Anemia profile in critical septic patients hospitalized in the ICU

The aim was to describe the anemia profile of medical or surgical patients with severe sepsis or septic shock in the ICU, assessing severity scale, length of stay and mortality. The prevalence of microcytic anemia is more than one-half of our septic patients. There are iron metabolism disorders without significant differences between medical and surgical patients. Transferrin, a protein related to malnutrition, inflammatory response and organ dysfunction, is significantly lower in the most severe patients with higher organ dysfunction scores.

Paciente transferido desde Equipo M��vil de Dispositivo de Cuidados Cr��ticos y Urgencias (EM DCCU) a sistema de helitransporte sanitario (HEMS): Gu��a de actuaci��n

Assistance and transfer of critical patients often takes place in an environment in which the medium response time, playing against an appropriate and de���nitive treatment at a center useful. The relationship in this sense arises between the resources of the level of primary care and the medical helicopter transport system (HEMS), is caused by the need to shorten those response times and referral in areas where initial care is taken to DCCU out by, despite being timedependent pathology that requires a fast transfer can not be offered by them with the possibility of optimization. The support in this sense of HEMS is essential: The knowledge of the environment and the establishment of policy guidance are necessary.

Application of Molecular Diagnostic Techniques for Viral Testing.

Nucleic acid amplification techniques are commonly used currently to diagnose viral diseases and manage patients with this kind of illnesses. These techniques have had a rapid but unconventional route of development during the last 30 years, with the discovery and introduction of several assays in clinical diagnosis. The increase in the number of commercially available methods has facilitated the use of this technology in the majority of laboratories worldwide. This technology has reduced the use of some other techniques such as viral culture based methods and serological assays in the clinical virology laboratory. Moreover, nucleic acid amplification techniques are now the methods of reference and also the most useful assays for the diagnosis in several diseases. The introduction of these techniques and their automation provides new opportunities for the clinical laboratory to affect patient care. The main objectives in performing nucleic acid tests in this field are to provide timely results useful for high-quality patient care at a reasonable cost, because rapid results are associated with improvements in patients care. The use of amplification techniques such as polymerase chain reaction, real-time polymerase chain reaction or nucleic acid sequence-based amplification for virus detection, genotyping and quantification have some advantages like high sensitivity and reproducibility, as well as a broad dynamic range. This review is an up-to-date of the main nucleic acid techniques and their clinical applications, and special challenges and opportunities that these techniques currently provide for the clinical virology laboratory.

Comienza el proceso de formaci��n para desarrollar grupos socioeducativos en Atenci��n Primaria

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

Telemedicine influence on the follow-up of type 2 diabetes patients.

OBJECTIVE This study was designed to evaluate the impact of a teleassistance system on the metabolic control of type 2 diabetes patients. RESEARCH DESIGN AND METHODS We conducted a 1-year controlled parallel-group trial comparing patients randomized (1) to an intervention group, assigned to a teleassistance system using real-time transmission of blood glucose results, with immediate reply when necessary, and telephone consultations, or (2) to a control group, being regularly followed-up at their healthcare center. Study subjects were type 2 diabetes patients >30 years of age followed in the primary care setting. RESULTS A total of 328 type 2 diabetes patients were recruited from 35 family practices in the province of M��laga, Spain. There was a reduction in hemoglobin A1c after 12 months from 7.62 +/- 1.60% to 7.40 +/- 1.43% (P = 0.027) in the intervention group and from 7.44 +/- 1.31% to 7.35 +/- 1.38% (P = 0.303) in the control group. The difference in the change between groups was not statistically significant. There was also a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, and body mass index in the intervention group. In the control group, the only significant decline was in low-density lipoprotein cholesterol. CONCLUSIONS A teleassistance system using real-time transmission of blood glucose results with an option to make telephone consultations is feasible in the primary care setting as a support tool for family physicians in their follow-up of type 2 diabetes patients.

La prevenci��n de la obesidad infantil desde la atenci��n primaria

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

Un paso m��s hacia las buenas pr��cticas en la atenci��n perinatal en Andaluc��a

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

El plan de parto y nacimiento, un paso m��s en la humanizaci��n de la atenci��n perinatal en Andaluc��a

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

Encuentros sobre inmigraci��n y salud: debates sobre la atenci��n a la multiculturalidad y la diversidad

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

La atenci��n primaria de salud, mas necesaria que nunca para afrontar la inequidad

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica y Participaci��n Social de la Consejer��a de Salud

Celebrado el I Encuentro de los Grupos Socieducativos de Atenci��n Primaria

Bolet��n semanal para profesionales sanitarios de la Secretar��a General de Salud P��blica, Participaci��n Social, Inclusi��n y Calidad de Vida de la Consejer��a de Salud y Bienestar Social

N��m 2, junio de 2013

Art��culos destacados: Buenas pr��cticas en gesti��n cl��nica: Mejora en el uso de tiras para autoan��lisis de glucemia capilar. Estrategia para la mejora del indicador de prescripci��n en receta "��ndice sint��tico de calidad". Identificaci��n de puntos cr��ticos de seguridad e informaci��n en el proceso embarazo, parto y puerperio. Planificaci��n anticipada de decisiones en pacientes que se encuentran en una situaci��n c��nica de cronicidad avanzada o de terminalidad.

Mejora en el uso de tiras para autoan��lisis de glucemia capilar

Secci��n "Buenas pr��cticas en gesti��n cl��nica"

Vocational rehabilitation: a multidisciplinary intervention

Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work. Clinical staff in contact with a person who has lost his job (general practitioner, specialized physician) must promote vocational rehabilitation. Medical rehabilitation for those with disabilities, whether new or old, has to be followed without delay by vocational rehabilitation. It is even better if these two intertwined processes are overlapping. They involve many professionals including physiotherapists, occupational therapists, psychologists, vocational trainers, job counsellors, teachers, case-managers, job placement agencies. Vocational rehabilitation has a financial cost, borne by many state organizations (security, social system, social affairs) as well as by employers and private insurances, which are in case of accident, concerned by this process. However, the evidence suggests that this is recouped 2- to 10-fold as suggested by the British Society of Rehabilitation Medicine

N��m 3, julio/agosto de 2013

Art��culos destacados: Buenas pr��cticas en gesti��n cl��nica: Mes de la diabetes. Abordaje compartido de la cefalea: Consenso Hospital Virgen de la Victoria y Hospital Regional de M��laga. Listado de verificaci��n de procedimientos invasivos en nefrolog��a: cat��ter peritoneal, cat��ter venoso central temporal para hemodi��lisis y biopsia renal percut��nea. Creaci��n de una Unidad de Gesti��n Cl��nica de Farmacia de ��mbito provincial