Conocimientos del personal del área de quirófano en el Hospital General Docente Ambato sobre sepsis quirúrgica.

Introducción: La sepsis es un síndrome clínico disfuncional potencialmente mortal, cuya incidencia se ha incrementado progresivamente. Objetivo: Determinar el nivel de conocimiento del personal del área de quirófano del Hospital General Docente Ambato sobre sepsis quirúrgica. Métodos: investigación de tipo descriptiva, observacional, no experimental y de corte transversal. La población del estudio estuvo conformada por todo el personal del área de quirófano del Hospital General Docente Ambato (HGDA), con una muestra censal: 7 enfermeras, 2 auxiliares de enfermería, 4 cirujanos, 2 anestesiólogos y 2 médicos a quienes se aplicó un inventario de evaluación conformado por 33 ítems, las variables se expresaron en niveles de conocimiento alto (entre 32 y 33 ítems correctos), medio (entre 16 y 31 ítems correctos) y bajo (menos de 16 ítems correctos) y fueron expresadas en frecuencias porcentuales y numéricas. Resultados: el 59% del personal de quirófano tiene un nivel de conocimiento alto respecto al tipo de cirugía. El 65% tiene un nivel de conocimiento medio sobre las causas de la sepsis, 59% sobre el cuadro clínico y el 47% sobre el tipo de sepsis. Un 65% del personal tuvo un nivel de conocimiento sobre los criterios diagnósticos. Conclusiones: la mayor parte del personal del área de quirófano del Hospital General Docente Ambato tiene un nivel medio de conocimiento respecto al cuadro clínico, tipos y causas de la sepsis quirúrgica. Se encontró un nivel alto de conocimientos respecto a los tipos de cirugía y bajo en conocimientos sobre criterios diagnósticos

Medicina e Interculturalidad

Introduction: The ignorance of the population on the adverse effects that could lead to the misuse of alternative therapies, through empirical knowledge, from the various therapeutic components, used to treat different conditions, It demands the unification of the traditional medicine with the pharmacological, managing to combine natural products with chemical products, with the aim to increase the therapeutic efficacy and to reduce the morbidity and mortality of the population. Objective: To identify the most used components of traditional medicine in the indigenous inhabitants of the communities of Pasa, Salasaca, Pilahuin and the health personnel who work in the primary care centers more accessible to each community in the Ambato canton of the Republic of Ecuador. Material and methods: A prospective descriptive study was projected for the approach of the perception of the interculturality in health during the period January-August 2018. The indigenous inhabitants of the communities of Pasa, Salasaca and Pilahuin and the health personnel working in the primary care centers more accessible to each community in the Ambato Canton of the Republic of Ecuador were considered as a sample of the study. Descriptive statistical methods were used. Results: We identified economic, cultural, social, demographic, population dispersal, empathy with health personnel, as involved in the use of conventional medicine and ancestral medicine, making more use in the components that use. Conclusions: The theoretical and practical budgets analyzed allowed to establish that the community prefers the traditional medicine, either by their customs, traditions, beliefs typical of the inhabitants, which reflects the way in which they choose the treatment for their Ailments, disconditions or some pathology itself, based on ancestral knowledge.Introducción: El desconocimiento de la población sobre los efectos adversos que podría llevar a la mala utilización de terapias alternativas, mediante conocimientos empíricos, a partir de los diversos componentes terapéuticos, utilizados para tratar diferentes padecimientos, demanda la unificación de la medicina tradicional con la farmacológica, logrando combinar productos naturales con productos químicos, con la finalidad de incrementar la eficacia terapéutica y disminuir la morbimortalidad de la población. Objetivo: Identificar los componentes más utilizados de la medicina tradicional en los habitantes indígenas de las comunidades de Pasa, Salasaca, Pilahuin y el personal de salud que labora en los centros de atención primaria más accesible a cada comunidad del Cantón Ambato de la República del Ecuador. Material y Métodos: Se proyectó un estudio descriptivo prospectivo para el abordaje de la percepción de la interculturalidad en salud durante el periodo Enero- agosto 2018. Se consideró como muestra de estudio a los habitantes indígenas de las comunidades de Pasa, Salasaca y Pilahuin y el personal de salud que labora en los centros de atención primaria más accesible a cada comunidad del Cantón Ambato de la República del Ecuador. Se utilizaron métodos estadísticos descriptivos. Resultados: Se identificaron factores económicos, culturales, sociales, demográficos, la dispersión de la población, empatía con el personal de salud, como intervienen en el uso de la medicina convencional y la medicina ancestral, haciendo más uso en los componentes que utilizan. Conclusiones: Los presupuestos teóricos y prácticos analizados permitieron establecer que la comunidad prefiere la medicina tradicional, ya sea por sus costumbres, tradiciones, creencias propias de los pobladores, lo cual refleja la manera en la que eligen el tratamiento para sus dolencias, malestares o alguna patología propiamente dicha, basado en el conocimiento ancestral

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care