Estado epiléptico convulsivo en adultos atendidos en el Instituto Nacional de Ciencias Neurológicas de Lima, Perú 2011-2013. / Convulsive status epilepticus in adults attending the Instituto Nacional de Ciencias Neurológicas in Lima, Perú 2011-2013.

Objetivos: describir las características clínicas y la evolución del estado epiléptico convulsivo (EEC) en pacientes adultos admitidos en el Servicio de Emergencia del Instituto Nacional de Ciencias Neurológicas de Lima, Perú entre los años 2011 y 2013. Métodos: Se realizó un estudio prospectivo de serie de casos. Resultados: Se incluyeron 28 pacientes mayores de 17 años, la mediana de edad fue 31 años. El 57% fueron hombres y el 89% tenían antecedentes de epilepsia. La principal causa del EEC fue el incumplimiento de la medicación antiepiléptica (54%). El diazepam seguido de la fenitoína fue el tratamiento antiepiléptico más empleado (75%) y la frecuencia de EEC refractario fue del 4%. Conclusiones: los pacientes fueron mayoritariamente varones, adultos jóvenes, con antecedentes de epilepsia que presentaron un EEC debido el incumplimiento de la medicación antiepiléptica y respondieron favorablemente al tratamiento con diazepam seguido de fenitoína.

Objectives: to describe the characteristics features and outcome of convulsive status epilepticus (CSE) in adult patients admitted to the Emergency Department at the Instituto Nacional de Ciencias Neurológicas in Lima, Peru between 2011 and 2013. Methods: a prospective study was conducted. Results: twenty-eight patients older than 17 years were included, the median age was 31 years old. 57% were male and 89% had a history of epilepsy. Main cause of CSE was antiepileptic medication noncompliance (54%). Diazepam followed by phenytoin was the most used therapeutic regimen (75%) and the frequency of refractory CSE was 4%. Conclusion: patients were mostly male, young adults with a history of epilepsy who presented a CSE caused by the antiepileptic medication noncompliance and the response to treatment based on diazepam followed by phenytoin was positive.

The impact of an emergency hiring plan on the shortage and distribution of nurses in Kenya: the importance of information systems

Objective:To analyse the effect of Kenya's Emergency Hiring Plan for nurses on their inequitable distribution in rural and underserved areas.Methods We used data from the Kenya Health Workforce Informatics System on the nursing workforce to determine the effect of the Emergency Hiring Plan on nurse shortages and maldistribution. The total number of nurses; the number of nurses per 100 000 population and the opening of previously closed or new heath facilities were recorded. Findings Of the 18 181 nurses employed in Kenya's public sector in 2009; 1836 (10) had been recruited since 2005 through the Emergency Hiring Plan. Nursing staff increased by 7in hospitals; 13in health centres and 15in dispensaries. North Eastern province; which includes some of the most remote areas; benefited most: the number of nurses per 100 000 population increased by 37. The next greatest increase was in Nyanza province; which has the highest prevalence of HIV infection in Kenya. Emergency Hiring Plan nurses enabled the number of functioning public health facilities to increase by 29. By February 2010; 94 of the nurses hired under pre-recruitment absorption agreements had entered the civil service.Conclusion The Emergency Hiring Plan for nurses significantly increased health services in Kenya's rural and underserved areas over the short term. Preliminary indicators of sustainability are promising; as most nurses hired are now civil servants. However; continued monitoring will be necessary over the long term to evaluate future nurse retention. The accurate workforce data provided by the Kenya Health Workforce Informatics System were essential for evaluating the effect of the Emergency Hiring Plan