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Id: biblio-978315
Autor: Restrepo, Diana; Duque, Marie; Montoya, Laura; Berrouet, Marie Claire; Rojas, Maylen; Lopera, Gloria; Giraldo, Kamila.
Título: Factores de riesgo y mortalidad hospitalaria de los pacientes quirúrgicos y no quirúrgicos con delirium / Risk Factors and Hospital Mortality in Surgical and Non-surgical Patients with Delirium
Fonte: Rev. colomb. psiquiatr;47(3):148-154, jul.-set. 2018. tab, graf.
Idioma: es.
Resumo: resumen Introducción: El delirium es un síndrome neuropsiquiátrico frecuente y con graves consecuencias, especialmente para los pacientes ancianos y con deterioro cognitivo preexistente. Métodos: Estudio descriptivo de una única cohorte retrospectiva. El objetivo es comparar los factores de riesgo y la mortalidad según el tipo de tratamiento (quirúrgico y no quirúrgico) en un grupo de pacientes con delirium hospitalizados. Resultados: Se analizó a 184 pacientes con delirium hospitalizados, por causas quirúrgicas el 29,3% y no quirúrgicas el 70,7%. El 50,5% eran mujeres; el 50% de los pacientes tenían 74 anos o menos (intervalo intercuartílico, 27 arios), con diferencias estadísticas, siendo mayores los no quirúrgicos (p = 0,002). El 42,9% de los pacientes presentaban deterioro cognitivo previo, con mayor proporción entre los no quirúrgicos (el 50,8 frente al 24,1%) y diferencias significativas (p = 0,001). El 89,7% recibía medicamentos anticolinérgicos y el 99,5%, más de 3 medicamentos, sin diferencias significativas. La mitad de los pacientes permanecieron en hospitalización 16,3 días o menos (intervalo intercuartílico, 23 días), y fue significativamente más larga la estancia en el grupo quirúrgico (p < 0,001); el 14,7% de los pacientes murieron en el hospital, sin diferencias estadísticas entre los grupos (p = 0,073). Discusión: No hubo diferencias significativas en la mortalidad entre los grupos, si bien fue mayor en el no quirúrgico (el 17,7 frente al 7,4%). En cuanto a la edad, se encontró que el grupo de mayor mortalidad (el no quirúrgico) tenía una edad y un deterioro cognitivo significativamente mayores, lo cual coincide con la literatura científica.

ABSTRACT Introduction: Delirium is a common neuropsychiatric syndrome with severe consequences, especially for elderly patients with pre-existing cognitive impairment. Methodology: Descriptive study of one retrospective cohort, with the aim of comparing risk factors and mortality between surgical treatment and non-surgical treatment in a group of hospitalised patients with delirium. Results: Of the 184 hospitalised patients with delirium analysed, 29.3% were for surgical causes and 70.7% for non-surgical causes. Just over half (50.5%) were women, and 50% of the patients were 74 years or less (interquartile range, 27 years), with statistical differences (P=.002). Prior cognitive impairment was observed in 42.9% of patients, with a greater proportion of non-surgical (50.8% vs 24.1%) with significant differences (P=.001). Anticholinergic medications were received by 89.7% of patients, and almost all of them (99.5%) received three or more medicines, with no significant differences. Half (50%) of the patients remained in hospital for 16.3 days or less (interquartile range, 23 days). Hospitalisation was significantly longer in the surgical group (P<.001). The hospital mortality was 14.7%, with no statistical differences between groups (P=.073). Discussion: Although there were no significant differences in mortality between the groups, it was higher in the non-surgical (17.7% vs. 7.4%). Increased mortality was found in the older group (non-surgical) that also had significantly greater cognitive impairment, which coincides with that in the scientific literature.
Descritores: Fatores de Risco
Mortalidade
Delírio
-Centro Cirúrgico Hospitalar
Síndrome
Hospitalização
Limites: Humanos
Masculino
Feminino
Idoso
Responsável: CO78 - Asociación Colombiana de Psiquiatría


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Id: biblio-1279740
Autor: Ocampo, Carlos G; Zandalazini, Hugo I; Alonso, Facundo.
Título: Impacto de la pandemia COVID-19 en la cirugía pancreática. Análisis en dos instituciones, una pública y otra privada / Impact of the COVID-19 pandemic on pancreatic surgery. Analysis in a public and a private institution
Fonte: Rev. argent. cir;112(3):266-273, jun. 2020. graf, tab..
Idioma: es.
Resumo: RESUMEN Antecedentes: la pandemia de COVID-19 ha introducido cambios drásticos en el sistema de salud. Las cirugías electivas son una de las actividades quirúrgicas que más han descendido durante la pandemia. Objetivo: analizar el impacto de la pandemia de COVID-19 en la cirugía pancreática en una institución pública y otra privada. Se comparó, en cada institución, con el número de cirugías en el mismo período del año pasado. Material y métodos: se revisaron en una base prospectiva los pacientes que recibieron una cirugía pancreática en las dos instituciones entre el 10/3/20 y el 24/6/20. Se determinaron los datos epide miológicos, el tipo de resección pancreática, el diagnóstico anatomopatológico, la morbilidad y la mor talidad. Se compararon con los pacientes en ambas instituciones que recibieron cirugía pancreática durante el período 10/3/19 al 24/6/19. Resultados: durante la pandemia se realizaron 23 resecciones pancreáticas (13 duodenopancreatec tomías cefálicas, 9 pancreatectomías izquierdas y 1 pancreatectomía total). El 70% (16/23) fueron adenocarcinomas. La morbilidad alcanzó el 34,7% y no se registró mortalidad. Ningún paciente ni miembro del equipo quirúrgico se infectó con coronavirus. La pandemia no tuvo impacto en el núme ro de cirugías en el centro privado (22 vs. 20, p = 0,88), mientras que en el centro público hubo una reducción significativa en el número de cirugías (14 vs. 3, p = 0,009). Conclusión: la cirugía pancreática se puede hacer con seguridad durante la pandemia. En el centro privado se mantuvo el número de cirugías pancreáticas. En el centro público, con máxima prioridad para pacientes con COVID-19, hubo un descenso significativo.

ABSTRACT Background: The COVID-19 pandemic has introduced dramatic changes in the health system. Elective surgeries are the surgical activities with greater decline during the pandemic. Objective: The aim of this paper is to analyze the impact of the COVID-19 pandemic in pancreatic sur gery in a public and a private institution. The number of surgeries performed in each institution was compared with those performed in same period of the previous year. Material and methods: Data from a prospective database of all the patients who underwent pancrea tic surgery between March 10, 2020, and June 3, 2020, were analyzed. The epidemiological data, type of pancreatic resection, pathology diagnosis, morbidity and mortality were determined in each insti tution and compared with patients who underwent pancreatic surgery in both institutions between March 3, 2019, and June 24, 2019. Results: 23 pancreatic resections were performed during the pandemic (13 cephalic pancreaticoduo denectomies, 9 left pancreatectomies and 1 total pancreatectomy); 70% (16/23) were adenocarcino mas. There were 34.7% complications and no deaths were reported. None of the patients was infected with coronavirus. The pandemic had no impact on the number of pancreatic resections in the private institution (22 vs. 20, p = 0.88), while the number of pancreatic surgeries was significantly lower in the public center (14 vs. 3, p = 0.009). Conclusion: Pancreatic surgery can be safely performed during the pandemic. The number of pancrea tic surgeries did not decline during the pandemic. The priority for treating patients with COVID-19 at the public center resulted in a significant decrease in pancreatic surgeries.
Descritores: Pancreatectomia/estatística & dados numéricos
Morbidade
COVID-19
-Pâncreas
Pancreatectomia/mortalidade
Centro Cirúrgico Hospitalar
Hospitais Privados
Hospitais Públicos
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Tipo de Publ: Estudo Comparativo
Responsável: AR144.1 - CIBCHACO - Centro de Información Biomedica del Chaco


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Id: biblio-995542
Autor: Armas-Bencomo , A; Osmin Tamargo-Barbeito, T; Fuentes-Valdés, E; Eugenia Jiménez-Paneque, R.
Título: Índice de gravedad para servicios quirúrgicos en un hospital cubano: estudio de revalidación / Severity of illness index for surgical departments in a Cuban hospital: a revalidation study
Fonte: Medwave;17(2):e6881, 2017.
Idioma: en; es.
Resumo: INTRODUCCIÓN En el contexto de la evaluación de servicios hospitalarios, la incorporación de índices de gravedad permite tener una variable de control esencial para la comparación del desempeño en el tiempo y el espacio a través del llamado ajuste por riesgo. El índice de gravedad para servicios quirúrgicos, se construyó en 1999 y se validó como un índice general para estos servicios. Dieciséis años después el contexto hospitalario ha cambiado y se consideró necesaria una revalidación de este índice de gravedad que avale su utilidad actual. OBJETIVO Evaluar la validez y confiabilidad del índice de gravedad para servicios quirúrgicos, que avale su uso razonable en las condiciones actuales. MÉTODOS Se realizó una investigación descriptiva retrospectiva en el servicio de cirugía general del Hospital Clínico Quirúrgico Hermanos Ameijeiras en el segundo semestre del año 2010. Se revisaron las historias clínicas de 511 pacientes egresados de este servicio. Las variables utilizadas fueron las mismas del índice original con sus ponderaciones. Se evaluaron validez conceptual o de constructo, validez de criterio y confiabilidad interevaluadores así como consistencia interna del índice propuesto. RESULTADOS La validez de constructo se expresó en una asociación significativa entre el valor del índice de gravedad para servicios quirúrgicos y el estado al egreso. Se comprobó también correlación significativa, aunque débil, con la estadía hospitalaria. En cuanto a validez de criterio, la correlación entre el índice de gravedad propuesto y el índice de Horn fue de 0,722 (intervalo de confianza de 95%: 0,677-0,761); mientras que con el índice Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) la correlación fue de 0,454 (intervalo de confianza de 95%: 0,388-0,514) con el riesgo de muerte y 0,539 (intervalo de confianza de 95%: 0,462-0,607) con el riesgo de morbilidad. La consistencia interna mostró α de Cronbach estandarizado de 0,8; la confiabilidad interevaluadores resultó en un coeficiente de confiabilidad de 0,98 para el índice de gravedad para servicios quirúrgicos cuantitativo y un coeficiente de κ ponderado global de 0,87 para el índice de gravedad para servicios quirúrgicos ordinal. CONCLUSIONES La validez y confiabilidad del índice propuesto fue adecuada en todos los aspectos evaluados. El índice de gravedad para servicios quirúrgicos puede utilizarse en el contexto original y es fácilmente adaptable a otros contextos.

INTRODUCTION In the context of the evaluation of hospital services, the incorporation of severity indices allows an essential control variable for performance comparisons in time and space through risk adjustment. The severity index for surgical services was developed in 1999 and validated as a general index for surgical services. Sixteen years later the hospital context is different in many ways and a revalidation was considered necessary to guarantee its current usefulness. OBJECTIVE To evaluate the validity and reliability of the surgical services severity index to warrant its reasonable use under current conditions. METHODS A descriptive study was carried out in the General Surgery service of the "Hermanos Ameijeiras" Clinical Surgical Hospital of Havana, Cuba during the second half of 2010. We reviewed the medical records of 511 patients discharged from this service. Items were the same as the original index as were their weighted values. Conceptual or construct validity, criterion validity and inter-rater reliability as well as internal consistency of the proposed index were evaluated. RESULTS Construct validity was expressed as a significant association between the value of the severity index for surgical services and discharge status. A significant association was also found, although weak, with length of hospital stay. Criterion validity was demonstrated through the correlations between the severity index for surgical services and other similar indices. Regarding criterion validity, the Horn index showed a correlation of 0.722 (95% CI: 0.677-0.761) with our index. With the POSSUM score, correlation was 0.454 (95% CI: 0.388-0.514) with mortality risk and 0.539 (95% CI: 0.462-0.607) with morbidity risk. Internal consistency yielded a standardized Cronbach's alpha of 0.8; inter-rater reliability resulted in a reliability coefficient of 0.98 for the quantitative index and a weighted global Kappa coefficient of 0.87 for the ordinal surgical index of severity for surgical services (IGQ). CONCLUSIONS The validity and reliability of the proposed index was satisfactory in all aspects evaluated. The surgical services severity index may be used in the original context and is easily adaptable to other contexts as well.
Descritores: Centro Cirúrgico Hospitalar
Procedimentos Cirúrgicos Operatórios
-Índice de Gravidade de Doença
Variações Dependentes do Observador
Reprodutibilidade dos Testes
Cuba
Tempo de Internação
Limites: Humanos
Tipo de Publ: Estudo de Validação
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1037800
Autor: Cauduro, Fernanda Leticia Frates.
Título: Avaliação da cultura de segurança em unidades cirúrgicas / Assessment of safety culture in surgical units.
Fonte: Curitiba; s.n; 20121210. 104 p. ilus, tab.
Idioma: pt.
Tese: Apresentada a Universidade Federal do Paraná para obtenção do grau de Mestre.
Resumo: A segurança do paciente é destaque nos assuntos relativos à qualidade da assistência em saúde e desde 2004 estratégias para a promoção da cultura de segurança são veiculadas pela Organização Mundial de Saúde por meio dos Desafios Globais. Nesse sentido, o Questionário de Atitudes de Segurança (SAQ) como instrumento que permite avaliar a percepção da cultura de segurança em serviços de saúde, é composto por 41 itens distribuídos em seis domínios e quatro itens isolados; a pontuação obedece a escala de Likert com afirmativas que variam desde discordo totalmente a concordo totalmente e escores entre 0 e 100; acima de 75 os escores são considerados positivos para a cultura de segurança. Neste contexto, foram objetivos desta pesquisa: avaliar a cultura de segurança em Centro Cirúrgico Geral (CCG) e Centro Cirúrgico Gineco-Obstétrico (CCGO) de um hospital de ensino, compara-los por domínios entre unidades e população do estudo, e verificar a associação dos escores geral e por domínios e as variáveis de interesse . A pesquisa foi aprovada por Comitê de Ética em Pesquisa e a escolha das unidades de estudo foi intencional uma vez que desde 2010 o Programa Cirurgia Segura está em implantação na instituição participante. Trata-se de uma pesquisa quantitativa do tipo survey, realizada entre junho e agosto de 2013, por meio da aplicação do SAQ. A população alvo foi composta por profissionais dos centros cirúrgicos que atendessem aos critérios de inclusão e exclusão definidos, e foi constituída por 132 participantes, 79 do CCG e 54 do CCGO. Os resultados de cada questionário foram transcritos para o programa Excel® versão 2007 e processados pelo software Statistica v.8.0. Predominaram participantes do sexo feminino (75,8%) com tempo de atuação no hospital entre 11 a 20 anos (21,2%). Ao comparar a cultura de segurança por domínios entre sexo, foi observado que o melhor escore (77,7) esteve entre mulheres no domínio "Satisfação no trabalho", seguido por "Percepção do estresse" (77,3) entre homens. O menor escore foi identificado no domínio "Percepção da gerência" hospitalar (43,3) para sexo masculino. Quando observado o tempo de atuação dos profissionais de ambas unidades o domínio "Satisfação no trabalho" apresentou a melhor pontuação entre aqueles com mais de 20 anos de trabalho. Em contrapartida, os menores escores foram atribuídos aos domínios "Percepção da gerência" hospitalar e "Clima de trabalho em equipe" entre servidores de CCG e CCGO com um a dois anos de atividade. A comparação dos domínios por categoria profissional mostrou que no CCG auxiliares e técnicos de enfermagem sentem-se mais satisfeitos em seu ambiente de trabalho (83,8), corroborando com a percepção dos enfermeiros do CCGO (90,8). As menores percepções por categoria profissional (escore <75) foram atribuídas por médicos residentes do CCG em todos os domínios e para cinco domínios entre os atuantes no CCGO. Entre os itens isolados , a baixa comunicação com prejuízos para a pontualidade dos procedimentos (item 36) foi percebida com os menores escores entre todos os profissionais de ambos centro cirúrgicos. Quando comparados os centros cirúrgicos, os maiores escores foram atribuídos por enfermeiros e médicos do CCGO. Destacam-se os médicos residentes os quais apresentaram a maior frequência de escores negativos, exceto para o domínio "Percepção do estresse" para residentes do CCGO. De modo geral, os profissionais de saúde do CCG e CCGO estão satisfeitos com seu trabalho e considerando o Programa de cirurgia segura em implantação, os resultados direcionam para a necessidade de ações gerenciais com vistas à melhoria da cultura de segurança, sobretudo às questões relativas à comunicação.

Patient safety is the spotlight in subjects related to the quality of medical assistance in healthcare and since 2004 strategies to the promotion of a safety culture are conveyed by the World Health Organization through Global Challenges. In this sense, the Safety Attitudes Questionnaire (SAQ) as an instrument that allows evaluation of the safety culture perception in health services, is compounded by 41 items distributed in 6 domains and 4 isolated items; the score follows the Likert scale with affirmatives sentences that vary from completely disagree to completely agree and scores between 0 and 100; Scores above 75 are considered positive for safety culture. In this context, the objectives of this research were:To evaluate the safety culture on the General Surgical Center (GSV) and Gynecology and Obstetrics Surgical Center (GOSC) from a teaching hospital,to compare them by domains between units and population of the study,and verify the association of general and domain scores and variables of interest.The Research Ethics Committee approved the research and the study units choice was intentional, given that since 2010 the Safe Surgery Program is under implementation on the participant institution. This is a quantitative survey research, conducted between June and August of 2013, by applying the SAQ. The target population is composed by surgical center professionals who meet the defined inclusion and exclusion criteria, and was constituted by 132 participants, 79 from GSV and 54 from GOSC. The results of each questionnaire were transcribed using Excel® software version 2007 and processed using Statistica v.8.0. Software. Female participants (75,8%) who have been working at the hospital from 11 to 20 years (21,2%) were predominant. When comparing the safety culture by sex domains, it was observed that the best score (77.7) was among women within the domain "Job Satisfaction", followed by "Stress perception" (77.3) among men.The lowest score was identified on the domain "Hospital management perception" (43.3), for males. When observing the time the professionals from both units have been acting on the field the domain "Job Satisfaction" showed the best scores among those who have 20 or more years of work.On the other hand, the lowest scores were attributed to the "Hospital management perception" and "Team work climate"among workers from GSV and GOSC working from one to two years in the area. The comparison of domains by professional category showed that at GSV nursing assistants and technicians feel more satisfied in their working environment (83,8), corroborating with the perception of the nurses from GOSC (90,8). The lowest perception by professional category (scores <75) were attributed by residents from GSV in all domains and for five domains among the staff from GOSC. Among the isolated items, the poor communication with losses to the procedures punctuality (item 36) was perceived with the lowest scores among all professionals from both surgical centers. When comparing the surgical centers, the highest scores were given by nurses and doctors from GOSC.Residents stand out as they provided the highest frequency for negative scores, except to the domain "Stress perception" from GOSC residents. In general, health professionals from GSV and GOSC are satisfied with their jobs and considering the Safe Surgery program that is being implemented, the results directed to the necessity of managing actions aiming to improve the safety culture, above all the questions related to communication.
Descritores: Segurança
Avaliação em Saúde
Atenção à Saúde
Centro Cirúrgico Hospitalar
Segurança do Paciente
-Enfermagem
Limites: Humanos
Masculino
Feminino
Adulto
Tipo de Publ: Estudo de Avaliação
Responsável: BR501.1 - Biblioteca de Ciências da Saúde / Sede Botânico
BR501.1; 613.6, C371


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Id: lil-271209
Autor: Morales Díaz, Ignacio A; Pérez Migueles, Leonardo; Pérez Jomarrón, Emilio.
Título: Peritonitis bacteriana difusa: análisis de 4 años (1995-1998) / Diffuse bacterial peritonitis: a 4-year analysis (1995-1998)
Fonte: Rev. cuba. cir;39(2):160-166, 2000. tab, graf.
Idioma: es.
Resumo: Se hace un estudio retrospectivo y descriptivo de 40 pacientes con peritonitis bacteriana difusa en 4 años, atendidos en el Servicio de Cirugía del Hospital Clinicoquirúrgico Docente "Joaquín Albarrán". La mortalidad por peritonitis difusa representó el 47,5 porciento de la muestra. Con relación a la mortalidad global del servicio, la peritonitis difusa representó el 12,1 porciento, el 67,5 porciento, a pacientes mayores de 60 años y la úlcera gastroduodenal perforada y la dehiscencia de sutura, a las causas más frecuentes de peritonitis difusa. El método cerrado se utilizó en 33 pacientes(AU)

A retrospective and descriptive study of patients with diffuse bacterial peritonitis for 4 years, who were cared for in the Surgery Service of "Joaquín Albarrán" Clinico-Surgical Teaching Hospital. Mortality from diffuse peritonitis represented 47.5 percent of the sample. In relation to global mortality of the Surgical Service, diffuse peritonitis represented 12.1 percent amd 67.5 percent in patients aged over 60 years. The perforated gastroduodenal ulcer and suture dehiscence were the most frequent causes of diffuse peritonitis. The close method was used in 33 patients(AU)
Descritores: Peritonite/mortalidade
Centro Cirúrgico Hospitalar
Infecções Bacterianas/etiologia
-Epidemiologia Descritiva
Estudos Retrospectivos
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1125779
Autor: Cumpa López, Nancy E; Gallino Fernández, Griselda.
Título: La mujer en Cirugía: una exploración de las barreras en la carrera laboral / Women in surgery: an exploration of career barriers
Fonte: Rev. argent. cir;112(1):30-42, mar. 2020. graf, tab.
Idioma: en; es.
Resumo: Antecedentes: las cirujanas en la Argentina experimentan barreras en el ámbito laboral y personal tratando de lograr sus objetivos profesionales. El objetivo de esta investigación fue explorar las barreras que enfrentan las cirujanas en su carrera laboral en las tres principales ciudades de la República Argentina. Material y métodos: estudio exploratorio transversal. Se utilizaron encuestas anónimas a cirujanas durante un período de 6 meses. Resultados: un 59% de las cirujanas son solteras y no viven en pareja. Aquellas con hijos son las principales encargadas de la crianza. Los esposos o convivientes aparecen en tercer lugar, con un muy bajo porcentaje de responsabilidad en la tarea. En la mayoría de los espacios laborales no existe un sistema que facilite el cuidado de hijos en su trabajo. El 65% afirma haber dejado de presentar trabajos científicos luego de la maternidad. Solo un 26% de los pacientes ha rechazado sus servicios en favor de ser intervenido por un cirujano hombre. Por el contrario, un 42% de los jefes ha rechazado ser acompañado en cirugías por cirujanas. Casi un 85% de las cirujanas ha recibido comentarios alusivos a su sexualidad durante su trabajo. Conclusión: las estructuras organizacionales quirúrgicas operan como un marco normativo estructurador de prácticas y discursos que han construido, en el nivel simbólico, subjetivo e institucional, las desigualdades entre mujeres y varones en el ámbito de la actuación médica. La feminización del sector en los últimos tiempos y la salida de la mujer al ámbito laboral no implican necesariamente la equidad de género.

Background: Women surgeons in Argentina face barriers in the workplace and in their personal life when trying to achieve their professional goals. The aim of this investigation was to explore the career barriers women surgeons face in the three main cities of Argentina. Material and methods: We conducted an exploratory cross-sectional study. Anonymous surveys were administrated to women surgeons during a six-month period. Results: Among survey respondents, 59% were single and did not live with a partner. Those with children are the primary carers. Spouses or partners appear in third place, with a very low percentage of responsibility as carers. Most workplaces where female surgeons work do not have childcare facilities. Sixty-five percent of the survey respondents had not presented scientific papers after having children. Only 26 percent of patients had rejected their services in favor of a male surgeon and 42% of head surgeons had refused to be assisted by female surgeons. Almost 85% of women surgeons have received comments about their sexuality during their work. Conclusions: The organizational structures of surgery departments work as a structured regulatory framework of practices and speeches that have constructed the inequalities between women and men in the field of medical action at the symbolic, subjective and institutional level. The recent feminization of the surgical field and the entrance of women in the workplace do not necessarily imply gender equality.
Descritores: Centro Cirúrgico Hospitalar/estatística & dados numéricos
Mulheres Trabalhadoras/psicologia
Iniquidade de Gênero
Papel de Gênero
-Centro Cirúrgico Hospitalar/tendências
Mulheres Trabalhadoras/estatística & dados numéricos
Aleitamento Materno
Gravidez
Estudos Transversais
Assédio Sexual/estatística & dados numéricos
Assédio não Sexual/estatística & dados numéricos
Internato e Residência/estatística & dados numéricos
Limites: Humanos
Feminino
Adulto
Pessoa de Meia-Idade
Adulto Jovem
Responsável: AR144.1 - CIBCHACO - Centro de Información Biomedica del Chaco


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Id: lil-295672
Autor: Mustafá García, Raúl; Mederos Curbelo, Orestes Noel; Roselló Fina, Jorge Rafael; Martín Gil, Luis Manuel.
Título: Resultados del comité de evaluación de intervenciones quirúrgicas en un hospital / Results of the committee of evaluation of surgical procedures in a hospital
Fonte: Rev. cuba. cir;40(1):[29-2], ene.-abr. 2001. tab.
Idioma: es.
Resumo: Se presenta un análisis de la evolución del Comité de evaluación de intervenciones quirúrgicas en el Hospital Universitario ®Comandante Manuel Fajardo¼, en el trienio 1995-1997 en cirugía mayor. Se comprueba que el 99,1 porciento de las operaciones tuvo evaluación A-1 y B-1, y no fue calificado sólo el 0,89 porciento. En la urgencia la evaluación de B-1, fue más frecuente que en el electivo(AU)

The evolution of the Committee of Evaluation of Surgical Procedures in relation to major surgery at the Comandante Manuel Fajardo Teaching Hospital was analyzed from 1995 to 1997. It was observed that 99.1 percent of the operations had evaluation A-1 and B-1 and that only 0.89 percent were not evaluated. The evaluation of B-1 was more frequent in emergency than in elective surgery(AU)
Descritores: Comitê de Profissionais/normas
Centro Cirúrgico Hospitalar
Procedimentos Cirúrgicos Operatórios/métodos
Avaliação de Resultados em Cuidados de Saúde/métodos
Técnicas e Procedimentos Diagnósticos/normas
-Pesquisa sobre Serviços de Saúde
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


  8 / 363 LILACS  
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Id: lil-295673
Autor: Rodríguez Rivero, Alexánder; Valdés Mesa, Pablo Guillermo; Armas Darias, Juan Carlos; Valdés Leyva, Fidel Raúl.
Título: Comportamiento de la cirugía mayor aplicada a pacientes ambulatorios / Behaviour of major surgery applied to outpatients
Fonte: Rev. cuba. cir;40(1):[33-7], ene.-abr. 2001. tab.
Idioma: es.
Resumo: Se realizó una investigación observacional-descriptiva para conocer el comportamiento de la cirugía mayor aplicada a pacientes ambulatorios del Servicio de Cirugía General del Hospital General Provincial Docente Capitán Roberto Rodríguez Fernández, de Morón, durante el período comprendido entre el 1ro. de enero de 1996 y el 30 de junio de 1998. La mayor proporción de casos de uno y otro sexos, pertenecía a los grupos de edad de 15 a 44 años. La hernia inguinal fue la afección más frecuente y por ende la intervención quirúrgica más realizada. El 10,5 porciento de los operados presentaba enfermedades asociadas. La anestesia espinal se utilizó en el 61,8 porciento de los intervenidos. El 2,2 porciento de los intervenidos tuvo complicaciones; sólo el 0,4 porciento de los pacientes necesitó hospitalización. El 100,0 porciento de los pacientes fue seguido por consulta especializada de cirugía y el médico de la familia. El método tuvo buena aceptación en el 99,6 porciento de los investigados(AU)

An observational descriptive research was made in order to know the behavior of major surgery applied to outpatients from the Service of General Surgery of the "Capitán Roberto Rodriguez Fernández" General Teaching Hospital, in Morón, from January 1st, 1996, to June 30th, 1998. Most of the cases of both sexes were 15-44 years old. Inguinal hernia was the most frequent affection and, therefore, the most performed operation. 10.5 percent of the operated on individuals had associated diseases. Spinal anesthesia was used in 61.8 percent of those who underwent surgery. 2.2 percent had complications and just 0.4 percent needed hospitalization. 100 percent of the patients were followed up by the specialized surgery department and the family physician. The method had good acceptation in 99.6 percent of the investigated patients(AU)
Descritores: Centro Cirúrgico Hospitalar
Procedimentos Cirúrgicos Ambulatórios/métodos
Hérnia Inguinal/cirurgia
-Epidemiologia Descritiva
Estudos Observacionais como Assunto
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: lil-324894
Autor: Valdéz Jiménez, Jesús; Barreras Ortega, Juan Carlos; Mederos Curbelo, Orestes Noel; Cantero Ronquillo, Alexis; Pedroso, Janet.
Título: Hallazgos necrópsicos en 100 pacientes del servicio de cirugía general / Necropsy findings in 100 patients from the service of general surgery
Fonte: Rev. cuba. cir;40(4):280-283, oct.-dic. 2001. tab.
Idioma: es.
Resumo: Se revisan los protocolos de necropsia de las defunciones del Servicio de Cirugía General, durante el período comprendido entre enero de 1996 y diciembre de 1998 y se seleccionan aquellos enfermos a los cuales se les practicó algún tipo de intervención quirúrgica. En los 100 fallecidos estudiados se hizo evidente que el incremento de la edad es proporcional al aumento de las complicaciones graves y la mortalidad, con significación en la alta frecuencia de las enfermedades asociadas (63,0 porciento). El 70 porciento de las operaciones tuvo carácter urgente y las principales indicaciones fueron el síndrome peritoneal (29 porciento), la obstrucción intestinal (27 porciento), el cáncer visceral (12 porciento) y el sangramiento digestivo alto (10 porciento). La peritonitis secundaria a perforación y dehiscencia de sutura fue la complicación quirúrgica más frecuente y entre las clínicas la bronconeumonía, la atelectasia y el tromboembolismo pulmonar. Las causas directas de muerte fueron la sepsis generalizada, el shock hipovolémico y la bronconeumonía(AU)

The necropsy protocols of the deaths registered at the Service of General Surgery from January, 1996, to December, 1998, were reviewed. Those patients who uderwent some kind of surgical procedure were selected. In the 100 studied deaths, it was proved that the age increase is proportional to the rise of severe complications and mortality. The high frequency of associated diseases was significant (63.0 percent). 70 percent of the operations had an emergent character and the main indications were peritoneal syndrome (29 percent), intestinal obstruction (27 percent), visceral cancer (12 percent) and high digestive bleeding (10 percent). Peritonitis secondary to perforation and dehiscence of suture was the most frequent surgical complication, whereas bronchopneumonia, atelectasis and pulmonary thromboembolism were among the commonest clinical complications. The direct causes of death were generalized sepsis, hypovolaemic shock and bronchopneumonia(AU)
Descritores: Choque/mortalidade
Autopsia/métodos
Centro Cirúrgico Hospitalar
-Broncopneumonia/mortalidade
Limites: Humanos
Masculino
Feminino
Idoso
Idoso de 80 Anos ou mais
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: lil-324896
Autor: Alemán Modeja, Linet; Guanche Garcell, Humberto.
Título: Etiología de la infección del sitio quirúrgico en pacientes egresados del Hospital Clinicoquirúrgico Docente Joaquín Albarrán enero a marzo del 2000 / Etiology of surgical site infection in patients discharged from Hospital Clinicoquirúrgico Docente Joaquín Albarrán: january to march of 2000
Fonte: Rev. cuba. cir;40(4):291-296, oct.-dic. 2001. tab.
Idioma: es.
Resumo: Se reporta que las infecciones del sitio quirúrgico (ISQ) constituyen formas frecuentes de infecciones nosocomiales, las cuales se originan por múltiples gérmenes (bacterias, virus, hongos). Se pretende mostrar la etiología de la ISQ de pacientes atendidos en el Hospital Clinicoquirúrgico Docente "Joaquín Albarrán" en el período de enero a marzo del 2000, cuando se observó una elevación de estas infecciones. Se realiza un estudio de serie de casos de ISQ, reportados por el sistema local de vigilancia de infecciones nosocomiales, del cual se obtuvieron sus características generales, de los procederes quirúrgicos realizados y la causa de dichas infecciones. De los casos presentados se les realizaron estudios microbiológicos a 31 pacientes y 61 aislamientos de gérmenes. El 9,6 porciento de ellos falleció y el 61,9 porciento tuvo que ser reintervenido por complicaciones quirúrgicas. Los factores de riesgo más frecuentes en los pacientes fueron la ancianidad (42,8 porciento) y el hábito de fumar (47,6 porciento), anemia y alcoholismo en el 19 (porciento) de los casos respectivamente. Klebsiella pneumoniae (26,2 porciento), Pseudomonas aeruginosa (21,3 porciento), Escherichia coli (19,7 porciento), Acinetobacter calcoaceticus (9,8 porciento) y Staphylococcus aureus (8,2 porciento), fueron los gérmenes más detectados; todos mostraron niveles elevados de resistencia a los antibióticos disponibles. Se evidenció que los casos reportados fueron pacientes con alto riesgo de adquirir ISQ, y éstas fueron producidas básicamente por gérmenes gramnegativos multirresistentes a los antibióticos. Se requiere una evaluación preoperatoria del riesgo de adquirir ISQ, y la implementación de medidas de prevención y control de eficacia demostrada para estas infecciones(AU)

It is reported that surgical site infections (SSI) are frequent forms of nosocomial infections, which are originated by multiple germs (bacteria, viruses, fungi). It is intended to show the etiology of SSI among patients attended at Joaquin Albarrán Clinical and Surgical Hospital from January to March, 2000, when it was observed an increase of these infections. A study of a series of SSI cases reported by the local surveillance system of nosocomial infections was conducted. Their general characteristics, the surgical procedures performed and the causes of infection were obtained from this study. 31 patients underwent microbiological studies and 61 isolations of germs. 9.6 percent of them died and 61.9 percent had to be reoperated due to surgical complicatons. The most frequent risk factors in these patients were aging (42.8 percent) smoking (47.6 percent), and anaemia and alcoholism in 19 percent of the cases, respectively. The most detected germs were: Klebsiella pneumoniae (26.2 percent), Pseudomonas aeruginosa (21.3 percent), Escherichia coli (19.7 percent), Acinetobacter calcoaceticus (9.8 percent) and Staphylococcus aureus (8.2 percent). All of them showed elevated levels of resistance to the available antibiotics. It was proved that the reported cases were patients at high risk for having SSI and that these infections were basically produced by Gram-negative germs multiresistant to antibiotics. It is required a preoperative evaluation of the risk for acquiring SSI and the implementation of measures of prevention and control of proven efficacy for these infections(AU)
Descritores: Centro Cirúrgico Hospitalar
Infecção da Ferida Cirúrgica/etiologia
Resistência Microbiana a Medicamentos
Infecção Hospitalar/etiologia
Fatores de Risco
-Infecção da Ferida Cirúrgica/prevenção & controle
Epidemiologia Descritiva
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional



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