An Sist Sanit Navar
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Aim. To analyse the accounts of the relatives of patients who died during one year in a hospital in Navarre, within a study of the quality of care for the dying. Method. ⋯ The lack of emotional support perceived by the relatives is also important. Conclusions. Besides the numerical variables contained in the survey, we believe that the narrative that a survey can contain provides key information for the analysis of care quality.
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Dignity should not be confused with the unbecoming conditions that a person can find himself in due to external situations or disease. The person/patient in a terminal situation has human dignity, which must be respected not because he/she is a terminal patient but simply because he/she is a person. But it is true that in terminal situations dignity can be particularly threatened. Nonetheless, one must not deduce from the criterion of respecting dignity the conclusion of prolonging biological life at all costs, but instead that of guaranteeing the best quality of living during the process of dying and of worthily accompanying the person who is approaching death by helping him to accept this.
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An Sist Sanit Navar · Sep 2006
Case Reports[Primary pyomyositis of the psoas muscles in a temperate climate. Review of two cases in children followed up over the long term].
We review two cases of primary pyomyositis of the psoas in children that occurred in Navarre, their management and long-term evolution. Primary pyomyositis of the psoas muscle is a rare infection in a temperate climate. Its diagnosis is difficult due to the similarity of the symptoms with several infectious processes, mainly septic arthritis of the hip in children and adolescents. The rarity of the present cases is due to several facts: occurrence in children, in a temperate climate (Navarre), immunocompetent patients and without subjacent pathology, besides their monofocal situation that is contrary to the more frequent multifocal presentation. These factors, besides the poor specificity of the symptoms, constitute a diagnostic challenge. ⋯ They were successfully treated by isolated antibiotherapy in one case and surgical drainage in the other. Healing was achieved in each case without relapse or sequels in a long-term revision. We carry out a global revision of this rare infection, emphasising the difficulty of its clinical diagnosis and the different treatment modalities and the proper indication. We suggest an algorithm as a clinical guide for its clinical-therapeutic management.
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Spontaneous pneumomediastinum (defined by the presence of free air in the mediastinum) is an infrequent entity that is presented in the absence of diseases or precipitating factors. It generally affects young and healthy males. Thoracic pain, dyspnea, or both, are the most frequent symptoms. ⋯ Simple radiography of the thorax allows for the diagnosis in a high percentage of patients. Conservative treatment is indicated in these patients and has a favourable prognosis. Relapses are infrequent.
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An Sist Sanit Navar · May 2006
[Reversion of atracurium and vecuronium residual nondepolarising neuromuscular blockade with low doses of neostigmine].
To assess the effectiveness of low doses of neostigmine in the reversion of residual non-polarising neuromuscular blockade (RNMB). ⋯ The reversion of the residual neuromuscular blockade of atracurium or vecuronium with low doses of neostigmine and atropine adjusted to the degree of RNMB is effective even in deep blockades, reducing the risk of secondary effects.