RESUMO
No disponible
Assuntos
Criança , Masculino , Humanos , Diagnóstico Diferencial , Granuloma Eosinófilo , Neoplasias Cranianas , Neoplasias de Tecidos MolesAssuntos
Abscesso/complicações , Infecções por Bacteroides/complicações , Febre de Causa Desconhecida/etiologia , Esplenopatias/complicações , Infecções Estreptocócicas/complicações , Abscesso/diagnóstico , Abscesso/microbiologia , Infecções por Bacteroides/diagnóstico , Infecções por Bacteroides/microbiologia , Criança , Humanos , Masculino , Esplenopatias/diagnóstico , Esplenopatias/microbiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Streptococcus sanguis , SíndromeRESUMO
No disponible
Assuntos
Criança , Masculino , Humanos , Infecções Estreptocócicas , Esplenopatias , Streptococcus sanguis , Síndrome , Infecções por Bacteroides , Abscesso , Febre de Causa DesconhecidaRESUMO
OBJECTIVE: The purpose of this study was to analyze the impact of a quality assurance program intended to improve the care of children with acute asthma in the emergency ward of a first level hospital. PATIENTS AND METHODS: New guidelines for acute asthma management in children were developed and applied beginning 1-1-1997. The ways to deal with an asthma crisis in 1996 and 1997 were compared. The quality guarantee cycle was the method for application of the guidelines, health workers being aware of the starting point (1996) and which areas could be improved. The quality of the clinical assessment of the asthma crisis, the adequacy of treatment, and the final destination of the patients (discharge or admission) were evaluated. RESULTS: Seventy-seven and 68 asthma crises were attended to during 1996 and 1997, respectively. We noticed significant improvements in the clinical assessment of the crisis (p < 0.001), in the correct usage of the term "asthma crisis" (p < 0.001) and in the description of the crisis severity (p < 0.001). The number of improper therapeutic procedures was reduced (p < 0.0001). Children with a mild crisis, except for those associated with risk factors (14% in 1996 and 6% in 1997), were discharged from the hospital. All children with severe crises were admitted to the hospital. Of the children with moderate crises, 75% need hospitalization in 1996, while only 45.1% did during 1997 (p = 0.05). CONCLUSIONS: Following appropriate guidelines during acute asthma attacks implies better care of the asthmatic child and reduces the number of hospital admissions. The quality guarantee cycle is a proper way to achieve these goals.
Assuntos
Asma/terapia , Hospitalização , Qualidade da Assistência à Saúde , Doença Aguda , Criança , Serviços de Saúde da Criança/normas , Serviços Médicos de Emergência/normas , Hospitais de Distrito , Humanos , Atenção Primária à Saúde , Garantia da Qualidade dos Cuidados de Saúde , Índice de Gravidade de Doença , EspanhaRESUMO
OBJECTIVES: To find out if differences in diet may justify the presence of idiopathic hypercalciuria (IH) and to verify if the calcium-restricted diet, often recommended for treatment of IH, is nutritionally appropriate. PATIENTS AND METHODS: Dietary intake and mineral and electrolyte urinary excretion were studied twice in 10 children diagnosed of IH and in 9 controls. First, while being on a free diet. Second, after a week of suppression of milk and dairy products. RESULTS: Intakes of calories, proteins, carbohydrates, fats, and minerals were similar in IH patients and controls. Withdrawal of dairy products of diet resulted in an important reduction in the intakes of calcium (71.1%), phosphorus (63.5%) and fats (30.1%), although only calcium intake was remarkably below international recommendations (33.6 +/- 10.4%). CONCLUSIONS: Spontaneous diet of this group of hypercalciuric children was no different from that of control children. Suppression of milk and dairy products causes a nutritionally inappropriate diet.
