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1.
Surgery ; 161(2): 477-484, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27614416

RESUMO

BACKGROUND: Advanced bipolar and ultrasonic devices have shown significant reduction in the surgical time of thyroid operations. This randomized, controlled trial assessed if operative time and other relevant outcomes are different for thyroidectomies performed either with a second-generation advanced bipolar device or traditional tie and suture technique. METHODS: Forty-one patients were randomized into 2 groups (advanced bipolar device and traditional tie and suture). Secondary end points included estimated blood loss, postoperative hemorrhage or hematoma requiring operative reintervention, recurrent laryngeal nerve injury, hypoparathyroidism, pain intensity, number of ligatures, analgesia usage, and loss of signal during recurrent laryngeal nerve monitoring. RESULTS: Preoperative characteristics were similar between both groups. Mean operative time in the advanced bipolar device group was reduced by 32.5 minutes compared with the traditional tie and suture group (P = .006). Intraoperative blood loss was similar in both groups. Four patients presented postoperative vocal cord dysmotility, 3 in the traditional tie and suture group and 1 in the advanced bipolar device group (P = ns). Two of these 4 patients also had a >50% amplitude decrease during continuous intraoperative neuromonitoring, 1 in each group. Pain intensity, 12 hours after operation, was significantly greater in the traditional tie and suture group (P = .015), even though pain medication requirements during the initial 24 hours after operation were similar between groups (P = .97). There were no cases of postoperative hemorrhage or hematoma requiring reintervention. Postoperative, symptomatic hypocalcemia occurred in 6 patients, 4 in the traditional tie and suture, and 2 in the advanced bipolar device group. One of them developed permanent hypocalcemia. CONCLUSION: The use of an advanced bipolar device in thyroid operation reduces operative time by >30 minutes, with a similar postoperative outcome profile when compared with the traditional tie and suture technique.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Hemostasia Cirúrgica/instrumentação , Tireoidectomia/instrumentação , Tireoidectomia/métodos , Adulto , Análise de Variância , Feminino , Seguimentos , Hemostasia Cirúrgica/métodos , Humanos , Hipertireoidismo/patologia , Hipertireoidismo/cirurgia , Tempo de Internação/estatística & dados numéricos , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Segurança do Paciente , Estatísticas não Paramétricas , Técnicas de Sutura , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Resultado do Tratamento
2.
Arch. méd. Camaguey ; 16(6)nov.-dic. 2012. tab
Artigo em Espanhol | CUMED | ID: cum-55482

RESUMO

Las enfermedades crónicas constituyen una verdadera epidemia, no solo en lospaíses desarrollados sino en los que avanzan hacia el desarrollo, y entre ellas ocupan un importante lugar las enfermedades renales crónicas. Objetivo: elevar el nivel deconocimiento en la prevención de la enfermedad renal crónica. Método: se realizó un estudio de intervención educativa, diseñado al respecto y aplicado a un grupo de pacientes en elconsultorio 13 del Policlínico Ignacio Agramonte de Camagüey, en el período de abril a junio del 2011 a los que se les aplicó una encuesta con variables y aspectos de conocimientosantes y después de la intervención. Resultados: la mayoría de los pacientes eran fumadores, antes de la intervención más de la mitad no identificaron que pertenecían a grupode riesgo, solo la minoría identificó que la alimentación hipercalórica era un aspecto a tener en cuenta en la dieta, así como la vacunación era preventiva de la enfermedad. Después dela estrategia el 100 por ciento reconoció que realizar ejercicios, estar vacunado, ser tratado ante infecciones o enfermedades parasitarias y el control de la tensión arterial y la glucemia eranaspectos a tener en cuenta para prevenir la enfermedad. Conclusiones: la intervención realizada fue satisfactoria ya que se logró que el mayor por ciento de los pacientes elevara los conocimientos acerca de los temas impartidos (AU)


Chronic diseases constitute an epidemic, not only in developed countries butalso in developing countries, chronic kidney diseases occupy an important place. Objective: to improve knowledge and understanding of chronic kidney disease. Method: an educationalintervention study was carried out, designed and applied to a group of patients in the doctors office 13, at the Ignacio Agramonte Polyclinic in Camagüey, from April to June 2011. A survey with variables and aspects concerning patients knowledge about the disease was applied before and after the intervention. Results: the majority of patients were smokers. Before carrying out the intervention more than half of patients didn't identify they belonged to a risk group. Only a minority of them recognized hypercaloric food was an aspect to consider in the diet, as well as vaccination prevented this disease. After the implementation of the strategy,the 100 percent of patients recognized that performing exercises, being vaccinated, being treated for infections or parasitic diseases, and the control of blood pressure and blood sugar were vitalmeasures to prevent disease. Conclusions: the intervention research was satisfactory since the highest percent of patients increased their knowledge about the topics dealt with (AU)


Assuntos
Humanos , Nefropatias , Medicina Preventiva , Risco , Insuficiência Renal Crônica
3.
Arch. méd. Camaguey ; 16(6): 1704-1717, nov.-dic. 2012.
Artigo em Espanhol | LILACS | ID: lil-665649

RESUMO

Las enfermedades crónicas constituyen una verdadera epidemia, no solo en lospaíses desarrollados sino en los que avanzan hacia el desarrollo, y entre ellas ocupan un importante lugar las enfermedades renales crónicas. Objetivo: elevar el nivel deconocimiento en la prevención de la enfermedad renal crónica. Método: se realizó un estudio de intervención educativa, diseñado al respecto y aplicado a un grupo de pacientes en elconsultorio 13 del Policlínico Ignacio Agramonte de Camagüey, en el período de abril a junio del 2011 a los que se les aplicó una encuesta con variables y aspectos de conocimientosantes y después de la intervención. Resultados: la mayoría de los pacientes eran fumadores, antes de la intervención más de la mitad no identificaron que pertenecían a grupode riesgo, solo la minoría identificó que la alimentación hipercalórica era un aspecto a tener en cuenta en la dieta, así como la vacunación era preventiva de la enfermedad. Después dela estrategia el 100 por ciento reconoció que realizar ejercicios, estar vacunado, ser tratado ante infecciones o enfermedades parasitarias y el control de la tensión arterial y la glucemia eranaspectos a tener en cuenta para prevenir la enfermedad. Conclusiones: la intervención realizada fue satisfactoria ya que se logró que el mayor por ciento de los pacientes elevara los conocimientos acerca de los temas impartidos


Chronic diseases constitute an epidemic, not only in developed countries butalso in developing countries, chronic kidney diseases occupy an important place. Objective: to improve knowledge and understanding of chronic kidney disease. Method: an educationalintervention study was carried out, designed and applied to a group of patients in the doctor’s office 13, at the Ignacio Agramonte Polyclinic in Camagüey, from April to June 2011. A survey with variables and aspects concerning patients’ knowledge about the disease was applied before and after the intervention. Results: the majority of patients were smokers. Before carrying out the intervention more than half of patients didn't identify they belonged to a risk group. Only a minority of them recognized hypercaloric food was an aspect to consider in the diet, as well as vaccination prevented this disease. After the implementation of the strategy,the 100 percent of patients recognized that performing exercises, being vaccinated, being treated for infections or parasitic diseases, and the control of blood pressure and blood sugar were vitalmeasures to prevent disease. Conclusions: the intervention research was satisfactory since the highest percent of patients increased their knowledge about the topics dealt with


Assuntos
Humanos , Nefropatias , Medicina Preventiva , Insuficiência Renal Crônica , Risco
4.
Arch. méd. Camaguey ; 15(1)ene.-feb. 2011. tab
Artigo em Espanhol | CUMED | ID: cum-45214

RESUMO

Entre las enfermedades infecciosas, las producidas por parásitos constituyen un problema médico-social que afecta no sólo a los países subdesarrollados sino a países de alto desarrollo económico. Objetivo: elevar el nivel de conocimiento sobre medidas de control en el parasitismo. Método: se realizó un estudio de intervención educativa, diseñado al respecto y aplicado a un grupo de madres en el consultorio No 4 del Policlínico Ignacio Agramonte, Municipio Camagüey, desde septiembre a diciembre de 2009; a las que se les aplicó una encuesta con diferentes variables antes y después de la intervención. Resultados: la mayoría de las madres tenían buen nivel socioeconómico. La oxiuriasis fue el párasito más padecido en sus hijos. Antes de la estrategia un número reducido de madres reconocieron los gases intestinales y urticarias como síntomas y signos, ninguna identificó la respiración sibilante. Después de la intervención el 100 por ciento de las madres reconocieron el lavado de las manos, de frutas y vegetales, hervir o clorar el agua, evitar desbordamiento de fosas y desagües, además de proteger los alimentos de suciedades. Conclusiones: la intervención realizada fue satisfactoria ya que se logró que el mayor por ciento de las madres elevara los conocimientos acerca de los temas impartidos (AU)


Among infectious diseases, those produced by parasites constitute a medical-social problem that not only affects to underdeveloped countries but to countries of high economic development. Objective: to elevate the knowledge level on control measures in parasitism. Method: an educational intervention study was carried out, which was applied to a group of mothers in the doctor´s office #4 at the Ignacio Agramonte Polyclinic, of Camagüey Municipality from September to December 2009. The universe was constituted by 58 mothers and the sample remain conformed by 26 to those were applied a survey with different variables and knowledge aspects before and after the intervention. Results: the majority of mothers had good socioeconomic level (69,2) and (65,3), oxyuriasis was the parasite most suffered in their children (61,5), before the strategy a reduced number of mothers recognized intestinal gases and hives like symptoms and signs, none of them identified the sibilant respiration. After the intervention the 100 percent of mothers recognized hands, fruits, and vegetables washing, to boil or chlorinate water, to avoid overflow of pits and drainages, besides protecting foods of dirtinesses. Conclusions: intervention was satisfactory since it was achieved the biggest percent of mothers elevated their knowledge on the given topics (AU)


Assuntos
Humanos , Criança , Enteropatias Parasitárias/prevenção & controle , Higiene dos Alimentos , Educação em Saúde/métodos
5.
Arch. méd. Camaguey ; 15(1): 1-11, ene.-feb. 2011.
Artigo em Espanhol | LILACS | ID: lil-584283

RESUMO

Entre las enfermedades infecciosas, las producidas por parásitos constituyen un problema médico-social que afecta no sólo a los países subdesarrollados sino a países de alto desarrollo económico. Objetivo: elevar el nivel de conocimiento sobre medidas de control en el parasitismo. Método: se realizó un estudio de intervención educativa, diseñado al respecto y aplicado a un grupo de madres en el consultorio No 4 del Policlínico Ignacio Agramonte, Municipio Camagüey, desde septiembre a diciembre de 2009; a las que se les aplicó una encuesta con diferentes variables antes y después de la intervención. Resultados: la mayoría de las madres tenían buen nivel socioeconómico. La oxiuriasis fue el párasito más padecido en sus hijos. Antes de la estrategia un número reducido de madres reconocieron los gases intestinales y urticarias como síntomas y signos, ninguna identificó la respiración sibilante. Después de la intervención el 100 por ciento de las madres reconocieron el lavado de las manos, de frutas y vegetales, hervir o clorar el agua, evitar desbordamiento de fosas y desagües, además de proteger los alimentos de suciedades. Conclusiones: la intervención realizada fue satisfactoria ya que se logró que el mayor por ciento de las madres elevara los conocimientos acerca de los temas impartidos.


Among infectious diseases, those produced by parasites constitute a medical-social problem that not only affects to underdeveloped countries but to countries of high economic development. Objective: to elevate the knowledge level on control measures in parasitism. Method: an educational intervention study was carried out, which was applied to a group of mothers in the doctor´s office #4 at the Ignacio Agramonte Polyclinic, of Camagüey Municipality from September to December 2009. The universe was constituted by 58 mothers and the sample remain conformed by 26 to those were applied a survey with different variables and knowledge aspects before and after the intervention. Results: the majority of mothers had good socioeconomic level (69,2) and (65,3), oxyuriasis was the parasite most suffered in their children (61,5), before the strategy a reduced number of mothers recognized intestinal gases and hives like symptoms and signs, none of them identified the sibilant respiration. After the intervention the 100 percent of mothers recognized hands, fruits, and vegetables washing, to boil or chlorinate water, to avoid overflow of pits and drainages, besides protecting foods of dirtinesses. Conclusions: intervention was satisfactory since it was achieved the biggest percent of mothers elevated their knowledge on the given topics.


Assuntos
Humanos , Criança , Educação em Saúde/métodos , Higiene dos Alimentos , Enteropatias Parasitárias/prevenção & controle
6.
Arch. méd. Camaguey ; 14(2)mar.-abr. 2010. tab
Artigo em Espanhol | CUMED | ID: cum-44934

RESUMO

Fundamento: la problemática que no se lacte hasta el sexto mes de vida, afecta hoy, no se han obtenido resultados favorecedores a pesar de las ventajas que ofrece la lactancia materna y su efecto protector que ha demostrado que los niños alimentados con pecho presentan menos incidencia de enfermedades respiratorias, gastrointestinales y otitis media aguda. Objetivo: elevar el nivel de conocimientos sobre la lactancia materna. Método: se realizó un estudio de intervención educativa, en cinco consultorios del Policlínico Universitario Este del Municipio Camagüey, de marzo a diciembre del 2007, en cincuenta y una gestantes que hubieran tenido hijos, con fecha probable de parto desde el primero de abril hasta el treinta de mayo; se les aplicó un formulario con diferentes variables y una encuesta de conocimientos antes y después de la intervención. Resultados: se encontró el mayor número de gestantes en la edad de veinticinco a veintinueve años, las que más lactaron fueron las de escolaridad pre-universitaria y las trabajadoras. Después de la intervención aumentó el número de madres que lactaron, así como el nivel de conocimiento en los temas impartidos. Conclusiones: la intervención fue satisfactoria ya que se logró que el mayor por ciento de las madres lactara hasta el sexto mes y se elevó el nivel de conocimiento sobre lactancia materna(AU)


Background: the problem of not suckle until the sixth month of life, affects today, no favorable results has been obtained in spite of the advantages that offers breast-feeding and its protective effect has demonstrated breast-fed children present less incidence of respiratory, gastrointestinal diseases and otitis media acute. Objective: to elevate the level of knowledge on breast-feeding. Method: an educational intervention study, in five doctors offices of the East Polyclinic of Camagüey Municipality was conducted, from March to December 2007, in fifty-one pregnant women that had had children, with probable childbirth date from April 1st up to May 30; a form with different variables and a knowledge survey before and after the intervention was applied. Results: the greatest number of pregnant women in the age from twenty-five to twenty-nine years was found, those that more suckled were those of pre-university schooling and workers. After the intervention the number of mothers that suckled, increased as well as the level of knowledge in the imparted topics. Conclusions: the intervention was satisfactory since it was achieved the greater percent of mothers suckled until the sixth month and the level of knowledge on breast-feeding increased(AU)


Assuntos
Humanos , Feminino , Aleitamento Materno , Mães/educação
7.
Arch. méd. Camaguey ; 14(2)mar.-abr. 2010. tab
Artigo em Espanhol | CUMED | ID: cum-44933

RESUMO

La alta morbilidad por infecciones respiratorias agudas sigue afectando a los niños pequeños. Objetivo: demostrar la eficacia de un programa de intervención educativa sobre infecciones respiratorias en madres de niños menores de un año. Método: se realizó un estudio de intervención educativa, en cuarenta y cinco consultorios del Policlínico Universitario Este del Municipio Camagüey, en el período de enero del 2007 a mayo del año 2008. El universo de estudio fue de setenta y dos madres, con fecha de parto desde el primero de junio hasta el treinta y uno de agosto del 2007. Se aplicó una encuesta que contenía las variables a estudiar, antes y después de la intervención educativa aplicada. Resultados: se encontró el mayor número de madres en la edad de treinta a treinta y cuatro años, de escolaridad pre-universitaria y trabajadoras, se incrementaron los conocimientos a un 90,27 por ciento Conclusiones: después de la intervención se incrementó el nivel de conocimientos sobre infecciones respiratorias en las madres. Se demostró la eficacia de la intervención educativa(AU)


The high morbidity for acute respiratory infections continues affecting little children. Objective: to demonstrate the effectiveness of an educational intervention program on respiratory infections in mothers with children smaller than one year of life. Method: an educational intervention study was carried out, in forty-five doctors offices of the East Polyclinic of Camagüey municipality, from January 2007 to May 2008. The study universe was constituted by seventy-two mothers, with childbirth date from June 1st to August 31 2007. A survey was applied that contained the variables to study, before and after the applied educational intervention. Results: the greatest number of mothers in the age from thirty to thirty-four years, of pre-university schooling and hard-working was found, knowledge were increased to 90,27 percent. Conclusions: after the intervention the level of knowledge on respiratory infections in mothers was increased. The effectiveness of the educational intervention was demonstrated(AU)


Assuntos
Humanos , Feminino , Adulto , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , Educação em Saúde/métodos
8.
Arch. méd. Camaguey ; 14(2)mar.-abr. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-577894

RESUMO

La alta morbilidad por infecciones respiratorias agudas sigue afectando a los niños pequeños. Objetivo: demostrar la eficacia de un programa de intervención educativa sobre infecciones respiratorias en madres de niños menores de un año. Método: se realizó un estudio de intervención educativa, en cuarenta y cinco consultorios del Policlínico Universitario Este del Municipio Camagüey, en el período de enero del 2007 a mayo del año 2008. El universo de estudio fue de setenta y dos madres, con fecha de parto desde el primero de junio hasta el treinta y uno de agosto del 2007. Se aplicó una encuesta que contenía las variables a estudiar, antes y después de la intervención educativa aplicada. Resultados: se encontró el mayor número de madres en la edad de treinta a treinta y cuatro años, de escolaridad pre-universitaria y trabajadoras, se incrementaron los conocimientos a un 90,27 por ciento Conclusiones: después de la intervención se incrementó el nivel de conocimientos sobre infecciones respiratorias en las madres. Se demostró la eficacia de la intervención educativa.


The high morbidity for acute respiratory infections continues affecting little children. Objective: to demonstrate the effectiveness of an educational intervention program on respiratory infections in mothers with children smaller than one year of life. Method: an educational intervention study was carried out, in forty-five doctor’s offices of the East Polyclinic of Camagüey municipality, from January 2007 to May 2008. The study universe was constituted by seventy-two mothers, with childbirth date from June 1st to August 31 2007. A survey was applied that contained the variables to study, before and after the applied educational intervention. Results: the greatest number of mothers in the age from thirty to thirty-four years, of pre-university schooling and hard-working was found, knowledge were increased to 90,27 percent. Conclusions: after the intervention the level of knowledge on respiratory infections in mothers was increased. The effectiveness of the educational intervention was demonstrated.


Assuntos
Humanos , Feminino , Adulto , Educação em Saúde/métodos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle
9.
Arch. méd. Camaguey ; 14(2)mar.-abr. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-577895

RESUMO

Fundamento: la problemática que no se lacte hasta el sexto mes de vida, afecta hoy, no se han obtenido resultados favorecedores a pesar de las ventajas que ofrece la lactancia materna y su efecto protector que ha demostrado que los niños alimentados con pecho presentan menos incidencia de enfermedades respiratorias, gastrointestinales y otitis media aguda. Objetivo: elevar el nivel de conocimientos sobre la lactancia materna. Método: se realizó un estudio de intervención educativa, en cinco consultorios del Policlínico Universitario Este del Municipio Camagüey, de marzo a diciembre del 2007, en cincuenta y una gestantes que hubieran tenido hijos, con fecha probable de parto desde el primero de abril hasta el treinta de mayo; se les aplicó un formulario con diferentes variables y una encuesta de conocimientos antes y después de la intervención. Resultados: se encontró el mayor número de gestantes en la edad de veinticinco a veintinueve años, las que más lactaron fueron las de escolaridad pre-universitaria y las trabajadoras. Después de la intervención aumentó el número de madres que lactaron, así como el nivel de conocimiento en los temas impartidos. Conclusiones: la intervención fue satisfactoria ya que se logró que el mayor por ciento de las madres lactara hasta el sexto mes y se elevó el nivel de conocimiento sobre lactancia materna.


Background: the problem of not suckle until the sixth month of life, affects today, no favorable results has been obtained in spite of the advantages that offers breast-feeding and its protective effect has demonstrated breast-fed children present less incidence of respiratory, gastrointestinal diseases and otitis media acute. Objective: to elevate the level of knowledge on breast-feeding. Method: an educational intervention study, in five doctor’s offices of the East Polyclinic of Camagüey Municipality was conducted, from March to December 2007, in fifty-one pregnant women that had had children, with probable childbirth date from April 1st up to May 30; a form with different variables and a knowledge survey before and after the intervention was applied. Results: the greatest number of pregnant women in the age from twenty-five to twenty-nine years was found, those that more suckled were those of pre-university schooling and workers. After the intervention the number of mothers that suckled, increased as well as the level of knowledge in the imparted topics. Conclusions: the intervention was satisfactory since it was achieved the greater percent of mothers suckled until the sixth month and the level of knowledge on breast-feeding increased.


Assuntos
Humanos , Feminino , Aleitamento Materno , Mães/educação
10.
Surgery ; 137(3): 337-41, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15746789

RESUMO

BACKGROUND: Exhaustive hemostasis is essential to successful thyroidectomy. Electrocoagulation to control bleeding has the potential risk of injuring the surrounding structures from lateral dispersion of heat. The Harmonic Scalpel (HS) cuts and coagulates simultaneously using mechanical vibration rather than high temperatures. Because its use in thyroidectomies has been limited, we sought to compare procedure parameters and complications of thyroidectomies performed using the HS with those using electrocoagulation. METHODS: Sixty patients were randomized into 2 surgical groups, HS and the standard technique using electrocautery and ligatures as the primary hemostatic method. A sample t test or Wilcoxon rank sum test was used to compare the following parameters: operative time, number of ligatures, blood loss, pain intensity, need for extra dose(s) of analgesic, incidence of recurrent laryngeal nerve palsy, and hypoparathyroidism. RESULTS: Both groups of 30 patients were comparable in age, gender, and nature of disease. In 38 patients (63%), surgery was performed for benign disease, and in 22 (37%), for differentiated carcinoma. Operative time (arithmetic mean +/- SD) was 25 minutes less in the HS group (96 +/- 23 vs 121 +/- 34, P = .005). Median number of ligatures in the HS group was 1 (range, 0-7) versus 17 (range, 6-28) ( P < .001). Mean blood loss, estimated by gauze weight, was less with HS (35 +/- 27 mL vs 54 +/- 51 mL, P = .06). Drainage during the first 24 postoperative hours and pain intensity during the first postoperative week were similar in both groups. There were no episodes of persistent nerve palsy or hypoparathyroidism in either group. CONCLUSION: The use of HS in thyroidectomies requires less operative time than does electrocoagulation.


Assuntos
Eletrocoagulação/instrumentação , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/instrumentação , Tireoidectomia/métodos , Adulto , Perda Sanguínea Cirúrgica , Drenagem , Feminino , Humanos , Hipoparatireoidismo/epidemiologia , Incidência , Ligadura , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Método Simples-Cego , Doenças da Glândula Tireoide/epidemiologia , Resultado do Tratamento , Paralisia das Pregas Vocais/epidemiologia
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