Asunto(s)
Humanos , Masculino , Femenino , Invenciones , Inteligencia Artificial , Telemedicina , Biomarcadores , Acceso a Internet , Mala Praxis , EspañaRESUMEN
Como el dolor es la primera causa de consulta médica en el mundo, el uso de opioides para el manejo del tipo crónico no oncológico ha aumentado y la falta de conocimiento favorece el uso inadecuado. Objetivo: Se describen los riesgos, efectos adversos, actitudes y prácticas que tienen los pacientes ambulatorios formulados con opioides para el manejo de dolor crónico no oncológico en un hospital de cuarto nivel en Bogotá DC, Colombia. Estudio descriptivo de corte transversal en dos fases, la primera la construcción y aprobación del cuestionario por un grupo evaluador usando metodología Delphi y la segunda su diligenciamiento en la población de interés: 81 pacientes entre septiembre y diciembre de 2014; sexo femenino 71,6%, edad promedio 56,6 años (DE: 15,2) y el diagnóstico más frecuente fue dolor lumbar (34,6%). El opioide con mayor formulación fue hidrocodona (24,1%).Resultados: El efecto secundario más reconocido fue estreñimiento (60,5%), 28,4% no saben si existe restricción para conducir vehículos y el 34,6% creen que es permitido; un 60,5% consultan de nuevo en caso de persistencia del dolor. El 23,5% guarda la medicación sobrante después de un cambio o suspensión, mientras que el 9,9% la regala.Conclusiones. Hay fallas en el conocimiento de los pacientes en cuanto a la limitación de actividades, efectos secundarios y disposición de la medicación opioide sobrante.
As pain is the leading reason for medical consultation worldwide, the use of opioids in the management of non-cancer related chronic pain has increased, and poor patient knowledge has led to opioid misuse.Objective: We describe the risks, adverse effects, attitudes, and practices of out-patients prescribed with opioids for non-cancer related chronic pain in a fourth level hospital in Bogotá DC, Colombia. A two-phase descriptive cross-sectional study was conducted. First, a questionnaire, approved by an evaluating panel, was constructed using the Delphi methodology. Second, the questionnaire was applied in the study population: 81 patients between September and December 2014; females 71.6%, mean age 56.6 years (SD: 15.2), and back pain (34.6%) being the most frequent diagnosis. The most commonly prescribed opioid medication was hydrocodone (24.1%).Results: The most commonly recognised side effect was constipation (60.5%); 28.4% do not know if driving is restricted, and 34.6% believe driving is allowed; 6.5% again consulted again due to persistent pain. 23.5% keep the remaining medication after it is changed or stopped, while 9.9% gives it to someone else.Conclusions: Poor patient knowledge on restricted activities, potential side effects and proper opioid medication disposal was detected.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Analgésicos Opioides , Dolor Crónico , Evaluación Educacional , Evaluación de MedicamentosRESUMEN
In the forensic laboratory the biological analyses for rape investigation commonly include vaginal swabs as sample material combined to biochemical tests including sperm cytology (SC) and detection of acid phosphatase activity (AP) and prostate-specific antigen (PSA, p30) for the conclusive identification of semen components. Most reports comparing these tests relied on analysis of semen samples or donor swabs taken under controlled conditions; however their individual or combined efficacy under real live sampling conditions in different laboratories is largely unknown. We carried out SC, APA and PSA analyses in vaginal swabs collected from casework rapes submitted to Mexican Forensic Laboratories at Texcoco and Toluca. On the basis of positive and negative results from each assay and sample, data were classified into eight categories (I-VIII) and compared with those obtained in the two only similar studies reported in Toronto, Canada and Hong Kong, China. SC and APA assays had the higher overall positivity in Toluca and Texcoco samples respectively and otherwise PSA had a lower but very similar positivity between these two laboratories. When compared to the previous studies some similarities were found, namely similar frequencies (at a ratio of approximately 1 out of 3) of samples being positive or negative by all techniques (Categories I and VI respectively) and a comparable overall positivity of APA and SC but higher than that of PSA. Indeed the combined results of using SC, APA and PSA tests was considered as conclusive for semen detection from approximately 1 out of 3 cases (Category I) to approximately 1 out of 2 cases in a scenario where at least SC is positive, strongly presumptive in 2 out of 3 cases (with at least one test positive) and the remainder 1 out of 3 cases (Category VI) suggested absence of semen. By determining Y-STR polymorphisms (12-loci) in additional samples obtained at Toluca laboratory, complete DNA profiles were determined from all Category I samples, none marker was detected from all Category VI samples and mostly partial profiles were obtained from samples of other categories. These observations give an overview on the variability in efficacy of each test performed at different laboratories and provide a general notion about the in praxis contribution of SC, APA and PSA tests for further DNA typing in the forensic analysis of rape.
