Cumplimiento de las recomendaciones de la guía clínica ministerial para diabetes mellitus tipo 1 en un centro de nivel secundario / Compliance with the recommendations of the ministerial guideline for type 1 diabetes mellitus in a center of secondary level

Introduction: diabetes mellitus type 1 (DM1) is incorporated into the Law of Universal Access with Explicit Guarantees (AUGE) and the Ministry of Health issued a clinical guideline. There is an association between compliance with clinical guidelines and health outcomes. Metabolic control reduces the risk of vascular complications. Objective: To describe the implementation of the guidelines for DM1 AUGE 2013, in patients treated in the endocrinological adult polyclinic hospital Carlos Van Buren. Methods: observational, descriptive and cross-sectional study. A simple random sampling was performed. A sample size of 139 patients was calculated. Quality indicators was drawn up to determine compliance with the recommendations. Quantitative variables were described with median and interquartile range (IQR), and qualitative, with absolute frequency and percentages. Results: Age had a median of 30 years (interquartile range 22 to 42 years). The time since diagnosis had a median of 14 years (interquartile range of 9-22 years). 61 patients were female (43.9 percent) sex. The recommendation was greater proportion of compliance scheme using intensified insulin (89.9 percent). Conducting an annual foot exam showed the lowest compliance (3.6 percent). Discussion: There are no similar studies on these guidelines. It is concerned about the low implementation of the recommendations, especially therapeutic goals. Among the limitations is the quality of the registration system and the systematic omission of variables. It is necessary to determine the cause of low compliance with recommendations for action.

Solución de morfina mas lidocaína peridural en el dolor crónico neoplásico, manejo médico y de enfermería: informe preliminar / Morphine solution and peridural lidocaine in chronic neoplasic pain, medical and nursery management: preliminary report

Generalmente al paciente portador de dolor crónico neoplásico (DCN) se deja morir en paz, la realidad es que lo hace con gran sufrimiento. Este informe preliminar evaluó el rendimiento como analgésico de una solución de morfina más lidocaína a través de un catéter peridural en forma permanente en 36 pacientes portadores de DCN. En 94,5 per cent se logró analgesia, todos presentaron a lo menos una reacción adversa a medicamento (RAM) que fué de fácil manejo domiciliario, las mínimas complicaciones del catéter y el bajo costo, hacen de esta técnica una excelente indicación para el tratamiento del DCN