5 results on '"Jiménez Gutiérrez, Paula María"'
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2. Debilidad pulmonar asociada a COVID-19 (DPAC): revisión sistemática y metaanálisis
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Redruello Guerrero, Pablo, Ruiz del Pino, Marta, Jiménez-Gutiérrez, Carmen, Jiménez Gutiérrez, Paula María, Carrasco Cáliz, Ana, Romero-Linares, Alejandro, Láinez Ramos-Bossini, Antonio Jesús, Rivera Izquierdo, Mario, and Cárdenas Cruz, Antonio
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Ventilación mecánica no invasiva ,Mortalidad ,High-flow nasal cannula ,Pneumomediastinum ,COVID-19 ,Pneumothorax ,Neumotórax ,Non-invasive mechanical ventilation ,Invasive mechanical ventilation ,Mortality ,Ventilación mecánica invasiva ,Neumomediastino ,Oxigenoterapia nasal de alto flujo - Abstract
Anexo. Material adicional Se puede consultar material adicional a este artículo en su versión electrónica disponible en doi:10.1016/j.medin.2023.04.010., Objetivo: Evaluar la mortalidad y diversos factores clínicos derivados del desarrollo de neumotórax (NTX) y/o neumomediastino (NMD) atraumáticos en pacientes críticos como consecuencia de la debilidad pulmonar asociada a la COVID-19 (DPAC). Diseño: Revisión sistemática con metaanálisis. Ámbito: Unidad de cuidados intensivos (UCI). Participantes: Investigaciones originales en las que se evaluase a pacientes, con o sin necesidad de ventilación mecánica invasiva (VMI), con diagnóstico de COVID-19 que hubiesen desarrollado NTX o NMD atraumáticos al ingreso o durante su estancia hospitalaria. Intervenciones: Se obtuvieron los datos de interés de cada artículo que fueron analizados y evaluados por la Escala Newcastle-Ottawa. El riesgo de las variables de interés principales se evaluó por los datos derivados de los estudios que incluyeron a pacientes que desarrollaron NTX o NMD atraumáticos. Variables de interés principales: Mortalidad, estancia media en la UCI y PaO2/FiO2 media en el momento diagnóstico. Resultados: Se recogieron datos de 12 estudios longitudinales. En el metaanálisis se incluyeron datos de un total de 4.901 pacientes, entre los cuales 1.629 presentaron un episodio de NTX y 253 de NMD atraumáticos. A pesar de encontrar asociaciones significativamente fuertes, la alta heterogeneidad entre los estudios hace que la interpretación de los resultados deba hacerse con cautela. Conclusiones: La mortalidad de los pacientes con COVID-19 fue mayor en los que desarrollaron NTX y/o NMD atraumáticos con respecto a los que no lo hicieron. La media del índice PaO2/FiO2 fue menor en los pacientes que desarrollaron NTX y/o NMD atraumáticos. Proponemos agrupar bajo el término DPAC estos casos., Objectives: To assess mortality and different clinical factors derived from the development of atraumatic pneumothorax (PNX) and/or pneumomediastinum (PNMD) in critically ill patients as a consequence of COVID-19-associated lung weakness (CALW). Design: Systematic review with meta-analysis. Setting: Intensive care unit (ICU). Participants: Original research evaluating patients, with or without the need for protective invasive mechanical ventilation (IMV), with a diagnosis of COVID-19 who had developed atraumatic PNX or PNMD on admission or during their hospital stay. Interventions: Data of interest were obtained from each article and analysed and assessed by the Newcastle-Ottawa Scale. The risk of the variables of interest was assessed by data derived from studies including patients who developed atraumatic PNX or PNMD. Main variables of interest: Mortality, mean ICU length of stay and mean PaO2/FiO2 at diagnosis. Results: Data were collected from 12 longitudinal studies. Data from a total of 4,901 patients were included in the meta-analysis. A total of 1,629 patients had an episode of atraumatic PNX and 253 patients had an episode of atraumatic PNMD. Despite finding significantly strong associations, the high heterogeneity between studies means that interpretation of the results should be made with caution. Conclusions: Mortality of COVID-19 patients was higher in those who developed atraumatic PNX and/or PNMD compared to those who did not. The mean PaO2/FiO2 index was lower in patients who developed atraumatic PNX and/or PNMD. We propose to group these cases under the term CAPD., Universidad de Granada/CBUA
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- 2023
3. Síndrome doloroso intenso por cistitis intersticial que mejora tras bloqueo y radiofrecuencia del ganglio impar
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Jiménez Gutiérrez, Paula María, De Pablos Florido, Violeta, Cabezas Fernández, Fátima, and González Gámiz, Francisco Javier
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Bloqueo de ganglio de Walter ,Cistitis intersticial ,Radiofrecuencia ,Ganglio impar ,Dolor pélvico crónico - Abstract
La cistitis intersticial (IC) es un tipo de dolor pélvico crónico (DPC), poco prevalente y que afecta de manera importante la calidad de vida de los pacientes. El diagnóstico es complicado y numerosos tratamientos se han ensayado para la IC, con eficacia parcial hasta el momento. Se presenta el caso de una paciente de 77 años diagnosticada de IC con sintomatología gravemente limitante y refractaria a tercera línea de tratamiento, que es tratada mediante radiofrecuencia pulsada del ganglio impar junto con infiltración de anestésico local y corticoide. En el seguimiento, la paciente refiere una marcada mejoría de la sintomatología a medio plazo. Tras su realización se obtuvo importante disminución de la dosis necesaria de analgésicos opioides y no opioides. El bloqueo de ganglio impar es una alternativa aceptable poco conocida para esta indicación. La realización de esta técnica percutánea se puede considerar de baja complejidad y con escasos efectos secundarios.
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- 2022
4. Artificial intelligence for the triage of COVID-19 patients at the emergency department: a systematic review.
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Redruello-Guerrero, Pablo, Jiménez-Gutiérrez, Carmen, Láinez Ramos-Bossini, Antonio Jesús, Jiménez-Gutiérrez, Paula María, Rivera-Izquierdo, Mario, and Benítez Sánchez, José Manuel
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COVID-19 pandemic , *MEDICAL triage , *COVID-19 , *ARTIFICIAL intelligence , *HOSPITAL emergency services - Abstract
The aim of this article is to systematically analyze the available literature on the efficacy and validity of artificial intelligence (AI) applied to medical imaging techniques in the triage of patients with suspected or confirmed coronavirus disease 2019 (COVID-19) in Emergency Departments (EDs). A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Medline, Web of Science, and Scopus were searched to identify observational studies evaluating the efficacy of AI methods in the diagnosis and prognosis of COVID-19 using medical imaging. The main characteristics of the selected studies were extracted by two independent researchers and were formally assessed in terms of methodological quality using the Newcastle-Ottawa scale. A total of 11 studies, including 14,499 patients, met inclusion criteria. The quality of the studies was medium to high. Overall, the diagnostic yield of the AI techniques compared to a gold standard was high, with sensitivity and specificity values ranging from 79% to 98% and from 70% to 93%, respectively. The methodological approaches and imaging datasets were highly heterogeneous among studies. In conclusion, AI methods significantly boost the diagnostic yield of medical imaging in the triage of COVID-19 patients in the ED. However, there are significant limitations that should be overcome in future studies, particularly regarding the heterogeneity and limited amount of available data to train AI models. [ABSTRACT FROM AUTHOR]
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- 2022
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5. A Comparative Analysis of International Classification Systems to Predict the Risk of Collapse in Single-Level Osteoporotic Vertebral Fractures.
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Láinez Ramos-Bossini AJ, Jiménez Gutiérrez PM, Luengo Gómez D, Rivera Izquierdo M, Benítez JM, and Ruiz Santiago F
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Introduction: Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse., Patients and Methods: A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses., Results: This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant's morphological, Genant's quantitative, Sugita 's, DGOU's, and AO Spine's classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant's quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association ( p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up., Conclusions: The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings.
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- 2024
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