Anales Del Sistema Sanitario De Navarra最新文献

Among the causes of acute surgical abdomen, infection of a urachal remnant may go unnoticed despite routine complementary studies. We present three cases in boys aged 11, 6, and 4 years who were brought to the emergency department for right iliac fossa pain, fever, and urinary symptoms. Examination and complementary tests results were compatible with acute complicated appendicitis and were sent to surgery. While in the operating room, appendicitis was excluded and inflammatory changes suggestive of infection of the urachal remnant were documented. Complications of urachal remnants should be considered in the differential diagnosis of acute surgical abdomen, since advanced infection of the urachus may be a cause of confusion. A more accurate presumptive diagnosis can change the therapeutic/surgical approach and follow-up.

Nodular fasciitis is a benign soft tissue lesion with rapid fibroblastic or myofibroblastic proliferation, rarely observed in pediatric patients. Here, we present the case of a seven-year-old boy with no relevant medical records, in whom an asymptomatic dorsal tumor was incidentally identified. Magnetic resonance imaging showed a left dorsal paravertebral lesion with hypointensity on T1, hyperintensity on T2, peripheral contrast enhancement, and the so-called fascial tail sign. Complete surgical resection of the lesion was achieved. The histopathological study showed a proliferation of spindle or stellate cells with nuclei without atypia in a myxoid or collagenized stroma. The immunohistochemical profile showed positivity for smooth muscle actin, muscle-specific actin antibody HHF35, and calponin. The lesion was diagnosed as nodular fasciitis, an entity with broad and complex differential diagnosis. Presence of specific radiological signs and adequate immunohistochemical characterization of the lesion help perform an accurate diagnosis.

The aim of this study was to determine the effectiveness of chlorhexidine use patients in adult intensive care units for preventing nosocomial infections. We carried out a systematic review of randomized clinical trials published over the past 10 years. We collected the following data: type of infection, mortality, isolated microorganisms, and multidrug-resistant microorganisms. In two out of the five studies included in the review, bathing with chlorhexidine was ineffective due to low cross-infection rates at baseline and Gram-negative bacteria being the most prevalent type of microorganism, against which chlorhexidine is not as effective. No decline in death rates was either observed. Chlorhexidine bathing was mainly effective in preventing bloodstream infections and those caused by Gram-positive bacteria. Thus, its use may be effective in intensive care units with high prevalence of infections by this type of microorganisms.

We aimed to assess the efficacy of different therapeutic exercise modalities in cardiac rehabilitation after acute myocardial infarction. A search of randomized controlled studies published between 2016 and 2021 in Scopus, PubMed, CINAHL, Web of Science and Cochrane Library was carried out using the MeSH terms "exercise therapy" and "myocardial infarction". Ten articles met the inclusion criteria; in these studies, the used exercises were combined or traditional programs that included relaxation training, and were performed either at home or at the hospital. We examined exercise tolerance, cardiovascular parameters, anthropometric measurements, and quality of life. Significant improvements in the assessed variables were observed in most studies. We conclude that all studied therapeutic exercise modalities are useful in cardiac rehabilitation after myocardial infarction, although the best outcomes are seen for combined therapeutic exercise programs.

Background: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context.

Methods: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed.

Results: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence. Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (>0.90).

Conclusions: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.

Paraneoplastic syndromes are a group of tumor-related symptoms not directly attributable to tumors or metastasis. Symptoms are caused by secretion of substances by the tumor or the production of antibodies from immune cross-reactivity between tumor and normal tissues. Among hematological paraneoplastic syndromes, cancer-associated hemolytic anemias associated are rare, particularly in solid tumors. We present the case of a patient with localized bladder (high-grade infiltrating papillary carcinoma pT1) and prostate (Gleason 7) cancer who developed warm antibody autoimmune hemolytic anemia during radiation therapy for prostate cancer. It was resolved with prednisone (1 mg/Kg/day, tapering schedule). To the best of our knowledge, this is the first time an autoimmune hemolytic anemia is described in the literature as a paraneoplastic syndrome in such early stages of tumor disease.

Background: Health care personnel providing direct care to COVID-19 patients may perceive high mental load. In this study, we aimed to determine the mental workload perceived by the workers during the COVID-19 pandemic and its relationship with different variables.

Methods: Cross-sectional study carried out in Chile that included 411 health care professionals. The following data were collected by means of an on-line questionnaire: sociodemographic, work-related, health, and psychological mediators and perception of the organizational conditions. The Subjective Mental Workload Scale (SCAM) -a 1 to 5 rating instrument- was applied. Scores >3 indicated high perceived mental load. We determined the independent predictors of perceived high mental load.

Results: Health care workers perceived medium-high mental load, 3.69 (IQR = 3.35-4.05); 78.4% of these professionals perceived high mental load. Several variables, mainly related to the organizational conditions of their job, acted as independent predictors for high mental load: being a nurse, having been in the job <6 years, had been working in hospital care, had had symptoms of stress and inadequate sleep, having a low perception regarding access to personal protection equipment and psychological support at their work site.

Conclusion: In the context of the COVID-19 pandemic, health care workers perceive high mental burden, mainly associated to the organizational conditions of their job.