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Medicina Clinica Practica最新文献

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Valoración de la importancia de la confidencialidad y del manejo adecuado de la historia clínica en el servicio de urgencias hospitalarias 评估医院急诊部门保密和妥善管理病史的重要性
Q4 Medicine Pub Date : 2025-07-15 DOI: 10.1016/j.mcpsp.2025.100510
Amparo Ruiz Carbonell , Florencia Laffont Oscoz , Begoña Navarro Lluesma , Alexander Sammel , Ginés Gómez Úbeda , Miguel Ángel García García

Objective

Healthcare professionals sometimes forget their obligations regarding professional secrecy and confidentiality. Violating them is punishable by law. We carried out a study to evaluate the degree of knowledge about the use of secrecy and confidentiality of patients' medical information in the care practice of the professionals of the Hospital Emergency Service of a second level hospital.

Methods

An anonymous survey was designed with questions about daily activity in the Emergency Department related to confidentiality. They tried to evaluate, by all the professional groups involved in the care of patients in the Emergency Department, 4 aspects: the degree of workers' perception of confidentiality; knowledge in confidentiality and the desire to obtain that knowledge; the perception of unauthorized exchange or search for information; and the perception of physical means to safeguard privacy. The statistical tests chi-square, t-Student and ANOVA were used, with a level of statistical significance of p < 0.05.

Results

100 workers from all professional groups responded to the survey. Knowledge of confidentiality was adequate (69.25% of positive responses), and the perception of unauthorized information exchange and physical means to safeguard privacy were less good (55 and 55.9% of positive responses).

Conclusions

The management of confidentiality in the emergency department of our hospital has a large room for improvement.
医疗保健专业人员有时会忘记他们对职业保密和保密的义务。违反这些规定将受到法律的惩罚。我们开展了一项研究,以评估在护理实践中使用保密和病人的医疗信息保密专业人员的知识程度。方法设计了一项匿名调查,问卷内容涉及急诊科与保密相关的日常活动。他们试图评估,由所有专业团体参与护理的病人在急诊科,4个方面:工作人员的保密程度的感知;保密知识和获取该知识的愿望;未经授权交换或搜索信息的行为;而感知物理意味着保护隐私。统计学检验采用卡方检验、t-Student检验和方差分析,p <; 0.05。结果来自各行各业的100名员工参与了调查。对保密的了解是足够的(69.25%的积极回应),对未经授权的信息交换和保护隐私的物理手段的感知不太好(55%和55.9%的积极回应)。结论我院急诊科的保密管理工作有很大的改进空间。
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引用次数: 0
Predictors of mortality in individuals infected with dengue: An Indian case study 登革热感染个体死亡率的预测因素:一个印度案例研究
Q4 Medicine Pub Date : 2025-06-20 DOI: 10.1016/j.mcpsp.2025.100511
Parthraj Shenoy, Ashok Kumar Pannu, Atul Saroch, Sourabh S. Sharda, Mandeep Bhatia, Deba Parsad Dhibar

Background and objectives

Dengue infection and its associated complication contributes to a significant number of deaths as per World Health Organization (WHO) statistics. The aim of the study is to identify Predictors associated with mortality in Dengue infection.

Materials and methods

In this prospective observational study conducted at the tertiary care hospitals of north India from August 2023 to December 2024, confirmed cases of dengue fever with a duration of less than seven days were recruited. Patients classified into Survivors or non-survivors, variables that were found to have statistically significant associations on univariate analysis were subjected to multivariate analysis by logistic regression by enter method for predictors of dengue mortality.

Results

A total of 158 dengue patients were recruited of which 18 (11.4%) died from the disease. Altered mental status, dyspnea at rest, and decreased urine output were significantly more frequent among non-survivors. Regarding laboratory parameters, non-survivor group exhibited significantly elevated levels of total leukocyte count, urea, creatinine, liver enzymes and International normalized ratio. Application of logistic regression using 3 factors-qSOFA (quick sequential organ failure assessment), creatinine and ferritin were performed which showed a statistically significant association with creatinine and ferritin. Odd Ratio (OR) for creatinine 1.449 indicates that for every unit increase in creatinine, the odds of mortality increase by 44.9%. Although the OR is exactly 1, the tight CI around 1 suggests that elevated ferritin is associated with mortality, but with a small effect size (p – 0.047).

Conclusions

The presence of raised creatinine and elevated serum ferritin were predictors associated with a higher risk of mortality.
背景和目的根据世界卫生组织(WHO)的统计数据,登革热感染及其相关并发症是造成大量死亡的原因。该研究的目的是确定与登革热感染死亡率相关的预测因素。材料和方法这项前瞻性观察研究于2023年8月至2024年12月在印度北部三级医院进行,招募持续时间少于7天的登革热确诊病例。患者分为幸存者或非幸存者,在单变量分析中发现有统计学显著关联的变量,通过输入法对登革热死亡率预测因子进行logistic回归多变量分析。结果共纳入158例登革热患者,其中死亡18例(11.4%)。精神状态改变、休息时呼吸困难和尿量减少在非幸存者中更为常见。关于实验室参数,非幸存者组表现出明显升高的总白细胞计数、尿素、肌酐、肝酶和国际标准化比率。应用qsofa(快速顺序器官衰竭评估)、肌酐和铁蛋白3因素进行logistic回归分析,结果显示肌酐和铁蛋白的相关性有统计学意义。肌酐的奇数比(OR)为1.449,表明肌酐每增加一个单位,死亡率增加44.9%。虽然OR正好为1,但接近1的紧密CI表明铁蛋白升高与死亡率相关,但效应量较小(p - 0.047)。结论肌酐升高和血清铁蛋白升高是死亡率增高的预测因素。
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引用次数: 0
Pulmonary embolism presenting with syncope, complicated by fatal delayed acute subdural hemorrhage 肺栓塞表现为晕厥,并发致命的迟发性急性硬膜下出血
Q4 Medicine Pub Date : 2025-06-18 DOI: 10.1016/j.mcpsp.2025.100512
Guo Li , Mingming Yang , Bo Cheng , Peng Wang
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引用次数: 0
Linfangiectasia intestinal primaria y síndrome de uñas amarillas 原发性肠道淋巴管扩张和黄指甲综合征
Q4 Medicine Pub Date : 2025-06-02 DOI: 10.1016/j.mcpsp.2025.100509
Laura López Allúe , Alejandra Romano Medina , Estibaliz Obregón Martínez , María de África Juárez Martin
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引用次数: 0
Transbronchial cryobiopsy under real-time radial mini-probe 实时桡骨微型探针下经支气管冷冻活检
Q4 Medicine Pub Date : 2025-05-27 DOI: 10.1016/j.mcpsp.2025.100508
Juan José Cruz-Rueda , Francisco Javier Velasco-Albendea , María Jesús Gil-Belmonte
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引用次数: 0
Longitudinally extensive myelitis with complete spine cord involvement associated with systemic lupus erythematosus 系统性红斑狼疮伴完全性脊髓受累的纵向广泛脊髓炎
Q4 Medicine Pub Date : 2025-05-27 DOI: 10.1016/j.mcpsp.2025.100507
Alex Echeverri Garcia , Andres Agualimpia Janning , Camilo Romo Escorcia , Santiago Lopez Garcia
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引用次数: 0
Mediastinal air leak following intense exercise in a patient with uncontrolled asthma 不受控制的哮喘患者剧烈运动后纵隔空气泄漏
Q4 Medicine Pub Date : 2025-05-22 DOI: 10.1016/j.mcpsp.2025.100506
Martin Fullana , Romina Bustos , Cynthia Padilla
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引用次数: 0
Púrpura trombótica trombocitopénica: importancia del trabajo multidisciplinar 血小板减少性紫癜:多学科工作的重要性
Q4 Medicine Pub Date : 2025-05-10 DOI: 10.1016/j.mcpsp.2025.100505
Angel Orera , Ines Gomez Segui , Javier de la Rubia , Ricardo Gimeno
Thrombotic thrombocytopenic purpura (TTP) is a medical emergency with life-threatening complications. It presents itself as a diagnostic challenge, as it involves multiple organs affected by widespread microthrombosis that can rapidly cause severe ischemic impairment. Early recognition and treatment are crucial. Treatment includes prompt initiation of plasma exchange (PEX), immunosuppressive therapy, and caplacizumab, along with close monitoring of clinical signs, especially brain and cardiac function.
We present a case report with a witnessed cardiac arrest, in which the extracorporeal cardiopulmonary resuscitation (ECPR) protocol was performed, and the first dose of intra-arrest caplacizumab together with plasma infusion, were administered due to the suspected diagnosis of TTP. The first PEX session was done within the first three hours after cardiac arrest. Despite thrombocytopenia and anemia, the cannulation of the ECMO device was achieved in less than 40 min. The patient's evolution was favorable with minimal neurological sequelae and cardiac function recovery.
血栓性血小板减少性紫癜(TTP)是一种危及生命的急症并发症。它本身是一个诊断挑战,因为它涉及多器官受广泛的微血栓形成影响,可迅速引起严重的缺血性损伤。早期识别和治疗至关重要。治疗包括及时开始血浆置换(PEX)、免疫抑制治疗和卡帕单抗,同时密切监测临床体征,特别是脑和心脏功能。我们报告了一例心脏骤停的病例,其中进行了体外心肺复苏(ECPR)方案,并且由于疑似TTP的诊断,进行了第一剂量的停搏内卡普拉珠单抗和血浆输注。第一次PEX治疗是在心脏骤停后的三个小时内进行的。尽管有血小板减少和贫血,ECMO装置的插管在不到40 min内实现。患者进展良好,神经系统后遗症最小,心功能恢复。
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引用次数: 0
Conjunctival dermolipoma Conjunctival dermolipoma
Q4 Medicine Pub Date : 2025-05-03 DOI: 10.1016/j.mcpsp.2025.100504
Julio C. Salas-Alanís , Mauricio Salas-Garza , Isaac H. Sicsik-Arévalo , Lucía E. Varela-Martínez , María G. Moreno-Treviño , Gerardo Rivera-Silva
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引用次数: 0
Pulmonary cryptococcosis 肺隐球菌病
Q4 Medicine Pub Date : 2025-05-03 DOI: 10.1016/j.mcpsp.2025.100503
María G. Moreno-Treviño , Daniel A. Morales-Jácome , Mariana Cepeda-Lerma , Julio C. Salas-Alanís , Mauricio Salas-Garza , Ma. Guadalupe Treviño-Alanís , Gerardo Rivera-Silva
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引用次数: 0
期刊
Medicina Clinica Practica
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