RESUMO
En este artículo, cuento la vida de un adolescente, durante un año en un internado de la ciudad de Badajoz. A través de sus propias palabras, conoceremos el significado de los nueve meses allí vividos, lo que todas la experiencias aportaron a su vida (AU)
Assuntos
Adolescente , Masculino , Humanos , Psicologia do Adolescente , Punição/psicologia , Relações Familiares , Comportamento do Adolescente/psicologia , Instituições Residenciais , Instituições AcadêmicasRESUMO
BACKGROUND: In order to achieve simultaneously a higher quality of hospital care and cost-containment, an objective assessment of alternative systems for surveillance of hospital infections is needed in our country. This assessment will allow to make a rational choice of the system to be used at each hospital. METHODS: 719 patients admitted to a Vascular Surgery ward were studied. Sensitivity, specificity, and predictive values for a selective system of surveillance of nosocomial infection (NI) were assessed. This selective system attempted to contain costs by means of limiting the revision of records to those patients who presented fever, prescription of antibiotics after admission or who required laboratory cultures. In this selective method charts revision was retrospectively performed by nurses. RESULTS: A low sensitivity (50.9%) and acceptable values for specificity and predictive values were found. CONCLUSIONS: Although this selective method requires only 20% of the reference method's time, its association with an important reduction in sensitivity precludes its systematic use and confines it eventually to low risk wards.
Assuntos
Infecção Hospitalar/epidemiologia , Vigilância da População/métodos , Antibacterianos/administração & dosagem , Antibacterianos/economia , Controle de Custos , Infecção Hospitalar/economia , Infecção Hospitalar/enfermagem , Infecção Hospitalar/prevenção & controle , Testes Diagnósticos de Rotina/economia , Febre/etiologia , Custos de Cuidados de Saúde , Hospitais Universitários/economia , Hospitais Universitários/organização & administração , Humanos , Prontuários Médicos , Avaliação em Enfermagem/economia , Diagnóstico de Enfermagem , Equipe de Assistência ao Paciente , Projetos Piloto , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/enfermagem , Complicações Pós-Operatórias/prevenção & controle , Valor Preditivo dos Testes , Medicina Preventiva , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Procedimentos Cirúrgicos VascularesRESUMO
The purpose of this work was to evaluate the therapeutic results attained with our 1980 protocol for Hodgkin's disease. The usefulness of staging laparotomy was also analysed. Along a 9-year period, 94 patients were diagnosed (stages IA and IIA: 26 cases, IB, IIB and IIIA: 24 cases, and IIIB and IV: 44 cases). The complete remission (CR) rate, as a whole, was 85%; there were 14 relapses, of whom a new CR was attained in 9 instances. The overall actuarial survival is 64% at 47 months. The appearance of 3 cases of acute non-lymphoblastic leukaemia is noteworthy. Laparotomy induced changes of the patient's staging in 49% of cases (rise in 43% and descent in 6%). In account of this, laparotomy seems an adequate procedure in staging, although the criteria for selecting the patients who will undergo this, procedure should be perhaps restrictive.
