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Biomedical subjects

R Salgado

Publications and source records attributed to R Salgado.

36 records · Page 2Linked to original sources
PubMed1997

[Detection of cognitive deterioration in elderly patients attending an emergency hospital service].

BACKGROUND: An increasing proportion of patients attended at hospital emergence departments (HED) are elderly people. OBJECTIVES: a) To check the reliability of the usual medical assessment to detect the cognitive deterioration in elderly people attended at HED, compared with that performed systematically by means of an evaluation test of cognitive functions; b) to study the applicability of such a test in HED, on the basis of the time necessary for its administration, and c) to describe the deterioration prevalence in that group of patients and identify the possible associated risks for its detection in patients. PATIENTS AND METHODS: Prospective study including patients aged > or = 60 years attended at a HED, using the orientation, memory and concentration test (OMC) to perform the cognitive assessment. RESULTS: A total of 352 patients who had no exclusion criteria out of the 536 attended during the study period were included. Cognitive deterioration was not detected in 111 patients (31.5%); it was mild in 147 (41.8%), moderate in 71 (20.2%) and severe in 23 (6.5%). In patients with moderate-severe deterioration according to the OMC test, such a deterioration was detected by the usual medical evaluation in 7% of cases. The mean time in completing the test was 2.6 +/- 0.9 minutes. An age > or = 80 years was associated with an increased relative risk for detecting moderate-severe cognitive deterioration (1.98; 95% CI, 1.42-2.78; p < 0.001), whereas the discharge diagnosis of respiratory disease was associated with a decrease of the relative risk (0.41; 95% CI, 0.19-0.89; p < 0.05). No association was observed with other factors, such as gender, home residence or final destination from the emergency department. CONCLUSIONS: The prevalence of cognitive deterioration in elderly people attended at HED is high and increases with age. The OMC test can be administered at HED to detect cognitive deterioration, which is not frequently detected by the usual medical assessment.

Age Factors↗
PubMed1996

[Utilization of antibiotics in a hospital emergency department. Quality of prescription].

OBJECTIVES: To know the frequency of antibiotic prescription, the conditions that motivate their usage, and to evaluate the quality of such therapies in a hospital emergency department (HED). METHODS: Retrospective study of 2,677 patients attended at a HED for a one-month period including those who had antibiotics prescribed in the discharge report. The parameters used to evaluate the therapeutic quality included the condition amenable to antibiotic therapy, appropriate antibiotic, dosage, interval of administration, and duration. Each parameter had a score which was used to quantitate the quality in a 0 to 100 scale. RESULTS: A total of 288 patients (10.7%) had antibiotics prescribed for treatment of respiratory tract infections (53.8%) and urinary tract infections (19.4%). The antibiotic group that accounted for most prescriptions was broad-spectrum penicillins (45%), followed by quinolones (12.8%), and urinary antiseptics (11.4%). Only 100 (50.3%) treatments were considered correct for all parameters analyzed. The most inadequate parameters were: non-appropriate antibiotic in 17.1% of cases and incorrect length of administration in 39.9%. The average quality according to scale was 89.6 (SD = 20.3). A lower quality was observed for treatments prescribed when on duty compared with normal working time (p = 0.006). CONCLUSIONS: Antibiotics are drugs frequently prescribed in HED. Errors were detected in choosing antibiotic therapies and antibiotic course duration in our department, which makes the adoption of intervention measures for its correction necessary.

Drug Prescriptions↗
PubMed1994

Factors associated with falling in elderly hospital patients.

Forty-four patients aged 65 years and over who fell whilst in an acute hospital and 44 patients who did not fall during their hospital stay underwent structured medical examinations to identify factors associated with falling. The control subjects were matched for age (+/- 3 years), sex, patient type, and primary diagnosis. The examination was based on established assessments of posture, balance and gait, the musculoskeletal system, vision, cardiovascular status, and neurological function. Bivariate analyses revealed seven assessment measures that were significantly associated with falls: cognitive impairment, particularly impaired orientation; evidence of previous cerebrovascular accident; incoordination as measured clinically; inability to perform the 'Get-up-and-go' test, especially an inability to turn around after a 5-metre walk, and the use of psycho-active medications. Of these variables, impaired orientation, psycho-active drug use, evidence of stroke, and impaired performance in the 'Get-up-and-go' test were included in a stepwise logistic regression which correctly classified 80% of the patients into faller and non-faller groups. Falling was also related to the number of these identified risk factors. These findings suggest that a simple screening protocol, taking about 5 min to complete, can assist in the identification of patients at risk of falls whilst in hospital.

Accidental Falls↗
PubMed1993

Sternoclavicular joint infection due to Bacteroides oralis.

A 60-year-old man in good health with no history of intravenous drug abuse was hospitalized for sternoclavicular joint pain and swelling. His complicated course required extensive debridement of the sternoclavicular joint. An insidious course, negative blood culture and requirement for surgery is common in infections of this joint.

Abscess↗
PubMed1988

The well baby lottery: motivational procedures for increasing attendance at maternal and child health clinics.

A lottery system was used to improve attendance at four well baby clinics in four colonias in Tijuana, Mexico. Mothers earned one lottery ticket for each visit to each clinic during the intervention period. At the end of each month, ticket receipts were entered into drawings for one of three bags of groceries. The lottery system was evaluated within a "multiple baseline design" whereby the intervention was staggered across the four clinics on a month-by-month basis. Although attendance was not enhanced uniformly, an overall improvement of 25 percent was realized. The lottery system was at times hampered by administrative problems, such as the breakdown of a public address system used to announce the open hours of a clinic in one of the colonias.

Child Development↗
PubMedDate not supplied

A mobile rehabilitation team program to assist patients in nursing homes rehabilitate and return to their homes.

A slow-stream rehabilitation program for frail elderly patients was developed utilising nursing homes visited by a mobile rehabilitation team (MRT) based at the hospital from which these patients had been discharged following major illness. The nursing homes were able to provide physiotherapy and the MRT contributed medical, nursing, occupational therapy and social work support through weekly visits. The supported group and a control group (also discharged to nursing homes from the same hospital but unsupported) were matched for age, sex and ADL level. Outcomes for the two groups were compared and were significantly different. Of the supported group (N = 33), 64% (N = 21) were discharged home compared with only 9% (N = 2) of the 23 control subjects (chi2 = 15.6, df. = 1, P < 0.05). The potential for patient rehabilitation in a modestly supported nursing home was realised.

Journal Article↗
PubMedDate not supplied

Volume rendering in clinical practice. a pictorial review.

Several post-processing techniques are currently available to the radiologist to optimize the review of the scan data acquired by multidetector CT. This is sometimes necessary as, when reviewing a volumetric data acquisition only as transaxial CT images, all the gathered information is not always displayed. Among all the current available post-processing possibilities, volume rendering is one of the most powerful techniques due to its various parameters and powerful segmentation capabilities. It is nevertheless the most complex technique, requiring a higher degree of training and experience from the radiologist to generate the desired result. Aim of this paper is to present the reader a pictorial review of the usefulness of volume rendering as a clinical tool, with emphasis on CT angiography and skeletal pathology.

Angiography↗
PubMedDate not supplied

CT angiography: basic principles and post-processing applications.

The introduction of spiral and more specifically multidetector CT scanners has provided unique opportunities in the field of CT angiography. It has also stressed the need of a basic knowledge of post-processing 3D imaging techniques to obtain maximum information of the CT data set. Aim of this article is to give a basic review of technical issues concerning CT angiography, with special attention to 3D imaging techniques such as surface shaded display (SSD), maximum intensity projection (MIP) and volume rendering (VR).

Angiography↗
PubMedDate not supplied

Tumors and tumor-like lesions of the jaw: radiolucent lesions.

Radiolucent lesions within the jaws represent a whole variety of lesions. Generally, they can be classified into two categories. The first category comprises well circumscribed lesions, either unilocular, multilobular or multilocular. They may be further subdivided into odontogenic or nonodontogenic lesions. The key feature that distinguishes these two subgroups is the relationship with the underlying dentition. Poorly circumscribed radiolucent lesions are the second category and consist of acute infectious disease and primary or metastatic malignancies. Although many of these lesions may present with non-specific imaging characteristics, careful analysis of a combination of imaging parameters may suggest a presumptive diagnosis. This article discusses the imaging features on different imaging techniques that may be useful in the characterization of these lesions.

Diagnosis, Differential↗
PubMedDate not supplied

Tumors and tumor-like lesions of the jaw mixed and radiopaque lesions.

Radiopaque lesions and lesions of mixed radioopacity are far less frequent than their radiolucent counterparts. Included in this spectrum are infectious and metastatic disease, inherited and developmental disorders and rare tumoral lesions. This article deals with the imaging features that may assist in the (differential) diagnosis of these lesions. in many instances, the radiological characterization is typical (osteoma, enostoma, fibrous dysplasia, Paget disease...), obviating the need for further invasive histological confirmation. Other lesions may share overlapping clinical, radiological and pathological features. In these cases, correlation of histopathological diagnosis with clinical findings and imaging features is of utmost importance for a correct diagnosis.

Diagnosis, Differential↗
PubMedDate not supplied

The influence of somatostatin on postoperative outcome after elective pancreatic surgery.

A series of 34 patients with pancreatic resections was evaluated with respect to the occurrence of local and general complications. Two groups were compared, depending on whether or not treatment with somatostatin was instituted. Postoperative morbidity and mortality were less frequent when somatostatin was given (resp. 50.0 and 5.5%) than when it was omitted (resp. 68.7 and 31.2%). Less complications were observed after resections performed for chronic pancreatitis than for pancreatic cancer in the non somatostatin-treated group. It is concluded that somatostatin treatment may be beneficial in preventing complications after elective pancreatic surgery.

Adult↗