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Biomedical subjects

A Langer

Publications and source records attributed to A Langer.

204 records · Page 12Linked to original sources
PubMedDate not supplied

[The factors associated with hospital maternal death in the state of Morelos, Mexico].

The objective of this case-control study was to assess some risk factors related to hospital maternal mortality in the state of Morelos, Mexico. The cases were all maternal deaths which occurred in Morelos between 1989 and 1991 (n = 35), and the controls were women who presented the same complications and were taken care for at the same hospitals than the cases, but survived pregnancy and delivery (n = 35). The results showed that living with a partner is a protective factor (OR = 0.08), as well as using family planning methods (OR = 0.15). Not receiving care at the first place where it was requested was a risk factor (OR = 6.6). Maternal deaths had the same number of prenatal care visits than controls, but their first visit occurred, in average, one month later. The implications of the small sample size, characteristic of the studies on maternal mortality, are discussed at length. The results pinpoint the need to strengthen high-risk pregnancies screening programs through early prenatal care, and promote intersectorial strategies to provide care to pregnant women.

Case-Control Studies↗
PubMedDate not supplied

[Psychosocial support in pregnancy as a strategy to promote the newborn's health].

In this project we developed a social support and health education intervention meant to answer whether or not a program of this kind, within the present medical system, can improve perinatal outcomes. A multicenter randomized controlled trial was conducted in four Latin American countries. In Mexico, the project was carried out in a third level obstetric hospital. Patients were screened between the 15th and 22nd week of gestation. Inclusion criteria were factors associated with high risk of low birthweight. A total of 620 women were recruited, randomized and followed up during pregnancy and up to the 40th day post partum. Women in the intervention group were visited four to six times during pregnancy, could use a telephone hot line and a consultation service. A poster and a pamphlet meant to reinforce health education were handed out in the first visit. A "guided tour" for women at the end of pregnancy was organized periodically. Outcomes were measured in both groups at the 36th week of gestation, post partum and 40 days after delivery. Neonatal outcomes were obtained by blind interviewers from the clinical records. Neither in the multicenter nor in the Mexican sample were we able to modify the incidence of low birthweight and prematurity. However, in Mexico we obtained positive effects on birthweight and gestational age in the whole sample and in some specific strata. These results strongly suggest the convenience of replicating the study in Mexico.

Adolescent↗
PubMedDate not supplied

[Analgesic efficacy of ketorolac and fentanyl in pediatric intensive care].

OBJECTIVE: To evaluate the efficacy of the two different drugs (Ketorolac and Fentanyl), used singularly or in association, in the management of postoperative pain in Picu. STUDY DESIGN: A randomized and prospective study. METHODS: 52 children were randomly assigned to receive intravenous Ketorolac and/or Fentanyl, according to four different analgesic treatments: A) Ketorolac 1.2 mg/kg every six hrs; B) Ketorolac 1.2 mg/kg (bolus) + 0.21 mg/ kg/hr; C) Fentanyl 1 gamma/kg/hr; D) Fentanyl 1 gamma/kg/hr + Ketorolac 0.21 mg/kg/hr. Each protocol was given to 13 children. The efficacy of treatments were evaluated by child's behaviour (Affective Facial Scale and CHEOPS score) and hemodynamical parameters (systolic and diastolic blood pressure, breathing rate, heart rate, oxygen saturation and oxygen arterial pressure) and analysed by statistical analysis. RESULTS: The children treated with protocol B (Ketorolac in continuous in infusion) showed better pain relief in respect to those treated with protocol A (Ketorolac in bolus), while the most efficient analgesia was obtained with the association of the two analgesic drugs (protocol D). Two cases of bradycardia, one case of hyperazotemia and one case of transaminase increase were noted. CONCLUSION: Ketorolac presents a good efficient analgesia, particularly evident when administered in continuous intravenous infusion. However, the association of this NSAID with an opioid drug can be favourably proposed in postoperative pain therapy of moderate to severe grade, since the confirmed analgesic efficacy is not aggravated by important side effects.

Age Factors↗