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PubMed | Hospital Universitari Of La Santa Creu nt Pau, Hospital Of Granollers, Hospital Germanstrias I Pujol Of Badalona, Hospital Moises Broggi and 9 more.
Type: | Journal: European journal of neurology | Year: 2016

The percentage of patients with clinical total anterior circulation infarct (TACI) syndrome treated with reperfusion therapies in the absence of intracranial large-vessel occlusion (ILVO) was determined and their characteristics and outcome are described.Data from a population-based, prospective, externally audited registry of all stroke patients treated with intravenous thrombolysis (IVT) and endovascular therapies in Catalonia from January 2011 to December 2013 were used. Patients with a baseline TACI and initial stroke severity measured by the National Institute of Health Stroke Scale (NIHSS) 8, evaluated less than 4.5 h post-onset, for whom a vascular study prior to treatment was available (n = 1070) were selected. Clinical characteristics, outcome and radiological data for patients treated with IVT alone (n = 605) were compared between those with detected ILVO (n = 474) and non-ILVO patients (n = 131).A total of 1070 patients met study criteria; non-ILVO was found in 131 (12.2%). Analysing the 605 patients treated only with IVT, no significant differences were found between non-ILVO and ILVO patients in age, sex, risk factors, time-to-treatment and type of radiological studies performed. Although non-ILVO patients had lower initial stroke severity (P < 0.001) and a better prognosis (P = 0.001), 51.3% had a poor outcome and 16% were deceased at 90 days. In 66.4% of patients without ILVO, a recent anterior territorial infarct was detected.Intracranial artery patency was observed in 12.2% of TACI patients evaluated within 4.5 h. Although absence of ILVO was associated with slightly better prognosis, more than half had a poor outcome at 3 months.


PubMed | Rovira i Virgili University, Complejo Hospitalario Of Jaen and Hospital Universitari Joan Xxiii Of Tarragona
Type: Journal Article | Journal: Enfermeria intensiva | Year: 2015

To contribute to the validation of the EMINA and EVAUCI scales for assessing the risk of pressure ulcers in the critical patient and compare their predictive capacity in this same context.Prospective study from December 2012 until June 2013.Polyvalent intensive care unit of 14 beds in a reference hospital for two sanitary areas.patients of 18 years of age or older and without pressure ulcers were included. They were followed until development of a pressure ulcer of grade I or greater, medical discharge, death or 30 days.presence of ulcers, daily score of the risk of developing pressure ulcers through EMINA and EVARUCI evaluation. The validity of both scales was calculated using sensitivity, specificity, and positive and negative predictive value. The level of significance was P0.05.A total of 189 patients were evaluated. 67.2% were male with a mean age of 59.4 (DE: 16,8) years old, 53 (28%) developed pressure ulcers, being the incidence rate of 41 ulcers per 1000 admission days. The mean day of diagnosis was 7.7 days (DE: 4,4) and the most frequent area was the sacrum. The sensitivity and specificity for the mean of observations was 94.34 (IC95% 87.17-100) and 33.33 (IC95% 25.01-41.66) for the EMINA scale for a risk>10 and 92.45 (IC95% 84.40-100) and 42.96 (IC95% 34.24-51.68) for the EVARUCI scale for a risk of>11.No differences were found in predictive capacity of both scales. For sensitivities>90%the scales show to be insufficiently specific in the pressure ulcer risk detection in critical patients.


Closa-Monasterolo R.,Rovira i Virgili University | Closa-Monasterolo R.,Hospital Universitari Joan Xxiii Of Tarragona | Gispert-Llaurado M.,Rovira i Virgili University | Luque V.,Rovira i Virgili University | And 6 more authors.
Clinical Nutrition | Year: 2013

Background & aims: The sterile newborn digestive tract is rapidly colonized after birth and feeding type could influence this process. Infant formulas try to mimic the bifidogenic effect of human milk using prebiotic supplementation. The aim of this study was to demonstrate the efficacy, safety and tolerance of a 0.8g/dL Orafti®Synergy1 (oligofructose-enriched inulin) supplemented infant formula during the first 4 months of life. Methods: In a double-blind, randomized, placebo-controlled and parallel trial, formula fed healthy term newborns were randomized to receive a control (controls) or SYN1 supplemented infant formula (SYN1). Breastfed newborns (BF) were also followed for comparison. Anthropometry, water balance, blood parameters, adverse events, stool frequency and characteristics and faecal microbiota were assessed. Results: A total of 252 formula fed infants were randomized at birth (n=124 controls, n=128 SYN1) and 131 BF infants were recruited; after 4 months 68 controls, 63 SYN1 and 57 BF completed the study. SYN1 infants showed a microbiota composition closer to that of BF infants, with a trend towards higher Bifidobacterium cell counts, softer stools and a higher deposition frequency compared to controls. There were no differences between formulas in anthropometry and relevant adverse events, water balance or blood parameters. Conclusion: A 0.8g/dL SYN1-supplemented infant formula during the first 4 months of life is safe and effective, promoting a gut microbiota closer to that of breastfeeding.This clinical trial was registered at Clinicaltrials.gov as Study on Fermentable Carbohydrates in Healthy Infants (number NCT00808756). © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.


PubMed | Rovira i Virgili University, Hospital Universitari Mutua Terrassa, University of Girona, Hospital Universitari Of Bellvitge and Hospital Universitari Joan Xxiii Of Tarragona
Type: Journal Article | Journal: Enfermeria intensiva | Year: 2016

The implementation of evidence based practice is essential in clinical practice. However, it is still a challenge in critical care patients.To identify the barriers for conducting research that nursing professionals perceive in intensive care and medical emergency departments, as well as to investigate the areas of interest and motivations to carry out research projects.Cross-sectional and multicentre study carried out in 4 intensive care units and in one Medical Emergency Department emergency pre-hospital carein Catalonia on 2014. The instrument used was The Barriers to Research Utilization Scale which had been previously validated into Spanish. A descriptive and bivariate analysis was performed. A statistical significance of P<.05 was assumed.One hundred seventy-two questionnaires were obtained (69.9% response). Of the total, 135 were from critical care, 27 to pre-hospital care, and 10 from both. Just over half (57.3%) had research experience, although 44.4% had related training. The questionnaire dimension considered most relevant was organisational characteristics. The most important barriers were: there is not enough time at work [3.11 (SD 1.21)], physicians do not collaborate in its implementation [2.99 (SD 1.22)], and nurses are isolated with respect to other professionals [2.86 (SD 1.32)]. Significant differences were observed in the barriers according to research experience and work place. The main motivation was to be updated in critical patient care.The main barriers perceived are related to the organisation. There are differences in the barriers according to research experience and work place.


PubMed | Hospital Universitari Joan Xxiii Of Tarragona, Beneo GmbH Obrigheim and Rovira i Virgili University
Type: | Journal: International journal of food sciences and nutrition | Year: 2016

Constipation is a common disorder in children.The objective of this study is to assess the beneficial effects of a daily supplementation with OraftiDouble-blind, randomised, placebo-controlled parallel group trial where constipated children received two doses of 2g OraftiTwenty-two children were included, 17 completed the study protocol (nine and eight for the control and the OF:IN group, respectively). Results showed that OraftiPrebiotic inulin-type fructans supplementation improves stool consistency in constipated 2-5-year old children. Clinicaltrials.gov, with number NCT02863848.


PubMed | Rovira i Virgili University and Hospital Universitari Joan Xxiii Of Tarragona
Type: Journal Article | Journal: Enfermeria intensiva | Year: 2016

A 69 year old man was admitted to the Intensive Care Unit (ICU) from the Emergency Department due to severe respiratory failure. Due to unsuccessful non-invasive mechanical ventilation, endotracheal intubation was performed. A category I ulcer in coccyx was detected 48h after admission. Eight hours later, a double erythema (the second one darker than the first one) with displacement between 30-45 over the bony prominence suggested there was a deep tissue injury. The lesion progressed rapidly during the next 24h. The shape and the rapid evolution of the injury lead us to diagnose a Kennedy terminal ulcer (KTU). At 72h after the admission, and once the causes of acute decompensation were ruled out, limitation of life-sustaining treatment was decided. An individualised plan of care was drawn up with the aim of identifying problems in a patient with KTU evolving from a critical to a terminal situation. Our overall objectives (NOC) were to adapt the care plan based on a realistic approach. Nursing interventions (NIC) included actions such as pain management, conservative treatment of the injury, agony care and support to help the family to make decisions.The diagnosis of KTU helped the health care team in the decision-making process when they considered limiting the life support, as well as in the adapting of the care plan to the actual situation.


PubMed | Hospital Universitari Joan Xxiii Of Tarragona and Institute Catala Of La Salut
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2015

An epidemiological study was conducted on all cases of invasive pneumococcal disease (IPD) diagnosed in Tarragona, Spain, between 1 January 2006 and 31 December 2009. A total of 286 IPD cases were observed, which was an overall incidence of 21.2 episodes per 100,000 persons-year (95% CI: 16.6-26.9). Incidence rates were 26.3/100,000 (95% CI: 14.4-44.3) among children, 12.2/100,000 (95% CI: 8.2-17.6) among patients between 15-64 years and 59.6/100,000 (95% CI: 40.0-85.8) in those 65 years. Overall lethality rate was 7.3% (none in children, 3.4% among patients 15-64 years, and 14.8% among patients 65 years; p<0.001).

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