ABSTRACT
AIMS: To assess the efficacy of a prompted voiding programme for restoring urinary continence at discharge in hospitalized older adults who presented with reversible urinary incontinence (UI) on admission to a functional recovery unit (FRU). To assess the maintenance of the outcomes achieved after hospitalization. To identify modifiable and unmodifiable factors associated with the success of the prompted voiding programme. DESIGN: Quasi-experimental, pre-/post-intervention study without a control group. METHODS: Participants were aged 65 and over with a history of reversible UI in the previous year who had been admitted to a FRU and were on a prompted voiding programme throughout their hospitalization period. The sample consisted of 221 participants. A non-probabilistic sampling method, in order of recruitment after signing the informed consent form, was used. The primary outcomes were UI assessed at discharge and 1 month, 3 months and 6 months after discharge. Funding was granted in July 2019 by the Spain Health Research Fund (PI19/00168, Ministry of Health). The proposal was approved by the Spanish Research Ethics Committee. DISCUSSION: The prompted voiding programme described can reverse UI or decrease the frequency and amount of urine loss in hospitalized older adults. IMPACT: Urinary incontinence is highly prevalent in hospitalized older adults. There is a need for care aimed at prevention, recovery and symptom control. Prompted voiding is a therapy provided by the nursing team during hospitalization and can also be provided by family caregivers at home after receiving proper training by the nursing team. Prompted voiding will enhance the health, functional ability and quality of life of older adults with UI, resulting in the reduction of associated healthcare costs and the risk of developing complications.
Subject(s)
Quality of Life , Urinary Incontinence , Activities of Daily Living , Aged , Humans , Spain , UrinationABSTRACT
El atrapamiento femoroacetabular es una patología que puede ser causa de artrosis precoz en pacientes jóvenes. Se trata de una anomalía morfológica en el acetábulo (AFA tipo PINCER), en el fémur (AFA tipo CAM) o en ambos (AFA tipo mixto). Un paciente joven que consulta repetidas veces por limitación de movimientos, por dolor inguinal con la rotación de la cadera en sedestación, durante o tras la realización de ejercicio físico y/o dolor trocantéreo con irradiación a la cara externa del muslo, debe alertar al médico de familia. Una buena anamnesis y una correcta exploración física orientan al diagnóstico, junto con radiología simple. Por ello es importante reconocerlo en la práctica clínica diaria para su derivación hospitalaria precoz con el objetivo de comenzar el estudio etiológico y tratamiento adecuado
The femoroacetabular impingement is a pathology that can cause early degenerative osteoarthritis in young patients.It involves a morphological anomaly in the acetabulum (PINCER-type FAI), in the femur (CAM-type FAI), or in both (mixed-type FAI). A young patient who consults repeatedly for limited mobility, for inguinal pain with hip rotation while sitting, and during or after physical exercise,and/or trochanteric pain with radiation to the outside of the thigh, must alert the Family doctor. A good anamnesis and a correct physical exploration guide the diagnosis, together with simple radiology. Therefore it is important to recognize it in everyday clinical practice for early hospital referralin order to begin the etiological study and a suitable treatment
Subject(s)
Humans , Male , Adult , Femoracetabular Impingement/diagnosis , Osteoarthritis, Hip/diagnosis , Acute Pain/etiology , Osteotomy , Femoracetabular Impingement/classification , Diagnosis, Differential , Motor Skills Disorders/etiology , Primary Health Care/statistics & numerical data , Range of Motion, Articular/physiologyABSTRACT
A 39-year-old Caucasian man was referred to University Hospital Salamanca from a primary care unit due to the presence of an erythematous violaceous nodule at the superior portion of his nose. Physical examination indicated that the firm, fixed erythematous violaceous nodule measured approximately 2 cm in diameter and was located inferior to a scar on the nasal bridge. Cutaneous involvement in sarcoidosis occurs in 25% of cases. A wide range of clinical presentations of cutaneous sarcoidosis is recognized. Skin lesions are classified as either non-specific, of which erythema nodosum is the most representative and specific, or as granulomatous, which includes maculopapular nodules, plaques, infiltrated scars, lupus pernio, ulcerations, warty lesions and erythroderma. Scar sarcoidosis is a type of cutaneous sarcoidosis.
ABSTRACT
La fibrilación auricular (FA) es la arritmia más frecuente en la práctica clínica. Es responsable de una elevada morbilidad y mortalidad. Un paciente con FA conocida, que sigue tratamiento adecuadamente, y comienza con mareo, debe alertar al Médico de Familia. Un electrocardiograma es fundamental para un correcto diagnóstico: la presencia de una bradicardia en un paciente con FA. Esta situación clínica constituye una causa de derivación hospitalaria no demorable para realizar estudio etiológico y tratamiento adecuado ante la gravedad del cuadro clínico (AU)
Atrial fibrillation (AT) is the most frequent type of arrhythmia in clinical practice. It causes a high rate of morbidity and mortality. A patient with known AF who follows adequate therapy and starts feeling dizzy, should alert his/her GP. An electrocardiogram is essential for correct diagnosis: the presence of bradycardia in a patient with AF. This clinical situation constitutes a non-delayable reason to refer the patient to the hospital in order to carry out an etiologic study and adequate therapy because of the seriousness of this clinical picture (AU)
Subject(s)
Humans , Male , Aged , Atrial Fibrillation/drug therapy , Atrial Fibrillation/surgery , Atrial Fibrillation , Bradycardia/complications , Bradycardia , Heart Block/diagnosis , Heart Block/physiopathology , Indicators of Morbidity and Mortality , Family Practice/methods , Electrocardiography/methods , Heart BlockABSTRACT
Trabajar en Atención Primaria supone pensar en las patologías más frecuentes que se dan en nuestro entorno. Un paciente joven que presenta úlceras genitales nos hace pensar en una infección de transmisión sexual. Sin embargo, la falta de respuesta al tratamiento empírico correcto y los resultados de la serología muestran el diagnóstico definitivo: fiebre botonosa mediterránea, con una localización poco común. Debemos recordar que una enfermedad común en nuestro medio puede parecerse a otra igualmente común, por lo que una correcta historia clínica será fundamental para distinguirlas (AU)
Working in primary health care means thinking about the most common pathologies which we encounter in our workplace. A young patient with genital ulcers makes us think of a sexually transmitted infection. However, the lack of response to the correct empirical treatment and serology results show a definitive diagnosis: Mediterranean spotted fever (also known as boutonneuse fever), with a rare location. It should be remembered that a commonly occurring disease in our environment may resemble another equally common one, thus a correct clinical history is fundamental in order to distinguish them (AU)
