| 2016 |
Perfil epidemiológico das vítimas de lesões autoinfligidas das mãos contra superfícies de vidro |
Diogo Petroni Caiado Fleury; Paulo Roberto da Costa; Leandro Ricardo de Aquino Santos; Larissa Cristina Clementino Lara; Andrea Maria Silveira |
As lesões autoinfligidas das mãos contra superfícies de vidro (LAIMCSV) são eventos violentos, pouco abordados na literatura nacional e internacional. O objetivo desta pesquisa foi estabelecer o perfil dos casos de LAIMCSV atendidos em um hospital de urgências em Belo Horizonte-MG. Foram estudados os registros médicos de pacientes atendidos entre abril de 2015 e março de 2016 avaliando-se variáveis sociodemográficas e clínicas. Foram identificados 18 pacientes acometidos por lesões autoinfligidas das mãos, ocasionadas por soco em vidro. Os indivíduos mais atingidos são do sexo masculino,
com idade média de 30 anos, ativos no mercado de trabalho. A construção civil foi o ramo de atividade mais frequente dos pacientes. A mão dominante foi acometida em 83,3% dos casos. As causas mais frequentes das lesões autoinfligidas foram as brigas familiares (61%). O consumo de álcool esteve presente em 44% dos casos. O compartimento anterior foi atingido em 77,8 % dos pacientes, com acometimento de tendões flexores e de nervos como o mediano e ulnar. Concluiu-se que as lesões autoinfligidas das mãos contra superfícies de vidro são lesões potencialmente graves que impactam negativamente a qualidade de vida do paciente e representam custos elevados para o sistema de seguridade social. |
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| 2017 |
Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia |
Rafael Henrique Rodrigues Costa, Natália Anício Cardoso, Ricardo Jayme Procópio,Túlio Pinho Navarro, Alan Dardike, Ligia de Loiola Cisneros |
Introduction: Foot ulcer is also a clinical marker for limb amputation and for death in diabetic patients.
The purpose of this study was to determine amputation and mortality rates and its associated factors in
patients with diabetic foot ulcerations in a tertiary hospital in Brazil.
Methods: Retrospective medical records from 654 diabetic foot patients were reviewed. The risk factors
were determined using the conditional logistic regression model analysis.
Results: The mean patient age was 63.1 years (SD 12.20). Peripheral arterial disease was present in 160
patients (24.5%). Major amputations were performed in 135 (21%). The in-hospital mortality rate was 12%
and the mortality rate of the amputees was 22.2%. The lowest hemoglobin level, the median value was
9.50 g/dL, (4.0–17.0). Anemia was detected in 89.6% of patients submitted to amputation and in 82,1% of
those who died. Hemoglobin <11 g/dL was the most significant risk factor for major amputation (odds
ratio 5.57, p < 0.0001). The presence of peripheral arterial disease and old age were also a risk for major
amputation (odds ratio 1.84, p = 0.007 and 1.02, p = 0.028, respectively). Factors associated with increased
risk for death were hemoglobin <11 g/dL (odds ratio 4.04, p < 0.001), major amputation (1.79, p = 0.03)
and old age (1.05, p < 0,001).
Conclusions: Diabetic foot ulcer is associated with high amputation and mortality rates. Old age,
peripheral arterial disease and low hemoglobin level are risk factor for major amputation. Old age, major
amputation and low hemoglobin level are risk factors for death. |
|
| 2015 |
Quality of life of people with diabetes mellitus pre revascularization surgery and post amputation – an exploratory study |
Ligia de Loiola Cisneros, Raquel Luiza Lopes Teixeira, Tulio Pinho Navarro |
Diabetic foot complications are the most serious and costly problem of Diabetes Mellitus affecting substantially
the quality of life of these patients. People with diabetic foot ulcers experience severe restrictions on daily life as a result of the ulcer. They face social isolation due to reduced mobility, they require frequent clinical treatment
and constant caution to ensure that effective care is taken of the feet. |
|
| 2015 |
Functional status after major amputation in diabetic foot patients from a tertiary hospital |
Ligia de Loiola Cisneros, Aline da Conceição Arruda, Tulio Pinho Navarro |
The purpose of this study was to verify functional status of diabetic foot patients submitted to lower limb major amputation after the discharge of a university hospital, reference in vascular surgery. A cohort of 31 diabetic foot patients was identified from the electronic medical records. Data were retrospectively collected from each patients chart including age, gender, peripheral arterial disease, level of amputation and number of readmissions. Patients were contacted by phone. A questionnaire investigated the survival, functional and ambulatory status: prosthesis use, reason for non-implantation of prosthetics, other hospitalization and amputation, mobility, self-performance of activities of daily living such as dressing and personal hygiene. |
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| 2018 |
Fatores Associados à Variação da CPK em Pacientes Vítimas de Trauma |
Mario Pastore Neto; Rafael Valério Gonçalves; Carla Jorge Machado; Vivian Resende |
Objetivo: identificar e analisar fatores associados à variação dos níveis plasmáticos de creatina fosfoquinase (CPK) em vítimas de trauma com evolução à rabdomiólise. Métodos: estudo longitudinal prospectivo, com 50 pacientes que seguiram para o protocolo “Onda Vermelha”, com evolução à rabdomiólise, após admissão hospitalar. Foram estudadas as variáveis: idade, sexo, escores, mecanismo e desfecho de trauma, CPK na admissão e final, intervalos de dias entre as avaliações laboratoriais, realização de cirurgia e complicações.
Os valores da CPK foram estratificados em <500U/L; ≥500 - <1000 U/L; ≥1000U/L, com cálculo da diferença entre os valores inicial e final. Resultados: à admissão, 83% dos pacientes (n=39) apresentavam CPK≥1000U/L, com predomínio de trauma contuso e lesão torácica (p<0,05), além de fratura ortopédica, lesão renal aguda e hemorragia digestiva, sendo que a CPK era menor naqueles sem lesão renal aguda, com tendência à significância estatística. Não houve diferenças na estratificação por CPK final. Fatores que se revelaram
independentemente associados à maior variação da CPK foram, positivamente, o tempo de internação superior a uma semana e síndrome compartimental, e negativamente, lesão renal aguda. Conclusão: como achado, nível de CPK de 1000U/L permanece como limite inferior, com importância à intervenção precoce em condições de agravamento do quadro, como hemorragia digestiva, lesão renal aguda e síndrome compartimental, que implicaram maiores diferenças absolutas entre CPK inicial e final, além do trauma contuso, lesão torácica e fratura ortopédica.
Descritores: Rabdomiólise. Creatina Quinase. Serviços Médicos de Emergência. |
|
| 2015 |
Epidemiology and outcomes of 655 diabetic foot patients in a Brazilian university hospital |
Ligia de Loiola Cisneros, Rafael Henrique Rodrigues Costa, Tulio Pinho Navarro |
Assessment of the epidemiological data and outcomes –
rates of mortality, hospital readmissions and limb salvage-of patients with diabetic foot infections treated in a
tertiary university hospital in Brazil. |
|
| 2017 |
Diabetic foot ulcer carries high amputation and mortality rates, particularly in the presence of advanced age, peripheral artery disease and anemia |
Rafael Henrique Rodrigues Costaa, Natália Anício Cardosob, Ricardo Jayme Procópioc, Túlio Pinho Navarrod, Alan Dardike, Ligia de Loiola Cisnerosf |
Introduction: Foot ulcer is also a clinical marker for limb amputation and for death in diabetic patients.
The purpose of this study was to determine amputation and mortality rates and its associated factors in
patients with diabetic foot ulcerations in a tertiary hospital in Brazil.
Methods: Retrospective medical records from 654 diabetic foot patients were reviewed. The risk factors
were determined using the conditional logistic regression model analysis.
Results: The mean patient age was 63.1 years (SD 12.20). Peripheral arterial disease was present in 160
patients (24.5%). Major amputations were performed in 135 (21%). The in-hospital mortality rate was 12%
and the mortality rate of the amputees was 22.2%. The lowest hemoglobin level, the median value was
9.50 g/dL, (4.0–17.0). Anemia was detected in 89.6% of patients submitted to amputation and in 82,1% of
those who died. Hemoglobin <11 g/dL was the most significant risk factor for major amputation (odds
ratio 5.57, p < 0.0001). The presence of peripheral arterial disease and old age were also a risk for major
amputation (odds ratio 1.84, p = 0.007 and 1.02, p = 0.028, respectively). Factors associated with increased
risk for death were hemoglobin <11 g/dL (odds ratio 4.04, p < 0.001), major amputation (1.79, p = 0.03)
and old age (1.05, p < 0,001).
Conclusions: Diabetic foot ulcer is associated with high amputation and mortality rates. Old age,
peripheral arterial disease and low hemoglobin level are risk factor for major amputation. Old age, major
amputation and low hemoglobin level are risk factors for death. |
|
| 2015 |
Quality of life of people with diabetes mellitus pre revascularization surgery and post amputation: an exploratory study |
Ligia de Loiola Cisneros, Raquel Luiza Lopes Teixeira, Tulio Pinho Navarro |
Background
Diabetic foot complications are the most serious and
costly problem of Diabetes Mellitus affecting substantially
the quality of life of these patients. People with diabetic
foot ulcers experience severe restrictions on daily life as a
result of the ulcer. They face social isolation due to
reduced mobility, they require frequent clinical treatment
and constant caution to ensure that effective care is taken
of the feet.
Objective
The primary aim of this study was to compare the patient
perceptions of their quality of life in two moments of the
timeline of the diabetic vascular disease: pre revascularization surgery period and post amputation |
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