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Horcajada-Reales C.,Hospital Universitario Of Fuenlabrada | Conde-Montero E.,Hospital Universitario Infanta Leonor
Piel | Year: 2017

Introduction: Juvenile acne is a very common medical condition among adolescents. Despite this high prevalence, adolescents have a remarkable lack of knowledge about this dermatosis, with friends and relatives being their most used information source. Acne has a significant impact on quality of life, and some patients may develop depressive symptoms and social isolation. Objective: To improve the knowledge about acne of pre-adolescent schoolchildren, and to provide them with the psychological tools for a better approach to this condition. Materials and methods: A non-randomised experimental study was conducted on adolescents (12-14 years old) in 3 schools in the area of Madrid, Spain. A pre-interventional questionnaire was completed to determine their knowledge and attitude towards acne. Talks were given by two dermatologists in the 3 schools, and the topics covered were pathophysiology, treatments, and psychological tools. A post-interventional questionnaire was completed 4 weeks later so that the impact of the programme could be evaluated. Results: A total of 334 students completed the pre-interventional questionnaire and 307 the post-interventional questionnaire. Questionnaires including nonsense answers were not considered for the statistical analysis (n = 23 and n = 16, respectively). Relatives and friends were found to be the main source of information about acne. Lack of personal hygiene was associated with acne by 50% of the participants, with 18% of the adolescents considering acne a contagious disease. It is remarkable the lack of knowledge about therapeutic options. Conclusions: Although this a limited experiment, the results of our study suggest that psycho-educational interventions are a well-accepted cost-effective tool that may change attitudes towards a very prevalent medical condition, and which can have a significant impact on quality of life. © 2017 Elsevier España, S.L.U.


Miravitlles M.,CIBER ISCIII | Garcia-Sidro P.,Hospital Of La Plana | Fernandez-Nistal A.,Takeda Farmaceutica Espana S.A | Buendia M.J.,Hospital Universitario Infanta Leonor | Espinosa de los Monteros M.J.,Hospital Universitario Virgen Of La Salud
Health and Quality of Life Outcomes | Year: 2013

Introduction: COPD exacerbations have a negative impact on lung function, decrease quality of life (QoL) and increase the risk of death. The objective of this study was to assess the course of health status after an outpatient or inpatient exacerbation in patients with COPD.Methods: This is an epidemiological, prospective, multicentre study that was conducted in 79 hospitals and primary care centres in Spain. Four hundred seventy-six COPD patients completed COPD assessment test (CAT) and Clinical COPD Questionnaire (CCQ) questionnaires during the 24 hours after presenting at hospital or primary care centres with symptoms of an exacerbation, and also at weeks 4-6. The scores from the CAT and CCQ were evaluated and compared at baseline and after recovery from the exacerbation.Results: A total of 164 outpatients (33.7%) and 322 inpatients (66.3%) were included in the study. The majority were men (88.2%), the mean age was 69.4 years (SD = 9.5) and the mean FEV1 (%) was 47.7% (17.4%). During the exacerbation, patients presented high scores in the CAT: [mean: 22.0 (SD = 7.0)] and the CCQ: [mean: 4.4 (SD = 1.2)]. After recovery there was a significant reduction in the scores of both questionnaires [CAT: mean: -9.9 (SD = 5.1) and CCQ: mean: -3.1 (SD = 1.1)]. Both questionnaires showed a strong correlation during and after the exacerbation and the best predictor of the magnitude of improvement in the scores was the severity of each score at onset.Conclusions: Due to their good correlation, CAT and CCQ can be useful tools to measure health status during an exacerbation and to evaluate recovery. However, new studies are necessary in order to identify which factors are influencing the course of the recovery of health status after a COPD exacerbation. © 2013 Miravitlles et al.; licensee BioMed Central Ltd.


Hodgkins P.,Shire Development LLC | Setyawan J.,Shire Development LLC | Mitra D.,RTI Health Solutions | Davis K.,RTI Health Solutions | And 4 more authors.
European Journal of Pediatrics | Year: 2013

This study was a retrospective chart review performed to examine and describe physician practice patterns in managing attention deficit/hyperactivity disorder (ADHD) across Europe. Physicians treating ADHD in the UK, France, Germany, Italy, the Netherlands and Spain were recruited. Each physician abstracted medical records of five patients (aged 6-17 years at time of review) with a documented diagnosis of ADHD made between January 2004 and June 2007. Data provided by the physician via the abstraction included (a) physician characteristics, (b) patient characteristics, (c) ADHD diagnosis and (d) ADHD outcomes (adherence, symptom control and satisfaction). A total of 779 patients met study inclusion criteria. In the overall population, patients' mean (SD) age at time of diagnosis was 8.9 (2.6) years. The predominant treatment choice was long-acting methylphenidate, which was prescribed to more than 56 % of patients. According to physicians, only 30.8 % of patients showed 'complete symptom control' on current treatment and only 31.8 % of physicians reported being 'very satisfied' with their patients' current treatment. Physicians' assessments of complete symptom control and physician satisfaction with treatment were low, indicating unmet needs with current ADHD management in Europe. © 2013 The Author(s).


Corella F.,Hospital Universitario Infanta Leonor | Del Cerro M.,Hospital Beata Maria Ana | Larrainzar-Garijo R.,Hospital Universitario Infanta Leonor | Larrainzar-Garijo R.,Complutense University of Madrid | Vazquez T.,Complutense University of Madrid
Journal of Hand Surgery: European Volume | Year: 2011

We present an anatomical study and description of a new surgical technique for arthroscopic treatment of scapholunate ligament injuries. Five cadaver specimens were used to perform the technique. After arthroscopic surgery, anatomic dissection was performed to measure the distances to critical wrist structures such as the posterior interosseous nerve and the radial artery, and the size and position of the plasty. This arthroscopic technique offers three advantages: soft tissue damage is reduced (avoiding an extensive approach and injury to the secondary stabilizers and reducing scar tissue); injury to the posterior interosseous nerve is avoided (maintaining wrist proprioception and the role of the dynamic stabilizers); and a biotenodesis is made that ensures proper placement, tension and functionality of the flexor carpi radialis ligament reconstruction. © The Author(s) 2011.


Ginsberg Y.,Karolinska Institutet | Quintero J.,Hospital Universitario Infanta Leonor | Anand E.,Eli Lilly and Company | Casillas M.,Eli Lilly and Company | Upadhyaya H.P.,Eli Lilly and Company
Primary Care Companion to the Journal of Clinical Psychiatry | Year: 2014

Objective: To raise awareness of attention-deficit/hyperactivity disorder (ADHD) as an underdiagnosed, undertreated, often comorbid, and debilitating condition in adults. Data Sources: PubMed was searched using combinations of keywords, including ADHD, adult, diagnosis, identify, prevalence, and comorbid, to find articles published between 1976 and 2013. Study Selection: In total, 99 articles were selected for inclusion on the basis of their relevance to the objective and importance to and representation of ADHD research, including international guidelines for adults with ADHD. Results: In a large proportion of children with ADHD, symptoms persist into adulthood. However, although adults with ADHD often experience chaotic lifestyles, with impaired educational and vocational achievement and higher risks of substance abuse and imprisonment, many remain undiagnosed and/or untreated. ADHD is usually accompanied by other psychiatric comorbidities (such as major depressive disorder, anxiety disorder, and alcohol abuse). Indeed, adults with ADHD are more likely to present to a psychiatric clinic for treatment of their comorbid disorders than for ADHD, and their ADHD symptoms are often mistaken for those of their comorbidities. Untreated ADHD in adults with psychiatric comorbidities leads to poor clinical and functional outcomes for the patient even if comorbidities are treated. Effective treatment of adults' ADHD improves symptoms, emotional lability, and patient functioning, often leading to favorable outcomes (eg, safer driving, reduced criminality). A few medications have now been approved for use in adults with ADHD, while a multimodal approach involving psychotherapy has also shown promising results. Conclusions: General psychiatrists should familiarize themselves with the symptoms of ADHD in adults in order to diagnose and manage ADHD and comorbidities appropriately in these patients. © 2014 Physicians Postgraduate Press, Inc.


Palencia Herrejon E.,Hospital Universitario Infanta Leonor | Bueno Garcia B.,Hospital Universitario Infanta Leonor
Medicina Intensiva | Year: 2013

In 2004 was published the first edition of the "Surviving sepsis campaign" guidelines for the management of severe sepsis and septic shock, opening a new era in the treatment of this syndrome. The paradox is that guidelines application have produced positive results despite including in some cases treatments proven ineffective. Eight years later has been published the third edition of the guides, which updates the prior in the light of new knowledge, but the quality of evidence remains weak. In this paper the authors express their critical view on the current edition of the guides, pointing out their weaknesses and suggesting how the development of future editions should be. © 2013 Elsevier España, S.L. and SEMICYUC.


Objectives: This paper aims to conduct a review of current scientific evidence on therapeutic hypothermia (TH) induced after cardiac arrest (CA).To examine the published literature; existing nursing knowledge; and the pursuit of the proper role of nursing. Background: CA is a problematic health status with a high associated mortality rate. Cardiopulmonary resuscitation (CPR) techniques have increased the number of patients who recover spontaneous circulation, whereas, mortality in intensive care units (ICU) arising from the neurological damage produced, remains very high. Induced TH is defined as a protective factor against neurological damage resulting from the CA and CPR, but despite the recommendations on its use in the management of post-cardiac arrest syndrome, there is little rigour in its use, little nurse standardisation, and a lack of protocols in our ICU. Search strategy: The databases which can be accessed are: Medline, Pubmed, Ocenet Health, Cochrane Library Plus, Cuiden, Scielo, and electronic platforms Elsevier, OVID and ProQuest. The following keywords were used to start the search: "Hypothermia, Induced", "Heart Arrest", "Nursing". Inclusion and exclusion criteria: only evidence published since 2005, regardless of the output language, focusing on those works involving nursing. Conclusions: This work shows clear evidence of the use of TH induced after CA, and the literature and knowledge required for nursing to interpret their own role, and to introduce standardised protocols for ICUs. © 2011 Elsevier España, S.L. y SEEIUC.


Garcia J.T.,Hospital Universitario Infanta Leonor | Bascunana J.,Hospital Universitario Infanta Leonor
AIDS Reviews | Year: 2016

Following the introduction of triple combination therapy in 1996, the paradigm of HIV infection has been modified by its transformation into a chronic disease and thereby significantly reducing its morbidity and mortality. The spectrum of drugs in use since then has changed dramatically with the advent of more potent molecules, new classes of drugs aimed at novel therapeutic targets and their optimization and simplification through fixed-dose combinations that are more convenient for patients, and which, taken together, have led to sustained virologic response rates in treatment-naive patients of more than 90%. However, the different drugs that make up antiretroviral therapy continue to pose problems of tolerability and toxicity (such as tenofovir-associated renal and bone toxicity, or neuropsychiatric toxicity that has been related to efavirenz and, more recently, to some integrase inhibitors), which can be detrimental to the patient’s compliance to a given antiretroviral therapy and lead to virologic failure. In this context of sustained virologic response, safety has emerged as probably the single most important factor in treatment and should be given serious consideration when choosing an antiretroviral therapy regimen. Herein, we review the role of the adverse effects that result from the different drugs that are currently available, as described in data published from clinical trials and real life cohort studies, as well as possible therapeutic strategies for the management of these toxicities. © 2016 Permanyer Publications.


Quintero J.,Hospital Universitario Infanta Leonor | de la Mota C.C.,Hospital Universitario Infanta Leonor
Pediatria Integral | Year: 2014

ADHD (Attention Deficit Hyperactivity Disorder) is neurodevelopmental disorder with great knowledge in the past years, but whose first references dating back two centuries ago. The diagnosis must be based on the newer criteria of the DSM-5 that defines it as a pattern of behavior and cognitive functioning that means difficulties in their cognitive, educational and/or labor functioning for the individual who suffers it. The prevalence varies between 5 and 10[%] globally; in Spain of 6.8[%] for children and adolescents, showing a higher prevalence in men than in women (especially phenotype hyperactive-impulsive). Its pathogenesis is multifactorial and that genetic, neurochemicals and neuroanatomics factors are interrelated, as well as influence of environmental factors. © 2014, Ediciones Ergon SA. All rights reserved.


Cobo P.A.,Hospital Universitario Infanta Leonor
Revista de la Sociedad Espanola de Enfermeria Nefrologica | Year: 2013

Currently has increased the use of tunneled catheters as permanent vascular access for hemodialysis patients despite having associated complications, such as bacteremia. The aim of this work is to show the incidence of catheter-related bacteremia for hemodialysis obtained with the strict implementation of a protocol tunneled catheter care by well-trained personnel in the Hemodialysis Unit of University Hospital Infanta Leonor between April 2008 and April 2013, and to describe possible causes of bacteremia, the relationship with any of the variables and their evolution in recent years. During 5 years of study there had been 9 episodes of catheter-related bacteremia which is an overall incidence rate of 0.25 / 1000 catheter days. The fee for each of the years was less than 1/1000 catheter days. Patients who had bacteremia had catheters implanted more than those who had not, and this difference was significant (p = 0.027). No differences were found with respect to age, sex, diabetes mellitus, the Charlson comorbidity index and location of catheters among patients who developed bacteremia from those without.

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