Search

Abdominal X-rays (AXRs) is the classic radiological procedure used to assess placement of a nasoenteric tube (NET). As a disadvantage, AXRs expose the patient to a dose of ionizing radiation and can cause potential adverse effects in the future. There are few studies about NET placement and ultrasound (US) assessment. Authors studied 41 patients undergoing NET placement keeping the wire until correct placement US assessment. Correct placement occurred in 38 patients, with a 97% sensitivity (confidence interval, 95%: 84.9-99.8%) and a 100% specificity (CI 95%: 19.7-100%). NET placement evaluation with abdominal US is a safe and practical procedure, associated with accurate diagnostic outcomes., La radiografía (Rx) abdominal, el método diagnóstico utilizado para verificar la posición de la sonda de alimentación enteral (SAE), es una fuente de irradiación y de potenciales efectos adversos para los pacientes. Hay pocos estudios sobre colocación de SAE y ecografía. Los autores estudiaron 41 pacientes con inserción de SAE y mantenimiento de la guía hasta la comprobación de su correcta colocación con ecografía, detectando una correcta colocación en 38 pacientes frente a 3 pacientes con una inadecuada posición de la SAE, con una sensibilidad del 97% (IC 95%: 84.9-99.8%) y una especificidad del 100% (IC 95%: 19.7-100%). La evaluación de la posición de la SAE a través del abdomen mediante ecografía es práctica y segura, asociándose con resultados diagnósticos satisfactorios.

Background Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). Previous trials have reported that gabapentin can relieve chronic neuropathic pain, but its effect on prevention of PHN is unclear. Objective To assess the efficacy of a 5-week course of gabapentin on acute herpetic pain and on the prevention of PHN at 12 weeks in patients with acute HZ. Methods This was a randomized, double blind, placebo-controlled trial conducted in 17 primary care health centers in Mallorca, Spain. All patients were older than 50 years, presented with HZ within 72 h of rash onset, and had moderate-severe pain (. 4 on a 10-point visual analogue scale [VAS]). Ninety-eight patients were randomized to receive gabapentin or placebo. All patients received valaciclovir for 7 days and analgesia if needed. The treatment period was 5 weeks, followed by 7 weeks of follow-up. Gabapentin was initiated at 300 mg/day and gradually titrated to a maximum of 1800 mg/day. The main outcome measure was pain at 12 weeks. Results Seventy-five patients completed the study, 33 in the gabapentin group and 42 in the control group. A total of 18.2% of patients in the gabapentin group and 9.5% in the control group reported pain at 12 weeks (p = 0.144). Four patients in the gabapentin group (12.1%), but no patients in the placebo group, reported pain of 4 or more on a 10-point VAS. Patients taking gabapentin reported worse health-related quality of life and poorer sleep quality. Three patients discontinued the trial due to adverse effects from gabapentin. Conclusion Addition of gabapentin to the usual treatment of HZ within 72 h of rash onset provided no significant relief from acute herpetic pain or prevention of PHN., This study was funded by the Ministry of Economy and Competitiveness, Carlos III Institute (www.isciii.es), grant PI12/01813. We also received support from the Health Promotion and Preventive Activities-Primary Health Care Network, sustained by the Ministry of Health ISCIII-RediApp awards RD16/0007/0008, also supported with European Union ERDF funds. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Este estudio de caso trata sobre la vivencia de David que a sus 20 años fue diagnosticado de Diabetes tipo I (DMI). El objetivo principal de este estudio es conocer la vivencia de este paciente teniendo en cuenta su aspecto clínico, psicológico y social. Mediante la observación neutra de cuatro variables: Dieta, Tratamiento, Entorno social/ Familia y Proceso de adaptación/ Rol enfermero. En estos puntos destacamos el caso particular de David, contrastándolo con evidencia científica. Por tanto, seria óptimo que los profesionales se adaptaran a las necesidades particulares de cada paciente en concreto a nivel biopsicosocial. This study of case is about David’s experience, he was diagnosed of diabetes type I when he was 20 years old (DMI). The main objective of this study is to know the experience of this patient observing the clinical, psychological and social aspects. Through the neutral observation of four variables: diet, treatment, social environment/family and the adaptation process/nursing role. In these points we remark David’s particular case, contrasting it with scientific evidence. Furthermore, it would be ideal that the professionals adapted to the patients particular needs and especially on a psychological level.

SPIRIT checklist. (PDF 41 kb)

Model consent form. (DOC 38 kb)

La violencia de género se ha convertido en un problema social, los casos de muertes por violencia de género no dejan de aumentar a pesar de todo el esfuerzo institucional que se está llevando a cabo para combatirla. Esto ha hecho que se haga necesario aplicar una Ley que abarque de forma transversal la prevención, aspectos educativos, sociales, asistenciales y de atención posterior a las víctimas se trata de la Ley Orgánica 1/2004, de 28 de diciembre, de Medidas de Protección Integral contra la Violencia de Género. Aún así las víctimas por violencia de género no dejan de aumentar de forma considerable, por lo que es necesario investigar cuales pueden ser los motivos por los que se sigue dando unas cifras tan elevadas. Por todo esto he basado mi investigación centrándome en la recogida de datos oficiales sobre las muertes que ha habido por violencia de género durante los últimos años. Para poder establecer una comparativa de la evolución que se ha producido en denuncias y muertes por violencia de género. Evidentemente no puede valorarse el éxito de la aplicación de la Ley contabilizando solo número de muertes y de denuncias, ya que no es posible saber las muertes que se han evitado gracias a dicha Ley. Tampoco es posible conocer el número real de mujeres que sufren violencia de género porqué no conocemos los datos de mujeres que aún sufriéndola no denuncian.

Background: Postherpetic neuralgia (PHN) is a chronic neuropathic pain that results from alterations of the peripheral nervous system in areas affected by the herpes zoster virus. The symptoms include pain, paresthesia, dysesthesia, hyperalgesia, and allodynia. Despite the availability of pharmacological treatments to control these symptoms, no treatments are available to control the underlying pathophysiology responsible for this disabling condition. Methods/design: Patients with herpes zoster who are at least 50 years old and have a pain score of 4 or higher on a visual analogue scale (VAS) will be recruited. The aim is to recruit 134 patients from the practices of general physicians. Participants will be randomized to receive gabapentin to a maximum of 1800 mg/day for 5 weeks or placebo. Both arms will receive 1000-mg caplets of valacyclovir three times daily for 7 days (initiated within 72 h of the onset of symptoms) and analgesics as needed. The primary outcome measure is the percentage of patients with a VAS pain score of 0 at 12 weeks from rash onset. The secondary outcomes measures are changes in quality of life (measured by the SF-12 questionnaire), sleep disturbance (measured by the Medical Outcomes Study Sleep Scale), and percentage of patients with neuropathic pain (measured by the Douleur Neuropathique in 4 Questions). Discussion: Gabapentin is an anticonvulsant type of analgesic that could prevent the onset of PHN by its antihypersensitivity action in dorsal horn neurons., This study was funded by the Ministry of Health, Carlos III Institute (grant PI12/01813). We also received support from the Health Promotion and Preventive Activities-Primary Health Care Network, sustained by the Ministry of Health, Carlos III Institute, Redes Tematicas de Investigacion Cooperativa en Salud (RETIC) award RD12/0005/0011, co-financed by the European Union European Regional Development Fund. The funders had no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript.