Ensayo clínico con intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular / Clinical trial with educational intervention in perimenopausal women with cardiovascular risk factor

Objetivo: Evaluar si una intervención educativa en mujeres en edad perimenopáusica con diabetes mellitus, hipertensión o dislipidemia podría mejorar aspectos relacionados con la calidad de vida o el ejercicio físico. Métodos: Ensayo clínico aleatorizado. Variables: actividad física, calidad de vida y peso en mujeres de 45-60 años de edad (n = 320) en el momento 0 y 12 meses después de la intervención. Grupo de intervención: tres talleres interactivos sobre prevención de enfermedad cardiovascular. Grupo control: información por correo. Resultados: El grupo de intervención obtuvo mejores puntuaciones en el componente mental de la calidad de vida 1 año después (p <0,05) y mostró un aumento significativo de la actividad física (p <0,01). Las mujeres del grupo de intervención mantuvieron su peso, mientras que las del grupo control lo aumentaron (p <0,01). Conclusiones: Una sencilla intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular mejora aspectos relacionados con la calidad de vida y con hábitos saludables como la actividad física (AU)

Objective: To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. Methods: A randomized clinical trial. Variables: physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. Results: The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01). Conclusions: A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity (AU)

[Clinical trial with educational intervention in perimenopausal women with cardiovascular risk factor]. / Ensayo clínico con intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular.

OBJECTIVE: To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. METHODS: A randomized clinical trial. VARIABLES: physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. RESULTS: The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01). CONCLUSIONS: A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity.

Relationship between volume and survival in closed intensive care units is weak and apparent only in mechanically ventilated patients.

BACKGROUND: Recent studies have found an association between increased volume and increased intensive care unit (ICU) survival; however, this association might not hold true in ICUs with permanent intensivist coverage. Our objective was to determine whether ICU volume correlates with survival in the Spanish healthcare system. METHODS: Post hoc analysis of a prospective study of all patients admitted to 29 ICUs during 3 months. At ICU discharge, the authors recorded demographic variables, severity score, and specific ICU treatments. Follow-up variables included ICU readmission and hospital mortality. Statistics include logistic multivariate analyses for hospital mortality according to quartiles of volume of patients. RESULTS: The authors studied 4,001 patients with a mean predicted risk of death of 23% (range at hospital level: 14-46%). Observed hospital mortality was 19% (range at hospital level: 11-35%), resulting in a standardized mortality ratio of 0.81 (range: 0.5-1.3). Among the 1,923 patients needing mechanical ventilation, the predicted risk of death was 32% (14-60%) and observed hospital mortality was 30% (12-61%), resulting in a standardized mortality ratio of 0.96 (0.5-1.7). The authors found no correlation between standardized mortality ratio and ICU volume in the entire population or in mechanically ventilated patients. Only mechanically ventilated patients in very low-volume ICUs had slightly worse outcome. CONCLUSION: In the currently studied healthcare system characterized by 24/7 intensivist coverage, the authors found wide variability in outcome among ICUs even after adjusting for severity of illness but no relationship between ICU volume and outcome. Only mechanically ventilated patients in very low-volume centers had slightly worse outcomes.

¿Cuál es la técnica idónea para disminuir las complicaciones locales secundarias a la administración subcutánea de enoxaparina? Ensayo clínico aleatorizado / What is the ideal technique to reduce local complications secondary to subcutaneous enoxaparin administration? A randomized clinical trial

Objetivo. Conocer la efectividad de 4 técnicas de administración de enoxaparina subcutánea en relación con la incidencia de hematomas de pared abdominal secundarios a su administración. Método. Ensayo clínico con asignación aleatorizada sobre 300 pacientes consecutivos a los que se administró enoxaparina subcutánea, distribuidos en 4 grupos, definidos por la inclusión o no de las variables aspirado previo y fármaco precargado o cargado en el momento de la administración. Se realizó un seguimiento de 10 días, o el tiempo que duró el tratamiento en los casos en que éste fue menor. Cada día se observaron y midieron las lesiones abdominales existentes. Resultados. El 60,6% de los pacientes presentó lesiones. La media de equimosis resultó de 0,4 (DE = 0,74). El área media de hematomas fue de 11,11 cm2, con un máximo de 127,75 cm2. La aparición de equimosis fue significativamente menor en el grupo de precarga (p = 0,048). No se encontraron diferencias estadísticamente significativas entre los grupos en relación con los hematomas ni con el tipo de aspirado. La incidencia de hematomas fue mayor en mujeres (p < 0,01), en personas obesas (p < 0,01) y en mayores de 60 años (p < 0,05). Conclusiones. Se establece la disminución de lesiones con la utilización del fármaco en jeringas precargadas. No hay conclusiones en cuanto a la conveniencia o no de aspirado previo a la administración. Harán falta nuevos estudios para confirmarlo

Objective. To determine the effectiveness of four techniques for subcutaneous enoxaparin administration with regard to the incidence of abdominal wall hematomas secondary to administration. Method. We performed a randomized clinical trial in 300 consecutive patients who underwent subcutaneous enoxaparin administration, distributed in four groups, according to whether the syringe was aspirated or not before injection and whether the syringe was prefilled or filled at the moment of administration. The follow-up period was 10 days or for the duration of treatment when treatment was administered for less than 10 days. Abdominal lesions were observed and measured every day. Results. 60.6% of patients presented lesions. The mean ecchymosis was 0.4 (SD = 0.74). The mean area of hematomas was 11.11 cm2, with a maximum of 127.75 cm2. The development of ecchymosis was significantly lower in the prefilled group (p = 0.048). No statistically significant differences were found among groups in relation to hematomas or type of aspirate. The incidence of hematomas was greater in women (p < 0.01), obese patients (p < 0.01), and patients aged more than 60 years (p < 0.05). Conclusions. Fewer lesions were produced when a prefilled syringe was used. No conclusions can be drawn about the advisability of aspirating the syringe before injection. Further studies are required to determine the utility of aspiration