Atención interdisciplinar para una adecuada adherencia al tratamiento en pacientes con nefritis lúpica

The review is based on the contribution that each discipline should provide the patient for a holistic care, which include medical assessment, monitoring and counselling as emotional support, assessment and nutritional monitoring as a key element in core requirements, physical activity that optimize the quality of life, social activities that can enter the individual in active groups, follow-up by nurses to the fulfillment of the ordered drug treatment, car care and orientation education to the family. The novelty of this proposal is to basically carry out care of the interdisciplinary team for treatment adherence. This review concluded that patients with lupus nephritis (NL) treated after assessment and follow-up holistic, such as system monitoring and adherence to the treatment of comprehensive care, provides better quality of life, and minimizes the risks of complication of the patient, avoiding recurrent hospitalizations.La revisión está fundamentada en el aporte en que cada disciplina debe brindar al paciente para un cuidado holístico, entre los cuales están la valoración médica, seguimiento y apoyo psicológico como soporte emocional, valoración y seguimiento nutricional como elemento fundamental en requerimientos primordiales, actividad física que optimice la calidad de vida, actividades sociales que logren incursionar al individuo en grupos activos, seguimiento por parte de enfermería al cumplimiento del tratamiento farmacológico ordenado, educación de auto cuidado y orientación a la familia. Lo novedoso de esta propuesta es básicamente llevar a cabo los cuidados del equipo interdisciplinario para la adherencia del tratamiento. Esta revisión permitió concluir, que los pacientes con Nefritis Lúpica (NL) tratados tras valoración y seguimiento holístico, como sistema de vigilancia y adherencia al tratamiento del cuidado integral, brindan mejor calidad de vida, minimiza los riesgos de complicación del paciente evitando hospitalizaciones recurrent

COVID-19 Severity and Survival over Time in Patients with Hematologic Malignancies: A Population-Based Registry Study

Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February–June 2020; n = 769 (66%)) and later (July 2020–February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11–0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01–3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22–0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81–1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.Depto. de MedicinaFac. de MedicinaTRUEFundación Madrileña de Hematología y HemoterapiaFundación Leucemia y LinfomaAsociación Madrileña de Hematología y Hemoterapiapu

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Psicología de la Salud en el Proyecto San Carlos Borromeo de Barranquilla, Colombia

Introducción: El Proyecto San Carlos Borromeo es parte fundamental del programa académico de Psicología en Extensión y Proyección Social de la Universidad Simón Bolívar. Se aplica en el sector 5 del Suroccidente del Área Metropolitana de Barranquilla, específicamente en el Centro de Atención Integral a la Familia (CAIFAM). El énfasis del programa de Psicología de la Salud que allí funciona está en la importancia de mantener estilos de vida saludables, realizando talleres educativos de promoción, prevención e intervención en poblaciones atendidas. Objetivo: Sistematizar el programa de psicología de la salud en el proyecto San Carlos Borromeo desde el segundo semestre de 2005 hasta el 5 de diciembre de 2010. Materiales y métodos: Investigación de tipo cualitativa, con sistematización de experiencias, y con una evaluación a través de la lluvia de ideas y escalas de factores de riesgo. Resultados: Se atendieron 3047 personas, 1518 de género masculino y 1529 de género femenino. La población estuvo constituida por 929 niños, 1481 jóvenes, 456 adultos y 181 adultos mayores. Se realizaron cartillas sobre hipertensión y diabetes, y folletos sobre prevención al maltrato, prevención al abuso y al consumo de drogas, videos, entre otros. Conclusión: Aunque se lograron cambios importantes, es necesario el constante trabajo, debido a que la población está expuesta al manejo inadecuado de comportamientos saludables por la predominancia de un nivel socioeconómico bajo y la convivencia de familias numerosas, en su mayoría no nucleares.ABSTRACTIntroduction: This paper focuses on Health Psychology programs. These programs are based on social and community work, which were carried out in San Carlos Borromeo Side 5 project from Barranquilla in its south-West Metropolitan Area, related to the Family Care Center (CAIFAM). The programs started in the second semester of 2005 and lasted until December 5, 2010. The emphasis of the health psychology program is to stress the importance of keeping healthy lifestyles, conducting educational workshops about promotion, prevention and intervention in populations during these six semesters. Objective: systematic program of health psychology at St. Charles Borromeo project. Materials and methods: A qualitative type, with systematization of experiences, with an evaluation through brainstorming and scales of risk factors. Results: Population and sample: 3,047 people served 1518 male and 1529 female. Distributed: 929 children, 1,481 youth, 456 adults and 181 elderly. Primers were achieved on hypertension and diabetes prevention brochures abuse, prevention and drug use, videos, and more. Conclusion: major changes could be achieved, but it constant work is necessary because people are exposed to inadequate management of healthy behaviors. Since the community is characterized by a low socioeconomic status, living with families, mostly non-nuclear

Estrategias de afrontamiento en pacientes con insuficiencia renal en fase dialítica

El objetivo de esta investigación consistió en identificar las estrategias de afrontamiento asumidas por pacientes con insuficiencia renal en fase dialítica. El enfoque elegido fue el cuantitativo, bajo el paradigma empírico analítico, con un tipo de diseño descriptivo. La muestra fue de 10 pacientes, con edades comprendidas entre 20 y 60 años, en tratamiento de hemodiálisis en la Unidad Renal de la Clínica de la Costa de Barranquilla, que fueron seleccionados en forma intencional y participaron voluntariamente. Se utilizó el cuestionario estandarizado en Colombia de afrontamiento al estrés de Sandin & Chorot. De acuerdo con los resultados, el estilo de afrontamiento más común en esta muestra es el centrado en el problema con sus tres dimensiones: centrada en el problema (80% de la población), reevaluación positiva, con un 80%, y búsqueda de apoyo (60%). Ello indica que este grupo de pacientes asume un papel activo y sigue unos pasos concretos, lo que lo hace responder de manera adecuada a los cambios, demandas y tratamiento impuestos por la enfermedad. Le sigue la religión como estilo de afrontamiento, con un 60% alto en las puntuaciones. La religión, perteneciente a la dimensión de evitación y escape, indica que esta muestra percibe una interferencia importante de su condición de salud sobre su función física y, consecuentemente, acude a sus creencias religiosas como una vía de alivio que mejorará la situación.The objective of this research was to identify coping strategies undertaken by patients with kidney failure on current dialysis. The approach chosen for this research was quantitative, since the empirical analytical paradigm, with a rate of descriptive design. The sample comprised 10 patients aged between 20 and 60 years, on current hemodialysis in Clinica de la Costa Renal Unit, Patients were intentionally selected besides their voluntary participation. Standardized questionnaire was used in Colombia to the stress of coping Sandin & Chorot. According to the results, the coping style they use, is focused on the problem with its three dimensions: focus on the problem, with a score of 80% of the population, also in the positive reappraisal with 80% of the population studied, and seeking support with 60% of the population, indicating that this group of patients take an active role, are still concrete steps, what they do to appropriately respond to changes and demands, and treatment imposed by the disease. It is then the religion as a coping style with a 60% higher in the standings. Religion belongs to the dimension of avoidance and escape, indicates that this sample perceived as a significant interference of their health condition on their physical function and consequently feel less vital, turns to their religious beliefs as a way of relief that the situation will improve

ESTRATEGIAS DE AFRONTAMIENTO EN PACIENTES CON INSUFICIENCIA RENAL EN FASE DIALÍTICA - COPING STRATEGIES IN PATIENTS WITH KIDNEY FAILURE IN THE DIALITIC STAGE

The objective of this research was to identify coping strategies undertaken by patients with kidney failure on current dialysis. The approach chosen for this research was quantitative, since the empirical analytical paradigm, with a rate of descriptive design. The sample comprised 10 patients aged between 20 and 60 years, on current hemodialysis in Clinica de la Costa Renal Unit, Patients were intentionally selected besides their voluntary participation. Standardized questionnaire was used in Colombia to the stress of coping Sandin & Chorot. According to the results, the coping style they use, is focused on the problem with its three dimensions: focus on the problem, with a score of 80% of the population, also in the positive reappraisal with 80% of the population studied, and seeking support with 60% of the population, indicating that this group of patients take an active role, are still concrete steps, what they do to appropriately respond to changes and demands, and treatment imposed by the disease. It is then the religion as a coping style with a 60% higher in the standings. Religion belongs to the dimension of avoidance and escape, indicates that this sample perceived as a significant interference of their health condition on their physical function and consequently feel less vital, turns to their religious beliefs as a way of relief that the situation will improve

Estrategias de afrontamiento en pacientes con insuficiencia renal en fase dialítica

Abstract The objective of this research was to identify coping strategies undertaken by patients with kidney failure on current dialysis. The approach chosen for this research was quantitative, since the empirical analytical paradigm, with a rate of descriptive design. The sample comprised 10 patients aged between 20 and 60 years, on current hemodialysis in Clinica de la Costa Renal Unit, Patients were intentionally selected besides their voluntary participation. Standardized questionnaire was used in Colombia to the stress of coping Sandin & Chorot. According to the results, the coping style they use, is focused on the problem with its three dimensions: focus on the problem, with a score of 80% of the population, also in the positive reappraisal with 80% of the population studied, and seeking support with 60% of the population, indicating that this group of patients take an active role, are still concrete steps, what they do to appropriately respond to changes and demands, and treatment imposed by the disease. It is then the religion as a coping style with a 60% higher in the standings. Religion belongs to the dimension of avoidance and escape, indicates that this sample perceived as a significant interference of their health condition on their physical function and consequently feel less vital, turns to their religious beliefs as a way of relief that the situation will improve. Resumen El objetivo de esta investigación consistió en identificar las estrategias de afrontamiento asumidas por pacientes con insuficiencia renal en fase dialítica. El enfoque elegido fue el cuantitativo, bajo el paradigma empírico analítico, con un tipo de diseño descriptivo. La muestra fue de 10 pacientes, con edades comprendidas entre 20 y 60 años, en tratamiento de hemodiálisis en la Unidad Renal de la Clínica de la Costa de Barranquilla, que fueron seleccionados en forma intencional y participaron voluntariamente. Se utilizó el cuestionario estandarizado en Colombia de afrontamiento al estrés de Sandin & Chorot. De acuerdo con los resultados, el estilo de afrontamiento más común en esta muestra es el centrado en el problema con sus tres dimensiones: centrada en el problema (80% de la población), reevaluación positiva, con un 80%, y búsqueda de apoyo (60%). Ello indica que este grupo de pacientes asume un papel activo y sigue unos pasos concretos, lo que lo hace responder de manera adecuada a los cambios, demandas y tratamiento impuestos por la enfermedad. Le sigue la religión como estilo de afrontamiento, con un 60% alto en las puntuaciones. La religión, perteneciente a la dimensión de evitación y escape, indica que esta muestra percibe una interferencia importante de su condición de salud sobre su función física y, consecuentemente, acude a sus creencias religiosas como una vía de alivio que mejorará la situación

Interdisciplinary care for adequate adherence totreatment in patients with lupus nephritis

The review is based on the contribution that each discipline should provide the patient for a holistic care, which include medical assessment, monitoring and counselling as emotional support, assessment and nutritional monitoring as a key element in core requirements, physical activity that optimize the quality of life, social activities that can enter the individual in active groups, follow-up by nurses to the fulfillment of the ordered drug treatment, car care and orientation education to the family. The novelty of this proposal is to basically carry out care of the interdisciplinary team for treatment adherence. This review concluded that patients with lupus nephritis (NL) treated after assessment and follow-up holistic, such as system monitoring and adherence to the treatment of comprehensive care, provides better quality of life, and minimizes the risks of complication of the patient, avoiding recurrent hospitalizations

Valorar el seguimiento y cumplimiento integral de adherencia al tratamiento en pacientes con nefritis lúpica

Existen múltiples factores que están relacionados con la deciente adherencia terapéutica farmacológica y no farmacológica. Objetivo: valorar el seguimiento y cumplimiento integral de adherencia al tratamiento en pacientes con nefritis lúpica en una institución prestadora de servicios de salud en Barranquilla, Colombia. Método: estudio retrospectivo en 2010-2014, aplicando dos medios para recolección de la información. Se diseñó una lista de chequeo, según los parámetros de la Guía de manejo para paciente renal en Colombia. Otros datos fueron extraídos de historias clínicas: sexo, edad, estado civil, nivel educativo, nivel socioeconómico, tiempo de diagnóstico, cumplimiento de controles y seguimiento interdisciplinar. Se estudiaron 51 registros clínicos que cumplieran con criterios de inclusión. Resultados: la enfermedad se presenta más en mujeres (90,2%), que hombres; la edad promedio fue de 28 a 32 años (60,8%); se atienden más a personas de bajos recursos económicos (43,1%); hay mayor procedencia del departamento del Atlántico (54,9%); el 33,3% de la población tiene un seguimiento entre 3 y 4 veces por año; por lo menos una vez han asistido a una consulta con médico general (100%) y una vez con nefrología; el 66,7% no cumple seguimiento de enfermería y el 59,8% asiste a evaluación nutricional (55%). La prednisolona fue el medicamento más ordenado y con mayor adherencia, y los de baja adherencia fueron: azatriopina, hidralazina, metilprednisolona y aspirina. Conclusión: se hace ineludible la valoración y seguimiento de manera precoz del tratamiento farmacológico y no farmacológico por el equipo interdisciplinario, para prevenir afecciones renales que lleven al deterioro del riñón y compliquen la salud del paciente