Search

Resumen Presentamos caso de un varón de 77 años con antecedentes de alcoholismo, limitación crónica al flujo aéreo, y trauma encéfalo craneano (TEC) antiguo, que ingresa por cuadro de insuficiencia respiratoria global con descompensación aparentemente infecciosa que evoluciona tórpidamente con asistencia de ventilación mecánica no invasiva (VMNI) persistente. Se objetiva diparesia de predominio braquial proximal lo que hace sospechar síndrome de hombre en barril (SHB). Se completa estudio con resonancia nuclear magnética (RNM) de columna cervical que muestra severa atrofia medular desde bulbo distal hasta C4. El paciente se mantiene con VMNI c/ BiPAP y apoyo kinésico, con lo que logra progresiva mejoría ventilatoria.

Bullying is one of the most serious problems that education has, and one of the most serious problems of the educational system in this day and age. It affects almost all students, with them either being a bully, a victim of bullying, or a bystander. But it also has an important effect on the teaching staff, the schools themselves, and the educational system. For this research, we asked first- and second-year university students about their perception of bullying in their stages as students of primary and secondary education. To do this, we evaluated 654 university students: 195 men (29.82%) and 459 women (70.18%). These students were from eight different departments at the University of Zaragoza. The age of the participants ranged from 18 to 27 years, with an average of 22.54 years (s.d. = .292). The results showed that men tend to be bullies to a greater extent than women, and no relationship was found between gender and being a victim of bullying. In addition, it was found that nearly two out of every three students have experienced bullying during these stages of education and that almost all students (nine out of ten) have seen episodes of bullying. As a conclusion, we must point out the need for further studies and research work to discuss and analyze the phenomenon of bullying – a phenomenon that affects both students and our educational system.

Neuromyelitis optica (NMO) is a severe demyelinating disease of the central nervous system, which preferentially attacks the optic nerve and spinal cord. It is associated with antibodies against aquaporin 4. Morbidity and mortality are higher than in multiple sclerosis and its treatment focuses on immunosuppressive drugs. Immunomodulators are contraindicated. We report a previously healthy 35 years old man, presenting with NMO concomitantly with a systemic lupus erythematosus. His evolution was torpid with three outbreaks in the 10 months after the diagnosis, requiring a first-line therapy with methylprednisolone and cyclophosphamide and then a second-line therapy with rituximab.

The user’s medical history is the only valid document that demonstrates the type of care a patient has received; therefore, it must faithfully reflect the quality of care provided by health professionals, as well as basic personal information, but of vital importance.In Colombia there is a great difficulty that gets in the process of quality care: each health promoting entity (EPS, for its initials in Spanish) generates a clinical history to its members, but does not share it with their counterparts when a user decides to migrate to another EPS, which causes duplication and loss of potentially important information. Through the bibliographic review of multiple national and international sources, the flow of health data in the national territory is evaluated, as well as the feasibility of implementing a national digital health records management system, among other aspects. This document presents the advantages of creating a national system that contains a unique clinical history by user in digital format, the existing regulations that favor the privacy of personal data, as well as practices that ensure the accuracy of the information supplied in each medical or legal proceeding. It is concluded that, in Colombia, it is necessary to implement a national system of electronic medical records that encourages the availability, quality and confidentiality of user data in order to streamline processes and procedures in the health sector. La historia clínica del usuario es el único documento válido que permite demostrar el tipo de atención que ha recibido un paciente, por ende, debe reflejar fielmente la calidad de la atención brindada por parte de los profesionales de la salud, así como información personal básica, pero de vital importancia. En Colombia existe una gran dificultad que se interpone en el proceso de atención de calidad: cada entidad promotora de salud (eps) genera una historia clínica a sus afiliados, pero no la comparte con sus homólogos cuando un usuario decide migrar a otra eps, lo que ocasiona duplicidad y pérdida de información potencialmente importante. Mediante la revisión bibliográfica de múltiples fuentes tanto nacionales como internacionales se evalúa el flujo de datos en salud en el territorio nacional, la viabilidad de la implementación de un sistema de gestión nacional de historias clínicas digitales, entre otros aspectos. En este documento se presentan las ventajas de la creación de un sistema nacional que contenga en formato digital una historia clínica única por usuario, la normatividad existente que propende por la privacidad de los datos personales, así como las prácticas que aseguran la veracidad de la información suministrada en cada trámite médico o legal. Se concluye que en Colombia es necesario implementar un sistema nacional de historias clínicas electrónicas que propenda por la disponibilidad, calidad y confidencialidad de los datos de los usuarios con el propósito de agilizar los procesos y procedimientos en el sector salud. A história clínica do usuário é o único documento válido que permite demonstrar o tipo de atenção que tem recebido um paciente, portanto, deve refletir fielmente a qualidade da atenção oferecida pelos profissionais da saúde, assim como informação pessoal básica, mas de vital importância. Em Colômbia existe uma grande dificuldade que se interpõe no processo de atenção de qualidade: a cada entidade promotora de saúde (eps) gera uma história clínica para cada um de seus filiados, mas não a compartilha com seus homólogos quando um usuário decide migrar a outra EPS, o que ocasiona duplicidade e perda de informação potencialmente importante. Através duma revisão bibliográfica de múltiplas fontes tanto nacionais como internacionais se avalia o fluxo de dados em saúde no território nacional, a viabilidade da implementação de um sistema de gestão nacional de histórias clínicas digitais, entre outros aspectos. Neste documento apresentam-se as vantagens da criação de um sistema nacional que contenha em formato digital uma história clínica única por usuário, a normatividade existente que dispõe-se para a privacidade dos dados pessoais, bem como as práticas que asseguram a veracidade da informação fornecida em cada trâmite médico ou legal. Conclui-se que em Colômbia é necessário implementar um sistema nacional de histórias clínicas eletrónicas que propenda pela disponibilidade, qualidade e confidencialidade dos dados dos usuários com o propósito de agilizar os processos e procedimentos no sector saúde.

Background:Cysticlean® is a cranberry extract product with a high quantity of proanthocyanidins (240 mg/capsule) with a significant dose-dependent anti-adhesion activity of Escherichia coli (EC) adhered to uroepithelial cells. Previous clinical assays showed that Cysticlean® is a product highly recommended in the prophylaxis and treatment of UTIs. The aim of this study is the evaluation of Cysticlean as an alternative to antibiotics to treat uncomplicated cystitis. Material and Methods This observational study included 30 consecutive ambulatory patients (17 women and 13 men), who were diagnosed of uncomplicated cystitis (UC) and agreed to participate in this observational study. Patients were informed to come to visit the doctor again after 15 days after Cysticlean® treatment was started (1 capsule of Cysticlean® every 12 h daily) and immediately if signs/symptoms did not disappear. In this case, Cysticlean® was stopped and patients treated with antibiotic. Results: 21 patients were successfully cured with Cysticlean® treatment only (70%) and 9 patients needed antibiotic to cure their UC. 82.35% of women and 53.,85% of men did not need antibiotic to be cured. No significant differences at baseline were found regarding signs/symptoms severity between those patients cured with extract alone and those who needed antibiotic. No side effects/adverse reactions were reported. Conclusions: These preliminary data strongly suggest that Cysticlean® could be considered as an alternative to antibiotics for a 1st line treatment of UC. Further clinical studies to confirm whether Cysticlean® could be an alternative to antibiotic treatment for UC and this approach could contribute to reduce world-wide growing antibiotic resistance.

Intracranial sinus thrombosis (1ST) after closed head injury is an uncommon but potentially serious complication. It has no correlation with the severity of the injury. The symptoms and clinical course are highly variable. The most frequent but least specific symptom is severe headache. Cerebral lesions and neurologic signs develop in half of patients with IST. We report a 29 year-old male who had an IST after a severe closed head injury. The patient initially developed headache and had later 2 secondarily generalized seizures. The magnetic resonance imaging showed a superior sagittal sinus thrombosis. Anticoagulation with unfractionated heparin and intravenous phenytoin was started. At the moment of this report he is asymptomatic and continues with oral anticoagulants and phenytoin.