Background: Chronic venous disease demands clinical assessment, quantification of hemodynamic effects, and definition of anatomic distribution before diagnostic and treatment decisions can be made. Methods: This is a prospective study conducted in 2015 with a sample of 1,384 patients (2,669 limbs) aged from 17 to 85 years, 1,227 of whom were female. The most common symptoms reported in response to the questionnaire were pain, tiredness, feelings of heaviness, burning, cramps, and tingling. Subsets were formed on the basis of number of limbs distributed by sex, body mass index, and age. After definition of subsets, Doppler ultrasonography was used to conduct examinations of the great saphenous vein (GSV) and patients were distributed into three clinical groups (I: symptoms present and varicose veins absent, II: symptoms absent and varicose veins present and III: symptoms present and varicose veins present). Statistical analysis employed the chi-square test or Fisher' s exact test to test for homogeneity between groups. When associations significant to 5% were detected, odds ratios were calculated. Results: For both sexes, the chance of GSV insufficiency was 11.2 times greater in group III. Among cases with morbid obesity, the chance was 9.1 times greater in the same group. Additionally, patients in this group with ages ranging from 30 to 50 years exhibited a 43.1 times greater chance of GSV insufficiency. Conclusions: Insufficiency of the GSV was significantly more frequent in group III, both overall and when considering only cases with morbid obesity, or cases in older age groups.
Objetivo: Desenvolver um fluxograma para o atendimento inicial ao paciente adulto queimado no Hospital Universitário de Maringá. Método: Realizado uma revisão integrativa da literatura de 2012 a 2022, com abordagem qualitativa de artigos completos inglês, português e espanhol disponíveis nas bases de dados SciELO (Scientific Eletronic Library Online), PubMed/Medline (Sistema Online de Busca e Análise de Literatura Médica), LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde), Portal Periódico CAPES. Como descritores foram utilizados os termos: Diretrizes (Guideline); Queimaduras (Burn); Emergência (emergency); Unidades de Queimados (Burn Units). Como critério de exclusão: estudos pacientes com <18 anos, queimadura em olhos e artigos de baixa evidência. Resultados: Com esta revisão foram identificados 90 estudos, do quais, selecionados 11, separando os duplicados, leitura de título e resumo. Destes, 8/11 descreveram sobre os tipos de limpeza e coberturas usadas nos curativos, 5/11 artigos recomendaram os princípios Advanced Trauma Life Support (ATLS) para anamnese inicial, 6/11 utilizam a fórmula de Parkland para reposição volêmica, 3/11 indicaram a vacina antitetânica e a aplicação de heparina como prevenção. No que se referem à analgesia, 5/11 artigos sugerem o uso de opioides endovenosos e como alternativa, tratamentos não farmacológicos. Com a perspectiva de melhorar e padronizar o atendimento, 2/11 descrevem da importância do treinamento da equipe multiprofissional que está envolvida na assistência do paciente queimado. Conclusão: Conclui-se então que são parcos estudos que descrevem sobre o primeiro atendimento ao queimado e é necessário o desenvolvimento de um fluxograma para a padronização da assistência.
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