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Bibliographic Details
Main Author:	Oscar Cárdenas
Format:	Artículo científico
Language:	es
Published:	Universidad del Pacífico 2019
Subjects:	Medicina Apendicitis diagnóstico sensibilidad y especificidad
Online Access:	https://www.redalyc.org/articulo.oa?id=749878808001 https://www.redalyc.org/journal/7498/749878808001/ https://www.redalyc.org/journal/7498/749878808001/html/ https://www.redalyc.org/journal/7498/749878808001/749878808001.epub https://www.redalyc.org/journal/7498/749878808001/movil
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Utilidad de la Escala de Alvarado en pacientes con sospecha de apendicitis aguda en un hospital público de Ciudad del Este, Paraguay Oscar Cárdenas Margarita Samudio Medicina Apendicitis diagnóstico sensibilidad y especificidad El diagnóstico de la apendicitis aguda, que es la primera causa de atención quirúrgica en el servicio de urgencias de los hospitales, es esencialmente clínico. Sin embargo, se han empleado diversas herramientas como la escala de Alvarado para mejorar la certeza diagnóstica. Estudio observacional, prospectivo y longitudinal con el objetivo de evaluar la utilidad diagnóstica de la escala de Alvarado en el diagnóstico de apendicitis aguda en el servicio de urgencia del hospital regional de Ciudad del Este, en el periodo junio a diciembre del 2015. Se aplicó la escala de Alvarado a un grupo de 222 pacientes entre 15 y 81 años de edad, 123 (55,4%) hombres y 99 (44,6%) mujeres con sospecha de apendicitis, clasificados posteriormente en dos grupos de acuerdo a si fueron sometidos (n=138) o no a apendicetomía (n=84). En los pacientes no operados, el diagnóstico se confirmó por control telefónico. Los criterios considerados en la escala de Alvarado como migración del dolor, signo de Blumberg y leucocitosis fueron significativamente (p < 0,001) más frecuentes en los operados. La sensibilidad de la escala de Alvarado fue de 94,2% y especificidad de 82,1%, tanto los valores predictivos positivo y negativo fueron de 89,6%. El resultado histopatológico mostró apendicitis flemonosa en el 50% de los operados. La escala diagnóstica de Alvarado es una herramienta muy útil para mejorar la eficiencia diagnóstica en la apendicitis aguda, por lo que se recomienda su uso en los servicios de atención ambulatoria y de urgencias. 2019 artículo científico 2664-2891 https://www.redalyc.org/articulo.oa?id=749878808001 https://www.redalyc.org/journal/7498/749878808001/ https://www.redalyc.org/journal/7498/749878808001/html/ https://www.redalyc.org/journal/7498/749878808001/749878808001.epub https://www.redalyc.org/journal/7498/749878808001/movil 10.53732/rccsalud/01.01.2019.01 es http://www.redalyc.org/revista.oa?id=7498 Revista Científica Ciencias de la Salud application/pdf Universidad del Pacífico Revista Científica Ciencias de la Salud (Paraguay) Num.1 Vol.1

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// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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