ABSTRACT
INTRODUCCIÓN: El área de emergencia es un lugar donde los cuadros dramáticos y la falta de tiempo predisponen a incumplir las normas de bioseguridad y sufrir accidentes laborales. Se plantea como objetivo determinar el impacto de la aplicación de un programa educativo para mejorar los Conocimientos, Actitudes y Prácticas del personal médico que labora en el servicio de trauma y emergencias del Hospital Vicente Corral Moscoso Cuenca-Ecuador y el Hospital Homero Castañer Crespo Azogues-Ecuador, en el año 2015. MÉTODO: Se trató de un estudio cuasiexperimental. El universo incluyó al personal médico de emergencia. Se realizó un cálculo muestral no probabilístico por cuotas con 76 participantes, se dividió proporcionalmente en 2 grupos: experimental y control. Primero se evaluó los CAPs en ambos grupos, y se utilizó un test validado. Después se ejecutó de forma simultánea los programas educativos, en el grupo intervención por simulación y en el grupo control por entrega de información (hojas volantes informativas o trípticos). Al final se analizó el impacto de cada programa. Se utilizó medidas estadísticas de asociación y efecto como riesgo relativo, intervalo de confianza de 95 %, T student, número necesario a tratar, chi cuadrado, McNemar y p valor de 0.05 para definir significancia estadística. RESULTADOS: Participaron 98 personas. La mayoría de participantes fue de sexo femenino (51.3 %), la media de edad fue de 28.6 años. El 64.5 % de los participantes eran solteros/as. El aprendizaje basado en simulacro se mostró efectivo al mejorar los conocimientos de 68.4 % a 81.6 % (diferencia de 26.3), respecto al grupo que recibió trípticos con 47.4 % a 55.3 % (diferencia de 10.6 %), encontrándose una diferencia estadísticamente significativa con un p valor: 0.026, y riesgo relativo de: 1.48 (IC: 1.07 2.04). CONCLUSIONES: El método basado en simulación fue eficaz para mejorar los conocimientos y prácticas en bioseguridad del personal médico que trabaja en el área de emergencias.(AU)
INTRODUCTION: The emergency room (ER) is a place where dramatic scenarios and lack of time, predispose to non-compliance of biosafety standards and work accidents. The aim of this investigation is to determine the impact of the implementation of an educational program to improve the knowledge, attitudes and practices (KAPs) of medical care team working in the trauma and emergency services in Vicente Corral Moscoso Hospital y Homero Castanier Crespo Hospital, during 2015. METHOD: This is aquasi-experimental study.The universe consists of 98 participants including emergency medical staff. A non-probabilistic sample calculation is performed by quotas with 76 participants, divided proportionally into 2 groups: experimental and control. CAPs are first evaluated in both groups with a validated test. Then the educational programs are executed simultaneously: in the intervention group by simulation and in the control group for information delivery (leaflets or triptychs). At the end we analyze the impact of each program. We used statistical measures of association and effect such as relative risk, 95 % confidence interval, Student T, Number Needed to Treat, Chi square 2, McNemar and p value of 0.05 to define statistical significance. RESULTS: 98 people participated. The majority of participants were female (51.3 %), mean age was 28.6 years. 64.5 % of the participants were single. Simulation-based learning was effective in improving knowledge from 68.4 % to 81.6 % (difference of 26.3), compared to the group that received leaflets with 47.4 % to 55.3 % (difference of 10.6 %), with a statistically significant difference p value: 0.026, and relative risk of: 1.48 (CI: 1.07 - 2.04). CONCLUSIONS: The simulation-based method is an effective way to improve knowledge and practices concerning biosafety of the medical staff working in the ER.(AU)
Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , Emergency Medical Services/statistics & numerical data , Biological Factors , Simulation Exercise , EmergenciesABSTRACT
Se presenta un caso de desgarro completo del músculo pectoral mayor (m. pectoralis major, TA) en un paciente fi sicoculturista durante su ejercicio en banca fi ja. Se procedió a reconstruir en 2 etapas. Primera etapa: se colocó toxina botulínica (200 UI). Segunda etapa: a los 21 días se procedió a la reparación quirúrgica de la zona con la colocación de malla de doble capa (polipropileno y politetrafl uoroetileno). Se obtuvo excelente recuperación funcional y estética.
A case of complete rupture of the pectoralis major muscle (m. pectoralis major, TA) in a bodybuilder patient during the exercise is presented. We carry out the reconstruction in 2 steps. First step: botulinum toxin (200 UI) in the muscle was injected. Second step: 21 days post-inyections we done a surgical repair with placing a double layer mesh (polypropylene and polytetrafl uoroethylene mesh). Excellent functional and aesthetic recovery was obtained
Subject(s)
Humans , Male , Adult , Pectoralis Muscles/injuries , Surgical Mesh , Botulinum Toxins/therapeutic use , Plastic Surgery Procedures/methodsABSTRACT
La reconstrucción del labio inferior es una práctica compleja y que requiere la restitución de la mucosa, músculos y piel. Se ha descripto una gran variedad de procedimientos; sin embargo, se debe adaptar cada técnica al caso. Se presenta una paciente con carcinoma espinocelular invasor que compromete la totalidad del labio inferior. Se decidió efectuar la reconstrucción con técnica de Webster y modifi cada por Schuchardt para compensar en la parte del mentón. Se muestran detalles técnicos así como los resultados funcionales y estéticos obtenidos
Reconstruction of the lower lip is a complex practice that requires to restore the mucosa, the muscles and the skin. There are a variety of procedures, however, each technique must be adapted to each case. We present a young patient with invasive squamous cell carcinoma that involves the entire lower lip. We decided to perform the Webster Technique reconstruction modifi ed by Schuchardt (chin fl ap). Technical details, functional and aesthetic results obtained are shown
Subject(s)
Humans , Female , Middle Aged , Lip Neoplasms/pathology , Carcinoma, Squamous Cell/therapy , Plastic Surgery Procedures/methodsABSTRACT
Concentrated starch gels were supplemented with four alpha-amylases from different sources. The retrogradation and recrystallization of the gels were evaluated using differential scanning calorimetry (DSC) and X-ray crystallography. Correlations between the retrogradation data and the carbohydrate fractions extracted from these gels were determined. The thermostable (TBA) and intermediate temperature stability (ISBA) bacterial alpha-amylases were most effective in decreasing the rate of retrogradation of the starch in the gels. The cereal alpha-amylase at the high level (CAH) was also effective. Supplementation with the alpha-amylases increased the crystallinity of the gels. Gels supplemented with TBA or ISBA were most crystalline and retrograded to a lesser extent. The results indicated that DSC gives not only a measure of recrystallized amylopectin but also a measure of total order (recrystallized amylopectin and double-helical content). The maltooligosaccharides produced by the enzymes did not appear to be responsible for the reduced rates of retrogradation, but they appeared to be an expression of the degree of starch modification that was responsible for the inhibition of retrogradation. The crystallinity and retrogradation data were similar to results reported for bread and strongly suggest that bread staling is caused by the retrogradation of starch. The results also indicate that alpha-amylases decrease the rate and extent of retrogradation of starch gels by inhibiting the formation of double helices.
Subject(s)
Bread/analysis , Gels/metabolism , Starch/chemistry , Starch/metabolism , Triticum/chemistry , alpha-Amylases/metabolism , Bacteria/enzymology , Calorimetry, Differential Scanning , Crystallization , Crystallography, X-Ray , Edible Grain/enzymology , Enzyme Stability , Food Preservation , Food Technology , Gels/chemistry , Hot Temperature , ThermodynamicsABSTRACT
The firming and carbohydrate fractions of concentrated starch gels supplemented with four alpha-amylases from different sources were evaluated. Correlations were found between the firmness data and results for the carbohydrate fractions extracted from the gels. The thermostable (TBA) and intermediate temperature stability (ISBA) bacterial alpha-amylases were most effective in decreasing the rate of firming. The cereal alpha-amylase at the high level (CAH) was also effective. The CAH produced the largest quantity of dextrins at storage time zero and the thermostable bacterial alpha-amylase at the high level (TBAH) after storage for 5 days. None of the maltooligosaccharides appeared to be responsible for the decreased rate of firming of the gels. The results indicated that the TBA and ISBA most effectively inhibited firming because they degraded the external branches and the intercluster regions of amylopectin during storage. Consideration of previously reported differential scanning calorimetry and X-ray crystallography results leads to the conclusion that the antifirming action of the TBA and ISBA is due to their ability to degrade the amylopectin and amorphous regions of the gels during storage, which inhibits the formation of double helices and decreases the strength of the starch gel matrix. Gels supplemented with the TBA and ISBA were most crystalline but firmed to a lesser extent. These results are similar to those previously reported by other researchers for bread and strongly suggest that starch retrogradation plays a primary role in bread staling.
