy at admission was of 62.1%. Age, public service, acute myocardial infarction, CVA, renal failure, diabetes and quality of therapy were associated independently with the occurrence of major cardiovascular events. Conclusions During the one-year follow-up of the ACCEPT registry, more than 10% of the patients had major cardiovascular events and this rate ranged according with the quality of therapy. Strategies must be elaborated to improve the use of evidence-based therapies to minimize the cardiovascular events among the Brazilian population. (Arq Bras Cardiol. 2020; 114(6):995-1003)


Subject(s)
Medical Records/statistics & numerical data , Acute Coronary Syndrome , Myocardial Infarction , Risk Factors
7.
Article in English | LILACS, BBO | ID: biblio-1135533

ABSTRACT

Abstract Objective: To determine the relationship between tobacco and alcohol consumption and staging of head and neck cancer in patients treated at a referral hospital for cancer treatment. Material and Methods: This is a cross-sectional study based on medical records of patients with head and neck cancer treated between 2008 and 2015. The following variables were considered: gender, age, marital status, educational level, place of residence, profession, affected site, clinical staging of neoplasms, histopathological diagnosis, tobacco and alcohol consumption. Results: Of the 154 medical records analyzed, there was a predominance of male patients (72.7%), single (50%), with low education (88.1%), rural workers (38.3%), residents in the state countryside (70.2%) and aged 20-94 years. T3 and T4 size tumors prevailed. A significant correlation was found between alcohol use and tumor size (p=0.03) and presence of nodules (p<0.001), as well as between alcohol use and smoking with tumor size (p=0.04) and presence of nodules (p=0.019). No correlations were observed between tobacco use and injury staging. Conclusion: There was strong significance between tumor size and presence of nodules, both with the use of alcohol alone and with tobacco, thus suggesting the existence of important carcinogenic action of this substance.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Alcohol Drinking/adverse effects , Mouth Neoplasms/pathology , Risk Factors , Tobacco Use/adverse effects , Head and Neck Neoplasms/pathology , Rural Workers , Brazil/epidemiology , Chi-Square Distribution , Medical Records/statistics & numerical data , Epidemiology, Descriptive , Cross-Sectional Studies/methods , Retrospective Studies
8.
Rev. bras. cir. plást ; 34(4): 497-503, oct.-dec. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1047912

ABSTRACT

Introdução: A úlcera plantar por hanseníase é uma lesão no pé resultante da falta de sensibilidade plantar. O objetivo é descrever o tratamento realizado em portadores de úlceras plantares por hanseníase. Métodos: Estudo de prontuários de portadores de úlcera plantar atendidos no Hospital Sarah em Brasília, de 2006 a 2016, quanto ao sexo, idade, etiologia, localização e tratamento. Resultados: Foram atendidos 27 pacientes, 17(62,96%) homens e 10 (37,04%) mulheres, procedentes de Goiás e DF, na faixa etária de 41 a 60 anos (40,74%). Todos necessitaram de um ou mais procedimentos cirúrgicos. Conclusão: Observou-se maior frequência no sexo masculino, grau avançado, localizadas no primeiro artelho. Todos necessitaram de procedimentos cirúrgicos e não cirúrgicos, evoluindo com cicatrização completa da ferida, amputação transtibial em um caso e de artelhos em sete casos, e 90% dos casos apresentaram recorrência da úlcera após um ano.


Introduction: Leprosy-induced plantar ulcers result from a lack of plantar sensitivity. Objective: This study aimed to describe the treatment provided to patients with leprosy-induced plantar ulcers. Methods: We retrospectively reviewed the medical records of patients with plantar ulcers treated at Sarah Hospital in Brasilia from 2006 to 2016 and collected information about sex, age, etiology, location, and treatment. Results: A total of 27 patients (17 [62.96%] men, 10 [37.04%] women; 40.74% were aged 41­60 years) were treated from Goiás and the Federal District. All required ≥1 surgical procedure. Conclusion: A higher frequency of advanced grade was observed in men, primarily on the first toe. All needed surgical and non-surgical procedures and achieved complete wound healing. Transtibial amputation was required in 1 case and toe amputation in 7 cases; 90% patients developed ulcer recurrence after 1 year.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , History, 21st Century , Rehabilitation , Therapeutics , Tertiary Treatment , Medical Records , Foot Ulcer , Leprosy , Rehabilitation/methods , Rehabilitation/statistics & numerical data , Therapeutics/methods , Therapeutics/statistics & numerical data , Tertiary Treatment/methods , Tertiary Treatment/statistics & numerical data , Medical Records/standards , Medical Records/statistics & numerical data , Foot Ulcer/surgery , Foot Ulcer/complications , Foot Ulcer/therapy , Leprosy/surgery , Leprosy/complications , Leprosy/therapy
9.
Rev. cuba. cir ; 58(3): e808, jul.-set. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1098972

ABSTRACT

RESUMEN Introducción: Los índices de severidad en trauma son una serie de escalas que permiten describir la gravedad de un individuo traumatizado y se asocian con su pronóstico y probabilidad de sobrevida. Objetivo: Determinar el valor pronóstico de los índices de severidad anatómicos en la evolución de pacientes con lesiones traumáticas de colon y recto. Métodos: Se realizó un estudio observacional descriptivo y de corte transversal. Se incluyeron los pacientes con lesiones traumáticas de colon o recto intervenidos quirúrgicamente en cuatro hospitales de La Habana en el periodo 2008-2015. Los datos fueron recolectados de la historia clínica. Se utilizó análisis de distribución de frecuencias y las curvas de operación característica del receptor (curvas ROC). Resultados: La edad promedio de los pacientes 37,4 años (desviación estándar 13,6 años). Predominó el sexo masculino (76, 7 por ciento). De los 6 scores estudiados, solamente CIS Flint y COIS resultaron ser útiles para predecir sepsis de la herida quirúrgica. En la predicción de defunción, el área mayor bajo la curva correspondió a COIS (0,92), posteriormente le siguió NISS (0,86) y luego CIS Flint (0,81). Los puntos de corte óptimos calculados fueron: ( 3 para COIS, ( 24 para NISS y ( 2 para CIS Flint. Conclusiones: Se demuestra el valor de los índices COIS y Flint, para pronosticar la ocurrencia de complicaciones en los pacientes con lesiones traumáticas de colon y recto, y la utilidad de los diferentes índices, en el pronóstico de defunción(AU)


ABSTRACT Introduction: Trauma severity indices are a series of scales that describe the severity of a traumatized individual and are associated with their prognosis and probability of survival. Objective: To determine the prognostic value of anatomical severity indices in the evolution of patients with traumatic lesions of the colon and rectum. Methods: A descriptive observational and cross-sectional study was carried out. Patients with traumatic lesions of the colon or rectum who underwent surgery in four Havana hospitals in the period 2008-2015 were included. The data was collected from the medical history. Frequency distribution analysis and receiver characteristic operation curves (ROC curves) were used. Results: The average age of the patients 37.4 years (standard deviation 13.6 years). Male sex predominated (76.7 percent). Of the 6 scores studied, only CIS Flint and COIS were found to be useful in predicting sepsis of the surgical wound. In the prediction of death, the largest area under the curve corresponded to COIS (0.92), followed by NISS (0.86) and then CIS Flint (0.81). The calculated optimal cut-off points were: ( 3 for COIS, ( 24 for NISS and ( 2 for CIS Flint. Conclusions: The value of the COIS and Flint indices is demonstrated to predict the occurrence of complications in patients with traumatic lesions of the colon and rectum, and the usefulness of the different indices in the prognosis of death(AU)


Subject(s)
Humans , Male , Female , Adult , Severity of Illness Index , Colostomy/methods , Survival Analysis , Data Collection/statistics & numerical data , Abdominal Injuries/complications , Medical Records/statistics & numerical data , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic
10.
Rev. bras. cir. plást ; 34(3): 310-314, jul.-sep. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1047144

ABSTRACT

Introdução: A demanda por cirurgia plástica tem aumentado progressivamente, dentre os procedimentos mais frequentes estão as cirurgias de mamas (aumento e redução). Métodos: Estudo retrospectivo de prontuários de pacientes que foram submetidas a mamoplastia redutora e de aumento, no período de janeiro de 2015 a junho de 2018, no Hospital PUC-Campinas. Resultados: Foram realizadas 13 mamoplastias de aumento e 275 mamoplastias redutoras. Das 288 cirurgias realizadas duas (n=2) evoluíram com TEP (tromboembolismo pulmonar). Conclusão: Portanto, a incidência de fenômenos tromboembólicos em mamoplastias de aumento e redutoras mostrou-se baixa no presente estudo, assim como na literatura. Já as pacientes acometidas no estudo eram consideradas de baixo risco para complicação tromboembólica, de acordo com protocolos de profilaxia, devendo-se atentar para tais fenômenos no pós-operatório. Ainda são necessários mais estudos para padronização do uso de medidas de profilaxia do tromboembolismo venoso.


Introduction: The demand for plastic surgery has progressively increased, and breast enlargement and reduction surgeries are among the most frequent procedures. Methods: This retrospective study reviewed the medical records of patients who underwent reduction and augmentation mammoplasty between January 2015 and June 2018 at the PUC-Campinas Hospital. Results: Thirteen augmentation mammoplasties and 275 reduction mammoplasties were performed. Of the 288 patients who underwent surgeries, two patients developed postoperative pulmonary thromboembolism. Conclusion: The incidence of thromboembolic phenomena in augmentation and reduction mammoplasty is low. Patients in this study were considered at low risk for thromboembolic complications. According to prophylaxis protocols, this phenomena should be monitored postoperatively. Further studies are needed to standardize the use of venous thromboembolism prophylaxis measures.


Subject(s)
Humans , Female , Adult , History, 21st Century , Patients , Pulmonary Embolism , Surgery, Plastic , Breast , Medical Records , Retrospective Studies , Embolism and Thrombosis , Venous Thrombosis , Patients/statistics & numerical data , Pulmonary Embolism/surgery , Pulmonary Embolism/complications , Surgery, Plastic/statistics & numerical data , Breast/surgery , Medical Records/statistics & numerical data , Embolism and Thrombosis/surgery , Venous Thrombosis/surgery , Venous Thrombosis/complications
11.
Prensa méd. argent ; 105(2): 82-91, apr 2019. tab, fig
Article in English | LILACS, BINACIS | ID: biblio-1025704

ABSTRACT

Staphylococcus aureus is one of the most important pathogenic type to humans, and the most common species responsible for a wide range of diseases such as furuncles, various abscesses, wounds abscesses resulting from surgical operations, dermatitis, soft tissue inflammation, arthritis, bones inflammation, bronchial pneumonia, inflammation of internal parts of the heart and injuries caused by toxins such as toxic shock syndorome and staphylococcus aureus syndrome and food poisoning. The current study aimed by finding the genes responsible for the virulence factors in S. aureus isolates by using the Single and Multiplex PCR mechanism (technology). A total of 60 specimens (urine, burn swabs, wound swaabs) from different clinical cases were collected from patients (in different age groups) who admitted to several health centers in Al-Diwaniyah Teaching Hospital, Iraq, during a period extending from October 2016 to January 2017. Some virulence factors were investigated for 30 isolate only of MRSA using Single and Multiplex PCR for detection virulence factor genes which both coa gene encoding production of coagulase, clfA gene encoding for clumpting factor, spa gene encoding for protein A, fnbA gene encoding for fibronectin binding proteins, luks gene encoding prouction of Panton Valentine Leukocidin (PVL). Results 30 (100%) were possess coa, clfA, spa and fnbA genes, 13 (43.3%) were possess luks gene


Subject(s)
Humans , Specimen Handling/instrumentation , Staphylococcal Protein A , Staphylococcus aureus/pathogenicity , Medical Records/statistics & numerical data , Polymerase Chain Reaction , Fibronectins , Coagulase , Coenzyme A/classification , Virulence Factors/genetics , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Leukocidins
12.
Revista Digital de Postgrado ; 8(3): e165, 2019. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1049952

ABSTRACT

La inserción del catéter venoso central (CVC) ha significado un gran avance en la medicina moderna y su uso generalizado ha permitido el desarrollo de nuevas técnicas diagnósticas y tratamientos especializados. En este estudio se dan a conocer las indicaciones presentes al momento de colocar el catéter venoso central y el tiempo de colocación en los pacientes. Métodos: La investigación fue de tipo retrospectivo, descriptivo y de corte transversal, con un diseño de investigación no experimental y tuvo la finalidad de conocer, en forma directa, la realidad de la problemática. Las unidades de observación fueron(188) historias clínicas de los pacientes que ingresaron en el servicio de medicina interna en el hospital Miguel Pérez Carreño en el periodo comprendido entre enero y abril de 2017. Resultados: El 68% de la indicación del catéter venoso central es para la medición de la presión venosa central (PVC) y control de líquidos, mientras que en el 32% la indicación fue por administración de fármacos. El tiempo de colocación tuvo un predominio del 61% de los pacientes que utilizaron el catéter venoso central durante 1 a 3 semanas, en segundo lugar, el 36% utilizo el catéter por unos días, solo un 3% amerito el uso del catéter venoso central durante 1 mes. Conclusiones: La mayoría de los pacientes estudiados tuvieron como principal indicación de CVC para control de líquido y medición de presión venosa central. Con una duración de 1 a 3 semanas(AU)


The insertion of the central venous catheter (CVC) has meant a great advance in modern medicine and its widespread use has allowed the development of new diagnostic techniques and specialized treatments. In this study we present the indications present at the moment of placing the central venous catheter and the time of use in patients. Methods: The research was of a retrospective, descriptive and cross-sectional type, with a non-experimental research design and aimed to know, in a direct way, the reality of the problem. The units of observation were (188) clinical records of patients admitted to the internal medicine service in the hospital Miguel Pérez Carreño in the period between January and April 2017. Results: 68% of the indication of the central venous catheter is for the measurement of central venous pressure (CVP) and fluid control, while in 32% the indication was for drug administration. The time of use had a predominance of 61% of patients who used the central venous catheter for 1 to 3 weeks, secondly, 36% used the catheter for a few days, only 3% required the use of the central venous catheter for 1 month. Conclusions: The majority of patients studied had CVC as main indication for fluid control and central venous pressure measurement. With a duration of 1 to 3 weeks(AU)


Subject(s)
Humans , Male , Female , Adolescent , Catheterization, Central Venous/methods , Central Venous Pressure , Time Management/methods , Catheter-Related Infections/microbiology , Central Venous Catheters/adverse effects , Medical Records/statistics & numerical data , Retrospective Studies , Vascular Access Devices , Hospitalization
13.
Revista Digital de Postgrado ; 8(3): e167, 2019. graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1087875

ABSTRACT

La utilización de catéter venoso central produce, en ocasiones, infecciones de tipo local o sistémico, como la bacteriemia no complicada o complicada (bacteriemia persistente, tromboflebitis séptica, endocarditis y otras complicaciones metastásicas). En este estudio se dan a conocer las infecciones ocasionadas por el uso de Catéter Venoso Central (CVC), así como los microorganismos presentes en los pacientes. Métodos: La investigación fue de tipo retrospectivo, descriptivo y de corte transversal, con un diseño de investigación no experimental y tuvo la finalidad de conocer, en forma directa, la realidad de la problemática. Las unidades de observación fueron (188) historias clínicas de los pacientes que ingresaron en el servicio de medicina interna en el hospital Miguel Pérez Carreño en el periodo comprendido entre enero y abril de 2017. Resultados: En 30 de los pacientes se realizó el cultivo de la punta del catéter venoso central. En el 67% no hubo crecimiento de microorganismos, mientras que el 33% crecieron microorganismos a las 24 horas. El 80% de las muestras cultivadas reportan la presencia de Cocos Gram positivos. Un 10% reportaron enterobacterias y un 10% reportan levaduras, finalmente con menor frecuencia pseudomona con un 0%. Conclusiones: Solo 78 pacientes ameritaron la colocación de un catéter venoso central, de los cuales se cultivaron 30 puntas de catéter, encontrándose que solo 10 de las puntas de catéteres dieron positivas para infección con crecimiento bacteriano a las 24 horas, siendo los cocos Gram positivos la principal bacteria aislada en los pacientes con CVC seguidos de enterobacterias(AU)


Intravascular catheterization is used for hemodynamic monitoring, hemodialysis, metabolic and nutritional support, fluid administration, chemotherapy and prolonged antibiotic therapy, blood and derivatives, among others. In this study, infections caused by the use of (CVC) central venous catheter are reported, as well as the microorganisms present in patients. Methods: The research was of a retrospective, descriptive and cross-sectional type, with a non-experimental research design and aimed to know, in a direct way, the reality of the problem. The observation units were (188) clinical records of the patients admitted to the internal medicine service at the Miguel Pérez Carreño Hospital in the period between January and April 2017. Results In 30 of the patients, the culture of the tip of the central venous catheter. In 67% there was no growth of microorganisms, while 33% grew microorganisms at 24 hours. 80% of the cultivated samples report the presence of Gram-positive cocci. 10% reported enterobacteria and 10% reported yeast, finally with less frequency pseudomonas with 0%. Conclusions: Only 78 patients required placement of a central venous catheter, of which 30 catheter tips were cultured, finding that only 10 of the catheter tips were positive for infection with bacterial growth at 24 hours, with Gram-positive cocci. the main bacteria isolated in patients with CVCfollowed by enterobacteria(AU)


Subject(s)
Humans , Adolescent , Adult , Thrombophlebitis/diagnosis , Catheterization, Central Venous/methods , Gram-Positive Cocci , Endocarditis/diagnosis , Catheter-Related Infections/microbiology , Central Venous Catheters/adverse effects , Bacterial Infections , Medical Records/statistics & numerical data , Cross Infection/epidemiology , Retrospective Studies
14.
Revista Digital de Postgrado ; 8(3): e171, 2019. graf, tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1087882

ABSTRACT

Para el estudio y diagnóstico de la patología endometrial se cuenta con el ultrasonido transvaginal y la biopsia de endometrio. Objetivo: Determinar la correlación clínica, ultrasonográfica e histológica en patología endometrial, en pacientes tratadas en el Servicio de Cirugía del Hospital Dr. Francisco Antonio Rísquez, entre 2006 y 2016. Métodos: Estudio retrospectivo, transversal. Se incluyeron las pacientes intervenidas quirúrgicamente por patologías uterinas, que contaron con información completa en la historia clínica. Se utilizó estadística descriptiva, sensibilidad, especificidad y coeficiente de correlación. Resultados: El grupo etario más afectado fue el de 41 a 50 años, con 62,73 %, el motivo de consulta más frecuente fue sangrado genital con 52 casos (47,3 %), 52 pacientes (47,3 %) presentaron sangrado menstrual abundante y 40 (36,4 %) refirieron sangrado abundante y prolongado. Ecográficamente, el diagnóstico más frecuente fue leiomiomatosis uterina (87 casos, 79,1 %). La línea endometrial estuvo entre 1,3 y 11,3 mm en 80,9 %; en 54 casos (49,1 %) la biopsia de endometrio reportó secretor sin atipia. No se observó correlación estadística entre la clínica y la biopsia de endometrio (p=0,478 Kappa=0,00). La correlación estadística entre el ultrasonido y la biopsia de endometrio fue casi perfecta (p=0,000 Kappa=0,947) y entre la biopsia preoperatoria y la definitiva fue moderada (p=0,000 Kappa 0,542). La sensibilidad del ultrasonido es de 100 % y especificidad de 90,91 %. Conclusiones: La sensibilidad y especificidad del ultrasonido respecto a la biopsia de endometrio fue elevada. La frecuencia de patología endometrial en la biopsia endometrial fue baja(AU)


For the study and diagnosis of endometrial pathology it has with transvaginal ultrasound and endometrial biopsy. Objective: To determine the correlation of clinical, ultrasound and histological endometrial pathology in patients treated in the service of surgery of the Hospital Dr. Francisco Antonio Rísquez, between 2006 and 2016. Methods: Retrospective, cross-sectional study. Included patients surgically treated by uterine pathologies, which counted with complete information in the medical record. We used descriptive statistics, sensitivity, specificity, and correlation coefficient. Results: The most affected age group was that of 41 to 50 years, in 62,73%, the reason for more frequent consultation was bleeding genital with 52 cases (47.3%), 52 patients (47.3%) they had heavy menstrual bleeding and 40 (36.4%) abundant and prolonged bleeding was referred. Ecograficamente, the most frequent diagnosis was uterine leiomyomatosis (87 cases, 794.1%). The endometrial line was between 1.3 and 11.3 mm 80.9%; in 54 cases (49.1%) the endometrial biopsy reported secretory without atypia. No statistical correlation between the clinic and the endometrial biopsy was observed (p = 0, 478 Kappa = 0, 00). The statistical correlation between ultrasound and endometrial biopsy was almost perfect (p = 0, 000 Kappa = 0, 947) and between preoperative biopsy and the final was moderate (p = 0, 0000,542 Kappa). The sensitivity of ultrasound is 100% and specificity of 90.91%. Conclusions: The sensitivity and specificity of ultrasound for endometrial biopsy was high. The frequency of endometrial pathology in endometrial biopsy was low(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Hemorrhage/surgery , Uterine Hemorrhage/diagnosis , Uterine Hemorrhage/pathology , Ultrasonography/instrumentation , Endometrium/pathology , Biopsy/methods , Medical Records/statistics & numerical data , Retrospective Studies , Leiomyomatosis/pathology
15.
Revista Digital de Postgrado ; 8(3): e172, 2019. graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1087886

ABSTRACT

La anestesia local es una opción válida para realizar procedimientos quirúrgicos de pequeña o mediana consideración. Permite la deambulación y el alta precoz. Objetivo: Evaluar los resultados del uso de anestesia local y bloqueo de los nervios ilioinguinal e iliohipogástrico, en pacientes a quienes se les realizó cura operatoria de hernia inguinal, en el Servicio de Cirugía del Hospital "Dr. Francisco Antonio Rísquez", en el periodo octubre 2017 - octubre 2018. Métodos: Estudio prospectivo, transversal que incluyó 23 pacientes que aceptaron se le realizara la hernioplastia con anestesia local. Resultados: Se realizaron 46 curas operatorias de hernia inguinal, y en 23 se realizó con anestesia local (50 %). Predominaron pacientes masculinos (87 %), con una distribución bimodal en relación a la edad (26,1 % entre 30 y 39 años y entre 70 a 79 años). La hernia inguinal derecha fue la más frecuente con el 40 % (10 casos). Todos los pacientes reportaron una puntuación de 0-1 en la escala visual análoga, tanto en el transoperatorio como en el posoperatorio. El 96% de los pacientes logró una deambulación precoz (antes de 4 horas) y todos toleraron la vía oral antes de las dos horas en el posoperatorio. No se observó ninguna complicación en el transoperatorio; hubo 1 recidiva. Conclusiones: La cura operatoria de hernia inguinal con anestesia local, resultó ser efectiva y bien tolerada por los pacientes, brindando un reintegro casi inmediato a sus actividades, lo que representa una disminución en los costos intrahospitalarios(AU)


Local anesthesia is an option to perform surgical procedures of small or medium account. It allows the ambulation, and early discharge. Objective: To evaluate the results of the use of local anesthesia and nerve block ilioinguinal and iliohypogastric, in patients who underwent surgical cure of inguinal hernia, surgery of the Hospital "Dr. Francisco Antonio Rísquez" service, in the October 2017 period - October 2018. Methods: Prospective, cross-sectional study involving 23 patients who accepted it will be the hernioplasty under local anesthesia. Results: 46 surgical cure of inguinal hernia were performed, and in 23 was held with local anesthesia (50%). Dominated male patients (87%), with a bimodal distribution in relation to the age (26.1% between 30 and 39 years and between 70 to 79 years). Right inguinal hernia was the most frequent with 40% (10 cases). All patients reported a score of 0-1 in the Visual analog escale, both in the intraoperative and postoperative. 96% of patients achieved early ambulation (within 4 hours) and all tolerated the mouth before the two hours in the postoperative. There were no complications in the intraoperative; there was 1 recurrence. Conclusions: e surgical cure of inguinal hernia under local anesthesia, proved to be effective and well tolerated by the patients, providing a return almost immediately to their activities, which represents a decrease in hospital costs(AU)


Subject(s)
Humans , Male , Female , Adult , Aged , Bupivacaine/pharmacology , Hernia, Inguinal/surgery , Hernia, Inguinal/diagnosis , Anesthesia, Local/methods , Nerve Block , Postoperative Care , Surgical Procedures, Operative/methods , Medical Records/statistics & numerical data , Retrospective Studies
16.
Esc. Anna Nery Rev. Enferm ; 23(4): e20190090, 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1039802

ABSTRACT

ABSTRACT Objective: To identify the profile of women with lymphedema after breast cancer treatment. Methods: This is a descriptive, retrospective and quantitative study with data from medical records of women with lymphedema who began treatment between 2010 and 2015 in a rehabilitation center. An instrument was used for data collection to characterize the participants and analysis was performed by means of descriptive statistics, the Chi-Square test and Fisher's exact test. Results: 235 women with a mean age of 56.8 years were included, with an association between lymphedema and age (p = 0.016). It was observed that 76.6% of the sample had some comorbidity associated with breast cancer, especially hypertension (48.1%). They underwent radical surgery (60%), axillary lymphadenectomy (77.9%), sentinel lymph node biopsy (16.6%) and radiotherapy (74%). Treatments carried out for lymphedema were decongestant therapy and complementary treatments with 95.7% of adherence of women to therapies. Conclusion and implications for practice: Women with lymphedema presented risk factors such as radical surgery, axillary lymphadenectomy and radiotherapy, and good adherence to the required treatments of lymphedema. Knowing the profile of this population is crucial to the treatment choice.


RESUMEN Objetivo: Identificar el perfil de mujeres con linfedema después del tratamiento del cáncer de mama. Métodos Estudio descriptivo, retrospectivo y cuantitativo con datos de fichas médicas de mujeres con linfedema que fueron atendidas entre 2010 y 2015 en un núcleo de rehabilitación. Para la recogida de datos fue utilizado instrumento para caracterizar a las participantes y el análisis fue hecho por medio de estadística descriptiva con las pruebas de Chi-Cuadrado y Fisher. Resultados: Fueron incluidas 235 mujeres con edad media de 56,8 años, habiéndose encontrado asociación entre linfedema y edad (p = 0,016). Se observó que 76,6% de la muestra presentó alguna comorbilidad asociada al cáncer de mama con destaque para la hipertensión (48,1%). Fueron sometidas a cirugía radical (60%), a linfadenectomía axilar (77,9%), a biopsia del linfonodo centinela (16,6%) y a radioterapia (74%). Los tratamientos para cuidados con el linfedema fueron la terapia descongestiva y tratamientos complementarios con adhesión de 95,7% de las mujeres a las terapias. Conclusión e Implicaciones para la práctica: Las mujeres con linfedema presentaron factores de riesgo como cirugía radical, linfadenectomía axilar y radioterapia; se encontró buena adhesión a los tratamientos necesarios para el control del linfedema. Conocer el perfil de esta población es primordial para seleccionar los tratamientos.


RESUMO Objetivo: Identificar o perfil de mulheres com linfedema após tratamento do câncer de mama. Métodos: Estudo descritivo, retrospectivo e quantitativo com dados de prontuários de mulheres com linfedema que iniciaram atendimento entre 2010 e 2015 em um núcleo de reabilitação. Para coleta de dados foi utilizado instrumento para a caracterização das participantes e análise por meio de estatística descritiva e teste de Qui-Quadrado e Fisher. Resultados: Foram incluídas 235 mulheres com média de idade de 56,8 anos havendo associação entre linfedema e idade (p =0,016). Observou-se que 76,6% da amostra apresentaram alguma comorbidade associada ao câncer de mama com destaque para hipertensão (48,1%). Foram submetidas a cirurgia radical (60%), linfadenectomia axilar (77,9%), biopsia do linfonodo sentinela (16,6%) e radioterapia (74%). Os tratamentos para cuidados com o linfedema foram terapia descongestiva e tratamentos complementares com adesão de 95,7% das mulheres às terapias. Conclusão e Implicações para a prática: As mulheres com linfedema apresentaram fatores de risco como cirurgia radical, linfadenectomia axilar e radioterapia, e boa adesão aos tratamentos necessários para controle do linfedema. Conhecer o perfil dessa população é primordial para eleição de tratamentos.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Health Profile , Breast Neoplasms/therapy , Breast Cancer Lymphedema/complications , Body Mass Index , Comorbidity , Medical Records/statistics & numerical data , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Breast Cancer Lymphedema/therapy , Manual Lymphatic Drainage , Hypertension , Obesity
17.
Rev. bras. epidemiol ; 22(supl.3): e190010.supl.3, 2019. tab
Article in English | LILACS | ID: biblio-1057816

ABSTRACT

ABSTRACT Introduction: Brazil presented a high proportion of ill-defined causes of death (IDCD) in 2000, compromising accurate cause-of-death analysis. Objective: To analyze specific underlying causes for deaths originally assigned as IDCD in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade), after investigation activities implemented in country between 2006 and 2017. Method: For all IDCD identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Specific causes among reclassified IDCD after investigation were evaluated according to age groups and four calendar periods. Results: Proportions of IDCD reassigned to other causes after review increased over time, reaching 30.1% in 2017. From a total of 257,367 IDCD reclassified in 2006-2017, neonatal-related conditions, injury, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively. Discussion: The similarity and plausibility of cause-specific proportions derived from the reclassification of IDCD by age group over time indicate the accuracy of the investigation data. Conclusion: High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement.


RESUMO Introdução: As proporções de causas de morte mal definidas (CMD) foram elevadas no Brasil em 2000. Objetivo: Analisar causas específicas para óbitos originalmente como CMD no Sistema de Informação sobre Mortalidade (SIM), após investigação implementada no país entre 2006 e 2017. Metodologia: Para as CMD identificadas no SIM, profissionais das secretarias de saúde coletaram informações sobre a doença final obtida nos registros hospitalares, autópsias, formulários de equipes de saúde da família e investigação domiciliar. Causas específicas entre as CMD reclassificadas após investigação foram avaliadas segundo idade em quatro períodos. Resultados: Proporções de CMD reclassificadas para outras causas após revisão aumentaram ao longo do tempo, atingindo 30,1% em 2017. De um total de 257.367 CMD reclassificadas entre 2006 e 2017, causas perinatais, causas externas, cardiopatia isquêmica e doença cerebrovascular foram os principais grupamentos de causas nos grupos etários de 0-9 anos, 10-29 anos, 30-69 anos, 70 anos ou mais, respectivamente. Discussão: A similaridade e a plausibilidade das proporções de causas específicas detectadas entre as CMD nos grupos etários ao longo do tempo indicam acurácia dos dados da investigação. Conclusão: Causas mais informativas detectadas após a revisão das CMD indicam o sucesso dessa abordagem para corrigir erros de classificação no SIM, que deve ser mantida. Maior capacitação dos médicos no preenchimento do atestado de óbito e melhor acesso e qualificação dos serviços de saúde são importantes para melhoria futura.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Information Systems/statistics & numerical data , Data Collection/methods , Cause of Death , Autopsy/statistics & numerical data , Time Factors , Brazil/epidemiology , Death Certificates , Medical Records/statistics & numerical data , Interviews as Topic/statistics & numerical data , Age Factors , Age Distribution , Middle Aged
18.
Rev. bras. cir. plást ; 33(2): 161-165, abr.-jun. 2018. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-909347

ABSTRACT

Introdução: A radiação influencia negativamente os resultados das reconstruções de mama que utilizam implantes. No entanto, os efeitos da radiação sobre as reconstruções de mama apenas com tecidos autólogos ainda não está clara. O objetivo do trabalho é avaliar as complicações pós-operatórias de pacientes submetidas à reconstrução de mama com retalho do músculo reto abdominal (TRAM) imediato e tardio e correlacionar estatisticamente essas complicações com a presença ou não da radioterapia (RT). Métodos: Levantamento retrospectivo de prontuários de pacientes submetidas à reconstrução mamária, das quais 126 pacientes realizaram reconstrução mamária com TRAM no período de 2004 a 2011. Foram analisadas a presença ou não de RT e as complicações pós-operatórias nas reconstruções imediatas e tardias. As pacientes foram divididas em 3 grupos: 1) sem RT (somente TRAM), 2) (TRAM→RT), 3) (RT→TRAM). Para cada grupo foi avaliada a presença e ausência de complicações menores e maiores e aplicados testes estatísticos. Resultados: Os grupos estudados foram considerados homogêneos quanto a idade e índice de massa corporal. Houve maior incidência de complicações maiores nos grupos com RT após o TRAM (29,6%) em relação aos demais grupos: sem RT (23,4%) e RT antes do TRAM (5,6%). Entretanto, a diferença entre os grupos não se mostra estatisticamente significativa. Para as Complicações Menores, também não há evidências de diferenças estatisticamente significativas entre os grupos. Conclusão: Nesse estudo a radioterapia adjuvante não se mostrou como fator potencializador de complicações nas pacientes submetidas à reconstrução imediata com TRAM pós-mastectomia.


Introduction: Radiation negatively influences the results of breast reconstruction using implants. However, the effects of radiation on breast reconstruction with autologous tissue is still unclear. The objective of this study was to evaluate the postoperative complications in patients who underwent immediate and late breast reconstruction with a transverse rectus abdominis myocutaneous (TRAM) flap and statistically correlate these complications with the use of radiotherapy (RT). Methods: A retrospective survey of the medical records of patients who underwent breast reconstruction was conducted. Of the patients, 126 underwent breast reconstruction with a TRAM flap between 2004 and 2011. The presence or absence of RT and postoperative complications in the immediate and late reconstructions was assessed. The patients were divided into 3 groups as follows: 1) without RT (TRAM alone group), 2) TRAM→RT group, and 3) RT→TRAM group. The patients in each group were evaluated for the presence and absence of minor and major complications, and results were statistically analyzed. Results: The groups were considered homogenous for age and body mass index. The incidence of major complications was higher in the groups with RT after TRAM (29.6%) than in the other groups, namely the groups without RT (23.4%) and with RT before TRAM flap reconstruction (5.6%). However, the differences among the groups were not statistically significant. No evidence of statistically significant differences in minor complications were found among the groups. Conclusion: In this study, adjuvant RT was not a potentiating factor of complications in the patients who underwent immediate reconstruction with a TRAM flap after mastectomy.


Subject(s)
Humans , Female , History, 21st Century , Postoperative Complications , Radiotherapy , Surgical Flaps , Breast , Medical Records , Retrospective Studies , Reconstructive Surgical Procedures , Postoperative Complications/diagnosis , Radiotherapy/methods , Surgical Flaps/surgery , Breast/surgery , Breast/radiation effects , Medical Records/standards , Medical Records/statistics & numerical data , Reconstructive Surgical Procedures/methods
19.
Rev. bras. cir. plást ; 33(2): 156-160, abr.-jun. 2018. tab
Article in English, Portuguese | LILACS | ID: biblio-909345

ABSTRACT

Introdução: A abdominoplastia é uma das cirurgias estéticas mais realizadas no Brasil. As complicações deste procedimento são diversas, sendo o seroma uma das mais frequentes. O objetivo do trabalho é identificar fatores de risco para formação de seroma tais como: índice de massa corporal (IMC), comorbidades, idade, hábitos e tempo de permanência de dreno. Métodos: Trata-se de um estudo retrospectivo com revisão de 94 prontuários de pacientes submetidos à abdominoplastia clássica no Serviço de Cirurgia Plástica e Queimados da Santa Casa de Misericórdia de São José do Rio Preto-SP, entre novembro de 2010 e novembro de 2013. Os fatores de risco para formação do seroma foram analisados utilizando-se o teste exato de Fisher ou Qui-quadrado. Considerou-se como resultado estatisticamente significativo o valor de p < 0,05. Resultados: O seroma foi identificado em 16 pacientes (17,02%) do total da amostra (n = 94). Não se observou significância estatística ao relacionar a elevação na incidência de seroma com o aumento do IMC, assim como os demais fatores de risco analisados. Houve relevância clínica quanto ao tempo de permanência do dreno. Pacientes que mantiveram o dreno por um período maior que um dia tiveram incidência menor de seroma. Conclusão: A formação do seroma deve ser considerada uma causa multifatorial. Os fatores de risco analisados não demonstraram estatisticamente aumento na incidência de seroma. Todavia, a permanência do dreno de sucção por um período maior que um dia demonstrou ser eficaz na prevenção do seroma.


Introduction: Abdominoplasty is one of the most common cosmetic surgeries in Brazil. The complications of this procedure are diverse, with seroma being one of the most frequent. The objective of this study was to identify the risk factors for the formation of seroma, such as increased body mass index, comorbidities, age, habits, and time of drain permanence. Methods: This was a retrospective study in which the medical records of 94 patients who underwent abdominoplasty at the Plastic Surgery and Burns Service of Santa Casa de Misericórdia de São José do Rio Preto-SP between November 2010 and November 2013 were reviewed. The risk factors for the formation of seroma were analyzed using Fisher's exact test and the Chi-square test, with the significance level set at p < 0.05. Results: Seroma was identified in 16 (17.02%) of the total patients (n = 94). No statistical significance was observed between increased incidence of seroma and increased BMI and other risk factors analyzed. Nevertheless, the time of drain permanence showed a clinical relevance. The patients who were maintained on the drain for > 1 day had a lower incidence of seroma. Conclusion: The causes of seroma should be considered multifactorial. The risk factors analyzed were not significantly related to the increased incidence of seroma. However, drain permanence for >1 day was effective in the prevention of seroma.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , History, 21st Century , Postoperative Complications , Body Mass Index , Medical Records , Retrospective Studies , Risk Factors , Seroma , Abdominoplasty , Postoperative Complications/surgery , Medical Records/standards , Medical Records/statistics & numerical data , Seroma/surgery , Seroma/complications , Abdominoplasty/methods
20.
Rev. bras. cir. plást ; 33(1): 56-63, jan.-mar. 2018. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-883638

ABSTRACT

Introdução: Os pacientes com defeitos de parede abdominal chegam ao consultório do cirurgião plástico em situações muitas vezes complexas, necessitando de abordagem cirúrgica avançada. Métodos: Estudo primário, retrospectivo e descritivo de pacientes submetidos a procedimentos cirúrgicos de reconstrução de parede abdominal pelo Serviço de Cirurgia Plástica do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE). Resultados: Foram revisados e incluídos os prontuários de 18 pacientes, 15 (83,3%) do sexo feminino e 3 (16,7%) do masculino, com idade variando de 16 a 79 anos (média de 41 anos). Dezessete pacientes possuíam histórico de cirurgia prévia (94,4%), sendo a cesárea presente em 8 dos casos (44,4%), seguida de cirurgia oncológica com 6 (33,3%), cirurgia do trauma com 2 (11,1%) e bariátrica com 2 (11,1%). Em relação à etiologia do defeito, 8 (44,4%) eram decorrentes de fasciite necrosante, 4 (22,2%) de hérnia incisional, 2 (11,1%) por trauma, 2 (11,1%) por infecção de ferida operatória e 2 (11,1%) por neoplasia de parede abdominal, sendo somente um (5,5%) paciente com defeito de espessura total. A técnica cirúrgica de separação dos componentes foi realizada em 7 dos casos (38,9%), seguida de retalho de avanço simples em 6 (33,3%), fechamento com tela associado à abdominoplastia em 3 (16,7%), e expansor tecidual em 2 (11,1%). Quanto às complicações, houve 4 casos (22,2%). Conclusões: Defeitos de parede abdominal são casos desafiadores para o cirurgião plástico, seu tratamento se mostra árduo, porém com resultados satisfatórios mesmo nos casos mais severos.


Introduction: Patients with abdominal wall defects present challenging complications that require the use of advanced surgical approaches. Methods: This primary, retrospective, and descriptive study evaluated patients who underwent abdominal wall reconstruction at the Plastic Surgery Service of the Clinics Hospital of the Federal University of Pernambuco. Results: The medical records of 18 patients were reviewed, including 15 women (83.3%) and 3 men (16.7%), with a mean age of 41 years (range, 16-79 years). Seventeen patients (94.4%) had a history of previous surgery. The causes of abdominal injury were cesarean section in eight cases (44.4%), oncologic surgery in six (33.3%), trauma surgery in two (11.1%), and bariatric surgery in two (11.1%). The etiology of the defect was necrotizing fasciitis in eight cases (44.4%), incisional hernia in four (22.2%), trauma in two (11.1%), surgical wound dehiscence in two (11.1%), abdominal wall neoplasia in two (11.1%), and total thickness defect in one (5.5%). The surgical interventions included the component separation technique in seven cases (38.9%), simple VY advancement flap in six (33.3%), closure with abdominoplasty in three (16.7%), and tissue expander in two (11.1%). Four patients (22.2%) presented complications. Conclusions: Abdominal wall defects are challenging cases for plastic surgeons, as their treatment is difficult, but the results are satisfactory even in the most severe cases.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , History, 21st Century , Minor Surgical Procedures , Medical Records , Retrospective Studies , Fasciitis, Necrotizing , Reconstructive Surgical Procedures , Abdominal Wall , Hernia, Abdominal , Abdomen , Fascia , Hernia, Ventral , Minor Surgical Procedures/adverse effects , Minor Surgical Procedures/methods , Medical Records/statistics & numerical data , Fasciitis, Necrotizing/surgery , Fasciitis, Necrotizing/complications , Reconstructive Surgical Procedures/instrumentation , Reconstructive Surgical Procedures/methods , Abdominal Wall/abnormalities , Abdominal Wall/surgery , Hernia, Abdominal/surgery , Hernia, Abdominal/complications , Fascia/injuries , Abdomen/surgery , Hernia, Ventral/surgery , Hernia, Ventral/complications
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