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1.
BMC Fam Pract ; 20(1): 15, 2019 01 18.
Artículo en Inglés | MEDLINE | ID: mdl-30657056

RESUMEN

BACKGROUND: Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. METHODS: Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138). Those who agreed to participate were randomized into one of two groups (27 tutors/26 residents in the intervention group, 23 tutors/ 23 residents in the control one).All were sent the Survey on Patient Safety Culture. After that, the intervention group received specific training in safety; they also recorded incidents over 15 days, documented them following a structured approach, and had feedback on their performance. The control group did not receive any action. All participants completed the same survey four months later. Outcome measures were the changes in safety culture as quantified by the results variables of the Survey: Patient Safety Grade and Number of events reported. We conducted bivariate and adjusted analyses for the outcome measures. To explore the influence of participants' demographic characteristics and their evaluation of the 12 dimensions of the safety culture, we fitted a multivariate model for each outcome. RESULTS: Trial followed published protocol. There were 19 drop outs. The groups were comparable in outcome and independent variables at start. The experiment did not have any effect on Patient safety grade (- 0.040) in bivariate analysis. The odds of reporting one to two events increased by 1.14 (0.39-3.35), and by 13.75 (2.41-354.37) the odds of reporting 3 or more events. Different dimensions had significant independent effects on each outcome variable. CONCLUSION: A educational intervention in family and community medicine teaching units may improve the incidents reported. The associations observed among organizational dimensions and outcomes evidence the complexity of patient safety culture measurement and, also, show the paths for improvement. In the future, it would be worthwhile to replicate this study in teaching units from different settings and with different health professionals engaged. TRIAL REGISTRATION: It was retrospectively registered with ( ISRCTN41911128 , 31/12/2010).


Asunto(s)
Medicina Familiar y Comunitaria/educación , Atención Primaria de Salud , Mejoramiento de la Calidad , Administración de la Seguridad , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Gestión de Riesgos
2.
J Helminthol ; 94: e21, 2018 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-30526698

RESUMEN

Schistosomiasis or bilharzia is a widespread parasitic disease caused by blood flukes of the genus Schistosoma. Some factors have been investigated previously regarding their effect on the pathophysiological mechanism of human schistosomiasis, but the possible influence of the ABO blood group on the severity of Schistosoma infection has been the most promising. Hence, we performed a systematic review and meta-analysis to further investigate the association of the ABO blood group with schistosomiasis susceptibility. Selected publications were retrieved from PubMed up to 21 August 2018, for related studies written in English. Number of cases (with schistosomiasis) and controls (without schistosomiasis) were extracted across all ABO blood types. Odds ratios (OR) and 95% confidence intervals (CI) were computed, pooled and interpreted. Subgroup analysis by the species of Schistosoma infecting the population and the participants' ethnicity was also performed. The overall analysis revealed heterogeneity in the outcomes, which warranted the identification of the cause using the Galbraith plot. Post-outlier outcomes of the pooled ORs show that individuals who are not blood type O are more susceptible (OR: 1.40; 95% CI: 1.17-1.67; PA < 0.001) to schistosomiasis than those who are blood type O (OR: 0.71; 95% CI: 0.60-0.85; PA < 0.001). Subgroup analysis yielded the same observations regardless of the species of schistosome and the ethnicity of the participants. Results of this meta-analysis suggest that individuals who are blood type B and A are more susceptible to schistosomiasis than those who are blood type O. However, more studies are needed to confirm our claims.


Asunto(s)
Sistema del Grupo Sanguíneo ABO/inmunología , Schistosoma/fisiología , Esquistosomiasis/parasitología , Sistema del Grupo Sanguíneo ABO/genética , Animales , Tipificación y Pruebas Cruzadas Sanguíneas , Femenino , Humanos , Masculino , Schistosoma/genética , Schistosoma/aislamiento & purificación , Esquistosomiasis/genética , Esquistosomiasis/inmunología
3.
Semergen ; 50(3): 102158, 2024 Apr.
Artículo en Español | MEDLINE | ID: mdl-38157749

RESUMEN

INTRODUCTION: The worldwide pandemic of SARS-Cov2 has had a great impact on the lives of adolescents, affecting their health and well-being. There is little evidence of the emotional impact of the pandemic on adolescents. OBJECTIVE: To explore the knowledge, perceptions, and attitudes of young people regarding COVID-19 and its impact on emotional well-being. METHOD: A cross-sectional observational and descriptive study based on a survey of students aged 16-20 from five high schools in Barcelona metropolitan area. RESULTS: The study was carried out on 291 surveys. Females made up 56.7% of the population. The average age was 16.9 years. A greater lack of knowledge about the transmission of the disease was detected. The most frequently used sources of information were social networks. In terms of emotional distress, the most important aspects were worry about getting sick (64%), family financial problems (46%), anxiety and irritability (27%), and apathy (26.5%). Gender differences were detected in terms of worries (women: 28.8%; men: 11.1%), sadness (women: 29.3%, men: 15.5%), and feelings of fear (women: 24.5%; men: 11%). 16.7% of the participants consulted a mental health professional, with this being more common in women (women: 23.8%; men: 7.4%). CONCLUSIONS: COVID-19 has affected the emotional well-being of adolescents, especially the female population. It is necessary to implement emotional well-being strategies in early childhood to cope with possible stressful situations in daily life and avoid future mental health problems. There is a growing use of social media to combat social isolation. The results of the study hold the potential to strategies aimed at preempting forthcoming biopsychosocial distress.


Asunto(s)
COVID-19 , Adolescente , Femenino , Humanos , Masculino , Ansiedad/epidemiología , Estudios Transversales , ARN Viral , SARS-CoV-2 , Adulto Joven
4.
Med Intensiva ; 37(1): 27-32, 2013.
Artículo en Inglés, Español | MEDLINE | ID: mdl-22959859

RESUMEN

OBJECTIVES: To evaluate a new organizational model in an intensive care unit, with the implementation of early warning systems and a support unit. DESIGN: A retrospective, comparative cohort study was carried out. SETTING: The study was carried out in the Department of Intensive Care Medicine (DICM) of a tertiary hospital (2009-2011), with the comparison of three time periods (P1, P2 and P3) that differed in terms of organization and logistics. PATIENTS: We analyzed all patients admitted to the ICU during the study period. Patients from maternal and infant intensive care were excluded. VARIABLES OF INTEREST: Percentage of patients with stays of under two days, with invasiveness used; readmission to the DICM, type of admission and percentage of stays of longer than one month; APACHE II score, mean stay in the ICU and shift distribution of the admissions. RESULTS: We analyzed a sample of 3209 patients (65% males), with a mean age of 58.23 (18.23) years, a mean APACHE II score of 16.67 (8.23), and presenting an occupancy rate of 7.3 (10.3) days in the analyzed period. The ratio APACHE II score/number of beds was 0.69 (0.34) in P1, compared to 0.68 (0.33) in P2 and 0.76 (0.37) in P3 (p<0.001). The intervention surveillance grade (grade 1) was 42% (39-46%) in P1, 40% (37-43%) in P2 and 31% (28-35%) in P3 (p<0.001). The average stay in the ICU ranged from 7.10 days (8.82) in P1 to 6.60 days (9.49) in P2 and 8.42 days (12.73) in P3 (p<0.001). CONCLUSIONS: There has been an increase in the number of patients seen in our DICM, with a decrease in the patients admitted to the conventional ICU. Patients now admitted to the ICU are more seriously ill, require a greater level of intervention, and give rise to an increase in the mean duration of stay in the ICU.


Asunto(s)
Cuidados Críticos/normas , Departamentos de Hospitales/organización & administración , Modelos Organizacionales , Estudios de Cohortes , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
5.
Artículo en Inglés | MEDLINE | ID: mdl-35760688

RESUMEN

BACKGROUND: Hospitalized COVID-19 patients are prone to develop persistent symptoms and to show reduced quality of life following hospital admission. METHODS: Prospective cohort study of COVID-19 patients admitted to a hospital from March 1 to April 30, 2020. The primary outcome was to compare health related quality of life and persistent symptoms six months after hospital admission, of COVID-19 patients who required ICU admission with those who did not. RESULTS: Among the 242 patients hospitalized during the defined period of time, 44 (18.2%) needed ICU admission. Forty (16.5%) patients died during hospital admission. Two hundred and two (83.5%) patients were discharged alive from the hospital. At six months, 183 (75.6%) patients completed the questionnaires (32 ICU patients and 151 non ICU patients). Ninety-six (52.4%) reported decreased quality of life and 143 (78.1%) described persistent symptoms. More ICU patients showed worsening of their quality of life (71.9% vs 43.7%, P=0.004). There were no differences in the proportion of patients with persistent symptoms between ICU and non ICU patients (87.5% vs 76.2%, P=0.159). ICU patients showed more frequently dyspnea on exertion (78.1% vs 47.7%, P=0.02), dyspnea on light exertion (37.5% vs 4.6%, P<0.001), and asthenia (56.3 vs 29.1, P=0.003). CONCLUSIONS: Survivors of COVID-19 needing hospitalization had persistent symptoms and a decline in the quality of life. ICU patients referred a large decrease of their quality of life compared with non ICU patients.


Asunto(s)
COVID-19 , COVID-19/complicaciones , Disnea , Hospitalización , Humanos , Unidades de Cuidados Intensivos , Estudios Prospectivos , Calidad de Vida , SARS-CoV-2
6.
Rev Esp Anestesiol Reanim ; 69(6): 326-335, 2022.
Artículo en Español | MEDLINE | ID: mdl-34176973

RESUMEN

Background: Hospitalized COVID-19 patients are prone to develop persistent symptoms and to show reduced quality of life following hospital admission. Methods: Prospective cohort study of COVID-19 patients admitted to a hospital from March 1 to April 30, 2020. The primary outcome was to compare health related quality of life and persistent symptoms six months after hospital admission, of COVID-19 patients who required ICU admission with those who did not. Results: Among the 242 patients hospitalized during the defined period of time, 44 (18.2%) needed ICU admission. Forty (16.5%) patients died during hospital admission. Two hundred and two (83.5%) patients were discharged alive from the hospital. At six months, 183 (75.6%) patients completed the questionnaires (32 ICU patients and 151 non ICU patients). Ninety-six (52.4%) reported decreased quality of life and 143 (78.1%) described persistent symptoms. More ICU patients showed worsening of their quality of life (71.9 vs. 43.7%, P = 0.004). There were no differences in the proportion of patients with persistent symptoms between ICU and non ICU patients (87.5 vs. 76.2%, P = 0.159). ICU patients showed more frequently dyspnea on exertion (78.1 vs. 47.7%, P = 0.02), dyspnea on light exertion (37.5 vs. 4.6%, P < 0.001), and asthenia (56.3 vs. 29.1, P = 0.003). Conclusions: Survivors of COVID-19 needing hospitalization had persistent symptoms and a decline in the quality of life. ICU patients referred a large decrease of their quality of life compared with non ICU patients.

8.
J Healthc Qual Res ; 34(6): 292-300, 2019.
Artículo en Español | MEDLINE | ID: mdl-31761742

RESUMEN

BACKGROUND: The Ministry of Health, Consumption and Social Welfare (MHCSW) since 2005 has been promoting, in collaboration with the Autonomous Communities (AC) and the Scientific Societies (SC), among them the Spanish Society for Healthcare Quality (SSHCQ), the Patient Safety Strategy (PSS). PSS 2015-2020 develops relevant aspects of patient safety (PS), such as risk management, reporting and learning systems (RLS), as well as promoting an adequate response when an adverse event (AE) unexpectedly occurs. The present work describes the current situation of the different AC in relation to these topics. MATERIAL AND METHODS: A Descriptive study, based on a survey developed ad hoc within the framework of the agreement between the MHCSW and SSHCQ, was conducted at national level. The questions' topics, prepared by consensus of the work team, considered the implementation of RLS and AE analysis, and legal protection for professionals involved in an AE in the AC. RESULTS: A total of 17 surveys were collected (16 AC and INGESA). All ACs had a RLS, a structure to support PS activities but very heterogeneous. Some ACs had a response plan to an AE and had established a coordination protocol with legal services to support patients and professionals involved in an AE. Some ACs had enacted some laws and regulations to facilitate PS culture. CONCLUSIONS: The ACs have risk management structures that lead the plans in PS, reporting and learning systems and have experience in the analysis of near miss and AE. However, a regulatory change that increases the legal safety of professionals to provide an adequate response to the AEs is a priority. This challenge should involve leaders of health organizations, scientific societies and professional associations, national and regional health authorities as it has been done in other European countries.


Asunto(s)
Encuestas de Atención de la Salud/estadística & datos numéricos , Programas Nacionales de Salud/normas , Seguridad del Paciente/normas , Administración de la Seguridad/normas , Humanos , Errores Médicos/prevención & control , Cultura Organizacional , Calidad de la Atención de Salud , España
9.
Rev. esp. anestesiol. reanim ; 69(6): 326-335, Jun - Jul 2022. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-205067

RESUMEN

Antecedentes/contexto: Existe una tendencia en los pacientes hospitalizados por COVID-19 a desarrollar síntomas persistentes y a presentar una disminución en su calidad de vida tras el ingreso hospitalario. Métodos: Estudio de cohorte prospectivo de pacientes con COVID-19 con ingreso hospitalario entre el 1 de marzo al 30 de abril de 2020. El objetivo primario fue comparar la calidad de vida relacionada con la salud y la presencia de síntomas persistentes seis meses después del ingreso, comparando los pacientes que requirieron ingreso en UCI con los que no lo precisaron. Resultados: De los 242 pacientes hospitalizados durante el período de estudio, 44 (18,2%) necesitaron ingreso en UCI. Cuarenta (16,5%) pacientes fallecieron durante el ingreso hospitalario. Doscientos dos (83,5%) pacientes fueron dados de alta del hospital. A los seis meses, 183 (75,6%) pacientes completaron los cuestionarios (32 pacientes UCI y 151 pacientes no UCI). Noventa y seis (52,4%) refirieron disminución de la calidad de vida y 143 (78,1%) describieron síntomas persistentes. Un número mayor de pacientes de UCI mostraron un empeoramiento de su calidad de vida (71,9 vs. 43,7%, p = 0,004). No hubo diferencias en la proporción de pacientes con síntomas persistentes entre los pacientes con UCI y sin UCI (87,5 vs. 76,2%, p = 0,159). Los pacientes de UCI mostraron con mayor frecuencia disnea de esfuerzo (78,1 vs. 47,7%, p = 0,02), disnea de pequeños esfuerzos (37,5 vs. 4,6%, p < 0,001) y astenia (56,3 vs. 29,1%, p = 0,003). Conclusiones: Los supervivientes de COVID-19 que necesitaron hospitalización presentaron síntomas persistentes y un deterioro de su calidad de vida. Los pacientes de UCI refirieron una mayor disminución de su calidad de vida, en comparación con los pacientes que no precisaron UCI.(AU)


Background: Hospitalized COVID-19 patients are prone to develop persistent symptoms and to show reduced quality of life following hospital admission. Methods: Prospective cohort study of COVID-19 patients admitted to a hospital from March 1 to April 30, 2020. The primary outcome was to compare health related quality of life and persistent symptoms six months after hospital admission, of COVID-19 patients who required ICU admission with those who did not. Results: Among the 242 patients hospitalized during the defined period of time, 44 (18.2%) needed ICU admission. Forty (16.5%) patients died during hospital admission. Two hundred and two (83.5%) patients were discharged alive from the hospital. At six months, 183 (75.6%) patients completed the questionnaires (32 ICU patients and 151 non ICU patients). Ninety-six (52.4%) reported decreased quality of life and 143 (78.1%) described persistent symptoms. More ICU patients showed worsening of their quality of life (71.9 vs. 43.7%, P = 0.004). There were no differences in the proportion of patients with persistent symptoms between ICU and non ICU patients (87.5 vs. 76.2%, P = 0.159). ICU patients showed more frequently dyspnea on exertion (78.1 vs. 47.7%, P = 0.02), dyspnea on light exertion (37.5 vs. 4.6%, P < 0.001), and asthenia (56.3 vs. 29.1, P = 0.003). Conclusions: Survivors of COVID-19 needing hospitalization had persistent symptoms and a decline in the quality of life. ICU patients referred a large decrease of their quality of life compared with non ICU patients.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Calidad de Vida , Estudios Prospectivos , Pacientes Internos , Unidades de Cuidados Intensivos , Betacoronavirus , Pandemias , Hospitalización , Estudios de Cohortes , Enfermedades Transmisibles , Enfermedades Respiratorias , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo
10.
Rev Calid Asist ; 31(5): 262-6, 2016.
Artículo en Español | MEDLINE | ID: mdl-26922161

RESUMEN

OBJECTIVE: To determine the opinion held by professionals in an intensive care unit on the limitation of therapeutic effort process at the end-of-life (LTE). To collect this information, and then use it to improve the basic aspects that the LTE have on the quality of care by intensive care unit staff. MATERIAL AND METHODS: A prospective descriptive study was carried out in the Intensive Care Unit of a third level public university hospital. A questionnaire was prepared that included questions on their demographic profile and others to provide an ethical valuation profile, as well as to find out the knowledge and information that the professional had on the LTE. Descriptive study of the sample and comparative statistics were performed using the chi-squared statistical test. RESULTS: A total of 65 valid questionnaires were obtained from a convenience sample of 70 professionals. Almost all of them (98%) were in favour of the limitation of therapeutic effort. The LTE was considered as some kind of euthanasia (active or passive) in up to 28% of the replies, valuations by professional categories is shown in. More than three-quarters (77%) had the belief that not to start treatment was not the same as withdrawing an already established treatment. Just over half (52%) of the respondents believe the value that should have more weight when considering LET would be the prognosis of the current illness of the patient, and 46% the future quality of life of the patient. The economic cost of treatment to be applied was not considered in any case. CONCLUSIONS: The LTE is approved by the majority of professionals in our Intensive Care Unit. Although a non-negligible percentage understood it as a form of euthanasia.


Asunto(s)
Unidades de Cuidados Intensivos , Calidad de Vida , Cuidado Terminal , Actitud , Hospitales Universitarios , Humanos , Estudios Prospectivos
11.
J Med Chem ; 23(6): 657-60, 1980 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-7392032

RESUMEN

The synthesis and cytostatic activity of several chloromethyl- and iodomethylpyrazole nucleosides are described. Glycosylation of ethyl 3(5)-(chloromethyl)pyrazole-5(3)-carboxylate (3) and 3(5)-(chloromethyl)pyrazole-5(3)-carboxamide (4) with poly(O-acetylated) sugars via an acid-catalyzed fusion method gave the corresponding 3-(chloromethyl)-5-carboxylate and 3-(chloromethyl)-5-carboxamide substituted nucleosides 7 and 9, respectively. From the reaction of 4 with tetra-O-acetyl-beta-D-ribofuranose, the 5-(chloromethyl)-3-carboxamide-substituted derivative 11 was also obtained. Reaction of 7, 9, and 11 with sodium iodide in acetone provided the related iodomethylpyrazole nucleosides 8, 10, and 12. In general, chloromethyl-substituted nucleotides showed moderate activities against HeLa cells, while all the corresponding iodomethyl derivatives exhibited high activities. Some of these latter compounds increased the life span of mice bearing ECA tumor.


Asunto(s)
Alquilantes/síntesis química , Nucleósidos/síntesis química , Pirazoles/síntesis química , Animales , Carcinoma de Ehrlich/tratamiento farmacológico , Células HeLa , Humanos , Masculino , Ratones , Ratones Endogámicos ICR , Nucleósidos/farmacología , Pirazoles/farmacología , Relación Estructura-Actividad
12.
Transplantation ; 49(6): 1105-9, 1990 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-1694316

RESUMEN

Lymphocytes were cultured from cardiac biopsies following heart transplantation using interleukin-2-conditioned medium. Using the technique of limiting dilution analysis the frequency of donor specific cytotoxic T lymphocytes was measured in cells cultured from biopsies and compared with that in peripheral blood lymphocytes taken at the same time as the biopsy. The graft cell population showed a considerably higher frequency of donor-specific CTL when compared with the PBL. CTL frequencies in the graft cells were always higher against the donor than against third-party cells. These data demonstrate that there was either selective sequestration or selective expansion of donor-reactive T cells in the heart following cardiac transplantation. These results emphasize the need to investigate more closely the events occurring in the heart, and may explain the lack of specificity and sensitivity in immune monitoring (IM) or cytoimmune monitoring (CIM) seen in many centers.


Asunto(s)
Epítopos , Rechazo de Injerto/inmunología , Trasplante de Corazón/inmunología , Linfocitos T Citotóxicos/inmunología , Antígenos CD/análisis , Antígenos de Diferenciación de Linfocitos T/análisis , Antígenos CD4/análisis , Antígenos CD8 , Antígenos HLA-DQ/análisis , Antígenos HLA-DR/análisis , Humanos , Linfocitos/inmunología , Donantes de Tejidos
13.
Clin Ther ; 7(3): 357-60, 1985.
Artículo en Inglés | MEDLINE | ID: mdl-3838919

RESUMEN

The biological effects of a new antiplatelet agent, triflusal, were evaluated in patients with cardiac valvular prostheses. Each patient received 900 mg/day of oral triflusal for 30 days. Triflusal significantly inhibited platelet aggregation induced by adenosine diphosphate (1 to 5 mumol) or epinephrine (12.5 mumol), showing a slight effect on bleeding time (basal: 6 +/- 1.7 min; 30 days of treatment: 8.0 +/- 2.7 min). Serum levels of thromboxane B2 were significantly reduced during treatment, but changes in serum levels of 6-keto-prostaglandin F1 alpha were not observed, suggesting that triflusal does not affect prostacyclin biosynthesis by the vascular wall. The results show that triflusal has a marked inhibitory and selective effect on platelet function in patients with cardiac valvular prostheses.


Asunto(s)
Prótesis Valvulares Cardíacas , Agregación Plaquetaria/efectos de los fármacos , Salicilatos/farmacología , 6-Cetoprostaglandina F1 alfa/sangre , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Salicilatos/uso terapéutico
14.
Farmaco ; 52(4): 243-6, 1997 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-9241830

RESUMEN

Easily accessible 2,5-diketopiperidines have been used as templates for the construction of Trp-Phe and Trp-Asp-Phe-NH2 mimics. The cycle [L-Trp psi[COCH2]-L-Phe] analogue 1a has shown to possess significant and selective affinity for CCKA receptors.


Asunto(s)
Piperidinas/metabolismo , Receptores de Colecistoquinina/metabolismo , Ligandos , Estructura Molecular , Péptidos , Piperidinas/química
15.
Med Clin (Barc) ; 100(17): 664-7, 1993 May 01.
Artículo en Español | MEDLINE | ID: mdl-8497173

RESUMEN

Endocarditis by Q fever is a diagnostic and therapeutic challenge given the diagnostic delay and elevated morbidity and mortality it carries. Six cases of endocarditis by Q fever attended over the last 7 years were retrospectively studied. Five patients had been previously diagnosed of valvular involvement and three had prosthesis. Five patients presented a febrile syndrome of prolonged duration with negative hemocultures and progressive valvular changes. One patient presented acute valvular failure requiring emergency surgery. The most significant laboratory data were anemia, thrombocytopenia, high ESR and hypergammaglobulinemia. In the echocardiograms valvular vegetations were observed in 4 cases. All the patients received medical treatment with doxicylin, one associated with rifampicin and another cotrimoxazol. In 4 patients valvular reposition was required due to a severe hemodynamic alteration. After a minimum follow up of 2 years all the patients remain asymptomatic. The serologic evolution is described.


Asunto(s)
Endocarditis Bacteriana/etiología , Fiebre Q/complicaciones , Adolescente , Adulto , Válvula Aórtica , Niño , Terapia Combinada , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/epidemiología , Endocarditis Bacteriana/terapia , Femenino , Estudios de Seguimiento , Prótesis Valvulares Cardíacas/efectos adversos , Prótesis Valvulares Cardíacas/estadística & datos numéricos , Humanos , Masculino , Válvula Mitral , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/epidemiología , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/terapia , Fiebre Q/diagnóstico , Fiebre Q/epidemiología , Fiebre Q/terapia , Estudios Retrospectivos , España/epidemiología
16.
Rev Esp Med Nucl ; 21(5): 356-61, 2002.
Artículo en Español | MEDLINE | ID: mdl-12236911

RESUMEN

We present a rare case of chronic infectious multifocal osteomyelitis with affectation symmetric in the both femures in a patient with spondyarthropathic secondary Inflammatory Bowel Disease. The diagnosis was confirmed with culture of the bone biopsy. The aim of this work is the revision of the Chronic Infectious Multifocal Osteomyelitis and the Chronic Recurrent Multifocal Osteomyelitis into SAPHO syndrome that both were the possibilities diagnoses.


Asunto(s)
Síndrome de Hiperostosis Adquirido/diagnóstico , Errores Diagnósticos , Osteomielitis/diagnóstico por imagen , Espondiloartropatías/diagnóstico , Infecciones Estafilocócicas/diagnóstico por imagen , Adulto , Biopsia , Enfermedad Crónica , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/cirugía , Diagnóstico Diferencial , Femenino , Fémur/diagnóstico por imagen , Fémur/patología , Galio , Humanos , Osteomielitis/etiología , Osteomielitis/microbiología , Osteomielitis/patología , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/patología , Cintigrafía , Radiofármacos , Recurrencia , Infecciones Estafilocócicas/etiología , Infecciones Estafilocócicas/patología , Tecnecio
17.
Acta Otorrinolaringol Esp ; 44(5): 327-31, 1993.
Artículo en Español | MEDLINE | ID: mdl-8129965

RESUMEN

We study the basic guidelines of the middle ear surgery, having as target the recuperation of the anatomic functional integrity of ear. There are different important elements in the quality/quantity of the functional results as follows: The surgery technical method used. The actual pathology in the middle ear. The quality of eustachian tube function. The surgeon's experience and ability and several factors. We review the concept introduced by Wullstein called it tympanoplasty from 1952 till nowadays. Finally, we described the most frequent surgery procedures used in the daily practice.


Asunto(s)
Oído Medio/cirugía , Membrana Timpánica/cirugía , Enfermedades del Oído/fisiopatología , Enfermedades del Oído/cirugía , Osículos del Oído/cirugía , Oído Medio/fisiopatología , Femenino , Humanos , Masculino , Apófisis Mastoides/cirugía , Miringoplastia , Otitis Media con Derrame/fisiopatología , Otitis Media con Derrame/cirugía , Ventana Oval/cirugía , Cirugía del Estribo , Membrana Timpánica/fisiopatología , Timpanoplastia
18.
Rev Calid Asist ; 29(6): 350-4, 2014.
Artículo en Español | MEDLINE | ID: mdl-25533239

RESUMEN

OBJECTIVE: To certify the nursing services using a quality management system, taking an international standard as a reference, and based on a continuous improvement process. MATERIAL AND METHOD: The standard was revised, and the Quality Management System documentation was updated, consisting of a Quality Manual and 7 control procedures. All the existing procedures were coded in accordance with the documentation control process. Each operational procedure was associated with a set of indicators which permitted to know the results obtained, analyze the deviations and to implement further improvements. RESULTS: The system was implemented successfully. Twenty-eight care procedures and eleven procedures concerning techniques were incorporated into the management system. Thirty indicators were established that allowed the whole process to be monitored. All patients were assigned to a nurse in their clinical notes and all of them had a personalized Care Plan according to planning methodology using North American Nursing Diagnosis Association (NANDA), Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC) international rankings. The incidence of falls, as well as the incidence of chronic skin wounds, was low, taking into account the characteristics of the patient and the duration of the stay (mean=35.87 days). The safety indicators had a high level of compliance, with 90% of patients clearly identified and 100% with hygiene protocol. The confidence rating given to the nurses was 91%. CONCLUSION: The certification enabled the quality of the service to be improved using a structured process, analyzing the results, dealing with non-conformities and introducing improvements.


Asunto(s)
Certificación , Enfermería/normas , Mejoramiento de la Calidad , Adhesión a Directriz , Unidades Hospitalarias , Higiene , Seguridad del Paciente , Garantía de la Calidad de Atención de Salud/legislación & jurisprudencia , Mejoramiento de la Calidad/organización & administración , Indicadores de Calidad de la Atención de Salud , Gestión de Riesgos , España
19.
Rev Calid Asist ; 29(6): 334-40, 2014.
Artículo en Español | MEDLINE | ID: mdl-25534567

RESUMEN

OBJECTIVE: To evaluate, for a consecutive year, the magnitude of unplanned extubation, looking for non-dependent patient variables. MATERIAL AND METHODS: Prospective, observational study of cases and controls in a mixed intensive care unit within in a tertiary hospital. Patients were considered cases with more than 24 hours who had an episode of unplanned extubation. Prospective collection of variables case as time of unplanned extubation (collection time), identification of the box where the patient was admitted, presence and type of physical restraint, development of ventilator-associated pneumonia (VAP) and death. RESULTS: There were 17 unplanned extubation in 15 patients, 1.21 unplanned extubation per 100 days of MV. The unplanned extubation had an inhomogeneous spatial distribution (number of boxes). The time distribution of cases compared with controls showed significant differences in time distribution (P=.02). The comparative analysis between cases and controls, showed increased mortality, increased length of ICU stay, longer hospital stay and increased risk for VAP when patients suffer an episode of unplanned extubation. DISCUSSION: Unplanned extubation occurs most frequently in a given time slot of the day, may play a role in the spatial location of the patient; occurs most often in patients who are in the process of weaning from mechanical ventilation, and develop greater VAP.


Asunto(s)
Extubación Traqueal/estadística & datos numéricos , Unidades de Cuidados Intensivos , Calidad de la Atención de Salud , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Mortalidad Hospitalaria , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Neumonía Asociada al Ventilador/epidemiología , Estudios Prospectivos , Respiración Artificial , Factores de Tiempo
20.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 50(3): [102158], Abr. 2024. tab
Artículo en Español | IBECS (España) | ID: ibc-232207

RESUMEN

Introducción: La pandemia mundial por SARS-CoV-2 ha ocasionado un gran impacto en la vida de los adolescentes afectando el bienestar infanto-juvenil, sin embargo, existe escasa evidencia del efecto que ha tenido a nivel emocional en esta población. Objetivo: Explorar los conocimientos, percepciones y actitudes de los jóvenes frente a la COVID-19 y el impacto provocado en el bienestar emocional. Material y método: Estudio observacional transversal y descriptivo, a partir de una encuesta realizada a alumnos de 16-20 años de cinco institutos del área metropolitana de Barcelona. Resultados: El estudio se efectuó sobre 291 encuestas. De los participantes, 56,7% fueron mujeres. La edad media fue de 16,8 años y la mediana de 17 años. Se detectó un mayor desconocimiento sobre la transmisión de la enfermedad. Las fuentes de información más utilizadas fueron las redes sociales. En cuanto al malestar emocional, destaca la preocupación por enfermar (64%), los problemas económicos familiares (46%), la ansiedad e irritabilidad (27%) y la apatía (26,5%). Se detectan diferencias entre géneros en cuanto a la preocupación (mujeres: 28,8%, hombres: 11,1%), tristeza (mujeres: 29,3%, hombres: 15,5%) y sensación de tener miedo (mujeres: 24,5%, hombres 11%). De los sujetos, 16,7% consultaron con un profesional de salud mental, siendo más frecuente en mujeres (23,8%, hombres: 7,4%). Conclusiones: La COVID-19 ha afectado el bienestar emocional de los adolescentes, sobre todo en la población femenina. Se detecta un mayor uso de las redes sociales para evitar el aislamiento social. Los resultados del estudio pueden ayudar a diseñar estrategias para evitar malestares futuros en el ámbito biopsicosocial.(AU)


Introduction: The worldwide pandemic of SARS-Cov2 has had a great impact on the lives of adolescents, affecting their health and well-being. There is little evidence of the emotional impact of the pandemic on adolescents. Objectiv: To explore the knowledge, perceptions, and attitudes of young people regarding COVID-19 and its impact on emotional well-being. Method: A cross-sectional observational and descriptive study based on a survey of students aged 16–20 from five high schools in Barcelona metropolitan area. Results: The study was carried out on 291 surveys. Females made up 56.7% of the population. The average age was 16.9 years. A greater lack of knowledge about the transmission of the disease was detected. The most frequently used sources of information were social networks. In terms of emotional distress, the most important aspects were worry about getting sick (64%), family financial problems (46%), anxiety and irritability (27%), and apathy (26.5%). Gender differences were detected in terms of worries (women: 28.8%; men: 11.1%), sadness (women: 29.3%, men: 15.5%), and feelings of fear (women: 24.5%; men: 11%). 16.7% of the participants consulted a mental health professional, with this being more common in women (women: 23.8%; men: 7.4%). Conclusions: COVID-19 has affected the emotional well-being of adolescents, especially the female population. It is necessary to implement emotional well-being strategies in early childhood to cope with possible stressful situations in daily life and avoid future mental health problems. There is a growing use of social media to combat social isolation. The results of the study hold the potential to strategies aimed at preempting forthcoming biopsychosocial distress.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Salud Mental , Salud del Adolescente , /psicología , Conducta del Adolescente , Cuarentena , Psicología del Adolescente , Estudios Transversales , Epidemiología Descriptiva , Atención Primaria de Salud , /epidemiología , Encuestas y Cuestionarios , España
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