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Revista da Associa??o Médica Brasileira (English Edition)最新文献

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Laser therapy in oral mucositis control: a meta-analysis 激光治疗口腔粘膜炎的荟萃分析
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70506-X
André Luiz Peixoto Figueiredo , Liliane Lins , Ana Carolina Cattony , Antônio Fernando Pereira Falcão
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引用次数: 10
Evaluation of the length of hospital stay in cases of coronary artery bypass graft by payer 支付者冠状动脉旁路移植术住院时间的评价
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70464-8
Gilmara Silveira da Silva , Alexandre Gonçalves de Sousa , Douglas Soares , Flávia Cortez Colósimo , Raquel Ferrari Piotto

Objective

The length of hospital stay (LOS) allows for the evaluation of the efficiency of a given hospital facility, as well as providing a basis for measuring the number of hospital beds required to provide assistance to the population in a specific area.

Methods

A retrospective survey was conducted on a database of 3,010 patients submitted to coronary artery bypass graft (CABG) from July, 2009 to July, 2010.

Results

Among 2,840 patients that met the inclusion criteria, 92.1% had their surgery paid by the Brazilian Unified Health System (Sistema Único de Saúde - SUS) and 7.9% by health plans or themselves (non-SUS). 70.2% were male, the average age was 61.9 years old, and the average risk score (EuroScore) was 2.9%. The SUS and the non-SUS groups did not differ regarding the waiting time for surgery (WTS) (2.59 ± 3.10 vs. 3.02 ± 3.70 days for SUS and non-SUS respectively; p = 0.790), but did differ with respect to the length of stay in intensive care unit (2.17 ± 3.84 vs. 2.52 ± 2.72 days for SUS and non-SUS respectively; p < 0.001), the postoperative period (8.34 ± 10.32 vs. 9.19 ± 6.97 days for SUS and non-SUS respectively; p < 0.001), and the total LOS (10.93 ± 11.08 vs. 12.21 ± 8.20 days for SUS and non-SUS respectively; p < 0.001). The non-SUS group had more events of non-elective surgery (p = 0.002) and surgery without cardiopulmonary bypass (p = 0.012). The groups did not differ regarding the associated valve procedure (p = 0.057) nor other non-valve procedures (p = 0.053), but they did differ with respect to associated non-cardiac procedures (p = 0.017). ICU readmission (p = 0.636) and postoperative complications rates were similar in both groups (p = 0.055).

Conclusion

The Non-SUS group showed longer LOS compared to the SUS group.

目的住院时间(LOS)可用于评估特定医院设施的效率,并为衡量向特定地区的人口提供援助所需的医院病床数量提供基础。方法对2009年7月至2010年7月行冠状动脉旁路移植术(CABG)的3010例患者进行回顾性调查。结果2840例符合纳入标准的患者中,92.1%的患者手术费用由巴西统一卫生系统(Sistema Único de Saúde -SUS)支付,7.9%的患者手术费用由健康计划或自己支付(非SUS)。男性占70.2%,平均年龄61.9岁,平均风险评分(EuroScore)为2.9%。SUS组与非SUS组在手术等待时间(WTS)方面无差异(分别为2.59±3.10天和3.02±3.70天);p = 0.790),但在重症监护病房的住院时间方面存在差异(SUS组和非SUS组分别为2.17±3.84天和2.52±2.72天;p & lt;0.001), SUS组和非SUS组的术后时间分别为8.34±10.32天和9.19±6.97天;p & lt;0.001),总生存期分别为(10.93±11.08 vs. 12.21±8.20)天;p & lt;0.001)。非sus组有更多的非选择性手术事件(p = 0.002)和无体外循环手术(p = 0.012)。两组在相关瓣膜手术(p = 0.057)和其他非瓣膜手术(p = 0.053)方面没有差异,但在相关非心脏手术方面存在差异(p = 0.017)。两组ICU再入院率(p = 0.636)及术后并发症发生率相似(p = 0.055)。结论非SUS组的LOS较SUS组长。
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引用次数: 3
What is the role of endoscopic ultrasound in palliative drainage of malignant biliary obstruction? 超声内镜在恶性胆道梗阻姑息性引流中的作用是什么?
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70496-X
Jarbas Faraco Maldonado Loureiro , Everson Luiz de Almeida Artifon , Elias Jirjoss Ilias
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引用次数: 0
Age-related macular degeneration 老年性黄斑变性
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70441-7
Conselho Brasileiro de Oftalmologia (Brazilian Council of Ophthalmology)
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引用次数: 1
Two days and two very special visits at RAMB headquarters 两天,两次非常特别的访问RAMB总部
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70419-3
Bruno Caramelli
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引用次数: 0
Update on age-related macular degeneration 年龄相关性黄斑变性的最新进展
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70461-2
Wanderley M. Bernardo, Flávio Rocha Lima Paranhos, Rogério Alves Costa, Rodrigo Meirelles, Ricardo Simões
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引用次数: 0
Atopic dermatitis in adults: clinical and epidemiological considerations 成人特应性皮炎:临床和流行病学考虑
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70468-5
Raquel Leão Orfali , Marta M. Shimizu , Roberto Takaoka , Mariana C. Zaniboni , Aline S. Ishizaki , Anderson A. Costa , Ana Paula L. Tiba , Maria Notomi Sato , Valéria Aoki

Objective

Atopic dermatitis (AD) is a chronic inflammatory disease causing intense pruritus, and with typical clinical features. There are few epidemiological studies concerning AD in adults, as well as little information about its prognostic. The aim of this study was to evaluate the clinical and epidemiological course of adults with AD.

Methods

80 patients aged above 18 years (mean age = 29 years) were selected (30 males and 50 females) and interviewed about hospitalization, systemic corticoid usage, age of AD onset, and personal and/or familial history of atopy. Disease severity was evaluated through the Scoring Atopic Dermatitis (SCORAD) tool. Laboratory examination included IgE serum levels and eosinophil blood count.

Results

71 out of 80 patients referred association with respiratory symptoms (18 had asthma, 17 had rhinitis, and 36 had both conditions); nine out of 80 patients denied any respiratory disease. AD patients were divided in mild (n = 25), moderate (n = 30), and severe (n = 25); 56% had one or more hospitalizations due to AD. A positive association was found between IgE serum levels, eosinophil blood count, and disease severity.

Conclusion

Adult AD represents a clinical challenge that needs to be better characterized, since it can be misdiagnosed and interferes with the patient's social and personal life. The association of skin and respiratory atopic disease is frequent, and laboratory parameters such as circulating IgE levels and eosinophil blood count may be helpful to assess disease severity.

目的特应性皮炎(AD)是一种引起剧烈瘙痒的慢性炎症性疾病,具有典型的临床特征。关于成人阿尔茨海默病的流行病学研究很少,关于其预后的信息也很少。本研究的目的是评估成人阿尔茨海默病的临床和流行病学病程。方法选取80例年龄在18岁以上(平均年龄29岁)的患者(男性30例,女性50例),对其住院情况、全身皮质激素使用情况、AD发病年龄、个人和/或家族特应性病史进行访谈。通过评分特应性皮炎(SCORAD)工具评估疾病严重程度。实验室检查包括血清IgE水平和嗜酸性粒细胞计数。结果80例患者中71例与呼吸道症状相关(18例哮喘,17例鼻炎,36例两者兼有);80个病人中有9个没有呼吸道疾病。AD患者分为轻度(n = 25)、中度(n = 30)和重度(n = 25);56%因阿尔茨海默病住院一次或多次。血清IgE水平、嗜酸性粒细胞计数与疾病严重程度呈正相关。结论成人AD是一项临床挑战,需要更好地表征,因为它可能被误诊并干扰患者的社交和个人生活。皮肤和呼吸道特应性疾病的关联是频繁的,实验室参数如循环IgE水平和嗜酸性粒细胞计数可能有助于评估疾病的严重程度。
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引用次数: 0
Polycystic ovary syndrome and intervening factors in adolescents from 15 to 18 years old 15 ~ 18岁青少年多囊卵巢综合征及其干预因素
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70485-5
Franciane Rocha de Faria , Laís Silveira Gusmão , Eliane Rodrigues de Faria , Vivian Siqueira Santos Gonçalves , Roberta Stofeles Cecon , Sylvia do Carmo Castro Franceschini , Silvia Eloiza Priore

Objective

To assess the factors related to the presence of polycystic ovary syndrome (PCOS) in adolescents.

Methods

This was a cross-sectional study, with female adolescents from 15 to 18 years old, divided into: group 1 (with a medical diagnosis of PCOS) and group 2 (not diagnosed with PCOS). The height-for-age index and the body mass index were used for classifying the nutritional status, and a semi-structured questionnaire was applied. The Mann-Whitney test, Fisher's exact test, Spearman correlation coefficients, and logistic regression were used.

Results

This study evaluated 485 adolescents with an average age of 16.3 ± 0.9 years old. The prevalence of PCOS was 6.2%. No difference was found between the groups regarding anthropometric parameters and period of contraceptive use; however, there were differences regarding the age at menarche (p < 0.004). Older age at menarche was a protection factor against the syndrome.

Conclusion

An association was found between younger age at menarche and the development of the PCOS in adolescents.

目的探讨青少年多囊卵巢综合征(PCOS)发生的相关因素。方法采用横断面研究,将15 ~ 18岁的女性青少年分为:1组(医学诊断为多囊卵巢综合征)和2组(未诊断为多囊卵巢综合征)。采用身高年龄指数和体重指数对营养状况进行分类,采用半结构式问卷。采用Mann-Whitney检验、Fisher精确检验、Spearman相关系数和logistic回归。结果本研究共纳入485例青少年,平均年龄16.3±0.9岁。PCOS患病率为6.2%。在人体测量参数和使用避孕药的时间方面,各组之间没有差异;然而,在月经初潮年龄方面存在差异(p <0.004)。月经初潮年龄较大是预防该综合征的一个保护因素。结论初潮年龄较低与青少年多囊卵巢综合征的发生有关。
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引用次数: 0
What are the recommendations for pregnant and lactating women undergoing endoscopic procedures? 对孕妇和哺乳期妇女进行内窥镜检查有什么建议?
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70439-9
Jarbas Faraco Maldonado , Elias Jirjoss Ilias
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引用次数: 0
Medication errors in hospitals: Bioethical issues 医院用药错误:生物伦理问题
Pub Date : 2013-01-01 DOI: 10.1016/S2255-4823(13)70436-3
Gabriella Rejane dos Santos Dalmolin, José Roberto Goldim
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引用次数: 0
期刊
Revista da Associa??o Médica Brasileira (English Edition)
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