1,720,954 research outputs found
Análisis de los factores de riesgo asociados a las complicaciones en pacientes intervenidos de fractura de cadera
Get PDFIntroducción
La fractura de cadera (FC) es una enfermedad del paciente anciano que supone un importante problema de salud, por su elevada incidencia y morbi-mortalidad.
Se trata de una patología compleja a cuya etiología se han asociado múltiples factores de riesgo. Esta enfermedad comporta un riesgo de complicaciones médicas y quirúrgicas durante su estancia hospitalaria y un deterioro catastrófico respecto a la situación funcional previa del paciente.
Los pacientes afectados son en su mayoría mujeres, de edad avanzada, dependientes, con comorbilidad, riesgo quirúrgico alto y susceptibles de sufrir complicaciones.
Hipótesis
Existen factores de riesgo modificables que podrían ayudarnos a prevenir las complicaciones que ocurren en esta patología.
Objetivos
El objetivo de este trabajo es identificar que factores de riesgo se asocian a tener complicaciones en los pacientes intervenidos quirúrgicamente de FC en un Servicio de Cirugía Ortopédica y Traumatología.
Material y métodos
El análisis de factores de riesgo de sufrir complicaciones se realizó con una cohorte de 329 pacientes intervenidos quirúrgicamente de FC.
Los datos fueron recogidos de las historias clínicas, y consistían en variables demográficas, clínicas, antecedentes clínicos, variables analíticas y las complicaciones postoperatorias.
Se realizo un modelo de regresión logística para ver el efecto de estas variables en el transcurso de una complicación, así como en los tipos de complicaciones más prevalentes.
Se utilizó el programa SPSS para realizar el análisis estadístico y se consideró estadísticamente significativo una p<0,05.
Resultados
La muestra final del estudio se ha constituido con 329 pacientes de los cuales un 75,7% son mujeres y un 24,3% hombres, con edades comprendidas entre los 38 y 98 años con un promedio de 80,6 años (DT = 9,6).
La aparición de complicaciones tras la cirugía se observó en el 38,4% de los pacientes de la muestra.
Por orden de frecuencia, las complicaciones fueron: Necesidad de trasfusión por sangrado intraoperatorio (60%), hematoma postoperatorio (38,9%), sangrado de la herida quirúrgica (37,1%), éxitus durante el primer año postoperatorio (27,4%), delirio durante el ingreso (21´9%) e infección (20%).
En nuestra muestra, el perfil de riesgo para sufrir una complicación es:
• Edad avanzada (OR=1,45; p=0,004)
• Ser mujer (OR=0,53; p=0,022).
• ASA III-IV (OR=1,58; p=0,034)
• Presentar una fractura de tipo pertrocantérea (OR=1,84; p=0,013).
• Ser intervenido mediante cirugía cerrada (OR=2,28; p=0,001; OR=8,05; p=0,018).
• Presentar niveles bajos de albúmina (OR=1,90; p=0,04).
• Presentar niveles bajos de hemoglobina (OR=3,42; p=0,015).
Tras el análisis de regresión logística (uni y multivariante), los factores modificables fueron:
• Anemia, hipoproteinemia e hipoalbuminemia.
• Disminuir la estancia hospitalaria.
• Identificar la osteoporosis y prevenir las caídas para evitar las fracturas pertrocantéreas que son las más frecuentes.
Conclusiones
La identificación de factores de riesgo y de grupos de alto riego constituye una importante estrategia a seguir para reducir la incidencia de complicaciones en los pacientes intervenido por FC osteoporótica.
Los pacientes mayores, con comorbilidad elevada, anémicos, desnutridos, con fractura pertrocantérea o en los que se demore la estancia hospitalaria, serían los mas susceptibles de complicarse durante el ingreso.
Entre los factores modificables encontramos que la albúmina, las proteínas y la hemoglobina bajas se asocian a mayor tasa de transfusión, sangrado de la herida quirúrgica o hematoma. Además, la hipoalbuminemia se asocia a mayores tasas de delirio y de éxitus. Actuar sobre ellos nos ayuda a prevenir las complicaciones más frecuentes que ocurren en las FC.Introduction
Hip fracture (HF) is a disease which affects elderly patient and is a major health problem due to its high incidence and morbidity mortality.
This is a complex pathology whose etiology has been related to multiple risk factors. This disease entails a risk of medical and surgical complications during hospital stay and a catastrophic deterioration with regard to the patient’s previous functional status.
The patients affected are mostly elderly dependent women with comorbidity, high surgical risk and susceptible to complications.
Hypothesis
There are modifiable risk factors which could help us to prevent this disease from complications.
Objectives
The aim of this work is to identify which risk factors are associated with having complications in HF surgically operated patients in an Orthopaedic and Traumatology Surgery Service.
Material and method
The analysis of the risk factors for complications was carried out with a cohort of 329 patients who had undergone HF surgical operation.
Data was collected from clinical histories and consisted of demographic, clinics, clinical background and analytical variables together with postoperative complications.
A logistic regression model was implemented in order to see the effect of these variables within the course of complications as well as the most prevalent types of them.
The SPSS statistics programme was used for the statistical analysis being p<0,05 considered statistically significant.
Results
The final sample of study has been constituted by 329 patients of whom 75,7% are women and 24,3% are men, aged from 38 to 98 years old with an average of 80,6 years (DT = 9,6).
The appearance of complications after the surgery was observed in 38,4% of the sample’s patients.
According to the frequency order, the complications were: necessity of transfusion by intraoperative bleeding (60%), postoperative hematoma (38,9%), surgical wound bleeding (37,1%), exitus during the first postoperative year (27,4%), delirium during the hospitalisation (21,9%) and infection (20%).
In the sample, the risk profile to suffer a complication is
• Advanced age (OR=1,45; p=0,004)
• To be a woman (OR=0,53; p=0,022)
• ASA III-IV (OR=1,58; p=0,034)
• To show a pertrochanteric fracture (OR=1,84; p=0,013)
• To be operated through percutaneous surgery (OR=2,28; p=0,001; OR=8,05; p=0,018)
• To show low albumin levels (OR=1,90; p=0,04)
• To show low hemoglobin levels (OR=3,42; p=0,015)
After the logistic regression analysis (uni and multivariable), the adjustable factors were:
• Anemia, hypoproteinemia and hypoalbuminemia
• To diminish hospital stay
• To identify osteoporosis and to prevent falls in order to avoid pertrochanteric fractures which are the most frequent.
Conclusions
The identification of risk factors and high risk groups constitutes an important strategy to follow so as to reduce the incidence of complications in patients who have been operated of HF osteoporotic.
Old anemic undernourished patients, with high comorbidity and pertrochanteric fracture, or those whose hospital stay is delayed, would be the most liable to complicate during the hospitalisation.
Among adjustable factors we find out that low albumin, proteins and hemoglobin are associated to a bigger rate of transfusion, surgical wound bleeding or hematoma. Besides, hypoalbuminemia is associated to greater delirium and exitus rates. Acting on them help us to prevent the most frequent complications which occur in HF
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
- …
