Intervención educativa en salud comunitaria para el empoderamiento de jefas de hogar en un sector económicamente vulnerable de la ciudad de Santiago de Chile / Health community educational intervention to empowerment female heads of households in an economic disadvantage community in Santiago Chile

OBJETIVO: contribuir al empoderamiento de las mujeres jefas de hogar pertenecientes a una comunidad de un sector económicamente vulnerable de la ciudad de Santiago, por medio de la entrega de herramientas y habilidades en salud. Muestra: 13 mujeres, entre 22 y 55 años. METODOLOGÍA: Intervención educativa basada en el Modelo 'Comunidad como Socio' de Anderson y McFarlane de Enfermería y el Modelo de Educación para Adultos de Jane Vella. Se respondió una encuesta anónima para recopilar información. El diagnóstico participativo permitió identificar temas a tratar: control de signos vitales y su aplicabilidad, y atención de primeros auxilios. RESULTADOS: Se aportó al conocimiento del manejo de cuidados básicos en salud (Signos Vitales, Primeros Auxilios y Hábitos de Vida Saludable) aplicados a su autocuidado y al de sus familias. Se practicó lo aprendido en un escenario simulado. CONCLUSIÓN: Se identificaron fortalezas, como motivación por el aprendizaje y buena recepción de las metodologías participativas. La intervención contribuyó al empoderamiento de las participantes mediante el aprendizaje de contenidos, otorgando seguridad para enfrentar situaciones de emergencia en su vida cotidiana.

OBJECTIVE: Contribute the empowerment of female heads of household belonging to a community of an economically vulnerable sector of the city of Santiago, through the delivery of tools and skills in health. Sample: 13 women, between 22 and 55 years old. METHODOLOGY: Educational intervention based on the "Community as a Partner" Model of Anderson and McFarlane of Nursing and the Adult Education Model of Jane Vella. A survey was answered anonymously to collect information. The participatory diagnosis allowed identifications of thetopics concerned including: control of vital signs and its applications and first aid attention demonstrated practically in the sessions. RESULTS: Contributions were made to the knowledge regarding the management of basic care in health (Vital Signs, First Aid and Habits of Healthy Living) applied to self-care of patients and their respective families. In a simulated scenario, participants in the survey demonstrated that they practiced what they had learned. CONCLUSION: Strengths such as motivation for learning and positive response to participative methodologies were identified. Additionally, the intervention contributed to the empowerment of the participants through the learning of contents and development of confidence to confront emergency situations in every day life.

Sildenafil in severe peripheral ischemia induced by terlipressin. A case report.

A female patient in the sixth decade of life developed renal failure secondary to gastrointestinal bleeding, which was non-responsive to conventional therapy. She was treated with terlipressin iv; showing improvement but developing, over the next few days, ischemia and necrosis of the toes in the lower extremities, simulating necrotizing vasculitis, without response to regular management. An alternative therapy, oral sildenafil 50mg BID, was used, with a rapid reversal of the clinical picture. The vasodilator action of sildenafil is useful in cases of ischemia induced by some drugs. The objective this report is to warm about the utility of sildenafil in some potentially severe cases, like the one above.

Sildenafil in severe peripheral ischemia induced by terlipressin. A case report

Una paciente de la sexta década de la vida desarrolló fallo renal secundario a hemorragia digestiva incoercible, con datos de choque hipovolémico, por lo que fue tratada con tarlipresina iv, con lo que hubo mejoría, pero presentó isquemia y necrosis de los dedos en extremidades inferiores, simulando vasculitis necrotizante sin respuesta al manejo terapéutico habitual, por lo que se empleó como alternativa sildenafil oral 50 mg 2 veces al día, con reversión rápida de su cuadro clínico. La acción vasodilatadora del sildenafil demostró ser una opción útil en el presente caso y el objetivo de esta comunicación es alertar de la respuesta satisfactoria al sildenafil en casos de isquemia inducida por medicamentos, semejantes a lo que se presenta en la práctica médica (AU)

A female patient in the sixth decade of life developed renal failure secondary to gastrointestinal bleeding, which was non-responsive to conventional therapy. She was treated with terlipressin iv; showing improvement but developing, over the next few days, ischemia and necrosis of the toes in the lower extremities, simulating necrotizing vasculitis, without response to regular management. An alternative therapy, oral sildenafil 50mg BID, was used, with a rapid reversal of the clinical picture. The vasodilator action of sildenafil is useful in cases of ischemia induced by some drugs. The objective this report is to warm about the utility of sildenafil in some potentially severe cases, like the one above (AU)

Infliximab en infusión intravenosa rápida. Eficacia y complicaciones / Rapid application of Infliximab. Efficacy and complications

Objetivo: Comparar la seguridad clínica de la infusión de infliximab rápida (30-45 min) con la tradicional (2 h). Pacientes y método: Estudio abierto prospectivo con inclusión consecutiva de 150 pacientes con artritis reumatoide (AR) y/o espondiloartritis (EA) rebeldes al tratamiento convencional. Se distribuyó aleatoriamente a los pacientes incluidos para que recibieran 1,5 o 3 mg/kg de peso (según criterio médico) en dos grupos de 75 pacientes: grupo A: pacientes con infusión intravenosa de infliximab rápida (30-45 min) y grupo B: infusion intravenosa tradicional (2 h). El ritmo de infusión se reguló con goteo y regla de 3 y el tiempo se cronometró con reloj digital. De todos los pacientes incluidos se recogieron datos sobre posibles efectos secundarios, así como parámetros de eficacia (escala analógica visual del dolor, número de articulaciones dolorosas y tumefactas), y se comparó las del grupo de infusión rápida de infliximab con las del de infusión tradicional. Resultados: Todos los pacientes concluyeron el estudio sin complicaciones serias. En el grupo de infusión rápida 3 pacientes manifestaron sensibilidad en el brazo canalizado y se presentó enrojecimiento facial en 7 más. La presencia de efectos secundarios no fue significativamente diferente en relación con la velocidad de infusión. Tampoco se observaron diferencias con respecto a la velocidad de infusión en relación con la dosis y la enfermedad de base de los pacientes (AR y/o EA). Con ambas formas de infusión, infliximab se mostró eficaz en el control de los síntomas de los pacientes, sin diferencias significativas entre ellas. Conclusiones: La ausencia de efectos secundarios destacables asociados a la reducción del tiempo de infusión de infliximab permite señalar que la infusión rápida puede ser un método a tener en cuenta para optimizar las prestaciones de los hospitales de estancia corta para terapias biológicas (AU)

Objective: To compare the clinical safety of the rapid infusion of infliximab (30-45 min) with the traditional one (2 h). Patients and method: Open, prospective study with the consecutive inclusion of 150 patients with rheumatoid arthritis (RA) and/or spondyloarthritis (AS), resistant to conventional treatment. Patients were randomly distributed to receive 1.5 or 3 mg/kg (according to medical criteria) into 2 groups of 75 patients. Group A: patients received a rapid infusion of infliximab (30-45 min) and group B: traditional intravenous infusion (2 h). The rhythm of infusion was regulated through drip counts and the rule of threes and time was counted on a digital chronometer. Data was obtained from all patients included on possible side effects, as well as efficacy parameters (visual analog scale for pain, tender, and swollen joint counts), and comparisons were made between the rapid infusion group and the traditional infusion group. Results: All patients concluded the study without serious complications. In the rapid infusion group 3 patients had hypersensitivity in the infusion arm and erythema was present in 7 more. The presence of side effects was not significantly different in relation with the infusion speed. Differences were not found in relation to the dosage or the type of illness (RA and/or AS) either. The efficacy of Infliximab for symptom control showed no differences using both types of infusion. Conclusions: The absence of noticeable secondary effects associated with the reduction in the time of infusion of infliximab permits us to point out that a reduction in the time of infusion of infliximab can be a method to optimize hospital resources concerning the outpatient clinic for biologic therapy (AU)

[Rapid application of infliximab. Efficacy and complications]. / Infliximab en infusión intravenosa rápida. Eficacia y complicaciones.

OBJECTIVE: To compare the clinical safety of the rapid infusion of infliximab (30-45 min) with the traditional one (2 h). PATIENTS AND METHOD: Open, prospective study with the consecutive inclusion of 150 patients with rheumatoid arthritis (RA) and/or spondyloarthritis (AS), resistant to conventional treatment. Patients were randomly distributed to receive 1.5 or 3 mg/kg (according to medical criteria) into 2 groups of 75 patients. Group A: patients received a rapid infusion of infliximab (30-45 min) and group B: traditional intravenous infusion (2 h). The rhythm of infusion was regulated through drip counts and the rule of threes and time was counted on a digital chronometer. Data was obtained from all patients included on possible side effects, as well as efficacy parameters (visual analog scale for pain, tender, and swollen joint counts), and comparisons were made between the rapid infusion group and the traditional infusion group. RESULTS: All patients concluded the study without serious complications. In the rapid infusion group 3 patients had hypersensitivity in the infusion arm and erythema was present in 7 more. The presence of side effects was not significantly different in relation with the infusion speed. Differences were not found in relation to the dosage or the type of illness (RA and/or AS) either. The efficacy of Infliximab for symptom control showed no differences using both types of infusion. CONCLUSIONS: The absence of noticeable secondary effects associated with the reduction in the time of infusion of infliximab permits us to point out that a reduction in the time of infusion of infliximab can be a method to optimize hospital resources concerning the outpatient clinic for biologic therapy.