Subject(s)
Abdominal Abscess/drug therapy , Acute Kidney Injury/complications , Anti-Bacterial Agents/therapeutic use , Drug Hypersensitivity/complications , Minocycline/analogs & derivatives , Abdominal Abscess/complications , Abdominal Abscess/diagnostic imaging , Abdominal Abscess/surgery , Aged , Anti-Bacterial Agents/adverse effects , Humans , Male , Minocycline/therapeutic use , Radiography , Tigecycline , beta-Lactams/adverse effectsSubject(s)
Anti-Bacterial Agents/therapeutic use , Diverticulitis/drug therapy , Minocycline/analogs & derivatives , Acute Disease , Aged , Bacteremia/diagnosis , Bacteremia/drug therapy , Bacteremia/microbiology , Diverticulitis/diagnosis , Diverticulitis/microbiology , Female , Humans , Minocycline/therapeutic use , Tigecycline , Tomography, X-Ray ComputedABSTRACT
Introduction: Focused lateral approach is widely accepted for the surgery of solitary parathyroid adenomas, because it is a minimally invasive approach and its aesthetic advantages. Notwithstanding, when the pathlogical gland is not easily recognized, this approach difficults the search and makes more susceptible for iatrogenic lesions. Sometimes, PTH levels do not decrease up to 75 percent of initial values 15 minutes after the gland resection; a smaller decreasement do not exelude that the pathological gland has been already resected. Case report: A 69-years old man underwent a minimally invasive parathyroidectomy. Surgical act is complex, because of a difficult identification of the gland. In the postoperative course, the patient developed a pharyngoesophageal fístula that was successfully managed with a conservative approach.
Introducción: El abordaje unilateral en la cirugía del adenoma solitario de paratiroides está ampliamente aceptado por sus ventajas estéticas y ser un procedimiento mínimamente invasivo. Sin embargo, cuando la glándula patológica no es fácilmente detectada, dificulta mucho su búsqueda y facilita la iatrogenia. En ocasiones, los niveles de PTH no descienden al 75 por ciento del valor inicial 15 minutos después de la paratiroidectomía; un descenso menor del 75 por ciento no excluye que la glándula patológica haya sido extirpada. Caso clínico: Varón de 69 años es sometido a paratiroidectomía a través de un abordaje mínimamente invasivo. La cirugía es compleja y prolongada al no identificarse fácilmente la glándula paratiroides. En el postoperatorio el paciente presenta una fístula faringoesofágica que se se maneja satisfactoriamente de forma conservadora.
Subject(s)
Humans , Male , Aged , Pharyngeal Diseases/etiology , Esophageal Fistula/etiology , Parathyroidectomy/adverse effects , Parathyroidectomy/methods , Drainage , Pharyngeal Diseases/therapy , Esophageal Fistula/therapy , Minimally Invasive Surgical Procedures/adverse effectsABSTRACT
ObjetivoConocer la satisfacción de los pacientes diabéticos respecto al servicio de retinografía.MétodosEncuesta telefónica a 64 usuarios entre julio de 2006 y marzo de 2007. El 57,8% eran varones. La edad media fue de 65,2 años. El 54,7% procedían de un equipo de atención primaria (EAP) urbano. Las variables fueron: sexo, edad, EAP, retinografía/tonometría (normal/patológica), accesibilidad, puntualidad, limpieza, tiempo dedicado, explicaciones, buenas manos, amabilidad en escala mala/regular/buena/muy buena/perfecta, y satisfacción telefónica/global en escala 010.ResultadosSe valoró (>80%) la accesibilidad, la puntualidad, la limpieza, el tiempo dedicado, las buenas manos y la amabilidad. La media de satisfacción global fue de 8,38 (intervalo de confianza del 95% [IC95%]: 8,038,72) y la telefónica fue de 7,88 (IC95%: 7,48,36). Se asociaron (p<0,05) con una satisfacción global (⩾8) el tiempo de visita, las explicaciones comprensibles y la llamada telefónica que informa del resultado. La regresión logística muestra (p<0,05) que en la satisfacción influye más recibir el resultado de las exploraciones por teléfono.ConclusionesEl servicio de retinografía está bien valorado. Los resultados telefónicos son los que más influyen en la elevada satisfacción. Se impulsarán las nuevas tecnologías (SMS, e-mail)(AU)
ObjectiveTo determine satisfaction with the retinography service among patients with diabetes.MethodsWe performed a telephone survey of 64 users from July 2006 to March 2007. The mean age was 65.2 years, 57.8% were men, and 54.7% were from urban primary care centers. The variables analyzed were sex, age, primary care team, retinography/tonometry (normal/pathologic), accessibility, punctuality, hygiene, consultation length, explanations, good hands, kindness on a scale rated bad/average/good/very good/perfect, satisfaction with the telephone call informing users of the results of the examination, and overall satisfaction, both rated on a scale from 0 to 10.ResultsAccessibility, punctuality, hygiene, consultation length, good hands and kindness received scores of >80%. The mean overall satisfaction score was 8.38% (95% confidence interval [95%CI]: 8.038.72), while satisfaction with the telephone call was 7.88% (95%CI: 7.48.36). The variables associated (p<0.05) with overall satisfaction of ⩾8 were consultation length, receiving comprehensible explanations, and the telephone call informing patients of the results of the examination. Logistic regression showed (p<0.05) that the variable with the greatest influence on satisfaction was the telephone call.Conclusionsthe retinography service was favorably evaluated. The variable with the greatest influence on high satisfaction was communicating the results by telephone. The service will promote new technologies (SMS, e-mail)(AU)
Subject(s)
Humans , /methods , Diabetic Retinopathy/diagnosis , Patient Satisfaction/statistics & numerical data , Health Care Surveys/statistics & numerical data , Mydriatics , Primary Health CareABSTRACT
OBJECTIVE: To determine satisfaction with the retinography service among patients with diabetes. METHODS: We performed a telephone survey of 64 users from July 2006 to March 2007. The mean age was 65.2 years, 57.8% were men, and 54.7% were from urban primary care centers. The variables analyzed were sex, age, primary care team, retinography/tonometry (normal/pathologic), accessibility, punctuality, hygiene, consultation length, explanations, good hands, kindness on a scale rated bad/average/good/very good/perfect, satisfaction with the telephone call informing users of the results of the examination, and overall satisfaction, both rated on a scale from 0 to 10. RESULTS: Accessibility, punctuality, hygiene, consultation length, good hands and kindness received scores of >80%. The mean overall satisfaction score was 8.38% (95% confidence interval [95%CI]: 8.03-8.72), while satisfaction with the telephone call was 7.88% (95%CI: 7.4-8.36). The variables associated (p<0.05) with overall satisfaction of 8 were consultation length, receiving comprehensible explanations, and the telephone call informing patients of the results of the examination. Logistic regression showed (p<0.05) that the variable with the greatest influence on satisfaction was the telephone call. CONCLUSIONS: the retinography service was favorably evaluated. The variable with the greatest influence on high satisfaction was communicating the results by telephone. The service will promote new technologies (SMS, e-mail).
