ADENI-UCI study: Analysis of non-income decisions in ICU as a measure of limitation of life support treatments.

OBJECTIVE: To analyze the variables associated with ICU refusal decisions as a life support treatment limitation measure. DESIGN: Prospective, multicentrico. SCOPE: 62 ICU from Spain between February 2018 and March 2019. PATIENTS: Over 18 years of age who were denied entry into ICU as a life support treatment limitation measure. INTERVENTIONS: None. MAIN INTEREST VARIABLES: Patient comorities, functional situation as measured by the KNAUS and Karnosfky scale; predicted scales of Lee and Charlson; severity of the sick person measured by the APACHE II and SOFA scales, which justifies the decision-making, a person to whom the information is transmitted; date of discharge or in-hospital death, destination for hospital discharge. RESULTS: A total of 2312 non-income decisions were recorded as an LTSV measure of which 2284 were analyzed. The main reason for consultation was respiratory failure (1080 [47.29%]). The poor estimated quality of life of the sick (1417 [62.04%]), the presence of a severe chronic disease (1367 [59.85%]) and the prior functional limitation of patients (1270 [55.60%]) were the main reasons for denying admission. The in-hospital mortality rate was 60.33%. The futility of treatment was found as a risk factor associated with mortality (OR: 3.23; IC95%: 2.62-3.99). CONCLUSIONS: Decisions to limit ICU entry as an LTSV measure are based on the same reasons as decisions made within the ICU. The futility valued by the intensivist is adequately related to the final result of death.

ADENI-UCI Study: Analysis of non-income decisions in ICU as a measure of limitation of life support treatments. / Estudio ADENI-UCI: Análisis de las decisiones de no ingreso en UCI como medida de limitación de los tratamientos de soporte vital.

OBJECTIVE: To analyze the variables associated with ICU refusal decisions as a life support treatment limitation measure. DESIGN: Prospective, multicentrico SCOPE: 62 ICU from Spain between February 2018 and March 2019. PATIENTS: Over 18 years of age who were denied entry into ICU as a life support treatment limitation measure. INTERVENTIONS: None. MAIN INTEREST VARIABLES: Patient comorities, functional situation as measured by the KNAUS and Karnosfky scale; predicted scales of Lee and Charlson; severity of the sick person measured by the APACHE II and SOFA scales, which justifies the decision-making, a person to whom the information is transmitted; date of discharge or in-hospital death, destination for hospital discharge. RESULTS: A total of 2312 non-income decisions were recorded as an LTSV measure of which 2284 were analyzed. The main reason for consultation was respiratory failure (1080 [47.29%]). The poor estimated quality of life of the sick (1417 [62.04%]), the presence of a severe chronic disease (1367 [59.85%]) and the prior functional limitation of patients (1270 [55.60%]) were the main reasons for denying admission. The in-hospital mortality rate was 60.33%. The futility of treatment was found as a risk factor associated with mortality (OR: 3.23; IC95%: 2.62-3.99). CONCLUSIONS: Decisions to limit ICU entry as an LTSV measure are based on the same reasons as decisions made within the ICU. The futility valued by the intensivist is adequately related to the final result of death.

[Repetition of pseudo-words in Spanish children with specific language disorder: a psycholinguistic marker]. / Repetición de pseudopalabras en niños españoles con trastorno específico del lenguaje: marcador psicolingüístico.

AIMS: To analyze whether repetition of nonwords (NWR) is a good method to differentiate between Spanish-speaking children with specific language impairment (SLI), children with normal language development (NL), and children with articulation disorder (AD), and to study whether phonological and syllabical characteristics, which are present in nonwords used in this task, are compatible with a SLI explanation on the basis of the temporal auditory limitation. PATIENTS AND METHODS: Eighteen 5- and 6-year-old children with NL, 19 with SLI, and 19 with AD, performed verbal tasks (principally, lexical and verbal memory tasks), and two NWR tasks: one is formed by four nonwords series with frequent syllables, in accordance with the analysis of syllable frequency in Spanish, and the other task is formed by nonwords with infrequent syllables. RESULTS: Like in English, NWR is the best method to differentiate children with SLI and children with NL; yet children with a minor impairment, like AD, show deficits in this task. Therefore, this disorder could be considered as an 'intermediate zone' between NL and SLI. Then it seems that AD is not an unmixed impairment of production only, since in its origin there are difficulties linked with the formation of the phonological representations of the words. CONCLUSIONS: With regard to syllable frequency, results do not support the explanation on the basis of temporal auditory limitation in Spanish. Results are discussed in relation to other explanations: general limitation of processing, with special incidence of the phonological working memory, and connectionist perspectives.

Repetición de pseudopalabras en niños españoles con trastorno específico del lenguaje: marcador psicolingüístico / Repetition of pseudo-words in spanish children with specific language disorder: a psycholinguistic marker

Objetivos. Saber si la repetición de pseudopalabras (RPP)es una tarea que diferencia bien a los niños hispanohablantes contrastorno específico de lenguaje (TEL) respecto a los que muestranun desarrollo normal del lenguaje (DN) y trastorno de articulación(TA), y comprobar si las características fonológicas y silábicas delespañol, presentes en las pseudopalabras utilizadas en esta tarea,son compatibles con una explicación del TEL basada en la limitaciónauditiva temporal. Pacientes y métodos. 18 niños con DN, 19con TEL y 19 con TA, todos de 5 y 6 años, han realizado tareas verbales(sobre todo léxicas y de memoria verbal) y dos tareas deRPP: una con sílabas frecuentes y otra con sílabas no frecuentes.Resultados. Como en inglés, la RPP es la tarea que diferencia mejora los niños con TEL respecto a los niños con DN; pero inclusolos niños con un trastorno menor, como el TA, muestran déficit enesta tarea; puede considerarse este trastorno como una ‘zona intermedia’entre le DN y el TEL. Parece, pues, que el TA no es sóloun trastorno puro de producción, sino que en su origen hay dificultadesrelacionadas con la formación de las representaciones fonológicasde las palabras. Conclusiones. En cuanto a la frecuenciade las sílabas, los resultados no apoyan la explicación basada en lalimitación auditiva temporal en español. Se discuten otras explicaciones:limitación general de procesamiento, con especial incidenciade la memoria fonológica de trabajo, y perspectivas conexionistas

Aims. To analyze whether repetition of nonwords (NWR) is a good method to differentiate between Spanishspeakingchildren with specific language impairment (SLI), children with normal language development (NL), and childrenwith articulation disorder (AD), and to study whether phonological and syllabical characteristics, which are present innonwords used in this task, are compatible with a SLI explanation on the basis of the temporal auditory limitation. Patientsand methods. Eighteen 5- and 6-year-old children with NL, 19 with SLI, and 19 with AD, performed verbal tasks (principally,lexical and verbal memory tasks), and two NWR tasks: one is formed by four nonwords series with frequent syllables, inaccordance with the analysis of syllable frequency in Spanish, and the other task is formed by nonwords with infrequentsyllables. Results. Like in English, NWR is the best method to differentiate children with SLI and children with NL; yet childrenwith a minor impairment, like AD, show deficits in this task. Therefore, this disorder could be considered as an ‘intermediatezone’ between NL and SLI. Then it seems that AD is not an unmixed impairment of production only, since in its origin there aredifficulties linked with the formation of the phonological representations of the words. Conclusions. With regard to syllablefrequency, results do not support the explanation on the basis of temporal auditory limitation in Spanish. Results are discussedin relation to other explanations: general limitation of processing, with special incidence of the phonological workingmemory, and connectionist perspectives