ABSTRACT
Introducción: Las lesiones de piel asociadas a la dependencia de cuidado, afectan la calidad de vida de los pacientes y tienen repercusiones negativas en los cuidadores informales. Objetivo: Determinar los conocimientos de los cuidadores informales acerca de la prevención de lesiones por presión en pacientes domiciliarios dependientes de Tunja, Colombia. Materiales y métodos: Estudio descriptivo de corte transversal y con fase psicométrica. La validación facial por juicio de expertos del COCU-LCRD 23 valoró la coherencia, relevancia y pertinencia de cada ítem. La aplicación del instrumento se hizo en muestra censal domiciliaria, tras la cual se calculó su confiabilidad. Resultados: La validación facial obtuvo concordancia moderada requiriendo mejoras en redacción de los ítems Kappa de Fleiss: 0,4582 (p=0,000). De los 30 cuidadores, la mayoría eran mujeres (83,3%) con edad promedio de 40 años (DS ±13,39), el 43,3% tienen un índice de conocimiento de 83,33, que incluye aspectos como hidratación, cambios de posición, entre otros. La versión ajustada del cuestionario obtuvo un alfa de Cronbach de 0,6322. Conclusiones: Los cuidadores informales presentan grados de escolaridad bajos, además de desconocimiento y poca experiencia en campo del cuidado preventivo en personas dependiente con riesgo de úlceras por presión.
Introduction: Skin lesions associated with home care affect patient quality of life and have negative effects on informal caregivers. Objective: To determine informal caregivers' knowledge regarding the prevention of pressure injuries in dependent homebound patients in Tunja, Colombia. Materials and methods: Descriptive cross-sectional study with a psychometric phase. Experts from the COCU-LCRD 23 performed facial validation, which assessed coherence, relevance, and pertinence of each item. The application of the instrument was carried out on population samples based on household census, after which its reliability was calculated. Results: Facial validation showed moderate concordance, requiring improvements in the wording of the Kappa de Fleiss items: 0.4582 (p=0.000). Most of caregivers were women (83.3%), with an average age of 40 years (SD±13.39) and 43.3% of them have a knowledge index of 83.33, which includes aspects such as hydration, position changes, among others. The adjusted version of the questionnaire reached a Cronbach's alpha of 0.6322. Conclusions: Informal caregivers have low education levels. Also, they are not knowledgeable and have limited experience regarding preventive care of dependent people at risk of pressure ulcers.
Introdução: As lesões de pele associadas à dependência de cuidados afetam a qualidade de vida dos pacientes e repercutem negativamente nos cuidadores informais. Objetivo: Determinar o conhecimento dos cuidadores informais sobre a prevenção de lesões por pressão em pacientes dependentes domiciliares em Tunja, Colômbia. Materiais e métodos: Estudo transversal descritivo com fase psicométrica. A validação facial por julgamento de especialistas do COCU-LCRD 23 avaliou a coerência, relevância e pertinência de cada item. O instrumento foi aplicado a uma amostra de censo domiciliar, após o que foi calculada sua confiabilidade. Resultados: A validação facial obteve concordância moderada, necessitando de melhorias na redação dos itens - Kappa de Fleiss: 0,4582 (p=0,000). Dos 30 cuidadores, a maioria eram mulheres (83,3%) com média de idade de 40 anos (DS±13,39), 43,3% possuem índice de conhecimento de 83,33, que inclui aspectos como hidratação, mudanças de decúbito, entre outros. A versão ajustada do questionário obteve alfa de Cronbach de 0,6322. Conclusões: Os cuidadores informais apresentam baixa escolaridade, além de desconhecimento e pouca experiência na área de cuidados preventivos em pessoas dependentes com risco de úlcera por pressão.
Subject(s)
Humans , Skin Diseases , Health Services , Wounds and Injuries , Caregivers , Pressure Ulcer , Home NursingABSTRACT
OBJETIVO: Analisar a efetividade de Polihexametileno Biguanida (PHMB), comparado à solução salina na carga microbiana de pacientes com feridas. MÉTODO: Protocolo de revisão sistemática, construído segundo o Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), de acordo com metodologia do Joanna Briggs Institute (JBI). Os estudos serão avaliados por dois pesquisadores independentes, nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF), Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)e Excerpta Medica Database (Embase). As pesquisas a serem incluídas serão aquelas publicadas em português, inglês ou espanhol e a busca não definirá recorte temporal. Serão desconsiderados estudos em animais ou in vitro, revisões, cartas ao editor ou estudos de casos. Após a seleção dos estudos, a extração de dados ocorrerá de maneira sistemática e os registros correspondentes serão feitos de forma narrativa e tabular.
OBJECTIVE: To analyze the effectiveness of polyhexamethylene biguanide (PHMB) compared to saline on the microbial load of wounds. METHOD: Systematic review protocol, built according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Joanna Briggs Institute's (JBI) methodology. Studies will be evaluated by two independent researchers in the following databases: Latin America and the Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Excerpta Medica Database (Embase). Studies published in Portuguese, English, or Spanish will be included, and the search will not be restricted by publication date. Animal or in vitro studies, reviews, letters to the editor, and case studies will be excluded. After selecting studies, data extraction will take place systematically, and the corresponding records will be presented in a narrative and tabular way.
Subject(s)
Humans , Adult , Aged , Wound Healing , Wound Infection , Wounds and Injuries , Biguanides , Bacterial Load , Saline Solution , BiofilmsABSTRACT
Os traumatismos dentários são emergências comuns na prática odontológica, que podem variar desde uma fratura coronária até a avulsão do elemento dentário, onde a rapidez e a eficiência dos primeiros socorros estão diretamente ligadas ao sucesso do tratamento. O presente estudo visa relatar um caso de traumatismo dentário dos elementos 11, 12 e 13 em um adolescente, que foi vítima de queda durante uma partida de futebol, atendido em um hospital público de emergência no Rio de Janeiro, objetivando fornecer informações sobre as características clínicas da lesão e a abordagem terapêutica mais adequada para o caso estudado.
Dental trauma are common emergencies in the dentistry, which can range from a coronary fracture to avulsion of the dental element, where the speed and efficiency of first aid are directly linked to the success of treatment. The present study has the objective to report a case of dental trauma of elements 11, 12 and 13 in a teenager, who fell during a football match, that was attended in a public hospital in Rio de Janeiro, aiming to provide information about clinical features of the lesion and the most appropriate therapeutic approach for the case studied.
Subject(s)
Humans , Male , Adolescent , Soccer , Wounds and Injuries , Clinical Protocols , Tooth InjuriesABSTRACT
Presentación del caso. Paciente masculino de 52 años que se presentó a la consulta de urología con historia de dos años de notar una lesión en el glande y el prepucio, de color rojo brillante, pruriginosa y dolorosa con aumento progresivo del tamaño que no mejoró con tratamientos antibióticos y anti fúngicos. Intervención terapéutica. Se realizó una glandectomía parcial con injerto de piel de muslo. Evolución clínica. Luego de un mes, el injerto presentó un 95 % de acoplamiento. No se observó recurrencia local de cáncer. El estudio histopatológico reportó un carcinoma escamoso invasor en la lesión del prepucio y en la piel del glande, con todos los márgenes quirúrgicos, limites laterales y profundos, negativos a malignidad. Luego de ocho meses posquirúrgicos, se observó el recubrimiento del glande con un adecuado resultado estético, con apariencia similar a la cubierta natural
Case presentation. A A 52-year-old male patient presented to the urology office with a two-year history of noticing a bright red, pruritic, and painful lesion on the glans and foreskin with a progressive increase in size that did not improve with antibiotic and antifungal treatments. Treatment. Partial glandectomy with thigh skin graft was performed. Outcome. After After one month, the graft presented a 95 % of coupling. No local recurrence of cancer was observed. The histopathological study reported invasive squamous cell carcinoma in the lesion of the foreskin and glans skin, with all surgical margins, lateral and deep limits, negative for malignancy. After eight months post-surgery, the covering of the glans was observed with an appropriate esthetic result, with a similar appearance to the natural covering
Subject(s)
Patients , Urology , Carcinoma, Squamous Cell , Erythroplasia , Wounds and Injuries , Skin Transplantation , Foreskin , NeoplasmsABSTRACT
Introdução: As lesões por pressão (LPP) correspondem a danos na pele ou em tecidos moles encobertos, geralmente em áreas de proeminências ósseas, ou associado ao uso de dispositivo médico ou outro tipo de artefato. Diante disso, a enfermeira deve desenvolver sua prática, baseada em evidências científicas e priorizar a prevenção da formação das lesões na pele. Objetivo: Relatar a experiência de estudantes de Enfermagem sobre o desenvolvimento de ações de promoção do cuidado seguro relacionado à prevenção de LPP em pacientes internados em um hospital público pediátrico na Bahia. Metodologia: Trata-se de um estudo de caráter descritivo, do tipo relato de experiência, realizado por seis estudantes de Enfermagem em um hospital estadual pediátrico localizado no estado da Bahia, no período de novembro 2022. Principais resultados: Percebeu-se que existem profissionais de enfermagem que possuem interesse em obter mais conhecimento sobre o assunto, porém ainda há lacunas de conhecimento por parte da equipe sobre alguns assuntos abordados, tais como a escala de Braden e a utilização do colchão caixa de ovo para todas as faixas etárias. Foi possível perceber que os passos para prevenir a lesão por pressão não são cumpridos por parte da equipe e isso pode dificultar a prevenção das lesões de forma efetiva. Conclusão: Recomenda-se, portanto, que as unidades assistenciais, juntamente com suas respectivas coordenadoras, realizem ações contínuas de educação permanente, a fim de contribuir para uma melhor qualificação profissional, promovendo, acima de tudo, a segurança do paciente.
Introduction: Pressure lesions (PPL) correspond to damage to the skin or covert soft tissue, usually in areas of bony prominence, or associated with the use of a medical device or other type of artifact. Therefore, nurses should develop their practice, based on scientific evidence and prioritize the prevention of skin lesion formation. Objective: To report the experience of nursing students on the development of actions to promote safe care related to the prevention of PPL in patients admitted to a pediatric public hospital in Bahia. Methodology: This is a descriptive study, of the type of experience report, conducted by six nursing students in a pediatric state hospital located in the state of Bahia, in the period of November 2022. Main results: It was noticed that there are nursing professionals who have an interest in obtaining more knowledge about the subject, but there are still gaps in knowledge on the part of the team on some subjects addressed, such as the Braden scale and the use of the egg box mattress for all age groups. It was possible to notice that the steps to prevent pressure injury are not met by the team and this can hinder the prevention of injuries effectively. Conclusion: It is recommended, therefore, that the care units, together with their respective coordinators, carry out continuous actions of continuing education, in order to contribute to a better professional qualification, promoting, above all, patient safety.
Introducción: Las lesiones por presión (LPP) corresponden a lesiones en la piel o tejidos blandos encubiertos, generalmente en zonas de prominencia ósea, o asociadas al uso de un dispositivo médico u otro tipo de artefacto. Por ello, el personal de enfermería debe desarrollar su práctica, basándose en la evidencia científica y priorizando la prevención de la formación de lesiones cutáneas. Objetivo: Relatar la experiencia de estudiantes de enfermería sobre el desarrollo de acciones para promover cuidados seguros relacionados a la prevención de PPL en pacientes internados en un hospital público pediátrico de Bahía. Metodología: Se trata de un estudio descriptivo, del tipo relato de experiencia, realizado por seis estudiantes de enfermería en un hospital público pediátrico localizado en el estado de Bahía, en el período de noviembre de 2022. Principales resultados: Se observó que hay profesionales de enfermería que tienen interés en obtener más conocimientos sobre el tema, pero todavía hay lagunas de conocimiento por parte del equipo en algunos temas abordados, como la escala de Braden y el uso del colchón caja de huevos para todos los grupos de edad. Se pudo notar que los pasos para prevenir lesiones por presión no son cumplidos por el equipo y esto puede dificultar la prevención de lesiones de forma efectiva. Conclusiones: Se recomienda, por lo tanto, que las unidades asistenciales, junto con sus respectivos coordinadores, realicen acciones continuas de formación continuada, con el fin de contribuir a una mejor cualificación profesional, promoviendo, sobre todo, la seguridad del paciente.
Subject(s)
Humans , Patients , Skin/injuries , Wounds and Injuries/nursing , Pressure Ulcer/nursing , Pediatrics , Professional Practice , Patient Safety , Case Reports as Topic , Health Promotion , Nurse Practitioners/education , Nurses , Nursing Care/methodsABSTRACT
Resumo Objetivo conhecer e analisar as vivências de mães no cuidado a crianças e adolescentes com Epidermólise Bolhosa. Método estudo descritivo de abordagem qualitativa desenvolvido junto a dez mães de crianças e adolescentes com Epidermólise Bolhosa de diferentes regiões do Brasil, a partir de entrevistas semiestruturadas, áudio e vídeo gravadas, por via remota, utilizando-se a plataforma Google Meet®, entre setembro e novembro de 2021. A técnica da análise temática direcionou a apreciação do material empírico. Resultados participaram do estudo mães com idade entre 23 e 53 anos. Duas categorias traduzem a vivência materna: i) O "baque" do diagnóstico e os desafios iniciais e ii) "Deixar de viver para viver para ele": as mudanças no cotidiano das famílias. Considerações finais e implicações para a prática as mães vivenciaram sentimentos de medo e insegurança diante do diagnóstico do filho e a rotina de cuidados, em especial, as trocas diárias de curativos, acarretaram sobrecarga física e emocional. Esses resultados podem subsidiar o acompanhamento dessas famílias de modo a instrumentalizá-las para o cuidado e apoiá-las emocionalmente.
Resumen Objetivo conocer y analizar la vida de las madres en el cuidado de niños y adolescentes con Epidermólisis Bullosa. Método estudio descriptivo de abordaje cualitativo desarrollado junto a diez madres de niños y adolescentes con Epidermólisis Bullosa de diferentes regiones de Brasil, a partir de entrevistas semiestructuradas con grabación de audio y video, por vía remota, utilizando la plataforma Google Meet®, entre septiembre y noviembre de 2021. La técnica de análisis temático dirigió la apreciación del material empírico. Resultados participaron en el estudio mujeres de entre 23 y 53 años. Dos categorías traducen la experiencia materna: i) El "shock" del diagnóstico y los retos iniciales; y ii) "Dejar de vivir para vivir por él": los cambios en la vida cotidiana de las familias. Consideraciones finales e implicaciones para la práctica las madres experimentaron sentimientos de miedo e inseguridad ante el diagnóstico de su hijo y la rutina de cuidados, especialmente los cambios de apósito diarios provocaron una sobrecarga física y emocional. Estos resultados pueden servir de apoyo para el seguimiento de estas familias, con el fin de poder cuidarlas y apoyarlas emocionalmente.
Abstract Objective to know and analyze mothers' experiences in caring for children and adolescents with Epidermolysis Bullosa. Method a descriptive qualitative study was developed with ten mothers of children and adolescents with epidermolysis bullosa from different regions of Brazil using semi-structured interviews recorded remotely using Google Meet® between September and November 2021. The thematic analysis technique guided the appreciation of the empirical material. Results mothers aged between 23 and 53 years participated in the study. Two categories translate the maternal experience: i) the "shock" of the diagnosis and the initial challenges and ii) "Stop living to live for them": the changes in the families' daily life. Final considerations and implications for practice mothers experienced fear and insecurity when their child was diagnosed, and the care routine, especially the daily dressing changes, caused a physical and emotional burden. These results can support the follow-up of these families to provide them with care tools and emotional support.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Child Care/psychology , Epidermolysis Bullosa/diagnosis , Mothers/psychology , Bandages , Wounds and Injuries , Qualitative ResearchABSTRACT
Background: Hysteroscopy is an essential tool to make intrauterine assessment in infertile patients. Diagnosis and appropriate correction of intrauterine anomalies are considered essential in order to increase chances of conception. Ourobjective was to determine the frequency and pattern of intra uterine anomalies identified among women attending hysteroscopy at the Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital Paul et Chantal Biya Yaoundé (GESHRTH). Methodsand results.Thiswas a cross sectional retrospective study of 96 women attending diagnostic or operative hysteroscopy at the GESHRTH between January 2020 and December 2021.The mean age was 38.7 ±7.6 years. Fifty-nine (61.5%) of the patients were nulliparous. Primary and secondary infertility were found respectively in fifty-two patients (54.2%) and forty-four patients (45.4%). Eleven patients (11.5%) were post-menopausal. Concerning previous surgery, 29 patients (30.2%) have had a myomectomy, 28 patients (29.1%) curettage,16 patients (16.6%) laparoscopy, eight (8.3%) hysteroscopy and one (1%) caesarean section. In all, 92 patients (95.8%) had abnormal intra uterine findings consisting of endometrial polyps (43.7%), sub-mucosal fibroids (42.7%), uterine cavity adhesions (20.8%), endometrial atrophy (4.1%), foetal bone (2%), uterine septum (1%) and non-absorbable suture thread (1%).Conclusion: Abnormal uterine findings were identified in 95.8% of patients attending hysteroscopy at GESHRTH. Most frequent findings were polypsin 43.7%, sub-mucosal fibroids in 42.7% and synechiae in 20.8%. The overall per operatory complication rate was 6.2%.
Introduction. Le recours à l'hystéroscopie constitue une étape indispensable au bilan cavitaire des patientes infertiles. Le diagnostic et la prise en charge adéquate des lésions intra cavitaires permettent d'améliorer les chances de conception.L'objectif de cette étude était de déterminer la fréquence et les caractéristiques des anomalies intra cavitaires chez les patientes opérées d'une hystéroscopie au Centre Hospitalier de Recherche et d'Application en Chirurgie Endoscopique et Reproduction Humaine Paul et Chantal Biya Yaoundé (CHRACERH).Méthodes et résultats. Nous avons mené une étude descriptive transversale de Janvier 2020 à Décembre 2021 et recruté 96 patientes. L'âge moyen était de38,7 ±7,6 ans. Soixante-neuf patientes (61,5%) étaient nullipares. Cinquante-deux (54,2%) et quarante-quatre (45,5%) présentaient une infertilité primaire et secondaire respectivement. Onze patientes (11,5%) étaient ménopausées. Concernant les antécédents chirurgicaux,nous avons identifié une myomectomie chez 29 patientes (30,2%), un curetage utérin chez 28 (29,1%), une cÅlioscopie chez 16 (16,6%), une hystéroscopie chez huit (8,3%) et une césarienne chez une (1%). Au total, 92 (95,8%) des patientes avaient des anomalies cavitaires objectivées. Il s'agissait de polypes endométriaux (43,7%), fibromes sous-muqueux (42,7%), synéchies utérines (20,8%), atrophie de l'endomètre (4,1%), métaplasie osseuse (2%), cloison utérine (1%) et corps étranger à type de fil de suture nonrésorbable (1%).Conclusion.Les anomalies intra-cavitaires étaient retrouvées chez 95,8% des patientes réalisant une hystéroscopie au CHRACERH. Les anomalies les plus représentées étaient les polypes endométriaux (43,7%), les fibromes sous-muqueux (42,7%) et les synéchies utérines (20,8%). Le taux global de complications opératoires était de 6,2%.
Subject(s)
Humans , Female , Polyps , Therapeutics , Epidemiology , Fibroma , Uterine Myomectomy , Wounds and Injuries , HysteroscopyABSTRACT
Introduction: Little information is available regarding the characteristics of patients attending the emergency centre (EC) in the Democratic Republic of Congo. This study aims to provide some epidemiological and clinical aspects of patients admitted to the emergency centre at Beni General Referral Hospital. Methodology: For a year, from January to December 2021, a cross-sectional study was conducted. Data regarding patients' characteristics, admission modality, stay duration, reason for admission, and discharge modality was anonymously collected from patients' registers. A descriptive analysis was done with Epi-Info 7. Result: A total of 1404 patients were admitted to the EC, with a male-to-female ratio of 1.2 to 1. The age group below 18 years accounted for 35.4%. Most of the patients (75.7%) originated from urban areas. In 83% of cases, there was no recommendation from another medical facility for EC admission. The most common reasons for admission are non-traumatic gathering on top of neuropsychiatric and non-specific symptoms. Road traffic accidents are the most frequent causes of trauma symptoms. Few patients (14.7%) spent less than 12 hours in the EC. Globally, 7.3% of patients admitted to the EC were discharged after being managed, and 89% were transferred to different wards. The intra-emergency centre mortality rate was 11.8% among admitted patients in the ER at Beni General Referral Hospital. Conclusion: This epidemiology database underlines the need for developing globalizing and multi-sectoral interventions (diagnosis, therapeutic strategy, organization, health program, or health policies) in the perspective of bringing change and/or taking action in the Democratic Republic of Congo's emergency medical system.
Subject(s)
Humans , Male , Female , Patient Admission , Wounds and Injuries , Emergencies , Emergency Medical Services , Health Policy , Accidents, TrafficABSTRACT
Background: Trauma is the leading cause of death in individuals between the ages of 1 and 44 years and it is the third commonest cause of death regardless of age. Thoracic trauma is a relatively common cause of preventable death among trauma patients. The spectrum of injuries after blunt chest trauma presents a challenging problem to the emergency physician. This study is intended to discuss the epidemiology, severity and initial management strategies in chest trauma patients, in a low income country. Methods: A cross sectional retrospective study among chest trauma patients seen in the emergency room of National Hospital Trauma Centre, Abuja, Nigeria, from January 2015 to December 2017. Relevant patients' information was retrieved from the trauma registry kept in the trauma centre. Data processing and analysis was done using statistical package for social sciences (SPSS) version 24. Test of significance was done where applicable using chi square and student t test, using p value less than 0.05 as significant. Results are presented in tables and figures. Results: A total of 637 patients, male to female ratio of 3.6 and mean age of 34.18 ± 11.34 were enrolled into the study. The most common mechanisms of injury were MVC (54.6%) and assault (23.5%). Blunt injuries were 3.5 times more frequent than the penetrating injuries. The RTS of 12 (76.3%) and the ISS of 1-15 category (52.3%) were the most common scores. Up to 98% of patients were managed non-operatively. Recovery rate was high (89%) with relatively low mortality rate of 4.2%. Conclusion: Majority of thoracic trauma can be managed effectively by employing simple, non-operative procedures such as needle decompression and chest tube insertion. Efforts should be made to include these procedures in the skill set of every medical officer working in the emergency room, particularly in low and middle income countries where there is paucity of emergency physicians.
Subject(s)
Humans , Male , Female , Surgical Procedures, Operative , Wounds and Injuries , Emergency Service, Hospital , Thoracic Injuries , Thorax , Wounds, NonpenetratingABSTRACT
Background: Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective: To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods: Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results: About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion: Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.
Subject(s)
Humans , Male , Female , Wounds and Injuries , Accidents, Traffic , Traffic , Risk Factors for Traffic Accidents , Motor VehiclesABSTRACT
Introduction: The global prevalence of trauma-related mortality ranges from 2% to 32%; however, In Egypt, it reaches 8%. Trauma chiefly affects people in the productive age group; seriously ill patients with multiple injuries present with various levels of polytrauma. Application of incorrect triage systems and improperly trained trauma teams increase mortality and morbidity rates in non-dedicated institutions; however, these rates can decrease with appropriate infrastructure. This study aimed to improve the quality of care for patients with polytrauma through improved knowledge of the different severity levels of polytrauma and defined databases, using a suitable triage trauma system, well-trained trauma team, and appropriate infrastructure. Methods: This observational cross-sectional study was conducted at the emergency department (ED), over a study period of 7 months, from August 10, 2019, to March 09, 2020. This study included 458 patients with polytrauma who had met the inclusion and exclusion criteria and attended the ED of Suez Canal University Hospital. Results: The incidence of trauma among all emergency cases in the ED was 5.3%. However, most multiple injuries are mild, accounting for 44.4%, while 27.3% of the cases had life-threatening injuries. Moreover, 41.9% of the patients were managed non-operatively, whereas 58.1% of the patients required surgical interventions. Concerning the outcome, 56% and 6.9% of patients with and without life-threatening injuries respectively, died. Conclusion: Facilities of the highest quality should be available for patients with polytrauma, especially those with life-threatening injuries. In addition, training emergency medical service staff for trauma triage is essential, and at least one tertiary hospital is required in every major city in the Suez Canal and Sinai areas to decrease trauma-related mortality.
Subject(s)
Wounds and Injuries , Multiple Trauma , Topography , Prevalence , Morbidity , Mortality , Emergency Medical Services , Tertiary Care Centers , TriageABSTRACT
Resumen La pandemia por COVID-19 obligó a paralizar el deporte en todo el mundo; por lo tanto, se redujo la carga de trabajo de los deportistas, lo cual, sumado al probable aumento de la densidad competitiva tras el período de confinamiento, resultará en un incremento del riesgo de lesión después del retorno a la competición. A este respecto, la rodilla es una de las zonas con mayor prevalencia de lesión en el fútbol femenino y la lesión del ligamento cruzado anterior (LCA) es de las más frecuentes y graves. En consecuencia, el objetivo del presente trabajo fue desarrollar un plan de prevención de lesión de LCA que pudiera ser llevado a cabo por mujeres futbolistas, durante períodos de confinamiento. Luego de una revisión de la literatura, se ha encontrado que el entrenamiento de fuerza (especialmente de la cadena posterior), el trabajo de la técnica de aterrizajes, así como el de estabilidad lumbopélvica y flexibilidad se asocian con un menor riesgo de lesión de LCA en mujeres. El programa se centra en factores de riesgo modificables, por lo que debe servir como una guía susceptible de adaptaciones, en función de cada contexto: las características individuales, el estado inicial y la evolución del sujeto durante su desarrollo. Por ende, en este estudio se plantea una intervención que pretende disminuir la probabilidad de lesión de LCA en mujeres futbolistas, tras el confinamiento, incidiendo, para ello, de forma directa sobre los mecanismos de lesión de LCA reportados en esta población.
Abstract The COVID-19 pandemic resulted in a worldwide sports shutdown, leading to a reduced athletes' workload, which is likely to increase the risk of injury after return to play when coupled with the expected increase in competitive density after the confinement period. In this regard, the knee is one of the joints with the highest injury prevalence among female soccer players, being the injury of the anterior cruciate ligament (ACL) one of the most frequent and severe. Thus, the present study aimed to develop an ACL injury prevention program that female soccer players could carry out during confinement periods. After reviewing the scientific literature, it was observed that strength training (with a main focus on the posterior chain), improved landing technique, lumbopelvic stability, and flexibility are associated with a lower risk of ACL injury in women. The program focuses on modifiable risk factors, so it should serve as a guide that can be adapted according to each context: individual characteristics, initial conditions, and evolution of the subject during development. Therefore, this study presents an intervention aiming at reducing the probability of ACL injury in female soccer players, after confinement periods, by directly influencing mechanisms of ACL injury previously reported for female soccer players.
Resumo A pandemia da COVID-19 forçou uma paralização mundial do esporte; portanto, a carga de trabalho dos atletas foi reduzida, o que, juntamente com o provável aumento da densidade competitiva após o período de confinamento, resultará em um risco maior de lesões após o retorno à competição. A esse respeito, o joelho é uma das áreas de lesão mais prevalecentes no futebol feminino e a lesão do ligamento cruzado anterior (LCA) é uma das mais frequentes e graves. Consequentemente, o objetivo do presente estudo é desenvolver um plano de prevenção de lesões do ACL que pode ser implementado por jogadoras de futebol feminino durante os períodos de internação. Após uma revisão da literatura, descobriu-se que o treinamento de força (especialmente da cadeia posterior), a técnica de aterrissagem, assim como o treinamento de estabilidade e flexibilidade lombo pélvica estão associados a um menor risco de lesão do LCA nas mulheres. O programa se concentra em fatores de risco modificáveis, portanto deve servir como um guia que possa ser adaptado de acordo com cada contexto: as características individuais, o estado inicial e a evolução da pessoa durante seu desenvolvimento. Portanto, este estudo propõe uma intervenção que visa reduzir a probabilidade de lesão do ACL em jogadoras de futebol feminino após o confinamento, afetando diretamente os mecanismos de lesão do ACL nelas relatados.
Subject(s)
Soccer , Wounds and Injuries , Anterior Cruciate Ligament Injuries/prevention & control , COVID-19Subject(s)
Humans , Male , Female , Wounds and Injuries , Emigrants and Immigrants , Sociodemographic Factors , Venezuela , ColombiaABSTRACT
Objective: to analyze the notified and confirmed cases of ACL in a municipality in east Minas Gerais, from 2007 to 2020. Methods: a combined study was carried out as a cross-sectional and an ecological approach of time series type, using notified and confirmed ACL cases, from 2007 to 2020. Primary and secondary data were used. Data were analyzed using descriptive and inferential statistics (simple linear regression, T-test, Mann-Whitney, chi-square (χ2) at a 5% significance level). Results: a total of 219 cases were reported with a decreasing temporal trend, with a higher frequency observed for the cutaneous form (82.6%), age group 40 to 59 years (32.1%), black race (56.4%), and completed elementary school (47.7%). Individuals with the mucosal clinical form had lesions for a longer time, a greater chance of not progressing to cure, and used more vials of meglumine antimoniate when compared to patients with the cutaneous form. Conclusions: different correlations were observed between the variables studied and the profile of involvement described in the scientific literature, with the clinical form predominantly cutaneous and with a good prognosis.
Objetivo: analisar os casos notificados e confirmados de LTA em um município do leste de Minas Gerais, no período de 2007 a 2020. Métodos: foi realizado um estudo combinado com abordagem transversal e ecológica do tipo série temporal, utilizando casos notificados e confirmados de LTA, de 2007 a 2020. Foram utilizados dados primários e secundários. Os dados foram analisados por meio de estatística descritiva e inferencial (regressão linear simples, teste T, Mann-Whitney, qui-quadrado (χ2) com nível de significância de 5%). Resultados: foram notificados 219 casos com tendência temporal decrescente, com maior frequência observada para a forma cutânea (82,6%), faixa etária de 40 a 59 anos (32,1%), raça negra (56,4%) e ensino fundamental completo (47,7%). Indivíduos com a forma clínica mucosa apresentaram maior tempo de lesão, maior possibilidade de não evoluir para cura e utilizaram mais ampolas de antimoniato de meglumina quando comparados aos pacientes com a forma cutânea. Conclusões: foram observadas diferentes correlações entre as variáveis estudadas e o perfil de acometimento descrito na literatura científica, com a forma clínica predominantemente cutânea e com bom prognóstico.
Subject(s)
Leishmaniasis, Cutaneous , Patients , Wounds and Injuries , Leishmaniasis, Mucocutaneous , Public Health , Epidemiology , Morbidity , Mucous MembraneABSTRACT
Introducción. El objetivo de este estudio fue evaluar el impacto sobre la mortalidad según el perfil de ingreso a un centro de trauma del suroccidente colombiano, como método para entender las dinámicas de atención del paciente con trauma. Métodos. Se realizó un subanálisis del registro de la Sociedad Panamericana de Trauma asociado a un centro de trauma en el suroccidente colombiano. Se analizaron los pacientes atendidos entre los años 2012 y 2021. Se compararon los pacientes con condición de ingreso directo y aquellos que ingresaron remitidos. Se hicieron análisis de poblaciones de interés como pacientes con trauma severo (ISS > 15) y pacientes con/sin trauma craneoencefálico. Se evaluó el impacto de los pacientes remitidos y su condición al ingreso sobre la mortalidad. Resultados. Se incluyeron 10.814 pacientes. La proporción de pacientes remitidos fue del 54,7 %. Los pacientes que ingresaron remitidos presentaron diferencias respecto a la severidad del trauma y compromiso fisiológico al ingreso comparado con los pacientes con ingreso directo. Los pacientes remitidos tienen mayor riesgo de mortalidad (RR: 2,81; IC95% 2,44-3,22); sin embargo, es el estado fisiológico al ingreso lo que impacta en la mortalidad. Conclusión. Los pacientes remitidos de otras instituciones tienen un mayor riesgo de mortalidad, siendo una inequidad en salud que invita a la articulación de actores institucionales en la atención de trauma. Un centro de trauma debe relacionarse con las instituciones asociadas para crear un sistema de trauma que optimice la atención de los pacientes y la oportunidad
Introduction. This study aims to evaluate the impact on mortality by admission profile to a trauma center in Southwest Colombia between direct and referred patients, as a method to understand the dynamics of trauma care.Methods. A sub-analysis of the Panamerican Trauma Society registry associated with a trauma center in Southwest Colombia was performed. Patients attended between 2012-2021 were analyzed. Patients with direct admission and referred condition were compared. Analyses of populations of interest such as patients with severe trauma (ISS > 15) and patients with/without brain trauma were made. The impact of referred patients and their admission status on mortality was evaluated. Results. A total of 10,814 patients were included. The proportion of referred patients was 54.7%. Patients admitted referred vs. with direct admission have differences regarding trauma severity and physiological compromise on admission. The referred patient has a higher risk of mortality (RR: 2.81; 95% CI 2.44-3.22). There is a high proportion of penetrating trauma by gunshot wounds. However, it is the physiological state at admission that impacts mortality. Conclusion. Patients referred from other institutions have a higher mortality risk, being a health inequity that invites the articulation of institutional actors in trauma care. A trauma center should relate to partner institutions to create a trauma system that optimizes care and timeliness
Subject(s)
Humans , Trauma Centers , Prehospital Care , Referral and Consultation , Wounds and Injuries , Trauma Severity Indices , Advanced Trauma Life Support CareABSTRACT
Introducción. El trauma cardíaco penetrante es una patología con alta mortalidad, que alcanza hasta el 94 % en el ámbito prehospitalario y el 58 % en el intrahospitalario. El algoritmo internacional para los pacientes que ingresan con herida precordial, hemodinámicamente estables, es la realización de un FAST subxifoideo o una ventana pericárdica, según la disponibilidad del centro, y de ser positivo se procede con una toracotomía o esternotomía. Métodos. Se hizo una búsqueda bibliográfica en las bases de datos Medline, Pubmed, Science Direct y UpTodate, usando las palabras claves: "taponamiento cardíaco", "herida precordial" y "manejo no operatorio". Se tomaron los datos de la historia clínica y las imágenes, previa autorización del paciente. Caso clínico. Paciente masculino ingresó con herida en área precordial, estable hemodinámicamente, sin signos de sangrado activo, con FAST subxifoidea "dudosa". Se procedió a realizar ventana pericárdica, la cual fue positiva para hemopericardio de 150 ml; se evacuaron los coágulos del saco pericárdico, se introdujo sonda Nelaton 10 Fr para lavado con solución salina 500 ml, hasta obtener retorno de líquido claro. Frente al cese del sangrado y estabilidad del paciente se decidió optar por un manejo conservador, sin toracotomía. Conclusiones. No todos los casos de hemopericardio traumático por herida por arma cortopunzante requieren toracotomía. El manejo conservador con ventana pericárdica, drenaje de hemopericardio más lavado y dren es una opción en aquellos pacientes que se encuentran estables hemodinámicamente y no se evidencia sangrado activo posterior al drenaje del hemopericardio.
Introduction. Penetrating cardiac trauma is a pathology with high mortality, reaching up to 94% in the prehospital and 58% in the hospital settings. The international algorithm for patients who are admitted to the hospital with a precordial wound and who are hemodynamically stable is to perform a subxiphoid FAST echo or a pericardial window according to the availability of the center and, if positive, proceed to perform thoracotomy or sternotomy. Methods. A literature search was made in the Medline, Pubmed, ScienceDirect, and UpTodate biomedical databases, using the keywords "cardiac tamponade", "precordial wound" and "non-operative management". The data was taken from the clinical history, the images and the surgical procedure. Clinical case. Male patient who was admitted to the emergency room due to a wound in the precordial area, hemodynamically stable without signs of active bleeding, with subxiphoid FAST that is reported as "doubtful". We proceeded to perform a pericardial window which is positive for 150 ml hemopericardium, evacuation of clots from the pericardial sac, inserted a 10 Fr Nelaton catheter and washed with 500 ml saline solution until the return of clear fluid was obtained. In view of the cessation of bleeding and the stability of the patient, it was decided to opt for a conservative management and not to perform a thoracotomy. Conclusions. Not all cases of traumatic hemopericardium from a sharp injury require thoracotomy. Conservative management with pericardial window drainage of the hemopericardium plus lavage and drain is an option in those patients who are hemodynamically stable and there is no evidence of active bleeding after drainage of the hemopericardium.
Subject(s)
Humans , Pericardial Effusion , Pericardium , Pericardial Window Techniques , Wounds and Injuries , Diagnostic Techniques and Procedures , Conservative TreatmentABSTRACT
La parálisis del VII par craneal o nervio facial, es una de las neuropatías más frecuentes. Sin embargo, la bilateral ocurre solo en el 0,3 a 2% de los casos. Se describe el caso de un paciente con parálisis facial periférica bilateral progresiva, secundaria a traumatismo craneoencefálico con fractura de ambos temporales, a quien se le realizó tratamiento médico con esteroides y fisioterapia con mejoría, por lo que se decidió expectar la conducta quirúrgica del nervio facial
Facial nerve palsy is one of the most common neuropathies. However, bilateral occurs only in 0.3 to 2% of cases. The case of a patient with progressive bilateral facial nerve palsy, secondary to cranioencephalic trauma with fracture of both temporal was treated with steroids and physiotherapy with subsequent resolution of symptoms, so it was decided dedicated wait for surgery
Subject(s)
Facial Paralysis , Wounds and InjuriesSubject(s)
Humans , Male , Female , Wounds and Injuries , Forms and Records Control , Public Policy , ColombiaABSTRACT
Resumen Introducción: Las lesiones en el hogar constituyen una problemática importante para la salud pública. Más de la mitad de los niños sufre algún tipo de lesión, siendo la más común las caídas. El bajo nivel de conocimiento sobre lesiones de los padres y cuidadores está relacionado con factores personales y sociales y puede tener consecuencias negativas en los menores. Objetivo: Identificar los factores relacionados con la prevalencia de conocimientos de cuidadores de menores de 5 años con respecto a lesiones en el hogar en Cali, Colombia. Metodología: este estudio se realizó en comunas de estratos socioeconómicos bajos y medio-bajos de Cali - Colombia. Participaron 519 madres y cuidadores. Se incluyeron variables sociodemográficas y se construyó la variable número de conocimientos adecuados frente a lesiones en el hogar. Se realizó un análisis descriptivo, se calculó la prevalencia de conocimientos de los cuidadores frente a las lesiones en el hogar y se construyó un modelo múltiple binomial negativo. Resultados: Se encontró que los conocimientos de cuidadores de menores de 5 años con respecto a lesiones en el hogar están explicados por la edad del cuidador (p = 0,010 - coeficiente de regresión (β) 0,110 / p = 0,049 - coeficiente de regresión (β) 0,080) y el tipo de vivienda (p = 0,029 - coeficiente de regresión (β) 0,099). Discusión y conclusiones: La problemática sobre las lesiones en el hogar en menores de 5 años se debe al alto desconocimiento de la población, en especial de aquellos que cumplen el rol de cuidadores.
Abstract Introduction: Injuries at home are an important problem for public health. More than half of children suffer some type of injury, the most common being falls. The low level of knowledge regarding injuries of parents and caregivers is related to personal and social factors and can have negative consequences on minors. Objective: Identify the factors related to the prevalence of knowledge of caregivers of children under 5 years of age regarding injuries at home in Cali, Colombia. Methodology: This study was carried out in communes of low and medium-low socioeconomic strata in Cali, Colombia. A total of 519 mothers and caregivers participated. Sociodemographic variables were included and the variable number of adequate knowledge regarding injuries at home was constructed. A descriptive analysis was performed, the prevalence of caregivers' knowledge of home injuries was calculated, and a multiple negative binomial model was constructed. Results: The results show that the knowledge of caregivers-is explained by the age of the caregiver (p = 0.010) and the type of dwelling (p = 0.029). Discussion and conclusions: The problem of injuries at home in children under 5 years of age is due to the high level of ignorance of the population, especially those who play the role of caregivers.
Subject(s)
Humans , Male , Female , Child, Preschool , Primary Health Care , Wounds and Injuries , Child, Preschool , Caregivers , KnowledgeABSTRACT
Resumen Introducción: El trauma representa la primera causa de mortalidad en edades tempranas en el mundo. Objetivo: Analizar la tendencia en la mortalidad debida a lesiones por trauma en Colombia entre 2007 y 2017. Metodología: Se trata de un estudio a partir de información oficial del Departamento Administrativo Nacional de Estadística (DANE). Incluyó análisis de tendencia de las tasas de mortalidad ajustada por edad y sexo, análisis bivariado para demostrar diferencias de proporciones con la prueba de independencia de ji-cuadrado y un análisis multivariado para calcular la razón de probabilidad (odds ratio, OR) para mortalidad por trauma mediante la regresión logística multivariada. Resultados: Se atribuyeron a trauma 214 258 defunciones; 88,2 % ocurrieron en hombres. La tasa media anual de mortalidad fue de 40,9 por 100 000 habitantes: 75,2 en hombres y 9,7 en mujeres. La primera causa de muerte en la población masculina se atribuye a lesiones por arma de fuego (OR multivariado=2,287; IC 95 % 2,217 - 2,358) mientras que en la población de sexo femenino fueron los accidentes de tránsito (OR multivariado= 2,224; IC 95 % 2,163 - 2,286). Conclusiones: En general, la mortalidad por traumatismos fue mayor en los hombres de todas las edades, sobre todo en el grupo de 25 a 29 años (149,5 por 100 000 hombres/año) y los de 30 a 34 años (133,9 por 100 000 hombres) tenían más probabilidades de morir debido a lesiones relacionadas con la violencia.
Abstract Introduction: Trauma injuries are the leading cause of premature mortality worldwide. Objective: To analyze trends in mortality due to trauma injuries in Colombia from 2007 to 2017. Methods: We conducted a study of association based on official information from the National Administrative Department of Statistics (In Spanish, DANE). It included a trend analysis of mortality rates adjusted for age and sex, bivariate analysis to demonstrate differences in proportions with the chi-square test and multivariate analysis to calculate the Odds Ratio (OR) for trauma mortality using multivariate logistic regression. Results: 214,258 deaths were attributed to trauma injuries, and 88.2 % of them occurred among men of all ages. The mean mortality rate during the study period was 40.9 deaths per 100,000 people (75.2 among men and 9.7 in women). The main causes of death among men were firearms injuries (OR multivariate=2,287; IC 95% 2,217 - 2,358) while road traffic among women (OR multivariate= 2,224; IC 95% 2,163 - 2,286). Conclusion: Overall, mortality rates due to trauma injuries were higher among men of all ages than women, but 25 to 29 (149,5 per 100 000 men/year) and 30 to 34 year-old (133,9 per 100 000 men). males were more likely to die due to violence-related injuries.