Visitas em ambientes virtuais manejadas por cardiologistas pediátricos: relato de experiência / Visits in virtual environments managed by pediatric cardiologists: report of experience / Visitas en entornos virtuales administrados por cardiólogos pediátricos: relato de experiencia

Objetivo: Relatar a experiência de contatos diários entre um centro de cardiologia pediátrica e 14 centros de saúde públicos da Paraíba. Metodologia: Diariamente, os cardiologistas deveriam estabelecer contato com as maternidades paraibanas. Essa comunicação poderia ser por WebEx, Skype ou, em último caso, via telefone. Foram anotados todos os casos clínicos e análises de ecocardiogramas, além das dificuldades enfrentadas para uma comunicação eficaz. O período entre 02/01/2013 e 05/08/2013 foi analisado. Resultados: Houve 1523 contatos entre o centro de referência e os 14 centros. Dificuldade técnica ocorreu em 363 das comunicações, sendo a dificuldade de responder ao chamado a maior responsável (57,7%) seguida pelos problemas com a conexão a internet (11,8%). Durante o período, foram discutidos 871 casos e 100 ecocardiogramas. Conclusão: Apesar das dificuldades estruturais foi possível manter uma boa comunicação e conduzir um grande número de casos. Por outro lado, o fator humano foi responsável pela maioria das dificuldades...

Objective: to report the experience of daily contact between a pediatric cardiology center and 14 public hospitals in Paraíba. Methodology: Everyday, cardiologists made contact with the maternities from Paraíba. This communication was done by WebEx, Skype and some cases via telephone. All clinical cases, analyzes of echocardiograms and the difficulties in effective communication were registered. For this analyzes we are only considering the time frame between 02/01/2013 and 05/08/2013. Results: A total of 1523 contacts between the reference center and 14 hospitals were made. Technical difficulty occurred in 363 of the communications: the difficulty of answering the call (57.7%), followed by problems with the internet connection (11.8%). During the period, 871 cases and 100 echocardiograms were discussed. Conclusion: Despite the structural problems, it was possible to maintain good communication and conduct a large number of cases. On the other hand, the human factor was responsible for the majority of technical difficulties...

Objetivo: Relatar las experiencias de contactos diarios entre un Centro de Cardiología Pediátrica y 14 Maternidades Públicas de Paraíba. Metodología: Diariamente los cardiologistas deberían establecer contacto con las maternidades Paraibanas. Esa comunicación podría ser por WebEx, Skype o en último caso, vía teléfono. Fueron anotados todos los casos clínicos y análisis de eco cardiogramas, además de las dificultades enfrentadas para una comunicación eficaz. El período entre 02/01/2013 y 05/08/2013 fue analizado. Resultado: Hubo 1523 contactos entre el Centro de referencia y las 14 maternidades. Dificultades técnicas ocurrieron en 363 comunicaciones, siendo la dificultad de responder al llamado la mayor responsable (57,7%), seguida por los problemas con la conexión a internet (11,8%). Durante el período fueron discutidos 871 casos y efectuados 100 eco cardiogramas. Conclusión: A pesar de las dificultades estructurales fue posible mantener una buena comunicación y atender un gran número de casos. Por otro lado, el factor humano fue responsable por la mayoría de las dificultades...

Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women: a prospective study

OBJECTIVE: This study aimed to compare the pelvic floor muscle strength of nulliparous and primiparous women. METHODS: A total of 100 women were prospectively distributed into two groups: Group 1 (G1) (n = 50) included healthy nulliparous women, and Group 2 (G2) (n = 50) included healthy primiparous women. Pelvic floor muscle strength was subjectively evaluated using transvaginal digital palpation. Pelvic floor muscle strength was objectively assessed using a portable perineometer. All of the parameters were evaluated simultaneously in G1 and were evaluated in G2 during the 20th and 36th weeks of pregnancy and 45 days after delivery. RESULTS: In G2, 14 women were excluded because they left the study before the follow-up evaluation. The median age was 23 years in G1 and 22 years in G2; there was no significant difference between the groups. The average body mass index was 21.7 kg/m² in G1 and 25.0 kg/m² in G2; there was a significant difference between the groups (p = 0.0004). In G2, transvaginal digital palpation evaluation showed significant impairments of pelvic floor muscle strength at the 36th week of pregnancy (p = 0.0006) and 45 days after vaginal delivery (p = 0.0001) compared to G1. Objective evaluations of pelvic floor muscle strength in G2 revealed a significant decrease 45 days after vaginal delivery compared to nulliparous patients. CONCLUSION: Pregnancy and vaginal delivery may cause weakness of the pelvic floor muscles.