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Search Results: 1 - 10 of 5132 matches for " Herrera-Espi?eira "
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Variability of indication criteria in knee and hip replacement: an observational study
Raquel Cobos, Amaia Latorre, Felipe Aizpuru, Jose I Guenaga, Cristina Sarasqueta, Antonio Escobar, Lidia García, Carmen Herrera-Espieira
BMC Musculoskeletal Disorders , 2010, DOI: 10.1186/1471-2474-11-249
Abstract: The pre-surgical condition of 1603 patients included was compared by their personal characteristics, clinical situation and self-perceived health status. Patients were asked to complete two health-related quality of life questionnaires: the generic SF-12 (Short Form) and the specific WOMAC (Western Ontario and Mcmaster Universities) scale. The type of patient undergoing primary arthroplasty was similar in the 15 different hospitals evaluated.The variability in baseline WOMAC score between hospitals in THR and TKR indication was described by range, mean and standard deviation (SD), mean and standard deviation weighted by the number of procedures at each hospital, high/low ratio or extremal quotient (EQ5-95), variation coefficient (CV5-95) and weighted variation coefficient (WCV5-95) for 5-95 percentile range. The variability in subjective and objective signs was evaluated using median, range and WCV5-95. The appropriateness of the procedures performed was calculated using a specific threshold proposed by Quintana et al for assessing pain and functional capacity.The variability expressed as WCV5-95 was very low, between 0.05 and 0.11 for all three dimensions on WOMAC scale for both types of procedure in all participating hospitals. The variability in the physical and mental SF-12 components was very low for both types of procedure (0.08 and 0.07 for hip and 0.03 and 0.07 for knee surgery patients). However, a moderate-high variability was detected in subjective-objective signs. Among all the surgeries performed, approximately a quarter of them could be considered to be inappropriate.A greater inter-hospital variability was observed for objective than for subjective signs for both procedures, suggesting that the differences in clinical criteria followed by surgeons when indicating arthroplasty are the main responsible factors for the variation in surgery rates.Total knee replacement (TKR) and total hip replacement (THR) are safe surgical procedures that achieve effecti
Validación de una escala reducida de capacidad funcional del cuestionario WOMAC
Escobar,Antonio; Vrotsou,Kalliopi; Bilbao,Amaia; Quintana,Jose M.a; García Pérez,Lidia; Herrera-Espieira,Carmen;
Gaceta Sanitaria , 2011, DOI: 10.1590/S0213-91112011000600013
Abstract: objective: the aim of this prospective study was to evaluate the validity, reliability and responsiveness of the spanish version of the 7-item short-form of the function dimension of the western ontario and mcmaster universities osteoarthritis index (womac). methods: we conducted a prospective 1-year cohort study that included 459 patients on the waiting list for total knee or hip replacement. the womac and eq-5d questionnaires were sent at four time points: baseline and at 3, 6 and 12 months post-surgery. based on a previously shortened scale, we performed a validation process with rasch analysis and agreement measured by bland-altman plots. results: the values of spearman's rho and lin concordance coefficients between the full and short-form ranged from 0.96 to 0.98. differences were statistically significant (p<0.001) among the three groups of severity measured by a item in the eq-5d. the two bland-altman plots showed no systematic differences and agreement was not dependent on the severity score. the short form fitted the rasch model. cronbach's α coefficients were higher than 0.85. responsiveness was higher than 1.27 and 1.72 in knee and hip replacement, respectively. conclusions: the spanish 7-item short form of the womac function dimension is valid, reliable and responsive for patients with total joint replacement. the use of this version will reduce the burden on patients in both clinical studies and clinical practice.
Efecto de un programa de atención telefónica tras el alta hospitalaria de una unidad de cirugía traumatológica
Herrera-Espieira,Carmen; Rodríguez del águila,María del Mar; Navarro Espigares,Jóse Luis; Godoy Montijano,Amparo; García Priego,Alfonso; Gómez Rodríguez,Javier; Reyes Sánchez,Isabel;
Gaceta Sanitaria , 2011, DOI: 10.1590/S0213-91112011000200009
Abstract: objective: to determine the impact of a 1-month telephone care program after hospital discharge from a trauma surgery unit on health services utilization and patient anxiety and to perform a budgetary analysis. methods: we carried out an experimental study in 604 patients who formed an experimental and a control group. the experimental group was offered telephone care to resolve doubts during the first month after discharge. after this period, data were collected from both groups on the following outcome variables: visits to the emergency department or family physician, hospital readmissions, and the results of an anxiety test. data analyses included logistic and linear multivariate analyses and calculation of the budgetary impact of the program on the hospital, the andalusian health service, and the national health system. results: a total of 73 telephone consultations were conducted with 60 patients, almost half for doubts about the therapeutic regimen. for the outcome variable "visit to emergency department", the group without telephone care had an odds ratio of 1.8 in the multivariate analysis adjusted for the other independent variables: days of hospital stay, patient anxiety and comprehension of discharge indications. no differences between groups were found in the remaining outcome variables. the budgetary analysis demonstrated the possibility of implementing the program at a cost of 1.65 € per patient. conclusions: this program proved effective in reducing visits to the emergency department at a low cost.
Evaluación de un programa de atención sanitaria con enfermera tutora en cirugía de traumatologia en un hospital de Granada, 2004
Herrera-Espieira,Carmen; Rodríguez del Aguila,Ma del Mar; Rodríguez del Castillo,Mercedes; Aguayo de Hoyos,Eduardo; Quero Rufián,Aurora; Martínez Cirre,Carmen; Cuesta Santos,Dolores; álvarez García,Pilar; Reyes Sánchez,Isabel;
Revista Espa?ola de Salud Pública , 2008, DOI: 10.1590/S1135-57272008000100006
Abstract: background: the current trend in patient care is towards a more humanized and higher-quality healthcare. the objective of the present study was to evaluate the results of implementing a programme of healthcare with a reference nurse who welcomes the patient at hospital admission, visits regularly during hospital stay, and resolves doubts and problems. methods: quasi-experimental study (149 cases and 454 non-tutored controls) in patients admitted for scheduled trauma surgery at the virgen de las nieves university hospital, granada. sociodemographic and clinical data were gathered at admission. at 15 days after discharge, patients were administered with an interviewer-administered zung score and anad hoc questionnaire on satisfaction with different healthcare aspects during hospital stay and understanding of information received. bivariate analyses and linear and multivariate logistic regression analyses were performed with a study of confunding variables. results: for the outcome variable anxiety level non-tutored patiens had a b coeficient of 2.64 (p<0,01) in the multivariate linear regression analisys controlling for the other variables in the final model: sex, presence of informal carer, professional activitiy, days of hospital stay and understanding of health information. for the outcome variable inadequate understanding information non-tutored patients showed an odds ratio of 3.48 in the multivariate analysis controlling for educational level and presence of informal carer. satisfaction with he friendliness of health care personnel and with the hospital setting did not significantly diference, although the percentage of dissatisfied patiens was higher in the non-tutored group: 15% vs 11% (p= 0.34) and 18% vs 12 % (p= 0.11) respectively. conclusions: the implemented continued care programme proved effective for these patients, increasing their understanding of information received and reducing anxiety levels.
Presente y futuro de los servicios de las bibliotecas médicas. Revisión de la literatura y estudio realizado en un hospital de más de 1.400 camas
Rodríguez del Castillo Martín, M.,Rodríguez del águila, M. M.,Herrera Espieira, C.,Quero Rufián, A.
Revista Espa?ola de Documentación Científica , 2006,
Abstract: More and more information resources exist in electronic format, such as online databases, journals, books, etc., instead of the traditional print format. Advances in information technology have introduced both new capabilities and interesting challenges in the access to medical literature. This has influenced dramatically medical libraries which have changed and will continue to do so. Studies of the impact of the internet on information retrieval behaviour of users in medical environments could provide very valuable information for medical libraries trying to adapt to this rapid evolution. This study aims to explore the real information needs of physicians at the hospital and their medical library use. A review was carried out of literature relating to health libraries in Pubmed, LISA, CINAHL, and Google Scholar. An ad hoc questionnaire was sent to the different hospital services. A systematic sample was made. Results of 118 completed questionnaires collected from 34 different services were analysed. Items regarding: medical information needs; change of information seeking behaviour; use of library services and services offered by the hospital librarian such as quality filtering and users training. Most users are familiar with information technologies such as Internet, online journals, webs, etc., but at the same time traditional systems are used. The assistance of professional medical librarians retrieving new and relevant information from databases and the Internet and teaching skills to retrieve and select information is considered necessary. En los últimos a os se han producido grandes cambios en la forma de acceder a la información en medicina y esto ha incidido profundamente en las bibliotecas médicas y en el modo de organizar sus servicios. Los bibliotecarios médicos han dedicado un especial interés en tratar de adaptarse al cambiante entorno de la información y satisfacer las demandas de sus usuarios. El presente estudio, aparte de realizar una revisión del estado de la cuestión, pretende averiguar las necesidades reales de información de los médicos de un hospital de más de 1.400 camas. Para ello se realizó una amplia revisión de la literatura a través de las bases de datos Pubmed, LISA, CINAHL y Google Scholar con el fin de conocer la actualidad de los sistemas de acceso a la información en Biomedicina. También se confeccionó un cuestionario ad hoc, con el objetivo de recabar datos concretos sobre necesidades y hábitos actuales de información de los médicos del Hospital. Los cuestionarios se distribuyeron al azar entre los distintos profesion
Democracia, movimentos sociais e nivelamento intelectual: considera??es sobre a amplia??o da participa??o política
Espieira, Maria Victória;Teixeira, Helder;
Caderno CRH , 2008, DOI: 10.1590/S0103-49792008000300005
Abstract: this paper has for theme the subject of the democratic legitimacy underlining, for such, the limits of representative democracy and the potentialities dammed inside of current political brazilian spectrum of individual and collective action, supplanting the quantitative bias that prevails in the analyses on the democratic process in brazil. beyond the variables traditionally seated in the triad vote, political parties and elections, this paper tries to demonstrate that the brazilian electoral democracy still didn't consolidate a democratic political culture, in the measure in that it is solidifying a differentiation plane between representatives and represented, due to mandates more and more imperatives and less bound to the control and participation of those represented. quantitative researches, primary sources, secondary sources and the analysis of recent social movements in the national scene allowed the building of the hypothesis worked here that the electoral process, for itself, doesn't answer for the construction and consolidation of a plural and participative democracy.
Movimentos sociais e política: releituras contemporaneas
Breno Bringel,Maria Victória Espieira
Caderno CRH , 2008, DOI: 10.1590/s0103-49792008000300001
Cirugía radical conservadora en la otitis media crónica
Machín González,Victoriano; Benito Soler,Isabel; Vieito Espieira,Rodolfo; Ortiz Nú?ez,Mildre;
Revista Cubana de Cirug?-a , 1999,
Abstract: 40 clinical histories of patients who had undergone radical conservative surgery of the mastoid due to chronic osteitic otitis media were reviewed. these patients received medical attention at the otorrhinolaringology service of the "joaquín albarrán" clinical and surgical teaching hospital between 1990 and 1996. pseudomonas aeruginosa was present in a high percentage of our cases. dry ear was attained in 36 patients with the subsequent eradication of the affection that was the main purpose of surgery. the functional results may generally be considered as good
Fibrobroncoscopia en el cáncer de pulmón
Machín González,Victoriano; Vieito Espieira,Rodolfo; Freyre Serentill,Juan C; Benito Soler,Isabel;
Revista Cubana de Cirug?-a , 1997,
Abstract: 160 patients with a clinical-radiological picture suggesting lung neoplasia was conducted. fibrobronchoscopy was perfomed as a reliable method to detect this disease. punch biopsy, exfoliative cytology, and bronchial lavage were used to obtain specimens for the histologycal study. of all the patients studied, 112 cases were positive and a proper diagnosis by biopsy was attained in 90 of them
Cirugía radical conservadora en la otitis media crónica
Victoriano Machín González,Isabel Benito Soler,Rodolfo Vieito Espieira,Mildre Ortiz Nú?ez
Revista Cubana de Cirugía , 1999,
Abstract: Se revisaron 40 historias clínicas de pacientes a los cuales se les practicó una cirugía radical conservadora de la mastoides, por presentar otitis media crónica osteítica. Los pacientes recibieron atención en el servicio de Otorrinolaringología del Hospital Clinicoquirúrgico Docente "Joaquín Albarrán", en el período comprendido entre 1990 y 1996. Se comprobó la presencia de Pseudomonas aeruginosa en un alto porcentaje de nuestros casos, y se logró un oído seco en 36 pacientes, con la consiguiente erradicación de la afección, objetivo fundamental de la cirugía. Los resultados funcionales se pudieron calificar de buenos en sentido general 40 clinical histories of patients who had undergone radical conservative surgery of the mastoid due to chronic osteitic otitis media were reviewed. These patients received medical attention at the Otorrhinolaringology Service of the "Joaquín Albarrán" Clinical and Surgical Teaching Hospital between 1990 and 1996. Pseudomonas aeruginosa was present in a high percentage of our cases. Dry ear was attained in 36 patients with the subsequent eradication of the affection that was the main purpose of surgery. The functional results may generally be considered as good
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