Profile of hip arthroplasty patients in a teaching hospital

OBJECTIVE: to characterize the epidemiological profile of patients undergoing hip replacement, primary or revisional. METHODS: we conducted a retrospective, descriptive study, including hip arthroplasties performed from January 2009 to June 2012 in a Belo Horizonte teaching hospital, Minas Gerais State - MG, Brazil. Data were analyzed using descriptive statistics. RESULTS: orthopedic procedures represented 45% of the operations at the hospital in the period, 1.4% hip arthroplasties. There were 125 hip replacements, 85 total, 27 partial and 13 reviews. Among the patients, 40% were male and 60% were female. Age ranged between 20 and 102 years, mean and median of 73 and 76 years, respectively. The most frequent diagnosis (82%) was femoral neck fracture by low-energy trauma caused by falling form standing position. In 13 revision operations, 12 required removal of the prosthesis. The infectious complication led to revision in 54% of the time, followed by dislocation (15%), peri-prosthetic fracture (15%) and aseptic loosening (15%). The infection etiologic agent was identified in 43% of occasions. The average length of the prosthesis to a revision operation was eight months. CONCLUSION: patients undergoing hip arthroplasty are elderly, with femoral neck fracture caused by falling form standing position, affecting more women. The incidence of hip prosthesis loosening was 10%. The main cause of the infection was loosening. The incidence of revisional hip arthroplasty was 10% and the incidence of hospital mortality in patients undergoing hip arthroplasty was 7.2%.

Comparison between open and laparoscopic elective cholecystectomy in elderly, in a teaching hospital

Objective: to analyze the differences in mortality rates, length of hospital stay, time of surgery and the conversion rate between elective open cholecystectomies (OC) and laparoscopic ones (LC) in elderly patients. Methods : we evaluated medical records of patients 65 years of age or older undergoing open or laparoscopic cholecystectomy at the Hospital Regional de Mato Grosso do Sul between January 2008 and December 2011. We excluded individuals operated in non-elective scenarios or who underwent intraoperative cholangiography. Results : we studied 113 patients, of whom 38.1% were submitted to the OC and 61.9%, to LC. Women accounted for 69% of patients and men, for 31%. The conversion rate was 2.9%. The mean age and duration of the procudure was 70.1 and 84 minutes, respectively, with no significant difference between OC and LC. Patients undergoing LC had shorter hospital stays (2.01 versus 2.95 days, p=0.0001). We identified operative complications in sixpatients (14%) after OC and in nine (12%) after LC, with no statistical difference. Conclusion : there was no difference in morbidity and mortality when comparing OC with LC. The laparoscopic approach led to shorter hospital stay. Operative time did not differ between the two access routes. The conversion rate was similar to other studies.

Teaching project: a low-cost swine model for chest tube insertion training

Objective: to describe and evaluate the acceptance of a low-cost chest tube insertion porcine model in a medical education project in the southwest of Paraná, Brazil. Methods: we developed a low-cost and low technology porcine model for teaching chest tube insertion and used it in a teaching project. Medical trainees - students and residents - received theoretical instructions about the procedure and performed thoracic drainage in this porcine model. After performing the procedure, the participants filled a feedback questionnaire about the proposed experimental model. This study presents the model and analyzes the questionnaire responses. Results: seventy-nine medical trainees used and evaluated the model. The anatomical correlation between the porcine model and human anatomy was considered high and averaged 8.1±1.0 among trainees. All study participants approved the low-cost porcine model for chest tube insertion. Conclusion: the presented low-cost porcine model for chest tube insertion training was feasible and had good acceptability among trainees. This model has potential use as a teaching tool in medical education.

Pediatric pain: prevalence, assessment, and management in a teaching hospital

The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients’ pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child’s pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.

Comparison of methodologies for moisture determination on dried bee pollen samples

Bee pollen moisture value is one of the quality parameters for this product. Some countries such as Argentina, Brazil, Bulgaria, Poland and Switzerland have bee pollen regulations on quality parameters, but these are not clear regarding which method should be used for moisture determination. The aim of this paper was to compare six methods of moisture determination in dried bee pollen samples. The methods were: conventional oven at 100 °C, vacuum oven at 70 °C, desiccator with sulfuric acid, drying out process with infrared light at 85 °C, lyophilization and Karl Fisher's method. Based on the results, the best methods for moisture determination of bee pollen were the drying process with infrared and the lyophilization, since these have shown lower moisture values.

Chemical profile of sugarcane spirits produced by double distillation methodologies in rectifying still

The objective of this study was to determine the chemical profile of sugarcane spirits produced by different double distillation methodologies in rectifying still. Fermented sugarcane juice was distilled in rectifying still according to three double distillation methodologies: the methodology used for cognac production; the methodology used for whisky production; and the 10-80-10 percentage composition methodology, referring to the volumes of head, heart and tail of the distillate fractions from the second distillation. For comparison purposes, a simple distilled spirit was also produced. The distillates were analyzed for concentrations of ethanol, copper, volatile acidity, furfural and hydroxymethylfurfural, aldehydes, esters, methanol and higher alcohols. The spirits were also evaluated on the sensory attributes of aroma, taste and preference. Compared to simple distillation, double distillation improved the chemical quality of the spirits, since it has reduced the concentrations of acids, aldehydes, esters, methanol, higher alcohols and, consequently, their coefficient of congeners. Regardless of the methodology employed, the double distillation improved the sensory quality of the spirits since they obtained higher sensory acceptance in relation to spirits produced by simple distillation. Among double distilled spirits, the one produced according to whisky methodology obtained the best scores from appraisers on the aroma and flavor parameters and it was also the most preferred.

Osmotic priming methodologies in relation to the physiological performance of rangpur lime seeds (Citrus limonia Osbeck)

Several mechanisms have been used to promote rapid germination of citrus seeds and uniform seedling emergence. We evaluated the effects of osmotic priming on the physiological performance of Rangpur lime seeds (Citrus limonia Osbeck). Seeds were treated with 30 g of Captan and 10 g of Tecto 600 in 20-litre batches and stored, without drying, at 10 ºC and 50% relative humidity for periods of 3, 6 and 9 months. After each period, seeds were primed at 25 ºC, in the light, by immersion in Poliethylenoglicol (PEG 6000), potassium nitrate (KNO3) and 70% PEG 6000 plus 30% KNO3, all at an osmotic potential of -1.1MPa, for priming periods of 3, 6, 9 and 12 days. Percentage germination, tray emergence and the emergence rate index (ERI) were evaluated. Priming in PEG 6000 solution, independent of priming period, or in KNO3 or PEG 6000 plus KNO3 for up to 9 days, were efficient at improving the physiological performance of seeds stored for up to 3 months. Osmotic priming appears to be a promising technique for improving the physiological quality of Rangpur lemon seeds.