RESUMO
El uso de la ecografía clínica, entendida como una extensión de la exploración física que ayuda a la toma de decisiones clínicas en tiempo real, se ha generalizado en diversas especialidades médicas y quirúrgicas. En los últimos años, los avances tecnológicos han permitido disponer de ecógrafos de bolsillo, económicamente asequibles, que pueden ser utilizados en el propio domicilio del paciente. En esta revisión se describen las principales aplicaciones de la ecografía clínica en cuidados paliativos, un escenario de potencial utilidad tanto para mejorar la certeza en el diagnóstico de procesos agudos intercurrentes, que producen un impacto en la calidad de vida del paciente, como para guiar la realización de procedimientos invasivos sin necesidad de desplazamientos al medio hospitalario. Para la implantación de la ecografía clínica en cuidados paliativos son necesarios programas formativos con objetivos concretos, definiendo curvas de aprendizaje y estableciendo alianzas con sociedades científicas de reconocida trayectoria docente, asistencial e investigadora para la acreditación de competencias (AU)
Combined with a physical examination, clinical ultrasound offers a valuable complement that can help guide clinical decision-making. In various medical and surgical specialties, it is increasingly used for diagnostic and therapeutic purposes. Due to recent technological advances, smaller and more affordable ultrasound machines are now being developed for use in home hospice care. The purpose of this paper is to describe how clinical ultrasound may be applied in Palliative Care, where it can be a valuable tool to assist the clinician in making better clinical decisions and to assist in accurately guiding palliative procedures. Furthermore, it can be used to identify unnecessary hospitalizations and prevent them from occurring. Training programs with specific objectives are necessary to implement clinical ultrasound in Palliative Care, as well as defining learning curves and promoting alliances with scientific societies that recognize the teaching, care and research trajectory for accreditation of competencies (AU)
Assuntos
Humanos , Ultrassonografia/métodos , Cuidados Paliativos/métodos , Sistemas Automatizados de Assistência Junto ao LeitoRESUMO
Carbon fiber is one of the most widely used materials in high demand applications due to its high specific properties, however, its post-recycling properties limit its use to low performance applications. In this research, the carbon fiber recovering is examined using two methods: two-step pyrolysis and microwave-assisted thermolysis. The results indicate that the fibers recovered by pyrolysis show reduced surface and structural damage, maintaining the original mechanical properties of the fiber with losses below 5%. The fibers recovered by microwaves undergo significant surface changes that reduce their tensile strength by up to 60% and changes in their graphitic structure, increasing their degree of crystallinity by Raman index ID/IG from 1.98 to 2.86 and their amorphous degree by ID"/IG ratio from 0.411 to 1.599. Recovering fibers from microwave technique is 70% faster compared to two step pyrolysis, and provides recycled fibers with superior surface activation with the presence of polar functional groups -OH, -CO, and -CH that react with the epoxy matrix. The thermal, morphological, structural and mechanical characterizations of the recovered fibers detailed in this work provide valuable findings to evaluate their direct reuse in new composite materials.
Assuntos
Pirólise , Fibra de Carbono , Resistência à TraçãoRESUMO
La malformación de Dandy Walker se define por hipoplasia del vermis cerebeloso y dilatación quística del cuarto ventrículo. Algunas de las manifestaciones clínicas son hidrocefalia, retraso en el desarrollo motor, hipotonía y ataxia. El objetivo del tratamiento es mejorar el funcionamiento general del individuo y proporcionar una mejor calidad de vida a través de un equipo multidisciplinario. En el presente caso clínico se describe la evolución de un paciente diagnosticado con malformación de Dandy Walker tras la intervención del modelo médico del Centro de Rehabilitación e Inclusión Infantil Teletón Guanajuato (CRIT) el cual se centra en la rehabilitación del paciente y la familia, cubriendo cada una de las áreas que engloban al paciente
Dandy-Walker malformation is characterised by hypoplasia of the cerebellar vermis and cystic dilation of the fourth ventricle. Some of the clinical manifestations of this malformation are hydrocephalus, delayed motor development, hypotonia, and ataxia. Treatment aims to improve the individual's overall functioning and enhance quality of life through a multidisciplinary team. This case report describes the outcome of a patient diagnosed with Dandy-Walker malformation, after the intervention of the medical model at Centro de Rehabilitación e Inclusión Infantil Teletón Guanajuato (CRIT), which focuses on rehabilitating the patient and the family, covering each of the areas encompassing the patient
Assuntos
Humanos , Masculino , Criança , Síndrome de Dandy-Walker/reabilitação , Terapia por Exercício/métodos , Equipe de Assistência ao Paciente/organização & administração , Resultado do Tratamento , Modalidades de Fisioterapia , Avaliação de Resultado de Intervenções Terapêuticas , Qualidade de VidaRESUMO
Dandy-Walker malformation is characterised by hypoplasia of the cerebellar vermis and cystic dilation of the fourth ventricle. Some of the clinical manifestations of this malformation are hydrocephalus, delayed motor development, hypotonia, and ataxia. Treatment aims to improve the individual's overall functioning and enhance quality of life through a multidisciplinary team. This case report describes the outcome of a patient diagnosed with Dandy-Walker malformation, after the intervention of the medical model at Centro de Rehabilitación e Inclusión Infantil Teletón Guanajuato (CRIT), which focuses on rehabilitating the patient and the family, covering each of the areas encompassing the patient.
Assuntos
Protocolos Clínicos , Síndrome de Dandy-Walker/reabilitação , Família , Criança , Humanos , Hidrocefalia/cirurgia , Masculino , México , Derivação VentriculoperitonealRESUMO
We present the clinical aspects and the evolution of 14 patients brought in the last 5 years in an ICU polyvalent with diagnostic of intoxication by organophosphate (OF) 10 and paraquat 4. The intoxicated by OF were subjugated at the same treatment record book with atropine, gastric washing, coal activated and pralidoxime. At the intoxicated by paraquat used precocious hemoperfusion. The mortality in intoxicated by OF went 20%, and 100% in paraquat intoxications. We analyzed to them the complications during their stay in ICU, as soon as diverse clinical aspects of this intoxications and equal form varied aspects about treatment.
