RESUMEN
Chikungunya infection is a febrile illness, which currently is afflicting the Caribbean islands including the Dominican Republic. We would like to report our experience with Chikungunya-related musculoskeletal manifestations in our arthritis clinics in the Dominican Republic. A total of 514 patients presented for the first time to our arthritis clinic exhibiting musculoskeletal manifestations, 473/514 (92%) exhibiting symmetric polyarthralgias, 344/514 (67%) arthritis, and 385 (75%) skin rash. The great majority 457.46 (89%) exhibited very good clinical response to nonsteroidal anti-inflammatory drugs (NSAIDs), 370 (72%) require low-dose steroids, and only 5 patients (0.97%) required methotrexate therapy. In addition, of a total of 328 patients with rheumatoid arthritis on biological treatment, 53 exhibited Chikungunya-related musculoskeletal manifestations; 51/53 (96.2%) exhibited symmetric polyarthralgias, 25/53 (47.1%) arthritis, and 13/53 (24.5%) tendinopathy. Of most patients, 51/53 responded to NSAIDs, of which, 23 patients only responded partially, and in total 25 (47.1%) required low-dose steroids. Disease-modifying antirheumatic drug (DMARD) therapy including biologics remained unchanged in this population.
Asunto(s)
Artritis Reumatoide/complicaciones , Artritis Reumatoide/tratamiento farmacológico , Terapia Biológica/métodos , Fiebre Chikungunya/complicaciones , Fiebre Chikungunya/epidemiología , Antiinflamatorios no Esteroideos/uso terapéutico , Antirreumáticos/uso terapéutico , Artralgia/tratamiento farmacológico , Artralgia/epidemiología , Artritis Reumatoide/virología , Brotes de Enfermedades , República Dominicana , Femenino , Humanos , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/complicaciones , Enfermedades Musculoesqueléticas/tratamiento farmacológico , Enfermedades Musculoesqueléticas/epidemiología , Esteroides/uso terapéuticoRESUMEN
Nurses from a national random sample of SANE programs were interviewed about their most recent experience providing expert witness court testimony (N = 110). Forty-three percent of the SANEs characterized this experience "fine" with no difficulties, but 58% mentioned that they had encountered problems. Challenges they faced while testifying are explored in depth and implications for forensic nursing practice are discussed.
Asunto(s)
Actitud del Personal de Salud , Testimonio de Experto , Enfermería Forense/organización & administración , Rol de la Enfermera/psicología , Violación/diagnóstico , Adaptación Psicológica , Adulto , Factores de Edad , Certificación , Distribución de Chi-Cuadrado , Competencia Clínica , Conducta Cooperativa , Testimonio de Experto/legislación & jurisprudencia , Testimonio de Experto/métodos , Femenino , Enfermería Forense/educación , Necesidades y Demandas de Servicios de Salud , Humanos , Relaciones Interprofesionales , Modelos Logísticos , Masculino , Enfermeras Administradoras/educación , Enfermeras Administradoras/organización & administración , Enfermeras Administradoras/psicología , Investigación Metodológica en Enfermería , Personal de Enfermería/educación , Personal de Enfermería/organización & administración , Personal de Enfermería/psicología , Afiliación Organizacional , Violación/legislación & jurisprudencia , Autoeficacia , Encuestas y Cuestionarios , Estados UnidosRESUMEN
We measured the consistency with which a national random sample of 110 Sexual Assault Nurse Examiner (SANE) programs provided 17 services to sexual assault victims. SANE programs consistently offered forensic evidence collection, sexually transmitted infection (STI) prophylaxis, information on HIV, information on pregnancy risk, and referrals to community resources. Reasons programs did not routinely offer particular services (e.g., STI cultures, HIV testing/prophylaxis, emergency contraception (EC)) included financial constraints, difficulties balancing medical care with legal prosecution, and affiliations with Catholic hospitals.
Asunto(s)
Enfermería de Urgencia/organización & administración , Violación/psicología , Servicios de Salud para Mujeres/organización & administración , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Estados UnidosRESUMEN
A random sample of representatives from Sexual Assault Nurse Examiner (SANE) programs throughout the United States were contacted to participate in in-depth telephone interviews about program operations and services for sexual assault patients. Programs that had been in operation 5 years or less at the time of this study are compared to older programs to examine trends.
