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  Subjects -> MEDICAL SCIENCES (Total: 8250 journals)
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MEDICAL SCIENCES (2224 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
3D Printing in Medicine     Open Access   (Followers: 4)
4 open     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 6)
ABCS Health Sciences     Open Access   (Followers: 7)
Abia State University Medical Students' Association Journal     Full-text available via subscription   (Followers: 2)
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 46)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
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Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Científica Estudiantil     Open Access  
Acta Facultatis Medicae Naissensis     Open Access  
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Acta Medica (Hradec Králové)     Open Access  
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Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 6)
Acupuncture and Natural Medicine     Open Access  
Addiction Science & Clinical Practice     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 9)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access   (Followers: 1)
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Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 8)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 8)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 7)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 26)
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Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5)
Advances in Molecular Oncology     Open Access   (Followers: 2)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7)
Advances in Parkinson's Disease     Open Access  
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Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20)
Advances in Regenerative Medicine     Open Access   (Followers: 3)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 6)
Advances in Wound Care     Hybrid Journal   (Followers: 12)
Aerospace Medicine and Human Performance     Full-text available via subscription   (Followers: 13)
African Health Sciences     Open Access   (Followers: 3)
African Journal of Biomedical Research     Open Access   (Followers: 1)
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 2)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 3)
African Journal of Thoracic and Critical Care Medicine     Open Access  
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 2)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 9)
AJOB Primary Research     Partially Free   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal  
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 4)
Al-Azhar Assiut Medical Journal     Open Access   (Followers: 2)
ALERTA : Revista Científica del Instituto Nacional de Salud     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 4)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 2)
Althea Medical Journal     Open Access   (Followers: 2)
American Journal of Biomedical Engineering     Open Access   (Followers: 14)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 8)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 11)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 5)
American Journal of Managed Care     Full-text available via subscription   (Followers: 12)
American Journal of Medical Case Reports     Open Access   (Followers: 1)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 4)
American Journal of Medicine     Hybrid Journal   (Followers: 50)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access   (Followers: 2)
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 10)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 6)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomica Medical Journal     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 3)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1)
Anatomy     Open Access   (Followers: 2)
Anatomy Research International     Open Access   (Followers: 3)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales des Sciences de la Santé     Open Access  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 2)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 3)
Annals of Bioanthropology     Open Access   (Followers: 5)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 4)
Annals of Clinical Hypertension     Open Access  
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 12)
Annals of Family Medicine     Open Access   (Followers: 14)
Annals of Health Research     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Microbiology     Hybrid Journal   (Followers: 11)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Rehabilitation Medicine     Open Access  
Annals of Saudi Medicine     Open Access  
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 5)
Annual Review of Medicine     Full-text available via subscription   (Followers: 17)
Anthropological Review     Open Access   (Followers: 23)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Technology Journal     Open Access   (Followers: 1)
Antibody Therapeutics     Open Access  
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 1)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Informatics     Hybrid Journal   (Followers: 3)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal   (Followers: 2)
Applied Medical Informatics     Open Access   (Followers: 13)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Asthma, Allergy and Immunology     Open Access  
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 4)
Archives of Medicine and Surgery     Open Access  
Archives of Trauma Research     Open Access   (Followers: 3)
Archivos de Medicina (Manizales)     Open Access  
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access  
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Full-text available via subscription   (Followers: 17)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 17)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access  
Asia Pacific Family Medicine     Open Access   (Followers: 1)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 12)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access  
Asian Bioethics Review     Full-text available via subscription   (Followers: 3)
Asian Biomedicine     Open Access   (Followers: 2)
Asian Journal of Cell Biology     Open Access   (Followers: 5)
Asian Journal of Health     Open Access   (Followers: 3)
Asian Journal of Medical and Biological Research     Open Access   (Followers: 4)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 2)
Asian Journal of Medical Sciences     Open Access   (Followers: 2)
Asian Journal of Scientific Research     Open Access   (Followers: 3)
Asian Journal of Transfusion Science     Open Access   (Followers: 1)
Asian Medicine     Hybrid Journal   (Followers: 5)
Asian Pacific Journal of Cancer Prevention     Open Access  
ASPIRATOR : Journal of Vector-borne Disease Studies     Open Access  
Astrocyte     Open Access  
Atención Familiar     Open Access  
Atención Primaria     Open Access   (Followers: 1)
Atti della Accademia Peloritana dei Pericolanti - Classe di Scienze Medico-Biologiche     Open Access  
Audiology - Communication Research     Open Access   (Followers: 10)
Auris Nasus Larynx     Full-text available via subscription  
Australian Coeliac     Full-text available via subscription   (Followers: 1)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Journal of Medical Science     Full-text available via subscription   (Followers: 1)

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Anales del Sistema Sanitario de Navarra
Journal Prestige (SJR): 0.157
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 1137-6627
Published by SciELO Homepage  [737 journals]
  • Ultrasound in clinical practice in Primary Care

    •  
  • Analysis of the use of point-of-care ultrasonography in Emergency
           Departments in public hospitals in Catalonia. ECURCAT Study

    • Abstract: Resumen Fundamento. El objetivo de este estudio es conocer el grado de implantación, las características y la formación de la ecografía a pie de cama, realizada por médicos de urgencias (MU), en los servicios de urgencias hospitalarios (SUH) públicos de Cataluña. Método. Estudio descriptivo basado en una encuesta realizada a los responsables de los SUH públicos de Cataluña y estructurada en tres bloques: dificultad de implementación de la técnica y motivos percibidos en dicha dificultad, aparataje disponible en urgencias y su uso, y formación de los MU. Resultados. Contestaron la encuesta el 96,3% de los SUH públicos. En el 63,5% los MU realizan ecografía a pie de cama. El 86,5% manifestaron un elevado grado de dificultad para implementar la ecografía y el 78,8% disponen de ecógrafo propio. El uso más frecuente es la exploración abdominal (87,9%), torácica (72,7%) o vascular periférica (69,7%). Es escasa la presencia de protocolos y registros de la actividad. La formación no es uniforme entre médicos de plantilla y de guardia. No se encontraron diferencias significativas en función del tipo de hospital, del grado de actividad o de la presencia de radiólogo las 24 horas del día, excepto para el protocolo FAST, más empleado en hospitales comarcales que en el resto (89,5% vs. 42,9%; p=0,007). Conclusiones. La ecografía a pie de cama hecha por MU se usa en más de la mitad de los SUH públicos catalanes. Es necesario que el uso de la ecografía en el SUH se extienda, sea más reglado, registrado de manera adecuada y que participen de él todos los médicos que trabajan en urgencias. Background. The aim of this study was to determine the degree of implantation, the characteristics and the formation of point-of-care ultrasonography, performed by emergency physicians in the public hospital emergency department (ED) of Catalonia. Methods. Descriptive study based on a survey conducted with those responsible for the public ED in Catalonia and structured in three blocks: difficulty of implementing the technique and perceived reasons for this difficulty, equipment available in the emergency room and its use, and training of emergency physicians. Results. The survey was answered by 96.3% of public ED; in 63.5% of them the emergency physicians performed point-of-care ultrasonography. Implementing ultrasonography was considered to have a high degree of difficulty in 86.5%, and 78.8% had their own ultrasound. The most frequent use is abdominal (87.9%), thoracic (72.7%) and peripheral vascular (69.7%). The presence of protocols and registers of the activity is scarce. The training is not uniform between staff doctors and those on call. No significant differences were found according to the type of hospital, the degree of activity or the presence of a radiologist 24 hours a day, the exception being the FAST protocol, which was more used in regional hospitals (89.5% vs. 42.9%; p=0.007). Conclusions. Point-of-care ultrasonography done by emergency physicians is used in more than half of the Catalan public ED. There is a need for extending the use of ultrasound in the ED, it should be more regulated, appropriately registered and involve all physicians working in the emergency department.
       
  • Burnout and executive functions in Palliative Care health professionals:
           influence of burnout on decision making

    • Abstract: RESUMEN Fundamento. Los profesionales sanitarios presentan una alta prevalencia del síndrome de burnout. Este síndrome podría implicar la afectación de funciones cognitivas superiores en el ámbito clínico. El objetivo ha sido evaluar si el burnout está relacionado con las funciones ejecutivas de inhibición, memoria de trabajo, toma de decisiones y flexibilidad cognitiva en el personal sanitario de Cuidados Paliativos. Material y métodos. Se ha evaluado el burnout en setenta y siete profesionales sanitarios de Cuidados Paliativos mediante el Maslach Burnout Inventory (MBI-HSS) y las funciones ejecutivas mediante el test Stroop (inhibición), test de letras y números (memoria de trabajo), Iowa Gambling Task (toma de decisiones) y Trail Making Test (flexibilidad). Los profesionales fueron clasificados en función tanto de su nivel de burnout (bajo, medio, alto) para cada dimensión del MBI-HSS (cansancio emocional, despersonalización y baja realización personal), como del número de dimensiones de burnout alteradas (con niveles altos en ninguna, una o más de una). Resultados. El 54,5% del personal sanitario presentó burnout, un 15,6% con más de una dimensión alterada; estos profesionales obtuvieron puntuaciones significativamente más bajas que los sanitarios sin burnout en los test Stroop, letras y números e Iowa Gambling Task. Niveles más altos de cansancio emocional y despersonalización se relacionaron con puntuaciones significativamente más bajas en el Iowa Gambling Task (toma de decisiones). Conclusiones. Los resultados mostraron que el personal sanitario de Cuidados Paliativos con alto burnout tiene un peor funcionamiento en inhibición, memoria de trabajo y toma de decisiones. Estas funciones ejecutivas pueden ser relevantes en el ámbito clínico, ya que están relacionadas con el procesamiento cognitivo necesario para un adecuado razonamiento clínico del profesional sanitario.ABSTRACT Background. Health professionals show a high prevalence of burnout syndrome. This syndrome could be involved in the alteration of higher cognitive functions in the clinical setting. The aim of this study is to evaluate whether burnout is related to the executive functions of inhibition, working memory, decision-making, and cognitive flexibility in palliative care health professionals. Method. Degree of burnout was evaluated in seventy-seven health professionals from palliative care units by the Maslach Burnout Inventory (MBI-HSS), while executive functions were evaluated by Stroop test (inhibition), Letter-Number Sequencing (working memory), Iowa Gambling Task (decision-making) and Trail Making Test (cognitive flexibility). The total sample was classified in relation to both degree of burnout (low, medium, high) in each subscale of MBI-HSS (emotional exhaustion, depersonalization, and reduced personal accomplishment), and the number of dimensions altered (high levels in none, one or more than one). Results. Burnout syndrome was present in 54.5% of palliative care health professionals, 15.6% of them with more than one dimension altered; these professionals showed significantly lower scores than professionals without burnout in the Stroop test, the Letter-Number Sequencing and the Iowa Gambling Task. Higher levels of emotional exhaustion and depersonalization were associated with significantly lower scores in the Iowa Gambling Task for assessing decision-making. Conclusions. The results showed that palliative care health professionals with a higher level of burnout have an alteration of inhibition, working memory and decision-making. These executive functions can be relevant in the clinical setting since they could be related to the cognitive thinking required for correct clinical reasoning by health professionals.
       
  • Exposure to service user violence and job satisfaction among nursing staff
           in public hospitals in Murcia Region

    • Abstract: RESUMEN Fundamento. Las manifestaciones de violencia tanto física como psicológica (no física) pueden afectar a los niveles de satisfacción laboral. El objetivo de este estudio fue determinar la frecuencia de exposición del personal de enfermería (incluidos auxiliares) a conductas violentas de baja intensidad de usuarios y comprobar si existe una relación entre esta exposición y el nivel de satisfacción laboral. Material y métodos. Estudio descriptivo transversal a través de un cuestionario anónimo autoaplicado al personal de enfermería de los hospitales públicos de la Región de Murcia (1.489 profesionales). Los instrumentos utilizados fueron la escala HABS-U (Hospital Aggressive Behaviour Scale-Users) para valorar la violencia y la OJS (Overall Job Satisfaction) para valorar la satisfacción laboral. Resultados. La frecuencia de trabajadores que, al menos anualmente, refirieron haber sufrido alguna manifestación de violencia fue superior en el caso de la violencia no física (71,0%) que de la física (19,9%). La satisfacción extrínseca media fue 30,1 (DT=6,9), siendo los compañeros de trabajo el factor con más trabajadores satisfechos (68,2%) frente al modo en el que la empresa está gestionada, factor con mayor porcentaje de insatisfechos (28,8%). La satisfacción intrínseca fue menor (M=25,5 y DT= 7,2), siendo la variedad de tareas que realiza en el trabajo el aspecto con mayor porcentaje de satisfechos (51,7%) y la posibilidad de promoción el factor con más insatisfechos (22,4%). Se observó que la satisfacción, tanto extrínseca como intrínseca, se asoció de forma inversa con la exposición a violencia no física y física: una mayor exposición a violencia disminuyó la satisfacción. Conclusiones. En general, las puntuaciones de satisfacción laboral en el personal de enfermería fueron bajas. Uno de los aspectos que podría afectar es la exposición a violencia laboral, por lo que disminuir la exposición a violencia podría aumentar la satisfacción laboral, lo que probablemente redundaría en una mejor atención al paciente.ABSTRACT Background. Manifestations of physical and psychological violence can affect the levels of job satisfaction. The objective of this study is to determine the frequency of exposure to user violence by the nursing staff in public hospitals in the region of Murcia and its relationship with their level of job satisfaction. Methods. Cross-sectional descriptive study through a self-administered and anonymous questionnaire sent to the nursing staff of the public hospitals in the region of Murcia (1,489 professionals). The instruments used were the Hospital Aggressive Behaviour Scale-Users (HABS-U) to rate violence and the Overall Job Satisfaction (OJS) to assess job satisfaction. Results. Most workers (71%) reported suffering at least one of the manifestations of non-physical violence and 19.9% one of the physical manifestations with at least an annual frequency. Mean extrinsic satisfaction was 30.1 (SD=6.9), being coworkers the factor with higher frequency of satisfied workers (68.2%) and how the company was managed the factor with more dissatisfied workers (28.8%). Intrinsic satisfaction was lower (25.5, SD=7.2), being variety of tasks the factor with more satisfied workers (51.7%) and promotion opportunity the one with more dissatisfied workers (22.4%). Both extrinsic and intrinsic satisfaction correlated inversely with the exposure to non-physical and physical violence (higher exposure to violence lowered job satisfaction). Conclusions. In general, the scores for nurses’ job satisfaction were low. One of the aspects affecting this dissatisfaction might be exposure to workplace violence; thus reducing exposure to violence could increase job satisfaction that, in turn, would improve patient care.
       
  • Renal cell carcinoma with sarcomatoid and rhabdoid features: a
           clinico-pathological series of 74 cases

    • Abstract: RESUMEN Fundamento. Nuestro objetivo fue comparar las variables clínico-patológicas de los carcinomas renales (CCR) con fenotipos sarcomatoide y rabdoide. Material y métodos. Se revisaron 1.258 CCR de pacientes consecutivos nefrectomizados entre 1988 y 2015, y se seleccionaron aquellos con ≥1% de cambio sarcomatoide y/o rabdoide. Se clasificaron como sarcomatoide o rabdoide según el fenotipo predominante, considerándose componente desdiferenciado la suma del porcentaje de ambos. Se recopilaron: sexo y edad de los pacientes, síntomas y existencia de metástasis al diagnóstico, parámetros del protocolo de CCR del Colegio Americano de Patólogos, patrón de crecimiento tumoral, invasión perineural, porcentaje de necrosis tumoral y características del infiltrado inflamatorio. Se describieron mediante la media/mediana o el porcentaje y se compararon mediante t de Student/U de Mann-Whitney o χ2/F de Fisher. Resultados. Se identificaron 45 CCR con predominio sarcomatoide (3,6%) y 29 con rabdoide (2,3%); los primeros mostraron mayor componente indiferenciado e invasión perineural respecto a los CCR con rasgos rabdoides (27,5 vs. 13,5%; p=0,003 y 28,9 vs. 3,4%, p=0,006, respectivamente), mientras que estos mostraron doble frecuencia de inflamación neutrofílica (44,8 vs. 22,2%, p=0,04) y surgieron más frecuentemente sobre un CCR de alto grado (55,9 vs. 90,5%, p<0,001). Conclusiones. Los CCR con fenotipos sarcomatoide y rabdoide compartieron características clínico-patológicas, excepto para componente desdiferenciado, invasión perineural, inflamación neutrofílica y origen en CCR de alto grado. Esta similitud sugiere la presencia de un mecanismo común, la transición epitelio-mesénquima, con una expresión morfológica doble que, de confirmarse, podría suponer la posibilidad de seleccionar pacientes para tratamiento o seguimiento a partir de sus características moleculares.ABSTRACT Objetives. Our aim is to analyze and compare the clinico-pathological features in renal cell carcinomas (RCC) with sarcomatoid and rhaboid phenotype. Material and methods. We reviewed 1,258 RCC from consecutive patients with nephrectomy from 1988 to 2015, and those with ≥1% of sarcomatoid and/or rhabdoid change were selected. They were classified as sarcomatoid or rhabdoid according with the predominant morphology, considering the global frecuency of both phenotypes as dedifferentiated component. The following variables were collected: sex, age, symptoms and existence of metastases at diagnosis, parameters listed in the protocol of renal carcinoma of the American College of Pathologists, pattern of tumor growth, perineural invasion, percentage of both tumor necrosis and characteristics of the inflammatory infiltrate. They were described by mean/median or percentage, and compared with Student-t/Mann-Whitney U or χ2/Fisher). Results. We identified 45 RCC with sarcomatoid predominance (3,6%) and twenty-nine with rhabdoid predominance (2,3%); the first one showed a higher dedifferentiated component and perineural invasion (27.5 vs. 13.5%, p=0.003 and 28.9 vs. 3.4%, p=0.006, respectively), while the former showed a higher proportion of neutrophilic inflammation (44.8 vs. 22.2%, p=0.04) and arose more frequently over high grade RCC (55.9 vs. 90.5%, p<0,001). Conclusions. There was overlapping of the clinico-pathological features of RCC with sarcomatoid and rhaboid phenotype, except for dedifferentiated component, perineural invasion and neutrophilic inflammation. This close relationship could be explained by a common underlying mechanism, the epithelial-mesenchymal transition, with a double morphological expression that, if confirmed, could lead to selecting patients that would benefit from follow-up or treatment depending on their molecular characteristics.
       
  • Analysis of our experience in the diagnosis and treatment of obturator
           hernia in a third level hospital

    • Abstract: RESUMEN La patología herniaria supone un porcentaje importante de las intervenciones quirúrgicas urgentes. La hernia obturatriz es una entidad poco frecuente, presentándose generalmente como un cuadro de oclusión intestinal agudo en mujeres adultas. El objetivo del estudio es analizar la experiencia en un hospital de tercer nivel en el diagnóstico y tratamiento de la hernia obturatriz, así como detectar aquellos signos que permitan un diagnóstico precoz. La técnica de imagen de elección para su diagnóstico es la tomografía computarizada. Se trata de un estudio observacional prospectivo, en el que se incluyeron pacientes intervenidos de forma urgente por hernia obturatriz entre los años 2000 y 2016. Para el registro de la morbilidad postoperatoria se empleó la clasificación de Clavien-Dindo. Se identificaron doce pacientes con clínica de obstrucción intestinal secundaria a hernia obturatriz. Todos ellos fueron intervenidos de forma urgente, realizándose laparotomía media urgente en el 59%, laparotomía media infraumbilical en el 33% y abordaje por vía inguinal posterior en un solo paciente (8%). En ocho pacientes (67%) fue necesario realizar una resección intestinal por isquemia intestinal. La técnica quirúrgica empleada fue la reparación mediante malla de polipropileno en seis pacientes (50%), mediante tapón en dos (17%) y cierre con puntos sueltos en cuatro (33%). Cuatro de ellos presentaron complicaciones postoperatorias, registrando un único exitus secundario a perforación por sufrimiento intestinal. Es prioritario establecer un diagnóstico precoz y tratamiento quirúrgico urgente para reducir la morbimortalidad asociada a la hernia obturatriz.ABSTRACT Hernia pathology accounts for a large percentage of urgent surgical interventions. Obturator hernia is rare, usually presenting as a picture of acute intestinal occlusion. The aim of the study is to analyze the experience in a third level hospital in the diagnosis and treatment of obturator hernia, as well as to detect those signs that allow an early diagnosis. This is a prospective observational study, which included patients operated on urgently for obturator hernia between 2000 and 2016. For the registration of postoperative morbidity, the Clavien-Dindo classification was used. We identified twelve patients with intestinal obstruction secondary to obturator hernia. All of them were operated on urgently. Urgent midline laparotomy was carried out on 59% of them, infraumbilical laparotomy on 33%, and a posterior inguinal approach was realized on only one patient (8%). In eight patients (67%) it was necessary to perform intestinal resection. Repair was performed by polypropylene mesh in six patients (50%), by plugging in two (17%) and closing with loose stitches in four patients (33%). Four of them presented postoperative complications, recording a single exitus secondary to perforation due to intestinal suffering. Obturator hernia is a rare entity that develops mostly as an occlusive condition in elderly women. The imaging technique of choice for diagnosis is computed tomography. Establishing an early diagnosis and urgent surgical treatment is a priority to reduce associated morbidity and mortality.
       
  • Analysis of claims for wrong-site surgery (1986-2017)

    • Abstract: RESUMEN Fundamento. La cirugía en sitio erróneo (CSE) es un evento adverso de la asistencia sanitaria potencialmente prevenible. Material y método. Análisis retrospectivo de las 9.129 reclamaciones registradas entre 1986 y 2017 en el Servicio de Responsabilidad Profesional Médica del Consejo de Colegios de Médicos de Cataluña. Resultados. Se localizaron 57 reclamaciones sobre CSE (1,78 reclamaciones/año) con incremento en los últimos diez años (0,92 a 3,83). Hubo un error de paciente correspondiente al procedimiento anestésico; las zonas anatómicas más implicadas fueron los dedos (17,5%) y la columna (15,8%), seguidos de la rodilla y los dientes (12,3% cada uno). Cirugía Ortopédica y Traumatología fue la especialidad más implicada (54,4%). Los procedimientos más frecuentemente implicados en la CSE fueron extracción dental, cirugía de hernia discal y resección ósea en dedo (7 casos cada uno, 12,3%). La vía de reclamación fue penal en 16 casos (28,1%) y civil en 9 (15,8%), con dos sentencias condenatorias por vía civil. El 59,6% de los expedientes conllevaron indemnización, con una cuantía media de 9.210,23 euros por caso, un 65,6% en vía extrajudicial y un 50% en vía judicial. Conclusiones. La CSE presenta una incidencia no desdeñable de reclamación y elevadas tasas de responsabilidad profesional médica, reforzando la necesidad de incrementar los esfuerzos en materia de seguridad del paciente en esta área.ABSTRACT Background. Wrong site surgery (WSS) is a potentially preventable adverse event in healthcare. Methods. We performed a retrospective analysis of the 9,129 claims managed by the Professional Liability Service of the Catalonian’s Colleges of Physicians from 1986 to 2017. Results. We identified 57 claims for WSS (1.78 per year), with an increase in the final ten years (0.92 to 3.83). One patient identification error corresponded to the anesthetic procedure; surgery involving fingers (17.5%), backbone (15.8%), knee (12.3%) and teeth (12.3%) was predominant. Orthopedic Surgery and Traumatology was the specialty most involved (54.4%), being tooth extraction, vertebral disc prolapsed surgery and finger bone resection the most frequent procedures with seven cases each (12.3%). Claims followed criminal (16 cases, 28.1%) or civil proceedings (9 cases, 15.8%), with two guilty verdicts on a civil basis. The frequency of claims leading to compensation was 59.6%, averaged 9,210.23 euros per claim, resolved through extrajudicial (65.6%) or judicial channels (50.0%). Conclusion. WSS events cannot be overlooked and shows high incidence of claims liability rates, which highlights the need to increase efforts to ensure patient safety in this area.
       
  • Night-shift work and breast and prostate cancer risk: updating the
           evidence from epidemiological studies

    • Abstract: ABSTRACT It has been hypothesized that circadian disruption is related to higher cancer risk. Since the International Agency for Research on Cancer classified shift work involving circadian disruption as probably carcinogenic to humans (Group 2A), multiple studies have been conducted to test this hypothesis. The aim of this systematic review was to summarize the findings and evaluate the quality of existing epidemiological studies (case-control and cohort studies) on the relationship between night-shift work and breast and prostate cancer risk. Thirty-three epidemiological studies investigating the relationship between night-shift work and breast (n = 26) or prostate (n = 8) cancer risk were included (one paper included both sites). The Newcastle-Ottawa Scale for the quality of non-randomized studies was used to assess the risk of bias of the publications. The studies included were heterogeneous regarding population (general population, nurses working in rotating shifts, and other) and measurement of exposure to night-shift work (ever vs. never exposure, short vs. long-term, rotating vs. permanent) and, thus, a diversity of outcomes were observed even within the same type of cancer. In summary, 62.5% works found some type of association between night-shift work and increased risk of cancer, for both breast and prostate. The risk of bias scored an average of 7.5 over 9 stars. Due to the limitations inherent in these studies, the evidence of a possible association between night-shift work and breast or prostate cancer risk remains uncertain and more studies providing greater control of exposure and confounding factors are required. Despite the lack of conclusive evidence, application of the precautionary principle seems advisable.RESUMEN Se ha formulado la hipótesis de que la disrupción circadiana está relacionada con un mayor riesgo de cáncer. Desde que la Agencia Internacional de Investigación sobre el Cáncer clasificó la disrupción circadiana asociada al trabajo por turnos como “probablemente carcinógeno para los humanos” (Grupo 2A) se han llevado a cabo numerosos estudios para confirmar o rechazar esta hipótesis. Por esa razón, el objetivo de esta revisión sistemática fue analizar la posible asociación entre el trabajo nocturno por turnos y el riesgo de cáncer de mama o próstata. Se incluyeron treinta y tres estudios epidemiológicos sobre la relación entre el riesgo de padecer cáncer de mama (n = 26) o próstata (n = 8) y el trabajo nocturno; un estudio evaluó ambas localizaciones. El riesgo de sesgo de los artículos se evaluó mediante la escala Newcastle-Ottawa. Los estudios incluidos en esta revisión fueron heterogéneos respecto a población incluida (población general, enfermeras a turnos, y otros), medida de la exposición a trabajo nocturno (siempre vs nunca, a corto vs largo plazo, a turnos o fijo) y, por tanto, los hallazgos fueron variados incluso para el mismo tipo de cáncer. En resumen, un 62,5% de los estudios encontraron asociación entre el trabajo nocturno y el riesgo aumentado de padecer cáncer, tanto de mama como de próstata. El riesgo de sesgo medio fue de 7,5 estrellas sobre 9. Debido a las limitaciones inherentes a estos estudios, la evidencia de una posible asociación entre el trabajo nocturno y el riesgo de cáncer de mama o próstata sigue siendo incierta, por lo que se requieren más estudios epidemiológicos con mayor control de la exposición y de los factores de confusión. No obstante, parece aconsejable la aplicación del principio de precaución.
       
  • Precision dietary guidelines and ingredients for chronic diseases in
           pre-senior and senior populations

    • Abstract: RESUMEN El envejecimiento de la población supone un importante reto, económico y cualitativo, para el sistema de salud orientándolo hacia una atención de tipo preventivo, en la que la nutrición de precisión (NP) y la prescripción de hábitos saludables adquieren relevancia capital. El fin de la NP es procurar una nutrición adaptada a cada individuo, entendiendo que la prevención o el tratamiento de trastornos crónicos (obesidad, diabetes, enfermedad cardiovascular, etc.) deben abordarse de un modo integral, considerando información personal y clínica relevante, edad y características feno- y genotípicas. La elaboración de la presente guía surge de la necesidad de desarrollar modelos nutricionales de precisión que permitan la individualización del tratamiento nutricional, con énfasis en el adulto mayor. Las necesidades nutricionales, las recomendaciones dietéticas y los ingredientes para una NP en las personas pre-sénior y sénior quedan resumidas en realizar al menos 3 comidas diarias, reducir las calorías totales, optar por una alimentación variada y equilibrada con alimentos frescos y de alta densidad nutricional, incorporar verduras, legumbres y pescado, consumir productos lácteos y fibra, preferir carnes blancas en lugar de rojas, evitar frituras, embutidos y alimentos procesados, moderar el consumo de sal, café y alcohol, e hidratarse adecuadamente.ABSTRACT The aging of the population underlines an important challenge for the health system not only from sanitary and economic reasons but also by quality perspectives concerning preventive care, where precision nutrition (PN) and the prescription or advice on healthy habits becomes relevant. PN focuses on provide nutrition adapted to each individual, understanding that the prevention or treatment of chronic disorders (obesity, diabetes, cardiovascular disease, etc.) must be addressed in a comprehensive way, considering not only relevant personal and clinical information, but also healthy aging and phenotypical and genotypical features. This guide was prepared due to the need to develop precision nutritional models that allow individualized nutritional treatment for each subject and physiopathological particularities with emphasis on the elderly. Therefore, the requirements of the Spanish pre-senior and senior populations, dietary recommendations and precision foods are reviewed in this document: have at least three daily meals, reduce total calories, choose a varied and balanced diet with fresh foods and high nutritional density, add vegetables, legumes and fish, consume dairy products and fiber, prefer white meat instead of red, avoid fried foods, sausages and processed foods, moderate the consumption of salt, coffee and alcohol, and get hydrated.
       
  • An infant with intestinal pneumatosis and pneumoperitoneum: the difficult
           decision not to intervene

    • Abstract: RESUMEN El neumoperitoneo en niños puede deberse a causas que no requieran cirugía urgente, como maniobras de reanimación cardiopulmonar, patología respiratoria grave o ventilación mecánica. Intervenir en estos casos podría, incluso, empeorar el pronóstico. Presentamos el caso clínico de un lactante varón, exprematuro, con antecedente al nacer de enterocolitis necrotizante y perforación ileal, que precisó laparotomía y resección intestinal en dos ocasiones y que desarrolló un microcolon por desuso secundario. A los seis meses, tras iniciar alimentación oral exclusiva, presentó distensión abdominal con extensa neumatosis intestinal y neumoperitoneo en las radiografías. Su aspecto era bueno con tránsito intestinal conservado y ausencia de peritonitis. El paciente se mantuvo a dieta absoluta con antibioterapia endovenosa, sondaje nasogástrico y nutrición parenteral. La evolución fue favorable, reiniciando la alimentación oral a los siete días del ingreso. La existencia de un neumoperitoneo no siempre obliga a realizar una laparotomía, y la valoración global del enfermo por un equipo multidisciplinar puede evitar tratamientos agresivos innecesarios.ABSTRACT Pneumoperitoneum in children may be due to causes that do not require urgent surgery (cardiopulmonary resuscitation manoeuvres, severe respiratory pathology or mechanical ventilation). Surgery in these cases could even worsen the prognosis. We present the case of a male infant, ex-preterm, with a history of necrotizing enterocolitis and ileal perforation at birth, requiring laparotomy and intestinal resection on two occasions and developing a secondary microcolon, due to disuse. At six months, after transitioning to full oral feeding, he presented abdominal distension with extensive intestinal pneumatosis and pneumoperitoneum on radiographs. His general appearance was good with normal intestinal transit and no peritonitis. The patient remained fasting with intravenous antibiotics, nasogastric decompression and parenteral nutrition. The evolution was favourable with oral feeding restarting on the seventh day of admission. The existence of pneumoperitoneum does not always require a laparotomy and global assessment of the patient by an interdisciplinary health team may avoid unnecessary aggressive treatments.
       
  • Appendicitis, an unusual cause of acute abdomen in neonatal patients. A
           case report

    • Abstract: RESUMEN La apendicitis es la entidad quirúrgica más frecuente en la infancia, pero es poco habitual en el periodo neonatal. A esta edad, su retraso diagnóstico (habitual dada la rareza de esta patología y la falta de sospecha clínica) y consecuentemente terapéutico, hace frecuente la perforación apendicular y la mala evolución posterior de esta patología. Presentamos el caso de un neonato con antecedentes de síndrome de Down y tetralogía de Fallot. Debido a su cardiopatía basal, precisó una intervención quirúrgica para realizar la creación de una fístula sistémico-pulmonar, como puente temporal hasta la cirugía cardíaca definitiva. En el postoperatorio de esta intervención presentó fiebre, abdomen agudo y radiografía abdominal compatible con la presencia de neumoperitoneo. Se realizó una laparotomía urgente que evidenció una peritonitis secundaria a un apéndice cecal gangrenoso con perforación en su tercio medio. La apendicitis neonatal suele presentarse asociada a enfermedades como la fibrosis quística, la enterocolitis necrotizante, o la enfermedad de Hirschsprung, como fue el caso de nuestra paciente. La apendicitis debe formar parte del diagnóstico diferencial en los neonatos con un abdomen agudo y presencia de neumoperitoneo, ya que precisa intervención quirúrgica urgente, a pesar de lo cual presenta una alta tasa de morbimortalidad. Una vez realizado el diagnóstico definitivo, debería descartase la presencia de cualquier patología basal que justificara su presencia.ABSTRACT Appendicitis is the most frequent surgical disease in childhood, but it is very uncommon in the neonatal period. In this period of life, a delay in diagnosis (frequently due to the rareness of this pathology and lack of clinical suspicion) and consequently in therapeutic approach, frequently results in appendicular perforation and a subsequently poor evolution of this pathology. We present the case of a neonate with a history of Down’s syndrome and Fallot’s tetralogy. Due to her basal cardiopathy, she required surgical intervention to create a systemic-pulmonary fistula, as a temporary bridge until definitive cardiac surgery could be performed. In the postoperative period of this surgery she presented fever, acute abdomen and abdominal radiography compatible with pneumoperitoneum. An emergency laparotomy was performed, which revealed peritonitis secondary to a cecal gangrenous appendix with perforation in its middle third. Neonatal appendicitis is usually associated with diseases such as cystic fibrosis, necrotizing enterocolitis, or Hirschsprung’s disease, as in the case of our patient. In neonates with acute abdomen and presence of pneumoperitoneum, appendicitis must be part of the differential diagnosis and requires urgent surgical intervention. Despite this, it presents a high rate of morbidity and mortality. Once the definitive diagnosis is made, any basal pathology that justifies its presence should be discarded.
       
  • Primary eosinophilic colitis in a celiac patient

    • Abstract: RESUMEN Los trastornos eosinofílicos primarios del tracto gastrointestinal abarcan una serie de enfermedades crónicas que cursan con un infiltrado eosinofílico a nivel intestinal en ausencia de otras causas de eosinofilia. Pueden afectar a cualquier área del tubo digestivo, siendo excepcional la afectación exclusiva del colon. Dada su baja prevalencia no suelen tenerse en cuenta en el diagnóstico diferencial de los pacientes con diarrea crónica, por lo que en muchos casos la demora diagnóstica puede ser de años. Describimos el caso de una paciente con enfermedad celíaca bien controlada y diarrea crónica de origen indeterminado que fue finalmente diagnosticada de una colitis eosinofílica. Recibió tratamiento con budesonida oral con muy buena respuesta clínica y en la actualidad se mantiene asintomática.ABSTRACT Primary eosinophilic gastrointestinal disorders include a spectrum of inflammatory chronic diseases in which eosinophils infiltrate the gut in the absence of known causes of such tissue eosinophilia. They may affect any area of the gastrointestinal tract although exclusive colonic disease is exceptional. Due to their low prevalence these disorders are not usually taken into account when making a differential diagnosis in a patient with chronic diarrhea, which is the reason why in many cases the diagnosis can take many years. We describe the case of a patient with well-controlled celiac disease and chronic diarrhea of indeterminate origin. The final diagnosis was eosinophilic colitis. A complete response was obtained when she was treated with oral budesonide. Nowadays she remains asymptomatic.
       
  • Laparotomy in a patient under opioid-free anaesthesia

    • Abstract: RESUMEN Los pacientes obesos sometidos a cirugía bariátrica tienen una alta probabilidad de presentar complicaciones que empeoran con el uso de opiáceos y que pueden ser disminuidas gracias a técnicas anestésicas como la anestesia libre de opiáceos (OFA). El riesgo de tener que reconvertir la técnica quirúrgica laparoscópica a cirugía abierta es una de las críticas a esta modalidad anestésica, ante la posibilidad de que no exista un correcto control simpático o nociceptivo. Presentamos el caso de una paciente programada para una cirugía bariátrica laparoscópica que, manteniendo la OFA, se reconvirtió a cirugía abierta (laparotomía exploradora), logrando un correcto control tanto hemodinámico como del dolor perioperatorio.ABSTRACT Obese patients subjected to bariatric surgery have a high probability of presenting complications that worsen with the use of opioids and can be reduced thanks to anaesthetic techniques like opioid-free anaesthetics (OFA). The risk of having to convert the laparoscopic surgical technique into open surgery is one of the criticisms aimed at this anaesthetic modality, facing the possibility of there not being a correct sympathetic or nociceptive control. We present the case of a patient scheduled for laparoscopic bariatric surgery who, while maintaining OFA, was converted to open surgery (exploratory laparoscopy), with correct control achieved of both haemodynamics and perioperative pain.
       
  • Non-invasive diagnosis of cardiac amyloidosis due to transthyretin. Case
           report

    • Abstract: RESUMEN La amiloidosis cardiaca por transtirretina se considera en la actualidad la forma más frecuente de amiloidosis cardiaca y su incidencia está aumentando gracias al avance de las técnicas de diagnóstico por imagen. Recientemente se han publicado unos criterios de diagnóstico no invasivo para esta entidad, y se están desarrollando nuevos fármacos para el tratamiento específico de este tipo de amiloidosis cardiaca. Por ello, la amiloidosis cardiaca por transtirretina podría pasar de ser una enfermedad rara a frecuente, y de incurable a potencialmente tratable. Presentamos el caso de un varón de 80 años diagnosticado de amiloidosis cardiaca mediante gammagrafía con 99mTc dicarboxipropano difosfonato (99mTc-DPD) según los nuevos criterios de diagnóstico no invasivo.ABSTRACT Amyloidosis due to deposits of transthyretin (ATTR) is currently considered the most frequent form of cardiac amyloidosis and its incidence is increasing thanks to the advances in diagnostic imaging techniques. Some non-invasive diagnostic criteria have recently been published on this entity that due to the development of new drugs for the specific treatment of cardiac ATTR, have prognostic and therapeutic implications. That is why cardiac ATTR could cease to be a rare disease and become a frequent one, and become potentially treatable instead of incurable. We present the case of an 80-year-old male diagnosed with non-hereditary cardiac ATTR by means of gammagraphy with 99mTc diphosfonate scintigraphy (99mTc-DPD) following the new criteria of non-invasive diagnosis.
       
  • Internal jugular venous valve as a cause of difficult central venous
           access

    • Abstract: RESUMEN La canulación venosa central es un procedimiento habitual en el medio hospitalario, siendo la vena yugular interna uno de los vasos más frecuentemente escogido para realizar el acceso venoso central. La presencia de válvulas venosas en dicha vena es un hecho conocido al que habitualmente no se concede importancia durante la canulación venosa central. No obstante, las válvulas venosas pueden llegar a dificultar este procedimiento, incrementando la probabilidad de que ocurran complicaciones. Presentamos el caso de un paciente en el cual la presencia de una válvula venosa yugular interna impidió obtener un acceso vascular a través de este vaso.ABSTRACT Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel.
       
  • Defensive Medicine in Primary Care

    • Abstract: RESUMEN La canulación venosa central es un procedimiento habitual en el medio hospitalario, siendo la vena yugular interna uno de los vasos más frecuentemente escogido para realizar el acceso venoso central. La presencia de válvulas venosas en dicha vena es un hecho conocido al que habitualmente no se concede importancia durante la canulación venosa central. No obstante, las válvulas venosas pueden llegar a dificultar este procedimiento, incrementando la probabilidad de que ocurran complicaciones. Presentamos el caso de un paciente en el cual la presencia de una válvula venosa yugular interna impidió obtener un acceso vascular a través de este vaso.ABSTRACT Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel.
       
  • Lethal interaction between 5-fluorouracil and brivudine

    • Abstract: RESUMEN La canulación venosa central es un procedimiento habitual en el medio hospitalario, siendo la vena yugular interna uno de los vasos más frecuentemente escogido para realizar el acceso venoso central. La presencia de válvulas venosas en dicha vena es un hecho conocido al que habitualmente no se concede importancia durante la canulación venosa central. No obstante, las válvulas venosas pueden llegar a dificultar este procedimiento, incrementando la probabilidad de que ocurran complicaciones. Presentamos el caso de un paciente en el cual la presencia de una válvula venosa yugular interna impidió obtener un acceso vascular a través de este vaso.ABSTRACT Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel.
       
  • End of life care in Spanish intensive care units

    • Abstract: RESUMEN La canulación venosa central es un procedimiento habitual en el medio hospitalario, siendo la vena yugular interna uno de los vasos más frecuentemente escogido para realizar el acceso venoso central. La presencia de válvulas venosas en dicha vena es un hecho conocido al que habitualmente no se concede importancia durante la canulación venosa central. No obstante, las válvulas venosas pueden llegar a dificultar este procedimiento, incrementando la probabilidad de que ocurran complicaciones. Presentamos el caso de un paciente en el cual la presencia de una válvula venosa yugular interna impidió obtener un acceso vascular a través de este vaso.ABSTRACT Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel.
       
  • Let’s educate the whole population in cardiopulmonary reanimation

    • Abstract: RESUMEN La canulación venosa central es un procedimiento habitual en el medio hospitalario, siendo la vena yugular interna uno de los vasos más frecuentemente escogido para realizar el acceso venoso central. La presencia de válvulas venosas en dicha vena es un hecho conocido al que habitualmente no se concede importancia durante la canulación venosa central. No obstante, las válvulas venosas pueden llegar a dificultar este procedimiento, incrementando la probabilidad de que ocurran complicaciones. Presentamos el caso de un paciente en el cual la presencia de una válvula venosa yugular interna impidió obtener un acceso vascular a través de este vaso.ABSTRACT Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel.
       
  • Improvement in quality of life following bariatric surgery

    • Abstract: RESUMEN La canulación venosa central es un procedimiento habitual en el medio hospitalario, siendo la vena yugular interna uno de los vasos más frecuentemente escogido para realizar el acceso venoso central. La presencia de válvulas venosas en dicha vena es un hecho conocido al que habitualmente no se concede importancia durante la canulación venosa central. No obstante, las válvulas venosas pueden llegar a dificultar este procedimiento, incrementando la probabilidad de que ocurran complicaciones. Presentamos el caso de un paciente en el cual la presencia de una válvula venosa yugular interna impidió obtener un acceso vascular a través de este vaso.ABSTRACT Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel.
       
 
 
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