Discapacidad visual y ceguera por catarata en Cuba en 2016 / Visual Impairment and Cataract Blindness in Cuba in 2016

Objetivo: Describir la discapacidad visual por catarata en la población de 50 años y más de edad y la cobertura de la atención oftalmológica en Cuba durante el año 2016. Métodos: Se realizó una investigación epidemiológica, descriptiva y transversal en personas de 50 años o más, que tomó la encuesta rápida de ceguera evitable realizada en Cuba en el año 2016. Con los datos obtenidos en los cuestionarios se confeccionó una base de datos. La muestra estuvo conformada por 3 920 habitantes distribuida en 112 conglomerados. Las variables estudiadas fueron la discapacidad visual, tipo de cirugía, tiempo de operados, resultados visuales y causas de malos resultados. Resultados: La prevalencia de ceguera bilateral fue de un porciento, para la discapacidad visual severa 2,7 por ciento, y moderada un 9,0 por ciento. El 66,2 por ciento de los ojos estudiados presentó buenos resultados visuales, de los cuales al 69,2 por ciento se le implantó una lente intraocular. Las comorbilidades oculares (67,1 por ciento) fueron la causa más frecuente de malos resultados visuales posquirúrgicos y representó el 44,7 por ciento en el total de ojos afectados. Conclusiones: El riesgo de presentar ceguera por catarata es del 1 por ciento. La discapacidad visual moderada es la más prevalente. En todos los rangos de discapacidad, la catarata bilateral no presenta diferencias entre sexo, pero en la unilateral el sexo masculino es el más frecuente. La primera causa de malos resultados posquirúrgicos son los trastornos refractivos en discapacidad visual moderada y las comorbilidades oculares para la discapacidad visual severa y ceguera(AU)

Purpose: To describe visual disability due to cataract in the population aged 50 years and older and the coverage of ophthalmologic care in Cuba during 2016. Methods: An epidemiological, descriptive and cross-sectional research was conducted in people aged 50 years and older, who took the rapid survey of avoidable blindness conducted in Cuba in 2016. With the data obtained from the questionnaires, a database was made. The sample, distributed in 112 clusters, consisted of 3 920 inhabitants. The variables studied were visual impairment, type of surgery, time of surgery, visual results and causes of poor results. Results: The prevalence of bilateral blindness was 1 percent, for severe visual impairment, 2.7 percent and for moderate visual impairment 9.0 percent. Good visual outcomes were observed in 66.2 percent of the eyes studied, of which 69.2 percent were implanted with an intraocular lens. Ocular comorbidities (67.1 percent) were the most frequent cause of poor postsurgical visual outcomes and accounted for 44.7 percent in the total number of affected eyes. Conclusions: The risk of presenting blindness due to cataract is 1 percent. Moderate visual impairment is the most prevalent. In all ranges of disability, bilateral cataract does not show differences between genders, but in unilateral cataract the male gender is the most frequent. The first cause of poor postoperative outcomes are refractive disorders in moderate visual impairment and ocular comorbidities for severe visual impairment and blindness(AU)

The efficacy of pediatric advanced life support training in emergency medical service providers.

Pediatric advanced life support (PALS) teaches skills unique to pediatric resuscitation. The purpose of this study was to assess the effect of PALS training among emergency medical service (EMS) providers in out-of-hospital trauma and medical resuscitations. A physician panel evaluated all EMS run sheets of pediatric traumas and medical resuscitations brought to a tertiary children's hospital/regional trauma center over a 3-year period. In 183 responses, EMS personnel were the sole providers of medical stabilization. Evaluation included the ability to secure an airway, establish vascular access, shock recognition, and appropriate cardiac rhythm assessment and resuscitation. The panel was blinded to the PALS training status of the responding EMS squad until completion of the review. Pediatric advanced life support-trained EMS personnel responded to 36% of the resuscitations reviewed. A significant difference in successful intubations was noted in PALS-trained squads compared with squads with no PALS training (85% vs 48%; P < 0.001). A significant difference was also noted in the ability to obtain vascular access in shock/arrest cases (100% vs 70%; P < 0.001). Similarly, PALS-trained squads were more successful in intraosseous line placement than non-PALS-trained squads (100% vs 55%; P < 0.01). However, despite better procedural skills, there was no difference in mortality rates between the groups (37% PALS vs 32% non-PALS). We conclude that PALS training improves procedural skills among EMS personnel and should be strongly considered as part of EMS training.