RESUMEN
El objetivo del artículo ha sido explicar la metodología utilizada para organizar el proceso de vacunación de la COVID-19 a pacientes dependientes en el Centro de Salud de Andorra. Durante la pandemia ha destacado de forma notable la colaboración de redes comunitarias, tanto en el ámbito nacional como local, llevando a cabo las acciones y actividades necesarias para paliar y resolver los problemas derivados de la crisis sanitaria. En esta ocasión, debido a las limitaciones de la vacuna, que no puede movilizarse una vez diluida, se ha recurrido de nuevo a los recursos locales de la zona para organizar el proceso y transportar a los pacientes dependientes, la mayoría de ellos con movilidad reducida y con problemas para llegar al centro de salud para poder vacunarse debido a las barreras arquitectónicas que dificultan el acceso. En primer lugar, se ha seleccionado a los pacientes dependientes priorizando por grado de dependencia, según el índice de Barthel obtenido, teniendo en cuenta el número de dosis que se iban a recepcionar en los 2 días programados para vacunar. Se ha contactado con ellos y/o sus familiares/cuidadores para saber si acudirían por medios propios o a través del transporte adaptado y de este modo planificar horarios. En esta fase, y tras analizar los datos registrados de cada paciente, se ha observado un porcentaje alto del total de personas dependientes vacunadas en solo 2 días. Además, se ha conocido el alto grado de satisfacción tanto de los pacientes como de sus familiares con la organización y la colaboración de las redes comunitarias. (AU)
The aim of the article was to explain the methodology used to organize the COVID-19 vaccination process for dependent patients in Andorra Health Centre. During the pandemic, the collaboration of Community Networks both at national and local levels was notable. The actions and activities necessary to relieve and solve problems arising from the health crisis were performed. On this occasion, due to vaccine limitations which cannot be used once diluted, local resources in the area were again used to organize the process and transport dependent patients - most with reduced mobility and architectural barriers that hinder access to the Health Centre - to be vaccinated. First, dependent patients were selected prioritizing by degree of dependency, according to the Barthel Index obtained. The number of doses to be received in the two days scheduled to vaccinate were taken into account. Patients and/or their family member/caregiver were contacted to find out whether they would come by their own means or using adapted transport and thus plan schedules. In this phase and after analyzing the data recorded for each patient, a high percentage of all dependent patients vaccinated in just two days was observed. In addition, the high degree of satisfaction of both patients and their families with the organization and collaboration of community networks was ascertained. (AU)
Asunto(s)
Humanos , Redes Comunitarias , Pacientes , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Pandemias , EspañaRESUMEN
BACKGROUND AND AIM OF THE STUDY: The natural history of the unicuspid aortic valve (UAV) is poorly described in the literature. In order to study the association between UAV with any other cardiac or extra cardiac abnormalities, an evidence-based systematic review was carried out. METHODS: A computerized search was carried out of the medical literature published between 1st January 1966 and 1st September 2008 of the following databases: MEDLINE; EMBASE; Web of Science; and the Cochrane Database. RESULTS: A total of 231 cases of adult UAV was identified in 38 articles. The mean patient age was 42 years, and the most common presenting symptoms reported (in 52 cases) included dyspnea (44%; n=23), angina (21%; n=11), and dizziness or syncope (8%; n=4). The most common lesion in UAV was isolated aortic stenosis (AS) (41%; n=95) and AS with or without aortic regurgitation (28%; n=64). The preoperative diagnosis of UAV is rare, and 139 cases (60%) of UAV were reported at autopsy or by examination of surgically excised valves. Aortic valve replacement was performed in 166 cases (82%). Concomitant aortic surgery was performed in 47 of the UAV cases (23%), either for a dilated or aneurysmal aorta. CONCLUSION: UAV shares many of the features of bicuspid aortic valve, including valvular dysfunction, aortic dilatation, aortic dissection, and dystrophic calcification, although these conditions develop at an earlier age and progress at a faster pace in UAV. Further investigations are warranted regarding the possibility of a familial incidence, associated histopathological changes in the aorta, preoperative diagnostic tools, ideal follow up and surgical intervention.
