Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review

[Abstract] The advances achieved in recent decades regarding cardiac surgery have led to a new risk that goes beyond surgeons’ dexterity; postoperative hours are crucial for cardiac surgery patients and are usually spent in intensive care units (ICUs), where the patients need to be continuously monitored to adjust their treatment. Clinical decision support systems (CDSSs) have been developed to take this real-time information and provide clinical suggestions to physicians in order to reduce medical errors and to improve patient recovery. In this review, an initial total of 499 papers were considered after identification using PubMed, Web of Science, and CINAHL. Twenty-two studies were included after filtering, which included the deletion of duplications and the exclusion of titles or abstracts that were not of real interest. A review of these papers concluded the applicability and advances that CDSSs offer for both doctors and patients. Better prognosis and recovery rates are achieved by using this technology, which has also received high acceptance among most physicians. However, despite the evidence that well-designed CDSSs are effective, they still need to be refined to offer the best assistance possible, which may still take time, despite the promising models that have already been applied in real ICUs.Xunta de Galicia; ED431C 2018/4

Electroacupuntura en un caso de neuralgia postherpética con afectación de la rama oftálmica del V par craneal

Postherpetic neuralgia consists of chronic neuropathic pain that appears as a complication of varicella-zoster virus infection and is characterized by intense and episodic pain. The treatment of choice is pharmacological but adequate therapeutic response is not always achieved, either due to drug intolerance or to inadequate pain control. We report the case of a woman with postherpetic neuralgia affecting the left ophthalmic branch of the trigeminal nerve, in whom distinct drug treatments failed to achieve adequate pain control. Given this situation, electroacupuncture sessions were started, combined with pharmacological therapy. The frequency and intensity of the pain exacerbations progressively diminished, allowing drug treatment to be discontinued. Electroacupuncture can constitute a therapeutic alternative in patients with drug intolerance or inadequate control of neuropathic pain with pharmacological treatment.Neuralgia postherpética: cuadro de dolor neuropático crónico que aparece como complicación de una infección por el virus de la varicela zóster. La clínica se caracteriza por un dolor intenso y episódico. El tratamiento de elección es farmacológico, pero en un porcentaje de pacientes no se consigue una adecuada respuesta terapéutica, bien por intolerancia a los fármacos bien por inadecuado control del dolor. Se presenta el caso clínico de una paciente con una neuralgia postherpética que afecta a la rama oftálmica izquierda del V par craneal, en la cual no conseguimos un adecuado manejo del cuadro doloroso tras probar diferentes pautas farmacológicas. Ante esta situación, se inició sesiones de electroacupuntura combinadas con fármacos. Se obtuvo una mejoría progresiva de las crisis dolorosas en intensidad y frecuencia, lo que permitió la supresión del tratamiento farmacológico. Alternativa terapéutica a pacientes que no toleran los tratamientos farmacológicos para su dolor neuropático o cuando éstos son ineficaces