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C de la Cuesta

Publications and source records attributed to C de la Cuesta.

13 recordsLinked to original sources
PubMed2002

Laparoscopic approach to incisional hernia.

BACKGROUND: After more than 8 years of working in the field, we thought it would be interesting to evaluate our experience in the laparoscopic repair of abdominal wall hernias, focusing attention on the lessons learned with time. METHODS: From January 1994 to November of 2000, a total of 270 patients with abdominal wall hernias were treated in our center using the laparoscopic approach. The data collected and analyzed were preoperative evaluation, operative findings, early and long-term complications, and recurrences. RESULTS: The mean follow-up time was 44 months, mean surgical time was 85 min, and mean hospital stay was 1.5 days. The average number of abdominal wall defects was 4.8 per patient. There were 9 (3.3%) small bowel perforations. Conversion to open surgery was required in 1 case (0.3%). Minor early postoperative complications occurred in 38 patients (14.07%). Twenty patients (7.4%) developed persistent postoperative abdominal pain. There was 1 case (0.3%) of small bowel incarceration through the mesh border and another case (0.3%) of small bowel leakage due to ischemia and subsequent peritonitis. The relapse rate was 4.4% (12 cases). CONCLUSION: The laparoscopic approach is a valuable option in the management of abdominal wall hernias, but it requires experience in laparoscopic surgery and there is a specific learning curve for the technique.

Abdominal Pain↗
PubMed2001

Taking love seriously: the context of adolescent pregnancy in Colombia.

Findings from a qualitative research study of the context of adolescent pregnancy are presented. Participants were 21 pregnant adolescents from Medellín, Colombia, and nearby villages in the region. Data were collected by means of 21 qualitative interviews, and analysis followed grounded theory procedures. The study reveals that adolescent pregnancy occurs in the context of a "genuine love affair" in which ideas of romantic love and gender rules guide young women's behaviour. Regarding an adolescent as immature or in a process of becoming might hinder adolescents' distinctive culture and circumstances. Ideas of romantic love and gender rules were powerful influences on those who unintentionally got pregnant.

Adolescent↗
PubMed1999

Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh.

BACKGROUND: Despite being one of the most exact indications, laparoscopic treatment of eventrations and ventral hernias is barely known among the array of laparoscopic techniques. METHODS: A total of 60 patients were assigned at random over a 3-year period to two homogeneous groups to be operated on for major ventral hernias with mesh. Half of them were operated upon laparoscopically and the rest with open surgery. Early and longer-term complications were analyzed, as were operative time and postoperative hospital stays. RESULTS: The two groups were homogeneous in terms of demographic and clinical characteristics. The group that was operated on laparoscopically presented a lower rate of postoperative and longer-term complications; similarly, surgery time was significantly lower (p < 0.05). Hospitalization time was also significantly lower than in the group undergoing conventional open surgery (p < 0.05). CONCLUSIONS: Laparoscopic treatment of postoperative eventration and primary ventral hernia reduces complications and relapse rates, eliminates reintervention through mesh infection, reduces operative time, and considerably shortens the hospital stay.

Female↗
PubMed1997

[Qualitative studies in the health field].

Qualitative investigation in the health care field is faced with the relative problems of scientific knowledge production or epistemological questions, methodological procedures in qualitative investigations, and the utility and use of qualitative findings. These questions and others are discussed, in a general manner, in this article.

Health Services Research↗
PubMed1994

Relationships in health visiting: enabling and mediating.

During a grounded theory study into health visiting the role of the relationship with clients was uncovered. It was found that they have a necessary enabling and mediating function for health visitors' work. Although the literature has highlighted the importance of the relationships in health visiting, the work involved in building them has been taken for granted. It is hoped that it will be considered when appraising health visitors' work.

Community Health Nursing↗
PubMed1994

Marketing: a process in health visiting.

A grounded theory study was undertaken to gain insight into the processes underpinning health visiting. It was found that health visitors introduce their services into the client domain via a process constructed in this study as 'marketing'. This process involves different strategies to adjust the content, presentation and distribution of health visiting to the particular client or situation. While the result of this process might also lead to gaining the client's collaboration, two undesirable effects are identified: that of creating dependence on the service and that of perpetuating unfair situations.

Community Health Nursing↗
PubMed1983

The nursing process: from development to implementation.

This paper summarizes the research study carried out in 1979 as part of an MSc. The study has two purposes: to analyse, in sociological terms, the nursing process development and to understand whether it can make a practical contribution to nursing. The concept of the nursing process emerged in the United States during the 1960s. Its content was shaped by the American context. It was transferred subsequently to the United Kingdom in a limited form, modified to accommodate a different context; thus, it is not just a theoretical concept but an ideology in the technical sense as well. As a method of practice, the study shows that the nursing process is not fully implemented either in the US or in the UK. However, it does represent an important step forward in nursing in that it has made real analytical gains. The findings of the study serve to identify some of the problems that must be tackled if the theory is to be turned into practice.

Literature↗
PubMedDate not supplied

Laparoscopic treatment of ventral abdominal wall hernias: preliminary results in 100 patients.

OBJECTIVE: The laparoscopic treatment of eventrations and ventral hernias has been little used, although these hernias are well suited to a laparoscopic approach. The objective of this study was to investigate the usefulness of a laparoscopic approach in the surgical treatment of ventral hernias. METHODS: Between January 1994 and July 1998, a series of 100 patients suffering from major abdominal wall defects were operated on by means of laparoscopic techniques, with a mean postoperative follow-up of 30 months. The mean number of defects was 2.7 per patient, the wall defect was 93 cm2 on average. There were 10 minor hernias (<5 cm), 52 medium-size hernias (5-10 cm), and 38 large hernia (>10 cm). The origin of the wall defect was primary in 21 cases and postsurgical in 79. Three access ports were used, and the defects were covered with PTFE Dual Mesh measuring 19 x 15 cm in 54 cases, 10 x 15 cm in 36 cases, and 12 x 8 cm in 10 cases. An additional mesh had to be added in 21 cases. In the last 30 cases, PTFE Dual Mesh Plus with holes was employed. RESULTS: Average surgery time was 62 minutes. One procedure was converted to open surgery, and only one patient required a second operation in the early postoperative period. Minor complications included 2 patients with abdominal wall edema, 10 seromas, and 3 subcutaneous hematomas. There were no trocar site infections. Two patients developed hernia relapse (2%) in the first month after surgery and were reoperated with a similar laparoscopic technique. Oral intake and mobilization began a few hours after surgery. The mean stay in hospital was 28 hours. CONCLUSIONS: Laparoscopic technique makes it possible to avoid large incisions, the placement of drains, and produces a lower number of seromas, infections and relapses. Laparoscopic access considerably shortens the time spent in the hospital.

Adult↗
PubMedDate not supplied

The laparoscopic approach in the treatment of diverticular colon disease.

BACKGROUND AND OBJECTIVES: The experience with treatment of diverticular colon disease (DCD) by the laparoscopic method is analyzed. METHODS: Between January 1994 and July 1997, a group of 22 patients with criteria for symptomatic diverticular disease in the descending and sigmoid colon underwent laparoscopy with average resections of 40 cm. Intra-abdominal mechanical anastomosis completed the procedure. RESULTS: The operative morbidity was 28%. Two cases, in acute diverticulitis phase, were reconverted to open surgery, and three cases presented postoperative rectorrhagia which ceased spontaneously. No long-term complications have been found. Postoperative hospitalization was 4-8 days (mean 5.5) and mean operative time was 165 minutes (range 120-240). CONCLUSIONS: Nevertheless, the learning curve precise to practice this type of surgery, the acceptable morbity-mortality rates which the laparoscopic method presents, especially with these high-risk groups of patients (age > 65, high blood pressure, etc), encouraged us to modified the criteria indicating surgery for the disease, offering first choice operative treatment with efficiency and safety. However, we feel that those patients with acute complications of diverticular colon disease must be excluded initially for laparoscopic approach.

Aged↗