Factores contribuyentes al abandono de la lactancia materna exclusiva en un área de salud / Factors contributing to exclusive breastfeeding discontinuation in a health area

Se realizó un estudio longitudinal, prospectivo, observacional y descriptivo de 40 mujeres, atendidas en el consultorio No. 26 del Policlínico Universitario "Josué País García" de Santiago de Cuba, desde enero del 2011 hasta igual mes del 2012, a fin de identificar los factores contribuyentes al abandono de la lactancia materna exclusiva. Entre las variables analizadas figuraron: edad de la madre, enfermedades crónicas, paridad, nivel socioeconómico, escolaridad y presencia de complicaciones en el parto. En la casuística, las madres que primero abandonaron la lactancia materna fueron las de 15-19 años (42,5 %), nulíparas (32,5 %), con nivel socioeconómico bajo (50,0 %) y escolaridad primaria. Se demostró que las complicaciones durante el parto influyeron en el abandono de este tipo de lactancia.

A longitudinal, prospective, observational and descriptive study was conducted in 40 women, treated at the doctor's office No. 26 of "Josué País García" University Polyclinic in Santiago de Cuba, from January 2011 to the same month of 2012, in order to identify the factors contributing to exclusive breastfeeding discontinuation. Among the analyzed variables were mother's age, chronic diseases, parity, socioeconomic status, education and complications in childbirth. In the case material, mothers who first discontinued breastfeeding were those between 15-19 years of age (42.5%), nulliparous (32.5%), with low socioeconomic status (50.0%) and primary education. It was demonstrated that complications during the childbirth influenced the discontinuation of this type of feeding.

Factors contributing to episodes of bradycardia hypotension during shoulder arthroscopic surgery in the sitting position after interscalene block / 대한마취과학회지

BACKGROUND: Arthroscopic shoulder surgery has been performed in the sitting position under interscalene block (ISB). Bradycardia hypotension (BH) episodes have a reported incidence of 13-29% in this setting. We performed a retrospective study to investigate contributing factors to the occurrence of BH episodes. METHODS: According to BH episodes, we divided 63 patients into two groups: BH group (n = 13) and non-BH group (n = 50). Anesthetic records and block data sheets were reviewed for demographic data, intraoperative medications, sites of ISB, use of epinephrine in local anesthetics, degree of sensory blockade, and percent change of heart rate or systolic blood pressure (SBP). Statistical analysis was done using Chi square test and Student's t-test. RESULTS: There were no significant differences in the use of epinephrine in local anesthetics between the two groups. The location of ISB site was different between the two groups in that there were relatively more right-sided ISBs in the BH group than in the non-BH group (P = 0.048). The degree of sensory blockade was lower, but not significantly, in the C8 and T1 dermatomes of the BH group than in the non-BH group (P = 0.060 and 0.077, respectively). There was a relatively higher incidence of fentanyl supplementation in the BH group than in the non-BH group (P = 0.000). CONCLUSIONS: These results suggest that right ISB and perioperative supplementation of fentanyl due to incomplete block are possible contributing factors to the occurrence of BH episodes in the sitting position during shoulder surgery using ISB.

Length of Stay of Psychiatric Patient and Its Correlate in Mental Health-related Facilities / 신경정신의학

OBJECT: This study was aimed to find the contributing factors that influence the length of stay in mental health related facilities and to present future direction for the mental health policy. METHODS: The 1,875 patients who are aged between eighteen and sixty-five are chosen by the stratified random sampling from ten psychiatric hospitals, six psychiatric nursing facilities and five homeless asylums. We investigate about length of stay of all subjects by sociodemographic characteristics, socioeconomic status, functional status, disease related characteristics and analyse contributing factors. RESULTS: From total subjects, average length of stay was 1,906 days, and facilities, where subjects are institutionalized, explains 40% of length of stay. Other related factors are female, old age, single, lack of supportive system before admission and after discharge, medical assistance type I, unavailable of public transportation and utility, long duration of illness, and psychotic disorder. CONCLUSION: For lowering the rate of long-term hospitalization, evaluation of appropriateness is needed for admission to nursing facility and homeless asylum and make up for the medical payment system and the supportive system from family and community.

Clinical Characteristics of Hospitalized Cases due to Asthma Attack Combined with Pneumonic Infiltrates / 소아알레르기및호흡기학회지

PURPOSE: The respiratory tract infections including pneumonia have been the major contributing factor for bronchial asthma, and are frequently involved in hospitalization due to asthma attack. We studied clinical characteristics of hospitalized cases due to asthma attack with and without pneumonic infiltrates. METHODS: Over 5 years between January 1993 and December 1997, 628 patients were hospitalized due to asthma attack. 315 of them had pneumonic infiltrates on chest X-ray (defined as pneumonia group) and 197 patients had no pneumonic infiltrates (uncomplicated group). The clinical characteristics of both groups were reviewed retrospectively. RESULTS: The age on admission and first attack in pneumonia group were significantly younger than those of uncomplicated group (P<0.05). The incidence of male was higher than that of female in both groups. The interval from attack to admission and duration of hospitalization were much longer in pneumonia group (P<0.05). The bronchial asthma attack was most frequently occurred between September and November. The atopy-perennial type was predominant in the both groups, and the incidence of non-atopy type was higher in the pneumonia group. The mild asthma attack was predominant in the pneumonia group and moderate one was predominant in the uncomplicated group. The incidence of fever and inflammatory reaction (peripheral blood WBC count, serum CRP level) were higher in the pneumonia group (P<0.05). There was no significant difference in the serum IgE level between two groups. CONCLUSION: Frequency and duration of hospitalization due to asthma attack might be lessened by prevention against respiratory tract infection.