BACKGROUND: There has been some controversy regarding the efficacy of sacral nerve stimulation (SNS) for the treatment of chronic constipation, due to less positive outcomes and concerns about cost-effectiveness in the long term. The aim of the present study was to evaluate the long-term outcomes of SNS in patients with chronic constipation. METHODS: A retrospective study was conducted on patients who had SNS for chronic constipation in 2008-2017 at our institution. Clinical factors, profile of constipation, physiology studies, and patient satisfaction with SNS therapy were investigated during a follow-up period up to 10 years after the implantation. RESULTS: Twenty-nine patients [86% female, median age 49 years (range 17-86)] were tested for SNS, and 24 received implants after a positive test phase [median 47 days (range 21-56 days)]. There were 27 bilateral and 2 unilateral implants, in S3 or S4 depending on best response. Mean follow-up was 59 months. Efficacy was considered as a score > 5 (on a scale of 1-10) in general symptom improvement. Nine (37.9%) implanted patients had a satisfaction score > 5. In 6 cases (25%), patient satisfaction was higher than 9. Due to the small sample size, there were no statistically significant variables considered as predictors of response. CONCLUSIONS: Our results agree with current studies which describe around a 30% response of SNS for refractory constipation. However, there is a small group of patients highly satisfied with SNS therapy. More studies are needed to better understand this profile and optimize outcomes.
Constipation/therapy , Electric Stimulation Therapy/methods , Patient Satisfaction/statistics & numerical data , Sacrum/innervation , Time Factors , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Male , Middle Aged , Retrospective Studies , Time , Treatment Outcome , Young Adult
Los cambios socio sanitarios precisan unos médicos especialistas distintos para el futuro. La declaración de Helsinki del Board de Anestesia de la UEMS, las propuestas de seguridad de la OMS, World Federation of Societies of Anaesthesiologists van orientadas hacia la seguridad y la calidad. Aproximadamente 30-40 % de las muertes maternas pueden ser prevenidas. La enseñanza debe ir dirigida hacia la mejoría de la asistencia de las enfermedades cardiovasculares, tromboembolismo, estados hipertensivos del embarazo, sepsis y la patología crítica, lo que podría disminuir la morbilidad materna y fetal. La aplicación del marco Europeo de Bolonia y de las recomendaciones de la UEMS debe ser una prioridad en España, que llevar a modificar la duración de la residencia y de los programas formativos (AU)
The social and health changes need a new type of physician for the future. The Helsinki declaration on patient safety in anaesthesiology of the UMS/EBA, the international standards for a safe practice of anaesthesia of the Worls Federation of Societies of Aanesthesiologist and WHO check lists are orientated for better security and quality of anaesthetic care. Approximately 30-40% of maternal deaths are potentially preventable. Teaching must be orientated on cardiovascular diseases, thromboembolism, hemorrhage, hypertensive disorders of pregnancy, sepsis and critical illness could decrease maternal and fetal morbility. The application of the Bologna principles and the transfer of the educational principles of UEMS in Spain must be a priority. We must modify duration of training and programs (AU)
Humans , Female , Anesthesia, Obstetrical/methods , Anesthesia, Obstetrical/trends , Anesthesia, Obstetrical , Maternal Mortality/trends , Learning , Anesthesiology/education , Anesthesiology/methods , Consumer Product Safety/legislation & jurisprudence , Consumer Product Safety/standards , Hypertension/complications , Hypertension/drug therapy , Hypertension/mortality , Thromboembolism/complications , Thromboembolism/diagnosis
El trasplante hepático ortotópico (THO) es el tratamiento de elección y en muchos casos definitivo de la patología hepática terminal. Desde la introducción de la técnica en España, en 1984, hasta la actualidad la supervivencia en el primer año posterior al THO ha aumentado aproximadamente un 10 %, situándose en el 85,9 % (1). Dicho aumento de la supervivencia se asocia a mejoras en la técnica quirúrgica, en el tratamiento inmunosupresor y en los cuidados perioperatorios. Es por tanto crucial, para asegurar la supervivencia y la calidad de vida de los pacientes sometidos a THO el conocimiento de todos los factores que pueden interferir en la evolución del injerto. Entre ellos se encuentran la indicación del THO, el estado basal de los pacientes antes del THO, la técnica quirúrgica y las distintas fases del THO, el tratamiento inmunosupresor y las probables complicaciones posoperatorias tanto precoces como tardías (AU)
Orthotopic liver transplantation (OLT) is the treatment of choice and in most cases the definitive treatment in end-stage liver disease. Since the introduction of the technique in Spain, in 1984, to the present day survival in the first year after OLT has increased approximately 10 %, reaching 85.9 % (1). This increase in survival is associated with improvements in the surgical technique, immunosuppressive therapy and perioperative care. In order to ensure the survival and quality of life of patients undergoing OLT it is crucial to know all factors that may interfere with the graft outcome. These include indication for OLT, preoperative state of patients, surgical technique and phases of OLT, immunosuppressive therapy and postoperative complications (AU)
Humans , Male , Female , Transplantation/instrumentation , Liver Transplantation/instrumentation , Liver Transplantation/methods , Immunosuppressive Agents/therapeutic use , Quality of Life , Liver Diseases/drug therapy , Liver Diseases/surgery , Postoperative Complications/drug therapy
No disponible
Humans , Male , Infant , Intubation, Intratracheal/instrumentation , Intubation, Intratracheal/methods , Intubation, Intratracheal/standards , Anesthesia, Endotracheal/methods , Anesthesia, Endotracheal/standards , Anesthesia/methods , Intubation, Intratracheal/ethics , Intubation, Intratracheal/trends , Intubation, Intratracheal , Anesthesia, Endotracheal/instrumentation , Anesthesia, Endotracheal/trends , Anesthesia, Endotracheal , Adjuvants, Anesthesia/administration & dosage
Airway Management/instrumentation , Intubation, Intratracheal/instrumentation , Laryngoscopes , Anesthesia, Inhalation , Cleft Lip/surgery , Cleft Palate/surgery , Equipment Design , Humans , Infant , Intraoperative Complications/prevention & control , Intubation, Intratracheal/methods , Laryngeal Edema/prevention & control , Male
No disponible
Humans , Male , Infant , Analgesia/instrumentation , Analgesia/methods , Respiratory Tract Diseases/drug therapy , Respiratory System , Analgesia/ethics , Embolism, Air/drug therapy , Airway Management/instrumentation , Airway Management/standards , Airway Management , Airway Extubation/methods
No disponible
Humans , Male , Female , /instrumentation , /methods , Radio Frequency Identification Device/trends , Cervical Vertebrae , Spine , Spine/metabolism
