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  Subjects -> MEDICAL SCIENCES (Total: 7854 journals)
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MEDICAL SCIENCES (2040 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access  
3D Printing in Medicine     Open Access   (Followers: 1)
AADE in Practice     Hybrid Journal   (Followers: 5)
ABCS Health Sciences     Open Access   (Followers: 3)
Abia State University Medical Students' Association Journal     Full-text available via subscription  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 42)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Facultatis Medicae Naissensis     Open Access  
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Medica (Hradec Králové)     Open Access  
Acta Medica Bulgarica     Open Access  
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Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
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Addiction Science & Clinical Practice     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 8)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access  
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access  
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 4)
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Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 5)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29)
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Advances in Parkinson's Disease     Open Access  
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Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20)
Advances in Regenerative Medicine     Open Access   (Followers: 3)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5)
Advances in Wound Care     Hybrid Journal   (Followers: 11)
Aerospace Medicine and Human Performance     Full-text available via subscription   (Followers: 11)
African Health Sciences     Open Access   (Followers: 3)
African Journal of Biomedical Research     Open Access   (Followers: 1)
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 2)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 2)
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 2)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 8)
AJOB Primary Research     Partially Free   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal  
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 2)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3)
Althea Medical Journal     Open Access  
American Journal of Biomedical Engineering     Open Access   (Followers: 13)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 7)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 11)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 5)
American Journal of Managed Care     Full-text available via subscription   (Followers: 11)
American Journal of Medical Case Reports     Open Access   (Followers: 1)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 4)
American Journal of Medicine     Hybrid Journal   (Followers: 47)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access   (Followers: 1)
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 9)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 5)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomica Medical Journal     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 3)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1)
Anatomy     Open Access   (Followers: 1)
Anatomy Research International     Open Access   (Followers: 2)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 1)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 2)
Annals of Bioanthropology     Open Access   (Followers: 4)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 17)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 3)
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 11)
Annals of Family Medicine     Open Access   (Followers: 14)
Annals of Health Research     Open Access  
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Microbiology     Hybrid Journal   (Followers: 11)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Rehabilitation Medicine     Open Access  
Annals of Saudi Medicine     Open Access  
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 4)
Annual Review of Medicine     Full-text available via subscription   (Followers: 17)
Anthropological Review     Open Access   (Followers: 23)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Technology Journal     Open Access   (Followers: 1)
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 1)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Informatics     Hybrid Journal   (Followers: 2)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal  
Applied Medical Informatics     Open Access   (Followers: 10)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arak Medical University Journal     Open Access  
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Medicine and Surgery     Open Access  
Archives of Trauma Research     Open Access   (Followers: 3)
Archivos de Medicina (Manizales)     Open Access  
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access  
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Full-text available via subscription   (Followers: 13)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 14)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access  
Asia Pacific Family Medicine     Open Access   (Followers: 1)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 10)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access  
Asian Bioethics Review     Full-text available via subscription   (Followers: 3)
Asian Biomedicine     Open Access   (Followers: 2)
Asian Journal of Cell Biology     Open Access   (Followers: 5)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 4)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 1)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 10)
Auris Nasus Larynx     Full-text available via subscription  
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 1)
Autopsy and Case Reports     Open Access  
Avicenna     Open Access   (Followers: 3)
Avicenna Journal of Clinical Medicine     Open Access  
Avicenna Journal of Medicine     Open Access   (Followers: 1)
Bangabandhu Sheikh Mujib Medical University Journal     Open Access   (Followers: 1)
Bangladesh Journal of Anatomy     Open Access   (Followers: 1)
Bangladesh Journal of Bioethics     Open Access  
Bangladesh Journal of Medical Biochemistry     Open Access   (Followers: 4)

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Journal Cover
Acta Médica Costarricense
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0001-6002
Published by SciELO Homepage  [726 journals]
  • Superando barreras

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  • (Epidemiological characteristics of patients diagnosed with sepsis and
           septic shock in a hospital in Cali, Colombia)

    • Abstract: Resumen Introducción: la sepsis es un problema de salud pública debido a la elevada mortalidad registrada en las salas de cuidado intensivo. El propósito de este estudio fue establecer las características epidemiológicas de pacientes diagnosticados con sepsis en la Unidad de Cuidados Intensivos de una clínica de la ciudad de Cali. Material y métodos: se realizó un estudio observacional, de corte transversal, con 295 historias clínicas de pacientes con diagnóstico de sepsis. La asociación entre las variables cualitativas y el desarrollo de a sepsis o choque séptico, se analizó mediante la prueba de χ2 con un valor significativo de p<0,05. El Odds Ratio se usó como medida de asociación con intervalo de confianza del 95 %, empleando el paquete estadístico SPSS. Vs 22.00. Resultados: La edad promedio de los pacientes fue 75 años (DS= 17,27), con un ligero predominio de hombres (56,6 %). La cavidad abdominal fue el foco más frecuente de sepsis, con un 28,8 % en pacientes con sepsis y un 23,6 % con choque séptico. Escherichia coli fue el agente más aislado. El mayor riesgo de mortalidad se presentó en pacientes hipertensos (39 %; OR:2,81; IC95 %: 1,39- 5,68; P= 0,003) y en aquellos con procesos hematológicos (17,1 %; OR:5,61; IC95 %: 1,96-16,12; P< 0,001). Conclusión: las bacterias Gram negativas y la cavidad abdominal como foco séptico primario fueron los factores más prevalentes en los pacientes con sepsis y choque séptico analizados. El riesgo de mortalidad se asoció a pacientes hipertensos y con procesos hematológicos. Introduction. Sepsis is a public health problem due to the high mortality rate in intensive care units. The purpose of this study was to establish the epidemiological characteristics of patients diagnosed with sepsis in the intensive care unit of a clinic in the city of Cali. Material and methods. A descriptive retrospective study was conducted with 295 clinical records of patients diagnosed with sepsis. The association between the quantitative variables and the development of sepsis or septic shock was analyzed using the χ2 test with a significant value of p <0.05. The Odds Ratio was used as a measure of association with a confidence interval of 95% using the SPSS statistical package, Vs 22.00. Results. The average age of the patients was 75 years (SD = 17.27). With a slight predominance of men (56.6%). The abdominal cavity was the most frequent focus of sepsis, with 28.8% in patients with sepsis and 23.6% with septic shock. Escherichia coli was the most isolated agent. The highest risk of mortality occurred in hypertensive patients (39%, OR: 2.81, 95% CI: 1.39-5.68, P = 0.003) and in those with haematological processes (17.1%; OR: 5 61, 95% CI: 1.96-16.12, P <= 0.001). Conclusion. Gram-negative bacteria and abdominal cavity, as primary septic focus were the most prevalent factors in the patients with sepsis and septic shock analyzed. The risk of mortality was associated with hypertensive patients and with hematological processes.
       
  • (Comparative study of mortality causes between subjects with bipolar
           disorder and a control sample between 1995 and 2005)

    • Abstract: Resumen Justificación: el trastorno afectivo bipolar afecta entre un 1 % y un 2 % de la población mundial. Se ha descrito que se acompaña de un aumento en la mortalidad por causas tanto violentas como no violentas. Existen pocos estudios en el país acerca de las causas de muerte en esta población. Este estudio tiene como objetivo analizar las causas de muerte de personas con trastorno afectivo bipolar y compararlas con las de controles sanos. Métodos: de los sujetos con trastorno afectivo bipolar previamente reclutados para estudios genéticos del Centro de Investigación en Biología Celular y Molecular de la UCR, se seleccionó a las 154 personas que habían fallecido entre 1993 y 2005. Se eligieron 154 controles apareados por sexo, que hubiesen nacido y fallecido en el mismo periodo que el sujeto, con una diferencia no mayor a tres meses. El análisis estadístico consistió en una prueba exacta de Fisher con 1000 simulaciones del valor de p con Monte Carlo. Resultados: de los 154 sujetos, un 50 % (n=77) fueron mujeres. No hubo diferencia en la causa de muerte entre sexos. Se encontró diferencia significativa en las principales causas de muerte entre casos y controles (p<0,05). Se observó una diferencia significativa en las categorías de “lesiones autoinflingidas” (χ2 (1)=11.0, p<0,05) y “cáncer” (χ2(1)= 4,1, p= 0,04). No se documentó diferencia en enfermedad cardiovascular (χ2(1)=0,3, p= 0,61), neumonía (χ2(1)=3,1, p= 0,07) y accidentes (χ2(1)= 2,0, p= 0,16). Conclusión: como se ha documentado en bibliografía internacional, las lesiones autoinfligidas son la causa de muerte de mayor importancia en la población afectada con trastorno afectivo bipolar. Background: Bipolar disorder affects 1% to 2% of the world population. It has been described that it is accompanied by an increase in mortality from both violent and non-violent causes. Few studies have been published in our country about causes of death in this particular population. The objective of our study is to analyze the causes of death of subjects with bipolar disorder and compare them to healthy controls. Methods: From the pool of subjects with bipolar disorder previously recruited for genetic studies conducted at the Cellular and Molecular Biology Research Centre of the UCR, we recruited the 154 subjects who had died between 1993 and 2005. Controls of the same sex who were born and died in the same period as the subject, with a difference no greater than three months, were selected. For the statistical analysis we ran a Fisher’s exact test with 1000 simulations of the p-value with Monte Carlo. Results: Of 154 subjects, 50% (n=77) were women. We found no difference in the cause of death between sexes among the cases. A significant difference in the main causes of death was found between cases and controls (p<0.05). A significant difference was observed in the categories of “self-inflicted lesions” (χ2 (1)=11.0, p<0.05) and “cancer” (χ2(1)= 4.1, p= 0.04). No difference was documented in cardiovascular disease, (χ2(1)=0.3, p= 0.61), pneumonia (χ2(1)=3.1, p= 0.07) nor accidents (χ2(1)= 2.0, p= 0.16). Conclusion: Self-inflicted lesions, as has been documented in international literature, are a cause of death of major importance in the population affected with bipolar disorder.
       
  • (Identification of β-thalassemia in hypochromic microcytic anemias
           refractory to iron treatment in Nicaragua)

    • Abstract: Resumen Justificación y objetivo: gran parte de los casos descritos de anemias microcíticas-hipocrómicas corresponden a anemias ferropénicas y síndromes talasémicos. El diagnóstico diferencial se complementa con pruebas de laboratorio como el hierro sérico, ferritina, entre otras; sin embargo, estas son de baja disponibilidad en países en vías de desarrollo. En Nicaragua, el diagnóstico de estas patologías se basa en el historial clínico y análisis hematológicos de rutina. El objetivo de este trabajo fue la implementación de la técnica de cuantificación de hemoglobina A2 en el diagnóstico clínico de β-talasemia. Métodos: se realizó un estudio transversal con 30 pacientes que mostraban microcitosis e hipocromía después de 3 meses de tratamiento con sales de hierro. Se realizó electroforesis de hemoglobina y se utilizó el kit de la casa comercial Beta-Thal HbA2 Quik Column para cuantificar la hemoglobina A2 en cada paciente. El análisis estadístico utilizado fue la prueba de t de student. Se consideraron significativas las diferencias a p<0,05. Esta investigación respetó los principios éticos que conciernen. Se contó con la aprobación del Comité de Ética Institucional, UNAN-Managua. Los participantes dieron su consentimiento informado. Resultados: al aplicar el método para cuantificación de hemoglobina A2, se obtuvo que el 67 % de las muestras presentaron una concentración de hemoglobina A2 mayor al valor de referencia establecido (3,3 %), siendo pacientes diagnosticados para β-talasemia menor. El 33 % restante presentó valores normales de hemoglobina A2 con microcitosis e hipocromía. Se encontraron diferencias estadísticamente significativas entre las medias de glóbulos rojos, volumen corpuscular medio, hemoglobina corpuscular media y hemoglobina A2, entre ambos grupos. Conclusión: el diagnóstico diferencial de anemias microcíticas hipocrómicas refractarias al tratamiento con hierro, se realiza inicialmente por el historial clínico del paciente, pero es necesario contar con pruebas diagnósticas como la cuantificación de hemoglobina A2 que permitan identificar las diversas patologías que cursan con microcitosis e hipocromía. Justification and objective: much of the described cases of microcytic-hypochromic anemias are ferropenic anemias and Thalassemia syndromes. The differential diagnosis is complemented by laboratory tests as serum iron, ferritin, among others; However, these are of low availability in developing countries. In Nicaragua, the diagnosis of these diseases is based on clinical history and routine blood analysis. The objective of this work was to implement a technique for quantification of hemoglobin A2 in the clinical diagnosis of β-Thalassemia. Methods: We conducted a cross-sectional study with 30 patients showing hypochromia and microcytosis after 3 months of treatment with iron salts. Hemoglobin electrophoresis was performed, a kit from Beta-Thal HbA2 Quik Column was used to quantify the hemoglobin A2 in each patient. The statistical analysis used was the student’s t test. The differences were considered significant at p < 0.05. This research respected ethical principles that concern. It had the approval of the committee of ethics institutional, UNAN-Managua and the participants gave their informed consent. Results: when applying the method for quantification of hemoglobin A2, 67% of samples presented a concentration of hemoglobin A2 greater than the reference value set at 3.3%, these patients were diagnosed with β-Thalassemia minor. The remaining 33% presented normal values of hemoglobin A2 with hypochromia and microcytosis. Statistically significant differences between the averages of red blood cells, mean corpuscular volume, mean corpuscular hemoglobin and hemoglobin A2 between the two groups was observed. Conclusion: The differential diagnosis of microcytic hypochromic anemias refractory to treatment with iron, is initially performed by the clinical history of the patient, but it is necessary to have diagnostic tests such as the quantification of hemoglobin A2, which allow the identification of patients with β-Thalassemia minor within this group. In our study 67% of the studied samples were identified as β-Thalassemia minor.
       
  • (Experience on children’s splenectomy: a ten year single center
           retrospective study)

    • Abstract: Resumen Objetivo: describir las características clínicas y la evolución de los pacientes sometidos a esplenectomía en el Hospital Nacional de Niños, de enero de 1996 a diciembre del 2006. Métodos: este es un estudio descriptivo retrospectivo que analiza un periodo de 10 años, de pacientes sometidos a esplenectomías en el Hospital Nacional se Niños. Se realizó una revisión de 107 expedientes con el diagnóstico en cuestión. De estos expedientes se obtuvieron: datos clínicos, epidemiológicos, indicaciones para el procedimiento y su respectiva evolución, complicaciones y mortalidad asociada. Se analiza además el seguimiento de las recomendaciones con respecto a profilaxis antibiótica y vacunación. Resultados: se analizó una muestra total de 107 casos. Entre los resultados se encontró que la edad promedio de intervención fue de 6,4 años. Los diagnósticos más comunes fueron hemoglobinopatías (59,8 %), púrpura trombocitopénica idiopática (16,8 %) y osteopetrosis maligna (8,4 %). Entre las indicaciones para esplenectomías predominaron el tratamiento de enfermedad de base (39,9%), hiperesplenismo (26,2 %) y ausencia de respuesta al tratamiento médico (22,4 %). El procedimiento quirúrgico más común fue la laparotomía en el 87,9 % de los casos. La complicación quirúrgica inmediata más frecuente fue la hemorragia persistente (3,7 %), mientras que la complicación quirúrgica tardía más común fue la sepsis (16,8 %). La respuesta terapéutica en la mayoría de los pacientes fue completa (66,7 %). Hubo 5 pacientes fallecidos, de los cuales en dos se relacionó su mortalidad con sepsis. La edad promedio al momento de fallecimiento fue de 6,7 años. Conclusiones: la esplenectomía es una alternativa para el tratamiento de las enfermedades médicas, tras la cual se evidenció una respuesta satisfactoria en la mayoría de los casos del estudio. Aim: to describe clinical characteristics and evolution of patients who underwent splenectomy in Costa Rica’s National Children’s Hospital during January 1996 through December 2006. Methods: This is a chart review study in a 10 year period including children who underwent splenectomy. A hundred and seven charts of children with ages between 0 and 18 years old were reviewed to obtain their clinical presentation, characteristics, indications for splenectomy, follow up, complications and mortality. Also the antibiotic prophylaxis and immunization schedule was analyzed based on international recommendations. Results: A total of 107 patients were included. Results showed that the mean age at which splenectomy was performed was 6.4 years. Most of the patients had their splenectomy due to hemoglobinophaties (59.8%), followed by immune thrombocytopenic purpura (16.8%) and malignant osteopetrosis (8.4%). The most common indications for splenectomy were treatment of the disease (39.9%), hyperesplenism (26.2%) and lack of responde to medical treatment (22.4%). Laparotomy was the most performed surgery (87.9%). Mainly sepsis and hemorrhage were found as complications due to procedure. Overall, complete response to surgical treatment was observed (66.7%). Five patients died during follow up. Conclusions: Splenectomy is an alternative for treating medical disease with predominantly good outcomes observed in our study.
       
  • (Survival of children born with congenital heart defects in Costa Rica: a
           retrospective study of the birth cohort 2006-2007)

    • Abstract: Resumen Justificación: alrededor del mundo las cardiopatías congénitas ocupan las primeras causas de mortalidad infantil. En Costa Rica son el grupo de defectos congénitos más frecuentes, con una prevalencia de 6 x 1000 nacimientos (IC95 % 5 -7 x 1000 nacimientos), que representan cerca del 13 % de la mortalidad infantil. El objetivo del estudio fue analizar la supervivencia a cinco años de edad de los niños nacidos con defectos cardiacos en Costa Rica. Métodos: se analizó una cohorte retrospectiva de 543 niños nacidos con cardiopatías congénitas entre enero de 2006 y junio de 2007 en Costa Rica; utilizando los registros médicos y la base nacional de defunciones se brindó un seguimiento mínimo de 5 años en todos los casos. Se obtuvo estimados de supervivencia de Kaplan-Meier al mes, año y cinco años de vida, y se evaluaron factores pronóstico empleando el modelo de riesgos proporcionales de Cox. Se estimaron riesgos relativos crudos y ajustados con su respectivo intervalo de confianza del 95 %. Resultados: la prevalencia de cardiopatías congénitas fue de 5,14 por 1000 nacimientos (IC95 % 4,73-5,60; n: 543) para el período de estudio. La mortalidad fue del 27,9 % (IC 95 % = 24,21- 31,73; n: 152). La supervivencia acumulada al año y cinco años fue del 76,1 % y el 72,4 %, respectivamente, frente al 99,1 % y 98,8 % sobrevivencia de la cohorte de nacimientos nacional (con y sin cardiopatía) de la misma edad. La edad temprana al diagnóstico, severidad, cardiopatías congénitas múltiples y la asociación de defectos congénitos mayores se asociaron significativamente (p≤0,05) a una menor probabilidad de supervivencia. Conclusiones: la cohorte de niños con cardiopatías congénitas estudiada presentó una alta mortalidad al año y cinco años. El peor pronóstico de supervivencia fue para aquellos que necesitaban una cirugía cardíaca a temprana edad. Background: Around the world, congenital heart defects occupy the first causes of infant mortality. In Costa Rica heart malformations are the most frequent group of birth defects, with a prevalence of 6 x 1000 births (95% CI 5-7 x 1000 births). They represent about 13% of infant mortality and are. the leading cause of death due to birth defects. The objective of this study is to analyze the survival of children with CC in Costa Rica. Methods: A retrospective cohort of 543 children born with CC between January 2006 and June 2007 in Costa Rica was analyzed. Using medical records and the national database of deaths, a minimum follow-up of 5 years was given in all cases. Kaplan-Meier survival estimates were obtained at month, year and five years of life. Prognostic factors were assessed using the Cox proportional hazards model. Raw and adjusted relative risks were estimated with their respective 95% confidence interval. Results: The prevalence of CC was 5.14 per 1000 births (95% CI: 4.73-5.60; n: 543) for the study period. Mortality was 27.9% (95% CI: 24.21-31.73; n: 152). Cumulative survival at one year and five years was 76.1% and 72.4%, respectively, compared to 99.1% and 98.8% of survival in the same national birth cohort (with and without CC), at the same age. Early age at diagnosis, severity, multiple CC and the association of major BD were significantly associated (p≤0.05) with a lower probability of survival. Conclusions: The cohort of children with congenital heart disease studied had a high mortality rate at one year and five years. The worst prognosis of survival was for those who needed cardiac surgery at an early age.
       
  • Faltas a la ética en la Caja Costarricense de Seguro Social

    • Abstract: Resumen Justificación: alrededor del mundo las cardiopatías congénitas ocupan las primeras causas de mortalidad infantil. En Costa Rica son el grupo de defectos congénitos más frecuentes, con una prevalencia de 6 x 1000 nacimientos (IC95 % 5 -7 x 1000 nacimientos), que representan cerca del 13 % de la mortalidad infantil. El objetivo del estudio fue analizar la supervivencia a cinco años de edad de los niños nacidos con defectos cardiacos en Costa Rica. Métodos: se analizó una cohorte retrospectiva de 543 niños nacidos con cardiopatías congénitas entre enero de 2006 y junio de 2007 en Costa Rica; utilizando los registros médicos y la base nacional de defunciones se brindó un seguimiento mínimo de 5 años en todos los casos. Se obtuvo estimados de supervivencia de Kaplan-Meier al mes, año y cinco años de vida, y se evaluaron factores pronóstico empleando el modelo de riesgos proporcionales de Cox. Se estimaron riesgos relativos crudos y ajustados con su respectivo intervalo de confianza del 95 %. Resultados: la prevalencia de cardiopatías congénitas fue de 5,14 por 1000 nacimientos (IC95 % 4,73-5,60; n: 543) para el período de estudio. La mortalidad fue del 27,9 % (IC 95 % = 24,21- 31,73; n: 152). La supervivencia acumulada al año y cinco años fue del 76,1 % y el 72,4 %, respectivamente, frente al 99,1 % y 98,8 % sobrevivencia de la cohorte de nacimientos nacional (con y sin cardiopatía) de la misma edad. La edad temprana al diagnóstico, severidad, cardiopatías congénitas múltiples y la asociación de defectos congénitos mayores se asociaron significativamente (p≤0,05) a una menor probabilidad de supervivencia. Conclusiones: la cohorte de niños con cardiopatías congénitas estudiada presentó una alta mortalidad al año y cinco años. El peor pronóstico de supervivencia fue para aquellos que necesitaban una cirugía cardíaca a temprana edad. Background: Around the world, congenital heart defects occupy the first causes of infant mortality. In Costa Rica heart malformations are the most frequent group of birth defects, with a prevalence of 6 x 1000 births (95% CI 5-7 x 1000 births). They represent about 13% of infant mortality and are. the leading cause of death due to birth defects. The objective of this study is to analyze the survival of children with CC in Costa Rica. Methods: A retrospective cohort of 543 children born with CC between January 2006 and June 2007 in Costa Rica was analyzed. Using medical records and the national database of deaths, a minimum follow-up of 5 years was given in all cases. Kaplan-Meier survival estimates were obtained at month, year and five years of life. Prognostic factors were assessed using the Cox proportional hazards model. Raw and adjusted relative risks were estimated with their respective 95% confidence interval. Results: The prevalence of CC was 5.14 per 1000 births (95% CI: 4.73-5.60; n: 543) for the study period. Mortality was 27.9% (95% CI: 24.21-31.73; n: 152). Cumulative survival at one year and five years was 76.1% and 72.4%, respectively, compared to 99.1% and 98.8% of survival in the same national birth cohort (with and without CC), at the same age. Early age at diagnosis, severity, multiple CC and the association of major BD were significantly associated (p≤0.05) with a lower probability of survival. Conclusions: The cohort of children with congenital heart disease studied had a high mortality rate at one year and five years. The worst prognosis of survival was for those who needed cardiac surgery at an early age.
       
 
 
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