Percepción del personal de enfermería sobre el manejo del dolor en neonatos / Neonatal nurses' perceptions of pain management

Objetivos: Describir las percepciones del personal de enfermería de unidades neonatales sobre el manejo del dolor, conocer el perfil formativo y describir el uso de herramientas de valoración del dolor y de medidas no farmacológicas. Método: Estudio multicéntrico observacional descriptivo transversal desarrollado durante febrero-septiembre de 2015 en los Servicios de Neonatología de tres hospitales de la Comunidad de Madrid, España. La recogida de datos se realizó a través de cuestionario de elaboración propia enviado en formato papel o electrónico utilizando la plataforma Survey Monkey®. Resultados: La muestra consta de 142 profesionales (tasa de respuesta: 55%). El 47,9% (68) afirman que han recibido formación específica sobre el manejo del dolor. El 39,5% (56) refieren que el dolor se evalúa de forma habitual en su unidad. Tan solo el 43,6% refieren utilizar escalas validadas, siendo la PIPP la más usada. La contención y la succión no nutritiva son las medidas no farmacológicas más usadas, seguidas de la sacarosa. Se identifica la canalización intravenosa como el procedimiento más doloroso. Conclusiones: El manejo del dolor está en vías de mejora, ya sea por la formación como por la escasa evaluación a través de escalas validadas. Destaca la mejora en el uso de medidas no farmacológicas (AU)

Objectives: To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. Methods: Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. Results: The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure.Conclusions: Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy (AU)

Neonatal nurses' perceptions of pain management. / Percepción del personal de enfermería sobre el manejo del dolor en neonatos.

OBJECTIVES: To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. METHODS: Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. RESULTS: The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure. CONCLUSIONS: Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy.

[Elevated serum aldosterone levels in dialysis patients: Are we underusing renin-angiotensin-aldosterone system blockers?] / Niveles elevados de aldosterona sérica en pacientes en diálisis: ¿estamos infrautilizando los bloqueantes del sistema renina angiotensina aldosterona en diálisis?

Serum aldosteronelevels (SA) are a marker of cardiovascular (CV) risk in the general population. OBJECTIVE: To analyze SA levels in dialysis patients and its relationship with characteristics of dialysis; comorbidity; blood pressure and the use of blocking renin-angiotensin-aldosterone system agents (BSRAA). METHODS: We determined SA in 102 patients: 81 on hemodialysis (HD) and 21 on peritoneal dialysis. Mean age 71.4±12 years; 54.9% male; 29.4% diabetics. Mean time on dialysis 59.3±67 months. In 44 HD patients plasma renin activity (PRA) was measured. RESULTS: Mean SA was 72.6±114.9ng/dl (normal range 1.17-23.6ng/dl). A total of 57.8% of patients had above normal levels which were not related to dialysis characteristics or comorbidity. Only 21% of patients with heart failure and 19.2% with ischemic heart disease used BSRAA. A number of 25 patients treated with BSRAA had significantly lower levels of SA. There was an inverse correlation between AS and systolic blood pressure (SBP), and direct with PRA. The logistic regression analysis conducted to find SA levels above the median associated factors showed that SBP was the only independent risk variable in the overall population (OR 0.97; P=.022); in the 44 patients in whom PRA was determined this was the only independent risk factor (OR 2.24; P=.012). CONCLUSIONS: A high percentage of dialysis patients have elevated levels of SA that are associated to diminished SBP and activated PRA and not to dialysis characteristics. In patients with a history of heart disease we underuse BSRAA.

[Rapid diagnosis of streptococcal pharyngo-tonsillitis in a primary care unit]. / Diagnóstico rápido de faringoamigdalitis estreptocócica en un equipo de atención primaria.

One of the main consulting motives in ambulatory pediatric practice is acute pharyngotonsillitis. This work values the efficacy of a test to confirm rapid diagnosis (30 minutes) of streptococcal pharyngitis. Authors selected 100 children in a office of primary health care whose ages were between two and seven years, from February to July in 1986. They have considered classical clinical symptoms of pharyngitis and have applied a throat culture and rapid test in all. After comparing test results and culture results, obtained sensibility and specificity have been 80% and 95% (p less than 0.01) respectively. According to these results, they believe on the necessity of a test that permits a rapid diagnosis and which enables to treat acute pharyngitis in a more suitable way in ambulatory pediatrics.