Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 135
Filtrar
1.
Rev Esp Salud Publica ; 942020 Jan 16.
Artigo em Espanhol | MEDLINE | ID: mdl-31942868

RESUMO

OBJECTIVE: There are few epidemiological studies on acute poisonings from pesticides, industrials and household products in Spain. The objective of this work is to describe the epidemiological and clinical profile of acute poisonings by chemical products in our country, and analyze their annual evolution. METHODS: The Spanish Toxicovigilance System (SETv) is a prospective registry that includes 32 Emergency Departments and Intensive Care Units in Spain. An observational descriptive study of acute poisoning by chemical agents (excluding pharmacological products and illicit drugs) was carried out, within 1999-2014. Statistical analysis was performed using Chi-square or exact Fisher's tests. Non-parametric continuous variables were compared using the Mann-Whitney U test. P-value less than 0.05 were considered significant. RESULTS: The 10,548 cases studied had a mean age of 38.41 (±22.07) years, being significantly higher in women (p=0.0001). 67.7% of the poisonings occurred at home, and the most frequent routes of exposure were respiratory (48.3%), digestive (35.3%) and ocular (13.1%). The most frequent toxic groups were toxic gases (31%), caustics (25.6%) and irritant gases (12.1%). Of the patients that required treatment (76.2%), antidotes were used in 27.2%. 20.6% of the patients were admitted at Hospital, with a median stay of 32 (±151.94) days, with significant differences for pesticides and solvents (p=0.02). Sequelae were presented at discharge in 2.1% of patients. Mortality was 1.4% (146 patients) with a mean age of 62.08 years (±19.58) (p=0.0001). CONCLUSIONS: The reduction of chemical poisonings should be prevented in the domestic environment, taking into account the sources of exposure to carbon monoxide and the handling of household cleaning products, both caustic liquids and the generation of irritating gases when mixed.

2.
An. sist. sanit. Navar ; 42(2): 227-230, mayo-ago. 2019. ilus
Artigo em Espanhol | IBECS-Express | ID: ibc-FGT-2820

RESUMO

El síndrome de hiperémesis por cannabis (SHC) es poco conocido entre los clínicos y se caracteriza por dolor abdominal y vómitos cíclicos, tras un consumo intensivo de cannabis durante años, que no responde al tratamiento con antieméticos pero sí a las duchas de agua muy caliente. Presentamos el caso de un paciente de 24 años, con antecedentes de consumo de cannabis desde los 14 años y un episodio de neumomediastino (NMD), etiquetado como idiopático, el mes anterior, que presentó asociación entre SHC y neumomediastino secundario a los intensos vómitos repetidos del SHC. Se le administró capsaicina tópica y 5 mg de haloperidol endovenoso, permaneciendo 48 h en la Unidad de Corta Estancia de Urgencias. Esta observación clínica aislada podría indicar la necesidad de descartar el SHC como causa de NMD en sujetos jóvenes y, de la misma manera, considerar la presencia de NMD en la exploración clínica de pacientes jóvenes con SHC o en pacientes con patologías en cuya etiología pueda influir el aumento de presión intratorácica


Cannabinoid hyperemesis syndrome (CHS) is little known amongst clinicians and is characterised by abdominal pain and cyclical vomiting, after intense consumption of cannabis over several years. It does not respond to treatment with antiemetics, but does respond to showers in very hot water. We present the case of a 24-year-old patient whose antecedents included cannabis consumption since the age of 14 and an episode of spontaneous idiopathic pneumomediastinum (PM) the previous month, which presented an association of CHS and secondary pneumomediastinum with the intense, repeated vomiting of the CHS. He was given topical capsaicin and 5 mg of intravenous haloperidol, and was kept for 48 hours in the Emergency Short Stay Unit. This isolated clinical observation appears to indicate the need to rule out CHS as the cause of PM in young patients and, similarly, to consider the presence of PM in the clinical exploration of young people with CHS and in patients with pathologies whose aetiology might be influenced by an increase in intrathoracic pressure

4.
Rev Esp Enferm Dig ; 111(7): 574-575, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31190547

RESUMO

Two recent publications in this journal regarding cannabinoid hyperemesis syndrome (CHS) reflect a common fact in the clinical practice. Although the syndrome is increasingly well-known, patients still receive a late diagnosis, sometimes after years of delay. This entails multiple visits to the ER, as well multiple outpatient visits and diagnostic tests in gastroenterology departments. Furthermore, there are many unnecessary hospital admissions that are often accompanied by an uncertain discharge diagnosis (psychogenic vomiting, etc.).

5.
Emergencias ; 31(3): 161-166, 2019 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31210447

RESUMO

OBJECTIVES: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). METHODS: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. RESULTS: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). CONCLUSION: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes.

6.
Emergencias (Sant Vicenç dels Horts) ; 31(3): 161-166, jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182725

RESUMO

Objetivo: Evaluar si la exposición a episodios de polvo sahariano predice los ingresos hospitalarios de los pacientes con insuficiencia cardiaca aguda (ICA) atendidos en un servicio de urgencias hospitalario (SUH). Método: Estudio unicéntrico, de cohorte retrospectiva, de pacientes con ICA atendidos en un SUH. La población de estudio se dividió en 2 grupos: pacientes ingresados por ICA y pacientes con ICA dados de alta directa a domicilio desde el SUH. Se analizaron las concentraciones medias de material partículado (PMx) (respirables, diámetro aerodinámico, da < 10 µm), PM2,5 (finas, da < 2,5 µm) y PM2,5-10 (gruesas, da 2,5-10 µm) desde el día de la llegada al SUH hasta 5 días previos. Se definió exposición intensa al polvo sahariano cuando las concentraciones medias diarias de PM10 estaban entre 50 y 200 µg/m3. La relación para estimar el riesgo de ingresar por ICA en función de la exposición de PMx durante los 5 días previos a su llegada a urgencias se analizó mediante análisis multivariable. Resultados: Se incluyeron 1.097 pacientes con ICA, ingresaron 318 pacientes (29%), 779 (71%) se dieron de alta. Los pacientes ingresados por ICA tenían mayor edad, elevada comorbilidad y mayor proporción de pacientes expuestos a episodios intensos de polvo sahariano (p < 0,0001). En el análisis multivariable la exposición a episodios de polvo sahariano intensos se relacionó con el ingreso hospitalario en los pacientes con ICA (OR = 2,36; IC 95% 1,21-4,58; p = 0,01). Conclusiones: En ausencia de estudios prospectivos, los resultados obtenidos de la serie analizada sugieren que la presencia de concentraciones elevadas de polvo sahariano (PM10: 50-200 µg/m3) puede constituir un factor precipitante de ingreso por ICA


Objective: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). Methods: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. Results: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). Conclusions: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Nevoeiro/efeitos adversos , Insuficiência Cardíaca/epidemiologia , Serviços Médicos de Emergência , Hospitalização/tendências , Exposição Ambiental/efeitos adversos , Material Particulado/efeitos adversos , Análise Multivariada , Estudos Retrospectivos , Admissão do Paciente/estatística & dados numéricos
7.
Eur J Emerg Med ; 26(1): 65-70, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29016534

RESUMO

OBJECTIVES: The aim of this study was to evaluate the evolution of the citation of articles from the European Journal of Emergency Medicine (EJEM) from 1994 (EJEM foundation) to 2015 and identify highly cited articles and their principal characteristics and determine a possible correlation between the citations counted in different databases. MATERIALS AND METHODS: We obtained the articles published in EJEM from 1994 to 2015 in ISI-WoS (main source) and Scopus, Google Scholar, and Medline databases (accessory sources). The citations were quantified and their annual evolution and the bibliometric indices derived (impact factor and SCImago Journal Rank) were evaluated. We identified and analyzed the highly cited EJEM articles and evaluated the possible correlation between the citations counted for these articles in the databases. RESULTS: Overall, 1705 EJEM articles were cited 9422 times in 8122 different articles. The evolution of the global citation, impact factor, and SCImago Journal Rank from 1994 to 2015 increased significantly. The h-index of EJEM was 30, and 31 articles were considered highly cited (≥30 citations), 16.1% of them being clinical trials. By subjects, 22.5% corresponded to cardiology, 19.3% to emergency department management, and 12.9% to pediatrics; by countries, 81% were from Europe, with Belgian authors publishing four (12.9%) highly cited articles, and French, Spanish, British, and Swedish authors having three (9.7%) each. Two studies in the EJEM achieved the definition of 'citation classics' (more than 100 citations). The number of citations in all the databases, except Medline, showed statistically significant correlations. CONCLUSION: Citation of EJEM articles has progressively increased and EJEM bibliometric indicators have improved; most highly cited articles are mainly by European authors.


Assuntos
Medicina de Emergência/história , Publicações Periódicas como Assunto/estatística & dados numéricos , Bibliometria , Europa (Continente) , História do Século XX , História do Século XXI , Humanos , Fator de Impacto de Revistas , Jornalismo Médico/história , Editoração
8.
Int J Environ Health Res ; 29(2): 130-139, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30185063

RESUMO

We conducted a cross-sectional study in the Hospital Universitario de Canarias (Tenerife, Canary Islands, Spain) measuring 22 inorganic elements in amniotic fluid (AF) samples obtained from 65 pregnant women. ICP-MS was used for quantification of inorganic elements. Newborn parameters at delivery were all within the normal range. Concentrations of all elements were detected in measurable amounts in AF. The concentration of elements was similar to those reported in the literature. The concentrations of the most dangerous heavy metals - Cd, Cr, Ni, Hg and Pb - were lower than those reported by other authors. This study demonstrates that toxic inorganic elements pass into and accumulate in AF. The presence of such pollutants in contact with developing embryos from the intrauterine period could exert adverse health effects that deserve future investigations.


Assuntos
Líquido Amniótico/química , Arsênico/análise , Poluentes Ambientais/análise , Metais/análise , Adolescente , Adulto , Estudos Transversais , Monitoramento Ambiental , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Espanha , Adulto Jovem
10.
Emergencias (Sant Vicenç dels Horts) ; 30(2): 105-114, abr. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-171587

RESUMO

Objetivo. Validar la Escala de Incertidumbre ante la Enfermedad en los pacientes y los acompañantes de un servicio de urgencias hospitalario (SUH). Método. La validación de contenido incluyó el desarrollo de una versión adaptada a urgencias mediante consenso (versión 1), una versión tras validación del contenido (versión 2) y una versión tras un estudio piloto en 20 usuarios del SUH (versión 3). El estudio de validación se realizó en 320 sujetos adultos (160 pacientes y 160 acompañantes) que acudieron a un SUH entre noviembre de 2015 y septiembre de 2016. La Escala de Incertidumbre ante la Enfermedad en el Servicio de Urgencias (ESINESU) constó de 12 ítems (60 puntos) y fue administrada por dos enfermeras durante la estancia de los pacientes y los acompañantes en el SUH. Se recogieron variables sociodemográficas, clínicas y de la percepción sobre la información recibida. Resultados. El grado de incertidumbre fue de 29 (DE 11) puntos en pacientes y 36 (DE 13) puntos en acompañantes. El análisis factorial confirmó, en las pruebas de validez de constructo, las dos dimensiones de la escala original (complejidad y ambigüedad), con 6 ítems en cada una de ellas. Dicho análisis factorial explicó un 60% de la varianza total en la versión de la escala para pacientes, y un 67% en la versión para acompañantes. Los valores de fiabilidad obtenidos fueron buenos, alfa de Cronbach de 0,912-0,938 y procedimiento de dos mitades 0,901-0,933. La validación convergente también mostró correlaciones significativas. Conclusiones. La ESINESU podría ser una escala sencilla, válida y fiable para medir la incertidumbre de pacientes y acompañantes en los SUH españoles (AU)


Objective. To validate a Spanish adaptation of the Mishel Uncertainty of Illness Scale for use with emergency-department (ED) patients and their accompanying relatives or friends (the UIS-ED). Methods. We first developed a version of the questionnaire for Spanish ED situations. Next we assessed the content validity index for each of its items, revised it, and reassessed its face validity to produce a second version, which we then piloted in 20 hospital ED patients. A third revised version was then validated in a population of 320 adults (160 patients and 160 accompanying persons) who attended the ED between November 2015 and September 2016. The 12-item UIS-ED (60 points) was administered by 2 nurses while the patients and accompanying persons were in the ED. We gathered sociodemographic and clinical data as well as the subjects' perception about the information they were given. Results. The mean (SD) uncertainty score among patients was 29 (11) points. Accompanying persons had a mean score of 36 (13) points. Factorial analysis confirmed the instrument's construct validity, finding that both dimensions of the original Mishel scale (complexity and ambiguity) were present in 6 items each. Factorial analysis explained 60% of the total variance in the patient version and 67% of the variance in the version for accompanying persons. Reliability statistics were good, with Cronbach's α values ranging from 0.912 to 0.938. Split-half reliability statistics ranged from 0.901 to 0.933. Correlations were significant in the analysis of convergent validity. Conclusion. The UIS-ED questionnaire may prove to be a simple, valid, and reliable way for assessing uncertainty in patients and their accompanying friends or relatives attending Spanish EDs (AU)


Assuntos
Humanos , Incerteza , Acompanhantes Formais em Exames Físicos/normas , Serviços Médicos de Emergência/organização & administração , Doença , Inquéritos e Questionários
11.
Emergencias ; 30(2): 105-114, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29547233

RESUMO

OBJECTIVES: To validate a Spanish adaptation of the Mishel Uncertainty of Illness Scale for use with emergency-department (ED) patients and their accompanying relatives or friends (the UIS-ED). MATERIAL AND METHODS: We first developed a version of the questionnaire for Spanish ED situations. Next we assessed the content validity index for each of its items, revised it, and reassessed its face validity to produce a second version, which we then piloted in 20 hospital ED patients. A third revised version was then validated in a population of 320 adults (160 patients and 160 accompanying persons) who attended the ED between November 2015 and September 2016. The 12-item UIS-ED (60 points) was administered by 2 nurses while the patients and accompanying persons were in the ED. We gathered sociodemographic and clinical data as well as the subjects' perception about the information they were given. RESULTS: The mean (SD) uncertainty score among patients was 29 (11) points. Accompanying persons had a mean score of 36 (13) points. Factorial analysis confirmed the instrument's construct validity, finding that both dimensions of the original Mishel scale (complexity and ambiguity) were present in 6 items each. Factorial analysis explained 60% of the total variance in the patient version and 67% of the variance in the version for accompanying persons. Reliability statistics were good, with Cronbach's α values ranging from 0.912 to 0.938. Split-half reliability statistics ranged from 0.901 to 0.933. Correlations were significant in the analysis of convergent validity. CONCLUSION: The UIS-ED questionnaire may prove to be a simple, valid, and reliable way for assessing uncertainty in patients and their accompanying friends or relatives attending Spanish EDs.


Assuntos
Autoavaliação Diagnóstica , Serviço Hospitalar de Emergência , Pacientes/psicologia , Índice de Gravidade de Doença , Inquéritos e Questionários , Incerteza , Adolescente , Adulto , Idoso , Compreensão , Análise Fatorial , Família/psicologia , Feminino , Amigos/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Projetos Piloto , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Espanha , Adulto Jovem
12.
Clin Toxicol (Phila) ; 56(1): 15-24, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28730896

RESUMO

INTRODUCTION: Cannabinoid hyperemesis syndrome is a clinical disorder that has become more prevalent with increasing use of cannabis and synthetic cannabinoids, and which is difficult to treat. Standard antiemetics commonly fail to alleviate the severe nausea and vomiting characteristic of the syndrome. Curiously, cannabinoid hyperemesis syndrome patients often report dramatic relief of symptoms with hot showers and baths, and topical capsaicin. OBJECTIVES: In this review, we detail the pharmacokinetics and pharmacodynamics of capsaicin and explore possible mechanisms for its beneficial effect, including activation of transient receptor potential vanilloid 1 and neurohumoral regulation. Putative mechanisms responsible for the benefit of hot water hydrotherapy are also investigated. METHODS: An extensive search of PubMed, OpenGrey, and Google Scholar from inception to April 2017 was performed to identify known and theoretical thermoregulatory mechanisms associated with the endocannabinoid system. The searches resulted in 2417 articles. These articles were screened for relevant mechanisms behind capsaicin and heat activation having potential antiemetic effects. References from the selected articles were also hand-searched. A total of 137 articles were considered relevant and included. Capsaicin: Topical capsaicin is primarily used for treatment of neuropathic pain, but it has also been used successfully in some 20 cases of cannabinoid hyperemesis syndrome. The pharmacokinetics and pharmacodynamics of capsaicin as a transient receptor potential vanilloid 1 agonist may explain this effect. Topical capsaicin has a longer half-life than oral administration, thus its potential duration of benefit is longer. Capsaicin and transient receptor potential vanilloid 1: Topical capsaicin binds and activates the transient receptor potential vanilloid 1 receptor, triggering influx of calcium and sodium, as well as release of inflammatory neuropeptides leading to transient burning, stinging, and itching. This elicits a novel type of desensitization analgesia. Transient receptor potential vanilloid 1 receptors also respond to noxious stimuli, such as heat (>43 °C), acids (pH <6), pain, change in osmolarity, and endovanilloids. The action of topical capsaicin may mimic the effect of heat-activation of transient receptor potential vanilloid 1. Endocannabinoid system and transient receptor potential vanilloid 1: Cannabinoid hyperemesis syndrome may result from a derangement in the endocannabinoid system secondary to chronic exogenous stimulation. The relief of cannabinoid hyperemesis syndrome symptoms from heat and use of transient receptor potential vanilloid 1 agonists suggests a complex interrelation between the endocannabinoid system and transient receptor potential vanilloid 1. Temperature regulation: Hot water hydrotherapy is a mainstay of self-treatment for cannabinoid hyperemesis syndrome patients. This may be explained by heat-induced transient receptor potential vanilloid 1 activation. "Sensocrine" antiemetic effects: Transient receptor potential vanilloid 1 activation by heat or capsaicin results in modulation of tachykinins, somatostatin, pituitary adenylate-cyclase activating polypeptide, and calcitonin gene-related peptide as well as histaminergic, cholinergic, and serotonergic transmission. These downstream effects represent further possible explanations for transient receptor potential vanilloid 1-associated antiemesis. CONCLUSIONS: These complex interactions between the endocannabinoid systems and transient receptor potential vanilloid 1, in the setting of cannabinoid receptor desensitization, may yield important clues into the pathophysiology and treatment of cannabinoid hyperemesis syndrome. This knowledge can provide clinicians caring for these patients with additional treatment options that may reduce length of stay, avoid unnecessary imaging and laboratory testing, and decrease the use of potentially harmful medications such as opioids.


Assuntos
Canabinoides/toxicidade , Capsaicina/uso terapêutico , Hidroterapia , Vômito/induzido quimicamente , Regulação da Temperatura Corporal , Capsaicina/farmacocinética , Capsaicina/farmacologia , Endocanabinoides/fisiologia , Humanos , Canais de Cátion TRPV/fisiologia , Vômito/terapia
14.
Emergencias ; 29(5): 327-334, 2017 10.
Artigo em Espanhol | MEDLINE | ID: mdl-29077292

RESUMO

OBJECTIVES: To analyze the research output of Spanish emergency physicians between 2005 and 2014 and to compare it to their output in the previous 10-year period (1995-2004) as well as to that of emergency physicians in other countries and Spanish physicians in other specialties. MATERIAL AND METHODS: Original articles indexed in the Science Citation Index Expanded of the Web of Science were included. Documents from Spanish emergency physicians were identified by combining the word Spain and any other search term identifying an emergency service or unit in Spain. To identify articles from 7 other Spanish specialties (hematology, endocrinology, cardiology, pneumology, digestive medicine, pediatrics, surgery and orthopedic medicine or traumatology) and emergency physicians in 8 other countries (United States, United Kingdom, Ireland, Italy, France, Germany, Netherlands, Belgium) we used similar strategies. Information about production between 1995 and 2004 was extracted from a prior publication. RESULTS: Spanish emergency physicians signed 1254 articles (mean [SD], 125 [44] articles/y) between 2005 and 2014. That level of productivity was greater than in the 1995-2004 period (mean, 26 [14] articles/y), although the annual growth rate fell from 12.5% in the previous 10-year period to 5.2% in the most recent one. Emergency medicine was among the least productive Spanish specialties we studied, but our discipline's annual growth rate of 5.2% was the highest. Spanish emergency medicine occupies an intermediate position (ranking fifth) among the 9 countries studied, although the population-adjusted rank was higher (fourth). When output was adjusted for gross domestic product, Spain climbed higher in rank, to second position. The annual growth rate was the fourth highest among countries, after Germany (9.9%), the Netherlands (7.3%), and Italy (6.0%). CONCLUSION: The research output of Spanish emergency physicians continues to be quantitatively lower than that of other Spanish specialties and of emergency physicians in other countries. The annual rate of growth in publications, although good, fell below the growth rate of the previous period.


Assuntos
Pesquisa Biomédica/tendências , Eficiência , Medicina de Emergência , Publicações Periódicas como Assunto/tendências , Médicos , Editoração/tendências , Pesquisa Biomédica/estatística & dados numéricos , Humanos , Estudos Longitudinais , Publicações Periódicas como Assunto/estatística & dados numéricos , Editoração/estatística & dados numéricos , Estudos Retrospectivos , Espanha
15.
Emergencias (St. Vicenç dels Horts) ; 29(5): 327-334, oct. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-167923

RESUMO

Objetivos. Analizar la producción investigadora realizada por urgenciólogos españoles en el decenio 2005-2014, compararla con el decenio anterior (1995-2004), con la de urgenciólogos de otros países y con la de otras especialidades médicas en España. Materiales y método. Se incluyeron artículos originales indexados en la base Science Citation Index Expanded (SCIE) de la Web of Science. Para capturar los documentos de los urgenciólogos españoles se combinó la palabra Spain y cualquier expresión que identifica un servicio-dispositivo de urgencias en España. Para analizar la producción de otras especialidades en España (hematología, endocrinología, cardiología, neumología, digestivo, pediatría, cirugía y traumatología) y de urgenciólogos de otros países (Estados Unidos, Reino Unido, Irlanda, Italia, Francia, Alemania, Holanda, Bélgica) se usaron estrategias similares. La producción del decenio 1995-2004 se obtuvo de una publicación previa. Resultados. Los urgenciólogos españoles firmaron 1254 artículos [media 125 (DE 44) documentos/año] durante 2005- 2014, una producción mayor que en 1995-2004 [media 26 (DE 14) documentos/año], si bien el ritmo anual de crecimiento ha disminuido (del 12,4% al 5,2% actual). Esta producción fue una de las más bajas entre las especialidades españolas estudiadas, pero la de mayor ritmo de crecimiento anual (5,2%). La producción científica de los urgenciólogos españoles ocupa una posición intermedia (5º lugar) entre los 9 países considerados, aunque mejora su posición cuando la producción se ajusta a la población (4º) y al producto interior bruto (2º). Respecto al ritmo anual de crecimiento, ocuparon el 4º lugar, después de Alemania (9,9%), Holanda (7,3%) e Italia (6,0%). Conclusiones. La producción científica de los urgenciólogos españoles continúa siendo cuantitativamente baja comparada con la de otros especialistas españoles y la de urgenciólogos de otros países. El ritmo anual de crecimiento, aunque es bueno, ha descendido respecto al periodo anterior (AU)


Objectives. To analyze the research output of Spanish emergency physicians between 2005 and 2014 and to compare it to their output in the previous 10-year period (1995-2004) as well as to that of emergency physicians in other countries and Spanish physicians in other specialties. Material and methods. Original articles indexed in the Science Citation Index Expanded of the Web of Science were included. Documents from Spanish emergency physicians were identified by combining the word Spain and any other search term identifying an emergency service or unit in Spain. To identify articles from 7 other Spanish specialties (hematology, endocrinology, cardiology, pneumology, digestive medicine, pediatrics, surgery and orthopedic medicine or traumatology) and emergency physicians in 8 other countries (United States, United Kingdom, Ireland, Italy, France, Germany, Netherlands, Belgium) we used similar strategies. Information about production between 1995 and 2004 was extracted from a prior publication. Results. Spanish emergency physicians signed 1254 articles (mean [SD], 125 [44] articles/y) between 2005 and 2014. That level of productivity was greater than in the 1995-2004 period (mean, 26 [14] articles/y), although the annual growth rate fell from 12.5% in the previous 10-year period to 5.2% in the most recent one. Emergency medicine was among the least productive Spanish specialties we studied, but our discipline's annual growth rate of 5.2% was the highest. Spanish emergency medicine occupies an intermediate position (ranking fifth) among the 9 countries studied, although the population-adjusted rank was higher (fourth). When output was adjusted for gross domestic product, Spain climbed higher in rank, to second position. The annual growth rate was the fourth highest among countries, after Germany (9.9%), the Netherlands (7.3%), and Italy (6.0%). Conclusions. The research output of Spanish emergency physicians continues to be quantitatively lower than that of other Spanish specialties and of emergency physicians in other countries. The annual rate of growth in publications, although good, fell below the growth rate of the previous period (AU)


Assuntos
Humanos , Pesquisa Científica e Desenvolvimento Tecnológico , Indicadores de Produção Científica , Assistência Ambulatorial/estatística & dados numéricos , Medicina de Emergência/estatística & dados numéricos , Resumos e Indexação como Assunto/estatística & dados numéricos , Estudos Longitudinais , Estudos Retrospectivos , Modelos Lineares
17.
Cardiovasc Drugs Ther ; 31(2): 209-213, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28265880

RESUMO

PURPOSE: Morphine has been used for several decades in cases of acute pulmonary edema (APE) due to the anxiolytic and vasodilatory properties of the drug. The non-specific depression of the central nervous system is probably the most significant factor for the changes in hemodynamics in APE. Retrospective studies have shown both negative and neutral effects in patients with APE and therefore some authors have suggested benzodiazepines as an alternative treatment. The use of intravenous morphine in the treatment of APE remains controversial. METHODS: The MIdazolan versus MOrphine in APE trial (MIMO) is a multicenter, prospective, open-label, randomized study designed to evaluate the efficacy and safety of morphine in patients with APE. The MIMO trial will evaluate as a primary endpoint whether intravenous morphine administration improves clinical outcomes defined as in-hospital mortality. Secondary endpoint evaluation will be mechanical ventilation, cardiopulmonary resuscitation, intensive care unit admission rate, intensive care unit length of stay, and hospitalization length. CONCLUSIONS: In the emergency department, morphine is still used for APE in spite of poor scientific background data. The data from the MIMO trial will establish the effect-and especially the risk-when using morphine for APE.


Assuntos
Ansiolíticos/administração & dosagem , Midazolam/administração & dosagem , Morfina/administração & dosagem , Edema Pulmonar/tratamento farmacológico , Vasodilatadores/administração & dosagem , Doença Aguda , Administração Intravenosa , Ansiolíticos/efeitos adversos , Reanimação Cardiopulmonar , Protocolos Clínicos , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Midazolam/efeitos adversos , Morfina/efeitos adversos , Edema Pulmonar/diagnóstico , Edema Pulmonar/mortalidade , Projetos de Pesquisa , Respiração Artificial , Espanha , Fatores de Tempo , Resultado do Tratamento , Vasodilatadores/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA