Vascular Trauma in Children-Review from a Major Paediatric Center

BACKGROUND: Traumatic noniatrogenic vascular injuries in children are rare and rarely discussed in literature. Pediatric vascular injuries pose a set of challenges mainly because of continued growth and development in a child or adolescent. The purpose of the study is to characterize management strategies and outcomes in these cases. METHODS: This is a single-center retrospective review of patients less than age 18 years (pediatric age) with acute, noniatrogenic traumatic vascular injuries between January 2009 and December 2015. Patient's demographics, injury characteristics, surgical management, complications, and follow-up were analyzed. RESULTS: From 2009 to 2015, 3277 children with traumatic injuries were treated, of which 21 (0.6%) had 23 significant vascular injuries: 17 arterial and 6 venous injuries. The majority were males (n = 16), and the median age was 14 years (range 1 to 16 years). Penetrating injuries were the predominant mechanism (n = 21), mainly by glass (n = 13). At presentation, 4 patients were hemodynamically unstable, 3 of them in hypovolemic shock. All patients were managed operatively. Operations for arterial injuries included 5 primary arterial repairs, 4 repairs using vein grafts and 8 ligations. The following adjunct procedures were necessary: one 4-compartment leg fasciotomy due to associated soft tissue trauma, 8 tendon repairs, and 11 nerve repairs. Operations for venous injuries included 4 ligations and 2 primary repairs. There were no intraoperative or postoperative deaths, major complications, or limb loss. The median length of stay in the hospital was 6 days (range: 2-23 days). The median time of follow-up was 52 months (range: 20-94 months). Ten patients did not have any sequelae, and 11 patients reported impaired mobility and/or decreased sensation, which was transitory in most cases and related to associated neurological or muscle tendon injuries. All reconstructions remained patent over the course of follow-up. No limb asymmetry was observed. CONCLUSIONS: Noniatrogenic pediatric vascular trauma is uncommon. Penetrating mechanism is more common than blunt and extremities are more frequently affected. Overall complications come from associated injuries to tendons and nerves.info:eu-repo/semantics/publishedVersio

The Portfolio as an Evaluation Tool: an Analysis of its Use in an Undergraduate Nursing Program

This qualitative study was carried out between April and August 2007. It analyzed the use of portfolios in the academic community. A total of nine full-time professors and 119 students enrolled in their third semester were interviewed through a semi-structured interview. Content analysis was used to analyze data. Learning evaluations are seen as a verification of knowledge and efficacy of pedagogical method, and also as an incentive to study. Evaluations are procedural, that is, evaluation is continuous, or one-time, e.g. semester end tests. The portfolio is defined as a gradual and continuous evaluation tool. The faculty members and students need to accept the use of portfolios and evaluate the possibilities of this resource. This study is a first attempt to appraise the evaluation process of an undergraduate program, and the use of portfolios and other strategies needs to be consolidated in order to improve the educational process in undergraduate nursing programs.Se trata de un estudio cualitativo, realizado en el período de abril a agosto de 2007. El objetivo fue analizar la utilización del portafolio por la comunidad académica. Se entrevistó a través de un guión a nueve docentes efectivos y 119 discentes matriculados a partir del tercer período. En el análisis de datos se utilizó el análisis de contenido. La evaluación del aprendizaje es considerada como verificación del conocimiento, como eficacia del método pedagógico e incentivo al estudio. Con relación al tipo de evaluación son procesuales y puntuales. El portafolio es definido como un instrumento de evaluación gradual y continuo. Es necesario que el cuerpo docente y discente acepte experimentar la utilización del portafolio y así evaluar las posibilidades de este recurso. Representa una primera aproximación al proceso de evaluación en la graduación y de esa forma el portafolio y otras estrategias necesitan ser consolidadas de forma a mejorar el proceso de formación en la graduación de enfermería.Este é um estudo qualitativo, realizado no período de abril a agosto de 2007. O objetivo foi analisar a utilização do portfólio pela comunidade acadêmica. Entrevistaram-se, através de um roteiro, nove docentes efetivos e 119 discentes matriculados a partir do terceiro período. Na análise de dados utilizou-se da análise de conteúdo. A avaliação da aprendizagem é considerada como verificação do conhecimento, como eficácia do método pedagógico e incentivo ao estudo. Com relação aos tipos de avaliação são eles processuais e pontuais. O portfólio é definido como instrumento de avaliação gradual e contínuo. É necessário que o corpo docente e discente aceite experimentar a utilização do portfólio e assim avaliar as possibilidades desse recurso. Representa a primeira aproximação ao processo de avaliação na graduação e, dessa forma, o portfólio e outras estratégias precisam ser consolidadas de forma a melhorar o processo de formação na graduação de enfermagem

Arterial hypertension and associated factors in patients submitted to myocardial revascularization

OBJECTIVE To identify the prevalence of arterial hypertension and associated factors in patients submitted to myocardial revascularization. METHOD Cross-sectional study using the database of a hospital in São Paulo (SP, Brazil) containing 3010 patients with coronary artery disease submitted to myocardial revascularization. A multiple logistic regression was performed to identify variables independently associated with hypertension (statistical significance: p1.3: (OR=1.37;CI:1.09-1.72). CONCLUSION A high prevalence of arterial hypertension and association with both non-modifiable and modifiable factors was observed