RESUMO
Objectives: To determine if the implementation of a personalized diet for three months improves the nutritional status of pregnant women with overweight and obesity of the UMF No. 56. Methodology: Prospective longitudinal study in 53 overweight or obese pregnant women to whom which were given a specific diet, according to its particular characteristics; were evaluated the characteristics of the right diet, 24 hours recall, frequency of food consumption, weight and biochemical indicators. The real, ideal and projected weight of the patients was compared. McNemar test and Kuskal-Wallis was applied with confidence interval of 95%. Results: the BMI pre-gestational average was 28.5 kg / m2. At the end ofthe study pregnant women improved the characteristics of the right diet: the complete one (9.4% vs 60.4%), the percentage of adequacy of lipids (7.5% vs 45.3%) and increased in active physical activity (22.6% vs 54.7%). Ideal gestational weight wasn't reached, but there was a weight control reflected in a projected weight higher than real in each intervention. No significant changes in the biochemical indicator (p> 0.05). Conclusions: The implementation of a personalized diet improved the nutritional status of overweight or obese pregnant women in their eating patterns and gestational weight control.
Objetivo: Determinar si la implementación de una dieta personalizada durante tres meses, mejora el estado nutricional de mujeres embarazadas con sobrepeso y obesidad de la UMF No. 56. Metodología: Estudio prospectivo longitudinal en 53 embarazadas con sobrepeso u obesidad a las que se les proporcionó una dieta específica, de acuerdo a sus características particulares; se evaluaron las características de la dieta correcta, la R24H, la frecuencia de consumo de alimentos, el peso corporal e indicadores bioquímicos. Se comparó el peso real, peso proyectado y peso ideal de las pacientes. Se aplicó prueba de McNemar y Kuskal-Wallis con nivel de confianza de 95%. Resultados: el promedio del IMC pregestacional fue 28.5 kg/m2. Al finalizar el estudio las gestantes mejoraron las características de la dieta correcta: la completa (9.4% a 60.4%), el porcentaje recomendable de adecuación de lípidos (7.5% a 45.3%) y aumentaron la actividad física activa (22.6% a 54.7%). No se alcanzó el peso ideal gestacional, pero se logró control de peso, reflejado en peso proyectado mayor al real en cada intervención. Sin cambios significativos en el indicador bioquímico (p>0.05). Conclusiones: La implementación de la dieta personalizada mejoró el estado nutricional de mujeres embarazadas con sobrepeso u obesidad en sus patrones de alimentación y en el control de peso gestacional.
Assuntos
Humanos , Estado Nutricional , Gestantes , Dieta , Sobrepeso , Obesidade , Aumento de PesoRESUMO
Background: Neuropathy is a common complication of diabetic patients. Aim: To determine the prevalence of diabetic peripheral neuropathy in Type 2 diabetic patients attended at a family medicine unit. Material and Methods: Cross-sectional assessment of 348 type 2 diabetic patients aged 34-89 years (60% females) with a disease duration of 5 to 15 years. Peripheral neurological status was evaluated using The Michigan Neuropathy Screening Instrument, a tool that includes a self-assessment of symptoms and a physical examination. Results: Diabetic neuropathy was found in 240patients (69%). The prevalence in males and females was 72 and 67% respectively. The prevalence in patients with a disease duration of 5, 10 and 15 years, was 59, 69 and 77%, respectively. Fifty percent of patients with neuropathy complained of dry skin, 2% had ulcers, 43% had an abnormal perception of vibration and 29% had an abnormal monofilament test. Conclusions: The overall prevalence of peripheral neuropathy in this group of patients was 69% and was directly associated with the duration of the disease.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /complicações , Neuropatias Diabéticas/epidemiologia , Distribuição por Idade , Estudos Transversais , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/etiologia , Prevalência , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
Traumatic injuries of the lower extremity vary from minimal lacerations to limb threatening open fractures. Complications and morbidity associated with these injuries can be significant. With appropriate treatment from simple wound closure to complex free tissue transfer morbidity can be minimized and the threat of limb loss can be averted. We review the present treatment of traumatic soft tissue injuries of the lower extremity.
Assuntos
Humanos , Lesões dos Tecidos Moles/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Traumatismos da Perna/cirurgia , Desbridamento , Transplante de Pele , Retalhos CirúrgicosRESUMO
BACKGROUND: Countries with scarce resources have the right to appropriate essential health care but very few reports discuss how this can be achieved. We assessed the survival of a large cohort of pediatric oncological patients to provide hard data on which to base realistic evaluation and planning schemes. PATIENTS AND METHODS: This multicenter retrospective survey covered consecutively diagnosed and treated patients admitted to eight national level hospitals in seven countries in Central America and the Caribbean. The research protocol was discussed extensively, so the data to be collected and the criteria for their evaluation were clearly pre-defined. We analysed 2214 patients diagnosed between 1996 and 1999 with various cancers, classified as hemato-oncological disorders (70%) and solid tumors (30%). RESULTS: Three-year overall survival was 48.4% [standard error (SE) 1.3]. Detailed analysis of acute lymphoblastic leukemia highlighted the wide intercountry variability: 3-year survival was 62.2% (SE 5.3) in Cuba, 74.2% (SE 3.3) in Costa Rica, 61.7% (SE 4.9) in Nicaragua, and lower in the other four countries. CONCLUSIONS: The yield of diagnostic-therapeutic protocols depends largely on the context of care in which they are applied. This paper documents the importance of including epidemiological research in interventions for cooperation in complex health areas such as pediatric oncology.
Assuntos
Neoplasias/epidemiologia , Região do Caribe/epidemiologia , América Central/epidemiologia , Criança , Humanos , Leucemia Mieloide Aguda/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Estudos Retrospectivos , Análise de SobrevidaRESUMO
La vigilancia del nivel de glicemia es considerada la piedra angular en el cuidado de la diabetes. Los resultados del estudio "Diabetes control and complication trial" (D.C.C.T) recomiendan el mantenimiento de niveles de glucosa lo más próximo a lo normal. debido a que las complicaciones crónicas de la diabetes tienen relación con el grado y duración de la hiperglicemia. La cuantificación de proteínas glicosiladas, principalmente la hemoglobina, permite con una simple medida determinar el promedio de glicemia de los 2 - 3 meses previos. Realizamos un estudios descriptivo en 437 pacientes diabéticos ambulatorios inscritos en la unidad de diabetes del Hospital Vargas (U.D.H.V) medimos los niveles iniciales de hemoglobina A1 en muestras de sangre venosa, usando método electroforético en agar gel a Ph 6.1. De los 437 pacientes encontrados 231 (52,9 por ciento) mujeres y 206 (47,1 por ciento) hombres. La edad promedio fue de 54,2 años. El valor promedio de HbA1 fue de 14,1 por ciento. El porcentaje de pacientes con control metabólico bueno de (13 por ciento), regular (20,4 por ciento) y malo (66.6 por ciento) concluimos que 2/3 partes de los pacientes inscritos en la U.D.H.V, tienen un mal control metabólico al momento de su ingreso. Esperamos que nuestro trabajo en la asistencia y educación terapéutica de los pacientes diabéticos pueda mejorar esta situación, así como prevenir y reducir el riesgo de incrementar las ccomplicaciones crónicas
Assuntos
Humanos , Masculino , Feminino , Diabetes Mellitus , Hemoglobinas Glicadas , MetabolismoRESUMO
Estudio retrospectivo de 67 pacientes con 90 orejas malformadas, y hallazgo de 6 oídos medios malformados con orejas normales, demostrados por estudios radiológicos
Assuntos
Humanos , Masculino , Feminino , Otopatias/fisiopatologia , Orelha Externa/anormalidades , Orelha Média/anormalidades , Orelha/embriologia , Radiografia , Tomografia Computadorizada de Emissão/métodosRESUMO
Completeness of tuberculosis case reporting in Puerto Rico was assessed. Cases diagnosed among hospitalized, tuberculosis, and human immunodeficiency virus clinic patients during 1992 were retrospectively reviewed. Hospital discharge diagnoses, pharmacy listings of patients receiving anti-tuberculous medications, laboratory and acquired immunodeficiency syndrome registry data were used for case finding in selected hospitals and clinics. Identified cases were matched to the health department TB case registry to determine previous reporting through routine surveillance. Records of unreported cases were reviewed to verify tuberculosis diagnoses. Of 159 patients with tuberculosis, 31 (19.5%) were unreported. A case was defined according to the Centers for Disease Control and Prevention definition. Unreported cases were less likely than previously reported cases to have specimens that were culture positive for M. tuberculosis, 14 of 31 (45.2%) compared with 111 of 128 (86.7%). Excluding the laboratory, tuberculosis diagnoses in acquired immunodeficiency syndrome registry patients had the highest predictive value of finding tuberculosis (94.1%), followed by tuberculosis clinic records (71.7%), and pharmacy listings (45.6%). Tuberculosis discharge diagnoses, however, yielded the largest number of unreported cases (14). Health care providers should be educated regarding the importance of promptly reporting all suspected TB cases regardless of results of laboratory testing.
Assuntos
Sistema de Registros , Tuberculose/epidemiologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Notificação de Doenças/estatística & dados numéricos , Métodos Epidemiológicos , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Porto Rico/epidemiologia , Distribuição Aleatória , Estudos Retrospectivos , Tuberculose/complicações , Tuberculose/diagnósticoRESUMO
The purpose of this study is to evaluate the use of Intraoperative Autotransfusion (IAT) as a second stage in the use of autologous blood to reduce the need of allogeneic transfusions. We reviewed the medical records of 41 pediatric patients who underwent spinal fusion procedures from September 1991, to August 1993. Our experience with IAT started in August 1992. The group of patients was divided into those who only received preoperative donation autologous blood (53.6%) and those who received preoperative donation autologous blood and IAT (46.4%). The use of preoperative autologous blood donation in combination with IAT has proven to be a safe method of operative blood loss replacement in pediatric age patients. Exclusive use of autologous blood can reduce or eliminate transfusion reactions and exposure to transfusion transmitted agents and helps to increase the blood reserve at blood banks.
Assuntos
Perda Sanguínea Cirúrgica , Transfusão de Sangue Autóloga/métodos , Cuidados Intraoperatórios/métodos , Cuidados Pré-Operatórios/métodos , Fusão Vertebral/efeitos adversos , Adolescente , Adulto , Transfusão de Sangue Autóloga/economia , Volume Sanguíneo , Criança , Pré-Escolar , Análise Custo-Benefício , Feminino , Hematócrito , Hemoglobinas/análise , Humanos , Lactente , Masculino , Estudos Retrospectivos , Reação TransfusionalRESUMO
Se analizan 222 casos de purpura trombocitopenica idiopatica (PTI) en ninos. La mayoria de ellos estuvo en edades comprendidas entre uno a seis anos. Las manifestaciones de sangrado fueron por lo regular de tipo leve o moderado, siendo poco frecuentes los sangrados severos y a nivel del sistema nervioso central. La evolucion aguda fue la mas frecuente, observada en 78% de los casos. De los 32 ninos que evolucionaron a la cronicidad, se esplenectomizaron 17; de estos, el 65% respondio favorablemente. El tratamiento con esteroides no parecio modificar la evolucion ni el pronostico de la PTI en estos ninos