Influencia estacional en las características de los pacientes ingresados en una unidad de cuidados intensivos / Seasonal influence in characteristics of patients admitted to an intensive care unit

Objetivo: Estudiar la variabilidad estacional en la epidemiología y el pronóstico de la enfermedad crítica. Diseño: Estudio retrospectivo de datos recogidos prospectivamente durante el período 2001 a 2008. Ámbito: Unidad de Cuidados Intensivos (UCI) polivalente del Hospital Universitario Insular de Gran Canaria. Pacientes: Todos los pacientes que ingresaron en la UCI, procedentes del Servicio de Urgencias, según el período estacional (primavera, verano, otoño e invierno). Variables de interés principales: Se recogieron datos demográficos y diagnósticos de los pacientes al ingreso, Acute Physiology and Chronic Health Evaluation [APACHE II], la necesidad de ventilación mecánica y, por último, la mortalidad. Resultados: Durante el período de estudio ingresaron en nuestra UCI, procedentes del Servicio de Urgencias, 3.115 pacientes, un 21% en verano, incidencia significativamente menor que en las otras estaciones del año (p<0,001). No encontramos diferencias estadísticamente significativas entre los 4 grupos en relación con la edad, el tipo de pacientes, la gravedad al ingreso según APACHE II, ni en la mortalidad en la UCI. Sin embargo, por sexos sí encontramos diferencias significativas, ya que ingresan un mayor procentaje de mujeres en verano que en invierno (un 33% versus un 27%; p=0,037). La estancia media en UCI de los que ingresaron en verano fue similar a los ingresados durante el invierno (4,9 días versus 5,8 días; p=0,052). La necesidad de ventilación mecánica y los días que precisaron de ésta, por grupos diagnósticos, fue similar entre el verano y el invierno. El análisis multivariado no mostró variables independientes asociadas al período estacional en el que ingresaron. Conclusiones: La estabilidad climática de nuestro entorno implica que este factor no influya en el pronóstico de los pacientes que ingresan con enfermedad crítica (AU)

Objective: To investigate seasonal variability in the epidemiology and the outcome of critical illness. Design: Retrospective analysis of prospectively collected data during the period 2001-2008. Setting: Polyvalent intensive care unit (ICU) of a tertiary hospital in the Canary Islands. Patients: Adult patients who were hospitalized in the ICU from the Emergency Department, according to the season period (spring, summer, autumn and winter). Primary variables of interest: Demographic data, clinical diagnosis on ICU admission, APACHE II, need of mechanical ventilation and, finally, the mortality were collected. Results: During the study period, 3,115 patients, coming from the Emergency Department, were hospitalized in our ICU. Of these, 21% were admitted during the summer, an incidence rate that is statistically lower than in other seasons of the year (P<0.001). We did not find any statistically significant differences between the four groups according to the age, type of patients, severity at the moment of admission to the ICU, according to the APACHE II score or in the mortality rate in the ICU. However, significant differences were found in regards to gender. Admission of women during the summer was higher than in winter (33% vs 27%, P=0.037). Average stay in the ICU of patients admitted in the summer was similar to winter (4.9 days vs 5.8 days; P=0.052). Need for mechanical ventilation and days it was required, by diagnostic groups, were similar between the summer and the winter. The multivariate analysis did not show independent variables associated with the seasonal period in which the patients were admitted. Conclusions: The stability of our climate implies that this factor does not influence the prognosis of patients who are admitted with critical illness (AU)

[Seasonal influence in characteristics of patients admitted to an intensive care unit]. / Influencia estacional en las características de los pacientes ingresados en una unidad de cuidados intensivos.

OBJECTIVE: To investigate seasonal variability in the epidemiology and the outcome of critical illness. DESIGN: Retrospective analysis of prospectively collected data during the period 2001-2008. SETTING: Polyvalent intensive care unit (ICU) of a tertiary hospital in the Canary Islands. PATIENTS: Adult patients who were hospitalized in the ICU from the Emergency Department, according to the season period (spring, summer, autumn and winter). PRIMARY VARIABLES OF INTEREST: Demographic data, clinical diagnosis on ICU admission, APACHE II, need of mechanical ventilation and, finally, the mortality were collected. RESULTS: During the study period, 3,115 patients, coming from the Emergency Department, were hospitalized in our ICU. Of these, 21% were admitted during the summer, an incidence rate that is statistically lower than in other seasons of the year (P<0.001). We did not find any statistically significant differences between the four groups according to the age, type of patients, severity at the moment of admission to the ICU, according to the APACHE II score or in the mortality rate in the ICU. However, significant differences were found in regards to gender. Admission of women during the summer was higher than in winter (33% vs 27%, P=0.037). Average stay in the ICU of patients admitted in the summer was similar to winter (4.9 days vs 5.8 days; P=0.052). Need for mechanical ventilation and days it was required, by diagnostic groups, were similar between the summer and the winter. The multivariate analysis did not show independent variables associated with the seasonal period in which the patients were admitted. CONCLUSIONS: The stability of our climate implies that this factor does not influence the prognosis of patients who are admitted with critical illness.

[Physicians' attitudes and perceptions regarding the critical care and critical care specialty]. / Actitudes y percepciones del personal médico del hospital acerca de los Cuidados Intensivos y de la especialidad de Medicina Intensiva.

OBJECTIVE: To evaluate the attitudes and perceptions of the doctors of a hospital regarding critical care and the speciality of Intensive Medicine. DESIGN: Prospective, descriptive study during 3 months. SETTING: Insular University Hospital in Gran CanaRia, Canary Islands, Spain. PATIENTS: Medical specialists and residents. INTERVENTION: Anonymous survey. MAIN VARIABLES: Demographic data of the interviewed doctors were collected and they were asked about their labour or personal previous relation with the Intensive Care Unit (ICU), the attitudes of the critical care doctors' of their hospital and their perceptions regarding the critical care speciality. RESULTS: We interviewed 116 doctors, 75 staff and 41 residents. Less of the third part believed that the ICU was a ward for potentially critical patients. A high percentage of the doctors whom had been refused some admission were not to agree with the arguments that they received. More than 40% of the interviewed ones affirmed had not requested bed in the ICU for any patient who had benefited from it, especially because they were thinking that the admission would be refused. Some doctors think that the professio - nals employed at the ICU are doctors of different specialities. The speciality of Intensive Medicine is perceived by a high level of stress among the professionals. CONCLUSIONS: We detect the ignorance of other professionals about the function of a Service of Intensive Medicine and the model of ICU of our country. Also we find high rates of dissatisfaction among the professionals who was refused some admission in the unit, because of we believe that clinical guides about the criteria of admission must be elaborated and to announce them among the doctors of the hospital. The professionals perceive that we suffer a high level of stress.

Actitudes y percepciones del personal médico del hospital acerca de los Cuidados Intensivos y de la especialidad de Medicina Intensiva / Physicians¿ attitudes and perceptions regarding the critical care and critical care specialty

Objetivo. Evaluar las actitudes y percepciones de los médicos de un hospital respecto a la labor asistencial del Servicio de Medicina Intensiva en su hospital y a la especialidad de Medicina In ten - si va. Diseño. Se trata de un estudio prospectivo, des criptivo, de 3 meses de duración. Ámbito. Hospital Universitario Insular de Gran Canaria, Canarias, España. Pacientes.Médicos no intensivistas, adjuntos y residentes del hospital. Intervención.Se llevó a cabo una encuesta anónima. Variables de interés principales.Se recogieron datos demográficos de los médicos entrevistados, se les preguntó acerca de su relación laboral o per sonal previa con la Unidad de Cuidados In - tensivos (UCI), las actitudes de los médicos intensivistas de su hospital y su percepción de la especialidad de Medicina Intensiva. Resultados. Se entrevistaron 116 médicos, 75 adjuntos y 41 residentes. Menos de la tercera parte creía que la UCI era una sala para enfermos potencialmente críticos. Un porcentaje elevado de los médicos a los que se les había denegado algún ingreso no estaba conforme con los argumentos que se les dieron. Más del 40% de los entrevistados afirmó no haber solicitado cama en la UCI para algún paciente que probablemente se hubiese beneficiado de ella, sobre todo porque pensaba que se le iba a denegar. Todavía hay médicos en el hospital que piensan que los profesionales que trabajan en la UCI son médicos de distintas espe cialidades. La especialidad de Medicina In - ten siva es percibida con un alto nivel de estrés entre los profesionales. Conclusiones. Detectamos el desconocimiento de otros profesionales acerca de la función de un Servicio de Medicina Intensiva y del modelo de UCI de nuestro país. También encontramos unas elevadas tasas de insatisfacción entre los profesionales a los cuales se les denegó algún ingreso en la unidad, por lo que creemos que se deben elaborar unas guías clínicas sobre los criterios de ingreso y darlos a conocer entre los médicos del hospital. Los profesionales perciben que sufrimos un alto nivel de estrés

Objetive.To evaluate the attitudes and perceptions of the doctors of a hospital regarding critical care and the speciality of Intensive Medicine. Design.Prospective, descriptive study during 3 months. Setting.Insular University Hospital in Gran Ca - na ria, Canary Islands, Spain. Patients.Medical specialists and residents. Intervention.Anonymous survey. Main variables.Demographic data of the interviewed doctors were collected and they were asked about their labour or personal previous relation with the Intensive Care Unit (ICU), the attitudes of the critical care doctors¿ of their hospital and their perceptions regarding the critical care speciality. Results. We interviewed 116 doctors, 75 staff and 41 residents. Less of the third part believed that the ICU was a ward for potentially critical patients. A high percentage of the doctors whom had been refused some admission were not to agree with the arguments that they received. More than 40% of the interviewed ones affirmed had not requested bed in the ICU for any patient who had benefited from it, especially because they were thinking that the admission would be refused. Some doctors think that the professio - nals employed at the ICU are doctors of different specialities. The speciality of Intensive Medicine is perceived by a high level of stress among the professionals. Conclusions.We detect the ignorance of other professionals about the function of a Service of Intensive Medicine and the model of ICU of our country. Also we find high rates of dissatisfaction among the professionals who was refused some admission in the unit, because of we believe that clinical guides about the criteria of admission must be elaborated and to announce them among the doctors of the hospital. The professionals perceive that we suffer a high level of stress (AU)

Gimnasia posnatal conjunta "madre-hijo" / No disponible

Tras el embarazo y el parto se producen cambios en la estática corporal que, aunque no constituyen alteraciones patológicas, deben ser restituidos a la normalidad lo antes posible. El ejercicio físico en el posparto es muy importante porque contribuye a la salud psicofísica de la mujer. Entre sus aportaciones principales se incluye: recuperación físico-orgánica, del equilibrio corporal y de la imagen corporal, aumento de la autoestima y disminución de la ansiedad. A partir de la bibliografía revisada se elabora una tabla de gimnasia posnatal con el recién nacido, trabajando los principales grupos musculares. La tabla se incorpora al Programa de Educación Maternal del Centro de Salud «Isabel II» de Parla, Área 10 Madrid, y tiene buena aceptación por parte las mujeres. Como objetivos futuros se propone: cuantificar las ventajas de la gimnasia posnatal con el recién nacido; estudiar las repercusiones físicas y psíquicas de esta tabla y compararlas con la gimnasia posnatal sin el recién nacido (AU)

Changes develop in women’ s body after pregnancy and delivery, despite this is not pathological, women should be back to normal balance as soon as posible Postpartum exercise is quite important, because it will keep women healthy. Some of its main contributions are: physical and body balance recovery, personal image improvement, self awareness developping and stress reduction. We followed a bibliographycal review in order to develop a postpartum exercise program with newborn, which allowed to work with main muscular groups. This program has been included in Maternal Education Programs of «Isabel II» Health Center in Parla (Madrid) and «Juan de la Cierva» Health Center in Getafe (Madrid). Good success among women. Future lines. To quantify the advantage of postnatal exercise programs with baby. To compare physical and psychical outcomes in postpartum programs with and without baby. To achieve a home exercise program with Baby (AU)

Programa de salud en atención primaria para la atención del duelo por la pérdida de un hijo en el período perinatal / Health program for coping with loss in primary care for losing the baby in the perinatal period

Este artículo presenta un programa de salud para la atención del duelo en atención primaria. El objetivo del programa es proporcionar a la mujer o a la mujer y su pareja los instrumentos necesarios para superar favorablemente el proceso de duelo ante la pérdida del hijo (mortinato o neonato). Se propone un programa de educación para la salud de seis sesiones. Se han marcado objetivos educativos y criterios de resultados. Se sugiere realizar la evaluación mediante cuestionario, para conocer si se han alcanzado los objetivos educativos propuestos. Además, se especifican los indicadores de evaluación del programa (AU)