Complicaciones postoperatorias en fractura de órbita: experiencia en el Hospital del Trabajador de Santiago

Objetivo: Describir la experiencia del equipo de cirugía maxilofacial del Hospital del Trabajador en el manejo de las fracturas de órbita. Materiales y Método: Estudio retrospectivo de 42 pacientes consecutivos operados por fractura de órbita en el Servicio de Cirugía Maxilofacial del Hospital del Trabajador entre enero de 2016 y diciembre de 2017. Se tabularon datos demográficos, información del trauma, tipo de fractura, fracturas asociadas, tratamiento y seguimiento. Resultado: De los 42 pacientes, la mayoría eran hombres (73,8%) con edad promedio de 40 ± 12,24 años. Los principales síntomas al ingreso fueron equimosis (64,3%), edema periocular (54,8%), hemorragia subconjuntival (33,3%) y diplopía (26,2%). La pared orbitaria más frecuentemente afectada fue el piso de la órbita (85,7%). Las fracturas se presentaron de forma aislada en 35,7% de los casos y asociada a otra fractura de la cara en 64,3%. Post cirugía, la tasa de complicación fue de 16,7%, producto de diplopía y enoftalmos leves que solo requirieron tratamientos conservadores para su resolución. Discusión: La baja tasa de complicaciones se debe a la experiencia del equipo médico con un seguimiento a largo plazo, la medición de volúmenes orbitarios, imagenología intraoperatoria, utilización de malla prefabricada y asistencia endoscópica. Conclusiones: Un adecuado diagnóstico y evaluación son fundamentales para el tratamiento de la fractura de órbita. Los datos demográficos, las características de las fracturas y las complicaciones descritas fueron muy similares a lo reportado por otras experiencias, mientras que la tasa de complicaciones fue menor.

Aim: To describe the experience of the Maxillofacial Surgical team of Hospital del Trabajador de Santiago in the management of orbital fractures. Materials and Methods: Retrospective study of 42 patients operated consecutively between January of 2016 and November of 2017 at Hospital del Trabajador de Santiago by the Maxillofacial Surgery team due to orbital fracture. The demographic data was tabulated and then a comparison between isolated and combined orbital fractures was made. Results: Of 42 patients most were men (73.8%) with an average age of 40±12.24 years. At admission the main symptoms were ecchymosis (64.3%), periorbital edema (54.8%), subconjunctival hemorrhage (33.3%) and diplopia (26.2%). The most frequently affected orbital wall was the floor (85.7%). Isolated fractures accounted for 35.7% of the cases and those associated with other facial fractures for 64.3%. The postoperative complication rate was 16.7% due to diplopia and enophthalmos. Both complications were mild and only required conservative management. Discussion: The low complication rate might be due to the experience of the surgical team in the management of orbital fractures, long-term following, orbital volume measurements, intraoperative imaging, the use of prefabricated mesh and endoscopic guidance. Conclusión: An adequate diagnosis and evaluation are fundamental for orbital fracture treatment. Demographic data, fracture characteristics and the complications described were similar to those reported by other studies, while the rate of complications was lower than those experiences.

Percepções de idosas quanto a não adesão a farmacoterapia: uma análise qualitativa / Perception of elderly for non-adherence to drug therapy: a qualitative analysis

As percepções do usuário sobre seus medicamentos devem ser compreendidas, visto que reflete os aspectos positivos e negativos que o mesmo vivencia ou vivenciou durante a sua farmacoterapia. Assim, o presente estudo visou identificar a percepção das idosas associados a não adesão à farmacoterapia prescrita, no Programa de Assistência Integral à Melhor Idade. Para tanto, foi realizada entrevista audiogravada, com duração média de cinco minutos e realizada análise de conteúdo. Para a análise dos dados, procedeu-se à ordenação das falas. Partes do material foram codificadas e organizadas em unidades de significação. O esquecimento, a falta ou incompletude de informação médica ou não entendimento das instruções profissionais repassadas e acesso aos medicamentos foram apontados pelas pacientes como motivos de baixo grau de adesão. Diante dos relatos apresentados, recomenda-se maior cuidado no desenvolvimento e pesquisa de dispositivos de adesão à farmacoterapia a partir do relato dos pacientes, aprofundando-se na essência e na compreensão tácita das suas falas.

The user's perceptions about their medications should be understood, since it reflects the positive and negative aspects that the sameone has experienced during their pharmacotherapy. Thus, this study aimed to identify the perception of the elderly associated with non-adherence to prescribed pharmacotherapy, in the Integral Assistance Program to the Golden Age. To do so, the interviews were recorded in audio, with an average duration of five minutes and content analysis. For data analysis, we proceeded to the ordination of speeches. Parts of the material were coded and organized into meaning units. Forgetfulness, the lack or incompleteness of medical information or not understanding of passed professional instruction and access to medicines were mentioned by patients as reasons for low level of compliance. Given the reports presented, it is recommended greater care in the development and research of adherence to pharmacotherapy devices from patients reports, deepening the essence and the tacit understanding of their speeches.

Leishmanicidal activity of carvacrol-rich essential oil from Lippia sidoides Cham

Leishamaniasis is a disease that affects more than 2 million people worldwide, whose causative agent is Leishmania spp. The current therapy for leishmaniasis is far from satisfactory. All available drugs, including pentavalent antimony, require parenteral administration and are potentially toxic. Moreover, an increase in clinical resistance to these drugs has been reported. In this scenario, plant essential oils used traditionally in folk medicine are emerging as alternative sources for chemotherapeutic compounds. In this study, in vitro leishmanicidal effects of a thymol- and a carvacrol-rich essential oil from leaves of Lippia sidoides Cham. were investigated. The essential oils were extracted and their constituents were characterized by gas chromatography coupled to mass spectrometry (GC/MS). Both essential oils showed significant activity against promastigote forms of Leishmania chagasi. However, we found that carvacrol-rich essential oil was more effective, with IC50/72 h of 54.8 μg/mL compared to 74.1 μg/mL for thymol-rich oil. Carvacrol also showed lower IC50 than thymol. Our data suggest that L. sidoides essential oils are indeed promising sources of leishmanicidal compounds.

Medicamentos caseros inocuos / Inocuos domestic medicaments

El presente trabajo demostró las diversas colonias de bacterias y hongos encontrados en los medicamentos caseros inocuos preparados en forma empírica y recetados por médicos inclusive oftalmólogos. Se cultivaron bacterias gram (-), un coco gram (+) y hongos, la recomendación final eliminar de la práctica médica cotidina la utilización de estos medicamentos caseros inocuos