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1.
Article in English | WPRIM (Western Pacific) | ID: wprim-719288

ABSTRACT

Recent changes in American and European guidelines on the management of arterial hypertension have caused a considerable shift in the landscape of hypertension management. The 2017 American College of Cardiology/American Heart Association/American Society of Hypertension guideline recommends an office visit blood pressure (BP) > 130/80 mmHg as the new threshold for diagnosis of hypertension, and states that the treatment goal for all hypertensive patients should be lowered to < 130/80 mmHg. In contrast, the 2018 European guideline maintains the diagnostic threshold of hypertension at 140/90 mmHg. However, despite their differences in thresholds for diagnosis of hypertension, both guidelines are in agreement that treatment should be considered in patients with BPs in the range of 130 to 139/80 to 89 mmHg if they have high cardiovascular risk. The results from the Systolic Blood Pressure Intervention Trial (SPRINT) study and recent meta-analyses suggest that BP lowering with antihypertensive treatment may be beneficial in reducing cardiovascular event rates in subjects with high-normal BP or stage 1 hypertension according to the new American guideline. However, intensive BP lowering is associated with increased incidence of treatment-associated adverse events, and evidence suggests that BP lowering below 120/70 mmHg increases the risk of cardiovascular events. In this review, we discuss the evidence supporting antihypertensive treatment in subjects with high-normal BP and discuss the specific subgroup of subjects that might benefit from BP lowering.


Subject(s)
Blood Pressure , Cardiovascular Diseases , Diagnosis , Heart , Humans , Hypertension , Incidence , Office Visits , Risk Assessment
2.
Porto Alegre; s.n; 2019. 20 p p.
Thesis in Portuguese | LILACS (Americas) | ID: biblio-1047575

ABSTRACT

Resumo: Há diversos movimentos sociais e políticos em defesa dos direitos da população em Situação de Rua. Na busca pela garantia do acesso a saúde e rompimento com a perspectiva excludente, muitos são os caminhos e ações intersetoriais construídos. Todavia ainda se faz necessário desvendar caminhos que possam fortalecer a rede de apoio e de serviços. A presente pesquisa procura conhecer o papel dos profissionais do Consultório na Rua Pintando Saúde no itinerário terapêutico da população em situação de rua, localizado na Zona Norte do município de Porto Alegre. Trata-se de um estudo qualitativo, tendo por procedimento metodológico entrevistas abertas com os profissionais envolvidos no cuidado. Com base nas entrevista foram propostas quatro categorias de análise: A Rua, Contrapontos na Rede, R-existências e Vinculação.. Os resultados descrevem os desafios enfrentados pela equipe no compartilhamento dos cuidados na rede intersetorial. Também apontam para a importância da prática cotidiana do Consultório na Rua tornar-se mais resolutiva, ampliando os instrumentos de atenção à saúde. (AU)


Subject(s)
Office Visits , Unified Health System , Brazil , Public Health
3.
Cambios rev. méd ; 17(2): 5-11, 28/12/2018. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1005224

ABSTRACT

INTRODUCCIÓN. La desnutrición y la depresión son problemas frecuentes en adultos mayores y tienen características propias. Varios factores modificables están asociados. OBJETIVO. Determinar la existencia de relación entre desnutrición y depresión en mujeres mayores de 65 años atendidas en la consulta externa del Hospital de Especialidades Carlos Andrade Marín en el año 2017. MATERIALES Y MÉTODOS. Estudio relacional, transversal en mujeres con estado nutricional normal y desnutrido. La muestra fue de 160 mujeres adultas mayores, en dos grupos de 80 pacientes con y sin desnutrición. Se aplicaron las escalas de: Yesavage para depresión, de Katz para dependencia y de Gijón para valoración socio-familiar. La asociación se estableció mediante Chi Cuadrado de homogeneidad, la fuerza de asociación se midió con Razón de prevalencia. RESULTADOS. La proporción de depresión en pacientes con desnutrición fue el doble que en las no desnutridas, p valor de 0,003 y OR de 2,82 (1,42-5,59). Además, se encontró relación estadísticamente significativa entre desnutrición con: viudez, baja instrucción, bajos ingresos, dependencia, poca ayuda social, aislamiento; y, vivienda con barreras arquitectónicas. CONCLUSIÓN. Existió asociación entre desnutrición y depresión. Las pacientes con desnutrición tienen más probabilidades de presentar síntomas depresivos.


INTRODUCTION. Malnutrition and depression are frequent problems in older adults and have their own characteristics. Several modifiable factors are associated. OBJECTIVE. To determine the existence of a relationship between malnutrition and depression in women over 65 years of age treated in the outpatient clinic of the Carlos Andrade Marín Specialty Hospital in 2017. MATERIALS AND METHODS. Relational, cross-sectional study in women with normal and malnourished nutritional status. The sample was 160 older adult women, in two groups of 80 patients with and without malnutrition. The following scales were applied: Yesavage for depression, Katz for dependency and Gijón for socio-family assessment. The association was established by Chi Square of homogeneity, the strength of association was measured with Reason of prevalence. RESULTS. The proportion of depression in patients with malnutrition was double that in the non-malnourished, p value of 0,003 and OR of 2,82 (1,42-5,59). In addition, a statistically significant relationship was found between malnutrition with: widowhood, low education, low income, dependency, little social help, isolation; and, housing with architectural barriers. CONCLUSIONS. There was an association between malnutrition and depression. Patients with malnutrition are more likely to have depressive symptoms.


Subject(s)
Humans , Male , Female , Aged , Aged , Socioeconomic Survey , Malnutrition , Office Visits , Activities of Daily Living , Depression
6.
Braz. dent. j ; 28(6): 720-725, Nov.-Dec. 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-888701

ABSTRACT

Abstract The aim of the present study was to evaluate colorimetric changes and tooth sensitivity in adolescents and young patients submitted to tooth bleaching with 20% and 35% hydrogen peroxide. A randomized, controlled, clinical trial was conducted with 53 patients aged 11 to 24 years who were allocated to groups based on the use of the following commercial products: Whiteness HP - FGM® (35% hydrogen peroxide); Whiteness HP Blue Calcium - FGM® (35% hydrogen peroxide); and Whiteness HP Blue Calcium - FGM® (20% hydrogen peroxide). After the bleaching procedure, the visual analog scale was used to measure tooth sensitivity and the Vita Classical Shade guide was used to determine changes in tooth color. Statistical analysis involved the Friedman, Kruskal-Wallis and Student-Newman-Keuls tests, with p≤0.05 considered indicative of statistical significance. The addition of calcium contributed to a reduction in tooth sensitivity, especially when the lower concentration of hydrogen peroxide (20%) was used. Tooth sensitivity occurred in a transitory way and did not influence the tooth bleaching process. Significant differences in color were found after each of the two bleaching sessions. In-office tooth bleaching was considered an effective method for adolescents and young adults. Further studies in this population are necessary in order to fully evaluate the effects of bleaching in young teeth.


Resumo O objetivo do presente estudo foi avaliar alterações colorimétricas e sensibilidade dentária em adolescentes e jovens submetidos ao clareamento dental com peróxido de hidrogênio a 20% e 35%. Foi realizado um ensaio clínico controlado e randomizado com 53 pacientes, com idade entre 11 e 24 anos, que foram alocados em grupos com base nos seguintes produtos comerciais: Whiteness HP - FGM® (35% peróxido de hidrogênio); Whiteness HP Blue Calcium - FGM® (peróxido de hidrogénio a 35%); e Whiteness HP Blue Calcium - FGM® (20% de peróxido de hidrogênio). Após o procedimento de clareamento, a escala analógica visual foi utilizada para medir a sensibilidade dentária e a escala clássica Vita® foi utilizada para determinar as alterações de coloração. A análise estatística envolveu os testes de Friedman, Kruskal-Wallis e Student-Newman-Keuls, com valor de p≤0,05 considerado indicativo de significância estatística. A adição de cálcio contribuiu para uma redução da sensibilidade dentária, especialmente quando se utilizou a menor concentração de peróxido de hidrogénio (20%). A sensibilidade dentária ocorreu de forma transitória e não influenciou o processo de clareamento dos dentes. Foram encontradas diferenças significativas na cor após cada uma das duas sessões de clareamento. O clareamento dental de consultório foi considerado um método eficaz para adolescentes e adultos jovens. Estudos adicionais nesta população são necessários para avaliar completamente os efeitos do clareamento em dentes jovens.


Subject(s)
Humans , Adolescent , Gels , Hydrogen Peroxide/administration & dosage , Office Visits , Tooth Bleaching/methods
7.
Arch. pediatr. Urug ; 87(4): 332-341, dic. 2016. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-827819

ABSTRACT

Introducción: la asistencia de niños con condiciones de salud pasibles de Cuidados Paliativos (CP) en servicios de emergencia pediátrica constituye un desafío para los equipos de salud. Objetivo: describir la prevalencia de consultas, problemas de salud y características de niños pasibles de CP asistidos en el Departamento de Emergencia Pediátrica del Centro Hospitalario Pereira Rossell. Metodología: estudio descriptivo, retrospectivo entre el 20/06/2014 y el 19/06/2015. Variables: edad, condición de salud, requerimiento de prótesis, motivo de consulta, existencia de: consulta previa, pediatra tratante, vinculación con Unidad de Cuidados Paliativos Pediátricos (UCPP), directivas anticipadas y condición al egreso. Resultados: se incluyeron 175 niños pasibles de CP. Éstos significaron 0,7% (340/ 46.706) de las consultas en el período analizado. Mediana de edad: 5,7 años, (1 mes - 16 años). Presentaban afectación neurológica severa 65%; portaban prótesis o dispositivo de tecnología médica 50,3% (11% más de una); consultaron por infecciones 42% (respiratoria 81%), problemas neurológicos 20,3% (convulsiones 87%). Presentaban consulta previa por igual motivo 93%. Refirieron: contar con pediatra tratante 66,3%; estar vinculados con la UCPP 42,3%; contaban con directivas anticipadas 20%. Ingresaron a: cuidados moderados 39%; terapia intensiva 2%. No se registraron fallecimientos. Conclusiones: se constataron diversas situaciones y características de los pacientes incluidos que traducen la complejidad de su condición clínica y eventuales dificultades para el abordaje en el primer nivel de atención o en sus departamentos de procedencia.


Introduction: the assistance of children in need of Palliative Care (CP) in pediatric emergency services is a challenge for health teams. Objective: To describe the prevalence of consultations, health problems and characteristics of children in need of PC assisted in the Pereira Rossell Hospital Center Pediatric Emergency Department. Methodology: descriptive, retrospective study between 20/06/ 2014- 19/06/2015. Variables: age, health condition, prosthesis, previous consultation, attending pediatrician, relation with Pediatric Palliative Care Unit (UCPP), advanced care plan and condition at discharge. Results: 175 children in need of PC were included which represented 0.7% (340 / 46,706) of consultations in the period. Median age: 5.7 years (1 month - 16 years); 65% had severe neurological impairment; 50.3% carried prosthesis or medical technological devices (11% more than one); reason for consultation was: 42% infections, 42% (81% respiratory), 20. 3% neurological problems (87% seizures); 93% presented a previous consultation for the same reason; 66.3% reported having an attending pediatrician; 42.3% were under UCPP assistance; 20% had advanced care plan. At discharge: 39% were admitted in moderate care; 2% in intensive care. No deaths were recorded. Conclusion: the different situations and characteristics of the patients included represent the complexity of their clinical condition and may be related to possible difficulties in addressing their problems at the primary care level or their provinces of origin.


Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Adolescent , Office Visits/statistics & numerical data , Palliative Care/statistics & numerical data , Pediatrics , Emergency Medicine/statistics & numerical data , Therapeutics/statistics & numerical data , Uruguay/epidemiology , Chronic Disease , Epidemiology, Descriptive , Prevalence , Retrospective Studies
8.
Rev. bras. med. fam. comunidade ; 11(38): 1-13, jan./dez. 2016. tab
Article in Portuguese | LILACS (Americas), ColecionaSUS | ID: biblio-878050

ABSTRACT

Objetivo: Avaliar o acesso às consultas médicas em serviços públicos de saúde. Métodos: Pesquisa transversal, analítica de base populacional, em município de porte médio, no estado de Minas Gerais, Brasil. Os dados foram coletados a partir de questionário semiestruturado a uma amostra representativa do município, de 2150 indivíduos. O tratamento estatístico considerou o nível de significância p<0,05. Resultados: Dos entrevistados, 19,4% afirmaram ter procurado um profissional/serviço público de saúde nos 15 dias anteriores à entrevista. Entre esses, 75,6% foram na Atenção Primária à Saúde (APS). A maior procura foi por parte do sexo feminino (p<0,001) e os sem plano de saúde (p<0,001). A maioria (77,2%) foi atendida na primeira vez que procurou o serviço de saúde pública. Pode-se destacar uma maior prevalência ao não acesso quando a procura foi na APS e para tratamento/reabilitação (p<0,05). A utilização de consultas médicas no ano foi observada para 54,4%, com maiores médias para mulheres, adultos e sem plano (p<0,05). Conclusão: Necessita-se repensar a gestão de saúde pública e as práticas dos profissionais para efetivar o acesso às consultas médicas. Assim, sugere-se adotar medidas de acolhimento e educação permanente junto aos profissionais da saúde da família.


Objective: To assess the accessibility to medical appointments in public health services. Methods: Transversal, analytic, population-based research in a medium-sized city in the state of Minas Gerais, Brazil. The data were collected from a semi structured questionnaire presented to a representative sample of the city, of 2150 people. The statistic treatment considered p<0.05 as the level of significance. Results: 19.4% of the interviewees reported having sought a public health professional/service up to 15 days prior to the interview. Among these cases, 75.6% occurred in the Primary Health Care (PHC). The majority of these seekers were females (p<0.001) and people with no private health insurance (p<0.001). The majority (77.2%) was seen in the first time they sought the public health service. A bigger prevalence of no access could be highlighted when the patient sought the PHC and for treatment/rehabilitation (p<0.05). The use of medical service in that year was reported to be 54.4%, with a higher average for women, adults and people with no private health insurance (p<0.05). Conclusion: It is necessary to think over the public health management and professional conduct to make medical appointments effective. Therefore, adopting welcoming and permanent teaching measures among family health professionals is advised.


Objetivo: Evaluar el acceso a las consultas médicas en los servicios públicos de la salud. Métodos: Investigación transversal, analítica de base poblacional en un municipio de porte medio, en el estado de Minas Gerais, Brasil. Los datos fueron recolectados a partir de cuestionario semiestructurado a una muestra representativa del municipio, de 2150 individuos. El tratamiento estadístico considero el nivel de significación p<0,05. Resultados: De los entrevistados, 19,4% afirmaron haber buscado un profesional/servicio público de salud, en los 15 días anteriores a la entrevista. Entre estos, 75,6% fueron en la Atención Primaria a la Salud (APS). La mayor búsqueda fue del sexo femenino (p<0,001) y los que no tienen seguro de salud (p<0,001). La mayoría (77,2%) fue atendida la primera vez que buscó el servicio de salud pública. Se puede destacar una mayor prevalencia al no acceso cuando la búsqueda fue en el APS y para tratamiento/rehabilitación (p<0,05). La utilización de consultas médicas en el año fue observada para 54,4%, con mayores promedios para mujeres, adultos y los que no tienen seguro (p<0,05). Conclusión: Se necesita volver a pensar la gestión de la salud pública y las prácticas de los profesionales para efectuar el acceso a las consultas médicas. Así, se sugiere adoptar medidas de recepción y educación permanente junto a los profesionales de la salud de la familia.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Consumer Behavior , Health Services Accessibility , Office Visits , Unified Health System
9.
Journal of Korean Diabetes ; : 253-256, 2016.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-726764

ABSTRACT

Comprehensive education is the cornerstone of diabetes management. However, in Korea, diabetes education is constrained by short office visits. This article intends to introduce various educational strategies, particularly regarding diet style modification, that can be employed in the time-limited outpatient setting to improve diabetes management. Instructing patients to reduce their intake of carbohydrates, the predominant nutrient consumed in a traditional Korean diet, may be beneficial. The use of novel educational technologies or the introduction of new healthy diet plans may also help.


Subject(s)
Carbohydrates , Diabetes Mellitus , Diet , Diet, Diabetic , Education , Educational Technology , Humans , Korea , Nutrition Therapy , Office Visits , Outpatients
10.
Article in English | WPRIM (Western Pacific) | ID: wprim-180367

ABSTRACT

OBJECTIVE: We sought to identify whether the characteristics of long-term visit-to-visit blood pressure (BP) and heart rate (HR) are related to baseline cognitive profiles in, Parkinson’s disease (PD). METHODS: We selected drug-naïve PD patients who visited our hospital at least 10 times with a baseline assessment of the Seoul neuropsychological battery. BP and HR were measured at each visit, and the variability of the systolic BP/diastolic BP (DBP) and HR was derived from the parameters of serial 10 office visits. Mild cognitive impairment (MCI) in PD patients was determined according to the proposed criteria with a cut-off value of z-score ≤ -2. RESULTS: Forty-seven patients with PD (mean follow-up duration = 22.3 months) were enrolled in the study. Compared with non-MCI PD patients, MCI PD patients revealed a significant increase in HR and/or variability in DBP. CONCLUSION: This exploratory study showed that baseline cognition in drug-naïve PD patients might be related to the visit-to-visit variability of DBP and/or HR.


Subject(s)
Blood Pressure , Cognition , Follow-Up Studies , Heart Rate , Heart , Humans , Cognitive Dysfunction , Office Visits , Parkinson Disease , Seoul
11.
Rev. gaúch. enferm ; 37(1): e51467, 2016. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-960716

ABSTRACT

RESUMO Objetivos avaliar o acompanhamento e desfecho do tratamento de casos de tuberculose pulmonar no programa de controle da tuberculose de um município prioritário do Sul do Brasil. Métodos estudo quantitativo, descritivo, documental, utilizando prontuários das pessoas com tuberculose em tratamento entre 2009-2013, a coleta ocorreu entre junho e julho de 2014 no Programa de Controle da Tuberculose. Utilizou-se estatística descritiva. Resultados a média de consultas, entre os 629 pacientes, foi de 7,2 por paciente, com intervalo médio de 1,03 meses entre as consultas. A média de baciloscopias foi de 2,7 exames por paciente, durante o período estudado. O desfecho do tratamento foi 87,8% de cura, 8,3% de abandono e 6,5% de óbitos. Conclusões apesar do alcance da taxa de cura, o abandono ainda é elevado, sendo necessário explorar estratégias para melhor a adesão ao tratamento, e o comprometimento da gestão municipal em articular o acompanhamento na atenção primária à saúde.


RESUMEN Objetivo evaluar el seguimiento y tratamiento de la tuberculosis pulmonar en el programa de control de la tuberculosis en una ciudad prioridad en el sur de Brasil. Método estudio cuantitativo, descriptivo, documental, usando los registros de personas con tuberculosis tratados entre 2009-2013, los datos fueron recogidos entre junio y julio de 2014 en el programa de control de la tuberculosis. Se utilizó estadística descriptiva. Resultados entre los 629 pacientes el número medio de visitas fue de 7,2 por paciente, con un intervalo medio de 1,03 meses entre las visitas, y la media fue de 2,7 microscopías por paciente, no periodo del estudio. El resultado del tratamiento fue del 87,8% de curación, el 8,3% de deserción y 6,5% de muertes. Conclusión a pesar de la tasa de curación, el abandono es aún elevado, siendo necesario explorar estrategias para mejorar la adherencia al tratamiento, así como el compromiso de la gestión municipal en el seguimiento conjunto de los pacientes con tuberculosis por la atención primaria.


ABSTRACT Objectives To monitor and assess the outcome of treatment for pulmonary tuberculosis in the tuberculosis control program in a prioritized municipality in Southern Brazil. Methods a quantitative study, descriptive, documentary, using records of people with tuberculosis in treatment between 2009-2013, the collection took place between June and July 2014 in the Tuberculosis Control Program. Descriptive statistics was used. Results The average number of consultations among the 629 patients was 7.2 per patient, with a mean interval of 1.03 months between visits. The average of smears was 2.7 tests per patient during the study period. The outcome of treatment was a cure rate of 87.8%, an abandonment rate of 8.3% and 6.5% of deaths. Conclusions despite the cure rate, abandonment is still high, thus, it is necessary to explore strategies for better adherence to treatment, and the commitment of the municipal administration in articulating monitoring in primary health care.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Tuberculosis/drug therapy , Office Visits/statistics & numerical data , Patient Dropouts/statistics & numerical data , Tuberculosis/epidemiology , Tuberculosis/diagnostic imaging , Urban Population , Brazil/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Comorbidity , HIV Infections/diagnosis , HIV Infections/epidemiology , Survival Rate , Treatment Outcome , Diabetes Mellitus/epidemiology , Diagnostic Tests, Routine/statistics & numerical data , Middle Aged , Antitubercular Agents/therapeutic use
12.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-59419

ABSTRACT

Pregnancy planning is critical to ensuring optimal conditions for conception, gestation, and the subsequent birth of a healthy child. Preconception care for men is important for reproductive life as much as women's preconception health and healthcare; however, little attention has been paid to male preconception care in Korea. Appropriate preconception care seeks to guide reproductive life planning, improve pregnancy outcomes, ensure a man's capacity for parenthood and fatherhood, and enhance reproductive health. Additionally, preconception care for either sex offers the opportunity for disease prevention and health promotion. Clinicians thus have the opportunity to positively impact the reproductive health of men. Although men are less likely than women to consistently seek medical services, an office visit for any reason should be seen as an opportunity to introduce the idea of reproductive health. The recommendation of a subsequent office visit for physical examination with a focus on health promotion, disease prevention, and reproductive assessment is strongly encouraged. This paper focuses on risk assessment, one of the key elements of comprehensive optimization of male preconception care.


Subject(s)
Child , Delivery of Health Care , Female , Fertilization , Health Promotion , Humans , Korea , Male , Multiple Endocrine Neoplasia Type 1 , Office Visits , Parturition , Physical Examination , Preconception Care , Pregnancy , Pregnancy Outcome , Reproductive Health , Risk Assessment
13.
Odontol. pediatr. (Lima) ; 14(1): 48-57, ene.-jul.2015. ilus, tab
Article in Spanish | LILACS (Americas), LIPECS | ID: lil-790455

ABSTRACT

Se realizó un estudio descriptivo prospectivo con el propósito de determinar los efectos cardiorrespiratorios en el niño durante su primera visita odontológica en la Clínica Estomatológica Pediátrica de la Universidad Alas Peruanas, sin la presencia de alguna condición pre-existente, como dolor, las visitas dentales traumáticas previas, uso de medicamentos y enfermedades sistémicas. Material y métodos: Se registró la frecuencia cardiaca, saturación de oxígeno, presión arterial, temperatura corporal y frecuencia respiratoria de 70 niños antes de la primera visita odontológica (sala de espera) y después de la atención (sala clínica) con un oximetro de pulso dactilar, tensiómetro digital, termómetro frontal y un reloj de pulsera. Resultados: mostro una temperatura corporal basal y post operatoria de 36°C y 36,l°C; respectivamente (p= 0,057). La presión arterial sistólica basal fue de 96 mm Hg y post operatoria de 93 mm Hg (p= 0,156), mientras que la diastólica basal fue de 63 mm Hg y post operatoria de 63 mm Hg (p= 0,624). La saturación de oxigeno basal de 96% y post operatoria 93% (p= 0,001). La frecuencia cardiaca basal fue de 88 ppm y post operatoria de 85 ppm (p= 0,229). La frecuencia respiratoria basal fue de 20 rpm y post operatoria de 20 rpm (p= 0,006). Se concluyó que existen cambios cardiorrespiratorios significativos en la primera visita odontológica, al presentar diferencias significativas en los valores de la saturación de oxígeno y frecuencia respiratoria, registradas antes y después de la atención odontológica...


A descriptive, cross-sectional study was performed to determine the cardiorespiratory effects in child's first dental visit to the Pediatric Dental Clinic at Alas Peruanas University, without the presence of any pre-existing condition, such as pain, previous traumatic dental visits, use of medications and systemic diseases. Material and methodos: To accomplish this, heart rate, oxygen saturation, blood pressure, body temperature and respiratory rate were recorded on 70 children before (waiting room) and after first dental visit (operating room) using a finger pulse oximeter, digital sphygmomanometer, thermometer and a wristwatch. Results: showed basal and postoperative body temperature registered 36° C and 36.1° C, respectively. Basal systolic blood pressure registered 96 mm Hg and postoperative 93 mm Hg, and basal diastolic blood pressure registered 63 mm Hg and postoperative 63 mm Hg. Basal oxygen saturation registered 96% and postoperative 93%. Basal heart rate registered 88 bpm and postoperative 85 bpm. Basal respiratory rate registered 20 bpm and postoperative 20 bpm. The author concluded that significant cardiorespiratory changes exist during first dental visit, existing significant differences in oxygen saturation and respiratory rate recorded before and after dental care...


Subject(s)
Humans , Male , Female , Child , Dental Anxiety , Dental Care for Children , Office Visits , Evaluation Studies as Topic , Evaluation Studies as Topic , Epidemiology, Descriptive
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-216630

ABSTRACT

BACKGROUND/AIMS: The detection of white coat hypertension (WCH), treated normalized hypertension, and masked hypertension (MH) is important to improve the effectiveness of hypertension management. However, whether global cardiovascular risk (GCR) profile has any effect on the discordance between ambulatory blood pressure (ABP) and clinic blood pressure (CBP) is unknown. METHODS: Data from 1,916 subjects, taken from the Korean Multicenter Registry for ABP monitoring, were grouped according to diagnostic and therapeutic thresholds for CBP and ABP (140/90 and 135/85 mmHg, respectively). GCR was assessed using European Society of Hypertension 2007 guidelines. RESULTS: The mean subject age was 54.1 ± 14.9 years, and 48.9% of patients were female. The discordancy rate between ABP and CBP in the untreated and treated patients was 32.5% and 26.5%, respectively (p = 0.02). The prevalence of WCH or treated normalized hypertension and MH was 14.4% and 16.0%, respectively. Discordance between ABP and CBP was lower in the very high added-risk group compared to the moderate added-risk group (odds ratio [OR], 0.649; 95% confidence interval [CI], 0.487 to 0.863; p = 0.003). The prevalence of WCH or treated normalized hypertension was also lower in the very high added-risk group (OR, 0.451; 95% CI, 0.311 to 0.655). CONCLUSIONS: Discordance between ABP and CBP was observed more frequently in untreated subjects than in treated subjects, and less frequently in the very high added-risk group, which was due mainly to the lower prevalence of WCH or treated normalized hypertension.


Subject(s)
Adult , Aged , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Chi-Square Distribution , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Masked Hypertension/diagnosis , Middle Aged , Multivariate Analysis , Observer Variation , Odds Ratio , Office Visits , Predictive Value of Tests , Prevalence , Registries , Reproducibility of Results , Republic of Korea/epidemiology , Risk Assessment , Risk Factors , White Coat Hypertension/diagnosis
15.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-172690

ABSTRACT

PURPOSE: Emergency department (ED) and Outpatient department (OPD) are similar to some extent, but there are differences. The difference is complaints that can be encountered during practice. The aim of this study was to investigate complaints of OPD and ED and factors associated with Re-visits. METHODS: We retrospectively investigated 431 official complaints of visitors and 426 re-visitors in one tertiary university hospital OPD and ED between January 1, 2011 and December 31, 2014. RESULTS: ED complaints were 18 times more common than OPD. The two groups differed in chronic disease, follow up duration and frequency, transportation, visiting day of the week, visiting time, relation between patient and claimant, claimant age, related department, medical department, method of expression, major reason for complaints, treatment result, and re-visit. The factors associated with ED re-visits were chronic disease, follow up duration and frequency, treatment result, and expression method. CONCLUSION: Doctors, particularly emergency physicians in the ED, were the subject of the most common complaints. Patients had more complaints about the subjective time delay than the ED retention time. Emergency physicians should be more alert for first visit patients.


Subject(s)
Chronic Disease , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Follow-Up Studies , Humans , Office Visits , Outpatients , Personal Satisfaction , Retrospective Studies , Tertiary Care Centers , Transportation
16.
Article in English | WPRIM (Western Pacific) | ID: wprim-76677

ABSTRACT

BACKGROUND/AIMS: Ambulatory blood pressure (BP) monitoring has been widely recommended for evaluating the status of BP, but is lacking in practicality. Determination of the specific time points for BP measurement that are representative of 24-hour mean BP could be useful and convenient in hypertensive patients with chronic kidney disease (CKD). METHODS: A total of 1,317 patients for whom 24-hour ambulatory BP monitoring was performed were enrolled in a multicenter study on hypertensive CKD. We analyzed the time points at which systolic blood pressure (SBP) values exhibited the smallest differences from 24-hour mean SBP (mSBP). We included office mSBP and analyzed the relationships between SBPs at the office and the time points with the smallest differences from 24-hour mSBP using several methods. RESULTS: The time points with the smallest differences from 24-hour mSBP were 7:00 AM, 2:00 PM, and 9:30 PM. In regression analysis, SBPs at 7:00 AM and 9:30 PM were better correlated with 24-hour mSBP than SBPs at 2:00 PM and the office. The proportions of patients with SBPs within 30% of 24-hour mSBP were higher at 7:00 AM and 9:30 PM. The best consistency between the uncontrolled hypertensive groups, defined as > or = 135 mmHg of 24-hour mSBP and higher values of SBPs corresponding to 135 mmHg of 24-hour mSBP, were observed at the 7:00 AM and 9:30 PM time points. CONCLUSIONS: The specific time points for SBPs that correlated well with 24-hour mSBP in hypertensive CKD patients were 7:00 AM and 9:30 PM.


Subject(s)
Adult , Aged , Blood Pressure , Blood Pressure Monitoring, Ambulatory/methods , Circadian Rhythm , Cross-Sectional Studies , Female , Humans , Hypertension/diagnosis , Male , Middle Aged , Office Visits , Predictive Value of Tests , Prospective Studies , Renal Insufficiency, Chronic/diagnosis , Republic of Korea , Time Factors , Young Adult
17.
Braz. dent. j ; 25(3): 207-211, 07/2014. tab, graf
Article in English | LILACS (Americas) | ID: lil-722160

ABSTRACT

Regardless of the high success rate, patients commonly report the occurrence of tooth sensitivity during the in-office bleaching procedures. Recently, it has been demonstrated that using a customized tray (called sealed in-office bleaching technique) reduces peroxide penetration. The aim of this randomized clinical study was to evaluate tooth sensitivity and bleaching efficacy of sealed bleaching, in comparison with a conventional in-office technique. Twenty patients were randomized allocated in two groups in which 35% hydrogen peroxide gel was used in a single 45-min application. For the sealed technique, a customized bleaching tray was fabricated and carefully positioned over the bleaching agent during the session. The color was recorded at a baseline, 7 and 28 days after the bleaching session, using Vita Easy Shade spectrophotometer. Tooth sensitivity was recorded during (20 and 40 min) and immediately after the treatment using a visual analogue scale. The bleaching efficacy was evaluated by repeated-measures ANOVA, while the absolute risk of tooth sensitivity and its intensity were evaluated by Fisher's exact and Mann-Whitney tests, respectively (α=0.05). No significant difference on bleaching efficacy was observed between the conventional (7.4 and 8.1 ΔE) and sealed techniques (7.8 and 8.3 ΔE) at both evaluation periods. No significant difference was observed regarding the absolute risk of tooth sensitivity (p=0.15). Sealed technique showed a significant decrease of sensitivity intensity after 40 min (p=0.03). Sealed bleaching technique was able to reduce the sensitivity intensity during the bleaching procedure, without jeopardizing the bleaching efficacy.


Apesar da alta taxa de sucesso, os pacientes comumente relatam a ocorrência de sensibilidade dental durante os procedimentos clareadores em consultório. Recentemente, foi demostrado que o uso de uma moldeira customizada (denominada de técnica de consultório selada) reduz a penetração de peróxido. O objetivo deste ensaio clínico randomizado foi avaliar sensibilidade dentária e eficiência de clareamento do clareamento selado, em comparação com a técnica convencional de consultório. Vinte pacientes foram aleatoriamente divididos em dois grupos. Em ambos os grupos, um gel de peróxido de hidrogênio a 35% foi usado em uma simples aplicação de 45 minutos. Para a técnica selada, uma moldeira de clareamento customizada foi confeccionada e cuidadosamente posicionada sobre o agente clareador durante a sessão. A cor foi registrada no início, 7 e 28 dias após a sessão de clareamento usando a espectrofotômetro Vita easy shade. Sensibilidade dental foi registrada durante (20 e 40 minutos) e imediatamente após o tratamento usando uma escala visual analógica. A eficácia do clareamento foi avaliada por ANOVA de medidas repetidas, enquanto o risco absoluto de sensibilidade dental e a sua intensidade foram avaliados pelos testes de Fisher e Mann-Whitney, respectivamente (α=0.05). Nenhuma diferença na eficácia do clareamento foi observada entre as técnicas convencional (7.4 e 8.1 ΔE) e selada (7.8 e 8.3 ΔE) para ambos os tempos de avaliação. Nenhuma diferença foi observada em relação ao risco de sensibilidade dental (p = 0,15). A técnica selada mostrou uma significante diminuição da intensidade de sensibilidade após 40 minutos (p = 0,03). A técnica selada de clareamento reduziu a intensidade da sensibilidade durante o procedimento clareador, sem ...


Subject(s)
Humans , Office Visits , Tooth Bleaching , Hydrogen Peroxide/administration & dosage , Single-Blind Method , Treatment Outcome
19.
Rev. gaúch. enferm ; 34(3): 22-30, set. 2013. tab
Article in Portuguese | LILACS (Americas) | ID: lil-695252

ABSTRACT

O estudo objetivou avaliar a adequabilidade da assistência pré-natal de baixo risco, conforme a recomendação do Ministério da Saúde, quanto ao número mínimo de consultas, e verificar possíveis fatores associados. Avaliou-se a atenção pré-natal de uma coorte histórica de 95 gestantes. Mais de 50% das mulheres fizeram 6 ou mais consultas de pré-natal. O início do pré-natal ocorreu no primeiro trimestre de gestação para 52% das mulheres; 84,2% das mulheres realizaram todos os exames de pré-natal e apenas 16,8% realizaram consulta no puerpério. A assistência pré-natal foi considerada adequada para 2,1% da amostra. Maior número de consultas pré-natal foi observado entre as mulheres com companheiro e com maior número de filhos.Os registros demonstraram baixa adequação à totalidade dos critérios mínimos estabelecidos e poucos fatores parecem explicar esse cenário.


El objetivo del estudio fue evaluar la adecuación de la atención prenatal de bajo riesgo, según lo recomendado por el Ministerio de Salud, y el número mínimo de consultas, e identificar los posibles factores asociados. Se evaluó la atención de prenatal de una cohorte histórica de 95 embarazadas. Más del 50% de las mujeres hicieron 6 o más consultas de prenatal. El inicio del prenatal se realizó en el primer trimestre de gestación para el 52% de las mujeres; el 84,2% de las mujeres realizó todos los exámenes de prenatal y sólo el 16,8% realizó consulta en el puerperio. La asistencia prenatal fue considerada adecuada para el 2,1% de la muestra. Más números de consultas prenatales fueron observados entre las mujeres con compañero y con mayor número de hijos.Los registros demostraron baja adecuación a la totalidad de los criterios mínimos establecidos y pocos factores parecen explicar ese escenario.


The study aimed to evaluate the adequacy of low-risk prenatal care, as recommended by the Ministry of Health, concerning the minimum number of consultations, and identify possible associated factors. Prenatal care was evaluated in a historical cohort study of 95 pregnant women. Over 50% of the women underwent six or more prenatal consultations. The beginning of the prenatal care began in the first trimester of the gestation for 52% of the women, 84.2% of the women did all their prenatal medical tests, and only 16.8% had postpartum consultations. Prenatal assistance was considered adequate for 2.1% of the sample. A higher number of prenatal consultation was observed among women who had a partner and who had other children.The records reveal a low adequacy level with all minimum criteria established and few factors seem to explain this scenario.


Subject(s)
Adolescent , Adult , Female , Humans , Pregnancy , Young Adult , Family Health , Patient Dropouts , Prenatal Care , Appointments and Schedules , Brazil , Cohort Studies , Diagnostic Tests, Routine , Episode of Care , Marital Status , Occupations , Office Visits/statistics & numerical data , Patient Dropouts/statistics & numerical data , Postnatal Care/organization & administration , Postnatal Care/statistics & numerical data , Postnatal Care , Prenatal Care/organization & administration , Prenatal Care/statistics & numerical data , Prenatal Care , Socioeconomic Factors
20.
Rev. Asoc. Méd. Argent ; 126(2): 29-34, 2013. ilus, graf
Article in Spanish | LILACS (Americas) | ID: lil-691137

ABSTRACT

Introducción. Las lesiones en cavidad oral representan un amplio espectro de afecciones: variaciones anómalas y del desarrollo; microtraumas; lesiones por agentes físicos, químicos; infectocontagiosas; inmunoalérgicas; enfermedades sistémicas; desórdenes nutricionales y tumorales. Objetivo. Presentar la experiencia de la atención estomatológica en la población pediátrica, en 10 años de trabajo interdisciplinario. Diseño. Estudio retrospectivo, descriptivo, corte transversal. Material y método. Revisamos, historias clínicas estomatológicas, período enero de 2000 a junio de 2010. Consideramos como variables de estudio edad; sexo; antecedentes personales; familiares; lesiones elementales; localización; síntomas y hallazgos patológicos en estudios complementarios. Expresamos los resultados en promedios y porcentajes. Resultados. Consignamos 499 pacientes; 221 (47,02%) masculinos y 277 (58,94%) femeninos; en un paciente no se consignó sexo. Agrupamos las patologías, en un intento de clasificación, por lesiones elementales; encontramos: 264 casos de tumores (52,91%); 58 vegetación, verrugosidad (11,62%); 55 pérdidas de sustancia (11,02%); 49 vesículas, ampollas (9,82%); 48 manchas, pseudomanchas (9,62%); 21 hiperplasia, hipertrofia (4,21%), 4 otras patologías (0,80%). Localizaciones preferentes: labio inferior, lengua, piso de boca, paladar, bermellón; mucosa yugal y labio superior. Conclusión. Encontramos predominio en sexo femenino; la patología tumoral fue la más frecuente, representada en especial por el mucocele. Consideramos que el eje de la prevención estomatológica en la población pediátrica, es el diagnóstico temprano; el examen de la cavidad oral debe ser sistemático; el manejo de las patologías en interdisciplina es lo más adecuado.


Introduction. Oral cavity lesions, representing a broad spectrum of conditions: abnormal variations and development; microtrauma; injury by physical, chemical, infectious, immuno, systemic diseases, nutritional disorders and tumor. Objective. Present experience dental care in the pediatric population, in 10 years of interdisciplinary work. Design. A retrospective, descriptive, crosssectional. Materials and methods. We review, dental records, period in January 2000, June 2010. We consider study variables age, sex, medical history, family, elementary lesions, location, symptoms and pathological findings in further studies. We express the results in averages and percentages. Results. Consign 499 patients, 221 (47.02%) male and 277 (58.94%) female, in a patient sex was not recorded. Pathologies grouped in an attempt classification, by elementary lesions; found: 264 tumor cases (52.91%); 58 vegetation warty (11.62%) loss of substance 55 (11.02%); 49 vesicles, blisters (9.82%), 48 spots, pseudomanchas (9.62%), 21 hyperplasia, hypertrophy (4.21%), 4 other pathologies (0.80%). Preferential localization: lower lip, tongue, floor of mouth, palate, vermilion, buccal mucosa and upper lip. Conclusion. Found predominantly in females, the disease was the most frequent tumor, represented especially by the mucocele. We believe that the axis of dental prevention in the pediatric population is early diagnosis, the oral cavity examination should be systematic, management of diseases in interdisciplinary is most appropriate.


Subject(s)
Humans , Male , Female , Child , Early Diagnosis , Mouth Diseases/diagnosis , Mouth Mucosa/pathology , Mouth Diseases/classification , Oral Medicine , Pediatrics , Office Visits/trends
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