[Increased knowledge of ARIA and GINA guides 2006 to general physicians by an educational intervention]. / Incremento del conocimiento de las guías ARIA y GINA 2006 para médicos generales mediante una intervención educativa.

BACKGROUND: Educational strategies look for the increase of knowledge in physicians; they are a useful resourse for the diffusion among physicians of guides GINA and ARIA. OBJECTIVE: To evaluate a course shop-like for physicians as an educative strategy. PARTICIPANTS AND METHODS: A transversal study was performed, where knowledge was evaluated to primary contact physicians about recent currents of guides of GINA and ARIA 2006. RESULTS: There was a participation of 69 primary contact physicians who applied a questionnaire of 30 questions: 20 about asthma (GINA) and 10 about allergic rhinitis (ARIA) before and after a course shop-like for physicians; there was improvement on calification after educative strategy on knowledge about asthma and allergic rhinitis with a p = < 0.05. CONCLUSION: The educative strategy proposed as course shop-like for primary contact physicians is effective for teaching the guides of GINA and ARIA 2006.

Factors that predict survival in patients with cirrhosis considered for liver transplantation.

OBJECTIVE: To identify prognostic factors for survival at 6 and 12 months in patients evaluated for liver transplantation using Child-Pugh (CP) classification and the Model for End-Stage Liver Disease (MELD) score. METHODS: We evaluated 144 patients with cirrhosis who were candidates for liver transplantation. We excluded patients with hepatocellular carcinoma, recent liver recipients, and patients who died because of factors unrelated to liver disease. The studied variables were age and sex; prothrombin time; platelet count; albumin, cholesterol, bilirubin, creatinine, and serum sodium concentrations; CP classification and MELD score; and the presence of ascites, encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis, and previous variceal bleeding. Data were processed using statistical software (SPSS version 13.0). RESULTS: Of the 144 patients, 27 (18.7%) did not survive because of complications of liver disease. Univariate analysis showed the most significant factors to be sex, prothrombin time, bilirubin and albumin levels; ascites, encephalopathy, CP classification, and MELD score. At Cox regression analysis, only CP classification proved to be a valid predictor of survival in our cohort. The lowest survival according to CP classification at 6 and 12 months corresponded to stage C and to MELD scores higher than 15. CONCLUSIONS: Child-Pugh classification is an independent prognostic factor for recipient survival. Stage C in the CP classification and a MELD score higher than 15 were strongly related to worse survival. Both scores must be taken into consideration for adequate evaluation of liver transplantation for candidates.

Aneurysm of the inferior vena cava: case report.

Venous aneurysms are uncommon. Despite their infrequency, venous aneurysms can present with significant clinical complications such as thrombosis, pulmonary embolism, and death. In this report, we present the case of a thrombosed inferior vena cava aneurysm discovered in a 16-year-old male who had deep vein thrombosis of the right lower extremity. Thrombosis of the inferior vena cava is uncommon in the pediatric population. Therefore, congenital abnormalities such as an inferior vena cava aneurysm should be considered when evaluating pediatric patients who present with deep vein thrombosis.

Acupuntura en las efermedades ginecológicas / Acupuncture in gynecological diseases

Se estudiaron 270 pacientes de forma aleatoria aquejadas de enfermedades ginecológicas (algia pélvica, tumores quísticos de ovario, fibromas uterinos, várices pelvianas, leucorrea, endometritis y otras) procedentes de las consultas de cirugía y ginecología del Hospital Militar “Comandante Manuel Fajardo Rivero”, desde febrero de 2000 hasta agosto de 2001, a las cuales se les realizó tratamiento acupuntural por el método de siembra con catgut cromado 000 ó 0000 en los puntos acupunturales E-36, B-6, B-10, R-3 y R-4; fueron evolucionadas mediante ultrasonido y examen físico ginecológico cada tres meses, con posterioridad al comienzo del tratamiento. Se demostró un resultado satisfactorio en 83,3 por ciento de las pacientes, con un ahorro económico de $ 28,40 por paciente(AU)

Consultoria Información, Educación y Comunicación (IEC)-El Programa Ampliado de Inmunización (PAI).Informe final / En

El objetivo del la consultoria es ejecutar,un plan de información,educación y comunicación dirigido a ectivar la demanda de vacunas en los servicios de salud y fortalecer la oferta vacunal en actividades de campaña,espcialmente en población rural dispersa y/o con insuficiencia en su red de servicios de salud

La enfermedad meningococica en cuidados intensivos (I): valor de los factores pronósticos / The meningoccocal illness in looking after intensive (I): courage of the factors presages

Se realiza un estudio de los factores pronosticos en los pacientes con enfermedad meningococica ingresados en la unidad de cuidados intensivos del hospital provincial clinico quirurgico docente "Dr. Gustavo Aldereguia Lima", en el periodo comprendido entre los años 1986- 1990. Se determina que estos factores junto a la experiencia práctica del médico de asistencia pueden ayudar a establecer índices pronóstico y realizar una terapéutica mas eficaz, asi como hacer la prevención de aquellas complicaciones que pueden aparecer una vez identificados estos signos. Se estudian 23 pacientes y se analiza la presencia de estos signos de mal pronóstico, tanto en los pacientes engresados vivos, como en los fallecidos encontrándose que la hipocelularidad del líquido cefalorraquídeo y la acidosis metabólica fueron los factores mas frecuentes en los fallecidos

Neonatal herpes simplex pneumonia: radiographic findings.

The radiologic findings in the lungs of 16 hospitalized neonates with disseminated herpes simplex infection were retrospectively reviewed. A sequential picture was devised of four stages in the evolution of the pneumonitis of this hematogenous infection. The radiologic stages were: Stage I, normal chest; Stage II, prominent perihilar interstitial markings; Stage III, coalescent areas of pulmonary infiltrates; and Stage IV, diffuse alveolar and interstitial disease ("white-out" lungs). In general, the pulmonary abnormalities were widespread and without air trapping. Pleural effusions were noted in one case. All affected neonates died and antemortem clinical and radiological findings were correlated with multiple-organ postmortem histopathologic evidence of viral infection, especially with the associated pneumonia.

Proximal tibial physis fracture and popliteal artery injury.

A case of fracture about the proximal tibial physis with associated popliteal artery injury is presented. These fractures are not common, but their complications can be disastrous. The radiologist should draw attention to the possibility of vascular injury when these fractures are recognized.

Computed tomographic evaluation of spontaneous healing of splenic hematoma.

Computed tomography has been successfully used to demonstrate spontaneous healing of splenic hematoma in a child. It showed shrinkage of the hematoma with revascularization and subsequent complete healing.

Calcified mediastinal lymph nodes in Hodgkin's disease.

Four new cases of calcified mediastinal lymph nodes in Hodgkin's Disease in children are reported. Calcifications appeared 13 months to 3 years 11 months following radiotherapy. One of the four cases continued to show a widened mediastinum despite remission. It is still to be determined if the presence of calcified mediastinal nodes in Hodgkin's disease represents a favourable prognostic sign.

Optimal visualization of the nasopharyngeal airway.

Two sequential nasopharyngeal radiographs (the initial image with the mouth open and the second image with the mouth closed) of 100 randomly selected patients were obtained. Based on this series and a fluoroscopic study of two adult volunteers, the authors conclude that optimal visualization of the nasopharyngeal airway is achieved when the film is exposed during the latter phase of inspiration with the patient's mouth closed.

Factores pronosticos en la sepsis.Analisis estadistico de 100 pacientes. / Prognostic factors in sepsis. Statistical analysis of 100 patients

Se estudio en un grupo de 100 pacientes septicos ingresados en el Centro de Tratamiento Intensivo del Hospital de Clinicas de Montevideo la significacion estadistica de diversos hechos clinicos y de laboratorio, como factores pronosticos. Se tuvo en cuenta la distibucion por edad y sexo, la duracion de la sepsis, la existencia de repercusion sobre los sistemas fisiologicos mayores, y la topografia del foco inicial. Tambien la presencia de hemorragia digestiva y de leucopenia. Resulto mui significativo como elemento de mal prognostico el compromiso pulmonar. No asi las otras afectaciones parenquimatosas, necesitadas para probar su importancia de una serie mayor. La prolongacion de la sepsis, la edad mayor de 40 anos, el origem quirurgico-abdominal del proceso - y la existencia de leucopenia tambien fueron estadisticamente significativos con agravantes de la evolucion La mortalidad general de la serie fue del 63