Experience of women with multiple sclerosis during the period of compulsory home confinement due to COVID-19 in Spain.

Compulsory home confinement due to COVID-19 pandemic has had an influence on the physical and emotional health. Nevertheless, it has been more prevalent in women and in people with chronic illness such as multiple sclerosis, so the aim of this study was to know the experience of women with multiple sclerosis during the home confinement period in Spain. Seven women aged over 18 years, with a definitive diagnosis of multiple sclerosis and who belonged to multiple sclerosis associations completed semi-structured interviews. Two main themes and multiple subthemes were identified. The first them was "living with multiple sclerosis during home confinement" which included the physical and emotional impact, confinement coping ability and time for reflection. The second theme was "the environment during confinement" and it included solidarity and support, family cooperation, importance of peer contact and adjustments in the health environment during the pandemic. The period of compulsory home confinement in Spain did not worsen the physical and emotional symptoms of these women. This might be related to the increased support they had received as well as the continuity of their rehabilitation activities at home. Regarding changes in health system, the participants referred the necessity to return to face-to-face visits.

Experience of women with multiple sclerosis about their sexuality.

PURPOSE: To understand how women with multiple sclerosis (MS) experience their sexuality. MATERIAL AND METHODS: This was a qualitative study in which eight women belonging to MS associations in Elche or Alicante (Spain) completed semi-structured interviews. We subsequently carried out a thematic analysis of this data. RESULTS: Four main themes and multiple sub-themes were identified. The first theme was the 'influence of stereotypes on sexual expression', which included social and gender perspectives; the second theme was 'physical and emotional causes of sexual dysfunction', which were classified as primary, secondary, and tertiary; the third theme was 'experiencing sexuality in a personalised way', which included relationships with a partner, the concept of sexuality, and resources for improving sexual function; and the final theme was 'external support', which included sexual assistance, professional care, and peer support. CONCLUSIONS: Sexual needs change in women with MS after diagnosis of the disease. However, this is not addressed routinely by health professionals. In their search for resources, women with MS highlighted that support from partners and from associations, could constitute a support network for the expression of their sexuality.IMPLICATIONS FOR REHABILITATIONWomen with MS refer changes in their sexual function, and these changes are not addressed routinely by healthcare providers.Inclusion of the sexual partners of women with MS in consultations regarding the treatment of sexual dysfunctions should be considered with previous consent.The positive experience of a woman with MS who used sexual assistant services may justify further research.MS associations can also play an important role in the sexual field as a meeting place for peers with shared experiences.

Degree of Accuracy of the BMI Z-Score to Determine Excess Fat Mass Using DXA in Children and Adolescents.

Obesity is caused by fat accumulation. BMI Z-score is used to classify the different degrees of weight status in children and adolescents. However, this parameter does not always express the true percentage of body fat. Our objective was to determine the degree of agreement between the fat mass percentage measured by DXA and the stratification of weight according to BMI Z-score in the pediatric age group. We designed a descriptive cross-sectional study. The patients were classified as underweight/normal weight with Z-scores between -2 and +0.99, overweight from 1 to 1.99, obese from 2 to 2.99, and very obese ≥3. We included 551 patients (47% girls), with a mean age of 11.5 ± 2.8 years (3.7-18 years). Higher BMI Z-scores were associated with a higher percentage of total fat (p < 0.001). However, there were important overlaps between both parameters, such that the BMI Z-score classified patients with the same percentage of total fat mass as having a different nutritional status classification. In conclusion, the stratification of weight status according to BMI Z-score revealed that 46.7% of patients had a fat percentage that did not correspond to their classification. For a more accurate weight assessment in clinical practice, we recommend combining anthropometric indices with diagnostic tools that better correlate with DXA, such as electrical bioimpedance.

Factors Influencing the Success of Peripheral Venous Access in Neonates.

PURPOSE: In neonatal units, the use of peripheral venous catheters is a commonly used technique involving risks and local complications. Catheter duration and viability is limited and may involve multiple insertion attempts. Catheterization was considered successful when there were no local complications and the catheter was removed owing to completion of treatment. The aim of the study was to determine the optimal location and instruments to reduce the number of catheter insertion attempts and to increase time without complications. DESIGN AND METHODS: A cross-sectional descriptive study was undertaken to analyze all the catheters inserted in the neonatal intermediate care unit of Vinalopó University Hospital (Elche, Spain). Between 2013 and 2017 the following variables were collected: sex, age, gestational age, and venipuncture site, as well as catheter type, number of insertion attempts, duration and complications. RESULTS: A total of 929 catheters were analyzed with a mean duration of 46.5 ±â€¯33.9 h, and were removed upon completion of treatment (success 38.3%). The preferred site was the dorsal hand (48.2%) followed by the cubital fossa (20.1%). In both sites the success of the catheter and its duration was higher than the mean (42.4%; 43.9% and 49.4 ±â€¯35.7; 50.3 ±â€¯33.4 h respectively). The most frequent complications were extravasation (47.0%) and phlebitis (5.9%). Just one attempt was needed for 63.8% of cannulations of the dorsal hand, followed by 38.9% in the forearm. No significant differences were found in fixation type, sex, weight, gestational age or infusion type (continuous/intermittent). CONCLUSIONS: The success of the technique is low. The preferred insertion sites with fewer complications, longer duration and fewer attempts were the dorsal hand and cubital fossa. With fewer attempts required for cannulation, better results were achieved on the dorsal hand.