Instrumental assessment of sleep bruxism: A systematic review and meta-analysis.

This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of portable electromyography (EMG) diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism. This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was registered with PROSPERO prior to the accomplishment of the main search. Ten clinical studies on humans, assessing the diagnostic accuracy of portable instrumental approaches with respect to PSG, were included in the review. Methodological shortcomings were identified by QUADAS-2 quality assessment. The certainty of the evidence analysis was established by different levels of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. A meta-analysis of diagnostic test accuracy was performed with multiple thresholds per study applying a two-stage random effects model, using the thresholds offered by the studies and based on the number of EMG bruxism events per hour presented by the participants. Five studies were included. The MA indicated that portable EMG diagnostic devices showed a very good diagnostic capacity, although a high variability is evident in the studies with some outliers. Very low quality of evidence due to high risk of bias and high heterogeneity among included studies suggests that portable devices have shown high sensitivity and specificity when diagnosing sleep bruxism (SB) compared to polysomnography. The tests performed in the MA found an estimated optimal cut-off point of 7 events/hour of SB with acceptably high sensitivity and specificity for the EMG portable devices.

Is there an association between sleep bruxism and obstructive sleep apnea? A case-control polysomnographic investigation.

OBJECTIVES: To estimate the statistical and epidemiological association between Sleep bruxism (SB) and Obstructive sleep apnea (OSA) based on OSA severity, and to describe sleep data findings within the analyzed population. METHODS: A case-control study (N = 37) was conducted on subjects with and without OSA. All subjects underwent a full-night polysomnographic recording at the Sleep Unit (Clinical Neurophysiology Department) of San Carlos University Hospital. The diagnosis and severity of OSA were determined using ICSD-3 and AASM-2.6 scoring. The definitive SB diagnosis was obtained through a self-report test, physical examination, and PSG recordings. Variables used to study the association between both conditions included the apnea and hypopnea episodes, the Apnea-hypopnea index (AHI), the number of SB episodes per night, and the bruxism index. Chi2, correlations, and ANOVA were calculated. The epidemiological association was calculated using the OR. RESULTS: SB showed an epidemiological association with OSA, with an OR of 0.15 (0.036-0.68), suggesting it could be considered a protective factor (p < 0.05). OSA patients presented fewer average SB episodes (6.8 ± 12.31) than non-OSA patients (25.08 ± 31.68). SB episodes correlated negatively (p < 0.05) with the AHI and the number of hypopneas (p < 0.05). The average number of SB episodes was significantly higher in patients with mild OSA compared to those with severe OSA. CONCLUSIONS: In this sample of patients with subclinical and mild OSA, SB may act as a protective factor. However, confirmation of these results with a larger sample size is necessary.

Diagnostic Accuracy of a Portable Electromyography and Electrocardiography Device to Measure Sleep Bruxism in a Sleep Apnea Population: A Comparative Study.

BACKGROUND: The gold standard for diagnosing sleep bruxism (SB) and obstructive sleep apnea (OSA) is polysomnography (PSG). However, a final hypermotor muscle activity often occurs after apnea episodes, which can confuse the diagnosis of SB when using portable electromyography (EMG) devices. This study aimed to compare the number of SB episodes obtained from PSG with manual analysis by a sleep expert, and from a manual and automatic analysis of an EMG and electrocardiography (EKG) device, in a population with suspected OSA. METHODS: Twenty-two subjects underwent a polysomnographic study with simultaneous recording with the EMG-EKG device. SB episodes and SB index measured with both tools and analyzed manually and automatically were compared. Masticatory muscle activity was scored according to published criteria. Patients were segmented by severity of OSA (mild, moderate, severe) following the American Academy of Sleep Medicine (AASM) criteria. ANOVA and the Bland-Altman plot were used to quantify the agreement between both methods. The concordance was calculated through the intraclass correlation coefficient (ICC). RESULTS: On average, the total events of SB per night in the PSG study were (8.41 ± 0.85), lower than the one obtained with EMG-EKG manual (14.64 ± 0.76) and automatic (22.68 ± 16.02) analysis. The mean number of SB episodes decreases from the non-OSA group to the OSA group with both PSG (5.93 ± 8.64) and EMG-EKG analyses (automatic = 22.47 ± 18.07, manual = 13.93 ± 11.08). However, this decrease was minor in proportion compared to the automatic EMG-EKG analysis mode (from 23.14 to 22.47). The ICC based on the number of SB episodes in the segmented sample by severity degree of OSA along the three tools shows a moderate correlation in the non-OSA (0.61) and mild OSA (0.53) groups. However, it is poorly correlated in the moderate (0.24) and severe (0.23) OSA groups: the EMG-EKG automatic analysis measures 14.27 units more than PSG. The results of the manual EMG-EKG analysis improved this correlation but are not good enough. CONCLUSIONS: The results obtained in the PSG manual analysis and those obtained by the EMG-EKG device with automatic and manual analysis for the diagnosis of SB are acceptable but only in patients without OSA or with mild OSA. In patients with moderate or severe OSA, SB diagnosis with portable electromyography devices can be confused due to apneas, and further study is needed to investigate this.

A unique association? A narcolepsy type 1 case comorbid with Primary Biliary Cholangitis.

The aim of the study was to present a woman affected of a narcolepsy with cataplexy (narcolepsy type 1) comorbid with an asymptomatic Primary Biliary Cholangitis (PBC). The HLA haplotype was DRB1*15:01, DQA1*01:02, DQB1*06:02. The allele DQB1*06:02 has been considered until now protective for PBC and dual pathology has not been published. We think the important clinical message of the Case would be of continuing to monitor adults with narcolepsy type 1 for late complications that may be associated with other autoimmune conditions. Clinicians should be aware of the relationship between Narcolepsy and PBC. This highlights the need for screening and management in these individuals.

Narcolepsy risk loci outline role of T cell autoimmunity and infectious triggers in narcolepsy.

Narcolepsy type 1 (NT1) is caused by a loss of hypocretin/orexin transmission. Risk factors include pandemic 2009 H1N1 influenza A infection and immunization with Pandemrix®. Here, we dissect disease mechanisms and interactions with environmental triggers in a multi-ethnic sample of 6,073 cases and 84,856 controls. We fine-mapped GWAS signals within HLA (DQ0602, DQB1*03:01 and DPB1*04:02) and discovered seven novel associations (CD207, NAB1, IKZF4-ERBB3, CTSC, DENND1B, SIRPG, PRF1). Significant signals at TRA and DQB1*06:02 loci were found in 245 vaccination-related cases, who also shared polygenic risk. T cell receptor associations in NT1 modulated TRAJ*24, TRAJ*28 and TRBV*4-2 chain-usage. Partitioned heritability and immune cell enrichment analyses found genetic signals to be driven by dendritic and helper T cells. Lastly comorbidity analysis using data from FinnGen, suggests shared effects between NT1 and other autoimmune diseases. NT1 genetic variants shape autoimmunity and response to environmental triggers, including influenza A infection and immunization with Pandemrix®.

Hemorragia hepática espontánea como causa inusual de abdomen agudo hemorrágico / Spontaneous hepatic hemorrhage as unusual cause of acute intra-abdominal hemorrhage

RESUMEN La hemorragia hepática espontánea (HHE) es una afección rara que resulta de una lesión en el parénquima hepático producida sin una causa externa. Presentamos el caso de una mujer de 74 años que, durante una internación por reagudización de su enfermedad pulmonar obstructiva crónica (EPOC), desarrolla episodio de hemorragia hepática espontánea que evoluciona a shock hemorrágico. Se realiza cirugía con resección atípica de carcinoma hepatocelular (HCC) con hemorragia activa en segmento III hepático. La paciente responde al tratamiento inicial, pero a los 16 días posoperatorios fallece en Unidad de Terapia Intensiva (UTI) debido a una afección respiratoria.

ABSTRACT Spontaneous hepatic hemorrhage (SHH) is a rare condition resulting from a breach in the hepatic parenchyma that occurs without an external cause. We report the case of a 74-year-old woman who, while being hospitalized due to exacerbation of chronic obstructive pulmonary disease (COPD), presented an episode of SHH with hemorrhagic shock. She underwent atypical resection of a hepatocellular carcinoma (HCC) with active bleeding in liver segment III. The patient had a favorable response to the initial treatment but died in the intensive care unit (ICU) on postoperative day 16 due to a respiratory tract complication.

Long-Term Outcome of a Series of Patients With Narcolepsy Type 1 and Comorbidity With Immunopathological and Autoimmune Diseases.

Background: The aim of this study was to evaluate the long-term outcome of our series of narcolepsy type 1 (NT1) patients with comorbid autoimmune diseases (ADs) and other immunopathological diseases (IDs), focusing on the incidence of new ADs and IDs in this sample. Methods: A longitudinal observational study was conducted over 6 years (2014 - 2020) in a series of 158 Caucasians NT1 patients (96 males; mean age: 50.1 ± 19.0 years) from the previous study. All but one case (familial case) were HLA-DQB1*06:02-positive. The diagnosis of narcolepsy was made according to the International Classification of Sleep Disorders (ICSD-3). Results: Twenty-one patients have been diagnosed with a new ID, 10 of them with an AD (autoimmune thyroid disease, psoriasis, rheumatoid arthritis, transverse myelitis, granuloma annulare, primary biliary cirrhosis, alopecia areata and antiphospholipid syndrome), and 11 with other IDs (allergic rhinitis, allergic asthma, atopic dermatitis, food allergy, contact dermatitis and drug allergy). One patient was diagnosed with two new ADs. We found IDs in 46 patients (24 females and 22 males) and the overall prevalence in this series is actually 29.11%; 22 of them (13.92%) had an AD, with a percentage higher than estimated in the general population. Conclusions: The prevalence of AD/ID is high in our series, suggesting that NT1 might arise on a background of generalized susceptibility to immune-mediated processes. The occurrence of an ID can in turn influence the development of others in genetically predisposed individuals, which explains the increased associations observed in this long-term study.

Tratamiento mininvasivo de las complicaciones del traumatismo hepático cerrado / Minimally invasive management of blunt hepatic trauma complications

RESUMEN Antecedentes: el manejo no operatorio del traumatismo hepático cerrado es exitoso en el 95% de los pacientes hemodinámicamente normales. Las lesiones de alto grado presentan una tasa de complicaciones de hasta un 14%, y una mortalidad del 27% cuando requieren cirugía abierta. Material y métodos: estudio descriptivo de informe de casos. Resultados: 3 casos con traumatismo hepático de alto grado. "A": manejo no operatorio inicial, lavado laparoscópico por hemoperitoneo sintomático, drenaje percutáneo de absceso hepático, recambio de catéter y CPRE, por fístula biliar persistente. "B": cirugía de control de daño inicial sin hepatectomía, drenaje percutáneo de absceso hepático y posterior recambio. "C": manejo no operatorio inicial, lavado laparoscópico por hemoperitoneo sintomático, posterior drenaje percutáneo de absceso hepático y recambio de drenajes. No presentaron mortalidad. Conclusión: estos casos resumen la utilización de las diferentes modalidades del manejo del traumatismo hepático cerrado y la posibilidad del manejo mininvasivo de las complicaciones.

ABSTRACT Background: Nonoperative management of blunt hepatic trauma is successful in 95% of hemodynamically stable patients. The complication rate of high-grade injuries is 14% and mortality reaches 27% when they require open surgery. Material and methods: We conducted a descriptive study of case reports. Results: Three cases of high-grade hepatic trauma are reported. "A": initial nonoperative management, laparoscopic lavage due to symptomatic hemoperitoneum, percutaneous drainage of liver abscess, catheter replacement and ERCP due to persistent biliary fistula. "B": initial damage control surgery without liver resections, percutaneous drainage of liver abscess and catheter replacement. "C": initial nonoperative management, laparoscopic lavage due to symptomatic hemoperitoneum, percutaneous drainage of liver abscess and catheter replacement. None of the patients died. Conclusion: These cases summarize the use of different management modalities of blunt hepatic trauma and the possibility of minimally invasive management of the complications.

Progressive vision loss as the initial symptom of Prostate Cancer.

Althought it may vary between countries, since the prostate specific antigen screening era, metastasic prostate cancer at diagnosis accounts for approximately 10% of cases. Intracranial dural metastases are uncommon, but when present they may lead to an increase in intracranial pressure that can subsequently damage intracranial structures, such as the cranial nerves. Prolonged intracranial hypertension can cause optic nerve ischemia, leading to progressive and irreversible vision loss if untreated, hence the importance of anamnesis, complete physical examination, and clinical suspicion.

[Peracute Diseases of the Esophagus - Bleeding from Esophageal Varices, Esophageal Varices]. / Perakute Erkrankungen des Ösophagus.

Peracute Diseases of the Esophagus - Bleeding from Esophageal Varices, Esophageal Varices Abstract. Due to a permanently increased portal venous pressure - usually due to infectious or ethyltoxic liver cirrhosis - varices can form in the lower esophagus due to expansion of the submucosal venous plexus. Acute bleeding from the esophageal varices is a life-threatening situation. In therapy, a distinction is made between primary prophylaxis of bleeding, control of acute bleeding and prevention of recurrent bleeding. In addition to non-selective betablockers, the transjugular intrahepatic portosystemic shunt (TIPS), which is introduced radiologically, plays a decisive role today, especially in the prophylaxis of recurrent bleeding. Apart from special indications, surgical shunt procedures are only of historical value. In liver cirrhosis patients, liver transplantation represents a causal treatment and lasting cure for esophageal varices.

Psychological Aggression, Attitudes About Violence, Violent Socialization, and Dominance in Dating Relationships.

Psychological aggression is a widespread form of abuse in dating relationships, especially in collectivist societies with ties to patriarchal beliefs. Despite the prevalence of psychological aggression, it has seldom been studied in connection with known antecedents of interpersonal violence, including dominance, attitudes supportive of violence, and violence socialization processes during childhood. The present study sought to test relationships among these variables in young men and women. A total of 500 Mexican undergraduate students in northern Mexico reported on their experiences with psychological aggression, the dominance of a dating partner, and violent socialization during childhood, as well as on their approval of violence within and outside the family. The results indicate that the dominance of a dating partner is directly linked to male and female intimate partner violence (IPV) perpetration. Violent socialization and proviolent attitudes appear to be related to female dominance. Female and male psychological aggression victimization was predicted by the participant's own perpetration. In general, a dyadic approach appears to be useful for explaining psychological aggression perpetration and victimization in a collectivist society, in light of recent changes in normative beliefs held by young educated Mexicans. Implications for future research and public policy are discussed.

Oxidized carbon nanotubes as sorbent for miniaturized solid-phase extraction of progestins from environmental water samples prior to their determination by HPLC-UV.

A solid-phase extraction method is presented for micro-extraction of three progestins (levonorgestrel, 19-norethisterone acetate and medroxyprogesterone acetate) from water samples. A mini-column was packed with 60 mg of oxidized multiwalled carbon nanotubes and coupled to a flow injection assembly. The extraction parameters, such as washing solution, eluent type, eluent volume, flow rate and sample volume, were optimized. Separation and determination were performed by HPLC with UV detection. The method has a good linear range (0.90-9.0 µg L-1), acceptable limits of detection (0.05-0.14 µg L-1) and low RSDs (0.8-4.6%). Attractive features of the method include low consumption of organic solvents and preconcentration factors of up to 100. The method was applied to analyze stream, underground and effluent water samples, and recoveries between 74 and 121% were obtained. Graphical abstractSchematic representation of the flow injection assembly couples to an ox-MWCNTs extraction column used to perform the solid phase extraction procedure of progestins in environmental water samples.

Physical Intimate Partner Violence and Controlling Behavior in Mexican University Students and Their Attitudes Toward Social Limits.

This study explored patterns of controlling behavior, physical violence, and attitudes toward social limits in young Mexican university students in light of the effect that socialization processes have in attitudes toward social norms and violent behavior as indicated in some of the literature. A total of 437 male and female heterosexual participants residing in Ciudad Juárez, Mexico, provided information on their perpetration/victimization experiences of controlling behavior (by means of the Controlling Behaviors Scale) and physical violence (using the Revised Conflict Tactics Scales [CTS2]) and their attitudes toward social limits (using the Attitudes Toward Social Limits scale). Results indicate similar chronicity levels of experienced controlling behavior and physical violence perpetration/victimization between the sexes. Participants expressed major tendency to adjust to a social norm rather than overstepping it. Males tend to overstep social limits more often than females, although no significant linear relationship was found between abusive behavior and attitudes promoting the infringement of social norms. Higher chronicity levels were rather found by dyadic type, relationships with mutual physical intimate partner violence (IPV), and controlling behavior in comparison with relationships where unidirectional violence prevails. Implications of findings involve the acknowledgment of change in dynamics used by more educated young Mexicans, and the recognition of IPV in these populations as a heterogeneous phenomenon for primary and secondary interventions.

Surgical Resection of a Parotid Gland Hemangioma in Teenager Managed with External Carotid Artery Ligation.

Parotid gland hemangiomas represent <0.6% of the total tumors of the gland and there are <50 tumors reported during adult age, so there is no standard treatment. A 18-year-old female presents with a mass in the right parotid gland of 18 months of a slow progressive asymptomatic growth; on physical examination, only the mass was detected. An angiography was performed, and it reported a possible hemangioma that depends on the right internal maxillary artery and right facial artery and was not suitable for embolization. Total parotidectomy was performed with prior ligation of the right external carotid artery, complete resection was achieved and preservation of the facial nerve and all branches with minimal loss of blood (150 cc). External carotid artery ligation is a safe technique that can be considered in carefully selected patients with vascular tumors that affect the head and neck to achieve a clean and safe surgery with minimal sequels.

Photonic Sorting of Aligned, Crystalline Carbon Nanotube Textiles.

Floating catalyst chemical vapor deposition uniquely generates aligned carbon nanotube (CNT) textiles with individual CNT lengths magnitudes longer than competing processes, though hindered by impurities and intrinsic/extrinsic defects. We present a photonic-based post-process, particularly suited for these textiles, that selectively removes defective CNTs and other carbons not forming a threshold thermal pathway. In this method, a large diameter laser beam rasters across the surface of a partly aligned CNT textile in air, suspended from its ends. This results in brilliant, localized oxidation, where remaining material is an optically transparent film comprised of few-walled CNTs with profound and unique improvement in microstructure alignment and crystallinity. Raman spectroscopy shows substantial D peak suppression while preserving radial breathing modes. This increases the undoped, specific electrical conductivity at least an order of magnitude to beyond that of single-crystal graphite. Cryogenic conductivity measurements indicate intrinsic transport enhancement, opposed to simply removing nonconductive carbons/residual catalyst.

[Double pneumotorax secondary to single proyectile weapon: One case report and review of literature]. / Doble neumotórax secundario a único proyectil de arma de fuego: reporte de un caso y revisión de la literatura.

BACKGROUND: The 25% of traumatic deaths are due to chest trauma with a mortality of 28%, and closed trauma is the most common mechanism of injury. The use of firearms increases the relative risk of death. The five more frequent specific chest injuries are lung contusion (31.8%), hemothorax/pneumothorax (19.4%), rib fractures (13.2%), and diaphragmatic injury (7.5%). CLINICAL CASE: Patient of 25 years with a single firearm projectile wound in the chest who assisted to the emergency room (ER) with significant respiratory distress and meriting surgical emergency airway, documenting double pneumothorax, aortic laceration and rupture of the trachea, which required management in the ER with bilateral chest tube placement and subsequent surgical repair. CONCLUSION: Anatomical and pathophysiological knowledge and the standardized management of the international guidelines are the key to keep a high level of suspect with a patient with chest penetrating trauma. Besides they improve the possibility of diagnosis and timely treatment.

Introducción: el 25% de las muertes traumáticas son secundarias a trauma de tórax con una mortalidad de 28%. De estas, el trauma cerrado es el mecanismo de lesión más común, en el que el uso de armas de fuego eleva el riesgo relativo. Las cinco lesiones especificas de tórax mas frecuentes son la contusión pulmonar (31.8%), el hemotórax/neumotórax (19.4%), la fractura costal (13.2%) y la lesión diafragmática (7.5%). Caso clínico: paciente de 25 años con herida por único proyectil de arma de fuego en tórax, la cual le condicionó dificultad respiratoria importante y ameritó vía aérea quirúrgica de urgencia. Se documentó doble neumotórax, laceración aórtica y ruptura de traquea, lo cual requirió manejo en la sala de Emergencias con colocación de sonda endopleural bilateral y posterior reparación quirúrgica. Conclusión: el conocimiento anatómico y fisiopatológico y el manejo estandarizado con guías internacionales son la base para mantener un elevado índice de sospecha ante un paciente con trauma penetrante de tórax. Además, mejoran la posibilidad de diagnóstico y tratamiento oportuno.

Comorbidity of Narcolepsy Type 1 With Autoimmune Diseases and Other Immunopathological Disorders: A Case-Control Study.

BACKGROUND: Several evidences suggest that autoimmune diseases (ADs) tend to co-occur in an individual and within the same family. Narcolepsy type 1 (NT1) is a chronic sleep disorder caused by a selective loss of hypocretin-producing neurons due to a mechanism of neural destruction that indicates an autoimmune pathogenesis, although no evidence is available. We report on the comorbidity of ADs and other immunopathological diseases (including allergy diseases) in narcolepsy. METHODS: We studied 158 Caucasian NT1 patients (60.7% male; mean age 49.4 ± 19.7 years), in whom the diagnosis was confirmed by polysomnography followed by a multiple sleep latency test, or by hypocretin-1 levels measurements. RESULTS: Thirty out of 158 patients (18.99%; 53.3% female; 29 sporadic and one familial cases) had one or more immunopathological diseases associated. A control group of 151 subjects were matched by gender and age with the narcolepsy patients. Results demonstrated that there was a higher frequency of ADs in our series of narcolepsy patients compared to the sample of general population (odds ratio: 3.17; 95% confidence interval: 1.01 - 10.07; P = 0.040). A temporal relationship with the age at onset of the diseases was found. CONCLUSIONS: Cataplexy was significantly more severe in NT1 patients with immunopathological diseases, and immunopathological diseases are a risk factor for severe forms of cataplexy in our series (odds ratio: 23.6; 95% confidence interval: 5.5 - 100.1).

Estudio cualitativo sobre la percepción de seguridad de los pacientes en dos hospitales de Bahía Blanca / Qualitative study on the perception of patient safety in two hospitals in Bahía Blanca City

INTRODUCCIÓN: pocos estudios exploran la percepción de los pacientes sobre su seguridad de atención y, en general, lo hacen desde la perspectiva de la calidad de atención y la satisfacción respecto a los cuidados recibidos. OBJETIVOS: Describir la percepción de los pacientes sobre su seguridad durante la estadía hospitalaria. MÉTODOS: Se realizó un estudio cualitativo con técnica de gruposfocales. Se incluyó a pacientes internados durante 2010 en doshospitales de la ciudad de Bahía Blanca, convocados telefónicamente a partir de un muestreo no probabilístico. RESULTADOS: Se realizaron cuatro grupos focales con un total de 28 pacientes. Se definieron dimensiones y categorías con los conceptos aportados por los participantes. Se construyó una matriz en la que se volcaron los datostranscriptos. El criterio de análisis fue la espontaneidad, el consenso y eldisenso. Las dimensiones definidas fueron: relación equipo de salud paciente; derechos del paciente; calidad del proceso de atención; vulnerabilidad percibida; eventos adversos y error. CONCLUSIONES: Los resultados obtenidos son exploratorios y no generalizables. La investigación permitió explorar, describir y comprender vivencias y perspectivas de los pacientes, profundizando acerca de su percepción sobre la seguridad en el sistema de salud y su forma de comunicarla. Los hallazgos proporcionan la base metodológica para desarrollar iniciativas destinadas a mejorar la seguridad en entornos de salud.

INTRODUCTION: few studies explore patients’ perception about health care safety. In general, they considerthe perspective of quality of care and satisfaction with received treatment. OBJECTIVES: To describe the perception of patients about their safety during hospital stay. METHODS: A qualitative study with focus group technique was performed. It included patients admitted in 2010 in two hospitals of Bahía Blanca city, who were invited by phone from anon-probabilistic sample. RESULTS: A total of 28 patients participated in four focus groups. Dimensions and categories were defined using concepts provided by the participants. A matrix was built for data transfer. The analysis criteria were spontaneity, consensus and dissent. The defined dimensionswere: health care team-patient relationship; patient´s rights; quality of care; perceived vulnerability; error and adverse events. CONCLUSIONS: The results are exploratory and notgeneralizable. The research allowed to explore, describe and understand patients’ experiences and perspectives,deeply examining their perception of health care safety and their way to communicate it. These findings provide the methodological basis to develop initiatives for improving safety in health environments.

Adaptación y aplicación de un cuestionario de percepción de seguridad en pacientes internados / Adaptation and application of a safety perception survey in hospitalized patients

Introducción: La seguridad del paciente ha adquirido gran relevancia en los últimos años. Involucrar a los pacientes en los diferentes aspectos de la sanidad puede mejorar la seguridad y el servicio prestado. Existen diferentes cuestionarios relacionados con la percepción del paciente en cuanto a la seguridad de servicios sanitarios. El Ministerio de Sanidad y Política Social de España validó en 2009 un instrumento. Objetivo: Describir la percepción de seguridad de los pacientes respectos a la atención sanitaria recibida durante su internación. Materiales y Métodos: Estudio cuantitativo descriptivo de corte transversal realizado en dos hospitales de la ciudad de Bahía Blanca. Muestreo no probabilístico, por conveniencia. Se encuestaron a 35 pacientes mediante el "Cuestionario sobre la percepción de seguridad de la atención sanitaria en el ámbito hospitalario", heteroadministrado. Resultados: de 24 encuestas, el puntaje obtenido fue una media de 81.16/100, lo cual indica un alto nivel de seguridad percibida. Sólo un paciente refirió haber sufrido un incidente durante la estadía hospitalaria y 6 pacientes refirieron haber tenido errores clínicos durante la hospitalización. Discusión: La seguridad percibida por los pacientes en la atención sanitaria fue similar a la descripta en el trabajo original, lo que indica en ambos casos un alto nivel de seguridad percibida. Las respuestas de los pacientes a la encuesta manifiestan su grado de satisfacción con la atención percibida y no el grado de seguridad, ya que aún habiendo incidentes reconocidos no se perciben como falta de seguridad.

Introduction: Patient safety has become very important in recent years. Involving patients in the different aspects of healthcare can improve safety and service provision. Different surveys were developed related to the patient's perception of safety in health services. The Ministry of Health and Social Policy of Spain validated an instrument in 2009. Objective: To describe the healthcare safety perceived by patients during their stay in hospital. Materials and Methods: Descriptive quantitative cross-sectional study conducted in two hospitals in the city of Bahía Blanca. A convenience nonprobability sampling method was used. Thirty five patients were surveyed by the hetero-administered "Survey on the healthcare safety perceived in hospitals". Results: 24 surveys were finally available for analysis. The score obtained was an average of 81.16/100, indicating a high level of perceived safety. Only one patient reported to have suffered an incident during hospital stay and 6 patients reported having clinical errors during hospitalization. Discussion: Health care safety perceived by patients was similar to that described in the original work, indicating in both cases a high level of perceived safety. Patients' answers expressed their satisfaction with the perceived healthcare and not the degree of safety. The incidents acknowledged were not perceived as lack of safety.

Prevalence of migraine in patients with restless legs syndrome: a case-control study.

OBJECTIVES: To assess and compare the prevalence of migraine in patients with restless legs syndrome (RLS) and matched controls. BACKGROUND: Recent studies have suggested an association between migraine and RLS. Our work is the first case-control study on this subject performed in an RLS population. METHODS: A case-control study was conducted in 47 RLS patients (27 women and 20 men aged between 18 and 65 years) and 47 age- and sex-matched controls. Validated questionnaires were used to investigate the presence of migraine, anxiety, and depression (Zung Self-Rating Anxiety and Depression scales), sleep quality (Pittsburgh Sleep Quality Index), and RLS severity (International RLS scale). RESULTS: RLS patients had higher lifetime prevalence of migraine than non-RLS controls (53.2% vs. 25.5%, P = .005; matched-OR 1.3 [P = .019]; adjusted odds ratio (OR) 3.8 [P = .03]). No significant associations were found between RLS and active migraine with aura or inactive migraine (no episodes in the previous year). However, active migraine without aura was significantly more prevalent in patients with RLS than in controls (40.4% vs. 12.8%, P = .001; matched OR 1.5 [P = .001]; adjusted OR 2.7 [P = .04]). Within the RLS group, patients with migraine had poorer sleep quality than those without migraine (Pittsburgh Sleep Quality Index >5:100 vs. 80.9%, P = .038) but did not differ in terms of RLS severity, anxiety and depression, use of dopaminergic agonists, and body mass index. CONCLUSION: There appears to be a relationship between RLS and migraine, in particular for active migraine without aura.