Background
Foley catheters have been subject to limited development in the last few decades. They fulfil their basic function of draining urine from the bladder but cause other associated problems. ...T‐Control is a new silicone Foley catheter with an integrated fluid control valve whose design aims to reduce the risks associated with bladder catheterization by a multifactorial approach. The general purpose of this study is to determine the effectiveness, comfort, and experience of the patient catheterized with T‐Control® compared with patients with a conventional Foley catheter.
Study Design
This trial is a mixed‐method study comprising a two‐arm, pilot comparative study with random allocation to T‐Control catheter or traditional Foley catheter in patients with long‐term catheterization and a study with qualitative methodology, through discussion groups.
Endpoints
The comfort and acceptability of the T‐Control® device (qualitative) and the quality of life related to self‐perceived health (quantitative) will be analysed as primary endpoints. As secondary endpoints, the following will be analysed: magnitude and rate of infections (symptomatic and asymptomatic); days free of infection; indication of associated antibiotic treatments; determination of biofilm; number of catheter‐related adverse events; use of each type of catheterization's healthcare resources; and level of satisfaction and workload of health professionals.
Patients and Methods
Eligible patients are male and female adults aged ≥18 years, who require a change of long‐term bladder catheter. The estimated sample size is 50 patients. Patient follow‐up includes both the time of catheter insertion and its removal or change 4 weeks later, plus the time until the discussion groups take place.
Background: News about suicide may have either
a contagion effect or a protective effect. For this reason,
interventions aimed to the media are a priority. However,
the effectiveness of the ...interventions has not yet been elucidated.
The objective of the study was to evaluate comparatively
the characteristics and adequacy of suicide
news articles between geographical areas in which interventions
aimed at media either exist or not.
Methods: We evaluated suicide news articles in the
four main digital media of Spain (without interventions)
and Victoria, Australia (with interventions), according to
Alexa (a website traffic statistics). We assessed adherence
to World Health Organization (WHO) recommendations,
avoidability, frequency, and typology of suicide news
articles. The evaluation period was 6 months. Bivariate
analysis was performed comparing the samples using ttest,
Chi-Squared test and Fisher’s exact test according to
the type of variable.
Results: We identified 378 suicide news articles:
141 in Spain and 237 in Victoria. Suicide news articles in
Spain showed a lower degree of adherence to the WHO
recommendations than those from Victoria (2.97 vs. 11.8;
p<0.001). Mean daily number of suicide news articles
was lower in Spain (0.78 vs. 1.31; p<0.001). Typology
according to contents was different between both regions
(p=0.045), with greater prevalence of “suicide after murder”
in Spain. However, there were no differences either
in avoidability, or in typology according to behaviour.
Conclusions: Suicide news articles are more adequate
in the geographic area in which interventions aimed
at media are performed. These better characteristics imply
lower risk of contagion effect, greater likelihood of protective
effect and, therefore, a potential beneficial effect
on the suicidal behaviour in the reference population.
Fundamentos: Dado que las noticias sobre suicidio
pueden favorecer tanto un efecto contagio como protector,
las intervenciones dirigidas a los medios de comunicación
resultan prioritarias. Sin embargo, la efectividad
de las intervenciones aún no se ha dilucidado. El objetivo
del estudio fue evaluar comparativamente las características
y adecuación de las noticias sobre suicidio entre áreas
geográficas en las que existían o no intervenciones dirigidas
a los medios.
Métodos: Evaluamos las noticias sobre suicidio en
los cuatro principales periódicos digitales de España (sin
intervenciones) y de Victoria, estado de Australia (con intervenciones),
utilizando Alexa (herramienta que proporciona
una clasificación de tráfico web). Evaluamos la adhesión
a las recomendaciones de la Organización Mundial
de la Salud (OMS), así como su evitabilidad, frecuencia
y tipología. El periodo de estudio fue de 6 meses. Se realizó
análisis bivariado comparando las muestras mediante
t-Student, Chi-cuadrado, y test exacto de Fisher según el
tipo de variable.
Resultados: Identificamos 378 noticias sobre suicidio:
141 en España y 237 en Victoria. Las noticias de
España presentaron menor grado de adhesión a las recomendaciones
de la OMS que las de Victoria (2,97 frente
a 11,8; p<0,001). La media de noticias diarias fue menor
en España (0,78 respecto a 1,31; p<0,001). La tipología
según contenido fue diferente entre ambas regiones
(p=0,045), con mayor notificación del “suicidio tras asesinato”
en España.
Conclusiones: Las noticias sobre suicidio con mayor
adecuación se producen en el área donde se realizan
intervenciones, lo que sugiere su efectividad. Estas mejores
características suponen menor riesgo de efecto contagio
y mayor probabilidad de efecto protector y, por ende,
un potencial efecto beneficioso sobre la conducta suicida
de la población.
Purpose
Preference-based measures are valuable tools for evaluating therapeutic interventions and for cost-effectiveness studies. Mapping procedures are useful when it is not possible to collect ...these kind of measures. The objective of this study was to evaluate which mapping method is the most appropriate to estimate the EQ-5D-5L index from the Spanish National Health Survey functional disability scale.
Methods
The sample, formed by 5708 older adults (aged 65 years or older), was drawn from the Spanish National Health Survey (“Encuesta Nacional de Salud en España,” ENSE in Spanish 2011–2012). The predictions of EQ-5D-5L index were performed with response mapping using Bayesian network (BN), ordered logit (Ologit), and multinomial logistic (ML). The following direct methods were used: ordinary least squares (OLS) and Tobit regression. The intraclass correlation coefficient (ICC), absolute error (MAE), mean squared error (MSE), and root-mean squared error (RMSE) were calculated to compare all models. The predictions of response models were obtained through the expected value method.
Results
BN model showed the highest ICC (0.756, 95% confidence interval, CI 0.733–0.777) and lowest MAE (0.110, 95% CI 0.104–0.115). OLS was the model with worse accuracy results with lowest ICC (0.621, 95% CI 0.553–0.681) and highest MAE (0.159, 95%CI: 0.145–0.173).
Conclusion
Indirect mapping methods (BN, Ologit, and ML) had a better accuracy than the direct methods. The response mapping approach provides a robust method to estimate EQ-5D-5L scores from the functional disability scale.
Sarcopenia and malnutrition have been associated in the elderly population with a poor prognosis in wound healing and with other adverse events, such as institutionalization or functional impairment. ...However, it is not known how these factors influence the prognosis of diabetic foot in the elderly. To answer this question, a prospective observational study of 45 patients over 65 years of age admitted with diagnoses of diabetic foot in a tertiary hospital has been conducted. All patients were assessed at admission and at 3 months after returning home to determine quality of life, pain, mobility and healing, overall hospital stay in relation to the presence of malnutrition (measured by BMI, CIPA scale and analytical parameters at admission of serum proteins and albumin), and sarcopenia measured by grip force, among other geriatric syndromes. The results found a relationship between altered sarcopenia and more pain and poorer quality of life, and altered BMI was related to a lower cure rate and worse mobility at follow-up. This study seems to indicate that, in the elderly population with diabetic foot, malnutrition and sarcopenia should be managed at the same time as the treatment of the diabetic foot itself.
The dramatic spread of SARS-CoV-2 infections calls for reliable, inexpensive tools to quickly identify patients with a poor prognosis. In this study, acute respiratory distress syndrome (ARDS) was ...assessed within 72 h after admission of each of 153 consecutive, SARS-CoV-2 infected, adult patients to either of two hospitals in Tenerife, Spain, using suitable routine laboratory tests for lymphocyte counts, as well as ferritin, lactate dehydrogenase (LDH), and C-reactive protein levels. Results were correlated with the patients' respiratory function, defined through their pulse oximetric saturation/fraction of inspired oxygen (SpO2/FiO2) ratio.
Within 72 h from admission, criteria matched ARDS (SpO2/FiO2 < 235) in 13.1% of cases. We found a significant, negative correlation between SpO2/FiO2 ratios and D-dimer, ferritin, and LDH levels (- 0.31, - 0.32, and - 0.41; p = 0.004, 0.004, and < 0.0001, respectively). In patients with ARDS, the mean LDH was 373 U/L (CI
: 300.6-445.3), but only 298 U/L (CI
: 274.7-323.1) when they did not develop the syndrome (p = 0.015). None of the additionally evaluated biomarkers correlated with the SpO2/FiO2 ratios. Serum LDH levels in patients hospitalised for COVID-19 correlate with ARDS, as defined by their SpO2/FiO2 ratio, and might help to predict said complication.
Background:
Pain secondary to chemotherapy-induced peripheral neuropathy (CIPN) can limit the administration of chemotherapy, cancer-treatment outcomes, and the quality of life of patients. Oxidative ...stress and inflammation are some of the key mechanisms involved in CIPN. Successful treatments for CIPN are limited. This report shows our preliminary experience using ozone treatment as a modulator of oxidative stress in chronic pain secondary to CIPN.
Methods:
Ozone treatment, by rectal insufflation, was administered in seven patients suffering from pain secondary to grade II or III CIPN. Pain was assessed by the visual analog scale (VAS).
Results:
All patients, except one, showed clinically relevant pain improvement. Median pain score according to the VAS was 7 (range: 5–8) before ozone treatment, 4 (range: 2–6) at the end of ozone treatment (
p
= 0.004), 5.5 (range: 1.8–6.3) 3 months after the end of ozone treatment (
p
= 0.008), and 6 (range: 2.6–6.6) 6 months after the end of ozone treatment (
p
= 0.008). The toxicity grade, according to the Common Terminology Criteria for Adverse Events (CTCAE v.5.0), improved in half of the patients.
Conclusion:
This report shows that most patients obtained clinically relevant and long-lasting improvement in chronic pain secondary to CIPN after treatment with ozone. These observed effects merit further research and support our ongoing randomized clinical trial (NCT04299893).
Most of rare disease (RD) patients are assisted in their homes by their family as informal caregivers, causing a substantial burden among family members devoted to care. The role of informal ...caregivers has been associated with increased levels of stress, poor physical/mental health and impaired HRQOL. The present study assessed the impact on HRQOL and perceived burden of long-term informal caregiving, as well as the inter-relationships of individuals affected by different RD in six European countries, taking advantage of the data provided by the BURQOL-RD project (France, Germany, Italy, Spain, Sweden and UK). Correlation analysis was used to explore the relation between caregiver HRQOL and caregiver burden (Zarit Burden Interview). Multinomial logistic regression models were used to explore the role of explanatory variables on each domain of caregivers HRQOL measured by EQ-5D. Caregivers’ HRQOL is inversely correlated with burden of caring. Mobility dimension of EQ-5D was significantly associated with patients age, time devoted to care by secondary caregivers, patient gender and patient utility index. Patients’ age, burden scores and patient utility index significantly predict the capacity of caregivers to perform activities of daily living. Employed caregivers are less likely of reporting ‘slight problems’ in pain/discomfort dimensions than unemployed caregivers. The EQ-5D instrument is sensitive to measure differences in HRQOL between caregivers with different levels of burden of care.
Assessing patients with chronic obstructive pulmonary disease (COPD) accounts for 30% of all pneumology outpatient evaluations. COPD is a heterogeneous disease and generates a massive public health ...problem. Overall morbidity, particularly cardiovascular disease, challenges patient management. This is an observational, multicentre study, performed at four hospitals in the Canary Islands (Spain), aimed at characterising patients with COPD referred to pneumology outpatient services. Demographic variables, lung function, and morbidity were assessed.
Of the 877 included patients, 44.9% were active smokers with a mean (± SD) age of 68.2 ± 10.3 years. The median (IQR) score for the Charlson comorbidity index was 2 (2), and 70.6% of the patients were assigned high risk according to the Spanish Guidelines for COPD (GesEPOC) 2021. The degree of airflow obstruction defined by the GOLD 2021 stages 1, 2, 3, and 4 corresponded to 13.6%, 49%, 31%, and 6.3% of patients, respectively. The most frequently associated morbidities were arterial hypertension (59.5%), dyslipidaemia (54.3%), and type 2 diabetes mellitus (31.2%); 32% of the patients suffered heart disease. There is a high prevalence of active smoking, type 2 diabetes mellitus, and heart disease in patients referred for COPD to Canary Island pneumology outpatient services.
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