ABSTRACT
INTRODUCTION: Patients with stroke are at risk of developing non-neurological in-hospital complications (NNIHC) during hospitalization. The NIHSS is a scale used and validated to determine stroke severity, treatment, and prognosis. We evaluated the relationship between the NIHSS score obtained on admission and the development of NNIHC during hospital stay. METHODS: Observational study of prospective cohorts. Patients admitted consecutively for stroke, to an intermediate care ward, in Argentina between 08/01/2017 and 02/29/20 were included. The patients were divided into Group1 (with NNIHC) and Group2 (without NNIHC). RESULTS: The final n consisted of 78 individuals, 41% women. When comparing the means of the NIHSS score, differences were observed between the groups in the development of NNIHC in general (P=.050) and in the following specific complications: dysphagia (P=.014), aspiration pneumonia (P=.006), in-hospital pneumonia (P=.010) and intrahospital urinary infection (P=.004). The cut-off point of 10.5 presented the best predictive performance of NNIHC (AUC=.706; P=.016). CONCLUSIONS: An NIHSS value ≥10.5 was related to the development of NNIHC in patients admitted for stroke.
Subject(s)
Brain Ischemia , Deglutition Disorders , Nervous System Diseases , Stroke , Deglutition Disorders/diagnosis , Deglutition Disorders/etiology , Female , Hospitals , Humans , Male , Predictive Value of Tests , Prospective Studies , Severity of Illness Index , Stroke/complications , Stroke/diagnosisABSTRACT
Objetivos: Describir la prevalencia de eventos de agresión laboral contra médicos en la ciudad de Rosario y alrededores ocurridos en el último año. Determinar las características de los hechos de violencia y analizar la relación entrelos mismos y las características de la población médica.Materiales y Métodos: Estudio observacional, descriptivo y analítico, prospectivo; elaborado a partir de encuestascerradas on-line, realizadas de manera consecutiva a médicos que ejercieran en Rosario, Villa Gobernador Gálvez yGranadero Baigorria; del 18/07/2017 al 24/07/2017. Muestreo de tipo consecutivo, probabilístico, aleatorio simple. Se calculó un tamaño muestra de 350 encuestas.Resultados: Se incluyeron 351 encuestas. Hombres en 33% (n=115) y mujeres en 67% (n=236). El 23,1% (n=81)pertenecía al medio privado; 35% (n=123) al público; 41,6% (n=146) ambos y 0,3% (n=1) NS/NC. El 80,1%(n=281) presentó un episodio de agresión en el último año, de los cuales 86,8% (n=244) fue verbal y 13,2%(n=37) física-verbal. La agresión, pudiendo identificarse más de un agresor, fue realizada por familiar del pacienteen 94%(n=237), paciente 66% (n=166), personal de salud no médico 33% (n=83) y 26% (n=67) por un colega.El sitio de agresión más frecuente fue la guardia externa. Las mujeres padecieron mayor cantidad de eventos deagresión. Las especialidades más agredidas fueron Obstetricia y Pediatría. Se identificaron como factores de riesgo:sexo femenino (p=0,01; OR=2; IC95%=1,1-3,4), ejercicio profesional en guardia externa (p<0,0001; OR=3,2;IC95%=1,8-5,8) y la especialidad pediatría (p=0,016; OR=1,2; IC95%=1,2-1,3)... (AU)
Purposes: Estimation of the prevalence of aggression events against physicians in the workplace in the city of Rosario and environmentsin last year. Description of the violence events and how they are related with the medical population characteristics.Materials and methods: This is an observational, descriptive and analytic, prospective research. Performed withphysicians working in Rosario, Villa Gobernador Gálvez and Granadero Baigorria cities, Santa Fe, Argentina in base ofclosed on line surveys in a consecutive way. The evaluation included the period from July 18th to July 24th, 2017. Thesample was consecutive, probabilistic and simply randomized. The calculated sample size was 350 surveys.Results: 351 surveys were included, 33% males (n=115) and 67% females (n=236). 23% (n=81) from privateinstitutions, 35% (n=236) public ones, 41,6% both (n=146) both and unknown / unanswered 0,3% (n=1). 80%(n=281) presented an episode of aggression in the previous year, of which 86% (n=244) was verbal and 13,2% (n=37)physical and verbal. The aggression was performed by a patient`s relative in 94% (n=237), the patient in 66% (n=166),non-medical health personnel 33% (n=83) and 26% (n=67) by a colleague. The most frequent place of aggression wasemergency room. The women suffered a higher frequency of aggression. Obstetrics and pediatrics were the specialties moreinvolved. The risk factors were: female sex (p=0.01; OR=2; CI95%=1,1-3,4); working in emergency room (p<0,0001;OR=3,2; IC95%=1,8-5,8 and the specialty of pediatrics (p=0,016; OR=1,2; CI95%=1,2-1,3)... (AU)
Subject(s)
Humans , Male , Female , Adult , Physicians/statistics & numerical data , Occupational Health/statistics & numerical data , Workplace Violence/trends , Workplace Violence/statistics & numerical data , Argentina , Social Problems , Workplace , Hospitals, StateABSTRACT
OBJECTIVES: To assess the percentage of patients that fulfill the American College of Rheumatology (ACR) 1990 as well as the ACR 2010 classification criteria, to evaluate whether there is a correlation between tender points and the Widespread Pain Index (WPI) as well as signs and symptoms that predict a fibromyalgia (FM) subtype and to identify those which have greater impact on functioning. MATERIALS AND METHODS: We performed a cross-sectional comparative study of 206 patients with previous clinical diagnosis of FM. The studied variables were age, sex, years of disease, tender points, control points, WPI, Symptom Severity Score, subtype of FM, presence of other rheumatic disorders and the Fibromyalgia Impact Questionnaire (FIQ) score. RESULTS: The new diagnostic criteria of FM correctly classified 87,03% of patients who satisfied the ACR 1990 criteria. Both criteria were equally effective in assessing the impact of the disease. FM had a severe impact on the quality of life in 74,87% of patients. Somatoform disorder was the predominant subtype. Hyperalgesic FM had a significantly lower FIQ score than the somatoform disorder and depressive subtypes. CONCLUSION: The ACR 2010 criteria are a simple evaluation tool to use in the primary care setting, that incorporate both peripheral pain and somatic symptoms. New and old criteria should coexist; they enable a major comprehension and ease the management of this prevalent disease.
