4 research outputs found
NeumonĂa adquirida en la comunidad en niños menores de 3 años: conocimiento del cuidado materno
Introduction: Community-acquired pneumonia (CAP) is a disease that occurs frequently and is considered a very serious infection in childhood, the objective of this study was to evaluate the epidemiological behavior of CAP in younger children. 3 years in the Pediatrics Area of ââthe Hospital Ambato IESS. Methodology: A retrospective and descriptive study was carried out in 113 children identified with CAP who attended the aforementioned hospital, in the period from August 2019 to March 2020. The selection of the sample was carried out through a consecutive purposive sampling. For the evaluation of the cases, the clinical data of the records records department of the health center were used. Results: According to the results obtained, it was evidenced that 54% corresponded to the female gender, 64% were between 2 and 3 years of age, 26% (n=29) of the CAPs had a bacterial origin, 25% (n=28) had a viral origin, the rest were not specified. In addition, 26% (n=29) had a common cold. 53% (n=60) had rural origin. The basic or primary educational level was the most common among parents (49%; n=55). Conclusions: the results show that CAP has a higher incidence in rural areas, with parents with a basic educational level and the bacterial etiology was slightly higher than the viral one, commonly associated with a common cold.IntroducciĂłn: La neumonĂa adquirida en la comunidad (NAC) es una enfermedad que ocurre de manera frecuente y es considerada como una infecciĂłn muy seria en la etapa de la infancia, el objetivo de este estudio fue evaluar el comportamiento epidemiolĂłgico de la NAC en niños menores de 3 años dentro del Ărea de PediatrĂa del Hospital Ambato IESS. MetodologĂa: Se realizĂł un estudio retrospectivo y descriptivo en 113 niños identificados con NAC que asistieron al mencionado hospital, en el perĂodo de agosto 2019 a marzo 2020. La selecciĂłn de la muestra se realizĂł mediante un muestro intencional consecutivo. Para la evaluaciĂłn de los casos, se emplearon los datos clĂnicos de las historias que se encuentran en el departamento de historias mĂ©dicas del centro de salud. Resultados: De acuerdo a los resultados obtenidos se evidenciĂł que el 54% correspondĂan al gĂ©nero femenino, el 64% eran de 2 a 3 años de edad, el 26% (n=29) de las NAC tuvieron un origen bacteriano, el 25% (n=28) tenĂan un origen viral, el resto no fue precisado. AdemĂĄs, el 26% (n=29) cursaba con un cuadro de resfriado comĂșn. El 53% (n=60) tenĂan procedencia rural. El nivel educativo bĂĄsico o primario fue el mĂĄs comĂșn entre los padres (49%; n=55). Conclusiones: los resultados evidencian que la NAC tiene mayor incidencia en las zonas rurales, con padres con un nivel educativo bĂĄsico y la etiologĂa bacteriana fue ligeramente superior a la viral, asociado comĂșnmente a un resfriado comĂșn
Complicaciones del embarazo mĂșltiple pretĂ©rmino en pacientes atendidas en el hospital IESS Latacunga
Background: Multiple pregnancy corresponds to pregnancies with two or more fetuses, this condition has increased in recent times due to assisted reproduction or due to the motherâs age. Objective: to describe the clinical characteristics and complications of multiple preterm pregnancy in patients treated at the IESS Latacunga Hospital, Ecuador. Methodology: A study with a retrospective and descriptive design was carried out in 15 pregnant women who were treated at the aforementioned hospital, during the period August 2019 - March 2020. The data were obtained from the medical records of the statistics department of the healthcare center. Results: 53% corresponded to mothers between 30 and 34 years old, 67% attended 4-6 prenatal controls, 80% were multiparous, 60% corresponded to a moderate preterm birth (32-34 weeks), the factors that influence in the complications, 53% were due to hypertension, 67% to poor prenatal control, the main maternal complication was high blood pressure (53%), as well as low weight and prematurity in neonates (60%). Conclusion: Poor prenatal control, age and a history of preterm delivery are frequent factors in pregnant women with multiple pregnancies, with a high frequency of maternal and neonatal complications.Antecedentes: Los embarazos mĂșltiples son considerados los que corresponden a gestaciones con dos o mĂĄs fetos los cuales se han incrementado en los Ășltimos tiempos debido a una reproducciĂłn asistida o por la edad de la madre. Objetivo: describir las caracterĂsticas clĂnicas y complicaciones del embarazo mĂșltiple pretĂ©rmino en pacientes atendidas en el Hospital IESS Latacunga, Ecuador. MetodologĂa: Se realizĂł un estudio con diseño retrospectivo y descriptivo en 15 en embarazadas que fueron atendidas en el mencionado hospital, durante el periodo agosto 2019 â marzo 2020. Los datos fueron obtenidos a partir de las historias clĂnicas del departamento de estadĂsticas del centro asistencial Resultados: El 53% correspondĂan a madres de 30 a 34 años, el 67% acudiĂł a 4-6 controles prenatales, el 80% era multĂpara, el 60% correspondĂa a un parto pretĂ©rmino moderado (32-34 semanas), los factores que influyen en las complicaciones el 53% se debiĂł a hipertensiĂłn, el 67% a mal control prenatal, las principal complicaciĂłn materna fue la presiĂłn arterial elevada (53%), asĂ como el bajopeso y prematuridad en los neonatos (60%). Conclusiones: El pobre control prenatal, la edad y el antecedente de parto pretĂ©rmino son factores frecuentes en las gestantes con embarazos mĂșltiples, existiendo una alta frecuencia de complicaciones maternas y neonatales
Salbutamol inhalado y frecuencia cardĂaca
Objetivos:
Exponer la experiencia personal sobre el uso diario del Salbutamol Inhalado y su relaciĂłn con la frecuencia cardĂaca, asi como su comparaciĂłn con un estudio similar de la literatura.
Material y MĂ©todos :
Se presenta un estudio en 24 pacientes AsmĂĄticos adultos de ambos sexos, en fase estable (intercrisis), a los cuales se les administrĂł Salbutamol en aerosol de dos formas, una con el tipo spray M.D.I. a la dosis de 800 mcg con cĂĄmara espaciadora (Aerochamber) y la otra del tipo nebulizado utilizando ventilador mecĂĄnico manomĂ©trico (Mark-8) a la dosis de 5mg/dosis de Salbutamol al 0.5% (1cc), en ambos casos el objetivo era determinar la acciĂłn de este sobre el Aparato Cardiovascular por medio de la detecciĂłn de la frecuencia del pulso, utilizando el pulsioxĂmetro OXY 9800 en modo grabaciĂłn.
A todos los casos previo al aerosol , se realizĂł un monitoreo de reposo de la frecuencia del pulso, con este mismo equipo.
La informaciĂłn recogida fue pasada por medio de un cable RS232 a una microcomputadora fue procesada por diferentes softwares tales como, NotedPad, Macro-Divisor, Tabla de Excel, y el estadĂstico SPSS, para realizar el estudio de las muestras pareadas Pre y Post Aerosol con las dos formas de inhalaciĂłn del Salbutamol, utilizando la pueba t-students.
Resultados:
No existieron diferencias significativas desde el punto de vista clĂnico en relaciĂłn al pulso basal con el pulso obtenido posterior a la inhalaciĂłn del Salbutamol de forma nebulizada.
En nuestro estudio, existieron diferencias estadĂsticamente significativas p < 0.005 entre el pulso basal y post aerosol M.D.I 800 mcg para un aumento de 4 latidos en relaciĂłn al basal lo cĂșal carece de significado clĂnico.
Conclusiones :
En nuestro estudio, el Salbutamol utilizado por via inhalatoria aĂșn a dosis moderadamente altas se comportĂł como un medicamento seguro.
No se presentaron arrĂtmias y el aumento de la frecuencia cardiaca no fue significativa
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)