Positional End-Point Nystagmus in Patients with Diagnosis of Acute Unilateral Vestibulopathy.

INTRODUCTION: Recently, end-point nystagmus, traditionally observed in an upright position, has been identified in the Dix-Hallpike position among healthy subjects, suggesting a physiological origin.However, its characteristics in individuals with vestibular hypofunction remain unexplored. OBJECTIVE: To elucidate the impact of vestibular hypofunction on the characteristics of positional end-point nystagmus. METHODS: Thirty-one patients diagnosed with acute unilateral vestibulopathy according to Bárány Society criteria were selected. A video head impulse test was conducted in all participants, followed by McClure and Dix-Hallpike maneuvers with and without gaze fixation, and with the initial position of the eye in the straight-ahead position or in the horizontal end-point position. Nystagmus direction, sense, latency, slow-phase velocity, and duration were recorded. The relationship between these characteristics and video head impulse test values was analyzed. RESULTS: Positional end-point nystagmus was observed in 92.6% of subjects with vestibular hypofunction, significantly more than in healthy individuals. Nystagmus direction varied depending on the performed positional test and on the vestibulo-ocular reflex gains. Gaze occlusion and the initial horizontal end-point position increased its frequency. CONCLUSION: Vestibular hypofunction influences the manifestation of positional end-point nystagmus. Recognizing this nystagmus can aid in resolving diagnostic uncertainties and preventing the misdiagnosis of benign paroxysmal positional vertigo in subjects with acute unilateral vestibulopathy.

Traqueotomía versus traqueostomía, la necesidad de una aclaración lexicográfica / Tracheotomy versus tracheostomy, the need for lexicographical clarification

Con frecuencia se usan en el ámbito sanitario los términos traqueotomía y traqueostomía, pudiendo generar dudas entre los propios profesionales sobre qué definición corresponde a cada término o cuál de ellos debe considerarse más correcto en casos concretos. Se ha realizado una búsqueda de los términos «traqueotomía» y «traqueostomía» en los diccionarios generalistas en idioma español del Diccionario de la Real Academia Española (DRAE) y del Diccionario Histórico de la Lengua Española de la Real Academia Española (DHLE), y de los términos en inglés «tracheotomy» y «tracheostomy» en los diccionarios generalistas en idioma inglés del Oxford Dictionary, del Cambridge Dictionary y del Collins English Dictionary. Asimismo, se ha hecho una búsqueda en los diccionarios de términos médicos en español del Diccionario de Términos Médicos de la Real Academia Nacional de Medicina (DTM) y en inglés del Farlex Dictionary. Los términos se buscaron también en el buscador generalista de Internet Google®. Se analizaron las definiciones desde el punto de vista lexicográfico y etimológico. Las definiciones que aparecen en los diccionarios generalistas, tanto en español como en inglés, son imprecisas, limitadas y adolecen de ambigüedad por mezclar indicaciones desactualizadas con criterios alejados de la etimología. Sin embargo, las definiciones en los diccionarios de términos médicos en ambos idiomas están más ajustadas a la etimología. La traqueotomía identifica estrictamente el procedimiento quirúrgico de realización de una apertura en la cara anterior de la tráquea. La traqueostomía identifica la realización de un orificio que comunica la tráquea con el exterior e implica una modificación del tracto aéreo superior al proporcionar una entrada adicional de la vía respiratoria. Solo en las laringectomías totales la traqueostomía es la única vía de entrada al tracto aéreo. Ambos términos pueden utilizarse sinónimamente cuando una traqueotomía culmina con una traqueostomía. No convendrá utilizar el término traqueostomía cuando se produce el cierre de los planos al final del procedimiento y este no resulta en la creación de un estoma. Los traqueostomas pueden ser cualificados con adjetivos de tiempo de permanencia (temporal/permanente), tamaño (grande/pequeño), forma (redondo/elíptico), o profundidad por sí mismos, sin vincularse a ningún tipo de enfermedad o de indicación quirúrgica. No todos los traqueostomas permanentes tienen lugar en laringectomías totales ni tienen sistemáticamente un carácter irreversible.(AU)

In the healthcare field, the terms “traqueotomía” and “traqueostomía” are frequently used, often leading to confusion among professionals regarding the appropriate definition for each term or which one should be considered more correct in specific cases. A search was conducted for the terms “traqueotomía” and “traqueostomía” in general Spanish-language dictionaries such as the Dictionary of the Royal Spanish Academy (DRAE) and the Historical Dictionary of the Spanish Language of the Royal Spanish Academy (DHLE), as well as for the English terms “tracheotomy” and “tracheostomy” in English general dictionaries like the Oxford Dictionary, the Cambridge Dictionary, and the Collins English Dictionary. Additionally, searches were performed in medical dictionaries in both Spanish, specifically the Dictionary of Medical Terms of the National Academy of Medicine (DTM), and English, including the Farlex Dictionary. The terms were also explored using the Google search engine. Definitions were analyzed from both lexicographical and etymological perspectives. Definitions found in general dictionaries, in both Spanish and English, were found to be imprecise, limited, and ambiguous, as they mixed outdated indications with criteria that deviated from etymology. In contrast, definitions in medical dictionaries in both languages were more aligned with etymology. “Traqueotomía” strictly identifies the surgical procedure of creating an opening in the anterior face of the trachea. “Traqueostomía” identifies the creation of an opening that connects the trachea to the exterior, involving a modification of the upper airway by providing an additional entry for the respiratory pathway. “Traqueostomía” becomes the sole means of entry to the airway in total laryngectomies. Both terms can be used synonymously when a traqueotomía culminates in a traqueostomía. However, it is not appropriate to use the term “traqueostomía” when the procedure concludes with the closure of the planes and does not result in the creation of a stoma. Traqueostomas can be qualified with adjectives indicating permanence (temporary/permanent), size (large/small), shape (round/elliptical), or depth, without being linked to any specific disease or surgical indication. Not all permanent traqueostomas are the result of total laryngectomies, and they do not necessarily have an irreversible character systematically.(AU)

Tracheotomy versus tracheostomy, the need for lexicographical clarification.

In the healthcare field, the terms "traqueotomía" and "traqueostomía" are frequently used, often leading to confusion among professionals regarding the appropriate definition for each term or which one should be considered more correct in specific cases. A search was conducted for the terms "traqueotomía" and "traqueostomía" in general Spanish-language dictionaries such as the Dictionary of the Royal Spanish Academy (DRAE) and the Historical Dictionary of the Spanish Language of the Royal Spanish Academy (DHLE), as well as for the English terms "tracheotomy" and "tracheostomy" in English general dictionaries like the Oxford Dictionary, the Cambridge Dictionary, and the Collins English Dictionary. Additionally, searches were performed in medical dictionaries in both Spanish, specifically the Dictionary of Medical Terms of the National Academy of Medicine (DTM), and English, including the Farlex Dictionary. The terms were also explored using the Google search engine. Definitions were analyzed from both lexicographical and etymological perspectives. Definitions found in general dictionaries, in both Spanish and English, were found to be imprecise, limited, and ambiguous, as they mixed outdated indications with criteria that deviated from etymology. In contrast, definitions in medical dictionaries in both languages were more aligned with etymology. "Traqueotomía" strictly identifies the surgical procedure of creating an opening in the anterior face of the trachea. "Traqueostomía" identifies the creation of an opening that connects the trachea to the exterior, involving a modification of the upper airway by providing an additional entry for the respiratory pathway. "Traqueostomía" becomes the sole means of entry to the airway in total laryngectomies. Both terms can be used synonymously when a traqueotomía culminates in a traqueostomía. However, it is not appropriate to use the term "traqueostomía" when the procedure concludes with the closure of the planes and does not result in the creation of a stoma. Traqueostomas can be qualified with adjectives indicating permanence (temporary/permanent), size (large/small), shape (round/elliptical), or depth, without being linked to any specific disease or surgical indication. Not all permanent traqueostomas are the result of total laryngectomies, and they do not necessarily have an irreversible character systematically.

Calidad asistencial percibida por los padres en una Unidad de Preescolares y Hemato-Oncología Pediátrica / Quality of care perceived by parents in an infant and Paediatric Hemato-Oncological Unit

Objetivo: Evaluar la calidad asistencial prestada en la Unidad de Preescolares y Hemato-Oncología pediátrica del Hospital Virgen Macarena, desde la perspectiva de los padres, y conocer su satisfacción con los cuidados de enfermería. Metodología: Estudio descriptivo transversal. Mediante un muestreo aleatorio sistemático se seleccionaron 138 padres. Se utilizó una encuesta que constaba de: registro de variables sociodemográficas y clínicas, 44 ítems que medían las dimensiones de calidad del modelo SERVQUAL, y un ítem para la satisfacción con los cuidados de enfermería. Se realizó un análisis descriptivo de las variables y, para determinar la relación entre la satisfacción y las dimensiones del modelo SERVQUAL se hallaron los coeficientes de correlación de Pearson, para un valor de p< 0,01. Se utilizó el programa SPSS 12.0. Resultados: En una escala del 0 al 4, las dimensiones de calidad del modelo SERVQUAL obtuvieron, las siguientes puntuaciones: seguridad 2,44 (DT=.43), empatía 2,49 (DT=.45), fiabilidad 3,43 (DT=.58), capacidad de respuesta 2,57 (DT= .45), y tangibilidad 2,63 (DT=.26). La satisfacción con los cuidados de enfermería, en una escala de 1 a 10, obtiene una media de 8,51 (DT= 1.31). Además, se hallaron relaciones estadísticamente significativas entre la variable satisfacción y todas las dimensiones de calidad del modelo SERVQUAL. Conclusiones: Los padres presentaron altos niveles de satisfacción con los cuidados de enfermería destacando la humanidad, amabilidad en el trato, y la preparación de los profesionales. La información fue adecuada desde el ingreso al alta. No obstante, son necesarias modificaciones en el mobiliario para hacerles más confortable la estancia (AU)

Objective: To evaluate the quality of care given in the Infant and Hemato-Oncological Unit at Virgen Macarena Hospital, from parents' perspective, and to know their satisfaction with nursing care. Methods: Descriptive transversal study. By means of a systematic random sample, 138 parents were selected. An inquiry was used. It consisted on: a registry of sociodemographic and clinic variables, 44 items to measure SERVQUAL model quality dimensions, and one item to measure satisfaction with nursing care. A descriptive analysis of all the variables in study was done, and to determine the relation between the variable satisfaction and SERVQUAL model dimensions, Pearson's correlations coefficient was calculated, for a value of p<0,01. SPSS 12.0 program was used. Results: Within a scale from 0 to 4, SERVQUAL model dimensions obtained the following scores: security 2.44 (DT=.43), empathy 2.49 (DT=.45), assurance 3.43 (DT=.58), responsiveness 2.57 (DT=.45), and tangibles 2.63 (DT=.26). Satisfaction with nursing care, within a scale form 1 to 10, it obtained a mean of 8.51 (DT=1.31). Also, statistical differences were found between the variable satisfaction and all SERVQUAL model dimensions. Conclusions: Parents had high levels of satisfaction with nursing care, highlighting nurses' humanity, kindness, and professional qualification. Information was appropriated from admittance to hospital discharge. Nevertheless, some modifications in furniture are necessary, in order to make parents' stay more comfortable (AU)

Evaluación de la Calidad de Vida tras el tratamiento primario del cáncer de mama / Evaluation of the quality of life after the end of breast cancer primary treatment

Objetivo: Evaluar la Calidad de Vida (CV) de las pacientes intervenidas de cáncer de mama tras finalizar el tratamiento primario. Diseño: Estudio descriptivo transversal. Participantes: 71 pacientes, seleccionadas mediante un muestreo consecutivo. Instrumentos: Registro de datos sociodemográficos, y la versión española del cuestionario SF-36. Análisis de los datos: Mediante el programa SPSS 14.0, se realizó un análisis descriptivo de las variables, y la prueba de ANOVA (p<.05) para determinar el impacto del tipo de cirugía y del tratamiento en la CV posterior. Resultados: Las pacientes tenían una edad media de 52,86 años (DT=11,076), tenían 2,46 hijos (DT=1,264), y estaban casadas un 56,3%. El 69,1% eran amas de casa, y tenían estudios primarios el 48,6%. Al 70,4% se le había practicado una mastectomía conjuntamente con linfadenectomía, y habían recibido quimioterapia asociada a radioterapia el 42,3%. Las áreas de salud más perjudicadas fueron el rol emocional y la vitalidad. El tipo de cirugía estaba relacionada con el dolor corporal (F= 3,546) y la función social (F= 2,806), mientras que el tipo de tratamiento está relacionado con el rol físico (F= 2,254). Conclusiones: El tratamiento primario del cáncer de mama continúa incapacitando a las pacientes, entre seis y nueve meses después de haberlo finalizado. El dolor, y los efectos secundarios del tratamiento, dificulta que las pacientes continúen desarrollando con normalidad sus actividades. Por otra parte, su nueva realidad las afecta en las áreas del rol emocional y la vitalidad (AU)

Aims: To evaluate the Quality of Life (QoL) of patients submitted to breast cancer surgery, after the end of the primary treatment. Design: A descriptive transversal study. Participants: 71 patients, selected by a consecutive sampling. Instruments: Inventory of sociodemographic data, and the Spanish version of SF-36 questionnaire. Data Analysis: A descriptive analysis of every variable was made with the SPSS program, version 14.0. Also, to determine the impact of the types of surgery and treatment on the next QoL, ANOVA test was completed (p<.05). Results: Patients had a mean age of 52,86 years (DT=11,076), and 2,46 sons (DT=1,264). Also, a 56,3%. were married, the 69,1% were housekeepers, and had elementary studies the 48,6%. A 70,4% of patients had been submitted to mastectomy jointly lymphadenectomy, and the 42,3% had received chemotherapy associate with radiotherapy. The poorer health areas were the emotional rol, and vitality. The type of surgery was related to bodily pain (F= 3,546) and social functioning (F= 2,806), whereas the type of treatment was associated with the physical rol (F= 2,254). Conclusions: The primary treatment of breast cancer keeps incapacitating patients, around six to nine months after having finished it. Pain, and the secondary effects of treatment difficult patients to continue developing their activities normally. On the other hand, patients' new reality affects their health areas of emotional rol and vitality (AU)

[Experiences of the caregivers of cardioverter defibrillator recipients during admission to the Virgin Macarena Hospital and after discharge]. / Experiencias de cuidadores principales de pacientes portadores de un desfibrilador durante el ingreso en el Hospital Virgen Macarena y tras el alta.

OBJECTIVE: To determine the needs of the main caregivers of implantable cardioverter defibrillator (ICD) recipients during admission to the Coronary Unit of the Virgin Macarena Hospital and after discharge. METHOD: A qualitative descriptive study was performed. Semi-structured and open interviews were carried out. Content analysis of the interviews was performed following Giorgi's method (1997). RESULTS: Twelve subjects participated. Notable findings during the hospitalization phase were poor communication between caregivers and nurses, the lack of caregivers' participation in providing care, and their difficulties to assimilate the information about ICD therapy. After hospital discharge, the first days at home were marked by fear and the need to overprotect the patient. Subsequent monitoring at the heart rhythm unit improved the process of adjustment to the new situation and confidence in the ICD. CONCLUSIONS: Families' needs for information and emotional support should be included in patients' care plans. Moreover, nurses should participate in the process of providing information about ICDs and their possible complications. This would allow personalized information to be progressively given and would help in preparation for discharge and adjustment to the new situation. The length of visiting hours should be modified according to the patient's and family's circumstances. Strategies aimed at improving communication between nurses and caregivers should be introduced.

Experiencias de cuidadores principales de pacientes portadores de un desfibrilador durante el ingreso en el Hospital Virgen Macarena y tras el alta / Experiences of the caregivers of cardioverter defibrillator recipients during admission to the Virgin Macarena Hospital and after discharge

Objetivo. Conocer las necesidades de los cuidadores principales de los pacientes portadores de un desfibrilador automático implantable (DAI) durante el ingreso en la Unidad Coronaria del Hospital Virgen Macarena y tras el alta hospitalaria. Método. Estudio cualitativo descriptivo. Se realizó mediante entrevistas semiestructuradas y abiertas. El análisis de contenido de las entrevistas se realizó siguiendo el método de Giorgi (1997). Resultados. Participaron 12 sujetos. Durante la hospitalización destacó la escasa comunicación entre los cuidadores principales y los profesionales de enfermería, su falta de participación en los cuidados y sus dificultades para asimilar la información acerca del DAI. Tras el alta, el miedo y la necesidad de sobreproteger al paciente marcaron los primeros días. El posterior seguimiento en la unidad de ritmo facilitó el proceso de adaptación y la confianza en el DAI. Conclusiones. Sería necesario incluir en la planificación de cuidados al paciente la atención a las necesidades de información y apoyo emocional de los familiares, y que los profesionales de enfermería participasen en el proceso de transmitir la información acerca del DAI y sus posibles complicaciones. Ello permitiría una información progresiva y personalizada, con el fin de preparar el alta y facilitar el ajuste a la nueva situación. Se debería modificar la duración de los horarios de visitas en función de las circunstancias de cada paciente y su familia. Sería necesario poner en marcha estrategias que favorezcan la comunicación entre los cuidadores y los profesionales de enfermería

Objective. To determine the needs of the main caregivers of implantable cardioverter defibrillator (ICD) recipients during admission to the Coronary Unit of the Virgin Macarena Hospital and after discharge. Method. A qualitative descriptive study was performed. Semi-structured and open interviews were carried out. Content analysis of the interviews was performed following Giorgi's method (1997). Results. Twelve subjects participated. Notable findings during the hospitalization phase were poor communication between caregivers and nurses, the lack of caregivers' participation in providing care, and their difficulties to assimilate the information about ICD therapy. After hospital discharge, the first days at home were marked by fear and the need to overprotect the patient. Subsequent monitoring at the heart rhythm unit improved the process of adjustment to the new situation and confidence in the ICD. Conclusions. Families' needs for information and emotional support should be included in patients' care plans. Moreover, nurses should participate in the process of providing information about ICDs and their possible complications. This would allow personalized information to be progressively given and would help in preparation for discharge and adjustment to the new situation. The length of visiting hours should be modified according to the patient's and family's circumstances. Strategies aimed at improving communication between nurses and caregivers should be introduced

Evaluación de la calidad asistencial y posterior ajuste a la nueva situación tras el implante de un desfibrilador en pacientes ingresados en la Unidad Coronaria del Hospital Virgen Macarena (Sevilla) / Evaluation of the quality of care in implantable cardioverter defibrillator recipients and their adjustment to this therapy in the Coronary Unit of the Hospital Virgen Macarena (Sevilla)

Objetivos. Evaluar la calidad asistencial de enfermería percibida por las personas receptoras de un desfibrilador automático implantable (DAI) ingresadas en la Unidad Coronaria del Hospital Virgen Macarena, e identificar los principales problemas y necesidades que tienen tras el alta, al objeto de mejorar la práctica clínica de enfermería y el proceso de ajuste a la nueva situación. Método. Estudio cualitativo. A 10 sujetos se les realizaron entrevistas semiestructuradas, cuyo guión incluía las dimensiones del modelo SERVQUAL para evaluar la calidad asistencial, y abiertas, para explorar el proceso de ajuste a la nueva situación. Para el análisis de contenido de las transcripciones aplicamos el método de Giorgi (1997). Resultados. Las dimensiones de calidad asistencial mejor valoradas fueron la capacidad de respuesta de enfermería a las necesidades que presentan en el ingreso hospitalario y la empatía. En contraste, algunos aspectos de la tangibilidad relacionados con las visitas de los familiares son los que obtienen una evaluación más negativa. Tras el alta, los pacientes expresaron limitaciones derivadas de cambios físicos, psicológicos y sociales. Estos resultados corroboran los obtenidos en otros estudios que señalan las dificultades en el ajuste a la nueva situación. Conclusiones. Es preciso introducir medidas de mejora durante la hospitalización encaminadas a corregir las deficiencias observadas en la dimensión de tangibilidad y a facilitar la adaptación a la nueva situación. Sería necesario planificar el alta progresivamente durante la hospitalización para paliar el miedo y desconocimiento que genera en los pacientes el readaptar los estilos de vida a la terapia con el DAI

Objectives. To evaluate the quality of nursing care perceived by patients receiving implantable cardioverter defibrillators (ICD) hospitalized in the Coronary Unit of the Hospital Virgin Macarena (Sevilla) and to identify the main problems and needs of these patients after discharge in order to improve clinical nursing practice and patients' adjustment to ICD therapy. Method. A qualitative study was performed. In 10 patients, semi-structured interviews that included the dimensions of the SERVQUAL model were used to evaluate the quality of care, while open interviews were used to explore the process of adjusting to ICD therapy. Content analysis of the transcripts was performed following Giorgi's (1997) method. Results. The quality dimensions receiving the highest rating were nurses' responsiveness to patients' needs on admission and empathy. By contrast, some aspects of tangibility related to family visits received the lowest rating. After hospital discharge, patients reported that they experienced limitations as a consequence of physical, psychological and social changes. These findings corroborate those of other studies that highlight patients' difficulties in adjusting to ICD therapy. Conclusions. Measures aimed at correcting the deficiencies found in the dimension of tangibility and facilitating adaptation to the implantation of ICD should be introduced. During hospitalization, patients should be progressively prepared for discharge to alleviate the fear and lack of knowledge about lifestyle changes required after ICD implantation