Programa de seguimiento a usuarios drogodependientes con VIH tras su ingreso en un centro hospitalario

Las prácticas peligrosas de inyección de drogas por parte de los usuarios de sustancias intravenosas influyen notablemente en el aumento de las tasas de infección por el VIH. Las personas drogodependientes con VIH suelen presentar un perfil concreto, con una serie de carencias y necesidades que afectan a todas las áreas de su vida (sanitaria, social, económica, familiar, etc.). Muchas de estas necesidades pueden ser abordadas desde el punto de vista del Trabajo Social, teniendo lugar el primer contacto en Centros de Atención Sanitaria Especializada. Debido al perfil de los pacientes, durante el ingreso en el hospital, se precisa la valoración social por parte de trabajadores sociales, ya que es en este momento cuando se detectan las necesidades principales, si bien el periodo de intervención suele ser breve dadas las características de atención asistencial del propio centro. Muchos de estos pacientes abandonan el hospital cuando reciben el alta y no se realiza un seguimiento de la intervención, debido, entre otros factores, al propio perfil de los pacientes y a la escasez de un recurso para tal propósito. Este proyecto tiene como objetivo principal la creación de un programa de seguimiento a pacientes drogodependientes con VIH, una vez que abandonan el centro hospitalario. A través de este seguimiento, se pretende preservar la adherencia al tratamiento médico e intervenir en las carencias sociales de este tipo de usuarios que hayan sido identificadas durante el ingres

Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer—A Randomized Clinical Trial

Alterations derived from lymphedema in the upper-limb secondary to breast cancer-related lymphedema (BCRL) decrease the health-related quality of life (HRQoL), but there is limited evidence of the impact of the different interventions on it. The aim of this research was to compare the effect of conventional treatment with another treatment based on Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) on HRQoL in women diagnosed with BCRL.This research was funded by the Call for research and innovation projects in the field of primary care, regional hospitals and high-resolution hospital centres of the Public Health System of Andalusia in 2021 by the Progreso y Salud Foundation, of the Ministry of Health and Families of the Junta de Andalucía, with EXP. No.: AP-0160-2021-C2-F2. He has also been awarded a scholarship by the Professional Association of Occupational Therapists of Extremadura (COPTOEX) (Spain) call 2020 and awarded a financial contribution from the Research Group in Primary Health Care of Aragon (GAIAP-B21-17R group), recognized and financed by the Government of Aragón (Spain) and by Feder Funds “Another way of making Europe”

Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

Lymphedema, secondary to breast cancer (BCRL), is the abnormal accumulation of protein-rich fluid in the interstitium caused by a malfunction of the lymphatic system. It causes swelling, deficiencies in upper limb functions and structures, sensory pain and emotional alterations, which have a chronic course and affect the upper limb’s functionality. This study aims to verify the efficacy and efficiency in the upper limb´s functionality of a protocolized experimental approach based on occupational therapy, TAPA (activity-oriented proprioceptive antiedema therapy), in the rehabilitation of BCRL in stages I and II, comparing it with the conservative treatment considered as the standard, complex decongestive therapy (CDT), through a multicenter randomized clinical trial.The study has been financed in the call for competitive competition of research and innovation projects in the field of Primary Care, Regional Hospitals and High Resolution Hospital Centers of the Public Health System of Andalusia for the year 2021, of the Andalusian Public Foundation Progress and Health, according to the definitive list of funded projects, published on 23 December 2021, with EXP. No.: AP-0160-2021-C2-F2, also in the call for “Grants for research projects in Occupational Therapy. Call 2020”, granted by the Professional Association of Occupational Therapists of Extremadura (COPTOEX), Spain and, in 2020, received an economic contribution from the Research Group in Primary Health Care of Aragon (GAIAP-B21-17R group)

Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

Background: Lymphedema, secondary to breast cancer (BCRL), is the abnormal accumulation of protein-rich fluid in the interstitium caused by a malfunction of the lymphatic system. It causes swelling, deficiencies in upper limb functions and structures, sensory pain and emotional alterations, which have a chronic course and affect the upper limb’s functionality. This study aims to verify the efficacy and efficiency in the upper limb´s functionality of a protocolized experimental approach based on occupational therapy, TAPA (activity-oriented proprioceptive antiedema therapy), in the rehabilitation of BCRL in stages I and II, comparing it with the conservative treatment considered as the standard, complex decongestive therapy (CDT), through a multicenter randomized clinical trial. Methods: a randomized and prospective clinical trial was conducted with experimental and control groups. Women diagnosed with BCRL belonging to institutions in Córdoba and Aragon (Spain) participated. Sociodemographic variables and those related to the functionality of the affected upper limb were evaluated before and after the intervention. Results: The results showed statistically significant differences in the analysis of covariance performed for the variable joint balance of the shoulder´s external rotation (p = 0.045) that could be attributed to the intervention performed; however, the effect size was minimal (η2 ≤ 0.080). In the rest of the variables, no significant differences were found. Conclusions: TAPA may be an alternative to the conservative treatment of women with BCRL. It was shown to be just as effective for volume reduction and activity performance as CDT but more effective in improving external rotation in shoulder joint balance

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective