[Gender differences in the hospitalization and reperfusion delays in the acute coronary syndrome]. / Diferencias de género en los retrasos de ingreso y reperfusión en el síndrome coronario agudo.

OBJECTIVE: To study delay times in women with acute coronary syndrome (ACS) and ST segment elevation (STSEACS) until administration of possible reperfusion therapy as well as its possible differences in relationship to the men. MATERIAL AND METHODS: A study was conducted in 1,849 patients consecutively hospitalized in a Coronary Unit from January 2000 to December 2005 who had been diagnosed of ACS. Different delay times were studied from the beginning of the symptoms, comparing them between genders and correcting this by variable age. RESULTS: The percentage of women was 24.4% with a mean age of 71.5 years. Medium delay time from the beginning of the symptoms to contact with the first health care agent was significantly (p < 0.001), longer for women than for men, 164 min. vs 120 min. Reperfusion treatments were used in 57.6% of the subjects, with a significant difference (p < 0.01) of 7.6% between men (59.5%) and women (51.9%). CONCLUSIONS: Delay times are greater in women than men, above all regarding the beginning of the symptoms until arrival to the first health care agent. Currently, reperfusion treatments are performed more in men than in women, the differences are minimum when adjusted by age.

Diferencias de género en los retrasos de ingreso y reperfusión en el síndrome coronario agudo / Gender differences in the hospitalization and reperfusion delays in the acute coronary syndrome

Objetivo. Estudiar los tiempos de retraso hasta una eventual terapéutica de reperfusiónen las mujeres con síndrome coronario agudo (SCA) y elevación del segmento ST, así comolas posibles diferencias en relación con los varones.Material y métodos. Se ha llevado a cabo un estudio con 1.849 pacientes con diagnósticode SCA ingresados consecutivamente en una Unidad Coronaria, desde enero de 2000 a diciembrede 2005. Se estudian diversos tiempos de retraso desde el inicio de los síntomas,se comparan entre sexos y se corrigen por la variable edad.Resultados. Fueron mujeres el 24,4%, con una media de edad de 71,5 años. La medianaen el tiempo de retraso desde el inicio de los síntomas hasta el contacto con el primerescalón sanitario fue significativamente (p < 0,001) más prolongada en las mujeres queen los hombres, 164 minutos frente a 120 minutos. Los tratamientos de reperfusión seemplearon en el 57,6% de los sujetos, con una diferencia significativa (p < 0,01) del 7,6%entre hombres (59,5%) y mujeres (51,9%).Conclusiones. Los tiempos de retraso son mayores en las mujeres que en los hombres,sobre todo desde el inicio de los síntomas hasta la llegada al primer escalón sanitario.Los tratamientos de reperfusión se realizan más en hombres que en mujeres, aunque,ajustando por edad, las diferencias son mínimas(AU)

Objective. To study delay times in women with acute coronary syndrome (ACS) and STsegment elevation (STSEACS) until administration of possible reperfusion therapy as wellas its possible differences in relationship to the men.Material and methods. A study was conducted in 1,849 patients consecutively hospitalizedin a Coronary Unit from January 2000 to December 2005 who had been diagnosed of ACS.Different delay times were studied from the beginning of the symptoms, comparing thembetween genders and correcting this by variable age.Results. The percentage of women was 24.4% with a mean age of 71.5 years. Mediumdelay time from the beginning of the symptoms to contact with the first health careagent was significantly (p < 0.001), longer for women than for men, 164 min. vs 120 min.Reperfusion treatments were used in 57.6% of the subjects, with a significant difference(p < 0.01) of 7.6% between men (59.5%) and women (51.9%).Conclusions. Delay times are greater in women than men, above all regarding thebeginning of the symptoms until arrival to the first health care agent.Currently, reperfusion treatments are performed more in men than in women, thedifferences are minimum when adjusted by age(AU)

Paciente intervenido de aneurisma de aorta abdominal por técnica quirúrgica endovascular. Caso clínico / Abdominal aortic aneurysm treated by endovascular surgery. A case report

Un aneurisma es una dilatación anormal o abombamiento irreversible de una porción de una arteria. La aorta abdominal es el lugar donde con mayor frecuencia se desarrollan los aneurismas y su aparición suele ser debida a la degeneración de la pared arterial, relacionada con la arteriosclerosis y favorecida por factores de riesgo como el tabaquismo y la hipertensión arterial, entre otros. La evolución natural de un aneurisma de aorta abdominal no tratado es hacia la rotura. El tratamiento esquirúrgico, consistente en la introducción en la aorta de una prótesis cuyos componentes básicos son un stent y un introductor. El caso clínico que se presenta es el de un paciente diagnosticado de aneurisma de aorta abdominal en un examen de salud rutinario, que ingresa ambulatoriamente para la realización de este procedimiento quirúrgico. Para ello se elaboró un plan de cuidados, siguiendo el modelo conceptual de Virginia Henderson. El plan se dividió en 2 partes: una fase de ejecución o preoperatoria y otra de vigilancia o período postimplante. En él hemos usado la taxonomía NANDA, NOC y NIC, problemas interdependientes y complicaciones potenciales. El paciente fue dado de alta a su domicilio tras contactar con la enfermera de referencia en el centro de salud, ya que durante la fase hospitalaria quedaron pendientes de resolución algunos indicadores NOC propuestos (AU)

An aneurysm is an abnormal dilation or irreversible convex of a portion of an artery. The most common site of aneurysms is the abdominal aorta and their appearance is often due to degeneration of the arterial wall, associated with atherosclerosis and favored by risk factors such as smoking and hypertension, among others. Left untreated, aneurysm of the abdominal aorta usually leads to rupture. Treatment is surgical, consisting of the introduction of a prosthesis, composed basically of astent and an introducer, into the aorta. We report the case of a person diagnosed with abdominal aortic aneurysm in a routine examination who was admitted for ambulatory surgical treatment. We designed a nursing care plan, following Virginia Henderson’s conceptual model. The careplan was divided into 2 parts, a first preoperative phase and a second post implantation or monitoring phase. The care plan contained the principal nursing diagnoses, based on the taxonomies of the North American Nursing Diagnosis Association (NANDA), nursing interventions classification (NIC) and nursing outcomes classifications (NOC), and collaboration problems/potential complications. The patient was discharged to home after contact was made with his reference nurse inthe primary health center, since during the hospital phase, some NOC indicators remained unresolved (AU)