Tesi: "Medicine Period"

1

Jonker, Dirk. "Self-assessed and direct measured physical workload among dentists in public dental clinics in Sweden during a period of rationalizations". Doctoral thesis, Linköpings universitet, Arbetslivsinriktad rehabilitering, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-65422.

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Much research has been done on interventions to reduce work-related musculoskeletal disorders (WMSDs) at the workplace. However, this problem is still a major concern in working life. The economic cost for WMSDs corresponds to between 0.5% and 2% of the gross national product in some European countries, and in 2007, 8.6% of workers in the EU had experienced work-related health problems during the previous 12 months. In Sweden, one in five of all employees have rated occurrence of WMSDs during the previous 12 months. In spite of comprehensive ergonomic improvements of workplace and tool design in dentistry the prevalence of musculoskeletal disorders in neck, upper arms and back is reported to be between 64% and 93%. The present thesis investigates if the perceived high exertion during work corresponds to actual physical exposures. Further, it is investigated if risk full physical exposures may be generated due to rationalisations. Specifically, changes in physical exposures are investigated prospectively during a period of rationalisations. Empirical data on production system performance, individual measured physical workload, and self-rated physical workload are provided. High estimates of self-rated workload were found. These high scores for perceived workload were associated with high measured muscular workload in the upper trapezius muscles. Also, negative correlations were found between low angular velocities in the head, neck and upper extremities on the one hand, and estimates for perceived workload on the other. Both measured muscular workload and mechanical exposure among dentists indicate a higher risk of developing WMSDs than in occupational groups with more varied work content. Value-Adding Work (VAW) comprised about 57% of the total working time and compared to industrial work an increase with about 20 percent units is hypothesised. Furthermore, VAW compared to non-VAW (“waste”) implies more awkward postures and especially low angular velocities interpreted as constrained postures. Consequently, when increasing the proportion of time spent in VAW due to rationalisations, work intensification is expected. However, at follow up, we did not find such work intensification. Previous research indicates that rationalisation in working life may be a key factor in the development of WMSD. The present thesis suggests that ergonomics may then be considered proactively as part of the rationalisation process.

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2

Sedgfield, Amber. "Mindfulness during the perinatal period". Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/76034/.

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It is well documented that the perinatal period (the time from pregnancy until the first year of a child’s life) is a crucial window of opportunity for foetal and infant development. Evidence suggests that parental psychopathology can have harmful consequences for the parent-infant relationship, parents’ relationship, infant’s development and later mental-health into adulthood. The focus of this thesis will be on exploring mindfulness as one possible non-pharmacological intervention that could benefit parents’ emotional well-being during the perinatal period. Chapter one contains a mixed methods systematic review of 14 published studies of Mindfulness and Acceptance Based Interventions (MABIs) during the perinatal period, for mothers experiencing anxiety and stress. The synthesis of quantitative and qualitative results were integrated and demonstrated tentative findings that MABIs can reduce anxiety, pregnancy anxiety and stress for mothers, whilst increasing self-efficacy and mindfulness. Qualitative themes discussed propose possible explanations for these findings. Methodological limitations are discussed in line with implications for clinical practice and recommendations for future research. Chapter two explores mothers’ and fathers’ experiences of mindfulness during parenting, one year following their attendance on the Mindfulness-Based Childbirth and Parenting programme (MBCP). Ten semi-structured interviews gathered rich, in-depth, idiosyncratic accounts which were subject to Interpretative Phenomenological Analysis (IPA). Two superordinate themes emerged from the data, ‘Getting closer to really living’ and ‘Greater connectedness and attunement’. Finally, Chapter 3 provides a reflective account of the author’s lived experience of the parallels between her own research journey and personal experience of becoming a mother. It addresses the author’s epistemological position and the researcher’s influence on the research process.

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3

Panayiotou, Barnabas N. "Blood pressure behaviour in the early period after stroke". Thesis, Keele University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301165.

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4

Švilpauskė, Jovita. "Odos tyliojo periodo tyrimo reikšmė, nustatant periferinių nervų pažeidimą". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20061016_135026-32771.

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Methods for assessing small peripheral nerve fiber function objectively are limited. The cutaneous silent period (CuSP), a transient supression of electromyographic voluntary activity that follows painful stimuli, could serve as an objective functional measure of the A delta fibers. The aim of this study was to evaluate function of small diameter A delta nerve fibers using the CuSP in normals and in patients with both focal (carpal tunnel syndrome - CTS) and generalised (polyneuropathies - PNP) peripheral nerve injuries. The objectives of the study were the following: 1. To determine the CuSP normal values by age, gender, side, height and weight in healthy controls. 2. To study the topography and extension of the CuSP by changing recording and stimulating sites in healthy controls. 3. To evaluate the CuSP in patients with CTS of different severity and to compare these results with those of healthy controls. 4. To estimate the CuSP onset latency and duration in relation with median nerve evoked compound muscle action potential amplitude, distal latency and conduction velocity in patients with CTS. 5. To evaluate the CuSP in patients with PNP of different types and to compare these results with those of healthy controls. 6. To estimate the CuSP onset latency and duration in relation with median nerve evoked compound muscle action potential amplitude, distal latency and conduction velocity in patients with PNP. We investigated the CuSP of the upper and lower limbs of 50 normal... [to full text]

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5

Eubanks, Elsie Irene. "Lead Poisoning from the Colonial Period to the Present". W&M ScholarWorks, 1996. https://scholarworks.wm.edu/etd/1539626037.

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6

Dodd, Will. "Minor Congenital Anomalies of the Newborn Period Contributing to Diagnosis of Underlying Disease". Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/8937.

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7

Biskis, Veronika N. "Feathered dinosaurs and the origin of avian flight". Thesis, Boston University, 2013. https://hdl.handle.net/2144/21125.

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Thesis (M.A.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
It is now widely accepted that modern day birds originated from the clade Theropoda represented by bipedal carnivorous dinosaurs that thrived between the late Triassic and Cretaceous period. New research illustrates how the evolutionary assembly of the avian body plan began in these theropods with small fore limbs, large hind limbs and stiff tails, and progressed through a series of increasingly bird-like, transitional anatomical stages. There is also a great deal of homoplasy among dinosaurs however, or evolution of the same traits in distantly related groups, which makes it even more difficult to pinpoint the phylogenetic relationships among theropods. A limited fossil record and confusing temporal inconsistency has also led paleontologists and ornithologists alike to dismiss this crucial connection. They often attribute the origin of birds instead to a basal archosaur, ancestor to both dinosaurs and crocodilians. However the recent discoveries of feathered non-avian theropods, especially from the Late Jurassic and Early Cretaceous of Liaoning, China may finally lay the argument to rest. The scientific community has remained especially divided over to what degree feathers and other flight characteristics are present amongst the advanced theropods, and Dinosauria in general. Understanding this distinction helps separate each species into separate clades along the cloudy phylogenetic timeline as a function of feather development, and therefore offers insight into where they initially became functional for flight. Because fossils depicting defined integumental structures have been recently uncovered by the hundreds over the last 20 years, there is more evidence of this transition than ever. Through studies of theropod and avian physiology, we can gain more insight into the macroevolutionary principles and selective pressures that led dinosaurs to take to the sky.
2031-01-01

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8

Hennessey, James Todd. "An examination of human anatomy in the drama of the early modern period". Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/7075/.

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An examination of the science of human anatomy and dissection as it occurs in plays of the early modern period. Starting with a survey of available literature on the subject, the thesis then moves on to examine the state of human anatomy in England at the time as well as an overview medical training, textbooks and information that may have been available to the public at large. This leads to an examination of a group of plays that refer explicitly to the practice of anatomy, references that are found to be either literal or metaphorical in nature. In this, the theatrical representation of anatomy is examined with an eye toward investigating the nature of these representations.

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9

Entrican, J. H. "The changing pattern of inflammatory bowel disease : A study of the epidemiology and clinical pattern of inflammatory bowel disease in the Lothian Region of Scotland over a defined period". Thesis, University of Aberdeen, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.374621.

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10

Kita, Lauren Elizabeth. "Investigating the relationship between sleep and postpartum depression : a longitudinal study examining the relationships between subjective and objective sleep during the perinatal period and postpartum depression". Thesis, Bournemouth University, 2013. http://eprints.bournemouth.ac.uk/21200/.

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Research has suggested that a bi-directional relationship exists between sleep disruption and depression. Not only is poor sleep a commonly reported symptom in those with depression, some aspects of sleep have also been shown to predict the onset of depression. Despite sleep problems being a commonly reported occurrence throughout the perinatal period, the field of perinatal sleep research remains in its relative infancy. However, recent studies suggest that sleep disturbances during this time may increase the risk of developing postpartum depression. Currently, research in this area is limited by studies that have failed to control for depressive symptoms at baseline, relied upon subjective, often retrospective, measures of sleep, and have only measured symptoms of postpartum depression in the early postpartum period. Few studies have used polysomnography, considered the ‘gold standard’ of sleep, and no studies to date have specifically compared the relationship between subjective and objective sleep. Therefore, the major aim of this thesis was to gain a better understanding of the specific aspects of sleep that were most relevant to postpartum depression. In order to address this aim, studies were carried out to: explore the aspects of sleep most relevant to major depressive disorder; examine differences in sleep between pregnant and non-pregnant women; investigate the relationships between subjective and objective measures of sleep; explore longitudinal changes in sleep, fatigue and depression throughout the perinatal period, and finally; examine which aspects of sleep at which time-point were most relevant to the development of postpartum depression. Overall this thesis found that women experience significant changes to their sleep throughout the perinatal period. While the sleep of third trimester women is considerably poorer than that of non-pregnant women (both objectively and subjectively), the most significant changes occur in the transition between late pregnancy and the early postpartum period. Furthermore, increased amounts of sleep and reports of difficulty falling asleep during late pregnancy predicted the development of postpartum depressive symptoms. This suggests that certain aspects of sleep during late pregnancy may serve as markers for women at risk of developing postpartum depression.

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11

Sučilienė, Elena. "Tuberculin reactivity of children vaccinated at different age with BCG vaccines in preschool period". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100702_105456-08947.

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Object of dissertation: The influence of different BCG vaccination schedules on the tuberculin reactivity, BCG scarring, specific serology and allergy. 509 children were included in this research, all of them received BCG vaccination with standard or half dosage as newborns or 3-months old. 3 months after BCG vaccination and at one, two, and six years of age they were tested with tuberculin, and examined for BCG scarring. Anti-tuberculosis antibodies were detected in sera and children were evaluated for allergy. In conclusions of the dissertation it is declared, that 3 months after BCG vaccination and at 1 year of age children, vaccinated as 3 months - old had stronger tuberculin reactions and better BCG scarring, in comparison to neonatal vaccination. Clear consistent patterns in anti-tuberculosis antibody levels were not established. BCG vaccination at 3 months of age reduced the risk of food –related allergic rash for girls in preschool period.
Disertacijos objektas: įvairių BCG skiepijimo režimų įtaka tuberkulino reakcijos išraiškai, vietinei BCG žymei, specifinei serologijai, alergijos klinikai vaikams iki 6 m. Tyrime dalyvavo 509 vaikai, vakcinuoti įprasta arba pusine BCG vakcinos doze naujagimio ar 3 mėn. amžiaus. Jiems 3 mėn. po BCG vakcinacijos, 1, 2 ir 6 m. atliktas tuberkulino mėginys, įvertintas BCG randelis, ištirti prieštuberkulioziniai antikūnai kraujo serume, įvertintos alerginės būklės. Disertacijos išvadose konstatuojama, kad pusine BCG vakcina skiepytųjų tuberkulino reakcijos silpnesnės, o susidariusi vietinė žymė mažesnė, o 3 mėn. BCG vakcinuotų vaikų tuberkulino reakcijos yra stipresnės, o susidariusi vietinė BCG žymė dažnesnė, nei skiepijant įprasta BCG vakcina naujagimio amžiaus vaikus lyginant su įprasta BCG vakcina naujagimio amžiaus skiepytais vaikais 3 mėn. po BCG vakcinacijos ar 1 m. vaikams. Aiškių prieštuberkuliozinių antikūnų dėsningumų nepavyko aptikti. 3 mėn. amžiaus BCG vakcinacija sumažino su maistu siejamų alerginių bėrimų riziką ikimokyklinio amžiaus mergaitėms.

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12

Hendricks, Katherine Elizabeth May. "Reproductive strategies in the postpartum dairy cow with reference to anovulation and postpartum uterine health". [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0007013.

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Thesis (M.S.)--University of Florida, 2004.
Typescript. Title from title page of source document. Document formatted into pages; contains 176 pages. Includes Vita. Includes bibliographical references.

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13

Haff, G. Gregory, Janna R. Jackson, Naoki Kawamori, Jon M. Carlock, Michael J. Hartman, J. Lon Kilgore, Robert T. Morris, Michael W. Ramsey, William A. Sands e Michael H. Stone. "Force-Time Curve Characteristics and Hormonal Alterations During an Eleven-Week Training Period in Elite Women Weightlifters". Digital Commons @ East Tennessee State University, 2008. https://dc.etsu.edu/etsu-works/4139.

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The purpose of this investigation was to study the effects of an 11-week training period performed by female weightlifters. Two weeks before this investigation, baseline measures for total testosterone, cortisol, and testosterone:cortisol ratio were collected. The 11-week training program consisted of the core exercises (i.e., clean, clean and jerk, and snatch) and other supplemental exercises (i.e., clean pull, snatch pull, squat, and front squat). Hormonal, isometric, and dynamic middle thigh pull force-time curve characteristics were assessed biweekly throughout the duration of the investigation, whereas volume load and training intensity were assessed weekly throughout the investigation. The testosterone:cortisol ratio of the baseline (1.19 ± 0.64) was significantly different from the ratio of weeks 1 (0.67 ± 0.36) and 9 (0.94 ± 0.66). When the week-to-week values were compared, week 1 (0.67 ± 0.36) was significantly different (P < 0.05; ηsup>2= 0.84) from week 3 (1.06 ± 0.54). A very strong correlation (r = −0.83; r 2 = 0.69) was found between the percentage change of the testosterone:cortisol ratio and volume load from weeks 1 to 11. Moderate to very strong correlations were noted between the percentage change in volume load and isometric peak force, peak force during the 30% isometric peak force trial, and peak force during the 100-kg trial during the 11 weeks of training. The primary finding of this study was that alterations in training volume load can result in concomitant changes in the anabolic-to-catabolic balance, as indicated by the testosterone:cortisol ratio, and the ability to generate maximal forces.

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Mikaelsdotter, Carolina. "Barriers affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya". Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-387655.

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Background: Antenatal care (ANC), facility delivery and postnatal care (PNC), are proven to reduce maternal and child mortality and morbidity in high burden settings. However, few rural pregnant women use these services sufficiently and it is essential to identify the barriers. Aim: The aim of this study was to examine barriers, with a focus on water, sanitation and hygiene (WASH), affecting women’s decision to seek care during pregnancy, childbirth and postnatal period in rural Kenya, and to examine if the Afya intervention helped overcome barriers. Methods: A qualitative study was conducted in the Siaya County, Kenya. 25 mothers were selected by using purposive sampling for in-depth interviews and focus group discussions. Assessment of WASH facilities was conducted at 5 healthcare facilities. Data were analysed by content analysis method. The “three delay model” informed the analytic process and discussion. Results: Women delayed seeking or did not attend ANC and PNC or gave birth at home, due to lack of knowledge of benefits of maternal health services and on complications; traditional and religious beliefs; embarrassed over pregnancy; busy with other life activities or of fear of HIV status and hospitals. Gender norms, distance and transport costs were the contributing factor for delaying in reaching the hospital. Unprofessional and inadequate number of staff, lack of equipment and supplies, and the water, sanitation and hygiene quality were factors delaying receiving quality care. The assessment showed on inadequate WASH facilities. Conclusion: Use of antenatal care, delivery and postnatal care in rural western Kenya is influenced by several barriers. The findings suggest a need to increase the knowledge about ANC and PNC, and to lower barriers preventing women from reaching the healthcare facility. There is also a need to improve the WASH facilities and the healthcare personnel’s treatment.

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King, Daniel A. "Painful stories : the experience of pain and its narration in the Greek literature of the Imperial period (100-250)". Thesis, University of Oxford, 2011. http://ora.ox.ac.uk/objects/uuid:c5509a42-cd3f-4e11-b9a1-8a3b6fa84101.

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This research project investigates the relationship between pain and the practices of explaining and narrating it to others. Current scholarship argues that the representation of suffering became, during the Imperial period, an increasingly effective and popular strategy for cultivating authority and that this explains the success of Christian culture’s representation of itself as a community of sufferers. One criticism of this approach is that the experience of pain has often been assumed, rather than analysed. Here, I investigate the nature of pain by attending to its intimate relationship with language; pain was connected to the strategies used to communicate that experience to others. I will show that writers throughout the Imperial period were concerned with questions about how to communicate pain and how that act of communication shaped, managed, and alleviated the experience. I investigate this culture along three axes. Part 1, ‘The Sublime Representation of Pain’, investigates the way different authors thought about the capacity of sublime language and rhetorical techniques such as enargeia to effectively communicate pain. I argue that for writers such as Longinus, the sublime offers an opportunity to replicate the traumatic experience of the pain sufferer in the audience or listener—pain is narrated to the audience through a traumatic communicative mode. Contrarily, I show how authors such as Plutarch and Galen were particularly concerned to desublimate the representation of pain, reducing the affective power of images of pain by promoting the audience’s conscious engagement with the text or representational medium. Part 2, ‘Medical Narratives’, examines a conflict between Galen and Aristides over the way language and narrative signified or referred to painful experiences. I show how both writers negotiate the way pain destroys and transcends ordered, structured, narrative by engaging in a process of narrative translation. I will illuminate the difference between scientific, diagnostic narratives which explain and rationalise pain experiences (in the case of Galen) and those which attempt to give witness to the nebulous, ineffable qualities of pain. In Part 3, ‘Narrating Cures’ I investigate ancient practices of psychotherapy. I show how various philosophical consolations were underpinned by an understanding of the power of pain to continually return and overwhelm the individual. I show further that the Greek romances engage in a type of talking cure: the novels use narration and story-telling to help assert the protagonists’ distance from their past traumatic experiences and, thus, allow the individual to overcome their painful past.

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Caicedo, Ceron Margarita. "The Availability and the Use of Basic Services in Relation to the Nutritional Status, Acute Diarrhetic Diseases and Acute Respiratory Infections in Children Under five Years of Age in Three Rural Communities of the Imbabura Province during the 1998-1999 Period". BYU ScholarsArchive, 2000. https://scholarsarchive.byu.edu/etd/5339.

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To a large degree, the political and economic conditions of third world countries influence poverty levels, especially in rural areas. This poverty affects the availability of basic services, such as potable water, refuse elimination, housing, and sewage systems. As a consequence of these deficiencies, more diseases are transmitted through the water and environment. These diseases include acute diarrhea and acute respiratory infections in children younger than five years of age. Consequently, it is important to have available water and sewage elimination to control these diseases among children and the general population.

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Saidah, Rassen. "Benefícios da acupuntura no pós-operatório das cirurgias artroscópicas no joelho". Faculdade de Medicina de São José do Rio Preto, 2001. http://bdtd.famerp.br/handle/tede/175.

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Made available in DSpace on 2016-01-26T12:51:43Z (GMT). No. of bitstreams: 1 rassen_dissert.pdf: 1247464 bytes, checksum: 68e143195fe25c1bd50b6681db4d40e7 (MD5) Previous issue date: 2001-09-28
The aim of the present study is to evaluate the result of the knee pain treatment using The Opposite Side Technique from the Traditional Chinese Medicine. Thirty-six patients with unilateral gonalgia were studied. 44.44% (16) with osteoarthrosis, 30.55% (11) with patella femural osteoarthrosis, 11.11% (4) with severe osteoarthrosis, 11.11% (4) with patella chrondomalacy and 2.77% (1) with synovial plica. The patients were divided in two groups: Group I (Acupuncture) were eighteen, who submitted to 20 acupuncture sessions, where it was used points of counter to lateral acupuncture to the affected knee and acupuncture points to the distance according to the Traditional Chinese Medicine and to the acupuncture neurophisiologic action standard to select these points for the treatment, and Group II (Phisiotherapy) also eighteen, who submitted to 20 physiotherapeutic sessions and antiinflamatory non steroid (AINS) medicines. According to the results from the statistical analysis, non-parametric, of the subjective data (the intensity of the described pain, difficulty in walking, in crouching, in going upstairs and downstairs, in running, in jumping, in claudicant motion, in making use of some walking support) as the objective parameters ( the restriction of the flexional moviment and also the one of the knee extension moviment, and the arc moviment) showed good results in all the studied parameters. The most refractory parameters were the objective ones above mentioned. The Jue Yin (Liver) energetic channel of the foot showed to be the most affected (22.22%), followed by the associations of the Jue Yin (Liver) and the Tae Yang (Bladder) energetic channel of the foot (22.22%), the Jue Yin (Liver) and the Yang Ming (Stomach) of the foot (16.66%), and the Jue Yin (Liver) and the Shao Yang (Gall Bladder) of the foot (11.11%), and another associations (16.66%). The false-Yang (52.77%) characteristics of disorders were the predominant in relation to the energetic ones followed by the Yin (33.33%) and the Yang (13.88%) disorders of the patients.
O presente estudo teve a finalidade de avaliar a eficácia da acunputura no pós-operatório das cirurgias artroscópicas no joelho utilizando - se a técnica "ao oposto" da medicina tradicional chinesa. As 36 gonalgias estudadas foram distribuídas conforme a patologia encontrada nas artroscópicas cirúrgicas: 50,0% tinham lesão do menisco medial isolada, 19,44% tinham lesão meniscal associada à artrose de joelho, 11,11% tinham lesão meniscal lateral associada à artrose de joelho, 8,33% tinham lesão meniscal lateral isolada de joelho, 2,77% apresentavam lesão em ambos os menisco associados à artrose de joelho, 2,77% apresentavam condromalácea de patela e 2,77% eram portador de corpo livre. Os pacientes foram dividos em dois grupos. Todos os pacientes do grupo i (acunputura) 18 foram submetidos a 20 sessões de acunputura, utilizando-se pontos de acunputura, utilizando-se pontos de acunputura contra-lateral ao joelho afetado, e os pacientes do grupo ii (fisioterapia), 18, foram submetidos a 20 sessões de fisioterapia, associadas a anti-inflamatórios não esteroídes (aine). Nota de Resumo A análise estatística não paramétrica dos resultados obtidos nos dados subjetivos (intensidade da dor relatada, dificuldade de andar, de agachar, de subir e descer degraus, de correr, de uso de apoio a marcha), como os parâmetros objetivos (limitação do movimento de flexão, extensão, arco de movimento, edema, derrame e trofismo de joelho) evidenciaram bons resultados na maioria dos parâmetros estudados. Embora os resultados fossem semelhantes, a acunputura apresentou melhores resultados do tratamento mais precocemente, enquanto a fisioterapia mais tardiamente.

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Masters, Grace A. "Bipolar Disorder in the Perinatal Period: Understanding Gaps in Care to Improve Access and Patient Outcomes". eScholarship@UMMS, 2021. https://escholarship.umassmed.edu/gsbs_diss/1127.

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Background: Bipolar disorder (BD) is a significant cause of perinatal morbidity and mortality. Because BD is hard to detect and treat, these individuals often go without care. This dissertation was designed to: (1) identify the prevalence rates of BD and bipolar-spectrum mood episodes in perinatal individuals, (2) understand pertinent barriers to mental healthcare, and (3) elucidate how to bridge healthcare gaps. Methods: Data sources included: primary qualitative and quantitative data from obstetric clinicians, encounter data from Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, a program aimed at helping clinicians to provide mental healthcare to perinatal patients. Analyses included: descriptive statistics, systematic review and meta-analysis, qualitative data analyses, longitudinal regression analyses, and group-based trajectory modeling. Results: The prevalence of BD in perinatal individuals was 2.6% (95% CI: 1.2 to 4.5%). Twenty to 54.9% were found to have a bipolar-spectrum mood episode. Barriers to mental healthcare for perinatal patients with BD included the paucity of psychiatric resources, difficulties in assessing BD, and stigma towards pharmacotherapy. Obstetric clinicians reported that MCPAP for Moms has helped them feel more comfortable in treating patients with BD. Longitudinal analyses of encounter data corroborated these findings - utilization of the program predicted increased clinician capacity to treat BD. Conclusion: Clinicians for perinatal individuals are being called upon and stepping up to care for complex illnesses like BD. Programs like MCPAP for Moms can help them feel more confident in this role, helping to bridge gaps in perinatal mental healthcare and ensuring that individuals with BD are able to receive appropriate care.

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Lloyd, Mimmi, e Sediga Haidari. "Kvinnors upplevelser och erfarenheter av att amma sitt nyfödda barn : En kvalitativ metasyntes". Thesis, Högskolan Dalarna, Sexuell, reproduktiv och perinatal hälsa, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:du-36036.

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Bakgrund: Amning har en central del i spädbarns överlevnad, och har en rad hälsofördelar både för kvinnan och barnet. Stöd till kvinnan direkt efter förlossningen är en viktig del för att initiera och etablera amningen. Svenska barnmorskor vill främja kvinnans önskemål om amning även om amningssvårigheter finns. Syfte: Syftet var att beskriva kvinnors upplevelser och erfarenheter av amning, för att främja barnmorskors förståelse och möjlighet att ge det stöd kvinnor önskar och behöver kring amning under nyföddhetsperioden. Metod: Designen är en kvalitativ metasyntes som baseras på 20 vetenskapliga, kvalitativa artiklar som kvalitetsgranskats och analyserats via meta-ethnografi. Resultat: Resultatet bestod av tre huvudteman; fysisk prestation, existentiell utmaning och yttre influenser. Fysisk prestation belyser upplevda kroppsliga effekter och amningsrelaterade svårigheter och hinder, som smärta, sår och utmattning. Existentiell utmaning beskriver upplevelser kring viljan att göra det bästa för sitt nyfödda barn, känslor som uppstår i samband med amning samt misstro till den egna kroppen. Yttre influenser beskriver sociala förväntningar på ammande kvinnor samt kvinnors upplevda behov och brister av stöd. Slutsats: Kvinnors upplevelser av att amma sitt nyfödda barn skiljer sig åt, och påverkas av fysiska och sociala utmaningar. De positiva hälsoeffekterna med amning är uppenbara, och kvinnor står inför olika utmaningar och hinder angående amningen. Även om kvinnor har stark avsikt att amma får misslyckanden dem att känna sig frustrerade och skyldiga. Praktiskt stöd, emotionell vägledning samt individanpassad undervisning och information kan hjälpa kvinnor att övervinna många av de interna och externa hinder som de står inför. Klinisk tillämpbarhet: Barnmorskan har en primär roll vid den perinatala vården. Om barnmorskan har kunskap om kvinnors upplevelser av amning skapas möjligheter hos barnmorskan att påverka amningen till det bättre, genom att undervisa, förebygga komplikationer och individanpassa vården, för bästa möjliga amningsinitiering.
Background: Breast milk has a central part in infant survival and has a number of health benefits for both the woman and the baby. Support for the woman immediately after the birth is an important part of initiating and establishing breastfeeding. Swedish midwives strive to promote the woman's desire for breastfeeding despite potential difficulties in breastfeeding. Purpose: The aim was to describe women's experiences of breastfeeding, to promote midwives' understanding and opportunities to provide the support women want and need around breastfeeding during the neonatal period. Method: The design is a qualitative meta-synthesis based on 20 scientific, qualitative articles that have been quality reviewed and analyzed via meta-ethnography. Results: The result was designed by three main themes; physical performance, existential challenge and external influences. Physical performance highlights physical effects and breastfeeding-related difficulties and obstacles, such as pain, sores and fatigue. Existential challenge describes experiences around the desire to do the best for one's newborn child, feelings that arise in connection with breastfeeding and mistrust of one's own body. External influences describe social expectations of breastfeeding women as well as women's perceived needs and lack of support. Conclusion: Women's experiences of breastfeeding their newborn baby differ, and are affected by physical and social challenges. The positive health effects of breastfeeding are obvious, and women face various challenges and obstacles regarding breastfeeding. Although women have a strong intention to breastfeed, failures make them feel frustrated and guilty. Practical support, emotional guidance and individualized information can help women overcome many of the internal and external obstacles they face. Clinical applicability: The midwife has a primary role in perinatal care. If the midwife has knowledge of women's experiences of breastfeeding, opportunities are created for the midwife to influence breastfeeding for the better, by teaching, preventing complications and adapting care to the individual, for the best possible initiation of breastfeeding.

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20

Kirk, Benjamin J. C. "Neuromuscular factors contributing to reductions in muscle force after repeated, high-intensity muscular efforts". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2067.

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Fatigue can accumulate sufficiently to limit muscular force production during repeated, forceful muscle contractions, including those that occur in the occupational, clinical and athletic settings. Fatigue during such efforts is likely to result from disturbances to multiple processes in the nervous system and muscle. However, previous research examining the mechanisms underpinning fatigue have typically required subjects to perform low-level constant-force contractions or to repeat maximal efforts in a single set format. Such tasks do not translate well to occupational, daily living or athletic situations where high-intensity, yet submaximal, repeated efforts may be performed in work bouts (or sets) with brief rest periods for recovery. Therefore, the overall aim of the present research was to investigate the neuromuscular mechanisms contributing to force loss after repeated, high-intensity muscular efforts with longer (90 s) periods of rest separating repetitions into sets of contractions. In Experiment 1, 16 resistance trained men performed 6 sets of unilateral isometric plantar flexor contractions of the right leg (3 s contraction/2 s rest) reaching a target level of 85% maximal voluntary contraction (MVC). Sets were separated by a 90-s inter-set rest and completed to failure (i.e. In Experiment 1, a significant reduction in maximum voluntary isometric plantar flexion torque (12.2%; p < 0.001) was observed post-exercise, which did not recover by POST-20. Significant reductions in triceps surae EMG/M (-6%; p = 0.024) and MEP/M amplitude (9%; p = 0.01) were found post-exercise but recovered by POST-10. Cortical silent period (an indicator of GABAB-mediated intracortical inhibition) was reduced (-4%; p = 0.016) post-exercise and did not recover by POST-20. In Experiment 2, temporal changes in torque were similar to Experiment 1. Significant reductions in the evoked torque response from 20 Hz (p < 0.001), 80 Hz (p < 0.001) and VFT (p < 0.001) stimulations were observed at POST and did not recover by POST-20, however no changes in 20:80 and 20:VFT ratios were observed. Finally, significant reductions in both Tvib (-13%; p = 0.035) and Tsust (-25%; p = 0.035) were found post-exercise but recovered by POST-10. The ingestion of caffeine allowed for a greater overall torque production and neural drive (EMG/M) but the lack of condition  time interaction effect indicated that it did not clearly affect the time course of fatigue or recovery. Further, no detectable effects were observed compared to the non-caffeine condition in corticospinal excitability, MN excitability or E-C coupling, as shown by the negligible changes in MEP/M amplitude, PIC facilitation, and torque during 20-Hz, 80-Hz and VFT stimulations. These data suggest that corticospinal tract efficiency and PIC-mediated facilitation of the MN pool can be compromised and are likely to account in part for the force loss immediately following an acute bout of repeated, high-intensity muscular efforts performed in sets (with 90 s rest). However, changes in E-C coupling efficiency (i.e. ‘peripheral fatigue) are likely to explain the ongoing, prolonged loss of force, at least to 20 min post-exercise. Therefore, it is likely that both changes in the nervous system as well as the muscle contribute to the loss of force following repeated, high-intensity muscular efforts.

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21

Kabali, Emmanuel. "Review of the effectiveness of the medicines regulatory systems in Zambia over the period 1995 to 2015". University of the Western Cape, 2018. http://hdl.handle.net/11394/5904.

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Magister Scientiae - MSc (Pharmacy Administration and Policy Regulation)
Due to inadequacy of data on the effectiveness of medicines regulatory systems in Zambia, this study was framed. The aim was to evaluate legislative provisions for medicines regulation under three legalregulatory- frameworks in place over the period from 1995 to 2015. The study was structured in two distinct phases: the first involved document review of available legislation and secondary data relevant to the subject matter, covering the study period; the second involved a questionnaire survey for health practitioners to gather opinions on the effectiveness of the medicines regulatory systems in Zambia. Assessment of secondary data reported by Ministry of Health, and World Health Organisation on treatment outcomes and medicines regulation was conducted. Reviewed data showed relative reduction in incidence of some selected diseases of national importance. It was also evident that the regulatory systems had improved considerably over the study period. Responses from Health Practitioners and other players in the health and pharmaceutical sectors indicated that they were aware of medicines regulatory requirements, supported the need for medicines regulation, and indicated the need for regional collaboration and increased public awareness raising as means for improving current medicines regulatory systems. It was recommended that more comprehensive studies be undertaken to establish causal relationships between medicines regulatory systems, and disease outcomes. A further recommendation was made to implement more integrated information management systems in the Ministry of Health, and the Zambia Medicines Regulatory Authority.

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22

Paulauskienė, Skaidrė. "Jaunuolystės amžiaus vyrų padidėjusio kraujospūdžio sąsajos su kritiniais augimo periodais". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2011. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2011~D_20110920_152416-70215.

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Pirminė arterinė hipertenzija diagnozuojama kas trečiam suaugusiam. Liga jaunėja, ypač tarp vyrų, šios tendencijos nepavyksta paaiškinti vien bendraisiais kardiovaskulinės rizikos veiksniais. Mažai kreipiamas dėmesys į galimą hipertenzijos ryšį su gimimo parametrais ir augimo ypatumais. Nebuvo aišku, kurie iš bendrųjų hipertenzijos rizikos veiksnių ir kokie kritinių augimo tarpsnių ypatumai daro didžiausią įtaką mūsų šalies jaunimo kraujospūdžio raidai. Todėl disertacija skirta įvertinti jaunuolystės amžiaus vyrų (18-21 metų) padidėjusio kraujospūdžio ryšį su skirtingų kritinių augimo periodų ypatumais, kardiovaskulinės rizikos veiksniais, paveldimumu ir jaunuolio šeimos socioekonominėmis sąlygomis. Ištirtas 231 asmuo (48 atvejo grupėje, 183 kontrolinėje grupėje). Darbe nustatyta, kad mažesnė galvos ir krūtinės apimtis gimus kartu su jaunuolystės kūno masės indeksu yra reikšmingi padidėjusio kraujospūdžio prognostiniai veiksniai. Greitesnis ūgio augimas per pirmus septynerius gyvenimo metus ir paauglystės tarpsnio kūno masės indekso bei svorio intensyvesnis augimo greitis turi reikšmingų sąsajų su padidėjusiu kraujospūdžiu jaunuolystėje. Nustatyta skirtinga liesos kūno masės ir riebalų masės įtaka kraujospūdžiui. Konstatuota, kad padidėjusį kraujospūdį turintys jaunuoliai yra stambesnio skeleto. Reikšmingą įtaką jo kraujospūdžiui turi rizikingais kiekiais vartojamas alkoholis ir mažesnis fizinis aktyvumas. Įvertinta mamos ankstyvo sergamumo pirmine arterine hipertenzija ir... [toliau žr. visą tekstą]
Primary arterial hypertension is diagnosed in every third adult. The disease tends to appear in younger individuals, especially men. However, general cardiovascular disease risk factors fail to explain this trend. Insufficient attention is given to the possible relation between hypertension and birth parameters as well as growth characteristics. It was not known which of the general hypertension risk factors and which of the critical growth period characteristics have major influence on the development of elevated blood pressure in young men in our country. Therefore, this dissertation aims at evaluating the relation of elevated blood pressure in young men (18-21 years old) to the characteristics of different critical growth periods, cardiovascular risk factors, heredity and the socio-economic conditions of the young man‘s family. The research showed the following results: smaller head and chest circumferences at birth along with the body mass index at young adult age are significant prognostic factors for elevated blood pressure; higher velocity of height growth within the first seven years of life and more intensive growth of the body mass index and weight in adolescence have significant relation to elevated blood pressure at young adult age; lean body mass and fat body mass have different influence on blood pressure; young men with elevated blood pressure have bigger skeletons; risky amounts of alcohol consumed and lower physical activity have significant influence on... [to full text]

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23

Paulauskienė, Skaidrė. "The relation between elevated blood pressure in young men and critical growth periods". Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2011. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2011~D_20110920_152526-26757.

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Primary arterial hypertension is diagnosed in every third adult. The disease tends to appear in younger individuals, especially men. However, general cardiovascular disease risk factors fail to explain this trend. Insufficient attention is given to the possible relation between hypertension and birth parameters as well as growth characteristics. It was not known which of the general hypertension risk factors and which of the critical growth period characteristics have major influence on the development of elevated blood pressure in young men in our country. Therefore, this dissertation aims at evaluating the relation of elevated blood pressure in young men (18-21 years old) to the characteristics of different critical growth periods, cardiovascular risk factors, heredity and the socio-economic conditions of the young man‘s family. The research showed the following results: smaller head and chest circumferences at birth along with the body mass index at young adult age are significant prognostic factors for elevated blood pressure; higher velocity of height growth within the first seven years of life and more intensive growth of the body mass index and weight in adolescence have significant relation to elevated blood pressure at young adult age; lean body mass and fat body mass have different influence on blood pressure; young men with elevated blood pressure have bigger skeletons; risky amounts of alcohol consumed and lower physical activity have significant influence on... [to full text]
Pirminė arterinė hipertenzija diagnozuojama kas trečiam suaugusiam. Liga jaunėja, ypač tarp vyrų, šios tendencijos nepavyksta paaiškinti vien bendraisiais kardiovaskulinės rizikos veiksniais. Mažai kreipiamas dėmesys į galimą hipertenzijos ryšį su gimimo parametrais ir augimo ypatumais. Nebuvo aišku, kurie iš bendrųjų hipertenzijos rizikos veiksnių ir kokie kritinių augimo tarpsnių ypatumai daro didžiausią įtaką mūsų šalies jaunimo kraujospūdžio raidai. Todėl disertacija skirta įvertinti jaunuolystės amžiaus vyrų (18-21 metų) padidėjusio kraujospūdžio ryšį su skirtingų kritinių augimo periodų ypatumais, kardiovaskulinės rizikos veiksniais, paveldimumu ir jaunuolio šeimos socioekonominėmis sąlygomis. Ištirtas 231 asmuo (48 atvejo grupėje, 183 kontrolinėje grupėje). Darbe nustatyta, kad mažesnė galvos ir krūtinės apimtis gimus kartu su jaunuolystės kūno masės indeksu yra reikšmingi padidėjusio kraujospūdžio prognostiniai veiksniai. Greitesnis ūgio augimas per pirmus septynerius gyvenimo metus ir paauglystės tarpsnio kūno masės indekso bei svorio intensyvesnis augimo greitis turi reikšmingų sąsajų su padidėjusiu kraujospūdžiu jaunuolystėje. Nustatyta skirtinga liesos kūno masės ir riebalų masės įtaka kraujospūdžiui. Konstatuota, kad padidėjusį kraujospūdį turintys jaunuoliai yra stambesnio skeleto. Reikšmingą įtaką jo kraujospūdžiui turi rizikingais kiekiais vartojamas alkoholis ir mažesnis fizinis aktyvumas. Įvertinta mamos ankstyvo sergamumo pirmine arterine hipertenzija ir... [toliau žr. visą tekstą]

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24

Pereira, João Nuno Mendes Santos. "Técnicas radiográficas em Medicina Dentária na detecção de lesões endo-perio: uma análise comparativa". Master's thesis, [s.n.], 2015. http://hdl.handle.net/10284/5046.

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária
A área da imagiologia e da endodontia estão em completa interligação. O diagnóstico e a concretização de um plano de tratamento dependem dos achados clínicos assim como os imagiológicos. No entanto, a quantidade de técnicas imagiológicas que hoje estão à disposição do clínico e do paciente invocam a necessidade de compreender quais as vantagens na utilização dos diversos meios para o sucesso no tratamento. Foi então realizada uma pesquisa nas bases de dados online PubMed, Scielo, Science Direct e b-On, compreendida entre o ano de 1996 e 2015, tendo sido seleccionados 48 artigos e o recurso a 3 livros para a concretização do trabalho. As conclusões obtidas são de que apesar da evolução e da descoberta de novas técnicas imagiológicas, não existe nenhuma que seja nem aconselhada ou desaconselhada ou sensível a 100% para o diagnóstico das patologias e que o recurso às diversas técnicas deve ter por base certos critérios que justifiquem a sua utilização. The imaging and endodontics area are in full interconnection. The diagnoses and the implementation of a treatment plan depend on the clinical as well as imaging foundings. However, the amount of imaging techniques that is now available to the clinician and patient, cal the need to understand the advantages in the use of various means to success in treatment. It was then carried out a search in online databases PubMed, Scielo, Science Direct and b -On, between 1996 and 2015 and was selected 48 articles and the use of 3 books for completing the work. The conclusions reached are in spite of evolution and discovery of new imaging techniques, there is none that is either recommended or discouraged or sensible at 100% for the diagnosis and that the use of various techniques should be based on certain criteria that justify its use.

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AlcÃntara, AntÃnia Celia de Castro. "Patients and evaluation with juvenile idiopathic arthritis accompanied the University Hospital in CantÃdio Walter period may 2008 may 2012". Universidade Federal do CearÃ, 2013. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13513.

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Juvenile idiopathic arthritis (JIA) is the most common chronic disease of childhood in USA and Europe. In Brazil, there are few epidemiological studies on the specific disease. This is the first study in Northeast Brazil who described the clinical profile, response to treatment with biological drugs and non-biological drugs and adverse events in JIA. Exclusion criteria were secondary causes of chronic arthritis. Two reviews with an average interval of 37 months were conducted: the first at baseline, the second at the end, which was researched treatment given, assessment of disease activity through DAS28 (Disease Activity Score), functional assessment by the CHAQ (Childhood Health Assessment Questionnaire) and joint damage by JADI AM (The Modified Juvenile Arthritis Damage Index). Seventy-four patients were enrolled and 05 were excluded because alternative diagnosis of chronic arthritis. We followed sixtynine: 46 girls and 23 boys. Forty-seven (68.1%) came from the capital, 48 (69.5%) lived with both parents. The mean age at onset was 7.89 Â 3.5 years, the average age of definitive diagnosis 9.70 Â 3.9 years and the time interval between the onset of symptoms and definitive diagnosis 12 months (01-60). At the time of definitive diagnosis, the average number of active joints was 7.7. Â 4.7, extra-articular manifestations occurred in 43 (62.3%) and joint deformity in 16 (23%), ESR was elevated in 68 (98.5%).The rheumatoid factor was positive in 16 (23.1%) and the Fan in 08 (11.5%). According to the ILAR classification: 23 (33.3%) had polyarticular negative rheumatoid factor, 13 (18.8%) polyarticular positive rheumatoid factor, 18 (26.0%) as oligoarticular (08 persistent and 10 extended), 10 (14.5%) as systemic, 04 (5.8%) with arthritis associated to enthesitis and 01 (1.4%) as psoriatic arthritis. The deformity group showed greater time interval between onset of symptoms and definitive diagnosis (p=0.04) and more active joints at diagnosis compared to those without deformity (p =0.008). The mean DAS28 at the beginning was 5.42 Â 0.77 and 3.25 Â 1.42 at the end. The mean duration of disease at study was 12.4 Â 6.2 years. In 21.97%, CHAQ was zero. Nineteen (27.5%) patients presented JADI AM> 0. During the study, 50.7% used NSAIDs, 17.3%, intraarticular steroid, 82.6% Methotrexate (MTX), Leflunomide (LFN) 62.3%, 28.9% etanercept, 5.7% adalimumab. MTX monotherapy do not sustained low disease activity in most patients; LFN was a safe and effective therapeutic option to MTX monotherapy before initiating biologic therapy. Etanercept was the most widely used biologic after failure with non-organic. The strategy adopted treatment reduced pain, discomfort, and contributed to improving the quality of life of children.
11 RESUMO Artrite idiopÃtica juvenil Ã a doenÃa crÃnica mais comum da infÃncia nos paÃses do hemisfÃrio Norte e na Europa. No Brasil, hÃ poucos estudos epidemiolÃgicos especÃficos sobre a doenÃa. Esse Ã o primeiro estudo no Nordeste brasileiro que descreveu o perfil clÃnico, a resposta ao tratamento com drogas nÃo biolÃgicas e biolÃgicas e eventos adversos dos pacientes com esse diagnÃstico. CritÃrio de exclusÃo consistiu no diagnÃstico de artrite crÃnica de outra causa definida. Duas avaliaÃÃes com intervalo mÃdio de 37 meses foram realizadas: a primeira no inÃcio do estudo; a segunda ao final, onde foi pesquisado tratamento utilizado, avaliaÃÃo de atividade de doenÃa pelo DAS28 (Disease Activity Score), avaliaÃÃo funcional pelo CHAQ (Childhood Health Assessment Questionaire) e de dano articular pelo JADI AM (The modified Juvenile Arthritis Damage Index). Setenta e quatro pacientes foram selecionados, 05 foram excluÃdos devido diagnÃstico alternativo de artrite crÃnica. Sessenta e nove foram seguidos: 46 meninas e 23 meninos. Quarente e sete (68,1 %) procedia da capital, 48 (69,5 %) residia com ambos os pais. A idade mÃdia no inÃcio dos sintomas foi de 7,89 Â 3,5 anos, a idade mÃdia do diagnÃstico definitivo 9,70 Â 3,9 anos e o intervalo de tempo entre o inÃcio dos sintomas e o diagnÃstico definitivo 12 meses (min 01, mÃx. 60). Na Ãpoca do diagnÃstico definitivo, o nÃmero mÃdio de articulaÃÃes ativas foi 7,7. Â 4,7; manifestaÃÃo extra-articular ocorreu em 43 (62,3 %) e deformidade articular em 16 (23 %); VHS estava elevado em 68 (98,5 %); 08 (11,5 %) apresentavam FAN reagente e 16 (23,1 %) fator reumatoide positivo. De acordo com a classificaÃÃo da ILAR:23 (33,3 %) apresentou o subtipo poli articular soronegativo, 13 (18,8 %) poli articular soropositivo, 18 (26,0 %) oligo-articular: 08 (11,6 %), persistente e 10 (14,5 %), estendido; 10 (14,5 %) sistÃmico, 04 (5,8 %) relacionado Ã entesopatia e 01 (1,4%) a forma psoriÃtica. O grupo com deformidade apresentou maior intervalo de tempo entre o inÃcio dos sintomas e o diagnÃstico definitivo (p=0,04) e mais articulaÃÃes ativas no diagnÃstico comparado ao grupo sem deformidade (p=0,008). A mÃdia do DAS28 no inÃcio foi 5,42 Â 0,77 e no final 3,25 Â 1,42. O tempo de doenÃa mÃdio ao final do estudo foi de 12,4 Â 6,2 anos. Em 21,97 % CHAQ foi igual a zero. Dezenove (27,5 %) pacientes apresentou JADI AM > 0. Durante o estudo 50,7 % utilizou anti-inflamatÃrio nÃo esteroidal, 17,3 % corticoide intra-articular, 82,6 % Metotrexato (MTX), 62,3 % Leflunomida (LFN), 28,9 % etanercepte, 5,7 % adalimumabe. Monoterapia com MTX nÃo sustentou baixa atividade de doenÃa na maioria dos pacientes; LFN foi uma opÃÃo terapÃutica segura e eficaz Ã monoterapia com MTX antes de iniciar terapia biolÃgica. Etanercepte foi o biolÃgico mais utilizado apÃs falha com nÃo biolÃgicos. A estratÃgia de tratamento adotado reduziu a dor e o desconforto e contribuiu para melhoria da qualidade de vida das crianÃas.

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Giron, Castellanos Said, e Sandoval Claudia Santiago. "FRECUENCIA DEL SINDROME DE BURNOUT DURANTE EL PERIODO GESTACIONAL EN TRABAJADORAS DE LA UNIDAD DE MEDICINA FAMILIAR No 92, EN EL PERIODO 2011-2013". Tesis de Licenciatura, Medicina-Quimica, 2014. http://ri.uaemex.mx/handle/123456789/14560.

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Wright, Barry. "Psychiatric symptomatology and menorrhagia, psychological morbidity and menstrual loss in women receiving endometrial ablation for heavy periods". Thesis, University College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368037.

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Karzis, Joanne. "Intramammary antibiotics in dairy goats withdrawal periods and tissue tolerance /". Electronic thesis, 2005. http://upetd.up.ac.za/thesis/available/etd-07242008-084703/.

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Ahlund, Veronica. "Development of Clostridium difficile resistance to Piperacillin/Tazobactam over a period of ten years". Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-57501.

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Daugherty, R. A., B. Bailey e Ivy A. Click. "Pregnancy and Depression in Appalachia: Implications for Depression Screening During the Prenatal and Postpartum Periods of Pregnancy". Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etsu-works/6420.

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Leclerc, de la Verpillière Lorraine. "Visceral creativity : digestion, earthly melancholy, and materiality in the graphic arts of early modern France and the German-speaking lands (c. 1530-1675)". Thesis, University of Cambridge, 2019. https://www.repository.cam.ac.uk/handle/1810/288424.

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Building on recent scholarship in the history of art which has started to reappraise the meaning of grotesque and scatological motifs, this thesis examines how digestion was conceived of as a model of creation, and how this was translated visually. Renaissance creativity was increasingly modelled on a series of natural processes like digestion, following a trend in favour of Aristotelian psychology. However, it has been largely overlooked in comparison to the bleeding, the pneumatic, and especially the procreative natural models, which have been extensively studied. The central argument of this thesis is that digestion constituted an alternative-albeit less 'decorous'-model of creation, denoting the intervention of a more 'earthbound' ingenium. I argue that this model was used by certain classes of artists as an acknowledgement of a strong engagement with materials and of the labour of a round-the-clock imagination. Goldsmithing and printmaking are artistic professions whereby the artistic process was often considered as an act of 'soiling' oneself, both in the sense of the body and the phantasia. This thesis focuses on a period spanning c. 1530 to 1675, from Rabelais' works to the facetious printer Jacques Lagniet. It mines a corpus of little-studied textual and visual sources from the north of the Alps, examining a continuity between France and the German lands: geographical areas which both had an especially pronounced 'culture of excretion'. From a broader perspective, this research responds to a widespread scholarly call for more attention to the organic soul and the lower body, nuancing the alleged hegemony of the brain and the higher senses throughout history. It seeks to modify the perception of early modern artists and viewers as cerebral intellectuals, presenting them as individuals who also 'thought with their guts'.

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Vigouroux, Mathias. "La transmission et l’assimilation des savoirs médicaux liés à la pratique de l’acuponcture et de la moxibustion au Japon (via la Chine et la Corée) et en Europe à l’époque pré-moderne (XVIe siècle - XIXe siècle)". Thesis, Lyon 3, 2014. http://www.theses.fr/2014LYO30088.

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À partir de la fin du XVIe siècle, l’acuponcture connut un renouveau au Japon sous l’impulsion de Manase Dôsan (1507-1594) et la mise en place de nouvelles écoles d’acuponcture qui commencèrent à se détacher de la tradition chinoise. Ils représentaient deux tendances qui n’étaient pas nécessairement antinomiques — à savoir d’un côté, une fidélité aux savoirs chinois, et de l’autre côté, l’apparition de nouvelles techniques et théories indigènes — et qui se retrouvèrent tout au long de la période d’Edo (1603-1858). Le développement de l’imprimerie et les stratégies de vulgarisation et de diffusion du savoir médical sino-japonais adoptées par de nombreux médecins lettrés à cette époque favorisèrent par ailleurs la circulation des connaissances. Ainsi, aux traités de médecine importés de Chine ou de Corée, s’ajoutaient leurs rééditions japonaises commentées ou non, les traités de médecine sino-japonaise écrits en chinois classique (avec ou sans signes de lecture) ou en langue vernaculaire et les traités de vulgarisation. Ces livres véhiculaient un savoir issu de différentes traditions, chinoise, coréenne, ou indigène, faisant du Japon pré-moderne un pays à la confluence des savoirs médicaux. Le XVIe et le XVIIe siècles correspondaient aussi à l’arrivée des puissances européennes et aux premières descriptions européennes de l’acuponcture et de la moxibustion, deux pratiques thérapeutiques qui continuèrent d’intéresser les médecins européens en poste à Dejima tout au long de l’époque d’Edo et plus généralement ceux en Europe qui avaient accès à leurs descriptions. Notre travail s’inscrit dans la problématique de la circulation des savoirs en Asie orientale et entre l’Asie orientale et l’Europe. Circulation des savoirs qu’il faut non seulement entendre au sens de transmission et de diffusion des savoirs et des savoir-faire, mais aussi en considérant l’impact de ces savoirs sur le pays récepteur. Nous analysons ainsi la nature des transformations qui se sont opérées au cours des processus de transmission, la manière dont les savoirs ont été compris et décrits par ceux qui ont pu les observer directement et la manière dont ils ont été assimilés par des individus d’un milieu différent de celui dans lequel ils ont été produits. La dynamique médicale de l’époque est restituée par une analyse combinée de la théorie et de la pratique clinique. Ce travail met notamment en lumière l’indissociabilité de la production des savoirs et de leur circulation en montrant comment une pratique se construit à partir des textes transmis. Notre approche méthodologique quantitative et qualitative des sources primaires laisse aussi apparaître le rôle limité de la mobilité humaine dans la transmission des savoirs liés à la pratique de l’acuponcture entre la Chine, la Corée et le Japon. Plus généralement, elle rend compte d’une transmission systématique de tout un système médical de la Chine vers le Japon et d’une transmission parcellaire de ce système du Japon vers l’Europe. L’analyse de la réception de la moxibustion et de l’acuponcture en France à la fin du XVIIIe siècle et au début du XIXe siècle révèle enfin l’importance des institutions médicales dans la soudaine popularité de ces thérapies et la manière dont les médecins français se les approprièrent en ne retenant que le terme (moxa et acuponcture) et le principe (combustion directe sur la peau et insertion d’une aiguille dans le corps)
This dissertation investigates the circulation of acupuncture knowledge between China, Korea and Japan, and between East Asia and Europe in the early modern period (16th century–19th century). In the first part, I analyze the sixteenth and seventeenth century revival of acupuncture focusing on Manase Dôsan (1507-1594) and the emergence of new indigenous theories and techniques. Using the archives of the Nagasaki trade and the transcript of the conversations between Chinese, Korean and Japanese physicians, I also identify the Chinese and Korean acupuncture textbooks transmitted to Japan during the Edo period (1603-1868), their reception by Japanese physicians, and the role geographical mobility played in the transmission of theoretical and tacit medical knowledge. In the second part, I first review the transmission of acupuncture and moxibustion to early modern Europe, and then I analyze their reception in the late eighteenth early nineteenth century France, focusing on the reasons of their sudden vogue in French hospitals, the way French physicians investigated these two therapies, and the reasons of their failure to deeply integrate medical practices
本論文では日本の鍼灸医学を研究対象にして、古い伝統をもつ中国医学と近世に発達した日本の医学とを比較軸にしながら、江戸時代の社会、および同時期のフランスにおいて日本医学の知識と技術がどのように形成され、そして普及したかについて、論述している。つまり、当該時期の中国・日本、およびフランスの医学文献・非医学文献に基づき、社会的・政治的な背景に配慮しながら、日本の鍼灸が近世期に入って中国医学から独立した新しい技術と理論を形成した過程を整理・考察し、また日本国内および国外にその日本の医学知識が普及した過程をも検討した。第一部前半では、五世紀以来これまで中国の鍼灸医学が絶対的な尺度であったのに対して、十六世紀後半の安土・桃山時代に入ると、鍼灸の流派が急増し、内容的にも独創的な気運が見え始める。それらは、打針、管針、腹診などのような中国の鍼灸医学に見られない新技術や新理論をともなって登場した。そこで、日本鍼灸の中国からの独立の過程に関して、技術および理論の両面から具体例に基づいて、中国医学・医術の摂取と独自化について述べる。この独立がどの程度のものであったのか、技術のみの独立か、理論のみの独立か、あるいは両方の独立かを明らかにする。例えば、道三流や杉山流のように、理論面では中国鍼灸医学に基づきながら、臨床面では針より灸を頻繁に使う点に日本鍼灸の特徴が見られる流派があった。打鍼流のように、理論・技術ともに中国鍼灸医学を離れ、新しい針術と理論を形成した流派もあった。砭針のように、古代中国医術の名を借りてはいるが、実際の臨床では全く違った技術もあった。第一部後半では、中国や朝鮮からの医書の輸入とその日本における覆刻の問題を取り上げ、併せて長崎経由で来日した中国人や朝鮮人の医師に注目しながら、鎖国といわれる体制のなかで日本と通商を許された限られた国々との医学上の交流を考察する。広く知られているように、江戸幕府は貿易相手国を三国に限定し、日本人の国外渡航を禁じて、出入国を厳重に取り締まる鎖国政策をとっていたが、この閉鎖的な政策にもかかわらず、輸出された医書の量や日本に渡来した医師の数を見ると、医学的・文化的な交流はかなり盛んであったことがわかる。そのうち本研究では、中国からの輸入医書を通した医学知識の摂取と、朝鮮からの来日医師を通した直接的な医術の摂取を明らかにする。特に、朝鮮通信使の参府に際しては、信使一行と接触した日本人の中には医師も含まれ、朝鮮人医師との間に医事に関する質疑も交わされている。その時の筆談記録『医事問答』等を中心に、来日朝鮮人医師、およびその日本への影響に関して検討する。結論としては、江戸時代に輸入された医書は、覆刻によって全国的な規模で医学知識の普及と形成に影響を及ぼしたのに対して、来日医師たちは地域的な規模でしか影響を及ぼさなかった。第三部では、同時代のフランスにおける日本の鍼灸医学の受容過程について論じる。中国由来の東洋医学とは異なる歴史と体系を持つ西洋医学は、十六世紀にポルトガル人の渡来とともに日本に伝えられ、江戸時代には長崎に滞在したオランダ東インド会社の医師たちを通して導入された。そのオランダ人の医師の中では、テン・ライネ、エンゲルベルト・ケンペル、フォン・シーボルトが日本の医学、特に鍼灸医学について興味を持ち、日本人医師に教わった鍼灸医学の理論と技術をヨーロッパの医師たちに紹介した。五世紀における中国医学の伝来以来、日本は常に医学知識の受信国であったが、オランダの医師を媒介として日本が初めて医学知識の輸出国になった。しかしながら、西洋医学に見られない経絡・陰陽のようなヨーロッパ人には理解しがたい理論が多かったので、理論よりも日本独特の管針・打針などの技術が受け入れられた。特にヨーロッパの国々の中でもフランスの医師が日本の鍼灸医学について強い関心を示し、十九世紀初から十九世紀の半ばにかけては『鍼灸極秘伝』などの日本の針灸書がフランス語に翻訳されたり、パリの公的な病院でも鍼灸医学の研究が行なわれたり、日本の鍼灸医学は盛んであった。そこで、フランスで出版された鍼灸医学について書かれた医学書、および大学に提出された博士論文に見える日本鍼灸医学－その拒否感・肯定感・再評価について述べる。

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García, Alvarado Jocelyn, e Rillo Arturo García. "“CARACTERIZACIÓN DE LA RELACIÓN NUTRIÓLOGO-PACIENTE EN ESTUDIANTES DE LA LICENCIATURA EN NUTRICIÓN, FACULTAD DE MEDICINA, UAEM, PERIODO 2012B”". Tesis de Licenciatura, Medicina-Quimica, 2013. http://hdl.handle.net/20.500.11799/14236.

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Antecedentes: El licenciado en nutrición en su práctica profesional, desempeña acciones de prevención, promoción y tratamiento nutricional a nivel individual o colectivo, con la finalidad de restablecer la salud del paciente y mejorar su calidad de vida. En cualquiera de los diferentes sectores o campos de acción donde se desenvuelve el nutriólogo de acuerdo a su perfil profesional, debe conducirse con ética en su relación con el paciente. La bioética se encarga del estudio sistemático de la conducta humana en el campo de las ciencias biológicas y la atención de la salud, en la medida que esta conducta se examine a la luz de principios y valores morales Existen varios aspectos de la bioética donde está directamente involucrada la práctica profesional del nutriólogo entre los cuales podemos mencionar: la relación nutriólogo-paciente. Las cualidades de tipo científico y personal del nutriólogo le permitirán tomar mejores decisiones para el tratamiento nutricional del paciente, cualidades de tipo personal como empatía o comunicación, le dará al paciente mayor satisfacción de la consulta y por ende un mayor apego al tratamiento nutricional. (9, 12,21) La caracterización de la relación nutriólogo-paciente depende de diversos modelos de comunicación, tipos de relación según el grado de participación (niveles) y grado de relación interpersonal (fases), vinculados a diferentes grados de respeto a los valores del paciente, al enfoque con que el nutriólogo atiende la enfermedad y los objetivos de la interacción. Por ello en este estudio es de interés determinar la caracterización de la relación nutriólogo-paciente de los pasantes en servicio social de la Licenciatura en Nutrición de la Facultad de Medicina de la Universidad Autónoma del estado de México (UAEM). Material y método: El presente estudio se realizó mediante un instrumento de investigación integrado por un cuestionario con 72 items dividido en 4 dimensiones, las respuestas a cada pregunta fueron valoradas con una escala tipo Likert de cinco grados que varió entre nunca, casi nunca, algunas veces, casi siempre y siempre; tuvieron entre 1 y 5 puntos orientados a explorar los tres dominios de la relación nutriólogo-paciente; modelos, niveles y fases de la relación. Se contó con una muestra de 27 estudiantes de ambos sexos de la licenciatura en nutrición de la Facultad de Medicina UAEM en servicio social, se identificó los modelos, niveles y fases de la relación nutriólogo-paciente predominantes en la población estudio y se relacionaron cada uno de ellos para caracterizar la relación nutriólogo-paciente. Resultados: Se encontró que la relación nutriólogo-paciente en los sujetos de estudio, tienen un predominio por el modelo informativo (41%) seguido por el paternalista (37%) esto nos denota una autonomía del nutriólogo y el único participante en la toma de decisiones, que hoy en día es un tanto obsoleto, aunque se encontró una combinación positiva respecto a los niveles y fases; ya que el nivel predominante es el nivel 3 (74%) donde la participación es mutua y la toma de decisiones, seguido por el nivel 2 (26%), ningún alumno en estudio presento preferencia por el nivel 1 resultando positivo, pues en este nivel la toma de decisiones es únicamente tarea del nutriólogo y no se toman en cuenta los valores del paciente; la fase de personalización (56%) lo ocupó la mayoría resultado positivo en la población estudio por caracterizar una relación interpersonal, donde el paciente no solo es una caso, sino también, una persona, la fase de objetivación (37%) y fase de llamada (7%) representando la minoría. Conclusiones: A pesar de que en su gran mayoría se presenta la inclinación por el modelo informativo, seguido por el paternalista, y en la minoría el modelo deliberativo; el cual sería el idóneo por tratarse de características donde la toma de decisiones es tarea de ambos y la habilidad de comunicación, el haber determinado también los niveles y las fases de la relación de cada sujeto de estudio y al cruzarlos o combinarlos, permitió determinar que a pesar de estos resultados respecto a los modelos, los estudiantes de servicio social de la licenciatura en nutrición en su gran mayoría presentan características importantes para una relación de cooperación mutua y toma de decisiones. Para ambos resulta positivo, pues la relación es más estrecha y de colaboración, y para el paciente habrá un mejor apego al tratamiento por este entendimiento entre nutriólogo-paciente.

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Paico, Liñan Elizabeth. "Calidad de sueño y somnolencia diurna en internos de medicina del Hospital Dos de Mayo periodo Setiembre – Noviembre 2015". Bachelor's thesis, Universidad Ricardo Palma, 2016. http://cybertesis.urp.edu.pe/handle/urp/461.

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Introducción: Según estudios previos la frecuencia de calidad de sueño en profesionales de la salud, como enfermeras, internos de medicina, residentes y estudiantes de medicina es elevada. Estudios Previos hechos en Lima encontraron frecuencias de 64 % y 58 % de mala calidad de sueño. Objetivo: Determinar la Calidad de sueño y Somnolencia Diurna en internos de medicina del Hospital Nacional Dos de Mayo durante el período Setiembre - Noviembre del 2015. Material y Método: tipo de estudio: descriptivo, transversal. La población de estudio fueron internos de medicina fueron internos de medicina del HNDM, muestra de 101 internos. Se midió la calidad de sueño mediante el Índice de calidad de sueño de Pittsburgh y la Somnolencia con la escala de Somnolencia de Epworth. Análisis estadístico: programa SPSS Statistics versión 23. Porcentajes, Medias. Resultados: Se obtuvo que un 56. 44 % tienen una calidad de sueño bastante mala y un 37.62 % presentan una somnolencia Marginal o Moderada. Discusión: La somnolencia y la calidad del sueño son variables subjetivas y están sujetas a variabilidad individual consideramos que tanto la escala de somnolencia Epworth como el cuestionario de Pittsburg son herramientas sencillas, económicas y útiles para calificar somnolencia y calidad de sueño en población peruana

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Vera, Hernandez Luis Edilberto. "Análisis de aforo de la Estación Hidrométrica Obrajillo. Periodo 2000-2001". Bachelor's thesis, Universidad Nacional Mayor de San Marcos. Programa Cybertesis PERÚ, 2002. http://www.cybertesis.edu.pe/sisbib/2002/vera_hl/html/index-frames.html.

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La ocurrencia de las épocas de avenida en las cuencas de nuestro país, hace que las labores de los aforos por correntómetro en las estaciones hidrométricas, constituyan una labor peligrosa, debido a que en dicha época los ríos registran volúmenes de agua importantes, que ponen en riesgo al personal a cargo de esta labor, y también el deterioro o perdida del equipo. Por esta razón hay la necesidad de utilizar metodologías de aforo en dichas épocas. El presente estudio determinará el método o métodos de extrapolación que mejor representen el comportamiento de los caudales, principalmente en niveles superiores, y señalar los caudales máximos instantáneos, registrados en la estación hidrométrica en el periodo analizado. El lugar seleccionado como zona de estudio es la Estación Hidrométrica Obrajillo, ubicada en la cuenca del Chillón y que cuenta con información hidrológica para el Año Hidrológico 2000-2001 Antes de hacer uso de la información disponible, se procedió a la verificación de la misma, con la finalidad, de contar con información básica confiable. Luego se procedió a la evaluación de la relación existente entre la lectura de escala y las variables hidrológicas, como el caudal aforado, área húmeda, velocidad media y perímetro mojado. Para la extrapolación de valores extremos superiores usamos los siguientes métodos: el Método Teórico; el Método del Área y Velocidad media; el Método de Manning; el Método de Stevens; el Método Ruso, Las Curva Analítica de Primer Tipo y de Segundo Tipo. Se analizó cada uno de los métodos mencionados a nivel anual, para determinar el método que mejor represente el comportamiento de los caudales, mediante su evaluación gráfica, y comparativa de los caudales aforados y generados, con un error porcentual menor a 10%, valor que es considerado como aceptable en los análisis y estudios hidrológicos. De este modo se terminó que el Método Teórico y el Método Ruso representaron mejor el comportamiento de los caudales en el periodo Setiembre 2000-Agosto 2001, con errores respectivos de 0,9 y 0,5% referente al promedio y máximos caudales de 42,811 m3/s y 42,733 m3/s, respectivamente. El nivel máximo para estos caudales fue de 1.56 m

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36

Molina, Romaní Sonia Paulina. "Prescripción de antimicrobianos de reserva en pacientes hospitalizados del servicio de medicina del Hospital II Ramón Castilla EsSALUD. Periodo 2017". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2019. https://hdl.handle.net/20.500.12672/11319.

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Evalúa el nivel de prevalencia de las recetas de antimicrobianos de reserva en pacientes hospitalizados en el servicio de medicina del Hospital II Ramón Castilla EsSalud, periodo primer trimestre 2017. Realiza un estudio observacional, mediante la revisión de prescripciones médicas. Utiliza una muestra total de 268 pacientes, de 1070 unidades de antimicrobianos de reserva dispensados en dosis unitaria en el servicio de hospitalización de medicina de abril a junio 2017. El instrumento elegido para la recolección de datos fue el formulario de datos. Encuentra que el número de pacientes atendidos a los que se les dispensó los antimicrobianos de reserva en el primer trimestre del año 2017 son de 102 siendo el ciprofloxacino 200mg el antimicrobiano de reserva más dispensado. La prevalencia del consumo de prescripciones de antimicrobianos de reserva por paciente mayoritariamente a la ceftazidima 1g, imipenen/cilastatina 500mg/500mg siendo de 510. El costo del consumo total de los antimicrobianos de reserva es de mayor valor es imipenen / cilastatina 500mg / 500mg con un nivel de 3,126.40 soles en el primer trimestre del año 2017. Concluye que el nivel de prevalencia de prevalencia de las recetas de antimicrobianos de reserva en pacientes hospitalizados es alta con relación a otros hospitales.
Trabajo académico

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37

Quintana, Mendoza Lizet. "ASOCIACIÓN ENTRE MOBBING Y SINDROME DE BURNOUT EN INTERNOS DE MEDICINA DEL HOSPITAL NACIONAL HIPOLITO UNANUE PERIODO OCTUBRE- DICIEMBRE 2016". Bachelor's thesis, Universidad Ricardo Palma, 2017. http://cybertesis.urp.edu.pe/handle/urp/865.

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Antecedentes: El Mobbing u hostigamiento laboral y el síndrome de Burnout son patologías emergentes que pueden causar serias consecuencias especialmente en los trabajadores de salud. Aunque hay algunos estudios sobre el Mobbing y síndrome de Burnout en el sector salud, son limitados los estudios sobre la relación y sobretodo en internos de medicina. Objetivo: Determinar la asociación entre el Mobbing y Síndrome de Burnout en internos de medicina del Hospital Nacional Hipólito Unanue en el periodo octubre-diciembre 2016. Materiales y Métodos: Se realizó un estudio analítico transversal y prospectivo. Se encuestó a 67 internos de medicina utilizándose una encuesta con sus datos generales, Escala de Cisneros para medir Mobbing y el Inventario de Maslach para medir el Sindrome de Burnout. Se determinó la asociación usando RP (Razón de prevalencia), IC95% (Intervalo de confianza al 95%) y valor p fueron obtenidos con modelos lineales generalizados, con familia Poisson, función de enlace log y con ajuste robusto para muestras pequeñas, usándose p < 0.005 como estadísticamente significativo. Resultados: De los 67 internos de medicina encuestados se obtuvo que 43.3%(n=29) tienen Mobbing y el 25.3%(n=17) tiene Síndrome de Burnuot. Aquellos que padecen Mobbing tienen 6.1 (IC95%: 1,9 – 19.4; Valor p<0,005) veces más de riesgo de padecer Sindrome de Burnout. Conclusión: Existe asociación entre Mobbing y Síndrome de Burnout en internos de medicina del Hospital Nacional Hipólito Unánue.

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38

Steinke, Alyssa K. "Exploring Spiritual Development in Transitional Periods Through Art and Journaling". Digital Commons at Loyola Marymount University and Loyola Law School, 2013. https://digitalcommons.lmu.edu/etd/27.

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Although research has been conducted on journaling, spirituality and art making separately, few studies investigate the potential for these modalities when combined together in a therapeutic context. This investigation explored the way that combining art making and journaling can contribute to spiritual growth and development during times of transformation. Specifically, by using self study and archival research approaches to conduct a systematic analysis of 5 of my previous journals and 5 of my previous art pieces which were created during times of transformation. Components illustrating spiritual growth such as contemplation, awareness, meaning making, connection, externalization, values and beliefs (Aten, 2011; Bryne & McKinlay, 2012; Hieb, 2005; Wiggins, 2011) were indicated. During this investigation, spirituality was examined through transpersonal and existential perspectives. The findings of this study suggest that examining a person’s core values, beliefs and how they seek meaning and connection with others is beneficial because it may be the source of unproductive thoughts, behaviors and feelings which motivate an individual to seek psychotherapeutic treatment. This study also illuminates the potential for spiritual development and maturation in spaces of disconnection.

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39

Cabral, Barreto Jamie Jesica, e Martínez César Jaramillo. "“Resultados clínicos posteriores a funduplicatura laparoscópica como tratamiento del Reflujo Gastroesofágico en pacientes del Centro Médico ISSEMYM durante el periodo enero-diciembre de 2009”". Tesis de Licenciatura, Medicina-Quimica, 2013. http://ri.uaemex.mx/handle/20.500.11799/14140.

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La enfermedad por reflujo gastroesofógico (ERGE) es una enfermedad cónica benigna que constituye un importante problema de salud pública, ya que ocasiona costes a la sociedad por una reducción laboral y de la actividad diaria de quienes la experimentan. En la actualidad la funduplicatura por laparoscopia es la técnica más empleada para el tratamiento quirúrgico de la ERGE. La evaluación del grado de satisfacción de los pacientes después del tratamiento quirúrgico de la ERGE con base a la severidad y frecuencia de los síntomas que la conforman, ha adquirido una gran relevancia debido a la percepción que tiene el paciente de sus síntomas, pues decide cuando estos afectan su calidad de vida. Es por ello, que se han utilizado cuestionarios o entrevistas estructuradas, como lo es la Escala de Impacto de la ERGE (GIS), para la valoración de los síntomas, no sólo en diferentes momentos postoperatorios sino también de manera previa a la cirugía, y se debe considerar su uso de manera cotidiana en los pacientes diagnosticados con ERGE.

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40

Andrade, Bucio Josue Alejandro, e Ponce Yisvanth Pérez. "“FRECUENCIA DE REOPERACIÓN EN PACIENTES POST OPERADOS DE FUNDUPLICATURA LAPAROSCOPICA EN EL PERIODO DE FEBRERO DE 2008 A MAYO DEL 2012 EN EL CENTRO MEDICO ISSEMYM”". Tesis de Licenciatura, Medicina-Quimica, 2013. http://ri.uaemex.mx/handle/20.500.11799/14033.

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Abstract (sommario):

La falla de la funduplicatura laparoscopica de Nissen se reporta del 2% al 17%, usualmente asociada a la falla de la plastia de hiato y/o a la migración de la funduplicatura hacia el tórax. Estos dos patrones propician la mayoríade fallas reportadas en la literatura especializada actual.

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41

Casana, Jara Kelly Milagritos. "Prevalencia de muerte en custodia en morgue central de Lima, periodo 2012 - 2013". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/11983.

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Determina la prevalencia de muerte en custodia en Morgue Central de Lima, periodo 2012 – 2013. La prevalencia en 2012 fue 1.17% (53), 2013: 0.85% (37) en un grupo etario de 25–54 años 63% (57), 18–24 años 17% (19), 60 años a más 10% (9), de 54 a 59 años 8% (7). Género: masculino 96% (86), femenino 4% (4). Necropsia de ley: lesiones traumáticas 52% (47), no traumáticas 31% (28), no precisan 17% (15). Área topográfica corporal: tórax 13.3% (12), cabeza 12.2% (11), cuello 8.8% (8), diferentes segmentos: abdomen y tórax-abdomen-extremidades 3.3% (3) cada uno, cabeza-tórax-extremidades y abdomen-miembros inferiores 2.2% (2) cada uno; pelvis, abdomen-pelvis, tórax-cuello, cabeza-cuello-tórax-abdomen, cabeza-tórax-abdomen-miembro inferior y tórax-miembro superior 1.1% (1) cada uno. Severidad - comportamiento trimodal de la muerte: 46% (41) 1º fase, 4% (4) 2º fase, 2% (2), 3º fase. Congruencia acta de levantamiento y necropsia: según agente causante 81% (73), según causa de muerte 76% (68). La muertes fueron antes de la detención 41% (37), durante la detención 3% (3), después de la detención 56% (50). Los formatos para el levantamiento de cadáver (2): Fiscalía 62% (56), Policía 38% (34). Los resultados de exámenes auxiliares: negativos 92.2% (83), positivo a alcohol etílico 4.4% (4), no lo solicitaron 3.3% (3). Patologías pre existentes 12% (11): 4 (4.4%) respiratorio, 4 (4.4%) inmunológico, 1 (1.1%) laringotraqueal, 1 (1.1%) digestivo/respiratorio, 1 (1.1%) cardiovascular/respiratorio. Los casos de muerte en custodia, ponen en evidencia hechos graves que configuran una cadena de actos violatorios contra diversos derechos fundamentales, tales como el derecho a la vida, integridad personal, tutela jurisdiccional efectiva, debido proceso y reparación, todos ellos, reconocidos por las normas del derecho internacional de los derechos humanos y por el ordenamiento jurídico nacional. Se recomienda implementar el uso de reglas y estándares internacionales con la finalidad de cumplir con normas de derechos humanos y del derecho internacional humanitario, que proporcionen los puntos claves tendientes a crear y operar un régimen de detención adecuado.
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42

Bajramaj, Ermira. "Microdialysis in the human masseter muscle- Methodological aspects". Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19896.

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Introduktion: Mikrodialys används för att studera metabola förändringar i olika vävnader. Vid mikrodialys sätts en kateter i muskeln vilket inducerar en traumafas, som kan påverka frisläpp av substanser. En 120 minuters stabiliseringstid har föreslagits så att metabola förändringar p.g.a. traumat ska normaliseras och ej påverka resultatet. En lång stabiliseringstid leder dock till att dessa studier är tidskrävande och därför även dyra och svårgenomförda. Syfte: Att undersöka och fastställa lämplig stabiliseringsperiod för mikrodialys av serotonin och glutamat i massetermuskeln hos friska individer samt hos patienter med myofascial TMD. Material och metod: Intramuskulär mikrodialys utfördes och dialysat samlades in på 15 friska kontroller samt 15 patienter med myofascial TMD för analys av serotonin och glutamat. För att tillåta vävnaden återhämta sig från traumafasen utvärderades en 120-minuters stabiliseringsperiod, där de första 20 minuterna utgjorde ursprunglig baseline och de sista 20 minuterna stabiliserad baseline. Resultat: Ingen signifikant förändring av serotonin och glutamat observerades över tid för kontroll-gruppen (P>0,05). För TMD-gruppen sågs däremot såg en signifikant sänkning av serotoninhalten over tid (P<0,001) följt av en signifikant ökning mellan tidpunkten T100-120 och T120-140 (P<0,001). För glutamat sågs en reduktion vid tidpunkten T20-40 jämför med det ursprungliga baselinevärdet (P<0,05). Konklusion: Resultaten antyder att 20 minuters stabiliseringsperiod är tillräcklig för friska individer vid mikrodialys av serotonin och glutamat i masseter muskeln. Hos patienter med myofacial TMD är glutamat-nivåerna stabiliserade efter 40 minuter. Serotonin nivåerna är däremot inte stabiliserade efter 120 minuter, vilket tyder på en spontan ökning av intramuskulär serotonin 2 timmar efter införandet av katetern.
Introduction: Microdialysis is a technique used to study metabolic changes in tissues. When performing microdialysis, a catheter is inserted into the muscle inducing a trauma phase, which may affect the release of substances. A 2-hour stabilization period has been suggested to allow tissues to recover from metabolic changes following the trauma. A long stabilization period however, makes these studies time-consuming and thus expensive.Aim: To investigate the necessary stabilization period for microdialysis of serotonin and glutamate in the masseter muscle in healthy subjects and in patients with myofascial TMD.Material and Methods: Intramuscular microdialysis was carried out in 15 patients with myofascial TMD and 15 healthy controls to collect serotonin and glutamate. To allow the tissue to recover following the probe insertion, a 120-min stabilization period was evaluated where the first 20 min served as the zero baseline and the last 20 min as the stabilized baseline. Results: No significant alterations of serotonin or glutamate were observed over the 2-hour period for the controls (P>0.05). For the TMD group, a significant decrease of serotonin was observed over time (P<0.001) followed by a significant increase between T100-120 and T120-140 (P<0.001). For glutamate, a significant reduction was observed at T20-40 compared with the zero baseline (P<0.05). Conclusion: A 20-min stabilization period is sufficient for healthy subjects for microdialysis of serotonin and glutamate in the masseter muscle. In patients with myofascial TMD, glutamate levels are stabilized after 40 minutes. Serotonin levels are not stabilized after 2 hours indicating a spontaneous increase of serotonin.

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43

PANEI, MARINA. "Il suicidio nella casistica medico-legale dell’Università Tor Vergata: aspetti epidemiologici e tossicologici sui casi esaminati nel periodo 2000-2013". Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2012. http://hdl.handle.net/2108/210048.

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44

Ojeda, Mejía Esther. "Morbimortalidad en el servicio de Medicina Interna del Hospital General Toluca del PRI Dr. Nicolás San Juan, en el periodo comprendido del 2009 al 2011". Tesis de Licenciatura, Medicina-Quimica, 2013. http://ri.uaemex.mx/handle/20.500.11799/13777.

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La mortalidad hospitalaria es un indicador de calidad asistencial y su estudio puede mejorar la asistencia de los pacientes hospitalizados, debemos tener en cuenta que la mortalidad es un tema muy importante, en especial en Medicina Interna, ya que es el Servicio que presenta una mayor cantidad de defunciones, pero se tiene que tomar en cuenta varios factores, como el que los pacientes atendidos son de edades más avanzadas y con patologías múltiples y crónicas, con mayor riesgo de complicaciones. Objetivos. Nuestro objetivo fue conocer las causas de muerte más frecuentes en los pacientes hospitalizados, tasa de mortalidad neta; identificar los días de estancia real, así como la morbilidad asociada, en el período comprendido del 2009 al 2011. Material y métodos. Se trata de un estudio restrospectivo transversal y observacional, se lleva a cabo a en la división de Medicina Interna del hospital general “Dr Nicolás San Juan”. Resultados. La principal causa de muerte fue la Diabetes mellitus, en los tres años estudiados, le siguen enfermedades del corazón, la insuficiencia renal crónica, enfermedades del hígado, neumonía, así como síndrome de dependencia al alcohol, con una tasa de mortalidad para el 2009 de 6.9; para el 2010 fue de 8.1 y para el 2011 de 7.1. Respecto a los días de estancia real fueron de 4.1 para el 2009 y 4.7 para los dos últimos años. Conclusiones. Ante los resultados obtenidos encontramos que la Diabetes Mellitus continúa siendo la principal causa de muerte así como sus complicaciones, y se mantiene en aumento, por lo que las principales acciones deben estar orientadas hacia la prevención, diagnóstico oportuno, así como manejo adecuado. Así mismo los días de estancia reales son mayores a los programados lo cual también es un factor de riesgo para mayores complicaciones como infecciones nosocomiales, por lo que se debe disminuir en lo más posible este número.

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45

Cardoso, Marcelo Pontual. "Mortalidade feminina em idade fertil no municipio de Cascavel - PR no periodo de 1991 a 2000". [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308230.

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Orientador: Anibal Faundes
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-04T02:33:09Z (GMT). No. of bitstreams: 1 Cardoso_MarceloPontual_D.pdf: 5034664 bytes, checksum: 38157191bd8cc9c9aa4a75a66a50657d (MD5) Previous issue date: 2005
Resumo: Estudo epidemiológico descritivo de base populacional, incluindo todas as Declarações de Óbitos (0.0.) de mulheres com idade de 10 a 49 anos, residentes no Município de Cascavel-PR, ocorridos entre 1991 e 2000. As 0.0. foram identificadas na Secretaria Municipal de Saúde, nos dois Cartórios de Registro de Óbito do Município, e na Divisão de Dados de Mortalidade da Secretaria Estadual de Saúde do Paraná Identificaram-se 869 0.0. Em casos de 0.0. incompletas ou duvidosas, realizou-se entrevista com familiares e pesquisa nos prontuários de hospitais. As causas básicas de óbito foram codificadas e/ou recodificadas de acordo com o CID-10 (Classificação Internacional de Doenças, 10a Revisão). Os dados populacionais foram estimados pelo Instituto Paranaense de Desenvolvimento Econômico e Social - IPARDES, e o número de nascidos vivos a partir do SINASC (Sistema de Informações dos Nascidos Vivos). A mortalidade foi analisada segundo causas, idade e ano de ocorrência. Foi utilizado o teste do qui-quadr<;ido de Mantel-Haenszel adotando-se como limite de significância p<0,05. O principal grupo de causas de óbito foi causas externas (coeficiente 29,4), 2° - doenças do aparelho circulatório (22,7), 3° - neoplasias (21,3), 4° - doenças infecto-parasitárias (5,8) e 5° - mortalidade materna (5,5). O grupo das causas externas de mortalidade foi o mais freqüente até a idade dos 34 anos, e o terceiro entre 35 e 49 anos. As causas cardiovasculares e as neoplasias (nessa ordem) foram as mais freqüentes no grupo entre os 35 e os 49 anos, com coeficiente de mortalidade tanto maior quanto maior a idade. A principal causa infecto-parasitária foi Aids, sobretudo a partir da segunda metade do período do estudo. A razão de mortalidade materna global foi de 83,1/100.000 nascidos-vivos, com 40% por causas indiretas. As principais causas diretas foram: hipertensão, aborto e as complicações do puerpério. No Município de Cascavel, como no resto de Brasil, a mortalidade feminina poderia ser bem menor com medidas que pudessem controlar melhor as causas externas de morte e a epidemia de Aids entre as mulheres jovens. Seria recomendável o monitoramento permanente da evolução da mortalidade feminina do Município
Abstract: Epidemiological descriptive population-based study, including ali Death Certificates (D.C.) of women aged 10-49 years, living in Cascavel in the period of 1991-2000. D.C. were identified at the Secretaria Municipal de Saúde, in notary offices and in the Divisão de Dados de Mortalidade da Secretaria Estadual de Saúde do Paraná As a whole, 869 D.C. were identified. When these D.C. were incomplete or doubtful, was carried out an investigation of the corresponding clinical records and with interviews of relatives. The basic causes of death were codified and/or recodified according to the ICD-10. Population data were estimated by the Instituto Paranaense de Desenvolvimento Econômico e Social - IPARDES, and the number of livebírths, from the "Live Births Information System" (SINASC). Mortality was analyzed according to causes, age and year of occurrence
Doutorado
Tocoginecologia
Doutor em Tocoginecologia

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46

Hinostroza, Izaguirre Luis Alberto. "Detección precoz de cáncer en adultos asintomáticos en la Unidad de Medicina Preventiva del Hospital Nacional Daniel Alcides Carrión durante el periodo 2008-2010". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2011. https://hdl.handle.net/20.500.12672/15561.

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Determina las características epidemiológicas y clínicas de la población adulta asintomática que acude a la unidad de medicina preventiva del HNDAC durante el periodo 2008 – 2010. El tipo de estudio es Descriptivo y el diseño Retrospectivo – Transversal, con un universo de 6000 pacientes. Se utilizó una ficha de recolección de datos, analizados por medio de STATA 10.0 y el empleo de fórmulas de estadística descriptiva, con un muestreo de 130 pacientes y un intervalo de confianza de 95%. Los datos se resumen en variables: Sociodemográficas, Factores asociados a riesgo de Neoplasia, Antecedentes Clínicos, Situación Clínica Actual y Resultado del screnning, obteniendo: 6% y 17% del total de varones y mujeres respectivamente, porcentaje compatible con neoplasia de inicio precoz, detectada por el método pertinente. Se concluye que el resultado positivo del screnning, el cual obtiene hallazgo sugestivo de proceso neoplásico, permite derivar de manera pertinente a la especialidad clínica respectiva, que aplica tratamiento precoz de bajo impacto clínico, económico y con escaso compromiso en la salud física y mental del individuo.
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47

Contreras, Samanez Ana María Giovanna. "Estudio retrospectivo de caso control de ehrlichiosis canina en la Facultad de Medicina Veterinaria de la Universidad Mayor de San Marcos : periodo 2002-2005". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2006. https://hdl.handle.net/20.500.12672/683.

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La ehrlichiosis canina es reconocida como una enfermedad infecciosa importante de distribución mundial y potencialmente fatal de los perros y otros miembros de la familia Canidae. Es ocasionada por Ehrlichia canis y transmitida por la garrapata marrón del perro Rhipicephalus sanguineus. El objetivo de este trabajo fue realizar un estudio retrospectivo de tipo casocontrol para evaluar los factores de riesgo asociados a la presentación de ehrlichiosis canina en pacientes de la Clínica de Animales Menores y del Laboratorio de Patología Clínica de la FMV - UNMSM. Con este fin se utilizaron datos de historias clínicas entre los años 2002-2005, de los cuales se consiguieron tanto los casos (caninos con ehrlichiosis: n igual 50) como los controles (caninos sin ehrlichiosis: n igual 100). Los datos recolectados fueron agrupados según raza, sexo, edad, antecedente de garrapatas y lugar de origen, y fueron analizados mediante la prueba de Chi2 para ver la asociación entre las variables. Se estimaron los odds ratios (OR) crudo y ajustado para saber el grado de riesgo de las variables en estudio. La enfermedad se presentó en 15 razas distintas. De los casos, el 50% fue de raza grande, 72% fueron machos, el 68% fue mayor de 2 años y el 82% presentó garrapatas. Los factores de riesgo asociados con la enfermedad fueron: razas grandes (OR igual 12.8, p igual a 0.024), raza Pastor alemán (OR igual 12.2, p menor a 0.01), edad (menor a 2-4 años: OR igual 4, p igual 0.008) y antecedente de garrapatas (82% (48/50) para los casos y 1% (1/100) para los controles). Palabras Claves: E. canis, garrapata, caso-control, factores de riesgo, odds ratio.
--- Canine ehrlichiosis is well known as a worldwide, very important and potentially fatal infectious disease of dogs and other members of the canidae family. It is caused by Ehrlichia canis and transmitted by the brown dog tick Rhipicephalus sanguineus. The aim of this work was to make a retrospective case-control study in order to evaluate the risk factors associated with the presence of canine ehrlichiosis in dogs from the Clínica de Animales Menores y Laboratorio de Patología Clínica de la FMV-UNMSM. For this purpose, cases (dogs with ehrlichiosis: n igual a 50) as well as controls (dogs without ehrlichiosis: n igual a 100) from clinic charts data among the years 2002-2005 were used. The data recollected was grouped by breed, sex, age, ticks history and place. Chi square, odds ratio (OR), and logistic regression were performed. Fifteen different breeds were seen. From the cases, a 50% large breeds, 72% males, 64% older than 2 years, and 82% ticks were found. The risk factors associated with the disease were large breeds (OR igual a 12.8, p igual 0.024), German shepherd dog (OR igual a 12.2, p menor a 0.01), age (menor a 2-4 years: OR igual a 4, p igual a 0.008) and ticks history (82% (48/50) for the cases and 1% (1/100) for the controls). Key Words: E.canis, tick, case-control, risk factors, odds ratio.
Tesis

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48

Anchivilca, Pumayauli Jorge Saúl. "Identificación de interacciones medicamentosas potenciales en el Servicio de Medicina Interna del Hospital Nacional Edgardo Rebagliati Martins durante el periodo abril - junio del 2015". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2017. https://hdl.handle.net/20.500.12672/6129.

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Identifica las interacciones medicamentosas en pacientes hospitalizados en el Servicio de Medicina Interna del Hospital Nacional Edgardo Rebagliati Martins. En este estudio se examina la relación de las interacciones farmacológicas potenciales con las siguientes variables: edad, sexo, presencia de comorbilidades, número de medicamentos consumidos. De 736 pacientes hospitalizados, 533 (72%) presentan una o más interacciones farmacológicas. Respecto al mecanismo involucrado, las interacciones son mayoritariamente de tipo farmacocinética. En relación a su severidad, la mayor parte de las interacciones farmacológicas detectadas son consideradas como de riesgo teórico potencial moderada (62%). Algunas variables como la edad, números de medicamentos prescritos, presentan una asociación significativa con la presencia de interacción, pero no así el género de los pacientes. Con los datos obtenidos se pueden realizar acciones de intervención y disminuir el riesgo potencial de repercusiones clínicas de las interacciones medicamentosas.
Tesis

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49

Huamaní, Charles, César Gutiérrez e Holguín Edward Mezones. "Correlación y concordancia entre el examen nacional de medicina y el promedio ponderado universitario: análisis de la experiencia peruana en el periodo 2007 – 2009". Instituto Nacional de Salud (INS), 2014. http://hdl.handle.net/10757/314461.

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Objetivos. Evaluar la correlación y concordancia entre el Examen Nacional de Medicina de Perú (ENAM) y el Promedio Ponderado Universitario (PPU) en estudiantes egresados del pregrado de medicina en el periodo 2007 a 2009. Materiales y Métodos. Se llevó a cabo un análisis secundario de datos, empleando el registro de inscritos en las convocatorias a los procesos del Servicio Rural Urbano Marginal en Salud de Perú (SERUMS) de los años 2008 a 2010, obteniéndose las calificaciones en el ENAM y el PPU. Se efectuó un análisis descriptivo por medio de medianas y percentiles 25 y 75 (p25/p75); la correlación entre ambas calificaciones se realizó por medio del coeficiente de correlación de Spearman; asimismo, se efectuó un análisis de regresión lineal y la concordancia fue medida a través del coeficiente de correlación y concordancia de Bland y Altman. Resultados. Se incluyeron 6 117 médicos, la mediana global del PPU fue 13,4 (12,7/14,2) y del ENAM fue 11,6 (10,2/13,0); del total de egresados el 36,8% reprobó el examen. Se observó un incremento anual de la mediana del ENAM, con la consecuente disminución de la diferencia entre ambas calificaciones. La correlación entre los puntajes es directa y moderada (0,582), independiente del año, ubicación o del tipo de gestión de la universidad (pública o privada). Sin embargo, la concordancia entre ambas calificaciones es regular; con un coeficiente global de 0,272 (IC 95%: 0,260 a 0,284). Conclusiones. Independiente del año, ubicación o tipo de gestión de la universidad, existe una moderada correlación entre la calificación del ENAM y el promedio ponderado del alumno, no obstante se evidencia solo una regular concordancia entre ambos puntajes.
Objectives: To evaluate the correlation and concordance between the ‘Peruvian National Exam of Medicine’ (ENAM) and the Mean Grade Point Average (GPA) in recently graduated medical students in the period 2007 to 2009. Materials and Methods: We carried out a secondary data analysis, using the records of the physicians applying to the Rural and Urban Marginal Service in Health of Peru (SERUMS) processes for the years 2008 to 2010. We extracted from these registers, the grades obtained in the ENAM and GPA. We performed a descriptive analysis using medians and 1st and 3rd quartiles (q1/q3); we calculated the correlation between both scores using the Spearman correlation coefficient, additionally, we conducted a lineal regression analysis, and the concordance was measured using the Bland and Altman coefficient. Results: A total of 6 117 physicians were included, the overall median for the GPA was 13.4 (12.7/14.2) and for the ENAM was 11.6 (10.2/13.0).Of the total assessed, 36.8% failed the TEST. We observed an increase in annual median of ENAM scores, with the consequent decrease in the difference between both grades. The correlation between ENAM and PPU is direct and moderate (0.582), independent from the year, type of university management (Public or Private) and location. However, the concordance between both ratings is regular, with a global coefficient of 0.272 (CI 95%: 0.260 to 0.284). Conclusions: Independently of the year, location or type of university management, there is a moderate correlation between the ENAM and the PPU; however, there is only a regular concordance between both grades.

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50

Valencia, Cardozo Jorge. "Prevalencia y disfunción orgánica según Marshall en pancreatitis aguda en el servicio de medicina del Hospital de Vitarte en el periodo enero – julio 2015". Bachelor's thesis, Universidad Ricardo Palma, 2016. http://cybertesis.urp.edu.pe/handle/urp/474.

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Objetivo principal: Determinar la prevalencia de pacientes adultos hospitalizados por pancreatitis aguda en el Servicio de Medicina del Hospital Vitarte durante el periodo Enero – Julio 2015. Materiales y Métodos: Estudio descriptivo, retrospectivo, transversal con un total de 114 pacientes hospitalizados en el periodo enero – julio 2015 en el servicio de medicina del hospital de vitarte con el diagnostico de pancreatitis agudo. Los datos fueron recabados mediante revisión de historias clínicas y trabajadas mediante el programa de SPSS versión 23. Resultados: Del análisis y discusión de los resultados obtenidos se estableció que la prevalencia de pacientes adultos hospitalizados por pancreatitis aguda en el Servicio de Medicina del Hospital Vitarte durante el periodo Enero – Julio 2015 fue de 21.39%. Hubo 96% de mujeres y 18% entre los pacientes. La edad media fue de 40,48 años. La etiología de mayor frecuencia fue la biliar en el 97.4% de los casos. La estancia hospitalaria promedio fue de 4 – 6 días. La manifestación clínica más frecuentes fue el dolor abdominal. La presencia de falla orgánica según la escala de Marshall es de 9.6%. Conclusión: La prevalencia de pacientes hospitalizados por Pancreatitis Aguda en el servicio de Hospitalización de Medicina del Hospital Vitarte en el periodo Enero – Julio 2015 fue de 21.39%. La presencia de falla orgánica según la escala de Marshall es de 9.6%.

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