The amputation of the upper limb, especially of the hand, is a serious trauma with significant functional and psychological impact. Treatment options include adaptation to the stump, use of prostheses, and composite tissue transplantation. Unfortunately, in Colombia, to date, there are no epidemiological data that characterize the sociodemographic and clinical variables of patients with upper limb amputation. ResultsFrom a sample of 443 amputee patients, eight were selected that met the inclusion criteria. There were 7/8 men (87%) aged 43 years. A total of 75% came from rural areas. In 3/8 patients, there was amputation of the dominant limb. The most common mechanisms were shear trauma and crushing in the context of an occupational accident. A total of 50% had a complete extra-hospital amputation, and reimplantation was not attempted in any of the cases. The most frequent levels of amputation were the proximal and distal third of the forearm. The longest follow-up time was 12 months. Only two patients mentioned the possibility of using a prosthesis during rehabilitation. ConclusionsThree young patients were identified, without comorbidities, with amputation of the dominant limb in the context of an occupational accident and without the possibility of rehabilitation with prostheses who benefit from a possible future hand transplant. However, it is necessary to implement a composite tissue transplantation program and public health policies that allow this procedure to be performed in Colombia.
Introducción: en la actualidad, la tuberculosis es considerada un problema mundial de salud pública de grave magnitud que requiere atención urgente y causa considerables costos directos e indirectos a los individuos y la sociedad. Directly Observed Therapy-Short Course (DOTS) es una estrategia acortada supervisada para el tratamiento de la tuberculosis, cuyo fin es asegurar la curación de la enfermedad. Objetivo: Determinar los conceptos y elementos claves que integran la estrategia DOTS en el tratamiento de la tuberculosis. Metodología: se hizo una revisión de la literatura en las bases de datos PubMed y Lilacs, empleando los términos: DOTS y tuberculosis. Se incluyeron todos los artículos de revisión en inglés y español con acceso gratuito que incluyeran un abordaje integral a dicha estrategia. Resultados: para el año 2000, 148 países habían adoptado la estrategia DOTS de la OMS para el control de la TB y un 27% de los casos mundiales de TB fueron tratados bajo esta. Aunque apreciable, este progreso no ha sido suficiente. Debido a problemas con los recursos humanos, recortes financieros, infraestructura inadecuada para la atención en salud y falta de abastecimiento seguro de fármacos antituberculosos de buena calidad, la estrategia DOTS no ha logrado un rápido crecimiento. Conclusiones: DOTS es una estrategia adecuada para asegurar la curación de la tuberculosis; sin embargo, son necesarias mayores inversiones económicas que busquen la prevención y adecuado control de esta enfermedad. [Cardona J, Jiménez E, Mejía L. La estrategia Directly Observe Therapy ShortCourse (DOTS), en búsqueda de la cura para la tuberculosis. MedUNAB 2014;16(3):143-148]
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