ABSTRACT
La identificación de pacientes en situación de enfermedad crónica avanzada y complejidad, y la fragmentación de cuidados hacia el final de la vida aconsejan trazar un plan terapéutico a largo plazo, congruente con los valores y preferencias de los pacientes, a la vez que con un pronóstico vital y funcional razonables. Disponer de una herramienta de ajuste en la adecuación de la intensidad diagnóstica y terapéutica sería de ayuda en la continuidad de cuidados y podría ser facilitadora de la toma de decisiones en las transiciones y en los cambios dinámicos que presentan los pacientes a medida que se acercan al final del proceso vital
The identification of patients with advanced and complex chronic diseases, and the fragmentation of care towards the end of life, requires the drawing up a long-term therapeutic plan. This should take into account the values and preferences of the patients, as well as the vital and functional prognosis. Having an adjustment tool for determining the diagnostic and therapeutic effort is helpful in the continuity of care, as well as in decision-making in the transitions and dynamic changes of patients as they approach the end of life process
Subject(s)
Humans , Male , Female , Aged , Hospice Care/methods , Multiple Chronic Conditions/epidemiology , Advance Care Planning/organization & administration , Land Management and Planning , Diagnosis of Health Situation , Decision Support Techniques , Hospitalization/statistics & numerical data , Organ Transplantation/statistics & numerical data , Geriatric Assessment/methodsABSTRACT
The identification of patients with advanced and complex chronic diseases, and the fragmentation of care towards the end of life, requires the drawing up a long-term therapeutic plan. This should take into account the values and preferences of the patients, as well as the vital and functional prognosis. Having an adjustment tool for determining the diagnostic and therapeutic effort is helpful in the continuity of care, as well as in decision-making in the transitions and dynamic changes of patients as they approach the end of life process.
Subject(s)
Advance Care Planning/standards , Terminal Care/standards , Consensus Development Conferences as Topic , Humans , Life Support Care/standards , Spain , Urban HealthABSTRACT
Molecular epidemiology allows us to know local HIV transmission and to design strategies of prevention. We studied 25 HIV newly diagnosed patients with the E138A mutation since the year 2010. Most transmission networks involved young and promiscuous men who have sex with men. Recent infection was only documented in patients grouped into the smaller clusters.
Subject(s)
HIV Infections/epidemiology , HIV Infections/virology , HIV Reverse Transcriptase/genetics , HIV/classification , HIV/genetics , Mutation, Missense , Adolescent , Adult , Cluster Analysis , Female , HIV/enzymology , HIV/isolation & purification , HIV Infections/transmission , Humans , Male , Middle Aged , Molecular Epidemiology , Spain/epidemiology , Young AdultSubject(s)
Humans , Female , Middle Aged , Aged, 80 and over , Dyskinesias/complications , Dyskinesias/diagnosis , Dyskinesias/drug therapy , Neuroimaging/instrumentation , Neuroimaging/methods , Haloperidol/therapeutic use , Quality of Life/psychology , Dyskinesias/etiology , Dyskinesias/physiopathology , Dyskinesias , Neuroimaging/standards , Neuroimaging/trends , NeuroimagingSubject(s)
Emigration and Immigration , Travel , Typhus, Endemic Flea-Borne/diagnosis , Adult , Antibodies, Bacterial/blood , Antibodies, Bacterial/immunology , Atlantic Islands/epidemiology , Cross Reactions , Humans , Male , Rickettsia conorii/immunology , Rickettsia typhi/immunology , Senegal/ethnology , Typhus, Endemic Flea-Borne/epidemiologyABSTRACT
No disponible
Subject(s)
Male , Adult , Animals , Humans , Typhus, Endemic Flea-Borne/diagnosis , Typhus, Endemic Flea-Borne/drug therapy , Rickettsia typhi/immunology , Rickettsia typhi/isolation & purification , Antibodies, Bacterial/blood , Transients and Migrants , Senegal/ethnology , TravelABSTRACT
We report the first cases of human infection by Rickettsia felis in the Canary Islands. Antibodies against R. felis were found in 5 adsorbed serum samples from 44 patients with clinically suspected rickettsiosis by Western blot serology. Fleas from 1 patient's dog were positive for R. felis by polymerase chain reaction.
Subject(s)
Rickettsia Infections/epidemiology , Rickettsia Infections/microbiology , Rickettsia felis/isolation & purification , Adult , Animals , Antibodies, Bacterial/blood , Dogs , Female , Humans , Male , Middle Aged , Rickettsia Infections/diagnosis , Rickettsia Infections/immunology , Rickettsia felis/genetics , Rickettsia felis/immunology , Siphonaptera/microbiology , Spain/epidemiologyABSTRACT
Murine typhus and "murine-typhus-like" disease are reemerging infectious diseases. In Canary Islands (Spain), a rather distinct clinical pattern characterized by higher incidence of complications, especially renal damage (including acute failure and urinalysis abnormalities), is apparent and highly suggestive. It could be related to different strains of Rickettsia typhi or other cross-reactive species.
