The management of pain associated with wound care in severe burn patients in Spain.

OBJECTIVE: To describe the management of pain prevention associated with burn care. METHODS: Multi-centre, observational, cross-sectional, descriptive study performed in 4 burn units in Spain. RESULTS: A total of 55 patients undergoing 64 procedures were analysed. Burns were classified as severe (90.4%), third-degree (78.2%) and caused by thermal agents (81.8%). Background analgesia consisted of non-opioid drugs (87.5%) and opioids (54.7%) [morphine (20.3%), morphine and fentanyl (14.1%) or fentanyl monotherapy (15.6%)]. Burn care was performed by experienced nurses (96.9%); 36.5% followed guidelines. The mean duration of procedures was 44 minutes (Statistical Deviation, SD: 20.2) and the mean duration of pain was 27 minutes (SD: 44.6). Procedural pain was primarily managed with opioid analgesics: fentanyl monotherapy and in combination (84%) and fentanyl monotherapy (48%) administered sublingually (89.1%). Patients described pain as different to usual baseline pain (97%), with a mean maximum intensity score of 4.2 points (SD: 3.3) on the VAS scale and a 34% increase in the intensity of pain. The mean patient and healthcare professional satisfaction score per procedure was 6/10 (SD: 1.9) and 5.5/10 (SD: 1.7), respectively. CONCLUSION: The results of the study describe the management of pain associated with burn care in clinical practice, helping optimise pain control.

Candidemia in major burns patients.

Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge.

[Short form of the WAIS-III for use with patients with schizophrenia]. / Versión abreviada del WAIS-III para su uso en la evaluación de pacientes con diagnóstico de esquizofrenia.

The aim of this study is to obtain a sufficiently guaranteed, abridged, Spanish version of the WAIS-III and thereby reduce the time needed to administer the complete scale. Although the samples used were based both on normal individuals (41 participants with no known history of mental illness) as well as individuals diagnosed with schizophrenia (41 participants), the real focus of the study was the clinical group because this is where the greatest advantages can be obtained by shortening the time to administer the scale. The data demonstrates that the best combination of tests was: Similarities, Picture Completion, Digit Span and Digit Symbol-coding because, with this reduced form, it was possible to obtain a linear correlation between the IQ of the complete scale and that of the abridged form of .91 in the clinical and .86 in the control group. For both groups, the differences between the real IQ averages and the estimated ones were nonsignificant.

Versión abreviada del WAIS-III para su uso en la evaluación de pacientes con diagnóstico de esquizofrenia / Short form of the WAIS-III for use with patients with schizophrenia

El presente trabajo tiene como objetivo obtener una forma abreviada de la versión española del WAISIII que permita, con las garantías suficientes, reducir el tiempo de aplicación de la escala completa. Aunque se utilizaron muestras procedentes tanto de población normal (41 participantes sin patología mental conocida) como de población con diagnóstico de esquizofrenia (41 participantes), realmente el interés estaba centrado en el grupo clínico, ya que en el mismo es donde mayores ventajas se pueden obtener al acortar el tiempo de aplicación de la escala. Los datos mostraron que la mejor combinación de tests fue la de Semejanzas, Figuras Incompletas, Dígitos y Clave de números, ya que con esta forma reducida se obtiene una correlación lineal entre el CI Total de la escala completa y el de la forma abreviada de 0,91 en el grupo clínico y de 0,86 en el control. Para ambos grupos las diferencias entre los CI medios reales y los estimados no fueron significativas(AU)

The aim of this study is to obtain a sufficiently guaranteed, abridged, Spanish version of the WAIS-III and thereby reduce the time needed to administer the complete scale. Although the samples used were based both on normal individuals (41 participants with no known history of mental illness) as well as individuals diagnosed with schizophrenia (41 participants), the real focus of the study was the clinical group because this is where the greatest advantages can be obtained by shortening the time to administer the scale. The data demonstrates that the best combination of tests was: Similarities, Picture Completion, Digit Span and Digit Symbol-coding because, with this reduced form, it was possible to obtain a linear correlation between the IQ of the complete scale and that of the abridged form of .91 in the clinical and .86 in the control group. For both groups, the differences between the real IQ averages and the estimated ones were nonsignificant(AU)