Optical fiber thermo-refractometer.

This work presents the implementation of a thermo-refractometer, which integrates the measurement of both refractive index and temperature in a single optical fiber structure. To this purpose, a lossy mode resonance (LMR)-based refractometer is obtained by means of the deposition of a titanium dioxide (TiO2) thin film onto a side-polished (D-shaped) single mode fiber. Measurement and subsequent temperature compensation are achieved by means of a fiber Bragg grating (FBG) inscribed in the core of the D-shaped region. The LMR wavelength shift is monitored in transmission while the FBG (FBG peak at 1533 nm) displacement is observed in reflection. The LMR is sensitive to both the surrounding refractive index (SRI), with a sensitivity of 3725.2 nm/RIU in the 1.3324-1.3479 range, and the temperature (- 0.186 nm/°C); while the FBG is only affected by the temperature (32.6 pm/°C in the 25°C - 45°C range). With these values, it is possible to recover the SRI and temperature variations from the wavelength shifts of the LMR and the FBG, constituting a thermo-refractometer, where it is suppressed the effect of the temperature over the refractometer operation, which could cause errors in the fourth or even third decimal of the measured SRI value.

Simultaneous Generation of Surface Plasmon and Lossy Mode Resonances in the Same Planar Platform.

A planar waveguide consisting of a coverslip for a microscope glass slide was deposited in one of its two faces with two materials: silver and indium tin oxide (ITO). The incidence of light by the edge of the coverslip permitted the generation of both surface plasmon and lossy mode resonances (SPRs and LMRs) in the same transmission spectrum with a single optical source and detector. This proves the ability of this optical platform to be used as a benchmark for comparing different optical phenomena generated by both metal and dielectric materials, which can be used to progress in the assessment of different sensing technologies. Here the SPR and the LMR were compared in terms of sensitivity to refractive index and figure of merit (FoM), at the same time it was demonstrated that both resonances can operate independently when silver and ITO coated regions are surrounded by different refractive index liquids. The results were supported with numerical results that confirm the experimental ones.

Twin lossy mode resonance on a single D-shaped optical fiber.

This Letter presents the fabrication of dual lossy mode resonance (LMR) refractometers based on titanium dioxide (TiO2) and tin oxide (SnO2) thin films deposited on a single side-polished D-shaped optical fiber. For the first time, to the best of our knowledge, two independent LMRs are obtained in the same D-shaped optical fiber, by using a step-shaped nanostructure consisting of a first section of TiO2 with a thickness of 120 nm and a second section with a thickness of 140 nm (120 nm of TiO2 and 20 nm of SnO2). Each section is responsible for generating a first-order LMR with TM-polarized light (LMRTM). TiO2 is deposited by atomic layer deposition and SnO2 by electron-beam deposition. The theoretical results show that the depth of each of the resonances of the dual LMR depends on the length of the corresponding section. Two experimental devices were fabricated with sections of different lengths, and their sensitivities were studied, achieving values ∼4000nm/refractiveindexunit (RIU) with a maximum of 4506 nm/RIU for values of the SRI between 1.3327 and 1.3485.

Female Colour Polymorphism and Unique Reproductive Behaviour in Polythore Damselflies (Zygoptera: Polythoridae).

We studied Polythore damselflies by mark-recapture techniques in the Jatun Sacha Biological Reserve (Ecuador) for a period of 48 days in October-December 2014. Three species were found: Polythore mutata (MacLachlan) was the commonest species (111 individuals marked), Polythore derivata (MacLachlan) was rare (24 individuals) and Polythore concinna (MacLachlan) occasional (four individuals). In P. mutata, we found two phenotypes amongst females, one of them with a white band on the wings, very similar in colouration to the conspecific male (androchrome), and the other with an amber band (gynochrome). The recapture of marked females indicates that both phenotypes are maintained since emergence to maturation and are not age-related (i.e. polymorphism). Androchromes represent 40% of females observed. The colour of the wing band showed an age-dependent change in size with opposite trends between sexes, increasing in males and decreasing in females. Males and females were observed to return to the same forest locations in different days. Courtships and ovipositions involving androchrome females were not observed. No matings were observed in any morph. In contrast, we recorded two consecutive matings of one female P. derivata. We found that Polythore males grasp the mesothorax of females during mating instead of the prothorax as in other Zygoptera. We discuss the rarity of reproductive behaviour in this genus and how female morphs might be maintained.

High sensitive refractometers based on lossy mode resonances (LMRs) supported by ITO coated D-shaped optical fibers.

Tin doped indium oxide (ITO) coatings fabricated onto D-shaped optical fibers are presented as the supporting medium for Lossy Mode Resonances (LMRs) generation. The characteristic geometry of ITO-coated D-shaped optical fibers enables to observe experimentally LMRs obtained with both TM and TE polarized light (LMR(TM) and LMR(TE)). This permits to obtain a maximum transmission decay of 36 dB with a LMR spectral width of 6.9 nm, improving that obtained in previous works, where the LMRs were a combination of an LMR(TM) and an LMR(TE). Surrounding medium refractive index (SMRI) sensitivity characterization of LMR(TM) has been performed obtaining a maximum sensitivity of 8742 nm/RIU in the range 1.365-1.38 refractive index units (RIU) which overcomes that of surface plasmon resonance-based optical fiber devices presented in recent works.

[Hemomediastinum caused by rupture of a bronchial artery aneurysm]. / Hemomediastino por rotura de aneurisma bronquial.

Hemomediastinum caused by rupture of a bronchial artery aneurysm is a very infrequent pathology. Clinical presentation can be variable; it can resemble an aortic pathology and be diagnosed in emergency situations. Computerized tomography (CT) of the thorax is the initial test for diagnosis. We present the clinical case of a 70-year-old man with an initial clinical assessment of transfixive thoracic pain resembling an acute aortic pathology. TC was carried out with a diagnosis of suspected mediastinal neoplasia (Hounsfield Units/HU 38 - soft tissue), biopsy sampling was carried out by gastroscopy and broncoscopy with haemorrhagic pap smear, presenting light anemization on admission and remaining haemodynamically stable and asymptomatic. Facing a high clinical suspicion of arterial pathology, CT was repeated in which hemomediastinum was described in resolution, with subsequent confirmation of the existence of ruptured bronchial artery aneurysm through angiography and proceeding to therapeutic embolization.

Hemomediastino por rotura de aneurisma bronquial / Hemomediastinum caused by rupture of a bronchial artery aneurysm

El hemomediastino por rotura de aneurisma bronquial es una patología muy poco frecuente. La presentación clínica puede ser variable, pudiendo simular patología aórtica y ser diagnosticado en situaciones de emergencia. La tomografía computarizada (TC) de tórax es la prueba de imagen inicial para el diagnóstico. Se presenta el caso clínico de un varón de 70 años con clínica inicial de dolor torácico transfixivo que simulaba patología aórtica aguda. Se realiza TC con diagnóstico de sospecha de neoplasia mediastínica (Unidades Hounsfield/UH 38 - tejidos blandos) realizándose toma de biopsia por gastroscopia y broncoscopia con citología hemorrágica, presentando leve anemización al ingreso y permaneciendo hemodinámicamente estable y asintomático. Ante alta sospecha clínica de patología arterial se repite TC donde se describe hemomediastino en resolución confirmándose posteriormente la existencia de rotura de aneurisma bronquial mediante angiografía y procediendo a su embolización te (AU)

Hemomediastinum caused by rupture of a bronchial artery aneurysm is a very infrequent pathology. Clinical presentation can be variable; it can resemble an aortic pathology and be diagnosed in emergency situations. Computerized tomography (CT) of the thorax is the initial test for diagnosis. We present the clinical case of a 70-year-old man with an initial clinical assessment of transfixive thoracic pain resembling an acute aortic pathology. TC was carried out with a diagnosis of suspected mediastinal neoplasia (Hounsfield Units/HU 38 - soft tissue), biopsy sampling was carried out by gastroscopy and broncoscopy with haemorrhagic pap smear, presenting light anemization on admission and remaining haemodynamically stable and asymptomatic. Facing a high clinical suspicion of arterial pathology, CT was repeated in which hemomediastinum was described in resolution, with subsequent confirmation of the existence of ruptured bronchial artery aneurysm through angiography and proceeding to therapeutic embolization (AU)

Manejo del embarazo en pacientes con lupus eritematoso sistémico / Management of pregnancy in patients with systemic lupus erythematosus

Las pacientes con lupus eritematoso sistémico están expuestas a un número no despreciable de potenciales complicaciones materno-fetales durante la gestación. El conocimiento de la influencia recíproca entre el lupus y el embarazo es un importante punto de partida para asegurar la correcta monitorización de las pacientes, así como lo es la realización de una exhaustiva valoración preconcepcional con el fin de evaluar de forma individualizada el riesgo de cada paciente. El perfil inmunológico, los antecedentes de nefropatía, la historia obstétrica previa, el daño crónico y la actividad son puntos clave que condicionarán el perfil de riesgo. Por último, es fundamental asegurar un correcto manejo farmacológico en este período, teniendo en cuenta el perfil de seguridad de los diversos tratamientos durante el embarazo y la lactancia(AU)

Patients with systemic lupus eythematosus are exposed to a remarkably high number of maternal-fetal complications during pregnancy. Knowledge regarding the reciprocal influence between lupus and pregnancy is the starting point to assure that these patients are correctly monitored. It is also important to carry out comprehensive preconception evaluation to individually evaluate the risk of each patient. The immunological profile, history of nephritis, presence of chronic damage and disease activity are the basic data that will determine the specific individual risk profile. Finally, correct drug management must be assured during this period, based on the safety profile of the different treatments during pregnancy and lactation(AU)

Optical fiber refractometers based on indium tin oxide coatings fabricated by sputtering.

This Letter presents the fabrication of optical fiber refractometers based on indium tin oxide (ITO) coatings deposited by sputtering with response in the visible region. ITO thin films have been sputtered by means of a rotating mechanism that enables the fabrication of smooth and homogeneous coatings onto the optical fiber core. The ITO coating acts as a resonance supporting layer. This permits us to couple light from the waveguide to the ITO-coating/external medium region at specific wavelength ranges. The device is sensitive to external medium refractive index, which allows its utilization as a refractometer. The sensitivity is dependent on the coating thickness, ranging from 523.21 to 1221 nm/refractive index unit in the explored sensors. The sensor development process is time effective compared to other techniques such as dip coating or layer-by-layer self-assembly, which is interesting in terms of mass production.

[Management of pregnancy in patients with systemic lupus erythematosus]. / Manejo del embarazo en pacientes con lupus eritematoso sistémico.

Patients with systemic lupus erythematosus are exposed to a remarkably high number of maternal-fetal complications during pregnancy. Knowledge regarding the reciprocal influence between lupus and pregnancy is the starting point to assure that these patients are correctly monitored. It is also important to carry out comprehensive preconception evaluation to individually evaluate the risk of each patient. The immunological profile, history of nephritis, presence of chronic damage and disease activity are the basic data that will determine the specific individual risk profile. Finally, correct drug management must be assured during this period, based on the safety profile of the different treatments during pregnancy and lactation.

XXVI Congreso de la Sociedad Española de Calidad Asistencial: un buen equilibrio entre calidad e innovación, ciencia y participación / 26th Conference of the Spanish Society of Quality in Healthcare: A good balance between quality, innovation, science and participation

La experiencia y el aprendizaje de programar, organizar y realizar un congreso cierran su círculo de calidad con la evaluación cuantitativa y cualitativa del proceso y de los resultados de cada comité científico y organizador. La transmisión de esta experiencia y aprendizaje a través de la revista nos hace mejorar a todos, a los comités de las futuras sedes de congresos, a los socios y a los participantes y colaboradores. En este trabajo presentamos la evaluación de la actividad desarrollada por los comités científico y organizador del XXVI Congreso de la Sociedad Española de Calidad Asistencial celebrado en octubre de 2008 en Zaragoza. La metodología seguida fue la de evaluar el cumplimiento del cronograma y las tareas asignadas a estos comités en el Manual de Congresos de la sociedad junto con la presentación de los resultados finales del congreso. Se recibieron 1.211 comunicaciones, con un porcentaje de rechazo del 9,1%. Del total, 577 comunicaciones se presentaron en formato oral y 544 en formato póster. Aragón fue la comunidad de origen del 24% de las comunicaciones. Por temáticas, las áreas de mayor interés fueron la seguridad del paciente, la organización y la gestión por procesos y el reflejo de la voz de los pacientes. Se realizaron 7 talleres de los 11 ofertados. La media de asistencia por taller fue de 12 personas. Acudió al congreso un total de 1.131 personas, de las cuales el 17% (193) eran socias de la Sociedad Española de Calidad Asistencial. Se distribuyeron 1.075 cuestionarios de satisfacción, con una tasa de respuesta del 9,30% (100) de la evaluación del congreso y del 54,2% de la evaluación de los talleres. La satisfacción con los talleres realizados tuvo una puntuación media de 4 (escala de 1–5). Con respecto a la valoración del congreso, el contenido científico se valoró con una puntuación media de 3,6 y la organización se valoró con una puntuación media de 3,87, ambas sobre un total de 5 puntos. Por el número de comunicaciones recibidas, el número de asistentes, el nivel de satisfacción con el programa científico y organizador podemos concluir que el XXVI Congreso de la Sociedad ha resultado un éxito, si bien seguimos en nuestro círculo de mejora constante de la calidad que hará que los próximos congresos sean todavía mejores(AU)

The experience and learning process of preparing a scientific conference programme, organising and conducting a conference ccompletes the quality circle with the quantitative and qualitative assessment of the process and results. The transmission of this experience and learning process through this paper will improve the performance of committees of future conference venues, partners and participants and collaborators. The method for performing this evaluation is the assessment of the activities of both the scientific and organising committees of the XXVI Conference of the Spanish Society of Quality Healthcare in October 2008 in Zaragoza. The methodology evaluated the observance of the timetable and tasks assigned to the committees in the Congress Manual of the society along with the presentation of final results of the congress concerning scientific participation and overall satisfaction. There were a total of 1211 communications with a rejection rate of 9.1%. Of the total, 577 communications were presented in oral format and 544 in poster format. Aragon was the community of origin of 24% of communications. By subject areas, those of most interest were patient safety, organisational and management processes, and patient perspectives. A total of 83 participants attended 7 of the 11 workshops offered. The average attendance for each workshop was 12 people. The response rate to the assessment of workshops questionnaire was 54.2% with an average score of 4 (scale of 1 to 5). A total of 1131 people attended the conference of which 17% (193) were SECA associates. Out of a total of 1075 overall satisfaction conference questionnaires distributed there was a response rate of 9.30% (100). The scientific content was assessed with an average score of 3.6 and the organization with 3.87, both on a total score of 5 points. According to the number of abstracts received, number of conferences, level of satisfaction with the scientific program and organisation, we can conclude that the XXVI Conference of the Society has been a success, although we are still in our continuous quality improvement circle that will make conferences even better(AU)

[26th Conference of the Spanish Society of Quality in Healthcare: a good balance between quality, innovation, science and participation]. / XXVI Congreso de la Sociedad Española de Calidad Asistencial: un buen equilibrio entre calidad e innovación, ciencia y participación.

The experience and learning process of preparing a scientific conference programme, organising and conducting a conference ccompletes the quality circle with the quantitative and qualitative assessment of the process and results. The transmission of this experience and learning process through this paper will improve the performance of committees of future conference venues, partners and participants and collaborators. The method for performing this evaluation is the assessment of the activities of both the scientific and organising committees of the XXVI Conference of the Spanish Society of Quality Healthcare in October 2008 in Zaragoza. The methodology evaluated the observance of the timetable and tasks assigned to the committees in the Congress Manual of the society along with the presentation of final results of the congress concerning scientific participation and overall satisfaction. There were a total of 1211 communications with a rejection rate of 9.1%. Of the total, 577 communications were presented in oral format and 544 in poster format. Aragon was the community of origin of 24% of communications. By subject areas, those of most interest were patient safety, organisational and management processes, and patient perspectives. A total of 83 participants attended 7 of the 11 workshops offered. The average attendance for each workshop was 12 people. The response rate to the assessment of workshops questionnaire was 54.2% with an average score of 4 (scale of 1 to 5). A total of 1131 people attended the conference of which 17% (193) were SECA associates. Out of a total of 1075 overall satisfaction conference questionnaires distributed there was a response rate of 9.30% (100). The scientific content was assessed with an average score of 3.6 and the organization with 3.87, both on a total score of 5 points. According to the number of abstracts received, number of conferences, level of satisfaction with the scientific program and organisation, we can conclude that the XXVI Conference of the Society has been a success, although we are still in our continuous quality improvement circle that will make conferences even better.

Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review.

OBJECTIVES: To determine the best available evidence regarding the effectiveness of nursing interventions for adult patients experiencing chronic pain. TYPES OF STUDIES: Randomized Controlled Trials (RCT) and Quasi-Randomized Controlled Trials. TYPES OF PARTICIPANTS: Participants were adults, aged at least 18 years, suffering from chronic pain (lasting for longer than six months). Pain of oncological origin and patients admitted in a hospital, were excluded. TYPES OF INTERVENTIONS: Non pharmacological nursing interventions for chronic pain. TYPES OF OUTCOME MEASURES: The primary outcome measure was chronic pain, and secondary outcome measures were: disability, depression, dependence and health related quality of life. SEARCH STRATEGY: All studies, published and unpublished, in English and Spanish, carried out between January 1997 and December 2007 were retrieved.. SELECTION OF STUDIES: The methodological quality of included articles was assessed by two independent reviewers using appropriate critical appraisal tools from the Joanna Briggs Institute. DATA EXTRACTION AND ANALYSIS: Data were independently extracted by two reviewers, using the standardised data extraction tool from the Joanna Briggs Institute.A meta-analysis was not possible as the trials were heterogeneous in their interventions, characteristics of the populations, intervention duration measurement instruments and outcomes measures. RESULTS: 1,666 references were identified that fit the aim of the review. 92 articles were retrieved, of which 13 were chosen to be critically appraised for their methodological quality. In the end, eight controlled trials were included.The main results were:Other outcome measures showed an improvement in the quality of life (sensorial stimulation and guided imagery), in depression, disability and empowerment (music therapy) and physical functioning (program of psycho-education).The main limitations of this review were: excluding studies were the professional performing the interventions were not detailed or the intervention was not carried out by a nurse and that the search strategy was limited up to 2007. IMPLICATIONS FOR PRACTICE: Listening to music, a cognitive-behavioural treatment programme, magnetic therapy, sensorial stimulation, a psychoeducation programme and guided imagery are nursing interventions that helps to reduce the chronic pain in adults and may be used as contributory to the pharmacological treatment. Short exercises for increasing endurance does not reduce pain. IMPLICATIONS FOR RESEARCH: For future reviews we do not recommend the inclusion of different interventions for the reduction of chronic pain, due to the great number and variability of intervention, but the development of a SR on specific interventions.

Blood conservation strategies in major orthopaedic surgery: efficacy, safety and European regulations.

Several major orthopaedic surgical procedures may result in significant blood loss and the need for allogeneic blood transfusion (ABT). However, overall concerns about adverse effects of ABT have prompted the review of transfusion practice and the search for transfusion alternatives to decrease or avoid the use of ABT. These strategies include the correction of perioperative anaemia, pharmacological and non-pharmacologic measures to reduce blood loss, preoperative autologous blood donation and perioperative red blood cell salvage. We have reviewed the efficacy and safety of these strategies and where appropriate offer evidence-based recommendations on their use in orthopaedic surgery. We also reviewed the European regulations on ABT alternatives. Pharmacological alternatives need to be used with a total adherence to European regulations in their legal and off-label use. The administration and use of pharmacological agents to stimulate erythropoiesis or reduce blood loss needs to be within the context of attempting to use allogenic blood in a rational manner. As for autologous blood, European Directives cover preoperative autologous blood donation, but not its clinical use, and perioperative red blood cell salvage devices, but not the product yielded by them. Therefore, the development of quality standards and good practice guidelines for perioperative red blood cell salvage, as well as its inclusion in the haemovigilance programme, is urgently needed. Finally, it is noteworthy that some recommendations given for ABT alternatives are not supported by a high level of evidence and that the goal of performing major orthopaedic surgical procedures without the use of ABT may be better accomplished by combining several of these techniques within a defined algorithm.

Mujer de origen filipino con tumoración en un pie / Native philippine women with tumor in one foot

No disponible

Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus.

Antimalarials have shown beneficial effects on systemic lupus erythematosus (SLE) activity. Our aim was to investigate whether antimalarials protect against thrombosis and influence survival in SLE patients. A prospective cohort including 232 patients with SLE were included in the study at the time of lupus diagnosis. End points were documented thrombosis and death due to any cause. A Cox regression-multiple-failure time survival analysis model was fitted to establish the effect of antimalarials on the development of thrombosis. Kaplan-Meier survival curves and propensity score adjusted-Cox regression analysis were performed to investigate the effect of antimalarials use on survival. Of our subjects, 204 patients (88%) were women. 230 patients (99%) were white. 150 patients (64%) had ever received antimalarials. Median time on antimalarials was 52 months (range three to 228 months). The Cox multiple-failure time survival analysis showed that taking antimalarials was protective against thrombosis (HR 0.28, 95% CI 0.08-0.90), while aPL-positivity (HR 3.16, 95% CI 1.45-6.88) and previous thrombosis (HR 3.85, 95% CI 1.50-9.91) increased the risk of thrombotic events. Twenty-three patients died, 19 of whom (83%) had never received antimalarials. No patient treated with antimalarials died of cardiovascular complications. Cumulative 15-year survival rates were 0.68 for never versus 0.95 for ever treated patients (P < 0.001). Age at diagnosis and propensity score-adjusted HR for antimalarials ever versus never users was 0.14 (95% CI 0.04-0.48). Our study shows a protective effect of antimalarials against thrombosis and an increased survival of SLE patients taking these drugs. These data support the routine use of antimalarials in all patients with SLE.

Identification and characterization of novel angiotensin-converting enzyme inhibitors obtained from goat milk.

The aim of the present study was to identify and characterize new inhibitory peptides of angiotensin I-converting enzyme (ACE) from goat milk and to analyze the effect of long-term intake of a goat milk hydrolysate-supplemented (GP-hyd) diet on the development of hypertension in spontaneously hypertensive rats (SHR). Three new inhibitory peptides for ACE (TGPIPN, SLPQ, and SQPK) were isolated. The inhibitory concentration 50% (IC50) values of individual peptides were 316, 330, and 354 micromol/L, respectively. Only TGPIPN was found to pass intact a monolayer of Caco-2 cells in small amounts. The SHR fed for 12 wk a diet (GP-hyd) enriched in a hydrolysate containing these peptides (estimated intake of TGPIPN was 230 mg/kg per d) showed lower (approximately 15 mmHg) systolic blood pressure than animals fed a control diet. The ACE activities in the aorta, left ventricle, and kidney were significantly decreased in the GP-hyd group compared with those of the control group and were similar to those found in SHR fed captopril (130 mg/kg per d). Impaired endothelium-dependent relaxation to acetylcholine by aortic rings from SHR was improved in those fed the GP-hyd diet. The left ventricle weight and kidney weight index were significantly reduced in the GP-hyd group and captopril groups. Moreover, long-term treatment of SHR with a diet enriched in goat milk hydrolysate, or captopril, attenuated the development of hypertension, cardiac and renal hypertrophy, and endothelial dysfunction. These effects might be related to the in vivo inhibitory effects of the hydrolysate on tissue ACE activity.

Novel aspects of endothelium-dependent regulation of vascular tone.

The vascular endothelium plays a crucial role in the regulation of vascular homeostasis and in preventing the initiation and progress of cardiovascular disease by controlling mechanical functions of the underlying vascular smooth muscle. Three vasodilators: nitric oxide (NO), prostacyclin, and endothelium-derived hyperpolarizing factor, produced by the endothelium, underlie this activity. These substances act in a co-ordinated interactive manner to maintain normal endothelial function and operate as support mechanisms when one pathway malfunctions. In this review, we discuss recent advances in our understanding of how gender influences the interaction of these factors resulting in the vascular protective effects seen in pre-menopausal women. We also discuss how endothelial NO synthase (NOS) can act in both a pro- and anti-inflammatory action and therefore is likely to be pivotal in the initiation and time course of an inflammatory response, particularly with respect to inflammatory cardiovascular disorders. Finally, we review recent evidence demonstrating that it is not solely NOS-derived NO that mediates many of the beneficial effects of the endothelium, in particular, nitrite acts as a store of NO released during pathological episodes associated with NOS inactivity (ischemia/hypoxia). Each of these more recent findings has emphasized new pathways involved in endothelial biology, and following further research and understanding of the significance and mechanisms of these systems, it is likely that new and improved treatments for cardiovascular disease will result.

Evaluación de la utilización de heparinas de bajo peso molecularcomo profilaxis de tromboembolismo venoso en pacientes demedicina interna / No disponible

Introducción: Existe suficiente evidencia para recomendarla tromboprofilaxis rutinaria en pacientes médicos con factores de riesgo, siendo las heparinas de bajo peso molecular (HBPM) la opción más adecuada para realizarla. El objetivo es conocer el grado de riesgo de tromboembolismo venoso (TEV) en pacientes de medicina interna tratados con HBPM en profilaxis, los hábitos de prescripción y su adecuación al protocolo del hospital, así como detectar la prevalencia de pacientes no tratados con riesgo. Material y método: Estudio descriptivo y prospectivo de 2 meses de duración sobre los pacientes ingresados en medicina interna. Se reclutaron aquellos con prescripción profiláctica de HBPM y se determinó su grado de riesgo de TEV y la dosis de HBPM adecuada, según el “Protocolo de prevención de enfermedad tromboembólica” de nuestro hospital. Paralelamente se analizaron los pacientes no tratados para estimar si eran subsidiarios de profilaxis con HBPM. Resultados: Al 30% de los ingresados se le prescribió una HBPM profiláctica, de los que el 43,5% recibió una prescripción ajustada a su grado de riesgo. Sus factores de riesgo más destacados fueron: edad, encamamiento, HTA, cardiopatía de riesgo, diabetes mellitus, dislipemias y EPOC. El test c20,05 entre grado de riesgo y HBPM instaurada reveló que no existía asociación. Del grupo de pacientes no tratados, el 72% presentaron un nivel de riesgo moderado o alto. Conclusiones:1. Una gran proporción de los pacientes estudiados presentan nivel considerable de riesgo de TEV. 2. No se observa relación entre nivel de riesgo y profilaxis pautada (AU)

Background: Sufficient evidence exists to recommend routine thromboembolic disease prophylaxis for medical inpatients with risk factors -with low-molecular-weight- heparins being(LMWH) the most suitable treatment option. The objective is to determine the thromboembolic risk level of Internal Medicine patients with LMWH prophylaxis, prescription habits and the iradequacy to hospital’s standards, as well as prevalence of non treated patients at risk. Material and methods: Descriptive and prospective study of internal medicine patients for 2 months. Patients with prophylactic LMWH prescription were chosen, and their thrombo embolicrisk level and suitable LMWH dose was determined according to the hospital’s “thromboembolic disease prevention standards”.On the other hand, patients with no LMWH prophylaxis were analysed in order to judge their candidacy. Results: 30% of patients had a prophylactical LMWH prescription, with 43.5% of these prescriptions being adequate to the risk level. The main risk factors were: age, bed-stay, hypertension,cardiopathy with risk factors, diabetes mellitus, dislipemias and COPD. c20.05 test between risk level and prescribed LMWH revealed no association. 72% of patients without LMWH prescription had a moderate or high risk level. Conclusions:1. A high proportion of the patients studied have a considerable thromboembolic risk level.2. There is not a statistical relationship between thromboembolic risk level and LMWH prescription.3. There is a high percentage of patients with no LMWH prophylaxis which could be eligible for it.4. A pharmaceutical intervention would be useful to approachpharmacological prophylaxis to each patient’s risk (AU)