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OBJETIVO: avaliar os pacientes com escoliose idiopática do adolescente após tratamento cirúrgico, pelo questionário SF-36, comparando-os com questionário realizado no pré-operatório. MÉTODOS: entre Fevereiro de 2004 a Março de 2006 foram selecionados 28 pacientes com escoliose idiopática do adolescente, tratados cirurgicamente pela equipe de cirurgia da coluna do Hospital Mário Covas, em Santo André. Todos os pacientes foram submetidos ao tratamento cirúrgico por via posterior e artrodese com instrumentação de terceira geração. Estes pacientes possuíam descompensação do tronco e mensuração do ângulo de Cobb maior que 50º para indicação cirúrgica. Todos eles foram submetidos ao questionário SF-36 no pré-operatório, este foi repetido em um mês, seis meses, um ano e dois anos após o tratamento cirúrgico. Foi utilizado o programa SPSS (Statistical Package for Social Sciences), versão 13.0, para a análise estatística dos casos. RESULTADOS: houve diferença estatística significante em quatro domínios do SF-36: capacidade funcional, dor, aspecto social e limitação por aspectos físicos. Nos domínios saúde mental, limitação por aspectos emocionais, vitalidade e estado geral de saúde não houve diferença estatística entre os momentos observados. CONCLUSÃO: neste estudo, os pacientes com escoliose idiopática do adolescente, submetidos a tratamento cirúrgico para correção da deformidade, obtiveram melhora da qualidade de vida em aspectos físicos avaliados por meio do questionário SF-36.OBJETIVO: evaluar los pacientes con escoliosis idiopática del adolescente después del tratamiento quirúrgico por medio del cuestionario SF-36, comparándolos con el cuestionario realizado pre operatoriamente. MÉTODOS: entre Febrero de 2004 a Marzo de 2006 fueron seleccionados 28 pacientes con escoliosis idiopática del adolescente tratados quirúrgicamente por el equipo de cirugía de la columna del Hospital Mário Covas, en Santo André. Todos los pacientes fueron sometidos al tratamiento quirúrgico por vía posterior y artrodesis con instrumentación de tercera generación. Estos pacientes poseían descompensación del tronco y medida del ángulo de Cobb mayor que 50º constituyéndose en indicación quirúrgica. Todos los pacientes fueron sometidos al cuestionario SF-36 preoperatorio y repetidos con un mes, seis meses, un y dos años después del tratamiento quirúrgico. Usamos el programa SPSS (Statistical Package for Social Sciences), versión 13.0, para análisis estadístico de los casos. RESULTADOS: hubo diferencia estadística significativa en cuatro dominios del SF-36: capacidad funcional, dolor, aspecto social y limitaciones por aspectos físicos. En los dominios de salud mental, limitación pos aspectos emocionales, vitalidad y estado general de salud no hubo alguna diferencia estadística entre los momentos observados. CONCLUSIÓN: en este estudio los pacientes con escoliosis idiopática del adolescente, sometidos al tratamiento quirúrgico para corrección de la deformidad, obtuvieron una mejoría en la calidad de vida en aspectos físicos evaluados por medio del cuestionario SF-36.OBJECTIVE: to assess health-related quality of life in patients with adolescent idiopathic scoliosis by SF-36 after surgical treatment, in comparison with questionnaires done before operation. METHODS: between February 2004 and March 2006, 28 patients with adolescent idiopathic scoliosis surgically treated by the spine group of Hospital Mário Covas, in Santo André, were assessed. All the patients were treated surgically by posterior approach and fusion with third generation instrumental. These patients had trunk rotation and Cobb angle more than 50º to have surgical indication. All patients were submitted to SF-36 before and after one month, six months, one year and two years after surgery. The SPSS (Statistical Package for Social Sciences), version 13.0 for statistical analysis was used. RESULTS: statistical significant differences were noted in four domains of SF-36: physical functioning, bodily pain, role physical and social functioning. In the other four domains, general health, mental health, role emotional and vitality there were no statistical differences in the observed moments. CONCLUSION: in the present study, the patients with adolescent idiopathic scoliosis, submitted to surgical procedures for deformity correction, had better results in the physical aspects assessed by SF-36.

INTRODUÇÃO: o mieloma múltiplo é uma neoplasia maligna de proliferação monoclonal e difusa de células plasmáticas na medula óssea comum no sistema esquelético. O sítio mais frequente é a coluna vertebral. O mieloma múltiplo pode provocar dor intratável, instabilidade e déficit neurológico na coluna vertebral. O tratamento cirúrgico dessa neoplasia na coluna vertebral consiste em descompressão ampla e artrodese com ou sem instrumentação. A literatura médica apresenta poucas pesquisas com foco no resultado clínico em relação à dor e à melhora neurológica. OBJETIVO: avaliar os resultados clínicos do tratamento cirúrgico de pacientes portadores de mieloma múltiplo na coluna. MÉTODOS: estudo retrospectivo de 16 pacientes portadores de mieloma múltiplo na coluna que foram submetidos à descompressão cirúrgica com ou sem instrumentação. A extensão das lesões foi classificada de acordo com o método de Tomita. Os pacientes foram avaliados em relação à melhora dos sintomas dolorosos e em relação ao quadro neurológico de acordo com a classificação de Frankel. RESULTADOS: os quatro pacientes que apresentavam exame normal (Frankel E) permaneceram sem déficit neurológico no período pós-operatório. Dois pacientes Frankel D evoluíram para Frankel E. Dos três pacientes que apresentavam Frankel C, dois obtiveram melhora (Frankel D) e um manteve o mesmo grau de déficit. Os quatro pacientes que apresentavam Frankel B evoluíram para Frankel D após a descompressão. Déficit neurológico completo (Frankel A) estava presente em três pacientes, dois evoluíram com melhora da função neurológica (Frankel B e C) e um evoluiu a óbito no pós-operatório imediato. CONCLUSÕES: o tratamento cirúrgico do mieloma na coluna apresenta bons resultados em relação à dor e melhora do quadro neurológico em casos bem selecionados.INTRODUCCIÓN: el mieloma múltiple es una neoplasia maligna de proliferación monoclonal y difusa de células plasmáticas en la médula ósea siendo común en el sistema esquelético. El sitio más frecuente es la columna vertebral. El mieloma múltiple puede provocar dolor intratable, inestabilidad y déficit neurológico en la columna vertebral. El tratamiento quirúrgico del mieloma en la columna vertebral consiste en descompresión amplia y artrodesis con o sin instrumentación. La literatura médica presenta pocas investigaciones con enfoque en el resultado clínico en relación al dolor y mejoría neurológica. OBJETIVOS: evaluar los resultados clínicos del tratamiento quirúrgico de pacientes portadores del mieloma múltiple en columna. MÉTODOS: estudio retrospectivo de 16 pacientes portadores del mieloma múltiple en la columna que fueron sometidos a la descompresión quirúrgica con o sin instrumentación. La extensión de las lesiones fue clasificada de acuerdo con el método de Tomita. Los pacientes fueron evaluados en relación a la mejoría de los síntomas dolorosos y en relación al cuadro neurológico de acuerdo con la clasificación de Frankel. RESULTADOS: los cuatro pacientes que presentaron examen normal (Frankel E) permanecieron sin déficit neurológico en el postoperatorio. Dos pacientes Frankel D evolucionaron para Frankel E. De los tres pacientes que presentaron Frankel C, dos obtuvieron mejoría (Frankel D) y uno mantuvo el mismo grado de déficit. Los cuatro pacientes que presentaron Frankel B evolucionaron para Frankel D después de la descompresión. Déficit neurológico completo (Frankel A) estaba presente en tres pacientes, dos evolucionaron con mejoría de la función neurológica (Frankel B y C) y un evolucionó con óbito en el postoperatorio inmediato. CONCLUSIÓN: el tratamiento quirúrgico del mieloma en la columna presenta buenos resultados en relación al dolor y mejoría del cuadro neurológico en casos bien seleccionados.INTRODUCTION: multiple myeloma is a malignant neoplasm of monoclonal and diffuse proliferation of plasma cells that typically involves the bone marrow. The spine is one of the most commonly affected sites. It may cause severe intractable pain, spinal instability, or neurological complications. The surgical treatment for multiple myeloma includes open decompressive surgery and arthrodesis with or without stabilization. The medical literature presents little researches focused on clinical outcome with regard to pain and neurological improvement. OBJECTIVE: to evaluate clinical outcomes in patients surgically treated for multiple myeloma of the spine. METHODS: a total of 16 consecutive patients who underwent spinal column decompression for multiple myeloma with or without stabilization were retrospectively studied. The local extent of tumor was graded based on Tomita et al. classification. The patients were assessed with regard to pain and neurological improvement according to Frankel's classification. RESULTS: the four patients with normal examination (Frankel E) remained without neurologic deficit in the postoperative period. Two Frankel D patients evolved to Frankel E. Two Frankel C patients evolved to improvement (Frankel D) and one Frankel C patient remained with the same status. Four Frankel B patients evolved to Frankel D after decompression. Two Frankel A patients (complete neurological deficit) also improved their neurological status (Frankel B and C), and one died in the immediate postoperative period. CONCLUSIONS: surgical treatment of spinal lesions due to myeloma presents good clinical outcome based on pain and neurological improvement in well selected cases.

OBJETIVO: avaliar se existe relação entre o número de parafusos pediculares (densidade de parafusos) e o percentual de correção da curva principal no tratamento cirúrgico das escolioses neuromusculares. MÉTODOS: foram avaliados, retrospectivamente, 55 pacientes portadores de escoliose neuromuscular submetidos ao tratamento cirúrgico por meio de artrodese exclusivamente pela via posterior. Foram analisados o valor da curva pré-operatória, o percentual de correção e o valor da curva pós-operatória nas radiografias no pré-operatório e no pós-operatório imediato. Foi calculada a densidade de parafuso (número de parafusos por pedículo na área correspondente à curva principal) e avaliada a sua relação com o percentual de correção pela análise de correlação de Spearman. RESULTADOS: dos 55 pacientes, 28 (51%) eram do sexo feminino e 27 (49%) do masculino, com média de idade de 16,04 anos (dp=4,45). A doença de base mais frequente foi a paralisia cerebral. O valor da escoliose pré-operatória foi, em média, de 81,96º (dp=25,49) e da escoliose residual de 33,82º (dp=19,02), com percentual de correção de 60,28% (dp=15,89). Houve uma relação positiva (r=0,266) e estatisticamente significante entre a densidade de parafusos e a correção da deformidade (p=0,045). CONCLUSÕES: no tratamento cirúrgico das deformidades neuromusculares existe uma relação positiva entre o maior número de parafusos dentro da área da curva principal e o percentual de correção.OBJETIVO: evaluar si existe una relación entre el número de tornillos pediculares (densidad de tornillos) y el porcentual de corrección de la curva principal en el tratamiento quirúrgico de la escoliosis neuromuscular. MÉTODOS: fueron evaluados, retrospectivamente, 55 pacientes portadores de la escoliosis neuromuscular sometidos al tratamiento quirúrgico por medio de la artrodesis, exclusivamente por la vía posterior. Fueron analizados el valor de la curva preoperatoria, el porcentual de corrección y el valor de la curva postoperatoria en las radiografías pre y postoperatoria inmediata. Se calculó la densidad de tornillos (número de tornillos por pedículo en el área correspondiente a la curva principal) y se evaluó su relación con el porcentaje de corrección, por medio del análisis de corrección de Spearman. RESULTADOS: de los 55 pacientes, 28 (51%) eran del sexo femenino y 27 (49%) del masculino, con promedio de edad de 16.04 años (dp=4.45). La patología de base más común fue la parálisis cerebral. El valor de la escoliosis preoperatoria fue en promedio de 81.96º (dp=25.49) y de la escoliosis residual de 33.82º (dp=19.02), con porcentual de corrección de 60.28% (dp=15.89). Hubo una relación positiva (r=0.266) y estadísticamente significativa entre la densidad de los tornillos y la corrección de la deformidad (p=0.045). CONCLUSIONES: en el tratamiento quirúrgico de las deformidades neuromusculares, hay una relación positiva entre el mayor número de tornillos dentro del área de la curva principal y el porcentual de corrección.OBJECTIVE: to investigate if the number of pedicular screw (screw density) within the major curve correlates with the curve correction in the surgical treatment of neuromuscular scoliosis. METHODS: a total of 55 patients with neuromuscular scoliosis that were exclusively submitted to posterior spinal fusion with pedicular screw constructs were retrospectively investigated. Data included major curve measurements assessed on pre and immediate postoperative radiographs, and the percentage of curve correction. The screw density (number of screw within the major curve relative to the number of available implant sites) was calculated; its relationship with the percentage of the curve correction was evaluated by the Spearman's rank correlation coefficient. RESULTS: twenty-eight (51%) females and 27 (48%) males were analyzed, with mean age of 16.04 years (sd=4.45). The commonest base pathology was the cerebral palsy. The preoperative Cobb angle was 81.96º (sd=25.49) and postoperative Cobb angle was 33.82º, (sd=19.02), with averaged curve correction of 60.28% (sd=15.89). There was a significant correlation between screw density and curve correction (r=0.266; p=0.045). CONCLUSIONS: major curve correction correlates positively with the number of pedicular screw within the curve in the surgical treatment of neuromuscular scoliosis.

OBJETIVO: avaliar o poder de correção do parafuso pedicular em comparação ao sistema de Luque-Galveston no tratamento cirúrgico da escoliose neuromuscular. MÉTODOS: foram avaliados 74 pacientes submetidos à artrodese exclusivamente pela via posterior, estendendo-se da região torácica alta ao sacro. Vinte e quatro pacientes foram submetidos à fixação com sistema de Luque-Galveston (Grupo 1) e 50, com parafusos pediculares (Grupo 2). Foram avaliadas as radiografias pré-operatórias, em tração e no pós-operatório imediato e mediu-se o valor da curva principal do período pré-operatório (Cobb pré), na tração (Cobb tração), e no pós-operatório (Cobb pós), e calculou-se a flexibilidade da curva e a correção final. Também foi calculado o Índice de Cincinnati, que leva em consideração a correção final e a flexibilidade (Cincinnati = Correção/Flexibilidade). Os mesmos parâmetros foram calculados para a obliquidade pélvica (OP): OP pré, OP tração, OP pós, Flexibilidade OP, Correção OP e Índice de Cincinnati para OP. RESULTADOS: a média da idade dos pacientes do Grupo 1 foi de 12,24 anos e do Grupo 2, de 16,13 anos (p=0,001). No Grupo 1, a principal doença foi a amiotrofia espinhal (38%) e no Grupo 2, a paralisia cerebral (62%). O ângulo de Cobb pré foi de 76,67º para o Grupo 1 e 85,54º para o Grupo 2. A flexibilidade foi de 45,32% para o Grupo 1 e 39,47% para o Grupo 2. A Correção foi de 63,07% para o Grupo 1 e 59,80% para o Grupo 2. O índice de Cincinnati para o Grupo 1 foi de 1,44 e de 1,71 para o Grupo 2. Quanto à OP, tivemos OP pré de 20,71º para o Grupo 1 e 26,60º para o Grupo 2. A Flexibilidade OP foi de 73,61% para o Grupo 1 e 56,54% para o Grupo 2 (p=0,047). A Correção OP foi de 73,47% para o Grupo 1 e de 72,11% para o Grupo 2. O Índice de Cincinnati da OP foi de 1,09 e 1,49, respectivamente para os Grupos 1 e 2 (p=0,045). CONCLUSÕES: a instrumentação com parafusos pediculares mostrou correção da escoliose semelhante à fixação com Luque-Galveston e maior poder de correção da obliquidade pélvica no tratamento das deformidades neuromuscluares.OBJETIVO: evaluar el poder de corrección del tornillo pedicular comparado al sistema de Luque-Galveston en el tratamiento quirúrgico de la escoliosis neuromuscular. MÉTODOS: fueron evaluados 74 pacientes sometidos a la artrodesis exclusivamente por la vía posterior, extendiéndose de la región torácica alta a la sacra. De estos pacientes, 24 fueron sometidos a la fijación con sistema de Luque-Galveston (Grupo 1) y 50 con tornillos pediculares (Grupo 2). Fueron evaluadas las radiografías preoperatorias, en tracción y en el postoperatorio inmediato, además de medido el valor de la curva principal preoperatoria (Cobb pre), en tracción (Cobb tracción) y en el postoperatorio (Cobb post). También fue calculada la flexibilidad de la curva y la corrección final. Fue calculado el índice de Cincinnati que lleva en consideración la corrección final y la flexibilidad (Cincinnati=corrección/flexibilidad). Los mismos parámetros fueron calculados para la oblicuidad pélvica (OP): OP pre, OP tracción, OP post, flexibilidad OP, corrección OP e índice de Cincinnati para OP. RESULTADOS: el promedio de edad de los pacientes del Grupo 1 fue de 12.24 años y del Grupo 2 de 16.13 años (p=0.001). En el Grupo 1, la principal patología fue la amiotrofia espinal (38%) y en el Grupo 2, la parálisis cerebral (62%). O Cobb pre fue de 76.67º para el Grupo 1 y 85.54º para el Grupo 2. La flexibilidad fue de 45.32% para el Grupo 1 y 39.47% para el Grupo 2. La corrección fue de 63.07% para el Grupo 1 y 59.80% para el Grupo 2. El índice de Cincinnati para el Grupo 1 fue de 1.44 y de 1.71 para el Grupo 2. Según el OP, tuvimos OP pre de 20.71º para el Grupo 1 y 26.60º para el Grupo 2. La flexibilidad OP fue de 73.61% para el Grupo 1 y 56.54% para el Grupo 2 (p=0.047). La corrección OP fue de 73.47% para el Grupo 1 y 72.11% para el Grupo 2. El índice de Cincinnati de la OP fue de 1.09 y 1.49, respectivamente para los Grupos 1 y 2 (p=0.045). CONCLUSIONES: la instrumentación con tornillos pediculares mostró corrección de la escoliosis semejante a la fijación con Luque-Galveston y mayor poder de corrección de la oblicuidad pélvica en el tratamiento de las deformidades neuromusculares.OBJETIVE: to compare the correction of the major curve and pelvic obliquity using Luque-Galveston instrumentation and pedicle screw constructs in the treatment of neuromuscular scoliosis. METHODS: seventy-four patients treated by fusion posterior to the sacrum were investigated using preoperative, traction and postoperative radiographs. Twenty-four cases were submitted to Luque-Galveston instrumentation (Group 1) and fifty were submitted to pedicle screw fixation (Group 2). Radiographic parameters were: major curve angle in the preoperative (Cobb preop), traction (Cobb traction), and postoperative films (Cobb postop), flexibility, final correction, and the Cincinnati Index, which correlates final correction and flexibility (Cincinnati = Correctioln / Flexibility). The same parameters were analyzed for pelvic obliquity (PO): PO preop, PO traction, PO postop, Flexibility PO, Correction PO, and Cincinnati Index for PO. RESULTS: mean age in the Group 1 was 12.24 years and 16.13 years in the Group 2 (p=0.001). The commonest disease in Group 1 was spinal muscular atrophy (38%) and in Group 2, cerebral palsy (62%). The mean major curve angle was 76.67º in Group 1 and 85.54º in Group 2. Flexibility was 45.32% in Group 1 and 39.47% in Group 2. Postoperative correction was 63.07% in Group 1 and 59.8% in Group 2. Cincinnati Index was 1.44 in the Group 1 and 1.77 in the Group 2. Mean PO preop was 20.71º in Group 1 and 26.60º in Group 2. PO Flexibility was 73.61% in Group 1 and 56.54% in Group 2 (p=0.047). PO Correction was 73.47% in Group 1 and 72.11% in Group 2. Cincinnati Index for PO was 1.09 in Group 1 and 1.49 in Group 2 (p=0.045). CONCLUSIONS: postoperative major curve correction was similar with pedicle screws and Luque-Galveston instrumentation, but pelvic obliquity correction was greater when pedicle screw was used in the surgical treatment of neuromuscular scoliosis.

INTRODUÇÃO: a cifose pós-traumática é uma complicação do tratamento conservador da fratura toracolombar tipo explosão. A maioria das séries avalia todos os subtipos de Magerl e discute seus achados com base na perda média de cifose no acompanhamento. OBJETIVO: avaliação do desfecho radiográfico quanto à cifose nos portadores de fraturas do subtipo A3 de Magerl de acordo com a variação das médias entre os indivíduos após acompanhamento mínimo de um ano. MÉTODOS: estudo retrospectivo com 36 pacientes submetidos à realização de gesso antigravitacional ou colete TLSO. A mensuração da cifose foi realizada pelo método de Cobb no momento da admissão no hospital e no final do acompanhamento médio de 66 meses. RESULTADOS: não houve diferença estatística entre a cifose antes e após o tratamento (12,2° versus 13,4°; p=0,2544). CONCLUSÃO: a cifose radiográfica no final do acompanhamento é similar à cifose encontrada nas radiografias iniciais neste grupo de pacientes.INTRODUCCIÓN: la cifosis postraumática es una complicación del tratamiento conservador de la fractura toracolumbar tipo explosión. La mayoría de las series evalúan todos los subtipos de Magerl y discuten sus resultados con base en la pérdida promedio de cifosis en el acompañamiento. OBJETIVO: evaluación del desenlace radiográfico según la cifosis en los portadores de fracturas del subtipo A3 de Magerl, de acuerdo con la variación de los promedios entre los individuos después de un acompañamiento mínimo de un año. MÉTODOS: estudio retrospectivo con 36 pacientes sometidos a la realización de yeso antigravitacional o chaleco TLSO. La medición de la cifosis fue realizada por el método de Cobb en el momento de la admisión en el hospital y en el final del acompañamiento promedio de 66 meses. RESULTADOS: no hubo diferencia estadística entre la cifosis antes y después del tratamiento (12.2° versus 13.4°; p=0.2544). CONCLUSIÓN: la cifosis radiográfica en el final del acompañamiento es similar a la encontrada en las radiografías iniciales en este grupo de pacientes.INTRODUCTION: the post-traumatic kyphosis is a complication reported after conservative treatment of thoracolumbar burst fracture. The majority of the series evaluates all subtypes of Magerl and discuss their findings based on the average loss of kyphosis during the follow-up. OBJECTIVE: evaluation of radiographic outcomes regarding kyphosis in patients with fractures subtype A3 of Magerl according to the average variation between individuals after follow-up of at least one year. METHODS: retrospective study with 36 patients treated with hyperextension cast or TLSO brace. The measurement of kyphosis was performed by means of Cobb method at the admission to the hospital and at the end of mean follow-up of 66 months. RESULTS: there was no statistical difference between the kyphosis before and after treatment (12.2° versus 13.4°, p=0.2544). CONCLUSION: the radiographic kyphosis at final follow-up and in the initial radiographs is similar in this group of patients.

Introduction: Asthma represents a real health problem which is widely spread around the world; and it has had an important increase in our municipality. Objective: Describing the behavior of the patients with status asthmaticus during a 6 year period at the 26 th of December General Teaching Hospital in Remedios municipality. Method: A retrospective, descriptive and longitudinal study, including 200 patients with a positive diagnosis of this condition, was carried out. Results: The most frequent age group was between 20 and 30 years of age (42.55%). The non-white race was the most susceptible (75.0%). Among the risk factors the most important one was the exposure to large amounts of allergens (28.5%). Most of the cases (71.0%) were diagnosed in the secondary health care, and 49. 0 percent of the patients did not comply with the inter-crises treatment due to oversight. The clinical evolution two hours after the treatment showed an increase of 10.0 percent with respect to the first hour. Pneumonia was the main complication with 34.0 percent. Conclusions: The most frequent age group was between 20 and 30 years of age, the no-white race was predominant, the main risk factor was the exposure to large amounts of allergens. Among the causes of the lack of inter-crises treatment we found the carelessness of the patients. A positive evolution was seen after two hours of treatment, and pneumonia was the most frequent complication.

O objetivo deste estudo foi conhecer os fatores que interferem na adesão à terapêutica medicamentosa em crianças infectadas pelo HIV/AIDS, relatados por 12 cuidadores em um serviço de referência em AIDS, em Fortaleza-CE. Os dados foram obtidos mediante entrevista, e, com eles, foram apurados fatores que dificultaram a adesão terapêutica, evidenciando relatos referentes à apresentação da droga, horário da tomada do medicamento, efeitos colaterais, falta na distribuição de medicamento gratuito, dificuldade de acesso regular ao serviço de saúde e problemas financeiros. Constatou-se a importância de conhecer o contexto social no qual a criança está inserida e as dificuldades no uso dos anti-retrovirais para intervir de forma eficiente e possibilitar uma melhor qualidade de vida às crianças.La finalidad de este estudio fue conocer los factores que interfieren en la adherencia a la terapéutica medicamentosa en niños infectados por el VIH/sida relatados por 12 cuidadores en un servicio de referencia en sida, en Fortaleza-CE, Brasil. Los datos fueron obtenidos mediante entrevista, y, con ellos fueran apurados factores que dificultaron la adherencia terapéutica, evidenciando relatos referentes a la presentación de la droga, horario de la toma del medicamento, efectos colaterales, falta en la distribución de medicamento gratuito, dificultad de acceso regular al servicio de salud y problemas financieros. Se constató la importancia de conocer el contexto social en que el niño está insertado y las dificultades en el uso de los anti-retrovirales para intervenir de forma eficiente y posibilitar una mejor calidad de vida a los niños.This study aimed to get to know the factors that interfere in medication treatment adherence among children infected by HIV/aids, as reported by 12 caregivers in a service reference to aids in Fortaleza/CE, Brazil. Data were collected through interviews, verifying factors that made treatment adherence difficult, evidencing reports about drug forms, time of medication intake, collateral effects, shortage in the free drugs distribution, difficulty to get regular access to the health service and financial problems. The importance was revealed of getting to know the social context the child is inserted in and the difficulties in the use of antiretroviral drugs, so as to intervene efficiently and permit a better quality of life for the children.

It is presented the case of a 28 years-old white male patient, who suffered from moderate and also advanced chronic inflammatory disease located in the anteroposterior and inferior sectors, which brought on pathological migrations and stressed dental mobility of incisors. It was decided a multidisciplinary orthodontic-periodontal treatment. The treatment began by deactivating the periodontal disease using a scaling and root planning. For the correction of occlusion the authors used the fixed orthodontic appliances after the zone had been recuperated. In this research work appear pictures, in which can be seen the satisfactory evolution of patient.

Este estudo descreve a visão do portador de esquizofrenia sobre seu cotidiano após o uso da clozapina e acompanhamento em grupo. A amostra foi constituída por 11 pacientes que participam do grupo de medicações atípicas (GRUMA) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. Para coleta de dados, utilizou-se uma entrevista semi-estruturada, guiada por um roteiro, em abril de 2003. As entrevistas foram gravadas e, posteriormente, transcritas na íntegra. Obteve-se, como resultados, melhora do paciente quanto aos sintomas da doença, evidenciada pela diminuição do isolamento social, retomada das atividades domésticas/trabalho, estudo e participação em atividades de convívio social. Tais resultados apontam para a necessidade de um novo olhar dirigido ao portador de transtorno mental, no sentido de buscar atitudes terapêuticas adequadas, que atuem na produção de vida, visando a um novo sentido para a existência, nas diferentes formas de convivência e de sociabilidade.Este estudio describió el punto de vista de los portadores de esquizofrenia en su cotidiano después del uso de clozapina y acompañamiento en grupo. La muestra fue constituida por 11 portadores de esquizofrenia que participaron del grupo de medicación clozapina del Hospital das Clínicas de Ribeirao Preto/USP. Para la colección de datos se utilizó una entrevista orientada por guión, en abril de 2003. Las entrevistas fueron registradas y después transcritas por entero. Los resultados indicaron la mejoría de los pacientes con respecto a los síntomas de la enfermedad, evidenciada por la disminución del aislamiento social, recomienzo de actividades domésticas/trabajo, estudio y participación en actividades de convivencia social. Tales resultados señalan la necesidad de una nueva manera de mirar el portador de trastorno mental y sus familiares en el sentido de buscar actitudes terapéuticas que actúen en la producción de vida, en un nuevo sentido para la existencia, en las diferentes formas de convivencia y de sociabilidad.This study was carried out with a sample of 11 patients who are part of the atypical medication group at the Hospital das Clínicas of the University of São Paulo at Ribeirão Preto's School of Medicine. For data collection semi-structured interviews guided by a script were held in April 2003. The interviews were first taped and fully transcribed afterwards. Results indicated an improvement in patients' symptoms, demonstrated by decreased social isolation, resumption of home/work activities and studies, as well as by participation in social events. They also point out to the need for a new vision regarding patients who suffer from mental disorders and their family members in the sense of searching for adequate therapeutic attitudes that have an impact on the production of life, aimed at giving a new existential meaning in the different forms of social contact and sociability.

Background: Immunotherapy efficacy in the control of patients affected by allergic diseases has been quite proved since 1911, it is of great importance for their betterment. Objectives: To determine the adherence to the treatment and patient´s satisfaction with control immunotherapy. Methods: A study made in the ¨Dr. Gustavo Aldereguia Lima¨ Hospital, where 100 patients from the external allergy consulter were evaluated for a year. Authorized personnel checked out the level of fulfilment of the security rules, clinical betterment was evaluated with a daily control of symptoms correlated with clinical history of allergy, and satisfaction was evaluated through a questionaire.Results: The 82% fits correctly with the treatment program, the 94% presented clinical betterment, and the 90% has an excellent satisfaction level.

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article summarizes the 30+-year evidence base of Multidimensional Family Therapy ( MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, ; and Europe-based organization is ) all support the potential for continued transfer of MDFT to real-world clinical settings. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study sought to determine the influence of postoperative complications on the clinical outcomes of patients who underwent thoracic and gastrointestinal cancer surgery. Methods: A prospective cohort study was conducted regarding 179 consecutive patients who received thorax or digestive tract surgery due to cancer and were admitted to an oncological intensive care unit. The Postoperative Morbidity Survey was used to evaluate the incidence of postoperative complications. The influence of postoperative complications on both mortality and length of hospital stay were also assessed. Results: Postoperative complications were found for 54 patients (30.2%); the most common complications were respiratory problems (14.5%), pain (12.9%), cardiovascular problems (11.7%), infectious disease (11.2%), and surgical wounds (10.1%). A multivariate logistic regression found that respiratory complications (OR = 18.68; 95%CI = 5.59 - 62.39; p < 0.0001), cardiovascular problems (OR = 5.06, 95%CI = 1.49 - 17.13; p = 0.009), gastrointestinal problems (OR = 26.09; 95%CI = 6.80 - 100.16; p < 0.0001), infectious diseases (OR = 20.55; 95%CI = 5.99 - 70.56; p < 0.0001) and renal complications (OR = 18.27; 95%CI = 3.88 - 83.35; p < 0.0001) were independently associated with hospital mortality. The occurrence of at least one complication increased the likelihood of remaining hospitalized (log-rank test, p = 0.002). Conclusions: Postoperative complications are frequent disorders that are associated with poor clinical outcomes; thus, structural and procedural changes should be implemented to reduce postoperative morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objective. To assess the implementation of HIV-related interventions for patients with tuberculosis (TB), as well as TB treatment outcomes in patients coinfected with HIV in Brazil in 2011. Methods. This was a cross-sectional, operational research study of HIV-related interventions among TB cases and the sociodemographic and clinical characteristics of TB-HIV coinfected patients. It also used a retrospective cohort design to determine the association between antiretroviral therapy (ART) and favorable TB treatment outcomes. The source of data was a linkage of 2011 administrative health databases used by the National TB and HIV/AIDS Programs. Results. Of 73 741 new cases of TB reported, 63.6% (46 865 patients) were tested for HIV; 10.3% were positive. Of patients with HIV, 45.9% or 3 502 were on ART. TB favorable outcome was achieved in 63.1% or 2 205 coinfected patients on ART and in only 35.4% or 1 459 of those not on ART. On multivariate analysis, the relative risk for the association between ART and TB treatment success was 1.72 (95% Confidence Interval = 1.64-1.81). Conclusions. The linkage between national TB and HIV datasets has created a convenient baseline for ongoing monitoring of HIV testing, ART use, and TB treatment outcomes among coinfected patients. The low rates of HIV screening and ART use in 2011 need to be improved. The association between ART and treatment success adds to the evidence supporting timely initiation of ART for all patients with TB-HIV coinfection. [ABSTRACT FROM AUTHOR]

INTRODUCCIÓN: En la Nutrición Parenteral Total (NPT) los equipos multidisciplinarios de soporte nutricional (EMSN) deben proporcionar una asistencia nutricional de calidad basada en la evidencia y en el seguimiento diario de los pacientes sometidos a NPT. Objetivos: Evaluar el grado de cumplimiento de los estándares de calidad en la asistencia prestada a los pacientes con NPT por parte del EMSN en dos períodos anuales sucesivos, de acuerdo con indicadores de estructura, proceso y resultado previamente definidos en el protocolo de trabajo del equipo. PACIENTES Y MÉTODOS: Estudio prospectivo de todos los pacientes que recibieron NPT en nuestro centro (hospital general docente con 421 camas) durante el año 2002 y durante el año 2003, utilizando los datos introducidos en NUTRIDATA© mediante el seguimiento diario de las condiciones clínicas, analíticas y complicaciones nutricionales y no nutricionales, comparando ambos períodos y considerando un nivel de significación de p < 0,05. RESULTADOS: 163 y 145 pacientes recibieron NPT durante 2002 y 2003 (65,90% varones), con parámetros similares en cuanto a sexo, edad, motivos de NPT, estado nutricional inicial, aporte nutricional medio y complicaciones no nutricionales. Respecto a los diferentes indicadores de calidad establecidos en el estudio comparativo encontramos una significativa mejoría en el año 2003 vs 2002 en cuanto a la valoración antropométrica inicial (71,03% vs 51,53%, p < 0,001), valoración bioquímica inicial (97,93% vs 92,63%, pINTRODUCTION: In total parenteral nutrition (TPN) nutritional support multidisciplinary teams (NSMT) must provide a high quality nutritional assistance based on evidence and daily follow-up of patients with TPN. Objectives: To assess the degree of adherence to quality standards of care provided to patients on TPN by the NSMT in two consecutive annual periods,according to structure, procedure, and outcomes indicators, previously defined in the team working protocol. PATIENTS AND METHODS: Prospective study of all patients that received TPN at our Center (421-bed general teaching hospital) during the years 2002 and 2003, using the data introduced in NUTRIDATA® by daily follow-up of clinical and analytical conditions, and nutritional and non-nutritional complications, comparing both periods and considering an statistical significance level of p

OBJECTIVE: Sexually transmitted infection (STI) services were offered by the nongovernmental organization Médecins Sans Frontières-Holland in Banteay Meanchey province, Cambodia, between 1997 and 1999. These services targeted female sex workers but were available to the general population. We conducted an evaluation of the operational performance and costs of this real-life project. METHODS: Effectiveness outcomes (syndromic cure rates of STIs) were obtained by retrospectively analysing patients' records. Annual financial and economic costs were estimated from the provider's perspective. Unit costs for the cost-effectiveness analysis included the cost per visit, per partner treated, and per syndrome treated and cured. FINDINGS: Over 30 months, 11 330 patients attended the clinics; of these, 7776 (69%) were STI index patients and only 1012 (13%) were female sex workers. A total of 15 269 disease episodes and 30 488 visits were recorded. Syndromic cure rates ranged from 39% among female sex workers with genital ulcers to 74% among men with genital discharge; there were variations over time. Combined rates of syndromes classified as cured or improved were around 84-95% for all syndromes. The total economic costs of the project were US$ 766 046. The average cost per visit over 30 months was US$ 25.12 and the cost per partner treated for an STI was US$ 50.79. The average cost per STI syndrome treated was US$ 48.43, of which US$ 4.92 was for drug treatment. The costs per syndrome cured or improved ranged from US$ 46.95-153.00 for men with genital ulcers to US$ 57.85-251.98 for female sex workers with genital discharge. CONCLUSION: This programme was only partly successful in reaching its intended target population of sex workers and their male partners. Decreasing cure rates among sex workers led to relatively poor cost-effectiveness outcomes overall despite decreasing unit costs.

Strategies for confronting the epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) have included a range of different approaches that focus on prevention and treatment. However, debate persists over what levels of emphasis are appropriate for the different components of the global response. This paper presents an overview of this debate and briefly summarizes the evidence on a range of interventions designed to prevent the spread of HIV infection, paying particular attention to voluntary counselling and testing, treatment for sexually transmitted infections and prevention of mother-to-child transmission. We also review the experience with antiretroviral therapy to date in terms of response rates and survival rates, adherence, drug resistance, behavioural change and epidemiological impact. Although various studies have identified strategies with proven effectiveness in reducing the risks of HIV infection and AIDS mortality, considerable uncertainties remain. Successful integration of treatment and prevention of HIV/AIDS will require a balanced approach and rigorous monitoring of the impact of programmes in terms of both individual and population outcomes.

This study presents a survey conducted among 132 Tuberculosis patients submitted to Supervised Treatment between 01/1998 and 12/1999, with a view to describing epidemiological aspects, according to the gender, (final) treatment result and HIV immunology result variables. The number of patients covered by Supervised Treatment rose from 19% to 30%. For each of these years, 64% and 71% of the patients were male, while 89% and 77% evolved towards cure. The rate of abandonment increased from 7% to 10%, while 4% and 10% of the patients died of Tuberculosis. The Tb/HIV co-infection represented 22% and 42% of the cases. The obtained results disclosed a tendency towards the gradual amplification of Supervised Treatment and its implementation implied.El estudio presenta un inventario realizado con 132 enfermos de Tuberculosis, sometidos al Tratamiento Supervisado desde 01/1998 hasta 12/1999, con el objetivo de describir aspectos epidemiológicos de acuerdo con las variables sexo, resultado de tratamiento y resultado de serología para HIV. La cobertura aumentó de 19% a 30%, con 64% y 71% del sexo masculino; 89% y 77% evolucionaron a la recuperación. Es posible explicar la disminución por la inclusión de pacientes de AIDS que son tratados en una de las Unidades existentes. Ocurrió un aumento de la tasa de abandono de 7% a 10% y 4% y 10% de los enfermos fallecieron por Tuberculosis. La coinfección Tb/HIV representó 22% y 42% de los casos. Los resultados manifiestan una tendencia en ampliar el Tratamiento Supervisado gradualmente pues su implantación puede implicar importantes alteraciones en los indicadores epidemiológicos de la Tuberculosis.O trabalho apresenta um levantamento realizado com 132 doentes de Tuberculose, submetidos ao Tratamento Supervisionado no período de 01/1998 a 12/1999, com objetivo de descrever aspectos epidemiológicos segundo as variáveis sexo, resultado de tratamento e resultado de sorologia para HIV. A cobertura aumentou de 19% para 30%, sendo 64% e 71% do sexo masculino; 89% e 77% evoluíram para a cura. Este decréscimo pode ser explicado pela inclusão dos doentes de AIDS tratados em uma das Unidades existentes. Houve um aumento da taxa de abandono de 7% para 10% e 4% e 10% dos doentes foram a óbito por Tuberculose. A co-infecção Tb/HIV representou 22% e 42% dos casos. Os resultados evidenciaram uma tendência em ampliar o Tratamento Supervisionado gradativamente, pois sua implantação pôde implicar em importantes alterações nos indicadores epidemiológicos da Tuberculose.

OBJECTIVE: To assess the factors affecting demand for an HIV/AIDS vaccine among adults in their prime earning and childbearing years and the impact of vaccination on risk behaviour in a high-prevalence, low-income country. METHODS: A contingent valuation survey of 1677 adults aged 18-60 years was conducted in 12 districts in Uganda. Respondents were asked about a hypothetical vaccine to prevent HIV infection. Households were randomly assigned survey questionnaires with one of two levels of vaccine efficacy (50% or 95%) and one of five prices. The influence of demographic characteristics, vaccine efficacy, self-assessed risk of infection, price, and household assets on vaccine demand was assessed using multivariate regression analysis. FINDINGS: Altogether, 94% (1576/1677) of respondents would be willing to be vaccinated with a free HIV/AIDS vaccine; 31% (78/251) would not be willing to be vaccinated at a price of 5000 Ugandan shillings (US$ 2.86). Household wealth, vaccine price, and risk behaviour were significant determinants of individual demand. Demand was equally high for both low-efficacy and high-efficacy vaccines. Respondents believed that condom use would be slightly less necessary with a high-efficacy vaccine (655/825; 79.4%) than a low-efficacy vaccine (690/843; 81.8% ). However, reported condom use with partners other than spouses in the absence of a vaccine was much lower (137/271; 50.6%), with 26% (175/670) of men and 9.5% (96/1007) of women reporting having had partners other than their spouses during the past year. CONCLUSION: The high demand for an AIDS vaccine of any level of efficacy can be explained by the heavy toll of AIDS in Uganda: 72% (990/1371) of respondents had lost a family member to the disease. An AIDS vaccine would be self-targeting: those with a greater chance of becoming infected and spreading HIV would be more likely to seek a vaccine, improving the efficiency of vaccination programmes. However, high levels of risk behaviour in the population suggest that a low-efficacy vaccine alone would have only a limited impact on the epidemic.

OBJECTIVE: To assess the short-term and long-term impact of selective mass treatment with ivermectin on the prevalence of intestinal helminthiases and parasitic skin diseases in an economically depressed community in north-east Brazil. METHODS: An intervention was carried out in a traditional fishing village in north-east Brazil where the population of 605 is heavily affected by ectoparasites and enteroparasites. The prevalence of intestinal helminths was determined by serial stool examination and the prevalence of parasitic skin diseases by clinical inspection. A total of 525 people out of a target population of 576 were treated at baseline. The majority of these were treated with ivermectin (200 µg/kg with a second dose given after 10 days). If ivermectin was contraindicated, participants were treated with albendazole or mebendazole for intestinal helminths or with topical deltamethrin for ectoparasites. Follow-up examinations were performed at 1 month and 9 months after treatment. FINDINGS: Prevalence rates of intestinal helminthiases before treatment and at 1 month and 9 months after mass treatment were: hookworm disease 28.5%, 16.4% and 7.7%; ascariasis 17.1%, 0.4% and 7.2%; trichuriasis 16.5%, 3.4% and 9.4%; strongyloidiasis 11.0%, 0.6% and 0.7%; and hymenolepiasis 0.6%; 0.4% and 0.5%, respectively. Prevalence rates of parasitic skin diseases before treatment and 1 month and 9 months after mass treatment were: active pediculosis 16.1%, 1.0% and 10.3%; scabies 3.8%, 1.0% and 1.5%; cutaneous larva migrans 0.7%, 0% and 0%; tungiasis 51.3%, 52.1% and 31.2%, respectively. Adverse events occurred in 9.4% of treatments. They were all of mild to moderate severity and were transient. CONCLUSION: Mass treatment with ivermectin was an effective and safe means of reducing the prevalence of most of the parasitic diseases prevalent in a poor community in north-east Brazil. The effects of treatment lasted for a prolonged period of time.

Introducción: Revisiones sistemáticas previas han apoyado la eficacia del consejo médico, como intervención breve, en el abordaje de bebedores excesivos detectados en la asistencia primaria. Sin embargo, estos resultados no pueden extrapolarse directamente a poblaciones que, como las mediterráneas, no están representadas en dichas revisiones. El objetivo de este estudio fue actualizar la evidencia sobre la eficacia de la intervención breve en consumidores excesivos de alcohol según estudios españoles. Métodos: Búsqueda de estudios en bases bibliográficas y consultas a expertos para localizar estudios no publicados. Se calcularon las estimaciones combinadas para dos variables de resultado, la reducción del consumo de alcohol y la disminución de la frecuencia de bebedores excesivos. Resultados: Dos de los 5 estudios localizados no estaban incluidos en una revisión previa. La eficacia de la intervención breve fue moderada para la disminución del consumo de alcohol (d = - 0,46; intervalo de confianza (IC) del 95%, - 0,29 a - 0,63; p < 0,0005; el grupo tratado mejoró un 22% más que el control) y pequeña para la disminución de la frecuencia de bebedores excesivos (OR = 1,55; IC del 95%, 1,06 a 2,26; p = 0,02; el grupo tratado mejoró un 11% más que el control). El análisis basado en el cumplimiento del protocolo sobrestimó 1,5 veces el tamaño del efecto respecto del análisis basado en la intención de tratamiento. Conclusiones: Los resultados del estudio señalan que, en nuestro país, la intervención breve en atención primaria sobre bebedores a riesgo es eficaz, aunque su efecto sea sólo moderado.Introduction: Former systematic reviews have backed the efficacy of medical counselling, a form of brief intervention, on the treatment of excessive drinkers detected in primary care settings. Nevertheless, these results cannot be applied without criticism to Mediterranean populations which, so far, have not been represented in the aforementioned studies. The aim of the present study was to update the results on the efficacy of brief interventions in primary care by pooling Spanish studies. Methods: Studies were searched for by using appropriate databases and also by consulting to experts in the field to retrieve grey literature. Pooled estimations of effect sizes were calculated for two outcomes, the reduction in the amount of alcohol consumption and the decrease in the number of excessive drinkers. Results: Two over the 5 retrieved studies were not included in a former review. The effect size regarding the decrease of alcohol consumption was medium (d = - 0.46; 95% CI, - 0.29 to - 0.63; p < 0.0005; the intervention group outperformed the control by a 22%) and small for the decrease in the frequency of excessive drinkers (OR = 1.55; 95% CI, 1.06 to 2.26; p = 0.02; the intervention group outperformed the control by a 11%). The analysis by complimented protocols at the end of the study showed an effect size 1.5 times larger than the analysis performed on intention-to-treat basis. Conclusions: The results of this meta-analysis support the efficacy of brief intervention for excessive drinkers in primary care settings in Spain.

Introducción: Revisiones sistemáticas previas han apoyado la eficacia del consejo médico, como intervención breve, en el abordaje de bebedores excesivos detectados en la asistencia primaria. Sin embargo, estos resultados no pueden extrapolarse directamente a poblaciones que, como las mediterráneas, no están representadas en dichas revisiones. El objetivo de este estudio fue actualizar la evidencia sobre la eficacia de la intervención breve en consumidores excesivos de alcohol según estudios españoles. Métodos: Búsqueda de estudios en bases bibliográficas y consultas a expertos para localizar estudios no publicados. Se calcularon las estimaciones combinadas para dos variables de resultado, la reducción del consumo de alcohol y la disminución de la frecuencia de bebedores excesivos. Resultados: Dos de los 5 estudios localizados no estaban incluidos en una revisión previa. La eficacia de la intervención breve fue moderada para la disminución del consumo de alcohol (d = - 0,46; intervalo de confianza (IC) del 95%, - 0,29 a - 0,63; p < 0,0005; el grupo tratado mejoró un 22% más que el control) y pequeña para la disminución de la frecuencia de bebedores excesivos (OR = 1,55; IC del 95%, 1,06 a 2,26; p = 0,02; el grupo tratado mejoró un 11% más que el control). El análisis basado en el cumplimiento del protocolo sobrestimó 1,5 veces el tamaño del efecto respecto del análisis basado en la intención de tratamiento. Conclusiones: Los resultados del estudio señalan que, en nuestro país, la intervención breve en atención primaria sobre bebedores a riesgo es eficaz, aunque su efecto sea sólo moderado.

Visual loss causes enormous suffering to both the patients and their families. About 80% of blindness is avoidable (preventable or curable). Therefore, we present four cases treated for several years in the low vision consultation of the Gustavo Aldereguía Lima University General Hospital of Cienfuegos due to a functional diversity secondary to various ophthalmologic conditions including high hyperopia, high myopia, chronic simple glaucoma at stage 4 and uncorrected aphakia. An extracapsular extraction with intraocular lens implantation was performed, using a primary Piggyback in one of them. All cases showed satisfactory results in various parameters such as visual acuity, visual field and reduced refractive error; thus, it was possible to improve the quality of life of these patients as well as their social and school inclusion. [ABSTRACT FROM AUTHOR]

Se realiza un estudio de 51 pacientes con cáncer de esófago, los cuales recibieron tratamiento quirúrgico por la técnica de Ivor-Lewis entre 1980 y 1997, ambos inclusive. Esta afección maligna del esófago se origina con más frecuencia en su tercio inferior en el 41,1 %. En el acto quirúrgico se verificó mayoritariamente el estadio III de los enfermos que representa 65 % y sólo el 9,6 % de éstos se encontraba en un estadio I. Las complicaciones pulmonares fueron las más halladas con una mortalidad operatoria de 23,5 % y un índice de dehiscencia de 3,9 %. El intervalo libre de enfermedad al año fue de 58 % y la supervivencia estuvo en relación con el estadio, al hallarse en el estadio I el 100 % a los 2 años y el 20 % a los 4 años; el estadio II, 100 y 7 % y el estadio III 48 y 0 % respectivamente

Se realizó un estudio del uso del cefadroxilo (cefalosporina oral de 1ra. generación) en 100 pacientes con diagnóstico de sespsis respiratoria baja extrahospitalaria, donde se utilizó un esquema de dosis de 500 mg de cada 12 horas durante 7 a 10 días. A 60 pacientes se les administró 1 g por 7 días, de los cuales curaron 49 para el 81 %; de los 36 pacientes a los que se les administró 1 g por 10 días curaron 28, lo que representa el 77 % y de los 4 restantes que recibieron una dosis de 2 g por 10 días curaron 2 para el 50 %. Se efectuó además un análisis comparativo de los costos en tratamientos con penicilina cristalina, cefazolina, ceftriaxona y aminoglucósidos en la misma afección y se logró una disminución en el costo hospitalario y el consumo de antibióticosA study on the use of cefadroxil (1st generation oral cephalosporins) was conducted among 100 patients with diagnosis of extrahospital lower respiratory sepsis. A dosage schedule of 500 mg every 12 hours during 7 or 10 days was used. 49 (81 %) of the 60 patients that were administered 1 g during 7 days healed, whereas 28 (77 %) of those who received 1 g for 10 days cured, too. 2(50 %) of the other 4 that were given doses of 2 g for 10 days recovered from the disease. A comparative analysis of the costs generated by the use of crystalline penicillin, ceftriaxone, cefazolin and aminoglycosides to treat the same affection was made, and a reduction of hospital cost and antibiotic consumption was attained