Revista Científica de la Sociedad de Enfermería Neurológica (English ed.)最新文献

Introduction

Stroke is a time-dependent pathology which requires a rapid and universal neurological assessment tool. Since October 2021, following training of nursing staff, the NIHSS scale has been implemented in order to increase comparability, concordance and improve communication with the medical team.

Objectives

1. To examine the concordance among scores of the NIHSS scale implemented by nursing staff and medical team in Neurology Service of the Ramón y Cajal Hospital. 2. To describe the subjective perception of using the NIHSS scale from the nursing staff in the Neurology Service of the Ramón y Cajal Hospital.

Method

Cross-sectional observational study that included 100 patients distributed in two periods of three months each in the Stroke Unit of the Ramón y Cajal Hospital. The NIHSS scale scores given by nursing and neurology were collected, as well as the discordant items of each assessment. Statistical analyzes included frequencies, percentages, Cronbach's alpha and the Intraclass Correlation Coefficient. A survey was conducted among the 22 professionals to assess the degree of acceptance.

Results

A high concordance (68% and 70% in each period) was achieved between the nursing and neurology. A total of 94% of professionals reported to get used to the NIHSS scale.

Conclusions

The implementation of the NIHSS scale is a clear opportunity for improvement in the stroke unit, facilitating communication between nursing and neurology teams, due to agreement between scores and increasing quality of medical care.

Spasticity plus syndrome (SSP) is a clinical diagnosis based on the presence of a compendium of symptoms that has been suggested recently in patients with demyelinating disease. Using this diagnosis might help to avoid polimedication and to offer a better symptomatology management in long-term patients.

Objective

The aim of this study is to retrospectively analyze the number of cases compatible with a SSP diagnostic in our nurse clinical-consultancy.

Methodology

We analyzed a time-window from 2002 till 2022 and we included cases compatible with SSP at those 2 time-points as well as the number of symptomatic treatments prescribed also in both time-points.

Results

All cases in the databased were compatible with SSP and also associated pain (90%), rigidity (83.3%), fatigue (75%) and bladder problems (43.3%). An increase in symptomatic treatments was stated (from 1.4 to 3.9 at the end of the temporal window of analysis), and THC:CBD was prescribed in 88.9% of them. There was no correlation between number of symptoms at the beginning and number of symptomatic treatments at the end of the time-window. No correlation either was found between number of symptomatic treatments and physical disability.

Conclusions

SSP is relatively easy to be diagnosed in our consultancy and it should be more frequently stated as it will offer the opportunity to individual management of symptoms and treatments for our patients that could impact their quality of life in the long-term.

The new coronavirus disease 2019 (COVID-19) outbreak has rapidly spread throughout the world, becoming a serious public health problem. COVID-19, in addition to respiratory symptoms, has neurotropic characteristics that can impact the nervous system. We present a 22-year-old female who developed diplopia and numbness of her limbs eight days after affecting by COVID-19 and she showed a left-sided outward gaze palsy without any history of previous a specific illness or medication. Supratentorial, infratentorial, and cervical cord enhancing plaques confirmed an acute demyelinating process in favor of Acute disseminated encephalomyelitis (ADEM). Her oligoclonal bands (OCB) were positive as well. As a result, a provisional diagnosis of ADEM was made. Her condition improved dramatically after starting corticosteroids and rituximab.

Objective

To determine the relationship of perceived social support with clinical variables, the profile of activities of daily living and quality of life in patients diagnosed with myasthenia gravis living in Spain and Latin America.

Methods

Observational, cross-sectional study. Subjects diagnosed with myasthenia gravis were recruited from associations, foundations and social media in the first quarter of 2022. The Medical Outcomes Study (MOS-SSS), the Myasthenia gravis activities of daily living profile (MG-ADL) and the 15-item Myasthenia Gravis Quality of Life scale revised (MG-QOL15R-S) instruments were included.

Results

Mean time to diagnosis (t = 2,38; P < .05), history of thymoma (χ2 = 5.18; P < .05), MG-ADL global score (t = 4.29; P < .001), and MG-QOL15R-S global score (t = 7.67; P < .001) were related to perceived social support in MG subjects. We also found that MOS-SSS score correlated significantly with MG-ADL (r = −0.15; P < .001) and MG-QOL15R-S (r = −0.27; P < .001) scores.

Conclusions

A history of thymoma reduces the likelihood of high perceived social support, and diagnosis of the disease at less than two years has been associated with a higher frequency of high perceived social support. In addition, high perceived social support is expected to correlate with high quality of life and lower severity of myasthenia gravis symptoms.