ABSTRACT
BACKGROUND: The recommended treatment in patients with severe haemophilia is prophylaxis. This prevents bleedings and reduces or delays the haemophilic arthropathy. Adherence defined as the follow-up of the patient to the prescriptions of the health professional to his treatment, both pharmacological and modifications in habits or stylelifes. Adherence rates in haemophilia are better than in other chronic diseases, but there remain reasons for nonadherence. The aim was to see if disease behaviour and disease perception together with coping strategies modulate adherence to treatment. MATERIAL AND METHODS: Multicenter cross-sectional descriptive study. Patients recruited in Units of Hemophilia Hospitals and Regional Haemophilia Associations. Twenty-three patients participated The instruments used are as follows: data sheet, SF-36, A36 Hemophilia-Qol, Illness Perception Questionnaire-Revised (IPQ-R), Illness Behavior Questionnaire (IBQ) and Coping Strategies Inventory (CSI) and VERITAS-Pro. RESULTS: We found that 56% of patients with haemophilia are adherent. The most relevant clinical variables were hemarthrosis, diagnosis of arthropathy and presence of any coinfection, as well as family history, labour status and sociodemographic variables. Age was not a relevant variable in adherence. The worst adherence coincides with poorer quality of life and inadequate coping style. Nonadherent patients show greater conviction of disease, perception of cyclicity, more hypochondriacal behaviour towards the illness and perception concern about possible side effects of medication. CONCLUSION: Adherence in haemophilia requires a more experiential approach and individualized education. It is important that professionals take into account the patient's perception, behaviour and attitude towards the disease to achieve a better adaptation of their coping resources.
ABSTRACT
INTRODUCTION: Medtep Hemophilia platform is an online tool that allows patients with congenital coagulopathies to keep track of their daily condition-related events with the objective of ensuring successful adherence to therapy. AIM: To assess the effectiveness of Medtep Hemophilia in improving adherence to prophylactic treatment in haemophilia A and B patients in a 1-year prospective observational study, as well as its impact on the patient's disease status. METHODS: Patients (>13 years old) received support material to familiarize themselves with Medtep Hemophilia. Adherence to treatment, quality of life (QoL) and illness perception were assessed. Values at baseline, 1, 6 and 12 months, and changes from baseline value were analysed. The Hemophilia Joint Health Score (HJHS) test was applied at baseline and study completion. RESULTS: Forty-six patients were enrolled (43 evaluable). After 1 year, 56.4% patients showed continued use of the platform (100% compliance) whereas 25.6% were inactive. Treatment adherence increased both significantly (P < .001) and progressively during the study. Similarly, improved QoL and illness perception were observed with respect to baseline in most of the questionnaire components (P < .05 after 12 months). A patient's age had no influence on the results, whereas compliant patients (>80% of platform use) tended to score better than noncompliant. The HJHS test values remained similar during the study. CONCLUSION: The Medtep Hemophilia online platform helped the studied patients with haemophilia to improve their adherence to prophylactic treatment, while increasing their QoL and illness perception, as well as joint arthropathies stabilization.
Subject(s)
Hemophilia A/therapy , Outcome Assessment, Health Care , Patient Compliance/statistics & numerical data , Telemedicine/statistics & numerical data , Adult , Female , Humans , Male , Quality of LifeABSTRACT
Introducción. El personal sanitario debe estar preparado para poder intervenir con eficacia en un incidente NBQ. El objetivo principal de este estudio exploratorio era conocer el nivel de preparación del personal sanitario que trabajaba en el ámbito militar ante incidentes NBQ en general, y químico en particular. Material y métodos: Se realizó un estudio descriptivo transversal mediante un cuestionario autoadministrado en una muestra de 348 oficiales del Cuerpo Militar de Sanidad (50,6% médicos y 49,4% enfermeros) de los que el 71,8% eran mujeres. Resultados: El 68,4% habían recibido formación especifica de Defensa NBQ durante su periodo de formación militar técnica, y el 23% la habían recibido fuera del ámbito militar. El 95,4% consideraban necesario recibir formación en defensa NBQ y el 89,3% no se consideran preparados para intervenir en un incidente NBQ. Dentro de los empleos de la muestra estudiada son los tenientes y capitanes los que muestran más interés en recibir formación. Discusión: A la vista de los resultados obtenidos parece que las actividades formativas no son suficientes para alcanzar la capacidad de intervención en incidentes NBQ. Conclusiones: Los empleos de teniente y capitán son los que refieren una mejor preparación para intervenir con eficacia frente a un incidente NBQ. Se deduce una necesidad en la preparación del personal sanitario por lo que se debe de establecer un sistema de capacitación sanitaria de defensa NBQ (AU)
Introduction: Health workers should be prepared to intervene effectively in a CBRN incident. The aim of this work is to know the preparedness level of health workers who work in NBC incidents in general, and chemical in particular, in military environment. Material and methods: A cross-sectional descriptive study was carried out using a self-administered questionnaire in a sample of 348 officers of the Military Health Corps (50.6% of physicians and 49.4% of nurses), of which 71.8% were women. Results: 68.4% had received specific training of CBRN defense during their military technical training, and 23% had received training in NBC Defense outside. 95.4% they considered necessary to receive training in NBC defense. 89.3% are not considered ready to intervene in a CBRN incident. Within the military ranks of the sample studied are lieutenants and captains who show more interest in receiving training. Discussion: In view of the results obtained, it seems that the training activities are not enough to reach the capacity of intervention in incidents NBC. Conclusion: The positions of lieutenant and captain are those that refer to a better preparation to intervene effectively against an NBC incident. It follows that there is a need for the preparation of health workers, which is why a NBC defense health training system should be established (AU)
Subject(s)
Humans , Man-Made Disasters , Biological Disaster , Education in Disasters/analysis , 34691 , Public Defender Legal Services , Relief, Assistance and Protection in Disasters , Professional Competence , Cross-Sectional StudiesABSTRACT
Introducción. A partir del atentado de Tokio en 1995 y de la crisis de los sobres en 2001, se observa un cambio en la percepción del riesgo NBQ entre los profesionales sanitarios. Un objetivo secundario del estudio era estudiar el nivel de percepción del riesgo NBQ entre los médicos y enfermeros militares. Material y Métodos. Se realizó un estudio exploratorio descriptivo transversal basado en un cuestionario autoadministrado dirigido a la población de médicos y enfermeros militares (348 oficiales del Cuerpo Militar de Sanidad -50,6% médicos y 49,4% enfermeros). Resultados. El 74,7% de los participantes consideraban como probable que se produjera un incidente NBQ en los próximos cinco años. El 78,7% consideraba que se vería implicado. El 42,7% consideraban que el entorno seria militar, mientras que el 24,5% consideraban que lo seria en entorno civil. En torno al 30% de los pertenecientes al Órgano Central y la Armada consideraban como más probable el escenario biológico. Discusión: Se observa una elevada percepción del riesgo NBQ entre el personal sanitario militar, fundamentalmente entre los menores de 30 años, siendo más marcada esta percepción en los hombres que en las mujeres. En relación al empleo militar, el personal con empleos de teniente y coronel son los que referían una mayor percepción del riesgo. Mientras que los tenientes coroneles, fundamentalmente médicos y destinados en el Órgano Central,consideraban que no se verían implicados profesionalmente en un incidente NBQ. Conclusiones: Existe una elevada percepción del riesgo NBQ entre el personal sanitario militar, fundamentalmente entre los tenientes y menores de 30 años. Hecho que se ve corroborado con la idea de la implicación profesional en incidentes NBQ en un futuro (AU)
Introduction. Since the Tokyo terrorist attack in 1995 and the Amerithrax in 2001, there has been a change in the perception of NBC risk among health professionals. A secondary objective of was to evaluate NBC risk perception among military health personnel. Material and Methods. It was made a descriptive cross-sectional study based on a self-administered questionnaire addressed to the population of medical and military nurses (348 348 officials of Health Branch -50,6% physicians and the 49,4% nurses. Results. The 74,7% considered as a possible that occurred a NBC incident in the next five years. The 78,7% considered that would be involved. The 42,7% considered that the incident will be military, while the 24,5% considered that it will be in civil area. Around 30% of personnel enlisted at the DoD (Central Organ) and the Navy considered that the biological scenario was the most probable. Discussion: A high perception of NBC risk is observed among the military health personnel, mainly among those under 30 years, a tendency stressed more in men than in women. Regarding the military employment, lieutenant and colonel are those reporting a greater perception whereas the physicians lieutenant colonel thought they would not be involved professionally in a NBC incident. Conclusions: There is a high perception of CBRN risk among the military medical personnel, mainly among lieutenants and those under 30 years old. This fact is corroborated by the idea of professional involvement in CBRN incidents in the future (AU)
Subject(s)
Humans , Man-Made Disasters , Biological Disaster , Education in Disasters/analysis , 34691 , Public Defender Legal Services , Relief, Assistance and Protection in Disasters , Professional Competence , Bioterrorism , Surveys and QuestionnairesABSTRACT
This article discusses, from a psychological perspective, the life experience of the adult and ageing person with haemophilia, including psychological issues, aspects of his personal and social integration, decision-making, communication and other factors that may affect treatment adherence and quality of life. The aim was to provide haematologists and healthcare staff with knowledge and resources to improve communication and support for adult persons with haemophilia, and raise awareness on psychosocial issues related to quality of life, sexuality and aspects associated with ageing with haemophilia. Adulthood is a period of many personal and social changes, and ageing with haemophilia is a relatively new phenomenon due to increased life expectancy in this population. Patients have to adapt to the disease continuously when facing new expectations, life projects and issues arising with increasing age, so the healthcare team should be ready to provide support. A good therapeutic alliance with the patient must be accompanied by assessment and counselling in aspects including satisfaction, perceived difficulties and barriers, and emotional needs. Raising awareness of all this will result in the patient benefiting from the recent improvements in treatments.
Subject(s)
Aging , Hemophilia A/psychology , Life Change Events , Quality of Life , Adult , Aged , Counseling , Hemophilia A/physiopathology , Humans , Middle AgedABSTRACT
INTRODUCTION: Alterations in the musculoskeletal system, especially in the lower limbs, limit physical activity and affect balance and walking. Postural impairments in haemophilic preteens could increase the risk of bleeding events and deteriorate the physical condition, promoting the progression of haemophilic arthropathy. AIM: This study aims to evaluate static postural balance in haemophilic children, assessed by means of the Wii Balance Board® (WBB). METHODS: Nineteen children with haemophilia and 19 without haemophilia aged 9-10 years, have participated in this study. Postural balance was assessed by performing four tests, each one lasting 15 s: bipodal eyes open (BEO), bipodal eyes closed (BEC), monopodal dominant leg (MD) and monopodal non-dominant leg (MND). Two balance indices, standard deviation of amplitude (SDA) and standard deviation of velocity (SDV) were calculated in the anterior-posterior (AP) and medial-lateral (ML) directions. RESULTS: Index values were higher in haemophilic group and the differences were statistically significant (P < 0.05) in only six (SDAAP in BEO, BEC and MD conditions, SDAML in BEO, SDVAP in BEO and SDVML in MND condition) of 16 parameters analysed. CONCLUSION: Tests performed indicate a poorer static postural balance in the haemophilic cohort compared to the control group. Accordingly, physiotherapy programmes, physical activity and sports should be designed to improve the postural balance with the aim of preventing joint deterioration and improving quality of life.
Subject(s)
Hemophilia A/diagnosis , Hemophilia A/physiopathology , Video Games , Child , Female , Humans , Male , Postural Balance/physiology , Quality of LifeABSTRACT
El modelo propuesto de tarjeta de primeros auxilios NBQ en incidentes químicos, sirve de registro de las acciones realizadas desde el momento de la generación del incidente hasta la llegada al Puesto de Socorro de Batallón o Grupo (o Unidad equivalente). Complementa a la Tarjeta de Evacuación establecido y se considera supone una ayuda a la clasificación de las bajas químicas generadas en un incidente químico
The proposed first aid NBC tag for chemical accidents is a document to register all actions undertaken since the generation of the incident until the arrival to the Battalion Aid Station (or equivalent unit). This tag complements the Evacuation card and it helps to the classification process of chemical casualties
Subject(s)
Humans , Triage Card , First Aid/methods , Chemical Warfare Agents/adverse effects , Decontamination/methods , Triage , Strategic Evacuation/standards , Chemical Warfare , Prehospital Care/organization & administrationABSTRACT
Persons with haemophilia, living with their condition from infancy, require attention from a biopsychosocial approach, in which both the biological and the biographical dimension are addressed. These patients and their environment may benefit greatly from having professionals to help them manage, pre-emptively if possible, to adapt to the disease, cope with the experience of suffering and overcome the difficulties caused by chronicity. The ultimate goal of the interventions was to achieve the best quality of life possible with tailored objectives throughout the patient's life, including disease control, addressing the particular difficulties, and achieving optimal empowerment. This article aims to describe the role of Health Psychology and its professionals in supporting the young patient with haemophilia and provide a brief guide that might be useful for health professionals involved in his care. From the psychological perspective, this paper focuses on communication of diagnosis, the role and support of the family, issues during infancy, childhood and adolescence and how the healthcare team can address them to provide successful support.
Subject(s)
Adaptation, Psychological , Hemophilia A/psychology , Psychosocial Support Systems , Adolescent , Child , Child, Preschool , Communication , Counseling , Hemophilia A/epidemiology , Humans , Infant , Patient Care Team , Physician-Patient Relations , Quality of Life , Young AdultABSTRACT
Haemophilia is a chronic disease that requires a multidisciplinary approach for proper management and control of its clinical manifestations. The perception and management of parents of children with haemophilia can be affected by stressful situations as a result of treatment or disease progression. The aim of this study was to evaluate the perception of stress and family functioning in parents of children with haemophilia 1-7 years. This is an observational clinical study involving 49 parents of children with haemophilia 1-7 years who attended the VIII Workshop for Parents of Children with haemophilia, organized by the Spanish Federation of Hemophilia in La Charca, Murcia (Spain). After obtaining parental consent, the questionnaires was applied to them, FACES III (family functioning) and Pediatric Inventory for Parents (perceived stress), and a record of data on the clinical characteristics and treatment. Significant differences in the perception of stressors by gender of parents were found. A family history of haemophilia, the use of port-a-cath, inhibitor development and gender of the parents were the descriptive variables most correlated with dependents variables. These variables, together with the type of haemophilia affect significantly in the parental stress and family functioning. Parents have difficulty adjusting to disease management, perceiving many stressors. Gender and family history, can hinder the proper compliance with treatments, reducing its effectiveness.
Subject(s)
Hemophilia A/epidemiology , Hemophilia B/epidemiology , Parents/psychology , Stress, Psychological , Adaptation, Psychological , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Quality of Life , Young AdultABSTRACT
Haemophilia is a haematological disorder with an orthopaedic outcome. It requires not only medical but rather comprehensive care from infancy. The aim of this study was to assess the effectiveness of an educational intervention of Physiotherapy in parents of children with haemophilia under 4 years old. This is a non-randomized clinical trial, in which 22 parents participated children's with haemophilia under 4 years old. Half of them received an educational intervention of Physiotherapy. At the beginning and end of the study, a psychologist blinded to the assignment of subjects to each of the study groups, assessed the perceived quality of life, anxiety, perceived stress and family functioning of parents. A significant improvement was observed in the variables of perceived stress and family functioning of parents in the experimental group. The realization of an educational intervention in parents of children with haemophilia under 4 years old is effective. It reduces the stressors perceived by the parents and improves family cohesion and adaptability, as a consequence of the disease. It is necessary to carry out studies with follow-up periods to assess the effectiveness of educational programs of Physiotherapy for long term.
Subject(s)
Hemophilia A/therapy , Hemophilia B/therapy , Parents/education , Physical Therapy Modalities/education , Adaptation, Psychological , Adult , Anxiety , Case-Control Studies , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Outcome Assessment, Health Care , Parents/psychology , Quality of Life , Stress, Psychological , Surveys and QuestionnairesABSTRACT
A cross-sectional serological study on cattle less than 2 years old, using an antigen ELISA for the detection of bovine cysticercosis was carried out between November 2009 and February 2010 in 10 slaughterhouses from the Catalonia region (North-Eastern Spain). Circulating antigen was detected in 23 of 2073 animals, i.e. a sero-prevalence of 1.11% (CI95%: 0.76-1.75%). The determined sero-prevalence was about 50 times higher than the prevalence obtained by visual inspection within the same period: 19 positive animals of 90,891 slaughtered animals (0.02%) in the same slaughterhouses. None of the animals with positive result in the Ag-ELISA was detected by meat inspection.
Subject(s)
Antigens, Helminth/immunology , Cattle Diseases/diagnosis , Cysticercosis/veterinary , Enzyme-Linked Immunosorbent Assay/veterinary , Abattoirs , Animals , Cattle , Cattle Diseases/parasitology , Cysticercosis/diagnosis , Cysticercosis/pathology , Spain/epidemiology , Taenia saginata/immunologyABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Myxoma/complications , Myxoma/diagnosis , Magnetic Resonance Imaging/methods , Laparotomy/methods , Gadolinium , Immunohistochemistry/methods , Immunohistochemistry , Diagnosis, Differential , Myxoma/therapy , Gadolinium/administration & dosage , Laparotomy , Myxoma , Abdomen/pathology , AbdomenSubject(s)
Breast Neoplasms, Male/diagnosis , Neoplasms, Muscle Tissue/diagnosis , Aged , Humans , MaleABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Neoplasms, Muscle Tissue , Gynecomastia/complications , Gynecomastia/diagnosis , Immunohistochemistry/trends , Immunohistochemistry , Sarcoma , Breast NeoplasmsSubject(s)
Antibodies, Bacterial/blood , Dog Diseases/epidemiology , Rickettsia Infections/veterinary , Rickettsia felis/isolation & purification , Rickettsia typhi/isolation & purification , Animals , Dogs , Female , Fluorescent Antibody Technique, Indirect , Immunoglobulin G/blood , Male , Rickettsia Infections/epidemiology , Rickettsia felis/immunology , Rickettsia typhi/immunology , Seroepidemiologic Studies , Spain/epidemiologyABSTRACT
BACKGROUND: The angle formed by the intersection of the line between triradiate cartilage of both hips (Hilgenreiner's line) and a line drawn between triradiate cartilage and the external roof of the acetabulum is called the acetabular index (AI), the angle formed by line of proximal femoral physis and middiaphysis axis of femur is called the epiphyseal angle (EA). Both decrease with age, but it is not described whether there is a relation between them in this development. It would be very useful to compare its evolution in children with normal hips, in order to compare them with dysplasic hips in the same groups of age. OBJECTIVE: To study the radiographic angles and the relationship between the acetabulum and the proximal femur. MATERIALS AND METHODS: Retrospective study was performed on pelvic X-rays in 224 children between 1 and 3 years of age. Children with injuries, sepsis or inflammatory disease were excluded. We measured by goniometer (error +/-1 degrees ): the AI, and the angle of the proximal femoral physis (EA). We have compared statistically the parameters. RESULTS: The AI was 21.1 degrees (+/-3.8), 19.9 degrees (+/-3.5), and 16.1 degrees (+/-4.2) and EA was 75.8 degrees (+/-5.1), 75.9 degrees (+/-6.3), and 75.6 degrees (+/-4.7), at the ages of 1, 2, and 3 years, respectively. A significant difference was noted for AI between 2 and 3 years old (P = 0.003), but there was not significative EA decrease. No significant correlation was found between AI and EA among the different groups, nor overall (r = 0.03). Sex or side was not a significant factor for both angles. CONCLUSION: The AI decreases significantly between 1 and 3 years of age, but not the EA. No significant relation was found between them in the different age groups. Normal children's hips have a tendency to spontaneously improve its acetabular morphology during the first 3 years of life.
Subject(s)
Acetabulum/diagnostic imaging , Epiphyses/diagnostic imaging , Femur Head/diagnostic imaging , Child, Preschool , Female , Hip Joint/diagnostic imaging , Humans , Infant , Male , RadiographyABSTRACT
Within the framework of a local animal health programme, the presence of ectoparasites and haemoparasites was investigated in a colony of 25 cats in Barcelona. Diagnosis was performed both by standard parasitological procedures and molecular techniques. All cats were negative to haematozoan infection by microscopic examination of blood smears. However, Hepatozoon spp. was found in four cats as shown by amplification and sequencing of the 18S rRNA gene. Cat isolates were 100% identical to the isolate Hepatozoon spp. (Spain 2) from Southern Spain. This is the first time that Hepatozoon spp. has been identified in cats from Northern Spain.
Subject(s)
Cat Diseases/parasitology , Coccidia/isolation & purification , Coccidiosis/veterinary , DNA, Protozoan/genetics , Animals , Animals, Wild , Base Sequence , Cat Diseases/diagnosis , Cat Diseases/epidemiology , Cats , Coccidia/genetics , Coccidiosis/diagnosis , Coccidiosis/epidemiology , Coccidiosis/parasitology , DNA Primers , Female , Gene Amplification , Male , Polymerase Chain Reaction/veterinary , RNA, Protozoan/genetics , RNA, Ribosomal, 18S/genetics , Spain/epidemiologyABSTRACT
Rickettsia slovaca is considered the etiological agent of tick-borne lymphadenopathy (TIBOLA), an emerging disease transmitted by tick bites. Dermacentor marginatus constitutes the most important vector and wild boar (Sus scrofa) is the main wild host in our area. The epidemiology of this tick-borne rickettsioses has not been completely clarified. During hunting season 2004, wild boar sera sample were collected from northeastern Spain. Ticks were collected both from wild boar and from flagging vegetation in the same areas where wild boar were hunted. Serologic study was carried out using the immunofluorescent antibody (IFA) technique. Ticks were identified as D. marginatus and Rhipicephalus uranicus. Based on sequence analysis on ompA gene, R. slovaca was identified in 30.5% D. marginatus ticks removed from wild boar and in 33.3% D. marginatus collected from flagging vegetation. Rickettsia sp. RpA4 was identified in 4 specimens of D. marginatus removed from wild boar. Twelve of 23 wild boar were seropositive to R. slovaca. Results suggested wild boar are exposed to R. slovaca infection and this pathogen is well established in the wild cycle of D. marginatus in our area.
