Robotic-assisted cholecystectomy versus conventional laparoscopic cholecystectomy for benign gallbladder disease: a systematic review and meta-analysis.

Laparoscopic cholecystectomy (LC) is the established gold standard treatment for benign gallbladder diseases. However, robotic cholecystectomy is still controversial. Therefore, we aimed to compare intraoperative and postoperative outcomes in LC and robotic-assisted cholecystectomy (RAC) in patients with nonmalignant gallbladder conditions. PubMed, Scopus, Cochrane Library, and Web of Science were systematically searched for studies comparing RAC to LC in patients with benign gallbladder disease. Only randomized trials and non-randomized studies with propensity score matching were included. Mean differences (MDs) were computed for continuous outcomes and odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Statistical analysis was performed using Software R, version 4.2.3. A total of 13 studies comprising 22,440 patients were included, of whom 10,758 patients (47.94%) underwent RAC. The mean age was 48.5 years and 65.2% were female. Compared with LC, RAC significantly increased operative time (MD 12.59 min; 95% CI 5.62-19.55; p < 0.01; I2 = 79%). However, there were no significant differences between the groups in hospitalization time (MD -0.18 days; 95% CI - 0.43-0.07; p = 0.07; I2 = 89%), occurrence of intraoperative complications (OR 0.66; 95% CI 0.38-1.15; p = 0.14; I2 = 35%) and bile duct injury (OR 0.99; 95% CI 0.64, 1.55; p = 0.97; I2 = 0%). RAC was associated with an increase in operative time compared with LC without increasing hospitalization time or the incidence of intraoperative complications. These findings suggest that RAC is a safe approach to benign gallbladder disease.

Hospitalization of elderly people for conditions sensitive to primary health care in a city in the Triângulo Mineiro

This study aimed to analyze the profile of hospitalizations sensitive to primary care in the elderly according to age and sex. This is an ecological study with description of sensitive hospitalizations of elderly residents in the city of Uberaba - MG from 2009 to 2018. The proportion of hospitalizations for sensitive conditions compared to the total number of hospitalizations and the rates of sensitive hospitalizations were analyzed. For the other analyzes, the causes of hospitalization by age and sex were analyzed, and descriptive analyzes were carried out in terms of frequency and percentage. The proportion of sensitive hospitalizations decreased in the period between 2009 and 2016, with the most expressive groups of causes related to the cardiovascular system (heart failure, angina, and cerebrovascular diseases), elderly people aged 80 years and over and male. Ecological studies with public domain data are of fundamental importance in the analysis of the health conditions of the populations and in the direction of the health actions undertaken, especially those carried out by Primary Health Care (PHC).

Queimaduras em crianças e adolescentes atendidos em um pronto-socorro infantil / Burns on children and adolescents assisted at a pediatric emergency room / Quemaduras en niños y adolescentes atendidos en una sala de emergencias pediátricas

Objetivo: Caracterizar os atendimentos por queimaduras em crianças e adolescentes em um Pronto-Socorro Infantil, no período de 2008 a 2018. Métodos: Estudo descritivo e retrospectivo, de abordagem quantitativa. Foram coletados dados secundários de sujeitos de 0 a 14 anos de idade, vítimas de queimaduras, disponíveis em prontuários e no sistema hospitalar. Foram conduzidas análises estatísticas descritiva e de associação (teste Qui-quadrado de Pearson p<0,05). Resultados: Identificaram-se 79 admissões por queimaduras, sendo 64,6% do sexo masculino. A maioria dos atendimentos (62%) correspondeu a crianças menores de 5 anos de idade. Do total analisado, 62% tiveram mais de 10% de Superfície Corporal Queimada. Houve predominância de queimaduras de 2.º grau (57%) e escaldaduras (58,2%). Conclusão: As queimaduras por escaldaduras e de 2.º grau foram as mais frequentes e acometeram mais o sexo masculino, o que reforça a necessidade de ações de promoção da saúde e prevenção de queimaduras envolvendo crianças e adolescentes (AU).

Purpose: To characterize the care for burns on children and adolescents at a Pediatric Emergency Room from 2008 to 2018. Method: Retrospective and descriptive study with quantitative approach. Data gathered from secondary data on subjects from zero to 14 years old, who were victims of burns, available in medical records and in the hospital system. Descriptive statistical analysis and association were conducted (Pearson's chi-square test p <0.05). Results: There were 79 admissions for burns, 64,6% were male. In most cases (62%), children under 5 years of age were involved. On the total analyzed, 62% presented less than 10% of Total Body Surface Area. There had been a predominance of second-degree burns (57%) and scalding (58.2%). Conclusion: Second-degree and scalding burns were the most frequent and affected the male sex the most, which reinforces the need for actions of health promotion and prevention of burns involving children and adolescents (AU).

Objetivo: Caracterizar la atención de los casos de quemaduras de niños y adolescentes en una sala de Emergencias Pediátricas de 2008 a 2018. Método: Estudio descriptivo y retrospectivo con abordaje cuantitativo. Se recolectaron datos secundarios de sujetos de cero a 14 años de edad, que fueron víctimas de quemaduras, disponibles en las historias clínicas y en el sistema hospitalario. Se realizaron análisis estadístico descriptivo y por asociación (Prueba de chi cuadrado de Pearson p <0,05). Resultados: Se identificaron 79 admisiones, el 64,6% era del sexo masculino. La mayoría de las consultas (62%) correspondía a niños con menos de 5 años de edad. Del total analizado, el 62% tenía más del 10% de la Superficie Corporal Quemada. Predominaron las quemaduras de 2º grado (57%) y las escaldaduras (58,2%). Conclusión: Las quemaduras de 2º grado y las escaldaduras fueron las más frecuentes y afectaron más al sexo masculino, lo que indica que es necesario tomar acciones para la promoción de la salud y prevención de las quemaduras en niños y adolescentes (AU).

Satisfação de idosos octogenários com os serviços de Atenção Primária à Saúde / Satisfaction of octogenarians with Primary Health Care services

OBJETIVO: Analisar a satisfação de idosos octogenários com os serviços de Atenção Primária à Saúde. MÉTODO: Estudo descritivo, com abordagem quantitativa, realizado com 30 idosos usuários da Estratégia Saúde da Família, selecionados por amostra não probabilística. Os dados foram coletados em domicílio, através dos seguintes questionários: Mini-exame do estado mental, questionário sociodemográfico, condições de saúde e acesso aos serviços e questionário de Satisfação com os Cuidados Primários de Saúde. Os dados foram analisados por meio de estatística descritiva. RESULTADO: A análise da satisfação evidenciou que os idosos octogenários estão satisfeitos quanto à atenção ( X´=6,0;±1,5X´=6,0;±1,5 ) e ao interesse que os agentes comunitários dispendem a eles ( X´=5,9;±1,6X´=5,9;±1,6 ) e a disponibilidade do Enfermeiro para lhes tratar ( X´=5,9;±1,1X´=5,9;±1,1 ). Os aspectos relacionados ao tempo de espera pelo atendimento dos Enfermeiros ( X´=4,6;±1,6X´=4,6;±1,6 ) e Médicos ( X´=4,9;±1,6X´=4,9;±1,6 ), instalações para deficientes ( X´=4,6;±1,4X´=4,6;±1,4 ) e percepção de que a unidade está próxima de uma unidade de saúde perfeita ( X´=4,6;±1,8X´=4,6;±1,8 ). CONCLUSÃO: os achados evidenciaram boa avaliação dos serviços e refletem a importância de se considerar a perspectiva dos usuários octogenários no planejamento das ações em saúde, já que a avaliação da qualidade desses serviços é capaz de instituir mudanças e direcionar as ações de forma a fazer sentido às realidades de vida dos usuários com maiores chances de efetividade, em especial direcionadas a população idosa octogenária.

METHOD: a descriptive study, with a quantitative approach, was carried out with 30 older users of the Family Health Strategy, selected by a non-probabilistic sample. Data were collected at home, using the following questionnaires: the mini-mental state exam, a questionnaire on sociodemographic factors, health conditions and access to services, and a questionnaire on satisfaction with Primary Health Care. Data were analyzed using descriptive statistics. RESULT: The satisfaction analysis showed that the elderly octogenarians are satisfied in terms of care ( X´=6,0;±1,5X´=6,0;±1,5 ) and the interest that community agents demonstrate in them ( X´=5,9;±1,6X´=5,9;±1,6 ) and the availability of nurses for their treatment ( X´=5,9;±1,1X´=5,9;±1,1 ). Aspects related to the waiting time for nurses ( X´=4,6;±1,6X´=4,6;±1,6 ) and doctors ( X´=4,9;±1,6X´=4,9;±1,6 ), facilities for the disabled ( X´=4,6;±1,4X´=4,6;±1,4 ) and the perception that the unit is close to a perfect health unit ( X´=4,6;±1,8X´=4,6;±1,8 ). CONCLUSION: The services were positively evaluated, reflecting the importance of considering the perspective of octogenarian users in the planning of healthcare actions, since the evaluation of the quality of these services can lead to changes and guide actions in a way that is coherent with the lives of users, increasing their effectiveness, especially regarding actions aimed at the octogenarian population.