Lista integrada de criterios diagnósticos para la esquizofrenia (LIDESQ) / Integrated list of criteria diagnoses for the schizophrenia (LIDESQ)

En el presente trabajo nosostros elaboramos un instrumento útil para el uso clínico y la investigación. El resultado es una lista de síntomas para facilitar el diagnóstico de esquizofrenia. Los ítems (55 en total) han sido creados tras la integración de los criterios para esquizofrenia de las clasificaciones internacionales CIE-10 y DSM-IV, pero se incluyen también otros criterios y clasificaciones como los de Kraepelin, Bleuler, Schneider, Langfeldt, Feighner, Astrachan y Taylor/Abraham (AU)

[Peripheral facial paralysis. The value of clinical neurophysiology]. / Parálisis facial periférica. Utilidad de la neurofisiología clínica.

AIMS: The aim of this study was to review the value of neurophysiological exploration in peripheral facial paralysis in the literature and in our own experience. METHOD: Peripheral facial paralysis is a frequently occurring cranial neuropathy with an acute presentation. Its striking clinical expression is usually in strong contrast to its benign prognosis, except for a small percentage of cases in which the existence of acute injury to the nerve (axonotmesis) will cause it to progress unfavourably, either due to the absence of nerve regeneration or because this is inadequate or insufficient. A neurophysiological study aids diagnosis and the functional and prognostic assessment. CONCLUSIONS: We recommend the utilisation of standardised studies involving a comprehensive electromyographic and electroneurographic evaluation of the facial territory, including reflexology (blink reflex). Use of a suitable methodology in the neurophysiological study of this neuropathy will allow us to complete the diagnosis and to evaluate progress, even from very early days (early surgical approach prior to the onset of nerve degeneration), all of which is decisive in the prognosis of injury throughout the process.

[Use of the anesthetic cream EMLA in arterial punction]. / Utilización de la crema anestésica EMLA en la punción arterial.

INTRODUCTION: Arterial puncture is a painful procedure requiring prior local anesthesia. Various products are available for pain relief, among them EMLA anesthetic cream. OBJECTIVE: To compare pain from simple puncture of the radial artery performed with or without application of EMLA anesthetic cream and after infiltration of mepivacaine. PATIENTS AND METHODS: A prospective, random double-blind study of 153 patients in three groups: group A, 51 patients who were applied 1 g of EMLA cream; group B, 52 patients who were applied 1 g of placebo cream; and group C, 50 patients who received infiltration of 0.2 ml of 1% mepivacaine. Pain was assessed on a 10 cm visual analog scale (0, absence of pain; 10, greatest imaginable pain). RESULTS: Pain intensity reported by the patients was 2.6 +/- 1.8 in group A, 2.9 +/- 1.8 in group B and 1.6 +/- 1.8 in group C. The results for group C were statistically different from those for groups A and B. The difference between groups A (EMLA) and B (placebo), however, was not statistically significant. CONCLUSIONS: Mepivacaine infiltration is the more effective method for minimizing pain from puncture of the radial artery. EMLA anesthetic cream is not effective against pain caused by this procedure.

Utilización de la crema anestésica EMLA® en la punción arterial / Use of EMLA® anesthetic cream for arterial puncture Introduction. Arterial puncture is a painful procedure requiring prior local anesthesia. Various products are available for pain relief, among them EMLA® anesthetic cream

Introducción. La punción arterial es un procedimiento doloroso que precisa anestesia local previa. Se han propuesto diferentes productos para aliviarlo, entre ellos la crema anestésica EMLA®.Objetivo. Comparar el dolor producido por la punción simple de la arteria radial, utilizando o no la crema anestésica EMLA®, frente a la punción con anestesia por infiltración de mepivacaína.Material y métodos. Estudio prospectivo, aleatorio y doble ciego en 153 pacientes divididos en tres grupos: A (51 pacientes), a quienes se aplicó 1 g de EMLA®; B (52 pacientes) a quienes se aplicó 1 g de crema placebo, y C (50 pacientes) con infiltración de 0,2 ml de mepivacaína al 1 por ciento. El dolor fue cuantificado mediante una escala analógica visual de 10 cm (0: ausencia de dolor; 10: dolor máximo imaginable).Resultados. La intensidad de dolor que expresaron los pacientes del grupo A fue de 2,6 ñ 1,8 cm; la de los del grupo B de 2,9 ñ 1,8 cm, y la de los del grupo C de 1,6 ñ 1,8 cm. Las diferencias observadas fueron estadísticamente significativas entre los grupos A y B respecto al C. La diferencia entre los grupos A (EMLA®) y B (placebo) no fue significativa.Conclusiones. La utilización de una infiltración previa con mepivacaína es el método más eficaz para minimizar el dolor al puncionar la arteria radial. La crema anestésica EMLA® no es eficaz en este procedimiento (AU)

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Pain during arterial puncture.

STUDY OBJECTIVE: To quantify the level of pain reported by patients during arterial puncture with or without local anesthesia, and to compare the results with levels reported for venous puncture. DESIGN: Double-blind study of puncture with and without local anesthesia. SETTING: Pulmonary function laboratory, department of pneumology. PATIENTS: We studied 270 consecutive patients undergoing arterial puncture divided into two groups. In group A (n = 210), we assessed level of pain with and without local anesthesia and with placebo. In group B (n = 60), we compared pain of arterial and venous puncture. INTERVENTIONS: The arterial puncture was performed in the radial artery; venous puncture was in the median basilic vein. MEASUREMENTS AND RESULTS: The pain was quantified on a visual analog scale (10 cm). Mean level of pain for all arterial punctures without anesthesia or placebo was slight to moderate (3.01 +/- 1.94 cm). Subcutaneous anesthetic infiltration before arterial puncture significantly reduced pain by more than 50%, to 1.50 +/- 1.54 cm, a level that was significantly lower than the pain level reported after conventional venous puncture (1.80 +/- 1.10 cm). The pain reported by patients who received no anesthesia was not significantly different (p = 0.45) from that perceived by those who received subcutaneous infiltration of saline solution (placebo). CONCLUSIONS: Arterial puncture with prior infiltration of local anesthetic is the least painful procedure among those studied. Use of local anesthesia is indicated whenever conventional arterial puncture is required.