Revistas UDEA (Universidad de Antioquia)
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El uso racional de la terapia de erradicación para Helicobacter pylori en pacientes con diagnóstico de úlcera duodenal perforada
No full textTrastornos depresivos y ansiosos en población con discapacidad intelectual
No full textIntellectual disability (ID) encompasses limitations in intellectual and adaptive functions that facilitate an individual’s social, familial and occupational development. In Latin America, it is estimated that the prevalence is four times higher than the rest of the world, with figures ranging from 4% to 16%. This article presents a literature review on the prevalence, behavior, diagnosis and treatment of anxiety and depression disorders in individuals with ID, considering the psychosocial consequences and overall health implications they entail. In this population, it is crucial to understand the diversity in the manifestations of mental disorders, as their presentation may vary compared to the general population. For this reason, we use scales and clinical interviews that, along with clinical judgement, will guide medical management. Treatments aimed at patients with ID and comorbid anxious or depressive disorders do not differ from those recommended for the general population, as the use of medications is directed at treating existing comorbidity without impacting the intellectual quotient or daily functionality. However, there is a lack of specific studies in this population group.La discapacidad intelectual (DI) comprende las limitaciones de las funciones intelectuales y adaptativas que permiten el desarrollo social, familiar y laboral de un individuo; en Latinoamérica se estima que la prevalencia es cuatro veces mayor que en el resto del mundo, con cifras que van del 4% al 16%. En este artículo se hizo una revisión de la literatura acerca de la prevalencia, el comportamiento, el diagnóstico y el tratamiento de trastornos de ansiedad y depresión en personas con DI, teniendo en cuenta las consecuencias psicosociales y en salud global que estas acarrean. En esta población es de suma importancia el conocimiento de la diversidad en las manifestaciones de los trastornos mentales, ya que su presentación podría variar con relación a la población general. Por esto, contamos con escalas y entrevistas clínicas que junto con el juicio clínico orientarán el manejo médico. Los tratamientos dirigidos a pacientes con DI y trastornos ansiosos o depresivos no difieren de los recomendados en población general, puesto que el uso de medicamentos estará dirigido a tratar la comorbilidad existente sin impacto en el coeficiente intelectual o la funcionalidad diaria, sin embargo, faltan estudios específicos en este grupo poblacional
Fisiopatología y características clínicas de las neuropatías en pacientes con COVID-19: una revisión narrativa
No full textIntroduction: SARS-CoV-2 possesses neurotropic and neuroinvasive capabilities that can generate neurological manifestations; however, the identification of patients with peripheral nervous system manifestations may go unnoticed.
Objectives: To describe the pathophysiology and clinical characteristics of neuropathies in patients with COVID-19.
Methodology: The information used in this review was collected from four bibliographic databases: PubMed, Clinical Key, Scielo, and Scopus. Articles in Spanish and English published between January 2019 and January 2022 were included. Cross-sectional studies, cohort studies, and case reports were analyzed.
Results: There are mechanisms that explain the neuroinvasive capacity of SARS-CoV-2, such as direct infection, underlying axonal transport, and hematogenous transport across the blood-brain barrier. These mechanisms can generate various neuropathies, with anosmia and ageusia being the most frequent symptoms. Other manifestations have been reported, including sensorimotor polyneuropathy, facial nerve neuropathy, ocular motor neuropathies, lower cranial neuropathy, multiple cranial neuropathies, and neuralgic amyotrophy, which may or may not be directly associated with the virus.
Conclusions: Neuropathies in patients with COVID-19 significantly impact functional prognosis following infection. Early recognition of neurological manifestations facilitates the implementation of rehabilitation therapies that improve the patient's quality of life.Introducción: el SARS-CoV-2 posee capacidades neurotrópicas y neuroinvasivas que pueden generar manifestaciones neurológicas; sin embargo, la identificación de pacientes con manifestaciones en el sistema nervioso periférico puede pasar desapercibida.
Objetivos: describir la fisiopatología y las características clínicas de las neuropatías en pacientes con COVID-19.
Metodología: la información utilizada en esta revisión fue recolectada de cuatro bases bibliográficas: PubMed, Clinical Key, Scielo y Scopus. Se incluyeron artículos en español e inglés publicados entre enero de 2019 y enero de 2022. Se analizaron estudios transversales, de cohorte y reportes de caso.
Resultados: existen mecanismos que explican la capacidad neuroinvasiva del SARS-CoV2 como infección directa, transporte axonal subyacente y transporte hematógeno por la barrera hematoencefálica. Lo anterior puede generar diferentes neuropatías, siendo los síntomas más frecuentes la anosmia y la ageusia. Otras manifestaciones han sido reportadas, como polineuropatía sensitivomotora, neuropatía del nervio facial, neuropatías motoras oculares, neuropatía craneal inferior, neuropatías craneales múltiples y amiotrofia neurálgica, las cuales pueden estar o no directamente asociadas con el virus.
Conclusiones: las neuropatías en pacientes con COVID-19 impactan de manera importante el pronóstico funcional posterior a la infección. El reconocimiento temprano de las manifestaciones neurológicas favorece la realización de terapias de rehabilitación que mejoran la calidad de vida del paciente
Clic laríngeo: reporte de caso con una causa anatómica no descrita
No full textIntroduction: Laryngeal click is a rare phenomenon largely unknown to physicians in general. There are approximately 20 cases reported in the literature, with the first report described by Counter in 1978. It presents as a click in the neck due to anatomical changes in the larynx. It can lead to repeated medical consultations and cause psychological symptoms, affecting quality of life, as patients are unaware of the benign nature of their condition.Objectives: The aim is to increase awareness of this condition to better manage patients with this rare symptomatology and highlight the importance of its diagnosis.Methods: We present a case of bilateral laryngeal click syndrome associated with tension dysphonia, where the inferior horn of the thyroid cartilage directly impacted the vertebral body, being, to our knowledge, the first report with this mechanism.Results: There are few reported cases with anatomical alterations different from the one presented in this article. A comprehensive and integrated approach should be taken to determine the anatomical causes and possible treatment options.Conclusions: It is important to be aware of this condition to perform comprehensive assessments and, depending on the etiology of the disease, offer therapeutic options to the patient.Introducción: el clic laríngeo es un fenómeno infrecuente y poco conocido por los médicos en general. Existe un aproximado de 20 casos reportados en la literatura, de los cuales el primero fue el informe hecho por Counter en 1978. Se presenta como un clic en el cuello por cambios anatómicos en la laringe. Puede ser causa de reconsultas médicas y provocar síntomas psicológicos que llegan a afectar la calidad de vida, dado que los pacientes desconocen la naturaleza benigna de esta afección.Objetivo: aumentar los conocimientos sobre la existencia de esta enfermedad para abordar pacientes con esta rara sintomatología y resaltar la importancia de su diagnóstico.Métodos: se presenta un caso de síndrome de clic laríngeo bilateral asociado a disfonía tensional, en donde el asta inferior del cartílago tiroides golpeaba directamente contra el cuerpo vertebral, tratándose así, hasta nuestro conocimiento, del primer reporte con este mecanismo.Resultados: son pocos los casos reportados con alteraciones anatómicas diferentes al presentado en este artículo. Se debe realizar un abordaje amplio e integral para determinar las causas anatómicas y los tipos de tratamiento posibles.Conclusiones: es importante conocer esta condición para poder realizar abordajes integrales y, según la etiología de la enfermedad, ofrecer opciones terapéuticas al paciente
Nursing Sensitive Outcomes evaluation in the Emergency Department: An Umbrella Review
No full textObjective. The aim of this review was to identify reported nursing-sensitive outcomes in the Emergency Department to date.
Methods. An Umbrella review was conducted. Four databases, CINAHL, Pubmed, Web of Science and Scopus, were searched from inception until October 2022. MeSH terms were: "nursing", "sensitivity and specificity", "emergency service, hospital", "nursing care". Two reviewers independently screened studies against the inclusion criteria for eligibility, extracted data and assessed study quality with the SIGN tool. Results of the included studies were summarized and described in themes for narrative analysis. The study was enrolled in the PROSPERO registry (CRD42022376941) and PRISMA guidelines were followed.
Results. The search strategy yielded 2289 records. After duplicate removal, title, abstract and full-text eligibility screening, nine systematic reviews were included in the review. A total of 35 nursing-sensitive outcomes were reported. The most described outcomes were waiting times, patient satisfaction and time to treatment. The less measured were mortality, left without being seen and physical function. Synthesizing nursing-sensitive outcomes in themes for reporting, the most measured outcomes were within the safety domain (n=20), followed by the clinical (n=9), perceptual (n=5) and the least explored functional domain (n=1).
Conclusion. Nursing sensitive outcomes research in emergency nursing practice is a conceptual challenge still in its early stage. Several nursing-sensitive outcomes were identified in this review that can evaluate the contribution of emergency department nursing care to patient outcomes. Further research is required to explore patient outcomes sensitive to emergency nursing care
An Analysis of Approaches to Reduction of HIV Stigma across the World through educational interventions: A Scoping Review
No full textObjective. To determinate the educational interventions for reducing the stigma caused by HIV worldwide.
Methods. This scoping review study analyzed all papers published from early 2000 to the end of 2022 by searching all the scientific databases, Scopus, Web of Science, PubMed, Cochrane, Embase and CINHAL. The quality assessment of the papers was done using the ROBIS tool checklist.
Results. 31papers were admitted to the scoping review process. Stigma reduction intervention was founded on three parts: Society, health and therapeutic services providers, and the patients who had HIV and their families. The interventions included education on the reduction of fear, and shame, observation of protective standards, conducting tests and treatment at the above levels, as well as the support provided by the society, policymakers, religious leaders and families of patients in economic, psychological and cultural terms, together with the establishment of social centres and organization of campaigns.
Conclusion. The stigma associated with HIV is a significant obstacle before treatment, life expectancy and living quality of patients. Therefore, the stigma associated with this disease can be reduced, and the living quality of patients can be raised using approaches such as education of healthcare service providers and afflicted people, as well as economic, social, cultural, and psychological support