RESUMO
BACKGROUND: Fractures in the elderly population are an economic, social and medical challenge. Not much is known about fractures in this population, which makes difficult the selection of an appropriate treatment. Hip fractures (HF) increase the risk of death and morbidity. Patients with midshaft femur fracture (MFF) have less morbidity and risk of death. The objective was to compare HF and MFF's survival. METHODS: Observational analytic study. The Hospital General de México database was used to gather patients aged 65 to 94 years with HF and MFF from 2010 to 2014. Patients had an heterogeneous follow-up and their cognitive status was not considered; we had a total of 146 patients. Follow-up was made through phone call. RESULTS: Kaplan-Meier estimate was used to assess survival. We compared survival depending on type of fracture and found no statistically significant difference (p = 0.97). On sub-analysis, we compared type of fracture on male gender (p = 0.21) and female gender (p = 0.316) and found no statistically significant difference on survival. This differs from what has been reported. It was used t test to evaluate survival in months, according to male (39.61 ± 19.1) and female (36.58 ± 23.19) gender; this showed a significant difference in both groups (p = 0.037). CONCLUSIONS: In the presence of fractures, we must consider gender when estimating survival on patients with hip or midshaft femur fracture.
INTRODUCCIÓN: las fracturas en los ancianos son un desafío económico, social y médico, de las cuales se desconoce mucho, lo cual dificulta la selección de un tratamiento adecuado. Las fracturas de cadera (FC) incrementan el riesgo de muerte y morbilidad. Los pacientes con fractura de diáfisis femoral (FDF) tienen menos morbilidad y riesgo de muerte. El objetivo fue comparar las FC y la supervivencia de la FDF. Métodos: estudio observacional analítico. Se usó la base de datos del Hospital General de México para recolectar pacientes de 65 a 94 años de edad con FC y FDF del 2010 al 2014. Los pacientes tenían un seguimiento heterogéneo y no se consideraba el estado cognitivo; fueron un total de 146. El seguimiento se hizo por medio de llamada telefónica. RESULTADOS: se usó la estimación de Kaplan-Meier para calcular la supervivencia. Se comparó la supervivencia dependiendo del tipo de fractura y no se encontró diferencia estadísticamente significativa (p = 0.97). En el subanálisis, se comparó el tipo de fractura en el sexo masculino (p = 0.21) y el sexo femenino (p = 0.316) y no hubo diferencias estadísticamente significativas en la supervivencia. Esto difiere de los hallazgos de la literatura. Se utilizó la prueba t para evaluar la supervivencia en meses según el sexo masculino (39.61 ± 19.1) y femenino (36.58 ± 23.19), lo que demuestra una diferencia significativa en ambos grupos (p = 0.037). Conclusión: ante la presencia de fracturas, debemos considerar el género para estimar la supervivencia en pacientes con FC o FDF.7.
Assuntos
Fraturas do Fêmur/mortalidade , Fraturas do Quadril/mortalidade , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , México/epidemiologia , Estudos RetrospectivosRESUMO
In this editorial we initially expose the agreements that have set the mechanisms to guarantee safety and fair treatment to human subjects in research. Later on, we offer alternatives from translational and multidisciplinary research to promote education and humanities research in health.
En el presente editorial se exponen, en un primer momento, los acuerdos que han establecido los mecanismos para garantizar la seguridad y el trato digno a las personas sujetas a investigación. Más tarde, se ofrecen alternativas, desde la investigación traslacional y la multidisciplina, para promover en el ámbito de la salud la investigación en educación y las humanidades.
Assuntos
Educação em Saúde , Experimentação Humana/ética , Ciências Humanas/ética , Pesquisa Translacional Biomédica , Comitês de Ética em Pesquisa , Educação em Saúde/ética , Educação em Saúde/métodos , Política de Saúde , Humanos , México , Pesquisa Translacional Biomédica/ética , Pesquisa Translacional Biomédica/métodosRESUMO
BACKGROUND: Modern medical education is focused on students, and it is necessary to assess its level of satisfaction. A questionnaire was validated and we then conducted a study about the educational satisfaction level of medical residents of the Hospital General of Mexico. METHODS: An observational, descriptive, cross-sectional and prospective study was conducted. A questionnaire of 21 items was validated and then applied to a representative sample of medical residents. Each item was evaluated with a scale from 0 to 10 and then gathered in groups: 0-5 = poor, 6-7 = average, 8 = good, 9 = very good, and 10 = excellent. Descriptive and inferential statistics were carried out using SPSS v.17.0. RESULTS: The questionnaire had internal validity with Cronbach's alpha >0.91 by item. Included in the study were 355 medical residents representing 37 different specialties. The performance perception of the ìheadî professors showed a wide heterogeneity: excellent (23.7%), very good (20.6%), good (16.9%), average (23.1%), poor (15.8%). Fourth-year residents and upward valued the educational performance higher (p = 0.001) as well as medical/surgical residents (p = 0.02). Intermediate-level residents valued the professor higher (p = 0.001), similar to students who were married or living with a partner (p <0.001). Upon contrasting the evaluation of the teacher's performance with the overall course performance, a linear, direct and significant correlation was obtained with Spearman's correlation coefficient = 0.78 and regression coefficient (p <0.001). CONCLUSIONS: We found a wide range of heterogeneity of results. Performance of the professors was the basic component to judge the quality of the residents' courses.
Assuntos
Comportamento do Consumidor , Internato e Residência , Médicos/psicologia , Adulto , Estudos Transversais , Currículo , Docentes , Feminino , Humanos , Masculino , Medicina , México , Estudos Prospectivos , Melhoria de Qualidade , Inquéritos e Questionários , Adulto JovemRESUMO
En este estudio presentamos un caso de infarto cerebral secundario a la realización de una angiografía. Revisamos la fisiopatología, clasificación de la enfermedad vascular y se realiza una revisión del tratamiento del vasoespasmo cerebral
