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1.
Arch. Soc. Esp. Oftalmol ; 98(11): 627-632, nov. 2023. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-227201

RESUMO

Introducción y objetivos Investigamos si la autoadministración de riboflavina por parte de los pacientes podría ser una opción viable para el cross-linking corneal (CXL), teniendo en cuenta los importantes recursos necesarios para la impregnación de la córnea. Analizamos si administrar la riboflavina en el fórnix inferior (lugar de autoadministración) resulta en concentraciones de riboflavina no menores a cuando se aplica directamente en la córnea (zona de aplicación por personal médico). Pacientes y métodos Realizamos un estudio prospectivo para evaluar las concentraciones de riboflavina en seis puntos de tiempo (basal, cinco, 15, 30, 45 y 60 minutos) en 18 voluntarios para cada uno de los dos lugares de aplicación: córnea y fórnix. Las concentraciones de riboflavina (Peschke® TE 0,25%; Peschke Trade GmbH, Huenenberg, Suiza) en la cámara anterior fueron medidas por fluorofotometría (FluorotronTM Master FM-2; OcuMetrics Inc., Mountain View, CA, EE. UU.). Resultados En los dos lugares de aplicación, córnea y fórnix, se observó una autofluorescencia de 16,7 ng/mL (desviación estándar [DE] 5,5) y 14,6 ng/mL (DE 4,6) al inicio de la serie de mediciones (p = 0,221). Después de 30 minutos, las concentraciones de fluorescencia en la cámara anterior habían aumentado a 55,1 ng/mL (DE 25,5) y a 46,1 ng/mL (DE 25,1) (p = 0,293) sin un incremento relevante adicional a los 60 minutos. Conclusiones Este estudio encontró que la aplicación de gotas de riboflavina en el fórnix inferior no fue menor a la aplicación directa en la córnea, según las mediciones fluorométricas de las concentraciones de riboflavina en la cámara anterior. Sugiere que la autoadministración es viable en términos de impregnación corneal de riboflavina (AU)


Introduction and objectives We investigated whether riboflavin self-administration by patients could be a feasible option for corneal cross-linking, given the considerable resources required to impregnate the cornea with riboflavin. We analysed whether administering riboflavin in the inferior fornix (the site of self-administration) results in non-inferior riboflavin concentrations as when applied directly on the cornea (the site of administration by medical personnel). Patients and methods We conducted a prospective study to evaluate riboflavin concentrations at six time-points (baseline, 5, 15, 30, 45 and 60min) in 18 healthy volunteers for each of two application sites: cornea and fornix. Anterior chamber riboflavin (Peschke® TE 0.25%) concentrations were measured by fluorophotometry (Fluorotron™ Master FM-2). Results For the two application sites cornea and fornix, participants did not differ in terms of age and sex. At baseline, the autofluorescence in the anterior chamber was 16.7ng/ml (SD 5.5) and 14.6ng/ml (SD 4.6) (p=0.221). After 30min, anterior chamber fluorescein concentrations had risen to 55.1ng/ml (SD 25.5) and 46.1ng/ml (SD 25.1) (p=0.293) without a further relevant increase by 60min. Conclusions This study found that applying riboflavin drops in the inferior fornix was non-inferior to applying it directly to the cornea, based on fluorophotometric measurements of anterior chamber riboflavin concentrations. This suggests that self-application of riboflavin is feasible in terms of corneal riboflavin impregnation (AU)


Assuntos
Humanos , Riboflavina/administração & dosagem , Riboflavina/análise , Complexo Vitamínico B/administração & dosagem , Fluorofotometria , Córnea/química , Estudos Prospectivos , Autoadministração
2.
Aten. prim. (Barc., Ed. impr.) ; 54(4): 102283, Abril 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-203966

RESUMO

Diferentes modelos de cuidado en contexto de cronicidad y multimorbilidad incorporan a la comunidad, sistema de salud, práctica clínica, políticas sanitarias, prevención y promoción de salud. Entre estos se señala el rol facilitador del equipo de salud en el automanejo, siendo las personas protagonistas de su proceso. El abordaje de la multimorbilidad se realiza mayormente desde un enfoque centrado en el riesgo y la enfermedad, limitando la exploración de los recursos de las personas y su entorno. Incorporar un enfoque de salud positiva puede aportar a una mayor integralidad. El propósito de este artículo es proponer un abordaje desde el modelo sinérgico de salud, integrando la salutogénesis y el modelo de activos, para facilitar el automanejo promoviendo la capacidad de agencia de las personas. Se presentan potenciales áreas de aplicación de estos modelos en el contexto de multimorbilidad, fomentando condiciones de salud y bienestar en las personas y sus familias.(AU)


Different models of care in context of chronicity and multimorbidity include community, health system, clinical practice, health policies, prevention, and health promotion. Among these, the role of the health team as a facilitator of self-management is pointed out, being people the protagonists of their process. Multimorbidity approach is mostly carried out from a risk and disease focused point of view, which limits the exploration of resources of people and their environment. Incorporating a positive health approach can contribute to a greater comprehensiveness. The purpose of this article is to propose an approach from the synergy model of health, integrating salutogenesis and health assets model, to help facilitate self-management promoting people's agency capacity. Potential areas of application of these models are presented to work in the context of multimorbidity, promoting health and well-being conditions in people and their families.(AU)


Assuntos
Humanos , Política de Saúde , Promoção da Saúde , Multimorbidade , Senso de Coerência , Autoadministração
6.
Pharm. pract. (Granada, Internet) ; 18(2): 0-0, abr.-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194051

RESUMO

BACKGROUND: Self-administered medication (SAM) is encouraged in many hospitals worldwide as it increases patients' knowledge and understanding of their medication, but the effects on other outcomes, e.g. compliance or medication errors, were unclear. OBJECTIVES: To compare medication knowledge, adherence, medication errors, and hospital readmission among inpatients receiving SAM education under the supervision of a multidisciplinary team (study group) with those receiving routine nurse-administered medication (control group). METHODS: This study was a PROBE design. Inpatients with chronic diseases were randomly allocated (1:1) to either the study group or the control group using stratified-block randomization. Knowledge of medications was measured at hospital discharge and at the first two follow-up visits; adherence was measured at the first two follow-up visits, medication errors while in hospital, and hospital readmission within 60 days after discharge. For normally distributed continuous outcomes, mean difference and 95%CI were estimated; otherwise the median and the Mann-Whitney test p-value were reported. The percentage difference and 95%CI were reported for binary outcomes. RESULTS: 70 patients were randomized (35 in each group); all received complete follow-up. Both groups were similar at baseline. Mean (SD) age (years) were 59.2 (11.0) for the study group and 58.3 (12.0) for the control group. Percentages of females in the respective groups were 54.3 and 60.0. Mean time from discharge to the first follow-up visit was two weeks in both groups and time to the second follow-up visit were 68.8 days (study group) and 55.0 days (control group). The study group had significantly higher medication knowledge than the control group at hospital discharge (of the 10-point scale, medians, 8.56 and 6.18, respectively, p < 0.001). The corresponding figures were similar in both groups at the first follow-up visit (medians, 8.25 and 6.26, respectively, p < 0.001). Adherence to medication at the first visit in the study group (percentage mean 92.50% (SD=5.33%)) was significantly higher than that in the control group (79.60% (SD=5.96%)), percentage mean difference 12.90%, [95%CI 10.20%:15.60%], p < 0.001. Medication knowledge and adherence were sustained at the second follow-up visit. During hospitalization, no medication errors were found in the study group, and minimal errors occurred in the control group (1.48%, [95%CI 0.68%:2.28%] of doses administered, p = 0.001). Hospital readmission within 60 days after discharge was significantly lower in the study group (11.4%) than that in the control group (31.4%), percentage difference 20.0% (95%CI 1.4%:38.6%), 1-side Fisher exact p = 0.039. CONCLUSIONS: Among in-patients with chronic diseases, SAM program significantly increased knowledge of and adherence to prescribed medications. Medication errors regarding administration errors were infrequent but significantly higher in the control group. SAM reduced hospital readmission within 60 after discharge


No disponible


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Autoadministração , Comunicação Interdisciplinar , Sistemas de Medicação/organização & administração , Conduta do Tratamento Medicamentoso , Estimativa de Kaplan-Meier , Erros de Medicação/prevenção & controle
7.
Pharm. pract. (Granada, Internet) ; 18(2): 0-0, abr.-jun. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194054

RESUMO

OBJECTIVE: To determine the accuracy, variability, and weight uniformity of tablet subdivision techniques utilized to divide the tablets of five drug products that are commonly prescribed for use as half tablets in Jordan. METHODS: Ten random tablets of five commonly subdivided drug products were weighed and subdivided using three subdivision techniques: hand breaking, kitchen knife, and tablet cutter. The five commonly subdivided drug products (warfarin 5 mg, levothyroxine 50 μg, levothyroxine 100 μg, candesartan 16 mg, and carvedilol 25 mg) were weighed. The weights were analyzed for acceptance, accuracy, and variability. Weight variation acceptance criteria were adopted in this work as a tool to indicate the properness of the subdivision techniques used to produce acceptable half tablets. Other relevant physical characteristics of the five products such as tablet shape, dimensions, face curvature, score depth, and crushing strength were measured. RESULTS: All tablets were round in shape, had weights that ranged between 100.63 mg (standard deviation=0.99) and 379.04 mg (standard deviation=3.00), and had crushing strengths that ranged between 23.29 N (standard deviation=3.58)and 103.35 N (standard deviation=14.98). Both candesartan and carvedilol were bi-convex in shape with an extent of face curvature equal to about 33%. In addition, percentage score depth of the tablets had a range between 0% and 24%. The accuracy and variability of subdivision varied according to the subdivision technique used and tablet characteristics. Accuracy range was between 81% and 109.8%. Moreover, the relative standard deviation was between 1.5% and 17.4%. Warfarin 5 mg subdivided tablets failed the weight variation test regardless of the subdivision technique used. Subdivision by hand produced half tablets that were acceptable for levothyroxine 50 μg and levothyroxine 100 μg. Subdivision by knife produced half tablets that were acceptable only for candesartan tablets. However, the tablet cutter produced half tablets that passed the weight variation test for four out of the five drug products tested in this study. CONCLUSIONS: The tablet cutter performed better than the other subdivision techniques used. It produced half tablets that passed the weight uniformity test for four drug products out of the five


No disponible


Assuntos
Humanos , Comprimidos/uso terapêutico , Autoadministração , Prescrições de Medicamentos , Reprodutibilidade dos Testes , Comprimidos/química , Tecnologia Farmacêutica/métodos , Erros de Medicação/prevenção & controle , Jordânia , Comprimidos/farmacocinética , Preparações de Ação Retardada/química , Preparações de Ação Retardada/farmacocinética
9.
Allergol. immunopatol ; 48(1): 3-7, ene.-feb. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-186585

RESUMO

Background: Anaphylaxis is a sudden, severe, and potentially life-threatening allergic reaction, affecting a portion of allergic patients. Adrenaline is the first-line medication for anaphylaxis and available in many parts of the world as adrenaline autoinjectors (AAIs). Objective: Aim of this study was to determine attitudes and knowledge levels of patients/parents regarding the use of AAIs, frequency, and rate of appropriate AAI use and to give a standardized and better education by improving on mistakes during administration. Method: 190 patients aged 1-18 years who were prescribed AAIs for any reason between 2012 and 2017 in Hacettepe University Pediatric Allergy Unit. Demographic data were collected during face-to-face interview or by telephone. Parents completed a mini-survey regarding use, carriage, and storage of AAI. Results: Some 190 patients (64.7% male) aged 7.83 (4.99-12.08) years, median (inter-quartile), were included in the study. The indications for AAI prescription were food allergy (78.9%); venom allergy (14.2%); idiopathic anaphylaxis (3.7%); mastocytosis (2.1%); and drug allergy (1.0%). One-fourth of AAI-prescribed patients experienced anaphylaxis requiring the use of AAI within the past five years. However, only 30% of the patients dared to use AAI; only three-quarters of whom had managed to use it correctly. Conclusion: After prescription of AAI and initial training, patients and parents' concerns and fears should be taken into consideration and necessary support should be provided. At every opportunity and each clinical visit, not only should training sessions be repeated but also the patients and parents should be psychologically supported


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Epinefrina/uso terapêutico , Autoadministração/métodos , Anafilaxia/tratamento farmacológico , Hipersensibilidade Alimentar/tratamento farmacológico , Asma , Rinite , Dermatite Atópica
10.
J. investig. allergol. clin. immunol ; 30(2): 77-85, 2020. tab, mapas, graf
Artigo em Inglês | IBECS | ID: ibc-195471

RESUMO

Adrenaline (epinephrine) is the first-line treatment for anaphylaxis and, therefore, is listed as an essential medication for the treatment of anaphylaxis by the World Health Organization (WHO). However, the availability of adrenaline autoinjectors (AAI) for use as first-aid treatment is limited to only 32% of all the world's 195 countries, most of which are high-income countries. The key issues leading to the lack of availability of AAIs include cost, national regulations, lack of regional evidence on the value of epinephrine, and limited accurate data about the epidemiology of anaphylaxis. For these reasons, regional and international allergy academies support initiatives to narrow these gaps. Our WHO Collaborating Centre is deeply involved in this process. This document aims to serve as a baseline to ensure the following: (1) adequate access to affordable autoinjectors for all patients/societies; and (2) the development of disease-/patient-specific approaches. Therefore, we propose a 5-step action plan that aims to gather accurate epidemiological data on anaphylaxis and autoinjector consumption, confirm partnerships, strengthen awareness, and include AAIs in the WHO Model List of Essential Medicines. These aspects should be considered in combination. A prioritized research agenda should encapsulate all these steps within the framework a global initiative against anaphylaxis. More than calling for universal availability of autoinjectors for optimal management of anaphylaxis, we propose an action plan as the baseline for a global initiative against anaphylaxis. We strongly believe that combined efforts will ensure a strong public health and societal approach that will lead to optimal care of allergic patients and best practices in allergology


La adrenalina es el tratamiento de primera línea de la anafilaxia y, por lo tanto, está catalogada como un medicamento esencial en su tratamiento por la Organización Mundial de la Salud (OMS). Sin embargo, la disponibilidad de los autoinjectores de adrenalina (AIA), indispensables en las fases iniciales del manejo de la anafilaxia, está limitada a solo el 32% de los 195 países del mundo, en su mayoría países con economías de primer orden. Los problemas clave que conducen a la falta de disponibilidad de los AIA incluyen el costo, pero también la regulación nacional, la falta de evidencia locales sobre el valor de la epinefrina y la escasez de datos precisos sobre la epidemiología de la anafilaxia. Por estas razones, las sociedades científicas de alergia, nacionales e internacionales, dan apoyo a las iniciativas encaminadas a reducir estas brechas. Nuestro Centro Colaborador de la OMS está profundamente involucrado en este proceso y el propósito de este documento es servir de punto de partida para alcanzar: (I) un acceso adecuado a los AIA a un costo asequible para todos los pacientes/sociedades y (II) el desarrollo de un abordaje específico para el binomio paciente/enfermedad. Por todo ello, proponemos un plan de acción en 5 pasos: recopilar datos epidemiológicos de calidad sobre la anafilaxia e indicadores de consumo de AIA, establecer alianzas entre todos los agentes implicados, reforzar la importancia del uso adecuado de los AIA e incluirlos en el listado de medicamentos esenciales de la OMS, que deben darse de forma conjunta. Una agenda de investigación priorizada debe incluir todos estos pasos en el marco de una iniciativa global contra la anafilaxia. Más que exigir la disponibilidad global de los AIA para un mejor abordaje de la anafilaxia, proponemos un plan de acción como base de una iniciativa mundial contra la anafilaxia. Creemos firmemente que estos esfuerzos combinados a nivel de sociedad y de salud pública conllevarán un cuidado óptimo de los pacientes alérgicos y la mejor práctica de la Alergología


Assuntos
Humanos , Autoadministração , Anafilaxia/tratamento farmacológico , Epinefrina/administração & dosagem , Epinefrina/provisão & distribuição , Saúde Global , Organização Mundial da Saúde
12.
Rev. clín. med. fam ; 11(1): 25-27, feb. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-171572

RESUMO

Presentamos un caso de inyección accidental en un dedo de la mano en personal sanitario resuelto con inmersión del dedo en agua caliente y aplicación tópica de pomada nitroglicerina. Los síntomas más habituales son el dolor, palidez y frialdad a nivel local, aunque se han descrito complicaciones graves por vasoconstricción severa como la necrosis isquémica, que obliga a tratamientos más agresivos como la administración de fentolamina. El uso cada vez más extendido de autoinyectores de adrenalina para el tratamiento de reacciones anafilácticas severas ha hecho que aumenten los casos de inyección accidental de estos dispositivos, siendo recomendable el conocimiento del manejo de estas situaciones por los profesionales de Atención Primaria y de los Servicios de Urgencia (AU)


We present the case of an accidental injection of adrenaline into a digital finger in health personnel, solved by immersion of the finger in warm water and topical application of nitroglycerine intment. Most common symptoms are local pain, pallor and coldness, although some cases may present serious complications due to severe vasoconstriction, such as ischemic necrosis, which requires more aggressive treatments, including administration of phentolamine. The increased use of adrenaline auto-injectors for the treatment of severe anaphylactic reactions has caused an increasing incidence of accidental injection from these devices. It is therefore advisable that Primary Care and Emergency Department professionals are knowledgeable about the management of these situation (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Epinefrina/efeitos adversos , Ferimentos Penetrantes Produzidos por Agulha/complicações , Fentolamina/uso terapêutico , Isquemia/tratamento farmacológico , Traumatismos Ocupacionais/etiologia , Traumatismos dos Dedos/etiologia , Autoadministração/efeitos adversos , Anafilaxia/tratamento farmacológico , Isquemia/induzido quimicamente
13.
Rev. derecho genoma hum ; (47): 83-105, jul.-dic. 2017.
Artigo em Espanhol | IBECS | ID: ibc-176417

RESUMO

Los test genéticos directos al consumidor tienen por objeto conocer la predisposición a padecer enfermedades comunes de origen multifactorial. Tal y como se ofrecen constituyen un reclamo cuya calidad y utilidad no ha sido probada, ya que, en muchos casos, no predicen el desarrollo de la enfermedad ni su gravedad. Objeciones tales como la falta de información y de consejo genético, el impacto en el individuo y en su familia, la agresiva publicidad y el riesgo de estigmatización justifican la adopción de cautelas y el sometimiento a unos estrictos estándares éticos y jurídicos


Direct-to-consumer genetic testing aim to meet the predisposition to common diseases of multifactorial origin. These tests are offered as a form of claim whose quality and usefulness has not been tested, since in many cases do not predict the development of the disease or its severity. Objections such as lack of information and genetic counselling, the impact on the individual and his family, aggressive advertising and the risk of stigmatization justify the need to take precautionary measures and to be subject to strict ethical and legal standards


Assuntos
Humanos , Testes Genéticos/ética , Doenças Genéticas Inatas/diagnóstico , Defesa do Consumidor/ética , Aconselhamento Genético/ética , Valor Preditivo dos Testes , Informação de Saúde ao Consumidor/ética , Autoadministração/ética , Publicidade Direta ao Consumidor/ética
14.
Rev. derecho genoma hum ; (47): 137-148, jul.-dic. 2017.
Artigo em Espanhol | IBECS | ID: ibc-176419

RESUMO

The development of market for commercial genetic testing allows free access to them for an unlimited number of people. Everyone can carry out genetic tests in every chosen medical service provider and receive interesting results. Moreover, the transfer of genetic material for testing and the results of these tests may be sent by post without a personal visit in the service provider. Theoretically, free access to genetic tests can be assessed as a guarantee of the right to protect private life. Everyone can receive detailed information about his person, in particular in the field of health and existing or potential diseases. Therefore, the genetic tests give the opportunity to broaden the scope of information about the state of health. What is more important, this information can allow, for instance, to choose appropriate treatment or to make some preventive decisions. In this context, even the ECHR treats the access to genetic testing as a possible way to guarantee the right to protect private life (for example prenatal genetic testing). However, free access to genetic tests is also connected with the threat to the right to protect private life. The possibility of sending the biological material for testing by post and the easy access to this material opens wide possibilities for receiving the genetic data of any person. This method of conducting genetic tests does not allow to prevent from obtaining the sensitive data of another person without his/her knowledge and consent. Furthermore, the advisory services for people conducting genetic tests privately does not exist. Patients cannot receive the proper interpretation of the results of genetic tests obtained commercially. Misinterpreted results of genetic tests may have the very negative impact on the life, on life decisions, and consequently on the realization of the right to protect private life. Therefore, he admissibility of conducting commercial genetic testing, in particular conducting by post, requires an appropriate balance between guarantees and threats to the right to protect private life. The proper protection of this right probably requires that direct-to-consumer genetic tests probably should be done only on the order of a physician


El desarrollo del mercado de pruebas genéticas comerciales permite el acceso gratuito a ellas para un número ilimitado de personas. Todo el mundo puede realizar pruebas genéticas con cada proveedor de servicios médicos elegido y recibir resultados interesantes. Además, la transferencia de material genético para las pruebas y los resultados de éstas, pueden enviarse por correo sin una visita personal al proveedor del servicio. Teóricamente, el acceso libre a pruebas genéticas puede evaluarse como una garantía del derecho a proteger la vida privada. Todo el mundo puede recibir información detallada sobre su persona, en particular en el campo de la salud y las enfermedades existentes o potenciales. Por lo tanto, las pruebas genéticas brindan la oportunidad de ampliar el alcance de la información sobre el estado de salud. Lo que es más importante, esta información puede permitir, por ejemplo, elegir el tratamiento adecuado o tomar algunas decisiones preventivas. En este contexto, incluso el Tribunal Europeo de Derechos Humanos trata el acceso a las pruebas genéticas como una forma posible de garantizar el derecho a proteger la vida privada (por ejemplo, pruebas genéticas prenatales). Sin embargo, el libre acceso a las pruebas genéticas también está relacionado con la amenaza al derecho de proteger la vida privada. La posibilidad de enviar el material biológico para la prueba por correo y el fácil acceso a este material abre amplias posibilidades para recibir los datos genéticos de cualquier persona. Este método de realizar pruebas genéticas no permite evitar la obtención de datos confidenciales de otra persona sin su conocimiento y consentimiento. Además, los servicios de asesoramiento para personas que realizan pruebas genéticas de forma privada no existen. Los pacientes no pueden recibir la interpretación adecuada de los resultados de las pruebas genéticas obtenidas comercialmente. Los resultados malinterpretados de las pruebas genéticas pueden tener un impacto muy negativo en la vida, en decisiones vitales y, en consecuencia, en la realización del derecho a proteger la vida privada. Por lo tanto, la admisibilidad de realizar pruebas genéticas comerciales, en particular la realización por correo, requiere un equilibrio adecuado entre las garantías y las amenazas al derecho a proteger la vida privada. La protección adecuada de este derecho probablemente requiera que las pruebas genéticas directas al consumidor solo se realicen por orden de un médico


Assuntos
Humanos , Testes Genéticos/ética , Doenças Genéticas Inatas/diagnóstico , Defesa do Consumidor/ética , Aconselhamento Genético/ética , Valor Preditivo dos Testes , Informação de Saúde ao Consumidor/ética , Autoadministração/ética , Privacidade Genética/ética , Prescrições
15.
Rev. derecho genoma hum ; (46): 177-196, ene.-jun. 2017.
Artigo em Inglês | IBECS | ID: ibc-176407

RESUMO

This paper explores the right to commercial speech of the companies that offer Direct To Consumer (DTC) genetic tests in the market. The paper discusses whether the bans to commercial speech currently in force in Spain are necessary and proportional or not, attending to the rights and public interests they try to protect, and balancing them with the communicative rights of the companies and the customers


El presente artículo analiza el derecho a la comunicación publicitaria de las empresas que ofrecen test directos al consumidor. Tras un análisis de la normativa vigente en España, se plantea la necesidad y proporcionalidad de las restricciones que el ordenamiento español impone a este tipo de publicidad, ponderando los intereses en conflicto: de un lado, el derecho a la comunicación de las empresas y los potenciales clientes de otro, la protección de la salud pública y de los consumidores y usuarios


Assuntos
Humanos , Autoadministração/ética , Testes Genéticos/ética , Doenças Genéticas Inatas/diagnóstico , Defesa do Consumidor/ética , Marketing de Serviços de Saúde/ética , Autocuidado/ética , Valor Preditivo dos Testes , Informação de Saúde ao Consumidor/ética
16.
Reumatol. clín. (Barc.) ; 13(1): 4-9, ene.-feb. 2017.
Artigo em Espanhol | IBECS | ID: ibc-159879

RESUMO

Objetivo. Conocer y analizar la actividad de la enfermería de reumatología en nuestro medio. Material y métodos. Se realizó un estudio transversal en servicios de reumatología de todo el país. Se utilizaron encuestas dirigidas a enfermería que incluyeron variables sociodemográficas, de medios estructurales y de actividad realizada por enfermería. Cada actividad fue comparada en función del lugar de trabajo, disponibilidad de medios y exclusividad laboral. Resultados. Se analizaron 67 encuestas, de 57 hospitales y 17 comunidades autónomas. Participaron un 97% de mujeres con una edad y experiencia laboral media de 48,9 y 6 años, respectivamente. El 56% trabajaron en consultas externas, el 35% en hospitales de día y el 9% en hospitalización y atención primaria. En cuanto a los medios: el 59% tenía despacho, el 77,3% agenda telefónica y el 60% agenda propia. Respecto a las actividades, el mayor número de profesionales realizó: monitorización de biológicos el 90,9%, seguimiento de terapias el 89,4% y entrenamiento en la autoadministración el 89,4%. La actividad en colaboración más frecuente fueron las infiltraciones, el 51,5%. Las actividades en docencia fueron el 50% y las de investigación dentro del servicio o con estudios en el área de enfermería el 78,8 y 51,5% respectivamente. Trabajar en consultas externas respecto a hospital de día, disponer al menos de despacho propio y realizar la jornada laboral con exclusividad en reumatología mostró diferencias significativas en distintas actividades. Conclusiones. El número de actividades realizadas por estos profesionales demostró ser mayor cuando el trabajo se realizó en la consulta externa, con despacho propio y exclusividad en reumatología (AU)


Objective. Describe and analyze nursing activity in rheumatology. Material and methods. A cross-sectional study was performed in Spanish rheumatology departments. Results were based on surveys administered to rheumatology nurses. We included variables on socio-demographics, the setting and available resources, and the activities they carried out. Each activity was compared in terms of workplace, available resources and dedication exclusively to one field. Results. Sixty-seven surveys were collected from 57 hospitals in 17 Spanish autonomous communities. 97% of the nurses were women, with an average age of 48.9 years and an average nursing experience of 6 years. 56% of the professionals had gained their experience in outpatient clinics, 35% in day hospitals and 9% in inpatient and primary care. As for the availability of resources, 59% had their own office, 77.3% had a phone listing and 60% scheduled and conducted patient visits. Of the 19 activities included, those performed by the highest number of nurses were managing, monitoring and coordinating the use of biological drugs (90.9%), therapy monitoring (89.4%) and training patients in self-medication (89.4%). The activity in which nurses most frequently collaborated with physicians was the administration of local injections (51.5%). Other activities were teaching (50%) and research (78.8%) in their departments and studies in the nursing field (51.5%). Work in outpatient clinics versus day hospitals showed statistically significant differences for health education, nutrition, splinting and bandaging, and collaboration in ultrasound studies. Conclusion. These professionals performed a greater number of activities when they worked in outpatient clinics, had their own office and worked exclusively in rheumatology (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Reumatologia , Reumatologia/métodos , Doenças Reumáticas/epidemiologia , Doenças Reumáticas/enfermagem , Cuidados de Enfermagem/normas , Cuidados de Enfermagem/tendências , Papel do Profissional de Enfermagem/psicologia , Estudos Transversais/métodos , Estudos Transversais/tendências , Inquéritos e Questionários , Autoadministração/métodos , Autoadministração/enfermagem
18.
J. investig. allergol. clin. immunol ; 25(6): 408-415, 2015. tab, graf
Artigo em Inglês | IBECS | ID: ibc-146912

RESUMO

Background: Our objective was to ascertain the degree of adherence to recommendations made to patients with anaphylaxis, most of whom were attended in our allergy outpatient clinic. Methods: A questionnaire was sent to 1512 patients who had experienced anaphylaxis and completed by 887. The chosen definition of anaphylaxis was that of the National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network Symposium. We evaluated the prescription, purchase, and use of epinephrine auto-injectors and oral drugs, as well as the avoidance of allergens involved in previous anaphylaxis episodes. Results: Most patients (94.53%) reported that they had received advice on avoidance of responsible allergens after their allergy workup. Epinephrine auto-injectors and oral drugs were prescribed according to the subtype of anaphylaxis. Only 30.74% of patients used the epinephrine auto-injector; 54.26% took oral medication. Most patients (88.3%) avoided the allergen. Conclusions: Despite general agreement that anaphylaxis occurring in the community should be treated with epinephrine auto-injectors, use of these devices to treat recurrences was low in our patients. Oral medication intake was more common than the epinephrine auto-injector in all subtypes. In order to increase adherence to epinephrine auto-injectors, it is necessary to think beyond the measures recommended during regular visits to allergy outpatient clinics (AU)


Antecedentes: Guías clínicas y documentos de posicionamiento recomiendan planes de acción urgentes personalizados para los pacientes que han tenido anafilaxia. El cumplimiento de estos planes es generalmente bajo. Objetivo: Nuestro objetivo fue determinar el grado de adherencia a diferentes recomendaciones hechas a los pacientes con anafilaxia, que en la mayoría de los cuales fueron atendidos en la consulta externa de Alergia de nuestro hospital. Métodos: Se envió un cuestionario a 1.512 pacientes que habían sufrido un episodio previo de anafilaxia y este fue completado por 887. La definición elegida de anafilaxia fue la del Instituto Nacional de Alergias y Enfermedades Infecciosas y el Simposio de la Food Allergy and Anaphylaxis Network (NIAID-FAAN). Se evaluó la prescripción, la compra y el uso de auto-inyectores de adrenalina y medicamentos orales, así como la evitación de alérgenos implicados en los episodios de anafilaxia anteriores. Resultados: La mayoría de los pacientes (94,53%) informaron que habían sido aconsejados sobre la evitación de alérgenos responsables después de su evaluación alergológica. Los auto-inyectores de adrenalina y los medicamentos orales se prescribieron de forma diferente según el subtipo de anafilaxia. Sólo el 30.74% de los pacientes utilizaron el auto inyector de adrenalina y el 54,26% tomo la medicación oral. La mayoría de los pacientes (88,3%) evitaron el alérgeno. Conclusiones: A pesar del acuerdo general que los episodios de anafilaxia que ocurren en la comunidad deben ser tratados con autoinyectores de adrenalina, el uso de estos dispositivos para el tratamiento de las recurrencias fue baja en nuestros pacientes. La ingesta oral de medicamentos es más común que el auto inyector de adrenalina en todos los subtipos. Con el fin de aumentar la adherencia a autoinyectores de adrenalina, es necesario investigar más allá de las medidas recomendadas durante las visitas regulares a las consultas de Alergia (AU)


Assuntos
Humanos , Anafilaxia/epidemiologia , Adesão à Medicação/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Anafilaxia/prevenção & controle , Recidiva , Epinefrina/uso terapêutico , Autoadministração
19.
Nutr. hosp ; 30(3): 585-593, sept. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-143781

RESUMO

Introducción: Numerosos estudios han tratado de verificar la eficacia de una intervención educativa en pacientes diabéticos tipo 1 (DM1). Objetivos: Analizar los conocimientos previos a la intervención educativa sobre hábitos alimentarios y ejercicio físico, comprobar una posible mejora del nivel de estos conocimientos tras la intervención y verificar la adquisición de destrezas relacionadas con el autoanálisis y la autoinyección. Metodología: Se incluyeron 32 pacientes con DM1 de entre 4 y 14 años de Melilla. Mediante un cuestionario se analizaron los conocimientos sobre alimentación y ejercicio físico, y los hábitos sobre los mismos, mediante cuestionario KrecePlus. Se realizó una intervención educativa y se analizaron nuevamente dichos conocimientos, así como las destrezas adquiridas sobre autoanálisis y autoinyección con un nuevo cuestionario. Resultados: En relación a los conocimientos sobre dieta y ejercicio físico, se alcanzó una mejora significativa (p<0,0001) tras la intervención. Igualmente, los resultados mostraron una mejora en los hábitos de alimentación y ejercicio físico. El estudio de destrezas sobre autoanálisis y autoinyección reveló que los sujetos eran independientes en los procesos de autoanálisis de glucemia y autoinyección de insulina tras la intervención. Conclusión: Una intervención educativa llevada a cabo por enfermeras especializadas constituye un procedimiento efectivo para mejorar y aumentar los conocimientos de pacientes con DM1 sobre alimentación, ejercicio físico y sobre la propia enfermedad, así como un incentivo para adquirir hábitos saludables respecto a alimentación y ejercicio físico (AU)


Introduction: Large researches have tried to verify the efficiency of the educational intervention in patients suffering from type 1 diabetes (T1D). Objectives: Analyzing the initial knowledge about diet habits and physical exercise, confirming a possible improvement of the level of this knowledge after the educational intervention and verifying the acquisition of skills related to self-analysis and self-injection. Methodology: 32 subjects with T1D, from 4 to 14 years old in Melilla were included. The knowledge about diet and physical exercise were analyzed using a questionnaire. Diet habits were evaluated using the KrecePlus questionnaire. An educational intervention was offered and that knowledge was analysed again, as well as the skills acquired about self-analysis and self-injection with a new questionnaire. Results: After the intervention, the knowledge about diet and physical exercise significantly improved (p <0,0001). The results also showed an improvement in diet habits and physical exercise. The study of self-analysis and self-injection skills evidenced that the subjects were independent in the processes of blood glucose self-analysis and insulin self-injection. Conclusion: An educational intervention developed by a nurse is an effective procedure to improve and increase the knowledge about diet, physical exercise and about the disease in diabetic type 1 diabetic, as well as an incentive to acquire healthy habits about diet and physical exercise (AU)


Assuntos
Criança , Humanos , Diabetes Mellitus Tipo 1/terapia , Educação em Saúde/métodos , Cuidados de Enfermagem/métodos , Autocuidado/métodos , Avaliação de Eficácia-Efetividade de Intervenções , Autoanálise/métodos , Autoadministração/métodos , Educação de Pacientes como Assunto/métodos , Terapia Nutricional/métodos
20.
Sanid. mil ; 70(1): 7-9, ene.-mar. 2014. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-122899

RESUMO

ANTECEDENTES: Los autoinyectables (AI) son dispositivos para administración de medicamentos de urgencia por vía parenteral (i.m.) por el afectado o un compañero. Tienen interés militar en Defensa NBQ para la administración de antídotos contra agentes nerviosos y otros medicamentos de urgencia. Se estiman necesarios cinco nuevos AI que pueden ser fabricados por los Servicios Farmacéuticos de la Defensa, además del que se fabrica en la actualidad. OBJETIVOS: Presentación del Autoinyectable AJP (AI-AJP) y su preparado Autoinyectable de atropina-oxima DEF (AI-AOD), resultantes de la I+D sobre AI en el CEMILFARDEF, y su caracterización. Aplicación de resultados al diseño de cinco nuevos AI de interés en Defensa NBQ. MÉTODOS: Ante la falta de ensayos y criterios de valoración oficiales para AI, se realiza una revisión bibliográfica y un estudio retrospectivo sobre la investigación básica llevada a cabo durante dos décadas en el desarrollo y fabricación del AI-AJP, estableciendo procedimientos de caracterización y evaluación de la calidad farmacéutica y propiedades funcionales en condiciones normales y de estrés. Mediante programas ACAD y ensayos galénicos se diseñan cinco nuevos AI. RESULTADOS: Obtención del AI-AJP y su presentación AI-AOD. Presentación de sus componentes, funcionamiento y resultados del análisis de las variables implicadas en su diseño, producción y control: usabilidad, portabilidad, funcionamiento, fuerzas, inyectabilidad, contenidos, esterilidad, partículas, pirógenos, estabilidad, y resistencia. Se expone el diseño de cinco nuevos AI, a los que son aplicables los resultados obtenidos en este estudio. CONCLUSIÓN: El Autoinyectable AJP cumple los requisitos exigidos por el estado actual de la ciencia, es seguro enfuncionamiento, y robusto en resistencia al estrés estático y dinámico. Es estable y la inyección consistente. Se han diseñado cinco nuevos AI (Atropina, Diazepam, Multicomponentes, Morfina y Epinefrina) necesarios en Defensa NBQ y situaciones de urgencia


BACKGROUND: Autoinjectors (AI) are devices for parenteral administration (im) of emergency medications for self or buddy aid. They have NBC Defence military interest for the administration of antidotes against nerve agents and other emergency medications. It is needed five new AI that can be manufactured by the Spanish Pharmaceutical Services, in addition to the one currently made. OBJECTIVES: AJP Autoinjector (AI-AJP) presentation and its military medication Autoinjector of atropine-oxime DEF (AI-AOD), as an I+D process result about AI carry out by the Military Pharmaceutical Services, and its characterization. The results are applied to the design of five new AI for NBC Defense. METHODS: In the absence of formal testing and evaluation criteria for these devices, the scientific publications and the experience gained from two decades of development and manufacture of AI-AJP have been reviewed, to set characterization procedures, and to evaluate the pharmaceutical quality and the functional properties under normal conditions and in static and dynamic stress. By mean of ACAD and pharmaceutical development programs, five new AI have been designed. RESULTS: AI-AJP availability, and its presentation AI-AOD. Components, operation, and results presentation from the analysis of design, process and control variables: usability, portability, dynamic operation, involved forces, injectability, contents, sterility, particles, pyrogens, stability, and physical resistance. The new five AI designs and characteristics are exposed, to which the results obtained in this study are applicable. CONCLUSION: The AJP Autoinyector meets the requirements demanded by the current science state, is safe in operation, and robust under static and dynamic stress. It is stable and the injection is consistent. Five new AI have been designed (Atropine, Diazepam, Multi-components, Morphine, and Epinephrine) needed to NBC Defense and Emergencies


Assuntos
Humanos , Atropina/administração & dosagem , Oximas/administração & dosagem , Antídotos/administração & dosagem , Autoadministração/métodos , Tratamento de Emergência/métodos , 51708 , Militares , Assistência Ambulatorial
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