Prevalencia del dolor no oncológico en la consulta de rehabilitación / The prevalence of non-cancer pain in rehabilitation practice

Introducción. El dolor es el síntoma acompañante que provoca con mayor frecuencia una consulta médica. El dolor crónico es un tema de gran relevancia para los profesionales de la salud, el paciente y la sociedad. Objetivo. Valorar la prevalencia de dolor en las consultas del médico rehabilitador. Material y métodos. Estudio descriptivo prospectivo, observacional multicéntrico en 3 hospitales. Se valoraron pacientes con dolor entre el 1.1.2012 y el 28.2.2012. Se analizaron: variables sociodemográficas, antropométricas y características del dolor. Resultados. El estudio incluyó a 1.168 pacientes: 974 padecían algún tipo de dolor, de los cuales el 62,5% son mujeres; la mayoría de pacientes padecía dolor en las extremidades superiores (32,1%) y la mitad de los pacientes presentaron dolor crónico, siendo los >58 años los que con más frecuencia sufrían dolor crónico (p > 0,001). La intensidad del dolor en la escala VAS fue de 54,70 y de 6,16 en la NRS. El 70,7% recibían tratamiento analgésico. Un 64,1% no realizaba ninguna actividad física. Conclusiones. Los resultados de nuestro estudio demuestran una alta prevalencia de dolor en las consultas del médico rehabilitador. Se podría considerar nuestra especialidad como referente en el manejo y tratamiento del dolor (AU)

Introduction. Pain is the most common symptom prompting medical consultation. Chronic pain is a highly important issue for health professionals, patients and society. Objective. To assess the prevalence of pain in rehabilitation practice. Material and methods. This descriptive, prospective, multicenter study evaluated pain in patients in 3 hospitals between 1st January, 2012 and 28th February, 2012. We analyzed sociodemographic and anthropometric variables and pain features. Results. The study included 1168 patients; 974 had some kind of pain, of which 62.5% were women. Most patients had pain in the upper extremities (32.1%). Half the patients had chronic pain. Pain was most common in patients aged >58 years (P<.001). Pain intensity on the VAS scale was 54.70 mm and 6.18 on the NRS. A total of 70.7% were receiving analgesics and 64.1% performed no physical activity. Conclusions. The results of our study demonstrate a high prevalence of pain in rehabilitation consultation. Our speciality could be considered as pivotal in the management and treatment of pain (AU)

Puesta en marcha de una Unidad de Ortogeriatría en un hospital de segundo nivel. Resultados clínicos y funcionales a corto y medio plazo / Start-up of an Orthogeriatric Unit in a general hospital. Short and medium-term clinical and functional outcomes

Introducción. En el año 2010 creamos la Unidad de Ortogeriatría (UOG) de nuestro hospital, una iniciativa multidisciplinaria que ofrece una asistencia continuada y especializada para ancianos con fractura de cadera (FC). Objetivo. Describir el funcionamiento de la unidad y evaluar las principales características médicas y funcionales de los pacientes ingresados. Material y método. Estudio descriptivo retrospectivo que incluye a los pacientes con FC osteoporótica ingresados desde noviembre del 2010 hasta abril del 2012. Se recogen variables sociodemográficas, médicas y funcionales durante el ingreso, al alta y a los 3 meses del alta. Resultados. Ciento noventa pacientes, con una media de edad 84 años, 74,2% mujeres, 91,1% procedentes de domicilio, 74,7% autónomos o levemente dependientes para las actividades básicas de la vida diaria (ABVD) y el 80,1% realizaba marcha independiente o supervisada. Estancia media prequirúrgica 5,4 días y total 14,7, por encima de las de los estudios de otras UOG pero inferiores a las de los pacientes atendidos por FC en nuestro hospital durante el 2009. Mortalidad intrahospitalaria 1,1%, inferior a la de los pacientes ingresados por FC en nuestro hospital durante el 2009. A los 3 meses eran autónomos o dependientes leves para las ABVD, el 48,3% de los pacientes y el 60,2% realizaba marcha independiente o supervisada. Conclusión. La UOG parece aportar mejoras en la evolución clínica y funcional del paciente anciano con FC y una disminución de la estancia hospitalaria, reduciéndose así los costes asistenciales. Estos resultados invitan a seguir con este sistema de atención del anciano con FC (AU)

Introduction. An Orthogeriatric Unit (UOG) was created in our hospital in 2010. This is a multidisciplinary initiative that provides continuous specialized care for elderly persons with hip fracture (HF). Objective. To describe the operation of the unit and evaluate the medical and functional characteristics of admitted patients. Material and method. A retrospective descriptive study was conducted of all patients with osteoporotic HF admitted from November 2010 to April 2012. We collected socio-demographic, medical and functional variables during admission, at discharge, and 3 months after discharge. Results. A total of 190 patients were included, with a mean age of 84 years. Of these, 74.2% were women, 91.1% were admitted from home, 74.7% were independent or slightly dependent for basic activities of daily living (BADL), and 80.1% performed independent or supervised ambulation. Mean pre-surgical length of stay was 5.4 days and the total length of stay was 14.7 days, which was higher than rates reported in other UOG studies but lower than our hospital data for 2009. In-hospital mortality was 1.1%, representing a decrease compared with patients admitted to our hospital for HF in 2009. At 3 months after discharge, 48.3% of the patients were independent or slightly dependent for BADL and 60.2% were able to walk independently or with supervision. Conclusion. UOG appears to improve clinical and functional outcomes in elderly persons with HF and to decrease length of hospital stay, thus reducing healthcare costs. These results support the continued use of this care system for elderly persons with HF (AU)

[Drug advertising in medical journals]. / Publicidad de medicamentos en las revistas médicas.

OBJECTIVE: To find the percentage of pages of advertising in 6 Spanish medical journals and compare their principal features with the criteria of the international committee of editors of medical journals. DESIGN: A descriptive crossover study. SETTING: The Spanish general medical journals with the highest circulation. PARTICIPANTS: All the issues of journals published between January and March 1993 (n = 56) were selected in order to calculate the average percentage of advertising. To analyse the adverts, all the adverts in 32 issues (n = 657) were selected by means of stratified random sampling of journals from the period July 1992 to June 1993. RESULTS: The average number of advertising pages was 39.16%. 7.8% were publicity articles with or without an advertisement. Adverts filled the best pages of the journals. In 11.7% of cases the adverts were connected with articles in the journal; in 23.9% they were inserted within article. 13.4% of the adverts analysed were for drug products with doubtful or nil intrinsic value; and 34.5% were pharmaceutical novelties (marketed after 1991). The therapeutic groups with most advertisements were ACE inhibitors (13.2%), analgesics (7.8%), calcium antagonists (7.2%) and AINE (7.2%). Paracetamol (6.1%) was the active principal advertised most often. CONCLUSION: The percentage of advertising seems excessive in all the journals except one and very much above the non-advertising informative material. There should be improvement by bringing journals into line with international editorial criteria.